Influence of pneumatic tube delivery system on laboratory results.

INTRODUCTION: The pneumatic tube system (PTS) is an automated and fast modality of transportation of biological samples, but it has been reported to induce preanalytical errors. AIM: To study the influence of transportation by PTS on biochemistry tests which are particularly sensitive to haemolysis and atmospheric pressure variation. MATERIALS AND METHODS: We compared laboratory results of arterial blood gas, sodium, potassium, chloride, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, glucose and haemolysis index of samples conveyed simultaneously by PTS and by courier. RESULTS: We recruited 30 patients from the sampling room and 40 patients from the intensive care unit. Transport through PTS resulted in a significant increase in aspartate aminotransferase and potassium without exceeding the limits of acceptability. Potassium was significantly more increased for samples transported in a higher speed line (p = .048) but without exceeding the limits of acceptability. No significant impact was noted on haemolysis indices. The pO2 variations due to PTS transportation exceeded the limit of acceptability with significant intra-individual variations. CONCLUSION: Our PTS is validated for biochemistry tests results. It reduces turnaround times without affecting sample quality. However, the interpretation of arterial blood gas results should be careful for samples transported by PTS.

The anti-Müllerian hormone: A useful tool for diagnosis of Polycystic Ovary Syndrome.

BACKGROUND: Polycystic Ovary Syndrome (PCOS) is the most frequent endocrine disorder that affects reproductive-age women with important long-term health implications. As such, the anti-Müllerian hormone (AMH) was proposed as a helpful test to identify women with PCOS. The aim of this study was to determine an AMH cut-off value for the diagnosis of PCOS. METHODS: This was a two-year cross-sectional study including women of reproductive age, diagnosed with PCOS according to Rotterdam criteria (2003). The control group of healthy women was age-matched. AMH was performed using an electrochemiluminescence immunoassay. AMH levels were compared and evaluated with the receiver operating characteristic curve analysis. RESULTS: A total of 130 women were enrolled in this study. Of these, 65 were diagnosed with PCOS, and 65 were healthy. No significant difference was detected in body mass index between the two groups. AMH levels were significantly higher in women with PCOS (p = < 0.001). No significant difference in AMH levels was detected between PCOS phenotypes. A cut-off of 25.1 pmol/L (3.5 ng/mL) could discriminate women with PCOS from controls with a sensitivity of 74% and specificity of 72.3%. The area under the curve was 0.811 (95% CI: 0.73-0.88). CONCLUSIONS: Our study suggests that AMH had good diagnostic potential as a complement to Rotterdam criteria for PCOS diagnosis in reproductive-age women of Tunisian origin.

Case report: Management challenges of late diagnosed 17-alpha hydroxylase deficiency.

Herein we report the intriguing case of a 42-year-old woman presenting with grade three hypertension, severe hypokalemia and primary amenorrhea, which revealed to be the complete form of 17 alphahydroxylase deficiency. We also discuss the challenging therapeutic approach as well as the outcomes and the follow-up of this patient.

Pheochromocytoma of the prostate: An unusual location.

Ectopic pheochromocytomas, also called paragangliomas, are defined as catecholamine -secreting tumors, which develop outside the adrenal medulla. Pheochromocytomas of the urinary tract represent less than 1% of all paragangliomas and are most commonly located in the bladder. Nevertheless, prostatic pheochromocytoma is an extremely rare clinical entity and only a few cases have been reported in the medical literature. Herein, we report a case of ectopic pheochromocytoma arising from the prostate, revealing with hypertensive crisis occurring immediately after ejaculation.

Assessment of acute neuromuscular fatigue manifestations and functional performances after heavy resistance exercise.

BACKGROUND: This study aimed to assess neuromuscular fatigue after heavy resistance exercise in rugby players. METHODS: Twelve male rugby players performed five sets of knee extension exercise lifting 80% of their one repetition maximum until failure, with 3min of rest in-between. Maximal voluntary contraction (MVC) and surface electromyographic activity from quadriceps muscles, as well as ions (i.e., Na+, K+, and Cl-) and metabolic responses (i.e., blood lactate and ammonia concentrations) were measured before and after exercise. Maximum repetitions performance and both peripheral (RPEp) and overall body (RPEo) rating of perceived exertion were recorded following each set. RESULTS: The number of maximum repetitions decreased significantly across sets (P<0.001). Both RPEp and RPEo increased significantly across sets (P<0.001) with higher RPEp values after each set (P<0.001). Both RPEp (r=-0.98, P<0.01) and RPEo (r=-0.99, P<0.001) were negatively correlated with the changes in the number of maximum repetitions. MVC (P<0.001), root mean square (P<0.05), and neuromuscular efficiency (P<0.01) as well as Na+ (P<0.01), Cl- (P<0.001) and blood concentrations of lactate (P<0.001) and ammonia (P<0.001) increased significantly after the exercise. However, K+ (P<0.001) increased after the resistance exercise. CONCLUSIONS: Heavy resistance exercise affected both objective (i.e., neuromuscular and biochemical parameters) and subjective (i.e., RPE) aspects of neuromuscular fatigue.

Vitamin D supplementation to prevent COVID-19 in patients with COPD: a research perspective.

There is increased evidence that the massive release of pro-inflammatory cytokines leading to the cytokine storm syndrome shapes the evolution of COVID-19 and is responsible of the severity of COVID-19 in some patients. A recent review argued that vitamin D deficiency could have increased the COVID-19 outbreak and suggested vitamin D supplementation as a preventive action. In fact, many factors seem to be correlated both to low vitamin D levels and the importance of COVID-19 spreading and severity. It is also important to highlight that the lockdown, implemented in many countries, prevents people to go out and then increases the risk of vitamin D deficiency. COPD patients are particularly at risk to have low levels of vitamin D due to multiple risk factors. COPD may generate a systemic inflammatory process responsible of secondary extra-pulmonary impairments. Vitamin D deficiency could sustain and aggravate the systemic inflammation associated to COPD. Reports have also shown that vitamin D deficiency was associated to exacerbations and hospital admissions, as well as lung function. Recent research showed that vitamin D supplementation significantly reduced COPD exacerbations. Although vitamin D deficiency was not proved to be neither a risk factor of COVID-19, nor a determinant of its severity, vitamin D supplementation represents a preventive perspective that needs to be further studied.

[Bipolar disorder vulnerability: The vitamin D path]. / Vulnérabilité au Trouble Bipolaire: La Piste de la Vitamine D.

OBJECTIVES: Bipolar disorder (BD) etiopathogenesis is still not well elucidated. It has recently been proven that 25-hydroxy vitamin D (25OHD) has an anti-inflammatory and neuroprotective role. Our objectives were to measure 25OHD plasma levels in patients with BD in acute decompensation and compare them with patients with schizophrenia (SCZ) or schizoaffective disorder (SAD) and with healthy controls. METHODS: This is a cross-sectional case-control study including male inpatients with a decompensation of their disease who were diagnosed with BD, SCZ or SAD according to DSM-5 criterias. The control group was constituted by unrelated healthy subjects, age-and-sex matched. RESULTS: The 25OHD level was significantly higher only in patients with BD compared to controls. 25OHD was also positively correlated to the PANSS scale (r = 0.282, p < 0.001) and to different MOCA scores (r = 0.326, p = 0.006) as well as aspects related to abstraction, attention and memory capacity. Multivariate analysis found that BD acute decompensation was independently related to the rise in plasma 25OHD (p = 0.012; OR =1.157, [1.032 -1.297]). CONCLUSION: Our study shows that BD acute decompensation is associated with the rise in plasma 25OHD synthesis. However, the vitamin D dosage relevance as a biomarker of this disease warrants a verification in other studies.

OBJECTIFS: L'étiopathogénie du trouble bipolaire (TB) demeure non encore bien élucidée. Récemment, il a été prouvé que la 25-hydroxy-vitamine D(25OHD) a un rôle anti-inflammatoire et neuroprotecteur. Nos objectifs étaient de mesurer les concentrations plasmatiques de la 25OHD chez des patients atteints de TB en décompensation aigue et de les comparer à celles de patients souffrant de schizophrénie (SCZ) ou de trouble schizo-affectif (TSA) et à celles de témoins sains. MÉTHODES: Il s'agissait d'une étude transversale de type cas-témoins qui a inclus des patients de sexe masculin hospitalisés pour une décompensation de leur maladie et chez qui les diagnostics de TB, SCZ, ou de TSA ont été retenus selon les critères du (DSM-5). Le groupe témoin a été constitué de sujets sains non apparentés, appariés selon l'age et le sexe. RÉSULTATS: La concentration de la 25OHD était significativement plus élevée uniquement chez les patients atteints de TB par rapport aux témoins. la 25OHD était aussi corrélée positivement à l'échelle PANSS (r = 0.282, p < 0.001) et aux différents scores de l'échelle MOCA (r = 0.326, p = 0.006) ainsi qu'aux dimensions concernant la capacité d'abstraction, d'attention et la mémoire . A l'analyse multivariée, la décompensation aigue du TB était liée de manière indépendante à l'élévation de la 25OHD plasmatique (p = 0.012; OR = 1.157, [1.032 -1.297]). CONCLUSION: Notre étude a montré que la décompensation aigue des TB était associée à une élévation de la synthèse de la 25OHD plasmatique. Toutefois, la pertinence du dosage de la vitamine D comme biomarqueur de cette maladie mérite d'être vérifiée par d'autres études.

A novel disease-causing mutation in the Renin gene in a Tunisian family with autosomal dominant tubulointerstitial kidney disease.

Autosomal dominant tubulointerstitial kidney disease (ADTKD) is a rare group of disease that affect the tubules of the kidney. There are 4 known subtypes of ADTKD classified based on causative genes and clinical features. In our study, we aimed to identify the causative subtypes of ADTKD in a Tunisian ADTKD family (3 affected members), in whom standard nephrological diagnosis did not provide clear subtype of ADTKD, until genetic testing was performed. Sanger sequencing was performed for UMOD, HNF1ß and REN genes. Mutational analysis allowed us to detect a heterozygous mutation in the REN gene: c.1172C > G, (p.T391R) in exon 10. In silico analyses predicted that the novel likely pathogenic mutation affect protein stability and 3D structure. Our study highlights the importance of establishing a genetic diagnosis to identify the subtype of ADTKD for better patient care. To the best of our knowledge, we report here a first Tunisian ADTKD-REN family.

Chemoprotective role of ethanol extract of Urtica urens L. against the toxicity of imidacloprid on endocrine disruption and ovarian morphometric in female rats, GC/MS analysis.

Imidacloprid (IMI) is a widely used in Tunisia and abroad, and high doses of IMI have been known to cause endocrine disruption. Some reports claim that Urtica urens L. (UU) can reduce toxicity thanks to it anti-inflammatory and antioxidant activities, but there is no scientific evidence justifying its use, which lets us think to its direct effect on the metabolism of the ovarian tissue. The present study was undertaken to evaluate the protective effect of UU against the toxicity of Confidor®, whose active substance is imidacloprid (IMI), in female rat, as well as the chemical compositions of UU ethanol (EtOH) extract by GC-MS. Female rats were divided into control group, 3 groups treated with IMI at 50, 200 or 300mg/kg/day and three groups co-treated with IMI (50, 200 or 300mg/kg/day)+100mg/kg/day of UU, for 60days. Blood samples were collected for the dosage of 17ß-estradiol levels. Ovaries were removed for tissular dosage of malondialdehyde (MDA), advanced oxidation protein products (AOPP), glutathione (GSH), vitamin E, catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx). Histological and histomorphometric examinations were performed as well. IMI caused an acute ovary injury, increased the ovary tissue levels of MDA and AOPP, and decreased the levels of GSH, vitamin E, and antioxidant enzyme activities. The number and the diameter of follicles were markedly diminished together with a reduction of the relative weight of ovaries. Compared with controls, the treated rats exhibited a significant reduction in serum 17b-estradiol levels. These results suggest an endocrine disruption by IMI which may interfere with ovarian follicles development in rat. The injection of UU EtOH extract improved the histological and all biochemical parameters cited above. In conclusion, IMI induced an acute ovary injury accompanied with disturbance of oxidant status and causes follicular atresia. Significant antioxidant activities were also observed in UU EtOH and a total of 31 compounds were identified. The injection of UU EtOH provided a significant protection which might be due to its antioxidant activities.

Evaluation of Bacillus subtilis SPB1 biosurfactant effects on hyperglycemia, angiotensin I-converting enzyme (ACE) activity and kidney function in rats fed on high-fat-high-fructose diet.

This study investigated the protective and the curative effects of Bacillus subtilis SPB1 crude lipopeptide biosurfactant in alleviating induced obesity complications in rats fed on high-fat-high-fructose diet (HFFD). Male Wistar rats were divided into five groups with the following treatment schedule: normal diet-fed rats (CD), HFFD-fed rats, HFFD-fed rats supplemented with SPB1 biosurfactant from the first day of the experiment (HFFD + Bios1), rats fed on HFFD receiving standard drug (HFFD + Torva), or SPB1 biosurfactant (HFFD + Bios2) during the last 4 weeks of the study. HFFD induced hyperglycemia, manifested by a significant (p < 0.001) increase (20%) in the levels of glucose and α-amylase activity in the plasma, when compared with CD. The administration of SPB1 biosurfactant to rats fed on HFFD reverted back normal blood glucose and α-amylase activity levels. Also, the findings clearly showed that acute oral administration of SPB1 biosurfactant reduced significantly (34%) the peak of blood glucose concentration 60 min after glucose administration, as compared with untreated rats fed on HFFD. Furthermore, renal dysfunction indices such as creatinine and urea as well as the level of angiotensin I-converting enzyme (ACE) exhibited remarkable increases in serum of rats fed on HFFD by 28.35%, 46%, and 92%,. Interestingly, SPB1 lipopeptides treatments decreased the creatinine and urea levels significantly (p < 0.001) near normal values, as compared with that of the HFFD group, and also showed an improvement of the kidney cortex architecture. Moreover, SPB1 biosurfactant displayed a potent inhibition of ACE activity in vitro (CI50 value= 1.37 mg/mL) as well as in vivo in obese rats by 42% and 27.25% with HFFD + Bios1 and HFFD + Bios2 treatments, respectively, and comparatively with the HFFD group. Besides, SPB1 lipopeptides treatments improved some of serum electrolytes such as Na+, K+, Ca2+ , and Mg2+. The results showed that SPB1 lipopeptide biosurfactant presented useful hypoglycemic and antihypertensive properties, and was able to alleviate renal lipid deposition in rats fed on a hypercaloric diet.

Antioxidative/oxidative effects and retarding osteoconductivity of ciprofloxacin-loaded porous polyvinyl alcohol/bioactive glass hybrid.

This study investigated the effect of bioglass (melting)-polyvinyl alcohol (BG (M)-PVA) and bioglass (melting)-polyvinyl alcohol-20 %ciprofloxacin (BG(M)-PVA-20Cip) in improving antioxidant activity and regenerating bone capacity. These composites were implanted in femoral condyles of ovariectomized Wistar rats and compared to that of controls groups. After the different period of implantation (15, 30, 60 and 90 days), the treatment of ovariectomized rats with BG(M)-PVA-20Cip showed a significantly higher malondialdehyde concentration when compared to that of BG(M)-PVA group. The superoxide dismutase, glutathione peroxidase and catalase in BG(M)-PVA-20Cip group showed significantly lower activities when compared to those in BG(M)-PVA group. So, BG(M)-PVA is more tolerated by organism than BG(M)-PVA-20Cip. Moreover, the alkaline phosphatase and acid phosphatase activities showed an excellent osteoinductive property of BG (M)-PVA. This property decreased with the presence of ciprofloxacin which is confirmed by histopathological analysis. Several physicochemical techniques showed a rapid reduction in Si and Na in one hand and an accelerator rise in Ca and P ions concentrations in other hand in BG(M)-PVA than in the BG(M)-PVA-20Cip. Therefore, the incorporation of ciprofloxacin in BG(M)-PVA is characterized by a prooxidant effect in oxidant-antioxidant balance at the beginning of treatment and a retard effect of formation of apatitic phase.

Protective and curative effects of Bacillus subtilis SPB1 biosurfactant on high-fat-high-fructose diet induced hyperlipidemia, hypertriglyceridemia and deterioration of liver function in rats.

This study was aimed to assess the plausible anti-obesity effects of Bacillus subtilis SPB1 crude lipopeptide biosurfactant on high fat high fructose diet-fed rats (HFFD). Male Wistar rats were divided into five groups with the following treatment schedule: normal diet (CD), HFFD, HFFD supplemented with SPB1 biosurfactant from the first day of the experiment (HFFD+Bios1, 10mg/kg/day), HFFD receiving standard drug (HFFD+Torva, 10mg/kg/day) or SPB1 biosurfactant (HFFD+Bios2, 10mg/kg/day) during the last 4 weeks of the study. The results showed an increase in body weight of HFFD by ∼19% as compared to controls (CD). Moreover, serum lipase activity underwent a threefold increase which led to an increase in the levels of total cholesterol (T-Ch), triglycerides (TG) and LDL-cholesterol (LDL-Ch) in serum of untreated HFFD, as well as a rise in the calculated atherogenic index (AI). Furthermore, liver dysfunction indices such as AST, ALT, CPK, LDH, GGT, ALP and T-Bilirubins exhibited remarkable increases in serum of HFFD as compared to controls (CD). Whereas, the administration of Bacillus subtilis SPB1 biosurfactant to HFFD improved the body weight gain and serum lipids profile and reverted back near normal the activities of lipase and liver toxicity indicators. In addition, notable protective and curative effects were reported in liver tissues. Overall, these results suggest that the lipopeptides biosynthesized by Bacillus subtilis SPB1 achieved an anti-obesity effect through the inhibition of lipid digestive and liver dysfunction enzymes.

[FT4 immunoassay interference : A case report]. / Interférence sur l'immunodosage de la FT4 : A propos d'une observation.

Measurement of thyrotropin and free thyroxin made using immunoassays are usually needed in clinical endocrinology. Here, we report a case of a patient with type 2 diabetes who presented a weight loss. To eliminate hyperthyroidism, thyroid function tests were performed. Free thyroxin (FT4) was decreased using two automated immunoassays TOSOH AIA 1800 and Roche ELECSYS 2010, with a normal thyrotropin value. Thyroid function tests repeated a month later were normal. The patient's history revealed contact with sheep, which may partly explain the interference. Investigations into the patient's serum were carried out using both the PEG test and dilution test. Interference factors were probably antibodies. Despite progress in immunoassays, we should be aware of interference occurrence since it can lead to false results, unnecessary investigations and incorrect treatment. Thus, simple tests must be carried out as if interference in immunoassays were suspected. Dilutions and PEG tests are generally performed as first line investigations.

Assessment of the antidiabetic and antilipidemic properties of Bacillus subtilis SPB1 biosurfactant in alloxan-induced diabetic rats.

The present study aimed to scrutinize the potential of Bacillus subtilis SPB1biosurfactant, orally administered, for preventing diabetic complications in rats. The findings revealed that, Bacillus subtilis biosurfactant was an effective reducer of α-amylase activity in the plasma. Moreover, this supplement helped protect the ß-cells from death and damage. Both the inhibitory action of SPB1 biosurfactant on α-amylase and the protection of the pancreas' ß-cells lead to a decrease of the blood glucose levels, consequently antihyperglycemic effect. Interestingly, this lipopeptide biosurfactant modulated key enzyme related to hyperlipidemia as lipase; which leads to the regulation of the lipid profile in serum by the delay in the absorption of LDL-cholesterol and triglycerides, and a significant increase in HDL-cholesterol. Histological analyses also showed that it exerted a protective action on the pancreases and efficiently preserved the liver-kidney functions of diabetic rats, evidenced by significant decreases in aspartate transaminase, alanine transaminase, gamma-glytamyl transpeptidase and lactate deshydrogenase activities in the plasma, as well as in the creatinine and urea contents. Overall, the present study demonstrated that the hypoglycemic and antilipidemic activities exhibited by Bacillus subtilis biosurfactant were effective enough to alleviate induced diabetes in experimental rats. Therefore, SPB1biosurfactant could be considered as a potential strong candidate for the treatment and prevention of diabetes.

[Impact of androgen therapy on metabolic and inflammatory profiles in male hypogonadism]. / Impact de l'androgénothérapie sur les profils métabolique et inflammatoire chez l'homme hypogonadique.

This study aims to evaluate the impact of androgen therapy on metabolic and inflammatoy profiles in male hypogonadic patients. Forty cases with isolated hypogonadism and 80 controls were enrolled. Clinical data were collected (age, weight, height, waist circonference and androgenothearapy). Blood tests were performed to evaluate testosterone, homeostasis index modal assessment (HOMA-IR), lipids and C reactive protein (CRP). Among hypogonadic patients, 14 of them were treated for 4 +/- 3.4 years. Amongst them testosterone levels were significantly elevated comparatively to non-treated patients and significantly lower than controls. Significant differences were noted on waist circumference between non treated patients and controls. Body mass index and HOMA-IR were significantly higher in non-treated patients. Triglycerides and HDLc were significantly decreased respectively in treated and non-treated patients. However, CRP levels were significantly decreased in controls. In conclusion, androgen therapy appeared to protect against obesity, insulin resistance, and hyperlipidemia. Effects on systemic inflammation seemed to be more discrete. Testosterone substitution should be strongly indicated in daily practice with careful prostate monitoring.

[Metabolic and inflammatory profiles in polycystic ovary syndrome associated to weight excess]. / Profils métabolique et inflammatoire dans le syndrome des ovaires polykystiques associé à l'excès pondéral.

Polycystic ovary syndrome (PCOS) and weight excess exhibited metabolic abnormalities and elevated cardiovascular risk. Our objective was to assess metabolic and inflammatory profiles in women with PCOS associated to weight excess; 85 women were enrolled. Four groups were then identified with and without PCOS and/or weight excess. Hyperlipidemia was significantly more observed in the two groups with weight excess. In whom insulinresistance and high sensitive C reactive protein were also elevated. Abnormalities observed when PCOS and weight excess are associated would mimic these observed in isolated weight excess with some particularities.

Atherogenic lipid profile in Behçet's disease: evidence of alteration of HDL subclasses.

BACKGROUND AND AIMS: Behçet's disease (BD) is an inflammatory vasculitis, most common in the Mediterranean area and Asia. Evidence for accelerated atherosclerosis in BD has been observed. The relationship between cardiovascular risk factors and accelerated atherosclerosis in patients with BD is still controversial. The aim of this study was to evaluate the lipid profile and to investigate the low-density lipoprotein (LDL) size and the distribution of high-density lipoprotein (HDL) subpopulations in BD patients. METHODS: Thirty six BD patients were compared to 36 healthy controls. Total cholesterol (TC), triglycerides (TG) and HDL-cholesterol (HDL-C) levels were measured using standard techniques. HDL subclasses and LDL-C size were estimated using polyacrylamide linear gradient gel electrophoresis. The LDL-C/HDL-C ratio was also calculated. High-sensitive C-reactive protein (hsCRP) level was measured by a turbidimetric method. Homocysteine (Hcy) level was determined using a liquid chromatography tandem mass spectrometry (LC/MS/MS). RESULTS: In BD patients, HDL-C levels as well as its subfraction levels were decreased (respectively, p <10(-6) and p <10(-3)). Percentage of HDL2 subpopulation was also decreased (p=0.02). HDL3 subfraction was significantly higher (p=0.02). The LDL-C/HDL-C ratio and CRP level were increased (respectively, p=10(-4) and p=0.003). TC was correlated with CRP. HDL-C and its subfractions were correlated with CRP and TG levels. HDL subparticle percentages were also correlated with age. CONCLUSIONS: Our findings of a reduction of HDL-C and HDL2 subpopulation and an increase HDL3 subclass and a higher LDL-C/HDL-C ratio may be considered as important predictors of cardiovascular events in BD patients.