How restful is it with all that noise? Comparison of Interleaved silent steady state (ISSS) and conventional imaging in resting-state fMRI.

Resting-state fMRI studies have become very important in cognitive neuroscience because they are able to identify BOLD fluctuations in brain circuits involved in motor, cognitive, or perceptual processes without the use of an explicit task. Such approaches have been fruitful when applied to various disordered populations, or to children or the elderly. However, insufficient attention has been paid to the consequences of the loud acoustic scanner noise associated with conventional fMRI acquisition, which could be an important confounding factor affecting auditory and/or cognitive networks in resting-state fMRI. Several approaches have been developed to mitigate the effects of acoustic noise on fMRI signals, including sparse sampling protocols and interleaved silent steady state (ISSS) acquisition methods, the latter being used only for task-based fMRI. Here, we developed an ISSS protocol for resting-state fMRI (rs-ISSS) consisting of rapid acquisition of a set of echo planar imaging volumes following each silent period, during which the steady state longitudinal magnetization was maintained with a train of relatively silent slice-selective excitation pulses. We evaluated the test-retest reliability of intensity and spatial extent of connectivity networks of fMRI BOLD signal across three different days for rs-ISSS and compared it with a standard resting-state fMRI (rs-STD). We also compared the strength and distribution of connectivity networks between rs-ISSS and rs-STD. We found that both rs-ISSS and rs-STD showed high reproducibility of fMRI signal across days. In addition, rs-ISSS showed a more robust pattern of functional connectivity within the somatosensory and motor networks, as well as an auditory network compared with rs-STD. An increased connectivity between the default mode network and the language network and with the anterior cingulate cortex (ACC) network was also found for rs-ISSS compared with rs-STD. Finally, region of interest analysis showed higher interhemispheric connectivity in Heschl's gyri in rs-ISSS compared with rs-STD, with lower variability across days. The present findings suggest that rs-ISSS may be advantageous for detecting network connectivity in a less noisy environment, and that resting-state studies carried out with standard scanning protocols should consider the potential effects of loud noise on the measured networks.

Active and placebo transcranial magnetic stimulation effects on external and internal auditory hallucinations of schizophrenia.

OBJECTIVE: Repetitive transcranial magnetic stimulation (rTMS) over the left temporo-parietal region has been proposed as a treatment for resistant auditory verbal hallucinations (AVH), but which patients are more likely to benefit from rTMS is still unclear. This study sought to assess the effects of rTMS on AVH, with a focus on hallucination phenomenology. METHOD: Twenty-seven patients with schizophrenia and medication-resistant AVH participated to a randomized, double-blind, placebo-controlled, add-on rTMS study. The stimulation targeted a language-perception area individually determined using functional magnetic resonance imaging and a language recognition task. AVH were assessed using the hallucination subscale of the Scale for the Assessment of Positive Symptoms (SAPS). The spatial location of AVH was assessed using the Psychotic Symptom Rating Scales. RESULTS: A significant improvement in SAPS hallucination subscale score was observed in both actively treated and placebo-treated groups with no difference between both modalities. Patients with external AVH were significantly more improved than patients with internal AVH, with both modalities. CONCLUSIONS: A marked placebo effect of rTMS was observed in patients with resistant AVH. Patients with prominent external AVH may be more likely to benefit from both active and placebo interventions. Cortical effects related to non-magnetic stimulation of the auditory cortex are suggested.

Phase III trial of doxorubicin plus cyclophosphamide (AC), docetaxel, and alternating AC and docetaxel as front-line chemotherapy for metastatic breast cancer: Japan Clinical Oncology Group trial (JCOG9802).

BACKGROUND: This randomized, multicenter, phase III trial compared doxorubicin plus cyclophosphamide (AC), single-agent docetaxel (D), and an alternating regimen of AC and docetaxel (AC-D) as first-line chemotherapy in metastatic breast cancer (MBC). PATIENTS AND METHODS: Patients with MBC resistant to endocrine therapy were entered in a randomized study to receive either six cycles of AC (doxorubicin 40 mg/m2 plus cyclophosphamide 500 mg/m2), D (60 mg/m2), or alternating treatment with AC-D (i.e. three cycles of AC and three cycles of D). Treatment was administered every 3 weeks. RESULTS: A total of 441 patients were entered in a randomized study. Response rates were 30% for AC, 41% for D, and 35% for AC-D. The median times to treatment failure (TTFs) were 6.4, 6.4, and 6.7 months (one-sided log-rank test, P = 0.13 for AC versus D, P = 0.14 for AC versus AC-D) and median overall survival (OS) was 22.6, 25.7, and 25.0 months (P = 0.09 for AC versus D, P = 0.13 for AC versus AC-D) in the AC, D, and AC-D, respectively. CONCLUSION: There was no difference in the TTF among the three arms. However, there was a trend toward a better response and better OS in the D than in the AC.

[The psychological experience of the mothers whose babies were born deformed in the neonatological ward of the academic hospital center of Treichville (Côte-d'Ivoire)]. / Vécu psychologique des mères de nouveau-nés malformés dans le centre hospitalier et universitaire de Treichville (Côte-d'Ivoire).

OBJECTIVE: When a baby is born deformed, his birth breaks up plans his family has made for his life as well as for the family itself. So, our objective was to describe the experience undergone by the mothers who gave birth to babies with serious deformities. METHOD: A prospective and descriptive study was carried out during 12 months about 35 mothers whose babies were born seriously deformed. The data were collected from newborn's medical file and from a well-conducted interview with volunteered mothers. RESULTS: The incidence of the major deformities was 1.4% and the antenatal diagnosis was carried out on only 6 cases. The announcement of deformities in the 30 cases discovered at birth by the clinical staff brought about a shock among mothers. In fact, 28 mothers were disappointed, while 23 experienced fear and 10 others felt guilty. Six mothers thought in terms of aborting, followed by 25 mothers who without any psychological aid felt lonely. Furthermore, 30 mothers suffered from a lack of communication with nurses and with medical staff concerning deformities. The anxiety of mothers was linked, respectively to fear of their husband (33 cases), to the social environment (35 cases) and to the health care (10 cases). CONCLUSION: Mothers facing congenital deformity experienced painful and violent emotional distress. Therefore, the emphasis must be put on the improvement of the neonatal diagnosis and of relationship between physicians and parents in order to achieve a close support toward mothers.

Cortical plasticity as a basis of phantom limb pain: Fact or fiction?

Cortical reorganization has been proposed as a major factor involved in phantom pain with prior nociceptive input to the deafferented region and input from the non-deafferented cortex creating neuronal activity that is perceived as phantom pain. There is substantial evidence that these processes play a role in neuropathic pain, although causal evidence is lacking. Recently it has been suggested that a maintenance of the cortical representation of the former hand area is related to phantom pain. Although interesting, evidence for this process is so far scarce. In addition, peripheral factors have been proposed as important for phantom limb pain. Although often introduced as contradictory, we suggest that cortical reorganization, preserved limb function and peripheral factors interact to create the various painful and nonpainful aspects of the phantom limb experience. In addition, the type of task (sensory versus motor), the interaction of injury- and use-dependent plasticity, the type of data analysis, contextual factors such as the body representation and psychological variables determine the outcome and need to be considered in models of phantom limb pain. Longitudinal studies are needed to determine the formation of the phantom pain experience.

[Treatment of childhood cancer in Africa. Action of the Franco-African childhood cancer group]. / Le traitement des cancers de l'enfant en Afrique. Travaux du groupe franco-africain d'oncologie pédiatrique.

The childhood cancer survival rate is currently 75% in industrialized countries. Rates in developing countries are much lower. The Franco-African Childhood Cancer Group (French acronym, GFAOP) was founded in 2000 with aim of reducing this unfavorable situation in Africa. The GFAOP has developed two forms of action. The main form consists of organizing two- to twelve-month training sessions for physicians and nurses in France and Morocco. The other form involves assessing the feasibility of modern treatment protocols for various cancers in Africa. The first feasibility trials were carried out on nephroblastoma and Burkitt's lymphoma in 12 pilot units in North Africa, West Africa, and Madagascar. In the first study from 2001 to 2005 we treated 306 cases of Burkitt's lymphoma using French LMB protocols adapted to the African setting and achieved a survival rate of 61%. A second study started in 2005 using Endoxan alone achieved a highly satisfactory survival rate of 73% for neuroblastoma in all stages except bilateral. Altogether from 2001 to 2007 more than 1000 cases of nephroblastoma and Burkitt's lymphoma were treated in African hospitals by African doctors and nurses. No patients were transferred to Europe. The GFAOP supplied drugs when necessary and took care of most travel expenses. African and French doctors worked together on protocol design, trial management, and data analysis. These promising results show that the latest therapeutic techniques can be used to treat childhood cancer in Africa by adapting the protocol to conditions in developing countries. Sanofi-Aventis Laboratories in association with the International Union against Cancer has launched a major campaign to improve Pediatric Oncology in developing countries. Projects in four GFAOP units are being financed through this campaign. In 2006 the GFAOP began assessment of two new treatment protocols, i.e., one for acute lymphoblastic leukemia and the other for Hodgkin's disease. Two other projects are being planned, i.e., one for treatment of retinoblastoma and the other for treatment of some types of brain tumors.

Neural correlates of evoked phantom limb sensations.

Previous work showed the existence of changes in the topographic organization within the somatosensory cortex (SI) in amputees with phantom limb pain, however, the link between nonpainful phantom sensations such as cramping or tingling or the percept of the limb and cortical changes is less clear. We used functional magnetic resonance imaging (fMRI) in a highly selective group of limb amputees who experienced inducible and reproducible nonpainful phantom sensations. A standardized procedure was used to locate body sites eliciting phantom sensations in each amputee. Selected body sites that could systematically evoke phantom sensations were stimulated using electrical pulses in order to induce phasic phantom sensations. Homologous body parts were also stimulated in a group of matched controls. Activations related to evoked phantom sensations were found bilaterally in SI and the intraparietal sulci (IPS), which significantly correlated with the intensity of evoked phantom sensations. In addition, we found differences in intra- and interhemispheric interaction between amputees and controls during evoked phantom sensations. We assume that phantom sensations might be associated with a functional decoupling between bilateral SI and IPS, possibly resulting from transcallosal reorganization mechanisms following amputation.

The neuropathology of HIV-infected African children in Abidjan, Côte d'Ivoire.

In an autopsy study of HIV-infected children in Abidjan, Côte d'Ivoire, the neuropathology of 76 HIV-1- and 2 HIV-2-positive children was compared with that of 77 frequency-matched HIV-negative children, in whom the systemic pathology was also known. Seventy of the 78 HIV-seropositive children were confirmed as HIV-infected, as determined by combined serology, IgA Western blots and clinicopathological criteria. The HIV-negative children showed a high background level (n = 49, 64%) of neuropathological abnormalities, including nonspecific inflammatory infiltrates, micromineralization, and bacterial and lymphocytic meningitis. In the HIV-positive children, HIV encephalitis was found in 4 (6%), cytomegalovirus in 2 (3%), toxoplasmosis in 3 (4%) and measles encephalitis in one (1%). Bacterial meningitis was equally common in both groups, but cerebral malaria was less common (n = 2, 3%) in HIV-positive than in HIV-negative children (n = 11, 14%). The low prevalence of HIV encephalitis may reflect comparatively early death in HIV infection in Africa as compared with our experience in Europe and the US.

Clinical spectrum of human immunodeficiency virus disease in children in a west African city. Project RETRO-CI.

OBJECTIVES: To determine the prevalence of HIV infection in children and to compare diagnostic syndromes and outcomes in HIV-positive and HIV-negative children. METHODS: Consecutive children hospitalized in Abidjan's three university hospitals were examined, tested for HIV infection and followed to discharge. Admission or discharge diagnoses and outcome (survived or died) were compared in HIV-positive and HIV-negative children. RESULTS: The prevalence of HIV infection in the 4480 children hospitalized for the first time was 8.2%; the highest age-specific rate (11.2%) was in children ages 15 to 23 months. Six clinical syndromes accounted for more than 80% of admissions in HIV-positive and -negative children (all ages combined): respiratory infection; malnutrition; malaria; anemia; diarrhea; and meningitis. The dominant syndromic diagnoses in HIV-positive children were respiratory infection (26.1%) and malnutrition (25.8%); in HIV-negative children they were malaria (30.4%) and respiratory infection (19.1%). The overall mortality rate in HIV-positive children was 20.8%, compared with 8.7% in HIV-negative children (relative risk, 2.4; 95% confidence interval, 1.9 to 3.1); the highest death rate (28.1%) was in children younger than 15 months. CONCLUSIONS: Clinical syndromes associated with HIV infection in African children are difficult to recognize without access to HIV serology. Respiratory infection and malnutrition were the dominant clinical syndromes in HIV-positive children in Abidjan. Greater overlap exists between the clinical presentations of HIV-associated disease and other common health problems in African children than in adults.

Western blot analysis in patients with hypocaeruloplasminaemia.

Inherited copper toxic disease, Wilson's disease, is an autosomal recessive disorder arising from a defect in biliary copper excretion. Although there are several pathognomonic clinical features, such a multisystem disease can be difficult to diagnose, particularly in the early stages of copper toxicity. Even measurements of serum copper and caeruloplasmin, the major copper-transporting protein typically reduced in Wilson's disease, may mimic other metabolic conditions such as Menke's disease and chronic active hepatitis. We have previously shown that the major biliary isoform of copper-transporting protein is 125 kDa caeruloplasmin, and this is always absent in the bile of Wilson's disease patients. In this paper we describe Western blot analysis of molecular species of caeruloplasmin in hypocaeruloplasminaemia, which can distinguish between the overlap which occurs in Wilson's disease homozygotes, heterozygotes and other conditions mimicking Wilson's disease. This may be useful for identifying patients with low plasma caeruloplasmin concentrations, and hepatic or neurological clinical features which may also be found in Wilson's disease.

Black-white differences in the stage at presentation of prostate cancer in the District of Columbia.

OBJECTIVES: Prostate cancer (PC) is a major health problem for American black males. Blacks experience higher PC incidence and mortality compared to whites. Although the racial difference in PC incidence remains unexplained, the difference in PC mortality has been largely attributed to the late stage of disease at presentation. By using the incidence data on District of Columbia residents, this study compares the stage at diagnosis between black men and white men and attempts to determine if observed differences may be attributed to socioeconomic status (SES). METHODS: Reporting facilities staged PC using the Surveillance, Epidemiology, and End Results summary staging scheme. Averages of high school education, income, and home ownership at the census tract level were used as proxies for SES, and frequency distributions were reported. Data were stratified based on stage to examine the influence of race and SES on stage. RESULTS: For 1987 to 1991, 980 men (median age, 71 years) were reportedly diagnosed with PC. Black patients are younger and prostate tumors appear more likely to be more aggressive among blacks than whites. SES is negatively associated with late stage PC, and currently married men, compared with previously married, are less likely to be diagnosed with metastatic PC. Black men are more likely to present with later stage disease, and this racial difference persists even when SES is controlled. CONCLUSIONS: Late stage diagnosis is associated with favorable SES indicators. But substantial racial gradients in the distribution of diagnostic stage persisted even after adjustment for SES. This suggests the need for more intensive efforts to address issues related to access, quality, and utilization of cancer screening services as they pertain to all African-American men in the District of Columbia irrespective of their social status.

3'-amino-2',4'-BNA: novel bridged nucleic acids having an N3'-->P5' phosphoramidate linkage.

Novel oligonucleotide analogues, containing a 3'-amino-2',4'-BNA unit, were successfully synthesized, and they showed superior duplex and triplex forming ability as well as BNA itself, along with remarkable enzymatic stability.

5-fluorouracil sensitivity and dihydropyrimidine dehydrogenase activity in advanced gastric cancer.

BACKGROUND: Dihydropyrimidine dehydrogenase (DPD) is the rate-limiting enzyme of 5-fluorouracil (5-FU) catabolism. Several studies have demonstrated the clinical importance of DPD in cancer patients, suggesting that the efficacy of 5-FU may be related to DPD activity in tumor tissue. In the present study, DPD activity and chemosensitivity to 5-FU were evaluated in advanced gastric cancer. MATERIALS AND METHODS: Thirty-four gastric cancers from 32 patients were studied and chemosensitivity to 5-FU was evaluated by histoculture drug response assay. RESULTS AND CONCLUSION: DPD activity and tumor inhibition of 5-FU among all cases showed no significant correlation, but among 14 histologically differentiated cases significant correlation was observed. DPD activity may be useful in determining the 5-FU sensitivity of differentiated gastric cancer.

Significance of para-aortic lymph node dissection in patients with advanced and recurrent gastric cancer.

Among 243 patients who underwent radical gastrectomy for advanced gastric cancer, 19 patients underwent radical gastrectomy with extended lymphadenectomy including cancer-positive para-aortic lymph nodes. Their prognosis was unexpectedly good, with a mean postoperative survival time of 24.1 months and a 2-year-survival rate of 42.4 percent. Another 4 patients developed para-aortic lymph node recurrence detected by computed tomographic scan during a follow-up examination. These 4 patients were treated with macroscopic curative dissection of the para-aortic lymph nodes. Although 2 of the 4 patients died within 6 months after re-operation, the prognosis of the other two patients was rather good when treated with active combination chemotherapy consisting of 5-fluorouracil, adriamycin and cisplatin. Dissection of para-aortic lymph nodes is considered of valuable in the treatment of advanced gastric cancer, and dissection of the para-aortic lymph node recurrence may also be valid when combined with potent chemotherapy.

Transcriptional regulation of nir and nor operons of Paracoccus denitrificans.

Transcripts of nitrite reductase (nir) and nitric oxide reductase (nor) operons of Paracoccus denitrificans were expressed only under anaerobic conditions in the presence of potassium nitrite. The nir and nor operons produced at least two transcription products. Large transcripts seemed to contain whole operons and small ones seemed to contain the genes encoding denitrifying enzymes. All transcription start sites were detected 41.5 or 42.5 bp downstream from the center of FNR boxes.

Pathology of paediatric human immunodeficiency virus infections in Cote d'Ivoire.

PIP: During an 8-month period in 1991-92, in Abidjan, Ivory Coast, autopsies were conducted on 156 cadavers of children (76 HIV-1 positive cadavers, 2 HIV-2 positive cadavers, and 77 HIV-negative cadavers) located in the morgue of Treichville University Hospital Center. Morgue personnel had screened 417 dead children 1 month to 14 years old for HIV-1 or HIV-2 during the same period, 80 (19%) of whom were HIV-1 or HIV-2 positive. Among the dead children younger than 18 months, 81% had HIV IgA antibodies. The age ranged from 1 to 96 months for all the HIV-infected dead children and 1 to 144 months for the HIV-negative dead children. Specific diseases found only among HIV-infected dead children included, in order of prevalence, pneumocystis pneumonia (15 months only), toxoplasmosis, herpes simplex, multinucleate giant cell encephalitis, and lymphocytic interstitial pneumonitis. Only 2 HIV-positive dead children had tuberculosis; they were older than 15 months. In both HIV-positive and HIV-negative dead children, the most common cause of death was pyogenic pneumonia. The prevalence of pneumocystis pneumonia in the HIV-positive dead children younger than 15 months was higher than it was for HIV-positive adults (31% vs. 3%).^ieng

Disease in children infected with HIV in Abidjan, Côte d'Ivoire.

OBJECTIVE: To document the range of disease in African children infected with HIV. DESIGN: Necropsy results in consecutive children aged 1 month or more who were HIV positive and in children who were HIV negative for comparison; IgA western blots on serum samples from children under 2 years of age who were positive for HIV-1 to test the validity of routine HIV serology. SETTING: Largest hospital in Abidjan, Côte d'Ivoire. SUBJECTS: 78 children who were HIV positive and 77 children who were HIV negative on whom a necropsy was performed; their median ages at death were 18 and 21 months respectively. 36 HIV positive children and 29 HIV negative children were 1-14 months old; 42 HIV positive and 48 HIV negative children were > or = 15 months old. MAIN OUTCOME MEASURES: Cause of death and prevalence of diseases confirmed pathologically. RESULTS: Respiratory tract infections were more common in HIV positive than in HIV negative children (73 (94%) v 52 (68%); P < 0.05), and were aetiologically heterogeneous. Pneumocystis carinii pneumonia was found in 11 out of 36 (31%) HIV positive children aged < 15 months, but in no HIV negative children. Among older children measles was more common in HIV positive children (8/42 (19%) v 2/48 (4%); P < 0.06). Pyogenic meningitis was present in similar proportions of HIV positive and HIV negative children aged < 15 months (7/36 (19%) and 7/29 (24%)). In HIV positive children tuberculosis (1/78), lymphocytic interstitial pneumonitis (1/78), and HIV encephalitis (2/78) were rare. CONCLUSIONS: There is greater overlap between diseases associated with HIV infection and other common health problems in African children than there is in adults. Compared with adults, HIV positive children had a high prevalence of P carinii pneumonia and a low prevalence of tuberculosis. Measles, but not malaria, was associated with HIV infection.

[Bacterial pneumopathies of the newborn: diagnostic and therapeutic aspects]. / Pneumopathies bactériennes du nouveau-né: aspects diagnostiques et thérapeutiques.

OBJECTIVES: To describe the diagnosis and therapeutic management of bacterial pneumopathies in a neonatology unit located in a tropical area. METHODS: Transverse and prospective survey over an 18-month period. The diagnosis was based on the comparison of anamnestic features with clinical, biological and radiological features. A research was made in order to determine the causal agent in the blood, in cerebrospinal fluid, in urines, in pleural liquid and skin lesions. A treatment by two antibiotics was administered through parenteral route. RESULTS: Risk factors were found in 61 selected patients. Polypnea was associated with signs of respiratory distress in 53 patients. Blood abnormalities were present in 47, 5% of the cases. All the patients showed a positive C reactive protein and abnormal X-rays. The diagnosis was confirmed bacteriologically in 32, 8% of the cases. The association of a third-generation cephalosporin with an aminoside was prescribed in 44 cases. The initial antibiotic therapy was not relevant in 19, 7% of the cases. The lethality rate was 24, 6%. The scarcity of bacteriological confirmation led us to consider the combination of radiological abnormalities with respiratory distress as significant symptoms of bacterial pneumopathy. Biological and anamnestic features were considered as extra elements. CONCLUSION: The severity of clinical features, the nature of germs and their sensitivity to antibiotics in our local environment led us to recommend a large prescription of third-generation cephalosporins combined to aminoglycosides.

[Long-lasting remission of Burkitt's disease in African children. Apropos of 6 cases]. / Longue rémission de la maladie de Burkitt de l'enfant africain. A propos de 6 cas.

Long complete remission in six cases of Burkitt's lymphoma in African children is reported. Complete remissions over eighteen months free of disease are considered as recovery because relapses are rare after this period. These remissions are obtained as well as in stage I and stages III-IV. If classic chemotherapy (cyclophosphamide and methotrexate) is effective, aggressive chemotherapy with several antimitotic drugs is recommended in the poor prognosis forms and relapses. Central nervous system chemoprophylaxis, radiation and maintenance chemotherapy are discussed. Prognosis improvement of Burkitt's lymphoma in African children needs early diagnosis and more aggressive treatment with less damage.

[Knowledge and practices of the mothers of children from 6 to 18 months relative to the conduct of weaning: cases from the general hospital of Marcory]. / Connaissances et pratiques des meres d'enfants de 6 a 18 mois relatives à la conduite du sevrage: cas de l' hôpital général de Marcory.

Weaning is a high-risk phase in the life of infants around the world, because poorly managed, it raises protein-energy malnutrition to levels causing crucial problems to the health of infants. AIMS: The purpose is to estimate the knowledge and the practices of the mothers regarding the conduct of food weaning of their children aged 6 to 18 months. MATERIALS AND METHODS: We conducted a descriptive cross-sectional survey at the general hospital of Marcory in Abidjan-CI on a sample of 100 mother-child pairs who came to consult. RESULTS: It emerges from this survey that.The mothers are young, with 94% younger than 35 years old. 88% of the mothers were of a low socioeconomic level. Dietary restrictions still remained a real obstacle to a better practice of weaning.The vast majority of the mothers (74%) ignore the notion of weaning and 40% of them had no information regarding this process. Food weaning was not conventional with an early weaning at 1 to 6 months in 38% of the cases and a late weaning (30%) after 13 months. CONCLUSION: It is necessary to set up a program focusing on the adequate conduct of weaning in infants to improve mothers' knowledge and the practices.

Le sevrage constitue une phase à haut risque dans la vie des nourrissons dans le monde , car mal conduit, le sevrage hisse la malnutrition protéino énergétique au rang des problèmes cruciaux de santé chez les nourrissons. OBJECTIF: Le but est d'évaluer les connaissances et les pratiques des mères concernant la conduite du sevrage alimentaire de leurs enfants âgés de 6 à 18 mois. MATERIEL: Nous avons réalisé une enquête transversale descriptive à l'hôpital général de Marcory à Abidjan-CI sur un échantillon de 100 couples mères enfants venus consulter. RESULTATS: Il ressort de cette enquête que.Les mères sont jeunes puisque 94% des mères avaient moins de 35 ans.88% des mères étaient d'un niveau socio économique bas. Les interdits alimentaires restaient encore un réel obstacle à une meilleure pratique du sevrage.La grande majorité des mamans (74%) méconnaissent la notion de sevrage et 40 % d'entre elles ne disposaient d'aucune information. Le sevrage alimentaire n'était pas conventionnel avec un sevrage précoce d'1 à 6 mois dans 38% des cas et un sevrage tardif (30%) au delà de 13 mois. CONCLUSION: Il faut mettre en place un programme axé sur la conduite adéquate du sevrage des nourrissons pour améliorer les connaissances et pratiques des mères.