Negative Survival Impact of High Radiation Doses to Neural Stem Cells Niches in an IDH-Wild-Type Glioblastoma Population

Aims: Assess the impact of radiation doses to neural stem cell (NSC) niches in patients with IDH-wild-type glioblastoma.Materials and Methods: Fifty patients were included in the study. NSC niches [SubVentricular Zone (SVZ) and Sub Granular Zone (SGZ)] were contoured by fusing CT scans and pre-therapy MRI, Tumor location defined ipsilateral and contralateral SVZ and SGZ. Prognostic significance of clinical, biological and dosimetric parameters were examined. We generated a Recursive Partitioning Analysis (RPA) model with independent prognostic classes.Results: Median follow-up: 23.8 months. Event free and overall survival (OS): 10 and 19.1 months. Incomplete surgery, PTV (planning target volume), ipsilateral SVZ or NSC niche mean dose > 57.4 Gy, contralateral NSC niche mean dose > 35 Gy and bilateral NSC niche mean dose > 44 Gy were significantly correlated with reduced OS. Only EGFR amplification was an independent prognostic factor (p = 0.019) for OS. RPA generated independent risk groups: 1 (low risk): [ipsilateral NSC mean dose (INMD) < 58.01 Gy and methylated MGMT promoter], 2: (INMD < 58.01 Gy and unmethylated MGMT promoter and contralateral SVZ mean dose < 18.6 Gy; p = 0.43), 3: (INMD < 58.01 Gy and unmethylated MGMT promoter and contralateral SVZ mean dose > 18.6 Gy; p = 0.002) and 4: (very high risk) (INMD > 58.01 Gy; p < 0.001).Conclusion: High radiation doses to ipsilateral NSC and contralateral SVZ could have a negative impact on overall survival in IDH-wild-type glioblastoma population

Negative Survival Impact of High Radiation Doses to Neural Stem Cells Niches in an IDH-Wild-Type Glioblastoma Population

International audienceAims: Assess the impact of radiation doses to neural stem cell (NSC) niches in patients with IDH-wild-type glioblastoma.Materials and Methods: Fifty patients were included in the study. NSC niches [SubVentricular Zone (SVZ) and Sub Granular Zone (SGZ)] were contoured by fusing CT scans and pre-therapy MRI, Tumor location defined ipsilateral and contralateral SVZ and SGZ. Prognostic significance of clinical, biological and dosimetric parameters were examined. We generated a Recursive Partitioning Analysis (RPA) model with independent prognostic classes.Results: Median follow-up: 23.8 months. Event free and overall survival (OS): 10 and 19.1 months. Incomplete surgery, PTV (planning target volume), ipsilateral SVZ or NSC niche mean dose > 57.4 Gy, contralateral NSC niche mean dose > 35 Gy and bilateral NSC niche mean dose > 44 Gy were significantly correlated with reduced OS. Only EGFR amplification was an independent prognostic factor (p = 0.019) for OS. RPA generated independent risk groups: 1 (low risk): [ipsilateral NSC mean dose (INMD) 18.6 Gy; p = 0.002) and 4: (very high risk) (INMD > 58.01 Gy; p < 0.001).Conclusion: High radiation doses to ipsilateral NSC and contralateral SVZ could have a negative impact on overall survival in IDH-wild-type glioblastoma population

Splenic artery aneurysm rupture in a pregnant woman with hepatosplenic schistosomiasis: case report and literature review

Abstract Background Pregnancy is not uncommon in patients with non-cirrhotic portal hypertension. Rupture of a splenic artery aneurysm remains a rare complication, associated with a very poor maternal–fetal prognosis. Our aim is to report a case of ruptured splenic aneurysm and to show the maternal–fetal over-risks during the association of pregnancy and portal hypertension, even in non-cirrhotic patients. Case presentation We report a case of a 34-year-old woman, pregnant at 24 weeks gestation, with non-cirrhotic portal hypertension due to hepatic schistosomiasis. She was hospitalized for variceal bleeding. Patient had undergone endoscopic variceal band ligation and no bleeding recurrence. An unexplained hypovolemic shock appeared during the hospitalization with the occurrence of an in utero fetal death. The fetus was delivered by vaginal delivery. Abdominal CT scan angiogram showed a splenic artery aneurysm rupture. The patient underwent an emergency laparotomy with ligation of the splenic artery associated with splenectomy. Postoperative course was simple. Management of portal hypertension was continued at discharge (diuretic, beta-blockers, and esophageal varices ligation). Conclusion The association of pregnancy and portal hypertension remains a serious situation with a high risk of maternal–fetal complications. Splenic artery aneurysm rupture is one of the rare complications of this association with a very poor maternal–fetal prognosis. Open repair is the surgical treatment of choice with a non-negligible morbi-mortality

Chirality Effects on Repellent Properties of 4-Alkoxycoumarins Against Asian Tiger Mosquito (Diptera: Culicidae)

International audienceThe use of semiochemicals as repellents and attractants has been proposed to complement insecticides used for the control of vector mosquito populations. In several studies, the optical purities of the molecules tested have been described as having little or no effect on repellent activity. However, these observations seem difficult to explain because of the chirality effect of molecules on the olfactory system of insects and humans. Thus, the purpose of this study is to assess the effects of chirality on the repellent properties of 4-alcoxycoumarins against Aedes albopictus Skuse, mosquito vector of arboviruses. We report here that the racemic (R/S)-4sec-butoxycoumarin had the highest repellent effect (Repellent Index = 49.9%) followed by (R) enantiomer (Repellent Index = 24.2%) for the dose of 5 mg/mL. Contrary, no significant repellent activity was recorded for S-(+)-4-sec-butoxycoumarin. This experiment demonstrates the close relationship between the molecules' optical purities and the behavioral response of mosquitoes

Development of Sustainable Chemistry in Madagascar: Example of the Valuation of CNSL and the Use of Chromones as an Attractant for Mosquitoes

This article describes a part of the results obtained from the cooperation between the University of Lyon1 (France) and the University of Antananarivo (Madagascar). It shows (among others) that useful research can be carried out in developing countries of the tropics if their social, technical, and economic conditions are taken into account. The concepts and methods associated with so-called “green chemistry” are particularly appropriated for this purpose. To illustrate this approach, two examples are shown. The first deals with industrial ecology and concerns waste transformation from the production of cashew nut into an amphiphilic product, oxyacetic derivatives. This product was obtained with a high yield and in a single step reaction. It exhibited an important surfactant property similar to those of the main fossil-based ones but with a much lower ecological impact. The second talks about chemical ecology as an alternative to insecticides and used to control dangerous mosquito populations. New substituted chromones were synthesized and showed biological activities toward Aedes albopictus mosquito species. Strong repellent properties were recorded for some alkoxylated products if others had a significant attractant effect (Kairomone) depending on their stereochemistry and the length of the alkyl chain

Endoscopic variceal ligation in primary and secondary prevention of variceal bleeding: a retrospective study in Digestive Endoscopy Unit, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar

Abstract Introduction Endoscopic variceal ligation (EVL) is a crucial procedure for the primary and secondary prevention of variceal bleeding. The objective of this study was to evaluate the efficacy and tolerability of EVL in the prevention of variceal bleeding. Methods This was a retrospective, single-center study over 8 years, from January 2013 to December 2020, including all patients who came for EVL in primary or secondary prevention. Results Fifty-seven patients (male/female: 39/18) were included. The mean age of the patients was 40.02 ± 12.32 years (range: 19–68). Portal hypertension was secondary to cirrhosis in 13 patients (22.8%) and to a non-cirrhotic cause in 44 patients (77.2%). EVL was indicated for primary and secondary prevention in 5.3% and 94.7%, respectively. All patients had received propranolol with a mean daily dose of 108.07 ± 38.52 mg (extremes: 80–160). Eradication of varices was achieved in 33 patients (57.9%) with an average of 3.06 ± 0.70 sessions (extremes: 1–5) and an average duration of 10.12 ± 6.21 months (extremes: 1–24). Ten patients (17.5%) had variceal bleeding, and one patient (1.8%) died. There was no significant difference between patients with cirrhotic and non-cirrhotic portal hypertension in terms of varices eradication, variceal bleeding, and mortality. Gender (HR: 37.18; CI: 0.14–18.4; p = 0.009) and the number of previous bleeds (HR: 1.34; CI: 1.01–1.80; p = 0.041) were independent predictors of variceal bleeding during EVL. Dysphagia (73.7%) and retrosternal pain (78.9%) were the main adverse events after ligation. Conclusion EVL is an efficient technique to eradicate varices. Its tolerance is good with post-ligation signs that are rapidly regressive