Les Ethmoidites Aigues Exteriorisees De L\'enfant Etude De 11 Observations

Les ethmoïdites sont les sinusites les plus fréquentes chez l\'enfant de moins de 3 ans. La gravité de cette affection est liée à l\'extériorisation orbito-oculaire et endocrânienne de l\'infection. But : Analyser les caractéristiques clinico- radiologiques et thérapeutiques de cette affection. Patients et méthodes : Il s\'agit d\'une étude rétrospective portant sur 11 enfants hospitalisés pour ethmoïdite aigue, dans le service de pédiatrie du CHU Farhat Hached de Sousse, durant une période de 6 ans. Résultats : L\'âge moyen de nos patients était de 4 ans et 1/2, ils se répartissaient en 8 filles et 3 garçons. Le délai de consultation était de trois jours en moyenne. La fièvre et l\'oedème palpébral étaient deux critères constants chez tous nos patients. L\'atteinte était unilatérale dans neuf cas, et bilatérale dans deux cas. La TDM éthmoïdo-orbitaire et cérébrale, réalisée pour tous les patients, nous a permis de confirmer le diagnostic et de préciser l\'extension locorégionale. Une cellulite préseptale, une cellulite orbitaire, un abcès sous périosté étaient retrouvées, dans trois cas et une collection orbitaire dans les deux autres. Une bithérapie (céfotaxime-fosfomycine) était prescrite de première intention chez 10 patients. La metronidazole a été associée dans 3 cas Un drainage chirurgical était réalisé chez quatre patients. L\'évolution était favorable dans tous les cas. Conclusion : contenu de la gravité et les germes rencontrés dans cette affection, l\'antibiothérapie de première intention doit être large, précoce et intensive. Le recours au drainage est impératif en cas de collection orbitaire.Acute ethmoiditis are bacterial infections of ethmoid sinuses, which may spread to the orbital or the endocranial spaces.They are the most frequent among bacterial sinusitis before 3 years. Population and methods:Our study is retrospective, it included all children hospitalized in our pediatric unit from 2000 to 2006 for an acute ethmoiditis. We analyzed clinical and radiological presentations, and discussed therapeutic modalities used to treat this pathology. Results:Over this 6-years period, 11 children (mean age 4.5 years) where hospitalized for acute ethmoïdites.They were 3 boy and 8 girls. All patients presented with high fever and palpabral oedems. Etmoïditis was unilateral in 9 Children and bilateral in two. Ethmoïdio-orbital CT scan confirmed acute ethmoïdis, the cerebral one assessed intra-cranial diffusion. The acute ethmoidis was complicated with, preseptal cellulites in three cases, orbital cellulitis in three cases, subperiostal abscess in three others and orbital collection in two patients. Most children received an association of cefotaxisme and fosfomycemie for a mean duration of 13 days. Metronidazole was associated to the previous antibiotherapy in three cases. Four patients, required surgical treatment in addition to antibiotherapy.All children saw favorable out come. Conclusion:It is always difficult to found the bacteria responsible for an acute ethmoiditis. The first antibiotic therapy must be chosen to be effective in the most frequently responsible bacteria tacking in consideration the potentiel severity of this sinusitis. Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 16 2006: pp. 22-2

Mucormycose Otocerebrale: À Propos D\'un Cas

La mucormycose est une affection mycosique rare mais souvent fatale, survenant sur des terrains débilités. Elle est due à la prolifération de champignons cosmopolites de la famille de mucorales. Elle entraîne des lésions délabrantes et extensives des parties molles avec risque de thromboses vasculaires. Observation : nous rapportons l\'observation d\'une petite fille, âgée de 3 ans , issue d\'un mariage consanguin, hypotrophe, hospitalisée pour otite externe évoluant depuis 3 semaines. La patiente a bénéficié d\'une antromastoidectomie et a été mise sous antibiotiques. Devant une aggravation de l\'état local, avec extension de la nécrose et destruction du conduit auditif externe, une infection mycosique est fortement suspectée, sur un terrain particulier de déficit immunitaire probable. L\'examen parasitologique d\'un prélèvement local a mis en évidence la présence de filaments mycéliens dont la culture a isolé un Rhizopus oryzae, confirmé aussi par l\'étude anatomopathologique. L\'exploration de l\'immunité a mis en évidence un déficit de l\'immunitaire céllulaire.Un traitement par amphotéricine B était mal toléré (choc anaphylactique), l\'évolution spontanée était rapidement défavorable avec une extension locorégionale importante et une thrombophlébite du sinus latéral homolatéral, aboutissement au décés. Conclusion : la localisation oto cérebrale de la mucormycose est exeptionnelle, on doit y penser devant une otite externe maligne sur un terrain particulier. La prise en charge doit être urgente afin d\'augmenter les chances de survie.Mucormycosis is a relatively rare, potentially life-threatening, fungal infection. It occurs predominately in immunocompromised hosts. Vascular invasion, thrombosis and rapid ischemic necrosis of infected tissue are the most characteristic features of this pathology. Early diagnosis and consequently effective treatment are needed to save life in this fatal condition. Report: We report a case of otocerebral mucormycosis occurring in an hypotrophic 3-years old girl suffering from language retardation and chronic diarrhea. Immune system\'s exploration revealed a profound cell-mediated immunity defect. The diagnosis was suspected because of the rapidly extensive necrosis of the external ear conduct, the existence of lateral sinus thrombosis and the resistance to an aggressive antibiotic therapy.The diagnosis was confirmed by identifying Rhizopus oryzae by pathological examination of the necrotic tissue. Treatment by intravenous amphotericin B was certainly lately begun and unfortunately complicated by anaphylactic shock. Because no alternative drug was possible, such as liposomal amphotericin B, the girl rapidly died. Conclusion: Otocerebral mucormycosis is extremely rare.It must be considered when ear lesions are necrotic and rapidly extensive mainly in patients with predisposing conditions. Successful treatment requires tissue excision and early injection of amphotericin B, preferably in its liposomal presentation. Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 16 2006: pp. 42-4

Gene Classification Based on Amino Acid Motifs and Residues: The DLX (distal-less) Test Case

BACKGROUND:Comparative studies using hundreds of sequences can give a detailed picture of the evolution of a given gene family. Nevertheless, retrieving only the sequences of interest from public databases can be difficult, in particular, when working with highly divergent sequences. The difficulty increases substantially when one wants to include in the study sequences from many (or less well studied) species whose genomes are non-annotated or incompletely annotated. METHODOLOGY/PRINCIPAL FINDINGS:In this work we evaluate the usefulness of different approaches of gene retrieval and classification, using the distal-less (DLX) gene family as a test case. Furthermore, we evaluate whether the use of a large number of gene sequences from a wide range of animal species, the use of multiple alternative alignments, and the use of amino acids aligned with high confidence only, is enough to recover the accepted DLX evolutionary history. CONCLUSIONS/SIGNIFICANCE:The canonical DLX homeobox gene sequence here derived, together with the characteristic amino acid variants here identified in the DLX homeodomain region, can be used to retrieve and classify DLX genes in a simple and efficient way. A program is made available that allows the easy retrieval of synteny information that can be used to classify gene sequences. Maximum likelihood trees using hundreds of sequences can be used for gene identification. Nevertheless, for the DLX case, the proposed DLX evolutionary is not recovered even when multiple alignment algorithms are used

Consumer perceptions of co-branding alliances: Organizational dissimilarity signals and brand fit

This study explores how consumers evaluate co-branding alliances between dissimilar partner firms. Customers are well aware that different firms are behind a co-branded product and observe the partner firms’ characteristics. Drawing on signaling theory, we assert that consumers use organizational characteristics as signals in their assessment of brand fit and for their purchasing decisions. Some organizational signals are beyond the control of the co-branding partners or at least they cannot alter them on short notice. We use a quasi-experimental design and test how co-branding partner dissimilarity affects brand fit perception. The results show that co-branding partner dissimilarity in terms of firm size, industry scope, and country-of-origin image negatively affects brand fit perception. Firm age dissimilarity does not exert significant influence. Because brand fit generally fosters a benevolent consumer attitude towards a co-branding alliance, the findings suggest that high partner dissimilarity may reduce overall co-branding alliance performance

Isolation and characterization of non-Frankia actinobacteria from root nodules of alnus glutinosa, casuarina glauca and elaeagnus angustifolia

Actinobacterial isolates randomly obtained on nitrogen-free BAP medium from surface sterilized root nodules of Alnus glutinosa, Casuarina glauca and Elaeagnus angustifolia sampled from fields were reported. They were assigned on the basis of partial 16S rRNA sequences to Micromonospora, Nocardia and Streptomyces genera. The isolates have been screened for hydrolytic activities, indole acetic acid (IAA) and siderophores production, phosphate solubilization and antagonistic activities. Results suggest putative traits as plant growth promoting bacteria proprieties of the isolates that occur in unique association in root nodules of the three analysed actinorhizal host species. © Springer Science+Business Media B.V. 2009