The medical abortion experiences of married and unmarried women in Tunis, Tunisia

CONTEXT: The study explores the social dimensions of abortion in Tunisia and offers evidence supporting the provision of medical abortion to special populations, such as young and unmarried women. METHODS: For this study we recruited 222 women (unmarried: n = 101, married: n = 121) at three clinics in Tunis, Tunisia, from April 1999 to March 2001. All eligible women who consented to participate were administered a simplified regimen of medical abortion consisting of 200 mg oral mifepristone + 400 microg oral misoprostol 2 days later either at home or in the clinic. RESULTS: Our results demonstrate that unmarried women (94.8%) are as likely as married women (94.1%) to have a successful abortion using this regimen. We noted a strong initial preference for home administration of misoprostol among both groups (unmarried: 73.3%, married: 80.2%), which grew even stronger after the procedure. Women indicated that home administration is desirable because transportation to the clinic is expensive (32.7%), home administration is more confidential (26.3%), easier and more convenient (12.8%). Both groups expressed a high degree of satisfaction with the method. CONCLUSIONS: Medical abortion with the option of home administration of misoprostol is safe and feasible for special populations; such as unmarried women in Tunisia.     

Time-Scale Feature Extractions for Emotional Speech Characterization

Emotional speech characterization is an important issue for the understanding of interaction. This article discusses the time-scale analysis problem in feature extraction for emotional speech processing. We describe a computational framework for combining segmental and supra-segmental features for emotional speech detection. The statistical fusion is based on the estimation of local a posteriori class probabilities and the overall decision employs weighting factors directly related to the duration of the individual speech segments. This strategy is applied to a real-world application: detection of Italian motherese in authentic and longitudinal parent–infant interaction at home. The results suggest that short- and long-term information, respectively, represented by the short-term spectrum and the prosody parameters (fundamental frequency and energy) provide a robust and efficient time-scale analysis. A similar fusion methodology is also investigated by the use of a phonetic-specific characterization process. This strategy is motivated by the fact that there are variations across emotional states at the phoneme level. A time-scale based on both vowels and consonants is proposed and it provides a relevant and discriminant feature space for acted emotion recognition. The experimental results on two different databases Berlin (German) and Aholab (Basque) show that the best performance are obtained by our phoneme-dependent approach. These findings demonstrate the relevance of taking into account phoneme dependency (vowels/consonants) for emotional speech characterization.     

The antiproliferative function of violacein-like purple violet pigment (PVP) from an Antarctic Janthinobacterium sp. Ant5-2 in UV-induced 2237 fibrosarcoma

Background In this study, we have investigated the chemotherapeutic potential of a purple violet pigment (PVP), which was isolated from a previously undescribed Antarctic Janthinobacterium sp. (Ant5‐2), against murine UV‐induced 2237 fibrosarcoma and B16F10 melanoma cells. Methods The 2237, B16F10, C50, and NIH3T3 cells were treated with PVP at different doses and for different times, and their proliferation and viability were detected by 3‐[4,5‐dimethylthiazol‐2‐yl]‐2,5‐diphenyltetrazolium bromide (MTT) assay. Cell cycle arrest induced by PVP in 2237 fibrosarcoma cells was assessed by flow cytometry and expression analysis of cell cycle regulatory proteins were done by Western blot. Apoptosis induced by PVP in 2237 cells was observed by annexin‐V/propidium iodide double staining flow cytometry assay and fluorescence microscopy. To further determine the molecular mechanism of apoptosis induced by PVP, the changes in expression of Bcl‐2, Bax and cytochrome c were detected by Western blot. The loss of mitochondrial membrane potential in PVP treated 2237 cells was assessed by staining with JC‐1 dye following flow cytometry. Caspase‐3, Caspase‐9 and PARP cleavage were analyzed by Western blot and Caspase‐3 and ‐9 activities were measured by colorimetric assays. Results In vitro treatment of murine 2237 cells with the PVP resulted in decreased cell viability (13–79%) in a time (24–72 h) and dose (0.1–1 μm )‐dependent manner. The PVP‐induced growth inhibition in 2237 cells was associated with both G0/G1 and G2/M phase arrest accompanied with decrease in the expression of cyclin dependent kinases (Cdks) and simultaneous increase in the expression of cyclin dependent kinase inhibitors (Cdki) – Cip1/p21 and Kip1/p27. Further, we observed a significant increase in the apoptosis of the 2237 fibrosarcoma cells which was associated with an increased expression of pro‐apoptotic protein Bax, decreased expression of anti‐apoptotic proteins Bcl‐2, disruption of mitochondrial membrane potential, cytochrome c release, activation of caspase‐3, caspase‐9 and poly‐ADP‐ribose‐polymerase (PARP) cleavage. Conclusions We describe the anti‐cancer mechanism of the PVP for the first time from an Antarctic bacterium and suggest that the PVP could be used as a potent chemotherapeutic agent against nonmelanoma skin cancers.     

Prognostic Factors of Prostate Cancer in Tunisian Men: Immunohistochemical Study

Background: Prostate cancer is the second most common male cancer and remains a leading cause of cancer death worldwide. Heterogeneity regarding recurrence, tumor progression and therapeutic response reflects the inadequacy of traditional prognostic factors and underlies interest in new genetic and molecular markers. In this work, we studied the prognostic value of the expression of 9 proteins, Ki-67, p53, Bcl-2, PSA, HER2, E-cadherin, p21WAF1/Cip1, p27Kip1 and p16ink4a in prostate cancer. Materials and Methods: We conducted a retrospective study of 50 prostate cancers diagnosed in Pathology Department of Farhet Hached Hospital, Sousse, Tunisia, during a period of 12 months. Clinico-pathological data and survival were investigated. Protein expression was analyzed by immunohistochemistry on archived material. Results: Expression or over-expression of Ki-67, p53, Bcl-2, PSA, HER2, E-Cadherin, p21WAF1/Cip1, p27Kip1 and p16ink4a was observed in 68%, 24%, 32%, 78%, 12%, 90%, 20%, 44% and 56% of cases, respectively. Overall five-year survival was 68%. A statistically significant correlation was observed between death occurrence and advanced age (p=0.018), degree of tumor differentiation (p=0.0001), perineural invasion (p=0.016) and metastasis occurrence (p=0.05). Death occurrence was significantly correlated with the expression of p53 (p=0.007), Bcl-2 (p=0.02), Ki-67 (p=0.05) and p27Kip1 (p=0.04). Conclusions: The p53, Bcl-2, Ki-67 and p27Kip1 proteins may be useful additional prognostic markers for prostate cancer. The use of these proteins in clinical practice can improve prognosis prediction, disease screening and treatment response of prostatic cancer.     

Familial Mediterranean fever in the Syrian population: gene mutation frequencies, carrier rates and phenotype-genotype correlation

BACKGROUND: Familial Mediterranean fever (FMF) is an autosomal recessive disease mainly affecting particularly Arabs, Non-Ashkenazi Jews, Armenians, and Turks. It is an autoinflammatory periodic disorder characterized by febrile and painful attacks due to inflammation involving the serosal membranes in the abdomen, chest or joints. Over 50 mutations have been identified in the MEFV gene responsible for FMF. OBJECTIVE: To identify the distribution and the frequency of the MEFV gene mutations in Syrian FMF patients and population and perform a genotype/phenotype correlation in the patients' cohort. PATIENTS AND METHODS: The study was carried out on 83 clinically diagnosed Syrian FMF patients and 242 healthy subjects. The tested individuals were screened for the most common five MEFV mutations (M694V, M694I, M680I, V726A and E148Q) by restriction fragment length polymorphism. Sequencing of exon 10 was performed only for the patients' DNA where just one or no mutation was detected. RESULTS AND DISCUSSION: Of the 83 patients studied, 74 (89%) were positive either for one, two or three mutations and nine (11%) had no mutations detected. Of those positive for mutations, 25 were homozygous, 30 were compound heterozygotes, three had complex alleles, and 16 patients had only one mutation. The M694V, V726A, M694I, M680I and E148Q mutations accounted for 45.8%, 26%, 13.9%, 4.8% and 6% of the alleles, respectively. The carrier rate in the Syrian population for the tested mutations was 17.5%, E148Q being the most common mutation, followed by V726A and M694V. The severity of the disease and development of amyloidosis seem to have an association with M694V, the most common mutation in Syrian FMF patients.     

Evaluation of the hemodynamic profile of mitral Saint Jude Medical prostheses in the early and late postoperative period

This study was to estimate the Doppler haemodynamic profiles of 56 prosthetic mitral valves (St Jude prosthesis) in the premature post-operating period, to study the correlation of the prosthetic area calculated by Doppler method (continuity equation (CE) and pressure half times (PHT)) and the area of the effective orifice in the post-operating premature period, in 6 weeks and after 6 months. The values of peak gradient and mean gradient at six week and at 12.5 months were not significantly different from those obtained in the premature exam. The prosthetic area calculated by continuity equation (ACE) in the premature postoperative period was significantly different between the various size (p = 0.0001). The (ACE) measured at 6 weeks and late (12.5 months), was not significantly different from that calculated in the premature exam (respectively p = 0.79 and p = 0.8). The (PHT) was very variable even within the different size of the prosthesis, however values measured at six weeks and in the late exam was not different from that calculated in the premature exam. In absence of complications, it seems to us that we can satisfy with using as reference exam data obtained in the premature exam.     

Hydatid cyst of the right atrium and rheumatic mitral disease: a fortuitous association

Ecchinococcal infestation of the heart accounts for only 0.5-2% of ecchinococcosis cases. A case is reported of right atrial hydatid cyst associated with rheumatic mitral valve disease in a 43-year-old woman. Physical examination and chest X-radiography revealed mitral disease. Transthoracic and transesophageal echocardiography demonstrated a single, large cystic mass of 4 x 4 cm located in the right atrium, and heavily calcified mitral rheumatic disease with commissural fusion. Confirmatory computed tomography and magnetic resonance imaging excluded other extracardiac locations. Radioisotopic lung perfusion scanning and angiographic scanning excluded pulmonary embolism. The patient underwent mitral valve replacement and the hydatid cyst was excised. An intraoperative examination and subsequent pathology confirmed a diagnosis of hydatid cyst.     

Cervical cancer screening by Pap smear: experience of the National Research Center in Reproductive Health. ONFP

We have analysed the result of 17,173 pap smears screened in the national research center in reproductive health of Ariana from 1 may 1993 to 30 april 1997. Among these pap smears, 613 colposcopy and 380 biopsy have been performed. The results show that: 1.9% of pap smears present cytological anomalies with 0.79% of low Squamous Intraepithelial lesions and 0.66% high Squamous Intraepithelial lesions. The incidence of CIN III is 1.8% and 0.9% for invasive cancer. The age interval 35-44 years is at high risk of CIN III and invasive cancer of the cervix. evaluation of our diagnostic approach shows that: positive predictive value of pap smears with low SLI is 43.2% positive predictive value of pap smears with high SLI is 37.3%.