Influence of warm-up duration and recovery interval prior to exercise on anaerobic performance.

The purpose of the study was to determine the impact of different active warm-up (AWU) durations and the rest interval separating it from exercise on anaerobic performance. Eleven male physical education students (22.6 ± 2.52 years; 179.2 ± 4.3 cm; 82.5 ± 9.7 kg; mean ± SD) participated in a cross-over randomized study, and they all underwent the Wingate test after three AWU durations: 5 min (AWU5), 15 min (AWU15) and 20 min (AWU20), with recovery (WREC) or without a recovery interval (NREC) separating the AWU and anaerobic exercise performance. All the AWUs consisted of pedalling at a constant pace of 60 rpm at 50% of the maximal aerobic power. The rest interval between the end of warm-up and the beginning of exercise was set at 5 min. During the Wingate test, peak power (PP), mean power (MP) and the fatigue index (FI) were recorded and analysed. Oral temperature was recorded at rest and at the end of the warm-up. Likewise, rest, post-warm-up and post-Wingate heart rate (HR) and rating of perceived exertion (RPE) were recorded during each session. The ANOVA showed a significant effect of recovery interval, warm-up duration and measurement point on RPE scores (P<0.001). Although the effect of AWU duration on MP and PP was significant (P<0.05), the effect of the recovery interval on both parameters was not significant (P>0.05). Moreover, the analyses showed a significant interaction between recovery interval and AWU duration (P<0.001 and P<0.05 for MP and PP respectively). The AWU15 duration improves the MP and PP when associated with a recovery interval prior to exercise of 5 min. However, the AWU5 duration allows better improvement of power output when the exercise is applied immediately after the warm-up. Consequently, physically active males, as well as educators and researchers interested in anaerobic exercise, must take into account the duration of warm-up and the following recovery interval when practising or assessing activities requiring powerful lower limb muscle contractions.

[Mercury impregnation in dentists and dental assistants in Monastir city, Tunisia]. / L'imprégnation mercurielle des dentistes et de leurs assistants dans la ville de Monastir, Tunisie.

INTRODUCTION: The property of mercury to amalgamate with other metals is used to create a material for filling teeth. This material remains the cheapest and most efficient in tooth restoration. Mercurial toxicity has been documented since Antiquity but the metal remains widely used in some countries. This study compared mercury impregnation in dentists and dental assistants in Monastir (Tunisia) to another population not exposed professionally. SUBJECTS AND METHODS: A cross-sectional study was made on 52 dentists and dental assistants working in private offices and in the stomatology unit of the Monastir teaching hospital, with a control group of 52 physicians and nurses working in the Monastir Fattouma Bourguiba hospital. The groups were paired according to age and gender. The study lasted three months. A questionnaire investigated the socioprofessional features of the study population, non professional mercury exposure, work environment, the various amalgam handling and preparation techniques, and preventive hygiene measures. Urinary and salivary sampling was performed so as to prevent any accidental mercurial contamination. Mercury level was assessed by atomic absorption spectroscopy in an automatic sampler, urine creatinine with Jaffé's colorimetric reaction. The results of mercury level assessment were expressed in microg/g of creatinine, salivary mercury in mug/l. The statistical analysis was made with the Epi.info 6 software. Khi(2) and Fisher tests were used to compare qualitative variables. The ANOVA test was used to compare averages with a statistic significance threshold at 0.05. RESULTS: Sixty-one percent of individuals with risk exposure worked in a dental clinic. Bruxism and onychophagia were more important in the control group with a significant statistical difference (respectively, p=0.01 and p<0.0001). The urinary and salivary mercury levels were significantly increased in the exposed group, with respective values of 20.4+/-42.4microg/g of creatinine and 10.6+/-13.02microg/l versus 0.04+/-0.3microg/g of creatinine and 0microg/l in the control group. Disposing of amalgam waste was inadequate in 94% of the cases. The variation of mercury in urine was significantly influenced by the presence of fabric curtains (p=0.04). Eating lunch at meals at the work place was also linked to a significant increase of mercury levels in urine (p=0.04). The storage mode of mercury in open containers was a significant factor for variation of mercury level (p=0.03). DISCUSSION: Most dentists' private offices in Monastir do not comply or comply weakly with prevention measures linked to risk of mercury poisoning. Awareness campaigns were launched as well as actions for the improvement of work conditions: efficient aspiration of offices containing fixed sources of mercury, adequate storage of mercury and waste, and compliance to occupational hygiene rules.

[Rhinitis and asthma related to cotton dust exposure in apprentices in the clothing industry]. / Rhinite et asthme liés à l'exposition aux poussières de coton chez des apprentis en habillement.

OBJECTIVE: Respiratory allergies are the most common occupational diseases in the world. The aim of this study was to determine the prevalence of rhinitis and asthma among apprentices exposed to cotton dust in the clothing industry and to describe their epidemiologic and clinical profiles. SUBJECTS AND METHODS: We carried out a descriptive study of 600 apprentices in a textile and clothing vocational training centre in the Monastir area. The investigation comprised a questionnaire exploring risk factors and symptoms appearing during their training. Subjects who developed allergic respiratory symptoms at the work-place underwent a clinical examination, rhinomanometry and investigation of their allergic status and respiratory function. RESULTS: One hundred twenty apprentices (20%) developed allergic respiratory reactions due to exposure to textile dust (exclusively cotton) during their training, with a positive withdrawal-re-exposure test. Conjunctivitis (14.3%) and rhinitis (8.5%) were the most frequent allergic symptoms. Twenty eight apprentices (4.6%) presented symptoms of asthma. Rhinitis was associated with asthma in 45% of cases. Two cases of asthma were diagnosed clinically at the work-place following their exposure to textile dust. The prick test performed in 120 symptomatic apprentices was positive in 41.6% of cases. There was sensitization to pollens in 29 cases and to dermatophagoides in 13 cases. Cotton and wool allergy was noted in two cases. Allergic symptoms developing during the training were significantly more frequent in the atopic group, and they varied according to the intensity of textile dust exposure. CONCLUSION: In the textile and clothing industry the frequency of respiratory disorders caused by allergens remains high, especially in atopic apprentices who constitute a population at high risk.

[Radiotherapy in the treatment of retinoblastoma: about 40 cases]. / Place de la radiothérapie dans le traitement du rétinoblastome : à propos de 40 cas.

PURPOSE: The aim of this study is to analyze the results and the complications of radiotherapy in the treatment of retinoblastoma. PATIENTS AND METHODS: Between 1994 and 2004, 40 children received radiotherapy for a retinoblastoma in Salah Azaiz Institute. The average age of the patients was 36 months (four to 132 months). There were 16 girls and 24 boys. Sixteen children presented a bilateral disease and 24 children a unilateral disease. Twenty eyes and thirty-six orbital cavities in 40 children with retinoblastoma were treated by radiotherapy. One child with a unilateral anterior retinoblastoma was treated with 106 ruthenium brachytherapy. External radiotherapy has been used to treat the 39 patients. In 20 cases the irradiation was conservative and in 36 cases postoperatively. The latter (n=36) presented at least one risk factor of relapses noted in the histological examination. The average dose was 44 Gy (1.8 to 2 Gy per fraction, five fractions weekly). This radiotherapy was associated with chemotherapy in 24 cases. RESULTS: Thirty-five children were followed with an average follow-up of 53 months (3-108 months). The average delay of relapses was of 10 months (two to 26 months). We found four orbital relapses and seven metastasis in nine children. The conservation of the eye with a useful visual field was noted in 18 cases among the 20 conservative irradiated eyes. The major therapeutic complication was the growth defect of the bones face. A femoral bone sarcoma was noted five years after the end of the irradiation and chemotherapy in one case. CONCLUSION: If the radiotherapy offers the advantage of the functional conservation and the improvement of the local control, its indications are more and more restricted in favor of the other therapeutic methods (chemotherapy, thermochemotherapy) and this considering the iatrogene risk. The development of new techniques of brachytherapy and the progresses of the conformational radiotherapy appear to reduce considerably this risk.

[Frontal relapse of medulloblastoma. Causes and consequences (a case report)]. / Rechute frontale du médulloblastome. Causes et conséquences (à propos d'un cas).

Medulloblastoma is a common paediatric brain tumor. Its prognosis is improved since the use of radiotherapy after surgery. This radiotherapy, so widely and complex, has one purpose: tumor control with less toxicity. Frontal relapse of medulloblastoma is not rare. Two hypothesis were proposed to explain this failure pattern: a geographic miss in cribriform plate due to targeting deviation and the migration of tumor cells to the cribriform plate caused by the "face down position" of the patient during surgery. We report the case of a 10-year-old boy who was treated in 1998 for a medulloblastoma with surgery and radiotherapy of the craniospinal axis (24 Gy) and the posterior fossa (54 Gy). Four years later, tumor relapsed only in the frontal area. A new surgery and chemotherapy were used with a complete response. A second frontal relapse associated with posterior fossa recurrence was detected after one year of the second treatment and treated by chemotherapy. Frontal relapse in medulloblastoma is an avoidable failure pattern when surgical and radiotherapeutic procedures are well controlled.

[Merkel cell carcinoma: outcome and role of radiotherapy]. / Carcinome à cellules de Merkel : prise en charge et place de la radiothérapie.

Merkel cell carcinoma (MCC) are rare neuroendocrine malignant tumor of the skin, occurring in elderly patients. It affects primarily the sun-exposed areas of the skin, with approximately 50% of all tumors occurring in the face and neck and 40% in the extremities. Immunohistochemical markers (CK20+, CK7- and TTF1-) are used to distinguish between MCC and other tumors. MCC have a tendency to rapid local progression, frequent spread to regional lymph nodes and distant metastases. Due to the rarity of the disease, the optimal treatment has not been fully defined. Localized stages (stages I and II) are treated by surgical excision of the primary tumor (with 2 to 3 cm margin) and lymphadenectomy in case of node-positive disease, followed by external beam radiotherapy (EBRT) to a total dose of 50 to 60Gy in the tumor bed. Adjuvant EBRT has been shown to decrease markedly locoregional recurrences and to increase survival in recent studies. Treatment of lymph nodes area is more controversial. Chemotherapy is recommended only for metastatic disease.

[Brain radionecrosis in patients irradiated for nasopharyngeal carcinoma: about nine cases]. / Radionécrose cérébrale chez les patients irradiés pour cancer du nasopharynx: à propos de neuf cas.

PURPOSE: To study the clinical, radiological, therapeutic and progressive aspects of brain radionecrosis after treatment for nasopharyngeal carcinoma. PATIENTS AND METHODS: Nine patients (seven men and two women) of mean age 47.7 years old (extremes: 18-57 years old) were treated for UCNT (undifferentiated carcinoma of the nasopharynx) between 1989 and 2003 and developed cerebral radionecrosis. All patients were treated with radical radiotherapy. The mean total dose was 73.5 Gy (70-75 Gy). Dose per fraction was 2 to 2.5 Gy, one fraction daily. One patient received adjuvant brachytherapy to the dose of 8 Gy and four patients also received chemotherapy. RESULTS: Brain radionecrosis was authenticated by brain imaging (CT scan+/-MRI): the imaging was ordered in seven cases to elucidate non-specific neurological signs and two cases were discovered fortuitously. The time to the appearance of neurological signs was 40.3 months (10 to 108 months). The localization was temporal in six cases, parieto-occipital (one case) and bulbomedullar (two cases). After a mean follow-up period of 30.6 months (12-84 months), clinical outcomes were favorable in all cases receiving medical treatment (corticoids), with a stabilization of the radiological lesions in eight cases and complete radiological regression in one patient. CONCLUSION: Brain radionecrosis is a late complication rarely occurring in patients irradiated for UCNT. Imaging techniques (CT scan but more so MRI) play a major role in the diagnosis. Corticotherapy resulted in a durable objective response in all patients and, in most cases, resulted in radiological stabilization.

[Primary non-Hodgkin lymphoma of the liver: case report and review of the literature]. / Lymphome non hodgkinien primitif du foie: à propos d'un cas et revue de la littérature.

Purpose was to describe the clinical, radiological and therapeutic features in primary liver lymphoma. We report the case of a 54-year-old patient, who is followed since the age of 20 years for neutropenia associated with mediastinal adenopathy. Systematical ultrasound find a mass of the left liver confirmed by Computed tomography (CT). Histological examination of laparoscopic liver biopsy specimens confirmed diffuse large-cell non-Hodgkin's lymphoma. The disease was confined to the liver without any evidence of extrahepatic involvement. The serology of Epstein Barr virus was highly positive. PET-scan show increased FDG uptake at the site of hepatic lesion and the mediastin. The patient received chemotherapy followed by radiation therapy of the left liver at the dose of 31 Gy. The patient was alive and free of disease 20 months after the diagnosis of primary liver lymphoma. The primary hepatic lymphoma is a rare malignancy, which classically affects 50-year-old patients with a male preponderance. The incidence is increased in immunosuppressed patients and some authors have suggested an association with hepatitis B or C infection, and with the Epstein Barr virus. The imaging studies including ultrasound, CT, magnetic resonance imaging (MRI) and now PET-scan help to establish the diagnosis and to the following. Treatment options are surgery, radiation, chemotherapy, or a combination.

[Ovarian irradiation in recurrent endometriosis]. / Irradiation ovarienne pour endométriose réfractaire inopérable.

We describe a case of a young woman with a history of an aplastic anaemia in which pelvic radiotherapy was used successfully in the management of a recurrent and inoperable endometriosis. The use of therapeutic pelvic or ovarian irradiation in endometriosis may be considered, when surgical and medical treatments have been exhausted and have failed.