les plaies cranio-encephaliques: Aspects epidemic-Cliniques et Therapeutiques a Dakar(Senegal)

Objectif Le but de cette étude était de montrer les aspects épidémio-cliniques des plaies crânio-encéphaliques et d’évaluer leur prise en charge dans un pays Africain tel le Sénégal.Introduction La plaie crânio-encéphalique est une solution de continuité de tous les plans de couverture séparant le parenchyme cérébral du milieu extérieur. L’infection devient alors la hantise et motive la rapidité de la prise en charge.Malades et méthodes Nous avons fait une étude rétrospective de 14 dossiers colligés de janvier 2006 à janvier 2008. Tous les patients ont été admis au service d’urgence ont été évalué cliniquement par le score de Glasgow et un examen neurologique complet. Ils ont bénéficié d’un scanner cérébral avant une prise en charge médicale et chirurgicale. Ils ont été suivis sur une durée moyenne de 17 mois.Résultats L’âge moyen de nos patients était de 30 ans, avec une prédominance masculine 11cas. La principale cause était les accidents de la voie publique (8cas) suivi par les agressions (4cas). Le délai moyen avant l’hospitalisation était de 24 heures et le délai moyen de prise en charge chirurgicale était de 57 heures ; la majorité des patients avaient un bon état de conscience selon l’échelle de GLASGOW 6 cas (15 - 13) et 4 cas (12 - 9). Le scanner cérébral a permis de montrer les lésions osseuses et intra parenchymateuses : 12 cas de contusions, sept cas de pneumencéphalie, cinq cas d’hématome sous dural et 1un cas de présence de corps étranger. La prise en charge thérapeutique comportait un volet médical et un autre chirurgical (craniectomie, reconstruction de la dure mère et de la peau). La durée moyenne d’hospitalisation était de 12 jours L’évolution post opératoire immédiate était excellente était dans 12 cas. Un patient était décédé et un autre avait gardé une hémiparésie. Conclusion Les plaies crânio-encéphaliques constituent une entité neuro-traumatique assez fréquente dont la principale complication est l’infection méningée. Une prise en charge précoce avec parage et antibioprophylaxie permettraient d’obtenir des résultats satisfaisants surtout en Afrique

Mitigation and Adaptation Strategies – Organic Agriculture

This psoter presents information on the following - The concept of organic farming in the context of climate change - Carbon sequestration on organic farms - Consequences of an area-wide conversion to organic agricultur

Elimination Theory for Nonlinear Parameter Estimation

The work presented here exploits elimination theory (solving systems of polynomial equations in several variables) [1][2] to perform nonlinear parameter identification. In particular show how this technique can be used to estimate the rotor time constant and the stator resistance values of an induction machine. Although the example here is restricted to an induction machine, parameter estimation is applicable to many practical engineering problems. In [3], L. Ljung has outlined many of the challenges of nonlinear system identification as well as its particular importance for biological systems. In these types of problems, the model developed for analysis is typically a nonlinear state space model with unknown parameter values. The typical situation is that only a few of the state variables are measurable requiring that the system be reformulated as a nonlinear input-output model. In turn, resulting the nonlinear input-output model is almost always nonlinear in the parameters. Towards that end, differential algebra tools for analysis of nonlinear systems have been developed by Michel Fliess [4][5] and Diop [6]. Moreover, Ollivier [7] as well as Ljung and Glad [8] have developed the use of the characteristic set of an ideal as a tool for identification problems. The use of these differential algebraic methods for system identification have also been considered in [9], [10]. The focus of their research has been the determination of a priori identifiability of a given system model. However, as stated in [10], the development of an efficient algorithm using these differential algebraic techniques is still unknown. Here, in contrast, a method for which one can actually numerically obtain the numerical value of the parameters is presented. We also point out that [11] has also done work applying elimination theory to systems problems

Unveiling induced folding of intrinsically disordered proteins – Protein engineering, frustration and emerging themes

Intrinsically disordered proteins (IDPs) can be generally described as a class of proteins that lack a well-defined ordered structure in isolation at physiological conditions. Upon binding to their physiological ligands, IDPs typically undergo a disorder-to-order transition, which may or may not lead to the complete folding of the IDP. In this short review, we focus on some of the key findings pertaining to the mechanisms of such induced folding. In particular, first we describe the general features of the reaction; then, we discuss some of the most remarkable findings obtained from applying protein engineering in synergy with kinetic studies to induced folding; and finally, we offer a critical view on some of the emerging themes when considering the structural heterogeneity of IDPs vis-à-vis to their inherent frustration

Comorbidité lèpre et tuberculose: à propos de six cas

Objectif : Rapporter 6 observations de co-infection de la lèpre et de la tuberculose. Méthodes : Il s’agissait d’une série rétrospective transversale à visée descriptive réalisée au Centre Hospitalier de l’Ordre de Malte à Dakar (Sénégal) sur une période de 15 ans (2001-2016).Résultats : Six dossiers étaient étudiés. La moyenne d’âge des patients était de 29 ans ± 10,4 [15 - 42 ans] avec un sex ratio H/F de 2 (4 hommes pour 2 femmes). Quatre patients avaient une lèpre lépromateuse et deux une lèpre borderline (boderline lépromateuse). Le délai médian d’évolution entre la tuberculose et la lèpre était de 32 mois [5 mois- 48 mois]. Les formes de tuberculose retrouvées étaient des formes purement pulmonaires dans 4 cas et multifocale (pleural et ganglionnaire ; pleural puis neurologique) dans 2 cas. Les facteurs de risque de survenue de la tuberculose étaient la corticothérapie générale au long cours, la malnutrition, l’anémie, le tabagisme et la grossesse. La sérologie antirétrovirale à VIH était négative chez tous les patients. Les traitements de la lèpre et de la tuberculose étaient prescrits selon les protocoles de l’OMS. Tous les patients étaient déclarés guéris de la lèpre et de la tuberculose.Conclusion : la survenue de la lèpre dans sa forme multibacillaire sur un terrain immunitaire déficitaire pourrait favoriser soit la réactivation d'une tuberculose latente sous-jacente ou une surinfection de la lèpre par Mycobacterium tuberculosis. Il paraît donc important de rechercher activement la tuberculose durant le screening des patients atteints de lèpre surtout lépromateus

Oxytocin via Uniject (a prefi lled single-use injection) versus oral misoprostol for prevention of postpartum haemorrhage at the community level: a cluster-randomised controlled trial

Background Access to injectable uterotonics for management of postpartum haemorrhage remains limited in Senegal outside health facilities, and misoprostol and oxytocin delivered via Uniject have been deemed viable alternatives in community settings. We aimed to compare the effi cacy of these drugs when delivered by auxiliary midwives at maternity huts. Methods We did an unmasked cluster-randomised controlled trial at maternity huts in three districts in Senegal. Maternity huts with auxiliary midwives located 3–21 km from the closest referral centre were randomly assigned (1:1; via a computer-generated random allocation overseen by Gynuity Health Projects) to either 600 μg oral misoprostol or 10 IU oxytocin in Uniject (intramuscular), stratifi ed by reported previous year clinic volume (deliveries) and geographical location (inland or coastal). Maternity huts that had been included in a previous study of misoprostol for prevention of postpartum haemorrhage were excluded to prevent contamination. Pregnant women in their third trimester were screened for eligibility either during community outreach or at home-based prenatal visits. Only women delivered by the auxiliary midwives in the maternity huts were eligible for the study. Women with known allergies to prostaglandins or pregnancy complications were excluded. The primary outcome was mean change in haemoglobin concentration measured during the third trimester and after delivery. This study was registered with ClinicalTrials.gov, number NCT01713153. Findings 28 maternity hut clusters were randomly assigned—14 to the misoprostol group and 14 to the oxytocin group. Between June 6, 2012, and Sept 21, 2013, 1820 women were recruited. 647 women in the misoprostol group and 402 in the oxytocin group received study drug and had recorded pre-delivery and post-delivery haemoglobin concentrations, and overall 1412 women delivered in the study maternity huts. The mean change in haemoglobin concentrations was 3·5 g/L (SD 16·1) in the misoprostol group and 2·7 g/L (SD 17·8) in the oxytocin group. When adjusted for cluster design, the mean diff erence in haemoglobin decreases between groups was not signifi cant (0·3 g/L, 95% CI –8·26 to 8·92, p=0·71). Both drugs were well tolerated. Shivering was common in the misoprostol group, and nausea in the oxytocin group. Postpartum haemorrhage was diagnosed in one woman allocated to oxytocin, who was referred and transferred to a higher-level facility for additional care, and fully recovered. No other women were transferred. Interpretation In terms of eff ects on haemoglobin concentrations, neither oxytocin nor misoprostol was signifi cantly better than the other, and both drugs were safe and effi cacious when delivered by auxiliary midwives. The programmatic limitations of oxytocin, including short shelf life outside the cold chain, mean that misoprostol could be more appropriate for community-level prophylaxis of postpartum haemorrhage

On the Effects of Disordered Tails, Supertertiary Structure and Quinary Interactions on the Folding and Function of Protein Domains

The vast majority of our current knowledge about the biochemical and biophysical properties of proteins derives from in vitro studies conducted on isolated globular domains. However, a very large fraction of the proteins expressed in the eukaryotic cell are structurally more complex. In particular, the discovery that up to 40% of the eukaryotic proteins are intrinsically disordered, or possess intrinsically disordered regions, and are highly dynamic entities lacking a well-defined three-dimensional structure, revolutionized the structure–function paradigm and our understanding of proteins. Moreover, proteins are mostly characterized by the presence of multiple domains, in-fluencing each other by intramolecular interactions. Furthermore, proteins exert their function in a crowded intracellular milieu, transiently interacting with a myriad of other macromolecules. In this review we summarize the literature tackling these themes from both the theoretical and experimental perspectives, highlighting the effects on protein folding and function that are played by (i) flanking disordered tails; (ii) contiguous protein domains; (iii) interactions with the cellular environment, defined as quinary structures. We show that, in many cases, both the folding and function of protein domains is remarkably perturbed by the presence of these interactions, pinpointing the importance to increase the level of complexity of the experimental work and to extend the efforts to characterize protein domains in more complex contexts