Micro and macrovascular complications of diabetes mellitus in Cameroon: risk factors and effect of diabetic check-up - a monocentric observational study

Introduction: The objective of this study was to evaluate the prevalence of vascular complications among diabetes patients (DP), to find out the relationship with risk factors and to assess the effect of diabetic check-up (DC) in the onset of these complications. Methods: Clinical and laboratory data of DP followed between 2000 and 2009 were retrospectively analyzed. Those with at least one DC were selected (140 out of 538). Risk factors were checked and listed. Prospectively, an electrocardiogram (ECG) was recorded for 121 of them. Results: The sample was constituted of 78 (56%) men and 62 (44%) females; mean age was 55 ± 12 years. Type 2 Diabetes accounted for 94.3%. Microangiopathy distribution was: retinopathy = 23.6%, nephropathy = 25% and neuropathy = 40%. Within macroangiopathy prevalence was: 5% for stroke, 17.1% for limbs ischemic disease and 23.6% for coronary heart disease. Occurrence of complications was associated with hypertension, duration of diabetes, dyslipidemia, microalbuminuria, 24-hour proteinuria, body mass index and HbA1c. Diabetic neuropathy was neither associated to HbA1c nor microalbuminuria. HbA1c was conversely but not significantly associated with the number of DC realized. Conclusion: Vascular complications are considerably present in diabetes patients in the studied center, especially among those practicing less glycemic controls. Normalizing the level of HbA1c, controlling risk factors, and realizing DC may prevent the onset of vascular complications in DP.Key words: Diabetes mellitus, Microangiopathy, Macroangiopathy, HbA1c, Diabetic check-up, Cameroo

La craniectomie decompressive dans la prise en charge des traumatismes craniens graves avec signes radiologiques d’engagement cerebral.

Introduction La craniectomie décompressive peut- elle améliorer le pronostic des patients victimes d’un traumatisme crânien fermé grave avec engagement cérébral ? Objectif Le but de la présente étude était d’évaluer l’efficacité de la craniectomie décompressive dans la prise en charge du traumatisme crânien grave, isolé et fermé avec signes radiologiques d’engagement cérébral. Méthodes Il s’agissait d’une étude réalisée à l’Hôpital Général de Douala pendant 36 mois, de janvier 2007 à décembre 2009, incluant 13 patients victimes d’un traumatisme crânien grave, isolé et fermé, présentant les signes radiologiques d’engagement cérébral. La craniectomie décompressive était indiquée devant l’aggravation ou la persistance du tableau clinique et radiologique malgré le traitement médical conventionnel. Résultats Après deux à dix mois de suivi, l’évolution fut classée selon le score du coma évolutif ; "Glasgow outcome scale (GOS) score ". Dix patients (76, 93 %) ont évolué favorablement GOS (4-5).Un patient (07,69%) est resté végétatif GOS3. Deux décès (15,38%) ont été observé GOS1. Les principales complications étaient : une hydrocéphalie, une hernie cérébrale à travers le foramen de craniectomie, un abcès du cerveau et un état de mal convulsif. Conclusion La craniectomie décompressive est une méthode efficace pouvant améliorer le pronostic des patients victimes de traumatisme crânien grave avec signes radiologiques d’engagement cérébral.Mots clés : craniectomie-décompressive-engagement cérébral-traumatisme crânien

A global agenda for advancing freshwater biodiversity research

This manuscript is a contribution of the Alliance for Freshwater Life (www.allianceforfreshwaterlife.org). We thank Nick Bond, Lisa Bossenbroek, Lekima Copeland, Dean Jacobsen, Maria Cecilia Londo?o, David Lopez, Jaime Ricardo Garcia Marquez, Ketlhatlogile Mosepele, Nunia Thomas-Moko, Qiwei Wei and the authors of Living Waters: A Research Agenda for the Biodiversity of Inland and Coastal Waters for their contributions. We also thank Peter Thrall, Ian Harrison and two anonymous referees for their valuable comments that helped improve the manuscript. Open access funding enabled and organised by Projekt DEAL

A global agenda for advancing freshwater biodiversity research

Global freshwater biodiversity is declining dramatically, and meeting the challenges of this crisis requires bold goals and the mobilisation of substantial resources. While the reasons are varied, investments in both research and conservation of freshwater biodiversity lag far behind those in the terrestrial and marine realms. Inspired by a global consultation, we identify 15 pressing priority needs, grouped into five research areas, in an effort to support informed stewardship of freshwater biodiversity. The proposed agenda aims to advance freshwater biodiversity research globally as a critical step in improving coordinated actions towards its sustainable management and conservation.Peer reviewe

Three essays on Social Trust and Government Policies

Esta tesis se centra en estudiar la relación intrínseca que existe entre los efectos que generan las políticas que implementa un gobierno en la confianza de los individuos, y la institución del gobierno. Estudio el impacto de la globalización en la confianza de los individuos, comparó el impacto que una depreciación de la moneda y una deregulación del mercado de trabajo tienen en el crecimiento económico, por último, analizo la repercusión que la implementación de políticas restrictivas tiene en la confianza de los individuos en el gobierno y en cuantos años un gobierno permanece en el poder

A new species of the freshwater crab genus Potamonemus Cumberlidge & Clark, 1992 (Crustacea: Potamonautidae) endemic to the forested highlands of southwest Cameroon, Central Africa

A new species of freshwater crab of the genus Potamonemus Cumberlidge & Clark, 1992, is described from Mount Manengouba Reserve and the Bakossi National Park in the tropical rainforests of southwestern Cameroon, Central Africa. Potamonemus man n. sp. is recognized by characters of the carapace and chelipeds. In addition, a phylogenetic analysis based on partial sequences of three mitochondrial DNA genes (COI, 12S rRNA, and 16S rRNA) that included representatives of all other freshwater crab genera found in Cameroon recovered each of the new species as a distinct lineage. A diagnosis and illustrations of the new species are provided, and it is compared to the other species in this genus. Brief notes are provided on the ecology of the new species and the two other species of Potamonemus. An identification key to the species of Potamonemus is provided and its conservation status discussed

A new species of the freshwater crab genus Potamonemus Cumberlidge & Clark, 1992 (Crustacea, Potamonautidae) endemic to the forested highlands of southwestern Cameroon, Central Africa

A new species of freshwater crab of the genus Potamonemus Cumberlidge & Clark, 1992 is described from Mount Manengouba Reserve and Bakossi National Park in the tropical rainforests of southwestern Cameroon, Central Africa. Potamonemus man sp. nov. is recognized by characters of the carapace and chelipeds. In addition, a phylogenetic analysis based on partial sequences of three mitochondrial DNA genes (COI, 12S rRNA, and 16S rRNA) that included representatives of all other freshwater crab genera found in Cameroon recovered each of the new species as a distinct lineage. A diagnosis and illustrations of the new species are provided, and it is compared to the other species of Potamonemus. Brief notes are provided on the ecology of the new species and the two other species of Potamonemus. An identification key to the species of Potamonemus is provided. The conservation status of the genus is discussed