Neobacillus massiliamazoniensis sp. nov., a new bacterial species isolated from stool sample of an inhabitant of the Amazon region.

Using a culturomics approach, a strain was isolated, identified and characterised following the taxonogenomics concept. Neobacillus massiliamazoniensis sp. nov., strain LF1T (=CSURP1359) was isolated from human stool. The 16S rRNA gene sequence analysis of strain LF1T (accession number: LK021124) exhibits 98.32% similarity levels with Neobacillus bataviensis strain IDA1115 (accession number: NR_036766.1), the phylogenetically closest related species with standing in nomenclature. The draft genome size of strain LF1T (accession number: CVRB00000000) is 4.6 Mbp with a G+C content of 34.1 mol%. Analysis of phylogenic tree, genomic analysis and phenotypic criteria described here sufficiently prove that this bacterium is different from previously known bacterial species with standing in nomenclature and represents a new Neobacillus species belonging to Firmicutes phylum.

Short bowel syndrome: difficulties of management in rural areas.

INTRODUCTION: The causes of short bowel syndrome are multiple, but most often in sub-Saharan Africa they result from extensive surgical resection that leaves less than 200 cm. Intestinal failure appears rapidly with a major hydroelectrolytic deficiency and malabsorption. Management requires parenteral nutrition that can be life-long. OBSERVATION: A 53 year-old patient underwent surgery in 1986 for peptic ulcer disease and recovered successfully. He was admitted in July 2015 for acute bowel obstruction of more than 8 hours duration. Intraoperative exploration showed irreversible ischemia in the small bowel, related to tight adhesions. An extensive resection leaving 110 cm of bowel was carried out. Postoperatively, nutritional monitoring and oral supplementation were prescribed and associated with proton pump inhibitors and antidiarrhea drugs. Parenteral feeding was not available. The postoperative period was characterized by temporary stability followed by a significant weight loss, then by two hospitalizations for severe malnutrition and intercurrent infection. Death occurred 7 months after the operation. CONCLUSION: Parenteral nutrition is essential in short bowel syndrome. Availability, especially for a long-term use, is a major problem in our context, and alternatives are rare.

[The traffic elbow. A series of 9 cases]. / Le coude de portière. A propos de neuf observations.

"Traffic elbow" is a condition occurring when high energy trauma involves a patient's elbow resting on the window of the car or completely outside it. This is a prospective study over 30 months of 9 patients with "traffic elbow" and therefore sufferring complex open trauma to the elbow. There were 8 men and 1 woman with a median delay of 4 hours before arrival in hospital. The dominant member was affected in 3 cases. The severity of the lesions, using the Mangled Extremity Severity Score (MESS), was more than 7, comprising lesions corresponding to type 1 of the complex trauma of the superior member (TCMS) in 2 patients and a MESS score of between 3 and 6 corresponding to types 2 or 3 of the TCMS for the other 7 patients. The therapeutic possibilities are limited considering the frequent context of polytrauma. In 4 cases we performed a debridement and external humero-ulnar fixation, in 3 cases a debridement and stabilization with Kirschner's wires completed by a fenestrated cast, and in 2 cases a lifesaving amputation. All patients, except those that had had amputation, developed deep sepsis that resolved after adequate treatment. Assessment of the non-amputee patients according to the Mayo Performance Score, yielded more than 70% of bad results. The authors stress the gravity of these lesions whose prognosis is guarded both concerning mobility of the elbow and the frequent neurovascular complications.

Complications inattendues de la chirurgie: deux cas de brûlure par plaque de bistouri électrique.

There is a real risk of electrical accidents in the operating theatre, with the growing number of electrical, electronic and flammable liquids used. Electrocautery remains the most commonly used device for its electrosurgical effect of coagulation or tissue section. When it is defective or misplaced on a small area of the skin, it can cause a typically deep, slow healing skin burn. It adds an unexpected iatrogenic morbidity to the initial condition, with devastating consequences for the patient, the surgeon and sometimes the hospital. We report two cases of cutaneous burn by the neutral plate that occurred intraoperatively when using electrocautery in monopolar mode, and discuss etiology, clinical and prevention aspects.

[Sickle cell disease neonatal screening. First evaluation]. / Dépistage néonatal de la drépanocytose au CHU de Dakar: premier bilan.

A neonatal screening allows a preclinical diagnosis of major sickle cell syndromes and an early management of the affected children. That would improve their life quality and expectancy. The preliminary program was set up on 518 senegalese newborn aged from 1 to 4 days, and coming from all the country ethnic groups. Isoelectrofocalisation is the test used on dried blood eluate and the positive control on citrate agar gel. 478 samples out of 518 (92.5%) have been analysed. Haemoglobinopathy have been found in 11.1% of cases, distributed as follow: heterozygoty FAS and FAC: 9%, double heterozygoty FSC: 0.2% and homozygoty FSS: 1.9%. Sickle cell neonatal screening should be imperatively implemented, with regards in economical considerations. It would be relevant to integrate it in a larger program including information, training and genetic counselling in order to avoid homozygotes birth and to lower the spread of this disease.