RESUMEN
OBJECTIVES: The aims of this study were to estimate the incidence of the post-partum post-traumatic stress disorder (PP-PTSD) in primiparous women, and to determine the profile of women at risk of developing this disorder. METHODS: We conducted a descriptive, prospective and longitudinal study carried out at the maternity department of the Hedi Chaker Hospital, Sfax-Tunisia over a period of 15 months. At the first stage of the study, the Saint-Antoine pain questionnaire, the peri-traumatic dissociative experiences questionnaire and the peri-traumatic distress inventory were used respectively to assess the pain of delivery, the peri-traumatic dissociation and distress. At the second stage of the study, the questionnaires, perinatal post-traumatic stress disorder (PPQ), hospital anxiety and depression scale and the Edinburgh postnatal depression scale were used respectively for the PP-PTSD screening and the assessment of the post-partum anxious and depressive symptomatology. RESULTS: The study population consisted of 183 parturients at the first stage of the study and 150 parturients at the second stage of the study. The incidence of the PP-PTSD was 9.3 %. In the multivariate study, some factors studied were significantly associated with the development of PTSD-PP, including a history of therapeutic termination of pregnancy, a history of miscarriage, exposure to a stressful event during pregnancy, prenatal hospitalization of the mother, instrumental delivery, pain intensity especially in the affective component, peri-traumatic dissociation and avoidance of sexual intercourse for fear of a new pregnancy. However the skin to skin contact with the new-born immediately after delivery was a significant protective factor. CONCLUSION: The psychological consequences associated with the first birth, particularly the PP-PTSD, are common. The Identification of women at risk and a systematic screening of postpartum post-traumatic stress symptoms are desirable.
Asunto(s)
Trastornos por Estrés Postraumático , Femenino , Embarazo , Humanos , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/etiología , Trastornos por Estrés Postraumático/diagnóstico , Estudios Longitudinales , Estudios Prospectivos , Factores de Riesgo , Encuestas y Cuestionarios , DolorRESUMEN
The peritoneum is one of the locations outside the most common pulmonary tuberculosis. Peritoneal tuberculosis poses a public health problem in endemic regions of the world. The phenomenon of migration, the increased use of immunosuppressive therapy and the epidemic of AIDS have contributed to a resurgence of this disease in regions where it was previously controlled. The aim of this review is to expose the clinical, biologic end radiologic futures of the peritoneal tuberculosis and to present the methods of diagnosis and treatment. The diagnosis of this disease is difficult and still remains a challenge because of its insidious nature, the variability of presentation and limitations of available diagnostic tests. The disease usually presents a picture of lymphocytic exudative ascites. There are many complementary tests with variable sensitivities and specificities to confirm the diagnosis of peritoneal tuberculosis. Isolation of mycobacteria by culture of ascitic fluid or histological examination of peritoneal biopsy ideally performed by laparoscopy remains the investigation of choice. The role of PCR, ascitic adenosine deaminase, interferon gamma and the radiometric BACTEC system can improve the diagnostic yield. An antituberculous treatment with group 1 of the WHO for 6 months is sufficient in most cases.
Asunto(s)
Peritonitis Tuberculosa , Humanos , Peritonitis Tuberculosa/diagnóstico , Peritonitis Tuberculosa/terapiaRESUMEN
Primary signet ring cell carcinoma of urinary bladder is a rare tumor; accounting for approximately 0.24% of all bladder malignancies. In this study, we report a case of a 58-year old man who consulted for complaints of gross hematuria, the bladder biopsy showed signet ring cell carcinoma; the exploration of gastrointestinal tract did not reveal any other tumor localizations. A total cystoprostatectomy was performed followed by radiotherapy. The aim of this study is to determine the anatomoclinical, therapy and evolution characteristics of this rare tumor.
Asunto(s)
Carcinoma de Células en Anillo de Sello/diagnóstico , Neoplasias de la Vejiga Urinaria/diagnóstico , Carcinoma de Células en Anillo de Sello/terapia , Cistectomía , Hematuria/etiología , Humanos , Masculino , Persona de Mediana Edad , Prostatectomía , Radioterapia Adyuvante , Neoplasias de la Vejiga Urinaria/terapiaRESUMEN
During the last years, a great deal of research on the production of energetic substances was directed to the use of cellulosic by-products. A technique of special interest is the production of fermentissible sugars by the enzymatic hydrolysis of cellulose. Mandels and Reese (1960) showed that a fungi strain of Trichoderma reesei is the best performant microorganism in the production of cellulolytic enzymes. Nevertheless, recent investigation indicated that the rate and the yield of conversion of cellulose to glucose of this strain are limited by its poor beta-glucosidase activity. In order to increase the efficiency of the hydrolytic power of the cellulasic complex two approaches can be considered. Beta-glucosidase enrichment of Trichoderma reesei enzymes. The selection and use of strains with a better performance. In our laboratory, we chose the second approach using Penicillium occitanie comparing it to Trichoderma reesei.