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The tumor of the orbital region is defined as a progressive and abnormal increase in the volume of the orbit, its contents or as a progressive, abnormal and simultaneous increase in the volume of these two structures, due to an excessive multiplication of tumor cells leading to a exophthalmos. The objective of this work is to study the clinical, paraclinical and therapeutic aspect of this lesion, and to identify the histological type of the tumor. It was Mrs. AD mother of a child, aged 19, with no known medical and surgical history; admitted on September 28, 2022 to the stomatology and maxillofacial surgery department of the Nianankoro Fomba hospital in Ségou for right ocular exophthalmos accompanied by pain and visual disturbance. Surgical treatment consisted of orbital exenteration, avoiding recurrences and postoperative superinfections and restoring the aesthetics of the face. The cytology result of the surgical specimen reveals a moderately differentiated sarcoma. Facial region tumors are lesions that aesthetically affect patients. Their prognosis and therapeutic follow-up after surgery depend on the histological type confirmed by cytological examination of the surgical specimen.

The sharing economy is a business model based on the idea of sharing underutilized resources or assets between individuals, rather than owning them individually. This concept has been widely applied in various industries such as transportation, accommodation, and equipment rental. Sharing economy platforms have disrupted traditional business models by creating new markets and providing greater access to goods and services. The performance of the sharing economy depends on the ability of companies to create trust, facilitate transactions, and ensure the safety and quality of the shared assets. While the sharing economy has brought benefits such as increased efficiency and sustainability, it has also raised concerns about regulation, labor rights, and the concentration of market power in the hands of a few large platforms.

Bone metastasis is frequent in bronchopulmonary cancer. We report a series of 52 patients, and analyze indications and the efficacy of surgery.We retrospectively studied the records of 52 patients operated on for spinal metastases of bronchopulmonary cancer over a 6-year period from January 2009 to December 2014 in the neurosurgery department of the North Hospital of Marseille, France.Mean age was 63.6years; with a sex ratio of 3:1 (M:F). Spinal pain associated with vertebral fracture and spinal cord compression was the most frequent clinical presentation (59.6%). SINS score was≥7 in 78.9% of cases. Karnofski Performance Status was average in 67.4% of cases. Predicted survival beyond 12months was zero according to the modified Tokuhashi score. The surgical indication was essentially palliative. Evolution showed regression of pain in 84.6% of cases, and stabilization and improvement in motor deficit in 80.6%. Median postoperative survival was 16months.Our results highlight the interest of surgery for pain relief, spinal stabilization and improvement in neurological function in patients with spinal metastases of bronchopulmonary cancer, and the unreliability of predictive survival scores.

Proliferating trichilemmal tumor (PTT) is an uncommon lesion that typically occurs on the scalp of older women. The risk factors which have been incriminated in the appearance of tumors of the scalp are: chronic sun exposure, the presence of sebaceous nevi, a history of ionizing radiation, burns, trauma or surgery of the scalp. CT can confirm the cystic and tissue nature of the lesion with the presence of calcifications, signs of locoregional invasion. The diagnosis of certainty is based on the anatomopathological study. The principle of treatment of TTP without the metastasis is a wide surgical excision with a margin of 1 cm in normal tissue. Endocranial extension and distant metastases are obstacles to surgical treatment. We report a rare case of scalp tumors in a hospital setting in a 75-year-old woman.

Resume L’agenesie pulmonaire est une malformation congenitale rare pouvant etre decouverte au decours des infections respiratoires. Un nourrisson de six mois issu d’une grossesse gemellaire est admis pour une detresse respiratoire avec hypoxie et asymetrie de l’auscultation pulmonaire. L’angioscanner thoracique revele une agenesie pulmonaire droite. L’evolution est favorable sous traitement avec neanmoins la persistance d’un stridor explore par une fibroscopie laryngee. Une corticotherapie inhalee au long cours a ete instauree dans le suivi. C’est un diagnostic rare qu’il faut savoir evoquer et qui justifie la realisation d’une radiographie pulmonaire au moindre doute.

Atmospheric stability conditions are known to impact the wind resource and yield assessments. However, they are too barely or not correctly taken into account in the industry due to several reasons such as limitations of commercial software or the relative inertia in updating industrial processes. This paper proposes a simplistic approach to improve wind resource and yield assessment certainty while keeping very similar software and industry processes. Two test cases are considered. First, the wind speed estimates made using a CFD software (Meteodyn 5.3) for different stability classes are compared to measurements obtained on a site with four met masts. Second, the wake losses obtained with a commercial yield assessment solver (WindPRO 3.5) considering different wake decay constant definitions are compared to SCADA data. In both cases, it appears that dividing the timeseries in “stability classes” and using corresponding stability parameters in the CFD and in the wake model parameters enable a reduction of the uncertainty. In the case of the energy estimation compared to SCADA, an improvement of 1.25% is obtained compared to the conventional approach.

Purpose: The purpose of this study was to determine HIV prevalence among participants admitted to the delivery room and recent birth attendants. Materials and Methods: This was a descriptive, cross-sectional, analytical study, with a prospective collection from February 1, 2018 to January 31, 2019 at fousseyni Daou Hospital in Kayes, Mali. Results: During our study period, we recorded 4269 deliveries. HIV-positive patients known before labour accounted for 0.21%. Four hundred and six participants received counselling/testing in the delivery room; of which 36 refused the test: 8.87% and 370 accepted or 91.13%. Thirteen patients tested positive or 3.51%. The 20 - 35 age group was the most represented at 76.92%. Positive patients tested received ARV treatment in the delivery room in 92.31% of cases; and 1 patient or 7.69% did not receive treatment for refusal. Vaginal delivery was the most common at 77%, with caesarean section 23%. Newborns had a good prognosis in their first weeks of life in 85%; fetal lethality was observed in 15% of newborns including 1 case of fresh stillbirth and 1 case of pediatric deaths for neonatal suffering. Conclusion: Counselling and voluntary HIV/AIDS testing during labour and immediate postpartum can detect many pregnant women who escape screening during antenatal consultations.

Secondary hypertrophic osteoarthropathy, or Pierre-Marie Bamberger syndrome, is characterized by the association of digital clubbing, polyarthritis and periostitis affecting the long bones. Most commonly it is a paraneoplastic syndrome associated with lung cancer in 80% of cases. We report the case of a 49-year-old female patient who is actively smoking, one pack per day for 20 years. Seen in consultation for pain and swelling of the hands, elbows, knees, ankles, and feet evolving for about 5 months, associated with a poorly differentiated pulmonary adenocarcinoma. On history, she told us about a weight loss of about 8 kg, no fever, no cough, no family history of inflammatory rheumatism or cancer. Bilateral digital clubbing was noted. The diagnosis was based on imaging and histology. Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and chemo-radiotherapy was started.

Objective: Rheumatologic disorders of chronic inflammatory bowel disease (IBD) and reactive arthritis with a digestive origin are part of the spondyloarthritis family. In black Africa, the prevalence of SpA associated with IBD is not clearly established. Thus the objective of our study was to describe the clinical and radiological characteristics of spondyloarthritis associated with IBD. Patients and Method: We carried out a prospective study in the rheumatology department of CHU Ignace Deen between January and December 2019. The diagnosis of SpA was based on clinical and biological arguments in accordance with the criteria of Amor and ASAS. Results: Fifteen observations of spondyloarthritis associated with IBD were collected in patients mean age 52 years with extremes of 32 and 65 years. 9 (53.33%) were female. Ten patients had Crohn’s disease (CD) and 5 had ulcerative colitis (UC). The mean number of pushes was 2.5 ± 1.2. The average diagnostic time was 46 months. Sacroiliitis was present in 73.3% of cases and the mean mSASSS score at diagnosis was 32.11/72. In total, corticosteroids were used in 9 (60%) of patients, NSAIDs in 26.6% while DMARDs salazopyrine and methotrexate in 33.3% and 20% of patients, respectively. Conclusion: The MICI and SpA association is undoubtedly underestimated in our regions. Better collaboration between rheumatologists and gastroenterologists could facilitate diagnosis and improve care.

Introduction : Les abcès cérébraux peuvent devenir graves s’ils sont non ou insuffisamment traités. La prise en charge inclue le traitement correct de la porte d’entrée. Celle-ci n’est pas toujours retrouvée. Nous rapportons notre expérience sur la prise en charge des abcès cérébraux à porte d’entrée non retrouvée à l’issue duquel nous proposerons un algorithme décisionnel de traitement. Patients et méthode : Il s’agit d’une étude retrospective et descriptive allant de novembre 2014 à décembre 2016. Elle a concerné les patients de tous âges traités dans le service de neurochirurgie du CHU Gabriel Touré pour un abcès cérébral chez qui le foyer initial n’a pas été retrouvé. Les paramètres cliniques, radiologiques et thérapeutiques ont été étudiés. Résultats :Durant notre période d’étude, les abcès cérébraux à point de départ non trouvé ont représenté 33,3% de tous les abcès cérébraux et 63,6% des abcès cérébraux opérés. L’âge moyen des patients était de 45 ans avec un sex ratio de 0,7. Tous nos patients étaient immunocompétents. La fièvre et l’hypertension intracranienne étaient les principaux signes. La lésion était de siège frontal et temporal principalement. Tous les patients ont bénéficié d’une ponction chirurgicale avec drainage d’abcès associé à une triantibiothérapie. L’évolution était défavorable dans 28,6% des cas (recollection d’abcès) et satisfaisante dans 71,4% des cas. La mortalité était nulle. Conclusion : La très bonne évolution clinique et radiologique après le traitement n’est une gage de la guérison d’un abcès du cerveau tant que le foyer infectieux initial n’est retrouvé et convenablement traité

Background: Mainly for economic reasons, histopathologic analysis is not a systematic practice in medical structures in Senegal, and the utility of this exam is being questioned by many authors. The purpose of this paper is to report the results of this exam, in our medical practice and try to determine if this exam should be systematic of kept only for individualized cases. Material and Methods: It was a retrospective study from January 2010 to December 2018, carried out in the Laboratory of Pathology of the Teaching Hospital of Grand Yoff in Dakar. The data were collected from the register of pathologic examinations of the laboratory. Results: We registered 543 results of histopathologic examination of products of conception from the first trimester abortion. The women mean age was 22.4 years ± 6.2 with extremes of 17 and 46 years. The routine histopathologic assessment of products of first- trimester miscarriages highlighted in our study three pathologies: hydatidiform mole (24.7%), infection (4.6%) and ectopic pregnancy (0.09%). Only 11.7% of cases of Hydatidiform mole (HM) were suspected before the histopathologic assessment. In our sample, molar pregnancy seems to be higher in anembryonic conception with a prevalence of 45%. The prevalence of Complete Hydatidiform Mole (CHM) was higher than the one of Partial Hydatidiform Mole (PHM) (14.8% vs. 9.9% of miscarriages). Indeed, both require follow up to prevent or manage at time the occurrence of choriocarcinoma. Conclusion: The results of the histologic analysis after abortion in the first trimester of pregnancy show that this exam should be practiced systematically in routine in our context because of high prevalence of hydatidiform mole.

Introduction: the roots of Leptadenia hastata, (L hastata) are remedies from the Senegalese pharmacopoeia and are as widely used as the leaves. However, few researchers have devoted themselves to their toxicity, unlike the leaves. However, in the traditional pharmacopoeia, the indications for use are very different. The aim of our study was to study the effect of the administration of methanolic extracts of roots of L hastata on renal tissue, using an animal model. Materials and Methods: a cohort of 18 rats was studied with a random distribution of the animals in 3 groups (n = 6). The first group was the control group. The treated groups (Group II and III) received the methanolic extract of L. hastata with an administration of 500 mg / kg / day and 1000 mg / kg / day respectively, for 28 days. Results: The dose of 1000 mg / kg / day was lethal in group III, from the first week in females. Serum creatinine was significantly higher in rats given the root extract. There was kidney damage with vacuolar degeneration starting at 500 mg / kg / day. The lesions were more severe in group III with glomerular involvement characterized by retraction in the renal corpuscles. Conclusion: If the leaves of L hastata seem to be safe for consumption according to the majority of authors in the literature, the roots of this same plant could be harmful. In addition to the lethality observed at the doses tested, the lesions in the renal parenchyma would be dose-dependent.

In the context of highly data-centric applications, close reconciliation of computation and storage should significantly reduce the energy-consuming process of data movement. This letter proposes a computational SRAM (C-SRAM) combining in- and near-memory computing (IMC/NMC) approaches to be used by a scalar processor as an energy-efficient vector processing unit. Parallel computing is thus performed on vectorized integer data on large words using usual logic and arithmetic operators. Furthermore, multiple rows can be advantageously activated simultaneously to increase this parallelism. The proposed C-SRAM is designed with a two-port pushed-rule foundry bitcell, available in most existing design platforms, and an adjustable form factor to facilitate physical implementation in a SoC. The 4-kB C-SRAM testchip of 128-b words manufactured in 22-nm FD-SOI process technology displays a subarray efficiency of 72% as well as an additional computing area of less than 5%. The measurements averaged on 10 dies at 0.85 V and 1 GHz demonstrate an energy efficiency per unit area of 35.6 and 1.48 TOPS/W/mm2 for 8-b additions and multiplications with 3- and 24-ns computing latency, respectively. Compared to a 128-b SIMD processor architecture, up to $2\times $ energy reduction and $1.8\times $ speed-up gains are achievable for a representative set of highly data-centric application kernels.

Tubal ligation is a surgical sterilization procedure that provides permanent and reliable contraception to women. Tubal obstruction is a method of permanent birth control that can be performed after mini-laparotomy under local anesthesia. Objective: To determine the outcome of tubal sterilizations by mini-laparotomy under local anesthesia performed in clients who underwent the surgical operation in the Maternity Ward of Ignace Deen National Hospital. Patients and Methods: The Gynecology and Obstetrics Department of Ignace Deen National Hospital was used as the place for the study. The study involved all the women seeking voluntary surgical contraception. This was a retrospective study of a descriptive type carried out from January 1, 2017 to December 31, 2018. A consent form was filled out and signed by spouses after an interview and a systematically carried out pre-operative clinical and para-clinical assessment. Results: During the study period, 56 tubal ligations were performed i.e. 4.72 percent of all family planning methods. The recruiting for the surgical contraception involved clients whose typical profile is that of women with an average age of 35, mostly housewives (35.71%), major multiparous (69.63%) with 6 living children on average. Married women made up the bulk of the recruiting i.e. 96.44%. Unmarried women made much more use of other methods. Indications of personal convenience were the most frequently encountered common reason. Among medical causes, high blood pressure concerned the majority of cases: 38% of the indications. Surgical contraception in between was more practiced than the post-partum one. The recorded complication was the parietal hematoma due to a lack of hemostasis and it accounted for 1.79% of cases. The progress was uncomplicated in 98.68% of cases. Forty couples (71.42%) expressed their feelings of satisfaction against only 6 cases of regret (10.71%). Conclusion: The surgical contraception has become a requirement for modern couples. Tubal ligation by mini-laparotomy is a simple operation and a harmless method of contraception that allows clients to use permanent contraception. Carried out on an outpatient basis, incidents and accidents are rare and may have psychological repercussions that are difficult to assess. The technical mastery of the gesture helps to minimize these incidents.

AIMS: To update and extend a previous cross-sectional international comparison of glycaemic control in people with type 1 diabetes.METHODS: Data were obtained for 520,392 children and adults with type 1 diabetes from 17 population and five clinic-based data sources in countries or regions between 2016 and 2020. Median HbA1c (IQR) and proportions of individuals with HbA1c < 58 mmol/mol (RESULTS: Median HbA1c varied from 55 to 79 mmol/mol (7.2 to 9.4%) across data sources and age groups so a pooled estimate was deemed inappropriate. OR (95% CI) for HbA1c < 58 mmol/mol (CONCLUSIONS: Glycaemic control of type 1 diabetes continues to vary substantially between age groups and data sources. While some improvement over time has been observed, glycaemic control remains sub-optimal for most people with Type 1 diabetes.

Type 1 diabetes is associated with an increased risk of vascular complications. We aimed to investigate the association between serum and tissue advanced glycation end-products (AGEs) and micro- and macrovascular complications in type 1 diabetes (T1D).We conducted a cross-sectional study on 196 adults with T1D (mean age 44.53 ± 16, mean duration of diabetes 22 ± 12 years, mean HbA1c 8 ± 1.2%). AGEs were measured in blood serum (i.e., carboxymethyllysine (CML), methylglyoxal-hydroimidazolone-1 (MGH1), and pentosidine) and by measurement of skin autofluorescence (SAF). Associations between AGEs levels and vascular complications were analyzed using binary logistic regression. Correlations between AGEs and pulse wave velocity (PWV) were also assessed by linear regressions. Significant differences were set for p values less than 0.05.We found positive associations between different AGEs and vascular complications. SAF was associated with both microangiopathy (retinopathy: OR = 1.92, p = 0.011; neuropathy: OR = 2.02, p = 0.04; any microangiopathy: OR = 2.83, p 0.0001) and macroangiopathy (coronaropathy: OR = 3.11, p = 0.009; any macroangiopathy: OR = 2.78, p = 0.003). For circulating AGEs, pentosidine was significantly associated with coronaropathy (OR = 1.61, p = 0.01) and any macroangiopathy (OR = 1.52, p = 0.005) while MGH1 was associated with nephropathy (OR 1.72, p = 0.03). Furthermore, a significant linear correlation was found between PWV and SAF (r = 0.43, p 0.001), pentosidine (r = 0.28, p 0.001), and MGH1 (r = 0.16, p = 0.031), but not for CML (r = 0.03, p = 0.598).Skin autofluorescence appears to be a useful marker for investigating both micro- and macrovascular complications in T1D. In this study, pentosidine was associated with macroangiopathy and MGH1 with nephropathy among the circulating AGEs. Furthermore, the correlations between PWV and AGEs may suggest their value in early prediction of vascular complications in T1D.

International audience; On-chip memories, and in particular SRAMs, are among the most critical components in terms of data security because they might contain sensitive data such as secret keys. Whenever a tampering event is detected, one should be able to erase efficiently and rapidly the full content of a memory holding such sensitive data, but current solutions based on simple power-off leadto very long erasure times. In this paper, we present a non-invasive design technique based on an innovative mechanism to remove electric charges from SRAM bitcells still powered on, beforerefreshing them with a new content not correlated with the previous one. The particularity of this novel hardware countermeasure is to be natively compatible with any SRAM circuit designed from pushed-rule foundry bitcells. We have designed and characterized an 8kB SRAM in 22nm FD-SOI process technology exploiting the proposed security strategy demonstrating an erase operation accomplished in the nanosecond time scale (versus 295$\mu$s with the conventional power-off solution) at the cost of an additional area of less than 5%. We have also shown that our solution is more efficient than a solution without prior erasure consisting in writing identical data to all memory addresses in a single clock cycle (1 ns). The use of the latter drops the ratio of zeroized addresses at 92%, while increasing the operating energy consumption by 2.1x under nominal operating conditions.

Resume Objectif Decrire les caracteristiques demographiques, cliniques, paracliniques et therapeutiques des patients ayant une dermatite atopique en Afrique sub-saharienne (SSA) et au Maghreb. Methodes Les medecins membres de la Federation Allergologie Internationale travaillant en Afrique sub-saharienne et au Maghreb ont ete invites a participer a cette etude transversale en incluant de facon consecutive les patientsatteints de dermatite atopique (DA) vus dans leurs consultations de septembre 2019 a janvier 2010 (5 mois). Resultats Au total, 69 patients (53,6 % de sexe feminin) ont ete inclus. La proportion des sujets de sexe feminin etait plus elevee chez les sujets inclus en Afrique SSA (69,7 % vs 38,9 %, p = 0,010). L’âge median (IIQ) etait de 8(2–23) ans. Au moins 3 zones corporelles etaient touchees chez 78,3 % des participants (72,7 % en Afrique SSA et 83,3 % au Maghreb). La somnolence diurne excessive a ete rapportee dans 31,9 % des cas. Quarante-huit patients (69,6 %) avaient une autre maladie cutanee associee notamment un prurigo simple (28 cas, 40,6 %) et une dermatite seborrheique (10 cas, 14,5 %). Les autres maladies allergiques les plus frequemment retrouvees chez nos patients etaient la rhinite allergique (55,1 %) et l’asthme (37,7 %). La prevalence de la sensibilisation aux aeroallergenes et aux allergenes alimentaires etait respectivement de 59,5 % et 40,6 %. Une surinfection bacterienne cutanee a ete exclusivement retrouvee chez 27,3 % des sujets africains. Conclusion Les caracteristiques cliniques classiquement decrites ont ete retrouvees avec en particulier une association de la DA avec d’autres maladies allergiques. La frequence de la surinfection bacterienne n’est pas negligeable.

INTRODUCTION : La DCV de la peau est une pratique courante chez les femmes en Afrique Subsaharienne avec une prévalence de 25 à 71%. Les principaux produits utilisés étaient les dermocorticoïdes d’activité très forte, l'hydroquinone et le mercure. Le CSC est très rare chez les patients atteints de phototype VI de Fitzpatrick. Depuis 2000, le premier cas de carcinome épidermoïde associé à une DCV de la peau a été rapporté par Addo à Accra, au Ghana. Nos objectifs étaient de décrire les cas de CSC survenus chez des femmes noires africaines vivant en Afrique Subsaharienne et d'en déterminer les facteurs associés. MATERIELS ET METHODES : Nous avons mené une étude descriptive multicentrique d'Août 2005 à Octobre 2021 au Mali, en Guinée, en Côte d'Ivoire et au Sénégal. Nous avons inclus tous les patients consultant pour un carcinome épidermoïde cutané associé à un blanchiment de la peau. Les données sociodémographiques, cliniques, paracliniques et thérapeutiques ont été enregistrées. RESULTATS : Au total 37 patientes ont été incluses. L'âge variait de 37 à 77 ans. L'hydroquinone topique et les corticoïdes très puissants ont été les principaux produits utilisés sur l'ensemble du corps, pendant une durée moyenne de 20,3 ans. Aucune maladie cutanée pré-néoplasique n'a été retrouvée chez nos patients. Les aspects cliniques des tumeurs étaient les suivants : ulcéro-bourgeonnant, ulcéré et nodulaire. Le délai moyen de développement avant consultation était de 6,75 mois. Les carcinomes épidermoïdes cutanés étaient localisés le plus souvent sur des lésions lichénoïdes ou des lésions ochronotiques exogènes sur les zones photo-exposées : visage, cou ou haut du dos. Un patient présente deux carcinomes épidermoïdes. Les aspects anatomo-pathologiques du carcinome épidermoïde étaient : la forme infiltrante, la forme invasive et le carcinome in situ. De plus, il existait des stigmates d’infection à HPV a l’histopathologie. L’exposition aux UV, l'immunosuppression et l'inflammation chronique sont certainement les principaux facteurs associés. Le facteur supplémentaire serait le virus HPV qui est oncogène. L'évolution était favorable chez la majorité des patients après résection chirurgicale. Quatre décès sont survenus. CONCLUSION : De 2000 à 2021, 37 cas de carcinomes épidermoïdes cutanés associés à l'utilisation cosmétique de produits de blanchiment ont été rapportés dans quatre pays d'Afrique Subsaharienne. Le mécanisme n'a pas été complètement élucidé et d'autres études sont nécessaires. Ces observations fournissent un argument supplémentaire pour lutter contre cette pratique et inclure le blanchiment de la peau parmi les facteurs de risque connus du carcinome épidermoïde.

INTRODUCTION : Le cancer de l’ovaire est un cancer dont la prise en charge est obligatoirement chirurgicale et la laparotomie est la voie d’abord par excellence. L’endoscopie planifiée dans la stratégie thérapeutique est d’un apport indéniable non seulement dans la confirmation diagnostique, mais également dans la décision opératoire d’emblée ou intervallaire. MATERIELS ET METHODES : Il s’agissait d’une collecte prospective et descriptive sur une période de six ans au Centre Hospitalier National de Pikine. Elle regroupe 53 cas de cancers avancés de l’ovaire ayant bénéficié d’un traitement chimiothérapique et ou d’une chirurgie cytoréductrice. Ont été incluses toutes les patientes ayant une tumeur de l’ovaire aux stades avancés (III et IV de la FIGO). Ainsi, toutes les patientes avaient bénéficié d’une cœlioscopie première, pour établir un diagnostic histologique et de décider de la stratégie finale de pris en charge. RESULTATS : L’âge moyen des patientes était de 50 ans avec des extrêmes de 18 et de 75 ans corrélé à un index de masse corporel moyen de 24 kg/m² de surface corporelle. Notre étude portait sur 53 patientes, dont 33 d’entre elles avaient eu à bénéficier d’une chirurgie. Parmi elles, 21 patientes, soit 39,6% étaient classés au stade IIIC de la FIGO. L’évaluation de la carcinose péritonéale était faite en utilisant le score de Fagotti et l’Index de Carcinose Péritonéale (PCI) de Sugarbaker. En se basant sur le score de Fagotti, la chirurgie était possible dans 15% des cas. En ce qui concerne l’index de carcinose péritonéale de Sugarbaker, 17 patientes avaient un score inférieur à huit, alors que six d’entre elles avaient un score supérieur à 18. Dans notre série, la qualité de la chirurgie était évaluée à l’aide de la « completeness cancer resection » (CCR score), ainsi le résidu tumoral était nul dans 90,9% alors que 9,1% avait un résidu tumoral dont la taille était inférieure à 2,5 cm. Dans notre série, huit patientes avaient un score d’Aletti bas, 12 patientes avaient un score d’Aletti intermédiaire alors celui était élevé dans 3% des cas. Parmi les patientes ayant eu une chirurgie complète, 11 étaient classés au stade FIGO IIIC, cinq présentaient un score PCI supérieure ou égale à 18, 10 avaient un score d’Aletti intermédiaire et seules deux avaient un score de Fagotti supérieure ou égale à huit. La cœlioscopie avait permis de prendre une décision jugée acceptable dans tous les cas, soit en chirurgie d’emblée première soit en chirurgie d’intervalle avec un taux de résidu R0 dans plus de 90% des cas. CONCLUSION : La cœlioscopie devient de plus en plus incontournable pour le diagnostic et la décision de résecabilité des patientes au stade avancé du cancer de l’ovaire. En diminuant la morbidité liée à une laparotomie diagnostique elle permet en outre de leur permettre une chimiothérapie néoadjuvante sans délai.

INTRODUCTION : De nombreux facteurs pronostiques ont été décrit pour les cancers de l’œsophage avec des stades différents, en particuliers ceux présentant des métastases ganglionnaires. Notre objectif était d’étudié l'impact des facteurs locaux liés à la tumeur sur le pronostic des patients atteints de carcinomes épidermoïdes de l'œsophage non métastatiques. MATERIELS ET METHODES : Nous avons revu rétrospectivement les données de 278 patients consécutifs atteints de carcinomes épidermoïdes de l'œsophage entre Janvier 2009 et Décembre 2016. Les facteurs pronostiques tels que le volume du GTV, le diamètre maximal du GTV et la longueur du GTV ont été analysés. RESULTATS : Les résultats de l'analyse de la courbe ROC ont montré que la valeur critique pronostique du volume du GTV, du diamètre maximal du GTV, de la longueur du GTV et de la longueur du transit baryté étaient respectivement de 27,98 cm3, 1,80 cm et 5,85 cm et 4,25 cm. L'analyse univariée a montré que le volume du GTV (p=0,0184), le diamètre maximal du GTV (p=0,0246), la longueur du GTV (p=0,0035) et la longueur du transit baryté (p=0,0004) étaient les facteurs pronostiques de survie. La longueur du transit baryté (p=0,0149) était le seul facteur pronostique du contrôle local. L'analyse multivariée a montré que la longueur du transit baryté (p=0,0013), le diamètre maximal du GTV (p=0,0047) et la longueur du GTV (p=0,0032) étaient les facteurs pronostiques indépendants associés à la survie. La longueur du transit baryté (p=0,0037) était le facteur pronostique indépendant pour le contrôle local. CONCLUSION : La longueur de la lésion œsophagienne était le principal facteur pronostique lié aux patients atteints de carcinomes épidermoïdes de l'œsophage non métastatiques, par conséquent, nous suggérons que les médecins accordent suffisamment d'attention et un traitement actif aux patients avec un long transit baryté.

INTRODUCTION : Evaluer les délais des différentes étapes du parcours de soins jusqu’à l’accès au traitement initial des cancers du sein suivis à l’Unité de Sénologie du Centre Hospitalo-Universitaire (CHU) Aristide le Dantec de Dakar. MATERIELS ET METHODES : Il s’agissait d’une étude descriptive, rétrospective et analytique portant sur les patients dont le diagnostic de cancer du sein était confirmé et suivis à l’Unité de Sénologie du CHU Aristide le Dantec de Dakar. Durant une période de trois ans, allant du 1er Janvier 2013 au 31 Décembre 2015, nous avons étudié pour tous les patients, le délai de chaque étape du parcours diagnostique et thérapeutique et l'évolution de la maladie avec un recul minimal de cinq ans au 31 Décembre 2020. RESULTATS : Cent soixante-dix-huit patients étaient inclus dans cette étude. Le délai moyen d’accès à l’Unité de Sénologie depuis les premiers symptômes du cancer était de 10,6 mois avec des extrêmes de sept jours et 121,7 mois ; celui de la confirmation du diagnostic après le premier contact était de 36,1 jours avec un minimum d’un jour et un maximum de 34,3 mois. Après le diagnostic, le délai moyen de l'évaluation en vue d'une décision du traitement initial était de 23,3 jours (d’un jour à 28,3 mois) et celui de la mise en œuvre effective du traitement initial était de 7,3 jours avec des extrêmes d’un jour à 87 jours ; après décision. En somme, le délai global d’accès au traitement initial d’un cancer du sein depuis les premiers symptômes jusqu'au premier acte thérapeutique était en moyenne de 13,2 mois (de 47 jours à 122 mois). L’impact pronostique de ces retards de prise en charge se résume en un taux de décès de 55,1% ; tous stades confondus, avec une survie à cinq ans qui ne dépasse guère 35,6%. CONCLUSION : Ces résultats montrent que les efforts devront surtout porter sur la première étape (accès à l’Unité) ; au niveau communautaire, en réduisant les facteurs limitant la prise de décision de consulter. Ensuite, une fois le premier contact établi, l’accent doit être mis sur l’amélioration de l’accessibilité (géographique et financière) et sur la disponibilité et la fonctionnalité des services d’aide au diagnostic y compris l’évaluation pré-thérapeutique.

Malaria is one of the most dangerous and deadly tropical disease in Africa affecting millions of individuals yearly. It is a major global public health problem, with an alarming spread of parasite resistance to the ACTs drugs. This situation explain the urge to discover new antimalarial compounds. Indigenous species to Africa and traditionally used for years by traditional healers, Artemisia afra is a big source for new antimalarial drugs. Aerial parts of Artemisia afra plant collected from South Africa, Kenya, Tanzania, Burundi and Senegal were each extracted with solvents of different polarity (hexane, dichloromethane, ethanol, and water), and the different extracts were then screened and compared for their antimalarial activities against two Plasmodium falciparum strains W2 (CQ resistant) and D6 (CQ sensitive); and also compared for their total phenols, flavonoids content and antioxidant activities. Phytochemical screening of the extracts revealed the presence of terpenoids, alkaloids, tannins, saponins and cardiac glycosides. Ethanolic extract of Artemisia afra collected from Burundi was found to have the highest concentration of phenols (606.9449 mg GAE/g of extract) and flavonoids (242.4745 mg Rutin/g of extract) and also exhibited the highest antioxidant activity (IC50 = 3.12 μg/mL) compare to the others. Total phenols and total flavonoids were found to correlate with the antioxidant activity. Artemisia afra collected from Burundi also showed the highest antimalarial activity compare to the other extracts, the hexane extract of A. afra from Burundi have the highest (IC50 = 0.71μ g/ml for W2 and IC50 = 3.18 μg/ml for D6); following by the ethanolic extract (IC50 = 2.66 μg/ml for W2 and 7.84 μg/ml for D6; then the dichloromethane extract (IC50 = 3.04 μg/ml for W2 and IC50 = 7.92 μg/ml for D6). Comparison of the five A. afra plants collected from South Africa, Kenya, Tanzania, Burundi and Senegal showed that the extracts from Burundi had the highest total content of phenols and flavonoids and also the highest level of antimalarial activity compared to the other plant extracts.

Purpose: The objective of this work was to describe different presentations of peritoneal tuberculosis on ultrasound. Materials and methods: This was a retrospective study conducted between 2008 and 2016 at the Main Hospital in Dakar, and including 38 cases of peritoneal tuberculosis. The tests were performed on Philips Envisor and Hitachi Preirus with 10 and 12 MHz linear transducers. The mean age was 26 years and the sex ratio was 0.8. The diagnosis of peritoneal tuberculosis was based on histological evidence (17 cases), isolation of BK from sputum (5 cases), positive adenosine deaminase in ascites fluid (4 cases) or a favorable clinical course after trial antituberculosis treatment (4 cases). The structures studied were the parietal peritoneum, the mesentery, the large omentum, as well as the characteristics of ascites, and extra-peritoneal lesions. Results: Parietal peritoneal involvement was found in 89.4% of patients, including regular diffuse hypoechoic thickening in 70.5% and nodular thickening in 11.7%. Ascites was present in 84.2% of patients. The great omentum showed anomalies in 73.6% of cases in relation to 3 aspects: trilamellar thickening made up of a thick, hyperechoic central layer surrounded by 2 thin peripheral hypoechoic layers in 46.4% of cases; a single-layer hyperechoic thickening in 21.4% of cases; heterogeneous hyperechogenic thickening with hypoechoic nodules in 32.1% of cases. Mesentery abnormalities were noted in 63.1% of patients with hypoechoic thickening. Conclusion: Ultrasound with the advantage of safety and accessibility is a reliable technique for the diagnosis of peritoneal tuberculosis. In some cases, it allows for a guided percutaneous biopsy to avoid the use of laparoscopy. Purpose: The objective of this work was to describe different presentations of peritoneal tuberculosis on ultrasound. Materials and methods: This was a retrospective study conducted between 2008 and 2016 at the Main Hospital in Dakar, and including 38 cases of peritoneal tuberculosis. The tests were performed on Philips Envisor and Hitachi Preirus with 10 and 12 MHz linear transducers. The mean age was 26 years and the sex ratio was 0.8. The diagnosis of peritoneal tuberculosis was based on histological evidence (17 cases), isolation of BK from sputum (5 cases), positive adenosine deaminase in ascites fluid (4 cases) or a favorable clinical course after trial antituberculosis treatment (4 cases). The structures studied were the parietal peritoneum, the mesentery, the large omentum, as well as the characteristics of ascites, and extra-peritoneal lesions. Results: Parietal peritoneal involvement was found in 89.4% of patients, including regular diffuse hypoechoic thickening in 70.5% and nodular thickening in 11.7%. Ascites was present in 84.2% of patients. The great omentum showed anomalies in 73.6% of cases in relation to 3 aspects: trilamellar thickening made up of a thick, hyperechoic central layer surrounded by 2 thin peripheral hypoechoic layers in 46.4% of cases; a single-layer hyperechoic thickening in 21.4% of cases; heterogeneous hyperechogenic thickening with hypoechoic nodules in 32.1% of cases. Mesentery abnormalities were noted in 63.1% of patients with hypoechoic thickening. Conclusion: Ultrasound with the advantage of safety and accessibility is a reliable technique for the diagnosis of peritoneal tuberculosis. In some cases, it allows for a guided percutaneous biopsy to avoid the use of laparoscopy.

An accelerating Brewer–Dobson circulation (BDC) is a robust signal of climate change in model predictions but has been questioned by trace gas observations. We analyse the stratospheric mean age of air and the full age spectrum as measures for the BDC and its trend. Age of air is calculated using the Chemical Lagrangian Model of the Stratosphere (CLaMS) driven by ERA-Interim, JRA-55 and MERRA-2 reanalysis data to assess the robustness of the representation of the BDC in current generation meteorological reanalyses. We find that the climatological mean age significantly depends on the reanalysis, with JRA-55 showing the youngest and MERRA-2 the oldest mean age. Consideration of the age spectrum indicates that the older air for MERRA-2 is related to a stronger spectrum tail, which is likely associated with weaker tropical upwelling and stronger recirculation. Seasonality of stratospheric transport is robustly represented in reanalyses, with similar mean age variations and age spectrum peaks. Long-term changes from 1989 to 2015 turn out to be similar for the reanalyses with mainly decreasing mean age accompanied by a shift of the age spectrum peak towards shorter transit times, resembling the forced response in climate model simulations to increasing greenhouse gas concentrations. For the shorter periods, 1989–2001 and 2002–2015, the age of air changes are less robust. Only ERA-Interim shows the hemispheric dipole pattern in age changes from 2002 to 2015 as viewed by recent satellite observations. Consequently, the representation of decadal variability of the BDC in current generation reanalyses appears less robust and is a major uncertainty of modelling the BDC.

Objectifs : Déterminer la séroprévalence des infections transmissibles par transfusion de produits sanguin labiles chez les donneurs de sang à l'hôpital Nianankoro Fomba de Ségou. Patients et Méthodes : Il s'agissait d'une étude rétrospective, descriptive effectuée chez les donneurs de sang de Janvier à Décembre 2016 à l'unité de la banque de sang de l'hôpital Nianankoro Fomba de Ségou. Les tests rapides ont été utilisés pour le dépistage des infections recommandées par l'OMS. Résultats : 3941 donneurs ont été colligés. L'âge moyen était de 31,21± 8,7 ans (Extrêmes : 18-60 ans). Le sex- ratio M/F était de 15,63. Les donneurs familiaux et les nouveaux donneurs de sang prédominaient avec respectivement 91,4% et 81%. La séroprévalence du VIH, de l'hépatite B, de l'hépatite C, et de la syphilis était respectivement de 5,30% ; 11% ; 2,40% et 5,40%. La séroprévalence du VIH, de l'hépatite B, de l'hépatite C et de la Syphilis était plus élevée chez les primo-donneurs de sang avec respectivement ; 4,62%, 9,69%, 2,11% et 4,69%. Conclusions : La séroprévalence du VIH, de l'hépatite B, de l'hépatite C et la syphilis est élevée chez les donneurs familiaux et les primo- donneurs d'où l'importance de fidéliser les donneurs bénévoles de sang

Thymic epithelial tumors (TET) are rare lesions. The brain metastases of these tumors are even rarer. We report a case of brain metastases in a known patient with a thymic carcinoma diagnosed in October 2016. She was a 73-year-old woman who presented with headache, nausea, and right hemiplegia. Brain MRI revealed five lesions (1 insular, 1 frontal and 2 left temporal, 1 right parafalcine). These lesions were initially treated using two stereotactic radiosurgery gamma knives. A macroscopically complete excision of the left frontal lesion was subsequently performed without any complications with a good evolution of the neurological symptoms postoperatively. Immunohistochemical examination was compatible with metastatic thymic carcinoma. The patient died 14 months after the initial diagnosis. A review of the literature in English has reported another 45 TET cases with brain metastases.

OBJECTIVE To determine the epidemiological and etiological profile of tinea capitis in adults in Dakar (Senegal). PATIENTS AND METHODS A 9-month prospective, multicenter, descriptive and analytic study. Patients included were aged over 18 years. Mycological tests were used to confirm the diagnosis. RESULTS 121 patients were included with a mean age of 36.1 years and a hospitalisation frequency of 0.8%. The age range of 64.4% of patients was between19 and 38 years. 51% of patients were housewives. A low socioeconomic level was found in 72.8% of cases. In 3.3% of patients, the disease began in childhood. 31.4% of patients had already consulted a traditional healer. Similar familial cases were noted in 60.3% of patients. Contact with a sheep was noted in 32.2% of cases, deliberate skin lightening in 64% of women, hair salon attendance in 46.7% of women, and immunosuppression in 17.3% of patients, while itching was present in 95.5%. Dermatologic examination showed scaled plaques and a diffuse form, with 92.6% and 64% (n=75) respectively. Wood's light examination was positive in 40.2% of patients. A positive culture test was found in 71%. The most frequently encountered species were: T. soudanense (65%), M. audouinii (21%), T. rubrum (4.7%), M. gypseum (3.5%), T. violaceum (2.3%), T. verrucosum (2.3%) and M. canis (1 case). The clinical course was favorable under treatment with griseofulvin or terbinafine. CONCLUSION Tinea capitis in adults mainly affects young women. The diffuse form is the most common. The most frequently encountered species was T. soudanense.

Objective: To evaluate the clinical and therapeutic aspects of male subfertility in the Region of Thies. Patients and methods: This is a retrospective and analytical study involving patients followed for subfertility over a period of 4 years from January 2013 to November 2017 at the level of 3 health structures in the region of Thies. Results: During the period, we collected 201 patients. The average age was 38 ± 8.4 years with a greater distribution in the age group 30-39 years. Primary subfertility was predominant with 81.1% of cases. The average duration was 5 years. We found a history of urethritis (4%) and orchiepididymitis (2.5%). Thirty-three percent of patients presented a varicocele (67 cases). Cryptorchidism was recorded in 2% of cases, testicular hypotrophy in 18.4% and testicular atrophy in 1.5%. The spermogram identified oligospermia-like abnormalities in 40.8% of cases, azoospermia 22.4%, and hypospermia 4%. For the qualitative abnormalities, we recorded cases of asthenospermia in 60.2% of the cases or 121 patients, a necrospermia 58.2% and a teratospermia 20.4%. A combination of these abnormalities was also reported as astheno-necrospermia in 19.4% of cases, oligo-astheno-necrospermia 14.4%, oligo-asthenotera-necrospermia 10% and oligo astero-teratospermia in 2.5%. An assessment of FSH, LH and testosterone was performed in 5.9% of the cases, or 12 patients. Varicocelectomy was performed in 68.4% of cases 19 patients, and (medically) assisted procreation in 2 patients. We recorded 13 cases of pregnancy. Conclusion: Male hypofertility is a real problem of management, and requires a particular approach.

Introduction: Ventriculomegaly is one of the most common abnormalities detected by prenatal ultrasound. This entity can be associated with brain abnormalities and other malformations. In order to perform a good prenatal counseling, the diagnosis is essential. Objective: Our purpose was to report the management of 3 cases of ventriculomegaly in our practice and underline the benefits of the neuropathologic exam. Methods: We analyzed retrospectively 3 medical files concerning fetus that were diagnosed as having one or two ventricles of >10 mm and a follow up for prenatal diagnosis. Results: All cases were diagnosed between 22 and 27 weeks of gestation by an ultrasound. In a case, the ventriculomegaly evolved rapidly to a hydrocephalus. In two cases, the pregnancy was terminated with medical interruption by the parent’s request. Amniocentesis confirmed the diagnosis of congenital toxoplasmosis in case 2 there were no chromosomal abnormalities after karyotyping. Causes included holoprosencephaly, congenital toxoplasmosis and mesencephalosynapsis. Conclusion: Ultrasonography may detect ventriculomegaly nerverthless in the cases presented, pathology exam was essential to assess the diagnostic. Causes are numerous and prognosis variable. We recommand MRI that is more and more accessible in our regions in the follow up of this entity and neuropathology exam in case of termination of the pregnancy. The establishment of main causes of ventriculomegaly in our regions (infectious causes for example) could help to prevent this outcome in our practice.

Vertebral hemangiomas are benign tumour and are rarely symptomatic. Aggressive forms represent less than 1% of all cases. Medical imaging allows both diagnosis and evaluation of their aggressivity. To assess the role of radiology, embolisation, percutaneous vertebroplasty and surgery in the diagnosis and treatment of vertebral hemangiomas, we report our experience of one patient who had an age of 13 years. She presented with progressive medullary compression and is investigated with CT and MRI. The vertebral hemangioma is located in the lumbar spine at L3. Lumbar CT scan and MRI were done. In the CT scan we noticed L3 vertebral body and posterior arc destruction associated with hind sliding of L2 on L3. These lesions are associated with a significant infiltration of peri-vertebral soft tissues and dural sheath with heterogenous enhancement. The patient has embolised before surgery.

The stratospheric Brewer–Dobson circulation (BDC) determines the transport and atmospheric lifetime of key radiatively active trace gases and further impacts surface climate through downward coupling. Here, we quantify the variability in the lower stratospheric BDC induced by the El Niño–Southern Oscillation (ENSO), using satellite trace gas measurements and simulations with the Lagrangian chemistry transport model, CLaMS, driven by ERA-Interim and JRA-55 reanalyses. We show that despite discrepancies in the deseasonalized ozone (O3) mixing ratios between CLaMS simulations and satellite observations, the patterns of changes in the lower stratospheric O3 anomalies induced by ENSO agree remarkably well over the 2005–2016 period. Particularly during the most recent El Niño in 2015–2016, both satellite observations and CLaMS simulations show the largest negative tropical O3 anomaly in the record. Regression analysis of different metrics of the BDC strength, including mean age of air, vertical velocity, residual circulation, and age spectrum, shows clear evidence of structural changes in the BDC in the lower stratosphere induced by El Niño, consistent with observed O3 anomalies. These structural changes during El Niño include a weakening of the transition branch of the BDC between about 370 and 420 K (∼100–70 hPa) and equatorward of about 60∘ and a strengthening of the shallow branch at the same latitudes and between about 420 and 500 K (∼70–30 hPa). The slowdown of the transition branch is due to an upward shift in the dissipation height of the large-scale and gravity waves, while the strengthening of the shallow branch results mainly from enhanced gravity wave breaking in the tropics–subtropics combined with enhanced planetary wave breaking at high latitudes. The strengthening of the shallow branch induces negative tropical O3 anomalies due to enhanced tropical upwelling, while the weakening of the transition branch combined with enhanced downwelling due to the strengthening shallow branch leads to positive O3 anomalies in the extratropical upper troposphere–lower stratosphere (UTLS). Our results suggest that a shift in the ENSO basic state toward more frequent El Niño-like conditions in a warmer future climate will substantially alter UTLS trace gas distributions due to these changes in the vertical structure of the stratospheric circulation.

Tenofovir reduces viral load during viral cirrhosis B and improves prognosis. The aim of this study was to evaluate the effectiveness and safety of Tenofovir during the treatment of viral B cirrhosis. The study was retrospective and prospective on patients with viral B cirrhosis treated with Tenofovir in the Hepato-Gastroenterology Department of University Hospital Gabriel Toure in Bamako (Mali) and evaluated between three and six months after the start of treatment. We included 89 patients. The mean age was 44.5 ± 16 years with extremes of 18 and 90 years. The sex ratio was 1.2. At inclusion all patients had a detectable viral load with an average of 2651.96 ± 1495.85 IU/ml. Follow-up viral load was undetectable in 84.3% with patients between 3 and 6 months of treatment. The average detectable viral load was only 27.04 ± 21.05 IU/ml. There was also an improvement in hepatocellular function and few side effects. Conclusion: This study shows the interest of Tenofovir in the treatment of viral cirrhosis B with very few adverse effects.

Background: Nasosinus mucoceles are expansive pseudocystic formations of the sinuses of the face formed by chronic retention of mucus in a sinus cavity due to ostial obstruction.Methods: This was a descriptive study of retrospective data collection. It was carried out over ten years (from 01 January 2008 to 01 January 2018) at the otorhinolaryngology and head and neck surgery department of the Donka University Hospital. Results: We found an incidence of 1.3 cases per year. The average age was 39.77 years with extremes of 10 years and 60 years. The sex ratio was 0.6. Headaches (92.3%) and facial swelling (76.9%) were the main reasons for consultation. The ethmoid-frontal form was predominant (53.8%). CT scan of the sinuses was performed in all patients. Magnetic resonance imaging was not performed. The diagnosis of certainty was made by anatomy pathology (100%). The paralateral nasal route was the main approach (46.2%). The simple postoperative follow-ups were simple (100%). Lethality was zero. Conclusions: We noted a low incidence of naso-sinus mucoceles in our series. The symptomatology was fairly standard. Imagery and anatomy pathology established the diagnosis. However, endonasal surgery has become essential in the management. Simple postoperative follow-up would be related to the experience of the surgeon, the severity of the lesions and the proper conduct of post-operative care.

Background To determine how clinicians with a DATA waiver to prescribe buprenorphine for opioid use disorder (OUD) adapted during the COVID-19 pandemic to emergency authorities, including use of telehealth to prescribe buprenorphine, the challenges faced by clinicians, and strategies employed by them to manage patients with OUD. Methods From June 23, 2020 to August 19, 2020, we conducted an electronic survey of U.S. DATA-waivered clinicians. Descriptive statistics and multivariable logistic regression were used for analysis. Results Among 10,238 respondents, 68 % were physicians, 25 % nursing-related providers, and 6% physician assistants; 28 % reported never prescribing or not prescribing in the 12 months prior to the survey. Among the 72 % of clinicians who reported past 12-month buprenorphine prescribing (i.e. active practitioners during the pandemic) 30 % reported their practice setting closed to in-person visits during COVID-19; 33 % reported remote prescribing to new patients without an in-person examination. The strongest predictors of remote buprenorphine prescribing to new patients were prescribing buprenorphine to larger numbers of patients in an average month in the past year and closure of the practice setting during the pandemic; previous experience with remote prescribing to established patients prior to COVID-19 also was a significant predictor. Among clinicians prescribing to new patients without an in-person examination, 5.5 % reported difficulties with buprenorphine induction, most commonly withdrawal symptoms. Conclusions Telehealth practices and prescribing to new patients without an in-person examination were adopted by DATA-waivered clinicians during the first six months of COVID-19. Permanent adoption of these authorities may enable expanded access to buprenorphine treatment.

Mosquitoes (Diptera, Culicidae) form a family of insects of considerable public health importance. Mention of their presence/absence was tackled in the literature and by specialized websites for eight African countries: Cape Verde, Mauritania, Senegal, Gambia, Mali, Burkina Faso, Niger and Chad. In total, 216 species have been recorded belonging to 13 genera

Circulating autoantibodies (auto-Abs) neutralizing high concentrations (10 ng/ml; in plasma diluted 1:10) of IFN-α and/or IFN-ω are found in about 10% of patients with critical COVID-19 (coronavirus disease 2019) pneumonia but not in individuals with asymptomatic infections. We detect auto-Abs neutralizing 100-fold lower, more physiological, concentrations of IFN-α and/or IFN-ω (100 pg/ml; in 1:10 dilutions of plasma) in 13.6% of 3595 patients with critical COVID-19, including 21% of 374 patients >80 years, and 6.5% of 522 patients with severe COVID-19. These antibodies are also detected in 18% of the 1124 deceased patients (aged 20 days to 99 years; mean: 70 years). Moreover, another 1.3% of patients with critical COVID-19 and 0.9% of the deceased patients have auto-Abs neutralizing high concentrations of IFN-β. We also show, in a sample of 34,159 uninfected individuals from the general population, that auto-Abs neutralizing high concentrations of IFN-α and/or IFN-ω are present in 0.18% of individuals between 18 and 69 years, 1.1% between 70 and 79 years, and 3.4% >80 years. Moreover, the proportion of individuals carrying auto-Abs neutralizing lower concentrations is greater in a subsample of 10,778 uninfected individuals: 1% of individuals 80 years. By contrast, auto-Abs neutralizing IFN-β do not become more frequent with age. Auto-Abs neutralizing type I IFNs predate SARS-CoV-2 infection and sharply increase in prevalence after the age of 70 years. They account for about 20% of both critical COVID-19 cases in the over 80s and total fatal COVID-19 cases. © 2021 The Authors, some rights reserved.

The purpose of this study was to analyse the socio-anthropological determinants (representations, beliefs, practices and perceptions of health services) of the high prevalence of obstetric fistulas in Guinea.From January 15 to February 15, 2018, we carried out a qualitative study in three health centres (one urban and two rural). The study focused on biological mothers who attended the centres to get vaccinated their children. The data were collected by semi-structured individual interview.None of the 42 respondents could link the occurrence of obstetric fistulas and obstructed labour. Participants at all three study sites believed that obstructed labour and obstetric fistula have a mystical origin. In Kissidougou, the respondents thought that obstructed labour and obstetric fistulas are caused either byRespondents' cultural beliefs and practices regarding childbirth limit women's attendance at maternity hospitals during childbirth and favour obstetric fistulas.

Summary Pathological conditions of the falciform ligament are rare, one of which is the twisting of a fatty fringe that can lead to fatty infarction of the peritoneal fat. To our knowledge, only 21 cases with radiological documentation have been published in the literature. Ultrasound and computed tomography facilitated prompt diagnosis of this rare finding. The condition is best managed conservatively, but sometimes, a surgical intervention is necessary. We report herein a case of torsion of fatty falciform ligament appendage in a 73-year old female.

Introduction Coronavirus is a virus with potential to target the nervous and respiratory systems. The aim of this work is to establish the prevalence of strokes in COVID19 positive patients in Guinea. Methods All patients with stroke confirmed by brain imaging and COVID-positive PCR were included in this study. Retrospective patient data were obtained from medical records. Informed consent was obtained. Results The RT-PCR confirmed the initial diagnosis and the chest CT scan provided a good diagnostic orientation. Brain imaging identified ischemic brain lesions. We report the case of four patients with stroke and a COVID-19 incidental finding in Guinea. Conclusion This work shows that the onset of ischemic stroke associated with COVID-19 is generally delayed, but can occur both early and late in the course of the disease. More attention is needed because the early symptoms of viral attack are not just pulmonary.