Social and cultural determinants of dental health practices in Morocco: results of a qualitative study

The objective of any health education program is to inculcate healthy life habits to improve the health status of the target population. The evaluation of an oral hygiene health education program for Moroccan schoolchildren implemented a decade ago by oral surgeons does not reveal any improvement of their dental health. To understand the obstacles to the acquisition of good oral hygiene habits, we conducted a qualitative survey of knowledge, attitude, and practices, based on semi-directive interviews with focus groups of children who had participated in the program. The results show that social and cultural determinants play an important role in the lack of impact of these programs and that Bourdieu's theory of action should be applied to understand the processes by which living conditions affect individuals'practices. Thus to inculcate healthy lifestyle habits, an ecological approach that takes into consideration the social, cultural, and economic environment is most likely to induce the emergence of favourable social conditions.     

Decidual natural killer cells: key regulators of placental development (a review)

Establishment of pregnancy initiates a dynamic and predictable series of changes in the uterus. In rodents, the trophectoderm of the blastocyst develops through the stage of an ectoplacental cone to become the placenta. The inner cell mass becomes the fetus and its associated extra-embryonic ectoderm and mesoderm. Maternal changes support development of the conceptus. These begin in the uterine stroma, which undergoes a process known as decidualization, and progress to include dilation and elongation of the uteroplacental arteries and activation and proliferation of specialized large granulated lymphocytes in the decidua basalis. This review focuses on these pregnancy-associated lymphocytes, known as uterine Natural Killer (uNK) cells and on their interactions with the other tissues that form the mesometrial aspect of the mouse maternal-fetal interface. Analogous lymphocytes are present in the decidualized human uterus. Understanding of uNK cell biology has advanced significantly through histological studies of implantation sites in immune deficient mice. Here, we summarize the key studies in lymphocyte-, cytokine- and cytokine receptor-deficient mice and in four enhanced models of gestation in these mice that incorporate transplantation or therapy with biologically active molecules.     

Adult primary myelodysplastic syndromes. Report of 36 cases

Between 1989 and 1999, 36 cases with primary myelodysplastic syndromes were diagnosed. They were 15 male and 21 females, the median age was 62 years (range: 22 to 90 years). Eighty one per cent of patients were presented symptoms of anemia. Lymphadenopathy, splenomegaly and skin manifestations were noted in 25% of cases. Hemogram showed anemia, leucopenia and thrombocytopenia respectively in 97%, 44% and 55% of cases. Refractory anemia with excess blasts (AREB) is the most frequent FAB subtypes of MDS (17 cases). Cytogenetic study concerned 24 patients. In 13 cases the karyotype was pathological with deletion 5 q in 64% of cases. Seventeen patients have received a chemotherapy. Survival rate to 36 months is 11%. At the time, the only curative treatment is the bone marrow transplantation, which is proposed to young patients with HLA identical donor.     

Drug interactions with herbal medicines

The use of herbal medicines (HM) is on the rise among the global population. Although the safety profile of many herbal medicines is promising, accumulated data show evidence of significant interactions with medications, which can place individual patients at great risk. A range of electronic databases have been reviewed for articles published in this field: Medline, Allied and Complementary Medicine Database, HealthSTAR, AMBASE, CINHAL, Cochrane Library, as well as Internet documents and manually searched references in medical journals. In this review, we examined the literature from 1966 to 2006 and focused on the importance of the risk of drug interactions and potential side effects when HM are involved. We discuss these in light of the documented findings. A review of the problematic issues is given and recommendations are made in order to encourage the setting up of clinical trials on HM and herb-drug interactions.     

Rottlerin inhibits human T cell responses

Rottlerin is a pharmacological inhibitor of protein kinase C (PKC) theta, a novel PKC selectively expressed in T lymphocytes. PKC theta is known to regulate T cell receptor (TCR)/CD28 signalling pathways in T lymphocytes, but the impact of PKC theta inhibition on human T cell responses remains undefined. In this work, we describe the effects of rottlerin on the responses of CD4+ and CD8+ human T lymphocytes upon polyclonal activation. We observed a dose-dependent inhibition of CD4+ and CD8+ T cell proliferation in response to anti-CD3/anti-CD28 antibodies stimulation in the presence of rottlerin. This inhibition was associated with impaired CD25 expression and decreased interleukin (IL)-2 production in activated T cells. In contrast, rottlerin did not alter IL-2-induced T cell proliferation. Furthermore, we demonstrated that rottlerin blocked interferon (IFN) gamma, IL-10 and IL-13 mRNA expression in TCR/CD28 activated CD4+ T cells. These findings place rottlerin as a potent immunosuppressive agent for the development of novel therapies in T cell mediated immune disorders.     

A huge cardiac hydatid cyst: An unusual cause of chest pain revealing multivisceral hydatidosis in a young woman

Hydatid disease remains endemic in some parts of the world. Cardiac hydatidosis with multivisceral involvement is uncommon but potentially fatal. We report the case of a 36-year-old Tunisian woman admitted with chest pain and T-wave inversion in the inferior leads on her electrocardiogram. Transthoracic echocardiography revealed a large hydatid cyst in the epicardium throughout the left ventricle. Thoraco-abdominal computerized tomography (CT) scan showed several hydatid cysts in the left lung, the liver, and in both breasts.After one week of albendazole treatment, surgical excision of the cardiac cyst on cardiopulmonary bypass was carried out as well as excision of the pulmonary and breast cysts. The postoperative course was uneventful and albendazole treatment was continued for six months. Though hydatid cardiac involvement is very rare, it should be considered in the differential diagnosis of atypical chest pain in young patients, especially those living in regions where hydatid disease is endemic.