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Among azobenzene derivatives, azothiophenes represent a relatively recent family of compounds that exhibit similar characteristics as dyes and photoreactive systems. Their technological applications are extensive thanks to the additional design flexibility conferred by the heteroaromatic ring. In this study, we present a comprehensive investigation of the structural and electronic properties of novel dyes derived from 3-thiophenamine, utilizing a multilevel approach. We thoroughly examined the potential energy surfaces of the E and Z isomers for three molecules, each bearing different substituents on the phenyl ring at the para position relative to the diazo group. This exploration was conducted through quantum chemistry calculations at various levels of theory, employing a continuum solvent model. Subsequently, we incorporated an explicit solvent (a dimethyl sulfoxide–water mixture) to simulate the most stable isomers using classical molecular dynamics, delivering a clear picture of the local solvation structure and intermolecular interactions. Finally, a hybrid quantum mechanics/molecular mechanics (QM/MM) approach was employed to accurately describe the evolution of the solutes’ properties within their environment, accounting for finite temperature effects.

Abstract Background The incidence of in-stent restenosis (ISR) remains relatively common despite the use of drug-eluting stents. Outcomes and prognostic factors following ISR revascularization are still being investigated. We aimed to describe the outcomes following different ISR treatment strategies in order to identify prognostic factors associated with worse outcomes. Results In a retrospective cohort study, we included patients who were admitted to our department and treated for ISR, from January 2017 to December 2018. All patients were followed up for a median period of 24 months. Major cardiac adverse event (MACE) was a composite outcome of the following events: myocardial infarction, target vessel revascularization, target lesion revascularization or cardiovascular death. MACEs were collected during follow-up. Our population consisted of 116 patients. Mean age was 60 years old with a sex ratio of 2.8. During follow-up, 44 patients (37.9%) had at least one MACE. Independent factors identified by multivariate logistic regression were ISR of the proximal left anterior descending artery [Odds ratio (OR) = 1.29; 95% confidence interval (95% CI) 1.16–1.81; p = 0.05], diffuse ISR [OR = 2.16; 95% CI 1.1–3.47; p = 0.022], double or triple vessel disease [OR = 2.97; 95% CI 1.2–6.8; p = 0.008], two or more stents per lesion [OR = 1.82; 95% CI 1.14–2.21, p = 0.031] and absence of post-dilatation in the initial angioplasty [OR = 1.32; 95% CI 1–1.35; p = 0.04]. Conclusions Our study suggested that ISR is related to poor outcomes. Identifying prognostic factors would play a key role in the refinement of interventional techniques.

Highly efficient and safe Covid-19 vaccines are available in Europe in amounts that theoretically allow for a high immune coverage. However, a notable proportion of the population is reluctant toward immunization. We aimed to determine, among people who chose to be vaccinated, when they made the decision and whether they would have preferred an earlier vaccination. A survey was conducted in a high-volume Covid-19 vaccination center in France from 28 May to 9 July 2021 through an anonymous questionnaire. The 2519 participants (54.1% males; median age 39 years) attributed lower efficacy and safety to Covid-19 vaccines than to vaccines in general. When asked when they decided to receive the vaccine, 15.5% and 16.0% answered “less than one month ago” and “less than one week ago,” respectively; age

Among azobenzene derivatives, azothiophenes represent a relatively recent family of compounds that exhibit similar characteristics as dyes and photoreactive systems. Their technological applications are extensive thanks to the additional design flexibility conferred by the heteroaromatic ring. In this study, we present a comprehensive investigation of the structural and electronic properties of novel dyes derived from 3-thiophenamine, utilizing a multilevel approach. We thoroughly examined the potential energy surfaces of the E and Z isomers for three molecules, each bearing different substituents on the phenyl ring at the para position relative to the diazo group. This exploration was conducted through quantum chemistry calculations at various levels of theory, employing a continuum solvent model. Subsequently, we incorporated an explicit solvent (a dimethyl sulfoxide–water mixture) to simulate the most stable isomers using classical molecular dynamics, delivering a clear picture of the local solvation structure and intermolecular interactions. Finally, a hybrid quantum mechanics/molecular mechanics (QM/MM) approach was employed to accurately describe the evolution of the solutes' properties within their environment, accounting for finite temperature effects. [ABSTRACT FROM AUTHOR]

BackgroundCoronary artery diseases remain the leading cause of death in the world. The management of this condition has improved remarkably in the recent years owing to the development of new technical tools and multicentric registries. ObjectiveThe aim of this study is to investigate the in-hospital and 1-year clinical outcomes of patients treated with percutaneous coronary intervention (PCI) in Tunisia. MethodsWe will conduct a prospective multicentric observational study with patients older than 18 years who underwent PCI between January 31, 2020 and June 30, 2020. The primary end point is the occurrence of a major adverse cardiovascular event, defined as cardiovascular death, myocardial infarction, cerebrovascular accident, or target vessel revascularization with either repeat PCI or coronary artery bypass grafting (CABG). The secondary end points are procedural success rate, stent thrombosis, and the rate of redo PCI/CABG for in-stent restenosis. ResultsIn this study, the demographic profile and the general risk profile of Tunisian patients who underwent PCI and their end points will be analyzed. The complexity level of the procedures and the left main occlusion, bifurcation occlusion, and chronic total occlusion PCI will be analyzed, and immediate as well as long-term results will be determined. The National Tunisian Registry of PCI (NATURE-PCI) will be the first national multicentric registry of angioplasty in Africa. For this study, the institutional ethical committee approval was obtained (0223/2020). This trial consists of 97 cardiologists and 2498 patients who have undergone PCI with a 1-year follow-up period. Twenty-eight catheterization laboratories from both public (15 laboratories) and private (13 laboratories) sectors will enroll patients after receiving informed consent. Of the 2498 patients, 1897 (75.9%) are managed in the public sector and 601 (24.1%) are managed in the private sector. The COVID-19 pandemic started in Tunisia in March 2020; 719 patients (31.9%) were included before the COVID-19 pandemic and 1779 (60.1%) during the pandemic. The inclusion of patients has been finished, and we expect to publish the results by the end of 2022. ConclusionsThis study would add data and provide a valuable opportunity for real-world clinical epidemiology and practice in the field of interventional cardiology in Tunisia with insights into the uptake of PCI in this limited-income region. Trial RegistrationClinicaltrials.gov NCT04219761; https://clinicaltrials.gov/ct2/show/NCT04219761 International Registered Report Identifier (IRRID)RR1-10.2196/24595

Abstract Background Wolf–Hirschhorn (WHS) is a set of congenital physical anomalies and mental retardation associated with a partial deletion of the short arm of chromosome 4. To establish a genotype–phenotype correlation; we carried out a molecular cytogenetic analysis on two Tunisian WHS patients. Patient 1 was a boy of 1-year-old, presented a typical WHS phenotype while patient 2, is a boy of 2 days presented an hypospadias, a micropenis and a cryptorchidie in addition to the typical WHS phenotype. Both the array comparative genomic hybridization and fluorescence in situ hybridization techniques were used. Results Results of the analysis showed that patient 2 had a greater deletion size (4.8 Mb) of chromosome 4 than patient 1 (3.4 Mb). Here, we notice that the larger the deletion, the more genes are likely to be involved, and the more severe the phenotype is likely to be. If we analyze the uncommon deleted region between patient1 and patient 2 we found that the Muscle Segment Homeobox (MSX1) gene is included in this region. MSX1 is a critical transcriptional repressor factor, expressed in the ventral side of the developing anterior pituitary and implicated in gonadotrope differentiation. Msx1 acts as a negative regulatory pituitary development by repressing the gonadotropin releasing hormone (GnRH) genes during embryogenesis. We hypothesized that the deletion of MSX1 in our patient may deregulate the androgen synthesis. Conclusion Based on the MSX1 gene function, its absence might be indirectly responsible for the hypospadias phenotype by contributing to the spatiotemporal regulation of GnRH transcription during development.

Introduction Suicide attempts are common and constitute a serious problem for public health.Thus, it is very important to evaluate risk factors for suicidal behavior. Objectives The purpose of this study was to explore the socio-demographic and clinical profile of attempted suicide patients consulting in the psychiatry department in Gabes (southern of Tunisia). Methods It was a retrospective descriptive and analytical study covering all patients who had attempted suicide during the period from the 1st of May, 2009 to September 25th, 2020 and who were referred to the psychiatry department in the regional hospital of Gabes. Sociodemographic and clinical data of the patients as well as characteristics of the suicide attemptswere assessed. Results Socio-demographic profile of the suicidal consultant in psychiatry department corresponded to a single (73.4%) female (78.8%), with a mean age of 26 years, from an urban area (46%). Suicide attempts were most often by the intentional drug ingestion (67.8%), committed between March and August in 54% of cases. At most of the time, the suicidal person was alone (85%) at home (94%) when he committed his suicidal attempt. He did not communicate his intention to commit suicide in 46% of the cases and only 22 cases (7.9%) notified a person before the suicide attempt and 12.6% afterwards. Suicide behavior was impulsive in 79.5% of the cases and a verbal expression of a desire to die was only noted in 24.5% of cases. Conclusions Our results suggest a systematic and specific psychiatric evaluation of any patient who attempts suicide. Conflict of interest No significant relationships.

Introduction Detecting warning signs of suicide attempts is a particular difficult task. However, people who plan to commit suicide almost always announce it to someone in some way. Objectives Aims of this study were to describe signs preceding the suicide attempt in a group of suicidal persons and its links with suicidal recurrence. Methods It was a retrospective study that included all the patients who attempted suicide during the period from May 1st, 2009 to September 25th, 2020 and who were referred to the psychiatry department of the regional hospital of Gabes. Sociodemographic and clinical data as well as suicidal attempts characteristics were assessed. Results 278 patients were included (female=78.1%), with mean age of 26. The common suicidal attempt method was intentional drug intoxication (67.8%). At least, one clinical manifestation was reported by 75.2% of suicide patients. The most common signs were the tendency to isolation (47.1%), a change in character or behavior (46.6%), thoughts of death (29.6%), anxiety or agitation (24.8%) and recent worsening of the pre-existing psychiatric symptoms (24.3%). Suicidal recurrence affected 24.8% of patients. It was correlated to the presence of a mental disorder (p

Introduction Adolescent suicide and suicide attempts (SA) present a complex and multifactorial problem that deserves special attention. Identifying particularities of suicidal behavior in this age group is essential in order to identify suffering adolescents. Objectives To determine the characteristics of adolescent suicide attempts compared to those of adults. Methods It was a retrospective study carried out on a clinical population who consult in the psychiatry department at the Gabes regional hospital during the period from January 1st, 2020 to September 30, 2020. Sociodemographic and clinical data of the patients as well as their family dynamics, their education, their personal and family history, characteristics of the SA and psychiatric symptoms preceding the act were assessed. We compared two subgroups: patients aged 10 to 19, and those aged 20 and over. Results 278 suicide patients were included. 101 of them were adolescents (10 -19 years), of which 89 (88.11%) were female. Mean age of suicidal adolescents was 16.5 years. They were mostly living with their families (92.07%). Intentional drug ingestion was more common in adolescents (81.1%) than in adults (40%). Adolescent suicide attempts were correlated with a conflictual family environment (p=0.04), exposure to mistreatment (p=0.001), the absence of underlying mental disorders (p

Introduction Vaginismus is the most common reason for unconsummated marriages in Tunisia. Objectives To describe the socio-demographic profile and to explore the clinical and cultural aspects of sexual functioning of women with vaginismus. Methods It was a cross-sectional study established over a period of 3 months from the November 1st, 2019 to January 31st, 2020. This study focused on a population of women with vaginismus recruited from outpatient consultations of the hospital’s gynecology and psychiatry departments at the regional hospital of Gabes. We used a pre-established sheet exploring socio-demographic data, medical and gyneco-obstetric history and informations concerning the partner, the marital relationship and the woman’s sexual activity. Results 35 women were included. They had a mean age of 30 years, jobless (54.5%) and with a secondary or university education (91.1%). The mean duration of marriage was 2.4 years. Partner had mean age of 36 and suffering from sexual dysfunction (21.3%). Among women, 12.5% had been sexually abused, 51.6% had suffered “Tasfih”, 70% had attended discussions about painful defloration. Vaginismus was primary in 85.7% and total in 50% of the cases. About the received thoughts of the women, 40% thought that vaginismus requires medical treatment, 13 of them (40%) thought that the disorder could be resolved spontaneously and 20% believed in a story of witchcraft. 85% consulted a physician and 24.2% a traditional therapist. Conclusions Vaginismus seems to be influenced by psychological and sociocultural factors so that a good psychoeducation of brides could reduce the incidence of this sexual disorder. Conflict of interest No significant relationships.

Introduction Nowadays, suicide is a global public health problem thus detection of risk factors more specifically individual factors can be used as a method for prevention and intervention. Objectives The aims of our study were to assess the incidence of suicidal recurrence and its individual associated factors. Methods A retrospective descriptive and analytical study was undertaken including all patients consulting for the first time at Gabes psychiatry department (in southern Tunisia) from the 4th March 2009 to the 25th September 2020 for suicidal attempt. Sociodemographic and clinical data as well as suicidal attempts’ characteristics were assessed. The statistical analysis was executed on the software SPSS (20th edition). Results 278 patients were collected including 217 female. The mean age was 26. Suicidal patients were unmarried (75.9%), childless (79.1%) and unemployed (47.5%). The common suicidal attempt method was voluntary drug intoxication (67.8%). Interference of individual factors was reported in 77% of cases, especially difficulties to cope with stress (46.4%), followed by low self-esteem (36.5%), personal psychiatric history (17.3%), personal medical history (8.3%) and alcohol or drug abuse (6.1%). A suicidal re-attempt was notedin 24.9 % of cases. Recurrence was associated with the female gender (72.4%), difficulties to cope with stress (

Introduction Seasonal changes, climatic factors such as temperature, sunlight intensity and precipitations as well as temporal factors seem to have an influence on suicidal behavior. Objectives Our study aimed to analyse the association between seasonal changes, climatic variations, temporal factors and suicide attempts. Methods A retrospective descriptive and analytical study was undertaken including all patients consulting for the first time at Gabes psychiatry department from the 4th March 2009 to the 25th September 2020 for suicidal attempt. Sociodemographic and clinical data as well as suicidal attempts’ characteristics were assessed. Meteorologic data, related to the years 2009 through 2020, were obtained from the official weather website of Tunisia. Results 278 patients were collected, including 217 female. Mean age was 26. Suicidal patients were unmarried (75.9%), childless (79.1%) and unemployed (47.5%). Results showed that suicidal attempts occurred most frequently in summer (32.5%) specifically in June and July (10.9% for each). Regarding the distribution of suicide attempts over the days of the week, the highest rate was observed on Monday (22.5%) and the lower one on Friday. There were a correlation between high temperature and suicide attempt by hanging (p=0.006), between days of sunlight and manifestations preceding the suicidal attempt (p=0.04) and between rainfall and anxiety disorder leading to suicidal attempt (p=0.03).We finded also an association between the summer and risk behavior such as runaways (p=0.024). Conclusions A better identification of seasonality, climatic and temporal factors in suicidal behavior could allow a better prevention in suicidal attempts and a reduction in death by suicide

The distal radial approach (DRA) is suggested to have benefits over the conventional radial approach (CRA) in terms of local complications and comfort of both patient and operator. Therefore, we aimed to compare the feasibility and safety of DRA and CRA in a real life population. We conducted a prospective, observational multicentric trial, including all patients undergoing coronary procedures in September 2019. Patients with impalpable proximal or distal radial pulse were excluded. Thus, the choice of the approach is left to the operator discretion. The primary endpoints were cannulation failure and procedure failure. The secondary endpoints were time of puncture, local complications and radial occlusion assessed by Doppler performed one day after the procedure. We enrolled 177 patients divided into two groups: CRA (n = 95) and DRA (n = 82). Percutaneous intervention was achieved in 37% in CRA group and 34% in DRA group (p = 0.7). Cannulation time was not significantly different between the two sets (p = 0.16). Cannulation failure was significantly higher in DRA group (4.8% vs 2%, p

INTRODUCTION : il est considéré que la mort subite qui survient lors d'une activité sportive touche un patient ayant une cardiopathie ignorée. L'ECG du sportif de race noire a été peu étudié et des particularités liées à l'ethnie ont été évoquées. Notre travail a pour objectif d'étudier le profil épidémiologique et les particularités de la repolarisation du sportif de race noire.Méthodes: une étude descriptive a été menée durant 8 mois de mars à octobre 2014, incluant des sportifs de race noire sélectionnés parmi tous les sportifs qui étaient suivi dans le centre sectoriel de la Médecine et des Sciences de sports de Sousse. Le recueil de données a été réalisé grâce à un questionnaire médical.Résultats: trente-cinq (35) athlètes ont été colligés, avec une prédominance masculine (94,28%), ayant un âge moyen de 24,34 ans. Quatre athlètes avaient une hypertrophie ventriculaire gauche à l'échographie cardiaque. Il y'avait 8 athlètes avec un BAV de 1er degré et 8 athlètes avaient un HVG électrique. Les modifications du segment ST étaient plus marquées au niveau des dérivations précordiales. Cinq athlètes (14,2%) avaient des ondes T négatives en V2 et V3, et il s'agissait des mêmes athlètes qui avaient le sus décalage du segment ST dans ces mêmes dérivations. Un aspect de repolarisation précoce a été constaté chez 3 athlètes. Tous ces cas étaient type notch.Conclusion: les sportifs de race noire semblent avoir des modifications électriques assez spécifiques dont il importe de connaitre. Toutefois, notre échantillon n'est pas suffisamment important pour affirmer ces résultats. Une étude comparative avec des sportifs de race blanche serait très intéressante.

BackgroundThe FAST-MI Tunisia registry was set up by the Tunisian Society of Cardiology and Cardiovascular Surgery to assess the demographic and clinical characteristics, management and hospital outcome of patients with ST-elevation myocardial infarction (STEMI).MethodsData for 459 consecutive patients (mean age 60.8 years; 88.5% male) with STEMI, treated in 16 public hospitals (representing 72.2% of public hospitals in Tunisia treating STEMI patients), were collected prospectively.The most common risk factors were smoking (63.6%), hypertension (39.7%), diabetes (32%) and dyslipidaemia (18.2%).ResultsAmong the 459 patients, 61.8% received reperfusion therapy: 30% with primary percutaneous coronary intervention (PPCI) and 31.8% with intravenous fibrinolysis (IF) (28.6% with pre-hospital thrombolysis). The median time from symptom onset to thrombolysis was 185 min and to PPCI was 358 min. In-hospital mortality was 5.3%. Compared with those managed at regional hospitals, patients managed at interventional university hospitals (n = 357) were more likely to receive reperfusion therapy (52.9% vs. 34.1%; pConclusionsData from the FAST-MI Tunisia registry show that a pharmaco-invasive strategy of management for STEMI should be promoted in non-interventional regional hospitals.

La survenue d'une varicelle clinique en cours de grossesse est rare, pouvant entrainer des risques maternels et fétaux. La varicelle maternelle périnatale peut entrainer une varicelle néonatale potentiellement grave, notamment en cas d'éruptions maternelles survenant entre 5 jours avant et 2 jours après l'accouchement. Nous rapportons huit observations de nouveau-nés de mères ayant eu une varicelle en péri-partum dans le but de synthétiser, l'état actuel des connaissances sur le risque de ce virus et d'essayer d'élaborer un protocole de prise en charge. Il s'agit d'une étude descriptive menée au centre de maternité et de néonatologie de Sousse, sur une période de 10 ans. Huit nouveau-nés ont été inclus dans l'étude. Le diagnostic était fait avant l'accouchement chez 7 mères. Une seule femme avait développé sa varicelle 3 jours après l'accouchement. Cinq nouveau-nés étaient symptomatiques à l'admission. Ils avaient tous des lésions cutanées typiques de la varicelle, trois parmi eux avaient une atteinte respiratoire associée. La prise en charge était basée sur l'isolement des nouveau-nés, les soins locaux, et le traitement par Acyclovir. L'évolution était favorable dans tous les cas. La survenue d'une varicelle au cours de la grossesse reste possible dans les pays ou la vaccination n'est pas encore accessible à tous. Les risques de complications maternelles et fétales qu'elle occasionne justifient une prise en charge spécifique et bien codifiée.