A short washout period from fingolimod to anti-CD20 therapy is safe and decreases the risk of reactivation.

The frequency of switches between Disease Modifying Therapies (DMTs) in Multiple Sclerosis (MS) has increased considerably over previous years. Between fingolimod and anti-CD20 therapies, a 1-month washout period is usually recommended. However, disease reactivations are frequent after fingolimod (Fg) cessation. Using a retrospective observational monocentric exposed/non-exposed cohort study, we investigated the efficacy and the safety of a shorter washout period (WP) between Fg and anti-CD20. We compared two groups: 25 patients with a short WP (<21 days) and 20 patients with a longer WP (>21 days). We observed no reactivation during WP in patients with a short WP against a relapse in 55% of patients in the longer group. Moreover, clinical and biological safety was excellent. Based on these findings, we recommend a shorter WP between fingolimod and anti-CD20 therapies in MS.

[Hyperthyroidism and diabetes mellitus: analysis of 10 African cases]. / Hyperthyroïdie et diabète sucré: analyse de 10 observations africaines.

This retrospective study of 10 patients with hyperthyroidisma and diabetes mellitus concerned 8 women and 2 men, aged from 15 to 77 years. The two disease developed at the same time in 8 cases. Diabetes mellitus occurred first in 2 cases. Common signs were loss of weight. Hyperthyroidism led to tachycardia at more than 100 bpm. Diarrhea was observed simultaneously in 2 cases and muscular weakness in 5. Goiter was found in 10 cases with a diffuse aspect. Graves' disease was diagnosed with exophthalmia in 9 cases and affected both eyes in 8. Elevated levels of thyroid hormones confirmed diagnosis in 8 cases. Diabetes was insulin-dependent in 3 cases and non-insulin dependent in the 7 others. IDDM patients (2 female and 1 male) were aged 15, 17 and 38. Keto acidosis was the first symptom in all cases. NIDDM patients (6 female and 1 male) were aged between 37 and 77.

[Scintigraphic aspects of thyroid nodules investigated at the University Hospital Center of Dakar]. / Aspects scintigraphiques des nodules thyroïdiens explorés au CHU de Dakar.

The authors studied the scintigraphical appearances of thyroid nodules. This study on 8 years period enabled the authors to list 876 thyroïd nodules. The scintigraphy shows: 14.05% of isofixant nodules, 10.73% of "hot" nodules, 58.44% of "cold" nodules, 16.78% of heteromultinodular goitries. The scintigraphy proved its great importance as in the diagnostic as in the way of therapy of this pathology.

[Dysthyroidism after 60 years of age]. / Dysthyroïdies à partir de 60 ans.

This work has been conducted on 162 subjects, aged over 60 years, living in Senegal, investigated in the Departement of Biophysics and Nuclear Medecine of Dakar for suspicion of dysthyroidism. The levels of T3, T4 and TSH US hormones were determined by a radio-immunological method. This technique, exhibiting good functionnal sensitivity and its high specificity, is likely to be beneficial to the diagnosis of dysthyroidisms. Besides, this experiment leads us to consider that the dosage of TSH remains an useful first intention examination for the old patients and could notably improve the screening of dysthyroidisms with a decrease in the cost of the investigation. However, because of the therapeutical implications, some biological profiles schould be interpreted cautiously. The equipment for the determination of the free fractions (T3 and T4) with the brought additional accuracy could allow to dismiss some diagnostci uncertainties.

[Rectal temperature trends during 24 hours in a hot climate with and without nutritional support]. / Evolution de la température rectale sur 24 heures en climat chaud avec et sans apport nutritionnel.

A group of 22 young subjects staying in rest was studied in the aim to follow the nycthemeral evolution of the rectal temperature, according to two situations: 1) normal feeding, 2) absence of feeding. The use of drinking water was not limited. The experimentation was carried out in tropical area, Kédougou (Eastern Senegal), during a high period of temperature. The mean of day temperature was 38 degrees C and the night temperature, 22 degrees C. The skin and rectal temperature, the arterial pressure and the cardiac frequency were measured every three hours. The results showed a significant difference in the nycthemeral rythm of the rectal temperatures. The nocturnal temperatures were not different in the two conditions. We observed a significant elevation (delta = 0.31 +/- 0.18 degree C) of the diurne post prandial temperature. The results supported that the thermic modification observed during the experience were linked to the feed.