Transient mutism after anterior transcallosal approach

Postoperative mutism is an infrequent complication of brain surgery. We report a third ventricular astrocytoma in a 16-year-old boy. The tumor was totally removed via anterior transcallosal approach. The operation was uneventful. On the second postoperative day he became mute. He could follow verbal commands, and write and read. Histopathological examination revealed a pilocystic astrocytoma. Four days postoperatively, he began to say simple words, and two weeks later he could talk normally. The possible cause and pathophysiological mechanism of mutism in the lesions of this region are discussed in this paperKey words: Mutism; Third ventricle; Corpus callosum; Transcallosal approac

Les metastases meningees solitaires prevalentes

Objectif Intérêt d’avoir une confirmation histologique, en présence d’un processus leptoméningée solitaire dont le diagnostic de méningiome bénin est souvent évoqué en premier. Introduction Les métastases méningées sont observées de plus en plus fréquemment chez les patients connus porteur d’une néoplasie, du fait de l’allongement de la survie des patients et l’amélioration des moyens diagnostiques ; elles représentent environ 8 % des métastases du système nerveux central.Observation Nous rapportons deux observations originales de patients sans histoire néoplasique, opérés pour un processus leptomeningé solitaire dont le diagnostic préopératoire était celui d’un méningiome. L’étude histologique révélait la nature néoplasique métastatique de la lésion, alors que le bilan radiologique a permis de détecter la localisation primitive méconnue. Conclusion et discussion La découverte à l’occasion d’une imagerie cérébrale (TDM et/ou IRM) chez un patient, sans histoire néoplasique, d’une ou plusieurs lésions leptoméningées, pose un problème diagnostique. Lorsque lalocalisation est unique, le diagnostic de méningiome est évoqué en premier ; alors que les lésions inflammatoires et secondaires des hémopathies malignes représentent un diagnostic différentiel lorsque les lésions sont diffuses. Seront discutées à lumière de ces observations et d’une revue de la littérature, les aspects physiopathologiques, cliniques, paracliniques, thérapeutiques et évolutifs de cette pathologie

Viscosity solutions of systems of PDEs with interconnected obstacles and Multi modes switching problems

This paper deals with existence and uniqueness, in viscosity sense, of a solution for a system of m variational partial differential inequalities with inter-connected obstacles. A particular case of this system is the deterministic version of the Verification Theorem of the Markovian optimal m-states switching problem. The switching cost functions are arbitrary. This problem is connected with the valuation of a power plant in the energy market. The main tool is the notion of systems of reflected BSDEs with oblique reflection.Comment: 36 page

Seasonal Variation (Winter vs. Summer) Crustacean Fauna of the Oualidia Lagoon, Morocco

The Oualidia lagoon on the Atlantic coast of Morocco provides important ecosystem services such as aquaculture, fisheries, tourism and high ecological and biological productivity. This is the first study to describe the spatio-temporal distribution of the crustacean community and potential controlling factors in the coastal waters of the Oualidia lagoon. Crustaceans were sampled with a Van Veen grab during two surveys in winter and summer 2013, and taxonomic composition and diversity were determined at 43 sampling sites. Of the eighteen crustacean taxa recorded, fifteen were new to Oualidia Lagoon. Sphaeroma serratum was the most abundant species in both seasons. Organic matter and chlorophyll a content were higher, temperature and salinity were lower in winter than in summer. The structure of the crustacean assemblages was characterised by the formation of two main clusters, organised according to a downstream gradient. Canonical Correspondence Analysis (CCA) showed that granulometry, organic matter and salinity strongly influenced the distribution pattern of crustaceans in the lagoon

Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments.info:eu-repo/semantics/publishedVersio

Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments.Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study.Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%.Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.</p

Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections : a prospective multicentre study (WISS Study)

Background: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. Methods: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study. Results: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p <0.0001). The multivariate logistic regression model was highly significant (p <0.0001, R-2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4. Conclusions: WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.Peer reviewe

Invariant subspace problem and compact operators on non-Archimedean Banach spaces

In this paper, the invariant Subspace Problem is studied for the class of non-Archimedean compact operators on an infinite-dimensional Banach space E over a nontrivial complete non-Archimedean valued field K. Our first main result (Theorem 9) asserts that if K is locally compact, then each compact operator on E possessing a quasi null vector admits a nontrivial hyperinvariant closed subspace. In the second one (Theorem 17), we prove that each bounded operator on E which contains a cyclic quasi null vector can be written as the sum of a triangular operator and a compact shift operator, each one of them possesses a nontrivial invariant closed subspace. Finally, we conclude that if K is algebraically closed, then every compact operator on E either has a nontrivial invariant closed subspace or is a sum of upper triangular operator and shift operator, each of them is compact and has a nontrivial invariant closed subspace.peerReviewe