Complications orbitaires de la polypose nasosinusienne de l’enfant

La polypose nasosinusienne (PNS) est une pathologie rare chez l’enfant. La symptomatologie clinique est habituellement celle de l’adulte. Exceptionnellement, une complication locorégionale lui est révélatrice. A travers deux observations de PNS diagnostiquées suite à une complication orbitaire, on discute les particularités cliniques de cette entité ainsi que ses implications thérapeutiques. Il s’agissait de deux enfants âgés de 13 ans ayant été hospitalisés pour une exophtalmie unilatérale d’apparition aiguë. L’examen clinique a découvert une PNS surinfectée évoquant alors le diagnostic de complication orbitaire d’origine infectieuse, confirmé par l’imagerie. Le traitement a associé un drainage chirurgical d’urgence de l’abcès orbitaire par voie externe paracanthale interne, suivi par une corticothérapie locale. L’ethmoïdectomie a été nécessaire dans un cas. L’évolution était favorable dans les deux cas avec une stabilisation de la PNS et une absence de signes de récidive de l’infection orbitaire

Restriction-based Fragmentation of Business Processes over the Cloud

Despite the elasticity and pay-per-use benefits of cloud computing (aka fifth utility computing), organizations adopting clouds could be locked-into single cloud providers, which is not always a “pleasant” experience when these providers stop operations. This is a serious concern for those organizations that who would like to deploy (core) business processes on the cloud along with tapping into these 2 benefits. To address the lock-into concern, this paper proposes an approach for decomposing business processes into fragments that would run over multiple clouds and hence, multiple providers. To develop fragments, the approach considers both restrictions over ownersof business processes and potential competition among cloud providers.Onthe one hand, restrictions apply to each task in a business process and are specialized into budget to allocate, deadline to meet, and exclusivity to request. On the other hand, competition leads cloud providers to offer flexible pricing policies that would cater to the needs and requirements of each process owner. A policy handles certain clouds’ properties referred to as limitedness, non-renewability, and nonshareability that impact the availability of cloud resources and hence, the whole fragmentation. For instance, a non- shareable resource could delay other processes, should the current process do not release this resource on time. During fragmentation interactions between owners of processes and providers of clouds happen according to 2 strategies referred to as global and partial. The former collects offers about cloud resources from all providers, while the latter collects such details from particular providers. To evaluate these strategies’ pros and cons, a system implementing them as well as demonstrating the technical feasibility of the fragmentation approach using credit-application case study, is also presented in the paper. The system extends BPMN2- modeler Eclipse plugin and supports interactions of processes’ owners with clouds’ providers that result to identifying the necessary fragments with focus on cost optimization

Atypical hemolytic uremic syndrome: A monocentric adult Tunisian study and review of literature

Atypical hemolytic uremic syndrome (aHUS) is characterized by microvascular thrombosis resulting in thrombocytopenia, hemolytic anemia, and multiorgan dysfunction. It is associated with genetic or acquired disorders of regulatory components of the complement system. For our study, we collected data from 16 patients diagnosed with aHUS between January 2010 and January 2014. The mean age was 33.6 years. The female-to-male ratio was 3. The median follow-up duration was 27 ± 3.5 months. The most common clinical presentation was hypertension. Renal involvement was noted in all cases. Ten patients had extrarenal manifestations. Semi-quantitative dysfunction of the alternative pathway of complement was found in all cases. A genetic study was not available for our patients. During the acute stage, all patients received plasma therapy, and among them, seven required dialysis and five were still on dialysis at the time of discharge. One patient underwent renal transplantation. None of our patients received eculizumab perfusion. The renal survival was inversely correlated to young age (5 mg/dL (P = 0.02). Mortality rate was significantly correlated to young age (<30 years old) (P = 0.01). Collecting multicentric data on adult patients with aHUS will enable better characterization of the spectrum of adult aHUS in our country and the evaluation of current treatments and different outcomes

New Rheumatoid Arthritis Genetic Factor and C5 Serum Level

International audienc

PTPN22 R620W Polymorphism Is Not Associated with Pemphigus

International audienc