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Résumé Afin d'identifier l'influence du secteur de pratique et de l'ancienneté dans l'exercice sur les attitudes et pratiques des médecins en matière de prévention et de promotion de la santé, nous avons interrogé l'ensemble des médecins de lère ligne exerçant dans la région sanitaire de Sousse (Tunisie). On note plus d'attitudes positives chez les médecins du secteur public par rapport à leurs confrères du secteur privé, cependant, en pratique, les comportements sont semblables entre les deux groupes de médecins. Bien que les jeunes médecins s'impliquent moins souvent que leurs aînés dans les activités de prévention et de promotion de la santé, le rôle de l'ancienneté dans l'exercice ne paraît pas évident. Parmi les obstacles aux activités de prévention et de promotion de la santé figurent principalement: 1-la croyance que le conseil du médecin agit peu sur le changement du comportement des individus, 2-la perception de la difficulté de modifier les comportements d'une manière générale et 3-le manque de temps afin d'assurer ce genre d'activités. Dans cette analyse, deux facteurs au moins doivent être considérés: un attrait différentiel des patients vers un mode de pratique particulier d'une part et une attirance potentiellement plus grande des médecins «préventeurs» vers la pratique de santé publique d'autre part.
Summary In order to identify the impact of the area of activity and years of practice on doctor's attitudes and practices regarding prevention and health promotion, a survey has been conducted among all primary health care practitioners active in the area of Sousse (central Tunisia). There are more positive attitudes among doctors working in public service as compared with those working in the private sector; however, in practice, the behaviors are similar between the two groups. Although young practitioners are less involved than others in prevention and health promotion activities, the impact of years of practice are not obvious. For both groups, the main obstacles to prevention and health promotion activities are: 1. the doctor's belief that his advice has little impact on individuals' changes of behavior, 2. his perception of the difficulty in changing behavior in general and 3. the lack of time for these activities. In this analysis, at least 2 factors have to be considered: a patients' differential attraction to a specific mode of practice and a doctors' differential attraction to public or private health practice.

Zusammenfassung Um den Einfluss des Praxisrahmens und des Alters auf die Einstellung und die Durchführung von Gesundheitsförderungs- und Präventionsprogrammen durch die Ärzte zu erfassen, wurde die Gesamtheit der praktizierenden Ärzte der Grundversorgung in der Region von Sousse (Tunesien) befragt. Die Ärzte im öffentlichen Sektor zeigen positivere Einstellungen als ihre Kollegen im Privatsektor. Tatsächlich aber äussert sich dieser Unterschied kaum im Verhalten der beiden Ärztegruppen. Obschon jüngere Ärzte sich weniger oft als ihre älteren Kollegen in Präventionsaktivitäten und Gesundheitsförderungsaktivitäten engagieren, ist die Rolle der Erfahrung dabei nicht so offensichtlich. Unter den Hindernissen für Präventions- und Gesundheitsförderungsaktivitäten finden sich hauptsächlich: 1. die Überzeugung, dass der ärztliche Rat weniger am Gesundheitsverhalten des Individuums ändert, 2. die Vorstellung, dass es schwierig ist, Verhalten generell zu ändern, 3. dass Zeit fehlt, diese Art der Aktivitäten durchzuführen. In diesen Analysen müssen allerdings zwei Faktoren berücksichtigt werden: unterschiedliche Anziehung verschiedener Praxisarten auf die Patienten und eine höhere Attraktivität des öffentlichen Gesundheitsdienstes für Ärzte, die sich der Prävention verschreiben.
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In this study, the authors attempted to propose the very first study on fabrication and characterization of zinc-boro-silicate (ZBS) glass-ceramics derived from the ternary zinc-boro-silicate (ZnO)0.65(B2O3)0.15(RHA)0.2 glass system through a conventional melt-quenching method by incorporating rice husk ash (RHA) as the silica (SiO2) source, followed by a sintering process. Optimization of sintering condition has densified the sintered samples while embedded beta willemite (β-Zn2SiO4) and alpha willemite (α-Zn2SiO4) were proven in X-ray diffraction (XRD) analysis. Field emission scanning electron microscopy (FESEM) has shown the distribution of willemite crystals in rhombohedral shape crystals and successfully form closely-packed grains due to intense crystallization. The photoluminescence (PL) spectra of all sintered ZBS glasses presented various emission peaks at 425, 463, 487, 531, and 643 nm corresponded to violet, blue, green, and red emission, respectively. The correlation between the densification, phase transformation, microstructure, and photoluminescence of Zn2SiO4 glass-ceramic phosphor is discussed in detail.  相似文献   
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Acute right ventricular (RV) failure is a frequent and serious clinical challenge in the intensive care unit. It is usually seen as a consequence of left ventricular failure, pulmonary embolism, pulmonary hypertension, sepsis, acute lung injury or after cardiothoracic surgery. The presence of acute RV failure not only carries substantial morbidity and mortality, but also complicates the use of commonly used treatment strategies in critically ill patients. In contrast to the left ventricle, the RV remains relatively understudied, and investigations of the treatment of isolated RV failure are rare and usually limited to nonrandomized observations. We searched PubMed for papers in the English language by using the search words right ventricle, right ventricular failure, pulmonary hypertension, sepsis, shock, acute lung injury, cardiothoracic surgery, mechanical ventilation, vasopressors, inotropes, and pulmonary vasodilators. These were used in various combinations. We read the abstracts of the relevant titles to confirm their relevance, and the full papers were then extracted. References from extracted papers were checked for any additional relevant papers. This review summarizes the general measures, ventilation strategies, vasoactive substances, and surgical as well as mechanical approaches that are currently used or actively investigated in the treatment of the acutely failing RV.  相似文献   
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Oil palm (Elaeis guineensis) leaf extract (OPLE) possesses good ex vivo vasodilation and antioxidant properties. This study evaluated the catechin-rich OPLE antioxidant, antihypertensive, and cardiovascular effects in normal and nitric oxide (NO)-deficient hypertensive rats. OPLE was administered orally (500 mg/kg of body weight/day) to normotensive Wistar rats and N(ω)-nitro-L-arginine methyl ester (L-NAME)-induced NO-deficient hypertensive rats. OPLE significantly (P<.05) attenuated blood pressure increases, increased serum NO, reduced lipid peroxidation, and showed antioxidant effects in NO-deficient hypertensive rats. OPLE decreased the coronary arteriole wall-to-lumen ratio to near normal values under NO deficiency. Although OPLE showed good antihypertensive and antioxidant effects under NO deficiency, it was not hypotensive to normal rats and produced no chronic cardiovascular toxicity in any of the rats throughout the 12-week study. This is the first report on the in vivo antihypertensive properties of green tea catechins extracted from an alternative source, namely, oil palm leaf, for use as a medicinal food for hypertension and cardiovascular ailments.  相似文献   
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Metabolic syndrome (MetS) is the physiological clustering of hypertension, hyperglycemia, hyperinsulinemia, dyslipidemia, and insulin resistance. The MetS-related chronic illnesses encompass obesity, the cardiovascular system, renal operation, hepatic function, oncology, and mortality. To perform pre-clinical research, it is imperative that these symptoms be successfully induced and optimized in lower taxonomy. Therefore, novel and future applications for a disease model, if proven valid, can be extrapolated to humans. MetS model establishment is evaluated based on the significance of selected test parameters, paradigm shifts from new discoveries, and the accessibility of the latest technology or advanced methodologies. Ultimately, the outcome of animal studies should be advantageous for human clinical trials and solidify their position in advanced medicine for clinicians to treat and adapt to serious or specific medical situations. Rodents (Rattus norvegicus and Mus musculus) have been ideal models for mammalian studies since the 18th century and have been mapped extensively. This review compiles and compares studies published in the past five years between the multitude of rodent comparative models. The response factors, niche parameters, and replicability of diet protocols are also compiled and analyzed to offer insight into MetS-related disease-specific modelling.  相似文献   
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This retrospective study on a large number of cases offers a vision of the modalities of care in prostate cancer diagnosed before the age of 55, according to different policies, aiming to propose other directions for 2005. Between January 1974 and December 2001, 365 patients had a pathological diagnosis of prostate cancer occurring before the age of 55. These patients were referred to the departments of radiation therapy affiliated to the Rare Cancer Network. A questionnaire was filled in retrospectively to allow further analysis of medical and surgical data. The treatments were those recommended at the time of analysis and progressed according to new accepted standards. Clinical and pathological features of the patients were as follows: 36% of the tumours were Gleason > 7 scored, 56% of the patients had a T3-T4 and 31 had metastases at the time of diagnosis. As far as treatment was concerned, 4 groups were considered: 83 patients had a radical prostatectomy, 155 received radiation therapy with a curative intent, 87 were treated by hormonal manipulation, and the remaining 40 patients received palliative care. The free of disease survival rate at 10 years was 38% for patients without immediate metastases, only 1% of patients with metastases were alive. The multivariate analysis demonstrated the significant impact of radiotherapy on both local and distant failure rates and of T stage on distant failure rate. Survival was affected by nodal involvement and local failure. A separate analysis of two periods of time (1974-1989 and 1990-2001) did not show any differences in terms of treatment results. This retrospective study suggests that age is not a negative prognostic factor as far as adequate curative treatments are carried out. Therapeutic modalities having considerably evolved in prostate cancer, a further analysis with a longer follow up may allow the evaluation of these treatments on rates of failures and survival. Screening for prostate cancer in family histories is likely to increase the number of cases diagnosed before 55. Therefore, a complete information on morbidity associated to the different means of treatment would lead to a better acceptance of late side effects.  相似文献   
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