Management of stage one and two-E gastric large B-cell lymphoma: chemotherapy alone or surgery followed by chemotherapy?

Management of localized primary gastric B lymphoma (PGL) remains controversial. The aim of this study is to compare two treatments: chemotherapy alone and surgery plus chemotherapy

MODELISATION DU COMPORTEMENT DU COMPTE COURANT : DETERMINANTS ET SOUTENABILITE

The imbalances in the current account may be a symptom of macroeconomic and financial pressures, that’s why  the analysis of its sustainability  is a major concern for policymakers. The purpose of this paper is to analyse the behavior of the Moroccan current account from 1980 to 2016 in order to identify the appropriate determinants of the current account and to better apprehend the potential risks threatening the moroccan economy. In this regard, we have applied a Vector Error Correction (VEC)  Model to quantify the impact of the exogenous variables on the current account balance and to analyse the long-term trajectory of this current account. The final purpose of this analysis is to validate or to reject the hypothesis of sustainability. Our results show that (i) Morocco's large and structural current account deficits are mainly explained by low inflows of the foreign direct investments (FDI), the volatility of the real effective exchange rate (REER) and the investment dynamics compared to the level of savings, (ii) the estimates of the model adopted confirm the hypothesis of sustainability of Morocco's current account, which can be explained by the implementation of several projects in the sectors of tourism, energy, automotive and aeronautics, as well as the favorable business climate for foreign investment and the consolidation of public finances.

Marché des changes du Maroc : Quelles pressions subies à l’ère de la réforme du régime de change et de la Covid-19 ?

This paper aims to measure the pressure on the dirham, the official currency of the Kingdom of Morocco, and also to identify periods of high tension on the foreign exchange market. This study takes place in a particular context characterized by the unprecedented spread of the SARS-Cov-2 all over the world andby the ongoing reform of the Moroccan exchange rate regime. Firstly, we used a very popular indicator called the Exchange Market Pressure Index (EMPI) known by its strong predictive capacity as it takes into account in its estimation two key indicators of the external sector, namely the change of the nominal effective exchange rate (NEER) and the foreign exchange reserves (FER). Secondly, we used theEMPI to quantify the contributions of some determining variables of the external sector to the pressures suffered by the foreign exchange market. Finally, we assessed the impact of the various measures implemented by the public authorities to counteract the Covid-19 crisis fallout, particularly those relating to the foreign exchange market. In terms of results, it appears that: (i) the foreign exchange market showed a strong resilience throughout the year 2020 despite the health crisis consequences and the transition to the 2nd phase of the exchange rate regime reform initiated in January 2018, (ii) the pressure identified in May 2020 was largely mitigated by the external fundamentals improvement in Q2-20 and (iii) the various measures undertaken by the government to guard against the external sector risks prevented significant pressures on the foreign exchange market in 2020.     JEL Classification : E31 Paper type : Empirical Researchidentifier les périodes à forte tension sur le marché des changes. Cette étude intervient dans un contexte mondial particulièrement difficile, marqué parla crise sanitaire liée au SARS-Cov-2 et, au niveau national, par la poursuite de la réforme du régime de change entamée en 2018. Dans un premier temps, nous avons utilisé un indice de stress appelé Exchange Market Pressure Index (EMPI); il s’agit d’un indicateur très populaire, caractérisé par sa forte capacité prédictive  grâce à son utilisation des deux indicateurs phares du secteur extérieur, à savoir, la variation du taux de change effectif nominal (TCEN) et les réserves de change (AOR). Secundo, nous avons utilisé l’indicateur précité en vue de quantifier, à travers son rapprochement avec certaines variables déterminantes du secteur extérieur, les contributions de ces dernières aux pressions subies par le marché des changes, à travers l’application d’un modèle probabiliste, appelé Logit. Finalement, nous avons essayé d’approcher l’impact des différentes mesures prises par les pouvoirs publics pour contrecarrer les effets de la crise de la Covid-19, notamment celles ayant visé à assainir la santé du marché des changes. Notre échantillon contient des données à fréquence mensuelle et trimestrielle, allant de 2001 à 2020. En termes de résultats, il ressort que : (i) le marché des changes a fait preuve d'une forte résilience sur l’ensemble de l’année 2020 face aux implications de la crise sanitaire, malgré le passage à la 2èmephase de la réforme du régime de change, (ii) la tension relevée en mai 2020 a été largement atténuée par l’amélioration des fondamentaux extérieurs au T2-20 et (iii) les différentes mesures prises par les pouvoirs publics pour se prémunir contre les risques afférents au secteur extérieur ont permis d’éviter des pressions significatives sur le marché des changes en 2020.   Classification JEL : E31 Type de papier : Recherche empiriqu

Breast cancer treatment and sexual dysfunction: Moroccan women's perception

<p>Abstract</p> <p>Background</p> <p>This exploratory prospective study evaluated women's responses to questions that asked them to describe how their body image and sexual functioning had changed since their breast cancer diagnosis to treatment.</p> <p>Methods</p> <p>A questionnaire concerning body image scale and various sexual problems experienced after diagnosis and treatment was anonymously completed by 120 women in the outpatient clinic of our hospital's Division of medical Oncology. To be eligible, subjects had to be sexually active and had histology proven breast cancer. They also had to have received treatment for breast cancer.</p> <p>Results</p> <p>100% of participants have never spoken with their doctor about this subject. 84% of the participants continued sexual activity after treatment, but there was an increase in the incidence of sexual functioning problems which resulted in a slight reduction in the quality of their sex lives. 65% of the women experienced dyspareunia followed by lubrication difficulties (54%) and the absence or reduction of sexual desire (48% and 64%, respectively) while, 37% had lack of satisfaction (37%). Female orgasmic disorder and brief intercourse and arousal were reported respectively by 40% and 38% of the subjects. The sexual dysfunctions were absent before diagnosis and management of breast cancer in 91.5% subjects and of these 100% subjects complained of a deterioration of the symptomatology after the various treatments. 90% of the dysfunctions were observed after chemotherapy, 9% after surgery and 3% after radiotherapy; none of the subjects indicated the onset of dysfunctions to have been associated with hormonotherapy. 100% expressed not having received sufficient information about how the disease and treatment (including surgery) might affect their sexual life.</p> <p>Conclusion</p> <p>Breast cancer and its treatment may result in significant difficulties with sexual functioning and sexual life. Addressing these problems is essential to improve the quality of life of Moroccan women with breast cancer.</p

Diagnostic challenge for ovarian malignant melanoma in premenopausal women: Primary or metastatic?

<p>Abstract</p> <p>Background</p> <p>In the ovary, metastatic malignant melanoma may be confused with primary malignant melanoma and presents a diagnosis challenge. Most cases are associated with disseminated diseases and poor prognosis. We present this case report of a metastatic ovarian malignant melanoma simulating primary ovarian cancer.</p> <p>Case report</p> <p>A 45-year-old premenopausal woman was incidentally found to have an abdominal mass, 3 years after removal of a cutaneous melanoma lesion. Ultrasound and CT scan revealed left two solid masses, which were found to be an ovarian tumor at laparotomy. Left oophorectomy was performed. Histopathology and immunohistochemistry showed melanoma metastasis to the ovary. Nine months later, the patient developed epilepsy and confusion. Magnetic Resonance Imaging showed unique Wright frontal lobe lesion. She underwent stereotactic radio surgery and dacarbazine monotherapy. For months later, the patient is died from disseminate disease progression.</p> <p>Conclusion</p> <p>Ovarian metastasis is an unusual presentation of cutaneous melanoma and the prognosis was dismal. As illustrated by this case report, a differential diagnosis of a metastatic malignant melanoma must be considered.</p