Profile and course of cardiovascular morbidity and mortality in Conakry. Apropos of 268 cases seen at the Cardiology Department of the Ignace-Deen University Hospital 1986-1987

Over a period of two years (1986-1987), the authors have studied the morbidity and mortality of various cardiovascular diseases in a hospital population of 268 patients. By comparing it with a previous similar study conducted over 5 years (1981-1985), they have reached the following conclusions: the prevalence of the main nosological groups is equivalent (H.B.P., rheumatoid valvulopathies, chronic pulmonary heart, ischemic cardiopathies; severity of the valvulopathies and their prognosis which raise social and medical problems especially that of cardiac surgery, still inexistent in Guinea; increased prevalence of diseases such as hypertension and rheumatoid valvulopathies. They suggest early screening, especially for rheumatoid valvulopathies and hypertension, which cause major social problems because of their complications. Besides, it would be desirable that visits at regular intervals be made mandatory in schools and universities and at preemployment examinations and in all SMI (?) centers in the country.     

In vivo and in vitro analysis of chloroquine resistance in Plasmodium falciparum isolates from Senegal

To determine the predictive value of chloroquine (CQ) resistance markers in Senegal, Plasmodium falciparum DNA polymorphisms in pfmdr1and pfcrt were examined in relation to clinical outcome. Despite CQ treatment, 17% of patients had parasitemia after 28 days. Examination of molecular markers of CQ resistance revealed that 64% of all isolates had the T76 resistant allele at the pfcrt locus, while 30% carried the Y86 resistant allele at the pfmdr1 locus. The pfcrt T76 allele was present not only in all in vivo resistant isolates, 89% of in vitro resistant isolates, but also in 35% of in vitro sensitive isolates. The pfmdr1 N86Y polymorphism did not correlate with in vitro or in vivo CQ resistance. Our data suggest that the pfcrt T76 allele alone is required but not a sufficient predictor for in vivo CQ resistance.     

Cadaveric topography and morphometry of the vermiform appendix

Our study justified by the frequency of acute appendicitis and the possibility of anatomic variations of the caecoappendicular area attempt to index the topographic variations of the vermiform appendix (v.a.). On 80 fresh native cadavers (62 men and 18 women) without surgical antecedent whose mean age was 36 years (range between 16 and 78 years) we note the morphotype and the height. More over we study the intraperitoneal projection of the Mac Burney point, topography and shape of the cecum and the situation, shape and dimensions of the v.a. We note also the level of implantation of this latter on the cecum, appearance of the mesoappendix and the distance separating the base of the appendix to the ileo-caecal junction. Mac Burney's point permitted to localize appendix in 66%; the cecum has more often than not the form of a bulb (98.7%) and sited in right fossa iliaca. We noted 7 types of topographic disposition; front varieties were more frequent (68.7%) notably the pelvic direction (51.2%) with a medial (72.5%) or a posteromedial (27.5%) establishment on the cecum. The v.a. was more often in the form of worm with a long mesoappendix; his mean length was 106.4 mm (between 65 and 160 mm) and the mean diameter 6.77 mm (range between 4 and 10 mm). The distance which separated the base of the appendix to the ileo-cecal junction varied between 15 to 40 mm with a mean distance of 24.2 mm. Thus in this study, dimensions of the v.a. were very variables. Located in right fossa iliaca he adopted a front topography with pelvic direction and medial establishment on bulbar cecum. In spite of scarcity of ectopic situation of the appendix for which laparoscopic approach is salutary, a similar topographic study during surgical treatment of acute appendicitis will be interesting.     

Microbiota That Affect Risk for Shigellosis in Children in Low-Income Countries

Pathogens in the gastrointestinal tract exist within a vast population of microbes. We examined associations between pathogens and composition of gut microbiota as they relate to Shigella spp./enteroinvasive Escherichia coli infection. We analyzed 3,035 stool specimens (1,735 nondiarrheal and 1,300 moderate-to-severe diarrheal) from the Global Enteric Multicenter Study for 9 enteropathogens. Diarrheal specimens had a higher number of enteropathogens (diarrheal mean 1.4, nondiarrheal mean 0.95; p<0.0001). Rotavirus showed a negative association with Shigella spp. in cases of diarrhea (odds ratio 0.31, 95% CI 0.17–0.55) and had a large combined effect on moderate-to-severe diarrhea (odds ratio 29, 95% CI 3.8–220). In 4 Lactobacillus taxa identified by 16S rRNA gene sequencing, the association between pathogen and disease was decreased, which is consistent with the possibility that Lactobacillus spp. are protective against Shigella spp.–induced diarrhea. Bacterial diversity of gut microbiota was associated with diarrhea status, not high levels of the Shigella spp. ipaH gene.