Infant mortality in French Guiana between 2001 and 2017 : Trends and comparisons with mainland France.

BACKGROUND: French Guiana is a French overseas territory which combines a well-funded universal health system and a population where half are under the poverty line. In this context, we aimed to measure and describe the causes of infant mortality and, because French Guiana is a French territory, to compare them with mainland France. METHODS: National death certificate data between 2001 and 2017 was used. RESULTS: Overall, 6.9 % of deaths before 65 years concerned infants <1 year (in mainland France 2.6%). The infant mortality rate over the 2001-2017 period was 2.6 times that of mainland France (1159.5 vs 446.2 per 100,000 infants <1 year) with excess incidence in perinatal causes, malformations and chromosomal anomalies, accidents, infectious causes, and in poorly defined conditions. Over time, there seemed to be a reduction of infant mortality for all the main causes, except for congenital malformations and chromosomal anomalies, which, on the contrary, seemed to increase. The data sources did not allow to study the weight of social factors or place of residence. CONCLUSIONS: All causes of infant mortality seemed to decline over time except malformations and chromosomal anomalies, which increased. Although exposure to heavy metals, infectious diseases are potential explanations we cannot pinpoint the cause of this increase with the available data. The present results suggest infant mortality and malformations should benefit from more detailed data sources in order to better assess and alleviate the burden of infant mortality in French Guiana.

[Life course violence, pregnancy experiences, use of alcohol and pemba, in French Guiana women]. / Violences au cours de la vie, vécu des grossesses et consommation d'alcool et de pemba des femmes en Guyane française.

OBJECTIVES: A survey was conducted in the maternity hospitals of French Guiana in 2017-2018 centered on uses of tobacco, alcohol and pemba (clay) during pregnancy, including questions about violence and the perception of adverse situations during pregnancy. The data used here allow an analysis of lifetime violence and the experience of the last pregnancy. METHODS: An ad hoc questionnaire was designed including some questions to identify at risk situations and T-Ace items for measuring problematic alcohol use. It was adapted to specificities of the local population groups, migrants or from borders, and asking for the maternal tongue. It was administered to women following childbirth. The questionnaire was strictly anonymous. The ethics committee had validated the questionnaire and the collection procedures (Decision 2017-25). In addition, to the issue of violence, seven questions were asked about women's experiences with pregnancy. A bivariate analysis identified significantly associated variables that were used for a multicomponent analysis to identify a typology of women based on their pregnancy experience (Modalisa8 and SPSS19). The very small number of women who smoked tobacco or cannabis during pregnancy (16 and 7 women respectively) led us to ignore these variables. RESULTS: The survey interviewed 789 women throughout Guyana. They were on average 28.9 years old at this pregnancy and had an average of 3.24 living children comprised this newborn. The questioned women were younger than in metropolitan France, less often married, with a low level of education, often foreigners, especially Haitian or Surinamese. Overall, 174 women, or 22% of the total reported having experienced violence in their lifetime, with four women refusing to answer the question. The profiles of the concerned women were not very different according to their ages or levels of education, but differed significantly from the average on several characteristics, such as their mother tongue, marital status, nationalities, whether living on state aid not related to employment or family allowances, or having no resources, living around Cayenne or Kourou and having been on the territory for less than two years. Three groups of women were distinguished by the multicomponent analysis. The first group comprised essentially foreign women living around Cayenne, alone with children, having a low educational level, and having experienced difficulties to cope with this pregnancy. They reported no use of psychoactive substances. They experienced violence more often than in the other groups (almost one in two). One in five had migrated during the last pregnancy. The second group was composed more often of French women, born in Guyana or in metropolitan France. They more often lived with a partner, had a good educational level, personal or marital incomes. They expressed more often worry, with sleep problems but with an entourage to rely on. Before pregnancy they drank alcohol at events but one in three had a T-Ace scoring at two or more. They had a good pregnancy follow-up. The last group was composed of women living around Saint-Laurent-du-Maroni or in remote communities, with a low educational level, living alone with numerous children. They didn't feel worry and had good sleep. They didn't experience violence. They differed by their use of pemba and beer and late or inadequate pregnancy follow-up. CONCLUSIONS: Data on violence in French Guyana show that young people and women declare more often having experienced physical violence, in or out of family life. Young women are overrepresented thus a survey in childbearing women must reveal a high frequency of these events. Our data allow us to go further, by associating this experience of violence and the experience of pregnancy with socio-demographic variables. We can thus see that the overall average obtained on a large number of indicators is smoothed by extremely contrasting situations, of women feeling safe or not, well followed or not for this pregnancy, etc. The groups distinguished by the MCA reveal the contrast between women of Haitian nationality in the Cayenne region and Surinamese or Nengee-speaking women, who are grouped around Saint-Laurent-du-Maroni or in the isolated municipalities of western Guyana. One sub-group stands out in particular for the combination of lifetime violence and very unfavorable conditions during the last pregnancy, both of precariousness, isolation and recent migration. The experience of violence and pregnancy in poor conditions require close actions to take charge of these women, especially since they are at risk for sexually transmitted diseases, including HIV.

[The interplay between isolation and precariousness, and hospitalization duration in French Guiana]. / Calcul de l'IP-DMS en Guyane : prendre en compte le poids réel de la précarité et de l'isolement.

BACKGROUND: French Guiana faces singular health challenges: poverty, isolation, structural lag, difficulties in attracting health professionals. Hospital stays exceed the recommended durations. The present study aimed to model the impact of precariousness and geographic isolation on the hospital duration performance indicator and to recalculate the indicator after incrementing severity by 1 unit when patients were socially precarious. METHODS: Cayenne hospital data for 2017 were used to model the hospital duration performance indicator (IP-DMS) using quantile regression to study the impact of geographic and social explanatory variables. This indicator was computed hypothesizing a 1 unit increment of severity for precarious patients and by excluding patients from isolated regions. RESULTS: Most excess hospitalization days were linked to precariousness: the sojourns of precarious patients represented 47% of activity but generated 71% of excess days in hospital. Quantile regression models showed that after adjustment for potential confounders, patients from western French Guiana and Eastern French Guiana, precarious patients and the interactions terms between residence location and precariousness were significantly associated with IP-DMS increases. Recalculating the IP-DMSafter exclusion of patients from the interior and after increasing severity by 1 notch if the patient was precarious led to IP-DMS levels close to 1. CONCLUSION: The results show the nonlinear relationship between the IP-DMS and geographical isolation, poverty, and their interaction. These contextual variables must be taken into account when choosing the target IP-DMS value for French Guiana, which conditions funding and number of hospital beds allowed in a context of rapid demographic growth.

[Paracoccidioidomycosis of the external ear]. / Paracoccidioïdomycose localisée au pavillon d'une oreille.

BACKGROUND: Paracoccidioidomycosis is a systemic fungal infection common in Latin America. Cutaneous involvement is frequent and usually affects multiple sites, being most frequently associated with lesions of the oropharyngeal mucosa. The cutaneous form on its own is rare. PATIENTS AND METHODS: We report a case of paracoccidioidomycosis isolated from the ear of a 43-year-old immunocompetent man. The lesion consisted of a partially ulcerated plaque on the auricle of the left ear. Direct examination, histopathological examination and PCR revealed the presence in the skin lesion of yeasts identified as Paracoccidioides brasiliensis. DISCUSSION: The sites of paracoccidioidomycosis on the ear can be confused with other tropical diseases frequently found in the Amazon region such as leishmaniasis, leprosy and lobomycosis. The absence of any other cutaneous sites in this case raised the question of whether the lesion was of primary or secondary origin.

[Paradoxical reactions and responses during antibiotic treatment for Mycobacterium ulcerans infection (Buruli ulcer). Four cases from French Guiana]. / Réponses et réactions paradoxales au cours du traitement médicamenteux de l'infection à Mycobacterium ulcerans (ulcère de Buruli). Quatre observations en Guyane française.

BACKGROUND: In recent years, first-line therapy for Mycobacterium ulcerans infection in French Guiana has consisted of antibiotics active against this organism. Two regimens are used comprising rifampicin associated with clarithromycin or amikacin. PATIENTS AND METHODS: We describe four patients presenting apparent worsening of their lesions during treatment: ulceration of a nodular lesion in a 32-year-old woman and worsening of an ulcerated lesion in three patients aged 16, 27 and 79 years. DISCUSSION: In these 4 patients, we concluded that the symptoms were caused by a paradoxical response or a reaction, a phenomenon already described in tuberculosis and leprosy. Such worsening is transient and must not be misinterpreted as failure to respond to treatment. The most plausible pathophysiological hypothesis involves the re-emergence of potentially necrotizing cellular immunity secondary to the loss of mycolactone, a necrotizing and immunosuppressive toxin produced by M. ulcerans, resulting from the action of the antibiotics.

[Oncology in French Guiana: A challenge to win]. / La cancérologie en Guyane : un défi à gagner.

French Guiana is an equatorial, multicultural, overseas territory in South America. The region is unique: a wealthy country with a universal healthcare system, but significant poverty, which bears little resemblance to its neighbors Brazil and Suriname. Cancer is the second leading cause of death. The incidence of cancer is lower than in France, stages are generally more advanced and the prognosis worse. To date, oncology has been organized through a joint venture between local institutions and healthcare professionals and a cancer center in mainland France, in line with the recommendations of the Institut National du Cancer. The implementation of a medical project and a complete medical studies curriculum in French Guiana is a tremendous opportunity for the development of oncology. The main challenges are consolidating medical care for patients, quality control, genetic oncology, molecular biology, implementation of radiotherapy and nuclear medicine, clinical and translational research, and teaching programs. Working in oncology in French Guiana is exciting because of the scientific interest (particular characteristics of cancers, notably the role of viral or micro-organism-induced carcinogenesis, genetic factors in these populations with African and Asian roots, and the importance of a public health policy) and human interest (patients from different cultures; all of them bring original approaches to health and illness that need to be deciphered in order to offer quality care). This requires the support of healthcare professionals who are enthusiastic about this unique adventure.

[The oncology residency program in French overseas]. / L'internat d'oncologie en outre-mer français.

Once his specialty has been chosen, and according to his ranking, the new resident in oncology decides on the subdivision in which he wishes to be among the 28 existing subdivisions. Two concern overseas departments and territories: the Antilles-Guyana subdivision and the Indian Ocean subdivision. The oncology residency has its own particularities because of the demographic characteristics and epidemiology of cancers in these areas, but also because of a particular organization of care and university teaching. The training of residents in these subdivisions is little known. Over the past ten years, most of the residents have been trained in oncology-radiotherapy in these subdivisions and some of them in medical oncology. The residency program is however experiencing a revival in terms of university education in parallel with the development of technical and human equipment in the centres of these regions. This article details the training of residents in oncology in French overseas territories by contextualizing it with epidemiological data and the characteristics of the oncology care offer in these territories.

The epidemiology of acute coronary syndromes in French Guiana.

BACKGROUND: French Guiana is an overseas territory of France with marked specificities in terms of populations, socioeconomic factors, risk factors, and an access to care. In this context, the objective of the present study was to describe the epidemiology of acute coronary syndromes in French Guiana and to make comparisons with mainland France and neighbouring country. METHODS: The data were obtained from a retrospective descriptive hospital-based cohort conceived to describe the incidence of acute coronary syndromes and their epidemiologic and clinical characteristics. It included patients aged 18 or more hospitalised for a first coronary syndrome in the reference centre for coronary syndromes in Cayenne French Guiana between Jan 1st 2012 and Dec 31st 2014. Overall, 266 patients were analysed. RESULTS: The mean age was 64 years (SD=12.54). A majority of patients were men (sex ratio=1.83). The proportion of patients born in an overseas French territory (44.36%) was similar to that of those born in a foreign country (43.98%), and 11.65% were born in mainland France. Only 59% of patients had regular health insurance. Moreover, 33.21% had universal medical insurance (CMU for those below a minimal income), 4.91% had state insurance (for illegal foreign patients) and 2.64% had no insurance at all. The main risk factors were high blood pressure (73.68%), diabetes (39.85%), hypercholesterolemia (40.23%), and smoking (37.97%). Overall, 82/266 patients developed an ST elevation coronary syndrome (STEMI) and 184/266 had a non-ST elevation coronary syndrome NSTEMI or unstable angina pectoris. Thrombolysis was only performed in 20.73% of patients with STEMI. Mortality at 1 month was 8/82 (9.76%) for STEMI and 2/184 (1.09%) for NSTEMI. CONCLUSIONS: The epidemiologic profile of acute coronary syndromes in French Guiana is different from that of mainland France and Europe to the neighbouring country Brazil. Mortality of STEMI also seems higher than in mainland France, but similar to Brazil. In a context of frequent health inequalities, interventions targeting the major risk factors, notably high blood pressure, obesity and diabetes, have the potential to significantly impact cardiovascular morbidity and mortality.

[Carpal Extensor Tenosynovitis and Adult Sickle Cell Vaso-Occlusive Crisis]. / Ténosynovite des extenseurs du carpe et crise vaso-occlusive drépanocytaire de l'adulte.

If the acute and chronic osteo-articular complications of sickle cell anemia are well-known to the rheumatologist, certain forms including hand-foot syndrome are less so since they almost exclusively concern small children less than 4 years of age. We report here the observation of a hand-foot syndrome in a 36-year-old adult, homozygous sickle cell disease (SS), during a vaso-occlusive crisis, manifested by tenosynovitis of carpal extensors. After eliminating the other etiologies, notably infectious of palmar tenosynovitis, the vaso-occlusive origin will be confirmed by the rapidly favorable evolution of the clinical picture.

Si les complications ostéoarticulaires aiguës et chroniques de la drépanocytose sont bien connues du rhumatologue, certaines formes dont le syndrome main-pied le sont moins, puisqu'elles concernent quasi exclusivement le petit enfant avant quatre ans. Nous rapportons ici l'observation d'un syndrome main-pied chez un adulte de 36 ans, drépanocytaire homozygote (SS), au cours d'une crise vaso-occlusive, se manifestant par une ténosynovite des extenseurs du carpe. Après avoir éliminé les autres étiologies, notamment infectieuses de ténosynovite palmaire, l'origine vaso-occlusive sera confirmée par l'évolution rapidement favorable du tableau clinique.

After 157 years, a second specimen and species of the phylogenetically enigmatic and previously monobasic genus Nototylus Gemminger & Harold, 1868 (Coleoptera, Carabidae, Nototylini).

The enigmatic beetle tribe Nototylini (Carabidae) is revised and a key to species is provided. Two species from South America are included in the genus. One species, Nototylus fryi (Schaum), is reviewed and a second, Nototylus balli Erwin & Kavanaugh, sp. nov., is described as new. Each species is known from a single specimen, neither of which is in good condition. The possible function of what appears to be a unique antennal grooming structure on the front femur is discussed.

ResumenLa tribu enigmática de escarabajos Nototylini (Carabidae) se revisa y se provee una clave para las especies. Dos especies de América del Sur están incluidas bajo este género. Se revisa una especie, Nototylus fryi (Schaum), y una segunda, Nototylus balli sp. nov., se describe como nueva. Ambas especies se conocen de un solo espécimen, ninguno de los cuales está en buenas condiciones. Se discute la posible función de lo que aparece ser una estructura para acicalamiento antenal el fémur anterior.

RésuméUne révision taxonomique de la tribu énigmatique de coléoptères Nototylini (Carabidae) est présentée et une clé pour l'identification d'espèces est fournie. Deux espèces d'Amérique du Sud sont incluses dans le genre. Une espèce est examinée (Nototylus fryi (Schaum)) et, une deuxième est décrite comme nouvelle espèce (Nototylus balli sp. nov.). Chaque espèce est connue à partir d'un seul spécimen dont aucun est en bon état. La possible fonction de ce qui semble être une structure de toilette antennaire sur le pro-fémur est discutée.

ResumoUma enigmática tribo de besouros, Nototylini (Carabidae), é revisada, e uma chave para as espécies de Nototylus é fornecida. O gênero agora inclui duas espécies: Nototylus fryi (Schaum), aqui redescrita, e Nototylus balli sp. nov., descrita como nova. Ambas são conhecidas por somente um espécimen em mal estado de conservação. Discute-se a função de uma estrutura singular do femur anterior, possivelmente usada na escovagem da antena.

New Cockroaches (Dictyoptera: Blattodea) from French Guiana and a Revised Checklist for the Region.

Although French Guiana is one of the greatest hotspots of cockroach biodiversity on Earth, there are still undocumented species. From both newly collected and museum specimens, we provide species descriptions for Buboblatta vlasaki sp. nov., Lamproblatta antoni sp. nov., and Euhypnorna bifuscina sp. nov. and report new geographic records for species in the genera Epilampra Burmeister, Euphyllodromia Shelford, Ischnoptera Burmeister, and Euhypnorna Hebard. Finally, we update the checklist of species known from the region to 163 total species records from French Guiana, making it the second greatest hotspot of known cockroach biodiversity on Earth.

Fasciolariidae (Gastropoda: Neogastropoda) of French Guiana and nearby regions, with descriptions of two new species and comments on marine zoogeography of northeastern South America.

The fasciolariid fauna from two expeditions to French Guiana is examined and augmented with published records and material of other collections from the Guianas and northeastern Brazil. Twelve species of Fasciolaria and Aurantilaria (Fasciolariinae), Aristofusus, Lyonsifusus and Fusinus s.l. (Fusininae), and Lamellilatirus and Polygona (Peristerniinae) are reported and discussed. Nine species are represented in expedition collections, and reports of three other species are evaluated. Two morphologically distinct species of Lamellilatirus are described as new; type localities of both are off French Guiana, 114-118 m. Ten Guianan fasciolariids range variously northward to Caribbean South America and the Lesser Antilles and southward to Ceará, Brazil; one other extends into the northern Caribbean, and one extends southward to Rio de Janeiro, Brazil.

Decreased antibiotic susceptibility of Enterobacteriaceae causing community-acquired urinary tract infections in French Amazonia.

OBJECTIVES: Urinary tract infections (UTIs) have rarely been studied in the Amazon region. We aimed to describe the epidemiology of bacteria causing UTIs in French Guiana. PATIENTS AND METHODS: We performed a monocenter retrospective study of adults consulting at the emergency department of Cayenne Hospital in 2014 with a diagnosis of UTI. The bacterial species and resistance profile were described. RESULTS: Two-hundred-and-eighty-nine patients presenting with UTI were included: 82 (28.4%) presented with cystitis, 166 (57.4%) with pyelonephritis, and 41 (14.2%) with male UTI. E. coli was predominant (74.1%), and had decreased susceptibility to ampicillin, amoxicillin-clavulanic acid, fluoroquinolones, co-trimoxazole, and furans compared with data from metropolitan France. Extended-spectrum beta-lactamases (ESBL) was isolated in 3.1% of E. coli and 31.6% of K. pneumoniae. CONCLUSIONS: Antibiotic susceptibility in UTI is lower than reported in metropolitan France without evidence for an excessive consumption of antibiotics.

[Risk of Infection Following Implant of Artificial Penile Nodule, Bouglous or Dominos: A Case Report in French Guiana]. / Risques d'infection suite à l'implant de nodules péniens bouglous ou dominos : à propos d'un cas en Guyane française.

Implant of artificial penile nodule (APN) is a socio-cultural practice, linked to penitentiary environment in French Guiana. Physicians are often unfamiliar with its existence. Although serious complications remain low regarding the high prevalence of this practice, urgent cares could be required. Indeed, implant of nodule can have functional sequelae, and sometimes life-threatening consequences, especially if infection occurs and spreads. We have reported the case of a 23-year-old male who presented an infection of the penis after the implant of two APN. Removal of the nodules associated with oral antibiotics was needed. We also present CT-scan images of another patient, as an example of fortuitous discovery of these nodules. We finally discuss the various complications already described in literature.

Le port de nodules péniens artificiels (NPA) est fortement lié à la fréquentation du milieu carcéral en Guyane française. Cette pratique est peu connue des professionnels de santé. Bien que les complications restent peu fréquentes malgré la prévalence élevée de ces nodules dans certaines populations, elles peuvent nécessiter une prise en charge diagnostique et thérapeutique urgente. En effet, il existe des risques fonctionnels, mais également vitaux survenant dans les suites d'une complication notamment infectieuse. Nous rapportons ici le cas d'une infection de la verge suite à l'implant de deux NPA chez un patient de 23 ans, pour laquelle le retrait des nodules et une antibiothérapie orale ont été nécessaires. Preuve de la forte prévalence de cette pratique, nous illustrons à l'aide d'une iconographie radiologique originale le cas d'un autre patient chez qui ces nodules ont été fortuitement découverts. Enfin, nous discutons des différentes complications décrites dans la littérature.

Clinical characteristics and predictive score of dengue vs. chikungunya virus infections.

BACKGROUND: Chikungunya (CHIKV) and dengue viruses (DENV) are two arboviruses with epidemic potential and similar clinical presentations. The potential life-threatening risk associated with DENV justifies an immediate biological assessment and medical follow-up which may be delayed for CHIKV. OBJECTIVES: To compare the clinical variables that would help differentiate patients infected with CHIKV or DENV, and then to compute a predictive score. PATIENTS AND METHOD: Retrospective case-control study comparing CHIKV-infected patients diagnosed by RT-PCR in 2014 with patients infected with DENV diagnosed by positive NS1 antigen test in 2013. Children aged<15 years and pregnant women were excluded. Clinical and biological variables were compared, and a multivariate analysis was performed. A clinical score was developed using the ß coefficients to differentiate the infections. RESULTS: Over the study period 168 patients infected with CHIKV were compared with 452 patients with DENV. The clinical variables independently associated with CHIKV was joint and back pain, and those associated with DENV were headache, muscle pain, nausea/vomiting, diarrhea, and hemorrhagic signs. The clinical score had 98% sensitivity for DENV and a ROC curve of 0.96. CONCLUSION: These two infections have a similar clinical presentation but the use of the proposed clinical score during the acute phase of the disease would make it possible to identify cases of DENV during a CHIKV epidemic to suggest adequate patient management.

[Initiation of first dialysis and three months quality of life of patients with end stage renal disease in the French territories of Guadeloupe and Guyane]. / Contexte initial de prise en charge et qualité de vie à 3 mois des patients dialysés pour insuffisance rénale chronique terminale dans deux départements français d'Amérique.

End stage renal disease is a major public health problem in the French Departments of Guadeloupe and Guiana because of the high prevalence of both type 2 diabetes and hypertension. We investigated factors associated with an emergency start of dialysis, 3 months' quality of life for patients starting a first replacement therapy in Guadeloupe and French Guiana using the data of the Réseau épidémiologie et information en néphrologie network, completed with data from the quality of life questionnaires SF-36 and KDQoL. A total of 242 patients (184 in Guadeloupe and 58 in Guiana) were included. An emergency start was found for 112 (46.5%) patients (Guiana: 74.1%; Guadeloupe: 37.7%). In the multivariate model, an emergency start was associated with the number of nephrology consultations in the year before dialysis and the creation of an arteriovenous fistula prior to the first dialysis. The quality of life scores did not differ between the groups emergency start or not but were higher than those measured in mainland French studies on dialyzed population. Lack of nephrology consultations and dialysis preparation are the main factors associated with an emergency start of the first dialysis, highlighting the need to adapt the provision of care for chronic kidney disease in these departments.

Aquatic life in Neotropical rainforest canopies: Techniques using artificial phytotelmata to study the invertebrate communities inhabiting therein.

In Neotropical rainforest canopies, phytotelmata ("plant-held waters") shelter diverse aquatic macroinvertebrate communities, including vectors of animal diseases. Studying these communities is difficult because phytotelmata are widely dispersed, hard to find from the ground and often inaccessible. We propose here a method for placing in tree crowns "artificial phytotelmata" whose size and shape can be tailored to different research targets. The efficacy of this method was shown while comparing the patterns of community diversity of three forest formations. We noted a difference between a riparian forest and a rainforest, whereas trees alongside a dirt road cutting through that rainforest corresponded to a subset of the latter. Because rarefied species richness was significantly lower when the phytotelmata were left for three weeks rather than for six or nine weeks, we recommend leaving the phytotelmata for twelve weeks to permit predators and phoretic species to fully establish themselves.

Scorpions from the Mitaraka Massif in French Guiana: Description of one new genus and species (Scorpiones: Chactidae).

A new genus and species, Spinochactas mitaraka gen. n., sp. n. (Chactidae) are described from the Mitaraka Massif in French Guiana, a site located near the borders of French Guiana, Brazil, and Suriname. The description of the new genus and species brings further evidence of the biogeographic pattern of distribution presented by some elements of the family Chactidae endemic to the Tepuys or to the Inselberg formations of South America.

Scorpions from the Mitaraka Massif in French Guiana. II. Description of a new species of Ananteris Thorell, 1891 (Scorpiones: Buthidae).

A new remarkable species belonging to the genus Ananteris Thorell, 1891 (Buthidae) is described from the Mitaraka Massif in French Guiana, a site located near the borders of French Guiana, Brazil, and Suriname. The description of this new species brings further evidence about the biogeographic patterns of distribution presented by most species of the genus Ananteris, which are highly endemic in most biogeographic realms of South America, including the Tepuys and Inselberg Massifs.

[Placental abruption: Background and revisited pronostic factors about a series of 171 cases]. / Hématome rétroplacentaire : terrain et facteurs pronostiques revisités à propos d'une série de 171 cas en Guyane francaise.

OBJECTIVE: To describe the epidemiological, clinical and prognostic factors of placental abruption and fetal death in utero and to investigate possible risk factors for their occurrence. PATIENTS AND METHODS: Observational retrospective study including the women having presented a placental abruption between January 2001 and January 2012, in a IIB maternity. Women's sociodemographic characteristics, clinical symptoms and the method used to detect placental abruption were collected. Patient data of those whose pregnancy resulted in fetal death were compared to those with more favorable outcomes. RESULTS: There were 171 cases of placental abruption among 21,913 patients having delivered, which represents a 0.78% incidence. Diagnosis was rarely based on clinical data (30%). The rate of fetal death in utero represented 25% of the pregnancy's outcomes. A history of fetal death in utero increased the risk of placental abruption (P<0.001). This complication was more frequent for patients who did not have pregnancy monitoring (P=0.054) and before 37 weeks of amenorrhoea (P=0.005). CONCLUSION: Placental abruption is an important cause of perinatal mortality and maternal morbidity. Among the observed risk factors, only regular pregnancy monitoring can be an easy way to prevent these complications.