AIM： To test whether antioxidant treatment could prevent the progression of Barrett＇s esophagus to adenocarcinoma. METHODS： In a rat model of gastroduodenoesophageal reflux by esophagojejunal anastomosis with gastr...AIM： To test whether antioxidant treatment could prevent the progression of Barrett＇s esophagus to adenocarcinoma. METHODS： In a rat model of gastroduodenoesophageal reflux by esophagojejunal anastomosis with gastric preservation, groups of 6-10 rats were randomized to receive treatment with superoxide dismutase （SOD） or vehicle and followed up for 4 too. Rat＇s esophagus was assessed by histological analysis, superoxide anion and peroxinitrite generation, SOD levels and DNA oxidative damage. RESULTS： All rats undergoing esophagojejunostomy developed extensive esophageal mucosal ulceration and inflammation by mo 4. The process was associated with a progressive presence of intestinal metaplasia beyond the anastomotic area （9% 1st mo and 50% 4th too） （94% at the anastomotic level） and adenocarcinoma （11% 1^ST mo and 60% 4th too）. These changes were associated with superoxide anion and peroxinitrite mucosal generation, an early and significant increase of DNA oxidative damage and a significant decrease in SOD levels （P〈0.05）. Exogenous administration of SOD decreased mucosal superoxide levels, increased mucosal SOD levels and reduced the risk of developing intestinal metaplasia beyond the anastomotic area （odds ratio = 0.326; 95%CI： 0.108-0.981; P = 0.046）, and esophageal adenocarcinoma （odds ratio = 0.243; 95%CI： 0.073-0.804; P = 0.021）. CONCLUSION： Superoxide dismutase prevents the progression of esophagitis to Barrett＇s esophagus and adenocarcinoma in this rat model of gastrointestinal reflux, supporting a role of antioxidants in the chemoprevention of esophageal adenocarcinoma.展开更多
Functional dyspepsia constitutes by its impact in quality of life and socio-economic impact areal public health problem (40% of the adult population in the Western world). The prevalence of infection with Helicobacter...Functional dyspepsia constitutes by its impact in quality of life and socio-economic impact areal public health problem (40% of the adult population in the Western world). The prevalence of infection with Helicobacter pylori (HP) in patients with functional dyspepsia is about 30% - 70%. The aim of our study is to observe the improvement of functional dyspepsia (FD) after Helicobacter pylori (HP) eradication. Methods: This is a prospective study over a period of 68 months (May 2009 - January 2015). We included all patients aged over 15 years, with functional dyspepsia defined by the Rome III criteria. The diagnosis of HP was made by histology and/or PCR. Patients infected with HP were treated in single-blind: standard triple therapy for 7 days or sequential treatment for 10 days. HP eradication control was made after: 3 months, 6 months and one year of treatment. Results: During the study period, 1190 patients were included of which 250 patients (21%) were in functional dyspepsia according to the Rome III criteria. The average age in patients with functional dyspepsia was 49 years [16 - 80], sex ratio M/F was 0.58 (N = 92/158). 60% of patients were older than 45 years (N = 150). Chronic smoking was found in 20% of patients (N = 50). One hundred and seventy five patients (70%) had HP infection (N = 175). One hundred and sixty five patients received the treatment of Helicobacter pylori (94.28%), 10 patients were lost to follow (5.71%). The eradication of HP was obtained in 98.41% with sequential treatment versus 88.73% with standard triple therapy (p = 0.026). All patients were reviewed at 3 months and 6 months after treatment, 86% were reviewed at 12 months (N = 143). Dyspeptic symptoms was disappeared in 43% of our patients (N = 71) partial disappearance of symptoms in 34.5% of cases (N = 57) persistence of symptoms in 22.42% of cases (N = 37). Conclusion: In our study the prevalence of Helicobacter pylori infection in patients with functional dyspepsia is high: 70%. Sequential therapy is better than the standard triple therapy in the eradication of HP in patients with nonulcer dyspepsia, which improves their symptoms in more than 50% of cases.展开更多
Gastric atrophy and intestinal metaplasia represent the most important premalignant lesions in gastric carcinogenesis. The severity of gastric mucosal inflammation depends on the bacterium Helicobacter pylori (HP), on...Gastric atrophy and intestinal metaplasia represent the most important premalignant lesions in gastric carcinogenesis. The severity of gastric mucosal inflammation depends on the bacterium Helicobacter pylori (HP), on the host and on environmental factors. The aim of our study is to determine the prevalence and factors associated with Gastric atrophy and intestinal metaplasia in patients infected with Helicobacter pylori. Methods: This is a prospective study over a period of 4 years (May 2009 - January 2015) conducted in the service of Hepatology and Gastroenterology in hospital university Hassan II of Fez in collaboration with microbiology and molecular biology laboratory and epidemiology service of Faculty of Medicine and Pharmacy Fes. We included in our study all patients aged over 15 years, having ulcerative dyspepsia, peptic ulcer disease, gastritis or esophagitis. Results: During the study period, 1190 patients were included of which 70% had HP infection (N = 833). The average age was 48.21 years [16 - 99 years], sex ratio M/F was 1, 11. 60% of patients were older than 45 years. Chronic smoking was found in 12% of patients. Gastric atrophy was observed in 84% (N = 699) of patients infected with HP. Gastric atrophy was localized in 70% in the antrum and 30% in the fundus and 24% in both. The activity of gastritis (p = 0.0001) and the density of the HP (p = 0.005) were factors associated with atrophy. Intestinal metaplasia was observed in 13.5% of patients (N = 112). The density of HP (p = 0.037) and severe atrophy (p = 0.001) were factors associated with metaplasia. Other factors studied: age, sex, smoking, CagA<sup>+</sup> genotype were not associated with either gastric atrophy or intestinal metaplasia. Conclusion: In our study, the prevalence of atrophic gastritis and intestinal metaplasia in patients infected with Helicobacter pylori was 84% and 13.5% respectively, which was a high prevalence. The activity of gastritis, and density of HP were factors associated with atrophy. The density of HP and severe atrophy were factors associated with metaplasia.展开更多
AIM:To determine the prevalence of a family history suggestive of Lynch syndrome (LS) among patients with colorectal cancer (CRC) followed in a coloproctology outpatient clinic in Southern Brazil.METHODS:A consecutive...AIM:To determine the prevalence of a family history suggestive of Lynch syndrome (LS) among patients with colorectal cancer (CRC) followed in a coloproctology outpatient clinic in Southern Brazil.METHODS:A consecutive sample of patients with CRC were interviewed regarding personal and family histories of cancer.Clinical data and pathology features of the tumor were obtained from chart review.RESULTS:Of the 212 CRC patients recruited,61 (29%) reported a family history of CRC,45 (21.2%) were diagnosed under age 50 years and 11 (5.2%) had more than one primary CRC.Family histories consistent with Amsterdam and revised Bethesda criteria for LS were identified in 22 (10.4%) and 100 (47.2%) patients,respectively.Twenty percent of the colorectal tumors had features of the high microsatellite instability phenotype,which was associated with younger age at CRC diagnosis and with Bethesda criteria (P < 0.001).Only 5.3% of the patients above age 50 years had been previously submitted for CRC screening and only 4% of patients with suspected LS were referred for genetic risk assessment.CONCLUSION:A significant proportion of patients with CRC were at high risk for LS.Education and training of health care professionals are essential to ensure proper management.展开更多
AIM： To evaluate the effects of indomethacin [dual cyclooxygenase （COX）-I/COX-2 inhibitor] and 3-（3,4-difluorophenyl）-4-（4-（methylsulfonyl） phenyl）- 2-（5H）-furanone （MF-tricyclic） （COX-2 selective inhibi...AIM： To evaluate the effects of indomethacin [dual cyclooxygenase （COX）-I/COX-2 inhibitor] and 3-（3,4-difluorophenyl）-4-（4-（methylsulfonyl） phenyl）- 2-（5H）-furanone （MF-tricyclic） （COX-2 selective inhibi- tor） in a rat experimental model of Barrett＇s esophagus and esophageal adenocarcinoma.METHODS： A total of 112 surviving post-surgery rats were randomly divided into three groups： the control group （n = 48）, which did not receive any treatment; the indomethacin group （n = 32）, which were given 2 mg/kg per day of the COX-I/COX-2 inhibitor; and the MF-tricyclic group （n = 32）, which received 10 mg/kg per day of the selective COX-2 inhibitor. Randomly se- lected rats were killed either 8 wk or 16 wk after sur- gery. The timing of the deaths was in accordance with a previous study performed in our group. Only rats that were killed at the times designated by the protocol were included in the study. We then assessed the histology and prostaglandin E2 （PGE2） expression levels in the rat esophagi. An additional group of eight animals that did not undergo esophagojejunostomy were included in order to obtain normal esophageal tissue as a control. RESULTS： Compared to a control group with no treat- ment （vehicle-treated rats）, indomethacin treatment was associated with decreases in ulcerated esophageal mucosa （16% vs 35% and 14% vs 17%, 2 mo and 4 mo after surgery, respectively; P = 0.021）, length of intestinal metaplasia in continuity with anastomosis （2 4- 1.17 mm vs 2.29 ＋ 0.75 mm and 1.25 4- 0.42 mm vs 3.5 4- 1.54 mm, 2 mo and 4 mo after surgery, respec- tively; P = 0.007）, presence of intestinal metaplasia beyond anastomosis （20% vs 71.4% and 0% vs 60%, 2 mo and 4 mo after surgery, respectively; P = 0.009）, severity of dysplasia （0% vs 71.4% and 20% vs 85.7% high-grade dysplasia, 2 mo and 4 mo after surgery, re- spectively; P = 0.002）, and adenocarcinoma incidence （0% vs 57.1% and 0% vs 60%, 2 mo and 4 mo after surgery, respectively; P 〈 0.0001）. Treatment with the selective COX-2 inhibitor, MF-tricyclic, did not prevent development of intestinal metaplasia or adenocarci- noma. In parallel, we observed a significant decrease in PGE2 levels in indomethacin-treated rats, but not in those treated with MF-tricyclic, at both 2 mo and 4 mo. Compared to control rats that did not undergo surgery （68 ＋ 8 ng/g, P = 0.0022 Kruskal-Wallis test） there was a significant increase in PGE2 levels in the esophageal tissue of the rats that underwent surgery either 2 mo （1332 ＋ 656 ng/g） or 4 mo （1121 ＋ 1015 ng/g） after esophagojejunostomy. However, no differences were found when esophageal PGE2 levels were compared 2 mo vs 4 mo post-esophagojejunostomy. At both the 2- and 4-mo timepoints, we observed a significant decrease in PGE2 levels in indomethacin-treated rat esophagi compared to those in either the control or MF-tricyclic groups （P = 0.049 and P = 0.017, respec- tively）. No differences in PGE2 levels were found when we compared levels in rats treated with MF-tricyclic to not-treated rats. CONCLUSION： In this rat model of gastrointestinal reflux, indomethacin was associated with a decrease in the severity of esophagitis and reduced development of esophageal intestinal metaplasia and adenocarcinoma.展开更多
Following the international guidelines criteria an adequate"diagnostic conclusion"of inflammatory bowel disease(IBD)can be achieved only if clinical,endoscopic and laboratory findings,together with sample te...Following the international guidelines criteria an adequate"diagnostic conclusion"of inflammatory bowel disease(IBD)can be achieved only if clinical,endoscopic and laboratory findings,together with sample technical adequacy and unequivocal histomorphological signs of the disease are available.Thus,a conclusive diagnosis requires a complex combination of clinical, endoscopic and histological data.A considerable number of endoscopic biopsies obtained from IBD patients do not meet the above-mentioned requirements.The aim of the present proposal is to introduce a binary system of evaluation in the"diagnostic conclusion"of the histopathological report that will help to simplify the clinical decisions and consequent patient management.In patients with no history of disease,the pathologist should classify the biopsies in"Diagnostic",when the criteria established by the international guidelines are satisfied and"not diagnostic"when one or more of the above-mentioned criteria are not met. The term"not diagnostic"should replace"highly suggestive"and"probable".This new terminology could avoid ambiguous expressions that encourage the clinician to classify the patient as affected by IBD without fulfilling all of the requirements for an accurate diagnostic approach.展开更多
Neuroendocrine tumors of the ovary tumors are little known and infrequent. They are made up of cells appearing in the endocrine and nervous systems. These tumors are rare, but most of them are very aggressive, especia...Neuroendocrine tumors of the ovary tumors are little known and infrequent. They are made up of cells appearing in the endocrine and nervous systems. These tumors are rare, but most of them are very aggressive, especially when they are diagnosed beyond FIGO Stage I. The distinction among the different subtypes is difficult and requires efficient techniques. Symptoms of neuroendocrine tumors are often nonspecific (redness in the face, diarrhea, asthma, abdominal pain and etc.,) and confused with more common diseases. Misdiagnosis is often asked: menopause or irritable bowel syndrome. Often the correct diagnosis is not made until years after the onset of symptoms. The relative rarity of these diseases and the lack of specificity of the symptoms make them often be diagnosed several years after onset. Fortunately, science has made significant advances in the diagnosis and treatment of neuroendocrine tumors. We report the case of a woman of 54 years, with abdominopelvic mass, in whom abdominal ultrasound revealed a mass avascular tissue Doppler taking the screen. The abdominopelvic CT showed a large cystic mass solido—abdominopelvic whose origin is difficult to determine. The patient underwent an exploratory laparotomy. Anapath the results of the right ovary were in favor of a well-differentiated neuroendocrine lesion.展开更多
The diagnosis and management of cerebral gliomas are challenging. The goal of this study was to evaluate the pattern of cerebral gliomas at the General Hospital Douala, Cameroon. A retrospective study was carried out ...The diagnosis and management of cerebral gliomas are challenging. The goal of this study was to evaluate the pattern of cerebral gliomas at the General Hospital Douala, Cameroon. A retrospective study was carried out over a period of 10 years. Non-glial lesions were not included. Data were analyzed with Epi info version 7.2.2.6 (Microsoft, Seattle, USA). 220 cases of brain tumors, comprising 56 gliomas (25.46% of all brain tumors) were managed during the study period. The mean age of the patients was 42.93 ± 16.90 years. 35 cases (62.5%) were males. Patients over 15 years of age represented 91.07% (n = 51) of the cases. The most frequent presenting complaints were headache and vomiting with 52 cases (92.86%) and 47 cases (83.93%) respectively. Brain computed tomography was done for all patients. The most frequent histological type was astrocytoma with 22 cases (39.29%) followed by glioblastoma with 20 cases (35.71%). The most performed surgical technique was partial removal with 33 cases (58.93%), followed by open biopsy with 14 cases (25.00%). Radiotherapy was administered to 54 patients (96.43%). The outcome ranged from full recovery in 8 cases (14.29%), recovery with persisting symptoms, in 15 cases (26.79%) and death in 26 cases (46.43%). Seven patients (12.50%) were lost to view. In this series, cerebral gliomas affected most often adult males. Most of them presented with signs of raised intracranial pressure. The outcome was poor with 46.43% of patients dying before 2 years after diagnosis.展开更多
Introduction: Violence is a major problem in today’s workplace. It affects workers in all sectors of activity. The aim of the study was to determine the prevalence and factors associated with violence among primary a...Introduction: Violence is a major problem in today’s workplace. It affects workers in all sectors of activity. The aim of the study was to determine the prevalence and factors associated with violence among primary and secondary school staff in Ouagadougou. Materials and Methods: This was a cross-sectional, descriptive and analytical study that took place from April 22, 2020 to February 18, 2021 in primary and secondary schools in Ouagadougou. It focused on the educational staff of these establishments. Results: A total of 362 agents took part in the study. The average age of participants was 36.5 ± 6.89 years. The sex ratio was 1.62 men to one woman. The majority of workers were teachers, with 300 participants (82.87%). The average job tenure was 7 years ± 6.91 years. With regard to violence in the workplace, 87 workers were victims, representing a prevalence of 24.03%. Of these workers, 59 (67.81%) were men and 36 (41.38%) had less than six years’ experience. Acts of violence were predominantly pushing observed in 15 workers (50%), while shouting and aggressive tone dominated psychological violence and concerned 54 cases (36.24%). On univariate analysis, the factors associated with violence were age (p = 0.046) and type of establishment (p = 0.012). On multivariate analysis, only the nature of the establishment was the only factor associated with the occurrence of violence among teaching staff (OR = 2.3690, p = 0.0213). Conclusion: The prevalence of violence is high in these educational establishments. Age and type of establishment are factors associated with its occurrence. It is therefore necessary to develop an effective strategy for preventing this risk in the workplace.展开更多
Female infertility is considered as a real obstacle to the development of a couple who cannot conceive in a natural way. The aim of this study is to evaluate female infertility using two complementary methods of explo...Female infertility is considered as a real obstacle to the development of a couple who cannot conceive in a natural way. The aim of this study is to evaluate female infertility using two complementary methods of exploration: hystero-laparoscopy and endometrial biopsy, to compare histopathological data with those of hystero-laparoscopy findings in the same patients, and finally assess the interest to couple both methods to detect a greater number of pathologies. Our prospective study included 64 patients aged 20 - 43 years with primary or secondary infertility for a period of 3 years ranging from 2012 to 2015 at obstetrics and gynecology department in which all patients were admitted to a hysteroscopy followed by laparoscopy. Endometrial biopsy curettage was performed and sent to the Pathological Anatomy Department for a histopathological study. On 64 infertile women explored, no pathologies were findings in 20 patients (31.3%) to the biopsy and 27 patients (42.2%) by hysteroscopy-laparoscopy. Histopathological study was in favor of dysfunctional endometrium (50%) followed by hyperplasia (10.9%). The lesions findings in the hystero-laparoscopy were in the first place uterine (18.8%) followed by equally between tubal and endometrial pathologies (10.9%). Associated diseases affecting the same organs or more were recorded with a percentage of 7.8%. The two methods have been shown effective and the most of common pathologies findings were uterine and endometrial. We concluded that the endometrial biopsy was more decisive in the exploration of endometrium pathologies while hystero-laparoscopy is more sensitive for the exploration of uterine, tubal and ovarian pathologies. Each method taken individually was revealed incomplete. It is more interesting to systematically couple the histology with endoscopic examination in order to detect a greater number of pathologies.展开更多
<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Thanks to the opening of the digestive endoscopy unit in the Reference General Hospita...<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Thanks to the opening of the digestive endoscopy unit in the Reference General Hospital of Panzi in Bukavu in the Democratic Republic of the Congo, which inspired our work on the profile of endoscopic lesions observed in a series of 1000 patients correlated with clinical and demographic criteria with the contribution of pathology examinations of the 292 biopsies performed. The aim of our work is to evaluate the prevalence of significant endoscopic lesions as well as that of <i>H. pylori</i> infection. <b>Material and Methods:</b> This is a retrospective, descriptive and analytical study, ranging from the 16<sup>th</sup> of December 2014 to the 16<sup>th</sup> of June 2016. It covered 1000 patients who benefited from a high digestive endoscopy and 292 of them had a biopsy with pathological examination. The data obtained were recorded and analyzed using the Epi-info software and chi-square test. <b>Results:</b> fifty-five percent of these patients were women.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">66% of the patients were under 50</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">years of age. Their major symptom was epigastric pain</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(89.2%),</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">the most observed endoscopic lesion was erythematous gastritis</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(82%) therefore we have noticed 21</span></span></span><span><span><span style="font-family:;" "="">.</span></span></span><span><span><span style="font-family:;" "="">5% of significant lesions. Gastric cancer was present in 3.9% of cases and gastric ulcer in 4.2% of cases. The gastric tumor was correlated with age and sex (P-value at 0.000 and 0.013). The gastroduodenal ulcer was linked to age, <i>NSAID</i> and tobacco use (P-value at 0.0007, 0.001, 0.007). Esophageal mycosis was correlated with HIV status (P-value at 0.000). <i>Helicobacter pylori</i> gastritis was the most frequent (61.30%) and</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><i><span style="font-family:;" "="">Helicobacter pylori</span></i></span></span><span><span><span style="font-family:;" "=""> were present in 63% of gastric biopsies. <b>Conclusion: </b>Upper digestive endoscopy is a major tool for the diagnosis of upper gastrointestinal disorders and should always be followed by a biopsy if there is a suspicious lesion for pathologic confirmation and adequate management.</span></span></span>展开更多
Purpose: To investigate the prognostic impacts of a combined clopidogrel-metabolizing genotypes CYP 2C19 (+ or -)*2/(+ or -)*17 on patients with acute coronary syndrome (ACS). Population and methods: Prospective, long...Purpose: To investigate the prognostic impacts of a combined clopidogrel-metabolizing genotypes CYP 2C19 (+ or -)*2/(+ or -)*17 on patients with acute coronary syndrome (ACS). Population and methods: Prospective, longitudinal study of 95 patients admitted for ACS to a single coronary care unit. Patients less than 75 years of age, who survived hospitalization and to whom clopidogrel was prescribed, were included. CYP2C19 genotyping was performed at dis- charge. For analysis, the patients were grouped as follows: Group A ([+]*2/[+]*17) n = 8;Group B ([+]*2/[-]*17) n = 18;Group C ([-]*2/[+]*17) n = 27;and Group D ([-]*2/[-]*17) n = 42. Platelet function was assessed by an ADP platelet aggregation test using a commercially available kit. The primary end-point was a composite of mortality or readmission for ACS. The median time of follow-up was 136.0 (79.0 - 188.0) days. Results: The mean age of the study patients was 59.9 ± 10.7 years, and 83.2% were male. The allele frequencies of CYP2C19*2 and CYP2C19 *17 were 14.2% and 20%, respectively. Both allele frequencies were in Hardy Weinberg equilibrium. The patient groups were homogenous for demographic data, cardiovascular risk factors, GRACE and CRUSADE bleeding scores, left ventricular ejection fraction, and coronary anatomy. ADP platelet aggre-gation was similar for all groups (respective rates for groups A, B, C, D were 17.5 U (10.3 – 18.7) vs 20.0 U (17.3 – 26.8) vs 16 U (12 – 19) vs 12 U (8 – 22), p = 0.4). Event-free survival was significantly lower for group B (respective rates for Groups A, B, C, D were 87.5% vs 68.8% vs 96.3% vs 92.5%;p = 0.02). By multivariate Cox regression analysis, the CYP2C19 (+)*2/(-)*17 diplotype was an independent predictor of outcome, conferring a 5.2-fold higher adjusted risk for the composite endpoint than the others diplotypes. Conclusion: In our study, patients with the intermediate plus non-ultrarapid clopidogrel-metabolizing genotype ([+]*2/[-]*17) had a significantly poor medium-term prognosis for ischemic events, compared with the other diplotypes.展开更多
Human cysticercosis is a neglected tropical parasitic disease due to the tapeworm Taenia solium, common in endemic developing countries. Cysticerci are most commonly found within the central nervous system, but they m...Human cysticercosis is a neglected tropical parasitic disease due to the tapeworm Taenia solium, common in endemic developing countries. Cysticerci are most commonly found within the central nervous system, but they may also localize in a variety of tissues, including the tongue. Here, we described a case of a 21-year-old woman with a painless, firm, smooth, mucosa-colored nodule located in the lateral region of the tongue was seen by a dentist. An excisional biopsy was performed, and the surgical specimen was examined histomorphologically. The analysis revealed the presence of a cystic lesion containing a serrated larva (Cysticercus cellulosae) as well as a cystic capsule with predominantly mononuclear inflammation. The morphological findings were consistent with the diagnosis of cysticercosis of the tongue. The patient was followed for 22 months and showed no signs of recurrence.展开更多
Background:“Gateway Drugs Theory”indicates the assumption that the use of an illicit drug or psychoactive substance may be associated with a greater likelihood of switching to using more harmful substances.Materials...Background:“Gateway Drugs Theory”indicates the assumption that the use of an illicit drug or psychoactive substance may be associated with a greater likelihood of switching to using more harmful substances.Materials and Methods:With reference to this theory,the objective of this study is to understand how many of the subjects that referred to the Service for Pathological Dependencies(SerDP)of Parma,from 2016 to 2019,and who kicked off their addiction to cannabis,have then switched to the use of different drugs,by analysing all the information obtained from the patients and their health life archive.Results:The total number of patients considered was 160(142 males and 18 females).35 out of 160 subjects(21.9%)manifested the switch,i.e.a substance"escalation"that induced the subject to being using cannabis as another drug.60%of the patients(21/35),after an average of 2 years of cannabis use,started abusing cocaine too.Among them,moreover,few particular cases arose,namely 4,in which simultaneous positivity also resulted for other substances.It turns out that 17 patients(48.6%)out of 35 experienced the switch towards cocaine,while 4 patients(11.4%)manifested a switch to more than one substance.Considering the passage to opiates,9 patients were identified(25.7%).5 patients all switched to amphetamine(14.3%).Conclusions:The theory of cannabis as a gateway drug should be associated with the theory of vulnerability according to which some people,due to genetic,individual and environmental characteristics,are more exposed at the risk of developing addiction if placed in contact with drugs.展开更多
Direct determination of the oxidative potential in exhaled air(OPEA)as a biological indicator of the redox balance status in airways requires an extremely sensitive sensing approach to counterbalance the high dilution...Direct determination of the oxidative potential in exhaled air(OPEA)as a biological indicator of the redox balance status in airways requires an extremely sensitive sensing approach to counterbalance the high dilution of the exhaled air matrix.In opposite to standard colorimetric assays based on Beer-Lambert Law,the use of simple multiscattering-enhanced absorbance(MEA)strategy results in an improved photonic sensing system.Based on this strategy and using the ferrous-xylenol orange assay,analytical performances allowing the detection of 3 pmol of H_(2)O_(2) could be obtained.The comparative analysis of photometric configurations–standard vs MEA–highlights the large absorbance gain obtained for tiny H_(2)O_(2) amounts–from 0 to 30 pmol–whereas similar sensing trends are observed at higher concentration range.The automated introduction of exhaled air sample into the reaction compartment via needle-impinger coupled with the MEA-based photonic cell enables ultrasensitive determination of OPEA in short time(<5 min).A pilot study conducted on healthy subjects(n=22)and chronic obstructive pulmonary disease(COPD)patients(n=23)volunteers shows a significant increase of the OPEA for COPD versus controls and strong negative correlation between OPEA and spirometry parameters(Tiffeneau index:FEV1/FVC)for ex-/non-smokers.Application perspectives to assess inflammatory episodes in obstructive lung diseases are thus made possible using this sensing approach.展开更多
基金Supported by grants from CICYT (SAF2000-0123) and Instituto de Salud Carlos Ⅲ (C03/02). Elena Piazuelo is supported by Instituto de Salud Carlos Ⅲ and Instituto Aragones de Ciencias de la Salud
文摘AIM： To test whether antioxidant treatment could prevent the progression of Barrett＇s esophagus to adenocarcinoma. METHODS： In a rat model of gastroduodenoesophageal reflux by esophagojejunal anastomosis with gastric preservation, groups of 6-10 rats were randomized to receive treatment with superoxide dismutase （SOD） or vehicle and followed up for 4 too. Rat＇s esophagus was assessed by histological analysis, superoxide anion and peroxinitrite generation, SOD levels and DNA oxidative damage. RESULTS： All rats undergoing esophagojejunostomy developed extensive esophageal mucosal ulceration and inflammation by mo 4. The process was associated with a progressive presence of intestinal metaplasia beyond the anastomotic area （9% 1st mo and 50% 4th too） （94% at the anastomotic level） and adenocarcinoma （11% 1^ST mo and 60% 4th too）. These changes were associated with superoxide anion and peroxinitrite mucosal generation, an early and significant increase of DNA oxidative damage and a significant decrease in SOD levels （P〈0.05）. Exogenous administration of SOD decreased mucosal superoxide levels, increased mucosal SOD levels and reduced the risk of developing intestinal metaplasia beyond the anastomotic area （odds ratio = 0.326; 95%CI： 0.108-0.981; P = 0.046）, and esophageal adenocarcinoma （odds ratio = 0.243; 95%CI： 0.073-0.804; P = 0.021）. CONCLUSION： Superoxide dismutase prevents the progression of esophagitis to Barrett＇s esophagus and adenocarcinoma in this rat model of gastrointestinal reflux, supporting a role of antioxidants in the chemoprevention of esophageal adenocarcinoma.
文摘Functional dyspepsia constitutes by its impact in quality of life and socio-economic impact areal public health problem (40% of the adult population in the Western world). The prevalence of infection with Helicobacter pylori (HP) in patients with functional dyspepsia is about 30% - 70%. The aim of our study is to observe the improvement of functional dyspepsia (FD) after Helicobacter pylori (HP) eradication. Methods: This is a prospective study over a period of 68 months (May 2009 - January 2015). We included all patients aged over 15 years, with functional dyspepsia defined by the Rome III criteria. The diagnosis of HP was made by histology and/or PCR. Patients infected with HP were treated in single-blind: standard triple therapy for 7 days or sequential treatment for 10 days. HP eradication control was made after: 3 months, 6 months and one year of treatment. Results: During the study period, 1190 patients were included of which 250 patients (21%) were in functional dyspepsia according to the Rome III criteria. The average age in patients with functional dyspepsia was 49 years [16 - 80], sex ratio M/F was 0.58 (N = 92/158). 60% of patients were older than 45 years (N = 150). Chronic smoking was found in 20% of patients (N = 50). One hundred and seventy five patients (70%) had HP infection (N = 175). One hundred and sixty five patients received the treatment of Helicobacter pylori (94.28%), 10 patients were lost to follow (5.71%). The eradication of HP was obtained in 98.41% with sequential treatment versus 88.73% with standard triple therapy (p = 0.026). All patients were reviewed at 3 months and 6 months after treatment, 86% were reviewed at 12 months (N = 143). Dyspeptic symptoms was disappeared in 43% of our patients (N = 71) partial disappearance of symptoms in 34.5% of cases (N = 57) persistence of symptoms in 22.42% of cases (N = 37). Conclusion: In our study the prevalence of Helicobacter pylori infection in patients with functional dyspepsia is high: 70%. Sequential therapy is better than the standard triple therapy in the eradication of HP in patients with nonulcer dyspepsia, which improves their symptoms in more than 50% of cases.
文摘Gastric atrophy and intestinal metaplasia represent the most important premalignant lesions in gastric carcinogenesis. The severity of gastric mucosal inflammation depends on the bacterium Helicobacter pylori (HP), on the host and on environmental factors. The aim of our study is to determine the prevalence and factors associated with Gastric atrophy and intestinal metaplasia in patients infected with Helicobacter pylori. Methods: This is a prospective study over a period of 4 years (May 2009 - January 2015) conducted in the service of Hepatology and Gastroenterology in hospital university Hassan II of Fez in collaboration with microbiology and molecular biology laboratory and epidemiology service of Faculty of Medicine and Pharmacy Fes. We included in our study all patients aged over 15 years, having ulcerative dyspepsia, peptic ulcer disease, gastritis or esophagitis. Results: During the study period, 1190 patients were included of which 70% had HP infection (N = 833). The average age was 48.21 years [16 - 99 years], sex ratio M/F was 1, 11. 60% of patients were older than 45 years. Chronic smoking was found in 12% of patients. Gastric atrophy was observed in 84% (N = 699) of patients infected with HP. Gastric atrophy was localized in 70% in the antrum and 30% in the fundus and 24% in both. The activity of gastritis (p = 0.0001) and the density of the HP (p = 0.005) were factors associated with atrophy. Intestinal metaplasia was observed in 13.5% of patients (N = 112). The density of HP (p = 0.037) and severe atrophy (p = 0.001) were factors associated with metaplasia. Other factors studied: age, sex, smoking, CagA<sup>+</sup> genotype were not associated with either gastric atrophy or intestinal metaplasia. Conclusion: In our study, the prevalence of atrophic gastritis and intestinal metaplasia in patients infected with Helicobacter pylori was 84% and 13.5% respectively, which was a high prevalence. The activity of gastritis, and density of HP were factors associated with atrophy. The density of HP and severe atrophy were factors associated with metaplasia.
文摘AIM:To determine the prevalence of a family history suggestive of Lynch syndrome (LS) among patients with colorectal cancer (CRC) followed in a coloproctology outpatient clinic in Southern Brazil.METHODS:A consecutive sample of patients with CRC were interviewed regarding personal and family histories of cancer.Clinical data and pathology features of the tumor were obtained from chart review.RESULTS:Of the 212 CRC patients recruited,61 (29%) reported a family history of CRC,45 (21.2%) were diagnosed under age 50 years and 11 (5.2%) had more than one primary CRC.Family histories consistent with Amsterdam and revised Bethesda criteria for LS were identified in 22 (10.4%) and 100 (47.2%) patients,respectively.Twenty percent of the colorectal tumors had features of the high microsatellite instability phenotype,which was associated with younger age at CRC diagnosis and with Bethesda criteria (P < 0.001).Only 5.3% of the patients above age 50 years had been previously submitted for CRC screening and only 4% of patients with suspected LS were referred for genetic risk assessment.CONCLUSION:A significant proportion of patients with CRC were at high risk for LS.Education and training of health care professionals are essential to ensure proper management.
基金Supported by Instituto de Salud Carlos III (CIBERehd)MFtricyclic was supplied free of charge by Merck Frosst Canada Inc
文摘AIM： To evaluate the effects of indomethacin [dual cyclooxygenase （COX）-I/COX-2 inhibitor] and 3-（3,4-difluorophenyl）-4-（4-（methylsulfonyl） phenyl）- 2-（5H）-furanone （MF-tricyclic） （COX-2 selective inhibi- tor） in a rat experimental model of Barrett＇s esophagus and esophageal adenocarcinoma.METHODS： A total of 112 surviving post-surgery rats were randomly divided into three groups： the control group （n = 48）, which did not receive any treatment; the indomethacin group （n = 32）, which were given 2 mg/kg per day of the COX-I/COX-2 inhibitor; and the MF-tricyclic group （n = 32）, which received 10 mg/kg per day of the selective COX-2 inhibitor. Randomly se- lected rats were killed either 8 wk or 16 wk after sur- gery. The timing of the deaths was in accordance with a previous study performed in our group. Only rats that were killed at the times designated by the protocol were included in the study. We then assessed the histology and prostaglandin E2 （PGE2） expression levels in the rat esophagi. An additional group of eight animals that did not undergo esophagojejunostomy were included in order to obtain normal esophageal tissue as a control. RESULTS： Compared to a control group with no treat- ment （vehicle-treated rats）, indomethacin treatment was associated with decreases in ulcerated esophageal mucosa （16% vs 35% and 14% vs 17%, 2 mo and 4 mo after surgery, respectively; P = 0.021）, length of intestinal metaplasia in continuity with anastomosis （2 4- 1.17 mm vs 2.29 ＋ 0.75 mm and 1.25 4- 0.42 mm vs 3.5 4- 1.54 mm, 2 mo and 4 mo after surgery, respec- tively; P = 0.007）, presence of intestinal metaplasia beyond anastomosis （20% vs 71.4% and 0% vs 60%, 2 mo and 4 mo after surgery, respectively; P = 0.009）, severity of dysplasia （0% vs 71.4% and 20% vs 85.7% high-grade dysplasia, 2 mo and 4 mo after surgery, re- spectively; P = 0.002）, and adenocarcinoma incidence （0% vs 57.1% and 0% vs 60%, 2 mo and 4 mo after surgery, respectively; P 〈 0.0001）. Treatment with the selective COX-2 inhibitor, MF-tricyclic, did not prevent development of intestinal metaplasia or adenocarci- noma. In parallel, we observed a significant decrease in PGE2 levels in indomethacin-treated rats, but not in those treated with MF-tricyclic, at both 2 mo and 4 mo. Compared to control rats that did not undergo surgery （68 ＋ 8 ng/g, P = 0.0022 Kruskal-Wallis test） there was a significant increase in PGE2 levels in the esophageal tissue of the rats that underwent surgery either 2 mo （1332 ＋ 656 ng/g） or 4 mo （1121 ＋ 1015 ng/g） after esophagojejunostomy. However, no differences were found when esophageal PGE2 levels were compared 2 mo vs 4 mo post-esophagojejunostomy. At both the 2- and 4-mo timepoints, we observed a significant decrease in PGE2 levels in indomethacin-treated rat esophagi compared to those in either the control or MF-tricyclic groups （P = 0.049 and P = 0.017, respec- tively）. No differences in PGE2 levels were found when we compared levels in rats treated with MF-tricyclic to not-treated rats. CONCLUSION： In this rat model of gastrointestinal reflux, indomethacin was associated with a decrease in the severity of esophagitis and reduced development of esophageal intestinal metaplasia and adenocarcinoma.
基金Supported by Fondazione Malattie Infiammatorie Intestinali (IBD)Onlus-TorinoCompagnia San Paolo,Torino
文摘Following the international guidelines criteria an adequate"diagnostic conclusion"of inflammatory bowel disease(IBD)can be achieved only if clinical,endoscopic and laboratory findings,together with sample technical adequacy and unequivocal histomorphological signs of the disease are available.Thus,a conclusive diagnosis requires a complex combination of clinical, endoscopic and histological data.A considerable number of endoscopic biopsies obtained from IBD patients do not meet the above-mentioned requirements.The aim of the present proposal is to introduce a binary system of evaluation in the"diagnostic conclusion"of the histopathological report that will help to simplify the clinical decisions and consequent patient management.In patients with no history of disease,the pathologist should classify the biopsies in"Diagnostic",when the criteria established by the international guidelines are satisfied and"not diagnostic"when one or more of the above-mentioned criteria are not met. The term"not diagnostic"should replace"highly suggestive"and"probable".This new terminology could avoid ambiguous expressions that encourage the clinician to classify the patient as affected by IBD without fulfilling all of the requirements for an accurate diagnostic approach.
文摘Neuroendocrine tumors of the ovary tumors are little known and infrequent. They are made up of cells appearing in the endocrine and nervous systems. These tumors are rare, but most of them are very aggressive, especially when they are diagnosed beyond FIGO Stage I. The distinction among the different subtypes is difficult and requires efficient techniques. Symptoms of neuroendocrine tumors are often nonspecific (redness in the face, diarrhea, asthma, abdominal pain and etc.,) and confused with more common diseases. Misdiagnosis is often asked: menopause or irritable bowel syndrome. Often the correct diagnosis is not made until years after the onset of symptoms. The relative rarity of these diseases and the lack of specificity of the symptoms make them often be diagnosed several years after onset. Fortunately, science has made significant advances in the diagnosis and treatment of neuroendocrine tumors. We report the case of a woman of 54 years, with abdominopelvic mass, in whom abdominal ultrasound revealed a mass avascular tissue Doppler taking the screen. The abdominopelvic CT showed a large cystic mass solido—abdominopelvic whose origin is difficult to determine. The patient underwent an exploratory laparotomy. Anapath the results of the right ovary were in favor of a well-differentiated neuroendocrine lesion.
文摘The diagnosis and management of cerebral gliomas are challenging. The goal of this study was to evaluate the pattern of cerebral gliomas at the General Hospital Douala, Cameroon. A retrospective study was carried out over a period of 10 years. Non-glial lesions were not included. Data were analyzed with Epi info version 7.2.2.6 (Microsoft, Seattle, USA). 220 cases of brain tumors, comprising 56 gliomas (25.46% of all brain tumors) were managed during the study period. The mean age of the patients was 42.93 ± 16.90 years. 35 cases (62.5%) were males. Patients over 15 years of age represented 91.07% (n = 51) of the cases. The most frequent presenting complaints were headache and vomiting with 52 cases (92.86%) and 47 cases (83.93%) respectively. Brain computed tomography was done for all patients. The most frequent histological type was astrocytoma with 22 cases (39.29%) followed by glioblastoma with 20 cases (35.71%). The most performed surgical technique was partial removal with 33 cases (58.93%), followed by open biopsy with 14 cases (25.00%). Radiotherapy was administered to 54 patients (96.43%). The outcome ranged from full recovery in 8 cases (14.29%), recovery with persisting symptoms, in 15 cases (26.79%) and death in 26 cases (46.43%). Seven patients (12.50%) were lost to view. In this series, cerebral gliomas affected most often adult males. Most of them presented with signs of raised intracranial pressure. The outcome was poor with 46.43% of patients dying before 2 years after diagnosis.
文摘Introduction: Violence is a major problem in today’s workplace. It affects workers in all sectors of activity. The aim of the study was to determine the prevalence and factors associated with violence among primary and secondary school staff in Ouagadougou. Materials and Methods: This was a cross-sectional, descriptive and analytical study that took place from April 22, 2020 to February 18, 2021 in primary and secondary schools in Ouagadougou. It focused on the educational staff of these establishments. Results: A total of 362 agents took part in the study. The average age of participants was 36.5 ± 6.89 years. The sex ratio was 1.62 men to one woman. The majority of workers were teachers, with 300 participants (82.87%). The average job tenure was 7 years ± 6.91 years. With regard to violence in the workplace, 87 workers were victims, representing a prevalence of 24.03%. Of these workers, 59 (67.81%) were men and 36 (41.38%) had less than six years’ experience. Acts of violence were predominantly pushing observed in 15 workers (50%), while shouting and aggressive tone dominated psychological violence and concerned 54 cases (36.24%). On univariate analysis, the factors associated with violence were age (p = 0.046) and type of establishment (p = 0.012). On multivariate analysis, only the nature of the establishment was the only factor associated with the occurrence of violence among teaching staff (OR = 2.3690, p = 0.0213). Conclusion: The prevalence of violence is high in these educational establishments. Age and type of establishment are factors associated with its occurrence. It is therefore necessary to develop an effective strategy for preventing this risk in the workplace.
文摘Female infertility is considered as a real obstacle to the development of a couple who cannot conceive in a natural way. The aim of this study is to evaluate female infertility using two complementary methods of exploration: hystero-laparoscopy and endometrial biopsy, to compare histopathological data with those of hystero-laparoscopy findings in the same patients, and finally assess the interest to couple both methods to detect a greater number of pathologies. Our prospective study included 64 patients aged 20 - 43 years with primary or secondary infertility for a period of 3 years ranging from 2012 to 2015 at obstetrics and gynecology department in which all patients were admitted to a hysteroscopy followed by laparoscopy. Endometrial biopsy curettage was performed and sent to the Pathological Anatomy Department for a histopathological study. On 64 infertile women explored, no pathologies were findings in 20 patients (31.3%) to the biopsy and 27 patients (42.2%) by hysteroscopy-laparoscopy. Histopathological study was in favor of dysfunctional endometrium (50%) followed by hyperplasia (10.9%). The lesions findings in the hystero-laparoscopy were in the first place uterine (18.8%) followed by equally between tubal and endometrial pathologies (10.9%). Associated diseases affecting the same organs or more were recorded with a percentage of 7.8%. The two methods have been shown effective and the most of common pathologies findings were uterine and endometrial. We concluded that the endometrial biopsy was more decisive in the exploration of endometrium pathologies while hystero-laparoscopy is more sensitive for the exploration of uterine, tubal and ovarian pathologies. Each method taken individually was revealed incomplete. It is more interesting to systematically couple the histology with endoscopic examination in order to detect a greater number of pathologies.
文摘<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Thanks to the opening of the digestive endoscopy unit in the Reference General Hospital of Panzi in Bukavu in the Democratic Republic of the Congo, which inspired our work on the profile of endoscopic lesions observed in a series of 1000 patients correlated with clinical and demographic criteria with the contribution of pathology examinations of the 292 biopsies performed. The aim of our work is to evaluate the prevalence of significant endoscopic lesions as well as that of <i>H. pylori</i> infection. <b>Material and Methods:</b> This is a retrospective, descriptive and analytical study, ranging from the 16<sup>th</sup> of December 2014 to the 16<sup>th</sup> of June 2016. It covered 1000 patients who benefited from a high digestive endoscopy and 292 of them had a biopsy with pathological examination. The data obtained were recorded and analyzed using the Epi-info software and chi-square test. <b>Results:</b> fifty-five percent of these patients were women.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">66% of the patients were under 50</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">years of age. Their major symptom was epigastric pain</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(89.2%),</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">the most observed endoscopic lesion was erythematous gastritis</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(82%) therefore we have noticed 21</span></span></span><span><span><span style="font-family:;" "="">.</span></span></span><span><span><span style="font-family:;" "="">5% of significant lesions. Gastric cancer was present in 3.9% of cases and gastric ulcer in 4.2% of cases. The gastric tumor was correlated with age and sex (P-value at 0.000 and 0.013). The gastroduodenal ulcer was linked to age, <i>NSAID</i> and tobacco use (P-value at 0.0007, 0.001, 0.007). Esophageal mycosis was correlated with HIV status (P-value at 0.000). <i>Helicobacter pylori</i> gastritis was the most frequent (61.30%) and</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><i><span style="font-family:;" "="">Helicobacter pylori</span></i></span></span><span><span><span style="font-family:;" "=""> were present in 63% of gastric biopsies. <b>Conclusion: </b>Upper digestive endoscopy is a major tool for the diagnosis of upper gastrointestinal disorders and should always be followed by a biopsy if there is a suspicious lesion for pathologic confirmation and adequate management.</span></span></span>
文摘Purpose: To investigate the prognostic impacts of a combined clopidogrel-metabolizing genotypes CYP 2C19 (+ or -)*2/(+ or -)*17 on patients with acute coronary syndrome (ACS). Population and methods: Prospective, longitudinal study of 95 patients admitted for ACS to a single coronary care unit. Patients less than 75 years of age, who survived hospitalization and to whom clopidogrel was prescribed, were included. CYP2C19 genotyping was performed at dis- charge. For analysis, the patients were grouped as follows: Group A ([+]*2/[+]*17) n = 8;Group B ([+]*2/[-]*17) n = 18;Group C ([-]*2/[+]*17) n = 27;and Group D ([-]*2/[-]*17) n = 42. Platelet function was assessed by an ADP platelet aggregation test using a commercially available kit. The primary end-point was a composite of mortality or readmission for ACS. The median time of follow-up was 136.0 (79.0 - 188.0) days. Results: The mean age of the study patients was 59.9 ± 10.7 years, and 83.2% were male. The allele frequencies of CYP2C19*2 and CYP2C19 *17 were 14.2% and 20%, respectively. Both allele frequencies were in Hardy Weinberg equilibrium. The patient groups were homogenous for demographic data, cardiovascular risk factors, GRACE and CRUSADE bleeding scores, left ventricular ejection fraction, and coronary anatomy. ADP platelet aggre-gation was similar for all groups (respective rates for groups A, B, C, D were 17.5 U (10.3 – 18.7) vs 20.0 U (17.3 – 26.8) vs 16 U (12 – 19) vs 12 U (8 – 22), p = 0.4). Event-free survival was significantly lower for group B (respective rates for Groups A, B, C, D were 87.5% vs 68.8% vs 96.3% vs 92.5%;p = 0.02). By multivariate Cox regression analysis, the CYP2C19 (+)*2/(-)*17 diplotype was an independent predictor of outcome, conferring a 5.2-fold higher adjusted risk for the composite endpoint than the others diplotypes. Conclusion: In our study, patients with the intermediate plus non-ultrarapid clopidogrel-metabolizing genotype ([+]*2/[-]*17) had a significantly poor medium-term prognosis for ischemic events, compared with the other diplotypes.
文摘Human cysticercosis is a neglected tropical parasitic disease due to the tapeworm Taenia solium, common in endemic developing countries. Cysticerci are most commonly found within the central nervous system, but they may also localize in a variety of tissues, including the tongue. Here, we described a case of a 21-year-old woman with a painless, firm, smooth, mucosa-colored nodule located in the lateral region of the tongue was seen by a dentist. An excisional biopsy was performed, and the surgical specimen was examined histomorphologically. The analysis revealed the presence of a cystic lesion containing a serrated larva (Cysticercus cellulosae) as well as a cystic capsule with predominantly mononuclear inflammation. The morphological findings were consistent with the diagnosis of cysticercosis of the tongue. The patient was followed for 22 months and showed no signs of recurrence.
文摘Background:“Gateway Drugs Theory”indicates the assumption that the use of an illicit drug or psychoactive substance may be associated with a greater likelihood of switching to using more harmful substances.Materials and Methods:With reference to this theory,the objective of this study is to understand how many of the subjects that referred to the Service for Pathological Dependencies(SerDP)of Parma,from 2016 to 2019,and who kicked off their addiction to cannabis,have then switched to the use of different drugs,by analysing all the information obtained from the patients and their health life archive.Results:The total number of patients considered was 160(142 males and 18 females).35 out of 160 subjects(21.9%)manifested the switch,i.e.a substance"escalation"that induced the subject to being using cannabis as another drug.60%of the patients(21/35),after an average of 2 years of cannabis use,started abusing cocaine too.Among them,moreover,few particular cases arose,namely 4,in which simultaneous positivity also resulted for other substances.It turns out that 17 patients(48.6%)out of 35 experienced the switch towards cocaine,while 4 patients(11.4%)manifested a switch to more than one substance.Considering the passage to opiates,9 patients were identified(25.7%).5 patients all switched to amphetamine(14.3%).Conclusions:The theory of cannabis as a gateway drug should be associated with the theory of vulnerability according to which some people,due to genetic,individual and environmental characteristics,are more exposed at the risk of developing addiction if placed in contact with drugs.
基金This study was supported in the frame of the project OxAirDirect(Grant EST2015-1-151)funded by the French Agency for Food,Environmental and Occupational Health&Safety(ANSES)the project ROBoCoP(Grant IZCOZ0-177,067)funded by the Swiss National Science Foundation(SNSF)the framework of CliniMARK COST Action(CA16113).
文摘Direct determination of the oxidative potential in exhaled air(OPEA)as a biological indicator of the redox balance status in airways requires an extremely sensitive sensing approach to counterbalance the high dilution of the exhaled air matrix.In opposite to standard colorimetric assays based on Beer-Lambert Law,the use of simple multiscattering-enhanced absorbance(MEA)strategy results in an improved photonic sensing system.Based on this strategy and using the ferrous-xylenol orange assay,analytical performances allowing the detection of 3 pmol of H_(2)O_(2) could be obtained.The comparative analysis of photometric configurations–standard vs MEA–highlights the large absorbance gain obtained for tiny H_(2)O_(2) amounts–from 0 to 30 pmol–whereas similar sensing trends are observed at higher concentration range.The automated introduction of exhaled air sample into the reaction compartment via needle-impinger coupled with the MEA-based photonic cell enables ultrasensitive determination of OPEA in short time(<5 min).A pilot study conducted on healthy subjects(n=22)and chronic obstructive pulmonary disease(COPD)patients(n=23)volunteers shows a significant increase of the OPEA for COPD versus controls and strong negative correlation between OPEA and spirometry parameters(Tiffeneau index:FEV1/FVC)for ex-/non-smokers.Application perspectives to assess inflammatory episodes in obstructive lung diseases are thus made possible using this sensing approach.
