Rabies in North Africa and the Middle East: current situation, strategies and outlook. / La rage dans les pays d'Afrique du Nord et du Moyen-Orient : situation actuelle et perspectives.

In the Middle East and North Africa (MENA) region, dogs are the main reservoir for rabies. In this region, rabies affects more domestic carnivores (50% of cases) than farm animals (40% of cases). Rabies in large livestock animals, which are infected mainly by dogs, results in economic losses, undermines food safety and poses a risk for humans. In the MENA region, rabies is largely an urban problem, the virus being transmitted to humans by free-roaming dogs, 30% of which are less than one year old. In cities, the density of the free-roaming dog population varies between 0.6 and 1.5 dogs per km2, and almost double this figure in suburban and rural areas, where 80% of canine rabies cases occur. In the Maghreb, the annual average number of confirmed human deaths from rabies is around 47, showing a strong correlation with the number of animal cases declared (approximately 1,442 cases a year). In the Middle East, only a few rabies cases in humans are officially reported, suggesting that rabies cases in humans are grossly underreported. National strategies to control rabies include vaccination, controlling the freeroaming dog population and raising awareness among the human population at risk. Owing to limited resources and poor coordination between the different stakeholders, these strategies are only partially implemented. The Food and Agriculture Organization of the United Nations, in close collaboration with the World Organisation for Animal Health and the World Health Organization, supports countries in formulating and implementing coordinated strategies between the ministries concerned, local authorities and non-governmental organisations.

Dans la région Moyen-Orient et Afrique du Nord, le chien est le principal réservoir de la rage. En effet, dans cette région, la rage affecte plus de carnivores domestiques (50 % des cas) que d'animaux de ferme (40 % des cas). L'infection des animaux d'élevage est essentiellement transmise par les chiens et entraîne des pertes économiques, un impact négatif sur la sécurité alimentaire et un risque pour les humains. Dans la région Moyen-Orient et Afrique du Nord, la rage est un problème principalement urbain, le virus étant transmis aux humains par des chiens errants dont 30 % sont âgés de moins d'un an. La densité de la population de chiens errants varie de 0,6 à 1,5 chien par km² dans les villes et à peu près le double dans les zones périurbaines et rurales où sont enregistrés 80 % des cas de rage canine. Au Maghreb, le nombre annuel moyen de cas confirmés de décès humains par la rage est d'environ 47, avec une forte corrélation avec le nombre de cas chez les animaux qui avoisine 1 442 cas confirmés par an. Au Moyen-Orient, seuls quelques cas de rage chez l'homme sont officiellement déclarés ce qui suggère que les cas de rage chez les humains sont largement sous-déclarés. Les stratégies nationales de lutte contre la rage comprennent la vaccination, le contrôle des populations de chiens errants et la sensibilisation des populations humaines au risque d'infection. Ces stratégies sont partiellement mises en oeuvre en raison des ressources limitées et du manque de coordination entre les différents intervenants. L'Organisation des Nations Unies pour l'alimentation et l'agriculture (FAO), en étroite collaboration avec l'Organisation mondiale de la santé animale (OIE) et l'Organisation mondiale de la santé (OMS), soutient les pays dans l'élaboration et la mise en oeuvre de stratégies coordonnées entre les ministères concernés, les autorités locales et les organisations non gouvernementales.

En la región del Oriente Medio y África del Norte, el perro es el principal reservorio de la rabia. En estas zonas, en efecto, la rabia afecta a un mayor número de carnívoros domésticos (un 50% de los casos) que de animales de granja (un 40% de los casos). El perro es la vía fundamental por la que los animales de producción pecuaria contraen la infección, que provoca pérdidas económicas, hace mella en la seguridad alimentaria y entraña un riesgo sanitario para todas las personas. En esta región la rabia es un problema esencialmente urbano, por cuanto la vía de transmisión del virus a las personas son perros vagabundos, de los que el 30% tiene menos de un año de edad. La densidad de población de estos perros varía: de 0,6 a 1,5 individuos por km² en las ciudades hasta aproximadamente el doble en las zonas periurbanas y rurales, donde se producen el 80 % de los casos de rabia canina. En el Magreb se registra un promedio anual de unos 47 casos confirmados de muerte humana por rabia, cifra que presenta una estrecha correlación con el número de casos confirmados que se dan anualmente en los animales, próximo a los 1.442 casos. En el Oriente Medio se declaran oficialmente contados casos humanos de rabia, lo que lleva a pensar que el número real de casos en el ser humano supera con creces el de casos declarados. Las estrategias nacionales de lucha contra la rabia prevén medidas de vacunación, control de las poblaciones de perros vagabundos y sensibilización de la población humana expuesta al riesgo de infección. Esas estrategias se aplican solo parcialmente debido a la escasez de recursos y a la falta de coordinación entre las distintas instancias encargadas de ello. La Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO), en estrecha colaboración con la Organización Mundial de Sanidad Animal (OIE) y la Organización Mundial de la Salud (OMS), respalda a los países en la elaboración y aplicación de estrategias coordinadas entre los ministerios competentes, las autoridades locales y las organizaciones no gubernamentales.

Metabolism plays the key roles in Th cells differentiation.

The increasing rate of autoimmunity in recent decades cannot be related to only genetic instabilities and disorders. Diet can directly influence our health. Studies have shown that there is a relationship between nutritional elements and alteration in the immune system. Among immune cells, the function of T lymphocyte is important in directing immune response. T CD4+ cells lead other immune cells to respond to pathogens by secreting cytokines. HIV+ patients, who have largely lost their T CD4+ cells, are susceptible to opportunistic infections, which do not normally affect healthy people. It seems that the metabolism of T cells is critical for their differentiation and their consequent functions. After activation, T cells need to undergo clonal expansion, which is a high energy- consuming process. Studies have shown that specific metabolites deprivation or their excess supply affects T CD4+cells subsets differentiation. Abnormal induction of subsets of T CD4+ cells causes some autoimmunity reactions and hyper-sensitivity as well, which may result from imbalance of diet uptake. In this mini-review, we describe the findings about fatty acids, glucose, amino acids, and vitamins, which are effective in determining the fates of T CD4+ cells. These findings may help us uncover the role of diet in autoimmune diseases.

Solid tumors after chronic lymphocytic leukemia patients: Report of six cases and review of the literature.

INTRODUCTION: Malignancies have been reported to occur with increased frequency in chronic lymphocytic Leukemia (CLL) patients. The aim of this study was to describe which second malignancies occur in patients with CLL, whether these malignancies are related to CLL, its treatment, or both. We also attempt to study factors predicting the development of other malignancies. PATIENTS AND METHODS: Between 1995 and 2009, six cases of CLL associated with solid tumor were diagnosed in Hematology Department of Military Hospital of Tunis. The diagnosis of CLL was made by immunophenotyping of peripheral blood circulating B cells, and the diagnosis of solid tumors was made by biopsy with anatomopathological exam and immunohistochemical study. RESULTS: The mean age of patients was 71 years. Five patients were male. The CLL was classified Stage A in one case, Stage B in three cases and Stage C in two cases. Two patients had abnormal karyotype. Three patients have not received specific treatment for their CLL. Solid tumors were represented by skin cancer in three cases, lung cancer in two cases and breast cancer in one case. The median time between diagnosis of CLL and that of solid tumor was 53 months. CONCLUSION: Patients with CLL have an increased risk of developing a second cancer. Awareness of risk factors could permit early detection.

Safety and technological properties of bacteriocinogenic enterococci isolates from Tunisia.

AIMS: To investigate the safety and technological traits of previously isolated bacteriocinogenic enterococci strains for potential use as starter/adjunct cultures in foods. METHODS AND RESULTS: Fifty-five bacteriocinogenic enterococci strains previously isolated from different origins in Tunisia were screened for safety. Twenty-two strains did not harbour the genes coding for virulence traits, were susceptible to relevant antibiotics such as vancomycin, and tested negative for haemolysis, histamine production, gelatinase activity and DNase activity. These strains were further assessed for some technological properties, demonstrating low milk-acidifying ability, low proteolytic activity, high peptidolytic activity and diacetyl production in milk. CONCLUSIONS: This study revealed that 22 bacteriocinogenic enteroccoci strains did not present virulence features and could be safely applied in food preservation. Some strains also showed good technological potential as adjunct/protective cultures in milk fermentation and cheese production. SIGNIFICANCE AND IMPACT OF THE STUDY: This is one of very few studies that identified safe Enterococcus strains capable of producing a wide variety of enterocins against different spoilage and pathogenic micro-organisms that have good potential for application as adjunct/protective cultures in foods.

High inhibition of Paenibacillus larvae and Listeria monocytogenes by Enterococcus isolated from different sources in Tunisia and identification of their bacteriocin genes.

UNLABELLED: A total of 300 isolates of Enterococcus, from different sources including faeces of poultry, cow and sheep, raw milk, ricotta cheese and water, in Tunisia, were screened for their antibacterial activity. Amongst them, 59 bacteriocin-producing strains were detected and identified by molecular methods. Genes encoding for entA, entP, entB, entL50A/B, AS-48 and bac31 bacteriocins were targeted by PCR. The bacteriocin-producing strains were assigned to the species Enterococcus faecium, Enterococcus faecalis, Enterococcus hirae, Enterococcus mundtii and Enterococcus durans, respectively, 34, 19, 3, 2 and 1 isolates. Antimicrobial activity was specifically observed against different spoilage and pathogenic micro-organisms, such as Listeria monocytogenes, Listeria innocua, Listeria ivanovii, Escherichia coli, Ent. faecalis, Staphylococcus aureus, Salmonella enterica serovar Enteritidis and Paenibacillus larvae. The inhibitory activity was totally lost after proteinase K treatment, thereby revealing the proteinaceous nature of the antimicrobial compound. Only three bacteriocin genes, namely entP, entA and entL50A/B were detected in the isolates included in this study. Enterocins A and P were the most frequent genes and they were found in 55 (93.2%) and 39 isolates (66.1%), respectively, followed by enterocin L50A/B present in 27 isolates (45.7%). These newly identified bacteriocin-producing enterococci have the potential to be used in bio-preservation of food as well as biological control of foulbrood disease. SIGNIFICANCE AND IMPACT OF THE STUDY: Enterococci possess interesting properties not only for the food industry, but also for animal and human health. The antimicrobial potential of these bacteria includes principally bacteriocin-like molecules. With the aim of identifying bacteriocinogenic strains, a collection of 300 enterococci isolated from different origins were screened and their spectrum of action, as well as the gene encoding the bacteriocin, was determined. Fifty-nine bacteriocin-producing Enterococcus showed high activity against Listeria monocytogenes and Paenibacillus larvae, the causative agent of American foulbrood. Enterocins A, P and L50A/B were found in various combinations. The most important finding of this study is the growth inhibition of P. larvae due to bacteriocin-producing Enterococcus, which opens up the possibility to use these strains to control the disease in honeybees.

[Extensive inflammatory and childhood dermatophytosis caused by Trichophyton rubrum]. / Dermatophytose extensive et inflammatoire infantile due à Trichophyton rubrum.

We report an observation of extensive and atypical dermatophytosis to Trichophyton rubrum coexisting with fingernails and tinea manuum candidiasis in a 13-year-old girl presenting inflammatory cutaneous lesions, involvement of scalp, as well as total dystrophic onychomycosis of feet associated with a perionyxis of hands. The results of the mycological examination of specimen showed fungal elements of septate hyphae and pilar parasitism. The fungal culture allowed the diagnosis of certainty of the dermatophytosis to T. rubrum. The therapeutic success of this infection was obtained thanks to the administration of antifungals by oral route.

[Seroprevalence of toxoplasmosis in pregnant women in Annaba, Algeria]. / Séroprévalence de la toxoplasmose chez les femmes enceintes dans la wilaya d'Annaba, Algérie.

BACKGROUND: The aim of the study was to estimate the seroprevalence and risk factors of toxoplasmosis in pregnant women in the department of Annaba, Algeria. METHODS: We performed a cross-sectional study with analytical purposes. The study was collaboration between the laboratory of Parasitology-Mycology, Faculty of Medicine of Annaba and Parasite Biology Department at the Pasteur Institute of Algeria. A total of 1028 pregnant women who underwent prenatal diagnosis/visit were included over a period of 4 years from January 2006 to December 2009. Immunoglobulin G and M were assayed, using the microparticle enzyme method. The avidity test was used to determine the date of contamination according to age of pregnancy. Search for the parasite was made by inoculation of the placenta and cord blood in white mice. The study compared mother-to-child serological profiles using Western Blot (WB) IgG and IgM. Direct (not well-cooked meat) and indirect (presence of cat, gardening) indicators were recorded to search for parasite exposure. RESULTS: Seroprevalence was 47.8 % (95 % CI: 44.8 to 51.0) and the rate of active toxoplasmosis was 1.1 % (95 % CI 0.6 to 1.8). According to their immune status, this was the first serology for 41 % (CI95 %: 38.0-44.0) of women; 12 % (CI95 %: 10.5-14.6) of primiparous women had only one serology test during their entire pregnancy. Major risk factors were consumption of poorly-cooked meat and exposure to cats. CONCLUSION: Toxoplasmosis during pregnancy is a serious issue and an effective prevention program is needed.

Stabilization of an inverted pendulum-cart system by fractional PI-state feedback.

This paper deals with pole placement PI-state feedback controller design to control an integer order system. The fractional aspect of the control law is introduced by a dynamic state feedback as u(t)=K(p)x(t)+K(I)I(α)(x(t)). The closed loop characteristic polynomial is thus fractional for which the roots are complex to calculate. The proposed method allows us to decompose this polynomial into a first order fractional polynomial and an integer order polynomial of order n-1 (n being the order of the integer system). This new stabilization control algorithm is applied for an inverted pendulum-cart test-bed, and the effectiveness and robustness of the proposed control are examined by experiments.

Transfusion-related acute lung injury (TRALI) during remission induction course of acute myeloid leukemia: a possible role for all-transretinoic-acid (ATRA)?

Transfusion-related acute lung injury (TRALI) is a clinical syndrome characterized by sudden onset of respiratory distress due to pulmonary edema during or following transfusion. Two proposed pathophysiologic mechanisms for TRALI were proposed: the antibody hypothesis and the two-event hypothesis. The two-event hypothesis postulates that a pathway to neutrophil activation and aggregation can occur without leukocyte antibodies. We report a case of TRALI occurring during remission induction course of acute myeloid leukemia in a 27-year-old woman who received All-transretinoic-acid (ATRA). We postulate that ATRA may have played a role in this life-threatening complication by priming neutrophil and enhancing their adherence and their activation in the pulmonary endothelium. TRALI improved with non-invasive ventilation support and use of high dose corticosteroids.

Glucagon does not affect catecholamine release in primary cultures of bovine adrenal chromaffin cells.

OBJECTIVE: Human pheochromocytoma tumor cells express glucagon receptors, and bolus i.v. glucagon injection rapidly increases plasma epinephrine levels, suggesting that glucagon can directly stimulate adrenomedullary secretion. In this study, we tested whether the catecholamine secretory response to glucagon was present in bovine chromaffin cells or exclusive to the tumor cells. DESIGN AND METHODS: Adrenomedullary cells were cultured in 24-well plates (10(6) cells per well). After 48-72 hours, wells were incubated for 1-20 minutes with (1) incubation medium (control), (2) catecholamine secretagogues (nicotine or potassium ion), or (3) glucagon (10(-8) to 10(-5) M). After incubation, catecholamine contents in medium and cells were assayed by high-pressure liquid chromatography with electrochemical detection. Fractional release rates of epinephrine, norepinephrine, and dopamine were calculated and compared to controls. Reverse-transcriptase PCR was performed to compare expression of mRNA of the glucagon receptor in chromaffin cells and pheochromocytoma cells. RESULTS: Nicotine and potassium evoked time-dependent release of epinephrine, norepinephrine, and dopamine. Glucagon did not affect catecholamine secretion at any concentration. Reverse-transcriptase PCR failed to detect mRNA for glucagon receptor in bovine adrenomedullary cells, but did detect it in human pheochromocytoma cells. CONCLUSIONS: In contrast to pheochromocytoma tumor cells, bovine adrenomedullary chromaffin cells do not express the glucagon receptor, and therefore do not secrete catecholamines in response to glucagon.

[Pneumocystis carinii pneumopathy in patients with AIDS. The first 3 cases reported in Algeria and review of the literature]. / Pneumopathie à pneumocystis carinii chez les malades atteints de sida. Les 03 premiers cas algériens et revue de la littérature.

Pneumocystis carinii pneumonia (PCP) is a severe and dangerous infection which afflicts patients with immune deficiency, particularly those with AIDS. This pathology isn't well known in Algeria. The aim of the present study is a contribution to make this disease more known in the algerian AIDS patients. It has focused on the research and the identification of P. carinii in the expectorations and in the bronchalveolar lavage (BAL) fluids of 14 patients with respiratory troubles: 13 were AIDS cases and one with an iatrogenic immune deficiency. 3 of these patients were women and the rest were men. Their average age was 35.

Antithymocyte globulin in cadaver kidney transplantation: a randomized trial based on T-cell monitoring.

The influence of horse antihuman thymocyte globulin (ATG) on renal allograft survival was assayed between March 1977 and August 1978. Fifty consecutive patients were randomly assigned to the treatment or the control group. Patients in both groups received azathioprine and prednisolone. ATG was added in the experimental group. The daily dosage was such as to maintain the rosette-forming cell (RFC) level at 10% of baseline values. The number of renal failure episodes (RFE's)was significantly lower in the experimental group during the period (1 month) ATG was given than it was in the control group during that same period of time. Two years after transplantation, kidney survival was 79% in the ATG group and 52% in the control group. The amount of steroids necessary to control RFE's was significantly lower in the ATG group. The dosages of ATG used in the experimental group were relatively small (average daily dose, 3.08 +/- 0.26 mg/kg of body wt), and adverse reactions were mild. Blood tolerance was excellent. T-cell monitoring thus appears to be an effective method in evaluating the daily dosage of ATG.

Are there non-steroid-dependent rejection episodes?

We undertook two randomised studies in an effort to decrease the dosage of steroids in transplanted patients and to replace harmful steroid therapy by nonsteroid anti-inflammatory (NSAI) drugs. In the first study, 50 consecutive transplant recipients were randomly assigned to the treatment or the control group. In both groups, patients received azathioprine and prednisolone. ATG was added to this protocol in the experimental group. The number of renal failure episodes and consequently the amount of steroid necessary to control these episodes were significantly lower in the ATG group than in the other group. Two year post-transplantation kidney survival was 79% in the ATG group and 52% in the control group. In the second study, 15 consecutive transplant recipients were randomly assigned to two control groups and to one experimental group, where steroids were replaced by NSAI drugs. This preliminary, and very limited, pilot trial demonstrates the existence of early acute renal failure episodes, probably of immunological origin, which can improve spontaneously in the absence of steroid therapy.