Effect of Multiscale Endplates on Wing-Tip Vortex

International audienc

COVID-19 Infections in Gonads: Consequences on Fertility?

COVID-19 may influence human fertility and sexuality in several ways. Different cell types in gonads show a constitutive expression of angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2), which provide potential entry pathways for SARS-CoV-2. In addition to the biological effects of a COVID-19 infection on the gonads, the impact of the ongoing COVID-19 pandemic on mental health issues and sexual behavior may affect reproduction. This review summarizes the current knowledge on the influence of COVID-19 on the gonads and discusses possible consequences on human fertility. In this context, the close interaction between the hypothalamic-pituitary-adrenal axis and the hypothalamic-pituitary-gonadal axis in response to COVID-19-related stress is discussed. Some women noticed changes in their menstrual cycle during the COVID-19 pandemic, which could be due to psychological stress, for example. In addition, occasional cases of reduced oocyte quality and ovarian function are described after COVID-19 infection. In men, COVID-19 may cause a short-term decrease in fertility by damaging testicular tissue and/or impairing spermatogenesis. Moreover, decreased ratio testosterone/LH and FSH/LH in COVID-19 compared to aged-matched healthy men has been reported. Available data do not suggest any effect of the available SARS-CoV-2 vaccines on fertility. The effects of long COVID on human fertility have been reported and include cases with premature ovarian failure and oligomenorrhoea in women and erectile dysfunction in men. Despite the increasing knowledge about the effects of COVID-19 infections on human gonads and fertility, the long-term consequences of the COVID-19 pandemic cannot yet be assessed in this context

The impact of COVID-19 on the mental health of Lebanese pharmacists: A national cross-sectional study

IntroductionThe COVID-19 pandemic has induced a global mental health crisis with variable consequences. This study aimed to assess the psychological impact of COVID-19 regarding anxiety, insomnia, depression, and response to trauma on pharmacists in Lebanon during COVID-19, and to identify factors contributing to psychological distress.MethodsThis was a cross-sectional study among pharmacists that involved the use of the 7-item Generalized Anxiety Disorder (GAD-7), 7-item Insomnia Severity Index (ISI), Patient Health Questionnaire 9-item depression module (PHQ-9), and Impact of Event Scale revised (IES-R) subscales. Descriptive statistical analyses were performed to determine the study distribution. The associations between the scores and the participants’ characteristics were assessed using the Chi-square test. Four binary logistic regression models were used to evaluate the association between the scores and the potential confounders, followed by four multivariable logistic regressions. An alpha of 0.05 was used to determine statistical significance.ResultsParticipants comprised 311 pharmacists from all Lebanese districts, of whom 251 (80.7%) were females and 181 (58.2%) aged between 26 and 35 years. The majority of the participants were community pharmacists (n = 178, 57.2%). A considerable proportion of participants had symptoms of anxiety (n = 128, 41.2%), insomnia (n = 64, 20.6%), depression (n = 157, 50.5%), and subjective stress (n = 227, 78.8%). Higher anxiety (aOR: 1.73, 95% CI: 1.08; 2.78, p-value: 0.02), higher depression (aOR: 3.06, 95% CI: 1.73; 5.39, p-value: 0.001), and higher stress (aOR: 1.86, 95 percent CI: 1.11; 3.14, p-value: 0.02) scores were significantly associated with pharmacists who reported that their work involves contact with infected/suspected COVID-19 patients. Interestingly, pharmacists who expressed concern about contracting COVID-19 infection had significantly higher anxiety (aOR: 2.35, 95% CI: 1.40; 3.94, p-value: 0.001) and higher depression scores (aOR: 2.64, 95% CI: 1.49; 4.67, p-value: 0.001) respectively.ConclusionThe preliminary results from pharmacists in Lebanon reflect increase in stress, burden, and frustration felt by pharmacists, creating a negative impact on their mental health and well-being during the global pandemic. As frontline healthcare workers, the role of pharmacists in the community should not be overlooked, and their mental health should be well investigated

Déterminants non médicamenteux de l'hypertension artérielle au niveau de la population

BACKGROUND: Hypertension is the most common chronic disease worldwide and a significant risk factor for cardiovascular diseases. Modifiable risk factors contribute partially to an increasing prevalence and inadequate blood pressure control. On this basis, non-pharmacological recommendations are available in worldwide guidelines for the prevention and management of hypertension. These measures include: maintain a normal body weight, engage in regular physical activity, limit alcohol consumption, reduce dietary salt intake and adhere to a healthy diet. OBJECTIVES: The objective of this thesis is to study the determinants of high blood pressure and to evaluate the relationship between lifestyle behavior and hypertension. In particular, the aim is to investigate the influence of an unhealthy behavior on blood pressure and the magnitude of the individual and combined effect of lifestyle factors on hypertension and blood pressure control. METHODS: Cross-sectional analyses were conducted using data from a representative sample of the adult Lebanese population and the French CONSTANCES cohort study. The Lebanese sample consisted of 2088 adults aged 20 years and above randomly selected following a sampling scheme across Lebanon. While CONSTANCES is an ongoing prospective cohort that included between February 2012 and January 2018 a total of 87,808 volunteer participants aged 18–69 randomly selected from the National Health Insurance Fund. In both studies, blood pressure measurements were done following standard operational procedures and lifestyle behaviors were assessed using self-reported validated questionnaires. Mostly, logistic regression models and general linear models were used to estimate the magnitude of the associations and to study adjusted mean blood pressure parameters, respectively. Adjusted odds ratios were presented along with 95% confidence interval. Statistical analyses were conducted using different statistical analysis software. RESULTS: Results of this thesis describe a high prevalence of hypertension and poor blood pressure control among treated individuals in the Lebanese population. While in France, epidemiologic data are in accordance with results of recent studies. From the conducted 3 analyses, increased body mass index (obesity and overweight), heavy alcohol consumption and non-adherence to dietary recommendations were seen to be independently associated with hypertension and poor blood pressure control, and they influenced systolic blood pressure levels. Controversial results were seen with physical activity in both studies and across different study populations. In terms of the magnitude of the association, body mass index and adherence to dietary approaches to stop hypertension (DASH) diet seem to have the biggest impact on increasing the odds of hypertension and uncontrolled blood pressure. Moreover, a combination of unhealthy behavior increased the odds of hypertension by more than 1.5 times, which highlighted the detrimental effect of an overall poor lifestyle on the risk of hypertension. Furthermore our findings suggest that the extent to which these factors are associated with hypertension is different by gender. CONCLUSION: Findings of this thesis provided needed epidemiologic data on hypertension in Lebanon and France. They emphasize that non-adherence to widely recommended lifestyle modifications has important impact on the risk of hypertension and influences BP control. From a population-based perspective, these findings promote that a global healthy lifestyle through improvement of modifiable behaviors could have major benefits in the prevention of hypertension.CONTEXTE: L'hypertension est la maladie chronique la plus fréquente dans le monde et un facteur de risque majeur des maladies cardiovasculaires. Les facteurs de risque modifiables contribuent en partie à l'augmentation de la prévalence et au mauvais contrôle tensionnel. Dans ce contexte, des mesures non médicamenteuses sont largement recommandées dans les textes de recommandations des sociétés savantes afin de prévenir l’hypertension et/ou d’améliorer le contrôle tensionnel des individus hypertendus. Ces mesures comprennent : le maintien d’un poids normal, la pratique d’une activité physique régulière, une consommation d’alcool limitée, la réduction de la consommation de sel et l’adhérence à une alimentation équilibrée OBJECTIFS: L'objectif de cette thèse est d'étudier les déterminants comportementaux de l'hypertension artérielle. En particulier, l’objectif est d’étudier l’influence d’un mode de vie malsain sur la pression artérielle ainsi que l’ampleur de l’effet individuel et de l’effet combiné des facteurs comportementaux sur l’hypertension et le contrôle tensionnel. MÉTHODES: Des analyses transversales ont été menées d’une part sur un échantillon de 2088 adultes âgés de 20 ans représentatif de la population Libanaise et d’une autre part sur une cohorte d’adultes Français participants à l’étude prospective CONSTANCES. Entre Février 2012 et Janvier 2018, CONSTANCES est constituée d’un échantillon de 87 808 participants volontaires âgés de 18 à 69 ans représentatif de la caisse nationale d’assurance maladie. Les mesures de la pression artérielle ont été effectuées selon des protocoles opératoires standardisés et les données des comportements liés au mode de vie ont été recueillies à l'aide d’auto-questionnaires. Des modèles de régression logistique et des modèles linéaires généraux ont été utilisés pour estimer l'ampleur des associations et pour étudier les moyennes des paramètres de pression artérielle, respectivement. Les odds ratio ajustés ont été présentés avec un intervalle de confiance de 95%. Les données ont été analysées à l'aide de différents logiciels (SPPS and SAS). RESULTATS: Les résultats de cette thèse décrivent une prévalence élevée d'hypertension et du mauvais contrôle chez les hypertendus traités dans la population Libanaise. Les données épidémiologiques issues de CONSTANCES semblent similaires à celles d’autres études 5 Françaises récentes. D'après les analyses effectuées, un indice de masse corporelle élevé (obésité et surcharge pondérale), une forte consommation d'alcool et la non adhérence aux recommandations nutritionnelles ont été significativement associés à l'hypertension et au mauvais contrôle tensionnel. De plus, ces facteurs sont associés à une augmentation du niveau de la pression artérielle systolique. Des résultats divergents ont été observés concernant l'activité physique et ceci dans les deux études et parmi les différentes populations étudiées. En termes d’ampleur de l’association, l’indice de masse corporelle et l’adhésion au régime DASH semblent avoir l’impact le plus important sur l’augmentation du risque d’hypertension et du contrôle tensionnel. De plus, une combinaison de comportements malsains multiplie par plus de 1,5 le risque d'hypertension, ce qui met en évidence les effets néfastes d'un mode de vie généralement malsain sur le risque d'hypertension. De plus, nos résultats suggèrent que l’ampleur de l’association de ces facteurs à l'hypertension diffère selon le sexe. CONCLUSION: Les résultats de cette thèse rapportent des données épidémiologiques nécessaires sur l'hypertension au Liban et en France. Egalement, ces résultats suggèrent que la non-adhérence à l’ensemble des mesures non-médicamenteuses recommandées a un impact important sur le risque d'hypertension et influence le contrôle tensionnel

Déterminants non médicamenteux de l'hypertension artérielle au niveau de la population

BACKGROUND: Hypertension is the most common chronic disease worldwide and a significant risk factor for cardiovascular diseases. Modifiable risk factors contribute partially to an increasing prevalence and inadequate blood pressure control. On this basis, non-pharmacological recommendations are available in worldwide guidelines for the prevention and management of hypertension. These measures include: maintain a normal body weight, engage in regular physical activity, limit alcohol consumption, reduce dietary salt intake and adhere to a healthy diet. OBJECTIVES: The objective of this thesis is to study the determinants of high blood pressure and to evaluate the relationship between lifestyle behavior and hypertension. In particular, the aim is to investigate the influence of an unhealthy behavior on blood pressure and the magnitude of the individual and combined effect of lifestyle factors on hypertension and blood pressure control. METHODS: Cross-sectional analyses were conducted using data from a representative sample of the adult Lebanese population and the French CONSTANCES cohort study. The Lebanese sample consisted of 2088 adults aged 20 years and above randomly selected following a sampling scheme across Lebanon. While CONSTANCES is an ongoing prospective cohort that included between February 2012 and January 2018 a total of 87,808 volunteer participants aged 18–69 randomly selected from the National Health Insurance Fund. In both studies, blood pressure measurements were done following standard operational procedures and lifestyle behaviors were assessed using self-reported validated questionnaires. Mostly, logistic regression models and general linear models were used to estimate the magnitude of the associations and to study adjusted mean blood pressure parameters, respectively. Adjusted odds ratios were presented along with 95% confidence interval. Statistical analyses were conducted using different statistical analysis software. RESULTS: Results of this thesis describe a high prevalence of hypertension and poor blood pressure control among treated individuals in the Lebanese population. While in France, epidemiologic data are in accordance with results of recent studies. From the conducted 3 analyses, increased body mass index (obesity and overweight), heavy alcohol consumption and non-adherence to dietary recommendations were seen to be independently associated with hypertension and poor blood pressure control, and they influenced systolic blood pressure levels. Controversial results were seen with physical activity in both studies and across different study populations. In terms of the magnitude of the association, body mass index and adherence to dietary approaches to stop hypertension (DASH) diet seem to have the biggest impact on increasing the odds of hypertension and uncontrolled blood pressure. Moreover, a combination of unhealthy behavior increased the odds of hypertension by more than 1.5 times, which highlighted the detrimental effect of an overall poor lifestyle on the risk of hypertension. Furthermore our findings suggest that the extent to which these factors are associated with hypertension is different by gender. CONCLUSION: Findings of this thesis provided needed epidemiologic data on hypertension in Lebanon and France. They emphasize that non-adherence to widely recommended lifestyle modifications has important impact on the risk of hypertension and influences BP control. From a population-based perspective, these findings promote that a global healthy lifestyle through improvement of modifiable behaviors could have major benefits in the prevention of hypertension.CONTEXTE: L'hypertension est la maladie chronique la plus fréquente dans le monde et un facteur de risque majeur des maladies cardiovasculaires. Les facteurs de risque modifiables contribuent en partie à l'augmentation de la prévalence et au mauvais contrôle tensionnel. Dans ce contexte, des mesures non médicamenteuses sont largement recommandées dans les textes de recommandations des sociétés savantes afin de prévenir l’hypertension et/ou d’améliorer le contrôle tensionnel des individus hypertendus. Ces mesures comprennent : le maintien d’un poids normal, la pratique d’une activité physique régulière, une consommation d’alcool limitée, la réduction de la consommation de sel et l’adhérence à une alimentation équilibrée OBJECTIFS: L'objectif de cette thèse est d'étudier les déterminants comportementaux de l'hypertension artérielle. En particulier, l’objectif est d’étudier l’influence d’un mode de vie malsain sur la pression artérielle ainsi que l’ampleur de l’effet individuel et de l’effet combiné des facteurs comportementaux sur l’hypertension et le contrôle tensionnel. MÉTHODES: Des analyses transversales ont été menées d’une part sur un échantillon de 2088 adultes âgés de 20 ans représentatif de la population Libanaise et d’une autre part sur une cohorte d’adultes Français participants à l’étude prospective CONSTANCES. Entre Février 2012 et Janvier 2018, CONSTANCES est constituée d’un échantillon de 87 808 participants volontaires âgés de 18 à 69 ans représentatif de la caisse nationale d’assurance maladie. Les mesures de la pression artérielle ont été effectuées selon des protocoles opératoires standardisés et les données des comportements liés au mode de vie ont été recueillies à l'aide d’auto-questionnaires. Des modèles de régression logistique et des modèles linéaires généraux ont été utilisés pour estimer l'ampleur des associations et pour étudier les moyennes des paramètres de pression artérielle, respectivement. Les odds ratio ajustés ont été présentés avec un intervalle de confiance de 95%. Les données ont été analysées à l'aide de différents logiciels (SPPS and SAS). RESULTATS: Les résultats de cette thèse décrivent une prévalence élevée d'hypertension et du mauvais contrôle chez les hypertendus traités dans la population Libanaise. Les données épidémiologiques issues de CONSTANCES semblent similaires à celles d’autres études 5 Françaises récentes. D'après les analyses effectuées, un indice de masse corporelle élevé (obésité et surcharge pondérale), une forte consommation d'alcool et la non adhérence aux recommandations nutritionnelles ont été significativement associés à l'hypertension et au mauvais contrôle tensionnel. De plus, ces facteurs sont associés à une augmentation du niveau de la pression artérielle systolique. Des résultats divergents ont été observés concernant l'activité physique et ceci dans les deux études et parmi les différentes populations étudiées. En termes d’ampleur de l’association, l’indice de masse corporelle et l’adhésion au régime DASH semblent avoir l’impact le plus important sur l’augmentation du risque d’hypertension et du contrôle tensionnel. De plus, une combinaison de comportements malsains multiplie par plus de 1,5 le risque d'hypertension, ce qui met en évidence les effets néfastes d'un mode de vie généralement malsain sur le risque d'hypertension. De plus, nos résultats suggèrent que l’ampleur de l’association de ces facteurs à l'hypertension diffère selon le sexe. CONCLUSION: Les résultats de cette thèse rapportent des données épidémiologiques nécessaires sur l'hypertension au Liban et en France. Egalement, ces résultats suggèrent que la non-adhérence à l’ensemble des mesures non-médicamenteuses recommandées a un impact important sur le risque d'hypertension et influence le contrôle tensionnel

Consecutive Case Series of Healed Single-Molar Sites Immediately Restored with Wide-Diameter Implants: A 1-Year Evaluation

Introduction. To evaluate outcomes of wide-diameter (6 mm) implants immediately provisionalized with cement-retained single crowns in posterior molar sites. Materials and Methods. Forty-eight consecutive patients received a total of 53 moderately rough-surface, 6 mm diameter implants in healed sites. All implants were immediately provisionalized with a cement-retained provisional crown. Final prosthesis with cement-retained porcelain fused to metal crowns was delivered 3–6 months later. Patients were followed up for 1 year. Outcome measures were implant failures and success rate, complications, marginal bone levels, bone level changes, papilla index, bleeding on probing, and inflammation. Results. One patient was lost to follow-up. At one year, the implant survival and success rate were 98.1%. The mean marginal bone loss after 1 year was −0.17±1.84 mm. Ideal papilla score was recorded at 83.8% of the sites. More than 95.6% of the sites showed no bleeding or inflammation. No procedure-related or device-related adverse events were reported. Conclusion. Wide-diameter (6 mm) implants can safely and successfully replace single posterior molars. Longer follow-up studies are necessary to evaluate the long-term success of these implants

A Late Presentation of a Fatal Disease: Juvenile Hemochromatosis

Juvenile hemochromatosis is a rare and severe form of hereditary hemochromatosis. We report the case of a 39-year-old female who presented with heart failure and cirrhosis from previously unrecognized juvenile hemochromatosis. This is the latest presentation described in the literature. An important clue to the diagnosis was a history of amenorrhea since the age of 20 that had never been investigated. The patient died of intractable heart failure two months after the initial presentation. Juvenile hemochromatosis should be suspected in a young patient with endocrine or cardiac manifestations. Early diagnosis is crucial since phlebotomy can improve the prognosis and delay or prevent progression to heart failure and cirrhosis