Infantile Scurvy: Two Case Reports

Background. Ascorbic acid (vitamin C) is necessary for the formation of collagen, reducing free radicals, and aiding in iron absorption. SCURVY, a disease of dietary ascorbic acid deficiency, is uncommon today. It still exists in high risk groups including economically disadvantaged populations with poor nutrition. The incidence of SCURVY in the pediatric population is very low. Cases Report. Here we report two cases of SCURVY revealed by subperiosteal hematoma in children with cerebral palsy and developmental delay. Conclusion. SCURVY is extremely rare in children. Musculoskeletal manifestations are prominent in pediatric SCURVY. Multiple subperiosteal hematomas are an important indicator for diagnosis

Nail-Patella Syndrome Associated with Short Stature: A Case Series

Introduction. Nail-patella syndrome (NPS) is a rare genetic disorder that is characterized by a pleiotropic malformation affecting the nail, the skeleton, and occasionally the central nervous system and the kidneys. Case Presentation. We report two paediatric cases, which are of two sisters, who aged, respectively, two and five years. They are admitted to explore short stature. The initial clinical examination and radiologic findings confirmed the diagnosis of Nail-patella syndrome. Conclusion. Skeletal, ophthalmologic, and renal involvements were mostly associated with NPS. The association with short stature was exceptional

Improvement of durum wheat (Triticum durum) surface irrigation in swelling soils

7 Pags., 2 Figs., 7 Tabls.This study is targeted to improve surface irrigation performance of durum wheat in swelling soils. For this purpose, furrow and border irrigation trials were carried out and evaluated under different soil water depletion rates, furrow spacing and unitary inlet discharges. Irrigation was triggered whenever the soil water depletion rate reached a predetermined threshold. A comprehensive irrigation evaluation produced hydraulic, agronomic and economic indicators, such as application efficiency, distribution uniformity, crop yield, gross margin and water productivity. Experimental results showed that supplied water depths exceeded soil water deficits, inducing relevant vertical and lateral water losses. Although border and furrow irrigation crop yields were virtually tantamount (about 5.5 Mg/ha), furrow irrigation was the system of choice. An irrigation strategy based on a furrow spacing of 150 cm, an inlet discharge of 2 l/s/furrow and a soil water depletion rate of 30% required a gross water depth of 4300 m3/ha/yr and generated an optimum crop yield of 58 qx/ha. In the analyzed range of soil water depletion, the gross margin and water value amounted to 1064 - 1390 Tunisian Dinar per hectare (TD/ha) and 0.39 - 0.44 TD/m3, respectively, for a furrow spacing of 150 cm.The authors are thankful to the INRGREF for the valuable support of this research.Peer reviewe

Effect of early contamination by <em>Botrytis cinerea</em> on the development of Grey mould on Muscat d’Italie in Tunisian vineyard

Grey rot, caused by Botrytis cinerea, is nowadays the most damaging disease of the Tunisian vineyard. The fungus attacks berries at the maturation stage and causes important economic losses. The protection of vineyard against this disease is very difficult due to the fungus characteristics. In fact B. cinerea is in the border of parasitism and saprophytism, in pre-veraison it usually survive as saprophyte then it attacks berries before their maturation. The purpose of this study is to highlight the role of pre-veraison’s contamination by B. cinerea on the development of the Grey rot on the berries after veraison. The results revealed that at the pre-veraison stage, B. cinerea grows as a saprophyte. The fungus’s rate presence is low on the barks (less than 10 %), very high on the floral buds (between 5 and 27 %) and relatively high in the immature berries (about 20 %). The quantification of bunches pollution, showed that the rate of contaminations by B. cinerea is very high (more than 70 %). On the other hand, the mapping out showed up that outbreak of the disease happened after veraison on Muscat d’Italie. Also, the rate of berries’ rot, were different each year, in relation to the climatic conditions and plant’s physiology. We found that the rate of rot inside bunches is relatively high (between 15 and 40 %) due to condia on stem or B. cinerea latent. The statistical analysis showed significant relationships between the rate of latent B. cinerea and the appearance of the disease after the veraison stage. Also, the scoring of conidia observed in the air showed a big activity of the fungus during flowering and the maturation of berries

The Efficiency of the EORTC Scoring System for the Prediction of Recurrence and Progression of Non-muscle-invasive Bladder Cancer Treated by Bacillus Calmette-Guerin Immunotherapy.

International audienceAbstract The authors determined the recurrence and progression at 1 year in patients with non-muscle-invasive urothelial carcinoma who underwent transurethral resection of bladder tumor (TURBT) and compared the results with the calculated risk according to the European Organization of Research and Treatment of Cancer (EORTC). Between 2002 and 2011, a total of 112 patients with NMIBC were treated with transurethral resection of bladder cancer. According to the EORTC scoring system, the patients were categorized in terms of number of tumors, tumor size, prior recurrence rate, T category, carcinoma in situ, and pathologic grade, and the scores were summed. According to the summed scores, the recurrence group and the progression group were divided into 3 subgroups: low, intermediate, and high risk, respectively. The recurrence rate and progression rate of each group were compared with the EORTC risk tables. The mean patient age was 63.9 years (range: 25-85) at diagnosis. Seventy-eight patients (68.4%) had a recurrent disease, 53 (47.3%) had a tumor larger than 3 cm in diameter, 55 (49.1%) had multiple lesions, 3 (0.26%) had carcinoma in situ, 44(39.3%) had stage T1 lesions, and 20 (17.8%) had a high-grade disease. The recurrence rates were 0, 14.2, 31.25, and 85.71% in groups with the predicted EORTC risks of 15, 24, 38, and 61%, respectively. There were 3 patients (0.2%) with progression of the diseases. The EORTC model successfully stratified recurrence and progression risks in this cohort. However, the discriminative ability of the EORTC tables decreased in these patients for progression

The impact of age and clinical factors in non-muscle-invasive bladder cancer treated with Bacillus Calmette Guerin therapy.

International audienceBACKGROUND: Bladder cancer is a disease of older persons, the incidence of which is expected to increase as the population ages. Prognostic factors for local recurrence for patients with non-muscle invasive bladder cancer have not been fully established. The aim of our study was to determine the influence of age on the outcomes of non muscle invasive bladder (NMIBC) cancer treated with intravesical Bacillus Calmette-Guerin (BCG) therapy. METHODS: We retrospectively reviewed the clinical and pathologic data of primary NMIBC from 112 patients who were treated with transurethral resection followed by BCG-immunotherapy. Time follow-up was 30 months. Clinicopathologic characteristics and response to BCG therapy were correlated with age using univariate and multivariate methods of analysis. RESULTS: Univariate analysis showed that age analyzed as a categorical variable was not associated with other clinicopathological characteristics. On the other hand, multivariate analysis showed that only multiplicity, stage and tumor size were independent significant prognosticators. CONCLUSIONS: The results of our study have shown that aging has no impact on the outcomes of high-risk NMIBC treated by BCG immunotherapy

The Efficacy of Intravesical Bacillus Calmette-Guerin in the Treatment of Patients with pT1 Stage Non-muscle-invasive Bladder Cancer.

Abstract Background: pT1 bladder urothelial carcinomas represent a heterogeneous group of tumors with different biologic behaviors, and identifying the subset of tumors that carries a high risk of disease recurrence and progression is therefore important. Induction and maintenance intravesical Bacillus Calmette-Guerin (BCG) has been proven to reduce tumour recurrence and progression. However, no markers are available to predict BCG response. The aim of this study is to evaluate the prognostic factors of stage in predicting recurrence after intravesical adjuvant BCG immunotherapy in patients with NMIBC. Methods: we retrospectively reviewed the clinical and pathologic data of primary NMIBC from 45 patients who were treated with transurethral resection followed by BCG-immunotherapy. Time follow-up was 30 months. The prognostic significance of clinicopathologics characteristics in determining the risk for recurrence after BCG therapy was studied with both univariate and multivariate methods of analysis. Results: univariate Cox regression analysis of clinicopathologic characteristics revealed that the rate of recurrence was statistically associated with tumor stage. Indeed, a significant concordance was noted between the EORTC s predicted risks and the actuarial recurrence rate of NMIBC at one year. On the other hand, multivariate analysis using Cox regression based on the AIC criteria and biological considerations, selected the score of recurrence as independent predictor of recurrence. Conclusion: The conventional clinicopathological factors used in EORTC model are relevant for the assessment of the outcome of pT1 stage bladder tumors treated by BCG immunotherapy. Management of pT1 bladder cancer patients remains one of the most difficult problems in urologic practice. At this time the decision to preserve the bladder or to perform a cystectomy depends on a number of clinicopathologic parameters, but none are able to sufficiently identify patients for the appropriate therapeutic modality. Additional studies using a more large scale of patients will be required to confirm our findings

Investigations into Physiological, Biochemical, and Histological Modifications in a Vine Decline Associated with Biotic and Abiotic Factors

Tunisian table grape production has significantly increased since two decades due to vineyards regional expansion and yield improvement. But, since several years, decline symptoms on Vitis vinifera have been recorded in some areas. A study case of a vineyard in Naassen area (near to Tunis) was chosen to investigate the disease origin and the physiological, biochemical, and histological modifications associated with vine decline. The investigation revealed characteristic symptoms on leaves, old and young shoots similar to decline symptoms of Grapevine Trunk Diseases. Based on cultural characteristics, laboratory investigations revealed the presence of Phaeomoniella chlamydospora and Phaeoacremonium spp., Diplodia seriata and Botryosphaeria dothidea, from root and shoot samples, respectively. These fungi are known as the main pathogens responsible for the Esca, Black dead arm and Excoriose. Molecular analysis confirmed the identification of Diplodia seriata. Beside morphological alterations on leaves and shoots, symptomatic vines presented significant reductions of 30 and 20% in trunk diameter and bud break rate, respectively, and delayed spring growth compared to healthy ones. Furthermore, roots and stems from declined vines contained 3 times more starch than those from asymptomatic ones. Decline survey revealed a heterogeneous dispersion of symptoms in the vineyard in accordance with water supply. The vines along the edge of vineyards are usually less watered and show more decline symptoms. Decline dynamics in time and space scales have to be considered in order to develop effective management strategies

Tumor multiplicity is an independent prognostic factor of non-muscle-invasive bladder cancer treated with Bacillus Calmette-Guerin immunotherapy.

International audienceBACKGROUND: Bacillus Calmette-Guerin (BCG) immunotherapy is regarded as the current treatment of choice for non muscle invasive bladder cancer (NMIBC), though its efficacy is limited by high recurrence and progression rate. Identification of factor prognosticators that might be helpful in discriminating between responders and nonresponders to BCG treatment is therefore of major clinical importance. The aim of this study is to evaluate the prognostic factors of recurrence after intravesical adjuvant BCG immunotherapy in patients with NMIBC. METHODS: we retrospectively reviewed the clinical and pathologic data of primary NMIBC from 112 patients who were treated with transurethral resection followed by BCG-immunotherapy. Time follow-up was 30 months. The prognostic significance of tumor stage, grade, multiplicity, age, sex and smoking in determining the risk for recurrence after BCG therapy was studied with both univariate and multivariate methods of analysis. RESULTS: According to univariate analysis of the prognostic significance for tumor stage, grade, loci number, sex, age and smoking, the pT1 stage and multiplicity seem to be associated in a statistically significant manner with higher risk for recurrence (P = 0.009, P = 0.011, respectively). In the other hand, multivariate analysis showed that only multiplicity was an independent significant prognosticator. CONCLUSION: Significant independent predictor for recurrence was multiplicity which offers important clinical information and may be a useful tool in the selection of suitable candidates for BCG-immunotherapy