Réhabilitation précoce post césarienne: enquête de pratique auprès des maternités de la région de Sfax en Tunisie

Introduction: Bien que la plupart des principes de réhabilitation précoce post césarienne paraissent applicable dans nos structures de soins, il semble que la mise en oeuvre reste limitée. Méthodes: Il s'agit d'une enquête structurée par courrier électronique auprès des médecins anesthésistes de la région de Sfax décrivant leurs pratiques habituelles dans les maternités étatiques et privées de la région de Sfax. Nous avons utilisé un questionnaire dans le cadre de prise en charge de la césarienne programmée. Résultats: Le taux de réponse des médecins était de 68% (30/44). L'analgésie orale a été débutée au cours des 24 premières heures par 13% des anesthésistes. La perfusion post opératoire a été arrêtée avant 24h dans 27% des cas. Le Retrait de la sonde < H6, la reprise des boissons < H6, la reprise de l'alimentation < H12 ont été observé respectivement dans 57%, 63% et 30% des cas. L'emploi d'ocytocine limité à H6 est la conduite de 60% des médecins interrogés. La carbétocine est encore non utilisée. Conclusion: Les différents composants de la réhabilitation précoce post césarienne sont encore insuffisamment mis en oeuvre.Pan African Medical Journal 2016; 2

Paravalvular Leaks: From Diagnosis to Management

Paravalvular leaks (PVLs) are complications of a surgical or percutaneous valve replacement. They are persistent defects between the native annulus and the sewing ring, which result in a regurgitant prosthesis. They are observed in 2–18% of patients after a surgical valve replacement (SVR) and in 7–40% after a transcatheter aortic valve replacement (TAVR). Clinical manifestations are heart failure and hemolysis. They develop in 1–5% of PVL patients, and they have a poor prognosis. Surgery was the only available treatment to improve the patient’s outcome. But it is a high-risk surgery in frail patients and PVL relapse is not rare. Percutaneous PVL closure has emerged as a promising technique. Nevertheless, it needs a careful assessment, demands high technical expertise, and still has limitations. This chapter focuses on the diagnosis of PVL after a SVR and transcatheter PVL closure (TPVL)

The etiology of neuromuscular fatigue induced by the 5-m shuttle run test in adult soccer players

This study investigated the etiology of neuromuscular fatigue induced by a 5-m shuttle run test (5MSRT) in soccer players. Nineteen adult male amateur soccer players (age: 20.0 ± 2.9 years) participated in the present study. Before and after the 5MSRT, they were instructed to complete a maximal voluntary isometric contraction (MVIC) of the knee extensors (KE) during and after which two electrical stimulations were applied at the femoral nerve. Voluntary activation level (VAL), surface electromyography recordings (sEMG), electrophysiological (Mmax) and potentiated resting twitch (Ptw) responses of the KE were compared between pre- and post-5MSRT. Rating of perception exertion (RPE) was also assessed before, during the test immediately following each sprint repetition and after the test. The distance covered during each sprint significantly decreased as the number of trials performed increased (p<.05). The RPE reported following each sprint significantly increased throughout the test. In addition, MVIC (-9%), sEMG (-23%), VAL (-15%), Ptw (-26%) and Mmax (~22%) of the KE were lowered from pre-to-post 5MSRT (.001 < p < .01). The 5MSRT induced a decrease of repeated-sprint running performance and MVIC of the KE. These decrements were accompanied by lowered VAL, sEMG, Ptw and Mmax values of the KE reflecting the involvement of both the central and peripheral origins in the 5MSRT-induced fatigue. Given the important muscle stress induced by 5MSRT, this strenuous test must be applied with caution, after an inevitable familiarization phase, and not during the competition period to avoid the risk of serious injury

An ontology-based monitoring system for multi-source environmental observations

Multi-source observed data are generally characterized by their syntactic, structural and semantic heterogeneities. A key challenge is the semantic interoperability of these data. In this context, we propose an ontology-based system that supports environmental monitoring. Our contributions could be resumed around 1) the construction of an ontology which allows to represent the knowledge and reuse it in a real-world way, 2) the guarantee of the semantic interoperability of ontological modules since the proposed ontology is based on the upper level ontology Basic Formal Ontology (BFO) 3) the modularity of the proposed ontology in order to facilitate its reuse and evolution. The proposed ontology has been implemented and evaluated using quality metrics. We also present a real use case study that demonstrates how the proposed ontology allows implicit knowledge generation