Sacroiliites infectieuses dans le centre tunisien: étude rétrospective de 25 cas

Les sacroiliites infectieuses sont rares mais peuvent se compliquer de séquelles fonctionnelles invalidantes. L’objectif de cette étude était de écrire les caractéristiques cliniques et bactériologiques des sacroiliites infectieuses chez les patients suivis à Sousse, Centre Tunisien. Etude rétrospective, descriptive, des cas de sacroiliites infectieuses chez les patients hospitalisés à Sousse entre 2000 et 2015. Le diagnostic a été retenu devant des signes cliniques, d’imagerie, et microbiologiques évocateurs. Vingt-cinq patients, 10 hommes et 15 femmes, d’âge moyen 41 ans (19-78) ont été inclus. Les sacroiliites étaient dues à des bactéries pyogènes dans 14 cas (56%), brucelliennes dans 6 cas (24%), et tuberculeuses dans 5 cas (20%). La durée moyenne d’évolution était de 61, 45 et 402 jours respectivement. Les signes cliniques les plus fréquents étaient les douleurs fessières (92%) et la fièvre (88%). La radiographie standard était anormale dans 75% des cas. La TDM et l’IRM sacro-iliaques dans tous les cas. Le diagnostic a été confirmé bactériologiquement dans 24 cas (96%). La durée moyenne d’antibiothérapie était de 83 jours dans les sacroiliites à pyogènes, et de 102 jours dans les SI brucelliennes. L’évolution était favorable chez 12 patients (48%), 9 patients (36%) ont gardé une douleur sacro-iliaque séquellaire, et 4 patients (16%) sont décédés. Dans notre étude, la durée d’évolution de la sacroiliite infectieuse ne permettait pas de prédire la bactérie responsable, d’où la nécessité d’obtenir une documentation bactériologique afin de prescrire une antibiothérapie appropriée.Pan African Medical Journal 2016; 2

Facial cellulitis revealing choreo-acanthocytosis: A case report

We report a 62 year-old-man with facial cellulitis revealing choreo-acanthocytosis (ChAc). He showed chorea that started 20 years ago. The orofacial dyskinisia with tongue and cheek biting resulted in facial cellulitis. The peripheral blood smear revealed acanthocytosis of 25%. The overall of chorea, orofacial dyskinetic disorder, peripheral neuropathy, disturbed behavior, acanthocytosis and the atrophy of caudate nuclei was suggestive of a diagnosis of ChAc. To our knowledge no similar cases of facial cellulitis revealing choreo-acanthocytosis  (ChAc) were found in a review of the literature.Key words: Choreo-acanthocytosis, facial cellulitis, dyskinetic movement

Correlation between superficial and intra-operative specimens in diabetic foot infections: results of a cross-sectional Tunisian study

Objective: To determine the correlation between superficial, and intra-operative specimens in diabetic foot infections (DFIs). Methods: We conducted a cross-sectional study in patients with DFIs hospitalized in a Tunisian teaching hospital. Superficial specimens were collected for all patients, and intra-operative specimens were collected in operated patients. The specimens were processed using standard microbiology techniques. Antimicrobial susceptibility testing was carried out according to the protocol established by the European Committee on Anti-microbial Susceptibility Testing. Intra-operative and superficial specimens were considered correlated if they isolated the same microorganism(s), or if they were both negative. Results: One hundred twelve patients, 81 males and 31 females, mean age 56 years, were included. Superficial samples were positive in 77% of cases, and isolated 126 microorganisms. Among the positive samples, 71% were monomicrobial. The most frequently isolated microorganisms were Enterobacteriaceae (53%), followed by streptococci (21%) and Staphylococcus aureus (17%). Nine microorganisms (7%) were multi-drug resistant. Intra-operative samples were positive in 93% of cases. Superficial specimens were correlated to intra-operative specimens in 67% of cases. Initial antibiotic therapy was appropriate in 70% of cases. The lower-extremity amputation and the mortality rates were 41% and 1%, respectively. Conclusion: In our study, DFIs were most frequently caused by Enterobacteriaceae and superficial specimens were correlated to intra-operative specimens in only two thirds of cases. Clinicians should emphasize on the systematic practice of intraoperative specimens in all patients with DFIs treated surgically, while well-performed superficial specimens could be useful for prescribing appropriate antibiotic therapy in other patients

Surveillance of sensitive fenced areas using duty-cycled wireless sensor networks with asymmetrical links

© 2018 Elsevier Ltd. This paper presents a cross-layer communication protocol for Wireless Sensor Network (WSN) enabled surveillance system for sensitive fenced areas, e.g., nuclear/oil site. Initially, the proposed protocol identifies the boundary nodes of the deployed WSN to be used as sentinel nodes, i.e., nodes that are always in active state. The remaining nodes are used as duty-cycled relay nodes during the data communication phase. The boundary nodes identification process and data routing are both performed using an enhanced version of the Greedy Perimeter Stateless Routing (GPSR) protocol, which relies on a Non Unit Disk Graph (N-UDG) and referred to as GPSR over Symmetrical Links (GPSR-SL). Both greedy and perimeter modes of GPSR-SL forward data through symmetrical links only. Moreover, we apply the Mutual Witness (MW) fix to the Gabriel Graph (GG) planarization, to enable a correct perimeter routing on a N-UDG. Simulation results show that the proposed protocol achieves higher packet delive ry ratio by up to 3.63%, energy efficiency and satisfactory latency when compared to the same protocol based on the original GPSR

Etude des rapports des agriculteurs bretons à leur territoire

*INRA, Unité Science du sol et Bioclimatologie, 65 rue de St-Brieuc, 35042 Rennes cedex Diffusion du document : INRA, Unité Science du sol et Bioclimatologie, 65 rue de St-Brieuc, 35042 Rennes cede