Impact of the interaction between the polymorphisms and hypermethylation of the CD36 gene on a new biomarker of type 2 diabetes mellitus: circulating soluble CD36 (sCD36) in Senegalese females.

BACKGROUND: Several predisposing factors for diabetes mellitus have been identified, including cluster determinant 36 (CD36) receptor expression. We aimed to determine the effects of CD36 gene polymorphisms and hypermethylation on the plasma CD36 protein levels in type 2 diabetes. MATERIALS AND METHODS: We conducted a cross-sectional study involving 100 females (lean healthy control subjects and subjects with type 2 diabetes). This study was conducted at the Human Physiology Laboratory at the Dakar Faculty of Medicine in Senegal. Circulating sCD36 levels and DNA methyltransferase 3a levels were determined by enzyme-linked immunosorbent assay. The other biological parameters were evaluated in a biochemical laboratory. CD36 gene polymorphisms and methylation were explored by real-time polymerase chain reaction and methylation-specific polymerase chain reaction, respectively. RESULTS: sCD36 was negatively correlated with HDL-cholesterol levels (r = - 0.52 p = 0.0001) and triglyceride levels (r = - 0.36 p = 0.01) in control subjects. However, in the type 2 diabetes group, sCD36 levels were positively correlated with total cholesterol levels (r = 0.28 p = 0.04). For rs3211867, control subjects harboring the CC genotypes had significantly higher sCD36 levels than control subjects harboring the AA/AC genotype (p = 0.02); in the type 2 diabetes group, the sCD36 level was not significantly lower in subjects harboring the AA/AC genotype than in subjects harboring the CC genotype (p = 0.27). CD36 gene methylation reduced the sCD36 level in the control subjects compared to control subjects without CD36 gene methylation (p = 0.03). This difference was not significant in the type 2 diabetes group comparing subjects with diabetes with CD36 gene methylation to subjects with diabetes without CD36 gene methylation (p = 0.09). We noted a nonsignificant increase in sCD36 levels in subjects with diabetes with CD36 gene methylation compared to control subjects with CD36 gene methylation (p = 0.27). A combination of the CD36 polymorphism effect and the CD36 methylation effect did not significantly reduce sCD36 levels in subjects with type 2 diabetes. CONCLUSION: CD36 gene polymorphisms and CD36 gene methylation separately reduce sCD36 levels. Their impacts are compensated for in subjects with type 2 diabetes by an increase in sCD36 levels, the mechanism of which needs to be elucidated.

Adaptation to chronic ER stress enforces pancreatic ß-cell plasticity.

Pancreatic ß-cells are prone to endoplasmic reticulum (ER) stress due to their role in insulin secretion. They require sustainable and efficient adaptive stress responses to cope with this stress. Whether episodes of chronic stress directly compromise ß-cell identity is unknown. We show here under reversible, chronic stress conditions ß-cells undergo transcriptional and translational reprogramming associated with impaired expression of regulators of ß-cell function and identity. Upon recovery from stress, ß-cells regain their identity and function, indicating a high degree of adaptive plasticity. Remarkably, while ß-cells show resilience to episodic ER stress, when episodes exceed a threshold, ß-cell identity is gradually lost. Single cell RNA-sequencing analysis of islets from type 1 diabetes patients indicates severe deregulation of the chronic stress-adaptation program and reveals novel biomarkers of diabetes progression. Our results suggest ß-cell adaptive exhaustion contributes to diabetes pathogenesis.

Improved In Vitro Anti-Mucorales Activity and Cytotoxicity of Amphotericin B with a Pegylated Surfactant.

The aim of this study was to evaluate the effect of the combination of amphotericin B (AmB) and various non-ionic surfactants on the anti-Mucorales activity of AmB, the toxicity of the combination on eukaryotic cells and the modification of AmB aggregation states. Checkerboards were performed on five genera of Mucorales (12 strains) using several combinations of different surfactants and AmB. These data were analyzed by an Emax model. The effect of surfactants on the cytotoxic activity of AmB was then evaluated for red blood cells and two eukaryotic cell lines by absorbance and propidium iodide internalization. Finally, the effect of polyethylene glycol (15)-hydroxystearate (PEG15HS) on the aggregation states of AmB was evaluated by UV-visible spectrometry. PEG15HS increased the efficacy of AmB on four of the five Mucorales genera, and MICs of AmB were decreased up to 68-fold for L. ramosa. PEG15HS was the only surfactant to not increase the cytotoxic activity of AmB. Finally, the analysis of AmB aggregation states showed that the increased efficacy of AmB and the absence of toxicity are related to an increase in monomeric and polyaggregated forms of AmB at the detriment of the dimeric form. In conclusion, PEG15HS increases the in vitro efficacy of AmB against Mucorales at low concentration, without increasing its toxicity; this combination could therefore be evaluated in the treatment of mucormycosis.

Facial fractures in post-revolution Tunisia as violence indicator: About 476 cases.

INTRODUCTION: On January 2011, Tunisia had known a revolution. To move from dictatorship to democraty project, the country suddenly fell into political instability, which was accompanied by a wave of social violence. Traumatology, and, particularly, maxilla-facial traumatology, is usually a reliable indicator of the degree of violence. AIM: The aim of this study was to establish the epidemiological profile of facial fractures during the various phases of political transition through which Tunisia has passed since revolution (2012-2016). PATIENTS AND METHODS: A retrospective cross-sectional study was conducted among all patients with facial fractures admitted to the department of Oral and Maxillo facial Surgery of University Hospital of Sahloul during five years (2012-2016). Fractures diagnosed late at the sequelae stage were excluded. Data of patients were recorded according to medical files, including cause of injury, age and gender, injury mechanisms and type of facial fracture. RESULTS: During the period of the study, a total of 476 patients were identified, with a sex-ratio of 7.2 to 1, patients ranged in age from 1 year to 76-years-old with a mean age of 27 years. Assaults were the most common cause of injury (39.1%). Mandible was fractured in 257 cases (54.2%) followed by zygoma (116 cases, 24.4%), nasal bone (99 cases, 20.8%) and Orbital walls (98 cases, 20.6%). DISCUSSION: The epidemiological profile of facial fractures in Tunisia has been changed since 2011. Facial fractures occur mainly after assaults, which are an indicator of increased social violence accompanying political instability present in our country.

Non-English languages enrich scientific knowledge: The example of economic costs of biological invasions.

We contend that the exclusive focus on the English language in scientific research might hinder effective communication between scientists and practitioners or policy makers whose mother tongue is non-English. This barrier in scientific knowledge and data transfer likely leads to significant knowledge gaps and may create biases when providing global patterns in many fields of science. To demonstrate this, we compiled data on the global economic costs of invasive alien species reported in 15 non-English languages. We compared it with equivalent data from English documents (i.e., the InvaCost database, the most up-to-date repository of invasion costs globally). The comparison of both databases (~7500 entries in total) revealed that non-English sources: (i) capture a greater amount of data than English sources alone (2500 vs. 2396 cost entries respectively); (ii) add 249 invasive species and 15 countries to those reported by English literature, and (iii) increase the global cost estimate of invasions by 16.6% (i.e., US$ 214 billion added to 1.288 trillion estimated from the English database). Additionally, 2712 cost entries - not directly comparable to the English database - were directly obtained from practitioners, revealing the value of communication between scientists and practitioners. Moreover, we demonstrated how gaps caused by overlooking non-English data resulted in significant biases in the distribution of costs across space, taxonomic groups, types of cost, and impacted sectors. Specifically, costs from Europe, at the local scale, and particularly pertaining to management, were largely under-represented in the English database. Thus, combining scientific data from English and non-English sources proves fundamental and enhances data completeness. Considering non-English sources helps alleviate biases in understanding invasion costs at a global scale. Finally, it also holds strong potential for improving management performance, coordination among experts (scientists and practitioners), and collaborative actions across countries. Note: non-English versions of the abstract and figures are provided in Appendix S5 in 12 languages.

Management of abdominal emergencies in adults using telemedicine and artificial intelligence.

The terms "telemedicine" and "artificial intelligence" (AI) are used today throughout all fields of medicine, with varying degrees of relevance. If telemedicine corresponds to practices currently being developed to supply a high quality response to medical provider shortages in the general provision of healthcare and to specific regional challenges. Through the possibilities of "scalability" and the "augmented physician" that it has helped to create, AI may also constitute a revolution in our practices. In the management of surgical emergencies, abdominal pain is one of the most frequent complaints of patients who present for emergency consultation, and up to 20% of patients prove to have an organic lesion that will require surgical management. In view of the very large number of patients concerned, the variety of clinical presentations, the potential seriousness of the etiological pathology that sometimes involves a life-threatening prognosis, healthcare workers responsible for these patients have logically been led to regularly rely on imaging examinations, which remain the critical key to subsequent management. Therefore, it is not surprising that articles have been published in recent years concerning the potential contributions of telemedicine (and teleradiology) to the diagnostic management of these patients, and also concerning the contribution of AI (albeit still in its infancy) to aid in diagnosis and treatment, including surgery. This review article presents the existing data and proposes a collaborative vision of an optimized patient pathway, giving medical meaning to the use of these tools.

Right Atrial Thrombus in Transient in a COVID-19 Patient: Clinical Echocardiographic Features-Case Report and Literature Review.

A 54-year-old male is admitted with COVID-19 pneumonia and received prophylactic anticoagulation. On day 8, the patient rapidly deteriorated requiring urgent endotracheal intubation. Transthoracic echocardiography revealed large right atrial thrombus in transient, resulting in pulmonary embolism and severe RV failure; fibrinolytic therapy was not effective and the patient passed away.

Prevalence of and factors associated with smoking among students in Sousse, Tunisia.

Within the framework of the fight against tobacco among young people, we conducted a descriptive cross-sectional study in 2013 to estimate the prevalence of smoking and to identify associated factors among students in Sousse. A questionnaire was administered to a representative sample of 556 students in 5 academic institutions in Sousse randomly drawn. The age of the participants was between 17 and 35 years. The prevalence of tobacco consumption in the past 12 months was 22.1% and consumption during the past 3 months was 65.3%. The average age of starting smoking was 17 years. Smoking prevalence was significantly higher for males (P < 0.001) and those aged over 25 years (P = 0.002). Students from 2 of the institutions were using more tobacco than their colleagues in the other institutions (P = 0.027). The high prevalence of smoking found among the students means that prevention measures are essential; this requires increasing self-esteem and evaluating intervention programmes implemented before smoking the first cigarette.

[Prevalence of and factors associated with smoking among students in Sousse, Tunisia]

Dans le cadre de la lutte contre le tabac auprès des jeunes, une étude descriptive transversale a été menée en 2013 afin d'estimer la prévalence du tabagisme et d'identifier les facteurs qui lui sont associés parmi les étudiants de la ville de Sousse. Un questionnaire a été administré auprès d'un échantillon représentatif de556 étudiants inscrits dans cinq établissements universitaires à Sousse tirés au hasard. L'âge des répondants variait entre 17 et 35 ans. La prévalence de la consommation de tabac durant les 12 derniers mois était de 22,1 % et la consommation durant les trois derniers mois était de 65,3 %. L'âge moyen de début de consommation tabagique était de 17 ans. La prévalence tabagique augmente significativement avec le sexe masculin (p<0,001) et l'âge supérieur à 25 ans (p =0,002). Les étudiants de deux institutions universitaires consommaient plus detabac que leurs collègues des autres facultés (p=0,027). La forte prévalence du tabagisme chez les étudiants fait de la prévention une mesure indispensable qui passe essentiellement par le renforcement de l'estime de soi et l'évaluation des programmes d'intervention mis en oeuvre avant la consommation de la première cigarette.

Within the framework of the fight against tobacco among young people, we conducted a descriptive cross-sectional study in 2013 to estimate the prevalence of smoking and to identify associated factors among students in Sousse. A questionnaire was administered to a representative sample of 556 students in 5 academic institutions in Sousse randomly drawn. The age of the participants was between 17 and 35 years. The prevalence of tobacco consumption in the past 12 months was 22.1% and consumption during the past 3 months was 65.3%.The average age of starting smoking was 17 years. Smoking prevalence was significantly higher for males (P < 0.001) and those aged over 25 years (P = 0.002). Students from 2 of the institutions were using more tobacco than their colleagues in the other institutions (P = 0.027). The high prevalence of smoking found among the students means that prevention measures are essential; this requires increasing self-esteem and evaluating intervention programmes implemented before smoking the first cigarette.

Dicyclo-hexyl-ammonium trimethyl-bis-(hydrogen phenyl-phospho-nato)stannate(IV).

In the title compound, (C(12)H(24)N)[Sn(CH(3))(3)(C(6)H(6)O(3)P)(2)], the SnMe(3) residues are axially coordinated by two monodentate [PhPO(3)H](-) anions, leading to a trigonal-bipyramidal geometry for the Sn(IV) atom. The two [SnMe(3)(PhPO(3)H)(2)](-) anions in the unit cell are associated into infinite chains along the a axis by O-H⋯O hydrogen bonds involving the hy-droxy group of the hydrogen phenyl-phospho-nate ion. The chains inter-act with one another via O-H⋯O hydrogen bonds along the c axis. These networks of anions assemble with the dicyclo-hexyl-ammonium ion through N-H⋯O hydrogen bonds, forming a three-dimensional network.

[Posterior reversible encephalopathy related to tacrolimus in a liver transplanted HIV patient]. / Encéphalopathie postérieure réversible liée au tacrolimus chez un patient transplanté hépatique infecté par le VIH.

Tacrolimus-related posterior reversible leukoencephalopathy (PRLE) is a rare complication which should be recognized by clinicians who regularly use immunosuppressive therapy. We report the case of an HIV-positive, hepatitis C-positive liver transplant patient who presented with this complication. Immunosuppression with tacrolimus was started after postsurgery. On the 20th day, the patient suffered two tonic-clonic convulsive attacks against a background of hypertension. Cerebral magnetic resonance imaging and lumbar puncture led to diagnosis of tacrolimus-related PRLE after eliminating other possible diagnoses. Therapeutic management consisted of withdrawing tacrolimus and initiating treatment with antiepileptogenic and antihypertensive drugs, supplemented with magnesium sulphate. The symptoms regressed in the days following withdrawal of tacrolimus and the majority of lesions on magnetic resonance imaging disappeared within two weeks. The aim of which should be to identify patients at risk of developing this complication. This would enable targeted prevention involving magnesium supplementation, strict control of blood pressure and serial monitoring of tacrolimus blood concentrations.

[Adrenal vein thrombosis during pregnancy]. / Thrombose veineuse surrénalienne en cours de grossesse.

Pregnancy represents an inner transitional prothrombotic state; that is why other coagulation abnormalities may be revealed during this time. Factor V Leiden mutation is the most frequent inherited thrombophilia in the general population. We report the case of a patient by whom this mutation has been revealed during pregnancy by an adrenal vein thrombosis. Through this case, we will review the physiopathology of resistance to activated protein C and its consequences.

Application of the electrosorption technique to remove Metribuzin pesticide.

The present work deals with the removal of Metribuzin from aqueous solutions in a batch and continuous mode using electrosorption technique. This technique is based on the combination of two processes: the adsorption of Metribuzin into activated granular carbon (GAC) column and the application of the electrochemical potential. The effects of various experimental parameters (electrochemical potential, volumetric flow rate and initial Metribuzin concentration) on the removal efficiency were investigated. The pesticide sorption capacity at the breakthrough point of the GAC column reached 22 mg(pesticide)g(GAC)(-1). It was increased by more than 100% when the desired electrical potential (-50 mV/SCE) was applied in comparison with the conventional GAC column in similar experimental conditions without electrical potential. Evenmore, the electrosorption technique reduced considerably the drastic decrease encountered when passing from batch mode to continuous column mode.

[MR detection of local prostate cancer recurrence after transrectal high-intensity focused US treatment: preliminary results]. / Détection par IRM des récidives locales du cancer de prostate après traitement par ultrasons focalisés de haute intensité (HIFU) transrectaux: étude préliminaire.

PURPOSE: To assess T2W and dynamic: contrast-enhanced (DCE) MR imaging in the detection of local tumor recurrence after transrectal high-intensity focused US (HIFU) treatment. MATERIALS AND METHODS: Fifteen patients treated by HIFU for prostate cancer were referred for MR due to biological evidence of tumor recurrence. Axial, sagittal and coronal T2W images and DCE images (12 3-mm thick axial images, temporal resolution: 15 seconds) were obtained first. Transrectal biopsies were then obtained under US guidance. MR findings were compared to biopsy results for 10 prostate sectors. RESULTS: Biopsies demonstrated tumor recurrence in 13/15 patients (23/108 sectors). On T2W images, the treated prostate tissue was diffusely hypointense which interfered with interpretation. Three patients (5 sectors) had suspicious areas of T2W signal abnormality and 15 patients (29 sectors) had suspicious areas on DCE scans. An analysis per sector for T2W and DCE imaging showed sensitivity, specificity, positive predictive and negative predictive values respectively of 0.13, 0.98, 0.6 and 0.81 and 0.70, 0.85, 0.55 and 0.91. DCE MR was strongly predictive of positive biopsy results (Odds ratio: 12.8 (95% confidence interval: 4.4-37.3)) whereas T2W imaging was not (Odds ratio: 4.0 (95% confidence interval: 0.5-30)). CONCLUSION: MR, especially DCE MR, is promising for the detection and localization of local prostate cancer recurrence after transrectal HIFU treatment.

[Tracheal rupture after orotracheal intubation in intensive care]. / Rupture trachéale après intubation orotrachéale en réanimation.

We report a case of an iatrogenic tracheal rupture following an endotracheal intubation. The 78-year-old patient was admitted to the intensive care unit because of an acute respiratory failure related to a severe nosocomial pneumonia occurring 21 days after an abdominal aorta surgery. His main antecedent was a cigarette smoke-induced chronic obstructive pulmonary disease. Immediately after being intubated, a traumatic tracheobronchial rupture was suspected because of the sudden appearance of cervicothoracic subcutaneous emphysema. A thoracic computed tomography with multiplanar reformations confirmed the diagnosis and the evolution was unfortunately rapidly unfavourable. Risk factors, clinical and radiological aspects, and management of this rare but serious complication of endotracheal intubation will be discussed.

[Modulation of skeletal muscle contraction by the non-toxic fraction of Buthus occitanus tunetanus venom via the cholinergic receptors]. / Modulation de la contraction du muscle squelettique par la fraction non toxique du venin de Buthus occitanus tunetanus via les récepteurs cholinergiques.

Cholinergic receptors have an essential physiological role in the central nervous system because of their implication in higher functions in the neuromuscular junction within the brain and also in the peripheral nervous system by activating nicotinic (nAChRs) or muscarinic (mAChRs) receptors. Moreover, cholinergic receptors could be recognized by animal toxins isolated from snake venoms or alkaloids having animal or vegetal origin. In this context, we aim to find such molecules in a non toxic venom fraction of Buthus occitanus tunetanus scorpion, M1, which could therefore constitute promising medical tool. We present here a physiological study in skeletal muscle cells that regroups data that have been recently published and some new results reinforcing the last ones. The global effect of M1, was firstly studied on isolated nerve-muscle preparation. In cultured myotubes, we have found that the intracellular calcium increase, induced by M1 was blocked when ryanodine or inositol 1,4,5-triphosphate receptors are inhibited. Moreover, we have shown that M1 application on myotubes, induced a membrane depolarization as seen with acetylcholine. The treatment of myotubes with alpha-bungarotoxin blocked in most parts the depolarization amplitude. Thus, these results confirm the presence of at least one component in M1 active in nAChRs.

[Gastric trichobezoar in an adolescent presenting with anemia: ultrasound and MRI findings]. / Trichobézoard gastrique révélé par une anémie chez une adolescente: association échographie--imagerie par résonance magnétique (IRM).

Trichobezoars are rare and composed of ingested hair or fibers. Diagnosis is usually made by plain radiographs and barium meal. The usefulness of computed tomography has been reported in the preoperative period. In the pediatric population the authors propose, based on a recent case report, a non invasive and non irradiating protocol using sonography and T1W and T2W MR imaging.