Diagnostic value of high-sensitivity troponin T in postmortem diagnosis of sudden cardiac death.

INTRODUCTION: Ischemic heart disease is the most common cause of sudden cardiac death. By autopsy, there may be no histologic evidence of acute myocardial damage few hours after death. The use of cardiac troponins in the postmortem diagnosis of sudden cardiac death is well known in the forensic setting. However, high-sensitivity cardiac troponin T (Hs-TnT) assay in cadaver fluids was tested in few studies. The aim of this study is to assess the diagnostic value of postmortem dosage of Hs-TnT in the diagnosis of sudden cardiac death. MATERIAL AND METHODS: Our study is prospective, dealing with cadavers autopsied at the Department of Forensic Medicine of the University Hospital Habib Bourguiba of Sfax-Tunisia from December 2016 to April 2018. Were excluded from the study resuscitated cases, severely traumatized victims and cadavers that were examined more than 36 h after death. Levels of Hs-TnT were measured in pericardial fluid, cardiac blood and peripheral blood. RESULTS: A total of 80 cases were identified with an average age of 44.5 ± 19 years. Hs-TnT levels in pericardial fluid and heart blood were correlated significantly between cardiac and non-cardiac groups with a p-value respectively at 0.14 and 0.04. Receiver-operator characteristic curves analysis showed that the pericardial fluid had the best sensibility (75%) and specificity (64%) with a cut-off level at 17.72 ng/ml and an area under the curve at 0.747. We found also a significant correlation between postmortem interval and Hs-TnT levels in pericardial fluid, cardiac and peripheral blood. CONCLUSION: Our data indicate that determination of cardiac troponin T by a highly sensitive assay in pericardial fluid may be a powerful aid in the postmortem diagnosis of sudden cardiac death.

Inhibitory effects of 1alpha, 25dihydroxyvitamin D3 and Ajuga iva extract on oxidative stress, toxicity and hypo-fertility in diabetic rat testes.

The aim of the current study is to investigate the therapeutic and preventive effects of 1alpha, 25dihydroxyvitaminD3 (1,25 (OH)2 D3) and Afuga iva (AI) extract on diabetes toxicity in rats testes. Thus diabetic rats were treated with 1alpha, 25dihydroxyvitaminD3 or Ajuga iva extract as both therapeutic and preventive treatments on diabetes toxicity in rats testes. Our results showed that diabetes induced a decrease in testosterone and 17beta-estradiol levels in testes and plasma. Besides, a fall in testicular antioxidant capacity appeared by a decrease in both antioxidant (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) activities) and nonenzymatic antioxidant (copper (Cu), magnesium (Mg) and iron (Fe) levels). All theses changes enhanced testicular toxicity (increase in testicular aspartate amino transaminase (AST), alanine amino transaminase (ALT), lactate dehydrogenase (LDH) activities and the lipid peroxidation and triglyceride (TG) levels). In addition, a decrease in testicular total cholesterol (TCh) level was observed in diabetic rats testes. All the changes lead to a decrease in the total number and mobility of epididymal spermatozoa. The administration of 1alpha,25dihydroxyvitaminD3 and Ajuga iva extract three weeks before and after diabetes induction interfered and prevented diabetes toxicity in the reproductive system. 1,25 (OH)2 D3 and Ajuga iva extract blunted all changes observed in diabetic rats. To sum up, the data suggested that 1,25 (OH)2 D3 and Ajuga iva extract have a protective effect on alloxan-induced damage in reproductive system by enhancing the testosterone and 17beta-estradiol levels, consequently protecting from oxidative stress, cellular toxicity and maintaining the number and motility of spermatozoids.

Alginate/chitosan polyelectrolyte complexes: A comparative study of the influence of the drying step on physicochemical properties.

Polyelectrolyte complexes (PECs) based on Alginate and Chitosan were prepared for biomedical application. These two biopolymers are valuable resources for biomedical applications. In the present work, three PECs materials were produced using three different drying techniques: hot air drying, lyophilization and supercritical CO2 drying. The choice of the drying technique allowed producing different type of structures, with different porosity scale. In order to evaluate their potential as intra-abdominal wound dressings, swelling ability in various media, enzymatic resistance and drug release behavior of the resulting materials was studied. It was shown that the increase of the porosity improved the swelling ability, without altering the resistance of the materials, whereas drug release studies revealed that the majority of the drug was released within the first 24h whatever the drying process.

Effect of chronic lead exposure on kidney function in male and female rats: determination of a lead exposure biomarker.

Several cytotoxic chemical pollutants inducing peroxidative damages are liable to induce kidney failure. Among these pollutants we find heavy metals such as: lead, nickel, cadmium, vanadium and mercury. Lead is one of the most dangerous metals because it is widely spread in the environment, and because it may be a source of several nervous diseases. The aim of this study is to provide evidence concerning the effect of this metal on the renal function and to try to determine a storage corner in the organism which serves as an indicator of a lead intoxication. Lead acetate was administered by oral route in the drinking water to adult rats aged three months at the rate of 0.3% (P1) and 0.6% (P2). Reference rats received distilled water to drink under the same conditions. The treatment continued for 15, 30, 45, 60 and 90 days. The creatinemia, uremia, glycemia and creatinuria are determined by colorimetric techniques. Lead concentration in blood as well as the lead content of the tail are determined by atomic absorption after nitroperchloric mineralization at the liquid stage. The results showed an increase of creatinemia on the 30th day of the experiment for both sexes in (P1 and P2). The same happened for ureamia. The increase of these two parameters would indicate a renal deficiency which is confirmed by a decrease of creatinuria and urinary pH observed mainly on and after the 45th day of the experiment. An increase of the renal relative weight was noticed in P1 and P2 on the 30th day of the treatment. The determination of the concentration of lead in the blood shows that this factor increases among treated subjects in a constant way, independently of the dose and the duration of the treatment. Nevertheless, the rate increase of lead in the tail seems to be dose-dependent. In conclusion, lead administered by oral route causes a renal deficiency to the rat without distinction between males and females. In addition, the tail seems to be a reliable exposure biomarker that demonstrates lead intoxication. The tail seems to be a dosimeter of lead bio-accumulation. It constitutes an endogenous source of lead impregnation. The concentration of lead in the blood is only an indicator of recent exposure.

[Effects of automobile lead on the general growth and sexual activity of the rat]. / Effets du plomb d'origine automobile sur la croissance générale et l'activité sexuelle du rat.

To identify the active element of automotive exhaust gas responsible for masculine infertility, previously proved by our laboratory, we undertook these experiments. Four hundred young male and female rats were exposed during two months (30 min/d) to three types of automotive exhaust gases. The first type emanated from an engine running on gasoline with lead, the second from an unleaded gasoline engine, the third from a diesel engine. These three engines had the same power (5 horsepower vehicles < 3.5 tons). For the first type of emissions, some lead deposits were found in the lungs by histologic techniques. This gas also induced in male rats the atrophy of the testicle, seminal vesicle and epididym, certain pathological changes in spermatogenesis shown by the histologic study, and a decrease of the serum's testosterone level. In female rats, the relative weights of the ovary and uterus, as well as the percentage of the arrival of oestrus, were not affected by the gaseous treatment. Both the second and third types of gases seemed less active on the masculine sex as far as these parameters are concerned. Our study suggests that, for light vehicles, leaded gasoline pollutes more than unleaded gasoline or diesel fuels, and that the lead present only in the first type would be the active element responsible for the masculine infertility and body weight gain reduction in rats.

[Perrault's syndrome: two cases]. / Syndrome de Perrault.

Perrault's syndrome is an autosomal recessive ovarian dysgenesis associated with sensorineural deafness. We report two cases in sisters issuing from consanguinous parents. Aged 16 and 21 years, both patients present the two cardinal symptoms of the syndrome. Magnetic resonance imaging in the second sister showed high intensity signals in the periventricular and subcortical white substance and in the central ovale, suggestive of cerebral leucodystrophy. This element may be one of a wide spectrum of neurological symptoms found in Perrault's syndrome. The discovery of the causal genes may allow better understanding of the biomolecular mechanisms involved in gonad and sensorineural differentiation.

[Rare cause of acute carpal tunnel syndrome: acute metacarpal osteomyelitis]. / Cause rare du syndrome aigu du canal carpien: ostéomyélite aiguë métacarpienne.

Acute carpal tunnel syndrome resulting from acute metacarpal osteomyelitis is an exceptional etiopathogenic entity. A 6-year-old boy developed an acute carpal tunnel syndrome on the left four days after trauma. The carpal tunnel was opened in an emergency setting and exploration revealed a pale median nerve with infiltration of neighboring tissue. After release, pus issued from the depth of the tunnel. A posterior approach disclosed the collection and a total loss of the 4th metacarpal periosteum, leading to the diagnosis of acute osteomyelitis. Edema and pain regressed rapidly with antibiotic therapy. A pathologic fracture of the 4th metacarpal discovered three months later was treated conservatively. At 10 months, the child has a very good functional result despite persistence of a short 4th metacarpal after healing. There was no motor or sensitive neurological deficit and thumb opposition was complete. We have been unable to find any other report of acute metacarpal osteomyelitis leading to acute carpal tunnel syndrome. Emergency treatment is crucial. Opening the annular ligament is the only way to achieve complete nerve recovery.

[Mucopolysaccharidoses in children. Experience of a general pediatric service. 11 cases]. / Les mucopolysaccharidoses de l'enfant. Expérience d'un service de pédiatrie générale. A propos de 11 cas.

The mucopolysaccharidosis are hereditary diseases. The neurological attack constitutes the principal factor of gravity of these affections. We conducted a retrospective study over a period of 12 years (1988-1999) in the pediatric department of Sfax University Hospital. This study allowed us to observe 11 cases of mucopolysaccharidosis confirmed by an enzymatic proportioning, with 3 cases of Hurler disease (IH), 3 cases of the disease of sanfilippo, (two II A and one III B), 3 cases of the disease of Morquio A (type IVA) and 2 cases of the disease of Maroteaux Lamy (type VI). A sex ratio of 1.75. The parents were cousins in 90% of the cases. The age of revelation ranged between 6 months to 4 years. The clinical examination has found a staturo-pondral delay in 81.8% of the cases, a craniofacial dysmorphy in 100%, deformations of the rachis in 63.6% of the cases, a psychomotor regression in 54.5% of the cases, a medullary compression in 18% of the cases, hepatosplenomegaly in 36.4%, and corneal opacities in 45.4% of the cases. The therapeutic treatment was limited to the symptomatic measures with genetic consulting and antenatal diagnosis.

[Oral-dental health status in patients with infectious endocarditis]. / Etat bucco-dentaire chez des patients atteints d'endocardite infectieuse.

Mouth and dental examination is a systematic act in the etiologic follow up of an infectious endocarditis. Our study concerned 42 patients collected during 5 years period, starting july 1995 until July 2000, in the dental medical service of Hedi Chaker university hospital of Sfax oriented by the cardiovascular diseases service looking for a buccodental entry of bacteria. Our patients group is divided into 25 men and 17 women of 36.1 years mean age. Dental or parodontal lesions were observed in 25 patients. Panoramic X-rays showed periapical lesions of granuloma or cystic type in 15 patients. Among the etiological factors encountered we noticed dental acts accomplished without antibioprophylaxis and dental bacterial collection medically treated without extraction. Buccodental lesions were a frequent cause of the infectious endocarditis in 59.5% of the patients studied in this report, and were due more to defectious hygienic conditions than to a disabled dental act.

A full genome screening in a large Tunisian family affected with thyroid autoimmune disorders.

The autoimmune thyroid diseases (AITDs) including Graves' disease (GD) and Hashimoto's thyroiditis (HT) are inherited as complex traits. We initiated a whole genome linkage study of patients with AITD, in order to identify the susceptibility genes involved in their pathogenesis. We studied 39 patients affected with GD or HT and 68 related controls, who belonged to a large consanguinous family composed of more than 200 members. Linkage analysis was performed using the lod score method under two arbitrary models, one dominant and one recessive. A positive lod score was found for D2S171, assuming a recessive mode of inheritance and 50% penetrance, which suggests the presence of a major AITD susceptibility gene on chromosome 2p21. However, no linkage was found with microsatellite markers spanning the HLA system. This locus localised outside MHC will be of interest for investigation of other autoimmune disorders.