Mesenteric schwannoma: about a rare disease

Parmi les tumeurs du mésentère, le schwannome est une variété exceptionnelle. Il fait partie des tumeurs conjonctives. Elles se caractérisent habituellement par leur latence clinique et leur faible potentiel de malignité. Nous rapportons un cas de schwannome mésentérique d’allure macroscopique maligne mais histologiquement bénin. Ce paradoxe clinique ainsi que la rareté de la tumeur font l’originalité de notre observation. La nature de la tumeur est donnée par histologie. La différenciation entre le caractère bénin et malin reste toujours difficile et parfois, seule, l’évolution peut trancher. Mots-clés Schwannome du mésentère, Tumeurs conjonctives, Macroscopie maligne mais histologie bénigne Le traitement repose sur l’exérèse chirurgicale. Le pronostic des schwannomes du mésentère est difficile à apprécier en raison du caractère exceptionnel ou de la rareté des cas rapportés. Les facteurs de mauvais pronostic sont : l’âge extrême, les schwannomes dans le cadre de la maladie de Von Recklinghausen (VR), la grande taille tumorale, le degré de la différenciation, l’importance de l’activité nécrotique et de l’activité mitotique

LE TRAITEMENT CHIRURGICAL DE L’ ANGIODYSPLASIE DUODENALE SURGICAL TREATEMENT OF DUODENAL ANGIODYSPLASIA

Management of angiodysplasia is usually based on endoscopic therapies. Surgical treatement is required in massive bleeding and when the others procedures failed. However the duodenal seat and diffuse lesions remains a challenging problem. We present two patients with duodenal angiodysplasia who underwent cephalic duodenopancreatectomy. Both patients had good follow-up. We justify our choice which is unusual by the duodenal seat, diffuse and symptomatic lesions and recurrent hemorrhage.Le traitement de l’angiodysplasie fait   habituellement appel aux méthodes endoscopiques. Le recours à la chirurgie s’impose devant une hémorragie massive ou en cas d’échec des autres thérapeutiques .Toutefois le siège duodénal et le caractère diffus des lésions angiodysplasiques rendent difficile la décision thérapeutique. Nous présentons deux cas d’angiodysplasie duodénale traités chirurgicalement. Le geste a consisté en une duodénopancréatectomie céphalique .Les suites immédiates et à distance étaient simples. Nous justifions notre choix thérapeutique qui reste exceptionnel par le siège duodénal des lésions, leur caractère symptomatique et durable ainsi que leur nombre élevé

Results of a phase 1, randomized, placebocontrolled first-in-human trial of griffithsin formulated in a carrageenan vaginal gel

HIV pre-exposure prophylaxis (PrEP) is dominated by clinical therapeutic antiretroviral (ARV) drugs. Griffithsin (GRFT) is a non-ARV lectin with potent anti-HIV activity. GRFT’s preclinical safety, lack of systemic absorption after vaginal administration in animal studies, and lack of cross-resistance with existing ARV drugs prompted its development for topical HIV PrEP. We investigated safety, pharmacokinetics (PK), pharmacodynamics (PD), and immunogenicity of PC-6500 (0.1% GRFT in a carrageenan (CG) gel) in healthy women after vaginal administration. This randomized, placebo-controlled, parallel group, double-blind first-in-human phase 1 study enrolled healthy, HIV-negative, non-pregnant women aged 24–45 years. In the open label period, all participants (n = 7) received single dose of PC- 6500. In the randomized period, participants (n = 13) were instructed to self-administer 14 doses of PC-6500 or its matching CG placebo (PC-535) once daily for 14 days. The primary outcomes were safety and PK after single dose, and then after 14 days of dosing. Exploratory outcomes were GRFT concentrations in cervicovaginal fluids, PD, inflammatory mediators and gene expression in ectocervical biopsies. This trial is registered with ClinicalTrials. gov, number NCT02875119. No significant adverse events were recorded in clinical or laboratory results or histopathological evaluations in cervicovaginal mucosa, and no anti-drug (GRFT) antibodies were detected in serum. No cervicovaginal proinflammatory responses and no changes in the ectocervical transcriptome were evident. Decreased levels of proinflammatory chemokines (CXCL8, CCL5 and CCL20) were observed. GRFT was not detected in plasma. GRFT and GRFT/CG in cervicovaginal lavage samples inhibited HIV and HPV, respectively, in vitro in a dose-dependent fashion. These data suggest GRFT formulated in a CG gel is a safe and promising on-demand multipurpose prevention technology product that warrants further investigation

National identity predicts public health support during a global pandemic

Changing collective behaviour and supporting non-pharmaceutical interventions is an important component in mitigating virus transmission during a pandemic. In a large international collaboration (Study 1, N = 49,968 across 67 countries), we investigated self-reported factors associated with public health behaviours (e.g., spatial distancing and stricter hygiene) and endorsed public policy interventions (e.g., closing bars and restaurants) during the early stage of the COVID-19 pandemic (April-May 2020). Respondents who reported identifying more strongly with their nation consistently reported greater engagement in public health behaviours and support for public health policies. Results were similar for representative and non-representative national samples. Study 2 (N = 42 countries) conceptually replicated the central finding using aggregate indices of national identity (obtained using the World Values Survey) and a measure of actual behaviour change during the pandemic (obtained from Google mobility reports). Higher levels of national identification prior to the pandemic predicted lower mobility during the early stage of the pandemic (r = −0.40). We discuss the potential implications of links between national identity, leadership, and public health for managing COVID-19 and future pandemics.publishedVersio

National identity predicts public health support during a global pandemic (vol 13, 517, 2022) : National identity predicts public health support during a global pandemic (Nature Communications, (2022), 13, 1, (517), 10.1038/s41467-021-27668-9)

Publisher Copyright: © The Author(s) 2022.In this article the author name ‘Agustin Ibanez’ was incorrectly written as ‘Augustin Ibanez’. The original article has been corrected.Peer reviewe

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Pneumatosis cystoides intestinalis with ascitis : an exceptional association

La pneumatose kystique intestinale (PKI) est une pathologie bénigne rare. C'est une entité qui reste encore mal connue et pose des problèmes diagnostiques et thérapeutiques. Les auteurs rapportent un cas de pneumatose kystique intestinale secondaire à une maladie ulcéreuse gastro-duodénale sténosante, associée à une ascite chez un homme de 36 ans qui s'est présenté avec des vomissements et une distension abdominale. L'endoscopie oeso-gastro-duodénale a révélé un énorme estomac de stase avec un pylore infranchissable. Le diagnostic de PKI a été évoqué à la radiographie de l'abdomen sans préparation et confirmé par laparotomie exploratrice. Le patient a bénéficié d'une gastrectomie des 2/3. L'évolution a été favorable avec disparition de l'ascite. Les auteurs exposent ce deuxième cas de pneumatose kystique et ascite; ils discutent la nature de cette association

A dose-finding, cross-over study to evaluate the effect of a Nestorone®/Estradiol transdermal gel delivery on ovulation suppression in normal ovulating women

Objective: This study aims to determine the lowest effective of three Nestorone (NES)/estradiol (E2) transdermal gel doses to ensure ovulation suppression in 90–95% of cycles. Methods: This was a randomized, open-label, three-treatment-period cross-over study to evaluate the effects of NES/E2 transdermal gel on ovulation inhibition, suppression of follicular growth and pharmacokinetic parameters. The doses were low (1.5 mg NES/0.5 mg E2), medium (3.0 mg NES/1.0 mg E2) and high (4.5 mg NES/1.5 mg E2). Participants applied gel daily to a fixed area on the abdomen for 21 consecutive days. They were interviewed regarding their experiences using the gel. Results: Eighteen participants were randomized; 16 completed the study. Median NES Cmax values for low, medium and high dose groups at day 21 were 318.6 pmol/L, 783.0 pmol/L and 1063.8 pmol/L, respectively. Median maximum follicular diameter was higher with the lowest dose with 16.2 mm versus 10.0 and 10.4 mm with the medium and high doses, respectively. Among adherent participants, ovulation was inhibited in all dose groups, except for one participant in the medium dose (6.7%) that had luteal activity and an ultrasound image suggestive of a luteinized unruptured follicle. There were few reports of unscheduled bleeding, with more episodes reported for the lower dose. Adverse events were mild, and no skin irritation was reported from gel application. Conclusion: While all three doses blocked ovulation effectively and were evaluated as safe and acceptable, the medium dose was considered the lowest effective dose based on a more adequate suppression of follicular development. Further development of this novel contraceptive delivering NES and E2 is warranted and has potential for improved safety compared to ethinyl-estradiol-based methods