Angioplastie coronaire percutanée chez la femme : particularités cliniques, procédurales et pronostiques

AbstractX Les résultats de l´angioplastie transluminale (ATL) des coronaires chez la femme ont été pendant de nombreuses années controversés et longtemps considérés comme moins favorable que chez l´homme. Le but de notre travail était d’évaluer les caractéristiques de l’angioplastie coronaire chez la femme, ainsi que les résultats immédiats et à moyen terme et de les comparer à ceux chez l’homme. Nous avons comparé 200 patients dont 100 femmes, ayant bénéficié d’une angioplastie coronaire, colligés au service de cardiologie de l’hôpital Hédi Chaker de Sfax entre 2002 et 2007. Les femmes étaient significativement plus âgées que les hommes. La comparaison de la fréquence des facteurs de risque d’athérosclérose chez les deux sexes, a permis de noter une co-morbidité franchement plus importante chez la femme, avec une différence statiquement significative. L’ATL a été plus motivée chez la femme devant un angor stable sévère (p<0,05) et un SCA ST- (p=NS). Les femmes avaient plus d’atteinte polytronculaire (p<0,05), d’atteintes des segments moyens et distaux (p<0,05) et plus des lésions serrées (p=NS), longues et calcifiées (p<0,05). 259 stents ont été déployés, un stenting direct était plus fréquent dans la population féminine (p<0,05). Le diamètre des artères féminines, assimilé à celui du stent et/ou ballon utilisé, a été significativement moins important que celui des hommes. La longueur des stents et/ou ballon utilisés, ainsi que les pressions de larguage des stents ont été plus importantes chez la population féminine (p<0,05). Le succès angiographique global a été obtenu chez 94% de la population générale, sans différence significative entre les deux sexes. Les évènements cardiaques majeurs (MACE) hospitaliers ont été plus fréquents chez la femme (p=0,05). Après un suivi moyen de 31 mois, le taux de MACE global a été significativement plus important chez la femme (39% vs. 28%, p<0,05), portant surtout sur la mortalité globale (13% vs. 3%, p<0,05). Le taux de resténose a été comparable chez les deux sexes. L’angioplastie coronaire constitue actuellement un moyen thérapeutique efficace et sur chez la femme, au prix de complications plus fréquentes.Key words: Angioplastie coronaire percutanée, syndrome coronarien aigu, sexes, mortalité, Tunisi

Lung function profiles and aerobic capacity of adult cigarette and hookah smokers after 12 weeks intermittent training

Introduction: Pulmonary function is compromised in most smokers. Yet it is unknown whether exercise training improves pulmonary function and aerobic capacity in cigarette and hookah smokers and whether these smokers respond in a similar way as do non-smokers.Aim: To evaluate the effects of an interval exercise training program on pulmonary function and aerobic capacity in cigarette and hookah smokers.Methods: Twelve cigarette smokers, 10 hookah smokers, and 11 non-smokers participated in our exercise program. All subjects performed 30 min of interval exercise (2 min of work followed by 1 min of rest) three times a week for 12 weeks at an intensity estimated at 70% of the subject’s maximum aerobic capacity (VO2max). Pulmonary function was measured using spirometry, and maximum aerobic capacity was assessed by maximal exercise testing on a treadmill before the beginning and at the end of the exercise training program.Results: As expected, prior to the exercise intervention, the cigarette and hookah smokers had significantly lower pulmonary function than the non-smokers. The 12-week exercise training program did not significantly affect lung function as assessed by spirometry in the non-smoker group. However, it significantly increased both forced expiratory volume in 1 second and peak expiratory flow (PEF) in the cigarette smoker group, and PEF in the hookah smoker group. Our training program had its most notable impact on the cardiopulmonary system of smokers. In the non-smoker and cigarette smoker groups, the training program significantly improved VO2max (4.4 and 4.7%, respectively), v VO2max (6.7 and 5.6%, respectively), and the recovery index (7.9 and 10.5%, respectively).Conclusions: After 12 weeks of interval training program, the increase of VO2max and the decrease of recovery index and resting heart rate in the smoking subjects indicated better exercise tolerance. Although the intermittent training program altered pulmonary function only partially, both aerobic capacity and life quality were improved. Intermittent training should be advised in the clinical setting for subjects with adverse health behaviors.Keywords: cigarette smokers; hookah smokers; pulmonary function; aerobic capacity; interval trainin

Fragmentation cross sections of Fe^{26+}, Si^{14+} and C^{6+} ions of 0.3-10 A GeV on CR39, polyethylene and aluminum targets

New measurements of the total and partial fragmentation cross sections in the energy range 0.3-10 A GeV of Fe^{26+}, Si^{14+} and C^{6+} beams on polyethylene, CR39 and aluminum targets are presented. The exposures were made at Brookhaven National Laboratory (BNL), USA, and Heavy Ion Medical Accelerator in Chiba (HIMAC), Japan. The CR39 nuclear track detectors were used to identify the incident and survived beams and their fragments. The total fragmentation cross sections for all targets are almost energy independent while they depend on the target mass. The measured partial fragmentation cross sections are also discussed.Comment: 4 pages, 5 eps figures. Talk given at the 24th International Conference on Nuclear Tracks in Solids, Bologna, Italy, 1-5 September 200

Penile hair coil strangulation of the child

AbstractWe report the case of a child with a delayed presentation of penile strangulation with a coil of hair that resulted in a complete transection of the urethra. Hair coil strangulation of the penis is uncommon. It is also known as penile Tourniquet syndrome. It has been reported with circumcised and uncircumcised penises and it can lead to serious complications like the amputation of the penis. Prompt diagnosis and treatment are necessary to prevent complications

Search for strange quark matter and Q-balls with the SLIM experiment

We report on the search for Strange Quark Matter (SQM) and charged Q-balls with the SLIM experiment at the Chacaltaya High Altitude Laboratory (5230 m a.s.l.) from 2001 to 2005. The SLIM experiment was a 427 m$^{2}$ array of Nuclear Track Detectors (NTDs) arranged in modules of $24 \times 24$ cm$^{2}$ area. SLIM NTDs were exposed to the cosmic radiation for 4.22 years after which they were brought back to the Bologna Laboratory where they were etched and analyzed. We estimate the properties and energy losses in matter of nuclearites (large SQM nuggets), strangelets (small charged SQM nuggets) and Q-balls; and discuss their detection with the SLIM experiment. The flux upper limits in the CR of such downgoing particles are at the level of $1.3 10^{-15}$/cm$^{2}$/s/sr (90% CL).Comment: 4 pages, 7 eps figures. Talk given at the 24th International Conference on Nuclear Tracks in Solids, Bologna, Italy, 1-5 September 200

Intérêt de la technique de Koyanagi dans le traitement de l’hypospadias posterieurchez l’enfant

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Morgagni's diaphragmatic hernia mimicking a severe congenital heart disease in a newborn: a case report

<p>Abstract</p> <p>Introduction</p> <p>Morgagni's congenital diaphragmatic defect is a rare malformation, the diagnosis of which, as in our case report, may be problematic. To the best of our knowledge, this is the first report of this kind of hernia presenting with signs and symptoms of severe cardiac malformation.</p> <p>Case presentation</p> <p>We report the case of a three-month-old Caucasian baby boy, who presented with heart failure and severe pulmonary hypertension. Compression of the heart by a bowel loop in the chest led to an incorrect diagnosis of congenital heart disease.</p> <p>Conclusions</p> <p>Even in this era of highly sophisticated diagnostic tools, a simple radiograph can provide sufficient information for a precise, rapid diagnosis.</p