Biosynthesis of Ag-Pt bimetallic nanoparticles using propolis extract: Antibacterial effects and catalytic activity on NaBH4 hydrolysis.

The critical environmental issues of antibiotic resistance and renewable energies supply urge researching materials synthesis and catalyst activity on hydrogen production processes. Aiming to analyse the antibacterial effect of platinum-silver (Ag-Pt) nanoparticles (NPs) and the catalyst effect on NaBH4 hydrolysis that can be used for hydrogen generation technology, in this work, Ag-Pt NPs were prepared using aqueous propolis extract. Various methods were used for the characterization (Uv-vis Spectroscopy, Transmission Electron Microscopy (TEM), Fourier Transform Infrared Spectroscopy (FTIR), Atomic Force Microscopy (AFM) and X-ray diffraction Spectroscopy (XRD)). The antimicrobial activity of Ag-Pt bimetallic nanoparticles was evaluated in vitro by the microdilution method against Escherichia coli, Staphylococcus aureus, Bacillus subtilis, Klebsiella pneumoniae, Staphylococcus epidermidis, and Serratia marcescens. The results confirmed the antimicrobial activity of bimetallic NPs Ag-Pt concentrations of (25, 50, and 100 µg/ml). A concentration of 100 µg/ml showed low bacterial viability varying between 22.58% and 29.67% for the six tested bacteria. For the catalyst activity on NaBH4 hydrolysis, the results showed high turnover factor (TOF) and low activation energy of 1208.57 h-1 and 25.61 kJ/mol, respectively, with high hydrogen yield under low temperature. Synthesized Ag-Pt NPs can have great potential for biological and hydrogen storage applications.

[Anaesthetic security: evolution of ideas]. / La sécurité anesthésique: evolution des concepts.

BACKGROUND: The concept of risk has not clear neither in the media nor in the medical field. It appears important to us to bring details relating some definitions in the field of anaesthesia safety. AIM: This work aims to clarify the concepts of safety, of risk in a medical activity like the Anaesthesia. METHODS: A search was carried out on Medline with the following key words: Risk anaesthetic, anaesthetic Safety, anaesthetic mortality. RESULTS: The definitions of risk, of acceptable risk taking account of social and economic considerations are brought in this text. The ways to evaluate safety and the methods to achieve it was developed. DISCUSSION: The indicator of quality more used to evaluate safety is anaesthetic mortality. Many difficulties exist with the interpretation of data on mortality. The standards of care are normally established according to the degree of necessary safety. Concurrently to these standards exist certainly the human error which is a phenomenon towards which must direct all the efforts of improvement of safety but more especially the errors of system which are found regularly in the analysis of accidents and incident. CONCLUSION: The identification of the failures is the mandatory step to achieve safety.

[Percutaneous balloon valvotomy for combined rheumatic mitral and aortic stenosis]. / Dilatation percutanee d'un double retrecissement mitral et aortique d'origine rhumatismale.

BACKGROUND: Balloon dilatation of the mitral valve is an established modality of treating patients with mitral stenosis. However, there is limited experience for simultaneous dilatation of combined mitral and aortic stenosis. AIM: Report our experience in percutaneous balloon valvotomy for combined mitral and aortic rheumatic stenosis. CASE REPORT: We describe a case of a 33 years old woman who successfully balloon valvotomy for rheumatic mitral and aortic stenosis via the transseptal anterograde approach using Inoué balloon for mitral valve and retrograde approach single balloon for aortic valve. CONCLUSION: Double valve balloon valvotomy is feasible and safe in selected patients with combined mitral and aortic rheumatic stenosis.

[Tetralogy of fallot with absent pulmonary valve]. / L'agenesie des valves pulmonaires avec communication interventriculaire.

BACKGROUND: Absent pulmonary valve with ventricular septal defect is a rare cardiac malformation. The aim of our study is to specify the anatomic characteristics and the clinical and echocardiographic features of this cardiac malformation and to discuss its management. METHODS: We report 8 cases of absent pulmonary valve with ventricular septal defected collected over a period of 24 years. The diagnosis was made during the first year of life in all cases in the presence of respiratory symptoms and/or cyanosis. It was confirmed by cardiac catheterization in 4 cases and echocardiography in 4 cases. RESULTS: Pulmonary vascular obstructive disease, related to aortopulmonary collateral vessels, was noted in one patient who died at the age of 20 years. One patient was lost to follow up and 6 patients were operated. Closure of the ventricular septal defect, widening of the pulmonary tract and insertion of a pulmonary valve were performed in the 6 cases. Reduction procedure of the pulmonary arteries was performed in 3 cases. One death related to early postoperative infective endocarditis was noted. At a mean follow up of 2 years, the 5 survivors are going well with no significant pulmonary stenosis. CONCLUSION: Although named "tetralogy of Fallot with absent pulmonary valve", absent pulmonary valve with ventricular septal defect is different from tetralogy of Fallot by aneurysmal dilatation of the pulmonary arteries which may compress the bronchial tree and lead to respiratory symptoms that can be severe with respiratory distress. Pulmonary arterioplasty eliminate airways obstruction and its results are satisfactory. The need for insertion of a pulmonary valve is debatable.

[Anomalous origin of coronary arteries from the aorta]. / Naissance anormale des arteres coronaires a partir de l'aorte.

The authors report the series of 9 patients (6 male and 3 female, aged from 32 to 64 years) with anomalous origin of coronary arteries from the aorta discovered at coronary arteriography. In 4 cases, the circumflex, artery aries from the right coronary sinus and in 5 cases, the right coronary artery arises from the left coronary sinus. Severe atherosclerotic coronary disease was discovered in 5 cases. We conclude that aberrant coronary origin from the aorta is a rare congenital anomalous discovered usually at coronary angiography and certain patients with this anomalous can develop severe myocardial ischemia especially when a vessel runs between the aorta and pulmonary artery.

[Esophageal abnormalities in patients with chest pain and normal coronary angiograms]. / Anomalies oesophagiennes chez les patients presentant des douleurs thoraciques avec coronarographie normale.

AIMS: To evaluate the frequency and the variety of esophageal abnormalities in patients with chest pain and normal coronary angiograms. PATIENTS AND METHODS: : We have conducted a prospective study including patients with noncardiac chest pain based on normal coronary angiograms. We performed for all patients an upper gastrointestinal endoscopy, 24-hour esophageal pH monitoring and stationary esophageal manometry. RESULTS: Fifty patients were studied on a 3-year period (24 men and 26 women, mean age: 51.5 years). Gastroesophageal reflux disease was found on 24-hour esophageal pH monitoring in 29 patients (58%), associated with a good symptomatic correlation in 17 patients (34%). Esophageal motor disorders as nutcracker esophagus and diffuse esophageal spasm were found in 6 patients (12%) associated with gastroesophageal reflux disease in two cases. Independent factors associated with gastroesophageal reflux disease and esophageal motor disorders were respectively presence of regurgitations (p = 0.005 : adjusted OR[IC95%] : 3.57 [1.28 - 16.66]) and age higher than 58 years (p = 0.01 : adjusted OR[IC95%]: 2.77 [1.33 - 12.50]). CONCLUSIONS: Gastroesophageal reflux disease is the most common esophageal abnormality n; patients with noncardiac chest pain. In the absence of regurgitations, 24-hour esophageal pH monitoring must be the first test to be performed.

[Coronary arteriography in severe aortic valve disease]. / La coronarographie dans les valvulopathies aortiques sévères.

Three hundred and twelve patients with severe aortic valve disease underwent a pre-operative haemodynamic study including coronary arteriography either as routine (age more than 50 years) or because of chest pains, previous myocardial infarction or for patients with risk factors of coronary atherosclerosis. Significant coronary artery disease was present in 9% of all cases. Coronary artery disease was more frequent in patients with angina and in patients with previous myocardial infarction but none of these factors was specific. We conclude that except young patients < 40 years old, with no chest pain and no coronary risk factors, coronary arteriography is recommended in patients with severe aortic valve disease before aortic valve replacement.

[Twenty years result of a corrective surgery of tetralogy of Fallot in a 50 years old woman]. / Resultat a 20 ans d'une reparation complete d'une tetralogie de Fallot chez une femme de 50 ans.

The authors report the case of a woman operated at a 50 years of age for a tetralogy of Fallot with a good late result.

[Multiple coronary artery-left ventricular fistulae. A case report]. / Fistules coronaires multiples dans la cavite ventriculaire gauche. A propos d'un cas.

The authors report the case of a patient with multiple coronary artery-left ventricular fistulae discovered in coronary angiography for exertional angina.

[Analysis of knowledge attitudes and practices of health care workers facing blood exposure accidents in a general surgery service]. / Analyse des connaissances attitudes et pratiques du personnel soignant face aux accidents d'exposition au sang en chirurgie generale.

In order to assess the degree of knowledge, attitudes and the personnel's practices exercising in a service of general surgery of the hospital Charles Nicolle of Tunis, concerning blood exposure accidents, we did a transverse survey during the month of January of the year 2002. A questionnaire has been addressed to 114 people while using the technique of the direct interview. The middle age of investigated is 35.7 years. The sex ratio is 0.7. Only the 2/3 declare have been vaccinated against the B hepatitis. The results show a good knowledge of the exposure risk to a communicable disease by blood (95.6%), but less good for the risk of contamination by the three viruses HBV, HCV and HIV. The resheathing of needles, considered like gesture to risk, is underestimated by 71.2% of investigated. The majority of investigated declare to know universal precaution principles (85.8%). However, to the maximum 4 measures only on the 10 advisable have been mentioned by investigated. The conduct to hold in case of blood exposure accident seems insufficiently known by our sample. It is represented, in 78.8% of cases, in the application of disinfectants Betadine type or alcohol iodized, whereas the practice of a serology to the patient source is ignored completely. 75% of investigated having had a blood exposure accident lasting the last 12 months (n = 44) didn't declare their blood exposure accident and only 11.4% declare to have undergone cares. Actions of information and formation, to the intention of the whole of the personnel of the service, on risks incurred by the nursing, gestures and procedures to risk, the universal precaution respect, the conduct to hold in case of a blood exposure accident, the interest of the declaration and the interest of the vaccination against the B hepatitis, are primordial.

[Predictive factors of morbidity and mortality after surgery in the elderly]. / Facteurs prédictifs de morbidité et de mortalité de la chirurgie du vieillard.

UNLABELLED: The aim of the study was to determine prognostic factors of post operative morbidity and mortality for patients aged 80 years and older. We compared two groups of patients aged 80 and over operated to determine predictive factors of morbidity and mortality: group of patients who presented post operative complication within 30 days after surgery and group of patients without any complication. Comparison of the two groups for global morbidity using univariate analysis showed only one prognostic factor: surgery of diabetic foot (p = 0.034). Predictive factors of mortality according to univariate analysis were: pre-operative shock (p = 0.001), abdominal wall pathology (p = 0.027), gastric or duodenal ulcer diseases (p = 0.011) and global morbidity (p = 0.006). After logistic regression, only pre-operative shock was an independent predictive factor of mortality (p = 0.0023). CONCLUSION: Risk for morbidity after surgery in the elderly 80 years and over is linked with type of surgery and not with soil. Likewise, risk for mortality is linked with advanced stage of disease that is presence of pre-operative shock and not with soil.

[Percutaneous mitral commissurotomy and left ventricular function in severe mitral stenosis]. / Commissurotomie mitrale percutanée et fonction ventriculaire gauche dans le retrecissement mitral serré.

The purpose of this study was to determine the immediate effect of percutaneous mitral commissurotomy (PMC) on left ventricular (LV) performance. We studied 30 patients with severe mitral stenosis undergoing successful PMC by cardiac catheterization and angiography before and 5 minutes after PMC. All patients were in sinus rhythm and no patient had hypertension or clinical coronary artery disease. We conclude that the left ventricular end-diastolic volume and the stroke volume increased significantly immediately after PMC because of and increase in LV filling after relieving the mitral mechanical obstruction.

[Congenital aortic valve stenosis with left ventricular dysfunction: effect of percutaneous valvuloplasty]. / Retrecissement valvulaire aortique congenital avec dysfonction ventriculaire gauche: effet de la dilatation percutanée.

Two girls aged 6 and 15 years with severe congenital valvular aortic stenosis and left ventricular (LV) dysfunction underwent successful balloon aortic valvotomy (BAV). Both patients had severe symptoms at the time of initial evaluation. The electrocardiograms showed LV hypertrophy and cardiac enlargement (cardiothoracic ratio 0.7 and 0.65) was evident in the chest roentgenograms. Immediately after BAV, the aortic valve peak-to-peak gradients decreased from 60 to 8 mmHg and 120 to 30 mmHg respectively, the LV end-diastolic pressures decreased from 47 to 13 mmHg and 40 to 15 mmHg, the LV ejection fractions improved from 40 to 65% in the second girl. On follow-up (30 and 36 ms respectively), both patients were asymptomatic with normalization of LV function and without a change in the residual gradient a cross the aortic valve.

[The immediate effect of Rashkind's atrioseptostomy on systemic saturation in transposition of the great arteries]. / L'effet immédiat de l'atrioseptostomie de Rashkind sur la saturation systémique dans la transposition des gros vaisseaux.

The purpose of this prospective study is to analyse the immediate effect of Rashkind's atrioseptostomy on systemic saturation in transposition of the great arteries (TGA). Thirteen neonates and infants (10 males and 3 females) with TCiA underwent balloon atrial septostomy (BAS) at a median age of 20 days (range 2 and 60 days). The mean atrial septal defect diameter after BAS was 6.5 +/- 1.1 mm. The right ventricular saturation increased from 37 +/- 17% to 67 +/- 13% (p < 0.001). There was no correlation between the atrial septal defect diameter and the increase of systemic saturation after BAS.

[Coronary-pulmonary arterial fistula in the adult: report of 6 cases and review of the literature]. / Les fistules coronaro-pulmonaires de l'adulte: a propos de 6 observations et revue de la littérature.

Six new patients and 33 previously reported with coronary-to-pulmonary artery fistula were reviewed. The mean age at the time of diagnosis was 51 years. A male predominance was found (65%). Angina was the most common symptom. The artery mostly involved was the left anterior descending coronary artery and the fistula drained more often to the main pulmonary artery. The left-to-right shunt is small in the majority of patients and the associated significant coronary artery disease was detected in 18% of cases. Good results of surgical closure of the fistula are usually obtained. An alternative to surgical treatment is percutaneous transcatheter embolization of coronary artery fistulas.

[Cardiac retrograde arterial catheterization in children under 2 years of age. Indications, techniques and complications]. / Le catheterisme cardiaque par voie arterielle retrograde chez le nourrisson de moins de 2 ans. Indications, techniques et complications.

Thirty children (15 males and 15 females) under 2 years of age (mean age 14 +/- 6 months, range 1 to 24 months, mean weight was 8.3 +/- 2.5 kg) underwent diagnostic cardiac percutaneous femoral arterial and venous catheterization for congenital heart disease. The anticoagulation with heparin was not given in any patient. Appropriate arterial sheath varying from 4F to 5F were used for catheterization. The mean duration of the exploration was 38 +/- 16 mn. The mean duration of the left heart exploration was 9.5 +/- 2.5 mn. There were no hemorrhagic or ischemic complications in this series.

Neuroendocrine tumours of the digestive tract report of two cases and literature review.

Neuroendocrine tumors (NET) of the digestive system are rare. They comprise only 1% of all the tumors of the gastrointestinal tract. The aim of this study is to report two cases of exceptional localization of non secretary neuroendocrine tumors. Their difficulty in diagnosis, treatment and controversy in chemotherapy merit their study in depth. These are two patients that were treated in the department of general surgery (Beau Séjour) in Charles Nicolle Hospital for non secretary (NET) of the pancreas and stomach. The first was presented as a painless epigastria mass with frequent diarrhea. The second was presented as a painful mass in the left hypochondriac area without any other symptoms. Biochemical evaluation confirmed their non secretary properties. Surgery remains the first line of treatment. It was possible for the gastric, but not for the pancreatic tumor. Both were very advanced and had metastasis. Histopathological evaluation and immunohistochemical study using the method of peroxydase antiperoxydase (PAP) complexes for some special monoclonal antibodies confirmed the diagnosis. Chemotherapy of both cases was mal tolerated and was discussed in details.

[Single coronary artery. A case report]. / Artere coronaire unique. A propos d'un cas.

The authors report the case of a patient undergoing coronary angiography for an inferior myocardial infarction related with atherosclerosic lesions but associated with a rare anomalous origin of all three coronary arteries from single ostia in the left sinus of valsalva.

[Transradial approach for coronary angiography and angioplasty]. / L'approche trans-radiale de la coronarographie et de l'angioplastie coronaire.

The transradial approach of coronary angiography and angioplasty is now become a good alternative to the femoral approach in patients with normal Allen test results, because low rate of access site complication, improved patient comfort and early ambulation. This approach is particularly interesting in obese patients, aortoiliac disease or in patients under anticoagulation treatment or thrombolytics.

[False left ventricular aneurysm: report of 5 cases]. / Faux anevrysme du ventricule gauche: a propos de 5 observations.

Between 1972 and 2000, left ventricular false aneurysm was diagnosed in 5 patients. These patients consisted of three man and 2 women, aged between 58 and 70 years. Clinical presentation was characterized by severe heart failure, complicating a posterior myocardial infarction, in 4 patients. Left ventricular angiography, has confirmed the false aneurysm in all patients. Three patients underwent surgical management, with good result in 2 cases (follow-up of 9 and 13 years), and an early postoperative death in one case. Two patients refused surgery and died suddenly. Ischemic myocardial disease, represent the most frequent etiology. Left ventricular false aneurysm prognosis should be improved by emergent surgical management, preventing fatal rupture.