Endocardite infectieuse en milieu cardiologique Dakarois: étude descriptive à propos de 39 cas

L’endocardite infectieuse est une complication fréquente des cardiopathies rhumatismales. L’objectif de ce travail était de faire une étude descriptive de l’endocardite infectieuse, en milieu hospitalier Dakarois. Il s’agit d’une étude rétrospective, descriptive, réalisée à la clinique cardiologique de l’hôpital Aristide Le Dantec, durant la période allant de Janvier 2004 à Décembre 2008. Etaient inclus tous les patients hospitalisés et traités pour endocardite infectieuse certaine ou probable, selon les critères de Durack. Nous avons étudié les paramètres épidémiologiques, cliniques, biologiques et échocardiographiques. Le nombre total d’admissions dans le service durant la période d’étude était de 3746 patients, dont 870 pour valvulopathies rhumatismales. Nous avions enregistré 39 cas d’endocardite infectieuse soit une prévalence de 1,04% et 4,48% valvulopathies rhumatismales. L’âge moyen de nos patients était de 24 plus ou moins 11,5 ans avec des extrêmes de 6 et 52 ans. Plus de la moitié des patients soit 58,9 % (23 patients) avaient moins de 25 ans. On notait une légère prédominance féminine avec un sex-ratio homes/femmes de 0,95. La porte d’entrée était essentiellement bucco-dentaire 40%. L’anémie était constante avec un taux d’hémoglobine moyen à 8,4g/dl. Les hémocultures étaient positives chez 6 patients et le Staphylococcus Aureus était le germe le plus retrouvé. L’électrocardiogramme avait montré des troubles du rythme et de la conduction respectivement dans 69,2 et 10,2% des cas. L’échographie cardiaque mettait en évidence des végétations chez tous les patients, une rupture de cordage dans 6 cas et un abcès chez trois patients. L’endocardite infectieuse constitue encore une réalité dans nos régions. Elle survient habituellement sur cardiopathie rhumatismale. Son diagnostic repose sur les hémocultures et l’échocardiographie

Hypertension artérielle pulmonaire au cours de la sclérodermie: à propos de 12 cas

Introduction: La survenue de l’hypertension artérielle pulmonaire (HTAP) est un tournant dans l’évolution de la sclérodermie. L’objectif de cette étude est de décrire les aspects épidémiologiques et évolutifs de l’HTAP au cours de la sclérodermie systémique.Méthodes: Nous avons réalisé une étude descriptive concernant des patients suivis pour sclérodermie systémique, au service de Dermatologie de l’hôpital Aristide Le Dantec entre Janvier 2000 et Août 2009. Ces patients étaient inclus dans l’étude après exploration cardio-vasculaire (ECG, échocardiographie-Doppler). Nous avons étudié les paramètres épidémiologiques, cliniques, paracliniques et évolutifs des patients. Résultats: Nous avons enregistré 12 cas d’hypertension artérielle pulmonaire parmi les 83 patients atteints de sclérodermie systémique soit une prévalence de 14,45%. L’âge moyen des patients était de 43,58 ans ± 12,5 ans et le sex-ratio (H/F) de 0,33. Sur le plan clinique, la dyspnée était quasi constante (75%) et la douleur thoracique présente dans 25% des cas. Le syndrome de Raynaud était observé chez 8 patients soit 66,67% de nos patients. L’électrocardiogramme montrait des signes de surcharge droite chez 4 malades (33,33%) et la radiographie thoracique en faveur d’une fibrose pulmonaire chez 4 patients. L’échocardiographie-Doppler notait une insuffisance tricuspide importante dans 58, 33% des cas (7 patients), une pression artérielle pulmonaire systolique (PAPs) en moyenne de 66,25 ± 29,3 mmHg, une dilatation des cavités cardiaques droites dans 5 cas et un mouvement paradoxal du septum interventriculaire chez 3 malades (33,33%). Il était également noté 3 cas (25%) d’épanchement péricardique. Nous avons déploré 4 décès (33,33%).Conclusion: L’hypertension artérielle pulmonaire est une complication fréquente et grave de la sclérodermie. Son dépistage, grâce à l’échocardiographie- Doppler systématique, constitue une étape fondamentale de la prise en charge

Combination of simulation and model-checking for the analysis of autonomous vehicles’ behaviors: A case study

International audienceAutonomous vehicles’ behavioural analysis represents a major challenge in the automotive world. In order to ensure safety and fluidity of driving, various methods are available, in particular, simulation and formal verification. The analysis, however, has to cope with very complex environments depending on many parameters evolving in real time. In this context, none of the aforementioned approaches is fully satisfactory, which lead us to propose a combined methodology in order to point out suspicious behaviours more efficiently. We illustrate this approach by studying a non deterministic scenario involving a vehicle, which has to react to some perilous situation

A possible role for Phlebotomus (Anaphlebotomus) rodhaini (Parrot, 1930) in transmission of Leishmania donovani

<p>Abstract</p> <p>Background</p> <p>Visceral leishmaniasis (VL, kala azar), caused by <it>Leishmania donovani </it>is a major health problem in Sudan and other East African countries. In this region the only proven vectors of <it>L. donovani </it>are <it>Phlebotomus orientalis </it>in eastern Sudan, Ethiopia and Upper Nile areas of Southern Sudan and <it>Phlebotomus martini </it>in Ethiopia, Kenya and Southern Sudan. In this report, we present the first evidence that <it>Phlebotomus rodhaini </it>may also play a role in maintaining transmission of <it>L. donovani </it>between animal reservoir hosts in eastern Sudan. The study was conducted in a zoonotic focus of visceral leishmaniasis in Dinder National Park, eastern Sudan, where previous work showed high infection rates of <it>L. donovani </it>in <it>P. orientalis</it>. Sand flies, captured by CDC traps were dissected and examined for infection with <it>Leishmania </it>parasites. Parasite isolates were subjected to <it>L. donovani </it>specific PCR. Field experiments were also carried out to compare efficiency of rodent baited and un-baited CDC traps in collection of <it>P. rodhaini </it>and determine its man-biting rate.</p> <p>Results</p> <p>Three female <it>P. rodhain</it>i were found infected with <it>Leishmania </it>parasites in an astonishingly small number of flies captured in three separate field trips. Two of these isolates were typed by molecular methods as <it>L. donovani</it>, while the third isolate was inoculated into a hamster that was subsequently lost. Although <it>P. rodhaini is </it>generally considered a rare species, results obtained in this study indicate that it can readily be captured by rodent-baited traps. Results of human landing collection showed that it rarely bites humans in the area.</p> <p>Conclusion</p> <p>It is concluded that <it>P. rodhaini </it>is a possible vector of <it>L. donovani </it>between animal reservoir hosts but is not responsible for infecting humans. It is suggested that the role of <it>P</it>. <it>rodhaini </it>in transmission of <it>L. donovani </it>in other zoonotic foci of visceral leishmaniasis in Africa should be re-examined.</p

The dominant Anopheles vectors of human malaria in Africa, Europe and the Middle East: occurrence data, distribution maps and bionomic précis

<p>Abstract</p> <p>Background</p> <p>This is the second in a series of three articles documenting the geographical distribution of 41 dominant vector species (DVS) of human malaria. The first paper addressed the DVS of the Americas and the third will consider those of the Asian Pacific Region. Here, the DVS of Africa, Europe and the Middle East are discussed. The continent of Africa experiences the bulk of the global malaria burden due in part to the presence of the <it>An. gambiae </it>complex. <it>Anopheles gambiae </it>is one of four DVS within the <it>An. gambiae </it>complex, the others being <it>An. arabiensis </it>and the coastal <it>An. merus </it>and <it>An. melas</it>. There are a further three, highly anthropophilic DVS in Africa, <it>An. funestus</it>, <it>An. moucheti </it>and <it>An. nili</it>. Conversely, across Europe and the Middle East, malaria transmission is low and frequently absent, despite the presence of six DVS. To help control malaria in Africa and the Middle East, or to identify the risk of its re-emergence in Europe, the contemporary distribution and bionomics of the relevant DVS are needed.</p> <p>Results</p> <p>A contemporary database of occurrence data, compiled from the formal literature and other relevant resources, resulted in the collation of information for seven DVS from 44 countries in Africa containing 4234 geo-referenced, independent sites. In Europe and the Middle East, six DVS were identified from 2784 geo-referenced sites across 49 countries. These occurrence data were combined with expert opinion ranges and a suite of environmental and climatic variables of relevance to anopheline ecology to produce predictive distribution maps using the Boosted Regression Tree (BRT) method.</p> <p>Conclusions</p> <p>The predicted geographic extent for the following DVS (or species/suspected species complex*) is provided for Africa: <it>Anopheles </it>(<it>Cellia</it>) <it>arabiensis</it>, <it>An. </it>(<it>Cel.</it>) <it>funestus*</it>, <it>An. </it>(<it>Cel.</it>) <it>gambiae</it>, <it>An. </it>(<it>Cel.</it>) <it>melas</it>, <it>An. </it>(<it>Cel.</it>) <it>merus</it>, <it>An. </it>(<it>Cel.</it>) <it>moucheti </it>and <it>An. </it>(<it>Cel.</it>) <it>nili*</it>, and in the European and Middle Eastern Region: <it>An. </it>(<it>Anopheles</it>) <it>atroparvus</it>, <it>An. </it>(<it>Ano.</it>) <it>labranchiae</it>, <it>An. </it>(<it>Ano.</it>) <it>messeae</it>, <it>An. </it>(<it>Ano.</it>) <it>sacharovi</it>, <it>An. </it>(<it>Cel.</it>) <it>sergentii </it>and <it>An. </it>(<it>Cel.</it>) <it>superpictus*</it>. These maps are presented alongside a bionomics summary for each species relevant to its control.</p

Screening of Cardiovascular Risk Factors among Workers of a Construction Company in a Developing Country, Senegal

Objectives: This study aimed to evaluate the prevalence of cardiovascular risk factors in workplace and the global risk among workers of a Construction Company in a developing country.Methods: It was a retrospective and descriptive survey over two years in a construction company in Dakar, Senegal.Results: We collected 64 workers with a male predominance. The average age of workers was 44.9 years. Evaluation and analysis of cardiovascular risk reflected four levels: low in 78.12%, moderate in 15.62%, high in 4.69% and very high in 1.57%. Sedentary was strongly associated with moderate or high cardiovascular risk. Metabolic syndrome was strongly associated with moderate or elevated cardiovascular risk.Conclusion: Our study reveals a high prevalence of cardiovascularrisk factors in Senegalese workers. It would be important to include a screening program and correct assessment of overall cardiovascular risk in this population.Keys-words: Cardiovascular risk factor; Cardiovascular disease; Prevention; Workplace; Construction compan