Carcinome epidermoïde du larynx chez la femme

Le cancer du larynx est assez rare chez la femme. Cependant, il risque d’être en recrudescence à cause de l’augmentation du tabagisme féminin. Peu de travaux se sont consacrés à rechercher les spécificités du cancer du larynx chez la femme.But: Analyser le profil épidémiologique et clinique des femmes porteuses d’un carcinome épidermoïde du larynx et dégager les caractéristiques thérapeutiques, évolutives et les facteurs pronostiques chez cette population.Méthodes: étude rétrospective portant sur 50 femmes prises en charge pour un carcinome épidermoïde du larynx sur une période de treize ans (1994-2006).Résultats : L’âge moyen de nos patientes était de 63,5 ans. L’intoxication tabagique était retrouvée chez 32,6% des patientes. Chez 30% de nos patientes aucun facteur de risque n’a été retrouvé. Les signes cliniques étaient dominés par la dysphonie suivie de la dyspnée et la dysphagie. Les tumeurs prenaient naissanceau dépend de l’étage glottique dans 55,8% des cas. Nous avons relevé que 60,4% des tumeurs étaient vus à un stade évolué T3-T4 et que 95,3% des tumeurs étaient initialement classées N0. La chirurgie a été pratiquée chez 47,5% des patientes tandis que 16,2% ont reçu une radio-chimiothérapie. La survie globale cumulée était de 78,8% à 3 ans et de 73,5% à 5 ans.Conclusion : L’absence des facteurs de risque classiques chez un grand nombre de nos patientes laisse supposer le rôle d’autres facteurs étiopathogéniques dans la genèse du cancer du larynx chez la femme. Toute dysphonie chez la femme doit être explorée même en l’absence de facteurs de risque. La prise en charge et le pronostic semblent superposables à celui de l’homme.Mots clés : Tumeur – Larynx – Femme – Epidémiologie – TabagismeLaryngeal cancer is quite uncommun in women. However, it may be on the rise due to the increase in smoking among women. Few studies have been devoted to find the specifics of laryngeal cancer in women.Purpose: to analyze the epidemiological and clinical profile of squamous cell carcinoma of the larynx in women, and to identify therapeutic characteristics and prognostic factors in this population.Methods: retrospective study of 50 womens treated for squamous cell carcinoma of the larynx over a period of thirteen years (1994- 2006).Results: The mean age of our patients was 63.5 years. The tobacco abuse was found in 32.6% of patients. In 30% of our patients no risk factors were found. Clinical signs were dominated by dysphonia followed by dyspnea and dysphagia. Primary tumor was localized in glottis in 55.8% of cases. We found that 60.4% of tumors were seen at an advanced stage T3-T4 and 95.3% of the tumors were initially classified N0. The surgery was performed in 47.5% of patients, while 16.2% received chemoradiotherapy. The cumulative overall survival was 78.8% at 3 years and 73.5% at 5 years.Conclusion: The absence of conventional risk factors in a large number of our patients suggests the role of other etiologic factors in the genesis of laryngeal cancer in women. Every dysphonia in women should be explored even in the absence of risk factors. The  management and prognosis seem congruent with that of man.Key words: Tumor-larynx-women-epidemiology-smokin

Pyocele du cornet moyen : a propos d’un cas

Introduction : Les mucocèles sont des formations kystiques bénignes mais expansives, tapissées par un épithélium respiratoire, sans connexion avec les cavités sinusiennes ou nasales. Elles se développent le plus souvent dans le complexe ethmoïdofrontal. Le terme pyocèle correspond à une mucocèle dont le contenu est infecté. La localisation turbinale moyenne est exceptionnelle.Observation : Nous rapportons l’observation d’un patient âgé de 75 ans qui se plaignait d’une obstruction nasale chronique gauche. L’examen clinique montrait un cornet moyen élargi obstruant la totalité de la fosse nasale gauche. L’Imagerie (TDM et IRM) a révélée une formation ovalaire d’allure kystique expansive développée aux dépens du cornet moyen, associée à un polype postérieur. Le diagnostic de mucocèle sur concha bullosa a été porté. Le patient a été opéré par voie endonasale avec marsupialisation et polypectomie. Les suites opératoires étaient simples avec amélioration des signes cliniques.Conclusion : Les pyocèles du cornet moyen sont des lésions rares bénignes, toutefois destructrices. Un bilan radiologique est indispensable pour guider le choix du traitement chirurgical. La voie endonasale reste le traitement de référence pour cette pathologie.Mots clés : Concha bullosa, Pyocèle, Obstruction nasaleIntroduction : A mucocele is an epithelium-lined cavity that contains mucus that fills the sinus and is capable of expansion. The majority of mucoceles are situated in the frontal and/or ethmoid sinuses. A pyocele occurs when a mucocele becomes infected. Concha bullosa mucopyocele is a rare entity that presents with persistent nasal symptoms.Case report : This paper presents patient aged 75 who were admitted with persistent nasal complaints. Anterior rhinoscopy showed enlarged middle turbinates obstructing the nasal cavities. MRI and CT Scann revealed expansif cystic lesion in the middle turbinate with a nasal polyp. With the diagnosis of concha bullosa mucocele, lateral part of the affected middle turbinate and the polyp were resected with an endoscopic approach. There were no intraoperative or postoperative complications. Nasal obstruction vanished postoperatively.Conclusion: Mucopyocele of middle turbinate are rare benign lesions. Radiological assessment is essential to guide the choice of surgical treatment. Endonasal approach is the standard treatment for this disease.Key words : Concha bullosa, Pyocele, Nasal obstructio

Genetic diversity in Tunisian horse breeds

This study aimed at screening genetic diversity and differentiation in four horse breeds raised in Tunisia, the Barb, Arab-Barb, Arabian, and English Thoroughbred breeds. A total of 200 blood samples (50 for each breed) were collected from the jugular veins of animals, and genomic DNA was extracted. The analysis of the genetic structure was carried out using a panel of 16 microsatellite loci. Results showed that all studied microsatellite markers were highly polymorphic in all breeds. Overall, a total of 147 alleles were detected using the 16 microsatellite loci. The average number of alleles per locus was 7.52 (0.49), 7.35 (0.54), 6.3 (0.44), and 6 (0.38) for the Arab-Barb, Barb, Arabian, and English Thoroughbred breeds, respectively. The observed heterozygosities ranged from 0.63 (0.03) in the English Thoroughbred to 0.72 in the Arab-Barb breeds, whereas the expected heterozygosities were between 0.68 (0.02) in the English Thoroughbred and 0.73 in the Barb breeds. All FST values calculated by pairwise breed combinations were significantly different from zero (p  <  0.05) and an important genetic differentiation among breeds was revealed. Genetic distances, the factorial correspondence, and principal coordinate analyses showed that the important amount of genetic variation was within population. These results may facilitate conservation programs for the studied breeds and enhance preserve their genetic diversity

Live Attenuated B. pertussis as a Single-Dose Nasal Vaccine against Whooping Cough

Pertussis is still among the principal causes of death worldwide, and its incidence is increasing even in countries with high vaccine coverage. Although all age groups are susceptible, it is most severe in infants too young to be protected by currently available vaccines. To induce strong protective immunity in neonates, we have developed BPZE1, a live attenuated Bordetella pertussis strain to be given as a single-dose nasal vaccine in early life. BPZE1 was developed by the genetic inactivation or removal of three major toxins. In mice, BPZE1 was highly attenuated, yet able to colonize the respiratory tract and to induce strong protective immunity after a single nasal administration. Protection against B. pertussis was comparable to that induced by two injections of acellular vaccine (aPV) in adult mice, but was significantly better than two administrations of aPV in infant mice. Moreover, BPZE1 protected against Bordetella parapertussis infection, whereas aPV did not. BPZE1 is thus an attractive vaccine candidate to protect against whooping cough by nasal, needle-free administration early in life, possibly at birth