Les osteomes sinusiens a extension orbitaire a propos de trois cas

Introduction : L’ostéome des sinus paranasaux est une tumeur bénigne rare, dévolution lente et qui peut être responsable de complications ophtalmologiques, sinusiennes et endocrâniennes. Son traitement lorsqu’il s’impose, n’est que chirurgical.Observations : Nous rapportons les observations médicales de trois patients opérés dans le service d’ORL et de chirurgie cervico-faciale de l’hôpital 20 aout de Casablanca pour des ostéomes sinusiens a extension orbitaire. L’origine de l’ostéome était frontale dans 1 cas et ethmoïdal dans 2 cas. La tumeur était le plus souvent révélée par une exophtalmie d’apparition progressive associée ou non a des céphalées L’indication opératoire a été posée chez les trois malades. La voie d’abord a été transfaciale dans deux cas et bicoronale dans un cas. L’évolution a été favorable chez tous les patients.Conclusion : : l’ostéome sinusien est une néoformation osseuse bénigne dont le traitement est chirurgical dans les formes symptomatiques. La voie d’abord dépend de la localisation tumorale.Mots clés : Ostéome, Sinus paranasaux, Extension orbitaire, Traitement.Objective : The osteoma of paranasal sinuses is a rare benign tumour, slow devolution and which may be responsible for ocular, intracranial and sinus complications. The treatment when it is required, is that surgical.Case report : We report the medical observations of three patients operated in the ENT service and cervical-facial surgery in the Hospital 20 August of Casablanca for sinus osteomas with orbital extension. The origin of the osteoma was frontal in one case, ethmoid in two cases. The tumor was most often revealed by a gradual exophthalmia associated or not with headache. The operative indication has been raised in three patients. The incision was transfacial in two cases and bicoronale in one case. The evolution was favorable in all patients.Conclusion: the sinus osteomas is a benign bone neoformation with surgical treatment in symptomatic forms. The surgical approach depends on tumor location.Keyswords : Osteoma, Paranasal sinuses, Orbital Extension, Treatment

Neurinome du nerf facial - A propos d’un cas et revue de la littérature

Introduction: Le neurinome du nerf facial est une tumeur bénigne rare qui peut intéresser n’importe quel segment du nerf facial et se révèle par une paralysie faciale soit isolée soit associée à des signes auditifs.Observation : Nous rapportons le cas d’une patiente de 18 ans qui a présenté une paralysie faciale grade v d’aggravation progressive associée à une discrète surdité de transmission. L’imagerie (TDM et IRM) était très évocatrice d’un neurinome de la portion tympanique et mastoïdienne du nerf facial. Le traitement a consisté en une résection tumorale par voie transmastoïdienne avec greffe nerveuse, sans détérioration de la fonction auditive avec bon résultat sur la fonction faciale.Commentaires et conclusion : La symptomatologie du neurinome du nerf facial dépend essentiellement de sa localisation, elle est donc très variable allant de la surdité légère isolée au syndrome cochleo-vestibulaire avec paralysie faciale. A travers cette observation et une revue de la littérature, les auteurs rappellent les particularités cliniques, paracliniques, thérapeutiques et évolutives de cette pathologie rare en insistant sur l’approche thérapeutique adaptée au stade d’extension tumorale et la fonction faciale préopératoire.Mots clés : schwannome du nerf facial, paralysie faciale, résection  nerveuse, greffe nerveus

Metastase axillaire d'un carcinome papillaire de la thyroïde: À propos d'un cas

Les métastases axillaires dans le cadre d'un cancer de la thyroïde sont extrêmement rares. Plusieurs hypothèses expliquent ce drainage. Nousrapportons le cas d'un patient de 78 ans ayant pour antécédents  chirurgicaux une lobo-isthmectomie en 1987, puis une totalisation chirurgicale en 1997 non documentés, admis en septembre 2008 pour exploration d'une masse latéro-cervicale gauche. Le reste de l'examen clinique révèle la présence de multiples adénopathies axillaires bilatérales. La biopsie exérèse d'une adénopathie axillaire droite (côté controlatéral) retrouve une métastase ganglionnaire d'un carcinome papillaire de la thyroïde avec effraction capsulaire. La tomodensitométrie cervico-thoracique note la présence d'un processus tumoral latéro-cervical gauche, un lobe thyroïdien droit siège de multiples nodules hypodenses, des adénopathies cervicales et axillaires et des lésions suspectes au niveau du parenchyme pulmonaire. Une thyroïdectomie totale avec curage  ganglionnaire cervical est décidée, complétée par une ablation des ganglions axillaires macroscopiquement atteints. Des cures d'iode  radioactif (IRA-thérapie) sont indiquées. Bien qu'exceptionnelle, la  présence de métastases axillaires d'un carcinome thyroïdien est de  pronostic péjoratif. On se demande alors si ces patients ne nécessitent pas une prise en charge particulière. Une réflexion à une stratégie  thérapeutique est donc nécessaire

ETHNOBOTANICAL SURVEY OF PLANTS USED IN THE MANAGEMENT OF DIABETES MELLITUS IN ABEOKUTA, NIGERIA

An ethnobotanical survey of some plants used for management of diabetes in Abeokuta, Ogun State, Nigeria was conducted. A total of 100 questionnaires were administered; (50 herbal practitioners and 50 on patients). Investigations were carried out on the plant parts used, methods of preparation and administration including, dosage and duration of usage. The results showed that fifty (50) plant species belonging to 30 families used in herbal anti-diabetes recipes. The most frequently used plant was Vernonia amygdalina (54%), followed by Azadirachta indica (44%), Ocimum gratissimum (20%), Mormodica charantia (10%) and Citrus aurantifolia (10%). Irrespective of the plant parts (leaves, fruits, stem- barks or roots) or combinations of the plant parts, water and alcohol were the main solvents. The most frequently used plant parts was leaf (62%) and mainly by decoction. Treatment regimens were by chewing or drinking of the aqueous herbal preparations (350-400ml) daily for 6-12 weeks or until symptoms of diabetes disappear.Keywords: Anti-diabetic plants, ethnobotanical survey, herbs, plant parts

The FEBEX benchmark test: case definition and comparison of modelling approaches

The FEBEX (Full-scale Engineered Barriers Experiment in Crystalline Host Rock) ‘‘in situ’’ test was installed at the Grimsel Test Site underground laboratory (Switzerland) and is a near-to-real scale simulation of the Spanish reference concept of deep geological storage in crystalline host rock. A modelling exercise, aimed at predicting field behaviour, was divided in three parts. In Part A, predictions for both the total water inflow to the tunnel as well as the water pressure changes induced by the boring of the tunnel were required. In Part B, predictions for local field variables, such as temperature, relative humidity, stresses and displacements at selected points in the bentonite barrier, and global variables, such as the total input power to the heaters were required. In Part C, predictions for temperature, stresses, water pressures and displacements in selected points of the host rock were required. Ten Modelling Teams from Europe, North America and Japan were involved in the analysis of the test. Differences among approaches may be found in the constitutive models used, in the simplifications made to the balance equations and in the geometric symmetries considered. Several aspects are addressed in the paper: the basic THM physical phenomena which dominate the test response are discussed, a comparison of different modelling results with actual measurements is presented and a discussion is given to explain the performance of the various predictions.Peer Reviewe

Assessing Conservation Values: Biodiversity and Endemicity in Tropical Land Use Systems

Despite an increasing amount of data on the effects of tropical land use on continental forest fauna and flora, it is debatable whether the choice of the indicator variables allows for a proper evaluation of the role of modified habitats in mitigating the global biodiversity crisis. While many single-taxon studies have highlighted that species with narrow geographic ranges especially suffer from habitat modification, there is no multi-taxa study available which consistently focuses on geographic range composition of the studied indicator groups. We compiled geographic range data for 180 bird, 119 butterfly, 204 tree and 219 understorey plant species sampled along a gradient of habitat modification ranging from near-primary forest through young secondary forest and agroforestry systems to annual crops in the southwestern lowlands of Cameroon. We found very similar patterns of declining species richness with increasing habitat modification between taxon-specific groups of similar geographic range categories. At the 8 km2 spatial level, estimated richness of endemic species declined in all groups by 21% (birds) to 91% (trees) from forests to annual crops, while estimated richness of widespread species increased by +101% (trees) to +275% (understorey plants), or remained stable (- 2%, butterflies). Even traditional agroforestry systems lost estimated endemic species richness by - 18% (birds) to - 90% (understorey plants). Endemic species richness of one taxon explained between 37% and 57% of others (positive correlations) and taxon-specific richness in widespread species explained up to 76% of variation in richness of endemic species (negative correlations). The key implication of this study is that the range size aspect is fundamental in assessments of conservation value via species inventory data from modified habitats. The study also suggests that even ecologically friendly agricultural matrices may be of much lower value for tropical conservation than indicated by mere biodiversity value

Study protocol for VIdeo assisted thoracoscopic lobectomy versus conventional Open LobEcTomy for lung cancer, a UK multicentre randomised controlled trial with an internal pilot (the VIOLET study)

INTRODUCTION: Lung cancer is a leading cause of cancer deaths worldwide and surgery remains the main treatment for early stage disease. Prior to the introduction of video-assisted thoracoscopic surgery (VATS), lung resection for cancer was undertaken through an open thoracotomy. To date, the evidence base supporting the different surgical approaches is based on non-randomised studies, small randomised trials and is focused mainly on short-term in-hospital outcomes. METHODS AND ANALYSIS: The VIdeo assisted thoracoscopic lobectomy versus conventional Open LobEcTomy for lung cancer study is a UK multicentre parallel group randomised controlled trial (RCT) with blinding of outcome assessors and participants (to hospital discharge) comparing the effectiveness, cost-effectiveness and acceptability of VATS lobectomy versus open lobectomy for treatment of lung cancer. We will test the hypothesis that VATS lobectomy is superior to open lobectomy with respect to self-reported physical function 5 weeks after randomisation (approximately 1 month after surgery). Secondary outcomes include assessment of efficacy (hospital stay, pain, proportion and time to uptake of chemotherapy), measures of safety (adverse health events), oncological outcomes (proportion of patients upstaged to pathologic N2 (pN2) disease and disease-free survival), overall survival and health related quality of life to 1 year. The QuinteT Recruitment Intervention is integrated into the trial to optimise recruitment. ETHICS AND DISSEMINATION: This trial has been approved by the UK (Dulwich) National Research Ethics Service Committee London. Findings will be written-up as methodology papers for conference presentation, and publication in peer-reviewed journals. Many aspects of the feasibility work will inform surgical RCTs in general and these will be reported at methodology meetings. We will also link with lung cancer clinical studies groups. The patient and public involvement group that works with the Respiratory Biomedical Research Unit at the Brompton Hospital will help identify how we can best publicise the findings

Transformations to groundwater sustainability: from individuals and pumps to communities and aquifers

If the success of agricultural intensification continues to rely on the depletion of aquifers and exploitation of (female) labour, transformations to groundwater sustainability will be impossible to achieve. Hence, the development of new groundwater imaginaries, based on alternative ways of organizing society-water relations is highly important. This paper argues that a comparative documentation of grass-roots initiatives to care for, share or recharge aquifers in places with acute resource pressures provides an important source of inspiration. Using a grounded anti-colonial and feminist approach, we combine an ethnographic documentation of groundwater practices with hydrogeological and engineering insights to enunciate, normatively assess and jointly learn from the knowledges, technologies and institutions that characterize such initiatives. Doing this usefully shifts the focus of planned efforts to regulate and govern groundwater away from government efforts to control individual pumping behaviours, to the identification of possibilities to anchor transformations to sustainability in collective action

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2–4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease