Impacts of several pollutants on the distribution of recent benthic foraminifera: the southern coast of Gulf of Gabes, Tunisia.

In addition to physicochemical methods, benthic foraminifera have become an essential tool for the assessment of polluted environments. The main objectives of the present work were to study the distribution of benthic foraminifera along the coastline of Skhira and Gabes (southern coast of Gulf of Gabes) and to predict the impact of pollution on these organisms. Thirty-one samples were studied and a polluted area was delimited by chemical analysis, where heavy metal, fluoride, phosphorus, nitrogen, and COT contents are very high. Thirty-four species of benthic foraminifera were identified and their response to pollution is very remarkable, in which their distribution shows barren area, corresponding to the highly polluted area. Away from the contaminated area, the density and the diversity of these organisms increase. Statistical analyses (principal component analysis (PCA)/FA and matrix correlation) show a possible control of these pollutants on biotic indices (with negative correlation), in addition to the presence of tolerant and sensitive species to pollution. A variety of test malformations were noticed especially in Ammonia beccarii, Peneroplis planatus, Sorites variabilis, and Adelosina pulchella. Unpolluted stations were dominated by species characteristic of shallow water environments with sandy sediment such Ammonia parkinsoniana, Triloculina trigonula, Quinqueloculina agglutinans, and P. planatus.

[Orbital inflammatory pseudotumor with optic neuritis in Behçet's disease]. / Pseudotumeur inflammatoire de l'orbite associée à une névrite optique au cours d'une maladie de Behçet.

OBJECTIVE: To report an atypical case of orbital inflammatory pseudotumor associated with optic neuritis revealing Behçet's disease. CASE REPORT: A 37-year-old man was worked up for headache and progressive decreased bilateral visual acuity most profound in the left eye. Initial ophthalmologic exam was without abnormal findings. Orbital CT scan and MRI appeared consistent with orbital inflammatory pseudotumor involving the left lateral rectus muscle (orbital myositis). The patient was treated with oral corticosteroids, but clinical response was incomplete. Follow-up ophthalmologic exam revealed acute inflammatory right optic neuritis (visual acuity: 5/10, papillitis on fundus exam and papillary edema on fluorescein angiography) and persistence of left orbital myositis. The diagnosis of Behçet's disease with ocular complications was made on the basis of recurrent oral ulcers, scars from genital ulcerations and pseudofolliculitis. It was decided to treat the patient with a bolus of IV methylprednisolone for 3 consecutive days, followed by oral prednisolone and cochicine, leading to stabilization of the ocular manifestations. CONCLUSION: To our knowledge, this is the first report of such an association leading to a diagnosis of Behçet's disease. The coexistence of these two manifestations as well as the contralateral nature of the involvement speaks to the pathogenic mechanism of these complications (systemic vasculitis).

[Sporotrichoid cutaneous leishmaniasis in Tunisia: a clinical and histological study]. / Forme sporotrichoïde de leishmaniose cutanée en Tunisie: étude clinique et histologique.

BACKGROUND: The sporotrichoid variety of cutaneous leishmaniasis is defined by the presence of dermal and hypodermal nodules along the lymphatic stream, and remote from the primary inoculation lesions. This clinical form is usually considered rare. The aim of our study was to investigate the epidemiological, clinical, histological and evolutionary particularities of sporotrichoid cutaneous leishmaniasis in the south of Tunisia. PATIENTS AND METHODS: During a systematic study of all cases of cutaneous leishmaniasis from the south of Tunisia diagnosed in our hospital in 2002, sporotrichoid forms were diagnosed on the basis of clinical criteria. In all cases of sporotrichoid cutaneous leishmaniasis, the principal clinical characters were systematically specified. Cutaneous biopsies of subcutaneous nodules were performed in six cases. RESULTS: Of 102 patients with cutaneous leishmaniasis, 19 presented sporotrichoid cutaneous leishmaniasis, that is, a frequency of 19%. Between two and 20 painless subcutaneous nodules were arranged in linear strings on the upper leg in 79% of cases. Time to appearance varied between 12 days and one year after the primary lesions. Fourteen appeared without any preliminary treatment for cutaneous leishmaniasis and five appeared after Glucantime infiltration in the primary lesions. Biopsies of the nodules showed an inflammatory infiltrate composed of lymphocytes and histiocytes. This infiltrate was particularly dense and rich in plasmocytes at the level of the deep dermis. The biopsies were deep enough to involve the hypoderm in one case and the same type of infiltrate was noted at the level of interlobular septa. A small number amastigotes was seen in one deep biopsy sample. Outcome was favourable in all cases under treatment. CONCLUSION: Sporotrichoid cutaneous leishmaniasis appears to be common in the south of Tunisia, were cutaneous leishmaniasis is dominant because of Leishmania major. It is not associated with a poor prognosis.

[Anatomo-clinical features of an erysipeloid form of cutaneous leismaniasis in Tunisia]. / Particularités anatomo-cliniques d'une forme érysipéloïde de leishmaniose cutanée en Tunisie.

The erysipeloid form of cutaneous leishmaniasis is considered as an unusual and rare clinical presentation in Tunisia. Our prospective study on 4 observations, aimed at examining the clinical, histological and progressive features of the "erysipeloid" form of cutaneous leishmaniasis. Our patients were 3 females and one male more than 62 years old. Their cutaneous leishmaniasis was clinically characterised by an infiltrated and extensive plaque which was localised on the face covering the nose and cheeks looking like erysipelas. The treatment was intramuscular meglumine antimoniate (Glucantime) in three cases and metronidazole in one case. A regression without scar was noticed in all the cases. On the histological examination, we observed an intense epidermic and constant hyperplasia with presence of amastigotes in 3 cases. Our study shows the lesional polymorphism of the old word cutaneous leishmaniasis in our region. The "erysipeloid" form of cutaneous leishmaniasis is a rare clinical presentation which generally affects women. If the clinical aspect is very meaningful, the histological aspect is meaningful but not specific.

[Clinical polymorphism of cutaneous leishmaniasis in centre and south of Tunisia]. / Polymorphisme clinique de la leishmaniose cutanée du centre et sud tunisien.

The cutaneous leishmaniasis (CL) is an affection which is quite well known in Tunisia. The zoonotic cutaneous leishmaniasis caused by Leishmania major by far the more frequent, is endemo-epidemic in the centre and south of the country. It is characterized by clinical polymorphism. The aim of our study is to precise the different clinical aspects of the CL in our region through a prospective study of 102 cases. The average age was 37.8 years old (from 4 to 78 years old) with a slight female predominance. All of our cases lived or stayed in an endemic zone. Various clinical forms were noted in our series. The ulcerated and crusted form was predominant: 54,9% of the cases, the lupoid form was noted in 15.7% of the cases and the sporotrichoid form was observed in 18.6% of the cases. Other rare forms were noted (papular erysipeloid, verrucous, vegetant, erythematous, ulcerated, necrotic and linear) were noted in 25.5% of the cases. Our series is characterized by the multiplicity of clinical forms. Besides, the classical form (ulcerated and crusted form), other clinical form can be individualised: lupoid, loco regional spreading (sporotrichoid form, satellite papules). Some atypical forms can be found which are due to variation of host immune responses and to the strain of the parasites involved.

[Sexual fantasies and impotence. Apropos of 2 cases]. / Fantasmes sexuels et impuissance. A propos de deux cas.

Sexual fantasies, drawn of the erotic memory that constitutes himself the long of the sexual history of each, are indispensable, for the good sexual working. Some authors tend to consider the imagination like a "veritable intra psychic erogenous zone". However, people who, for a reason or an another, persisted to avoid all sexual activity before the marriage and to separate all erotic velleity, don't they risk to have an erotic imaginary atrophied, who could sound negatively once on their sexual behaviour, after the marriage, when all is suddenly authorized for them? Through two clinical observations of secondary sexual impotence, we are going to try to show the ominous consequences of such a relentlessness (imposed by the education, the social morals or the religion), against sexual stimulation, on the sexuality. These consequences are more easily observable in men, of the fact of their active role, in the sexual activity. Our purpose is to insist on the necessity to explore the sexual history owing all sexual dysfunction, and to place it in the biographic setting of the impatient; but also and especially to attract the attention on the importance of a precocious sex education, adapted to age, to the personal maturation and the cultural and educational context.

[Periarteritis nodosa associated with lung cancer. A new observation]. / Periarterite noueuse et cancer du poumon. Une nouvelle observation.

The cases of vasculitis associated to malignant tumour are uncommon, their course which is often parallel suggests a direct link between them. We report the observation of periarteritis nodosa associated with a lung cancer discovered in the following of vasculitis; whereas the course is favorable in 83 years old man without particular history. The frequency of neoplasia with vasculitis is estimated between 3 and 8%, and periarteritis nodosa can't be a paraneoplastic syndrome. Lung and colic tumours are the most frequent reported of the solid tumours. The delay of appearance of vasculitis varies from 25 months before to 9 months after cancer diagnosis. There are many factors, either some treatment, the neoantigens involve the formation of immune complexes, lymphokines and some vasoactive substances.