La Leucémie Myéloïde Chronique Pédiatrique: Une Entité Très Rare Au Service d’Hématologie De Yopougon

Contexte: La leucémie myéloïde chronique (LMC) est un syndrome myéloprolifératif dû à une prolifération myéloïde monoclonale prédominant sur la lignée granuleuse. Son pronostic a été amélioré par l’avènement des inhibiteurs de la tyrosine kinase. Elle survient le plus souvent chez l’adulte jeune. Les auteurs rapportent un cas clinique chez un enfant de 6 ans. Présentation de cas: Il s’agissait d’un enfant de 6 ans, de sexe masculin, référé en consultation en hématologie pour splénomégalie volumineuse évoluant depuis 3 mois. L’hémogramme a montré une hyperleucocytose à 282 Giga/L avec myélémie importante et polymorphe une anémie à 66 g/l et une thrombocytose à 870G/L. L’examen cytogénétique a retrouvé le chromosome Philadelphie sans anomalie additionnelle. Le traitement par imatinib mesylate a pu être débuté. Conclusion: La leucémie myéloïde chronique est certes rare chez l’enfant mais les praticiens doivent y penser devant une hyperleucytose importante persistente. Background: Chronic myeloid leukemia (CML) is a myeloproliferative syndrome due to monoclonal myeloid proliferation predominant over the granular line. His prognosis was improved by the advent of tyrosine kinase inhibitors. It occurs most often in young adults. The authors report the clinical case of a 6-year-old child because of its rarity. Case report: This was a 6-year-old male child, referred in hematology consultation for persistent of large splenomegaly. The hemogram showed hyperleucocytosis at 282 Giga/L with large myelemia and polymorphic anemia at 66 g/l and thrombocytosis at 870 G/L. the cytogenetic analyse found the Philadelphia chromosome without additional anomaly. The treatment with imatinib mesylate has therefore begun. Conclusion: Although the CML is uncommon at young people, but practicians must think about it when we have an important hyperleucocytosis

Outcome of undiagnosed traumatic diaphragmatic injuries: A review of our management

The authors relate on the outcomes of traumatic diaphragmatic injuries unknown early. The files of three patients have been reviewed retrospectively. All of them presented early undiagnosed injuries. The first patient had a left diaphragmatic injury consecutive to a stab wound to the left hypochondrium. The diagnosis was made 18 days later. He died 2 days after operation because of septicaemia. The second patient presented a colonic strangulation through a left diaphragmatic rupture consecutive to a stab wound three years before. A resection and anastomosis to the colon was performed. The patient left the hospital with a definitive pachypleuritis. The third patient was admitted for blunt trauma to the chest with dyspnoea. The chest X-ray showed the diaphragmatic rupture. The peri- operative exploration showed an old rupture with fibrosis banks. The lesion had been respected. The outcomes of early missed traumatic diaphragmatic rupture are various. Their treatment is sometime difficult and dangerous

Les traumatismes du diaphragme en urgence clinique et therapeutique a propos de 31 cas au Chu de Popougon

The authors report their experience of diaphragmatic traumas management. The retrospective survey had collected all files of the patients who presented, during a 15 years period in CHU Yopougon, a diaphragmatic trauma with communication between abdominal and pleural cavities. The hospital prevalence of the diaphragmatic wounds is between 0.3% and 7.6% of all the laparotomies performed for traumatism. The traumatism was closed (22.6%) and opened (77.4%) with predominance of fire arms (12.1%). The male predominance was clean with a sex ratio of 5. The middle age was 31ans ± 7 with extremes of 15 and 58 years. A hemothorax and a pneumothorax were respectively present in 58.1% and 35.5%. A dyspnaea was recovered in 83.9%. The standard x-ray of the thorax showed digestives pictures into the thorax. Drainage of the thorax has been achieved first in 18 patients presenting a hemothorax, a pneumothorax or a hemo-pneumothorax. The laparotomy incision was median (n=24), left hypochondre (n=4) and right hypochondre (n=1). In two cases a thoracotomy has been performed. The right dome was injured in 45.2% of the cases and in 54.8% the lesion was on the left. There were 9 ruptures and 22 punctiform wounds. All recent lesions have been sutured. In 90.3% continuations were simple and complicate in 9.7% of the cases. A patient died in a stern infection. The diaphragmatic wounds during the traumatisms are rare. The exam clinic and the x-ray standard of the thorax permit the diagnosis. A precocious suture presents good results. Les auteurs rapportent ici leur expérience de la prise en charge des traumatismes du diaphragme. L’étude rétrospective avait colligé tous les dossiers des patients qui, sur une période de 15 ans au CHU de Yopougon, ont présenté une solution de continuité diaphragmatique faisant communiquer les cavités abdominale et pleurale.La prévalence hospitalière des lésions diaphragmatiques était de 0,3% et de 7,6% de l’ensemble des laparotomisés pour traumatisme. Le traumatisme était fermé (22,6%) et ouvert (77,4%) avec prédominance des armes à feu (12,1%). La prédominance masculine était nette avec un sexe ratio de 5. L’âge moyen était de 31ans +/- 7 avec des extrêmes de 15 et 58 ans. Un hémothorax et un pneumothorax étaient présents dans 58,1% et 35,5% respectivement. Une dyspnée était retrouvée dans 83,9%. La radiographie standard du thorax mettait en évidence des images digestives dans le thorax. Un drainage premier du thorax a été réalisé chez 18 patients présentant un hémothorax, un pneumothorax ou un hémo-pneumothorax. La voie d’abord de la laparotomie était médiane (n=24), sous-costale gauche (n=4) et sous-costale droite (n=1). Dans deux cas une thoracotomie a été réalisée. La coupole droite était lésée dans 45,2% des cas et dans 54,8% la lésion était à gauche. Il y avait 9 ruptures et 22 plaies punctiformes. Toutes les lésions récentes ont été saturées. Dans 90,3% les suites étaient simples et compliquées dans 9,7% des cas. Un patient est décédé dans un tableau infectieux sévère. Les lésions diaphragmatiques au cours des traumatismes sont rares. L’examen clinique et la radiographie standard du thorax permettent posent le diagnostic. La suture précoce donne de bons résultats

How effective are DNA barcodes in the identification of African rainforest trees?

DNA barcoding of rain forest trees could potentially help biologists identify species and discover new ones. However, DNA barcodes cannot always distinguish between closely related species, and the size and completeness of barcode databases are key parameters for their successful application. We test the ability of rbcL, matK and trnH-psbA plastid DNA markers to identify rain forest trees at two sites in Atlantic central Africa under the assumption that a database is exhaustive in terms of species content, but not necessarily in terms of haplotype diversity within species.Journal ArticleResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Lassa fever clinical course and setting a standard of care for future randomized trials: A protocol for a cohort study of Lassa-infected patients in Nigeria (LASCOPE)

Background: Lassa Fever (LF), is a severe viral disease prevalent in Western Africa. It is classified as a priority disease by the World Health Organization (WHO). Ribavirin is the recommended therapy despite weak evidence of its efficacy. Promising therapeutic agents are becoming available for evaluation in human. Before launching therapeutic trials, we need data on the evolution of the disease under the best possible conditions of care. Methods: We have initiated a prospective study in Nigeria to better understand the clinical course and prognostic factors of LF while implementing high quality standardized care. Inclusion criteria are: suspected or confirmed LF and informed consent. Participants are followed 60 days from admission and receive free of charge standardized supportive care and biological monitoring, as well as intravenous ribavirin for those with confirmed LF. Data are collected using standardized case report forms (CRF). Primary and secondary outcomes are fatality and severe morbidity, with special focus on acute kidney dysfunction and pregnancy complications. Factors associated with outcomes will be investigated. Results: The cohort is planned for 3 years. Inclusions started in April 2018 at the Federal Medical Center Owo in Ondo State. A second site will open in Nigeria in 2020 and discussions are underway to open a site in Benin. 150 to 200 new participants are expected per year. Conclusions: This cohort will: provide evidence to standardize LF case management; provide key inputs to design future clinical trials of novel therapeutics; and establish clinical research teams capable of conducting such trials in LF-endemic areas

Data from: The ancient tropical rainforest tree Symphonia globulifera L. f. (Clusiaceae) was not restricted to postulated Pleistocene refugia in Atlantic Equatorial Africa

Understanding the history of forests and their species' demographic responses to past disturbances is important for predicting impacts of future environmental changes. Tropical rainforests of the Guineo-Congolian region in Central Africa are believed to have survived the Pleistocene glacial periods in a few major refugia, essentially centred on mountainous regions close to the Atlantic Ocean. We tested this hypothesis by investigating the phylogeographic structure of a widespread, ancient rainforest tree species, Symphonia globulifera L. f. (Clusiaceae), using plastid DNA sequences (cpDNA, psbA-trnH intergenic spacer) and nuclear microsatellites (SSRs). SSRs identified four gene pools located in Benin, West Cameroon, South Cameroon and Gabon, and São Tomé. This structure was also apparent at cpDNA. Approximate Bayesian Computation detected recent bottlenecks approximately dated to the last glacial maximum in Benin, West Cameroon and São Tomé, and an older bottleneck in South Cameroon and Gabon, suggesting a genetic effect of Pleistocene cycles of forest contraction. CpDNA haplotype distribution indicated wide-ranging long-term persistence of S. globulifera both inside and outside of postulated forest refugia. Pollen flow was four times greater than that of seed in South Cameroon and Gabon, which probably enabled rapid population recovery after bottlenecks. Furthermore, our study suggested ecotypic differentiation - coastal or swamp vs. terra firme - in S. globulifera. Comparison with other tree phylogeographic studies in Central Africa highlighted the relevance of species-specific responses to environmental change in forest trees