Imaging low-mass planets within the habitable zone of α Centauri.

Giant exoplanets on wide orbits have been directly imaged around young stars. If the thermal background in the mid-infrared can be mitigated, then exoplanets with lower masses can also be imaged. Here we present a ground-based mid-infrared observing approach that enables imaging low-mass temperate exoplanets around nearby stars, and in particular within the closest stellar system, α Centauri. Based on 75-80% of the best quality images from 100 h of cumulative observations, we demonstrate sensitivity to warm sub-Neptune-sized planets throughout much of the habitable zone of α Centauri A. This is an order of magnitude more sensitive than state-of-the-art exoplanet imaging mass detection limits. We also discuss a possible exoplanet or exozodiacal disk detection around α Centauri A. However, an instrumental artifact of unknown origin cannot be ruled out. These results demonstrate the feasibility of imaging rocky habitable-zone exoplanets with current and upcoming telescopes.

Use of topical glucocorticoids: a population-based cohort study.

BACKGROUND: Little is known about the prescriptions of topical glucocorticoids in the general population. OBJECTIVES: To report an overall picture of topical glucocorticoid prescriptions in France. METHODS: This study used the Echantillon Généraliste de Bénéficiaires (EGB) database, a 1/97th random sampling of the French population covered by the main national healthcare insurance system (approximately 90% of the whole population). All patients prescribed topical glucocorticoids over a 5-year period (1 January 2011 to 31 December 2015) were identified using a specific code list for topical glucocorticoids. RESULTS: Over the 5-year study period, 662 531 individuals were recorded for at least 1 day in the EGB. Among them, 220 345 (33.3%) were prescribed at least once topical glucocorticoid. The prevalence of topical glucocorticoid prescription increased regularly from 2011 (11.7%) to 2015 (12.5%). A total of 922 026 tubes of topical glucocorticoids were dispensed, mainly high-potency glucocorticoids, and were mainly prescribed by general practitioners (73.1%). A total of 1713 (0.8%) patients were prescribed at least 24 tubes over a calendar year. These patients were more frequently men (P < 0.001) and older (P < 0.001) than the overall population of patients prescribed topical glucocorticoids. The 124 844 tubes prescribed to these patients had stronger potency than those prescribed to the overall population (P < 0.001) and were mostly prescribed by general practitioners (68.1%). The reasons for prescription were available for only 371 patients (21.7%) and were mainly psoriasis, auto-immune bullous dermatoses and eczema. CONCLUSION: About 12% of the French general population is prescribed topical glucocorticoids at least once each year. Most prescriptions are issued by general practitioners, dermatologists being the prescribers in less than one-quarter of cases.

Cold-associated perniosis of the thighs histopathologically mimicking lupus. Six observations.

BACKGROUND: Equestrian cold panniculitis has been described since 1980 in horse riders or in stable employees. Histological aspect is underdescribed. PATIENTS AND METHODS: We describe clinical and histological features of six horse riding or stable employees patients presenting with upper lateral thigh lesions during the winter months between 2014 and 2016 in our dermatological department. RESULTS: Six horse riding or stable employees ladies without any known disease presented with similar symptoms. They had urticarial or violaceous, slightly pruritic, sometimes necrotic lesions of the upper lateral thighs. Clinically, equestrian cold panniculitis, insect bite or a caustic dermatitis was suspected. Four of these patients had a cutaneous biopsy. They all showed a similar histological appearance resembling lupus erythematosus, combining dermo-epidermal lesions, with foci of interface dermatitis, an abundant dermal lymphocytic infiltrate and a dermal mucinosis. Hypodermal infiltration was present on samples including subcutis. Laboratory workup for systemic disease was unremarkable for two patients and not performed for the four others, having no other clinical sign of lupus. All patients improved rapidly with very high potent topical steroids. CONCLUSION: Cold-associated perniosis of the thighs should be considered whenever a histopathological appearance of lupus is associated with lesions of the upper lateral thighs in patients practicing horse riding. This disease belongs to the spectrum of miscellaneous cold-induced dermatoses in which histopathological lesions identical to lupus can be encountered.

Hepatitis B seroprevalence in HIV-infected patients consulting in a public day care unit in Bobo Dioulasso, Burkina Faso.

OBJECTIVE: The authors had for aim to assess the prevalence of hepatitis B co-infection in a cohort of HIV-infected patients, routinely followed-up at the Day Care Unit of the Bobo Dioulasso Sanou Souro University Hospital, Burkina Faso. PATIENTS AND METHODS: The Elisa technique was used to dose HBs antigen (AgHBs), antibodies anti-HBs and anti-HBc in all the patients followed by the biological laboratory, from October to December 2008. RESULTS: The AgHBs prevalence was 12.7% [CI at 95%: 10.7-15.0%] and men were slightly more likely to be positive for AgHBs than women (16.5% [12.0-21.9%] versus 11.6% [9.4-14.1%]; P=0.047); 83.3% of the patients [80.8-85.6%] were positive for hepatitis B core antibody, and 32.6% [29.7-35.6%] for hepatitis B surface antibody; 29.9% of the patients [27.1-32.8%] had a complete profile of former hepatitis B infection, 41.3% [38.2-44.4%] expressed core antibodies only; 13.8% [11.7-16.0%] had a negative serological test, and 2.3% [1.5-3.4%] presented a vaccinal immunity. CONCLUSION: These results stress the usefulness of screening for hepatitis B in all HIV-infected patients, along with the initial biological tests. This would help adapt HIV treatment to co-infected patients and to build an expanded program of vaccination for non-immune patients.

Left atrium papillary fibroelastomas: a cause of cerebral emboli.

Papillary fibroelastomas are cardiac benign tumours. Among the benign cardiac tumor, papillary fibroelastomas are reported second after myxomas. Most often diagnosed incidentally, papillary fibroelastomas may embolize to cerebral circulation. Valvular locations are predominant; location in left atrium is rare. In this paper, we present a case of papillary fibroelastoma located in left atrium with symptoms of cerebral embolization. Transoesophageal echocardiography diagnosed a mobile mass. The patient was treated with surgical resection without further embolic complication.

[Spitting cobras: description of 2 cases in Djibouti]. / Cobras cracheurs: 2 observations à Djibouti.

The purpose of this report is to describe two cases involving ophthalmic exposure to venom from spitting cobras. Based on these cases, readers are reminded that eye injury can be prevented by low-cost treatment consisting of prompt, prolonged saline irrigation. This treatment also reduces pain.

[Problems of neonatal transfer to the pediatric service of the CHU Gabriel Touré of Bamako]. / Problematique du transfert neonatal vers le service de pediatrie du CHU Gabriel Toure de Bamako.

UNLABELLED: Neonatal morbidity and mortality is a real concern in our context. Several factors including the organization of the reference contribute to it. Our work was aimed at studying the conditions of newborns transfer of the towards the service of pediatrics of teaching hospital Gabriel Touré. MATERIAL AND METHODS: Our study proceeded from October 15th, 2006 to January 15th, 2007 in the unit of neonatology of the service of Pediatrics of the CHU of the Hospital Gabriel Touré. It was a cross sectional and descriptive study. All the newborns referred by a health structure were included. RESULTS: We included 760 referred newborns out of 1072 neonatal admissions which means a frequency of reference of 71%. In 91.6% of the cases, the newborn were referred on the very day of their birth. Prematurity (29%), perinatal anoxia (24%), respiratory distress (13.9%) were the main reasons for reference. In no case, the service of pediatrics was contacted in advance by the referring health agent. More than half of the cases (58.6%), the public transport was used. Ambulance car transported 17.4% of the newborns. All the newborns came held in the arms of a member of their family. The referring agent was a physician in 70.3% of cases. Hypothermia was found for all the newborns (759/760) when being received. More half of the newborns (56.4%) had a small weight at birth and the quarter (25.8%) was resuscited. Lethality was 32%. Mother illiteracy, small weight at birth, the outborn birth were factors related to neonatal mortality. CONCLUSION: In our context, the reduction of neonatal morbidity and mortality has to go through an improvement of the reference system.

[Mitral valve repair for rheumatic valve disease in children in Senegal: a review of 100 cases]. / La plastie mitrale sur valve rhumatismale chez l'enfant au Sénégal: 100 observations.

Mitral valve repair is a better therapeutic alternative than valve replacement for rheumatic valve disease in children. Repair procedures are especially well suited to developing countries where heart prostheses and life-long anti-coagulation therapy are largely unaffordable. The purpose of this study was to evaluate medium-term outcome of mitral valve repair in children in Senegal. A retrospective review was conducted in a cohort of 100 patients who underwent mitral valve repair for rheumatic mitral lesions over the 8-year period from 1999 to 2007. Mean age was 12 +/- 5 years (range, 7 to 17 years). The most common symptom of valve disease was dysypnea (stage IV in 26 cases and stage III in 74). Valve lesions were complex with anterior leaflet prolapse in 62 cases, posterior leaflet restriction in 35, commissural fusion in 30, and fusion of chordaes in 54. Repair procedures consisted of transfer and shortening of chordaes in 73 cases in association with commissurotomy in 22 cases and cleft closure in 17. Ring annuloplasty was performed in 84 patients. Hospital mortality was 2%. Postoperative morbidity was characterized by residual mitral regurgitation in four cases. Mean follow-up was 5 years. No late deaths were observed. Outcome was satisfactory in 84 patients with low-grade mitral regurgitation (grade I-II). Reduction of left ventricle diameter was statistically significant during systole and diastole, i.e., from 29.5 +/- 6.2 mm to 33.1 +/- 5.3 mm (p<0.05) and from 47.1 +/- 8.6 mm to 50.5 +/- 9.4 mm (p<0.05) respectively. Improvement in cardiac function was not significant, i.e., from 63.3 +/- 4.8% to 62 +/- 6.4% (p = 0.99). Mitral valve repair was successful in stabilizing myocardial function and remodeling the left ventricle. Outcome is dependent on careful patient selection and evaluation of lesions. Middle-term outcome is encouraging.

[Klippel-Trenaunay syndrome: a case report]. / Le syndrome de Klippel-Trenaunay: a propos d'un cas.

OBJECTIVES: The purpose of this study is to illustrate a rare vascular malformation and to make a literature review. PATIENT: Klippel-Trenaunay's syndrome is a congenital disorder which characterized by capillary malformation, varicosities and bony or soft tissue hypertrophy. This disease is subject to significant morbidity like bleeding, deep vein thrombosis, embolic complications and in some cases enlargement of limb that may require amputation. Our case study was a young woman of twenty years suffering since birth, from a painful, heaviness and enlarged left lower limb that reached 2.5 cm. The distal hypertrophy at the big toe which the site of a botriomycoma (telengectasic granuloma). The inner side of the thigh was also the site of small port-wine stains and varicose of the great saphenous vein. Vascular Doppler ultrasound, skeletal computed tomography and angio-MRI of the limb indicated a klippel-Trenaunay disease. A surgical abstention was decided. The patient underwent only to resection of the toe's botriomycoma followed by an elastic contention associated with "a heel pad compensation" and an anti platelet therapy to prevent deep vein thrombosis and embolic complications. CONCLUSION: The syndrome of Klippel-Trenaunay is a rare vascular malformation. The basic pathology can not be corrected. The treatment's aims are to control varicose veins, to prevent complications and to preserve aesthetic and functional prognosis of the leg.

[Post traumatic air tamponade under assisted ventilation. Case report from Dakar, Senegal]. / Une ventilation mortelle.

Compressive pnemopericardium is an uncommon cause of shock after blunt trauma. The purpose of this report is to describe a case of air tamponnade observed during management of a patient with thoraco-abominal injuries in Dakar, Senegal. Diagnosis was suspected based on chest x-rays and subsequently confirmed by CT-scan. Clinical features included shock syndrome, small heart sign, and constant deterioration under assisted ventilation. Despite initial improvement after needle aspiration, the patient died due to probable recurrence of air tamponnade. Based on their review of the literature, the authors discuss the physiopathology of air tamponande and emergency treatment by needle aspiration that must be followed by surgery for creation of a pericardial window.

[Centipede bite in a woman with heterozygotous sickle cell disease]. / Morsure de scolopendre chez une drépanocytaire hétérozygote au Sénégal.

Although centipede bits can cause severe symptoms, they are seldom reported since outcome is generally favorable. The purpose of this report is to describe a case of centipede envenomation causing severe and prolonged symptoms in a woman with sickle cell trait.

[Study of oro-dental injuries during seizures in Senegalese children with epilepsy]. / Etude des traumatismes bucco-dentaires au cours de l'epilepsie chez l'enfant au Sénégal.

The objectives of this study were to study the prevalence of oral traumatisms and their relationship to epileptic seizures in Senegalese children. This study was undertaken in the Children's National Hospital of Dakar and deal with children with epilepsy. Sotf tissues and the teeth traumatisms that have occurred during epileptic seizures were recorded. We have also studied the relationship between the frequency of the seizures and the oral soft and hard tissues traumatisms. One hundred and eight children aged from 5 to 15 years with 67 boys and 41 girls with an average age of 8.16+/-2.86 years were enrolled. Several types of epileptic seizures were observed during which 44.5% of the children presented oral traumatisms of soft tissues (27.8%) and the teeth (16.7%). There is no significant relationship between the number of seizures and the frequency of the dental traumatisms (p = 0.352). The tooth fractures are the lesions most frequently noticed and are observed in 24.4% of the children. The traumatisms of the maxillary central incisors account for 38% of the traumatisms, followed by the canines (2.7%) and the molars (1.9%). The lower central incisors are the least affected. The traumatisms of soft tissues were observed in 27.8% of the children: the lips are more often affected (44%), followed by the tongue (30%), the association between lip and tongue (18%) and the cheeks (8%). There is no significant relationship between the number of seizures and the frequency of the traumatisms of soft tissues (p = 0.35).

[Neonatal thrombosis of the jugular veins: long-term repercussions on cerebral development (two cases)]. / Thrombose néonatale des veines jugulaires: retentissement à long terme sur le développement cérébral (à propos de deux cas).

Bilateral obstruction of the internal jugular veins is rare in the neonatal period and no long-term follow-up has been reported yet. We report two cases. The first developped an extensive thrombosis of superior veina cava related to a central veinous line, the second an unilateral thrombosis of the transverse-sigmoid sinus associated to a constitutional hypoplasia of the contralateral jugular vein. In the latter case, no cause or risk factor was noticeable, except for a forceps delivery. In both cases the clinical course was dominated by the development of a prominent collateral network of cervico-facial veins and by a progressive macrocrania. According to MRImaging, the latter was not related to a dilation of CSF spaces, but to a macro-encephaly, either by inflation of the vascular veinous compartment inside the parenchyma or by genuine brain's overgrowth. Long-term follow-up showed a grossly normal course, both from the neurological and the scholar point of view. However, slight neuropsychological anomalies were noticed, bringing some shade on the prognosis.

[Effectiveness of syndromic approach for management of urethral discharge in Senegal]. / Evaluation de l'efficacité du traitement des écoulements urétraux au Sénégal selon l'approche syndromique.

The World Health Organization has proposed the syndromic approach for management of sexually transmissible diseases (STD) in countries where diagnostic laboratory tests are not consistently available. The purpose of this study was to evaluate the effectiveness of this approach for treatment of ureteral discharge in Senegal. Twenty seven men presenting ureteral discharge underwent two-week treatment using a combination of cotrimoxazole plus tetracycline for suspected gonococcal and a chlamydial infections. Ureteral samples were collected before and after treatment to detect Neisseria gonorrhoeae by culture and Chlamydia trachomatis by direct immunofluorescence and ELISA. Results demonstrated successful treatment of all patients presenting gonococcal and chlamydial infections i.e. 84.6% of cases. Neither germ was detected in 15.4% of cases. Before treatment, Neisseria gonorrhoeae, Chlamydia trachomatis or both were found respectively in 53.9%, 5.1% and 25.6% of samples respectively. Based on these findings we conclude that the syndromic approach was effective in 84.6% of cases but treatment was in adequation with STD biologically documented only with 25.6% of cases.

Growth hormone receptors in the porcine testis during prepuberty.

Supplementation of exogenous growth hormone (GH) during prepuberty advances onset of spermatogenesis in boars, but the mechanism of action is unknown. The present study is an investigation of the presence and characteristics of testicular growth hormone receptors (GHR). A total of 36 boars were castrated, three boars every 10 days, between the ages of 10 and 120 days. Testicular membrane preparations of 10, 20, 30, 50, 70, 100 and 120-day-old boars were used to determine (125)I-bGH binding and Scatchard analysis. Liver from a 60-kg barrow was used for comparison. Specific (125)I-bGH binding to testicular membrane preparations occurred in all age groups with the exception of 20-day-old boars at levels of 30-40% of liver binding. At 30 days of age the unlabelled bGH at 1.1 ng/tube achieved half maximal inhibition (ID(50)). Results of Scatchard analysis indicated a single class of binding sites. Binding affinity was 2.89 x 10(9) m with a binding capacity of 12 fmole/mg membrane protein. The results from this study suggest that GH may act directly on the cells of the prepubertal boar testis.

[Cryptococcal meningitis and positive syphilitic serology in a patient infected by HIV]. / Cryptococcose neuroméningée associée à une sérologie syphilitique positive chez un sujet infecté par le VIH.

Co-infection of Cryptococcal meningitis and syphilis is rare. We report the first case of coinfection with cryptococcus neoformans and treponema pallidum in Dakar. There was a 41 yearold senegalese man with HIV2 infection despite a CD4 count of 50 /mm3. The patient have had the history of precedent genital ulcerations and trush. Finally he died on eigth day of treatment with Fluconazol and Penicillin G.

[Effect and mechanism of action of Tinospora bakis roots on biliary secretion using in vivo models]. / Etude de l'effet et du mécanisme d'action des racines de Tinospora bakis sur la sécrétion biliaire àpartir de modèles in vivo.

The aim of this study is to determine the choleretic properties of lyophilized aqueous extract of Tinospora bakis roots. For thus, we have used healthy and cholestatic Wistar rats. After administration of the extract (4 mg/100 g of weight) biliary flow, biliary acids flow, biliary glutathione and glucose concentrations were measured by specific methods. Comparative results between treated rats and non treated rats show: For healthy rats: a significant increase of biliary flow, biliary acids flow in the group of treated rats versus non treated healthy rats. There were no significant difference in the glutathione and glucose concentrations. For cholestatic rats: we noted also significant increase of biliary flow, biliary acids flow and glutathione concentration in the treated rats group. These results suggest that Tinospora bakis has a choleretic effect in vivo which depends on biliary acids and/or glutathione concentration.

[Hepatitis B virus infection in the school milieu of Kiffa and Selibaby, Mauritania]. / Etude de l'infection du virus de l'hépatite B en milieu scolarie de Kiffa et Sélibaby, Mauritanie.

Our survey was concerned with searching for different markers of Hepatitis B virus infection in 267 primary and secondary school children in two Mauritanian sites in the south and south-east of the country. The results showed that for the surveyed subjects, 16.8% were carriers of HBs antigen, 21% of anti-HBs antibodies, 50.2% of anti-HBc antibodies and 45.4% of anti-HBe antibodies. Furthermore, 28.9% of the carriers of HBs antigen were also of HBe antigen. In all, 32.2% of the subjects had not been exposed to the Hepatitis B virus. These results confirmed the serious problem posed to public health by Hepatitis B infection and should prompt a programme to combat it.