Biomedical subjects
Publications and source records attributed to M Sarr.
We reported four cases of Takayasu's arteritis cases. Hypertension in only one arm was found in three of them. The other one were a reversed coarctation of the aorta. Diagnosis was made by clinical examination, vascular Doppler Echography, and, in one case, arteriography. Thus, were examined the etiology of this disease, it might probably due to tuberculosis, the outcome and therapy problems at the occlusive stage.
We reported six patients with Marfan's syndrome, studied retrospectively from May 1990 to April 1992 in the department of Cardiology in Dakar. Morphological, cardiovascular, skeletal and ocular abnormalities have been reviewed. All the patients had been evaluated by echocardiography. Prevalence of Marfan's syndrome among congenital heart diseases during this period was 4.8%. The mean age was 27.6 years. The mean height was 1.80 m (range 1.38-2.02 m) for a mean weight of 62.8 kg. All the patients had dolichostenomely and arachnodactyly. Kyphosis or scoliosis was present in 5 cases. Chest deformities (pectus carinatum and excavatum) were present in 5 cases. 5 patients had hyperextensible joints. 5 patients had ocular abnormalities. Cardiac pathology was found in 5: mitral prolapse with insufficiency in 2; mitral prolapse with aortic dystrophy in 2; and isolated dilatation of ascending aorta in an other. One patient with diffuse Marfan's syndrome died of cardiac failure. Our study confirm polymorphic manifestations of Marfan's syndrome and the frequency of cardiac abnormalities which are the major determinants of life-prognosis in these patients. Echocardiography is very useful as a noninvasive method for defining the extent of cardiovascular involvement and following its course, for more appropriate treatment.
The authors report a rare observation of left intraventricular thrombus in a 39 years old senegalese man with a dilated non-obstructive cardiomyopathy. With the echocardiographic follow-up, it was possible to follow the regression of the clot. Echocardiographic diagnosis and evolutive problems of such left intraventricular thrombus are reviewed.
The authors use an investigation carried out at Pikine Social Paediatric Institute on children consulting for diarrhoea to underline the epidemiological factors of this affliction in Dakar suburbs: the average age of the children is 14 months; almost half the children came from families with low or irregular incomes; coprologic examination showed parasitic germs in 26.7% of the cases, rotavirus in 24.4%, and bacteria in 17.6%.
The authors depict the main clinical tables relating to endocrine and cytogenetic study on 7 confirmed cases and stress the difficulties they faced taking care of these children. These were dominated by: the unavailability of sufficient suitable medicine; and the absence of complementary examinations indispensable for biologically checking the children treated and for their therapeutic readjustment.
The authors report the first case in Senegal of an esophagotracheal fistula isolated in a suckling child 1,1/2 months old, and stress: the clinical profile and the rarity of this deformity; the difficulties of providing for such patients in view of the close medico-surgical collaboration required.
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This report concerns hepatitis B virus (HBV) infections observed in 155 infants from Senegal, studied with a view to determining the factors involved in development of the chronic carrier state. A chronic carrier state was observed in 50.3% of the infants. This study confirms that the risk of chronic carriage is linked to age. This risk declines very rapidly with age, falling from 82% in infants under 6 months old, to 15% in children between the ages of 2 and 3 years. Spontaneous elimination of hepatitis B surface antigen (HBsAg) is uncommon in HBsAg carriers during childhood. The difference observed in chronic carriage between males and females is due to a difference in susceptibility of the two sexes to the development of the chronic carrier state: HBV infections (before 2 years of age) lead to a chronic carriage in 77% of males as against 50% of females. These conclusions are important in view of the immunisation programs being carried out against hepatitis B virus in endemic areas. For a maximum efficacy, vaccination must be carried out at birth, or shortly afterwards.
Persistence of anti-HBs in 156 Senegalese infants immunized with hepatitis B vaccine was studied for periods ranging from 2 to 6 years after booster dose administration. Six years after the booster dose, 90.4% of the infants had detectable anti-HBs antibodies, with 78.1% having titers higher than 10 mIU/ml. The geometric mean titer was 60 mIU/ml. Females showed higher anti-HBs values than males. In a group of 11 infants who received no booster dose, anti-HBs antibodies were detectable 7 years after the first dose. However, the geometric mean titer was lower (26 mIU/ml). Revaccination (56 infants) led to an increase of the geometric mean titer to 469 mIU/ml 2 months later. These results show that a booster injection every 5-6 years should provide adequate protective anti-HBs levels in infants.
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Controversy exists in management of cardiac trauma as to whether or not injuries of the cardiac valves or septum should be repaired at initial operation. A patient is presented who required immediate mitral valve replacement for acute disruption of the mitral valve apparatus following a transventricular gunshot injury. The need to consider early repair or replacement of injured cardiac valves when they appear to have hemodynamic significance is emphasized.
The diagnosis of psychosocial deprivation dwarfism is difficult. It is also of practical importance since it leads to the only one appropriate treatment: the decision to send the child in a new environment, foster institution or foster family. The present work reports the clinical, biological and psychologic characteristics of 34 children and adolescents aged 9 months to 17 years, in whom a severe growth deficiency had been considered as probably related to psychosocial deprivation, and who were thus sent in foster institutions with good medical and psychological support. The result was in 24 cases a sharp increase of growth rate, giving confirmation of the diagnosis suspected, and in 10 a failure, making this diagnosis unlikely. A comparison of these two groups does not demonstrate any significantly different criterion. The conclusion suggested is thus the following: a trial of at least three months in a foster home, decided on concordant clinical and psychological data, without regard to the biological data, is the only way for distinguishing the truly and falsely deprivation-related dwarfism, or at least to give appropriate support for long-term therapeutic decisions.
A booster dose of hepatitis B vaccine was given to 143 children in whom hepatitis B had not developed 1 year after initial vaccination. Over the next six years the incidence of hepatitis B in this group was 1.5% per year compared with 11.5% per year in a similar group of unvaccinated children. In the first 4 years the protective efficacy of the vaccine was 100%, but during the 5th and 6th years it fell to 67%. For maximum protection a second booster is needed, 5 years after the first.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.