Breast Milk Lipidome Is Associated with Early Growth Trajectory in Preterm Infants

Human milk is recommended for feeding preterm infants. The current pilot study aims to determine whether breast-milk lipidome had any impact on the early growth-pattern of preterm infants fed their own mother's milk. A prospective-monocentric-observational birth-cohort was established, enrolling 138 preterm infants, who received their own mother's breast-milk throughout hospital stay. All infants were ranked according to the change in weight Z-score between birth and hospital discharge. Then, we selected infants who experienced "slower" (n = 15, -1.54 ± 0.42 Z-score) or "faster" (n = 11, -0.48 ± 0.19 Z-score) growth; as expected, although groups did not differ regarding gestational age, birth weight Z-score was lower in the "faster-growth" group (0.56 ± 0.72 vs. -1.59 ± 0.96). Liquid chromatography-mass spectrometry lipidomic signatures combined with multivariate analyses made it possible to identify breast-milk lipid species that allowed clear-cut discrimination between groups. Validation of the selected biomarkers was performed using multidimensional statistical, false-discovery-rate and ROC (Receiver Operating Characteristic) tools. Breast-milk associated with faster growth contained more medium-chain saturated fatty acid and sphingomyelin, dihomo-γ-linolenic acid (DGLA)-containing phosphethanolamine, and less oleic acid-containing triglyceride and DGLA-oxylipin. The ability of such biomarkers to predict early-growth was validated in presence of confounding clinical factors but remains to be ascertained in larger cohort studies.

[Epidemiological, clinical and judicial aspects of sexual assault in Bamako (Mali)]

BACKGROUND

Sexual assault rates are underestimated in Mali. This study was designed to assess the epidemiological, clinical and judicial aspects of sexual assault.

PATIENTS AND METHOD

A retrospective study was conducted from 1st July 2007 to 30 April 2010 in the health care centre of the 4th Commune of Bamako. The study included 37 sexual assault victims selected from the medical records and sexual assault certificates from a total of 1,810 patients attending the gynaecology clinic during the study period.

RESULTS

The frequency of sexual assault was therefore 2%. 78.4% of the victims took legal action against the alleged perpetrator. Victims admitted at the request of Police officers accounted for 43.25%; 59.5% of victims attended the clinic within 24 hours following the assault. The age ranged from 2 to 40 years with a mean of 21 years; 37.9% were single and 48.6% were students. The assault was perpetrated by one person in 89.2%, a relative was involved in 5.4%; rape consisted of genito-genital intercourse in 64.9%; 32.4% of the victims had perineal and/or vulval injuries.

CONCLUSION

Sexual assault is relatively frequent in Mali, particularly among students and housewives. It represents a real tragedy, which must be prevented by increasing the awareness of the population, judicial assistance to victims and prosecution of perpetrators.

[Impact of malaria on HIV infection]

Malaria and HIV are two major public health issues, especially in sub-Saharan Africa. HIV infection increases the incidence of clinical malaria, inversely correlated with the degree of immunodepression. The effect of malaria on HIV infection is not as well established. Malaria, when fever and parasitemia are high, may be associated with transient increases in HIV viral load. The effect of subclinical malaria on HIV viral load is uncertain. During pregnancy, placental malaria is associated with higher plasma and placental HIV viral loads, independently of the severity of immunodeficiency. However, the clinical impact of these transient increases of HIV viral load remains unknown. Although some data suggests that malaria might enhance sexual and mother-to-child transmissions, no clinical study has confirmed this. Nevertheless pregnant women and children with malaria-induced anemia are also exposed to HIV through blood transfusions. Integrated HIV and malaria control programs in the regions where both infections overlap are necessary.

[Value of radiographic evaluation of the second metacarpal in the determination of bone age]

PURPOSE

Age determination based on bone maturate evaluation is routinely used in forensic science and anthropology. The aim of this study was to purpose a quantitative method of age determination on the second metacarpal in a population of children and adolescents by measurements of the epiphyso-metaphysal ratio (REM) (epiphysal diameter divided by metaphysal diameter) and the cortical index (IC).

MATERIAL

and methods. We evaluated the REM and the IC on 417 hand radiographs of 2 from aged 20-year-old children.

RESULTS

The correlation between REM and age for males (R2=0.62; p<0.001) and females (R2=0.68; p<0.001) was a good and significant. The correlation between IC and age for males (R2=0.34; p<0.001) and females (R2=0.30; p<0.001) was also significant but poor.

CONCLUSION

Measurement of IC should not be used for age assessment. Measurement of REM is simple, reproducible and poor X-ray exposing technique. It should be very useful for age determination.

[Actualities in extrinsic allergic alveolities or hypersensitivity pneumonitis]

Significant advances have been noticed in the pathogenesis and the diagnosis of extrinsic allergic alveolitis during the last few years. Indeed the immune mechanism and the enabling conditions have been more precisely defined, the clinical stages and the diagnosis criterias clearly defined, new antigens incriminated and some etiological agents have been reclassified. The present pathogenic explanation insists on the type IV hypersensitivity reaction with sensitization of T lymphocytes, activation macrophages, the formation of IgG type antibodies and immune complexes, activation of complement and secretion of cytokines. The involvement of certain HLA classes (HLA2, DR3, DRB1, DQB1), interaction of genetics and environments factors, the role of infections agents and smoking have been demonstrated in several studies. The development of news clinical and biological diagnosis criteria have led the discovery of new extrinsic allergic alveolitis in the work places, a better knowledge of the prognostic elements and an appropriate adaptation of prevention measures.

[Comparative review of the Senegalese and French deontology codes]

The medical deontology regroups duties of the physicians and regulate the exercise of medicine. The code of medical deontology of Senegal inspired of the French medical deontology code, has not been revised since its institution whereas the French deontology code knew three revisions. Comparing the two codes of deontology titles by title and article by article, this work beyond a parallel between the two codes puts in inscription the progress in bioethics that are to the basis of the revisions of the French medical deontology code. This article will permit an advocacy of the health professionals, in favor of a setting to level of the of Senegalese medical deontology code. Because legal litigation, that is important in the developed countries, intensify in our developing countries. It is inherent to the technological progress and to the awareness of the patients of their rights.

[Medico-legal conditions of recognition and compensation of occupational asthma in Sénégal]

The aims of this study were to appreciate how frequent asthma was named in the legal list of worker's compensation, state hazards and occupations involved and appreciate conditions required for a legal recognition of the disease. The study consisted of a review of the legal list of occupational diseases of all tables where asthma was stated. Medical, technical and administrative criteria allowing compensation were looked for. Asthma was listed in 12 among the 67 tables; causal substances listed were known as sensitizers and included mainly organic and metallic compounds. Numerous occupations were concerned in all primary, secondary and tertiary sectors. Medical conditions refered to "all asthma confirmed by functionally respiratory tests or regenerated by a new exposure". Time length of declaration was seven days. Variety of occupations concerned and numerous substances involved should invite to look for occupations in all patients with asthma. Physicians should be aware of theses legal conditions in order to recognize better occupational asthma and ease it legal compensation.

[HIV in workplace: knowledges and attitudes of workers in three Senegaleses manufactures]

This study was conducted from may to august 2000 in three senegalese work sites randomly selected among seven which benefited from HIV preventive program. The aims were to evaluate knowledge, attitude and behavior related to HIV infection. A sample of 200 workers randomly chosen were asked about the ways of transmission and methods of protection as well as their risky attitudes and behaviors. Mean age was 41 years, 82.5% were male and 75.5% benefited from high school education; 75.75% had a good level of knowledge on HIV infection, 58% CI [51-65] stated having changed their sexual behavior into abstinence, fidelity to their partner (52.5%) and use of condom (46.5%). This good level of Knowledge and the positive changes in attitude are related to the high rate of alphabetization in our sample, information message diffused by media and preventive programs undertaken in workplace. Information campaigns via media should be maintained and strengthened and preventive programs diffused in all workplaces which will reduce diffusion of HIV in population.

[Acute hydrogen sulfite intoxication: report of three lethal cases occurred at a Senegalese chemical plant]

We report an hydrogen sulfite intoxication which occurred in a Senegalese chemical plant and which lead to the death of three temporary workers in charge of cleaning up the pumping basin of seawater. Hydogen sulfite was generated by the decomposition of seaweeds and other inorganic compounds. Agitation of water due to human presence increased the air concentration at very high levels. The death of workers trying to rescue their colleagues was due to their ignorance of key elementary prevention rules. Diagnosis was based upon microbiologic analysis and air sampling. The ignorance of toxicologic effects of this widespread substance invite to inform people working in industries where the risk of hydrogen sulfite intoxication is high.

[Bronchial hyperreactivity syndrome : a case report following exposure to sulfur dioxide]

A variety of occupational asthma is induced by important exposure to irritants. A case is reported, where le patient developed asthma symptoms like, following huge exposure to sulfur dioxide. All Books criteria were met, except for the metachlorine challenge which was not performed. Nevertheless the bronchial reactivity in the work place, shown by a portable pick flow eased le diagnosis. General practitioners and occupational physicians should be aware of this new medical entity for a better management.