A short washout period from fingolimod to anti-CD20 therapy is safe and decreases the risk of reactivation.

The frequency of switches between Disease Modifying Therapies (DMTs) in Multiple Sclerosis (MS) has increased considerably over previous years. Between fingolimod and anti-CD20 therapies, a 1-month washout period is usually recommended. However, disease reactivations are frequent after fingolimod (Fg) cessation. Using a retrospective observational monocentric exposed/non-exposed cohort study, we investigated the efficacy and the safety of a shorter washout period (WP) between Fg and anti-CD20. We compared two groups: 25 patients with a short WP (<21 days) and 20 patients with a longer WP (>21 days). We observed no reactivation during WP in patients with a short WP against a relapse in 55% of patients in the longer group. Moreover, clinical and biological safety was excellent. Based on these findings, we recommend a shorter WP between fingolimod and anti-CD20 therapies in MS.

Place de la scintigraphie osseuse dans le bilan d'extension des metastases osseuses du cancer du sein au Senegal : etude preliminaire a propos de 40 cas

L'etude portait sur 40 patients dont l'age variait entre 26 et 84 ans avec une moyenne de 46;9 et un ecart type de 13 ans. Le cancer du sein droit predominait avec 62.5 contre 32.5 pour le sein gauche. Seul deux cas de cancer bilateral ont ete retrouves (5). Douze (12) patientes sur 40 presentaient une hyperfixation (30).Parmi ces dernieres; 11 presentaient des localisations multiples a type d'hyperfixations diffuses et focales (91;67 ) et 1 cas (8;33) avait une localisation unique et focale. Deux patientes (5) avaient une scintigraphie non contributive. La duree d'evolution du cancer etait inferieur ou egale a 3 ans dans 66;67 et superieure a 3 ans dans 33;33 avaient des fixations extra osseuses associees du radio-traceur.Les sites associes les plus frequents sont le poumon (40); le cour; la rate et l'estomac qui representait chacun (20)

[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.

[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.

[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.

[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.

Audit on medical case records at the P.C.M. Hospital : 1983-1992

Medical audit was done on 500 case records; selected at random within a period of 10 years; at the Princess Christian Maternity Hospital. Each case record was scored against a formulated protocol. 216 (43 per cent) case records scored 50 per cent and over. A small sample (56) of surgical case records were audited within the same period. 28 (50 per cent) of the cases scored 50 per cent and over. Detail of the audit; demonstrated many inadequacies of the medical case records

The outcome of teenage pregnancy at P.C.M. Hospital; 1992

This is a retrospective study of teenage pregnant women at Princess Christian Maternity Hospital in 1992. Their adults counterparts were used as the control group. Teenagers from 13 per cent of the newly registered patients at the Antenatal Clinic. 76 per cent were married. Teenage women accounted for 34 per cent of the preclampsia patients; 45 per cent of the eclamptic patients and 17 per cent of the patients who had spontaneous abortion. The cesarean section rate of the adolescent women was 14 per cent. Three in ten maternal deaths were teenagers. They had a prematurity rate of 35 per cent. The only noted morbidity was; two in ten have VVF repaired. 34 per cent of the induced abortions patients were their teens and never registered above