La baisse de la densité osseuse au cours des maladies inflammatoires chroniques de l’intestin : prévalence et facteurs de risqué

Introduction: La baisse de la densité minérale osseuse représente la principale manifestation osseuse décrite au cours des maladies inflammatoires chroniques de l'intestin. En Tunisie, très peu d'études ont rapportés sa prévalence et ses facteurs de risque. Le but de ce travail était de déterminer la prévalence de la perte osseuse au cours des maladies inflammatoires chroniques de l'intestin, et rechercher ses facteurs de risque. Méthodes: Patients et méthodes: étude ouverte transversale, réalisée de 2007 jusqu'à 2012. Résultats: 146 cas étaient colligés, dont 105 avaient une maladie de Crohn (71,9%) et 41 avaient une rectocolite hémorragique (28,1%). Il s'agissait de 62 hommes et 84 femmes. L'âge moyen était de 33,18 ans. La perte osseuse était trouvée chez 85 patients (58,2%). Il s'agissait d'une ostéopénie dans 57 cas et d'ostéoporose dans 28 cas. Les facteurs de risque de perte osseuse étaient une activité physique limitée  (p=0,013), un indice de masse corporel '20 kg/m2 (p=0,015), une maladie active (p=0,035), l'étendue de l'atteinte intestinale (p=0,006) et une dose cumulée de corticothérapie dépassant 4,5g de Prednisone (p=0,003). Conclusion: La déminéralisation osseuse est une complication fréquente mais non constante. Ceci justifie un dépistage précoce chez les patients à risque, qui pourront ainsi bénéficier d'un traitement substitutif.Key words: Maladie de Crohn, recto-colite hémorragique, densité minérale osseuse, ostéopénie, ostéoporos

Update on Bartonella neuroretinitis

Purpose: To review the clinical features, diagnosis, treatment modalities, and prognosis of Bartonella-associated neuroretinitis. Methods: This is a narrative review on Bartonella-associated neuroretinitis including general and ophthalmological aspects of the disease. A comprehensive literature review between January 1950 and September 2018 was conducted in PubMed database. Epidemiology, clinical features, diagnosis, treatment, and prognosis of Bartonella neuroretinitis were reviewed. Results: Cat scratch disease (CSD) is a worldwide distributed systemic infectious disease caused by a bacterium, Bartonella henselae (B. henselae) which is usually transmitted to humans through contact with infected cats. Ocular manifestations of CSD are diverse, with neuroretinitis and superficial retinal infiltrates being the most common and typical manifestations. Neuroretinitis typically presents as optic disc edema with a partial or complete macular star in association with mild vitritis. Macular star may be absent at the initial presentation, becoming evident 1�2 weeks after the onset of optic disc edema. Diagnosis of CSD is confirmed by reliable laboratory tests. Neuroretinitis usually has a self-limited course. Antibiotic therapy is required for severe systemic disease and vision-threatening ocular involvement. The adjunctive use of oral corticosteroids may further improve the visual outcome. Conclusions: The diagnosis of Bartonella-associated neuroretinitis is based on typical clinical findings and positive serology. The prognosis is usually favorable in immunocompetent individuals. © 2019 Iranian Society of Ophthalmolog

The Prognostic Significance of Whole Blood Global and Specific DNA Methylation Levels in Gastric Adenocarcinoma

Epigenetics, particularly DNA methylation, has recently been elucidated as important in gastric cancer (GC) initiation and progression. We investigated the clinical and prognostic importance of whole blood global and site-specific DNA methylation in GC. tests. Survival analyses were carried out using the Kaplan-Meier method and log rank test. A backward conditional Cox proportional hazards regression model was used to identify independent predictors of survival. = 0.02) respectively.Analysis of global and site-specific DNA methylation in peripheral blood by pyrosequencing provides quantitative DNA methylation values that may serve as important prognostic indicators

Prevalence of JC Virus in Chinese Patients with Colorectal Cancer

BACKGROUND: JCV is a DNA polyomavirus very well adapted to humans. Although JCV DNA has been detected in colorectal cancers (CRC), the association between JCV and CRC remains controversial. In China, the presence of JCV infection in CRC patients has not been reported. Here, we investigated JCV infection and viral DNA load in Chinese CRC patients and to determine whether the JCV DNA in peripheral blood (PB) can be used as a diagnostic marker for JCV-related CRC. METHODOLOGY/PRINCIPAL FINDINGS: Tumor tissues, non-cancerous tumor-adjacent tissues and PB samples were collected from 137 CRC patients. In addition, 80 normal colorectal tissue samples from patients without CRC and PB samples from 100 healthy volunteers were also harvested as controls. JCV DNA was detected by nested PCR and glass slide-based dot blotting. Viral DNA load of positive samples were determined by quantitative real-time PCR. JCV DNA was detected in 40.9% (56/137) of CRC tissues at a viral load of 49.1 to 10.3×10(4) copies/µg DNA. Thirty-four (24.5%) non-cancerous colorectal tissues (192.9 to 4.4×10(3) copies/µg DNA) and 25 (18.2%) PB samples (81.3 to 4.9×10(3) copies/µg DNA) from CRC patients were positive for JCV. Tumor tissues had higher levels of JCV than non-cancerous tissues (P = 0.003) or PB samples (P<0.001). No correlation between the presence of JCV and demographic or medical characteristics was observed. The JCV prevalence in PB samples was significantly associated with the JCV status in tissue samples (P<0.001). Eleven (13.8%) normal colorectal tissues and seven (7.0%) PB samples from healthy donors were positive for JCV. CONCLUSIONS/SIGNIFICANCE: JCV infection is frequently present in colorectal tumor tissues of CRC patients. Although the association between JCV presence in PB samples and JCV status in tissue samples was identified in this study, whether PB JCV detection can serve as a marker for JCV status of CRC requires further study

Swept-Source optical coherence tomography angiography shows choriocapillaris flow reduction in multiple evanescent white dot syndrome

Purpose: To report two cases of typical multiple evanescent white dot syndrome (MEWDS), in which swept-source optical coherence tomography angiography (SS-OCTA) revealed transient areas of flow deficit at the level of the choriocapillaris. Methods: The SS-OCTA images of two female patients with typical MEWDS were analyzed at the onset of the disease and during follow-up. Results: The patients were aged 24 and 25 years, respectively. Previous medical history was unremarkable in both cases. The diagnosis of MEWDS was made on the basis of typical clinical findings and results of fundus autofluorescence, fluorescein angiography, and optical coherence tomography. At presentation, SS-OCTA showed a few small hypointense areas of flow deficit at the level of the choriocapillaris in both cases. During follow-up, SS-OCTA showed complete resolution of choriocapillaris flow voids. Conclusion: Both our patients with typical acute MEWDS showed SS-OCTA multifocal small areas of flow reduction at the level of the choriocapillaris, with full recovery during the follow-up. This finding supports the hypothesis of transient, primary, or secondary choriocapillaris hypoperfusion in typical MEWDS

Infectious optic neuropathies: a clinical update

Rim Kahloun, Nesrine Abroug, Imen Ksiaa, Anis Mahmoud, Hatem Zeghidi, Sonia Zaouali, Moncef KhairallahDepartment of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, TunisiaAbstract: Different forms of optic neuropathy causing visual impairment of varying severity have been reported in association with a wide variety of infectious agents. Proper clinical diagnosis of any of these infectious conditions is based on epidemiological data, history, systemic symptoms and signs, and the pattern of ocular findings. Diagnosis is confirmed by serologic testing and polymerase chain reaction in selected cases. Treatment of infectious optic neuropathies involves the use of specific anti-infectious drugs and corticosteroids to suppress the associated inflammatory reaction. The visual prognosis is generally good, but persistent severe vision loss with optic atrophy can occur. This review presents optic neuropathies caused by specific viral, bacterial, parasitic, and fungal diseases.Keywords: optic neuropathy, viruses, bacteria, parasites, fungi, vaccinatio