Ischemic strokes revealing neurosyphilis: Study of six (6) observations at the neurology Department of the University Hospital of Conakry.

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.

Relationship between periparturient diseases, metabolic markers and the dynamics of hair cortisol concentrations in dairy cows.

Hair cortisol concentration (HCC) might represent a promising marker for retrospective welfare assessment of dairy cows. The objective of the study was to explore the dynamics of HCC in diseased and healthy cows from eight-week ante partum (AP) to eight-week post partum (PP). Twenty-four pregnant cows were followed from drying off to week eight PP. Tail hair was used to measure cortisol at five different time points. The occurrence of peripartum diseases, lameness and the body condition score (BCS) were monitored on a weekly basis. Blood ß-hydroxybutyric acid, non-esterified fatty acids, calcium and insulin-like growth factor-1 (IGF-1) concentrations were measured. The temperature-humidity index (THI) was continuously recorded. The median values of HCC in all cows were 0.4, 0.3, 0.6, 0.8 and 0.5 pg/mg at weeks eight, four AP, calving, weeks four, eight PP, respectively. There was no association between HCC and the occurrence of peripartum diseases (P ≥ 0.05). A positive correlation between HCC and BCS loss (P < 0.01) and THI (P < 0.05) was observed. The occurrence of peripartum diseases was associated with low IGF-1 during the study period but no relationship was found between cortisol and IGF-1 levels (P ≥ 0.05). Brown Swiss cows showed higher HCC (P < 0.01) at weeks eight, four AP, and week four PP and lower average milk yield (P < 0.05) than Holstein-Friesian cows. In conclusion, HCC was not a suitable marker for peripartum diseases but it could reflect a stress response, which is linked to BCS loss, heat stress and breed.

EPILEPTIC SEIZURES REVEALING STURGE WEBER'S DISEASE IN A TROPICAL ENVIRONMENT: STUDY OF EIGHT CASES.

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.

GAYET WERNICKE'S ENCEPHALOPATHY AFTER COVID-19 IN ELDERLY SUBJECTS IN TROPICAL ENVIRONMENTS: STUDY OF SIX (6) OBSERVATIONS IN CONAKRY.

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.

Postoperative effects of intra-alveolar application of 0.2% chlorhexidine or 1% hyaluronic acid bioadhesive gels after mandibular third molar extraction: a double-blind randomized controlled clinical trial.

OBJECTIVE: The aim of this study was to analyze the postoperative effects of intra-alveolar applications of 0.2% chlorhexidine (CHL) or 1% hyaluronic (HA) acid bioadhesive gels following the extraction of mandibular impacted third molars (MITMs). MATERIALS AND METHODS: In this double-blind randomized controlled clinical trial, 90 patients with one asymptomatic MITM were randomized into three group (n = 30 per group): group 1 (0.2% CHL), group 2 (1% HA), and group 3 (control). Visual analogue scales (VAS) were used to assess postoperative pain 24, 48, and 72 h and 7 days after surgery. Postsurgical complications were recorded: trismus, alveolitis osteitis, infection, or hematoma. RESULTS: In order from least to greatest, postoperative pain at all evaluation times was 0.2% CHL < 1% HA < control. At 24 h, statistically significant differences were found between both study groups and the control groups (0.2% CHL/control: P = 0.001; 1% HA/control: P = 0.010). At 48 and 72 h, significant differences were only found between 0.2% CHL and the control group (P = 0.229 and P = 0.046, respectively). At 7 days, no significant differences were found between any groups. Comparing the incidence of postoperative trismus, alveolitis osteitis, infection, or hematoma, although complications were more frequent in the control group, no statistical differences between groups were found (P > 0.050). CONCLUSIONS: Both 0.2% CHL and 1% HA bioadhesive gels applied intra-alveolarly minimize the postoperative complications after MITM extraction. Further research is necessary to confirm the present results. CLINICAL RELEVANCE: This study might help to reduce the postsurgical complications in patients after MITM extraction.

Immediate post-extraction implants placed in acute periapical infected sites with immediate prosthetic provisionalization: a 1-year prospective cohort study.

BACKGROUND: Few studies have reported the outcomes of immediate placement at infected post-extraction sites. The aim of this study was to compare clinical and radiological outcomes of immediately placed implants with immediate prosthetic provisionalization in sockets with or without acute periapical pathology. MATERIAL AND METHODS: A total of 100 patients with immediately placed implants with immediate provisionalization and 1- year of follow up were included (50 patients with acute periapical pathology and a control group of 50 patients without acute periapical pathology). Clinical parameters (bleeding on probing, buccal keratinized mucosa width, clinical recession, and probing depth) and radiological parameters (distance from implant shoulder to first point of bone-to-implant contact [IS-BIC]) were assessed. RESULTS: Clinical parameters showed no significant differences between the study and control groups after 1-year follow up (p>0.05). IS-BIC presented the following values: 0.35 ± 0.51 mm (study group) and 0.15 ± 0.87 mm (control), without significant differences between the groups (p=0.160). None of the 50 radiographs of immediate implants placed in sockets with periapical pathology revealed retrograde peri-implantitis. CONCLUSIONS: Immediate placement of implants with immediate prosthetic provisionalization at sites with acute periapical pathology can be a successful treatment modality for at least 1-year.

Attitudes of dental implantologists in Spain to prescribing antibiotics, analgesics and anti-inflammatories in healthy patients.

BACKGROUND: The implantologists frequently prescribe antibiotics, analgesics and anti-inflammatories in dental implant surgery. The aims of this study were to evaluate the attitudes of implantologists in Murcia (Spain) to prescribing antibiotics, analgesics and anti-inflammatories in healthy patients during different implant dentistry procedures, and to see how these are influenced by individual dentist's academic level, professional experience, and ongoing training (attending courses or reading scientific literature on medication use). MATERIALS AND METHODS: This cross-sectional study included a total of 200 implantologists from the Murcia area (Spain), who each completed a two-page questionnaire consisting of 26 questions. RESULTS: The implant procedure in which most dentists (n=97) prescribed antibiotics was multiple implant surgery with flap raising, in which 55.6% of these 97 respondents used a prophylactic antibiotic regime for 7 days after implant placement. All subjects (n=200) prescribed analgesics for eight out of the eleven procedures included in the survey and anti-inflammatories in six. Dentists with higher academic levels or longer professional experience prescribed more antibiotics, but those who underwent continuous training (attending courses or reading scientific literature) reduced antibiotic prescription. CONCLUSIONS: Dentists often prescribed antibiotics, analgesics and anti-inflammatories in almost all implant procedures in healthy patients, but ongoing training reduced the frequency of antibiotic prescription in some procedures.

[Study Of Immediate Post-Partum Care Satisfaction (Ssoppi) At The Reference Health Center Of The Community V Of Bamako]. / Étude De La Satisfaction Des Soins Du Post-Partum Immédiat (Ssoppi) Au Centre De Santé De Référence De La Commune V De Bamako.

The objectives of the work were to measure the degree of satisfaction of women in the postpartum period and to determine the stability of the immediate postpartum care satisfaction scale (PASS). MATERIAL AND METHOD: The motherhood of the reference health center of commune V served as a study framework. The study was descriptive for evaluative purposes in postpartum women. It covered the period from 11 July 2014 to 14 January 2015. Two interview questionnaires (SSOPPI1) and (SF12 and SSOPPI2) were used for data collection. The data analysis was done on the software EPI-info version 3.5.3. RESULTS: The study involved a total of 145 women in SSOPPI1 and SSOPPI2. The average age was 25.6 years ± 5.5 years. The level of satisfaction for the two phases of the study (SSOPPI1 and SSOPPI2) was a function of level of study, occupation, mode of initiation of labor, route of delivery, status of newborn at birth. Satisfaction was 98.6% in SSOPPI1 and was 98,5% in SSOPPI2 with a statistically insignificant difference (p = 0.67). CONCLUSION: The degree of overall satisfaction was a function of a number of factors. This satisfaction remained stable during both phases of the study.

Les objectifs du travail étaient de mesurer le degré de satisfaction des femmes dans le post-partum et de déterminer la stabilité de l'échelle de mesure de la satisfaction des soins post-partum immédiat(SSOPPI). MATÉRIEL ET MÉTHODE: La maternité du centre de santé de référence de la commune V a servi de cadre d'étude. L'étude était descriptive à visée évaluative portant sur les femmes en post-partum. Elle a couvert la période allant du 11juillet 2014 au 14 janvier 2015. Deux questionnaires d'entrevue (SSOPPI1) et (SF12 et SSOPPI2) ont été utilisés pour la collecte des données. L'analyse des données a été faite sur le logiciel EPI-info version 3.5.3. RÉSULTATS: L'étude a porté sur un total de 145 femmes en SSOPPI1 et SSOPPI2. L'âge moyen était de 25, 6ans±5,5ans. Le degré de satisfaction pour les deux phases de l'étude (SSOPPI1 et SSOPPI2) était fonction du niveau d'étude, la profession, le mode de déclenchement du travail, la voie d'accouchement, l'état du nouveau-né à la naissance. La satisfaction était de 98,6% en SSOPPI1 et de 98,5% en SSOPPI2 avec une différence statistiquement non significative (p=0,67). CONCLUSION: Le degré de satisfaction globale était fonction d'un certain nombre de facteurs. Cette satisfaction est restée stable pendant les deux phases de l'étude.

Rachianesthésie pour le cerclage du col utérin

Introduction :Notre étude avait pour but d'évaluer la rachianesthésie à faible dose de bupivacaïne et de fentanyl pour le cerclage du col de l'utérus chez des patientes en surpoids ou obèses. Le cerclage du col utérin est indiqué dans le traitement de l'incompétence cervicale, généralement réalisé sous anesthésie générale et en chirurgie ambulatoire. Méthodes : Il s'agissait d'une étude prospective observationnelle et multicentrique réalisée sur une période de 18 mois portant sur la rachianesthésie pour cerclage du col utérin. Etaient inclues les patientes de classes ASA 1 et 2, ayant un indice de masse corporelle supérieur ou égal à 25 Kg/m2. La rachianesthésie était réalisée avec une association de 5 mg de bupivacaïne et de 25 µg de fentanyl. Les principales variables étudiées étaient la qualité du bloc sensitif et moteur, les paramètres hémodynamiques, le délai de sortie de l'hôpital. L'analyse statistique a été faite à l'aide du logiciel SPSS 21.0. Résultats : Cinquante-neuf patientes d'un âge moyen de 27 ± 7 ans avec un âge de grossesse de 16 ± 4 semaines d'aménorrhée (SA) ont été inclues. Le délai d'installation du bloc sensitif était de 3,86±1,06 minutes, pour un niveau d'anesthésie à T11 chez 86,44% des patientes, et un score de Bromage à 1 à la mise en position gynécologique. Aucune plainte douloureuse n'a été exprimée à la préhension du col. La durée moyenne du cerclage était de 22,83 ± 5,04 min. Aucun cas d'hypotension artérielle ou de bradycardie n'a été observé. La récupération postopératoire était complète (score de Bromage 0) à la 2ème heure. La sortie était faite à la fin de la 3ème heure post-opératoire chez toutes les patientes. Conclusion : La rachianesthésie à faible dose de bupivacaïne et de fentanyl est suffisante et efficace pour le cerclage du col, chez des patientes à terrain particulier, permettant ainsi une récupération post interventionnelle précoce

Étude de la satisfaction des soins du post-partum immédiat (SSOPPI) au centre de santé de référence de la commune V de Bamako

Les objectifs du travail étaient de mesurer le degré de satisfaction des femmes dans le post-partum et de déterminer la stabilité de l'échelle de mesure de la satisfaction des soins post-partum immédiat(SSOPPI). Matériel et méthode : La maternité du centre de santé de référence de la commune V a servi de cadre d'étude. L'étude était descriptive à visée évaluative portant sur les femmes en post-partum. Elle a couvert la période allant du 11juillet 2014 au 14 janvier 2015. Deux questionnaires d'entrevue (SSOPPI1) et (SF12 et SSOPPI2) ont été utilisés pour la collecte des données. L'analyse des données a été faite sur le logiciel EPI-info version 3.5.3. Résultats : L'étude a porté sur un total de 145 femmes en SSOPPI1 et SSOPPI2. L'âge moyen était de 25, 6ans±5,5ans. Le degré de satisfaction pour les deux phases de l'étude (SSOPPI1 et SSOPPI2) était fonction du niveau d'étude, la profession, le mode de déclenchement du travail, la voie d'accouchement, l'état du nouveau-né à la naissance. La satisfaction était de 98,6% en SSOPPI1 et de 98,5% en SSOPPI2 avec une différence statistiquement non significative (p=0,67). Conclusion : Le degré de satisfaction globale était fonction d'un certain nombre de facteurs. Cette satisfaction est restée stable pendant les deux phases de l'étude

Robotic Implementation of the Necessary Mechanism for the Human Characteristics Simulation: Approach from Self-Care Conceptual Modeling.

The vertiginous development of robotics, as part of the Artificial Intelligence, is currently raising its potential from the point of view of care. The purpose of the present article is the robotic implementation of a logical sequence model of the phases that happen in proper care. This requires approaching the representation and formalization of knowledge about care, what and how the care is: starting with the conceptual dissertation between life, and human characteristics, and also consider this care with the aim to lay the groundwork for Robots based on care..

Diversity of Anopheles spp. (Diptera: Culicidae) in an Amazonian Urban Area.

The genus Anopheles encompasses several species considered as vectors of human infecting Plasmodium. Environmental changes are responsible for behavior changes in these vectors and therefore the pattern of malaria transmission. To better understand the dynamics of malaria transmission, this study aimed at identify the species of adult anophelines found in a malaria endemic urban area of the Amazon region, Mâncio Lima, located in the Acre State Brazil. Using Shannon-type light traps installed at 11 collection points near fish ponds, a total of 116 anophelines were collected belonging to nine species. Anopheles darlingi Root 1926 and An. albitarsis s.l. Lynch-Arribalzaga 1878 were the most abundant and predominant species. Despite the low number of captured adult anophelines, the occurrence of An. darlingi throughout all urban area and the presence of secondary vectors reinforce the need of a permanent and continuous entomological surveillance.

Murine melanoma cells incomplete reprogramming using non-viral vector.

OBJECTIVES: The reprogramming of cancer cells into induced pluripotent stem cells or less aggressive cancer cells can provide a modern platform to study cancer-related genes and their interactions with cell environment before and after reprogramming. Herein, we aimed to investigate the reprogramming capacity of murine melanoma B16F10 cells. MATERIALS AND METHODS: The B16F10 was transfected using non-viral circular DNA plasmid containing the genes Sox-2, Oct4, Nanog, Lin28 and green fluorescent protein (GFP). These cells were characterized by immunofluorescence, analysis RT-PCR and cell cycle. RESULTS: Our results demonstrated for the first time that reprogramming of B16F10 may be induced using non-viral minicircle DNA containing the four reprogramming factors Oct4, Sox2, Lin 28, Nanog (OSLN) and the GFP reporter gene. The resulting clones are composed by epithelioid cells. These cells display characteristics of cancer stem cells, thus expressing pluripotent stem cell markers and dividing asymmetrically and symmetrically. Reprogrammed B16F10 cells did not form teratomas; however, they showed the suppression of tumourigenic abilities characterized by a reduced tumour size, when compared with parental B16F10 cell line. In contrast to parental cell line that showed accumulation of the cells in S phase of cell cycle, the cells of reprogrammed clones are accumulated in G1 phase. Long-term cultivation of reprogrammed B16F10 cells induces regression of their reprogramming. CONCLUSIONS: Our data imply that in result of reprogramming of B16F10 cells less aggressive Murine Melanoma Reprogrammed Cancer Cells may be obtained. These cells represent an interesting model to study mechanism of cells malignancy as well as provide a novel tool for anti-cancer drugs screening.

Species Identification and Resistance Status of Anopheles gambiae s.l. (Diptera: Culicidae) Mosquitoes in Guinea.

Insecticide resistance is one of the primary threats to the recent gains in malaria control. This is especially true in Guinea, where long-lasting insecticidal nets are currently the primary vector control intervention. To better inform the national malaria control program on the current status of insecticide resistance in Guinea, resistance bioassays were conducted, using Anopheles gambiae s.l. Giles, in three sites. Molecular analyses were also done on An. gambiae s.l. to determine the species and find whether the target-site mutations kdr and Ace1R were present. Susceptibility tests revealed resistance to DDT and pyrethroids, although mosquitoes were susceptible to deltamethrin in two of the three sites tested. Mosquitoes were susceptible to bendiocarb, except in Kissidougou, Guinea. The kdr-west mutation was widespread and the frequency was 60% or more in all sites. However, the Ace1R mutation was present in low levels. Insecticide susceptibility should continue to be monitored in Guinea to ensure insecticide-based vector control methods remain effective.

Sperm dimorphism in the Triatoma brasiliensis species complex and its applications.

Morphological and structural features of the sperm of the Triatoma brasiliensis Neiva, 1911 (Hemiptera: Reduviidae) species complex were examined in this first study investigating the sperm of Heteroptera and the genus Triatoma. Males were dissected and their seminal vesicles removed. For measurement, seminal vesicles were squashed on glass slides, spread, fixed and observed under a photomicroscope. The images were analysed and measures of sperm were made. Data were analysed using one-way analysis of variance and Tukey's test to detect differentiation among taxa. Furthermore, seminal vesicles were prepared for studies of transmission electron microscopy. All taxa studied showed polymorphic (short and long) sperm. The sperm of Triatoma brasiliensis macromelasoma was significantly longer (in total length) than that of the other four members of the complex, which supports the hypothesis of hybrid speciation of this member of the complex as an increase in the size of typical hybrids under heterosis was previously shown. The sperm cells of the five taxa have similar ultrastructural morphology. The ultrastructural features observed confirm the hypothesis, raised by previous studies, that they are synapomorphic to the suborder Heteroptera.

Role of the Na+/K+-ATPase ion pump in male reproduction and embryo development.

Na+/K+-ATPase was one of the first ion pumps studied because of its importance in maintaining osmotic and ionic balances between intracellular and extracellular environments, through the exchange of three Na+ ions out and two K+ ions into a cell. This enzyme, which comprises two main subunits (α and ß), with or without an auxiliary polypeptide (γ), can have specific biochemical properties depending on the expression of associated isoforms (α1ß1 and/or α2ß1) in the cell. In addition to the importance of Na+/K+-ATPase in ensuring the function of many tissues (e.g. brain, heart and kidney), in the reproductive tract this protein is essential for embryo development because of its roles in blastocoel formation and embryo hatching. In the context of male reproduction, the discovery of a very specific subunit (α4), apparently restricted to male germ cells, only expressed after puberty and able to influence sperm function (e.g. motility and capacitation), opened a remarkable field for further investigations regarding sperm biology. Therefore, the present review focuses on the importance of Na+/K+-ATPase on male reproduction and embryo development.

[The register of activity at the Ebola treatment center in Forecariah (Guinea) from april 23 to june 5, 2015: analysis and thoughts]. / Bilan d'activité du centre de traitement Ebola de Forécariah (Guinée) du 23 avril au 5 juin 2015 : analyse et réflexions.

The register of activity at the Ebola Treatment Center (ETC) in Forecariah (Guinea), from April 23 to June 5, 2015 is presented for analysis. The viral load of each patient is evaluated by the cycle threshold (Ct). One hundred and thirty patients were seen in Triage at the ETC, of which 24 (18.5%) patients who failed to meet theWHO case criteria for viral hemorrhagic fever were excluded from admission to the ETC. Of the 106 patients admitted in the ETC, 72 (67.9%) were declared non-cases after the results of their two PCR (drawn 48 hours apart) tests were negative. Thirty-four patients were tested positive for Ebola virus disease (EVD): 19 women and 15 men (sex ratio: male/female = 0.78), mean age of 33.51 ± 20.1 years (extremes of 42 days to 70 years), of which six children were aged below 8 years. The median initial Ct value was 21.6 ± 6.3 cycles in this group. Enquiry into patient contacts was only able to identify actual contacts in 20 of these patients (58.8%). Thirteen patients were ultimately cured of EVD (six men and seven women) - with a median age of 31.8 years (extremes of 4 to 54 years). These patients presented on admission with a median Ct value of 21.88 ± 6.2 cycles (extremes of 17.6 to 31.7). Of the six children aged below 8 years, only one survived. Twenty-one patients (61.76%) with EVD died (9 men and 12 women) - median age, 34 ± 21 years (extremes of 42 days to 70 years). They presented on admission with a median Ct value of 18 ± 7 cycles (extremes of 12 to 24). The single most important factor associated with lethality was the Ct value at the time of admission to the ETC (P = 0.0004), i.e., the lower the Ct value, the higher the lethality rate or simply stated, the higher the viral load, the greater the lethality. Age, sex, identification of contact, and delay between the onset of symptoms and admission did not prove to be predictive of death outcome in our series.

[Input of a laboratory in the management of patients with Ebola virus disease and in the training of health personnel: experience of the Forecariah Ebola treatment centre (Guinea) in 2015]. / Apport d'un laboratoire dans la prise en charge des patients atteints de la maladie à virus Ebola et dans la formation des personnels soignants : expérience du Centre de traitement d'Ebola de Forécariah (Guinée) en 2015.

Ebola virus disease (EVD) is associated with a high lethality rate even when the afflicted are provided with good support in an Ebola treatment center (ETC). Basic laboratory tests can help to better understand the pathophysiology of the disease, to guide treatment and to establish simple protocols and procedures tailored to the practice of medicine in the context of such precarious environment for caregivers. Based on a few clinical cases of patients treated in the ETC of Forecariah, Guinea, run by the French Red Cross, this article describes the difficult conditions associated with the provision of medical practice in this challenging environment, aiming to minimize the casualties in the EVD patient and to train the health staff.