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Pantone-Valentine leucocidin (PVL) and gAMMA-haemolysin (Hlg) are members of the synergohymenotropic toxin family produced by Staphylococcus aureus and encoded by pvl and hlg genes, respectively. Many reports describe an association between PVL toxin and necrotic lesions involving skin and mucosa. The aim of this study was to determine the prevalence of S. aureus strains carrying pvl and hlg genes and to investigate a possible relationship between pvl- and hlg-positive S. aureus with specific clinical presentations. Between January 2005 and July 2007, a total of 143 S. aureus strains including 58 meticillin-resistant S. aureus (MRSA) and 85 meticillin-susceptible S. aureus were screened for pvl and hlg genes by multiplex polymerase chain reaction. These strains were isolated from 141 patients for whom demographic and clinical data were recorded. Thirty-one (21.7%) and 77 (53.7%) isolates were positive for pvl and hlg genes, respectively. Twenty-one (67.7%) pvl-positive strains were MRSA (P = 0.001). Among pvl-positive strains, 16 (51.6%) were community-acquired. There was a strong association between pvl genes and skin and soft tissue infections, especially abscesses (60% of strains; P = 0.008) and furunculosis (55.5% of strains; P = 0.036). Our findings confirmed the association between pvl-positive strains, cutaneous infections and meticillin resistance in S. aureus. [ABSTRACT FROM AUTHOR]

Delamination is one of the most important defects in fiber reinforced composite laminates. This paper presents the delamination resistance of thick woven glass fiber reinforced polyester specimens and experimentally examines the effect of ply orientations in terms of the critical strain energy release rate. Specimens with different ply orientations (0°, 30°, 45° and 70°) are fabricated with plain woven (taffetas) fabrics. The tests used for the experiments are Double Cantilever Beam (DCB) for pure mode I, End Load Split (ELS) for pure mode II and Mixed Mode Flexure (MMF) for mixed mode I/II under static conditions. The experimental results have been expressed in terms of total strain energy release rate and R -curves. Results show that fiber bridging for woven fabrics occurred due to non-midplane crack propagation. The fracture toughness results show that the delamination resistance increase with ply angle until 45° then it decrease. [ABSTRACT FROM AUTHOR]

Abstract: Cellular materials such as aluminium honeycombs combine lightweight with an efficient crash energy absorption capability. They have a major role in a wide range of transport applications to reduce gas emission by the design of lighter structures but remaining safe in accident case. Many investigations on the honeycomb behaviour have been performed, under uni-axial compression loading and more recently under mixed shear–compression loading. The influence of the in-plane orientation has not been however considered. The objective is to develop a reduced numerical model able to investigate, with a reduced cost of calculations, the dynamic behaviour of honeycomb under mixed shear–compression loading and taking into account of the in-plane orientation angle. Reduced model based on the periodicity procedure is developed and its validity range is evaluated. The numerical results show that in terms of pressure–crush curve and collapse mechanisms, the reduced model is consistent with a complete FE model composed of 39 cells with a CPU-time gain efficiency about 97.17%. The reduced model is valid from a loading angle to a loading angle contained between and . The reduced model allows investigating in depth the influence of the in-plane orientation and the loading angles on the crush behaviour with minimum time calculations in accord with the validity range. [Copyright &y& Elsevier]

Summary: Panton–Valentine leucocidin (PVL) and γ-haemolysin (Hlg) are members of the synergohymenotropic toxin family produced by Staphylococcus aureus and encoded by pvl and hlg genes, respectively. Many reports describe an association between PVL toxin and necrotic lesions involving skin and mucosa. The aim of this study was to determine the prevalence of S. aureus strains carrying pvl and hlg genes and to investigate a possible relationship between pvl- and hlg-positive S. aureus with specific clinical presentations. Between January 2005 and July 2007, a total of 143 S. aureus strains including 58 meticillin-resistant S. aureus (MRSA) and 85 meticillin-susceptible S. aureus were screened for pvl and hlg genes by multiplex polymerase chain reaction. These strains were isolated from 141 patients for whom demographic and clinical data were recorded. Thirty-one (21.7%) and 77 (53.7%) isolates were positive for pvl and hlg genes, respectively. Twenty-one (67.7%) pvl-positive strains were MRSA (P =0.001). Among pvl-positive strains, 16 (51.6%) were community-acquired. There was a strong association between pvl genes and skin and soft tissue infections, especially abscesses (60% of strains; P =0.008) and furunculosis (55.5% of strains; P =0.036). Our findings confirmed the association between pvl-positive strains, cutaneous infections and meticillin resistance in S. aureus. [Copyright &y& Elsevier]

Copyright of Journal of Medical Mycology / Journal de Mycologie Médicale is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Medical Mycology / Journal de Mycologie Médicale is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims This study aimed (1) to evaluate the impact of pre-procedural two-dimensional speckle-tracking echocardiography (2D-STE) on long-term outcome after successful percutaneous mitral balloon commissurotomy (PMC) in patients with mitral stenosis (MS) and the prognostic value on BNP for restenosis. Methods and results One hundred and twenty-two consecutive MS patients with preserved left ventricular ejection fraction (LVEF ≥ 50%) and who underwent successfully PMC were studied. Successful immediate result was defined as post-procedural mitral valve area ≥ 1.5 cm 2 and ≤ 2/4 mitral regurgitation by catheterization. During a follow-up of 5.5 ± 2.3.0 years, there were 14 hospitalisations for heart failure (11%) and 22 late mitralvalve reintervention for restenosis (18%) and 21 patients experienced atrial fibrillation (17%). Univariate predictors of heart failure were global longitudinal strain (GLS), age, right ventricular function, left atrial volume, BNP, and pre- and post-procedural pulmonary artery pressures (PAP). In the multivariate Cox model, GLS and PAP were the strongest predictor of HF [hazard ratio (HR) (95% CI), 1.56 (1.03–4.2); P = 0.01 and 1.26 (1.1–12.4); P = 0.02]. For atrial fibrillation and restenosis, LA volume, GLS and post-procedural left atrial pressure (LAP) were univariate predictors’ factors. Multivariable analysis, demonstrated that GLS and LA volume remained in the final model with interesting predictive value [GLS HR (95% CI), 1.27 (0.87–11.72); P = 0.056, 2.66 (1.24–12.44); P = 0.01]. There was no correlation between BNP value and restenosis. Conclusion GLS and PAP are interesting predictor of long-term outcome after successful PMC and provides incremental prognostic value over traditional parameters. BNP and LA volume provide more informations regarding supraventricular arythmia on the follow-up. [ABSTRACT FROM AUTHOR]

Numerical simulations of honeycomb behaviour under mixed shear-compression loading are performed to overcome a limitation of the experimental measurements and to investigate the normal and the shear honeycomb behaviours separately. A detailed FE model allowing to simulate the mixed shear-compression honeycomb behaviour is presented. A validation between numerical and experimental results in terms of crushing responses and collapse mechanisms allows to dissociate the normal and shear forces components. They are used to identify the parameters of a macroscopic yield criterion expressed as a function of the impact velocity, the loading angle and the in-plane orientation angle. A well known dynamic enhancement phenomenon is confirmed by this macroscopic yield criterion. However, as a new result, this dynamic enhancement is reversed when the loading angle reaches a critical value. An analysis of the collapse mechanisms is carried out under both quasi-static and dynamic loading conditions in order to explain this inversion. [ABSTRACT FROM AUTHOR]

Understanding the phenomenon of fracture is very important for many industrial applications. Numerical tools are needed to describe the crack pattern and the energies evolution in any specimen. Then, for example, the acoustic properties of any structure can be used for nondestructive testing. The aim of this article is to demonstrate the capabilities of the phase-field model for these processes. It can be used not only to study the wave propagation in materials consisting of several different materials or phases in composite pieces, but also to study the crack nucleation and propagation in homogeneous or composite materials. Numerical analysis of brittle fracture using the phase-field model is elaborated in this paper. We focus on the behavior of the linearly elastic bodies submitted under quasi static and dynamic loading. The influence of considering the kinetic energy on the dynamic phase-field pattern and on energies evolution is detailed. In fact, using the finite element method with Newmark scheme, we show the influence of the transverse wave and the celerity C T on energies evolution. Also, some numerical computations in quasi static fracture using phase-field model and staggered scheme will be elaborated. A qualitative agreement with experiments is shown. A comparison between quasi static and dynamic crack propagation is made. [ABSTRACT FROM AUTHOR]

This study proposes a constitutive model of viscous behaviour of short-fibre reinforced composites (SFRC) with complex distributions of fibre orientations and for a wide range of strain rates. The model is based on an additive decomposition of the state potential for the computation of composite macroscopic behaviour. Thus, the composite material is seen as the assembly of a matrix medium and several linear elastic fibre media. The division of short fibres into several families means that complex distributions of orientation or random orientation can be easily modelled. The matrix behaviour is strain-rate sensitive, i.e. viscoelastic and/or viscoplastic. Viscoelastic constitutive laws are based on a generalised linear Maxwell model and the modelling of the viscoplasticity is based on an overstress approach. The accuracy of the model is assessed for the case of polypropylene reinforced with short glass fibres. Matrix material parameters are identified from experimental tests carried out at several loading rates. Distributions of fibre orientation are characterised by micro-computed tomography. Comparisons between numerical and experimental responses in different loading directions and under different strain rates demonstrate the efficiency of the model. [ABSTRACT FROM AUTHOR]

Cellular materials such as aluminium honeycombs combine lightweight challenges with high mechanical performance for crash energy absorption regulations. This paper investigates experimentally the dynamic behaviour of an aluminium alloy honeycomb under mixed shear-compression loading with a special attention on the combined effects between the cells in-plane orientation and the loading angles. An improvement of an existing experimental SHPB set-up is proposed and an original measurement technique based on an electro optical extensometer is used to overcome a separation phenomenon observed during the test. A significant effect of the loading angle ψ is reported in the crushing responses. The in-plane orientation angle β effects become more significant when the loading angle increases. An investigation of collapse mechanisms is also presented. Three deforming pattern modes are identified and it is shown that their distribution is related to the combined effects of the in-plane orientation angle β and the loading angle ψ . [ABSTRACT FROM AUTHOR]

Résumé Introduction La maladie de Behçet (MB) est une vascularite multisystémique qui associe diverses manifestations. L’atteinte oculaire fait partie des critères diagnostiques de la MB. Elle constitue une atteinte fréquente et grave qui survient dans 30 à 80 % des cas. Patients et méthodes Nous avons mené une étude rétrospective des dossiers de patients suivis pour MB entre 1995 et 2010. Les patients ayant une atteinte oculaire confirmée par l’examen ophtalmologique et l’angiographie ont été analysés et comparés avec les patients sans atteinte oculaire. Résultats Parmi 150 dossiers de patients suivis pour MB, 85 dossiers ont été retenus. Parmi ces 85 patients, 33 (38,5 %) avaient une atteinte oculaire. L’âge moyen des patients était de 35,3 ans. Le sex-ratio H/F était de 5,6. L’atteinte oculaire était bilatérale chez 26 patients (78,8 %). L’uvéite était l’atteinte oculaire la plus fréquente retrouvée chez 31 patients (93,9 %). La panuvéite était la localisation anatomique la plus fréquente retrouvée chez 21 patients (63,6 %). La comparaison des patients suivis pour MB avec ou sans atteinte oculaire a montré une association statistiquement significative entre l’atteinte oculaire et neurologique ( p = 0,03). Tous nos patients ayant une atteinte oculaire ont été traités par corticoïdes. Les immunosuppresseurs (IS) étaient utilisés chez 28 patients (84,8 %). Le cyclophosphamide (CPM) était l’IS le plus utilisé de première intention (71,4 %). Le CPM relayé par l’azathioprine (AZA) était le schéma thérapeutique le plus adopté (28,5 %). L’infliximab (IFX) a été prescrit chez 7 patients. Conclusion Le pronostic oculaire au cours de la MB peut être amélioré par une prise en charge précoce et un suivi régulier. Il est important d’adapter le protocole thérapeutique à la forme anatomo-clinique, à la sévérité de l’uvéite et aux manifestations extraoculaires associées. Background Behçet's disease is a multisystemic inflammatory disease characterized by recurrent oral and genital ulcers, skin lesions and uveitis. The diagnosis of Behçet's disease is based on clinical criteria. The etiology of the disease is unknown but the wide variations of ethnic prevalence and of the prevalence in the same ethnic group in different geographic areas indicate environmental triggering of a genetically determined disorder. Patients and methods A retrospective analysis of the medical charts of 150 Behçet's disease patients seen in our internal medicine department between 1995 and 2010 was undertaken. Patients with confirmed ocular involvement were analyzed and compared with those without ocular involvement. Results Among the 150 medical charts studied, 85 patients were included in the study. Thirty-three patients (38.5%) had ocular involvement. Mean age at ocular BD diagnosis onset were 35.3. Male to female ratio was 5.6. Ocular involvement was bilateral in 26 patients (78.8%). Uveitis was the most common ocular lesion ( n = 31 patients, 93.9%). Panuveitis was the most common anatomical location ( n = 21, 63.6%). The comparison of patients treated for BD with or without ocular involvement showed a statistically significant association between ocular and neurological manifestations ( p = 0.03). All patients with ocular involvement were treated with corticosteroids. Immunosuppressive (IS) treatments were used in 28 patients (84.8%). Cyclophosphamide was the most used as first-line treatment (71.4%). Cyclophosphamide relayed by azathioprine was the most adopted protocol (28.5%). In case of resistance or relapse and depending on the other manifestations of the BD, the IS used in first intention was replaced by another one. Seven of the 33 patients had received treatment with infliximab (IFX) after failure of other therapeutic lines. Conclusion Ocular prognosis in the BD can be improved by early treatment and regular monitoring. It is important to adjust the therapeutic protocol to the anatomic form, to the severity of uveitis and to the extra-ocular manifestations associated. [ABSTRACT FROM AUTHOR]

Objective To compare the benefits of a thermal cure and non-thermal rehabilitation in treatment of knee osteoarthritis (KOA). Methods Randomized therapeutic trial including patients with knee osteoarthritis (American College of Rheumatology criteria). Patients were randomly divided into two groups. Spa treatment consisted of underwater shower, massage-jet showers, hydromassage, pool rehabilitation and peloid therapy. Non-thermal rehabilitation consisted of analgesic physiotherapy, muscle strengthening and group physical rehabilitation. A blinded evaluation was carried out at day 21 and 12 months following treatment. It was based on the visual analogic scale of pain (VAS), which represented the primary endpoint. Results Two hundred and forty patients were included (February–June 2005). The spa treatment and non-thermal rehabilitation groups included 119 and 121 patients respectively. Two hundred and thirty-three patients completed their treatments. Significant improvement of the visual analogic scale of pain was noted in the thermal cure group (61.6 ± 15 at day 0 versus 46.5 ± 22.4 at 12 months, P < 0.001), but not in the non-thermal group (64.1 ± 15 at day 0 versus 62 ± 29 at 12 months, P = 0.68). At day 21, comparison of the two groups revealed no significant difference on the VAS ( P = 0.08). However, at 12 months, the thermal cure group was significantly more improved ( P = 0.000). Conclusion In our study, crenobalneotherapy had resulted, at 12 months, in more pronounced long-term improvement of the painful symptoms of KOA than had non-thermal rehabilitation. [ABSTRACT FROM AUTHOR]

Abstract: Background: Limited data are available on the frequency of RBC alloimmunization and autoimmunization in transfusion-dependant Tunisian β thalassaemia patients. Materials and methods: We analyzed the clinical and transfusion records of 130 patients (57 females and 73 males; mean age 119months; range 12–11months) with β thalassaemia major and who had regular blood transfusions for periods ranging from 12 to 311months. Results: Of the 130 patients, ten (7.7%) developed RBC alloantibodies. The most common alloantibodies were directed against antigens in the Rh systems. Erythrocyte-autoantibodies as determined by a positive direct antiglobulin Coombs test, developed in 52(40%) patients with and without underlying RBC alloantibodies, thereby causing autoimmune haemolytic anaemia in eleven patients (21%). Conclusions: Autoimmunization to erythrocyte antigens is a frequent complication in patients with β thalassaemia major. Several factors might have contributed to the high autoimmunization rate observed in this study, including non phenotypic blood exposure and alloantibody formation prior to positive Coombs test. [Copyright &y& Elsevier]

Summary: The promotion and support of breast-feeding is a global priority with benefits for maternal and infant health, particularly in developing countries. The objective was to test if a specified programme of health professional breast-feeding support affects the initiation and the duration of breast-feeding. Population and methods: Two troops of children and their mothers were followed compared to the practice of the breast-feeding in two maternal and infantile protection centres in Tunis. The health professionals in the first centre received a strengthening of the formation on this practice with supervision and training, a calendar of follow-up of these children was applied. No additional formation was given to the health professionals in the second centre. The data were seized and analyzed by Epi Info software. The test of Log Rank was used in the analysis of the reliability''s Kaplan Mayer survival curves. Results: The reliability curves of the breast-feeding according to the age showed a statistically significant difference between the two centres. The intermediate duration of the continuation of the breast-feeding was 13months for the first centre versus five months for the second (p <10−3). The study in logistic regression showed that only the accompaniment of the health professionals was correlated with the continuation of the breast-feeding (RR: 5.16 CI 95%: [3.52–4.93], p <10−3). Conclusion: The accompaniment of the health professionals would intervene like a direct factor in the maintenance of the breast-feeding. [Copyright &y& Elsevier]

Abstract: Aims of the study: Idiopathic dilated cardiomyopathy (IDC) is a complex disease. The interest of this study were to investigate the epidemiology characteristics of the disease and to evaluate the prognostic echocardiographic markers by region in order to highlight the existence of genetic risk factors and/or environmental and to identify those patients who could benefit from early treatment and better care to avoid further complications of the disease. Patients and methods: This is a retrospective study based on the Fischer exact and bilateral Mann-Whitney test. Results: We included 526 patients with dilated cardiomyopathies of them we detected 50 cases of IDC including 12 families: The average age was 39,3±15.2 years. The sex ratio was 2.6. Mean left ventricular end-diastolic diameter (DIVGd) was higher in patients from the North East region (44.3±6.2mm/m2). Using Receiver Operating Characteristics (ROC) curve, we found a threshold value of 40mm/m2. The odds ratio associated with this cutoff was 9.2. Conclusion: Our results suggest that the prevalence and severity of IDC were higher in the North East region of Tunisia. Furthermore, large-scale prospective studies are needed to confirm these findings. In confirmation of a higher prevalence, a genetic study should be undertaken in this region. [Copyright &y& Elsevier]

Abstract: Objectives: In this study we have determined the allele frequency of HFE mutations H63D and C282Y in a group of Tunisian β-thalassemia major patients. These two mutations are implicated in hereditary hemochromatosis among Caucasians. In this study we wanted to correlate these mutations with the iron status in major β-thalassemia patients. Design and methods: Fifty Tunisian major β-thalassemia were screening for the C282Y and H63D by digestion of polymerase chain reaction products (RFLP). Serum ferritin level was measured by immunoenzymatic microparticular essay. Results: The allele frequency of H63D mutation was 17%. C282Y mutation was not present in our studied patients. No statistically significant difference of serum ferritin level was found between major β-thalassemia with and without HFE mutations. Conclusion: Our results suggest that H63D mutation is so frequent in Tunisian major β-thalassemia patients than in the general population and that the coinheritance of H63D mutation does not influence the severity of iron overload in these patients. [Copyright &y& Elsevier]