Laryngocele a propos de 9 cas

La laryngocèle est une pathologie rare. elle est définit par la dilatation progressive du saccule laryngé. Le diagnostic est suspecté par l’examen clinique, sa prise en charge est encore discutée. nous rapportons une étude rétrospective portant sur 9 patients ayant été suivis et traités pour une laryngocèle. La série a été colligée sur une période de 14 ans, allant de 1998 à 2011. Six de nos patients avaient une laryngocèle externe, deux patients avaient une laryngocèle mixte et un patient avait une laryngocèle interne. Une surinfection a été notée chez trois patients réalisant ainsi le tableau de pyolaryngocèle. Tous les patients ont eu un examen clinique complet comportant un examen OrL et cervico-facial ainsi qu’un examen laryngé au nasofibroscope. La tomodensitométrie cervicale a été réalisée de façon systématique. Huit de nos malades ont été abordés par voie cervicale permettant une exérèse complète du sac. Le recul moyen était de 38 mois sans récidive. Toute laryngocèle découverte, doit être traitée afin d’éviter les complications essentiellement locales pouvant mettre en jeu le pronostic vital. Les modalités thérapeutiques dépendent du type de la laryngocèle.Mots-clés : laryngocèle, nasofibroscopie laryngée, traitement endoscopique, thyrotomie.A laryngocele is a rare affection which consists in an abnormal dilatation of the laryngeal saccule. The diagnosis is suspected after clinical exam. The management of this pathology remains a subject of debating. We report a retrospective review including nine patients with laryngocele treated over a 14 years-period. Six patients had external laryngoceles; two had combined laryngocele; another one had an internal laryngocele. Preoperative diagnosis of each patient was made on flexible nasolaryngoscopy following routine otorhinolaryngologic exam. CT scan was systematically done. mrI was realized in case of a diagnostic doubt. eight of our patients were treated via external approach. no recurrences were encountered during the following-up. Laryngoceles must be treated to provide different complications. Some of these complications can cause death. The modalities of the treatment depend on the type of laryngocele.Keywords : laryngocele, nasolaryngoscopy, endoscopic treatment, thyrotomy

Valeur de l’examen extemporane en pathologie thyroïdienne

OBJECTIF : Etudier la valeur de l’examen extemporané dans la pathologie thyroidienne et identifier ses limitesMATERIELS ET METHODES : Notre étude est rétrospective incluant 800 examens extemporanés réalisés sur des pièces de résectionthyroïdienne colligés dans notre service sur une période de 12 ans (2000-2011).Les résultats ont été comparés à ceux del’examen anatomopathologique définitif.RESULTATS : Les résultats étaient concordants dans 96,5%, discordants dans 3,5 %. La sensibilité de l’examen extemporané toustypes confondus était de 78 % et la spécificité de 100 %CONCLUSION : Notre étude a montré une spécificité parfaite de l’examen extemporané cependant l’interprétation difficile des lésionsthyroïdiennes d’architecture vésiculaire expliquent une sensibilité de 78 %.Mots Clés : Thyroïdectomie, examen extemporanOBJECTIVE: To assess the value of frozen-section examination in thyroid surgery and evaluate its limitationsPATIENTS AND METHODES: This retrospective study examined the results of 800 frozen-sections of thyroid specimens analysedover the 12 –year period (2000-2011). Their results were compared with definitive anatomo-pathological examinationRESULTS :Frozen-section diagnosis was concordant with subsequent histopathological examination in 96,5% ,discordant in 3,5%.The global specificity of frozen section analysis for all histological subtypes was 100 % and its sensitivity was 78 %.CONCLUSION: This study shows the good specificity of frozen section .Discordances between frozen-section and definitive diagnosiswas associated with microfllicular lesions wich explain the sensibility of 78%Key Words: Thyroid surgery, frozen section examinatio

Pharmacogenomics of the efficacy and safety of Colchicine in COLCOT

© 2021 The Authors. Circulation: Genomic and Precision Medicine is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited and is not used for commercial purposes.Background: The randomized, placebo-controlled COLCOT (Colchicine Cardiovascular Outcomes Trial) has shown the benefits of colchicine 0.5 mg daily to lower the rate of ischemic cardiovascular events in patients with a recent myocardial infarction. Here, we conducted a post hoc pharmacogenomic study of COLCOT with the aim to identify genetic predictors of the efficacy and safety of treatment with colchicine. Methods: There were 1522 participants of European ancestry from the COLCOT trial available for the pharmacogenomic study of COLCOT trial. The pharmacogenomic study's primary cardiovascular end point was defined as for the main trial, as time to first occurrence of cardiovascular death, resuscitated cardiac arrest, myocardial infarction, stroke, or urgent hospitalization for angina requiring coronary revascularization. The safety end point was time to the first report of gastrointestinal events. Patients' DNA was genotyped using the Illumina Global Screening array followed by imputation. We performed a genome-wide association study in colchicine-treated patients. Results: None of the genetic variants passed the genome-wide association study significance threshold for the primary cardiovascular end point conducted in 702 patients in the colchicine arm who were compliant to medication. The genome-wide association study for gastrointestinal events was conducted in all 767 patients in the colchicine arm and found 2 significant association signals, one with lead variant rs6916345 (hazard ratio, 1.89 [95% CI, 1.52-2.35], P=7.41×10-9) in a locus which colocalizes with Crohn disease, and one with lead variant rs74795203 (hazard ratio, 2.51 [95% CI, 1.82-3.47]; P=2.70×10-8), an intronic variant in gene SEPHS1. The interaction terms between the genetic variants and treatment with colchicine versus placebo were significant. Conclusions: We found 2 genomic regions associated with gastrointestinal events in patients treated with colchicine. Those findings will benefit from replication to confirm that some patients may have genetic predispositions to lower tolerability of treatment with colchicine.info:eu-repo/semantics/publishedVersio

Effect of Systemic Hypertension With Versus Without Left Ventricular Hypertrophy on the Progression of Atrial Fibrillation (from the Euro Heart Survey).

Hypertension is a risk factor for both progression of atrial fibrillation (AF) and development of AF-related complications, that is major adverse cardiac and cerebrovascular events (MACCE). It is unknown whether left ventricular hypertrophy (LVH) as a consequence of hypertension is also a risk factor for both these end points. We aimed to assess this in low-risk AF patients, also assessing gender-related differences. We included 799 patients from the Euro Heart Survey with nonvalvular AF and a baseline echocardiogram. Patients with and without hypertension were included. End points after 1 year were occurrence of AF progression, that is paroxysmal AF becoming persistent and/or permanent AF, and MACCE. Echocardiographic LVH was present in 33% of 379 hypertensive patients. AF progression after 1 year occurred in 10.2% of 373 patients with rhythm follow-up. In hypertensive patients with LVH, AF progression occurred more frequently as compared with hypertensive patients without LVH (23.3% vs 8.8%, p = 0.011). In hypertensive AF patients, LVH was the most important multivariably adjusted determinant of AF progression on multivariable logistic regression (odds ratio 4.84, 95% confidence interval 1.70 to 13.78, p = 0.003). This effect was only seen in male patients (27.5% vs 5.8%, p = 0.002), while in female hypertensive patients, no differences were found in AF progression rates regarding the presence or absence of LVH (15.2% vs 15.0%, p = 0.999). No differences were seen in MACCE for hypertensive patients with and without LVH. In conclusion, in men with hypertension, LVH is associated with AF progression. This association seems to be absent in hypertensive women

Progression From Paroxysmal to Persistent Atrial Fibrillation. Clinical Correlates and Prognosis

Objectives: We investigated clinical correlates of atrial fibrillation (AF) progression and evaluated the prognosis of patients demonstrating AF progression in a large population. Background: Progression of paroxysmal AF to more sustained forms is frequently seen. However, not all patients will progress to persistent AF. Methods: We included 1,219 patients with paroxysmal AF who participated in the Euro Heart Survey on AF and had a known rhythm status at follow-up. Patients who experienced AF progression after 1 year of follow-up were identified. Results: Progression of AF occurred in 178 (15%) patients. Multivariate analysis showed that heart failure, age, previous transient ischemic attack or stroke, chronic obstructive pulmonary disease, and hypertension were the only independent predictors of AF progression. Using the regression coefficient as a benchmark, we calculated the HATCH score. Nearly 50% of the patients with a HATCH score >5 progressed to persistent AF compared with only 6% of the patients with a HATCH score of 0. During follow-up, patients with AF progression were more often admitted to the hospital and had more major adverse cardiovascular events. Conclusions: A substantial number of patients progress to sustained AF within 1 year. The clinical outcome of these patients regarding hospital admissions and major adverse cardiovascular events was worse compared with patients demonstrating no AF progression. Factors known to cause atrial structural remodeling (age and underlying heart disease) were independent predictors of AF progression. The HATCH score may help to identify patients who are likely to progress to sustained forms of AF in the near future. \ua9 2010 American College of Cardiology Foundation

Finite-difference time-domain method for design and analysis of microcavity - Coupled submicron-width waveguides

In this paper the finite-difference time-domain (FDTD) method is reviewed and then used to model and predict the geometric parameters used for the design of the device. The waveguide consists of a periodic array of air gap etched into a silicon (Si) strip on a silicon dioxide (SiO2) layer. The width and the depth of the grooves of the air gap (n = 1) as well as the length of the silicon layer (n = 3.4) are investigated. Using FDTD, the optical parameters are characterized. The effect of the air gap on the field profile distribution of the whole structure is calculated and performed in the range 0.09687 μm –1.55 μm. The field profile, and the response of the microcavity against frequency are calculated from sinusoidal sources. The spectral behavior of the structure is performed and its validity is verified by calculation of the reflectance spectra

Design of two-dimensional photonic crystal structure based in all-angle negative refractive effect for application in focusing systems

A design of a polarisation independent focusing system of electromagnetic waves in a two-dimensional photonic crystal (PC) is proposed and numerically demonstrated by using the finite-difference time-domain method. We have shown that by the careful selection of both the refractive index of the high index material and the air cylinder radius, a complete all-angle negative refraction can be obtained for both the transverse electric (TE) and the transverse magnetic (TM) polarisations. We have demonstrated that the proposed PC structures can focus either the TE or the TM or both TE and TM polarised waves with sub-wavelength resolution. In addition, a significant improvement of the image resolution has been presented

Effect of sequence built on photonic band gap properties of one-dimensional quasi-periodic photonic crystals: Application to Thue-Morse and Double-period structures

International audienceWe elaborated by Radio frequency magnetron sputtering two types of one-dimensional quasi-periodic photonic crystals, based on Si/SiO2 materials, according to the Thue Morse sequence and the Double-period one. We have investigated their optical properties, throughout the reflection transmission spectra, experimentally as well theoretically by using the transfer matrix method. The experimental spectra of these two structures are performed at normal incident light configuration, in the near infrared wavelengths range, and, are compared for the same number of layers, for a generation number N varying from 0 to 5, corresponding to a number of layers varying from 1 to 32, respectively. We experimentally put in evidence the appearance of photonic band gaps for N higher than 2, which are then well defined for N equal to 4, for the two structures. Furthermore, the results show that these two quasi-periodic structures exhibit sharp localized modes of light within the photonic band gaps, covering the optical telecommunication wavelengths 133 and 1.55 pm, with different number and position depending, on the built in distribution structures. The results also show a good agreement between the experimental and calculated spectra. (C) 2017 Elsevier Ltd. All rights reserved

Triplet-triplet interaction in a nearly one dimensional molecular crystal: Application to 1,4-dibromonaphtalene

The effect of a magnetic field (6 kG) on the delayed fluorescence in a 1,4-Dibromonaphtalene at 300 K and 20 K is analysed using a new approach of calculation of the triplet-triplet annihilation rate constant. The agreement of the best fit between experiment and theory allows reaching at 300 K and 20 K respectively the lifetimes and the interaction constant of the triplets pairs