Malaria and primary education in Mali: A longitudinal study in the village of Donéguébougou

This article assesses the role of malaria and certain social determinants on primary education, especially on educational achievement in Donéguébougou, a small village in a malaria-endemic area near Bamako, Mali. Field data was collected by the authors between November 2007 and June 2008 on 227 schoolchildren living in Donéguébougou. Various malaria indicators and econometric models were used to explain the variation in cognitive abilities, teachers’ evaluation scores, school progression and absences. Malaria is the primary cause of school absences. Fixed-effects estimates showed that asymptomatic malaria and the presence of falciparum malaria parasites had a direct correlation with educational achievement and cognitive performance. The evidence suggests that the correlation is causal.     

Evaluation of a flow cytometry method for CD4 T cell enumeration based on volumetric primary CD4 gating using thermoresistant reagents

Laboratory follow-up of HIV patients in resource-limited settings requires appropriate instruments for CD4 T cell enumeration. In this study, we evaluated the application of a simplified, mobile and robust flow cytometry system, the Apogee Auto 40 analyzer (Auto40) using thermoresistant reagents, for CD4 T cell enumeration. We measured the absolute CD4 counts in fresh whole blood samples from 170 Senegalese subjects, including 129 HIV-positive (HIV+) patients and 41 HIV-negative (HIV-) controls. Based on volumetric primary CD4 gating, cells were stained with commercially available reagents (Easy MoAb CD4;Bio-D, Valenzano, Italy) and analyzed on the Auto40. The results were compared with those from the FACSCount system (Becton Dickinson, San Jose, USA). Repeatability analysis was performed on duplicate testing of 49 samples on both FACSCount and Auto40. The intra-run precision was measured by 10 replicates using 3 clinical blood samples with low, intermediate and high CD4 concentrations. The results from the two instruments were in good agreement. The percent similarity between the results of both instruments was 99%±relative standard deviation of 12.7%. The concordance correlation coefficient was 0.99. The absolute bias and limits of agreement (LOA) between the two instruments, calculated by Bland-Altman analysis, were clinically acceptable (bias: +4 cells/μl; LOA: -111 to +120 cells/μl). The clinical agreement between the two instruments at a cutoff of 200 CD4 cells/μl was 94%. The repeatability of measurements on the Auto40 was also similar to that observed with FACSCount system (bias +0.1 cells/μl, coefficient of variation 2.5% vs bias -1.1cells/μl, coefficient of variation 2.9% respectively). In conclusion, our results indicate that the Auto 40 system, using thermoresistant reagents, is suitable for CD4 T cell enumeration and will be a helpful tool to improve HIV laboratory monitoring in resource-limited settings.     

Coronary artery anomalies diagnosed by magnetic resonance angiography

Coronary artery anomalies are uncommon entities that may be associated with sudden death. Because of its 2‐D projection imaging nature, conventional X‐ray coronary angiography may not accurately delineate the origins and course of aberrant coronary arteries with respect to the great vessels. Non‐invasive, cross‐sectional imaging techniques such as coronary CT angiography and magnetic resonance angiography are increasingly used in clinical practice to diagnose coronary artery anomalies. Although this study reviews coronary artery anatomy and selected anomalies as seen with true fast imaging with steady‐state precession magnetic resonance angiography, the information provided is equally applicable to electrocardiogram‐gated coronary CT angiography.     

人脐血CD34+ 细胞静脉移植对急性心肌梗死大鼠血流动力学指标和超声心动图指标的影响

目的:观察人脐带血CD34 细胞移植治疗急性心肌梗死大鼠的可行性及其对心功能的影响。方法:实验于2006-03/10在首都医科大学附属北京友谊医院完成。①选取11～13周龄雄性SD大鼠40只,随机数字表法分为假手术组10只、模型对照组15只、细胞移植组15只。脐血由北京市脐血干细胞库提供,采自无妊娠并发症、身体健康、新生儿足月分娩(37～40周)孕妇,均签署知情同意书,自愿捐献用于科学研究和临床治疗。②一次性血袋抽取孕妇脐带血80～120mL,按5∶1比例加入60g/L羟乙基淀粉,4℃420r/min离心8min;去除红细胞,留取上层含有核细胞的血浆层,4℃1180r/min离心10min,去除血浆,留取有核细胞,测CD34 含量为0.35%～0.42%。③模型对照组、细胞移植组大鼠建立急性心肌梗死模型,麻醉后切开第4、5肋间肌,暴露心脏,在动脉圆锥和左心耳间、距左心耳下1mm处(相当于左前降支近段)用Prolene线结扎。假手术组只挂线不结扎。根据左室前壁颜色变白、活动减弱和心电图ST段明显抬高作为急性心肌梗死模型成功标志。④术后3h内,细胞移植组经尾静脉注射0.5mL人脐血干细胞悬液(含干细胞2×1010L-1),模型对照组经尾静脉注射0.5mL生理盐水。饲养30d。⑤分别于术前、术后1d和术后30d进行超声心动图检测。并于术后30d进行血流动力学检测。结果:假手术组挂线过程中死亡1只,模型对照组造模及细胞移植过程死亡4只,细胞移植组造模及细胞移植过程死亡5只。①人脐血CD34 细胞移植30d后对大鼠血流动力学的影响:与假手术组比较,模型对照组左室收缩压、左室压力最大变化率均明显减小(t=2.16～5.14,P均<0.05),左室舒张末压、心率均明显增加(t=2.01～8.86,P<0.01或0.05);与模型对照组比较,细胞移植组左室收缩压、左室压力最大变化率均明显增加(t=2.72～2.35,P均<0.05),左室舒张末压明显减小(t=4.24,P<0.01),心率无明显变化(t=1.67,P>0.05)。②人脐血CD34 细胞移植前后超声心动图检查结果:与假手术组比较,术前模型对照组和细胞移植组各指标无明显变化;术后1,30d模型对照组和细胞移植组左室舒张末期内径、左室收缩末期内径、左室舒张末容积、左室收缩末容积均明显增加(t=2.14～9.98,P<0.05或0.01),左室前壁厚度、左室后壁厚度、左室射血分数、左室短轴缩短率均明显减小(t=2.52～14.23,P<0.05或0.01)。与模型对照组比较,术前和术后1d细胞移植组各指标无明显变化,但术后30d左室舒张末期内径、左室收缩末期内径、左室舒张末容积、左室收缩末容积均明显减小(t=2.07～7.04,P<0.05或0.01),左室前壁厚度、左室后壁厚度、左室射血分数、左室短轴缩短率均明显增加(t=3.22～9.85,P均<0.01)。结论:在未使用免疫抑制剂的情况下,人脐带血CD34 细胞静脉移植可明显改善急性心肌梗死大鼠各项心功能指标,未见明显不良反应。     

Supernumerary teeth and orthodontic treatment]

According to the orthodontist supernumerary teeth on dental arches necessitate a special analysis of the occlusion to decide which to keep and which ones to pull out. Then he must solve the problem of the new occlusion to have. Thus in this study the authors, from their personal experiences of treatment of cases about supernumerary teeth go through the matter.     

Low seroprevalence of herpes simplex virus type 2 among pregnant women in Senegal

Herpes simplex virus type 2 (HSV-2) is considered as a major co-factor of both sexual transmission and acquisition of the human immunodeficiency virus (HIV). The HIV epidemic in Senegal is characterized by a remarkable and stable low prevalence. Whether HSV-2 may also constitute a possible co-factor favouring the spreading of HIV epidemic in Senegal is yet unknown. This prompted us to evaluate the HSV-2 seroprevalence in the sentinel population of pregnant women in Senegal. Two hundred and sixty pregnant women attending Roi Baudouin maternity in the capital city Dakar (n = 14; 135) and the antenatal clinic in Kaolack (n = 125), the third city of Senegal, were prospectively recruited between March and August 2003. Fifty-six women (22%) were positive for HSV-2 serology. The prevalence of HSV-2 seropositivity was higher in women living in Dakar (26%) than in those living in Kaolack (16%) (P < 0.01). Only two women from Dakar and two other from Kaolack were found to be HIV-1-infected. Our observations suggest a seemingly low seroprevalence of HSV-2 infection in adult women Senegal, comparable with those usually reported in Western countries. Further, epidemiological surveys are needed to confirm these results in the general population.