Pregnancy in Sickle Cell Disease Is a Very High-Risk Situation: An Observational Study.

Sickle cell disease is a serious genetic disorder affecting 1/235 births in French Guiana. This study aimed to describe the follow-up of pregnancies among sickle cell disease patients in Cayenne Hospital, in order to highlight the most reported complications. 62 records of pregnancies were analyzed among 44 females with sickle cell disease, between 2007 and 2013. Our results were compared to those of studies conducted in Brazil and Guadeloupe. There were 61 monofetal pregnancies and 2 twin pregnancies, 27 pregnancies among women with SS phenotype, 30 SC pregnancies, and five S-beta pregnancies. The study showed that the follow-up of patients was variable, but no maternal death was found. We also noted that the main maternofetal complications of pregnancies were anemia (36.5%), infection (31.7%), vasoocclusive crisis (20.6%), preeclampsia (17.5%), premature birth (11.1%), intrauterine growth retardation (15.9%), abnormal fetal heart rate (14.3%), and intrauterine fetal death (4.8%). Pregnancies were more at risk among women with SS phenotype. Pregnancy in sickle cell disease patients requires a supported multidisciplinary team including the primary care physician, the obstetrician, and the Integrated Center for Sickle Cell Disease.

Risk factors for delayed access to specialized care in French Guiana.

The variables influencing the interval between diagnosis and effective access to specialized care were studied in a cohort of 2,661 human immunodeficiency virus (HIV)-positive patients in French Guiana between 1992 and 2008. Patients with a subsequent follow-up interruption were significantly more likely to have a delayed first consultation after the HIV diagnosis. Ordinal logistic regression showed that younger persons, women, and French citizens were independently associated with greater delays between the HIV diagnosis and the first specialized consultation. However, persons with acquired immunodeficiency syndrome (AIDS) were less likely to have a delay between the HIV diagnosis and the first specialized consultation. Focusing on the link between the private sector and specialized health care may shorten delays and improve care and follow-up.

What is AIDS in the Amazon and the Guianas? Establishing the burden of disseminated histoplasmosis.

The pathogen ecology of Amazonian regions may lead to specific differences in the most frequent clinical presentations of acquired immunodeficiency syndrome (AIDS). A retrospective cohort study was thus conducted to describe the main AIDS-defining events in French Guiana. Disseminated histoplasmosis was the most frequent opportunistic infection (15.4/1000 person years).

Suicide attempt by ingestion of rotenone-containing plant extracts: one case report in French Guiana.

INTRODUCTION: Several species of plants in the Fabaceae family are traditionally used for poison fishing because they contain ichthyotoxic rotenoids. In French Guiana two species of Fabaceae belonging to Lonchocarpus genus with a toxic rotenone effect are used for such ancestral practices. Rotenone is of low toxicity for humans when it is diluted, but its neurotoxicity at higher concentrations is well known to users. CASE REPORT: The purpose of this article is to describe a case of self-poisoning by an 86-year-old woman who ingested a bowl of mashed ichthyotoxic plants. Despite early onset of severe symptoms, the patient regained consciousness and resumed normal breathing within a few hours with only symptomatic treatment. CONCLUSION: The clinical pattern observed in this patient (onset of digestive manifestations followed quickly by loss of conscience and respiratory insufficiency) is in agreement with the few poisonings reported in the literature involving other Fabaceae species containing rotenoids in Asia or involving concentrated rotenone used in insecticides. In patients, who survive the initial phase, symptoms usually regress quickly.