Prise en charge des complications de la chirurgie partielle du larynx

Introduction : Le cancer du larynx est un cancer fréquent occupant la première place des cancers des voies aéro-digestives chez l’homme en Tunisie. Le tabac est le principal facteur favorisant surtout s’il est associé à l’éthylisme chronique. Il s’agit le plus souvent d’un carcinome épidermoïde plus ou moins différencié. Son pronostic est généralement bon, en raison de son développement dans un tube rigide bien limité et d’un traitement chirurgical actuellement bien codifié. La chirurgie partielle du cancer du larynx est une chirurgie à risque de complications postopératoires nécessitant une prise en charge adéquate.Patients et méthodes : Notre série comprend 54 patients ayant bénéficié d’une chirurgie partielle du larynx au sein du service de chirurgie carcinologique de l’institut Salah Azaiez sur une période de 15 ans (1997-2011).But : Présenter notre expérience en matière de prise en charge des complications de la chirurgie partielle du larynx.Résultats : La moyenne d’âge de nos patients était de 54,9 ans avec des extrêmes allant de 33 à 69 ans. La prédominance masculine était nette avec un sex-ratio de 26. La consommation tabagique était notée dans 92,6% des cas et la dysphonie était présente chez 40 patients porteurs d’une tumeur à localisation glottique. Six types d’interventions ont été pratiqués: cordectomie (9 cas), laryngectomie fronto-latérale (4 cas), laryngectomie frontale antérieure reconstructive type Tucker (10 cas), laryngectomie partielle supra-cricoïdienne avec crico-hyoïdopexie (CHP) (4 cas), laryngectomie partielle supra-cricoïdienne avec crico-hyoïdo-épiglottopexie (CHEP) (24 cas) et laryngectomie horizontale supra-glottique (3 cas). Une antibioprophylaxie était administrée chez 79,6% des patients pour une durée moyenne de 7 jours. Les complications postopératoires ont été analysées et discutées en fonction du type de la chirurgie partielle pratiquée et du type d’antibiothérapie utilisée. Ces complications étaient les suivantes: infection du trachéostome (20,4%), infection de paroi (5 cas), complications respiratoires (29,6%), emphysème sous cutané (7,4%), fistule salivaire (1 cas) et pancréatite aigüe (1 cas).Conclusion : Cette étude montre dans l’ensemble des bons résultats tant sur le plan infectieux que respiratoires, justifiant ainsi l’importance de la prise en charge des complications de la chirurgie partielle du cancer du larynx.Introduction : Laryngeal cancer is a common cancer occurring mainly in men. Smoking is the main risk factor especially if associated with chronic alcoholism. Squamous cell carcinoma is the most common histologic type. Prognosis is generally good, due to the development of the tumor in a very limited rigid tube and to a well-codified surgical treatment. Partial surgery of laryngeal cancer is characterized by postoperative complications requiring an adequate management.Methods : Our series includes 54 cases of laryngeal cancer treated with partial laryngectomy in the ENT department of Salah Azaiez Institute over a period of 15 years from 1997 to 2011.Objective : To present our experience in the management of partial laryngeal surgery complications.Results : Average age of our patients was 54.9 years ranging from 33 to 69 years. Male predominance was marked with a sex ratio of 26. Tobacco abuse was found in 92.6%. Dysphonia was the most common symptom found in 40 patients with glottic cancer. Six varieties of partial laryngectomy were performed: cordectomy (9 cases), fronto-lateral laryngectomy (4 cases), fronto-anterior reconstructive laryngectomy (10 cases), partial supra-cricoid laryngectomy with CHP (4 cases), partial supra-cricoid laryngectomy with CHEP (24 cases) and supra glottic horizontal laryngectomy (3 cases). 79.6 % of our patients received prophylactic antibiotics for an average of 7 days. Postoperative complications were analyzed and discussed in terms of the type of surgery performed and the antibiotic used. Complications observed were: infection of the tracheostoma (20.4%), parietal infection (5 cases), respiratory complications (29.6%), subcutaneous emphysema (7.4%), salivary fistula (1 case) and acute pancreatitis (1 case).Conclusion : This study shows overall good results for partial laryngeal cancer surgery with minimal post-operative complications and oncologic failure justifying the importance of an early management of these complications

Valeur de l’examen extemporane en pathologie thyroïdienne

OBJECTIF : Etudier la valeur de l’examen extemporané dans la pathologie thyroidienne et identifier ses limitesMATERIELS ET METHODES : Notre étude est rétrospective incluant 800 examens extemporanés réalisés sur des pièces de résectionthyroïdienne colligés dans notre service sur une période de 12 ans (2000-2011).Les résultats ont été comparés à ceux del’examen anatomopathologique définitif.RESULTATS : Les résultats étaient concordants dans 96,5%, discordants dans 3,5 %. La sensibilité de l’examen extemporané toustypes confondus était de 78 % et la spécificité de 100 %CONCLUSION : Notre étude a montré une spécificité parfaite de l’examen extemporané cependant l’interprétation difficile des lésionsthyroïdiennes d’architecture vésiculaire expliquent une sensibilité de 78 %.Mots Clés : Thyroïdectomie, examen extemporanOBJECTIVE: To assess the value of frozen-section examination in thyroid surgery and evaluate its limitationsPATIENTS AND METHODES: This retrospective study examined the results of 800 frozen-sections of thyroid specimens analysedover the 12 –year period (2000-2011). Their results were compared with definitive anatomo-pathological examinationRESULTS :Frozen-section diagnosis was concordant with subsequent histopathological examination in 96,5% ,discordant in 3,5%.The global specificity of frozen section analysis for all histological subtypes was 100 % and its sensitivity was 78 %.CONCLUSION: This study shows the good specificity of frozen section .Discordances between frozen-section and definitive diagnosiswas associated with microfllicular lesions wich explain the sensibility of 78%Key Words: Thyroid surgery, frozen section examinatio

The aquaculture supply chain in the time of covid-19 pandemic: vulnerability, resilience, solutions and priorities at the global scale

The COVID-19 global pandemic has had severe, unpredictable and synchronous impacts on all levels of perishable food supply chains (PFSC), across multiple sectors and spatial scales. Aquaculture plays a vital and rapidly expanding role in food security, in some cases overtaking wild caught fisheries in the production of high-quality animal protein in this PFSC. We performed a rapid global assessment to evaluate the effects of the COVID-19 pandemic and related emerging control measures on the aquaculture supply chain. Socio-economic effects of the pandemic were analysed by surveying the perceptions of stakeholders, who were asked to describe potential supply-side disruption, vulnerabilities and resilience patterns along the production pipeline with four main supply chain components: a) hatchery, b) production/processing, c) distribution/logistics and d) market. We also assessed different farming strategies, comparing land- vs. sea-based systems; extensive vs. intensive methods; and with and without integrated multi-trophic aquaculture, IMTA. In addition to evaluating levels and sources of economic distress, interviewees were asked to identify mitigation solutions adopted at local / internal (i.e., farm-site) scales, and to express their preference on national / external scale mitigation measures among a set of a priori options. Survey responses identified the potential causes of disruption, ripple effects, sources of food insecurity, and socio-economic conflicts. They also pointed to various levels of mitigation strategies. The collated evidence represents a first baseline useful to address future disaster-driven responses, to reinforce the resilience of the sector and to facilitate the design reconstruction plans and mitigation measures, such as financial aid strategies.publishe

The synergistic impacts of anthropogenic stressors and COVID-19 on aquaculture: a current global perspective

The rapid, global spread of COVID-19, and the measures intended to limit or slow its propagation, are having major impacts on diverse sectors of society. Notably, these impacts are occurring in the context of other anthropogenic-driven threats including global climate change. Both anthropogenic stressors and the COVID-19 pandemic represent significant economic challenges to aquaculture systems across the globe, threatening the supply chain of one of the most important sources of animal protein, with potential disproportionate impacts on vulnerable communities. A web survey was conducted in 47 countries in the midst of the COVID-19 pandemic to assess how aquaculture activities have been affected by the pandemic, and to explore how these impacts compare to those from climate change. A positive correlation between the effects of the two categories of drivers was detected, but analysis suggests that the pandemic and the anthropogenic stressors affect different parts of the supply chain. The immediate measurable reported losses varied with aquaculture typology (land vs. marine, and intensive vs. extensive). A comparably lower impact on farmers reporting the use of integrated multitrophic aquaculture (IMTA) methods suggests that IMTA might enhance resilience to multiple stressors by providing different market options under the COVID-19 pandemic. Results emphasize the importance of assessing detrimental effects of COVID-19 under a multiple stressor lens, focusing on areas that have already locally experienced economic loss due to anthropogenic stressors in the last decade. Holistic policies that simultaneously address other ongoing anthropogenic stressors, rather than focusing solely on the acute impacts of COVID-19, are needed to maximize the long-term resilience of the aquaculture sector.publishe

Water Quality Assessment of the Shallow and Deep Aquifers of Hajeb Layoun-Jelma Basin (Central Tunisia)

The assessment of the groundwater quality is an important way to ensure its sustainability for various uses. In this study, the suitability of groundwater for irrigation and drinking uses was assessed by determining the water quality index, sodium adsorption ratio, electrical conductivity, Kelly’s ratio, and sodium percentage values of water samples. The results show that not all the groundwater in Hajeb Layoun-Jelma Basin can be used for irrigation. According to World Health Organization guidelines and the national standards, the major parameter data of drinking water indicate that the majority of the analyzed samples of groundwater in the area are suitable for drinking

Les cancers rares du larynx : a propos de 20 cas

Introduction : Les cancers rares du larynx sont définis comme étant des entités d’histopathologie inhabituelle au niveau laryngé. Ils ont été rapportés dans la littérature mondiale sous forme de cas isolés ou de séries de quelques cas. Le but de ce travail est de présenter la démarche diagnostique et la prise en charge de ces types de tumeurs à l’institut Salah Azaiez de Tunis.Patients et méthodes : Etude rétrospective portant sur 20 cas de cancers laryngés primitifs autre que le carcinome épidermoide sur la période 1989-2009.Résultats : L’âge moyen était de 59,35 ans. Le sexe ratio était de 3/1. La dysphonie était le motif de consultation dans 95% des cas. La mobilité laryngée était conservée dans 50% des cas. L’examen anatomopathologique avait conclu à un carcinosarcome dans 25% des cas, un carcinome type-glandes salivaires dans 20% des cas, une tumeur neuro-endocrine dans 10% des cas, un sarcome dans 25% des cas et un lymphome dans 20% des cas. Le traitement était chirurgical dans 14 cas, par radiothérapie exclusive dans 2 cas, radio et chimiothérapie dans 2 cas et chimiothérapie seule dans 2 cas. Le pronostic était bon avec une survie globale de 80%.Conclusion : Seul l’examen anatomopathologique précis et la bonne connaissance du cours évolutif des cancers rares du larynx sont les seuls garants d’une thérapeutique adaptée à chaque type.Mots clés : Larynx - Histologie - Sarcome – Lymphome - Cylindrome - Adénocarcinome-Diagnostic -ThérapeutiqueObjective: Rare cancers of the larynx are defined as unusual laryngeal histologicalentities. They have been reported in the world literature as isolated cases or series of a few cases.The aim of this work is to present our experience in this type of tumors.Patients and methods: A retrospective study of 20 cases of primitive laryngeal cancers other than squamous cell carcinoma of the period 1989-2009.Results: Mean age was 59,35 years. Sex ratio was 3/1. Dysphony an was there a son for consultation in 95% of cases. Laryngeal mobility was preserved in 50% of cases. The histopathological examination concluded a carcinosarcoma in 25% of cases, carcinoma- type salivary glands in 20% of cases, aneuroendocrinetumorin 10% of cases, sarcoma in 25% of cases and lymphoma in 20%. The treatment was surgical in 14cases, exclusive radiotherapy in 2 cases, radio and chemotherapy in 2 cases and chemotherapy alone in 2 cases. Overall survival was 80%.Conclusion: Only the accurate histology and good knowledge of the evolutive patterns of rare cancers of the larynx are the only guarantors of adapted therapeutic to each type.Keywords: Larynx-Histology -Sarcoma -Lymphoma -Cylindroma-Adenocarcinoma-Diagnosis - Therap

Machine Learning Based Data Reduction in WSN for Smart Agriculture

International audienceNowadays, the agriculture domain faces a lot of challenges for a better usage of its natural resources. For this purpose, and for the increasing danger of climate change, there is a need to locally monitor meteorological data and soil conditions to help make quicker and more adapted decision for the culture. Wireless Sensor Networks (WSN) can serve as a monitoring system for those types of features. However, WSN suffer from the limited energy resources of the motes which shorten the lifetime of the overall network. Every mote periodically captures the monitored feature and sends the data to the sink for further analysis depending on a certain sampling rate. This process of sending big amount of data causes a high energy consumption of the sensor node and an important bandwidth usage on the network. In this paper, a Machine Learning based Data Reduction Algorithm (MLDR) is introduced. MLDR focuses on environmental data for the benefits of agriculture. MLDR is a data reduction approach which reduces the amount of transmitted data to the sink by adding some machine learning techniques at the sensor node level by keeping data availability and accuracy at the sink. This data reduction helps reduce the energy consumption and the bandwidth usage and it enhances the use of the medium while maintaining the accuracy of the information. This approach is validated through simulations on MATLAB using real temperature data-sets from Weather-Underground sensor network. Results show that the amount of sent data is reduced by more than 70% while maintaining a very good accuracy with a variance that did not surpass 2 degrees

The Aquaculture Supply Chain In The Time Of Covd-19 Pandemic: Vulnerability, Resilience, Solutions And Priorities At The Global Scale

[EN] The COVID-19 global pandemic has had severe, unpredictable and synchronous impacts on all levels of perishable food supply chains (PFSC), across multiple sectors and spatial scales. Aquaculture plays a vital and rapidly expanding role in food security, in some cases overtaking wild caught fisheries in the production of high quality animal protein in this PFSC. We performed a rapid global assessment to evaluate the effects of the COVID19 pandemic and related emerging control measures on the aquaculture supply chain. Socio-economic effects of the pandemic were analysed by surveying the perceptions of stakeholders, who were asked to describe potential supply-side disruption, vulnerabilities and resilience patterns along the production pipeline with four main supply chain components: a) hatchery, b) production/processing, c) distribution/logistics and d) market. We also assessed different farming strategies, comparing land-vs. sea-based systems; extensive vs. intensive methods; and with and without integrated multi-trophic aquaculture, IMTA. In addition to evaluating levels and sources of economic distress, interviewees were asked to identify mitigation solutions adopted at local / internal (i.e., farm site) scales, and to express their preference on national / external scale mitigation measures among a set of a priori options. Survey responses identified the potential causes of disruption, ripple effects, sources of food insecurity, and socio-economic conflicts. They also pointed to various levels of mitigation strategies. The collated evidence represents a first baseline useful to address future disaster-driven responses, to reinforce the resilience of the sector and to facilitate the design reconstruction plans and mitigation measures, such as financial aid strategies.We are grateful to all the respondents who took the time to take the survey and to many colleagues for their effort done in facilitating the circulation of questionnaires. M.C.M.'s research activity was supported by the European Union's Horizon 2020 Research and Innovation pro-gramme under the Marie Skodowska-Curie Action (Grant agreement no. 835589, MIRROR Project) . People at the Laboratory of Ecology have been funded by the PRIN-MAHRES project (Ministry of Italian Research; MUR-017MHHWBN_003 Linea C) and by the Interreg Italia-Malta HARMONY 2016 (Grant C1-3.1-31) . C. Pita and A. Nogueira would like to thank FCT/MCTES for the financial support to CESAM (UIDP/50017/2020+UIDB/50017/2020) , through national funds. J.M.F. Babarro thanks project PID2019-106008RB-C21 for support through Spanish Government funds. The authors would like to thank also the ERASMUS+-FISHAQU project (No. 610071-EPP-1-2019-1-PT-EPPKA2-CBHE-JP) . We deeply thank Mr. Gaspare Barbera for his technical feedback during the questionnaire design looking at it under the lens of a stakeholder. We are grateful to QUALTRICS (Inc. USA) Product Spe-cialists based in Italy to have always answered to queries about software technicality. We recognised the wide, prompt and effective support offered by the Ethical Committee at the University of Palermo in assessing the questionnaire.Mangano, MC.; Berlino, M.; Corbari, L.; Milisenda, G.; Lucchese, M.; Terzo, S.; Bosch-Belmar, M.... (2022). The Aquaculture Supply Chain In The Time Of Covd-19 Pandemic: Vulnerability, Resilience, Solutions And Priorities At The Global Scale. Environmental Science & Policy. 127:98-110. https://doi.org/10.1016/j.envsci.2021.10.0149811012

Creating and Characterising Electricity Load Profiles of Residential Buildings

The 2020 International Workshop on Advanced Analytics and Learning on Temporal Data (AALTD 2020),Ghent, Belgium (held online due to coronavirus outbreak), 18 September 2020Intelligent planning, control and forecasting of electricity usage has become a vitally important element of the modern conception of the energy grid. Electricity smart-meters permit the sequential measurement of electricity usage at an aggregate level within a dwelling at regular time intervals. Electricity distributors or suppliers are interested in making general decisions that apply to large groups of customers, making it necessary to determine an appropriate electricity usage behaviour-based clustering of these data to determine appropriate aggregate load profiles. We perform a clustering of time series data associated with 3670 residential smart meters from an Irish customer behaviour trial and attempt to establish the relationship between the characteristics of each cluster based upon responses provided in an accompanying survey. Our analysis provides interesting insights into general electricity usage behaviours of residential consumers and the salient characteristics that affect those behaviours. Our characterisation of the usage profiles at a fine-granularity level and the resultant insights have the potential to improve the decisions made by distribution and supply companies, policy makers and other stakeholders, allowing them, for example, to optimise pricing, electricity usage, network investment strategies and to plan policies to best affect social behavior.Science Foundation Irelan