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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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A Comparative Study for Compressible Turbulence Models

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World Journal of Mechanics 2022年第1期12卷 1-16页

作者： Hechmi khlifi Adnan Bourehla Laboratory of Aeronautical Structure and Control of System Flows SACES (UR17DN01) School of Military Avition Borj el Amri Tunisia

The incompressible models for the pressure-strain correlation are unable to correctly predict the turbulence flows evolving with significant compressibility. Huang and Fu use a damping function of the turbulent Mach number to modify two numerical coefficients of the incompressible model for the pressure strain developed by Launder, Reece and Rodi. This model predicts the spreading rate and the shear stress behavior in compressible turbulent mixing well. However, the model does not show the well-known compressibility effects on the compressible homogenous shear flow. In the present work, the model of Huang-Fu is revised, all resulting model coefficients become dependent on the turbulent Mach number, the gradient Mach number and the convective Mach number. The proposed model is tested in different compressible turbulent homogeneous shear flow and mixing layers cases. In general, the predicted results from the proposed model are in an acceptable agreement with DNS and experiment data.

关键词： Turbulence Compressible Model Pressure-Strain

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Steady State Analysis of an Isolated Self-Excited Dual Three-Phase Induction Generator for Renewable Energy

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International Journal of Modern Nonlinear Theory and Application 2014年第5期3卷 191-198页

作者： Mohamed Arbi khlifi Badr M. Alshammari College of Engineering Hail University Hail KSA

In this paper modelling and analysis in autonomous mode of dual three-phase induction generator (DTPIG) with a new algorithm have been done. We develop the steady state model of a dual three-phase self-excited induction generator for stand-alone renewable generation dispensing with the segregating real and imaginary components of the complex impedance of the induction generator. The obtained admittance yields the adequate magnetizing reactance and the frequency. These two key parameters are then used to compute the self-excitation process requirements in terms of the prime mover speed, the capacitance and the load impedance on the one hand and to predict the generator steady state performance parameters on the other. Steady state performances and characteristics of different configurations are clearly examined and compared. The analytical results are found to be in good agreement with experimental results.

关键词： Dual Stator Windings Asynchronous Generator Autonomous Mode Steady State Analysis Renewable Electric Energy Generation

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