Value of Lung Ultrasound Sonography B-Lines Quantification as a Marker of Heart Failure in COPD Exacerbation

Fadwa Lajili,1,2 Marwa Toumia,1,2 Adel Sekma,1,2 Khaoula Bel Haj Ali,1,2 Sarra Sassi,1,2 Asma Zorgati,3 Hajer Yaakoubi,3 Rym Youssef,3 Mohamed Habib Grissa,1,2 Kaouther Beltaief,1,2 Zied Mezgar,4 Mariem Khrouf,4 Ikram Chamtouri,5 Wahid Bouida,1,2 Hamdi Boubaker,1,2 Mohamed Amine Msolli,1,2 Zohra Dridi,6 Riadh Boukef,1,3 Semir Nouira1,2 1Research Laboratory LR12SP18, Monastir University, Monastir, 5019, Tunisia; 2Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia; 3Emergency Department, Sahloul University Hospital, Sousse, 4011, Tunisia; 4Emergency Department, Farhat Hached University Hospital, Sousse, 4031, Tunisia; 5Department of Cardiology B, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia; 6Department of Cardiology A, Fattouma Bourguiba University Hospital, Monastir, 5000, TunisiaCorrespondence: Semir Nouira, Emergency Department and Laboratory Research(LR12SP18), Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia, Tel +21673106046, Email [email protected]: Identifying heart failure (HF) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can be challenging. Lung ultrasound sonography (LUS) B-lines quantification has recently gained a large place in the diagnosis of HF, but its diagnostic performance in AECOPD remains poorly studied.Purpose: This study aimed to assess the contribution of LUS B-lines score (LUS score) in the diagnosis of HF in AECOPD patients.Patients and methods: This is a prospective cross-sectional multicenter cohort study including patients admitted to the emergency department for AECOPD. All included patients underwent LUS. A lung ultrasound score (LUS score) based on B-lines calculation was assessed. A cardiac origin of dyspnea was retained for a LUS score greater than 15. HF diagnosis was based on clinical examination, pro-brain natriuretic peptide levels, and echocardiographic findings. The LUS score diagnostic performance was assessed by receiver operating characteristic (ROC) curve, sensitivity, specificity, and likelihood ratio at the best cutoffs.Results: We included 380 patients, mean age was 68± 11.6 years, sex ratio (M/F) 1.96. Patients were divided into two groups: the HF group [n=157 (41.4%)] and the non-HF group [n=223 (58.6%)]. Mean LUS score was higher in the HF group (26.8± 8.4 vs 15.3± 7.1; p< 0.001). The mean LUS score in the HF patients with reduced LVEF was 29.2± 8.7, and was 24.5± 7.6 in the HF patients with preserved LVEF. LUS score area under ROC curve for the diagnosis of HF was 0.71 [0.65– 0.76]. The best sensitivity (89% [85.9– 92,1]) was observed at the threshold of 5; the best specificity (85% [81.4– 88.6]) was observed at the threshold of 30. Correlation between LUS score and E/E’ ratio was good (R=0.46, p=0.0001).Conclusion: Our results suggest that LUS score could be helpful and should be considered in the diagnostic approach of HF in AECOPD patients, at least as a ruling in test.Keywords: chronic obstructive pulmonary disease, COPD, heart failure, dyspnea, lung ultrasound sonograph

A survey of fertility preservation options available to cancer patients around the globe

Purpose: Oncofertility focuses on providing fertility and endocrine-sparing options to patients who undergo life-preserving but gonadotoxic cancer treatment. The resources needed to meet patient demand often are fragmented along disciplinary lines. We quantify assets and gaps in oncofertility care on a global scale. Methods: Survey-based questionnaires were provided to 191 members of the Oncofertility Consortium Global Partners Network, a National Institutes of Health–funded organization. Responses were analyzed to measure trends and regional subtleties about patient oncofertility experiences and to analyze barriers to care at sites that provide oncofertility services. Results: Sixty-three responses were received (response rate, 25%), and 40 were analyzed from oncofertility centers in 28 countries. Thirty of 40 survey results (75%) showed that formal referral processes and psychological care are provided to patients at the majority of sites. Fourteen of 23 respondents (61%) stated that some fertility preservation services are not offered because of cultural and legal barriers. The growth of oncofertility and its capacity to improve the lives of cancer survivors around the globe relies on concentrated efforts to increase awareness, promote collaboration, share best practices, and advocate for research funding. Conclusion: This survey reveals global and regional successes and challenges and provides insight into what is needed to advance the field and make the discussion of fertility preservation and endocrine health a standard component of the cancer treatment plan. As the field of oncofertility continues to develop around the globe, regular assessment of both international and regional barriers to quality care must continue to guide process improvements

Survey of Third-Party Parenting Options Associated With Fertility Preservation Available to Patients With Cancer Around the Globe

Purpose: In the accompanying article, “Analysis of Fertility Preservation Options Available to Patients With Cancer Around the Globe,” we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions. Methods: We provide data on the legalities of third-party assisted reproductive technologies and other family-building options in the 28 oncofertility-practicing countries surveyed. Results: We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms. Conclusion: Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients

Survey of third-party parenting options associated with fertility preservation available to patients with cancer around the globe

bstract PURPOSE In the accompanying article, “Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe,” we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions. METHODS We provide data on the legalities of third-party assisted reproductive technologies and other familybuilding options in the 28 oncofertility-practicing countries surveyed. RESULTS We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms. CONCLUSION Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients

Consanguinity and reproductive health among Arabs

Consanguineous marriages have been practiced since the early existence of modern humans. Until now consanguinity is widely practiced in several global communities with variable rates depending on religion, culture, and geography. Arab populations have a long tradition of consanguinity due to socio-cultural factors. Many Arab countries display some of the highest rates of consanguineous marriages in the world, and specifically first cousin marriages which may reach 25-30% of all marriages. In some countries like Qatar, Yemen, and UAE, consanguinity rates are increasing in the current generation. Research among Arabs and worldwide has indicated that consanguinity could have an effect on some reproductive health parameters such as postnatal mortality and rates of congenital malformations. The association of consanguinity with other reproductive health parameters, such as fertility and fetal wastage, is controversial. The main impact of consanguinity, however, is an increase in the rate of homozygotes for autosomal recessive genetic disorders. Worldwide, known dominant disorders are more numerous than known recessive disorders. However, data on genetic disorders in Arab populations as extracted from the Catalogue of Transmission Genetics in Arabs (CTGA) database indicate a relative abundance of recessive disorders in the region that is clearly associated with the practice of consanguinity

A View from the Past Into our Collective Future: The Oncofertility Consortium Vision Statement

Today, male and female adult and pediatric cancer patients, individuals transitioning between gender identities, and other individuals facing health extending but fertility limiting treatments can look forward to a fertile future. This is, in part, due to the work of members associated with the Oncofertility Consortium. The Oncofertility Consortium is an international, interdisciplinary initiative originally designed to explore the urgent unmet need associated with the reproductive future of cancer survivors. As the strategies for fertility management were invented, developed or applied, the individuals for who the program offered hope, similarly expanded. As a community of practice, Consortium participants share information in an open and rapid manner to addresses the complex health care and quality-of-life issues of cancer, transgender and other patients. To ensure that the organization remains contemporary to the needs of the community, the field designed a fully inclusive mechanism for strategic planning and here present the findings of this process. This interprofessional network of medical specialists, scientists, and scholars in the law, medical ethics, religious studies and other disciplines associated with human interventions, explore the relationships between health, disease, survivorship, treatment, gender and reproductive longevity. The goals are to continually integrate the best science in the service of the needs of patients and build a community of care that is ready for the challenges of the field in the future

Rapport IV.4. Rhéologie des saumures et des eaux saumâtres

Systematic model investigations on the variation of brine and salt water viscosity with concentration and temperature are described. The overall results are given in graph form, together with an interpolation formula based on the Arrhenius formula. Further thermo-physical properties are investigated in an attempt to establish a relationship between the characteristic parameters for solution state and behaviour and liquid theory methods.A l’occasion d’études sur modèles de laboratoire, de problèmes d’écoulement d’eaux salées, voire de saumures, nous avons étudié de manière systématique la viscosité de solutions en fonction de la concentration et de la température. La communication proposée donne une synthèse des résultats obtenus sous forme d’abaques et une formule d’interpolation inspirée de la relation d’Arrhénius. Examinant aussi d’autres propriétés thermophysiques, nous avons essayé de relier les divers paramètres caractéristiques de l’état et du comportement des solutions par analogie avec les méthodes utilisées dans les théories des liquides.Thirriot Claude, Khrouf M.-L. Rapport IV.4. Rhéologie des saumures et des eaux saumâtres. In: Hydrotechnique des liquides industriels. Compte rendu des douzièmes journées de l'hydraulique. Paris, 6-8 juin 1972. Tome 2, 1973

SIR Analytical Expression for Dispersive Channels in OFDM/OQAM Transmission Systems

International audienceIn this paper, we derive the analytical expression of the signal to interference ratio (SIR) for orthogonal frequency division multiplexing with offset quadrature amplitude modulation (OFDM/OQAM) systems, in time and frequency dispersive channels. In this derivation, we use the dispersive approach, which is based on using a matched filter and provides optimal reception. Finally, we search optimal transmitter prototype function s that maximize the SIR

Efficiency of the TR Technique and the POPS Algorithm for Waveform Optimization in MISO-OFDM Systems

International audienceIn this paper, we extend the joint use of the Time Reversal (TR) precoding technique and the Ping-Pong Optimized Pulse Shaping (POPS) waveform optimization algorithm to design optimal transmit and receive waveforms for Multiple Input Single Output-Orthogonal Frequency Division Multiplexing (MISO-OFDM) systems. The design process banks on a full characterization of the scattering function of the TR-MISO channel, followed by the implementation of the POPS approach. Numerical analysis reveal a significant gain, brought by the optimized waveforms in TR-MISO-OFDM systems, in terms of Signal to Interference plus Noise Ratio (SINR), compared to the optimized waveforms in TR-SISO-OFDM systems and the PHYDYAS waveform in TR-MISO-OFDM systems