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Morbidity and Mortality of Acute Renal Failure in COVID-19 Patients in Intensive Care According to Waves/Variant: Case of the Grand hô;pital de l’Est Francilien Site de Meaux

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Open Journal of Internal Medicine 2024年第1期14卷 16-29页

作者： Khazy Anga Ariel Makembi Éric Amisi Éric delpierre Vivien hong Tuan ha Wilfrid Mbombo Jean Claude Mubenga Dan Kankonde Chris Nsituavibidila Lionel Diyamona Noelly Mukuna Gracia Likinda Tharcisse Mabiala Martin Mukenga Médard Bula-Bula Berthe Barhayiga Département d’Anesthésie Réanimation Université de Kinshasa Kinshasa République démocratique du Congo service de Réanimation Grand H&ocircpital de l’Est Francilien Meaux France Département de Médecine Interne Université de Kinshasa Kinshasa République démocratique du Congo service d’Anesthésie Réanimation Centre Hospitalier Monkole Kinshasa République démocratique du Congo department of Anaesthesia and Intensive Care H&ocircpital Général de Référence de Kinshasa Kinshasa République démocratique du Congo department of Anaesthesia and Intensive Care Université Protestante du Congo Kinshasa République démocratique du Congo

Introduction: The incidence of acute renal failure (ARF) varies between 20% and 40% of cases for COVID-19 patients admitted to the intensive care unit, with very high mortality, but heterogeneous according to the different epidemic waves, probably due to the genetic variant phenomenon of the virus. The aim of this study is to determine the morbidity and mortality of COVID-19 patients admitted with ARF to the intensive care unit of the Grand h?pital Est Francilien (GhEF) according to the waves and variants. Methods: Cross-sectional observational study of COVID-19 patients with ARF admitted to the intensive care unit of the GhEF site in Meaux covering the period from March 1st 2020 to december, 31st 2021. Per-hospitalisation and outcome data were collected and analysed with SPSS version 25.0 software using the Chi-square or Fischer’s exact test or Student’s t-test and logistic regression for p Results: A total of 86 patients were included. The mean age was higher (70 ± 8.5) in patients in the fourth wave than in the other waves (p = 0.015), with male predominance in all waves without significant difference. Co-morbidities: hypertension, diabetes, heart disease, dyslipidaemia and arrhythmia complete with fibrillation were present in all waves. The majority of patients were classified as KDIGO 1 for the different waves (1st: 61.9%, 2nd: 86.5%, 3rd: 80%, and 4th: 75%), with the same trend according to variant (alpha: 80%, beta: 75%, delta: 81.3%, omicron: 75%). Mortality by the wave was: 1st: 28.5%, 2nd: 37.5%, 3rd: 23% and 4th: 11%) and by variant: alpha: 24.2%, beta: 44.8%, delta: 20.7%, omicron: 10.3%). Overall mortality was 33.7%. Case fatality was higher in the fourth wave. hypertension, shock, failure to recover renal function, acute lung oedema, ventilator-associated lung disease and hyperkalaemia were factors associated with mortality (p Conclusion: Acute renal failure is common in COVID-19 patients admitted to the intensive care unit, and mortality is not negligible. The beta variants an

关键词： Mortality COVID-19 Morbidity Renal Failure Intensive Care Unit

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Associations between physical activity levels and ATPase inhibitory factor 1 concentrations in older adults

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Journal of Sport and health Science 2024年第3期13卷 409-418页

作者： Jérémy Raffin Yves Rolland Annelise Genoux Guillaume Combes Mikael Croyal Bertrand Perret Sophie Guyonnet Bruno Vellas Laurent O.Martinez Philipe de Souto Barreto For the MAPT/DSA Group Institut du Vieillissement Gérontopôle de ToulouseCentre Hospitalo-Universitaire de ToulouseToulouse 31000France Centre d'Epidémiologie et de Recherche en santédes Populations UnitéMixte de Recherche 1295Institut National de la Santéet de la Recherche MédicaleUniversitéToulouse-III-Paul-SabatierToulouse 31000France LimitAging Team Institut des Maladies Métaboliques et CardiovasculairesUnitéMixte de Recherche 1297Institut National de la Santéet de la Recherche MédicaleUniversitéToulouse III-Paul SabatierToulouse 31432France service de Biochimie Pôle de biologieHôpital de PurpanCentre Hospitalo-Universitaire de ToulouseToulouse 31300France L'Institut du Thorax Institut National de la Santéet de la Recherche MédicaleCentre National de la Recherche ScientifiqueCentre Hospitalo-Universitaire de NantesNantes UniversitéNantes 44000France BioCore US16Structure Fédérative de Recherche BonamyInstitut National de la Santéet de la Recherche MédicaleCentre National de la Recherche ScientifiqueCentre Hospitalo-Universitaire de NantesNantes UniversitéNantes 44000France Plate-forme de spectrométrie de masse Centre de Recherche en Nutrition HumaineOuestNantes 44000France 不详

Background:Adenosine triphosphatase inhibitory factor 1(IF1)is a key protein involved in energy metabolism.IF1 has been linked to various agerelated diseases,although its relationship with physical activity(PA)remains unclear.Additionally,the apolipoprotein A-I(apoA-I),a PA-modulated lipoprotein,could play a role in this relationship because it shares a binding site with IF1 on the cell-surface ATP synthase.We examined here the associations between chronic PA and plasma IF1 concentrations among older adults,and we investigated whether apoA-I mediated these associations.Methods:In the present work,1096 healthy adults(63.8%females)aged 70 years and over who were involved in the Multidomain Alzheimer Prevention Trial study were included.IF1 plasma concentrations(square root of ng/mL)were measured at the 1-year visit of the Multidomain Alzheimer Prevention Trial,while PA levels(square root of metabolic equivalent task min/week)were assessed using questionnaires administered each year from baseline to the 3-year visit.Multiple linear regressions were performed to investigate the associations between the first-year mean PA levels and IF1 concentrations.Mediation analyses were conducted to examine whether apoA-I mediated these associations.Mixedeffect linear regressions were carried out to investigate whether the 1-year visit IF1 concentrations predicted subsequent changes in PA.Results:Multiple linear regressions indicated that first-year mean PA levels were positively associated with IF1 concentrations(B=0.021;SE=0.010;p=0.043).Mediation analyses revealed that about 37.7%of this relationship was mediated by apoA-I(B_(ab)=0.008;SE=0.004;p=0.023).Longitudinal investigations demonstrated that higher concentrations of IF1 at the 1-year visit predicted a faster decline in PA levels over the subsequent 2 years(time×IF1:B=0.148;SE=0.066;p=0.025).Conclusion:This study demonstrates that regular PA is associated with plasma IF1 concentrations,and it suggests that apoA-I partly mediates this association.Additionally,this study f

关键词： Aging Apolipoprotein Bioenergetics Exerkine Mitochondria

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Vaccination effect on a stochastic epidemic model with healing and relapse

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International Journal of Biomathematics 2024年第1期17卷 29-59页

作者： M.M.Abdeslami L.Basri M.El Fatini I.Sekkak R.Taki Laboratory of Partial Differential Equations Spectral Algebra and Geometry department of Mathematics Faculty of Sciences Ibn Tofail UniversityBP 133KénitraMorocco Centre de Recherche en sante publique Montréal(Québec)h3N 1X9 Canada Departement de Medecine Sociale et Preventive Ecole de SantéPublique de I'Universitéde Montreal 101Avenue du ParcMontréal(Quebec)H3N 1X9Canada EST Sidi Bennour Chouaib Doukkali UniversityEl JadidaMorocco

In this work,we consider a stochastic epidemic model with vaccination,healing and relapse.We prove the existence and the uniqueness of the positive solution.We establish sufficient conditions for the extinction and the persistence in mean of the stochastic system.Moreover,we also establish sufficient conditions for the existence of ergodic stationary distribution to the model,which reveals that the infectious disease will persist.The graphical illustrations of the approximate solutions of the stochastic epidemic model have been performed.

关键词： Stochastic epidemic model with relapse and healing vaccination extinction persistence in mean Markov semigroup stationary distribution

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Epidemiological Profile of Men Who have Sex with Men: First Data about Male Sex Workers in Central African Republic (CAR)

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Advances in Sexual Medicine 2024年第1期14卷 1-11页

作者： hermione Dahlia Mossoro-Kpinde Balekouzou Augustin Paola Julienne demba henri Saint Calvaire Diemer Direction de la Médecine du Travail Ministère du Travail de l’Emploi de la Protection Sociale et de la Formation Professionnelle Ban-gui République Centrafricaine Comité National de Lutte contre le Sida Bangui République Centrafricaine Faculté des Sciences de la santé Université de Bangui Bangui République Centrafricaine Département de santé publique Faculté des Sciences de la Santé Université de Bangui Bangui République Centrafricaine

Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.

关键词： Men Who have Sex with Men Sex Workers Gender-Based Violence Informal Sector Central Africa

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Epidemiological, Clinical and Evolutionary Aspects of human African Trypanosomiasis in Children in Nola

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Open Journal of Pediatrics 2024年第2期14卷 344-358页

作者： Brice Olivier Bogning Mejiozem Gaspard Tékpa Synthia Ningatoloum Nazita Jocelyn Tony Nengom Danebera Lydie Verlaine Carine Judith Kiteze Nguinzanémou Rostand Juste Koyangboi Kombaya Iris Vanessa Gaspiet Sonny Jean Chrysostome Gody Complexe hospitalier Pédiatrique de Bangui Bangui République Centrafricaine service des Maladies Infectieuses H&#244pital de l’Amitié Bangui République Centrafricaine Faculté des Sciences de la santé de l’Université de Bangui Bangui République Centrafricaine Centre hospitalo Universitaire Communautaire de Bangui Bangui République Centrafricaine Faculté de Médecineet des Sciences Biomédicales Université de Yaoundé 1 Yaoundé Cameroun

Background: human African trypanosomiasis (hAT) occurs in three historical foci in the Central African Republic. Objective: To describe the morbi-mortality of childhood hAT in rural Central African Republic with the aim of early management. Methods: descriptive and analytic cross-sectional study conducted from January 1, 2017 to March 30, 2018 at Nola prefectural hospital. This study was included all children seen as outpatients and/or hospitalized in the pediatric wards, in whom the diagnosis of hAT was confirmed. Statistical analysis was performed using Epi-info software. Results: Forty children were included from Bilolo (60%), Nola (30%) and Salo (10%). The sex ratio was 0.66 with a median age of 8.65 ± 12.48 years. Fever (82.5%), nocturnal insomnia (75%), daytime somnolence (67.5%), headache (65%), polyarthralgia (62.5%), convulsions 52.5% (n = 21), tremor (27.5%), trypanidism (7.5%) and delirium (2.5%) were the main functional signs. Examination signs were adenopathy (52.5%), paresthesia (30%), decreased cutaneous-abdominal reflexes (25%) and osteoarticular reflexes (17.5%), hyperesthesia (20%), extrapyramidal hypertonia (15%) and depression (2.5%). The children were in the lymphatic-blood phase in 65% of cases, and meningoencephalitis in 35%. Pentamidine was administered in 65% of cases. Four children died and 6 had neurological sequelae. There was an association between age under 5, Bilolo’s focus, the children’s history and the severity of the disease. Age under 5, gender, household, children’s activity, history and occurrence of sequelae were also associated. Conclusion: hAT remains a permanent threat to Central African children. Any clinical presentation combining long-term infectious signs and unexplained neurological or neuropsychological disorders must be treated with caution.

关键词： Morbidity-Mortality Child hAT Nola CAR

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Risk Factors for Neonatal Mortality at the Institute of Nutrition and Child health of the Donka/Guinea-Conakry National hospital

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Open Journal of Pediatrics 2024年第2期14卷 327-337页

作者： Bangoura Mmah Aminata Kolié Ouo Ouo Camara Salématou hassimiou Baldé Mariama Bangoura Kaba Diop Mamadou Moustapha Camara Emmanuel Diallo Fatoumata Binta Doukouré Mamadou Aliou Mamadou Mouctar Sow Bémy Pé Néabey Institut de Nutrition et de santé de l’Enfant Conakry Guinea service de Pédiatrie hô pital National Donka Conakry Guinea service de Pédiatrie hô pital National d’Ignace Deen Conakry Guinea

Introduction: The birth of a baby is a moment of joy and celebration. however, the neonatal period is a very delicate phase of life. Neonatal mortality rates remain high in low-income countries. In Guinea, after 20 years, this rate has fallen from 34.2% in 1998 to 32% in 2018. Objective: To identify the main risk factors for neonatal mortality. Methods: This was an observational, analytical case-control study, lasting 6 months from January 1 to June 30, 2019, conducted at the Institut de Nutrition et de la santé de l’Enfant (INSE) at Donka National hospital. Results: We collected 242 cases and 242 controls, i.e. a total of 484 records. 748 patients were registered, with 32.35% deaths. 82.86% of deaths occurred in the early neonatal period. Statistical analysis revealed the main risk factors: prematurity (RQ 7.39 95% CI 3.27 - 16.61 p = 0.0000003), hypothermia (RQ 2.29 95% CI 1.51 - 3.46 p = 0.0001), acute fetal distress (RQ 2.13 95% CI 1.33 - 3.43 p = 0.0016), low birth weight (QR 1.91 95% CI 1.12 - 3.24 p = 0.016), home birth (QR 3.26 95% CI 1.25 - 8.46 p = 0.015). Conclusion: Neonatal mortality is a health problem in the INSE neonatology department. To reduce the mortality rate in this referral facility, it is essential to equip it and provide ongoing training for staff.

关键词： Neonatal Mortality INSE Guinea-Conakry

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Women Breast Cancer: Knowledge, Attitudes, Practices and Factors Associated with Early Screening in the Municipality of Abomey-Calavi in Benin in 2018

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Open Journal of Epidemiology 2024年第1期14卷 131-156页

作者： Stéphane Arold Bidossessi Senahoun Nicolas hamondji Amegan Mahougnon hugues Serge Dohou hermann Comlanvi Agbedjinou Lucresse Corine Fassinou Tècle Edwige Korogone Armand Ibikounle Dieudonné Fambo Joël Gamêlé Mikponhoué Christiane Tshabu Aguemon Ecole Doctorale des Sciences de la santé Université d’Abomey-Calavi Cotonou Bénin Ecole de santé publique de l’Université de Montréal Québec Canada Unité de Formation et de Recherche en Médecine Cardiovasculaire Faculté de Médecine de l’Université de Parakou Parakou Bénin Ecole de santé publique Université Libre de Bruxelles Bruxelles Belgique Ecole Nationale des Techniciens Supérieurs en santé publique et en Surveillance Epidémiologique Université de Parakou Parakou Bénin Faculté des Sciences de la santé Université d’Abomey-Calavi Cotonou Bénin

Background: Breast cancer is the dominant cancer in women in both developed and developing countries. The objective of this study was to assess the knowledge, attitudes, practices and factors associated with early breast cancer screening among women in the Municipality of Abomey-Calavi in Benin. Methods: This was a cross-sectional, descriptive, analytical study with prospective data collection from October 1 to 8, 2018, involving 1740 women in the Municipality of Abomey-Calavi, aged 18 years or older and selected by WhO four-stage random cluster sampling. Consenting women who were mentally competent, 18 years of age or older at the time of the survey, and residing continuously in the Municipality of Abomey-Calavi for the last six months prior to the survey were included. On the other hand, women who belonged to a breast cancer prevention service, women in whom secondary screening was noted, or non-consenting women were not included. The initial minimum size was estimated by the Schwartz formula with a cluster effect of k = 2. Information was collected by questionnaire survey, entered with Epidata 3.1. Fr and analyzed with R Studio 3.5.1. software. Results: The mean age of the women surveyed was 32.0 ± 11.5 years with a range of 18 and 71 years. Regarding knowledge, the clinical manifestation known by the majority of women was the presence of a nodule (68.50%). In the series, 1308 (75.17%) declared having heard about breast cancer once before, either on the radio, television or from friends and 726 (55.50%) had heard about breast cancer screening. Five hundred and twelve (70.52%) of the 726 who had heard of breast cancer said they knew that breast cancer could be screened earlier. Breast self-examination was the most cited screening method (67.58%). The disease is of natural origin according to 37.84% of them. Regarding attitudes and practices, the prevalence of early breast cancer screening was 12.93%, of which 11.67% declared that they had checked themselves to know whether they were carriers of the disease or n

关键词： Breast Cancer Early Screening Knowledge Practices Attitudes Associated Factors

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Clinical and Bacteriological Profile of Infections in Sickle Cell Children in Two Referral hospitals in Niamey, Niger

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Open Journal of Pediatrics 2024年第1期14卷 36-42页

作者： Kamaye Moumouni Samaila Aboubacar Garba Moumouni Georges Thomas Ibrahim Mamoudou Abdou Djafar Mamane halima hamadou Ibrahim hamani Issaka Djibrilla Almoustapha Amadou Yacouba Abdourahamane Marou Soumana Boubacar Moussa Saley Sahada Bade Malam Abdou Soumana Alido service de Pédiatrie A H&#244pital National de Niamey Niamey Niger Faculté des Sciences de la santé Université Abdou Moumouni de Niamey Niamey Niger service de Pédiatrie H&#244pital national Amirou Boubacar Diallo Niamey Niger service d’Onco-hématologie H&#244pital national de Niamey Niamey Niger service de Biologie Médicale H&#244pital national Amirou Boubacar Diallo Niamey Niger

Introduction: Infections are significant causes of mortality in sickle cell children in resource-limited countries. This study aimed to determine the clinical profile and bacterial ecology of infections in children with sickle-cell disease in two referral hospitals in Niamey. Patients and methods: A retrospective descriptive study was conducted from January 2018 to July 2020 in two referral hospitals in Niamey. All children aged one (1) to 15 years with sickle cell disease admitted for suspected infection, including at least one bacterial culture, were studied. Bacteriological analysis was performed using the appropriate culture media, using BactAlert (Reference 4700003 BTA3D60 BioMérieux). Results: Over 36-months, 350 children with a mean age of 10.9 months were admitted. The sex ratio was 1.2. The SS electrophoretic profile was the most common (93.4%). Immunization status was up to date in 66% of patients. Fever was the common reason for consultation (55.1%). Infection was confirmed in 62 patients (17.7%). The primary diagnoses were bacterial gastroenteritis (24.2%) and urinary tract infection (19.4%). Blood cultures were isolated from Salmonella typhi (13.0%) and Escherichia coli (8.7%). Klebsiella spp (7.1%) and Escherichia coli (5.0%) were detected in cytobacteriological examination of urine. Salmonella typhi (23.5%) and Escherichia coli (5.9%) were isolated on coproculture. Conclusion: Bacterial ecology appears not different from that usually observed in sickle-cell children. Salmonella and Escherichia coli were predominant.

关键词： Sickle Cell Disease Child Infection Niger

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Evaluating pediatric ureteropelvic junction obstruction:Dynamic magnetic resonance urography vs renal scintigraphy 99mtechnetium mercaptoacetyltriglycine

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World Journal of Radiology 2024年第3期16卷 49-57页

作者： Yousuf Al-Shaqsi Matthieu Peycelon Annabel Paye-Jaouen Elisabeth Carricaburu Anca Tanase Christine Grapin-Dagorno Alaa El-Ghoneimi department of Pediatric Surgery Sultan Qaboos University HospitalMuscat 123Oman service de Chirurgie Viscérale et Urologie Pédiatrique Hôpital Universitaire Robert-DebréAssistance-Publique Hôpitaux de ParisParis 75019France Centre de Références Maladies Rares Malformations Rares des Voies Urinaires(MARVU)Paris 97019France Facultéde Médecine Universitéde ParisParis 75006France service d’Imagerie Pédiatrique Hôpital Universitaire Robert-DebréAssistance-Publique Hôpitaux de ParisParis 75019France UniversitéParis 13 Sorbonne Paris CitéParis 75013France

BACKGROUND Ureteropelvic junction obstruction(UPJO)is a common congenital urinary tract disorder in children.It can be diagnosed as early as in utero due to the presence of hydronephrosis or later in life due to symptomatic occurrence.AIM To evaluate the discrepancy between dynamic contrast-enhanced magnetic resonance urography(dMRU)and scintigraphy 99m-technetium mercaptoacetyltriglycine(MAG-3)for the functional evaluation of UPJO.METhODS Between 2016 and 2020,126 patients with UPJO underwent surgery at Robert debréhospital.Of these,83 received a prenatal diagnosis,and 43 were diagnosed during childhood.Four of the 126 patients underwent surgery based on the clinical situation and postnatal ultrasound findings without undergoing functional imaging evaluation.Split renal function was evaluated preoperatively using scintigraphy MAG-3(n=28),dMRU(n=53),or both(n=40).In this study,we included patients who underwent surgery for UPJO and scintigraphy MAG-3+dMRU but excluded those who underwent only scintigraphy MAG-3 or dMRU.The patients were divided into groups A(10%discrepancy).We examined the discrepancy in split renal function between the two modalities and investigated the possible risk factors.RESULTS The split renal function between the two kidneys was compared in 40 patients(28 boys and 12 girls)using scintigraphy MAG-3 and dMRU.Differential renal function,as determined using both modalities,showed a difference ofhildren and>10%in 9 children.Calculation of the relative renal function using dMRU revealed an excellent correlation coefficient with renal scintigraphy MAG-3 for both kidneys.CONCLUSION Our findings demonstrated that dMRU is equivalent to scintigraphy MAG-3 for evaluating split renal function in patients with UPJO.

关键词： Uteropelvic junction obstruction Scintigraphy 99m-technetium mercaptoacetyltriglycine Magnetic resonance imaging Dynamic contrast-enhanced magnetic resonance urography

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Interest of thoracic ultrasound after cardiac surgery or interventional cardiology

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World Journal of Cardiology 2024年第3期16卷 118-125页

作者： Martin Boussuges Philippe Blanc Fabienne Bregeon Alain Boussuges service de Pneumologie Centre Hospitalier Universitaire Sud ReunionSaint Pierre 97410Ile de la ReunionFrance department of Cardiac and Pulmonary Rehabilitation Ste Clotilde&YlangYlang Rehabilitation CenterSainte Clotilde 97491Ile de la ReunionFrance service d’Explorations Fonctionnelles Respiratoires Centre Hospitalier Universitaire NordAssistance Publique des Hôpitaux de MarseilleMarseille 13015France Institut hospitalo-Universitaire-Méditerranée Infection Aix Marseille UniversitéMarseille 13005France Center for Cardiovascular and Nutrition Research Aix Marseille UniversitéInstitut National de la Santéet de la Recherche MédicaleInstitut National de Recherche pour l’Agriculturel’Alimentation et l’EnvironnementMarseille 13005France

Thoracic ultrasound has attracted much interest in detecting pleural effusion or pulmonary consolidation after cardiac surgery.In 2016,Trovato reported,in the World Journal of Cardiology,the interest of using,in addition to echocardiography,thoracic ultrasound.In this editorial,we highlight the value of assessing diaphragm function after cardiac surgery and interventional cardiology pro-cedures.Various factors are able to impair diaphragm function after such interventions.Diaphragm motion may be decreased by chest pain secondary to sternotomy,pleural effusion or impaired muscle function.hemidiaphragmatic paralysis may be secondary to phrenic nerve damage complicating cardiac surgery or atrial fibrillation ablation.Diagnosis may be delayed.Indeed,respi-ratory troubles induced by diaphragm dysfunction are frequently attributed to pre-existing heart disease or pulmonary complications secondary to surgery.In addition,elevated hemidiaphragm secondary to diaphragm dysfunction is sometimes not observed on chest X-ray performed in supine position in the intensive care unit.Analysis of diaphragm function by ultrasound during the recovery period appears essential.Both hemidiaphragms can be studied by two complementary ultrasound methods.The mobility of each hemidiaphragms is measured by M-mode ultrasonography.In addition,recording the percentage of inspiratory thickening provides important information about the quality of muscle function.These two approaches make it possible to detect hemidiaphragm paralysis or dysfunction.Such a diagnosis is important because persistent diaphragm dysfunction after cardiac surgery has been shown to be associated with adverse respiratory outcome.Early respiratory physio-therapy is able to improve respiratory function through strengthening of the inspiratory muscles i.***.diaphragm and accessory inspiratory muscles.

关键词： Ultrasonography Diaphragm Phrenic nerve hemidiaphragm Thickening fraction Physiotherapy

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