Traitement Chirurgical De L\'hyperparathyroidie Primaire : Techniques Et Resultats

L\'hyperparathyroïdie est secondaire à une sécrétion élevée de parathormone. Le diagnostic positif est biologique et le diagnostic de localisation est radiologique et isotopique. Le traitement chirurgical est la règle. Le but : de ce travail est d\'étudier notre stratégie thérapeutique en cas d\'hyperparathyroïdie primitive et ses résultats. Patients et méthodes : Nous avons mené une étude rétrospective à propos de 34 patients traités pour hyperparathyroïdie primitive durant la période entre 1992 et 2004. Résultats : L\'âge moyen de nos patients était de 51 ans avec une nette prédominance féminine. Notre stratégie chirurgicale était l\'exploration sous anesthésie générale des 4 glandes parathyroïdes. Les glandes pathologiques ont siégé au niveau des compartiments inférieurs dans la majorité des cas. Histologiquement l\'aspect adénomateux a été observé chez 26 patients. L\'examen extemporané était systématique. Son résultat était concordant avec l\'examen anatomopathologique final lui conférant une fiabilité de 100 %. L\'hypocalcémie post-opératoire immédiate a été rencontrée chez 11 patients. Elle était transitoire dans 8 cas. Un seul patient avait une hypercalcémie persistante conférant à notre stratégie chirurgicale un taux de succès de 97,15 %. Discussion : le risque d\'hypocalcémie immédiate varie dans la littérature de 3 à 50%. Dans notre série il était de 32,35%. Ceci est surtout expliqué par notre technique opératoire exposant les parathyroïdes à la dévascularisation. D\'autres techniques chirurgicales moins invasives ont été essayées visant à diminuer le risque d\'hypoparathroidie transitoire ou définitive. Elles sont basées sur un bilan localisateur performant actuellement surplombé par la scintigraphie au sestamibi.Primary hyperparathyroidism is secondary to an elevated secretion of parathormone. The positive diagnosis is biologic. The diagnosis of localization is radiological and isotopic. The surgical treatment is the rule. The aim : of this work is to study our therapeutic strategy in cases of primary hyperparathyroidism and its results. Patients and methods: We proceed to a retrospective study about 34 patients treated for primary hyperparathyroidism during the period between 1992 and 2004. Results: The middle age of our patients was of 51 years with a female predominance. Our surgical strategy was the exploration under general anaesthesia of the 4 parathyroid glands. The pathological glands were in the lower compartments in the majority of cases. Histologically, adenoma has been observed at 26 patients. Extemporary exam was systematic. Its result was in agreement to the final anatomopathological result conferring him a reliability of 100%. The immediate post-operative hypocalcaemia has been observed at 11 patients. It was transient in 8 cases. One alone patient had an obstinate hypercalcaemia conferring to our surgical strategy a rate of success of 97,15%. Discussion: the risk of immediate hypocalcaemia varies in the literature from 3 to 50%. In our study it was 32,35%. It is especially explained by our operative technique exhibitor parathyroïd to the devascularisation. Other operative techniques less invasiveness have been tried aiming to decrease the risk of transient or definitive hypoparathroidy. They are based currently on a effective exam of localization overhung by the scintigraphy to the sestamibi. Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 16 2006: pp. 8-1

Oncocytome renal geant

No Abstract. African Journal of Urology Vol. 12 (3) 2006: 161-16

Sustainable agriculture and forestry in the Mediterranean Partners Countries and Turkey: factors, indicators and challenges

The aim of this study is to define the main factors of sustainable agriculture and forestry in Egypt, Morocco, Tunisia and Turkey. The study is based on the review of existing literature and country level analyses. In the study indicators which can be used to measure sustainability are defined and examined and data on these is collected. Major challenges of the sector in the study countries are tentatively examined. According to the study relatively much data is available, but not enough to guarantee balanced sustainability assessments. More data is needed especially on resource quality and land degradation, agricultural productivity and to some extent also on rural poverty. To biodiversity and cultural values should be given stronger emphasis than is currently done. For better understanding of the development, data gathering systems in the countries should be widened so that data is collected periodically and also from the regions and that in data collecting all aspects of sustainability are taken into account.Peer reviewe

Policy recommendations for competitiveness of the fresh orange export sector in Mediterranean partner countries

Contribution WP4 - Deliverable D20. Projet FP7 : SUSTAINMED - Sustainable agri-food systems and rural development in the Mediterranean Partner Countries.International audienceThis report represents the second half of Work Package 4 (WP4) as part of the SustainMED project as part of D20. The objective of SustainMED is to examine the impacts of EU and national agricultural, rural, environmental and trade policies in the Mediterranean Partner Countries (MPCs). The specific aim of WP4 is to analyse the competitiveness of selected agrofood value chains in selected MPCs with this report presenting the findings from the fresh orange export chain. D15 presented an approach to competitiveness based on the principles of value chain thinking using the fresh orange export sector as the main unit of analysis to demonstrate this approach. D20 is a natural progression from this and using Global Value Chain Analysis (GVCA), we propose broad policy implications to improve the competitiveness of the sector. We first review the methodology and main findings from the Global Value Chain Analysis (GVCA) and then, using key informant information from project partners in MPCs plus Turkey, present the main policy recommendations as required in D20

Prise en charge des abces prostatiques: A propos de 47 observations

No Abstract. African Journal of Urology Vol. 12 (3) 2006: 146-15

Policy recommendations for competitiveness of the fresh orange export sector in Mediterranean partner countries

Contribution WP4 - Deliverable D20. Projet FP7 : SUSTAINMED - Sustainable agri-food systems and rural development in the Mediterranean Partner Countries.International audienceThis report represents the second half of Work Package 4 (WP4) as part of the SustainMED project as part of D20. The objective of SustainMED is to examine the impacts of EU and national agricultural, rural, environmental and trade policies in the Mediterranean Partner Countries (MPCs). The specific aim of WP4 is to analyse the competitiveness of selected agrofood value chains in selected MPCs with this report presenting the findings from the fresh orange export chain. D15 presented an approach to competitiveness based on the principles of value chain thinking using the fresh orange export sector as the main unit of analysis to demonstrate this approach. D20 is a natural progression from this and using Global Value Chain Analysis (GVCA), we propose broad policy implications to improve the competitiveness of the sector. We first review the methodology and main findings from the Global Value Chain Analysis (GVCA) and then, using key informant information from project partners in MPCs plus Turkey, present the main policy recommendations as required in D20