Paradoxical effect of lenalidomide on cytokine/growth factor profiles in multiple myeloma.

BACKGROUND: Lenalidomide is an active immunomodulatory and antiproliferative agent in multiple myeloma. However, the molecular mechanisms driving these activities are not yet fully elucidated. Therefore, we investigated the modulation of the cytokine/growth factor patterns of myeloma cells under LEN treatment. METHODS: Lenalidomide effect on myeloma cell proliferation was investigated in a myeloma cell line collection (n=23) by (3)H-thymidine incorporation. Modulation of the cytokine/growth factor patterns of myeloma cells under LEN treatment was analysed by real-time quantitative PCR. RESULTS: Lenalidomide inhibits the proliferation of two-thirds of myeloma cell lines independently of their genetic background. We demonstrated that LEN increased TNF-α and IL-8 inflammatory cytokines and insulin-like growth factor-1 (IGF-1) growth factor in both sensitive and resistant myeloma cells to LEN. CONCLUSION: Lenalidomide favours a uniform TNF-α and IL-8 inflammatory and IGF-1 secretory profile of myeloma cells, an observation that raises important questions for therapeutic approaches incorporating the agent.

Field survey data on the effectiveness of agrometeorological services for smallholder farmers in Niger.

The dataset contains the answers of smallholder farmers to a semi-structured field survey and the 2020 yield plot measurements conducted in 8 municipalities of the Dosso and Tillabéri regions in Niger. It is a systematic sampling of about 320 questionnaires and 192 yield plot samples equally distributed in eight municipalities of intervention. The dataset contains several pieces of information about the uptake and the impacts of a tailored climate service (CS) produced by the National Meteorological Service (NMS) and disseminated through a network that involves Ministry of Agriculture extension services at the municipal level developed in the context of the AdaptatioN Au changement Climatique, prévention des catastrophes et Développement agrIcole pour la sécurité Alimentaire du Niger (ANADIA) Project. The material gathered by the survey gives a picture of the preferences of local farmers in the broadcasting of climate services information and their consequent strategical and tactical decisions in farm practices. Moreover, the survey investigates the preferences regarding the information that farmers would like to receive during the cropping season. Furthermore, the measurement of yield and its relation to the farmers' access to climate information and participation in training initiatives gives an indication of the impact of the CS on agricultural production in these regions. The dataset could benefit further studies and investigations about CSs for smallholder farmers in semi-arid regions. This article is a co-submission of the article: "Effectiveness of agrometeorological services for smallholder farmers: the case study in the regions of Dosso and Tillabéri in Niger" submitted to the journal Climate Services.

[Availability and affordability of diagnosis and treatment for asthma and COPD in Ouagadougou, Burkina Faso]. / Disponibilité et accessibilité financière aux moyens diagnostiques et thérapeutiques de l'asthme et de la bronchopneumopathie chronique obstructive dans la ville de Ouagadougou, Burkina Faso.

INTRODUCTION: Chronic respiratory diseases, particularly asthma and Chronic Obstructive Pulmonary Disease (COPD), pose a significant threat to public health. This study aims to determine the accessibility and affordability of means of diagnosis and treatment. METHODS: This was a cross-sectional study covering the period from August to December 2021 in Ouagadougou, Burkina Faso. This study involved 107 health centers and 135 pharmacies. The World Health Organization/Health Action International definition was used as a benchmark for accessibility to medicines. RESULTS: Out of 107 health centers, 29 (27.1%) had a spirometer. The average cost of spirometry represented 19.88 days of salary for a patient paid at the minimum wage. The most widely available drugs were salbutamol in a pressurized metered dose inhaler (pMDI) (88.1%) and prednisone 20mg tablet (87.4%). No disease-modifying drug was available in public pharmacies. Affordable drugs were salbutamol 4mg tablet and aminophylline 100mg tablet. CONCLUSION: The means of diagnosis and treatment of asthma and COPD are insufficiently available, especially in the public sector, which is characterized by a nearly total absence of basic treatment.

The cap-translation inhibitor 4EGI-1 induces apoptosis in multiple myeloma through Noxa induction.

BACKGROUND: Cancer cells are frequently addicted to deregulated oncogenic protein translation. The small molecule 4EG-I selectively inhibits the cap-dependent translation of mRNAs. As multiple myeloma is an incurable disease that requires new therapeutic approaches, we investigated whether targeting the translation initiation pathway could be a target for myeloma therapy. METHODS: Six myeloma cell lines and primary samples were included in this study. The 4EGI-1 effect was determined by AnnexinV staining and caspase activation. Modification of Bcl-2 protein expression was analysed, and the significance of modified proteins was analysed by knock-down experiments. RESULTS: We demonstrated that 4EGI-1 impaired the assembly of the eIF4F complex and decreased the expression of the eIF4E-regulated proteins in myeloma cells. Furthermore, we showed that 4EGI-1 induced strong apoptosis in five out of six myeloma cell lines. Apoptosis is associated with the activation of the intrinsic mitochondrial pathway. The 4EGI-1 triggered Noxa induction only in cells undergoing apoptosis through endoplasmic reticulum (ER) stress. Furthermore, Noxa silencing prevented myeloma cells from 4EGI-1-induced apoptosis. Finally, Noxa induction led to a disruption of Mcl-1/Bim complexes in parallel to the generation of 'Mcl-1-free Noxa'. CONCLUSION: Our results suggested that the use of inhibitors that directly target the translation initiation complex eIF4F could represent a potential novel approach for multiple myeloma therapy.

Contribution of large pig for renal ischemia-reperfusion and transplantation studies: the preclinical model.

Animal experimentation is necessary to characterize human diseases and design adequate therapeutic interventions. In renal transplantation research, the limited number of in vitro models involves a crucial role for in vivo models and particularly for the porcine model. Pig and human kidneys are anatomically similar (characterized by multilobular structure in contrast to rodent and dog kidneys unilobular). The human proximity of porcine physiology and immune systems provides a basic knowledge of graft recovery and inflammatory physiopathology through in vivo studies. In addition, pig large body size allows surgical procedures similar to humans, repeated collections of peripheral blood or renal biopsies making pigs ideal for medical training and for the assessment of preclinical technologies. However, its size is also its main drawback implying expensive housing. Nevertheless, pig models are relevant alternatives to primate models, offering promising perspectives with developments of transgenic modulation and marginal donor models facilitating data extrapolation to human conditions.

[Tropical otitis]. / Otite tropicale.

A 68-year-old patient presents with chronic right-sided otorrhea associated with hypoacousis and chronic cough. Otoscopy showed multiple perforations of the right eardrum. The search of acid-fast bacilli was positive for direct examination of sputum and negative for the examination of ear pus. A antituberculosis treatment has been initiated.

[Factors associated with the occurrence of acute respiratory distress and death in patients with COVID-19 in Burkina Faso]. / Facteurs associés à la survenue de la détresse respiratoire aiguë et au décès chez des patients atteints de COVID-19 au Burkina Faso.

INTRODUCTION: The development of acute respiratory distress syndrome indicates a serious form of COVID-19. Although there have been several studies on the prognostic factors of its severe form, no such study has been conducted in Burkina Faso. METHODS: This was a retrospective cohort study conducted from March 9 to June 9, 2020 in Ouagadougou, Burkina Faso which involved 456 patients with COVID-19. RESULTS: Nearly a quarter of the patients (23.2%) had presented with acute respiratory distress and 44.3% of them died. Being over 65 years old (HR: 2.7; 95% CI: 1.5-5.1) and having hypertension (HR: 1.9; 95% CI: 1-3.5) were independently associated with the risk of mortality. However, after adjustment, only age over 65 years (HR: 2.3; 95% CI: 1.2-4.3) was a risk factor for death. The survival rate for patients over 65 was 38.5% at 7 days and 30.3% at 15 days. CONCLUSIONS: Acute respiratory distress leading to death is mainly found in older people with COVID-19. Close monitoring of these high-risk patients may reduce the risk of death.

[Mechanism and implication of regulation of the pricing of essential medicines in the private pharmaceutical sector in Mali]. / Processus et enjeux de la réglementation des prix des médicaments essentiels dans le secteur pharmaceutique privé au Mali.

The healthcare and pharmaceutical professions in Mali were privatized in 1985. Privatization led to swift expansion of the private sector and upset the balance that had existed between the public and private sectors. A national pharmaceutical policy did not emerge until a decade later. Its purpose was to promote a system ensuring fair access to essential generic medicines for all. It was hoped that synergy between the two sectors would promote that objective. However, the policy calling for distribution of essential generic medicine through the private sector was not accompanied by an adequate system for pricing. This problem led the government to adopt a price regulation policy to realign market dynamics with public health goals. This experience shows that a sustained effort from public policy makers is necessary to prevail against the professional and business interests that can conflict with the public interest. Analysis of this experience also demonstrates the need to improve, restructure, and control the pharmaceutical industry. The government must continue to play its crucial role in the context of limited resources and inequality between consumers and pharmaceutical companies.

Laryngeal Papillomatosis in Adults: Assessment for Ten Years at the ENT Department of the National University Hospital of Fann (Dakar, Senegal).

OBJECTIVES: The aim of this study was to describe the epidemiological, diagnostic, and therapeutic aspects of adult laryngeal papillomatosis in Senegal. Patients and Methods. This is a retrospective descriptive study of patients aged above 18 years with laryngeal papillomatosis and followed at the ENT department of the NUH of Fann between 01 January 2009 and 31 December 2018. RESULTS: The mean age at diagnosis was 37.74 years and a sex ratio of 0.93. The 20-29 age group was the most represented (45.2%). The average consultation delay was 8.34 years. All patients had dysphonia at the moment of the diagnostic and in 35.5% of cases, and it was associated with laryngeal dyspnea. Glottis localization was present in all our patients, i.e., 100% of the cases. A tracheotomy was performed in 9.67% of cases. All of our patients have had their papilloma peeled per endoscopic with tweezers. No cases of malignant degeneration were found in our study. CONCLUSION: Laryngeal papillomatosis is the most common benign tumor of the larynx in both children and adults. Despite the progress of endoscopy and antiviral treatments, its treatment poses many problems in our undermedicalized countries.

Prevalence of symptoms of sleep apnoea syndrome in Burkina Faso.

INTRODUCTION: Sleep apnoea syndrome (SAS) is a frequent and underdiagnosed pathology. Epidemiological studies in sub-Saharan Africa are few. Our study aimed to determine the prevalence of SAS symptoms in an adult population in Burkina Faso. METHODS: A cross-sectional study whose data collection took place at the Yalgado Ouédraogo Teaching Hospital, from 1 September to 31 October 2014. We randomly enrolled all subjects aged at least 25 accompanying an outpatient t the time of a visit. A strong suspicion of SAS was established for every combination of ordinary snoring with excessive daytime sleepiness and/or sleep apnoea. RESULTS: The study included 311 subjects - 181 men and 130 women. The mean (standard deviation (SD)) age was 31.84 (8.25) years and the average (SD) BMI was 23.14 (3.67) kg/m². The prevalence of excessive daytime sleepiness, snoring and sleep apnoea was 4.5%, 26% and 9.6%, respectively. A strong suspicion of SAS was found in 9.6% of respondents and the risk factors associated with this strong suspicion were BMI≥25 kg/m² (odds ratio (OR) 2.7; p=0.012), and poor-quality sleep (OR 3.7; p<0.001). CONCLUSION: A significant proportion of our sample had symptoms suggestive of SAS. Testing with either respiratory polygraphy or polysomnography should be proposed to the presumptive cases for early diagnosis and treatment.

[A case of malformation of aortic arches simulating asthma]. / Un cas de malformation des arcs aortiques simulant un asthme.

INTRODUCTION: Abnomalies of the aortic arches are rare and account for 1% of congenital cardiovascular malformations. They constitute one of the causes of compression of the airways with attacks of dyspnea sometimes simulating an asthma. We report the case of an infant with an anomaly development of aortic arches with impact breathing. CASE REPORT: It was a 22-month-old infant who consulted for a dyspnea with a type of stridor associated with a fat cough. This clinical table started 45 days after its birth and led to many hospitalizations in the pediatric emergency. Clinical exam found polypnea, with a wheezing, bronchial groan and diffuse sibilants on the auscultation. The chest X-ray revealed a slightly retractile right lung. The angioscanner of the thoracic and abdominal aorta showed a double aortic arch with retro-oesophageal left ventricular artery. A thoracotomy was performed and the operative sequences were simple. CONCLUSION: The congenital anomalies of the aortic arch are rare and varied, sometimes asymptomatic. This case reminds us that, in front of any recurrent or digestive respiratory signs in the infant, malformation of the aortic arches should be considered.

Laryngeal papillomatosis in Senegal: A ten-year experience.

OBJECTIVES: The objectives of this study were to describe the epidemiological, clinical and therapeutic characteristics of laryngeal papillomatosis in the Fann teaching hospital ENT department in Dakar, Senegal. PATIENTS AND METHODS: We retrospectively reviewed all cases of laryngeal papillomatosis managed in the Fann teaching hospital ENT department between 1st January 2006 and 31st December 2015. Epidemiological, clinical and therapeutic characteristics of laryngeal papillomatosis were studied. Statistical analysis was performed with SPSS 18 software. RESULTS: The median age at diagnosis was 11 years and the sex ratio was 1.88. The mean time to consultation was 4.5 years. The predominant symptom was dysphonia, present in all cases, followed by laryngeal dyspnoea in 64.6% of cases. The glottic area was involved in all patients. Tracheostomy was performed in 20.8% of cases. All patients in our study underwent endoscopic excision of the lesions. CONCLUSION: Laryngeal papillomatosis is the most common benign tumor in children, but it can also occur in adults. Treatment has been revolutionized by progress in endoscopy and antiviral therapy. However, tracheostomy still occupies an important place in our practice.

[Knowledge, attitudes and practices of healthcare professionals at the Souro Sanou university hospital of Bobo Dioulasso regarding Mellitus diabetes]. / Connaissances, attitudes et pratiques des professionnels de Sante du centre hospitalier universitaire Souro Sanou de Bobo Dioulasso en Matiere de diabete sucre.

INTRODUCTION: In Burkina Faso, the insufficiency of doctoral interns, of endocrinologists, and medical services specialized in the coverage of the diabetes, means that these cases are relegated to general practitioners and the paramedical staff. OBJECTIVES: To study the level of knowledge, attitudes and practices of the medical and paramedical staff on the coverage of sugar diabetes in the Souro Sanou University Hospital of Bobo Dioulasso. METHOD: A cross-sectional study of descriptive type was conducted over a 3 month period, from March 1st to May 31st, 2013. The investigated population was constituted of healthcare professionals represented by general practitioners, female nurses, State-certified male nurses, and patented male nurses of the Souro Sanou University Hospital of Bobo Dioulasso. A questionnaire, adapted for each professional category, was administered to the participants. A notation grid enabled us to record the level of knowledge, attitude and practice of the staff regarding sugar induced diabetes. RESULTS: Three hundred four (304) healthcare professionals, 187 men and 117 women (sex ratio of 1.59) were investigated. The average age was of 40.84 years with extremes of 26 and 60 years. Their level of knowledge, attitude and practice on sugar induced diabetes varied from one professional category to another. Clinical signs of the disease, as well as its physiopathology were well known by healthcare providers. However, the definition of the disease, its diagnostic criteria, its classification by cause, were little known general practitioners. The general practitioners, had a good attitude and practice in front of a case of diabetes compared to other professional categories. CONCLUSION: Adapted staff recycling is essential across the professional categories for healthcare providers of the university hospital.

INTRODUCTION: Au Burkina Faso, l'insuffisance de médecins internistes, d'endocrinologues, et des services médicaux spécialisés dans la prise en charge du diabète sucré, font que les médecins généralistes et le personnel paramédical sont relégués au premier. OBJECTIFS: Etudier le niveau de connaissances, attitudes et pratiques du personnel médical et paramédical sur la prise en charge du diabète sucré au CHU SS de Bobo Dioulasso. MÉTHODE: Il s'est agi d'une étude transversale de type descriptif, déroulée sur trois (03) mois, du 1er mars au 31 mai 2013. La population enquêtée était constituée de professionnels de santé représentés par les médecins généralistes, les attachés de santé, les infirmiers diplômés d'état, les sages-femmes/maïeuticiens d'état, les infirmiers brevetés du CHU SS de Bobo Dioulasso. Un questionnaire a été administré au personnel consentant adaptée à la catégorie professionnelle. Une grille de notation a permis d'apprécier le niveau de connaissance, d'attitude et de pratique du personnel en matière de diabète sucré. RÉSULTATS: Trois cent quatre (304) agents de santé dont 187 hommes (sex ratio = 1,59) ont été enquêtés. Leur moyenne d'âge était de 40,84 ans avec des extrêmes de 26 et 60 ans. Leur niveau de connaissance, d'attitude et de pratique sur le diabète sucré était variable d'une catégorie professionnelle à une autre. Ainsi, les signes cliniques de la maladie, ainsi que sa physiopathologie étaient bien connus par les agents de santé. Cependant, la définition de la maladie, ses critères diagnostiques, sa classification étiologique, étaient peu connus des médecins généralistes. Les médecins généralistes, avaient une bonne attitude et pratique devant un cas de diabète sucré par rapport aux autres catégories professionnelles. CONCLUSION: Des besoins de recyclage du personnel adapté aux catégories professionneles s'avèrent indispensables pour les agents de santé du CHU SS.

[Survival of malignant and paramalignant pleural effusions in Ouagadougou]. / Survie des pleurésies malignes et paramalignes à Ouagadougou.

This study aimed to present the survival of patients with malignant and paramalignant pleural effusion (MPE) in a context of resource-limited countries. We retrospectively studied patients received for malignant and paramalignant pleural effusion in three health facilities in Ouagadougou from 1st August 2009 to 30 July 2015. Survival was analyzed according to various characteristics related to patients and disease. Eighty patients with a mean age of 54 years were selected. The sex-ratio was 0.9. Sixteen patients had comorbidities. Pleural effusion was revealing, synchronous and metachronous in respectively 55 %, 26.3 % and 17.5 % of cases. Lung cancer was the most common cause of MPE (27.5 %), followed by breast cancer (18.7 %). The median overall survival was 3 months; it varied between primary cancers: 5 months for primary cancer unknown, 4 months for lung cancers and 2 months for breast cancers. Sex and the presence of comorbidities were independent factors influencing survival of patients. In this study, patient survival length is strongly compromised by inadequacies of medical technical equipment.

[Inventory of fixtures on the tolerance of the treatment) of the resistant multi-tuberculosis (Burkina Faso)]. / Etat des lieux sur la tolerance du traitement de la tuberculose multi resistante (Burkina Faso).

OBJECTIVES: Estimate the tolerance of antituberculous drugs prescribed in the treatment of multi resistant tuberculosis on patients followed in the service of Pneumology of the University hospital of Yalgado Ouedraogo. PATIENTS AND METHODS: It was a retrospective and prospective longitudinal investigation. The files of patients allowed to inform the questionnaire for the retrospective phase (2010-2011), the follow-up of patients during the prospective phase (2011-2013) allowed for data collection. All the patients under antituberculous treatment of 2nd line between January 1st, 2010 and the August 31st, 2013 were included. RESULTS: 71 cases of multi resistant tuberculosis (MRT) were included. The sex-ratio was 3.4. The age bracket from 30 to 39 was the most represented (39.4 %). A notion of tubercular contage was found in 18 (25.3%) patients. All MRT patient had histories of treatment including aminoside lasting more than 2 months. Intolerance of the treatment was reported in 57 patients. Intolerance predominated in 30 to 39 years olds and in Tuberculosis/HIV co-infected patients. The neurological (47.9%) and psychiatric (47.9%) infringements were the most represented. Vestibulocochlear impact was seen in 42.3% of cases with 18.3% reporting of total deafness. CONCLUSION: The intolerance of the antituberculous treatment of the second line is real focus for clinicians. Shorter timeframes would avoid certain therapeutic modifications thought to be at the origin of failures.

OBJECTIFS: Apprécier la tolérance des antituberculeux prescrits dans le traitement de la tuberculose multi résistante chez les patients suivis dans le service de Pneumologie du Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU YO). PATIENTS ET MÉTHODES: Il s'est agi d'une enquête longitudinale rétrospective et prospective. Les dossiers des patients ont permis de renseigner le questionnaire pour la phase rétrospective (2010­2011), le suivi des patients durant la phase prospective (2011­2013) a permis la collecte des données. Etaient inclus tous les patients sous traitement antituberculeux de 2ème ligne entre le 1er Janvier 2010 et le 31 Aout 2013. RÉSULTATS: Au total 71 cas de tuberculose multi résistante (TB-MDR) ont été recrutés. Le sex- ratio était 3,4. La tranche d'âge de 30 à 39 était la plus représentée (39,4%). Une notion de contage tuberculeux a été retrouvée chez 18 (25,3%) des patients. Tous les patients TB-MR avaient des antécédents de traitement incluant des aminosides de durée supérieure à 2 mois. L'intolérance au traitement a été rapportée chez 57 patients. Elle prédominait chez les 30 à 39 ans et chez les sujets co-infectés Tuberculose/VIH. Les atteintes neurologiques (47,9%) et psychiatriques (47,9%) étaient les plus représentées. L'atteinte vestibulo-cochléaire était de 42,3% avec 18,3% de surdité totale. CONCLUSION: L'intolérance du traitement antituberculeux de deuxième ligne est un véritable hantise pour le clinicien. Des régimes plus courts éviteraient certainement des modifications thérapeutiques à l'origine de survenue d'échecs.

[Contribution of medical files for mining workers in Burkina Fasso]. / Apport du bilan medical chez le travailleur de mines au Burkina Faso.

INTRODUCTION: The inhalation of silica dust stemming from traditional mining in Burkina Faso is associated with a high amount of pneumoconiosis cases. A medical consultation performed before and after the hiring of a mine worker should allow authorities to make the diagnosis. MATERIAL AND METHOD: A cross-sectional retrospective study with descriptive aim was conducted from January, 2010 until December, 2012 including mine workers admitted in several health centers in Ouagadougou for medical check-ups. The data was collected by means of a questionnaire informed during the exploration of their files. RESULTS: 331 male mine workers, with an average age of 33.05 ± 5.9 years old [range: 21-54]. Among them, 224 (67.7%) had come for a pre-employment medical examination (PME).The consumption of tobacco and alcohol were found at more than 40 % of the worker of mine in the PME. No respiratory dysfunctions and very few thoracic radiographic anomalies (TR) had been recorded during the mine workers' PMEs. During the annual medical examination (AME) respiratory dysfunctional signs were recorded in 63.9% of the workers, dominated by exertional dyspnea (19.6%). Spirometry revealed obstructive ventilatory disorders in 40.9% of the worker. The TR showed small rounded opacities of type "p" and "q" in 33.3% of the cases. 57 worker (25.4%) were declared unfit during this AME. CONCLUSION: The medical check-up remains a strong avenue for the prevention of occupational diseases such as pneumoconiosis in all mine workers. They should serve not only as an individual precaution but as a collective measure.

INTRODUCTION: L'inhalation de la poussière de silice issue de l'exploitation minière artisanale au Burkina Faso est associée à bon nombre de cas de pneumoconiose. Un bilan médical avant et après l'embauche du mineur devrait permettre d'en faire le diagnostic. MATÉRIEL ET MÉTHODE: Il s'est agi d'une étude transversale rétrospective à visée descriptive de janvier 2010 à décembre 2012 chez des mineurs reçus dans des structures de soins de la ville de Ouagadougou pour des bilans de santé. Les données ont été collectées à l'aide d'un questionnaire renseigné au cours de l'exploitation de leurs dossiers. RÉSULTATS: Les 331 mineurs, tous de sexe masculin avaient un âge moyen de 33, 05 ± 5,9 ans [21- 54]. Parmi eux, 224 (67,7%) étaient venus pour une visite médicale d'embauche (VME). La consommation de tabac et d'alcool étaient retrouvée chez plus de 40% des mineurs à la VME. Aucun signe fonctionnel respiratoire et très peu d'anomalies radiographiques thoraciques (RT) avaient été rapportés chez les mineurs lors VME. A la visite médicale annuelle (VMA) les signes fonctionnels respiratoires étaient retrouvés chez 63,9% des mineurs, et dominés par la dyspnée d'effort (19,6%). La spirométrie révélait des troubles ventilatoires obstructifs (TVO) chez 40,9% des mineurs. La RT montrait des petites opacités arrondies de types « p ¼ et « q ¼ dans 33,3% des cas. Au total 57 mineurs (25,4%) ont été déclarés inaptes lors de cette VME. CONCLUSION: Le bilan de santé reste un maillon fort pour la prévention de l'apparition des maladies professionnelles dont la pneumoconiose chez tout travailleur de mines. Il devrait être complété aussi bien par des mesures préventives individuelles que collectives.

[Pseudo-tumoral aspergillus rhinosinusitis: About two cases]. / Aspergillose sinusienne invasive pseudo tumorale: à propos de deux cas.

INTRODUCTION: Pseudo-tumoral fongal rhinosinusitis is a rare and benign illness due to saprophyte germ, Aspergillus flavus. OBSERVATION: We reported two cases of invasive pseudo-tumoral fongal rhinosinusitis. CT scan helped with diagnosis and allowed for extension assessment. Complete surgical excision was done through external approach. Bacteriological examination evidenced the germ. DISCUSSION: Pseudo-tumoral invasive fongal rhinosinusitis remains a potentially serious pathology because of its local aggressiveness and its multiple extensions.

[State of tolerance of multi resistant tuberculosis treatment (Burkina Faso)]. / Etat des lieux sur la tolerance du traitement de la tuberculose multi resistante (Burkina Faso).

OBJECTIVES: Estimate the tolerance of antituberculous drugs prescribed in the treatment of multi resistant tuberculosis on patients followed in the service of Pneumology of the University hospital of Yalgado Ouedraogo. PATIENTS AND METHODS: It was a retrospective and prospective longitudinal investigation. The files of patients allowed to inform the questionnaire for the retrospective phase (2010-2011), the follow-up of patients during the prospective phase (2011-2013) allowed for data collection. All the patients under antituberculous treatment of 2nd line between January 1st, 2010 and the August 31st, 2013 were included. RESULTS: 71 cases of multi resistant tuberculosis (MRT) were included. The sex-ratio was 3.4. The age bracket from 30 to 39 was the most represented (39.4 %). A notion of tubercular contage was found in 18 (25.3%) patients. All MRT patient had histories of treatment including aminoside lasting more than 2 months. Intolerance of the treatment was reported in 57 patients. Intolerance predominated in 30 to 39 years olds and in Tuberculosis/HIV co-infected patients. The neurological (47.9%) and psychiatric (47.9%) infringements were the most represented. Vestibulocochlear impact was seen in 42.3% of cases with 18.3% reporting of total deafness. CONCLUSION: The intolerance of the antituberculous treatment of the second line is real focus for clinicians. Shorter timeframes would avoid certain therapeutic modifications thought to be at the origin of failures.

OBJECTIFS: Apprécier la tolérance des antituberculeux prescrits dans le traitement de la tuberculose multi résistante chez les patients suivis dans le service de Pneumologie du Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU YO). PATIENTS ET MÉTHODES: Il s'est agi d'une enquête longitudinale rétrospective et prospective. Les dossiers des patients ont permis de renseigner le questionnaire pour la phase rétrospective (2010­2011), le suivi des patients durant la phase prospective (2011­2013) a permis la collecte des données. Etaient inclus tous les patients sous traitement antituberculeux de 2ème ligne entre le 1er Janvier 2010 et le 31 Aout 2013. RÉSULTATS: Au total 71 cas de tuberculose multi résistante (TB-MDR) ont été recrutés. Le sex-ratio était 3,4. La tranche d'âge de 30 à 39 était la plus représentée (39,4%). Une notion de contage tuberculeux a été retrouvée chez 18 (25,3%) des patients. Tous les patients TB-MR avaient des antécédents de traitement incluant des aminosides de durée supérieure à 2 mois. L'intolérance au traitement a été rapportée chez 57 patients. Elle prédominait chez les 30 à 39 ans et chez les sujets co-infectés Tuberculose/VIH. Les atteintes neurologiques (47,9%) et psychiatriques (47,9%) étaient les plus représentées. L'atteinte vestibulo-cochléaire était de 42,3% avec 18,3% de surdité totale. CONCLUSION: l'intolérance du traitement antituberculeux de deuxième ligne est un véritable hantise pour le clinicien. Des régimes plus courts éviteraient certainement des modifications thérapeutiques à l'origine de survenue d'échecs.

[Epidemiology of bovine brucellosis in Mali: serologic investigation and initial isolation of strains of Brucella abortus]. / Epidémiologie de la brucellose bovine au Mali: enquête sérologique et isolement des premières souches de Brucella abortus.

The authors report the results of an epidemiological survey of bovine brucellosis in Mali, based on a relatively representative sample of 1,000 serum samples from 236 herds. The prevalence of infection in the herds, established by indirect enzyme-linked immunosorbent assay (ELISA) was 53% +/- 6.4. The proportion of animals infected was 23.3% +/- 2.5, falling to 22% when compared with the basic serum pool of 9,466 samples. This rate was relatively high in stationary herds in the semi-arid, sub-humid and arid zones. Four strains of Brucella abortus were isolated from cattle bearing hygromas.