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Biomedical subjects

M Sane

Publications and source records attributed to M Sane.

At least 19 recordsLinked to original sources
PubMed2005

[Exercise-induced dyspnea and hilar enlargement].

We report the case of a 46-year-old man with an uneventful history who was hospitalized for suspected pulmonary embolism. The chest x-ray did not reveal any parenchymatous anomaly but disclosed pseudo-tumoral enlargement of the pulmonary arteries. There was no right ventricular overload at cardiac echography and the pulmonary arterial pressure was normal. Helicoidal angioscan demonstrated aneurismal dilatation of the both pulmonary arteries, complicated by a thrombus on the right. Outcome was favorable with anticoagulation. After ruling out acquired aneurysm, the diagnosis retained was idiopathic aneurysm of the pulmonary arteries.

Aneurysm↗
PubMed2005

[Pseudotumoral presentation of American pulmonary histioplasmosis].

In France, American pulmonary histoplasmosis is an imported deep mycosis, caused by inhalation of Histoplasma capsulatum. Clinical and radiological features of this exotic disease are multiple, simulating tuberculosis or cancer. We report two cases of American histoplasmosis with pseudo-tumoral form, in immunocompetent subjects working in Venezuela, with a multinodular pulmonary presentation.

Adult↗
PubMed2005

[Clinical and laboratory features of typhoid fever in Senegal. A 70-case study].

Clinical and laboratory features, complications and treatment were retrospectively studied in 70 patients with bacteriologically documented typhoid fever, treated between January 1995 and June 2002 at Principal Hospital in Dakar, Senegal. Data analysis was done on a global basis as well as comparatively between the 37 children (under 15 years) and 33 adults. Mean age was 16.7 years (range, 1 to 52). The sex ratio was 1.4. Clinical manifestations included fever (97%), headache (50%), vomiting (71%), abdominal pain (54%), diarrhoea (49%), nnd splenomegaly (10%) without statistically significant difference between children and adults. Lyinphopenia was found in 51% of patients and anaemia in 78%. Coexisting illnesses Included malaria in 25.5% (mainly children) and hepatitis (transminases > 10N) in 24%. Complications included cholecystitis in 3 patients, gastrointestinal haemorrhage in 2, peritonitis in one, endocnrditis in one and osteomyelitis in one. Only one patient (HIV-positive) died. The incidence of antibiotic resistance was low, i.e., ainoxicilline: 2%, nalidixic acid: 1% and cotrimoxazole: 8.2%. No multidrug resistance was observed. This study shows that typhoid fever remains a major health problem in Dakar with slow resolution and potential complications. Amoxicililne and chloramphenicol can still be used for first-line treatment of typhoid fever. Little difference was found between children and adults.

Adolescent↗
PubMed2003

[Description of the first cases of serotype A, sequence type (ST)-11 meningococcal meningitis in Senegal].

Senegal is located in the African meningitis belt and meningococcal meniningitis outbreaks are yearly events. Occurrence of an epidemic involving serogroup W135 in 2000 and its spread following the Hajj (pilgrimage to Mecca) exposed the strongly Moslem population of Senegal to the risk of early infection. Indeed the first two cases in Dakar occurred simultaneously with the spread of this epidemic strain. The purpose of this article is to describe clinical, laboratory, and therapeutic findings in these two cases and the results of the ensuing epidemiological survey. The relationship with the pilgrimage and consequences on public health in Senegal are discussed.

Child, Preschool↗
PubMed2001

[Hypothalamo-hypophyseal-adrenal hypofunction caused by the use of bleaching cosmetics in Senegal].

Cosmetic use of bleaching agents to clear skin is widespread among black West African women. In Dakar, most products used for whole body applications contain highly potent corticosteroids. Whereas cutaneous adverse effects are well described, little is known about possible systemic consequences. In order to assess transcutaneous absorption of glucocorticoids, hypothalamo-pituitary-adrenal axis functionality can be tested. We measured plasma cortisol concentration at 8 h and 1 h after intramuscular injection of 250 micrograms of cosyntropin (Synacthen) in 12 women with a more than 10 years use of bleaching agents. Cortisol at 8 H was also measured in 9 non exposed women without disease or treatment able to disturb glucocorticoids metabolism. All controls had 8 H cortisol concentration (mean = 521 +/- 113 nmol/l) above the minimal normal level considered by our laboratory. The 8 H cortisol concentrations were under the minimal normal level in 9 exposed women and the overall mean value was significantly lower than the one observed in controls (264 +/- 81 nmol/l; p < 0.001). After cosyntropin, cortisol concentrations were elevated among all exposed women (469 +/- 196 nmol/l), and less so in 3 of them. Most of the bleaching agents users present a functional inertia of hypothalamo-pituitary adrenal axis. While there is no absolute evidence for risk of stress-induced adrenal insufficiency, our results show conclusively that an excessive corticosteroids charge among users who could be exposed to systemic adverse effects.

Absorption↗
PubMed2000

[Hepatitis C virus and chronic hepatopathies in Dakar: case-control study].

In Black Africa, the role of hepatitis C virus (HCV) in the onset of chronic hepatic disease is unclear. This is particularly true in Senegal where the prevalence of HCV is moderate. To gain insight into this question, a case-control study including 73 patients and 73 controls was carried out at Principal Hospital in Dakar in 1995. The patients included in this study presented chronic hepatitis in 2 cases cirrhosis in 25 and hepatocellular carcinoma in 46. Patients and controls underwent serologic testing for HCV (ELISA screening test followed by 3rd generation ELISA test in case of positive results and confirmation by immunoblot) with determination of HCV serotype using the immunoenzymatic method. Testing also included research for infection by hepatitis B virus and for anti-delta antibodies. Anti-HCV antibodies were detected in two patients (3 p. 100) and serology was suspicious in two others. Serotype 2 was detected in one of these patients. No positive results were recorded in controls. Fifty-four patients (74 p. 100) and 15 controls (21 p. 100) presented the HBs antigen including 13 patients (24 p. 100) and I control (7 p. 100) with anti-delta antibodies. This study shows that HCV currently plays a minor role in the onset of hepatic disease in hospitalized patients in Senegal. It also confirms the predominant role of hepatitis B and complicating effect of the delta hepatitis virus. These findings are compared with reported data for Black African countries. The impact of HCV appears to be lower in Senegal than in central Africa.

Adult↗
PubMed2000

[The new poor expatriates in the third world].

This report describes four cases involving French expatriates who developed serious health problems while living destitute in Senegal. A 37-year-old man presented with embolism-like symptoms in relation with lung involvement due to spreading of untreated staphylococcal skin infection. A 64-year-old man was admitted for high output cardiac failure secondary to severe anemia caused by malnutrition. A 50-year-old man presented recurrent fever with loss of consciousness after successful treatment of neuromalaria and finally attributed to delirium tremens. A 25-year-old man was hospitalized with presumed meningoencephalitis that had been ongoing for two weeks. All four patients had been in Senegal for several months and had cut all ties to mainland France. Being jobless and homeless, they had been unable to obtain proper nutrition or medications. With minimal entry requirements and low-cost air travel, Senegal has been come a common sight-seeing destination and has developed a small but apparently growing population of destitute travelers. Alienation from the home community and resulting seclusion enhance clinical consequences and delay intervention by foreign service officials.

Adult↗
PubMed1999

[Adults with sickle cell anemia in Senegal. Clinical study of 40 homozygote subjects].

While the well-documented life expectancy of patients with homozygous sickle cell anemia (SS) is 40 years in industrialized countries, this question remains unanswered in black Africa. The purpose of this prospective study was to establish the clinical phenotype for Senegal. A severity score based on 12 clinical, laboratory, radiological, and prognostic findings was calculated and correlated with age and hemoglobin F level. A total of 40 SS homozygotes over 15 years of age (mean age: 25 years) were hospitalized between January 1996 and January 1998 at the Principal Hospital in Dakar. The most common events requiring hospitalization were vasoocclusive phenomena (n = 26) but the incidence of these complications declined significantly with age (p < 0.05). The mean hemoglobin level was 4.4 mmol/l and the mean hemoglobin F level was 6.2 p. 100. The incidence of visceral involvement was low (lithiasic vesicules in 17 cases, necrosis of the head of the femur in 7, and abnormal cardiac ultrasound findings in 10). Only one patient died during the study. No correlation was found between severity score and either age or hemoglobin F level. These findings confirm that the phenotype is less severe in Senegal. However they also show that organ damage is common by the time that patients reach adulthood and thus underline the need for prevention and education to improve survival of SS homozygotes in Senegal.

Adolescent↗
PubMed1998

[Cardiac manifestations of polymyositis. Apropos of 2 Senegalese cases].

INTRODUCTION: Polymyositis cardiac involvement varies between 37% and 70%. EXEGENESIS: The authors report two cases of polymyositis with myocardial involvement observed in Senegal; the first case is a cardiac failure revealing an acute polymyositis occurring in a 44-year-old woman; the second case is a 34-year-old woman who had polymyositis with tachycardia and dyspnea: in the two cases echocardiography showed a left ventricular concentric hypertrophy with preserved systolic function and altered diastolic function; clinical and echocardiographic resolution were obtained by corticosteroid medication. CONCLUSION: Myocardial localization is the most common polymyositis cardiac involvement; clinical symptomatology is rare (3.3% to 6%). sometimes revealing polymyositis; electrocardiographic abnormalities are found in 18% to 81% cases and echographic abnormality in 42% cases; cardiac involvement is of bad prognosis.

Acute Disease↗
PubMed1998

[Pulmonary manifestations associated with malaria].

Pulmonary manifestations are frequently observed in children, pregnant women and travellers with malaria. The pathophysiology of these pulmonary manifestations is poorly understood but would appear to be secondary to an interaction between the parasitized red cells and the pulmonary capillary endothelium. Bronchitis and pneumonia do not directly compromise outcome but, left unrecognized, the delay in diagnosis and treatment may be fatal. Acute respiratory distress in children is the first cause of overmortality, coming before neurological involvement. The acute respiratory distress caused by severe malaria has no specific characteristics. Iatrogenic complications and pulmonary superinfections must be differentiated. The prevention of pulmonary manifestations associated with malaria can easily be accomplished by limiting water intake and carefully monitoring urinary output and weight. Treatment is the same as for acute flare-ups in combination with symptomatic respiratory treatment when required.

Adult↗
PubMed1998

[Pulmonic plague].

One hundred years after Yersin discovered Yersinia pestis during the plague epidemic in Hong Kong in 1894, human plague still has not been eliminated. The epidemic in 1994 in India, a country where no cases had been observed since 1996, raised great concern. Plague is an epizootic bacterial infection caused by a Gram negative coccobacillus, Y. pestis, transmitted by the bite of infected fleas. Bubonic plague is the most common form. Other clinical presentations include asymptomatic plague, abortive plague, pharyngeal plague, septicemic plague, meningeal plague, and primary or secondary pneumonic plague which is observed in 5 to 20% of cases. Plague is a highly communicable disease between humans despite antibiotic therapy which has reduced mortality by 80%. The prognosis depends on early diagnosis. Streptomycin and cyclines are the gold standard treatment.

Anti-Bacterial Agents↗