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Influenza vaccination coverage of children with chronic disease is insufficient in France, although a nasal live attenuated influenza vaccine (LAIV) has been approved.We aimed to evaluate the acceptance of nasally administered vaccines by parents of children with chronic illness, by comparing LAIV vs. injectable inactivated influenza vaccine (IIV) acceptance.We performed a retrospective, observational study (December 2014 to April 2015) including parents of all children vaccinated with the LAIV during the 2013-2014 influenza vaccination campaign at our university hospital. It was an opinion survey on the tolerance and acceptance of the LAIV.A standardized evaluation form was completed by 67/79 parents of all children who received the LAIV (mean age: 113±56 months; 64% with a chronic respiratory disease). The parents responded that vaccines in general were important (99%) but only 58% of them accepted the injectable route of administration. Of the 48 parents of children who had received both LAIV and IIV in the past, global opinion (P0.0001) and tolerance (P0.0001) were better for LAIV. For the future, 81% of parents would prefer LAIV, mainly because of needle absence and/or less painful character, and 18% IIV, mainly because of easier administration or habit.The better acceptance of a nasally administrated vaccine could increase vaccination coverage in the future for nasal vaccines.

Objective The objective of this study was to evaluate the impact of a rapid diagnostic test for influenza (the Sofia® Influenza A+B FIA rapid diagnostic test [RDT]) in a pediatric emergency department (PED). Methods A retrospective, observational, cross-sectional study was conducted in the PED of the Lille University Hospital between 2013 and 2015. All patients under 18 years of age for whom influenza RDT was administered were included. Clinical data, management, and related hospitalizations were compared between positive and negative RDT groups. The length of stay in the PED (main outcome) and the number of additional tests (biological and radiographic tests) between the two groups were compared. Results A total of 238 tests were reported: 119 positive, 110 negative, nine invalid. The mean length of stay in the PED was significantly lower in the positive RDT group: 4.0 h vs. 7.4 h (P Conclusions This study showed a significant medical impact of the use of Sofia® Influenza RDT A+B FIA in a PED regarding the length of stay and the number of additional explorations.

This research aimed to analyze the epidemio- clinical characteristic and the prognosis of patients with eclampsia admitted to the intensive care unit at the University Hospital of Point G.The clinical records of all patients admitted to intensive care for eclampsia from September 2009 to February 2011 were retrospectively collected. We analyzed the following parameters: age, parity, gravidity, the admission deadline, the beginning of eclampsia compared to the term of pregnancy, the number of seizure, mode of delivery, score of Glasgow, blood pressure, proteinuria, complications and evolution.Among 702 admissions, 158 patients, with a mean age of 20 ± 4 were hospitalized for eclampsia (22.5%). We recorded 106 cases of first pregnancies (67.1%) and 104 primiparous (65.8%). The admission period after the first seizure was over 6 hours for 90 patients (57%). The first seizure had occurred in ante-partum period for 69 patients, in per-partum period for 4 patients and in postpartum period for 85 patients.Ninety-three patients (59%) had consciousness disorders at admission, 12 patients received oxygen treatment .Vaginal delivery was the mode of delivery for 93 patients and cesarean section for 65 patients.Eclampsia was associated with renal failure in 25 patients, HELLP syndrome for 15 patients, the stroke for 5 patients, acute pulmonary edema for 3 patients, the coagulation disorders for one patient; and the sepsis for 6 patients. Maternal and perinatal lethality was 9.5% and 10.8% respectively.Eclampsia is a frequent medical and obstetric emergency in intensive care unit of the University Hospital of Point G and affects young patients during their first pregnancy and delivery. Maternal and perinatal lethality remains high, due to the delay in the cases management and the associated factors of gravity. Strong actions are needed to raise awareness for early medical visit and to prepare medical teams for better cases management.Analyser les caractéristiques épidémio - clinique et le pronostic de l'éclampsie en réanimation au centre hospitalier et universitaire (CHU) du Point G.Les dossiers cliniques de toutes les patientes hospitalisées en réanimation pour une éclampsie de septembre 2009 à février 2011 ont été colligés de façon rétrospective. Nous avons analysé les paramètres suivants: l'âge, la parité, la gestité, le délai d'admission, le délai de survenue de l'éclampsie par rapport au terme de la grossesse, le nombre de crise convulsive, le mode d'accouchement, le score de Glasgow, la pression artérielle, la protéinurie, les complications et l'évolution.Sur 702 admissions, 158 patientes, d'âge moyen 20 ans ± 4 ont été hospitalisées pour éclampsie (22,5%). Nous avons enregistré 106 dossiers de primigestes (67,1%) et 104 primipares (65,8%). Le délai d'admission après la première crise convulsive était supérieur à 6 heures chez 90 patientes (57%). La première crise convulsive était survenue en antépartum chez 69 patientes, en perpartum chez 4 patientes et en postpartum chez 85 patientes. Quatre vingt treize patientes (59%) avaient présenté des troubles de la conscience à l'admission, 12 patientes ont été mises sous assistance ventilatoire. La voie basse était le mode d'accouchement chez 93 patientes, et la césarienne chez 65 patientes. L'éclampsie était associée à l'insuffisance rénale chez 25 patientes, au HELLP-syndrome chez 15 patientes, à l'accident vasculaire cérébral chez 5 patientes, à l'œdème aigue du poumon chez 3 patientes, aux troubles de la coagulation chez une patiente; et une septicémie était retrouvé chez 6 patientes. La létalité maternelle et périnatale était respectivement de 9,5 % et de 10,8 %.L'éclampsie est une urgence médico — obstétricale fréquente au service de réanimation du CHU du Point G et touche les patientes jeunes primigesteset primipares. La létalité maternelle et périnatalereste élevée, liée au retard de la prise en charge et aux facteurs de gravité associés. Pour renverser cette situation il est nécessaire de sensibiliser les populations pour une consultation précoce mais aussi de mieux préparer les équipes médicales pour une meilleure prise en charge.

Determine prevalence of the depression in a population of patients chronic hemodialysis. Look for the associated sociodemographic, clinical and biological factors.It was a transverse study. She concerned the at least 18-years-old patients, followed in the center of Hemodialysis of the CHU at the rate of 2 - 3 sessions a week. The patients having agreed, were in dialysis at least for 3 months and benefited from an individual interview through an index card of investigation based of Hamilton's scale French version in 17 items.On a sample of 107 patients, the average age was 43, 24 ± 14 years old with extremes between 20 and 75 years. The average duration in dialysis was of ±40, 37 36, 5 months with extremes between 4 and 144 months. Prevalence of the depression was 88 %. The depression was light in 78, 5 %, moderated in 6,5% and severe in 3 %. The anemia was present at 94 patient's among whom 76 had a light depression.We observed that prevalence of the depression remains high to the chronic hemodialysis.Déterminer la prévalence de la dépression dans une population de patients hémodialysés chroniques. Rechercher les facteurs sociodémographiques, cliniques et biologiques.Il s'est agi d'une étude transversale. Elle a concerné les patients âgés d'au moins 18 ans, suivis au Centre d'Hémodialyse à raison de 2 – 3 séances par semaine. Les patients ayant acceptés, étaient en dialyse au moins depuis 3 mois et ont bénéficiés un entretien individuel à travers une fiche d'enquête basé sur l'échelle d'Hamilton version française à 17 items.Sur un échantillon de 107 patients, l'âge moyen était de 43,24 ± 14 ans avec les extrêmes entre 20 et 75 ans. La durée moyenne en dialyse était de 40,37 ±36,5 mois avec les extrêmes entre 4 et 144 mois. La prévalence de la dépression était de 88 %. La dépression était légère dans 78,5 %, modéré dans 6,5 % et sévère dans 3 %. L'anémie était présente chez 94 patients dont 76 avaient une dépression légère.Nous avons observé que la prévalence de la dépression reste élevée chez les hémodialysés chroniques.

The aim of this study was to take stock of the practice of the loco-regional anesthesia (LRA) at the University Hospital Center of Point G from January 2004 to December 2008.This is a retrospective study, assessing the practice of LRA. The demographic data, the surgery, the technical characteristics of the procedure made, the type of local anesthetic used, adverse events were evaluated.The LRA involved 1261 patients - 8.30% of the total number of surgical procedures occurring during the studied period. The American Society of Anesthesiology (ASA) classification was used for the evaluation of patients in scheduled surgery. The patients belonged to class 1 (50.40%) and Class 2 (49.60%). The main surgical procedures were: 26.20% surgical prostatic adenomectomy, 23.80% of caesarean section, and the fistulogram test for 19.04%. The LRA techniques performed were: spinal anesthesia, 87.60%, epidural anesthesia, 12%. Three hundred and three adverse events (24%) have been reported, three (1%) of them have resulted in the death of the patient. The incidence of arterial hypotension was 94.40%, and 4.6% for bradycardia. The three heart attacks were fatal (0.024 ‰). Patients operated under spinal anesthesia and patients aged 60 years and older had more adverse events with 20% and 10.38% for p0.05 respectively. Sixty eight failures (5.4%) were observed.The practice of LRA at the University Hospital of Point G is characterized by adverse events and a low number of deaths. Patients operated under spinal anesthesia and patients aged 60 years and older are at greatest risk of adverse events.Etait de faire le point de la pratique de l'ALR au Centre Hospitalier Universitaire (CHU) du Point G, de janvier 2004 à décembre 2008.Il s'agissait d'une étude retrospective, évaluant la pratique de l'ALR. Les données démographiques, l'acte chirurgical, les caractéristiques techniques du geste effectué, le type d'anesthésique local utilisé, les événements indésirables ont été évalués.L'ALR avait concerné 1.261 patients, soit 8,30%. La classification de l'American Society of Anesthesiology (ASA) était utilisée pour l'évaluation des patients en chirurgie programmé. Les patients étaient de la classe ASA1 (50,40%) et de la classe ASA2 (49,60%). Les principaux actes chirurgicaux étaient: l'adénomectomie 26,20%, la césarienne 23,80% et la fistulorraphie 19,04%. Les techniques d'ALR réalisées étaient: la rachianesthésie, 87,60%, l'anesthésie péridurale, 12%. Trois cents trois événements indésirables soit 24% ont été rapportés, dont trois soit 1% ont entrainé le décès du patient. L'incidence de l'hypotension artérielle a été de 94,40%, la bradycardie de 4,6%. Les trois arrêts cardiaques ont été fatals (0,024‰). Les patients opérés sous rachianesthésie et les patients âgés de 60 ans et plus avaient présenté plus d'événements indésirables avec respectivement 20% et 10,38% pour un p0,05. Soixante huit échecs (soit 5,4%) avaient été constatés.La pratique de l'ALR au CHU du Point G est caractérisée par des événements indésirables et un nombre de décès faible. Les patients opérés sous rachianesthésie et les patients âgés de 60 ans et plus sont les plus exposés aux événements indésirables.

The infection by the virus of the hepatitis C can be associated with other infectious diseases, including the viral and bacterial infections of which the tuberculosis. The infection to Mycobacterium tuberculosis can remain latent during several years and show itself during a state of immunesuppression. The role of the antiviral treatment in the reactivation of the tuberculosis is debated. We bring back an observation of tubercular reactivation during dual therapy with pegylated interferon and ribavirin for a viral chronic hepatitis C. A virologique answer slow was obtained in the 40th week, as well as the reactivation of the tuberculosis. The tuberculosis was of ganglionic localization at our patient. The antituberculous treatment was established while maintaining the treatment. The evolution of the tuberculosis under treatment was favorable but for the VHC, we noted a virologique answer with premature relapse.

The objective of this study was to evaluate the impact of a rapid diagnostic test for influenza (the SofiaA retrospective, observational, cross-sectional study was conducted in the PED of the Lille University Hospital between 2013 and 2015. All patients under 18 years of age for whom influenza RDT was administered were included. Clinical data, management, and related hospitalizations were compared between positive and negative RDT groups. The length of stay in the PED (main outcome) and the number of additional tests (biological and radiographic tests) between the two groups were compared.A total of 238 tests were reported: 119 positive, 110 negative, nine invalid. The mean length of stay in the PED was significantly lower in the positive RDT group: 4.0h vs. 7.4h (P10This study showed a significant medical impact of the use of Sofia

The pentoxifylline seems to have some effects on immune cells by inhibiting tumor necrosis factor alpha (TNFα). Its role as a sparing corticosteroids in the treatment of sarcoidosis remains to be defined.We present the case of a patient with sarcoidosis corticodependent despite the use of azathioprine. It was finally improved clinically, functionally and by a thoracic computed tomography with addition of pentoxifylline.When the tolerance of the pentoxifylline is good and there is not a bleeding risk, the benefit-risk in the long term might be interesting in some patients with sarcoidosis corticodependent.

Healthy Love is a brief, highly interactive, single-session, group-level HIV prevention intervention designed for African American women that is effective at reducing sex risk behaviors and increasing condom use and HIV testing among participants. The Centers for Disease Control and Prevention, through a contract, developed a user-friendly intervention package that would allow organizations to adopt and implement Healthy Love with fidelity.Training and implementation materials were developed to support original research protocols, and piloted and revised to conduct field-testing with case study agencies (CSAs). Three CSAs were selected to deliver the intervention over a 3-month period to test the utility of intervention materials and feasibility of implementation.All CSAs were able to successfully deliver 10 sessions with a total of 185 women ranging from 18 to 59 years of age. Successes and challenges encountered in training, preimplementation activities, and intervention delivery are described.Lessons learned from training, technical assistance, and process monitoring and evaluation informed final package revisions. Research to practice recommendations are shared as is guidance for future implementations of Healthy Love. The research to practice process used is a model approach for developing a comprehensive intervention package and will support the adoption of Healthy Love by other organizations.

L"objectif était de tester une méthode simple adaptée à un contexte de ressources limitées pour mesurer l"observance et identifier les motifs de non observance rencontrés dans le suivi des traitements antirétroviraux (ARV) en milieu décentralisé au Mali. Il s"agissait d"une étude transversale de juin 2006 à décembre 2008 chez des patients VIH suivis en consultation dans l"Unité de Soins et d"Accompagnements et de Conseils (USAC) de Koulikoro.. C"est ainsi que l"observance pour les ARV a été mesurée. Les patients ont été considérés comme observants si d"après le nombre de comprimés restants ils n"ont sauté aucune prise de leur traitement. L"étude a porté sur 250 patients. La tranche d"âge 30 à 34 ans était la plus représentée dans la série avec 17,6%. La majorité des patients était de sexe féminin soit 75,1%. La majorité de patients résidait dans la commune urbaine de Koulikoro soit 74,4%. Le schéma 2 Inhibiteurs Nucléosidiques de la Transcriptase Inverse (INTI) + 1Inhibiteur Non Nucleosidique de la Transcriptase Inverse (INNTI) était le plus prescrit soit 91,6%. Tous les patients étaient sous traitement ARV, avec 78% sous Triomune (Lamivudine + Stavudine + Nevirapine en combinaison fixe). Les patients qui ont fait un abandon (ou refus) de prendre le médicament étaient majoritaires avec 27,4%. L"observance était de 75,2%. L"indice global d"observance donne 188 patients (75,2%) comme observants et 62 patients (24,8%) comme non observants. L"observance thérapeutique dans l"étude est relativement bonne (75,2 % des patients). Cette étude montre que la mesure de l"observance est possible et faisable en utilisant le comptage des comprimés des patients en milieu décentralisé. Les causes d"inobservances étaient dominées par le refus (27,4%) ; l"oubli (24,2%) ; le voyage (16,1%) ; les effets indésirables des antirétroviraux de type allergique (12,9%). Notre étude a montré que 24,8% des patients ont été non observants en raison du refus,de l"oubli, du voyage et des effets indésirables. Les prestataires ou agents de santé avaient eu plusieurs astuces pour améliorer l"observance des patients telles que relier la prise du traitement à une activité quotidienne ou avant le petit déjeuner. Les associations des PVVIH œuvrent auprès des agents de santé afin de faire accepter aux nouveaux inclus leur statut et surtout le traitement ARV. Mots clés : VIH, Observance, ARV, Koulikoro.

Resume Introduction Les concentrations plasmatiques de la parathormone (PTH) et de l’acide urique (AU) s’elevent des que le debit de filtration glomerulaire (DFG) commence a diminuer au cours de la maladie renale chronique (MRC). L’objectif de cette etude etait d’evaluer l’association entre le DFG et l’augmentation de ces 2 parametres chez l’enfant. Patients et methodes Etude retrospective de 100 enfants âges de 5 a 18 ans ayant realise une exploration fonctionnelle renale (EFR), et qui presentaient une augmentation de la PTH ou de l’AU. Le DFG a ete mesure par la clairance de l’inuline (C In). Resultats Le DFG etait normal (> 90 mL/min/1,73 m2) chez 39 % des enfants, l’AU etait augmente chez 44 % et la PTH chez 75 % ; 29 % des enfants ayant une PTH elevee avaient un DFG normal. Une correlation inverse a ete observee entre l’AU et le DFG (r = −0,452, p ≤ 0,0001), et entre la PTH et le DFG (r = −0,226, p = 0,024). La meme relation negative a ete observee entre l’AU et la PTH (r = −0,266, p = 0,007), ainsi qu’entre l’AU et le taux de reabsorption du phosphore (TRPhosph) (r = −0,415, p Discussion L’hyperuricemie s’observait a tous les stades de la MRC, faisant discuter une atteinte tubulaire precoce infraclinique. L’augmentation precoce de la PTH dans cette cohorte semble en contradiction avec certaines etudes nord-americaines decrivant des concentrations de PTH normales en phase precoce de la MRC. Des etudes prospectives sont necessaires pour confirmer ces donnees et evaluer le role de l’AU dans la genese des anomalies minerales et osseuses de la MRC.

International audience; This paper presents an all-metal parallel plate waveguide (PPW) Luneburg lens designed using an array of subwavelength Fakir bed of nails unit-cells. Variation of the metal post height and PPW-spacing modulates the effective refractive index. The lens operates in the Ku-band of frequencies, with more than 40% bandwidth, in a quasi-TEM mode. Broadband and low loss, with high directivity and wide field-of-view, this antenna could be an excellent candidate as a lens-like beamformer for multiple beams satellite communication applications. © 2017 Euraap.

A study was conducted to determine the optimal level of nitrogen for a better performance of the virgin canes. The vegetal materiel is composed of the variety SP 70-1284. The materiel of laboratory is composed of an electric grinder ("Jeffco" food and fodder cutter grinder, model 265 B, set L 1710), a refractometer (Schmidt+Haensch, HARD-SW model, set 29129) and a polarimeter (Saccharomat Z, set 29305). The test was conducted with the variety SP 70-1284 as an experimental randomized complete block with 9 treatments, with 4 repetitions. The total doses of N of three contributions for the cycle of harvest (35, 70, 105, 140, 175, 210, 245, 280, 0 kg ha 1) correspond to the T1 treatments, T2, T3, T4, T5, T6, T7, T8 and T0. The T0 (14, 79 t s ha-1 ± 1, 03) recorded the weak quantity of sugar. The quantity raised of sugar has been observed on the T8 (16, 83 t s ha-1 ± 1, 09), T5 (16, 84 t s ha-1 ± 1,15) and T7 (16,94 t s ha-1 ± 1,12). The weak rate of the Brix has been revealed on the T2 (22, 05% ± 0, 84). The T4 (23, 15% ± 0, 77), T3 (23, 21% ± 0, 21), T8 (23, 43% ± 0, 62) recorded the strong rates of the Brix. The elevated Pol rate is gotten with the T8 (20, 90% ± 0, 55), the lowest with the T2 (19, 45% ± 0, 80). The weak rate of Wealth Hugo Simplifiee (RHS) is recorded on the T2 (12, 84% ± 0, 55), the T8 (13, 87% ± 0, 45) got the elevated rate. The dose of 280 kg N ha-1 corresponding to T8 appears to be effective and can be used for the profitability of the variety SP 70-1280 to the Agro Industrial Complex of the CST-Banda in Chad.

Le succès du traitement des morsures de serpent en milieu rural passe par l'implication des tradipraticiens de santé. Le but de cette étude effectué auprès des tradipraticiens de santé de Kolokani (Mali) était de répertorier les différentes plantes utilisées dans la prise en charge des morsures de serpents. Au total nous avons interviewé 21 tradipraticiens de santé (TPS). La majorité des TPS était des hommes (17/21) soit 80,95%. Plus de 71% (15/21) des enquêtés n'étaient pas alphabétisés. 69,91% (13/21) des TPS exerçaient leur profession depuis plus de 20 ans. La quasi-totalité des TPS enquêtés soit 95% (20/21) pouvait nous citer au moins un problème de santé dans la communauté. Pour la prise en charge des morsures de serpent, au total 16 plantes appartenant à 11 familles botaniques ont été identifiées. Les trois premières plantes les plus citées ont été : Securidaca longipedunculata Fres (Polygalaceae) Gardenia ternifolia…..(Rubiaceae) et Tamarindus indica L. (Ceasalpiniaceae). Les feuilles étaient utilisées majoritairement et le plus souvent sous forme de décocté pour boisson et poudre pour massage.

Resume La cancerologie est percue comme un probleme de sante secondaire dans les pays emergents, Pourtant, l'incidence annuelle des cancers y est en pleine croissance (environ 100 a 120/100 000 actuellement en Afrique subsaharienne). Cela peut s'expliquer par l'incidence elevee des pathologies infectieuses a risque oncogene (hepatites, VIH, Helicobacter, etc.) mais aussi par des politiques nationales et internationales de prevention encore trop reduites. Si cette tendance epidemiologique se poursuit, l'Afrique comptera en 2020 pres d'un million de nouveaux cas de cancers chaque annee. Si l'incidence augmente, la morbimortalite y est egalement importante. Cette constatation depasse la simple consequence d'un defaut de moyens. Le paysage socioculturel et les representations de la maladie font egalement partie integrante des causes de ce constat. Nous evoquerons dans cette tribune la situation de l'Afrique en citant l'exemple du Mali. Nous conclurons sur les apports qui peuvent etre faits a l'echelle individuelle au travers de l'exemple de l'association « OncoMali ».

Mycobacterium abscessus is a common non tuberculous mycobacterium associated with diseases in patients with underlying conditions. The diagnosis is often missed in resource limited settings. We reported a case of M. abscessus in a patient with renal failure. A young female patient admitted at the hospital for kidney failure was diagnosed with malignant hypertension based on clinical and laboratory findings. Over the course of hospitalization, the patient presented hematuria and leukocyturia and the urine culture was positive for acid-fast bacilli. Empirically antituberculous treatment given to the patient was changed to clarithromycin after confirmation of M. abscessus by probe line hybridization assay. Favorable outcome was achieved with regression of symptoms and the decrease of the serum creatinine level. In patients with underlying conditions, differential diagnosis should be considered particularly in resource limited settings.

Le syndrome d’hypertension portale (HTP) est frequemment rencontre dans les services de Medecine a Bamako. Cependant, aucune etude au Mali ne lui a ete consacree; d’ou l’interet de notre etude dont l’objectif etait de determiner la frequence de l’HTP et ses differentes etiologies.

A longitudinal study was undertaken in Burkina Faso among 293 children aged 6 months to 9 years in order to determine the correlation between an antibody response to several individual malarial antigens and malarial infection. It was found that the presence of a positive antibody response at the beginning of the rainy season to three long synthetic peptides corresponding to Plasmodium falciparum Exp-1 101-162, MSP-3 154-249 and GLURP 801-920 but not to CSP 274-375 correlated with a statistically significant decrease in malarial infection during the ongoing transmission season. The simultaneous presence of an antibody response to more than one antigen is indicative of a lower frequency of malarial infection. This gives scientific credibility to the notion that a successful malaria vaccine should contain multiple antigens.

Notre etude retrospective avait pour objectifs de determiner la frequence de la tuberculose peritoneale, d’en decrire les manifestations cliniques, laparoscopiques et les caracteristiques du liquide d’ascite. Ont ete inclus dans cette etude les dossiers des malades presentant a la laparoscopie des granulations et/ou des nodules peritoneaux. Dans tous les cas, l’examen anatomo-pathologique de ces lesions avait confirme le diagnostic de tuberculose peritoneale. 26 dossiers repondaient aux criteres d’inclusion (10 hommes et 16 femmes). La tuberculose peritoneale representait 4,13 % de l’ensemble des cas de tuberculose. L’âge moyen a ete de 37,7 ±15 ans avec des extremes a 12 et 65 ans. Les signes cliniques ont ete domines par l’ascite (88,5 %) des cas, l’amaigrissement (53,8 %), l’anorexie (53,8 %), la douleur abdominale (42,2 %), l’asthenie (42,3 %) et la fievre (42,3 %). L’association des granulations aux nodules a ete l’anomalie laparoscopique la plus frequente: 80,76 % (21/26). L’examen direct avec la coloration de Ziehl Neelson et la culture du bacille de Koch (BK) sur milieu de Lowenstein ont ete positifs respectivement dans 50 % (3/6) et 60 % (3/5) des cas. En Afrique, la laparoscopie demeure un examen de choix dans le diagnostic de la tuberculose peritoneale. Elle a permis la mise en evidence de granulations: lesions classiques, mais aussi de nodules peritoneaux pouvant faire discuter des metastases peritoneales. The objectives of our retrospective study were to determine peritoneal tuberculosis frequency, to describe its laparoscopic and clinical manifestations and the characteristics of the ascitis fluid. The included patients recorded forms were those presenting granulations and/or peritoneal nodules at laparoscopy. In all cases, the anatomical and pathological examination of these lesions confirmed the diagnosis of peritoneal tuberculosis. Twenty-six patients were included in the study: 10 men and 16 women. Peritoneal tuberculosis occurred in 4.13 % of the tuberculosis total case. The mean age was 37.7 ±15 years from 12 to 65 years. The most important clinical signs were ascitis (88.5 %), weight loss (53,8 %), anorexia (53.8 %), abdominal pain (42.2 %), asthenia (42.3 %) and fever (42.3 %). The association of granulations and nodules was the most laparoscopically frequent abnormality: 80.76 % (21/26). The direct examination with Ziehl Neelson coloration and the bacillus of Koch (BK) culture in Lowenstein media were positive in 50 % (3/6) et 60 % (3/5) respectively. In Africa, laparoscopy remains an examination of choice for the diagnostic of peritoneal tuberculosis. It allows the discovery of granulations: classical lesions but also peritoneal nodules that could be discussed as peritoneal metastasis.

Le but de cette etude etait d’etudier les caracteres non histologiques des ulceres malins. Nous avons effectue de janvier 1986 a decembre 1998 (soit 12 ans), une etude retrospective de dossiers de malades vus en endoscopie digestive haute dans le centre d’endoscopie de l’hopital du point « G ». Tous les malades ayant un ulcere gastrique avec un examen histo-pathologique ont ete inclus. Parmi les 914 ulceres gastriques diagnostiques, 241 ont ete biopsies sur lesquels 34 etaient malins soit 15,88 % (34/241). L’âge moyen des malades ayant un ulcere malin etait de 53,50 ± 3,15 ans. 76,47 % de ces ulceres avaient un diametre compris entre 10 et 110 mm. Les ulceres dont le diametre depassait 110 mm etaient tous malins. Les ulceres malins etaient situes sur la face anterieure de l’antre dans 67,64% des cas, dans 94,10% des cas, le fond sale etait necrotique et hemorragique; leurs contours etaient arrondis dans 82,36 % des cas. Ils etaient creusants dans 97,50 % des cas, durs dans 100 % des cas, avec un bourrelet epais dans 70,50 % des cas. La lesion histologique a ete exclusivement l’adenocarcinome gastrique: 100 % des cas. En l’absence d’examen anatomo-pathologique, les ulceres gastriques repondant a cette description doivent etre referes au chirurgien. The goal of this survey was to describe the non-histological characteristics of malignant ulcer. We conducted a retrospective survey of patients submitted to an endoscopic examination of the upper digestive tract in the endoscopy unit of the hospital “Point G” from January 1986 to December 1998 (12 years). Subjects with gastric ulcer and histopathological exam were included. A biopsy was performed on 241 of the 914 subjects with gastric ulcer. Of the 214 subjects who had biopsy and histological exam, 34 (15,88 %) were diagnosed with malignant ulcer. The mean age of subjects with malignant ulcer was of 53,50 ± 3,15 years. 76,47 % of these malignant ulcers have a diameter of 10 to 110 mm and all cases of ulcer with a diameter over 110 mm were malignant. The malignant ulcers were located on the anterior face of the stomach in 67,64 % of cases, the bottom was soiled with necrosis and hemorrhage in 94,10 % of cases. The contours of the malignant ulcers were of rounded shape in 82,36 % of cases, excavated in 97,50 %, hard in 100 %, with a thick pad in 70,50 %. The type of histolological lesions in all cases (100 %) was gastric adenocarcinoma. In the absence of anatomopathological exam, cases of gastric ulcers with the above characteristics should be referred to the surgeon.

In Malian traditional medicine, aerial parts of Glinus oppositifolius are used in the treatment of many disorders, particularly inflammations and joint pains.The present study was initiated to investigate the antioxidant potential of Glinus oppositifolius.Aqueous and ethanol extracts were prepared from the dried aerial parts. Both extracts were examined for the phenolic content and antioxidant activity. Total phenolic content was quantified by Folin-Ciocalteu method. Antioxidant activity was studied in vitro by evaluating the ability to scavenge different free radicals (ABTS, superoxide and hydroxyl radicals, nitric oxide) and to chelate ferrous ions.Aqueous extract was found to contain a higher level of total phenols than ethanol extract (1.27 +/- 0.04 vs. 0.94 +/- 0.05 g GAE/100 g extract). Both extracts lacked the ability to scavenge superoxide anion radical but scavenged ABTS and hydroxyl radicals, nitric oxide and chelated ferrous ions in a concentration-dependent manner. According to the EC50 values, aqueous extract showed stronger antioxidant effects than ethanol extract (174.32 +/- 1.49 vs. 276.76 +/- 1.52 microg/mL in ABTS radical cation scavenging assay, 119.91 +/- 1.70 vs. 240.57 +/- 0.97 microg/mL in nitric oxide scavenging assay, 1.99 +/- 0.01 vs. 6.54 +/- 0.08 mg/mL in ferrous ion chelating assay). In hydroxyl radical scavenging assay, aqueous extract had an EC50 value of 0.86 +/- 0.00 mg/mL while the EC50 value of ethanol extract was higher than the highest concentration that was tested (3.75 mg/mL).Our results clearly indicate the antioxidant potential of Glinus oppositifolius aerial parts and suggest that the antiinflammatory activity might be partly related to the antioxidant potential.

Introduction Depuis 8 ans, l’OMS conseille de ne realiser que 2 prelevements respiratoires diagnostiques devant une suspicion de tuberculose pulmonaire. Malgre tout, la realisation de 3 prelevements reste habituelle en France. L’objectif de notre etude etait d’analyser l’interet des 3es prelevements respiratoires pour le diagnostic et l’evaluation de la contagiosite de la tuberculose chez les patients pris en charge au CHU de Tours. Methodes Nous avons realise une etude retrospective des 6987 examens microscopiques et cultures provenant des expectorations ou des tubages gastriques realises chez 2443 patients dans le cadre de suspicion de tuberculose entre le 1er janvier 2010 et le 31 decembre 2014 au CHRU de Tours et compare l’interet de la realisation d’un 3e prelevement diagnostique a celle limitee a 2 prelevements. Resultats Une tuberculose etait diagnostiquee chez 64 patients (3 %) a partir de 134 cultures de Mycobacterium tuberculosis (CMT) positives. La CMT a permis d’etablir le diagnostic chez 77 % des patients (n = 49) des le premier prelevement, chez 13 % (n = 8) au 2e et 11 % (n = 7) au 3e. Un examen microscopique direct (ED) etait positif chez 87/134 prelevements CMT positifs (65 %) provenant de 37 patients. Les BAAR etaient presents chez 89 % des ED+ (n = 33) des le premier prelevement, chez 5 % (n = 2) au 2 e et chez 5 % (n = 2) au 3e. Alors que la sensibilite de l’ED parmi les CMT+ etait de 48 %, le gain de sensibilite de l’ED obtenu par la realisation d’un 3e prelevement au lieu de 2 etait de 4 %. La VPN ne s’ameliorait que de 0,1 % entre le 2e et 3e prelevement. Les 7 patients qui n’avaient que le 3e prelevement positif en CMT, venaient de pays a forte endemie (86 % vs 44 %, p = 0,02) et etaient moins bacilliferes (29 % vs 61 %, p = 0,03) que les patients dont les 2 premiers prelevements etaient diagnostiques. Conclusion La realisation de 2 expectorations ou tubages gastriques semble suffisante pour porter le diagnostic et evaluer la contagiosite d’une tuberculose pulmonaire dans un hopital francais.

Background: There is little information on the incidence of AIDS-defining events which have been reported in the literature to be associated with immune reconstitution inflammatory syndrome (IRIS) after combined antiretroviral therapy (cART) initiation. These events include tuberculosis, mycobacterium avium complex (MAC), cytomegalovirus (CMV) retinitis, progressive multifocal leukoencephalopathy (PML), herpes simplex virus (HSV), Kaposi sarcoma, non-Hodgkin lymphoma (NHL), cryptococcosis and candidiasis. Methods: We identified individuals in the HIV-CAUSAL Collaboration, which includes data from six European countries and the US, who were HIV-positive between 1996 and 2013, antiretroviral therapy naive, aged at least 18 years, hadCD4+ cell count and HIV-RNA measurements and had been AIDS-free for at least 1 month between those measurements and the start of follow-up. For each AIDS-defining event, we estimated the hazard ratio for no cART versus less than 3 and at least 3 months since cART initiation, adjusting for time-varying CD4+ cell count and HIV-RNA via inverse probability weighting. Results: Out of 96 562 eligible individuals (78% men) with median (interquantile range) follow-up of 31 [13,65] months, 55 144 initiated cART. The number of cases varied between 898 for tuberculosis and 113 for PML. Compared with non-cART initiation, the hazard ratio (95% confidence intervals) up to 3 months after cART initiation were 1.21 (0.90-1.63) for tuberculosis, 2.61 (1.05-6.49) for MAC, 1.17 (0.34-4.08) for CMV retinitis, 1.18 (0.62-2.26) for PML, 1.21 (0.83-1.75) for HSV, 1.18 (0.87-1.58) for Kaposi sarcoma, 1.56 (0.82-2.95) for NHL, 1.11 (0.56-2.18) for cryptococcosis and 0.77 (0.40-1.49) for candidiasis. Conclusion: With the potential exception of mycobacterial infections, unmasking IRIS does not appear to be a common complication of cART initiation in high-income countries. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Introduction: The mango fruit is among the most consumed fruits in the world and it has several traditional reported uses. Chemical components like flavonoids, vitamins, proteins have been isolated and biological activities such as antioxidant; antibacterial and antidiabetic properties are reported. The fruit has been largely studied, but little attention has been paid to the beneficial effect of the peal Objective: The aim of this study was to determine and compare the chemical composition of peal collected from mango fruits at three different stages of maturation: unripe, mid-mature and mature fruits; and to determine their antibacterial properties on Salmonella typhi, Escherichia coli and Staphyloccocus aureus, three microorganisms responsible of the most encountered infectious diseases in Mali. Material: Peals collected from unripe, mid-mature and mature mango fruits have been air-dried and pulverized. Antibacterial test was performed with clinical strains of Staphylococcus aureus and Escherichia and the reference strain 451 of Salmonella typhi. Methods: Tests for chemical analysis were carried out on peal powder using conventional test reagents that give specific color with a specific chemical group. Monosaccharide composition was determined by gas chromatography analysis after methanolysis. The antibacterial activities were evaluated using the disk diffusion technique and the antioxidant test was performed by applying as solution of DPPH on TLC plate. Results and Discussion: Results of the chemical investigation showed that the mango peal content of anthocyanins carotenoids, sterols and triterpenes and amounts of monosaccharides increase with maturation; glucose and glucuronic acid were the most abundant monosaccharides. Aqueous extracts of mid-mature mango fruit peal showed a moderate inhibition of S. aureus at a dose of 200 µg while mature and unripe fruits peals extracts showed no activity. A high DPPH inhibition activity was seen with all samples.

Resume Une reevaluation des indices erythrocytaires et des concentrations de ferritine dans le sang du cordon est necessaire depuis l'introduction de nouvelles techniques automatiques de comptage des globules et de la supplementation en fer des femmes enceintes. Population et methodes. - Des echantillons de sang du cordon ont ete recueillis apres clampage precoce chez tous les nouveau-nes du lundi au vendredi pendant 2 mois; ont ete analyses les parametres erythrocytaires, la concentration en hemoglobine, les concentrations en ferritine serique et erythrocytaire; une electrophorese de l'hemoglobine a egalement ete realisee. Les resultats ont ete compares pour les meres a leur âge, a leur parite et a la duree de la supplementation en fer, et pour les nouveau-nes a leur âge gestationnel et a leur poids de naissance. Resultats. - Les 159 nouveau-nes etudies sont nes de 154 meres, 87% d'entre elles ayant recu une supplementation en fer. Les valeurs des differents indices erythrocytaires sont legerement inferieures a celles rapportees jusqu'ici dans la litterature. Elles sont associees a des valeurs moyennes de ferritine serique et erythrocytaire, se situant respectivement autour de 135 μg/l et 348 ag/cellule. Conclusion. - Dans cette population non carencee, il n'y a pas de correlation entre les parametres erythrocytaires et les valeurs de ferritine.

Better land and crop management systems are needed to resolve actual problem of land and environmental degradation in Africa. Assessment of required technology must consider both impacts on crop yields and the different environmental compartments (soil, water and atmosphere). With these concerns, an experimental study was conducted on these basis at Cinzana research station (13° 15’N; 5° 57'W), Mali. Effects of five crop management systems (treatments T1 to T5) are compared from 1992 to 1997 in a split-plot arrangement with two tillage levels (simple ridging and tied one): sorghum monoculture with crop residues export (T1); crop residue restitution every two years (T2); rotation cowpea – sorghum (T3); rotation green manure sesbania – sorghum (T4); rotation green manure dolic – sorghum (T5). All treatments received Tilemsi rock phosphate (300 kg ha-1) in 1995. Soil samples were analyzed and sorghum yields quantified. Between 1990 and 1996, pH increased in T2 and T3 and decrease in T1 and T4. All treatments improved slightly and equivalently, soil organic carbon (SOC) (0.3%), decreased the cation exchange capacity (CEC) and bases (except Ca) and increased available P. Grain sorghum yields decreased in monoculture (23 and 14%), and increased in rotations (6 to 12%). The results confirmed the value of leguminous and green manure with addition of Tilemsi rock phosphate in improving sorghum productivity. Key words: Sudano-Sahelian zone, Mali, sorghum, green manure, Tilemsi rock phosphate, soil quality.

Parathyroid hormone (PTH) and uric acid (UA) levels increase early during chronic kidney disease (CKD). The objective of this study was to evaluate the relationship between these two parameters at different stages of pediatric CKD.One hundred patients (range, 5-18 years) were included in this retrospective study: they had undergone renal exploration with a direct measurement of the glomerular filtration rate (GFR) using the reference standard (i.e., inulin clearance, Cin) and presented with increased circulating levels of PTH and/or UA.GFR was normal in 39% of patients, with UA increased in 44% and PTH in 75% of them. Interestingly, 29% of the children with increased PTH levels had a strictly normal GFR (i.e., above 90 mL/min/1.73 m(2)). An inverse association was found between UA and GFR (r=-0.452, P ≤ 0.0001) as well as between PTH and GFR (r=-0.226, P=0.024). The same negative relationships were found between UA and PTH (r=-0.266, P=0.007), and between UA and the phosphate reabsorption rate (r=-0.415, P0.001).Since hyperuricemia was found at all stages of CKD, an early silent tubular impairment can be discussed to explain these findings. The early increase in PTH levels during CKD has not been described by all authors, with North American studies describing rather late increased PTH levels during CKD. Prospective studies are required to confirm these data and evaluate the role of UA in the pathophysiology of the mineral disorders observed during CKD.

To assess the social and psychological state development of our patients six months after their dialysis treatment.It was about a prospective study within January to June 2006. The data collection was conducted on personal search records and a questionnaire "Choice Health Experience Questionnaire" (CHEQ). The CHEQ self managed assessed the mental health, the physical health, the sexual and social functioning, the concept of sleeping disorders, familial life, leisure's and education's level. The typing was done on Epi Info 6,0 and the analyse on SPSS10.They where 20 men and 10 women or a ratio sex of 2. The average age was 40.36 years ±13.08. Twenty three patients (76.7%) were satisfied of their life in general. Four patients (13.3%) were depressed, two had sleeping disorders. Fifteen men (75%) had erection disorders.Our patients' quality of life in iterative haemodialysis remains satisfactory. A better care taking of the anaemia is necessary because it plays an important role in the erection disorders.

Helicobacter pylori plays a significant role in gastric disease. The aim of the present pilot study was to evaluate the prevalence of H. pylori detected by real-time polymerase chain reaction (real-time PCR) in the sub-gingival plaque of chronic periodontitis patients and to determine periodontopathogens profile of positive sites at H. pylori.109 subgingival samples collected from 17 subjects with chronic periodontitis were studied. The DNA was extracted from the oral samples and analyzed for the presence of H. pylori by real-time PCR (LightCycler) using 16S rRNA#120 primers which targeted the 16S rRNA gene. DNA from H. pylori DSM 4867 was used as a positive control. Seven bacteria implicated in chronic periodontitis were selected to explore the presence of these periodontopathic species in the oral positive sites for H. pylori.16 of 109 samples (14.7%) were positives of H. pylori. All the positives sites were also positives to Fusobacterium nucleatum and Eikenella corrodens, 62.5% to Porphyromonas gingivalis, 31.25% to Treponema denticola, 25% to Prevotella intermedia, 12.5% to Aggregatibacter actinomycetemcomitans and 6.25% to Tannerella forsythia.H. pylori may be present in the subgingival plaque samples of patients with chronic periodontitis who are resident in a developing country. F. nucleatum and E. corrodens could coaggregate with H. pylori in the subgingival dental plaque.

Dans le but d’evaluer les effets de la matiere organique sur la resistance du riz NERICA (New Rice for Africa) au stress hydrique sur sol ferralitique, un essai est realise au champ a Faranah de juillet a novembre 2008. Le dispositif utilise est le Blocs Complets Randomises factoriel a trois repetitions. Les traitements comportent: (i) trois dates de semis, a 15 jours d’intervalle, induisant trois niveaux de stress : 25/07/08 (d1), 9/08/08 (d2), 24/08/08 (d3); (ii) deux doses de matiere organique D0 (temoin) et D1 (60 tonnes de fumure par hectare). La reponse au stress hydrique est evaluee a travers la croissance (hauteur des plants, longueur de la racine la plus allongee), le nombre de talles fertiles, le rendement et l’indice de sensibilite au stress. Les resultats montrent que quelque soit la date de semis l’apport de fumure augmente les rendements par rapport au temoin soit: 4,06 t/ha a d1, 2,43 t/ha a d2 1,44 t/ha a d3. Ainsi l’utilisation de la matiere organique permet-elle de maintenir des niveaux de production plus eleves par rapport au temoin; donc la fertilisation ameliore la resistance a l’insuffisance d’eau due a un semis tardif ou semi-tardif.

Pain induced by pinching the peritoneum betrays a pathology of that membrane. It is absent when the peritoneum is perfectly healthy. Pain is elicited by a special palpation technique. Clinically and statistically, the presence of this pain is pathognomonic, but it does not inform on the aetiology. In the present study the most frequent causes of positive abdominal peritoneal pinching test were peritoneal tuberculosis, followed by portal hypertension with or without liver cirrhosis.

Knowledge of dental prosthetic needs will develop strategies for prevention and treatment through a package of individual, community and professional policies. The aim of this study was to evaluate prosthetic needs in Senegalese dental offices. The survey was conducted among people aged 15 years and more attending Senegalese dental clinics. The mean number of missing teeth was 4.4. Only 55.3% of the sample expressed the need for dentures and 81.8% had a diagnosed need for prosthesis. A statistically significant difference was noticed between the needs diagnosed and the expressed needs (p0.0001). Finally, this study reveals that the need for prosthetic treatment is real in the Senegalese dental offices.

Metallic nanoparticles are more and more widely used in an increasing number of applications. Consequently, they are more and more present in the environment, and the risk that they may represent for human health must be evaluated. This requires to increase our knowledge of the cellular responses to nanoparticles. In this context, macrophages appear as an attractive system. They play a major role in eliminating foreign matter, e.g. pathogens or infectious agents, by phagocytosis and inflammatory responses, and are thus highly likely to react to nanoparticles. We have decided to study their responses to nanoparticles by a combination of classical and wide-scope approaches such as proteomics. The long term goal of this study is the better understanding of the responses of macrophages to nanoparticles, and thus to help to assess their possible impact on human health. We chose as a model system bone marrow-derived macrophages and studied the effect of commonly used nanoparticles such as TiO2 and Cu. Classical responses of macrophage were characterized and proteomic approaches based on 2D gels of whole cell extracts were used. Preliminary proteomic data resulting from whole cell extracts showed different effects for TiO2-NPs and Cu-NPs. Modifications of the expression of several proteins involved in different pathways such as, for example, signal transduction, endosome-lysosome pathway, Krebs cycle, oxidative stress response have been underscored. These first results validate our proteomics approach and open a new wide field of investigation for NPs impact on macrophages, Comment: Nanosafe2010: International Conference on Safe Production and Use of Nanomaterials 16-18 November 2010, Grenoble, France, Grenoble : France (2010)

Dental extraction is a surgical act frequently carried out in the African dental structures. It requires the rigorous respect of the conditions of asepsis and antisepsis. Equipments and anaesthetic and avulsional products must be also sufficient. Our study undertaken among 46 dental services in areas health centers of Senegal aimed to determine the conditions under which dental extractions are carried out. The principle results of our study showed that 93% of dental practitioners wore sterilized gloves. 49% of the dentist's care activity consisted in dental extractions. 50% of the practitioners re-use anaesthetic needles, 2% re-use anaesthetic carpules. We noticed that the dental structures were facing a deficit of materials and products of extraction. Face to the outbreak of serious illnesses as infections of HIV and Hepatitis B, the practitioner and his team must be sensitized and trained to struggle against the transmissible infections and to carry out the dental extraction only if the conditions of asepsis and antisepsis are joined together. A pleading towards the medical authorities must be done to support the services in equipments and periodic renewals of the materials and products of extractions.

Oncology is perceived as a secondary problem of public health in emerging countries. Nevertheless the annual incidence of cancers is rapidly expanding (approximately 100 to 120/100 000 subsaharan Africa). It can explain by the high incidence of the infectious pathologies associated with a high oncogene risk (hepatitis, HIV, Helicobacter ...) but also by national and international prevention policies still too much reduced. If this epidemiological tendency continues, Africa will count in 2020 near a million new cases of cancers every year. The incidence increases but the morbi-mortality is also very high in these countries. This observation exceeds the simple consequence of a defect of means. The sociocultural landscape and the mental representations of this disease are also in cause. We shall evoke in this article the situation of Africa by quoting the example of Mali. We shall conclude on the individual contributions which can be made through the example of the association "OncoMali".

Induction motors have good efficiencies when operating at full load. At lower than rated loads, however, efficiency is greatly re - duced. This letter describes using fuzzy logic to optimize the efficiency of an induction motor drive while keeping good dynamic response. The proposed fuzzy controller adjusts the magnetizing current component with respect to the torque current component to give the minimum total copper and iron losses. Nomenclature: VV sr () : stator (rotor) voltage II sr () : stator (rotor) current ϕ: stator current and voltage phase delay angle ω s : stator frequency ω : mechanical frequency µ: magnetization subscript o: nominal value subscript Introduction: Electrical machines normally operate at rated flux in a variable frequency drive to get the best transient response. Most of the