Notes

DULoc: quantitatively unmixing protein subcellular area patterns in immunofluorescence photos determined by deep mastering characteristics.
001). Men had significantly higher scores than women in the hyperthymic temperament while women had significantly higher scores in the anxious, cyclothymic and depressive temperaments. For the age, the scores of the cyclothymic temperament decreased while the scores of the anxious temperament increased (P less then 0.05). CONCLUSION The Tunisian version of the TEMPS-A has good psychometric properties with an overlap between depressive and anxious items. Moreover, the scores of affective temperaments differed by age and gender. Subsequent studies with larger samples should be realized to verify these results.INTRODUCTION Emergency medical services (EMS) supports an increasing number of elderly patients. AIM To evaluate outcome and autonomy of patients aged 65 and older who managed in the prehospital theater. METHODS We conducted a prospective observational multicenter study over one year (October 2015 -September 2016). We included patients aged 65 or older managed in the pre hospital setting. We studied demographic criteria, pre-hospital care, severity (IGSA score and GCS), baseline and 3-month autonomy was assessed using the Katz score. Multivariate analysis was performed to identify predictive factors of mortality at 24 hours. RESULTS we included 385 patients. Average age was 81 ± 8 years and sex ratio was equal to 1.08. Thirty eight (10%) patients were in cardiac arrest at the arrival of EMS team and 50% of them were resuscitated without recuperation. The IGSA score was 7 [5-10] on the initial examination versus 6 [4-7] on the arrival at the hospital (p less then 0.01). Baseline autonomy was 2 [0-6] versus 3 [0-6] at 3 months with p = 0.02. Ninety four patients (33%) regained their baseline autonomy after the acute episode. At 24 hours the mortality rate was 9% (n=32). In multivariate analysis, the independent predictor factor of mortality was GCS less then 8 with an adjusted OR=9,22 ;95%CI[3,44-24,70] ; p less then 0.001. CONCLUSION Except out of hospital cardiac arrest, the survival of elderly subjects managed by EMS teams was encouraging. In the medium term, one-third of them regained their autonomy after the acute episode. These elements suggest successful integration into the emergency system.INTRODUCTION Giant tear retinal detachments have long been recognized for their management difficulties and poor anatomical surgical prognosis. METHOD Retrospective, descriptive study of 15 patients collected from IOHRT Department A. These patients were treated for rheumatogenic retinal detachment by giant tear. All patients underwent endocular vitreoretinal surgery. A visual acuity, FO and OCT check was performed at 7 days, 21 days, 45 days and 3 months, 6 months and 1 year postoperatively. RESULTS Our study included 15 eyes from 15 patients with rheumatogenic giant tear retinal detachments. The average follow-up is 9 months. The average age of the patients was 45 years. Six patients were severely short-sighted; 30% of patients had stage C vitreous proliferations at diagnosis. Immediate postoperative anatomical reapplication was achieved in 85% of patients. After 1 year, anatomical reapplication was achieved in 100% of patients. The average visual acuity was 2/10. CONCLUSION Surgery for rheumatogenic retinal detachment caused by a giant tear is a procedure that is still considered difficult with uncertain results. The progress of endocular surgery and tamponade methods has made it possible to revolutionize the prognosis of these detachments.BACKGROUND Multiple arterial coronary artery bypass grafting is a controversial surgical procedure that is still uncommon worldwide. The aim of our study was to determine the outcomes and perioperative complications of the multiple arterial myocardial revascularization and their predictive factors, the mid-term and long term clinical and angiographic prognosis of the studied patients. METHODS This was a single center study of the cardiovascular department of The Rabta hospital. Patients included had serial multiple arterial coronary artery bypass grafting between January 2008 and December 2014. A statistical univariate and multivariate analysis had been conducted to identify complications and their predictive factors and a Kaplan-Meier study was done for the clinical and angiographic late outcomes. RESULTS We included 322 patients mean aged 58 years, sex-ratio was 7.7 with a preserved left ventricle ejection fraction (LVEF) in 68.94% of cases. On-pump 1109 bypasses were made, among them 788 arterial grafts we Data of long term following could be collected only in 39.4% of cases. Major Adverse Cardiologic and Cerebral Events (MACCE) occurred in 30.71% controlled patients. Free-MACCE survival was 52.9% at 5. Initially total arterial bypass grafting was superior to other configurations in free-MACCE survival (p=0.036) but we lost significance beyond 5-years following because of selection bias. CONCLUSION Multi arterial coronary artery bypass grafting was secure in early morbidity and mortality. Long term prognosis seemed to be better in case of total arterial revascularization.INTRODUCTION Chronic hepatitis C (CHC) is assimilated to a systemic disease because of its multiple extrahepatic manifestations particularly rheumatological. AIM To determine the prevalence and the characteristics of rheumatological manifestations (RM) associated with CHC. 2-bromopalmitate clinical trial METHODS a retrospective study including all patients suffering from CHC followed over a period of 11 years (2002 - 2012) at the department of gastroenterology B at La Rabta hospital. Were excluded all patients co-infected by hepatitis B virus or by human immunodefficiency virus and those having decompensated cirrhosis. Different RM were collected and analyzed according to the epidemiological, clinico-biological, immunological, virological and histological data of the CHC. RESULTS two hundred and four patients affected by CHC were included, meanly aged by 52 years [22- 66 years]. The sex-ratio was 0,46. RM were noted in 76 patients (37,25%) dominated by inflammatory polyarthralgia of big joints (88,15%). Non erosive arthritis was observed in a woman, myalgia was noted in 11 cases (14,47%) among them, 2 appeared under antiviral treatment. Dryness syndrome was observed in 17 cases (22,36%). RM were associated to other extrahepatic manifestations of CHC in 69,7% of cases, notably to mixed cryoglobulinemia (MC) (60%) and to non specific antinuclear antibodies (21,6%). A partial to total amelioration of RM was noted in most patients under antiviral treatment often associated to symptomatic measures. In univariate analysis, only female sex and presence of MC were significantly correlated to the presence of RM. CONCLUSION RM occur frequently inCHC and are dominated by arthralgia, myalgia and dryness syndrome. Authentic arthritis are uncommon and constitute a diagnostic problem particularly when they inaugurate the disease. MC is the immunological factor the most associated with RM. MR treatment remains mainly antiviral.BACKGROUND Smoking cessation should be a priority for smokers, especially coronary patients. AIM To study the place and effectiveness of acupuncture in smoking cessation in coronary patients. METHODS We conducted a prospective open-label study of 25 coronary smokers treated by acupuncture over a 10-month period, from June 2017 to March 2018. A 2-session protocol acupuncture weekly for three to five weeks, with a positive response. In order to evaluate the effectiveness of acupuncture, a questionnaire was completed by the doctor during the treatment, at three and six months after the end of the sessions. Positive response was defined by total cessation of smoking. RESULTS The average age of our patients was 55.5 years (33 to 77 years). The sex ratio of our population was 1.5 with a male predominance. All our patients had a coronary history. The average cigarette consumption was 22.7 pack-years on average. The results of our study showed that acupuncture allows the withdrawal of 5 smokers (20%) from the first session. After the fifth session, 60% of our patients stopped smoking. At the end of the treatment, 17 smokers (70%) stopped smoking completely. At 3 and 6 months of treatment, we observed a stabilization of smoking cessation and decrease rates. CONCLUSION Smoking cessation is difficult to obtain whatever the therapeutic method used, which encourages us to strengthen preventive measures.INTRODUCTION The diagnosis of interstitial lung disease (ILD) requires elimination of underlying connective tissue disease. Consequently, antinuclear antibodies (ANA) are routinely screened in patients with idiopathic interstitial pneumonia. However the clinical usefulness of this practice is not well clear. AIM In this study, we evaluated the frequency of ANA in ILD's patients and investigated the clinical significance of the ANA's presence in these patients. METHODS We conducted a retrospective study of hospitalized patients diagnosed ILD at pulmonary department and for which ANA was performed in the immunology laboratory of our institution. Demographic features, clinical symptoms, biological and radiologic findings and CTD-ILD diagnoses were compared between patients with positive ANA versus negative ANA. RESULTS We enrolled 73 patients. The ANA's prevalence was 32%. There were no significant differences in demographics, pulmonary function test values and radiologic findings between patients with and without ANA. Patients with positive ANA had more cutaneous manifestations (p꞊0.011) and Raynaud's phenomenon (p꞊0.029). The diagnosis of connective tissue disease was made in 42% of patients with positive ANA versus 8% with negative ANA (p꞊ 0.001). ANA's titer higher than 1/320 was predictive of CTD diagnosis (OR꞊14.4) (p less then 0.001). link2 CONCLUSIONS The research of ANA in PID's patients is an important tool of CTD diagnosis specially in those with suggestive symptoms of autoimmune disease.INTRODUCTION Osteoporosis and fractures are known to complicate spondyloarthritis (SA). The Fracture Risk Assessment Tool (FRAX) estimate the 10-year probability of major osteoporotic fracture (MOF) and also hip fracture (FH). It can be useful as risk assessment tools for the purpose of preventing fracture in SA. AIM To measure the bone mineral density (BMD), to evaluate the FRAX and to determinate factors associated with high risk of fracture in patients with SA. link3 METHODS It's a prospective cross-sectional study that included seventy-five patients admitted for SA, in the rheumatology department of Kassab institute in Tunisia. All of them fulfilled the modified New York criteria for SA. RESULTS Sixty-two men and thirteen women were enrolled, with mean age of 36.8 ± 11.8 years. The mean age at disease onset was 27.8± 9.9 years. Mean BASDAI and ASDAS CRP were respectively 3.5 ± 2.4 and 3 ± 0.83. The mean BASRI was 8.9 ± 4.2 and the mean mSASSS was 17.6 ± 19.6. Vitamin D insuffiency and deficiency were found in 43 and 30 patients respectively. Osteoporosis (T score ≤ -2,5 SD) were found in 49% of patients and 80 % of them have a reduced BMD (T score ≤ -1 SD). The mean MOF score was 0,36 ± 0,3 [0-0,9] and the mean FH score was 0,3 ± 0 [0-0,5].The MOF was significantly associated with Bone loss (p=0.000). A trend for a significant association was also found with ASDASCRP (p=0.05). The MOF and FH were both significantly associated to the age at the onset of SA (respectively, p=0,003 and p=0,002). The risk of FH was higher when hip BASRI (p=0..036) and ESR were high (p=0,014), it's also associated to age (p=0..002) and vitamin D deficiency (p= 0.043). However, no correlation was found between the MOF and FH and the presence of peripheral arthritis, enthesitis or hip arthritis. CONCLUSION The MOF score, in patient's wih SA, was associated with bone loss, age at disease onset and ASDASCRP. The HF score was associated with age, Vitamine D deficiency, age at disease onset, high hip BASRI and high ESR.
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