Cystic Echinococcosis of the Liver: Correlation Between Intra-Operative Ultrasound and Pre-Operative Imaging.

Background: Imaging plays an essential role in the management of hepatic hydatid cysts (HCE). The objective of our study was to determine the correlation between pre-operative ultrasound, computed tomography (CT), and intra-operative ultrasound (IOUS) in studying the characteristics and complications of HCE. Patients and Methods: This was a prospective, descriptive, and analytical study conducted in the General Surgery Department of Habib Bourguiba Hospital in Sfax. The study included patients with HCE who underwent conservative surgery between April 2017 and June 2022. Results: We enrolled 49 patients with 94 cysts. At the end of our study, IOUS allowed for better detection of HCE (98.8%) regardless of the number of cysts per patient. IOUS and CT were accurate in studying the location of cysts (κ = 1), whereas pre-operative abdominal ultrasound was less efficient (κ = 0.870). IOUS was the best examination for detecting exocysts (κ = 0.961), studying daughter cysts (κ = 0.823), and exploring vascular relations, but it was less effective (κ = 0.523) in detecting calcifications. Regarding classifications, ultrasound and CT had similar results. However, IOUS was most reliable in differentiating between CE3b and CE4 types (κ = 0.653). Ultrasound, CT, and IOUS were not sensitive in detecting latent HCE suppurations and cystobiliary fistulas. Conclusions: Performing IOUS is essential to prevent recurrences and reduce post-operative morbidity.

Effect of shading imposed by the algae Chaeotomorpha linum loads on structure, morphology and physiology of the seagrass Cymodocea nodosa.

In shallow coastal waters, seagrass and macroalgae occur together but under eutrophic conditions, bloom-forming algae can take over seagrasses causing an irreversible regime shift. Understanding the effect of macroalgae loads on seagrass meadows at an early stage can help prevent the loss of these ecosystems and the services they provide. In the present study, in situ experiments were conducted for 90 days in Bekalta (eastern coast of Tunisia) to assess the response of the seagrass Cymodocea nodosa when challenged with shading induced by filamentous macroalgae Chaetomorpha linum. Structural, morphological and physiological variables were regularly measured during the experiment. Shaded plants showed a sharp decline in shoot density, growth rate, and above-ground biomass, the impact being more pronounced on the physiological traits. Besides, shading by C. linum induced a significant increase in the contents of leaf photosynthetic pigments and phenolic compounds, whereas causing a decrease in soluble protein and sugar concentrations. Thus, shading imposed by C. linum loads appeared to induce a phoadpatative response in C. nodosa concomitant with carbon mobilization.

[Predictive factors for anastomotic leakage after colon cancer surgery]. / Facteurs prédictifs de fistule anastomotique après colectomie pour cancer.

Introduction: in colon cancer surgery, anastomotic fistula (AF) is considered the most feared complication. The purpose of this study was to identify predictive factors associated with anastomotic fistula after colon cancer surgical resection and to describe the impact of this complication on mortality and postoperative length of stay. Methods: we conducted a retrospective, descriptive and analytical study in the Department of General Surgery at the Habib Bourguiba Hospital in Sfax, Tunisia from 1st January 2013 to 31 December 2020. Results: we collected data from the medical records of 163 patients who had undergone surgery for colon cancer. The average age of patients was 62.7 years with a sex ratio of 1.36. The postoperative course was uneventful in 64.4% of cases and complicated in 35.6% of cases. Surgical morbidity was mainly due to anastomotic fistulas (22 patients). This study demonstrated that predictors of the development of this complication were: diabetes p = 0.04, smoking p = 0.01, hypoalbuminaemia p = 0.01, preoperative haemoglobin less than 10g/dl, p < 0.01, anastomotic fistula located in the left colonic angle p = 0.02, perioperative transfusion p <0.01, and duration of surgery longer than 180 min p = 0.04. Moreover, the occurrence of anastomotic fistula was associated with specific mortality rate (9%) and significantly prolonged postoperative length of stay. Conclusion: the prevention of anastomotic fistulas should be part of a multimodal approach based on the correction of nutritional deficiencies and possible pre-operative anemia.

A comparative study of trace elements in Cymodocea nodosa from three semi-enclosed coastal areas in Tunisia.

The present study quantifies the levels of five trace elements (TEs) Zn, Cu, Ni, Pb, and Cd in the leaves and rhizomes of Cymodocea nodosa as well as the surficial sediments from three semi-enclosed coastal areas in Tunisia, in the south Mediterranean Sea. Samples were taken from the Bizerte and Ghar El Melh lagoons and from marina Cap Monastir. The TE ranking was found to be Zn > Cu > Pb > Ni > Cd in sediments and Zn > Cu = Ni = Pb = Cd in C. nodosa leaves and rhizomes. Except for Ni, levels of Zn, Cu, Pb, and Cd significantly differed between the sites. Translocation factors (TFs) were > 1 for all trace elements proving the high capacity of C. nodosa to accumulate TEs in its above-ground tissues. Results show that marina Cap Monastir's meadow exhibits higher TFs than the Bizerte and Ghar El Melh lagoons. This can be due to the presence of the non-indigenous species Halophila stipulacea. The present study highlights the need for further investigation on the effect of interspecific interaction on TE uptake by seagrasses.