Place du paludisme en saison de haute transmission dans les urgences fébriles au Centre Hospitalier Universitaire Gabriel Touré de Bamako

Le but de cette étude est d'évaluer la fréquence du paludisme parmi les causes de fièvres chez les patients admis au Service d'Accueil des Urgences (SAU) du CHU ­Gabriel Touré de Bamako. Il s'agissait d'une étude transversale allant du 1er août au 30 novembre 2015. Tous les patients admis au Service d'Accueil des Urgences étaient inclus dans notre étude. La goutte épaisse ou le Test de Diagnostic rapide étaient utilisés pour la confirmation biologique des cas de paludisme. Nous avions enregistré 6 641 patients parmi lesquels 5,07 % étaient fébriles. L'âge moyen des patients était de 21 ans avec une prédominance de la tranche d'âge de 18-40 ans soit 52 %. Le sex-ratio était de 1,5 en faveur des hommes. Les élèves-étudiants représentaient 34,85 % des cas suivis des ménagères avec 20,71 %. Le diagnostic clinique réalisé par des médecins avait donné un taux de 74,5 % de paludisme contre 58,8 % selon la GE/TDr. L'incidence du paludisme comme cause de la fièvre était de 58,8 %. Tous les cas de paludisme simple ont été traités avec les CTA et les cas graves avec des formes injectables de l'artesunate dans 68,38 %, l'artemether dans 17,65 % et la quinine dans 13,17 %. Le paludisme est fréquent parmi les urgences fébriles au SAU du CHU-GT. Les dispositions doivent être renforcées pour une confirmation biologique systématique de tous les cas suspects de paludisme pour éviter les erreurs diagnostics

The effect of nicotine on osteoinduction by recombinant human bone morphogenetic protein 2.

Nicotine, one of the constituents of tobacco, is known to have an adverse effect on human health. We sought to clarify the interaction between nicotine and recombinant human bone morphogenetic protein 2 (rhBMP-2) in terms of osteogenesis in vitro and osteoinduction in vivo. Nicotine did not inhibit or stimulate alkaline phosphatase (ALP) activity or the amount of osteocalcin in C2C12 cells in the presence of rhBMP-2 in vitro. Ectopic bone formation using a collagen sponge containing rhBMP-2 was evaluated with and without nicotine after 21 days using radiographic, histological, biochemical, and immunohistochemical analyses. ALP activity in the medium-dose group (2.2±0.9IU/mg protein; P=0.047) and the high-dose group (2.0±0.1IU/mg protein; P=0.03) was significantly lower than in the control group. The calcium content in the medium-dose group (35.4±12.9µg/mg tissue; P=0.0099) and high-dose group (34.8±10.5µg/mg tissue; P=0.006) was significantly lower than in the control group. The number of vascular endothelial growth factor-positive cells in the high-dose group (671.9±57.3cells/mm(2); P=0.03) was significantly lower than in the control group. Results showed that nicotine did not inhibit the stimulatory effect of rhBMP-2 in vitro, but a high dose of nicotine inhibited bone formation in vivo by adversely affecting vascularization.

Phenotypes of CCAAT/enhancer-binding protein beta deficiency: hyperdontia and elongated coronoid process.

OBJECTIVES: This investigation aimed to conduct a case-control study of mandibular morphology and dental anomalies to propose a relationship between mandibular/dental phenotypes and deficiency of CCAAT/enhancer-binding protein beta (CEBPB). MATERIALS AND METHODS: Skulls of CEBPB(-/-), CEBPB(+/-) and CEBPB(+/+) mice were inspected with micro-computed tomography. Mandibular morphology was assessed with a method of Euclidean distance matrix analysis. RESULTS: Elongation of the coronoid process was identified in CEBPB(+/-) (P ≤ 0.046) and CEBPB(-/-) 12-month-olds (P ≤ 0.028) but not in 14-day-olds (P ≥ 0.217) and 0-day-olds (P ≥ 0.189) of either genotype. Formation of supernumerary teeth in CEBPB(-/-) adult mice was demonstrated (χ(2) = 6.00, df = 1, P = 0.014). CONCLUSIONS: CEBPB deficiency was related to elongation of the coronoid process and formation of supernumerary teeth. The mandibular and dental phenotypes of CEBPB deficiency were unseen by the 14th day after birth. Future investigations into the influence of CEBPB on mandibular and dental development are needed.

N-[[1-(2-phenylethyl)pyrrolidin-2-yl]methyl]cyclohexanecarboxamides as selective 5-HT1A receptor agonists.

A series of benzamides was synthesized as selective agonists for the 5-HT1A receptor. It was found that (S)-N-[[1-(2-phenylethyl)pyrrolidin-2-yl]methyl]cyclohexanecarb oxamide(7-(S)) has potent and selective agonistic activity for the 5-HT1A receptor (5-HT1A; Ki 0.49 nmol/L, D2; IC50 = >1000 nmol/L, 5-HT2; Ki = 240 nmol/L).

[A case of peripelvic extravasation related to pregnancy].

A 35-year-old woman was hospitalized at 39 weeks 0 days of gestation because of acute left flank pain. Magnetic resonance imaging (MRI) revealed bilateral hydronephrosis with peripelvic extravasation of contrast material around the left kidney. The pregnancy ended with a cesarean section and after the cesarean section a left double-J-stent was placed cystoscopically. An excretory urogram following the removal of the ureteral stent showed no extravasation or hydronephrosis in either kidney.

First pass metabolism and in vitro metabolism of a new orally active dopamine prodrug, N-(N-acetyl-L-methionyl)-O,O-bis(ethoxycarbonyl)dopamine in dogs.

To elucidate the first pass metabolism of the dopamine prodrug N-(N-acetyl-L-methionyl)-O,O-bis(ethoxycarbonyl)dopamine (TA-870) in the small intestine and liver of dogs, the blood and plasma concentrations of unchanged TA-870 and metabolites in the gastroduodenal vein, portal vein, hepatic vein, and abdominal aorta were measured by HPLC after intraduodenal administration of TA-870. In addition, an in vitro metabolic study of TA-870 was carried out using liver, small intestinal wall, and blood homogenates of dogs. The order of maximal concentration (Cmax 0-30 min) in gastroduodenal blood or plasma was unchanged TA-870 greater than deethoxycarbonylated TA-870 (DEC-TA-870) greater than conjugated dopamine greater than free dopamine (DA) greater than free homovanillic acid (HVA) greater than free 3,4-dihydroxyphenylacetic acid (DOPAC). This result showed that the main pathway of metabolism in the small intestine is catechol ester hydrolysis and minor pathways are amido hydrolysis, oxidative deamination, and catechol 3-O-methylation. The order of Cmax in the hepatic vein and abdominal aorta was conjugated DA greater than free DEC-TA-870 greater than free HVA greater than free DA greater than free DOPAC greater than conjugated DOPAC greater than unchanged TA-870. The main metabolic pathways in the liver were hydrolyses of ester and amido-linkage of TA-870 and conjugation of DA. In the in vitro studies, the main metabolites of TA-870 in liver, small intestinal wall, and blood homogenates were DEC-TA-870, 3- or 4-mono-deethoxycarbonylated TA-870, DA, and an unknown compound.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical evaluation of prophylactic intranasal 1-phenyl-3-(4-phenyl-2-thiazolyl) guanidine (CL 88,277) medication against rhinovirus 44 challenge.

The prophylactic intranasal medication with a new antiviral compound, 1-phenyl-3-(4 phenyl-2-thiazolyl) guanidine (CL 88,277) was evaluated in humans against rhinovirus 44 challenge. One ml containing 250 mg of CL 88,277 was administered to 10 seronegative volunteers three times a day plus one dose prior to the rhinovirus challenge (32 TCID 50) and for six consecutive post-challenge days. Ten other subjects received 56% polyethylene glycol (PEG-400), the solvent of CL 88,277 at the same time. Five subjects in each of the CL 88,277-treated and placebo-treated groups developed illness. There were no differences between the two groups in the occurrence of the severe illness and of the moderate and severe illnesses. Each sign and symptom occurred almost equally in the two groups and there was no difference in their scores between the two groups. The challenge virus was isolated from both groups but the total number of the virus isolates was less and the time span of virus excretion was shorter for the drug-treated group. The post-challenge serum antibody titers were markedly lower in the drug-treated group. Prophylactic intranasal CL 88,277 medication did not affect the course of illness induced by rhinovirus 44 challenge. It appears, however, that the virus replication in the nose was reduced and as a result the serum antibody response was diminished. PEG-400 caused a transient irritation of the nasal mucosa in all recipients.

Clinical and serologic effects of live attenuated serum inhibitor-resistant influenza B vaccine in seronegative adults.

The clinical effects, nasal and serum antibody responses, and virus excretion of a live attenuated serum inhibitor-resistant influenza B virus vaccine, R75, was evaluated in 43 seronegative healthy adults by a random double-blind study. Symptom responses were minimal and were not significantly different between vaccine and placebo groups. No fevers, abnormalities in physical examination or laboratory testing developed during 4 weeks of observation. Among vaccinees, 10 (48%) developed serum hemagglutination-inhibition (HI) antibodies, 16 (76%) developed serum neutralization (N) antibodies and 4 (19%) developed nasal N antibodies. The GMT responses from study day 0 to day 28 were 4.0 to 10.4 for serum HI, 1.8 to 9.8 for serum N, and 1.0 to 1.4 for nasal N. There were no significant titer changes in the placebo group. No virus excretion was detected. Although there are some questions concerning the relationship of antibody levels to protection, the low antibody responses in this study are an indication that R75 is not sufficiently immunogenic.

The effects of intramyometrial injection of prostaglandin F2alpha on severe post-partum hemorrhage.

Effectiveness of prostaglandin F2alpha (PGF2alpha) in controlling postpartum uterine hemorrhage was evaluated with the following results. (1) Systemic administration, whether by continuous i.v. infusion or by gluteal i.m. injection, was not a completely adequate method for hemostasis. (2) Local administration by directly injecting into the uterine musculature, whether transabdominally or transvaginally, resulted in a dramatic reduction of the rate of bleeding. Routine clinical application of the direct intramyometrial injection of PGF2alpha for severe post-partum hemorrhage is recommended in view of its easy performance, excellent hemostatic effect, minimal side effects and good prognosis.

Double-blind clinical assessment of ribavirin (virazole) in the prevention of induced infection with type B influenza virus.

The prophylactic effectiveness of oral administration of ribavirin (1-beta-D-ribofuranosyl-1,24-triazole-3-carboxamide, virazole) against artificially induced influenza B infection was evaluated in a double-blind clinical trial. Fifteen seronegative men received ribavirin capsules (600 mg/day in three divided doses), and 15 other men received placebo capsules two days before the inoculation of 6.4 X 10(4) 50% tissue culture infective doses of influenza virus B/Georgia/26/74 and for eight days after challenge. Ten men (69%) in each of the two groups developed mild to severe influenzal illness. Of these, five placebo-treated men developed severe febrile illness, while only one drug-treated man had illness of comparable severity. Illness of moderate severity was observed in three placebo-treated conrols and two drug recipients. There was no difference between the frequencies of isolation of virus or the anitbody responses in the two groups. Ribavirin suppressed signs and symptoms induced by influenza B challenge, but its effectiveness was marginal.