A huge left buttock mass in an old female.

Introduction: Myxofibrosarcoma also known as myxoid malignant fibrous histiocytoma is a rare soft tissue sarcoma that has a predilection for the elderly (beyond the 6th decade). Clinical observation: We report a case of a 64 years old patient that presented gradual appearance of huge tumor on her left buttock. Radiologic examination (MRI) concluded to MFS. There was no evidence of systemic involvement. The patient was directed in an oncology center, where the diagnostis of MFS was confirmed through surgical biopsy. Discussion: MFS is one of the most frequent sarcoma of soft tissue that occurs in elderly patients. This is an infiltrant tumor that is extending through muscular fascia. MRI is the gold standard in characterisation; it makes the positive diagnosis of MFS thanks to the myxoid signal, triple signal and the tail sign that is corresponding to the extension of the tumor into the muscular fascia and peri nervous spaces. Conclusion: Cross-sectionnal imaging in particular MRI plays a key role in the positive diagnosis of soft tissue tumors. It makes possible to approach with great precision the exact nature of the tumor thanks to specific radiological semiology without however claiming to replace histology.

Spatial distribution, geochemical processes of high-content fluoride and nitrate groundwater, and an associated probabilistic human health risk appraisal in the Republic of Djibouti.

In the northern East African Rift System, the Republic of Djibouti relies exclusively on groundwater, with levels of fluoride (up to 14 mg/L) and nitrate (up to 256 mg/L) posing potential health risks. To address this, 362 samples were considered, including 133 shallow groundwater samples, along with new and previously published data dating back to 2012 on deep (88) and thermal (141) groundwater samples. To understand the enrichment mechanisms, dissolved anion and cation constituents, geochemical and thermodynamic tools, and stable isotope ratios, such as δ2H(H2O), δ18O(H2O), δ15N(NO3-), and δ18O(NO3-), were used. In particular, two activity diagrams (Mg2+ vs. Ca2+ and Na+ vs. Ca2+), focused on aqueous and solid fluoride species in an updated thermodynamic dataset of 15 fluoride-bearing minerals, are shown for the first time. The dataset offers new and valuable insights into fluoride geochemistry (classic thermodynamic datasets combined with geochemical codes rely solely on fluorapatite and fluorite F-bearing minerals). Activity diagrams and geochemical modeling indicate that mineral dissolution primarily drives groundwater fluoride enrichment in all water types, whereas the elevated nitrate levels may stem from organic fertilizers like animal manure, as indicated by nitrate isotopes and NO3-/Cl- vs Cl- diagrams. Despite the arid climate and 2H18O enrichment in shallow waters, evaporation seems to play a minor role. Monte Carlo simulations and sensitivity analysis were used to assess the health risks associated with elevated F- and NO3- concentrations. Mapping-related spatial distribution analysis identified regional contamination hotspots using a global Moran's I and GIS tools. One fluoride and three nitrate contamination hotspots were identified at a p-value of 0.05. Groundwater chemistry revealed that 88 % of groundwater being consumed exceeded the permissible levels for fluoride and nitrate, posing potential health risks, particularly for teenagers and children. This study pinpoints specific areas with excessive nitrate and fluoride contamination, highlighting a high non-carcinogenic risk.

Review of Vibration Control Strategies of High-Rise Buildings.

Since the early ages of human existence on Earth, humans have fought against natural hazards for survival. Over time, the most dangerous hazards humanity has faced are earthquakes and strong winds. Since then and till nowadays, the challenges are ongoing to construct higher buildings that can withstand the forces of nature. This paper is a detailed review of various vibration control strategies used to enhance the dynamical response of high-rise buildings. Hence, different control strategies studied and used in civil engineering are presented with illustrations of real applications if existing. The main aim of this review paper is to provide a reference-rich document for all the contributors to the vibration control of structures. This paper will clarify the applicability of specific control strategies for high-rise buildings. It is worth noting that not all the studied and investigated methods are applicable to high-rise buildings; a few of them remain limited by many parameters such as cost-effectiveness and engineering-wise installation and maintenance.

Traumatic diaphragmatic injuries: epidemiological, diagnostic and therapeutic aspects.

INTRODUCTION: Diaphragmatic injuries include wounds and diaphragm ruptures, due to a thoracoabdominal blunt or penetrating traumas. Their incidence ranges between 0.8 and 15 %. The diagnosis is often delayed, despite several medical imaging techniques. The surgical management remains controversal, particularly for the choice of the surgical approach and technique. The mortality is mainly related to associated injuries. The aim of our study was to evaluate the incidence of diaphragmatic injuries occuring in thoraco-abdominal traumas, and to discuss their epidemiology, diagnosis and treatment. PATIENTS AND METHODS: We performed a retrospective study over a period of 21 years, between January 1994 and June 2015 at the Department of General Surgery of the Aristide Le Dantec hospital in Dakar, Senegal. All patients diagnosed with diaphragmatic injuries were included in the study. RESULTS: Over the study period, 1535 patients had a thoraco-abdominal trauma. There were 859 cases of blunt trauma, and 676 penetrating chest or abdominal trauma. Our study involved 20 cases of diaphragmatic injuries (1.3 %). The sex-ratio was 4. The mean age was 33 years. Brawls represented 83.3 % (17 cases). Stab attacks represented 60 % (12 cases). The incidence of diaphragmatic injury was 2.6 %. The wound was in the thorax in 60 % (seven cases). Chest radiography was contributory in 45 % (nine cases). The diagnosis of wounds or ruptures of the diaphragm was done preoperatively in 45 % (nine cases). The diaphragmatic wound was on the left side in 90 % (18 cases) and its mean size was 4.3 cm. The surgical procedure involved a reduction of herniated viscera and a suture of the diaphragm by "X" non absorbable points in 85 % (17 cases). A thoracic aspiration was performed in all patients. Morbidity rate was 10 % and mortality rate 5 %. CONCLUSION: The diagnosis of diaphragmatic rupture and wounds remains difficult and often delayed. They should be kept in mind in any blunt or penetrating thoraco-abdominal trauma. Diaphragmatic lesions are usually located on the left side. Surgery is an efficient treatment.

INTRODUCTION: Les traumatismes du diaphragme comprennent les ruptures et les plaies du diaphragme. Leur incidence varie entre 0,8 % et 15 %. Elles sont très souvent méconnues malgré les techniques performantes d'imagerie médicale. Leur prise en charge chirurgicale reste controversée. La mortalité de cette pathologie est liée aux lésions associées. Le but de notre étude était d'apprécier l'incidence des lésions diaphragmatique dans les traumatismes thoraco-abdominaux, et de discuter les aspects épidémiologiques, diagnostiques et thérapeutiques. PATIENTS ET MÉTHODE: Il s'agissait d'une étude rétrospective sur 21 ans allant du 1er janvier 1994 au 30 juin 2015. Cette étude a été réalisée au Service de Chirurgie Générale de l'Hôpital Aristide Le Dantec de Dakar. Etaient inclus dans cette étude tous les patients qui présentaient une lésion diaphragmatique consécutive à un traumatisme abdominal et/ou thoracique ouvert ou fermé. RÉSULTATS: Durant cette période d'étude, nous avons reçu 1535 patients victimes de traumatisme thoracique et/ou abdominal. Il s'agissait de 859 cas de contusions et 676 cas de plaies thoraciques et/ou abdominaux. Notre étude portait sur 20 cas de lésions diaphragmatiques (1,3 %). Le sex-ratio était de 4. L'âge moyen était de 33 ans. Les agressions par arme blanche représentaient 60 % (12 cas). L'incidence des lésions diaphragmatiques était de 2,6 %. La plaie cutanée était de siège thoracique dans 60 % (7 cas). La radiographie du thorax était contributive dans 45 % (9 cas). Le diagnostic de lésion diaphragmatique était préopératoire dans 45 % (9 cas). La brèche diaphragmatique siégeait à gauche dans 90 % (18 cas) et la taille moyenne était de 4,3 cm. Le geste chirurgical avait consisté en une réduction des viscères herniés et une suture du diaphragme par des points en « X ¼ dans 85 % (17 cas). Le drainage thoracique était systématique. Le taux de morbidité était de 10 % et la mortalité de 5 %. CONCLUSION: Leur diagnostic est difficile. Elles siègent le plus souvent à gauche. Leur traitement est chirurgical et la voie d'abord préférentielle est la laparotomie.

Wastewater reclamation using discarded reverse osmosis membranes for reuse in irrigation in Djibouti, an arid country.

The purpose of this paper is to establish the feasibility of recovering discarded reverse osmosis (RO) membranes in order to reduce the salinity of domestic treated wastewater. This study shows that the reuse of RO membranes is of particular interest for arid countries having naturally high mineralized water such as Djibouti. The pilot desalination unit reduces the electrical conductivity, the turbidity and the total dissolved salt respectively at 75-85, 96.7 and 95.4%. The water produced with this desalination unit contains an average of 254 cfu/100 mL total coliforms and 87 cfu/100 mL fecal coliforms. This effluent meets the World Health Organization standards for treated wastewater reuse for agricultural purposes. The annual cost of the desalination unit was evaluated as US $/m(3) 0.82, indicating the relatively high cost of this process. Nevertheless, such processes are required to produce an effluent, with a high reuse potential.

Posterior Mediastinal Bronchogenic Cyst Compressing Left Atrium.

The echocardiographic literature contains exceedingly few reports of mediastinal bronchogenic cyst; in most published cases of this entity, the cysts were imaged by computed tomography or magnetic resonance imaging. Because mediastinal bronchogenic cyst is little known as a cause of cardiorespiratory symptoms, we report such a case.