Malunion of fractures of the midshafts of the radius and ulna in adults. A series of 10 cases

The authors evaluated the management of malunions of midshaft fractures of the radius and ulna in an Orthopedic and Traumatology departement at Le Dantec University hospital (Dakar, Sénégal). Over a six-year period, there were 10 cases found for analysis. All patients presented with disabilities due to limited pronosupination. Surgical care improved the pronosupination amplitude in all patients.The role of conservative treatment of these fractures in causing malunion is discussed. Correction of these malunions should be by osteotomy, followed by rigid internal fixation with a plate and screws.     

Effets d'une restriction hydrique et alimentaire prolongée (ramadan) sur la performance et les réponses cardiovasculaires au cours d'un exercice incrémental en milieu tropical chaud

Backgroung

Previous studies showed that maximal oxygen uptake and maximal heart rate were not different during prolonged fasting (ramadan) compared to normal feeding period. However, the effect of ramadan on the blood pressure response during incremental exercise has not been investigated.

Objective

This study aimed to evaluate the evolution of blood pressure during incremental trial in ramadan period.

Methods

Twelve young trained male aged 24 ± 4 yrs participated as voluntary subjects. Their anthropometric parameters, maximal aerobic power and maximal heart were measured in fasting and in normal feeding periods during incremental trial on cycle ergometer.

Results

No significant difference was observed in any anthropometric parameter. Maximal aerobic power of fasting period was significantly less (P < 0,05) compared to normal feeding. Heart rate at rest, at maximal exercise and during a 15 min period of recovery was not significantly affected. Systolic blood pressure of fasting period at maximal power was significantly lower than during the control period (P < 0,05).

Conclusion

Ramadan negatively influences the capacity of maximal power and cardiovascular response at maximal power.     

Evaluation of the antibody response to Anopheles salivary antigens as a potential marker of risk of malaria

The evaluation of human immune responses to arthropod bites may be a useful marker of exposure to vector-borne diseases, with applications to malaria, the most serious parasitic infection in humans. The specific antibody (Ab) IgG response to saliva obtained from Anopheles gambiae mosquitoes was evaluated in young children from an area of seasonal malaria transmission in Senegal. Specific IgG was higher in children who developed clinical Plasmodium falciparum malaria within the 3 months that followed than in those who did not (P<0.05), and it increased significantly (P<0.0001) with the level of Anopheles exposure, as evaluated by conventional entomological methods. These results suggest that evaluation of antisalivary Ab responses could be a useful approach for identifying a marker for the risk of malaria transmission.     

Episodic somnolence in an infant with Riley-Day syndrome

Familial dysautonomia is an autosomal recessive congenital neuropathy that occurs almost exclusively in the Ashkenazi Jewish population and has rarely been diagnosed in the neonatal period in unaffected families. This report describes a patient who, during the neonatal period, had episodes of marked decrease in the level of consciousness with durations of 4-15 hours. Other signs and symptoms included the absence of fungiform papillae of the tongue, areflexia, and failure to thrive. The diagnosis was confirmed by the demonstration of mutations in the IkappaB kinase complex-associated protein gene with the identification of IVS20 (+6T --> C) which is responsible for more than 99.5% of known Ashkenazi Jewish patients with familial dysautonomia. The prognosis of this disease and the possibility of genetic counseling are clearly related with an early definitive diagnosis, and this patient illustrates the importance of episodes of somnolence as a possible sign of familial dysautonomia.     

Aspects of antihyperglycemic oral bitherapy in 76 cases of non insulindependent diabetes in Dakar

Some reasons justify the introduction of the association of sulfonylurea and metformine when monotherapy is ineffective. Hereafter a period of monotherapy by sulfonylurea or metformine only bitherapy has been instituted. Socio-demography, number of consultations, type of monotherapy and of association, duration of treatment, body mass index, fasting blood glycemia and post-prandial glycemia, blood pressure and type of complication were studied. There were 2.5 times more women than men with lower mean age for women. The majority of patients were from Dakar (81.6%). More than half of patients were women at home (60.5%). Present obesity (plethoric diabetes) or past obesity (metaplethoric diabetes) concerned 90.3% of patients. Patients have done 9.14 4.39 consultations under bitherapy. The gliclazide-metformin association was observed 37 times and the glibenclamide-metformin association 67 times. The duration of monotherapy was 45.9 39.7 months and that of bitherapy 92.5 43.7 months. The variations of body mass index showed a diminution of 1.26 kg/m2 and for fasting blood glycemia and augmentation of 0.011 g/L and post-prandial a diminution of 0.05 g/L. The body mass index variations in diabetic patients showed a diminution of weight more in plethoric patients in bitherapy compared to monotherapy. This study is retrospective and cannot show the optimal efficacy of bitherapy. But the combination of enhancement of glucose captation and lowering of hepatic glucose production has been shown during this bitherapeutic association. Addition of metformine and treatment with sulfonylurea make a combination that significatively improves glycemic control but also cholesterol level and allows obtation of better weight in type 2 non insulin-dependent diabetes with insulinoresistance.     

Dynamics of CD8+ T cell priming by dendritic cells in intact lymph nodes

The cellular dynamics underlying activation of CD8+ T cells by dendritic cells (DCs) in the lymph node are not known. Here we have tracked the behavior of T cells and DCs by subjecting intact lymph nodes to real-time two-photon microscopy. We show that DCs scan at least 500 different T cells per hour in the absence of antigen. Antigen-bearing DCs are highly efficient in recruiting peptide-specific T cells and can engage more than ten T cells simultaneously. The duration of these interactions is of the order of hours, not minutes. The overall avidity of the interaction influences the probability that T cells will be stably captured by DCs, providing a possible basis for T cell competition. Taken together, our results identify the cellular behaviors that promote an efficient CD8+ T cell response in the lymph node.