Detection and molecular typing of human papillomaviruses: prevalence of cervical infection in the Tunisian central region

There are compelling molecular and epidemiological data which indicate that infection with certain genital human papillomaviruses (HPVs), such as HPV 16 and HPV 18, has a critical role in initial changes that lead to cervical and probably other anogenital cancers. These observations prompted us to investigate the prevalence of cervical infection with genital human papillomaviruses in Tunisia. We used the polymerase chain reaction (PCR) to detect and type HPV DNA. The prevalence of HPV infection in a population of 106 Tunisian women recruited at the Offices Nationaux de la Famille et de Population (ONFP) was 13.6%. Molecular HPV typing indicated a high prevalence of HPV at high oncogenic risk; Our results indicate that the infection with genital human papillomaviruses is frequent in the Tunisian population.     

Nosocomial outbreak of acute gastroenteritis in a neonatal intensive care unit in tunisia caused by multiply drug resistantSalmonella wien producing SHV-2 beta-lactamase

In a Tunisian hospital 27 babies, including 12 who were premature, in a single intensive care unit suffered acute gastroenteritis in the period from January to May 1988. The mean age at the onset of gastroenteritis was 8.4 days; nine babies died.Salmonella wien was isolated from stools (all babies) and blood (4 babies). It was also isolated from the stools of one nurse and from a mattress. Twelve of the babies had received cefotaxime, which was successfully replaced by oral colimycin. The outbreak was stopped by the implementation of infection control measures. All isolates ofSalmonella wien were of the same biotype, and had the same antibiotic resistance pattern (third generation cephalosporins, monobactams, aminoglycosides, chloramphenicol, trimethoprim and sulphonamides) and plasmid DNA restriction pattern. The isolates were all susceptible to a combination of cefotaxime and clavulanic acid (a -lactamase inhibitor), which displayed synergy, suggesting the presence of a -lactamase (geometric mean MICs 11.24 µg/ml for cefotaxime alone and 0.24 µg/ml in combination with 0.1 µg/ml potassium clavulanate). All isolates produced TEM-1 and SHV-2 -lactamase which was not transferable toEscherichia coli by conjugation. The presence of the SHV-2 enzyme inSalmonella wien may allow it to adapt to newer -lactams which is a cause for concern in this hospital.     

Narasin poisoning in the dromedary camel (Camelus dromedarius)

Narasin poisoning was reported in 15 camels, 7 adults and 8 young, after accidental access to poultry feed medicated with 60 g narasin per ton. Fourteen camels died between 3 and 20 days, and one young animal survived the dose after developing a chronic course of a disease. The main clinical signs of narasin toxicity in the dromedary include: weakness of hind limbs, lack of coordination, oedema of dependent parts, inappetence, ruminal atony, myoglobinuria, profound depression, tachycardia, sternal recumbency and death. The lesions were mainly in the heart and skeletal muscles and consisted of multifocal degeneration and necrosis of heart and skeletal muscle fibres with areas of regeneration and lung oedema. There was high enzyme activity for creatine kinase (CK), lactate dehydrogenase, aspartate aminotransferase and alanine aminotransferase and an increase in urea concentration and white blood cells, neutrophil and platelet counts. Cardiac markers, troponin T, CK-MB and C-reactive protein, showed slight or no changes terminally.     

Anasarque fœtoplacentaire et hypothyroïdie congénitale

Hydrops fetalis (HF) is characterized by the presence of soft tissue effusions including pleural, pericardial effusions and ascites. The incidence of immune hydrops fetalis has markedly declined after the use of Rh (D) immune globulin prophylaxis and the non-immune HF have become the most common. We report the case of a premature newborn with HF diagnosed at 32 weeks of GA with congenital hypothyroidism. The child has no medical history with Rh positive blood group and negative indirect Coombs test. At birth, the newborn presented generalized oedema and needed mechanical ventilation with chest and ascites paracentesis. The pleural fluid was in favor of a chylothorax. He had no anemia or neurological, renal, cardiac or digestive malformations. Because of skin oedema, persistent pleural effusion and lethargy, laboratory tests of the thyroid function were performed and showed a low serum l-thyronine (T4) level and an elevated thyroid-stimulating hormone (TSH) level thereby confirming the diagnosis of congenital hypothyroidism. This article describes the relation between hypothyroidism and chylothorax, based on a review of literature. Because of the importance of early diagnosis, the tests of the thyroid function must be a part of HF investigation, especially in countries where neonatal screening is not done.     

Thymoquinone protects rat liver after partial hepatectomy under ischaemia/reperfusion through oxidative stress and endoplasmic reticulum stress prevention

Ischaemia reperfusion (I/R) is associated with liver injury and impaired regeneration during partial hepatectomy (PH). The aim of this study was to investigate the effect of thymoquinone (TQ), the active compound of essential oil obtained from Nigella sativa seeds, on rat liver after PH. Male Wistar rats were divided equally into four groups (n = 6) receiving an oral administration of either vehicle solution (sham and PH groups) or TQ at 30 mg/kg (TQ and TQ + PH groups) for 10 consecutive days. Then, rats underwent PH (70%) with 60 minutes of ischaemia followed by 24 hours of reperfusion (PH and TQ + PH groups). Alanine aminotransferase (ALT) activity and histopathological damage were determined. Also, antioxidant parameters, liver regeneration index, hepatic adenosine triphosphate (ATP) content, endoplasmic reticulum (ER) stress and apoptosis were assessed. In response to PH under I/R, liver damage was significantly alleviated by TQ treatment as evidenced by the decrease in ALT activity (P < .01) and histological findings (P < .001). In parallel, TQ preconditioning increased hepatic antioxidant capacities. Moreover, TQ improved mitochondrial function (ATP, P < .05), attenuated ER stress parameters and repressed the expression of apoptotic effectors. Taken together, our results suggest that TQ preconditioning could be an effective strategy to reduce liver injury after PH under I/R. The protective effects were mediated by the increase of antioxidant capacities and the decrease of ER stress and apoptosis.     

The Neglected Lead on Electrocardiogram: T Wave Inversion in Lead aVL,Nonspecific Finding or a Sign for Left Anterior Descending Artery Lesion?

Background

The electrocardiogram (ECG) is the most important diagnostic tool for acute myocardial infarction (AMI). T wave inversion (TWI) in lead aVL has not been emphasized or well recognized.

Objective

This study examined the relationship between the presence of TWI before the event and mid-segment left anterior descending (MLAD) artery lesion in patients with AMI.

Methods

Retrospective charts of patients with acute coronary syndrome between the months of January 2009 and December 2011 were reviewed. All patients with MLAD lesion were identified and their ECG reviewed for TWI in lead aVL.

Results

Coronary angiography was done on 431 patients. Of these, 125 (29%) had an MLAD lesion. One hundred and six patients (84.8%) had a lesion > 50% and 19 patients (15.2%) had a lesion < 50%. Of the 106 patients who had a MLAD lesion > 50%, 90 patients (84.9%) had TWI in lead aVL and one additional lead. Of the 19 patients who had an MLAD lesion < 50%, 8 patients (42.1%) had TWI in lead aVL and one additional lead. Isolated TWI in lead aVL had an overall sensitivity of 76.7% (95% confidence interval [CI] 0.65–0.86), a specificity of 71.4% (95% CI 0.45–0.88), a positive predictive value of 92%, a negative predictive value of 41.7%, a positive likelihood ratio of 2.7 (95% CI 1.16–6.22), and negative likelihood ratio of 0.32 (95% CI 0.19–0.58) for predicting a MLAD lesion of > 50% (p = 0.0011).

Conclusions

TWI in lead aVL might signify a mid-segment LAD lesion. Recognition of this finding and early appropriate referral to a cardiologist might be beneficial. Additional studies are needed to validate this finding.     

Uptake and metabolism of carbamazepine (CBZ) by clam Ruditapes decussatus and its effects in biochemical responses

1. Laboratory experiments were carried out to assess uptake and metabolism of the epilepsy drug, carbamazepine and its consequent biological responses in marine clam (Ruditapes decussatus) a model non-target organism in ecotoxicology.

2. Clams were exposed to two nominal concentrations (C1?=?30?μg/L and C2?=?50?μg/L) of CBZ for a maximum period of 14 days. Analysis of CBZ and their metabolites in clam and water after exposure to two nominal concentrations of the pharmaceutical drug were performed using UPLC-HRMS analysis. CBZ accumulation reached an average tissue concentration of 1241.59 ng/g dw and 1664.33 ng/g dw at low and high nominal concentration, respectively.

3. Furthermore, a metabolite (3-hydroxy-CBZ) was detected in tissues indicating carbamazepine translocation and metabolism inside clam, suspect screening of CBZ glucuronides was also performed by accurate mass extraction but it could not be detected.

4. Activities of antioxidant enzymes superoxide dismutase, catalase and gluthatione-S-transferase generally increased. Change in the contents of glutathione, malondialdehyde and protein carbonyl were also studied.

5. Results indicated that the bioaccumulation of CBZ resulted in the changes of the antioxidant defense system and the production of ROS with the oxidative stress, ultimately induced alteration in lipid peroxidation and protein carbonyl.