Diagnostic accuracy of 18-F FDG-PET/CT in evaluation of malignant neuronal involvement in neurologically manifested cancer patients

Aim and objectives

The aim of this study was to assess the role of 18-F FDG-PET/CT in evaluating the peripheral malignant neuronal affection as well as perineural tumoral spread that occurs in patients with cancers.

Analysis of the Proximal Orifice Flowfield Under Pulsatile Flow Conditions and Confining Wall Geometry: Implications in Valvular Regurgitation

Hemodynamic studies of regurgitant lesions in the heart focus on identifying a reliable noninvasive method of volumetric flow calculation. In these studies the influence of blood viscosity to the flowfield under pulsatile flow conditions and constraining wall geometry has not been examined in detail. Pulsatile flow studies in straight tubes have shown that viscous effects significantly influence the periodic flowfield, especially near the wall. The purpose of this study is to investigate the significance of transient effects in the flowfield proximal to a lesion under constraining wall geometry. The proximal flowfield was analyzed with computational fluid dynamics (CFD) computer simulations and color flow Doppler mapping (CFM). Three different stroke volumes and regurgitant waveforms were investigated for upstream wall orientations that varied from - 64° to + 64° (measured from the orifice plane). Results showed that for each upstream wall orientation, a single instantaneously normalized centerline velocity distribution characterized the flowfield throughout the cycle. The centerline distributions were in phase with the pressure gradient and almost identical to the corresponding steady-state distributions. Minor deviations were observed near the wall, where viscous effects were predominant. Transient flow effects such as blunt profiles and pressure velocity phase shifts, which were observed in straight circular tubes, were not observed in regurgitant orifice flowfields. This is true even under severe confinement conditions.     

Tamsulosin therapy improved the outcome of ureterorenoscopy for lower ureteral stones: A prospective,randomised, controlled,clinical trial

Introduction

Tamsulosin is an α-1A-specific blocker inducing selective relaxation of ureteral smooth muscle and inhibition of ureteral spasms leading to ureteral dilatation that can facilitates retrograde ureterorenoscopy (URS).

Effect of Potassium Bromate on the Liver of Adult Male Albino Rat and A Possible Protective Role of Vitamin C: Histological,Immunohistochemical, and Biochemical Study

Potassium bromate (KBrO₃) is a food additive which is used primarily as a maturing agent for flour. It is proved as a toxic agent with significant reduction in the activities of antioxidant capacity. The therapeutic efficacy of vitamin C as antioxidant may provide a possible solution to KBrO₃ mediated oxidative damage. Twenty four adult male albino rats were used to evaluate the protective role of vitamin C against KBrO₃ induced hepatotoxicity and divided into four groups; Group 1 (control), Group 2: received 30 mg/Kg/day vitamin C orally for 4 weeks, Group 3: received 20 mg/Kg/dose KBrO₃ orally twice weekly for 4 weeks and Group 4: received both KBrO₃ and vitamin C. Liver specimens were processed for histological study by light and electron microscopes and stained immunohistochemically to detect glial fibriller acidic protein (GFAP). Serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were estimated as well as the levels of malondialdehyde (MDA), glutathione (GSH) and superoxide dismutase (SOD) activities in all dissected tissues were determined. KBrO₃ induced histological alterations in the form of degeneration, cellular infiltration and significant increase in collagen deposition in portal tracts with a significant increase in immunoexpression of GFAP. Significant rise in serum levels of AST, ALT, and MDA in liver tissues were recorded. However, levels of GSH and SOD were significantly decreased. Most of these changes were improved by vitamin C treatment. In conclusion, vitamin C ameliorates the histological and biochemical alterations of the liver induced by KBrO₃. Anat Rec, 299:1256–1269, 2016. © 2016 Wiley Periodicals, Inc.     

Maxillary expansion and molar rotation using the Nitanium Molar Rotator

In a presentation illustrated by clinical cases, the author describes the Nitanium Molar Rotator (NMR), its indications and its use, its advantages and its disadvantages. He also shows how to incorporate this super flexible arch wire with excellent memory and tight fitting bracket insertion in lateral sectors in order to maximize expansion of the maxilla. With this device orthodontists can create or modify the tipping of molars as they are being distalized.     

Les médecins maghrébins ont-ils besoin de renforcement de leurs capacités en investigation et contrôle des épidémies ?

Objective:

Describe the training needs of young Maghreb doctors in epidemic management.

Methods:

This is a study to quantify the need for medical training on "epidemic management". The study population was formed by residents and assistant professors of the French-speaking faculties of medicine in the Greater Maghreb, hospital-university professors, who were invited to respond to an online questionnaire. The "need" for learning a skill was defined by the perception of its importance, of its low coverage by the curricula and its poor mastery. A grid with 20 items, coded according to the Likert scale of 1 to 5 points, was specially developed for the measurement of need, retained beyond the thresholds of 45/90 points for the two dimensions "confirmation" and "investigation", 60/120 points for the "control" dimension, and 150/300 for the total sum.

Results:

A total of 121 young Maghreb doctors answered the questionnaire to assess the needs for learning epidemic management skills. The median overall scores for the chapters "importance", "coverage" and "performance" were 76, 40 and 48 respectively out of 100 points. The median scores for training «needs» were 54/90, 48/90 and 67/120 points, respectively, for the dimensions «confirmation», «investment» and «control», giving a global median score of 168 / 300.

Conclusion:

Capacity building in epidemic management is a need felt by young Maghreb doctors, partially covered by current medical school programs, and consequently altering their professional performance.     

40 ans des Soins de Santé de Base en Tunisie d'Alma Ata à Astana. Il est temps de revitaliser la première ligne des soins

In order to readjust the national policy of Basic Health Care (SSB) to the declaration of Primary Health Care (SSP) of Astana (2018), 40 years after that of Alma Ata (1978), this paper summarizes the lessons learned from the international and national experience of PHC / SSB and presents the originator lines of the roadmap of the second version of SSB in Tunisia. WHO and Unicef have identified four lessons from PHC policy: 1. Political leadership, prioritizing primary care. 2. Sufficient funding to ensure the availability of basic services and their access by the population served. 3. Health personnel specifically trained in primary care, with decent working conditions. 4. A support strategy for the quality of care, based on financial and moral motivation. In Tunisia, the history of SSBs has memorized images of successes such as the organization of simulation sessions for the preparation of the “oral rehydration solution”, “mobile teams” of home visits, “deadlines” for monitoring vaccination and “school social action units” for multisectoral management of the problem of school backwardness. The "Think Tank" groups, having reflected on the perspectives of SSBs in Tunisia, came up with a roadmap made up of four fundamental axes. 1. Creation of a National Health Insurance Fund (CNAS), affiliated with the Ministry of Health, and promoting prevention and health promotion. 2. Focus on non-communicable diseases, both young and old. 3. Establishment of a periodic health assessment, stratified by sex and age, guiding health behaviors and "self-care" skills. 4. The development of “nursing homes”, providing continuous care, by multi-functional and multidisciplinary teams. Thus, the reform of the SSB policy of Tunisia, by referring to the Astana declaration and the cumulative national expertise, is essential to revitalize the first line of care and ensure the Tunisian population a "health for all", leaving no one behind”.