Artificial intelligence (AI) is revolutionizing the healthcare sector worldwide. In Morocco, several AI applications are being deployed in public and private healthcare establishments, improving appointment management...Artificial intelligence (AI) is revolutionizing the healthcare sector worldwide. In Morocco, several AI applications are being deployed in public and private healthcare establishments, improving appointment management, surgical operations, diagnostics, patient record tracking, biology and radiology, and OR organization. This article explores the main AI applications used in the Moroccan healthcare sector, their frequency of use, the types of establishments adopting them, as well as the main functionalities of each application and its contribution to the sector. The aim of this study is to analyze the impact of the main AI applications on quality of care and process efficiency in Moroccan healthcare facilities. This research focuses on several fundamental questions: Which AI applications are most frequently used? What types of establishments are adopting these technologies, and for which specific functionalities? What are the benefits and challenges of integrating AI into the Moroccan healthcare system, particularly in terms of territorial distribution and accessibility? The methodology is based on a quantitative analysis of data collected from selected healthcare establishments, combined with studies of reports from public health authorities and a sweep of their websites. The results show that 45% of hospitals use AI systems for appointment scheduling and 30% for medical diagnosis. The use of surgical robots, such as the Da Vinci system, increased by 30% between 2020 and 2024. Comparisons with other emerging countries highlight Morocco’s acceptable advances, while underlining the challenges, particularly in terms of the territorial distribution of these technological infrastructures generally centralized in the country’s major cities.展开更多
Textile dyes are dramatic sources of pollution and non-aesthetic disturbance of aquatic life and therefore represent a potential risk of bioaccumulation that can affect living species.It is imperative to reduce or eli...Textile dyes are dramatic sources of pollution and non-aesthetic disturbance of aquatic life and therefore represent a potential risk of bioaccumulation that can affect living species.It is imperative to reduce or eliminate these dyes from liquid effluents with innovative biomaterials and methods.Therefore,this research aims to highlight the performance of Capparis spinosa L waste-activated carbon(CSLW-AC)adsorbent to remove crystal violet(CV)from an aqueous solution.The mechanism of CV adsorption on CSLW-AC was evaluated based on the coupling of experimental data and different characterization techniques.The efficiency of the CSLW-AC material reflected by the equilibrium adsorption capacity of CV could reach more than 195.671 mg·g^(–1) when 0.5 g·L^(–1) of CSLW-AC(Particle size≤250μm)is introduced into the CV of initial concentration of 100 mg·L^(–1) at pH 6 and temperature 65℃ and in the presence of potassium ions after 60 min of contact time according to the one parameter at a time studies.The adsorption behavior of CV on CSLW-AC was found to be consistent with the pseudo-second-order kinetic model and Frumkin's linear isothermal model.The thermodynamic aspects indicate that the process is physical,spontaneous,and endothermic.The optimization of the process by the Box Behnken design of experiments resulted in an adsorption capacity approaching 183.544 mg·g^(–1)([CV]=100 mg·L^(–1) and[CSLW-AC]=0.5 g·L^(–1) at 35 min).The results of the Lactuca sativa seeds germination in treated CV(70%),adsorbent solvent and thermal regeneration(more than 5 cycles),and process cost analysis(1.0484 USD·L^(–1))tests are encouraging and promising for future exploitations of the CSLW-AC material in different industrial fields.展开更多
A versatile and environmentally friendly method for α,α’-bis(substituted ben-zylidene) cycloalkanones has been developed using a heterogeneous catalysis technology. We have synthesized a series of the α,α’-bis(s...A versatile and environmentally friendly method for α,α’-bis(substituted ben-zylidene) cycloalkanones has been developed using a heterogeneous catalysis technology. We have synthesized a series of the α,α’-bis(substituted benzylidene) cycloalkanones, a biologically important class of compounds, via the cross aldol condensation between arylaldehydes and cycloketones using sodium-modified fluorapatite (Na/FAP) as a highly efficient solid catalyst under conventional heating in aqueous media and solventless conditions under microwave. Catalyst reuse, ease of separation of the pure product, and high yields are some of the unique features of this process. Shorter reaction times (4 - 7 min) and higher yields (80% - 94%) were achieved under microwave irradiation conditions.展开更多
To determine the antioxidant activity of the water (WE), methanol (ME), ethanol (EE) and ethyl acetate extracts (EAE) from the leaves of Cistus monspeliensis, several methods such as 1,1-diphenyl-2-picryhydrazyl (DPPH...To determine the antioxidant activity of the water (WE), methanol (ME), ethanol (EE) and ethyl acetate extracts (EAE) from the leaves of Cistus monspeliensis, several methods such as 1,1-diphenyl-2-picryhydrazyl (DPPH) radical-scavenging assay, 2,2’-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical cation decolorization assay, reducing power assay, metal chelating assay, Thiobarbituric acid test (TBARS) and β-carotene linoleic acid system assay were investigated. Because of the important roles of total phenolics and total flavonoids as antioxidants, the amounts of total phenolics and total flavonoids in the extracts were also determined. The WE and ME showed a higher scavenging activity on the DPPH and ABTS radical. Both extracts also exhibited a strong chelating effect on Fe2+ and performed the best in the reducing power assay. On the other hand, the WE and ME were found to have the higher total phenolic contents (23.13 and 23.25 mg GAE/g of extract respectively) and total flavonoid contents (55.08 and 47.77 mg rutin/g of extract respectively). Thus, both extracts are promising alternatives to synthetic substances as food ingredients with antioxidant activity. The ME and the WE showed the similar levels in phenolic content.展开更多
This study aimed to estimate renal effective dose during abdominal CT scans in order to assess the renal risks of cancer and heredity per procedure in Moroccan hospitals. It’s consisted of examining a total of 120 pa...This study aimed to estimate renal effective dose during abdominal CT scans in order to assess the renal risks of cancer and heredity per procedure in Moroccan hospitals. It’s consisted of examining a total of 120 patients referred to three radiology departments for an abdominal CT scan at the rate of 40 per hospital. The data that collected for this diagnostic exam included scanner acquisition parameters, number of series, use of the contrast medium, and rotation time as well as slice thickness, the displayed CT dose index (CTDI<sub>vol)</sub> and the Dose Length Product (DLP). Renal dose, effective dose and biological risks were estimated using the International Commission on Radiological Protection (ICRP) conversion factor. The patients included in this study were an average age of the (46.49 ± 14.16) years and an average weight of (73.34 ± 7.58) kg. For the mean effective dose (<em>E</em>) and average kidney dose (<em>D<sub>K</sub></em>) received per patient during an abdominal CT scan, it were respectively of (6.67 ± 2.73) and (18.26 ± 7.74) mSv. The distribution of these values according to the hospital variable shows a difference in mean effective dose of the order of 0.26, 0.38 and 1.45 mSv and a difference in the mean renal dose of the order of 8.76, 4.94 and 0.48 mSv respectively for H1, H2 and H3. The induction cancer risk of abdominal and kidney per 10<sub>5</sub> procedures was respectively of 3 and 10. The kidney cancer risk by procedure is two to three times more likely than abdominal. For hereditary risk of abdominal and renal exposure per 10<sub>6</sub> procedures, it is 14 and 21 respectively. The renal stochastic effect by procedure is also two to three times more likely than that of the abdomen. Our values are relatively higher than those of published in some previous studies. Cancer risk and heredity estimation highlights the need to limit radiation dose. This first ever survey confirmed the need to improved training of health professionals involved in computed tomography on factors affecting image quality, doses and protocols optimization.展开更多
With regards to an ex-situ conservation plan and program of Moroccan houbara bustards, the genetic diversity of a captive breeding stock of (Chamydotis undulata undulata) was studied and assessed using metapopulationa...With regards to an ex-situ conservation plan and program of Moroccan houbara bustards, the genetic diversity of a captive breeding stock of (Chamydotis undulata undulata) was studied and assessed using metapopulational approaches. The present study aims thus, the description and comparison of various strategies implemented in the species conservation that would conduct to: 1) a better quantification of the gain and loss of genetic diversity of the houbara herd made up of wild and captive populations, and consequently, to 2) a pertinent tracing of conservation and management priorities of the Moroccan avian subspecies.展开更多
Objective:To assess the applicability degree of the international guidelines by Moroccan radiotherapists,in order to improve the management of cervical cancer(CC),since CC is the second most common cancer for women in...Objective:To assess the applicability degree of the international guidelines by Moroccan radiotherapists,in order to improve the management of cervical cancer(CC),since CC is the second most common cancer for women in Morocco.Methods:This cross-sectional study was carried out using a questionnaire sent online to Moroccan radiotherapists.The questionnaire covered participants'characteristics,initial assessment and treatment preparation,techniques and indications for radiotherapy and brachytherapy,dose and indications,as well as on the protocol adopted in the intermediate stages and the location of adjuvant treatments and assessments'follow-up.Results:74 radiotherapists out of 300 have responded to the survey.Only 27.0%of practitioners reported discussing patient records systematically in a multidisciplinary consultation meeting(MCM).For the initial assessment,77.0%requested pelvic magnetic resonance imaging(MRI).It is significantly less requested in regional oncology centers(ROCs)than in university hospital centers(UHCs)or the private sector(P<0.001).Furthermore,Clinicians in ROCs do not have access to new techniques of radiotherapy.In 83.8%of cases,the most prescribed radiotherapy protocols were 45–46 Gy in 1.8–2 Gy per fraction.Three-dimensional gynaecological brachytherapy high-throughput dose guided by dosimetric scanner was available in 75.5%of structures while interstitial gynaecological brachytherapy was only available in 23%of centers.The two most prescribed dose protocols were 47 Gy and 37 Gy in 74.4%and 21.6%of cases,respectively.Finally,monitoring during the first two years was based mainly on pelvic MRI(82.2%)while PET/CT was recommended by only less than 10%.Conclusions:The findings obtained show that our radiotherapists generally comply with international guidelines for the cervical cancer management.However,they should still enhance their practices for the first staging evaluation,the use of systematic MCMs,the doses and treatment techniques used,and the follow-up evaluation.展开更多
<strong>Objective:</strong> <span style="font-family:""><span style="font-family:Verdana;">We introduced two novel hemostatic techniques to achieve hemostasis for postp...<strong>Objective:</strong> <span style="font-family:""><span style="font-family:Verdana;">We introduced two novel hemostatic techniques to achieve hemostasis for postpartum hemorrhage (PPH). The first one (A: Uterus Isthmic Plication) was a new uterine compression suture, which compresses the hysterotomy site. In a severe case, we further added vessel ligation suture after </span><span style="font-family:Verdana;">performing A-suture (B-combination suture: B-suture: A + Wide Lateral Uterine </span><span style="font-family:Verdana;">Vascular Ligation). </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Of 140 PPH cases, 90 were with mild PPH and 40 were with severe PPH. Our policy was: perform A-suture to mild PPH and perform B (combination) to severe PPH. Study was performed during 2018-2019. The primary endpoint to evaluate the efficacy of the</span><span><span style="font-family:Verdana;"> procedures was preserving the uterus (no hysterectomy). </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> A-procedure,</span></span><span style="font-family:Verdana;"> performed to 90 patients with mild PPH, was effective to all 90 patients, with all preserving the uterus. B-procedure, performed 38 patients with severe PPH (excluding two patients with uterine rupture), was effective in 37 patients, with one having undergone hysterectomy due to coagulopathy. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Uterus Isthmic Plication (A-procedure) and addition of Wide Lateral Uterine Vascular Ligation to procedure-A (B-procedure) achieved hemostasis in patients with PPH. Prospective study is necessary to confirm the present data.</span></span>展开更多
Objective:To evaluate the knowledge and practices of Moroccan physicians in terms of radioprotection of patients when prescribing computed tomography(CT)procedures.Methods:This is a cross-sectional study in which a qu...Objective:To evaluate the knowledge and practices of Moroccan physicians in terms of radioprotection of patients when prescribing computed tomography(CT)procedures.Methods:This is a cross-sectional study in which a questionnaire with 23 multiple-choice questions was sent to prescribers of CT examinations such as radiotherapists(RMs),other medical specialists(OMSs),general practitioners(GPs)and residents/interns(R/Is).The first eight questions asked about the demographics of the participants,while the remaining questions asked about knowledge of ionizing radiation examinations,doses received,relative risks,and patient radiation safety training.Results:A total of 223 physicians participated in this survey.Radiation therapists,considered as the reference group,had a better knowledge of irradiating and non-irradiating imaging compared to the other groups(P=0.003).Thus,67%of the reference group declared to take into account the number of scans performed by the patient during the last year,unlike the other groups(P=0.002).Furthermore,the knowledge of the different groups about the risks related to exposure to ionizing radiation was globally low(2%)(P=0.73).Regardless of their specialties and seniority,only 12%of the participants informed the patient at the time of prescription about the risks of X-rays.Finally,only 21%of the participants declared having had training in radiation protection,with no significant differences between the subgroups(P=0.832).Conclusions:The results obtained are similar to those reported in previous studies.They show that Moroccan prescribers have a low level of knowledge of the risks associated with CT examinations.Training on patient radiation protection should be included in the initial curriculum of interns and the continuing professional development of physicians should be reinforced.展开更多
The aim of this review was to examine the theoretical,preclinical and clinical bases of the combination radiotherapy immunotherapy in the management of non-small cell lung cancer(NSCLC).Preclinical studies have shown ...The aim of this review was to examine the theoretical,preclinical and clinical bases of the combination radiotherapy immunotherapy in the management of non-small cell lung cancer(NSCLC).Preclinical studies have shown that in addition to its well-established tumoricidal effects,radiotherapy can activate the host immune system and modify the tumor microenvironment.Immunotherapy is currently part of the therapeutic arsenal of the NSCLC given its capacity to restore the host's immune system's ability to recognize and destroy tumor cells.The combination of radiotherapy and immunotherapy seems to be synergistic,particularly with inhibitors of immune checkpoints.This association has become standard in the metastatic stages and especially in consolidation after radiochemotherapy in the locally advanced,unresectable and stable stages.Several questions remain unanswered including the optimal sequence of this combination,the type of radiotherapy(hypo-fractionated or normofractionated),the association of several immunotherapies and the cross-toxicity of the combination.The association of radiotherapy and immunotherapy is a promising treatment.展开更多
It is predicted that the life cycle,incidence and spread of several infectious diseases will be increasingly and adversely affected by climate change.Morocco,designated as an area of significant impact by numerous rep...It is predicted that the life cycle,incidence and spread of several infectious diseases will be increasingly and adversely affected by climate change.Morocco,designated as an area of significant impact by numerous reports of Intergovernmental Panel on Climate Change,is notably susceptible to such drastic climate-related health consequences.The present work thus examines the increasing risk of vector-borne diseases in hazard-prone localities,while also highlights the current lack of dedicated scientific research in this critical area.It further identifies the severe challenges both of health adaptation to climate change and of consequent policy responses,before providing a more detailed overview of Morocco’s adaptive capacity to such crises.展开更多
Context:The errors made during repetitive patient placements affect significantly the accuracy of treatment and the results of radiotherapy.Objectives:To determine the total,systematic and random error in order to est...Context:The errors made during repetitive patient placements affect significantly the accuracy of treatment and the results of radiotherapy.Objectives:To determine the total,systematic and random error in order to estimate the margin between the Clinical Target Volume(CTV)and the Planning Target Volume(PTV)in the pelvic region.Materials and methods:Set up errors was estimated by superimposing a digitally reconstructed radiograph(DRR)as a reference image with an electronic portal image device(EPID).The total errors in the Medio-Lateral(ML),Cranio-Caudal(CC)and Antero-Posterior(AP)directions were compared by t-test.For systematic and random errors,the ratio of variance(F statistic)was used.Margins were calculated using Van Herk formalis.Results:208 images(80 DRRs and 128 EPIDs)were assessed.The systematic error ranged from 1.93 to 2.01 mm,1.26 to 1.39 mm,and 1.20 to 2.94 mm in the x,y and z-axis,respectively.The random error ranged from 2.33 to 2.90 mm,1.25 to 1.66 mm,and 1.04 to 1.28 mm.The PTV margin according to the Van Herk equation in the x,y and z directions was estimated to be 7.11,4.64 and 3.90 mm for the cervix uteri and a 6.47,4.03,and 3.70 mm for the rectum.Conclusion:The use of weekly EPID/DRR allows estimating the setup of the planning target volume(PTV)expansion according to our configuration.In this study,the evaluated set up margin was approximately 8 mm in the X-axis,5 mm in Y and Z axis for pelvic conformal radiotherapy.展开更多
文摘Artificial intelligence (AI) is revolutionizing the healthcare sector worldwide. In Morocco, several AI applications are being deployed in public and private healthcare establishments, improving appointment management, surgical operations, diagnostics, patient record tracking, biology and radiology, and OR organization. This article explores the main AI applications used in the Moroccan healthcare sector, their frequency of use, the types of establishments adopting them, as well as the main functionalities of each application and its contribution to the sector. The aim of this study is to analyze the impact of the main AI applications on quality of care and process efficiency in Moroccan healthcare facilities. This research focuses on several fundamental questions: Which AI applications are most frequently used? What types of establishments are adopting these technologies, and for which specific functionalities? What are the benefits and challenges of integrating AI into the Moroccan healthcare system, particularly in terms of territorial distribution and accessibility? The methodology is based on a quantitative analysis of data collected from selected healthcare establishments, combined with studies of reports from public health authorities and a sweep of their websites. The results show that 45% of hospitals use AI systems for appointment scheduling and 30% for medical diagnosis. The use of surgical robots, such as the Da Vinci system, increased by 30% between 2020 and 2024. Comparisons with other emerging countries highlight Morocco’s acceptable advances, while underlining the challenges, particularly in terms of the territorial distribution of these technological infrastructures generally centralized in the country’s major cities.
文摘Textile dyes are dramatic sources of pollution and non-aesthetic disturbance of aquatic life and therefore represent a potential risk of bioaccumulation that can affect living species.It is imperative to reduce or eliminate these dyes from liquid effluents with innovative biomaterials and methods.Therefore,this research aims to highlight the performance of Capparis spinosa L waste-activated carbon(CSLW-AC)adsorbent to remove crystal violet(CV)from an aqueous solution.The mechanism of CV adsorption on CSLW-AC was evaluated based on the coupling of experimental data and different characterization techniques.The efficiency of the CSLW-AC material reflected by the equilibrium adsorption capacity of CV could reach more than 195.671 mg·g^(–1) when 0.5 g·L^(–1) of CSLW-AC(Particle size≤250μm)is introduced into the CV of initial concentration of 100 mg·L^(–1) at pH 6 and temperature 65℃ and in the presence of potassium ions after 60 min of contact time according to the one parameter at a time studies.The adsorption behavior of CV on CSLW-AC was found to be consistent with the pseudo-second-order kinetic model and Frumkin's linear isothermal model.The thermodynamic aspects indicate that the process is physical,spontaneous,and endothermic.The optimization of the process by the Box Behnken design of experiments resulted in an adsorption capacity approaching 183.544 mg·g^(–1)([CV]=100 mg·L^(–1) and[CSLW-AC]=0.5 g·L^(–1) at 35 min).The results of the Lactuca sativa seeds germination in treated CV(70%),adsorbent solvent and thermal regeneration(more than 5 cycles),and process cost analysis(1.0484 USD·L^(–1))tests are encouraging and promising for future exploitations of the CSLW-AC material in different industrial fields.
文摘A versatile and environmentally friendly method for α,α’-bis(substituted ben-zylidene) cycloalkanones has been developed using a heterogeneous catalysis technology. We have synthesized a series of the α,α’-bis(substituted benzylidene) cycloalkanones, a biologically important class of compounds, via the cross aldol condensation between arylaldehydes and cycloketones using sodium-modified fluorapatite (Na/FAP) as a highly efficient solid catalyst under conventional heating in aqueous media and solventless conditions under microwave. Catalyst reuse, ease of separation of the pure product, and high yields are some of the unique features of this process. Shorter reaction times (4 - 7 min) and higher yields (80% - 94%) were achieved under microwave irradiation conditions.
文摘To determine the antioxidant activity of the water (WE), methanol (ME), ethanol (EE) and ethyl acetate extracts (EAE) from the leaves of Cistus monspeliensis, several methods such as 1,1-diphenyl-2-picryhydrazyl (DPPH) radical-scavenging assay, 2,2’-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical cation decolorization assay, reducing power assay, metal chelating assay, Thiobarbituric acid test (TBARS) and β-carotene linoleic acid system assay were investigated. Because of the important roles of total phenolics and total flavonoids as antioxidants, the amounts of total phenolics and total flavonoids in the extracts were also determined. The WE and ME showed a higher scavenging activity on the DPPH and ABTS radical. Both extracts also exhibited a strong chelating effect on Fe2+ and performed the best in the reducing power assay. On the other hand, the WE and ME were found to have the higher total phenolic contents (23.13 and 23.25 mg GAE/g of extract respectively) and total flavonoid contents (55.08 and 47.77 mg rutin/g of extract respectively). Thus, both extracts are promising alternatives to synthetic substances as food ingredients with antioxidant activity. The ME and the WE showed the similar levels in phenolic content.
文摘This study aimed to estimate renal effective dose during abdominal CT scans in order to assess the renal risks of cancer and heredity per procedure in Moroccan hospitals. It’s consisted of examining a total of 120 patients referred to three radiology departments for an abdominal CT scan at the rate of 40 per hospital. The data that collected for this diagnostic exam included scanner acquisition parameters, number of series, use of the contrast medium, and rotation time as well as slice thickness, the displayed CT dose index (CTDI<sub>vol)</sub> and the Dose Length Product (DLP). Renal dose, effective dose and biological risks were estimated using the International Commission on Radiological Protection (ICRP) conversion factor. The patients included in this study were an average age of the (46.49 ± 14.16) years and an average weight of (73.34 ± 7.58) kg. For the mean effective dose (<em>E</em>) and average kidney dose (<em>D<sub>K</sub></em>) received per patient during an abdominal CT scan, it were respectively of (6.67 ± 2.73) and (18.26 ± 7.74) mSv. The distribution of these values according to the hospital variable shows a difference in mean effective dose of the order of 0.26, 0.38 and 1.45 mSv and a difference in the mean renal dose of the order of 8.76, 4.94 and 0.48 mSv respectively for H1, H2 and H3. The induction cancer risk of abdominal and kidney per 10<sub>5</sub> procedures was respectively of 3 and 10. The kidney cancer risk by procedure is two to three times more likely than abdominal. For hereditary risk of abdominal and renal exposure per 10<sub>6</sub> procedures, it is 14 and 21 respectively. The renal stochastic effect by procedure is also two to three times more likely than that of the abdomen. Our values are relatively higher than those of published in some previous studies. Cancer risk and heredity estimation highlights the need to limit radiation dose. This first ever survey confirmed the need to improved training of health professionals involved in computed tomography on factors affecting image quality, doses and protocols optimization.
文摘With regards to an ex-situ conservation plan and program of Moroccan houbara bustards, the genetic diversity of a captive breeding stock of (Chamydotis undulata undulata) was studied and assessed using metapopulational approaches. The present study aims thus, the description and comparison of various strategies implemented in the species conservation that would conduct to: 1) a better quantification of the gain and loss of genetic diversity of the houbara herd made up of wild and captive populations, and consequently, to 2) a pertinent tracing of conservation and management priorities of the Moroccan avian subspecies.
文摘Objective:To assess the applicability degree of the international guidelines by Moroccan radiotherapists,in order to improve the management of cervical cancer(CC),since CC is the second most common cancer for women in Morocco.Methods:This cross-sectional study was carried out using a questionnaire sent online to Moroccan radiotherapists.The questionnaire covered participants'characteristics,initial assessment and treatment preparation,techniques and indications for radiotherapy and brachytherapy,dose and indications,as well as on the protocol adopted in the intermediate stages and the location of adjuvant treatments and assessments'follow-up.Results:74 radiotherapists out of 300 have responded to the survey.Only 27.0%of practitioners reported discussing patient records systematically in a multidisciplinary consultation meeting(MCM).For the initial assessment,77.0%requested pelvic magnetic resonance imaging(MRI).It is significantly less requested in regional oncology centers(ROCs)than in university hospital centers(UHCs)or the private sector(P<0.001).Furthermore,Clinicians in ROCs do not have access to new techniques of radiotherapy.In 83.8%of cases,the most prescribed radiotherapy protocols were 45–46 Gy in 1.8–2 Gy per fraction.Three-dimensional gynaecological brachytherapy high-throughput dose guided by dosimetric scanner was available in 75.5%of structures while interstitial gynaecological brachytherapy was only available in 23%of centers.The two most prescribed dose protocols were 47 Gy and 37 Gy in 74.4%and 21.6%of cases,respectively.Finally,monitoring during the first two years was based mainly on pelvic MRI(82.2%)while PET/CT was recommended by only less than 10%.Conclusions:The findings obtained show that our radiotherapists generally comply with international guidelines for the cervical cancer management.However,they should still enhance their practices for the first staging evaluation,the use of systematic MCMs,the doses and treatment techniques used,and the follow-up evaluation.
文摘<strong>Objective:</strong> <span style="font-family:""><span style="font-family:Verdana;">We introduced two novel hemostatic techniques to achieve hemostasis for postpartum hemorrhage (PPH). The first one (A: Uterus Isthmic Plication) was a new uterine compression suture, which compresses the hysterotomy site. In a severe case, we further added vessel ligation suture after </span><span style="font-family:Verdana;">performing A-suture (B-combination suture: B-suture: A + Wide Lateral Uterine </span><span style="font-family:Verdana;">Vascular Ligation). </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Of 140 PPH cases, 90 were with mild PPH and 40 were with severe PPH. Our policy was: perform A-suture to mild PPH and perform B (combination) to severe PPH. Study was performed during 2018-2019. The primary endpoint to evaluate the efficacy of the</span><span><span style="font-family:Verdana;"> procedures was preserving the uterus (no hysterectomy). </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> A-procedure,</span></span><span style="font-family:Verdana;"> performed to 90 patients with mild PPH, was effective to all 90 patients, with all preserving the uterus. B-procedure, performed 38 patients with severe PPH (excluding two patients with uterine rupture), was effective in 37 patients, with one having undergone hysterectomy due to coagulopathy. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Uterus Isthmic Plication (A-procedure) and addition of Wide Lateral Uterine Vascular Ligation to procedure-A (B-procedure) achieved hemostasis in patients with PPH. Prospective study is necessary to confirm the present data.</span></span>
文摘Objective:To evaluate the knowledge and practices of Moroccan physicians in terms of radioprotection of patients when prescribing computed tomography(CT)procedures.Methods:This is a cross-sectional study in which a questionnaire with 23 multiple-choice questions was sent to prescribers of CT examinations such as radiotherapists(RMs),other medical specialists(OMSs),general practitioners(GPs)and residents/interns(R/Is).The first eight questions asked about the demographics of the participants,while the remaining questions asked about knowledge of ionizing radiation examinations,doses received,relative risks,and patient radiation safety training.Results:A total of 223 physicians participated in this survey.Radiation therapists,considered as the reference group,had a better knowledge of irradiating and non-irradiating imaging compared to the other groups(P=0.003).Thus,67%of the reference group declared to take into account the number of scans performed by the patient during the last year,unlike the other groups(P=0.002).Furthermore,the knowledge of the different groups about the risks related to exposure to ionizing radiation was globally low(2%)(P=0.73).Regardless of their specialties and seniority,only 12%of the participants informed the patient at the time of prescription about the risks of X-rays.Finally,only 21%of the participants declared having had training in radiation protection,with no significant differences between the subgroups(P=0.832).Conclusions:The results obtained are similar to those reported in previous studies.They show that Moroccan prescribers have a low level of knowledge of the risks associated with CT examinations.Training on patient radiation protection should be included in the initial curriculum of interns and the continuing professional development of physicians should be reinforced.
文摘The aim of this review was to examine the theoretical,preclinical and clinical bases of the combination radiotherapy immunotherapy in the management of non-small cell lung cancer(NSCLC).Preclinical studies have shown that in addition to its well-established tumoricidal effects,radiotherapy can activate the host immune system and modify the tumor microenvironment.Immunotherapy is currently part of the therapeutic arsenal of the NSCLC given its capacity to restore the host's immune system's ability to recognize and destroy tumor cells.The combination of radiotherapy and immunotherapy seems to be synergistic,particularly with inhibitors of immune checkpoints.This association has become standard in the metastatic stages and especially in consolidation after radiochemotherapy in the locally advanced,unresectable and stable stages.Several questions remain unanswered including the optimal sequence of this combination,the type of radiotherapy(hypo-fractionated or normofractionated),the association of several immunotherapies and the cross-toxicity of the combination.The association of radiotherapy and immunotherapy is a promising treatment.
文摘It is predicted that the life cycle,incidence and spread of several infectious diseases will be increasingly and adversely affected by climate change.Morocco,designated as an area of significant impact by numerous reports of Intergovernmental Panel on Climate Change,is notably susceptible to such drastic climate-related health consequences.The present work thus examines the increasing risk of vector-borne diseases in hazard-prone localities,while also highlights the current lack of dedicated scientific research in this critical area.It further identifies the severe challenges both of health adaptation to climate change and of consequent policy responses,before providing a more detailed overview of Morocco’s adaptive capacity to such crises.
基金We thank the staff at Regional Center of Oncology of Agadir for their help during data collections.No authors received funding for this research study.
文摘Context:The errors made during repetitive patient placements affect significantly the accuracy of treatment and the results of radiotherapy.Objectives:To determine the total,systematic and random error in order to estimate the margin between the Clinical Target Volume(CTV)and the Planning Target Volume(PTV)in the pelvic region.Materials and methods:Set up errors was estimated by superimposing a digitally reconstructed radiograph(DRR)as a reference image with an electronic portal image device(EPID).The total errors in the Medio-Lateral(ML),Cranio-Caudal(CC)and Antero-Posterior(AP)directions were compared by t-test.For systematic and random errors,the ratio of variance(F statistic)was used.Margins were calculated using Van Herk formalis.Results:208 images(80 DRRs and 128 EPIDs)were assessed.The systematic error ranged from 1.93 to 2.01 mm,1.26 to 1.39 mm,and 1.20 to 2.94 mm in the x,y and z-axis,respectively.The random error ranged from 2.33 to 2.90 mm,1.25 to 1.66 mm,and 1.04 to 1.28 mm.The PTV margin according to the Van Herk equation in the x,y and z directions was estimated to be 7.11,4.64 and 3.90 mm for the cervix uteri and a 6.47,4.03,and 3.70 mm for the rectum.Conclusion:The use of weekly EPID/DRR allows estimating the setup of the planning target volume(PTV)expansion according to our configuration.In this study,the evaluated set up margin was approximately 8 mm in the X-axis,5 mm in Y and Z axis for pelvic conformal radiotherapy.
