État actuel du problème d'étiologie du trachome

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Étude du virus de la poliomyélite

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Étude de la stabilité du peptide natriurétique de type B (BNP) dans le sang total et le plasma

Evaluation of BNP stability in whole blood and plasma. BNP is proposed as a biochemical marker which could provide a useful screening test to select patients for further cardiac investigations in heart failure. The applicability of such a biochemical test in clinics, hospital wards, and clinical service laboratories is dependent on its ease of use and, whether, careful and complex sample handling are necessary. The present study was undertaken to evaluate the stability of BNP under a number of different handling conditions (samples collection, storage temperatures, freezing temperatures) assayed with a commercially available kit. The results clearly demonstrate that BNP is stable at room temperature for 24 hours, or up to 30 °C for 12 h in the presence or not of aprotinin, on the condition that BNP is assayed within one month (frozen at −20 °C) after blood collection. In contrast, the presence of aprotinin prevents BNP degradation in case of preservation of samples over than one month at −20 °C before assay.     

Étude biochimique du liquide céphalorachidien dans le cadre de la sclérose en plaques

The aim of the biochemical analysis of cerebrospinal fluid in support to clinical diagnosis of multiple sclerosis and inflammatory disorders of the central nervous system is the detection of intrathecal IgG synthesis. According to the European consensus report, we have developed a sensitive and specific iso-electric focusing method for detection of oligoclonal immunoglobulin banding in CSF and serum, and performed evaluation of blood-brain barrier and quantification of humoral immune response by albumin and immunoglobulin determination.We present a retrospective study of 537 patients having a CSF and serum pair analysed for intrathecal IgG synthesis study, 140 of them being suspected of multiple sclerosis according to Poser criteria.Quantitative and qualitative methods for IgG intrathecal detection are compared in the area of multiple sclerosis diagnosis contribution. This study confirms the interest to search IgG oligoclonal banding by the most sensible method (iso-electric focusing of oligoclonal IgG, according to the European consensus).     

Étude du rapport PSA libre/PSA total par 5 systèmes différents dans le cadre du diagnostic précoce du cancer de la prostate

The aim of this prospective study is to compare results obtained with five systems measuring total and free PSA, and to evaluate interest of fPSA/tPSA for prostate cancer diagnostic. We studied patients with suspected prostate cancer, who needed biopsy. Blood was taken before biopsy, for measurement of total and free PSA. Determinations were made with five analytical systems. Results were compared for total PSA and free/total PSA ratio, then analysed in terms of efficiency.Reproducibility, better for total PSA than for free PSA, is satisfactory for all kits, but there is some differences between results obtained. ROC curves are not significantly different from one system to another.In this study, free/total PSA ratio is less discriminative between cancer and non-cancer than PSA density (ratio between total PSA  and gland volume). Definition of a cut-off is difficult. Free/total PSA ratio seems to be an orientation test: towards benign pathology if upper than 20% (VPN = 70%) and towards cancer if lower than 10% (VPP = 52%). Ratio is little contributive between 10 and 20%.     

Évaluation du traitement de la maladie de Kaposi par la vinblastine au Togo: étude de 23 cas

The aim of this study was to evaluate the efficacy of treatment of AIDS-related and non AIDS-related Kaposi’s sarcoma (KS) using vinblastine (Velbé®). A retrospective study was conducted between January 1990 and December 2009 in the Department of Dermatology at the Lomé teaching hospital. The therapeutic protocol is the administration of 10 injections of vinblastine every 15 days. Evaluation was done at 10 weeks, 5 months, 11 months and 17 months. Twenty-three patients including 11 cases of non AIDS-related KS and 12 cases of AIDS-related KS were included in our study. The average age of patients was 39.3 ± 11.2 years. The sex-ratio (M/F) was 6:7. At ten weeks, partial remission was 26% and failure rate was 74%. Side effects as a result of the first five injections were dominated by anemia. At 5 months, complete remission was 17% including 3 cases of non AIDS-related KS, partial remission was 26% including 4 cases of non AIDS-related KS. Side effects of the last five injections were dominated by anemia and nervous toxicity. At 11 months, one patient was lost to follow-up and complete remission persisted in 13% of the patients. At 17 months, complete remission persisted in 9% of the patients against 4% of relapses. No long-term side effects were identified. Our study shows a poor efficacy of vinblastine in the treatment of AIDS-related and non AIDS-related KS and confirms the hematologic and nervous toxicity of this drug. The efficacy is better in the non AIDS-related KS than in the AIDS-related KS.     

Kyste hydatique du cœur au CHU Erriadh de Constantine (Algérie). Étude rétrospective de 2008 à 2009

The hydatic disease is cosmopolitan and is due to the development of the larva of a small tapeworm called Echinococcus granulosus. Although rare, today, there are many cases of hydatic cyst of the heart. Echocardiography and other physical examinations reveal the fluid collection and also specify its exact location on the heart. Our study focused on patients undergoing surgery for hydatic cysts of the heart during the years 2008 and 2009 in Erriadh teaching hospital, where we have collected seven cases over this period. The young average age of patients, 18 years, favors a high incidence. The sex ratio is 0.14. All the heart walls and cavities were the site of hydatic development. In addition, serology for primitive cardiac hydatidosis provided very low levels of antibodies. The cystic echinococcosis remains a scourge. The cardiac localization remains a very severe disease. The management of patients is very complex. The hydatic cyst of the heart affects teenagers and young adults. It is the main cause for long-term, major complications. In patients from endemic areas and for any patient who developed hydatidosis, it is essential to conduct a systematic search for localization by cardiac echocardiography. This simple measure can manage patients more quickly and avoid complications with socioeconomic consequences.     

Étude séroépidémiologique de la circulation du virus West Nile chez l’Homme en Tunisie

West Nile virus (WNV) is an arbovirus classified into the family of Flaviviridae, genus Flavivirus. It is responsible for neurological diseases that occurred frequently as outbreaks and considered as an emerging infection in different regions of the world. In Tunisia, two outbreaks of meningoencephalitis due to this virus occurred, in 1997 and 2003. The virus circulation is studied only in Sahel, region affected by the two epidemics. The aim of this study is to determine if WNV is present in other regions of the country where, up to now, no data are available. A total of 1,854 sera collected from healthy patients were investigated by ELISA to detect specific IgG, during January to December 2007. Patients included are from three governorates: Kairouan, Bizerte, and Sfax. The governorate of Sfax (center of Tunisia) was affected by the two outbreaks, whereas only two cases were observed previously at Kairouan and no cases at Bizerte. Specific IgG were detected in 12.5% of studied population. This seroprevalence varied largely between the three governorates studied. Globally, three regions with different endemicity were described: high endemicity at Kairouan (27.7%), moderate at Sfax (7.5%), and low at Bizerte (0.7%). At Kairouan, the seroprevalence is significantly higher in individuals aged over 40. Our results suggest that WNV circulates in Tunisia; it has a high risk not only in regions affected by previous outbreaks but throughout the country. An active surveillance should be instituted in the country. It must target individuals, and animals, which can be vectors or reservoirs for the virus.