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Background: Signet-ring cell carcinoma of the stomach (SRCC) is a particular gastric cancer entity. Its incidence is increasing. Its diagnosis is pathological; it corresponds to adenocarcinoma with a majority of signet-ring cells component (> 50%). These histological features give it its aggressiveness characteristics. This has repercussions on the prognostic level and implications for the alternatives of therapy, especially since some authors suggest a potential chemoresistance. This survey aimed to identify the epidemiological, pathological, therapeutic, and prognostic characteristics of SRCC as a separate disease entity. Methods: This was a retrospective study of 123 patients admitted for gastric adenocarcinoma to Habib Thameur Hospital in Tunis over 11 years from January 2006 to December 2016. A comparative study was performed between 2 groups: the SRCC group with 62 patients and the non-SRCC (non-signet-ring cell carcinoma of the stomach) with 61 patients. Results: The prevalence of SRCC in our series was 50%. SRCC affected significantly younger patients (55 vs 62 years; p = 0.004). The infiltrative character was more common in SRCC tumors (30.6 vs 14.8%; p = 0.060), whereas the budding character was more often noted in non-SRCC tumors (78.7 vs 58.1%; p = 0.039). There was no significant difference in tumor localization between both groups. Linitis plastica was noted in 14 patients with SRCC against a single patient with non-SRCC (p = 0.001). The tumor size was more important in the non-SRCC group (6.84 vs 6.39 cm; p = 0.551). Peritoneal carcinomatosis was noted in 4.3% of cases in the SRCC group versus 2.2% of cases in the NSRCC group (p = 0.570). Total gastrectomy was more often performed in the SRCC group (87 vs 56%; p = 0.001). Resection was more often curative in the non-SRCC group (84.4 vs 78.3%; p = 0.063). Postoperative chemotherapy was more commonly indicated in the SRCC group (67.4 vs 53.3%; p = 0.339). Tumor recurrence was more common in the non-SRCC group (35.7 vs 32%; p = 0.776). The most common type of recurrence was peritoneal carcinomatosis in the SRCC group (62.5%) and hepatic metastasis in the non-SRCC group (60%; p = 0.096). The overall 5-year survival in the SRCC group was lower than in the non-SRCC group, with no statistically significant difference (47.1 vs 51.5%; p = 0.715). The overall survival was more important for SRCC in early cancer (100 vs 80%; p = 0.408), whereas it was higher for non-SRCC in advanced cancer (48.1 vs 41.9%; p = 0.635). Conclusion: Apart from its epidemiological and pathological features, SRCC seems to have a worse prognosis. Indeed, it is diagnosed at a more advanced stage and has a worse prognosis in advanced cancer than non-SRCC. It is therefore to be considered as a particular entity of gastric adenocarcinoma requiring a specific therapeutic protocol where the place of chemotherapy remains to be more investigated. [ABSTRACT FROM AUTHOR]

Seroprevalence studies are essential to get an accurate estimate of the actual SARS-CoV-2 diffusion within populations. We report on the findings of the first serosurvey conducted in Tunis prior to the implementation of mass vaccination and analyzed factors associated with seropositivity. A household cross sectional survey was conducted (March–April 2021) in Tunis, spanning the end of the second wave and the beginning of the third wave of COVID-19. SARS-CoV-2 specific immunoglobulin G (IgG) antibodies to the spike (S-RBD) or the nucleocapsid (N) proteins were detected by in-house ELISA tests. The survey included 1676 individuals from 431 households. The mean age and sex ratio were 43.3 ± 20.9 years and 0.6, respectively. The weighted seroprevalence of anti-N and/or anti-S-RBD IgG antibodies was equal to 38.0% (34.6–41.5). In multivariate analysis, age under 10, no tobacco use, previous diagnosis of COVID-19, a history of COVID-19 related symptoms and contact with a COVID-19 case within the household, were independently associated with higher SARS-CoV-2 seroprevalence. More than one third of people living in Tunis obtained antibodies to SARS-CoV-2. Further studies are needed to monitor changes in these figures as Tunisian population is confronted to the subsequent epidemic waves and to guide the vaccine strategy. [ABSTRACT FROM AUTHOR]

Assessing the extent of plagiarism within academics remains the first step in the fight against this behavior. The current study aimed to explore the attitudes of the Faculty of Medicine of Tunis (FMT)'s academics toward plagiarism. A cross-sectional study was conducted within the FMT during the 2018–2019 academic year. Data were collected using a questionnaire including the English version of the attitudes toward plagiarism questionnaire (ATPQ) which is composed of 29 statements divided into three attitudinal factors: positive, negative attitudes and subjective norms toward plagiarism. A total of 340 faculty members responded to the survey. The mean scores for both positive attitudes (28.8 ± 6.9) and subjective norms (24.6 ± 4.9) were between low to moderate and that of negative attitudes was moderate (22.4 ± 2.6). In multivariate analysis, participants with higher academic rank, those who had a good level of English or who attended English courses and those who attended workshops in scientific writing were less tolerant toward plagiarism. The implementation of courses on research practices as well as the introduction of medical English courses in the FMT's post graduate program could constitute relevant approaches to limit the extent of plagiarism. [ABSTRACT FROM AUTHOR]

The main objectives of this work are: firstly, the study of the circulation of Rotavirus A (RVA) in wastewater sampled from a semi-industrial wastewater pilot plant. The plant is situated in a residential area of Tunis and irrigated by three different neighboring hospitals; and secondly, the evaluation of the functioning of two wastewater biological treatment procedures (natural lagoons and biodisks) in a semi-industrial pilot plant for RVA removal using molecular characterization and quantification technology. A total of 102 wastewater samples were collected from two biological treatment processes in a semi-industrial pilot plant that receives effluents of the sewage system of Tunis City (Tunisia). RVA was detected and quantified in 51 wastewater samples (50%) from the pilot plant. The mean values of viral content (genome copies/μL) obtained in the effluent of the two treatments procedures showed a significant decrease in the prevalence and viral content of RVA observed from upstream to downstream of the studied procedure: natural lagoons and at the exit of the biodisks line. The main G-type was G8 (35.5%), followed by G9 (16%), G1 (13%), G10 (10%), G3 (13%) and three mixed combined genotypes: G3/G9 (3%), G8/G10 (3%), G9/G8 (6.5%) were identified. The data obtained in this study represent the first documentation in Tunisia dealing with the effectiveness of wastewater biological treatment for the removal of RVA through two biological treatment procedures in a semi-industrial pilot plant located in the area of Tunis (Tunisia). [ABSTRACT FROM AUTHOR]

Introduction: Autism spectrum disorder (ASD) is a common neurodevelopmental disorder. Its underlying causes and pathophysiologies remain unclear. Recent data support the potential involvement of neuroinflammation in the onset of this disorder. Objectives: The aim of our study was to investigate the potential link between ASD and inflammatory mediators. Methods: This descriptive study was conducted among ASD outpatients followed-up at the child and adolescent psychiatry department in the Military Hospital of Instruction of Tunis. Blood samples were collected for inflammatory cytokines dosage, notably the interleukin 1β (IL-1β), interleukin 6 (IL-6) and the Tumor Necrosis Factor α (TNF-α) immunodosage. Results: Twenty-four patients were included in this study, aged between four and ten years old (mean age= 6,55 years; minimum=4; maximum=10 years). Our sample was mainly represented by male patients (95,6%). TNF-α plasmatic levels were high (>5pg/mL) among all of our sample with a mean of 11,6 pg/mL (minimum= 6,87; maximum=17,7 pg/mL; standard deviation= 3,52 pg/mL), suggesting abnormal peripheral blood mononuclear cells response. However, IL-1β and IL-6 plasmatic levels were relatively normal. Conclusions: An immune response dysregulation was detected in our sample. Multiple clinical and experimental studies investigated the implication of inflammatory cytokines in neurodevelopmental disruption. Their results, however, remain controversial and limited by small samples. Further studies need to be done in order to investigate the neuroimmunological factors linked with ASD. [ABSTRACT FROM AUTHOR]

A methodology for the seismic vulnerability assessment of historical monuments is presented in this paper. The ongoing work has been conducted in Tunisia within the framework of the FP6 European Union project (WIND-CHIME) on the use of appropriate modem seismic protective systems in the conservation of Mediterranean historical buildings in earthquake-prone areas. The case study is the five-century-old Zaouia of Sidi Kassem Djilizi, located downtown Tunis, the capital of Tunisia. Ambient vibration tests were conducted on the case study using a number of force-balance accelerometers placed at selected locations. The Enhanced Frequency Domain Decomposition (EFDD) technique was applied to extract the dynamic characteristics of the monument. A 3-D finite element model was developed and updated to obtain reasonable correlation between experimental and numerical modal properties. The set of parameters selected for the updating consists of the modulus of elasticity in each wall element of the finite element model. Seismic vulnerability assessment of the case study was carried out via three-dimensional time-history dynamic analyses of the structure. Dynamic stresses were computed and damage was evaluated according to a masonry specific plane failure criterion. Statistics on the occurrence, location and type of failure provide a general view for the probable damage level and mode. Results indicate a high vulnerability that confirms the need for intervention and retrofit. [ABSTRACT FROM AUTHOR]

Abstract: The aim of our retrospective study was to analyze the short- and long-term follow-up of 298 renal transplantations performed between June 1986 and May 2005. All were first transplantations except 4 cases, with 54 from cadaveric and 244 from living donors. The recipients included 196 males and 102 females of overall mean age of 31.21 ± 8.9 years (range, 16–61 years). A combination of prednisolone and azathioprine was presented for 212 patients or mycophenolate mofetil for 86 patients. Polyclonal or monoclonal antibodies were used as induction therapy in 183 cases. Cyclosporine was administered to 188 cases and tacrolimus only to 16. HLA matching was 0 mismatches (MM) in 65 cases; 1 or 2 MM in 113; 3 MM in 99; and ≥4 MM in 21. Acute tubular necrosis occurred in 45 cases. One hundred eighteen patients experienced at least 1 acute rejection episode: 102 cases (41.8%) among living and 16 (29.6%) among cadaveric kidneys donor (P = .0007). The actuarial patient and graft survival rates at 1, 5, 10, 15, and 20 years were 95.9%, 87.4%, 77.5%, 65.6%, and 60.8%, and 94.9%, 84.5%, 75.4%, 65.4%, and 53%, respectively. Sixty-three patients died and 72 patients returned to dialysis. Our results were comparable to experienced centers. However, the member of kidney transplantations does not match the increased number of patients on renal replacement therapy. It is advisable to promote obtaining organs from brain-dead donors. [Copyright &y& Elsevier]

Introduction: ambulatory surgery is continuously expanding in global reach because of its several advantages. This study aimed to describe the experience of our department in outpatient hernia surgery, evaluate its feasibility and safety, and determine the predictive factors for failure of this surgery. Methods: we conducted a monocentric retrospective cohort study on patients who had ambulatory groin hernia repair (GHR) and ventral hernia repair (VHR) in the general surgery department of the Habib Thameur Hospital in Tunis between January 1st, 2008 and December 31st, 2016. Clinicodemographic characteristics and outcomes were compared between the successful discharge and discharge failure groups. A p-value of = 0.05 was considered significant. Results: we collected data from the record of 1294 patients. One thousand and twenty patients had groin hernia repair (GHR). The failure rate of ambulatory management of GHR was 3.7%: 31 patients (3.0%) had unplanned admission (UA) and 7 patients (0.7%) had unplanned rehospitalization (UR). The morbidity rate was 2.4% while the mortality rate was 0%. On multivariate analysis, we did not identify any independent predictor of discharge failure in the GHR group. Two hundred and seventyfour patients underwent ventral hernia repair (VHR). The failure rate of ambulatory management of VHR was 5.5%: 11 patients (4.0%) had UA and 4 patients (1.5%) had UR. The morbidity rate was 3.6% and the mortality rate was zero. On multivariate analysis, we did not identify any variable predicting discharge failure. Conclusion: our study data suggest that ambulatory hernia surgery is feasible and safe in well-selected patients. The development of this practice would allow for better management of eligible patients and would offer many economic and organizational advantages to healthcare structures. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aim of this study was to investigate the molecular epidemiology of Stenotrophomonas maltophilia strains responsible for respiratory infection in a neonatal intensive care unit (NICU) in Tunis City, isolated during 22 months (December 2003–September 2005). Materials and methods: Twelve strains of S. maltophilia isolated from tracheal aspirates of distinct infants and two environmental strains were tested for antibiotic susceptibility and genotyped by pulsed-field gel electrophoresis (PFGE) method. Results: Unlike a large heterogeneity demonstrated by the antibiotyping method, PFGE identified two concomitant outbreaks consisting of nine, including an environmental strain (clone A), and four strains (clone B), respectively; a distinguishable strain was classified in a unique pattern (PFGE type C). The long-term dissemination of these strains is a characteristic feature of these outbreaks. Improvement of hygienic conditions attributed to a markedly decrease in their isolation frequencies. Concomitant outbreaks and long period persistence of S. maltophilia in NICU is an important finding of this study. Conclusion: Identification of two clonal strains of S. maltophilia responsible of respiratory infection. Epidemic strains are hardly eradicated when colonization is established. [Copyright &y& Elsevier]