Identification and antifungal susceptibility profile of uncommon yeast species at Fattouma Bourguiba University Hospital in Tunisia.

Despite the severe impact of uncommon yeast fungal infections and the pressing need for more research on the topic, there are still few studies available on the identification, epidemiology, and susceptibility profile of those pathogens. The aims of the current study were to define the profile of uncommon yeast species at Fattouma Bourguiba University Hospital using phenotypic, molecular, and proteomic methods and to study their antifungal susceptibility profile. Pre-identified uncommon yeast species were collected from 2018 to 2021. These isolates were further identified using phenotypic methods (ID32C® system and Vitek2® YST), matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS), and sequencing. The antifungal susceptibility profile was studied using the reference CLSI broth microdilution method. In total, 30 strains were collected during the study period. Referring to the sequencing, the most isolated uncommon species were Saprochaete capitata, Candida lusitaniae, Candida kefyr, Candida inconspicua, and Candida guilliermondii. A total of 90% of isolates were correctly identified by MALDI-TOF MS compared to 76.7% and 63.3% by ID32® C and VITEK® 2 YST, respectively. The isolated species showed variable responses to antifungals. Candida guilliermondii showed increased azole minimum inhibitory concentrations. Misidentification of uncommon yeast species was common using commercial phenotypic methods. The high percentage of concordance of MALDI-TOF results with sequencing highlights its high performance and usefulness as a routine diagnosis tool.

There is still little information on the epidemiology of uncommon emergent yeasts, although their implication in severe diseases and mainly invasive infections. Thus, the importance of an accurate identification and antifungal susceptibility testing for a better monitoring of related infections.

The Effect of Single-Anastomosis Sleeve Ileal (SASI) Bypass on Patients with Severe Obesity in Three Consecutive Years.

BACKGROUND: Sparse data are available regarding the efficacy and safety of single anastomosis sleeve ileal (SASI) bypass surgery, where most available studies utilized short-term follow-ups. Therefore, this study was conducted to evaluate the safety and outcomes of this procedure in three consecutive years after the surgery. MATERIALS AND METHODS: This retrospective study was carried out with 116 patients who underwent SASI from October 2016 to September 2021. Anthropometric, clinical, and biochemical data were recorded before, 1, 2, and 3 years after surgery. RESULTS: The 1, 2, and 3-year percentage of excess weight loss (%EWL) were 87.37%, 90.7%, and 80.6%, respectively. Remission or improvement was recorded for diabetes mellitus in 90.9%, hypertension in 80.0%, hyperlipidemia in 100%, sleep apnea in 100%, and irregular menstruation in 58.06 at 3 years after surgery. No mortality and 5.1% early major postoperative complications were recorded. Eight patients (6.8%) had reversal surgery due to EWL > 100%. CONCLUSIONS: The SASI bypass is an effective bariatric surgery that achieved sequential weight loss and improvement in medical comorbidities three years after the surgery; however, standardization of SASI procedure technique is needed to ameliorate nutritional deficiencies.

The pre- and postoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: The comparison of laparoscopy and laparotomy in colorectal cancer patients.

INTRODUCTION: The management of inflammation after colorectal surgery is important to decrease the susceptibility to postoperative complications. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood are known as two important inflammatory markers. In this study we evaluated and compared colorectal laparoscopy and laparotomy based on the PLR and NLR. METHODS: Totally, 76 patients were divided into two groups including patients who underwent laparoscopy (45 cases) or laparotomy (31 cases). The PLR and NLR were calculated based on cell blood count analysis of preoperative and postoperative day (POD) one and three in both groups. Statistical analysis was performed using SPSS software version 22. RESULTS: The PLR and NLR have no significant association with age, gender and tumor site (p > 0.05). However, both ratios were significantly increased in laparotomy patients at POD1 compared with the laparoscopy patients (p < 0.05). According to the two by two comparisons, the preoperative and postoperative PLR were significantly different in the laparotomy group (p < 0.05) but not in the laparoscopy group (p > 0.05). However, the preoperative and postoperative NLR were significantly different in both laparoscopy and laparotomy groups (p < 0.05). CONCLUSION: The NLR and PLR markers indicated that laparoscopy can be a better choice for colorectal surgery due to lower induction of inflammation compared with laparotomy.

Tunisian population quality of life: a general analysis using SF-36.

BACKGROUND: The SF-36 is the instrument for measuring the health relatedquality of life (HRQOL) of patients in many clinical and national studies to describe the health status of populations, by obtaining comparable data on health status internationally. AIMS: This study aimed to obtain population norms for the Tunisian version of SF-36 and to assess the association between socio HRQOL scores with the demographic characteristics of the Tunisian population. METHODS: Face-to-face interviews for a cross-sectional study were carried out in 2005 to collect socio demographic and environmental variables as well as self-reported quality of life. A representative sample of 6543 aged between 35 and 70 years old were selected. RESULTS: All scores had a high level of internal consistency reliability coefficient. HRQOL score levels were associated with sociodemographic characteristics and a decrease as age increased. The averages of the physical and mental component summary were 53+/-8 for males and 47.7+/-10 for females. CONCLUSIONS: This study was the first to address the general Tunisian population. This study shed light on factors associated with HRQOL in the Tunisian context.

[Investigating into whether systematic fetal weight estimation by ultrasound in the delivery room increases the risk of cesarean delivery]. / Le recours systématique à l'estimation échographique du poids fœtal en salle de naissances augmente-t-il le risque d'accouchement par césarienne?

Ultrasound is a valuable tool commonly used in the delivery room. It has multiple applications. The objective of this study was to investigate whether systematic fetal weight estimation by ultrasound in the delivery room increases the risk of cesarean delivery. Monocentric cohort study. All parturients with singleton pregnancies who gave birth full-term at = 39 weeks were enrolled in the study. We excluded all patients with a contraindication to vaginal birth as well as those in whom fetal weight estimation (FWE) by ultrasound on day of delivery was deemed necessary in making obstetric decision. Parturients enrolled in the study were divided into two groups: - G1: parturients who systematically underwent FWE - G2: parturients who never underwent FWE. We compared cesarean delivery rate with adjustment for potentially confounding factors according to logistic regression. 838 parturients were enrolled in the study. Prematurity, FWE and weight at birth were risk factors for cesarean delivery. After adjustment for confounding factors, FWE by ultrasound systematically performed in G1 proved to be an independent risk factor for cesarean delivery with OR = 3.8 (CI 95% = [2.67 to 5.48]). This risk increased significantly with estimated fetal weight (EFW): OR=2,27(CI 95;1,15-4,47; p=0.018) for 3500 < EFW < 4000g and OR = 10.64 (CI 95; 4.28 to 26.41; p < 0.001 ) for EFW > 4000 g. FWE by ultrasound systematically performed in the delivery room represents an independent and potentially modifiable risk factor for cesarean delivery.