Prise en charge des complications des fistules artério-veineuses pour hémodialyse chronique

La fistule artério-veineuse native est l'accès vasculaire de choix pour  l'hémodialyse chronique en raison de sa longévité, son taux faible de complication et de mortalité par rapport aux pontages artério-veineux et aux cathéters. Cependant, il arrive assez souvent que l'on assiste à des complications qui sont dominées par la sténose et la thrombose. C'est une étude rétrospective des complications ayants survenues pour 31 fistules artério-veineuses pour hémodialyse chronique des 200 fistules réalisées chez 200 patients au sein du service de chirurgie vasculaire du CHU Hassan II de Fès sur une période de trois ans, étendue de Janvier 2007 à  Décembre 2009. Ces complications ont été présentés par les thrombosesdans 14 cas soit 45,15% de l'ensemble des complications, les sténoses dans 4 cas (12,90%,) les anévrismes dans 4 cas (12,90%), les  complications ischémiques dans 3 cas (9,67%), l'infection dans 3 cas (9,67%), l'hémorragie dans 2 cas (6,45%) et l' hyperdébit dans un seul cas soit 3,22%. On a pu conserver 22 fistules soit 70,96% par traitement chirurgical ou endovasculaire, on a confectionné une nouvelle fistule dans 8cas soit 25,80%, et on a adressé une patiente (3,22%) pour pose d'un cathéter veineux tunnelisé permanent. Les complications des fistules artério-veineuses pour l'hémodialyse chronique sont la principale cause de morbidité chez les patients hémodialysés, il est donc important de s'impliquer lors de leur création, et de donner un maximum d'attention quand ils sont manipulés. Ceci suggère la mise en place d'un programme de surveillance de ces fistules en raison de l'impact des complications sur la morbi-mortalité du patient hémodialysé et sur le plan financier

The geoenvironmental factors influencing slope failures in the Majerda basin, Algerian-Tunisian border

In mountainous regions globally, landslides pose severe threats to both human lives and infrastructure, with the Mediterranean region, in particular, being highly susceptible to these destructive events that result in substantial damage to settlements and infrastructure. In this study, we employ a GIS-based approach to comprehensively characterize terrain instabilities along the Algerian-Tunisian border, recognizing the critical need for effective land planning and disaster mitigation strategies in this context. Our methodology integrates geological, geophysical, and geotechnical reconnaissance techniques and multi-criteria analysis, with a particular focus on geotechnical parameters. Our findings reveal significant slope instability within the study area; it is particularly concentrated in the mid-altitude slopes of the eastern basin, with high and very high susceptibility zones covering 20.89% of the study area. Validation of our model through ROC analysis demonstrates its high accuracy, with an area under the curve (AUC) value of 0.92. Crucially, slope gradients and precipitation emerge as key contributors to landslide occurrence, alongside Triassic lithofacies, which is a significant geological factor influencing susceptibility. These results emphasize the necessity of identifying high-landslide-susceptibility regions for sustainable land management and risk reduction, which will ultimately enhance the resilience of the studied region and mitigate the associated natural hazard risks

Genetic structure and variability within and among populations of the fat-tailed Barbarine sheep breed using microsatellites markers

This study investigates the genetic diversity and the structure of the most dominant native fat-tailed Tunisian sheep breed (Barbarine, BAR) using microsatellite markers. Blood samples from 183 BAR animals, belonging to 4 subpopulations according to phenotypic traits, were collected across all regions in Tunisia. BAR animals and 31 Appenninica Italian sheep breed (APP) used as an out-group were genotyped at 17 microsatellites loci. A total of 270 alleles were identified with average gene diversity equal to 0.812. The mean observed heterozygosity (0.745) and allelic richness (8.09) estimates were high within BAR breed highlighting notable levels of genetic diversity. The low FIS (0.078) and FIT (0.084) values indicate low level of inbreeding within this breed while a low FST estimate (0.007) shows that the subpopulations are not genetically differentiated. The clustering analysis performed with ‘structure’ detected the absence of substructures and the clear uniqueness of the BAR. Tomiuk and Loeschcke’s DTL genetic distance values confirmed the distinction between APP and BAR breeds. Results arising from our microsatellites analysis represent a starting point for the valorization of this indigenous Tunisian sheep breed. A suggestion was made to monitor its genetic variability and for the preservation of this breed for the next generations.Keywords: Tunisian Barbarine sheep breed, microsatellite markers, genetic variability, population structureAfrican Journal of Biotechnology, Vol. 13(1), pp. 44-54, 1 January, 201

Estimación de la composición tisular de corderos Barbarine de cola grasa mediante medidas en vivo de la cola

Los autores agradecen al personal del INRAT, especialmente a Zina Taghouti por su colaboración.Publishe

Synchronous Primary Tumors of the Kidney and Pancreas: Case Report

The simultaneous presence of primary carcinomas in the same patient is uncommon and synchronous primary tumors involving the kidney and pancreas are extremely rare. There are a few reports in the English literature of synchronous primary malignancies of the kidney and pancreas. We present a 62-year-old man who had weight loss of 9 kg and epigastric pain. Findings showed a Furhman grade II renal papillary carcinoma confined to the kidney and a synchronous well differentiated pancreatic ductal adenocarcinoma.Key Words: Synchronous double cancer, renal cell carcinoma, pancreatic carcinom

Impact of age on NIS2+™ and other non-invasive blood tests for the evaluation of liver disease and detection of at-risk MASH

\ua9 2024 The Author(s)Background & Aims: Robust performance of non-invasive tests (NITs) across ages is critical to assess liver disease among patients with metabolic dysfunction-associated liver disease (MASLD). We evaluated the impact of age on the performance of NIS2+™ vs. other NITs. Methods: An analysis cohort (N = 1,926) with biopsy-proven MASLD was selected among individuals screened for the phase III RESOLVE-IT clinical trial and divided into ≤45, 46–55, 56–64, and ≥65 years groups. To avoid potential confounding effects, a well-balanced cohort (n = 708; n = 177/age group) was obtained by applying a propensity score-matching algorithm to the analysis cohort. Baseline values of biomarkers and NITs were compared across age groups using one-way ANOVA, and the impact of age and histology were compared through three-way ANOVA. The impact of age on NIT performance for the detection of at-risk metabolic dysfunction-associated steatohepatitis (MASH; MASLD activity score [MAS] ≥4 and fibrosis stage [F] ≥2) was also evaluated. Results: Age did not affect the distributions of NIS2+™ and APRI (aspartate aminotransferase-to-platelet ratio index), but significantly (p <0.0001) impacted those of NFS (NAFLD fibrosis score), FIB-4 (Fibrosis-4 index), and Enhanced Liver Fibrosis (ELF™) score. NIS2+™ was the only NIT on which fibrosis and MAS exerted a moderate to large effect. While the impact of fibrosis on APRI was moderate, that of MAS was low. The impact of age on FIB-4 and NFS was larger than that of fibrosis. NIS2+™ exhibited the highest AUROC values for detecting at-risk MASH across age groups, with stable performances irrespective of cut-offs. Conclusions: NIS2+™ was not significantly impacted by age and was sensitive to both fibrosis and MAS grade, demonstrating a robust performance to rule in/out at-risk MASH with fixed cut-offs. Impact and Implications: While metabolic dysfunction-associated steatotic liver disease (MASLD) can affect individuals of all ages, patient age could represent an important confounding factor when interpreting non-invasive test (NIT) results, highlighting the need for reliable and efficient NITs that are not impacted by age and that could be interpreted with fixed cut-offs, irrespective of patient age. We report the impact of age on different well-established NITs – among those tested, only two panels, NIS2+™ and APRI, were not impacted by age and can be used and interpreted independently of patient age. NIS2+™ was also sensitive to both fibrosis and MAS, further confirming its efficiency for the detection of the composite endpoint of at-risk MASH and its potential as a valuable candidate for large-scale implementation in clinical practice and clinical trials

Arginine deprivation alters microglia polarity and synergises with radiation to eradicate non arginine auxotrophic glioblastoma tumors

New approaches for the management of glioblastoma (GBM) are an urgent and unmet clinical need. Here, we illustrate that the efficacy of radiotherapy for GBM is strikingly potentiated by concomitant therapy with the arginine depleting agent ADI-PEG20 in a non-arginine auxotrophic cellular background (Arginine Succinate Synthetase 1 positive). Moreover, this combination led to durable and complete radiological and pathological response with extended disease-free survival in an orthotopic immune competent model of GBM with no significant toxicity. ADI-PEG20 not only enhances the cellular sensitivity of Arginine succinate synthetase 1 positive GBM to ionising radiation by elevated production of nitric oxide (NO) and hence generation of cytotoxic peroxynitrites, but also promotes glioma-associated macrophages/microglia infiltration into tumors and turns their classical anti-inflammatory (pro-tumor) phenotype into a pro-inflammatory (anti-tumor) phenotype. Our results provide an effective, well-tolerated and simple strategy to improve GBM treatment which merits consideration for early evaluation in clinical trials