Physiopathology and surgical correction of gastroesophageal reflux: review of the issues

The authors review the pathophysiology of gastroesophageal reflux, pointing out the predominant role of the lower esophageal sphincter in antireflux mechanisms. The diagnosis of gastroesophageal reflux must be based on the results of detailed examination and other tests of which endoscopy and esophageal pH monitoring are the most important. The authors describe how to manage operation for gastroesophageal reflux so as to prevent complications. Although the Hill, Belsey and Nissen operations, referred to as valvuloplasties, have proved their effectiveness in curing gastroesophageal reflux, a review of the literature shows that better results are achieved by Nissen total fundoplication.     

Interferon-gamma mRNA expression upon in vitro T lymphocyte activation is decreased in rheumatoid arthritis patients

A decreased production of interferon-gamma (IFN-gamma) and interleukin-2 (IL-2) upon in vitro stimulation by phytohemagglutinin (PHA) peripheral blood leucocyte in active rheumatoid arthritis (RA) patients has been described as an important immunological abnormality in this disease. However, the molecular level at which this defect might occur has not been fully documented. We have investigated the kinetics of IFN-gamma, interleukin-2 receptor (IL-2 R), and interleukin-1 beta (IL-1 beta) messenger RNA (mRNA) expression in RA patients (n = 9) and normal controls (n = 5) after PHA leucocyte activation. We demonstrate here a significantly decreased expression of IFN-gamma mRNA in RA patients without modification of its kinetics associated with a similar IL-1 beta mRNA expression.     

糖尿病透析患者自主神经病变与透析低血压的关系

检测25 例糖尿病透析患者和40 例慢性肾炎透析患者心电图RR 间隔变异系数(CVRR) ,卧立位收缩期血压差及血清甲状旁腺素(PTH) ,监测患者透析中血压下降值。结果显示:糖尿病透析患者的自主神经病变发生率(80 % ) 明显高于慢性肾炎透析组(57-5 % )( P < 0 .05) ;有自主神经病变的患者,透析中低血压发生率(37-2 % ) ,明显高于自主神经功能正常者(18-2 % )( P< 0 .05) ;各组间PTH 值差异无显著性(P > 0 .05) 。表明糖尿病透析患者易合并自主神经病变,是透析中患者出现低血压的原因之一     

HLA class II DR-DQ and increased risk of cervical cancer among Senegalese women.

To examine Senegalese women to confirm and extend associations between HLA class II types and cervical cancer previously observed among African-American, Caucasian, Hispanic, and Japanese ethnic populations, 55 Senegalese women with invasive cervical carcinoma were compared with age-matched (human papillomavirus) HPV-positive (n = 83) and HPV-negative (n = 107) control women. PCR-based HPV and HLA typing methods were used. Data were analyzed using a global randomization test and conditional logistic regression. Although this study failed to confirm a previously reported association between cervical cancer and DQB1*03 alleles, the DRB1*1101-DQB1*0301 haplotype was detected more frequently among cervical carcinoma cases than among controls (adjusted odds ratio, 2.6; 95% confidence interval, 1.0-7.1). Furthermore, as reported by others, we observed a negative association of borderline statistical significance between DRB1*13 and cervical carcinoma (adjusted odds ratio, 0.5; 95% confidence interval, 0.2-1.1). Observations from this study confirm earlier findings of a negative association between DRB1*13 and cervical cancer and suggest that specific DRB1-DQB1 haplotype combinations, rather than individual DQB1*03 alleles, increase the risk for cervical cancer.     

Contact Tracing Activities during the Ebola Virus Disease Epidemic in Kindia and Faranah,Guinea, 2014

The largest recorded Ebola virus disease epidemic began in March 2014; as of July 2015, it continued in 3 principally affected countries: Guinea, Liberia, and Sierra Leone. Control efforts include contact tracing to expedite identification of the virus in suspect case-patients. We examined contact tracing activities during September 20–December 31, 2014, in 2 prefectures of Guinea using national and local data about case-patients and their contacts. Results show less than one third of case-patients (28.3% and 31.1%) were registered as contacts before case identification; approximately two thirds (61.1% and 67.7%) had no registered contacts. Time to isolation of suspected case-patients was not immediate (median 5 and 3 days for Kindia and Faranah, respectively), and secondary attack rates varied by relationships of persons who had contact with the source case-patient and the type of case-patient to which a contact was exposed. More complete contact tracing efforts are needed to augment control of this epidemic.     

Tumeurs malignes de l’abdomen chez l’adulte au CHU Gabriel-Touré

The diagnosis of abdominal cancer in adult is late. The aims were to determine the hospital frequency and to analyse the diagnostic and therapeutic aspects of the cancers. We did a retrospective study from January 1999 to December 2004. It concerned all patients aged more than 14 years, treated in our service of general surgery of the teaching hospital Gabriel-Touré, for malign abdominal tumour which diagnosis was confirmed by histology or by cytology. Oesophageal tumour and non-confirmed tumours were excluded. We brought together 152 files, which represented 1.6% of hospitalization. The average age of the patients was 54.4 years (28 and 83 years). We had 86 men and 66 women. The tumour were sited on the stomach in 90 cases (59.2%), the pancreas in 22 cases (14.5%), the colon in 17 cases (11.2%), the rectum in 14 cases (9.2%), the ovarium in 5 cases (3.3%), the liver in 4 cases (2.6%). One hundred thirty patients (85.5%) were in poor social condition. The average hospital stay was 24 days (4 and 60 days). Operability rate has been 77% (117 cases). The treatment was curative in 23% of cases (35 patients). It was palliative in 47.4% of cases (72 patients), 45 patients (29.6%) were inoperable. Histology or cytology had shown 90% of adenocarcinoma (137 patients). Postoperative Mortality and morbidity rate were 6% (7 patients) each. The global survival rate at 5 years has been 6% (7 patients). The mean average of the cost of the care was evaluated to 158,745 F CFA without chemotherapy and radiotherapy.     

Résistance d’Anopheles gambiae s.l. aux pyréthrinoïdes et au DDT à Tiassalékro, village de riziculture irriguée en zone sud forestière de Côte-d’Ivoire

An assessment of the sensitivity of Anopheles gambiae s.l.to three pyrethroids (alphacypermethrin, permethrin, deltamethrin) and DDT has been carried out with a laboratory strain (Kisumu reference sensitive strain) and a wild strain (Tiassalékro strain) using larvae from an irrigated rice-growing area of Tiassalékro, located in the southern forest of Ivory Coast. The sensitivity tests were performed according to the standard WHO cylinder tests with adult female A. gambiae s.l. aged 2 to 4 days. The results showed that the strain of Tiassalékro is resistant to the three tested pyrethroids and DDT. The molecular forms M and S were identified, with a predominance of M form. The resistance mechanism involved is the Kdr mutation. In this region, control measures against malaria vectors by using bed nets impregnated with these insecticides or household sprays could be compromised.     

Analysis of reasons for extraction of endodontically treated teeth: a prospective study

Introduction

The purpose of this prospective study was to analyze the factors related to extraction of endodontically treated teeth.

Methods

One hundred nineteen cases of extraction of endodontically treated teeth were consecutively reviewed, and the following items were recorded: type of tooth; presence and type of coronal restoration; motive of consultation; reasons for extraction; patient’s age, gender, level of education; smoking status. Association between factors was investigated with χ² analysis.

Results

Dental pain was the main motive for consultation (68.9%). The teeth most extracted were mandibular molars (51.3%), followed by maxillary molars (16.1%). First molars were the most frequently extracted (29.4%). Ninety-one teeth (76.5%) were restored coronally with or without post, and crowned teeth represented 5.9% of the sample. The reasons for extraction were periodontal disease (40.3%), endodontic failure (19.3%), vertical root fracture (13.4%), nonrestorable cuspid and crown fracture (15.1%), nonrestorable caries (5.2%), iatrogenic perforations and stripping (4.2%), and prosthetic (0.8%). Analysis between gender, smoking status, and education level showed no significant difference for reasons of extraction (P = .33 and .34).

Conclusions

The mandibular first molar without crown was the most frequently extracted tooth. The main reasons for extractions were periodontal disease, endodontic failure, and nonrestorable tooth damage caused by fracture or caries.