4,934 research outputs found
Trends in Secondary Prevention of Coronary Heart Disease in Tunisia: Prevention of Recurrences of MI and Stroke
ObjectivesThe survival benefits achieved by prescription of antiplatelet agents, B-adrenoreceptor antagonists (beta-blockers), angiotensin II receptor blockers (ARB), and lipid lowering agents in patients surviving the myocardial infarction (MI) have been well documented in large clinical trial. Despite well-established benefits, these pharmacological agents continue to be underutilized. The main objective of this study was to evaluate the progress of cardiovascular secondary prevention practices in Tunisia.MethodsThe PREMISE (Prevention of Recurrence of Myocardial Infarction and Stroke) is a descriptive, cross-sectional study conducted in Tunisia in two phases (2002 and 2009). Seven hundred eighty two patients were recruited. The recruitment criteria were: previous MI, stable angina, unstable angina, percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG), stroke, transient ischemic attack (TIA) or carotid endarterectomy. This analysis is limited to coronary heart disease (CHD) patients. Five hundred hospital patients were interviewed and their medical records were reviewed: 250 in 2002 and 250 in 2009. Patients were included if they had confirmed diagnosis of MI, angina, CABG or PTCA, and if their first cardiovascular event had occurred more than one month but not later than 3 years ago. We compared the total of both patient groups, using the prevalence of Cardio-Vascular Risk Factors (CVRF) and the treatment prescribed at hospital discharge.ResultsThe proportion of patients with reported hypertension, diabetes, hypercholesterolemia and current smoker patients had decreased. Concerning pharmacological prescriptions, a significant increase was observed in prescribing statins (38.9% vs. 70.3%) and ACE inhibitors (49.3% vs. 69.9%), non pharmacological prescriptions as healthy diet or tobacco cessation had opposite trends. Adherence to treatment did not change substantially.ConclusionAlthough the use of cardioprotective drugs had increased in CHD patients, there are still gaps in secondary prevention in Tunisia. The recommended strategies of secondary prevention need to be applied more intensively in clinical practice
Insights into Hydration Dynamics and Cooperative Interactions in Glycerol-Water Mixtures by Terahertz Dielectric Spectroscopy.
We report relaxation dynamics of glycerol-water mixtures as probed by megahertz-to-terahertz dielectric spectroscopy in a frequency range from 50 MHz to 0.5 THz at room temperature. The dielectric relaxation spectra reveal several polarization processes at the molecular level with different time constants and dielectric strengths, providing an understanding of the hydrogen-bonding network in glycerol-water mixtures. We have determined the structure of hydration shells around glycerol molecules and the dynamics of bound water as a function of glycerol concentration in solutions using the Debye relaxation model. The experimental results show the existence of a critical glycerol concentration of âŒ7.5 mol %, which is related to the number of water molecules in the hydration layer around a glycerol molecule. At higher glycerol concentrations, water molecules dispersed in a glycerol network become abundant and eventually dominate, and four distinct relaxation processes emerge in the mixtures. The relaxation dynamics and hydration structure in glycerol-water mixtures are further probed with molecular dynamics simulations, which confirm the physical picture revealed by the dielectric spectroscopy
Le traitement de la tuberculose ganglionnaire cervicale a propos de 361 cas
Introduction : La tuberculose ganglionnaire cervicale reprĂ©sente la localisation extra pulmonaire la plus frĂ©quemment observĂ©e. Cependant, le traitement dâune affection aussi rĂ©pandue dans le monde ne fait pas consensus. Lâobjectif de cette Ă©tude est de prĂ©ciser, Ă travers une revue de la littĂ©rature, les diffĂ©rents moyens de traitement antituberculeux et de discuter en particulier la place de la chirurgie dans le traitement de la tuberculose ganglionnaire cervicale.Patients et mĂ©thodes : Ă©tude rĂ©trospective portant sur 361 malades atteints de tuberculose ganglionnaire cervicale colligĂ©s au service dâORL et de CCf de lâhĂŽpital farhat Hached de Sousse sur une pĂ©riode de 30 ans (Janvier 1982- dĂ©cembre 2011)RĂ©sultats : LâĂąge moyen de nos patients Ă©tait de 29 ans avec une prĂ©dominance fĂ©minine. Le traitement chirurgical a concernĂ© 96,4% des malades. LâĂ©volution Ă©tait bonne pour 77,2% des malades. une rĂ©sistance et une rĂ©cidive ont Ă©tĂ©Â constatĂ©es chacune dans 4,4% des cas.Conclusion : le traitement de la tuberculose ganglionnaire cervicale reste avant tout mĂ©dical. Cependant, la chirurgie garde toujours une place prĂ©pondĂ©rante dans un but diagnostique et en cas dâĂ©chec du traitement mĂ©dical. La durĂ©e de la chimiothĂ©rapie antituberculeuse est encore sujet de controverse.Mots clĂ©s : tuberculose ganglionnaire, adĂ©nopathie cervicale, antituberculeux, chirurgie.Objective : Lymph node infection is the most frequent localization of extrapulmonary tuberculosis. The treatment does not make general agreement. The aim of this study is to specify, from a review of the literature, the different ways of antimicrobial treatment and the indications of surgery.Patients and methods : A retrospective study concerning 361 patients hospitalized for cervical lymph node tuberculosis in the department of Otolaryngology-Head and Neck surgery of the hospial of farhat Hached of Sousse over a period of 30 years (from January 1982 to december 2011)Results : the mean age of our patients is of 29 years. A female predominance was noted. Surgical treatment has interested 96, 4% of patients. The course of the disease was favorable for 77,2% of patients. Lymph node recurrence and failure of treatment was observed in 4,4% of cases, each.Conclusion: Treatment of lymph node tuberculosis is above all medical. Surgery retains an important place in the diagnosis of cervical lymph node tuberculosis and in case of failure of the medical treatment. No reliable published data was found as to the optimal duration of treatment.Keyswords : lymph node tuberculosis, cervical lymphadenopathy, anti tuberculosis drug, surgery
Lâesthesioneuroblastome olfactif : a propos de 7
Introduction : LâesthĂ©sioneuroblastome est une tumeur maligne rare dĂ©veloppĂ©e aux dĂ©pens du neuro-Ă©pithĂ©lium olfactif. Câest lâune des plus rares tumeurs des fosses nasales. Lâobjectif de ce travail est dâĂ©tudier Ă travers une revue de la littĂ©rature, les caractĂ©ristiques histocliniques, les modalitĂ©s thĂ©rapeutiques et les facteurs pronostiques de cette tumeur.MatĂ©riel et mĂ©thodes : Etude rĂ©trospective Ă propos de sept cas dâesthĂ©sioneuroblastome olfactif traitĂ©s dans le service dâORL et de CCF de lâhĂŽpital Farhat Hached de Sousse sur une pĂ©riode de 26 ans.RĂ©sultats : LâĂąge moyen de nos patients Ă©tait de 36 ans avec une prĂ©dominance fĂ©minine. La symptomatologie clinique Ă©tait dominĂ©e par lâobstruction nasale et lâĂ©pistaxis. Cinq patients Ă©taient classĂ©s stade B de Kadish, et 2 stade C. Six patients ont eu un traitement chirurgical dont cinq ont eu une radiothĂ©rapie post opĂ©ratoire. Une patiente avait une importante extension locorĂ©gionale et Ă©tait au dessus de tout traitement Ă visĂ©e curative. Trois malades sont en rĂ©mission complĂšte avec un recul moyen de 6 ans. Trois malades ont prĂ©sentĂ© une rĂ©cidive tumorale.Conclusion : LâesthĂ©sioneuroblastome olfactif est une tumeur naso-sinusienne maligne rare, caractĂ©risĂ©e par son polymorphisme clinique et son agressivitĂ© locale. MalgrĂ© la chirurgie et la radiothĂ©rapie, le pronostic reste rĂ©servĂ© Ă long terme.Mots clĂ©s : EsthĂ©sioneuroblastome olfactif - Imagerie- Immunohistochimie- Chirurgie -RadiothĂ©rapieIntroduction: Introduction: Esthesioneuroblastoma is a rare malignant tumor, which develops from olfactory neuroepithelium and is one of the rarest tumors of the nasal cavity. The aim of this study is to specify through a review of the literature, histoclinic characteristics, therapeutic terms and prognostic factors of this tumor.Material and methods: a retrospective study concerning seven cases of olfactory neuroblastoma treated in the department of otolaryngology- Head and Neck surgery at Farhat Hached Hospital Sousse over a period of 26 years.Results: The mean age of our patients was 36 years. A female predominance was noted. Clinical symptomatology was dominated by nasal obstruction and epistaxis. Five patients were classified as Kadish B and 2 patients as Kadish C. Six patients underwent surgicaltreatment, five of them had postoperative radiotherapy. One patient was above all therapeutic resources. 3 patients are in complete remission with a mean follow-up of 6 years. Recurrence was observed for the remaining patients.Conclusion: olfactory esthesioneuroblastoma is a rare sinonasal malignant tumor, characterised by clinical polymorphism and local agressivity. In spite of the surgery and the radiotherapy, the forecast remains reserved in the long term.Key words: Olfactory neuroblastoma â Imagery â Immunohistochemestry â Surgery - Radiotherap
Resultats du traitement chirurgical de lâotospongiose notre experience a propos de 310 cas
Introduction : Le traitement de lâotospongiose est chirurgical. Plusieurs facteurs peuvent intervenir dans lâindication opĂ©ratoire ou influencer les rĂ©sultats fonctionnels. Lâobjectif de notre Ă©tude est dâĂ©valuer nos rĂ©sultats audiomĂ©triques et dâĂ©tudier les facteurs prĂ©dictifs de lâĂ©chec fonctionnel. MatĂ©riel et mĂ©thodes : Il sâagit dâune Ă©tude rĂ©trospective Ă propos de 310 oreilles opĂ©rĂ©es pour otospongiose, sur une pĂ©riode de 21 ans (1985-2005). On a effectuĂ© une analyse des rĂ©sultats audiomĂ©triques Ă partir des audiogrammes postopĂ©ratoires faits Ă 3 mois, Ă 1an et au dernier contrĂŽle. Nous avons ensuite Ă©tudiĂ© 8 facteurs pouvant ĂȘtre prĂ©dictifs de lâĂ©chec fonctionnel. Ce dernier Ă©tait dĂ©fini par un Rinne rĂ©siduel post-opĂ©ratoire (RRPO) > 10 dB.RĂ©sultats : Le RRPO Ă©tait en moyenne de 7,9 dB avec des extrĂȘmes de 5 dB Ă 33 dB. La fermeture du Rinne a Ă©tĂ© obtenue dans 87,3% des cas. AprĂšs Ă©tude multivariĂ©e avec rĂ©gression logistique, nous avons retenu 2 facteurs indĂ©pendants significativement prĂ©dictifs de lâĂ©chec fonctionnel : un stade audiomĂ©trique III ou IV dâAubry (OR : 19,06/p : 0,0001) et un Rinne post-opĂ©ratoire prĂ©coce supĂ©rieur Ă 35 dB (OR : 4 ,01/p : 0,0025). Conclusion : Une audiomĂ©trie post-opĂ©ratoire prĂ©coce serait intĂ©ressante pour dĂ©pister prĂ©cocement un Ă©chec chirurgical dâune part et pour prĂ©juger du rĂ©sultat fonctionnel dĂ©finitif dâautre part. Un stade audiomĂ©trique III ou IV dâ Aubry, prĂ©dictif certes dâun moins bon rĂ©sultat fonctionnel, ne contre-indique pas la chirurgie qui permettra entre autres une meilleure adaptation audio- prothĂ©tique.Mots-clĂ©s : otospongiose - chirurgie - rĂ©sultats â facteurs prĂ©dictif
Velocity Dependence Of One- And Two-electron Processes In Intermediate-velocity Ar16++He Collisions
We report investigations of one- and two-electron processes in the collisions of 0.9-keV/u to 60-keV/u (vp=0.19-1.55 a.u.) Ar16+ ions with He targets. The cross sections for these processes were measured by observing the final charges of the Ar ions and the recoiling target ions in coincidence. The average Q values for the capture channels were determined by measuring the longitudinal momenta of the recoiling target ions. Single capture (SC) is the dominant process and is relatively independent of the projectile energy. The two-electron transfer-ionization (TI) process is the next largest and slowly increases with projectile energy. The Q values for both SC and TI decrease with increasing projectile energy. Our data thereby suggest that electrons are captured into less tightly bound states as the collision velocity is increased. Both double capture and single ionization are much smaller and fairly independent of the projectile energy. The energy independence of SI is somewhat surprising as our energy range spans the region of the target electron velocity where ionization would be expected to increase. Our analysis suggests that the ionization process is being suppressed by SC and TI processes. © 1993 The American Physical Society
Les lymphomes de lâanneau de Waldeyer traitement et pronostic
Les lymphomes non Hodgkiniens (LNH) qui prennent naissance au niveau de lâanneau de Waldeyer constituent une entitĂ© bien particuliĂšre tant sur le plan clinique, thĂ©rapeutique que pronostique. Les auteurs rapportent une Ă©tude rĂ©trospective de 44 observations de LNH de lâanneau de Waldeyer colligĂ©es entre 1995 et 2002. Une chimiothĂ©rapie exclusive aĂ©tĂ© indiquĂ©e chez 80,6% des malades et une association chimio-radiothĂ©rapie a Ă©tĂ© rĂ©alisĂ©e chez 19,4%. Le taux de survie globale Ă©tait de 42% Ă 5 ans. Dans notre Ă©tude quatre facteurs de mauvais pronostic ont Ă©tĂ© individualisĂ©s : un Ăąge â„ Ă 40 ans, les stades dâAnn Arbor II, III et IV, un taux de LDH â„ 1,5 fois la normale et la survenue de rechute.Mots-clĂ©s : Lymphome, anneau de Waldeyer, chimiothĂ©rapie, radiothĂ©rapie, pronosti
Cloaked Facebook pages: Exploring fake Islamist propaganda in social media
This research analyses cloaked Facebook pages that are created to spread political propaganda by cloaking a user profile and imitating the identity of a political opponent in order to spark hateful and aggressive reactions. This inquiry is pursued through a multi-sited online ethnographic case study of Danish Facebook pages disguised as radical Islamist pages, which provoked racist and anti-Muslim reactions as well as negative sentiments towards refugees and immigrants in Denmark in general. Drawing on Jessie Danielsâ critical insights into cloaked websites, this research furthermore analyses the epistemological, methodological and conceptual challenges of online propaganda. It enhances our understanding of disinformation and propaganda in an increasingly interactive social media environment and contributes to a critical inquiry into social media and subversive politics
A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.
BACKGROUND: Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. METHODS AND FINDINGS: Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of 39,000,000 and 31674 LYG in Syria; 1,3000,000,000 and 378439 LYG in Turkey. CONCLUSION: Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives
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