The Impact of Destination Image on Tourist’s Behavioral Intentions: Case of the Essaouira City

In a tourism destination, tourists are the main factor and what matters is to attract them. Therefore, in the competitive context of tourism destinations, those who can create, enhance and differentiate their image are more successful as they improve their popularity, reputation, and ability to attract more tourists in the future. Hence, we can infer that the image of the destination is one of effective marketing tools to attract more tourists. The purpose of this paper is to examine the impact of destination images on behavioral intentions. More specifically, we investigate the impact of cognitive and affective destination image on intentions to revisit and recommend the destination among past tourists. Data were collected from 249 tourists who visited the city of Essaouira and the model was tested using structural equation modeling based on the PLS method. The results of this study is to support the positive impact of the destination image on behavioral intentions.In a tourism destination, tourists are the main factor and what matters is to attract them. Therefore, in the competitive context of tourism destinations, those who can create, enhance and differentiate their image are more successful as they improve their popularity, reputation, and ability to attract more tourists in the future. Hence, we can infer that the image of the destination is one of effective marketing tools to attract more tourists. The purpose of this paper is to examine the impact of destination images on behavioral intentions. More specifically, we investigate the impact of cognitive and affective destination image on intentions to revisit and recommend the destination among past tourists. Data were collected from 249 tourists who visited the city of Essaouira and the model was tested using structural equation modeling based on the PLS method. The results of this study is to support the positive impact of the destination image on behavioral intentions

Unusual toxicity of bevacizumab (Avastin®): Hyperlipemia?

Le bevacizumab (Avastin®) est un anticorps monoclonal exerçant une activité antiangiogénique. Son utilisation apporte un gain en survie dans plusieurs localisations tumorales en phase métastatique dont le cancer du sein, le cancer colorectal, le cancer du rein et le cancer bronchique non à petites cellules. Ce traitement est pourvoyeur de toxicités spécifiques comme l’hypertension artérielle, la protéinurie, les perforations digestives ou les évènements thromboemboliques artériels. Nous rapporterons une série de 7 cas d’hyperlipémies apparues (5 cas) ou s’étant aggravées (2 cas) lors d’un traitement par bevacizumab. Tous nos malades ont évolué favorablement par les mesures hygiéno-diététiques, associées ou non à un traitement médical par statines.Bevacizumab (Avastin®) is an antibody humanized monoclonal neutralizing anti-VEGF (anti-growth factor vascular endothelial) exerting anti-angiogenic activity. It has shown its impact on relapse-free survival of patients treated for metastatic tumors including breast cancer, colorectal cancer, kidney cancer and no small cell lung cancer. This treatment is a provider of specific toxicities such as hypertension, proteinuria, gastrointestinal perforation or arterial thromboembolic events. We report a series of seven cases who received this therapy including 5 patients who had no dyslipidemia before treatment and 2 cases who had increased their initial lipid profile. All the patients were placed under Lifestyle and diet, associated or not to medical treatment by statins. The evolution was favorable in all cases

Is there any advantage to combined trastuzumab and chemotherapy in perioperative setting her 2neu positive localized gastric adenocarcinoma?

We report here a 44-year-old Moroccan man with resectable gastric adenocarcinoma with overexpression of human epidermal growth factor receptor 2 (HER2) by immunohistochemistry who was treated with trastuzumab in combination with chemotherapy in perioperative setting. He received 3 cycles of neoadjuvant chemotherapy consisting of trastuzumab, oxaliplatin, and capecitabine. Afterwards, he received total gastrectomy with extended D2 lymphadenectomy without spleno-pancreatectomy. A pathologic complete response was obtained with a combination of trastuzumab and oxaliplatin and capecitabine. He received 3 more cycles of trastuzumab containing regimen postoperatively

Surgical Management of Undiagnosed Laceration of Superior Vena Cava Caused by Blunt Trauma

International audienceIntrapericardial rupture of the superior vena cava resulting from blunt thoracic trauma is a rare and life-threatening condition that has to be ruled out in the presence of signs of cardiac tamponade and a history of blunt thoracic trauma. We report the case of undiagnosed superior vena cava laceration caused by a high-speed road traffic accident in a 25 year-old patient revealed by cardiac tamponade. We highlight the need of urgent surgical exploration in all patients whose condition is unstable in the setting of blunt thoracic trauma regardless of imaging conclusions

When tyrosine kinase inhibitor sunitinib can be discontinued in metastatic renal cell carcinoma to pancreas: a case report

Abstract Background Long-term survival with durable response remains possible in the area of targeted therapies. Discontinuation of sunitinib could improve quality of life and reduce treatment costs in metastatic renal cell carcinoma with long-term disease stabilization. We discuss a case of successful interruption of antiangiogenic therapy in a patient with persisting evidence of metastases. The discontinuation of antiangiogenic therapy seems to be an option, even in indolent oligo-metastatic renal cell carcinoma with long disease stabilization before sunitinib. This observation contributes important data to the ongoing discussion on the discontinuation of treatment with kinase inhibitors in selected patients with metastatic renal cell carcinoma. Case presentation We report a case of an 80-year-old Moroccan man treated for renal clear cell carcinoma with multiple pancreatic metastases. He was not on any other medications. He underwent active surveillance with deferred sunitinib at disease progression. He showed significant disease control on sunitinib therapy demonstrating partial response with stable disease after a total of 28 months of therapy. He experienced toxicities which were manageable with supportive care and dose adjustments. Our patient asked for a break of the sunitinib administration, and the treatment was stopped. The disease remained stable after 13 months’ discontinuation of sunitinib therapy. The patient was in excellent overall health. Conclusions All available agents for metastatic renal cell carcinoma have side effects, which may become serious in a minority of patients. Clinicians and patients must therefore carefully balance the goals of maximal efficacy with minimal toxicity. Sunitinib can be discontinued without negatively impacting outcomes in indolent disease. Further research is needed to characterize the molecular determinants of response and resistance to targeted therapy

Renal damage induced by pemetrexed causing drug discontinuation: a case report and review of the literature

Abstract Background Pemetrexed maintenance therapy holds tremendous potential in improving the survival of patients with advanced pulmonary adenocarcinoma. Major side effects include myelosuppression and cutaneous reactions. However, little data are available on pemetrexed nephrotoxicity. Our case describes clinically relevant renal events leading to treatment discontinuation in routine practice. Case presentation We report a case of a 69-year-old Moroccan man treated for metastatic non-small cell lung cancer. He was not on any other medications and he did not receive any nephrotoxic agents. He was exposed to intravenously administered contrast from thoracoabdominal computed tomography in the week of his last pemetrexed treatment. He developed kidney disease related to pemetrexed. He was submitted to renal biopsy, which showed acute tubular damage and interstitial fibrosis. His kidney function remained impaired, but stable, after discontinuation of pemetrexed therapy. He died 5 months later. Conclusions Medical oncologists should be aware of renal adverse events for patients with advanced non-small cell lung cancer eligible for pemetrexed maintenance therapy. Suggestions for mitigating the risk for renal toxicities (dehydration, non-steroidal anti-inflammatory drugs and zoledronic acid, radiocontrast agents) during pemetrexed maintenance should be followed to enable early detection and management of this adverse event

Spatial Distribution of Desert Plant Species According to Soil Salinity

The arid climate of the Saharan regions is accentuated even more by the consequences of climate change and environmental threats, thus affecting normal plant development. The salinization of soils is one of the major stresses in the Moroccan Sahara Desert that strongly penalizes the production. In this sense, it would be interesting to explore the native flora of the target regions, and using it remains the best option to provide sustainable agriculture. The present study is part of a collaborative project with the aim of exploring desert plant species. Different parameters were taken for each species, including soil salinity and density. Two zones showed the highest levels of salinity, Daoura and Akhfennir, both in the Tarfaya province with 19.38 and 24.33 mS/cm, respectively. Although, several species were highly tolerant to salinity and were present at moderate to high densities. Among them, one can cite Aeluropus littoralis (Gouan) Parl., Halocnemum strobilaceum (Pall.) M. Bieb. and Suaeda ifniensis Caball. ex Maire