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Oligometastatic (OMT) form of pancreatic adenocarcinoma (PDAC) is a particular entity of this tumor, the definition of which is being more precise: limited number of metastases which varies between 2 and 4 depending on the organs affected, most often liver and lung, and a low CA19-9 serum lever when contributory (classically < 1 000 IU/mL). This subgroup of patients, which represents 5%-10% of metastatic forms, has prolonged survival, particularly in case of pulmonary location. The incidence of OMT forms is increasing because patients are now better selected and have a longer survival since the improvement of surgical management and the advent of more effective adjuvant chemotherapies, such as modified FOLFIRINOX. Among the OMT forms, metachronous metastases occurring in a context of postoperative recurrence are the only ones AP that can be locally treated. Their management may consist of surgical excision, stereotactic radiotherapy or radiofrequency, which should only be discussed after prolonged induction chemotherapy between 6 and 12 months, at best lightened, in order to better select patients. For those not eligible for this type of approch despite a low tumor burden, a de-escalation of chemotherapy deserves to be better evaluated in order to preserve quality of life. This article focuses on the diagnosis, prognosis and therapeutic possibilities for OMT forms of PDAC diagnosed in a context of post-operative tumour relapse. [ABSTRACT FROM AUTHOR]

In patients who underwent surgery for pancreatic cancer and who can start treatment within three months of surgery, adjuvant chemotherapy is currently recommended to limit the risk of disease recurrence, but questions remain for the clinician. Recently, modified FOLFIRINOX has become the standard in the non-Asian population, but there is still a risk of toxicity and its administration may be limited in heavily pretreated patients or those who have not enough recovered from surgery. The gemcitabine-nab-paclitaxel combination, gemcitabine or 5-FU single agents are alternatives to discuss for patients not eligible for FOLFIRINOX. In Asia, chemotherapy based on the compound S1 is the reference. The objective of this review is to summarize the adjuvant management after resection of pancreatic cancer and to highlight current and future questions, in particular the need for biomarkers and the optimization of the management of patients. [ABSTRACT FROM AUTHOR]

Guyon's canal syndrome is a compression of the ulnar nerve at the wrist and is a rare condition. It is most commonly caused by a synovial cyst. However, diagnosis of the syndrome can be challenging, and the etiological investigation should include a detailed medical history focusing on the duration, location and progression, of symptoms. The level of compression can be clinically estimated during examination by assessing motor and sensory changes in the hand. Additional tests are used to confirm the diagnosis. Mild symptoms can be treated non-surgically. Surgical exploration and decompression are standard treatment for neuro-compressive causes, with generally good outcomes. [ABSTRACT FROM AUTHOR]

Gastrointestinal cancers have a high incidence with colorectal cancer being the main cause. Malnutrition has an extremely negative impact on quality of life and the toxicities of treatments. Supportive care, including nutritional support and adapted physical activity, plays a decisive role in the management of gastrointestinal cancers in association with conventional treatments. Nutritional status must be assessed as soon as the diagnosis is announced and during treatment, whether medical or surgical. In all cases, the nutritional care strategy must be defined with the patient at the start of their treatment. Whatever the nutritional care proposed, it is recommended to achieve at least energy intakes of 25 to 30 kcal/kg/day and 1 to 1.5 g of protein per kg/day. Gastrointestinal cancer surgeries are at high risk of morbidity, perioperative nutritional care is crucial and must be done according to the nutritional grade. Immunonutrition is also indicated perioperatively during these surgeries in order to reduce the risk of postoperative infectious complications. Multimodal care combining adapted physical activity should also be encouraged regardless of the type of care. [ABSTRACT FROM AUTHOR]

Intussusceptions of the small intestine in adults is very rare and represents only 1% of all cases of intestinal obstruction; this condition is rarely described in the literature. Surgery is the procedure of choice in most cases. We report a case of ileo-ileal intussusceptions secondary to a melanoma metastatic tumor, occurring 4 years after surgery for malignant melanoma of the cheek. The diagnosis of intussusception was confirmed by abdominal CT-Scan. However, only palliative surgery was feasible for this patient. At seven months after his surgery, the patient is alive and in good general condition. Intussusception in adults is the main clinical presentation indicative of intestinal metastasis from malignant melanoma. After our review of the literature, it seems that this complication occurs mainly in male patients and the site of predilection for this metastasis is the jejunum.

This article shows how adjusting to the inequalities that prevail between “here” and “there” is at the root of a tension between two strategies, “from above” and “from below”, which structures international humanitarian action at different scales. This article draws on the initial results of a survey, based on archive consultation and interviews, into the implementation of surgical programs by the organization Médecins Sans Frontières. It suggests an approach that goes beyond this example to study the structuring tensions that characterize the epistemic components of the practical normativity deployed by humanitarian professionals.

Fibroadenomas are the most common benign breast disorders. The aim of this study was to identify the clinical and therapeutic aspects of fibroadenoma in the obstetric gynecology department and General Surgery of Teaching hospital Gabriel TOURE in Bamako Mali. Patients and Methods: The study was descriptive with retrospective data collection from July 1, 2018 to July 31, 2021. The records of patients treated for fibroadenoma were included in accordance with ethical principles guaranteeing anonymity and confidentiality of data. Results: A total of 112 patients were selected for the study period, representing 15. 9% of all breast pathologies. We recorded 642 cases of breast mass, with fibroadenoma accounting for 16.72% of these breast tumors. Among all 154 benign breast tumors, fibroadenoma accounted for 72%. The mean age was 27 years, with a standard deviation of 14.8 years (13 years and 62 years). The 20-35 age group was the most represented, at 44%. The frequency of fibroadenoma decreased with increasing gestational age and parity. Over 60% of patients were overweight. The main reason for consultation was the presence of breast swelling. Unilateral left breast swelling was predominant in 46% of cases, and location in the upper-outer quadrant accounted for 50%. Surgical excision was the most frequent management modality, accounting for 56,2% of cases. Conclusion: fibroadenoma of the breast are a fairly common benign condition. Diagnosis requires surveillance. Surgical treatment should be discussed according to age, size and the presence of risk factors for malignancy. [ABSTRACT FROM AUTHOR]

The growing proportion of patients with IBD and obesity (15 to 40%) makes their management a critical therapeutic challenge. Obesity has a negative impact on the natural course of the disease, leads to an attenuated response to biotherapies and favors surgical complications. A nutritional assessment is therefore essential, and physicians should be aware of screening patients for malnutrition (even in the presence of obesity), sarcopenia and obesity-related complications. A multidisciplinary approach must be proposed to the patients: supervised changes in eating habits to avoid causing or worsen deficiencies, especially during inflammatory flare-ups, as well as practicing regular physical activity. Drug treatments for obesity, particularly GLP-1 analogs, can be proposed, although their impact on the evolution of inflammatory bowel disease has yet to be demonstrated. Bariatric surgery, when indicated, should be proposed to patients, as it has a demonstrated benefit on post-operative evolution in IBD. [ABSTRACT FROM AUTHOR]

ABSTRACTBackground Postoperative pain cannot be measured accurately among many children with intellectual and developmental disabilities, resulting in underrecognition or delay in recognition of pain. The Critical-Care Pain Observation Tool (CPOT) is a pain assessment tool that has been widely validated in critically ill and postoperative adults.Aims The objective of this study was to validate the CPOT for use with pediatric patients able to self-report and undergoing posterior spinal fusion surgery.Methods Twenty-four patients (10–18 years old) scheduled to undergo surgery were consented to this repeated-measure, within-subject study. To examine discriminative and criterion validation, CPOT scores and patients’ self-reports of pain intensity were collected prospectively by a bedside rater before, during, and after a nonnociceptive and nociceptive procedure on the day following surgery. Patients’ behavioral reactions were video recorded at the bedside and retrospectively viewed by two independent video raters to examine interrater and intrarater reliability of CPOT scores.Results Discriminative validation was supported with higher CPOT scores during the nociceptive procedure than during the nonnociceptive procedure. Criterion validation was supported with a moderate positive correlation between the CPOT scores and the patients’ self-reported pain intensity during the nociceptive procedure. A CPOT cutoff score of ≥2 was associated with the maximum sensitivity (61.3%) and specificity (94.1%). Reliability analyses revealed poor to moderate agreement between bedside and video raters and moderate to excellent consistency within video raters.Conclusions These findings suggest that the CPOT may be a valid tool to detect pain in pediatric patients in the acute postoperative inpatient care unit after posterior spinal fusion.

Copyright of Revue d'Orthopédie Dento-Faciale is the property of Parresia 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.)

Surgery is a branch of medicine that requires specific practical skills in addition to theoretical knowledge. Teaching with online tools has significant benefits, especially in contexts with limited resources where sharing and collaboration play an essential role. The objective of this study was to describe the use of e-learning tools in the general surgery residency program at Faculty of Health Sciences of Gaston Berger University. We conducted a prospective cross-sectional study focusing on the teachings of the first cohort of residents during the academic year 2020-2021. We evaluated the number of students, the number of hours of online courses delivered, the number of teachers, and their affiliations. The online tools used were the university online course management system and Google Meet. In total, 11 students were enrolled in the residency program, with 5 undergoing practical training at Saint-Louis Regional Hospital and 6 others at university hospitals in Dakar. For theoretical courses, 115 hours were delivered online, involving 17 teachers from 5 different universities (3 from Senegal, 2 from France, and Canada). Although acquiring theoretical foundations often requires traditional face-to-face teaching formats, the use of online resources can be significantly beneficial, especially in contexts with limited human and material resources. E-learning tools have facilitated collaboration with teachers from various countries and universities. [ABSTRACT FROM AUTHOR]

Colorectal cancer is one of the most frequently diagnosed cancers in France and worldwide, with a peak incidence in patients over 70 years old, whose life expectancy is increasing. Long excluded from therapeutic trials, elderly patients are now the focus of special attention and dedicated studies. However, as treatment algorithms for metastatic colorectal cancer become increasingly complex, it is clear that a significant percentage of elderly colorectal cancer patients may not be optimally treated. The aim of this article is to review what is known about the treatment of metastatic colorectal cancer in the elderly and to discuss recent and ongoing advances. [ABSTRACT FROM AUTHOR]

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 Orthodontie Française 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.)

Adrenal incidentaloma (IA) is an incidental discovery of an adrenal mass by radiological examinations. Its incidence is increasing with technological advances and the increase in radiological examinations. In the vast majority of cases, it is a benign non-secreting adenoma. A minimal basic hormonal assessment must be carried out. Radiological exploration, in particular the adrenal CT scan, makes it possible to categorize the lesion as potentially benign or malignant. The management of IA is currently under debate. There is a consensus on the need for an evaluation by a team of multidisciplinary experts and a surgical approach in patients presenting with a significant hormonal excess and/or radiological signs suspicious of malignancy demonstrated at diagnosis or during follow-up. [ABSTRACT FROM AUTHOR]

La coelioscopie a constitué une révolution pour la chirurgie de l'endométriose, faisant de cette voie d'abord un standard indiscutable. L'arrivée de la chirurgie robotique, durant la première décennie des années 2000, a constitué un pas technologique significatif. Rapidement, les chirurgiens de l'endométriose se sont approprié cet outil et ont démontré la faisabilité pour l'ensemble des techniques spécifiques à cette pathologie. Les données cliniques ne prouvent aujourd'hui que la non-infériorité du robot sur la coelioscopie. Les atteintes rectales, et notamment celles du bas rectum, les atteintes diaphragmatiques et les atteintes des racines sacrées et du nerf sciatique sont particulièrement contraignantes pour le chirurgien et risquées pour la patiente. En extrapolant les avantages du robot déjà démontrés dans d'autres spécialités, notamment en termes de préservation nerveuse, ces formes d'endométrioses complexes devraient bénéficier de cette technologie et plus encore le chirurgien. Laparoscopy has been a revolution in endometriosis surgery, making this approach an indisputable standard. The arrival of robotic surgery in the first decade of the 2000s was a significant technological step forward. Endometriosis surgeons quickly adopted this tool and demonstrated feasibility for all surgeries specific to this pathology. The clinical data today only prove that the robot is not inferior to laparoscopy. Rectal involvement, especially of the lower rectum, diaphragmatic involvement, and involvement of the sacral roots and the sciatic nerve are particularly constraining for the surgeon and risky for the patient. By extrapolating the advantages of the robot already demonstrated in other specialties, notably in terms of nerve preservation, these forms of complex endometriosis should benefit from this technology and the surgeon even more. [ABSTRACT FROM AUTHOR]

Right ventricle perforation complicating temporary cardiac pacing Temporary cardiac pacing is a life-saving procedure indicated in symptomatic bradyarrhythmias when they are reversible or when the permanent pacemaker cannot be implanted. We report a clinical case with temporary cardiac pacing complicated by right ventricle perforation. The tip of the temporary pacing wire passed through the right ventricle wound and extended into the pericardial cavity. The patient was managed surgically and the site of the perforation was sutured. Finally, a dual-chamber pacemaker with epicardial leads was implanted. [ABSTRACT FROM AUTHOR]

Cardiac hydatid cyst is a rare but potentially serious parasitic disease. The clinical presentation is often atypical, and the infection can remain asymptomatic for a long time. The diagnosis can be made during systematic echocardiography or when complications occur, such as pericardial effusion or heart conduction disorders. We report a case of cardiac hydatid cyst revealed by pericardial effusion caused by the rupture of hydatid cyst in the pericardium. [ABSTRACT FROM AUTHOR]

Memory biases for previous pain experiences are known to be strong predictors of postsurgical pain outcomes in children. Until recently, much research on the subject in youth has assessed the sensory and affective components of recall using single-item self-report pain ratings. However, a newly emerging focus in the field has been on the episodic specificity of autobiographical pain memories. Still in its infancy, cross-sectional work has identified the presence of various memory biases in adults living with chronic pain, one of which concerns the lack of spatiotemporal specificity. Moreover, a recent prospective longitudinal study found that adults scheduled for major surgery who produced fewer specific pain memories before surgery were at greater risk of developing chronic postsurgical pain up to 12 months later. The present review draws on this research to highlight the timely need for a similar line of investigation into autobiographical pain memories in pediatric surgical populations. We (1) provide an overview of the literature on children’s pain memories and underscore the need for further research pertaining to memory specificity and related neurobiological factors in chronic pain and an overview of the (2) important role of parent (and sibling) psychosocial characteristics in influencing children’s pain development, (3) cognitive mechanisms underlying overgeneral memory, and (4) interplay between memory and other psychological factors in its contributions to chronic pain and (5) conclude with a discussion of the implications this research has for novel interventions that target memory biases to attenuate, and possibly eliminate, the risk that acute pain after pediatric surgery becomes chronic.

In case of infertility due to obstructive azoospermia (OA), 2 main attitudes can be discussed: perform reconstructive surgery or perform epididymal or testicular sperm extraction followed by intracytoplasmic sperm injection (ICSI). Reconstructive surgeries include vasovasostomy (VV) and vasoepididymostomy (VE) and are the only option leading to natural conception. They cannot be considered in cases of bilateral absence of the vas deferens, or in cases of staged obstructions. They are particularly effective in cases of short obstructions such as after vasectomy. The average patency rate after vasectomy reversal is about 80 %, with an average pregnancy rate of about 50%. Obstruction interval, presence of a granuloma, surgeon experience, and sperm discovery intraoperatively are the main predictors of postoperative patency and postoperative fertility. In addition, female factors of hypofertility, including the age, are strongly correlated with the occurrence of pregnancy. In the case of OA, sperm retrieval techniques usually find enough sperm to perform ICSI. The incidence of postoperative hematoma, pain and infections are low regardless of the technique used (MESA, PESA, TESE, TESA). There is no significant difference in pregnancy rates with testicular and epididymal sperm in men with OA. However, MESA may result in higher live birth rates. In cases of distal obstructive AO (ejaculatory duct obstruction, prostatic cyst), endoscopies may be considered for curative purposes with high postoperative patency rates. In conclusion, the physician should present to the couple whose partner has OA the different possibilities available to them and involve them as much as possible in the choice of the most appropriate procedure to conceive. [ABSTRACT FROM AUTHOR]

Ingestion of foreign bodies are common emergency situations. Pica is a form of eating disorder in adults. We report 3 cases of digestive lesions in patients with Pica in the visceral emergency department of the Yalgado Ouédraogo University Hospital. The 1st case was that of a 36-year-old female patient with a 5-year history of psychiatric disorders. She was treated for acute generalized peritonitis due to ileal perforation. The plane abdominal x-ray showed numerous non consumable intra-abdominal objects. Laparotomy was performed. The second case describes a 21-year-old female patient who was seen for fever and right iliac fossa pain. Plain abdominal x-ray revealed calcium like opacities describing the colonic framework and the small intestine compatible with geophagy, an appendectomy was performed. The 3rd patient was a 22-year-old patient who was admitted with acute generalized peritonitis. There was a 3-year history of depression. The plain abdominal x-ray showed an intra-abdominal metallic object compatible with a mechanic's flat key. Laparotomy was performed. The management of pica should be mainly preventive and educational. Surgery remains necessary in case of mechanical complications of these ingested bodies. [ABSTRACT FROM AUTHOR]

The authors report a case of generalized acute peritonitis by perforation secondary to the ingestion of multiple magnets in a 9-year-old boy. They report on the diagnostic difficulties and the challenges of surgical management in this case and underline the importance of prevention. [ABSTRACT FROM AUTHOR]

The term “amputation” has several meanings that need to be clarified in view of the various interpretative consequences. In the sense in which it is commonly understood, amputation is a surgical operation which seems all the more complex because it is carried out today by specialists in an aseptic environment. This act has been practiced since prehistoric times, under conditions that are probably far from those presented as necessary today. It responds to a medical logic which, in archaeology, is most often a finding whose cause remains undetermined. In addition, the question of the modus operandi comes up against too much incomplete information at first sight, despite the elements of the osteological diagnosis of the section. This is why a methodical examination of each case, according to a multidisciplinary approach, remains essential.

Understanding mechanisms that underly the transition from acute to chronic pain and identifying potential targets for preventing or minimizing this progression have specific relevance for chronic postsurgical pain (CPSP). Though it is clear that multiple psychosocial, family, and environmental factors may influence CPSP, this review will focus on parallels between clinical observations and translational laboratory studies investigating the acute and long-term effects of surgical injury on nociceptive pathways. This includes data related to alterations in sensitivity at different points along nociceptive pathways from the periphery to the brain; age- and sex-dependent mechanisms underlying the transition from acute to persistent pain; potential targets for preventive interventions; and the impact of prior surgical injury. Ongoing preclinical studies evaluating age- and sex-dependent mechanisms will also inform comparative efficacy and preclinical safety assessments of potential preventive pharmacological interventions aimed at reducing the risk of CPSP. In future clinical studies, more detailed and longitudinal peri-operative phenotyping with patient- and parent-reported chronic pain core outcomes, alongside more specialized evaluations of somatosensory function, modulation, and circuitry, may enhance understanding of individual variability in postsurgical pain trajectories and improve recognition and management of CPSP.

Introduction. The objective of the study was to determine the incidence of neuroendocrine tumours in patients undergoing appendectomy because of acute appendicitis and to investigate the treatment and follow-up of these tumours. Materials and methods. The data of 6592 patients who were operated for acute appendicitis in two different health centers, between January 2012 and May 2020, were obtained from an electronic database. Fourteen patients with neuroendocrine pathologies were included in the study. Results. Of the 6592 patients undergoing appendectomy, 14 had neuroendocrine tumours. Of these 14 patients, six were male and eight were female. The mean age of the patients was 36.71 years. Six of the tumours were distal, seven were medial and one was in the appendix radix. The mean tumour size was 1.17 cm. Right hemicolectomy was performed in two patients with appendix radix tumours (2 cm in size) and the remaining 12 patients underwent appendectomy. The mean follow-up duration was 36.4 months. Conclusions. The pathologies of the patients who undergo appendectomy for acute appendicitis should be closely monitored, cases with neuroendocrine tumours should be reevaluated, and treatment and follow-up of these cases should be done based on the tumour characteristics.

Adolescence is a period of personal and relational construction. The adolescent must reclaim her body in transformation and nurture her self-esteem. Aesthetic, restorative and reconstructive surgery performed on this population must take into account the psychological aspects specific to this age group.Dysmorphisms or physical difference in adolescent girls can be the cause of rejection by the group. This rejection impacts an already low self-esteem. Some patients may try to compensate for the lack of reassuring relationships with a desire for perfection that goes as far as dysmorphophobia. The plastic surgeon must look for the relational issues at the origin of the requests for care. Preoperative meetings are an opportunity to identify patients for whom surgery is not the answer and those who will need associated psychological support. [ABSTRACT FROM AUTHOR]

Copyright of Nouveau Praticien Vétérinaire - Équine is the property of EDP Sciences 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 Nouveau Praticien Vétérinaire - Équine is the property of EDP Sciences 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 Nouveau Praticien Vétérinaire - Équine is the property of EDP Sciences 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 Nouveau Praticien Vétérinaire - Équine is the property of EDP Sciences 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 Nouveau Praticien Vétérinaire - Équine is the property of EDP Sciences 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 Nouveau Praticien Vétérinaire - Équine is the property of EDP Sciences 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 Nouveau Praticien Vétérinaire - Équine is the property of EDP Sciences 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 Nouveau Praticien Vétérinaire - Équine is the property of EDP Sciences 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 Nouveau Praticien Vétérinaire - Équine is the property of EDP Sciences 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.)

Thymic hyperplasia is an anterior mediastinal mass with a variable clinical presentation. It causes differential diagnostic problems in the pediatric age group and there is no consensus on the therapeutic approach. We here report the case of a 1-month-old infant treated for respiratory distress syndrome. Chest CT scan revealed anterior mediastinal mass, which was excised through median sternotomy. Anatomopathological examination showed thymic hyperplasia. Clinical outcome was satisfactory. This encouraging result suggests that, contrary to what some authors propose, it would be more appropriate to opt for an aggressive therapeutic strategy when managing symptomatic thymic hyperplasia. This is even more justified in a socio-economic context characterised by difficult access to care and follow-up measures limited by patients' means. [ABSTRACT FROM AUTHOR]

Subungual exostosis is a benign, uncommon osteocartilaginous tumour that tends to recur. We here report the case of a 17-year boy with subungual exostosis, who reported a history of trauma. Treatment was based on direct surgery. The tumor was completely excised. The postoperative course was uneventful, with no recurrence identified. [ABSTRACT FROM AUTHOR]

Objectives: Carrying out a pregnancy to term in a patient with a paraganglioma or pheochromocytoma (PPGL) results from a multidisciplinary challenge. The objective was to compare our therapeutic attitude with the existing literature and to identify optimal treatment., Methods: Description of a case of paraganglioma treated during pregnancy at the University Hospital Center of Caen (France) in 2024 and comparison with the literature., Results: We describe a patient with a family history of paraganglioma, in whom paravesical PPGL was discovered at 18 weeks of gestation. The symptoms were marked by episodes of palpitations and headaches during urination. The diagnosis was confirmed by a measurement of urinary metanephrines associated with magnetic resonance imaging. After initiation of alpha-blocker treatment, delivery was performed by cesarean section at 36 weeks of gestation. An excision was carried out by laparoscopy 2 months postpartum without intra- and post-operative complications., Conclusions: The absence of antenatal diagnosis of PPGL is the main risk factor increasing maternal and fetal mortality. Certain criteria such as a family history, the appearance of early or malignant arterial hypertension should suggest the diagnosis of PPGL. The initiation of alpha-blocker treatment upon diagnosis is essential. The curative therapy remains surgical excision. Its timing depends on its size, location, term of pregnancy and route of delivery. It is preferable to postpone it until postpartum in order to reduce the risk of complications., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Retinopathy of prematurity (ROP, ORPHA: 90050) is the main cause of visual impairment in preterm infants and the leading preventable cause of childhood blindness in high- and middle-income countries. However, severe stages of the disease remain rare. While screening recommendations for the disease are well-established in France, management of ROP requiring treatment is less standardized, especially since new therapeutic options have been approval on this indication. The management of preterm infants requiring treatment for ROP is complex and involves a multidisciplinary team, including pediatric ophthalmologists, vitreoretinal surgeons, neonatologists, pediatric anesthetists, nurses, and orthoptists, within an adapted structure for premature infants care. There is a genuine need to unify national practices, with a strong demand from physicians involved in ROP care along the country. The objective of this National Diagnostic and Care Protocol (PNDS) is to provide guidelines for diagnostic and management for ROP, and to optimize and harmonize the management of this disease across the country. The main treatment indications, the different treatment modalities including laser photocoagulation, anti-VEGF injections, and vitreoretinal surgery as well as follow-up calendar, are reviewed to establish the best practice recommendations on ROP., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Purpose: There is no consensus on the utility of postoperative antibiotherapy in hand infections after surgical management. The aim of this study was to evaluate if the absence of postoperative antibiotic therapy was detrimental after surgical treatment., Methods: We included 287 patients operated on for a hand infection between January 2018 and October 2023. Preoperative or postoperative antibiotic prescription was collected for every patient. Patients cured for their infection with a single surgery were classified as "simple evolution", while patients requiring repetitive surgery or who had at least one complication directly linked to the initial infection (extension of infection or necrosis) were considered "complicated"., Results: From a total of 287 patients, we included 188 paronychia, 40 phlegmons, 47 abscesses and 12 superinfected wounds. The revision surgery rate was 9.4%, and the complication rate was 27.2%. One hundred and seventeen (40.8%) patients received preoperative antibiotic therapy from emergency physicians or general practitioners, among whom a complication rate of 31.6% was observed. The causal link did not reach the significance threshold for the whole group of patients (P=0.079). However, preoperative antibiotic use in phlegmon patients was directly correlated with the occurrence of at least one complication (P=0.032). In all, 82.9% of patients did not require postoperative antibiotic therapy, 95% of whom had an uncomplicated course., Conclusions: Preoperative probabilistic antibiotic therapy is an independent risk factor for complications, particularly if given at a collected stage. Antibiotics should not be routinely prescribed postoperatively in a correct debridement is performed. We recommend that antibiotics be used only in very specific cases (osteitis, arthritis, necrosis and/or high-risk patients)., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Introduction: Patients treated with immunotherapy might need surgical procedures in addition to the medical treatment. The main indications are cytoreductive nephrectomy, cystectomy (as part of clinical trials) and metastasis removal in some oligometastatic patients. This study aims to assess the feasibility of surgery for patients treated by immunotherapy and describes the histological modifications found in the pathological analysis., Material and Methods: We conducted a retrospective, monocentric study. We included all patients operated for a urologic cancer and previously treated with systemic immunotherapy between February 2018 and June 2022. We compared this population with a control group of patients treated with surgery without having previous immunotherapy. Patients were compared according to the cancer type, age and sex. We compared perioperative complications. We performed an analysis for evaluation of the peri-tumoral inflammatory infiltration., Results: We included 50 patients in this study. The two groups were comparable in age (63.7 vs. 63.3years old, P=0.95) and sex (4 and 6 women in the first and second group). The peroperatory complication rate was comparable (20% vs. 16%, P=1). The mean bleeding volume was comparable (664 vs. 629mL; P=0.89). The postoperative complication rate (48% vs. 56%; P=0.78) and their grade (Clavien III-IV 8% vs. 24%; P=0.24) were comparable. The anatomopathological analysis described the same rate and intensity of peri-tumoral inflammatory infiltrate (96% vs. 96%; P=1)., Conclusions: Preoperative immunotherapy does not appear to be associated with increased surgical difficulty and perioperative complications. Blind histological analysis of the surgical specimens did not reveal any specific features related to pre operative immunotherapy., Level of Evidence: Grade 3 HAS., (Copyright © 2024 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Physicians were often summoned as expert witnesses in the law courts of the city of Valencia in the Late Middle Ages. Their aid was requested for various reasons and they were expected to render judgments or make prognoses. One of the settings in which they intervened was the prison. Torture was part of the unfolding of the legal proceedings as a way to prove the facts and thus dispel any doubt the judge might have. Doubts that had been raised by any possible feigned illnesses required the proficiency of those experts who were the ones to decide whether or not to inflict torture on the prisoners. This paper analyzes in extensive detail a particular case which took place in Valencia in 1440, and required the expert opinion of four physicians and a surgeon.

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This is the first part of the report on the special sessions held during the 40th SFB congress in Toulon from October 5th to 7th, 2021. It includes the «surgical» and «intensive care» sessions, awaiting completion of the «rehabilitation» report. [ABSTRACT FROM AUTHOR]

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Perianastomotic stenoses, of which juxtaanastomotic stenosis is the most frequent, complicating arteriovenous fistulas (AVF) for hemodialysis, can lead to thrombosis or even the loss of the vascular approach. We report the case of a patient with juxta anastomotic stenosis treated by surgery. [ABSTRACT FROM AUTHOR]

Adrenal incidentaloma (IA) is an incidental discovery of an adrenal mass by radiological examinations. Its incidence is increasing with technological advances and the increase in radiological examinations. In the vast majority of cases, it is a benign non-secreting adenoma. A minimal basic hormonal assessment must be carried out. Radiological exploration, in particular the adrenal CT scan, makes it possible to categorize the lesion as potentially benign or malignant. The management of IA is currently under debate. There is a consensus on the need for an evaluation by a team of multidisciplinary experts and a surgical approach in patients presenting with a significant hormonal excess and/or radiological signs suspicious of malignancy demonstrated at diagnosis or during follow-up. [ABSTRACT FROM AUTHOR]