[Percutaneous angioplasty of renal artery stenosis: Short- and long-term results]. / Angioplastie des sténoses de l'artère rénale : résultats à court et à long termes.

INTRODUCTION: Renal artery stenosis (RAS) may be symptomatic. The treatment of these lesions is primarily medical but may sometimes require surgical or endovascular revascularization. RAS angioplasty is well controlled but its results are discussed. The objective of this work was to report the short- and long-term results of the endovascular treatment of renal arteries in our center. METHODS: We report a retrospective study between 2013 and 2018, including patients who received endovascular treatment for severe symptomatic RAS (≥75%). RESULTS: Our population consisted of 17 patients. Mean age was 51.1 years [18-76], sex ratio 2.4. RAS was discovered during work-up for severe renovascular hypertension resistant to medical treatment for 16 patients and rapidly progressive renal failure for one patient. The etiology retained was: atherosclerosis (9 cases), fibromuscular dysplasia (6 cases) and Takayasu's disease (2 cases). The average stenosis rate was 85.9% [75-97%]. We performed simple angioplasty in 47% of the cases and stenting in 53%. The technical success rate was 100%. At 1 month, morbidity-mortality rates were zero. Mean follow-up was 12 months [6-36 months]. Patients with renovascular hypertension experienced a decrease in blood pressure, with discontinuation of antihypertensive therapy in 62.5% of cases and reduction of doses in 37.5% of cases. The permeability rate was 100% at 1 year, 94% at 2 years and 94% at 3 years. One patient had asymptomatic stent thrombosis at the 18th month. The restenosis rate was zero. CONCLUSION: Angioplasty of symptomatic RAS may be indicated as first-line treatment. It is associated with satisfactory results in the short and long terms.

Determinants of occupational multisite musculoskeletal disorders: a cross sectional study among 254 patients.

The aim was to describe the profile of workers with occupational multi-site musculoskeletal disorders (MSMSD) and study the relationship between these lesions and socio-professional factors. This is a cross-sectional study involving 254 subjects with occupational musculoskeletal disorders (MSD), identified in the Department of Occupational Medicine at the University Hospital of Mahdia, in Tunisia, over a period of 10 years from 2005 to 2014. The study population was subdivided into two groups; mono-site MSD and multi-site (≥2 sites) groups. Data collection was based on a questionnaire prepared beforehand and covered the description of sociodemographic and professional characteristics. To study psychosocial constraints at work, we have used the Karasek questionnaire. MS-MSD was correlated to the number of dependent children (p=0.02), job/place of work (p=0.00), qualification (p=0.02), taking a rest period (p=0.03), decision latitude (p=0.00), mental demands (p=0.002), social support (p=0.00) and job stress (p=0.04). After binary logistic regression, MS-MSD depended significantly on the number of dependent children (p=0.013; OR=0,33; IC=0,17-0,83), working spouse (p=0.05; OR=0.35; IC=0.12-0.99), job/place of work (p=0.00; OR=4.16; IC=1.95-8.88), qualification (p=0.008; OR=0.28; IC=0.11-0.72), taking a break during work (p=0.04; OR=3.10; IC=1.04-9.22) and social support (p=0.00; OR=7,1; IC=1,9-25,3). When individual risk factors are fixed, the prevention of MS-MSD must target modifiable levers, related to the professional environment of the employees.

Work-related carpal tunnel syndrome treatment: a cross-sectional study among 106 patients.

The objective is to assess the influence of sociodemographic, professional and clinical variables on the choice of treatment of work-related carpal tunnel syndrome (CTS). An exhaustive and trans-sectional study was conducted over a period of eight years, from 1st January 2006 to 31 December 2013 in the Department of Occupational Medicine at University Hospital of Mahdia, Tunisia. The study population was represented by patients with work-related carpal tunnel syndrome. Data collection was based on a questionnaire sheet, describing social, occupational and medical characteristics of patients. The study population was characterized by a large female dominance, representing 95.3% with an average age of 42±7.8 years. Patients medically treated represented 38.7% and 61.3% had had surgical treatment. After binary logistic regression, surgical indication of CTS was significantly correlated to diabetes (p=0.017), other musculoskeletal disorders (p=0.02), functional signs of CTS (acrocyanosis p=0.05; muscle weakness p=0.015; radiating pain p=0.01; painful discomfort of the hand, the forearm or arm p=0.027) and to the atrophy of thenar muscles (p=0.018). According to this study, the choice of therapy for occupational CTS depends only on clinical data. More detailed studies will be needed to refine these results.

Stress and burnout in postgraduate dental education.

INTRODUCTION: High levels of stress and burnout have been documented among dental students and practicing dentists, but evidence among dental residents and postgraduate students is lacking. MATERIALS AND METHODS: Ninety-nine postgraduate students enrolled in clinical, non-clinical and PhD programmes in the Athens University School of Dentistry completed the Graduate Dental Environment Stress (GDES) questionnaire and the Maslach Burnout Inventory. Perceived stress was measured in two domains, academic (GDES-A) and clinical (GDES-C) and burnout was measured using the scales of emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). Analyses relied on descriptive, univariate and multivariate methods based on ANOVA and generalised linear models. RESULTS: Participants' mean age was 30 years; two-thirds were women and practised dentistry independently of their graduate studies. Residents in clinical programmes reported significantly higher levels of perceived stress compared to non-clinical and PhD students (P<0.05). There were no gender differences in perceived stress. Forty per cent of respondents were burnout 'cases' on the EE scale, while this proportion was 38% for reduced PA and smaller, 13% for DP. Perceived stress was positively correlated with all burnout dimensions, whereas independent dental practice and higher age had a protective effect. CONCLUSIONS: High rates of burnout manifestations were detected among this sample of Greek postgraduate dental students. Perceived stress correlated with burnout and was more pronounced among those enrolled in clinical residency compared to non-clinical and PhD programmes.

Effect of blue light on the proliferation of human gingival fibroblasts.

OBJECTIVES: Previous studies have reported that blue light, under conditions similar to those used for orthodontic bonding, influences several aspects of cellular physiology. The purpose of this study was to investigate the effect of the exposure to blue light curing sources, i.e. halogen, light emitting diode (LED) and plasma arc irradiation, on the proliferation of human gingival fibroblasts. METHODS: Primary cultures of human gingival fibroblasts were exposed to halogen, LED and plasma arc irradiation for 240, 180 and 120 s, respectively. The effect of blue light on DNA synthesis and cell proliferation was estimated by tritiated thymidine incorporation and direct cell counting, respectively. The possible involvement of an oxidative stress on the effect of blue light irradiation was studied by using N-acetyl-cysteine. Finally the formation of DNA double-strand breaks after irradiation was studied by immunofluorescence with an antibody against histone H2A.x phosphorylated in Ser139. RESULTS: Blue light showed no immediate effect on the regulation of DNA synthesis. However, exposure of cells to these light sources inhibits cell proliferation measured one week after irradiation. This phenomenon is not attributed to the formation of DNA double strand breaks and cannot be annulled by N-acetyl-cysteine. SIGNIFICANCE: The results presented here indicate a mild inhibition of gingival fibroblasts' proliferation after exposure to blue light and necessitate further study to clarify the exact mechanism underlying this effect.