Le carcinome indifférencié des glandes salivaires

Le carcinome indifferencie primitif des glandes salivaires est rare. Son association avec le virus Epstein Barr, initialement decrite chez les esquimaux, est retrouvee dans la majorite des cas publies. Nous rapportons un nouveau cas tunisien survenu chez un homme age de 64 ans, revele par une tumefaction de la glande parotide gauche. Microscopiquement se discutait le caractere primitif ou secondaire de la tumeur, etaye par les examens complementaires. Le patient etait traite par une parotidectomie suivie d’un curage ganglionnaire et d’une radiotherapie. L’evolution etait favorable apres un an de recul.  Mots clès : Glande salivaire- Carcinome indifferencie- Virus Epstein Bar

Anticardiolipin Autoantibodies as Useful Biomarkers for the Prediction of Mortality in Septic Patients

Background. The detection of antiphospholipid antibodies (aPL) is of interest because of their importance in the pathogenesis of arterial or venous thrombosis. They could be a “second hit” of an inflammatory event such as infection. The aim of our study was to assess the performance of antiphospholipid antibody biomarker to predict in-hospital mortality in intensive care unit (ICU) septic patients. Methods. We conducted a prospective single-center observational study including consecutive critically ill septic adults admitted to the intensive care unit. Clinical and laboratory data including enzyme-linked immunosorbent assay for antiphospholipid antibodies (anticardiolipin (aCL), antiphosphatidylserine (aPS)) were obtained. Blood samples were collected on days 1, 3, 5, 8, and 10 of hospitalization. The primary study endpoint was ICU mortality defined as death before ICU discharge. Secondary end points included correlation between SOFA score and biological parameters. Results. A total of 53 patients were enrolled. 18.8% of patients were aPL positive. In-hospital mortality rate was 60%. Multivariate analysis showed that age and aCL at days 3 and 5 along with SOFA at day 3 were independent outcome predictors. A significant positive correlation existed between SOFA at days 3, 5, and 8 and antiphospholipid antibody concentrations. Conclusions. Our data showed that antiphospholipid was useful biomarkers for the prediction of mortality in critically ill septic patients. We found a positive correlation between SOFA score and antiphospholipid antibodies