Medical and surgical outcome of tricuspid regurgitation caused by flail leaflets

AbstractObjectiveWe sought to evaluate the medical and surgical outcome of tricuspid regurgitation caused by flail leaflets.MethodsWe analyzed the cause, clinical presentation, outcome, and natural history of 60 patients with tricuspid regurgitation caused by flail leaflets, a cause of mostly severe and organic tricuspid regurgitation, diagnosed by means of echocardiography between 1980 and 2000.ResultsThe main cause was traumatic (62%). Clinical presentation was often severe: 57% were symptomatic, 33% had a history of congestive heart failure, and 40% had a history of atrial fibrillation. Compared with expected survival of the US matched population, excess mortality (39% ± 10% at 10 years or 4.5% yearly, P < .01) was observed. Even patients asymptomatic at presentation experienced high tricuspid-related event rates (at 10 years, 75% ± 15% had symptoms or heart failure, atrial fibrillation, surgical intervention, or death). In those patients severe enlargement of right-sided chambers was predictive of poor outcome (at 5 years: 86% ± 9% vs 39% ± 11%, P < .01) independent of cause (P = .31). The poor medical outcome was further confirmed by high event rates (69% ± 9% at 15 years) in the natural history beginning from the flail's occurrence. Tricuspid operations were performed in 33 patients (55% ± 7% at 5 years), with valve repair in 82%, low mortality (3%), and, despite frequently refractory atrial fibrillation, symptomatic improvement in 88%.ConclusionTricuspid regurgitation caused by flail leaflets is a serious disease associated with excess mortality and high morbidity. Tricuspid valve repair can often be performed with low risk, allowing symptomatic improvement. These results suggest that surgical intervention should be considered early in the course of the disease before the occurrence of irreversible consequences

Mesure et effets de l'insatisfaction: Application au marché des services aériens

International audienceCette recherche évalue le concept d'insatisfaction appliqué au marché des services aériens entre le Canada et la France. Elle en identifie les causes, en suggère une méthode de mesure, puis analyse les comportements de réaction à l'insatisfaction. Il en découle une relation de cause à effet qui établit les bases d'un positionnement des compagnies aériennes et des classes de service sur le marché en fonction des sources d'insatisfaction et des formes de réaction. Ce positionnement fournit aussi les axes d'une stratégie concurrentielle de gestion «défensive» de l'insatisfaction

Une comparaison empirique de la validité prédictive de la méthode de composition, de l'analyse conjointe et de l'analyse conjointe hybride

International audienceCette recherche évalue l'efficacité de différentes méthodes de modélisation des préférences des consommateurs au niveau individuel : la méthode de composition (phase I et II d'ACA4 de Sawtooth Software), l'analyse conjointe traditionnelle (Conjoint Analyzer de Bretton Clark; profil complet) et l'analyse conjointe hybride (ACA4 de Sawtooth Software).Les conclusions principales sont les suivantes : dans le cas où le nombre d'attributs est inférieur à six, la validité prédictive de l'analyse conjointe hybride et de l'analyse conjointe traditionnelle (profil complet) est supérieure à celle de la méthode de composition. En revanche, la validité prédictive de l'analyse conjointe hybride est inférieure à celle de l'analyse conjointe traditionnelle (profil complet)

Comparative advertising: citing or not the leading brand and its price

International audiencePurpose– The purpose of this research is to examine the influence of direct comparative advertising on brand information processing and purchase intentions compared with that of indirect comparative advertising in non-forced exposure conditions.Design/methodology/approach– The overall sample of 240 female consumers (aged between 25 and 51 years, and representative of French women in terms of region and profession) was divided into two equal groups. These two groups viewed a televised montage that followed GfK ' s pretest methodology for TV advertising (a 20-minute television show, an advertising break with seven commercials, a short questionnaire, a 20-minute television show, an advertising break with four commercials, and a longer questionnaire), which favors a low involvement context in laboratory conditions. These two groups were respectively exposed to two 20-second ads for a well-known challenger brand (identical except for whether they name the leading brand and its price or “brand X” without price information).Findings– This research provides original evidence that the comparative ad that cites the name and price of the leading brand increases purchase intentions for the sponsored brand, more than an equivalent that uses brand X. This effect operates through an increased probability of message processing, which in turn enhances the perceived compelling character of ad content.Originality/value– Despite the many studies of comparative advertising in existing literature, little research has been devoted to the potential alternative of replacing a “brand X” designation with the name of a competing brand. Moreover, previous research often includes participants (e.g. students) engaged in deliberate processing of a single advertisement in conditions of artificial exposure

Cohérence et complétude des échelles d'Ambroise et de Valette-Florence et de de Barnier appliquées à la mesure de la personnalité des marques et des supports de presse

International audienc

Cohérence et complétude des échelles d'Ambroise et de Valette-Florence et de de Barnier appliquées à la mesure de la personnalité des marques et des supports de presse

International audienc

Cohérence et complétude des échelles d'Ambroise et de Valette-Florence et de de Barnier appliquées à la mesure de la personnalité des marques et des supports de presse

International audienc

Cohérence et complétude des échelles d'Ambroise et de Valette-Florence et de de Barnier appliquées à la mesure de la personnalité des marques et des supports de presse

International audienc