Uric acid-lowering effects of sodium-glucose cotransporter 2 inhibitors for preventing cardiovascular events and mortality: A systematic review and meta-analysis.

BACKGROUND: To evaluate the effect of a 1 mg/dl reduction in uric acid (UA) on cardiovascular events and mortality in patients treated with sodium-glucose cotransporter 2 (SGLT2) inhibitors. RESEARCH DESIGN AND METHODS: We performed a systematic review of the MEDLINE and EMBASE databases searched up to 30 June 2023 (PROSPERO, CRD42022355479) to identify large-scale SGLT2 inhibitor trials. Random-effects meta-analyses were used to pool the estimates. RESULTS: In total, five SGLT2 inhibitor trials (31 535 patients, 54% with heart failure) were analysed. Over a median follow-up of 2.2 years, the mean reduction in UA was -0.79 mg/dl (95% confidence interval (CI), -1.03 to -0.54). Every 1 mg/dl reduction in UA was associated with a significantly lower risk of a composite of cardiovascular death and hospitalization for heart failure [hazard ratio, 0.64 (95% CI, 0.46-0.88)] and hospitalization for heart failure (0.68; 95% CI, 0.62-0.74), with a similar risk of mortality. CONCLUSIONS: SGLT2 inhibitors reduced UA levels and cardiovascular events independently of heart failure status.

Multidisciplinary estimates of connectivity and population structure suggest the use of multiple units for the conservation and management of meagre, Argyrosomus regius.

Information on population structure and connectivity of targeted species is key for proper implementation of spatial conservation measures. We used a combination of genomics, biophysical modelling, and biotelemetry to infer the population structure and connectivity of Atlantic meagre, an important fisheries resource throughout its distribution. Genetic samples from previously identified Atlantic spawning locations (Gironde, Tejo, Guadalquivir, Banc d'Arguin) and two additional regions (Algarve and Senegal) were analysed using genome-wide SNP-genotyping and mitochondrial DNA analyses. Biophysical models were conducted to investigate larval dispersal and connectivity from the known Atlantic spawning locations. Additionally, thirteen fish were double-tagged with biotelemetry transmitters off the Algarve (Portugal) to assess movement patterns and connectivity of adult individuals. This multidisciplinary approach provided a robust overview of meagre population structure and connectivity in the Atlantic. Nuclear SNP-genotyping showed a clear differentiation between the European and African populations, with significant isolation of the few known Atlantic spawning sites. The limited level of connectivity between these subpopulations is potentially driven by adults, capable of wide-ranging movements and connecting sites 500 km apart, as evidenced by tagging studies, whilst larval dispersal inferred by modelling is much more limited (average of 52 km; 95% of connectivity events up to 174 km). Our results show sufficient evidence of population structure, particularly between Africa and Europe but also within Europe, for the meagre to be managed as separate stocks. Additionally, considering the low degree of larvae connectivity, the implementation of marine protected areas in key spawning sites could be crucial towards species sustainability.

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.

[Gunshot wounds of low urinary tract in period of security crisis at the Sominé Dolo Hospital of Mopti (Mali): Epidemiological and diagnostic aspects]. / Blessures par arme à feu du bas appareil urinaire en période de crise sécuritaire à l'hôpital Sominé Dolo de Mopti (Mali) : aspects épidémiologiques et diagnostiques.

INTRODUCTION: Firearm injuries to the lower urinary tract are injuries resulting from an energy transfer from a projectile fired by a firearm or a blast from a firearm, to the bladder, prostate, urethra and terminal ureter. Our objective was to describe the epidemiological and diagnostic aspects in the context of a security crisis. PATIENTS AND METHOD: This was a descriptive cross-sectional study of lower urinary tract firearm injuries at Sominé Dolo Hospital in Mopti from January 2017 to December 2021. RESULTS: In five years, 29 traumas of the lower urinary tract have been collected, about 6 cases per year. The mean age of patients was 27.48 years, the sex ratio was 13.5/1. The main circumstances of occurrence were intercommunal violence 51.72 %, war wounds 31.03 %. Injuries were inflicted by rifles in 62.1 % and improvised explosive devices in 37.9 %. The main modes of discovery were acute urine retention, hematuria and penoscrotal wounds respectively in 31.03 %, 20.69 %, 17.24 %. The organs affected were the urethra in 58.62 %, the bladder, 37.93 %, the prostate 3.45 %. Associated non-urological lesions present in 68.96 % (n=20) were dominated by intestinal lesions and pelvic fractures. CONCLUSION: Firearm injuries to the lower urinary tract are rare despite the context of the security crisis. They affect young men, are mostly linked to intercommunal violence, and are dominated by urethral and bladder injuries.

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.

Spinal metastases of bronchopulmonary cancer: Role of spinal surgery and value of prognostic scores (Modified Tokuhashi and Tomita).

INTRODUCTION: Bone metastasis is frequent in bronchopulmonary cancer. We report a series of 52 patients, and analyze indications and the efficacy of surgery. MATERIALS AND METHODS: We retrospectively studied the records of 52 patients operated on for spinal metastases of bronchopulmonary cancer over a 6-year period from January 2009 to December 2014 in the neurosurgery department of the North Hospital of Marseille, France. RESULTS: Mean age was 63.6years; with a sex ratio of 3:1 (M:F). Spinal pain associated with vertebral fracture and spinal cord compression was the most frequent clinical presentation (59.6%). SINS score was≥7 in 78.9% of cases. Karnofski Performance Status was average in 67.4% of cases. Predicted survival beyond 12months was zero according to the modified Tokuhashi score. The surgical indication was essentially palliative. Evolution showed regression of pain in 84.6% of cases, and stabilization and improvement in motor deficit in 80.6%. Median postoperative survival was 16months. CONCLUSION: Our results highlight the interest of surgery for pain relief, spinal stabilization and improvement in neurological function in patients with spinal metastases of bronchopulmonary cancer, and the unreliability of predictive survival scores.

Hypnosis reduces food impulsivity in patients with obesity and high levels of disinhibition: HYPNODIET randomized controlled clinical trial.

BACKGROUND: The obesogenic environment of Western countries raises questions about its current management. Some clinical studies have explored hypnosis, although the current state of knowledge does not lead to definitive conclusions about its efficacy. OBJECTIVES: We assessed the impact of Ericksonian hypnosis and self-hypnosis on disinhibition of eating in adults with obesity and high food impulsivity levels, compared with standard nutritional education. METHODS: From September 2014 to July 2015, adults with BMI (in kg/m2) of 30-40 and a high disinhibition score [>8 on the Three Factor Eating Questionnaire (TFEQ-51)] were included in a randomized controlled trial. The control and hypnosis groups received the same standard nutrition education in 8 workshops. In the hypnosis group, subjects had 8 sessions of hypnosis combined with training in self-hypnosis. Disinhibition (primary outcome) and other scores from the TFEQ-51 as well as anthropometric, food intake, cardiometabolic, and physical activity variables were collected at inclusion and at 8 mo. RESULTS: Of 82 randomly assigned adults, 70 participated in all sessions; 80 participated in ≥1 session and were included in the main analysis (hypnosis group, n = 41; control group, n = 39). After 8 mo of follow-up, disinhibition scores adjusted for baseline values were lower in the hypnosis group, with a mean between-group difference of 4.2 (95% CI: 2.8, 5.5; P < 0.001); 67.7% of adults in the hypnosis group had normalized their disinhibition (compared with 11.1% in control; P < 0.0001). Differences for weight (1.8 kg; 95% CI: -0.1, 3.7 kg; P = 0.052), BMI (0.8; 95% CI: 0.1, 1.4; P = 0.028), susceptibility to hunger score (2.2; 95% CI: 1.0, 3.3; P < 0.001), and its 2 subscales also favored the hypnosis group. CONCLUSIONS: In the management of adults with obesity and a high disinhibition score, hypnosis and self-hypnosis can significantly improve the deep mechanisms of eating behaviors and seem to have a beneficial effect on weight loss.This trial was registered at clinicaltrials.gov as NCT02292108.

In-plane InGaAs/Ga(As)Sb nanowire based tunnel junctions grown by selective area molecular beam epitaxy.

In-plane InGaAs/Ga(As)Sb heterojunction tunnel diodes are fabricated by selective area molecular beam epitaxy with two different architectures: either radial InGaAs core/Ga(As)Sb shell nanowires or axial InGaAs/GaSb heterojunctions. In the former case, we unveil the impact of strain relaxation and alloy composition fluctuations at the nanoscale on the tunneling properties of the diodes, whereas in the latter case we demonstrate that template assisted molecular beam epitaxy can be used to achieve a very precise control of tunnel diodes dimensions at the nanoscale with a scalable process. In both cases, negative differential resistances with large peak current densities are achieved.

A rare localisation of intra-abdominal focal fat infarction: The falciform ligament. Contribution of imagery.

Pathological conditions of the falciform ligament are rare, one of which is the twisting of a fatty fringe that can lead to fatty infarction of the peritoneal fat. To our knowledge, only 21 cases with radiological documentation have been published in the literature. Ultrasound and computed tomography facilitated prompt diagnosis of this rare finding. The condition is best managed conservatively, but sometimes, a surgical intervention is necessary. We report herein a case of torsion of fatty falciform ligament appendage in a 73-year old female.

[Knee dislocation at chu Gabriel TOURE : therapeutic and evolutionary aspects]. / Luxations du genou au chu Gabriel TOURE : aspects therapeutiques et evolutifs.

INTRODUCTION: Dislocations of the knee are serious, involving the functional prognosis and sometimes the vital prognosis of the limb concerned. The aim of our work was to assess the functional results of our care. MATERIALS AND METHODS: This were a prospective study concerning patients with dislocation of the knee, treated and followed in the Department of Orthopedics-Traumatology at the CHU Gabriel TOURE from January 2015 to October 2018. RESULTS: We collected 30 patients with knee dislocation. The male sex predominated (60%) with a sex ratio of 1.5. The average age was 32.56 years. AVP was the main etiology with 83.3%. The mechanism was direct in 86.7%. Standard knee X-ray with front and side views was performed in all patients. Posterolateral dislocation was the most common type of pathology (20%). Associated lesions were observed in 56.6%. The response time was less than 6 hours in 100%. The treatment was orthopedic in 93.3%. Complications were dominated by knee laxity with 43%. At the average follow-up of 18.9 months, the functional results were good in 20%. CONCLUSION: Knee dislocations are the prerogative of the young subject. Accidents due to motorcycles are the main circumstances. Associated lesions are frequent. Orthopedic treatment is still relevant but the evolution is still unpredictable despite the early treatment.

INTRODUCTION: Les luxations du genou sont graves mettant en jeu le pronostic fonctionnel et parfois le pronostic vital du membre concerné. Le but de ce travail était de déterminer les aspects épidémiologiques, cliniques et d'évaluer les résultats du traitement. MATÉRIEL ET MÉTHODES: il s'agissait d'une étude retro prospective concernant les patients présentant une luxation du genou , traités et suivis dans le service d'Orthopédie-Traumatologie au CHU Gabriel TOURE de janvier 2015 à octobre 2018. RÉSULTATS: Nous avons colligé 30 patients présentant une luxation du genou. Le sexe masculin a prédominé (60%) avec un sex-ratio de 1,5. L'âge moyen était de 32,56 ans. Les AVP ont été la principale étiologie avec 83,3%. Le mécanisme était direct dans 86,7%. Les radiographies standards du genou de face et profil ont été réalisées dans 100%. La luxation postéro-latérale a été le type anatomopathologique le plus fréquent (20%). Les lésions associées étaient observées dans 56,6%. Le délai de prise en charge a été de moins de 6 heures dans 100%. Le traitement a été orthopédique dans 93,3%. Les complications étaient dominées par la laxité du genou avec 43%. Au recul moyen de 18,9 mois, les résultats fonctionnels ont été bons dans 20%. CONCLUSION: Les lésions associées sont fréquentes. Le traitement orthopédique reste toujours d'actualité, mais l'évolution est toujours imprévisible malgré la précocité de la prise en charge.

[Acetabular Fractures at CHU Gabriel Toure : epidemiology, therapeutic and evolutinaryaspects]. / Les Fractures Acetabulaires au CHU Gabriel Toure : aspects epidemiologiques therapeutiques et evolutifs.

INTRODUCTION: Acetabularfractures involving the functionalprognosis of the hip. The aim of thisworkwas to determine the epidemiological, clinical, and outcome aspects of treatment. MATERIALS AND METHODS: This wasa retro-prospective study of patients withacetabulum fracture treated and followedfromJanuary 2015 to June 2018. RESULTS: Wecollected 49 patients with an acetabulum fracture. Acetabulum fractures made up 8.3% of all pelvic injuries during the studyperiod. The male sexprevailed (87.8%) with a sex ratio of 7.16. The averageagewas 36.14 years (range: 17 years and 77 years). The circumstances of the trauma were accidents on the public highway (69.4%), accidents atwork (14.3%), accidents in the home (10.2%), accidents in sports (4.1%), assaults (2%). The mechanismwas indirect in 87.8%.Pain with total functional impotence wasobservedin 83.7% and with a vicious attitude of the traumatized limbin 89, 8%. The standard radiographywith the incidences of the pelvis face as well as the ¾ wing and ¾ obturatorwasperformed in all patients. The transverse fracture of the acetabulumwas the mostcommonanatomo-radiological type (61.2%). Shock (34.6%) and hip dislocation (24.4%) were the mostcommonearly complications. Treatment was orthopedicin 95.9%. After an averagefollow-up of 23.24 months, the anatomicalresultsweresatisfactoryin 32.7% and the functionalresults good in 51%. Lameness (91.8%), mechanical pain (30.6%) and osteoarthritis (16.3%) were the main complications in the medium term. CONCLUSION: Fractures of the acetabulum are the preserve of the adult, especially of the male. The complications are dominated by mechanical pain, lameness and early hip osteoarthritis. The anatomicalresultsthat condition the functionalresults are less good with the orthopedictreatment.

INTRODUCTION: Les fractures de l'acétabulum mettent en jeu le pronostic fonctionnel de la hanche et leur traitement est difficile. Le but de ce travail était de déterminer les aspects épidémiologiques, cliniques, et d'évaluer les résultats du traitement. MATÉRIEL ET MÉTHODES: il s'agissait d'une étude retro prospective concernant les patients présentant une fracture de l'acétabulum, traités et suivis de janvier 2015 à juin 2018. RÉSULTATS: Nous avons colligé 49 patients présentant une fracture de l'acétabulum. Les fractures de l'acétabulum ont constitué 8, 3% des traumatismes du bassin pendant la période d'étude. Le sexe masculin a prédominé (87,8%) avec un sex-ratio de 7,16. L'âge moyen était de 36,14 ans (extrêmes : 17 ans et 77 ans). Les circonstances du traumatisme ont été les accidents de la voie publique (69,4%), les accidents de travail (14,3%), les accidents de vie domestique (10,2%), les accidents de sport (4,1%), les agressions (2%). Le mécanisme était indirect dans 87,8%. La douleur avec impotence fonctionnelle totale a été observée dans 83,7%, et avec une attitude vicieuse du membre traumatisé dans 89, 8%. La radiographie standard avec les incidences du bassin de face ainsi que les ¾ alaire et ¾ obturateur était réalisée chez tous patients. La fracture transversale de l'acétabulum a été le type anatomoradiologique le plus fréquent (61, 2%). L'état de choc (34,6%) et la luxation coxo-fémorale (24,4%) ont été les complications précoces les plus observées. Le traitement a été orthopédique dans 95,9%. Après un recul moyen de 23,24 mois, les résultats anatomiques ont été satisfaisants dans 32,7% et les résultats fonctionnelsbons dans 51%. La boiterie (91,8%), la douleur mécanique (30, 6%) et l'arthrose (16, 3%) ont été les principales complications à moyen terme. CONCLUSION: les fractures de l'acétabulum touchent fréquemment l'adulte, surtout de sexe masculin. Les complications sont dominées par les douleurs mécaniques, la boiterie et la coxarthrose précoce. Les résultats anatomiques qui conditionnent les résultats fonctionnels sont moins bons avec le traitement orthopédique.

Amputation labiale par morsure humaine: à propos d'un cas à l'hopital national donka

Les morsures humaines représentent 3 % des morsures rencontrées au service d'urgence. Les preuves et le consensus sur les meilleures pratiques en matière de gestion des morsures humaines font défaut d'échec et de déterminer l'intérêt d'une réparation secondaire. Notre première tentative de reconstitution à partir de la pièce amputée étant échouée alors us avons entrepris cette étude dont les objectifs étaient d'identifier les facteurs OBSERVATION:Une patiente de sexe féminin âgée de 24 ans, ménagère A l'examen endo buccal, on notait une ouverture buccale d'amplitude normale. Les 32 et 31 sont exposées du fait de la perte de substance labiale. L'articulé dentaire conservée, l'hygiène bucco-dentaire défectueuse A l'admission, la patiente détenait dans un verre rempli d'eau minérale la pièce amputée de 2 cm x 1,8 cm dont la couleur laissait présager une vitalité compromise par défaut de vascularisation Les examens biologiques n'ont révélé aucune particularité. Le délai entre l'amputation et l'admission dans le Service était de 7h compromettant plus ou moins la vitalité de la pièce. Un délai nettement inférieur à celui trouvé par Roland et al. dans trois études différentes et qui ont trouvé moins de 14 % des patients ont été admis et plus de 80 % se sont présentés dans les 12 ou 24 heures suivant la morsure. CONCLUSION: Une tentative de replacement intentionnel d'une pièce amputée par morsure humaine sans chirurgie vasculaire est vouée à l'échec par une nécrose évolutive. Cependant la réparation chirurgicale de seconde intention donne un résultat esthétique et fonctionnel satisfaisant.

Lesions de l'appareil locomoteur par agressions physiques au centre hospitalier universitaire Gabriel Touré / Injuries of the musculoskeletal system by physical aggression at the Gabriel Touré university hospital

Introduction : les lésions de l'appareil locomoteur liées aux agressions physiques sont parfois complexes nécessitant parfois une prise en charge multidisciplinaire. Le but était de déterminer les aspects épidémio-cliniques, thérapeutiques et pronostiques des lésions de l'appareil locomoteur par agressions au service d'orthopédie-traumatologie du CHU Gabriel TOURE Bamako. Matériel et méthodes : il s'agissait d'une étude rétro prospective descriptive portant sur des patients présentant une lésion de l'appareil locomoteur par agression, pris en charge de janvier 2017 à décembre 2019. Résultats : Nous avons colligé 151 patients. Le sexe masculin a représenté 91,4%. L'âge moyen de nos patients était de 31, 31 ans, avec des extrêmes de 7 ans et 85 ans. Les élèves/étudiants ont constitué la couche la plus représentée (17,9%). Les blessures par arme à feu ont représenté 53%. Les membres supérieurs étaient les plus touchés avec 52,98%. Dans 3,31% les lésions siégeaient à la fois aux membres supérieurs et inférieurs. Les segments les plus touchés ont été la jambe et l'avant-bras avec respectivement 15, 9% et 14,6%. Les lésions vitales associées étaient observées dans 8 cas (5, 29%). La radiographie standard effectuée a mis en évidence 64,9 % de fractures et 2,6% de fractures-luxations. Les lésions tendineuses, nerveuses et vasculaires ont représenté respectivement 27,15%, 19,86% et 18,4%. L'association traitement médicochirurgical et orthopédique a été réalisée dans 81,5%. Les principales complications enregistrées ont été la raideur (27,9%), cal vicieux (13,9%), paralysie du membre traumatisé (7,3%), amputation (4,6%), 1cas de décès. Conclusion : les lésions par agressions physiques de l'appareil locomoteur sont de plus en plus fréquentes et graves, constituant un problème de santé publique. Ces lésions sont parfois complexes et multiples nécessitant une prise en charge pluridisciplinaire.

Introduction and Aim : Injuries to the musculoskeletal system related to aggression are sometimes complex, sometimes requiring multidisciplinary care. The aim was to determine the epidemiological-clinical, therapeutic, and prognostic aspects of injuries to the musculoskeletal system by aggression at the orthopedic-traumatology department of the Gabriel Toure Bamako University Hospital. Equipment and Methods : This was a prospective and descriptive retrospective study of patients with aggression injury to the musculoskeletal system, managed from January 2017 to December 2019. Results: We collected 151 patients. Males accounted for 91.4%. The average age of our patients was 31, 31 years, with extremes of 7 years and 85 years. Pupils/students were the most represented layer (17.9%). Firearm injuries accounted for 53%. The upper limbs were the most experienced with 52.98%. In 3.31% of the lesions were in the upper and lower limbs. The most affected segments were the leg and forearm with 15.9% and 14.6% respectively. Associated vital lesions were observed in 8 cases (5. 29%). Standard X-ray performed showed 64.9% fractures and 2.6% fracture-dislocations. Tendon, nerve, and vascular lesions accounted for 27.15%, 19.86%, and 18.4% respectively. The combination of medicalsurgical and orthopedic treatment was carried out in 81.5%. The main complications recorded were stiffness (27.9%), vicious callus (13.9%), paralysis of the traumatized limb (7.3%), amputation (4.6%), 1 case of death. Conclusion : Injuries by the aggression of the musculoskeletal system are becoming more frequent and serious, constituting a public health problem. The lesions are sometimes complex and multiple requiring multidisciplinary care.

[Study of the prevalence of antibodies to some arboviruses in the population of the Republic of Guinea].

INTRODUCTION: Acute febrile diseases kill more than 250,000 people annually in West Africa. Malaria and typhoid fever traditionally occupy most of the total structure of registered fevers. However, these data do not fully reflect the true overall disease patterns in the West African region. This is due to the fact that diagnosis is mainly based on the clinical signs of the infectious process, suggesting that a certain number of diseases may be caused by arboviruses. The detection of specific antibodies (ABs) to infectious pathogens in the blood sera of residents of a particular area is a reliable indicator of the circulation of these pathogens in a particular territory.The aim of this study was to determine the prevalence of antibodies to a number of arboviruses: Dengue (DENV), West Nile (WNV) (family Flaviviridae), Crimean-Congo hemorrhagic fever (orthonairo)virus (CCHFV), Batai (Batai virus), Bhanja (BHAV) (order Bunyavirales), Chikungunya (CHIKV), and Sindbis (SINV) (family Togaviridae) in the population of the Republic of Guinea. MATERIAL AND METHODS: In total, a panel of 2,620 blood serum samples from people living in all landscape and geographical areas of Guinea was collected for the study. Detection of IgG antibodies was performed using an enzyme-linked immunoassay (ELISA). RESULTS: In total, ABs to Batai virus were detected in 144 samples (5.5%), BHAV in 58 (2.2%), WNV in 892 (34.0 %), DENV in 659 (25.2 %), CCHFV in 58 (2.2 %), CHIKV in 339 (12.9 %), and SINV in 52 samples (2.0 %). DISCUSSION: The obtained results indicate serological evidence of the spectrum of arboviruses in the population of all landscape and geographical zones of the Republic of Guinea, confirming their active circulation in this territory. CONCLUSION: Given the high epidemiological significance of arbovirus infectious diseases, it is an urgent task to continue studying its share in the structure of febrile diseases in the territory of the Republic of Guinea.

[Profile and quality of life of patients with rheumatoid arthritis in Guinea Conakry and Cameroon]. / Profil et qualité de vie de patients atteints de polyarthrite rhumatoïde en Guinée Conakry et au Cameroun.

INTRODUCTION: rheumatoid arthritis (RA) dramatically affects the quality of life of patients. The objective of our study was to study the link between the activity of the disease and the quality of life of Guinean (Conakry) and Cameroonian patients with RA. METHODS: pilot multicentric cross-sectional study (Ignace Dean National Hospital of Conakry in Guinea and Efoulan Yaoundé District Hospital in Cameroon) for 15 months (1st October 2016 to 30th January 2018). The diagnosis of RA was based on the criteria of the ACR/EULAR. Disease activity was assessed by DAS 28. The EMIR questionnaire and the Steinbrocker score were used to assess quality of life. RESULTS: fifty-two patients, 82% of whom were women. The total EMIR score was 5.06±0.50 as a relatively impaired quality of life. Alteration of quality of life was more marked on psychic components (6.78±0.99) and pain (5.37±0.99). The work component was the least affected (4.03±0.98). DAS28 was significantly related to psychic components (p=0.036, R=0.29), pain (p=0.076, R=0.25), physical (p=0.0029, R=0.41), and at the overall quality of life (total EMIR) (p=0.027, R=0.31). CONCLUSION: the most significant of RA on quality of life was related to pain (EVA-pain) and RA activity (DAS 28). The results of this pilot study will have to be confirmed by a largest study.