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Coastal lagoons are highly dynamic and physically complicated systems. They are environmentally productive and socio-economically valuable. Contemporary global development and management pressures require a better understanding of their dynamics and sustainability. The present study focuses on the problem of water confinement in the Oualidia lagoon (Atlantic coast of Morocco). This lagoon is characterized by an asymmetric tidal propagation, with a shorter duration of the flood (rising tide) than the ebb (falling tide). In the long term, this contributes to the reduction of depths and the confinement of water upstream. After extensive studies, a sediment trap was created in 2011 to trap the finest sediment in the upstream part of the lagoon. This study aims to analyze the morphodynamical and sedimentological changes in the lagoon of Oualidia, after the sediment trap dredging. For this purpose, bathymetric surveys covering 6 years between 2006 and 2012 were analyzed, providing sufficient data to identify the morphological changes that the lagoon has undergone during this period. The data analysis was followed by a study of the lagoon bed dynamics using profile lines extracted from the bathymetric data in a GIS environment. As a result, the findings partly show that over 6 years, an average height of +0.65 m was gained by the lagoon, while the average change in the eroded areas was estimated to be −0.42 m. In addition, the eroded area in the lagoon was estimated to be about 1,513,800 m2 with an erosion volume of 633,383 m3, while the accumulated area found was about 2,699,396 m2 with an accumulation volume of 1,765,866 m3. These changes can be related to the large input of marine sediment, mainly caused by tidal currents and waves, but also to the creation of a sediment trap in the upstream area of the lagoon. [ABSTRACT FROM AUTHOR]

This study focuses on morpho-sedimentary changes in the bay of Safi (Atlantic coast of Morocco), due to a progressive extension of the port. For this purpose, several bathymetric and sedimentary surveys carried out by the Hydrographic and Oceanographic Service of the Navy (SHOM) in 1892, 1906 and 1940 respectively, coupled with a bathymetric and sedimentary measurement mission in 2009, were analyzed to understand the impact of the port developments on the bottom of Safi Bay. This analysis consists of making maps of the evolution of (i) sedimentary facies (of different dates 1892, 1906, 1940 and 2009) and (ii) the shallow seabed of the three periods 1892–1906, 1906–1940 and 1940–2009. The sedimentary facies maps show that the facies appear unstable and evolve intermittently in response to environmental changes in the bay (port construction and expansion). In addition, the overlay of the bathymetric maps indicates that the bay has undergone changes (lowering, stability, and raising) controlled by hydrodynamic conditions before, during, and even after harbor construction. Analysis of the data showed that the expansion of the port often reshaped the morphology of the bay's seabed. The consequences of these evolutions are the appearance of the fattening or the erosion of the bank and the filling of small depressions of sediments. This evolution is reflected in the modification of the funds near the port and the beach of Safi. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and usefulness of (99m)Tc-sestamibi scintigraphy and gamma probe localization of parathyroid glands in patients with primary hyperparathyroidism and establish radio-guided minimally invasive parathyroidectomy at Hussain Makki Al Jumma Center for Specialized Surgery, Kuwait. Subjects and Methods: Twelve patients with primary hyperparathyroidism (mean age: 48 +/- 14 years; median age: 46 years; age range: 29-68 years) were evaluated. The diagnosis of hyperparathyroidism was established by elevated serum calcium and parathyroid hormone levels. All patients had a well-defined parathyroid lesion on previous standard (99m)Tc-sestamibi scintigraphy with or without ultrasound study. All had a normal thyroid gland, no history of familial hyperparathyroidism or multiple endocrine neoplasia nor any history of previous neck irradiation. On the day of surgery, patients were injected with 740 MBq (20 mCi) of (99m)Tc -sestamibi followed by a half-hour-delayed single standard pinhole view of the neck. A skin marker was placed on the basis of maximum count intensity during gamma probe localization. Patients were then sent for radio-guided minimally invasive parathyroidectomy. Results: The preoperative localization of the affected gland was successful in all cases using a gamma probe and (99m)Tc -sestamibi scintigraphy. The pathological parathyroid tissue was localized and successfully removed with the gamma probe. The histopathological diagnosis was parathyroid adenoma in 11 cases and hyperplasia in the remaining one. All patients remained disease and symptom free at 12-month follow-up. Conclusions: Our initial experience with intraoperative use of a gamma probe to carry out minimally invasive parathyroidectomy was a useful, easy and safe procedure for treating patients with primary hyperparathyroidism. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and usefulness of 99mTc-sestamibi scintigraphy and gamma probe localization of parathyroid glands in patients with primary hyperparathyroidism and establish radio-guided minimally invasive parathyroidectomy at Hussain Makki Al Jumma Center for Specialized Surgery, Kuwait. Subjects and Methods: Twelve patients with primary hyperparathyroidism (mean age: 48 ± 14 years; median age: 46 years; age range: 29–68 years) were evaluated. The diagnosis of hyperparathyroidism was established by elevated serum calcium and parathyroid hormone levels. All patients had a well-defined parathyroid lesion on previous standard 99mTc-sestamibi scintigraphy with or without ultrasound study. All had a normal thyroid gland, no history of familial hyperparathyroidism or multiple endocrine neoplasia nor any history of previous neck irradiation. On the day of surgery, patients were injected with 740 MBq (20 mCi) of 99mTc -sestamibi followed by a half-hour-delayed single standard pinhole view of the neck. A skin marker was placed on the basis of maximum count intensity during gamma probe localization. Patients were then sent for radio-guided minimally invasive parathyroidectomy. Results: The preoperative localization of the affected gland was successful in all cases using a gamma probe and 99mTc -sestamibi scintigraphy. The pathological parathyroid tissue was localized and successfully removed with the gamma probe. The histopathological diagnosis was parathyroid adenoma in 11 cases and hyperplasia in the remaining one. All patients remained disease and symptom free at 12-month follow-up. Conclusions: Our initial experience with intraoperative use of a gamma probe to carry out minimally invasive parathyroidectomy was a useful, easy and safe procedure for treating patients with primary hyperparathyroidism. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Ethnopharmacological Relevance: The harsh dry environment of the Badia region in Jordan harbors many valuable plant species that are well known to be used by the local Bedouins (Bedu) for medicinal purposes. An ethnobotanical study was conducted as a part of the local knowledge study which was carried out in 2010. The target participants were livestock owners in the arid Jordanian Badia region., Aim of the Study: The objective of the study was to document traditional knowledge in using wild plants to treat health problems in order to conserve this valuable knowledge from loss; to identify the key plant species used; and to calculate the Informant Consensus Factor (ICF) for each category of health disorder, the Fidelity Level (FL%) and the Use Value (UV) of the plant species used by the Bedouin., Materials and Methods: The data was collected by interviewing 80 participants whom were interviewed face to face of whom 21% were women. The team designed a questionnaire that helped in the data gathering, and also recorded the procedures used by the local communities on video., Results: A total of 47 plant species are used by local Bedouins for medicinal purposes. The majority of these species are native to the study area, for example: Artemisia judaica, Citrullus colocynthis, Ecballium elaterium and Rheum palaestinum. The study showed that the plant species with the highest UV is Artemisia herba-alba and that Ducrosia flabellifolia is a remarkable native plant species with a high FL% in curing dental pain. Moreover, the highest value of ICF was scored for dental disorders, followed by gastrointestinal disorders, and jaundice which may indicate the high incidental occurrences of these diseases and/or the lack of dental care services in the rural areas., Conclusion: The study showed an agreement of the local Bedouins on using certain plant species, particularly natives in their dry surroundings, in treating certain health disorders. Some plants showed high use values and fidelity levels to treat certain health problem. Further investigation should be carried out in Jordan on the pharmaceutical value and production practices of these native medicinal plants that have very low water requirements in a country with extreme water shortages., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Purpose: To assess Blood Oxygen Level-Dependent (BOLD) Magnetic Resonance Imaging (MRI) for noninvasive preoperative prediction of Microvascular Invasion (MVI) in Hepatocellular Carcinoma (HCC)., Materials and Methods: In this prospective, institutional review board approved study, 26 patients (21 men and 5 women age range, 34-77 years with mean age of 61 years) with HCC were evaluated preoperatively with liver MRI including baseline and post oxygen (O2) breathing BOLD MRI. Post processing of MRI data was performed to obtain R2* values (1/s) and correlated with histopathological assessment of MVI. Statistical analysis was performed to assess correlation of baseline R2*, post O2 R2* and R2* ratios to presence of MVI in HCC by binary logistic regression analysis., Results: MVI was present in 15/26 (58%) of HCC on histopathology. The mean R2* values ± SD at baseline and post O2 with and without MVI were 35 ± 12, 36 ± 12, 38 ± 10, 42 ± 17. The R2* values between the groups with and without MVI were not significantly different statistically., Conclusion: BOLD MRI is unable to accurately predict MVI in HCC. The noninvasive preoperative MRI detection of MVI in HCC remains elusive., (Copyright © 2012 Wiley Periodicals, Inc.)

Aim: To determine predictors of clinical outcome following percutaneous transluminal angioplasty (PTA) in elderly patients with below knee atherosclerotic lesions causing intermittent claudication (IC) or critical limb ischaemia (CLI)., Materials and Methods: Over 7.5 years, 76 patients (CLI 72%, n = 55) underwent below knee PTA. The composite end-point of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up which was defined as clinical failure, need for subsequent endovascular or surgical revascularization or amputation. Actuarial freedom from MACO was assessed using Kaplan-Meier curves and multivariable Cox proportional hazards regression., Results: IC was improved in 95% at mean 3.4 years (range 0.5-108 months). Successful limb salvage and ulcer healing were seen in 73% with CLI. Most failures were in the CLI group (27% CLI vs. 5% IC), with an amputation rate of 16% for CLI vs. 5% for IC and persistent ulceration in 24% of CLI. Significant independent predictors of MACO were ulceration (hazard ratio 4.02, 95% CI = 1.55-10.38) and family history of atherosclerosis (hazard ratio 2.53, 95% CI = 1.1-5.92)., Conclusion: Primary below knee PTA is a feasible therapeutic option in this elderly population. Limb ulceration and family history of atherosclerosis may be independent predictors of adverse outcome., (Copyright © 2009. Published by Elsevier Ireland Ltd.)

Purpose: The clinical importance of angiographically detected asymptomatic lower-limb stenoses and occlusions is unknown. This study aims to (i) assess the clinical outcome of asymptomatic lesions in the lower limb, (ii) identify predictors of clinical deterioration, and (iii) determine which asymptomatic lower-limb lesions should be treated at presentation., Materials and Methods: All 918 patients undergoing peripheral angiography with or without angioplasty over a period of 7.5 years (January 1999 through June 2006) at a single institution were retrospectively evaluated. One hundred twenty-two patients (54% men; mean age, 70.3 years; age range, 41-91 y) with angiographic stenoses (> or =50%) or occlusions on the asymptomatic leg were included. The composite endpoint of interest was major adverse clinical outcome (MACO) of the asymptomatic limb at clinical follow-up, which was defined as the development of intermittent claudication (IC), critical limb ischemia (CLI), or need for subsequent endovascular or surgical revascularization. Actuarial freedom from MACO was assessed with Kaplan-Meier curves and multivariable Cox proportional-hazards regression., Results: During a 4.2-year mean follow-up in 122 patients with significant concomitant asymptomatic disease, 32.8% of patients developed symptoms (13.9% with IC, 18.9% with CLI); 42.5% of these cases required revascularization. Cox regression revealed two independent predictors of MACO on the asymptomatic side: contralateral below-knee amputation (BKA; hazard ratio, 2.93; 95% CI, 1.21-7.10; P = .01) and statin treatment (hazard ratio, 3.56; 95% CI, 1.56-8.13; P = .003)., Conclusions: Asymptomatic peripheral angiographic stenoses and occlusions become symptomatic in one third of patients, necessitating treatment in 13.9% overall. Previous contralateral BKA and statin use were independent predictors of adverse outcome in this population. Close clinical follow-up and appropriate risk factor modification are recommended.

Purpose: To determine the clinical outcomes and success rates after percutaneous subintimal angioplasty (SIA) in patients with lower-limb occlusive lesions causing intermittent claudication (IC) or critical limb ischemia (CLI) at midterm to long-term follow-up. The secondary aim was to elicit factors predictive of a successful outcome., Materials and Methods: Between January 1999 and June 2006, 75 consecutive patients (45 men; age range, 46-91 years; CLI in 79%) underwent SIA of iliac and infrainguinal (84%) occlusions. Outcomes were determined on an intent-to-treat basis. The composite endpoint of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up, which was defined as the development of IC, CLI, or need for subsequent endovascular or surgical revascularization. Actuarial freedom from MACO was assessed via Kaplan-Meier curves and multivariable Cox proportional-hazards regression., Results: SIA was performed on 75 lesions, with an initial procedure success rate of 83% (n = 62). Procedure failure was caused by heavily calcified lesions (n = 5) and failure of reentry (n = 8). A total of 56.3% of patients with claudication were free from ipsilateral claudication at follow-up (mean, 32 months; range, 1-64 months), and those with CLI had a 79.7% limb salvage rate at a mean follow-up of 30.7 months (range, 0.5-91 months). On Cox regression analysis, the following variables were identified as independent predictors of MACO within the limb treated with SIA: ABI after SIA (hazard ratio, 0.21; 95% CI, 0.05-0.89; P = .035) and number of patent runoff vessels (ie, /=2; hazard ratio, 0.29; 95% CI, 0.15-0.59; P = .001)., Conclusions: SIA is a feasible therapeutic option for occlusive atherosclerotic lesions in IC and CLI and is the evolving preferred strategy in CLI and perhaps IC with long-segment occlusions.