[Stigma in psychiatry]. / Stigmatisation en psychiatrie.

Mental illness affects 48.9 % of the Moroccan population. Despite this significant figure, mental illness remains unrecognized. The patients suffering from mental disorders are therefore subject to stigma and social rejection. A descriptive study was conducted at the consultation service of the psychiatric Ibn Nafiss hospital of the CHU of Marrakech. We chose as a sample 100 stabilized patients, followed on an outpatient basis. The study included the three mental disorders: depressive disorder, bipolar disorder, and schizophrenia. The number of patients in each group had been fixed beforehand; and we tried to get a fairly even distribution between the two genders. The questionnaire had three main axes: (1) Sociodemographic data of the patient. (2) Knowledge of the disease. (3) Evaluation of the experience of stigma. The results of our sample were as follows: For both sexes the age extremes were 19 to 68 years with an average of 38.5 with a clear predominance of women. For the entire population, most patients were single with a percentage of 60 %. Two thirds of the patients, i.e. 59 %, did not exceed primary school. For personal medical history, endocrine pathologies were the most prevalent, at 18 % of cases, while depression was the most common family psychiatric history in our study. We noticed that our population suffered more discrimination and disclosure from those around them regardless of family, social and professional with less appreciation of the positive aspects.

FEV1 and FVC pulmonary function reference values among 6-18-year-old children: a multi-centre study in Saudi Arabia.

It is important to establish lung function reference values for each population. This study aimed to determine the spirometric reference values for healthy Saudi Arabian children and adolescents and to derive prediction equations for these. A cross-sectional study was conducted among healthy schoolboys and girls aged 6-18 years old, selected randomly from the 6 administrative regions of Saudi Arabia. Data were collected by questionnaire and physical examinations including spirometry. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were significantly higher in males than females. Height was the anthropometric variable most strongly correlated with FEV1 (r = 0. 61), more so for males (r = 0.71) than females (r = 0.50). In males the multivariate linear regression model explained 53.9% of FEV1 and 35.1% of FVC variations. In females it explained 25.3% of FEV1 and 16.5% of FVC variations. All changes in R² were statistically significant.

[Anaphylaxis to protamine during cardiovascular surgery]. / L'allergie à la protamine en chirurgie cardiovasculaire.

Protamine is a polypeptide with low molecular weights that is used widely to reverse heparin anticoagulation during cardiac surgery. Protamine, efficient and relatively sure, can produce multiple adverse reactions after intravenous administration, including pulmonary hypertension, or systemic hypotension leading at times to cardiovascular collapse and death. Physiopathologic mechanisms, underlying these reactions, are not clear. Immunologic and non-immunologic pathways are suggested. Some risk factors expose to protamine's adverse reactions. Preoperative identification of these factors should prompt specific preventive measures. The anesthesiologist and the cardiac surgeon must be vigilant when administrating protamine. Reheparinization and reinstitution of cardiopulmonary bypass should be considered in patients with refractory shock.

The Effects of Electric Fields on Protein Phase Behavior and Protein Crystallization Kinetics.

We experimentally studied the effects of an externally applied electric field on protein crystallization and liquid-liquid phase separation (LLPS) and its crystallization kinetics. For a surprisingly weak alternating current (AC) electric field, crystallization was found to occur in a wider region of the phase diagram, while nucleation induction times were reduced, and crystal growth rates were enhanced. LLPS on the contrary was suppressed, which diminishes the tendency for a two-step crystallization scenario. The effect of the electric field is ascribed to a change in the protein-protein interaction potential.

Annealing effect on the physical properties of TiO2 thin films deposited by spray pyrolysis.

Titanium dioxide (TiO2) thin films were deposited on glass substrates at 350 °C using the spray pyrolysis technique. As deposited and annealed thin films were characterized by X-ray diffraction, scanning electron microscopy, UV-VIS spectroscopy, and photodetection. Unlike the as deposited samples which were amorphous, annealed samples show an anatase phase. Films were absorbent in the UV region and the band gap energy decreases from 3.78 eV to 3.4 eV with annealing. The photoresponse of TiO2 photodetectors was recorded under UV (λ1 = 365 nm, λ2 = 254 nm) and visible light illumination by reversible switching (ON/OFF) cycles using DC electrical characterization. Photosensitive properties such as reproducible photosensitivity, responsivity, and detectivity were also studied.

Outbreak of tularaemia in brown hares (Lepus europaeus) in France, January to March 2011.

We report an outbreak of tularaemia in brown hares (Lepus europaeus) in France, which occurred from January to March 2011 and was characterised by a high mortality rate in the local hare population. In France, hare tularaemia is usually sporadic and does not significantly affect hare populations. The epizootic form of the outbreak reported here led us to reconsider the potential associated risks for hare populations and public health.

[Variation of cognitive functions and glycemia during physical exercise in Ramadan fasting]. / Variation des fonctions cognitives et de la glycémie lors de l'exercice physique durant le jeûne du mois de Ramadan.

INTRODUCTION: During the month of Ramadan, Muslims fast every day from dawn to sunset. Several studies have shown that Ramadan fasting affects biochemical parameters, sleep/wake cycle, behaviour and food habits. The purpose of the study was to evaluate the effect of Ramadan fasting (RF) and physical exercise on cognitive functions, blood glucose. METHODS: Eleven healthy male volunteers aged 20.45+/-1.65 years were assessed before RF (B.RF), during the 1st week (wk), 3rd wk and 1 wk B.RF, in blood sugar, work memory (WM), visual perception (VP), before exercise (B. Ex) and after exercise (A. Ex) exercise of 1000 m. RESULTS: Compared to control days (B.RF), there were no significant changes in body mass index. Physical performance declined significantly during 1st wk (p<0.001), 3th wk (p<0.013) and before (p<0.046) of RF. At the level of the glycemia, the results show a significant effect of Ramadan by increasing gradually during Ramadan but nevertheless, the values remain lower of 100mg/dl. No significant change was observed between B. Ex and A. Ex value in WM during RF. However, the WM A. Ex value increase significantly during and after RF (respectively 1st wk (p<0.013), 3rd wk (p<0.005) and before (p<0.003). The VP was significantly affected by fasting effect (F=16.84, p<0.001) and exercise effect (F=14.01, p<0.0001), and was progressively increased 15.56% in the 1st wk, 25.69%, the 3rd wk during RF, and 27.07% A.RF, but no significant change was found in errors performances of VP during and after RF. CONCLUSION: These results showed that the intermittent fasting imply differently effects on cognitive functions and physiological.

Comparative genomics-guided loop-mediated isothermal amplification for characterization of Pseudomonas syringae pv. phaseolicola.

AIMS: To design and evaluate a loop-mediated isothermal amplification (LAMP) protocol by combining comparative genomics and bioinformatics for characterization of Pseudomonas syringae pv. phaseolicola (PSP), the causal agent of halo blight disease of bean (Phaseolus vulgaris L.). METHODS AND RESULTS: Genomic sequences of Pseudomonas syringae pathovars, P. fluorescens and P. aeruginosa were analysed using multiple sequence alignment. A pathovar-specific region encoding pathogenicity-related secondary metabolites in the PSP genome was targeted for developing a LAMP assay. The final assay targeted a polyketide synthase gene, and readily differentiated PSP strains from other Pseudomonas syringae pathovars and other Pseudomonas species, as well as other plant pathogenic bacteria, e.g. species of Pectobacterium, Erwinia and Pantoea. CONCLUSION: A LAMP assay has been developed for rapid and specific characterization and identification of PSP from other pathovars of P. syringae and other plant-associated bacteria. SIGNIFICANCE AND IMPACT OF THE STUDY: This paper describes an approach combining a bioinformatic data mining strategy and comparative genomics with the LAMP technology for characterization and identification of a plant pathogenic bacterium. The LAMP assay could serve as a rapid protocol for microbial identification and detection with significant applications in agriculture and environmental sciences.

[Middle aortic syndrome: a case report]. / Middle aortic syndrome: à propos d'un cas.

Middle aortic syndrome (MAS) results from a diffuse narrowing of the distal thoracic or abdominal aorta commonly involving both the visceral and renal arteries. Congenital, acquired, inflammatory, and infectious etiologies have been described. Symptoms typically occur within the first three decades of life and include hypertension, lower extremity claudication, and mesenteric ischemia. The condition is considered a life-threatening emergency as a result of the complications associated with severe hypertension. Diagnosis is made with magnetic resonance and computed tomography angiography. Surgical bypass grafting is the optimal method of treatment and must be tailored depending on the distribution of disease. We report one case of MAS treated with thoracic aorta to abdominal aorta bypass and reimplantation of the right renal artery.

Chemical composition and antifungal effect of hydroalcoholic extract of Allium tripedale (Tvautv.) against Candida species.

BACKGROUND AND PURPOSE: Treatment of life-threatening fungal infections caused by Candida species has become a major problem. Candida spp. are the most important causative agents of candidiasis. Allium tripedale is a medicinal plant that has been traditionally used to treat infections. In the present study, we aimed to determine the chemical compounds and antimicrobial activity of hydroalcoholic extract of A. tripedale against different species of Candida. MATERIALS AND METHODS: Phytochemical analysis was performed to identify the possible bioactive components of this extract by using gas chromatography and mass spectroscopy (GC-MS). The hydroalcoholic extract of A. tripedale were collected. Different concentrations of A. tripedale (50, 25, 12.5, and 6.25 mg/ml) were used to evaluate its antifungal activity against Candida species (C. albicans, C. parapsilosis, and C. krusei) using disk diffusion assay. RESULTS: The GC-MS analysis revealed the presence of 40 different phytoconstituents with peak area; the major compounds were tetracosane, hexadecanoic acid, 1-eicosanol, 1,2-dihydro-pyrido[3,2,1-kl]phenothiazin-3-one, 2-hexadecen-1-ol, and 3,7,11,15-tetramethyl. Hydroalcoholic extract showed strong antimicrobial activity (inhibition zone ⩾ 20 mm), moderate antimicrobial activity (inhibition zone < 12-20 mm), and no inhibition (zone < 12 mm). In addition, the hydroalcoholic extract exhibited the highest antimicrobial properties against C. albicans strains. CONCLUSION: A. tripedale extract had a considerable inhibitory effect against various Candida species, but its highest inhibitory effect was against Candid albicans. Further investigations are required to detect the performance of this plant in the treatment of Candida infection.

[Chronic epicarditis, a soft pericardial constriction: about one case]. / L'épicardite chronique, une constriction à péricarde souple : à propos d'un cas.

Chronic constrictive epicarditis is a special form of chronic pericarditis. It is characterized by a thickening of the visceral pericardium that becomes adherent to cardiovascular structures, thus impeding the diastolic filling of the ventricles. The parietal pericardium remains soft, without symphysis with the visceral pericardium. We illustrate the diagnostic and therapeutic approaches to this pathology by a clinical case.

Surgical management of congenital obstruction of the left main coronary artery with supravalvular aortic stenosis.

OBJECTIVE: Stenosis of the left main coronary artery is a recognized complicating feature of supravalvular aortic stenosis. We have retrospectively identified three anatomic subtypes of left main coronary obstruction in patients with supravalvular aortic stenosis, each necessitating a distinct surgical approach. METHODS: From 1991 to 1998, 9 patients underwent surgical repair of supravalvular aortic stenosis and left main coronary stenosis. Five patients (group 1) had obstruction from near-circumferential thickening of the left main ostium, 2 patients (group 2) had restricted coronary flow due to fusion of an aortic valve leaflet to the supravalvular ridge, and 2 patients (group 3) had diffuse narrowing of the left main coronary artery. Group 1 patients were treated with patch aortoplasty encompassing the left main ostium and supravalvular aortic stenosis. Group 2 patients were treated with excision of the fused leaflet from the aortic wall and patch aortoplasty. Group 3 patients were treated with bypass grafting and aortoplasty. RESULTS: Surgical strategy was determined by coronary angiography and intraoperative assessment of coronary anatomy. There was 1 early death. All surviving patients underwent echocardiography with or without postoperative catheterization. The mean postoperative supravalvular gradient for 7 patients was 8 mm Hg (range 2-15 mm Hg). One patient required reoperation for a residual aortic gradient as a result of aortic arch involvement. No evidence of left main coronary artery stenosis was seen in groups 1 and 2; bypass grafts were patent in group 3 patients at a mean follow-up of 54.8 months. CONCLUSION: Three subtypes of left main coronary stenosis with supravalvular aortic stenosis are described. Each anatomic type mandates an individual surgical approach. Favorable surgical outcomes are achievable with each category.

Pulmonary thromboendarterectomy combined with other cardiac operations: indications, surgical approach, and outcome.

BACKGROUND: Patients with pulmonary hypertension due to chronic thromboembolic disease benefit from pulmonary thromboendarterectomy. A subset of these patients present with concomitant coronary or valvular disease. METHODS: From July 1990 to July 2000, 90 patients (68 males, 22 females, mean age 68 years) with pulmonary vascular resistance (PVR) ranging from 297 to 2261 dynes x sec x cm(-5) underwent pulmonary thromboendarterectomy in conjunction with coronary bypass grafting (59 patients), coronary artery bypass grafting/foramen ovale closure (24 patients), tricuspid annuloplasty (3 patients), mitral valve repair (2 patients), and aortic valve replacement (2 patients). The perioperative and hemodynamic outcomes of these patients were compared with the cohort of 1,100 isolated pulmonary thromboendarterectomies performed at our institution during this time. RESULTS: Overall perioperative survival (93.3%; 84 of 90 patients) and mean diminution in PVR (521 dynes x sec x cm(-5)) for patients undergoing combined operations were similar to those undergoing pulmonary thromboendarterectomy alone (94.2% survival; 1034 of 1100 patients; 547 dynes x sec x cm(-5) mean PVR reduction). Although patients undergoing combined operations were older (mean age 68 vs 50 years, p < 0.0001), had longer hospital stays (median 14 vs 9 days), and had worse left ventricular function (mean preoperative cardiac output 3.1 vs 4.4, p < 0.0001), there was no difference in cross-clamp time, resolution of tricuspid regurgitation, or postoperative systolic function between these two groups. CONCLUSIONS: Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension may be performed safely in conjunction with other cardiac operations. Older patients evaluated for pulmonary thromboendarterectomy should be screened for concomitant coronary and valvular disease.

alpha- and beta-adrenergic binding sites in sheep cerebral cortex: characterisation, effects of photoperiod and treatment with estrogen/progesterone.

The radioligands [3H]-dihydroergocryptine and [3H]-dihydroalprenolol were used to characterise alpha- and beta-adrenergic binding sites, respectively, in membrane fractions of sheep cerebral cortex. In terms of affinity, density and specificity these sites possess properties similar to those previously characterised in rat brain. Further, in preliminary studies, these sites also appear to be responsive to treatment with estradiol/progesterone as well as to photoperiod. Thus, estrogen treatment can elevate both alpha- and beta-adrenergic binding sites in cortical tissue of sheep kept in natural light. In contrast, artificial light either has no effect or inhibits binding in response to estrogen.

Serotonin deficiency in phenylketonuria embryopathy.

The development and evolution of PKU can be prevented by prescribing an appropriate diet at an early age. A systematic neonatal screening has been set up in most countries. However, young women suffering from PKU give birth to very severely malformed children (PKU embryopathy: microcephaly, mental retardation, hypotrophy, cardiopathy) unless they again take up the specific diet, until the PHE level has lowered down to normal, before the beginning of gestation. The treatment has to be continued at least during the first months of gestation. This management is very unpleasant and sometimes not easily accepted. The mechanism of this embryopathy is still unknown. It is possible that (1) the excess of PHE or the presence of abnormal metabolites, or (2) serotonin deficiency (which is a feature of PKU) could be responsible for the maldevelopment of the embryo. Some authors consider that serontonin has a morphogenetic role in normal embryogenesis. Previously we described an experimental animal model using in vitro culture of rat embryos in human PKU sera. Mouse embryos have been subsequently used, since they show a greater sensitivity. Malformations, consisting essentially of neural tube defects, were present in almost 100% of the embryos cultured in serum from PKU patients. Using this animal model, we tested the hypothesis of serotonin deficiency. For this purpose, mouse embryos were cultured in human serum depleted of serotonin. Under these conditions, 100% of the embryos showed oculo-neural malformations characteristic of the experimental embryopathy. These results indicate the importance of serotonin deficiency in the occurrence of PKU embryopathy.

Genital herpes simplex virus infections: laboratory confirmation in diverse patient groups.

The laboratory diagnosis of genital herpes simplex virus (HSV) infections in various patient groups with diverse clinical manifestations including asymptomatic pregnant women with history of genital herpes and in a high prevalence group consisting of male patients with recurring genital ulcerations is described. HSV was detected by conventional cell culture and also by a CPE-enhancement technique using human embryonic lung fibroblasts (MRC-5) and Vero cells with subsequent typing of isolate by HSV type-specific monoclonal antibodies. A definite improvement in HSV diagnosis was noted by the use of the CPE-enhancement technique with the reduction of turn-around time to 24 h at which 61.1% and 50% isolation rates were detected in MRC-5 cells in comparison to 38.9% and 16.6% by conventional cell culture in the high prevalence patient population and asymptomatic pregnant women, respectively. Delayed development of CPE and reduced isolation rates were detected using Vero cells. Follow-up sampling of subsequent episodes of genital ulcerations in those with history of recurrence but an initial negative cell culture result, increased the isolation rate substantially and enabled the confirmation of diagnosis of genital HSV infection.

Comparative Evaluation of Iron Deficiency among Obese and Non-obese Children.

BACKGROUND: Obese children are at the risk of micronutrient deficiency especially iron deficiency. Given the importance of iron deficiency in this age group and considering the existing discrepancies, present study was performed with the aim of evaluating iron deficiency in obese children. MATERIAL AND METHOD: This study was conducted, in the form of a case-control study, on 100 children aged between 5 to 15 during June and November 2013 in Kashan. Cases consisted of 50 obese children and controls were 50 children who were not obese.Blood sample was drawn to check for serum iron, total iron binding capacity (TIBC) by biochemistry method and plasma ferritin by ELISA method. The obtained data were entered into SPSS software version 16 and statistically analyzed. P < 0.05 was identified as statistically significance. RESULTS: The mean values of serum iron were 52.38 and 64.50 microg/dL for the case and control groups (P<0.02). TIBC levels in obese and non-obese Children were 434.80 and 382.28 microg/dL (P<0.008). The ferritin level in the study group was 70.56 versus 68.06 ng/ml in the control group (P=0.79). In the obese children group, 8.3% (n=2) of children with iron deficiency had ferritin levels less than 15 while in control group 100% (n=14) of iron deficient children had ferritin levels below 15 (P<0.001). CONCLUSION: In our study, mean serum iron levels were lower among obese children in comparison with control group. However, ferritin concentrations were similar in both groups. It is supposed that due to inflammatory state caused by obesity, serum ferritin levels are naturally higher in obese people. It is suggested that higher levels of ferritin considered as normal reference values in obese people.

[Syphilitic aortic regurgitation: a sexually transmissible cardiopathy]. / L'insuffisance aortique d'origine syphilitique : une cardiopathie sexuellement transmissible.

Syphilitic cardiovascular complications are currently rare. It concerns the tertiary phase of the disease and results in sacciform aneurysm of the thoracic aorta or ostial coronary artery stenosis. Syphilitic aortic regurgitation is even more rare. We illustrate it by a clinical observation and discuss its diagnosis and its treatment.

State-of-the-art chronic thromboembolic pulmonary hypertension diagnosis and management.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a debilitating disease caused by chronic obstruction of pulmonary artery branches following episodes of pulmonary embolism and incomplete thrombus resolution. The prognosis of patients with CTEPH is poor unless an early diagnosis is made and treatment is initiated. Chest radiography and echocardiography are used in the initial assessment of suspected pulmonary hypertension. A diagnosis of CTEPH may be confirmed by the presence of a mismatched wedge-shaped perfusion deficit during ventilation/perfusion scintigraphy or characteristic findings during multi-slice computed tomography (CT) angiography, including a mosaic perfusion pattern, dilatation of proximal pulmonary arteries and right heart chambers, and the presence of vascular stenosis or obstruction. Prior to possible surgery, pulmonary angiography remains the definitive diagnostic technique, indicating the site and accessibility of the obstruction. However, many centres utilise CT and magnetic resonance imaging following recent advances in these noninvasive techniques. Haemodynamic evaluation via right heart catheterisation is also mandatory, as pulmonary vascular resistance is the most important determinant of both prognosis and the risk associated with pulmonary endarterectomy surgery. Accurate CTEPH diagnosis and characterisation of its extent and distribution are imperative to allow the prompt initiation of treatment, particularly surgical pulmonary endarterectomy in eligible patients.