Immunofunctional assay of human growth hormone (hGH) in serum: A possible consensus for quantitative hGH measurement

Confirmation of the diagnosis of GH deficiency in adults and children involves provocative testing for human (h) GH. Different commercially available immunoassays yield largely discrepant results in the measurement of GH levels in human serum. These discrepancies result in doubtful relevance of cut-off levels proposed for GH provocative testing. We have developed an immunofunctional assay method that allows quantitation of only those GH forms in circulation that possess both binding sites of the hormone for its receptor and thus can initiate a biological signal in target cells. An anti-hGH monoclonal antibody recognizing binding site 2 of hGH is immobilized and used to capture hGH from the serum sample. Biotin-labeled recombinant GH-binding protein in a second incubation step forms a complex with those hGH molecular isoforms that have both binding sites for the receptor. The signal is detected after a short third incubation step with labeled streptavidin. The assay is sensitive (detection range, 0.1-100 micrograms/L) and has average inter- and intraassay precisions of 10.3% and 7.3% respectively. Endogenous GH-binding protein does not interfere with the hGH result; placental lactogen slows no detectable cross-reaction in this immunofunctional assay. The degree of immunofunctionally active hGH forms in serum samples, calculated by comparison of immunofunctional assay and RIA results, varied between 52-93%. We propose this immunofunctional assay for GH measurement as a new reference method for hGH quantitation in serum. The immunofunction assay translates only hGH forms into an assay signal that are capable of dimerizing GH receptors and, thus, of initiating a biological effect in target cells

Aspects épidémiologiques et étiologiques des affections pulmonaires d’origine parasitaire et fongique en milieu hospitalier à Ouagadougou (Burkina Faso)

Dans le souci de déterminer l’aspect épidémiologique et étiologique des affections pulmonaires d’origines parasitaire et fongique, une étude prospective transversale a été réalisée en milieu hospitalier à Ouagadougou de novembre 2012 en mai 2013, sur 103 patients suspectés avoir la maladie. Les examens parasitologiques, mycologiques et immunologiques ont été effectués selon les indications des prescripteurs, sur des prélèvements du liquide de lavage broncho-alvéolaire, du liquide pleural, des expectorations et du sang. A l’issue de ces examens, 59,2% des patients confirmés porteurs de parasites et/ou de mycètes dans leur appareil pulmonaire avec une prédominance des cultivateurs (26,2%) ont été détectés. Les hommes étaient les plus touchés avec un sex-ratio de 1,9. Parmi les antécédents médicaux, il y a eu une fréquence élevée des sujets à sérologie VIH positive. Trois parasites et 71 souches de champignons ont été isolés dont 4 types de coinfections fongiques. Ces données de bases montrent que les parasites et les champignons provoquent une pathologie pulmonaire non spécifique sur le plan clinique, radiologique et endoscopique. Le contexte épidémiologique et biologique permet d’orienter le diagnostic. La confirmation est apportée par la mise en évidence directe ou par des arguments indirects sérologiques. Ce qui permet d’obtenir une guérison par un traitement adapté au germe en cause.Mots clés : Affection pulmonaire, parasites, champignons, Burkina Faso

Shea (Vitellaria paradoxa C.F. Gaertn.) – a peripheral empire commodity in French West Africa, 1894–1960

Burkinabé women have traded shea kernels and shea butter in periodic local markets, and on a regional scale with the densely-populated West African littoral, for centuries. This paper traces the origins of French colonial efforts to develop shea as a commodity of empire from the 1890s to independence in 1960. Colonial effo rts to incorporate Upper Volta, a French colonial backwater, into the world economy was drawn out, heterogenous, and messy. The colonial state assumed erroneously that little shea trade existed, and that producers would respond positively to market incentives. Yet, we suggest that French colonial policies failed due to a composite of factors including the limited investment in either the colony or shea as an oilseed crop, adaptation by women shea producers to the extraction of male labour and the trade opportunities created by new international borders, and the ‘blindness’ of colonial officials to the economic, social and cultural functions of periodic local markets used by women shea traders. The historical trajectory of the shea trade continues to have implications for current-day shea markets and their actors

PLoS One

Objectives Mental health is a largely neglected issue among in Sub-Saharan Africa, especially among key populations at risk for HIV. The aim of this study was to estimate the prevalence of psychological distress (PD) and to assess the factors associated among males who have sex with males (MSM), female sex workers (FSW) and drug users (DU) in Togo in 2017. Study design A cross-sectional bio-behavioral study was conducted in August and September 2017 using a respondent-driven sampling (RDS) method, in eight cities in Togo. Methods A standardized questionnaire was used to record sociodemographic characteristics and sexual behaviors. The Alcohol Use Disorders Identification Test (AUDIT) and a subset of questions from the Tobacco Questions for Survey were used to assess alcohol and tobacco consumption respectively. PD was assessed with the Kessler Psychological Distress Scale. A blood sample was taken to test for HIV. Descriptive statistics, univariable and multivariable ordinal regression models were used for analysis. Results A total of 2044 key populations including 449 DU, 952 FSW and 643 MSM with a median age of 25 years, interquartile range (IQR) [21–32] were recruited. The overall prevalence of mild PD among the three populations was 19.9% (95%CI = [18.3–21.8]) and was 19.2% (95%CI = [17.5–20.9]) for severe/moderate PD. HIV prevalence was 13.7% (95%CI = [12.2–15.2]). High age (≥ 25 years) [aOR = 1.24 (95% CI: 1.02–1.50)], being HIV positive [aOR = 1.80 (95% CI: 1.31–2.48)] and hazardous alcohol consumption [aOR = 1.52 (95% CI: 1.22–1.87)] were risk factors for PD. Secondary [aOR = 0.52 (95% CI: 0.42–0.64)] or higher [aOR = 0.46 (95% CI: 0.32–0.64)] education levels were protective factors associated with PD. FSW [OR = 0.55 (95% CI: 0.43–0.68)] and MSM [OR = 0.33 (95% CI: 0.24–0.44)] were less likely to report PD compared with DU. Conclusion and recommendations This is the first study conducted among a large, nationally representative sample of key populations in Togo. The prevalence of PD is high among these populations in Togo and was associated to HIV infection. The present study indicates that mental health care must be integrated within health programs in Togo with a special focus to key populations through interventions such as social support groups

Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW Study.

The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter observational study underwent in 68 medical institutions worldwide during a six-month study period (October 2012-March 2013). The study included patients older than 18 years undergoing surgery or interventional drainage to address complicated intra-abdominal infections (IAIs).1898 patients with a mean age of 51.6 years (range 18-99) were enrolled in the study. 777 patients (41%) were women and 1,121 (59%) were men. Among these patients, 1,645 (86.7%) were affected by community-acquired IAIs while the remaining 253 (13.3%) suffered from healthcare-associated infections. Intraperitoneal specimens were collected from 1,190 (62.7%) of the enrolled patients.827 patients (43.6%) were affected by generalized peritonitis while 1071 (56.4%) suffered from localized peritonitis or abscesses.The overall mortality rate was 10.5% (199/1898).According to stepwise multivariate analysis (PR = 0.005 and PE = 0.001), several criteria were found to be independent variables predictive of mortality, including patient age (OR = 1.1; 95%CI = 1.0-1.1; p < 0.0001), the presence of small bowel perforation (OR = 2.8; 95%CI = 1.5-5.3; p < 0.0001), a delayed initial intervention (a delay exceeding 24 hours) (OR = 1.8; 95%CI = 1.5-3.7; p < 0.0001), ICU admission (OR = 5.9; 95%CI = 3.6-9.5; p < 0.0001) and patient immunosuppression (OR = 3.8; 95%CI = 2.1-6.7; p < 0.0001). © 2014 Sartelli et al.; licensee BioMed Central Ltd

Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study)

Peer reviewe

Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections : a prospective multicentre study (WISS Study)

Background: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. Methods: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study. Results: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p <0.0001). The multivariate logistic regression model was highly significant (p <0.0001, R-2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4. Conclusions: WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.Peer reviewe