Prévalence de l’atteinte artérielle macrovasculaire des 4 membres dans la sclérodermie systémique : à propos de 14 patients

Introduction

Trophic disorders of the extremities are a common complication of systemic sclerosis (SSc), mainly related to microvascular damage. However, SSc seems to be a risk factor for premature athero-thrombotic disease that can affect the peripheral arteries, participate in the occurrence of trophic disorders and promote the occurrence of infectious complications. The objective of this study was to assess the prevalence of arterial disease of the limbs in SSc patients.

Review: indications for ultrasound use in low- and middle-income countries

Objective To determine the indications for using ultrasound, in low‐ and middle‐income countries (LMICs) and to assess whether its use alters clinical management. Methods Literature review. We conducted a Pubmed search on the clinical use of ultrasound in LMIC for articles published between January 2000 and December 2010, recording country of origin, speciality and whether ultrasound use led to a change in management. Results Fifty‐eight articles were identified from 32 countries and represented nine specialties. Ultrasound was most commonly used for assisting with the diagnosis of obstetrical conditions, followed by intra‐abdominal conditions such as liver abscesses and intussusceptions. Clinical management was altered in >30% of cases. Conclusion Ultrasound is a highly valuable diagnostic tool in LMICs and its use should be considered essential for all district medical facilities. The use could be applied more widely, eg., for tropical and non‐communicable diseases. Additional research is needed to further characterize the impact of task shifting on ultrasound use in LMICs.     

Antibacterial activity of selected Cameroonian dietary spices ethno-medically used against strains of Mycobacterium tuberculosis

Ethnopharmacological relevance

Tuberculosis (TB) is considered as a re-emerging disease and one of the most important public health problems worldwide. The use or (in most cases) misuse of existint anti-tuberculosis drugs over the years has led to an increasing prevalence of resistant strains, establishing an urgent need to search for new effective agents. Spices are largely used ethno-medically across Africa.

Aim of the study

The present study aimed to evaluate the in vitro antimycobacterial activities of a total of 20 methanol crude extracts prepared from 20 Cameroonian dietary spices for their ability to inhibit the growth of or kill Mycobacterium tuberculosis strains H₃₇Rv (ATCC 27294) and H₃₇Ra (ATCC 25177).

Materials and methods

The antituberculosis screening was performed using the Microplate Alamar Blue Assay (MABA) method to determine the minimum inhibitory concentration (MIC) and the minimum mycobactericidal concentration (MBC).

Results

Fifteen (15) plant extracts out of 20 showed varied levels of antimycobacterial activity against the strains M. tuberculosis H₃₇Rv and H₃₇Ra, with MICs in the range of 2.048–0.016 mg/ml. The extract of Echinops giganteus exhibited the most significant activity with a MIC value of 32 μg/ml and 16 μg/ml, respectively against H₃₇Ra and H₃₇Rv. To the best of our knowledge, the antimycobacterial activity of the tested spices has not been reported before and therefore our results can be evaluated as the first report about the antimycobacterial properties.

Conclusions

The results of this study suggest that Echinops giganteus and Piper guineense could be important sources of bactericidal compounds against M. tuberculosis and could probably be promising candidates that can be further investigated.     

Homoparentalité et assistance médicale à la procréation : que sait-on du développement des enfants de mères lesbiennes ?

Goals of the study

The diversification of studies about the development of children in same-sex families, as well as the methodological advances in these studies, make it possible to better take into account the specificity of the different options available to same-sex couples to create a family. The revision of the bioethics laws in France in 2018 invites us to examine in detail research specifically analyzing the development of children of lesbian mothers conceived by assisted reproductive technics (ART).

Sevrage tabagique chez les patients fumeurs VIH : expérience de la consultation de tabacologie de l’HEGP à Paris

Introduction

There is a particular need among HIV-infected patients to stop smoking because of the risk of smoking-related complications and the high prevalence of cigarette smoking among them. Only a few studies have focused on this population in real-world settings.

Obstetrics during civil war: Six months on a maternity ward in Mallavi,Northern Sri Lanka

A long‐term, large‐scale ethnic armed conflict continues in Sri Lanka, where militant separatists control a northern section of the island. The conflict has resulted in a large population of internally displaced persons and a shortage of medical staff. Drug and equipment shortages compound the difficulty in access to medical care. This article reports the experiences from 1 November 2000 to 30 April 2001 recorded by review of medical records and by interviews, in the peripheral unit, in a separatist controlled area of the Mallavi maternity ward. There were 704 births. Most of the mothers had been displaced by the war (69.5 per cent) and had experienced food shortage (67.5 per cent). Referred patients (18.1 per cent) had a high rate of caesarean section (44.3 per cent) and had travelled a mean of 57.6km to reach Mallavi. There had been substantial antenatal care (94.0 per cent), tetanus toxoid vaccination (95.1 per cent) and malaria prophylaxis (86.4 per cent). Risk factors for low birth weight included a maternal body mass index less than 19 (RR 1.55, CI 1.11–2.16, P=.011), primiparity (RR 1.44, CI 1.05–1.97, P=.024) and self‐reported malarial infection during pregnancy (RR 1.42, CI 1.03–1.97, P=.036). Rates of low birth weight, stillbirths, neonatal deaths and maternal mortality in the Mallavi units were higher than the Sri Lankan national averages. Improvements in quality of care and access to health care are unlikely while the war continues.     

Büschelartiges Hämangiom („tufted angioma“) Klinisch-pathologische und immunhistologische Analyse von fünf Fällen einer distinkten Entität im Spektrum der kapillären Hämangiome

Zusammenfassung Es werden fünf Patienten, zwei weibliche und drei m?nnliche Patienten mit einem büschelartigen H?mangiom („tufted angioma“) vorgestellt. Das Alter der Patienten lag zum Zeitpunkt der Exzision zwischen 10 und 62 Jahren, die L?sionen waren in jeweils zwei F?llen im Kopf/Halsbereich bzw. im Bereich der oberen Extremit?ten und bei einem Patienten am K?rperstamm lokalisiert. Die Tumoren imponierten klinisch als erhabene Plaques, als flache Tumoren mit papul?sen und makul?ren Arealen oder als erythemat?se Plaques mit kleinknotigen Anteilen. Vier der L?sionen wurden bioptiert, bei einer Patientin wurde eine operative Entfernung der L?sion mit anschlie?ender plastischer Deckung vorgenommen. Die fünf Tumoren waren histologisch durch irregul?r in der Dermis bzw. in einem Fall auch in der oberen Subkutis verteilte, vaskul?re Lobuli gekennzeichnet, die aus plumpen Endothelien und spindeligen Perizyten bestanden und immer wieder von gekrümmten vaskul?ren Spaltr?umen unvollst?ndig umfa?t wurden. Die Immunpositivit?t für CD 31 bzw. CD 34 und alpha-glattmuskul?rem Aktin bei Negativit?t der endothelialen Zellen gegenüber Faktor VIII assoziiertem Antigen verdeutlichen das Vorhandensein zweier zellul?rer Komponenten im büschelartigen H?mangiom und die Unreife der endothelialen Tumorzellen. Der Nachweis von regul?ren Mitosefiguren in zwei F?llen und die erh?hte proliferative Aktivit?t in drei von vier untersuchten F?llen in den vaskul?ren Lobuli unterstreichen die neoplastische Natur des klinisch h?ufig langsam progredienten büschelartigen Tumors. Das benigne büschelartige H?mangiom stellt eine distinkte Entit?t im Spektrum der kapill?ren H?mangiome dar und mu? von weiteren vaskul?ren L?sionen unterschieden werden. Eingegangen am 21. August 1995 Angenommen am 25. Oktober 1995