Occurrence of Hypopituitarism in Tunisian Turner Syndrome patients: familial versus sporadic cases.

OBJECTIVE: To explore unusual association between Turner Syndrome (TS) and Hypopituitarism in a Tunisian cohort. METHODS: We reported 6 patients with TS associated to Hypopituitarism, including three familial cases except the fourth sister who showed only a TS phenotype. Biochemical analysis, resonance magnetic imaging and cytogenetic analyses were performed. RESULTS: The average age of our patients was 17.2 years (11-31 years). They were all referred for short stature and pubertal delay, except for the fourth sister who presented spontaneous puberty with the integrity of the pituitary axis and the presence of an X ring chromosome. Karyotype analysis showed monosomy in 3 cases and a mosaic TS in the 3 remaining cases, including one patient with abnormal X chromosome structure. Somatotropic and corticotropic deficiencies were confirmed in 2 sporadic cases while the gonadotropic and thyrotropic axes were spared. In contrast; familial cases were consistently affected by the integrity of the corticotropic axis. MRI showed pituitary hypoplasia in all familial cases and pituitary stalk interruption syndrome in only one sporadic case. No correlation was found between the chromosome formula and the anterior pituitary involvement. CONCLUSION: Co-segregation of congenital Hypopituitarism with pituitary hypoplasia and X chromosome aberrations could imply a molecular anomaly of transcription factors responsible for the differentiation and development of pituitary cells such as PROP1, POUF1, Hesx1, Lhx3, Lhx4. The etiopathogenic link between X chromosome abnormalities and the occurrence of Hypopituitarism remains unclear; however, the progress of molecular biology may clarify the interrelation between transcription factors and sex chromosome segregation abnormalities.

Stock discrimination of Chelidonichthys obscurus (Triglidae) in the central Mediterranean Sea using morphometric analysis and parasite markers.

Assessing fish stocks has important implications for fisheries management and conservation biology. Gurnards are marine demersal fish that commonly occur in the Mediterranean, but their population in this region remains to be quantified. This study examines the population structure of the longfin gurnard Chelidonichthys obscurus (Walbaum, 1792) in waters off eastern Tunisia, using morphometry and parasite assemblages. A total of 134 fish are investigated from two studied zones - the Gulf of Hammamet and the Gulf of Gabès. Discriminant analysis is used to compare gurnard populations in the two studied zones using 13 morphometric characters and the infection parameters of seven parasites. Morphometric analysis reveals strong spatial variations between the studied zones, providing evidence for the existence of an ecological differentiation along the eastern Tunisian coast. Mahalanobis distances show that body height, pectoral fin length and first dorsal fin length are the most salient morphometric characters for determining the position of samples from the Gulf of Gabès. The effectiveness of using parasites to study longfin gurnard stocks is uncertain. The use of short-lived parasites as biological tags is questionable, at least in the present case. Future research, based on complementary approaches such as otolith microchemistry and genetics, may improve our understanding of the global stock structure of longfin gurnard to suitably inform regional organizations involved in fisheries management.

Helminth parasites of the chub mackerel Scomber colias off the Tunisian coast and their use in stock discrimination.

Nine helminth parasites were used as biological tags to discriminate diverse areas of Scomber colias Gmelin, 1789. During three seasons, a total of 369 fish were examined in four zones off the Tunisian coast, including Bizerte in the north, Kelibia and Mahdia in the centre and Zarzis in the south. Discriminant analyses were used to identify distinct areas of S. colias. Fish from Bizerte were grouped as one area and were correlated negatively with the monogenean Grubea cochlear and the digenean Lecithocladium excisum. Specimens from Kelibia and Mahdia were grouped together and were characterized by the ectoparasite Pseudokuhnia minor and by endoparasites Prodistomum orientalis, Monascus filiformis and anisakid larvae. Fish from Zarzis were grouped as one area and were positively correlated with the monogenean G. cochlear and the digenean L. excisum. These results were corroborated by comparing the prevalence and mean abundance of parasites among zones. Results of other discriminant analyses used for the classification of S. colias between localities after pooling specimens from the central areas of Kelibia and Mahdia also allowed the identification of three distinct areas: one in the north, correlated negatively with G. cochlear and L. excisum; one in the centre, characterized by P. minor, P. orientalis, M. filiformis and anisakid larvae; and one in the south, from Zarzis, characterized by G. cochlear and L. excisum. Results of comparisons of infection parameters between seasons and those of seasonal discrminant analyses showed a seasonal stability of communities from the northern and the southern areas. Specimens from the central regions showed variability between seasons, suggesting migratory movements.

Testicular adrenal rest tumours in young adult males with congenital adrenal hyperplasia: prevalence and impact on testicular function.

Testicular adrenal rest tumours (TARTs) have been described in patients with congenital adrenal hyperplasia (CAH). The aim of the study was to determine the prevalence of TARTs in patients with CAH, the associated factors and their impact on gonadal function. It is a prospective study concerning six young adult men with CAH, four cases with 21-hydroxylase deficiency and two cases with 11-hydroxylase deficiency. All patients were under glucocorticoid therapy. The mean age was 25 years (range: 20-31). All patients underwent a physical examination with testicular palpation, scrotal ultrasonography, a blood sample for serum testosterone, FSH, LH, inhibin B, ∆4-androstenedione and 17-OH-progesterone measurements and a semen analysis. Ultrasound revealed TARTs in four patients; three were bilateral. The mean tumour size was 6.3 ml (range: 0.02-14.1). The tumours were palpable in two cases. 17-OH-progesterone was <10 ng/ml in all cases. Decreased testosterone level was found in one case. The semen analysis revealed azoospermia in one case and poor semen quality in four patients. TARTs were common and associated with impaired spermatogenesis.

Spatial variability of helminth parasites and evidence for stock discrimination in the round sardinella, Sardinella aurita (Valenciennes, 1847), off the coast of Tunisia.

Three digeneans - Parahemiurus merus (Linton, 1910), Aphanurus stossichii (Monticelli, 1891) and Lecithochirium sp. - and one tetraphyllidean cestode larva were used as biological tags to discriminate the stock of Sardinella aurita (Valenciennes, 1847). In total, 579 fish were examined in five zones off the Tunisian coast, including Bizerte and Kelibia in the north, Mahdia in the east, Gabes and Zarzis in the south. Discriminant analyses used for the separation of S. aurita allowed for the identification of two discrete stocks. Sardinella aurita from Bizerte, Kelibia and Zarzis clumped together as a single stock. Parahemiurus merus and A. stossichii were the most important species in determining the location of sampled fish from these regions. Specimens from Mahdia and Gabes were grouped as one stock characterized by the presence of Lecithochirium sp. and larvae of the Tetraphyllidea. These results were corroborated by comparing the parameters of prevalence and mean abundance of parasites among zones. The separation of S. aurita between localities after pooling specimens from Bizerte, Kelibia and Zarzis and separately pooling those from Mahdia and Gabes also allowed the identification of two discrete stocks, one in offshore waters from Bizerte, Kelibia and Zarzis characterized by the digeneans P. merus and A. stossichii and one in inshore waters from Mahdia and Gabes characterized by Lechithochirium sp. and tetraphyllidean larvae.

Vitamin D status and determinants of deficiency in non-supplemented athletes during the winter months in Tunisia.

Recent reports suggest that hypovitaminosis D in athletes is as common as in the general population. This study was devised to examine vitamin D status and determinants of deficiency in athletes living in a sunny country (Tunisia). One hundred and fifty national elite athletes, training outdoors (n = 83) or indoors (n = 67), were enrolled from January to February 2012. Plasma 25-hydroxyvitamin D was measured by radioimmunoassay. Concentrations were between 50 and 75 nmol · l(-1) in 21.3% of participants, between 25 and 50 nmol · l(-1) in 55.3% of participants and <25 nmol · l(-1) in 14.7% of participants. The concentrations were significantly lower in indoor athletes than outdoor athletes (36.2±19.0 nmol · l(-1) vs. 49.1±19.2 nmol · l(-1); p < 0.001). In multivariate analysis, vitamin D deficiency (25-hydroxyvitamin D <50 nmol · l(-1)) was associated with indoor sports [multi-adjusted odds ratio (95% confidence interval), 5.03 (1.64-15.4); p = 0.005], female gender [3.72 (1.44-9.65); p = 0.007] and age < 18 years [2.40 (1.01-5.85); p = 0.05]. Athletes living in sun-rich environments are exposed to a high risk of vitamin D inadequacy. Given the importance of vitamin D in health and athletic ability, targeting sufficient levels of plasma 25-hydroxyvitamin D in athletes is well justified.

Urinary creatine at rest and after repeated sprints in athletes: a pilot study.

Creatine plays a key role in muscle function and its evaluation is important in athletes. In this study, urinary creatine concentration was measured in order to highlight its possible significance in monitoring sprinters. The study included 51 sprinters and 25 age- and sex-matched untrained subjects as a control group. Body composition was measured and dietary intake estimated. Urine samples were collected before and after standardized physical exercise. Creatine was assessed by gas chromatography mass spectrometry. Basal urinary creatine (UC) was significantly lower in sprinters than controls (34±30 vs. 74±3 µmol/mmol creatinine, p < 0.05). UC was inversely correlated with body mass (r = -0.34, p < 0.01) and lean mass (r = -0.30, p < 0.05), and positively correlated with fat mass (r = 0.32, p < 0.05). After acute exercise, urinary creatine significantly decreased in both athletes and controls. UC is low in sprinters at rest and further decreases after exercise, most likely due to a high uptake and use of creatine by muscles, as muscle mass and physical activity are supposed to be greater in athletes than untrained subjects. Further studies are needed to test the value of urinary creatine as a non-invasive marker of physical condition and as a parameter for managing Cr supplementation in athletes.

Unbalanced bone remodeling in Tunisian patients with inflammatory bowel diseases.

BACKGROUND: Bone loss is an ignored complication in inflammatory bowel diseases. Its underling mechanisms are not fully elucidated. OBJECTIVES: To investigate bone turnover in patients with inflammatory bowel diseases. METHODS: The study included 67 patients with inflammatory bowel diseases and 54 age- and sex-matched healthy subjects. Urinary degradation products of C-terminal telopeptide of type I collagen, serum osteocalcin, parathyroid hormone, 25 hydroxy vitamin D and interleukin-6 were assessed. Bone mineral density was measured by dual energy-X-ray absorptiometry and osteoporosis was defined as T score < -2.5 SD. RESULTS: Patients showed significantly higher levels of C-terminal telopeptide of type I collagen and interleukin-6 and lower levels of 25 hydroxy vitamin D. Serum osteocalcin and parathyroid hormone were in normal range. In multivariate analysis, urinary degradation products of C-terminal telopeptide of type I collagen were associated with disease activity (p=0.04) and osteocalcin was associated with parathyroid hormone (p=0.04). Urinary degradation products of Cterminal telopeptide of type I collagen and interleukin-6 were significantly increased in inflammatory bowel disease patients with osteoporosis. No association was found between osteoporosis and serum osteocalcin, parathyroid hormone and 25 hydroxy vitamin D. CONCLUSION: Bone resorption rate is increased and is associated with osteoporosis in inflammatory bowel disease patients. Inflammation, malnutrition, and hypovitaminosis D may contribute to the bone loss.

Effects of moderate- vs. high-intensity interval training on physical fitness, enjoyment, and affective valence in overweight/obese female adolescents: a pre-/post-test study.

OBJECTIVE: The aim of this study was to compare the effects of 12-week moderate-intensity interval training (MIIT) vs. high-intensity interval training (HIIT) on body composition, physical fitness, and psychological valence in overweight/obese (OW/OB) female adolescents. PATIENTS AND METHODS: Thirty-eight OW/OB female students were randomized into HIIT (n=13), MIIT (n=13) or control (n=12) groups. The participants underwent a 12-week interval-training program at 100% to 110% and 60% to 75% of maximal aerobic speed for HIIT and MIIT, respectively. The control group kept their usual physical activity without completing the training program. Pre- and post-training measurements were performed to assess body composition, aerobic capacity, and anaerobic performance (using selected tests evaluating speed, jumping ability, and strength). Ratings of perceived exertion and the feeling scale were evaluated every three weeks. Enjoyment was measured at the end of the program. A two-way analysis of variance with repeated measurements was applied to test for "group×time" interactions for body composition, physical fitness, and affective variables. RESULTS: Significant "group×time" interactions were detected for aerobic and anaerobic performance, body composition indices, and the feeling scale. HIIT resulted in more noticeable improvements in body composition and physical performance than MIIT, while no significant changes were found in the control group. Throughout the program, the feeling score has progressively increased in the MIIT group but decreased in the HIIT group. Ratings of the perceived exertion have increased in both groups, more noticeably in the HIIT group. At the end of the program, the MIIT group showed a higher enjoyment score. CONCLUSIONS: Despite offering better body composition improvement and physical fitness enhancement, HIIT offered lesser enjoyment and affective valence than MIIT in OW/OB female adolescents. MIIT might be an alternative time-efficient protocol for improving health in this population.

Prehypertension among adults in Great Tunis region (Tunisia): A population-based study.

PURPOSE: The present study aimed to determine the prevalence of prehypertension (preHTN) and its cardiometabolic profile in Tunisians, and to estimate the risk for coronary heart disease (CHD) according to blood pressure status. PATIENTS AND METHOD: This cross-sectional study was conducted in 2004-2005, and used a two-stage cluster sampling method to select a representative sample of the Great Tunis population. A total of 2712 individuals (1228 men and 1484 women), aged 35 to 69 years were included. Definition and classification of hypertension (HTN) was performed according to guidelines from the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-7) report. RESULTS: The prevalence of preHTN and HTN was 56.8% and 25.0% in males, and 43.1% and 36.1% in females, respectively. Subjects with preHTN and those with HTN showed higher prevalence of diabetes, dyslipidemia, obesity and abdominal obesity than the normotensive (NT) group. The metabolic syndrome (MetS) was found in 8.0%, 17.8% and 53.8% of NT, preHT and HTN subjects, respectively. The risk of developing CHD within 10 years, as predicted by the Framingham-Anderson model, was above 15% for 3.9%, 31.1% and 65.0% among NT, preHTN and HTN subjects, respectively. In multivariate analysis, preHTN was associated with age (OR [95% CI], 1.02 [1.01-1.03]; P<0.01), male gender (2.51 [1.89-3.23]; P<0.001), obesity (2.36 [1.71-3.26]; P<0.01), abdominal obesity (1.53 [1.14-2.06]; P<0.01) and smoking (0.70 [0.53-0.92]; P<0.01). CONCLUSION: PreHTN is very common in Tunisians. It is associated with a higher prevalence of cardiometabolic risk factors and confers a higher risk for subsequent CHD. These findings support the recommendations of lifestyle modification for preHTN patients.

The G3057A LEPR polymorphism is associated with obesity in Tunisian women.

OBJECTIVES: The aim of this study was to evaluate the effect of the G3057A (rs62589000) LEPR polymorphism on obesity risk and plasma leptin, insulin, and lipid levels in a sample of the Tunisian population. DESIGN AND METHODS: Three hundred and ninety-three obese patients and 317 controls participated in this study. The G3057A genotype was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. RESULTS: In the entire study sample, no significant differences in genotype frequencies were observed between obese patients and controls. However, stratified analysis by gender revealed a quantitative increase in the variant allele (33.3% vs. 25.8%; χ(2)=4.90, p=0.026) in obese women (but not men) compared to controls. When a dominant model of inheritance was assumed, the GA+AA genotypes were more prevalent in these obese female patients than in controls (58.3% vs. 47.8%; χ(2)=4.08, p=0.044). Unconditional logistic regression showed that in women only, obesity risk was significantly higher for homozygotes for the variant allele (OR=2.73, 95% CI 1.03-7.21) and for carriers of GA+AA genotypes (OR=1.53, 95% CI 1.01-2.31) compared with homozygotes for the normal allele. The association between the G3057A LEPR variant and obesity remained statistically significant even after adjustment for age. No relationship was found between the G3057A LEPR polymorphism and leptin and insulin levels. Additionally, this LEPR gene variant had no effect on plasma lipid concentrations. CONCLUSION: There is evidence in this study that the G3057A LEPR polymorphism is associated with obesity in Tunisian women.

Metabolic syndrome in Tunisian psoriatic patients: prevalence and determinants.

BACKGROUND: A significant association between psoriasis and the metabolic syndrome (MetS) has been frequently reported. OBJECTIVE: The aim of this study was to specify the main factors that determine the MetS in psoriatic Tunisian patients. METHODS: A case-control study has included 164 psoriatic patients and 216 controls. RESULTS: The prevalence of MetS was higher in cases than in controls but without statistical differences [35.5% vs. 30.8%, odds ratio (OR): 1.39 CI: 0.88-2.18; P=0.095]. According to gender, the prevalence of MetS was significantly increased only in psoriatic women (47.4% vs. 30%, OR: 1.89, CI: 1.11-3.21; P=0.01). A multiple logistic regression, considering the effect of age, and gender, showed that the prevalence of MetS was significantly higher in cases than in controls (OR: 1.73, CI: 1.06-2.82; P=0.03). MetS components analysed seperately showed a significantly higher prevalence of decreased high-density lipoprotein cholesterol (HDLc) (60.9% vs. 35.9%, OR: 2.77, CI: 1.8-4.27, P<0.001) and for increased hypertension (50% vs. 40%, OR: 1.48, CI: 0.97-2.257, P=0.04) in psoriatic patients. According to gender, HDLc was significantly decreased in both genders (male: OR: 2.075, CI: 1.24-3.47, P=0.004; female: OR: 3.58, CI: 2.07-6.19, P<0.0001), while hypertension was increased only in psoriatic men (OR: 2.09, CI: 1.24-3.51, P=0.004) and abdominal obesity only in psoriatic women (OR: 2.31, CI: 1.30-4.11, P=0.002). CONCLUSION: Decreased HDLc is the main biological abnormality that characterized MetS in Tunisian psoriatic patients. Moreover, contrary to men, psoriatic women have shown a significantly higher prevalence of MetS, which is, in addition to decreased HDLc, mainly attributed to abdominal obesity.

Metabolic syndrome is associated with gastroesophageal reflux disease based on a 24-hour ambulatory pH monitoring.

Several studies have focused on the relationship between metabolic syndrome and gastroesophageal reflux disease (GERD). They were based on GERD complications, whereas little is known about the association between metabolic syndrome and objectively measured esophageal acid exposure. The aim of our study was to assess the relationship between metabolic syndrome and GERD based on a 24-hour pH testing. It was a cross-sectional study including 100 consecutive patients who underwent a 24-hour pH-metry monitoring and were assessed for the five metabolic syndrome components as well as for body mass index (BMI). Among the 100 patients, 54 had a pathological acid GERD. The 46 GERD-free patients represented control group. Sex distribution was comparable between both groups but GERD patients were older than controls (44.59 vs. 37.63 years, P= 0.006) and more often obese or with overweight (83.3 vs. 60.9%, P= 0.01). Frequency of metabolic syndrome as a whole entity was higher among patients with GERD than those without GERD (50 vs. 19.56%; P= 0.002) with a crude odds ratio of 4.11 (95% confidence interval: 1.66-10.14). Multivariate regression analysis showed that metabolic syndrome as well as an age ≥ 30 years were independent factors associated to GERD but not BMI and sex. Abnormal waist circumference and fasting glucose level ≥ 100 mg/L were the only independent factors among the five components of metabolic syndrome. Metabolic syndrome but not BMI was an independent factor associated to GERD. These results confirm the hypothesis that central obesity is associated to GERD.

Retention of nickel from aqueous solutions using iron oxide and manganese oxide coated sand: kinetic and thermodynamic studies.

In this study, the removal of nickel ions from aqueous solutions using iron oxide and manganese oxide coated sand (ICS and MCS) under different experimental conditions was investigated. The effect of metal concentration, contact time, solution pH and temperature on the amount of Ni(II) sorbed was studied and discussed. Langmuir and Freundlich isotherm constants and correlation coefficients for the present systems at different temperatures were calculated and compared. The equilibrium process was well described by the Langmuir isotherm model: the maximum sorption capacities (at 29 K) were 2.73 mg Ni/g and 3.33 mg Ni/g of sorbent for ICS and MCS, respectively. Isotherms were also used to evaluate the thermodynamic parameters (deltaG degrees, deltaH degrees, deltaS degrees) of adsorption. The sorption kinetics were tested for the pseudo-first-order, pseudo-second-order and intra-particle diffusion models. Good correlation coefficients were obtained for the pseudo-second-order kinetic model, showing that the nickel uptake process followed the pseudo-second-order rate expression.

Ketosis-onset diabetes in Tunisian adults: immunological markers and beta-cell function.

The aim of this study in Tunisia was to classify ketosis-onset diabetes in adult patients. All patients aged > 30 years without known diabetes, presenting with ketosis and admitted to our department were studied. Patients with secondary or gestational diabetes and those on corticoid therapy or with coinciding infection were excluded. The data included clinical characteristics, immunological markers and beta-cell function. Of the 63 patients, islet-cell antibodies were present in 27.0%, glutamic acid decarboxylase antibodies in 25.4% and thyrosin phosphatase antibodies in 19.0%. Beta-cell functional reserve was preserved in 54.0%. Our results confirm that patients with ketosis-onset diabetes mellitus in adulthood are a heterogeneous group.

[Testosterone and chronic obstructive pulmonary disease]. / Testostéronémie et bronchopneumopathie chronique obstructive.

INTRODUCTION: Testosterone level has been shown to be associated with respiratory function and loss of lean body mass in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to assess the relationship between testosterone level and functional respiratory parameters during COPD. METHODS: We conducted a cross-sectional study that included 95 male patients with stable COPD. Functional tests (body plethysmography, six-minute walk test (6MWT), arterial blood gas) were performed in all patients and serum levels of testosterone, prolactin, FSH, LH and C-reactive protein were determined. Lean body mass was measured using bioelectric impedance. RESULTS: The average age was 63.78±8.90years. COPD was classified as stage 3 in 38% of cases and stage 4 in 11% of cases, group C in 10% of cases and group D in 18% of cases. The average testosterone was 20.87±8.60nmol/L. A significant positive correlation was found between FEV1 (P=0.005), FVC (P=0.005), FEV1/FVC ratio (P=0.001), lean mass index (P=0.021), and testosterone. However, testosterone was not correlated with 6MWT or blood gas parameters. Similarly, it was not correlated with FSH, LH, prolactin and C-reactive protein. CONCLUSION: This study found that serum testosterone level was associated with lung function and lean mass during COPD. Further investigations are required to better evaluate the relationship between COPD and serum testosterone levels and the effect of androgen substitution in lung function.

Autoimmune thyroid diseases: genetic susceptibility of thyroid-specific genes and thyroid autoantigens contributions.

Autoimmune thyroid diseases are common polygenic multifactorial disorders with the environment contributing importantly to the emergence of the disease phenotype. Some of the disease manifestations, such as severe thyroid-associated ophthalmopathy, pretibial myxedema and thyroid antigen/antibody immune complex nephritis are unusual to rare. The spectrum of autoimmune thyroid diseases includes: Graves' disease (GD), Hashimoto's thyroiditis (HT), atrophic autoimmune thyroiditis, postpartum thyroiditis, painless thyroiditis unrelated to pregnancy and thyroid-associated ophthalmopathy. This spectrum present contrasts in terms of thyroid function, disease duration and spread to other anatomic location. The genetic basis of autoimmune thyroid disease (AITD) is complex and likely to be due to genes of both large and small effects. In GD the autoimmune process results in the production of thyroid-stimulating antibodies and lead to hyperthyroidism, whereas in HT the end result is destruction of thyroid cells and hypothyroidism. Recent studies in the field of autoimmune thyroid diseases have largely focused on (i) the genes involved in immune response and/or thyroid physiology with could influence susceptibility to disease, (ii) the delineation of B-cell autoepitopes recognized by the main autoantigens, thyroglobulin, thyroperoxidase and TSH receptor, to improve our understanding of how these molecules are seen by the immune system and (iii) the regulatory network controlling the synthesis of thyroid hormones and its dysfunction in AITD. The aim of the present review is to summarize the current knowledge regarding the relation existing between some susceptibility genes, autoantigens and dysfunction of thyroid function during AITD.

Preparation of activated carbon from Tunisian olive-waste cakes and its application for adsorption of heavy metal ions.

The present work explored the use of Tunisian olive-waste cakes, a by-product of the manufacture process of olive oil in mills, as a potential feedstock for the preparation of activated carbon. Chemical activation of this precursor, using phosphoric acid as dehydrating agent, was adopted. To optimize the preparation method, the effect of the main process parameters (such as acid concentration, impregnation ratio, temperature of pyrolysis step) on the performances of the obtained activated carbons (expressed in terms of iodine and methylene blue numbers and specific surface area) was studied. The optimal activated carbon was fully characterized considering its adsorption properties as well as its chemical structure and morphology. To enhance the adsorption capacity of this carbon for heavy metals, a modification of the chemical characteristics of the sorbent surface was performed, using KMnO(4) as oxidant. The efficiency of this treatment was evaluated considering the adsorption of Cu(2+) ions as a model for metallic species. Column adsorption tests showed the high capacity of the activated carbon to reduce KMnO(4) into insoluble manganese (IV) oxide (MnO(2)) which impregnated the sorbent surface. The results indicated also that copper uptake capacity was enhanced by a factor of up to 3 for the permanganate-treated activated carbon.

[Prevalence of conventional cardiovascular risk factors in the Great Tunis population]. / Prévalence des facteurs de risque cardiovasculaires conventionnels dans la population du Grand Tunis.

BACKGROUND: This study was designed to determine the prevalence of main cardiovascular risk factors in the population of Great Tunis. SUBJECTS AND METHODS: This cross-sectional study included 2483 individuals aged 35 to 70 years dwelling in the Great Tunis region, recruited between March 2004 and June 2005. The sample was weighted using the inverse of response rate according to governorate, district and sex. RESULTS: Obesity and abdominal obesity were observed respectively in 34 and 48% of subjects. The prevalence of these two factors was particularly elevated in females (46 and 69% respectively). Hypertension was common (31%), especially in women (36%). Diabetes mellitus and dyslipemia were found in 15 and 21% of subjects, respectively, without difference according to sex. More than half of men and 8% of women were current smokers. CONCLUSION: The prevalence of conventional cardiovascular risk factors is dramatically high in the population of Great Tunis. These findings predict a future expansion of cardiovascular diseases in this population. Profound changes of lifestyle and dietary habits of Tunisians are needed to reduce the risk of cardiovascular morbidity and mortality.

The -2548G/A LEP polymorphism is associated with blood pressure in Tunisian obese patients.

OBJECTIVE: To examine the association of a common -2548G/A (rs7799039) promoter variant of the human leptin gene (LEP) with obesity or body mass index (BMI) and its associated phenotypes such as blood pressure variability and the prevalence of hypertension in a sample of the Tunisian population. DESIGN AND METHODS: Two hundred and twenty-nine obese patients were screened and compared with 251 normal weight subjects. The -2548G/A LEP polymorphism was analysed by PCR-RFLP procedure. RESULTS: No significant association was found between the -2548G/A polymorphism and obesity or BMI. However, in obese patients subjects with AA genotype had significantly higher systolic (p = 0.003) and diastolic (p = 0.002) blood pressure compared with those with GA or GG genotypes. Stratified analysis by gender revealed that male patients but not female homozygous for -2548A allele exhibited significantly increased systolic (p = 0.01) and diastolic (p<0.001) blood pressure than did carriers of -2548G allele. Multiple linear regression analysis revealed that AA genotype significantly affect systolic and diastolic blood pressure in obese men. Additionally, significant association between AA genotype and higher prevalence of hypertension was found in male patients (p = 0.03). CONCLUSION: The present study showed that the -2548G/A LEP polymorphism is associated with blood pressure in obese male patients.