Prescription of Proton Pump Inhibitors in Elderly Subjects in Real Life: A Retrospective Study in a Gastroenterology Department

The proton-pump inhibitor (PPI) is an effective and widely used treatment but may cause side effects, especially for the elderly. Materials and methods: this is a cross-sectional study including 45 patients older than 65 years, followed at our outpatient and treated with PPIs for at least a year. The indication for PPI, the results of any endoscopy, and the quality of the tolerance of these molecules is specified by the data folder. During the consultation, we conducted an interrogation to an update of the history and medications to our patients and a type checking of the molecule, the dose, and the quality of the observance. Results: patients were divided into 32 women and 13 men with a mean age of 75 ± 7 years (65–92). The average length of PPI use was 6 ± 4 years (1–16) with a consumption of a double dose for at least 1 year in 28.8% of cases. The prescribed dose was higher than the recommended dose in at least 15.5% of cases. PPIs were well tolerated. One patient had presented a microscopic colitis, revealed by diarrhea regressed after discontinuation of PPIs. Conclusion: PPIs were prescribed in elderly subjects by gastroenterologists, in a university center, with a high dose and long. In our series, this treatment is well tolerated in the elderly

Yeast Biomass: An Alternative for Bioremediation of Heavy Metals

Heavy metal pollution has become one of the most serious environmental problems throughout the world. Among the innovative solutions for treatment of contaminated water and soil, bioremediation that use biological materials like living or dead microorganisms is a promising, safe and economical technology. One of the most ubiquitous biomass types available for bioremediation of heavy metals is yeast. Yeast cells represent an inexpensive, readily available source of biomass that retains its removal ability for a broad range of heavy metals to varying degrees. Furthermore, yeasts exhibit the ability to adapt to extreme conditions such as temperature, pH and high levels of organic and inorganic contaminants. To understand the different mechanisms of interactions between metals and yeast strains in the environment, this paper will give an overview on the role that yeasts play in the immobilization/mobilization of toxic metals and factors affecting these processes. Biotechnological applications in the bioremediation of heavy metal such as bioaugmentation using degradation abilities of yeasts will also be discussed

Oxidative stress markers in intestinal mucosa of Tunisian inflammatory bowel disease patients

Background / Aims: Inflammatory bowel diseases (IBDs), Crohn′s disease (CrD) and ulcerative colitis (UC), are chronic gastrointestinal inflammatory disorders. The precise etiology of IBD remains unclear, and it is thought that interactions among various factors, including, genetic factors, the host immune system and environmental factors, cause disruption of intestinal homeostasis, leading to dysregulated inflammatory responses of the gut. As inflammation is intimately related to formation of reactive intermediates, including, reactive oxygen species, oxidative stress has been proposed as a mechanism underlying the pathophysiology of IBD. The purpose of this study is to examine the lipid peroxidation, protein oxidation and anti-oxidative profile in Tunisian IBD. Materials and Methods: Malondialdehyde (MDA), conjugated dienes (CD), protein thiol levels, as well as the catalase (CAT) activity were evaluated in intestinal biopsies of 17 patients affected by IBD (12 CrD and 5 UC) and 12 healthy control individuals. Results: Oxidative stress was confirmed in these two types of disease biopsies as compared to controls. MDA and CD levels were significantly increased in both UC and CrD patients′ biopsies as compared to controls′ biopsies ( P 0.05). Anon-significant decrease in thiol (SH) level was observed in both UC and CrD patients′ biopsies compared with controls′ biopsies ( P > 0.05). Conclusion: Increased levels of MDA and CD in IBD patients′ biopsies underline the implication of oxidative stress in the physiopathology of IBD

Effets indésirables de la sulfasalazine : discussion de leur mécanisme et du rôle de la composante sulfamidée

La sulfasalazine est largement utilisée dans le traitement des maladies inflammatoires chroniques de l’intestin (MICI) et de certaines affections rhumatologiques. Cependant, son utilisation est associée à un taux élevé d’effets indésirables (EI). Ces effets peuvent être cutanés, hématologiques, rénaux, hépatiques, digestifs ou neurologiques. L’objectif de notre travail était de colliger tous les cas d’EI suspectés d’être liés à l’utilisation de la sulfasalazine, chez des patients hospitalisés au service de gastroentérologie de l’hôpital Hédi Chaker de Sfax (Tunisie) durant une période de 5 ans et de préciser la fraction responsable de la réaction (mésalazine ou sulfapyridine). Notre population d’étude a comporté 69 patients qui ont reçu la sulfasalazine pour le traitement d’une MICI. Nous avons colligé, chez 23 patients (33 %), 25 EI suspects d’être liés à la sulfasalazine. Ces EI sont surtout de type cutané et hématologique. L’administration ultérieure de la mésalazine a été effectuée chez 15 patients. Elle a été bien tolérée chez 14 patients. Ainsi, la responsabilité de la fraction sulfamidée a été fortement suspectée dans ces cas. Le mécanisme des EI induits par la sulfasalazine peut être toxique ou immuno-allergique avec possibilité d’allergie croisée avec les autres sulfamides et/ou salicylés

Autoimmune diseases association study with the KIAA1109–IL2–IL21 region in a Tunisian population

This deposit is composed by a publication in which the IGC's authors have had the role of collaboration (it's a collaboration publication). This type of deposit in ARCA is in restrictedAccess (it can't be in open access to the public), and can only be accessed by two ways: either by requesting a legal copy from the author (the email contact present in this deposit) or by visiting the following link: https://link.springer.com/article/10.1007%2Fs11033-014-3596-5This deposit is composed by the main article plus the supplementary materials of the publication.This publication hasn't any creative commons license associated.Further funders are not indicated in the document.Autoimmune diseases (ADs) share several genetic factors resulting in similarity of disease mechanisms. For instance polymorphisms from the KIAA1109-interleukin 2 (IL2)-IL21 block in the 4q27 chromosome, has been associated with a number of autoimmune phenotypes. Here we performed a haplotype-based analysis of this AD related region in Tunisian patients. Ten single nucleotide polymorphisms (rs6534347, rs11575812, rs2069778, rs2069763, rs2069762, rs6852535, rs12642902, rs6822844, rs2221903, rs17005931) of the block were investigated in a cohort of 93 systemic lupus erythematosus (SLE), 68 ulcerative colitis (UC), 39 Crohn's disease (CD) patients and 162 healthy control subjects of Tunisian origin. In SLE population, haplotypes AGCAGGGTC, AGAAGAGTC, AGAAGGGTC and AGCCGAGTC provided significant evidence of association with SLE risk (p = 0.013, 0.028, 0.018 and 0.048, respectively). In the UC population, haplotype AGCCGGGTC provided a susceptibility effect for UC (p = 0.025). In the CD population, haplotype CAGGCC showed a protective effect against the development of CD (p = 0.038). Haplotype AAGGTT provided significant evidence to be associated with CD risk (p = 0.007). Our results support the existence of the associations found in the KIAA1109/IL2/IL21 gene region with ADs, thus confirms that the 4q27 locus may contribute to the genetic susceptibility of ADs in the Tunisian population.This work was supported by a grant from the «Ministère de la recherche Scientifique et de la recherche scientifique» (Tunisia). Genotyping was supported by the Instituto Gulbenkiande Ciência, Oeiras, Portugal.info:eu-repo/semantics/publishedVersio

A survey to explore the psychological and professional impact of change imposed by COVID-19

Aim: Staff of a department underwent a change following the COVID-19 pandemic. The objective of this study was to assess the psychological and professional impact of this change. Materials & methods: This is cross-sectional study, including all department staff conducted from 15 July 2021 to 15 August 2021 Results: All the staff concerned (n = 36) participated. Only 9.37% declared that they understood the change. The main problem encountered by participants was poor communication (86.2%). More than 75% among participants had a demotivation and 54.5% had resisted. The main cause of resistance was quality of organization (42.4%). Conclusion: Our study illustrates the difficulties encountered by actors involved in organizational change and the high risk of their resistance

Short-term maximal performance, alertness, dietary intake, sleep pattern and mood states of physically active young men before, during and after Ramadan observance.

PurposeTo assess changes in short-term maximal performance, alertness, dietary intake, sleep pattern and mood states of physically active young men before (BR), during and after Ramadan observance.MethodsTwelve physically-active men (age: 21.9±2.4yrs, height:1.77±0.09m, body-mass: 72.6±7.8kg, exercising: ≥3h/week) performed the 5-jump and the digit-cancellation (alertness) tests 15-days BR, on the first (FR) and last 10-days of Ramadan (ER) and 10-days (AR10) and 20-days (AR20) after Ramadan. During each period, sleep pattern (Pittsburgh-Sleep-Quality-Index (PSQI)), mood states (Profile-of-Mood-States (POMS)) and dietary intake were recorded.ResultsNo significant changes in the 5-jump, digit-cancellation test and POMS parameters appeared during and after Ramadan relative to BR. However, the PSQI total score was lower during FR compared to AR10 (pConclusionRamadan had no-adverse effects on the 5-jump performance, alertness, or mood states in physically active young men. However, the sleep duration was shorter and the sleep quality was improved following compared to during Ramadan. The fractional intake of fat also increased at the expense of carbohydrate during Ramadan, and the protein intake was lower at the beginning of Ramadan than before, at the end of and after Ramadan

Cirrhotic cardiomyopathy: is there any correlation between the stage of cardiac impairment and the severity of liver disease?

Cirrhotic cardiomyopathy is associated with poor prognosis and risk of acute heart failure after liver transplantation or interventional procedures. We aimed to assess the relationship between the severity of cardiac impairment and hepatic disease. Eighty patients and eighty controls underwent echocardiography, tissue Doppler imaging and speckle tracking measures. We assess the correlation between echocardiographic parameters and Child and MELD scores. Systolic parameters function (s wave, p < 0.001) and global longitudinal strain (p < 0.001) as well as diastolic parameters were significantly more impaired in cirrhotic patients compared to controls. There were no differences among the different groups in ‘Child score’ regarding systolic function as well as diastolic function. Paradoxically, the left atrium size correlated positively to both Child (p = 0.01, r = 0.26) and MELD scores (p = 0.02, r = 0.24). Left ventricular ejection fraction was significantly lower in decompensated patients as compared to compensated patients(p = 0.02).. We did not identify any association between severity of liver disease and cardiac dysfunction. Therefore, a transthoracic echocardiography should be performed in all cirrhotic patients before interventional and surgical procedures regardless of the severity of liver disease

Alexithymia impairs quality of life in irritable bowel syndrome

Aim: Our objectives were to compare the frequency of alexithymia and the alteration of quality of life in irritable bowel syndrome (IBS) and to determine the factors associated with alexithymia and quality of life deterioration. Method: This is a comparative study which collected 80 IBS patients and 80 controls. Results: Quality of life was impaired in 75% of patients vs 37.5% (p < 0.0001). The prevalence of alexithymia was 50% in patients vs 1.2% (p < 0.0001). In multivariate analysis, an impaired quality of life was associated with alexithymia (p = 0.003). The factors associated with impaired quality of life were anxiety and alexithymia. Conclusion: Alexithymia was present in half of patients with IBS and its was associated with impaired quality of life