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Atypical Renal Cysts: Is MRI a Compulsory Examination in 2020 before Therapeutic Management?

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Open Journal of Urology 2020年第10期10卷 253-262页

作者： Idriss Ziani Ahmed Ibrahimi Hamza Dergamoun Omar Belouki hachem el sayegh Lounis Benslimane Yassine Nouini Urological Surgery Department “A” IBN Sina University Hospital CHU RABAT Rabat Morocco RABAT Faculty of Medicine Mohammed V University Rabat Morocco

Introduction: Kidney cancer represents 2% to 3% of malignant tumors, with an incidence of 5.8/100,000 in Western countries, a very specific subgroup of renal tumors that are cystic tumors. In fact, almost 50% of the population over 50 has a renal cyst. Materials and Methods: The objective of this study is to establish a correlation between the preoperative Bosniak score and the postoperative anatomopathological analysis in order to answer this question, the use of contrast ultrasound or MRI should be systematically performed before an atypical renal cyst? This is a retrospective study of 50 patients treated for renal cysts between January 2010 and March 2016. All patients have an abdominopelvic ultrasound and an abdominal scanner. Cysts have been classified according to the Bosniak classification. We treated our patients based on the radiological examination urocsanner and we classified our patients according to the classification of Bosniak, and uro MRI was performed in cases of atypical cysts or diagnostic doubt before considering a therapeutic attituderding to the classification of Bosniak. Results: In our work, the Uro MRI was sharper for atypical cysts (type IIF and Type III cyst) with sensitivity greater than that of the scanner but with a specificity similar to that of the scanner. And therefore be a key examination in the atypical kidney cysts. Conclusions: URO MRI is currently in 2020 a key examination of atypical bonsiak IIf and III cysts before management of the therapeutic load.

关键词： Atypical Cyst BosniaK Cystic Tumors URO MRI

Fournier’s Gangrene: Analysis of 14 Cases

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Open Journal of Urology 2014年第8期4卷 109-113页

作者： Mohammed Asseban Adil Kallat Adil Mazdar hachem el sayegh Ali Iken Lounis Benslimane Yassine Nouini Urology A Department Ibn Sina University Hospital Rabat Morocco

Introduction: Perineo-scrotal gangrene is a necrotizing fasciitis concerning soft parts of the genital area which necessitates a rapid, complete and multidisciplinary medical management. The aim of our study was to describe the epidemiologic, diagnostic and therapeutic aspects of Fournier’s gangrene. Patients and methods: We have carried out a retrospective study with 14 patients with Fournier’s gangrene, who were treated from January 2011 to November 2013 at the Urology A Department of Ibn Sina University Hospital, Rabat, Morocco. Results: The average age was 58 years (47 to 76 years). All patients were male. Average time (delay) between onset of infection and consultation was one week. Clinical symptomatology was dominated by edema and erythema signs, fever and pain. In most cases, skin necrosis initially affected perineo-scrotal region. 43% of patients were diabetic. 5 patients (35%) had a urethral stricture. The most common germs found were: Escherichia coli (50%), Streptococcus (22%) and Klebsiella (14%). The treatment consisted in a large debridement, associated with fluid and electrolyte replacement and parenteral broadspectrum antibiotics with drainage of urine. Orchiectomy was required in 2 patients. The average length of hospital stay was 3 weeks. 4 patients (28%) had a scrotal collection. 2 patients (14%) died from a toxic septic shock. Conclusion: Fournier’s gangrene remains, despite the multidisciplinary medical management, a serious affection associated with high mortality. Early consultation and correction of general disorders and immune deficiencies can improve its prognosis.

关键词： Necrotizing Fasciitis Perineo-Scrotal Gangrene Diabetes Necrosectomy Septic Shock

Barosinusitis due to routine weather changes:A cross-sectional analysis of public websites

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 18-23页

作者： James C.Campbell Julia E.Canick Philip G.Chen Ralph Abi hachem David W.Jang Department of Head and Neck Surgery&Communication Sciences Duke University School of MedicineDurhamNorth CarolinaUSA Duke University School of Medicine DurhamNorth CarolinaUSA Department of Otolaryngology-Head and Neck Surgery University of Texas Health Science Center San AntonioSan AntonioTexasUSA

Background:Sinusitis is a common diagnosis that can be erroneously associated with routine weather‐related barometric pressure *** actuality,these pressure changes likely exacerbate migraine headaches,which can cause facial pain and pressure rather than true sinus ***:The present study sought to characterize the representation of both sinusitis and migraine in association with barometric pressure changes across websites on the ***:An Internet search for relevant terms was conducted,and content of the resulting pages was assessed for associations between weather‐related pressure changes and either sinusitis or *** in reported results across different subtypes of Internet sources were *** primary outcomes measured were(1)whether a given media source associated barometric weather changes with sinusitis,(2)whether that source associated barometric weather changes with migraine,and(3)treatment options offered by that ***:Of the 116 included webpages,36(31.03%)associated sinusitis and routine barometric pressure *** these,10(27.77%)were otolaryngology practice ***‐seven webpages(57.76%)associated migraine and routine barometric pressure *** these,nonotolaryngology webpages were more likely to report this ***:Otolaryngology practice sites were observed to be the most frequent professional medical resource reporting the unsubstantiated claim that routine barometric pressure changes are associated with *** sources were more likely to link weather‐related pressure changes to *** results suggest that opportunities exist for otolaryngology practice sites to educate patients about nonrhinogenic headache etiologies.

关键词： acute rhinosinusitis balloon sinus dilation headache migraine sinusitis

Management Practices of Locally Advanced and Metastatic Urothelial Carcinoma: A Questionnaire-Based Survey among Lebanese Oncologists

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Open Journal of Urology 2024年第2期14卷 138-149页

作者： Joseph Kattan Sally Temraz Fadi Nasr Arafat Tfayli Christina Khater Anas Mugharbel Hady Ghanem Hampig Raphael Kourie Georges hachem Sarah Masri Jamil Debs Ali Shamseddine Department of Hematology-Oncology H&#244tel-Dieu de France University Hospital Faculty of Medicine Saint-Joseph University of Beirut Beirut Lebanon Department of Internal Medicine Hematology-Oncology Division American University of Beirut Medical Center Beirut Lebanon Hematology-Oncology Division American University of Beirut Medical Center Beirut Lebanon Department of Hematology-Oncology Saint Charles Hospital Beirut Lebanon Department of Internal Medicine Makassed General Hospital Beirut Lebanon Hematology-Oncology Division Lebanese American University Medical Center - Rizk Hospital Beirut Lebanon Department of Hematology-Oncology Saint George Hospital University Medical Center Beirut Lebanon Pfizer Medical Affairs Beirut Lebanon

Background and Objective: The outcome of locally advanced and metastatic urothelial carcinoma LA/mUC has improved over the past years with a plethora of new treatments and the approval of immune checkpoint inhibitors (ICIs), antibody-drug conjugates, and targeted agents, to identify locally advanced metastatic urothelial carcinoma’s current management practices in Lebanon and the implication of the ongoing economic crisis on the medical practice. Methods: An online questionnaire was used to survey ten Lebanese oncologists from six different hospitals, between July 5 and July 11, 2022, requesting information pertaining to their current clinical practice in the pharmacological treatment of locally advanced metastatic urothelial carcinoma. Key Findings: Cisplatin-based chemotherapy was the most frequently reported initial treatment of locally advanced metastatic urothelial carcinoma. Participants reported using immune checkpoint inhibitors in platinum-ineligible patients and those with PDL1 positive tumors. Also, they would not consider the concomitant use of immunotherapy and chemotherapy in the first-line setting. Participants believed that avelumab maintenance is effective in the absence of progression after first-line platinum-based chemotherapy;they would consider initiating it 2 - 10 weeks after completion of chemotherapy. Conclusions and Clinical Implications: After comparing with current international guidelines, this study shows that Lebanese oncologists follow international guidelines and have deep knowledge of recent clinical trials for the management of locally advanced metastatic urothelial carcinoma, regardless of economic crisis challenges.

关键词： Clinical Practice Chemotherapy Immune Checkpoint Inhibitors PDL1 Urothelial Carcinoma

Tissue-specific cancer stem/progenitor cells:Therapeutic implications

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World Journal of Stem Cells 2023年第5期15卷 323-341页

作者： Amani Yehya Joe Youssef Sana hachem Jana Ismael Wassim Abou-Kheir Department of Anatomy Cell Biology and Physiological SciencesAmerican University of BeirutBeirut 1107-2020Lebanon

Surgical resection,chemotherapy,and radiation are the standard therapeutic modalities for treating *** approaches are intended to target the more mature and rapidly dividing cancer ***,they spare the relatively quiescent and intrinsically resistant cancer stem cells(CSCs)subpopulation residing within the tumor ***,a temporary eradication is achieved and the tumor bulk tends to revert supported by CSCs'resistant *** on their unique expression profile,the identification,isolation,and selective targeting of CSCs hold great promise for challenging treatment failure and reducing the risk of cancer ***,targeting CSCs is limited mainly by the irrelevance of the utilized cancer models.A new era of targeted and personalized anti-cancer therapies has been developed with cancer patient-derived organoids(PDOs)as a tool for establishing pre-clinical tumor ***,we discuss the updated and presently available tissue-specific CSC markers in five highly occurring solid ***,we highlight the advantage and relevance of the threedimensional PDOs culture model as a platform for modeling cancer,evaluating the efficacy of CSC-based therapeutics,and predicting drug response in cancer patients.

关键词： Cancer stem cells Therapy resistance Tissue-specific cancer stem cell markers Patient-derived organoids Pre-clinical cancer models

Hepatic portal venous gas: Physiopathology, etiology, prognosis and treatment

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World Journal of Gastroenterology 2009年第29期15卷 3585-3590页

作者： Bassam Abboud Jad el hachem Thierry Yazbeck Corinne Doumit Department of General Surgery Hotel-Dieu de France Hospital Boulevard Alfred Naccache Beirut 16-6830 Lebanon

Hepatic portal venous gas (HPVG), an ominous radiologic sign, is associated in some cases with a severe underlying abdominal disease requiring urgent operative intervention. HPVG has been reported with increasing frequency in medical literature and usually accompanies severe or lethal conditions. The diagnosis of HPVG is usually made by plain abdominal radiography, sonography, color Doppler flow imaging or computed tomography (CT) scan. Currently, the increased use of CT scan and ultrasound in the inpatient setting allows early and highly sensitive detection of such severe illnesses and also the recognition of an increasing number of benign and non-life threatening causes of HPVG. HPVG is not by itself a surgical indication and the treatment depends mainly on the underlying disease. The prognosis is related to the pathology itself and is not influenced by the presence of HPVG. Based on a review of the literature, we discuss in this paper the pathophysiology, risk factors, radiographic findings, management, and prognosis of pathologies associated with HPVG.

关键词：生理病理肝门静脉预后气体治疗计算机断层扫描病因医学文献

Bladder Perforation during Transurethral Resection of Bladder Tumor Is Not an Innocent Accident: Literature Review Based on a Clinical Case Experience

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Open Journal of Urology 2023年第2期13卷 49-54页

作者： Ziad Zalaquett Maria Catherine Rita hachem Clarisse Kattan Joseph Kattan Department of Hematology-Oncology H&#244tel-Dieu de France University Hospital Saint Joseph University Beirut Lebanon

Urothelial Carcinoma (UC) is one of the most frequent cancers worldwide. Transurethral Resection of Bladder Tumor (TURBT) is a standard treatment in the disease’s early stages, with bladder perforation being a possible and classical complication. However, extravesical tumor seeding resulting from perforation is a rare phenomenon. We hereby report the case of a 76-year-old man with a history of smoking diagnosed with high-grade T1 urothelial carcinoma. TURBT was performed and bladder perforation occurred during the procedure. Radical cystectomy after neoadjuvant chemotherapy failed to reveal an invasive tumor. However, the patient experienced peritoneal recurrence with liver metastasis 3 years following the operation. This case left physician wondering whether the bladder perforation and the resulting tumor seeding are the cause behind the late peritoneal recurrence of an early-stage urothelial carcinoma.

关键词： Bladder Cancer Transurethral Resection of Bladder Cancer Bladder Perforation Peritoneal Carcinomatosis

Epidemiological Aspects and Anatomopathological of Ear Nose and Throat (ENT) and Cervico-Facial (CF) Cancers at the Military Hospital of Nouakchott

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Health 2021年第10期13卷 1091-1096页

作者： Brahim Moulaye el Hassen Edde Dih Haimedah Moulay Ahmed Moulay hachem Pathological Anatomy Department National Oncology Center Nouakchott Mauritania Department ENT and Maxillofacial Surgery Nouakchott Military Hospital Nouakchott Mauritania Pathological Anatomy Department National Police Medical Center Nouakchott Mauritania

This retrospective study, the first of its kind in Mauritania, was carried out at the military hospital of Nouakchott. We sought to approximate the epidemio-logical, anatomopathological profile of Ear, Nose and Throat (ENT) and cervico-facial (CF) cancers in Mauritania. Over a period of two years, from January 1, 2019 to December 31, 2020, we noted 36 histologically confirmed cases, they represented 15.47% of all patients consulted in ENT and CF cancers affected the age group between 25 and 70 years, the age group most affected was that of 50 and 59 years, with 33.33% of cases. More affected in the proportion of 2 men to women, which can be explained by the risk factors mainly found in men, including smoking. First rank was cancers of the upper aero-digestive tract, the pharyngolarynx in head. Histologically, ENT and CF cancers were dominated by squamous cell carcinomas 78%, well ahead of papillary carcinomas 8% and vesicular thyroid carcinomas 5%, UCNTs, adenosquamous carcinomas and lymphomas each represented 3%.

关键词： Anatomopathological ENT Cancers Cervico-Facial Military Hospital Mauritania

Causes of Water Resources Scarcity in Iraq and Possible Solutions

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Engineering（科研） 2023年第9期15卷 467-496页

作者： Nadhir Al-Ansari Nasrat Adamo Ali Hussain hachem Varoujan Sissakian Jan Laue Salwan Ali Abed Department of Civil Environmental and Natural Resources Engineering Lulea University of Technology Lulea Sweden Private Consultant Engineer Norrk&oumlping Sweden Private Consultant Engineer Kut Iraq Department of Petroleum Engineering Komar University of Science and Technology Sulaymaniyah Iraq College of Science University of Al-Qadisiyah Diwaniyah Iraq

Iraq relies in its water resources on the waters of the Tigris and Euphrates and their tributaries. The country is located in the lower part of the catchment area of these rivers. The long-term average annual flow that enters Iraq from these rivers is about 30 BCM from the Euphrates, 21.2 BCM from the Tigris, 24.78 BCM from tributaries and 7 BCM from side valleys between Iraq and Iran. Now, the flow of these rivers is decreasing due to climate change and hydrological projects established in the upper parts of the catchment. It is indicated that precipitation will decrease by 15% - 25% during this century and that means that the flow of the Tigris and Euphrates rivers will be reduced by 29% - 73%. This will cause a grave depletion of groundwater resources. Türkiye is trying to finish building 22 dams and 19 hydropower stations. Iran built 12 dams and diverted the flow of some tributaries inside Iran and blocked all the valleys that contribute water from its land to Iraq. For these reasons, Iraq is experiencing shortages in its water resources and there is some sort of friction and conflict between riparian countries within the Tigris and Euphrates basins because each country tries to secure its water resources. In this research, the factors affecting the hydro politics within these basins are water scarcity, climate change and hydrological projects, population growth rate, energy issues, water mismanagement, economic changes, expansions of projects and technology, political issues, international water laws and public awareness. In case the situation remains as it is, Iraq will experience many problems in health, environment, economy, and security. To solve the problem of water scarcity in Iraq, two parallel lines of action are to be considered. These are: 1) Reach agreements with Riparian Parties;2) Develop a long-term strategy that should take the following: a) Rehabilitating of existing dams, barrages & pump stations, b) Improving the efficiency of diversion and su

关键词： Tigris River Euphrates River Iraq