Seasonal variability of picophytoplankton under contrasting environments in northern Tunisian coasts, southwestern Mediterranean Sea.

We investigated at the single cell level during 16months (June 2012 to September 2013) the temporal distribution of picophytoplankton (picoeukaryotes, Synechococcus and Prochlorococcus) communities in two contrasted ecosystems: the Bay of Bizerte characterised by an oligotrophic regime typical of the Mediterranean Sea and the Bizerte Lagoon that exhibits a mesotrophic/eutrophic state. We aimed at depicting seasonal variations and quantifying the relationships between the environmental factors and the structure and abundance of picophytoplankton communities. Results showed that picophytoplankton groups were able to grow under a wide range of environmental conditions varying seasonally, although their abundances and contributions to the total chlorophyll biomass significantly varied and showed importance in the Bay of Bizerte. Synechococcus was the most abundant group reaching 225∗103cells·cm-3 in the Bay and 278∗103cells·cm-3 in the lagoon. This group was present all over the year in both ecosystems. Structural equation model results pointed out a different configuration regarding the picophytoplankton environmental drivers. The complexity of the configuration, i.e. number of significant links within the system, decreased under enhanced eutrophication conditions. The less exposure to anthropogenic stress, i.e. in the Bay of Bizerte, highlight a larger role of nutrient and hydrological conditions on the seasonal variations of picophytoplankton, whereas a negative effect of eutrophication on picophytoplankton communities was unveiled in the Bizerte Lagoon. We stress that such influence may be exacerbated under expected scenarios of Mediterranean warming conditions and nutrient release in coastal ecosystems.

Dual infection with Bordetella pertussis and Mycoplasma pneumoniae in three infants: case reports.

Studying pertussis-like respiratory infections, we report the cases of three infants with evidence of both Bordetella pertussis and Mycoplasma pneumoniae. Bordetella infection was identified by the real-time polymerase chain reaction (RT-PCR) of nasopharyngeal specimens. Neither B. pertussis nor B. parapertussis were recovered on the culture of nasopharyngeal aspirates (NPAs) from any subjects. M. pneumoniae etiology was diagnosed by culture and RT-PCR. The evolution was fatal for all of the subjects. We conclude that, among patients with Bordetella infection, co-infection with another respiratory pathogen is often probable, and these mixed infections might cause a more severe form of illness, sometimes leading to death.

[The re-emergence of pertussis in Tunisia]. / La réémergence de la coqueluche en Tunisie.

OBJECTIVE: The authors had for aim to analyze pertussis epidemiology in Tunisia by studying nasopharyngeal specimens of infants hospitalized in Tunis. METHODS: Between march 2007 and march 2008, clinical nasopharyngeal samples were collected from infants with a suspected diagnosis of whooping cough, pertussoid cough, or pertussis-like syndrome, admitted at the Tunis children's hospital. The laboratory diagnostic criteria were culture isolation of Bordetella species on Bordet-Gengou medium and real-time PCR. RESULTS: Fifty-nine percent of the 74 investigated children with suspected pertussis were less than two months of age. The diagnosis of pertussis was proved positive by real-time PCR for 41%. Culture was negative in all cases. CONCLUSIONS: Whooping cough is still prevalent in Tunisia despite an important vaccination coverage. Real-time PCR is an invaluable tool for the rapid diagnosis of pertussis, however culture must also be associated.

[Unipolar versus bipolar depression: clues toward predicting bipolarity disorder]. / Dépression unipolaire versus dépression bipolaire: facteurs prédictifs d'une évolution bipolaire.

Bipolar and unipolar disorders share a common depressive clinical manifestation. It is important to distinguish between these two forms of depression for several reasons. First, prescribing antidepressors in monotherapy indubitably worsens the prognosis of bipolarity disorders. Second, postponing the prescription of a mood stabilizer reduces the efficacy of the treatment and multiplies the suicidal risks by two. The object of this study is to reveal the factors that distinguish between unipolar and bipolar depression. This is a retrospective study on patients' files. It includes 186 patients divided according to DSM IV criteria into two groups: patients with bipolar disorder type I or II with a recent depressive episode (123 patients) and patients with recurrent depressive disorder (63 patients). A medical record card was filled-in for every patient. It included socio-demographic data, information about the disorder, family antecedents, CGI score (global clinical impressions), physical comorbidity, substance abuse and personality disorder. In order to sort out the categorization variables, the two groups were compared using chi2 test or Fischer's test. With regard to the quantitative variables, the two groups were compared using Krostal Wallis's test or Ancova. Our study has revealed that bipolar disorder differs significantly from unipolar disorder in the following respects: bipolar disorder is prevalent among men (sex-ratio 2) while unipolar disorder is prevailing among women (sex-ratio 0.8); patients with bipolar disorder are younger than patients with unipolar disorder (38.1 +/- 5 years vs. 49.7 +/- years); the age at the onset of bipolar disorder is earlier than that of unipolar disorder (20.8 +/- 2 years vs. 38.7 +/- 5 years); family antecedents are more important in bipolar patients than in unipolar patients (51.1% vs. 33%). More importantly, bipolar disorder differs from unipolar disorder in the following aspects: The number of suicidal attempts (25.3% vs. 23.6%); the degree of substance abuse (15.4% vs. 14.5%); the level of somatic comorbidity (20.3% vs. 17.4%); the amount of anxiety manifestations (5.6% vs. 4.8%); the extent of personality disorder (30.8% vs. 23.8%); the degree of socio-professional impairment (bachelorhood and unemployment). On the other hand, we noted that unipolar patients differ from bipolar patients in terms of the frequency of hospitalizations (3.5 vs. 3.1) and the length of stays in hospitals (25.8 vs. 20.7 days) with significant differences of 0.003 and 0.0000001 respectively. Moreover, the CGI scores of unipolar patients are higher than those of bipolar patients. However, the difference is not significant. Consequently, an early distinction between bipolar and unipolar disorder is of utmost importance for the treatment of these two illnesses.

[Myasthenia in children. Apropos of 3 cases]. / Myasthénie de l'enfant. A propos de trois observations.

We report 3 cases of juvenile myasthenia in 2 girls and 1 boy, who at onset, were respectively 21 months, 13 yr and 4 and a half yr old. Clinical features were common but in 2 cases included acute respiratory failure leading to artificial ventilation. Thymectomy was performed in 1 girl with thymoma who presented a vitiligo 5 yr later.

[Epidemiologic profile of accidents in Tunisian children]. / Profil épidémiologique des accidents chez l'enfant tunisien.

The results of a retrospective study of 2,108 accidents in 0-14-year-old children are presented, recorded over a 1-year period at the Sfax Medical Centre, Tunisia. The average age of the children was 6 years 4 months. Our results show that 85% of the accidents were domestic (traumatisms 72%; poisoning 11%). The frequency and gravity of poisoning due to scorpion bites is emphasized: it represented 7% of the accidents, 35% of mortality due to accidental causes and a lethality rate of 10%. The total mortality rate due to accidental causes was 2%. Five per cent of the patient population had sequelae. Factors influencing the nature and gravity of the accident have been analysed and some recommendations have been made regarding prevention of accidents in children.

[Apnea disclosing Chlamydia trachomatis infection in a premature infant]. / Apnées révélatrices d'une infection à Chlamydia trachomatis chez un prématuré.

The authors report a peculiar type of maternofetal Chlamydia trachomatis (CT) infection in a 34 week-premature neonate. The revealing sign was the occurrence, at age 11 days, of frequent apneas with bradycardia, needing mechanical ventilation associated with adapted antibiotic therapy for 14 days. Diagnosis was confirmed by the isolation of CT in tracheal secretions. Immediate evolution was favorable. Literature data are reviewed and a short epidemiological survey is reported.

[Bilateral galactocele in an infant]. / Galactocèle bilatérale chez un nourrisson.

The authors report a case of a 2 month-old male baby with bilateral mammary gland swelling diagnosed as galactocele that resolved after simple puncture. Galactocele, or milk filled mammary gland cyst, is a possible complication of the neonatal genital crisis, but may also appear after the first months of life. This condition has been described only in males and was rarely noted in the literature. It should be considered as one of the possible causes of infantile gynecomastia.