Plasmapheresis in thyrotoxicosis: a single-center case series.

BACKGROUND: Plasmapheresis represent an alternative therapeutic option for hyperthyroidism with thyroid storm or refractory cases. It provides a rapid decrease in plasma thyroid hormones and anti-thyroid antibodies. The aim of this paper was to report our single center's experience in managing particular situations of hyperthyroidism using apheresis. CASES PRESENTATION: The following case series describes three young African patients (two females, one male) aged 29, 37, and 25 years old, respectively, with Graves' disease who presented with drug ineffectiveness, drug-induced agranulocytosis, and thyroid storm with multi-organ failure. The three patients underwent plasmapheresis sessions leading to effective decline of thyroid hormone levels and offering a window for processing total thyroidectomy. DISCUSSION/CONCLUSION: The standard management of thyrotoxicosis and thyroid storm was usually codified by the concomitant use of antithyroid medication, iodine, beta-blockers, and corticosteroids. This medical preparation can be effective in most cases. However, drug toxicity or ineffectiveness can limit the use of such therapeutics. Our paper supports the efficiency and safety of therapeutic plasma exchange in the preoperative management of thyrotoxicosis.

Monitoring of type 2 diabetic patients during the 'Covid 19' pandemic by teleconsultation.

Introduction: Glycemic control in type 2 diabetic patients is a constant challenge. The objective of our study is to evaluate glycemic control in type 2 diabetic patients since the start of the "Covid-19" pandemic by comparing their glycemic and degenerative profiles in the pre-confinement,per and post-confinement periods. Patients and methods: This is a descriptive and analytical,cross-sectional study,bringing together 720 type 2 diabetic patients followed by teleconsultation at the endocrinology,diabetology and nutrition department,from mid-March to mid-October 2020. Results: The mean age of the patients was 62.5 ± 11.3 years, with a sex ratio (M / F) of 0.71,the average duration of diabetes was 10.6 ± 7, 4 years.The mean pre-lockdown Hba1c level was 8.5±1.9%.Only 137 patients have been able to do the HBa1c test since the start of lockdown,which averaged 8.4 ± 1.8%.Regarding the degenerative complications installed after containment,4.4% of the patients presented an acute coronary syndrome,2.2% a cerebrovascular accident,1.4% developed a stage 2 chronic renal disease,and a foot injury appeared in 5.1% of patients while no patient developed diabetic retinopathy among those who performed ophthalmic evaluation.In our series,the death rate was estimated at 1.8%.Drug therapy was adjusted in the majority of patients with initiation of insulin therapy in 7.2% of patients and intensification of insulin doses in 9.4% of patients. Conclusion: At the heart of the pandemic Covid-19 crisis,teleconsultation has taken an essential place in the strategy of access to care, particularly the monitoring of chronic diseases,the results of our study are similar to those of other studies published during this pandemic.

Chiral colloidal clusters.

Chirality is an important element of biology, chemistry and physics. Once symmetry is broken and a handedness is established, biochemical pathways are set. In DNA, the double helix arises from the existence of two competing length scales, one set by the distance between monomers in the sugar backbone, and the other set by the stacking of the base pairs. Here we use a colloidal system to explore a simple forcing route to chiral structures. To do so we have designed magnetic colloids that, depending on both their shape and induced magnetization, self-assemble with controlled helicity. We model the two length scales with asymmetric colloidal dumbbells linked by a magnetic belt at their waist. In the presence of a magnetic field the belts assemble into a chain and the steric constraints imposed by the asymmetric spheres force the chain to coil. We show that if the size ratio between the spheres is large enough, a single helicity is adopted, right or left. The realization of chiral colloidal clusters opens up a new link between colloidal science and chemistry. These colloidal clusters may also find use as mesopolymers, as optical and light-activated structures, and as models for enantiomeric separation.