99 research outputs found
Circuit et expérience de la gestion pharmaceutique des produits locaux utilisés dans un essai clinique contrÎlé par un placebo
La spiruline, une algue douĂ©e de propriĂ©tĂ©s thĂ©rapeutiques et immunostimulantes, est frĂ©quemment utilisĂ©e par les personnes infectĂ©es par le VIH (PvVIH). Un essai clinique contrĂŽlĂ© par un placebo, a Ă©tĂ© menĂ©e chez les personnes infectĂ©es par le VIH de type 1 (PvVIH-1) avec la spiruline enrichi en zinc et en sĂ©lĂ©nium, et appelĂ©e «spiruline plus». Lâobjectif de lâĂ©tude Ă©tait de dĂ©finir un circuit dâapprovisionnement et de gestion de la « spiruline plus » et du placebo. LâĂ©tude qui a eu lâapprobation du ComitĂ© dâEthique National des Sciences et de la SantĂ© a durĂ© 12 mois. Les patients inclus dans lâĂ©tude ont Ă©tĂ© randomisĂ©s dans six sĂ©ries. Les quatre-vingt-dix-sept patients de lâĂ©tude Ă©taient composĂ©s de 52,6% des sujets sous placebo contre 47,4% sous « la spiruline plus ». Les 63.7% des patients Ă©taient sous traitement antirĂ©troviraux contre 36.3% sans traitement. Neuf cent cinq traitements ont Ă©tĂ© dispensĂ©s aux quatre-cent-quatre-vingt-neuf patients sous placebo et quatre cent seize patients sous « spiruline plus ». Le circuit dĂ©fini a permis la dispensation de la « spiruline plus » et du placebo aux patients de lâĂ©tude pendant 12 mois.Mots clĂ©s: Circuit, gestion, «spiruline plus», PvVIH-
Connaissances, attitudes et pratiques des diabétiques sur les complications oculaires du diabÚte à Lomé (Togo).
But : Ă©valuer les connaissances, attitudes et pratiques des diabĂ©tiques sur les complications oculaires du diabĂšte Ă LomĂ©. MatĂ©riels et mĂ©thode : Nous avons menĂ© une enquĂȘte transversale sur les patients diabĂ©tiques du 1er Avril au 31 Juin 2020 dans 6 centres de prise en charge du diabĂšte Ă LomĂ©. Le taux de bonnes rĂ©ponses a Ă©tĂ© Ă©tabli pour chaque volet. -Connaissances : mauvaise (65%)RĂ©sultats : Nous avons inclus 150 patients. LâĂąge moyen Ă©tait de 56,98 ± 13,37 ans avec un sexe ratio de 1,1 (79H/71F). Le niveau de connaissance globale Ă©tait faible (50,6%) reparti en 65,47% pour les connaissances gĂ©nĂ©rales sur le diabĂšte et 35,82% pour les complications oculaires du diabĂšte.  Les attitudes Ă©taient approximatives (68,7%). Devant une baisse de vision 84% des patients sâadresseraient Ă lâophtalmologue.  Le niveau de pratique Ă©tait nĂ©faste soit 20,4%. Pour le suivi diabĂ©tique 36,7% des patients ont dĂ©jĂ consultĂ© un ophtalmologue, 41,3% ont rĂ©alisĂ© un fond dâĆil, 17,3% une angiographie rĂ©tinienne, 4% une photocoagulation rĂ©tinienne au laser et 2,7% une IVT. Une sĂ©ance de sensibilisation sur les complications oculaires du diabĂšte a Ă©tĂ© suivi pour 52,7% des patients et 50,7% des patients ont suivi une sĂ©ance dâĂ©ducation thĂ©rapeutique.Conclusion : Le niveau de connaissance Ă©tait insuffisant, les attitudes approximatives et les pratiques nĂ©fastes. Il est donc important de mettre en place une sensibilisation sur le diabĂšte et ses complications oculaires en vue dâun changement de comportement.
La maladie de von-hippel lindau dans une famille togolaise
La maladie de Von Hippel Lindau(VHL) est une affection hĂ©rĂ©ditaire autosomique dominante dont lâexpression phĂ©notypique est variable et multiviscĂ©rale. Le diagnostic nĂ©cessite des arguments cliniques et un plateau technique de pointe. nous rapportons les rĂ©sultats dâune enquĂȘte au sein dâune famille togolaise à partir de deux observations cliniques. Ces observations mettent en exergue les difficultĂ©s de la pratique mĂ©dicale en Afrique subsaharienne liĂ©es Ă un plateau technique inexistant
Transcriptome-wide association study of breast cancer risk by estrogen-receptor status
Previous transcriptome-wide association studies (TWAS) have identified breast cancer risk genes by integrating data from expression quantitative loci and genome-wide association studies (GWAS), but analyses of breast cancer subtype-specific associations have been limited. In this study, we conducted a TWAS using gene expression data from GTEx and summary statistics from the hitherto largest GWAS meta-analysis conducted for breast cancer overall, and by estrogen receptor subtypes (ER+ and ER-). We further compared associations with ER+ and ER- subtypes, using a case-only TWAS approach. We also conducted multigene conditional analyses in regions with multiple TWAS associations. Two genes, STXBP4 and HIST2H2BA, were specifically associated with ER+ but not with ER- breast cancer. We further identified 30 TWAS-significant genes associated with overall breast cancer risk, including four that were not identified in previous studies. Conditional analyses identified single independent breast-cancer gene in three of six regions harboring multiple TWAS-significant genes. Our study provides new information on breast cancer genetics and biology, particularly about genomic differences between ER+ and ER- breast cancer.Peer reviewe
Grand Challenges in global eye health: a global prioritisation process using Delphi method
Background
We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations.
Methods
Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists.
Findings
Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity.
Interpretation
This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenge
Genomic investigations of unexplained acute hepatitis in children
Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK1. Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children
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