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For q > 1, let E be a q-uniformly smooth real Banach space with dual space E Let A : E → E be a Lipschitz and strongly monotone mapping such that A-1(0) = For given x1 E, let {xn} be generated iteratively by the algorithm ... where J is the normalized duality mapping from E into E and λ is a positive real number choosen in a suitable interval. Then it is proved that the sequence {xn} converges strongly to x, the unique point of A-1(0). Our theorems are applied to the convex minimization problem. Futhermore, our technique of proof is of independent interest. [ABSTRACT FROM AUTHOR]

We study by means of the 2D Blume–Emery–Griffiths (BEG) spin-1 model, spin-crossover (SCO) and prussian blue analogs (PBAs) solids. In this model, the spin states, which can be high-spin (HS) or low-spin (LS), interact magnetically and elastically with their nearest neighbors. To account for the volume change, accompanying the spin transition phenomenon, all interactions through the lattice are assumed as temperature-dependent. In addition, the system is subject to a variable magnetic field lifting the degeneracy in the HS state. A stochastic cooperative dynamics of this BEG-like Hamiltonian, describing the equilibrium and nonequilibrium properties of ferromagnetic spin-crossover solids, is derived from the Glauber approach, with appropriate Arrhenius microscopic transition rates. The model generates under the magnetic field, sigmoidal relaxation and a hysteresis phenomenon of the HS fraction, as well as multistep behavior of the magnetization. These behaviors open the way to new route of multi-stable systems, desired in multi-byte electronics. [ABSTRACT FROM AUTHOR]

Abstract Etiological factors of childhood ischemic stroke depend on the epidemiological context. The purpose of this study was to determine the risk factors, the clinical and radiologic features, and the outcome of arterial ischemic stroke in a case series of Senegalese children. We carried out a retrospective registry-based study on arterial ischemic stroke in children hospitalized in the neurology department of Fann Teaching Hospital and Albert Royer Children's Hospital, from January 2005 to December 2015. We enrolled 116 cases with an age range from 2 months to 18 years. The mean age at stroke occurrence was 71.5 months. The most common manifestations were hemiparesis (84%), aphasia (19%), and partial motor seizures (10%). The middle cerebral artery was the most affected (81%). Risk factors were predominantly sickle cell disease (38%), embolic heart disease (9%), and anemia (3%). Twenty-eight percent of patients were lost to follow-up, 62% had neurological impairments, and 4% died. Secondary prevention was based on antithrombotic agents. Prevention must be prioritized and public health actions need to focus on sickle cell disease, rheumatismal disease, anemia, and related disorders. It will be necessary to set up policies that fight against consanguineous marriage, endemic infections, and argue for better nutrition. [ABSTRACT FROM AUTHOR]

Project VeSElkA (Vertical Stratification of Element Abundances) has been initiated with the aim to detect and study the vertical stratification of element abundances in the atmosphere of chemically peculiar stars. Abundance stratification occurs in hydrodynamically stable stellar atmospheres due to the migration of the elements caused by atomic diffusion. Two HgMn stars, HD 53929 and HD 63975, were selected from the VeSElkA sample and analysed with the aim to detect some abundance peculiarities employing the zeeman $\scriptstyle{2}$ code. We present the results of abundance analysis of HD 53929 and HD 63975 observed recently with the spectropolarimeter ESPaDOnS (Echelle SpectroPolarimetric Device for the Observation of Stars) at Canada–France–Hawaii Telescope. Evidence of phosphorus vertical stratification was detected in the atmosphere of these two stars. In both cases, phosphorus abundance increases strongly towards the superficial layers. The strong overabundance of Mn found in stellar atmosphere of both stars confirms that they are HgMn-type stars. [ABSTRACT FROM AUTHOR]

Résumé: L’hypomagnésémie congénitale est une affection rare mais son retentissement neurocognitif est important en l’absence d’une prise en charge précoce et adaptée. Nous rapportons l’observation familiale de 3 enfants sénégalais issus d’un mariage consanguin, qui avaient présenté des convulsions néonatales et un retard des acquisitions psychomotrices. La tomodensitométrie cérébrale avait mis en évidence une atrophie cortico-sous-corticale et des calcifications dans un cas et l’imagerie par résonance magnétique cérébrale avait objectivé une atrophie cérébelleuse prédominante chez les deux autres enfants. Le bilan biologique avait mis en évidence une hypocalcémie, une hyperphosphorémie et une hypomagnésémie chez les trois enfants. Le taux de parathormone sanguine était effondré chez deux enfants et normal chez l’autre. L’un de ces enfants est décédé à l’âge de 7 mois. Pour les deux autres, une supplémentation en calcium et en magnésium avait permis la normalisation de la calcémie et de la phosphorémie mais la magnésémie était restée basse malgré de fortes doses. [ABSTRACT FROM AUTHOR]

Several 60 L dry batch anaerobic digestion (AD) reactors were implemented with or without liquid reserve on cattle manure. The immersed part modulation of cattle manure increased the methane flow of about 13%. The quantitative real time PCR and the optimized DNA extraction were implemented and validated to characterize and quantify the methanogen dynamic in dry batch AD process. Final quantities of methanogens converged toward the same level in several inocula at the end of AD. Methanogen dynamic was shown by dominance of Methanosarcinaceae for acetotrophic methanogens and Methanobacteriales for the hydrogenotrophic methanogens. Overall, methanogens populations were stabilized in liquid phase, except Methanosaetaceae. Solid phase was colonized by Methanomicrobiales and Methanosarcinaceae populations giving a support to biofilm development. The methane increase could be explained by a raise of Methanosarcinaceae population in presence of a total contact between solid and liquid phases. Methanosarcinaceae was a bio-indicator of the methane production. [ABSTRACT FROM AUTHOR]

Abstract: This work reports measurement of temperatures of the melting drops in the previously designed and presented melt dripping experiments of thermoplastic polymers. A simple heat transfer model has been used to compute the surface temperatures of the polymer sample at various furnace temperatures and thus the temperatures of the molten drops dripping from the melting surface. The model has been validated by experimental results. The temperatures of the molten drops could help in predicting the degree of degradation in a polymer during melt dripping. By conducting thermogravimetric analysis of both the polymers and their molten drops, a degree of degradation could also be predicted. The values obtained from both approaches have been compared in order to understand the melt dripping/degradation behaviour of polymers. [Copyright &y& Elsevier]

In this paper we propose a new method to detect inclusions. The proposed method is based on shape and topological optimization tools. In fact after presenting the problem, we use topological optimization tools to detect inclusions in the domain. Numerical results are presented. [ABSTRACT FROM AUTHOR]

Abstract: Background: Malaria is a real public health problem in Africa; more than 300 million new cases and approximately two million deaths arise every year. In spite of the blood transfusion is a potential way of Plasmodium transmission, there is no consensus for measures to prevent post-transfusion malaria in endemic area. This work aimed at comparing some tools and to discuss various strategies to be implemented. Material and methods: The study concerned 3001 blood donors recruited in seven blood transfusion centers in Senegal during two periods: dry season (June–July, 2003) and rainy season (October–November, 2003). We evaluated the efficiency of the selection questionnaire for the blood donors to exclude those who are potentially asymptomatic carriers of the Plasmodium. Every donation was screened for pLDH antigen and antibodies against Plasmodium by Elisa technique (DiaMed, Cressier sur Morat, Suisse), morphological tests was also performed, as well as the screening of HIV, HBs Ag, HCV Ab and syphilis. Results: Median age of blood donors was of 27.7 years. Anti-Plasmodium antibodies prevalence was 65.3% and pLDH antigen was of 0.53%, all positivity was confirmed by microscopy. The prevalence of the other infectious markers was 11.7% for HBs Ag; 0.83% for syphilis; 0.49% for HCV Ab and 0.46% for HIV Ab. The risk factors associated with an asymptomatic carrier of Plasmodium were: the rainy season, irregular character of the blood donations, high frequency of malaria attacks in the past, and absence of treatment during the last episode. Conclusion: Plasmodium represents the third risk of blood transmitted infectious agents after hepatitis B virus, syphilis, and before HCV and HIV in Senegal. The medical questionnaire is not useful enough for asymptomatic carriers deferral, and we propose to introduce Plasmodium screening. The screening for Plasmodium pLDH by Elisa technique seems to be the best tool in endemic area and the strategy of systematic screening is the most suited in terms of blood transfusion safety. [Copyright &y& Elsevier]

Abstract: The aqueous extract of the Parinari excelsa barks at doses of 100 and 300 mg/kg/day for 7 days has a significant antihyperglycemic effect on alloxan-induced diabetic rats. At the same dose the acute oral administration of aqueous extract of the P. excelsa barks (100 and 300 mg/kg) induced a significant decrease of blood glucose on glucose-loaded normoglycaemic rats. Our results seem to confirm the rational bases for its use in traditional medicine. [Copyright &y& Elsevier]

Abstract: Two important components that determine sheep production efficiency are reproduction and live bodyweight. An understanding of environmental factors affecting these traits is needed to implement optimal breeding and selection programs in Benin (West Africa). In this study, age at first lambing, length of the lambing interval, prolificacy, dam''s post-partum weights, lambs weight at weaning and productivity indices of West African Dwarf sheep (Djallonke sheep) were analysed under research conditions. The non-genetic effects (season of birth, year of birth, parity of the ewes and sex of lambs) were determined. Age at first lambing (622.4±55.6 days) was significantly (p <0.001) affected by year and season of birth. Lambing interval (242.6±20.8 days) was affected (p <0.001) by the year of lambing, sex of the lamb, type of birth (single, twin), parity of the ewe and type of birth–parity interaction. The number of offspring per birth (1.4±0.5) was significantly affected (p <0.001) by the year of lambing. Lamb weaning weights at 90 days of age (10.6±2.1kg) and ewe postpartum weights at lambing (27.5±2.4kg) were significantly affected (p <0.001) by all the fixed effects. Ewes with a heavier body weight exhibited shorter lambing intervals (p <0.001) and heavier offspring at 90 day of age (p <0.01). Productivity expressed as the body weight of a 90 days of old lamb produced per breeding female per year (17.0±3.1kg), per kg breeding female per year (0.6±0.1kg) and per kg breeding female per year (1.4±0.2kg) were affected (p <0.01) by the year of lambing, the parity of ewes, the sex of lambs, and the parity sex interaction. The number of births per month (95.7±74.4) was higher during the rainy season than in dry season. Environmental effects estimated in this study are important and will need to be taken into consideration for sheep breeding improvement. [Copyright &y& Elsevier]

Proposes an integrated management of chronic respiratory and allergic diseases in developing countries and specifically sub-Saharan Africa. Needs for equity in health and healthcare in developed and developing countries; Program on disability-adjusted life years launched by the World Bank and supported by the World Health Organization; Reasons for the focus on the sub-Saharan Africa.

Aim. – Evaluate the knowledge of retail pharmacists of doping in sport and to describe their attitude in front to this phenomenon.Methods. – We proceeded by a prospective self-reported survey by postal mail with 105 retail pharmacists in Dakar which contains 299 pharmacies.Results. – We have received 68 answers. Only 10% of pharmacists know doping definition. They are 66% who think that senegalese sportsmen use doping products. They feel concerned with the problem of doping (81%) and 19% of them said having been contacted during these last 12 months for advice on doping products. They consider that doping is a kind of drug addiction and a public health problem. They estimated to 95% that the most effectiveness means of prevention would be to talk about side effects of doping products with the support of doctors.Conclusion. – This study which has to be extended must bring us to do big preventing actions. [Copyright &y& Elsevier]

Specific immunotherapy is effective for the treatment of allergic rhinitis and stable asthma. It reduces symptom scores and drug needs and has a preventive effect by alterning the natural history of the allergic disease as long as strict rules of prescription are followed and allergen vaccines are of high quality. [Copyright &y& Elsevier]

Summary: Cryptococcus meningitis is uncommon in childhood. We report a Senegalese case of cryptococcus meningitis diagnosed in an apparently immunocompetent child. A 9-year-old boy was admitted for acute meningoencephalitis. A computerized tomography scan of the brain showed an ischemic lesion in the left caudate and study of cerebrospinal fluid (CSF) revealed cytological and biochemical abnormalities and Cryptococcus neoformans on direct exam and culture. HIV and syphilis antibodies were negative and the blood CD4 lymphocyte count was 804/mm3. The child had no immunocompromising factors such as hematologic abnormalities, solid tumor, or undernutrition. He was treated with fluconazole intravenously, but clinical outcome was unsuccessful. The patient died after 1 month from cardiovascular and respiratory distress. [Copyright &y& Elsevier]

Purpose: To describe the repercussions of teleworking among the employees of an humanitarian agency based in Dakar, in the context of the Covid-19 pandemic. Material and methods: We carried out a transversal, descriptive study, from June 10 to 13, 2021. An anonymous online questionnaire, created via Google Survey platform, was sent to the various employees of this agency. Results: Married people were more numerous (76%). The average age was 45.7 years old. The employees lived in families of an average of six peoples. The most enumerated advantages of teleworking were the economic gains linked to the absence of travel (88%), the improvement of work/family balance (84%), the increase in efficiency (64%) and feeling of freedom felt (56%). On the other hand, the increase in working time (96%), low back pain (72%), the family environment often not very favorable to teleworking (52%) and the decrease in social ties between colleagues (60%) were the main limitations of teleworking. Conclusion: It has many advantages and also has limitations. These could be minimized by better organization and psychological support for the staff. [ABSTRACT FROM AUTHOR]

In the central western Senegal, great progress has been made against malaria following the successful implementation of effective malaria control interventions, including Indoor Residual Spraying (IRS) and Seasonal Malaria Chemoprevention (SMC). However, residual transmissions are still occurring in several hotspots involving some secondary vector species, such as An. melas. This study was undertaken in central and western costal area of Senegal, to provide the first data on the insecticide susceptibility of local An. melas population using WHO test kits, the allelic frequencies of the Kdr and Ace-1R mutations using qPCR and also re-evaluate the palp biometry technique as a proxy to discriminate An. melas from other freshwater species within the Gambiae complex. Insecticide susceptibility test revealed a susceptibility of An. melas to Pirimiphos-methyl, and Bendiocarb, the two main non-pyrethroid insecticides recommended by the WHOPES for use in public health. The molecular characterization of the Kdr and Ace-1 target site mutations revealed the absence of both mutations. The biometric palps technique has been a valid method for species diagnose between An. melas and its freshwater sibling. Indeed, while the former species collected exclusively from salty breeding sites (with a level of salinity above 21 g/l), consistently displayed a palpal index ≥0.81; the latter, sampled for breeding site of low salinity level (up to 3.6 g/l) and subsequently mainly identified as An. arabiensis and in a lesser extend as An. gambiae, presented a palpal index less than 0.81. This study has re-evaluated and validated the palps biometric technique as a morphological tool for the identification of An. melas, which population still susceptible to main insecticide used in public health and revealed the absence of KDR and Ace-1 mutations. The data provided here can help the Senegalese NMCP to better target and efficiently control An. melas populations in malaria hotspot, where they contribute to maintain residual transmission hampering the malaria elimination goal. [ABSTRACT FROM AUTHOR]

Let E be a real normed linear space and E* its dual. In a recent work, Chidume et al. [ Chidume, C. E. and Idu, K. O., Approximation of zeros of bounded maximal monotone mappings, solutions of hammerstein integral equations and convex minimizations problems, Fixed Point Theory and Applications, 97 (2016)] introduced the new concepts of J-fixed points and J-pseudocontractive mappings and they shown that a mapping A : E → 2E* is monotone if and only if the map T : = (J - A) : E → 2E* is J-pseudocontractive, where J is the normalized duality mapping of E. It is our purpose in this work to introduce an algorithm for approximating J-fixed points of J-pseudocontractive mappings. Our results are applied to approximate zeros of monotone mappings in certain Banach spaces. The results obtained here, extend and unify some recent results in this direction for the class of maximal monotone mappings in uniformly smooth and strictly convex real Banach spaces. Our proof is of independent interest. [ABSTRACT FROM AUTHOR]

Reports on the registration of "Yacine" cowpea cultivar in the U.S. Description of the cultivar; Resistance to cowpea aphis and bacterial blight; Possible uses of the cultivar.

Introduction les nécroses digitales posent en règle les difficultés de leur diagnostic étiologique. Peu d’études ont été réalisées dans nos régions. L’objectif de notre étude était de déterminer les aspects étiologiques et évolutifs des nécroses digitales. Patients et méthodes Il s’agissait d’une étude rétrospective d’une durée de 7 ans (janvier 2008 à mai 2014). Le diagnostic reposait sur la clinique, l’histologie, l’immunologie et l’imagerie. Résultats Nous avions colligé 17 dossiers de patients dont 6 hommes et 11 femmes soit un sex-ratio de 0,35. L’âge moyen était de 41,5 (extrêmes de 24 et 71 ans). Les nécroses intéressaient les membres supérieurs dans 6 cas et les membres inférieurs dans 4 cas. L’atteinte touchait à la fois les membres supérieurs et inférieurs dans 7 cas. Les signes cliniques associés étaient dominés par le syndrome de raynaud et les polyarthralgies inflammatoires. À la biologie, le syndrome inflammatoire était quasi-constant. Le bilan immunologique réalisé chez 15 patients était contributif au diagnostic dans 13 cas. L’écho-doppler artériel de 10 patients objectivait un épaississement pariétal dans 4 cas, une thrombose dans 3 cas. L’histologie était réalisée chez deux patients. Les diagnostics étaient les suivant : sclérodermie ( n : 5), SAPL ( n : 3), syndrome de chevauchement (lupus, sclérodermie dans le premier cas ; lupus sclérodermie et syndrome de Sjögren dans le deuxième cas) ( n : 2), vascularites systémiques ( n : 6) : à ANCA ( n : 1) ; secondaires ( n : 3) et indéterminées ( n : 2), Leo-Buerger ( n : 1), Le traitement médical était instauré chez tous les patients. Un traitement chirurgical était effectué chez 14 patients. Des complications immédiates ont été retrouvées chez 2 patients. Un cas de décès était noté et une récidive nécrose ischémique dans 2 cas. Conclusion Dans notre série les étiologies étaient dominées par les maladies auto-immunes systémiques. Le retard diagnostique et thérapeutique pourrait mettre en jeu le pronostic vital d’où l’intérêt d’une prise en charge médico-chirurgicale rapide. [ABSTRACT FROM AUTHOR]

Résumé L’hypomélanose d’Ito est un syndrome neurocutané rare. Nous en rapportons 4 observations chez des enfants âgés de 8 à 20 mois. Ils présentaient tous une épilepsie, un retard de développement psychomoteur et des lésions hypopigmentées diffuses. L’électroencéphalogramme montrait des anomalies irritatives diffuses ou focales sur un rythme de fond normal ou ralenti. La tomodensitométrie cérébrale était normale chez 2 enfants et montrait dans un cas une atrophie hémisphérique sous-corticale. Malgré un traitement antiépileptique et une rééducation psychomotrice, l’amélioration clinique est restée pauvre avec persistance d’une épilepsie pharmacorésistante et d’un retard des acquisitions psychomotrices. Summary Ito hypomelanosis is a rare neurocutaneous condition. We report on four observations in infants aged between 8 and 20 months. They all presented with epilepsy, psychomotor delay, and diffuse hypomelanosis. The electroencephalograms showed diffuse irritative abnormalities. Brain imaging was normal in two infants and showed hemispheric atrophy in another case. Despite antiepileptic treatment and physical therapy, no significant progression was noted and all children continued to have drug-resistant epilepsy and psychomotor delay. [ABSTRACT FROM AUTHOR]

Objective: To determine the periodontal factors associated with stroke in melanodermic subjects in Senegal. Study design: Case-control study. Methods: One hundred and twenty cases and 120 controls were included in this study. Cases had been diagnosed with stroke by a neurologist, with the diagnosis confirmed by scanner. Controls had never had any type of stroke. Data were collected regarding sociodemographic characteristics, lifestyle behaviours, general history, type of stroke (ischaemic or haemorrhagic) and periodontal parameters [plaque index, papillary bleeding index, pocket depth, clinical attachment loss, Community Periodontal Index of Treatment Needs and periodontitis (defined by clinical attachment loss >2 mm and pocket depth >3 mm)]. Logistic regression analysis was performed using R software to isolate a final model after adjustment for the 5% threshold. Results: All periodontal characteristics were more common among cases than among controls. Periodontitis (odds ratio 1.58, 95% confidence interval 1.1-3.022) and periodontal parameters were significantly associated with stroke, adjusted for hypertension, sedentary lifestyle, and the interaction between periodontitis and age. Conclusions: Periodontal disease is associated with stroke in the Senegalese population. Prospective longitudinal studies should be undertaken to improve understanding. [ABSTRACT FROM AUTHOR]

Charcot-Marie-Tooth type 1A (CMT1A) is an inherited neuropathy with an estimated prevalence of 1/5000 in the general population. CMT1A results from abnormal dosage of the PMP22 gene, arising from non-allelic homologous recombination (NAHR) events between paralogous sequences called CMT1A-REPs, flanking the gene. While extensively documented in Caucasian individuals, CMT1A is under-reported in individuals of African genetic ancestry. We hypothesize that this is due to differences in the CMT1A-REPs between individuals of African and non-African genetic background. Our aim is to study the variability of CMT1A-REPs between populations using available genetic data and in silico analyses. Here, we have built a combined dataset from previous whole genome sequencing efforts (1KGP, HGDP and other available datasets at EGA) with a focus on capturing African genetic variation. Leveraging this data, we explore haplotypes based on both common and rare SNPs, structural variants in CMT1A-REP regions, recombination-related elements, and their potential interactions, as well as their distribution across different populations. We find that individuals of African genetic ancestry harbour distinct CMT1A-REP haplotypes with lower recombination rates and reduced sequence similarity compared to other ethnicities. This suggests potential genetic variation protective against NAHR-mediated events causing CMT1A. Additionally, recombination regulators like PRDM9 might differ between African and non-African ethnicities, hinting at distinct mechanisms at play. In conclusion, our study shows genetic differences in the CMT1A locus between African and non-African ancestries, which may account to the under-reporting of CMT1A in individuals of African genetic origin. However, further research is needed to better understand the epidemiology of inherited neuropathies and CMT1A in the African continent and how CMT1A-REP variations influence disease risk. [ABSTRACT FROM AUTHOR]

Facioscapulohumeral dystrophy (FSHD) is the third most prevalent inherited form of muscular dystrophy in individuals of European ancestry. FSHD is caused by derepression of the transcription factor DUX4 in skeletal muscle. For most cases of European ancestry, FSHD is caused by contraction of the D4Z4 repeat to a range of 1-10 units (U), known as FSHD1, whereas the typical size ranges between 8-100U. Alternatively, pathogenic variants in chromatin modifiers such as SMCHD1 underlie FSHD (FSHD2). Recent studies suggest that the northeast Asian population is less susceptible to FSHD1 as the common FSHD1 allele size ranges here between 1-7U. Only a few sub-Saharan African FSHD patients have been described, without genetic confirmation. Under-reporting of FSHD in individuals with African genetic ancestry may be attributed to limited access to diagnostic tools and scarcity of Neurology specialists in Africa. However, it is possible that epidemiological differences could arise from a different genomic background influencing susceptibility to FSHD between populations. We provide a clinical and genetic description of FSHD in eight unrelated individuals with African genetic ancestry from Senegal, Ivory Coast, Ethiopia, South Africa, Curaçao and the USA. Individuals were evaluated using the FSHD Evaluation Score and the FSHD Clinical Severity Score. Genetic analysis confirmed FSHD1 in seven individuals, where the FSHD1 allele ranged between 2-6U. One individual was genetically FSHD2, showing typical D4Z4 hypomethylation, a pathogenic SMCHD1 variant and an FSHD permissive haplotype with 11U repeat. More detailed analysis showed African-specific D4Z4 haplotypes in 6/7 patients. Genome wide SNP analysis confirmed the African genetic background in most of the patients. These findings underscore the importance of further investigation into factors contributing to the variability of FSHD presentation across diverse populations and highlight the need for tailored genetic diagnosis. [ABSTRACT FROM AUTHOR]

Neuromuscular disorders (NMDs) are understudied in sub-Saharan Africa, and their underlying genetic causes are predominantly unknown. The underrepresentation of ethnically diverse populations in human genetic studies challenges our ability to understand the genetic architecture of NMDs across populations. Here, we present the preliminary results of SENEGENE, an exploratory study to characterise the clinical and molecular profile of NMDs in Senegal, West Africa. Adult and paediatric individuals with suspicion of NMDs and related controls were recruited from October 2021 to April 2024 at the Neurology Department of CHNU de Fann, in Dakar, and other associated centres. Individuals were phenotyped with HPO terms and evaluated with biochemical and neurophysiological studies when necessary. Information was recorded into a REDCAP database. Genetic sequencing followed a progressive approach including MLPA, WES & WGS. The bioinformatic analysis used state-of-the-art alignment, variant calling and analysis pipelines for SNVs & indels, mitochondrial variants, CNVs, STRs and other SVs. Annotated variants were evaluated based on phenotype relevance, segregation, frequency and functional consequences. 500 study participants were recruited from over 200 unrelated families. Diagnostic categories included dystrophinopathy (23.1%), limb-girdle muscular dystrophy (18.4%), congenital myopathy/congenital muscular dystrophy (21%), hereditary neuropathy (15.6%), spinal muscular atrophy (13.2%), congenital myasthenic syndrome (3.4%), channelopathies (2.4%), facioscapulohumeral muscular dystrophy (<1%) and others (2.4%). Genetic diagnosis was solved in ∼65% of cases, allowing improved medical care and genetic counselling. In conclusion, we provide the first comprehensive description of NMDs in Senegal, increasing diversity and novel pathogenic variant knowledge in neuromuscular genetics. We also highlight potential epidemiological differences between West African and European populations. [ABSTRACT FROM AUTHOR]

Neuromuscular disorders (NMDs) are under-diagnosed in sub-Saharan Africa and their underlying genetic causes are largely unknown. This is mainly due to a lack of infrastructure and access to sophisticated diagnostic pipelines such as muscle biopsy and genetic testing, but also to social and economic factors that prevent patients from accessing healthcare. Lack of precise genetic diagnosis often leads to poor medical care and reproductive counselling, as well as a lack of awareness. Furthermore, the under-representation of ethnically diverse populations in human genetic studies challenges our ability to understand the genetic architecture of NMDs across populations. Given that Africa is the most genetically diverse continent, it is possible that some of the genetic associations identified in populations of European ancestry are not necessarily generalisable to Africans. This could have implications for diagnostic tests being less accurate for African populations, but also for future therapies not being inclusive. With the African population set to double to 2.5 billion by 2050, there is a need to improve our understanding of NMDs on the African continent. Here, we report on our recent experience in building a collaborative clinical genomics partnership for NMDs between Barcelona and Dakar in Senegal, West Africa. We use advances in genomics and cloud services to provide NMD patients with high-precision genetic diagnoses based on DNA samples and clinical data collected remotely. The benefits range from increasing the number of patients with accurate diagnoses to providing personalised clinical management plans and genetic counselling. Linking with available resources and networks helps to build capacity and generate local expertise, in line with recent calls for global action on rare diseases in Africa. We found positive patient attitudes towards genetic testing and significant local involvement in advocacy and public awareness activities for NMDs. [ABSTRACT FROM AUTHOR]

Les publications sur l'accident vasculaire cérébral (AVC) sont rares au Sénégal, en particulier au niveau régional. Le but de l'étude était de déterminer les aspects épidémiologiques, cliniques, tomodensitométriques et évolutives de l'AVC de l'enfant et de l'adolescent à Ziguinchor. Il s'agissait d'une étude rétrospective de dossiers de patients pédiatriques hospitalisés pour AVC à Ziguinchor, du 1er octobre 2015 au 31 octobre 2020. Nous avons collecté 16 cas (9 garçons et 7 filles). L'âge moyen des patients était de 7,7 ans avec des extrêmes allant de 7 mois à 18 ans [7 mois–18 ans]. Onze enfants étaient issus de famille ayant un niveau socioéconomique bas. Le tableau clinique était dominé par l'hémiplégie/l'hémiparésie 13 cas ; les convulsions 13 cas ; l'hyperthermie 8 cas. Le délai moyen de réalisation du scanner cérébral était de 61,5 heures [28,5–160]. Les AVC ischémiques et hémorragiques représentaient respectivement 13 cas (81,3 %) et 03 cas (18,7 %). Les principaux facteurs étiologiques étaient la drépanocytose (37,6 %), la cardiopathie congénitale (18,8 %). La durée moyenne d'hospitalisation était de 11,1 jours [5–23]. Deux décès ont été déplorés. Après un recul d'au moins trois mois, nous avons enregistré 2 enfants avec une récupération satisfaisante ; 9 enfants avec une récupération insatisfaisante et 3 enfants perdus de vus. L'AVC représente une pathologie grave de l'enfant et de l'adolescent à Ziguinchor et se présente sous forme de déficit moteur, de convulsions, d'hyperthermie. L'ischémie cérébrale est la forme la plus fréquente et les principaux facteurs étiologiques sont la drépanocytose et la cardiopathie congénitale. Publications on cerebrovascular accident (stroke) are rare in Senegal, especially at the regional level. The aim of the study was to determine the epidemiological, clinical, tomodensitometric and evolutionary aspects of stroke in children and adolescents in Ziguinchor. This was a retrospective study of records of pediatric patients hospitalized for stroke in Ziguinchor, from October 1st, 2015 to October 31st, 2020. We collected 16 cases (9 boys and 7 girls). The average age of patients was 7.7 years with extremes ranging from 7 months to 18 years [7 months–18 years]. Eleven children came from families with a low socioeconomic level. The clinical picture was dominated by hemiplegia/hemiparesis in 13 cases; seizures 13 cases; hyperthermia 8 cases. The average time to perform a brain scan was 61.5 hours [28.5–160]. Ischemic and hemorrhagic strokes represented 13 cases (81.3%) and 03 cases (18.7%), respectively. The main etiological factors were sickle cell disease (37.6%), congenital heart disease (18.8%). The mean hospital stay was 11.1 days [5–23]. Two deaths were deplored. After a follow-up of at least three months, we recorded 2 children with satisfactory oucome; 9 children with an unsatisfactory outcome and 3 children lost to follow up. Stroke is a serious pathology in children and adolescents in Ziguinchor and presents in the form of motor deficit, seizures, hyperthermia. Cerebral ischemia is the most common form and the main causative factors are sickle cell anemia and congenital heart disease. [ABSTRACT FROM AUTHOR]

Introduction: The Richard-Toll social security fund agency ranks second in terms of declaration of work accidents (WA) in Senegal. In view of this and in the absence of a study that is interested in this subject, we initiated this work, the aim of which was to study these WA declared in the said agency. Methodology: This was a retrospective and descriptive study carried out from January 1, 2018 to December 31, 2020. The parameters studied were the socio-professional information of the victims and the characteristics of the accidents. Results: A total of 1,071 workplace accidents were recorded. The average age of the victims was 37.1 years old. Agricultural workers and laborers were more concerned (95.5%). Site accidents accounted for 95% of cases. Lesions were mainly wounds (83.3%) and were benign in 98.2% of cases. The machete was incriminated in 48.5% of cases. Accidents occurred while cutting sugar cane in 81% of cases. The Senegalese sugar company was the main reporter (99%) and 84.4% of accidents were recorded periodically from December to May. Conclusion: Work accidents are a reality in the Senegalese sugar company. Studies are urgently needed to better understand this issue. The purpose was to strengthen pre-existing prevention programs. [ABSTRACT FROM AUTHOR]

Résumé: Les tumeurs neuroectodermiques primitives sont un ensemble de tumeurs malignes rares, très agressives. Leur localisation cervico-faciale est rare, voire exceptionnelle. Nous rapportons l’observation d’un nourrisson de 4 mois, de sexe masculin, ayant consulté pour une dyspnée supra-laryngée sévère. L’examen avait révélé une masse sous angulo-mandibulaire gauche ferme, mobile, étendue à la région parotidienne, douloureuse, avec une voussure de la paroi latérale gauche de l’oropharynx. La tomodensitométrie cervicale avait objectivé une masse bien limitée de la région carotidienne, rehaussée par le produit de contraste. L’examen anatomopathologique de cette masse vascularisée qui était développée aux dépens du nerf vague, avait montré qu’il s’agissait d’une tumeur neuroectodermique primitive. [ABSTRACT FROM AUTHOR]

To address the epidemic of hypertension in blacks born and living in sub-Saharan Africa, we compared in a randomised clinical trial (NCT01030458) single-pill combinations of old and new antihypertensive drugs in patients (30-69 years) with uncomplicated hypertension (140-179/90-109 mm Hg). After 4 weeks off treatment, 183 of 294 screened patients were assigned to once daily bisoprolol/hydrochlorothiazide 5/6.25 mg (n=89; R) or amlodipine/valsartan 5/160 mg (n=94; E) and followed up for 6 months. To control blood pressure (<140/<90 mm Hg), bisoprolol and amlodipine could be doubled (10 mg per day) and α-methyldopa (0.5-2 g per day) added. Sitting blood pressure fell by 19.5/12.0 mm Hg in R patients and by 24.8/13.2 mm Hg in E patients and heart rate decreased by 9.7 beats per minute in R patients with no change in E patients (-0.2 beats per minute). The between-group differences (R minus E) were 5.2 mm Hg (P<0.0001) systolic, 1.3 mm Hg (P=0.12) diastolic, and 9.6 beats per minute (P<0.0001). In 57 R and 67 E patients with data available at all visits, these estimates were 5.5 mm Hg (P<0.0001) systolic, 1.8 mm Hg (P=0.07) diastolic and 9.8 beats per minute (P<0.0001). In R compared with E patients, 45 vs 37% (P=0.13) proceeded to the higher dose of randomised treatment and 33 vs 9% (P<0.0001) had α-methyldopa added. There were no between-group differences in symptoms except for ankle oedema in E patients (P=0.012). In conclusion, new compared with old drugs lowered systolic blood pressure more and therefore controlled hypertension better in native African black patients. [ABSTRACT FROM AUTHOR]

Les hémorragies intra cérébrales représentent environ 15 % des 115 000 accidents vasculaires cérébraux survenant chaque année en France. Bien que leur prise en charge dispose d'un arsenal thérapeutique plus réduit que pour l'infarctus cérébral, il existe des éléments importants permettant de réduire la morbi-mortalité à court terme, en limitant l'expansion de l'hématome et la survenue de complication précoces, et à long terme en diminuant le risque de récidive. Le but de cette mise au point est de répertorier les éléments clés permettant actuellement l'amélioration du pronostic des patients victimes d'hémorragies intra cérébrales. Intracerebral hemorrhage accounts for approximately 15% of the 115,000 strokes occurring each year in France. Although therapeutic strategies are more limited than for ischemic stroke, major points in the management of intracerebral hemorrhage can reduce short term morbidity and mortality by limiting the expansion of the hematoma and the occurrence of early complications, and long term patients' outcome by reducing the risk of recurrence. This article aims to update the key elements that contribute to improve of the prognosis of intracerebral hemorrhage patients. [ABSTRACT FROM AUTHOR]

Les infarctus cérébraux représentent 80 % des accidents vasculaires cérébraux et sont l'une des principales causes de décès, de handicap et de démence dans le monde. Autrefois considérée comme contemplative, leur prise en charge a connu de nombreuses avancées avec la création des unités de soins intensifs neurovasculaires, l'avènement des stratégies de recanalisation, l'optimisation de la prise en charge des complications et la prévention de la récidive précoce. L'objectif de cette mise au point est d'effectuer une revue générale de ces interventions permettant d'améliorer le pronostic des patients pris en charge pour un infarctus cérébral. Ischemic stroke accounts for 80% of overall stroke, and is one of the leading causes of death, disability and dementia in worldwide. Management of patients with acute ischemic stroke dramatically improved over time with the implementation of intensive care stroke units, the development of acute recanalization strategies, the optimization of the management of post-stroke complications, and the prevention of early stroke recurrence. The objective of this article is to provide a general overview of the current management of patients with acute ischemic stroke aiming at improving post-stroke outcome. [ABSTRACT FROM AUTHOR]

The paper deals with the problem of locating new facilities in presence of attracting and repulsive demand points in a continuous location space. When an arbitrary norm is used to measure distances and with closed convex constraints, we develop necessary conditions of efficiency. In the unconstrained case and if the norm derives from a scalar product, we completely characterize strict and weak efficiency and prove that the efficient set coincides with the strictly efficient set and/or coincides with the weakly efficient set. When the convex hulls of the attracting and repulsive demand points do not meet, we show that the three sets coincide with a closed convex set for which we give a complete geometrical description. We establish that the convex hulls of the attracting and repulsive demand points overlap iff the weakly efficient set is the whole space and a similar result holds for the efficient set when we replace the convex hulls by their relative interiors. We also provide a procedure which computes, in the plane and with a finite number of demand points, the efficient sets in polynomial time. Concerning constrained efficiency, we show that the process of projecting unconstrained weakly efficient points on the feasible set provides constrained weakly efficient points. [ABSTRACT FROM AUTHOR]

Objectives: to determine the mechanisms, lesions and hospital management of work-related accidentduringtraditional fishing,an activity subject to vital occupational risks. Materials and methods: Descriptive retrospective study on occupational injury files in artisanal fishing professions, registered at the Saint-Louis Regional Hospital (Senegal), from January 2014 to December 2019. All complete records of trauma during any activity related to artisanal fishingwereincluded. Data on accident mechanisms, injuries observed, and hospital management were collected. Results: 47 male workers were on average 28.4 years old. Direct shock from a pirogue was most frequent (68.10%), followed by sharp or blunt objects (16.27%). The lesions were characterized by bone fractures in 63.83% of cases (n=30); chest-abdominal-pelvic and limb contusions and wounds represented 12.67% and 21.27% of cases, respectively. Medical management was done in 21 cases (44.7%). Surgery was dominated by intramedullary nailing in 15 cases (31.9%). Two laparotomies were performed with intestinal sutures. A chest contusion death was reported. Conclusion: Traumatic occupational risks in traditional fishing are life threatening. A better understanding of these risks and their consequencesmakes it possible to ensure good prevention. [ABSTRACT FROM AUTHOR]

Les hémorragies intracrâniennes néonatales sont relativement fréquentes. L'objectif de notre étude était de décrire les aspects diagnostiques et thérapeutiques des hémorragies intracrâniennes du nouveau-né au Centre hospitalier national d'Enfant Albert Royer (CHNEAR) de Dakar. Il s'agissait d'une étude descriptive, rétrospective et prospective incluant tous les nouveau-nés hospitalisés dans le service de réanimation néonatale du CHNEAR de Dakar entre le 1er janvier 2017 et 30 avril 2020 pour une hémorragie intracrânienne. Le diagnostic était fait à l'imagerie cérébrale. Vingt-trois (23) nouveau-nés ont été colligés dont 14 filles. L'âge moyen des nouveau-nés était de 8,2 jours avec des extrêmes de 5 heures à 26 jours. Les manifestations cliniques étaient dominées par les signes neurologiques (82,6 %), la détresse respiratoire (60,9 %). L'hémorragie intraventriculaire de grade 2 était plus retrouvée (52,2 %) suivie de l'hémorragie intraventriculaire de grade 1 (34,8 %). Des localisations multiples avaient été retrouvées chez 7 nouveau-nés (30,4 %). Les facteurs étiologiques étaient dominés par les infections (56,5 %) et la prématurité (47,8 %). Le traitement comportait une oxygénothérapie (86,9 %), une transfusion (60,8 %) (culot globulaire (47,8), plasma frais congelé (13 %)), une osmothérapie (13 %), des anticonvulsivants (17,4 %). L'évolution était favorable chez 16 nouveau-nés (69,6 %) et 6 nouveau-nés (26,1 %) étaient décédés. Les hémorragies intracrâniennes ne sont pas exceptionnelles dans notre contexte et prédominent chez les prématurités. Elles peuvent être une cause majeure de morbimortalité. Les unités de néonatologie devraient disposer d'appareils d'échographie permettant leur diagnostic précoce. Neonatal intracranial hemorrhages are relatively common. The objective of our study was to describe the diagnostic and therapeutic aspects of intracranial hemorrhages in the newborn at the Albert Royer National Children's Hospital (ARNCH) in Dakar. This was a descriptive, retrospective and prospective study including all newborns hospitalized in the neonatal intensive care unit of ARNCH in Dakar (Senegal) between January 1st 2017 and April 30th 2020 for intracranial hemorrhage. The diagnosis was made on brain imaging. Twenty-three (23) newborns were collected including 14 girls. The mean age of the newborns was 8.2 days with extremes of 5 hours to 26 days. Clinical manifestations were dominated by neurological signs (82.6 %) and respiratory distress (60.9 %). Grade 2 intraventricular hemorrhage was more common (52.2 %) followed by grade 1 intraventricular hemorrhage (34.8 %). Multiple locations were found in 7 newborns (30.4 %). Etiological factors were dominated by infections (56.5 %) and prematurity (47.8 %). Treatment included oxygen therapy (86.9 %), transfusion (60.8 %) (red blood cells (47.8), fresh frozen plasma (13 %)), osmotherapy (13 %), anticonvulsants (17.4 %). The evolution was favourable in 16 newborns (69.6 %) and 6 newborns (26.1 %) had died. Intracranial hemorrhages are not exceptional in our context and predominate in preterm. They can be a major cause of morbidity and mortality. Neonatology units should have ultrasound equipment for their early diagnosis. [ABSTRACT FROM AUTHOR]

Context. – The progress realized in the treatment of sickle cell anemia has resulted to a better and longer life for these patients in developed countries. Ongoing challenge are to manage complication and social living for these patients. The purpose of this study was to determine morbidity, mortality and socioprofessional insertion of homozygous sickle cell patients, followed up in Dakar university hospital.Patients and methods. – We performed a longitudinal and prospective study including 108 homozygous sickle cell anemia patients, whose age were above 20 years, followed in a regular basis (at least 3 times per year), during 5 years on average (3 to 12 years). All patients had a quarterly hematological check-up and a annual statement to detect chronic complications. Clinic and paraclinical data, as information in socioprofessional insertion were noted in medical records for analysis.Results. – Mean age was 27 years (20–51 years). The age between 20–29 years was represented by 67.5%, 26.9% aged 30–39 years and 5.6% were above 40 years of age. Men were slightly predominant with a sex-ratio of 1.25. Concerning morbidity, 96.3% of patients had at least 1 vaso-occlusive crisis per year, 26.9% were transfused and 64.8% had been hospitalized during the follow-up. A chronic complication was found in 49% of patients (53/108). The more frequent of these complications were gall stone (10%), femoral head necrosis (9.2%), priapism (11.6% of men), chronic leg ulceration (4.6%), ophthalmic involvement (3.7%), renal and cardiac complications (2.7% for each one). The presence of complications was not significantly influenced by patient’s sex. Five patients died during a mean follow-up of 5 years. Concerning school attendance, 13% reach university level whereas 47% stop their education on the secondary level and 40% on primary level. Professionally, 36.2% of patients had no exercise any activity.Conclusion. – Our results emphasize that life expectancy can be prolonged in sickle cell anemia patients in Africa, when they have a benefit of a regular follow-up. We show also the respective frequency of chronic complications and then, the necessity of multidisciplinary teams to optimize the take care of sickle cell anemia patients in Africa. [Copyright &y& Elsevier]

Reliability studies are fundamental to optimize the use of new emerging technologies such as AlGaN/GaN HEMTs. This paper reports a reliability study on two power amplifiers using AlGaN/GaN HEMT in real operating conditions for radar applications. Three pulsed-RF long aging tests (8000 h/11,000 h total) are performed under different conditions of (V ds), Temperature, gain compression and Duty cycle. A following of various degradation indicators during the aging tests is presented (P out , I ds , I gs , R ds (on) , G m and V th). This study will contribute to establish a new reliability prediction model of GaN devices and update the FIDES guide. • This paper reports a reliability study on two power amplifiers using AlGaN/GaN HEMT in real radar operating conditions. • This paper presents the main results of three pulsed-RF long ageing tests (8000h/11000h total). • A following of various degradation indicators during the ageing tests is presented (Pout, Ids, Igs, Rds(on), Gm and Vth). • This study will contribute to establish a new reliability prediction model of GaN devices and update the FIDES guide. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to precise the role of thoracic CT angiography in the diagnosis of pulmonary embolism in our practice. Patients and methods: We conduct a prospective eight (8) month study in the radiology department of the Teaching Hospital of Point "G" Seventy seven patients suspected of pulmonary embolism were included. A thoracic CT angiography was performed in emergency after chest X ray for each patient. Pulmonary embolisms were classified according to the Qanadli index. Results: The average age of our patients was 52 years old (23 - 85 years). The age group 55-64 was predominant. The clinical probability was low, medium and high respectively in 8,9%, 28,9% and 62,33%. Chest X ray was suspect of embolism in 92,2% (71/77%), thoracic CT angiography was positive in 58,44% (45/77). Embolism was located in a lobar pulmonary artery in 57,78% and the right side was the most concerned. Among the cardiopulmonary consequences, dilatation of the trunk of the pulmonary artery predominated in 42,22% of cases. According to Qanadli index, the severity of pulmonary embolism was moderate (53;33%), severe (35,56%), and massive (11,11%). Conclusion: CT angiography is in our practice, the best choice in the diagnosis of pulmonary embolism. It allows to confirm the diagnosis, and to precise the topography of pulmonary embolism. In addition, this examination makes it possible the severity specification of the affection. [ABSTRACT FROM AUTHOR]

Introduction La maladie de Charcot-Marie-Tooth est une neuropathie périphérique héréditaire rare, qui se manifeste dès l’enfance ou à l’âge adulte. Elle représente un groupe de maladies cliniquement et génétiquement hétérogènes, caractérisées par une atteinte des nerfs périphériques des membres supérieurs et inférieurs. Il s’agit d’une affection qui touche les fibres nerveuses ou leur gaine de protection, allant de la moelle épinière aux extrémités des membres. L’évolution est lentement progressive. La prise en charge est basée sur les mesures préventives et les traitements symptomatiques. Observation Nous rapportons l’observation d’un patient âgé de 29 ans qui, présente des troubles de la marche d’installation progressive évoluant depuis l’âge de 15 ans. Ces troubles de la marche sont accompagnés de douleurs, à type de brûlure des extrémités (mains et pieds). Des cas similaires ont été rapportés dans la famille (mère, sœur aînée). L’électroneuromyographie a été réalisée chez le patient, notant une neuropathie sensitivomotrice diffuse avec un ralentissement des vitesses de conduction, et des signes d’atteinte axonale. Le diagnostic de maladie de Charcot-Marie-Tooth a été retenu. La rééducation fonctionnelle a été recommandée, avec le port des chaussures orthopédiques et des orthèses des releveurs de pieds. Conclusion La maladie de Charcot-Marie-Tooth (CMT) représente la cause la plus fréquente des neuropathies périphériques héréditaires. Le développement de la biologie moléculaire en Afrique subsaharienne permettra d’identifier les anomalies génétiques dans ces affections. Dans l’attente d’un traitement curatif disponible dans les prochaines années, un traitement symptomatique est proposé aux patients. La prévention est aussi nécessaire, dans les pays à forte consanguinité. Il faudra donc informer la population sur l’existence de ces affections en vue d’un changement de comportement. [ABSTRACT FROM AUTHOR]

Résumé Introduction Les cardiopathies congénitales de l’adulte regroupent les malformations traitées dans l’enfance qui décompensent secondairement et celles qui, asymptomatiques à la naissance, se révèlent tardivement. Les objectifs de ce travail étaient d’identifier les cardiopathies congénitales de l’adulte dans un service de cardiologie générale du Sénégal et d’étudier les présentations cliniques, les traitements et l’évolution. Méthodologie Nous avons mené une étude transversale, descriptive, portant sur les dossiers de patients âgés d’au moins 16 ans, suivis pour une cardiopathie congénitale dans le service de cardiologie de l’Hôpital Général de Grand-Yoff de Dakar entre mai 2003 et mars 2015. Le diagnostic de la cardiopathie était basé sur l’échocardiographie. Résultats Nous avons colligé 50 dossiers de patients soit une prévalence de 0,75 %, avec une prédominance féminine (64 %). L’âge moyen des patients était de 36,16 ± 18,4 ans (16–79 ans) et 29,76 ± 22,58 ans au moment du diagnostic. La dyspnée était le principal signe révélateur (60 %). Les principales malformations étaient la communication inter-auriculaire (38 %), la sténose pulmonaire (14 %), la communication inter-ventriculaire (12 %) et la persistance du canal artériel (10 %). Selon la classification de Bethesda, la cardiopathie était de complexité simple (42 %), intermédiaire (58 %) ou sévère (10 %). Le traitement était médical chez 43 patients et chirurgical chez 7 patients. Les principales complications étaient l’endocardite infectieuse (10 %), la fibrillation atriale (12 %), l’insuffisance cardiaque (24 %) et l’hypertension artérielle pulmonaire (50 %). Conclusion Les cardiopathies congénitales de l’adulte semblent sous-estimées dans nos régions et la correction chirurgicale y est rare. Il incombe d’assurer une bonne gestion de la transition entre l’âge pédiatrique et adulte. Background Congenital heart diseases in adults include malformations treated in childhood that decompensate secondarily and those asymptomatic at birth, appear later. This study aims to identify congenital heart diseases in adults in general cardiology department of Senegal and to assess clinical presentations, treatment and outcomes. Methods We conducted a cross-sectional and descriptive study based on the records of patients aged at least 16 years and followed for congenital heart disease in the cardiology department of the General Hospital of Grand-Yoff in Dakar between May 2003 and March 2015. Diagnosis of heart disease was based on echocardiography. Results We have registered 50 dossiers of patients equivalent to a prevalence of 0.75%, with a female predominance (64%). The average age of patients was 36.2 ± 18.4 years (16–79 years), and mean age of diagnosis was 29.76 ± 22.58 years. Dyspnea was the main sign (60%). Main malformations were the atrial septal defect (38%), pulmonary stenosis (14%), the ventricular septal defect (12%) and patent ductus arteriosus (10%). According to the classification of Bethesda, heart disease was simple complexity (42%), intermediate (58%) or severe (10%). The treatment was medical in 43 patients and 7 patients had surgical repair. Main complications were infective endocarditis (10%), atrial fibrillation (12%), heart failure (24%) and pulmonary arterial hypertension (50%). Conclusion Congenital heart diseases in adults seem underestimated in our countries. Surgical repair is rare. It is necessary to ensure a good management of the transition between pediatric and adult age. [ABSTRACT FROM AUTHOR]

Introduction La maladie de Rosai-Dorfman (MRD) est une affection rare, dominée par les localisations ganglionnaires [1]. Nous en rapportons trois observations avec atteinte ganglionnaire, dont une à révélation cutanée. Observation Observation 1 : un patient âgé de 27 ans était adressé pour des papulo-nodules cutanés et des adénopathies. Il avait reçu antérieurement 3 cures de chimiothérapie (CHOP) pour un diagnostic erroné de lymphome porté à l’adénogramme. L’évolution était marquée par une exacerbation des lésions cutanées qui a motivé sa consultation dans notre service. À l’admission, il présentait des papulo-nodules cutanés disséminés lupoïdes et asymptomatiques. Ces lésions étaient tumorales et cérébriformes au niveau prétragien et sous mandibulaires. On notait par ailleurs des nodules endonasaux de couleur chaire et des polyadénoadénopathies tumorales sous mandibulaires, cervicales, sus-claviculaires, axillaires, inguinales et un amaigrissement de 7 kg en 7 mois. L’échographie abdomino-pelvienne révélait de multiples adénopathies hilaires rénales, spléniques et latéro-aortiques. L’examen histologique des lésions cutanées mettait en évidence un infiltrat dense, polymorphe, contenant de grands histiocytes à cytoplasme pâle qui phagocytent les lymphocytes (empéripoièse). La biopsie ganglionnaire était en faveur d’une prolifération histiocytaire au sein des sinus lymphoïdes avec empéripoièse. Le diagnostic de MRD à localisation cutanée, ganglionnaire et ORL était retenu. L’évolution était favorable au bout de 6 mois sous prednisone. Observation 2 : une patiente de 18 ans était admise dans notre service pour l’exploration de poly adénopathies non fébriles. Sa symptomatologie évoluait depuis un an et demi et avait nécessité plusieurs consultations et deux biopsies avec immuno-histochimie non contributives. À l’admission, la conscience était claire, les constantes étaient normales et l’état général était conservé. L’examen clinique retrouvait des macro-poly adénopathies chroniques diffuses non compressives et non fistulisées. Le reste de l’examen était normal. Les explorations biologiques montraient une accélération isolée de la vitesse de sédimentation et une hypergammaglobulinémie polyclonale, le reste était sans particularités. Le bilan tuberculeux était négatif. L’imagerie ne révélait pas d’adénopathies profondes. L’histologie sur pièce de biopsie ganglionnaire objectivait une dilatation sinusale avec une prolifération histiocytaire et des images d’empéripoèse. Le diagnostic de MRD était retenu. L’évolution était favorable sous prednisone à 1 mg/kg/j avec adjuvants, puis à doses dégressives avec 2 ans de recul. Observation 3 : une patiente de 40 ans était transférée dans notre service pour des polyadénopathies fébriles, dans un contexte d’altération générale. Ce tableau clinique avait fait suspecter une tuberculose ganglionnaire et un traitement étaient institués depuis trois mois dans l’hôpital de sa localité sans succès. À l’admission, la conscience était claire, les muqueuses pales et la température était à 37,8 °C. L’examen notait des macro-polyadénopathies chroniques diffuses. Le bilan biologique montrait un syndrome inflammatoire. L’imagerie révélait des adénopathies médiastinales, [ABSTRACT FROM AUTHOR]