A rare case of pediatric primary central nervous system differentiating neuroblastoma: an unusual and rare intracranial primitive neuroectodermal tumor (a case report)

Neuroblastoma represents the most common solid extracranial tumor in children under 5, accounting for 8% to 10% of all childhood cancers. Primary central nervous system (CNS) neuroblastomas are a very rare location and only few cases are available in the literature. It was first described in 1973 by Hart and Earl as supratentorial primitive neuroectodermal tumors. Clinical presentation is highly variable and depends on the initial location of the tumor. Regarding imaging, primary brain neuroblastoma shows no pathognomonic appearance on brain computed tomography (CT) whether or not enhanced or magnetic resonance imaging (MRI). There were no standard guidelines available for the adjuvant treatment in case of primary CNS neuroblastoma. Surgery remains the main and the first tool toward these lesions. Radiotherapy associated or not to chemotherapy is offered based on patient´s age. Here, the authors report a new pediatric case of primitive central nervous system neuroblastoma revealed by an intracranial hypertension syndrome and confirmed by both histopathological and immunohistochemistry study after a gross total surgical excision. The postoperative course was uneventful and the child had good recovery

L’endocardite à Bartonella en Tunisie: Particularités lésionnelles et évolutives

L'endocardite à Bartonalla est une infection ubiquitaire, son diagnostic est difficile vu qu'il s'agit souvent d'endocardite à hémoculture négative. Lebut de cette étude est d'analyser les particularités lésionnelles et  évolutives de cette entité dans un pays du nord d'Afrique, la Tunisie et dedémontrer la gravité de cette infection. Nous avons étudié  rétrospectivement les dossiers médicaux de 20 patients atteints  d'endocardite à Bartonella, confirmée selon les critères de Dukes modifiés. L'âge moyen de nos patients était 37 ans avec une prédominance  masculine (SR=3). Tous nos malades avaient un niveau socio-économique bas. Le motif essentiel de consultation était la dyspnée, 6 patients étaient admis dans un tableau d'insuffisance cardiaque congestive. Une  prédilection des lésions au niveau de la valve aortique a été notée (14 cas). Quatorze patients avaient des végétations endocarditiques avec une taille qui dépasse 10 mm chez 8 malades. La majorité des patients (18 patients) présentaient une régurgitation valvulaire massive en rapport principalement avec des mutilations importantes (6 cas de ruptures de cordages mitraux, 2 cas de déchirures des sigmoïdes aortiques, un cas de perforation valvulaire aortique, un cas de désinsertion de prothèse  mitrale). Quinze malades (3/4) avaient nécessité une chirurgie à la phase active de la maladie, l'indication majeure était l'insuffisance cardiaque. Une complication neurologique était notée chez 2 malades et une  complication rénale chez 3 malades. Treize patients étaient guéris, 5 malades étaient décédés et 2 malades opérés ont présenté une  réinfection à staphylococcus aureus et à candida albicans en  postopératoire. L'endocardite à Bartonella est une infection grave. Cette Bactérie possède un potentiel destructif important. Le recours à la chirurgie est quasi constant. La morbi-mortalité est élevée. La recherche de cette bactérie devrait être alors systématique chez nos malades suspects d'endocardite d'autant plus que la bartonellose est endémique sur nos terres

Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis and Mycoplasma genitalium infections and semen quality of infertile men

<p>Abstract</p> <p>Background</p> <p>Genital ureaplasmas (<it>Ureaplasma urealyticum </it>and <it>Ureaplasma parvum</it>) and mycoplasmas (<it>Mycoplasma genitalium </it>and <it>Mycoplasma hominis</it>) are potentially pathogenic species playing an etiologic role in both genital infections and male infertility. Reports are, however, controversial regarding the effects of these microorganisms infections in the sperm seminological variables. This study aimed at determining the frequency of genital ureplasmas and mycoplasmas in semen specimens collected from infertile men, and at comparing the seminological variables of semen from infected and non-infected men with these microorganisms.</p> <p>Methods</p> <p>A total of 120 semen samples collected from infertile men were investigated. Semen specimens were examined by in-house PCR-microtiter plate hybridization assay for the presence of genital ureaplasmas and mycoplasmas DNA. Semen analysis was assessed according to the guidelines of the World Health Organization. Standard parametric techniques (<it>t</it>-tests) and nonparametric techniques (Wilcoxon tests) were used for statistical analysis.</p> <p>Results</p> <p>The frequency of genital ureaplasmas and mycoplasmas detected in semen samples of infertile men was respectively 19.2% (23/120) and 15.8% (19/120). The frequency of <it>Ureaplasma urealyticum </it>(15%) was higher than that of <it>Mycoplasma hominis </it>(10.8%), <it>Ureaplasma parvum </it>(4.2%) and <it>Mycoplasma genitalium </it>(5%). Mixed species of mycoplasmas and ureaplasmas were detected in 6.7% of semen samples.</p> <p>Comparison of the parameters of the standard semen analysis between the male partners of the infertile couples with and without genital ureaplasmas and mycoplasmas infection showed that the presence of <it>Mycoplasma hominis </it>DNA in semen samples is associated with low sperm concentration (<it>p </it>= 0.007) and abnormal sperm morphology (<it>p </it>= 0.03) and a negative correlation between sperm concentration and the detection of <it>Mycoplasma genitalium </it>in semen samples of infertile men (<it>p </it>= 0.05). The mean values of seminal volume, pH, vitality, motility and leukocyte count were not significantly related either to the detection of genital mycoplasmas DNA or to the detection of ureaplasmas DNA in semen specimens.</p> <p>Conclusion</p> <p>Our results demonstrate that genital mycoplasmas and ureaplasmas seem to be widespread among the male partners of infertile couples in Tunisia. Genital mycoplasmas infections of the male genital tract could negatively influence semen quality. Our results also indicate that PCR-microtiter plate hybridization assay method provides a rapid and effective technique to detect human genital mycoplasmas and ureaplasmas which is useful for etiological and epidemiological studies of these pathogens.</p

Evaluation of an in silico predicted specific and immunogenic antigen from the OmcB protein for the serodiagnosis of Chlamydia trachomatis infections

<p>Abstract</p> <p>Background</p> <p>The OmcB protein is one of the most immunogenic proteins in <it>C. trachomatis </it>and <it>C. pneumoniae </it>infections. This protein is highly conserved leading to serum cross reactivity between the various chlamydial species. Since previous studies based on recombinant proteins failed to identify a species specific immune response against the OmcB protein, this study evaluated an <it>in silico </it>predicted specific and immunogenic antigen from the OmcB protein for the serodiagnosis of <it>C. trachomatis </it>infections.</p> <p>Results</p> <p>Using the ClustalW and Antigenic programs, we have selected two predicted specific and immunogenic regions in the OmcB protein: the N-terminal (Nt) region containing three epitopes and the C-terminal (Ct) region containing two epitopes with high scores. These regions were cloned into the PinPoint Xa-1 and pGEX-6P-1 expression vectors, incorporating a biotin purification tag and a glutathione-S-transferase tag, respectively. These regions were then expressed in <it>E. coli</it>. Only the pGEX-6P-1 has been found suitable for serological studies as its tag showed less cross reactivity with human sera and was retained for the evaluation of the selected antigens. Only the Ct region of the protein has been found to be well expressed in <it>E. coli </it>and was evaluated for its ability to be recognized by human sera. 384 sera were tested for the presence of IgG antibodies to <it>C. trachomatis </it>by our in house microimmunofluorescence (MIF) and the developed ELISA test. Using the MIF as the reference method, the developed OmcB Ct ELISA has a high specificity (94.3%) but a low sensitivity (23.9). Our results indicate that the use of the sequence alignment tool might be useful for identifying specific regions in an immunodominant antigen. However, the two epitopes, located in the selected Ct region, of the 24 predicted in the full length OmcB protein account for approximately 25% of the serological response detected by MIF, which limits the use of the developed ELISA test when screening <it>C. trachomatis </it>infections.</p> <p>Conclusion</p> <p>The developed ELISA test might be used as a confirmatory test to assess the specificity of serological results found by MIF.</p

The Effect of Mental Fatigue on Cognitive and Aerobic Performance in Adolescent Active Endurance Athletes: Insights from a Randomized Counterbalanced, Cross-Over Trial

The aim of this randomized counterbalanced, 2 × 2 cross-over study was to investigate the effects of mental fatigue on cognitive and aerobic performance in adolescent active endurance athletes. Ten active male endurance athletes (age = 16 ± 1.05 years, height = 1.62 ± 0.54 m, body mass = 55.5 ± 4.2 kg) were familiarized to all experimental procedures on day 1. On days 2 and 3, participants provided a rating of mental fatigue before and after completing a 30 min Stroop test that measures selective attention capacity and skills and their processing speed ability (mentally fatigued condition), or a 30 min control condition in a randomized counterbalanced order. They then performed d2 test and a 20 m multistage fitness test (MSFT), which was used to measure selective and sustained attention and visual scanning speed (i.e., concentration performance (CP) and total number of errors (E)) and aerobic fitness (i.e., maximum oxygen uptake (VO2max) and velocity at which VO2max occurs (vVO2max)), respectively. Rating of perceived exertion (RPE) was assessed after a MSFT. Subjective ratings of mental fatigue were higher after the Stroop task (p < 0.001). CP (p = 0.0.1), E (p < 0.001), vVO2max (p = 0.020), and estimated VO2max (p = 0.021) values were negatively affected by mental fatigue. RPE were significantly higher in the mentally fatigued than in the control conditions (p = 0.02) post-MSFT. Mental fatigue impairs aerobic and cognitive performance in active male endurance athletes

The Relationship between Cognitive Function, Lifestyle Behaviours and Perception of Stress during the COVID-19 Induced Confinement: Insights from Correlational and Mediation Analyses

Background: Home confinement during the COVID-19 outbreak may affect lifestyle behaviours, such as daily physical activity, social relationships, eating behaviours, and sleep, among others, which in turn may compromise mental health and psychological states. The aim of the present study was to determine the effects of COVID-19-induced home confinement on stress, attention, and lifestyle behaviours and the correlations between them. Methods: Participants included 144 students (aged 18–22 years, 62.5% female, 89.5% single). Stress, attention, and lifestyle behaviours were assessed using the Perceived Stress Scale (PSS), d2 test, and the Simple Lifestyle Indicator Questionnaire adapted and modified (SLIQ), respectively. Total PSS score, concentration performance (CP), errors (E), and lifestyle behaviours (e.g., diet, exercise/activity, alcohol, and smoking) before and during confinement were calculated. Results: The data showed a significant difference between before and during confinement in total PSS, CP, E, and all lifestyle behaviours (all, p < 0.05). Significant correlations existed between total PSS score, CP, E, and lifestyle behaviours (r= −87–98, all, p < 0.05). Conclusions: Home confinement has a negative effect on stress, attention, and lifestyle behaviours. This study suggests that the adoption of proper lifestyle behaviours, particularly diet, disciplined hygiene, and physical activity, boost health, psychological states, and cognitive function during COVID-19-induced confinement

Rickettsia felis–associated Uneruptive Fever, Senegal

During November 2008–July 2009, we investigated the origin of unknown fever in Senegalese patients with a negative malaria test result, focusing on potential rickettsial infection. Using molecular tools, we found evidence for Rickettsia felis–associated illness in the initial days of infection in febrile Senegalese patients without malaria