Communication during covid area: The impact of creating a new communication center.

Background: Since the breakout of COVID-19 pandemic, many ways have been proposed to improve the quality of communication between the medical staff patient and their familiesIn our department of intensive care unit in tanger Morocco and due to the lack of resources we proposed to create a communication center near the hospital to keep the families updated. Objectives: Explore the outcomes and the satisfaction of family members and intensive care unit physicians about the quality of communication through reception center during the restrictive measures imposed by COVID-19. Methods: we have conducted a satisfaction survey with sample of 100 families and 35 members of ICU physician during the period between August and December 2021. Results: We found that communications allowed families a better understanding of the clinical state of their patient, However it was inferior to the visit near bed visits, they also thought that it helps reduce the stress due to the lack of information. Physicians believed: that the communication center improved the quality of care given to the patient and helped to reduce the tension with family and increased the trust link between then and family members. Conclusion: The creation of reception center improved the relation between physicians and families and improved the quality care however it remains insufficient and other strategies should be considered including telecommunication and near bed visits specially in seriouslyç ill patients.

A rare case of intracerebral hemorrhage complicating heparin-induced thrombocytopenia in a COVID-19 patient.

INTRODUCTION: Heparin-induced thrombocytopenia is a rare complication of heparin therapy associated with thrombocytopenia and mainly thrombotic complications. CASE REPORT: we herein describe a case of a woman hospitalized for management of a severe case of COVID-19 treated with low molecular weight heparin, who developed heparin-induced thrombocytopenia complicated by intracerebral hemorrhage with no thrombotic complications. CONCLUSION: Discontinuation of heparin was effective without the use of other non-heparin anticoagulants, platelet transfusion or plasmapheresis.

Phytotoxic activity and chemical composition of Cassia absus seeds and aerial parts.

The present study was conducted to assess the phytotoxic potential and the phytochemical composition of Cassia absus. Aqueous extracts caused significant reduction in root growth of Lactuca sativa. Seed extract was more effective than aerial part extract. Successive extractions of this plant were performed using solvents with increasing polarities. The methanolic seed extract exerted strong phytotoxic effect on seedling growth, followed by petroleum ether extract of the aerial part. The phytochemical investigation showed that among the organic extracts, methanol extracts of seeds and aerial parts contained the highest amounts of total phenolics and proanthocyanidins. Seeds were rich in linoleic acid followed by palmitic acids. Palmitic, stearic and arachidic acids were the major fatty acids in aerial parts. HPLC-DAD analysis of the methanolic extracts revealed the presence of luteolin in C. absus aerial parts.

[Urodynamic profile of voiding disorders persisting after treatment of posterior urethral valve]. / Profil urodynamique des troubles vésico-sphinctériens persistants après cure de valves de l'urètre postérieur.

PURPOSE: Posterior urethral valves (PUV) are the most common cause of bladder outlet obstruction in infancy that impairs renal and bladder function. MATERIAL AND METHODS: We realize a retrospective study and examined 35 boys with urinary disorders post-treatment of PUV, seen at the urodynamic consultation. RESULTS: The mean age: 7.56 years, urinary problems are dominated by recurrent urinary tract infections and urinary leakage, morphological assessment is marked by the constant expansion of the urinary tract and bladder, 18 children have end-stage renal disease of which 8 are candidates for transplantation. About urodynamic, the uroflowmetry with measure of post-void urine residue: dysuria with significant residual urine in 14 children; for cystometry, 20 children with bladder hyperactivity, 9 bladders are hypotonic hypoactive with high capacity, 6 explorations are normal. CONCLUSION: Urodynamic explorations are all interest when voiding symptoms persist after endoscopic section valves and despite a good radiological result.

[Gastric pneumatosis complicated by a neonatal digestive occlusion]. / Pneumatose gastrique compliquée d'une occlusion digestive néonatale.

Gastric pneumatosis is a rare pathology. Its occurrence in the neonatal period requires looking for ulcerative-necrotizing enterocolitis in a context of prematurity or an underlying surgical obstacle. We report a case of gastric pneumatosis at a newborn child born at term, admitted on the third day of life for neonatal occlusion with a flat stomach. The abdomen without preparation showed substantial gastric distension with aspects of gastric pneumatosis and embellishes with images showing a double gastric bubble. The surgical exploration showed gastric pneumatosis, complete duodenal atresia located at the level of the second duodenal portion, and an annular pancreas. Progression was favorable after duodenostomy.

Facial palsy associated with leptospirosis.

INTRODUCTION: The authors report a rare case of facial palsy associated with leptospirosis. CASE REPORT: A 60-year-old man was admitted to ICU with severe leptospirosis. On the eighth day of hospitalisation, he developed left peripheral facial palsy with a favourable course in response to corticosteroids. DISCUSSION: Several types of neurological complications of leptospirosis have been reported: encephalitis, myelitis, stroke, cerebral arteritis, mononeuritis, polyradiculoneuropathy, and cranial nerve palsy. Peripheral facial palsy is a rare complication of leptospirosis. CONCLUSION: This case illustrates the possible association between leptospirosis and facial palsy.

[Fahr syndrome discovered following a bacterial meningitis]. / Syndrome de Fahr découvert à la suite d'une méningite à pneumocoque.

Fahr's disease refers to a rare syndrome characterized by symmetrical and bilateral intracranial calcifications. The basal ganglia and dentate nucleus are the most common site of involvement and most cases present extrapyramidal symptoms. This disease is mostly associated with a phosphocalcic metabolism disorder, especially to hypoparathyroidism. The authors report a case of Fahr syndrome (FS) discovered when a young patient with hypocalcemia and bacterial meningitis had a cerebral CT scan disclosing intracerebral calcifications. She fully recovered after both meningitis and hypocalcemia were treated.

Trichobezoar with small bowel obstruction in children: two cases report.

A trichobezoar is a mass of cumulated hair within the gastrointestinal tract. Stomach is the common site of occurrence. Intestinal obstruction due to trichobezoar is extremely rare. The authors report two cases of a trichobezoar obstructing the terminal ileum in one and the jejunum in another.

Analyzing Mycobacterium tuberculosis proteomes for candidate vaccine epitopes.

Secreted antigens of Mycobacterium tuberculosis (Mtb) induce strong T cell responses and interferon-gamma (IFN-gamma) secretion, both of which are integral in the defense against Mtb. We used web-based tools (SignaIP and Prosite) to identify putative secreted proteins from Mtb genomes CDC 1551 and H37Rv. We then used EpiMatrix, a proprietary pattern-matching algorithm, to do a preliminary analysis of these proteins for regions that contained a high number of class II MHC binding motif matches. The use of bioinformatics tools reduced the number of potential epitopes to be screened to 5% of the 1.3 million overlapping peptides. Peripheral blood mononuclear cells (PBMC) were obtained from healthy, asymptomatic tuberculin skin test-positive donors. Of the 17 highest-ranking peptide candidates that could be synthesized for this preliminary in vitro evaluation, 15 (88%) stimulated IFN-gamma response, and eight (47%) stimulated lymphocyte proliferation in vitro. IFN-gamma ELISpot assays were therefore a more sensitive test for T cell response to these peptides than were proliferation assays. One highly promiscuous epitope (MT2281-26-J, WRRRPLSSALLSFGLLLGGLPL) induced IFN-gamma secretion in PBMC from 11 of 25 Mtb immune subjects (44%). Overall, 15 epitopes, and MT2281-26-J in particular, are candidates for inclusion in a multi-epitope TB vaccine. These findings support the systematic application of bioinformatics tools to whole genomes when used in combination with in vitro methods for screening and confirming epitopes.

Rapid determination of HLA B*07 ligands from the West Nile virus NY99 genome.

Defined T cell epitopes for West Nile (WN) virus may be useful for developing subunit vaccines against WN virus infection and diagnostic reagents to detect WN virus-specific immune response. We applied a bioinformatics (EpiMatrix) approach to search the WN virus NY99 genome for HLA B*07 restricted cytotoxic T cell (CTL) epitopes. Ninety-five of 3,433 WN virus peptides scored above a predetermined cutoff, suggesting that these would be likely to bind to HLA B*07 and would also be likely candidate CTL epitopes. Compared with other methods for genome mapping, derivation of these ligands was rapid and inexpensive. Major histocompatibility complex ligands identified by this method may be used to screen T cells from WN virus-exposed persons for cell-mediated response to WN virus or to develop diagnostic reagents for immunopathogenesis studies and epidemiologic surveillance.

Use of T cell epitopes for vaccine development.

T lymphocytes play a major role in the recognition and subsequent elimination of tumors and intracellular pathogens. Induction of epitope-specific T cell responses can help in the clearance of diseases for which no conventional vaccines exist. However, the lack of simple methods to identify relevant T cell epitopes, the high mutation rate of many pathogens, and HLA polymorphism have made the development of efficient T cell epitope-based, or "epitope-driven" vaccines difficult to achieve. Our research over the past several years has applied bioinformatics tools in conjunction with T cell assays to identify naturally processed putative T cell epitopes from several pathogens. This strategy will accelerate the development of new generation T cell epitope-based vaccines against various pathogens including viruses such as HIV and WNV, bacteria such as M.tb., and parasites such as plasmodium. This chapter will review the use of a bioinformatics-based approach to identify putative T cell epitopes. It will summarize the current state of knowledge regarding T cell-epitope-based vaccines and discuss several ways to improve their efficacy.

Improved immunogenicity of HIV-1 epitopes in HBsAg chimeric DNA vaccine plasmids by structural mutations of HBsAg.

To improve the immunogenicity of epitopes from the envelope protein of HIV-1, we have developed gene gun-delivered subunit DNA vaccines by inserting the sequences encoding the V3 region into the hepatitis B virus (HBV) envelope gene, often called the surface antigen (HBsAg). We have examined the possibility of modifying the immune response to V3 by introducing modifications into the carrier HBsAg in gene gun DNA immunization of mice. In some plasmid constructions, the V3 sequence was introduced into the preS2 region of the HBsAg. Although this region is not present in all protein subunits of the HBsAg particles produced, abolishing the internal translational initiation site for the S protein had no effect on the immune response to V3. Expression of V3 at the N-terminal or C-terminal part of the HBsAg protein resulted in equal anti-V3 antibody and cytotoxic T-lymphocyte (CTL) responses. However, elimination of secretion by single amino-acid mutations in the HBsAg decreased the anti-HBsAg antibody response but enhanced the anti-V3 antibody response. In contrast, the CTL response to V3 was independent of the structural mutations but could be improved by a total deletion of the HBsAg sequence part. Thus, the immune response to heterologous epitopes can be altered by modifications in the carrier HBsAg protein. Modifications of the HBsAg carrier might interfere with the dominant immune response to the HBsAg epitopes, allowing better antibody induction to less immunogenic foreign epitopes. However, for induction of CTL responses, the expression of minimal epitopes may be advantageous.