A phage-encoded RNA-binding protein inhibits the antiviral activity of a toxin-antitoxin system.

Bacteria harbor diverse mechanisms to defend themselves against their viral predators, bacteriophages. In response, phages can evolve counter-defense systems, most of which are poorly understood. In T4-like phages, the gene tifA prevents bacterial defense by the type III toxin-antitoxin (TA) system toxIN, but the mechanism by which TifA inhibits ToxIN remains unclear. Here, we show that TifA directly binds both the endoribonuclease ToxN and RNA, leading to the formation of a high molecular weight ribonucleoprotein complex in which ToxN is inhibited. The RNA binding activity of TifA is necessary for its interaction with and inhibition of ToxN. Thus, we propose that TifA inhibits ToxN during phage infection by trapping ToxN on cellular RNA, particularly the abundant 16S rRNA, thereby preventing cleavage of phage transcripts. Taken together, our results reveal a novel mechanism underlying inhibition of a phage-defensive RNase toxin by a small, phage-encoded protein.

Marginal specificity in protein interactions constrains evolution of a paralogous family.

The evolution of novel functions in biology relies heavily on gene duplication and divergence, creating large paralogous protein families. Selective pressure to avoid detrimental cross-talk often results in paralogs that exhibit exquisite specificity for their interaction partners. But how robust or sensitive is this specificity to mutation? Here, using deep mutational scanning, we demonstrate that a paralogous family of bacterial signaling proteins exhibits marginal specificity, such that many individual substitutions give rise to substantial cross-talk between normally insulated pathways. Our results indicate that sequence space is locally crowded despite overall sparseness, and we provide evidence that this crowding has constrained the evolution of bacterial signaling proteins. These findings underscore how evolution selects for "good enough" rather than optimized phenotypes, leading to restrictions on the subsequent evolution of paralogs.

Transthyretin Cardiac Amyloidosis: An Evolution in Diagnosis and Management of an "Old" Disease.

Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome, and cardiac amyloidosis (CA) is one of the causes of HFpEF, that has established and emerging treatment options. However, it remains an underdiagnosed and often overlooked cause of HFpEF. The importance of early diagnosis cannot be emphasized enough, as emerging therapies are more effective early in the course of the disease. Further, because of the unique physiologic and hemodynamic features of CA, patients poorly tolerate traditional heart failure medications and experience worse outcomes compared with other causes of HFpEF. With the aging of the population, transthyretin (ATTR) CA, once thought to be a rare disease, will become the most common type of systemic amyloidosis. ATTR-CA is increasingly recognized due to enhanced clinical awareness; advances in diagnostic imaging that have led to a diagnostic approach that does not require a biopsy, as well as the recent introduction of novel disease-modifying treatments. ATTR-CA causes restrictive and infiltrative cardiomyopathy that results in heart failure, atrial and ventricular arrhythmias, and conduction disease, and is associated with significant morbidity and mortality. Our goal in this review is to provide an overview of the historical, epidemiologic, diagnostic, and therapeutic evolution of ATTR-CA, and to emphasize the importance of early suspicion and detection of HFpEF.

The Role of Genetics, Epigenetics, and the Environment in ASD: A Mini Review.

According to recent findings, variances in autism spectrum disorder (ASD) risk factors might be determined by several factors, including molecular genetic variants. Accumulated evidence has also revealed the important role of biological and chemical pathways in ASD aetiology. In this paper, we assess several reviews with regard to their quality of evidence and provide a brief outline of the presumed mechanisms of the genetic, epigenetic, and environmental risk factors of ASD. We also review some of the critical literature, which supports the basis of each factor in the underlying and specific risk patterns of ASD. Finally, we consider some of the implications of recent research regarding potential molecular targets for future investigations.

Factors Associated with Foot Lesions in Diabetic Patients at Saint-Louis Hospital (Senegal): A Case-Control Study Protocol.

INTRODUCTION: Diabetes prevalence has increased over the past years. In Senegal, this prevalence is 4% in the general population. However, the region of Saint-Louis (in the north of the country) has the highest rate with 10.4%. The main prognosis problem is the occurrence foot lesions that can lead to lower-limbs amputation. Diabetic foot is a real public health issue, due to its economic burden and its serious repercussions on patients, leading to poor quality of life. The objective of this case-control study is to identify factors associated with foot lesions in diabetic patients. METHODS AND ANALYSIS: It will be a case-control study from January to December 2021. The patients will be recruited from the departments of general surgery, internal medicine, and emergency. An univariate then multivariate analysis (logistic regression) will allow us to select the variables associated with foot lesions in our study population. The parameters included in the logistic regression will be those with a p < 0.20 in the univariate analysis. Finally, a binary logistic regression analysis (with the calculation of Odds Ratios (OR) with confidence intervals (CI)) according to the backward stepwise method will identify the factors independently associated to foot lesions in diabetic patients. ETHICS AND DISSEMINATION: This research protocol will be submitted to the Ethics Committee of our institution for approval. The knowledge of factors causing diabetic foot will help to communicate with policymakers to raise the awareness in our community. Finally, it will help to prevent lower limb amputations. HIGHLIGHTS: Diabetes is the leading cause of non-traumatic lower-limb amputation in the world.The region of Saint-Louis (Senegal) has the highest prevalence of diabetes.Controlling factors associated with foot lesions in diabetic patients can prevent from amputation.

Detection of kdr and ace-1 mutations in wild populations of Anopheles arabiensis and An. melas in a residual malaria transmission area of Senegal.

In the central western Senegal, malaria transmission has been reduced low due to the combination of several effective control interventions. However, despite this encouraging achievement, residual malaria transmission still occurring in few areas, mainly ensured by An. arabiensis and An. melas. The resurgence or the persistence of the disease may have originated from the increase and the spread of insecticide resistance genes among natural malaria vectors populations. Therefore, assessing the status and mechanisms of insecticides resistance among targeted malaria vectors is of highest importance to better characterize factors underlying the residual transmission where it occurs. Malaria vectors were collected from three selected villages using nocturnal human landing catches (HLC) and pyrethrum spray collections (PSC) methods. An. gambiae s.l. specimens were identified at the species level then genotyped for the presence of kdr-west (L1014F), kdr-east (L1014S) and ace-1R mutations by qPCR. An. arabiensis (69.36%) and An. melas (27.99%) were the most common species of the Gambiae complex in the study area. Among An. arabiensis population, the allelic frequency of the kdr-east (22.66%) was relatively higher than for kdr-west mutation (9.96%). While for An. melas populations, the overall frequencies of both mutations were very low, being respectively 1.12% and 0.40% for the L1014S and L1014F mutations. With a global frequency of 2%, only the heterozygous form of the G119S mutation was found only in An. arabiensis and in all the study sites. The widespread occurrence of the kdr mutation in both An. arabiensis and An. melas natural populations, respectively the main and focal vectors in the central-western Senegal, may have contributed to maintaining malaria transmission in the area. Thus, compromising the effectiveness of pyrethroids-based vector control measures and the National Elimination Goal. Therefore, monitoring and managing properly insecticide resistance became a key programmatic intervention to achieve the elimination goal where feasible, as aimed by Senegal. Noteworthy, this is the first report of the ace-1 mutation in natural populations of An. arabiensis from Senegal, which need to be closely monitored to preserve one of the essential insecticide classes used in IRS to control the pyrethroids-resistant populations.

Investigating the remediation potential of iron oxide nanoparticles in Cu-polluted soil-plant systems: coupled geochemical, geophysical and biological approaches.

Although the use of iron oxide nanoparticles (IONPs) has high potential in remediation and agriculture, a major hindrance to their use includes the risk of contamination of soil and water resources with underexplored effects of IONPs on biota. The fate, phytotoxicity and remediation potential of IONPs are investigated with soil column experiments using 7 nm-sized magnetite (Fe3O4) nanoparticles (magnNPs) and sunflower (Helianthus annuus). Control soil, magnNP-containing soil (10 g magnNPs per kg soil), copper-polluted soil (500 mg Cu per kg soil) and copper-polluted soil containing magnNPs (10 g magnNPs per kg soil and 500 mg Cu per kg soil) support sunflower growth for 57 and 95 days. In magnNP-exposed plants, the occurrence of magnNPs does not affect the growth of the vegetative aerial parts and photosynthetic efficiency. Decreased lipid peroxidation indicates an enhanced antioxidant enzymatic response of magnNP-exposed plants. In plants grown in Cu- and magnNP-Cu-soils, the physiological and biochemical impacts of excess copper are clearly identified, resulting in growth retardation, decreased pigment contents and photosynthetic efficiency, and increased lipid peroxidation and peroxidase (POD) activities. Based on magnetic susceptibility, a higher amount of magnNPs is detected after 57 days in the roots of magnNP-exposed plants (1400 mg kg-1) than in the roots of magnNP-Cu-exposed plants (920 mg kg-1). In the latter, magnNP internalization is likely hampered because of the plants' physiological responses to Cu toxicity. At the working Cu and magnNP concentrations, magnNPs neither decrease Cu accumulation in the plant tissues nor alleviate the overall growth retardation of sunflowers and certain phytotoxic effects induced by excess Cu. However, this study highlights several positive environmental aspects relative to magnNP use, including the harmless effects of magnNPs on sunflowers (1% magnNPs in soil) and the ability of magnNPs to influence Cu mobility in the soil (which could be even more pronounced at lower Cu concentration).

How do we fight COVID-19? Military medical actions in the war against the COVID-19 pandemic in France.

'We are at war', French President Emmanuel Macron said in an address to the nation on 16 March 2020. As part of this national effort, the French Military Medical Service (FMMS) is committed to the fight against COVID-19. This original report aimed to describe and detail actions that the FMMS has carried out in the nationwide fight against the COVID-19 pandemic in France, as well as overseas. Experts in the field reported major actions conducted by the FMMS during the COVID-19 pandemic in France. In just few weeks, the FMMS developed ad hoc medical capabilities to support national health authorities. It additionally developed adaptive, collective en route care via aeromedical and naval units and deployed a military intensive care field hospital. A COVID-19 crisis cell coordinated the French Armed Forces health management. The French Military Centre for Epidemiology and Public Health provided all information needed to guide the decision-making process. Medical centres of the French Armed Forces organised the primary care for military patients, with the widespread use of telemedicine. The Paris Fire Brigade and the Marseille Navy Fire Battalion emergency departments ensured prehospital management of patients with COVID-19. The eight French military training hospitals cooperated with civilian regional health agencies. The French military medical supply chain supported all military medical treatment facilities in France as well as overseas, coping with a growing shortage of medical equipment. The French Armed Forces Biomedical Research Institute performed diagnostics, engaged in multiple research projects, updated the review of the scientific literature on COVID-19 daily and provided expert recommendations on biosafety. Finally, even students of the French military medical academy volunteered to participate in the fight against the COVID-19 pandemic. In conclusion, in an unprecedented medical crisis, the FMMS engaged multiple innovative and adaptive actions, which are still ongoing, in the fight against COVID-19. The collaboration between military and civilian healthcare systems reinforced the shared objective to achieve the goal of 'saving the greatest number'.

Mise en place d'un centre de traitement des épidémies (CTE) pour COVID-19 dans un service de Médecine Interne; les leçons apprises / Establishment of an Outbreak Center for Covid-19 (OCC), in an Internal Medicine department

Introduction: La fulgurante progression de la pandémie à covid -19 a imposé au Sénégal l'adoption de stratégies de riposte parmi lesquelles la mise en place de centres de traitement des épidémies (CTE) au sein des hôpitaux . Nous nous proposons d'évaluer les activités d'un CTE Covid-19 implanté dans un service de médecine interne et les leçons tirées de ce vécu. Méthodologie : Le CTE Covid -19 a été installé dans le service de médecine interne de l'Hôpital Régional de Thiès (HRT), mais avec conservation de lits dédiés aux patients non atteints de Covid-19. Les étudiants en année de doctorat affectés dans le service de médecine interne étaient responsables de la gestion quotidienne du CTE sous la supervision des spécialistes en médecine interne Ce service était subdivisé en deux parties: le CTE qui prenait en charge les cas de Covid -19 et le reste du service qui devait continuer à accueillir les patients atteints d'autres affections ou qui y étaient régulièrement suivies. Résultats : Du 1er mai au 30 octobre 2020, 237 patients ont été admis dans le CTE. Ils étaient âgés de 7 à 88 ans avec une moyenne d'âge de 53,41 ans et un sexe ratio de 1,60. Les motifs d'admission étaient une désaturation en oxygène inférieure à 90%, la présence d'au moins une comorbidité (autres infections, diabète , hypertension artérielle , obésité, maladies auto-immunes, cancers…). L'âge avancé mais aussi les patients ne pouvant être à domicile faisaient également partie des critères d'admission . Trois (3) cas de co-infection Covid-19 et tuberculose pulmonaire ont été relevés et trois (3) patients avaient un portage chronique du virus de l'hépatite B. Dans le cadre des hospitalisations non Covid -19, les affections suivantes ont été retrouvées : 8 cas de diabète déséquilibrés et autant d'hépatopathie (6,10%); l'accès palustre dans 3, 05% (n=3) ; la tuberculose pulmonaire (3,81%, n=3) ; 3 cas (2,29 %) d'anémie de type biermerien et de lupus érythémateux systémique. De même, 1 cas (0,76%) d 'empyème cérébral ; une polyarthrite rhumatoïde (0,76 %), une (01) maladie rénale chronique , 1 cas de défaillance cardiaque ont également été enregistrées. Cinq (5) cas (3,81 %) non affectés par l'infection à Covid -19 , à leur admission l'ont été au cours de leur hospitalisation et donc transférés au niveau de la zone rouge du CTE. Conclusion: La mise en place du CTE au niveau du service de Médecine interne , a permis une adaptation efficiente dans la prise en charge des patients concernés mais aussi de ceux qui étaient suivis pour des pathologies chroniques comme les urgences médicales reçues durant la période. La continuité des soins a été assurée et les liens avec les autres secteurs de la pyramide sanitaire du Sénégal ont été raffermis.

Introduction : The fast progression of covid -19 throughout the world has forced Senegal to adopt response strategies including the establishment of Outbreak Center for Covid- 19 (OCC ) within hospitals . We propose to evaluate the activi ties of an OCC implemented in an internal medicine department and the lessons learned from this experience. Methodology: The center for care of Covid-19 has been installed in the Internal Medicine department of the Thies Regional Hospital (HRT ), but with dedicated beds for patients non affected by the pandemic . Fifteen doctoral students were assigned, by local medical school , to the Department of Internal Medicine in order to be responsible for the day-to-day management of the OCC. They were supervised by internal medicine specialists . This service was divided into two parts: the OCC that handled Covid -19 cases and the rest of the service , which was to continue to take care of patients with other conditions or who were regularly monitored. Results: From May 1 to October 30, 2020, 237 patients were admitted to the CTE They ranged from 7 to 88 years old with an average age of 53.41 and a sex ratio of 1.60 .The reasons for admission were an oxygen desaturation of less than 90%, the presence of at least one comorbidity (other infections, diabetes, arterial hypertension, obesity, autoimmune diseases, cancers, etc .). Advanced age but also patients who could not be at home were also part of the admission criteria. Three (3) cases of Covid -19 co -infection and pulmonary tuberculosis were identified and three (3) patients had a chronic carriage of the hepatitis B virus. In the context of non -Covid -19 hospitalizations, the following conditions have been found: 8 cases of unbalanced diabetes and as many hepatopathy (6.10%); malaria access in 3.05% (n = 3); pulmonary tuberculosis (3.81%, n = 3); 3 cases (2.29%) of biermeric type anemia and systemic lupus erythematosus. Similarly, 1 case (0.76 %) of cerebral empyema; rheumatoid arthritis (0.76%), one (01) chronic kidney disease, 1 case of heart failure were also recorded Five (5) cases (3.81%) not affected by Covid-19 infection, on admission, were during their hospitalization and therefore transferred to the red zone of the CTE. Conclusion : The establishment of the OCC in the internal medicine service allowed an efficient adaptation in the care of the patients affected by covid disease but also of those who were followed for chronic pathologies or admitted for other medical emergencies This strategy has improved and strengthened the links with other sectors of Senegal 's health pyramid.

Experience of a Tertiary-Level Urology Center in Clinical Urological Events of Rare and Very Rare Incidence. V. Urological Tumors: 1. Adrenal Myelolipoma.

OBJECTIVES: To present our center's experience in the management of adrenal myelolipoma in the context of shifting from the open to the laparoscopic adrenalectomy approach. MATERIALS AND METHODS: A retrospective search of our center's records was done for reported cases of adrenal myelolipoma during the period July 2001-June 2016. All the cases with histopathologically-documented adrenal myelolipoma diagnosis were included. Relevant demographic and clinical variables were studied with a comparison between the open and laparoscopic approaches. RESULTS: Of more than 82,000 urological surgeries, 238 adrenalectomies were done with only 22 cases of myelolipoma that had a mean age and body mass index of 52.4 ± 10.3 years and 30.23 kg/m2, respectively. The main clinical presentation was accidental discovery. The largest dimension of tumors varied from 6 to 16 cm. Computed tomography described a characteristic picture of hypodense heterogeneous adrenal tumors in all cases, while magnetic resonance imaging was indicated for malignancy suspicion in only 5 cases. Adrenal tumor markers were normal in all cases. Open and transperitoneal laparoscopic adrenalectomies were used in 14 and 8 cases, respectively. The latter approach was insignificantly advantageous in the need for blood transfusion, postoperative pain degree, need for analgesia, and hospital stay duration (p = 0.22). Histo-pathological examination revealed benign adipose tissue and myeloid cells and confirmed the diagnosis of adrenal myelolipoma in all cases. CONCLUSIONS: Adrenal myelolipoma is a rare non-functioning benign tumor. Laparoscopic excision seems to be a promising alternative approach to the traditional open adrenalectomy, even in the context of large tumors and obesity.

Permeability improvement of polyethersulfone-polietylene glycol (PEG-PES) flat sheet type membranes by tripolyphosphate-crosslinked chitosan (TPP-CS) coating.

In this study, improvement of urea and creatinine permeability of polyethersulfone (PES) membrane by coating with synthesized tripolyphosphate-crosslinked chitosan (TPP-CS) has been conducted. Original and modified membranes, e.g. pristine PES, polyethersulfone-polyethylene glycol (PES-PEG) and PES-PEG/TPP-CS membranes were characterized using FTIR, DTG, SEM, AFM, water uptake, contact angles, porosity measurement, tensile strength test and permeation tests against urea and creatinine. The results show that the PES modification by TPP-CS coating has been successfully carried out. The water uptake ability, hydrophilicity and porosity of the modified membranes increase significantly to a greater degree. All modified membranes have good thermal stability and tensile strength and their permeation ability towards urea and creatinine increase with the increasing concentration of TPP-CS. PES membrane has urea clearance ability of 7.36 mg/dL and creatinine of 0.014 mg/dL; membrane PES-PEG shows urea clearance of 11.87 mg/dL and creatinine of 0.32 mg/dL; while PES-PEG/TPP-CS membrane gives urea clearance of 20.87-36.40 mg/dL and creatinine in the range of 0.52-0.78 mg/dL. These results suggest that the PES-PEG membrane coated with TPP-CS is superior and can be used as potential material for hemodialysis membrane.

Quality indicators for hyperthermia treatment: Italian survey analysis.

AIM: Nowadays, no Quality Indicators (QI) have been proposed for Hyperthermia treatments. Starting from radiotherapy experience, the aim of this work is to adapt radiotherapy indicators to Hyperthermia and to propose a new specific set of QI in Hyperthermia field. MATERIAL AND METHODS: At first, radiotherapy quality indicators published in literature have been adapted to hyperthermia setting. Moreover, new specific indicators for the treatment of hyperthermia have been defined. To obtain the standard reference values of quality indicators, a questionnaire was sent to 7 Italian hyperthermia Institutes with a list of questions on physical and clinical hyperthermia treatment in order to highlight the different therapeutic approaches. RESULTS: Three structure, five process and two outcome QI were selected. It has been possible to adapt seven indicators from radiotherapy, while three indicators have been defined as new specific indicators for hyperthermia. Average values used as standard reference values have been obtained and proposed. CONCLUSION: The survey performed on 7 Italian centres allowed to derive the standard reference value for each indicator. The proposed indicators are available to be investigated and applied by a larger number of Institutes in which hyperthermia treatment is performed in order to monitor the operational procedures and to confirm or modify the reference standard value derived for each indicator.

Incidence of acute respiratory tract infections (2006-2015) and influenza (2006-2013) among French armed forces.

OBJECTIVES: We aimed to assess the incidence of respiratory tract infections in military settings between 2006 and 2015. PATIENTS AND METHODS: We performed a retrospective epidemiological study of the entire military population from 2006 to 2015. Comprehensive data was collected from all medical centers, operational medical units, naval services, and army training hospitals and provided by the epidemiological surveillance of the armies. RESULTS: The annual average population of the study was 331,394 soldiers. For acute respiratory tract infections (2006-2015), 22,818 cases were reported in metropolitan France, 3,211 cases in French overseas territories, 1,595 cases in the French Navy, and 1,318 cases in external military operations for a total of 28,942 cases. For influenza (2006-2013), 934 cases were reported in metropolitan France, 101 cases in French overseas territories, and 23 cases in external operations, for a total of 1,058 cases. The mean incidence rate of acute respiratory tract infections expressed as case number per 1,000 person-years (PY) was 8.7 PY (95% CI [8.6-8.8]) with an exceptional increased incidence rate in 2009 (25.9 PY, 95% CI [25.4-26.4]). The mean incidence rate of influenza was 0.35 PY (95% CI [0.33-0.37]) with a peak incidence rate of 1.9 PY in 2009. CONCLUSION: Acute respiratory tract infections are at the forefront of infectious episodes in the French armies. Although not necessarily severe, current prevention measures are not enough to reduce the incidence threshold of these infections and need to be improved.

[Study of the factors associated with the delay of health consultation of victims of rape in Senegal]. / Étude des facteurs associés au retard de consultation sanitaire des victimes de viols au Sénégal.

INTRODUCTION: Rape remains one of the most serious forms of sexual violence because of its negative impact on the physical and mental health of victims. The objective of this study is to identify the factors associated with the delay in rape victims seeking medical assistance from healthcare professionals in Senegal. METHODOLOGY: A retrospective, descriptive and analytical observation study was conducted. The study population consisted of all the court files of girls or women victims of rape recorded by the investigators at the 11 high courts of Senegal during the period from 2006 to 2015. An exhaustive recruitment of the full records of rape victims meeting the inclusion criteria were completed. The uni and multivariate analyses were carried out with Epi Info 2000 and R 2.2.9 software respectively. RESULTS: At the end of the collection, 1,037 cases of rape were included in the study population. The average age of the victims was 16.3±7.9 years (range 1-72). Minors (<18 years) accounted for 24.8 %. The median time from rape to consultation at a health facility was 24hours. Long delay in consultation (>24hours) was noted for 38.6 % of victims. Risk of late consultation after rape was higher among victims residing in the southern areas (ORaj=4.31 [1.15-16.14]), or northern areas (ORaj=4.22 [1.26-14.14]), who were major (ORaj=1.67 [1.04-2.68]) or married (ORaj=3.44 [1.58-7.5]) or who were pregnant after the aggression (ORaj=34.03 [15.47-74.85]) or had an abortion (ORaj=5.45 [1.04-24.47]). CONCLUSION: Medical and judicial assistance are more difficult if there is a long delay between the aggression and consultation. Thus, it is important for the health and judicial authorities to raise awareness about the harmful consequences of sexual violence, and to put forward the benefits of therapeutic care, compensation for the harm suffered by rape victims, as well as the availability of holistic care services 24hours a day.

Predicting locally advanced rectal cancer response to neoadjuvant therapy with 18F-FDG PET and MRI radiomics features.

PURPOSE: Pathological complete response (pCR) following neoadjuvant chemoradiotherapy or radiotherapy in locally advanced rectal cancer (LARC) is reached in approximately 15-30% of cases, therefore it would be useful to assess if pretreatment of 18F-FDG PET/CT and/or MRI texture features can reliably predict response to neoadjuvant therapy in LARC. METHODS: Fifty-two patients were dichotomized as responder (pR+) or non-responder (pR-) according to their pathological tumor regression grade (TRG) as follows: 22 as pR+ (nine with TRG = 1, 13 with TRG = 2) and 30 as pR- (16 with TRG = 3, 13 with TRG = 4 and 1 with TRG = 5). First-order parameters and 21 second-order texture parameters derived from the Gray-Level Co-Occurrence matrix were extracted from semi-automatically segmented tumors on T2w MRI, ADC maps, and PET/CT acquisitions. The role of each texture feature in predicting pR+ was assessed with monoparametric and multiparametric models. RESULTS: In the mono-parametric approach, PET homogeneity reached the maximum AUC (0.77; sensitivity = 72.7% and specificity = 76.7%), while PET glycolytic volume and ADC dissimilarity reached the highest sensitivity (both 90.9%). In the multiparametric analysis, a logistic regression model containing six second-order texture features (five from PET and one from T2w MRI) yields the highest predictivity in distinguish between pR+ and pR- patients (AUC = 0.86; sensitivity = 86%, and specificity = 83% at the Youden index). CONCLUSIONS: If preliminary results of this study are confirmed, pretreatment PET and MRI could be useful to personalize patient treatment, e.g., avoiding toxicity of neoadjuvant therapy in patients predicted pR-.

[Epidemiological, Clinical And Radiological Profile Of Positive Microscopy Pulmonary Tuberculosis (PMPT) At The Regional University Hospital Of Saint-Louis]. / Profil Epidemiologique, Clinique Et Radiologique De La Tuberculose Pulmonaire A Microscopiepositive (TPM+) Au Centre Hospitalier Regional Universitaire De Saint-Louis (CHRU SL).

Pulmonary tuberculosis is still a global scourge, especially in developing countries, despite the control measures that have been in place for decades. The aim of this work was to describe the epidemiological, clinical radiological and evolutionary aspects of PMPT at the Saint-Louis Regional Hospital Center. This was a retrospective descriptive study on 191 PMPT files, hospitalized in the medical department from January 1, 2016 to December 31, 2017. PATIENTS AND METHOD: Were included in the study, all cases of pulmonary tuberculosis proved by the presence of bacillus Koch on direct examination of sputum. Were excluded from the study, cases of pulmonary tuberculosis with negative microscopy and cases of pulmonary tuberculosis in patients younger than 14 years. RESULTS: Of 1417 hospitalizations, 191 patients had a PTPM. The average age was 36.5 years with extremes of 14 to 81 years. The sex ratio was 2.2 in favor the male. Fishermen were the most affected with 34% of cases. A family tuberculosis was noted in 61 patients. One hundred and forty-six new PMPT cases were noted. CONCLUSION: Positive microscopy pulmonary tuberculosis remains a public health problem in Senegal. Much work remains to be done in Saint-Louis, which a region with a high burden of tuberculosis.

INTRODUCTION: la tuberculose pulmonaire demeure encore un fléau mondial en progression surtout dans les pays en voie de développement, malgré les actions de lutte mises en place depuis des décennies. Le but de ce travail était de décrire les aspects épidémiologiques, cliniques radiologiques et évolutifs de la TPM (+) au centre hospitalier régional de Saint-Louis. Il s'agissait d'étude descriptive rétrospective portant sur 191 dossiers de TPM+, hospitalisés au service de médecine du 1er Janvier 2016 au 31 Décembre 2017. Étaient inclus dans l'étude, tous les cas de TPM+ prouvée par la présence de BAAR à l'examen direct des crachats. Étaient exclus de l'étude les patients de moins de 14 ans, les cas de TPM(-) Résultats : Sur 1417 hospitalisations, 191 patients avaient une TPM+. L'âge moyen était de 36,5 ans avec des extrêmes de 14 à 81 ans. Sex-ratio de 2,2. Les pêcheurs étaient les plus touchés avec 34 % des cas. Un contage tuberculeux familial était noté chez 61 malades. Cent quarante six nouveaux cas de TPM(+) ont été notés. Conclusion : la TPM(+) demeure un problème de Santé Publique au Sénégal. Beaucoup d'efforts restent à faire dans la région de Saint-Louis à forte charge de tuberculose.

[Knowledge, Attitudes And Practice Of The Pupils Of The High School Famolo Coulibaly Of Kolokani On The HIV And The AIDS (Mali)]. / Connaissances, Attitudes Et Pratiques Des Eleves Du Lycee Famolo Coulibaly De Kolokani Sur Le VIH Et Le Sida (Mali).

INTRODUCTION: The epidemic of the AIDS is global. No country or territory is saved. Mali takes into account the preventive education in the AIDS in the sectorial programs of the Ministry of Education and the courses of study. OBJECTIVE: to estimate the level of the Knowledge, Attitudes and Practice of the pupils regarding prevention of the HIV and the AIDS. METHODS: it was about an exhaustive, quantitative and transverse survey led to the high school of Kolokani. The survey concerned 515 pupils questioned from 2 till 7 March 2007. RESULTS: At the level of the knowledge the mode of transmission the most quoted by the pupils was the sexual intercourse with multiple partners (78.46 % for the boys and 71.22 % for the girls). Compared with the behavior, 62.89% of sexually active pupils used the condom in their last high-risk sexual intercourse. Only 25.05% of students reported having conducted a voluntary screening test. Attitudes of discrimination exist because 18.06 % of pupils have a feeling of fear towards the People Living with the HIV. CONCLUSION: These results show that there is a risk of transmission of the HIV and the AIDS in schools. This has to motivate the intensification of the activities of raising sensitization and prevention to improve the indicators of prevention of this pandemic.

INTRODUCTION: L'épidémie du SIDA est globale. Aucun pays ou territoire n'est épargné. Le Mali prend en compte l'éducation préventive au SIDA dans les programmes sectoriels du Ministère chargé de l'éducation et des programmes scolaires. OBJECTIF: Evaluer le niveau des Connaissances, Attitudes et Pratiques des élèves en matière de prévention du VIH et du SIDA. MÉTHODES: Il s'agissait d'une étude exhaustive, quantitative et transversale menée au lycée de Kolokani. L'enquête a porté sur 515 élèves interrogés du 2 au 7 Mars 2007. RÉSULTATS: Au niveau des connaissances le mode de transmission le plus cité par les élèves était le rapport sexuel avec les partenaires multiples (78,46% pour garçons et 71,22% pour les filles). Par rapport aux comportements 62,89% des élèves sexuellement actifs ont utilisé le préservatif lors de leur dernier rapport sexuel à haut risque. Seulement 25,05% des élèves ont déclaré avoir effectué un test de dépistage volontaire. Les attitudes de discrimination existent car 18,06% des élèves ont un sentiment de peur envers les Personnes Vivant avec le VIH. CONCLUSION: Ces résultats montrent qu'il y a un risque de transmission du VIH et du SIDA en milieu scolaire. Ceci doit motiver l'intensification des activités de sensibilisation et de prévention pour améliorer les indicateurs de prévention de cette pandémie.