Search

Ngari virus is a mosquito-borne virus belonging to the genus Orthobunyavirus (Peribunyaviridae family). This virus is pathogenic to humans and causes severe illness. Ngari virus is present in several African countries, including Madagascar. Here, we report the detection of Ngari virus in ixodid ticks collected from cows in Guinea. A tick survey was conducted in March-November of 2018 in six regions of Guinea. The sample comprised 710 pools, with a total of 2067 ticks belonging to five species collected from 197 cows. At the initial stage, we screened a subsample of tick pools of vector-borne viruses with a multiplex genus-specific primer panel. In the second stage of the study, we narrowed the search and screened all the samples by qPCR for the detection of Ngari virus. All positive samples were sequenced with primers flanking Ngari virus-specific fragments on the S and M segments. We found Ngari virus in 12 pools that were formed from engorged ticks collected from livestock in three villages of the Kindia and Kankan regions. Sequencing of the S and M segments confirmed that the detected viruses belong to Ngari virus, and the viruses were most similar to the strain Adrar, which was isolated in Mauritania. We detected viral RNA in ticks of the following species: Amblyomma variegatum, Rhipicephalus geigyi, and Rh. (Boophilus) spp. There is no evidence that ixodid ticks are competent vectors of the Ngari virus. Most likely, the ticks obtained the virus through blood from an infected host. The study of engorged ticks can be recommended as a simpler approach for the wide screening of the Ngari virus and subsequent testing of cattle and mosquitos in those locations where the PCR-positive ticks were collected.

Introduction/Background Severe Traumatic Brain Injury (TBI) is the main cause of children mortality and disability in developed countries. Among cognitive sequelae, memory impairment is frequent and impacts everyday functioning and academic achievement. The aims of this study were: (1) to measure memory functioning in children who sustained a severe TBI, and performance's evolution over time; (2) to assess factors associated to memory function and recovery. Material and method In the TGE (Traumatisme crânien grave de l’enfant) cohort, a prospective longitudinal study, 65 children aged 0 to 15 years old who sustained a severe TBI were included. Memory function was assessed using the Children's Memory Scale (CMS) at 3, 12 and 24 months post-injury. Results Memory was assessed in 46 children aged 5–15 years. Significant memory impairment was found at 3months post-injury (mean general memory (GENM) score = 89.1, SD = 20.5). Significant improvement was found at 24 months, but less so for verbal, learning and attention/concentration abilities. At 3 and 24 months post-injury, GENM score was significantly correlated to TBI severity indices (length of coma, Pediatric Traumatic Scale and Injury Severity Score). It was strongly correlated to full-scale intellectual quotient at each time point. Female gender was associated with worse memory impairment, whereas age at injury and socio-economic status were not. Furthermore, presence of motor impairment (MI) was correlated with worse memory recovery, probably as a marker of injury severity. Finally, the GENM score was significantly correlated with less favorable educational outcome. Conclusion Memory functioning is significantly impaired following severe TBI; it is mostly influenced by initial TBI severity and strongly impacts educational outcome. Those patients should benefit from long-term follow-up post injury.

UNLABELLED Constraint-induced movement therapy is a promising technique for improving upper limb function in adults with hemiplegia. It involves restraint of the non-involved limb and intensive movement practice with the paretic limb. Although the technique has been applied successfully to children with cerebral palsy, only two studies have used it in children with acquired brain injury. OBJECTIVE To assess the feasibility and efficacy of constraint-induced movement therapy in children with acquired brain injury. METHODS We used a single-subject experimental design in three children (aged five at the time of the intervention) with hemiplegia in the chronic phase following acquired brain injury. The intervention involved restraint of the unaffected arm with a Mayo Clinic elbow brace for seven hours a day in a hospital setting, together with three hours a day of physical and occupational therapy rehabilitation for five days a week for two weeks. The children were assessed twice at baseline and then once immediately post-treatment and again two months post-treatment. Assessment included a range of timed, quantitative measures of upper limb use, assessment of unilateral spatial neglect and qualitative assessment by therapists and parents in terms of activities of daily living. RESULTS The three children completed the full protocol and improved significantly in all timed, quantitative tests of motor function. These improvements were partially maintained at two months. No improvement in unilateral spatial neglect was found in the paper-and-pencil tasks, although less spatial neglect was observed in activities of daily living such as eating and walking. CONCLUSION Constraint-induced movement therapy appears to be both feasible and efficient in children with acquired brain injury.

IntroductionThe GOS-E Pediatric version allows measuring overall outcome in children and adolescents following ABI. Scores range from 1: upper good recovery, to 7: vegetative state.ObjectivesTo validate the French translation of the GOS-E Peds in children with (ABI) of various severity and stages post-injury.MethodsThe GOS-E Peds was used in a PMR department devoted to children with ABI, in three groups of patients: (1) patients shortly hospitalised post-ABI: GOS-E Peds was rated upon admission, at 3 and 6 months post-injury; (2) patients several years post-injury, requiring services of a multi-disciplinary outreach team; (3) patients followed-up on simple medical clinics. The type and severity of ABI were collected.Results398 patients were included [2/3 boys; mean age at injury 6 years (SD=4)]. In group 1 (n=124), mean (SD) GOS-E Peds scores were 5.9(.77) upon admission, 5.12(1.2) at 3 months (n=99) and 4.88(1.45) at 6 months (n=83); scores were significantly worse in case of hemiplegia (66%). GOS-E Peds improved over time (0–3 months P

Resume Le syndrome du bebe secoue (SBS) est un traumatisme crânioencephalique secondaire a un acte violent de secouement de la part d’un adulte envers un nourrisson. Les criteres diagnostiques du SBS ont ete recemment valides par la Haute Autorite de sante. La mortalite globale apres un SBS est en moyenne de 21,6 % et l’evolution a long terme n’est jugee favorable que pour 8 a 36 % des patients suivis plus de cinq ans en moyenne. Cet article decrit les sequelles, leurs mecanismes et les facteurs pronostiques ainsi que des pistes pour l’amelioration de la prise en charge des patients a long terme.

Objective Childhood traumatic brain injury (TBI) is a leading cause of death and lifelong acquired disability. The aim of this study was to prospectively study intellectual ability following childhood severe TBI over 7–8 years post-injury, and factors influencing outcome and change over time. Material/patients and methods Children (0–15 years) consecutively admitted in a single trauma center for severe non-inflicted TBI over a 3-year period were included in a prospective longitudinal study. Assessment was conducted at 3, 12 and 24 months, and at 7–8 years using age appropriate Wechsler Intelligence Scales. For the 7–8-year follow-up, one third of the group was aged 18 years or more, and a group of matched controls was included. SES was assessed by parents’ education. Results Sixty-five of the 81 included children survived (66% boys). After a mean delay post-injury of 7.6 years (SD = 1.5), 39 patients (60%) participated in the study [mean age at injury 7.6 years (SD = 4.72; n = 15; ≥ 6 years, n = 23); median initial Glasgow Coma Scale (GCS) score: 6; mean coma duration: 6 days (SD = 4.8)]. Participants and non-participants did not differ in terms of demographic and severity factors, or initial full scale IQ (FSIQ). For 36% of the sample, at least one parent had graduated from high school. At the 7–8 year follow-up, mean FSIQ in the TBI group was significantly lower than in the control group (86.4; SD = 18 versus 97.2; SD = 11.2; P = 0.016), with no significant change over time when compared with initial FSIQ (3 months post-injury; 85.2; SD = 18). In multivariate analysis, FSIQ was predicted mainly by parental SES ( P = 0.031), with a marginal effect of length of coma ( P = 0.079) and no effect of age at injury, initial GCS or intracranial hypertension. Discussion–conclusion Severe childhood TBI leads to severe and long-standing cognitive impairments, without significant improvement over time. Parental education appears to be the main predictor of cognitive outcome several years post-injury, consistent with previous studies in the literature.

Resume Le syndrome de SAPHO est evoque devant une patiente senegalaise, âgee de 47 ans, presentant une tumefaction du quart interne de la clavicule droite et des antecedents de pustulose palmaire. L’etat general est conserve, la biologie montre un syndrome inflammatoire non specifique (VS acceleree, CRP elevee) et une absence d’hyperleucocytose. L’examen anatomopathologique retrouve un granulome inflammatoire polymorphe avec des cellules mononucleees et des cellules geantes. La radiologie standard et le scanner ne decelent pas la lesion, alors que la scintigraphie montre dans la region sternoclaviculaire droite une image d’hyperfixation « en cornes de taureau » evocatrice d’un syndrome de SAPHO. Le frequent retard au diagnostic positif, habituellement lie a la meconnaissance du syndrome et a la crainte d’un processus tumoral osseux, est une source majeure de traitements antibiotiques abusifs et/ou de biopsies traumatisantes pour les patients. La scintigraphie osseuse a un role majeur a jouer en orientant le diagnostic lorsqu’elle decouvre des foyers claviculaires et du sternum, elle peut egalement etre utile pour faire le bilan des atteintes et apprecier leur evolutivite.

Introduction Childhood acquired brain injury (ABI) is responsible for severe cognitive and behavioural disorders, sometimes leading to violent and/or offending behaviours. The aim of this study was to review the cases of patients treated in a rehabilitation unit dedicated to children with ABI, who subsequently demonstrated behaviors leading to an intervention of the police and/or the justice, and identify any common characteristics. Methods Retrospective inventory of patients with ABI treated in a single rehabilitation department, who subsequently had contact with the police/justice following offenses. We collected demographic factors, type and severity of ABI, initial neurological examination, first and last neuropsychological assessment, type of schooling pre- and post-injury, and data from their offenses. Results Searches retrieved 40 patients (36 boys): 34 traumatic brain injury (TBI; 27 severe), 4 brain tumours, 1 frontal hemorrhagic stroke and 1 anoxia; mean age at injury was 9.7 years [SD = 4; (2.1–15.7)]. In 88% of cases, none of the parents had graduated from high school. Half of the children had previous school difficulties and 30% had repeated a grade. Overall, children sustained severe injuries, with impaired neurological function, major cognitive deficits [mean initial full-scale IQ 73.1 (SD = 12.8)] without significant improvement [77.4 (SD = 13.4) at the last assessment]. The processing speed index was particularly low [73.2 (±15.4)] and did not improve over time. 76% had behavioural disorders already evident during hospitalization. Upon discharge, 62% required adapted and/or specialized schooling. After an average follow-up of 8 and a half years, only 6 patients still followed an ordinary curriculum and 8 were not attending school anymore. Four girls were victims, and among 36 boys, all were perpetrators, but 3 had been victims previously. The offenses were mainly cases of violence (56%), but also entailed thefts, traffic offences, sexual assaults, drug use and vandalism. Discussion Children with ABI who suffer or commit offenses are mainly boys, from very low socioeconomic background, with pre-injury academic and social difficulties, who sustained severe TBI. They suffer very severe and disabling cognitive deficits and behavioral disorders. Multidisciplinary care and follow-up of those children more at risk is essential in the long-term.

Resume Propos - Reputee frequente chez le sujet âge, de symptomatologie pauvre et masquee, l'hyperthyroidie n'a pas ete etudiee dans la population Noire de plus de 50 ans en milieu africain. Methodes Notre etude a concerne 31 patients sur 300 cas hyperthyroidies repertories. Nous avons analyse la frequence de certains parametres, les caracteristiques demographiques, le motif de consultation, le syndrome de thyrotoxicose, les signes non thyrotoxiques, les manifestations cardiaques, les caracteristiques hormonales et scintigraphiques, l'etiologie de la maladie, les facteurs etiologiques et le traitement. Resultats La frequence de l'hyperthyroidie dans ce type de population etait de 10 %. Le plus grand nombre de cas (20 cas sur 31) a ete observe dans la population des femmes au foyer. Le groupe le plus important (13 cas sur 31) etait d'origine rurale. Trois signes predominaient dans les motifs de consultation : un amaigrissement (23 cas sur 31), une tumeur au niveau cervical (17 cas sur 31) et des palpitations (12 cas sur 31). Les trois signes majeurs suivants ont ete observes dans le syndrome de thyrocoxicose : un amaigrissement (29 cas sur 31), une tachycardie (27 cas sur 31) et des tremblements (22 cas sur 31). Le dosage des hormones thyroidiennes a montre une valeur de 265 ± 74 nmol/L en moyenne pour la thyroxine (T 4 ) et de 6 ± 2 nmol/L pour la tri-iodothyronine (T 3 ); le dosage radio-immunometrique a montre une valeur de la TSH ultrasensible de 0,17 ± 0,23 μlU/mL. Dans le syndrome non thyrotoxique, la protrusion du globe oculaire predominait (25 cas sur 31). Les formes etiologiques comprenaient 25 maladies de Basedow, dont 22 typiques. Les complications cardiaques comprenaient deux fibrillations auriculaires. Aucune forme iatrogene n'a ete constatee. La posologie initiale moyenne de carbimazole etait de 34 ± 8 mg/j. L'evolution s'est averee favorable dans 15 cas sur 23. Conclusion Dans cette serie africaine, l'originalite de nos resultats chez le sujet âge reside moins dans la preponderance du nombre de femmes au foyer de race noire presentant un hyperthyroidisme et dans l'origine rurale des patients que dans l'etiologie basedowienne. Cette derniere notion tient peut-etre a la jeunesse de la population etudiee, en fait reflet de la population generale.

OBJECTIVE: Childhood traumatic brain injury (TBI) is the first cause of death and acquired disability and it represents a major public health issue. Childhood severe TBI can lead to motor, cognitive, behavioural and social cognition deficits, which have consequences on academic achievement, social integration, participation and quality of life. Consequences may only appear after a delay, when the skills are supposed to be fully developed. The aim of this study was to prospectively assess academic outcome, health-related quality of life (HRQoL), amount of ongoing care and participation, following childhood severe traumatic brain injury (TBI) over 7-8years post-injury, in comparison with a matched uninjured control group. MATERIAL/PATIENTS AND METHODS: Sixty-five children, aged 0-15years, consecutively admitted in a single trauma center over a 3-year period for severe non-inflicted TBI were included in a prospective longitudinal study. At 7-8years, they were compared with a matched control group regarding schooling modalities, amount of ongoing care, and standardized questionnaires of HRQoL (PedsQL, including fatigue module), and participation (Child and Adolescent Scale of Participation - CASP). Family socio-economic status (SES) was assessed by parental education level. RESULTS: After a mean delay of 7.7years, 39 patients participated in the study (60% of the initial sample; 66% boys; mean coma duration: 6.6days; SD=4.83; mean age at injury: 7.6years, SD=4.72; mean age at assessment: 15.3years, SD=4.46, range 7.2-22.2), with no significant differences between participants and non-participants regarding demographic and severity factors, or initial intellectual ability). Only 62% of the TBI group was attending mainstream education (as opposed to 100% of controls). The amount of ongoing rehabilitation was high (35.3% speech-language therapy, 26.4% occupational therapy; 17.6% physiotherapy). Self-reported HRQoL was significantly lower in the TBI than in the control group [71.1; 95% IC 64.8-77.5 versus 83.9; 95% IC 79.3-88.4; P=0.0026], including the fatigue module [61.1; 95% IC 54.6-67.5 versus 77.4; 95% IC 71.9-82.8; P=0.0005]. Parent ratings of participation were relatively good but significantly lower than those of controls [86.4; 95% IC 81.4-91.3 versus 96.3; 95% IC 94.6-98.1; P=0.0002]. DISCUSSION-CONCLUSION: Severe childhood TBI leads to severe and long-standing impairments, evident several years post-injury, with consequences on school integration, independence, participation and HRQOL.Copyright © 2016. Published by Elsevier Masson SAS. Language: en

Objective Childhood acquired brain injury (ABI) is the leading cause of acquired disability in childhood, with significant consequences on independence, academic achievement and participation. The “Child and Adolescent Scale of Participation” (CASP; Bedell 2004) has been specifically developed to assess participation following childhood ABI. The aim of this study was to examine the psychometric properties of the French version of the Child and Adolescent Scale of Participation. Material/patients and methods Cross-sectional, monocentric study. The CASP questionnaire was given to 133 caregivers of children or adolescents (5 to 18 years) who were followed-up in a rehabilitation department following ABI. The CASP is comprised of 20 items in 4 subsections: (1) home participation; (2) neighborhood and community participation; (3) school participation; (4) home and community living activities. Parents are asked to rate the 20 items of the CASP using a four-point Likert scale: (4 = aged expected; 3 = somewhat limited; 2 = very limited; 1 = unable), or “not applicable”. Cronbach's alpha and factor analyses were performed to examine the psychometric properties of the French translation of the CASP and correlations of the CASP with demographic and clinical factors were explored. Results Eighty-five parents [(64%response rate; 61% boys; age at onset 5.66 years (SD = 3.9); age at assessment 10.51 years (SD = 3.4)] answered the questionnaire. There was no significant difference between respondents and non-respondents regarding demographic, medical, injury severity or level of neurological or cognitive impairment. Internal consistency was high (Cronbach alpha 0.84). Factor analysis yielded a five-factor structure explaining 88% of the variance. The total score of the CASP was correlated with the mother's education level (P = 0.04), but not with any of the other medical data, such as age at injury, age at assessment, injury severity, clinical condition (presence of hemiplegia, epilepsia, cerebellar signs), intellectual ability or number of ongoing rehabilitation types. Discussion - conclusion Our results confirm the cross-cultural psychometric properties of the French adaptation of the CASP. Interestingly, the CASP was not correlated with any of the clinical factors. Parental ratings of their child's participation probably rely on other factors such as emotional status, coping ability and environmental factors.

botulinum toxin (BT) appears to be a potentiel treatment of sialorrhea for children with CP (Jongerius et al., Eur J Pediatr 2001). Literature on this topic becomes richer but utilisation is not reached by consensus. Objective.– An exhaustive literature review has been realised in order to generate a situational awareness of conditions of use of BT in sialorrhea of children with CP. Method.– Explored databases were Medline, Embase and Cochrane Library. Utilized key words were: ‘‘sialorrhea’’, ‘‘drooling’’, ‘‘children’’ and ‘‘botulinum toxin’’. Only articles in English were selected. Age of children was to be more than 4. Type of BT had to be precised. Data looked for were: evaluation criteria, evaluation of efficacy, side effects and injection protocol. Results.– Thirty-two articles were selected in first reading out of which 9 were kept at last: three randomised controlled trials, four non controlled trials and two case reports. Several evaluation techniques of sialorrhea existed, both objective and subjective. BT was effective but conditions of use were not consensual. Discussion.– BT is effective in treatment of sialorrhea and its side effects are infrequent. It certainly has its place in arsenal armamentarium against sialorrhea. Literature proposes reflexions about some predictive factors of efficacy, in order to precise indications of treatment, but none can be admitted today. A work is currently carried out about french practices (enlarged former Botuloscope). After this and considering the literature, we would propose a utilisation and evalution protocole of BT for sialorrhea of children with CP.