Radiographic aspects of acute community-acquired bacterial pneumonia and pulmonary tuberculosis in children

Background: The etiological diagnosis of pneumonia is often difficult because of the impossibility of microbiological confirmation most of the time. Therefore, chest X-ray is still essential for a positive diagnosis and etiological orientation. The main objective of our study was to describe the radiographic aspects of acute community-acquired pneumonia and tubercular pneumonia in children.Methods: This was a descriptive retrospective study conducted at the university hospital mother and child of Tsaralalana from January 1st to July 31st, 2017.Results: Sixty-nine cases of pneumonia were included, including 13 cases of TB pneumonia and 46 cases of acute community-acquired pneumonia. The average age was 36.68 months with a male predominance. Clinically, respiratory functional signs predominated in both cases. Alteration in general condition was mainly observed in tubercular pneumonia (26.08%). Alveolar syndromes were present in 43.47% of TB pneumonias and 36.94% of acute community-acquired pneumonia. With regard to the radiographic images, alveolar involvement was common to both types of pneumonia; the nodular image was present in 8.69% of the tubercular pneumonias and 2.17% of the acute community-acquired pneumonia; the cavity image was present only in the tubercular pneumonia (p=0.04); the right-sided location predominated in both cases.Conclusions: X-ray images were common to both TB pneumonia and acute community-acquired pneumonia; some images were specific to TB pneumonia. However, the etiologic orientation of pneumonia is based on a combination of epidemiologic, clinical, and radiographic evidence

Place des Stratégies dans la Pratique de Développement Durables au Sein des PMES Malgaches

Le développement durable est un terme récent voire nouveau notamment pour Madagascar étant donné que le pays a commencé à s’y préoccuper qu’à partir des années 90, et les entreprises ont commencé à s’y intéresser en début de l’an 2000. Les PMEs afin de se démarquer concurrentiellement essaient de s’intégrer dans la pratique de développement durable.  Ainsi se pose la problématique de savoir comment les entreprises adaptent-elles leurs stratégies aux pratiques de développement durable ?En partant d’une hypothèse les stratégies d’entreprises  pourront  impacter leurs projets de développements durables, l’objectif de cette étude est d’identifier les actions déjà mises en œuvre, la prise de décision et la rationalisation du développement durable par les entreprises en question. Les analyses des données qualitatives issues des entretiens avec vingt PMEs malgaches a permis d’affirmer l’importance de la stratégie dans la pratique du développement durable.

Comparison of the efficiency of the nebulization of salbutamol, epinephrine and normal saline on treatment of bronchiolitis

Background: Bronchiolitis is a frequent cause of hospitalization. Despite the frequency of this pathology, there is not a single, widely practiced evidence-driven treatment especially using of nebulization. Present purpose was to compare which is efficient: nebulized salbutamol, epinephrine or normal saline.Methods: We have preceded to a prospective study from January 1st 2011 to March 31st 2012 including children between 29 days old and 2 years old.Results: We have included 90 patients divided in three groups and received nebulized salbutamol, epinephrine or normal saline. There was no real difference in the variables of the groups: clinical score, oxygen saturation, heart rate, temperature and weight but the hospitalization duration was shorter in the group who have been cured by normal salineConclusions: This study shows that salbutamol, epinephrine and normal saline can be used in the same situation but the normal saline has more advantages because of his low coast and the absence of risk of side effects

Grasses of the Isalo National Park, Madagascar – checklist, origins, and significance

Grasses are one of the best documented plant families worldwide in terms of taxonomy, but they are still poorly known in Madagascar. Our understanding of their diversity remains incomplete since grasses and grasslands are assumed by many tobe weeds and degraded wastelands. This project aimed to list thegrasses in Isalo National Park (NP) in order to understand theirdiversity and endemicity, as well as the history of Isalo’s grasslands. Examination of herbarium specimens and new field inventories allowed us to confirm 589 records of grass occurrences in ourstudy area. They were assigned to 112 species, of which 38 species are new records for Isalo NP. The Isalo grass flora includes seven of the eleven Poaceae subfamilies present in Madagascar and is particularly rich in Panicoideae, which make up 65% of the species. Nearly 22% of the grass species of Isalo are endemic to Madagascar, of which three species and one variety are restricted to Isalo massif, including two unusual ground cover species Tristachya humbertii A.Camus and Tristachya [Isalus isalensis]. Open grasslands harbour the highest diversity of grass species, followed closely by riparian forests. The history of the management of Isalo NP by the Bara people, as well as the endemism and the native origin of its grasses and  other species are consistent with an ancient origin of Isalo’s ecosystems. We urge that the conservation of Isalo’s grassy ecosystems, as well as that  of the plants and animals that inhabit them be prioritized.Les graminées sont parmi les familles de plantes les mieux documentées au niveau mondial en termes de taxonomie, mais sont encore mal  connues à Madagascar. Notre compréhension de leur diversité reste incomplète, vu que les graminées et les savanes sont considérées par beaucoup comme des mauvaises herbes et des friches dégradées. Ce projet visait à établir une liste des graminées connues du Parc National (PN) de l’Isalo, afin de comprendre leur diversité et leur endémicité, ainsi que l’histoire des écosystèmes herbeux de l’Isalo. L’examen des spécimens d'herbiers et les nouveaux inventaires sur terrains nous ont permis de générer 589 occurrences de graminées de notre site d’étude. Elles ont été  attribuées à 112 espèces de Poaceae, dont 38 sont de nouvelles collectes pour le massif de l’Isalo. La flore herbacée du massif de l'Isalo comprend  sept des onze sous-familles de Poaceae présentes à Madagascar et est particulièrement riche en Panicoideae qui représentent 65% des espèces.  Près de 22% des espèces de graminées de l’Isalo sont endémiques de Madagascar, dont trois espèces et une variété sont restreintes à Isalo, y  compris les deux espèces de plantes couvre-sols inhabituelles Tristachya humbertii A.Camus et Tristachya [Isalus isalensis]. Les prairies ouvertes  abritent la plus grande diversité d'espèces de graminées, suivies de près par les forêts ripicoles. L’histoire de la gestion du PN de l’Isalo par les  habitants de la région du groupe Bara, ainsi que l’endémisme et l’origine autochtone de ses graminées et autres espèces sont cohérents avec une  origine ancienne des écosystèmes de l’Isalo. Nous préconisons instamment que la conservation de ces prairies et savanes de l'Isalo, ainsi que les plantes et les animaux qui les habitent soit priorisée

Hepatitis B Virus X protein and polyploidy in the development of hepatocellular carcinoma

Hepatitis B Virus (HBV) X protein (pX) is implicated by an unknown mechanism in hepatocellular carcinoma (HCC) development, characterized by increased rate of chromosomal aberrations. Although most patients clear the infection and develop immunity, chronic infection in 5 to 10% infected patients lead to HCC development in the 4th to 5th decade of life. I demonstrate that tetracycline-regulated pX expression induces multipolar spindles and polyploidy (\u3e4N DNA). To understand the mechanism of pX-mediated polyploidy, I investigated whether pX promotes DNA re-replication. Dual-parameter flow cytometry demonstrates pX-dependent BrdU incorporation in cells with \u3e4N DNA. pX also induces expression of replication initiation factors Cdc6 and Cdtl, while suppressing geminin expression, a negative regulator of re-replication. G2-phase synchronized cells exhibit pX-dependent: (i) nuclear Cdc6 and Mcm5 co-localization; (ii) absence of nuclear geminin; (iii) increased BrdU incorporation; (iv) ATR activation; (v) RAD17 and H2AX phosphorylation; and (vi) co-localization of γ-H2AX with the DNA elongation factor PCNA. I monitor the evolution and the growth of pX-induced polyploidy. I observe that polyploid cells acquire p53-insensitive growth that leads to cell transformation. Thus I was able to formulate a model for liver cancer progression that is initiated by pX induced DNA re-replication

Hepatitis B virus X protein increases the Cdt 1 to to geminin ratio inducing DNA re-replication and polyploidy

International audienceHepatitis B virus X protein (pX) is implicated in hepatocellular carcinoma pathogenesis by an unknown mechanism. Employing the tetracycline-regulated pX-expressing 4pX-1 cell line, derived from the murine AML12 hepatocyte cell line, we demonstrate that pX induces partial polyploidy (>4N DNA). Depletion of p53 in 4pX-1 cells increases by 5-fold the polyploid cells in response to pX expression, indicating that p53 antagonizes pX-induced polyploidy. Dual-parameter flow cytometric analyses show pX-dependent bromodeoxyuridine (BrdUrd) incorporation in 4pX-1 cells containing 4N and >4N DNA, suggesting pX induces DNA re-replication. Interestingly, pX increases expression of endogenous replication initiation factors Cdc6 and Cdtl while suppressing geminin expression, a negative regulator of rereplication. In comparison to a geminin knockdown 4pX-1 cell line used as DNA re-replication control, the Cdt1/geminin ratio is greater in 4pX-1 cells expressing pX, indicating that pX promotes DNA re-replication. In support of this conclusion, pX-expressing 4pX-1 cells, similar to the geminin knockdown 4pX-1 cells, continue to incorporate BrdUrd in the G 2 phase and exhibit nuclear Cdc6 and MCM5 co-localization and the absence of geminin. In addition, pX expression activates the ATR kinase, the sensor of DNA re-replication, which in turn phosphorylates RAD17 and H2AX. Interestingly, phospho-H2AX-positive and BrdUrd-positive cells progress through mitosis, demonstrating a link between pX-induced DNA re-replication and polyploidy. Our studies highlight a novel function of pX that likely contributes to hepatocellular carcinoma pathogenesis

Clinical picture of pulmonary plague observed in the paediatric wards of antananarivo

Introduction: In Madagascar, plague is a highly contagious acute endemic infectious disease. The diagnosis of the most severe form of pneumonic plague remains difficult in children, hence the objectives of the present study; which is to identify the clinical signs of this clinical form in children and to describe its epidemiological and evolutionary profile. Methods: A retrospective case-control study was conducted in four pediatric wards in Antananarivo during the urban pneumonic plague outbreak from September 2017 to January 2018. Those cases were defined as children aged 0-15 years old suspected of having plague with positive RDT and PCR, and they were defined as children aged 0-15 years old with negative RDT and PCR. Results: Fifty-two cases of pneumonic plague were identified, half of which (50%) were under 24 months of age. A male predominance was noted with a sex ratio of 1.23 and 86.54% of the patients were from urban areas. Several clinical signs were found but none was specific for pneumonic plague: cough (59.62% p: 0.5), dyspnea (3.85% p: 0.16), chest pain (3.85% p: 0.26%), hemoptysis (7.69% p: 0.17), vomiting (9.62% p: 0.14), diarrhea (11.54% p: 0.45), altered general condition (38.46% p: 0.24%). Two deaths were noted (3.8%). Conclusion: No specific clinical warning signs have been identified in childhood pneumonic plague. In the event of an epidemic of urban pneumonic plague, any bacterial pneumonia should at least initially include active treatment against Yersinia pestis

Comparison of the efficiency of the nebulization of salbutamol, epinephrine and normal saline on treatment of bronchiolitis

Background: Bronchiolitis is a frequent cause of hospitalization. Despite the frequency of this pathology, there is not a single, widely practiced evidence-driven treatment especially using of nebulization. Present purpose was to compare which is efficient: nebulized salbutamol, epinephrine or normal saline.Methods: We have preceded to a prospective study from January 1st 2011 to March 31st 2012 including children between 29 days old and 2 years old.Results: We have included 90 patients divided in three groups and received nebulized salbutamol, epinephrine or normal saline. There was no real difference in the variables of the groups: clinical score, oxygen saturation, heart rate, temperature and weight but the hospitalization duration was shorter in the group who have been cured by normal salineConclusions: This study shows that salbutamol, epinephrine and normal saline can be used in the same situation but the normal saline has more advantages because of his low coast and the absence of risk of side effects

Polo-like kinase 1 inhibition suppresses hepatitis B virus X protein-induced transformation in an in vitro model of liver cancer progression

Chronic hepatitis B virus (HBV) infection is linked to development of hepatocellular carcinoma (HCC). The HBV X protein (pX) is implicated in HCC pathogenesis acting as a weak oncogene or a cofactor in hepatocarcinogenesis. pX induces DNA re-replication, DNA damage, and partial polyploidy in a poorly differentiated, immortalized hepatocyte cell line. In this study we employed sorted, pX-induced polyploid cells to investigate their growth and oncogenic transformation potential over the course of 70 cell doublings. Immediately after live cell-sorting, nearly 40% of pX-induced polyploid cells undergo apoptosis, whereas the surviving cells exhibit proliferation sensitive to p53. After 40 cell generations the pX-expressing polyploid cultures exhibit loss of p53 function and become growth factor- and anchorage-independent, indicative of oncogenic transformation. The pX-induced polyploid cultures in the course of 70 cell generations undergo progressively increasing DNA damage, propagate damaged DNA to daughter cells, and display increased expression of a cluster of proliferation genes shown to be elevated in human HCC, including HBV-HCC. One of these genes is the mitotic kinase Polo-like kinase 1 (Plk1). Oncogenic transformation is suppressed in the absence of pX expression, and significantly, by inhibition of Plk1. These results identify Plk1 as crucial in pX-mediated oncogenic transformation. Conclusion: Partial polyploidy induced by pX is not immediately associated with oncogenic transformation. Continued DNA damage for 40 cell generations is reproducibly associated with loss of p53 function, enhanced expression of Plk1, and oncogenic transformation. Because Plk1 expression is also elevated in HBV-HCC tumors, this in vitro cellular model simulates liver cancer progression and pathogenesis in chronic HBV patients. Inhibition of Plk1 activity suppresses pX-mediated oncogenic transformation, identifying Plk1 as a promising therapeutic target for HBV-mediated HCC