Comprehensive molecular classification of localized prostate adenocarcinoma reveals a tumour subtype predictive of non-aggressive disease.

Background: Management of localized prostate cancer (PCa) is a major clinical challenge since most of these cancers would not evolve but a majority of patients will still undergo a life-changing radical surgery. Molecular studies have shown that PCa can be classified according to their genomic alterations but none of the published PCa molecular classifications could identify a subtype corresponding to non-evolutive tumours. Materials and methods: Multi-omics molecular profiling was carried out on post-radical prostatectomy material from a cohort of 130 patients with localized PCa. We used unsupervised classification techniques to build a comprehensive classification of prostate tumours based on three molecular levels: DNA copy number, DNA methylation, and mRNA expression. Merged data from our cohort and The Cancer Genome Atlas cohort were used to characterize the resulting tumour subtypes. We measured subtype-associated risks of biochemical relapse using Cox regression models and survival data from five cohorts including the two aforementioned. Results: We describe three PCa molecular subtypes associated with specific molecular characteristics and different clinical outcomes. Particularly, one subtype was strongly associated with the absence of biochemical recurrence. We validated this finding on 746 samples from 5 distinct cohorts (P = 3.41 × 10-8, N = 746 tumour samples), and showed that our subtyping approach outperformed the most popular prognostic molecular signatures to accurately identify a subset of patients with a non-evolutive disease. We provide a set of 36 transcriptomic biomarkers to robustly identify this subtype of non-evolutive cases whose prevalence was estimated to 22% of all localized PCa tumours. Conclusion: At least 20% of patients with localized PCa can be accurately predicted to have a non-evolutive disease on the basis of their molecular subtype. Those patients should not undergo immediate surgery and rather be placed under active surveillance.

Genetic control of rhizosheath formation in pearl millet.

The rhizosheath, the layer of soil that adheres strongly to roots, influences water and nutrients acquisition. Pearl millet is a cereal crop that plays a major role for food security in arid regions of sub-Saharan Africa and India. We previously showed that root-adhering soil mass is a heritable trait in pearl millet and that it correlates with changes in rhizosphere microbiota structure and functions. Here, we studied the correlation between root-adhering soil mass and root hair development, root architecture, and symbiosis with arbuscular mycorrhizal fungi and we analysed the genetic control of this trait using genome wide association (GWAS) combined with bulk segregant analysis and gene expression studies. Root-adhering soil mass was weakly correlated only to root hairs traits in pearl millet. Twelve QTLs for rhizosheath formation were identified by GWAS. Bulk segregant analysis on a biparental population validated five of these QTLs. Combining genetics with a comparison of global gene expression in the root tip of contrasted inbred lines revealed candidate genes that might control rhizosheath formation in pearl millet. Our study indicates that rhizosheath formation is under complex genetic control in pearl millet and suggests that it is mainly regulated by root exudation.

The human imperative of stabilizing global climate change at 1.5°C.

Increased concentrations of atmospheric greenhouse gases have led to a global mean surface temperature 1.0°C higher than during the pre-industrial period. We expand on the recent IPCC Special Report on global warming of 1.5°C and review the additional risks associated with higher levels of warming, each having major implications for multiple geographies, climates, and ecosystems. Limiting warming to 1.5°C rather than 2.0°C would be required to maintain substantial proportions of ecosystems and would have clear benefits for human health and economies. These conclusions are relevant for people everywhere, particularly in low- and middle-income countries, where the escalation of climate-related risks may prevent the achievement of the United Nations Sustainable Development Goals.

[HIV/AIDS prevalence among the attendees at the Center for Voluntary Anonymous Detection and Support in Pikine/Guediawaye, Senegal]. / Prévalence du VIH/sida chez les clients du Centre de Dépistage Volontaire Anonyme et d'Accompagnement de Pikine/Guédiawaye, au Sénégal.

Within the framework of HIV/AIDS epidemic control, a Center for Voluntary Anonymous Detection and Support (CDVAA) was opened in March 2003 in Pikine/Guediawaye, Senegal. The purpose of this study was to analyze the prevalence of the HIV infection among attendees at the center over a one-year period as a basis for targeting the services of the CDVAA towards improving public health. This retrospective epidemiological study based on analysis of CDVAA attendee records was carried out from April 8, 2003 to April 7, 2004. The CDVAA in Pikine/Guediawaye shares premises with the Departmental Center for Popular and Sports Education. Sampling was exhaustive with inclusion of all people that attended the CDVAA during the study period. Study variables were age, sex, family status, educational level, ethnic group, religion, reason for detection, knowledge about HIV/AIDS prevention methods, results of the test, and, in case of infection, acceptance/refusal of referral to an appropriate management facility. Data were computed and analyzed using EpiInfo 6.04d software. The most common reason for detection was curiosity to know serologic status (69%). Test results were positive in 3% of cases. Infection was due to HIV1 in 65% of cases, HIV2 in 24%, and both (HIV1-HIV2 co-infection) in 11%. Ninety-one percent of attendees that underwent testing returned to pick-up their results. Sixty-eight percent of attendees that tested positive accepted referral to an appropriate management facility. HIV infection was significantly more frequent in attendees who were 24 years old, married, or illiterate and in attendees reporting risky behavior. To further encouraging progress already achieved, the CDVAA must improve the quality of its services and promote its activities as a means of familiarizing the target population on prevention of sexual transmitted diseases and HIV/AIDS, with a particular focus on safe behavior.

[Annual assessement of a mobile ultrasonography service in the region of Ziguinchor, Senegal]. / Bilan d'activité annuel de l'echographie en stratégie avancée dans la région de Ziguinchor (Sénégal).

To provide rural populations with access to ultrasound scanning, a mobile ultrasound service was set up in the health districts of Sédhiou, Oussouye, Bignona and Ziguinchor in Casamance, Senegal. In 2001 the mobile unit performed a total of 56 missions and provided examinations to 1273 patients. The main indications were pregnancy assessment, amenorrhea, detection of pregnancy, painful pelvic tumors and hemorrhage. Findings allowed diagnosis of disorders in 25% cases. Disorders were pregnancy-related in 47% of cases and gynecological in 53%. Ultrasound examinations were performed for follow-up purposes in 15% cases, for therapeutic purposes in 24% and for referral to the regional hospital center in 61%. These findings demonstrate the utility of a mobile ultrasound service in managing health problems not only for the community but also for health-care structures. This service should be maintained until ultrasound equipment becomes available in district hospitals and personnel at those facilities have adequate training in ultrasound scanning.

Incidence, mortality and receptor status of breast cancer in African Caribbean women: Data from the cancer registry of Guadeloupe.

BACKGROUND: Geographical disparities in breast cancer incidence and outcomes are reported worldwide. Women of African descent show lower incidence, higher mortality rates and earlier age of onset. We analyzed data from the cancer registry of Guadeloupe for the period 2008-2013. METHODS: We describe breast cancer characteristics by molecular subtype, as well as estimated observed and net survival. We used Cox proportional hazard models to determine associations between cancer subtypes and death rate, adjusted for variables of interest. RESULTS: Overall, 1275 cases were recorded with a mean age at diagnosis of 57(±14) years. World standardized incidence and mortality were respectively 71.9/100,000 and 14.1/100,000 person-years. Age-specific incidence rates were comparable to European and US populations below the age of 45, and higher in Guadeloupean women aged between 45 and 55 years. Overall, 65.1% of patients were hormone receptor (HR)+ and 20.1% were HR-. Triple negative breast cancers (TNBC) accounted for 14% of all cases, and were more frequent in patients under 40 (21.6% vs. 13.4%, p=0.02). Five-year net survival was 84.9% [81.4-88.6]. It was higher for HR+/Her2+ and HR+/Her2- subtypes, and lower for HR-/Her2+ and TNBC patients. CONCLUSION: We found high age-specific incidence rates of breast cancer in women aged 45 to 55 years, which warrants further investigation in our population. However, this population of mainly African descent had good overall survival rates, and data according to subtypes are consistent with those reported internationally. These results may suggest that poorer survival in other African descent populations may not be an inherent feature of the disease but may be amenable to improvement.

[Self-treatment of fever in the northern district of Dakar, Senegal]. / L'automédication de la fièvre dans le district nord de Dakar, au Sénégal.

Malaria is assimilated with its cardinal symptom, i.e., fever. Treatment of fever with antimalarial drugs is crucial to the prevention of malaria-related death in Senegal. The objective of this study was to analyze fever-treatment practices as a basis for making realistic recommendations for self-treatment in the northern health district of Dakar, Senegal. This cross-sectional study was conducted from March 1 to April 30, 2003. The population included all patients with body temperature higher or equal to 37.5 degrees C (99.5 degrees F) associated with at least one of the following symptoms: headache, shivering, vomiting and diarrhoea. Study endpoints included demographic data and fever treatment modalities including the nature, dosage, and duration of the drugs used. Malaria was suspected in 180 of the 271 patients enrolled in the study. Treatment had already been undertaken in 134 patients including 108 (81%) who had initiated self-treatment. Drugs included antipyretics, antibiotics, and/or antimalarials. Antimalarial drug dosage was incorrect in 84% of those who initiated self-treatment. Dosage errors involved number of daily doses (55%), duration of treatment (13%), or both (32%). Only 45% of patients fully completed treatment. Medical advice was sought in 30% of the cases and drugs were obtained over the counter in pharmacies in 59%. Patients under the age of 15 years were significantly more likely to initiate self-treatment (p=6.10-6), to treat symptoms early, and to use an antimalarial (p=4.10-6). Although self-treatment shortened the delay between onset of symptoms and initiation of treatment, it is likely that indiscriminate and incomplete treatment is responsible for development of resistance to chloroquine in the northern health district of Dakar. Strategies must be adapted to numerous local factors influencing self-treatment including the availability of health-care services and drugs of quality. Special attention must be given to the improvement of antimalarial drug packaging and of the awareness of people that provide self-treatment drugs.

FUNGAL SYMBIONTS. Global assessment of arbuscular mycorrhizal fungus diversity reveals very low endemism.

The global biogeography of microorganisms remains largely unknown, in contrast to the well-studied diversity patterns of macroorganisms. We used arbuscular mycorrhizal (AM) fungus DNA from 1014 plant-root samples collected worldwide to determine the global distribution of these plant symbionts. We found that AM fungal communities reflected local environmental conditions and the spatial distance between sites. However, despite AM fungi apparently possessing limited dispersal ability, we found 93% of taxa on multiple continents and 34% on all six continents surveyed. This contrasts with the high spatial turnover of other fungal taxa and with the endemism displayed by plants at the global scale. We suggest that the biogeography of AM fungi is driven by unexpectedly efficient dispersal, probably via both abiotic and biotic vectors, including humans.

Subcutaneous lymphoid hyperplasia arising at site of ethnic scarifications and mimicking subcutaneous panniculitis-like T-cell lymphoma.

The case of a 40-year-old black man, who developed a very unusual tumour-like lymphoid hyperplasia involving primarily the subcutaneous tissue, is reported. The lesion, which arose at a site of tribal scarifications, displayed a deceptive morphology that closely resembled subcutaneous panniculitis-like T-cell lymphoma (SPTCL). An accurate diagnosis could only be made following detailed immunohistochemical and molecular studies. Although SPTCL has been thought to represent a very specific clinicopathologic entity, the present case illustrates that its histological appearance can, however, be closely mimicked by reactive and benign conditions.

[Laboratory diagnosis of monoclonal gammopathies. Prospective study of 14 cases in Dakar, Senegal]. / Diagnostic au laboratoire des gammapathies monoclonales. Etude prospective de 14 cas à Dakar, Sénégal.

Monoclonal gammapathies are detected because of clinical symptoms and biological tests confirm their presence. Wishing to investigate these diseases, we carried out a series of biochemical tests on 14 patients from October 1995 to July 1996: protein, cryoglobulin, electrophoresis of proteins, proteinuria of BENCE JONES, C-reactive protein, weight measuring of immunoglobulins (Ig), immunofixation of Ig, creatinine and calcium. The results we obtained confirmed the presence of 14 cases of myeloma with: -9 IgG myelomas with 6 kappa light chains and 3 lambda light chains -4 IgA myelomas with 2 kappa light chains and 2 lambda light chains -1 IgG kappa, Ig lambda biclonal gammapathy united to a cryoglobulin of class I. We observed a predominance of the IgG over the others Ig and the kappa over the alpha light chains. The proteinuria of BENCE JONES was present among 3 patients, hypercalcemia among 4 patients and hypercreatininemia in 1 patient with chronic renal failure.

[Hematologic abnormalities and immunodepression in HIV/AIDS- related pulmonary tuberculosis]. / Anomalies de l'hémogramme et immunodépression dans l'associaton VIH/SIDA-tuberculose pulmonaire.

Our objectives were to describe hemato-immunological abnormalities encountered in tuberculosis patients HIV seropositive (TBVIH+, n = 67) or not (TBVIH-, n = 39) and in HIV asymptomatic patients (aSVIH+, n = 40). We found: a great reduction of mean value of RBC and Hb in TBVIH+ and TBVIH-; a reduction of mean value of leucocytes, total lymphocytes and CD4+ lymphocytes in TBVIH+ and aSVIH+; an inversion of [formula: see text] ratio, more important in TBVIH+ than in aSVIH+. HIV and tuberculosis association, HIV1 serotype and CD4 < 200/mm3 were found to promote significantly hemato-immunological abnormalities.

[Sebaceous carcinoma of the submandibular gland: a case report]. / Carcinome sébacé de la glande sous-maxillaire. A propos d'un cas.

Primary sebaceous carcinoma of the major salivary glands is very rare, arising mainly in the parotid. The submandibular gland localization is exceptional and only two cases have been reported in the literature. We report a third case diagnosed in Beaujon's Hospital in a 80 year old woman. Histologically, the tumor was poorly differentiated and lobules contained clear cells, foam cells or adipocyte-like cells, containing lipids stained with Oil Red O. We report the clinical, histological and prognostic features of this rare entity. We also discuss the differential diagnoses that pathologists should discard.

[Fibrosarcomatous variant of dermatofibrosarcoma protuberans: clinicopathologic analysis of 4 cases]. / Variante fibrosarcomateuse du dermatofibrosarcome protuberans: à propos de 4 cas.

We present a series of 4 cases of fibrosarcomatous dermatofibrosarcoma protuberans. This variant, which is composed of areas of typical DFSP associated with more cellular, fascicular foci, reminiscent of fibrosarcoma, should be recognised because of its more aggressive behavior, with a significant metastatic potential (15%). Our series illustrates the clinical, morphological, immunohistochemical and cytogenetic features of this uncommon tumor, with emphasis on differential diagnosis.

[Economic contribution of gynecological and obstetrical ultrasound in an advanced strategy for the Zinguinchor region]. / Intérêt économique de l'échographie gynécologique et obstétricale en stratégie avancée dans la région de Zinguinchor (Sénégal).

Aiming to strengthen the accessibility of ultrasound technology to rural populations, an advanced strategy ultrasound programme was implemented in the health districts of Sedhiou, Oussouye, Bignona and Ziguinchor all located within Casamance in Senegal. Within the first year of activity (January 1, 2001-December 31, 2001), the team from the regional health centre (RHC) was dispatched 56 times. Ultrasound scans were performed in the homes of 1,273 patients among which 192 were referred to the RHC for specialised follow-up and treatment. The financial benefit for the RHC totaled 3,120,000 francs; 2,612,500 francs for the district hospital; and 3,561,300 francs for the population at large. The advanced strategy for performing ultrasound scans has therefore been economically profitable at the community level as much as at the level of health structures. Through supporting the activities of the district hospitals, the RHC contributed technical support and increased the potential, not solely for the treatment of disease but for the health services overall. The revenue generated has given managers a greater possibility to improve health care and services. The decentralisation programme and reduction in the cost have decreased the unsatisfied needs in ultrasound services by making the technology more financially and geographically accessible. Thus, by saving input costs in terms of time, transportation and capital, the practice of ultrasound scans in district hospitals has been strengthened and has improved the capacity to provide care and treat the population's health problems. The continuation of this programme is advantageous, but necessitates two complementary actions: enhancing of the technical level and capacity of the district hospitals with the installation of ultrasound technology and equipment, and raising the level of knowledge by training staff in administering ultrasound scans.

[Impact of the number of antenatal consultations on the morbidity and mortality of children and women in the health district of Ziguinchor]. / Impact du nombre de consultations prénatales (CPN) sur la morbimortalité maternofoetale dans le district sanitaire de Ziguinchor.

In order to assess the impact of the number of antenatal consultations (CPN) on the foetal and maternal morbidity and mortality, a prospective survey has been carried out in 1999, in the health district of Ziguinchor, Senegal. The investigation was led in seven health facilities which offered obstetrical cares, from January 1 to march 31, over a sample of 862 delivered women and 870 newborns. The number of antenatal consultations was zero in 26 cases (3%), one in 130 cases (15%), two in 198 cases (23%), three in 302 cases, and more than three in 206 cases (24%). Three elements of the mothers' profile have a statistically significant influence on the number of antenatal consultations: the delivery facilities, the ethnic groups, and the caesarean antecedent. For the other elements, the test is not significant. The number of antenatal consultations has a statistically significant link with: eclampsia, abruptio placentae, distich and maternal death. Some elements of the mothers' profile seem to be a cause of morbidity and mortality of children and women. In fact, we have notice: a statistically significant link between the health facilities and the dystocy; and between ethnic groups and abruptio placentae; an impossibility of drawing conclusion for the other cases. In short, the eclampsia and the maternal death are the only elements which seem to be improved by an increasing number of CPN without any influence of external factors.

Contrasting responses to ectomycorrhizal inoculation in seedlings of six tropical African tree species.

Five caesalpinioid legumes, Afzelia africana, Afzelia bella, Anthonotha macrophylla, Cryptosepalum tetraphylum and Paramacrolobium coeruleum, and one Euphorbiaceae species, Uapaca somon, with a considerable range in seed sizes, exhibited different responses to inoculation by four species of ectomycorrhizal (ECM) fungi, Scleroderma dictyosporum, S. verrucosum, Pisolithus sp. and one thelephoroid sp. in greenhouse conditions. Thelephoroid sp. efficiently colonized seedlings of all of the five caesalpinioid legumes except U. somon, but provided no more growth benefit than the other fungi. Thelephoroid sp. and S. dictyosporum colonized seedlings of U. somon poorly, but stimulated plant growth more than the other fungi. The relative mycorrhizal dependency (RMD) values of the caesalpinioid legumes were never higher than 50%, whilst U. somon had RMD values ranging from 84.6 to 88.6%, irrespective of the fungal species. The RMD values were negatively related to seed mass for all plant species. Potassium concentrations in leaves were more closely related than phosphorus to the stimulation of seedling biomass production by the ECM fungi. Our data support the hypothesis that African caesalpinioid legumes and euphorbe tree species with smaller seeds show higher RMD values than those with the larger seeds.

The early-stage ectomycorrhizal Thelephoroid fungal sp. is competitive and effective on Afzelia africana Sm. in nursery conditions in Senegal.

This study was conducted to evaluate the competitiveness and effectiveness of Thelephoroid fungal sp. ORS.XM002 against native ectomycorrhizal fungal species colonizing potted Afzelia africana seedlings during 3 months of growth in different forest soils collected from under mature trees. Using morphotyping and restriction fragment length polymorphism (RFLP) analysis of the nuclear rDNA internal transcribed spacer (ITS), we were able to distinguish the introduced Thelephoroid fungal sp. ORS.XM002 among native ectomycorrhizal fungal species that form ectomycorrhizae in A. africana seedlings. The morphotype (MT) of the introduced fungus showed some color variation, with a shift from light- to dark-brown observed from younger to older mycorrhizal tips. We were able to differentiate the ITS type xm002 of the introduced fungus from the 14 ITS-RFLP types characterizing the 9 native MT that occurred in forest soils. The frequency of ITS type xm002 ranged from 40% to 49% depending on the forest soil used, and was always higher than those of ITS types from native dark-brown MT that occurred in inoculated seedlings 3 months after inoculation. We considered Thelephoroid fungal sp. ORS.XM002 to be responsible for stimulation of mycorrhizal colonization of inoculated A. africana seedlings when compared with control seedlings in forest soils. This fungus appeared to be more effective in increasing the root dry weight of A. africana seedlings. To identify the unknown introduced fungal species and native MT, we sequenced the ML5/ML6 region of the mitochondrial large subunit rRNA. Sequence analysis showed that these fungi belong to three ML5/ML6 groups closely related to the Cortinarioid, Thelephoroid, and Sclerodermataceous taxa. The molecular evidence for the persistence of Thelephoroid fungal sp. ORS.XM002 despite competition from native fungi argues in favor of using this fungus with A. africana in nursery soil conditions in Senegal.

Developpement d'une matrice ethylcellulose/eudragitr pour la liberation controlee et continue de l'insuline

But : Le diabete de type I est une maladie chronique necessitant des prises repetees d'insuline toute une vie durant par voie parenterale. Ce mode d'administration en plus d'etre traumatisant peut poser un probleme d'observance du traitement chez le patient. Dans le souci de pallier ces difficultes; nous avons envisage le developpement d'une matrice ethylcellulose/eudragitr susceptible de faciliter la mise au point d'un systeme therapeutique transdermique de liberation controlee (STTLC) de l'insuline. Materiel et methode : Comme principe actif nous avons utilise de l'insuline humaine anhydre Actrapidr HM des laboratoires Novo Nordisk; les excipients sont l'ethylcellulose; les Eudragitr RS 100 et le butylphtalate. Nous avons elabore deux matrices Ethylcellulose/Eudragit dans les rapports 1 : 1 et 2 : 1 dans lesquels sont incorporees differentes proportions d'insuline. Resultats : L'etude de la liberation de l'insuline en milieu tampon phosphate a pH 7;4 a montre une liberation continue avec des profils fortement dependants du rapport Ethylcellulose/Eudragit et de la charge initiale en insuline. Conclusion : Cette etude a montre que la matrice Ethylcellulose/Eudragit se prete a la mise au point d'un systeme a liberation controlee d'insuline. Ceci nous permet d'envisager pour la poursuite de notre travail l'association de cette matrice avec d'autres elements pour la realisation d'un STTLC de l'insuline

Prevalence du VIH/sida chez les clients du Centre de Depistage Volontaire Anonyme et d'Accompagnement de Pikine/Guediawaye; au Senegal

Dans le cadre de la lutte contre le VIH/SIDA; un Centre de Depistage Volontaire Anonyme et d'Accompagnement (CDVAA) a ete ouvert en mars 2003 a Pikine/Guediawaye; au Senegal. Cette etude cherche a analyser la prevalence de l'infection chez les clients durant une annee d'activite dans le but d'orienter les services du CDVAA pour une meilleure sante des populations. L'etude porte sur la periode allant du 08 avril 2003 au 07 avril 2004. Il s'agit d'une etude epidemiologique retrospective basee sur l'exploitation des fiches des clients du CDVAA qui; a Pikine/Guediawaye; etait abrite par le Centre Departemental d'Education Populaire et Sportive. Elle portait sur l'ensemble des personnes recues au CDVAA durant la periode consideree. Les variables etudiees portaient sur l'age; le sexe; le statut matrimonial; le niveau d'instruction; l'ethnie; la religion; les raisons du depistage; les connaissances concernant les modes de prevention; les resultats du test et; en cas de positivite; l'acceptation ou non de la reference vers une structure de prise en charge. Les donnees ont ete saisies et analysees sur Epiinfo 6.04dfr. Les raisons du depistage etaient dominees par la curiosite de connaitre le statut serologique (69). Le resultat du test etait positif dans 3des cas. L'infection etait due au VIH1 dans 65des cas; au VIH2 dans 24des cas; et a l'association VIH1+VIH2 dans 11des cas. Parmi ceux qui ont fait le test; 91sont venus retirer leurs resultats. Parmi les personnes infectees par le VIH/SIDA; 68ont accepte d'etre referees vers une structure de prise en charge. La seropositivite a ete significativement plus frequente chez les clients ages de plus de 24 ans; marie(e)s; non scolarise(e)s et assurer sa promotion pour mieux sensibiliser la population cible sur la prevention des IST/VIH/SIDA; avec un accent particulier sur le changement de comportement