Changements développementaux dans la survenue d'épisodes de somnambulisme chez les patients somnambules adultes

Loin d'être bénins, les épisodes somnambuliques peuvent être fréquents et/ou graves et comporter un risque élevé de blessures. Une amnésie rétrograde variable peut également accompagner les épisodes. Ce mémoire a examiné l'évolution des épisodes de somnambulisme a trois différentes phases de la vie, un sujet qui reste peu étudié. Des somnambules adultes ayant reçu un diagnostic de somnambulisme primaire, et qui ont été somnambules dès leur enfance (n = 113), ont été évalués pour la fréquence de leurs épisodes, le rappel des contenus mentaux liés à leurs épisodes et l’occurrence d’épisodes agressifs pendant l'enfance, l'adolescence et l'âge adulte. Également, les somnambules qui font des terreurs nocturnes (une parasomnie de sommeil lent souvent observés chez les somnambules) depuis leur enfance (n = 52) ont été évalués pour les changements développementaux dans leurs terreurs nocturnes. Les résultats démontrent que les épisodes de somnambulisme sont demeurés stables pendant l'enfance et l'adolescence de nos somnambules, mais ont augmenté à l'âge adulte. Une tendance opposée a été observée quant à la fréquence des terreurs nocturnes. Le rappel des contenus mentaux associé au somnambulisme et les épisodes agressifs ont augmenté progressivement de l’enfance à l’âge adulte. En contrepartie, le rappel des contenus mentaux associé aux terreurs nocturnes est demeuré stable. De plus, une fréquence plus élevée d'épisodes de somnambulisme agressif c’est avérée un prédicteur d’une fréquence plus élevée d’un rappel de contenu mental lié au somnambulisme. Ces résultats sont comparables entre les hommes et les femmes. Dans l’ensemble, cette recherche démontre que chez les somnambules chroniques, le contenu mental associé aux épisodes somnambuliques augmente et que la fréquence et la sévérité des épisodes s'aggravent entre l’enfance et l’âge adulte.Far from being benign, somnambulistic episodes can be frequent and/or severe and with high risk of injury. Episodes may also be accompanied by sleep mentation with variable degrees of retrograde amnesia. The present thesis investigated how somnambulistic episodes unfold over time, a topic that remains understudied. Adult sleepwalkers with a diagnosis of primary somnambulism and a childhood onset of the disorder (n = 113) were assessed for changes in frequency of their episodes, recall of episode-related sleep mentation and aggressive episodes during childhood, adolescence and adulthood. Additionally, sleepwalkers (n= 52) with childhood- onset of sleep terrors (a NREM parasomnia commonly experienced by sleepwalkers) were assessed for developmental changes in sleep terror frequency. The frequency of somnambulistic episodes remained unchanged during childhood and adolescence before increasing into adulthood. An opposite trend was observed for the frequency of sleep terrors. The frequency of aggressive somnambulistic episodes and of sleep mentation associated with somnambulism increased from childhood to adolescence and into adulthood. By contrast, the recall of sleep mentation associated with sleep terrors did not change over time. Additionally, a higher frequency of aggressive somnambulistic episodes predicted a higher frequency of sleep mentation associated with somnambulism. These findings were similar between men and women. In conclusion, our study demonstrates that in chronic sleepwalkers, sleep mentation associated with somnambulistic episodes increases with age while episodes worsen in frequency and severity from childhood to adulthood

Rupture of Hydatid Liver Cyst into Peritoneal Cavity Following Blunt Abdominal Trauma; a Case Report

Hydatid cyst is a serious parasitic infection in places which people has a close contact with dogs or sheep. They may be found as an incidental findings during routine clinical examination or even followed by radiographic or ultrasonography evaluation. The disease becomes more complicated if rupture of the cysts occurs due to blunt trauma or spontaneously increases of intra-cystic pressure. Here, we reported a case of hydatid liver cyst that ruptured into the peritoneal cavity after blunt abdominal trauma

Cryptosporidium spp. infection in Iranian children and immunosuppressive patients: A systematic review and meta-analysis

Background: Cryptosporidiosis is an important cause of diarrhea in children and immunosuppressive patients. The current study was intended to evaluate the prevalence rate of Cryptosporidium infection and clarify the epidemiological characteristics of the infection in both children and immunosuppressive patients in Iran. Methods: Five English electronic databases including PubMed, Google Scholar, Science Direct, Scopus and Cochrane, and two Persian language databases Magiran and Scientific Information Database were searched. Additionally, reports from the Iranian congresses of parasitology and graduate student thesis dissertations were assessed manually. Results: Out of 1856 studies from the literature search, our search resulted in a total of 27 articles published from 1991 to 2016. These include 14 reports on cryptosporidiosis in children and 13 papers regarding immunosuppressive patients. 8520 children and 2015 immunosuppressed cases were evaluated. Oocysts of Cryptosporidium were found in 3.8% and 8% children cases and immunosuppressed patients, respectively. There was a relatively high variation in the prevalence estimates among different studies, and the Q statistics was high among articles regarding children (p<0.0001) and also between records regarding immunosuppressed patients (p<0.0001). Findings showed that the prevalence rates of Cryptosporidium infection are significantly higher in children under 5 years (P=0.00). Conclusions: In summary, the present study provides a comprehensive view of the epidemiology of Cryptosporidium in children and immunosuppressive patients in Iran. Furthermore, a multidisciplinary and multicenter study to evaluate the real prevalence of Cryptosporidium infection and to determine its risk factors using an adequate sample size and standardized methods is highly recommended

Characterization of antigens expressed on the surface of infected erythrocytes with Plasmodium falciparum

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A Multi-Locus Study of Cryptosporidium Parasites Isolated From Patients Living In Iran, Malawi, Nigeria, the United Kingdom, and Vietnam

  Background: Cryptosporidium species are important cause of diarrheal diseases in both developing and developed countries. This study aimed to compare the perfor-mance of several molecular methods for identification of Cryptosporidium species, and to detect genetic variation among each of these species isolated from Iran, Ma-lawi, Nigeria, Vietnam and the United Kingdom. Methods: The oocysts DNA samples were derived from 106 Cryptosporidium posi-tive feces. Polymerase chain reaction, PCR- restriction fragment length polymor-phism and DNA sequence analysis of the 18S rRNA and the Cryptosporidium oo-cysts wall protein genes; PCR and DNA sequence analysis of a fragment of 70 kDa heat shock protein and 60 kDa glycoprotein genes were carried out. Results: Based on these analysis, three species of Cryptosporidium including C. homi-nis, C. parvum and C. meleagridis, and both C. hominis and C. parvum were found in Iranian and the UK samples, respectively. Also, three C. hominis (Ib, Ib3& Id) and three C. parvum (IIa, IIc & IId) subtypes were identified by sequence analysis of the GP60 gene. Of these, C. hominis Ib was predominant and interestingly, one subgen-otype (C. hominis Ib A10G2) accounted for the majority of the samples. Conclusion: The current study demonstrates the complex subtypes of Cryptosporid-ium isolates in both developing and developed countries. This is the first report of C. parvum IId subgenotype and three new subtypes of C. parvum IIa in the UK, a new subtype of C. hominis Id from Malawi; and the first multi-locus study of three species of Cryptosporidium in human from Iran

Recognition of Cryptosporidium oocysts in fresh and old stool samples: comparison of four techniques

Objective: To perform a comparative diagnosis of Cryptosporidium infection in fresh and old stool specimens. Methods: A total of 518 stool samples including 464 diarrheic human samples, 53 samples from calves with or without diarrhea and one sample from a sheep were screened. Initially, the auramine phenol, modified Ziehl-Neelsen and ELISA techniques, were preformed. Subsequently, PCR of the 18S rRNA gene of Cryptosporidium was carried out on all positive samples obtained by microscopy and ELISA. Results: Auramine phenol and Ziehl-Neelsen identified Cryptosporidium oocysts in 49 (9.5%) and 56 (10.8%) out of 518 samples, respectively. Cryptosporidium specific antigen was found in 97/518 (18.7%) of the samples by the ELISA test. The 18S rRNA gene of the parasite was amplified in 79 out of 119 (66.4%) samples by PCR. Comparison of the detection rates between the diagnostic methods, i.e. PCR and ELISA, showed that there was a moderate level of agreement between these tests (Kappa=0.55). Conclusions: The current study suggested that PCR or ELISA methods with one of microscopy technique should be used for screening of Cryptosporidium infection in a stool sample collection

Comparison of ertapenem non-susceptibility with 2-mercaptopropionic acid phenotypic tests in predicting NDM-1 and IMP-1 production in clinical isolates of Escherichia coli

Background: A routine phenotypic test has not been recommended for detection of metallo-&#946;-lactamases (MBLs) producing Enterobacteriaceae species such as Escherichia coli. The current study was conducted to compare the 2-Mercaptopropionic acid (2-MPA) phenotypic method and ertapenem non-susceptibility test with polymerase chain reaction in predicting the production of MBLs in clinical isolates of E. coli. Methods: Antimicrobial susceptibility test for beta-lactam antibiotics were performed by disk diffusion method. All isolates which showed inhibition zones of &#8804; 22 mm for CAZ and &#8804; 27 mm for CTX were considered potential MBLs producing isolates. The production of MBLs was confirmed using 2-MPA compound. Also, susceptibility to ertapenem was evaluated in all isolates. Conventional PCR was performed to detect blaIMP-1 and/or blaNDM-1 genes in all potential MBLs producing E. coli isolates. Results: Of 259, 138 (53.3) isolates were potential MBLs producing bacteria. One hundred and fifteen out of 138 (83.3) isolates were susceptible to ertapenem. MBLs production was confirmed in 75/138 (54.4) isolates by 2-MPA phenotypic method.&#160; The blaNDM-1 or/and blaIMP-1 genes were found in 30/75(40) and 39/115(33.9) isolates which were confirmed by 2-MPA and were susceptible to ertapenem, respectively. The Sensitivity of 2-MPA method and ertapenem non-susceptibility test compared with PCR were 65.2 and 15.2, and the specificity was 52.1 versus 82.6, respectively. Conclusion: This study demonstrated that the 2-MPA phenotypic method does not have acceptable sensitivity and specificity in comparison with PCR, but its results are more reliable for the detection of MBL producing E. coli isolates compared with non-susceptibility to ertapenem

Vaccination — A Step Closer to Universal Health Coverage

Vaccination saves countless lives worldwide. However, a gap in accessibility to and acceptability of vaccines is observed locally and globally. This gap must be addressed through a combined intersectoral approach that takes into account different social, economic, political and environmental aspects of vaccination. In addition, a comprehensive strategy is necessary to provide better immunization to all as the Decade of Vaccines comes to an end

Rupture of Hydatid Liver Cyst into Peritoneal Cavity Following Blunt Abdominal Trauma; a Case Report

Hydatid cyst is a serious parasitic infection in places which people has a close contact with dogs or sheep. They may be found as an incidental findings during routine clinical examination or even followed by radiographic or ultrasonography evaluation. The disease becomes more complicated if rupture of the cysts occurs due to blunt trauma or spontaneously increases of intra-cystic pressure. Here, we reported a case of hydatid liver cyst that ruptured into the peritoneal cavity after blunt abdominal trauma.</p