[Oculoplastic Surgery At CHU-IOTA In Mali]. / La Chirurgie Oculoplastique Au CHU-IOTA Au Mali.

Esthetic and functional surgeries in the periocular region fall into the domain of oculoplastic, or plastic and reconstructive surgery and otorhinolaryngology. Oculoplasty is the largest surgical spectrum in ophthalmology including eyelids, orbits and the lacrimal system. Our purpose was to study the frequency of eyelid, lacrimal and orbital (oculoplastic) surgery at the CHU IOTA. MATERIAL AND METHODS: Retrospective medical chart review of all the patients who underwent oculoplastic surgery was conducted from October 2015 to September 2016. RESULTS: A total of 233 patients were included with 52% female and 48% male. Patients were 37 years old on average. In total, the surgery was performed on the eyelids in83 cases (35.6%), the orbits in 113 cases (48.5%) and the lachrymal system in 37 cases (15.9%).Eyelid surgery commonly resulted from eye trauma (43,3%), followed by malpositions (30,2%). Mutilating surgery accounted for 92% of the orbital surgery. External dacryocystorhinostomy was the main lacrimal surgery (42%) followed by canalicular lacerations 25%. CONCLUSION: Oculoplasticsurgeryoccupies an important place in the surgical activities of the ophthalmologic University hospital despite a larger volume for cataractsurgery. Our studydoesn't highlight the outcome of the surgery itself but the epidemiology to help decision makers in their eye health policy including the reduction of mutilating surgery and oculoplastic training.

La chirurgie esthétique et fonctionnelle de la région périoculaire est du domaine de l'oculoplastie, ainsi que de la chirurgie plastique et reconstructive et de l'otorhinolaryngologie. L'oculoplastie constitue le plus large éventail chirurgical en ophtalmologie regroupant la paupière, l'orbite et le système lacrymal. OBJECTIF: Etudier la fréquence des procédures chirurgicales orbito-palpébrales et lacrymales (oculoplasties) dans un centre de troisième référence. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude rétrospective des dossiers de patients opérés pour pathologies oculoplastiques d'octobre 2015 à septembre 2016. RÉSULTATS: Au total 233 patients ont été inclus dont 52% de sexe féminin et 48% de sexe masculin avec un âge moyen de 37 ans ; parmi lesquels 83 cas (35,6%) de chirurgie palpébrale, 113 cas (48,5%) de chirurgie orbitaire et 37 cas (15,9%) chirurgie lacrymale.La chirurgie palpébrale était dominée parréparationdesplaies traumatiques (43,3%), suivi des malpositions (30,2%). La chirurgie mutilante constituait 92% de la chirurgie orbitaire. La dacryocystorhinostomie par voie externe était la principale chirurgie lacrymale soit 42%, suivie des lacérations canaliculaires 25%. CONCLUSION: Notre étude ne met pas en exergue le résultat de la chirurgie elle-même, mais l'épidémiologie du traitement chirurgical afin d'aider les décideurs dans leur politique de santé oculaire notamment sur la réduction de la chirurgie mutilante et la formation oculoplastique.

Towards a personalized and dynamic CRT-D. A computational cardiovascular model dedicated to therapy optimization.

BACKGROUND: In spite of cardiac resynchronization therapy (CRT) benefits, 25-30% of patients are still non responders. One of the possible reasons could be the non optimal atrioventricular (AV) and interventricular (VV) intervals settings. Our aim was to exploit a numerical model of cardiovascular system for AV and VV intervals optimization in CRT. METHODS: A numerical model of the cardiovascular system CRT-dedicated was previously developed. Echocardiographic parameters, Systemic aortic pressure and ECG were collected in 20 consecutive patients before and after CRT. Patient data were simulated by the model that was used to optimize and set into the device the intervals at the baseline and at the follow up. The optimal AV and VV intervals were chosen to optimize the simulated selected variable/s on the base of both echocardiographic and electrocardiographic parameters. RESULTS: Intervals were different for each patient and in most cases, they changed at follow up. The model can well reproduce clinical data as verified with Bland Altman analysis and T-test (p > 0.05). Left ventricular remodeling was 38.7% and left ventricular ejection fraction increasing was 11% against the 15% and 6% reported in literature, respectively. CONCLUSIONS: The developed numerical model could reproduce patients conditions at the baseline and at the follow up including the CRT effects. The model could be used to optimize AV and VV intervals at the baseline and at the follow up realizing a personalized and dynamic CRT. A patient tailored CRT could improve patients outcome in comparison to literature data.

The effects of Italian Mediterranean organic diet (IMOD) on health status.

OBJECTIVE: The aim of this study was to verify the effects of Italian Mediterranean Diet (IMD), consisting of organic versus conventional foods, on body composition, and biochemical parameters in a healthy individuals and in Chronic Kidney Disease (CKD) patients, in order to decrease cardiovascular diseases (CVD) risk factor and the progression of renal diseases. DESIGN: After providing a written fully informed consent to the study, 150 Caucasian Italian men were recruited: 100 healthy male individuals (mean age 44,66+/-13,98 years; range 30-65 years) and 50 male CKD patients (mean age 46,25+/-5,97 years; range 42-54 years). These patients were affected by stage 2 and 3 of Chronic Renal Failure according to the K-DOQI 2003. Usual dietary intake and physical activity, during the previous 12 months were estimated by a semiquantitative food-frequency questionnaire. The following were measured at baseline and after consumption of conventional/organic 14 days IMD: Body mass index (BMI), Body composition, by Dual-X absorptiometry (DXA) scanner, total plasma homocysteine (tHcy), serum phosphorus, glycemia concentrations, lipid profile, and microalbuminuria. RESULTS: A significant reduction of total homocysteine (tHcy) and phosphorus blood values were observed in the studied subjects. Body composition analysis by DXA highlighted high significant differences between conventional (T(0)) and organic diet (T(1)) for fat mass parameter, expressed as kilograms and as percentage (p<0.001). Improvement of lean body mass was observed in CDK patients (p=0.004). CONCLUSIONS: Our study clearly demonstrates that the Italian Mediterranean Organic Diet (IMOD), according to the "Nicotera diet", was able to reduce tHcy, phosphorus, microalbuminuria levels and CVD risk in healthy individuals and in CDK patients.