Facteurs thérapeutiques affectant la cicatrisation au cours des gangrènes du périnée

Les gangrène du Fournier est une fasciite nécrosante rare et grave. Elle est grevée d'une lourde morbi-mortalité nécessitant une prise en charge médico-chirurgicale rapide et énergique. Le traitement initial repose sur la réanimation associée au débridement chirurgical. Secondairement le problème majeur reste la cicatrisation et les séquelles que gardent les patients. Plusieurs modalités thérapeutiques sont actuellement disponibles a fin d'améliorer et accélérer la cicatrisation. Notre étude rétrospective a colligé 20 cas. L'âge médian dans notre série était d 56 ans. Il y avait 16 hommes et 7 femmes. Une comorbidité était présente chez 15 patients. L'antibiothérapie a été entreprise dans tous les cas avec une durée médiane de 15 jours Le traitement chirurgical était entrepris dans tous les cas. Des révisions itératives étaient nécessaires chez tous les patients avec une médiane de 3 changements de pansements. Une colostomie était réalisée dans 6 cas. Une oxygénothérapie hyperbare était réalisée dans 4 cas. Une vaco-thérapie dans 1 cas. Un geste de recouvrement cutané était nécessaire dans 2 cas. La durée médiane de cicatrisation était de 15 jours avec l oxygénothérapie versus 24 jours en l absence de ce traitement. La durée médiane d'hospitalisation était de 20 jours. Quatre décès ont été dénombrés dans cette série. L obtention d'une cicatrisation sans séquelles est un chalenge dans la prise en charge thérapeutique. Malgré l'adjonction de nouvelles modalités thérapeutique ses résultats restent non satisfaisants. Cependant une approche multidisciplinaire associée à une oxygénothérapie et une vac-thérapie pourrait améliorer les résultats chez ces patients

Experimental design and Bayesian networks for enhancement of delta-endotoxin production by Bacillus thuringiensis

Bacillus thuringiensis (Bt) is a Gram-positive bacterium. The entomopathogenic activity of Bt is related to the existence of the crystal consisting of protoxins, also called delta-endotoxins. In order to optimize and explain the production of delta-endotoxins of Bacillus thuringiensis kurstaki, we studied seven medium components: soybean meal, starch, KH2PO4, K2HPO4, FeSO4, MnSO4, and MgSO4 and their relationships with the concentration of delta-endotoxins using an experimental design (Plackett—Burman design) and Bayesian networks modelling. The effects of the ingredients of the culture medium on delta-endotoxins production were estimated. The developed model showed that different medium components are important for the Bacillus thuringiensis fermentation. The most important factors influenced the production of delta-endotoxins are FeSO4, K2HPO4, starch and soybean meal. Indeed, it was found that soybean meal, K2HPO4, KH2PO4 and starch also showed positive effect on the delta-endotoxins production. However, FeSO4 and MnSO4 expressed opposite effect. The developed model, based on Bayesian techniques, can automatically learn emerging models in data to serve in the prediction of delta-endotoxins concentrations. The constructed model in the present study implies that experimental design (Plackett—Burman design) joined with Bayesian networks method could be used for identification of effect variables on delta-endotoxins variation

Modeling-based optimization approaches for the development of Anti- Agrobacterium tumefaciens activity using Streptomyces sp TN71

A new aerobic bacterium TN71 was isolated from Tunisian Saharan soil and has been selected for its antimicrobial activity against phytopathogenic bacteria. Based on cellular morphology, physiological characterization and phylogenetic analysis, this isolate has been assigned as Streptomyces sp. TN71 strain. In an attempt to increase its anti-Agrobacterium tumefaciens activity, GYM + S (glucose, yeast extract, malt extract and starch) medium was selected out of five different production media and the medium composition was optimized. Plackett-Burman design (PBD) was used to select starch, malt extract and glucose as parameters having significant effects on antibacterial activity and a Box-Behnken design was applied for further optimization. The analysis revealed that the optimum concentrations for anti-A. tumefaciens activity of the tested variables were 19.49 g/L for starch, 5.06 g/L for malt extract and 2.07 g/L for glucose. Several Artificial Neural Networks (ANN): the Multilayer perceptron (MLP) and the Radial basis function (RBF) were also constructed to predict anti-A. tumefaciens activity. The comparison between experimental with predicted outputs from ANN and Response Surface Methodology (RSM) were studied. ANN model presents an improvement of 12.36% in terms of determination coefficients of anti A. tumefaciens activity. To our knowledge, this is the first work reporting the statistical versus artificial intelligence based modeling for optimization of bioactive molecules against phytopathogen

Treatment of phenanthrene and benzene using microbial fuel cells operated continuously for possible in situ and ex situ applications

Bioelectrochemical systems could have potential for bioremediation of contaminants either in situ or ex situ. The treatment of a mixture of phenanthrene and benzene using two different tubular microbial fuel cells (MFCs) designed for either in situ and ex situ applications in aqueous systems was investigated over long operational periods (up to 155 days). For in situ deployments, simultaneous removal of the petroleum hydrocarbons (>90% in term of degradation efficiency) and bromate, used as catholyte, (up to 79%) with concomitant biogenic electricity generation (peak power density up to 6.75 mWm−2) were obtained at a hydraulic retention time (HRT) of 10 days. The tubular MFC could be operated successfully at copiotrophic (100 ppm phenanthrene, 2000 ppm benzene at HRT 30 days) and oligotrophic (phenanthrene and benzene, 50 ppb each, HRT 10 days) substrate conditions suggesting its effectiveness and robustness at extreme substrate concentrations in anoxic environments. In the MFC designed for ex situ deployments, optimum MFC performance was obtained at HRT of 30 h giving COD removal and maximum power output of approximately 77% and 6.75 mWm−2 respectively. The MFC exhibited the ability to resist organic shock loadings and could maintain stable MFC performance. Results of this study suggest the potential use of MFC technology for possible in situ/ex situ hydrocarbon-contaminated groundwater treatment or refinery effluents clean-up, even at extreme contaminant level conditions

Comparative Study of the Long-Term Impact of the COVID-19 Pandemic on Mental Health and Nutritional Practices Among International Elite and Sub-Elite Athletes: A Sample of 1420 Participants from 14 Countries

Background Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockdown has had negative impacts on mental health and eating behaviors among the general population and athletes, few studies have examined the long-term effects on elite and sub-elite athletes. The present study aimed to investigate the long-term impact of COVID-19 lockdown on mental health and eating behaviors in elite versus sub-elite athletes two years into the pandemic. A cross-sectional comparative study was conducted between March and April 2022, involving athletes from 14 countries, using a convenient non-probabilistic and snowball sampling method. A total of 1420 athletes (24.5 ± 7.9 years old, 569 elites, 35% women, and 851 sub-elites, 45% women) completed an online survey-based questionnaire. The questionnaire included a sociodemographic survey, information about the COVID-19 pandemic, the Depression, Anxiety and Stress Scale—21 Items (DASS-21) for mental health assessment, and the Rapid Eating Assessment for Participants (REAP-S) for assessing eating behavior. Results The results showed that compared to sub-elite athletes, elite athletes had lower scores on the DASS-21 (p = .001) and its subscales of depression (p = .003), anxiety (p = .007), and stress (p < .001), as well as a lower REAP-S score indicating lower diet quality (p = .013). Conclusion In conclusion, two years into the pandemic, elite athletes were likelier to have better mental health profiles than sub-elite athletes but surprisingly had lower diet quality. Key Points Elite athletes had better mental health profiles compared to sub-elite athletes, with lower levels of depression, anxiety, and stress. Elite athletes reported greater psychological support and perceived themselves as more financially secure during the pandemic than sub-elite athletes do. Elite athletes were more likely to have poor eating habits compared to sub-elite athletes

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children &lt;18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p&lt;0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p&lt;0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p&lt;0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer