Paratesticular Liposarcoma: What is the Best Therapeutic Strategy?

Introduction: Liposarcomas are neoplasms of mesodermal origin derived from adipose tissue and correspond to 10–14% of all soft tissue sarcomas. Paratesticular liposarcoma is very rare.Case report: We report a 60-year old man who presented with a left testicular tumor 20 cm in diameter. Initial incisional biopsy was reported as fibromatosis. Chest and abdominal CT scan did not show distant metastases. Through an inguinal incision orchidectomy with homolateral inguinal node dissection was performed. Histopathological examination showed a paratesticular myxoid liposarcoma. Adjuvant radiotherapy without chemotherapy was administered. The patient remains well at 11 months followup, with no evidence of recurrence.Conclusion: Complete surgical extirpation reduces the risk of local recurrence. Neoadjuvant chemotherapy or radiotherapy may reduce the tumor size, thus facilitating complete excision

Experience du service de medecine nucleaire sahloul sousse dans la prise en charge des carcinomes differencies de la thyroïde a thyroglobuline elevee.

But : L’objectif de notre travail est de présenter notre expérience dans la prise en charge des cancer différencié de la thyroïde (CDT) à Thyroglobuline (Tg) élevée, tout en identifiant les paramètres modifiant l’efficacité de l’Irathérapie et la valeur seuil de la Tg permettant avec un balayage post thérapeutique négatif de conclure à une rémission.Matériels et méthodes : Il s’agit d’une étude rétrospective portant sur 150 patients opérés pour CDT, suivis entre 1990 et 2006 et présentant une Tg>2ng/ml.Résultats : Il s’agit de 122 femmes et 28 hommes. L’âge moyen était de 52 ans. La Tg ne dépendait pas du type histologique mais il existait une relation statistiquement significative entre la Tg et la taille tumorale, l’atteinte ganglionnaire, l’extension locorégionale, la présence de métastases et le stade TNM. La réponse thérapeutique des CDT avec une Tg élevée dépendait de l’âge des patients, des caractéristiques anatomopathologiques de la tumeur et des valeurs de la Tg.Conclusion : L’efficacité ablative est optimisée par des cures d’iode 131 qui doivent être prolongées tant que la Tg reste élevée. La surveillance à vie, au cours de la quelle on exige des seuils de Tg infèrieurs à 2ng/ml, est nécessaire. Mots clés : Cancers différenciés de la thyroide, Thyroglobuline, Irathérapie, Pronostic, Surveillance.Purpose: The aim of our work is to present our experience in the management of differentiated thyroid cancer (DTC) with high thyroglobulin (Tg) , to identify parameters changing iodine effectiveness and Tg threshold with negative post treatment scan conclude to remission.Materials and Methods: This is a retrospective study of 150 patients undergoing CDT, followed between 1990 and 2006 and having a Tg > 2ng/ml .Results: Our study concerns 122 women and 28 men. The average age was 52 years . Tg value does not depend on the histological type but there was a statistically significant relationship between Tg and tumor size, lymph node involvement, locoregional , metastasis and TNM stage . The therapeutic response of CDT with a high Tg was dependent on the age of patients, the pathological characteristics of the tumor and the Tg values ofConclusion: The ablative efficiency is optimized by 131 cures iodine should be extended until the Tg remains high. Monitoring life is necessary and the thresholds Tg below 2ng/ml is required.Keywords: Differentiated thyroid Cancers, Thyroglobulin, Iodine 131, Prediction, Monitoring

Facteurs predictifs de l’efficacite ablative de l’iode 131 dans les cancers differencies de la thyroïde

La prise en charge des cancers différenciés de la thyroïde (CDT) comporte souvent une radiothérapie métabolique à l’iode131 (IRA-thérapie). Le but de ce travail est d’évaluer le caractère prédictif des différents éléments anatomopathologiques, de la classification pTNM et de la stadification pronostique sur l’activité ablative requise d’iode131. Notre travail est une étude analytique rétrospective portant sur 275 cas de CDT ayant subit une thyroïdectomie totale. Tous ces patients ont eu une ou plusieurs activités ablatives. Nous avons cherché – au moyen d’une analyse statistique par test de Khi2 ou test Anova – toute corrélation entre les éléments de l’examen anatomopathologique de la tumeur, la classe pTNM, le stade pronostique correspondant d’une part  et l’efficacité de l’irathérapie ablative d’autre part. Dans notre série, une activité ablative plus élevée est nécessaire lorsque la taille du foyer tumoral dépasse les 6 cm (p=0,012), en cas de dépassement de la graisse péri thyroïdienne (

The EU’s Democracy, Human Rights and Resilience Discourse and Its Contestation

MEDRESET Work Package 4 (WP4) aims at evaluating the effectiveness of EU policies on democracy promotion and human rights in the Southern and Eastern Mediterranean (SEM) region from the perspective of bottom-up actors’ interests, needs, perceptions and expectations, both at the local and the EU level, with the purpose of identifying inclusive, responsive and flexible policy actions to reinvigorate Euro-Mediterranean relations. This paper will firstly provide a background analysis for WP4, based on a critical review of the discourses of the EU and other key international and regional players, discursive positions of civil society actors (including at this stage only documents produced by civil society networks which span the Mediterranean) and the academic discourse. The second part will give an introductory overview on the central role played by civil society in the Arab uprisings and beyond, while the third part will outline the analytical and methodological indications that will inform research and fieldwork in this WP

The impact of fire on habitat use by the short-snouted elephant shrew ('Elephantulus brachyrhynchus') in North West Province, South Africa

Several studies have investigated the response of small mammal populations to fire, but few have investigated behavioural responses to habitat modification. In this study we investigated the impact of fire on home range, habitat use and activity patterns of the short-snouted elephant shrew (Elephantulus brachyrhynchus) by radio-tracking individuals before and after a fire event. All animals survived the passage of fire in termite mound refugia. Before the fire, grassland was used more than thickets, but habitat utilization shifted to thickets after fire had removed the grass cover. Thickets were an important refuge both pre- and post-fire, but the proportion of thicket within the home range was greater post-fire. We conclude that fire-induced habitat modification resulted in a restriction of E. brachyrhynchus movements to patches of unburned vegetation. This may be a behavioural response to an increase in predation pressure associated with a reduction in cover, rather than a lack of food. This study highlights the importance of considering the landscape mosaic in fire management and allowing sufficient island patches to remain post-fire ensures the persistence of the small mammal fauna

Application de la technique de 137Cs à l'estimation de l'érosion hydrique dans le bassin versant de Moulay Bouchta, Rif occidental, Maroc

Au Maroc, l’érosion hydrique est un processus majeur de dégradation des sols, en particulier dans la zone rifaine, où l’érosion engendre des dégâts importants en amont et en aval des structures hydrauliques, remettant en cause la durabilité de l’exploitation de ces dernières. De même, l’évaluation quantitative de ce processus reste difficile à mettre en oeuvre du fait de la complexité du comportement des particules du sol, aussi bien dans l’espace que dans le temps, en réponse à la diversité et l’interaction des facteurs naturels et anthropiques. C’est ainsi qu’on propose d’évaluer les sédiments déplacés qui sont l’élément perceptible de ce phénomène à travers le suivi du traceur radioactif le Césium 137 (137Cs) caractérisé par son affinité aux particules fines du sol (argile et matière organique). La méthodologie adoptée combine l’utilisation de la technique du 137Cs et les Systèmes d’Information Géographique (SIG), ainsi, on a défini une trentaine d’unités fonctionnelles combinant trois paramètres agro-environnementaux « l’occupation du sol, le type de sol et l’inclinaison de la pente ». Jusqu’à présent, on a échantillonné 9 unités, représentant 68% du bassin versant, deux sites de référence et un prélèvement au niveau de la retenue du barrage pour évaluer le taux de sédimentation. Ensuite, les échantillons ont été analysés par spectrométrie gamma, les activités du 137Cs (Bq/kg), ainsi obtenues, sont converties en taux de perte ou de gain du sol (t/ha/an) à l’aide du modèle masse balance 2 (MBM2) pour les sites perturbés (terrains cultivés) et le modèle de diffusion et migration (DMM) pour les sites non perturbés (forêts et matorrals). Les résultats des pertes en sol à long terme (~ 50 ans) montrent que la majorité des sédiments arrachés (98%) proviennent des terrains cultivés. Ces terrains présentent des taux d’érosion variant de 18 à 36 (t/ha/an), alors que les sites du matorral et de la forêt présentent des taux d’érosion nettement plus faibles, ne dépassant pas 4,5 (t/ha/an). Ainsi, l’érosion globale calculée par pondération des surfaces de production de chaque unité de même sensibilité à l’érosion est estimée à 23 (t/ha/an). D’un autre coté, le taux de sédimentation mesuré dans la retenue du barrage montre que 0,34 cm de sédiments sont déposés chaque année, soit une dégradation spécifique de 50 (t/ha/an)

Valorisation of plastic waste from the beverage industry through its transformation into adsorbent and solid fuel materials

In the present study, char and activated carbon (AC) materials were prepared from water bottles, recuperated from the waste collection point in Mourouj, Ben Arous, Tunisia, by using a rotative horizontal tubular furnace, on a lab/pilot scale and through chemical and physical activation. Different samples were characterized by $\text{N}_2$ adsorption isotherms, SEM-EDX, XRD, EA as well as by the determination of the $\text{pH}_{\mathrm{zpc}}$. The efficiency of the ACs to remove (2-methyl-4-chlorophenoxyacetic acid (MCPA) and 2,4-dichlorophenoxyacetic acid (2,4-D)) herbicides from aqueous solutions was also investigated. The results demonstrated that a maximum adsorption capacity of $192~\text{mg}{\cdot }\text{g}^{-1}$, for MCPA, and $290~\text{mg}{\cdot }\text{g}^{-1}$ for 2,4-D had been attained. The adsorption kinetics was fitted to pseudo first, second order and Elovich model, while the adsorption isotherms were fitted applying the Langmuir and Freundlich isotherm models. The potential use as solid fuel materials was evaluated using elemental analysis and numerical high calorific value (HCV). The experimental results were compared to the conventional solid fuels classified in the Van Krevelen graph. The essays performed showed that the HCV was in the range of 10.2–11.9 MJ/kg

Valorisation of plastic waste from the beverage industry through its transformation into adsorbent and solid fuel materials

In the present study, char and activated carbon (AC) materials were prepared from water bottles, recuperated from the waste collection point in Mourouj, Ben Arous, Tunisia, by using a rotative horizontal tubular furnace, on a lab/pilot scale and through chemical and physical activation. Different samples were characterized by $\text{N}_2$ adsorption isotherms, SEM-EDX, XRD, EA as well as by the determination of the $\text{pH}_{\mathrm{zpc}}$. The efficiency of the ACs to remove (2-methyl-4-chlorophenoxyacetic acid (MCPA) and 2,4-dichlorophenoxyacetic acid (2,4-D)) herbicides from aqueous solutions was also investigated. The results demonstrated that a maximum adsorption capacity of $192~\text{mg}{\cdot }\text{g}^{-1}$, for MCPA, and $290~\text{mg}{\cdot }\text{g}^{-1}$ for 2,4-D had been attained. The adsorption kinetics was fitted to pseudo first, second order and Elovich model, while the adsorption isotherms were fitted applying the Langmuir and Freundlich isotherm models. The potential use as solid fuel materials was evaluated using elemental analysis and numerical high calorific value (HCV). The experimental results were compared to the conventional solid fuels classified in the Van Krevelen graph. The essays performed showed that the HCV was in the range of 10.2–11.9 MJ/kg

Los esfuerzos para dirección de bosque de alcornoque y sus efectos sobre conservación de suelo, la meseta Shoul, región de Rabat, Marruecos

The Shoul oak grove is a forested ecosystem inherited from a Holocene phase of ecological optimum; its evolution, through the double geologic and human temporality, and in relation with several processes of degradation, led to the progressive loss of its environmental equilibrium and further to the reduction of its economic contributions. The fragility of these forests is the consequence of the convergence of two main factors, i) the intrinsic fragility of the forested environment based on an unstable balance between the tree, the leached soils and their moisture content ; ii) the anthropological action on the forest environment and its degradation with the change of its floristic composition. During the colonization the new context was at the origin of the new social and economic relation between the forest and the surrounding populations. The current use of this oak grove is in a classic scheme of the reports society / forest in Morocco. The population is especially of pastoral main activity in the bordering communes. But the oak groves of Mamora-Sehoul are integrated into the area of influence of several cities, what exposes the forest to the risks of uncontrolled urbanization. These oak groves are thus in the centre of interest of several stakeholders with opposite behaviour and a new paradigm of relation rural/urban. Through a double approach, environmental and socio-economic, this paper will try to bring elements of answer by analyzing the interactions between a forest which reached an alarming threshold of degradation and a society affected by important changes in its modes of intervention and exploitation.La arboleda de roble Shoul es un ecosistema arbolado heredado de una fase de Holocene de grado óptimo ecológico; su evolución, por la doble temporalidad geológica y humana, y en relación con varios procesos de degradación, conducida a la pérdida progresiva de su equilibrio ambiental y con relación a la reducción de sus contribuciones económicas. La fragilidad de estos bosques es la consecuencia de la convergencia de dos factores principales, i) la fragilidad intrínseca del ambiente arbolado basado en un equilibrio(saldo) inestable entre el árbol, los suelos leached y su contenido de humedad; ii) la acción antropológica sobre el ambiente forestal y su degradación con el cambio de su composición floristic. Durante la colonización el nuevo contexto estaba en el origen de la nueva relación social y económica entre el bosque y las poblaciones circundantes. El empleo corriente de esta arboleda de roble está en un esquema clásico de la sociedad de informes / el bosque en Marruecos. La población es sobre todo de actividad pastoral principal en las comunas de lindar. Pero las arboledas de roble de Mamora-Sehoul son integradas en el área de influencia de varias ciudades, que expone el bosque a los riesgos de urbanización incontrolada. Estas arboledas de roble son así en el centro de interés de varios tenedores de apuestas con el comportamiento de enfrente y un nuevo paradigma de relación rural/urbana. Por un doble acercamiento, ambiental y socioeconómico, este papel(periódico) tratará de traer los elementos de respuesta por analizando las interacciones entre un bosque que alcanzó un umbral alarmante de degradación y una sociedad afectada por cambios importantes de sus modos de intervención y explotación

Exacerbations of chronic obstructive pulmonary disease: when are antibiotics indicated? A systematic review

BACKGROUND: For decades, there is an unresolved debate about adequate prescription of antibiotics for patients suffering from exacerbations of chronic obstructive pulmonary disease (COPD). The aim of this systematic review was to analyse randomised controlled trials investigating the clinical benefit of antibiotics for COPD exacerbations. METHODS: We conducted a systematic review of randomised, placebo-controlled trials assessing the effects of antibiotics on clinically relevant outcomes in patients with an exacerbation. We searched bibliographic databases, scrutinized reference lists and conference proceedings and asked the pharmaceutical industry for unpublished data. We used fixed-effects models to pool results. The primary outcome was treatment failure of COPD exacerbation treatment. RESULTS: We included 13 trials (1557 patients) of moderate to good quality. For the effects of antibiotics on treatment failure there was much heterogeneity across all trials (I(2 )= 82%). Meta-regression revealed severity of exacerbation as significant explanation for this heterogeneity (p = 0.016): Antibiotics did not reduce treatment failures in outpatients with mild to moderate exacerbations (pooled odds ratio 1.09, 95% CI 0.75–1.59, I(2 )= 18%). Inpatients with severe exacerbations had a substantial benefit on treatment failure rates (pooled odds ratio of 0.25, 95% CI 0.16–0.39, I(2 )= 0%; number-needed to treat of 4, 95% CI 3–5) and on mortality (pooled odds ratio of 0.20, 95% CI 0.06–0.62, I(2 )= 0%; number-needed to treat of 14, 95% CI 12–30). CONCLUSION: Antibiotics effectively reduce treatment failure and mortality rates in COPD patients with severe exacerbations. For patients with mild to moderate exacerbations, antibiotics may not be generally indicated and further research is needed to guide antibiotic prescription in these patients