Rôle des Malassezias dans la dermatite atopique de la tête et du cou

Introduction. – Malassezia are lipophilic yeasts, saprophytic on human skin. For the past 20 years, Malassezia were thought to be involved in the pathogenesis of certain forms of head and neck dermatitis (HND). The aim of the present study was to investigate the role of this organism in HND. We also studied possible cross-reactivity with two other yeasts, Candida albicans and Saccharomyces cerevisiae.Patients and methods. – Fifty-three subjects were included: 25 patients with HND, 10 patients with generalized atopic dermatitis (AD) and 18 healthy controls. The 25 patients with HND had yeast cultures taken for Malassezia, and all 53 subjects had patch tests, skin prick tests and IgE antibody assays for Malassezia, C. albicans and S. cerevisiae. The HND patients were then treated with ciclopiroxolamine, a topical antimycotic.Results. – We found no statistically significant relationship between the results of yeast cultures, skin tests and the serological results or the results of the antimycotic treatment in these subjects. We did find increased sensitivity to Malassezia in patients with AD compared to the healthy controls, but there was no statistical difference between HND patients and patients with generalized AD. Nevertheless, for the entire group of patients, there was a significant relationship between results of skin prick tests and specific antibodies for Malassezia, C. albicans and S. cerevisiae, suggestive of possible cross-reactivity between these three yeasts.Conclusion. – The results lead us to propose two hypotheses: (1) Patients may be sensitized to yeast proteins but have no signs of an allergy requiring antifungal treatment, i.e. HND. (2) Patients with HND might be sensitized to several yeasts, and they would need systemic antifungal treatment that is active on Malassezia and C. albicans and, in addition, a S. cerevisiae-free diet.     

De l’intérêt de la corticothérapie nasale dans la rhinite allergique de l’enfant

Glucocorticosteroids are the most powerful anti-inflammatory medications available and, since the 70s, their local application has become an essential element in the treatment of allergic rhinitis. Thanks to an increased efficacy, a lower biodistribution and a better tolerability, the modern molecules are not only more and more proposed as first choice in adults, but they also find their place in the treatment of allergic children. However, following different reports, some caution must be taken in daily practice. Finally, guidelines for the treatment of allergic rhinitis have been recently published in order to standardize the management of allergic rhinitis and to specify the place of each therapeutic option.     

Prévalence de la rectocolite hémorragique dans le centre d’endoscopie digestive de l’hôpital Aristide-Le-Dantec de Dakar

Introduction

In Sub-Saharan Africa, ulcerative colitis (UC) has been considered as quite inexistent for a long time. Today, with development of endoscopy, more and more cases are reported in south countries. Aim: The aim of our study was to determine the prevalence and clinical aspects of UC in the digestive endoscopy unit of Universitary Hospital Aristide-Le-Dantec in Dakar.

Method

That was a retrospective study of low endoscopy reports over a period of seven years (from January 2001 to December 2007). We included all patients in whom endoscopic diagnosis of UC was confirmed by histology. Results: Among 2,667 endoscopy exams, there were 32 cases of ulcerative colitis means 1.2%. Mean age was 33.8 years. Female predominance was noted with sex ratio at 0.68. Average duration was 4.8 years. Clinical manifestations were mainly glairy or bloody diarrhoea (62.5%), proctorrhagia (31.2%) and abdominal pains (25%). Endoscopic exam founded usual elementary lesions of UC. Forms with intermediate extent represented 75% of cases. Histologic aspect was characteristic with transmucous inflammation and modification of crypts architecture.

Conclusion

Existence of UC is real in tropical areas of Africa where it is hidden by infectious colitis. Digestive endoscopy and histologic examination lead to diagnosis.     

Rôle du bruit dans le développement de l’hypertension artérielle en milieu aéroportuaire

ObjectivesThe authors have tried to assess the noise annoyance and its relation with the development of hypertension for the staff working at the civilian airport of Algiers. This population is constantly subject to aircraft noises. The noise, through creating stress, acts on the central nervous system and on the autonomic nervous system and is likely to cause hypertension by increasing peripheral resistance, total cholesterol, fatty acids, adrenaline, cortisol and blood glucose. A number of studies revealed that starting from 65 decibels, the noise causes hypertension for patients of more than 40 years following 5 years of exposure.MethodsAn analytical study was conducted in 2000, which made the comparison between two groups of men working at Air Algérie company. There were 91 officers belonging to air crew, whose number was estimated at that time at 547, and whose average age was 49 years, compared with 111 officers of the ground crew on a total of 1200 persons and whose average age was 56 years. All those officers have received work medical consultation. Patients with suspected hypertension were systematically oriented to cardiologist. Similarly, everyone has had a biological assessment, an ophthalmologic consultation and ENT consultation as well.ResultsHypertension was found in 9.25% of the ground crew and in 16.63% of the air crew (P < 0.001). Hypertension is more common among air crew, subject to a more important noise nuisance, at a younger age and with less risk factors than the ground crew, who develops hypertension with similar prevalence to general population's but at a younger age. The air crew gives more importance to treatment due to the risk of losing their navigation license. The ENT examination was abnormal in 39% of the air crew versus 8% of the ground crew.ConclusionIn the light of these results, the noise seems to really interfere in the development of hypertension in airport environment. It would be more interesting to identify the number of strokes and particularly acute coronary syndromes which are far from being rare in this population subject to this noise annoyance. Preventive measures are of course extremely important.