Hématomes Extraduraux Chez L’adulte Au Togo

Purpose: The purpose of this work was to evaluate our neurosurgical practice about extradural hematoma and to describe their prognosis in our context. Patients and methods: This is a retrospective study of patients treated for extradural hematoma at Sylvanus Olympio university teaching hospital, which houses the only neurosurgery unit in Togo between April 2008 and August 2014. We included in our study, the files of patients of both sexes, aged over 15 years, with extradural hematoma isolated or not at the cerebral scanner, treated during the study period. Thus, 62 patients were taken into account. There was a male predominance (sex ratio of 19.7). The average age was 29.8 years with extremes of 02 and 70 years of which 41.9% of patients were between 20 and 29 years old. The surgical technique was the making of a burr hole or a cranial flap. We examined the parameters related to surgical treatment and the evolutionary mode. Results: In this study, 34 patients (54.8%) underwent surgery: cranial section (27 cases), widened hole craniotomy (07 cases). The average time between trauma and surgery was 09 days with extremes of 01 to 30 days. Twenty-four patients were operated more than 48 hours after diagnosis and the average postoperative follow-up time was 11.1 days with extremes of 07 and 18 days. Twenty-eight patients (45.2%) were not operated on. Among them, 20 patients presented with a HED blade (thickness of less than 10mm) and the eight (08) others for lack of financial means. The average hospital follow-up time for non-operated patients was 15.4 days with extremes of 08 and 60 days. The evolution was evaluated by the Glasgow Outcome Scale over three months. Fifty-five patients or 88.7% recovered without sequel. We obtained 3 cases (4.8%) of deaths including 2 cases that were not operated due to lack of financial means. Conclusion: We have observed that a low Glasgow admission score, long treatment delays, and associated lesions are factors that appear to reduce the prognosis in the treatment of extradural hematoma in Togo. These prognostic factors must be better documented in our future studies to identify them in order to act on them in order to reduce the morbidity and mortality that these extra-mural hematoma cause in our environments

Concordance in hpv detection between self-collected and health provider-collected cervicovaginal samples using carehpv in tanzanian women

Cervical cancer screening is one of the strategies to prevent the disease among women at risk. Human papillomavirus (HPV) DNA testing is increasingly used as the cervical cancer screening method because of its high sensitivity. Self-collection of cervical specimens has the potential to improve participation. However, there is only limited information on comparison between self-collected and provider-collected samples with regard to detection of high-risk HPV using the careHPV method. The study aimed to compare HPV detection by careHPV in self-collected and provider-collected cervical samples and to assess the acceptability of self-collection techniques. MATERIAL AND METHODS: Women attending cervical cancer screening clinics at Ocean Road Cancer Institute, Kilimanjaro Christian Medical Centre or Mawenzi Hospital in Tanzania were included in the study. They underwent a face-to-face interview, HIV testing, and collected a self-sample using Evalyn Brush. Subsequently, they had a cervical sample taken by a health provider. Both samples were tested for high-risk HPV DNA using careHPV. RESULTS: Overall, 464 women participated in the study. The high-risk HPV prevalence was 19.0% (95% CI, 15.6 to 22.9) in the health provider samples, but lower (13.8%; 95% CI, 10.9 to 17.3) in the self-collected samples. There was a good overall agreement 90.5% (95% CI, 87.5 to 93.0) and concordance (κ = 0.66; 95% CI, 0.56 to 0.75) between the two sets of samples. Sensitivity and specificity were 61.4% (95% CI, 50.4 to 71.6) and 97.3% (95% CI, 95.2 to 98.7), respectively, varying with age. Most women preferred self-collection (79.8%). CONCLUSION: Overall, self-sampling seems to be a reliable alternative to health-provider collection and is acceptable to the majority of women. However, instructions on proper procedures for sample collection to the women are important

Performance of <i>care</i>HPV, hybrid capture 2 and visual inspection with acetic acid for detection of high-grade cervical lesion in Tanzania:A cross-sectional study

ObjectiveTo examine the test performance of careHPV, Hybrid Capture2 (HC2) and visual inspection with acetic acid (VIA) for detection of cytologically diagnosed high-grade cervical lesions or cancer (HSIL+).DesignCross-sectional study.SettingOcean Road Cancer Institute (ORCI) and Kilimanjaro Christian Medical Center (KCMC), Tanzania.PopulationWomen attending routine cervical cancer screening.MethodWe enrolled 4080 women (25-60 years) in the study. The women were interviewed on lifestyle habits, and tested for HIV. A cervical specimen for careHPV testing (performed at ORCI and KCMC), and a liquid-based cytology sample for HPV DNA detection using HC2 (performed at Tuebingen University Hospital, Germany) and for cytology assessment (performed at Vejle Hospital, Denmark) were obtained at a gynecological examination. Subsequently, VIA was performed. With cytology as gold standard, the sensitivity and specificity of careHPV, HC2, and VIA for detection of HSIL+ were calculated.ResultsAltogether, 23.6% had a positive careHPV test, 19.1% had positive HC2 test, and 6.3% had a positive VIA test. The sensitivity/specificity was 88.9%/78.9% for careHPV and 91.1%/83.7%, for HC2. VIA showed a low sensitivity of 31.1% but a high specificity (94.6%) for detection of HSIL+. The sensitivity of careHPV, HC2 and VIA was higher among younger women, and among HIV positive women. VIA triage of careHPV positive women improved specificity, but sensitivity dropped to 27%.ConclusionOur results confirm the low sensitivity of VIA for detection of HSIL+ and further document that careHPV test is promising as a primary screening method for cervical-cancer prevention in low-resource regions. A suitable triage test has to be identified

Vasculocentric Axonal NfH in Small Vessel Disease.

Cerebral small vessel disease (SVD) causes lacunar stroke and vascular cognitive impairment in older people. The pathogenic pathways from vessel pathology to parenchymal damage in SVD are unknown. Neurofilaments are axonal structural proteins. Neurofilament-light (NfL) is an emerging biomarker for neurological disease. Here, we examined the high molecular weight form neurofilament-heavy (NfH) and quantified a characteristic pattern of peri-arterial (vasculocentric) NfH labeling. Subcortical frontal and parietal white matter from young adult controls, aged controls, and older people with SVD or severe Alzheimer disease (n = 52) was immunohistochemically labeled for hyperphosphorylated NfH (pNfH). The extent of pNfH immunolabeling and the degree of vasculocentric axonal pNfH were quantified. Axonal pNfH immunolabeling was sparse in young adults but a common finding in older persons (controls, SVD, or AD). Axonal pNfH was often markedly concentrated around small penetrating arteries. This vasculocentric feature was more common in older people with SVD than in those with severe AD (p = 0.004). We conclude that axonal pNfH is a feature of subcortical white matter in aged brains. Vasculocentric axonal pNfH is a novel parenchymal lesion that is co-located with SVD arteriopathy and could be a consequence of vessel pathology

Phylogenetic study on wild allies of Lima bean, Phaseolus lunatus (Fabaceae), and implications on its origin

An investigation was made of the phylogenetic relationships among wild accessions of Lima bean (Phaseolus lunatus) and wild allies of Mesoamerican and Andean origins, using electrophoresis of seed storage proteins and isozymes. Mesoamerican wild species are phylogenetically more distant from P. lunatus than Andean species, and apparently belong to the tertiary gene pool of Lima bean. The Andean wild species, which are investigated for the first time, reveal a high similarity to the Lima bean, and particularly with its Mesoamerican gene pool. These Andean species probably constitute a secondary gene pool of Lima bean, and are thus of considerable interest in the context of genetic improvement of the crop. Based on these observations, an Andean origin is suggested for the Andean wild species and for P. lunatus. These results point out the importance of collecting and conserving Andean Phaseolus germplasm.SCOPUS: ar.jinfo:eu-repo/semantics/publishe