On the Use of Embedded Fiber Optic Sensors for Measuring Early-Age Strains in Concrete.

Detailed information about concrete behavior in real structures is an important issue in controlling its performance during its service life, and the use of embedded sensors to obtain desired information such as temperature, onset of the cracking process and evolution of strains, has gained the attention of the building concrete industry. Data obtained using this technology can provide valuable information for decision making about the need for corrective interventions that can ensure the integrity and safety of concrete structures for long period of time. This paper presents a review of the current state-of-the-art of embedded fiber optic sensors used to assess concrete information of a wide range of aspects, comprising: existing alternative technologies, characteristics and advantages, practical applications and future developments. Complementarily, the work presents preliminary results of the use of fiber optic sensors to automatically and continuously perform expansion readings of AAR in concrete elements that facilitate both the storage-with elimination of the usual interruptions for manual readings-and the availability of continuous results of expansion data that are not possible to obtain with usual AAR tests code reading recommendations.

Toxic epidermal necrolysis in a female with metastatic breast cancer treated with vinorelbine.

Vinorelbine is an anticancer agent with high clinical efficacy for the treatment of metastatic breast cancer. Toxic epidermal necrolysis is a rare but serious cutaneous adverse reaction associated with drug therapy. We hereby present a case report of a patient with metastatic breast cancer, treated with vinorelbine, who developed toxic epidermal necrolysis. To the best of our knowledge, ours is the second case report describing this exceptional dermatologic emergency associated with vinorelbine. In June 2014, a 33-year-old female was treated for localized breast cancer. In December 2016, a brain magnetic resonance imaging revealed cerebral and cerebellar recurrence of the breast cancer. Whole brain radiation therapy was administered and treatment with vinorelbine was subsequently initiated. On day 3 of the first cycle of chemotherapy, she presented a general malaise and an itchy rash with conjunctivitis, oral ulcers and diffuse alopecia. The clinical diagnosis was toxic epidermal necrolysis due to vinorelbine. The patient was transferred to the burn unit. Treatment with intravenous steroids, topical steroids and desloratadine was initiated. She subsequently developed Staphylococcus aureus bacteremia and died of multi-organ failure. Toxic epidermal necrolysis is an extremely rare, acute hypersensitivity reaction involving the skin and mucous membranes. Features more suggestive of toxic epidermal necrolysis are acute onset and rapid worsening of painful lesions of the skin and mucous membranes. Specific treatment with active interventions should be practiced in the context of an international and multicentre clinical study in order to give sufficient power for such trials in this rare disease.

La vinorelbine est un agent anticancéreux très efficace dans le cancer du sein métastatique. La nécrolyse épidermique toxique est un effet indésirable médicamenteux cutané rare mais grave. Nous présentons le cas d'une patiente avec un cancer du sein métastatique traité par vinorelbine, qui a développé une nécrolyse épidermique toxique. A notre connaissance, c'est le deuxième cas de la nécrolyse épidermique toxique due à la vinorelbine. En juin 2014, une femme de 33 ans a été traitée pour un cancer mammaire localisé. En décembre 2016, elle a présenté des métastases cérébrales et cérébelleuses. Une radiothérapie encéphalique a été administrée puis un traitement par vinorelbine a été initié. Au troisième jour du premier cycle de chimiothérapie, elle a présenté un malaise général et une éruption cutanée avec démangeaisons accompagnée de conjonctivite, d'ulcères buccaux et d'alopécie diffuse. Le diagnostic était en faveur de la nécrolyse épidermique toxique à la vinorelbine. La patiente a été transférée à l'unité de brûlure et a reçu des stéroïdes intraveineux et locaux et la desloratadine. Elle a ensuite développé une bactériémie à Staphylococcus aureus et est décédée d'une défaillance multiviscérale. La nécrolyse épidermique toxique est une réaction d'hypersensibilité aiguë extrêmement rare touchant la peau et les muqueuses. Elle est évoquée devant l'apparition aiguë et l'aggravation rapide de lésions douloureuses de la peau et des muqueuses. Un traitement spécifique avec des interventions actives doit être recherché dans le cadre d'une étude internationale et multicentrique, afin de donner assez de puissance à de tels essais dans cette maladie rare.

FOLFOX as Perioperative Chemotherapy of localized Gastric Cancer: Efficacy and Tolerance.

BACKGROUND: Use of perioperative chemotherapy had significantly improved prognosis of localized gastric cancer. Two studies have validated this approach using cisplatin based chemotherapy despite important toxicities. We conducted this study with the aim to evaluate efficacy and toxicity of FOLFOX regimen in this setting. MATERIAL AND METHODS: This is a retrospective study including patients followed for gastric cancer in the Oncology Department of the military hospital Mohamed V in Rabat, Morocco over a period of 7 years from 2007 to 2013. Patients received 4 cycles of mFOLFOX as perioperative regimen. Assessment of tumor response after completion of preoperative chemotherapy was granted by comparative CT scan, tumor markers measurements and R0 surgery rate.Adverse events were graded according to classification of the National Cancer Institute Common Toxicity Criteria version 4.0. RESULTS: Thirty-one patients were included in this study. Use of preoperative chemotherapy showed partial response in fourteen patients (45.1%), stabilization in fifteen patients (48.4%). Tumor markers CEA and CA 19- 9 were significantly decreased. R0 resection rate was 83.87%. Only 2 (6.45%) cases of grade 3/4 hematologic toxicity were reported in our study. Achieving programmed postoperative chemotherapy was possible in 72.41% of patients. CONCLUSIONS: Our study is limited by the retrospective design and small sample size but FOLFOX chemotherapy seems effective and well tolerated in this setting and its place deserves to be studied in a larger study.

Endometrial stromal sarcoma: prognostic factors and impact of adjuvant therapy in early stages.

BACKGROUND AND OBJECTIVES: Endometrial stromal sarcomas (ESS) are rare uterine neoplasms. surgery remains the cornerstone of treatment for early stages and consists of an abdominal hysterectomy with bilateral salpingo-oopherectomy. Despite appropriate surgical treatment, relapse rates are high (18% to 45%) and the value of adjuvant therapies is not clear. We evaluated prognostic factors and the impact of adjuvant treatment on localized ESS (stages I and II). DESIGN AND SETTING: Retrospective, case-control study conducted at the National Institute Of Oncology in Rabat, Morocco over 10 years from 2000 to 2009. PATIENTS AND METHODS: twenty-one cases of localized ESS were included in the analysis. RESULTS: standard surgery was performed in 71.4% of our patients. Myometrial invasion was noted in 57.1% of cases. Mitotic activity was considered high in five patients. Adjuvant treatment was given to 52.3% of patients: endocrine therapy in five patients and radiotherapy in six. Survival was significantly longer in the group of patients who underwent standard surgical treatment (P=.0007), in the absence of deep myometrial invasion (P=.0248) in cases with a low mitotic index (P<.0001) and in patients who received adjuvant therapy (hormone or radiotherapy) (P=.0048). In a multivariate analysis independent risk factors for monitoring were inadequate surgical treatment and absence of adjuvant treatment. CONCLUSIONS: Myometrial invasion and mitotic index appear to be important prognostic factors. the reference surgery is hysterectomy with bilateral salpingo-oopherectomy. Lymph node dissection does not appear to provide a benefit. finally adjuvant treatment may carry a significant survival benefit.

[Cardiac safety of trastuzumab in adjuvant: a review across 53 observations]. / Tolérance cardiaque du trastuzumab en adjuvant: revue à travers 53 observations.

Trastuzumab has been a revolution in the treatment of breast cancer overexpressing HER. Its use as an adjuvant for a period of 1 year is currently an international standard. Its major toxicity is cardiac, where the systematic monitoring of the LVEF before and during treatment. To evaluate the cardiac safety for our patients, we conducted this retrospective case-control study. The average in LVEF before the start of trastuzumab was 62.5% (51-80), and at the end of treatment 60.55 (40-77), a decrease in absolute value by 2%. This difference is statistically significant with P<0.001. Eighty-three percent of our patients have completed treatment, of whom 26.4% with a provisional arrest because of a regressive fall in LVEF. A final arrest has been made in 17% cases due to either a nonregressive reduction in LVEF or the appearance of symptomatic heart failure found in two patients. Analysis of risk factors toxicity found in this group of patients with a cardiotoxicity persisting an average age and average number of treatments received anthracyclines higher than the rest of our sample, and diminished baseline LVEF. But all these differences were not statistically significants. During the period of monitoring of these patients, six (67%) had spontaneous recovery of their LFEV 5 months ± 2.01 after discontinuation of trastuzumab. For two cases of symptomatic heart failure, they had a clinical improvement under medical treatment in February but is still less than 40%. The cardiac safety in our study seems comparable with the literature data but located in the upper range of levels of toxicity. The lack of statistical power of our study does not exclude a greater cardiac toxicity of trastuzumab among Moroccan women and should prompt a more cautious use of this drug and the achievement of larger studies that could answer this question.