Profil épidémiologique des femmes enceintes cardiaques dans le centre de maternité de Tunis: expérience du service A

Nous rapportons dans ce travail, le profil épidémiologique des femmes enceintes porteuses d'une cardiopathie ayant accouché dans le service «A» du centre de maternité de Tunis. Il s'agit d'une étude rétrospective descriptive sur 3 ans, de janvier 2010 à décembre 2012, portant sur les dossiers des parturientes cardiaques suivies et ayant accouché dans notre service, à l'exclusion des cardiopathies hypertensives. Les paramètresanalysés étaient la gestité et parité des parturientes, le type de la cardiopathie, le mode d'accouchement et le pronostic foetal. Cinquante six cas sur 19655 accouchements avaient été recrutés, soit une incidence de 1 pour 351 accouchements (0,285%). L'âge moyen de nos parturientes était de 30,89±5,3 ans avec des extrêmes allant de 21 à 42 ans. 23 (41,07%) avaient une cardiopathie congénitale, 35 (62,5%) une valvulopathie, 6 (10,71%) un trouble du rythme, 3 (5,35%) un trouble de la conduction à type de bloc auriculo-ventriculaire et 3 (5,35%) une cardiopathie ischémique. Cinquante deux parturientes (92,85%) avaient accouché à un terme dépassant les 37 semaines d'aménorrhée (SA). L'accouchement s'est déroulé par les voies naturelles chez 22 (39,28%) patientes et par césarienne chez 34 (60,71%). Le poids moyen des nouveaux nés à la naissance était de 3341,25 grammes. 3 transferts néonataux en unité de réanimation étaient réalisés avec un seul cas de décès néonatal. La grossesse et l'accouchement chez la femme cardiaque constituent un haut risque materno-foetal dépendant du type, mais surtout du stade de la cardiopathie, nécessitant une prise en charge précoce et multidisciplinaire de la parturiente

Comparison of inhaled antibiotics for the treatment of chronic Pseudomonas aeruginosa lung infection in patients with cystic fibrosis: systematic literature review and network meta-analysis

PURPOSE: In Europe, 4 inhaled antibiotics (tobramycin, colistimethate sodium, aztreonam, and levofloxacin) are currently approved for the treatment of chronic Pseudomonas aeruginosa lung infection in patients with cystic fibrosis (CF). Levofloxacin inhalation solution (LIS) is the most recently approved inhaled antibiotic for adult patients with CF. A systematic literature review and Bayesian network meta-analysis (NMA) was conducted to compare the relative short-term (4 weeks) and long-term (24 weeks) outcomes of these inhaled antibiotics versus LIS. METHODS: A systematic literature search was conducted on February 16, 2016, using EMBASE and Medline via OvidSP. All randomized controlled trials comparing any of the aforementioned inhaled antibiotics with 4 or 24 weeks of follow-up were evaluated. NMA was performed for the following outcomes: relative and absolute percent changes from baseline in forced expiratory volume in 1 second (FEV1%) predicted, change in P aeruginosa sputum density, respiratory symptoms score from the CF questionnaire-revised, hospitalization, additional antibiotics use, and study withdrawal rates. RESULTS: Of the 685 articles identified, 7 unique studies were included in the 4 weeks' NMA and 9 unique studies were included in the 24 weeks' NMA. Aztreonam was predicted to result in the greatest numerically increase in FEV1% predicted at 4 weeks, whereas LIS were predicted to be numerically greater than colistimethate sodium, tobramycin inhaled solution (TIS), and tobramycin inhaled powder (TIP). However, all of the 95% credibility intervals (CrIs) of these comparisons included zero. At 24 weeks, none of the treatments was significantly more effective than LIS. The estimates for the mean change from baseline to 24 weeks in relative FEV1% versus LIS was -0.55 (95% CrI, -3.91 to 2.80) for TIS, -2.36 (95% CrI, -7.32 to 2.63) for aztreonam, -2.95 (95% CrI, -10.44 to 4.51) for TIP, and -9.66 (95% CrI, -15.01 to -4.33) for placebo. Compared with LIS, the odds ratio for hospitalization at 24 weeks was 1.92 (95% CrI, 1.01-3.30) for TIS, 2.25 (95% CrI, 1.01-4.34) for TIP, and 3.16 (95% CrI, 1.53-5.78) for placebo, all statistically worse than LIS. P aeruginosa sputum density scores, additional use of antipseudomonal antibiotics, and study withdrawal rates were comparable among all inhaled antibiotics at all times. IMPLICATIONS: Based on this NMA, the analyses for many of the outcomes did not provide significant evidence to indicate that the other approved inhaled antibiotics were more effective than LIS for the treatment of chronic P aeruginosa lung infection in patients with CF. Study withdrawal rates seemed to be comparable among these inhaled antibiotics

Composición bioquímica y potencial antioxidante del pepino del mar Mediterráneo comestible Holothuria tubulosa

The sea cucumber or holothurian is a marine species which has been prized in some Asian coun­tries for its nutritional qualities. The purpose of this work was to study the biochemical composition and free radical scavenging and antioxidant activities of Holothuria tubulosa tegument from the Bizerta lagoon in north­ern Tunisia. The obtained data demonstrated that the extract of sea cucumber teguments exhibited high bio­chemical levels (such as moisture 80.77%, protein 7.07%, lipids 10.21%, energy value 13.64 Kcal/g ww), and an important nutritional value (including n-3/n-6: 2.11, EPA+DHA: 20.96, AI: 1.38 and TI: 0.54). High anti­oxidant activities were recorded in the integument by the radical scavenging tests of ABTS and DPPH as well as by the total antioxidant capacity and the FRAP in comparison with the BHT standard. Our results showed that H. Tubulosa tegument has high nutritional value with high antioxidant activities and could be considered a nutraceutical product.El pepino de mar o la holoturia es una especie marina apreciada en algunos países asiáti­cos por sus cualidades nutricionales. El propósito de este trabajo fue estudiar la composición bioquímica y las actividades antioxidantes y de eliminación de radicales libres del tegumento de Holothuria tubulosa de la laguna de Bizerta, en el norte de Túnez. Los datos obtenidos demuestran que el extracto de tegumentos de pepino de mar mostró altos niveles bioquímicos (como humedad 80,77%, proteína 7,07%, lípidos 10,21%, valor energético 13,64 Kcal/gww) y un valor nutricional importante (incluyendo n-3/ n-6: 2,11, EPA+DHA: 20,96, AI: 1,38 y TI: 0,54). Se registraron altas actividades antioxidantes en el tegumento mediante las pruebas de eliminación de radicales de ABTS y DPPH, así como por la capacidad antioxidante total y el FRAP, y esto, en comparación con el estándar BHT. Nuestros resultados mostraron que el tegumento de H. Tubulosa tiene un valor nutricional importante con una alta actividad antioxidante y podría considerarse un producto nutracéutico

Bis(oxonium) tetra­kis(o-toluidinium) cyclo­hexa­phosphate

In the title compound, 4C7H10N+·2H3O+·P6O18 6−, the complete cyclo­hexa­phosphate anion is generated by crystallographic inversion symmetry. In the crystal, the H3O+ ions and the [P6O18]6− anions are linked by O—H⋯O hydrogen bonds, generating infinite layers lying parallel to the ab plane at z = 1/2. These layers are inter­connected by the organic cations, which establish N—H⋯O hydrogen bonds with the [P6O18]6− anions

2,6-Diethyl­anilinium dihydrogen phosphate–phospho­ric acid (1/1)

In the crystal structure of the title salt, C10H16N+·H2PO4 −·H3PO4, the H2PO4 − and H3PO4 components are connected into infinite chains extending along the b-axis direction by way of O—H⋯O links. These chains are also linked through O—H⋯O hydrogen bonds thus building up a supra­molecular two-dimensional framework extending parallel to (001). The organic cations cross-link the anionic layers by way of multiple N—H⋯O inter­actions, leading to a cohesive network

Molecular Basis of Increased Serum Resistance among Pulmonary Isolates of Non-typeable Haemophilus influenzae

Non-typeable Haemophilus influenzae (NTHi), a common commensal of the human pharynx, is also an opportunistic pathogen if it becomes established in the lower respiratory tract (LRT). In comparison to colonizing isolates from the upper airway, LRT isolates, especially those associated with exacerbations of chronic obstructive pulmonary disease, have increased resistance to the complement- and antibody-dependent, bactericidal effect of serum. To define the molecular basis of this resistance, mutants constructed in a serum resistant strain using the mariner transposon were screened for loss of survival in normal human serum. The loci required for serum resistance contribute to the structure of the exposed surface of the bacterial outer membrane. These included loci involved in biosynthesis of the oligosaccharide component of lipooligosaccharide (LOS), and vacJ, which functions with an ABC transporter encoded by yrb genes in retrograde trafficking of phospholipids from the outer to inner leaflet of the cell envelope. Mutations in vacJ and yrb genes reduced the stability of the outer membrane and were associated with increased cell surface hyrophobicity and phospholipid content. Loss of serum resistance in vacJ and yrb mutants correlated with increased binding of natural immunoglobulin M in serum as well as anti-oligosaccharide mAbs. Expression of vacJ and the yrb genes was positively correlated with serum resistance among clinical isolates. Our findings suggest that NTHi adapts to inflammation encountered during infection of the LRT by modulation of its outer leaflet through increased expression of vacJ and yrb genes to minimize recognition by bactericidal anti-oligosaccharide antibodies

The Effects of the Monoamine Stabilizer (-)-OSU6162 on Binge-Like Eating and Cue-Controlled Food-Seeking Behavior in Rats.

Binge-eating disorder (BED) is characterized by recurring episodes of excessive consumption of palatable food and an increased sensitivity to food cues. Patients with BED display an addiction-like symptomatology and the dopamine system might be a potential treatment target. The clinically safe monoamine stabilizer (-)-OSU6162 (OSU6162) restores dopaminergic dysfunction in long-term alcohol-drinking rats and shows promise as a novel treatment for alcohol use disorder. Here, the effects of OSU6162 on consummatory (binge-like eating) and appetitive (cue-controlled seeking) behavior motivated by chocolate-flavored sucrose pellets were evaluated in non-food-restricted male Lister Hooded rats. OSU6162 significantly reduced binge-like intake of chocolate-flavored sucrose pellets without affecting prior chow intake. Furthermore, OSU6162 significantly reduced the cue-controlled seeking of chocolate-flavored sucrose pellets under a second-order schedule of reinforcement before, but not after, the delivery and ingestion of reward, indicating a selective effect on incentive motivational processes. In contrast, the dopamine D2/D3 receptor antagonist raclopride reduced the seeking of chocolate-flavored sucrose pellets both pre- and post reward ingestion and also reduced responding under simpler schedules of seeking behavior. The D1/5 receptor antagonist SCH23390 had no effect on instrumental behavior under any reinforcement schedule tested. Finally, local administration of OSU6162 into the nucleus accumbens core, but not dorsolateral striatum, selectively reduced cue-controlled sucrose seeking. In conclusion, the present results show that OSU6162 reduces binge-like eating behavior and attenuates the impact of cues on seeking of palatable food. This indicates that OSU6162 might serve as a novel BED medication.These studies were financially supported by a grant from the Swedish Society of Medicine (SLS-253061) to PS and JA, and a Medical Research Council Programme Grant (no. G1002231) to BJE. The Behavioural and Clinical Neuroscience Institute is cofunded by the Medical Research Council and the Welcome Trust. JA was supported by the Swedish Pharmaceutical Society and the Swedish Research Council (350-2012-230). A travel grant from the Swedish Society for Medical Research enabled KF to participate in this collaboration. PS was supported by the Swedish Research Council (2015-03525)