Increased levels of soluble HLA-G molecules in Tunisian patients with chronic hepatitis B infection.

Hepatitis B virus (HBV) infection is a global health problem. The mechanisms of immune tolerance in HBV infection are still unclear. The host immune response plays a critical role in determining the outcome of HBV infection. Human leucocyte antigen-G (HLA-G) is involved in immunotolerogenic process and infectious diseases. This study aimed to explore the implication of soluble HLA-G (sHLA-G) and its isoforms in HBV infection. Total sHLA-G (including shedding HLA-G1 and HLA-G5) was analysed by ELISA in 95 chronic HBV patients, 83 spontaneously resolvers and 100 healthy controls (HC). To explore the presence of sHLA-G dimers, we performed an immunoprecipitation and a Western blot analysis on positive samples for sHLA-G in ELISA. The serum levels of sHLA-G were significantly increased in patients with chronic HBV patients compared to spontaneously resolvers and HC (P<.0001). Interestingly, we found an increased level of sHLA-G1 in chronic HBV patients than in spontaneously resolvers and HC (P<.001). In addition, the expression of HLA-G5 seems to be higher in the sera of chronic HBV patients than spontaneously resolvers (P=.026). The analysis of HLA-G dimers showed the presence of homodimers in 93% of chronic HBV patients, 67% in spontaneously resolvers and 60% in HC. These results provide evidence that sHLA-G may have a crucial role in the outcome of HBV infection and could be proposed as a biomarker for infection outcome. Based on its tolerogenic function, HLA-G might be considered as a new promising immunotherapeutic approach to treat the chronic infection with HBV.

Risk scores for diabetes and impaired glycaemia in the Middle East and North Africa.

AIMS: To develop risk scores for diabetes and diabetes or impaired glycaemia for individuals living in the Middle East and North Africa region. In addition, to derive national risk scores for Algeria, Saudi Arabia and the United Arab Emirates and to compare the performance of the regional risk scores with the national risk scores. METHODS: An opportunistic sample of 6588 individuals aged 30-75 years was screened. Screening consisted of a questionnaire and a clinical examination including measurement of HbA(1c). Two regional risk scores and national risk scores for each of the three countries were derived separately by stepwise backwards multiple logistic regression with diabetes [HbA(1c) ≥ 48 mmol/mol (≥ 6.5%)] and diabetes or impaired glycaemia [HbA(1c) ≥ 42 mmol/mol (≥ 6.0%)] as outcome. The performance of the regional and national risk scores was compared in data from each country by receiver operating characteristic analysis. RESULTS: The eight risk scores all included age and BMI, while additional variables differed between the scores. The areas under the receiver operating characteristic curves were between 0.67 and 0.70, and for sensitivities approximately 75%; specificities varied between 50% and 57%. The regional and the national risk scores performed equally well in the three national samples. CONCLUSIONS: Two regional risk scores for diabetes and diabetes or impaired glycaemia applicable to the Middle East and North Africa region were identified. The regional risk scores performed as well as the national risk scores derived in the same manner.

Valorization of lignocellulosic biomass into sustainable materials for adsorption and photocatalytic applications in water and air remediation.

An exponential rise in global pollution and industrialization has led to significant economic and environmental problems due to the insufficient application of green technology for the chemical industry and energy production. Nowadays, the scientific and environmental/industrial communities push to apply new sustainable ways and/or materials for energy/environmental applications through the so-called circular (bio)economy. One of today's hottest topics is primarily valorizing available lignocellulosic biomass wastes into valuable materials for energy or environmentally related applications. This review aims to discuss, from both the chemistry and mechanistic points of view, the recent finding reported on the valorization of biomass wastes into valuable carbon materials. The sorption mechanisms using carbon materials prepared from biomass wastes by emphasizing the relationship between the synthesis route or/and surface modification and the retention performance were discussed towards the removal of organic and heavy metal pollutants from water or air (NOx, CO2, VOCs, SO2, and Hg0). Photocatalytic nanoparticle-coated biomass-based carbon materials have proved to be successful composites for water remediation. The review discusses and simplifies the most raised interfacial, photonic, and physical mechanisms that might take place on the surface of these composites under light irradiation. Finally, the review examines the economic benefits and circular bioeconomy and the challenges of transferring this technology to more comprehensive applications.

Predicting the risk of recurrent venous thromboembolism: Impact and therapeutic consequences of inherited thrombophilia.

BACKGROUND: Over the past decades, thrombophilia testing in patients with venous thrombo-embolism has increased tremendously. However, the role of inherited thrombophilie in prediction the risk of recurrence remains controversial. Consequently, it is still unclear whether thrombophilia testing influences decisions regarding duration of anticoagulation in clinical practices. The aim of this study was to evaluate the impact if inherited thrombophilia on venous thrombosis treatment decisions and on predicting the risk of recurrence. METHODS: A retrospective longitudinal study (January 2011-Decembre 2016) including 131 patients with confirmed venous thrombo-embolism referred to the hematology laboratory from the internal medicine department for inherited thrombophilia screening was carried out. RESULTS: The mean age patients was 39.4 years and the sex ratio (M/F) was 0.61. Inherited thrombophilia was confirmed in 27.5% of patients. A long term anticoagulation was decided in 46.9% of patients with thrombophilia. There was no significant difference in the duration of anticoagulation between patients with or without thrombophilia. Thrombosis recurrence was recorded in 16 (17%) patients. The 24 years cumulative incidence of recurrence was 19% in patients with thrombophilia and 17% in those without (plog Rank= 0.6). Inherited thrombophilia was not associated with increased risk of recurrence after treatment withdrawal (Hazard ratio=1.31 IC (0.47-3.63); P=0.6). CONCLUSION: In clinical practice, inherited thrombophilia did not influence anticoagulation duration and was not associated with a higher venous thrombosis risk of recurrence. It seems to be less relevant for decision making than presumed.

Influence of entropy on Brinkman-Forchheimer model of MHD hybrid nanofluid flowing in enclosure containing rotating cylinder and undulating porous stratum.

The current article aims to discuss the natural convection heat transfer of Ag/Al2O3-water hybrid filled in an enclosure subjected to a uniform magnetic field and provided with a rotating cylinder and an inner undulated porous layer. The various thermo-physical parameters are investigated such as Rayleigh number ([Formula: see text]), Hartmann number ([Formula: see text]), and the nanoparticles concentration ([Formula: see text]). Likewise, the rotational speed of the cylinder ([Formula: see text]), as well as several characteristics related to the porous layer, are examined li its porosity ([Formula: see text]), Darcy number ([Formula: see text]) which indicates the porous medium permeability and the number of undulations ([Formula: see text]). The calculations are carried out based on the Galerkin Finite element method (GFEM) to present the streamlines, isotherms, entropy generation, and average Nusselt numbers in details. The main results proved that increment of Rayleigh number and Darcy number enhances heat transfer convection within the enclosure. Whilst, the porosity presents a minimal impact. Also, the rotational speed in a positive direction has a favorable influence on the heat transfer dispersion across the cavity.

Association between cardiac autonomic neuropathy and hypertension and its potential influence on diabetic complications.

AIMS: To examine the association between cardiac autonomic neuropathy and hypertension and the role of this association in diabetic complications. METHODS: We included 310 patients, 138 with Type 1 and 172 with Type 2 diabetes, 62 of them with hypertension. Cardiac autonomic neuropathy was assessed by analysing heart rate variations during three standard tests (deep breathing, lying to standing and Valsalva) and looking for postural hypotension. RESULTS: Cardiac autonomic neuropathy was present in 123 patients and 39 also had hypertension. The prevalence of a cardiac autonomic neuropathy/hypertension association was higher in Type 2 patients (P < 0.002). The prevalence of hypertension increased with the severity of cardiac autonomic neuropathy. In multiple logistic regression analysis, cardiac autonomic neuropathy was an independent risk factor for hypertension [odds ratio 2.86 (1.54-5.32); P < 0.001]. Only confirmed or severe cardiac autonomic neuropathy (two or more abnormal function tests, respectively) were independent risk factors for hypertension (P < 0.005 and < 0.0001). Cardiac autonomic neuropathy was found in most of the patients with macrovascular complications, retinopathy or nephropathy, but a large majority of the patients with these complications exhibited the cardiac autonomic neuropathy/hypertension profile. This profile was more prevalent among the patients with coronary or peripheral artery disease or antecedent stroke than among those free of these complications (P < 0.001). In logistic regression analyses, the cardiac autonomic neuropathy/hypertension profile associated significantly with macro- and microvascular complications. CONCLUSIONS: These data are strongly in favour of the role of cardiac autonomic neuropathy in hypertension in diabetic patients. The association of the cardiac autonomic neuropathy/hypertension profile with vascular complications is consistent with a deleterious effect on vascular hemodynamics and structure, additional to the effects of hypertension.

[Death due to myocardial infarction in young patients: A study of 312 cases of sudden death]. / La mort par infarctus du myocarde chez le sujet jeune : étude de 312 cas de mort subite.

Sudden cardiac death in young is seen as a dramatic phenomenon requiring knowledge of its impact. We aim to study the epidemiological characteristics of sudden cardiac ischemic death in young, and to discuss his involvement in the occurrence of death. We performed a retrospective cohort study using autopsy data from the department of forensic medicine of the University Hospital of Fattouma Bourguiba, Monastir-Tunisia. A review of all autopsies performed during 23 years was done. In each case, clinical information and circumstances of death were obtained. We have included all sudden death in persons aged between 1 year and 35 years for the male and from one year to 45 years for female. We collected 312 cases of sudden death during the studied period. The collected data were processed using SPSS 20. The significance level was set at 0.05. Thirty-two cases of cardiac ischemic sudden death have been collected. Myocardial infarction was the second cause of sudden death in young patients. There was a male predominance. The most affected subjects were aged between 25-45 years. The death occurred more frequently at rest. Coronary artery disease has been discovered in twenty-four cases (75%). The myocardial infarction occurred on healthy coronary arteries in eight cases. An anomalous course of coronary arteries, in particular myocardial bridging, was found in eight cases (25%). Toxicological screening was negative in all cases. Identifying epidemiological characteristics of sudden cardiac ischemic death in this population is important for guiding approaches to prevention that must be based on dietary hygienic measures and the control of cardiovascular risk factors.

[Sudden cardiovascular death in adults: Study of 361 autopsy cases]. / La mort subite cardiovasculaire de l'adulte : étude autopsique de 361 cas.

AIMS OF THE STUDY: To describe epidemiological aspects of sudden cardiovascular death and to specify the etiopathogenic characteristics. PATIENTS AND METHOD: Our study is retrospective and descriptive. It included 361 cases of sudden cardiovascular death, which underwent autopsy in forensic medicine department of Monastir during eight years, from 1st January 2004 to 31st December 2011. RESULTS: The incidence of sudden cardiovascular death was 9 per 100,000 person. A marked male predominance was noted. The mean age was 55.75 years. In our series, myocardial infarction represents the leading cause of sudden cardiovascular death, 57.8% of cases. Other etiologies were hypertrophic cardiomyopathy (4.7%), heart failure (1.9%), arrhythmogenic right ventricular dysplasia (2.8%), valvular disease (2%), cardio-myo-pericarditis (1.9%), hydatid cyst of the heart (0.8%), ruptured aneurysm (2.5%), pulmonary embolism (1.9%) and aortic dissection (1.3%). A sudden cardiovascular death at work was found in 25 cases. These cases pose essentially a problem of imputability. CONCLUSION: Sudden cardiac death is usually the complication of underlying heart disease, sometimes overlooked. Several risk factors are involved. Sudden cardiac death in healthy heart or death caused by arrhythmia is an important entity seeking the intervention of several actors (forensic doctor, cardiologist, geneticist, media…) for prevention.

HLA-E polymorphism and soluble HLA-E plasma levels in chronic hepatitis B patients.

Chronic hepatitis B virus (HBV) infection occurs in association to a deregulation of immune system. Human leukocyte antigen E (HLA-E) is an immune-tolerant nonclassical HLA class I molecule that could be involved in HBV progression. To measure soluble (s) HLA-E in patients with chronic HBV hepatitis (CHB). We tested the potential association of HLA-E*01:01/01:03 A > G gene polymorphism to CHB. Our cohort consisted of 93 Tunisian CHB patients (stratified in CHB with high HBV DNA levels and CHB with low HBV DNA levels) and 245 healthy donors. Plasma sHLA-E was determined using enzyme-linked immunosorbent assay (ELISA). Genotyping was performed using polymerase chain reaction sequence-specific primer. No association between HLA-E*01:01/01:03 A > G polymorphism and HBV DNA levels in CHB patients was found. G/G genotype is less frequent in CHB patients without significance. sHLA-E is significantly enhanced in CHB patients compared with healthy controls (P = 0.0017). Stratification according to HBV DNA levels showed that CHB patients with low HBV DNA levels have higher sHLA-E levels compared with CHB patients with high HBV DNA levels. CHB patients with G/G genotype have enhanced sHLA-E levels compared with other genotypes (P = 0.037). This significant difference is maintained only for CHB women concerning G/G genotypes (P = 0.042). Finally, we reported enhanced sHLA-E in CHB patients with advanced stages of fibrosis (P = 0.032). We demonstrate, for the first time, the association of sHLA-E to CHB. Owing to the positive correlation of HLA-E*01:01/01:03 A > G polymorphism and the association of sHLA-E to advanced fibrosis stages, HLA-E could be a powerful predictor for CHB progression. Further investigations will be required to substantiate HLA-E role as a putative clinical biomarker of CHB.

[Arrhythomgenic right ventricular dysplasia and sudden death: An autopsy and histological study]. / Dysplasie arythmogène du ventricule droit et mort subite : étude autopsique et histologique.

Arrhythmogenic right ventricular dysplasia (ARVD) is cardiomyopathy where normal myocardial tissue is replaced with fibrofatty tissue. Histological examination performed on myocardial biopsy or on autopsy samples are used to confirm the diagnosis. However, in many cases, the diagnosis cannot be made on a simple macroscopic and histological study and requires genetic analysis and molecular biology. In this work, we propose to describe the main macroscopic and histological findings of ARVD through the study of an autopsy series. We report 12 autopsy cases of sudden death in ARVD collected in the Department of Forensic Medicine of the University Hospital Fattouma Bourguiba Monastir (Tunisia) during a period of 20years. Microscopic examination was performed on 5microns thick histological sections. All slides were reviewed by two operators in a double blind (physician pathologist, pathologist) and in each, the percentage of adipose tissue, fibrosis and infarction in the right ventricle, left ventricle and interventricular septum, the presence or absence of inflammatory infiltrate, the presence or absence of signs of degeneration of myocytes were noticed. ARVD was found in 12 cases (1.8% of sudden cardiac death). The age ranged between 13 and 67years (mean age: 45.3years). The death occurred in half of the cases during exercise. Macroscopic examination of the RV showed the presence of a wall thinning (thickness<3mm) in 9 cases. Histological study highlight RV adipose infiltration in all cases with a percentage between 15% and 60%, fibrotic lesions were observed in only 9 cases with an average percentage of 10.25% and signs of degeneration of myocytes were noted in 10 cases. In concordance with what has been reported in the literature, there is still no consensus regarding the criteria to be adopted to pose with certainty the diagnosis of ARVD and the presence of adipose tissue remains the criterion more suggestive.

[Tricuspid endocarditis with right-left shunt in the atrium]. / Endocardite tricuspidienne avec shunt droite-gauche à l'étage auriculaire.

A case of tricuspid regurgitation due to endocarditis causing a right-to-left shunt through a patent foramen ovale is reported. Tricuspid valve endocarditis occurred after septic abortion and caused valvular regurgitation with dyspnea and cyanosis. The diagnosis was made by echocardiography and the finding of peripheral arterial desaturation, and it was confirmed at surgery. The physiopathology of these right-to-left shunts is the same as that already described during traumatic tricuspid regurgitation: reopening of the foramen ovale by the right atrial dilatation and ventricularisation of right atrial pressures. The presence of a shunt is an indication for surgery.

[Reproducibility of venous occlusion plethysmography. Value of a computerized system of calculation]. / Reproductibilité de la pléthysmographie à occlusion veineuse. Intérêt d'un système de calcul automatisé.

The manual interpretation of identical occlusive venous plethysmography curves by different technicians is subject to a wide variation. The object of this study is to verify this state of affairs and to propose an automatic calculation of the different parameters usually used: the percentage volume increase (delta V), the time taken to half empty (t V/2) and the maximal venous outflow (MVO). We compared the variations, due to the operators, in the measurement of the parameters characterising identical curves obtained by occlusive venous plethysmography. Sixty curves from 30 patients, were photocopied and each was measured independently by four different operators. The results were compared with the measurements obtained automatically from a micro-computer connected to the plethysmograph. The measurements of the percentage volume increase and the time taken to half empty differed among the operators and the computer by less than 2%. However, the maximal venous outflow was subject to very large variations amongst the operators (up to 60%). This uncertainty is due to the operators choice of the point on the curve where the tangent is measured. The micro-computer, by fixing this point at 0.3 second after releasing the cuff allows a standardisation of this parameter.

[The contribution of imagery in the early diagnosis of Fournier's gangrene]. / Apport de l'imagerie dans le diagnostic précoce de la gangrène de Fournier.

Scrotal ultrasonography, completed by MRI, allowed the early diagnosis of a case of Fournier's gangrene, before the appearance of subcutaneous crepitation allowing rapid treatment adapted to the extent of necrosis. Ultrasonography is recommended in the assessment of inflammatory disease of the scrotum and/or perineum. MRI is able to refine the ultrasonographic data, and define the extent of gangrene as well as its starting point.

Glycaemic threshold for diabetes-specific retinopathy among individuals from Saudi Arabia, Algeria and Portugal.

We studied the glycaemic threshold and prevalence of diabetic retinopathy in screen-detected diabetes in Saudi Arabia, Algeria and Portugal. The prevalence of diabetes-specific retinopathy started to increase at an HbA1c level of 6-6.4% (42-47 mmol/mol) and in individuals with HbA(1c) >7.0% the prevalence was 6.0%.

Enhancement of the bleaching and degradation of textile wastewaters by Gliding arc discharge plasma in the presence of TiO2 catalyst.

The degradation of two polluted textile wastewaters from SOITEX (silk and textile) industry using the plasma-catalytic process, has been studied by non-thermal Gliding arc technique coupled to Degussa P25 titanium dioxide (TiO(2)) as photo-catalyst. Experiments were carried out to optimise the amount of phtoto-catalyst. The results showed that maximum degradation was attained for 3 g L(-1) TiO(2) concentration. For wastewater (1) degradation was 95% at the end of 60 min of treatment time. The same wastewater was completely decolourised after only 30min of plasma-catalytic treatment time. In parallel, the biodegradability was significantly enhanced through 20 min of exposure to the plasmagenous source for both wastewater samples. Turbidity of wastewater (1) and wastewater (2) decreased with rate constants of 0.015 and 0.017m in(-1), respectively. The TiO(2)-mediated Gliding Arc discharge (GAD(TiO(2)) showed potential application for the treatment of liquid wastes, resulting in the mineralization of the wastewater samples confirmed by chloride, sulphate and phosphate ions formation. In both cases of GAD treatments, with and without photo-catalyst, the plasmagenous process proves efficient in the field of wastewaters degradation.

[Cancer of the testis in cryptorchidism. Apropos of 5 cases]. / Le cancer du testicule cryptorchide. A propos de 5 observations.

Five cases of cancer of the testicle in patients with cryptorchidism are presented. In one case the tumour occurred 16 years after cure for cryptorchidism at 15 years of age. In the other cases, the tumour developed on a testicle in an inguinal or intra-abdominal position. In two cases, it was impossible to remove the tumour which had developed on an intra-abdominal position. These patients died. These cases emphasize the importance of surgical cure in all cases of cryptorchidism, preferable before the age of 2 years, in order to improve functional prognosis and reduce the risk of cancerization. The gravity of cancer of the testicle in cases of cryptorchidism is often discovered too late.