Traitement Chirurgical De L\'hyperparathyroidie Primaire : Techniques Et Resultats

L\'hyperparathyroïdie est secondaire à une sécrétion élevée de parathormone. Le diagnostic positif est biologique et le diagnostic de localisation est radiologique et isotopique. Le traitement chirurgical est la règle. Le but : de ce travail est d\'étudier notre stratégie thérapeutique en cas d\'hyperparathyroïdie primitive et ses résultats. Patients et méthodes : Nous avons mené une étude rétrospective à propos de 34 patients traités pour hyperparathyroïdie primitive durant la période entre 1992 et 2004. Résultats : L\'âge moyen de nos patients était de 51 ans avec une nette prédominance féminine. Notre stratégie chirurgicale était l\'exploration sous anesthésie générale des 4 glandes parathyroïdes. Les glandes pathologiques ont siégé au niveau des compartiments inférieurs dans la majorité des cas. Histologiquement l\'aspect adénomateux a été observé chez 26 patients. L\'examen extemporané était systématique. Son résultat était concordant avec l\'examen anatomopathologique final lui conférant une fiabilité de 100 %. L\'hypocalcémie post-opératoire immédiate a été rencontrée chez 11 patients. Elle était transitoire dans 8 cas. Un seul patient avait une hypercalcémie persistante conférant à notre stratégie chirurgicale un taux de succès de 97,15 %. Discussion : le risque d\'hypocalcémie immédiate varie dans la littérature de 3 à 50%. Dans notre série il était de 32,35%. Ceci est surtout expliqué par notre technique opératoire exposant les parathyroïdes à la dévascularisation. D\'autres techniques chirurgicales moins invasives ont été essayées visant à diminuer le risque d\'hypoparathroidie transitoire ou définitive. Elles sont basées sur un bilan localisateur performant actuellement surplombé par la scintigraphie au sestamibi.Primary hyperparathyroidism is secondary to an elevated secretion of parathormone. The positive diagnosis is biologic. The diagnosis of localization is radiological and isotopic. The surgical treatment is the rule. The aim : of this work is to study our therapeutic strategy in cases of primary hyperparathyroidism and its results. Patients and methods: We proceed to a retrospective study about 34 patients treated for primary hyperparathyroidism during the period between 1992 and 2004. Results: The middle age of our patients was of 51 years with a female predominance. Our surgical strategy was the exploration under general anaesthesia of the 4 parathyroid glands. The pathological glands were in the lower compartments in the majority of cases. Histologically, adenoma has been observed at 26 patients. Extemporary exam was systematic. Its result was in agreement to the final anatomopathological result conferring him a reliability of 100%. The immediate post-operative hypocalcaemia has been observed at 11 patients. It was transient in 8 cases. One alone patient had an obstinate hypercalcaemia conferring to our surgical strategy a rate of success of 97,15%. Discussion: the risk of immediate hypocalcaemia varies in the literature from 3 to 50%. In our study it was 32,35%. It is especially explained by our operative technique exhibitor parathyroïd to the devascularisation. Other operative techniques less invasiveness have been tried aiming to decrease the risk of transient or definitive hypoparathroidy. They are based currently on a effective exam of localization overhung by the scintigraphy to the sestamibi. Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 16 2006: pp. 8-1

Social suffering and the psychological impact of structural violence and economic oppression in an ongoing conflict setting: The Gaza Strip

Structural violence and economic oppression (e.g. control over resources, politically engineered poverty and unemployment) are common features of warfare, yet there is a lack of research exploring the impact this has on civilian wellbeing in conflict‐affected areas. This study, embedded within a human rights and community liberation psychology framework, aims to address this need by studying young Palestinian university graduates living under military blockade and occupation in the Gaza Strip. Semi‐structured interviews were conducted. Thematic analysis indicated that economic and political domains adversely affected multiple aspects of civilian life and wellbeing. The findings revealed the deleterious effects of structural violence and economic oppression which created: human insecurity; poor psychological wellbeing and quality of life; existential, psychological and social suffering; humiliation; injuries to dignity; multiple losses; and led to life being experienced as ‘on hold’. Local expressions and idioms to express distress were identified. The findings contributed to unique insights regarding how continual, systemic, and structural oppression can be potentially more psychologically detrimental than specific incidents of conflict and violence. The implications and the relevance of the findings to mental health and disaster relief are considered. Interventions providing human security and economic security should be prioritised

Parent and child agreement for acute stress disorder, post-traumatic stress disorder and other psychopathology in a prospective study of children and adolescents exposed to single-event trauma

Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined by structured interview in a prospective study of assault and motor vehicle accident (MVA) child survivors, assessed at 2-4 weeks and 6 months post-trauma. Children were significantly more likely to meet criteria for ASD, as well as other ASD and PTSD symptom clusters, based on their own report than on their parent's report. Parent-child agreement for ASD was poor (Cohen's κ = -.04), but fair for PTSD (Cohen's κ = .21). Agreement ranged widely for other emotional disorders (Cohen's κ = -.07-.64), with generalised anxiety disorder found to have superior parent-child agreement (when assessed by phi coefficients) relative to ASD and PTSD. The findings support the need to directly interview children and adolescents, particularly for the early screening of posttraumatic stress, and suggest that other anxiety disorders may have a clearer presentation post-trauma

Dynamic 3D shape of the plantar surface of the foot using coded structured light:a technical report

The foot provides a crucial contribution to the balance and stability of the musculoskeletal system, and accurate foot measurements are important in applications such as designing custom insoles/footwear. With better understanding of the dynamic behavior of the foot, dynamic foot reconstruction techniques are surfacing as useful ways to properly measure the shape of the foot. This paper presents a novel design and implementation of a structured-light prototype system providing dense three dimensional (3D) measurements of the foot in motion. The input to the system is a video sequence of a foot during a single step; the output is a 3D reconstruction of the plantar surface of the foot for each frame of the input. Methods Engineering and clinical tests were carried out to test the accuracy and repeatability of the system. Accuracy experiments involved imaging a planar surface from different orientations and elevations and measuring the fitting errors of the data to a plane. Repeatability experiments were done using reconstructions from 27 different subjects, where for each one both right and left feet were reconstructed in static and dynamic conditions over two different days. Results The static accuracy of the system was found to be 0.3 mm with planar test objects. In tests with real feet, the system proved repeatable, with reconstruction differences between trials one week apart averaging 2.4 mm (static case) and 2.8 mm (dynamic case). Conclusion The results obtained in the experiments show positive accuracy and repeatability results when compared to current literature. The design also shows to be superior to the systems available in the literature in several factors. Further studies need to be done to quantify the reliability of the system in clinical environment

Time-Fractional Optimal Control of Initial Value Problems on Time Scales

We investigate Optimal Control Problems (OCP) for fractional systems involving fractional-time derivatives on time scales. The fractional-time derivatives and integrals are considered, on time scales, in the Riemann--Liouville sense. By using the Banach fixed point theorem, sufficient conditions for existence and uniqueness of solution to initial value problems described by fractional order differential equations on time scales are known. Here we consider a fractional OCP with a performance index given as a delta-integral function of both state and control variables, with time evolving on an arbitrarily given time scale. Interpreting the Euler--Lagrange first order optimality condition with an adjoint problem, defined by means of right Riemann--Liouville fractional delta derivatives, we obtain an optimality system for the considered fractional OCP. For that, we first prove new fractional integration by parts formulas on time scales.Comment: This is a preprint of a paper accepted for publication as a book chapter with Springer International Publishing AG. Submitted 23/Jan/2019; revised 27-March-2019; accepted 12-April-2019. arXiv admin note: substantial text overlap with arXiv:1508.0075

Bullets over ballots: Islamist groups, the state and electoral violence in Egypt and Morocco

This article is concerned with state-sponsored electoral violence in liberalized autocracies. The first section of the paper identifies a number of variables that can help explain the decision calculus of authoritarian incumbents to deploy force against strong electoral challengers. The second section then examines these propositions with reference to Egypt and Morocco. Drawing on recent parliamentary elections in both countries the article questions why, despite facing the challenge of political Islam, the two regimes differed so markedly in their willingness to manipulate the polls by recourse to violence. Whilst the Egyptian authorities decided to abrogate all pretence of peaceful elections in favour of violent repression against the Muslim Brotherhood candidates and sympathizers, no such tactics were deployed by the ruling elite in Morocco. We suggest that three principal factors influenced the regimes' response to this electoral challenge: (1) the centrality of the elected institution to authoritarian survival; (2) the availability of alternative electioneering tools; and (3) the anticipated response of the international community. The article concludes by suggesting that in order to understand better when and how states deploy violence in elections, we need to focus on a more complex set of factors rather than simply on the electoral potency of key opposition challengers or the authoritarian nature of the state

Identification of Fluorescent Compounds with Non-Specific Binding Property via High Throughput Live Cell Microscopy

10.1371/journal.pone.0028802PLoS ONE71

Effects of vitamin E supplementation on renal non-enzymatic antioxidants in young rats submitted to exhaustive exercise stress

<p>Abstract</p> <p>Background</p> <p>Exercise stress was shown to increase oxidative stress in rats. It lacks reports of increased protection afforded by dietary antioxidant supplements against ROS production during exercise stress. We evaluated the effects of vitamin E supplementation on renal non-enzymatic antioxidants in young rats submitted to exhaustive exercise stress.</p> <p>Methods</p> <p>Wistar rats were divided into three groups: 1) control group; 2) exercise stress group and; 3) exercise stress + Vitamin E group. Rats from the group 3 were treated with gavage administration of 1 mL of Vitamin E (5 mg/kg) for seven consecutive days. Animals from groups 2 and 3 were submitted to a bout of swimming exhaustive exercise stress. Kidney samples were analyzed for Thiobarbituric Acid Reactive Substances to (TBARS) by malondialdehyde (MDA), reduced glutathione (GSH) and vitamin-E levels.</p> <p>Results</p> <p>The group treated with vitamin E and submitted to exercise stress presented the lowest levels of renal MDA (1: 0.16+0.02 mmmol/mgprot vs. 2: 0.34+0.07 mmmol/mgprot vs. 3: 0.1+0.01 mmmol/mgprot; p < 0.0001), the highest levels of renal GSH (1: 23+4 μmol/gprot vs. 2: 23+2 μmol/gprot vs. 3: 58+9 μmol/gprot; p < 0.0001) and the highest levels of renal vitamin E (1: 24+6 μM/gtissue vs. 2: 28+2 μM/gtissue vs. 3: 43+4 μM/gtissue; p < 0.001).</p> <p>Conclusion</p> <p>Vitamin E supplementation improved non-enzymatic antioxidant activity in young rats submitted to exhaustive exercise stress.</p