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Colorectal cancer is a major public health problem and is the 4th most common cancer in the world. 75% of patients have a surgical resection, the only way to obtain a cure. Most recurrences are metastatic (80%) and occur within the first three years after surgery. An increasing number of recurrences are being treated with curative intent, which justifies appropriate post-operative monitoring. Physical examination, abdominal ultrasound and chest X-ray are the reference examinations for postoperative monitoring in France. They should be repeated regularly: every 3 months for 3 years, then every 6 months for 2 years. CEA testing is no longer recommended according to recent data (national French recommendations, Grade B), apart from monitoring of its post-operative normalization. Post-operative endoscopic surveillance is recommended at 1 year, then at 3 years and at 5 years if normal. If the initial colon examination is incomplete, a colonoscopy should be done within 6 months of surgery. Screening for and treating functional digestive sequelae is an essential part of follow-up. [ABSTRACT FROM AUTHOR]

We have found a particular, fundamental and, to this point in time, little-explored concordance between Kierkegaard and Nietzsche, essentially the two founders of modern continental philosophy. Both, that is to say, link eternity with recurrence. They also both emphasize that the will is central to this type of eternity – one must correctly want – while at the same time linking recurrence with the core of reality itself, with the core of the world. This union of eternity and recurrence is, moreover, linked in both cases with the rejection of existing metaphysics. The author of the study queries the connection between these thusly-conceived “repetitive eternities.” At the same time she makes reference to the interpretation of Friedrich Nietzsche that was put forth by Pavel Kouba, the interpreter who emphasized that the very heart of eternal return is recurrence.

Approximately 10 to 15% of patients with breast cancer will have a local recurrence after initial conservative treatment or mastectomy. Total mastectomy has historically been the standard treatment for local recurrence. However, the question of reirradiation may arise as part of a second conservative treatment in conjunction with segmentectomy or in the case of chest wall recurrence to improve local control. Different modalities are available: brachytherapy, external beam radiotherapy with or without hyperthermia. Although the carcinologic results are encouraging, this complex situation requires rigorous patient selection and technical requirements to achieve the best local control and limit toxicity events. This article presents a review of the literature on the different indications and techniques for reirradiation of ipsilateral recurrent breast cancer, with the aim of providing decision support in clinical practice., (Copyright © 2024 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)

Background: Superficial leiomyosarcoma is a rare malignant soft tissue tumor arising from smooth muscle cells, accounting for 2-3% of superficial sarcomas, with limited literature available on the subject. It is typically observed in patients aged 50-60 years and affects both men and women equally in the subcutaneous subtype, whereas the cutaneous subtype predominantly affects men., Objective: This study aims to examine the clinicopathological features and therapeutic outcomes of patients with leiomyosarcoma., Method: This is a descriptive retrospective study of 26 cases of cutaneous and subcutaneous leiomyosarcomas, with histological confirmation., Results: We identified 10 (38.5%) subcutaneous leiomyosarcomas and 16 (61.5%) cutaneous leiomyosarcomas. The majority of tumors were located in the lower limbs, accounting for 13 (50%) cases. During follow-up, 6 patients experienced recurrence, and 7 developed metastases, including 2 of the 7 patients who had R0 resection margins. Among these, 3 out of the 6 recurrent cases and 3 out of the 7 metastatic cases were subcutaneous leiomyosarcomas. The average time to recurrence was 6.2 years., Conclusion: The observed risk of metastases and recurrences, despite clear surgical margins, in both cutaneous and subcutaneous leiomyosarcomas, along with the delayed onset of these events, justifies prolonged patient follow-up. The lungs, bones and liver have been identified as the most common site of metastasis., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

New-onset atrial fibrillation (AF) occurring during acute medical illness or post-operatively has long been considered a benign phenomenon, and its recurrence risk was deemed low. However, recent data suggest a high risk of AF recurrence, and a thromboembolic risk similar to the risk associated with AF occurring without a provoking factor. As we lack interventional data, there are currently no guidelines on the long-term management of new-onset AF occurring during an acute medical condition. This paper aims to review current knowledge on epidemiology, recurrence risk, thromboembolic risk and anticoagulation strategies in the setting of new-onset AF occurring transiently with acute stress., Competing Interests: les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

This article explores specific representation of regret in The Tale of Khan Tokhtamysh’ Invasion of Moscow. While there are two existing versions of this text, a brief version (Simeonovskaya Chronicle, Rogozhskii Chronicler) and an extended version (Novgorodskaya Chronicle 4, Sofiiskaya and Novgorodskaya Karamzinskaya Chronicles), the article focuses on the hitherto understudied brief version. In Simeonovskaya version, different recurrent patterns that underline the main idea of the chronicle and define its pathos, compensate for the minimum of expressive tropes employed in the narrative of the 1382 invasion. The analysis reveals two major motifs — of plundering and burning — that support the author’s main thought: Tokhtamysh’s invasion was a plunder and a terrible destruction that caused massive damage to Moscow and the neighboring towns. Whereas the author of the extended version focuses more on the heroism of the city defenders and laments the cruel death of civil citizens and clergy, the author of the brief chronicle is more concerned with the description of the devastating event itself. The author of the brief version regrets the material damage caused by Tokhtamysh more than he would grieve for the victims. It is possible to explain this peculiarity by turning to earlier chronicles. By the time the brief chronicle of Tokhtamysh invasion was written, Simeonovskaya Chronicle had developed a structural and stylistic pattern describing invasions of the Horde that accentuated motifs of plundering and burning. The recurrence of similar events in a long time-period together with laconic style typical for chronicles resulted in the mentioned specificity: the brief version of the chronicle, following the pattern, puts to the fore regret about the material damage instead of mourning.

Résumé: La possibilité d'être réinfecté par le SARS-CoV-2 est une des principales problématiques de la pandémie actuelle, d'autant plus depuis l'émergence des variants d'intérêt. La question de l'efficacité de l'immunité conférée par une infection à SARS-CoV-2 se pose. Quels sont les facteurs de risque d'une éventuelle réinfection et comment la prévenir ? La description d'un cas de réinfection et une revue de la littérature tentent d'apporter des éléments de réponse à ces différentes interrogations. The possibility of being reinfected by the SARS-CoV-2 is a major problematic in the COVID-19 pandemic, even more since the emergence of the variants of interest. There are several questions regarding the immunity conferred by a SARS-CoV-2 infection. What is its efficiency? What are the risk factors of a potential reinfection and how to prevent it? The description of a case of reinfection associated with a literature review try to bring answers to these interrogations. [ABSTRACT FROM AUTHOR]

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Les microangiopathies thrombotiques (MAT) sont un groupe hétérogène de pathologies caractérisées à différents degrés par une anémie hémolytique mécanique, une thrombopénie et une occlusion microvasculaire histologique. Les MAT peuvent se compliquer de multiples atteintes d’organe, principalement neurologiques et néphrologiques (définissant alors le syndrome hémolytique et urémique). La classification fondée sur la physiopathologie de la maladie a mis en évidence l’importance de la dérégulation de la voie alterne du complément dans les SHU atypiques (SHUa) (non-liés aux infections). Cependant, la physiopathologie et le traitement de nombreuses formes de SHUa dans des contextes spécifiques (tels que la grossesse, la transplantation rénale ou l’urgence hypertensive) restent mal caractérisés. Dans cet article, nous reprenons les avancées diagnostiques et thérapeutiques récentes dans ces trois formes de SHUa aux contextes spécifiques. Nous montrons les spécificités de ces formes et décrivons les enjeux actuels et futurs de leur prise en charge.

Introduction: Given the contradictory data available in the literature, the aim of this systematic review was to investigate the impact of the diagnostic method for borderline personality disorder (BPD) on the acute response and the risk of early relapse in major depressed individuals treated with electroconvulsive therapy (ECT)., Method: After a systematic literature review performed during March 2023 in the PubMed-Medline database according to the PRISMA criteria, 47 articles were identified using the keyword algorithm ("Electroconvulsive Therapy" [Mesh] or electroconvulsive therapy) and ("Borderline Personality Disorder" [Mesh] or borderline personality disorder). The inclusion criteria applied for the selection of articles in this systematic review were: (1) articles investigating the impact of BPD on the acute response and/or the risk of early relapse in major depressed individuals (> 18 years old) treated with ECT, (2) diagnosis of BPD and major depressive disorder by validated screening tests and/or systematic psychiatric interviews based on diagnostic criteria of international classification, (3) any type of study (cross-sectional, longitudinal, prospective, retrospective, interventional and experimental), (4) articles written in English or French, and (5) articles published after January 2000. After assessment of the 47 articles based on these inclusion criteria by two authors, seven studies investigating the impact of BPD diagnosed by systematic psychiatric interview or screening tests on the acute response and the risk of early relapse in major depressed individuals treated with ECT were included in this systematic review., Results: Unlike the three studies diagnosing BPD by screening tests, the four studies diagnosing BPD by systematic psychiatric interview demonstrated a negative impact of this personality disorder on the acute response or the risk of early relapse in major depressed individuals treated with ECT. However, all studies included in this systematic review presented a low level of scientific evidence (cross-sectional epidemiological studies and retrospective cohort studies)., Conclusion: Despite the need for studies of better scientific quality, the results of this systematic review seem to indicate that screening for BPD by systematic psychiatric interview during the pre-ECT assessment and the establishment of adequate therapeutic strategies in case of comorbid BPD could be promising options to allow better acute response and better prevention of early relapses in major depressed individuals treated with ECT., (Copyright © 2024 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Thyroglossal duct cysts (TDC) are the most common congenital cervical abnormality. On the other hand, lingual TDC are rare, comprising between 0.6% -3% of all Quanta Cloud Technology (QCT). We present the case of a patient with recurrence of the TDC, at the base of the tongue. Five-year-old patient with TDC was admitted on a scheduled basis to excise it. Exeresis of the cyst is performed using the Sistrunk technique. Postoperative elapsed without incidents, being discharge on the 3rd postoperative day. Three years after surgery, the patient returned for dysphagia and the appearance of a tumour on the base of the tongue (A). Cervical ultrasound was performed, showing a suprahyoid cystic structure, adjacent to the posterior third of the tongue, dependent on the blind foramen, compatible with lingual TCD (B). The patient underwent an intraoral approach, allowing complete removal of the cyst. Pathological anatomy confirmed the suspicion of TCD. TCD form anywhere from the blind foramen of the tongue to the base of the neck. Sixty one percent of the cysts are located between the thyroid gland and the hyoid bone and 1-2% are intralingua. Cases of transoral exeresis and using the Sistrunk technique are reported. We performed the first one, since the patient has already undergone cervical surgery. The exploration of the oral cavity in these patients is essential, since, as we have seen and learned in this case, there may be a recurrence or extension of the cyst to the blind foramen of the tongue.

INTRODUCTION: Thyroid carcinoma is more frequent in women of reproductive age. It can affect both fertility and the course of pregnancy. The aim of the study was to investigate the influence of pregnancy as a factor of recurrence or progression, on the prognosis of thyroid carcinoma. METHODS: we conducted a case-control study of 117 young female patients followed up for papillary thyroid carcinoma (PTC) at the Department of Endocrinology, Diabetology and Metabolic Diseases of Ibn Rochd University Hospital of Casablanca, from January 2010 to December 2018, divided into 2 groups: group 1 composed of pregnant patients (n=42) and group 2 being the control group (n=75). Statistical analysis was made using SPSS software version 22.0.0. RESULTS: average age of pregnant patients was 35 ± 6.5 years old. Mean duration between first pregnancy and treatment completion was 4.4 ± 3.1 years. Over an average treatment duration of 14.4 months in postpartum, 30 patients were in remission (thyroglobulin (Tg)=1μg/l, negative thyroglobulin antibody and no morphological abnormality), while 12 had persistent symptoms (detectable Tg/thyroglobulin antibody and/or morphological abnormality). Thyroid stimulating hormone (TSH) during pregnancy was on average 0.83 mIU/l. Cancer progression was correlated with persistence of thyroid cancer to treatment before pregnancy (p = 0.01), pre-existing distant or locoregional metastases (p = 0.02) and delayed administration of radio-iodine therapy (p = 0.01). Interval between diagnosis and pregnancy, TSH level during pregnancy or the pre-conception thyroglobulin level did not have a statistically significant impact. Pregnancy was not associated with progression or recurrence of thyroid cancer (adjusted risk ratio 1.04, 95% confidence interval 0.91-1.32). CONCLUSION: this study shows that pregnancy has no impact on recurrence or progression of thyroid cancer in patients declared in remission prior to conception.

Introduction: Thrombotic thrombocytopenic purpura (TTP) is a rare but potentially fatal hematological disorder that requires urgent treatment. Once the diagnosis has been made, plasma exchange (PE) must be started immediately and until a response is obtained., Aim: Evaluate PE in terms of responses and complications in the treatment of TTP., Methods: This was a monocentric, descriptive, retrospective study including patients in whom TTP was diagnosed and treated with plasmapheresis in the clinical hematology department at Aziza Othmana Hospital, between January 2010 and December 2020., Results: Our study included 26 patients. PE was initiated within a median of 1 day. The rhythm of exchanges was daily in 22 patients. Twenty PE-related complications were noted, hypocalcemia being the most frequent (30%). CR was achieved in 15 patients after PE alone. Nine patients were refractory, and six received 2nd-line treatment, with CR achieved in five patients. Relapse was noted in six patients (40%). They were treated by PE and only one patient received rituximab. Four patients had a response. The overall response rate was 69% and overall mortality was 30%. OS at 2 years was 68,3% and RFS was 84,4%. Factors associated with the achievement of CR were the fall in LDH at D5 of treatment (p=0,027,OR=0,59 ;IC 95%[0,32-1,08]) and the daily rhythm of PE (p=0,005, OR=0,35; IC 95%[0,14-0,91])., Conclusion: Our results were comparable to those of the literature, but the rate of refractory disease was higher. Rituximab may enhance our results.

After a first episode of unprovoked vein thrombosis, the risk of recurrence persists for many years. Long term of anticoagulant therapy prevents the recurrence of vein thrombosis but is associated with a major risk of bleeding. As platelets play a role in the initiation and propagation of venous thromboembolism as well, antiplatelet agents, may play a role in the treatment and prevention of this disease. This review summarizes available evidence on effect of aspirin in the prevention of recurrent deep vein thrombosis., Competing Interests: Déclaration de liens d'intérêts Les auteurs déclarent n'avoir aucun lien d'intérêt., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Pheochromocytoma is a rare neuroendocrine tumor characterized by overproduction of catecholamines. The overproduction of catecholamines leads to cardiac remodeling which manifests in several forms ranging from Takotsubo to dilated cardiomyopathy. Studies suggest that pheochromocytoma-induced cardiomyopathy can take various forms depending on the duration of catecholamine exposure. Myocarditis is a fairly rare presentation of cardiac manifestations of pheochromocytoma which are mainly dominated by Takotsubo and dilated cardiomyopathies. We report a rare case of recurrent myocarditis in a young 37-year-old patient revealing the diagnosis of adrenal pheochromocytoma. Through this case and through a review of the literature we will take stock of the epidemiology of cardiac involvement in pheochromocytoma, mainly cardiomyopathies, and we will take stock of the value of diagnosis and early management in improving the prognosis of patients., Competing Interests: Conflit d'intérêt Les auteurs déclarent n'avoir aucun conflit d'intérêts., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Patients with cancer are at significantly increased risk of venous thromboembolism (VTE), due both to the impact of malignant disease itself and to the impact of certain anticancer drugs on haemostasis. This is true both for first episode venous thromboembolism and recurrence. The diagnosis and management of VTE recurrence in patients with cancer poses particular challenges, and these are reviewed in the present article, based on a systematic review of the relevant scientific literature published over the last decade. Furthermore, it is uncertain whether diagnostic algorithms for venous thromboembolism, validated principally in untreated non-cancer patients, are also valid in anticoagulated cancer patients: the available data suggests that clinical decision rules and D-dimer testing perform less well in this clinical setting. In patients with cancer, computed tomography pulmonary angiography and venous ultrasound appear to be the most reliable diagnostic tools for diagnosis of pulmonary embolism and deep vein thrombosis respectively. Options for treatment of venous thromboembolism include low molecular weight heparins (at a therapeutic dose or an increased dose), fondaparinux or oral direct factor Xa inhibitors. The choice of treatment should take into account the nature (pulmonary embolism or VTE) and severity of the recurrent event, the associated bleeding risk, the current anticoagulant treatment (type, dose, adherence and possible drug-drug interactions) and cancer progression., (Copyright © 2024 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)

According to Huemer (2019), existence is evidence of immortality, provided past time is infinite. The argument is based on, inter alia, an alleged contradiction between the fact of one’s existence now and its improbability. I suggest that Huemer’s argument is flawed in equating the infinitesimally small with its limit value, and in assuming a philosophically significant difference between the a priori probability of the occurrence of a unique incarnation and that of anyone among an infinite number.

This paper is a survey on different strategies used by Roman artists to produce meta-figurative effects. It deals with four questions: 1/ how relieves on a couple of Augustan altars managed to perform a mise en abyme, 2/ how famous works of art were “quoted” on a Pompeian fresco (house of Venus in the Shell), 3/ if Roman painters explored self-portraiture and 4/ how they varied reflections on painted mirrors considering the gender of the reflected subject. This first survey throws light on the way Roman image-makers have explored a large panel of meta-figuration: they comment their own technique through these images that must be studied considering the time they were performed by the gaze of their different viewers, and the time they were perpetuated through ages.

We report a case of penis cancer at the military hospital in Rabat, about a 75-year-old patient with a history of a bladder tumor that has been treated with radical cysto-prostatectomy with bilateral ilio-obturator scouring and Briker-type urinary diversion. The symptoms were marked by the appearance of an induration of the left corpus cavernosum in its proximal part on a normal penile skin. The biopsy was not possible and MRI was inconclusive, the FDG-PET/CT played a relevant role detecting tumor mass and lymph node metastases. The treatment, after multidisciplinary discussion, consisted of a total penectomy with bilateral orchiectomy completed secondarily by bilateral inguinal scraping. the evolution was marked by the appearance of skin metastases and the death of the patient during chemotherapy.

INTRODUCTION: Epithelial ovarian cancer (EOC) is the most lethal gynaecological cancer with a recurrence rate as high as 85% after an initial treatment. However, there are currently no reliable means of predicting the risk of recurrence after first-line treatment. This study investigated the risk factors that predict early recurrence of EOC after primary treatment among women in Lagos, Nigeria. METHODS: this was a retrospective cohort study involving the review of all histologically confirmed EOC patients managed at the Lagos University Teaching Hospital, Lagos, Nigeria over a 7-year period from January 2010 to December 2016. A study proforma was used to retrieve relevant information and descriptive statistics were computed for all data. The associations between variables were tested and multivariate analysis was done to adjust for all the possible characteristics that predict early EOC recurrence. RESULTS: the rate of recurrence of EOC was 76.4%. Suboptimal debulking surgery is the only independent predictor of early tumour recurrence. CONCLUSION: women should be adequately counselled and encouraged to report their symptoms early to ensure optimal primary treatment. Strategic efforts should also be made to further improve subspecialty training programs and skills development in gynaecological oncology in Nigeria and sub-Saharan Africa.

The psychological and verbal pressure that often saturates the atmosphere in the interrogation scenes of certain subgenres of post-WWII drama can be achieved through various stylistic means. Among these are repetition and recurrence, which conveniently suit the nature of vicious interrogations, where questions (often illogical) are posed repeatedly, partly to extort information from the victim but predominantly to break the victim’s resistance. Used in the utterances of the speaker, these repetitive questions or parts thereof intensify the distressing mood and strengthen the superiority of the speaker who intimidates, humiliates or otherwise degrades the victim. In this study, the focus will be on those instances of repetition and recurrence that contribute strongly to creating such situations and relationships in contemporary drama. The traditional iteration patterns will be identified, analysed and categorized according to the potential intensity of the repression and the schematic type of recurrence. The examples are taken from plays by Arthur Miller, Harold Pinter and Drago Jančar.

Le cancer du poumon est le quatrième cancer le plus fréquent en France avec une prévalence de 30 000 nouveaux cas par an. La chirurgie par lobectomie avec curage est le traitement de référence pour les carcinomes bronchiques non à petites cellules localisés de stade T1-T2. Une segmentectomie peut éventuellement être proposée aux patients opérables mais fragiles sur le plan respiratoire. Pour les patients ayant des critères médicaux d'inopérabilité ou des épreuves fonctionnelles respiratoires médiocres, une radiothérapie en conditions stéréotaxiques peut être proposée, permettant d'obtenir des taux de contrôle local variant de 85 à 95 % à 3–5 ans. Plusieurs études se sont intéressées aux facteurs pronostiques après radiothérapie stéréotaxique pulmonaire. Nous avons effectué une revue générale de la littérature afin de répertorier les facteurs influant sur le contrôle local. Lung cancer is the fourth most common cancer in France with a prevalence of 30,000 new cases per year. Lobectomy surgery with dissection is the gold standard treatment for T1-T2 localized non-small cell lung carcinoma. A segmentectomy may be proposed to operable patients but fragile from a respiratory point of view. For inoperable patients or patients with unsatisfactory pulmonary function tests, local treatment with stereotactic radiotherapy may be proposed to achieve local control rates ranging from 85 to 95% at 3–5 years. Several studies have examined prognostic factors after stereotaxic pulmonary radiotherapy. We conducted a general review of the literature to identify factors affecting local control. [ABSTRACT FROM AUTHOR]

Introduction: the relationship between computed tomography (CT) scan findings and the risk of recurrence of primary spontaneous pneumothorax (PSP) is controversial. The purpose of this study is to determine the relationship between the Dystrophy Severity Score (DSS) and PSP recurrence after an initial episode. Methods: we conducted a retrospective study including patients admitted to the hospital with PSP (first episode) between 2005-2017. The study population was divided into 2 groups, G1: PSP recurrence, G2: No recurrence. We undertook univariate analysis including various variables such as the DSS score followed by multivariate analysis. Results: eighty-six patients were included in this study. Forty-eight percent of cases had PSP recurrence. Although the DSS score was significantly associated with PSP recurrence (p=0.008), multivariate analysis showed that the presence of bubbles on chest CT scan was the independent risk factor associated with PSP recurrence after a first episode (risk report: 3.26, p < 0.008). Conclusion: the risk of PSP recurrence is significantly associated with the presence of bubbles on chest CT scan. Further studies are needed for better assessment of the DSS score. [ABSTRACT FROM AUTHOR]

Primary naso-sinusal tuberculosis (TB) is a relatively rare or exceptional disorder characterized by polymorphic or non-specific clinical manifestation. Diagnosis is based on anatomo-pathological examination and mycobacteriology test of biopsy specimen. Predictor of good outcome is early conventional anti-tuberculous antibiotic therapy. However, our study reports recurrence at this rare site in an immunocompetent patient despite early suitable TB treatment and good adherence with therapy. Relapse was correlated with underdosing of rifampicin. This study highlights the diagnostic, etiological and therapeutic management of this relapse. Our experience could help clinicians to better manage this uncommon condition. [ABSTRACT FROM AUTHOR]

Background: retrospective study to elucidate the epidemio-clinical and pathological characteristics, management and evolutional aspects of DFS with comparison with the data of the literature. Procedure: a thirty seven-year study of all cases of DFS. Results: Forty-nine cases of DFS (22 males and 27 females) were diagnosed. Mean age at diagnosis was 48.2 years. The tumor appeared before the age of 15 years in five patients (10%). This was a recurrence in 12% of cases. Five patients reported a history of trauma. The average delay before consultation was 5.6 years. A solitary nodule was the predominant clinical aspect of DFS (59.2%). Mean size was 4.7 cm. The tumor was mainly located on the trunk. The diagnosis of dermatofibrosarcoma protuberans was histologically confirmed in all cases. Immunohistochemical study was achieved in 34 cases and showed positive staining for CD34. The treatment consisted of large surgical excision in all patients. Four patients had revision surgery because of tumor margins. Eight cases (17.4%) presented a local recurrence after a mean delay of 12.5 months. Conclusion: DFS is a low-malignancy potential skin tumor. Treatment of choice is surgery. The main risk is tumor relapse. A long follow-up is then very important to detect it. [ABSTRACT FROM AUTHOR]

Background: Primary cutaneous leiomyosarcoma (LCP) is a malignant tumor that can originate from smooth muscles (hair arrestor or vessels of hypodermic tissue). Recidivism rates vary by type. We report two particular cases by the volume of their recidivism and to underline the difficulties of management. Observations: ZA, 41 years old, was received after surgery for a voluminous, painless, firm, mobile and ovoid mass of 7 cm on the knee. The tumor occupied mainly the superficial and reticular dermis. It did not have immunohistochemistry but a re-reading of the blade concluded at diagnosis. The assessment of the extension did not objectify anything and the patient lost sight of. KM, 36 years was received 3 months after surgery, under the same conditions for a voluminous ulcerous burgeoning tumor, oblong 9 cm long axis of the shoulder curve. The histopathological lesions were extended to the subcutaneous tissue. The extension report showed lymphadenopathy, hepatic and pulmonary metastases. The patient underwent clean surgery associated with adjuvant chemotherapy. Conclusion: These relapses have no reliable information on the prognostic factors of their initial management. Nevertheless, the major factor of recurrence remains the tumor clearance, probably not obtained during the first excision. Close multidisciplinary collaboration is essential for the appropriate management of LCP.

Rhabdomyosarcoma (RMS), a tumor of skeletal muscle origin, is the most common soft tissue sarcoma encountered in childhood and adolescence; it is primarily found in the head and neck region, it is relatively uncommon tumors of the oral cavity. Clinical signs depend on the exact location of the lesion in the oral cavity and its development. Authors reported the case of a 14-year-old patient who presented an oropharyngeal mass causing voice dysfunction, after two surgical operation the patient experimented two 2 recurrences of the lesion. The histopathological examination objectifies an oropharyngeal rhabdomyosarcoma. Immediate postoperative outcome was uneventful with improvement in the voice dysfunction and dysphagia one month after surgery. Complementary treatment (chemotherapy and radiotherapy) was not available and accessible to the patient. Twenty months (20) after surgery, the examination found a recurrence of the tumor with pulmonary metastases and neurological complications. Oropharyngeal rhabdomyosarcomas are rare. Their interest lies in the fact that they often affect children and adolescents. The prognosis remains unfavorable in our context, even for cases accessible to surgery since complementary treatment with chemotherapy and / or radiotherapy does not exist. The prognosis depends on tumor size, location, staging, age of patients and especially the quality of the management.

INTRODUCTION: Incidence of urethral stricture recurrence ranges between 2% to 36.4% with 75% occurring within the first 6 months of surgery. Hence, they need to identify the predictors of recurrence following urethroplasty. METHODS: this is a retrospective study involving patients that had urethroplasty from January 2008 to December 2017. Patients' records were reviewed. Analyzed data were for patients with a minimum follow up of one year from the time of urethroplasty and included aetiology of urethral stricture, presence of suprapubic cystostomy, prior urethral dilatation, urine M/C/S, site of urethral stricture, length of urethral stricture, type of urethroplasty, level of training of the surgeon, type of urethral stent used and duration of stenting. Analysis was done using SPSS version 23. P-value of 0.05 was considered significant. RESULTS: eighty seven urethroplasties were done, from January 2008 to December 2017. However, only records of 44 patients were accessible. Twenty patients completed duration of follow up e" one year. Urethral stricture recurrence was defined as resurgence of Lower Urinary Tract Symptoms (LUTS) within one year. Median age of the patients was 39.5 ( 19) years. Urethral stricture recurrence rate was 25% with mean time to recurrence from urethroplasty of 5.3(3) months. The use of preoperative suprapubic catheter (SPC) for urinary diversion as well as urethroplasties performed by the consultants had a lower incidence of recurrence. CONCLUSION: this study found urethral stricture recurrence of 25%. The level of training of surgeon vis-à-vis the expertise and experience seems to be an important factor, though not statistically significant in determining the outcome of urethroplasty.

Introduction: Due to the absence of consensual definition and agreed-upon pediatric treatment, pneumothorax (PNO) in children and adolescents often remains difficult to properly apprehend., State of the Art: While initial diagnostic suspicion is clinical, confirmation necessitates chest imaging, and lung ultrasound has become increasingly prevalent, often at the expense of chest radiography. The goal of treatment is twofold, on the one hand to a fully re-expand the lungs, and on the other hand to forestall PNO recurrence. Depending on PNO severity and clinical tolerance, it may be advisable to envision conservative management, oxygen supplementation, needle exsufflation, or chest tube drainage., Perspectives: In order to harmonize clinical practices, guidelines for the precise definition and graduated management of PNO in children and adolescents are highly advisable., Conclusions: Idiopathic spontaneous PNO frequently occurs in teenage populations, and its likewise frequent recurrence is not satisfactorily predicted by chest CT findings. It is of paramount importance that patients be fully informed of the risk of recurrence., (Copyright © 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Loss of heterozygosity or HLA loss is a genomic-type escape mechanism highlighted in certain types of relapses after allogeneic hematopoietic stem cell transplantation with a non-HLA identical donor, and especially after haplo-identical transplantation. The diagnosis must be made with certainty because the result conditions the therapy. In this article, the different mechanisms and techniques that can be used for the diagnosis of loss of heterozygosity, as well as the therapeutic options are reviewed, making it possible to establish clinico-biological recommendations for the diagnosis confirmation and management of the patients in relapse., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Relapse after allogeneic hematopoietic cell transplantation (allo-HCT) remains a major concern because it is associated with poor survival. A second allo-HCT is a valid option in this situation. During the 13th annual harmonization workshops of the francophone Society of bone marrow transplantation and cellular therapy (SFGM-TC), a designated working group reviewed the literature in order to update the second allo-HCT recommendations elaborated during the previous workshop (2016). The main indication for a second allo-HCT remains relapse of initial hematologic malignancy. Disease status; complete remission (CR), and relapse time after the first allo-HCT>6 months impact positively the overall survival of patients after the second allo-HCT. Donor change is a valid option, particularly if there is HLA loss on leukemic cells after a first haploidentical or following a mismatched allo-HCT is documented. Reduced intensity conditioning is recommended, while a sequential protocol is a reasonable option in patients with proliferative disease. A post-transplant maintenance strategy after hematological recovery is recommended as soon as day 60, even if the immunosuppressive treatment has not yet been stopped. Hypomethylating agents, and targeted therapies such as anti FLT3, anti BCL2, anti-IDH1/2, TKI, anti-TP53, anti-CD33, anti-CD19, anti-CD22, anti-CD30, check point inhibitors, and CAR-T cells can be used as a bridge to transplant or as an alternative treatment to the second allo-HCT., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Darrier-Ferrand dermatofibrosarcoma (DFSC) is the most common cutaneous sarcoma. It generally affects subjects with an average age of 40 years, without gender or race predominance. It is a tumour characterised by a slow evolution and local aggressiveness. The reasons for consultation are pain, pruritus or rapidly progressive evolution. There are no specific imaging studies for this tumour. The diagnosis of certainty is based on immunohistochemistry with positive CD34 labelling. Treatment is surgical based on wide excision., Material and Methods: This is an observation of a patient operated in our department for the initial diagnosis of cutaneous leiomyosarcoma of the right flank that rapidly increased in volume to 10cm in six months. A large fasciocutaneous excision was performed. The postoperative course was simple., Discussion: In our patient, this lesion occurred on an old burn scar. This notion of skin trauma preceding the appearance of DFSC is reported in 10 to 20% of cases. The rapid increase in volume was the reason for consultation. The diagnosis of DFSC could only be made on definitive analysis of the surgical specimen, which showed positive immunostaining for CD34. The occurrence of metastases, although rare, confers a survival of no more than two years. The prognostic factors depend on the quality of the surgical excision, the presence of metastases and certain locations (head, neck), which make the surgery particularly mutilating. Only long-term monitoring attests to definitive cure, given the frequency of recurrence., Conclusion: DFSC is a rare and slowly evolving tumour. Wide surgical excision should be attempted in most cases. In inoperable cases, the use of targeted therapies (IMATINIB) has led to complete cures in some cases., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bulletin de la Société de Pathologie Exotique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Liver steatosis is the hepatic manifestation of the metabolic syndrome, and is one of the leading causes of chronic liver disease. The treatment of dysmetabolic cirrhosis with liver failure and/or hepatocellular carcinoma is liver transplantation (LT). With an increase of 170% in 10 years, it is now the second indication of listing for LT in the United States. At listing, patients with dysmetabolic cirrhosis are older, with numerous cardiovascular (CV) and renal comorbidities, and this requires multidisciplinary pre-transplant assessment. After LT, 5-year survival is similar to other indications, despite an increased immediate CV mortality. The leading causes of death are infectious, cancers and CV. Obesity is an independent factor of increasing morbidity and mortality after LT. The recurrence of the initial disease is frequent: 30% to 90% of the patients present recurrent liver steatosis at 5 years, and 30% progress towards cirrhosis. No specific immunosuppressive regimen is recommended, but the toxicity profiles must probably be taken into account. In these patients, the only etiological treatment is that of obesity, in the absence of specific therapy for non-alcoholic steatohepatitis. The place of bariatric surgery has to be defined, probably sleeve gastrectomy, in a stable patient, 6 to 12 months after LT. [ABSTRACT FROM AUTHOR]

Purpose: Assessment of a second surgical conservative treatment (T) [N = 41] compared to total mastectomy (M) [N = 93] for ipsilateral breast tumor recurrence after initial breast conserving surgery in a retrospective study of 134 patients. Results: Five years global survival was 82.5% in each group. No statistical difference for the specific survival and survival without metastasis. The 5 years local control was 92.9% in group M and 66.2% in group T (RR = 4.48). Lymphovascular invasion (LVI), multifocal tumors, and clinical symptoms of the recurrence are pejorative factors for survival. Over the 134 patients, 25 have preserved their breast. Conclusion: In order to lower the risk of recurrence after a second breast conserving surgery, one may propose this second conserving surgery for an isolated recurrence, < 2 cm, low grade, without LVI and strictly unifocal. Surgery must ensure clear margins and a good cosmetic result. The patient is involved in the choice of the treatment. [ABSTRACT FROM AUTHOR]

Dans cet article nous abordons trois perspectives concernant la prise en charge de la dépression chronique ou récurrente par le médecin généraliste. La première concerne l'évaluation et la prise en charge de la dépression chronique : nous soulignons l'importance d'évaluer si le patient est ainsi depuis le début de l'âge adulte ou non, s'il a des antécédents de traumatismes infantiles et s'il a déjà répondu favorablement à des traitements antidépresseurs. La seconde décrit la possibilité d'assurer le suivi en cabinet de médecine générale d'un patient avec des antécédents de dépression récurrente et au bénéfice d'une pharmacothérapie antidépressive préventive des rechutes. La troisième insiste sur l'importance de repérer chez des patients déprimés chroniques ou récurrents des formes de bipolarité où les caractéristiques bipolaires sont cachées dans un tableau d'état mixte ou de cycles rapides. [ABSTRACT FROM AUTHOR]

This article aims to identify and to interpret a recurring topos regarding the relationships between the video game player and the screen : screen crossing. By “screen crossing” I mean representations which feature screens crossed in one way or the other, by the player or by the game’s diegetic figures. The identification of this topos first goes with the tracking of its appearances as well as its variations as soon as the early 1980’s, within the illustrations in video game press, in advertisements, in movies, or in cartoon books. Regarding its interpretation, the works of Scott Bukatman and Vivian Sobchack about science-fiction allow us to think of the screen crossing in the terms of a decentered subjectivity, of a subject projected into the machine. Then the mistreated body of the player, as represented in many ads and cartoons, appears to be the correlate of the individual caught into the lines of the program, submitted to the visual and attentional logics of the machine. In this way, as depicted in numerous ads, the gaming situation is explicitly labeled as “action” and the player is thus often commanded to react. The video game player appears in close proximity with what Georges Vigarello has called an “informational body”, that is, the individual’s capacity to react and to adapt to the screen’s flow of information. The screen crossing topos betrays a confused situation, one of a body which is neither truly in front of the screen nor truly within it. From the representations and the discourses, such a situation is inherent to transformations regarding the screen, and leads us to think in a different way about the notions of immersion and interactivity.

INTRODUCTION: Although Laryngeal papillomatosis is a rare disease and can be conventionally managed through surgical excision as well as adjuvant therapy yet Laryngeal papillomatosis has high tendency to recur raising its prevalence in the community, airway involvement warrants dangerous complications requiring emergency tracheostomy, especially if clinical course is poorly understood and misdiagnosis is common. The study aims to determine the prevalence, clinical features, risk factors and recurrence of Laryngeal Papillomatosis among patients attending ENT department at KCMC from 2005 to 2015. METHODS: this was a 10 year experience/ Descriptive hospital based cross-sectional study conducted based on patients' medical record at KCMC. Information was recorded into data collection sheets, entered and analyzed through SPSS version 20, summarized and presented in tables and charts, proportions and percentage used to compare groups. RESULTS: 51 patients were identified over the 10 years study period corresponding to a prevalence of 0.09%. 26 were males and 25 females, ages ranging from 1 to 67 years. The median age of onset was 6 years. Children less than 5 years accounted for 19 (37.3%) and 58.8% had repeated surgeries. Clinical presentation ranged from hoarseness in 43 (84.3%) patients to weight loss 3 (5.9%) and 96.1% showed complete or partial presence of the clinical triad of risk factors. CONCLUSION: laryngeal papillomatosis is a rare disease that carries severe morbidity due to its highly recurring nature. It is primarily a paediatric disease, generally affecting more males; its clinical features highly resemble other airway obstructive diseases and therefore a careful thorough clinical evaluation is required in order to correctly diagnose Laryngeal papillomatosis.

Dermatofibrosarcoma protuberans (DFSP) is a rare slow growing skin neoplasm which is characterized by a low potential of malignancy. It rarely shows metastasis to local lymph nodes or distant sites. However, it appears locally aggressive with a tendency to peripheral tumor extensions and recurrence. While DFSP can occur in all ages, it affects in the majority of cases the patients between the third and the fifth decades of age. A high index of suspicion should be taken when facing unusual lesion with a history of slow but persistent growth. DFSP involves most commonly the trunk and extremities but can also be located at any site such as scalp, head, neck, breast, pubic area and vulva. Here, we present a case of recurrent DFSP in a 52-year-old woman with a slow enlarging mass in the upper of the thorax, between the two breasts. She was previously managed by surgery several years before for a DFSP developed at the same site. Complete resection including wide surgical margins of at least 3 cm followed by immediate reconstruction is the treatment of choice to minimize recurrence rate. Marked propensity of DFSP to recur necessitates referral to a specialized center to achieve optimal oncological resection and avoid unnecessary re-operation. However, the minimum resection margin required remains undefined. Radiation and chemotherapy have been tried with limited success, although adjuvant radiotherapy may be used in advanced cases where surgery is no longer feasible. Imatinib can contribute to disease control in patients with locally advanced or metastatic DFSP.

Background: Basal cell carcinomas (BCCs) represent 90% of malignant tumors of the eyelids, which can be locally invasive and destructive. The observation of histological safety margins (MHS) allows for the prevention of recurrence while maintaining a fair compromise between aesthetics and functionality. However, to date, there is no consensus or national recommendations concerning the MHS to be observed according to the various histological subtypes of BCCs., Methods: Through a retrospective analysis of patient records and corresponding excisional slides, we studied the 6-year recurrence rate of 98 patients who underwent surgery for palpebral BCC., Results: MHS were mostly absent in the excisional specimens of recurrent BCCs and significantly more narrow than in non-recurrent BCCs, on average over 2mm., Conclusion: The results of our study suggest that an average MHS greater than 2mm prevents most recurrences., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Purpose: To optimize the pterygium management by delineating the role of sutureless, glueless conjunctival graft., Materials and Methods: This was a prospective cohort study carried out at the Centre hospitalier universitaire de Cocody between October 1st, 2021 and March 31st, 2022. It analyzed a series of 36 cases of stage I, II and III pterygium by Cornand's classification, who underwent surgery by a sutureless conjunctival graft technique without biological glue., Results: Demographically, 33.3% of our study population were between 30 and 40 years of age, with a mean of 47.86 years. The patients showed a female preponderance, 53%, with a male:female ratio of 0.89. At the clinical level, 75% of our population presented for ocular redness, 84% had a nasal pterygium, and 75% were stage 2. In terms of postoperative course and appearance, we observed 80.55% graft stability, 5.56% graft retraction, 2.78% graft displacement, and 11.11% graft loss. At the conclusion of follow-up, we noted an 8.33% recurrence rate., Discussion: The use of intraoperative blood ensures patient safety and postoperative comfort. This technique demonstrates satisfactory results with primary, nasal pterygia., Conclusion: Conjunctival autograft without sutures or biological glue might be a very promising surgical alternative in the surgical treatment of pterygium., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Spontaneous pneumothorax is a classical medical condition encountered in emergency centers, and by primary care and respiratory physicians. The traditional distinction between primary and secondary pneumothorax, although old and increasingly blurred, still allows to guide initial management and to determine whether pleurodesis is indicated. In case of spontaneous pneumothorax, a targeted family history is essential because it can suggest the presence of a genetic syndrome as the underlying cause of the pneumothorax, a condition often associated with a high risk of pneumothorax recurrence, and the occurrence of extrathoracic manifestations which may be serious if recognized late. This review addresses the classification of spontaneous pneumothorax, its pathogenesis, the risk factors of occurrence including genetic syndromes, and its management., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.