Connaissance sur la vitamine D : état des lieux de la prévalence de l’hypovitaminose D chez la population marocaine

De par le monde, la vitamine D (VTD) suscite  un important  gain d’intérêt auprès de la communauté scientifique en raison, d’une part, de ses effets sur l’organisme, et d’autre part,  au caractère de sa déficience observé chez  la  population.  L’objectif de cet article est de présenter un état d’art sur les généralités relatives à la  VTD et de mettre en exergue la prévalence de l’hypovitaminose D, à partir de certaines études non exhaustives, chez la  population marocaine. A ce titre, la VTD peut être considérée comme une pro-hormone qui exerce des effets ubiquitaire sur l’organisme et  dont les répercussions de sa déficience affectent aussi bien la santé osseuse et extra osseuse de l’individu. Par ailleurs,  la prévalence de la déficience de la VTD  chez la population marocaine est très présente, ainsi, ce taux est entre  78.1 %   et  98.4%  chez la population féminine, de 85. 2% chez la population masculine et fluctue   entre   70.1 %  et de 90% chez la  population  marocaine consultante en médecine ambulatoire. Tenant compte, de la prévalence d’hypovitaminose D chez l’adulte marocain  et de ses effets sur l’organisme, une action de sensibilisation quant à l’importance de la VTD pour l’organisme s’inscrit dans une démarche de santé publique marocaine.

Rapid and sensitive methods for detection of Allorhizobium vitis, causal agent of grapevine crown gall

A rapid method and sensitive methods for extraction of bacterial DNA from pure culture and directly from plant materiel were compared in polymerase chain reaction with specific primers VCF3/VCR3 to see the reliable method that can used in the detection of tumorigenic strain of Allorhizobium vitis causal agent of grapevine crown gall. From the three tested methods of DNA extraction from pure culture, the alkaline method is the most effective technique for the extraction presenting a high sensitivity with a detection threshold equal to 5.104 CFU/ml. Five different protocols for extracting bacterial DNA from plant tissues of infected tomato, based on the use of an extraction buffer, were tested to see its usefulness in detecting pathogenic strain of A. vitisS4. Two protocols based on the use of Triton X-100 and Tween 20 were efficient for detecting A. vitis S4 directly from tomato tumors with a sensitivity of 103 CFU/ml for the both protocols. Consequently, these protocols were proposed as specific protocols for the detection of tumorigenic strain of A. vitis from symptomatic and asymptomatic plants

Flavonoids as an efective sensitizer for anti‑cancer therapy: insights into multi‑faceted mechanisms and applicability towards individualized patient profles

Cost-efficacy of currently applied treatments is an issue in overall cancer management challenging healthcare and causing tremendous economic burden to societies around the world. Consequently, complex treatment models presenting concepts of predictive diagnostics followed by targeted prevention and treatments tailored to the personal patient profiles earn global appreciation as benefiting the patient, healthcare economy, and the society at large. In this context, application of flavonoids as a spectrum of compounds and their nano-technologically created derivatives is extensively under consideration, due to their multi-faceted anti-cancer effects applicable to the overall cost-effective cancer management, primary, secondary, and even tertiary prevention. This article analyzes most recently updated data focused on the potent capacity of flavonoids to promote anti-cancer therapeutic effects and interprets all the collected research achievements in the frame-work of predictive, preventive, and personalized (3P) medicine. Main pillars considered are: - Predictable anti-neoplastic, immune-modulating, drug-sensitizing effects; - Targeted molecular pathways to improve therapeutic outcomes by increasing sensitivity of cancer cells and reversing their resistance towards currently applied therapeutic modalities

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Prevalence of the hypovitaminosis D among Moroccan woman consulting in ambulatory medicine

peer reviewedActuellement, la vitamine D est considérée comme une hormone aux effets pleïotropes et ne peut plus être limitée uniquement qu’à la prévention du rachitisme et de l’ostéomalacie. Une déficience en vitamine D dans l’organisme est corollaire à une panoplie de pathologies osseuses et extra osseuses chroniques. Objectif : La présente étude s'intéressait à la prévalence de l'hypovitaminose D chez les femmes en médecine ambulatoire dans la région de Meknès au Maroc. Matériel et méthodes : Un échantillonnage de convenance de 1247 femmes pour lesquelles un clinicien avait prescrit le dosage de la 25 Hydroxyvitamine D(25OHD) était sélectionné entre Janvier 2013 et Décembre 2015 auprès de deux laboratoires. La concentration de la 25OHD, la saison de son dosage et l'âge ont été recensés. La calcémie n’était évaluée que pour 759 femmes de l'échantillon. Résultats : La prévalence de l'hypovitaminose D, pour un seuil inférieur à 20 ng/ml, était de 70,1%, et variait significativement en fonction de la saison et de l'âge. Les prescriptions du dosage de la 25OHD émanaient à 52.8% de médecins généralistes et de rhumatologues et 32,8% des dosages étaient enregistrés en hiver. La calcémie était de 2,28 mg/l (ET 0,22) chez les 759 (60,8%) femmes, 188 (37,8%) parmi elles, présentaient une hypocalcémie et une hypovitaminose D. La régression logistique indiquait que la saison (Exp (B)=0,23, p<0.01) était un facteur associé à la variation de l'hypovitaminose D. Conclusion : L’hypovitaminose D représente Mots un problème de santé publique et les médecines doivent être sensibilisés à ce sujet

Natural Compounds in Glioblastoma Therapy: Preclinical Insights, Mechanistic Pathways, and Outlook

Glioblastoma (GBM) is an aggressive, often fatal astrocyte-derived tumor of the central nervous system. Conventional medical and surgical interventions have greatly improved survival rates; however, tumor heterogeneity, invasiveness, and chemotherapeutic resistance continue to pose clinical challenges. As such, dietary natural substances—an integral component of the lifestyle medicine approach to chronic diseases—are examined as potential chemotherapeutic agents. These heterogenous substances exert anti-GBM effects by upregulating apoptosis and autophagy, inducing cell cycle arrest, interfering with tumor metabolism, and inhibiting proliferation, neuroinflammation, chemoresistance, angiogenesis, and metastasis. Although these beneficial effects are promising, natural substances’ efficacy in GBM is constrained by their bioavailability and blood–brain barrier permeability; various chemical formulations are proposed to improve their pharmacological properties. Many of the reviewed substances are available as over-the-counter dietary supplements, underscoring their viability as lifestyle interventions. However, clinical trials remain necessary to substantiate the in vitro and in vivo properties of natural substances

Designing a Channel Access Mechanism for Wireless Sensor Network

Although there are various Medium Access Control (MAC) protocols proposed for Wireless Sensor Network (WSN), there is no protocol accepted as a standard specific to it. This paper deals with completing the design of our previously proposed MAC for WSN by proposing a channel access mechanism (CAM). The CAM is based on developing a backoff mechanism which mainly differentiates nodes’ backoffs depending on their different identification numbers, and it employs a performance tuning parameter for reaching a required performance objective. The probability distribution of the backoff period is constructed and Markov chain modeling is used to analyze and evaluate the CAM against the IEEE802.15.4 slotted CSMA/CA based on single- and multihop communication with respect to the reliability, the average delay, the power consumption, and the throughput. The analysis reveals that the required performance of CAM against the IEEE slotted CSMA/CA can be obtained by choosing the maximum backoff stages number and the tuning parameter value and that CAM performs better than the IEEE with larger nodes number. The multihop scenario results in a good end-to-end performance of CAM with respect to the reliability and delay becomes better with lengthier paths at the expense of increasing the energy consumption