Lymphome t/nk primitif du larynx : localisation inhabituelle de lymphome extranodal

Nous rapportons un cas de lymphome extranodal T/Nk primitif du larynx. il s’agit d’un patient âgé de 22 ans qui s’était présenté pour une dysphonie chronique associée à une dyspnée inspiratoire. une chimiothérapie protocole SMiLE avec radiothérapie ont été institués avec obtention d’une rémission complète. Huit mois plus tard, le patient présentait une récidive de la tumeur avec un oedème palpébral et une obstruction du canal lacrymonasal. L’évolution a été fatale suite à une aspergillose invasive en cours de chimiothérapie.Mots clés : lymphome, larynx.A rare case of primary laryngeal T/Nk- cell lymphoma, nasal type is reported. The patient was 22-year old male who presented with dysphonia, dyspnea. Chemotherapy protocol SMiLE and radiotherapy were instituted with complete remission of the tumor. Eight months afterward, he presented with tumor recurrence, palpebral edema, obstruction of the lacrymonasal duct. He died within few days with invasive aspergillosis while he was receiving chemotherapy SMiLE regimen.Keyswords : lymphoma, larynx

Longitudinal investigation of training status and cardiopulmonary responses in pre- and early-pubertal children

PurposeThe presence of a maturational threshold that modulates children’s physiological responses to exercise training continues to be debated, not least due to a lack of longitudinal evidence to address this question. The purpose of this study was to investigate the interaction between swim-training status and maturity in nineteen trained (T, 10 ± 1 years, −2.4 ± 1.9 years pre-peak height velocity, 8 boys) and fifteen untrained (UT, 10 ± 1 years, −2.3 ± 0.9 years pre-peak height velocity, 5 boys) children, at three annual measurements.MethodsIn addition to pulmonary gas exchange measurements, stroke volume (SV) and cardiac output ( Q˙) were estimated by thoracic bioelectrical impedance during incremental ramp exercise.ResultsAt baseline and both subsequent measurement points, trained children had significantly (P < 0.05) higher peak oxygen uptake (year 1 T 1.75 ± 0.34 vs. UT 1.49 ± 0.22; year 2 T 2.01 ± 0.31 vs. UT 1.65 ± 0.08; year 3 T 2.07 ± 0.30 vs. UT 1.77 ± 0.16 l min−1) and Q˙ (year 1 T 15.0 ± 2.9 vs. UT 13.2 ± 2.2; year 2 T 16.1 ± 2.8 vs. UT 13.8 ± 2.9; year 3 T 19.3 ± 4.4 vs. UT 16.0 ± 2.7 l min−1). Furthermore, the SV response pattern differed significantly with training status, demonstrating the conventional plateau in UT but a progressive increase in T. Multilevel modelling revealed that none of the measured pulmonary or cardiovascular parameters interacted with maturational status, and the magnitude of the difference between T and UT was similar, irrespective of maturational status.ConclusionThe results of this novel longitudinal study challenge the notion that differences in training status in young people are only evident once a maturational threshold has been exceeded

Impact of COVID-19 pandemic on cardiovascular testing in Asia: the IAEA INCAPS-COVID study

BACKGROUND The coronavirus disease-2019 (COVID-19) pandemic significantly affected management of cardiovascular disease around the world. The effect of the pandemic on volume of cardiovascular diagnostic procedures is not known. OBJECTIVES This study sought to evaluate the effects of the early phase of the COVID-19 pandemic on cardiovascular diagnostic procedures and safety practices in Asia. METHODS The International Atomic Energy Agency conducted a worldwide survey to assess changes in cardiovascular procedure volume and safety practices caused by COVID-19. Testing volumes were reported for March 2020 and April 2020 and were compared to those from March 2019. Data from 180 centers across 33 Asian countries were grouped into 4 subregions for comparison. RESULTS Procedure volumes decreased by 47% from March 2019 to March 2020, showing recovery from March 2020 to April 2020 in Eastern Asia, particularly in China. The majority of centers cancelled outpatient activities and increased time per study. Practice changes included implementing physical distancing and restricting visitors. Although COVID testing was not commonly performed, it was conducted in one-third of facilities in Eastern Asia. The most severe reductions in procedure volumes were observed in lower-income countries, where volumes decreased 81% from March 2019 to April 2020. CONCLUSIONS The COVID-19 pandemic in Asia caused significant reductions in cardiovascular diagnostic procedures, particularly in low-income countries. Further studies on effects of COVID-19 on cardiovascular outcomes and changes in care delivery are warranted

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

TAILORED MOBILE PHONE APP PROMOTING DAILY PHYSICAL ACTIVITY: A RANDOMIZED TRIAL

International audienceBackground/Objective: Do adults better adhere to daily physical activity when they were provided a personalized program an App delivered compared to single pedometer feedback? An experimental study including randomized parallel group with or without the personalized program aimed at assessing the effect of a PA App designed to enhance daily physical activity in healthy adults. Methods: The participants were 30 adults (12 men and 18 women), aged between 35 and 60 years (45.33 ± 7.6). They were randomly assigned to a control group (CG, N=15), or to an experimental group (EG, N=15). Participants from the EG received their program from an app linked to a web-platform and benefited from daily walking step-count feedback, individually adapted goals per week, behavioral advices and health information. Participants from the CG only benefited of daily walking step-count on their smartphones. Results: The primary outcomes measures were number of walking steps per week; they were collected at baseline, week 6 and week 12. The secondary outcome was adherence based on the number of weeks the participants connected their smartphone to the web-platform. Non-parametric statistics indicated that (i) the EG maintained their adherence to the program more than the CG and (ii) the number of steps walked by participants from the EG increased significantly. Conclusion: Adults adhere better to daily physical activity when they benefit from a personalized program an app delivered

TAILORED MOBILE PHONE APP PROMOTING DAILY PHYSICAL ACTIVITY: A RANDOMIZED TRIAL

Background/Objective: Do adults better adhere to daily physical activity when they were provided a personalized program an App delivered compared to single pedometer feedback?  An experimental study including randomized parallel group with or without the personalized program aimed at assessing the effect of a PA App designed to enhance daily physical activity in healthy adults.&#x0D; Methods: The participants were 30 adults (12 men and 18 women), aged between 35 and 60 years (45.33 ± 7.6). They were randomly assigned to a control group (CG, N=15), or to an experimental group (EG, N=15). Participants from the EG received their program from an app linked to a web-platform and benefited from daily walking step-count feedback, individually adapted goals per week, behavioral advices and health information. Participants from the CG only benefited of daily walking step-count on their smartphones.&#x0D; Results: The primary outcomes measures were number of walking steps per week; they were collected at baseline, week 6 and week 12. The secondary outcome was adherence based on the number of weeks the participants connected their smartphone to the web-platform.&#x0D; Non-parametric statistics indicated that (i) the EG maintained their adherence to the program more than the CG and (ii) the number of steps walked by participants from the EG increased significantly.&#x0D; Conclusion: Adults adhere better to daily physical activity when they benefit from a personalized program an app delivered.</jats:p

A Multi-Objective Approach for Optimizing Virtual Machine Placement Using ILP and Tabu Search

Efficient Virtual Machine (VM) placement is a critical challenge in optimizing resource utilization in cloud data centers. This paper explores both exact and approximate methods to address this problem. We begin by presenting an exact solution based on a Multi-Objective Integer Linear Programming (MOILP) model, which provides an optimal VM Placement (VMP) strategy. Given the NP-completeness of the MOILP model when handling large-scale problems, we then propose an approximate solution using a Tabu Search (TS) algorithm. The TS algorithm is designed as a practical alternative for addressing these complex scenarios. A key innovation of our approach is the simultaneous optimization of three performance metrics: the number of accepted VMs, resource wastage, and power consumption. To the best of our knowledge, this is the first application of a TS algorithm in the context of VMP. Furthermore, these three performance metrics are jointly optimized to ensure operational efficiency (OPEF) and minimal operational expenditure (OPEX). We rigorously evaluate the performance of the TS algorithm through extensive simulation scenarios and compare its results with those of the MOILP model, enabling us to assess the quality of the approximate solution relative to the optimal one. Additionally, we benchmark our approach against existing methods in the literature to emphasize its advantages. Our findings demonstrate that the TS algorithm strikes an effective balance between efficiency and practicality, making it a robust solution for VMP in cloud environments. The TS algorithm outperforms the other algorithms considered in the simulations, achieving a gain of 2% to 32% in OPEF, with a worst-case increase of up to 6% in OPEX