Prévalence de l’anémie chez les enfants malnutris de 6 à 59 mois hospitalisés au CHD/Zou-Collines dans le plateau d’Abomey (Centre du Bénin)

L’anémie constitue un grand problème de santé publique associée à un risque accru de morbidité et de mortalité, surtout pour les femmes  enceintes et les jeunes enfants. L’objectif de cette étude est de cerner la prévalence de l’anémie chez les enfants de moins de 5 ans malnutris hospitalisés dans le service de pédiatrie du Centre Hospitalier  Départemental/Zou-Collines. Il s’agit d’une étude prospective, descriptive et analytique sur une période de six (6) mois porté sur 251 enfants malnutris hospitalisés et leurs mères. Il ressort de notre étude que 41,43% des enfants sont anémiés et que la prévalence de l’anémie est beaucoup plus  remarquable chez les enfants de moins 24 mois. Par ailleurs, 55,8% des enfants souffrent d’une anémie sévère. La principale cause de l’anémie reste la carence en  fer (78,80%). La mauvaise pratique de sevrage, l’insuffisance de consommation des aliments riches en fer biodisponible et des fruits seraient les facteurs mis en  cause dans l’avènement de l’anémie nutritionnelle au sein de la population étudiée. Il urge de mener des stratégies de lutte préventive en matière de soins de santé  primaire, d’intensification des campagnes d’information, d’éducation et de sensibilisation des populations par rapport aux pratiques  d’allaitement maternel  exclusif, à la diversification alimentaire et de conseil aux mères sur les avantages des surveillances pédiatriques.Mots clés : Bénin, enfants malnutris, anémie, carence en fer, pratique de sevrage

Difficult management of an extremely rare case of giant pigmented epithelioid melanocytoma

Pigmented epithelioid melanocytoma (PEM), a heavily pigmented and highly uncommon melanocytic lesion, is extremely rare. It comes under several forms and names. We report the case of a three-year-old boy born with an isolated right lumbopelvic and femoral giant PEM. The boy was unable to walk due to the size and the shape of the lesion. He underwent two stages of intra lesional resections, one in Benin and the second in Switzerland. The first surgery was followed by hypothetic hypovolemic and anaphylactic shocks, and the second surgery by a continuous lymphatic leakage from the wounds for months. The strategic management approach, the surgery and follow-up of this case of giant PEM presented a real challenge. (C) 2017 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND licens

Surgery on burns sequelae in developing countries.

The purpose of this study is to analyze the effectiveness of surgery and follow-up of children operated on for burn sequelae. For many years, we have organized two missions per year to Benin and Togo, one for surgery and one for follow-up. We analyzed the files of children born in Africa and victims of burns from the years 2002 to 2011. Children were referred through a non-governmental organization (NGO) and assessed in Africa by local paediatricians before and after surgery. Treatment consisted in operating on burn sequelae such as contractures, hypertrophic scars and hard cords. Impaired mobility was our only indication for the operation. We kept a database on all patients. Sixty files were reviewed, of which fifty were deemed suitable for analysis. The most common methods of surgery were skin grafting and Z-plasty. There were no complications, such as infection or graft/flap necrosis after immediate surgery. Long-term follow-up revealed a recurrence of hypertrophic scarring (47%), retractions (24%) and hard cords (2%) due to a lack of occupational therapy and physiotherapy treatment. Partnership with an NGO and a local team allows us to treat children with burn injury sequelae in Western Africa. A continued and often long-lasting follow-up by occupational therapists and physiotherapists is highly mandatory in order to guarantee good long-term results. In 2010, we initiated local rehabilitation therapy

Frontoethmoidal Encephalocele Correction Surgery in Benin: A Case Report.

Primary encephalocele is a rare deformity that is challenging for the neurosurgeon. It requires a multidisciplinary team for adequate reconstructive surgery. We report the case of a 6-month-old African boy who presented with a frontoethmoidal encephalocele; we present a technical description of the surgical procedure, using no implant. The postoperative evolution of the boy was uneventful, with a good clinical result at the follow-up

Success and Failure for Children Born with Facial Clefts in Africa: A 15-Year Follow-up.

BACKGROUND: This study reviews the 15 year program of our Department of Pediatric Surgery for the treatment and follow-up of children born with a cleft in Benin and Togo. METHODS: We analyzed files of children born in Africa with a cleft. They were referred to us through a nongovernmental organization (NGO) between 1993 and 2008 and assessed in Africa by local pediatricians before and after surgery. Operations were performed by our team. RESULTS: Two hundred files were reviewed: 60 cases of unilateral cleft lip, seven of bilateral cleft lip, 44 of unilateral cleft lip palate (UCLP), 29 of bilateral cleft lip palate (BCLP), 53 of cleft palate (CP), three of bilateral oro-ocular cleft, one of unilateral and two of median clefts (Binder), and one of commissural cleft. Sixty-nine (35 %) of these cases were not operated in Africa: 25 (12.5 %) had not shown up, 28 (15 %) were considered unfit for surgery (Down's syndrome, HIV-positive, malnutrition, cardiac malformation), and 16 (7.5 %) were transferred to Switzerland. Palatal fistula occurred in 20 % of UCLP, 30 % of BCLP, and 16 % of CP. Evaluation of speech after palate surgery gave less than 50 % of socially acceptable speech. CONCLUSIONS: Our partnership with a NGO and a local team makes it possible to treat and subsequently follow children born with a cleft in West Africa. Surgery is performed under good conditions. If aesthetic results are a success, functional results after palate surgery need further improvement to promote integration in school and social life

The anticancer effects of chaetocin are independent of programmed cell death and hypoxia, and are associated with inhibition of endothelial cell proliferation

BACKGROUND: We previously reported that chaetocin has potent and selective anti-myeloma activity attributable to reactive oxygen species (ROS) induction imposed by inhibition of the redox enzyme thioredoxin reductase; we now detail its effects in solid tumours. METHODS: Cellular assays, transcriptional profiling and the NCI60 screen were used to assess the effects of chaetocin in solid tumour and endothelial cells. RESULTS: NCI-60 screening demonstrated chaetocin to even more potently inhibit proliferation in solid tumour than in haematological cell lines; transcriptional profiling revealed a signature consistent with induction of inflammatory response and cell death pathways. Chaetocin induced ROS, oxidative damage to cellular proteins and apoptosis, with 2–10 n IC(50)s (24 h exposures) in all tested solid tumour cell lines. The pan-caspase inhibitor zVAD-fmk did not block chaetocin-induced cell death despite inhibiting mitochondrial membrane depolarisation and apoptosis. Further, Molt-4 rho(0) cells lacking metabolically functional mitochondria were readily killed by chaetocin; in addition chaetocin-induced cytotoxicity was unaffected by autophagy inhibitors or hypoxia and consequent HIF-1α upregulation. Moreover, chaetocin inhibited SKOV3 ovarian cancer xenografts producing less vascular tumours, and inhibited human umbilical vein endothelial cell proliferation. CONCLUSION: Chaetocin has intriguing and wide-ranging in vitro and in vivo anticancer effects, and is an attractive candidate for further preclinical and clinical development