Successful Treatment of a Case of Crescentic Glomerulonephritis in a Patient with Primary Peritoneal Carcinoma: A case report

Crescentic glomerulonephritis (CGN) has been associated with several solid tumor malignancies. Only a few cases of nephropathy have been reported in association with tubo-ovarian/peritoneal malignancies. We describe a case of 55 years old female who developed combined immune complex-mediated glomerulonephritis and pauci-immune necrotizing crescentic vasculitis simultaneously with the diagnosis of tubo-ovarian/peritoneal cancer. The baseline estimated glomerular filtration rate (eGFR) was 13 ml/min. The patient received two doses of Rituximab and three doses of pulse corticosteroids, leading to significant improvement in renal function and the disappearance of her proteinuria. The eGFR improved to >60ml/min, and her proteinuria gradually resolved after 10 weeks of treatment. She was in a position to be given a combination chemotherapy treatment for tubo-ovarian/peritoneal cancer because of normalization of her CA-125 after three months of therapy. Keywords: tubo-ovarian/peritoneal cancer, Glomerulonephritis, Vasculitis, Chemotherapy

Manifestations Orl du Rgo chez l’enfant quelle attitude observer ?

Si les manifestations digestives ou respiratoires du reflux gastro-oesophagien sont connues depuis longtemps, la notion de pathologies ORL chroniques ou récidivantes liées au reflux est relativement récente et reste sujette à controverse. A travers une revue de la littérature récente, nous avons tenté de mettre en évidence un lien de causalité entre RGO et manifestations extra digestives, en particulier ORL, et d’en déduire une ligne de conduite thérapeutique.Mots Clés : RGO, Manifestations extra digestives, Pathologie ORL, Traitement médicamenteux, Traitement chirurgical, Traitement coelioscopique

An Unusual Presentation of Choriocarcinoma in A postmenopausal woman: A case report

Choriocarcinoma (CC) is a malignant neoplasm of the trophoblastic tissue, with a potential to metastasize to distant organs. A limited case of gestational CC develops after a long latent period. We describe the case of a 52-year-old postmenopausal woman who developed metastatic choriocarcinoma presumably of gestational origin, 8 years after the last pregnancy, and 2 years after the last menstrual period. The patient was diagnosed with CC metastatic to the brain, spleen, lung and the kidney. The β-human chorionic gonadotrophin level was found to be raised (1,292,867 mIU/mL). The International Federation of Gynecologic Oncology (FIGO) risk score was calculated to be 14 (very high risk). The patient was initially treated with whole-brain radiotherapy (WBRT) and splenic artery embolization because of a hemoperitoneum. Afterwards the patient received systemic treatment using the standard EMA/CO regimen till complete serological remission. Keywords: Choriocarcinoma; Postmenopausal; Latent period; Brain; Oman

Managing the Adverse Events Associated with the Combination Pembrolizumab and Lenvatinib Therapy in Endometrial Cancer

Endometrial cancer (EC) is the most common gynecological cancer. The combination of lenvatinib plus pembrolizumab has exhibited efficacy as the second line treatment for advanced EC, with a significant benefit in terms of progression free survival (PFS) and overall survival (OS), but the adverse effects (AE) profile is complex. AEs associated with the treatment may represent a limitation to this combination. Here, we report the case of a 38-year-old lady diagnosed with stage IV EC elsewhere, whose disease progressed after the first line of treatment, and was referred to our center in 2021. We treated her with the combination of lenvatinib and pembrolizumab. During the course of the treatment. she developed hand- foot syndrome (HFS) grade III, and hypothyroidism grade II. The AEs were managed with supportive medications, dose interruptions, dose reductions, and multidisciplinary care, which allowed us to continue the treatment. The patient achieved a good partial response, and an ongoing PFS of more than 12 months. Keywords: cancer, endometrial, lenvatinib, pembrolizumab, adverse drug events, hand foot syndrome, hypothyroidism, Oman

A potential use for the C-band polarimetric SAR parameters to characterise the soil surface over bare agriculture fields

The objective of this study was to analyze the potential of the C-band polarimetric SAR parameters for the soil surface characterization of bare agricultural soils. RADARSAT-2 data and simulations using the Integral Equation Model (IEM) were analyzed to evaluate the polarimetric SAR parameters' sensitivities to the soil moisture and surface roughness. The results showed that the polarimetric parameters in the C-band were not very relevant to the characterization of the soil surface over bare agricultural areas. Low dynamics were often observed between the polarimetric parameters and both the soil moisture content and the soil surface roughness. These low dynamics do not allow for the accurate estimation of the soil parameters, but they could augment the standard inversion approaches to improve the estimation of these soil parameters. The polarimetric parameter alpha_1 could be used to detect very moist soils (>30%), while the anisotropy could be used to separate the smooth soils

Soil surface moisture estimation over a semi-arid region using ENVISAT ASAR radar data for soil evaporation evaluation

The present paper proposes a method for the evaluation of soil evaporation, using soil moisture estimations based on radar satellite measurements. We present firstly an approach for the estimation and monitoring of soil moisture in a semi-arid region in North Africa, using ENVISAT ASAR images, over two types of vegetation covers. The first mapping process is dedicated solely to the monitoring of moisture variability related to rainfall events, over areas in the "non-irrigated olive tree" class of land use. The developed approach is based on a simple linear relationship between soil moisture and the backscattered radar signal normalised at a reference incidence angle. The second process is proposed over wheat fields, using an analysis of moisture variability due to both rainfall and irrigation. A semi-empirical model, based on the water-cloud model for vegetation correction, is used to retrieve soil moisture from the radar signal. Moisture mapping is carried out over wheat fields, showing high variability between irrigated and non-irrigated wheat covers. This analysis is based on a large database, including both ENVISAT ASAR and simultaneously acquired ground-truth measurements (moisture, vegetation, roughness), during the 2008–2009 vegetation cycle. Finally, a semi-empirical approach is proposed in order to relate surface moisture to the difference between soil evaporation and the climate demand, as defined by the potential evaporation. Mapping of the soil evaporation is proposed

Le kyste de la vallecule : a propos de 2 observations

Le kyste de la vallécule est une malformation laryngée rare pouvant parfois mettre en jeu le pronostic vital. Diagnostiqué et traité à temps, le risque de complications et de morbidité peut être écarté. Les auteurs rapportent 2 cas de kystes de la vallécule. La tomodensitométrie a confirmé la présence d’une formation kystique prenant origine au niveau de la vallécule. Une laryngoscopie directe a été faite pour les 2 patients sous anesthésie générale. Le premier malade a eu une résection endoscopique complète du kyste et le 2ème une large marsupialisation au Laser. L’examen anatomopathologique a confirmé la bénignité de la formation kystique dans les 2 cas.Mots-clés : Kyste de la vallécule, laryngoscopie directe, résection endoscopique, marsupialisation

Laryngocele a propos de 9 cas

La laryngocèle est une pathologie rare. elle est définit par la dilatation progressive du saccule laryngé. Le diagnostic est suspecté par l’examen clinique, sa prise en charge est encore discutée. nous rapportons une étude rétrospective portant sur 9 patients ayant été suivis et traités pour une laryngocèle. La série a été colligée sur une période de 14 ans, allant de 1998 à 2011. Six de nos patients avaient une laryngocèle externe, deux patients avaient une laryngocèle mixte et un patient avait une laryngocèle interne. Une surinfection a été notée chez trois patients réalisant ainsi le tableau de pyolaryngocèle. Tous les patients ont eu un examen clinique complet comportant un examen OrL et cervico-facial ainsi qu’un examen laryngé au nasofibroscope. La tomodensitométrie cervicale a été réalisée de façon systématique. Huit de nos malades ont été abordés par voie cervicale permettant une exérèse complète du sac. Le recul moyen était de 38 mois sans récidive. Toute laryngocèle découverte, doit être traitée afin d’éviter les complications essentiellement locales pouvant mettre en jeu le pronostic vital. Les modalités thérapeutiques dépendent du type de la laryngocèle.Mots-clés : laryngocèle, nasofibroscopie laryngée, traitement endoscopique, thyrotomie.A laryngocele is a rare affection which consists in an abnormal dilatation of the laryngeal saccule. The diagnosis is suspected after clinical exam. The management of this pathology remains a subject of debating. We report a retrospective review including nine patients with laryngocele treated over a 14 years-period. Six patients had external laryngoceles; two had combined laryngocele; another one had an internal laryngocele. Preoperative diagnosis of each patient was made on flexible nasolaryngoscopy following routine otorhinolaryngologic exam. CT scan was systematically done. mrI was realized in case of a diagnostic doubt. eight of our patients were treated via external approach. no recurrences were encountered during the following-up. Laryngoceles must be treated to provide different complications. Some of these complications can cause death. The modalities of the treatment depend on the type of laryngocele.Keywords : laryngocele, nasolaryngoscopy, endoscopic treatment, thyrotomy

MPM Job-shop under Availability Constraints

A large part of scheduling literature assumes that machines are available all the time. In this paper, the MPM Job-shop scheduling problem, where the machine maintenance has to be performed within certain time intervals inducing machine unavailability, is studied. Two approaches to solve the problem are proposed. The first is a two-phase approach where the assignment and the sequencing are solved separately. The second is an integrated approach based on the exact resolution of the 2-job problem using the geometric approach

Le Traitement Chirurgical Des Poches De Retraction Tympaniques De L\'enfant

Objectifs : Préciser les principes du traitement chirurgical et les particularités des poches de rétraction tympaniques (PDR) chez l\'enfant. Matériel et méthodes : Nous rapportons une étude rétrospective à propos de 37 PDR (28 enfants) opérés entre 1995 et 2006. Tous les patients avaient bénéficié d\'un examen clinique et un bilan audiométrique. Le traitement consistait en un renforcement tympanique par un greffon cartilagineux éventuellement associé à une attico-mastoïdectomie. Les résultats anatomiques et fonctionnels post opératoires ont été évalués avec un recul moyen de 29 mois. Résultats : L\'âge moyen des patients était de 10,5 ans et le sex-ratio de 1,33. Sept enfants avaient des antécédents d\'otite séromuqueuse bilatérale, avec pose d\'ATT. L\'hypoacousie était le signe fonctionnel le plus fréquent (67,8%). Les PDR étaient classées stade III, II et I (Charachon) respectivement dans 56,8%, 29,7% et 13,5% des cas. L\'audiométrie trouvait une surdité de transmission moyenne à 25 ± 15 dB. Une chirurgie de renforcement a été pratiquée dans tous les cas, associée à une mastoïdectomie chez 12 patients. Aucune récidive de rétraction n\'a été notée en post opératoire. Par ailleurs, l\'analyse des résultats fonctionnels a montré un gain auditif moyen de 10 dB et un Rinne résiduel < 15 dB dans 75,6% des cas. Conclusion : La chirurgie de renforcement tympanique par du cartilage, prend une place importante dans la prise en charge des PDR de l\'enfant et donne d\'excellents résultats anatomiques et fonctionnels.Objective: To precise the bases of surgical treatment and the particularities of tympanic retraction pockets (RP) in children. Materials and methods: We report a retrospective study about 37 RP (28 children) operated between 1995 and 2006. All patients had otological examination, nasal endoscopy and audiometric explorations. Treatment consists in reinforcement of the tympanic membrane with cartilage graft in all cases. After treatment, anatomical and functional results were evaluated with a mean follow-up of 29 months. Results: Mean-age was 10,5 years and sex-ratio 1,33. Seven children had bilateral seromucous otitis with ventilation tube insertion. Hearing-loss was the most frequent sign (67,8%). RP were classified (Charachon) stage III, II and I in 56,8%, 29,7% et 13,5%, respectively. Audiometery showed an average air conduction threshold of 25± 10 dB. Reinforcement tympanoplasty was performed in all cases, associated with canal wall-up mastoidectomy in 12 ears. No recurrence of retraction of the graft has been noted after treatment. Furthermore, analysis of functional results showed an average air conduction gain of 10 dB and air conduction gap < 15 dB in 75,6 % of cases. Conclusion: Reinforcement tympanoplasty with cartilage, takes a large place in the management of RP in children and achieves good anatomical and functional results. Keywords: Tympanic retraction – Surgery – Cartilage – Supervision Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 18 2007: pp. 12-1