Chlorophyll and pheophytin protonated and deprotonated ions: Observation and theory

Pheophytin a and chlorophyll a have been investigated by electrospray mass spectrometry in the positive and negative modes, in view of the importance of the knowledge of their properties in photosynthesis. Pheophytin and chlorophyll are both observed intensely in the protonated mode, and their main fragmentation route is the loss of their phytyl chain. Pheophytin is observed intact in the negative mode, while under collisions, it is primarily cleaved beyond the phytyl chain and loses the attaching propionate group. Chlorophyll is not detected in normal conditions in the negative mode, but addition of methanol solvent molecule is detected. Fragmentation of this adduct primarily forms a product (-30 amu) that dissociates into dephytyllated deprotonated chlorophyll. Semi-empirical molecular dynamics calculations show that the phytyl chain is unfolded from the chlorin cycle in pheophytin a and folded in chlorophyll a. Density functional theory calculations have been conducted to locate the charges on protonated and deprotonated pheophytin a and chlorophyll a and have found the major location sites that are notably more stable in energy by more than 0.5 eV than the others. The deprotonation site is found identical for pheophytin a and the chlorophyll a-methanol adduct. This is in line with experiment and calculation locating the addition of methanol on a double bond of deprotonated chlorophyll a.

Stabilization of a Pickering Emulsion by Nanoparticles of Eudragit RSPO and Pol-epsilon Caprolactone: Contact Angle Measurement and Surface Tension Studies

The use of colloidal particles to prepare and stabilize emulsions, known as "Pickering emulsions “, has aroused growing interest in recent years. Pickering and Ramsden demonstrated at the beginning of the last century the feasibility of surfactant-free emulsions, in presence of these emulsions is called "Pickering Emulsions". This concept of emulsions stabilized by solid particles is experiencing renewed interest nowadays given the many advantages it offers good stability, environmental protection, user safety, and particle varieties. The first part is devoted to the synthesis of Eudragit RSPO and pol epsilon-caprolactone nanoparticles and their characterization. The characterization of the nanoparticles is performed by dynamic light scattering and geometry. The understanding of the interfacial behavior of these nanoparticles and their associated stabilization mechanisms for emulsions was carried out. The second part of the study investigated the formulation and stabilization of the emulsion using the washed suspension containing the nanoparticles as the only stabilizer. The objective of this part is to stabilize and characterize the formulated emulsions.  Droplet size determination and microscopy were performed using a Zeiss optical microscope. The direction of the formulated emulsions was determined by conductimetry. In conclusion, Pickering emulsions stabilized solely by Eudragit RSPO and Poly-epsilon Caprolactone nanoparticles appear to be highly effective innovative drug carriers, opening new doors as potential drug delivery systems.

PATLAB: A graphical computational software package for photoacoustic computed tomography research

Photoacoustic tomography (PAT) provides high resolution optical images of tissue at depths of up to several centimetres. This modality has been of interest to researchers for at least 30 years and is still the subject of intensive research. However, PAT researchers lack access to a comprehensive open-source graphical simulation and reconstruction software package. In this article, we introduce PATLAB, an open-source MATLAB-based graphical software package that can perform both PAT simulation and image reconstruction. PATLAB is simple to use yet is capable of complex PAT data processing tasks and offers advanced users a framework to build and test new methods.

Personality traits associated with Healthy Diet and Obesity: A systematic review

Objective

This study aimed to examine the association between personality traits and either dietary behaviour or weight-related outcomes.

Methods

A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement was conducted through Scopus, PubMed and PsychInfo databases. Studies were included if they used a facet of personality that we were confidently able to map to a Big Five dimension.

Results

A total of 21 studies were eligible for inclusion. Most studies that reported a measure of association found a result that was statistically insignificant at the 5% level. In studies where the result was statistically significant, Extraversion, Openness, Agreeableness and Conscientiousness were almost always positively associated with healthy dietary behaviour and negatively associated with fat consumption, eating problems, obesity and measures of unhealthy weight across all the populations. Four studies found statistically significant results in the opposite direction. Neuroticism was associated with unhealthy behaviours or weight problems.

Conclusions and Implications

The Big-Five-model is an adequate instrument to measure the relationship between personality and diet. Healthy dietary behaviour tends to be associated with more pro-social personality characteristics, whereas poor weight control could be linked with Neuroticism. These results suggest there may be some benefit from using psychological traits to personalise interventions aimed at improving nutrition.

Key messages

There may be some benefit from using psychological traits to personalise interventions aimed at improving nutrition. Another interesting line of research may take account of the role of peer-effects and role-models in promoting healthy or unhealthy behaviour across social networks.

Quality of life, health and social costs of patients with spinal cord injury: A systematic review

Objective

To systematically reviews the costs, resource uses, clinical complication and quality of life among patients with spinal cord injury.

Methods

A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement was conducted through Scopus, PubMed and Embase databases.

Results

A total of 52 studies were eligible for inclusion. The estimated lifetime economic burden per individual with SCI ranges from $1.5 million to $3.0 million. Among studies which reported clinical outcomes, the mortality rates were estimated less than 4%, the most medical complication reported are spasticity, pain, pressures score and neurological deteriorations. Overall health status is negatively associated with QoL. People with a higher severity the of injury, a longer duration of injury, ambulatory mode, and with depression are more likely to report score low values of QoL. Employment and salary are consistently positively associated with better QoL. Age is negatively correlated with QoL.

Conclusions

Although spinal cord injury is related with high costs, no studies were found with detailed resources use. Also, A variety of instrument were used to examine how different factors have a role in predicting quality of life in spinal cord injury population. However, it is important to consider that differences found in those studies may at least be part in function of the instruments used. Therefore, standardized instruments should be used as part of these process.

Key messages

Paraplegia or the severity of SCI impact negatively quality of life and positively on healthcare and social costs. Promoting the employment of subjects with SCI generates a positive impact on their quality of life.

[Ensuring continuity of care at the time of COVID-19: challenges for the Dakar Integrated Support Center for Addictions]

The COVID-19 pandemic has an impact on health systems, whose modes of adaptation and response on the ground are still poorly documented and are evolving. The Dakar Integrated Support Center for Addictions (CEPIAD) has been implementing risk reduction since 2014, particularly with drug users. The COVID-19 pandemic and related public health measures were an obstacle to its attendance by patients, in particular due to movement restriction. In addition to the implementation of individual and collective preventive measures in the center, CEPIAD has experimented "take-home" for methadon that is generally provided daily through directly observed treatment. The center has also taken care of amnestied incarcerated cannabis users. Several aspects of this experience, perceived positively, could be relevant outside the pandemic context.

Mass testing and treatment for malaria followed by weekly fever screening, testing and treatment in Northern Senegal: feasibility, cost and impact

Background

Population-wide interventions using malaria testing and treatment might decrease the reservoir of Plasmodium falciparum infection and accelerate towards elimination. Questions remain about their effectiveness and evidence from different transmission settings is needed.

Methods

A pilot quasi-experimental study to evaluate a package of population-wide test and treat interventions was conducted in six health facility catchment areas (HFCA) in the districts of Kanel, Linguère, and Ranérou (Senegal). Seven adjacent HFCAs were selected as comparison. Villages within the intervention HFCAs were stratified according to the 2013 incidences of passively detected malaria cases, and those with an incidence ≥ 15 cases/1000/year were targeted for a mass test and treat (MTAT) in September 2014. All households were visited, all consenting individuals were tested with a rapid diagnostic test (RDT), and, if positive, treated with dihydroartemisinin-piperaquine. This was followed by weekly screening, testing and treatment of fever cases (PECADOM++) until the end of the transmission season in January 2015. Villages with lower incidence received only PECADOM++ or case investigation. To evaluate the impact of the interventions over that transmission season, the incidence of passively detected, RDT-confirmed malaria cases was compared between the intervention and comparison groups with a difference-in-difference analysis using negative binomial regression with random effects on HFCA.

Results

During MTAT, 89% (2225/2503) of households were visited and 86% (18,992/22,170) of individuals were tested, for a combined 77% effective coverage. Among those tested, 291 (1.5%) were RDT positive (range 0–10.8 by village), of whom 82% were < 20 years old and 70% were afebrile. During the PECADOM++ 40,002 visits were conducted to find 2784 individuals reporting fever, with an RDT positivity of 6.5% (170/2612). The combination of interventions resulted in an estimated 38% larger decrease in malaria case incidence in the intervention compared to the comparison group (adjusted incidence risk ratio = 0.62, 95% CI 0.45–0.84, p = 0.002). The cost of the MTAT was $14.3 per person.

Conclusions

It was operationally feasible to conduct MTAT and PECADOM++ with high coverage, although PECADOM++ was not an efficient strategy to complement MTAT. The modest impact of the intervention package suggests a need for alternative or complementary strategies.

[Recidives of Mycetoma after Amputation in Dakar (Senegal)]

The treatment of fungal mycetoma is essentially surgical. This carcinological-like surgery consists of amputation in case of bone involvement. The recurrences after amputation are rare and address the problem of the operative indication. We report 5 cases of recurrence of fungal black-grain mycetoma after amputation of leg or thigh. Case 1: a 52-year-old patient with a mycetoma of the knee evolving for 8 years. There is no history of surgery. A thigh amputation with ganglion dissection is performed. One year after the surgical procedure, the patient presents a recurrence on the amputation stump and on the lymph node dissection site. An indication of hip disarticulation is made and performed 17 months after amputation. Case 2: a 25-year-old patient who has a black-grain mycetoma of the foot with osteitis evolving since 10 years. A leg amputation was performed. The patient had a recurrence at the popliteal level at 15 months postoperatively. An indication of amputation of the thigh is posed and refused by the patient. Case 3: a30-year-old woman with black-grain mycetoma of the knee with bone involvement for more than 10 years. A thigh amputation was performed and at nine months postoperativeshe presented a recurrence in the amputation stump. She was lost of sight despite the decision of surgical revision. Case 4: a 43-year-old patient operated on his foot and leg mycetoma at least 5 timesbefore amputation in 2000. The recurrence occurred one year after amputation. 18 years after amputation, a new surgical procedure was difficult due to extension of the lesions in the pelvis. Case 5: a 50-year-old female patient operated in Mauritania in 2012 (thigh amputation for mycetoma of the knee). She presented a recurrence on the amputation stump in 2018. An indication of disarticulation of the hip was posed and refused by the patient. These recurrences were testified by to the persistence of grains on the preserved segment. They pose the problem of the level of amputation and therefore of preoperative planning. Good preoperative planning allows optimization of the surgical procedure and avoids certain recurrences.

Oral health assessment in Senegal: stepwise method

Background

The STEPwise approach to surveillance (STEPS) helps to assess the prevalence and risk factors of major chronic diseases. Designed to have the ability to integrate optional modules, it allows any attitude to collect data according to planning, prevention and advocacy strategies for the allocation of resources of member countries. The Ministry of Health of Senegal took the option in 2015 to include the oral health module in the STEPS program. This original public health approach has necessitated the development of specific methods and tools that are presented in this communication.

Methodology

On the initiative of the WHO Regional Office for Africa and the Ministry of Health of Senegal, behavioral, clinical and biological modules have been validated to identify risk factors and the prevalence of dental and periodontal diseases. Integrated into the Stepwise National Observational Transversal Study, including 6306 adults aged 18-69, these modules provide a framework for future studies. The evaluation of the program, via a SWOT analysis, formalizes the positive and negative points and identifies the factors of its environment that may favorably or negatively influence the recommendations.

Results

62.5% of subjects had never used oral care. The prevalence of caries was 76.3% with an average DMF of 5.5. Strong institutional political will to promote oral health as well as good intra sectoral collaboration emerge. However, the economic constraints remain for a sustainability as well as a limit in the harmonization and the political valorization of the data in terms of recommendations of strategies of health.

Conclusions

Integrating oral health into the Stepwise survey provides national information in a context of scarcity of resources. Obtaining integrated quality data should allow for a standardized extension of the program to other countries in the Africa region, subject to adjustments and corrective measures.

Key messages

Integrating oral health into the Stepwise survey provides national information in a context of scarcity of resources. Obtaining integrated quality data should allow for a standardized extension of the program to other countries in the Africa region.

Molecular detection and quantification of Plasmodium falciparum gametocytes carriage in used RDTs in malaria elimination settings in northern Senegal

BACKGROUND

Malaria surveillance requires powerful tools and strategies to achieve malaria elimination. Rapid diagnostic tests for malaria (RDTs) are easily deployed on a large scale and are helpful sources of parasite DNA. The application of sensitive molecular techniques to these RDTs is a modern tool for improving malaria case detection and drug resistance surveillance. Several studies have made it possible to extract the DNA of Plasmodium falciparum from RDTs. The knowledge of gametocyte carriage in the population is important to better assess the level of parasite transmission in elimination settings. The aim of this study was to detect P. falciparum gametocytes from used RDTs by quantitative PCR for molecular monitoring of malaria transmission.

METHODS

DNA was extracted from 303 RDT devices (SD Bioline Malaria Pf) using the Chelex-100 protocol. qPCR was performed in a 20 μL reaction to detect and quantify transcripts of the pfs25 gene. The cycle threshold (Ct) was determined by the emission fluorescence corresponding to the initial amount of amplified DNA.

RESULTS

The study found an overall prevalence of 53.47% with an average Ct of 32.12 ± 4.28 cycles. In 2018, the prevalence of gametocytes was higher in the Ranérou district (76.24%) than in the Saint-Louis district (67.33%) where an increase in the number of gametocyte carriers in 2018 was noted, in comparison with 2017.

CONCLUSIONS

RDTs are a good source of DNA for molecular monitoring of gametocyte carriage. This method is a simple and effective tool to better understand the level of malaria transmission with a view to elimination.

[Tuberculosis Abscess of the Chest Wall on an Immunocompetent Patient in the Teaching Hospital of Dakar (Senegal)]

Tuberculosis remains a problem of public health, in spite of the numerous significant advances noted in the diagnosis in recent years. The involvement of the thoracic wall is a rare extra lung shape. Its clinical presentation is not specific and a collected thoracic tumefaction is the main clinical demonstration. The diagnosis is improved by the use of non-invasive tools such as the Xpert MTB/Rif® test with a good sensibility on the pus. Medical care is based on medical treatment and sometimes associated with surgical treatment.

Implementation of an in-house quantitative real-time polymerase chain reaction method for Hepatitis B virus quantification in West African countries

Hepatitis B virus (HBV) is a major cause of chronic liver disease worldwide. HBV infection is diagnosed by serological tests, while real-time polymerase chain reaction (qRT-PCR) assays are used to quantify viral load, which is a crucial parameter to determine viral replication and to monitor antiviral treatments. However, measuring viral load in resource-limited countries remains nonsystematic, due to the high cost of commercial kits. Here, we describe the development, validation and implementation of a low-cost, in-house qRT-PCR assay to monitor HBV viral load in chronic carriers enrolled in the PROLIFICA programme in the Gambia and Senegal. Over 1500 HBsAg-positive patients, including 210 chronically infected HBV patients, who were given antiviral treatment (tenofovir), were monitored by qRT-PCR using the SYBR Green- and HBV-specific primers. Twenty-four tenofovir-treated patients were followed up and their viral load was tested every 3 months over the 12-month experimental time course. Compared to commercial assays, our in-house assay was shown to be (i) highly reliable, with good intra- and interassay reproducibility over a wide range (45-4.5 × 108 copies mL-1 ), (ii) very similar in the viral loads detected (R2  = .90), (iii) highly sensitive, as it detected loads as low as 30 copies mL-1 (~5 IU mL-1 ), (iv) cheaper (2- to 3-fold), (v) easier to implement and (vi) more rapid. Based on our experience, we recommend this assay as a reliable alternative to commercial assays, for monitoring HBV viraemia in resource-limited, highly endemic countries to reduce the cost and technical obstacles associated with commercial kits.

Insights on stock structure of round sardinella Sardinella aurita off north-west Africa based on otolith shape analysis

This study examines the geographic variability in otolith shape of round sardinella Sardinella aurita as a tool for stock discrimination. Fish were analysed from six sampling locations from Senegal to the Mediterranean coast of Morocco. A combination of otolith shape indices and elliptic Fourier descriptors was investigated by multivariate statistical procedures. Within the studied area, three distinct groups were identified with an overall correct classification of 78%. Group A: Nador (Alboran Sea), group B: Casablanca (northern Morocco) and group C: Senegalese-Mauritanian. The results of this study confirm the absence of an Atlantic Ocean-Mediterranean Sea transition for this species, the Gibraltar Strait acting as an efficient barrier for S. aurita population separation. Off north-west Africa, fish from northern Morocco form a single group which is clearly isolated from Senegalese-Mauritanian waters, confirming the existence of a distinct stock in this area. Among group C, some discontinuity exists and suggests the existence of a sedentary fraction of S. aurita in northern Mauritania (Arguin Bank). The results are discussed in relation to oceanographic features and physical barriers to dispersal and fish management strategy in the study area.

Foraging range of arthropods with veterinary interest: New insights for Afrotropical Culicoides biting midges (Diptera: Ceratopogonidae) using the ring method

The identification of blood meal source of arthropod vector species contributes to the understanding of host-vector-pathogen interactions. The aim of the current work was to identify blood meal source in Culicoides biting midge species, biological vectors of internationally important arboviruses of livestock and equids, using a new ecological approach. We examined the correlation between blood meal source identified in engorged Culicoides females collected in a suction light trap and the available vertebrate hosts along four rings (200, 500, 1000 and 2000 m) centered at the trap site and described the foraging range of the three main vector species of veterinary interest present in the study area, Culicoides imicola, Culicoides kingi and Culicoides oxystoma. The study was performed in four sites localized in the Niayes region of Senegal (West Africa) where recent outbreaks of African horse sickness occurred. Blood meal source identification was carried out by species-specific multiplex PCRs with genomic DNA extracted from the abdomen of engorged females collected during nine night collections for twenty-six collections. The four most abundant hosts present in the studied area (horse, cattle, goat and sheep) were surveyed in each ring zone. The blood meal source varied according to Culicoides species and host availability in each site. C. oxystoma and C. imicola females mainly fed on horses readily available at 200 m maximum from the trap location whereas females of C. kingi fed mainly on cattle, at variable distances from the traps (200 to 2000 m). C. oxystoma may also feed on other vertebrates. We discuss the results in relation with the transmission of Culicoides-borne arboviruses and the species dispersion capacities.

[The "Health system delay" in tuberculosis patients in Saint-Louis Senegal]

Sixty patients with positive acid fast bacilli sputum smears between were enrolled consecutively between March and August 2012 in the Saint-Louis (Senegal) health district to determine the Health System Delay in response to tuberculosis. The length of time between the first consultation of a TB patient and the start of treatment was, on average, 8.1 days and is among the shortest in the literature. This promptness reduces the risk of infection related to delayed care. This is one of the focuses of the National Programme of Fight against nosocomial infections in Senegal (PRONALIN), as well as the implementation of environmental procedures and the use of masks and respiratory protection equipment.

Accounting for pharmacokinetic differences in dual-tracer receptor density imaging

Dual-tracer molecular imaging is a powerful approach to quantify receptor expression in a wide range of tissues by using an untargeted tracer to account for any nonspecific uptake of a molecular-targeted tracer. This approach has previously required the pharmacokinetics of the receptor-targeted and untargeted tracers to be identical, requiring careful selection of an ideal untargeted tracer for any given targeted tracer. In this study, methodology capable of correcting for tracer differences in arterial input functions, as well as binding-independent delivery and retention, is derived and evaluated in a mouse U251 glioma xenograft model using an Affibody tracer targeted to epidermal growth factor receptor (EGFR), a cell membrane receptor overexpressed in many cancers. Simulations demonstrated that blood, and to a lesser extent vascular-permeability, pharmacokinetic differences between targeted and untargeted tracers could be quantified by deconvolving the uptakes of the two tracers in a region of interest devoid of targeted tracer binding, and therefore corrected for, by convolving the uptake of the untargeted tracer in all regions of interest by the product of the deconvolution. Using fluorescently labeled, EGFR-targeted and untargeted Affibodies (known to have different blood clearance rates), the average tumor concentration of EGFR in four mice was estimated using dual-tracer kinetic modeling to be 3.9 ± 2.4 nM compared to an expected concentration of 2.0 ± 0.4 nM. However, with deconvolution correction a more equivalent EGFR concentration of 2.0 ± 0.4 nM was measured.

[Spatiotemporal distribution of tuberculosis cases in the city of Saint-Louis Senegal from 2008-2011]

BACKGROUND

We studied the incidence of tuberculosis in the health district of Saint-Louis, Senegal over a period of 4years (2008-2011). One thousand three hundred and eighty-six cases were identified, producing an annual standardized incidence ratio of 129 cases per 100,000 inhabitants.

RESULTS

Men in the 15-24-year old age group were more likely to be affected, and diagnosis was more common in the second half of the year. Treatment compliance was excellent (96%), and the cure rate of patients with a TB-positive microscopic examination was 95%. The overall treatment failure rate was 1% and the 6-month morality was 2%. Seropositivity, measured in volunteer patients (48%) was 3%.

CONCLUSION

A spatial and temporal map of tuberculosis in the city of Saint-Louis, Senegal has been established. A cluster appears to be very likely in Guet Ndar, a particularly dense population zone in a fishing area. There is also a possible secondary cluster at Pikine.

Kinetic model optimization for characterizing tumour physiology by dynamic contrast-enhanced near-infrared spectroscopy

Dynamic contrast-enhanced (DCE) methods are widely used with magnetic resonance imaging and computed tomography to assess the vascular characteristics of tumours since these properties can affect the response to radiotherapy and chemotherapy. In contrast, there have been far fewer studies using optical-based applications despite the advantages of low cost and safety. This study investigated an appropriate kinetic model for optical applications to characterize tumour haemodynamics (blood flow, F, blood volume, V(b), and vascular heterogeneity) and vascular leakage (permeability surface-area product, PS). DCE data were acquired with two dyes, indocyanine green (ICG) and 800 CW carboxylate (IRD(cbx)), from a human colon tumour xenograph model in rats. Due to the smaller molecular weight of IRD(cbx) (1166 Da) compared to albumin-bound ICG (67 kDa), PS of IRD(cbx) was significantly larger; however, no significant differences in F and V(b) were found between the dyes as expected. Error analysis demonstrated that all parameters could be estimated with an uncertainty less than 5% due to the high temporal resolution and signal-to-noise ratio of the optical measurements. The next step is to adapt this approach to optical imaging to generate haemodynamics and permeability maps, which should enhance the clinical interest in optics for treatment monitoring.

[Thrombocytopenia purpura, myositis and cytolitic hepatitis: a rare association linked with atorvastatin]

Statins are generally well tolerated molecules. However, some cases have seen potentially lifethreatening consequences. We report a case of a 70-year-old woman with high blood pressure who was treating hypercholesterolemia by atorvastatin. Two weeks after beginning this new treatment, the patient developed muscular weakness in all four limbs with myalgias; and a purpura in the upper limbs and abdomen. A biological study revealed the presence of severe thrombocytopenia, myolysis and cytolytic hepatitis. Stopping the atorvastatin intake resulted in an improved situation within twenty days. This suggests that the medical anomalies found in the patient were drug-induced. The literature confirms the rarity of this association. The severity of some side effects of statins should remain in the minds of medicine prescribers.

[Unusual aspect of pernicious anemia during association of beta-thalassemia: a new case report and literature review]

Pernicious anemia appears classically by macrocytosis. We report a case of a late discovered Biermer disease, on a 42-year-old young black woman. The reason was an unusual aspect of this disease in a context of betathalassemia. The patient presented chronic anemia which evolved during about ten year. Biology showed a normocytosis and signs of hemolysis according to beta-thalassemia. This was confirmed by an electrophoresis showing 9.1 % of fraction F some haemoglobin. Since this date, the patient was treated by folic acid alone with periodic transfusions of red blood cell. She presented eight years after the beginning of her disease, neurological deterioration. Diagnosis of pernicious anemia was finally established up on histological gastritis, low level of the blood rate of vitamin B12, macrocytosis, and presence of intrinsic anti-factor and parietal anti-cells antibodies.

[Prevalence of child and teenage obesity in schools in Dakar]

Obesity is currently viewed as a serious worldwide public health issue. In this survey, we aim to determine its prevalence among schoolchildren and teenagers in Dakar. The sample of our survey consisted of 2,356 students aged 11-17, including 1,110 boys and 1,246 girls. For each of them, we have calculated their body mass index. Based on the higher value of the norm of that index, referred to the 97th percentile of Rolland-Cachera MF's curves, we have identified obese students according to their age and sex. The prevalence of obesity within our sample is 9.34%, with 2.88% for boys and 6.46% for girls. It is at its peak in the age of 11, though there is no significance (p > 0.05) in its decrease (from age 12 to 17). There are significantly (p < 0.05) more obese students in "catholic private" schools than in "public" schools where schooling is free. Child and teenage obesity is a reality in Dakar schools. Consequently, it is advisable to determine its nationwide prevalence to take on its prevention as well as its cure.

[The left gastroepiploic artery: a splenic origin but a variable birthplace]

The left gastroepiploic artery (LGEA) is rarely described. The aim of this study is to report the fashion of its origin considering the greatly surgical interest of the short gastric vessels in the spleen-preserving distal pancreatectomy with excision of splenic pedicle. About 79 fresh cadaveric pieces we dissect and opacified the LGEA to specify its origin based on the Pinus's classification. We measured the distances between the origin of the LGEA and the terminal division of the splenic artery, the splenic hilus and the great gastric curvature. The LGEA arise from the splenic artery. Dissection underlines a troncular origin (type I) in 20.25% of cases, a distal origin from an inferior polar branch (type II) in 68.35% of cases and an origin from a common spleno-gastroepiploic trunk (type III) in 11.4% of cases. The three distances measured was respectively of 28.7, 25.3 and 31.4mm. The arteriography revealed respectively for the same types 21.21, 51.51 and 27.28%. The vascular disposition of the type III well illustrates the important role of the LGEA for the vascularization of the inferior pole of the spleen. Although the LGEA arise from a polar splenic lower branch in more half of the cases, it is important to know the frequency of the other modalities of its origin. These anatomical variations vascular are to be considered during spleen-preserving distal pancreatectomy with excision of splenic pedicle as well as for gastric esophagoplasty.

[Perforation and haemorrhage duodenal bulbar ulcers in a child: a case report]

A perforation rarely reveals a primary duodenal ulcer. The occurring of digestive haemorrhage in post operative followings evokes spontaneously a stress ulcer. We report an observation of a child who presented on fourth day delay after operation an ulcer of the anterior duodenal bulbar face and a haemorrhage of the posterior bulbar face. A 7-year-old girl with no particular pathological antecedent was admitted for abdominal pain, bile vomiting and constipation evolving since 6 days. Clinical examination revealed a general state thickening, an infectious syndrome, a meteoric and general abdominal sensitivity. The abdominal radiography without preparation showed a pneumoperitoneum. The surgical exploration discovered a perforated ulcer on the bulbar anterior face. A simple closure associated with omental patch was performed. Four days after operation, she presented an abundant digestive haemorrhage with shock. The resuscitation did not improve the patient's general state. The upper digestive endoscopy revealed a haemorrhage of the posterior bulbar face. An adrenalin injection stopped the bleeding. The treatment by neutron pump inhibitors and an eradicating treatment of Helicobacter pylori permitted the healing of the ulcers. The occurring of digestive haemorrhage in the followings of surgical intervention for perforated ulcer involves an upper digestive endoscopy. This examination can reveal misdiagnosed ulcer during the surgical exploration and permits to perform a haemostatic act.

Anatomical basis of neuropathies and damage to the ilioinguinal nerve during repairs of groin hernias. (about 100 dissections)

Surgical access to the inguinal region, notably during hernia repairs, exposes the ilioinguinal nerve to the risk of damage at the origin of the neuralgia. The incidence of these post-operative neuropathies and their medicolegal consequences justify this study about the anatomical variations of the ilioinguinal nerve. With the aim of preventing its damage during repairs of groin hernias and identifying the factors of onset of chronic spontaneous neuropathy of the ilioinguinal nerve, we dissected 100 inguinal regions of 51 fresh adult corpses. The nerve was absent in seven cases and double in one case. Out of the 94 ilioinguinal nerves observed, we analyzed the path in relation to the inguinal ligament and the connections with the walls of the inguinal canal and its content. The ilioinguinal nerve travels along the superficial surface of the internal oblique muscle, passing on average 1.015 cm from the inguinal ligament. In one case, the fibers of the internal oblique muscle spanned it in several places. The nerve was antero-funicular in 78.72% of cases and perforated the fascia of the external oblique in 28.72% of cases. The terminal division took place in the inguinal canal in 86% of cases, with terminal branches that sometimes perforated the fascia of the external oblique. These results enabled us to better understand the etiopathogenic aspects of certain neuropathies of the groin and to propose techniques useful for the protection of the nerve during repairs of groin hernias.

[Anastomotic method of the gastro-omental arterial circle: interest in the transillumination method at the gastric esophagoplasty]

The gastroomental (gastroepiploic) arterial circle of the stomach is the main vascular axis of the gastroplasty use as esophagus substitute after esophagectomy. The aim of this anatomoangiographic study is to study the anastomosis between the right and left gastroomental arteries and emphasize interest of the transillumination: an ordinary anatomic method use in surgical practice. We use forty five fresh cadaveric stomach of adult for determine the anastomotic fashion of the arterial circle of the great gastric curvature. About three models of gastric esophagoplasty we verify similarity of vascular transillumination results and we compare with the radiographic exploration. The thickness of the gastrocolic ligament in which progress the gastroomental arterial circle can lead astray for macroscopic determination of anastomotic mode. Thus the type I, II, III and IV which are of 60%, 22,2%, 13,3% and 4,4% at macroscopic observation become 64,1%, 15,4%, 15,4% and 5,1% after arteriographic analysis. Even if the submucosal arteriolar network and the rich parietal anastomosis confer at the stomach the best qualities for esophageal replacement, the multifactorial particularity of success in esophagogastroplasty require identification and preservation of the gastroomental arterial circle. The transillumination which facilitate evaluation of this arterial axis is a simple and accessible process which we advocate.

The arch of the great saphenous vein: anatomical bases for failures and recurrences after surgical treatment of varices in the pelvic limb. About 54 dissections

The arch of the great saphenous vein presents numerous tributaries. Misappreciation of their anatomical variations might cause recurrence after surgical treatment of varices. We dissected 54 inguino-femoral regions of fresh, black African corpses. Our purpose was to study the anatomical variations in the vein confluents of the arch of the great saphenous vein; its positions in relation to the external pudendal artery; establish palpable anatomical markers for its surgical approach. The conventional type in a 'vein star' shape was not the most frequent. Upper or abdominal common vein produced through the merging of superficial veins of the anterior abdominal wall and genital or internal common vein were more frequent. An anterior saphenous vein was found in 23 cases. The external pudendal artery crossed beneath the arch of the great saphenous vein cross in 56% of cases and previously in 44% of cases. On average, the top of the arch of the great saphenous vein was projected out 10.88 cm from the ventral and cranial iliac spine, 3.83 cm from the pubic tubercle and 4.19 cm from the inguinal ligament. In view of our results, variations are real. Knowing and taking them into account are essential to prevent recurrences after surgical treatment of varices of the pelvic limb.

Influence of Speed Variation and Age on Ground Reaction Forces and Stride Parameters of Children's Normal Gait

The aim of this study was to assess the influence of both age and speed on ground reaction forces and temporal parameters during normal gait in children. Fifteen children aged 4-6 years (group 1), 16 aged 6-8 years (group 2), and 16 aged 8-10 years (group 3) walked at 2.7 km/h, 3.6 km/h, and 4.5 km/h on a treadmill. For each child thirty successive steps were recorded. The influence of speed and age on normalized gait parameters was examined with two-way analysis of variance. The first vertical peak force (Fz1) and all the antero-posterior forces of group 1 were higher than those of the other groups for the three speeds. The minimum vertical force (Fz2), the second vertical peak force (Fz3), and the duration of stride and stance were significantly higher in groups 2 and 3. For all the groups, Fz1 and all the antero-posterior forces increased with the speed while Fz2, stride, stance, and double-stance duration decreased. Fz3 was not influenced by speed variation. The results of this study show that age and walking speed influence ground reaction forces and stride time parameters in 4- to 10-year-old children.

Evaluation of novel diagnostic tools for peste des petits ruminants virus in naturally infected goat herds

A survey was carried out in two goat herds during a single peste des petits ruminant (PPR) outbreak. Clinical examination showed that animals belonging to the West African Dwarf species had severe symptoms while those belonging to the West African long-legged species had mild symptoms. To confirm and to monitor the disease in each species, the study required specific monoclonal antibody-based diagnostic tools. An association of shedding of PPR virus (PPRV) and acute or mild clinical signs of the disease could be demonstrated by the rinderpest virus (RPV)/PPRV immunocapture ELISA assay. Between 85 and 100% of nasal secretions obtained from clinically diseased goats during the PPR outbreak reacted positively. Parallel serological surveillance for specific measurement of PPR antibodies revealed that between 34.4 and 88.5% of animals with no detectable virus were, however, able to seroconvert and therefore seemed to demonstrate that PPR subclinical infections do occur. Antibodies were shown to impair the RP heterologous vaccination. This evaluation offers new prospects for diagnosis and management of PPRV infection as well as for RPV control.