ABSTRACT
Introduction : L'hospitalisation en néphrologie n'avait pas fait l'objet de plusieurs études au Sénégal et les données sont limitées. Notre travail avait pour but de déterminer les facteurs associés à l'hospitalisation prolongée et à la mortalité en néphrologie. Patients et méthodes : Il s'agissait d'une étude observationnelle prospective de 5 mois incluant tous les patients hospitalisés dans le service durant au moins 24H. La durée d'hospitalisation (la période allant du jour d'admission dans la chambre d'hospitalisation au jour de sortie du patient) était dite prolongée si > 12 jours. Résultats : Quatre-vingt-dix-neuf patients ont été analysés durant cette période avec une durée moyenne en hospitalisation de 11,14 ± 9,89 jours. L'âge moyen était de 45,22 ± 18,03 ans avec un sex-ratio (H/F) de 0,62. Les anomalies biologiques étaient : l'hyponatrémie (62,36%), l'hypokaliémie (23,91%), l'hypocalcémie (25%), l'hyperphosphatémie (51,21%), l'anémie (92,30%), la CRP élevée (90,90%) et l'hypoalbuminémie (80,76%). La protéinurie moyenne était de 3,38 ± 3,35 g/24h avec 34,61% de protéinurie néphrotique. La mortalité hospitalière était de 25,25%. En analyse univariée, l'hospitalisation prolongée était associée à l'âge ≤ 45 ans (p = 0,018), aux patients non dialysés chroniques (p=0,034), à la transfusion sanguine (p=0,008) tandis que la mortalité était liée à l'âge de plus de 45 ans (p=0,032), le diabète (p=0,014), l'hypokaliémie (p=0,045) et l'hospitalisation prolongé (p=0,007). En analyse multivariée, les patients présentant des Ådèmes et ceux ayant été transfusés avaient respectivement 2,89 et 3,9 fois plus de risque d'avoir une hospitalisation prolongée. Les patients diabétiques avaient 4,63 fois plus de risque de décès et ceux ayant été hospitalisés de plus de 12 jours avaient 0,14 fois de risque de décès. Conclusion : La durée d'hospitalisation était relativement prolongée avec une mortalité élevée. Cependant l'impact de certains facteurs a été démontré permettant ainsi de réduire la durée d'hospitalisation et le nombre de décès.
Introduction: Hospitalization in nephrology had not been the subject of several studies in Senegal and the data are limited. Our work aimed to determine the factors associated with prolonged hospitalization and mortality in nephrology. Patients and methods: This was a 5-month prospective observational study including all patients hospitalized in the department for at least 24 hours. The duration of hospitalization (the period from the day of admission to the hospital room to the day of the patient's discharge) was said to be prolonged if > 12 days. Results: Ninety-nine patients were analyzed during this period with an average hospital stay of 11.14 ± 9.89 days. The mean age was 45.22 ± 18.03 years with a sex ratio (M/F) of 0.62. The biological abnormalities were: hyponatremia (62.36%), hypokalemia (23.91%), hypocalcemia (25%), hyperphosphatemia (51.21%), anemia (92.30 %), elevated CRP (90.90%) and hypoalbuminemia (80.76%). The mean proteinuria was 3.38 ± 3.35 g/24h with 34.61% nephrotic proteinuria. Hospital mortality was 25.25%. In univariate analysis, prolonged hospitalization was associated with age ≤ 45 years (p = 0.018), chronic non-dialysis patients (p = 0.034), blood transfusion (p = 0.008) while mortality was related to age over 45 (p=0.032), diabetes (p=0.014), hypokalaemia (p=0.045) and prolonged hospitalization (p=0.007). In multivariate analysis, patients with edema and those who had been transfused were respectively 2.89 and 3.9 times more likely to have prolonged hospitalization. Diabetic patients had a 4.63 times greater risk of death and those who had been hospitalized for more than 12 days had a 0.14 times greater risk of death. Conclusion: The duration of hospitalization was relatively prolonged with high mortality. However, the impact of certain factors has been demonstrated, thus making it possible to reduce the duration of hospitalization and the number of deaths
Subject(s)
Humans , Male , Female , NephrologyABSTRACT
The pharmacokinetics and mammary excretion of eprinomectin were determined in zebu Gobra following topical administration of 0.5 mg kg(-1). The kinetics of plasma and milk was analysed using a one-compartment model. The maximum plasma concentration of 8.83+/-2.15 ng ml(-1) occurred 1.30 days post-administration. The area under the plasma concentration-time curve was 30.63+/-5.56 ng day(-1) ml(-1) and the mean residence time was 3.38+/-0.60 days. Eprinomectin was detected in milk at the first sampling time and thereafter for at least 8 days. The systemic availability of eprinomectin was significantly lower than that for other breeds of cattle. Comparison of the milk and plasma data demonstrated the parallel disposition of the drug in the milk and plasma with a milk/plasma ratio of 0.094. The very low extent of mammary excretion supports the permitted use of eprinomectin in lactating zebu Gobra.
Subject(s)
Anthelmintics/pharmacokinetics , Cattle/metabolism , Ivermectin/analogs & derivatives , Milk/chemistry , Administration, Topical , Animals , Anthelmintics/administration & dosage , Anthelmintics/blood , Area Under Curve , Biological Availability , Cattle/blood , Ivermectin/administration & dosage , Ivermectin/blood , Ivermectin/pharmacokineticsABSTRACT
Plasma disposition kinetics of ivermectin was evaluated in a West African cattle breed. Five clinically healthy zebu Gobra cattle (Bos indicus) weighing 220-270 kg were treated (0.2 mg kg-1) with a commercially available ivermectin formulation for cattle. Blood samples were collected by jugular puncture at different times between 0.5 h and 40 days post-treatment. After plasma extraction and derivatization, samples were analysed by HPLC with fluorescence detection. Ivermectin was detected in plasma between 30 min and 20 days post-treatment. The observed peak plasma concentration (Cmax) was 46.3+/-13.8 ng ml-1 and the time to reach Cmax (t(max)) was 0.9+/-0.2 day. The values for the absorption half-life (t1/2ab) and the elimination half-life (t1/2el) were 0.3+/-0.2 and 2.8+/-0.7 days, respectively. The calculated area under the concentration-time curve (AUC) was 185.2+/-12.1 ng day ml-1 and the mean residence time (MRT) was 4.2+/-1.3 days. The availability of ivermectin is low in zebu Gobra in comparison to other breeds cattle but equivalent to that reported in the yak and is likely to be due to physiological characteristics of this breed.
Subject(s)
Anthelmintics/pharmacokinetics , Cattle/metabolism , Ivermectin/pharmacokinetics , Animals , Anthelmintics/administration & dosage , Anthelmintics/blood , Area Under Curve , Desert Climate , Half-Life , Injections, Subcutaneous/veterinary , Ivermectin/administration & dosage , Ivermectin/blood , SenegalABSTRACT
Seroepidemiological investigations in Guinea were carried out to estimate the areas of Lassa virus circulation. The recombinant protein of Lassa virus nucleocapsid was used as the antigen to analyse blood sera by ELISA. In some regions, from 30 to 54.9% of the population had antibodies to Lassa virus, but in others only 6-7%.
