First molecular detection of Rickettsia felis in fleas from Algeria

Fleas collected in Algeria in the district of Oran between July and September 2003 were tested by polymerase chain reaction for the presence of Rickettsia spp. DNA using primers amplifying gltA and OmpA genes. Two gltA sequences identical to those of an emerging pathogen, Rickettsia felis, were detected including i) R. felis California 2 in Ctenocephalides canis from rodents and ii) R. felis RF2125 in Archeopsylla erinacei from hedgehogs.     

Evaluation of Pistacia lentiscus seed oil and phenolic compounds for in vitro antiproliferative effects against BHK21 cells

Context: Within the global context of increasing cancer diseases, natural products are important in devising new drugs and providing unique ideas in cancer therapy. In Tunisian folk medicine, Pistacia lentiscus L. (Anacardiaceae) fixed oil is used for cancer treatment.

Objective: This investigation studied, for the first time, the antiproliferative effect of Pistacia lentiscus fixed oil and its phenolic extract on BHK21 cancer cells.

Materials and methods: Oil was extracted from fruits harvested in northwest Tunisia and the phenolic fraction was obtained by mixing with methanol. The anti-proliferative activity of the two tested substances on BHK 21 cells were investigated in vitro using trypan blue assays. Cells were treated with different concentrations of P. lentiscus oil (0.009, 0.018, 0.036, and 0.09 g/mL) and the phenolic extract (0.007, 0.014, 0.03, and 0.07 g/mL) for 24, 48, and 72 h.

Results: The inhibitory effect of Pistacia lentiscus fixed oil increases with the increase in dose. The IC₅₀ value was estimated at 0.029 g/mL. The percentage of cell viability was 42.46 ± 3.4% at a dose of 0.09 g/mL and was significantly lower than that of the untreated control (96.24 ± 2.5%, p<0.01). The phenolic extract demonstrated a dose- and time-dependent inhibitory effect on BHK21 cell growth. After 48 h of incubation, the IC₅₀ value was estimated at 0.15 g/mL.

Discussion and conclusion: The results demonstrated the potential of Pistacia lentiscus fixed oil in treating cancer, as it is used in traditional medicine.     

Identification of N1-methyl-2-pyridone-5-carboxamide and N1-methyl-4-pyridone-5-carboxamide as components in urine extracts of individuals consuming coffee

Caffeine metabolites were extracted from urine samples collected 4 h after consumption of a cup of coffee and were separated by high-performance liquid chromatography (HPLC) on a C18 (5 microm) reverse-phase column using an acetonitrile (5%), acetic acid (0.05%) solution as the mobile phase. The elution profiles indicated the constant presence of a major and a minor components eluting between the caffeine metabolites 5-acetamido-6-formyl-3-methyluracil (AFMU) and 7-methylxanthine (7X) in an approximate nine. A procedure was developed for the isolation of the major component in an apparent pure form, and the yield was 10-20 mg from 400 ml of urine. The minor component was isolated in an apparent pure form by this procedure as well, and the yield was 0.5 mg from 200 ml of urine. The average ratio of the two components in urine, UV absorption and 1H-NMR spectra of the two components, and 13C-NMR spectrum, mass spectrum and elemental analysis of the major component identified the major and minor components as N(1)-methyl-2-pyridone-5-carboxamide and N(1)-methyl-4-pyridone-5-carboxamide, respectively, two major metabolites of the vitamin niacin present in a significant amount in coffee beans. The two metabolites were present in the same average amount in urine extracts of individuals irregardless of coffee consumption. The findings are briefly discussed in relation to the nutritional sources of niacin and to current procedures for measuring amounts of the two metabolites in urine samples.     

Abnormalities of haemostasis in myocardial infarction with normal coronary artery

Myocardial infarction with normal coronary artery is ussually inaugural, with electric and clinical characteristics similar to those with atheroma. The role of constitutional or acquired abnormalities of haemostasis has been more incriminated in the pathogenesis of myocardial infarction with normal coronary. The aim of our study was to research abnormalities of haemostasis in patients with myocardial infarction and angiographically absolutely normal coronary arteries. PATIENTS AND METHODS: Thirty nine patients with myocardial infarction and normal coronary arteries where included in our study. They were 33 males and 6 females aged between 22 and 75 years (44 + 13 years), in whom the deficiency in protein C and S. antithrombin, activated protein C resistance and antiphospholipid antibodies were assessed. RESULTS: Concurrent abnormalities of haemostasis were found in 10 patients: Antiphospholipid antibodies, found in 5 patients constitute the most frequent abnormality. The other abnormalities were deficiency in protein C in two cases, deficiency in protein S 2 cases, deficiency in antithrombin in 2 ceses and activated protein C resistance in 3 cases . CONCLUSION: In our study. in face of the high prevalence of these abnormalities, it seems reasonable to research them, especially in young patients with myocardial infarction with normal coronary artery. This should have an impact on the management of these patients.     

Validation and comparative evaluation of four osteoporosis risk indexes in Moroccan menopausal women

Introduction Measuring bone mineral density (BMD) is a widely accepted strategy for identifying subjects with an increased risk of fracture. However, because of limited availability of BMD technology in some communities and cost considerations, it has been proposed that BMD measurements be targeted to subjects with risk factors for osteoporosis. Recently, many risk assessment indices have been developed to identify women who are more likely to have low BMD and thus undergo BMD testing. The objective of this study was to compare the performance of four risk indices for osteoporosis in white women in Morocco. Methods We analysed in an epidemiological cross-sectional study the records for 986 postmenopausal white Moroccan women seen at an out-patient rheumatology centre. Four osteoporosis risk index scores were compared to bone density T-scores. The ability of each risk index to identify women with low BMD (T-score<−2.0) or osteoporosis (T<−2.5) was evaluated. Results Using an Osteoporosis Self-Assessment Tool (OST) score<2 to recommend DXA referral, we found that sensitivity ranged from 61% at the lumbar spine to 85% at the total hip to detect BMD T-scores of −2.5, and specificity ranged from 62% at the lumbar spine to 67% at the total hip. The negative predictive value was high at all skeletal sites (79–98%), demonstrating the usefulness of the OST to identify patients who have normal BMD and should not receive DXA testing. All risk indices performed similarly and showed better results in identifying women with osteoporosis or low BMD based on hip measurement. Conclusions This is the first study that validated several risk osteoporosis indexes in Moroccan women. The performance of these risk indices among women in Morocco was similar to that reported earlier for other samples in Asian countries, the US, and Belgium. The OST and other risk indices are effective and efficient tools to help target high-risk women for DXA measurement.     

Robotic Versus Laparoscopic Adrenalectomy: A Systematic Review and Meta-analysis

Context

Over the last decade, robot-assisted adrenalectomy has been included in the surgical armamentarium for the management of adrenal masses.

Objective

To critically analyze the available evidence of studies comparing laparoscopic and robotic adrenalectomy.

Evidence acquisition

A systematic literature review was performed in August 2013 using PubMed, Scopus, and Web of Science electronic search engines. Article selection proceeded according to the search strategy based on Preferred Reporting Items for Systematic Reviews and Meta-analysis criteria.

Evidence synthesis

Nine studies were selected for the analysis including 600 patients who underwent minimally invasive adrenalectomy (277 robot assisted and 323 laparoscopic). Only one of the studies was a randomized clinical trial (RCT) but of low quality according to the Jadad scale. However, the methodological quality of included nonrandomized studies was relatively high. Body mass index was higher for the laparoscopic group (weighted mean difference [WMD]: −2.37; 95% confidence interval [CI], − 3.01 to −1.74; p < 0.00001). A transperitoneal approach was mostly used for both techniques (72.5% of robotic cases and 75.5% of laparoscopic cases; p = 0.27). There was no significant difference between the two groups in terms of conversion rate (odds ratio [OR]: 0.82; 95% CI, 0.39–1.75; p = 0.61) and operative time (WMD: 5.88; 95% CI, −6.02 to 17.79; p = 0.33). There was a significantly longer hospital stay in the conventional laparoscopic group (WMD: −0.43; 95% CI, −0.56 to −0.30; p < 0.00001), as well as a higher estimated blood loss (WMD: −18.21; 95% CI, −29.11 to −7.32; p = 0.001). There was also no statistically significant difference in terms of postoperative complication rate (OR: 0.04; 95% CI, −0.07 to −0.00; p = 0.05) between groups. Most of the postoperative complications were minor (80% for the robotic group and 68% for the conventional laparoscopic group). Limitations of the present analysis are the limited sample size and including only one low-quality RCT.

Conclusions

Robot-assisted adrenalectomy can be performed safely and effectively with operative time and conversion rates similar to laparoscopic adrenalectomy. In addition, it can provide potential advantages of a shorter hospital stay, less blood loss, and lower occurrence of postoperative complications. These findings seem to support the use of robotics for the minimally invasive surgical management of adrenal masses.     

Molecular Evidence of Bartonella Infection in Domestic Dogs from Algeria,North Africa,by Polymerase Chain Reaction (PCR)

Bartonella species are being recognized as important bacterial human and canine pathogens, and are associated with multiple arthropod vectors. Bartonella DNA extracted from blood samples was obtained from domestic dogs in Algiers, Algeria. Polymerase chain reaction (PCR) and DNA sequence analyses of the ftsZ gene and the 16S-23S intergenic spacer region (ITS) were performed. Three Bartonella species: Bartonella vinsonii subsp. berkhoffii, Bartonella clarridgeiae, and Bartonells elizabethae were detected infecting Algerian dogs. To our knowledge, this study is the first report of detection by PCR amplification of Bartonella in dogs in North Africa.