Impact des facteurs psychosociaux sur la santé mentale du personnel de nettoyage

Purpose

To describe the relationship between psychosocial factors and mental health among housekeepers.

Primary hydatidosis of the central nervous system: A retrospective study of 39 Tunisian cases

Objective

To analyze epidemiological characteristics, clinical symptoms, radiological aspects, treatment and outcome of central nervous system hydatidosis and compare our results with those reported in literature.

Patients and methods

In our retrospective study, we reviewed 39 cases of primary central nervous system hydatid cysts operated on in our hospital between 1998 and 2007.

Results

There were 20 male and 19 female patients (sex-ratio M/F = 1.05) between 2 and 68 years of age (mean = 26.5 years). Thirteen of the patients were children (33.3%) with a mean age of 6.8 years and 26 were adults (66.7%) with a mean age of 36.3 years. The location of hydatid cysts was intracranial in 27 cases (69.2%) and spinal in 12 cases (30.8%). Headache and motor deficits were the predominant symptoms in patients with intracranial hydatidosis whereas back pain and spinal cord compression syndrome were the most frequent clinical presentations in patients with spinal hydatidosis. All patients underwent surgical resection of the cyst. Pathologic findings were consistent with hydatid cyst in all cases. During the follow-up period which ranged between 12 months and 5 years, 12 patients had recurrence (30.7%). Only one patient with intracranial hydatid cyst died postoperatively due to anaphylactic shock.

Conclusion

Despite all the advances in imaging techniques and therapeutic methods, central nervous system hydatidosis remains difficult to cure and patient outcomes are not satisfactory especially in case of spinal involvement due to the high incidence of recurrence.     

Plasticity of the Superior and Middle Cerebellar Peduncles in Musicians Revealed by Quantitative Analysis of Volume and Number of Streamlines Based on Diffusion Tensor Tractography

This work was conducted to study the plasticity of superior (SCP) and middle (MCP) cerebellar peduncles in musicians. The cerebellum is well known to support several musically relevant motor, sensory and cognitive functions. Previous studies reported increased cerebellar volume and grey matter (GM) density in musicians. Here, we report on plasticity of white matter (WM) of the cerebellum. Our cohort included 10/10 gender and handedness-matched musicians and controls. Using diffusion tensor imaging, fibre tractography of SCP and MCP was performed. The fractional anisotropy (FA), number of streamlines and volume of streamlines of SCP/MCP were compared between groups. Automatic measurements of GM and WM volumes of the right/left cerebellar hemispheres were also compared. Musicians have significantly increased right SCP volume (p = 0.02) and number of streamlines (p = 0.001), right MCP volume (p = 0.004) and total WM volume of the right cerebellum (p = 0.003). There were no significant differences in right MCP number of streamlines, left SCP/MCP volume and number of streamlines, SCP/MCP FA values, GM volume of the right cerebellum and GM/WM volumes of the left cerebellum. We propose that increased volume and number of streamlines of the right cerebellar peduncles represent use-dependent structural adaptation to increased sensorimotor and cognitive functional demands on the musician's cerebellum.     

Low-Frequency Electrical Stimulation Attenuates Muscle Atrophy in CKD—A Potential Treatment Strategy

Effective therapeutic strategies to treat CKD-induced muscle atrophy are urgently needed. Low-frequency electrical stimulation (LFES) may be effective in preventing muscle atrophy, because LFES is an acupuncture technique that mimics resistance exercise by inducing muscle contraction. To test this hypothesis, we treated 5/6-nephrectomized mice (CKD mice) and control mice with LFES for 15 days. LFES prevented soleus and extensor digitorum longus muscle weight loss and loss of hind-limb muscle grip in CKD mice. LFES countered the CKD-induced decline in the IGF-1 signaling pathway and led to increases in markers of protein synthesis and myogenesis and improvement in muscle protein metabolism. In control mice, we observed an acute response phase immediately after LFES, during which the expression of inflammatory cytokines (IFN-γ and IL-6) increased. Expression of the M1 macrophage marker IL-1β also increased acutely, but expression of the M2 marker arginase-1 increased 2 days after initiation of LFES, paralleling the change in IGF-1. In muscle cross-sections of LFES-treated mice, arginase-1 colocalized with IGF-1. Additionally, expression of microRNA-1 and -206, which inhibits IGF-1 translation, decreased in the acute response phase after LFES and increased at a later phase. We conclude that LFES ameliorates CKD-induced skeletal muscle atrophy by upregulation of the IGF-1 signaling pathway, which improves protein metabolism and promotes myogenesis. The upregulation of IGF-1 may be mediated by decreased expression of microRNA-1 and -206 and/or activation of M2 macrophages.     

Amiloride derivatives modulate PS externalization in neutrophil-like PLB-985 cells

During brain or cardiac ischemia/reperfusion neutrophils are recruited and activated contributing to inflammation and tissue damage. Neutrophils are removed from inflamed tissues by phosphatidylserine-dependent phagocytosis. Production of reactive oxygen species by the neutrophil NADPH-oxidase is known to affect phosphatidylserine externalization. Amiloride derivatives are inhibitors of the sodium-proton exchanger providing substantial protection in animal models of brain and cardiac ischemia/reperfusion injury; however their effects on neutrophils remain incompletely known. We investigated the effect of 5-(N,N-hexomethylene)amiloride (HMA) on phosphatidylserine externalization in wild type and NADPH-oxidase deficient PLB-985 cells differentiated into neutrophils. We show that HMA had a dual effect: (1) 60 μM HMA induced phosphatidylserine externalization in at least 40% of the cells; (2) 20 μM HMA had no direct effect but enhanced phosphatidylserine externalization induced by cell activation with PMA or calcium ionophore A23187. Both effects were independent of the NADPH-oxidase and were not due to changes in intracellular pH. 60 μM HMA induced a capacitative calcium entry which was necessary for phosphatidylserine externalization. The HMA-induced PS externalization was inhibited by salubrinal, an inhibitor of ER-stress-linked apoptosis. Lower HMA concentration enhanced PMA or A23187 effects through PKC and calcium dependent pathways. The caspase inhibitor Z-VAD-FMK weakly diminished phosphatidylserine externalization, suggesting that activation of caspases 7, 8, 9 and 3 was not involved. Increasing phosphatidylserine externalization by low concentrations of HMA improved the engulfment of PMA-activated PLB-985 cells by macrophages, providing a novel therapeutic strategy to limit the accumulation of neutrophils in injured tissues.     

Incidence of community‐acquired methicillin‐resistant Staphylococcus aureus carrying Pantone‐Valentine leucocidin gene at a referral hospital in United Arab Emirates

Community‐acquired methicillin‐resistant Staphylococcus aureus (CA‐MRSA) is an emerging pathogen in hospitalized patients worldwide. The present study was undertaken to identify CA‐MRSA in hospitalized patients in a 350‐bed tertiary care hospital in Sharjah, UAE over a 2‐year period from January 2011 to December 2012. CA‐MRSA was defined based on identification within first 48 h of admission in the hospital. Staphylococcal cassette chromosome (SCC) mec typing of the CA‐MRSA isolates was carried out by multiplex polymerase chain reaction (PCR). Detection of PVL and mecA genes was done by PCR using the GenoType^® MRSA test system (Hain Lifescience). Patient's clinical data and antimicrobial susceptibility pattern of the CA‐MRSA isolates were also evaluated. Fifty seven of the 187 MRSA isolates were identified as CA‐MRSA. All the CA‐MRSA strains in our study belonged to SCCmecIV type and were positive for both PVL and mecA genes. The patients with CA‐MRSA infections were young (median age, 32 years) and the majority of infections involved the skin and soft tissue (36%). Antimicrobial susceptibility pattern of the CA‐MRSA isolates showed a better susceptibility profile to the non‐beta‐lactam antimicrobials with the exception of ciprofloxacin having 28% resistance. This study evidently strengthens the recent observation of an increase in CA‐MRSA emergence among hospitalized patients in the UAE.     

Health-related quality of life in Egyptian children and adolescents with hemophilia A

Quality of life (QoL) in hemophilia is an important area in hemophilia outcome assessment. The Haemo-QoL instrument is a set of questionnaires to measure QoL in those children. The objectives of this study was to assess health-related quality of life (HRQoL) in Egyptian hemophilic children and adolescents using an Arabic version of the Haemo-QoL questionnaire. Sixty patients with severe hemophilia A were recruited from 2 hemophilia treating centers in Egypt. Assessment of quality of life was done using the Haemo-QoL questionnaire. The scores of HRQoL were found to be for all dimensions widely above 50. It was highly significant in the 3 dimensions (physical health-family-treatment) in different age groups, but it was impaired in the dimension of "physical health" for 2 groups, and in the dimension of "family" for the oldest group, whereas the youngest group had highly impaired scores concerning the "treatment." The HRQoL in this study was not affected by the presence of factor VIII (FVIII) inhibitors. The QoL in hemophilic patients in Egypt needs strenuous efforts from hemophilia care-integrated teams of pediatric hematologists and psychiatrists in order to properly assess and improve QoL.