Increase in condom use and decline in HIV and sexually transmitted diseases among female sex workers in Abidjan, C?te d'Ivoire, 1991-1998.

OBJECTIVE: To assess clinic- and community-based trends in demographic and behavioral characteristics and clinic-based trends in HIV infection and other sexually transmitted diseases (STD) in female sex workers in Abidjan, C?te d'Ivoire. DESIGN: Multiyear cross-sectional study of first-time attenders in Clinique de Confiance, a confidential STD clinic; biannual community-based behavioral surveys. METHODS: From 1992 to 1998, female sex workers were invited to attend Clinique de Confiance, where they were counseled, interviewed, clinically examined during their first visit and tested for STD and HIV infection. Community-based surveys, conducted in 1991, 1993, 1995, and 1997, interviewed women regarding socio-demographic characteristics and HIV/STD-related knowledge, attitudes and behavior. RESULTS: Among female sex workers in Abidjan, there was a trend toward shorter duration of sex work, higher prices, and more condom use. Among sex workers attending Clinique de Confiance for the first time, significant declines were found in the prevalence of HIV infection (from 89 to 32%), gonorrhoea (from 33 to 11%), genital ulcers (from 21 to 4%), and syphilis (from 21 to 2%). In a logistic regression model that controlled for socio-demographic and behavioral changes, the year of screening remained significantly associated with HIV infection. CONCLUSION: The increase in condom use and the decline in prevalence of HIV infection and other STD may well have resulted from the prevention campaign for female sex workers, and such campaigns should therefore be continued, strengthened, and expanded.     

Retroperitoneoscopic nephrectomy for non-functioning kidneys related to renal stone disease

Laparoscopic nephrectomy has become the gold standard procedure for nonfunctioning or symptomatic benign kidneys due to renal calculi, obstructive, refluxive, and inflammatory nephropathies or renovascular hypertension. We aimed to investigate the effect of renal calculi as a reason of non-functioning on the progress and complication rates of the retroperitoneoscopic nephrectomy (RPN).During a 2-year period, 108 patients with benign renal conditions underwent RPN by single surgeon. Among these patients, total of 27 (Group 1) with a non-functioning kidney due to renal calculi were retrospectively compared with 27 patients (Group 2) with other benign renal conditions. The two groups were matched for age, body mass index, and previous renal surgery. We analyzed operative and post-operative findings and complications. The mean age and the BMI of the groups were similar. The operation time was significantly longer in Group 1 than Group 2 (p?=?0.0001). There was no significant difference between the groups with respect to mean hemoglobin drop postoperatively (p?=?0.9) and hospitalization time (p?=?0.06). The perioperative and postoperative complication rates were higher in Group 1 but not statistically different from Group 2 (p?=?0.19, p?=?0.29, respectively). RPN for nonfunctioning calculous kidneys is more challenging procedure and is associated with prolonged operation time related to difficult dissection of dense adhesions. It can be safely performed by experienced hands with similar perioperative and postoperative complication rates as well as for other benign conditions of the kidney.     

Sleeping sickness diagnosis: use of buffy coats improves the sensitivity of the mini anion exchange centrifugation test

Objectives To evaluate a modification of the mini anion exchange centrifugation test (mAECT) for the diagnosis of Trypanosoma brucei (T.b.) gambiense human African trypanosomiasis (HAT). To increase its sensitivity, this test uses 350 μl of buffy coat withdrawn from 5 ml of blood instead of blood. Methods The new protocol was first tested experimentally on serial dilution of trypanosomes and was then further evaluated under field conditions on 57 patients with HAT diagnosed during a medical survey in Guinea. Results Experimentally, the use of buffy coats improved mAECT sensitivity at least five fold and enabled to consistently detect parasites in blood at a concentration of 10 trypanosomes/ml. During the field evaluation, more patients tested positive by mAECT‐bc (96.5%) than by mAECT‐blood (78.9%, χ² = 6.93, P = 0.008) and lymph juice examination (77.2%, χ² = 7.67, P = 0.005). Furthermore, the number of parasites per collectors was significantly higher (7.2 vs. 2.6, P = 0.001) when buffy coats were used instead of blood. Conclusion The use of the mAECT‐bc protocol enabled a significant improvement of HAT parasitological diagnosis in Guinea, without any additional costs. It would deserve to be tested in other T.b. gambiense endemic areas.     

Patterns of paediatric facial fractures in a hospital of São Paulo,Brazil: A retrospective study of 3 years

The objective of this study is to analyze patterns of facial fractures in children treated at the Service of Oral and Maxillofacial Surgery of the Vila Penteado General Hospital (HGVP), in São Paulo, Brazil, in a period of 3 years. Between May 2008 and April 2011 the authors reviewed 110 records of patients under 12 years old with facial fractures. The following parameters were evaluated: age and sex distribution, aetiology of trauma, incidence and type of fractures, monthly distribution and treatment modality. Male-to-female ratio was 1.8:1, and the mean age was 8.13. The majority of the involved patients were aged between 6 and 12 years. The most prevalent cause was fall (58%) and nasal fractures were the most common type of fracture (69%). Monthly distribution was similar in all seasons. Of 110 patients, 69 (62%) were treated conservatively. The incidence of facial fractures in the area of study is high. The high incidence of nasal fractures should be a warning to maxillofacial surgeons, so that they are not overlooked. Safety programs should be installed in Brazil to increase public awareness and to decrease morbidity resulting from paediatric trauma.     

Intercontinental Spread of Eurasian Highly Pathogenic Avian Influenza A(H5N1) to Senegal

In January 2021, Senegal reported the emergence of highly pathogenic avian influenza virus A(H5N1), which was detected on a poultry farm in Thies, Senegal, and in great white pelicans in the Djoudj National Bird Sanctuary. We report evidence of new transcontinental spread of H5N1 from Europe toward Africa.     

Properties of reciprocal synapses in the mouse accessory olfactory bulb.

Reciprocal dendrodendritic synapses between mitral and granule cells in the accessory olfactory bulb have been implicated in a specialized form of olfactory learning in mice, in which a female forms a memory to the pheromonal signal of the male that mates with her. Relatively little is known, however, about the mechanism of synaptic transmission at the reciprocal synapses. We analyzed synaptic currents generated in accessory olfactory bulb mitral cells in slice preparations with the patch-clamp technique in nystatin-perforated whole-cell configuration. A brief (5-20-ms) depolarizing voltage step from -70 to 0 mV applied to a single mitral cell evoked GABA(A) receptor-mediated inhibitory postsynaptic currents. The inhibitory postsynaptic currents persisted in the presence of tetrodotoxin, indicating that the inhibitory postsynaptic current in mitral cells can be elicited through purely dendritic interactions. The inhibitory postsynaptic currents were greatly enhanced by washout of extracellular Mg(2+). In Mg(2+)-free solution, the N-methyl-D-aspartate (NMDA) receptor antagonist D,L-2-amino-5-phosphonovaleric acid greatly reduced the inhibitory postsynaptic currents, whereas the non-NMDA receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-(1H,4H)-dione (CNQX) slightly reduced them.These data demonstrate that NMDA receptors play an important role in the generation of dendrodendritic inhibition in mitral cells of the mouse accessory olfactory bulb.     

Gabaergic control of olfactory learning in young rats.

Olfactory learning in young rats correlates with neural plasticity in the olfactory bulb, and involves noradrenergic modulation of reciprocal dendrodendritic synapses between mitral cells and GABAergic granule cells. The purpose of this study was to examine, in vivo, the consequences of manipulating bulbar GABA transmission during training. In the first experiment, postnatal day 11 rat pups were trained in an olfactory associative learning task with citral odor and foot shock as the conditioned and unconditioned stimuli, respectively. The pups received continuous infusion of saline or the GABA(A) receptor agonist muscimol into the olfactory bulbs throughout a 30-min training session. The pups were then tested on postnatal day 12 for a preference for or an aversion to citral odor. Saline-infused control pups developed an aversion to citral odor. The GABA(A) receptor agonist muscimol impaired this aversive learning in a dose-dependent manner. In the second experiment, pups were exposed to the odor for 30 min while receiving continuous intrabulbar infusion of a low or high dose of the GABA(A) receptor antagonist bicuculline, without any other reinforcer. Depending on whether a low (0.2 nmol/bulb) or high (1.0 nmol/bulb) dose of bicuculline was infused, the pups showed a preference or an aversion for citral odor after infusion of low and high doses, respectively. These results indicate that disinhibition of mitral cells in the olfactory bulb is critical for olfactory learning in young rats, and suggest that the degree of disinhibition is an important determinant in acquiring either preference or aversion for the conditioned odor.