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Introduction: Surgery is indicated for acute appendicitis but there is controversy regarding precise timing for appendectomy. Objective: Our aim was to evaluate the impact of time delay from emergency department presentation to surgery in developing complicated appendicitis in children and associated morbidity. Methods: 540 charts of children, who underwent appendectomy, between January 2013 and December 2016 were retrospectively reviewed. Groups were divided by time of intervention. Group 1: less than 24h (n=209, 38.7%), group 2: 24h to 48h (n=293, 54.5%), and group 3: greater than 48h (n=38, 6.8%). We considered complicated appendicitis gangrenous, abscess or perforated appendix per operatively and on histopathologic examination. Statically analysis and was performed to search the predictors of complicated appendicitis and evaluate postoperative complications. Results: Among 540 children included in the study, 164 (30.4%) had complicated acute appendicitis. There was no correlation between delay to surgery and the risk of developing a complicated form of the disease for group 1 and Group 2. Beyond the 48th h (group 3), the rate of developing complicated appendicitis and post-operative complications increased significantly. Hospital stay was not affected by delayed surgery. Conclusion: A short in-hospital delay before surgery less than 48 h, for acute appendicitis in child, is not associated with an increased rate of complex appendicitis neither associated morbidity.

International audience; Fault tolerance is an essential requirement for critical programming systems, due to potential catastrophic consequences of faults. Several approaches to evaluate system reliability parameters exist today; however, their work is based on the assumptions that hardware and software failures happen independently. The challenge in this field is to take into account the hardware-software interactions in the evaluation of the model. In the continuity of the CETIM project (Belhadaoui et al. 2007) whose principal objective is to define an integrated design of dependable mechatronic systems, this work evaluates important reliability parameters of an embedded application in a stack processor architecture using two dynamic models. The first one (stack processor emulator (Jallouli et al. 2007)) allows the study of dynamic performance and the evaluation of a fault-tolerant technique. The second one (information flow approach (Hamidi et al. 2005)) evaluates the failure probability for each assembler instruction and for some program loops. The main objective is to estimate the failure probability of the whole application. The hierarchically modelling with the information flow approach makes it possible to evaluate the efficiency of protection program loops. These loops ensure the fault tolerance policy by recovering imminent failures and allow the application to run successfully thanks to a permanent software recover mechanism: in case of a detected and not corrected error, the system returns to the last faultless state. This work is useful because it allows adjusting the architecture and shows the advantages of the hardware-software interactions during the co-design phase before the hardware implementation. It puts the hand on the critical points in term of reliability thanks to the scenarios of critical failure paths in the processor architecture.

Nasopharyngeal carcinoma (NPC) is the primary cancer of the head and neck localisations in the Salah Azaiz Institute (Tunisia). From 1970 to 1987, 80 patients with histologically proven T4 N0 NPC, were treated with exclusive radiation (70-75 Gy to the primary lesion and 50-55 Gy to cervical lymph nodes). The T4 N0 represents 7% of all NPC and 16% of the T4 treated in our Institute. Ninety percent of the patients are over 20 years old with a mean age of 52 years. The sex-ratio was 4:1. Extension to the brain was observed in 55% of the cases. Local control was 70% at 2 months after the end of irradiation. The actuarial survival at 5 years was 47%. Distant metastasis represent 13% (30% of all NPC). The main failure of treatment was local recurrence. The T4 N0 is probably a particular entity concerning the age, the response to radiotherapy and the low rate of distant metastasis.