Prise en charge de l’hematome extradural a Dakar. A propos de 40 cas

Introduction L’hématome extradural est une affection rare mais grave car engage rapidement le pronostic vital. Il s’agit d’une urgence thérapeutique nécessitant par conséquent une prise en charge rapide.Objectif L’objectif de ce travail est d’évaluer les aspects épidémiologiques, diagnostiques et thérapeutiques de l’hématome extradural depuis l’avènement du scanner dans notre pays.Patients et méthode Il s’agit d’une étude rétrospective multicentrique réalisée dans quatre de nos hôpitaux durant une période de huit ans, de juillet 1994 à juin 2002. Nous avons pu collecter 40 dossiers de patients traumatisés cranioencéphaliques présentant un hématome extradural à la tomodensitométrie cérébrale.Résultats Sur 1296 patients ayant consulté pour un traumatisme cranio-encéphalique toute gravité confondue, 40 ont présenté un hématome extra dural soit 3,09%. L’age moyen était de 26.1 ans avec une fréquence maximale entre 11 et 20 ans. Le sex. Ratio est de 9.1. Les accidents de la voie publique représentent l’étiologie la plus fréquente avec 55% des cas. Le délai de consultation est long avec une moyenne de 2 à 3 jours. L’examen clinique retrouve des signes d’hypertension intracrânienne chez 87,5% des patients, un déficit moteur chez 30% des patients, des troubles de la conscience dans 55% des cas. Les résultats scannographiques ont montré une localisation temporo pariétale prédominante (72,5%) . 87,5% des patients ont bénéficié d’une prise en charge chirurgicale. L’évolution est favorable dans 75% des cas. Nous avons noté 20% de mortalité.Conclusion L’hématome extradural constitue l’urgence neurochirurgicale type. Son pronostic est bon si traité précocement

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Vowel deletion in Pulaar: Rime and nuclear mergers and the issue of the syntax-phonology interface

published or submitted for publicationis peer reviewe

Aspects of Pulaar Non-Linear Phonology

231 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 1998.The language under study in this thesis is Pulaar, a dialect of Fula. Fula belongs to the West Atlantic language group of the Niger-Congo family (cf. Greenberg 1960). It is spoken by an estimated fifteen to seventeen million people from the Atlantic to the Sudan and into parts of Ethiopia (cf. Crystal 1987 for figures, and Paradis 1986, 1993; Labouret 1952, Arnott 1970, etc... for description/analysis of various dialects). Fula is referred to as (Haal) Pulaar (Mauritania, Senegal, Guinea, Mali, Gambia), Fulfulde (Niger, Nigeria, Sudan), Toucouleur/Tukulor (Senegal), Fulacunda, Peulh, etc. The dialect studied in this thesis is spoken in (southern) Mauritania, more specifically in the Kayhaydi area. The purpose of the thesis is to study aspects of Pulaar Phonology from a non-linear perspective. The thesis is divided into six chapters organized as follows: we begin with an introductory chapter in which we present certain crucial facts and general notions about Pulaar. We give the vowel as well as consonant inventory of the language and a general review of the morphology and syntax of Pulaar. Because many processes discussed in this dissertation make reference, in one way or another to the syllable, chapter two is going to discuss the Pulaar syllable, using the moraic framework. In this chapter we present arguments in favor of syllable-internal structure in moraic phonology. Chapter three describes and analyzes vowel deletion and vowel spreading with a view to determining the domain of the rule. It will be demonstrated that vowel deletion is sensitive to syntactic information and that current approaches within the syntax-phonology interface cannot adequately handle the Pulaar data. In this chapter we also deal with issues related to the interaction between vowel deletion and the Pulaar syllable. Chapter four is about vowel harmony in Pulaar and its domain. In this chapter we also discuss the interaction between vowel harmony and vowel deletion. Following this, chapter five is going to deal with vowel length alternations in Pulaar. It will be shown that previous solutions for the phenomenon (Paradis 1986, 1993; Prunet and Tellier 1984) could be improved in order to account for data that either seemed problematic for or not dealt with by the previous authors. In addition, we will also discuss the interaction between vowel length alternations, vowel deletion, and the facts of Pulaar syllable. Chapter six summarizes the dissertation.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD

HOW DEAL WITH BRAIN TUBERCULOMAS? ( STUDY OF 4 CASES ) QUE FAIRE DEVANT UNE SUSPICION DE TUBERCULOMES INTRACRANIENS ? ( SERIE CONSECUTIVE DE 4 CAS ) (Francais)

Background and purpose: Neurosurgeons face a lot of pitfalls while dealing with brain tuberculomas. Our purpose is to set an algorithm . Methods: From 1996 to 2001 ,the authors reported 4 patients harbouring brain tuberculomas who have been hospitalised at our neurosurgical department .Medical reports of theses 4 patients were outlined and the authors discussed on diagnosis approach difficulties ,neuroimaging studies and the evolution for every patient. Results: Sex studies shows 3 males for 1 female .Median age is 40 years old .A1l for patients have been tested negative to H.I.V. For 2 patients a progressive lung tuberculosis existed and for one patient we find an history of lung tuberculosis. Intractable seizures were the first symptoms for 3 patients and only one expressed signs of intracranial hypertension with slow setting of hemiparesis. Brain C-T scan findings were for 3 patients a ring enhanced lesion surrounded with oedema characteristic of tuberculomas. For one patient neuroimaging study mimicked meningioma and the diagnosis has been done after surgery. For the last patient the good therapeutic response attested on serial C-T scan ,under antituberculosis treatment ,lead to the diagnosis of brain tuberculomas .The follow up demonstrated a good evolution for 3 patients and only one died after a post surgery status epilepticus. Conclusion: Because e of the high endimicity of tuberculosis on developing countries neurosurgeon practicing on theses area should be aware on brain s tuberculomas .Though every time that C-T scan shows a ring enhanced lesion with the context of lung tuberculosis ,one should start an antituberculosis treatment .Lack of good therapeutic response may lead to perform cerebral biopsy and later surgical resection of the lesion . Key words: brain tuberculomas; antituberculosis chemotherapy; surgery Objectif: L\'approche diagnostique et thrapeutique des tuberculomes, est remplie d\'cueils. L\'objectif de cette tude est de proposer un algorithme de dcision thrapeutique et diagnostique. Matriel et methods: Les auteurs rapportent sur une priode de 6 ans (1996- 2001), 4 cas de patients porteurs de tuberculomes intracrniens. Nous rapportons quatre observations cliniques qui ont t analys selon leurs caractres cliniques, para cliniques et thrapeutiques en insistant sur le profil volutif de chaque patient . Rsultats: Il s\'agit de 3 hommes et une femme dont l\'ge moyen lors du diagnostic tait de 40 ans. Tous ces patients avaient une srologie H.I.V. ngative .Chez 2 patients il existait une notion de tuberculose pulmonaire volutive dont une associe une tuberculose pritonale .Chez un patient dans les antcdents on notait dune tuberculose pulmonaire traite. Les circonstances de dcouverte ont t chez 3 patients une pilepsie rebelle et associe chaque fois un dficit post-critique ; chez un seul patient le tableau clinique correspondait l\'installation progressive d\'un dficit hmicorporel dans un contexte de syndrome d\'hypertension intracrnienne. Le scanner crbral a montr chez 3 patients une lsion vocatrice de tuberculome sous la forme d\'un nodule homogne dont le rehaussement se fait en cocarde entour d\'dme .Chez un patient ,l\'aspect scannographique orientait vers un mningiome et le diagnostic a t redress aprs la chirurgie . Chez une patiente, la bonne rponse thrapeutique avec disparition de l\'image au scanner nous a fait retenir le diagnostic de tuberculome crbral. Deux patients ont t biopsis par trpano-ponction avec une histologie concluante. Trois patients ont bnficie d\'une chirurgie d\'exrse en bloc avec poursuite en post-opratoire du traitement anti tuberculeux sur une priode de 12 mois .L volution a t bonne chez 3 patients .Un patient est dcd dans un tableau d\'tat de mal pileptique post-opratoire. Conclusion: partir de cette exprience et des donnes de la littrature, les auteurs ont tabli un algorithme. L\'endmicit de la tuberculose dans nos rgions, doit imposer un traitement anti-tuberculeux d\'preuve devant une neuro-imagerie vocatrice et devant l\'absence d\'une rponse thrapeutique franche, il est licite de procder d\'abord une biopsie crbrale et enfin l\'exrse en bloc. Af. Jnl Neurological Sciences Vol.23(1) 200

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field