Sousse, Tunisia
Sousse, Tunisia

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Corbin V.,Service des Maladies Infectieuses et Tropicales | Beytout J.,Service des Maladies Infectieuses et Tropicales | Beytout J.,French National Institute for Agricultural Research | Auclair C.,Service dEpidemiologie | And 5 more authors.
Infection | Year: 2013

In 2009-2011, 113 adult in- and outpatients with measles were referred to the University Hospital of Clermont-Ferrand (centre of France): 71 (62.8 %) needed hospitalisation, 31 had pneumonia, 29 diarrhoea, 47 liver enzymes elevation, 38 thrombopaenia, one encephalitis and there were no deaths. Nineteen cases occurred among healthcare workers and five of them were hospital-acquired. There were 92 unvaccinated patients. The 2011 peak of that measles re-emerging epidemic occurred when non-immunised adults were affected. © 2013 Springer-Verlag Berlin Heidelberg.


PubMed | Nancy University Hospital Center, Service depidemiologie, Service de medecine interne and Blida University
Type: Journal Article | Journal: Annales de cardiologie et d'angeiologie | Year: 2015

The metabolic syndrome is a risk factor for cardiovascular diseases. It exposes to two main complications: cardiovascular diseases and type II diabetes. This risk is higher among women. It causes a high cardiovascular mortality.Assess the prevalence of the metabolic syndrome (MS) among our black hypertensive population. Study of the distribution of the different criteria in the cluster. Search cardiovascular complications.This longitudinal study that was carried out included one thousand five hundred and fifty subjects of both sexes from black and white populations aged 40 and older, living in the Algerian Sahara and reviewed after six years of decline. The control consisted of filling a questionnaire oriented on civil status, in addition to a clinical examination, including morphometry, measurement of blood pressure performed with validated electronic device (OMRON 705 CP). Also, a biological check-up was done (glycemy, HDL, cholesterol). A univariate and multivariate analysis have been carried out. All calculations and statistical analyzes are processed by the SPSS 17.0 and Epi Info6 software.The MS frequency is 20.8%, more frequent among women than among men, with a significant difference (28.4% versus 15.1%, P<0.001). We found out a difference between black and white populations in terms of obesity (37.6% versus 31.1%), hypertension (60.6% versus 55.0%), diabetes (25.2% versus 19.2%) or other metabolic syndrome criteria. The most frequent complications according to decreasing frequency are: hospitalization for cardiovascular diseases 8.9%, stroke 6.3%, heart failure 5.8%, myocardial infarction 3.6%. The mortality rate is 14.7% among the blacks and 11.3% among the whites without difference. The survival rate of the population is influenced by the MS and by a non-checked blood pressure by an antihypertensive treatment.The MS is highly prevailing among hypertensive black population, and significantly higher among women. The ranking of the cluster elements frequency shows clearly the specifities of our population. It is necessary to elaborate an adequate strategy to prevent such cardiovascular morbidity and mortality.


Bouhabel A.,University of Mentouri Constantine | Laib Z.,Service depidemiologie | Hannache K.,Service de medecine interne | Aberkane A.,CHU de Constantine
Nephrologie et Therapeutique | Year: 2014

End-stage renal failure is considered a public heath problem that constitutes a heavy cost on communities worldwide. To be able to plan the treatment of this pathology, we must have reliable and updated information through health network which represents the best mean for planning and reflexion locally and nationwide. The aim of our study was to answer to this need through a local registry of renal replacement therapy and nephrology network that we have for the first time an inventory of this pathology in an Algerian town (Constantine), and in this article we present the first results concerning patients under chronic hemodialysis.


PubMed | University dAuvergne, Boucharenc Podo orthesiste, Unite de biostatistique, University of Auvergne and Service depidemiologie
Type: Journal Article | Journal: Annals of physical and rehabilitation medicine | Year: 2015

French validation of the Foot Function Index (FFI), self-questionnaire designed to evaluate rheumatoid foot according to 3 domains: pain, disability and activity restriction.The first step consisted of translation/back translation and cultural adaptation according to the validated methodology. The second stage was a prospective validation on 53 patients with rheumatoid arthritis who filled out the FFI. The following data were collected: pain (Visual Analog Scale), disability (Health Assessment Questionnaire) and activity restrictions (McMaster Toronto Arthritis questionnaire). A test/retest procedure was performed 15 days later. The statistical analyses focused on acceptability, internal consistency (Cronbachs alpha and Principal Component Analysis), test-retest reproducibility (concordance coefficients), external validity (correlation coefficients) and responsiveness to change.The FFI-F is a culturally acceptable version for French patients with rheumatoid arthritis. The Cronbachs alpha ranged from 0.85 to 0.97. Reproducibility was correct (correlation coefficients>0.56). External validity and responsiveness to change were good.The use of a rigorous methodology allowed the validation of the FFI in the French language (FFI-F). This tool can be used in routine practice and clinical research for evaluating the rheumatoid foot. The FFI-F could be used in other pathologies with foot-related functional impairments.


PubMed | Service depidemiologie, Association Tunisienne de Lutte Contre le Cancer, Center doncologie Ibn Rochd, Institute Pasteur du Maroc and 4 more.
Type: Journal Article | Journal: BMC medical genetics | Year: 2016

Genetic susceptibility plays a key role in the development of nasopharyngeal carcinoma (NPC) and in fact the disease presents with an unusually high incidence in certain regions of the world like North Africa. We investigated the association between polymorphism of the Transforming growth factor-1 (TGF-1) and risk of NPC in North Africa. TGF-1 is a multifunctional cytokine that acts as both a tumor suppressor and a stimulator of cancer development; it has been shown to influence risk of numerous other carcinomas including lung, breast and prostate cancer.TGF-1 polymorphisms C-509T and T869C were studied in a large North African sample of 384 NPC cases and 361 controls, matched for age, sex and urban or rural residence in childhood. Genotypes were determined using polymerase chain reaction-restriction fragment length polymorphism.No association was observed between individual single nucleotide polymorphisms or their haplotypes and NPC susceptibility (for TGF-1 C-509T: OR=0.74; 95% CI 0.46-1.18; for TGF-1 T869C: OR=0.86; 95% CI 0.56-1.31), even when the samples were stratified by age, gender and TNM stage.Contrary to what has been observed in Asian samples, in our North African sample, the TGF-1 C-509T and T869C polymorphisms did not substantially influence NPC susceptibility.


PubMed | Brest University Hospital Center, Service depidemiologie and University of Western Brittany
Type: Journal Article | Journal: Diagnostic and interventional imaging | Year: 2014

The purpose of our study is to determine whether there is a relation between overweight, age, sex, hospitalised/outpatient status and a non-inflammatory hypersignal of the subcutaneous lumbosacral adipose tissue in T2 Short-Tau Inversion-Recovery (T2-STIR) MR imaging sequences.One hundred and six lumbar MRI, including a T2-STIR and T1 Fluid Attenuated Inversion-Recovery (FLAIR) weighted sagittal sequences, were retrospectively taken from the picture archiving and communication system (PACS) of our hospital and then made anonymous and analysed. The presence or absence of a T2-STIR hypersignal within subcutaneous adipose tissue behind the paraspinal muscle aponeurosis was determined. In addition, the weight, thickness of the fat tissue, the administrative status of the patient, the age, sex, time of the examination and, when present, the height of this hypersignal were noted. A uni- and multivariate analysis by logistic regression was carried out in order to examine the relationship between the data gathered.In the examinations selected, 25.5% (n=27) demonstrated a T2-STIR hypersignal in the subcutaneous tissue. We identified the weight (P<0.023), thickness of the fat tissue (P<0.001), the age of the patient (P<0.017) and the hospitalised status (P<0.009) as significant variables associated with this T2-STIR hypersignal. The mean height of the hypersignal was 109.5mm. Five of the 27 patients had an injection of gadolinium chelate and no enhancement was found at this level.We found a significant link between overweight, age and hospitalised status and the non-inflammatory infiltration of lumbar adipose tissue. This phenomenon seems to correspond with an interstitial oedema, related to subcutaneous stasis. This anomaly should not be confused with a local inflammation.


Gauvain C.,Service d'epidemiologie | Lena H.,Rennes University Hospital Center | Corre R.,Rennes University Hospital Center | Ricordel C.,Rennes University Hospital Center | And 2 more authors.
Oncologie | Year: 2016

Immunotherapy, in particular immune response checkpoint inhibitors, has shown to be extremely effective in terms of survival in locally advanced or metastatic nonsmall cell lung cancer, as a second line treatment in PS 0 or PS 1 patients who have progressed following platinumbased first line chemotherapy. In squamous cell cancers, nivolumab, a PD1 antibody, enables an overall survival of 9.2 months vs 6 months to be achieved, HR = 0.59; P < 0.001; in non-squamous cell carcinoma, the benefit is of the same order (12.2 months vs 9.4 months, HR = 0.73; P = 0.002), but clearly correlated to the PDL1 expression rate by the tumour cells, with no benefit for patients without expression, and a considerable benefit for those patients with strong expression. This is confirmed through trials using pembrolizumab, another PD1 antibody, with an increase in survival over docetaxel (HR = 0.71; P = 0.0008), with a more considerable benefit seen in the sub-group of patients who have PDL1 expression > 50% and, more recently, with a PDL1 antibody, atezolizumab, which in a phase II randomised study showed an increase in survival of 12.6 vs 9.7 months compared with docetaxel, HR = 0.73; P = 0.04, which correlated with the PDL1 expression rate from the tumour and immune cells. The tolerance of these drugs is good; however, with rare, but often serious immune type events, they require specific management. Numerous questions remain unanswered regarding specific populations: the elderly, those with co-morbidities, those who are PS 2 and those with brain metastases. Finally, numerous trials are ongoing, evaluating the use of these second line immunotherapies, given concomitantly or not with chemotherapy. © 2016, Lavoisier.


Bensalem S.,Laboratoire Of Recherche Diab Suc | Lakehal A.,Service Depidemiologie | Roula D.,Laboratoire Of Recherche Diab Suc
Medecine des Maladies Metaboliques | Year: 2014

Of 432 pregnant women screened according to WHO criteria, 6.3% [95% CI: 4.2 to 9.1] had a gestational diabetes (GDM). Referring to criteria developed by the International Association of Diabetes and Pregnancy Study Group (IADPSG) the GDM frequency reaches 14.6%. All screened GDM had risk factors. All of them are older than 25 years (mean age: 35.6±4.6 years) and multiparous and among them 81.5 % had a BMI >25 kg/m2. Their family and obstetric history are quite rich compared to non-diabetic pregnant women. Macrosomia was found in 22.2 % of GDM. The only two independent risk factors for macrosomia found in our diabetic population are fasting hyperglycemia and overweight. OGTT performed at 12 weeks postpartum in GDM revealed that 18.5% had abnormal glucose tolerance. In light of these results, targeted screening is required by economic necessity. During pregnancy the presence of risk factors such as encountered in our population: age >30 years, multiparity, BMI >27 kg/m2, 1st degree family diabetes history, obstetric personal history of GDM or macrosomia, hypertension or obesity should prompt a targeted and early detection of gestational diabetes. © 2014 - Elsevier Masson SAS - Tous droits réservés.


Ramel J.-C.,Service dOphtalmologie | Bron A.-M.,Service dOphtalmologie | Isaico R.,Service dOphtalmologie | Meillon C.,Service dOphtalmologie | And 2 more authors.
Journal Francais d'Ophtalmologie | Year: 2014

Introduction Endophthalmitis is the most dreaded complication after intravitreal injection. With the rise of antiangiogenics their rate is getting higher each year. The use of antibioprophylaxis is controversial. We tried to evaluate the impact of antibioprophylaxis on intravitreal injection endophthalmitis incidence. Methods All patients who received intravitreal injections between January 2007 and October 2012 were included in this retrospective study. Until June 2012 all patients had antibiotics the days following the injection. From July 2012 the antibiotic was replaced by an antiseptic immediately after the injection. Results An overall number of 11,450 injections were performed. The overall rate of endophthalmitis was 6/11,450 (0.052%). The incidence of endophthalmitis in the group with antibiotics was 3/10,144 injections (0.03%), 2 were culture proven (0.02%). The incidence in the group without antibiotics was 3/1306 (0.23%). The difference was significant (P = 0.024). Conclusion The incidence of endophthalmitis post-intravitreal injections seems to be lower when using antibiotics. However, a prospective study is mandatory to draw more robust conclusions. © 2014 Elsevier Masson SAS. Tous droits réservés.


Ouhadj O.,Service dOphtalmologie | Bouarfa A.,Service dOphtalmologie | Akel S.,Service dOphtalmologie | Mendil L.,Service dOphtalmologie | And 2 more authors.
Journal Francais d'Ophtalmologie | Year: 2010

Introduction: Macular choroidal neovascularization (CNV) is a serious complication of high myopia, compromising the visual prognosis in young patients. The purpose of this study was to evaluate the safety and efficacy of first-line intravitreal ranibizumab in the treatment of myopic CNV. Patients and methods: We conducted a single-center prospective, consecutive, interventional study of patients with subfoveal or juxtafoveal CNV secondary to pathologic myopia (PM) treated with intravitreal injection of ranibizumab in the Beni-Messous University Hospital from January 2009 to April 2010. Best-corrected visual acuity (BCVA), fundus examination, optical coherence tomography (OCT), and fluorescein angiography (FA) were performed at baseline and monthly for all patients. Indications for retreatment were persistence or recurrence of the neovascular activity. Results: The study included 40 eyes of 40 patients, 33 of whom were females (82.5%), with a mean age of 40.22 ± 10.81 years (range, 20-55 years), with visual acuity between 1/100 and 1/10. The mean spherical equivalent refractive error was -14.13 ± 4.65 diopters (range, -7 D to -23 D). The mean follow-up time was 8 months (range, 3-15 months). The mean number of intravitreal injections administered for each patient was 2.2 (range: 1-4). Follow-up ranged from 3 to 15 months (mean, 8 months). All patients maintained or improved their vision; the average gain in visual acuity was three lines (range: 1-9 lines). No injection complications or drug-related side effects were noted during the follow-up period. Discussion: Intravitreal ranibizumab to treat CNV complicated by high myopia seems to be associated with an improvement in VA and good tolerance. This study confirms the efficacy of first-line anti-VEGF, in particular, ranibizumab in this indication. Conclusion: In this series of eyes with limited follow-up, intravitreal ranibizumab was a safe and effective treatment for CNV secondary to PM, resulting in functional and anatomic improvement. © 2010 Elsevier Masson SAS. Tous droits réservés.

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