Résumé :Lors du CETSIS en 1999 [1], les premiers prototypes de partie opérative simulée, appelés Maquettes Virtuelles (MV), avaient été présentés. Les MV sont une représentation fidèle, tant au niveau fonctionnel que comportemental des systèmes habituellement utilisés en Travaux Pratiques (TP). Les MV reposent sur une plateforme initialement développée pour des recherches dans le domaine de la conception et l'évaluation d'outils de supervision adaptés à l'homme [2,3]. Lors du CETSIS en 2001 [4], nous avions présenté l'architecture choisie pour la nouvelle salle d'API, qui d'une part intégrait les MV et d'autre part permettait une utilisation des API à distance au moyen du réseau Ethernet de l'Université. Les MV, sont actuellement utilisées dans les Universités de Reims, Tours et Valenciennes avant tout pour remplacer les « boites à boutons ». Nous avons aussi réalisé une expérience pédagogique originale de télé-TP dont le bilan est présenté dans cet article. Enfin, nous montrons que la plate-forme développée, compte tenu des technologies utilisées, est devenu un outil pour l'enseignement des TIC dans les architectures d'automatismes.

Acute myocarditis represents a challenging diagnosis as there is no pathognomonic clinical presentation. It is rare to see heart block as the first-and-only presentation of infectious myocarditis. We report the case of a young healthy patient who presented with syncope secondary to a complete heart block. It was caused by acute presumed viral myocarditis. The diagnosis was confirmed with cardiac magnetic resonance imaging. With close monitoring, the EKG abnormalities resolved over the following 5 days. In this case report, we present the importance of several imaging tools to diagnose a rare and reversible cause of conduction disturbances. In at-risk individuals, clinicians should rule out a treatable cause of heart block before proceeding with permanent pacemaker implantation due to enormous clinical and cost implications involved.

Objective: Given the increase of sedentarily and bad diet in our life, the prevalence of obesity and overweight has remarkably increased among the most of population, last years. We aimed in this work to assess the impact of weight on blood pressure control in hypertensive patients based on data from the Tunisian national registry Nature HTN Design and method: Nature HTN is a national multicentric study conducted by the Tunisian society of cardiology and including hypertensive patients who consulted their doctors during one month in 2019. We collected clinical data, blood pressure measurements and lab test. We defined Overweight. Results: We enrolled 25890 hypertensive patients, with female predominance (SR = 1.2) and mean age 64.4 ± 12.2 year-old. The hypertension was newly diagnosed in 2286 patients (8.8%) and known more than six months in 23601 persons. The mean BMI was 28.1 ± 4.57. Obesity and overweight were observed respectively in 25.8% and 44.6%. Female were significantly more obese than male (34.7% vs 17.6%, p < 10-3). Patients with uncontrolled BP were more frequently obese (30.5% vs 27.4%, p < 10-3) and have a higher BMI. Among patients with overweight or obesity there was a correlation the prevalence of uncontrolled BP and the severity of obesity (71.5% in overweight people, 74.8 in patient with moderate obesity, 79.4% in patients with severe obesity, p = 0.001). Moreover obesity was found as independent predictor of non-controlled BP in our cohort (OR = 1.14, 95% CI[1.07–1.21]. Conclusions: Obesity is a health problem growing and should keep in mind when treating patients with hypertension because it is a strong predictor of non-controlled BP.

Background Hypertension is the leading cause of morbi-mortality in our country. Thus, we conducted this national survey on hypertension to analyze the profile of the Tunisian hypertensive patient and to assess the level of blood pressure control. Methods Nature HTN is an observational multicentric survey, including hypertensive individuals and consulting their doctors during the period of the study. Blood pressure measurements were conducted during consultation, using a standardized auscultatory or oscillometric sphygmomanometer after at least 15 min of rest. The diagnosis of new hypertension is based on the 2018 ESC/ESH criteria. The primary endpoint of our study was uncontrolled hypertension defined by a systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Results Three hundred twenty-one investigators participated in the study. We enrolled 25,890 patients with a female predominance (Sex ratio, 1.21) and an average age of 64.4 ± 12.2 years. Most individuals were treated in the public sector (74%), 39.4% of patients were diabetic, 25.8% were obese, 44.6% were overweight and 14% were smokers. Hypertension was controlled in 51.7% of cases if we consider 140/90 as a BP target, and only in 18.6% if we consider 130/80 as a target. The independent predictors of uncontrolled blood pressure were male sex (OR = 1.09, 95%CI [1.02–1.16]), age > 65 year-old (OR = 1.07, 95% CI[1.01–1.13], diabetes (OR = 1.18, 95% CI [1.11–1.25], Smoking (OR = 1.15, 95% CI [1.05–1.25]), Obesity (OR = 1.14, 95% CI[1.07–1.21]), management in public sector (OR = 1.25, 95% CI [1.16–1.34]), and Heart rate > 80 bpm (OR = 1.59, 95% CI [1.48–1.71]). Contrarily, high educational level (OR = 0.9, 95% CI [0.84–0.97], absence of history of coronary disease (OR = 0.86, 95% CI [0.8–0.93]), salt restriction (OR = 0.48, 95% CI [0.45–0.51]), drug compliance (OR = 0.57, 95% CI[0.52–0.61]), and regular physical activity (OR = 0.77, 95% CI[0.71–0.84]) are strong predictors of blood pressure control. Conclusion NaTuRe HTN showed that blood pressure control was reached in more than half of the Tunisian people. The control remains low in patients with high cardiovascular profiles and in those treated in the public sector. A national health program based on therapeutic education, regular control and continuous support to the public institutions is needed to decrease the burden of hypertension incidence rate.

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