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Drought stress ranks among the most critical environmental challenges facing agriculture today, causing significant impairments to plant growth and development. In Morocco, these negative impacts are projected to intensify further under the combined pressures of climate change and the worsening water shortage crisis. The imperative need for sustainable arganiculture (cultivation of Argane trees) in dry lands necessitates the expeditious identification of drought-tolerant elite Argania spinosa trees. In this context, we investigated the drought tolerance of 2-year-old A. spinosa seedlings from two contrasting provenances Lakhssas (LKS) and Aoulouz (ALZ) under severe stress by evaluating their antioxidative defense mechanisms. A total of 24 parameters related to reactive oxygen species (ROS), oxidative damage, and enzymatic and non-enzymatic antioxidant defense were measured and compared between both provenances. The results showed that the drought-stressed conditions significantly increased the activity of enzymatic antioxidants, including superoxide dismutase, catalase, peroxidase, polyphenoloxidase, glutathione peroxidase, glutathione S-transferase, and ascorbate-glutathione cycle enzymes, as well as the content of non-enzymatic antioxidants, including reduced glutathione (GSH), ascorbic acid (AsA), α-Tocopherols (α-toc), polyphenols, anthocyanins, and group thiols. The ability of A. spinosa trees to greatly enhance their antioxidant system to limit cellular damage caused by ROS production might be an important attribute linked to drought tolerance. Regarding the inter-provenance variation under drought stress conditions, LKS provenance exhibited superior antioxidative capacity through enhanced AsA-GSH cycle activity and elevated levels of AsA-GSH, α-toc, and polyphenols. However, ALZ demonstrated elevated anthocyanin levels and reduced peroxidative stress markers (hydrogen peroxide and malonyldialdehyde). Significant and positive correlations were recorded between studied ROS and antioxidants. Investigating the multifaceted antioxidative defense system underpinning drought tolerance in A. spinosa can facilitate the identification of drought-tolerant argane trees for the development of a future breeding program allowing sustainable arganiculture in dry lands.

This study focuses on the current energy crisis, highlighting the challenges and opportunities it presents, particularly in the electricity, coal, and natural gas sectors. In this context, a compact and efficient heat exchanger has been developed to recover waste heat from power plants and industries, thus promoting energy savings. The aim of this study is to enhance the thermal performance of this heat exchanger by combining two methods. By analyzing various parameters such as the Nusselt number and thermal performance factor across a range of Reynolds numbers and using different fluids, the study reveals the positive impact of semi-circular inserts on thermal performance. Results show a significant improvement in thermal performance factor with the addition of inserts, particularly in case (4) where it reaches 1.86 at a Reynolds number of 140,000. Additionally, the study compares five perforated models, demonstrating that model (2) stands out as the most thermally efficient, with a maximum value of 1.8787 at a Reynolds number of 140,000. Perforations in the inserts promote better fluid flow uniformity and reduce pressure losses. In conclusion, the optimal configuration, specifically model (2) with perforations, exhibits superior thermal and hydrodynamic performance, providing valuable insights for thermal engineering and heat exchanger optimization in various industrial and technological applications. The findings of this study offer tangible prospects for thermal engineering, providing important guidelines for heat exchanger design and optimization, with significant implications for a wide range of industrial and technological applications, and offering a solid foundation for future research in the field of heat transfer and fluid thermodynamics.

Résumé : Dans un contexte de mondialisation et de concurrence internationale accrue sur le marché du travail, la maîtrise de langues véhiculaires comme l'anglais et le français représente un atout majeur pour les jeunes diplômés algériens. En Algérie, si le français conserve une place significative dans l'enseignement supérieur, héritage de l'histoire, l'anglais gagne progressivement du terrain, s'imposant comme la lingua franca de la science et de la technologie. Ainsi, cet article met en évidence l’intérêt du plurilinguisme qui offre de nombreux avantages aux diplômés algériens. Sur le marché du travail national, les entreprises accordent une grande importance à la maîtrise du français et de l'anglais lors des recrutements. Au niveau international, les compétences linguistiques permettent d'élargir les débouchés professionnels auprès d'entreprises multinationales et de faciliter la mobilité en saisissant des opportunités à l'étranger. Des études montrent que les travailleurs plurilingues ont jusqu'à 40% de chances supplémentaires d'être embauchés dans un autre pays. Pour promouvoir ce plurilinguisme indispensable, il est crucial de renforcer l'enseignement des langues étrangères à l'université en améliorant les programmes, les méthodes pédagogiques et la formation des enseignants. Des campagnes de sensibilisation mettant en avant les témoignages de professionnels plurilingues doivent également être menées auprès des étudiants et des parents pour valoriser ces compétences linguistiques. Mots-clés: Plurilinguisme, Marché du travail, Mobilité professionnelle, Enseignement des langues, Sensibilisation

Objective Patients with X linked agammaglobulinemia are susceptible to enterovirus (EV) infections. Similarly, severe EV infections have been described in patients with impaired B-cell response following treatment with anti-CD20 monoclonal antibodies (mAbs), mostly in those treated for haematological malignancies. We aimed to describe severe EV infections in patients receiving anti-CD20 mAbs for immune-mediated inflammatory diseases (IMIDs).Methods Patients were included following a screening of data collected through the routine surveillance of EV infections coordinated by the National Reference Center and a review of the literature. Additionally, neutralising antibodies were assessed in a patient with chronic EV-A71 meningoencephalitis.Results Nine original and 17 previously published cases were retrieved. Meningoencephalitis (n=21/26, 81%) associated with EV-positive cerebrospinal fluid (n=20/22, 91%) was the most common manifestation. The mortality rate was high (27%). EV was the only causal agents in all reported cases. Patients received multiple anti-CD20 mAbs infusions (median 8 (5–10)), resulting in complete B-cell depletion and moderate hypogammaglobulinemia (median 4.9 g/L (4.3–6.7)), and had limited concomitant immunosuppressive treatments. Finally, in a patient with EV-A71 meningoencephalitis, a lack of B-cell response to EV was shown.Conclusion EV infection should be evoked in patients with IMIDs presenting with atypical organ involvement, especially meningoencephalitis. Anti-CD20 mAbs may lead to impaired B-cell response against EV, although an underlying primary immunodeficiency should systematically be discussed.

The presence of organics materials in phosphate ores generates foam during the manufacture of phosphoric acid, thus affecting the production performance and the quality of the products. Today, in the phosphate industry defoamers are used to reduce the negative impact of foam phosphoric production. In the present work, we focused on root cause evaluation for foam generation during the phosphoric acid production process, we evaluated the effect of phosphate rock quality in terms of organic carbon (OC) and carbonate content, on foam generation using a laboratory protocol for foaming ability evaluation. The results show that there is a relationship between the volume of the foam generated and the values of those impurities, while the volume of foam generated is higher when the concentration of OC and Carbonate is high. In our work, we confirm that the foaming ability of the phosphate rock can be avoided if the concentration of organic carbon less than 0.1% and less than 3% for carbonate. [ABSTRACT FROM AUTHOR]

Cadmium (Cd) accumulation is one of the serious global issues among the multitude of food security challenges. Their toxic effects are evident in different physiological and metabolic behaviors of plants. In this context, a potted study was conducted to investigate the effectiveness of salicylic acid (SA) spraying in alleviating Cd toxicity in chia (Salvia hispanica) seedlings. This pseudocereal as a superfood is characterized by high nutritional value and high therapeutic potential. We examined some growth traits, photosynthetic pigments, anthocyanin, antioxidant defense system, malondialdehyde (MDA), and certain osmoregulatory molecules. The results showed that the chia seedlings exposed to Cd showed a substantial decline in growth, especially in shoot and root length and number of leaves (25.5, 21.5, and 22.6%, respectively), whereas the aforesaid biochemical parameters were not significantly affected. However, SA treatment alleviated the Cd stress applied and markedly enhanced the stem and root growth, especially shoot length of about 32.3% compared to Cd treatment. Under combined treatment Cd+SA, we also recorded a significant increase in the accumulation of proline (85.3%) and anthocyanin (83.1%), and a significant enhancement in peroxidase activity (34.9%), compared to control. These responses exhibit the involvement of SA in mitigating Cd-induced oxidative damage and improving Cd tolerance in Chia. Principal component analysis and cluster analysis showed differences between individual and combined treatment. Based on these results, exogenous SA used in the right amounts could alleviate Cd-induced stress and boost chia seedlings’ growth.

Abstract Background DiGeorge syndrome (DGS), caused by a deletion del(22)(q11.2q11.2), is the most frequently observed microdeletion syndrome. There is a vast clinical heterogeneity in DGS, and several studies suggested also heterogeneity of clinical signs and phenotypic appearance to be related to ethnic differences. Here, clinical characteristics of 72 patients with molecular diagnosed deletion del(22)(q11.2q11.2) derived from different countries from Europe, America, Africa, and Asia are summarized and compared. Results Unless ethnic differences, the expected major clinical signs were present in all cases. Frequent clinical manifestations found in this study were congenital heart disease with 68% (49/72), followed by dysmorphic features found in 61% (44/72); neurodevelopmental disorders were present in 43% (31/72) and thymus hypoplasia/aplasia in 32% (23/72). However, clinical features of the patients appeared/were recognized at different times during their lives. Within the group, under 2 years predominated heart disease, dysmorphic features, and hypocalcemia and/or hypoparathyroidism. In the group older than 2 years, the following combination of clinical findings was most frequent: dysmorphic features, congenital heart disease, intellectual disability, and immunological disorders. In the eight cases detected prenatally, abnormal sonographic findings were the major clinical signs (cardiovascular malformations and renal malformations). Conclusions Despite the heterogeneous nature of the sample analyzed, a number of clinical findings could be highlighted to be useful for the clinical delineation of this DGS. Interestingly, diagnostic indicators may vary depending on the age at diagnosis. Finally, apparent differences in DGS patients from different regions seem to be rather due to applied test systems than to real differences in patients from different ethnicities.

BackgroundFecal Microbiota Transplantation (FMT) has become the preferred treatment for recurrent Clostridioides difficile Infections (CDI). However, donor screening is a complex process that varies between countries. The primary objective of screening is to prevent the transfer of potential pathogens from the donor to the recipient via feces. Many guidelines recommend Cytomegalovirus (CMV) testing as part of donor screening, but is the risk of CMV transmission well supported by evidence?Materials/methodsA French prospective cross-sectional multicenter single-arm study estimated the frequency of detection of CMV in the stool of voluntary healthy donors selected for FMT. All preselected donors were tested for CMV antibodies in blood, and if positive, CMV DNA PCR was performed on whole blood and stool. For samples CMV positive in stool PCR, or case of serological markers positive for IgM, we planned isolation of CMV in cell culture.ResultsFrom June 1, 2016, to July 31, 2017, 500 healthy donors (250 per center) were recruited and 483 included. Of these, 301 were CMV seronegative, and 182 tested positive for CMV IgM and/or IgG. Stool CMV PCR was performed in 162 donors. In two cases, the initial analysis was positive, but below the limit of quantification. Repeated PCR tests using Siemens and Altostar assays were negative. No infectious CMV could be detected in cell culture of these two samples and in the stool of 6 CMV IgM-positive donors.ConclusionsOur study shows that healthy volunteers with positive CMV serology do not shed CMV DNA in their stool, as detected by PCR or cell culture. This study provides another argument to remove CMV screening for FMT donors.

Syphilis cases in childhood are usually associated with congenital transmission. Acquired transmission is uncommon, and primarily related to sexual abuse or close contact/nursing with infected family members. We here describe a case of syphilis in a 14-month-old girl resulting from intrafamilial infection, with a subsequent transmission to her mother.

Magnetic resonance imaging (MRI) is being increasingly used for imaging suspected recurrence in prostate cancer therapy. Functional MRI with diffusion and perfusion imaging has the potential to demonstrate local recurrence even at low PSA value. Detection of recurrence can modify the management of postprostatectomy biochemical recurrence. MRI scan acquired before salvage radiotherapy is useful for the localization of recurrent tumors and also in the delineation of the target volume. The objective of this review is to assess the role and potential impact of MRI in targeting local recurrence after surgery for prostate cancer in the setting of salvage radiation therapy.

Introduction L’amylose systémique de type AL a été décrite dans presque tous les organes. Cependant l’atteinte conjonctivale est relativement rare et décrite le plus souvent sous forme de cas isolés et petites séries de cas. Elle est le plus souvent une manifestation de l’amylose oculaire localisée; toutefois, une atteinte palpébrale peut survenir dans le cadre d’une forme systémique. Nous rapportons l’observation d’une amylose AL, qui apparait originale par l’atteinte conjonctivale révélatrice en soulignant le retard diagnostic et thérapeutique du à la méconnaissance de cette localisation et les tentatives de traitement symptomatique. Observation Un patient de 58 ans présentait un purpura palpébral, périorbitaire bilatéral en lunette et des masses conjonctivales avec notion d’hémorragies conjonctivales intermittentes. Cette symptomatologie évoluait depuis plus de 12 mois, ayant suscitée plusieurs consultations ophtalmologiques et dermatologiques, ainsi que divers traitements symptomatiques jusqu’à réalisation d’un bilan biologique objectivant un pic des gammaglobulines à l’électrophorèse des protéines sériques suivi de la réalisation d’une biopsie conjonctivale posant le diagnostic d’amylose et imposant une recherche extensive ayant retrouver d’autres localisations d’amylose associées au myélome multiple. Discussion/ Conclusion L’amylose conjonctivale est une affection rare, dont le diagnostic est suspecté cliniquement et confirmé par examen histopathologique. Elle peut être le seul signe révélateur d’une atteinte systémique et son diagnostic impose une recherche systémique d’autres localisations.

Background: Acute myeloid leukemia (AML) is a complex disease that is linked to genetic and environmental factors. The gluthatione S-transferase (GST) is a family of enzymes that play a crucial role in the detoxification of carcinogens. These compounds could cause DNA damage, which might lead to the development of cancer. Interindividual inherited differences caused by the presence of single nucleotide polymorphisms (SNPs) in detoxification enzyme, could play a major role in cancer predisposition. The present study aimed to investigate the association between GST gene polymorphisms and AML risk. Methods: The GSTP1 genotype was determined by the PCR-RFLP and multiplex PCR for GSTT1 and GSTM1. Meta-analysis was conducted to evaluate the association between GST gene and the risk of AML. Results: We found that GSTT1 null genotype was significantly associated with the risk of AML. However, GSTM1 and GSTP1 polymorphisms did not influence the AML risk. Subjects carrying the GSTM1 Present, GSTT1 null and GSTP1 Ile / Val et Val /Val genotypes had a higher risk of developing AML. The results of meta-analysis showed a positive association between GSTM1 null, GSTT1 null and Ile105Val GSTP1 polymorphisms and AML risk in East Asians, Caucasians, and mixed populations, respectively. Conclusion: GST gene polymorphisms may be risk factors for acute myeloid leukemia.

The argan tree, Argania spinosa (L.) Skeels, is a horticultural forestry species characterized by its endemicity and adaptation to arid and semi-arid zones in the southwest of Morocco. Despite its limited geographical distribution, argan tree presents large genetic diversity, suggesting that improvement of argan is possible. This species plays important ecological, and socioeconomic roles in the sustainable development of the country. The integration of arganiculture into Moroccan agricultural policy has been implemented through a sector strategy, which is fully aligned with the conservation and regeneration of argan forest. A. spinosa is suitable for incorporation into different agroforestry productive systems under agro-fruit-forest model and its domestication will provide a powerful means of socio-economic and environmental management. Here, we provide an overview of the argan tree literature and highlight the specific aspects of argan stands, as agro-forest systems, with the aim of developing an adequate strategy of conservation and domestication of this species. We introduce promising programs and projects for argan plantations and arganiculture, which have been adopted to relieve anthropogenic pressure on the natural argan forest.

Enteroviruses are a frequent source of infection and among the most common central nervous system viral pathogens. Enteroviruses – in particular, the Coxsackie B viruses – are a known cause of myocarditis. Rituximab is a genetically engineered chimeric anti-CD20 monoclonal antibody. Many reports in the literature suggest a higher risk of infection following repeated rituximab therapy, including viral infection. However, observations of enterovirus-related myocarditis in the context of rituximab treatment are scarce. The authors describe the case of a patient with neuromyelitis optica spectrum disorder who developed severe and fatal enterovirus-related myocarditis after rituximab therapy with a difficult differential diagnosis of autoimmune or giant-cell myocarditis. This case highlights the importance of complete diagnostic workup in difficult cases of myocarditis, including endomyocardial biopsies.

Abstract Vegetables from the genus Ziziphus (Rhamnaceae) have been identified as one of the main dietary antioxidants, especially phenolic compounds. However, their chemical composition varies according to the specie or the part of the plant. Mineral composition (potassium, magnesium, calcium, sodium, iron, and zinc), polyphenolic content (Flavan-3-ol, Proanthocyanidin, total polyphenol content) and antioxidant capacity (DPPH, ABTS, and ORAC Assay) in four different matrices (whole fruit, pulp, seed and almond) of Ziziphus (Z. Lotus and Z. Spina Christi) commonly grown in Morocco were investigated. As a result, minerals, polyphenolic contents and antioxidant capacity fluctuated significantly (p ≤ 0.05) between different matrices and Ziziphus species analyzed. Seeds displayed a significantly higher mineral level, polyphenolic content and antioxidant capacity in comparison to whole fruit, pulp and almond. Among species, Z. spina-christi have a significantly higher content of mineral, phenolics and antioxidant activity. These results suggest that the mineral level, polyphenolic content and antioxidant capacity vary considerably depending on the Ziziphus species and part of the plant analyzed. Furthermore, Z. spina-christi seeds presented properties desirable for use in functional food.

Langerhans cell histiocytosis (LCH), formerly known as histiocytosis X, is a non-malignant disease involving clonal proliferation of Langerhans cells. It is an orphan disease affecting mainly the child and the young adult. Its etiology is still unknown, and its clinical spectrum is quite wide. Systemic treatment incorporating steroids and cytostatic drugs for at least one year has improved prognosis of multisystem LCH and represents the current standard of care. We report the case of a multifocal bone LCH in a 2-year-old girl affecting the frontal and parietal bones, associated with emphysematous bulla. The diagnosis was confirmed with histological examination. The evolution was favorable after treatment. Based on this observation, we will make a brief review of the literature to present the clinical, histological, radiological, therapeutic and evolutionary aspects of this orphan disease.

Enteroviruses (EVs) infect millions of people annually. EV infections can be asymptomatic or symptomatic with conditions ranging from mild illnesses to serious diseases such as dilated cardiomyopathy. A causal relationship between EV infections and type 1 diabetes mellitus (T1DM) has been heavily debated, with some studies suggesting that this relationship is not yet conclusive and requires additional evidence, whereas others strongly argue for this correlation. While this relationship is well investigated in some developed countries like the USA and Finland, it is understudied or neglected in other countries like Russia for many reasons such as the low incidence of T1DM. Although the Middle East and North Africa (MENA) are highly affected by T1DM, the role of EVs in the disease in MENA has not been investigated extensively. Therefore, we aimed to address the relationship between T1DM and EVs in MENA and other regions globally.

Drought and heat are major abiotic stresses that reduce crop productivity and weaken global food security, especially given the current and growing impacts of climate change and increases in the occurrence and severity of both stress factors. Plants have developed dynamic responses at the morphological, physiological and biochemical levels allowing them to escape and/or adapt to unfavorable environmental conditions. Nevertheless, even the mildest heat and drought stress negatively affects crop yield. Further, several independent studies have shown that increased temperature and drought can reduce crop yields by as much as 50%. Response to stress is complex and involves several factors including signaling, transcription factors, hormones, and secondary metabolites. The reproductive phase of development, leading to the grain production is shown to be more sensitive to heat stress in several crops. Advances coming from biotechnology including progress in genomics and information technology may mitigate the detrimental effects of heat and drought through the use of agronomic management practices and the development of crop varieties with increased productivity under stress. This review presents recent progress in key areas relevant to plant drought and heat tolerance. Furthermore, an overview and implications of physiological, biochemical and genetic aspects in the context of heat and drought are presented. Potential strategies to improve crop productivity are discussed.

Le lymphome T/NK intestinal primitif est une entité extrêmement rare dont le diagnostic précoce est souvent difficile. Pour mieux comprendre cette entité, nous rapportons le cas d'un patient de 43 ans diagnostiqué avec un lymphome T/NK colique primitif localisé et isolé sans entéropathie associée, ayant été traité par 3 cycles (AspaMetDex) avec un échec à l'évaluation et la survenue du décès au cours du traitement dans le tableau d'un abdomen aigu. Le lymphome T/NK intestinal primitif atteint le plus souvent le sujet jeune avec un pronostic péjoratif. En raison des caractères cliniques et endoscopiques non spécifiques, il est difficile de distinguer entre un lymphome T/NK intestinal et les troubles intestinaux inflammatoires ou infectieuses. Les données histopathologiques et immunohistochimiques ainsi que l'étude de l'ADN permettent de redresser le diagnostic et de classer ce lymphome selon l'EuropeanEnteropathy-Type Intestinal T-CellLymphoma (ETL).

Le lymphome de Burkitt (LB) est une forme de lymphome malin non-Hodgkinien qui provient de l'évolution maligne et de la prolifération de cellules lymphoïdes de type B. Le diagnostic positif repose sur la biopsie d'une masse tumorale ou la ponction de la moelle osseuse révélant la présence de cellules tumorales. Le cas rapporté est celui d'un jeune homme d'une vingtaine d'années qui a été adressé pour des tuméfactions gingivales évoluant depuis 1 mois suite à des extractions dentaires. L'examen anatomopathologique après biopsie complété par l'immunohistochimie conclut à un lymphome de Burkitt. La prise en charge a consisté en une chimiothérapie. Bien que rare, le lymphome de Burkitt est une tumeur agressive qui représente un véritable problème de santé publique d'où la place importante qu'occupe le médecin dentiste dans le diagnostic précoce afin de permettre une prise en charge rapide et appropriée seule garante de la guérison.

The Tunisian industrial phosphoric acid (IPA) was obtained from the phosphate rock by the wet process. However, the organic matter (OM) contained in the acid may interact with organic solvents to form stable foams, preventing phase settling, or simply by forming cross layers and organic phases, and denaturing part of the solvent. Hence, removal of these organics seems to be an important step for the production of decontaminated phosphoric acid. In the phosphoric acid plant of M'dhilla, the OM can be found as colloidal suspension and soluble forms. The colloidal organics are coagulated and deposited with the gypsum precipitation during the aging of H3PO4, while the soluble part remains behind. The purpose of this work was to study the OM adsorption onto montmorillonite bentonite. Equilibrium data are analyzed by the Langmuir, Freundlich and Redlich–Peterson adsorption isotherm models.

Several species of the genus Enterovirus cause persistent infections in humans. Human rhinovirus (HRV) infections are generally self-limiting but occasionally persistent infections have been described. This study aimed to identify persistent HRV infections and investigate the clinical and virologic characteristics of patients with persistent infections. From January 2012 to March 2015, 3714 respiratory specimens from 2608 patients were tested for respiratory viruses by using a multiplex reverse transcription-polymerase chain reaction. A retrospective study was performed. Patients with at least two specimens positive for HRV/enterovirus taken 45 days or longer apart were identified and the HRV/enteroviruses were typed. Patients with persistent infection were compared to patients with reinfection and patients with cleared infection. Phylogenetic analysis of the viral protein(VP)4/VP2 region was performed. 18 patients with persistent HRV/enterovirus infection were identified. Minimum median duration of persistence was 92 days (range 50-455 days). All but one patients with persistence were immunosuppressed. Immunosuppression and hematologic disorders were more frequent in patients with persistence (n = 18) than in patients with reinfection (n = 33) and with cleared infection (n = 25) (p = 0.003 and p = 0.001, respectively). In conclusion, this retrospective study identified HRV persistence in vivo which occurred mainly in immunosuppressed patients.

La leucémie/lymphome à cellules T de l'adulte est une prolifération tumorale de cellules lymphoïdes T matures activées, dont l'agent étiologique est le rétrovirus humain T cell-leukemia virus type 1, ce virus entraine rarement des désordres inflammatoires bronchioloalveolaires. Nous rapportons l'observation d'un patient hospitalisé pour une pneumopathie interstitielle diffuse et dont le bilan étiologique a révélé une leucémie lymphome à cellules T de l'adulte HTLV1+.

L'hyperbilirubinémie à des taux élevés est nephrotoxique par divers mécanismes allant de la tubulopathie proximale aux dépôts massifs de bilirubine. Cette entité bien que décrite depuis le début du vingtième siècle est souvent méconnue dans la littérature moderne. Nous rapportons le cas d'un patient présentant une cirrhose probablement d'origine médicamenteuse (Amiodarone*), dont la fonction rénale s'est altérée parallèlement à la majoration de l'hyperbilirubinémie. Aucune autre cause de l'insuffisance rénale aigue n'a été retrouvée.

La cytogénétique constitue un outil indispensable pour le diagnostic et le pronostic de la leucémie aigue myéloïde (LAM). La t(8 ;16)(p11 ;p13) est rare au cours de cette pathologie. Nous décrivons le cas d'une patiente de 22 ans, admise pour un syndrome d'insuffisance médullaire complet associé à une altération de l'état général. L'examen clinique initial montrait un purpura ecchymotique diffus et des adénopathies latérocérvicales centimétriques bilatérales. L'hémogramme avait montré une anémie à 7,6g /dl normochrome normocytaire, des globules blancs à 87,8,109/L, 15% de polynucléaires neutrophiles , 60% de blastes, 24% de lymphocytes, 1% de Monocytes et 65,109/L de plaquettes. Le myélogramme avait objectivé une LAM1. Sur l'immunophenotypage les marqueurs positifs étaient le CD33 (99%), le CD15 (73%), le CD38 (95%) et l'HLA-DR (88%), les marqueurs monocytoïdes CD14 et CD64 étaient positifs, le CD34, les marqueurs lymphopïdes, la MPO (26%) et le CD13 (2%) étaient négatifs. Le caryotype avait montré: t(8,16)(p11 , p13) add16 (20/20). L'inversion du chromosome 16 recherchée par FISH était négative. Le traitement avait consisté en 2 cures d'induction et 2 cures de consolidation selon le protocole national de traitement des LAM (Cytarabine, daunorubicine, etoposide), la rémission complète avait été obtenue en fin d'induction I, maintenue 9 mois suivie d'une rechute; Vu l'absence de possibilité d'une allogreffe, un traitement palliatif a été instauré, la malade est décédée de sa maladie un mois après la rechute. Notre cas se présente comme les cas décrits dans la littérature avec des données clinico- biologiques particulières.

Nous rapportons le cas d'un patient marocain de 40 ans, suivi pour aplasie médullaire sous traitement immunosuppresseur et ayant présenté 6 mois après le début du traitement une MK iatrogène. L'histologie cutanée a permis de poser le diagnostic et était en faveur d'une MK. Le traitement consistait à des cures de Bléomycine avec une évolution favorable. Notre cas illustre l'intérêt d'un suivi régulier des patients sous immunosuppresseurs. Cette forme particulière de MK constitue un vrai défi thérapeutique pour le praticien.

Mlle K.M, âgée de 19 ans, est suivie au service d'hématologie pour une LAL diagnostiqué sur les données cliniques (syndrome d'insuffisance médullaire, un syndrome tumoral important) et paracliniques (hyperleucocytose majeure à 145 720/mm3 et 95% de blastes). Le myélogramme et l'immunophénotypage confirmait le diagnostic de LAL biphénotypique T et B. Le caryotype était complexe. La patiente a été traitée selon le protocole national des LAL (protocole MARALL) avec une rémission complète après l'induction. Suite à son traitement de consolidation par MTX à haute dose (5g), la patiente présentait une fièvre à 40c, une mucite grade 4 avec des ulcérations buccales douloureuses à surface fibrineuse, touchant le palais et la muqueuse jugale et débordant sur les lèvres empêchant l'alimentation. Ont noté également, une mélanodermie diffuse, hépato-splénomégalie et colite toxique (diarrhées profuses). Le bilan biologique objectivait une aplasie profonde, insuffisance rénale et cytolyse hépatique. Le diagnostic de toxicité grave au MTX cutanée, hématologique et viscérale a été retenu. Le traitement a consisté en une hydratation, alimentation parentérale, repos digestive, antalgiques, antibiotiques et acide folinique avec une très bonne évolution. Actuellement la patiente est en rémission complète maintenue. Le MTX est un cytostatique de la famille des antifolates, utilisé à haute dose en onco-hématologie. Ses effets secondaires sont dose-dépendants. Différents organes peuvent être touchés. La thrombopénie et la leucopénie sont les signes les plus précoces suivies de la stomatite ulcéreuse. Les signes cutanés sont à type de réaction anaphylactique, érythème et desquamation palmo-plantaires, associés à une mucite importante, un décollement bulleux voire une érythrodermie.

L'association de la leucémie aiguë (LA) et grossesse est rare. Son incidence est estimée à 1/100 000 grossesses. Dans les 2/3 des cas ce sont des leucémies aiguës myéloblastiques. Le diagnostic est généralement fait pendant le 2ème et le 3ème trimestre. Elle pose un problème éthique et thérapeutique car La chimiothérapie au cours de la grossesse expose le fétus aux complications. Tout retard ou changement de traitement pour sauvetage fétal risque d'aggraver le pronostic maternel. L'objectif de ce travail est de décrire les particularités de la prise en charge de la leucémie aiguë chez la femme enceinte. Etude prospective descriptive des femmes enceintes atteintes de leucémie aiguë colligées au service d'hématologie et d'oncologie pédiatrique à l'hôpital 20 Août du CHU IBN ROCHD de Casablanca depuis janvier 2009 à Août 2011. Le diagnostic de LA est fait selon les critères de l'OMS. Le traitement était instauré après consentement des patientes selon le type de LA. Huit cas de leucémies aiguës au cours de la grossesse sont colligés au service d'hématologie et d'oncologie pédiatrique à l'hôpital 20 Août du CHU IBN ROCHD de Casablanca. Sept leucémies aiguës myéloblastiques et une leucémie aiguë lymphoblastique. Quatre cas ont été diagnostiqués durant le 1er trimestre de la grossesse, Un cas pendant le 2ème trimestre et 3 cas pendant le 3ème trimestre. L'accouchement est par césarienne programmée dans 2 cas et par voie basse dans 3 cas dont un est prématuré, 2 fausses couches et une mort fétal après décès maternel. Trois patientes ont reçue la chimiothérapie durant la grossesse après consentement éclairé et les 5 autres après l'accouchement. Les 5 nouveau-nés sont bien portants avec un bilan malformatif négatif. L'association de la leucémie aiguë et grossesse est un évènement rare. Elle nécessite une prise en charge multidisciplinaire tenant compte des impératifs de la maladie et de son traitement, de la femme et de son désire de grossesse ainsi que des dimensions éthiques et morales.

Background: Early diagnosis of congenital CMV infection (cCMVI) allows for early intervention and follow-up to detect delayed hearing loss. While CMV PCR in urine is the gold standard for cCMVI diagnosis, saliva testing is often performed., Objectives: Our aim was to determine (i) if swab saliva sampling needed standardization, (ii) if a threshold value in "virus copies per million cells (Mc)" in saliva samples could improve clinical specificity, and (iii) to establish a correlation between viral load in saliva and symptomatology/outcome of cCMVI., Materials and Methods: In our institution, universal newborn screening is performed on saliva swabs at delivery or until day 3 of life. If positive, CMV PCR in urine is done within 2 weeks to confirm or exclude cCMVI., Results: Cell quantification showed that saliva swab sampling was well performed as 95.4 % samples had more than 100 cells/10 µL. There was a good correlation between saliva viral load in copies/mL and in copies/Mc (Pearson's r = 0.96, p < 0.0001). However, threshold values, established to determine a viral load level at which we could confidently identify infected newborns, did not improve positive predictive value (21.8 % for copies/mL and 21 % for copies/Mc vs 25.4 % without threshold) but instead reduced sensitivity (88 % and 85% vs 100 % without threshold). Samples collected on day 2 or 3 had better positive predictive value (38.7 %) compared to those collected on day 1 (23.8 %). Symptomatology at birth was not significantly associated with viral load in saliva at diagnosis. However, sequelae occurrence was associated with viral load in saliva (copies/Mc)., Discussion: Our results confirm that saliva swab is a suitable sample for universal neonatal screening. However, identifying newborns that will develop sequelae remains an issue in the management of cCMVI., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Commercial immunoassays that detect IgG and IgM directed toward VCA and IgG EBNA are used in combination to assess EBV immune status. However, this strategy does not always confirm/exclude recent/past EBV infection or absence of immunity., Objectives: The aim of our study was to perform complementary investigations on samples with atypical EBV serological profiles, in order to identify the clinical situation they correspond to., Study Design: EBV serology was performed using EBV VCA IgM/IgG and EBNA IgG LXL® DiaSorin assay. Complementary investigations included ELISA IgM VCA, immunoblots, CMV IgM/IgG and CMV IgG avidity, and EBV PCR., Results: In our study, 12810 EBV serological results were analyzed, and 3580 atypical profiles were detected (28 %). Among these latter, isolated VCA IgG represented 42.9 %, the three positive markers accounted for 29.1 %, isolated EBNA IgG represented 18.5 %, isolated VCA IgM accounted for 6.4 % and positive VCA IgM & positive EBNA IgG represented 3.1 %. VCA IgG detected alone were specific in 100 % cases and EBNA IgG detected alone were specific in 91.7 % cases. VCA IgM detected alone were false positive or due to a cross reaction with CMV in 52.8 % cases. The pattern positive VCA IgM and positive EBNA IgG correspond to a false positive in VCA IgM, EBNA IgG or both in 83.4 % cases. Positive EBV VCA IgM/IgG and EBNA IgG were unreliable to detect active EBV infection in 66.7 % cases., Discussion: Atypical EBV serological profiles may correspond to several clinical situations and complementary investigations allow to determine the immune status in more than 98.5 % cases., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: Human herpesvirus-8 (HHV-8) can cause Kaposi's sarcoma or B lymphoproliferative disorders such as multicentric Castleman disease. Patient follow-up is based on assessing the HHV-8 viral load, which is usually achieved using real-time polymerase chain reaction (PCR). The HHV-8 Premix r-gene kit (BioMérieux) was used by some laboratories in the past, but BioMérieux ceased the production and distribution of this kit in 2021-2022. Other kits need to be tested so that they can be used for diagnostic purposes. Here we evaluated two commercial kits: HHV8 ELITe MGB Kit (ELITech) and Quanty HHV-8 (Clonit) and compared them with the HHV-8 Premix r-gene kit., Methods: We used whole blood samples that had previously been tested with the HHV-8 Premix r-gene kit for diagnostic purposes. Overall, 46 samples (37 HHV-8-positive and 9 HHV-8-negative) were tested with the ELITe MGB Kit and 37 (29 HHV-8-positive and 8 HHV-8-negative) with the Quanty HHV-8 kit. The different methods were compared using Bland-Altman and Passing-Bablok tests with Analyse-it software., Results: Qualitative results were concordant except for one HHV-8 low-positive sample that was found to be negative by the ELITe MGB Kit. The quantitative results were also concordant; both kits showed mean differences of 0.58 log 10 copies/ml and 0.73 log 10 copies/ml, respectively, compared to the Premix r-gene kit., Conclusions: Both the methods tested produced acceptable results and could be used for diagnostic purposes. It should be remembered that there is no international standard for HHV-8 quantification and that patients should always be followed using the same method., Competing Interests: The authors have no competing interests to declare., (© 2024 The Authors.)

Vaccination against COVID-19 is the main public health approach to fight against the pandemic. The Spike (S) glycoprotein of SARS-CoV-2 is the principal target of the neutralizing humoral response. We evaluated the analytical and clinical performances of a surrogate virus neutralization test (sVNT) compared to conventional neutralization tests (cVNTs) and anti-S eCLIA assays in recovered and/or vaccinated healthcare workers. Our results indicate that sVNTs displayed high specificity and no cross-reactivity. Both eCLIA and sVNT immunoassays were good at identifying cVNT serum dilutions ≥1:16. The optimal thresholds when identifying cVNT titers ≥1:16, were 74.5 U/mL and 49.4 IU/mL for anti-S eCLIA and sVNT, respectively. Our data show that neutralizing antibody titers (Nab) differ from one individual to another and may diminish over time. Specific assays such as sVNTs could offer a reliable complementary tool to routine anti-S serological assays.

Background: Coronavirus disease 2019 (COVID-19) has severely affected the elderly, who are expected to display decreased immune responses due to immunosenescence., Methods: This study retrospectively assesses neutralizing antibody (NAb) production up to 12 months after infection in long-term care patients. We used Roche Diagnostics immunoassay to quantify anti-spike (S) antibodies and a competitive immunoassay from YHLO as a surrogate test for NAb., Results: We included 91 patients (mean age, 86 years). There was no significant variation in anti-S titers over time. There was a significant decrease of NAb titers between month 3 and month 6 but no further significant change up to month 12. Overall, 75 of 91 (82%) and 52 of 91 (57%) patients had, at least once, anti-S titers >75 U/mL and NAb titers >50 AU/mL, respectively, corresponding to a significant neutralizing activity in vitro. All 68 patients studied at M12 had detectable anti-S antibodies and 60 (88%) had detectable NAb; 60 of 68 (88%) and 29 of 68 (42.6%) still had anti-S titers >75 U/mL and NAb titers >50 AU/mL. Higher NAb titers were correlated with severe infection, higher levels of C-reactive protein, and lower lymphocyte counts. No patient developed reinfection., Conclusions: Elderly people can display robust and persistent humoral response after severe acute respiratory syndrome coronavirus 2 infection, with NAb lasting up to 12 months., Competing Interests: Potential conflicts of interest. All authors: No reported conflicts of interest., (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

(1) Background: What is the role of serum CMV PCR in the diagnosis of recent primary infection (PI) in pregnant women when IgG avidity is uninformative? (2) Methods: Retrospective cohort study to compare serum versus whole blood CMV PCR. (a) Qualitative assessment: CMV PCR was performed on 123 serum samples and 74 whole blood samples collected from 132 pregnant women with recent CMV PI. PCR positivity rate was used to calculate sensitivity in serum and whole blood. (b) Quantitative assessment: CMV PCR was performed on 72 paired samples of serum and whole blood collected on the same day from 57 patients. (3) Results: In pregnant women, PCR positivity rate was 89% for serum samples versus 100% in whole blood in the case of very recent PI (<15 days), but only 27% in serum versus 68% in whole blood for PI occurring from 6 weeks to 3 months before. Comparing CMV viral loads between serum and whole blood, we determined the limit of CMV DNA detection in serum as 3 log copies/mL (whole blood equivalent). (4) Conclusions: Serum CMV PCR is reliable in confirming PI in cases when only IgM is detected. It is therefore a valuable tool in introducing valaciclovir treatment as early as possible to prevent mother-to-child CMV transmission.

Objective: Antibody response to the messenger RNA (mRNA) COVID-19 vaccine has been shown to be diminished in rituximab (RTX)-treated patients. We undertook this study to compare humoral and T cell responses between healthy controls, patients with autoimmune diseases treated with RTX, and those treated with other immunosuppressants, all of whom had been vaccinated with 2 doses of the mRNA COVID-19 vaccine., Methods: We performed anti-spike IgG and neutralization assays just before and 28 days after the second BNT162b2 (Pfizer-BioNTech) vaccine dose. The specific T cell response was assessed in activated CD4 and CD8 T cells using intracellular flow cytometry staining of cytokines (interferon-γ, tumor necrosis factor, and interleukin-2) after stimulation with SARS-CoV-2 spike peptide pools., Results: A lower proportion of responders with neutralizing antibodies to the vaccine was observed in the RTX group (29%; n = 24) compared to the other immunosuppressants group (80%; n = 35) (P = 0.0001) and the healthy control group (92%; n = 26) (P < 0.0001). No patients treated with RTX in the last 6 months showed a response. Time since last infusion was the main factor influencing humoral response in RTX-treated patients. The functional CD4 and CD8 cellular responses to SARS-CoV-2 peptides for each single cytokine or polyfunctionality were not different in the RTX group compared to the other immunosuppressants group or the control group. In RTX-treated patients, the T cell response was not different between patients with and those without a humoral response., Conclusion: RTX induced a diminished antibody response to the mRNA COVID-19 vaccine, but the functional T cell response was not altered compared to healthy controls and autoimmune disease patients treated with other immunosuppressants. Further work is needed to assess the clinical protection granted by a functionally active T cell response in the absence of an anti-spike antibody response., (© 2021 American College of Rheumatology.)

Background: Anti-hepatitis A virus (HAV) antibody titers at 20 IU/L are assumed to correlate with protection against HAV challenge., Methods: We examined the accuracy and precision of currently in use immunoassays for total or anti-HAV IgG determination, by repeated testing of dilutions of the international anti-HAV standard, within a 10-50 IU/mL concentration range., Results and Conclusion: Eight immunoassays were evaluated. All could confidently identify people who need to be vaccinated, or who might benefit from a booster vaccine: no positive interpretation for the 10 and 15 IU/mL concentrations. However, qualitative interpretation may differ from test to test in the 15-30 IU/mL range. This variation has to be taken into account when comparing seroprevalence data., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

We report a transfusion-transmitted hepatitis A virus infection in an immunocompromised patient in France, detected shortly after a transfusion of pathogen-reduced pooled platelets. This case raises questions about the efficacy of donor screening methods. Additional safety measures, such as routine donation screening, should be considered.

Background: To manage severe or potentially severe cases of CoronaVirus Disease 2019 (COVID-19), therapeutic monoclonal antibodies targeting Spike protein of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) have been designed. It has been noted in vitro that upon exposure to these treatments, mutations could be selected., Case Presentation: We here report the case of an immunosuppressed patient infected with a B.1.1.7 variant, who received a combination of monoclonal antibodies, and subsequently selected mutations K417N, E484K and Q493R on Spike protein of SARS-CoV-2., Conclusions: Our case raises the importance of monitoring SARS-CoV-2 mutations in patients receiving monoclonal antibodies and having persistent excretion of the virus, in order to offer optimal management of their infection, and strengthen prevention measures to avoid subsequent transmission of these selected variants., (© 2021. The Author(s).)

Mitochondria respond to many cellular functions and act as central hubs in innate immunity against viruses. This response is notably due to their role in the activation of interferon (IFN) signaling pathways through the activity of MAVS (mitochondrial antiviral signaling protein) present at the mitochondrial surface. Here, we report that the BHRF1 protein, a BCL2 homolog encoded by Epstein-Barr virus (EBV), inhibits IFNB/IFN-β induction by targeting the mitochondria. Indeed, we have demonstrated that BHRF1 expression modifies mitochondrial dynamics and stimulates DNM1L/Drp1-mediated mitochondrial fission. Concomitantly, we have shown that BHRF1 is pro-autophagic because it stimulates the autophagic flux by interacting with BECN1/Beclin 1. In response to the BHRF1-induced mitochondrial fission and macroautophagy/autophagy stimulation, BHRF1 drives mitochondrial network reorganization to form juxtanuclear mitochondrial aggregates known as mito-aggresomes. Mitophagy is a cellular process, which can specifically sequester and degrade mitochondria. Our confocal studies uncovered that numerous mitochondria are present in autophagosomes and acidic compartments using BHRF1-expressing cells. Moreover, mito-aggresome formation allows the induction of mitophagy and the accumulation of PINK1 at the mitochondria. As BHRF1 modulates the mitochondrial fate, we explored the effect of BHRF1 on innate immunity and showed that BHRF1 expression could prevent IFNB induction. Indeed, BHRF1 inhibits the IFNB promoter activation and blocks the nuclear translocation of IRF3 (interferon regulatory factor 3). Thus, we concluded that BHRF1 can counteract innate immunity activation by inducing fission of the mitochondria to facilitate their sequestration in mitophagosomes for degradation. Abbreviations: 3-MA: 3-methyladenine; ACTB: actin beta; BCL2: BCL2 apoptosis regulator; CARD: caspase recruitment domain; CCCP: carbonyl cyanide 3-chlorophenylhydrazone; CI: compaction index; CQ: chloroquine; DAPI: 4',6-diamidino-2-phenylindole, dihydrochloride; DDX58/RIG-I: DExD/H-box helicase 58; DNM1L/Drp1: dynamin 1 like; EBSS: Earle's balanced salt solution; EBV: Epstein-Barr virus; ER: endoplasmic reticulum; EV: empty vector; GFP: green fluorescent protein; HEK: human embryonic kidney; IFN: interferon; IgG: immunoglobulin G; IRF3: interferon regulatory factor 3; LDHA: lactate dehydrogenase A; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; MAVS: mitochondrial antiviral signaling protein; MMP: mitochondrial membrane potential; MOM: mitochondrial outer membrane; PINK1: PTEN induced kinase 1; RFP: red fluorescent protein; ROS: reactive oxygen species; SQSTM1/p62: sequestosome 1; STING1: stimulator of interferon response cGAMP interactor 1; TOMM20: translocase of outer mitochondrial membrane 20; VDAC: voltage dependent anion channel.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread across the globe, leading to the declaration of a pandemic. While most present mild symptoms, it appears as though nearly 20% of confirmed patients develop significant complications. At this time of uncertainty, we are struggling to provide appropriate care to hematological cancer patients. We need to weigh the risks and benefits of giving cancer treatment against the odds of infecting them with COVID-19. As hematological cancer patients are immunocompromised and there are high chances of exposure during hospital visits, they can get infected and outcome can be fatal. So in this case report, we intend to discuss the possible impact of the current COVID-19 pandemic on patients with acute leukaemia in terms of diagnosis, chemotherapy, and prophylactic measures., Competing Interests: The authors declare no competing interests., (Copyright: Louardi Mounir et al.)

Background: Viral load (VL) determination is an essential parameter of the management of patients infected with HIV, HBV or HCV. Many available molecular systems run on a "batch" mode while "random access" systems provide more flexibility., Objectives: We compared the performance of HIV-1, HCV and HBV quantification assays on the recently developed Abbott Alinity m system to the m2000 RealTime assays., Study Design: Plasma specimens sent for viral load determination were prospectively tested on m2000 and Alinity m systems, according to manufacturers' instructions. Additional low and high tittered samples were used to assess reproducibility., Results: Assays concordance was evaluated from 180 samples for HIV-1, 122 for HBV, and 92 for HCV. A good correlation and a linear relation over the quantification range was observed for the three markers (r > 0.974). The Alinity m assays yielded higher results with a mean quantification bias of 0.22 log cp/ml for 75 HIV-1, 0.3 log IU/ml for 79 HBV, and 0.2 log for 35 HCV samples, though results were equivalent within an allowable difference of 0.3-0.4 log. Qualitative discordance was observed for 43/180 HIV results, 10/122 HBV and 7/92 HCV and involved undetectable or low-level VL., Conclusion: The Alinity m assays have performance equivalent to m2000. Upon implementation, physicians should be aware of the relative overquantification compared to previous Abbott assays, particularly around clinical decision thresholds. With reduced turnarounds and hands-on times compared to the m2000 system, the Alinity m platform may improve significantly the laboratory workflow efficiency for the benefit of physicians and patients., Competing Interests: Declaration of Competing Interest None, (Copyright © 2020 Elsevier B.V. All rights reserved.)