Dermatological signs in bovine tropical theileriosis (T heileria annulata infection), a review.

Bovine tropical theileriosis (Theileria annulata infection) is an important tick-borne disease in several regions of the world. This paper describes two clinical cases of tropical theileriosis in northern Tunisia with the uncommon sign of skin nodules. The density of nodules was estimated at 15-20 per 10 cm2; they were distributed over the animal's body and were 0.5-2 cm in diameter. Microscopic examination of the skin nodules 18 days after treatment onset showed a perivascular infiltrate of lymphocytes, macrophages and eosinophils. Nevertheless, no schizonts were observed. Appropriate treatment led to the recovery of one of the two animals with total disappearance of the skin lesions; the other animal died. A review of clinical cases of tropical theileriosis (T. annulata infection) with cutaneous lesions is presented. Various dermatological signs are described in the literature: skin nodules, haemorrhagic lesions, cutaneous gangrene, etc. Most authors reported the presence of schizonts in the nodular lesions. Dermatological involvement in bovine tropical theileriosis should be considered by field veterinarians and should be differentiated from other diseases with dermatological signs.

La theilériose tropicale bovine (infection à Theileria annulata) est une maladie majeure à transmission vectorielle présente dans plusieurs régions du globe. Les auteurs décrivent deux cas cliniques de theilériose tropicale survenus dans le nord de la Tunisie, qui présentaient un tableau peu courant de lésions nodulaires. La densité estimée des nodules était de l'ordre de 15 à 20 nodules pour 10 cm² ; ils mesuraient de 0,5 à 2 cm de diamètre et étaient présents sur toutes les parties du corps de l'animal. L'examen au microscope des nodules cutanés 18 jours après le début du traitement a révélé une infiltration périvasculaire de lymphocytes, macrophages et éosinophiles. En revanche, aucun schizonte n'a été observé. L'administration d'un traitement approprié a éliminé l'infection chez l'un des deux animaux, avec une disparition totale de ses lésions cutanées ; l'autre animal est mort. Les auteurs présentent une synthèse des cas cliniques de theilériose tropicale (infection à T. annulata) s'accompagnant de lésions cutanées. Plusieurs manifestations dermatologiques sont décrites dans la littérature : nodules cutanés, lésions hémorragiques, gangrène cutanée, etc. La plupart des auteurs signalent la présence de schizontes dans les lésions nodulaires. Les manifestations dermatologiques associées à la theilériose tropicale bovine doivent être prises en compte par les vétérinaires de terrain et faire l'objet d'un diagnostic différentiel par rapport à d'autres maladies présentant un tableau dermatologique comparable.

La teileriosis tropical bovina (infección por Theileria annulata) es una importante enfermedad transmitida por garrapatas que afecta a varias regiones del mundo. Los autores describen dos casos clínicos de teileriosis tropical diagnosticados en el norte de Túnez que presentaban un síntoma inhabitual: nódulos cutáneos, con una densidad estimada de 15 a 20 nódulos por cada 10 cm2. Los nódulos, distribuidos por todo el cuerpo del animal, tenían un diámetro de entre 0,5 y 2 cm. El examen microscópico de los nódulos a los 18 días de tratamiento reveló una infiltración perivascular de linfocitos, macrófagos y eosinófilos, pero no se observaron esquizontes. La administración del tratamiento apropiado llevó a la recuperación de uno de los dos ejemplares, con desaparición completa de las lesiones cutáneas, mientras que el otro murió. Los autores pasan revista a una serie de casos clínicos de teileriosis tropical (infección por T. annulata) con presencia de lesiones cutáneas. En la bibliografía están descritos varios casos con síntomas dermatológicos: nódulos cutáneos, lesiones hemorrágicas, gangrena cutánea, etc. La mayoría de los autores señalan la presencia de esquizontes en las lesiones nodulares. Los veterinarios que trabajan sobre el terreno deben tener en cuenta que la teileriosis tropical bovina puede acompañarse de afectación cutánea y distinguir esta enfermedad de otras patologías que provocan síntomas dermatológicos.

Leishmaniosis (Leishmania infantum infection) in dogs.

The authors present an overview of canine leishmaniosis due to Leishmania infantum. This protozoan is transmitted by sandflies and the disease is frequently characterised by chronic evolution. Cutaneous and visceral clinical signs appear as the infection progresses. Lymph node enlargement, emaciation and skin lesions are the main signs observed in the classical forms of the disease. Control is difficult since infected dogs remain carriers for years and may relapse at any time. The mass screening of infected animals and their treatment or euthanasia represent the best way to reduce the prevalence of this disease in endemic regions. Further research is needed to improve the efficiency of the vaccines available to protect dogs against infection. This disease is zoonotic; in humans, clinical cases are reported mainly in elderly people, the young and those whose immune systems have been compromised.

Effects of sub-acute co-exposure to WIFI (2.45 GHz) and Pistacia lentiscus oil treatment on wound healing by primary intention in male rabbits.

BACKGROUND: The bioeffects of WIFI on cutaneous wound healing remains unexplored. In addition, several medicinal plant products including lentisk oil have been shown to interfere with wound healing process. Since the use of this oil is increasing, the co-exposure (WIFI-Lentisk oil) assessment is of paramount importance. OBJECTIVES: We aimed in the present study to investigate the effects of WIFI exposure as well as the application of Pistacia lentiscus oil on sutured wounds (SW). METHODS: New Zealand male rabbits (n = 24) were used and randomly divided into four groups of six animals each: a control group (SW) and three experimental groups (i) a first group exposed to WIFI (2.45 GHz, 6 h/day) during 16 days (SWW); (ii) a second group exposed to WIFI (2.45 GHz, 6 h/day) during 16 days and treated with lentisk oil (SWWL) and (iii) a third group not exposed to WIFI but treated with lentisk oil (SWL). The wound healing was evaluated by monitoring clinical parameters (temperature, food intake, relative weight variation, and macroscopic aspect) and histology. RESULTS: The mean food intake was higher in the SWWL group compared to the three other groups (p < 0.001) and higher in the SWL group compared to the SW group (p = 0.014). The exposition to WIFI (SWW group) or lentisk oil application (SWL group) can promote the collagen deposition and ameliorate the general aspect of wounds. By contrast, the co-exposure to WIFI and lentisk oil (SWWL) results in antagonist effects and extends the inflammatory phase of wound healing. CONCLUSIONS: Wounds treated topically with Pistacia lentiscus oil should not be exposed to WIFI.

Biofilm and siderophore effects on secondary waste water disinfection.

The efficiency of ultraviolet (UV) light disinfection of wastewater effluent using a large-scale pilot system was studied. The relationship between biofilm and siderophore production and UV doses received by Pseudomonas aeruginosa strain ATCC 15442 was determined. UV decreased pyoverdine production and enhanced biofilm production. Consequently external factors conditioned by both pyoverdine and biofilm may affect the UV effect on bacterial disinfection.

[Mycobacterial cervical lymphadenitis: role of surgery]. / Adénopathies cervicales tuberculeuses: place de la chirurgie.

OBJECTIVE: To discuss the place of surgery in the management of mycobacterial cervical lymphadenitis. PATIENTS AND METHODS: It's a retrospective study (1982-2002) about 246 patients treated in the ENT department of Farhat Hached Sousse for cervical lymph node tuberculosis. Resolution was considered when neither symptoms nor lymphadenopathy in examination were noted. RESULTS: The mean age of our patients was 28 years. A light female prevalence was noted. In 5 patients diagnosis was established by lymph node punction. A medical treatment of first intention was then managed with a failure in 3 cases, after deadlines from 3 to 4 months. All other patients were operated: cellulolymphadenectomy (47%), adenectomy (47%) or drainage of a cervical abscess (4%). Recurrence and antituberculosis treatment resistance were noted respectively in 6% and 3% of cases. DISCUSSION: Two questions are still discussed in the management of mycobacterial cervical lymphadenitis: 1- Is surgery necessary for the diagnosis? 2- When is surgery indicated directly? Histological specimen established the diagnosis in all cases and excluded a mestastatic lymph node. In some situations surgery must be indicated at first: cold abscess, lymph node fistulation. CONCLUSION: Surgery still has an important place in the treatment of tuberculosis lymphadenopathy.

[Primary digestive tract Kaposi sarcoma with idiopathic CD4+ lymphocytopenia, HIV negative, HHV8 positive]. / Sarcome de Kaposi digestif primitif avec lymphocytopénie CD4 idiopathique, VIH négatif, HHV8 positif.

A 52-year-old Tunisian patient had fever, impaired health and several opportunistic infections (Campylobacter jejuni, Mycobacterium hominis, Herpes virus, Giardia intestinalis, Vibrio metschnikovii). Lymphocytopenia was noted (348/mm3; CD4+: 2.2%; CD4+/CD8+: 0.1). Polymerase chain rection search for HIV was negative in serum and in tumor tissue. Diagnosis of primary digestive Kaposi sarcoma was established at autopsy due to the deep location of the lesions. There was an ulcerofungating tumor spreading over 1.3 m of the duodenojejunum. This is the fourth reported case of CD4+ lymphocytopenia, a new and very rare immunodeficiency syndrome recently defined by the Centers for Disease Control. We detected human herpes virus 8 by immunohistochemistry of tumor tissue. Human herpes virus 8 is implicated in the pathogenesis of Kaposi sarcoma.

[Unusual localization of embryonal rhabdomyosarcoma of the gallbladder]. / Localisation exceptionnelle du rhabdomyosarcome embryonnaire à la vésicule biliarie.

We report a second case of gallbladder embryonal rhabdomyosarcoma diagnosed in a 54 year old female. We had previously published a first similar case in a 48 year old male. In the review of the literature 5 other cases were collected. Five of the 7 cases occurred in 4 females and one male adult mean aged 63.4 years, and 2 in young girls aged 40 months. Three cases were of botryoid type, three were of alveolar type and one was of undetermined type. Immunohistochemistry demonstrated intra-cytoplasmic positivity of tumoral cells with anti-vimentin, anti-desmin and anti-actin anti-bodies. The prognosis remains bad. Death occurred, in 5 patients, in a period going from 18 days to 8 months after clinical diagnosis with a 5 months mean survival. The shortest survival was observed in a 40 month old child with AIDS. Only one case with surgical resection followed by radiochemotherapy had a 9 month survival.

[Pseudotumor extramedullary hematopoiesis. Report of 3 cases and review of the literature]. / L'hématopoïèse extramédullaire pseudo tumorale. A propos de 3 observations avec revue de la littérature.

We report 3 cases of extramedullary hematopoiesis with a sacrococcygeal, right obturatory hole and paravertebral dorso lumbar locations respectively in 30, 34 and 58 years old patients (two males and woman). A medullary tuberculosis was discovered in one case, a beta thalassemia in the second, and the third was classified as idiopathic. Radiologic picture often permitted to evoke the diagnosis on the aspect of a well limited multilocular tumor especially when there is a paravertebral location as in our third patient. Fine needle punction cytologic examination can permit the diagnosis and avoid surgery, except if complications occur.

[Intestinal perforation by a fish bone. Apropos of a case and review of the literature]. / Perforation intestinale par arête de poisson. A propos d'une observation avec revue de la littérature.

We report a case of transverse colon perforation by a fish bone (Grouper) in a toothless-old female. A review of the literature revealed a great variety of foreign bodies which may cause perforations at variable sites of the gastrointestinal tract. Fish bones were responsible for 46% of intestinal perforations in a review of 24 cases collected in 1984. Advanced age and poor patient dentition, as well as mental debility constitute predisposing factors for the swallowing of foreign bodies. Emergency radiology may be required. An exaggerated inflammatory reaction may give rise to a misleading pseudo tumor appearance. We agree that a well conducted and well analysed clinical history associated with a careful pathologic examination are very helpful in the diagnosis.

[Intraepithelial carcinoma and invasive carcinoma of the sclero-corneal limbus. Anatomo-clinical study apropos of 20 cases]. / Carcinome intraépithélial et carcinome invasif du limbe scléro-cornéen. Etude anatomo-clinique à propos de 20 cas.

We report a retrospective multicentric study of 20 cases of sclero-corneal limbus tumours carcinome including 9 cases of Bowen's disease and 11 squamous cell carcinomas. These cases were observed over two 10 and 20-year periods in two pathology departments. Epidemiological, clinical, pathological and therapeutic data as well as the clinical course were studied and the results compared with a large review of the literature. The mean age of the patients was 38 years for Bowen's disease and 47 for carcinoma. Two young subjects, 5 and 22 years, had xeroderma pigmentosum and had Bowen's disease and an epidermoid microinvasive carcinoma, respectively. All of the patients with Bowen's disease were men and were more than 90% of the patients with carcinoma. Tumour size was greater in carcinomas (7 to 10 mm) than in Bowen's disease (1 to 5 mm). All tumours were unilateral. Clinical manifestations included irritative or inflammatory reactions in one-fourth of the patients with Bowen's disease and in one-third of those with carcinoma. Pathology examination revealed an intact basal membrane separating healthy tissue from Bowen's lesions which showed disrupted cell architecture mostly involving the medial layers of the epithelium in 37% of the cases. All of the lesions were treated by exeresis. No recurrence has been observed after a follow-up of 1 month to 2 years for Bowen's disease and 1 year (maximum) for squamous cell carcinomas.

[Ag-NORS and non-pigmented tumors of the sclerocorneal limbus. Apropos of 20 cases]. / Ag-NORS et tumeurs non pigmentées du limbe scléro-cornéen. A propos de 20 cas.

We studied nucleolar organizers (Ag-NORS) in 20 cases of ocular limbic tumours of which 7 were Bowen disease or intraepithelial carcinoma and 13 were invasive carcinomas. The NOR-Index, reflecting cellular activity, increased from intraepithelial carcinoma (3.97) to microinvasive (5.45) and invasive carcinoma (5.81). Results of Nor-Index, reflecting proliferation, was in agreement with other technics such as immuno-labelling with Ki67 and PCNA antibodies.

[Placental aspergillosis: myth or reality? Apropos of a case with fetal death in utero]. / L'aspergillose placentaire: mythe ou réalité? A propos d'une observation avec mort foetale in utero.

The authors report an original case-history of massive aspergillosis of the placenta that occurred in a 24 year old primigravida who had had no previous history or clinical changes in pregnancy. It caused fetal death in utero with retention and maceration of the fetus. Macroscopic examination showed that the left lip was cleft and that the placenta was studded with isolated confluent diffuse whitish granulations. Histologic examination made us think that these appearances were those of aspergillar granulomas occurring even in the placental villi and intravillous spaces. Laboratory findings showed that there was Aspergillus Niger in the blood of the mother. A wide search of the literature failed to find any case in humans. On the other hand aspergillosis occurs frequently in animals causing intrauterine growth retardation and prematurity with abortion. There is great economic loss as a result. Why the animal placenta should be susceptible to infection of aspergillosis and how it acquires it is discussed! Finally the association of aspergillosis of the placenta with a cleft lip found in our case, is unique and one wonders if there is any relationship.

[Thoracic computed tomography data and cytology of the bronchoalveolar lavage fluid in an adult case of Niemann-Pick disease. The physiognomy of the disease in Tunisia]. / Manifestation tomodensitométrique thoracique et cytologie du liquide de lavage broncho-alvéolaire dans un cas adulte de maladie de Nieman-Pick. Physionomie de la maladie en Tunisie.

From a personal observation of a case of the chronic type-B form Niemann-Pick's disease in a 23 year old adult, the authors decided to review all the Tunisian published cases. They bring to light, in a review of the literature, the pulmonary disorder that occurs during this disease and discuss the contribution of computed tomography and the value of broncho-alveolar lavage as a method of diagnosis and prognosis in this disorder.

[The nucleolus organizer region (Ag NORS) in urothelial tumors. Apropos of 10 cases]. / Etude des organisateurs nucléolaires (Ag NORS) dans les tumeurs urothéliales. A propos de dix cas.

The authors study nucleolar organisers (Ag NORS) in ten cases of urothelial tumours, graded as grade I in five cases, grade II in two cases, grade III in two cases and intermediate grade II-III in one case. Study of the NOR index showed a mean value of 3.89 for grade I, 4.66 for grade II, 5.88 for grade III and 4.90 for the intermediate grade II-III. Different values were recorded in the same heterogeneous tumours containing tumour zones of different grades, providing an additional argument in favour of the heterogeneity of these urothelial tumours and accounting for the difficulties of their classification reported in the literature. Adequate sampling should allow a more objective and more representative study of all of the tumours examined.

[Prognostic study of cell proliferative markers ki67, PCNA and p53 oncoprotein in bladder tumors]. / Etude pronostique des marqueurs de prolifération Ki67 et PCNA et de l'oncoprotéine p53 dans les tumeurs vésicales.

We report a study of cell proliferative factors Ki67, PCNA and p53 oncoprotein in 55 patients with bladder tumors. Fifty-three of the patients were male and two were female, with a mean age of 56.6 and 68.5 years, respectively. These tumors were of transitional cell type in 97.9% of the cases. Staging was, respectively, pTis (4.76%), pTa (30.9%), pT1 (19.04%), pT2 (23.8%) and Pt3 (21.4%). Our study of proliferative nuclear markers Ki67 showed that cell proliferation increased in bladder tumors according to grade in the same stage. This variation was highlighted by our results for PCNA but was not verified for Ki67. However, these results revealed an increase of cell proliferation for a same grade (grade I and II) in different stages (pTa, pT1, pT2) for PCNA; this was not ascertained for Ki67. The study of p53 oncoprotein showed that detection of mutated p53 protein increased according to grade only for grades II and III and to stage only when moving from pTis to superficial tumors (pTa, pT1) and to deep tumors (pT2, pT3), thus individualizing two groups without significant variation within these groups. A variation according to grade in the same stage was noted only for stages pT1 and pT2. A variation for a same grade (grades II and III) was reported between stages pTa, pT1 and pT2. The combined study of Ki67, PCNA and p53 oncoprotein showed a prognostic correlation between these three markers in general.

[Anesthesia and resuscitation in Arabo-Islamic medicine: analytic study through Ibn Sina].

Nervous system anatomy knowledge acquired by arabo-islamic physicians enabled them to know its physiology represented by its excitability and its conductibility, and to understand pain physiology. Ibn Sina in his book entitle "The Canon of Medicine" precise anesthetic drugs and their side effects. Among these anesthetic means there were opium and ice. Ibn Sina distinguished organic pain and psychogenic pain. He used sedative and antalgic and soporific drugs in treatment of some psychologic diseases as melancholia. Moslem physicians were the first to use cold water to treat superficial burns. Anesthesia which lead to heavy sleep to used achieve surgical operations by oral, nasal(inhalation) and rectal route as it was described by Ibn Sina who indicated dosage to achieve three or four hour anesthesia which was necessary in an amputation surgery.

Gastric MALT lymphoma. A clinico-pathological study of 65 cases. Relationship to Helicobacter pylori.

We report 65 cases of MALT gastric lymphomas. HP was looked for with Giemsa and Whartin Starry stains. Immunohistochemistry was done with PAP method. Anti-HP treatment was used in 9 cases. 38 were of low grade of malignancy, 23 were high grade, 4 were high grade with a low grade component. The mean age was 51.5 years, the sex ratio 1.5. Epigastric pain was the most frequent feature (87.7% of cases). Endoscopically, low grade lymphomas presented as unique or multiple ulcerations (55.3% of cases) with antral localisation (52.6% of cases). 60% of our patients were stage IE, of which 61% had low grade lymphoma, 18% were at stage II2E, 10% at stage III and 10% at stage IV. From 23 operated patients, 29% had early lymphoma which was low grade malignant in 71.5% of cases, and 71% had lymphomas which were widely spread beyond the submucosa. HP was found in 63% of cases. Histologic regression of two early lymphomas of low grade malignancy was achieved after HP eradication.

[Ewing's sarcoma. Retrospective study of 108 cases with review of the literature]. / Le sarcome d'Ewing. Etude rétrospective de 108 cas avec revue de la littérature.

108 cases of Ewing's Sarcoma are collected at the "Curie Institute" and studied by the authors using the modern Technics of electron microscopy, cytochemistry, immunohistochemistry and cytogenetics. They raise the histogenesis and etiological factors not entirely resolved yet at the light of literature review.

[Epidemiological and clinical studies of ovine caseous lymphadenitis]. / Contribution à l'étude épidémiologique et clinique de la lymphadénite caséeuse chez les ovins.

A field survey was undertaken, to determine epidemiological, clinical and biological data on Ovine Caseous Lymphadenitis disease in 54 flocks originated from Sfax area in Tunisia. The mean morbidity rate of the cutaneous form was 5.1%. This form affected sheep over 3 months and under 2 years old. On the other hand, the mean morbidity rate of the visceral form, encountered in abattoirs, was 11.02%. The clinical aspect of the superficial (or cutaneous) form was often corresponding to one abscess, located particularly in the lymphatic nodes of the animal's head; while visceral (or internal) form of the disease was represented by the presence of a unique abscess found in the pulmonary lymphatic nodes. The macroscopic aspect of lesions showed that the size of abscess was comprised between 4 and 10 cm in diameter. At the cut, colour of the pus was white yellowish to yellow greyish with a fluid or a thick aspect like onion peels; pus was microscopic. Lesions were characterised by a fibrous shell, a pyogenic membrane and a necrotic center. Bacteriological research revealed that Corynebacterium pseudotuberculosis was the pathogen the most frequently isolated, followed by Staphylococcus aureus subsp anaerobius which was particularly found in sheep aged between 3 months and 2 years old.