Confection D’une Colostomie De Maydl (Sur Baguette) En Situation De Precarite

Nous avions présenté une procédure simplifiée et reproductible de réalisation d’une colostomie sur baguette de Maydl, en conditions de précarité. Il s’agissait d’utiliser une seringue stérile de 10 cc et un fil à peau

Neurinomes et neurofibromes spinaux diagnostic et resultats du traitement chirurgical a yaounde

Description les neurinomes et neurofibromes spinaux restent très peu étudiés en Afrique sub-saharienne. Objectif rapporter les résultats du traitement chirurgical des neurinomes et neurofibromes spinaux à Yaoundé. Méthodes étude rétrospective menée à l’Hôpital Général et à l’Hôpital Central de Yaoundé, du 1er Janvier 1995 au 1er Janvier 2005. Critères d’inclusion: dossier médical comprenant les résultats de l’examen clinique pré et post opératoire, ceux des examens neuroradiologiques et histopathologiques, le compte rendu opératoire. Un suivi post-opératoire minimal de six mois. Le résultat fonctionnel été évaluée par l’échelle de Karnofsky. Résultats sur 62 patients opérés d’une tumeur intrarachidiennes, 12 (19,35 %) ont été sélectionnés (neuf neurinomes, deux neurofibromes, un neurofibrosarcome). L’age moyen était de 40,66 ans ±13,20, le sex ratio 0,71. La durée moyenne de symptômes avant le diagnostic était de 17,83 mois ± 5,81, extrêmes 6 et 28 mois ; le signe d’appel le plus fréquent était la radiculalgie (six cas). Cinq patients étaient paraplégiques. Le score deKarnofsky moyen préopératoire était de 50,00 ±12,79 et de 70,83±23,53 en postopératoire. Le siège tumoral était cervical (quatre cas), dorsal (six cas), lombaire (deux cas). La tumeur était extradurale dans six cas, intra durale quatre, intra et extradurale deux cas. L’exérèse était macroscopiquement complète dans neuf cas, partielle dans trois. Cinq patients ont connu une amélioration permettant une réinsertion professionnelle. Conclusion le diagnostic des neurinomes et neurofibromes reste tardif dans notre environnement, ce qui limite lerésultat chirurgical

Xenomonitoring of sleeping sickness transmission in Campo (Cameroon)

Background: The sleeping sickness focus of Campo in South Cameroon is still active, at a low endemic level, for more than a century, despite a regular medical surveillance. The present study focuses on the spatial distribution of xenomonitoring information obtained from an entomological survey performed in the dry season 2012. It appears that humans constitute a third of the blood meals and that the flies' densities were coherent with those classically observed in the different biotopes. Paradoxically, the epicenter of the focus is the place where the risk indicators are the lowest ones. Methods: Particular attention was paid to the entomological device so that it covered the main part of human activities in the study area. One hundred and sixty-two pyramidal traps were used to catch tsetse flies twice a day that were identified, counted, dissected. Molecular analysis using classical and specific molecular markers was conducted to determine the importance of trypanosome infections and the nature of the feeding hosts. This information was used to calculate a Transmission Risk Index and to define a gradient of risk that was projected into a Geographical Information System. Results: Conventional entomological indicators such as species identification of tsetse flies or the Apparent Density per Trap per day, show that Glossina palpalis palpalis is the main species in the campo area which is classically distributed into the different biotopes of the study area. Molecular analysis reveals that humans constitute a third of the blood feeding hosts and that 20 % of the dissected flies were infected with trypanosomes, principally with Nannomonas. Nevertheless, one fly was carrying Trypanosoma brucei gambiense, the pathogen agent of sleeping sickness, showing that the reservoir is still active in the epicenter of the focus. Paradoxically, the Transmission Risk Index is not important in the epicenter, demonstrating that endemic events are not only depending on the man/vector contact. Conclusion: Xenomonitoring provides a valuable guide/tool to determine places at higher risk for vector/human contact and to identify trypanosomes species circulating in the focus. This information from xenomonitoring demonstrates that decision makers should include a veterinary device in a control strategy

Efficacité et rémanence de deux pyréthrinoïdes en imprégnation de tulle moustiquaire sur deux moustiques du sud-Cameroun

Des bio-essais ont permis d'évaluer les réactions immédiates et retardées d'#Anopheles gambiae, souche Yaoundé et de #Culex quinquefasciatus, souche Yaoundé et souche Douala. La mise en contact forcé des moustiques a duré trois minutes. L'imprégnation du tulle moustiquaire a été effectuée avec la deltaméthrine ou la perméthrine, chacune avec trois concentrations différentes. Des résultats obtenus avec les moustiques testés, il ressort que la deltaméthrine est un insecticide sensiblement supérieur tant pour l'efficacité que pour la rémanence. La deltaméthrine est à préférer à la perméthrine pour l'imprégnation des moustiquaires dans le sud-Cameroun. (Résumé d'auteur

Evaluation of LATEX/T.b.gambiense for mass screening of Trypanosoma brucei gambiense sleeping sickness in Central Africa

We compared the Card Agglutination Test for Trypanosomiasis (CATT), which consists of lyophilized bloodstream form trypomastigotes of Trypanosoma brucei gambiense (T.b.g.) variable antigen type LiTat 1.3, with LATEX/T.b.g., which consists of a lyophilized suspension of latex particles coated with variable surface glycoproteins of T.b.g. variable antigen types LiTat 1.3, 1.5 and 1.6. This study was carried out during two mass screening surveys in 1998 in Campo, a sleeping sickness focus in Cameroon, with a low prevalence (0.3%) and in 1999 in Batangafo which belongs to the Central African focus of Ouham which has a higher prevalence (3%). In Campo, we compared the CATT performed on whole blood with the LATEX/T.b.g. on diluted blood. In Batangafo, both tests were performed on diluted blood. In all circumstances, the specificity of the LATEX/T.b.g. was higher than of CATT. The use of LATEX/T.b.g. on diluted blood instead of CATT results in an important decrease of workload and as a consequence, of costs related to parasitological examinations. In the case of Campo the workload was up to 12 times less than when using CATT 1.3 on whole blood and the cost divided by 3. In Batangafo the workload was decreased by nearly 20% with the LATEX/T.b.g. Finally, it should be noted that in Batangafo, one of the parasitologically confirmed sleeping sickness patients was negative in CATT and positive in LATEX/T.b.g. and that the reading of the test result in LATEX/T.b.g. is easier than in CATT

Mechanical ventilation preserves diaphragm mitochondrial function in a rat sepsis model

International audienceAbstract Background To describe the effect of mechanical ventilation on diaphragm mitochondrial oxygen consumption, ATP production, reactive oxygen species (ROS) generation, and cytochrome c oxidase activity and content, and their relationship to diaphragm strength in an experimental model of sepsis. Methods A cecal ligation and puncture (CLP) protocol was performed in 12 rats while 12 controls underwent sham operation. Half of the rats in each group were paralyzed and mechanically ventilated. We performed blood gas analysis and lactic acid assays 6 h after surgery. Afterwards, we measured diaphragm strength and mitochondrial oxygen consumption, ATP and ROS generation, and cytochrome c oxidase activity. We also measured malondialdehyde (MDA) content as an index of lipid peroxidation, and mRNA expression of the proinflammatory interleukin-1β (IL-1β) in diaphragms. Results CLP rats showed severe hypotension, metabolic acidosis, and upregulation of diaphragm IL-1β mRNA expression. Compared to sham controls, spontaneously breathing CLP rats showed lower diaphragm force and increased susceptibility to fatigue, along with depressed mitochondrial oxygen consumption and ATP production and cytochrome c oxidase activity. These rats also showed increased mitochondrial ROS generation and MDA content. Mechanical ventilation markedly restored mitochondrial oxygen consumption and ATP production in CLP rats; lowered mitochondrial ROS production by the complex 3; and preserved cytochrome c oxidase activity. Conclusion In an experimental model of sepsis, early initiation of mechanical ventilation restores diaphragm mitochondrial function

Bone tumours in Cameroon: incidence, demography and histopathology

A multicentre analysis was carried out on bone tumours in Cameroon during a 10-year period. Registers and patient records of five pathology laboratories were consulted, and all patients with a histological report of a bone tumour were included in the study. A total of 268 bone tumours were studied and the average incidence was 27 tumours a year, or two per one million inhabitants. Of these tumours 48% were benign, 45% were primary bone cancers and only 6% were metastatic disease. Among the primary malignant bone tumours, osteosarcoma was the most frequent (39%), followed by non-Hodgkin's primary bone lymphoma, fibrosarcoma, chondrosarcoma, and Ewing's sarcoma. Primary site of the metastatic bone tumours was prostatic adenocarcinoma, breast cancer, hepatocarcinoma and thyroid cancer. In Cameroon many bone tumours are not diagnosed due to lack of medical facilities and little awareness among our medical staff. It is likely that the real incidence is at least ten times higher than that shown in our report

Etat vegetatif post-traumatique: quand arrêter la réanimation en zone déshéritée? - Fait clinique

L'état végétatif est l'une des complications les plus redoutables du traumatisme crânien. Les auteurs présentent un cas clinique à propos d'un état végétatif chez une femme de 32 ans suite à un traumatisme crânien après accident de la circulation. La patiente est entrée avec un Glasgow à 6/15. L'évolution a été marquée par la survenue d'une anémie, des convulsions et d'une fièvre à J7 d'hospitalisation. Un état végétatif à été note J38. La prise en charge a consisté en : un remplissage, une antibiothérapie, l'administration du phénobarbital, levo-dopa et du valproate de sodium. La patiente est décédée à J90 de suite d'une surinfection des escarres. Les patients en état végétatif posent beaucoup de problèmes de prise en charge dans les pays en voie de développement, pour des raisons économiques (car n'étant pas assurés) et logistiques (très peu de formations sanitaires sont adaptées à la prise en charge de ces patients en phases primaire et secondaire). Mots cles: etat végétatif, arrêt thérapeutique, prise en charge, pays en voie de développement Clinics in Mother and Child Health Vol. 2(1) 2005: 291-29

Challenges towards the elimination of Human African Trypanosomiasis in the sleeping sickness focus of Campo in southern Cameroon

The sleeping sickness focus of Campo lies along the Atlantic coast and extends along the Ntem River, which constitutes the Cameroonian and Equatorial Guinean border. It is a hypo-endemic focus with the disease prevalence varying from 0.3 to 0.86% during the last few decades. Investigations on animal reservoirs revealed a prevalence of Trypanosoma brucei gambiense of 0.6% in wild animals and 4.83% in domestic animals of this focus. From 2001 to 2012, about 19 931 tsetse were collected in this focus and five tsetse species including Glossina palpalis palpalis, G. pallicera, G. nigrofusca, G. tabaniformis and G. caliginea were identified. The analysis of blood meals of these flies showed that they feed on human, pig, goat, sheep, and wild animals such as antelope, duiker, wild pig, turtle and snake. The percentage of blood meals taken on these hosts varies according to sampling periods. For instance, 6.8% of blood meals from pig were reported in 2004 and 22% in 2008. This variation is subjected to considerable evolutions because the Campo HAT focus is submitted to socio-economic mutations including the reopening of a new wood company, the construction of autonomous port at "Kribi" as well as the dam at "Memve ele". These activities will bring more that 3000 inhabitants around Campo and induce the deforestation for the implementation of farmlands as well as breeding of domestic animals. Such mutations have impacts on the transmission and the epidemiology of sleeping sickness due to the modification of the fauna composition, the nutritional behavior of tsetse, the zoophilic/anthropophilic index. To achieve the elimination goal in the sleeping sickness focus of Campo, we report in this paper the current epidemiological situation of the disease, the research findings of the last decades notably on the population genetics of trypanosomes, the modifications of nutritional behavior of tsetse, the prevalence of T. b. gambiense in humans, domestic and wild animals. An overview on the types of mutations occurring in the region has been raised and a discussion on the strategies that can be implemented to achieve the elimination of the disease has been made

Hemangiopericytome Meninge: Rapport clinico-pathologique d\'un cas

Nous rapportons l\'observation d\'un hémangiopéricytome de localisation méningée (HPCM) chez une femme de 42 ans reçue à l\'Hôpital Général de Yaoundé, Cameroun. Cette tumeur est rare chez nous, et la localisation méningée exceptionnelle. Le diagnostic histologique est difficile, la tumeur étant souvent confondue à un méningiome. La patiente a été opérée et ensuite soumise à une radiothérapie. Elle se porte bien 6 mois après son traitement. Il est recommandé aux pathologistes d\'exclure un probable HPCM en cas de ‘méningiomes atypiques\' primaires, récidivants ou métastatiques. Etant donné le taux de récurrence élevé avec des métastases tardives, un suivi des patients traités de cette tumeur à long terme s\'avère important. Une surveillance à long terme est prévue.The authors report the case of a meningeal hemangiopericytoma (MHPC) in a 42-year-old woman seen at the General Hospital Yaoundé, Cameroon. This tumour is rare in our environment, and the meningeal location is even rarer, difficult to diagnose histologically and often confused with a meningioma. The patient, who was treated by surgery followed by radiotherapy, is well six months after treatment. Pathologists are advised to rule out an MHPC in case of a primary, recurrent or metastatic ‘atypical meningioma\'. Given the high recurrent rate with late metastasis of this tumour, long term follow up of patients is important. A long term surveillance and follow-up is envisaged Keywords: Hemangiopericytoma - meningeal- Cameroon.Clinics in Mother and Child Health Vol. 5 (2) 2008: pp. 937-94