Assessment of MYCN amplification status in Tunisian neuroblastoma: CISH and MLPA combining approach

Background: Neuroblastoma [NB] shows a complex combination of genetic aberrations. Some of them represent poor genetic prognosis factors that require specific and intensive chemotherapy. MYCN amplification consists of the major bad outcome prognostic factor, it is indeed frequently observed in aggressive neuroblastomas. To date different methods are used for MYCN status detection

Objectives: The primary aim of our study was to provide a critical assessment of MYCN status using 2 molecular techniques CISH and MLPA. We also focused on the correlation between neuroblastoma genetic markers and patient's clinical course among 15 Tunisian patients

Methods: we developed a descriptive study that includes 15 pediatric Tunisian patients referred to our laboratory from 2004 to 2011. We reported the analysis of fresh and FFPE NB tumors tissues

Results:No significant correlation was found between COG grade and patients overall survival. Assessment of NMYC gene copy number by kappa statistic test revealed high concordance between CISH and MLPA tests [kappa coefficient = 0.02]

Conclusion: Despite misdiagnosing of MYCN status fewer than 5 copies, MLPA remains an effective molecular technique that enables a large panel of genomic aberrations screening. Thus combining CISH and MLPA is an effective molecular approach adopted in our laboratory. Our results allow pediatric oncologists to set up the first Neuroblastoma therapeutic strategy based on molecular markers in Tunisia

[ natural history of hepatitis B virus cirrhosis after the first hepatic decompensation in Tunisia]

To define the natural long term course of viral B cirrhosis after the onset of hepatic decompensation and to determine the predictive factors of death. Retrospective longitudinal study including 77 cases of viral B cirrhosis among 192 consecutive patients with cirrhosis, hospitalized between 1997 and 2005 for the first hepatic decompensation. All those patients were followed- up until death or until December 2006. The probability of survival after the first hepatic decompensation was calculated using the Kaplan Meier method. The predictive factors of death were determined through univariate and multivariate analyses with the Cox regression model. Fifty four men and 23 women with an average age of 54 +/- 14.9 years were hospitalized for the first decompensation of the viral B cirrhosis. The 77 patients had been under observation for an average period of 24.2 +/- 21.1 months. During that time 64% among them died. The probability of survival after decompensation was 47% in 2 years and 22% in 5 years. During follow- up, ascites was the most frequent decompensation [85%] followed by hepatic encephalopathy [38%], variceal hemorrhage [34%], jaundice [30%], hepato renal syndrome [27%], hepatocellular carcinoma [21%], and spontaneous bacterial peritonitis [14%]. At univariate analysis four factors were predictive of death: Child Pugh C score [p=0.009], hepatocellular carcinoma [p=0.01], rate of serum gammaglobulin superior to18g / l [p=0.008] and prothrombin time inferior to 50% [p=0.02]. According to the multivariate analysis only the rate of serum gammaglobulin superior to 18g /l was an independent predictive factor of mortality [p=0,001] with IC [95%] [1.623 - 5.88]. In Tunisia, the prognosis of viral B cirrhosis after the first decompensation is bad, because a patient on 5 only was able to survive beyond 5 years. Ascites is the most frequent decompensation. Only the rate of serum gammaglobulin superior to 18g / l is an independent predictive factor of mortality

Comparison of cigarette and waterpipe smoking among pupils in the urban area of Sousse, Tunisia

Epidemiological and observational evidence suggests that waterpipe use is growing in popularity worldwide. The purpose of this study was to examine the prevalence of cigarette and water pipe tobacco use among pupils aged 13-17 years in the urban area of Sousse, Tunisia and to identify the factors which predict current cigarette and/or waterpipe smoking in this population. A cross-sectional study was carried Out on a representative sample of schoolchildren aged between 13 and 17 years in colleges and public secondary schools of the urban area of Sousse. We used a pre tested and self administered questionnaire to measure tobacco consumption. The significance level for all analyses was p<0.05. Statistical analysis was conducted with SPSS 10.0 software. Participants were 1569 youth. Fifty two percent of them were male. The mean age of the sample was 15 +/- 1.5 years. Total cigarette smoking percentage for ever and current use were 33.1%and 7.6%respectively. Total water pipe smoking percentage for ever and current use were 19.3%and 5.2%respectively. Overall, the total percentages of cigarette and water pipe smoking [ever and current] were higher for male and aged pupils. Multivariate regression analyses showed that the two types of tobacco use were related. Despite the growing adoption of water-pipe smoking, there remains limited research in this area. Increased surveillance and additional research are necessary to address this growing threat to public health

[Profiles of embryos designed by fertilization assisted and their impact on the rate of pregnancies]

evaluation of our experience in assisted fertilization by ICSI with analysis of prognostic factors. retrospective study of 199 cycles of ICSI during a 2 years and half period between September 2001 and February 2004. The procedure of ICSI included several stages: collection and preparation of the semen, stake in culture of oocytes, removing of cumulus cells and microinjection of oocytes, control of the fertilization and embryo transfer respectively 18 to 22 hours and 48 hours after the microinjection. the mean age of the patients was 32,4 years and the mean duration of infertility was 7 years. The mean fertilization rate was 50%. The mean number of embryos transferred was 2.46. We got 41 pregnancies of which 36 were clinical pregnancies [87.8%]. The pregnancy rate was 26.1% by transfer and 21% by retrieval. The women age was the first prognostic factor of ICSI. The pregnancy rate was 27% before the age of 35 years, decreases with age and annul himself after 40 years [P=0.02]. The other prognostic factor was the number of 4 cells embryos transferred. The pregnancy rate increases with significant way with the number of 4 cells embryos transferred: 15% after transfer of only one embryo versus 43% after transfer of 3 embryos or more [P=0.04]. The ICSI prognostic has not been influenced with significant way by the origin or the sperm mobility, by the duration of infertility and by the total number of embryos transferred. the ICSI represents currently the treatment of choice of couple having extreme spermatic changes. The results of our study are comparable to those reported in the literature. The women age and the number of 4 cells embryos transferred are the main factors predicting of the ICSI prognostic

[Tracking of cardiovascular risk factors among school children: a four-year study of a population in Susa, Tunisia]

In order to confirm the phenomenon of tracking of cardiovascular risk factors among school children, we undertook in 2003, a prospective survey of a population of 789 pupils aged 13 to 15 years who had participated in a first investigation on cardiovascular risk factors in 1999. We were able to follow and study 453 pupils [57.4% of the initial population]. Prevalences of hypertension and obesity were respectively 11.3% and 6.1% without significant difference between sexes. On the other hand, hypercholesterolemia was significantly more elevated among girls than boys [16.1% versus 9.3%, p=0.039]. Children classified initially as hypertensive, obese or having a hypercholesterolemia were identified 4 years later at a subsequent exam as hypertensive, obese or having a hypercholesterolemia in respectively 25%, 48.9% and 59%. The stability of cardiovascular risk factors among children imposes an early screening for a better management and a policy of cardiovascular health promotion since childhood based essentially on prevention of risk factors in order to reduce the cardiovascular disease burden in adulthood