Rationale: In addition to the overwhelming lung inflammation that prevails in coronavirus disease 2019 (COVID-19), hypercoagulation and thrombosis contribute to the lethality of subjects infected with severe acute respiratory syndrome coronavirus 2. Platelets are chiefly implicated in thrombosis. Moreover, they can interact with viruses and are an important source of inflammatory mediators. While a lower platelet count is associated with severity and mortality, little is known about platelet function during COVID-19. Objective: To evaluate the contribution of platelets to inflammation and thrombosis in patients with COVID-19. Methods and Results: Blood was collected from 115 consecutive patients with COVID-19 presenting nonsevere (n=71) and severe (n=44) respiratory symptoms. We document the presence of severe acute respiratory syndrome coronavirus 2 RNA associated with platelets of patients with COVID-19. Exhaustive assessment of cytokines in plasma and in platelets revealed the modulation of platelet-associated cytokine levels in both patients with nonsevere and severe COVID-19, pointing to a direct contribution of platelets to the plasmatic cytokine load. Moreover, we demonstrate that platelets release their alpha- and dense-granule contents in both nonsevere and severe forms of COVID-19. In comparison to concentrations measured in healthy volunteers, phosphatidylserine-exposing platelet extracellular vesicles were increased in nonsevere, but not in severe cases of COVID-19. Levels of D-dimers, a marker of thrombosis, failed to correlate with any measured indicators of platelet activation. Functionally, platelets were hyperactivated in COVID-19 subjects presenting nonsevere and severe symptoms, with aggregation occurring at suboptimal thrombin concentrations. Furthermore, platelets adhered more efficiently onto collagen-coated surfaces under flow conditions. Conclusions: Taken together, the data suggest that platelets are at the frontline of COVID-19 pathogenesis, as they release various sets of molecules through the different stages of the disease. Platelets may thus have the potential to contribute to the overwhelming thrombo-inflammation in COVID-19, and the inhibition of pathways related to platelet activation may improve the outcomes during COVID-19.

The aim of this study is to prove the effectiveness of IR spectroscopy as an identification test able to discriminate between mineral compounds in mixtures. This work is concerned with the physical characterisation of purified bentonite, bentonite in organic mixtures and organic excipients, and mineralized organic mixture containing bentonite using FT-IR spectroscopy. The different spectra were compared with each other in order to determine fingerprints of bentonite represented by bands located at 3632 cm⁻¹ and 3437 cm⁻¹. The analysis of the spectra of the nonmineralized mixture demonstrates the presence of two bands at 1454 and 2928 cm⁻¹, superimposed on those of the excipients and which disappear after 2 hours of mineralization at 500°C. Finally, we notice a displacement of the stretching band of H₂O to the right with increasing the proportion of the excipients.

Children with cardiac defects need many hospitalizations and repetitive antibiotic therapies, with an increasing risk of colonization with multidrug-resistant bacteria (MDRB) such as extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) Post-operative infections with these bacteria in paediatric cardiac surgery are life threatening. This article aims to study the prevalence of ESBL colonization among paediatric cardiac surgery patients, and to compare occurrence of post-operative infections with and without ESBL colonization. We also aim to study the correlation between the onset of postoperative infection and other parameters such as age, length of stay and preoperative antibiotic therapy. A retrospective cohort study included paediatric cardiac surgery patients in Cheikh Zaid hospital in Rabat, Morocco, between the 1st of January 2011 and 31 December 2014. A screening for ESBL colonization was requested for children who had a risk factor (previous hospitalization and/or taking antibiotics) at admission. Swabs were collected from three sites (throat, nose and anus). Two groups were compared – patients colonized and not colonized with ESBLs. Statistical analysis was performed using R software. ESBL colonization screening was performed in 111 patients. Positive colonization was detected in 17 cases (15%). Klebsiella pneumoniae (KP): 9 (53%) was the most frequently isolated species. Among the 17 patients, 23.5% (4/17) developed a postoperative infection due to ESBLs versus only one patient without colonization (1%). There was a statically significant difference in terms of occurrence of postoperative infection between the two groups (p = 0.001). Relative risk of developing a postoperative infection with positive colonization was 22 (95% CI, 8.37–58.5). The analysis of colonization with multidrug-resistant bacteria and the prevention of nosocomial infections appear to be important challenges for paediatric cardiac surgery. Systematic screening of ESBL colonization for cardiac surgery could have a significant contribution, on one hand to guide prophylactic antibiotic therapy of patients, and on the other, to prevent spread of those infections.

The Cervical Cancer (CC) is one of the heavy and costly diseases for the population and the health system. We want to know through this study, the first in Morocco, the annual cost of the treatment of this disease at the National Institute of Oncology (NIO) in Rabat, we also want to explore the possibility of flat-rate management of this disease in order to standardize medical practices and improve reimbursement by health insurance funds. 550 patients were treated for their cervical cancer in the Rabat's NIO. Data of all of medical and surgical services offered to patients were collected from the NIO registry. The cost of care was assessed using the method of micro-costing. We will focus to the total direct cost of all the services lavished to patients in NIO. The global cost was about US$ 1,429,673 with an average estimated at US$ 2,599 ± US$ 839. Radiotherapy accounts for 55% of total costs, followed by brachytherapy (27%) and surgery (7%). This three services plus chemotherapy influence the overall cost of care (p <0.001). Other services (radiology, laboratory tests and consultations) represent only 10%. The overall cost is influenced by the stage of the disease, this cost decreased significantly evolving in the stage of CC (p <0.001). The standardization of medical practices is essential to the equity and efficiency in access to care. The flat-rate or lump sum by stage of disease is possible and interesting for standardizing medical practices and improving the services of the health insurance plan.

The development of safe fiberoptic endoscopy in neonates led to the identification of the occurrence of severe esophageal and gastric lesions (EGL) in the first days of life. The cause of these early acute lesions, which are associated most of the time with severe clinical symptoms, remains unknown. 34 neonates with EGL were compared with controls born in the same maternity unit immediately after those enrolled in the EGL series. Clinical and obstetric data were not different in the 2 groups. Breast-feeding was less frequent (p < 0.01) and given later (p = 0.0001) in babies with EGL. This retrospective analysis yielded no indication relative to the causative phenomenon leading to such mucosal alterations. In contrast, it provides the first evidence of a possible protective role of breast-feeding.

Recent technological progress has bolstered efforts to bring personalized medicine from theory into clinical practice. However, progress in areas such as therapeutic drug monitoring (TDM) has remained somewhat stagnant. In drugs with well-known dose-response relationships, TDM can enhance patient outcomes and reduce health care costs. Traditional monitoring method such as chromatography-based or immunoassay techniques are limited by their higher costs and slow turnaround times, making them unsuitable for real-time or onsite analysis. In this work, we propose the use of a fast, direct and simple approach using Fourier transform infrared spectroscopy (ATR-FTMIR) combined with chemometric techniques for the therapeutic monitoring of valproic acid. In this context, a database of FT-IR spectra was constructed from human plasma samples containing various concentrations of valproic acid; these samples were characterized by the reference method (immunoassay technique) to determine the valproic acid contents. The ATR-FTMIR spectra were processed by two chemometric regression methods: partial least squares regression (PLS) and support vector regression (SVR). The results provide good evidence for the effectiveness of the combination of ATR-FTMIR spectroscopy and SVR modeling for estimating valproic acid in human plasma. SVR models showed better predictive abilities than PLS models in terms of RMSEC, RMSEP, R²Cal, R²Pred and RPD. This analytical tool offers potential for real-time TDM in the clinical setting. FTIR spectroscopy was evaluated for the first time to predict valproic acid in human plasma for TDM. Two regressions were evaluated to predict valproic acid in human plasma, and the best performing model was obtained using nonlinear support vector regression.