Assessment of therapeutic compliance and its associated factors in tunisian adult asthmatic patients.

INTRODUCTION: Despite therapeutic advances, morbidity attributed to asthma continues to increase. This seems partly to be due to poor adherence. AIM: To assess therapeutic adherence and the association between poor compliance and asthma control. METHODS: We carried out a descriptive cross-sectional study on a sample of 150 asthmatics, followed in the pneumology department of Charles Nicolle hospital for more than 6 months. The survey took place over 1 month. The 4-item Morisky questionnaire (MMAS-4) was used to assess adherence to therapy. RESULTS: Our patients had a median age of 44.2 years and a sex ratio of 0.47. Asthma was severe in 48% of cases and poorly controlled in 34% of cases. Adherence was poor in 66% of patients. Factors significantly associated with adherence were educationlevel (p=0.02), socio- economic status (p = 0.01), treatment cost (p= 0.02), its availability (p=0.04) and its free cost (p = 0.001), consultation waiting time (p=0.03) and knowledge on asthma (p=0,04). We retained in multivariate analyze two factors determining therapeutic adherence, which are socio-economic status (OR = 2.02 ; [1.2-6.26]) and participation in the therapeutic choice (OR = 1.2 ; 95% CI [2.02-4.25]). CONCLUSIONS: It appears that medication adherence is widely influenced by socio-economic status. So, improving these conditions would guarantee better treatment compliance.

Gut-specific telomerase expression counteracts systemic aging in telomerase-deficient zebrafish.

Telomere shortening is a hallmark of aging and is counteracted by telomerase. As in humans, the zebrafish gut is one of the organs with the fastest rate of telomere decline, triggering early tissue dysfunction during normal zebrafish aging and in prematurely aged telomerase mutants. However, whether telomere-dependent aging of an individual organ, the gut, causes systemic aging is unknown. Here we show that tissue-specific telomerase expression in the gut can prevent telomere shortening and rescues premature aging of tert-/-. Induction of telomerase rescues gut senescence and low cell proliferation, while restoring tissue integrity, inflammation and age-dependent microbiota dysbiosis. Averting gut aging causes systemic beneficial impacts, rescuing aging of distant organs such as reproductive and hematopoietic systems. Conclusively, we show that gut-specific telomerase expression extends the lifespan of tert-/- by 40%, while ameliorating natural aging. Our work demonstrates that gut-specific rescue of telomerase expression leading to telomere elongation is sufficient to systemically counteract aging in zebrafish.

Features of patients with 2019 novel coronavirus admitted in a pneumology department: The first retrospective Tunisian case series.

AIM: On 2 March 2020, Tunisia has reported the first confirmed case of COVID-19. Since then, the disease has affected about 700 persons in the country. The purpose of our study was to report epidemiological, clinical, radiological and therapeutic features of patients with 2019-nCoV infection admitted in the pneumology department. METHODS: We extracted the data of the consequetive 20 patients managed in the department of pneumology B at Abderrahmen Mami hospital, from March, 26 to April, 8, 2020. RESULTS: The median age was 61 years old [41-85]. There were 9 men and 11 women.  Underlying disorders were observed in 16 patients (80%). Five patients were health care workers. Three patients did not have any known exposure. Common symptoms included fever (100%), shortness of breath (70%) and cough (70%). Computed tomography scans showed bilateral ground glass opacities in 7/9 cases. Fifteen patients received both chloroquine and azithromycin. Fourteen patients (70%) were discharged before April, 8, 2020. Reported complications were: hypokalemia (3 cases), pulmonary embolism (2 cases) and QT prolongation (1 case). One patient died from acute cardiac injury. CONCLUSION: Knowing the different aspects of moderate and severe forms of the disease can contribute to advance in infection control strategies.