Pneumocephalie sous durale expansive apres une ventriculo- cisternostomie endoscopique

La pneumocéphalie sous durale est une complication classique de la ventriculo-cisternostomie endoscopique (VCE). Il s’agit le plus souvent d’une pneumocéphalie simple sans traduction clinique. . Nous rapportons le cas d’une femme de 38 ans, ayant subi une VCE pour une hydrocéphalie par sténose de l’aqueduc du mésencéphale. Elle a développé une hémiparésie gauche postopératoire avec un retard de réveil. Le scanner cérébral de contrôle a montré une importante pneumocéphalie sous-durale expansive (signe du Mont Fuji) prédominante à droite. Une surveillance en position TRENDELENBURG, une réhydratation et une oxygénation au masque ont permis d’obtenir une régression complète de l’hémiparésie et la résorption de la pneumocéphalie sur le scanner à J3 postopératoire.Mots clés : Ventriculocisternostomie ; Pneumocéphalie ; Complication

Les barotraumatismes de l’oreille moyenne

Objectif : Le barotraumatisme de l’oreille moyenne est une entité pathologique particulière rare et spécifique.Matériel et méthodes : Nous rapportons une série rétrospective de 13 cas de barotraumatismes de l’oreille moyenne diagnostiqués et suivis au centre d’expertise et de médecine aéronautique de Tunis.Résultats : L’âge moyen de nos patients est de 34 ans. Les signes fonctionnels étaient dominés par l’otalgie et l’hypoacousie. L’atteinte était bilatérale dans deux cas. Il s’agissait d’atteinte bénigne de stade (I et II) chez huit patients et d’épanchement rétrotympanique dans quatre cas. Une perforation tympanique a été observée chez un seul pilote. Le bilan clinique a permis de mettre en évidence la présence de circonstances favorisantes à la survenue du barotraumatisme dans neuf cas. Sur le plan fonctionnel, nous avons observés quatre barotraumatismes à audition conservée .Par ailleurs, La surdité était de type transitionnelle. La prise en charge thérapeutique était fonction du bilan lésionnel. L’évolution était favorable chez neufs patients avec une récupération auditive totale.Une dispense de vol fût proclamée dans tous les cas. La durée  d’inaptitude initiale était fonction du bilan lésionnel anatomique et fonctionnel et a variée entre dix et soixante jours.Mots-clés : Barotraumatisme, Surdité, Oreille moyenne, Pilote

Mal de pott révelé par un abcès latéropharyngien chez un pilote

Introduction: Pott's disease is the most frequent localisation of osteoarticular tuberculosis. The authors report a case of cervical Pott's disease with lateropharyngeal abscess.Observation: Our patient is a 44 years old pilot; he presented since 6 months cervicalgy, dysphagia and weighting loss.  Clinical findings showed a swelling of posterior and lateral oropharyngeal wall extending to hypopharynx. A palsy of the XI th nerve and an abolition of the bicipital reflex were also noticed. CT scan showed a lateropharyngeal collection extending from C4 to D1. It was also noticed a subtotal destruction of C6.However, there were no medullar lesions in the cervical spine MRI.Tuberculosis was confirmed thanks to histological analysis of caseum taken during cervical biopy. The patient was operated using anterior approach. He had surgical removal of C6 which was replaced by iliac prothesis. Medical treatment was based on antituberculosis drugs used during 12 months. After three years of follow up, the out come was favourable with no recurrence and satisfying consolidation. For aeronautic considerations, the patient was declared unable for flying mission.Conclusion: Tuberculosis constitutes a problematic infectious disease in Tunisia which may have serious consequences on publish health. We insist on preventing measurements because there are neither specific clinical findings nor radiological characterising features.Keywords: Tuberculosis, Pott's disease, lateropharyngeal absces

U-Control Chart Based Differential Evolution Clustering for Determining the Number of Cluster in k-Means

The automatic clustering differential evolution (ACDE) is one of the clustering methods that are able to determine the cluster number automatically. However, ACDE still makes use of the manual strategy to determine k activation threshold thereby affecting its performance. In this study, the ACDE problem will be ameliorated using the u-control chart (UCC) then the cluster number generated from ACDE will be fed to k-means. The performance of the proposed method was tested using six public datasets from the UCI repository about academic efficiency (AE) and evaluated with Davies Bouldin Index (DBI) and Cosine Similarity (CS) measure. The results show that the proposed method yields excellent performance compared to prior researches

Predicting Distribution of Aedes Aegypti and Culex Pipiens Complex, Potential Vectors of Rift Valley Fever Virus in Relation to Disease Epidemics in East Africa.

The East African region has experienced several Rift Valley fever (RVF) outbreaks since the 1930s. The objective of this study was to identify distributions of potential disease vectors in relation to disease epidemics. Understanding disease vector potential distributions is a major concern for disease transmission dynamics. DIVERSE ECOLOGICAL NICHE MODELLING TECHNIQUES HAVE BEEN DEVELOPED FOR THIS PURPOSE: we present a maximum entropy (Maxent) approach for estimating distributions of potential RVF vectors in un-sampled areas in East Africa. We modelled the distribution of two species of mosquitoes (Aedes aegypti and Culex pipiens complex) responsible for potential maintenance and amplification of the virus, respectively. Predicted distributions of environmentally suitable areas in East Africa were based on the presence-only occurrence data derived from our entomological study in Ngorongoro District in northern Tanzania. Our model predicted potential suitable areas with high success rates of 90.9% for A. aegypti and 91.6% for C. pipiens complex. Model performance was statistically significantly better than random for both species. Most suitable sites for the two vectors were predicted in central and northwestern Tanzania with previous disease epidemics. Other important risk areas include western Lake Victoria, northern parts of Lake Malawi, and the Rift Valley region of Kenya. Findings from this study show distributions of vectors had biological and epidemiological significance in relation to disease outbreak hotspots, and hence provide guidance for the selection of sampling areas for RVF vectors during inter-epidemic periods

Gastric Marginal Zone B Cell Lymphoma of the Duodenum

Small bowel lymphomas of the extranodal type occur in the young and are characteristically associated with malabsorption syndrome. We present the case of an elderly in whom there was no malabsorption and the duodenal tumor was a gastric type marginal zone B cell lymphoma also known as gastric mucosa-associated lymphoid tissue (MALT) lymphoma. A 73-year-old woman presented to the emergency room with 2 weeks of general weakness, recurrent vomiting containing food particles and abdominal distension. She had been diagnosed with diabetic gastroparesis 4 years prior. CT of the abdomen and pelvis was suggestive of gastric outlet obstruction but no evidence of pancreatic or duodenal mass. Endoscopy and biopsy of the tumor obstructing the distal first part of the duodenum confirmed a gastric marginal MALT lymphoma. The patient's symptoms improved with radiotherapy. Gastric MALT lymphoma, an extranodal lymphoma primarily described in the stomach, can also present in the small bowel and is not associated with malabsorption

Semen quality in Peruvian pesticide applicators: association between urinary organophosphate metabolites and semen parameters

<p>Abstract</p> <p>Background</p> <p>Organophosphates are broad class of chemicals widely used as pesticides throughout the world. We performed a cross-sectional study of associations between dialkylphosphate metabolites of organophosphates and semen quality among pesticide applicators in Majes (Arequipa), Peru.</p> <p>Methods</p> <p>Thirty-one men exposed to organophosphate (OP) pesticides and 31 non-exposed were recruited (age, 20–60 years). In exposed subjects, semen and a blood sample were obtained one day after the last pesticide application. Subjects were grouped according to levels of OP metabolites in urine. Semen samples were analyzed for sperm concentration, percentage of sperm motility, percentage of normal morphology, semen leucocytes and concentrations of fructose and zinc. Exposure to OP was assessed by measuring six urinary OP metabolites (dimethyl and diethyl phosphates and thiophosphates) by gas chromatography using a single flame photometric detector.</p> <p>Results</p> <p>Diethyldithiophosphate (p = 0.04) and diethylthiophosphate (p = 0.02) better reflected occupational pesticide exposure than other OP metabolites. Semen analysis revealed a significant reduction of semen volume and an increase in semen pH in men with OP metabolites. Multiple regression analysis showed that both occupational exposure to pesticides and the time of exposure to pesticides were more closely related to alterations in semen quality parameters than the single measurement of OP metabolites in urine.</p> <p>Conclusion</p> <p>The study demonstrated that occupational exposure to OP pesticides was more closely related to alterations in semen quality than a single measurement of urine OP metabolites. Current measurement of OP metabolites in urine may not reflect the full risk.</p

The Use of Haplotypes in the Identification of Interaction between SNPs

Although haplotypes can provide great insight into the complex relationships between functional polymorphisms at a locus, their use in modern association studies has been limited. This is due to our inability to directly observe haplotypes in studies of unrelated individuals, but also to the extra complexity involved in their analysis and the difficulty in identifying which is the truly informative haplotype. Using a series of simulations, we tested a number of different models of a haplotype carrying two functional single nucleotide polymorphisms (SNPs) to assess the ability of haplotypic analysis to identify functional interactions between SNPs at the same locus. We found that, when phase is known, analysis of the haplotype is more powerful than analysis of the individual SNPs. The difference between the two approaches becomes less either as an increasing number of non-informative SNPs are included, or when the haplotypic phase is unknown, while in both cases the SNP association becomes progressively better at identifying the association. Our results suggest that when novel genotyping and bioinformatics methods are available to reconstruct haplotypic phase, this will permit the emergence of a new wave of haplotypic analysis able to consider interactions between SNPs with increased statistical power.</p

Gain-through-filtering enables tuneable frequency comb generation in passive optical resonators

Optical frequency combs (OFCs), consisting of a set of phase-locked, equally spaced laser frequency lines, have enabled a great leap in precision spectroscopy and metrology since seminal works of Hänsch et al. Nowadays, OFCs are cornerstones of a wealth of further applications ranging from chemistry and biology to astrophysics and including molecular fingerprinting and light detection and ranging (LIDAR) systems, among others. Driven passive optical resonators constitute the ideal platform for OFC generation in terms of compactness and low energy footprint. We propose here a technique for the generation of OFCs with a tuneable repetition rate in externally driven optical resonators based on the gain-through-filtering process, a simple and elegant method, due to asymmetric spectral filtering on one side of the pump wave. We demonstrate a proof-of-concept experimental result in a fibre resonator, pioneering a new technique that does not require specific engineering of the resonator dispersion to generate frequency-agile OFCs