Veinous thrombectomy. Six case reports]

The aim of this study is to raise up the effect of surgical thrombectomy among other alternative therapies. This retrospective study reports 6 patients (mean age 63 years) admitted with phlegmasia cerulea dolens. All patients underwent surgical venous thrombectomy associated with infracava filter insertion in 2 cases. One patient died in the early postoperative course. In all other cases we noticed good early and late outcome both on clinical examination and duplex scanning assessment. In conclusion, surgical venous thrombectomy can be considered as a good and efficient procedure in the presence of phlegmasia cerulea dolens in order to relieve ischemia and to prevent whenever possible severe chronic venous disorders. However, fibrinolytic therapy might achieve as good results as surgery. Thus, the latter is to be reserved to very severe veinous ischemia with limb loss threatening where fibrinolytic therapy fails or is contre-indicated.     

Présentation insolite d’un sarcome embryonnaire indifférencié du foie : à propos d’un cas

Undifferentiated embryonal sarcoma of the liver is a rare tumor occurring in late childhood. This tumor is often characterized by a misleading clinical and radiological presentation. We report a case of primary hepatic embryonal sarcoma in a 15 years old girl erroneously assumed to be a rupture hydatic cyst and discuss its clinicopathologic, therapeutic and evolutive features.     

Propolis attenuates cobalt induced-nephrotoxicity in adult rats and their progeny

The aim of this study was to evaluate the biochemical changes in cobalt-exposed rats and to investigate the potential role of Tunisian propolis against the cobalt-induced renal damages. Twenty-four pregnant Wistar rats were divided into four groups and were treated as follows: group 1 (control) received distilled water; group 2 received 350 ppm of CoCl₂ in drinking water; group 3 received 350 ppm CoCl₂ in drinking water and a propolis-supplemented diet (1 g/100 g of diet); group 4 received a propolis-supplemented diet (1 g/100 g of diet) without cobalt. In the cobalt group, a significant decrease in body, absolute and relative weights was noted when compared to controls. The administration of cobalt to pregnant rats from the 14th day of pregnancy until day 14 after delivery resulted in an increased level of renal malondialdehyde, a decreased renal content of glutathione and antioxidant enzyme activities such as superoxide dismutase, catalase and glutathione peroxidase in lactating rats and their pups. A statistically significant increase in plasma urea and creatinine serum levels was seen in treated female rats and their pups. Histopathologically, the cobalt-administration induced degenerative changes in the kidney of lactating rats and their pups. When compared with cobalt-treated rats, those receiving the propolis supplementation (along with cobalt-treatment) had lower malondialdehyde levels, higher antioxidant activities and the cobalt-related histopathological changes in the kidneys were at lower severity.Our results suggested that the propolis might be a potential candidate agent against cobalt-induced nephrotoxicity in adult and juvenile rats when administered to female rats during the late pregnancy and the early postnatal period.     

Pulmonary arterial aneurysms in Behçet's syndrome. Report of 4 cases

Pulmonary involvement in Behcet's disease is uncommon and pulmonary arterial aneurysms are present in about 1 to 7% of patients. But despite their scarcity, they represent a life-threatening complication and are usually regarded as of a poor prognosis. Our study aims to describe the epidemiological and therapeutic aspects of this condition. Among 180 patients with Behcet's disease according to the criteria of the international study group for Behcet's disease, four were diagnosed as having pulmonary artery aneurysms (2.22%). All were male, the mean age at the time of the diagnosis of pulmonary artery aneurysms was 29.8 years and the mean disease duration was 6.6 years. Hemoptysis was the presenting symptom in all cases. The patients were treated by corticosteroid, colchicine and cyclophosphamide pulses. The outcome was good with disappearance of hemoptysis in all cases and disappearance of pulmonary aneurysms in three. One patient had recurrence of aneurysms 40 months after the first episode and died 18 months later. So, we can hope, thanks to medical treatment, a better outcome than previously reported in this complication.     

Design of a chattering-free integral terminal sliding mode approach for DFIG-based wind energy systems

This article proposes a Fuzzy Second Order Integral Terminal Sliding Mode (FSOITSM) control approach for DFIG-based wind turbines subject to grid faults and parameter variations. Since traditional terminal sliding mode control (SMC) suffers from singularity, a novel integral terminal sliding manifold is proposed to eliminate chattering and improve the wind turbine's performance in the presence of faults and disturbances. A fuzzy system is proposed to auto-tune the controllers' gains and ensures the invariance of the sliding surfaces even under heavy uncertainties, thus further improving the reliability and performance of the proposed controller. The performance of the proposed approach was assessed under various operating conditions. A comparison analysis with a standard SMC approach as well as the state of the art in voltage sag mitigation was also carried over. Reliability, robustness, and power availability under faulty grid conditions are among the main features of the proposed approach. In addition, the proposed approach exhibited chattering free dynamics and enabled the finite time convergence of the sliding manifold and overcame the singularity problem associated with standard TSMC.     

Métastase calcanéenne d’un carcinome rénal : à propos d’un cas et revue de la littérature

Acrometastases of the bones of the foot are extremely rare.We are presenting the case of a male patient, aged 73 years who is being monitored for clear renal cell carcinoma with metastases to the lungs. He underwent a total nephrectomy procedure. Five months later, he was seen as an emergency due to pain in his left foot and functional impairment. Investigations highlighted calcaneal metastasis of the renal carcinoma. Our patient underwent tumour resection followed by cementoplasty then radiotherapy treatment; he has now been offered targeted therapy. He is currently still alive with a follow-up of 14 months. As a result of this rare calcaneal metastasis of a renal carcinoma, we are proposing to investigate clinical, radiological and therapeutic aspects of this rare entity as well as a review of the literature.