Ischemic cardiomyopathy revealed by central retinal artery occlusion (CRAO)

Here we report a case of central retinal artery occlusionrevealing an ischemic cardiomyopathy. A 54-year old smoker man presented at the hospital because of sudden visual loss in his left eye. There was cherry-red spot in the macula in his left eye. We performed a fluorescein angiogram and cervical color Doppler. Later   investigations revealed an ischemic cardiomyopathy undiagnosed until then.Key words: Central retinal artery occlusion, ischemic cardiomyopathy, cardiac thrombu

Cardiac metastasis from a renal cell carcinoma

Here we report a case of asymptomatic right ventricular tumor, for which surgical removal was done.  Pathology reveals that the mass is a metastasis of a renal carcinoma.Key words: Renal cell carcinoma, cardiac metastasis, myocardium, cardiac tumor

Przetoka wieńcowa uchodząca do lewej komory z objawami dławicy piersiowej

Coronary arterial fi stula is a rare defect characterized by a connection between one or more of the coronary arteries and a cardiac chamber or great vessel. Complications include ‘steal’ from the adjacent myocardium, thrombosis and embolism, cardiac failure, atrial fi brillation, rupture, endocarditis/endarteritis and arrhythmias. Here we report the case of a 73-year-old female that was admitted for unstable angina. Coronary angiography revealed the presence of multiple large coronary-cameral fi stula. CT scan confi rmed the presence of ecstasis of the left main artery, associated with coronary-cameral fi stulae between left ventricle and ramus intermedius artery and the circumfl ex artery.Przetoka wieńcowa to rzadka wada naczyniowa polegającą na obecności połączenia między jedną lub większą liczbą tętnic wieńcowych a jamą serca lub dużym naczyniem krwionośnym. Powikłania obejmują podkradanie krwi z przyległego obszaru mięśnia sercowego, zakrzepicę i zatorowość, niewydolność serca, migotanie przedsionków, pęknięcie, zapalenie wsierdzia/zapalenie ściany tętnic i zaburzenia rytmu. W niniejszej pracy przedstawiono przypadek 73-letniej chorej przyjętej do szpitala z powodu niestabilnej dławicy piersiowej. Koronarografi a ujawniła poszerzenie pnia lewej tętnicy wieńcowej oraz obecność dużej mnogiej przetoki wieńcowo-komorowej między lewą komorą a gałęzią pośrednią i gałęzią okalającą

Antioxidant Properties of Metabolites from New Extremophiles Microalgal Strain (Southern, Tunisia)

With the demand for bioproducts that can provide benefits for biotechnology sectors like pharmaceuticals, nutraceuticals, and cosmeceuticals, the exploration of microalgal products has turned toward extremophiles. This chapter is intended to provide an insight to most important molecules from halotolerant species, the cyanobacteria Phormidium versicolor NCC-466 and Dunaliella sp. CTM20028 isolated from Sfax Solar Saltern (Sfax) and Chott El-Djerid (Tozeur), Tunisia. These microalgae have been cultured in standard medium with a salinity of 80 PSU. The in vitro antioxidant activities demonstrated that extremolyte from Dunaliella and Phormidium as, phycocaynin, lipids, and polyphenol compound presents an important antioxidant potential

Cost-Utility Analysis of Oxybutynin vs. OnabotulinumtoxinA (Botox) in the Treatment of Overactive Bladder Syndrome

From MDPI via Jisc Publications RouterHistory: accepted 2021-08-06, pub-electronic 2021-08-19Publication status: PublishedBackground: The UK National Health Service (NHS) propose the use of oxybutynin prior to onabotulinumtoxinA (Botox) in the management of overactive bladder syndrome (OAB). Oxybutynin is costly and associated with poor adherence, which may not occur with Botox. We conducted a cost-utility analysis (CUA) to compare the medications. Methods: we compared the two treatments in quality-adjusted life years (QALYS), through the NHS’s perspective. Costs were obtained from UK-based sources and were discounted. Total costs were determined by adding the treatment cost and management cost for complications on each branch. A 12-month time frame was used to model the data into a decision tree. Results: Our results found that using Botox first-line had greater cost utility than oxybutynin. The health net benefit calculation showed an increase in 0.22 QALYs when Botox was used first-line. Botox also had greater cost-effectiveness, with the exception of pediatric patients with an ICER of £42,272.14, which is above the NICE threshold of £30,000. Conclusion: Botox was found to be more cost-effective than antimuscarinics in the management of OAB in adults, however less cost-effective in younger patients. This predicates the need for further research to ascertain the age at which Botox becomes cost-effective in the management of OAB

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

Caractérisation moléculaire des mutations germinales et somatiques associées au syndrome de Lynch en Tunisie

Bien que le cancer colorectal (CCR) soit relativement peu fréquent en Tunisie, la proportion de cancers colorectaux développés à un âge précoce est particulièrement élevée, suggérant une susceptibilité génétique. Néanmoins, jusqu'à présent, aucune étude génétique n'a été réalisée dans la population tunisienne. Le syndrome de Lynch ou syndrome HNPCC (cancer colo-rectal héréditaire sans polypose) constitue la cause la plus fréquente de CCR héréditaire. Il est dû à des mutations germinales affectant les gènes MMR de réparation des mésappariements de l'ADN. Notre travail de Thèse a eu pour objectif principal d'étudier les caractéristiques cliniques et génétiques du syndrome de Lynch en Tunisie. L'étude a porté sur 31 familles tunisiennes suspectées de syndrome de Lynch, dont 13 (42%) répondants aux critères d'Amsterdam. Dix mutations différentes, dont 8 nouvelles, ont été identifiées dans 11 familles (35,5%) : 5 dans MSH2 et 5 dans MLH1, dont un réarrangement de grande taille. Ainsi, dans la population tunisienne, au moins 35,5% des cancers développés dans le cadre d'une suspicion de syndrome de Lynch sont liés à des mutations germinales des gènes MMR. Ceci constitue une donnée particulièrement importante à prendre en considération pour la prise en charge des patients et de leur famille. L'identification des patients présentant avec un risque élevé de développer un CCR reste problématique. Celle-ci repose essentiellement sur l'histoire familiale des patients. Néanmoins, la recherche d'instabilité microsatellitaire et l'étude de l'expression des protéines MMR sont d'un intérêt majeur pour le dépistage du syndrome de Lynch. Une partie de notre travail a eu pour objectif de tenter d'identifier de nouveaux marqueurs d'aide au diagnostic de susceptibilité au cancer colorectal. Nous avons étudié le phénotype et les caractéristiques génétiques des tumeurs de 51 patients sélectionnés selon les critères de Bethesda. Comme attendu, la présence d'instabilité microsatellitaire et la perte d'expression des protéines MMR était significativement associées à l'existence chez les patients d'antécédents familiaux de cancers colorectaux (P < 0,001). De plus, la mucine sécrétée MUC5AC qui n'est pas exprimée dans le côlon adulte normal était plus fréquemment exprimée dans les tumeurs des patients présentant une histoire familiale de cancer colorectal (P = 0,039). Bien que préliminaire, ce résultat suggère que l'étude de l'expression de MUC5AC pourrait avoir un intérêt pour l'aide au dépistage des patients à haut risque de développer un cancer colorectalLILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

A comprehensive physical insight of inclined magnetic field on the flow of generalized Newtonian fluid within a conduit with Homogeneous-heterogeneous reactions

Modern nanomaterials and their flow dynamism processes promote complex chemical reactions that are necessary for the accurate synthesis of bespoke geometries at high temperatures. Such flow processes are very intricate and involve viscous behavior along with mass and heat transfer. Such flows mechanism can be controlled by external magnetic fields. Mathematical models offer an inexpensive opening into the fundamental properties of these dynamical processes. The homogeneous-heterogeneous reactions for nanofluids flow are established by invoking the Buongiorno's nanofluid model, in which the homogeneous reactions are regulated by first order kinetics occurring in the flowing liquid and the heterogeneous reactions are given by isothermal cubic autocatalytic kinetics. To testify the feasibility of this model, the steady, laminar Jaffrey-Hamel flow problem in the converging conduit is extended to rheological model. The system steady states are evaluated under the scenario where the reactant and the catalyst's diffusion coefficients are equivalent. In order to investigate heat and mass transfer analysis, viscous dissipation affirmation, Joule heating, and homogeneous-heterogeneous reactions are incorporated. The mathematical model prevailing the dimensionless function, velocity for flow, temperature for heat, and nanoparticles volume fraction for concentration are simulated numerically by means of Runge-Kutta method. The numerical algorithm has been validated in comparison to previously published research with extremely good agreement. The acquisition and detailed discussion of distributions of flow structure, heat, concentrations, and average Nusselt, Sherwood number at a wide range of critical characteristics. The fluid velocity in the conduit center increases significantly as the Reynolds number rises. By intensifying the magnetic field, the flow reversal control is accomplished. Applications in the allied domains have enormous promise since the ratio of Brownian and thermophoretic diffusivity has a significant impact on the transport mechanisms of homogeneous-heterogeneous processes. Chemical species A∗ and B∗ behave in fundamentally distinct ways in the reduced concentrations