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In sub-Saharan Africa (SSA), the etiological factors of epilepsy are multiple and phacomatoses, in particular Sturge weber's disease, are rarely reported due to under-medicalization and insufficient multidisciplinary care. We carried out a retrospective study of 216 patients hospitalized for recurrent epileptic seizures between 2015 and 2022 in the neurology and pediatrics department of the University Hospital Center of Conakry, among whom eight (8) patients were identified for Sturge Weber's disease in order to reassess this pathology from a clinical and paraclinical point of view in a tropical environment. Sturge Weber's disease was retained in eight (8) on the presence of symptomatic partial epileptic seizures (age 6 months to 14 years) with frequency of status epilepticus, homonymous lateral hemiparesis linked to occipital involvement, piriform calcifications on imaging and ocular disorders. The delay in consultation and medical care revealed severe mental deterioration in our patients. This study shows a stereotyped clinical picture in a context of aggravation of signs related to a delay in multidisciplinary management. These results are important for the diagnostic, therapeutic and prognostic discussion.
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Disfunción Cognitiva , Epilepsia , Niño , Humanos , Estudios Retrospectivos , Guinea , Epilepsia/complicaciones , Epilepsia/diagnóstico , Convulsiones/diagnóstico , Convulsiones/etiologíaRESUMEN
In sub-Saharan Africa, the COVID-19 pandemic has caused severe malnutrition in elderly populations with the appearance of vitamin deficiencies, in particular thiamine responsible for Gayet Wernicke's encephalopathy (EGW). We present a series of six (6) patients hospitalized in the Neurology Department of the CHU Ignace Deen for the management of a brain syndrome with vigilance disorders after recovery from COVID-19, including oculomotor disorders, motor incoordination on a course of severe weight loss. The six patients underwent an evaluation of malnutrition by determining the WHO body mass index, the Detsky index, the serum albumin assay, the thiamine assay and a neuroradiological assessment (MRI) and an electroencephalogram (EEG) examination although this does not seem necessary for diagnosis. Study of nutritional status: weight loss greater than 5%, patients in Desky group B and C, plasma albumin<30 g/l, lowered thiamine and MRI neuroradiological data: by the existence of hypersignals in certain regions of the neocortex, certain gray nuclei, the mammillary bodies the thalamic nuclei close to the wall of the 3rd ventricle and the regions bordering the 4th ventricle sign Gayet Wernicke's encephalopathy syndrome. This study shows a stereotyped clinical, biological, neuroradiological and evolutionary profile of Gayet Wernicke's encephalopathy in elderly subjects recovered from Covid-19 with proven malnutrition. These results are useful for the therapeutic and prognostic discussion.
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Encefalopatías , COVID-19 , Desnutrición , Encefalopatía de Wernicke , Anciano , Humanos , Encefalopatía de Wernicke/diagnóstico , Encefalopatía de Wernicke/diagnóstico por imagen , COVID-19/complicaciones , Pandemias , Guinea , Tiamina/uso terapéutico , Desnutrición/complicacionesRESUMEN
BACKGROUND: Although Drug resistance tuberculosis is not a new phenomenon, Mali remains one of the "blank" countries without systematic data. METHODS: Between 2006 and 2014, we enrolled pulmonary TB patients from local TB diagnostics centers and a university referral hospital in several observational cohort studies. These consecutive patients had first line drug susceptibility testing (DST) performed on their isolates. A subset of MDR was subsequently tested for second line drug resistance. RESULTS: A total of 1186 mycobacterial cultures were performed on samples from 522 patients, including 1105 sputa and 81 blood samples, yielding one or more Mycobacterium tuberculosis complex (Mtbc) positive cultures for 343 patients. Phenotypic DST was performed on 337 (98.3%) unique Mtbc isolates, of which 127 (37.7%) were resistant to at least one drug, including 75 (22.3%) with multidrug resistance (MDR). The overall prevalence of MDR-TB was 3.4% among new patients and 66.3% among retreatment patients. Second line DST was available for 38 (50.7%) of MDR patients and seven (18.4%) had resistance to either fluoroquinolones or second-line injectable drugs. CONCLUSION: The drug resistance levels, including MDR, found in this study are relatively high, likely related to the selected referral population. While worrisome, the numbers remained stable over the study period. These findings prompt a nationwide drug resistance survey, as well as continuous surveillance of all retreatment patients, which will provide more accurate results on countrywide drug resistance rates and ensure that MDR patients access appropriate second line treatment.
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Antituberculosos/farmacología , Infecciones por VIH/epidemiología , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Tuberculosis Pulmonar/epidemiología , Adolescente , Adulto , Antituberculosos/uso terapéutico , Estudios de Cohortes , Farmacorresistencia Bacteriana Múltiple , Femenino , Fluoroquinolonas/farmacología , Infecciones por VIH/microbiología , Humanos , Masculino , Malí/epidemiología , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Prevalencia , Retratamiento , Esputo/microbiología , Tuberculosis Resistente a Múltiples Medicamentos/diagnóstico , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Tuberculosis Resistente a Múltiples Medicamentos/microbiología , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/tratamiento farmacológico , Tuberculosis Pulmonar/microbiología , Adulto JovenRESUMEN
BACKGROUND: Despite the frequency of hysterectomy, several studies have reported physical and psychological sequelae of this intervention. BUT: To evaluate the consequences of hysterectomy, their level of importance and how patients experience hysterectomy. METHODS: That is a prospective study of 70 patients who underwent a hysterectomy from January 2009 to June 2011 at Pikine National Hospital. The experience of hysterectomy was determined by the physical and psychosocial felt after surgery. RESULTS: Hysterectomy represented 5.9 % of gynecological surgical activities. The indications were dominated by myoma (57.1%). Hysterectomy was performed abdominally in 78.6% of cases and associated with bilateral salpingo-oophorectomy in 87% of cases. After surgery, new symptoms appeared: hot flushes, night sweats, urinary incontinence and urge incontinence in respectively 65.7%, 54.3%, 7.1% and 11.4% of patients. A proportion of 45.6% of them had resumed sexual activity after 90 days. The fear of pain at the time of intercourse was expressed in 55.7% of cases. A decrease in the frequency of sexual intercourse was found in 54.3% of patients. A drop of pleasure during sex was expressed in 38.6% of patients. Psychological effects were also reported by patients: decreased confidence in 31.4% of patients, feeling of being rejected by her husband in 5.7% of cases, sensation of mutilation in 24.3% of cases. CONCLUSION: Physical and psychological postoperative impacts of hysterectomy are real. Adequate accompanying measures are necessary, in addition to preoperative preparation, to allow patients to improve the experience of hysterectomy.
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Histerectomía/efectos adversos , Adulto , Femenino , Hospitales Públicos , Sofocos/epidemiología , Sofocos/etiología , Humanos , Hiperhidrosis/epidemiología , Hiperhidrosis/etiología , Histerectomía/psicología , Persona de Mediana Edad , Satisfacción del Paciente/estadística & datos numéricos , Complicaciones Posoperatorias/epidemiología , Senegal/epidemiología , Disfunciones Sexuales Psicológicas/epidemiología , Disfunciones Sexuales Psicológicas/etiología , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria/etiología , Adulto JovenRESUMEN
Introduction: In sub-Saharan Africa (SSA), stroke is a major public health problem and the etiological aspects are poorly studied and documented because of under-medicalization; the syphilitic etiology is rarely mentioned. Patients and methods: We performed a retrospective study of 472 patients hospitalized for ischemic stroke between 2016 and 2021 in the Neurology Department of the University Hospital of Conakry, confirmed by neuroradiological explorations (brain CT, MRI-Angio) and a biological workup including VDRL-TPHA serological reactions in blood and CSF. Results: Syphilitic etiology was retained for six (6) patients (4 men and 2 women) with a mean age of 43 years (extremes 36 and 49 years). The clinical picture was dominated by carotid syndromes: superficial and deep sylvian syndrome, anterior cerebral artery syndrome and vertebro-basilar syndromes and one case of lacunar syndrome.The diagnosis was based on the positivity of serological reactions (VDRL-TPHA) in blood and cerebrospinal fluid (CSF) and the presence of a predominantly lymphocytic hypercellularity and a hyperproteinorachy in the CSF in the absence of any other etiology. Conclusion: These neurological vascular syndromes consecutive to a cerebral treponematous attack are often the result of a still poorly conducted management of primary and secondary syphilis in our country.
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INTRODUCTION: Limb-Girdle Muscular dystrophies (LGMD) is a group of inherited diseases characterized by predominantly proximal and limb muscle weakness. These are rare diseases that have not been well studied in sub-saharan Africa. The aim of our was the clinical and paraclinical characterization of patients with recessive LGMD at the Department of Neurology of the Teaching Hospital of Point G. PATIENTS AND METHODS: We conducted a longitudinal prospective study which took place from March 2014 to May 2019. Patients with recessive LGMD phenotype were enrolled. Sociodemographic, clinical and laboratory data were analyzed. RESULTS: We enrolled 46 families (67 patients), i.e. a frequency of 16.7% among the neurodegenerative diseases seen in the service. Among them, 45.6% came from the Sikasso region. Autosomal recessive inheritance pattern was suspected in 67.4% of the families. Symptoms appeared mainly in the first decade of life. Proximal muscle weakness was found in almost all patients. Cardiac examination showed dilated cardiomyopathy in 4.5% of cases. CONCLUSION: Limb-Girdle muscular dystrophy is a disabling disease that is found in Mali. Further study of these cases could elucidate the underlying genetic defects.
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Background: The external quality assessment (EQA) or external quality control is an evaluation conducted by a certified external organization to inquire about the quality of the results provided by a laboratory. The primary role of EQA is to verify the accuracy of laboratory results. This is essential in research because research data should be published in international peer-reviewed journals, and laboratory results must be repeatable. In 2007, the University Clinical Research Center (UCRC's) biosafety level 3 (BSL-3) laboratory joined the EQA program with the College of American Pathologists in acid-fast staining and culture and identification of mycobacteria as per laboratory accreditation preparedness. Thus, after 11 years of participation, the goal of our study was to evaluate the performance of our laboratory during the different interlaboratory surveys. Methods: We conducted a descriptive retrospective study to evaluate the results of UCRC mycobacteriology laboratory from surveys conducted during 2007 and 2017. Results: Of the 22 evaluations, the laboratory had satisfactory (100% of concordance results) in 18 (81.8%) and good (80% of concordance results) in 4 (18.2%). Overall, the laboratory was above the commended/accepted limits of 75%. Conclusion: So far, UCRC's BSL-3 performed well during the first 11 years of survey participation, and efforts should be deployed to maintain this high quality in the preparedness for laboratory accreditation and support to clinical trials.
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Acreditación , Ensayos Clínicos como Asunto , Contención de Riesgos Biológicos/normas , Laboratorios/normas , Estudios Transversales , Humanos , Malí , Técnicas Microbiológicas/métodos , Técnicas Microbiológicas/normas , Mycobacterium/crecimiento & desarrollo , Mycobacterium/aislamiento & purificación , Garantía de la Calidad de Atención de Salud/normas , Estudios Retrospectivos , Coloración y Etiquetado , Tuberculosis/diagnóstico , Tuberculosis/microbiologíaRESUMEN
BACKGROUND: Non-conversion on auramine smear microscopy indicates a lack of treatment response, possibly associated with initial rifampicin-resistant tuberculosis (RR-TB). However, dead bacteria still stain positive and may be detected. Fluorescein diacetate smear microscopy (FDA) shows live mycobacteria only. Therefore, we studied the potential of 2-month (2M) FDA for the identification of initial RR-TB.METHODS: Between 2015 and 2018, we enrolled new smear-positive pulmonary TB patients from five local centres in Bamako, Mali. After baseline screening, sputum samples were collected at 1M, 2M, 5M and 18M. We used rpoB sequencing to identify initial RR-TB.RESULTS: Of 1359 patients enrolled, 1019 (75%) had rpoB sequencing results. Twenty-six (2.6%, 95%CI: 1.7-3.7) had mutations conferring rifampicin resistance. Most frequent rpoB mutations were located at the codons Asp435Val (42.4%) and Ser450Leu (34.7%). Among patients with initial RR-TB, 72.2% were FDA-negative at 2M (P = 0.2). The positive and negative predictive value of 5M FDA for culture-based failure was respectively 20.0% and 94.7%.CONCLUSION: FDA did not identify the majority of patients with initial RR-TB or culture-based failure. As the full spectrum of mutations identified on sequencing was identified using Xpert, our data support its rapid universal implementation in Mali.
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Mycobacterium tuberculosis , Tuberculosis Resistente a Múltiples Medicamentos , Farmacorresistencia Bacteriana , Fluoresceínas , Humanos , Malí , Técnicas de Diagnóstico Molecular , Mycobacterium tuberculosis/genética , Rifampin , Sensibilidad y Especificidad , EsputoRESUMEN
INTRODUCTION: Diabetes Mellitus (DM) increases worldwide, mostly in low- and middle-income countries. In Mali, the prevalence in the adult population is estimated at 1.8%, but tuberculosis (TB) patients are not systematically screened. The goal of our study was to determine the prevalence of DM among newly diagnosed TB patients. METHODS: We conducted a cross sectional study and a pilot prospective cohort study in four health centers in Bamako. All patients underwent fasting capillary-blood glucose (FCBG) test at Day 0, and repeated after one-week of TB treatment. Venous FBG test was performed for discrepancies between the two FCBG results. Thereafter, FCBG was performed for pilot study at month-2 (M2) and M5 of TB treatment. RESULTS: Two hundred and one patients were enrolled in this study. Impaired fasting blood glucose was identified in 17 (8.5%), of whom 11 (5.5%) had DM (VFBG >7â¯mmol/L). Among patients with DM, seven (63.6%) had successful TB treatment outcome, versus 142 (74.7%) of those without DM (pâ¯=â¯0.64), and (OR: 1.69, 95%CI 0.47-6.02). CONCLUSION: The prevalence of DM among TB patients in Bamako exceeds that of the general population and screening at TB diagnosis suffices to identify those with DM. Systematic screening of both diseases will allow better treatment.
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We describe a general method of finding the transport properties of molecules in polymer films by photolysis. Poly(methyl methacrylate) samples held at different temperatures are exposed to UV radiation at discrete wavelengths, and the time evolution of the volatile photoproducts are detected with a quadrupole mass spectrometer. A diffusion model is used to fit the experimental data and deduce diffusion coefficients for the main photoproduct methyl formate. The average value at room temperature was equal to 1.9 x 10 (-11) cm (2) s (-1) at all wavelengths investigated. Together with the values derived at other temperatures, an Arrhenius plot was obtained and the activation energy for methyl formate diffusion within the polymeric thin film calculated from the slope of the graph. We envision that this new method will find application to a variety of problems involving the mass transport of molecules through boundary layers of single or multilayer thin film structures.
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PPARs are supposed to be involved in pathogenesis of diabetes and its complications. According to some authors, L162V PPARalpha gene polymorphism would be associated to dyslipidemia susceptibility during diabetes, whereas for some authors, it rather would confer resistance to these metabolic abnormalities. The aim of this study is to search the relationship between this polymorphism and the occurrence of diabetes and its complications within a Senegalese black population constituted of 261 diabetic and 128 controls, by comparing alleles frequencies. Genomic analysis for alleles identification has been performed by the allelic discrimination technic TaqMan 5' Nuclease, after DNA extraction (Nucleon Bacc2. Amersham Int.). The results of genetic variants analysis revealed that L162V PPARalpha polymorphism would not be present among Senegalese black population, and consequently, should not be involved in diabetes onset.
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Población Negra , Diabetes Mellitus Tipo 2/genética , PPAR alfa/genética , Polimorfismo Genético , Humanos , SenegalRESUMEN
The authors report 13 cases of Gayet-Wernicke's encephalopathy observed in 13 patients of a refugee population. 11 presented the classical triad: oculomotor signs, cerebral ataxia and state of confusion and in 2 patients, only 2 symptoms were noted. The etiological factors: chronic alcoholism, malnutrition, uncontrollable vomiting, HIV and tuberculosis were identified. The outcome was evaluated on the basis of the disappearance of symptoms after treatment with 500 mg of thiamine in 7 patients, 1 death and 5 patients progressed toward Korsakoff amnesic syndrome.
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Encefalopatía de Wernicke/patología , Alcoholismo/complicaciones , Confusión/etiología , Guinea , Infecciones por VIH/complicaciones , Humanos , Refugiados , Tasa de Supervivencia , Sobrevivientes , Tiamina/uso terapéutico , Tuberculosis/complicaciones , Encefalopatía de Wernicke/tratamiento farmacológico , Encefalopatía de Wernicke/mortalidad , Encefalopatía de Wernicke/psicologíaRESUMEN
INTRODUCTION: Prison constitutes a risk factor for the emergence of multi-drug resistance of tuberculosis (MDR-TB). The aim of this work was to study MDR-TB in a black African carceral center. MATERIAL AND METHODS: Prospective study from January to December 2016 at the central house of arrest for men, Bamako. The study population was composed of tuberculous detainee. The suspicion of MDR-TB was done in any tuberculosis case remained positive in the second month of first-line treatment or in contact with an MDR-TB case. RESULT: Among 1622 detainee, 21 cases of pulmonary tuberculosis were notified (1.29%), with an annual incidence of 13 cases/1000 detainee, they were 16 cases of SP-PTB (microscopy smear positive tuberculosis) and five cases of microscopy smear negative tuberculosis. The mean age was 28±7 years, extremes of 18 and 46 years. A negative association was found between the notion of smoking and occupation in the occurrence of tuberculosis (OR=0.036, [95% CI: 0.03-0.04], P=0.03. Among the 21 tuberculosis cases notified, one confirmed case of MDR-TB was detected (4.7%). In the first semester of 2016 cohort, we notified a cure rate of 87.5% (7/8 SP-PTB cases), and the confirmed MDR-TB case on treatment (21-month regimen), evolution enameled of pulmonary and hearing sequelae at seven months treatment. CONCLUSION: It was the first case of MDR-TB detected in a prison in Mali. Late diagnosis, evolution is enameled of sequelae and side effects.
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Antituberculosos/uso terapéutico , Tuberculosis Resistente a Múltiples Medicamentos/etnología , Tuberculosis Pulmonar/etnología , Adolescente , Adulto , Negro o Afroamericano , Humanos , Incidencia , Masculino , Malí/epidemiología , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Prisiones/estadística & datos numéricos , Estudios Prospectivos , Factores de Riesgo , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Tuberculosis Pulmonar/tratamiento farmacológico , Adulto JovenRESUMEN
The 9th meeting of the African Society of Human Genetics, in partnership with the Senegalese Cancer Research and Study Group and the Human Heredity and Health in Africa (H3Africa) Consortium, was held in Dakar, Senegal. The theme was Strengthening Human Genetics Research in Africa. The 210 delegates came from 21 African countries and from France, Switzerland, UK, UAE, Canada and the USA. The goal was to highlight genetic and genomic science across the African continent with the ultimate goal of improving the health of Africans and those across the globe, and to promote the careers of young African scientists in the field. A session on the sustainability of genomic research in Africa brought to light innovative and practical approaches to supporting research in resource-limited settings and the importance of promoting genetics in academic, research funding, governmental and private sectors. This meeting led to the formation of the Senegalese Society for Human Genetics.
Le 9ème congrès de la Société Africaine de Génétique Humaine, en partenariat avec le Groupe d'Etude et de Recherche sur le Cancer (GERC) et le Consortium H3Africa, s'est tenu à Dakar, au Sénégal. Le thème était «Renforcer la recherche en Génétique Humaine en Afrique¼. Les 210 participants sont venus de 21 pays africains et de six non africains. L'objectif était de valoriser la génétique et la génomique à travers l'Afrique avec comme but ultime d'améliorer la santé des populations, et de promouvoir les carrières des jeunes chercheurs Africains. Une session sur la pérennité de la recherche génomique a révélé des approches innovantes et pratiques supportant la recherche dans des contextes de ressources limitées et l'importance de promouvoir la formation universitaire en génétique, le financement de la recherche par les gouvernements et le privé. Ce congrès conduisit à la création de la Société Sénégalaise de Génétique Humaine.
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The purpose of this report is to describe 29 cases of phakomatosis including 18 cases of tuberous sclerosis (Bourneville) and 11 cases of neurofibromatosis (von Recklinghausen) observed over a 10-year period at the Neurology Department of the University Hospital Centre in Conakry, Guinea. Findings during this period were consistent with those classically reported in the literature: high frequency of advanced skin lesions coalescing into massive tumours, occurrence of seizures of all types and development of a wide variety of complications as a result of late diagnosis. Our experience underscores the need for follow-up and surveillance of these patients by somatic studies based on neurological, ophthalmologic and tomographic data depending on clinical findings.
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Síndromes Neurocutáneos/diagnóstico , Electroencefalografía , Guinea , Humanos , Neurofibromatosis 1/diagnóstico , Convulsiones , Enfermedades de la Piel , Tomografía Computarizada por Rayos X , Esclerosis Tuberosa/diagnósticoRESUMEN
INTRODUCTION: This study aimed to investigate the mechanism of action of acetonic and hexanic extracts of the leaves of Vernonia colorata on blood glucose regulation. MATERIALS AND METHODS: Experiments were performed in normoglycaemic, type 1 and 2 diabetic rats. The effects of acetonic and hexanic extracts on blood glucose were evaluated. The antagonism effect of hexanic extract on the decrease of blood glucose induced with glibenclamide and metformin was also tested. RESULTS: The hexanic extract of the leaves of V. colorata (HELVC) dose dependently increased the blood glucose in normoglycaemic rats. At the dose of 30 and 100 mg/kg, the glycaemia varied from 0.84 +/- 0.02 to 1.11 +/- 0.10 g/l and 0.68 +/- 0.02 to 1.31 +/- 0.30 g/l (p<0.05, n = 5). Such glibenclamide, the acetonic extract of the leaves of V. colorata (AELVC) induced hypoglycaemia in normoglycaemic rats. The HELVC prevents significantly the AELVC and glibenclamide induced hypoglycaemia. The chronic administration of the AELVC and HELVC as well as glibenclamide in type 1 diabetic rats did not change significantly the level of blood glucose. In type 2 diabetic rats, the single dose administration of metformin (300 mg/kg, per os) decreased the glycaemia which is completely prevented by a HELVC pretreatment. CONCLUSION: These results suggest that: i) The respective hypo- and hyperglycaemic effects of AELVC and HELVC require the presence of the pancreatic beta cells. ii) The AELVC would act by a sulfonylurea-like mechanism as glibenclamide to induce an hypoglycaemic effect.
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Glucemia/efectos de los fármacos , Diabetes Mellitus Experimental/tratamiento farmacológico , Vernonia , Animales , Masculino , Extractos Vegetales/farmacología , Hojas de la Planta , Ratas , Ratas WistarRESUMEN
INTRODUCTION: Many studies have underlined the theorical and practical role of Skin Tuberculin Test (STT) as an important tool for the diagnosis and for the screening of tuberculosis in the population. PATIENTS AND METHOD: This prospective study evaluated STT in 51 smear positive tuberculosis patients and 108 contacts tuberculosis patients apparently in a good health condition. Twenty seven patients have disappeared before the end of the study and 7 patients were excluded for non suitable results. So we analysed only 73 cases. RESULTS: The mean age was 34 years, with extreme of 1 and 77 years. There were 33 male and 40 female patients for a sex-ratio of 0,8. BCG vaccination scar was found in 64% of patients. We calculated the Body-Mass-Index and we found a proteinocaloric malnutrition (BMI<18,5) in 30%. The mean diameter of STT induration was 12,3mm with extremes of 7 and 20mm. Considering a STT < 7 mm as negative, 4 patients (5%) had a negative STT and 69 (95%) a positive STT. 13 of these 69 patients had a STT > 15mm. The age group of the 10 to 50 years had more positive STT. Meanwhile, according to the sexe and to the nutritional status, there was no statistical difference. All patients with a negative STT received BCG vaccination after 2 months of follow-up. Those with STT>15mm were examinated and had a chest X-ray the day of their enrolment, at the second month and at the sixth month and we didn't find any evolutive tuberculosis. CONCLUSION: According to these results, we can conclude that STT is not an important test for the screening of pulmonary tuberculosis in contact patients. Clinical examination, chest X-ray and sputum smear remain very important for the diagnosis. Despite these results, STT remain the only validated technic between the different tuberculin tests. Its interest was twofold: the research of an acquired immunity against tuberculosis after BCG immunisation and it is clinical test for the diagnosis of tuberculosis in children.
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Prueba de Tuberculina , Tuberculosis Pulmonar/diagnóstico , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Estudios Prospectivos , Tuberculosis Pulmonar/transmisiónRESUMEN
During their evolution, mammals have developed cellular factors interfering with retroviral replication, known as « restriction factors ¼. The prototype of these factors, Fv1, was characterized in the late 60's and blocks MLV infection. Some Fv1-like factors interfering with complex retroviruses, including HIV, have recently been discovered in primate cells. These restriction factors are referred to as Ref1, which blocksMLVreplication in human cells, and Lv1, which blocks the infection of non-human primate cells by various retroviruses, including MLV and HIV. These factors are all saturable by an excess of virus, target the viral capsid and interfere with an early step of viral replication. Lv1 and Ref1 have recently been found to be species-specific variants of a single protein called TRIM5α, a member of the TRIM protein family. The mechanism of action of these factors is still unknown. The existence of natural inhibitors of retroviral infection raises new hopes for the development of therapeutic tools against HIV infection.
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In tropical countries, laboratory-confirmed diagnostic certainty of parasitic and other infectious causes of acute myelopathy is difficult because of a shortage of medical professionals and consulting delays. We performed a retrospective study of 168 patients hospitalized for spinal disorders between 2007 and 2013 and identified 26 diagnosed with acute non-compressive myelopathy of presumed sudden onset. An parasitic or other infectious cause was established for all. A preliminary clinical infection preceding the development of neurologic signs was reported for 22 patients (84.6 %). Neurological signs were limited to the existence of a progressive sensorimotor symptomatology with sphincter disorders.
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Enfermedades de la Médula Espinal/microbiología , Enfermedades de la Médula Espinal/parasitología , Enfermedad Aguda , Adolescente , Adulto , Femenino , Guinea , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Enfermedades de la Médula Espinal/epidemiología , Adulto JovenRESUMEN
Cardiovascular and neurological manifestations associated with thiamine deficiency in Guinean prisons are common but not reported.We performed a prospective study of 38 cases related to vitamin B1 deficiency over a period of 4 years. In this population, the literature of traditional data gathered: frequency peak after thirty (92.6%) and clear representation male (sex ratio M/F: 18/1). The clinical symptomatology remains essentially dominated by sensorimotor polyneuropathy and pure sensory (52.2%), overall heart failure (31.5%) and to a lesser degree by Gayet Wernicke's encephalopathy (7.8%) and shoshin beriberi with severe evolution (5.2%). The study of nutritional status by body mass index (BMI) of the World Health Organization, by the criteria of Detsky and biological markers including albumin, shows that these patients are severely malnourished.