Explorations cardiologiques nucléaires dans la cardiomyopathie de Takotsubo

Transient left ventricular apical ballooning syndrome, also known as Takotsubo cardiomyopathy (TTC) was described for the first time in Japan in the earliest nineties. It represents 1 to 2 % of acute cardiac events and mimics closely acute myocardial infarction. The aim of this study was to investigate ^99mTc-tetrofosmine or ²⁰¹Thallium myocardial Single Photon Emission Computed Tomography (SPECT), ¹²³I-metaIodoBenzylGuanidine (¹²³I-mIBG) myocardial SPECT and myocardial Positron Emission Tomography using ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) in patients with TTC, assessing respectively left ventricular perfusion, innervation and metabolism. We studied four patients (three females) with TTC. We performed two weeks after acute phase (subacute phase) myocardial perfusion SPECT and ¹²³I-mIBG myocardial SPECT for each patient. Two of them underwent myocardial PET with FDG. Then, we assessed left ventricular innervation and metabolism three months (chronic phase I) and more than six months (chronic phase II) after the acute phase. We compared the discrepancies between radionuclides uptake in the left ventricular apical region during a follow-up period of more than six months. In subacute phase, perfusion SPECT was normal for each patient. Conversely, ¹²³I-mIBG SPECT and FDG-PET showed concordant apical uptake defect. This perfusion-metabolism pattern called “inverse flow-metabolism mismatch” is the metabolic state of stunned myocardium. After three months, we found improvement of apical tracer uptake in both FDG-PET and ¹²³I-mIBG SPECT. These findings suggest that TTC is characterized by myocardial apical stunning which is related to a disturbance of cardiac sympathetic innervation. ¹²³I-mIBG SPECT might be useful to diagnose earlier this pathology and to rule out acute myocardial infarction.     

Antifungal mechanism of the combination of Cinnamomum verum and Pelargonium graveolens essential oils with fluconazole against pathogenic Candida strains

The present study aimed to investigate the anti-Candida activity of ten essential oils (EOs) and to evaluate their potential synergism with conventional drugs. The effect on secreted aspartic protease (SAP) activity and the mechanism of action were also explored. The antifungal properties of essential oils were investigated using standard micro-broth dilution assay. Only Cinnamomum verum, Thymus capitatus, Syzygium aromaticum, and Pelargonium graveolens exhibited a broad spectrum of activity against a variety of pathogenic Candida strains. Chemical composition of active essential oils was performed by gas chromatography-mass spectrometry (GC-MS). Synergistic effect was observed with the combinations C. verum/fluconazole and P. graveolens/fluconazole, with FIC value 0.37. Investigation of the mechanism of action revealed that C. verum EO reduced the quantity of ergosterol to 83%. A total inhibition was observed for the combination C. verum/fluconazole. However, P. graveolens EO may disturb the permeability barrier of the fungal cell wall. An increase of MIC values of P. graveolens EO and the combination with fluconazole was observed with osmoprotectants (sorbitol and PEG6000). Furthermore, the combination with fluconazole may affect ergosterol biosynthesis and disturb fatty acid homeostasis in C. albicans cells as the quantity of ergosterol and oleic acid was reduced to 52.33 and 72%, respectively. The combination of P. graveolens and C. verum EOs with fluconazole inhibited 78.31 and 64.72% SAP activity, respectively. To our knowledge, this is the first report underlying the mechanism of action and the inhibitory effect of SAP activity of essential oils in synergy with fluconazole. Naturally occurring phytochemicals C. verum and P. graveolens could be effective candidate to enhance the efficacy of fluconazole-based therapy of C. albicans infections.     

Molecular Diagnostic and Prognostic Subtyping of Gliomas in Tunisian Population

It has become increasingly evident that morphologically similar gliomas may have distinct clinical phenotypes arising from diverse genetic signatures. To date, glial tumours from the Tunisian population have not been investigated. To address this, we correlated the clinico-pathology with molecular data of 110 gliomas by a combination of HM450K array, MLPA and TMA-IHC. PTEN loss and EGFR amplification were distributed in different glioma histological groups. However, 1p19q co-deletion and KIAA1549:BRAF fusion were, respectively, restricted to Oligodendroglioma and Pilocytic Astrocytoma. CDKN2A loss and EGFR overexpression were more common within high-grade gliomas. Furthermore, survival statistical correlations led us to identify Glioblastoma (GB) prognosis subtypes. In fact, significant lower overall survival (OS) was detected within GB that overexpressed EGFR and Cox2. In addition, IDH1R132H mutation seemed to provide a markedly survival advantage. Interestingly, the association of IDHR132H mutation and EGFR normal status, as well as the association of differentiation markers, defined GB subtypes with good prognosis. By contrast, poor survival GB subtypes were defined by the combination of PTEN loss with PDGFRa expression and/or EGFR amplification. Additionally, GB presenting p53-negative staining associated with CDKN2A loss or p21 positivity represented a subtype with short survival. Thus, distinct molecular subtypes with individualised prognosis were identified. Interestingly, we found a unique histone mutation in a poor survival young adult GB case. This tumour exceptionally associated the H3F3A G34R mutation and MYCN amplification as well as 1p36 loss and 10q loss. Furthermore, by exhibiting a remarkable methylation profile, it emphasised the oncogenic power of G34R mutation connecting gliomagenesis and chromatin regulation.     

In situ immunocytochemical detection of potyviral proteins in plant cells

A method for in situ protein immunodetection using a peroxidase labeling system is described for detecting functional and structural proteins encoded by potato virus Y (Tunisian isolate) in plant tissues. Such Potyviruses are characterized by the accumulation of inclusion bodies containing viral encoded proteins other than coat protein. These proteins are functional at early stages of infection, making them easy to detect. Data are compared to those obtained by immunofluorescence techniques. Our technique can be used as a preliminary method for rapid detection of virus infection using antibodies directed against functional proteins.     

Neurologic manifestations of hepatic distomiasis caused by Fasciola hepatica]

The hepatic distomiasis is a parasitic and cosmopolite affection caused by a trematode Fasciola hepatica. The clinical manifestation usually includes an invasion phase with toxi-infectious hepatitis and intermittent angiocholitis episodes during the chronic phase of the disease. Many authors insist for few years, on some revealing manifestations of the disease that are unusual in the classical forms, especially the neurological manifestations that are rare and of extreme polymorphism. Based on a 12 years old tunisian child case of distomiasis caused by F. hepatica associated with neurological manifestations and through the analysis of 25 literature cases, the symptomatological and physiopathological aspects of this clinical form that generally makes the physician perplex, are reviewed.     

Comparative performance of δ13C,ion accumulation and agronomic parameters for phenotyping durum wheat genotypes under various irrigation water salinities

The use of efficient selection traits for screening under contrasting irrigation water salinity is a challenge for breeders. To identify patterns, grain yield (GY) and yield components (kernels m^?2, thousand kernels weight), growth traits (plant height, biomass), flag leaf ion accumulation (Na⁺ and K⁺), carbon isotope composition (δ¹³C_grain) and nitrogen concentration (N_grain) of grains were assessed on 25 durum wheat genotypes (G) in two consecutive growing seasons (2010 and 2011), in three semi‐arid locations in Tunisia. Each location differed in their irrigation water salinity as measured by electrical conductivity: Echbika (S1, 6 dS m^?1), Barrouta (S2, 12 dS m^?1) and Sidi Bouzid (S3, 18 dS m^?1). GY was shown to be negatively correlated to N_grain as well as to δ¹³C_grain. This is confirmed by a multiple linear regression analysis that showed that both δ¹³C_grain and N_grain were the major determinant components for GY variability under S3. A high genotypic variability was observed and the improved genotype Maali exhibited the most stable GY under the three irrigation water salinities and the two cropping seasons. Maali showed the lowest δ¹³C_grain. This indicates that tolerance in durum wheat is likely to be correlated to the ability of maintaining a high stomatal conductance. According to our data suggests δ¹³C_grain can be used for an efficient screening of salt tolerant durum wheat. Under our experimental conditions, N_grain was shown to be highly correlated to δ¹³C_grain and can therefore be easier‐to‐use trait to assess the tolerance to salinity.     

Non-Pneumatic Anti-Shock Garment (NASG), a First-Aid Device to Decrease Maternal Mortality from Obstetric Hemorrhage: A Cluster Randomized Trial

Background

Obstetric hemorrhage is the leading cause of maternal mortality. Using a cluster randomized design, we investigated whether application of the Non-pneumatic Anti-Shock Garment (NASG) before transport to referral hospitals (RHs) from primary health care centers (PHCs) decreased adverse outcomes among women with hypovolemic shock. We hypothesized the NASG group would have a 50% reduction in adverse outcomes.

Methods and Findings

We randomly assigned 38 PHCs in Zambia and Zimbabwe to standard obstetric hemorrhage/shock protocols or the same protocols plus NASG prior to transport. All women received the NASG at the RH. The primary outcomes were maternal mortality; severe, end-organ failure maternal morbidity; and a composite mortality/morbidity outcome, which we labeled extreme adverse outcome (EAO). We also examined whether the NASG contributed to negative side effects and secondary outcomes. The sample size for statistical power was not reached; of a planned 2400 women, 880 were enrolled, 405 in the intervention group. The intervention was associated with a non-significant 46% reduced odds of mortality (OR 0.54, 95% CI 0.14–2.05, p = 0.37) and 54% reduction in composite EAO (OR 0.46, 95% CI 0.13–1.62, p = 0.22). Women with NASGs recovered from shock significantly faster (HR 1.25, 95% CI 1.02–1.52, p = 0.03). No differences were observed in secondary outcomes or negative effects. The main limitation was small sample size.

Conclusions

Despite a lack of statistical significance, the 54% reduced odds of EAO and the significantly faster shock recovery suggest there might be treatment benefits from earlier application of the NASG for women experiencing delays obtaining definitive treatment for hypovolemic shock. As there are no other tools for shock management outside of referral facilities, and no safety issues found, consideration of NASGs as a temporizing measure during delays may be warranted. A pragmatic study with rigorous evaluation is suggested for further research.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00488462","term_id":"NCT00488462"}}NCT00488462     

Beneficial effects of Salvia officinalis essential oil on vanadium-induced testicular injury,DNA damage and histological alterations in Wistar rats

BioMetals - Vanadium has been shown to catalyze the generation of reactive oxygen species. Since free radical production and lipid peroxidation are potentially important mediators in testicular...     

Heterologous expression and secretion of an antifungal Bacillus subtilis chitosanase (CSNV26) in Escherichia coli

The aims of the study were the production improvement, the purification, the characterization and the activity investigation of chitosanase CSNV26 of Bacillus subtilis (V26). The gene csnV26 encoding for this protein was amplified and cloned in the pBAD vector then expressed in Escherichia coli (Top10). The SDS-PAGE and zymogram analysis of the recombinant protein showed that it has two active forms sized 27 and 31 kDa, corresponding to the protein with and without signal peptide. This protein has the particularity of being secreted by Top10-pBAD-csnV26 with a high yield of 6.2 g/l. The HPLC purification of CSNV26 from supernatant confirmed the presence of the two sizes. The investigation of the CSNV26 thermostability showed that the pure protein is highly stable keeping 68 % of its activity after 30-min treatment at 100 °C, contrarily to the protein present within the supernatant of E. coli and B. subtilis (V26). The molecular dynamics study of the predicted structure of protein in both forms showed that the presence of the peptide signal in the form of 31 kDa gave it a remarkable thermal stability. The antifungal activity of CSNV26 was evidenced on Rhizopus nigricans and Rhizopus oryzae. Indeed, it has provoked an alteration and embrittlement of their hyphae with onset of protoplast.