Mathematical and numerical study of the concentration effect of red cells in blood

International audienc

158 Prothetic abcess complicating Infective endocarditis

The cardiac abscess formation is appraised to 20–30% during the infectious endocarditis (IE). It is more frequent during prosthesis endocarditis and it can reach 60%. The prognosis is generally reserved. Objective To determine echocardiographic, bacteriological and evolutive features of prothetic IE complicated of abscess.Retrospective study including 51 patients having certain or probable IE according to Duke criterias between 2002 and 2005. At 9 patients (17,64%) the endocarditis was complicated of prothetic abscess. It was about 6 men and 3 women with a middle age of 39 ± years. IE was la ate IE in 5 cases. Clinical and biological infectious syndrome was constant. Isolated germs were staphylococcus aureus in 2 cases, GRAM négatif Bacillus in 2 cases. Culture negative endocarditis were noted in 5 cases. Brucellosis serology was positive at one patient. Prothetic abcess was diagnosed by transthoracic echocardiography (TTE) at 2 patients and by transesophagal echocardiography (TEE) at all patients.The abcess was localized on the aortic prosthesis at 5 patients, mitral prothesis at 3 patients and mitroaortic prothesis at one patient. TEE identified annular abcess at 2 patients and a myocardial abcess at 1 patient. Secondary septic localizations were noted at 6 patients: 4 cerebral abscesses, 2 splenic localization, a renal localization and an articular localization. High degree atrioventricular blocks were observed at 3 patients. The recourse to the surgery was frequent (7 patient/9 patient). It was an emergent sugery at 2 patients because of a heart failure. For the others, the indication for surgery was medical failure treatment at a mean delay of 19 days. The evolution was fatal at 5 patients. and the evolution was favorable at the others.Prothetic endocarditis complicated of abscess are serious requiring frequently a prothetic replacement, a very high risked surgery. TEE must be systematic at all patients carrier of prosthesis if they have infectious syndrome in order to carry the early diagnosis of IE and to avoid abcess formation

034 Creatinine clearance and adverse hospital outcomes in patients with myocardial infarction

IntroductionNormal renal function has been Shown in epidemiological studies and clinical trials to be an independent predictor of survival.ObjectiveTo determine whether creatinine clearance at the time of hospital admission is an independent predictor of hospital mortality and adverse outcomes in patients with ST-segment elevation myocardial infarction (STEMI).Patients231 patients hospitalized with STEMI in our institution between January 2005 to December 2006.In-hospital outcomes were compared for patients with creatinine clearance rates of > 60ml/min (normal renal function) and ≤60ml/min (moderate and severe Baseline Renal Dysfunction, BRD).ResultsPatients with BRD were older, were more likely to be women, and presented to with more comorbidites.Patients with BRD had presented more ischemic atrial fibrillation (p = 0.033).A greater number of patients with BRD had impaired left ventricle systolic performance, so this patients had more presented acute heart failure (p = 0.008), and cardiogenic shock (p = 0.017).Patients with worsened renal function had presented more mechanical complications:-free wall rupture and apical ventricular septal defect, in two separate cases, following anterior myocardial infarction, leading to immediate death of these two patients.-ischemic mitral regurgitation in one caseThe in hospital death rate of BRD patients was 6.6%, compared with 0.9% for non BRD patients.In comparison with patients with normal or minimally impaired renal function, patients with moderate renal dysfunction were seven times more likely to die (odds ratio 7, 09, 95% confidence interval 0.7 to 68) after adjustment for other potentially confounding Variables.The risk of bleeding episodes was increased in patients with worsened renal functionOnly one patient, with moderate renal dysfunction, had an ischemic stroke.ConclusionIn patients with ACS, creatinine clearance is an important independent predictor of hospital death

Giant cell reparative granuloma of the hallux following enchondroma

Giant cell reparative granuloma (GCRG) is a rare, benign intra osseous lytic lesion occurring especially in gnathis bone but also seen in feet and hands. It has similar clinical and radiological presentations than giant cell tumor, chondroblastoma, aneurysmal bone cyst, and hyperparathyroidism brown tumors but with specific histological findings We report a case of a GCRG of hallux phalanx in 18 years old patient appearing many years after enchondroma curettage and grafting. Radiographs showed a multiloculated osteolytic lesions involving whole phalanx with cortical thinning and without fluid-fluid levels in CT view. Expected to be an enchondroma recurrence, second biopsy confirmed diagnosis of GCRG with specific histological findings. Although if aetiopathogeny remains unknown, GCRG is reported to be a local non neoplasic reaction to an intraosseous hemorrhage. Our exceptional case claims that this tumor can appear in reaction to cellular disturbance primary or secondary

A fusion of machine learning and cryptography for fast data encryption through the encoding of high and moderate plaintext information blocks

Within the domain of image encryption, an intrinsic trade-off emerges between computational complexity and the integrity of data transmission security. Protecting digital images often requires extensive mathematical operations for robust security. However, this computational burden makes real-time applications unfeasible. The proposed research addresses this challenge by leveraging machine learning algorithms to optimize efficiency while maintaining high security. This methodology involves categorizing image pixel blocks into three classes: high-information, moderate-information, and low-information blocks using a support vector machine (SVM). Encryption is selectively applied to high and moderate information blocks, leaving low-information blocks untouched, significantly reducing computational time. To evaluate the proposed methodology, parameters like precision, recall, and F1-score are used for the machine learning component, and security is assessed using metrics like correlation, peak signal-to-noise ratio, mean square error, entropy, energy, and contrast. The results are exceptional, with accuracy, entropy, correlation, and energy values all at 97.4%, 7.9991, 0.0001, and 0.0153, respectively. Furthermore, this encryption scheme is highly efficient, completed in less than one second, as validated by a MATLAB tool. These findings emphasize the potential for efficient and secure image encryption, crucial for secure data transmission in real-time applications

Spin-dependent transport properties of Fe3O4/MoS2/Fe3O4 junctions

Magnetite is a half-metal with a high Curie temperature of 858 K, making it a promising candidate for magnetic tunnel junctions (MTJs). Yet, initial efforts to exploit its half metallic nature in Fe3O4/ MgO/Fe3O4 MTJ structures have been far from promising. Finding suitable barrier layer materials, which keep the half metallic nature of Fe3O4 at the interface between Fe3O4 layers and barrier layer, is one of main challenges in this field. Two-dimensional (2D) materials may be good candidates for this purpose. Molybdenum disulfide (MoS2) is a transition metal dichalcogenide (TMD) semiconductor with distinctive electronic, optical, and catalytic properties. Here, we show based on the first principle calculations that Fe3O4 keeps a nearly fully spin polarized electron band at the interface between MoS2 and Fe3O4. We also present the first attempt to fabricate the Fe3O4/MoS2/Fe3O4 MTJs. A clear tunneling magnetoresistance (TMR) signal was observed below 200 K. Thus, our experimental and theoretical studies indicate that MoS2 can be a good barrier material for Fe3O4 based MTJs.Our calculations also indicate that junctions incorporating monolayer or bilayer MoS2 are metallic

Leydig Cell Tumor Associated with Testicular Adrenal Rest Tumors in a Patient with Congenital Adrenal Hyperplasia due to 11β-Hydroxylase Deficiency

Congenital adrenal hyperplasia (CAH) describes a group of inherited autosomal recessive disorders characterized by enzyme defects in the steroidogenic pathways that lead to the biosynthesis of cortisol, aldosterone, and androgens. Chronic excessive adrenocorticotropic hormone (ACTH) stimulation may result in hyperplasia of ACTH-sensitive tissues in adrenal glands and other sites such as the testes, causing testicular masses known as testicular adrenal rest tumors (TARTs). Leydig cell tumors (LCTs) are make up a very small number of all testicular tumors and can be difficult to distinguish from TARTs. This distinction is interesting because LCTs and TARTs require different therapeutic approaches. Hereby, we present an unusual case of a 19-year-old patient with CAH due to 11β-hydroxylase deficiency, who presented with TARTs and an epididymal Leydig cell tumor

Qatar Ambulance Service staff's perception on the Quality-of-Service delivery to patients

Background: Quality improvement has been well documented in various industries to improve safety and processes. 1 However, limited research has taken place within the pre-hospital sector in this regard. Various factors can be attributed to the delivery of effective services. Studies often investigate customer/patient perception and often sideline the importance of employee perception. 2 This study evaluates Qatar's Hamad Medical Corporation Ambulance Service (HMCAS) staffs’ perception on service delivery to patients they treat and transport. Methods: An online survey was designed and distributed to HMCAS staff working within the emergency section (N = 750). A 5-point Likert scale (1 = strongly disagree to 5 = strongly agree) was used. The SERVQUAL model consisting of 5 dimensions (RATER): Reliability, Assurance, Tangibility, Empathy, and Responsiveness was used. 3 Two variables with the highest perception score were regarded as the drivers of service quality. A negative gap score (perception minus expectation) was used as the basis for the study recommendations. Results: As per the required calculated sample size to achieve a 95% confidence interval, 255 questionnaires were completed. Respondents were 79% Ambulance Paramedics, 18% supervisors, and 3% managers. The weights of each dimension's variables were calculated to obtain perception and expectation scores. Descriptive statistics and gap scores of the survey responses are presented in Table 1 for the two variables of each dimension. None of the gap scores were found to be statistically significant. The proposed recommendations generated from this study are presented in Table 2. Conclusion: A standardized staff quality perception tool can assist in identifying potentially missed quality-related service issue(s). In this study, the SERVQUAL model was easily adapted and applied to the pre-hospital Emergency Medical Service setting in Qatar and proved useful in identifying service delivery proponents needing attention. Overall and reassuringly, the staff believes that they provide quality service to their patients