Prévalence des hémorragies digestives au cours des vagues de COVID-19 au service de Réanimation Chirurgicale du CHU Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar / Prevalence of gastrointestinal bleeding during the waves of COVID -19 in the surgical intensive care unit of the CHU Joseph Ravoahangy Andrianavalona,Antananarivo, Madagascar

Introduction : La CoViD-19 est une maladie à « plusieurs visages ¼ qui peut affecter tous les systèmes. La survenue d'hémorragies digestives fait partie des manifestations de cette maladie. L'objectif de cette étude est de présenter les cas d'hémorragies digestives chez des patients infectés par le SARS-CoV-2. Matériels et Méthodes : Une étude rétrospective couvrant la période correspondant aux deux vagues de CoViD-19 à Antananarivo (Madagascar) a été réalisée, plus particulièrement au service de Réanimation Chirurgicale du Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona. Résultats : Huit sur 101 patients de 51 à 81 ans, hospitalisés pour CoViD-19, ont présenté une hémorragie digestive dont les manifestations allaient de l'hématémèse au méléna ou une association de ces deux manifestations hémorragiques. Ces patients ont été traités par, entre autres une anticoagulation et une corticothérapie, comme défini dans le protocole national de prise en charge de la CoViD-19, avant l'épisode hémorragique. Aucun patient n'a présenté d'état de choc, l'indice de choc allait de 0,5 à 0,9. Deux patients ont pu bénéficier d'une fibroscopie digestive haute. Le score de Glasgow Blatchford variait de 6 à 13. Parmi ces huit patients, quatre sont décédés. Conclusion : Lors de la prise en charge de la CoViD-19, au vu des manifestations thrombotiques surtout, il faut procéder à une protection au niveau digestif lorsqu'une anticoagulation à titre curatif doit être réalisée. Également cette protection digestive doit être effectuée au-devant de la corticothérapie, laquelle entre dans le cadre du traitement de la CoViD-19. Tout cela pour minimiser le risque de survenue de saignement gastro-intestinal .

Background: CoViD-19 is a "many-faced" disease that can affect all the body organism. The occurrence of gastrointestinal bleeding is one of the manifestations of this disease. The aim of this study was to present cases of gastrointestinal bleeding in patients infected with SARS-CoV-2. Materials and Methods: A retrospective study covering the period corresponding to the two waves of CoViD-19 in Antananarivo (Madagascar) was carried out, more particularly in the Surgical Intensive Care Unit of the University Hospital Joseph Ravoahangy Andrianavalona. Results: Eight out of 101 patients aged 51 to 81, hospitalized for CoViD-19, presented gastrointestinal bleeding, with hematemesis or melena or a combination of these two bleeding manifestations. These patients were treated, among other coagulation and corticosteroid therapy as defined in the national protocol for the management of CoViD-19 before the bleeding episode. None of the patients presented with a shock; the shock index ranged from 0.5 to 0.9. Two patients were able to benefit from an upper digestive fibroscopy. The Glasgow Blatchford score ranged from 6 to 13. Of these eight patients, four died. Conclusion: During the management of CoViD-19, the thrombotic manifestations are treated with curative anticoagulation must be performed, which can cause digestive bleeding. Also, in front of the corticosteroid therapy which is part of the treatment of CoViD-19, also digestive protection must be carried out to minimize the risk of occurrence of gastrointestinal bleeding.

Comparative histology in the liver and spleen of three species of freshwater teleost

We describe and compare the histology of liver and spleen ofGeophagus brasiliensis (Perciformes), Hypostomus francisci (Siluriformes) and Hoplias aff. malabaricus (Characiformes), tropical freshwater fishes. InG. brasiliensisandH. aff. malabaricusthe hepatocytes were arranged in tubular form whereas in H. franciscithey cord-like. In all species, hepatocytes presented glycogen, but in G. brasiliensis and H. aff. malabaricus they showed strong stained for hemossiderin in the cytoplasm. InG. brasiliensis and H. aff. malabaricus, melanomacrophage centres (MMCs) were associated to hepatic structures and only in G. brasiliensis was observed intrahepatic exocrine pancreas. The spleen, in all species, was characterized by red and white pulp without boundary between the two regions, but only in H. francisci was recorded nodular organization in splenic parenchyma. The G. brasiliensisandH. aff. malabaricuspresented in the white pulp MMCs linked mainly to ellipsoids. Besides, we observed large MMCs in the spleen in relation to liver of G. brasiliensis and H. aff. malabaricus. In liver, highest values of reticular fibers and collagen were observed inG. brasiliensis. In spleen, highest values of reticular fibers and collagen were recorded inH. aff. malabaricusandH. francisci, respectively. Histological differences confirm the hypothesis that the phylogenetic distance is reflected in liver and spleen.(AU)

Nós descrevemos e comparamos a histologia do fígado e do baço de Geophagus brasiliensis (Perciformes), Hypostomus francisci (Siluriformes) e Hoplias aff. malabaricus (Characiformes), peixes neotropicais de água doce. Em G. brasiliensis e H. aff. malabaricus os hepatócitos organizaram-se na forma tubular enquanto que em H. francisci eles apresentaram-se como cordões celulares. Em todas as espécies, os hepatócitos apresentaram glicogênio, mas em G. brasiliensis e H. aff. malabaricus, eles mostraram forte marcação para hemossiderina no citoplasma. Em G. brasiliensis e H. aff. malabaricus, centros melanomacrofágicos (CMMs) foram associados a estruturas hepáticas e somente em G. brasiliensis foi observado pâncreas exócrino intrahepático. O baço, em todas as espécies, foi caracterizado pela polpa vermelha e branca sem limites entre as duas regiões, mas somente em H. francisci foi registrado uma organização nodular no parênquima esplênico. G. brasiliensiseH. aff. malabaricusapresentaram na polpa branca CMMs associados principalmente a elipsoides. Além disso, nós observamos CMMs grandes no baço em relação ao fígado de G. brasiliensis e de H. aff. malabaricus. No fígado, valores altos de fibras reticulares e colágeno foram observado em G. brasiliensis. No baço, valores altos de fibras reticulares e colágeno foram registrados em H. aff. malabaricuseH. francisci, respectivamente. Diferenças histológicas confirmam a hipótese que a distância filogenética está refletida no fígado e no baço.(AU)

Volatile compounds of Lamiaceae exhibit a synergistic antibacterial activity with streptomycin

Bacterial infections cause thousands of deaths in the world every year. In most cases, infections are more serious because the patient is already weakened, and often, the bacteria are already resistant to the antibiotics used. Counterparting this negative scenario, the interest in medicinal plants as an alternative to the synthetic antimicrobial drugs is blossoming worldwide. In the present work, we identified the volatile compounds of ethanol extracts of Melissa officinalis, Mentha sp., Ocimum basilicum, Plectranthus barbatus, and Rosmarinus officinalis by gas chromatography/mass spectrometry (GC/MS). Also was evaluated antimicrobial activity of ethanol extracts against 6 bacteria of clinical interest, and was tested the interaction of these extracts with a commercial antibiotic streptomycin. Phytol was a compound identified in all extracts by GC/MS, being majoritary component in Plectranthus barbatus and Rosmarinus officinalis. The Gram-positive bacteria were more sensitive to ethanol extracts, and Plectranthus barbatus and Rosmarinus officinalis were the most active extracts. Ethanol extracts exhibited a synergetic effect with streptomycin. These results encourage additional studies, in order to evaluate the possibilities of using ethanol extracts of Lamiaceae family as natural source for antibacterial activity.