Hypocalcémie post-thyroïdectomie

Introduction : L’hypocalcémie est la complication la plus préoccupante de la thyroïdectomie totale. Elle impose un traitement substitutif et un suivi à vie. Objectifs : Le but de cette étude est d’évaluer l’incidence de l’hypocalcémie après chirurgie et d’étudier sa corrélation avec les caractéristiques cliniques, biologiques et le type de chirurgie pratiqué. Matériels et méthodes : Etude rétrospective portant sur 488 cas de thyroïdectomies, opérées entre 1992 et 1996. L’hypocalcémie est définie par une calcémie inférieure à 80 mg/l «2 mmol/l ». Les patients, toujours dépendants d’un traitement substitutif un an après la chirurgie, ont été considérés comme ayant une hypocalcémie définitive. Résultats : Dans notre étude, 368 patients ont eu une thyroïdectomie totale et 120 ont eu une thyroïdectomie subtotale. Le goitre multinodulaire était la pathologie la plus fréquente, noté dans 359 cas, suivie des cancers thyroïdiens noté dans 83 cas. L’hypocalcémie postopératoire a été retrouvée chez 54 patients (11,06%) dont 25 étaient asymptomatique. Cette hypocalcémie s’est révélée définitive chez 14 d’entre eux (2,8%). Nous n’avons pas trouvé de corrélation statistiquement significative entre l’hypoparathyroïdie définitive et les caractéristiques cliniques biologiques et le type de chirurgie.Conclusion : Dans la plupart des cas, l’hypocalcémie est liée à un hypoparathyroïdisme transitoire, secondaire au traumatisme ou à la dévascularisation des parathyroïdes. L’hypoparathyroïdie définitive est rare, elle est toujours secondaire à une lésion irréversible des parathyroïdes. Les caractéristiques cliniques initiales des patients et les examens biologiques précoces ne permettent pas de prédire l’évolution.Mots-clés : Thyroïde, chirurgie, hypocalcémie, parathyroïde

Recidive tardive d'un sarcome a cellule claire

Introduction : The clear cell sarcoma (melanoma of soft tissue) is a rare tumor of young adults. Hi occur most commonly in the extremities. We report the case of a man of 70 years, with previous history of a malignant melanoma of the cervical trachea treated by radiotherapy, who present 18 years after Tracheo-esophageal tumor. The tumor was totally removed.Final pathologic diagnosis is a recurrence of his sarcoma cell clear. Three years later, the patient has no signs of recurrence. The aim of this work is to study the clinical features, the prognosis of these cancers and the modality of her treatments.Keywords: the clear cell sarcoma, melanoma of soft tissue, radiotherapy, surgery

A highly efficient green synthesis of 1, 8-dioxo-octahydroxanthenes

SmCl3 (20 mol%) has been used as an efficient catalyst for reaction between aromatic aldehydes and 5,5-dimethyl-1,3-cyclohexanedione at 120°C to give 1,8-dioxo-octahydroxanthene derivatives in high yield. The same reaction in water, at room temperature gave only the open chain analogue of 1,8-dioxo-octahydroxanthene. Use of eco-friendly green Lewis acid, readily available catalyst and easy isolation of the product makes this a convenient method for the synthesis of either of the products

Cross-national variations in reported discrimination among people treated for major depression worldwide: The ASPEN/INDIGO international study

Background: No study has so far explored differences in discrimination reported by people with major depressive disorder (MDD) across countries and cultures. Aims: To (a) compare reported discrimination across different countries, and (b) explore the relative weight of individual and contextual factors in explaining levels of reported discrimination in people with MDD. Method: Cross-sectional multisite international survey (34 countries worldwide) of 1082 people with MDD. Experienced and anticipated discrimination were assessed by the Discrimination and Stigma Scale (DISC). Countries were classified according to their rating on the Human Development Index (HDI). Multilevel negative binomial and Poisson models were used. Results: People living in 'very high HDI' countries reported higher discrimination than those in 'medium/low HDI' countries. Variation in reported discrimination across countries was only partially explained by individual-level variables. The contribution of country-level variables was significant for anticipated discrimination only. Conclusions: Contextual factors play an important role in anticipated discrimination. Country-specific interventions should be implemented to prevent discrimination towards people with MDD

Grand Challenges in global eye health: a global prioritisation process using Delphi method

Background: We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods: Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings: Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation: This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges. Funding: The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission. Translations: For the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section

Grand Challenges in global eye health: a global prioritisation process using Delphi method

Background We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenge

Effect of Al2O3 decoration on the opto-electrical properties of a porous Si/Cr2O3 composite

In this work, we present an extensive investigation of the effect of Al₂O₃ decoration on the morphological, structural and opto-electronic properties of a porous Si (Sip)/Cr₂O₃ composite. The Sip layers were prepared by the anodization method. Al₂O₃ and Cr₂O₃ thin films were deposited by physical vapour deposition. The morphological and micro-structural properties of Sip/Cr₂O₃/Al₂O₃ were studied using the scanning electron microscope, energy dispersive X-ray spectroscopy and X-ray diffraction techniques. It was found that Al₂O₃ decoration with different concentration strongly affects the Sip/Cr₂O₃ microstructure mainly at the level of porosity. Variable angle spectroscopic ellipsometry demonstrates a strong correlation between optical constants (n and k) of Sip/Cr₂O₃/Al₂O₃ and microstructure properties. Dielectric properties of Sip/Cr₂O₃/Al₂O₃ such as electrical conductivity and conduction mechanism were explored using impedance spectroscopy over the temperature interval ranging from 340 to 410°C. A semiconductor to the metallic transition has been observed at high frequency

Several Aspects of Information Flows in PLM

Part 1: Knowledge ManagementInternational audienceThere are lots of activities in the product lifecycle, which are grouped into three main phases: beginning of life (BOL), middle of life (MOL), and end of life (EOL). Thanks to recent emerging technologies, information flows of whole product lifecycle can be visible and controllable. The PLM under this environment allows all actors of the whole product lifecycle to access, manage, and control information flows. These flows can be used to streamline several operations of BOL, MOL and EOL. In order to recognize the benefit of these information flows, first of all, it is necessary to comprehend them in detail. For this purpose, this study will deal with several aspects of information flows in PLM. It will clarify the concept of information flows and identify which product lifecycle information are required for streamlining lifecycle operations, and classify them into several types depending on their characteristics

Angiomyxome agressif de la joue : a propos d’une observation

L’angiomyxome agressif est une tumeur mésenchymateuse développée aux dépens du tissu conjonctif avec un site de prédilection pour les parties molles du périné féminin. Cette tumeur croit progressivement mais n’est pas métastatique. Le traitement indiqué actuellement est l’exérèse chirurgicale large sans conséquences fonctionnelles lourdes. La tumeur a une tendance à la récidive locale, qui est fréquente, liée à la difficulté d’une exérèse initiale complète. Les auteurs rapportent ici le cas d’un angiomyxome agressif de la joue, qui a été traité par chirurgie et chimiothérapie. Les aspects cliniques, histologiques et thérapeutiques de la tumeur ont été discutés.Mots-clés : L’angiomyxome agressif, tumeur mésenchymateuse, exérèse, récidive