Esthésioneuroblastome nasosinusien: Nouvelles modalités thérapeutiques

Introduction : L’esthésioneuroblastome est une tumeur maligne rare des cavités nasosinusiennes. La chirurgie par voie externe et la radiothérapie ont été le traitement de référence. L’utilisation ces dernières années de la chirurgie endoscopique endonasale et de la chimiothérapie parait prometteuse.Observations : Nous présentons deux cas cliniques de patients traités pour esthésioneuroblastome nasosinusien : Le premier par une chirurgie endoscopique endonasale et une radiothérapie, le second par une chimio-radiothérapie. L’évolution a été favorable respectivement à 39 mois et à 49 mois.Discussion : A travers une revue de la littérature, nous discuterons les différentes modalités thérapeutiques de cette tumeur.Mots clés : esthésioneuroblastome, sinus, traitement

Prefix-Projection Global Constraint for Sequential Pattern Mining

Sequential pattern mining under constraints is a challenging data mining task. Many efficient ad hoc methods have been developed for mining sequential patterns, but they are all suffering from a lack of genericity. Recent works have investigated Constraint Programming (CP) methods, but they are not still effective because of their encoding. In this paper, we propose a global constraint based on the projected databases principle which remedies to this drawback. Experiments show that our approach clearly outperforms CP approaches and competes well with ad hoc methods on large datasets

Dacryocystorhinostomie par voie endoscopique endonasale

Introduction : La dacryocystorhinostomie (DCR) endoscopique endonasale est une chirurgie mini invasive du sac lacrymal. Le but de notre travail est d’analyser et d'évaluer prospectivement nos patients opérés pour DCR endoscopique endonasale utilisant une sonde de trans-illumination, durant 2010.Patients et méthode : étude prospective de 20 DCR endoscopique (18 patients) utilisant la sonde de transillumination. Ce travail consiste en une analyse des données épidémiologiques, des indications opératoires, des données cliniques et radiologiques, des constatations per opératoires et des résultats fonctionnels et anatomiques postopératoires.Résultats : Cette étude a concerné 16 femmes (88,9%) et 2 hommes. L'âge médian est de 34 ans. Les indications chirurgicales sont réparties entre échec de DCR par voie externe (6 cas), pathologie rhino-sinusienne associée (13 cas), dacryocèle (1 cas). Notre taux de succès est de 85,7% (12 cas/14) dans les DCR de première intention. Il est de 83,3%(5cas/6) dans les reprises des voies externes. A 6 mois du post opératoire l’orifice de la stomie est identifiable dans 14 cas soit 70%. Aucune complication majeure n’est colligée.Discussion et conclusion : La DCR endoscopique endonasale est une technique physiologique et esthétique. Elle reste tout aussi efficace et fiable que la voie externe avec un taux de succès pratiquement  comparable (85% à 90%). Le succès d'une DCR par voie endoscopique endonasale est conditionné par une collaboration multidisciplinaire étroite(ORL/Ophtalmologistes/Radiologues), par une maitrise des impératifs techniques et enfin, par des soins postopératoires de qualité.Mots clés : dacryocystorhinostomie endoscopique, traitement

La prise en charge d’un goitre compressif chez une femme enceinte

Introduction: Les médecins d'urgence reçoivent fréquemment des patients atteints d'une pathologie de la thyroïde. Cependant, il est rare que ces troubles mettent la vie du patient en danger. La compression des voies aériennes supérieures due à une augmentation du volume d'une tumeur bénigne de la thyroïde et peut nécessiter un traitement chirurgical urgent.But: rappeler les modalités de prise en charge d'un goitre chez une femme enceinte.Observation: nous rapportons un cas d'une femme enceinte qui a été admise pour un goitre compressif avec dyspnée laryngée, qui exigeait une thyroïdectomie totale en urgence.Conclusion: La thyroïdectomie urgente chez la femme enceinte peut être réalisée si on respecte les précautions nécessaires.Mots clés: goitre, grossesse, thyroïdectomie.Introduction: emergency physicians frequently encounter patients with thyroid disease. However, it is unusual for these thyroid disorders to create acute, life-threatening situations. Critical airway compression attributable to benign thyroid enlargement may occur suddenly and require urgent treatement.Aim: we recall making procedures in charge of a goiter in pregnant women.Case -report : We report a case of pregnant women who was admitted for compressive goiter with laryngeal dyspnea, which required emergency total thyroidectomy.Conclusion: Urgent thyroidectomy in pregnant women can be performed if we respect the precautions.Keywords: goiter, pregnancy, thyroidectomy

eLearning resources to supplement postgraduate neurosurgery training.

BACKGROUND: In an increasingly complex and competitive professional environment, improving methods to educate neurosurgical residents is key to ensure high-quality patient care. Electronic (e)Learning resources promise interactive knowledge acquisition. We set out to give a comprehensive overview on available eLearning resources that aim to improve postgraduate neurosurgical training and review the available literature. MATERIAL AND METHODS: A MEDLINE query was performed, using the search term "electronic AND learning AND neurosurgery". Only peer-reviewed English-language articles on the use of any means of eLearning to improve theoretical knowledge in postgraduate neurosurgical training were included. Reference lists were crosschecked for further relevant articles. Captured parameters were the year, country of origin, method of eLearning reported, and type of article, as well as its conclusion. eLearning resources were additionally searched for using Google. RESULTS: Of n = 301 identified articles by the MEDLINE search, n = 43 articles were analysed in detail. Applying defined criteria, n = 28 articles were excluded and n = 15 included. Most articles were generated within this decade, with groups from the USA, the UK and India having a leadership role. The majority of articles reviewed existing eLearning resources, others reported on the concept, development and use of generated eLearning resources. There was no article that scientifically assessed the effectiveness of eLearning resources (against traditional learning methods) in terms of efficacy or costs. Only one article reported on satisfaction rates with an eLearning tool. All authors of articles dealing with eLearning and the use of new media in neurosurgery uniformly agreed on its great potential and increasing future use, but most also highlighted some weaknesses and possible dangers. CONCLUSION: This review found only a few articles dealing with the modern aspects of eLearning as an adjunct to postgraduate neurosurgery training. Comprehensive eLearning platforms offering didactic modules with clear learning objectives are rare. Two decades after the rise of eLearning in neurosurgery, some promising solutions are readily available, but the potential of eLearning has not yet been sufficiently exploited

Optimal constraint-based decision tree induction from itemset lattices

International audienceIn this article we show that there is a strong connection between decision tree learning and local pattern mining. This connection allows us to solve the computationally hard problem of finding optimal decision trees in a wide range of applications by post-processing a set of patterns: we use local patterns to construct a global model. We exploit the connection between constraints in pattern mining and constraints in decision tree induction to develop a framework for categorizing decision tree mining constraints. This framework allows us to determine which model constraints can be pushed deeply into the pattern mining process, and allows us to improve the state-of-the-art of optimal decision tree induction

Perceptions and Attitudes of Egyptian Health Professionals and Policy-Makers towards Pharmaceutical Sales Representatives and Other Promotional Activities

Pharmaceutical promotion activities in low and middle-income countries are often neither regulated nor monitored. While Egypt has the highest population and per capita use of medicines in the Arab world, we know very little about pharmaceutical companies promotional activities in the country.To explore and analyze the perceptions of physicians towards promotional and marketing activities of pharmaceutical companies among physicians and pharmacists in Egypt.Perspectives of different healthcare system stakeholders were explored through semi-structured, in-depth interviews conducted in 2014 in Cairo, Egypt. Interviewees were chosen via purposive sampling and snowball technique. Each interview was recorded and transcribed. Then qualitative, thematic analysis was conducted with the help of NVIVO software.The majority of physicians and pharmacists acknowledged exposure to pharmaceutical promotion. It was commonly believed that interaction with the pharmaceutical industry is necessary and both associated risks and benefits were acknowledged. The interviewed physicians considered themselves competent enough to minimize risks and maximize benefits to their prescribing habits. Views diverged on the extent and magnitude of the risks and benefits of pharmaceutical promotion, especially in regard to the influence on patients' health.Pharmaceutical promotion in Egypt is intensely directed at prescribers and dispensers. Physicians, pharmacists and policymakers expressed little skepticism to the influence of promotion towards their individual prescribing. Raising awareness of the pitfalls of pharmaceutical promotion is necessary, especially among the less experienced physicians

Altered Resting State in Diabetic Neuropathic Pain

BACKGROUND: The spontaneous component of neuropathic pain (NP) has not been explored sufficiently with neuroimaging techniques, given the difficulty to coax out the brain components that sustain background ongoing pain. Here, we address for the first time the correlates of this component in an fMRI study of a group of eight patients suffering from diabetic neuropathic pain and eight healthy control subjects. Specifically, we studied the functional connectivity that is associated with spontaneous neuropathic pain with spatial independent component analysis (sICA). PRINCIPAL FINDINGS: Functional connectivity analyses revealed a cortical network consisting of two anti-correlated patterns: one includes the left fusiform gyrus, the left lingual gyrus, the left inferior temporal gyrus, the right inferior occipital gyrus, the dorsal anterior cingulate cortex bilaterally, the pre and postcentral gyrus bilaterally, in which its activity is correlated negatively with pain and positively with the controls; the other includes the left precuneus, dorsolateral prefrontal, frontopolar cortex (both bilaterally), right superior frontal gyrus, left inferior frontal gyrus, thalami, both insulae, inferior parietal lobuli, right mammillary body, and a small area in the left brainstem, in which its activity is correlated positively with pain and negatively with the controls. Furthermore, a power spectra analyses revealed group differences in the frequency bands wherein the sICA signal was decomposed: patients' spectra are shifted towards higher frequencies. CONCLUSION: In conclusion, we have characterized here for the first time a functional network of brain areas that mark the spontaneous component of NP. Pain is the result of aberrant default mode functional connectivity

Socially learned attitude change is not reduced in medicated patients with schizophrenia

Schizophrenia is often associated with distinctive or odd social behaviours. Previous work suggests this could be due to a general reduction in conformity; however, this work only assessed the tendency to publicly agree with others, which may involve a number of different mechanisms. In this study, we specifically investigated whether patients display a reduced tendency to adopt other people’s opinions (socially learned attitude change). We administered a computerized conformity task, assumed to rely on reinforcement learning circuits, to 32 patients with schizophrenia or schizo-affective disorder and 39 matched controls. Each participant rated 153 faces for trustworthiness. After each rating, they were immediately shown the opinion of a group. After approximately 1 hour, participants were unexpectedly asked to rate all the faces again. We compared the degree of attitude change towards group opinion in patients and controls. Patients presented equal or more social influence on attitudes than controls. This effect may have been medication induced, as increased conformity was seen with higher antipsychotic dose. The results suggest that there is not a general decline in conformity in medicated patients with schizophrenia and that previous findings of reduced conformity are likely related to mechanisms other than reinforcement based social influence on attitudes

Discovery of novel targets for multi-epitope vaccines: Screening of HIV-1 genomes using association rule mining

© 2009 Paul and Piontkivska; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens