La Tunisie médicale
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La Tunisie médicale · Aug 2004
[Clinical course of the ventilatory function in COPD: analytical study of 160 cases].
The incidence of chronic obstructive pulmonary disease (COPD) is increasing particularly in developing countries. Their prognosis depend on several factors in particular the one second forced expiratory volume (FEV1) decline. To study FEV1 decline speed and factors affecting it, we carried out a retrospective study of 160 cases of COPD in stable state and heaving at least two FEV1 measures at 6 months of interval in the minimum and. ⋯ We confirmed by multivariate analysis that age and smoking habit and increased the FEV1 decline. However this last correlated with FEV1% predicted. We concluded that the decline of FEV1 is higher in COPD that in the general population and slowing it needs smoking stop.
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The Lofgren syndrom is a particular variety of sarcoidose. The ocular attack is dominated in this syndrome by anterior uveitis. More rarely the eyelids and the orbitary structures are attached. ⋯ The Lofgren syndrome is a multivisceral chronic affection. The eye and its annexes constitute frequent cibles of this affection for which they react by a diverse and rich symptomalogy and which can be presented by eye-lid tumors with orbital extension.
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La Tunisie médicale · Apr 2004
Comparative Study[Evaluation of electrocardiogram's interpretation in the emergency department].
The aim of this study was to determine the concordance of emergency physicians' and cardiologists' interpretations of emergency department (ED) electrocardiograms (ECG) and to evaluate the impact of ECG misinterpretation on patient management. From December 1993 to April 1994 one hundred ninety five ECG interpretations (3.3% of all consultants) were registered prospectively using a programmed-response data sheet. A second blinded interpretation by a cardiologist was performed and compared with the emergency physicians' interpretations. The overall concordance between emergency physicians' and cardiologist ECG interpretations was observed in 149 (76%) cases (kappa = 0.41). The concordance rate was lower in abnormal ECGs (kappa = 0.19). ⋯ In our study, the quality of ECG interpretation by ED physicians is satisfactory and the rare misinterpretations have minimal clinical impact.
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The alpha2-adrenoceptor agonists have several beneficial actions during the perioperative period. They exert a central sympatholytic action, improving haemodynamic stability in response to endotracheal intubation and surgical stress, reducing the anesthetic and opioid requirements and causing sedation, anxiolysis and analgesia. ⋯ Recent alpha2-adrenoceptor agonists with short duration of action (dexmedetomidine and mivazerol) are adapted for the administration to patients at high risk for coronary artery disease during surgery. The alpha2-adrenoceptor agonists have an analgesic action at several sites of the peripheral and central nervous system as well as the prolongation of epidurally or intrathecally administered local anesthetics and opioids.
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Ischemic cerebral infarction associated with myocardial infarction is yet a real diagnosis challenge. If during the acute myocardial phase the mechanism is mostly embolic, at long-term, the mechanism is not clearant and other causes should be searched. ⋯ Atrial fibrillation was suspected and no other abnormalities could be found. The diagnosis of cardio-embolic ischaemic stroke could not be made with certainly.