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October 4th, 2019 by admin

IPA 1ère année : Traduction

Voici un premier jet.  N’hésitez pas à signaler coquilles et éventuelles améliorations.

Contexte: L’adhésion à un régime pauvre en sodium est le fondement de la gestion individuelle de leur maladie par les patients atteints d’insuffisance cardiaque (IC).  Une perception altérée du goût du sel dus aux inhibiteurs de l’enzyme de conversion de l’angiotensine (ECA) qui sont souvent prescrits à ces patients peut augmenter la/leur consommation de sodium.  Notre hypothèse était que la prise de sodium serait nettement plus élevée chez des patients en IC prenant des ECA comparés à ceux qui ne prenaient pas ce médicament.

Objectif : Le but de cette étude était d’évaluer le lien entre la densité de sodium dans le régime des patients en IC à qui on avait prescrit des inhibiteurs d’ECA.

Méthode : Nous avons procédé à une analyse secondaire des données de référence de patients en IC dans une étude longitudinale observationnelle.  La densité de sodium a été calculé en prenant la moyenne de consommation quotidienne de sodium à partir de journaux alimentaires tenus sur 4 jours divisée par la moyenne de kilocalories consommées.  Les dossiers médicaux ont été consultés pour déterminer les médicaments prescrits. Les patients ont été classifiés comme sous ordonnance pour inhibiteurs d’ECA ou pas.   Un t-test a été utilisé pour comparer la consommation de sodium dans les deux groupes, et une régression linéaire a été effectué pour savoir si la prise des inhibiteurs d’ECA pouvait prédire la densité de sodium en contrôlant/ajustant pour l’âge, le sexe, la classification New York Heart Association, la prise de diurétiques, et béta-bloquants.

Résultat : L’analyse portait sur 255 patients en IC âgés de 61 (+/- 12) ans, dont 67% d’hommes, 44% de classe III ou IV selon la New York Heart Association, et 68% qui prenaient un inhibiteur d’ECA.  Comparé à ceux qui n’en prenaient pas, les personnes sous ordonnance d’inhibiteurs d’ECA consommaient 13% de plus de sodium par kilocalorie.  La prise d’inhibiteur d’ECA était un facteur indépendant de prédiction de densité de sodium consommé (([beta] = 0,238, P = 0,009).

Conclusion : La consommation de sodium était plus élevée chez les patients qui prenaient des inhibiteurs d’ECA. On peut donc prendre en compte les médicaments prescrits dans les interventions visant à aider les patients en IC à maitriser leur consommation de sodium alimentaire.

 

October 4th, 2019 by admin

Powerpoints UE7.4

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October 3rd, 2019 by admin

Orthophonie UE7.4 Commentaire essai randomisé contrôlé

Ci-dessous le lien pour télécharger un commentaire pour l’article étudié en cours.

Thomeer, Marcus L., et al. “Randomized Controlled Trial of Mind Reading and In Vivo Rehearsal for High-Functioning Children with ASD.” Journal of Autism and Developmental Disorders 45.7 (2015): 2115-2127.

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October 2nd, 2019 by admin

UE7.4 synthèse des critiques – Article 2

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Art 2 Critique

September 25th, 2019 by admin

Case report – Simple English

Here is a simplified version of the document : McNeil, Julian. “Complete heart block in a Caucasian woman with Behçet’s disease: a case report.” Journal of medical case reports 10.1 (2016): 1.

This case concerns a 48 year old Caucasian woman who was hospitalized for lightheadedness, muscular weakness, blurred vision, feeling faint, and feeling sick, with an abnormal heartbeat. Doctors carried out an electrocardiogram to visualize the heartbeat which showed that the electrical signals were not being correctly transmitted between the chambers of the heart. This explained the woman’s symptoms, and because it can be fatal doctors fitted a pacemaker and the symptoms disappeared. They then checked the the levels of a protein called troponin were normal and this allowed them to conclude that there was no damage to the heart muscle.

The woman subsequently suffered from frequent watery diarrhea, and said that she had regularly had painful ulcers on her mouth and genitals over the previous 10 months, and sometimes complained of swollen and tender joints, as well as a period of redness in her eyes that lasted two weeks. She had been to hospital 3 weeks earlier for chest pain due to an inflammation of the heart muscle, and tests showed a normal heartbeat with signs of fluid around the heart. She had a swollen right knee, and ulcers inside her mouth and on her vulva. She was a relatively heavy smoker, and when pregnant with her second child she had suffered from a blood clot in her right leg.

Doctors found no signs of bowel disease, or of skin injuries that were resistant to healing, and all tests for diseases where the body’s immune system attacks healthy cells were negative. They then tested for certain substances in the blood and the stools which might cause an immune reaction. An internal examination of the digestive system uncovered an ulcer in a part of the intestine often associated with another disease, but which was not consistent with that disease. Further tests showed inflammation of the blood vessels, but enabled doctors to eliminate the disease. Based on the woman’s ulcers, inflammation of the membranes in her joints, the ulcer in the digestive tract and her episode of inflamed eyes, doctors diagnosed a disorder named Behçet’s disease (BD). She was prescribed a drug called predisnalone to treat the inflammation, gradually decreasing the dose, and another called sulfasalzine to treat her diarrhea. Symptoms had disappeared at her follow-up appointments one and three months later.

Doctors made their diagnosis of BD on the basis of the woman’s symptoms after eliminating other possible causes. Although they did not find any long standing skin injuries, a symptom associated with BD, its absence is not enough to rule out the diagnosis. This case is interesting for a number of reasons. First of all, BD is more often found in men than in women, and secondly it occurs more frequently in regions along the Silk Road. Thirdly, despite the fact that heart problems are known to occur in BD, and that problems with electrical signals in the heart, known as heart block have already been recorded in BD patients from a non-Caucasian background, this is the first time heart block and BD have been reported in a Caucasian woman.

The fact that the levels of the protein called troponin, were normal, and that the heart muscle was in good condition led the doctors to eliminate other possible causes of heart block, and this was confirmed by the normal electrocardiogram when she was first in hospital. Therefore the doctors concluded that the heart problems were likely caused by Behçet’s disease. This led them to recommend that when BD is diagnosed, heart-related problems should be considered, even when the treatment for other aspects of the disease seems to be working, since heart block can be fatal.

September 25th, 2019 by admin

Orthophonie UE7.4 Critique d’article N°1

Voici un document de synthèse.  Vous aurez également un retour de vive voix lors du cours du 26/9

Art 1 – Critique

September 19th, 2019 by admin

IPA 2 – fichiers PowerPoint

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September 19th, 2019 by admin

UE7.4 fichiers PowerPoints

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