Prise en charge des complications orbitaires et endocrâniennes des sinusites bacteriennes aiguës

Les complications orbitaires et endocrâniennes des sinusites aiguës infectieuses posent un problème diagnostique et thérapeutique Le but de notre travail est de proposer un algorithme de prise en charge de ces complications à travers une revue de littérature Les sinusites de la base du crâne (frontal, sphénoïdal et éthmoïdal) sont les plus fréquents en cause de complications endocrâniennes. Les atteintes orbitaires sont le plus souvent consécutives à des sinusites éthmoïdales chez l’enfant et fronto-maxillaires chez l’adulte. L’imagerie joue un rôle important dans le diagnostic précoce et précis de ces affections et pour guider le traitement. Le traitement du foyer sinusien est systématique aussi bien pour les complications orbitaires ou endocrâniennes si l’indication chirurgicale est retenue. Les complications orbitaires sont traitées par des antibiotiques visant les bactéries en cause avec des indications chirurgicales selon la classification scannographique de Chandler. Le traitement est désormais plus conservateur notamment pour l’abcès sous périosté. Pour les complications endocrâniennes le traitement est basé sur un traitement médical antibiotique. Le geste chirurgical serait fait en fonction du résultat de l’imagerie. Le pronostic est amélioré actuellement grâce à la précocité du diagnostic, ainsi qu’aux progrès rapportés dans le domaine de la chirurgie endonasaleMots clés : sinusite, complications orbitaires, complications endocrâniennes, imagerie, antibiotique, chirurgieOrbital and intracranial complications of acute infectious sinusitis (SIA) pose a diagnostic and therapeutic problem. The aim of our work is to provide an algorithm support these complications through literature review. Sinusitis the base of the skull (frontal, ethmoid and sphenoid) are more involved in intracranial complications. Orbital sufferers are most often secondary to ethmoidal sinusitis in children and fronto -maxillary adults. The imaging plays an important role in the early and accurate diagnosis of these diseases and to guide treatment. The treatment of sinus home is also good for the systematic orbital or intracranial complications if surgical indication is retained. Orbital complications are treated with antibiotics for the bacteria involved with some surgical indications according to CT scan classification Chandler. The treatment is now more conservative including subperiosteal abscess. Intracranial complications for treatment are based on medical treatment and between other antibiotic. The surgical procedure was done according to the result of imaging The prognosis is currently improved with early diagnosis, and the progress reported in the field of endonasal surgeryKeywords: sinusitis, orbital complications, intracranial complications, imagery, Antibiotic, surger

Interval Slopes as Numerical Abstract Domain for Floating-Point Variables

The design of embedded control systems is mainly done with model-based tools such as Matlab/Simulink. Numerical simulation is the central technique of development and verification of such tools. Floating-point arithmetic, that is well-known to only provide approximated results, is omnipresent in this activity. In order to validate the behaviors of numerical simulations using abstract interpretation-based static analysis, we present, theoretically and with experiments, a new partially relational abstract domain dedicated to floating-point variables. It comes from interval expansion of non-linear functions using slopes and it is able to mimic all the behaviors of the floating-point arithmetic. Hence it is adapted to prove the absence of run-time errors or to analyze the numerical precision of embedded control systems

Evidence for surface uplift of the Atlas Mountains and the surrounding peripheral plateaux: Combining apatite fission-track results and geomorphic indicators in the Western Moroccan Meseta (coastal Variscan Paleozoic basement)

This work represents an initial attempt to link the evolution of the topography in relation to the general tectonic framework of western Morocco. For this purpose, in a section of the Western Moroccan Meseta different tools are combined in order to attain the general objective. Apatite fission-track (AFT) data of granitic rocks of the Rabat–Khenifra area give ages around 200 Ma with track length distributions which are compatible with the thermal models already established for the area. An inverse correlation between AFT ages and elevation is observed which is compatible with previous models indicating northward tilting of the whole Western Moroccan Meseta which is younger than 20–25 Ma. In order to test this possibility a detailed analysis of the topography at different scales in the Western Moroccan Meseta has been performed. Results indicate that two open folds with different amplitudes are recognized and that the one with wider wavelength could correspond to a lithospheric fold as previously stated by other authors on the basis of independent geological arguments. The northward tilting proposed based on the AFT data agrees with the results obtained in the analysis of the topography which reinforces the presence of a very open fold with a wavelength of 200–300 km in the north-western limb of the Western Moroccan Meseta

A molecular mechanism of artemisinin resistance in Plasmodium falciparum malaria

Artemisinins are the cornerstone of anti-malarial drugs. Emergence and spread of resistance to them raises risk of wiping out recent gains achieved in reducing worldwide malaria burden and threatens future malaria control and elimination on a global level. Genome-wide association studies (GWAS) have revealed parasite genetic loci associated with artemisinin resistance. However, there is no consensus on biochemical targets of artemisinin. Whether and how these targets interact with genes identified by GWAS, remains unknown. Here we provide biochemical and cellular evidence that artemisinins are potent inhibitors of Plasmodium falciparum phosphatidylinositol-3-kinase (PfPI3K), revealing an unexpected mechanism of action. In resistant clinical strains, increased PfPI3K was associated with the C580Y mutation in P. falciparum Kelch13 (PfKelch13), a primary marker of artemisinin resistance. Polyubiquitination of PfPI3K and its binding to PfKelch13 were reduced by the PfKelch13 mutation, which limited proteolysis of PfPI3K and thus increased levels of the kinase, as well as its lipid product phosphatidylinositol-3-phosphate (PI3P). We find PI3P levels to be predictive of artemisinin resistance in both clinical and engineered laboratory parasites as well as across non-isogenic strains. Elevated PI3P induced artemisinin resistance in absence of PfKelch13 mutations, but remained responsive to regulation by PfKelch13. Evidence is presented for PI3P-dependent signalling in which transgenic expression of an additional kinase confers resistance. Together these data present PI3P as the key mediator of artemisinin resistance and the sole PfPI3K as an important target for malaria elimination