Post discharge management of heart failure patients: clinical findings at the first medical visit in a single-center study.

BACKGROUND: The Post Discharge Management of patients with heart failure impact significantly their incomes. This study aims to analyze the clinical findings and management at the first medical visit of these patients in our context. MATERIAL AND METHODS: This is a retrospective cross-sectional descriptive study on consecutive files of patients hospitalized for heart failure from January to December 2018 in our Department. We analyse data from the first post discharge medical visit including medical visit time, clinical conditions and management. RESULTS: Three hundred and eight patients (mean age: 53.4 ± 17.0 years, 60% males) were hospitalized on median duration of 4 days [1-22 days]. One hundred and fifty-three patients (49,67%) were presented at the first medical visit after 66.53 days[0.06-369] on average, 10 (3.24%) patients died before this first medical visit and 145 (47.07%) had been lost to follow-up. The re-hospitalization and treatment non-compliance rates were 9.4% and 3.6%, respectively. Male gender (p = 0.048), renal failure (p = 0.010), and Vitamin K antagonist (VKA) /direct oral anticoagulant (DOAC) (p = 0.049) were the main lost to follow-up factors in univariate analysis without statistic signification in multivariate analysis. Hyponatremia (OR = 2.339; CI 95% = 0.908-6.027; p = 0.020) and atrial fibrillation (OR = 2.673; CI 95% = 1.321-5.408; p = 0.012) were the major mortality factors. CONCLUSION: The management of patients with heart failure after discharge from hospital seems to be insufficient and inadequate. A specialized unit is required to optimize this management.

Restauration prothétique amovible partielle et implantologie dans la qualité de vie orale des patients: revue narrative / Restoration of partial removable prosthetic and implantology in oral quality of life of patients: narrative review

L'association des implants aux prothèses amovibles partielles (PAP) ne sont pas bien perçues contrairement à la prothèse amovible complète. Cet article examine les connaissances actuelles sur la qualité de vie orale des patients porteurs de Prothèses amovibles partielles supra implantaires (PAPSI), en prenant en compte les performances cliniques, la comparaison des PAP versus les PAPSI et le taux de survie des implants. Les édentements mandibulaires en extension sont les plus concernés par les PAPSI avec une utilisation prépondérante de piliers axiaux. Le passage de la PAP à la PAPSI augmente de manière significative la satisfaction du patient. Le taux de survie des implants varie de 91.6% à 100% sur une durée de 2.5 à 7 ans. Au total, l'utilisation des PAP associée à des implants améliore la qualité de vie orale des patients. Des études cliniques prospectives sont davantage nécessaires pour évaluer cette approche.

The association of implants with partial removable prostheses (RPPs) is not well perceived in contrast to complete removable prostheses. This article reviews the current knowledge on the oral quality of life of patients with supra-implant removable partial dentures (SIRPDs), considering clinical performance, comparison of RPPs versus SIRPDs and implant survival. Extended mandibular edentulous teeth are the most concerned by PAPSI with a preponderance of axial abutments used. The switch from RPDs to SIRDs significantly increases patient satisfaction. The survival rate of the implants varies from 91.6% to 100% over a period of 2.5 to 7 years. Overall, the use of RPPs in combination with implants improves the oral quality of life of patients. More prospective clinical studies are needed to evaluate this approach.

Ibuprofen Lyell's Syndrome In An Eight-Year-Old Child.

Lyell's syndrome or toxic epidermal necrolysis (TEN) is a rare but serious drug-like toxiderma. Treated as a recent extensive burn in intensive care, its management must be urgent, and adapted in order to improve the vital prognosis of patients and reduce their mortality. We report a severe case of Lyell's syndrome occurring 24 hours after oral administration of an anti-inflammatory drug (ibuprofen) as a self-medication in an eight-year-old child.

Le syndrome de Lyell (nécrolyse épidermique toxique - NET) est une toxidermie médicamenteuse rare mais grave. Son prise en charge, urgente, doit être réalisée en CTB car elle s'approche de celle d'un brûlé. Nous rapportons le cas d'une NET survenue 24h après la prise orale, en automédication, d'ibuprophène.

Effects of wearing removable dentures and aging on palatal mucosa blood flow by laser doppler.

Aim: The purpose of this work is to analyze the effects of removable dental prostheses and aging on blood microcirculation in the palatal mucosa. Settings and Design: Blood flow was measured in two groups using the Laser Doppler Flowmeter at three specific anatomical sites: Retro incisive papilla, medial raphe, and Schroeder area. Materials and Methods: Group 1 included young, healthy dentulous individuals (mean age: 23 ± 3 years), and Group 2 contained elderly edentulous individuals (mean age: 62 ± 11.69 years). For Group 1, measurements were taken in a single session; for Group 2, the measurements were taken in two sessions: The first just before the prosthetic load (E1) and again 1 week after new dentures were provider (E2). Statistical Analysis Used: Statistical analyses were performed using SAS software, Version 9.4 of the SAS System for Windows, Copyright © 2017 SAS Institute Inc. (Cary, NC, USA). A P < 0.05 was classified as statistically significant. Results: Measurements of blood flow of the palatal mucosa showed that the healthy young dentulous participants had significantly lower perfusion unit values than the elderly edentulous participants at all three anatomical sites (P < 0.05). For Group 2, the comparisons between the measurements taken before (E1) and after (E2) new dentures were provided showed no significant differences. Conclusion: Our results indicate that the process of aging significantly modifies the blood flow of the palatal mucosa while wearing removable dental prostheses does not modify the blood flow of the palatal mucosa in a 1week period. These results are not influenced by systemic pathology (e.g., diabetes, cardiovascular diseases) or smoking.

High electrical energy harvesting performance of an integrated microbial fuel cell and low voltage booster-rectifier system treating domestic wastewater.

To harvest directly usable electrical energy from real domestic wastewater, a new power management system (PMS), transistor-based low voltage boosters followed by a voltage rectifier (LVBR), was developed and tested for its energy harvesting performance. Three air-cathode MFCs were individually linked with LVBs, which were electrically stacked in parallel and then connected with a single voltage rectifier (MFC-LVBR). The MFC-LVBR system could increase VMFCto 11.9 ± 0.6 V without voltage reversal, which was capable of charging a lithium-ion batteryand supercapacitor-based power banks. When the integrated MFC-LVBR system was linked with a lithium-ion battery, the highest normalized energy recovery (NERCOD) of 0.76 kWh/kg-COD (NERvolumeof 0.22 kWh/m3) was achieved with a minimal energy loss of 14.4%, whichwas much higher than those previously reported values.Furthermore, the electrical energy charged in the lithium-ion battery successfully powered a DC peristaltic pump requiring a minimum operating power of 0.46 W.

Effect of poised cathodic potential on anodic ammonium nitrogen removal from domestic wastewater by air-cathode microbial fuel cells.

Performances of anodic ammonia oxidation have been investigated for various bioelectrochemical systems at a wide range of poised anodic potentials in the literature. The effect of poised cathodic potential on ammonium nitrogen (NH4+-N) and total nitrogen (TN, sum of NH4+-N, NO2--N, and NO3--N) removal from domestic wastewater by single chamber air-cathode microbial fuel cells (MFCs) was investigated. Poising the air-cathode potential at +0.7 V vs. SHE significantly increased current generation (from 11 ± 1 mA to 22.8 ± 5 mA) and oxygen permeation into the MFC through the air-cathode (from 75.4 ± 1.2 g-O2/m3/d to 151 ± 3.7 g-O2/m3/d), which consequently resulted in a high NH4+-N removal rate of 150 ± 13 g-NH4+-N/m3/d and TN removal rate of 63 ± 16 g-TN/m3/d. These high NH4+-N and TN removal rates could be attributed to the enhancement of dual respiratory pathways: the electrode-assisted anodic and aerobic NH4+ oxidation.

Bioelectrochemical anoxic ammonium nitrogen removal by an MFC driven single chamber microbial electrolysis cell.

Nitrogen removal from wastewater is an indispensable but highly energy-demanding process, and thus more energy-saving treatment processes are required. Here, we investigated the performance of bioelectrochemical ammonium nitrogen (NH4+-N) removal from real domestic wastewater without energy-intensive aeration by a single chamber microbial electrolysis cell (MEC) that was electrically powered by a double chamber microbial fuel cell (MFC). Anoxic NH4+-N oxidation and total nitrogen (TN) removal rates were determined at various applied voltages (0-1.2 V), provided by the MFC. The MEC achieved a NH4+-N oxidation rate of 151 ± 42 g NH4+-N m-3 d-1 and TN removal rate of 95 ± 42 g-TN m-3 d-1 without aeration at the applied voltage of 0.8 V (the anode potential Eanode = +0.633 ± 0.218 V vs. SHE). These removal rates were much higher than the previously reported values and conventional biological nitrogen removal processes. Open and closed-circuit MEC batch experiments confirmed that anoxic NH4+-N oxidation was an electrochemically mediated biological process (that is, an anode acted as an electron acceptor) and denitrification occurred simultaneously without NO2- and NO3- accumulation. Moreover, ex-situ15N tracer experiment and microbial community analysis revealed that anammox and heterotrophic denitrification mainly contributed to the TN removal. Thus, the bioelectrochemical anodic NH4+-N oxidation was coupled with anammox and denitrification in this MFC-assisted MEC system. Taken together, our MFC-driven single chamber MEC could be a high rate energy-saving nitrogen removal process without external carbon and energy input and high energy-demanding aeration.

[Couple life and management of HIV infection in the pneumology department of the Teaching hospital center of Cocody, Abidjan, Côte d'Ivoire]. / Vie de couple et prise en charge de l'infection à VIH au service de pneumologie du CHU de Cocody, Abidjan, Côte d'Ivoire.

Introduction: The life of a couple is a place of emotional support. It can allow the management of patients infected with HIV on antiretroviral therapy to be optimized.The objective of our study was to analyze the impact of married life on the therapeutic follow-up of patients living with HIV. Methodology: We carried out a mono-centric, prospective, descriptive and analytical study in the care unit of patients living with HIV of the pneumology service of the Cocody Teaching Hospital in Abidjan. The investigation took place from September 1, 2015 to March 31, 2016. Results: We included 411 patients. The sex ratio was 0.51. The average age was 43.2 years with extremes of 19 and 69 years. The patients lived as a couple in 59.1% of cases. Couple life was associated with severe immunosuppression at 12 months in 23.3% (42/180) of cases [p = 0.043 OR = 1.735 (0.964 - 3.121)], the appearance of new opportunistic conditions between the 6th and the 12th month of treatment in 5.6% (13/232) of cases [p = 0.006; OR = 9.438 (1.222 - 72.890)], information sharing with the partner before the start of treatment in 92.4% (208/225) of cases [p = 0.035; OR = 1.976 (1.005-3886)] and the existence of sexual intercourse since the discovery of the disease in 92.6% (225/243) of cases [p < 0.001; OR = 14.423 (8.174 - 25.448)]. Sexual relationships were less protected among people living in a couple 65.9% (149/226) versus 78% (64/82) among others [p = 0.027; OR = 0.544 (0.301 - 0.923)]. The loss of the sexual partner at the onset of the disease was observed regardless of marital status (p = 0.203). Conclusion: The life of a couple negatively influences the management of HIV infection. It appears necessary to set up counseling and testing programs for couples.

High voltage generation from wastewater by microbial fuel cells equipped with a newly designed low voltage booster multiplier (LVBM).

Although microbial fuel cells (MFCs) can produce renewable energy from wastewater, the generated power is practically unusable. To extract usable power from an MFC fed with wastewater, we newly developed a low voltage booster multiplier (LVBM), which is composed of a self-oscillating LVB and multistage voltage multiplier circuits (VMCs). The low output MFC voltage (ca. 0.4 V) was successfully boosted up to 99 ± 2 V, which was the highest voltage that has been ever reported, without voltage reversal by connecting an LVB with 20-stage VMCs. Moreover, the boosted voltage (81 ± 1 V) was stably maintained for > 40 h even after disconnecting the LVBM from the MFC. The energy harvesting efficiency of LVBM was > 80% when an LVB with 4-stage VMCs was charged to 9.3 V. These results clearly suggest that the proposed LVBM system is an efficient and self-starting energy harvester and storage for low-power generating MFCs.

[Epidemiology and mortality factors of acute intoxication in intensive care in Bouaké (Ivory Coast) from 2015 to 2018]. / Epidemiologie et facteurs de mortalite des intoxications aiguës en reanimation a Bouake (Cote d'Ivoire) de 2015 a 2018.

INTRODUCTION: Acute poisoning is a common reason for admission to intensive care. OBJECTIVE: To describe the epidemiological profile, to analyze the mortality factors of patients admitted to intensive care for acute intoxication. PATIENTS AND METHODS: A retrospective, descriptive and analytical study covering four years (from January 1, 2015 to December 31, 2018) .Includes patients admitted to intensive care in Bouaké for acute intoxication. The variables studied were: socio-demographic characteristics, intoxication characteristics, clinical, therapeutic, evolutionary and prognostic characteristics. RESULTS: Of a total of 1476 admissions during the study period, 131 patients were admitted for acute intoxication, with a hospital prevalence of 8.8%. The average age was 19 (range: 1 month to 70 years). The sex ratio was 0.84. The majority of poisonings occurred at home (94%). Psychiatric history was present in 11% of patients. The poisoning occurred in urban areas in 72% of cases. The place of intoxication was the family home in 94% of cases. The nature of the intoxication and the type of poison toxin depended on the age of the intoxicated patients. The average admission time was 7.38 hours ± 12 hours (range: 30 minutes to 72 hours). The poisoning was symptomatic in 93% of the patients. The clinical symptoms observed were: gastrointestinal (70%), respiratory (62%) and neurological (43%). Vomiting attempts associated with self-medication were performed in 69% of patients. The substances used for self-medication were: palm oil (80%) and milk (20%). The treatment in intensive care was initially symptomatic then secondarily adapted to the nature of the incriminated or suspected toxin. The use of tracheal intubation and mechanical ventilation was necessary for 10% of the patients. The average stay in hospital was 1.64 ± 1.5 days (range: 1 to 10 days). The lethality was 8%. The factors of poor prognosis were the existence of a cardiovascular collapse (p <0.001), the presence of a deep coma (p <0.001) and the use of mechanical ventilation (p <0. 001). CONCLUSION: Acute intoxication is a public health problem in Bouaké and requires preventive action.

INTRODUCTION: Les intoxications aiguës constituent un motif fréquent d'admission en réanimation. OBJECTIF: Décrire le profil épidémiologique, analyser les facteurs de mortalité des patients admis en réanimation pour intoxications aiguës. PATIENTS ET MÉTHODES: Etude rétrospective, descriptive et analytique, portant sur quatre ans (du 1er janvier 2015 au 31 décembre 2018).Etaient inclus les patients admis en réanimation à Bouaké pour une intoxication aiguë. Les variables étudiées étaient: les caractéristiques sociodémographiques, les caractéristiques de l'intoxication, les caractéristiques cliniques, thérapeutiques, évolutives et le pronostic. RÉSULTATS: Sur un total de 1476 admissions durant la période d'étude, 131 patients ont été admis pour une intoxication aiguë, soit une prévalence hospitalière de 8,8 %. L'âge moyen était de 19 ans (extrême : 1 mois et 70 ans). Le sex-ratio était de 0,84. La majorité des intoxications avaient eu lieu au domicile (94 %). Les antécédents psychiatriques étaient présents chez 11% des patients. Les intoxications avaient lieu en milieu urbain dans 72% des cas. Le lieu de l'intoxication était le domicile familial dans 94% des cas. La nature de l'intoxication et le type de toxique incriminé était fonction de l'âge des patients intoxiqués. Le délai moyen d'admission était de 7,38 heures ± 12heures (extrêmes: 30 mn et 72 heures). Les intoxications étaient symptomatiques chez 93% des patients. Les symptômes cliniques observés étaient : gastro-intestinaux (70%), respiratoires (62 %) et neurologique (43%). Des tentatives de vomissements associées à une automédication ont été réalisées chez 69% des patients. Les substances utilisées pour l'automédication étaient : l'huile de palme (80 %) et de lait (20%). Le traitement en réanimation était initialement symptomatique puis secondairement adapté à la nature du toxique incriminé ou suspecté. Le recours à l'intubation trachéale et à la ventilation mécanique a été nécessaire chez 10% des intoxiqués. Le séjour moyen en hospitalisation a été de 1,64±1,5 jours (extrêmes : 1 et 10 jours). La létalité était de 8 %. Les facteurs de mauvais pronostic étaient : l'existence d'un collapsus cardiovasculaire (p <0,001), la présence d'un coma profond (p <0,001) et la réalisation d'une ventilation mécanique (p <0,001). CONCLUSION: Les intoxications aiguës constituent un problème de santé publique à Bouaké et nécessite des actions de prévention.

Virtual design of novel Plasmodium falciparum cysteine protease falcipain-2 hybrid lactone-chalcone and isatin-chalcone inhibitors probing the S2 active site pocket.

We report computer-aided design of new lactone-chalcone and isatin-chalcone (HLCIC) inhibitors of the falcipain-2 (PfFP-2). 3D models of 15 FP-2:HLCIC1-15 complexes with known observed activity (IC50exp) were prepared to establish a quantitative structure-activity (QSAR) model and linear correlation between relative Gibbs free energy of enzyme:inhibitor complex formation (ΔΔGcom) and IC50exp: pIC50exp = -0.0236 × ΔΔGcom+5.082(#); R2 = 0.93. A 3D pharmacophore model (PH4) derived from the QSAR directed our effort to design novel HLCIC analogues. During the design, an initial virtual library of 2621440 HLCIC was focused down to 18288 drug-like compounds and finally, PH4 screened to identify 81 promising compounds. Thirty-three others were added from an intuitive substitution approach intended to fill better the enzyme S2 pocket. One hundred and fourteen theoretical IC50 (IC50pre) values were predicted by means of (#) and their pharmacokinetics (ADME) profiles. More than 30 putative HLCICs display IC50pre 100 times superior to that of the published most active training set inhibitor HLCIC1.

Angioedème bradykinique d'évolution fatale suite à une prise d'énalapril. A propos d'un cas

L'angiœdème bradykinique est une maladie rare et grave qui constitue une complication exceptionnelle du traitement aux Inhibiteurs de l'Enzyme de Conversion (IEC). Elle engage le pronostic vital des patients dans 75% des cas et représente une urgence médicale majeure. L'évolution de cette affection est totalement imprévisible avec un risque de décès par asphyxie. Les auteurs rapportent l'observation d'une patiente de 70 ans hypertendue qui a présenté un angiœdème bradykinique d'évolution fatale deux jours après l'initiation de son traitement antihypertenseur par les IEC. Au travers cette observation, les auteurs voudraient mettre en lumière cette affection mortelle, de diagnostic difficile souvent méconnue

[Fatal Toxic Epidermal Necrolysis Induced by Diclofenac Re-Administration in the Teaching Hospital of Bouaké (Côte d'Ivoire)]. / Syndrome de Lyell d'évolution fatale suite à la réadministration de diclofénac, au CHU de Bouaké (Côte d'Ivoire).

Lyell's syndrome or toxic epidermal necrolysis is an acute and severe cutaneous adverse drug reaction with a significant morbidity and mortality. It is a very rare condition but a vital emergency with a poor prognosis. The diagnosis is clinical and confirmed by a cutaneous biopsy showing a necrosis of the epidermis. It can be due to many drugs including non-steroidal anti-inflammatory drugs. We report a case of fatal Lyell's syndrome after oral re-administration of diclofenac in a patient with a previous history of diclofenac-related Stevens-Johnson syndrome, four years back.

Nous rapportons un cas de syndrome de Lyell mortel après réadministration orale de diclofénac chez un patient ayant des antécédents de syndrome de Stevens-Johnson lié au diclofénac quatre ans auparavant.

The use of laser Doppler flowmetry to evaluate oral soft tissue blood flow in humans: A review.

The objective of this work is to define the conditions for improving the use of laser Doppler flowmetry (LDF) and to determine the limits for the use of this technique. This article systematically reviews the literature on the evaluation of oral soft tissue blood microcirculation by LDF. We analysed the available literature through October 2016 using the database resources Medline/PubMed, the Cochrane Oral Health Group Specialist Trials Register and the ISI Web of Knowledge. Several points emerged from this literature review The use of LDF involves specific constraints; however, the influence of different factors (temperature, tobacco, pressure etc.) must be adequately controlled when using LDF. LDF measurements of soft tissue within the oral cavity vary depending on the anatomical site. In dentistry, LDF can be used to track healing progress in periodontal surgery and to diagnose vascular flow changes in the connective tissue of mucosae covered by a removable prosthesis at an early stage prior to the onset of clinical inflammation signs.

[Use of the Xpert® MTB/RIF test in routine screening of new cases of pulmonary tuberculosis in an endemic area]. / Test Xpert® MTB/RIF et dépistage des nouveaux cas de tuberculose pulmonaire en routine dans une zone de haute endémicité tuberculeuse.

BACKGROUND: Developed initially for the diagnosis of multidrug-resistant tuberculosis, the Xpert® MTB/RIF test has shown to be useful for the diagnosis of tuberculosis, especially among HIV-infected subjects. The objective of the study was to determine the contribution of the Xpert® MTB/RIF test for routine pulmonary tuberculosis diagnosis in an endemic area. METHODOLOGY: We undertook a prospective study among patients presenting with cough and sputum. The sputum was submitted to microscopic examination, to the Xpert® MTB/RIF test and cultured by the Mycobacteria growth indicator tube (MGIT) technique. The study compared cases of pulmonary tuberculosis confirmed by a positive sputum culture and cases with cough but negative sputum culture. RESULTS: In multivariate analysis, the factors associated with positive cultures were the following: male gender, cough for more than 2 weeks, loss of weight and fever. The estimated clinical suspicion score consisted of 4 signs each having a coefficient of 1. The sensitivity of each clinical sign varied between 79 and 94%. In 348 cases of negative microscopic examination (composed of 295 cases with score<4 and 53 cases with score=4), the predictive positive value of the Xpert® MTB/RIF was 80% for a score equal to 4 and 40.9% for a score<4. In cases of negative microscopic examination of the sputum, the Xpert® MRT/RIF test should be undertaken if the score=4. CONCLUSION: The diagnosis of tuberculosis in endemic zones could be improved by using the Xpert® MTB/RIF.

Profil épidémiologique des traumatismes crânio-encéphaliques au Centre Hospitalier et Universitaire de Bouaké

Introduction : Les traumatismes crânio-encéphaliques représentent une des principales causes de mortalité dans le monde. L'étude de leur épidémiologie permet d'identifier les facteurs de risque pour mieux cibler les actions de prévention. Patients et méthodes : Il s'agissait d'une étude rétrospective descriptive réalisée au service de réanimation polyvalente du CHU de Bouaké de janvier 2013 à décembre 2014. Elle concernait les patients admis en réanimation pour un traumatisme crânio-encéphalique avec un score de Glasgow inférieur à 14. Les paramètres étudiés étaient : le sexe, l'âge, la profession, les circonstances de survenue les modalités de transport, le délai d'admission à l'hôpital et la durée d'hospitalisation. Résultats : Au total 1244 patients ont été hospitalisés durant la période d'étude, dont 92 pour un traumatisme crânio-encéphalique, soit une prévalence hospitalière de 7,39%. Il y avait 86 hommes et 6 femmes. L'âge moyen était de 32,6 ans ± 17,03 (extrêmes 2 à 76 ans). Les conducteurs de mototaxi et les élèves étaient concernés dans respectivement 49% et 24% des cas. Les étiologies étaient dominées par les accidents de la voie publique (87%) qui impliquaient les engins à deux roues motorisés dans 40% des cas. Le transfert des patients a été effectuée par le groupement des sapeurs-pompiers militaires dans 48,9% des cas. L'admission des patients s'est faite dans 61% des cas avant la 6e heure suivant le traumatisme et le délai moyen d'admission était de 3 heures. La durée moyenne de séjour était de 4,37 ± 4,23 jours (extrêmes 1 à 21 jours). La mortalité globale était de 66%. Conclusion : Les traumatismes crânio-encéphaliques sont fréquents à Bouaké et font suite à un accident de la voie publique impliquant un engin motorisé à deux roues dans la majorité des cas. La prévention repose sur la sensibilisation au respect du code de la route

Brain lesions in eclampsia: A series of 39 cases admitted in an Intensive Care Unit.

The aim of this study was to identify the encephalic lesions in the eclampsia occurrences. Within a period of 18 months, computed tomography (CT) of the brain was performed in all patients admitted in intensive care for eclampsia. These CTs were analyzed and intracerebral lesions were identified. Thirty-nine patients were included. We noted 10 cases of ischemic stroke, 9 cases of cerebral edema, and 3 cases of hemorrhagic stroke and subarachnoid hemorrhage. The CT scan came back to normal in 20 eclamptic patients. Overall, delays in obstetric and intensive care and time of completion of the CT were long. CT has allowed highlighting in patients with eclampsia varied intracerebral lesions. The early performance of the CT is therefore essential for a better support of patients.

Population Genomics and the Statistical Values of Race: An Interdisciplinary Perspective on the Biological Classification of Human Populations and Implications for Clinical Genetic Epidemiological Research.

The biological status and biomedical significance of the concept of race as applied to humans continue to be contentious issues despite the use of advanced statistical and clustering methods to determine continental ancestry. It is thus imperative for researchers to understand the limitations as well as potential uses of the concept of race in biology and biomedicine. This paper deals with the theoretical assumptions behind cluster analysis in human population genomics. Adopting an interdisciplinary approach, it demonstrates that the hypothesis that attributes the clustering of human populations to "frictional" effects of landform barriers at continental boundaries is empirically incoherent. It then contrasts the scientific status of the "cluster" and "cline" constructs in human population genomics, and shows how cluster may be instrumentally produced. It also shows how statistical values of race vindicate Darwin's argument that race is evolutionarily meaningless. Finally, the paper explains why, due to spatiotemporal parameters, evolutionary forces, and socio-cultural factors influencing population structure, continental ancestry may be pragmatically relevant to global and public health genomics. Overall, this work demonstrates that, from a biological systematic and evolutionary taxonomical perspective, human races/continental groups or clusters have no natural meaning or objective biological reality. In fact, the utility of racial categorizations in research and in clinics can be explained by spatiotemporal parameters, socio-cultural factors, and evolutionary forces affecting disease causation and treatment response.

[Pharmacist interventions on antibiotic prescriptions in outpatient pediatric unit in a teaching hospital of Côte d'Ivoire]. / Interventions pharmaceutiques sur les prescriptions d'antibiotiques en consultations externes de pédiatrie d'un centre hospitalier universitaire de Côte d'Ivoire.

OBJECTIVES: The objectives of our study were to analyse the prescriptions of antibiotics and assessing the relevance of pharmacist interventions (PI) in outpatient consultations in a pediatric unit of a Teaching Hospital of Abidjan, Côte d'Ivoire. METHODS: We conducted a cross-sectional descriptive study from May to December 2013. The analysis of antibiotic prescriptions was documented. The tool of PI classification validated by the French Society of Clinical Pharmacy was used. The PI rating was made by prescribers. This rating evolved from PI0 to PI3 depending on the severity of the clinical impact of the problem and to the severity of clinical consequences avoided by the PI. The relevance was evaluated by the PI acceptance rate by physicians and clinical evaluation of their impact. RESULTS: Our study included 150 patients with a mean age of 11.75 months and a sex ratio (M/F) of 2. The amoxicillin-clavulanic acid (27.2 %) and amoxicillin (22.3 %) were the most prescribed antibiotics. Sixty-three drug-related problems (DRPs) were detected on the antibiotic prescriptions. They were non-optimal drug administration plan (88.9 %) and underdose (11.1 %). The amoxicillin-clavulanic acid (61.9 %) and josamycin (17.4 %) were the most affected by these DRPs. PI were related to the precision of modes of drug administration (88.9 %) and dose adjustments (11.1 %). The prescribers accepted 93.7 % of PIs. All accepted PIs was rated PI1 (significant clinical impact). CONCLUSIONS: PIs performed on antibiotic prescription were relevant with a high rate of acceptance and a significant clinical impact.