L’échographie doppler dans la prévention des amputations des membres inférieurs du diabétique en Côte d’Ivoire

ObjectiveThe aim of this study was to demonstrate the role of the Doppler ultrasound examination in the management of diabetic feet and particularly in the prevention of the diabetic's amputation.Patients and methodIt is about a retrospective study carried out over a 4-year period at Yopougon University Hospital (Abidjan, Côte d’Ivoire). It consisted in the analysis of the records of 78 patients hospitalized for diabetic foot and in whom was performed a Doppler ultrasound examination of the lower limbs vessels. The analysis of patients’ records helped to bring out the epidemiological, clinical, radiographic, biologic, therapeutic and evolutional elements.ResultsPatients’ mean age was 57.6 years. The sex ratio was 1.05. Adult diabetes accounted for 93.5% of cases and had been developing for 11.49 years on average. On the Doppler ultrasound scan of the lower limbs arterial anomalies of these limbs were found in 70 cases. They were associated with a venous anomaly in four cases. Arterial anomalies were represented by stenosis (34 cases), occlusions (10 cases), medialarterosclerosis (four cases), small arteries (six cases) and the associations of several elementary lesions (nine cases). In three cases, the arterial abnormality was not indicated. A medical treatment was instituted for all the patients. The outcome was favorable for 61 patients, 13 were amputated and four deaths were recorded.ConclusionColor Doppler ultrasound examination of lower limbs vessels helped to bring out a vascular anomaly in 89.7% of patients with diabetic foot whose treatment helped to keep the lower limb in 78.2%. We recommend the systematic request of this examination in the African diabetic with adult diabetes which has been developing for more than 10 years before the onset of diabetic foot.     

Performance et vulgarisation de l’écho-Doppler par couplage sus-pubien et endovaginal dans le diagnostic précoce des grossesses extra-utérines en Côte d’Ivoire

ObjectiveThe aim of our study was to describe the epidemiological profile of ectopic pregnancies (EP) in Côte d’Ivoire and to show the utility of ultrasound Doppler in the early diagnosis of EP.Patients and methodOur prospective study had been carried out for 24 months (from February 2006 to January 2008). It concerned 32 cases of ectopic pregnancy discovered at the suprapubic or endovaginal ultrasound scan with or without Doppler use.ResultsThe frequency of ectopic pregnancies was estimated at 1.7%. Patients’ mean age was 26.2 years. The personal history was dominated by abortions (32%) and adnexal infections (20%). Most of the patients were nulliparous (52.5%). Requests for ultrasound scans were motivated for most of them by metrorrhagia. The ectopic pregnancy was diagnosed at the ruptured stage in 65.6% of the cases (21 patients) and at the nonruptured stage in 34.4 % of the cases (11 patients). In six cases of nonruptured stage, we used the Doppler. The elementary lesions found were hematosalpinx in 40.6% of the cases, embryonate ectopic gestational sac (31.3%) and nonembryonate ectopic gestational sac (18.7%). In three cases (9.4%), no elementary lesions were found.Conclusionin Côte d’Ivoire, the ectopic pregnancy concerns a very young nulliparous population with abortion and adnexal history. The use of color signal of Doppler added to the endovaginal ultrasound scan, allows establishing the diagnosis at the early stage.     

Nouvelle stratégie dans le diagnostic,la prévention et le suivi de l’ostéonécrose drépanocytaire en Côte d’Ivoire à partir de la scintigraphie osseuse

Osteonecrosis is the most frequent complications of sickle-cell disease (SCD) whose prevalence in Côte d’Ivoire is 21%. The main of this study was to compare scintigraphy, clinical and radiological observations to assess earlier diagnosis in SCD osteonecrosis. It was a prospective study about 45 SCD patients who presented coxopathy and had radio-labelled diphosphonates bone scintigraphy. The results revealed 49% of lesions whose 48% appeared wiyh homogeneous hyperfixation, 11% homogeneous hypofixation, 5% of hypofixation contourned by hyperfixation. Eighty-one percent of lesions concerned femoral head, 6% femoral condyle and 3% humoral head. Fifty percent of osteonecrosis was not visible in radiology and corresponded to the earlier stade. These invisible radiology aspects were observed in 100% hips without lameness, and in 43% permanent lameness. Scintigraphy (sensitive in 100%) isolated 38% more than conventional radiography. In main to improve SCD osteonecrosis prognostic in Côte d’Ivoire, this preliminary study outline that scintigraphy is fundamental in management.     

Enjeux,défis,opportunités et stratégie durable d’implantation de l’imagerie hybride TEMP/TDM dans un pays à ressources médicales limitées,la Côte d’Ivoire

From HO Anger's analogic gamma camera to digital camera, developed countries are at the time of hybrid cameras SPECT/CT and PET/CT. Sub-Saharan black Africa in the image of Côte d’Ivoire, a country with limited medical resources shows an important delay in the evolution of the health system in general and particularly in medical imaging equipment. The purpose of this paper was to approach the issues, challenges and sustainable strategy for the implementation of hybrid imaging SPECT/CT in a developing country where the rate of morbidity and mortality remains high due to infectious but also cancer diseases because of the inadequacy of the health technical platform. To address these challenges, Côte d’Ivoire like many countries in sub-Saharan Africa with limited medical resources must design, test and develop clinical strategies adapted to developing countries. Health authorities of this country must develop a policy for sustainable financing of medical imaging, including the training of the adequate health personnel according to a model of corporate leadership. In this perspective, Côte d’Ivoire must have a SPECT/CT instead of a simple gamma camera. This would allow to optimize its diagnostic health system in oncology, bone and joint disease and in many other medical disciplines. And especially since the SPECT/CT is a high-performance device that has largely demonstrated its diagnostic efficiency and that can be used as SPECT alone or as isolated CT. In addition, this country should take over digital imaging in the context of cooperation with some countries of Africa and Europe ahead in the field of modern medical imaging, seeking assistance from international organizations (IAEA, RAD-AID, WHO,…). Finally this country should implement methods of assessment, types of performance indicators to guide planning for future projects of its system.     

Première découverte d’un squelette de Channidae (Poisson téléostéen) dans le Miocène inférieur d’Illerkirchberg, près d’Ulm (Wurtemberg, Allemagne)

A skeleton of a Channid fish is reported for the first time from the European Lower Miocene. Because of the lack of any appropriate diagnostic character, it is nevertheless impossible to determine if it belongs either to the Asiatic genusChanna Scopoli or to the African one,Parachanna Teugels &Daget. For this reason, its palaeobiogeographical significance remains unclear. Otoliths (sagitta) that very likely belong to the same Channid species have been described from Illerkirchberg asChanna elliptica (vonSalis). They are compared to the sagitta from recent species of the generaChanna (Scopoli) andParachanna (Teugels &Daget). Their morphological characters are intermediate between those characterizing the sagitta of both genera.     

Determinants of bushmeat supply sources in rural areas of Côte d’Ivoire

The bushmeat trade provides an income to hunters, transporters, and vendors living in the vicinity of protected areas but remains a challenge to wildlife conservation objectives. The key factors driving the source, choice and use of bushmeat vary among actors in the commercial bushmeat value chain, and insights into these determinants are required to facilitate the development of conservation strategies. Therefore, we aimed to identify the socioeconomic factors that explain the source of supply and quantities of bushmeat available in households and local restaurants. We carried out a survey with 144 rural household heads and 24 restaurant owners in 20 villages in the Western part of Taï National Park in Côte d’Ivoire. We found that bushmeat quantity and species diversity were low in households, originating mainly from subsistence hunting. However, both the amount of bushmeat and the variety of species were high in restaurants and primarily supplied by commercial hunters. Furthermore, the quantity of bushmeat was lower in households with other protein sources and in restaurants in villages that had been the target of more conservation awareness campaigns. We highlight the importance of understanding the determinants of bushmeat supply to regulate the bushmeat trade by applying relevant conservation interventions.     

Prostasomes, dérivés actifs de l’oxygène et sperme humain

Prostasomes are particular lipid vesicles secreted by the human prostate and found in the semen. No specific action has yet been attributed to prostasomes, but they appear to act at various levels. For example, prostasomes enhance sperm motility in vitro and participate in the immunomodulation properties of seminal plasma. Excessive production of reactive oxygen species (ROS) in human semen has a negative influence on the functional capacities of spermatozoa. The presence of leukocytes in semen is associated with increased production of ROS that can be harmful to sperm cells, under certain conditions. Previous results tend to suggest a possible role of prostasomes on ROS production in human semen. After reviewing the literature concerning the structural and functional characteristics of prostasomes and the role of ROS in human semen, we report our results concerning the influence of prostasomes on ROS production and the consequences on semen. We have demonstrated that prostasomes exert an antioxidant function in human semen. This function is effective both on polymorphonuclear neutrophils and on sperm cells. The mechanism of action of prostasomes is unusual, as they act on ROS production mainly on the plasma membranes of neutrophils. They induce a decrease of NADPH-oxidase activity associated with rigidification of the plasma membrane. Prostasomes protect the functional capacities of spermatozoa during an oxidative stress created by the presence of NADPH in the incubation medium.     

Mapping malaria risk among children in Côte d’Ivoire using Bayesian geo-statistical models

ABSTRACT: BACKGROUND: In Cote d'Ivoire, an estimated 767,000 disability-adjusted life years are due to malaria, placing the country at position number 14 with regard to the global burden of malaria. Risk maps are important to guide control interventions, and hence, the aim of this study was to predict the geographical distribution of malaria infection risk in children aged <16 years in Cote d'Ivoire at high spatial resolution. METHODS: Using different data sources, a systematic review was carried out to compile and georeference survey data on Plasmodium spp. infection prevalence in Cote d'Ivoire, focusing on children aged <16 years. The period from 1988 to 2007 was covered. A suite of Bayesian geo-statistical logistic regression models was fitted to analyse malaria risk. Non-spatial models with and without exchangeable random effect parameters were compared to stationary and non-stationary spatial models. Non-stationarity was modelled assuming that the underlying spatial process is a mixture of separate stationary processes in each ecological zone. The best fitting model based on the deviance information criterion was used to predict Plasmodium spp. infection risk for entire Cote d'Ivoire, including uncertainty. RESULTS: Overall, 235 data points at 170 unique survey locations with malaria prevalence data for individuals aged <16 years were extracted. Most data points (n = 182, 77.4%) were collected between 2000 and 2007. A Bayesian non-stationary regression model showed the best fit with annualized rainfall and maximum land surface temperature identified as significant environmental covariates. This model was used to predict malaria infection risk at nonsampled locations. High-risk areas were mainly found in the north-central and western area, while relatively low-risk areas were located in the north at the country border, in the northeast, in the south-east around Abidjan, and in the central-west between two high prevalence areas. CONCLUSION: The malaria risk map at high spatial resolution gives an important overview of the geographical distribution of the disease in Cote d'Ivoire. It is a useful tool for the national malaria control programme and can be utilized for spatial targeting of control interventions and rational resource allocation.     

Rôle du pathologiste dans la prise en charge et le diagnostic d’une infection osseuse

The diagnosis of a bone infection is sometimes made difficult when clinical signs and imaging are not typical. In these cases, the role of a pathologist is important since he makes the diagnosis and improves the management of the infection. The main histopathological features of a bone infection and its complications, as well as the involvement of a pathologist in this pathology, are described in this article.     

Market Hunting in the Taï Region,Côte d’Ivoire and Implications for Monkey Populations

We studied the effect of market hunting on primate species in the Taï National Park and adjacent forests in Côte d’Ivoire. We assessed the impact of hunting by comparing the calculated maximal reproduction rate with the current off-take rate. We assessed the average bushmeat consumption per capita/per year from weekly investigations on bushmeat available in 88 bushmeat restaurants and markets over a 12-mo period in 1999. We derived data on preferences for particular game species from interviews of 162 bushmeat consumers, 25 subsistence hunters and 3 groups of professional hunters. Hunting pressure was highest on the larger primate species such red colobus (Procolobus badius), black- and- white colobus (Colobus polykomos) and sooty mangabeys (Cercocebus atys). The amount of primate bushmeat extracted from the Taï National Park and surrounding forests was 249,229 kg in 1999. We estimated population densities using line transect surveys. By referring to current population densities we calculated the maximum production of each species using the Robinson Redford model (2001) and assuming unhunted conditions. A comparison of current harvest levels with maximum production suggests that harvest of Procolobus badius is sustainable, whereas current off-take of Colobus polykomos, Cercocebus atys, Cercopithecus diana (diana monkey) and C. campbelli (Campbell’s monkeys) exceeds sustainability by ≤3 times. We recommend that wildlife managers promote programs that encourage the production of domestic animals as a substitute for wild meat.     

Occurrence of ochratoxin A in spices commercialized in Abidjan (Côte d’Ivoire)

Ochratoxin A (OTA) is a mycotoxin produced mostly by several species of Aspergillus and Penicillium. OTA is nephrotoxic in all animal species in which it has been tested and is cancerogenic in rodents. It is associated with Balkan endemic nephropathy. It is naturally present in many crop products such as cereals (barley, wheat, maize) and dried fruits, spices, coffee, wine, olives, and cocoa. The aim of this study was to assess the contamination of three Ivoirian spices with OTA (ginger, chili, and pepper) widely consumed by the population. A total of 90 spice samples (ginger: n?=?30; chili: n?=?30; pepper n?=?30) was taken from various sales outlets of Abidjan. OTA was quantified using an HPLC apparatus coupled with a fluorimetric detector. The chili and ginger samples were contaminated with OTA at a mean concentration of 57.48?±?174 and 0.12?±?0.15 μg/kg, respectively. No contamination of the pepper samples was detected. Eight (26.67 %) of the chili samples exceeded the maximum limit of 15 μg/kg established by European regulation. These results should serve as an alert on the risk to the consumer population of these products that are highly contaminated with OTA.     

L'acide ascorbique ou vitamine C dans la cellule et sa détection

Résumé La répartition si générale de l'acide ascorbique dans tous les éléments végétaux et animaux semble indiquer que ce corps joue un rôle général et fondamental. Mais cette répartition n'est pas homogène. Elle varie beaucoup avec les organes. Sa concentration si élective dans certaines cellules parait correspondre à des propriétés fonctionnelles communes à tous ces éléments.Histochimiquement on peut déceler l'acide ascorbique jusque dans la cellule où sa présence se localise au cytoplasma ou même à certains de ses organites: chondriome, appareil de Golgi.Sa mise en évidence y dépend de divers facteurs et en particulier de la présence d'autres substances qui bloquent son pouvoir réducteur: ce dernier fait n'est peut être pas sans importance physiologique.     

L'erreur dans la détermination histophotométrique de l'acide désoxyribonucléique et la variation individuelle des noyaux en acide désoxyribonucléique

Sans résumé