Profil clinique, biologique et traitement des drépanocytaires régulièrement suivis au Centre Hospitalier Universitaire de Libreville / Clinical, biological and treatment profile of sickle cell patients regularly followed at Libreville University Hospital Center

Introduction: La mise en place depuis Septembre 2016 au Centre Hospitalier Universitaire (CHUL) d'une consultation d'hématologie dédiée aux adultes drépanocytaires a été l'occasion de mener cette étude dont le but principal était d'établir les profils clinique et paraclinique de l'adulte drépanocytaire régulièrement suivi.Patients et méthodes : Il s'agissait d'une étude rétrospective. La population d'étude était constituée de patients drépanocytaires homozygotes de 18 ans et plus, qui avaient effectués au moins trois consultations d'hématologie sur une année. Les informations recueillies, après étude du dossier médical et entretien téléphonique avec le patient, concernaient les données socio-démographiques, l'histoire de la drépanocytose, les antécédents, les complications de la maladie, les examens biologiques et radiologiques et le traitement.Résultats : Au total 88 patients répondaient aux critères d'inclusion sur les 233 drépanocytaires vus durant la période de l'étude. L'âge moyen était de 30,4 ± 7,8 ans. L'interrogatoire révélait que la crise vaso-occlusive (CVO) était la principale complication aiguë et la lithiase vésiculaire (36,3%) la première complication chronique. L'hémoglobine moyenne était de 7,8 g/dl et pour 49,3% des patients elle se situait entre 7 et 9 g/dl. Les leucocytes étaient augmentés dans 65,7%. L'échographie cardiaque réalisée chez 35 patients retrouvait 11,1% d'hypertension artérielle pulmonaire et 22,8% d'hypertrophie ventriculaire gauche. L'intensité de la crise douloureuse motivait une consultation au service des urgences du CHU dans 81,6% des cas dont plus de 62% déploraient un retard dans l'exécution de cette prise en charge bien qu'ils en aient été satisfaits dans 54,9% des cas.Conclusion : Les drépanocytaires adultes régulièrement suivis au CHUL sont peu nombreux. La transition entre le suivi pédiatrique et adulte doit se faire avec une transmission des informations du dossier médical sur l'histoire de la drépanocytose.

Introduction: The establishment since September 2016 at the University Hospital Center (CHUL) of a hematology consultation dedicated to adults with sickle cell disease was an opportunity to conduct this study, the main purpose of which was to establish the clinical and paraclinical profiles of the adults with sickle cell disease regularly monitored. Patients and methods: This was a retrospective study. The study population consisted of homozygous sickle cell patients aged 18 and over, who had performed at least three hematology consultations over a year. The information collected, after studying the medical file and telephone interview with the patient, concerned socio-demographic data, history of sickle cell disease, history, complications of the disease, biological and radiological examinations and treatment. Results: A total of 88 patients met the inclusion criteria out of the 233 sickle cell patients seen during the study period. The mean age was 30.4 ± 7.8 years. The questioning revealed that vaso-occlusive crisis (VOC) was the main acute complication and cholelithiasis (36.3%) the first chronic complication. The average hemoglobin was 7.8 g/dl and for 49.3% of the patients it was between 7 and 9 g/dl. Leukocytes were increased in 65.7%. Cardiac ultrasound performed in 35 patients found 11.1% pulmonary arterial hypertension and 22.8% left ventricular hypertrophy. The intensity of the painful crisis motivated a consultation in the emergency department of the CHU in 81.6% of cases, of which more than 62% complained of a delay in the execution of this care although they were satisfied with it in 54 .9% of cases.Conclusion: Few adult sickle cell sufferers are regularly monitored at the CHUL. The transition between pediatric and adult follow-up must be made with a transmission of information from the medical file on the history of sickle cell disease

Anethole reduces oxidative stress and improves in vitro survival and activation of primordial follicles

Primordial follicles, the main source of oocytes in the ovary, are essential for the maintenance of fertility throughout the reproductive lifespan. To the best of our knowledge, there are no reports describing the effect of anethole on this important ovarian follicle population. The aim of the study was to investigate the effect of different anethole concentrations on the in vitro culture of caprine preantral follicles enclosed in ovarian tissue. Randomized ovarian fragments were fixed immediately (non-cultured treatment) or distributed into five treatments: α-MEM+ (cultured control), α-MEM+ supplemented with ascorbic acid at 50 μg/mL (AA), and anethole at 30 (AN30), 300 (AN300), or 2000 µg/mL (AN2000), for 1 or 7 days. After 7 days of culture, a significantly higher percentage of morphologically normal follicles was observed when anethole at 2000 μg/mL was used. For both culture times, a greater percentage of growing follicles was observed with the AN30 treatment compared to AA and AN2000 treatments. Anethole at 30 and 2000 µg/mL concentrations at days 1 and 7 of culture resulted in significantly larger follicular diameter than in the cultured control treatment. Anethole at 30 µg/mL concentration at day 7 showed significantly greater oocyte diameter than the other treatments, except when compared to the AN2000 treatment. At day 7 of culture, levels of reactive oxygen species (ROS) were significantly lower in the AN30 treatment than the other treatments. In conclusion, supplementation of culture medium with anethole improves survival and early follicle development at different concentrations in the caprine species.

Effects of alpha-tocopherol and ternatin antioxidants on morphology and activation of goat preantral follicles in vitro cultured / Efeitos dos antioxidantes alpha-tocoferol e ternatina na morfologia e na ativação de folículos pré-antrais caprinos cultivados in vitro

The effects of α-tocopherol and ternatin on the morphology, activation, and growth of goat preantral follicles in vitro cultured, for one or five days, were evaluated. Ovarian fragments were immediately fixed (non-cultured control) or in vitro cultured for one or five days in Minimum Essential Medium (MEM) with or without α-tocopherol or ternatin supplementation, both at concentrations of 5, 10, or 15µM, corresponding to the following treatments: MEM, TOC5, TOC10, TOC 15, TER5, TER10, and TER15. The percentages of morphologically normal preantral follicles in non-cultured ovarian tissue (control) was 73.2 percent and after five days of culture, there was a decrease on these percentages in all treatments (P<0.05) when compared with non-cultured control. Culture of ovarian cortex for five days increased the percentages of follicular activation in all treatments (P<0.05). Ultrastructural analysis did not confirm the integrity of caprine preantral follicles cultured for five days in medium containing antioxidants. This study demonstrated that α-tocopherol and ternatin can promote follicular activation; however, addition of these antioxidants in the tested concentrations reduced the follicular viability after in vitro culture.

Os efeitos do α-tocoferol e da ternatina sobre morfologia, ativação e crescimento de folículos pré-antrais caprinos cultivados in vitro, por um ou cinco dias, foram avaliados. Os fragmentos ovarianos foram imediatamente fixados (controle não-cultivado) ou cultivados in vitro, por um ou cinco dias, em Meio Essencial Mínimo (MEM) com ou sem suplementação com α-tocoferol ou ternatina nas concentrações de 5, 10 ou 15µM, formando os tratamentos MEM, TOC5, TOC10, TOC 15, TER5, TER10, TER15. O percentual de folículos pré-antrais normais no controle não-cultivado foi de 73,2 por cento, depois de cinco dias de cultivo, houve redução desse percentual em todos os tratamentos, quando comparados com o controle não-cultivado (P<0,05). O cultivo por cinco dias aumentou a ativação folicular em todos os tratamentos (P<0,05). A análise ultra-estrutural não mostrou folículos pré-antrais íntegros após cinco dias de cultivo em meio contendo antioxidantes. Concluiu-se que o α-tocoferol e a ternatina podem promover a ativação folicular, no entanto a adição desses antioxidantes nas concentrações testadas reduziu a viabilidade folicular após o cultivo in vitro.

Característica histológica, ultra-estrutural e produção de nitrito de folículos pré-antrais caprinos cultivados in vitro na ausência ou presença de soro / Histological and ultrastructural feature and nitrite production of caprine preantral follicles in vitro cultured in the presence or absence of serum

Avaliou-se o efeito da adição de diferentes tipos e concentrações de soro sobre o desenvolvimento e a sobrevivência de folículos ovarianos pré-antrais (FOPA) caprinos in vitro. Além disso, verificou-se a relação entre as concentrações de nitrito presentes no meio de cultivo e a viabilidade folicular. Cada par ovariano foi dividido em 29 fragmentos, sendo um destinado ao controle. Os fragmentos foram cultivados por um ou sete dias em meio essencial mínimo suplementado (MEM+) ou MEM+ com diferentes concentrações (10 ou 20 por cento) de soro fetal bovino (SFB), soro de cabra em estro (SCE) ou soro de cabra em diestro (SCD). Na análise morfológica após sete dias, apenas o tratamento com 10 por cento de SFB apresentou percentual de FOPA normais similar ao MEM+ (P>0,05). A análise ultra-estrutural dos folículos cultivados por sete dias com MEM+ ou MEM+ com 10 por cento de SFB mostrou danos oocitários, porém células da granulosa normais. A análise do meio de cultivo revelou correlação positiva entre a viabilidade folicular e a produção de nitrito. A suplementação com soro não melhorou a viabilidade de FOPA e a concentração de nitrito no meio de cultivo funcionou como um indicador da viabilidade das células da granulosa de FOPA caprinos cultivados in vitro.

The effect of the addition of different types and concentrations of sera on the viability and development of caprine preantal follicles (PAF) in vitro cultured was analyzed. In addition, it was evaluated the correlation between nitrite concentrations in culture medium and folicular viability. Each ovarian pair was divided in 29 fragments and one was used as control. The fragments were cultured for one or seven days in minimal essential medium (MEM+) or MEM+ with different concentrations of (10 or 20 percent) bovine fetal serum (BFS), estrous goat serum (EGS), or diestrous goat serum (DGS). After seven days, the morphological analysis showed that only the treatment with 10 percent BFS maintained the percentage of normal PAF similar to MEM+ (P>0.05). The ultrastructural analysis of follicles cultured for seven days in MEM+ or MEM+ with 10 percent BFS showed some oocyte damage, although the granulosa cells were normal. Analysis of culture medium revealed a positive correlation between follicular viability and nitrite production. Supplementation with serum did not improve the viability of PAF and nitrite levels in culture medium served as an indicator of viability of granulose cells from caprine PAF in vitro cultured.