The Occurrence and Health Risk Assessment of Aflatoxin M1 in Raw Cow Milk Collected from Tunisia during a Hot Lactating Season

Milk is a staple food that is essential for human nutrition because of its high nutrient content and health benefits. However, it is susceptible to being contaminated by Aflatoxin M1 (AFM1), which is a toxic metabolite of Aflatoxin B1 (AFB1) presented in cow feeds. This research investigated AFM1 in Tunisian raw cow milk samples. A total of 122 samples were collected at random from two different regions in 2022 (Beja and Mahdia). AFM1 was extracted from milk using the QuEChERS method, and contamination amounts were determined using liquid chromatography (HPLC) coupled with fluorescence detection (FD). Good recoveries were shown with intra-day and inter-day precisions of 97 and 103%, respectively, and detection and quantification levels of 0.003 and 0.01 µg/L, respectively. AFM1 was found in 97.54% of the samples, with amounts varying from values below the LOQ to 197.37 µg/L. Lower AFM1 was observed in Mahdia (mean: 39.37 µg/L), respectively. In positive samples, all AFM1 concentrations exceeded the EU maximum permitted level (0.050 µg/L) for AFM1 in milk. In Tunisia, a maximum permitted level for AFM1 in milk and milk products has not been established. The risk assessment of AFM1 was also determined. Briefly, the estimated intake amount of AFM1 by Tunisian adults through raw cow milk consumption was 0.032 µg/kg body weight/day. The Margin of Exposure (MOE) values obtained were lower than 10,000. According to the findings, controls as well as the establishment of regulations for AFM1 in milk are required in Tunisia

Primary cutaneous leiomyosarcoma of the flank: Case report and review

Cutaneous leiomyosarcoma is a rare soft tissue sarcoma. We present a case of a 50-year-old man, with a rare location in the flank. Clinical presentation showed an ulcerative lesion. Imaging features were evocative of malignancy. Surgical excision was performed, involving oblique muscles. The diagnosis of low-grade leiomyosarcoma with free margins was made. No adjuvant therapy was indicated. Clinical and radiological follow-up of the patient during two years did not reveal recurrences. Cutaneous leiomyosarcoma of the flank is extremely rare and takes part in a group of infrequent and unknown tumors. Clinical presentation is unspecific and histological evidence is mandatory for diagnosis. Tumor extension in depth constitutes the major determinant factor for therapeutic management and prognosis. Wide surgical resection is crucial to minimize recurrence risk especially when poor prognostic factors take place

Pure mucinous carcinoma of breast cancer in 56 Tunisian women

Background: Pure mucinous carcinoma breast cancer (PMBC) is a relatively rare subtype cancer of breast malignancy and associated with favorable prognosis. This retrospective study aims to investigate clinical, pathological features and clinical long-term outcomes. Methods: A retrospective review of 56 patients' files with pure mucinous breast cancer was performed. We evaluated the clinic-pathologic characteristics and survival status. Results: The mean age was 59 years. 37 patients underwent modified radical mastectomy; 14 underwent breast-conserving surgery. The 5-years overall survival (OS) and disease free survival (DFS) rates were respectively 75,3% and 74%. According to univariate analysis for OS, age (p = 0,049), menopausal status (p = 0,024), clinical T stage (p = 0,037), N stage (p = 0,002) and pathological T stage (p = 0,033) were statistically significant factors for survival. The DFS was better in postmenopausal women (p = 0,02), histological tumor size smaller than 20 mm (p = 0,024), and negative lymph nodes (p = 0,049). Conclusion: Pure mucinous breast cancer has a favorable prognosis and is characterized by lower tumor grade, higher hormone receptor expression and lower incidence of nodal involvement. Thanks to its good prognosis, this subtype of cancer should be treated less aggressively than invasive ductal carcinoma