158 Prothetic abcess complicating Infective endocarditis

The cardiac abscess formation is appraised to 20–30% during the infectious endocarditis (IE). It is more frequent during prosthesis endocarditis and it can reach 60%. The prognosis is generally reserved. Objective To determine echocardiographic, bacteriological and evolutive features of prothetic IE complicated of abscess.Retrospective study including 51 patients having certain or probable IE according to Duke criterias between 2002 and 2005. At 9 patients (17,64%) the endocarditis was complicated of prothetic abscess. It was about 6 men and 3 women with a middle age of 39 ± years. IE was la ate IE in 5 cases. Clinical and biological infectious syndrome was constant. Isolated germs were staphylococcus aureus in 2 cases, GRAM négatif Bacillus in 2 cases. Culture negative endocarditis were noted in 5 cases. Brucellosis serology was positive at one patient. Prothetic abcess was diagnosed by transthoracic echocardiography (TTE) at 2 patients and by transesophagal echocardiography (TEE) at all patients.The abcess was localized on the aortic prosthesis at 5 patients, mitral prothesis at 3 patients and mitroaortic prothesis at one patient. TEE identified annular abcess at 2 patients and a myocardial abcess at 1 patient. Secondary septic localizations were noted at 6 patients: 4 cerebral abscesses, 2 splenic localization, a renal localization and an articular localization. High degree atrioventricular blocks were observed at 3 patients. The recourse to the surgery was frequent (7 patient/9 patient). It was an emergent sugery at 2 patients because of a heart failure. For the others, the indication for surgery was medical failure treatment at a mean delay of 19 days. The evolution was fatal at 5 patients. and the evolution was favorable at the others.Prothetic endocarditis complicated of abscess are serious requiring frequently a prothetic replacement, a very high risked surgery. TEE must be systematic at all patients carrier of prosthesis if they have infectious syndrome in order to carry the early diagnosis of IE and to avoid abcess formation

Association analysis of polymorphisms in EGFR, HER2, ESR1 and THRA genes with coronary artery diseases

Background: Research in the genetic basis of coronary artery diseases (CAD) has identified some genes and pathways associated with diseases that would not be considered to underlie conventional risk factors. Among these genes there are the EGFR (epidermal growth factor receptor) receptor family genes and the regulation factor genes (such as thyroid hormone receptor a (THRA) and estrogen receptor a (ESR1)).Aim: In this study we investigated the relation between 4 polymorphisms within EGFR, HER2 (human epidermal growth factor receptor 2), ESR1 and THRA genes and CAD.Subjects and methods: The association analysis was performed with 151 healthy individuals and 151 CAD patients documented by angiography.Results: No significant difference was found in the allelic and genotypic frequency distribution of the four variants studied between the control and patient groups. We have also investigated the relationship of these polymorphic sites with clinical and biochemical parameters such as smoking habit, diabetes mellitus, hypertension, dyslipidemia, CAD severity, glucose, triglyceride, total cholesterol and urea levels. The EGFR and THRA variants were associated with glycemia and triglyceride levels, respectively. Also a significant correlation was found between the ESR1 polymorphism and the levels of urea and triglyceride.Conclusion: Our results suggest the absence of any significant association between the four polymorphisms analyzed and CAD risk as well as disease severity

Management of Perinatal Testicular Torsion: A Single Centre Experience

Perinatal testicular torsion (PTT) is a rare entity. The management of PTT is controversial, due to the low viability of the testis and the possibility of bilateral torsion. This is a review of our experience with six cases of PTT, highlighting diagnostic and therapeutic difficulties of this condition

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Aldolisation des alpha-trialkylsilyl-alpha-diazoacétones induite par l'ion fluorure

Diazoketones are valuable intermediates in organic synthesis and the elaboration of α-diazocarbonyl scaffolds has aroused a steady interest for many years. The terminal diazoketones can be added to aldehydes under basic conditions to produce beta-hydroxy-alpha-diazoketone compounds with a high synthetic potential. In this context, our project aimed at promoting this type of reaction under mild conditions without using a base. The strategy adopted was based on the use of α-trialkylsilyl-α-diazoacetones and their specific nucleophilic activation by a fluoride ion. Initially, the synthesis of α-trialkylsilyl-α-diazoacetone was optimized and then, an extensive study of the reaction parameters allowed the development of an efficient aldolisation of TES-diazoacetone induced by TBAF. The nucleophilic, weakly basic conditions employed tolerate a wide range of substrates and constitute a practical high-yielding experimental procedure. The asymmetric extension of this methodology was then studied by using a chiral ammonium fluoride derived from Cinchona alkaloid. The condition set up allowed to elaborate the first enantioenriched beta-hydroxy-alpha-diazoacetones (e.e = 35%) in high yields. Finally, this methodology was successfully extended to TIPS-diazoacetone. The robustness of the TIPS protective group makes it possible to envision a range of synthetic « methyl-side » transformations without desilylation of the azomethine position of the diazo-aldol. This study paves the way for future exploration of the reactivity of TIPS diazoaldols.Les composés diazocétoniques sont des intermédiaires utiles en synthèse organique et l’élaboration de motifs diazocarbonylés est à ce titre un enjeu important. Les diazocétones terminales peuvent subir une addition sur des aldéhydes dans des conditions basiques pour conduire de façon convergente à des composés béta-hydroxy-alpha-diazocétoniques à fort potentiel synthétique. Dans ce contexte, notre projet visait à promouvoir ce type de réaction dans des conditions douces et peu basiques. La stratégie adoptée reposait sur l’utilisation des alpha-trialkylsilyl-alpha-diazoacétones et leur activation nucléophile spécifique par un ion fluorure. Dans un premier temps, la synthèse de la TES-diazoacétone a été optimisée, puis une étude approfondie des paramètres réactionnels a permis la mise au point de la réaction d’aldolisation de la TES-diazoacétone, induite par le TBAF. Deux protocoles expérimentaux faciles de mise en œuvre ont ainsi été mis en place pour conduire à une large gamme de béta-hydroxy-alpha-diazoacétones avec des rendements élevés. L’extension asymétrique de cette méthodologie a ensuite été étudiée en mettant en jeu un fluorure d’ammonium chiral dérivé d’alcaloïde de Cinchona conduisant à la formation des premières béta-hydroxy-alpha-diazoacétones énantioenrichies (e.e = 35%) avec des rendements élevés. Enfin, cette méthodologie a été étendue avec succès à la TIPS-diazoacétone. La robustesse du groupement protecteur TIPS permet d’envisager une large gamme de transformations synthétiques « methyl-side », sans induire une désilylation partielle de la position azométhine du diazo-aldol. Ceci ouvre la voie à l’exploration future de la réactivité des diazoaldols TIPS

Fluoride induced aldol reaction of α-trialkylsilyl-α-diazoacetones

Les composés diazocétoniques sont des intermédiaires utiles en synthèse organique et l’élaboration de motifs diazocarbonylés est à ce titre un enjeu important. Les diazocétones terminales peuvent subir une addition sur des aldéhydes dans des conditions basiques pour conduire de façon convergente à des composés béta-hydroxy-alpha-diazocétoniques à fort potentiel synthétique. Dans ce contexte, notre projet visait à promouvoir ce type de réaction dans des conditions douces et peu basiques. La stratégie adoptée reposait sur l’utilisation des alpha-trialkylsilyl-alpha-diazoacétones et leur activation nucléophile spécifique par un ion fluorure. Dans un premier temps, la synthèse de la TES-diazoacétone a été optimisée, puis une étude approfondie des paramètres réactionnels a permis la mise au point de la réaction d’aldolisation de la TES-diazoacétone, induite par le TBAF. Deux protocoles expérimentaux faciles de mise en œuvre ont ainsi été mis en place pour conduire à une large gamme de béta-hydroxy-alpha-diazoacétones avec des rendements élevés. L’extension asymétrique de cette méthodologie a ensuite été étudiée en mettant en jeu un fluorure d’ammonium chiral dérivé d’alcaloïde de Cinchona conduisant à la formation des premières béta-hydroxy-alpha-diazoacétones énantioenrichies (e.e = 35%) avec des rendements élevés. Enfin, cette méthodologie a été étendue avec succès à la TIPS-diazoacétone. La robustesse du groupement protecteur TIPS permet d’envisager une large gamme de transformations synthétiques « methyl-side », sans induire une désilylation partielle de la position azométhine du diazo-aldol. Ceci ouvre la voie à l’exploration future de la réactivité des diazoaldols TIPS.Diazoketones are valuable intermediates in organic synthesis and the elaboration of α-diazocarbonyl scaffolds has aroused a steady interest for many years. The terminal diazoketones can be added to aldehydes under basic conditions to produce beta-hydroxy-alpha-diazoketone compounds with a high synthetic potential. In this context, our project aimed at promoting this type of reaction under mild conditions without using a base. The strategy adopted was based on the use of α-trialkylsilyl-α-diazoacetones and their specific nucleophilic activation by a fluoride ion. Initially, the synthesis of α-trialkylsilyl-α-diazoacetone was optimized and then, an extensive study of the reaction parameters allowed the development of an efficient aldolisation of TES-diazoacetone induced by TBAF. The nucleophilic, weakly basic conditions employed tolerate a wide range of substrates and constitute a practical high-yielding experimental procedure. The asymmetric extension of this methodology was then studied by using a chiral ammonium fluoride derived from Cinchona alkaloid. The condition set up allowed to elaborate the first enantioenriched beta-hydroxy-alpha-diazoacetones (e.e = 35%) in high yields. Finally, this methodology was successfully extended to TIPS-diazoacetone. The robustness of the TIPS protective group makes it possible to envision a range of synthetic « methyl-side » transformations without desilylation of the azomethine position of the diazo-aldol. This study paves the way for future exploration of the reactivity of TIPS diazoaldols

Reduction of impulsive noise in color image using an Adaptive Vector Distance Directional Filter

International audienceIn this paper, multichannel image processing using an adaptive approach is the subject of our study. Thus, we have proposed a new Adaptive Vector Directional Distance Filter (VDDF). Simulation results illustrate that this new proposed filter outperforms the classic Vector Directional Distance Filterwhen images are contaminated with impulsive noise. In addition, efficiency of this filter is proven since it provides an excellent balance between the noise attenuation and the signal-details preservation

IMPULSIVE NOISE DIMINUTION USING NEW ADAPTIVE VECTOR MEDIAN RATIONAL HYBRID FILTER

International audienc