[Hyperthyroidism and diabetes mellitus: analysis of 10 African cases]. / Hyperthyroïdie et diabète sucré: analyse de 10 observations africaines.

This retrospective study of 10 patients with hyperthyroidisma and diabetes mellitus concerned 8 women and 2 men, aged from 15 to 77 years. The two disease developed at the same time in 8 cases. Diabetes mellitus occurred first in 2 cases. Common signs were loss of weight. Hyperthyroidism led to tachycardia at more than 100 bpm. Diarrhea was observed simultaneously in 2 cases and muscular weakness in 5. Goiter was found in 10 cases with a diffuse aspect. Graves' disease was diagnosed with exophthalmia in 9 cases and affected both eyes in 8. Elevated levels of thyroid hormones confirmed diagnosis in 8 cases. Diabetes was insulin-dependent in 3 cases and non-insulin dependent in the 7 others. IDDM patients (2 female and 1 male) were aged 15, 17 and 38. Keto acidosis was the first symptom in all cases. NIDDM patients (6 female and 1 male) were aged between 37 and 77.

[An innovative training experience in public health at the Cheikh Anta Diop University of Dakar]. / Une expérience innovante d'enseignement de la santé publique à l'Université Cheikh Anta Diop de Dakar.

The Institute for Health and Development (ISED) at the University of Dakar, was created in 1987. Its mission is to fulfill the public health training needs of Senegalese health care professionals. ISED is responsible for a training program entitled "Certificat d'études Spéciales" (CES), the equivalent of a Masters of Public Health degree. The "CES" is a two-year program comprised of six modules, which last four months each. The ISED training approach stresses trainee responsibility above all. It is based on the trainee's professional tasks and is oriented toward the problems identified by the trainees themselves. In this sense it is highly adaptive and flexible. Each module is implemented in the same way; initially there is a 15 day residential phase for intensive theoretical courses, followed by an application period of 75 days in the trainee's work place, and then a final residential phase of 15 days for writing and presenting a technical report on the work in the field. This model allows trainees to bring together the theoretical and the practical. The trainers directly supervise each of these three phases. The two residential phases are conducted in the ISED training center, located in Mbour, 80 Km south of Dakar. 103 trainees are enrolled in the program in seven different classes. Of these trainees, 93 are health care specialists (85 physicians 7 pharmacists, 1 dentist). Ninety percent of previous graduates have been civil servants who work for the Ministry of Health in Senegal and the remaining 10% were from Burkina Faso and Togo. The training program is considered by all stockholders, beneficiaries, and relevant financial institutions, to be appropriate, beneficial and successful.

[Central temperature and its circadian rhythm in men acclimated to the intertropical zone]. / La température centrale et son rythme circadien chez l'homme acclimaté à la zone intertropicale.

The central temperature has been measured at rest over 623 black men who are between 18 and 78 years old, and perfectly fit to warm weather in the intertropical areas. The measures have been taken according to two protocols: dealing with the ambiant temperature and the humidity (ambiant temperature varying from 20 degrees C to 42 degrees C, the humidity from 70% to 80%). dealing with the daily cycle: The central temperature was recorded every 3 hours by 24 hours at two different periods in the year, on June (the ambiant temperature varying from 28 degrees C to 42 degrees C and the humidity from 33 to 42%), and on December (the ambiant temperature varying from 21 degrees C to 25 degrees C and the humidity from 70 to 90%). On the one hand, the results showed an influence of the external temperatures on the circadian curves of the central temperature (maximal central temperature taken in the afternoon was 37.2 degrees C in winter and 37.6 degrees C in summer). On the other hand, there's a linear relation between central temperature and ambiant temperature, at least on certain limit and apart from the weather. In spite of two modifications, the thermoregulator system of some designed individual remain efficiency but would work rather than according to the mechanism of the "following" systems.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effects of water deprivation on rectal and skin temperature and on performance in sustained muscular exercise in a hot climate]. / Effets de la privation hydrique sur les températures rectale, cutanée et sur la performance lors de l'exercice musculaire de longue durée en climat chaud.

This study was performed on 16 Senegal young soldiers well trained in physical activities. Experimentation was done in tropical zone in Kedougou (Oriental Senegal) during Scorching period if the year, diurnal-room temperature 34 degrees 9 average. The subject had to ride on a cyclo ergometer to a force corresponding to 75% maximum. The central cutaneous temperature, the provided force, and the cardiac frequence were measured at the end of the muscular's exercise. For each subject that effort's test was once in normal alimentation and the other one after 24 hours' hydric privation. We noticed a significant low of the provided power for having 75% of the maximal cardiac frequence, after half hours (30 mn) of exercise during the hydric restriction compared to normal alimentation. In other respects, a regular increase was observed of the rectal temperature in the course of the activity in any case. That rise was more important to subject in hydric restriction. On the other hand there wasn't any significant difference of the cutaneous temperatures in both situations. The hydric privation has caused a hypohydration in origin of the significant decrease of the performance even if they remain moderated.

[Scintigraphic aspects of thyroid nodules investigated at the University Hospital Center of Dakar]. / Aspects scintigraphiques des nodules thyroïdiens explorés au CHU de Dakar.

The authors studied the scintigraphical appearances of thyroid nodules. This study on 8 years period enabled the authors to list 876 thyroïd nodules. The scintigraphy shows: 14.05% of isofixant nodules, 10.73% of "hot" nodules, 58.44% of "cold" nodules, 16.78% of heteromultinodular goitries. The scintigraphy proved its great importance as in the diagnostic as in the way of therapy of this pathology.

[Serum cortisol level variations in thyroid diseases]. / Variations de la cortisolémie au cours des dysthyroidies.

This work studies the thyroid disorders impact on adrenals glands by measuring total cortisol. Radioimmunoassays of thyroid hormones and cortisol were performed in 108 subjects, aged 20-52 years, with thyroid diseases. Our results show low cortisol values (80.35 nmol/L) in 4.77% of hyperthyroids, high values in 3.57% of hyperthyroids (1348.18 nmol/L) and 12.5% of hypothyroids (969.05 nmol/L). In hyperthyroidism, thyroid hormone stimulates the secretion of 11 ceto metabolites biologically inactive, unable to slow pituitary activity, inducing an increased production of endogene cortisol. Excessive catabolism can lead to the exhausting of overstimulated adrenal glands, and therefore to a decreased cortisol. In hypothyroidism, high cortisol results of increase cortisol half life and decrease of metabolic clearance. Control mechanisms often allow normal cortisol values. These alterations in functional activity of adrenal glands, seen in nearly 10% of these subjects, sometimes command a specific attitude in diagnosis and therapy.

[Rectal temperature trends during 24 hours in a hot climate with and without nutritional support]. / Evolution de la température rectale sur 24 heures en climat chaud avec et sans apport nutritionnel.

A group of 22 young subjects staying in rest was studied in the aim to follow the nycthemeral evolution of the rectal temperature, according to two situations: 1) normal feeding, 2) absence of feeding. The use of drinking water was not limited. The experimentation was carried out in tropical area, Kédougou (Eastern Senegal), during a high period of temperature. The mean of day temperature was 38 degrees C and the night temperature, 22 degrees C. The skin and rectal temperature, the arterial pressure and the cardiac frequency were measured every three hours. The results showed a significant difference in the nycthemeral rythm of the rectal temperatures. The nocturnal temperatures were not different in the two conditions. We observed a significant elevation (delta = 0.31 +/- 0.18 degree C) of the diurne post prandial temperature. The results supported that the thermic modification observed during the experience were linked to the feed.

[Echography in a neuro-pediatric milieu in Senegal. Apropos of 75 cases in Dakar]. / Echographie en milieu neuro-pédiatrique au Sénégal. A propos de 75 observations dakaroises.

In neuro-paediatry, echography is one of the easiest examinations to conduct. It is one of the most bearable, least traumatic and most informative. Furthermore, by utilizing the fontanelle window, brain structure can be discerned. In the light of these 75 observations, the authors establish echo-anatomical correlations and diagnostic strategy.

[Dysthyroidism after 60 years of age]. / Dysthyroïdies à partir de 60 ans.

This work has been conducted on 162 subjects, aged over 60 years, living in Senegal, investigated in the Departement of Biophysics and Nuclear Medecine of Dakar for suspicion of dysthyroidism. The levels of T3, T4 and TSH US hormones were determined by a radio-immunological method. This technique, exhibiting good functionnal sensitivity and its high specificity, is likely to be beneficial to the diagnosis of dysthyroidisms. Besides, this experiment leads us to consider that the dosage of TSH remains an useful first intention examination for the old patients and could notably improve the screening of dysthyroidisms with a decrease in the cost of the investigation. However, because of the therapeutical implications, some biological profiles schould be interpreted cautiously. The equipment for the determination of the free fractions (T3 and T4) with the brought additional accuracy could allow to dismiss some diagnostci uncertainties.

Hepatitis B vaccine in infants from an endemic area: long-term anti-HBs persistence and revaccination.

Persistence of anti-HBs in 156 Senegalese infants immunized with hepatitis B vaccine was studied for periods ranging from 2 to 6 years after booster dose administration. Six years after the booster dose, 90.4% of the infants had detectable anti-HBs antibodies, with 78.1% having titers higher than 10 mIU/ml. The geometric mean titer was 60 mIU/ml. Females showed higher anti-HBs values than males. In a group of 11 infants who received no booster dose, anti-HBs antibodies were detectable 7 years after the first dose. However, the geometric mean titer was lower (26 mIU/ml). Revaccination (56 infants) led to an increase of the geometric mean titer to 469 mIU/ml 2 months later. These results show that a booster injection every 5-6 years should provide adequate protective anti-HBs levels in infants.