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Introduction: A substantial proportion of obese subjects are metabolically healthy and free from metabolic complications. Many mechanisms that could explain the existence of the metabolically healthy obese phenotype have been suggested, involving in particular a healthy lifestyle and diet. The aim of this study was to study the anthropometric, nutritional and biological profile of two groups: obese with metabolic syndrome (MS+) and obese without metabolic syndrome (MS-). Methods: It is a cross-sectional study, conducted between January 2022 and 15 March 2022. We recruited 90 obese MS+ and 82 obese MS - . Both groups were matched for age and sex. The glycemia, triglycerides (TG), total cholesterol (TC), HDL-C, LDL-C were measured as well as the body composition and anthropometric data. The diet was determined by the 24-hour recalls. Eating disorders, sleep disorders (PSS4 scale) and depression (HADS) were also searched. Results: In MS+ group we noticed: higher BMI, waist circumference, more caloric diet, elevated consumption of saccharides. This group had more eating disorders such as night eating syndrome and bulimia and sleeping disorders (sleep onset and total insomnia). MS + group was more stressed and depressed. The MS – group had a Mediterranean diet and had more intake of: EPA, DHA, olive oil, green tea, oleaginous fruits, linseed, vegetables and whole grains. They also practiced more fasting. Conclusions: It is important to know the protective nutritional factors of the metabolic syndrome in order to be able to focus on them during education sessions and thus protect the obese from metabolic complications.

In this paper, the composites with the matrix of gelatin (GA) and poly(vinylpyrrolidone) (PVP) blend with nanoparticles of zinc oxide (ZnO) were prepared. In order to improve the mechanical properties, the samples were cross-linked with glutaraldehyde (GTA). The processing was carried out by the solution casting method, and the influence of cross-linking and nanoparticles on the mechanical properties of the obtained composites was investigated. FTIR analysis confirmed the cross-linking of the polymer matrix and that no chemical bond was formed during processing between the polymer matrix and zinc oxide nanoparticles. Examination of the mechanical properties showed that the cross-linking and addition of 1 wt% zinc oxide increased tensile strength, modulus of elasticity, hardness and reduced modulus of elasticity.

Clay minerals are used widely in health products both as cosmetic and pharmaceutical ingredients. To optimize use, natural compounds are mixed with clay powder. The aim of the present study was to synthesize new, coloured hybrids based on purified Tunisian clay and powders of natural flowers: Malva sylvestris, Chrysanthemum coronarium, Silene dioica, Anagallis monellin and Pelargonium × hortorum. The floral pigments in Tunisian flowers were studied. The chlorophylls (a and b), total flavonoids (TF), total phenolic compounds (TPC), and carotenoids were analyzed using UV-Vis spectrophotometry and high-performance liquid chromatography (HPLC-DAD). In addition, the antioxidant capacity was determined using the oxygenated radical absorption capacity assay (ORAC) and the antioxidant capacity to reduce ferric ion assay (FRAP). The properties of the studied clay were evaluated by means of pharmaceutical and microbiological tests. The coloured hybrids were prepared by solid–solid reaction and analyzed using X-ray diffraction (XRD) and Fourier transform infrared (FTIR) spectroscopy. Chlorophyll a is present in large quantities in the Malva flower which presents the smallest antioxidant capacity. Chlorophyll b and the TPC are more abundant in the Pelargonium × hortorum. The TF appears in large quantities in the Anagallis flower. The carotenoids are present in the largest amounts in the Chrysanthemum. The results of the clay characterization justify its use as a pharmaceutical and cosmetic agent. The mixture of dried flowers and purified clay is used in the synthesis of new and biocoloured hybrids; these can be used as biocosmetic products without negative side effects on human health or the environment.

Purpose Epstein-Barr virus (EBV) is crucial for the pathogenesis of classical Hodgkin lymphoma (CHL). In this study, we evaluated whether the EBV could predict the clinical behavior of CHL and impact the tumor microenvironment(TME) signatures. Methods We conducted immunohistochemical analyses for the expression of EBV-latent membrane protein 1 (LMP1) and markers reflecting immune cells, including CD3, CD4, CD8, FOXP3, CD20, and CD68 in 102 CHL samples and calculated the ratios between cell subsets for each specimen. Results EBV-LMP1 positivity was detected in 35 (34%) cases and remained an independent poor prognostic factor for overall survival (OS) (p = 0.022). In addition, the CD8/FOXP3+ ratio was significantly increased in LMP1+ than in LMP1- tumors (p = 0.027). Using Cox modeling, a high CD8/CD68+ ratio was associated with shorter OS in LMP1+ tumors compared to a low CD8/CD68+ ratio (p = 0.039); however, neither CD8+ nor CD68+ separately was correlated to the CHL survival. Moreover, the Kaplan-Meier method showed an association of a high CD8/CD68+ ratio with inferior OS in LMP1+ tumors (p = 0.013). In multivariate analysis, a high CD8/CD68+ ratio and B-symptoms tended to be independent prognostic factors for OS (HR = 9.80 (0.56-171.5), p = 0.11; HR = 10.28 (1.00-106.0), p= 0.05; respectively). Conclusion EBV-LMP1+ is an independent unfavorable prognostic factor for CHL, modulating the TME towards a cytotoxic profile. Besides, CD8/CD68+ ratio could be a potential factor acccruately predicting the clinical outcomes of LMP1+ CHL patients, providing more prgnostic information than each cell seperately.

This paper investigates the using potential of acryl-functionalized kraft lignin (AKL) in reducing the flammability of polymer composites based on recycled unsaturated polyester resins (UPR). Acryl functionalization of kraft lignin was performed by direct esterification of free polyphenolic groups with acryloyl chloride, after what, the AKL was blended in UPR resin synthesized from the polyols obtained by catalytic depolymerization of waste poly(ethylene terephthalate). The AKL was homogenized in UPR resin in different weight ratios: 2.5, 5.0, 7.5, and 12.5 wt.%. Structural and dynamic-mechanical characteristics of acryl-functionalized kraft lignin and composites were determined using FTIR spectroscopy, dynamicmechanical analysis (DMA), and tensile tests. The influence of functionalization and mass fraction of AKL on tensile and thermal properties of UPR resin was studied. The thermal properties of the composite were tested according to the standard UL-94 method, based on which the highest category of heat-resistant materials is a composite with 12.5 wt.% acylfunctionalized lignin.

The management of obesity is difficult with many failures of lifestyle measures, hence the need to broaden the range of treatments prescribed. The aim of our work was to study the influence of pre and probiotics on weight loss psychological profile and metabolic parameters in obese patients.It is a clinical trial involving 45 obese patients, recruited from the Obesity Unit of the National Institute of Nutrition between March and August 2022 divided into three groups: diet only (low-carbohydrate and reduced energy diet), prebiotics (30 g of carob/day) and probiotics (one tablet containing Bifidobacterium longum, Lactobacillus helveticus, Lactococcus lactis, Streptococcus thermophilus/day). The three groups were matched for age, sex and BMI. Patients were seen after 1 month from the intervention. Anthropometric measures, biological parameters, dietary survey and psychological scores were performed.The average age of our population was 48.73 ± 7.7 years, with a female predominance. All three groups showed a significant decrease in weight, BMI and waist circumference with p .05. Only the prebiotic and probiotic group showed a significant decrease in fat mass (p = .001) and a significant increase in muscle strength with p = .008 and .004, but the differences were not significant between the three groups. Our results showed also a significant decrease in insulinemia and HOMA-IR in the prebiotic group compared to the diet-alone group (p = .03; p = .012) and the probiotic group showed a significant decrease in fasting blood glucose compared to the diet alone group (p = .02). A significant improvement in sleep quality was noted in the prebiotic group (p = .02), with a significant decrease in depression, anxiety and stress in all three groups.The prescription of prebiotics and probiotics with the lifestyle measures seems interesting for the management of obesity especially if it is sarcopenic, in addition to the improvement of metabolic parameters and obesity-related psychiatric disorders.

(1) Background: Magnesium deficiency is usually associated with type 2 diabetes mellitus (T2DM). Individuals living with T2DM with hypomagnesemia show a more rapid disease progression and have an increased risk for diabetes complications. (2) Methods: This is a cross-sectional and descriptive study in the National Institute of Nutrition and Food Technology of Tunis in Tunisia, including all adult outpatients (≥18 years old) with a diagnosis of T2DM from 1 September 2018 to 31 August 2019. The aim of this study was to evaluate the prevalence of plasmatic magnesium deficiency in a Tunisian population of T2DM and to study the relationship between magnesium status and intake, glycemic control and long-term diabetes-related complications. (3) Results: Among the 101 T2DM outpatients, 13 (12.9%) presented with a plasmatic magnesium deficiency. The mean age was 56 ± 7.9 years with a female predominance (62%, n = 63). The mean of the plasmatic magnesium level was 0.79 ± 0.11 mmol/L (0.5–1.1), and the mean of 24 h urinary magnesium excretion was 87.8 ± 53.8 mg/24 h [4.8–486.2]. HbA1c was significantly higher in the plasmatic magnesium deficiency group than the normal magnesium status group (10% ± 1.3 vs. 8.3% ± 1.9, p = 0.04), with a significant difference in participants with a poor glycemic control (HbA1c &gt, 7%) (100%, n = 13/13 vs. 53%, n = 47/88, p = 0.001). A weak negative relationship was also found between plasmatic magnesium and HbA1c (r = −0.2, p = 0.03). Peripheral artery disease was more commonly described in individuals with low plasmatic magnesium levels than in individuals with normal levels (39%, n = 5 vs. 0%, n = 0, p &lt, 0.001). The mean plasmatic magnesium level in participants without diabetic nephropathy and also peripheral artery disease was significantly higher compared to individuals with each long-term diabetes-related complication (0.8 mmol/L ± 0.1 vs. 0.71 mmol/L ± 0.07, p = 0.006) and (0.8 mmol/L ± 0.1 vs. 0.6 mmol/L ± 0.08, 0.001), respectively. (4) Conclusions: Hypomagnesemia was identified in individuals with T2DM, causing poor glycemic control and contributing to the development and progression of diabetes-related microvascular and macrovascular complications.

Signal transducers and activators of transcription 5a and 6 (STAT5a and STAT6) play a critical role in tumorigenesis of mammary glands. Based on previous studies, the breast cancer is largely dependent on hormone receptors. Consequently, it is very interesting to decipher the relationship between the STAT5a and STAT6 expression and the molecular distribution of estrogen receptors (ERs) and progesterone receptors (PRs) in mammary tumors.Our study analyzed the expression of STAT5a and STAT6, ERα, ERβ and PR in 40 breast tumor tissues using quantitative real-time polymerase chain reaction (qRT-PCR). Furthermore, the Ki-67 and HER2 status were detected using immunohistochemistry.STAT5a and STAT6 were retained in the majority of the cases studied. Increasing of STAT5a and STAT6 is significantly associated with ERs and PR. The coexpression of both STAT5a and STAT6 with ERs and PR is associated with high tumor grades. Moreover, the coexpression of STAT5a and STAT6 with ERα and PR is associated with a high proliferation index. In addition, (STAT6 + ERβ+) and (STAT6 + PR+) breast cancer subgroups are associated with lymph node infiltration (P = 0.001 and P = 0.03, respectively).Our study results provide an interaction between STAT5a and STAT6 with ERs and PR inducing cell proliferation. Coexpression of STAT5a and STAT6 with ERs and PR can predict sensibility to hormonal therapy.

Classical Hodgkin lymphoma (CHL) is characterized by extensive inflammatory immune cells, which predict the disease prognosis. Therefore, this study aimed to explore the significance of different tumor-infiltrated immune cells and subpopulation ratios observed in the tumor microenvironment of CHL, particularly relating to the disease's prognosis-focusing on overall survival (OS) and event-free survival (EFS). Utilizing immunohistochemistry, the quantification and exploration of selected immune cells' subsets, including CD3+, CD4+, CD8+, FOXP3+, CD20+, and CD68+ were conducted on 102 histological samples with primary CHL. Eosinophils were pathologically assessed. Besides, we determined the ratios between different tumor-infiltrated immune cells for each patient. Kaplan-Meier method and Cox regression modeling were used for survival analysis. We demonstrated that among all ratios and immune cells individually, only a higher FOXP3+/CD68+ ratio (≥1.36 cutoff) displayed a tendency towards a favorable OS (p = 0.057, HR = 0.43 [0.18-1.02]) and EFS (p = 0.067, HR = 0.44 [0.18-1.06]) using Cox regression modeling. Moreover, the Kaplan-Meier method showed an association of a higher FOXP3+/CD68+ ratio with a longer 5-years OS (p = 0.037) and a tendency to a better EFS (p = 0.051); however, neither the combined FOXP3+ and CD68+ nor FOXP3+ or CD68+ separately was correlated to the CHL survival. Together, these results demonstrated that the FOXP3+/CD68+ ratio could predict the outcomes of CHL, providing more informative significance than FOXP3+ and CD68+ combined or FOXP3+ and CD68+ individually and might be a potential indicator of risk stratification, which has an important value for guiding the clinical treatment.

Résumé Introduction : Face aux échecs fréquents de la prise en charge médicale de l'obésité, la chirurgie bariatrique offre une option thérapeutique prometteuse en raison de ses bénéfices à la fois pondéraux et métaboliques. Objectif : Etudier l'impact de la sleeve gastrectomie sur le profil glucidique d'un groupe de sujets obèses. Méthodes : Il s'agit d'une étude prospective menée auprès de 40 patients obèses (7 Hommes et 33 Femmes) ayant bénéficié d'une sleeve gastrectomie entre 2016 et 2018. Les données cliniques et biologiques ont été recueillies avant l'intervention, à six mois et un an après. L'insulinorésistance a été définie par un indice de HOMA-IR supérieur à 2,4. La rémission du diabète a été définie selon les critères de l'American Society for Metabolic and Bariatric Surgery (ASMBS). Résultats : L'âge moyen de nos patients était de 34,65±8,17 ans. L'indice de masse corporelle (IMC) moyen initial était de 50,23±8,3 kg/m². Un an après la sleeve gastrectomie, la fréquence de l'insulinorésistance était passée de 89% à 4% (p

Background: Taste disorders (TDs) have been reported to be very common in patients suffering from coronavirus disease 2019 (COVID-19), which is caused by the SARS-CoV-2 virus. In most of the hitherto conducted studies, a gustatory assessment was performed on the basis of surveys or self-reports by patients. The aim of our study was to undertake an objective assessment of four basic taste qualities by conducting tasting sessions that allowed detection thresholds in COVID-19 Tunisian patients and to study their associations with inflammation. Methods: This analytical cross-sectional study was conducted on 89 patients aged between 21 to 70 years who had been diagnosed with COVID-19. We used Burghart taste strips to assess taste perception of the four taste qualities, i.e., sour, bitter, sweet, and salty. Serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) were measured. Results: Taste disorders were reported by 40.4% of the patients, while objective assessments revealed that 63.8% of participants were suffering from hypogeusia and/or ageusia. Sour taste was the most altered (70.8%) gustatory quality. Patients with severe COVID-19 had significantly lower sour and bitter taste scores when compared to patients with minor/moderate forms. There was no significant association between serum inflammatory markers and taste disorders. However, the relationship between bitter and sweet taste qualities and IL-1β levels was significant (p = 0.018 and p = 0.041). Conclusions: Our results demonstrate the interest in the objective assessment of taste dysfunctions in COVID-19 patients.

The effect of the molecular structure of three dyes such as methyl orange (MO), indigo carmine (IC) and phenol red (PR) on the surface of Tunisian HDPy+-modified clay has been studied. Batch sorption experiments were carried to evaluate the influence of pH, contact time, initial dye concentration, and temperature. All studies showed a difference in the adsorption capacity suggesting that the retention of dyes was influenced by structure and functional groups of dyes. The pH results suggested that the adsorption of MO dye on HDPy+-clay was pH-independent and the IC and PR adsorption capacity decreased slightly along with the increasing solution pH of 6.0. These results provided that dye adsorption onto modified clay should be mainly controlled only by hydrophobic interaction mechanism for MO dye, along with a considerable contribution of the anionic exchange mechanism for IC and PR dyes. The adsorption onto HDPy+-clay attained equilibrium quickly within 30 min for IC, PR and 60 min for MO. Four adsorption kinetics equations (pseudo-first-order, pseudo-second-order, intraparticle diffusion and Elovich) were employed to evaluate experimental kinetics data. The adsorption kinetic followed the pseudo-second order kinetic model. The monolayer adsorption capacity of the adsorbent, predicted by the Langmuir model, was 227.27, 326.40, and 344.82 mg/g for MO, IC, and RP, respectively. The adsorption isotherms suggeted that HDPy+-clay could be employed as low-cost material for the removal of dyes from wastewater. Thermodynamic parameters indicated the feasibility and spontaneity of the adsorption process. Its process was exothermic in nature for MO dye and endothermic in nature for IC and PR dye.

Chaotic PWM control is a new emergent method for suppressing conducted electromagnetic interference (EMI) generated by the dc-dc power converter. It effectively suppresses the peaky harmonics by spreading it all around the central frequency in the desired wide frequency band. Thus the EMI spectrum is smoothed and flattened with a reduced EMI noise level. The current paper presents a chaotic Pulse Position Modulation (PPM) technique based on the Logistic map. It is generated digitally through a dsPIC microcontroller. Then, it is applied to a boost converter to reduce the conducted EMI generated within. Looking for accuracy, an electromagnetic (EM) prototype of the boost converter was developed using LTspice in order to analyse the EMI reduction level. Finally, spectrum simulations were carried out. The chaotic PPM was benchmarked to traditional PWM for the boost converter. Simulations show a significant reduction of EMI with a flattened EMI spectrum.

Conditional risk measuring plays an important role in financial regulation and depends on volatility estimation. A new class of parameter models called Generalized Autoregressive Score (GAS) model ...

Colored clays are prepared by a solid state reaction of dried leaves of flowers with a Tunisian clay used for pharmaceutical and cosmetic applications. The structural properties, photo- and thermal stability of the resulting samples were characterized by X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, Differential scanning calorimetry analysis (DSC) and UV–visible spectroscopy. The mineralogical structure, physicochemical properties and pharmacopoeial tests of the purified clay suggested that this clay mineral can function in cosmetic products. The XRD results of colored clays revealed a slight difference in values of basal spacing d001 when compared to values obtained from purified clay. FTIR analysis confirmed changes in functional groups and surface properties of purified clay. DSC results proved a high thermal stability for purified and modified clays. UV–visible spectra of colored materials displayed a new band compared to purified clay in 400–700 nm wavelength region. The microbiological tests revealed the suitability of all clays for the cosmetic products.

Spread-spectrum (SS)-based pulsewidth modulation (PWM) techniques play an important role when tackling the electromagnetic interference (EMI) problem in the switch-mode power supply (SMPS) domain. They achieve the best EMI noise reduction and emerge as a promising and very effective solution to comply with electromagnetic standards. The current work provides an insight into the SS techniques: its history, its types, and mainly its ability to mitigate the EMI problem in the SMPS domain. Moreover, it gives a short review of the different SS-based PWM techniques going from the most basic and simple, i.e., the periodic modulation, to the most developed and complex, i.e., the random and chaotic modulations. Besides, a short review of the different implementation methods was addressed and they were categorized into analog and digital implementation techniques where its pros and cons were provided. Finally, a new fast digital implementation method based on a dsPIC33F microcontroller is presented. Its effectiveness was proved and its advantages over the reviewed implementation techniques were recognized. It reached a 20 dBuV EMI level reduction when the digital chaotic and periodic profiles were embedded into a boost converter prototype.

Purified and surfactant-modified Tunisian clays were investigated for their capacity to remove cationic and anionic dyes (crystal violet, CV and methyl orange, MO) from aqueous solution. The samples were characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and potentiometric acid-base titration. Batch-sorption experiments were carried out to evaluate the influence of pH, contact time, initial dye concentration and temperature on the adsorption of dyes. Pseudo-first order, pseudo-second order, intra-particle diffusion and Elovich kinetic models were considered to evaluate the kinetic parameters. To understand the interaction of the dye with the adsorbent, Langmuir, Freundlich, Temkin and Dubinin-Radushkevish isotherms were applied. Thermodynamics studies were conducted to calculate the changes in free energy (Δ°G), enthalpy (Δ°H) and entropy (Δ°S). A difference in the maximum adsorption capacity was observed, suggesting that the retention of dyes was influenced by structure, functional groups of dyes and surface properties of the adsorbents. Moreover, different mechanisms may control the removal of dyes. The purified Tunisian clays are excellent adsorbents for removal of the cationic dye CV and its modified form is suitable for removal of the anionic dye, MO, from aqueous solution.

Background Male breast cancer (MBC) is a rare and neglected disease. Prognostic and predictive factors in MBC are extrapoled from trials conducted on its female counterpart. Objective Since the relationship between the transcription factor Forkhead box M1 (FOXM1) expression and the clinical response to chemotherapy and hormonotherapy in MBC remains unknown, we sought to investigate the predictive value of FOXM1 in MBC. Methods FOXM1 expression was assessed in 130 MBC cases. Clinical significance was analyzed by Kaplan Meier curves, log-rank test and multivariate Cox regression analyses. Results Patients with high FOXM1 expression had a significantly lower response rate to chemotherapy (P = 0.045) and hormonotherapy (P = 0.029) than those with low FOXM1 expression. Multivariate analyses indicated that FOXM1 was an independent prognostic factor for disease free survival in MBC patients (P Conclusions FOXM1 may have a reliable predictive significance in male breast cancer and thus may become an important target for male breast cancer therapy in the near future.

Background Growing evidence have shown promise for targeting programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) signaling in several tumors. In female breast cancer, PD-L1 expression has been correlated with poor clinical outcome. However, whether PD-L1 has any indication for prognosis in male breast cancer (MBC) patients remains unknown. The purpose of this study was to examine the expression levels of PD-L1 in MBC and to identify the relationship between PD-L1 expression and patient survival. Methods We retrospectively identified 110 male breast cancer patients diagnosed between 2000 and 2013 at Salah Azaïz Cancer Institute. PD-L1 expression was evaluated by immunohistochemistry (IHC) using CD274 antibody. Specimens were scored as IHC low or high, when < 5% or ≥ 5% of cells were PD-L1 positive, respectively. The association between expression of PD-L1 and survival was investigated using Kaplan-Meier survival and COX proportional hazard regression analyses. Results Median follow up was 12.5 months [range 1-132 months]. High expression of PD-L1 was observed in 64.5% of MBC samples (71/110). PD-L1 expression was significantly associated with advanced clinical stage (p=0.012), higher histological grade (p=0.014), higher Ki67 expression (p=0.023) and hormone-receptor negative status (p=0.024). Patients with high PD-L1 expression had significantly shorter overall survival (OS) than patients with low expression (p=0.002, hazard ratio (HR) =5 [2.624–10.642]). Multivariate analysis identified PD-L1 as an independent prognostic factor for OS (p Conclusion Our results indicate that high PD-L1 expression may be a prognostic indicator for reduced OS. Thus, PD-L1 expression is a promising novel biomarker with prognostic significance in MBC and may suggest a potential therapeutic target of anti-PD-L1 antibody therapy in MBC patients. Citation Format: Abdeljaoued S, Bettaieb I, Adouni O, Goucha A, Chiba D, Bouzaiene H, Ben Hassouna J, Boussen H, Rahal K, Gamoudi A. Prognostic value of PD-L1 expression in male breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-23-05.

Objectif Evaluer la frequence des maladies auto-immunes chez les diabetiques type 1. Patients et methode Il s’agit d’une etude retrospective incluant 100 malades diabetiques type 1 hospitalises au service A a l’Institut national de nutrition de Tunis. Resultats L’âge moyen de nos patients etait de 28 ± 19 ans avec un sex-ratio H/F = 0,7. La duree moyenne d’evolution du diabete etait de 10 ± 8 ans. La frequence des maladies auto-immunes etait 22 % avec une incidence plus elevee chez les femmes : 82 % contre 18 % hommes. L’hypothyroidie etait en tete de liste avec une frequence de 16 %. La frequence de la maladie cœliaque etait 6 %. La frequence de l’hyperthyroidie etait 3 %. La frequence de la maladie d’Addison etait 1 %. Les associations suivantes ont ete notees : – hypothyroidie et maladie cœliaque avec une frequence de 2 %, – hyperthyroidie et maladie cœliaque avec une frequence de 1 %, – hypothyroidie et maladie d’Addison avec une frequence de 1 %. Le diabete type 1 a precede la dysthyroidie dans 95 % et les autres maladies auto-immunes sus-citees dans 100 % des cas. Conclusion Vu la frequence des maladies auto-immunes chez le diabetique type 1, le praticien est incite a les depister au minimum, des la decouverte du diabete et devant des signes evocateurs.

Objectif L’association diabete-HTA est frequente, elle augmente le risque cardio-vasculaire. Le but de ce travail est de decrire les habitudes de prescription des anti-hypertenseurs chez les patients diabetiques et evaluer leur efficacite. Materiels et methodes Etude retrospective descriptive portant sur 100 patients diabetiques type 2 et hypertendus. Resultats L’âge moyen des patients etait de 63,14 ± 10,5 ans avec un sexe-ratio H/F de 0,4. La duree moyenne d’evolution du diabete etait de13,73 ± 6,8 ans. Le BMI moyen etait de 30,52 kg/m2, 22,5 %sont tabagiques. L’HbA1c moyenne etait de 11,16 % et la clairance moyenne de la creatinine est de 84,73 ml/min. Pour le traitement de l’HTA:42. 5 % sont sous monotherapie, 36,25 % bitherapie, 20 % tritherapie et 1,25 % quadritherapie. Les Inhibiteurs de l’enzyme-de-conversion(IEC) sont prescrits en premiere ligne (71,25 %), suivis des inhibiteurs calciques(IC)(35 %), Antagonistes-des-recepteurs-de-l’angiotensine2(ARAII) (23,75 %) et des diuretiques (22,5 %). La bitherapie la plus frequente est IEC-IC (55,17 %) suivi des IEC-beta-bloquants(24,13 %). La tritherapie la plus frequente est l’association ARAII-beta bloquant-diuretiques dans 31. 25 % et IEC-IC-Betabloquants 25 % des cas. La quadritherapie a consistee en l’association d’un IC-ARAII-beta bloquants-diuretique. Soixanete cinq pour cent de nos patients ont un controle optimal de la pression arterielle [1] . Discussion Les anti-hypertenseurs prescrits a nos patients sont conformes aux dernieres recommandations. Le choix du traitement anti-HTA chez les diabetiques doit tenir compte de la presence des comorbidites et du cout. Ce dernier critere est fondamental dans le traitement de l’hypertension arterielle dans les pays a faibles ressources financieres.

Background Pure mucinous carcinoma breast cancer (PMBC) is a relatively rare subtype cancer of breast malignancy and associated with favorable prognosis. This retrospective study aims to investigate clinical, pathological features and clinical long-term outcomes. Methods A retrospective review of 56 patients' files with pure mucinous breast cancer was performed. We evaluated the clinic-pathologic characteristics and survival status. Results The mean age was 59 years. 37 patients underwent modified radical mastectomy; 14 underwent breast-conserving surgery. The 5-years overall survival (OS) and disease free survival (DFS) rates were respectively 75,3% and 74%. According to univariate analysis for OS, age (p = 0,049), menopausal status (p = 0,024), clinical T stage (p = 0,037), N stage (p = 0,002) and pathological T stage (p = 0,033) were statistically significant factors for survival. The DFS was better in postmenopausal women (p = 0,02), histological tumor size smaller than 20 mm (p = 0,024), and negative lymph nodes (p = 0,049). Conclusion Pure mucinous breast cancer has a favorable prognosis and is characterized by lower tumor grade, higher hormone receptor expression and lower incidence of nodal involvement. Thanks to its good prognosis, this subtype of cancer should be treated less aggressively than invasive ductal carcinoma.

The aim of this study is to assess the suitability of purified Tunisian clay for its possible pharmaceutical and cosmetic uses. Mineralogical, chemical and physicochemical characterization was performed with the aid of tools like X-ray diffraction (XRD), Chemical composition, DTA/TGA analysis, Cation exchange capacity (CEC), particle size distribution by laser dispersion (PSD), surface area (BET method), Point of zero charge (PZC) and surface charge density σ H . Pharmacopoeia tests were also carried: Swelling capacity, sedimentation volume and pH measurement. For microbiological tests, the absence of Salmonella species, Escherichia coli , Staphylococcus aureus and Pseudomonas aeruginosa was tested. The X-ray diffraction data revealed that the Tunisian sample is an interstratified illite-smectite. The percentage of smectitic fraction is estimated to be 78%. The chemical, textural and porosimetric results show important values suggesting that this mineral clay can function in creams, powders and emulsions. In view of the fundamentals of major pharmacopoeias for use of bentonite in pharmacy and considering the swelling capacity and sedimentation volume values, and microbiological results we could designate a pharmaceutical acceptable denomination for Tunisian purified clay.

El cancer de mama inflamatorio representa una entidad agresiva de cancer de mama, clasificada como T4d, relativamente frecuente en Tunez y en el norte de Africa (5-7%) y mas rara en Europa y Estados Unidos (1-2%). El diagnostico clinico se basa en la presencia de signos inflamatorios cutaneos: dolor, edema, piel de naranja y/o eritema. El diagnostico positivo es histologico y se efectua despues de la biopsia de la afeccion cutanea y/o del tumor mamario subyacente. La histologia, la inmunohistoquimica y la genomica muestran una frecuencia mas elevada de cancer triple negativo o que sobreexpresa HER2. El estudio de extension locorregional y a distancia se basa en la exploracion fisica, la mamografia y la ecografia mamaria bilateral, la resonancia magnetica mamaria, la tomografia computarizada de cuerpo entero y la tomografia por emision de positrones con fluorodesoxiglucosa. El proceso diagnostico y terapeutico es multidisciplinario y se basa en la quimioterapia neoadyuvante, asociada a la terapia dirigida anti-HER2 en caso de sobreexpresion del oncogen HER2, seguida de una cirugia radical oncologica y, despues, una radioterapia locorregional. Por otra parte, el tratamiento comporta la continuacion de la terapia dirigida anti-HER2 con una duracion total de 1 ano y el inicio de un tratamiento hormonal si los receptores hormonales son positivos. La aportacion de la quimioterapia neoadyuvante secuencial con antraciclinas y taxanos asi como las terapias dirigidas anti-HER2 han mejorado considerablemente el porcentaje de control locorregional, asi como la supervivencia global y sin enfermedad del cancer de mama inflamatorio, actualmente superior al 40% a los 5 anos.