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Abstract Tuberculosis is one of the most widespread infectious diseases in the world. It constitutes a major public health problem, especially in developing countries, including Algeria. Globally and among all tuberculosis cases, WHO reports 14% extra-pulmonary tuberculosis (EPT) without concomitant pulmonary involvement. In our country and in recent years, an upsurge in extrapulmonary tuberculosis has been observed. The objective of this article was to present an atypical case of cerebral tuberculosis whose diagnosis was late, made by anatomopathological examination with a review of the literature. We report the case of a young patient hospitalized in emergency for an intracranial hypertension syndrome with neurological disorders. Cerebral computed tomography revealed multiple brain locations with active hydrocephalus. The extension assessment was without anomaly.The patient underwent a surgical intervention, the operative consequences were favorable. The pathological examination was in favor of a specific inflammatory granulomatous lesion made up of large areas of caseous necrosis. The patient was cured under anti-tuberculosis treatment. The diagnostic problem and the results will be discussed with a review of the literature. Cerebral tuberculosis is a rare form of extrapulmonary tuberculosis. The clinic as well as the neuroimaging (CT, MRI) are atypical. The diagnosis is postoperative, based on the pathological examination. The prognosis depends on the early diagnosis, the site of the lesion and the response to anti-tuberculosis treatment. Résumé La tuberculose est une des maladies infectieuses les plus répandues dans le monde .Elle représente un problème de santé publique majeur dans les pays en voie de développement, y compris l’Algérie . À l’échelle mondiale et parmi tous les cas de tuberculose, l’OMS rapporte 14 % de tuberculose extra-pulmonaire (TEP) sans atteinte pulmonaire concomitante. Dans notre pays et durant ces dernières années, une recrudescence de la tuberculose extrapulmonaire a été observée. L’objectif de cet article était de présenter un cas atypique de tuberculose cérébrale dont le diagnostic a été tardif, posé par l’examen anatomopathologique avec une revue de la littérature. C’est le cas d’une jeune patiente hospitalisée dans le cadre de l’urgence pour un syndrome d’hypertension intracrânienne avec troubles neurologiques. La tomodensitométrie cérébrale a objectivé de multiples localisations cérébrales avec une hydrocéphalie active. Le bilan d’extension était sans anomalie. La patiente avait bénéficié d’une intervention chirurgicale, les suites opératoires ont été favorables. L’examen anatomo-pathologique était en faveur d’une lésion inflammatoire spécifique granulomateuse faite de larges plages de nécrose caséeuse. La patiente a répondu au traitement antituberculeux. Le problème diagnosticque et les résultats seront discutés avec une revue de la littérature. La tuberculose cérébrale est une forme rare de la tuberculose extra-pulmonaire. Le tableau clinique ainsi que la neuro-imagerie (TDM, IRM) sont atypiques. Le diagnostic était postopératoire, reposant sur l’examen anatomopathologique. Le pronostic dépend de la précocité du diagnostic, du siège de la lésion et de la réponse au traitement antituberculeux.

The primary aim of this study was to assess the association between clinical efficacy outcomes (i.e., polysomnography (PSG) results) of maxillomandibular advancement (MMA) and surgeons' experience. The second aim was to assess the association between the occurrence of postoperative complications of MMA and surgeons' experiences. Patients treated with MMA for moderate to severe obstructive sleep apnea (OSA) were enrolled in this retrospective study. The patient population was divided into two groups based on two different surgeons performing MMA. The associations between surgeons' experience on the one hand and PSG results and postoperative complications on the other hand were investigated. A total of 75 patients were included. There was no significant difference in baseline characteristics between the two groups. The reductions in apnea-hypopnea index and oxygen desaturation index were both significantly greater in group-B than group-A (p = 0.015 and 0.002, respectively). The overall success rate after MMA was 64.0%. There was a negative correlation between surgeon experience and surgical success (odds ratio: 0.963 [0.93, 1.00], p = 0.031). No significant association was found between surgeon experience and surgical cure. Additionally, there was no significant association between surgeon experience and the occurrence of postoperative complications. Within the limitations of this study, it is concluded that surgeon experience may have little to no influence on the clinical efficacy and safety of MMA surgery in OSA patients. [ABSTRACT FROM AUTHOR]

Thesis and aims: In 45 years, the definitions and practice of the urodynamically based overactive bladder (OAB)/detrusor overactivity (DO) system have failed to adequately address pathogenesis and cure of urinary urge incontinence, frequency and nocturia. Methods: We analysed the OAB syndrome with reference to the Integral Theory paradigm's (ITS) binary feedback system, where OAB in the female is viewed as a prematurely activated, but otherwise normal micturition caused mainly, but not entirely, by ligament damage/laxity. The ITS Clinical Assessment Pathway which details the relationships between structural damage (prolapse), ligaments and dysfunction (symptoms) is introduced. Results: The ITS was able to "better explain" OAB pathophysiology in anatomical terms with reference to the binary model. The phasic patterns diagnostic of "detrusor overactivity" are explained as a struggle for control by the closure and micturition reflexes. The exponentially determined relationship between urethral diameter and flow explains why obstructive patterns occur, why they do not and why urine may leak with no recorded pressure. Mechanically supporting ligaments ("simulated operations") during urodynamic testing can improve low urethral pressure, negative pressure during coughing with SUI and diminish urge sensation or even DO patterns, transforming urodynamics from non-predictive test to accurate predictor of continence surgery results. High cure rates for OAB by daycare repair of damaged ligaments is a definitive test of the binary system's validity. Conclusion: Conceptual progression of OAB to the Integral Theory paradigms's prematurely activated micturition validates OAB component symptoms as a syndrome, explains pathogenesis, and unlocks a new way of understanding, diagnosing, treating and researching OAB. [ABSTRACT FROM AUTHOR]

Endometriosis is a benign inflammatory disease that affects a large proportion of women in their reproductive age. A peculiar type is the one situated on the postsurgical scars in the form of endometriomas. Whilst most patients with this pathology do not have a history of pelvic endometriosis, the explanation for its appearance is the theory of implantation of endometriotic cells during surgery, as well as the existence of primitive, pluripotent mesenchymal cells that have undergone differentiation and metaplasia processes. Pain is the main symptom of this condition, accompanied frequently by the appearance of an abdominal wall mass, which are both influenced by menstrual periods. Endometriosis is an estrogendependent disease, thus the medical treatment could comprise contraceptives-containing progesterone, as well as antiestrogens, but the long-term success rate is low, the treatment of choice being the surgical one. [ABSTRACT FROM AUTHOR]

Endometriosis is a benign inflammatory disease that affects a large proportion of women in their reproductive age. A peculiar type is the one situated on the postsurgical scars in the form of endometriomas. Whilst most patients with this pathology do not have a history of pelvic endometriosis, the explanation for its appearance is the theory of implantation of endometriotic cells during surgery, as well as the existence of primitive, pluripotent mesenchymal cells that have undergone differentiation and metaplasia processes. Pain is the main symptom of this condition, accompanied frequently by the appearance of an abdominal wall mass, which are both influenced by menstrual periods. Endometriosis is an estrogen dependent disease, thus the medical treatment could comprise contraceptives containing progesterone, as well as antiestrogens, but the long-term success rate is low, the treatment of choice being the surgical one. [ABSTRACT FROM AUTHOR]

Cancer growth and spread is an intricate process dependent upon both tumor and host. This laboratory is interested in the role of the fertility cycle, specifically cyclic changes in steroid hormone levels, in tumor growth and metastases. Our previous studies, using a murine model, have documented that breast cancer growth rate and post-resection metastatic behavior each change reproducibly during the estrous cycle, and that post-resection cancer spread depends upon the time within the estrous cycle that an advanced transplanted cancer is resected. Twelve to thiry-two percent cure rates were seen in these studies. That early work described estrous cycle stages just prior and near to putative ovulation to be superior while those stages farther from ovulation were disadvantageous times for surgery. Data presented here confirm the role of the estrous cycle in post-resection metastatic spread. This current work validates vaginal smear determined estrous cycle stage with uterine weight. A primary, transplantable, mammary carcinoma, which metastasizes to the lungs, was resected for surgical cure in cycling C3HeB/FeJ female mice at each fertility cycle stage. A group of oophorectomized (ovx) animals was also used. In two large, independent studies resecting much earlier stage cancers than in prior studies, a 96% surgical cure frequency was documented when the tumor is resected during estrus. The second best surgical cure rate is achieved when tumors are resected during metestrus (79% overall cure rate). Cure frequency in ovx animals is intermediate. These results further support a probable role for circulating E2 and P4 levels in modulating the metastatic process. We conclude that the timing of surgical resection within the estrous cycle affects the cancer's metastatic potential and that the optimal timing of resection may also depend to some extent upon the size (stage) of the resected cancer. [ABSTRACT FROM AUTHOR]