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The phases of a cutaneous infection are initially the adhesion of the microorganism to the cells of the host, followed by the invasion of the tissues, than the elaboration of toxins and the escape from the defense systems of the host. The Human Amniotic Membrane (HAM) is extracted from the placenta of donors after caesarean section. The amnios is characterized by a monolayer of epithelial cells, a basement membrane and an avascular stroma of collagen. The HAM showed to promote chronic wound healing. We evaluated the "in vivo" and "in vitro" activity and efficacy of the HAM in subjects with chronic diabetic skin lesion. This clinical case showed that the HAM promote the wound healing of complex chronic skin lesion in a follow-up period of 6 months after the first graft.Esophageal cancer is one of the most common cancers associated with the high mortality rate. Timely diagnosis and treatment are important to manage the disease and prevent comorbidities. Autophagy inhibitor Surgical resection of the tumor and lymph nodes is usually practiced either with or without chemo or chemoradiotherapy. Despite advancements in surgical methods and skills, complex nature of the esophagus and invasiveness of the surgery can lead to serious complications in these patients. In order to predict postoperative outcomes, preoperative examination of the patients, in addition to risk factors, should be conducted. Conclusion Lastly, early detection of adverse postoperative events may help faster recovery, reduce hospital stay and prevent other morbidities.Background lymph node tuberculosis is the most common form of extra pulmonary tuberculosis. Although diagnosis is usually difficult, therapeutic management remains a challenge and a subject of national and international debate. Materials and methods the medical records of patients with cervical lymph node tuberculosis who were treated at 20 August Hospital, Casablanca, Morocco, between May 2017 and November 2018 were reviewed. The results of the treatment were analyzed retrospectively.The aim of our work was to identify all causes of medical treatment failure in cervical lymph node tuberculosis, and to propose indications for the use of surgery in cervical lymph node tuberculosis in Morocco. Results Out of a total of 104 patients, the mean age was 24 years, the sex ratio was 0.51 (women 66.3%), twenty (19.2%) patients received medical treatment alone, and 84 (80.8%) patients required medical and surgical treatment. Surgery was required when the size of the lymphadenopathies was greater than or equal to 3 cm (p = 0.005), when the patient presented with an abscess and/or fistula(p = 0.005), when the patient presented with resistance to antibacillary drugs(p = 0.032), or developed a paradoxical upgrading reactions (p = 0.001), or when the patient had a recurrence of lymph node tuberculosis(p = 0.008) on multivariate analysis. Conclusion antibiotic therapy remains the main treatment for all patients in lymph node tuberculosis, but the results of our work show the value of surgery in some indications.Introduction The feasibility and efficacy of emergency curative resection of complicated colorectal cancer is still controversial. This prospective study aim was to assess surgical and oncologic outcomes after emergency compared to elective curative resection of colorectal cancer. Methods 60 consecutive patients presented with complicated colorectal cancer managed by emergency surgery were included and compared to another 155 consecutive patients admitted during the same period with uncomplicated colorectal cancer managed by elective surgery. Both groups were compared regarding curative resection rate, early postoperative mortality and morbidity, 3-years tumor recurrence and survival rates. Results Complicated colorectal cancer presented at a more advanced stage with a lower resectability rate and higher postoperative mortality and morbidity rates when compared to uncomplicated ones. Emergency resection of stage I/II colorectal cancer had similar 3-years disease free, overall survival and cancer-specific mortality rates approximating elective. But, emergency resection of stage III tumors had significantly decreased 3-years disease free and overall survival rates although there was no significant increase in cancer specific mortality rate. Conclusions Complicated colonic cancers present at a more advanced stage with a lower resectability rate, and higher postoperative morbidity and mortality rates when compared with uncomplicated ones. In medically fit patients, emergency curative resection of complicated colorectal cancer could be done safely with survival outcomes approximating elective resection of uncomplicated cancer in the same stage if proper oncologic resection done by expert surgeon.Objectives Running a marathon has been equivocally associated with acute changes in cardiac performance. First-phase ejection fraction is a novel integrated echocardiographic measure of left ventricular contractility and systo-diastolic coupling which has never been studied in the context of physical activity. The aim of this study was to assess first-phase ejection fraction following recreational marathon running along with standard echocardiographic indices of systolic and diastolic function.Design and participants Runners (n = 25, 17 males), age (mean ± standard deviation) 39 ± 9 years, were assessed before and immediately after a marathon race which was completed in 4 h, 10 min ± 47 min. Main outcome measures Central hemodynamics were estimated with applanation tonometry; cardiac performance was assessed using standard M-mode two-dimensional Doppler, tissue-doppler imaging and speckle-tracking echocardiography. First-phase ejection fraction was calculated as the percentage change in left ventricular volume from end-diastole to the time of peak aortic blood flow. Results Conventional indices of systolic function and cardiac performance were similar pre- and post-race while aortic systolic blood pressure decreased by 9 ± 8 mmHg (P less then 0.001) and first-phase ejection fraction increased by approximately 48% from 16.3 ± 3.9% to 22.9 ± 2.5% (P less then 0.001). The ratio of left ventricular transmitral Doppler early velocity (E) to tissue-doppler imaging early annular velocity (e') increased from 5.1 ± 1.8 to 6.2 ± 1.3 (P less then 0.01). Conclusion In recreational marathon runners, there is a marked increase in first-phase ejection fraction after the race despite no other significant change in cardiac performance or conventional measure of systolic function. More detailed physiological studies are required to elucidate the mechanism of this increase.

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