Trends in Secondary Prevention of Coronary Heart Disease in Tunisia: Prevention of Recurrences of MI and Stroke

ObjectivesThe survival benefits achieved by prescription of antiplatelet agents, B-adrenoreceptor antagonists (beta-blockers), angiotensin II receptor blockers (ARB), and lipid lowering agents in patients surviving the myocardial infarction (MI) have been well documented in large clinical trial. Despite well-established benefits, these pharmacological agents continue to be underutilized. The main objective of this study was to evaluate the progress of cardiovascular secondary prevention practices in Tunisia.MethodsThe PREMISE (Prevention of Recurrence of Myocardial Infarction and Stroke) is a descriptive, cross-sectional study conducted in Tunisia in two phases (2002 and 2009). Seven hundred eighty two patients were recruited. The recruitment criteria were: previous MI, stable angina, unstable angina, percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG), stroke, transient ischemic attack (TIA) or carotid endarterectomy. This analysis is limited to coronary heart disease (CHD) patients. Five hundred hospital patients were interviewed and their medical records were reviewed: 250 in 2002 and 250 in 2009. Patients were included if they had confirmed diagnosis of MI, angina, CABG or PTCA, and if their first cardiovascular event had occurred more than one month but not later than 3 years ago. We compared the total of both patient groups, using the prevalence of Cardio-Vascular Risk Factors (CVRF) and the treatment prescribed at hospital discharge.ResultsThe proportion of patients with reported hypertension, diabetes, hypercholesterolemia and current smoker patients had decreased. Concerning pharmacological prescriptions, a significant increase was observed in prescribing statins (38.9% vs. 70.3%) and ACE inhibitors (49.3% vs. 69.9%), non pharmacological prescriptions as healthy diet or tobacco cessation had opposite trends. Adherence to treatment did not change substantially.ConclusionAlthough the use of cardioprotective drugs had increased in CHD patients, there are still gaps in secondary prevention in Tunisia. The recommended strategies of secondary prevention need to be applied more intensively in clinical practice

Menopause and metabolic syndrome in Tunisian women

Objectives. This study aimed to evaluate the effect of menopausal status on the risk of metabolic syndrome (MetS) in Tunisian women. Methods. We analyzed a total of 2680 women aged between 35 and 70 years. Blood pressure, anthropometric indices, fasting glucose, and lipid profile were measured. The MetS was assessed by the modified NCEP-ATPIII definition. Results. The mean values of waist circumference, blood pressure, plasma lipids, and fasting glucose were significantly higher in postmenopausal than in premenopausal women, a difference that was no longer present when adjusting for age. Except for hypertriglyceridaemia, the frequency of central obesity, hyperglycemia, high blood pressure, and high total cholesterol was significantly higher in postmenopausal than in premenopausal women. After adjusting for age, the significance persisted only for hyperglycemia. The overall prevalence of MetS was 35.9%, higher in postmenopausal (45.7% versus 25.6%) than in premenopausal women. A binary logistic regression analysis showed that menopause was independently associated with MetS (OR = 1.41, 95% CI 1.10-1.82) after adjusting for age, residence area, marital status, family history of cardiovascular disease, education level, and occupation. Conclusions. The present study provides evidence that the MetS is highly prevalent in this group of women. Menopause can be a predictor of MetS independent of age in Tunisian women

International Lattice Data Grid

We propose the co-ordination of lattice QCD grid developments in different countries to allow transparent exchange of gauge configurations in future, should participants wish to do so. We describe briefly UKQCD's XML schema for labelling and cataloguing the data. A meeting to further develop these ideas will be held in Edinburgh on 19/20 December 2002, and will be available over AccessGrid.Comment: Lattice2002(plenary

Synthesis by the polyol process and ionic conductivity of nanostructured La2Mo2O9 powders

International audienceLa2Mo2O9 nanostructured powders were synthesized by the polyol process. The effects of the nature of the polyol, the refluxing time, the hydrolysis ratio, the metal concentration and the addition of hydroxide ions, on the purity and morphology of the powders are determined. Two main morphologies are observed, the particles being in the shape of platelets or spheres, with respectively diethylene glycol or ethylene glycol as solvent. A specific surface area of 24 m2/g was reached by varying the metal concentration. The conductivity measurements were recorded on pellets that present in some cases a closed porosity, the relative density reaching 95% without any milling step. According to the synthesis parameters, the grain conductivity can be slightly increased, the total conductivity remaining only slightly lower than that of pellets made of powders synthesized by solid state reaction

On Hilbert-Schmidt operator formulation of noncommutative quantum mechanics

This work gives value to the importance of Hilbert-Schmidt operators in the formulation of a noncommutative quantum theory. A system of charged particle in a constant magnetic field is investigated in this framework

Facteurs predictifs de l’efficacite ablative de l’iode 131 dans les cancers differencies de la thyroïde

La prise en charge des cancers différenciés de la thyroïde (CDT) comporte souvent une radiothérapie métabolique à l’iode131 (IRA-thérapie). Le but de ce travail est d’évaluer le caractère prédictif des différents éléments anatomopathologiques, de la classification pTNM et de la stadification pronostique sur l’activité ablative requise d’iode131. Notre travail est une étude analytique rétrospective portant sur 275 cas de CDT ayant subit une thyroïdectomie totale. Tous ces patients ont eu une ou plusieurs activités ablatives. Nous avons cherché – au moyen d’une analyse statistique par test de Khi2 ou test Anova – toute corrélation entre les éléments de l’examen anatomopathologique de la tumeur, la classe pTNM, le stade pronostique correspondant d’une part  et l’efficacité de l’irathérapie ablative d’autre part. Dans notre série, une activité ablative plus élevée est nécessaire lorsque la taille du foyer tumoral dépasse les 6 cm (p=0,012), en cas de dépassement de la graisse péri thyroïdienne (

L’esthesioneuroblastome olfactif : a propos de 7

Introduction : L’esthésioneuroblastome est une tumeur maligne rare développée aux dépens du neuro-épithélium olfactif. C’est l’une des plus rares tumeurs des fosses nasales. L’objectif de ce travail est d’étudier à travers une revue de la littérature, les caractéristiques histocliniques, les modalités thérapeutiques et les facteurs pronostiques de cette tumeur.Matériel et méthodes : Etude rétrospective à propos de sept cas d’esthésioneuroblastome olfactif traités dans le service d’ORL et de CCF de l’hôpital Farhat Hached de Sousse sur une période de 26 ans.Résultats : L’âge moyen de nos patients était de 36 ans avec une prédominance féminine. La symptomatologie clinique était dominée par l’obstruction nasale et l’épistaxis. Cinq patients étaient classés stade B de Kadish, et 2 stade C. Six patients ont eu un traitement chirurgical dont cinq ont eu une radiothérapie post opératoire. Une patiente avait une importante extension locorégionale et était au dessus de tout traitement à visée curative. Trois malades sont en rémission complète avec un recul moyen de 6 ans. Trois malades ont présenté une récidive tumorale.Conclusion : L’esthésioneuroblastome olfactif est une tumeur naso-sinusienne maligne rare, caractérisée par son polymorphisme clinique et son agressivité locale. Malgré la chirurgie et la radiothérapie, le pronostic reste réservé à long terme.Mots clés : Esthésioneuroblastome olfactif - Imagerie- Immunohistochimie- Chirurgie -RadiothérapieIntroduction: Introduction: Esthesioneuroblastoma is a rare malignant tumor, which develops from olfactory neuroepithelium and is one of the rarest tumors of the nasal cavity. The aim of this study is to specify through a review of the literature, histoclinic characteristics, therapeutic terms and prognostic factors of this tumor.Material and methods: a retrospective study concerning seven cases of olfactory neuroblastoma treated in the department of otolaryngology- Head and Neck surgery at Farhat Hached Hospital Sousse over a period of 26 years.Results: The mean age of our patients was 36 years. A female predominance was noted. Clinical symptomatology was dominated by nasal obstruction and epistaxis. Five patients were classified as Kadish B and 2 patients as Kadish C. Six patients underwent surgicaltreatment, five of them had postoperative radiotherapy. One patient was above all therapeutic resources. 3 patients are in complete remission with a mean follow-up of 6 years. Recurrence was observed for the remaining patients.Conclusion: olfactory esthesioneuroblastoma is a rare sinonasal malignant tumor, characterised by clinical polymorphism and local agressivity. In spite of the surgery and the radiotherapy, the forecast remains reserved in the long term.Key words: Olfactory neuroblastoma – Imagery – Immunohistochemestry – Surgery - Radiotherap

A mixed method study on the metacognitive awareness of reading strategies used by Saudi EFL students

Metacognitive awareness of reading strategy has a significant impact on language learning. It addresses how students organize context-based interactions and how they may employ reading comprehension strategies. Saudi students of English still face reading comprehension issues that significantly affect their overall language learning. Therefore, this mixed method study sought to assess Saudi English students’ metacognitive awareness of reading strategies, determine whether gender and university level affect their use of these strategies, and explore English instructors’ views on this issue. Two instruments were used to achieve these objectives. Two hundred ten students were surveyed for quantitative data. 15 English instructors were interviewed in a semi-structured manner for qualitative data. Descriptive statistical analysis was used to analyze the quantitative data gathered, while pattern matching and thematic content analysis were applied to analyze the qualitative data. The results demonstrated that Saudi EFL students’ metacognitive awareness of reading methods was generally moderate. This awareness was moderate regarding the use of global reading strategies and low regarding support and problem-solving strategies. The metacognitive awareness levels for global strategies vary significantly by gender, in favour of females. Senior and junior university students had better global and support reading methods than freshmen. The qualitative data from the interview supported the quantitative data suggesting Saudi EFL students had low to moderate metacognitive awareness. Their low-to-moderate level explains their poor reading comprehension. Based on these findings, limitations and recommendations are given

Les lymphomes de l’anneau de Waldeyer traitement et pronostic

Les lymphomes non Hodgkiniens (LNH) qui prennent naissance au niveau de l’anneau de Waldeyer constituent une entité bien particulière tant sur le plan clinique, thérapeutique que pronostique. Les auteurs rapportent une étude rétrospective de 44 observations de LNH de l’anneau de Waldeyer colligées entre 1995 et 2002. Une chimiothérapie exclusive aété indiquée chez 80,6% des malades et une association chimio-radiothérapie a été réalisée chez 19,4%. Le taux de survie globale était de 42% à 5 ans. Dans notre étude quatre facteurs de mauvais pronostic ont été individualisés : un âge ≥ à 40 ans, les stades d’Ann Arbor II, III et IV, un taux de LDH ≥ 1,5 fois la normale et la survenue de rechute.Mots-clés : Lymphome, anneau de Waldeyer, chimiothérapie, radiothérapie, pronosti