[Laryngo-tracheo-bronchial foreign bodies in children at the University Hospital Center of Ouagadougou (analysis of 96 cases)]. / Les corps étrangers laryngo-trachéo-bronchiques chez l'enfant au CHU de Ouagadougou (une analyse de 96 observations).

Over a 10-year period, a series 96 patients were treated for laryngotracheal and bronchial foreign bodies in the ENT department of the Ouagadougou University Hospital Center (Burkina Faso). The purpose of this study was to analyze the epidemioclinical features and therapeutic pitfalls encountered in that series and to propose measures to improve management. The age of patients ranged from 10 months to 14 years. The male-female ratio was 1.7. Anamnesis documented foreign body aspiration was obtained in 77% of cases. The foreign body was organic in 78 cases (81.2%) including vegetal material in 56 cases. Management was delayed due to late diagnosis since only 59.3% of the patients were admitted to the hospital within the 48 first hours. Endoscopic removal was performed in all cases but such procedures remain challenging in developing countries due to a lack of proper anesthetic facilities, skilled personnel and adequate equipment. Tracheostomy was performed in 10.4% of cases mainly in patients with foreign bodies located in larynx. One patient died during extraction. In addition to providing more information and education on prevention of laryngotracheal and bronchial foreign bodies, better management requires better training of medical personnel and improvement of technical facilities.

ACTH 1-17 effects in insulin dependent diabetes mellitus.

The aim of this study was to evaluate the metabolic effects of a new synthetic ACTH analogue (ACTH 1-17) in insulin-dependent diabetic subjects. ACTH 1-17 (100 micrograms, intramuscular injection) was administered at 07(00)-07(30) every second day for 20 days. Changes in insulin dosage were carried out to maintain the same metabolic control during the period of the study. Before and after treatment diurnal plasma glucose profiles were superimposable and insulin requirement increased only in 16 out of 19 patients (mean: 6.7 +/- 2 U/die; range: 2-22 U/die). No changes were observed in diurnal profiles of blood alanine, glycerol, total ketone bodies and plasma NEFA, C-peptide, glucagon. The physiological blood lactate and pyruvate peaks following the evening meal were initially absent and could be detected after treatment. From our data it is not clear whether the more physiological pattern of blood lactate and pyruvate is caused by the modest increase in insulin dosage or is a specific effect of the treatment.

Correlations between glycosylated haemoglobin and other metabolic parameters in insulin-dependent diabetics.

The metabolic parameters of 40 insulin-dependent patients (22 females and 18 males) have been studied to evaluate their intercorrelations. We obtained positive correlation between glycosylated haemoglobin and triglycerides (r = +0,460; p less than 0,01) and between HbA1 and mean diurnal plasma glucose (MDPG) (r = +0,652; p less than 0,001). There was a negative correlation between HbA1 and high density lipoproteins (HDL) cholesterol (r = -0,406; p less than 0,05). No significant correlation was found between HbA1 and either uric acid or total cholesterol. Correlations were also found between MDPG and triglycerides, MDPG and HDL-cholesterol, triglycides and HDL-cholesterol, uric acid and HDL-cholesterol. These correlations are discussed.

[Correlations between NEFA and ketone bodies in normal and diabetic subjects]. / Correlazioni NEFA-chetocorpi in soggetti normali e diabetici.

We have studied the correlation between NEFA and KB in 25 controls and in 24 diabetics, receiving or no insulin therapy. There is a correlation (r=0,64) between NEFA and KB in normal subjects and a more significant correlation (r=0,85) in diabetics. The "b" value of the two regression lines in the two groups is different, and this is dependent by variations in the hormonal (insulin and glucagon) and metabolic responses.