Les complications urinaires des traumatismes du bassin: aspects anatomocliniques et thérapeutiques au CHU de Conakry, Guinée

Objective

To stick out the anatomoclinic aspects and to evaluate the therapeutic results of a series of some pelvic trauma complications is followed at the Urology-Andrology ward in the teaching hospital of Conakry.

Material and method

It’s about a retrospective examined joining together 52 cases of some pelvic trauma complications in a period of five years.

Results

The pelvic trauma complications were representing 3% of whole the hospitalisations during the period of study. The mean age of our patients was 33 years with extremes of 10 and 63 years. The traumas were due to accidents on the public road in 54.9% of cases. In terms of clinics, the symptomatology was essentially constituted by the acute retention of urines with 80.7% of cases and the hemorrhage (hematury and uretrorragy). The main trauma was a back urethral lesion with 82.7% of cases. All the patients profited a surgical treatment. The therapeutics has been judged after an average relapse of 52 months in terms of urinary and sexual complications. Thus, in terms of urinary complications results have been judged good in 59.6% of cases, less in 17.3% and bad in 23.7% of cases. In terms of sexual, we remarked 53.8% of good result, 25% of medium results and 21.2% (N = 11) of bad results.

Conclusion

Management of urinary complication after pelvic trauma is controversy. Thus, we insist on more necessary collaboration between urologist and orthopedist because the stabilisation of the pelvic trauma is very interesting to the management.     

Identification by PCR of Non-typhoidal Salmonella enterica Serovars Associated with Invasive Infections among Febrile Patients in Mali

Background

In sub-Saharan Africa, non-typhoidal Salmonella (NTS) are emerging as a prominent cause of invasive disease (bacteremia and focal infections such as meningitis) in infants and young children. Importantly, including data from Mali, three serovars, Salmonella enterica serovar Typhimurium, Salmonella Enteritidis and Salmonella Dublin, account for the majority of non-typhoidal Salmonella isolated from these patients.

Methods

We have extended a previously developed series of polymerase chain reactions (PCRs) based on O serogrouping and H typing to identify Salmonella Typhimurium and variants (mostly I 4,[5],12:i:-), Salmonella Enteritidis and Salmonella Dublin. We also designed primers to detect Salmonella Stanleyville, a serovar found in West Africa. Another PCR was used to differentiate diphasic Salmonella Typhimurium and monophasic Salmonella Typhimurium from other O serogroup B, H:i serovars. We used these PCRs to blind-test 327 Salmonella serogroup B and D isolates that were obtained from the blood cultures of febrile patients in Bamako, Mali.

Principal Findings

We have shown that when used in conjunction with our previously described O-serogrouping PCR, our PCRs are 100% sensitive and specific in identifying Salmonella Typhimurium and variants, Salmonella Enteritidis, Salmonella Dublin and Salmonella Stanleyville. When we attempted to differentiate 171 Salmonella Typhimurium (I 4,[ 5],12:i:1,2) strains from 52 monophasic Salmonella Typhimurium (I 4,[5],12:i:-) strains, we were able to correctly identify 170 of the Salmonella Typhimurium and 51 of the Salmonella I 4,[5],12:i:- strains.

Conclusion

We have described a simple yet effective PCR method to support surveillance of the incidence of invasive disease caused by NTS in developing countries.     

A complement fixing polysaccharide from Biophytum petersianum Klotzsch, a medicinal plant from Mali, West Africa

Biophytum petersianum Klotzsch (syn. Biophytum sensitivum (L.) DC) is a medicinal plant having a traditional use, among others, as a wound healing remedy in Mali and other countries. As a water extract of the aerial parts of the plant is a frequently used preparation, we decided to look for a bioactive polysaccharide in this extract. One of the obtained polysaccharide fractions, BP100 III, isolated from a 100 degrees C water extract from the aerial parts of B. petersianum and having a monosaccharide composition typical for pectic substances, was shown to exhibit potent dose-dependent complement fixating activity. The BP100 III fraction was subjected to degradation by endo-alpha-d-(1-->4)-polygalacturonase, and three fractions were obtained by gel filtration. The highest molecular weight fraction, BP100 III.1, had a more potent activity in the complement test system than the native polymer, while the two lower molecular weight fractions were less active than the native polymer. The major part of BP100 III.1 consists of galacturonic acid and rhamnose, with branches being present on both the rhamnose and galacturonic acid residues. Arabinogalactan type II is also present in the polymer, indicating that BP100 III.1 has a structure typical of the hairy region of pectins. The major part of the two other fractions is a galacturonan, containing a strikingly high number of branch points, some to which xylose is attached. These results indicate that the pectic substance in B. petersianum contains both rhamnogalacturonan and xylogalacturonan regions.     

Schistosomiasis Coinfection in Children Influences Acquired Immune Response against Plasmodium falciparum Malaria Antigens

Background

Malaria and schistosomiasis coinfection frequently occurs in tropical countries. This study evaluates the influence of Schistosoma haematobium infection on specific antibody responses and cytokine production to recombinant merozoite surface protein-1-19 (MSP1-₁₉) and schizont extract of Plasmodium falciparum in malaria-infected children.

Methodology

Specific IgG1 to MSP1-₁₉, as well as IgG1 and IgG3 to schizont extract were significantly increased in coinfected children compared to P. falciparum mono-infected children. Stimulation with MSP1-₁₉ lead to a specific production of both interleukin-10 (IL-10) and interferon-γ (IFN-γ), whereas the stimulation with schizont extract produced an IL-10 response only in the coinfected group.

Conclusions

Our study suggests that schistosomiasis coinfection favours anti-malarial protective antibody responses, which could be associated with the regulation of IL-10 and IFN-γ production and seems to be antigen-dependent. This study demonstrates the importance of infectious status of the population in the evaluation of acquired immunity against malaria and highlights the consequences of a multiple infection environment during clinical trials of anti-malaria vaccine candidates.     

Losartan attenuates neuroinflammation and neuropathic pain in paclitaxel‐induced peripheral neuropathy

Paclitaxel‐induced peripheral neuropathy (PIPN) is often associated with neuropathic pain and neuroinflammation in the central and peripheral nervous system. Antihypertensive drug losartan, an angiotensin II receptor type 1 (AT1R) blocker, was shown to have anti‐inflammatory and neuroprotective effects in disease models, predominantly via activation of peroxisome proliferator‐activated receptor gamma (PPARγ). Here, the effect of systemic losartan treatment (100 mg/kg/d) on mechanical allodynia and neuroinflammation was evaluated in rat PIPN model. The expression of pro‐inflammatory markers protein and mRNA levels in dorsal root ganglia (DRGs) and spinal cord dorsal horn (SCDH) were measured with Western blot, ELISA and qPCR 10 and 21 days after PIPN induction. Losartan treatment attenuated mechanical allodynia significantly. Paclitaxel induced overexpression of C‐C motif chemokine ligand 2 (CCL2), tumour necrosis alpha (TNFα) and interleukin‐6 (IL‐6) in DRGs, where the presence of macrophages was demonstrated. Neuroinflammatory changes in DRGs were accompanied with glial activation and pro‐nociceptive modulators production in SCDH. Losartan significantly attenuated paclitaxel‐induced neuroinflammatory changes and induced expression of pro‐resolving markers (Arginase 1 and IL‐10) indicating a possible shift in macrophage polarization. Considering the safety profile of losartan, acting also as partial PPARγ agonist, it may be considered as a novel treatment strategy for PIPN patients.     

Protection influence on grassland structure in Widou Thiengoly's grazing areas at Ferlo

This work consisted of analysing the impact of protection on the Widou Thiengoly's grasslands structure. Data were collected from three selected sites by the quadrat point methodology, consisting of reading the herbaceous on a 10 m line. These sites were the 2013 defended plot (site A), the 2009 semi‐protected plot (site B) and the unprotected grazing areas or off plot (site C). The results revealed a floristic composition of 45 species, belonging to 34 genera and 17 botanical families. The number of species identified was 28 in site A, 31 in site B and 29 in site C. Despite a certain similarity noted in the number of species, the herbaceous vegetation was more balanced in 2013 plot than in 2009 plot and in off plot where it tended to be homogeneous. The herbaceous cover in October 2015 was 99.8% in the 2013 plot; 98.8% in the 2009 plot; and 96.8% in the unprotected sites. The vertical stratification of herbaceous cover showed a better development at the intermediate strata (between 20 cm and 50 cm) in all the sites except in off plot where small grasses dominated. In this study, protection improved the specific balance, while semi‐protection had a positive effect on the specific richness and growth of the grasses.     

Reproductive Isolation among Sympatric Molecular Forms of An. gambiae from Inland Areas of South-Eastern Senegal

The Anopheles gambiae species complex includes at least seven morphologically indistinguishable species, one of which, Anopheles gambiae sensu stricto, is the primary mosquito vector responsible for the transmission of malaria across sub-Saharan Africa. Sympatric ecological diversification of An. gambiae s.s. is in progress within this complex, leading to the emergence of at least two incipient species (the M and S molecular forms now recognized as good species and named An. coluzzii and An. gambiae respectively) that show heterogeneous levels of divergence in most parts of Africa. However, this process seems to have broken down in coastal areas of West Africa at the extreme edge of the distribution. We undertook a longitudinal study to describe An. gambiae s.s. populations collected from two inland transects with different ecological characteristics in south-eastern Senegal. Analysis of samples collected from 20 sites across these two transects showed the M and S molecular forms coexisted at almost all sampled sites. Overall, similar hybridization rates (2.16% and 1.86%) were recorded in the two transects; sites with relatively high frequencies of M/S hybrids (up to 7%) were clustered toward the north-western part of both transects, often near urban settings. Estimated inbreeding indices for this putative speciation event varied spatially (range: 0.52–1), with hybridization rates being generally lower than expected under panmictic conditions. Such observations suggest substantial reproductive isolation between the M and S molecular forms, and further support the ongoing process of speciation in these inland areas. According to a recent reclassification of the An. gambiae complex, the M and S molecular forms from this zone correspond to An. coluzzii and An. gambiae, respectively. There is considerable evidence that these molecular forms differ in their behavioural and ecological characteristics. Detailed study of these characteristics will allow the development and implementation of better insect control strategies for combating malaria.     

Compatibility of Stabilized Whole Blood Products with CD4 Technologies and Their Suitability for Quality Assessment Programs

Background

CD4 T cell enumeration is the most widely used prognostic marker for management of HIV disease. Internal quality control and external quality assessment (EQA) programs are critical to ensure reliability of clinical measurements. The utility of stabilized whole blood products (SWBP) as a test reagent for EQA programs such as Quality Assessment and Standardization for Immunological measures relevant to HIV/AIDS (QASI) program have been demonstrated previously. Since then, several new commercial SWBPs and alternative CD4 enumeration technologies have become available. Seven SWBPs were evaluated on seven different enumeration platforms to determine which product(s) are most suitable for EQA programs that support multiple analytical technologies.

Method

Assessment of SWBPs was based on two criteria: (1) accuracy of CD4 T cell measurements and; (2) stability under sub optimal storage conditions.

Results

Three SWBPs (Multi-Check, StatusFlow and CD4 Count) showed accurate CD4 T-cell absolute count and percentage values across six of the enumeration platforms. All products retain stability up to 18 days at 21–23°C with the exception of Multi-Check-high on FacsCount and Multi-Check-Low and StatusFlow-Low on Pima. One of the products (CD4 Count) retained stability for three days on all platforms tested when stored at 37°C.

Conclusion

This study demonstrated that the characteristics of commercially available SWBPs vary across multiple CD4 platforms. The compatibility of testing panels for EQA programs with multiple analytical platforms needs to be carefully considered, especially in large multiplatform CD4 EQA programs. The selection of a suitable cross-platform SWBP is an increasing challenge as more reagents and platforms are introduced for CD4 T-cell enumeration.     

Early infant feeding practices in three African countries: the PROMISE-EBF trial promoting exclusive breastfeeding by peer counsellors

Background

Immediate and exclusive initiation of breastfeeding after delivery has been associated with better neonatal survival and child health and are recommended by the WHO. We report its impact on early infant feeding practices from the PROMISE-EBF trial.

Methods

PROMISE-EBF was a cluster randomised behaviour change intervention trial of exclusive breastfeeding (EBF) promotion by peer counsellors in Burkina Faso, Uganda and South Africa implemented during 2006-2008 among 2579 mother-infant pairs. Counselling started in the last pregnancy trimester and mothers were offered at least five postnatal visits. Early infant feeding practices: use of prelacteal feeds (any foods or drinks other than breast milk given within the first 3 days), expressing and discarding colostrum, and timing of initiation of breastfeeding are presented by trial arm in each country. Prevalence ratios (PR) with 95% confidence intervals (95%CI) are given.

Results

The proportion of women who gave prelacteal feeds in the intervention and control arms were, respectively: 11% and 36%, PR 0.3 (95% CI 0.2, 0.6) in Burkina Faso, 13% and 44%, PR 0.3 (95% CI 0.2, 0.5) in Uganda and 30% and 33%, PR 0.9 (95% CI 0.6, 1.3) in South Africa. While the majority gave colostrum, the proportion of those who expressed and discarded it in the intervention and control arms were: 8% and 12%, PR 0.7 (95% CI 0.3, 1.6) in Burkina Faso, 3% and 10%, PR 0.3 (95% CI 0.1, 0.6) in Uganda and 17% and 16%, PR 1.1 (95% CI 0.6, 2.1) in South Africa. Only a minority in Burkina Faso (<4%) and roughly half in South Africa initiated breastfeeding within the first hour with no large or statistically significant differences between the trial arms, whilst in Uganda the proportion of early initiation of breastfeeding in the intervention and control arms were: 55% and 41%, PR 0.8 (95% CI 0.7, 0.9).

Conclusions

The PROMISE-EBF trial showed that the intervention led to less prelacteal feeding in Burkina Faso and Uganda. More children received colostrum and started breastfeeding early in the intervention arm in Uganda. Late breastfeeding initiation continues to be a challenge. No clear behaviour change was seen in South Africa.

Trial registration

NCT00397150.