Antifungal and antioxidant compounds from the root bark of Fagara zanthoxyloides

Phytochemical investigation of the CH 2 Cl 2 extract of Fagara zanthoxyloides Lam. (Rutaceae) led to the isolation of eleven compounds. One phenylethanoid derivative is a new natural product. The isolation of the antifungal and the antioxidant compounds was monitored by direct TLC bioautographic assays. The structures of the isolated compounds were elucidated by classical spectroscopic methods including UV, NMR, MS and HR-MS.     

Interest of the cervical gland dissection after radiotherapy with or without chemotherapy

OBJECTIVES: The aim of this study was to evaluate the necessity and morbidity of neck dissection after radiation therapy within organ preservation treatment. PATIENTS AND METHODS: We present a retrospective study of 64 patients, treated initially by radiotherapy with or without chemotherapy for squamous cell carcinoma of head and neck with cervical metastases (> 2 cm), who underwent post-radiation neck dissection between January 1992 and August 2000. Eight (13%) patients were classified T1, nineteen (30%) T2, twenty (31%) T3, eleven (17%) T4 and six (9%) Tx. Eleven patients had N1 neck disease (17%), fifteen patients N2a (24%), eleven patients N2b (17%) and twenty-seven patients N3 (42%). RESULTS: Follow-up ranged from 3 to 86 months with a mean of 39 months. The average length of time between neck dissection and the end of treatment was 60 days. Complications were recorded in 21 patients (33%). Forty-four (68%) of 64 patients had microscopic residual disease. Eight (72%) of 11 patients with N1 neck disease and 17 (63%) of 27 patients with N3 neck disease had pathology. Initial N status was not a predictive factor of microscopic residual disease (p = 0.51). There was no significant relationship between clinical residual adenopathy and microscopic residual disease (p = 0.53). Fourteen patients are still alive without recurrent disease. Eight (57%) of these 14 patients had a positive pathology at the time of neck dissection. The mean follow-up time of these patients is 32.6 months, with a follow up longer than 2 years for half of them (n = 7). CONCLUSION: Neck dissection after radiation was planned for all patients with an initial node > 2 cm in diameter regardless of clinical response in the neck. We confirm that neck dissection appears to be safe after radiotherapy and is necessary because it improves quality of life and prevents fatal evolution with uncontrollable neck disease.     

Giant pleomorphic adenoma of the submaxillary gland: case report

We report an exceptional case of giant cell tumor of the submaxillary gland in a 76-year-old woman. The tumor progressed slowly over a period of 40 years. Submaxillectomy removed a 3-kg mass before fixation. The postoperative period was uneventful and the patient was discharged fifteen days later. Pathology examination revealed a pleomorphous adenoma developed within the salivary gland.     

A home nutritional rehabilitation trial for severly malnourished children

A nutritional rehabilitation trial for severely malnourished children aged 6 to 36 months (weight/height index using Z-score of less than -3 as the reference mean) was conducted in the poor suburban areas of Dakar, Senegal. Its purpose was to determine the effectiveness of a rehabilitation programme delivered in the home as compared to one provided in a nutritional recovery center (CREN). Ninety-seven children benefited from rehabilitation at home and 51 at the CREN. At the end of two months of rehabilitation and after five months of charting their weight, the average weight gain was better in the group followed at home, but it still remained well under the 50 g/day recommended by WHO. Within the two groups, all of the children stayed underweight, with an average weight/height index Z-score of less than -2.5 in the group followed at home, and a Z-score of less than -2.9 in the other group. The dropouts and the death rates in the two groups were comparable. The presence and availability of the mother as well as health education sessions adapted to each specific case through interpersonal communication seem to be the elements favouring the most effective rehabilitation being in the home.     

Gastric pneumatosis as a sign of duodenal stenosis in a child with Down syndrome

A case of gastric pneumatosis is described in a 6 month old girl with Down syndrome. Plain abdominal radiographs showed a radiolucent rim within the gastric wall and a dilated stomach. Ultrasonography showed diffuse echoic streaks of air in the gastric wall, pneumobilia and gastroduodenal dilatation. Upper GI series showed duodenal stenosis. Gastric pneumatosis (air within the gastric wall), is an unusual radiographic finding. It may be of mechanical or inflammatory origin or, in some rare cases, remain unexplained.     

Limit of root canal obturation by gutta percha compaction technique in single rooted teeth. Clinical data apropos of 168 canals]

After the introduction of the lateral compactage of gutta percha in endodontic clinic of OdontoStomatology Institute of Dakar in 1995; the immediate evaluation of the quality and the limit of the canal obturation due to a prospective study on 157 monoradicular teeth so be 168 canals (11 supplementary canals) has shown that 75% of canals are of type I of Vertucci and that the apical limit of security is reached within 80.25% of cases. The manual step back canal preparation (79.17%) and the technique of canal obturation by lateral compactage of gutta percha [(64.88%); Apical limit of security: 59.52%] permit to obtain a densities (95.83%) and homogeneous (79.57%) canal obturation. The indication of gutta percha compactage on monoradicular teeth (hermetic and tridimensional root canal filling) must avail to apical curved roots of lateral incisive, the use of adapted instruments in case of canines (31 mm) and apical stop cone on necrotic pulp teeth.     

Facteurs associés aux perdus de vue des patients sous traitement antirétroviral dans un centre de traitement ambulatoire du VIH à Conakry,Guinée

Background

Late or inadequate therapeutic management increases the risk of mortality associated with HIV/AIDS. The aim of this study was to analyze the proportion and factors associated with loss of follow-up in HIV patients who receiving antiretroviral therapy at Conakry.

HIV-1 subtypes and recombinants in the Republic of Congo.

To document the actual genetic diversity of HIV-1 strains in the Republic of Congo, 114 HIV-1 positives persons were sampled in 2003 and 2004 after their informed consent. They were attending the teaching hospital, the reference health center in Makelekele, Brazzaville and the regional hospital centers in Pointe-Noire, Gamboma and Ouesso. A total of 104 samples were genetically characterized by direct sequencing of the p24 gag region and 80 were also subtyped in the V3-V5 env region. The genetic subtype distribution of the Congolese strains showed the predominance of subtype A (36.5% and 32.5% in gag and env, respectively) and G (30.8% and 21.25%), whereas subtype D strains represented 12.5% and 15%. Subtypes C, F, H, J, K and the CRFs-01, -02, -05 -06, and also the recently characterized CRF18 were seen at lower rates. Finally, 4.8% (gag) and 6.25% (env) of the strains could not be classified. Moreover, a high intra-subtype diversity was observed in our study. Among 70 strains which have been characterized in the two genomic regions, 14 (20%) appeared to be unique recombinants. These data show a high genetic variability in the Republic of Congo, where all the subtypes have been documented together with certain subsubtypes and several CRFs.     

Estimating interaction between genetic and environmental risk factors: efficiency of sampling designs within a cohort

Large prospective cohorts originally assembled to study environmental risk factors are increasingly exploited to study gene-environment interactions. Given the cost of genetic studies in large samples, being able to select a subsample for genotyping that contains most of the information from the cohort would lead to substantial savings. We consider nested case-control and case-cohort sampling designs with and without stratification and compare their efficiency relative to the entire cohort for estimating the effects of genetic and environmental risk factors and their interactions. Asymptotic calculations show that the relative efficiency of the case-cohort and nested case-control designs implementing the same sampling stratification are similar over a range of scenarios for the relationships among genes, environmental exposures, and disease status. Sampling equal numbers of exposed and unexposed subjects improves efficiency when the exposure is rare. The case-cohort designs had a slight advantage in simulations of sampling designs within the Framingham Offspring Study, using the interaction between apolipoprotein E and smoking on the risk of coronary heart disease as an example. It was possible to estimate the interaction effect with precision close to that of the full cohort when using case-cohort or nested case-control samples containing fewer than half the subjects of the cohort.