66 research outputs found

    Assessment of serum cystatin C in the early detection of type 2 diabetic nephropathy in Cotonou, Benin

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    Introduction: Diabetic nephropathy is a frequent and dreaded complication of diabetes mellitus. The purpose of this work was to study the role of serum cystatin C in the early detection of diabetic nephropathy among type 2 diabetic patients.Methods: This was a cross-sectional study conducted in Cotonou over a period of six months. Blood samples were tested at the regional food safety testing analysis laboratory. Type 2 diabetic patients older than 15 years, who gave their informed consent, were included in the study. Patients with proven proteinuria, acute kidney injury, haematuria, a positive urine test for nitrite, or reduced glomerular filtration rate <60 mL/min/1.73 m2 were excluded from the study. All patients were subjected to serum cystatin C and microalbuminuria assays.Results: Eighty-eight patients were included in the study. Their average age was 50.7 ± 9.6 years and the male to female ratio was 1.4:1. Twenty-four-hour microalbuminuria was positive in 53 (60%) cases whereas serum cystatin C tested positive in only 2 cases. Sensitivity and specificity tests applied to cystatin C showed very low sensitivity (4%) with a positive predictive value of 100% and high specificity (100%) with a negative predictive value of 41%.Conclusions: When compared with 24-hour microalbuminuria, serum cystatin C assay was not sensitive enough to prove suitable for screening for diabetic nephropathy. Serum cystatin C would therefore not be useful for the early detection of nephropathy among type 2 diabetic patients

    Polykystose renale autosomique dominante (PKAD) au CNHU-HKM de Cotonou: profil épidémiologique, clinique, biologique et intérêt du dépistage familial

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    Introduction: Étudier le profil épidémiologique, clinique et paraclinique de la PKAD chez des patients diagnostiqués au CNHU de Cotonou et évaluer l'intérêt d'un dépistage chez les patients à risque. Méthodes: Il s'agit d'une étude transversale comportant une revue de dossiers des patients  cliniquement diagnostiqués PKAD à la clinique universitaire de néphrologie et d'hémodialyse du 1er janvier 2000 au 31 janvier 2011, et une enquête familiale chez les patients où le diagnostic de PKAD a été confirmé entre le 1er février et le 31 Août 2011.Un séquençage à la recherche de mutations dans les gènes de la Polycystine 1 et 2 a été réalisé chez les cas index. Résultats: L'incidence hospitalière de la PKAD était de 7,8 cas par an. Le dépistage familial avait permis d'examiner 99 membres de 22 familles et de confirmer 14 cas de PKAD. L'âge moyen des patients était de 45,6±12,8ans. Le signe physique le plus fréquent était l'hypertension artérielle (HTA (83%). Une  insuffisance rénale chronique était observée dans 75% des cas. Le séquençage direct avait permis de mettre en évidence 7 nouvelles mutations dont 02 mutations dans les gènes PKD2 et 5 dans PKD1. Conclusion: La PKAD relativement fréquente, présente de nouvelles mutations chez les patients  diagnostiqués au CNHU de Cotonou. Le conseil génétique est particulièrement indiqué dans les familles où la maladie rénale a débuté précocement.Key words: Polykystose rénale autosomique dominante, dépistage, mutations PKD2 et PKD

    Kidney Injury in Children Infected with HIV, Followed at the Teaching Hospital of Borgou (Benin): Epidemiological and Clinical Aspects

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    The history of kidney disease associated with HIV infection dates back to the years of HIV breakthrough. The objective was to study kidney damage in children infected with HIV at the Teaching Hospital of Borgou (Benin) in 2019. This was a cross-sectional, descriptive, analytical, matching-type study carried out from June 1, 2019 to September 30, 2019 at the pediatrics department of Teaching Hospital of Borgou (Benin). The study included HIV-positive children, followed in consultations, and whose parents gave their consent. The biological markers were demonstrated with urine dipstick. Glomerular filtration rate was calculated using the Schwartz test and classified according to stages. The dependent variable was the presence of at least one impairment (biological or functional). Sample size was determined by Schwartz’s method on the basis of one case for two controls. Sociodemographic, clinical, biological, and therapeutic data were collected. Comparisons were made using the Chi- square test or Fisher’s exact test. The identification of associated factors was possible using a multiple logistic regression model at 5% threshold. In total, we included 117 children, including 39 HIV-positive children. The average age was 8 ± 4.81 years and the gender ratio was 1:17. The frequency of kidney damage was 76.5%. Permanent proteinuria and at least two crosses on urine dipstick were present in 20.5%, leukocyturia in 2.6%, and proximal tubular dysfunction in 5.1%. Glomerular hyperfiltration was found in 38.5%, acute kidney injury in 38.5%, and chronic kidney injury in 5.1%. Associated factors were age (P = 0.004), presence of opportunistic infections (P = 0.00), and treatment adherence (P = 0.004). Kidney damage is common in HIV-positive children. Careful follow-up is necessary to avoid complications

    Insuffisance Rénale Aigue Post-Opératoire Au Centre Hospitalier Universitaire Et Départemental Du Borgou : Fréquence Et Facteurs De Risques Associés

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    Introduction: Acute renal failure (ARF) post-operative is a specific form of acute deficiencies causing multiple declining factors. Objective: This survey aims to study the incidence and risk factors associated with acute renal failure (ARF) in post-operative surgical intensive care units to University Hospital of Borgou (UH-B): during 2015. Patients and Methods this study is a cross sectional, descriptive and analytical ones with the prospective data collection from March 1st to August 31th, 2015. The research has involved all patients admitted to the operating room for surgery and motherhood whatever reason and then transferred respectively to the intensive care areas at UH-B. The postoperative ARF has been investigated inner patients following inclusion criteria and classification according to RIFLE score. The socio-demographic, clinical and biological variables monitoring, even support and evolution are experimented. A questionnaire is designed for data collection. Data are analyzed by Epi-Info means with 5% of significance level. Results: 130 patients are registered. The mean age is 27.68 ± 12.87 years. The sex ratio is 0.66. The frequency of post-operative ARF reaches 12.31%. The associated risk factors are: hypertension (p = 0.0018), diabetes (p = 0.002), heart failure (p = 0.0104), severe sepsis (p = 0.006) hypovolemic shock (p = 0.002), ASA class ≥ 3 (p = 0.0014), preeclampsia-eclampsia (p = 0.012), the Altémier class classification ≥ 3 (p = 0.0164), a pathological urinary sediment like a proteinuria (p=0.006), haematuria (p= 0.001) and nitrituria (p=0.007). Consequently, three (03) subjects out of sixteen (16) have died (18.75%). Conclusion: The post-operative ARF is a reality in University Hospital Borgou , with a higher mortality rate. Thus, the prevention strategy is the best treatment through the screening and monitoring promotion towards risk factors

    Prévalence et déterminants de l’albuminurie dans le diabète de type 2 chez le sujet noir au Sud du Bénin

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    Objectif: Décrire les facteurs déterminants de l’albuminurie chez le diabétique de type 2.Méthodes: Nous avons mené une étude transversale, prospective à visée descriptive et analytique. Elle s’est déroulée sur une période de 06 mois de février à Août 2014. Ont été inclus les patients diabétiques de type 2 suivis par un spécialiste et ayant fait les dosages nycthéméraux de l’albumine urinaire par la méthode immunoturbidimétrique. Ces dernières sont considérées comme positives à partir de 30 mg/24 h d’albuminurie. La régression logistique, en analyse multivariée, a permis de mesurer l’association entre la survenue de l’albuminurie et ses déterminants.Résultats: Cent quatre-vingt-un (181) patients étaient retenus, 86 présentaient une albuminurie positive (soit 47.5%) avec une sex-ratio de 0,7. L’âge variait de 19 à 85 ans. L’IMC variait entre 18.9 et 56.0 kg/m². L’albuminurie positive chez les patients ayant un diabète déséquilibré, était de 57.4% contre 32.9% des diabétiques équilibrés (p = 0.001). L’albuminurie positive chez les patients hypertendus était de 65.2% contre 36.6% diabétiques normotendus (p < 0.001). L’hypercholestérolémie totale était associée à une albuminurie positive (p = 0.04). L’ancienneté du diabète était également associée à une l’albuminurie positive (p = 0.01).Conclusion: L’hypertension artérielle, l’hypercholestérolémie, l’équilibre du diabète et l’ancienneté du diabète jouent un rôle important dans la survenue de l’albuminurie chez le diabétique de type 2. Un contrôle strict de ces déterminants s’avère indispensable.Objective: To describe albuminuria causal factors among type 2 diabetes patients.Methods: We carried out a cross-sectional retrospective study aimed at describing and analyzing the subject matter. It was conducted over a six-month period from February to August 2014. Type 2 diabetic patients regularly seen by a specialist who underwent immunoturbidimetric assay of urine albumin were included in the study. It was considered positive for albuminuria above 30 mg/24h. The multivariate logistic regression analysis enabled us to measure the association between albuminuria and its determinants.Results: One hundred and eighty one (181) patients were selected, 86 had positive albuminuria (47.5%) and the sex ratio was recorded at 0.7. Age ranged from 19 to 85 years. BMI ranged from 18.9 to 56.0 kg/m². Positive albuminuria among uncontrolled diabetes patients represented 57.4% against 32.9% controlled diabetes patients (p = 0.001). Positive albuminuria among hypertensive patients was 65.2% against 36.6% in normotensive diabetic patients (p < 0.001). Hypercholesterolemia was associated with positive albuminuria (p = 0.04). Diabetes seniority was also associated with positive albuminuria (p = 0.01).Conclusions: Blood pressure, hypercholesterolemia, the control of diabetes and duration of diabetes all played a significant role in occurrence of albuminuria among type 2 diabetic patients. It is important to carry out a thorough check on these determinants.Objectif                                                                                                           Décrire les facteurs déterminants de l’albuminurie chez le diabétique de type 2.Patients et MéthodesNous avons mené une étude transversale, prospective à visée descriptive et analytique. Elle s’est déroulée sur une période de 06 mois de février à Août 2014. Ont été inclus les patients diabétiques de type 2 suivis par un spécialiste et ayant fait les dosages nycthéméraux de l’albumine urinaire par la méthode immunoturbidimétrique. Ces dernières sont considérées comme positives à partir de 30 mg/24 h d’albuminurie.La régression logistique, en analyse multivariée, a permis de mesurer l’association entre la survenue de l’albuminurie et ses déterminants.RésultatsCent quatre-vingt-un (181) patients étaient retenus, 86 présentaient une albuminurie positive (soit 47,5%) avec une sex-ratio de 0,7. L’âge variait de 19 à 85 ans. L’IMC variait entre 18,93 et 56,01 kg/m².L’albuminurie positive chez les patients ayant un diabète déséquilibré, était de 57,4% contre 32,9% des diabétiques équilibrés. (p = 0,001)L’albuminurie positive chez les patients hypertendus était de 65,2% contre 36,6% diabétiques normotendus. (p = 0,000)L’hypercholestérolémie totale était associée à une albuminurie positive. (p = 0,04)L’ancienneté du diabète était également associée à une l’albuminurie positive. (p = 0,01) Conclusion L’hypertension artérielle, l’hypercholestérolémie, l’équilibre du diabète et l’ancienneté du diabète jouent un rôle important dans la survenue de l’albuminurie chez le diabétique de type 2. Un contrôle strict de ces déterminants s’avère indispensabl

    A Clear View of a Cloudy Brown Dwarf Companion from High-Resolution Spectroscopy

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    Direct imaging studies have mainly used low-resolution spectroscopy (R20100R\sim20-100) to study the atmospheres of giant exoplanets and brown dwarf companions, but the presence of clouds has often led to degeneracies in the retrieved atmospheric abundances (e.g. C/O, metallicity). This precludes clear insights into the formation mechanisms of these companions. The Keck Planet Imager and Characterizer (KPIC) uses adaptive optics and single-mode fibers to transport light into NIRSPEC (R35,000R\sim35,000 in KK band), and aims to address these challenges with high-resolution spectroscopy. Using an atmospheric retrieval framework based on petitRADTRANS, we analyze KPIC high-resolution spectrum (2.292.49 μ2.29-2.49~\mum) and archival low-resolution spectrum (12.2 μ1-2.2~\mum) of the benchmark brown dwarf HD 4747 B (m=67.2±1.8 MJupm=67.2\pm1.8~M_{\rm{Jup}}, a=10.0±0.2a=10.0\pm0.2 au, Teff1400T_{\rm eff}\approx1400 K). We find that our measured C/O and metallicity for the companion from the KPIC high-resolution spectrum agree with that of its host star within 12σ1-2\sigma. The retrieved parameters from the KK band high-resolution spectrum are also independent of our choice of cloud model. In contrast, the retrieved parameters from the low-resolution spectrum are highly sensitive to our chosen cloud model. Finally, we detect CO, H2_2O, and CH4_4 (volume mixing ratio of log(CH4_4)=4.82±0.23-4.82\pm0.23) in this L/T transition companion with the KPIC data. The relative molecular abundances allow us to constrain the degree of chemical disequilibrium in the atmosphere of HD 4747 B, and infer a vertical diffusion coefficient that is at the upper limit predicted from mixing length theory.Comment: 33 pages, 16 figures, Accepted to Ap

    HARMONI at ELT: project status and instrument overview

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    Role of Seaports and Imported Rats in Seoul Hantavirus Circulation, Africa

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    Seoul orthohantavirus (SEOV) is not considered a major public health threat on the continent of Africa. However, Africa is exposed to rodentborne SEOV introduction events through maritime traffic after exponential growth of trade with the rest of the world. Serologic studies have already detected hantavirus antibodies in human populations, and recent investigations have confirmed circulation of hantavirus, including SEOV, in rat populations. Thus, SEOV is a possible emerging zoonotic risk in Africa. Moreover, the range of SEOV could rapidly expand, and transmission to humans could increase because of host switching from the usual brown rat (Rattus norvegicus) species, which is currently invading Africa, to the more widely installed black rat (R. rattus) species. Because of rapid economic development, environmental and climatic changes, and increased international trade, strengthened surveillance is urgently needed to prevent SEOV dissemination among humans in Africa

    Role of Seaports and Imported Rats in Seoul Hantavirus Circulation, Africa

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    International audienceSeoul orthohantavirus (SEOV) is not considered a major public health threat on the continent of Africa. However, Africa is exposed to rodentborne SEOV introduction events through maritime traffic after exponential growth of trade with the rest of the world. Serologic studies have already detected hantavirus antibodies in human populations, and recent investigations have confirmed circulation of hantavirus, including SEOV, in rat populations. Thus, SEOV is a possible emerging zoonotic risk in Africa. Moreover, the range of SEOV could rapidly expand, and transmission to humans could increase because of host switching from the usual brown rat (Rattus norvegicus) species, which is currently invading Africa, to the more widely installed black rat (R. rattus) species. Because of rapid economic development, environmental and climatic changes, and increased international trade, strengthened surveillance is urgently needed to prevent SEOV dissemination among humans in Africa.Rodents are widespread, opportunistic, and competent host reservoirs involved in the maintenance, circulation, and transmission of a wide panel of zoonotic pathogens (1). Rodent-related zoonoses cause up to 400 million human infections worldwide each year (1,2). Among zoonotic pathogens, hantaviruses (order Bunyavirales, family Hantaviridae, genus Orthohantavirus) are among agents considered most likely to emerge and have a global public health impact (3).Hantaviruses are enveloped, negative, single-stranded RNA viruses with a tripartite genome comprised of large, medium, and small segments. Transmitted to humans via inhalation of aerosolized virus in contaminated rodent urine and feces, hantaviruses can cause hemorrhagic fever with renal syndrome (HFRS) or hantavirus pulmonary syndrome (4). Hantaviruses are generally carried by a rodent species host, and geographic distribution of the host can determine the area in which the associated disease occurs among humans. From this perspective, Seoul orthohantavirus (SEOV), identified in South Korea in 1982, deserves special attention because its cosmopolitan host, the Norwegian rat (Rattus norvegicus), also known as the brown rat, has been dispersed worldwide, resulting in a global distribution of the virus today (5). Detection of SEOV is often considered anecdotal and speculated to be driven by sporadic introduction of infected brown rats via transportation but also by pet or laboratory rats (6,7). Diagnosing SEOV in humans remains a challenge due to milder and atypical HFRS pathology (8). However, mild symptoms can progress to acute renal disease associated with HFRS, in which patients experience low blood pressure, acute shock, and acute kidney failure, and the case-fatality rate is ≈1% (9)
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