[Lactic acidosis in resuscitation].
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Acidosis↗
Biomedical subjects
A Diallo
Publications and source records attributed to A Diallo.
[Retroperitoneal mesenchymatous tumor. A case of lipogranuloxanthoma].
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Journal Article↗
[Hemorrhagic necrosis of the adrenal glands].
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Adrenal Cortex Hormones↗
[Massive rise in S.G.O.T. in cardiology (Literature review apropos of 6 cases)].
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Adult↗
Hepatitis-E-virus-associated antigen: improved detection in stools by protein Fv removal.
ELISA detection of a hepatitis-E-virus-associated antigen (HEV-AAg) in stools was reappraised for its possible interference with a new Fab-binding factor, termed protein Fv, released during infectious hepatitis. Transaminase elevation, HEV-AAg discharge and Fv leakage appeared simultaneously in a Cercopithecus monkey inoculated with infected stools. Labelled normal, or immune human IgG, were compared with pre- and post-inoculation simian IgG, for HEV-AAg and Fv detection. Coated normal and patient human IgM were also compared to pre- and post-inoculation simian IgM in HEV-AAg and Fv capture assays. Simian IgM and beta-galactosidase-labelled simian IgG minimized Fv interference and appeared to be the best adapted system for HEV-AAg detection. Nevertheless, Fv was still the cause of false-positive interpretations in some cases; therefore adsorption with monoclonal IgM was required to ensure HEV specificity. The improved test was performed on stools from 30 Senegalese patients hospitalized for various sporadic attacks of viral hepatitis. HEV-AAg was detected in 6 out of 30 cases and no positivity was observed in patients suffering from hepatitis due to HAV, HBV, cytomegalovirus or Epstein-Barr virus. The specificity of the assay was confirmed by inhibition experiments with the sera from HEV-infected patients. Hence, this inhibition assay can also be used to detect serum antibodies to HEV-AAg.
Animals↗
[Cholera epidemic in Senegal in 1995-1996: an example of geographic approach to health].
There have been many cholera outbreaks in Senegal since 1971. The last outbreak began in the Dakar region in August 1995. It spread to the Diourbel, Fatick, Saint-Louis and Thies regions. In January 1996, the outbreak hit the Niakhar study area in the Fatick region. A team from ORSTOM (the French Institute of Scientific Research for Development in Cooperation) has been recording demographic events in this area for almost 15 years. The geographic approach is based on the automated mapping of cholera in hamlets and villages. Such studies investigate the factors determining the spread of diseases, within the context of land use. Three sets of data were used: demographic data that had been routinely collected and were available from a database, digitized maps and epidemiological data from a surveillance system set up to monitor the outbreak. A series of incidence maps, over time and on various scales, were generated using specialized software. The maps were analyzed and the outbreak was found to be heterogeneous over time. There were two waves of the outbreak and differences according to age and gender. The degree of heterogeneity depended on the place of residence. Heterogeneity was probably determined by village size, roads and the concentration of inhabitants within hamlets, which is roughly equivalent to the number of people per bore hole. These preliminary results suggest that further research is necessary, looking at different geographical scales (e.g. households, districts and regions). Qualitative studies of water use and the organization of the water supply are also required.
Adolescent↗
[Climate variability and number of deaths attributable to malaria in the Niakhar area, Senegal, from 1984 to 1996].
There are a number of reasons why climate, in certain physical and social environments, could have an impact on the epidemiology of malaria. Events, such as floods or drought, are related to the number of malaria cases and deaths, both seasonally and interannually. At a smaller scale, this study analyses the relation between climate variability and the variability in the number of deaths attributable to malaria in Niakhar, Senegal. The Niakhar area has a population of 30,000 and has been under demographic surveillance system since 1984. The rainfall in this region is highly seasonal, with a rainfall maximum in August and almost no rain between October/November and May/June. In addition to this seasonal cycle, rainfall also varies greatly from year to year (interannual variation). Over the 13 years, there were 661 deaths attributed to malaria with a marked interannual variability (range from 23 to 100, with a median of 43). There was also a strong seasonality in mortality, with nearly all deaths (89.1%) occurring between August and December. The number of deaths peaks in October, two months after the rainfall peak. Standardised monthly values were calculated for each climatic series (rainfall, relative humidity, temperature) as well as standardised five-month and monthly values of the number of deaths attributed to malaria between August and December. Correlation coefficients were calculated between these standardised values. The correlation between the variability in August rainfall and the variability in the number of deaths attributed to malaria between August and December was positive and statistically significant (r = +0.61, p = 0.02). In addition, highly significant cross-correlations were found between monthly rainfall series and monthly mortality series at one- and two-month lag (r = + 0.43, p = 0.0004 for one-month lag; r = + 0.26, p = 0.03 for two-month lag). This correlation is somewhat lower than the correlation of August rainfall alone with August to December mortality, but the result adds confidence to the signal given the increased degrees of freedom in the analysis. Similar, but slightly weaker, results were found when precipitation data were replaced with surface humidity data. Results with temperature were less clear; while temperature could in some circumstances have a direct impact on malaria, in this case here it is possible that the weak negative correlation between malaria deaths and temperature arises mainly because precipitation is physically connected to both the indices, correlating positively with malaria and negatively with temperature. The availability of a continuous demographic and medical survey since 1984 in a region of highly variable rainfall has created a rare opportunity to analyse with some confidence a climate versus malaria relationship. The findings are consistent with our understanding of the proposed link between rainfall and conditions for the reproduction of the malaria vector, leading to a lag time (here of one to two months) between anomalies of rainfall and deaths attributable to malaria. These results may have practical implications in Sub-Saharan regions marked by a great seasonal and interannual variability in rainfall by providing a simple tool to forecast the impact of climate variability on malaria mortality.
Animals↗
[Investigation of a shigellosis outbreak in a rural zone of Senegal].
The investigation of this outbreak took place in Niakhar (IRD project study area), a rural area located 150 km East of Dakar. Covering 30 villages, with a population of about 30,000 inhabitants, the area has been under demographic and epidemiological surveillance. In 1999, the surveillance allowed 973 cases of shigellosis to be recorded out of 1,751 cases of dysenteric diarrhoeas. The outbreak reached a peak during the raining season (73% of the cases in September and October). All the villages and all age groups were concerned. The attack rate in the population was 3%. During the same period, 22 deaths were attributed to shigellosis, leading to a lethality of 2.3%. Children under five were the most affected. The bacteriological examination isolated S. flexneri in 72% of 12 stools samples and S. dysenteriae A1 (SD1) in 14%. All serotypes were resistant to ampicillin and susceptible to quinolones. Susceptibility to cotrimoxazole was unconstant. Apart from the usual factors involved in the spread of diarrhoeas, the main reason evoked to explain the duration of the epidemic has been the lack of adequate emergency antibiotherapy treatment. Quinolones, recommended by the health authorities, could not be provided by health services. The identification of the SD1 serotype confirmed its involvement in the outbreak of shigellosis. The exact role of S. flexneri in shigellosis epidemics should be further studied.
Adolescent↗
[Prevalence of hypertension in Guinean rural areas].
OBJECTIVE: To determine the prevalence and awareness of HTA in Guinean rural populations with respect to age and gender. DESIGN AND SETTING: Cross-sectional survey in rural Guinea: Köpèrè-Döfili (400 inhabitants) and Töbölön (900 inhabitants). PARTICIPANTS: 188 subjects (81 in Köpèrè-Döfili and 107 in Töbölön), 15 years and older were visited in their homes between November 2000 and April 2001. METHODS: The blood pressures were measured with an electronic tensiometer "Philips HF305". Awareness of HTA and risk factors were determined by interviews. HTA was defined as mean SBP/DBP = 140/90 mmHg. RESULTS: Overall, 69% (56/81) in Köpèrè-Döfili and 27% (29/107) in Töbölön were hypertensive. Among these, only 2 (Köpèrè) and 6 patients (Töbölön) were aware of their condition. HTA was strongly gender dependent in Köpèrè where 98% (44/45) of the males were concerned. In Köpèrè-Döfili, the combined systolo-diastolic hypertension (SDH) was predominant (80%; 45/56) and was associated to the male gender (80%; 36/45). In the hypertensive population of Töbölön, the isolated PAD (DH) was mainly associated with the female group (47%, 8/17). The grade III HTA (PAS/PAD > or = 180/110 mmHg) concerned both gender (41%, 18/44 for males; 42%, 5/12 for females) in Köpèrè-Döfili and mainly the female group in Töbölön (29%, 5/17). Smoking was the most frequently associated risk factor in the studied population of Köpèrè-Döfili (70%) and Töbölön (45%). The smokers were predominantly female in Köpèrè-Döfili (89%, 32/36) or male in Töbölön (51%, 24/47). Among the smokers, the hypertensive individuals were 96% (24/25) of the males and 38% (12/32) of the females in Köpèrè, 29% (7/24) of the males and 38% (9/24) of the females in Töbölön. CONCLUSION: Hypertension is highly prevalent in two Guinean rural localities where less than 5% of the studied population were aware of their conditions, suggesting the nationwide demand for preventing and controlling HTA in Guinea.
Adolescent↗
Serological markers of pulmonary tuberculosis and of response to anti-tuberculosis treatment in a patient population in Guinea.
The aim of the study was to evaluate serological correlates of active tuberculosis and of response to antituberculosis treatment in a cohort of HIV-negative patients with pulmonary tuberculosis studied at diagnosis and during treatment at the Service de Pneumo-Phtisiologie, Centre Hospitalier-Universitaire Ignace Deen, Conakry, Republic of Guinea. Two similar cohorts of HIV-negative healthy households of patients and healthy community controls were included in the study. Plasma samples were obtained from 168 untreated tuberculosis patients, 167 healthy household controls, and 168 healthy community controls. Serial plasma samples were also obtained from the tuberculosis patients at 2 and 8 months after initiation of chemotherapy. IgG antibody levels were measured by an enzyme-linked immunosorbent assay (ELISA) using ten purified M. tuberculosis antigens. ELISA results were analysed by comparing geometric means of data. Of the ten antigens tested, five (14kDa Ag, 19kDa Ag, AlaDH, MS, and MPT83) elicited similar antibody responses in untreated TB patients and controls. In contrast, levels of three antibodies (ESAT-6, LAM, and 38kDa Ag) were higher in untreated TB patients than in household or community controls (p<0.0001). Levels were higher in untreated patients than in community controls also for the anti-Rv2626c antibody (p = 0.0001) and, at a lower significance level, for the anti-FdxA antibody (p<0.025). Antibody levels against ESAT-6 and Rv2626c decreased during therapy, while antibody levels to the 38 kDa antigen and LAM increased during therapy; FdxA antibody levels did not vary with treatment. Neither severity of presentation nor chest X-ray patterns affected levels of these antibodies before treatment. In contrast, after the 8-month therapeutic course, patients who presented with moderate/severe disease had higher levels of anti-ESAT-6, anti-FdxA, and anti-38kDa antibodies than those of patients with mild disease onset. Patients with bilateral lung lesions had significantly higher anti-38kDa and anti-LAM levels, both at diagnosis and after 8-month treatment, than patients with lesions involving only one lung. Antibodies to alanine dehydrogenase and malate synthetase measured at initiation of treatment were higher in tuberculosis patients who subsequently failed therapy than in those who were cured. The main conclusions of the study are: a) plasma levels of antibodies to a number of M. tuberculosis represent serological correlates of active disease; b) these correlates are affected in an antigen-specific fashion by anti-tuberculosis treatment; c) particular serological markers may be predictive of treatment outcome.
Adolescent↗
[From suspicion to diagnosis. Clinical, epidemiological, radiological and endoscopic aspects of bronchopulmonary cancer in Senegal. Apropos of 700 endoscopies performed at the Principle Hospital of Dakar from 1987 to 1990].
700 bronchial endoscopies were performed over a period of three years at the Dakar "Hôpital Principal". 40 bronchopulmonary cancers were identified (34 epidermoid, 4 adenocarcinoma, 2 with "small cells") out of 80 suspect cases. When we examine the clinical, radiological, endoscopic features, we are able to classify the following as the most established facts: 1. Higher radiological frequency of the pulmonary retractile condensation syndrome (40 cases). 2. Main frequency of proximal granulated tumors (45) in comparison with endoscopic bronchial stenosis (22). 3. Identification almost exclusive of bronchial epidermoid cancer in that series (34). 4. Male sex and smoking are two unequivocal elements of that pathology. Bronchial endoscopy, absolutely necessary test easy to perform and to get, enables to visualize a lesion and to bring forward the indisputable histological evidence through the biopsy either alone or associated with endoscopic brushing and alveolar washing.
Adult↗
[Pseudomembranous colitis after antibiotic therapy associated with the presence of Entamoeba histolytica histolytica. Apropos of 2 cases].
The authors report on two cases of pseudomembranous colitis (P.M.C.) developed in two Senegalese women of 38 and 36 years, and discovered at the 4th and 5th day respectively of an antibiotherapy based on ampicillin. In these two observations, cysts of Entamoeba histolytica histolytica were found in both feces and biopsies. They recall the circumstances of the occurrence, diagnosis techniques and treatment. They underline the unfrequency of this disease in Africa south of Sahara and they discuss the correlation with amoebiasis colitis. One has to keep in mind the possibility of a P.M.C. during any antibiotherapy, and consequently to have a rectoscopy to perform. Such an exploration is enough to pose a diagnosis. In day to day practice it is not necessary to show clearly the specific germ Clostridium difficile or its entero-toxin. To stop any antibiotherapy is required and beneficial. Metronidazole or Vancomycin are the best drugs in this case.
Adult↗
[Rectocolonic polyps in Senegal. Results of 1500 lower endoscopies carried out at the Dakar General Hospital].
57 polyps were discovered during 1,500 low endoscopies, and 24 of them were adenoma. In the same period of time, 26 proctocolitic adenocarcinomas were found. Adenomatous polyps appear to be 5 times less frequent in Senegal than in industrialized countries and frequency of colitic cancer should be of the same frequency, that is far less negligible. Even if proctocolitic cancer does not set up any Public Health problems one could envisage systematic screening of polyadenoma in every patient aged more than 40. Proctosigmoid being the seat of most adenoma, fibrosigmoidoscopy appears well adapted to this kind of screening because it does not require any preparation, it is easy to perform and well accepted.
Adolescent↗
[Value of ultrasonically-guided liver puncture biopsy in the diagnosis of primary liver cancer. Apropos of 84 cases].
Ultrasonographicaly guided fine needle aspiration of liver was performed in 84 patients having a confirmed HCC. This technics utilizes a CHIBA type fine needle, after blood coagulation tests have been checked. Out of 84 fine needle aspirations performed: 64 were positive (76,2%), 9 negative (10,7%), 11 (13,19%) were questionable (6) or nonanalysable (5). It is ascertained that the sensibility of this technics is over 75%. It should be possible to improve it by repeating such an exam in previously negative patients. The causes of failure are discussed. Tolerance of the technics is good. It is attraumatic, and of very easily performance. No accident, no mishap was noted.
Adolescent↗
[Moraxella infections in resuscitation].
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Anti-Bacterial Agents↗
[Pulmonary embolism as a complication of medical resuscitation].
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Acidosis↗
[Glucose-6-phosphate dehydrogenase deficiency in Mali. Epidemiology and pathological aspects].
I,858 semi quantitative G6PD determinations were done in Mali (mostly in the Point G Hospital, in Bamako). 15.7% of the men and 4.5% of the women had a G6PD deficiency. The age did not affect the incidence of the disease. G6PD deficiency was more frequent among the Sonrais than among the other ethnic groups tested. It did not occur more frequently among subjects having the sickling trait of AC hemoglobinopathy but no G6PD was found among subjects having a major hemoglobinopathy (SS or SC). Severe hemolytic anemia was rather infrequent among adults subjects. Hemolysis was induced by drugs--such as dapsone or niridazole--but it was usually mild and time-limited.
Adolescent↗