La craniectomie decompressive dans la prise en charge des traumatismes craniens graves avec signes radiologiques d’engagement cerebral.

Introduction La craniectomie décompressive peut- elle améliorer le pronostic des patients victimes d’un traumatisme crânien fermé grave avec engagement cérébral ? Objectif Le but de la présente étude était d’évaluer l’efficacité de la craniectomie décompressive dans la prise en charge du traumatisme crânien grave, isolé et fermé avec signes radiologiques d’engagement cérébral. Méthodes Il s’agissait d’une étude réalisée à l’Hôpital Général de Douala pendant 36 mois, de janvier 2007 à décembre 2009, incluant 13 patients victimes d’un traumatisme crânien grave, isolé et fermé, présentant les signes radiologiques d’engagement cérébral. La craniectomie décompressive était indiquée devant l’aggravation ou la persistance du tableau clinique et radiologique malgré le traitement médical conventionnel. Résultats Après deux à dix mois de suivi, l’évolution fut classée selon le score du coma évolutif ; "Glasgow outcome scale (GOS) score ". Dix patients (76, 93 %) ont évolué favorablement GOS (4-5).Un patient (07,69%) est resté végétatif GOS3. Deux décès (15,38%) ont été observé GOS1. Les principales complications étaient : une hydrocéphalie, une hernie cérébrale à travers le foramen de craniectomie, un abcès du cerveau et un état de mal convulsif. Conclusion La craniectomie décompressive est une méthode efficace pouvant améliorer le pronostic des patients victimes de traumatisme crânien grave avec signes radiologiques d’engagement cérébral.Mots clés : craniectomie-décompressive-engagement cérébral-traumatisme crânien

Fistule artério-veineuse ulno-basilique pour hémodialyse au CHU de Yaoundé: à propos de deux cas

La fistule ulno-basilique est une éventualité peu sollicitée dans le choix des abords vasculaires pour hémodialyse. Elle est construite sur la veine basilique qui est souvent la seule veine épargnée par les ponctions veineuses de routine dans les services de médecine. De par l'existence de nombreuses complications comme l'infection des prothèses et des cathéters centraux, les thromboses, les patients hémodialysés chroniques nécessitent plus d'un accès veineux au cours de leur suivi médical. Les fistules artério-veineuses natives présentent moins de risques de complications que les prothèses d'une façon générale et une plus longue durée de vie. La confection d'une fistule sur une topographie proximale compromet le recourt à cette veine sur une localisation distale ultérieurement. Il existe donc une hiérarchisation dont il faut tenir compte pour une utilisation optimale du capital veineux disponible. Nous rapportons ici deux observations concernant des patients chez qui deux fistules ulnobasiliques ont été réalisées avec succès au CHU de Yaoundé.Key words: Fistule artério-veineuse, hémodialyse, ponction veineus

Pesticides use in cocoa sector in Cameroon: characterization of supply source, nature of actives ingredients, fashion and reasons for their utilization

The chemical control is the widely control method applied in Cameroon for pests and diseases by all the cocoa producers without technical suitable assistance by the State as before 1980’S. However, it is known that farmers have less knowledge on the good pesticides use for the control of a specific pest. The objective of this study was to provide insight in current pesticide use in the cocoa sector in Cameroon. A stratified sampling scheme was used. A total of 251 cocoa farmers, 20 post-harvest cocoa traders and 37 chemical retailers were randomly selected and interviewed. The study showed that 35 different chemicals were marketed in Cameroon for use in cocoa: 4 herbicides, 11 fungicides and 20 insecticides. Of 251 farmers consulted, 96.8% said that they use pesticides on their farms while 3.2% did not. Fungicides were used most often by farmers 61.8%) followed by insecticides (38.2%). Eight active ingredients although, officially banned, were still being used on cocoa farms. Over 77% of farmers do not respect the official spray recommendations for chemicals. Moreover, 64% do not respect recommended doses. Two main pesticide-supply-pathways exist in Cameroon: a legal and illegal supply chain, which provides 51% of pesticides to cocoa farmers, resulting in an estimated loss of value added tax for the Cameroonian government of about 550 000 to 2.4 million Euros per year. These results suggest that improved pests and diseases control by the State and raising farmer awareness about pesticide use in cocoa could greatly attribute to more sustainable cocoa economy in Cameroon.Keywords : Cocoa, pesticides, insecticides, fungicides, Cameroon

Electrostatic phase separation: a review

The current understanding and developments in the electrostatic phase separation are reviewed. The literature covers predominantly two immiscible and inter-dispersed liquids following the last review on the topic some 15 years. Electrocoalescence kinetics and governing parameters, such as the applied field, liquid properties, drop shape and flow, are considered. The unfavorable effects, such as chain formation and partial coalescence, are discussed in detail. Moreover, the prospects of microfluidics platforms, non-uniform fields, coalescence on the dielectric surfaces to enhance the electrocoalescence rate are also considered. In addition to the electrocoalescence in water-in-oil emulsions the research in oil-in-oil coalescence is also discussed. Finally the studies in electrocoalescer development and commercial devices are also surveyed. The analysis of the literature reveals that the use of pulsed DC and AC electric fields is preferred over constant DC fields for efficient coalescence; but the selection of the optimum field frequency a priori is still not possible and requires further research. Some recent studies have helped to clarify important aspects of the process such as partial coalescence and drop–drop non-coalescence. On the other hand, some key phenomena such as thin film breakup and chain formation are still unclear. Some designs of inline electrocoalescers have recently been proposed; however with limited success: the inadequate knowledge of the underlying physics still prevents this technology from leaving the realm of empiricism and fully developing in one based on rigorous scientific methodology

Electromagnetic Field Effect or Simply Stress? Effects of UMTS Exposure on Hippocampal Longterm Plasticity in the Context of Procedure Related Hormone Release

Harmful effects of electromagnetic fields (EMF) on cognitive and behavioural features of humans and rodents have been controversially discussed and raised persistent concern about adverse effects of EMF on general brain functions. In the present study we applied radio-frequency (RF) signals of the Universal Mobile Telecommunications System (UMTS) to full brain exposed male Wistar rats in order to elaborate putative influences on stress hormone release (corticosteron; CORT and adrenocorticotropic hormone; ACTH) and on hippocampal derived synaptic long-term plasticity (LTP) and depression (LTD) as electrophysiological hallmarks for memory storage and memory consolidation. Exposure was computer controlled providing blind conditions. Nominal brain-averaged specific absorption rates (SAR) as a measure of applied mass-related dissipated RF power were 0, 2, and 10 W/kg over a period of 120 min. Comparison of cage exposed animals revealed, regardless of EMF exposure, significantly increased CORT and ACTH levels which corresponded with generally decreased field potential slopes and amplitudes in hippocampal LTP and LTD. Animals following SAR exposure of 2 W/kg (averaged over the whole brain of 2.3 g tissue mass) did not differ from the sham-exposed group in LTP and LTD experiments. In contrast, a significant reduction in LTP and LTD was observed at the high power rate of SAR (10 W/kg). The results demonstrate that a rate of 2 W/kg displays no adverse impact on LTP and LTD, while 10 W/kg leads to significant effects on the electrophysiological parameters, which can be clearly distinguished from the stress derived background. Our findings suggest that UMTS exposure with SAR in the range of 2 W/kg is not harmful to critical markers for memory storage and memory consolidation, however, an influence of UMTS at high energy absorption rates (10 W/kg) cannot be excluded

The IL17F and IL17RA Genetic Variants Increase Risk of Cerebral Malaria in Two African Populations

International audienceno abstrac