Optimal advertising and pricing for a three-stage time-lagged monopolistic diffusion model incorporating income

A three-stage time-lagged diffusion model that incorporates consumers' income, advertising and price effects is proposed. The derivation of the model synthesizes and relies upon a number of important arguments made in the diffusion and economic literature. Optimal control theory is used to derive normative advertising and pricing strategic implications for a monopolist introducing a new durable product.     

Continuous perfusion of insulin in the treatment of acidoketotic coma in children

Ketoacidosis is still a frequent complication as far as our diabetic patients are concerned. The insulin regimen during this acute diabetic ketoacidosis was, until October 1981, administered at the start, half intravenously and half intramuscularly, then discontinuously every four hours, subcutaneously, according to the rate of glucose and acetoacetate. Since then, a new method has been used for the treatment of diabetic ketoacidosis providing a continuous perfusion without pumps, of insulin, glucose and electrolytes. The authors describe their experience, using this technique on ten children admitted to hospital because of severe diabetic ketoacidosis. A certain number of parameters and the evolution were studied. The glycemia graph shows a more harmonious and regular normalisation, urinary ketosis disappears within 8 and 24 hours (with an average of 16,22 h). The next step that consists in administering mixed insulin is taken between the 16th and 48th hours (with an average of 25,42 h). Two hypoglycemia have been reported contrary to the statements of other authors. Furthermore, these parameters were compared to those of 10 children submitted to the classical regimen. The authors conclude that a continuous perfusion presents a better method with approximately similar results, and its use is much simpler both for the patient and for the staff.     

Necrotising otitis externa: A single centre experience

Introduction:Necrotising otitis externa(NOE)is a rare infection of the ear canal with frequent bone erosion.This study’s objective is to describe the different features of NOE as well as its management in an ear-nose-throat department.We also tried to identify the particularities of the fungal infection.Patients and methods:It is an observational cohort that included all the patients hospitalised for the management of NOE.The study was carried out in the ear-nose-throat Department of Mahdia University Hospital in Tunisia between January 2006 and december 2019.Results:A total of 40 patients were included.The mean age was 65±12.9 years and the sex ratio was 0.9.Ninety percent of the patients included were diabetics.The most common signs found were oedema of the external canal(97.5%)and auricular discharge(92.5%).The main pathogen isolated was Pseudomonas aeruginosa(61.7%).Fungi were isolated in 9 cases(26.47%).Computed tomography was performed for 32 patients(80%).Bone erosion was seen in 26 cases(81.3%).The main complications were cerebral venous thrombosis,retropharyngeal abscess and cerebral empyema.Thirty one patients received only antibiotics,2 received only antifungal treatment,and 7 received both antibiotics and antifungal treatment.All patients had a favorable outcome.Univariate analysis showed a higher median erythrocyte sedimentation rate was associated with fungal infections.No other differences were noted.Conclusion:Our management protocol seems to be efficient since all patients had initial favorable outcome.A higher median erythrocyte sedimentation rate was associated with fungal infections.     

Emotional disorders and inflammatory bowel disease

Background: The co-occurrence of emotional disorders (alexithymia, depression and anxiety) and inflammatory bowel disease (IBD) is reported in the literature. There are several possible explanations for this co morbidity. Aim : To evaluate the prevalence of alexithymia, anxiety and depression among patients with IBD and to compare them with a control group of healthy individuals and to discuss the relation between emotional disorders and IBD. Methods: We built a case - control study of 50 patients with IBD (ulcerative colitis (UC) and Crohn's disease (CD)). The control group compounded 50 subjects without IBD and paired according sex, age, and school level. Alexithymia was assessed with the 20-item version of the Toronto Alexithymia Scale (TAS -20). Participants completed the Hospital Anxiety and Depression Scale (HADS), which is a 14-item self-report scale providing separate subscale scores for anxiety (HADS-A) and depression (HADS-D). Results: Among the group of patients, the rates of anxiety, depression and alexithymia were, respectively, 52%, 44% and 54%. In this group, there were significantly more anxious, depressed, and alexithymic subjects than in the control group (p respectively, 0,007, 0,015 and 0,002). The anxiety and the depression were more frequent among patients who had active disease or symptoms than those in remission (p respectively, 0,011 and 0,035). Conclusion: The comorbidity of emotional disorders and IBD seems to be frequent. Therefore, clinicians should look for those disorders in patients with IBD, by using specific scales. The adjunction of emotional disorder treatment, if needed, would allow optimizing the management of MICI.