Prospects for the Thomson scattering system on NSTX-Upgrade

The paper discusses the projected configuration of the Thomson system on the National Spherical Torus Experiment (NSTX-U). In this paper, we discuss the projected configuration of the Thomson system on NSTX-U. More specifically, we determine, through both optical modeling of the collection optics and in-vessel measurements, that the collecting fibers are to be displaced by at most 1 cm toward the imaging plane along the optical axis. Finally, we estimate the performance of the Thomson system in measuring the electron temperature for NSTX-U discharges.

Usefulness of a global clinical ichthyosis vulgaris scoring system for predicting common FLG null mutations in an adult caucasian population

BACKGROUND

Loss of function FLG alleles were first identified as causative of ichthyosis vulgaris (IV) and were subsequently found to be major predisposing factors for atopic dermatitis (AD) and atopic disorders.

OBJECTIVES

To identify independent factors associated with the clinical IV phenotype in adult caucasian patients with AD and to assess the performance of a global clinical severity score of IV in predicting common FLG null mutations.

PATIENTS AND METHODS

This was a prospective study conducted from January 2007 to June 2008. Adult patients attending the department of dermatology with a diagnosis of AD with or without IV were eligible to participate. For each patient, five clinical signs of IV were scored from 0 to 3 - diffuse xerosis, hyperlinearity of palms, scales on legs, scalp desquamation and keratosis pilaris - and a global IV clinical severity score was derived (0-15). Age of onset of AD, SCORAD (SCORing of Atopic Dermatitis), family and personal history for other signs of atopy, and total immunoglobulin E were recorded. Genotyping was performed for R501X and 2282del4. Univariate and multivariate analysis for factors associated with AD or AD + IV were conducted.

RESULTS

In univariate analysis, family history of atopy, global clinical severity scoring and 2282del4 FLG mutation were positively correlated with the AD + IV phenotype. Using multivariate analysis, SCORAD for AD (OR 0·94, P = 0·01) and global clinical severity scoring for AD + IV (OR 2·62, P < 0·0001) were found to be independent factors.

CONCLUSIONS

The 2282del4 FLG mutation was confirmed as a good marker of early-onset disease. Moreover, our global clinical severity score yielded a good negative predictive value of common caucasian null FLG mutations.

High-harmonic fast-wave power flow along magnetic field lines in the scrape-off layer of NSTX

A significant fraction of high-harmonic fast-wave (HHFW) power applied to NSTX can be lost to the scrape-off layer (SOL) and deposited in bright and hot spirals on the divertor rather than in the core plasma. We show that the HHFW power flows to these spirals along magnetic field lines passing through the SOL in front of the antenna, implying that the HHFW power couples across the entire width of the SOL rather than mostly at the antenna face. This result will help guide future efforts to understand and minimize these edge losses in order to maximize fast-wave heating and current drive.

Halo naevi and leukotrichia are strong predictors of the passage to mixed vitiligo in a subgroup of segmental vitiligo

BACKGROUND

Until now, segmental vitiligo has been considered as a stable entity and mixed vitiligo, the association of segmental and nonsegmental vitiligo, has been reported rarely.

OBJECTIVES

The aim of this study was to search for factors associated with the generalization of vitiligo in patients with segmental vitiligo.

PATIENTS AND METHODS

This was a prospective observational study conducted in the vitiligo clinic of the Department of Dermatology of Bordeaux, France. The Vitiligo European Task Force questionnaire was completed for each patient attending the clinic with a confirmed diagnosis of segmental vitiligo after exclusion of other forms of vitiligo (focal, mucosal, not classifiable.) Thyroid function and antithyroid antibodies were screened if not obtained in the previous year.

RESULTS

One hundred and twenty-seven patients were recruited: 101 had segmental vitiligo and 26 had segmental vitiligo that evolved into mixed vitiligo; 56 were male and 71 were female. Most patients had onset of segmental vitiligo before the age of 18. When conducting multivariate analysis, we found the following to be independent factors associated with the evolution of patients' disease from segmental vitiligo to mixed vitiligo: initial percentage of body surface involvement of the segment >1% [odds ratio (OR) 15·14, P=0·002], the presence of halo naevi (OR 24·82, P=0·0001) and leukotrichia (OR 25·73, P=0·0009).

CONCLUSIONS

Halo naevi association and leukotrichia at first consultation in segmental vitiligo are risk factors for the progression of segmental vitiligo to mixed vitiligo. In addition, this progression of segmental vitiligo to mixed vitiligo carries a stronger link if initial segmental involvement is situated on the trunk.

[Comparaison between the association of chlorhydrate ketamin-magnesium sulfate ketamin chlorhydrate and in paracetamol aving in visceral surgery]

AIM

To compare paracetamol saving followed by the association of ketamine chlorhydrate - magnesium sulfate to ketamine chlorhydrate and analyze cost after the 2 protocols administration.

MATERIAL AND METHODS

We conducted this comparative study from June 2005 to January 2006 in the services of anesthesiology and resuscitation and visceral surgery of the teaching hospital Gabriel Touré, Bamako. 80 patients were split into 2 groups - group A receiving: 0,25mg/kg of ketamine chlorhydrate plus 50mg /kg of magnesium sulfate, group B receiving: 0,25mg/kg of ketamine chlorhydrate.

RESULTS

The 2 groups were compared by anthropometrical and clinical data (age, sex, weight) and ASA. The reduction of paracetamol dosage was 57, 50 % of the 4 g actually used per day in A group against 48, 50% in B group.

CONCLUSION

Ketamin chlorhydrate associated to magnesium sulfate insure a post-operative analgesic saving in visceral surgery. Cost of analgesia actually used is reduced.

[Problems related to informing families of patients in intensive care unit AT CHU Gabriel Touré (Mali)]

INTRODUCTION

The admission of a patient in intensive care justified by the severity of the disease, is a stressful situation for his heirs. A fair and understandable information is a major component of the process quality of care.

OBJECTIVE

Evaluate the practice of informing families of patients and their satisfaction in intensive care unit.

METHOD AND MATERIAL

We conducted a prospective study of 90 families of patients. The demographics of family representatives, and satisfaction data were collected.

RESULTS

The majority of parents were aged between 20-40. The sex ratio was 2.9 for men. The siblings had accounted for 23 parents whether 25,6%. In 46 cases whether 51%, the relatives of families were satisfied with information received. 57.8% did not have good information on the risks of treatment complications. The lack of explanation about the evolution of the disease remained a major concern for 36 families. 69 of parents whether 76.7% felt that the frequency of visits was satisfactory. In our series no contradiction has been recorded in the information provided in 87 (96.7%) parents of patients. 80 (88.9%) of parents of patients showed the courtesy of staff at the reception. 54 relatives of patients whether 60% said they could not have been involved in the therapeutic management of the patient. 41 parents of patients whether 45.6% do not differentiate between the role of different caregivers. 45 parents felt uncomfortable.

CONCLUSION

Despite the lack of normative information , most family members of patients were very satisfied with the information they were provided. Efforts to improve the satisfaction of families go through identifying the needs of the latter and effective communication strategy.

[Cervico-facial traumatic injuries at the Donka national hospital of the teaching hospital of Conakry]

The Cervico-Facial Traumatic Injuries (CFTI) can entrain complications and serious aesthetic and functional sequella. The objectives of this study were to determine the frequency of CFTI, to describe the clinical forms and to evaluate the treatment. It was a prospective study conducted from February to July 2010 in the National Donka hospital of the Teaching Hospital of Conakry. The study concerned 265 patients, who benefited a treatment and reevaluated. The young adults aged between 21-30 years were the most affected (38.49%). 74.34 % were men and 25.66 % were females with a sex ratio of 2.9. Road accident was the etiology of injuries in 70.57% of cases. Clinically, the lesions were dominated by the wounds type II (49.05 %) followed by the wounds type I (48.30 %) and 2,65 % of wounds was type III. The treatment was medical and surgical. Evolution was considered favorable in 82.13 % of cases and disfavorable in 17.85 % of cases.

[Intrapartum obstetrical transfers: sociodemographic, clinical and prognosistic aspects in Conakry, Guinea]

The objectives of this descriptive prospective study were to determine the frequency of intrapartum obstetrical transfers, assess the sociodemographic profile of parturients requiring transfer, describe transfer modalities, and assess maternal and newborn outcomes. Study included all patients requiring intrepartum obstetrical transfer to the Ignace Deen University Hospital Gynecology Obstetrics Clinic in Conakry, Guinea from August 1st, 2009 to July 31st, 2010. Out of 3122 deliveries during the study period, intrapartum transfer was required in 220 cases, i.e. 7.05%. Mean patient age was 23.2 years (range, 14 to 44). The risk for intrapartum transfer was higher among multiparous or nulliparous women (incidence, 8.79%) and adolescents (incidence, 10%). Patients requiring transfer were mainly housewives (60%) and uneducated women (57.27%). Most had had an insufficient number (<4) of antenatal examinations (76.36%) and had been examined at peripheral maternity units (62.73%). In 175 cases (79.54%), patients were transferred by taxi. In 191 patients, treatment required surgery including 130 caesarian sections. There were 12 maternal deaths (5.45%) and 45 neonatal deaths out of 242 newborns including 22 twin deliveries (18.59%). Further work is necessary to improve referral and transfer at all levels of the health pyramid.

Coma in the elderly: Etiological factors, management, and prognosis in the department of anesthesia and intensive care

Objective:

To study the etiologies, therapeutic and prognosis factors of coma in the elderly in the Department of Anesthesia and Intensive Care of Gabriel TOURE Teaching Hospital, Mali.

Materials and Methods:

This was a prospective descriptive study of all cases of coma in the elderly, registered from February 1, 2008 to January 31, 2009 at the Department of Anesthesiology CHU Gabriel Touré, Bamako.

Results:

During the study period, 564 patients were admitted to the intensive care unit (ICU) in which 174 (30.85%) were older people. We collected 100 subjects with impaired consciousness, the object of our study, which represented 17.73% of all admissions in the Department of Anesthesiology during the study period and 57.47% of all admissions of older people; 66% of our subjects were male. Hypertensive patients accounted for 60% of cases. In 46% of cases, it was a coma from cardiovascular causes and in 28% of cases; it was a coma of metabolic origin. The diagnoses made in the wake of the care of the elderly in ICU were predominantly stroke (46%) and electrolyte disturbances (13%). The coma was sudden onset in 58% of cases, including 28 cases of stroke whether 48.27%. The prognosis was marked by a fatality with 51% of deaths in our sample.

Conclusion:

The prognosis improvement of the elderly in coma through to the introduction of proxy measures.

[Entomological investigations conducted around ten cases of yellow fever in 2009 in the Denguélé sanitary region, Côte-d'Ivoire]

In November 2009, ten suspicious cases of yellow fever, including six deaths, were notified in the region of Denguélé, in the northwest of Côte-d'Ivoire. In order to evaluate the extent of yellow fever virus circulation and the risk for local people, a mission of entomological investigation was carried out by the Ministry of Health and Public Hygiene of Côte-d'Ivoire. Entomological investigations were conducted in the villages of confirmed cases (Banakoro and Tron-Touba) and the centers of consultation and hospitalization of cases during illness. Breteau index and recipient index were quasi nil. Aedes aegypti was absent among the captured mosquitoes. On the other hand, Aedes luteocephalus and Aedes opok were present at Banakoro and Tron-Touba with respective average biting rates of 0.8 and 0.6 bite/man/twilight. This situation of epidemic in the northwest of Côte-d'Ivoire could be explained by the deterioration of Denguélé region's health system which is a consequence of the war started in the country in 2002 and which has lowered the immunity of the population.

[Breech presentation: mode of delivery and maternal and fetal outcomes at the Ignace Deen Clinic of Gynecology and Obstetrics, Conakry University Hospital]

The authors in a prospective, analytical study of 8 months from January 1st to August 31st performed at the Ignace Deen Clinic of Gynecology and Obstetrics, Conakry University Hospital; assessed the impact of the mode of delivery in breech presentation on maternal and fetal outcome in the African context of Guinea. Breech presentation in mono fetal pregnancy of at least 28 weeks of amenorrhea was the inclusion criterion in this study. Among 1490 deliveries, 144 breech presentations were reviewed, representing a frequency of 9.66%. Half of breech deliveries (49.99%) were premature against only 11.85% in cephalic presentations. The breech was incomplete in 57.64% cases and complete in 42.35%. Caesarean section was performed in 40.97% of cases against 39.54% in cephalic presentation. The indications were often primiparity (30.50%), acute fetal distress (28.81%) and macrosomia (23.72%). Deliveries through the lower route frequently used the maneuver of Bracht (52.50%). 54.16% of the new-born babies had a fetal weight lower than 2500 g at born. Morbid Apgar score at the 1st minute after delivery through the lower route was found in 69.40% of the breech presentation born babies; however, this rate was 32.70% in cephalic presentation (p=0.000). The maternal morbidity concerned essentially perineal lesions (26.53%). The outcome is largely better in case of delivery through the upper route. The caesarean section is an alternative for the improvement of fetal outcome in countries with low resources.

[Epidemiologic profile of acute intoxications at the Gabriel Touré University Hospital]

PURPOSE

Determine the epidemiology of intoxications in the emergency service medico-surgical.

MATERIALS AND METHODS

The stady was retrospective and transversal from January 2002 to December 2006 in the service of medical surgical emergencies of the teaching hospital Gabriel Touré. Where included all patients admitted and presenting with acute poisoning. Chi2 test was used to compare our results and the level of significance set at p <0.05.

RESULTS

Over 5 years, 365 cases of intoxication were collected on a total of 10997 admission with a prevalence of 3.32 %. Patients aged of 0-20 years accounted for 46.58% of cases. The female patients were predominant with 62.47 % of cases. Pupils and students predominated with 31.51 %. Antimalarials were found primarily at the base of poisoning with 32.33 % of cases of drug poisoning. The digestive tract was predominant with 97.81%.

CONCLUSION

The typical profile of acute poisoning is a young female pupil or student who took a voluntary drug substance.

[Epidemiogic and clinical profile of severe pre-eclampsia at the university hospital of Gabriel Touré]

AIMS

To determine the epidemio-clinical profile of severe pre-eclampsia.

PATIENTS AND METHOD

It was about a transversal study done from November 2005 to juin 2006 at the teaching hospital Gabriel Touré. Were included pregnant women with severe pre-eclampsia. Statistical analysis compared the proportions and means, the proportions were compared using the chi (2 with) P < 0,05 considered significant.

RESULTS

during the period of study, 130 cares of severe pré-eclamsia were brougthbto gether among 1667 pregnant women, which was 7,8 %.The mean age was 17.15 years with extremes of 15 and 42 years. The most frequent signs of severe preeclampsia were the association of epigastrium pain, nausea, vomiting and headaches in 54- 62 %.

CONCLUSION

Ther profile type severe pre-eclampsia is 17 years old pregnant women, of an uterus height between 33 and 36 cm, with an insuffisant number of prenatal consultation.

[Lidocaine in endotracheal intubation]

AIM

To evaluate the effect of lidocaîne use by IV during endotracheal intubation.

PATIENTS AND METHOD

Our study was simple insu randomized prospective and comparative. It was done at the teaching hospital Gabriel Touré of Bamako from march to September 2005. Patients were distributed in 3 groups. The first group I: got fentanyl 2 nmg /kg+penthotal 5mg/kg+vecuronium 0.1mg/kg and intubation 3 mn later. The group II: lodocaîne 1,5mg +fentanyl 2nmg/kg+penthotal 5mg /kg + vecuronium 0.1mg/kg and intubation 3mn later. The group III: lodocaïne 1.5 mg/kg+pentothal 5mg/kg+vecuronium 0.1mg/kg and intubation 3 mn later.

RESULTS

The mean arterial pression to intubation has been 105.88±13.82 mmhg in the groupI, 96.60±15.01mmhg in the group II and 96.44±12.09mmhg in the group III with P = 0.008. To incision it has been 99.12±11.82 in the group I, 94.90 ±6.67 mmhg in the group II and 92.26±8.81 mmhg in the groupIII with P = 0.017.

CONCLUSION

Lidocaïne, used alone in Iv or associated to fentanyl 3 mn before intubation prevents hypertension related to intubation and incision.

[Prevention of mother to child HIV transmission in an African hospital, Bamako-Mali]

AIM

Pregnant women HIV infection has main risk the contamination of newborn. MTCT actions permit to reduce that risk.

MATERIAL AND METHODS

Our survey has been realized in Gabriel Touré teaching hospital gynecology and obstetrics and pediatric departments. It is about an observational prospective and descriptive survey that spreads on a period from January 2005 to December 2008. Has been included in the study all the HIV positive pregnant women followed in our service and their babies that had received ARV prophylaxis and 18 months of life serology.

RESULTS

We recorded 211 HIV positive pregnant women on a total of 9291 childbirths (2.27%). We noted 90.52% of HIV-1 vs 7.11% of type 2. The mother treatment consisted in a tri therapy in 77.25 vs 0.47% of bi anti retroviral and 22.28% of mono anti retro viral therapy. Maternal viral load was undetectable at the moment of delivery in 78.20% of cases. We noted vaginal delivery in 84.36% vs 15.64% of caesarean section. Newborns respectively received 67.32%; 4.88% and 22.92% of bi, tri and mono therapy. They formula-fed in 98.98%. The mother to child HIV transmission rate was 1.98%.

CONCLUSION

HIV prevalence in pregnant patients is relatively height. HARRT in HIV positive mothers associated to bi therapy and formula feeding to their infants permit to obtain low vertical HIV transmission rate.

[Epidemiological and clinical profile of traffic accident victims at the emergency department of the University Hospital of Gabriel Touré]

OBJECT

Studying the Epidemiological and clinical profile of accidents on public ways at the welcome service of emergencies, CHU Gabriel Touré within the scope of accident reduction on public ways and an improvement of their taking in charge.

METHODOLOGY

Retro prospective study over a three-year- period including all the files of any patient emitted for accident happening on public ways without regard to race and sex.

RESULT

Over a three-year-period (from January 2007 to December 2009). Our team has analized 2450 hospitalization files with a follow-up going from 0 to 45 days. The most concerned ages range from 15 to 29 years (43 per cent) with a male predominance (81 per cent). The mechanism motorcycles-pedestrians (30.9 per cent) was the most represented. The mains lesions observed were cranial traumatisms (58.9 per cent), followed with fractures of limbs (13.5 per cent). Death-rate has been risen at the level of young men above all (from 15 to 29 years) and it was mainly due to cranial traumatisms.

CONCLUSION

Accidents on public ways represent a keen problem in matter of public health. The taking in charge of the curse should be very urgent. Information, communication and education of all the professional and social stratums seem necessary.

Doppler coherence imaging and tomography of flows in tokamak plasmas (invited)

This article describes the results of spatial heterodyne Doppler "coherence imaging" of carbon ion flows in the divertor region of the DIII-D tokamak. Spatially encoded interferometric projections of doubly ionized carbon emission at 465 nm have been demodulated and tomographically inverted to obtain the spatial distribution of the carbon ion parallel flow and emissivity. The operating principles of the new instruments are described, and the link between measured properties and line integrals of the flow field are established. An iterative simultaneous arithmetic reconstruction procedure is applied to invert the interferometric phase shift projections, and the reconstructed parallel flow field amplitudes are found to be in reasonable agreement with UEDGE modeling.

[Change of protocol in the verbal autopsy method and measure of malaria mortality in rural areas in Senegal]

In rural Senegal, three populations have been followed up since several decades and the malaria mortality trend has been observed since the mid-1980s. However, limits are associated with the verbal autopsy method used to determine causes of death, especially deaths due to malaria. A change in protocol occurred in recent years in two of these three sites with the involvement of two physicians (instead of only one) in the diagnosis. The objective is here to measure its potential impact on diagnosis of malaria deaths. Five hundred and fifteen diagnoses reported on child deaths occurred from 2000 to 2005 have been analysed. We have identified, on the basis of a multinomial logistic regression model, factors affecting the determination of malaria deaths among the characteristics of the child, the death, the illness and its symptoms, and we also took into account method factors. Factors related to the method do not play on the malaria diagnosis. This result insures the continuity of the series on malaria mortality statistics since 2000 in the two sites despite changes in the method. However, the new protocol leads to vanish possibility of having deaths among ill-defined or unknown causes. In the African context of absence of health statistics, data obtained through the verbal autopsy method in demographic surveillance system can provide accurate information in the epidemiological field, even regarding malaria.