Effects of strain and stocking density on leg health, activity, and use of enrichments in conventional broiler chicken production.

Conventional broiler production needs to evolve towards more animal-friendly production systems in order to meet increasing consumer concerns regarding animal welfare. Genetics and stocking density are 2 of the most promising leads to make this change possible. In this study, 6 strains with different growth rates (42-61 g/d) were reared at contrasting densities: 37 kg/m² (HD) and 29 kg/m² (LD). At the same body weight of 1.80-1.95 kg, we evaluated how growth rate and stocking density influenced broiler behaviors (general activity, interactions with enrichments), broiler health (mortality, leg problems, cleanliness and plumage growth) and litter quality. Density did not affect body weight, mortality or behaviors. For all strains, LD was associated with a lower prevalence of hock burns, a better gait score, and improved litter quality and broiler cleanliness. For the 3 strains most affected by pododermatitis, a lower prevalence was observed in LD than in HD pens. Fewer birds were inactive and more birds were standing and interacting with the enrichments (as proposed in the experiment) as soon as the growth rate was lower than that of the control strain (Ross 308). Others welfare indicators such as gait score, plumage growth improved as well. Litter humidity decreased with growth rate, contributing to better leg conditions and cleaner breasts. The prevalence of hock burns and certain behaviors (i.e., the proportion of birds grooming or walking/running) were not affected by growth rate. The proportion of birds foraging was higher at a lower growth rate. These results suggest that reducing growth rate as a preliminary measure, and reducing density as a supplementary one, would improve conventional broiler welfare.

Research Note: Effect of a phlorotannin extract of the brown seaweed Ascophyllum nodosum as a potential control strategy against Campylobacter in broilers.

Poultry is generally recognized as the main source of human campylobacteriosis and Campylobacter is highly prevalent at the farm level. To reduce the relative risk of human campylobacteriosis attributable to broiler meat, it is necessary to reduce Campylobacter loads in broiler ceca but to date, no effective, reliable and practical strategy is available. The marine environment is a rich source of original natural compounds exhibiting different biological activities. The objective of this study was to test a phlorotannin extract of the brown seaweed Ascophyllum nodosum as a potential control strategy against Campylobacter in broilers. Bactericidal activity has been demonstrated in vitro, on several Campylobacter spp. strains at a range of 0.06 to 0.47 mg/mL. Therefore, an in vivo trial in experimental facilities was performed to evaluate addition of 0.2% (w/w) of an A. nodosum extract to feed distributed at the end of rearing from day 31 to day 35, and to assess the effect on artificial Campylobacter jejuni colonization. No statistical differences in Campylobacter enumeration were observed between the treated and control groups. Another trial was performed in a commercial broiler flock. Feed containing the extract at 0.2% (w/w) (2 kg/t) was distributed during the last 5 days of rearing (day 33-day 38). No significant effects on Campylobacter colonization and on growth parameters were observed compared to the control group. Additional studies are needed to assess whether active polyphenols are found in the cecum.

Primary resistance to antiretroviral drugs of HIV strains in Chad: a retrospective investigation by analysis of frozen dried blood spot samples.

No data concerning antiretroviral drug's (ARV) primary resistance mutation rates in Chad are available. We retrospectively analysed frozen-stored dried blood spot samples that were collected from 48 Chadian human immunodeficiency virus (HIV)-1 seropositive patients naïve of ARV. HIV-1 protease and reverse transcriptase genes were successfully sequenced for 24 (60.0%) of the 40 patients displaying a viral load > 1000 copies/ml. Seven (29.2%) displayed mutations conferring resistance against one or more classes of ARV. We evidenced high levels of primary ARV resistance mutations in Chad, but lower than those observed in patients with failure to first-line ARV.

[Diagnosis and surgical traitment of intracerebral hydatic cyst in Mali]. / Diagnostic et traitement chirurgical du kyste hydatique cerebral au Mali.

AIMS: Cerebral hydatic cysts are common in North African and pastoral countries but still underdiagnosed in sub-saharian ones.We report the first two casesoperated in Mali andhistologically proven of cerebral hydatic cysts. PATIENTS AND METHOD: Our study was aboutabout a 46 years old patient, admitted for Bravais-Jacksonian crisis, dysarthry and right hemiparesy, and another 38 years old male one, with a intracranial hypertension syndrome associated with cranial fistulized cerebral hydatic cyst.The CT scan has shown a cerebral cyst in the first case and multi-locular cysts in the second. The patients underwent surgery, with complete removal in one case and a rupture in the second case, but with a good outcome. Anatomo-pathological analysis concluded to hydatic cerebral cysts in both cases. CONCLUSION: With these first cases, the diagnosis of cerebral hydatic cyst must be evoked more frequently in our countries, because of the evolution of radiological diagnosis and surgical abilities.

INTRODUCTION: L'hydatidoseest une parasitose frequente dans les pays d'elevage de moutons (maghreb). Le kyste hydatique cerebral en est une localisation rare (1 a 4%) et souvent meconnue en afrique sub-saharienne. Nous rapportons2 cas de kystes hydatiques cerebraux operes au Mali. OBSERVATIONS: Le premier patient de 46 ans, cultivateur et éleveur, vivant en milieu rural, admis pour crises convulsives Bravais-Jacksoniennes, dysarthrie et hémiparésie droite. Le deuxième, âgé de 38 ans présentait un syndrome d'hypertension intra-crânienne et une tuméfaction occipitale fistulisée. La tomodensitométriecérébrale a objectivé une lésion kystique unique dans un cas et multi-cloisonnée dans le deuxième cas. Après concertation pluridisciplinaire, le diagnostic de kyste hydatique a été évoqué.Une exérèse complète des lésions a été effectuéeet l'anatomo-pathologie a confirmé un kyste hydatique cérébral dans les deux cas. Les suites ont été favorables. CONCLUSION: Le kyste hydatique cérébral est une affection rare et peu connue au Mali. Une hypertension intracranienne, des signes focaux, des crises convulsives, ainsi que les donnéesTDM et l'IRM sont les clés du diagnostic. La prise en charge neurochirurgicale permet une évolution favorable. La prévention permet l'interruption de la chaîne de transmission.

[Summary Of Admissions To The Bamako Dermatology Hospital]. / Bilan Des Admissions A l'Hôpital De Dermatologie De Bamako.

OBJECTIVE: It was to take stock of the dermatological conditions managed within the hospital over a period of five years. PATIENTS AND METHODS: Retrospective and descriptive study performed from January 2015 to December 2019 at the Bamako Dermatology Hospital, based on the records of patients received in consultation. RESULTS: During the period, 6,322 new consultations were recorded. The mean age was 42 ± 12.5 years with extremes of two months and 82 years. The sex ratio was 0.6. The majority of our patients (76.1%) came directly from home. Socio-professionally, the patients were mainly peasants (45%), housewives (23.9%) and workers (12%). Among the 6,322 consultants, 27.1% were hospitalized. In terms of diagnosis, skin conditions were dominated by infections (56.1%), followed by allergies (15.4%); system diseases (12.0%); genetic dermatoses (7.5%) and tumor dermatoses (5.2%). The average length of hospital stay was 46 ± 18.7 days in adults and 21 ± 11.6 days in children. CONCLUSION: This study made it possible to identify the skin conditions subject to consultation in dermatology which are dominated by infections and allergies.

OBJECTIF: Faire le bilan des différentes affections dermatologiques prises en charge au sein de l'hôpital sur une période de cinq années. PATIENTS ET MÉTHODES: Etude rétrospective et descriptive menée de janvier 2015 à décembre 2019 à l'Hôpital de Dermatologie de Bamako, basée sur les dossiers des patients reçus en consultation. RÉSULTATS: Durant la période, 6322 nouvelles consultations ont été enregistrées. La moyenne d'âge était de 42±12,5 ans avec des extrêmes de deux mois et 82 ans. Le sex-ratio était de 0,6. La majorité de nos patients (76,1%) était venue directement de la maison. Sur le plan socioprofessionnel, les patients étaient surtout des paysans (45%), des ménagères (23,9%) et des ouvriers (12%). Parmi les 6322 consultants, 27,1% ont été hospitalisés. Sur le plan diagnostique, les affections cutanées étaient dominées par les infections (56,1%), suivies des allergies (15,4%) ; les maladies de système (12,0%) ; les dermatoses génétiques (7,5%) et celles tumorales (5,2%). La durée moyenne d'hospitalisation était de 46±18,7 jours chez les adultes et de 21±11,6 jours chez les enfants. CONCLUSION: Cette étude a permis de recenser les affections cutanées faisant objet de consultation en dermatologie qui sont dominées par les infections et les allergies.

New technologies for controlling emerging infectious diseases in Guinea and the Democratic Republic of the Congo: their role in response to the Ebola epidemic.

Emerging infectious diseases appear recurrently and represent a threat to global health security. Africa is particularly exposed to the risks of infectious epidemics, due to both the number of circulating infectious agents, especially in wildlife, and the social and environmental factors that promote their epidemic spread. Ebola outbreaks in West Africa in 2014 and those in the DRC that began in 2018 were an opportunity to develop and deploy new diagnostic techniques in laboratories in Guinea and the Democratic Republic of the Congo (DRC). These tools made it possible to identify the infectious agent rapidly, to trace contamination chains in real time to enable effective interventions, and to develop a reliable serological tool for differential diagnoses. Today, equipped and functional facilities exist in both countries, led by Guinean and Congolese researchers trained to high levels of competence and benefiting from unique experience and field knowledge.

Kinetics of maternally-derived serogroup A, C, Y and W-specific meningococcal immunoglobulin G in Malian women and infants.

A prospective, randomised, controlled observer-blind trial measuring the efficacy and immunogenicity of trivalent influenza vaccine (TIV) and the immunogenicity of quadrivalent meningococcal conjugate vaccine (MCV) in pregnant women and their infants up to 6 months of age was conducted in Mali. Here we reported the immunogenicity of MCV, which was used as a comparator vaccine to TIV, in this population. Third-trimester pregnant Malian women were randomized to receive TIV or MCV. Blood samples were collected from women prior to vaccination, 28 days post-vaccination, at delivery and 3 and 6 months post-delivery and from infants at birth and 3 and 6 months of age. Meningococcal-specific serogroup (Men) A, C, Y and W-specific antibodies were measured by enzyme linked immunosorbent assay in a randomly selected subset of 50 mother-infant pairs where the mother had received MCV. At birth, 94.0% (47/50) of infants had MenA specific IgG levels ≥ 2 µg/mL decreasing to 72.9% and 30.4% at 3 and 6 months of age. For MenC, 81.3% (39/48) of infants had MenC specific IgG levels ≥ 2 µg/mL at birth decreasing to 29.4% and 17.8% at 3 and 6 months of age. For MenY, 89.6% (43/48) of infants had MenY specific IgG levels ≥ 2 µg/mL at birth decreasing to 64.6% and 62.5% at 3 and 6 months of age. For MenW, 89.6% (43/48) of infants had MenW specific IgG levels ≥ 2 µg/ml at birth decreasing to 62.5% and 41.7% at 3 and 6 months of age. Maternal immunization with MCV conveyed protective levels of IgG at birth through to 3 months of age in the majority of infants.

Differential effects of dietary fibres on colonic barrier function in elderly individuals with gastrointestinal symptoms.

Gastrointestinal problems are common in elderly and often associated with psychological distress and increased levels of corticotrophin-releasing hormone, a hormone known to cause mast cell (MC) degranulation and perturbed intestinal barrier function. We investigated if dietary fibres (non-digestible polysaccharides [NPS]) could attenuate MC-induced colonic hyperpermeability in elderly with gastrointestinal (GI) symptoms. Colonic biopsies from elderly with diarrhoea and/or constipation (n = 18) and healthy controls (n = 19) were mounted in Ussing chambers and pre-stimulated with a yeast-derived beta (ß)-glucan (0.5 mg/ml) or wheat-derived arabinoxylan (0.1 mg/ml) before the addition of the MC-degranulator Compound (C) 48/80 (10 ng/ml). Permeability markers were compared pre and post exposure to C48/80 in both groups and revealed higher baseline permeability in elderly with GI symptoms. ß-glucan significantly attenuated C48/80-induced hyperpermeability in elderly with GI symptoms but not in healthy controls. Arabinoxylan reduced MC-induced paracellular and transcellular hyperpermeability across the colonic mucosa of healthy controls, but did only attenuate transcellular permeability in elderly with GI symptoms. Our novel findings indicate that NPS affect the intestinal barrier differently depending on the presence of GI symptoms and could be important in the treatment of moderate constipation and/or diarrhoea in elderly.

[Squamous cell carcinoma associated with use of skin-lightening cream]. / Carcinome épidermoïde associé à une dépigmentation volontaire.

BACKGROUND: Women widely use skin-lightening products for cosmetic purposes in sub-Saharan Africa despite numerous reported cutaneous and systemic complications. The occurrence of epidermoid carcinoma has long been reported, but only three cases have been published so far. We report the first case in Mali. PATIENTS AND METHODS: A 30-year old woman with no noteworthy medical history was seen at our outpatient center for cervical ulceration that had been present for the last 5 years. She had used cosmetic bleaching cream over a period of around ten years. Physical examination revealed extensive ulceration on the left side of her neck. Blood tests for viral hepatitis and human immunodeficiency virus were negative. The pathological examination of the skin biopsy confirmed the diagnosis of squamous cell carcinoma. After failure of the initial excision with early relapse, multiple surgical ablations were performed 3 months later. DISCUSSION: The high prevalence of skin-lightening cosmetic use contrasts with the rarity of epidermoid carcinoma in depigmented skin. However, a large chronic ulcer on uncovered parts of the upper body, particularly the neck, should prompt physicians to consider skin cancer. Appropriate preventive measures include the promotion of educational messages for the general population, the use of sun-protection devices, and routine skin biopsy for all women presenting chronic cervical ulceration after long-term use of skin-lightening products.

Kaposi's disease in an HIV positive child, with probable contamination from his grandmother.

Kaposi's disease in children with HIV is rarely reported in everyday practice. This is a case study of cutaneous Kaposi's disease revealing HIV in a 5-year-old child with polymorphic eruption of papules and nodules on the face, trunk, back, and limbs. Histopathological examination confirmed the diagnosis of Kaposi's disease. The child's HIV serology was positive with a CD4 count of 240/mm3, normochromic and normocytic anemia, and a hemoglobin level at 8.5 g/dl. It was found that the child, after early weaning from his HIV-negative mother, had repeatedly suckled his healthy grandmother, who had no skin lesions but was HIV1 positive. Both grandmother and child were referred for treatment in their locality. The case is noteworthy for the way in which the HIV1 virus infected the child during weaning and then being suckled by his grandmother. The child already had an initial dental flare that could have injured his grandmother. Thus, in our case, there is a contamination by HIV1 virus most likely from the grandmother and contamination by the HHV8 virus, source unidentified as a technical plateau was reached.

[Peripheral facial paralysis revealing HIV infection in black African populations]. / Paralysie faciale peripherique revelatrice d'une infection par le VIH chez le noir Africain.

INTRODUCTION: Peripheral facial paralysis (PFP), a frequent complication during infection with the human immunodeficiency virus (HIV), is a major cause of morbidity for these patients. The aim of this study was to show the place of unilateral PFP in the discovery of HIV infection in tropical areas. MATERIAL AND METHODS: This is a descriptive cross-sectional study with prospective data collection over a 12-month period, in the ENT departments of the Ignace Deen National Hospital and Neurology Hospital of the Sino-Guinean Friendship Hospital (CHU de Conakry). RESULTS: Of the 2517 patients received during the study period, 64 had PFP, a prevalence of 2.54%. HIV serology was performed in 56 patients, 24 of whom had a positive serological reaction, a prevalence of 42.86%. The young adult population was the most exposed, with an average age of 34.5 years. There were 9 men and 15 women, or a sex ratio of 0.6. In 70.83% of cases, the consultation period occurred between the 1st and 3rd week. Unilateral facial asymmetry and persistent opening of the palpebral fissure were the main clinical signs. A total of 75% of our patients were infected with HIV1. CD4 levels ranged from 175 to 400/mm3. All our patients had received PFP and HIV treatments. The evolution was marked by a complete recovery with no sequelae of PFP in 62.5% of cases. CONCLUSION: The occurrence of isolated PFP in apparently healthy adults should suggest seroconversion to HIV. The prognosis of these PFPs is often good despite the delay in diagnosis.

INTRODUCTION: La paralysie faciale périphérique (PFP), complication fréquente au cours de l'infection par le virus de l'immunodéficience humaine (VIH), constitue une cause importante de morbidité chez ces patients. Le but de cette étude était de montrer la place de la PFP unilatérale dans la découverte de l'infection par le VIH en zone tropicale. MATÉRIEL ET MÉTHODES: Il s'agit d'une étude transversale descriptive avec collecte des données prospective, sur une période de 12 mois, réalisée dans les services d'ORL de l'Hôpital National Ignace Deen et de Neurologie de l'hôpital de l'amitié Sino-Guinéenne (CHU de Conakry). RÉSULTATS: Sur les 2517 patients reçus en consultation durant notre période d'étude, 64 présentaient une PFP soit une prévalence de 2,54%. La sérologie VIH avait été réalisée chez 56 patients, dont 24 avaient eu une réaction sérologique positive, soit une prévalence 42,86 %. La population adulte jeune était la plus exposée, avec un âge moyen de 34,5 ans. Il s'agissait de 9 hommes et 15 femmes, soit un sex-ratio de 0,6. Le délai de consultation était, dans 70,83% des cas, situé entre la 1ère et 3ème semaine. L'asymétrie faciale unilatérale et la persistance d'ouverture de la fente palpébrale étaient les principaux signes cliniques. Au total 75 % de nos patients étaient porteurs du VIH1. Le taux de CD4 variait entre 175 et 400/mm3. Tous nos patients avaient bénéficié d'un traitement de la PFP et du VIH. L'évolution avait été marquée par la récupération totale et sans séquelle la PFP dans 62,5% des cas. CONCLUSION: La survenue d'une PFP isolée chez l'adulte apparemment en bonne santé, doit faire évoquer une séroconversion au VIH. Le pronostic de ces PFP est souvent bon malgré le retard diagnostic.

[Epidemic meningitis in 2013 in Republic of Guinea: Nesseria meningitidis W135 emergence]. / Epidémie de méningite en République de Guinée en 2013 : émergence de Nesseria meningitidis W135.

A prospective study conducted from 1 January to 31 December 2013 described a meningitis epidemic in Republic of Guinea. The identification of the germs was based on Gram stain, latex agglutination and culture. During the study period, 480 suspected cases of meningitis were reported by 21 health districts. The average age was 18±8 years and 62.5% were men. The vaccination status was unknown in all patients. The largest attack rates were found in Siguiri (3.2 per 10,000), Kankan (2.6 per 10,000) and Dabola (3.9 per 10,000). The locality of Kintinian in Siguiri was the only one to cross the epidemic threshold. The identified microorganisms were Haemophilus influenzae (1 time), Pneumococcus (2 times), Neisseria meningitidis A (4 times) and W135 (10 times) with a total of 17 positive samples. All of these germs were sensitive to chloramphenicol, ceftriaxone and ciprofloxacin. The average hospital stay was 6.5±2 days. The lethality was 13.8%. This meningitis epidemic was characterized by the emergence of Neisseria meningitidis W135. The monitoring of this serogroup should be increased and future vaccination strategies must include it presence.

Associations Between Discrimination and Cardiovascular Health Among Asian Indians in the United States.

Asian Indians (AI) have a high risk of atherosclerotic cardiovascular disease. The study investigated associations between discrimination and (1) cardiovascular risk and (2) self-rated health among AI. Higher discrimination scores were hypothesized to relate to a higher cardiovascular risk score (CRS) and poorer self-rated health. Asian Indians (n = 757) recruited between 2010 and 2013 answered discrimination and self-reported health questions. The CRS (0-8 points) included body-mass index, systolic blood pressure, total cholesterol, and fasting blood glucose levels of AI. Multiple linear regression analyses were conducted to evaluate relationships between discrimination and the CRS and discrimination and self-rated health, adjusting for psychosocial and clinical factors. There were no significant relationships between discrimination and the CRS (p ≥ .05). Discrimination was related to poorer self-reported health, B = -.41 (SE = .17), p = .02. Findings suggest perhaps there are important levels at which discrimination may harm health.

The effects of experimentally manipulated social status on acute eating behavior: A randomized, crossover pilot study.

Both subjective and objectively measured social status has been associated with multiple health outcomes, including weight status, but the mechanism for this relationship remains unclear. Experimental studies may help identify the causal mechanisms underlying low social standing as a pathway for obesity. Our objective was to investigate the effects of experimentally manipulated social status on ad libitum acute dietary intakes and stress-related outcomes as potential mechanisms relating social status and weight. This was a pilot feasibility, randomized, crossover study in Hispanic young adults (n=9; age 19-25; 67% female; BMI ≥18.5 and ≤30kg/m(2)). At visit 1, participants consumed a standardized breakfast and were randomized to a high social status position (HIGH) or low social status position (LOW) in a rigged game of Monopoly™. The rules for the game differed substantially in terms of degree of 'privilege' depending on randomization to HIGH or LOW. Following Monopoly™, participants were given an ad libitum buffet meal and energy intakes (kcal) were estimated by pre- and post-weighing foods consumed. Stress-related markers were measured at baseline, after the game of Monopoly™, and after lunch. Visit 2 used the same standardized protocol; however, participants were exposed to the opposite social status condition. When compared to HIGH, participants in LOW consumed 130 more calories (p=0.07) and a significantly higher proportion of their daily calorie needs in the ad libitum buffet meal (39% in LOW versus 31% in HIGH; p=0.04). In LOW, participants reported decreased feelings of pride and powerfulness following Monopoly™ (p=0.05) and after their lunch meal (p=0.08). Relative to HIGH, participants in LOW demonstrated higher heart rates following Monopoly™ (p=0.06), but this relationship was not significant once lunch was consumed (p=0.31). Our pilot data suggest a possible causal relationship between experimentally manipulated low social status and increased acute energy intakes in Hispanic young adults, potentially influenced by decreased feelings of pride and powerfulness. Increased energy intake over time, resulting in positive energy balance, could contribute to increased risk for obesity, which could partially explain the observed relationship between low social standing and higher weight. Larger and longitudinal studies in a diverse sample need to be conducted to confirm findings, increase generalizability, and assess whether this relationship persists over time.

A multi-pronged approach to the search for an alternative to formaldehyde as an egg disinfectant without affecting worker health, hatching, or broiler production parameters.

Research was carried out to determine the effectiveness of 4 hatching eggs disinfection processes (i.e., disinfecting products and administration method) using a multi-pronged approach assessing the reduction of microbial eggshell contamination, the effects on worker exposure, hatching results and broiler performance, and, finally, suitability for use in commercial hatcheries. The 4 disinfection processes were: sodium dichlorocyanurate (DC) by thermonebulization, hydrogen peroxide 6% by nebulization (HP6), electrolyzed oxidizing water (EOW) by fogging, and hydrogen peroxide 30% vapor (HP30). In order to meet commercial hatchery conditions, the tested products were applied in an experimental hatchery by aerial disinfection in a dedicated room, not sprayed directly onto the eggs. Compared to the untreated control group, eggshell microbial load was significantly decreased by over 1 log10 cfu per egg in groups DC and HP30. These results were confirmed during a second experiment. In addition, these 2 products comply with legal requirements on worker exposure. Fertility and hatching results were significantly higher in group HP30 than in group DC, with no impact on chick quality and subsequent broiler performance. Under these study conditions, the disinfection process (i.e., administration of the product, contact with the eggs and aeration) lasted 65 min in group DC vs. 135 min in group HP30. When considering commercial hatchery conditions, this difference in application time confers a clear advantage on the DC process. Moreover, the investment required for HP30 is much higher than for DC. Overall, HP30 presented a clear advantage for hatching results whereas DC is a relatively more practical and less expensive disinfection process. To our knowledge, this is the first report on the use of hydrogen peroxide vapor as an egg disinfection process. Further research is needed to confirm the results of this study under commercial hatchery conditions.

The influence of clopidogrel on ischemia diagnosed by myocardial perfusion stress testing.

BACKGROUND: Clopidogrel is a platelet adenosine receptor antagonist which can influence coronary vascular tone and thus can potentially interfere with myocardial perfusion imaging. We investigated whether clopidogrel can hamper the diagnosis of ischemia in patients undergoing myocardial perfusion testing. METHODS: Data from a database of 6349 myocardial perfusion stress tests were analyzed. Using a propensity analysis, patients who were taking clopidogrel were compared with patients not taking clopidogrel for the presence of reversible perfusion defects on myocardial single-photon emission computed tomography scans. RESULTS: Of the 6349 tests, the stress technique was adenosine in 2713 patients and exercise in 3636. At the time of the stress test, 277 (4.3%) of the patients were taking clopidogrel. The odds ratio (OR) for patients taking clopidogrel to have a reversible perfusion defect was 2.75 (95% confidence interval [CI] 2.09-3.62; P < .01). After adjusting for the propensity to take clopidogrel, the OR was 1.06 (CI 0.76-1.49; P = .73) for patients undergoing adenosine stress tests and 1.60 (CI 0.85-3.00; P = .14) for patients undergoing exercise stress tests. CONCLUSIONS: We found no evidence that the use of clopidogrel decreases the likelihood of ischemia on adenosine or exercise stress myocardial perfusion scans.

Efficacy of feed additives against Campylobacter in live broilers during the entire rearing period.

Poultry meat is the major source of human campylobacteriosis, the most frequently reported zoonosis in the EU. The prevalence of Campylobacter colonization in European broiler flocks is 71%. Despite considerable efforts, there is still no effective strategy available to prevent or reduce Campylobacter colonization in broilers. This study tested a wide variety of feed additives to reduce Campylobacter shedding in primary poultry production. Twelve additives containing organic or fatty acids, monoglycerides, plant extracts, prebiotics, or probiotics were tested. For each additive, broilers contaminated with Campylobacter jejuni were fed with an additive free diet (control group) or with a supplemented diet (treated group) and Campylobacter loads compared at three sampling times. No treatment was able to prevent broiler colonization by Campylobacter, and there was a high degree of variation in contamination among the birds. At 14 d of age, eight treatments significantly decreased the colonization level compared to the control group by a maximum of 2 log10 CFU/g. At 35 d of age, three of these treatments still had a significant effect with a maximum reduction of 1.88 log10 CFU/g for a probiotic. At 42 d of age, only one short-chain fatty acid was still significantly efficient with a mean reduction over 2 log10 CFU/g. In addition, a probiotic and a prebiotic-like compound significantly decreased the contamination by a maximum of 3 log10 CFU/g, only at the 42-d sampling period. This study gives promising results regarding the use of feed additives to reduce Campylobacter infection in flocks. Nevertheless, a global approach, combining intervention measures at the different steps of the broiler meat production chain could have a greater impact on the reduction of public health risk.

[Histologic kidney lesions during pure nephrotic syndrome in adults in Conakry]. / Lesions histologiques renales au cours du syndrome nephrotique pur de l'adulte a Conakry.

INTRODUCTION: Nephrotic syndrome represents a significant part of chronic kidney disease in Black Africa. Our work aimed to determine the frequency and type of kidney lesions in an adult carrying pure nephrotic syndrome. PATIENTS AND METHODS: We conducted a prospective and descriptive study (2003-2004), 40 patients were recruited on the basis of the presence of a pure nephrotic syndrome. Proteinuria was plentiful, selective to albumin greater than 3 g/24h, not accompanied by hematuria, or high blood pressure, or kidney failure. Cases of bacterial, parasitic and viral infections (hepatitis B, C, HIV) were excluded. By following contra-indications of renal biopsy, samples were taken under local anesthesia by means of percutaneous lumbar and fixed in two tubes, one containing "Michel's medium" and the other 12% Formalin. These techniques and readings were carried out in the pathological anatomy Laboratories of Nantes (France) and Conakry (Guinea). RESULTS: There were 24 men and 16 women with an average age of 26.2 ± 8 years [range: 20-51]. Clinical symptoms were dominated by weight gain characterized by edema. Proteinuria was between 3-3.5 g/24h in 16 (40%); between 3.6-5 g in 2 cases (5%) and greater than 5 g/24h in 22 cases (55%). The number of glomeruli was on average 11 ± 9 [range: 3-36]; glomerular permeability was on average 10.4 ± 10. Renal impairment was glomerular in 22 cases, tubulointerstitial in 12 cases and vascular in 6 cases. Immunofixation was positive in 30/40 cases for IgA IgG IgM; in 26 cases for C1q C3; in 4 cases for C1q C3 C4; and finally for fibrin in 28 cases. Histological renal lesions were FSGS (40%), MDC (35%), MGN (5%), MPGN (5%) and undetermined (15%). CONCLUSION: A regular practice of renal anatomopathological examination "on the spot" will lead us to carefully assess the causes of kidney failure associated with nephrotic syndrome.

INTRODUCTION: Le syndrome néphrotique représente une part importante d'insuffisance rénale chronique en Afrique noire. Notre travail avait pour but de déterminer la fréquence et le type de lésions histologiques rénales chez un adulte porteur d'un syndrome néphrotique pur. PATIENTS ET MÉTHODES: Au cours d'une étude prospective et descriptive (2003­2004), 40 patients ont été sélectionnés sur la base de la présence d'un syndrome néphrotique pur. La protéinurie était abondante, sélective à l'albumine, supérieure à 3 g/24h, non accompagnée d'hématurie, ni d'hypertension artérielle, ni d'insuffisance rénale. Les cas d'infections bactériennes, parasitaires et virales (hépatites B, C, HIV) ont été volontiers exclus. En respectant les contre indications de la biopsie rénale, les prélèvements ont été effectués sous anesthésie locale, par voie lombaire percutanée, puis fixés dans deux tubes dont un contenait du « liquide de Michel ¼ et l'autre du Formol à 12%. Les techniques et lectures ont été effectuées aux Laboratoires d'anatomie pathologique de Conakry (Guinée) et de Nantes (France). RESULTATS: Il s'agissait de 24 hommes et de 16 femmes âgés en moyenne de 26,2 ± 8 ans [20­51]. La symptomatologie clinique était dominée par une prise de poids marquée par les œdèmes. La protéinurie était comprise entre 3­3,5 g/24h dans 16 cas (40%); entre 3,6­5 g dans 2 cas (5%) et supérieure à 5 g/24h dans 22 cas (55%). Le nombre de glomérules était en moyenne de 11 ± 9 [3­36]; la perméabilité des glomérules était en moyenne de 10,4 ± 10. L'atteinte rénale était glomérulaire dans 22 cas, tubulo-interstitielle dans 12 cas et vasculaire dans 6 cas. L' immunofixation a été positive dans 30 cas /40 pour les IgA IgG IgM; dans 26 cas pour C1q C3; dans 4 cas pour C1q C3 C4; et en fin pour la fibrine dans 28 cas. Les lésions histologiques rénales étaient une HSF (40%), une LGM (35%), une GEM (5%), une GNMP (5%) et indéterminée (15%). CONCLUSION: Une pratique régulière de l'examen anatomo-pathologique rénal «sur place" nous amènerait à apprécier judicieusement les causes d'insuffisance rénale en rapport avec un syndrome néphrotique.

[A descriptive study of ventricular septal defect (VSD) in the Luxembourg mother-child Hospital in Bamako]. / Etude descriptive de la CIV au centre hospitalier mere-enfant le Luxembourg.

OBJECTIVE: This work aimed to determine the incidence, epidemiological, clinical, echocardiographic aspects, and treatment of ventricular septal defect (VSD) in the Luxembourg mother-child Hospital in Bamako. METHOD: A descriptive cross-sectional study was conducted between September 1, 2011 and May 31, 2012. It focused on children of both sexes seen in consultation or for echocardiography, in whom VSD was found through echocardiography. Were not included in the study VSD in complex malformations such as CAV, T4F, VU. RESULTS: VSD was the first congenital heart disease noted with 39.4%. It was detected mainly in the first 2 years of life (66.7% of cases). The boy:girl sex ratio was 0.93. The perimembranous defect type and the VSD group II were dominant with respectively 76.8% and 57.4% of cases (IIa: 38.9%; IIb: 18.5%). A surgical indication was raised in 59.3% of cases based on clinical presentation and ultrasound data. Management was primarily medical, the high cost of surgical through evacuation is beyond the financial means of our patients most of the time. CONCLUSION: VSD is the most common congenital heart disease, but its management is currently almost exclusively medical.

OBJECTIF: Ce travail a eu pour but de déterminer la fréquence, les aspects épidémio-cliniques, échographiques, et thérapeutiques des communications interventriculaires (CIV) au centre hospitalier mère -enfant le Luxembourg de Bamako. MÉTHODE: L'étude était descriptive transversale menée entre le 1er septembre 2011 et le 31 mai 2012. Elle a porté sur les enfants des deux sexes reçus en consultation ou pour échographie cardiaque, chez qui une CIV a été retrouvée à l'échographie doppler cardiaque. N'ont pas été inclus la CIV dans le cadre de malformations complexes telles que canal atrio-ventriculaire, la tétralogie de Fallot ou le ventricule unique. RÉSULTATS: La CIV représentait la première malformation cardiaque avec 39.4 %. La pathologie a été découverte dans 66,7% des cas les deux premières années. Le sex ratio Garcons :Filles était de 0.93. La topographie périmembraneuse et la CIV du groupe II étaient dominantes avec respectivement 76.8 et 57.4 % des cas (IIa 38.9 % IIb 18.5 % ). Une indication opératoire a été posée dans 59.3 % des cas au vu de la présentation clinique et des données échographiques. La prise en charge était essentiellement médicale, le coût élevé de l'évacuation sanitaire étant hors de portée de nos populations le plus souvent. CONCLUSION: La CIV est la plus fréquente des cardiopathies congénitales, mais sa prise en charge pour le moment est presqu'exclusivement médicale.