Apport de la TDM dans les traumatismes du massif facial : étude prospective à propos de 361 cas

IntroductionDe gravité variable, les traumatismes du massif facial ont une percussion tant sur le plan esthétique que fonctionnel, rarement vitale (quand  isolés).Sa fréquence ne fait accroitre ces quatre dernières décennies en imagerie d’urgence, à cause de l’insécurité routière, et de la consommation excessive d’alcool et des stupéfiants.La population jeune est la plus concernée. Matériels et méthodesEtude prospective de 361 patients victimes de traumatismes faciaux, admis au service des urgences. L'exploration était faite en mode hélicoïdal avec reconstructions axiales, coronales, sagittales, et 3D.RésultatsLes traumatismes de la face constituent un motif fréquent de recours aux soins en urgence. Les circonstances de survenue sont dominées par les AVP et les agressions et touchent surtout la population jeune. L'exploration a permis  l'identification des fractures, et leurs éventuels déplacements, de classer les différents types lésionnels, la recherche de complications graves et les lésions associées extra faciales nécessitant une prise en charge rapide. ConclusionLes traumatismes de la face sont caractérisés par la multiplicité des lésions. La gravité est liée aux séquelles esthétiques, fonctionnelles et parfois vitales. La TDM est l'examen de référence dans l'exploration des traumatismes du massif facial. Elle permet de faire une étude exhaustive des lésions et de classer les lésions graves nécessitant une surveillance ou une prise en charge urgente

Hospital-based Surveillance Provides Insights Into the Etiology of Pediatric Bacterial Meningitis in Yaoundé, Cameroon, in the Post-Vaccine Era.

BACKGROUND:Meningitis is endemic to regions of Cameroon outside the meningitis belt including the capital city, Yaoundé. Through surveillance, we studied the etiology and molecular epidemiology of pediatric bacterial meningitis in Yaoundé from 2010 to 2016. METHODS:Lumbar puncture was performed on 5958 suspected meningitis cases; 765 specimens were further tested by culture, latex agglutination, and/or polymerase chain reaction (PCR). Serotyping/grouping, antimicrobial susceptibility testing, and/or whole genome sequencing were performed where applicable. RESULTS:The leading pathogens detected among the 126 confirmed cases were Streptococcus pneumoniae (93 [73.8%]), Haemophilus influenzae (18 [14.3%]), and Neisseria meningitidis (15 [11.9%]). We identified more vaccine serotypes (19 [61%]) than nonvaccine serotypes (12 [39%]); however, in the latter years non-pneumococcal conjugate vaccine serotypes were more common. Whole genome data on 29 S. pneumoniae isolates identified related strains (<30 single-nucleotide polymorphism difference). All but 1 of the genomes harbored a resistance genotype to at least 1 antibiotic, and vaccine serotypes harbored more resistance genes than nonvaccine serotypes (P < .05). Of 9 cases of H. influenzae, 8 were type b (Hib) and 1 was type f. However, the cases of Hib were either in unvaccinated individuals or children who had not yet received all 3 doses. We were unable to serogroup the N. meningitidis cases by PCR. CONCLUSIONS:Streptococcus pneumoniae remains a leading cause of pediatric bacterial meningitis, and nonvaccine serotypes may play a bigger role in disease etiology in the postvaccine era. There is evidence of Hib disease among children in Cameroon, which warrants further investigation

MILK SUPPLY ADJUSTMENTS AND INVESTMENT BEHAVIOR IN ARIZONA AND NEW MEXICO.

Government involvement in the production and marketing of milk and dairy products is more pronounced than in any other agricultural product. The U.S. government administers two major programs that affect significantly the production and marketing of milk throughout the United States. These are the Federal Milk Marketing Order Program and the Dairy Price Support Program. In Arizona, in addition to these two major programs, the United Dairymen of Arizona Cooperative operates a base system that determines how cooperative milk revenues are allocated among producer members. This dissertation discusses some theoretical models that provide some insights into the following questions: (1) How would the dairy industry perform without the historically administered prices? (2) What are the benefits and costs associated with the order program and the base system? Then, this inquiry focuses on the Arizona and New Mexico dairy sectors. The two production sectors are quite similar, as are the marketing institutions, except for the existence of the base system in Arizona. Milk supply response in Arizona and New Mexico is investigated. Two ways in which supply adjustments can be achieved are identified and empirically investigated. (1) Creation of new dairy facilities or relocation of dairy facilities from other markets. If the decision to invest in Arizona or New Mexico is assumed as given, it is found that the existence of base system is a significant factor in explaining the location choice of new producers. (2) Expansion in output of existing dairy farms. It is found that dairy farmers in Arizona and New Mexico respond to changes in the farm level price of milk. The last effort of the empirical investigation is on the consumers' welfare losses due to the regulations of the Arizona and New Mexico dairy markets. It is found that the milk marketing orders and the policies of the UDA Cooperative in Arizona and AMPI in New Mexico, on the average, enforce a tax on Arizona's consumers of fluid milk in the amount of 10 million dollars per year, or 13.5 percent of producers' total revenue, and a tax on New Mexico's consumers of fluid milk in the amount of 5.6 million dollars per year, or 12.6 percent of producers' total revenue. (Abstract shortened with permission of author.