Expression of epidermal growth factor receptor (EGFR) in colorectal cancer: An immunohistochemical study

Background and study aim

The epidermal growth factor receptor (EGFR) plays an important role in tumourigenesis and tumour progression of colorectal cancer (CRC) and leads to the activation of intracellular signaling pathways. The use of anti-EGFR-targeted therapy has increased for patients with metastatic CRC. Today, the clinical utility of immunohistochemistry has remained somewhat inconclusive. It is based on EGFR screening methods using paraffin-embedded tumour specimen to select patients eligible for treatment. There is still lack of agreement on reproducible scoring criteria for EGFR immunohistochemistry has in various clinical trials.

Efficacité pédagogique de la simulation dans l’apprentissage du sevrage tabagique par les étudiants en sciences de santé : Revue systématique

Background: Simulation is one of the educational tools that can be used in thelearning process to help with smoking cessation. Aim: To synthesize all the publications studying the contribution of simulation as aneducational tool in the acquisition of skills to help with smoking cessation. Methods: We performed a systematic review of the Francophone and Anglophoneliterature over the past 24 years (1997 to 2020) using the PubMed, Science Direct andCochrane Library databases. Results: A total of 14 articles were included. The most used methods were thestandardized patient, role play and video projection with discussion. The simulation hasnot only proved its effectiveness in terms of acquiring knowledge and self-confidencein the management of the smoking patient in the short term, but also in the acquisitionof verbal and non-verbal skills in the long term. Conclusion: This review highlighted the interest of simulation as an educational tool toacquire skills to help with smoking cessation regardless of the method used.     

Death in Unverricht–Lundborg disease

The objective of this study is to report cases of unexpected deaths in Unverricht–Lundborg disease (ULD) patients, a comparatively benign form of progressive myoclonus epilepsy. We performed a multicentric study of the circumstances of death in ULD patients seen in the last 16 years. We assessed age, sex, severity and duration of disease, antiepileptic drugs, circumstances and presumed cause of death. Nineteen observations (12 females, 7 males) were collected from four centers (Tunis, Marseille, Milan, Belgrade). The most common causes of death are (1) SUDEP (six cases, all female), with 4/6 on phenobarbital alone, and (2) complications of severe ULD (six cases). Two patients committed suicide. Only one death was clearly unrelated to ULD (car accident), while four patients died of stroke, drowning, complications of chronic alcoholism and Wernicke encephalopathy, respectively. In conclusion, although the prognosis of ULD has progressed, there are still spontaneously severe forms and high risk of early death, including SUDEP.     

Antenatal diagnosis of multicystic renal dysplsia. Report of 11 cases

BACKGROUND: Multicystic dysplastic of the kidney (UCDK) in the most common cause of an abdominal man in the new born period and is the most common cystic malformation of the kidney in infancy. The increasingly widespread use of prenatal diagnostic techniques has revealed that UCDK is apparently even more prevalent than had been assumed. THE AIM: of this study was to assess the utility of antenatal ultra ecography for in utero diagnosid of UCDK and its management. METHODS: A retrospective study of 11 UCDK cases diagnosed by antenatal ultra echography performed between the 4th and 6th monts of pregnancy. The outcome measure was radiographic imaginy It acts of a retrospective study of the 11 cases of DRMK diagnosed in anténatal by an echography obstétricale of the second quarter. A diagnostic confirmation was obtained by radiological examinations in post native for the pregnancies carried. RESULT: Patients with UCDK have significant associated urological and/or non urological malformations. In certain cases of non lethal anomalies, antenatal detection may influence both obstetric and postnatal management. Conservative management requires appropriate investigation of urinary tract tract and long-term follow-up.     

Surveillance for hepatocellular carcinoma: does it work?

BACKGROUND: The surveillance of cirrhotic patients for early detection of hepatocellular carcinoma is recommended but its efficacy is now discussed. The aim of our study was to present the results of a screening program in 110 patients. METHODS: it is a retrospective study that included 110 patients with cirrhosis in a screening program of hepatocellular carcinoma, based on the realization of abdominal ultrasound exam and the determination of alpha-fetoprotein amount every 6 months in 95 patients and every 3 months in 15 patients. RESULTS: the mean duration of the surveillance was 36 months. A hepatocellular carcinoma was diagnosed in 13 patients. Curative treatment was done in only 3 cases and consisted in a hepatic resection in 1 patient and an alcoolisation in 2 cases. Ten patients had new treatment : for 8 patients the discussed was very agressive and 2 patients had a server hepotic failure. The cost of this study was 37.500 Tunisian dinars. CONCLUSIONS: systematic screening for hepatocellular carcinoma offer a limited cost effectiveness ratio.     

Unrepaired persistent truncus arteriosus in a 38-year-old woman with an uneventful pregnancy

Persistent truncus arteriosus (PTA) is a rare conotruncal defect, defined as a single arterial vessel arising from the heart, which gives origin to the systemic, pulmonary and coronary circulations. It has an extremely poor prognosis and carries a high mortality rate during the early years of life unless surgically repaired. A few known cases have been reported of patients reaching maturity, and exceptionally, patients suffering from this disease having lived into the fourth decade.The purpose of this report was to present a new case of PTA type 1, diagnosed by echocardiography and MRI, in a 41-year-old woman, with the peculiarity of long survival into adult life. She had also experienced a full-term pregnancy and delivery of a normal infant three years prior to her diagnosis. Pulmonary vascular disease made her condition inoperable but she was doing well with medical management after a follow up of 15 months. Based on this work, we concluded that pulmonary arterial hypertension is deleterious for life in some cardiovascular diseases, but in others, allows survival, as occurred in these patients with PTA. The patient’s clinical course and anatomical findings are reported, along with factors that may have contributed to her longevity.     

Osteogenesis imperfecta and Ledderhose disease: Is there a link? A report of two Tunisian siblings

IntroductionOsteogenesis imperfecta (OI) or “brittle bone disease” is a rare genetic disorder tissue due to an abnormal production of type I collagen. It can cause hearing loss, dentinogenesis imperfecta, heart failure, spinal cord problems and permanent deformities. Ledderhose’s disease or Plantar fibromatosis (PF) is also a rare condition that may be caused by an abnormal proliferation of collagen tissue. It is a benign fibroblastic proliferative disorder in which fibrous nodules may develop in the plantar aponeurosis, more specifically on the medial plantar side of the foot arch and on the forefoot region. Rare cases of association of polyfibromatosis with keloids or arthritis have been reported.Case reportWe report two Tunisian brothers aged 17 and 14 years old, from a first-degree consanguineous marriage and with medical history of multiple bone fractures. The elder brother has medical history of juvenile arthritis treated with methotrexate and etanercept. Clinical examination of both patients showed blue sclera, bone deformities with humeral and femoral curvature and unequal leg length. They were diagnosed with OI and received bisphosphonate to prevent further fractures. One year later, they developed lumps under the sole skin of their feet. They were diagnosed with PF and received conservative treatment including non-steroidal anti-inflammatory drugs, physiotherapy and orthotic support.ConclusionTo the best of our knowledge, the association of PF with OI has never been reported. Both diseases suggest an association with abnormalities involving collagen. A question remains currently with no answer: is it a fortuitous association?     

The Effect of the Composition of a Concrete Mixture on Its Volume Changes

The presented research aims to clarify the specific effect of the individual components of concrete with Portland cement CEM I 42.5 R on the volume changes of concrete. The effect of the filler component was evaluated from the point of view of the composition and type of aggregate (crushed versus mined) and from the point of view of the mineralogical composition of the aggregate. Concrete formulas with a maximum aggregate grain size of 16 and 22 mm were assessed. The effect of the binder component on the shrinkage of the concrete was monitored on the concrete mixtures produced using the same aggregate and maintaining the same strength class of concrete, C 45/55. The effect of the addition of finely ground limestone, finely ground granulated blast furnace slag and coal high-temperature fly ash was monitored. It was found that the maximum aggregate grain and the type of grading curve do not have a significant effect on the volume changes of concrete. Concretes with mined aggregates showed lower shrinkage than concretes with crushed aggregates. The most significant is the effect of the type of aggregate on the volume changes in the first 24 h. Mineral additives have a positive effect on the elimination of the volume changes of concrete, while the addition of high-temperature fly ash proved to be the most suitable.