Cytological detection of lesions of the uterine cervix: results of a campaign in Senegal

The authors have analysed the results of 5131 Papanicolaou tests carried out in Senegal between November 1980 and July 1983. They emphasize the importance of classes II and III, which correspond to lesions that can be treated so as to ensure prevention of cervical cancer. The classical etiopathogenic factors of this type of cancer are studied, and results obtained from a group tested systematically are compared with those of a group that were tested only at the time of a gynaecological examination for another purpose. This comparison demonstrated the usefulness of systematic screening. The authors propose a scheme for organizing the prevention and screening of this type of cancer at the subregional level in Africa.     

Baclofen and Alcohol‐Dependent Patients: A Real Risk of Severe Self‐Poisoning

Baclofen is often prescribed in high doses to fight cravings experienced by alcohol‐dependent patients. Such an increase in the availability of baclofen is concerning. This study aimed to determine the change in number and profile of self‐poisoning with baclofen over time, as baclofen has become increasingly popular, in order to describe the severity of self‐poisoning with baclofen and to focus on co‐existing alcohol use disorders, and psychiatric illnesses determine predictors of severity. This was a retrospective study of self‐poisoning with baclofen as reported by the western France Poison Control Center (PCC), which represents a population of more than 12 million people from January 2008 to March 2014. One hundred and eleven cases of self‐poisoning with baclofen were reported to the western France PCC (62 males and 49 females; average age 39 ± 12). Poisoning severities were as follows: ‘null’ (nine cases), ‘minor’ (37 cases), ‘moderate’ (19 cases) and ‘high’ (46 cases, including four deaths). The most frequently reported symptoms were neurological (45%) and cardiovascular (27%). The severity was significantly associated with psychiatric disorders (OR = 2.9; p = 0.03). Baclofen, prescribed in high doses, may lead to severe poisoning, particularly in patients with psychiatric illnesses. Authorities should put forward a new policy for prescribing the drug as a treatment for alcohol dependence.     

High HBsAg and anti-delta carrier rate among asymptomatic Africans living on the campus of the University of Niamey, Niger

In 1984 and 1985, a non-random survey was conducted among healthy Africans living on the campus of the University of Niamey, Niger. Of 238 asymptomatic subjects, 17.6% carried hepatitis B surface antigen (HBsAg) in their serum, while 50.8% demonstrated protective anti-HBs antibodies. Antibodies to delta virus were detected in 29.3% of HBsAg-positive sera. This suggests that hepatitis B virus (HBV) and hepatitis delta virus (HDV) are common in Niger, and the factors that increase the likelihood of HBV transmission may also enhance the risk of HDV transmission.     

Adaptation française et analyse des qualités psychométriques du questionnaire d’évitement et de fusion (AFQ) dans une population adulte

Objectives

The transdiagnostic approach of psychological disorders puts forward a set of psychological manifestations that would be responsible for the maintenance and aggravation of certain disorders such as depression, phobia, anxiety or addictive behaviors. One of these symptoms, the experiential avoidance, is characterized by the avoidance of internal events such as thoughts, emotions and sensations, as well as cognitive fusion (taking thoughts as real facts). The latter would engender psychological inflexibility in the individual and some psychological disorders. Tools such as the Avoidance and Fusion Questionnaire allows to detect this psychological inflexibility. This questionnaire, originally intended for a population of children and adolescents, was adapted and validated in an adult population but not in the French language. Then, we translated it in French and explored its psychometric qualities.

Design and fabrication of custom mandible titanium tray based on rapid prototyping

During the past few years, the combination of medical imaging and rapid manufacturing technique has proven to be a very important development. On the other hand, the conventional method has some drawbacks. For example, it takes longer time to complete an operation and it also presents some difficulty in matching the repaired contours. With advanced software and hardware, an image of an undamaged bone similar to that of the patient can be made from computerised tomography (CT); and a physical object constructed by the mirror-processed image data can be quickly fabricated with a high degree of fitting with the patient's bone. This paper presents a methodology for the design and fabrication of an individual titanium tray for the repair of mandible defects. Methods for the tray modeling using CAD system are presented: A 3D model of the bony defect is generated after the acquisition of helical CT data. An individual tray is designed using freeform surfaces geometries and fabricated by rapid prototyping (RP) technology. The results of tray filling with bone-grafting materials are then presented. Result: the tray is inserted into the patient mandible segment. The symmetry and reconstruction quality contour of the repaired mandible was satisfactory. Thus, the patient is able to eat normally. The bone-grafting material harvested from the anterior ilium was low. The clinical experience showed that rapid prototyping and reverse engineering software are effective methods of fabricating custom trays for mandibular reconstruction after bone loss due to a tumor.     

First presentation for care of HIV-infected patients with low CD4 cell count in Lyon, France: risk factors and consequences for survival

To identify the risk factors associated with presentation for care with CD4 cell count ≤ 200 cells/mm(3) and death in HIV-infected patients in Lyon, France. Data were analyzed on participants from mid-1992 to December 2006 in the Lyon section of the French Hospital Database on HIV Infection. Patients were stratified into two categories according to CD4 cell count at first presentation for care in University of Lyon hospitals: Group 1 (Gr1) patients with CD4 ≤ 200 cells/mm(3) and Group 2 (Gr2) patients with CD4 >200 cells/mm(3). Multivariate logistic regression assessed the risk factors associated with first presentation for care with CD4 ≤ 200 cells/mm(3). Survival was analyzed according to the Cox regression model. Among 3569 eligible patients (838 females and 2731 males, mean age: 36.3 ± 10.3 years), 1139 (31.9%) were categorized as Gr1. The factors associated with first presentation for care with CD4 ≤ 200 cells/mm(3) were: older age, male gender, route of HIV transmission, migrant populations, geographical areas other than Rh?ne-Alpes, and access to care in 1992-1997. Overall mortality was higher in Gr1 than in Gr2 (24.4% [278/1139] vs. 4.1% [101/2430]; p<0.001). The risk of death was 5.81 [4.61-7.32] in Gr1 compared to Gr2. In addition to CD4 cell count, age and enrollment periods for care were factors independently related to death. Despite public health efforts in Lyon, one-third of HIV-infected patients reach the health care system with CD4 cell count ≤ 200 cells/mm(3), which was linked with higher mortality.