Search

La mort subite d’origine cardiaque est une pathologie à l’origine 50 000 décès soudains annuels en France. Elle atteint aussi bien les sujets âgés porteurs d’une coronaropathie que les sujets jeunes porteurs de cardiopathie structurelle ou non structurelle. Nous rapportons l’observation de deux jeunes patients, porteurs de canalopathies (syndrome de repolarisation précoce et syndrome du QT long), ayant bénéficié de l’implantation d’un défibrillateur sous-cutané en prévention secondaire après une mort subite récupérée.

Particularities of African descent patient's electrocardiogram have been described for many years. Variations such as higher QRS voltage, early repolarization pattern, precordial T-wave inversion and anterior ST segment elevation associated with T-wave inversion are more frequently observed. Ignorance of these variations can lead to misdiagnosis or therapeutic negligence. We present the electrocardiographic particularities attributed to the patient of African origin.

Resume Introduction Les liens entre cœur et thyroide sont etroits et les complications cardiaques de la maladie de Basedow sont essentiellement representees par des troubles du rythme supra-ventriculaires ou une insuffisance cardiaque a debit cardiaque augmente, sans veritable atteinte myocardique. Observation Un homme de 40 ans ayant une maladie de Basedow resistante au traitement conventionnel etait hospitalise pour douleur thoracique aigue avec elevation des biomarqueurs cardiaques, le bilan initial excluant une cause coronaire. Le diagnostic de myocardite aigue etait confirme par IRM cardiaque, sans element pour une cause infectieuse. L’hypothese d’une myocardite aigue auto-immune au cours d’une maladie de Basedow active etait retenue. Conclusion La myocardite aigue est une complication exceptionnelle de la maladie de Basedow, dont le mecanisme auto-immun est le plus probable. Ses consequences rythmiques ou hemodynamiques sont parfois fulminantes, justifiant de realiser un bilan cardiologique minimal avant l’introduction d’un traitement beta bloquant.

Introduction The etiology of myocarditis often remains undetermined. A large variety of infectious agents, systemic diseases, drugs, and toxins can cause the disease. We report the case of a 19-year-old man who developed myocarditis three days after Pfizer-BioNTech COVID-19 booster vaccination. Case report A 19-year-old man, presenting with troponin-positive acute chest pain, was referred to our department. He had received the Pfizer-BioNTech COVID-19 vaccine three days prior to his admission. The diagnosis of acute myocarditis was confirmed by cardiovascular magnetic resonance imaging. Patient hemodynamic status remained stable during hospitalization. The left ventricular ejection fraction was preserved during hospital stay and at one-month follow-up. We found no evidence for another infectious or autoimmune etiology. Conclusion Although imputability of the vaccine cannot be formally established on the basis of this case report, the findings raise the possibility of an association between mRNA COVID-19 vaccination and acute myocarditis.

Doping is the use of a substance that artificially increases an individual's physical ability for competition purpose. Products and methods used in doping are not without risk, especially at cardiovascular level. Here we review the most common doping substances in sport and their cardiovascular consequences.

Particularities of African descent patient's electrocardiogram have been described for many years. Variations such as higher QRS voltage, early repolarization pattern, precordial T-wave inversion and anterior ST segment elevation associated with T-wave inversion are more frequently observed. Ignorance of these variations can lead to misdiagnosis or therapeutic negligence. We present the electrocardiographic particularities attributed to the patient of African origin.

Infantile- and childhood-onset parkinsonism is mainly due to genetic alterations and is an exceedingly rare condition, unlike Parkinson's disease (PD), which is one of the most common neurologic disorders in adulthood. The clinical characterization of parkinsonism during early stages of neuromotor development is controversial due to the lack of consensus regarding the clinical criteria of PD or parkinsonism in the immature brain. The classification here proposed is based on a review of conditions that emerge during infancy and childhood, with key symptoms evocative of adult parkinsonism. The proposed nosography is based on age at presentation, clinical features, outcome, and etiological background. It includes developmental parkinsonism, infantile degenerative parkinsonism, parkinsonism in the setting of neurodevelopmental disorders, parkinsonism in the setting of multisystem brain diseases, juvenile parkinsonism and dystonia-parkinsonism, and acquired parkinsonism. The subgroups denoting peculiar clinical presentations as a consequence of disease impact on the immature brain are developmental parkinsonism due to monoamine metabolic disorders and infantile degenerative parkinsonism caused by DAT and WASR2 defects. More tardive parkinsonisms occur in genetic conditions that cause a generalized derangement of neurodevelopmental processes, such as those due to MECP2, NR4A2, SCN1A, and RAB39B. Some conditions presenting with neurodevelopmental disorder can progress later, disclosing their neurodegenerative nature (i.e. WDR45 and KCND3). Finally, new emerging conditions with childhood-onset parkinsonism arise from the cumulative effect of multiple genetic lesions. © 2020 Elsevier Ltd

Kounis syndrome is an allergic acute coronary syndrome. It occurs on healthy or pathological arteries. Its complications, although often benign, can lead to cardiac arrest and death. Its triggering factors are multiple and include contrast products used in diagnostic imaging. We report the case of an 81 years old patient affected by hepatocellular carcinoma, who presented a type 2 Kounis syndrome with inferior myocardial infarction, complicated by cardiac arrest related to complete heart block following a gadoteric acid injection.

Unlike the previous scientific works on the vertical axis turbines which were mostly limited to design improvements, performance metrics and flow dynamics but significantly ignored the effect of operational uncertainties on the power output, this paper presents how the performance of a low-speed vertical axis hydrokinetic turbine can be attributed to the inherent uncertainties in the operating conditions. While a complete set of uncertainty sources in the design, development and operation of a water turbine is pictured with real and hypothetical relationships, this study focuses mainly on two uncertainties. Starting from the methodological illustration of a towing tank experiment, the sources of uncertainty are defined as ±0.7% in free-stream velocity V 0 and ±1.06% in the turbine’s rotational velocity Ω . The stochastic space is constructed on a two-dimensional Clenshaw-Curtis grid and finite-volume-based deterministic computations are performed at each grid node. The sensitivity of the turbine’s performance to these input uncertainties is quantified using probability methods, including response surface, PDF and CDF. Flow-related non-linearities such as vortex release and blade-vortex interaction are directly reported in stochastic space and corresponding variations in the force coefficients of the turbine’s blade are identified. It is observed that the uncertainty in the turbine’s rotation is more influential on the power output compared to free-stream velocity.

Resume Background La prise en charge du syndrome coronaire aigu avec sus-decalage du segment ST n’a pas ete recemment evaluee. L’objectif de l’etude est d’evaluer leur prise en charge en France en 2014 et de la comparer aux recommandations actuelles. Methodes Cette etude multicentrique s’appuie sur un questionnaire envoye par mail aux angioplasticiens francais. Il evalue les donnees demographiques des coronarographistes, la prise en charge interventionnelle et medicamenteuse et le devenir des patients. Resultats Cent soixante-seize reponses ont ete analysees. La majorite des centres realisaient plus de 600 angioplasties annuelles. En moyenne, 209 infarctus ont ete admis par centre en 2014, plus frequemment en centre hospitalo-universitaire qu’en centre regional ou prive (respectivement 51, 32 et 17 % des infarctus). La thromboaspiration – dont nous discutons l’apport – et les anti-GPIIbIIIa (34 % des cas) n’etaient pas systematiques mais adaptes a chaque patient, conformement aux recommandations. L’abord radial (85 % des cas) et les stents actifs (62 % des cas) etaient privilegies. L’heparine non fractionnee et l’enoxaparine representaient plus de 80 % des traitements anticoagulants. Les taux d’utilisation du clopidogrel, du prasugrel et du ticagrelor etaient comparables. La readaptation cardiovasculaire etait insuffisamment proposee a 50 % des patients. Conclusion Malgre une heterogeneite de prise en charge du syndrome coronaire aigu avec sus-decalage du segment ST, l’ensemble des pratiques s’integre dans les recommandations actuelles. Des efforts pourraient etre faits sur l’utilisation des nouveaux inhibiteurs P2Y12.

Resumen Antecedentes y objetivo En 2010 publicamos que en Espana el 53% de los carcinomas hepatocelulares (CHC) se diagnostican fuera de programas de cribado, lo que conlleva una menor supervivencia. El objetivo del presente estudio es evaluar la situacion actual y las causas del diagnostico fuera de cribado. Material y metodos Registro prospectivo entre el 1 de octubre de 2014 y el 31 de enero de 2015 en 73 centros asistenciales espanoles de segundo/tercer nivel. Se registraron las caracteristicas basales y el primer tratamiento de los tumores primarios hepaticos incidentales de ese periodo. Resultados Se incluyeron 720 pacientes: CHC (n = 686), colangiocarcinoma intrahepatico (n = 29), hepatocolangiocarcinoma (n = 2), otros (n = 3). Los pacientes con CHC fueron varones en el 82% de los casos; media de 67 anos; cirrosis en el 87%; etiologia: alcohol 35%, VHC 30%, alcohol y VHC 15%, enfermedad hepatica por deposito de grasa 6%; estadio tumoral: BCLC-0 11%, A 43%, B 19%, C 16% y D 11%; tratamiento inicial: quimioembolizacion transarterial (23%), ablacion percutanea (22%), tratamiento sintomatico (20%), reseccion (11%), sorafenib (11%). Se diagnosticaron fuera de cribado 356 pacientes (53%). Los motivos principales fueron la ausencia de diagnostico previo de hepatopatia (76%) y la mala adherencia al cribado (18%). Estos pacientes eran predominantemente varones (p Conclusiones En Espana, la principal causa del diagnostico de CHC fuera del cribado es la ausencia de diagnostico previo de enfermedad hepatica, principalmente en varones con consumo de alcohol. La deteccion de hepatopatia en poblacion asintomatica y la mejora de la adherencia al cribado son los principales aspectos para mejorar la deteccion precoz.

El sobrecrecimiento bacteriano intestinal (SBI) es muy frecuente en las hepatopatías crónicas. Las causas, aunque no bien conocidas, parecen ser varias. Las dos principales son la hepatopatía y el etilismo y las alteraciones que ambos producen: disminución de la secreción gástrica, sobre todo de clorhídrico, disminución de la liberación de IgA y la malnutrición. A su vez el SBI aumenta la gravedad de la hepatopatía y produce con bastante frecuencia peritonitic bacteriana espontánea. Todos estos datos ponen de manifiesto la importancia del SBI como agravante de la hepatopatía y, por ello, no se le puede descuidar.

The determination of ply properties of Fiber Reinforced Polymers (FRP) for particular operational environmental conditions in aeronautical applications is mandatory in order to fulfill current industry stringent certification requirements. However, the traditional experimental approach requires massive investments of resources and time. From the behaviour obtained experimentally, constitutive equations including failure criteria are then devised to be used in the design of FRP structures. The ply longitudinal behaviour under compression is generally the most difficult to measure and characterize. In this work, an alternative coupled experimental-computational micromechanics approach is proposed to determine the longitudinal compression properties of unidirectional FRP plies under different environmental conditions. This methodology includes experimental characterization of matrix and fiber/matrix interface, combined with numerical simulations of realistic microstructures. The interface decohesion is simulated using cohesive-frictional interactions. A pressure dependent, elasto-plastic model that includes tensile damage is employed to capture the matrix nonlinear behaviour. The numerical predictions match the experimentally-obtained ply properties available in the literature in a remarkable way and suggest that virtual ply property characterization is a mature and reliable approach to conduct screening of materials. The authors would like to acknowledge the support provided by AIRBUS SAS through the project SIMSCREEN (Simulation for Screening Composite Materials Properties). Additionally, C.S. Lopes acknowledges the support of the Spanish Ministry of Economy and Competitiveness (RYC-2013-14271) through the Ramón y Cajal program. The collaboration with NASA Langley Research Center in some aspects of this work is also acknowledged.

Resume But de l’etude Malgre les progres therapeutiques et diagnostiques, l’incidence et la mortalite de l’endocardite infectieuse (EI) n’ont pas diminue au cours des dernieres annees. L’objectif de l’etude est de decrire les caracteristiques epidemiologiques et le pronostic des EI dans un centre non universitaire en les comparant aux donnees actuelles et a celles d’une etude menee dans le meme centre 10 ans auparavant. Patients et methode Une etude retrospective incluant les EI confirmees selon les criteres de Duke modifies entre 2004 et 2014 a ete menee dans un centre non universitaire francais. Resultats Les resultats – notamment le taux de deces intrahospitalier de 16 % – sont superposables aux donnees francaises et internationales. En 10 ans, on constate une augmentation (non significative) des endocardites a Staphylococcus et sur pacemaker . Les EI liees aux soins sont en expansion. En analyse univariee, les facteurs predictifs du deces intrahospitalier sont l’insuffisance renale, l’âge superieur a 77 ans et le Staphylococcus aureus . En analyse multivariee, seules l’insuffisance renale et l’absence de prise en charge chirurgicale sont associees a la mortalite. On note une surmortalite non significative lors des endocardites a S. aureus ou en cas d’insuffisance cardiaque. Conclusion L’EI reste une maladie severe et le Staphylococcus est de plus en plus souvent implique. Cette pathologie semble pouvoir etre prise en charge de maniere sure en centre peripherique s’il existe un partenariat avec un centre de reference.

En el presente trabajo se ha estudiado la disproteinemia hepática por medio de una técnica inmunoquímica cuantitativa en una serie de ratas con lesiones hepáticas tóxicas por Cl4C y otra serie de ratas a las que se había practicado una hepatectomía standard del 75 %. Junto a este estudio experimental se ha analizado la disproteinemia en una serie de enfermos afectos de hepatitis crónica y de cirrosis. Este análisis inmunoquímico ha sido completado con un estudio de la persistencia plasmática de la IgG marcada con yodo 131 en la serie de ratas con lesiones experimentales, y un análisis del depósito de gamma globulina en el parénquima hepático de estos animales. Los análisis obtenidos nos han permitido valorar las variaciones de la albúmina transferrina y de las tres inmunoglobulinas, en los diversos tipos y grados de afectación hepática. Comprobando que en las lesiones iniciales sólo están aumentadas la IgA e IgM mientras que la IgG tarda más tiempo en aumentar presentando sus máximos valores en los últimos estadios lesionales. La albúmina y transferrina descienden conforme las lesiones son más avanzadas. Estas variaciones fueron independientes del tipo de lesión hepática inducida. La alteración de las inmunoglobulinas en los enfermos hepáticos ha mostrado una estrecha correlación con el tiempo de protrombina, encontrándose un aumento precoz de la IgA e IgM cuando las alteraciones del tiempo de protrombina eran poco marcadas, mientras que en los pacientes con grandes alteraciones de la protrombina el incremento de las inmunoglobulinas era más homogéneo. Estos resultados son concordantes con los obtenidos mediante el marcaje de IgG con yodo 131 y sugieren la posibilidad de que cuando hay mayor incapacidad funcional hepática existe también un déficit catabólico más marcado para las inmunoglobulinas.

Se han valorada comparativamente dos métodos de aislamiento de transferrina sérica humana y se ha estudiado el efecto de la administración de esta proteína sobre la incorporación hemática del Fe59 en ratas Wistar. Mediante experiencias de administración oral y parenteral, se ha precisado también la influencia que tiene la utilización de una y otra vía sobre la incorporación hemática de Fe59. Los resultados obtenidos permiten establecer las conclusiones siguientes: 1. La utilización combinada de la precipitación con Rivanol y con sulfato amónico permite obtener preparaciones más puras de transferrina que si se utiliza sulfato amónico solo. 2. Mediante la filtración en Sephadex G-25 de preparaciones de transferrina unida a Fe59, puede seleccionarse una fracción del eluido que contenga transferrina sin vestigios contaminantes de otras proteínas séricas. 3. La tasa de incorporación hemática de Fe59 se incrementó en un 150 % cuando se administraba con transferrina por vía parenteral y en un 176 % cuando se administraba con transferrina por vía oral. 4. La velocidad de incorporación hemática de Fe59 fue significativamente mayor cuando a éste se le unió transferrina, tanto por vía intraperitoneal, como por vía oral. 5. La transferrina suministrada por vía oral o intraperitoneal prolongó la vida media biológica del Fe59 incorporado a la sangre. Se discuten los resultados obtenidos resaltando las implicaciones clínicas y terapéuticas de los mismos.

Objective Definitive staging for cervical (CC) and endometrial cancer (EC) takes place once surgery is performed. The aim of this study was to evaluate the role of PET/CT in detecting lymphatic metastasis in patients with CC and EC using dual-time-point imaging (DPI), taking the histopathological results of sentinel lymph node (SLN) and lymphadenectomy as the reference. Material and methods A prospective study was conducted on 17 patients with early CC, and 13 patients with high-risk EC. The patients had a pre-operative PET/CT, MRI, SLN detection, and lymphadenectomy, when indicated. PET/CT findings were compared with histopathological results. Results In the pathology study, 4 patients with CC and 4 patients with EC had lymphatic metastasis. PET/CT showed hypermetabolic nodes in 1 patient with CC, and 5 with EC. Four of these had metastasis, one detected in the SLN biopsy. Four patients who had negative PET/CT had micrometastasis in the SLN biopsy, 1 patient with additional lymph nodes involvement. The overall patient-based sensitivity, specificity, positive and negative predictive values, and accuracy of PET/CT to detect lymphatic metastasis was 20.0%, 100.0%, 100.0%, 87.9%, and 88.2%, respectively, in CC, and 57.1%, 88.9%, 66.7%, 84.2% and 80.0%, respectively, in EC. DPI showed higher retention index in malignant than in inflammatory nodes, although no statistically significant differences were found. Conclusions PET/CT has low sensitivity in lymph node staging of CC and EC, owing to the lack of detection of micrometastasis. Thus, PET/CT cannot replace SLN biopsy. Although no statistically significant differences were found, DPI may help to differentiate between inflammatory and malignant nodes.

Introduction La selection de variables est un processus permettant de ne retenir que les variables les plus pertinentes, parmi un ensemble de variables candidates, pour expliquer et/ou predire les valeurs prises par une variable cible. Il existe plusieurs types de methodes de selection de variables, notamment les methodes dites « filtres ». Ces methodes evaluent, independamment d’un algorithme d’apprentissage, le caractere pertinent d’un ensemble de variables candidates a partir d’une fonction d’evaluation. A cet effet, la γ-metric [1] offre une mesure du caractere discriminant d’un ensemble de variables. Materiel et methodes La γ-metric est calculee grâce aux valeurs et vecteurs propres des matrices de variance-covariance de chaque classe d’observations et a partir du sous-ensemble de variables candidates. Elle mesure la separabilite entre les differentes classes d’observations. On choisit ainsi le sous-ensemble maximisant l’indice. Quatre methodes de selection ont ete construites a l’aide de la γ-metric, se distinguant par la direction d’exploration des sous-ensembles de variables candidates (« forward », « backward », « hill-climbing » et « best-first »). Les methodes de selection de variables, classiques et avec la gamma-metric, ont ete appliquees dans le cadre de la detection de troubles du rythme cardiaque (fibrillation atriale) et a partir des jeux de donnees mises a disposition par PhysioNet [2] . Nous avons applique un classifieur binaire de type « Support Vector Machine » avec les differents sous-ensembles de variables retenus. La comparaison des methodes de selections a ete faite a partir de l’estimation par bootstrap de l’indice de Jaccard, obtenu en prediction sur un jeu de donnees de validation externe, et du nombre de variables retenues par chaque methode. L’indice de Jaccard mesure la similarite entre la prediction obtenue et l’observation. Un indice de Jaccard a 1 signifie que les predictions sont identiques aux observations. Resultats Sur le jeu de validation externe, les modeles construits a partir des methodes de selection de variables utilisant la γ-metric ont obtenu de bonnes performances en termes d’indice de Jaccard : 0,967 (IC a 95 % [0,965 ; 0,967]) pour les methodes utilisant les directions d’exploration « forward » et « best-first », 0,960 (IC [0,958 ; 0,961]) pour la methode utilisant la direction « backward » et 0,939 (IC [0,825 ; 0,967]) pour celle utilisant la direction « hill-climbing ». Les modeles qui ont ete construits ΰ partir de la γ-metric et les directions « forward » et « best-first » (deux variables retenues) ont obtenu le deuxieme meilleur indice de Jaccard. Celui utilisant la direction « backward » (97 variables) avait des performances similaires a la plupart des autres modeles construits. Enfin, celui construit a partir du « hill-climbing » (50 variables) avait un indice de Jaccard moins eleve que les autres modeles. Conclusion Les resultats obtenus sur cette application ont montre que la γ-metric peut etre utilisee comme fonction d’evaluation pour la selection de variables. En effet les modeles de classification construits avec les variables selectionnees par ses methodes, donnaient des performances similaires aux modeles construits a partir de variables jugees pertinentes par d’autres methodes de selection de variables plus classiques.

Interactions between heart and thyroid are strong. Main cardiac complications of Graves' disease are supra-ventricular tachycardia or high output cardiac failure, without real myocardial involvement.A 40-year-old man with history of refractory Graves' disease was hospitalized for an acute chest pain with elevated cardiac biomarkers and normal coronarography. Acute myocarditis was confirmed by cardiac MRI. We found no evidence for an infectious etiology. We retained the hypothesis of acute autoimmune myocarditis in the context of active Graves' disease.Acute myocarditis is an exceptional complication of Graves' disease, with most likely an autoimmune mechanism. Possible occurrence of fulminant rhythmic or hemodynamic complications justify minimal cardiological check-up before introducing beta blockers.

International audience; The aim of this work is to develop an efficient data-driven method for automatic medical decision making, especially for cardiac arrhythmia diagnosis. To achieve this goal, we have targeted the most common arrhythmia worldwide -atrial fibrillation (AF). Most of reported studies are dealing with inter-beat interval time series analysis coupled with univariate and/or multivariate data-driven methods. The state of the art of this subject revealed that although satisfactory detection findings have been achieved for long AF durations, there is still scope for improvement which needs to be addressed for brief episodes which is highly desired by healthcare professionals. Relevance vector machine (RVM) has been developed to address this issue. Several kernel functions and parameters have been tested to optimize RVM. Five geometrical and nonlinear features were extracted from 30s inter-beat time series. The RVM classifier was trained on 3000 randomly selected samples from four publicly-accessible sets of clinical data and tested on 1000 samples. The performance of the diagnosis model was evaluated by 10-fold cross-validation method. The results showed that the RVM model performed better than do existing algorithms, with 96.58% success rate. The automatic diagnosis on another dataset of 118985 samples of AF and Normal Sinus Rhythm (NSR) has yield 96.64% of classification accuracy. This automated data-driven decision making approach can be exploited for medical diagnosis of other arrhythmias.

International audience; The circulation control around the Darrieus turbine blades is considered as a significant practical solution so as to improve the machine's performance. This paper describes a kinematics-based method, through which the pitching motion of the blades varies in such a way that the flow is controlled around them as well as across the rotor. For this purpose, the potential flow approach is used to derive the blade pitching laws being compatible with the unsteady Kutta-Joukowski condition at the trailing edge of the blade. By means of this, a constant circulation around the blade is ensured. Preliminary CFD investigations have evidenced the operating conditions at which the constant-circulation framework may be applied to turbulent flows in order to control the vortex shedding and avoid blade-vortex interactions. Nonetheless, a strict application of this concept prevents the turbine from harvesting the energy. As an alternative strategy, the application of a locally variable-circulation is proposed in order to enhance the power output without compromising on flow control. Three major accomplishments of the variable-circulation-based blade pitching proposition are the following: a. flow control around the turbine blades with definite patterns of vortical structures, b. consistent increase in the turbine's coefficient of power, and c. widened operating range of the turbine.

In this paper, a preliminary study about the most suitable dry electrode materials is done in the context of electrocardiogram (ECG) measurement systems used at home. Therefore, the electrical equivalent circuit between two electrodes through the body is developed as well as the ECG quality evaluation factors. Finally, an initial series of impedance and ECG quality measurements is presented which led to the conclusion that dry stainless steel electrodes seem to provide the best ECG signal quality.

Increasing demand for renewable energy due to the limitations in using the hydrocarbon fuels and their availability is a debating topic. To this end, wind and tidal energy sources are grabbing the attention in both academics and industry. However, better exploitation of such renewable systems require a detailed information about the flow physics due to the unsteady effects and non-linearities of the flow. This paper presents the performance and flow evaluation for a low-speed hydrokinetic turbine of Darrieus type, operating in a confined flow channel. The investigation methods include computations (2D CFD) using Chimera meshes and experiments (2D-2C PIV) including phase-locked measurements. SST k − ω turbulence model based numerical results for velocity fields, instantaneous vortex dynamics, wake geometry and Q-criterion are validated using experimental findings. Continuous validation of performance measurements takes blockage effects into account. This is important due to the neglected 3D flow variations in computations. Also, the influence of incoming stream velocity on turbine's performance and flow pattern is analysed. Such an inclusive analysis helps to qualify the turbine design as well as investigation methods for practical applications with a focus on flow confinement.

Se describe un caso de duplicación de la vesícula biliar acompañado de lesión congénita de corazón, megaureter, y vértebra lumbosacra, con su sintomatología clínica muy discreta. Un breve resumen de la duplicación de la vesícula biliar.

Resume Introduction Le syndrome des antiphospholipides est une affection auto-immune favorisant les thromboses veineuses et arterielles. Les complications coronaires aigues sont rares mais potentiellement gravissimes. Observation Nous rapportons l’observation d’une patiente de 39 ans presentant un infarctus du myocarde aigu de territoire anterieur au decours d’une corticotherapie intraveineuse dans le cadre d’une poussee de polyarthrite lupique. Ce premier episode thrombotique permettait la mise en evidence d’un syndrome des antiphospholipides. Une coronarographie en urgence etait realisee avec angioplastie par stent actif (risque eleve de restenose) et ceci malgre la necessite d’un traitement anticoagulant et antiagregant plaquettaire prolonge. Conclusion La gestion des traitements antiagregants et anticoagulants est primordiale chez les patients porteurs d’un syndrome des antiphospholipides et presentant un syndrome coronaire aigu pour prevenir la recidive thrombotique.

Objective Metabolic tumour volume (MTV) and total lesion glycolysis (TLG) from 18F-FDG PET/CT are emerging prognostic biomarkers in various solid neoplasms. These volumetric parameters and the SUVmax have shown to be useful criteria for disease prognostication in preoperative and post-treatment epithelial ovarian cancer (EOC) patients. The purpose of this study was to evaluate the utility of 18F-FDG PET/CT measurements to predict survival in patients with recurrent EOC.