Détermination du débit de filtration glomérulaire (DFG) au cours du diabète : Cockroft et Gault, MDRD ou CKD-EPI ?

Plusieurs paramètres peuvent être étudiés pour évaluer le rein. Parmi ceux-ci, le débit de filtration glomérulaire (DFG) a été déterminé avec les formules de Cockroft et Gault (CG), du Modification of Diet in Renal Disease (MDRD) et du Chronic Kidney Disease EPIdemiology Collaboration (CKD-EPI) et la formule la mieux adaptée pour le diabétique a été recherchée. Chez 59 diabétiques de type 1 (DT1) et 70 diabétiques de type 2 (DT2), le DFG a été déterminé avec les formules de CG, du MDRD et du CKD-EPI. Avec l’analyse statistique, les seuils de significativité ont été fixés pour p<0,05 ; T0α>1,96 et Z0α>1,96. Le MDRD est superposable au CKD-EPI chez les DT1 et DT2. Chez les DT1, le DFG moyen et la corrélation entre 1/créatininémie et DFG ne varient pas si CG ou CKD-EPI ; cependant, les sujets à DFG réduit (< 90 ml/min/1,73 m²) sont plus nombreux avec CG plutôt qu’avec CKD-EPI (66,10% vs 47,46% ; T0α=2,05). Chez les DT2, le DFG moyen et la proportion de sujets à DFG réduit sont indépendants de la formule utilisée, mais la corrélation entre 1/créatininémie et DFG est plus forte si CKD-EPI que CG (0,961 vs 0,632 ; Z0α=7,02). Ainsi, la formule la mieux adaptée pour la détermination du DFG serait CG chez les DT1 et CKD-EPI chez les DT2, sachant que CKD-EPI est équivalent à MDRD quel que soit le type de diabète.Mots clés : Cockroft et Gault - MDRD - CKD-EPI – débit de filtration glomérulaire (DFG) – diabète

Aggravation de l’anémie et polymorphisme de l’haptoglobine au cours de la drépanocytose au Sénégal

La drépanocytose homozygote s’accompagne d’une augmentation de l’hémoglobine (Hb) plasmatique, susceptible d’exposer les hématies à un stress oxydant. L’haptoglobine présente trois phénotypes majeurs (Hp1-1, Hp 2-1 et Hp 2-2) susceptibles de fixer l’hémoglobine extracellulaire avec une efficacité différente. L’objectif de ce travail est de voir si la connaissance du phénotype d’Hp pouvait constituer un élément prédictifde l’anémie sévère. Pour cela, il a été recruté 68 drépanocytaires  homozygotes, âgés de 5 à 31 ans. Pour chaque patient, un témoin de même sexe et de même âge ± 2 ans a été recruté. Le phénotypage de l’Hp a été réalisé par électrophorèse sur gel de polyacrylamide. Les résultats du dosage de l’Hb font ressortir que les taux d’Hb sont significativement différentes chez les patients comparées à celles des témoins (p = 0,001). Lorsque la répartition a été faite en fonction du phénotype d’Hp, une différence statistiquement significative a étéretrouvée entre le phénotype Hp1-1 et le phénotype Hp2-2 (p < 0,001) chez les patients et non chez les témoins. Les résultats de cette étude préliminaire suggéreraient que la connaissance du phénotype d’Hp seraitun facteur prédictif de l’anémie sévère au cours de la drépanocytose.Mots clés : Drépanocytose, anémie, phénotypes d’haptoglobine

Can HIV self-testing reach first-time testers? A telephone survey among self-test end users in Côte d'Ivoire, Mali, and Senegal

BACKGROUND: Coverage of HIV testing remains sub-optimal in West Africa. Between 2019 and 2022, the ATLAS program distributed ~400 000 oral HIV self-tests (HIVST) in Côte d'Ivoire, Mali, and Senegal, prioritising female sex workers (FSW) and men having sex with men (MSM), and relying on secondary redistribution of HIVST to partners, peers and clients to reach individuals not tested through conventional testing. This study assesses the proportion of first-time testers among HIVST users and the associated factors. METHODS: A phone-based survey was implemented among HIVST users recruited using dedicated leaflets inviting them to anonymously call a free phone number. We collected socio-demographics, sexual behaviours, HIV testing history, HIVST use, and satisfaction with HIVST. We reported the proportion of first-time testers and computed associated factors using logistic regression. RESULTS: Between March and June 2021, 2 615 participants were recruited for 50 940 distributed HIVST (participation rate: 5.1%). Among participants, 30% received their HIVST kit through secondary distribution (from a friend, sexual partner, family member, or colleague). The proportion who had never tested for HIV before HIVST (first-time testers) was 41%. The main factors associated with being a first-time tester were sex, age group, education level, condom use, and secondary distribution. A higher proportion was observed among those aged 24 years or less (55% vs 32% for 25-34, aOR: 0.37 [95%CI: 0.30-0.44], and 26% for 35 years or more, aOR: 0.28 [0.21-0.37]); those less educated (48% for none/primary education vs 45% for secondary education, aOR: 0.60 [0.47-0.77], and 29% for higher education, aOR: 0.33 [0.25-0.44]). A lower proportion was observed among women (37% vs 43%, aOR: 0.49 [0.40-0.60]); those reporting always using a condom over the last year (36% vs 51% for those reporting never using them, aOR: 2.02 [1.59-2.56]); and those who received their HISVST kit through primary distribution (39% vs 46% for secondary distribution, aOR: 1.32 [1.08-1.60]). CONCLUSION: ATLAS HIVST strategy, including secondary distribution, successfully reached a significant proportion of first-time testers. HIVST has the potential to reach underserved populations and contribute to the expansion of HIV testing services in West Africa

Evaluation of Group Genetic Ancestry of Populations from Philadelphia and Dakar in the Context of Sex-Biased Admixture in the Americas

Population history can be reflected in group genetic ancestry, where genomic variation captured by the mitochondrial DNA (mtDNA) and non-recombining portion of the Y chromosome (NRY) can separate female- and male-specific admixture processes. Genetic ancestry may influence genetic association studies due to differences in individual admixture within recently admixed populations like African Americans.We evaluated the genetic ancestry of Senegalese as well as European Americans and African Americans from Philadelphia. Senegalese mtDNA consisted of approximately 12% U haplotypes (U6 and U5b1b haplotypes, common in North Africa) while the NRY haplotypes belonged solely to haplogroup E. In Philadelphia, we observed varying degrees of admixture. While African Americans have 9-10% mtDNAs and approximately 31% NRYs of European origin, these results are not mirrored in the mtDNA/NRY pools of European Americans: they have less than 7% mtDNAs and less than 2% NRYs from non-European sources. Additionally, there is <2% Native American contribution to Philadelphian African American ancestry and the admixture from combined mtDNA/NRY estimates is consistent with the admixture derived from autosomal genetic data. To further dissect these estimates, we have analyzed our samples in the context of different demographic groups in the Americas.We found that sex-biased admixture in African-derived populations is present throughout the Americas, with continual influence of European males, while Native American females contribute mainly to populations of the Caribbean and South America. The high non-European female contribution to the pool of European-derived populations is consistently characteristic of Iberian colonization. These data suggest that genomic data correlate well with historical records of colonization in the Americas

Inhibition of Adaptive Immune Responses Leads to a Fatal Clinical Outcome in SIV-Infected Pigtailed Macaques but Not Vervet African Green Monkeys

African green monkeys (AGM) and other natural hosts for simian immunodeficiency virus (SIV) do not develop an AIDS-like disease following SIV infection. To evaluate differences in the role of SIV-specific adaptive immune responses between natural and nonnatural hosts, we used SIVagmVer90 to infect vervet AGM and pigtailed macaques (PTM). This infection results in robust viral replication in both vervet AGM and pigtailed macaques (PTM) but only induces AIDS in the latter species. We delayed the development of adaptive immune responses through combined administration of anti-CD8 and anti-CD20 lymphocyte-depleting antibodies during primary infection of PTM (n = 4) and AGM (n = 4), and compared these animals to historical controls infected with the same virus. Lymphocyte depletion resulted in a 1-log increase in primary viremia and a 4-log increase in post-acute viremia in PTM. Three of the four PTM had to be euthanized within 6 weeks of inoculation due to massive CMV reactivation and disease. In contrast, all four lymphocyte-depleted AGM remained healthy. The lymphocyte-depleted AGM showed only a trend toward a prolongation in peak viremia but the groups were indistinguishable during chronic infection. These data show that adaptive immune responses are critical for controlling disease progression in pathogenic SIV infection in PTM. However, the maintenance of a disease-free course of SIV infection in AGM likely depends on a number of mechanisms including non-adaptive immune mechanisms

Avaliação da adsorção de tetraciclina em adsorvente convencional e modificado com cloreto de ferro, sulfato de cobre e peróxido de hidrogênio : análise regenerativa e aplicação em matriz aquosa real

A tetraciclina (TC) é uma droga lícita amplamente utilizada no âmbito farmacêutico. Considerada um indicador de contaminação antropogênica, é de grande interesse o estudo de técnicas eficazes para sua remoção. O processo de adsorção pode ser considerado um tratamento complementar ao tratamento convencional de água e efluentes. Nesse contexto, o presente trabalho tem como objetivo determinar as condições operacionais ótimas e o mecanismo de adsorção para a remoção de TC, utilizando sólido adsorvente convencional (CA) e modificado por cloreto de ferro (CAFe), sulfato de cobre (CA-Cu) e peróxido de hidrogênio (CA-H2O2), além de avaliar suas aplicações em matriz aquosa sintética e real e diferentes técnicas de regeneração. Na adsorção em batelada foram avaliadas as influências do pH (2 – 10), concentração de adsorvente (5 – 80 g.L-1) e tempo de contato (5 – 300 min). Foi realizada a investigação da cinética, do equilíbrio e da termodinâmica de adsorção. Analisaram-se a influência da temperatura, o tipo de solvente e o tempo de sonificação, respectivamente, para os três métodos regenerantes do sólido adsorvente – térmico, químico e ultrassônico. Para avaliar o tratamento com matriz aquosa real, a caracterização da carga poluidora e detecção de tetraciclina foram realizadas antes e após o processo de adsorção. Por fim, para confirmar suas propriedades, os materiais adsorventes foram caracterizados com análises de pHPCZ, MEV, DRX, FTIR e isotermas de adsorção/dessorção de N2. Os resultados mostraram que as condições ótimas de adsorção de TC para o sólido convencional são pH 4,0, tempo de retenção de 120 minutos e dosagem de adsorvente de 30 g.L-1. Os sólidos modificados se destacam, uma vez que não foi necessária a realização do ajuste de pH, apresentaram uma cinética inicial mais rápida e proporcionaram uma redução de no mínimo 50% de massa de adsorvente (15, 10 e 5 g.L-1 para CA-H2O2, CA-Fe e CA-Cu, respectivamente) necessária para a adsorção da tetraciclina, comparado com o sólido sem tratamento. Além disso, apresentaram uma maior área superficial e volume de mesoporos e não comprometeram a estrutura do material após a modificação. O modelo de pseudossegunda ordem foi o que melhor representou a cinética de adsorção do fármaco estudado. A isoterma de Redlich-Peterson descreveu o equilíbrio da TC nas três temperaturas, para todos os sólidos adsorventes. O estudo termodinâmico indicou que a adsorção foi espontânea, favorável e endotérmica. O tratamento com matriz aquosa real confirmou que a etapa de coagulação/floculação não consegue remover por completo a tetraciclina. Por fim, na etapa regenerativa, a eficiência de regeneração alcançou valores acima de 85%. Entre as três técnicas empregadas, o tratamento térmico a 200 °C foi selecionado como o agente regenerativo ótimo para o estudo, apresentando uma capacidade regenerativa de 90% até o sexto ciclo. De forma geral, este trabalho apresenta grande potencial em termos de remoção do micropoluente emergente tetraciclina, tanto em matriz aquosa sintética como real além uma possibilidade eficaz de regeneração e reutilização do sólido adsorvente saturado, minimizando resíduos e custos de tratamento.Tetracycline (TC) is a licit drug widely used in the pharmaceutical field. Considered an indicator of anthropogenic contamination, it is of great interest to study effective techniques for its removal. The adsorption process can be considered as a complementary treatment to conventional water and wastewater treatment. In this context, the present work aims to determine the optimal operating conditions and the adsorption mechanism for the removal of tetracycline drug (TC) using conventional adsorbent solid (CA) and modified by iron chloride (CA-Fe), copper sulfate (CA-Cu) and hydrogen peroxide (CA-H2O2), besides evaluating their applications in real aqueous matrix and different regeneration techniques. In batch adsorption the influences of pH (2 - 10), concentration of adsorbent (5 - 80 g.L-1) and contact time (5 - 300 min) were evaluated. The kinetics, equilibrium and adsorption thermodynamics were investigated. The influence of temperature, type of solvent and sonification time, respectively, were analyzed for the three regenerative methods of the adsorbent solid - thermal, chemical and ultrasonic. To evaluate the treatment with real aqueous matrix, the characterization of the pollutant charge and tetracycline detection were performed before and after the adsorption process. Finally, to confirm their properties, the adsorbent materials were characterized with pHPCZ, SEM, XRD, FTIR and N2 adsorption/desorption isotherms. The results showed that the optimum TC adsorption conditions for the conventional solid are at pH 4.0, retention time of 120 minutes and adsorbent dosage of 30 g.L-1. The modified solids stand out as no pH adjustment was required, had a faster initial kinetics and provided a minimum of 50% reduction in adsorbent mass (15, 10 and 5 gL-1 for CA-H2O2, CA-Fe and CA-Cu, respectively) for tetracycline adsorption compared to the untreated solid. Moreover, they presented a larger surface area and volume of mesoporous and did not compromise the material structure after modification. The pseudo-second order model best represented the adsorption kinetics of the studied drug. The Redlich-Peterson isotherm described the equilibrium of TC at all three temperatures for all adsorbent solids. The thermodynamic study indicated that the adsorption was spontaneous and favorable, besides increasing with the temperature increase. The actual aqueous matrix treatment confirmed that the coagulation/flocculation step cannot completely remove tetracycline. Finally, in the regenerative stage, the regeneration efficiency reached values above 85%. Among the three techniques employed, heat treatment at 200 ° C was selected as the optimal regenerative agent for the study, with a regenerative capacity of 90% until the sixth cycle. In general, this work has great potential in terms of removal of the emerging micro-pollutant tetracycline, both in synthetic and real aqueous matrix and an effective possibility of regeneration and reuse of saturated adsorbent solid, minimizing waste/treatment costs