273 New cardiac biomarkers after marathon in woman

In a prospective study we evaluated kinetic of hFABP, CAIII and GPBB during the 2008 Marathon du Médoc by 67 healthy volunteered. Blood were collected at baseline (T1), immediately after (T2) and 3 h after (T3). Biomarkers were assayed by Cardiac array on Evidence Investigator (EI) RANDOX, cTnI and myoglobine by Dimension RxL too. 10 (5%) TnIc values disagreed between RxL and EI, all at T2 and T3. cTnI (EI) was negative in all subjects before, increased transiently in 4 (6%) at T2 then normalized. Increased ratio of Myo to FABP from [4-46] to [5-1208] then [5-43] indicated that Myo was more likely to originate from muscle. hFABP normal at T1 but for one, increased for all but one at T2 [4->150] and T3 [5->150]. CAIII increased from [8-68 ng/mL] to [45->145] then [57->145] indicated skeletal muscle damage. GPBB baseline was in [2-7 ng/mL] but for one. 13 (19%) rates increased at T2 [8-27], which 7 returned to baseline after 3 h and 6 remained high. 6 (9%) increased only at T3 [8,5-141]. Combination of markers showed that by the 4 women who had elevated cTnI (T3), Myo, hFABP and CAIII increased in all cases and GPBB in two. GPBB, presented as released early from injured myocardial cells, increased however in 19 (28%) women after marathon. Moderate elevation of GPBB would more likely reflect active glycogenolysis and heart fatigue than injury. These new markers don’t offer adequate cardiospecificity to rule out myocardial damage in runners

Progenitor “Mycobacterium canettii” Clone Responsible for Lymph Node Tuberculosis Epidemic, Djibouti

“Mycobacterium canettii,” an opportunistic human pathogen living in an unknown environmental reservoir, is the progenitor species from which Mycobacterium tuberculosis emerged. Since its discovery in 1969, most of the ≈70 known M. canettii strains were isolated in the Republic of Djibouti, frequently from expatriate children and adults. We show here, by whole-genome sequencing, that most strains collected from February 2010 through March 2013, and associated with 2 outbreaks of lymph node tuberculosis in children, belong to a unique epidemic clone within M. canettii. Evolution of this clone, which has been recovered regularly since 1983, may mimic the birth of M. tuberculosis. Thus, recognizing this organism and identifying its reservoir are clinically important

Clinical Survey of Dengue Virus Circulation in the Republic of Djibouti between 2011 and 2014 Identifies Serotype 3 Epidemic and Recommends Clinical Diagnosis Guidelines for Resource Limited Settings.

Dengue virus is endemic globally, throughout tropical and sub-tropical regions. While the number of epidemics due to the four DENV serotypes is pronounced in East Africa, the total number of cases reported in Africa (16 million infections) remained at low levels compared to Asia (70 million infections). The French Armed forces Health Service provides epidemiological surveillance support in the Republic of Djibouti through the Bouffard Military hospital. Between 2011 and 2014, clinical and biological data of suspected dengue syndromes were collected at the Bouffard Military hospital and analyzed to improve Dengue clinical diagnosis and evaluate its circulation in East Africa. Examining samples from patients that presented one or more Dengue-like symptoms the study evidenced 128 Dengue cases among 354 suspected cases (36.2% of the non-malarial Dengue-like syndromes). It also demonstrated the circulation of serotypes 1 and 2 and reports the first epidemic of serotype 3 infections in Djibouti which was found in all of the hospitalized patients in this study. Based on these results we have determined that screening for Malaria and the presence of the arthralgia, gastro-intestinal symptoms and lymphopenia < 1,000cell/ mm3 allows for negative predictive value and specificity of diagnosis in isolated areas superior to 80% up to day 6. This study also provides evidence for an epidemic of Dengue virus serotype 3 previously not detected in Djibouti

Significance of the Identification in the Horn of Africa of an Exceptionally Deep Branching <em>Mycobacterium tuberculosis</em> Clade

<div><p>Molecular and phylogeographic studies have led to the definition within the <em>Mycobacterium tuberculosis</em> complex (MTBC) of a number of geotypes and ecotypes showing a preferential geographic location or host preference. The MTBC is thought to have emerged in Africa, most likely the Horn of Africa, and to have spread worldwide with human migrations. Under this assumption, there is a possibility that unknown deep branching lineages are present in this region. We genotyped by spoligotyping and multiple locus variable number of tandem repeats (VNTR) analysis (MLVA) 435 MTBC isolates recovered from patients. Four hundred and eleven isolates were collected in the Republic of Djibouti over a 12 year period, with the other 24 isolates originating from neighbouring countries. All major <em>M. tuberculosis</em> lineages were identified, with only two <em>M. africanum</em> and one <em>M. bovis</em> isolates. Upon comparison with typing data of worldwide origin we observed that several isolates showed clustering characteristics compatible with new deep branching. Whole genome sequencing (WGS) of seven isolates and comparison with available WGS data from 38 genomes distributed in the different lineages confirms the identification of ancestral nodes for several clades and most importantly of one new lineage, here referred to as lineage 7. Investigation of specific deletions confirms the novelty of this lineage, and analysis of its precise phylogenetic position indicates that the other three superlineages constituting the MTBC emerged independently but within a relatively short timeframe from the Horn of Africa. The availability of such strains compared to the predominant lineages and sharing very ancient ancestry will open new avenues for identifying some of the genetic factors responsible for the success of the modern lineages. Additional deep branching lineages may be readily and efficiently identified by large-scale MLVA screening of isolates from sub-Saharan African countries followed by WGS analysis of a few selected isolates.</p> </div

comparison of the Percy556 <i>mce3</i> deletion 79 with the organisation of the operon in H37Rv, in “<i>M. canettii”</i> strain CIPT140010059, and in <i>M. bovis</i> BCG.

<p>Four different organizations are observed. The most parsimonious explanation is that the <i>M. canettii</i> configuration represents the ancestral situation from which 3 different deletions are derived via at least 2 independent deletion events.</p

Minimum spanning tree representation of the clustering of 435 isolates from the Horn of Africa.

<p>The color code reflects the main MLVA clusters. Lineages (1 to 6) and some sublineages (CDC1551, H37Rv, …) are indicated. The size of the circles reflects the number of isolates with an identical genotype. Branches longer than 10 are not drawn. The main outlier candidates are arrowed (red arrows: isolates selected for sequencing).</p

Schematic representation of the main historic events along the lineage 7 and Percy256-Percy556 associated geotype.

<p>The evolution of lineage 7 is displayed in a linear fashion from the <i>M. tuberculosis</i> ancestor (the obligate human pathogen in contrast to its environmental unknown <i>Mycobacteria</i> progenitor) to the Percy256-Percy556 geotype representative. The relative timing of the different splits is indicated. The hypothetical temporal succession of the split of the two Ancestral superlineages indicated here is suggested by the slightly abnormal mutation pattern along branch (6,7). More precise rooting of the MTBC will be needed to test this hypothesis.</p

Minimum spanning tree based upon whole genome SNP analysis.

<p>The tree is based upon 13382 SNPs. The tree size is 13463, i.e. it contains approximately 0.6% of homoplasia. The length of each branch expressed in SNP numbers is indicated. The red star marks the approximate branching point of the <i>M. canettii</i> lineage according to <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0052841#pone.0052841-Namouchi1" target="_blank">[19]</a>. The two blue stars indicate the positions of newly defined ancestral nodes within the two Africanum lineages 5 and 6.</p

Minimum spanning tree representation of the Horn of Africa isolates with respect to 700 isolates of various origins.

<p>The 435 isolates from the Horn of Africa are displayed in white, whereas the isolates of worldwide origins are colored according to lineage using the same color code as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0052841#pone-0052841-g001" target="_blank">Figure 1</a>. Red arrows: isolates selected for sequencing. The minimum spanning tree analysis is based upon the 19 VNTR loci shared by the 24 loci MLVA assays used by <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0052841#pone.0052841-Fabre2" target="_blank">[13]</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0052841#pone.0052841-Supply1" target="_blank">[22]</a>.</p