Application of Trace Biological Evidence Collection Kit in DNA Examination of Trace Bloodstain Samples from the Scene.

ABSTRACT: Objective To evaluate the effects of DNA examination of trace bloodstain samples from the scene collected with Trace Biological Evidence Collection kit. Methods Venous blood was made into bloodstains on the ground. The trace bloodstain samples were collected with Trace Biological Evidence Collection kit and common methods, respectively. DNA examination of trace bloodstain samples （50 from each group） was conducted on the constant temperature shaker for 2, 24, 48, 72, and 96 h, respectively, and the examination results of every group were compared. Results When the trace bloodstain samples were placed on the constant temperature shaker for 24, 48, 72, and 96 h, the DNA detection rates in the group which used Trace Biological Evidence Collection kit （100.00%, 100.00%, 100.00%, 96.00%） were significantly higher than those in the group using common methods （62.00%, 26.00%, 10.00%, 0）, the differences had statistical significance （P<0.05）. When the trace bloodstain samples were placed on the constant temperature shaker for 2 h, the differences of DNA detection rates between the two groups had no statistical significance （ P>0.05）. Conclusion The Trace Biological Evidence Collection kit can effectively improve DNA detection rate and extend detection time limit for trace bloodstain samples from the scene that have been stored for a relatively long time.

[Effect of Benzidine Test on DNA Analysis of Bloodstain].

OBJECTIVES: To explore the effect of benzidine test and related reagents on DNA analysis of bloodstain. METHODS: A total of 970 bloodstain filter paper samples with 1 µL venous blood were collected, and 10 of them acted as control samples. After benzidine test and related reagent processing, DNA of 960 samples was extracted by Chelex-100 and silica bead methods and then multiplex amplified by AmpFℓSTR™ Identifiler™ Plus PCR kits. The results of STR typing were compared between different groups. RESULTS: DNA were extracted immediately after benzidine test. Totally STR loci （3.80±1.34） were detected by silica bead method, while no STR loci were obtained by Chelex-100 method. Thirteen samples （21.7%） with whole STR typing results were obtained by drying after benzidine test, and the STR locus number （12.90±1.49） which obtained by silica bead method was much higher than by Chelex-100 method （4.70±1.96） （P<0.05）. When DNA was extracted immediately after the addition of glacial acetic acid, the STR locus number was （9.40±2.09） by silica bead method, but no STR typing result was obtained by Chelex-100 method. All 15 STR loci could be obtained by only adding glacial acetic acid after drying and only adding tetramethylbenzidine alcoholization liquid or 3% hydrogen peroxide liquid. CONCLUSIONS: Benzidine test has significant influence on DNA analysis of bloodstain. The Chelex-100 method is not suitable for the DNA extraction of bloodstain after benzidine test. Drying after benzidine test and silica bead methods can effectively enhance the STR locus number of bloodstain.

Correlation analysis between single nucleotide polymorphism of DRD1 gene and stereotyped behavior of blue fox.

This study was performed to investigate the correlation between stereotyped behavior of the blue fox and single nucleotide polymorphisms (SNPs) of the DRD1 gene. We choose the DRD1 gene as a major gene for investigating the correlation of gene polymorphism and self-biting disease by means of direct sequencing. Part of the DRD1 gene exon of the blue fox was cloned; the length of the whole sequence was 864 bp. Four SNPs were detected and analyzed by the chi-square analysis; the results showed that the gene polymorphism of T206C in the DRD1 gene had a significant correlation with self-biting (P < 0.01). Therefore, marker-assistant selection on self-biting of blue foxes using these SNPs can be applied to select healthy individuals.

Cloning and analysis of the soybean MEKK gene.

In this paper, homologous cloning methods were used to clone the soybean GmMEKK gene, which possesses a high degree of similarity to Arabidopsis thaliana AtMEKK1. AtMEKK1 is formed by 595 amino acids, and its secondary structure is formed by 38 irregular curls, 24 α helix, 14 ß, with S-TKc domain, transmembrane domain and does not have membrane spanning domain and signal peptide. GmMEKK-GFP subcellular localization fusion and prokaryotic expression vectors were generated and it was revealed that GmMEKK encodes a highly conserved 66.8-kDa nuclear protein that is expressed in soybean roots, stem floral pieces, and leaves. A real-time quantitative PCR analysis of GmMEKK under different abiotic stresses revealed that the expression level of GmMEKK increased under drought and low phosphorus and nitrogen conditions. Taken together, these data suggest that GmMEKK may play an important role in the soybean abiotic stress response.

Animal board invited review: Quantification of resilience in farm animals.

Resilience, when defined as the capacity of an animal to respond to short-term environmental challenges and to return to the prechallenge status, is a dynamic and complex trait. Resilient animals can reinforce the capacity of the herd to cope with often fluctuating and unpredictable environmental conditions. The ability of modern technologies to simultaneously record multiple performance measures of individual animals over time is a huge step forward to evaluate the resilience of farm animals. However, resilience is not directly measurable and requires mathematical models with biologically meaningful parameters to obtain quantitative resilience indicators. Furthermore, interpretive models may also be needed to determine the periods of perturbation as perceived by the animal. These applications do not require explicit knowledge of the origin of the perturbations and are developed based on real-time information obtained in the data during and outside the perturbation period. The main objective of this paper was to review and illustrate with examples, different modelling approaches applied to this new generation of data (i.e., with high-frequency recording) to detect and quantify animal responses to perturbations. Case studies were developed to illustrate alternative approaches to real-time and post-treatment of data. In addition, perspectives on the use of hybrid models for better understanding and predicting animal resilience are presented. Quantification of resilience at the individual level makes possible the inclusion of this trait into future breeding programmes. This would allow improvement of the capacity of animals to adapt to a changing environment, and therefore potentially reduce the impact of disease and other environmental stressors on animal welfare. Moreover, such quantification allows the farmer to tailor the management strategy to help individual animals to cope with the perturbation, hence reducing the use of pharmaceuticals, and decreasing the level of pain of the animal.

SNAPIG: a model to study nutrient digestion and absorption kinetics in growing pigs based on diet and ingredient properties.

Current feed formulation and evaluation practices rely on static values for the nutritional value of feed ingredients and assume additivity. Hereby, the complex interplay among nutrients in the diet and the highly dynamic digestive processes are ignored. Nutrient digestion kinetics and diet × animal interactions should be acknowledged to improve future predictions of the nutritional value of complex diets. Therefore, an in silico nutrient-based mechanistic digestion model for growing pigs was developed: "SNAPIG" (Simulating Nutrient digestion and Absorption kinetics in PIGs). Aiming to predict the rate and extent of nutrient absorption from diets varying in ingredient composition and physicochemical properties, the model represents digestion kinetics of ingested protein, starch, fat, and non-starch polysaccharides, through passage, hydrolysis, absorption, and endogenous secretions of nutrients along the stomach, proximal small intestine, distal small intestine, and caecum + colon. Input variables are nutrient intake and the physicochemical properties (i.e. solubility, and rate and extent of degradability). Data on the rate and extent of starch and protein hydrolysis of different ingredients per digestive segment were derived from in vitro assays. Passage of digesta from the stomach was modelled as a function of feed intake level, dietary nutrient solubility and diet viscosity. Model evaluation included testing against independent data from in vivo studies on nutrient appearance in (portal) blood of growing pigs. When simulating diets varying in physicochemical properties and nutrient source, SNAPIG can explain variation in glucose absorption kinetics (postprandial time of peak, TOP: 20-100 min observed vs 25-98 min predicted), and predict variation in the extent of ileal protein and fat digestion (root mean square prediction errors (RMSPE) = 12 and 16%, disturbance error = 12 and 86%, and concordance correlation coefficient = 0.34 and 0.27). For amino acid absorption, the observed variation in postprandial TOP (61 ± 11 min) was poorly predicted despite accurate mean predictions (58 ± 34 min). Recalibrating protein digestion and amino acid absorption kinetics require data on net-portal nutrient appearance, combined with observations on digestion kinetics, in pigs fed diets varying in ingredient composition. Currently, SNAPIG can be used to forecast the time and extent of nutrient digestion and absorption when simulating diets varying in ingredient and nutrient composition. It enhances our quantitative understanding of nutrient digestion kinetics and identifies knowledge gaps in this field of research. Already useful as research tool, SNAPIG can be coupled with a postabsorptive metabolism model to predict the effects of dietary and feeding-strategies on the pig's growth response.

[Epidemiological and clinical aspects of atrial fibrillation at the cardiology department of kati university hospital]. / Aspects epidemiologique et clinique de la fibrillation auriculaire au service de cardiologie du chu de kati.

Atrial fibrillation is the most frequent permanent rhythm disorder.Theaim of this work was to determine the epidemiological and clinical aspects of atrial fibrillation cases hospitalized in the cardiology department of the University Hospital of Kati. MATERIALS AND METHODS: We carried out a descriptive retrospective study, from January 2018 to December 2019.Patients of all ages and both sexes with clinical and EKG atrial fibrillation admitted to the department during the study period were included in the study.The variables studiedwere: socio-demographic characteristics, clinical signs, classification of atrial fibrillation, and comorbidities associated. RESULTS: A total of 52 patients were included in the studyof 203 cases hospitalized in the department, with a hospital prevalence of 25.61%, the female sex was predominant 69.23%. The main reason for consultation was heart failure syndrome (46.15%).Arterial hypertension (55.76%) was the mostassociatedcomorbidity. Permanent atrial fibrillation accounted for 63.46% of cases . CONCLUSION: Atrial fibrillation is the most frequent arrhythmia in our environment, preventive measures must be put in place for early detection and better management of comorbiditiesassociatedwith atrial fibrillation.

La fibrillation auriculaire est le trouble du rythme le plus fréquent. Le but de ce travail était de déterminer les aspects épidémiologiques et cliniques de la fibrillation atriale dans le service de cardiologie du CHU de Kati. MATÉRIELS ET MÉTHODES: Il s'agit d'une étude rétrospective descriptive menée de janvier 2018 à décembre 2019. Ont été inclus dans cette étude les patients de tout âge et des deux sexes ayant présenté une fibrillation atriale sur des critères cliniques et électrocardiographiques, admis dans le service pendant la période d'étude. Les variables étudiées étaient : les caractéristiques sociodémographiques, les signes cliniques et électriques, et les comorbidités associées. RÉSULTATS: Au total 52 patients ont été inclus dans l'étude sur 203 cas hospitalisés dans le service soit une prévalence hospitalière de 25,61%, le sexe féminin a été prédominant 69,23%. Le principal motif de consultation était le syndrome d'insuffisance cardiaque (46,15%). L'hypertension artérielle (55,76%) a été la comorbidité la plus associée. La fibrillation atriale permanente représentait 63,46% des cas. CONCLUSION: La fibrillation atriale est l'arythmie la plus fréquente dans notre milieu, des mesures préventives doivent être mise en place pour une détection précoce et une meilleure prise en charge des comorbidités associées.

Clinical, paraclinical and genetic aspects of autosomal recessive cerebellar ataxias (ARCA) in Mali.

Introduction: Autosomal recessive cerebellar ataxias (ARCA) are a group of rare and heterogynous neurodegenerative diseases mainly characterized by unbalance and walking difficulty and movement incoordination. Objectives: To clinically and paraclinically characterize ARCA in the department of Neurology at the Teaching Hospital of Point G and identify the underlying genetic defect. Patients and method: We have conducted a longitudinal and prospective study from January 2018 to December 2020. Patients with ARCA phenotype seen in the Department of Neurology at the Teaching Hospital of Point "G" were enrolled. Results: We have enrolled 7 families totaling 13 patients after giving an informed verbal and written consent. The sex ratio was 2.2 in favor of males, Kayes region and Fulani ethnic group were respectively the most represented region and ethnic group.Walking difficulty represented the major symptom followed by loss of vibration and joint sense, nystagmus, dysarthria and skeletal deformities. Alpha-foetoprotein level was high in one patient. Genetic testing confirmed Friedreich ataxia in one family and was not conclusive in 4 families. Conclusion: This study showed that ARCA are not uncommon in Mali and genetic testing is crucial to confirm the diagnosis.

Introduction: Les ataxies cérébelleuses autosomiques récessives (ACAR) constituent un groupe de maladies neurodégénératives rares et hétérogènes caractérisées essentiellement par un trouble de l'équilibre et de la marche, et un trouble de la coordination des mouvements. Objectifs: Caractériser les signes cliniques, paracliniques et génétiques des ataxies cérébelleuses autosomiques récessives au Service de Neurologie du CHU du Point "G". Patients et méthodes: Nous avons réalisé une étude de cas enrôlé dans le cadre d'une étude longitudinale et prospective allant de Janvier 2018 à Décembre 2020, portant sur des patients présentant des symptômes d'ACAR et ayant donné leur consentement éclairé. Résultats: Nous avons enrôlé sept familles totalisant 13 patients. Le sexe ratio était de 2,2 en faveur des hommes, la région de Kayes était la plus représentée et l'ethnie peulh était majoritaire. Les troubles de la marche ont représenté les signes majeurs suivis de troubles de la sensibilité profonde, de nystagmus, de dysarthrie, et des déformations ostéoarticulaires. L'alpha-foetoprotéine était élevée chez une patiente. Le test génétique a retrouvé l'ataxie de Friedreich dans une famille et n'a pas été concluant dans quatre autres. Conclusion: Cette étude montre que les ACAR ne sont pas rares au Mali et l'exploration génétique constitue un outil indispensable pour leur diagnostic de certitude.

Long-term prognosis of patients with permanent cardiac pacemaker indication in three referral cardiac centers in Cameroon: Insights from the National pacemaker registry.

BACKGROUND: There is evidence that cardiac pacemakers improve symptoms and quality of life in patients with severe bradycardia. Globally, the number of pacemaker implantations is on the rise. However, the associated high-cost limits pacemaker's accessibility in low resource settings. This study aimed to investigate access to pacemakers and the long-term outcome of patients requiring a pacemaker. METHOD: We conducted a cohort study in 03 health care structures in Cameroon. Participants aged at least 18 years with indication for a permanent pacemaker between January 2010 and May 2016 were included. Clinical profile, electrocardiography, pacemaker implantation parameters were recorded. Long-term survival was studied by event-free analysis using the Kaplan-Meier method. RESULTS: In total, 147 participants (mean age 67.7±13.7 years, female 58.5%) were included. Fatigue (78.7%), dyspnoea (77.2%), dizziness (47.1%) and palpitations (40.4%) were the main symptoms while syncope was present in 35.7% of patients. The main indication for cardiac pacemaker was atrioventricular block (85.3%). Forty (27.2%) could not be implanted with 34 (85%) of participants highlighting cost of intervention as main reason. VVIR was the main mode of stimulation (70.5%). Of 125 patients in which follow-up was ascertained, 17(13.5%) died after a median survival time of 2.8 years post diagnosis [IQR: 1.8-4.2]. The survival curve was better in participants with a pacemaker with a Hazard ratio of 2.7 [CI: 1.0-7.3, P=0.045]. CONCLUSION: Our patients with severe heart blocks presented late and more than a quarter did not have access to pacemaker but its implantation multiplied the survival rate by 2.7 times at approximately 3 years post diagnosis. Improving early detection of heart blocks and access to cardiac pacing to reduce mortality shall be a key future priority.

[Epidemiology of Covid-19 and high blood pressure association at Mali'shospital]. / Epidemiologie de l'association Covid-19 et hypertension arterielle a l'hopital du Mali.

INTRODUCTION: High blood pressure is a major cardiovascular risk factor. Patients with cardiovascular risk factors are at risk of developing COVID-19. The objective of this study was to determine epidemiology of Covid-19 infected in patients with high blood pressure. PATIENTS AND METHOD: Descriptive cross-sectional study from April 2020 to June 2020 about patients hospitalized for Covid 19 by PCR diagnosis at the Hopital du Mali Bamako and having high blood pressure. Admission registry and patient charts were used to collect data. RESULTS: We collected 78 out of 484 in patients which mean hospital frequency of 16.11%. The mean age was 55.21 +/- 14.61 years. Sex ratio M / F was 1.36. Patients were followed for high blood pressure in 59% of cases. Medical history was ischemic heart disease in 2.6% and dilated cardiomyopathy in 2.6%. Main functional signs were cough in 41.02% and lost of taste in 11.53%. High blood pressure on admission was grade 2 in 37.2% and grade 3 in 3.8%. Treatments received were calcium channel blockers 41.02%, inhibitors of the reninangiotensinaldosterone system 16.66% and combinations 15.38%. Hospital mortality was 10.3%. There was no statistically significant difference in mortality between known hypertensive patients and de novo hypertensive patients. There was also no statistically significant difference in mortality by grade of hypertension. CONCLUSION: High blood pressure can be associated to Covid 19. Treatment is based on calcium channel blockers and reninangiotensinaldosterone system inhibitors. It has an impact on the prognosis of the disease with significant mortality.

INTRODUCTION: L'hypertension artérielle (HTA) est un facteur de risque cardiovasculaire majeur. Dans la littérature elle est fréquemment retrouvée chez les patients atteints de la COVID-19.L'objectif de cette étude est de décrire l'épidémiologie de cette association chez les patients hospitalisés pour Covid-19. PATIENTS ET MÉTHODE: L'Etude est transversale et descriptive ; elle a été réalisée sur la période du 1erAvril 2020 au 30 Juin 2020. Elle a concerné les patients hospitalisés pour Covid 19 avec un test PCR positif à l'hôpital du Mali de Bamako et ayant une HTA. Les registres d'admission et les dossiers des patients ont servi pour la collecte des données. RÉSULTATS: Nous avons colligé 78 sur 484 patients hospitalisés soit une fréquence de 16,11%. L'âge moyen était de 55,21 +/- 14,61 ans. Le sex ratio H/F était de 1,36.Les patients étaient suivis pour HTA dans 59% des cas. Les antécédents médicaux étaient la cardiopathie ischémique chez 2,6% et la cardiomyopathie dilatée chez 2,6%. Les principaux signes fonctionnels étaient la toux chez 41,02% et l'agueusie chez 11,53%. L'HTA à l'admission était de grade 2 dans 37,2% des cas et de grade 3 dans 3,8% des cas. Les traitements reçus étaient les inhibiteurs calciques 41,02%, les inhibiteurs du système rénine angiotensine aldostérone 16,66% et les associations 15,38%. La mortalité hospitalière était de 10,3%. Il n'y avait pas de différence statistiquement significative concernant la mortalité entre les patients connus hypertendus et les patients hypertendus de novo. Il n'y avait pas non plus de différence statistiquement significative concernant la mortalité selon le grade de l'HTA. CONCLUSION: l'HTA peut être associée au Covid 19. Le traitement est basé sur les inhibiteurs calciques et sur les inhibiteurs du système rénine angiotensine aldostérone. Elle a un impact sur le pronostic de la maladie avec une mortalité importante.

[HIV sentinel surveillance of pregnant women in Mauritania from 2001 to 2007]. / Surveillance sentinelle du VIH chez les femmes enceintes en Mauritanie entre 2001 et 2007.

According to the 2008 report on global AIDS epidemic, 33 millions of people are living with HIV/AIDS. Subsaharian Africa is the most affected part of the world. The first case of AIDS in Mauritania was reported in 1987. The national prevalence of HIV/AIDS in the country is estimated at less than 1%. The HIV serosurveillance among pregnant women started in country in 2001. This work has focused on HIV sentinel surveillance among pregnant women in antenatal clinics, attending health centres in different wilayas (regions) of the country in order to assess evolution of prevalence between 2001 and 2007. An anonymous and non-correlated method is used for this survey. A questionnaire was administered and venous sampling made for eligible women. Analyses were performed with an algorithm based on two screening tests (ELISA) and another test for confirmation (New Lav Blot). Despite some disparities between the sites considered, the results have shown a low prevalence rate (between 0.1 and 1.48). The average prevalence of HIV infection samples collected increased from 0.57% [0.34-0.80] in 2001 to 0.61% [0.40-0.82] in 2007 with 95% confidence interval. Statistical analysis showed no significant changes between 2001 and 2007 at all these sites. HIV1 is the most frequent type with a proportion of 93.5% in 2007. After several years of classic HIV sentinel surveillance, and to better understand disparities between sites, we recommend a second generation sentinel surveillance (behavioural and serological) approach.

Modelling the feed intake response of growing pigs to diets contaminated with mycotoxins.

Quantifying robustness of farm animals is essential before it can be implemented in breeding and management strategies. A generic modelling and data analysis procedure was developed to quantify the feed intake response of growing pigs to perturbations in terms of resistance and resilience. The objective of this study was to apply this procedure to quantify these traits in 155 pigs from an experiment where they received diets with or without cereals contaminated with the mycotoxin deoxynivalenol (DON). The experimental pigs were divided equally in a control group and three DON-challenged groups. Pigs in each of the challenged groups received a diet contaminated with DON for 7 days early on (from 113 to 119 days of age), later on (from 134 to 140 days of age) or in both periods of the experiment. Results showed that the target feed intake trajectory of each pig could be estimated independently of the challenge. The procedure also estimated relatively accurately the times when DON was given to each challenged group. Results of the quantification of the feed intake response indicated that age and previous exposure to DON have an effect on the resilience capacity of the animals. The correlation between resistance and resilience traits was modest, indicating that these are different elements of robustness. The feed intake analysis procedure proved its capacity to detect and quantify the response of animals to perturbations, and the resulting response traits can potentially be used in breeding strategies.

A procedure to quantify the feed intake response of growing pigs to perturbations.

Improving robustness of farm animals is one of the goals in breeding programmes. However, robustness is a complex trait and not measurable directly. The objective of this study was to quantify and characterize (elements of) robustness in growing pigs. Robustness can be analysed by examining the animal's response to perturbations. Although the origin of perturbations may not be known, their effect on animal performance can be observed, for example, through changes in voluntary feed intake. A generic model and data analysis procedure was developed (1) to estimate the target trajectory of feed intake, which is the amount of feed that a pig desires to eat when it is not facing any perturbations; (2) to detect potential perturbations, which are deviations of feed intake from the estimated target trajectory; and (3) to characterize and quantify the response of the growing pigs to the perturbations using voluntary feed intake as response criterion. The response of a pig to a perturbation is characterized by four parameters. The start and end times of the perturbation are 'imposed' by the perturbing factor, while two other parameters describe the resistance and resilience potential of the pig. One of these describes the immediate reduction in daily feed intake at the start of the perturbation (i.e., a 'resistance' trait) while another parameter describes the capacity of the pig to adapt to the perturbation through compensatory feed intake to rejoin the target trajectory of feed intake (i.e., a 'resilience' trait). The procedure has been employed successfully to identify the target trajectory of feed intake in growing pigs and to quantify the pig's response to a perturbation.

Acetylcholine-induced Ciliary Beat of the Human Nasal Mucosa Is Regulated by the Pannexin-1 Channel and Purinergic P2X Receptor.

Background Airway mucociliary transport is an important function for the clearance of inhaled foreign particulates in the respiratory tract. The present study aimed at investigating the regulatory mechanism of acetylcholine (Ach)-induced ciliary beat of the human nasal mucosa in ex vivo. Methods The inferior turbinate mucosa was collected from patients with chronic hypertrophic rhinitis during endoscopic surgery. The mucosa was cut into thin strips, and ciliary movement was observed under a phase-contrast light microscope with a high-speed digital video camera. The sample was alternatively subjected to scanning electron microscopic observation. Results Cilia on the turbinate epithelium were well preserved at the ultrastructural level. The baseline ciliary beat frequency (CBF) was 6.45 ± 0.32 Hz. CBF was significantly increased by stimulation with 100 µM Ach and 100 µM adenosine triphosphate. The Ach-induced CBF increase was completely inhibited by removing extracellular Ca2+. Significant inhibition of the Ach-induced CBF was also observed by the addition of 1 µM atropine, 40 µM 2-aminoethoxydiphenyl borate (inositol trisphosphate [IP3] receptor antagonist), 10 µM carbenoxolone (pannexin-1 blocker), 1 mM probenecid (pannexin-1 blocker), 100 µM pyridoxalphosphate-6-azophenyl-20,40-disulfonic acid (P2X antagonist), and 300 µM flufenamic acid (connexin blocker). Meanwhile, 30 nM bafilomycin A1 (vesicular transport inhibitor) did not inhibit the Ach-induced CBF increase. CONCLUSIONS: These results indicate that the regulatory mechanism of the Ach-induced ciliary beat is dependent on extracellular Ca2+ and involves the muscarinic Ach receptor, IP3 receptor, pannexin-1 channel, purinergic P2X receptor, and connexin channel. We proposed a tentative intracellular signaling pathway of the Ach-induced ciliary beat, in which the pannexin-1-P2X unit may play a central role in ciliary beat regulation.

Serum Uric Acid Is Associated with Poor Outcome in Black Africans in the Acute Phase of Stroke.

BACKGROUND: Prognostic significance of serum uric acid (SUA) in acute stroke still remains controversial. OBJECTIVES: To determine the prevalence of hyperuricemia and its association with outcome of stroke patients in the Douala General Hospital (DGH). METHODS: This was a hospital based prospective cohort study which included acute stroke patients with baseline SUA levels and 3-month poststroke follow-up data. Associations between high SUA levels and stroke outcomes were analyzed using multiple logistic regression and survival analysis (Cox regression and Kaplan-Meier). RESULTS: A total of 701 acute stroke patients were included and the prevalence of hyperuricemia was 46.6% with a mean SUA level of 68.625 ± 24 mg/l. Elevated SUA after stroke was associated with death (OR = 2.067; 95% CI: 1.449-2.950; p < 0.001) but did not predict this issue. However, an independent association between increasing SUA concentration and mortality was noted in a Cox proportional hazards regression model (adjusted HR = 1.740; 95% CI: 1.305-2.320; p < 0.001). Furthermore, hyperuricemia was an independent predictor of poor functional outcome within 3 months after stroke (OR = 2.482; 95% CI: 1.399-4.404; p = 0.002). CONCLUSION: The prevalence of hyperuricemia in black African stroke patients is quite high and still remains a predictor of poor outcome.

[Evaluation of malaria rapid diagnostic test Optimal-IT® pLDH along the Plasmodium falciparum distribution limit in Mauritania]. / Evaluation du test de diagnostic rapide du paludisme OptiMal-IT® pLDH à la limite de la distribution de Plasmodium falciparum en Mauritanie.

Performance of the malaria Rapid Diagnostic Test (RDT) OptiMal-IT® was evaluated in Mauritania where malaria is low and dependent on a short transmission season. Slide microscopy was considered as the reference method of diagnosis. Febrile patients with suspected malaria were recruited from six health facilities, 3 urban and 3 rural, during two periods (December 2011 to February 2012, and August 2012 to March 2013). Overall, 780 patients were sampled, with RDT and thick blood film microscopy results being obtained for 759 of them. Out of 774 slides examined, of which 200 were positive, P. falciparum and P. vivax mono-infections were detected in 63.5% (127) and 29.5% (59), while P. falciparum/P. vivax coinfections were detected in 7% (14). Both species were observed in all study sites, although in significantly different proportions. The proportions of thick blood film and OptiMal-IT® RDT positive individuals was 26.3% and 30.3% respectively. Sensitivity and specificity of OptiMal-IT® RDT were 89% [95% CI, 84.7-93.3] and 91.1% [88.6-93.4]. Positives and negative predictive values were 78.1% [72.2-83.7] and 95.9% [94.1-97.5]. These diagnostic values are similar to those generally reported elsewhere, and support the use of RDTs as the main diagnostic tool for malaria in Mauritanian health facilities. In the future, choice of RDTs to be used must take account of thermostability in a hot, dry environment and their ability to detect P. falciparum and P. vivax.

[Clinical and paraclinical profile of heart transplanted patients at the Thoracic and cardiovascular surgery service of the Pitié Salpétrière Hospital in 2009]. / Profil clinique et paraclinique des patients transplantes cardiaques dans le service de chirurgie thoracique et cardiovasculaire du groupe Hospitalier Pitie-Salpetriere (GHPS) en 2009.

OBJECTIVE: To determine the clinical and paraclinical profile of heart transplanted patients in 2009 in the Thoracic and Cardiovascular Surgery (TCVS) of the Pitié-Salpêtrière Hospital (PS). METHOD: It was a retrospective and descriptive study on heart transplantation patients between January 1 and December 31, 2009 in the TCVS of PS. Data collection was conducted from medical records, medical correspondence and pre-transplant assessment data and relevant laboratory tests, ultrasound, angiographic and operative reports. The collected data were entered and analyzed by Excel and analyzed by SPSS 12. RESULTS: The sample size was 63 patients or 50.6% of patients awaiting heart transplantation. The mean age of patients was 47.66 ± 12.79 years, sex ratio Male:Female 2.70. The circumstances of transplantation were: super-emergency (37%), non-emergency (63%) and in 1/3 of redux surgery. All patients were symptomatic (average VO2 max of 12.76 ± 3.20 ml/kg/min), with 85.7% having a left ventricular ejection fraction <30% and 100% diastolic dysfunction. The primary dilated cardiomyopathy was the main causal disease with 38.1% of cases. CONCLUSION: Heart transplantation as a last resort is practiced more and more with improved results and highlights dilated cardiomyopathy as the main cause. The clinical and paraclinical profile has not changed much over the last 5 years.

BUT: Déterminer le profil clinique et paraclinique des patients transplantés en 2009 Service de Chirurgie Thoracique et Cardiovasculaire (SCTCV) du Groupe Hospitalier Pitié-Salpétrière.( GHPS). MATÉRIEL ET MÉTHODES: L'étude était rétrospective descriptive sur les patients transplantés cardiaques entre le 1er janvier et le 31 décembre 2009 dans le SCTCV du GHPS.La collecte des données a été réalisée à partir des dossiers médicaux, des courriers médicaux et des données du bilan pré-greffe et a concerné les examens biologiques, échographiques, coronarographique et les comptes rendus opératoires. Les données recueillies ont été saisies et analysées par le logiciel Excel et analysées par SPSS 12. RÉSULTATS: La taille de l'échantillon était de 63 patients soit 50,6 % des patients en attente de transplantation. L'âge moyen des patients était de 47,66 ± 12,79 ans, le sex-ratio H: F de 2,70. Les circonstances de la transplantation étaient: en super-urgence (37%), hors-urgence (63%) et redux dans 1/3 des cas. Tous les patients étaient symptomatiques (VO2 max moyenne de 12,76 ±3,20 ml/Kg/min), 85,7% avec avaient une FE < 30% et 100% une dysfonction diastolique. La cardiomyopathie dilatée primitive représentait la principale pathologie causale avec 38.1% des cas. CONCLUSION: La transplantation cardiaque en tant qu'ultime recours se pratique de plus en plus avec une amélioration des résultats et fait ressortir les cardiomyopathies dilatées comme principale cause. Le profil clinique et paraclinique n'a pas beaucoup évolué par rapport aux 5 dernières années.

[Orthostatic low blood pressure in patient suffering from hypertension, in external cardiology consultation]. / L'Hypotension orthostatique chez l'hypertendu en consultation externe de cardiologie.

This work was aimed to describe the epidemiological, clinical, biological and electrical aspects of orthostatic low blood pressure (LBP) within patients with high blood pressure (HBP) in the cardiology department of the Kati University Hospital. This was a prospective cross-sectional study conducted between June 1st, 2012 and May 31st, 2013. It included all the patients with HBP regularly assessed for at least a month, following their treatment and having no other treatments which can induce a orthostatic LBP. RESULTS: With a total of 300 subjects with high blood pressure, 42 subjects presented an orthostatic LBP with or without suggestive clinical demonstrations, among which 16 men and 26 women, with an average age of 55 year. In the HBP population, the orthostatic LBP had a 14% frequency (42/300), the sex ratio was 0.61. Most of the patients were 55 years old or more. The HBP was not controlled in 66.7% of cases. Twelve percent of the patients with orthostatic LBP were diabetics. The number of antihypertensive drug used did not appear to influence the appearance of an orthostatic LBP. Monotherapy was associated with an orthostatic LBP in 47.6% of cases and this monotherapy used the calcic inhibitors in 62% of the cases. Orthostatic low blood pressure is frequent within patient with HBP undergoing treatment. It must be systematically looked for, especially in the uncontrolled HBP, among older subjects, the diabetics, and those with a personal history of neurological disease.

OBJECTIF: Ce travail visait à décrire les aspects épidémiologiques, cliniques, biologiques et électriques de l'hypotension orthostatique chez l'hypertendu dans le service de cardiologie du CHU de Kati. PATIENTS ET MÉTHODES: L'étude était transversale et prospective allant du 1er Juin 2012 au 31 Mai 2013 dans le service de cardiologie du CHU de Kati. Il s'agissait de l'ensemble des patients hypertendus régulièrement suivis depuis un mois et plus, bien observant et n'ayant pas d'autres traitements pouvant favorisés l'hypotension orthostatique. RÉSULTATS: Au total 42 sujets présentant une hypotension orthostatique avec ou sans manifestations cliniques évocatrices ont étés inclus, dont 16 hommes et 26 femmes, en moyenne âgés de 55 ans. Dans la population d'hypertendus, l'hypotension orthostatique avait une fréquence de 14% (42/300), le sex ratio était de 0,61. Les patients âgés de plus de 55 ans étaient plus nombreux. L'hypertension artérielle n'était pas contrôlée dans 66,7%. 11,9% des patients hypotendus orthostatiques étaient diabétiques. Le nombre d'antihypertenseur utilisé ne paraissait pas influencer l'apparition d'une hypotension orthostatique. La monothérapie était associée à une hypotension orthostatique dans 47,6% et cette monothérapie utilisait les inhibiteurs calciques dans 62% des cas. CONCLUSION: L'hypotension orthostatique est fréquente chez les hypertendus traités. Elle doit être recherchée systématiquement, en particulier dans l'HTA non contrôlée, chez les sujets âgés, les diabétiques, et chez ceux ayant un antécédent neurologique.

[Veinus thrombosis of the limbs in the cardiology service of the Gabriel Touré Teaching Hospital]. / Thrombophlebite des membres dans le service de cardiologie du CHU Gabriel Toure.

OBJECTIVE: Determine the frequency of thrombosis of the upper and lower limbs in the cardiology specialist unit. Describe the clinical and paraclinical signs observed. Identify etiological factors. Evaluate the response to treatment. MATERIAL AND METHODS: This longitudinal prospective study was conducted from the 1st January 2007 to 31st May 2008 in the service of cardiology of the Gabriel Touré Teaching Hospital of Bamako. Included in the study were all the patients diagnosed with deep vein thrombosis confirmed by venous ultrasound imaging. The data was analyzed with the software Ear-information-6.04d. RESULTS: 12 cases of deep vein thrombosis confirmed for a total of 1171 hospitalizations, either of 1,88% with a high frequency between 30 and 44 years old (40,9%) without any preference of sex (sex ratio=1). 63,6% had no known cardiovascular antecedent. The clinical signs were evocative in 90 cases, 9%. Prolonged confinement was present in 59.09% of cases, and was associated with HIV infection in 18.1% of cases. The attack of the left lower limb was recorded the most (72.7%), only one case of the left upper limb (4.5%). The attack of the major network preferentially prevailed (86.3%) with preferably proximal seat (72.7%). The femoral vein was reached (50%). 86.3% of the patients received HBPM +AVK with 68.18% of cure without after-effect. The evolution was complicated by pulmonary embolism in 13.6% of cases and death in 4.5%. CONCLUSION: Deep vein thrombosis of the limbs occupies a significant place among cardiovascular pathologies in Bamako and HIV seems to increase its frequency.

OBJECTIF: Déterminer la fréquence des thromboses veineuses profondes des membres supérieurs et inferieurs dans le milieu spécialisé cardiologique. Décrire les signes cliniques et para cliniques. Identifier les facteurs étiologiques. Evaluer l'évolution sous traitement. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude prospective et longitudinale qui s'est déroulée du 1er janvier 2007 au 31 mai 2008 dans le service de cardiologie du Centre Hospitalier Universitaire Gabriel Touré de Bamako. Etaient inclus tous les patients qui présentaient une thrombose veineuse profonde des membres confirmée échographiquement. Les données ont été analysées avec le logiciel Epi-info-6.04d. RÉSULTATS: 22 cas de thrombophlébite confirmée pour un total de 1171 hospitalisations, soit une fréquence de 1,88% avec un âge de survenue entre 30 et 44ans (40,9%) sans aucune préférence de sexe (sex ratio=1). Soixante et trois virgule six pour cent n'avaient aucun antécédent cardiovasculaire connu. Les signes cliniques étaient évocateurs dans 90,9%. L'alitement prolongé était présent dans 59,09% des cas, associé à l'infection au VIH dans 18,1%. L'atteinte du membre inférieur gauche prédominait (72,7%), un seul cas du membre supérieur gauche (4,5%). L'atteinte du réseau profond prédominait (86,3%) avec un siège préférentiellement proximal (72,7%). La veine fémorale a été la plus thrombosée (50%). Quatre-vingt et six virgule trois pour cent des patients ont reçu les Héparines de Bas Poids Moléculaire (HBPM) + Anti Vitamine K (AVK) avec 68,18% de guérison sans séquelle. L'évolution s'est compliquée d'embolie pulmonaire dans 13,6% et de décès dans 4,5%. CONCLUSION: La thrombose veineuse profonde des membres occupe une place importante parmi les pathologies cardiovasculaires en milieu spécialisé cardiologique à Bamako et l'infection au VIH semble augmenter sa prévalence.

[Proteinuria in hypertensive patients in the cardiology department of the Gabriel TOURE University Hospital]. / La proteinurie chez l'hypertendu dans le service de cardiologie du CHU Gabriel TOURE.

OBJECTIVE: This study aimed to describe epidemiological, clinical, and biological aspects of proteinuria in hypertensive patients in the cardiology department of the Gabriel Touré University Hospital in Bamako. PATIENTS AND METHODS: A cross-sectional descriptive study conducted from January to December 2007 in the cardiology department of the Gabriel Touré University Hospital. RESULTS: A total of 114 subjects were included (60 men and 54 women) with a mean age of 57 years, the sex ratio was 1.11. In the hypertensive population, stage 1 to 2 chronic renal failure was found in 12.9% (114/880). Patients under 60 years of age were more frequently affected with 61.5%. Proteinuria was found in 37 among 114 patients in chronic renal failure (32.5%). Proteinuria frequency in the general hypertensive population was 4.2% (37/880). Microalbuminuria was predominant compared to macro-albuminuria: 25.5% versus 7%. Dyspnea (38.6%) and headache (36.8%) were the main symptoms of hypertension. Renal ultrasound was abnormal in 14.1% with a predominance of stage 0 (76%), stages 1 and 2 each accounted for 7%. CONCLUSION: Proteinuria is a biological anomaly frequently associated with hypertension. His research is required when renal impairment is associated with hypertension. Its discovery in hypertension significantly changes the management strategy of this affection.

OBJECTIF: Ce travail visait à décrire les aspects épidémiologiques, cliniques et biologiques de la protéinurie chez l'hypertendu avec une augmentation de la créatininémie dans le service de cardiologie du CHU Gabriel TOURE de Bamako. PATIENTS ET MÉTHODES: L'étude était transversale et descriptive allant du 1er Janvier au 31 Décembre 2007 dans le service de cardiologie du CHU Gabriel TOURE. RÉSULTATS: Au total 114 sujets ont étés inclus, dont 60 hommes et 54 femmes, en moyenne âgés de 57 ans, le sex ratio était de 1,11. Dans la population d'hypertendus, l'IRC débutante à modérée avait une fréquence de 12,9% (114/880). Les patients âgés de moins de 60 ans étaient plus nombreux avec une fréquence de 61,5%. La protéinurie était retrouvée chez 37/114 patients en insuffisance rénale chronique soit 32,5%. La fréquence de la protéinurie dans la population générale d'hypertendus était de 4,2 % (37/880).L'atteinte rénale marquée par la micro-albuminurie était prédominante par rapport à la macro-albuminurie : 25,5% contre 7%. La dyspnée (38,6%) et les céphalées (36,8%) étaient les principales manifestations de l'HTA. L'échographie rénale était anormale dans 14,1% avec une prédominance du stade 0 (76 %), les stades 1 et 2 représentaient chacun 7%. CONCLUSION: La protéinurie est une anomalie biologique fréquemment associée à l'HTA. Sa recherche s'impose lorsqu'une atteinte rénale est associée à l'HTA. Sa découverte au cours de l'HTA change considérablement la stratégie de prise en charge de cette affection.