Study of variations in the broncho-arterial pedicles of the upper right lung lobe

Bronchial distribution and functional arterial vascularization of the upper lobe of the right lung are subject to many anatomical variations. The control of  these variations is essential for endoscopic and agiographic examinations. It also offers a better guarantee for safe and controlled surgery. In this  preliminary work, the exploitation of 15 heart-lung blocks treated by the injection corrosion method allowed us to study the general arrangement of the  broncho-arteries of the right upper lung lobe and their anatomical variations in the Senegalese population. Our results were as follows: the right upper  lobar bronchus was born on average at 1.25 cm from the tracheal bifurcation, with an average length of 1.13 cm. It ended with trifurcation into apical  (B1), dorsal (B2) and ventral (B3) segmental bronchi in 10 cases (66.66%); in 3 cases (20%), it ended with bifurcation into the dorsal segmental bronchus  and the apico-ventral trunk (B1+B3) (1 case), the apico-dorsal trunk (B1+B2) and the ventral segmental bronchus (B3), finally, in ventral and dorsal  segmentary bronchi giving each one an apical branch (1 case); in a last case, it ended by quadrifurcation, giving an external parabronche. The right upper  lobe was vascularized by 1 to 4 arteries, with eight modes of vascularization. It received more frequently two arteries. The anterior mediastinal  artery was the most common (100%). These results allowed us to discuss anatomical variations in the bronchial tree of the right upper lung lobe and the  pulmonary arterial distribution in that lobe. These variations must be taken into account during endoscopic examinations of imaging and surgery of  pulmonary excision, under penalty of accidents.&nbsp

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century