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Selenium (Se) and zinc (Zn) are essential trace elements with antioxidant properties, and their supplementation has been shown to be protective against the toxicity of various environmental and dietary substances. The aim of this study was to investigate the potential protective effect of selenium and zinc as adjuvants against barium (Ba) toxicity in lactating rats and their offspring. The pregnant rats were divided into six groups: the first as control; group 2 received barium (67 ppm) in the drinking water; group 3 had combined Ba + Se (0.5 mg/kg) in the diet; group 4 received Zn (50 mg/kg bw) by gavage together with Ba; groups 5 and 6, positive controls, were treated with selenium (0.5 mg/kg) and zinc (50 mg/kg bw), respectively. MDA, H2O2, AOPP, CAT, GPx, and SOD levels were measured and lung histopathology was performed. Our results showed that barium administration caused lung damage as evidenced by an increase in MDA, H2O2, and AOPP levels and a decrease in the activities of CAT, GPx, and SOD in mothers and their offspring. A decrease in lung GSH, NPSH, and MT levels was also observed. Supplementation of Ba-treated rats with Se and/or Zn significantly improved the pulmonary antioxidant status of mothers and their offspring. Histopathological examinations were also consistent with the results of biochemical parameters, suggesting the beneficial role of Se and Zn supplementation, as evidenced by less accumulation of collagen fibers as studied by hematoxylin and eosin (H&E) and Masson's trichrome staining. In conclusion, we demonstrate the adverse effects of maternal barium exposure during pregnancy and on neonatal lung health and the protective effects of selenium and zinc in preventing the adverse effects of barium exposure.
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BACKGROUND: The PI3K protein is involved in the PI3K/AKT/mTOR pathway. Deregulation of this pathway through PIK3CA mutation is common in various tumors. The aim of this work is to identify hotspot mutation at exons 9 and 20 in Tunisian patients with sporadic or hereditary breast cancer. METHODS: Hotspot mutations in exon 9 and exon 20 of the PIK3CA gene were identified by QPCR-High Resolution Melting followed by COLD-PCR and sequencing in 63 (42 sporadic cases and 21 hereditary cases) tumor tissues collected from Tunisian patient with breast cancer. MCF7, and BT20 breast cancer cell lines harboring the PIK3CA hotspot mutations E545K and H1047R in exon 9 and exon 20 respectively, were used as controls in HRM experiments. RESULTS: PIK3CA hotspot mutations were detected in 66.7% (28 out of 42) of sporadic BC cases, and in 14.3% (3 out of 21) of hereditary BC. The E545K and the H1048Y were the most prevalent mutations identified in patients with sporadic and hereditary BC, whereas the H1047R hotspot mutation was not found in our patients. Statistical analysis showed that PIK3CA mutation associated with an aggressive behavior in patients with sporadic BC, while it's correlated with age, tumor stage and tumor size in the group patients with hereditary breast cancer. CONCLUSIONS: Our results showed a novel PIK3CA hotspot mutation in Tunisian breast cancer patients detected by HRM-COLD-PCR. Moreover, the absence of PIK3CA hotspot mutation associated with good prognosis.
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Neoplasias da Mama , Classe I de Fosfatidilinositol 3-Quinases , Mutação , Humanos , Classe I de Fosfatidilinositol 3-Quinases/genética , Feminino , Neoplasias da Mama/genética , Pessoa de Meia-Idade , Adulto , Idoso , Éxons , Reação em Cadeia da Polimerase , Linhagem Celular Tumoral , TunísiaRESUMO
Dipeptidyl peptidase-4 inhibitors (DPP-4i), or gliptins, are a widely used glucose-lowering agents. A growing amount of evidence pointed to a possible role of DPP-4i in the induction of bullous pemphigoid (BP), which is an auto-immune skin blistering disease that mainly affects the elderly. In this article we discuss a case of DPP-4i associated BP and we provide an updated review of the current knowledge regarding this emerging entity. Use of DPP-4i, particularly vildagliptin, was found to significantly increase the risk of BP. BP180 would be in the center of the aberrant immune response. DPP-4i induced BP is thought to be associated with male gender, mucosal involvement, and milder inflammatory phenotype especially in Asian population. Generally, patients may not remit fully after DPP-4i withdrawal only and require either topical or systemic glucocorticoid courses.
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This study aimed to evaluate the potentiality of a mineral and antioxidant-rich methanolic extract of the red marine alga Falkenbergia rufolanosa (FRE) against methyl-thiophanate (MT)-induced toxicity in adult rats. The animals were allocated into four groups: controls, MT (300 mg/kg), MT + FRE, and FRE-treated group for 7 days. Our results demonstrated severe mineral perturbations due to MT treatment, especially in calcium and phosphorus levels in plasma, urine, and bone. Similarly, the hematological analysis revealed increased red blood cells, platelets, and white blood cells associated with striking genotoxicity. Interestingly, a significant rise in lipid peroxidation and advanced oxidation protein products level in erythrocytes and bone were noted. Meanwhile, a depletion of the antioxidant status in both tissues occurred. These biochemical alterations were in harmony with DNA degradation and histological variation in bone and blood. In the other trend, data showed that treatment with alga improved MT-induced hematotoxicity, genotoxicity, and oxidative stress in the blood and bone. Osteo-mineral metabolism and bone histo-architecture were also noted. In conclusion, these findings demonstrated that the red alga Falkenbergia rufolanosa is a potent source of antioxidant and antibacterial agents, as revealed by the in vitro analysis.
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Bone metastases from hepatocellular carcinoma (HCC) are unusual. Optimal treatment strategies are not well defined. The prognosis of this entity is very poor with a survival that does not exceed 1 year. We report here a new case of metastatic HCC with longer overall survival of more than 5 years in a 67-year-old man.
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Mixed hepatocellular-neuroendocrine carcinoma (HCC-NEC) is a rare entity with a poor prognosis. We report a case of a 44-yearold Tunisian man who was admitted for diffuse abdominal pain. Body computed tomography showed multinodular hepatomegaly. Pathologic findings concluded to HCC-NEC. Clinicians should be aware about this entity. Further collection of case reports is needed to standardize the optimal treatment.
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Carcinoma Hepatocelular , Carcinoma Neuroendócrino , Neoplasias Hepáticas , Masculino , Humanos , Adulto , Carcinoma Hepatocelular/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Carcinoma Neuroendócrino/diagnóstico por imagem , Dor Abdominal , HepatomegaliaRESUMO
Guillain-Barré syndrome (GBS) and polymyositis (PM) are two rare autoimmune diseases, one of which affects the peripheral nervous system and other the muscle. We report the case of a young woman with no previous medical history who was hospitalized with an ascending paralysis associated with acute respiratory failure due to a GBS. The patient was treated with plasmapheresis with unfavorable outcome and permanent proximal muscular disability. The diagnosis of an associated PM was retained based on biological myolysis and the results of electromyography and muscular biopsy. To our knowledge, this association of GBS and PM has been reported only once in the literature. The search for syndromic associations in the presence of an autoimmune helps to avoid diagnostic errors.
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Lupus nephritis (LN) is a type of immunological complex glomerulonephritis characterized by chronic renal inflammation which is exacerbated by infiltrating leukocytes and fueled by a variety of pro-inflammatory cytokines. A profound understanding of the pathogenesis of LN is necessary to identify the optimal molecular targets. The role of RNA-binding proteins (RBPs) in post-transcriptional gene regulation in the immune system is being explored in greater depth to better understand how this regulation is implicated in inflammatory and autoimmune diseases. Tristetraprolin (TTP), Roquin-1/2, and Regnase-1 are 3 RBPs that play a critical role in the regulation of pro-inflammatory mediators by gating the degradation and/or translational silencing of target mRNAs. In this study, we proposed to focus on the differential expression of these RBPs in immune cells and renal biopsies from LN patients, as well as their regulatory impact on a specific target. Herein, we highlight a novel target of anti-inflammatory treatment by revealing the mechanisms underlying RBP expression and the interaction between RBPs and their target RNAs.
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True thymic hyperplasia results from stressful situations such as chemotherapy. It commonly presents as an anterior mediastinal mass; cervical location is exceptional. Here we report a case of a cervical true thymic hyperplasia in a 12-year-old girl who had a Hodgkin lymphoma treated by radiotherapy and chemotherapy. She was referred to our department for a left cervical mass. The PET scan showed a hypermetabolic adenopathy. Mediastinal MRI was unremarkable. The patient underwent resection of the cervical mass under general anesthesia. Pathological examination confirmed the diagnosis of a true thymic hyperplasia. The aim of this paper is to illustrate a case of an incidental ectopic cervical thymic hyperplasia in a patient treated for Hodgkin lymphoma.
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This study aimed to investigate the microencapsulation of novel condensed tannins isolated from Periploca angustifolia roots, using ß-cyclodextrin macrocyclic oligosaccharides, in order to enhance their antioxidant and antihyperlipidemic potentials. Scanning electron microscopy and Fourier transform infrared spectroscopy results revealed that tannin fraction was successfully included into ß-cyclodextrin cavities proved with an encapsulation efficacy of 70%. Our in vitro findings highlighted that both pure and encapsulated tannins have efficient inhibition capacities of pancreatic lipase activity. However, the inclusion complex has the greatest, in vivo, antioxidant, and antihyperlipidemic effects. In fact, results showed that complexed tannins had markedly restored serum lipid biomarkers, lipid peroxidation, protein carbonyl oxidation, and antioxidant enzyme defense. These findings were additionally confirmed by aortic and myocardial muscle sections of histological examination. Consequently, ß-cyclodextrin microencapsulation may be considered as an effective and promising technique for tannin delivery with improved antioxidant and antihyperlipidemic activities.
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Periploca , Proantocianidinas , beta-Ciclodextrinas , Animais , Antioxidantes/metabolismo , Hipolipemiantes/farmacologia , Estresse Oxidativo , Periploca/química , Periploca/metabolismo , Proantocianidinas/farmacologia , Ratos , Espectroscopia de Infravermelho com Transformada de Fourier , Taninos/farmacologia , beta-Ciclodextrinas/químicaRESUMO
INTRODUCTION: Myxomas are benign mesenchymal neoplasms which arise mainly in the heart. The laryngeal localization is very rare. We aim to describe the clinical, histological and therapeutic features of this condition. CASE REPORT: We report two cases of laryngeal myxomas occurred in male and female patients, presenting with a history of prolonged hoarseness. Laryngoscopy revealed a polypoid mass on the true vocal folds. The lesions were excised with cold instruments. One patient presented a recurrence 4 years after the first surgery. CONCLUSIONS: Laryngeal myxoma should be considered in case of a benign looking vocal fold lesion, especially a vocal cord polyp. Histologic exam is the only tool to confirm the diagnosis. It is treated by surgical resection. In the literature, recurrence is rare in laryngeal site, but patients need to be kept on close follow-up.
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Adenoid cystic carcinoma (ACC) is a rare malignant cancer that arises from secretory glands. Slow growth, perineural invasion, and late recurrences are the main characteristics of ACC. Only few cases of kidney metastases from ACC have been reported in the literature. We report here the case of a 66-year-old female patient who presented with bilateral renal metastases from ACC of the nasal cavity, detected 14 years after treatment of primary tumor and 6 years after metastasectomy of lung metastases. Histological examination confirmed diagnosis and the patient was treated with systemic chemotherapy. Radiological evaluation showed stability of the disease. However, a progression with occurrence of metastases in other sites (lung and bones) has been observed after 7 months. She is still receiving second-line chemotherapy. To the best of our knowledge, this is the second case of kidney metastases from ACC of the nasal cavity.
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BACKGROUND: Sarcoidosis is a systemic granulomatous disease of unknown etiology. It affects mostly young adults. In the elderly, the presentation of this disease is different, often posing positive diagnosis problems. OBJECTIVES: We intend to describe the various clinical features and the management of sarcoidosis in elderly patients (age ≥65 years) compared to the younger ones. METHODS: We performed a retrospective, descriptive and comparative study in the Department of Internal Medicine in the University Hospital Hedi Chaker, Sfax, Tunisia, between 1996 and 2016. RESULTS: From a series of 80 patients, we found sixteen patients (20%) with sarcoidosis diagnosed after the age of 65 years. A female preponderance (81,25%) was noted. Intrathoracic involvement concerned 13 patients (81,3%). Extrapulmonary signs were also frequent (93,8%). The main extrathoracic manifestations were ganglionar involvement (75%), an alteration of the general health (31,3%), hepatic involvement (31,3%), cutaneous involvement (25%) and ocular involvement (25%). Biological manifestations were hypercalcemia, hypercalciuria, lymphopenia and hypergammaglobulinemia noted in respectively 12,5%, 12,5%, 31,3% and 50% of the cases. Angiotensin-converting enzyme(ACE) level was elevated in 100% of the patients. Lymphadenopathy and cutaneous biopsies were important contributing factors to diagnosis (respectively: 100% and 75% were positive). Oral corticosteroid therapy was required in 50% of cases. Evolution was marked by pulmonary fibrosis in two cases. Satisfactory course of the disease was observed in the other patients. CONCLUSION: Young and elderly subjects had common characteristics of sarcoidosis, except for more coexisting chronic morbidities, no erythema nodosum and more frequent high levels of ACE in the elderly group.
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Multifocal nodular oncocytic hyperplasia is an uncommon oncocytic lesion that rarely occurs in the parotid gland. Here, we report a case of a 43-years-old woman who presented with isolated gradual swelling in the 2 parotid regions. She underwent exofacial right parotidectomy. Histologic exam confirmed the diagnosis of oncocytoma arising in a background of multifocal nodular oncocytic hyperplasia with a histological variant of clear cells. Since the lesion was diagnosed as a benign lesion, surgery of the left side was not done. Our case is characterized by: early onset, the histological variant of clear cells and the presence of synchronous oncocytoma. We describe the clinical, histological and therapeutic features of this entity.
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Adenoma Oxífilo , Neoplasias Parotídeas , Doenças das Glândulas Salivares , Adenoma Oxífilo/diagnóstico por imagem , Adenoma Oxífilo/cirurgia , Adulto , Feminino , Humanos , Hiperplasia/patologia , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/patologia , Glândula Parótida/cirurgia , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/cirurgia , Doenças das Glândulas Salivares/patologiaRESUMO
BACKGROUND: The incidence of breast cancer (BC) and/or ovarian cancer (OC) is increasing in Tunisia especially in young women and mostly those with family history. However, the spectrum of BRCA mutations remains little explored in Tunisian patients in particular in the southern region. METHODS: We sequenced the entire coding regions of BRCA1and BRCA2 genes using next generation sequencing (NGS) in 134 selected patients with BC and/or OC. RESULTS: Among the 134 patients, 19 (14.17%) carried pathogenic mutations (10 are BRCA1 mutation carriers and 9 are BRCA2 mutation carriers) that are mainly frameshift index (76.9%). Interestingly, 5 out of the 13 variants (38.46%) were found at least twice in unrelated patients, as the c.1310-1313 delAAGA in BRCA2 and the c.5030_5033 delCTAA that has been identified in 4/98 BC patients and in 3/15 OC patients from unrelated families with strong history of cancer. Besides recurrent mutations, 6 variant (4 in BRCA1 and 2 in BRCA2) were not reported previously. Furthermore, 3 unrelated patients carried the VUS c.9976A > T, (K3326*) in BRCA2 exon 27. BRCA carriers correlated significantly with tumor site (p = 0.029) and TNBC cases (p = 0.008). In the groups of patients aged between 31 and 40, and 41-50 years, BRCA1 mutations occurred more frequently in patients with OC than those with BC, and conversely BRCA2 carriers are mostly affected with BC (p = 0.001, and p = 0.044 respectively). CONCLUSIONS: The overall frequency of the BRCA germline mutations was 14.17% in patients with high risk of breast/ovarian cancer. We identified recurrent mutations as the c.1310_1313 delAAGA in BRCA2 gene and the c.5030_5033 delCTAA in BRCA1 gene that were found in 4% and 20% of familial BC and OC respectively. Our data will contribute in the implementation of genetic counseling and testing for families with high-risk of BC and/or OC.
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Neoplasias da Mama , Neoplasias Ovarianas , Adulto , Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias da Mama/genética , Feminino , Genes BRCA2 , Predisposição Genética para Doença , Mutação em Linhagem Germinativa/genética , Humanos , Pessoa de Meia-Idade , Mutação/genética , Neoplasias Ovarianas/genética , TunísiaRESUMO
Introduction. Pure extra-thoracic sarcoidosis is rare and poorly characterized in the literature. Herein we present features of pure extra-thoracic sarcoidosis, in comparison with sarcoidosis with intra-thoracic involvement, in a population from the south of Tunisia. Methods. Retrospective, descriptive and comparative study of the patients presenting systemic sarcoidosis and attending the Department of Internal Medicine at the Hedi Chaker University Hospital, Sfax, Tunisia, for 21 years, from January 1996 to December 2016. Results. Twenty-four patients presented pure extra-thoracic sarcoidosis (30% of the cases of systemic sarcoidosis). There was a female predominance (79%). The mean age was 50 years. The main features were polyadenopathies (10 patients: 41.7%), cutaneous involvement (10 patients: 41.6%), inflammatory polyarthralgia (8 cases: 33.3%), general symptoms (6 patients: 25%), uveitis (6 cases: 25%), cholestasis (3 cases) and kidney involvement (2 cases). Lymphopenia, hypercalcemia, and hypercalciuria were observed each one in 12.5% of the cases, and high angiotensin converting enzyme (ACE) level in 38.5% of the cases. The histological proof was required in all the patients. Statistically significant associations identified were mainly hepatic involvement with general symptoms (p=0.035), peripheral lymphadenopathies (p=0.035) and kidney damage (p=0.022), and cutaneous involvement with articular manifestations (p=0.032). Systemic corticosteroids were used in half of the cases, with a good outcome in 21 cases, and recurrence in two cases. One patient was lost to follow up. The comparison to the form with mediastino-pulmonary involvement showed less lymphadenopathies (p=0.001), less lymphopenia (p=0.006), and less frequent use of corticosteroids (p=0.044). Conclusion. Our series was characterized by the frequency of the pure extra-thoracic form and the diversity of the systemic manifestations.
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Nefropatias , Linfadenopatia , Linfopenia , Idoso , Feminino , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sarcoidose/diagnóstico , Sarcoidose/tratamento farmacológico , Sarcoidose/epidemiologia , Tunísia/epidemiologiaRESUMO
AIMS: The present study investigates the effectiveness of platelet-rich plasma (PRP) gel without adjunct to induce cartilage regeneration in large osteochondral defects in a rabbit model. METHODS: A bilateral osteochondral defect was created in the femoral trochlear groove of 14 New Zealand white rabbits. The right knees were filled with PRP gel and the contralateral knees remained untreated and served as control sides. Some animals were killed at week 3 and others at week 12 postoperatively. The joints were harvested and assessed by Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) MRI scoring system, and examined using the International Cartilage Repair Society (ICRS) macroscopic and ICRS histological scoring systems. Additionally, the collagen type II content was evaluated by the immunohistochemical staining. RESULTS: After 12 weeks post-surgery, the defects of the PRP group were repaired by hyaline cartilage-like tissue. However, incomplete cartilage regeneration was observed in the PRP group for three weeks. The control groups showed fibrocartilaginous or fibrous tissue, respectively, at each timepoint. CONCLUSION: Our study proved that the use of PRP gel without any adjuncts could successfully produce a good healing response and resurface the osteochondral defect with a better quality of cartilage in a rabbit model. Cite this article: Bone Joint Res 2021;10(3):192-202.
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Leydig cell tumor (LCT) is a rare testicular tumor with a low incidence accounting 3% of all testicule neoplasms. Due to its rarity, the natural history of LCT is poorly understood. Patients can present with atypical symptoms and endocrine disorders. The diagnosis of LCT is based on histological and immunohistochemical examination. We report a new case of leydig cell tumor in a 61-year-old man presenting with a left testis hydrocele. The patient underwent a left orchidectomy and the diagnosis of LCT was established. Even in front of a benign pathology such as hydrocele, exploration is necessary to detect any testicle tumor.