[Causes of death in Tunisia: estimates of years of life lost]

This study estimated the number of years of life lost [YLL] by cause due to premature death in Tunisia for the year 2006. We adopted the methodology [SEYLL] proposed by Murray and Lopez. The crude rate of YLL was 58.1 per 1000 inhabitants. After age-standardization using the world population, we obtained a rate of 57.7 YLL per 1000. Cardiovascular diseases [CVD] [19.3% of total YLL] and cancers [17.8%] dominated the burden of premature mortality, followed by perinatal conditions [13.6%]. Excluding extreme age groups where perinatal conditions [0-4 years] and CVD [> 60 years] dominated the YLL's causes, injuries [road traffic crashes, falls, etc.] and cancers were most responsible for YLL. The present study highlights the major contribution of noncommunicable diseases to YLL in Tunisia. The promotion of healthy lifestyle and the reinforcement of secondary prevention in primary health care are the best ways to tackle these diseases

[Differentiation between physiological left ventricular hypertrophy and hypertrophic cardiomyopathy of athletes, usefulness Doppler tissue imaging]

Athlete's heart is a cardiac adaptation to long-term, intensive training, wich includes physiological changes as increased ventricular cavity, wall thickness and mass. Maron highlighted a "gray zone" of wall thickness with difficult distinction between physiological left ventricular hypertrophy of athletes from hypertrophic cardiomyopathy [HCM]. The aim of the study is to analyse the data published about the diagnostic tools wich differentiate between physiological athlete's left ventricular hypertrophy and HCM. Even if the standard two-dimensional echocardiography represents an irreplaceable method in the evaluation of cardiac adaptations to physical exercice, the data currently available suggests the usefulness of Doppler tissue imaging [DTI] in the distinction between HCM and athlete's heart. The authors, will report the best DTI parameters recommended in this setting. The best DTI parameter to differentiate pathological hypertrophy of HCM from physiological hypertrophy of athletes was the gradient of diastolic velocity between the endocardium and the epicardium. On this ground, DTI may be taken into account in the Maron's diagnosis cascade