F. Mghirbi - Academia.edu (original) (raw)
Papers by F. Mghirbi
E-Posters, 2021
Methods There are no current standards against which to audit the departments learning curve for ... more Methods There are no current standards against which to audit the departments learning curve for adoption of sentinel lymph node mapping as endometrial cancer staging. We identified published quality indicators for sentinel lymph node mappingincluding <5% false negative rate, >20 cases per surgeon performing the procedure, successful bilateral mapping in >50% of cases. Our local gynae oncology database was searched to identify all cases of sentinel lymph node dissection for endometrial and cervical cancer. Data from the gynae oncology database and the patients electronic clinical record was then collated and analysed using excel. Results 43 patients were identified having undergone a sentinel lymph node biopsy ± lymphadenectomy for endometrial or cervical cancer. Bilateral sentinel lymph nodes were mapped in 67.4% of cases. In the first 21/43 patients 57.1% were mapped, comparative to 77.3% in latter 22/43 patients. 38 sides with successful lymph node mapping and lymphadenectomy were identified. Sentinel lymph nodes had a 33% sensitivity for identifying lymph node metastasis in the first half of the data set comparative to 100% in the latter half. Conclusions The data demonstrated a significant learning curve, within the department, in the successful mapping of sentinel lymph nodes in endometrial cancer.
Annals of Oncology, 2020
Background: Between 13 March 2020 – date of national lockdown and passing to a third level nation... more Background: Between 13 March 2020 – date of national lockdown and passing to a third level national alert- and 11 May –first day of progressive release- confirmed cases rose from 24 to 1035 cases 46 deaths Knowing that oncology health workers are treating cancer patients who have a higher risk of complication due to COVID-19, strict measures were applied Understanding the psychological impact of the COVID-19 outbreak among health care workers is crucial in guiding policies and interventions to maintain their psychological well-being Methods: Health care workers in oncology were invited to participate with a self-administered questionnaire In addition to information on demographic characteristics and medical history, the questionnaire included the validated Patient Health Questionnaire -9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) and the Insomnia Severity Index Results: Of 100 health workers invited, 48 (48%) participated in the study;baseline characteristics are shown in the Table Eleven (22 9%) participants screened positive for anxiety, 37 (77 1%) for mild to moderately severe depression, 7 (14 6%) for severe depression, noting that 14 (29 3%) are at risk of self-harm at least on several days 15(31 3%) participants are suffering from clinical insomnia and one (2 1%) from severe insomnia The prevalence of depression was higher among nonmedical health care workers than medical personnel (76 2% versus 44 4% moderate to severe depression) Similarly, higher anxiety level were amongst paramedical staff (38 1% versus 11 1% for medical staff) 16 Participants (33 4%) suffer from clinical insomnia with higher numbers among non-medical staff (42 9% versus 25 9% for medical staff) [Formula presented] Conclusions: As the pandemic continues, important clinical and policy strategies are needed to support health care workers Our study identified a vulnerable group susceptible to psychological distress Early psychological intervention for this target group may be beneficial Legal entity responsible for the study: The authors Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest
La Tunisie medicale, 2018
La Tunisie medicale, 2017
Sao Paulo Medical Journal, 2001
Late breaking abstracts, 2021
The aim of this study was to elaborate a new algorithm, based on serum CA125, HE4 and age, to ass... more The aim of this study was to elaborate a new algorithm, based on serum CA125, HE4 and age, to assess the risk of malignancy in premenopausal patients with pelvic mass Methodology The training dataset included 284 premenopausal patients operated because of presence of pelvic mass, out of which 35 and 249 had malignant and benign disease respectively. A novel algorithm, based on serum HE4, CA125 and patient's age as variables, has been developed by using the scenario of discrimination "benign diseases versus all stages of epithelial ovarian cancer (EOC) together with borderline ovarian tumors (BOT) FIGO stage 1c2-3c". This algorithm was named Risk of Ovarian Cancer Kazan Index (ROCK-I). The validating dataset consisted of consecutively operated premenopausal patients with pelvic mass out of which there were 187 cases of benign diseases, 20 EOC and 4 BOT FIGO stage 1c2-3c. An analysis with inclusion of BOT stage 1a-1c1 and non-EOC will be reported separately. Result(s)* In the validating dataset the specificities of ROCK-I and ROMA were 92% and 85% respectively (p<0.05). When the above-mentioned scenario of discrimination was used the sensitivities of ROCK-I and ROMA were 95.8% and 91.7% respectively, accuracies 92.4 and 85.8%, positive predictive values 60.5% and 44% respectively. Areas under receiveroperating-characteristic curves (ROC-AUC) of ROCK-I, ROMA and CA125 were 0.984, 0.94 and 0.901 respectively. The difference in ROC-AUC between ROCK-I and CA125 was statistically significant (p=0.03). A more detailed comparison of the performance of algorithms is shown in table 1 and figure 1.
Urology Case Reports, 2021
Testicular metastases in colorectal cancer are rare, and pathogenesis still remains unclear. It t... more Testicular metastases in colorectal cancer are rare, and pathogenesis still remains unclear. It tends to occur in late stage of disease and has a poor prognosis. We present a 37-year-old patient complained from abdominal pain with deterioration of performance status and weight loss. Body scan showed a recto sigmoid tumor associated with metastasis in the left liver with pelvic lymphadenopathy and hetero nodular testis. Colonoscopy showed a stenosing upper rectum tumor. Histology concluded to an adenocarcinoma. The patient had a transverse colon resection and a right orchiectomy. Histology concluded to an invasive adenocarcinoma with carcinosis, secondary testicular and hepatic metastasis.
E-Posters, 2021
Methods There are no current standards against which to audit the departments learning curve for ... more Methods There are no current standards against which to audit the departments learning curve for adoption of sentinel lymph node mapping as endometrial cancer staging. We identified published quality indicators for sentinel lymph node mappingincluding <5% false negative rate, >20 cases per surgeon performing the procedure, successful bilateral mapping in >50% of cases. Our local gynae oncology database was searched to identify all cases of sentinel lymph node dissection for endometrial and cervical cancer. Data from the gynae oncology database and the patients electronic clinical record was then collated and analysed using excel. Results 43 patients were identified having undergone a sentinel lymph node biopsy ± lymphadenectomy for endometrial or cervical cancer. Bilateral sentinel lymph nodes were mapped in 67.4% of cases. In the first 21/43 patients 57.1% were mapped, comparative to 77.3% in latter 22/43 patients. 38 sides with successful lymph node mapping and lymphadenectomy were identified. Sentinel lymph nodes had a 33% sensitivity for identifying lymph node metastasis in the first half of the data set comparative to 100% in the latter half. Conclusions The data demonstrated a significant learning curve, within the department, in the successful mapping of sentinel lymph nodes in endometrial cancer.
Annals of Oncology, 2020
Background: Between 13 March 2020 – date of national lockdown and passing to a third level nation... more Background: Between 13 March 2020 – date of national lockdown and passing to a third level national alert- and 11 May –first day of progressive release- confirmed cases rose from 24 to 1035 cases 46 deaths Knowing that oncology health workers are treating cancer patients who have a higher risk of complication due to COVID-19, strict measures were applied Understanding the psychological impact of the COVID-19 outbreak among health care workers is crucial in guiding policies and interventions to maintain their psychological well-being Methods: Health care workers in oncology were invited to participate with a self-administered questionnaire In addition to information on demographic characteristics and medical history, the questionnaire included the validated Patient Health Questionnaire -9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) and the Insomnia Severity Index Results: Of 100 health workers invited, 48 (48%) participated in the study;baseline characteristics are shown in the Table Eleven (22 9%) participants screened positive for anxiety, 37 (77 1%) for mild to moderately severe depression, 7 (14 6%) for severe depression, noting that 14 (29 3%) are at risk of self-harm at least on several days 15(31 3%) participants are suffering from clinical insomnia and one (2 1%) from severe insomnia The prevalence of depression was higher among nonmedical health care workers than medical personnel (76 2% versus 44 4% moderate to severe depression) Similarly, higher anxiety level were amongst paramedical staff (38 1% versus 11 1% for medical staff) 16 Participants (33 4%) suffer from clinical insomnia with higher numbers among non-medical staff (42 9% versus 25 9% for medical staff) [Formula presented] Conclusions: As the pandemic continues, important clinical and policy strategies are needed to support health care workers Our study identified a vulnerable group susceptible to psychological distress Early psychological intervention for this target group may be beneficial Legal entity responsible for the study: The authors Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest
La Tunisie medicale, 2018
La Tunisie medicale, 2017
Sao Paulo Medical Journal, 2001
Late breaking abstracts, 2021
The aim of this study was to elaborate a new algorithm, based on serum CA125, HE4 and age, to ass... more The aim of this study was to elaborate a new algorithm, based on serum CA125, HE4 and age, to assess the risk of malignancy in premenopausal patients with pelvic mass Methodology The training dataset included 284 premenopausal patients operated because of presence of pelvic mass, out of which 35 and 249 had malignant and benign disease respectively. A novel algorithm, based on serum HE4, CA125 and patient's age as variables, has been developed by using the scenario of discrimination "benign diseases versus all stages of epithelial ovarian cancer (EOC) together with borderline ovarian tumors (BOT) FIGO stage 1c2-3c". This algorithm was named Risk of Ovarian Cancer Kazan Index (ROCK-I). The validating dataset consisted of consecutively operated premenopausal patients with pelvic mass out of which there were 187 cases of benign diseases, 20 EOC and 4 BOT FIGO stage 1c2-3c. An analysis with inclusion of BOT stage 1a-1c1 and non-EOC will be reported separately. Result(s)* In the validating dataset the specificities of ROCK-I and ROMA were 92% and 85% respectively (p<0.05). When the above-mentioned scenario of discrimination was used the sensitivities of ROCK-I and ROMA were 95.8% and 91.7% respectively, accuracies 92.4 and 85.8%, positive predictive values 60.5% and 44% respectively. Areas under receiveroperating-characteristic curves (ROC-AUC) of ROCK-I, ROMA and CA125 were 0.984, 0.94 and 0.901 respectively. The difference in ROC-AUC between ROCK-I and CA125 was statistically significant (p=0.03). A more detailed comparison of the performance of algorithms is shown in table 1 and figure 1.
Urology Case Reports, 2021
Testicular metastases in colorectal cancer are rare, and pathogenesis still remains unclear. It t... more Testicular metastases in colorectal cancer are rare, and pathogenesis still remains unclear. It tends to occur in late stage of disease and has a poor prognosis. We present a 37-year-old patient complained from abdominal pain with deterioration of performance status and weight loss. Body scan showed a recto sigmoid tumor associated with metastasis in the left liver with pelvic lymphadenopathy and hetero nodular testis. Colonoscopy showed a stenosing upper rectum tumor. Histology concluded to an adenocarcinoma. The patient had a transverse colon resection and a right orchiectomy. Histology concluded to an invasive adenocarcinoma with carcinosis, secondary testicular and hepatic metastasis.