Feasibility of outpatient daycase local anaesthestic Rezūm™ without sedation

Background Rezūm™ is a relatively new bladder outflow obstruction (BOO) procedure that uses thermal energy through water vapour to cause necrosis of prostatic tissue. The standard delivery of this treatment is in an operating theatre under a general or spinal anaesthetic, or under local anaesthetic with sedation that requires patient monitoring. Methods We propose an outpatient daycase method of delivering Rezūm™ under local anaesthetic without sedation, using a prostatic local anaesthetic block and cold local anaesthetic gel instillation into the urethra. Results Preliminary results of our first thirteen patients demonstrate the feasibility of this new technique, with a mean pain score of 2.1 out of 10 on a visual analogue scale, a successful trial without catheter in all 13 patients (one patient voided successfully on second trial), a reduction in mean International Prostate Symptom Score (IPSS) from 20.6 to 5.4, and improvement in maximum flow from 8.8 ml/s to 14.4 ml/s. The complications were minor (Clavien-Dindo less than III) and included a UTI, minor bleeding not requiring admission, and retrograde ejaculation. Conclusions We demonstrate that an outpatient local anaesthetic daycase service without sedation is feasible. This can be delivered in a clinic setting, reduce waiting times for BOO surgery, and increase availability of operating theatre for other general anaesthetic urological procedures.Peer reviewe

ÉTUDE DES POLLUANTS CONTENUS DANS LES LIXIVIATS ISSUS DE LA DÉCHARGE PUBLIQUE DE LA VILLE DE MEKNES (MAROC)

The rationale behind this study is to evaluate the impact of leachate resulting from the public landfill of Meknès city (MOROCCO), on the environment and more specifically on the waters of the aquifer. For this, a spatio-temporal monitoring of Nitrites, Nitrates, total germs, Sulfito reducing bacteria, Salmonella was performed at eight stations during the four seasons of the year 2013, in order to make a comparison between the pollution load of the leachate and, the possibility that juice discharge contamins groundwater. However, other different sampling point, are believed to be at the beginning of their infection. As to test this, we analyzed seven samples (water wells and springs) around the landfill by physico-chemical and bacteriological analyzes. We confirm in this study that the marl is a temporary powerful obstacle, in contrast with permanent increasing pollution, generated by the decomposition of waste in landfill of Meknes city

THEORETICAL STUDY OF SOLVENT EFFECTS AND NMR SHIELDING TENSORS OF DLPC

The effect of the polarity of the environment on the conformation zwitterionic membrane dilauroyl phosphatidylcholine (DLPC) has been investigated with calculation at the Hatree-Fock level using the 6-31G* basis set with Onsager continuum solvation model. The ‘Gauge Including Atomic Orbital' (GIAO) approach is used to investigate Ab initio GIAO calculations of NMR chemical shielding tensors carried out within SCF-Hartree-Fock approximation are described. In order to compare the calculated chemical shifts with experimental ones, it is important to use consistent nuclear shielding for NMR reference compounds like TMS. Conformation of DLPC was evaluated with four different solvents with different dielectric constant (Water (ε = 78.39), Dimethyl Sulfoxide (ε = 46.7), Acetone (ε = 20.7) and Heptane (ε = 1.92). In concern with conformational energy, Water could be the most suitable solvent for DLPC. Moreover, as the polarity of the medium increase, the conformational stability of this molecule increases faster than that of DLPC in the gas phase. Consequently, the relative energy of DLPC also depends on the polarity of the environment. This subject was considered as well as the most variable in some dihedral angles degree and NMR isotropic shift were in the less dielectric constant (ε = 1.92). It could be in polar medium DLPC conformer becomes additionally stabilized by intermolecular ionic and hydrogen bond interactions with polar neighboring molecules. On the basis of this work it can be concluded that the effect of the polarity of the environment clearly are influenced on the isotropic values by geometry variation due to intermolecular motion in molecule.   Keywords: Onsager continuum model, DLPC ,NMR shielding, isotropic, solvent models, anisotropi

Mort subite chez le sujet jeune : à propos de deux de cas.

Bien que la mort subite du sujet jeune sans antécédente soit un évènement rare, sa survenue est toujours dramatique. Ce type de mort a un impact socioculturel major. A travers deux cas cliniques et une revue de la littérature, les auteurs discutent les données épidémiologiques, étiologiques, les facteurs de risque ainsi que les moyens de dépistage et de prévention

ÉTUDE DES POLLUANTS CONTENUS DANS LES LIXIVIATS ISSUS DE LA DÉCHARGE PUBLIQUE DE LA VILLE DE MEKNES (MAROC)

The rationale behind this study is to evaluate the impact of leachate resulting from the public landfill of Meknès city (MOROCCO), on the environment and more specifically on the waters of the aquifer. For this, a spatio-temporal monitoring of Nitrites, Nitrates, total germs, Sulfito reducing bacteria, Salmonella was performed at eight stations during the four seasons of the year 2013, in order to make a comparison between the pollution load of the leachate and, the possibility that juice discharge contamins groundwater. However, other different sampling point, are believed to be at the beginning of their infection. As to test this, we analyzed seven samples (water wells and springs) around the landfill by physico-chemical and bacteriological analyzes. We confirm in this study that the marl is a temporary powerful obstacle, in contrast with permanent increasing pollution, generated by the decomposition of waste in landfill of Meknes city

Catalytic decomposition of 2-chlorophenol using an ultrasonic-assisted Fe3O4-TiO2@MWCNT system: Influence factors, pathway and mechanism study.

As a reusable sonocatalyst, magnetically separable Fe3O4-TiO2@MWCNT (FMT) was synthesized by an ultrasound-assisted wet impregnation method and was evaluated in the removal of 2-chlorophenol (2CP). Physical and chemical properties of the catalyst composite materials were investigated by all catalysts were systematically characterized using Transmission Electron Microscopy (TEM), X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), X-ray Photoelectron Spectroscopy (XPS), Energy Dispersive X-ray Analysis (EDX), Dynamic light scattering (DLS), and N2-physisorption. The efficiency and kinetics of 2CP removal by FMT-assisted sonocatalysis (FMT-US) was systematically investigated under various operational parameters i.e. pH, FMT and 2CP concentration, temperature and ultrasonic power. The results indicated that 0.4gL-1 FMT dosage, pH 5, temperature of 35°C as well as 50 w ultrasound power are the most favorable conditions for the degradation of the 2CP. Furthermore, both of the superoxide and hydroxyl radicals were produced in the reaction, however, superoxide radicals were assumed to be the dominating reactive species for the 2CP degradation, according to the scavenging tests and electron paramagnetic resonance tests. Moreover, the FMT catalyst exhibited a high reusability and stability in the US/FMT system during the five repetitive experiments. The intermediate products were identified by GC-MS, thereby a possible degradation pathway is proposed. The chemical oxygen demand (COD) and corresponding total organic carbon (TOC) removal efficiencies were 64.9% and 56.7%, respectively. Finally, toxicity tests showed that the toxicity of the solution increased during the first 5min and then decreased significantly with the progress of the oxidation. The mechanisms of ultrasound irritation enhanced FMT activation were also proposed. Copyright © 2017 Elsevier Inc. All rights reserved