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Special Features of Metaplastic Breast Cancer in Tunisian Women

Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1310-1323页

作者： Raja Briki Ons Cherif Mouna Derouich Anouar Chaieb Sassi Boughizane abdeljalil khlifi Hedi Khairi Department of Gynecology and Obstetrics Farhat Hached University Hospital Sousse Tunisia

Introduction: Metaplastic breast carcinomas are a rare, heterogeneous group of breast malignancies characterized by an intrinsically aggressive histology and an unfavorable prognosis. Objective: To determine the clinical and pathological characteristics of metaplastic breast cancers in Tunisian patients, and evaluate their impact on its evolution. Methods: A retrospective study of 44 cases of metaplastic cancers archived during a 26-year period in the Cancer Registry of the Tunisian Center. Results: The frequency of metaplastic cancer was 0.97%. Mean age at diagnosis was 55.4 years (range 26 - 84). Average time to diagnosis was 5.5 months. Average clinical tumor size was 4.95 cm (range 1.5 - 15). Axillary ipsilateral adenopathy was present at diagnosis in 45.9%. The clinical stages IIB (31.8%) and IIA (22.7%) predominated. Squamous metaplasia was the most common (68%) followed by the heterologous mesenchymal subtype. Ganglionic invasion was histologically proven in 17 cases, of which 77% had only adenocarcinomatous contingents. Absence of hormone receptor expression and HER2 overexpression predominated. Primary surgery was carried out in 95% of cases. Average follow-up was 40 months (range 2 - 135). Average overall survival (OS) was 74 months, 63% at 5 years and 60% at 10 years. Average progression free survival (PFS) was 29 months (range 3 - 129), 38% at 5 years and 32% at 10 years. Factors significantly influencing OS and PFS were histological lymph node involvement (p = 0.001 and p = 0.002 respectively). Conclusion: Metaplastic breast cancer observed in Tunisian women constitutes a histological type with an unfavorable prognosis whose improvement requires a more adapted therapeutic strategy.

关键词： Breast Metaplastic Cancer Pathology Prognosis

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Place of Tranexamic Acid and Fibrinogen Association in the Management of Severe Postpartum Haemorrhage

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Open Journal of Obstetrics and Gynecology 2018年第11期8卷 1040-1051页

作者： Raja Briki Fahmi Ferhi Ons Cherif Med Amine Saadi Mouna Derouich abdeljalil khlifi Sassi Boughizane Khalil Tarmiz Obstetrics and Gynecology Department University Hospital Farhat Hached Sousse Tunisia Anesthesia and Resuscitation Department University Hospital Farhat Hached Sousse Tunisia

Introduction: Severe postpartum hemorrhage (PPH) is the main cause of death in Tunisia. Its management is multidisciplinary and requires perfect knowledge of a regularly updated protocol and consistent with available resources. We propose an evaluation of the impact of different therapeutic attitudes, in particular the combination of tranexamic acid and fibrinogen concentrates in the management of this hemorrhage. Material and Methods: This was a retrospective, descriptive and analytical study, conducted in the departments of Gynecology-Obstetrics and Surgical Resuscitation anesthesia of the Farhat Hached University Hospital, Sousse, Tunisia. The study was conducted over six years (2009-2014), and included all parturients who were treated for severe PPH that occurred on a term greater than 24 weeks of amenorrhea. Patients were divided into two groups according to the study period: 1) Group 1 (G1): from 1 January 2009 to 31 December 2011, 2) Group 2 (G2): from January 1, 2012 to December 31, 2014, a group that benefited particularly from the combination of tranexamic acid and fibrinogen concentrates for the management of their PPH. Results: 166 patients were included: 57 in G1 and 109 in G2. The overall incidence of severe PPH was 3.15/1000 deliveries. We noted a significant decrease in the fall of hemoglobin in per and post haemorrhagic manifestations in favor of G2 with a p value of 0.003 and p = 0.025, respectively. The use of blood transfusion decreased significantly, in frequency and in number of packed red cells per patient, between the two groups;transfusion ratio was 1/1.7/1.5 for G1, and 1/2/1.8 for G2. Fluid therapy, use of macromolecules and catecholamines were less important in G2. The use of tranexamic acid, fibrinogen and the association of both increased significantly between the two groups (p 10-4). Haemostasis hysterectomies were less performed (p 10-3) in G2. Conclusion: The management of PPH has evolved over the years. The use of tranexamic acid in

关键词： Postpartum Haemorrhage Tranexamic Acid Fibrinogen Management

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Embryonal Rhabdomyosarcoma of the Uterine Cervix: Two Cases Report and Literature Review

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Open Journal of Obstetrics and Gynecology 2014年第14期4卷 868-873页

作者： khlifi abdeljalil Boukadida Asma Mouna Kouira Hachani Faten Meddeb Sawssen Hidar Samir Bibi Mohamed Essaidi Habib Khairi Hedi Department of Gynecology and Obstetrics University Teaching Hospital Farhat Hached Sousse Tunisia

Introduction:?Embryonal rhabdomyosarcoma (RMS) of the uterine cervix is a rare and extremely aggressive malignant entity. However, prognosis seems to be improved with the use of multimodality approach treatment. Cases: We report the cases of 50- and 51-year-old women, presenting with vaginal bleeding and mass. The two patients underwent radical surgery. Histological examination revealed RMS of uterine cervix. Treatment was effective in the first case but despite the chemotherapy, the second patient died two months later. Discussion and Conclusions: The prognosis of the cervical embryonal RMS depends on clinical and histological features. The current treatment protocols are based on trials done on pediatric patients. Studies on embryonal RMS treatment and outcomes are limited in women over forty years. In patients with unfavorable prognosis characteristics, the multimodality approach including surgery, adjuvant chemo and radiotherapy can be effective. Otherwise, surgery alone can effectively be proposed.

关键词： Embryonal Rhabdomyosarcoma Uterine Cervix Radiation Therapy Chemotherapy Surgery

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Infrared spectroscopy analyses of air-CH_4 or air-CO gas flows interacting with polycrystalline CeO_2, La_2O_3 and Lu_2O_3 oxides

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Journal of Rare Earths 2012年第8期30卷 835-841页

作者： Bahcine BAKIZ Lamia BOURJA abdeljalil BENLHACHEMI Frédéric GUINNETON Madjid ARAB Jean-Raymond GAVARRI Institute Materials Microelectronics & Nanosciences of Provence UMR CNRS 6242 University SOUTH Toulon-Var Laboratory Materials & Environment Faculty of Sciences University Ibn Zohr

A comparative study of reactivity between air-CH4 or air-CO gas flows and CeO2, La2O3 and Lu2O3 rare earth oxides was per- formed using Fourier transform infrared spectroscopy analyses of CO2 gas resulted from the conversion of CH4 or CO gases. Polyerystalline samples of CeO2, La2O3 and Lu2O3 were first prepared by specific precipitation methods followed by low temperature calcination process. In the case of Lu2O3 oxide, a new specific route was proposed. Crystallite dimensions were determined by X-ray diffraction and transmission electron microscopy analyses. Morphologies were characterized using scanning electron microscopy. Specific surface areas were determined from Bnmauer-Emmett-Teller （BET） technique. Using infrared spectroscopy analyses, the conversion rates of CH4 or CO into CO2 were de- termined from the evolutions of CO2 vibrational band intensities, as a function of time and temperature. It was dearly established that, despite its low specific surface, the Lu2O3 oxide presented the highest capacity of conversion of CH4 or CO into CO2.

关键词： lutetium oxide rare earth oxides elaboration gas solid interactions infrared spectroscopy

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Effect of Ship Bow Overhang on Water Shipping for Ship Advancing in Regular Head Waves

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Journal of Marine Science and Application 2016年第1期15卷 33-40页

作者： abdeljalil Benmansour Benameur Hamoudi Lahouari Adjlout Department of Maritime Engineering University of Science and Technology of Oran Mohamed Boudiaf Oran 31130 Algeria

This paper presents the results of an experimental investigation dealing with the effect of bow overhang extensions on the quantity of shipping water over the foredeck in case of ships advancing in regular head waves. To perform this investigation, a series of free-running tests was conducted in regular waves using an experimental model of a multipurpose cargo ship to quantify the amount of shipping water. The tests were performed on five bow overhang variants with several combinations of wavelength and ship speed conditions. It was observed that the quantity of shipping water was affected by some parameters such as wavelength, ship speed, and bow shape in terms of an overhang extension. The results show the significant influence of an overhang extension, which is associated with the bow flare shape, on the occurrence of water shipping. These results involve the combined incoming regular waves and model speed.

关键词： water on deck shipped water amount ship model tests bow overhang green water regular head waves

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Pathological fractures of the mandible: A report of ten cases and a review of the literature

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Open Journal of Stomatology 2013年第8期3卷 419-424页

作者： Badreddine Abir Alae Guerrouani abdeljalil Abouchadi Department of Plastic Maxillo-Facial Surgery and Stomatology Mohamed V Military Hospital Rabat Morocco

Introduction: Pathological fractures of the mandible are rare. They account for approximately 2% of all mandibular fractures. The main purpose of the study is to report our experience concerning this condition and to analyse data and review the literature available. Material and methods: This study reviewed retrospectively the records of patients who presented to the department of Plastic and Maxillofacial surgery between 2000 and 2008 with a pathological fracture of the mandible. The collected data included age, sex, mechanism of injury, aetiology, anatomic site of fracture, treatment and complications. Results: There were 10 patients with an average age of 48 years and 10 months. There were three cases of fracture due to a local malignancy, two cases of osteoradionecrosis, two cases of mandibular cysts, one patient presenting a mandibular histiocytosis, one patient with a metastatic carcinoma (Thyroid), and one case related to mandibular atrophy. Most common mechanisms of injury were chewing and falls. Pathological fractures were often located in the body of the mandible. A surgical approach was performed in most cases. Conclusion: Surgical management of pathological fractures of the mandible depends largely on the aetiology. Complications occur more often because of local condition and bad oral hygiene.

关键词： Mandibular Fracture Pathological Fracture

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Pan-Facial Fractures: A Retrospective Study and Review of Literature

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Open Journal of Stomatology 2018年第4期8卷 110-119页

作者： abdeljalil Abouchadi Hind Taoufik Oussama Nacir Adil Arrob Department of Maxillo Facial Stomatology and Plastic Surgery Avicenne Military Teaching Hospital Marrakech Morocco

Purpose: The aim of this retrospective study was to analyze the characteristics of panfacial fractures and evaluate treatment results at the Maxillofacial, Stomatology and plastic surgery department at the AVICENNE military hospital over a period of 5 years. Patients and Methods: Forty eight patients with panfacial fractures were treated in Maxillofacial, stomatology and plastic surgery department of the AVICENNE Military Teaching Hospital between 2012 and 2017. The criteria for inclusion in the study were patients who had fractures of at least three of the four axial segments of the facial skeleton: frontal, upper midface, lower midface, and mandible. Results: 48 patients with panfacial fractures had a total of 116 subtypes of facial bone fractures. A total of seventeen (14.6%) LeFort II fractures in 16 (33.4%) patients were recorded, fifteen LeFort I fractures were recorded in 3 (6.2%) cases;seven (6%) LeFort III fractures were recorded in 5 (10.4%) cases, thirteen (11.2%) fractures of the NOF complex were recorded in 6 (12.5%) patients;sixteen (33.4%) patients had thirty eight (32.7%) fractures involving the mandible. Ten (8.6%) NOM (naso-orbito-maxilla) complex fractures occurred in 9 (18.7%) cases. 5 (10.4%) patients had a total of five (4.3%) CNEMFO (naso-ethmoido-maxillo-fronto-orbital) complex fractures. Our case series included five Comminuted premaxillary fractures and six Intermaxillary disjunctions. All 48 cases had facial deformities and thirty six had malocclusions. The treatment plan to reduce and fix the facial bone fractures was sequenced “Bottom up, Outside in”. Postoperative complications were reported, there were 5 cases whose malocclusions, 4 cases of zygomatic non-union or partial defects, 13 had enophthalmos and hypoglobus. Seven had scars from the trauma, 2 had lower eyelid ectropion, and 2 had temporal muscle atrophy. Conclusion: Panfacial fractures seem to be complex and difficult to treat, but with an organized and flexible approach, appro

关键词： Panfacial Trauma Fracture Treatment Complications

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Association between Malnutrition and Cognitive Impairment among Morocco’s Older Adults

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Open Journal of Medical Psychology 2019年第1期8卷 1-14页

作者： abdeljalil Talhaoui Youssef Aboussaleh Ahmed Ahami Rachid Sbaibi Naima Agoutim Behavioral Neuroscience & Nutritional Health Team Laboratory of Nutrition & Health Department of Biology Faculty of Sciences Ibn Tofail University Kenitra Morocco

Objective: The aim of this study was to determine the association between the malnutrition and risk of cognitive impairment among Morocco older adults. Materials and methods: A sample of 237 older adults aged above 60 years were recruited from three nursing homes belonging to three different cities, Rabat, Kenitra and Sidi Kacem City and from one health center in Sidi Kacem City. From them, 172 subjects (56.4% men) were included in our study for their completion. Cognitive functions were assessed by the Mini-Mental State Examination. Nutritional status, depression and physical activity were assessed using respectively: MNA, GDS-15 and GPAQ. The binary logistic regression was performed where the cognitive function was taking as the dependent variable and all other outcomes as independent variables. Results: Our results showed that 69.8% of total simple were classed as having cognitive impairment while only 30.2% were normal. The binary logistic regression assessed showed that the malnutrition (OR = 3.03, 95% CI: 1.34 - 6.85), gender (OR = 2.22, 95% CI: 1.03 - 5.71) and low education (OR = 8.35, 95% CI: 1.32 - 52.83) were risk factors for cognitive impairment, when moderate level of physical activity (OR = 0.19, 95% CI: 0.06 - 0.54) was a protective factor compared to the limited level. Conclusions: Our study supported past literature that malnutrition and low level of physical activity were risk factors of cognitive impairment. These indicate that nutritional status monitoring and the practice of regular physical activities can prevent it from leading to Alzheimer’s disease.

关键词： Cognitive Impairment Cognitive Function Malnutrition Older Adults

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Mesenchymal Mandibular Chondrosarcoma: A Case Report and Review of Literature

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Open Journal of Stomatology 2018年第4期8卷 127-134页

作者： abdeljalil Abouchadi Hind Taoufik Adil Arrob Oussama Nacir Issam Rharrassi Department of Maxillo Facial Stomatology and Plastic Surgery Avicenne Military Teaching Hospital Marrakech Morocco

Introduction: Chondrosarcomas (CS) are malignant cartilaginous tumors of rare maxillary localization. Their evolution is generally slow in time. They have a high tendency for locoregional recurrence after surgical treatment. Their prognosis depends on their degree of differentiation and the quality of resection. The authors report a clinical case of mesenchymal mandibular chondrosarcoma (MC), which is considered to be a subtype of CS, and specify the epidemiological, diagnostic, therapeutic and evolutionary features of this tumor. Case Report: A 73-year-old woman reported in February 2018 in our department complained of a slowly enlarging mass involving the right part of the lower jaw for the last 18 months. On examination a firm multilobular painful mass was palpated with cortical expansion, occupying the right side. A CT scan with 3D reconstruction was achieved and showed osteolysis lesions and cortical thickening. The mass biopsy for histological examination found a grade I well-differentiated bone chon-drosarcoma. We performed a hemi-mandibulectomy with complete resection of the tumor. The anatomopathologic examination of the resection specimen was in favour of a grade II mesenchymal chondrosarcoma. No radiotherapy was needed. The patient’s follow up was uneventful. Discussion: CS grading is the key to its management. Low grade CS (grades I and II) of the facial skeleton are luckily the most common, they are best treated with a local resection using 1.5 cm margins for bone and soft tissue. According to published literature, CS was historically considered as a radio resistant tumor. Radiotherapy and chemotherapy were therefore mainly reserved for high-grade tumors and for non-operable lesions. However, radical local surgery appears to be the treatment of choice for low grade chondrosarcoma. Conclusion: CS’s definitive diagnosis depends on appropriate radiographic evaluation along with adequate biopsy with meticulous histopathological examination and adjunctive im

关键词： Chondrosarcoma Mandible Mesenchymal Tumor

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Principles and Techniques of Post-Traumatic Rhinoplasty: A Review of the Literature

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Modern Plastic Surgery 2024年第4期14卷 74-86页

作者： Maroua Berrezouk Fiqhi Mohammed Kamal Samir Maidam Mohamed Lakouichmi abdeljalil Abouchadi Hpital Militaire Avicenne Marrakech Morocco

Post-traumatic rhinoplasty is the surgical treatment of the complex functional and aesthetic sequelae of nasal trauma. Correcting a post-traumatic nose is a challenging task, requiring the surgeon to employ a range of techniques and grafts to adequately address the deformities observed. The results of our research show that restoring pre-traumatic form and function remains complex, although many guidelines have been established to refine and optimize the management of the after-effects of nasal trauma. But it is achievable with the right techniques. The objective of our review is to highlight the various post-traumatic nasal sequelae, describe the fundamental principles in the field of post-traumatic rhinoplasty and provide the surgeon with the various existing surgical techniques and strategies so that he or she can make an appropriate choice for the patient.

关键词： Nasal Trauma Sequelae Post-Traumatic Rhinoplasty Deviation Saddle Nose

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