Relationship between asthma, atopy and obesity in adolescents living in the Wilaya of Constantine, Algeria. [Relation entre asthme, atopie et obésité chez l’adolescent habitant la wilaya de Constantine, Algérie]

Introduction. Pediatric asthma is predominantly atopic, but no data are found on atopy in obese asthmatic child in the literature. In addition, the increased obesity rates, sensitization to airborne allergens are a risk factor for asthma. Objective. To determine whether elevation of body mass index (BMI) was associated with asthma severity or with sensitization to inhalation allergens in adolescents in the wilaya of Constantine. Material and methods. This was a prospective, descriptive and cross-sectional study, carried out during the 2017-2018 school year, on 104 asthmatic adolescents, aged between 13 and 14, in schools in Constantine. The weight status of the patients was assessed using the 2012 thresholds of the International Obesity Task Force (IOTF), and a BMI ≥ 25 kg/m2 defined overweight or obesity. Asthmatics obese and non-obese groups were compared for the prevalence of severe asthma and sensitization using the Chi-square test, at the 95% confidence interval. Results. Twenty-five per cent of asthmatics were overweight or obese with an average BMI of 28,20±3,80. Asthma symptoms were persistent in 66%, and uncontrolled in 40% of cases. Almost 70% of the population were atopic, and 50% were poly-sensitized. Sensitization occurred in both groups with a significant positive ratio (p=0.03). No association was observed between obesity and prevalence of severe asthma (p=0.5), or poly-sensitizations. Conclusion. The quarter of adolescents is overweight or obese, and tends to present an atopy. However, no positive association is found between obesity and prevalence of severe asthma symptoms. Further prospective studies are needed for a better understanding of this obese asthmatics group. [Résumé Introduction. L’asthme pédiatrique est majoritairement atopique, mais aucune donnée n’existe sur l’atopie de l’enfant asthmatique obèse dans la littérature. En outre, l’élévation du taux d’obésité, la sensibilisation aux pneumallergènes sont un facteur de risque pour l’asthme. Objectif. Déterminer si l’élévation de l’indice de masse corporelle (IMC) est associée à la sévérité de l’asthme ou à la sensibilisation aux pneumallergènes, chez des adolescents asthmatiques dans la wilaya de Constantine. Matériel et méthodes. Une étude prospective, descriptive et transversale est réalisée durant l’année scolaire 2017-2018, et a porté sur 104 adolescents asthmatiques, âgés entre 13 et 14 ans, au sein des établissements scolaires de Constantine. Le statut pondéral des malades a été évalué en utilisant les seuils de l’International Obesity Task Force (IOTF), avec un indice de masse corporelle (IMC) ≥ 25 kg/m² définissant le surpoids ou l’obésité. Des groupes d’asthmatiques obèses et non obèses ont été comparés afin de noter la prévalence de l’asthme sévère et la sensibilisation en utilisant le test de Chi-deux à l’intervalle de confiance de 95 %. Résultats. Un quart des asthmatiques étaient en surpoids ou obèses avec un IMC moyen de 28,20±3,80. Les symptômes d’asthme étaient persistants chez 66%, et non contrôlés chez 40% des cas. Près de 70% de la population était atopique et 50 % étaient polysensibilisés. La sensibilisation s’est produite dans les deux groupes avec un rapport positif significatif (p=0,03). Aucune association n’est observée entre l’obésité et la prévalence de l’asthme sévère ou les poly-sensibilisations. Conclusion. Le quart des adolescents sont en surpoids ou obèses et ont tendance à présenter une atopie. Cependant, aucune association n’est notée entre l’obésité et la prévalence des symptômes sévères d’asthme. D’autres études prospectives sont nécessaires pour une meilleure compréhension du groupe d’asthmatiques obèses.

Multimodal polarimetric nonlinear microscopy in tissues

International audienc

Flow cytometry-based diagnostic approach for inborn errors of immunity: experience from Algeria

PurposeIn this study, we retrospectively reviewed the use of flow cytometry (FCM) in the diagnosis of inborn errors of immunity (IEIs) at a single center in Algeria. Sharing insights into our practical experience, we present FCM based diagnostic approaches adapted to different clinical scenarios.MethodsBetween May 2017 and February 2024, pediatric and adult patients presenting with clinical features suggestive of immunodeficiency were subjected to FCM evaluation, including lymphocyte subset analysis, detection of specific surface or intracellular proteins, and functional analysis of immune cells.ResultsOver a nearly seven-year period, our laboratory diagnosed a total of 670 patients (372 (55.5%) males and 298 (44.5%) females), distributed into 70 different IEIs belonging to 9 different categories of the International Union of Immunological Societies classification. FCM was used to diagnose and categorize IEI in 514 patients (76.7%). It provided direct diagnostic insights for IEIs such as severe combined immunodeficiency, Omenn syndrome, MHC class II deficiency, familial hemophagocytic lymphohistiocytosis, and CD55 deficiency. For certain IEIs, including hyper-IgE syndrome, STAT1-gain of function, autoimmune lymphoproliferative syndrome, and activated PI3K delta syndrome, FCM offered suggestive evidence, necessitating subsequent genetic testing for confirmation. Protein expression and functional assays played a crucial role in establishing definitive diagnoses for various disorders. To setup such diagnostic assays at high and reproducible quality, high level of expertise is required; in house reference values need to be determined and the parallel testing of healthy controls is highly recommended.ConclusionFlow cytometry has emerged as a highly valuable and cost-effective tool for diagnosing and studying most IEIs, particularly in low-income countries where access to genetic testing can be limited. FCM analysis could provide direct diagnostic insights for most common IEIs, offer clues to the underlying genetic defects, and/or aid in narrowing the list of putative genes to be analyzed

Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

OBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally

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

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