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Abstract Imatinib (IMA) is a highly potent tyrosine kinase inhibitor used as first-line anti-cancer drug in the treatment of chronic myeloid leukemia. Due to its universal mechanism of action, IMA also has endocrine and mutagenic disrupting effects in vivo and in vitro , which raises the question of its environmental impact. However, to date, very little information is available on its environmental fate and the potential role of its transformation products (TPs) on aquatic organisms. Given the IMA resistance to hydrolysis and direct photolysis according to the literature, we sought to generate TPs through oxidative and radical conditions using the AOPs pathway. Thus, the reactivity of the cytotoxic drug IMA in water in the presence of OH and h+ was investigated for the first time in the present work. In this regard, a non-targeted screening approach was applied in order to reveal its potential TPs. The tentative structural elucidation of the detected TPs was performed by LC-HRMSn. The proposed approach allowed detecting a total of twelve TPs, among which eleven are being described for the first time in this work. Although the structures of these TPs could not be positively confirmed due to lack of standards, their chemical formulas and product ions can be added to databases, which will allow their screening in future monitoring studies. Using the quantitative structure-activity relationship (QSAR) approach and rule-based software, we have shown that the detected TPs possess, like their parent molecule, comparable acute toxicity as well as mutagenic and estrogenic potential. In addition to the in silico studies, we also found that the samples obtained at different exposure times to oxidative conditions, including those where IMA is no longer detected, retained toxicity in vitro. Such results suggest further studies are needed to increase our knowledge of the impact of imatinib on the environment. Graphical abstract Unlabelled Image Highlights • Imatinib (IMA) has endocrine and mutagenic disrupting effects. • But very little is known about IMA environmental significance. • IMA reactivity in photocatalyst-containing water was investigated for the first time. • 11 new IMA transformation products (TPs) were tentatively identified in this work. • These TPs would have a toxicity profile comparable to that of the parent molecule. [ABSTRACT FROM AUTHOR]

Introduction: Bipolar disorder is a frequent and serious psychiatric disease. Antipsychotics are habitually required for its management especially during an acute manic episode. The association of cancer with bipolar disorder may impact psychiatric management. The choice of the adequate antipsychotic drug remains a challenge in this case. The clinical benefit of tamoxifen is obtained after the hepatic metabolism with cytochrome P450 2D6 which generates endoxifen, the potent metabolite of tamoxifen. Evidence has emerged that antipsychotics may potentially inhibit the CYP2D6. Study data supporting this interaction are rare. Objectives: In this work, we aimed to illustrate the modalities of care of bipolar disorder in a patient receiving tamoxifen. Methods: Presentation of a clinical case of a patient treated by Tamoxifen for her breast cancer and who was admitted in our department for acute mania with psychotics features, followed by a literature review. Results: A 53-year-old woman with past history of breast cancer diagnosed in 2018, treated with lumpectomy and radiation, followed by tamoxifen. She has been admitted in 2019 in our department for an acute mania with psychotics features. Olanzapine was prescribed with good clinical evolution. The psychiatric and oncologic status of the patientwas stable after one year under tamoxifen and olanzapine. Conclusions: Psychiatrists must be aware that some of the prescribed medications co-administered with tamoxifen interfere with the CYP2D6 function, which may potentially increase the risk of breast cancer recurrence. A close collaboration between psychiatrists and oncologists is required to adapt therapeutic protocols. [ABSTRACT FROM AUTHOR]

Abstract: We have studied and compared two types of Schottky diodes prepared by the evaporation of molybdenum (Mo) and titanium (Ti) on a 4H-SiC semiconductor. The electrical characteristics of these diodes are analyzed based on the standard thermionic emission model. The main electrical parameters including the series resistance Rs , the ideality factor n and the barrier height ΦB are extracted from current–voltage–temperature (I–V–T) measurements. In the Ti/4H-SiC structure, the series resistance increases from 1.51mΩcm2 to 27.68mΩcm2 when the temperature is varied from 70K to 450K. In contrast, the series resistance does not exceed a 6.17mΩcm2 at 450K in the Mo/4H-SiC Schottky diode. We have decomposed the series resistance into three components. The deduced static and dynamic parameters were used to define an electrical model. The switching behavior of the equivalent circuit indicates a reverse recovery time (Trr) of 1.412ns for Ti/4H-SiC and 3.27ns for Mo/4H-SiC. [Copyright &y& Elsevier]

The article examines the probability and results of combined first-stage hepatectomy and colorectal resection in a two-stage hepatectomy strategy for bilobar synchronous colorectal liver metastases. Subjects with similar cases between 2000 and 2008 were selected from a collected database at two institutions. Overall and disease-free survival rates for patients who underwent the procedure were determined. The therapeutic benefits of combined resection of the primary tumour and first-stage hepatectomy were also identified.

Abstract: Schottky diodes realized on 4H–SiC n-type wafers with an epitaxial layer and a metal-oxide overlap for electric field termination were studied. The oxide was grown by plasma enhanced chemical vapor deposition (PECVD) and the Schottky barriers were formed by thermal evaporation of titanium or nickel. Diodes, with voltage breakdown as high as 700V and ideality factor as low as 1.05, were obtained and characterized after packaging in standard commercial package (TO220). The electrical properties such as ideality factor, hight barrier, the series resistance R s were deduced by current/voltage (I–V) analysis using the least mean square (LMS) method. The temperature effect on break voltage, R s and saturation current was studied. A model based on two parallel Schottky diodes with two barrier heights is presented for some devices having an inhomogeneous contact. It is shown that the excess current at low voltage can be explained by a lowering of the Schottky barrier in localized regions. We use the two series RC components electrical model in order to study the dynamic behaviour of the Schottky diode in low frequency and to improve the effect of barrier inhomogeneities in electrical properties. [Copyright &y& Elsevier]

Abstract: Most of power electronic circuits use power semiconductor switching devices which ideally present infinite resistance when off, zero resistance when on, and switch instantaneously between those two states. Switches and rectifiers are key components in power electronic systems, which cover a wide range of applications, from power transmission to control electronics and power supplies. Typical power switching devices such as diodes, thyristors, and transistors are based on a monocrystalline silicon semiconductor or silicon carbide. Silicon is less expensive, more widely used, and a more versatile processing material than silicon carbide. The silicon carbide (SiC) has properties that allow devices with high power voltage rating and high operating temperatures. The technology overcomes some crystal growth obstacles, by using the hydrogen in the fabrication of 4H-SiC wafers. The presence of structural defects on 4H-SiC wafers was shown by different techniques such as optical microscopy and scanning electron microscopy. The presence of different SiC polytypes inclusions was found by Raman spectroscopy. Schottky diodes were realized on investigated wafers in order to obtain information about the correlation between those defects and electrical properties of the devices. The diodes with voltage breakdown as 600 V and ideality factor as 1.05 were obtained and characterized after packaging. [Copyright &y& Elsevier]

The local microstructure and optical and electrical properties were investigated of amorphous carbon nitride (a-CN) films deposited by reactive radio-frequency (RF) sputtering. Two series prepared in nitrogen or in a nitrogen and argon mixture were studied. The optical properties were investigated by transmittance/reflectance and photothermal deflection spectroscopies. Combined infrared measurements and Raman scattering spectroscopies were used to investigate the microstructure of a-CN films in terms of nitrogen incorporation within the films and C sp2 content. These experiments were completed by dark electrical conductivity measurements performed in coplanar configuration in the temperature range 50-450 K. The films exhibit semiconductor behaviour and the temperature dependence suggests two types of conduction. An increase in nitrogen incorporation induces an increase with clustering of sp2 phase replacing C=C olefinic groups with aromatic groups. [ABSTRACT FROM AUTHOR]

Background: The da Vinci robot laparoscopic incisional hernia repair with intracorporeal suturing may offer an alternative to transabdominal sutures and tackers.Methods: From 2003 to 2005, 11 patients (median age, 71 years; median body mass index [BMI], 28) with small and medium-sized incisional hernias (median fascial defect, 19.6 cm2) were treated with the da Vinci robot system using intracorporeal mesh fixation with interrupted sutures. This pilot study aimed to assess the feasibility and report the morbidity with special reference to postoperative pain and long-term recurrence.Results: The median operative time was 180 min. There was no conversion to open or standard laparoscopy and no postoperative mortality. The overall morbidity rate was 27%. One patient underwent reoperation on postoperative day 3 for peritonitis secondary to small bowel injury. The median visual analog pain score on postoperative day 1 was 3. Seven patients (63%) needed parenteral paracetamol until postoperative day 2. The median hospital stay was 3 days. During a median follow-up period of 25 months, no patient experienced recurrent hernia. One patient had a trocar-site herniation at 6 months. No patient experienced chronic suture site pain or discomfort.Conclusion: This is the first report of robot-assisted laparoscopic incisional hernia with exclusive intracorporeal suturing for mesh fixation in humans. The findings show that this technique is feasible and may not be associated with chronic postoperative pain. Further evaluation is needed to assess the benefit to the patient, but this investigation may be the basis for a future, prospective, randomized study. [ABSTRACT FROM AUTHOR]

We investigated the possible role of chromosome 10q losses in colorectal cancer metastasis by carrying out an allelic imbalance study on a series of microsatellite instability-negative (MSI-) primary tumours (n=32) and metastases (n=36) from 49 patients. Our results demonstrate that 10q allelic losses are associated with a significant proportion (25%) of MSI- colorectal tumours, but are not involved in the metastatic process. PTEN and BMPR1A, two genes located in the common deleted region, were screened for mutations in samples with loss of heterozygosity. The absence or low frequency of mutations indicates that the inactivation of these genes by deletion of one allele and mutation of the other one plays only a minor role in MSI- tumours. [ABSTRACT FROM AUTHOR]

In rod-shaped bacteria such as Bacillus subtilis, division site selection is mediated by MinC and MinD, which together function as a division inhibitor. Topological specificity is imposed by DivIVA, which ensures that MinCD specifically inhibits division close to the cell poles, while allowing division at mid-cell. MinD plays a central role in this process, as it positions and activates MinC and is dependent on DivIVA for its own positioning at the poles. To investigate MinD activities further, we have constructed and analysed a collection of minD mutants. Mutations in the conserved ATPase motifs lead to an inactive protein, possibly unable to oligomerize, but which nevertheless retains some affinity for the cell membrane. Several mutations affecting the mid- to C-terminal parts of MinD led to a protein probably unable to interact with DivIVA, but that could still stimulate division inhibition by MinC. These findings suggest that the ATPase activity of MinD is necessary for all its functions (possibly in part by controlling the oligomerization state of the protein). The other mutations may identify a surface of MinD involved in its interactions with DivIVA and a possible mechanism for control of MinD by DivIVA. [ABSTRACT FROM AUTHOR]

Introduction: Tamoxifen is an antioestrogen agent used in breast cancer treatment. According to some guidelines, this molecular was also proposed for the treatment of acute mania. In fact, Tamoxifen inhibits the intracellular action of the protein kinase C (PKC), which is the direct target in the treatment of mania episodes. Lithium and valproate have also the same action. Objectives: We aimed to show the case of an acute mania under an inhibitor PKC treatment and insisted that other studies are recommended. Methods: Case report description and research on medline, pubmed with the keywords: Tamoxifen, Bipolar disorder, protein kinase C, mania. Results: We reported a case of a 53-year-old woman with past history of unipolar depression. In 2018 when she was diagnosed with breast cancer. She received antidepressant drugs but she interrupted the treatment after a few months. She was treated for her breast cancer with mastectomy, radiotherapy, and 20 mg per day of Tamoxifen prescribed since Mars 2018. She had been admitted in June 2019 in our department for acute mania. The patient received Tamoxifen as it was prescribed. She was not taking any concomitant medications. No history of drug abuse was reported. Medical examination, laboratory, and radiological investigations did not indicate any medical pathology. Conclusions: In our case, Tamoxifen had not ovoid the acute mania in spite of its Known anti-manic properties as reported in the literature. Possible neurobiological effect of tamoxifen on the nervous system should be studied to evaluate the safety of this treatment mainly in patients with bipolar disorder. [ABSTRACT FROM AUTHOR]

Background: In the decision to perform elective surgery, it is of great interest to have data about the outcomes of surgery to individualize patients who could safely undergo sigmoid resection. The aim of this study was to provide information on the outcomes of elective sigmoid resection for sigmoid diverticular disease (SDD) at a national level. Methods: All consecutive patients who had elective surgery for SDD (2010–2021) were included in this retrospective, multicenter, cohort study. Patients were identified from institutional review board-approved databases in French member centers of the French Surgical Association. The endpoints of the study were the early and the long-term postoperative outcomes and an evaluation of the risk factors for 90-day severe postoperative morbidity and a definitive stoma after an elective sigmoidectomy for SDD. Results: In total, 4617 patients were included. The median [IQR] age was 61 [18.0;100] years, the mean ± SD body mass index (BMI) was 26.8 ± 4 kg/m2, and 2310 (50%) were men. The indications for surgery were complicated diverticulitis in 50% and smoldering diverticulitis in 47.4%. The procedures were performed laparoscopically for 88% and with an anastomosis for 83.8%. The severe complication rate on postoperative day 90 was 11.7%, with a risk of anastomotic leakage of 4.7%. The independent risk factors in multivariate analysis were an American Society of Anesthesiologists (ASA) score ≥ 3, an open approach, and perioperative blood transfusion. Age, perioperative blood transfusion, and Hartmann's procedure were the three independent risk factors for a permanent stoma. Conclusions: This series provides a real-life picture of elective sigmoidectomy for SDD at a national level. Trial registration: Comité National Information et Liberté (CNIL) (n°920361). [ABSTRACT FROM AUTHOR]

Background: In the decision to perform elective surgery, it is of great interest to have data about the outcomes of surgery to individualize patients who could safely undergo sigmoid resection. The aim of this study was to provide information on the outcomes of elective sigmoid resection for sigmoid diverticular disease (SDD) at a national level. Methods: All consecutive patients who had elective surgery for SDD (2010–2021) were included in this retrospective, multicenter, cohort study. Patients were identified from institutional review board-approved databases in French member centers of the French Surgical Association. The endpoints of the study were the early and the long-term postoperative outcomes and an evaluation of the risk factors for 90-day severe postoperative morbidity and a definitive stoma after an elective sigmoidectomy for SDD. Results: In total, 4617 patients were included. The median [IQR] age was 61 [18.0;100] years, the mean ± SD body mass index (BMI) was 26.8 ± 4 kg/m2, and 2310 (50%) were men. The indications for surgery were complicated diverticulitis in 50% and smoldering diverticulitis in 47.4%. The procedures were performed laparoscopically for 88% and with an anastomosis for 83.8%. The severe complication rate on postoperative day 90 was 11.7%, with a risk of anastomotic leakage of 4.7%. The independent risk factors in multivariate analysis were an American Society of Anesthesiologists (ASA) score ≥ 3, an open approach, and perioperative blood transfusion. Age, perioperative blood transfusion, and Hartmann’s procedure were the three independent risk factors for a permanent stoma. Conclusions: This series provides a real-life picture of elective sigmoidectomy for SDD at a national level. Trial registration: Comité National Information et Liberté (CNIL) (n°920361). [ABSTRACT FROM AUTHOR]

Introduction Participating in the political life is a key goal of democratic institutions. The main achievement of the Tunisian revolution has been the democratization of political life and the re-conquest of liberties that remain to consecrate and consolidate. Several studies have focused on evaluating the participation of some specific groups in political life (youth, women…) but none have shed a light on the mentally ill. Objective and method Our study aims to assess the participation of patients followed in different psychiatric units of the Razi hospital in activities such as voting, attendance at political meetings, adhesion and contributions to political parties as members, political debates with their neighbors… The investigation focused on 40 patients and relied on a preestablished questionnaire. Results The study group was 40 patients followed at Razi hospital with 25 men and 15 women. The average age of patients was 40 years (24–56). The turnout was very low at 10% (4 male patients) versus an average of 60% of the general population. One patient was an active member of a political party and political meetings. Women seemed to be less interested in political issues. Conclusion The participation of the mentally ill in politics, as in the different aspects of social life, remains very limited in a particularly vulnerable group in society that has suffered considerable discrimination. [ABSTRACT FROM AUTHOR]

Introduction Substance abuse is a widespread phenomenon in Tunisia. However, although the principles of prevention and addiction treatment are accepted in Tunisia, the laws of our country remains sketchy and marked by the traditional punitive approach to drug users. Aims Assess knowledge of methadone, opioid substitution therapy, among Tunisian psychiatrists. Methods This is a descriptive cross-sectional study that included psychiatrists in the public sector, liberal sector or in training courses. These doctors completed a self-administered questionnaire posted on the website of the Tunisian Society of Psychiatry and the Association of Tunisian residents and young psychiatrists. The survey includes 18 items. The questions were grouped under three main headings: – sociodemographic data; – general knowledge of methadone; – methadone and its place in their daily practice. Results The participation rate was 15% ( n = 35). The average participant age was 32.13 years. Psychiatry residents were the most represented grade 94%. Twenty-eight percent of participants had training in addiction ( n = 10) Eighty-five percent have heard about methadone. Conclusion Given the importance of the scourge of drug abuse including opioids, political circles have expressed the desire to improve the Tunisian legislation on substitution treatment. Nevertheless, others projects more directly related to “Arab Spring” are government priorities. [ABSTRACT FROM AUTHOR]

Introduction Tunisia is knowing a significant increase of the elderly population, this phenomenon comes along with an increase of the incidence of degenerative pathologies “dependent on the age” as the Alzheimer's disease. The physical and psychic consequences of the disease and also the behavior of family members are an important determinant of quality of life and economic activities of both patients and informal caregivers. Objectives and methods Our aims are to establish characteristicsof60 informal cargivers of Alzheimer's patients followed in the department of neurology in Razi's Hospital and to estimate their socioeconomic burden through a descriptive study. Results Our sample of caregivers was predominantly female with a moderate socio-economic conditions in 36,66%. The support was provided in 2/3 of cases exclusively by the informal caregivers. 22,66% ( n = 13) of them lost their profession since the beginning of assistance's relationship. Among caregivers, 8% were forced to leave their homes to be closer to their ailing sibling. Conclusion Our results reflect the distress of informal caregivers of Alzheimer's patients, the importance of their involvement and the adverse consequences on their quality of life and professional activities. [ABSTRACT FROM AUTHOR]

Introduction Impulsivity, as defined by Barratt in 1983, is the inability to associate a behavior to context or consequences. It refers to a variety of risky behaviors, inappropriate to the situation and can lead to undesirable consequences. It is well-established that impulsivity is strongly related to bipolar disorder. Currently, we speak of impulsivity trait present even in bipolar patients in euthymia given the hereditary nature of bipolar disorder. In this study, we are interested in assessing impulsiveness in healthy relatives of bipolar patients. Methodology Impulsivity was measured using BARRAT scale [the Barratt impulsiveness Scale-11 (BIS-11)] in 30 healthy subjects who are first degree relatives of bipolar patients treated in Razi hospital; and comparing the results to 30 subjects, witnesses matched for age and sex with no personal or family history of psychiatric disorders. Results The impulsivity score among parents of bipolar patients was significantly higher compared to controls especially for motor impulsivity with average scores 19.15 versus 16.94, respectively. The general impulsivity score among parents of bipolar patients was 61.53 ± 13.83 versus an average score in controls of 47.20 ± 18.26. Limits The small sample size did not allow conclusive results. The difficulties in determining the mental history of the control group (to check the absence of a family history of bipolar disorder). [ABSTRACT FROM AUTHOR]

Introduction Les pneumopathies acquises sous ventilation mécanique (PAVM) sont fréquentes et associées à une mortalité et un surcoût conséquents. Des mesures de prévention peuvent être mises en œuvre afin de réduire efficacement leur incidence [1] . L’objectif de ce travail était d’observer les conséquences des différentes mesures prises dans une nouvelle unité de réanimation sur l’incidence des PAVM et sur le taux de mortalité. Matériel et méthodes Étude prospective menée dans un service de réanimation. Entre avril et août 2013, tous les épisodes de PAVM ont été documentés (Gr–1) ; en septembre 2013, un plan d’action modifiant les mesures de prévention des PAVM était mis en place (Gr–2). Cette date servait de référence pour évaluer nos pratiques avant puis après mise en place de mesures correctrices. Le critère de jugement principal était la densité d’incidence des PAVM. Les critères secondaires étaient les durées de séjour et de ventilation, la mortalité, la consommation antibiotique et la modification de l’écologie bactérienne. Notre étude a englobé tous les patients hospitalisés et ventilés plus de 48 heures. Analyse statistique : test de Student pour les variables quantitatives et Chi 2 avec correction de Fisher pour les variables qualitatives. p < 0,05 était considéré significatif. Résultats Les données de 84 patients ont été analysées : 50 pour le Gr–1 et 34 pour le Gr–2. Entre les deux périodes, les patients ne sont pas différents en termes d’âge (50 ± 10 vs 46 ± 20 ans), d’IGS II (38 vs 34), de sex-ratio ou d’incidence du tabagisme. La durée moyenne de séjour en réanimation a diminué de 27,8 à 12 jours ( p < 0,05). La densité d’incidence des PAVM a été significativement réduite passant de 58 à 46,4 % ( p < 0,05). Dans le Gr–1, 100 % des PAVM étaient précoces versus 47 % dans le Gr–2 ( p < 0,05). Dans le Gr–1, 91,3 % des patients ont présenté deux épisodes de PAVM durant leur séjour comparativement au Gr–2 : 44,12 % ( p < 0,05). La mortalité était de 60,9 % dans le Gr–1 et de 44 % dans le Gr–2. Le profil bactériologique des PAVM précoces dans le Gr–1 était dominé par Klebsiella pneumoniae (34,8 %) et Acinetobacter baumanii (17,4 %). Dans le Gr–2, E. coli et Staphylococcus aureus étaient les deux germes prédominants (27,27 %). Discussion Les mesures actives actualisées régulièrement dans la lutte contre les PAVM et la limitation des indications de l’intubation en privilégiant la VNI ont permis de réduire la densité d’incidence des PAVM au sein de notre unité. Plusieurs mesures préventives ont été instaurées : position proclive du patient à 45 o sauf contre indication, mesure de la pression du ballonnet de la sonde endotrachéale et utilisation plus fréquente d’humidificateurs chauffants. Par contre, ces mesures n’ont pas montré d’impact sur la consommation d’antibiotiques ni sur l’écologie bactérienne. L’obtention d’une amélioration des densités d’incidence des PAVM doit inciter au respect scrupuleux des mesures mises en place et au développement de nouvelles techniques permettant de majorer le bénéfice obtenu. [ABSTRACT FROM AUTHOR]

Comparative study between solar cell sensitized by several naturel dyes and fabricated with two methods: electrophoretic deposition process (EPD) and doctor blade technique (DB) have been presented. TiO 2 layers have been deposited on the glass FTO (Fluorine doped tin oxide: SnO 2 : F) for the tow techniques. Structural and morphological properties were presented and correlated to deposition conditions of growing films. Natural dyes have been prepared and used to realize Dye-Synthetized Solar cells (DSSCs). Developed electrical model was used to study and extract experimental parameters. The compared I – V measurements under 100 mW/cm 2 illumination have shown an increase in both filling factor (FF) to reach 58.85% and open circuit voltage ( V oc ) value of 0.66 V for mallow sensitized solar cell fabricated with EDP technique. A decrease in short circuit current ( I sc ) and efficiency ( η ) due to the TiO 2 layer thickness and the cracks appearing in the layer fabricated with EPD technique. [ABSTRACT FROM AUTHOR]

At the time of diagnosis, 25% of patients with colorectal cancer present with synchronous liver metastases. The majority of these metastases are considered unresectable, thus requiring palliative care. Whether primary tumour resection followed by chemotherapy or immediate chemotherapy without primary tumour resection is the best therapeutic option in these patients is still debated. No prospective randomized study is available to clarify this issue. The objective of this review was to carry out a critical analysis about the importance of primary tumour resection in patients with asymptomatic or pauci-symptomatic colon cancer and unresectable synchronous liver metastases. [ABSTRACT FROM AUTHOR]

Aim We report on our experience of elective subtotal colectomy and ileosigmoid anastomosis for colon cancer with focus on postoperative results, function and quality of life. Method Between 1998 and 2011, 106 consecutive patients with colonic malignancy underwent this procedure electively. Function and quality of life ( EORTC QLQ- C30) were evaluated retrospectively with questionnaires sent to all patients free of recurrence. Results There were 62 men and 44 women (mean age 63 years). Postoperative mortality and morbidity rates were 1.9 and 26.4%, respectively. Persistent ileus was the main early complication (16%). After a mean follow-up of 67 ± 36 months, 50 (78.1) out of 64 patients have been evaluated for function and quality of life. The mean number of bowel movements per 24 h was 3 ± 2 and significantly lower when the length of the remaining sigmoid colon was more than 15 cm ( P = 0.049). Compared with a European reference population for EORTC QLQ- C30 results, our patients had significantly more diarrhoea (26 vs 3, P = 0.0002) but less pain (10 vs 25, P < 0.0001) and better global quality of life (77 vs 62, P < 0.0001). Conclusion Elective subtotal colectomy for colon cancer is safe and associated with good function and quality of life. Ileosigmoid anastomosis should be discussed when extended colectomy is required, providing the rectosigmoid junction and its vascular supply can be oncologically preserved. For tumours located in the transverse colon or at the splenic flexure, this procedure may be the best surgical option. [ABSTRACT FROM AUTHOR]

Abstract: The identification of constitutional and/or acquired risk factor is of major importance in the treatment of thromboembolic disease in young people; it contributes to evaluate the risk of recurrence and to define the period of oral prophylactic anticoagulant treatment. Several congenital or acquired abnormalities of haemostasis are actually defined. In this paper, we report the case of a 34-year-old man who developed a deep venous thrombosis, five months before the diagnosis of megaloblastic anemia, probably due to pernicious anemia. The thrombosis was partially explained by the acquired hyperhomocysteinemia induced by vitamin B12 deficiency. Moreover, activated protein C resistance due to factor V Leiden, was revealed in our patient. This latter improved under anticoagulant treatment combined with vitamin B12. Combination in one individual, of different risk factors predisposing to inherited and / or acquired thrombophilia, results in increased risk for thrombo-embolic disease, suggesting synergic interaction between these factors. [Copyright &y& Elsevier]

Aim: It is not known whether patients with obstructive left colon cancer (OLCC) with caecal ischaemia or diastatic perforation (defined as a blowout of the caecal wall related to colonic overdistension) should undergo a (sub)total colectomy (STC) or an ileo‐caecal resection with double‐barrelled ileo‐colostomy. We aimed to compare the results of these two strategies. Method: From 2000 to 2015, 1220 patients with OLCC underwent surgery by clinicians who were members of the French Surgical Association. Of these cases, 201 (16%) were found to have caecal ischaemia or diastatic perforation intra‐operatively: 174 patients (87%) underwent a STC (extended colectomy group) and 27 (13%) an ileo‐caecal resection with double‐end stoma (colon‐sparing group). Outcomes were compared retrospectively. Results: In the extended colectomy group, 95 patients (55%) had primary anastomosis and 79 (45%) had a STC with an end ileostomy. In the colon‐sparing group, 10 patients (37%) had simultaneous resection of their primary tumour with segmental colectomy and an anastomosis which was protected by a double‐barrelled ileo‐colostomy. The demographic data for the two groups were comparable. Median operative time was longer in the STC group (P = 0.0044). There was a decrease in postoperative mortality (7% vs 12%, P = 0.75) and overall morbidity (56% vs 67%, P = 0.37) including surgical (30% vs 40%, P = 0.29) and severe complications (17% vs 27%, P = 0.29) in the colon‐sparing group, although these differences did not reach statistical significance. Cumulative morbidity included all surgical stages and the rate of permanent stoma was 66% and 37%, respectively, with no significant difference between the two groups. Overall survival and disease‐free survival were similar between the two groups. Conclusion: The colon‐sparing strategy may represent a valid and safe alternative to STC in OLCC patients with caecal ischaemia or diastatic perforation. [ABSTRACT FROM AUTHOR]

Background: In an elective setting, there is no consensus regarding the type of colectomy that is best for patients with tumors of the splenic flexure: segmental left colectomy (or splenic flexure colectomy), left hemicolectomy or subtotal colectomy (or extended right hemicolectomy). In the United Kingdom, extended right hemicolectomy is preferred by surgeons. The aim of the present survey was to report on the practices in France for this particular tumor location. Methods: Between 15/07/17 and 15/10/17, members of two French surgical societies [the French Association of Surgery (AFC) and the French Society of Digestive Surgery (SFCD)] and two French surgical cooperative groups [the French Federation of Surgical Research (FRENCH) and the French Research Group of Rectal Cancer Surgery (GRECCAR)] were solicited by email to answer an online anonymous questionnaire. Results: A total of 190 out of 420 surgeons participated in this study (response rate 45%). The preferred procedure was splenic flexure colectomy (70%), followed by left hemicolectomy (17%) and subtotal colectomy (13%). The most used surgical approach was laparoscopy (63%), followed by laparotomy (31%) and hand-assisted laparoscopy (6%). Lymph node dissection was extended to the middle colic artery in 29% of splenic flexure colectomies and in 33% of left hemicolectomies. Twenty-nine percent of responders thought that tumors of the splenic flexure had a worse prognosis in comparison with other colonic sites, because of insufficient lymph node dissection (73%) or a more advanced stage (50%) at diagnosis. However, this opinion did not change the type of colectomy performed. Conclusions: There is a strong consensus in France to operate tumors of the splenic flexure with a splenic flexure colectomy and lymph node dissection limited to the left colic artery. [ABSTRACT FROM AUTHOR]

Aim: The aim was to define risk factors for postoperative mortality in patients undergoing emergency surgery for obstructing colon cancer (OCC) and to propose a dedicated score. Method: From 2000 to 2015, 2325 patients were treated for OCC in French surgical centres by members of the French National Surgical Association. A multivariate analysis was performed for variables with P value ≤ 0.20 in the univariate analysis for 30‐day mortality. Predictive performance was assessed by the area under the receiver operating characteristic curve. Results: A total of 1983 patients were included. Thirty‐day postoperative mortality was 7%. Multivariate analysis found five significant independent risk factors: age ≥ 75 (P = 0.013), American Society of Anesthesiologists (ASA) score ≥ III (P = 0.027), pulmonary comorbidity (P = 0.0002), right‐sided cancer (P = 0.047) and haemodynamic failure (P < 0.0001). The odds ratio for risk of postoperative death was 3.42 with one factor, 5.80 with two factors, 15.73 with three factors, 29.23 with four factors and 77.25 with five factors. The discriminating capacity in predicting 30‐day postoperative mortality was 0.80. Conclusion: Thirty‐day postoperative mortality after emergency surgery for OCC is correlated with age, ASA score, pulmonary comorbidity, site of tumour and haemodynamic failure, with a specific score ranging from 0 to 5. [ABSTRACT FROM AUTHOR]

Résumé But de l’étude L’objectif de notre travail était d’évaluer la fréquence de la cyberaddiction dans une population d’étudiants et de relever leurs principaux facteurs de risque. Patients et méthode Nous avons mené une étude transversale, descriptive et comparative auprès d’une population d’étudiants de la faculté des sciences d’El Manar. La population était constituée de 310 étudiants. Nous avons recueilli les données sociodémographiques et cliniques par l’intermédiaire d’un auto-questionnaire semi-structuré. Nous avons utilisé le MINI pour dépister la dépression, l’échelle d’anxiété de Beck et le questionnaire de Young de la cyberdépendance. Résultats Un peu plus d’un quart des étudiants présentait une cyberaddiction (26,8 %). Les facteurs corrélés à la cyberaddiction étaient l’âge, le lieu d’habitation, le parcours scolaire, les antécédents, la dépression, l’anxiété et la consommation d’alcool et de cannabis. Conclusion Notre étude est en faveur de la fréquence de la cyberaddiction parmi les étudiants enquêtés. Objective In this study, our aims were to find the cyberaddiction's prevalence among student's sample of Tunis scientific university and to seek for the most important cyberaddiction's risk factors. Methods Our study included 310 students from the scientific university of Tunis El Manar. All students completed a questionnaire. The questionnaire was composed by three parts: the first included the social and demographic data, the second included personnel and familiar data. We used the MINI to detect depressive symptoms during the last two weeks. We used the Beck anxiety scale to detect anxiety symptoms during the last week. Finally we used the Young cyberaddiction scale to seek for cyberdependency. Results The sample was composed by 57.4% girls ( n = 178) and 42.6% boys ( n = 132), the sex-ratio F/H was 1.34. Mean age was 21.9 years ± 1.4. A total of 27.7% ( n = 86) of students have a major depressive episode during the two last weeks (MINI criteria's). While, meanly the half of students (53.5%, n = 166) have anxiety symptoms (Beck anxiety scale). A total of 19.7% of students ( n = 61) present an alcohol use (19.7%, n = 61). Eight students use occasionally cannabis (2.6%). A total of 26.8%; n = 83 of students are addicted to Internet, if Young internet addiction criteria's was applied. All the students use frequently Internet. The most of them all days (82.3%, n = 255). The connexion mean time was 3.8 ± 2 hours/day. The most frequent activities on the net were the chat (online discussion, forums…) in 79.1% of cases. Meanly 25% of students of the sample have three activities on the net (chat, founding, save, games on line…). The age ( P < 0.001), the residence ( P = 0.017) and the scholar failure ( P < 0.001) were correlated to the cyberdependency (OR = 2.8; 2.3 and 2.8, respectively). Family history was also correlated to cyberaddiction ( P = 0.023). We also note most depression, anxiety symptoms, and alcohol and cannabis addictions among group of cyberaddicted students. The relative risk was estimated respectively to 4.6; 4.4; 3.2 and 8.5. Conclusion The cyberdependency was frequent among students. Depressive and anxiety symptoms were also important in case of net addiction. It is important to detect and prevent this cyberaddiction and those psychiatric comorbidities. [ABSTRACT FROM AUTHOR]

Background:and aims: Colorectal cancer (CRC) harbours different types of DNA alterations, including microsatellite instability (MSI). Cancers with high levels of MSI (MSI-H) are considered to have a good prognosis, probably related to lymphocyte infiltration within tumours. The aim of the present study was to characterise the intratumoural expression of markers associated with the antitumour immune response in mismatch repair (MMR)-proficient (MSS) colon cancers. Methods: Ninety human colon cancers (T) and autologous normal colon mucosa (NT) were quantified for the expression of 15 markers of the immune response with quantitiative reverse transcription-PCR (qRT-PCR). mRNA expression levels were correlated with MMR status. Immunohistochemistry (IHC) was performed using both interleukin 17 (IL17) and CD3 antibodies. Results: Expression of cytotoxic markers (FasL, granzyme B and perform), inflammatory cytokines (IL1β, IL6, IL8, IL17 and transforming growth factor β (TGFβ)) and a marker of regulatory T cells (forkhead box P3 (Foxp3)) was significantly higher in tumours than in autologous normal tissues. Adjusting for MMR status, higher tumoural expression of both granzyme B and perform was associated with the MSI-H phenotype, and the perform T/NT ratio was higher in MSI-H tissues than in MSS tissues. Higher tumoural expression of Foxp3, IL17, IL1 β, IL6 and TGFβ was associated with the MSS phenotype, and the IL17 TINT ratio was higher in MSS tissues than in MSI-H tissues as assessed by both qRT-PCR and IHC. Conclusions: Immune gene expression profiling in CRC displayed different patterns according to MMR status. Higher Foxp3, IL6, TGFβ and IL17 expression is a particular determinant in MMR-proficient CRC. These may be potential biomarkers for a new prognostic "test set" in sporadic CRCs. [ABSTRACT FROM AUTHOR]

Background: Since 1997, the authors have performed laparoscopic left lateral sectionectomy of lesions of the liver in preference to open surgery. The aim of this study was to assess the outcome. Methods: Between October 1997 and March 2005, 36 laparoscopic left lateral sectionectomies were performed using five trocars and a small incision for specimen retrieval. Liver resection was performed mainly using a harmonic scalpel and staplers. The Pringle manoeuvre was used in 24 patients. Results: The mean patient age was 55·2 (range 31-80) years. Twelve patients had underlying cirrhosis. Surgery was performed for 20 malignant lesions and 16 benign lesions with a mean size of 42·7 (range 5-110) mm. Conversion to laparotomy occurred in one patient. The mean operating time was 171·5 (range 90-240) min. Operatiing time and use of the Pringle manoeuvre were significantly decreased in the second half of the series. Mean blood loss was 208 (range 50-600) ml. No transfusion was required. There were no deaths. Two patients had postoperative complications (one incisional hernia and one pneumonia). The median postoperative stay was 5·2 days. Conclusion: The laparoscopic approach to left lateral sectionectomy was safe and feasible in this series and could be considered as a routine approach in selected patients. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Public databases now contain multitude of complete bacterial genomes, including several genomes of the same species. The available data offers new opportunities to address questions about bacterial genome evolution, a task that requires reliable fine comparison data of closely related genomes. Recent analyses have shown, using pairwise whole genome alignments, that it is possible to segment bacterial genomes into a common conserved backbone and strain-specific sequences called loops. Results: Here, we generalize this approach and propose a strategy that allows systematic and non-biased genome segmentation based on multiple genome alignments. Segmentation analyses, as applied to 13 different bacterial species, confirmed the feasibility of our approach to discern the 'mosaic' organization of bacterial genomes. Segmentation results are available through a Web interface permitting functional analysis, extraction and visualization of the backbone/loops structure of documented genomes. To illustrate the potential of this approach, we performed a precise analysis of the mosaic organization of three E. coli strains and functional characterization of the loops. Conclusion: The segmentation results including the backbone/loops structure of 13 bacterial species genomes are new and available for use by the scientific community at the URL: http://genome.jouy.inra.fr/mosaic. [ABSTRACT FROM AUTHOR]

Introduction: Mental disorders of pregnancy or postpartum correspond to all the psychopathological states linked to the period of the pregnancy-puerperium. They are the subject of prevention and screening and are currently a public health priority Objectives: Describe the socio-demographic characteristics of the patients who presented mental disorders during pregnancy and/or postpartum. Identify the various risk factors predisposing to these disorders Methods: We carried out a retrospective descriptive analytical study including patients who presented mental disorders during their pregnancy or postpartumand who were hospitalized during the period from January to October 2020.We collected 20 patients. Results: The average age was 39.84 years. Mental disorders were present in 73.7% during the postpartum period. The patients had a personality disorder in 47.7%. They were smokers in 57% of cases. Pregnancy was desired in 73.7% with regular follow-up in 84.2%. Pregnancy was complicated by toxemia in 22% of cases and gestational diabetes in 27% of cases. Delivery was by caesarean section in 68.4% with primiparity in 50%. According to the DSM5, the psychic disorder most often found during pregnancy was the characterized depressive disorder 43%, and during the postpartum we found the brief psychotic episode 42.1%. The treatment was in half of the cases association between antidepressants and antipsychotics. Mental disorders were significantly correlated with the presence of stressful life events during pregnancy (p =0.02) Conclusions: Mental disorders during pregnancy and postpartum are frequent and important to detect. Early diagnosis and adequate care are the two essential elements that should allow these women to fully experience their motherhood. [ABSTRACT FROM AUTHOR]

Introduction: Functional disability in bipolar disorder, despite optimal treatment, has been associated with residual symptoms. Nevertheless, the impact and relevance of each of them remain unclear in clinical practice. Objectives: The aims of the present study were to evaluate the impact of residual symptoms on overall functioning in euthymic patients with bipolar disorder and to explore the relationship between residual symptoms and specific areas of functional impairment. Methods: This was a cross-sectional, non-interventional study of adult bipolar outpatients. All patients were euthymic at the time of assessment (YMRS score <8 and BDRS =8). The Functioning Assessment Short Test was used to assess overall and specific domains of functioning (autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships, and leisure time). Various residual symptoms were assessed (residual mood symptoms, sleep and sexual disorders). Logistic correlation was used to determine the best model of association between functional domains and residual symptoms. Results: Almost quarter of 40 patients included (22,5%) had poor overall functioning. Residual depressive symptoms were associated with poor overall functioning and occupational functioning outcome (r=0,405, p=0,009; r=0,343, p=0,003 respectively). In addition, sleep quality appeared to have an impact on global functioning and autonomy (r=0,402, p=0,01; r=0,46, p=0,003 respectively). Residual manic symptoms and sexual function weren't correlated with functioning impairment. Conclusions: ln this study, residual depressive symptoms and sleep quality impairments were the most prominent factors associated with the level of functioning. Thereby, these residual symptoms need to be targeted in order to optimize bipolar patients functioning and quality of life. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this prospective study was to investigate the involvement of angiogenesis in the etiopathogenesis of the different classes of erythrocytosis (polycythemia vera PV, idiopathic erythrocytosis and secondary erythrocytosis). The angiogenic activity was evaluated by the assessment of the serum VEGF levels in 78 untreated erythrocytosis patients and 21 healthy subjects. The results indicated that VEGF was overproduced in advanced and untreated PV patients and at less degree, in early PV, a subgroup of idiopathic erythrocytosis, thus confirming an increased angiogenic activity. However, VEGF does not play an angiogenic role in secondary erythrocytosis. [Copyright &y& Elsevier]

Cell biology is increasingly dependent on quantitative methods resulting in the need for microscopic labelling technologies that are highly sensitive and specific. Whilst the use of fluorescent proteins has led to major advances, they also suffer from their relatively low brightness and photo-stability, making the detection of very low abundance proteins using fluorescent protein-based methods challenging. Here, we characterize the use of the self-labelling protein tag called HaloTag, in conjunction with an organic fluorescent dye, to label and accurately count endogenous proteins present in very low numbers (<7) in individual Escherichia coli cells. This procedure can be used to detect single molecules in fixed cells with conventional epifluorescence illumination and a standard microscope. We show that the detection efficiency of proteins labelled with the HaloTag is ≥80%, which is on par or better than previous techniques. Therefore, this method offers a simple and attractive alternative to current procedures to detect low abundance molecules. [ABSTRACT FROM AUTHOR]

Introduction Violence against elderly persons is an intricate social, legal and ethic issue. Alzheimer's patients are the most vulnerable individuals to mistreatment and neglect. The aggressor can be even the main helper of the patient. We noticed a wide underestimation of this phenomenon, which remains taboo subject in our society. Objectives and methods The aim of our study is to identify predictive factors of mistreatment of Alzheimer's patients through a prospective and descriptive study, within patients following in the department of neurology in Razi's hospital. – We evaluate cognitive function (MMSE) and the importance of behavioural disorders. – We explored helpers’ sociodemographic characteristics and the quality of aid relationship. – Anger and hostility within relationship were estimated through family attitude scale. Results -Our sample accounts 60 informal caregivers predominately female (91,7%) with an average age of 49,67 years, mostly are married (71,66%) and jobless (38,88%). – In 78,3% of cases, caregivers spent about 12 to 24 hours per day with Alzheimer's patient. – The average score of FAS was about52,4%with an important emotional charge (score > 60). – Twenty-five caregivers wished the death of the patient and 42 others admitted being sarcastic with him. – We noticed a correlation between mistreatment and both cognitive function and behavioural disorders. Conclusion Our results support the fact that mistreatment of people with dementia is closely related with the exhausting situation of the main caregiver. [ABSTRACT FROM AUTHOR]

Introduction The important role of family caregivers, particularly among Alzheimer's patients is increasingly recognized. The Alzheimer's patient assistance relationship is a morally painful experience, most frequently discussed in terms of “burden” in the literature. We intended to assess the level of burden among caregivers of patients with Alzheimer's disease and to search factors associated with a high level of burden. Methodology This is a retrospective descriptive study. Patients were recruited from neurology department of Razi hospital. The burden was measured using the Zarit inventory. Results and discussion Thirty patients were included, the majority female. Most caregivers are descendants (60%), then, daughters-in-law (33.33%), and finally the spouses (23.33%). Eighty percent of caregivers lived in the same home as patients. The average burden in our sample is 59.9 + 16. We observed that 3.33% have absent to light burden (score < 21), 10% have a light to moderate burden (between 21 and 40), 36.66% have moderate to severe burden (between 41 and 60) and 50% have a severe burden (> 60), according to the classification proposed by Zarit. Sex, kinship and cohabitation with the patient were not associated with a higher burden. Caregivers who support more severe patients have a higher burden. Thus, behavioral disorders are more frequent or severe and the numbers of incapacity to perform activities of daily life are more important. However, there the gravity of burden is not affected by age of the assisted person. Conclusion The study of factors correlated with high levels of burden aims at finding ways of intervention. However, the research needs to be broadened to further analyze the causal links between these factors. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which describes a case of erythermalgia, with polycythemia vera and a cervical rib aetiology in a 73-year-old female patient.

Introduction Les pneumopathies acquises sous ventilation mécanique (PAVM) représentent une des premières causes de morbi-mortalité en réanimation. Chez l’homme, le pH trachéal est légèrement plus acide que le pH plasmatique [1] . Dans cette étude, nous nous proposons, d’étudier la relation entre le pH trachéal et la survenue de PAVM. Matériel et méthodes Étude prospective observationnelle menée dans une réanimation médico-chirurgicale sur une période de 60 jours ayant inclus 25 patients intubés les premières 48 heures de leur admission. Le pH trachéal a été mesuré par des bandelettes réactives sur les sécrétions trachéales dès l’intubation (T0) puis tous les jours à une heure fixe de la journée. Au même moment, nous avons relevé les autres paramètres nécessaires pour calculer « clinical pulmonary infection score » (CPIS). Nous avons également relevé les données bactériologiques et notamment les prélèvements distaux protégés (PDP). Les patients ont été classés en deux groupes : PAVM (+) et (−) en fonction du CPIS et du PDP. Analyse statistique sur SPSS 18.0 : variables qualitatives exprimées sous forme d’effectif et %. Analyse univariée afin de comparer les groupes PAVM (+) et PAVM (−) à l’aide du test de Chi 2 . Résultats À T0, le pH trachéal était acide (pH < 7) chez tous les patients sauf trois qui avaient inhalé (pH > 8). Au cours du séjour en réanimation, sur les 25 patients hospitalisés, 13 ont développé une PAVM (4 précoces et 8 tardives) avec un CPIS > 6. Le pH trachéal était alcalin chez 11 patients. Parmi les patients qui avaient développé une PAVM, 8 étaient déjà sous antibiothérapie probabiliste préalable : 2 pour pneumopathie d’inhalation et 6 pour des foyers extrapulmonaires. Nous avons noté aussi bien le pH trachéal concomitant au PDP ainsi que le CPIS correspondant ( Tableau 1 ). Discussion En comparant ces résultats préliminaires aux données de la littérature, nous retrouvons une discordance. Le pH trachéal acide favorise la survenue de pneumopathie [2,3] . La majorité des patients infectés (CPIS > 6) ont un pH alcalin indépendamment du délai de survenue et d’une antibiothérapie préalable à visée pulmonaire ou autre. Il est certain que notre étude présente quelques limites : outre l’effectif initial réduit, le pH n’est pas mesuré au niveau des voies aériennes distales et pourrait être influencé par des conditions locales et la mesure elle-même n’est pas aussi performante (bandelette réactive). Néanmoins, des résultats contradictoires à ceux retrouvés dans la littérature et concernant un sujet aussi pertinent, éveilleraient la curiosité de tout clinicien et pousseraient à mieux étudier ce sujet en s’offrant de meilleurs moyens. Parmi les infections nosocomiales en réanimation, les PAVM sont probablement l’une des plus sévères entraînant une surmortalité et une sur-morbidité. C’est pour cela que toute aide à un diagnostic précoce serait la bienvenue. [ABSTRACT FROM AUTHOR]