Intérêt de la recherche de β2-transferrine dans des prélèvements susceptibles de contenir du LCR

When there is a clinical suspicion of CSF leakage, we can detect the presence of β2-transferrin in fluids from different origins. We used two techniques in the laboratory coupling electrophoresis with immuno-blotting. These two methods are realized on microsamples collected by syringe or on microcollagen sponges. The difference between the two methods concern the nature of the gel electrophoresis: agarose for the first one (zone electrophoresis) which allow separation of β1 and β2 transferrin by the electric charge, and agarose with ampholytes (isoelectrofocusing) allowing separation by isoelectric point of all transferrin isoforms. Whatever the method two controls are used: serum of the patient (negative control) and CSF (positive control).     

Apport des techniques de biologie moléculaire dans le diagnostic prénatal de la toxoplasmose congénitale

The purpose of this study was to report the performances of polymerase chain rection on amniotic fluid for the prenatal diagnosis of congenital toxoplasmosis. Amniocentesis was performed in 261 patients with acquired toxoplasmosis during pregnancy. The detection of Toxoplasma gondii was performed by PCR and mouse inoculation. Of the 60 cases of congenital toxoplasmosis, 56 were detected prenatally. The sensitivity of PCR (90%) was higher than mouse inoculation (70%). The 2 tests had a specificity and a positive predictive value of 100%. The negative predictive value was 94% for PCR and 83% for mouse inoculation. All cases diagnosed by prenatal diagnosis were confirmed by serological follow up of infants. PCR test performed on amniotic fluid is a method of great interest, simple and rapid. It permits an early diagnosis and treatment of infected fetuses and reduces the number of terminations of pregnancy.     

Bases anatomiques de la prévention des hématomes de la paroi abdominale induits par le placement des trocarts

Conclusion N'ignorant pas que le choix des sites d'incision pour la chirurgie laparoscopique peut être influencé par une multitude de facteurs, afin de minimiser le risque de lésions des vaisseaux de la paroi abdominale, nous suggérons de placer les trocarts sur la ligne blanche et dans une zone de 5 cm de large en dehors du bord latéral de la gaine du m. droit

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Traduction : O Armstrong et JF Delattre     

Comparaison de l’efficacité de la chloroquine versus sulfadoxine-pyriméthamine dans la prévention du paludisme chez la femme enceinte dans la région de Toamasina (Madagascar)

Malaria still represents a great cause of death in sub-Saharan African areas, mainly among pregnant women. We conducted this prospective study during two years in a malaria-endemic stable region in the east of Madagascar (Toamasina) with an aim to compare the efficacy of weekly chloroquine (CQ) and the use of intermittent presumptive treatment by sulfadoxine-pyrimethamine (SP). 519 pregnant women were included in this study (CQ = 285; SP = 256). Socio-demographical characteristics of each group were identical. We found more peripheral parasitemia (CQ = 8.07% vs SP = 2.73%; P = 0.0068) and severe malaria in the CQ group (CQ = 1.75% vs SP = 0%; P = 0.0332). Anemia was more frequent in the CQ group (CQ = 4.21% vs SP = 0.35%; P = 0.0038). Placental infestation rate was also higher in the CQ group (CQ = 7.01% vs SP = 0.39%; P = 0.00001). Low birth weight and fetal death were lower in the SP group respectively [(CQ = 4.21% vs SP = 0.78%; P = 0.0121) and (CQ = 1.75%vs SP = 0%; P = 0.0332)].     

Intérêt du dosage de la désoxypyridinoline urinaire dans le dépistage des métastases osseuses du mélanome

Urinary deoxypyridinoline as a marquer of bone metastases in patients with melanoma. We measured urinary deoxypyridinoline (DPD) in 168 melanoma bearing patients, by an chemiluminescence immunoassay. The results were expressed as ratio to creatinine (DPD/Cr in nmol/mmol). The patients were distributed in five groups: patients without any detectable metastases, patients with cutaneous metastases, with lymph nodes metastases, with visceral or bone metastases. The control group included 40 healthy volunteers. We calculated reference values and means of level DPD/Cr in each group. The mean DPD/Creatinine was significantly higher for women with bone metastases than for the control group (respectely 16.7 nmol/nmol and 4.96 nmol/mmol (p = 0.003)) with a sensitivity of 62 % and a specificity of 98 %. We determinated a cutoff level at 15 nmol/mmol. However, no significantly inter group difference was observed for men. Measurement of urinary DPD is not superior to bone scintigraphy in the early detection of bone metastases, but may provide an useful alternative tool to bone scintigraphy for diagnosis of bone metastases.     

Intérêt de l’étude du gène bêtaglobine dans le dépistage des hémoglobinopathies

As part of hemoglobinopathy’s study in the hospital of Saint-Denis, we search β globin gene mutations to complete standard techniques with the assay “βglobin Strip A^ssay” of Vienna Lab Labordiagnostika, sold by Ingen. This assay allows the detection of 20 frequent β thalassemia mutations, hemoglobin S and C. This assay is executed for β thalassemia and in a number of sickle cell diseases (SS and S-β thalassemia). Mutation was found in 38% of β thalassemia. In sickle cell diseases: SS and S-β+ thalassemia in newborns were confirmed. Nevertheless, considering the origin of our sickle cell disease’s patients, it is essential to complete this assay with African mutations.     

Schistosomose et géohelminthoses dans le nord-est du Bénin : cas des écoliers des communes de Nikki et de Pèrèrè

Infection with schistosomiasis and soil-transmitted helminthiasis are widespread in sub-Saharan Africa and the burden of disease associated with parasites is enormous. A study was performed to determine the transmission and prevalence of human schistosomiasis and soil-transmitted helminthiasis among school children of Nikki and Perere, two north eastern towns of Benin, bordering Republic of Nigeria. Parasitological investigations by urine filtration and Kato-Katz conducted on 1,344 school children indicated a mean prevalence of S. haematobium and S. mansoni 48.44% and 0%, respectively, in the children of Nikki area and 45.24% and 4.11% in Perere area. Only schoolchildren of Sonon locality were infected by S. mansoni with a mean prevalence rate of 36.24%. KatoKatz tests releaved five species of soil-transmitted helminths: Ankylostoma duodenale (8.16% and 6.73%), Ascaris lumbricoides (6.26% and 2.30%), Enterobius vermicularis (1.09% and 1.97%), Trichuris trichiura (1.97% and 1.90%) and Strongyloides stercoralis (2.04% and 0.99%), respectively, in the schoolchildren of Nikki and Perere areas. The malacological investigations carried out in the freshwater points of each visited locality highlighted the presence of four species of freshwater snails known as intermediate host of schistosome: Biomphalaria pfeifferi, Bulinus forskalii, B. globosus and B. truncatus.Two B. globosus and B. pfeifferi collected in Sonon locality were naturally infected by schistosome, indicated the importance of their two species of snail in schistosome transmission cycle.     

De la mise à disposition de l'outil télémédecine à la réalisation des objectifs attendus

From 1996 to 2000, the number of telemedicine applications used routinely at the Assistance publique-Hôpitaux de Paris has been increased threefold. The identification of medical needs, telemedicine's impact evaluation and telemedicine services management are key factors in the spread of telemedicine.     

Profil de l’hémogramme et intérêt de la mesure de l’hémoglobine pré-don chez des donneurs de sang de la région Nord-Ouest du Maroc

Background

Blood donation in Morocco and more particularly in the northwest region is carried out without prior determination of the pre-donation hemoglobin. In addition, we note the lack of scientific research that reports data on the red blood cells, leukocytes and platelet lines in donated blood at the regional or even national level.