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immersion in cold-water is one of the most common recovery and rehabilitation techniques among athletes. However, several factors such as shocking induced by cold water can affect the effectiveness of this technique.

The aim of this study was to investigate the effect of 4 weeks cold water habituation on the effectiveness of CWI recovery technique on muscle damage and function indices of young soccer players.

Twenty young men with no previous experience of CWI participated in this study. Output power and RSADec of subjects were measured. The subjects then performed a simulated soccer test and, after collecting blood samples, were immediately immersed in 15 ° C water for 15 minutes. Twenty-four hours later blood sampling and functional tests were repeated. selleck products Subjects then were divided randomly into two groups of exercise with CWI recovery and exercise with passive recovery. After four weeks, the blood sampling and performance tests repeated like the pre-test.

The CWI had no significant effect on serum levels of AST and LDH before and after 4 weeks of CWI (P> 0.05). Also, there was no significant difference in power output and RSADec after CWI before and after cold water habituation (P> 0.05).

It seems that the experience of recovering by immersion in cold-water has no effect on the effectiveness of this method. Therefore, soccer coaches and athletes should think more about using this recovery method.

It seems that the experience of recovering by immersion in cold-water has no effect on the effectiveness of this method. Therefore, soccer coaches and athletes should think more about using this recovery method.

Graves' disease (GD) is a common autoimmune disorder. Graves'orbitopathy (GO) is its most common extrathyroidal manifestation. It is rare but may reveal the disease.

To describe the demographic, clinical and therapeutic features of GO.

We carried out a retrospective and descriptive analysis of 82 patients with GO. This study was conducted in Ophthalmology and Endocrinology departments of Taher Sfar University Hospital in Mahdia, between January 2010 and December 2017. GD patients diagnosed with GO were included.

The mean age was 36.17 years ± 12.81. Patients aged 19-40 years had the highest rate of GO. The male-to-female ratio was 0.49. Family history of autoimmune thyroid disease was present in 15% and associated autoimmune disease in 4% of cases. Smoking was seen in 71% of patients. The onset of GO was simultaneous with onset of GD in 45%, before in 21% and after the onset of GD in 34% of cases. GO was bilateral in 76% of patients. The most common ocular symptoms were prominent eyes (55% of patientssease, which is associated with impaired quality of life and can potentially result in sight-threatening complications. Appropriate diagnosis, convenient therapy and a regular follow-up are necessary to improve results and avoid the aesthetic and functional sequelae.

Acute bronchiolitis management involves all pediatricians and primary care physicians. The national guidelines for bronchiolitis diagnosis and treatment were published in Tunisia to reduce excessive use of diagnostic tests and unify bronchiolitis management.

We aimed to assess the real impact of the national guidelines on acute bronchiolitis management in Tunisia.

We conducted an evaluative cross-sectional study. We randomly distributed anonymous questionnaires to physicians managing acute bronchiolitis during the period from 1st March 2014 to 30 November 2015.

We analyzed 140 questionnaires. Ninety-three interviewed physicians (66.4%) were advised of the latest national guidelines, half of them (33.6%) declared they didn't follow these guidelines. Real and complete guidelines adherence was observed in only 1.4% of interviewed physicians. According to bronchiolitis diagnosis, appropriate Chest X-rays and blood tests were requested respectively by 57.8% and 59.3% of interviewed doctors. Regarding bronchiolitis therapeutic management, bronchodilators and epinephrine nebulization weren't prescribed by respectively 45.7% and 38.6% of them. Antibiotics were prescribed by 92.9% of interviewed doctors and chest physiotherapy was well indicated by 47.8% of them.

There is a disconnect between the bronchiolitis guidelines and clinical practice. National strategies have to be developed to reduce excessive use of diagnostic tests and unrecommanded therapies.

There is a disconnect between the bronchiolitis guidelines and clinical practice. National strategies have to be developed to reduce excessive use of diagnostic tests and unrecommanded therapies.

The combination of gallbladder stone and main biliary stone is seen in 10-25% of cases. Its management with the combination of endoscopic and surgical treatment is increasingly adopted.

To evaluate the efficacy and safety of preoperative retrograde endoscopic retrograde cholangiopancreatography in the treatment of concomitant gallstones and common bile duct stones.

Retrospective study including patients with concomitant gallstones and common bile duct stones and who had preoperative endoscopic retrograde cholangiopancreatography. The rate of clearance from the main bile duct and the rate of complications were evaluated.

One hundred and twenty patients aged 57.4±2.7 years were included on average. The rate of catheterization of the main bile duct was 90%. Endoscopic retrograde cholangiopancreatography was unnecessary in 34.1%. Main bile duct clearance was obtained in 95.5% of patients who presented lithiasis during the procedure. The endoscopic treatment was efficient in 53,3% of cases Post endoscopic retrograde post cholangio-pancreatography acute panreatitis occurred in 1.6% of cases with an overall complication rate of 6.6%.

Preoperative endoscopic treatment of concomitant gallstones and common bile duct stones is effective with good safety.

Preoperative endoscopic treatment of concomitant gallstones and common bile duct stones is effective with good safety.

Rapid Atrial fibrillation (AF) is a common arrhythmia in emergency department (ED) that requires an urgent control of ventricular rate.

To evaluate the safety and efficiency of magnesium sulfate as an adjunctive therapy in addition to usual care for rapid AF in emergency department.

This was a prospective, randomized, double-blind study. We included patients who presented to ED with rapid AF >110 batt/min. Group A received 3g of magnesium in 100mL of glucose solution and group B received 100 ml of glucose solution. Primary endpoint was slowing the ventricular rates to less than 110 beats/ min in the first 12 hours of management.

One hundred and three patients were included. Fifty-three patients in group A with a mean heart rate of 146 ± 18 beats / min and fifty patients in group B with a mean heart rate of 143 ± 17 beats / min. A significantly greater number of patients slowed down their ventricular rate in group A during the first hour of management (p = 0.02). After 12 hours, mean heart rate was significantly lower in group A (p = 0.