Profil glucido-lipidique et risque cardiovasculaire chez les diabétiques de type 2

AbstractBackground-Diabetes is a real health public problem because of its many potential complications,particularly the cardiovascular ones.The aim of this work was to describe the clinicaland biological profile in type 2 diabetic population, then to study the relationship betweenglycemic control and lipid abnormalities with micro and macro vascular complications.Methods - It was about a retrospective study of 341 type 2 diabetes patients’ with an averageage of 60.1 ± 11.71 years.The IBM® SPSS statistics 20.0 software was used for analyzing data.Only significant associations (p ≤ 5%) were retained.Results -An HbA1c level ≥7% was observed in 82,5% of patients, More than 60% have dyslipidemia.52,8% of them have an LDLc level ≤ 1 g/l, and 64,4% have a Non-HDLc level >1g/l.Sixty-six percent of patients have high blood pressure. The macrovascular disorders wereobserved on 30,9% of patients and microvascular ones on 66,8% of them (p = 0.0001).Thelogistic regression analysis showed that HbA1c was the most significant biological parameter(p=0,008).while for micro-vascular complications, high blood pressure was the only associatedfactor (p = 0.03). For ischemic heart disease, dyslipidemia and high blood pressurewere the most associated factors.Conclusion - this study showed a high frequency of micro and macrovascular complications,lipid abnormalities and a very poor glycemic control. The elevation of HbA1clevel, the high blood pressure and dyslipidemia are the most associated factors with ahigh cardiovascular risk. RésuméIntroduction-Le diabète est un véritable problème de santé publique du fait deses nombreuses complications potentielles, notamment cardiovasculaires. Notreobjectif était de décrire le profil clinico-biologique chez une population de diabétiquetype 2 et d’étudier la relation entre l’équilibre glycémique et les anomalieslipidiques avec les complications micro et macroangiopathiques.Matériels et méthodes -Nous avons mené une étude rétrospective portant sur 341 patientsdiabétiques type 2.Les données ont été analysées par le logiciel IBM® SPSS statistics20.0. Seules, les associations significatives (p ≤ 5%) étaient retenues.Résultats - quatre-vingt deux pourcent et demi des patients ont un taux d’HbA1c ≥7 %.Plus de 60 % ont une dyslipidémie. Cinquante deux pourcent des patients ont un taux duLDLc ≤ 1 g/l, et 64,4 % ont un taux du Non-HDLc >1g/l. Environ 66 % des patients ont unehypertension artérielle. quarante pourcent des patients ont présenté une macroangiopathieet 66,8 % une microangiopathie (p=0,0001). L’analyse par régression logistique,a montré que l’HbA1c est le paramètre biologique le plus associé aux complicationsmacroangiopathiques (p=0,008), alors que pour les complications micro-angiopathiques,l’HTA était le seul facteur associé (p = 0,03). Pour la cardiopathie ischémique, la dyslipidémieet l’HTA étaient les facteurs les plus associés.Conclusion -Notre étude a montré une fréquence élevée des complications microet macroangiopathiques et des anomalies lipidiques, ainsi qu’un très mauvais équilibreglycémique. L’HbA1c, la dyslipidémie et l’HTA sont les facteurs les plus associés au risquecardiovasculaire

Analysis of circulating tumor DNA: a new concept in clinical oncology

In recent years ,scientific and technological oncologie advances had allowed the emergence of a new concept which tends to become a new model in medicine; personalized medicine, capable to analyze the genomic specificities of each individual, to better meet their needs.Indeed, it is currently possible to detect and quantify in blood «liquid biopsy» without invasive act compared to tissue biopsy, several biomarkers as circulating tumor DNA (ctDNA), circulating tumor cells and circulating micro-RNA, with three major potential applications:early detection and diagnosis of cancers, estimation and quantitative monitoring of tumor burden; and the detection of mutations that may possibly be predictive of response or resistance to treatment.In this article, we will focus on the role of circulating tumor DNA in the early diagnosis, therapeutic monitoring, prognosis and prediction of response to treatment in colorectal, non-small cell lung cancers (CRC, NSCLC) and breast cancer.&nbsp

Mutation resistant to tyrosine kinase inhibitors in chronic myeloid leukemia : about a case

Introduction - The management and long-term outcome of patients affected by chronic myeloid leukemia (CML) hadimproved considerably with the introduction in the 2000’s of tyrosine kinase inhibitors, that revolutionized the prognosis of the disease and improved overall the survival of patients. However, failures are observed. The appearance of mutations in the tyrosine kinase domain of BCR-ABL1 protein constitutes an important cause of resistanceto therapy and represents the most studied mechanism.Observation - Here, we report a 20 years old patient diagnosed in 2015 and followed for chronic myeloid leukemia in chronic phase. His biological monitoring was marked by primary resistance to tyrosine kinase inhibitors of 1st and 2nd generation (Imatinib, Dasatinib and Nilotinib)

MELD–Na as a prognostic score for cirrhotic patients

Background-The high mortality of cirrhosis is a global public health problem. For predicting the outcome of patients with cirrhosis, many prognostic models were proposed.The new Model for End-Stage Liver Disease including serum sodium (MELD-Na) has been proposed as an alternative to the original MELD, to increase the accuracy of the score in predicting short-term mortality. The purpose of this study was to assess the ability of MELD-Na scoring system to predict three-month mortality among cirrhotic patients, and comparing it to the MELD score. Methods-An observational study was carried out, at the Hepato-Gastro-Enterology De­partment of the University Hospital Center of Oran. A retrospective review of the medical records of all patients with cirrhosis, between 1st January 2019 and 31st December 2021, was performed. Among 103 patients, 47 were selected after excluding the patients who were lost to follow-up after three months or with missing data. The information collected included demographic data, clinical characteristics and laboratory values of: bilirubin, creatinine, international normalized ratio (INR) of prothrombin and sodium. The MELD-Na and MELD scores were calculated using online calculators, then the ability of the mo­dels to predict the risk of mortality at three months was assessed, using the area under the receiver operating characteristic curve (AUC). Results - : Eight (17%) patients died at three months. The MELD-Na and MELD both had significantly high area under the curve (AUC): MELD-Na: 0.952, 95% confidence interval [CI]: 0.885–1.00, MELD: 0.931, 95% confidence interval [CI]: 0.834–1.000. The MELD-Na score was slightly better than the MELD, with a sensitivity and a specificity of 87.5% and 87.2%, respectively, for a cut-off value = 21. Conclusion -The MELD-Na score seems to be a good predictor of mortality at three mon­ths among patients with cirrhosis.

Frequency of BCR-ABL 1 Fusion Transcripts Variants in Chronic Myeloid Leukemia Algerian patients

Aim - In chronic myeloid leukemia (CML), the research of BCR-ABL1 fusion transcript became essential to confirm the molecular diagnosis. In this study, we describe the different types of BCR-ABL1 fusion transcripts found in CML patients in West Algerian patients.Methods - A total of 167 CML suspected patients were included in our study. A qualitative research on fusion transcripts was carried out by reverse transcription polymerase chain reaction (RT-PCR) technique in the biochemistry laboratory of Oran’s university hospital establishment.Results. The two types of major BCR-ABL1 fusion transcript Mb3a2 and Mb2a2 were present in 59,8 % and 36,4% of cases respectively. Two patients (1,8%) had an atypical and rare transcript type e19a2 and two others (1,8%) co-expressed b3a2 and b2a2 transcript types. Conclusion - Our study confirmed the data in the literature with a higher incidence of the major transcript

The proportion of different BCR-ABL1 transcript types in chronic myeloid leukemia. An international overview

There are different BCR-ABL1 fusion genes that are translated into proteins that are different from each other, yet all leukemogenic, causing chronic myeloid leukemia (CML) or acute lymphoblastic leukemia. Their frequency has never been systematically investigated. In a series of 45503 newly diagnosed CML patients reported from 45 countries, it was found that the proportion of e13a2 (also known as b2a2) and of e14a2 (also known as b3a2), including the cases co-expressing e14a2 and el 3a2, was 37.9% and 62.1%, respectively. The proportion of these two transcripts was correlated with gender, e13a2 being more frequent in males (39.2%) than in females (36.2%), was correlated with age, decreasing from 39.6% in children and adolescents down to 31.6% in patients >= 80 years old, and was not constant worldwide. Other, rare transcripts were reported in 666/34561 patients (1.93%). The proportion of rare transcripts was associated with gender (2.27% in females and 1.69% in males) and with age (from 1.79% in children and adolescents up to 3.84% in patients >= 80 years old). These data show that the differences in proportion are not by chance. This is important, as the transcript type is a variable that is suspected to be of prognostic importance for response to treatment, outcome of treatment, and rate of treatment-free remission