Predicting the fine-scale spatial distribution of zoonotic reservoirs using computer vision

Zoonotic diseases threaten human health worldwide and are often associated with anthropogenic disturbance. Predicting how disturbance influences spillover risk is critical for effective disease intervention but difficult to achieve at fine spatial scales. Here, we develop a method that learns the spatial distribution of a reservoir species from aerial imagery. Our approach uses neural networks to extract features of known or hypothesized importance from images. The spatial distribution of these features is then summarized and linked to spatially explicit reservoir presence/absence data using boosted regression trees. We demonstrate the utility of our method by applying it to the reservoir of Lassa virus, Mastomys natalensis, within the West African nations of Sierra Leone and Guinea. We show that, when trained using reservoir trapping data and publicly available aerial imagery, our framework learns relationships between environmental features and reservoir occurrence and accurately ranks areas according to the likelihood of reservoir presence.

Effectiveness of a water-vending kiosk intervention toward household water quality and surveyed water security in Freetown, Sierra Leone

Low-income urban residents of Freetown, Sierra Leone, have limited access to safely managed piped drinking water services. The Government of Sierra Leone, in partnership with the United States Millennium Challenge Corporation, implemented a demonstration project of ten water kiosks providing distributed, stored, treated water among two neighborhoods in Freetown. This study quantifies the impact of the water kiosk intervention by utilizing a quasi-experimental propensity score matched difference-in-differences study design. Results indicate a 0.6 % improvement in household microbial water quality and an 8.2 % improvement in surveyed water security within the treatment group. Furthermore, low functionality and adoption of the water kiosks were observed.

Sprinkler flow rate affects physiological, behavioural and production responses of Holstein cows during heat stress

Holstein Friesian cows are known for their high milk yield. They are popular in the commercial dairy  sector of Pakistan. Heat stress is a major challenge for these animals owing to the longer summer season with high ambient temperatures (35 - 40 °C) and relative humidity (30 - 50%) in the area (Butt et al., 2020). Mitigating the effects of heat stress requires substantial investments in energy and water. Spraying dairy  cows with water in the holding pen or at the feed bunk is common practice as it lowers  body  temperature and respiration rate (Kendall et al., 2007; Chen et al., 2013; 2016), and improves feed  intake  and milk yield (Keister et al., 2002). Owing to the recent decrease in global groundwater, studies have  focused on strategies to reduce the use of water to cool dairy cows (Chen et al., 2016). Sprinkler flow  rates  of 1.3 and 4.9 L/min had similar effects on physiological responses of cows to heat load but  produced a 73%  difference in water use (Chen et al., 2016). Similarly, Tresoldi et al. (2019) concluded that  a sprinkler flow rate of 4.9 L/min had poor efficiency compared with 3.3 L/min, as the additional water did not result in increased biologically relevant cooling. These studies were conducted in Mediterranean climates with an average temperature humidity index in the range of 76 to 78. A recent study with Nili Ravi buffaloes revealed a sprinkler flow rate 1.25 L/min was more efficient than one of 2.0 L/min during subtropical summers (Bah et al., 2021). Because water is projected to be scarce in Pakistan by 2030 (Mustafa et al., 2013), holistic strategies for water conservation in the dairy sector are important nationally. The objective of this study was to evaluate the effects of various sprinkler flow rates on the performance of lactating Holstein Friesian cows in a typical corporate dairy farm setting during the subtropical summer. Performance of these cows was assumed to be similar, irrespective of the sprinkler flow rates.

Random antral follicle count performed on any day of the menstrual cycle has the same predictive value as AMH for good ovarian response in IVF cycles

OBJECTIVE

To determine whether the predictive value of AFC for ovarian response to stimulation for IVF depends on the day of the menstrual cycle when ultrasound is performed.

METHODS

410 women undergoing their first IVF cycle were included. All the women had AFC performed twice. The first measurement, random AFC (r-AFC), was performed during the fertility workup whatever the day of their menstrual cycle. Three groups were constituted according to the period of ultrasound performance: at early follicular phase i.e., day 1 to day 6 (eFP-AFC); at mid follicular phase i.e., day 7 to 12 (mFP-AFC) and at luteal phase i.e., day 13 or after (LP-AFC). A second AFC measurement was performed before the start of the ovarian stimulation (SD1-AFC). AMH dosing was done in the early follicular phase.

RESULTS

Random AFC (r-AFC) was correlated to AMH (r = 0.69; p<0.001), SD1-AFC (r = 0.75; p<0.001) and number of oocytes retrieved (r = 0.49; p<0.001). When regarding AFC depending on the cycle day group, the correlation with AMH was 0.65, 0.66 and 0.85 for the eFP-AFC, the mFP-AFC and the LP-AFC respectively (all p were <0.001). The ROC analysis showed the same predictive value for good ovarian response (more than 6 oocytes retrieved) for the eFP-AFC, mFP-AFC and LP-AFC (AUC 0.73, 0.75 and 0.84 respectively; p = 0.28). The AUC of r-AFC (0.76) were similar to those of AMH (0.74) and SD1-AFC (0.74) (p = 0.21 and 0.92 respectively).

CONCLUSION

AFC is strongly correlated with AMH and highly predictive of good ovarian response during the whole menstrual cycle.

P–599 random antral follicle count, performed at any day of the menstrual cycle, demonstrates the same predictive value for ovarian response in in vitro fertilization cycles

Study question

Does antral follicle count (AFC) retains its predictive value for ovarian response to stimulation for in vitro fertilization (IVF) throughout the whole menstrual cycle?

Summary answer

AFC is strongly correlated to anti-mullerian hormone (AMH) and highly predictive of good ovarian response whatever the day of cycle the ultrasound is performed.

What is known already

Usually performed in the early follicular phase (at day 2–3 of the menstrual cycle), AFC and AMH are the most accurate markers of ovarian reserve. They are routinely used to predict ovarian response to ovarian stimulation for IVF and eventually to individualize the gonadotropin starting dose.

Study design, size, duration

Retrospective cohort study performed between January, 2017 and December, 2019.

Participants/materials, setting, methods

410 consecutive women aged 20 to 42 years were included. Random AFC (r-AFC) was performed during the fertility workup whatever the day of their menstrual cycle was: early follicular phase i.e. day 1 to day 6 (eFP-AFC), mid follicular phase i.e. day 7 to 12 (mFP-AFC) and luteal phase i.e. day 13 or after (LP-AFC). A second AFC was performed before the start of the stimulation (SD1-AFC). AMH was measured in the early follicular phase.

Main results and the role of chance

Random AFC (r-AFC) was correlated to AMH (r = 0.692; p &lt; 0.001), SD1-AFC (r = 0.756; p &lt; 0.001) and number of oocytes retrieved (r = 0.491; p &lt; 0.001). When regarding AFC depending on the cycle day group, the correlation with AMH was significantly higher for the LP-AFC, (LP-AFC) (r = 0.853) than for the eFP-AFC (r = 0.657; p &lt; 0.001) and for the mFP-AFC (r = 0.668). The correlation with SD1-AFC was similar regardless of the time of performance of r-AFC (r = 0.739, 0.783, 0.733, respectively for eFP, mFP and LP-AFC). Moreover, the ROC analysis showed the same predictive value for good ovarian response (more than 6 oocytes retrieved) for the eFP-AFC, mFP-AFC and LP-AFC (AUC 0.73, 0.75 and 0.84 respectively) as well as for AMH and SD1-AFC (AUC 0.74 and 0.74, respectively).

Limitations, reasons for caution

This is a retrospective analysis, however data were prospectively collected and the method for ultrasound acquisition of AFC was standardized.

Wider implications of the findings: The absence of significant variation of AFC across the menstrual cycle allows to its random performance. Ultrasound performed besides early follicular phase discloses informations on ovaries, the uterus and the endometrium. It is more comfortable and convenient for women and physicians by limiting targeted appointment during menstruation and reiterated examination.

Trial registration number

Not applicable

[Dysthyroidism in children and adolescents at the Mali hospital]

INTRODUCTION

Dysthyroidism (hyperthyroidism or hypothyroidism) in children and adolescents is much rarer than in adults. The purpose of our study was to study the epidemiological, clinical, paraclinical, etiological and etiological aspects and to specify the therapeutic and evolutionary modalities of this condition.

METHOD

This was a five-year descriptive, retrospective and prospective study of children and adolescents under 18 years of age with dysthyroidism.

RESULTS

We collected 90 children and adolescents with dysthyroidism (hyperthyroidism 77.8% (n=70) and hypothyroidism 22.2% (n=20). For hyperthyroidism (n=70): the average age was 13.07 years and the sex ratio was 0.16. The family history of dysthyroidism was found in 24.3% (n=17). Clinical manifestations were dominated by tachycardia 88.57% (n=62), weight loss 87.14% (n=61), vibrating pulse 87.14% (n=61) and palpitation 81.42% (n=57). Bilateral exophthalmos was present in 70% of patients (n=49) with palpebral retraction in 51.42% (n=56). Goitre was present in 54 patients (77.1%). It was diffuse in 62.9% (n=44) and nodular in 12.9% (n=9). Basedow's disease represented the first etiology with 84.3% (n=59), followed by toxic multinodular goitre12, 9% (n=9). Sixty-eight patients (97.1%) received medical treatment with synthetic antithyroid drugs. Clinical remission was achieved in 64.3% (n=45) and 54.3% of patients were in biological euthyroidism at 6 months follow-up. For hypothyroidism (n=20): the average age was 10.70 years and the sex ratio was 0.53. Six family cases of hypothyroidism and three cases of family goitre were found. The clinical picture was dominated by signs of hypo metabolism at hypersomnia type 95% (n=19) and anorexia 75% (n=15). The skin was dry in 60% (n=12). A staturo-weight delay in 65% (n=13), behavioural disorders in 55% (n=11), weight gain in 40% (n=8) and puberty delay in 10% (n=2). Goitre was nodular in 25% (n=5) with cervical adenopathy present in 15% (n=3). Hashimoto's thyroiditis accounted for 45% (n=9) of etiologies followed by iodine deficiency disorders in 15% (n=3) and iatrogenic causes (2 cases of thyroidectomy). All patients were started on hormone replacement therapy for life. Five patients with large multinodular goiter received total thyroidectomy in addition to medical treatment. Euthyroidism was observed in 55% (n=11) of patients at 6 months follow-up.

CONCLUSION

Dysthyroidism in children and adolescents exists in our health facilities. Its management is deficient because of the technical and financial platform. Our public health decision-makers must help implement a screening strategy to facilitate faster diagnosis and treatment.

[Epidemiological And Clinical Aspects Of Obesity In The Medicine And Endocrinology Service Of Mali Hospital]

INTRODUCTION

Lifestyle changes have played an important role in increasing the prevalence of obesity. The objectives were to describe the epidemiological, clinical and progressive aspects of obesity in patients of the Mali hospital.

PATIENTS AND METHOD

this is a descriptive study with retrospective collection of data from the medical records of patients hospitalized in the Medicine and Endocrinology department. Our patients benefited from weight gain, height, waist measurement and hip measurement with calculation of the body mass index.

RESULTS

the study concerned 90 obese patients out of 1515 hospitalized (5.94% of frequency). The mean age was 42 ± 5 with extremes 10 and 74. The sex ratio was 0.38. Obesity was mixed: 75.4% of men, 60% of woman; Android in 36% of men, 18% of women and the only child aged 10 had morbid obesity. The reason for hospitalization was complications of obesity in 13.30%. The psychological reactions collected were: anxiety 54.40%, indifference 40% and shame 5.60%. There were 68.90% complications including 37.80% cardio metabolic (hypertension associated in 51.10%). The lipid assessment carried out showed hyper LDLdemia: 70%; HDL hypoemia: 67.80%, hyper triglyceridaemia: 66.70%. Our patients received dietary and dietary advice. No drug or surgical treatment has been initiated despite the indication. We recorded 3.30% of deaths.

CONCLUSION

The epidemiological and clinical description, diagnosis and evaluation of the repercussions of obesity are easy in our daily practice. However, care remains insufficient due to the inadequacy of the technical platform, the lack of financial means and the prejudices of our patients (ignorance of obesity as a disease).

[Management of Hyperprolactinemia at the Hôpital du Mali]

INTRODUCTION

Hyperprolactinemia, which is a supra-physiological secretion of prolactin, is the most common anterior pituitary disorder encountered in clinical practice. Its incidence and prevalence are poorly defined in Africa and the rest of the world. The objectives were to study the clinical, paraclinical, etiological and therapeutic aspects of hyperprolactinemia at the Mali hospital.

METHODOLOGY

This was a 5-year cross-sectional study. Data collection was retrospective (July 2011 to October 2015) and prospective (December 2015 to July 2016).

RESULTS

We collected 37 cases of hyperprolactinemia. The sex ratio was 0.85. The average age was 37.32 years with extremes ranging from 15 to 74 years. The clinical picture was dominated in women by amenorrhea (80%), galactorrhea (70%), headache (55%), hypofertility (50%), visual disorders (25%) and in men by decreased libido (64.7%), gynecomastia (47.1%), headache (47.1%), visual disorders (41.2%) and erection disorders (29.4%). Basal prolactinemia was greater than 100ng/ml in 45.9% of patients. Cerebral CT had objectified: 11 cases of macroadenomas and 5 cases of pituitary microadenomas. The main causes of hyperprolactinemia were: prolactin pituitary adenoma (43.24%); hypothyroidism (5.40%) and estrogen-progestin use in 5.40%. For treatment, 64.9% of patients were placed on cabergoline; 27% on bromocriptine and 8.10% on simple clinical and biological monitoring.

CONCLUSION

Hyperprolactinemia is a condition that exists in our health care facilities. Clinicians should consider this in the face of galactorrhea amenorrhea or decreased libido. It is also necessary to improve the technical platform for better care.

[Problem Of Diabetic Foot Amputations]

INTRODUCTION

The diabetic foot wound is a real public health problem, 10% of the reasons for hospitalization. The risk of amputation is 10 to 30 times higher in diabetics than the general population.

OBJECTIVE

To study the problem of amputations of the diabetic foot.

METHOD

This was a descriptive and cross-sectional study that took place in the Department of Medicine and Endocrinology of the Mali Hospital from July 1st, 2016 to June 30th, 2017.

RESULTS

Twenty-five (25) diabetic patients were enrolled in our study. The sex ratio was 0.66. At admission, 100% of our patients had arterial disease, 96% neuropathy, and mixed foot in 80%. Poor glycemic control in 64% of patients; osteitis in 52% of cases; 92% of the patients had a 100% amputation risk according to the University of Texas classification. Nearly half or 46% of patients had amputations in the leg. We recorded 1 death case that is 4%.

CONCLUSION

The problem of amputation of diabetic feet is a function of the poor equilibrium and progressive neurological and vascular complications of diabetes.

[Status Of Markers Of Oxidative Stress At The Internal Medicine And Endocrinology Department Of The Mali Hospital]

Oxidative stress represents an imbalance between the endogenous antioxidant defenses and the production of pro-oxidant molecules. The present study describes oxidative stress markers (oxidant and antioxidant) metabolic disturbances in diabetic and non-diabetic patients at the Internal Medicine and Endocrinology ward of hospital of Mali.

MATERIALS AND METHODS

We conducted a descriptive case / control study involving 30 diabetic and 30 non-diabetic patients. Studied markers were Glutathione erythrocyte peroxidase (GPX), intra erythrocyte Superoxide dismutase (SOD), plasmatic uric acid, direct and total bilirubins, albumin and markers for diagnosis and monitoring of diabetes.

RESULTS

Non-diabetic patients (9%) had higher glutathione peroxidase levels compared diabetics (3%) (p = 0.005). An increase in superoxide dismutase was observed in 73.3% of diabetics versus 40% of nondiabetics (p = 0). The albumin, uric acid and bilirubin levels were identical in both populations. Glycated hemoglobin was significantly correlated with microangiopathies (p = 0.0058) and macro angiopathies( p=0,0007) in diabetics.

CONCLUSION

The study showed an increase in antioxidant defenses in diabetics by the elevation of superoxide dismutase and a relative normalization of glutathione peroxidase.

Progress on elimination of lymphatic filariasis in Sierra Leone

Background

A baseline survey in 2007–2008 found lymphatic filariasis (LF) to be endemic in Sierra Leone in all 14 districts and co-endemic with onchocerciasis in 12 districts. Mass drug administration (MDA) with ivermectin started in 2006 for onchocerciasis and was modified to add albendazole in 2008 to include LF treatment. In 2011, after three effective MDAs, a significant reduction in microfilaraemia (mf) prevalence and density was reported at the midterm assessment. After five MDAs, in 2013, mf prevalence and density were again measured as part of a pre-transmission assessment survey (pre-TAS) conducted per WHO guidelines.

Methods

For the pre-TAS survey, districts were paired to represent populations of one million for impact assessment. One sentinel site selected from baseline and one spot check site purposefully selected based upon local knowledge of patients with LF were surveyed per pair (two districts). At each site, 300 people over five years of age provided mid-night blood samples and mf prevalence and density were determined using thick blood film microscopy. Results are compared with baseline and midterm data.

Results

At pre-TAS the overall mf prevalence was 0.54% (95% CI: 0.36–0.81%), compared to 0.30% (95% CI: 0.19–0.47) at midterm and 2.6% (95% CI: 2.3–3.0%) at baseline. There was a higher, but non-significant, mf prevalence among males vs females. Eight districts (four pairs) had a prevalence of mf < 1% at all sites. Two pairs (four districts) had a prevalence of mf > 1% at one of the two sites: Koinadugu 0.98% (95% CI: 0.34–2.85%) and Bombali 2.67% (95% CI: 1.41–5.00%), and Kailahun 1.56% (95% CI: 0.72–3.36%) and Kenema 0% (95% CI: 0.00–1.21%).

Conclusions

Compared to baseline, there was a significant reduction of LF mf prevalence and density in the 12 districts co-endemic for LF and onchocerciasis after five annual LF MDAs. No statistically significant difference was seen in either measure compared to midterm. Eight of the 12 districts qualified for TAS. The other four districts that failed to qualify for TAS had historically high LF baseline prevalence and density and had regular cross-border movement of populations. These four districts needed to conduct two additional rounds of LF MDA before repeating the pre-TAS. The results showed that Sierra Leone continued to make progress towards the elimination of LF as a public health problem.

Impact of five annual rounds of mass drug administration with ivermectin on onchocerciasis in Sierra Leone

BACKGROUND

Onchocerciasis is endemic in 12 of the 14 health districts of Sierra Leone. Good treatment coverage of community-directed treatment with ivermectin was achieved between 2005 and 2009 after the 11-year civil conflict. Sentinel site surveys were conducted in 2010 to evaluate the impact of five annual rounds of ivermectin distribution.

METHODS

In total, 39 sentinel villages from hyper- and meso-endemic areas across the 12 endemic districts were surveyed using skin snips in 2010. Results were analyzed and compared with the baseline data from the same 39 villages.

RESULTS

The average microfilaridermia (MF) prevalence across 39 sentinel villages was 53.10% at baseline. The MF prevalence was higher in older age groups, with the lowest in the age group of 1-9 years (11.00%) and the highest in the age group of 40-49 years (82.31%). Overall mean MF density among the positives was 28.87 microfilariae (mf)/snip, increasing with age with the lowest in the age group of 1-9 years and the highest in the age group of 40-49 years. Males had higher MF prevalence and density than females. In 2010 after five rounds of mass drug administration, the overall MF prevalence decreased by 60.26% from 53.10% to 21.10%; the overall mean MF density among the positives decreased by 71.29% from 28.87 mf/snip to 8.29 mf/snip; and the overall mean MF density among all persons examined decreased by 88.58% from 15.33 mf/snip to 1.75 mf/snip. Ten of 12 endemic districts had > 50% reduction in MF prevalence. Eleven of 12 districts had ≥50% reduction in mean MF density among the positives.

CONCLUSIONS

A significant reduction of onchocerciasis MF prevalence and mean density was recorded in all 12 districts of Sierra Leone after five annual MDAs with effective treatment coverage. The results suggested that the onchocerciasis elimination programme in Sierra Leone was on course to reach the objective of eliminating onchocerciasis in the country by the year 2025. Annual MDA with ivermectin should continue in all 12 districts and further evaluations are needed across the country to assist the NTDP with programme decision making.

[Turner syndrome in the hôpital du Mali, a case]

Turner syndrome is a chromosomal aberration linked to the complete or partial absence of an X chromosome. Its prevalence is 1/2500 female newborns. We report a case in the department of internal medicine and endocrinology of the hospital of MALI. This was a 14-year old girl who consulted for stunting and puberty. She presented clinically a dysmorphic syndrome, TANNER stage1 secondary sexual characteristics, weight and height at -3 DS and a bone age estimated to 9½ years old on the X-ray of the hand. The hormonal assessment showed an elevation of FSH and LH and the genetic study showed an iso chromosome Xq. This result was part of a Turner syndrome with Xq iso chromosome.

[Hirsutism secondary to a luteal cyst of the right ovary at the department of internal medicine and endocrinology of the Mali Hospital]

The authors are reporting here for the first time a documented case of androgen-secreting luteal cyst responsible for primary sterility in Mali. A 26-year married woman with a history of familial hyper androgenia of diabetes and high blood pressure who consulted for hyper androgen syndrome and primary infertility. Hirsutism with the presence of hairs on her chin, upper lips, thorax, forearms, arms, and her legs under waxing which made a Ferriman and Galloway scoreof10. A pelvic ultrasound coupled with a laparoscopy allowed us to retain the diagnosis of luteal cyst.

CONCLUSION

Hyper androgenicity in women is rare and the luteal cystis one of its multiple etiologies.

Regulation of Epithelial-to-Mesenchymal Transition Using Biomimetic Fibrous Scaffolds

Epithelial-to-mesenchymal transition (EMT) is a well-studied biological process that takes place during embryogenesis, carcinogenesis, and tissue fibrosis. During EMT, the polarized epithelial cells with a cuboidal architecture adopt an elongated fibroblast-like morphology. This process is accompanied by the expression of many EMT-specific molecular markers. Although the molecular mechanism leading to EMT has been well-established, the effects of matrix topography and microstructure have not been clearly elucidated. Synthetic scaffolds mimicking the meshlike structure of the basement membrane with an average fiber diameter of 0.5 and 5 μm were produced via the electrospinning of poly(ε-caprolactone) (PCL) and were used to test the significance of fiber diameter on EMT. Cell-adhesive peptide motifs were conjugated to the fiber surface to facilitate cell attachment. Madin-Darby Canine Kidney (MDCK) cells grown on these substrates showed distinct phenotypes. On 0.5 μm substrates, cells grew as compact colonies with an epithelial phenotype. On 5 μm scaffolds, cells were more individually dispersed and appeared more fibroblastic. Upon the addition of hepatocyte growth factor (HGF), an EMT inducer, cells grown on the 0.5 μm scaffold underwent pronounced scattering, as evidenced by the alteration of cell morphology, localization of focal adhesion complex, weakening of cell-cell adhesion, and up-regulation of mesenchymal markers. In contrast, HGF did not induce a pronounced scattering of MDCK cells cultured on the 5.0 μm scaffold. Collectively, our results show that the alteration of the fiber diameter of proteins found in the basement membrane may create enough disturbances in epithelial organization and scattering that might have important implications in disease progression.

On the role of endothelial TRPC3 channels in endothelial dysfunction and cardiovascular disease

In endothelium, calcium (Ca(2+)) influx through plasma membrane Ca(2+)-permeable channels plays a fundamental role in several physiological functions and in the pathogenesis of cardiovascular disease. Current knowledge on the influence of Ca(2+) influx in signaling events associated to endothelial dysfunction has grown significantly over recent years, particularly after identification of members of the Transient Receptor Potential Canonical (TRPC) family of channel forming proteins as prominent mediators of Ca(2+) entry in endothelial cells. Among TRPC members TRPC3 has been at the center of many of these physiopathological processes. Progress in elucidating the mechanism/s underlying regulation of endothelial TRPC3 and characterization of signaling events downstream TRPC3 activation are of most importance to fully appreciate the role of this peculiar cation channel in cardiovascular disease and its potential use as a therapeutic target. In this updated review we focus on TRPC3 channels, revising and discussing current knowledge on channel expression and regulation in endothelium and the roles of TRPC3 in cardiovascular disease in relation to endothelial dysfunction.

Vasoactive and antioxidant activities of plants used in Mexican traditional medicine for the treatment of cardiovascular diseases

This study demonstrated that the aqueous extracts of plants employed in Mexican traditional medicine for the treatment of cardiovascular diseases are able to modify the tone of arterial smooth muscle. Agastache mexicana (Kunth) Lint & Epling (Labiatae), Chenopodium murale L. (Chenopodiaceae), Chirantodendron pentadactylon Larreat (Sterculiaceae), Dracocephalum moldavica L. (Labiatae), Psittacanthus calyculatus G. Don (Loranthaceae), Prunus serotina ssp. capuli (Cav. ex Spreng) McVaugh (Rosaceae), and Sechium edule Sw. (Cucurbitaceae) contain secondary metabolites that promote vascular relaxation and display antioxidant activities. As expected, their antioxidant effects showed a significant correlation with the polyphenolics content. However, a lower correlation was found between the antioxidant activity and the maximum vasodilatory effect, suggesting that the vasodilatation elicited by the plant extracts could be only partly attributed to their antioxidant properties. The extract of P. calyculatus, which displayed a maximum vasorelaxant effect that was higher than that of acetylcholine, induced endothelium-dependent vasodilatation. Futhermore, the vasorelaxant response to the P. calyculatus extract was reduced after adding an inhibitor of soluble guanylate cyclase activity, providing evidence that the NO/cGMP pathway is involved. On the other hand, the extracts of Bocconia frutescens L. (Papaveraceae), Magnolia grandiflora L. (Magnoliaceae), and Solanum rostratum Dunal (Solanaceae) induced concentration-dependent contraction of rat aortic rings, suggesting that these plants have potential health benefits for the treatment of ailments such as venous insufficiency. The pharmacological activities of the extracts studied provide scientific support for their ethnomedical use.

'Desperate house genes': the dramatic example of hypoxia

BACKGROUND

Microenvironmental conditions in normal or tumour tissues and cell lines may interfere on further biological analysis. To evaluate transcript variations carefully, it is common to use stable housekeeping genes (HKG) to normalise quantitative microarrays or real-time polymerase chain reaction results. However, recent studies argue that HKG fluctuate according to tissues and treatments. So, as an example of HKG variation under an array of conditions that are common in the cancer field, we evaluate whether hypoxia could have an impact on HKG expression.

METHODS

Expression of 10 commonly used HKG was measured on four cell lines treated with four oxygen concentrations (from 1 to 20%).

RESULTS

Large variations of HKG transcripts were observed in hypoxic conditions and differ along with the cell line and the oxygen concentration. To elect the most stable HKG, we compared the three statistical means based either on PCR cycle threshold coefficient of variation calculation or two specifically dedicated software. Nevertheless, the best HKG dramatically differs according to the statistical method used. Moreover, using, as a reference, absolute quantification of a target gene (here the proteinase activating receptor gene 1 (PAR1) gene), we show that the conclusions raised about PAR1 variation in hypoxia can totally diverge according to the selected HKG used for normalisation.

CONCLUSION

The choice of a valid HKG will determine the relevance of the results that will be further interpreted, and so it should be seriously considered. The results of our study confirm unambiguously that HKG variations must be precisely and systematically determined before any experiment for each situation, to obtain reliable normalised results in the experimental setting that has been designed. Indeed, such assay design, functional for all in vitro systems, should be carefully evaluated before any extension to other experimental models including in vivo ones.

[Undesirable effects of medicine in the Internal Medicine Service of the University Hospital Center du Point G]

The aim of this study was to determine the frequency of adverse reactions to drugs, the WHO grade, describe the clinical features and identify the drug responsible. This was a descriptive cross-sectional study which took place from February 2005 to January 2006 in the Internal Medicine Department at the hospital point G. Were included in this study, all patients hospitalized during the study period, which presented adverse drug reactions (ADRs) that the relation of cause and effect was certain or likely. Thus, 47 ADRs were identified in 39 patients of 426 admitted during the same period a frequency of 9.2%. The average age of our patients was 48.5 ± 16.5 years. The sex-ratio was 1.6 for women. Eighty-two percent of our patients had an ADR and 18% more than one. The WHO grade 1 was the most met or 36.2%, followed by grades 4 and 2 respectively 27.7% and 25.5%. Antidiabetics were responsible for adverse reactions in 46.8% and 21.3% in TB. Adverse events were neurological in 53.2% and type of manifestations of hypoglycemia 46.8% (22/47 cases), polyneuritis 6.4% (3 / 47 cases) and 29.8% in digestive cases dominated by vomiting 12.8% (6 / 47 cases), the epigastria pain 6.4% (3 / 47 cases). The outcome was favorable in 87.2% of cases, however, 3 cases of death among those over 60 years all grade 4 WHO. ADRs deserve special attention to this high death rate (6.4% 3/47 cases) where the interest to search systematically for all patients under medical treatment with a good clinical examination and questioning some thoroughly.

A randomised controlled trial of azithromycin following surgery for trachomatous trichiasis in the Gambia

BACKGROUND/AIM

Trachomatous trichiasis frequently returns following surgery. Several factors may promote recurrence: preoperative disease severity, surgeon ability, surgical procedure, healing responses, and infection. This study investigates whether enhanced control of infection, both of Chlamydia trachomatis and other bacteria, with azithromycin can improve surgical outcome in a trachoma control programme.

METHODS

Individuals with trachomatous trichiasis were examined and operated. After surgery patients were randomised to the azithromycin or control group. The azithromycin group and children in their household were given a dose of azithromycin. Antibiotic treatment was repeated at 6 months. All patients were reassessed at 6 months and 12 months. Samples were collected for C trachomatis polymerase chain reaction and general microbiology at each examination.

RESULTS

451 patients were enrolled. 426 (94%) were reassessed at 1 year, of whom 176 (41.3%) had one or more lashes touching the eye and 84 (19.7%) had five or more lashes. There was no difference in trichiasis recurrence between the azithromycin and control group. Recurrent trichiasis was significantly associated with more severe preoperative trichiasis, bacterial infection, and severe conjunctival inflammation at 12 months. Significant variability in outcome was found between surgeons. Visual acuity and symptoms significantly improved following surgery.

CONCLUSION

In this setting, with a low prevalence of active trachoma, azithromycin did not improve the outcome of trichiasis surgery conducted by a trachoma control programme. Audit of trichiasis surgery should be routine.

Trial of the Trachoma Rapid Assessment methodology in The Gambia

PURPOSE

To test the validity and repeatability of a newly designed Trachoma Rapid Assessment (TRA) methodology.

METHOD

Results from an initial TRA in 20 villages (TRA1) are compared with those of a second validation TRA (TRA2) after 6 weeks in 13 villages, randomly selected out of the original 20, conducted by different field staff. Findings of TRA1 and TRA2 are compared with those of a door-to-door survey of the entire population of all 13 villages.

RESULTS

There is a considerable amount of variation between the results of TRA1 and TRA2 and between the results of both TRA's and the door-to-door survey. Even indicators that should have remained the same, like distance to Primary Health Centre or distance to trichiasis surgery facility, scored differently.

CONCLUSIONS

The TRA methodology is easy to use and the results are quickly available. The scoring system indicates which intervention(s) of the SAFE strategy are needed and facilitates priority setting. The definition of some indicators, like availability and use of latrines, may need modification. In some cases, the scoring system seems to exaggerate differences between the actual findings. The consistency between two TRA's in the same village is low and the accuracy in measuring the actual situation is doubtful.

Smooth muscle relaxing activity of gentiopicroside isolated from Gentiana spathacea

Bioassay directed fractionation of the (1:1) chloroform-methanol extract of Gentiana spathacea H.B.K (Gentianaceae) led to the isolation of gentiopicroside (gentiopricrin) (1), the major spasmolytic component of the plant. Gentiopicroside inhibited, in a concentration-dependent manner, the spontaneous contractions of isolated guinea pig ileum. Contractions induced by histamine, acetylcholine, BaCl2 and KCl on the ileum were also significantly blocked by this monoterpene glucoside, which suggests that this compound might be interfering with calcium influx into the smooth muscle cells.

Cowdria ruminantium antibodies in acaricide-treated and untreated cattle exposed to Amblyomma variegatum ticks in The Gambia

An indirect enzyme-linked immunosorbent assay (ELISA), based on the major antigenic protein I fragment B (MAPI-B) of Cowdria ruminantium, was used to assess seroprevalence in cattle in The Gambia. Two groups of 20 N'Dama and 20 Gobra zebu cattle were monitored for 12 months with flumethrin treatment and for another 10 months without acaricidal treatment. Two groups of 20 N'Dama and 20 Gobra cattle served as untreated controls. During the period of acaricidal treatment, the cumulative proportions of positive serum samples were 25.6 +/- 5.6% (+/- confidence interval) and 34.7 +/- 6.8% in treated N'Dama and Gobra cattle respectively; the proportion of positive sera in untreated cattle was 52.2 +/- 6.9% in N'Damas and 61.4 +/- 7.3% in Gobras. Within breed, difference in antibody prevalence between treated and untreated cattle was significant (P < 0.001) but between breed differences were not significant. In the 10 months following suspension of acaricide application, there was an increase of proportion of positive serum samples in previously treated N'Dama and Gobra cattle. In both previously treated and untreated animals the peak of positive seroreactions occurred during and subsequent to the period of activity of Amblyomma variegatum adults. Cumulative seroprevalences in previously treated N'Dama and Gobra cattle were 32.6 +/- 6.9% and 44.7 +/- 8.5%, respectively; in untreated animals seroprevalence was 38.6 +/- 7.2% in N'Dama and 65.3 +/- 8.4% in Gobra cattle. Throughout the study period, within the N'Dama breed, the seropositive rate in previously treated cattle did not differ from that in untreated animals. Conversely, within the Gobra breed, the number of positive seroreactions was higher (P < 0.002) in untreated animals than in previously treated cattle. These results provide a support for designing A. variegatum and heartwater control strategies, if necessary, in The Gambia in relation to cattle breeds.

Spasmolytic activity of some plants used by the Otomi Indians of Quéretaro (México) for the treatment of gastrointestinal disorders

The present study was performed to investigate the effect of chloroform-methanol (1:1) extracts derived from Baccharis heterophylla H. B. K (Asteraceae), Desmodium grahami Gray (Leguminosae), Dyssodia pinnata var. pinnata Rob. (Asteraceae), Gentiana spathacea H. B. K. (Gentianaceae), Loeselia mexicana Brand. (Polemoniaceae), Selaginella pallescens Spring. (Selaginellaceae) and Zornia diphylla Pers. (Fabaceae) on the spontaneous contractions of isolated rat ileum. The concentration-response curves and IC50 values were obtained and the respective relaxant potencies were compared with that of the CHCl3-MeOH (1:1) extract of Datura lanosa. The data showed that all the extracts produce a concentration-dependent inhibition of spontaneous ileum contractions. In addition, the antimicrobial activity of the extracts against pathogenic enterobacteria was tested. The pharmacological actions shown by the extracts of the selected species tend to support ethnomedical use of the plants for the treatment of gastrointestinal disorders.

Efficiency and cost of strategic use of acaricide for tick control in N'Dama cattle in The Gambia

The efficiency of strategic and strategic/selective applications of flumethrin spray formulation for controlling ticks were assessed, respectively, in two groups of fourteen N'Dama cattle (Group S and Group S/S) by comparison of the number of feeding ticks with thirteen untreated N'Dama cattle (Group U) over a period of 11 months (June 1996 to April 1997). During the expected peak of tick abundance, acaricide was applied fortnightly on the whole body in animals in Group S and only on the most infested body areas in cattle in Group S/S. Weight changes and skin lesions, directly associated with tick attachment, were recorded in cattle in the three groups. The costs of the two tick control schemes were estimated. Maximum level of ticks, all species together, feeding on cattle was observed in the rainy season. Both in Group S/S and Group S, cattle carried a lower (P < 0.001) number of feeding ticks than animals in Group U over the whole study period. Percentage of tick control, over the entire period of tick investigation, was satisfactory in both acaricide-treated groups, reaching 61.2 and 75.2% in Groups S/S and S, respectively. However, the proportion of control varied according to tick species or genus. Significantly lower prevalence of skin lesions was observed on the ano-genital and udder region in cattle in Group S/S (P < 0.05) and Group S (P < 0.01) in comparison with cattle in Group U. Mean amount of acaricide solution used and relative estimated cost of treatment in cattle in Group S/S were, respectively, 25- and 14-fold lower than those in cattle in Group S. At the end of the study, animals in Groups S/S and S were, respectively, 7.2 and 15.9 kg heavier than animals in Group U. The difference was statistically significant (P < 0.02) only between Groups S and U. However, the efficiency, low cost and derived benefits of the strategic/selective acaricide application scheme indicated that it might be the most cost effective.

Effect of controlling natural field-tick infestation on the growth of N'Dama and Gobra zebu cattle in the Gambia

The effect of tick infestations on liveweight gain (LWG) was assessed by comparison of weight changes in flumethrin-treated N'Dama and Gobra zebu cattle (16-20 months old) with respective control groups submitted to natural tick challenge over 1 year. Flumethrin was applied monthly, fortnightly or weekly. Preventive treatments against anaplasmosis, babesiosis and trypanosomosis were given. Mortality rate was recorded and post-mortem examinations carried out. In both treated and control animals, significantly fewer Hyalomma spp. and Amblyomma variegatum were found on N'Dama than on Gobra zebu cattle. Both breeds are equally susceptible to Rhipicephalus senegalensis infestation. Total annual tick burdens did not cause significant differences in LWG between acaricide-treated and control cattle in either breeds. LWG was also not affected during or after the annual peak of tick infestation (composed mainly by A. variegatum and R. senegalensis). Equally-high mortality (35%), due to unidentified causes, was recorded in acaricide-treated and control Gobra cattle; mortality in N'Dama cattle was 7.5%. In both breeds, about the 90% of mortality occurred at the end of the dry season. Breed differences in tick burden confirm previous results. If tick-borne infections do not influence LWG or mortality, then it is concluded that intensive tick control is not justifiable in Gambian livestock.

Susceptibility to different tick genera in Gambian N'Dama and Gobra zebu cattle exposed to naturally occurring tick infestations

Tick collection on one side of the body and whole tail was performed weekly over one year on 11 Gambian N'Dama (Bos taurus) and 11 Gobra zebu (Bos indicus) cattle to assess breed susceptibility to naturally occurring ticks. Enzyme-linked immunosorbant assay was also performed to assess the serological prevalence of Anaplasma marginale antigen and Babesia bigemina antibody. Packed red cell volume was measured and liveweight gain was recorded. Significantly higher numbers of Amblyomma variegatum (P < 0.002) and Hyalomma spp. (P < 0.001) were found on Gobra zebu than on N'Dama cattle. The serological prevalence of A. marginale antigen was significantly (P < 0.001) lower in N'Dama breed, whilst no difference in the serological prevalence of B. bigemina antibody was found between N'Dama and Gobra cattle. Packed red cell volume was negatively affected by A. marginale infection in both breeds, but to a lesser extent in N'Dama cattle. Liveweight gain was significantly (P < 0.003) higher in N'Dama in comparison with Gobra cattle during the period of abundance of A. variegatum and Hyalomma spp. adults. The significantly lower burdens of A. variegatum and Hyalomma spp. ticks in Gambian N'Dama in comparison with Gobra zebu cattle confirms previous findings. It also shows a more deleterious effect of ticks and tick-borne diseases on animal production and health in Gobra zebu than in N'Dama cattle. The presence of a tick resistant trait in N'Dama cattle is suggested.

Experimental Trypanosoma congolense infection on naturally occurring ticks in N'dama and Gobra zebu cattle

The effects of experimental Trypanosoma congolense infection in Gambian N'dama and Gobra zebu cattle on number of naturally-occurring adult ticks attaching were studied. An indirect fluorescent antibody test was performed to detect serological prevalence of Cowdria ruminantium antibody. The intravenously imposed trypanosome infection did not result in significant (P > 0.05) differences in Amblyomma variegatum and Hyalomma spp. infestations between control and infected N'dama cattle. Control N'damas carried significantly (P < 0.001) lower numbers of A. variegatum and Hyalomma spp. than the control zebus. Serological frequency of C. ruminantium antibody was similar in both control or infected N'dama and in control or infected zebu cattle. No deaths occurred among N'dama cattle, while all six trypanosome infected zebus progressively died within nine weeks post-infection but trypanosomosis was excluded as the primary cause of death. Examined Giemsa-stained blood smears were negative for the presence of tick-borne micro-organisms. Four positive cases of cowdriosis were identified during post-mortem examination. It was concluded that N'damas, even when submitted to trypanosome infection, react consistently better than Gobra zebus to tick attachment. These results emphasize the benefits of rearing disease resistant cattle breeds, such as N'dama, in areas where risks of trypanosomosis and cowdriosis coexist.

Hepatotoxic pyrrolizidine alkaloids in the Mexican medicinal plant Packera candidissima (Asteraceae: Senecioneae)

A study of the hepatotoxic pyrrolizidine alkaloids (PAs) contained in Packera candidissima (Greene) Weber & Löve (Senecio candidissimus Greene), a Mexican medicinal plant used for the treatment of kidney ailments and noted for its antiseptic properties, is reported. Analysis by TLC and GC-MS have shown the presence in high levels of both PAs and their N-oxides in the root (0.76% dry weight) and the aerial parts (0.36% dry weight) of the plant material. GC-MS analysis showed the presence of senecionine, integerrimine, retrorsine, and usaramine in the aerial parts. The root was found to contain senkirkine as the major component. These results indicate that users of this herb are at high risk of poisoning, especially members of certain cultural groups in Northern Mexico and the Hispanic population in the southwestern United States. In addition, two sesquiterpenes, neoadenostylone and epineoadenostylone were identified from the neutral extracts of this plant material. The 6 alpha-angeloyloxy-9-oxo-delta 10(1)-furanoeremophilane is reported for the first time as a natural product.

A comparison of field tick infestation on N'Dama, Zebu and N'Dama x Zebu crossbred cattle

Tick burdens, estimated from cumulative tick counts, were determined on N'Dama, Zebu and F1 N'Dama x Zebu crossbred cattle. N'Dama showed significantly fewer ticks than the Zebu and F1 cattle (P < 0.001). A previous trypanosomosis infection did not affect tick burdens on the three genotypes. Amblyomma variegatum had a prevalence of 84.8% and Hyalomma spp. 15.2%, with the ratio similar on all cattle breeds. Trypanosomosis infection increased the serological prevalence of Anaplasma marginale in Zebu and F1 cattle but not in N'Dama cattle. These observations supported the view that N'Dama cattle are less susceptible to tick attachment than Zebu cattle.

Comparison of the efficacy of propranolol and amiodarone in suppressing ventricular arrhythmias following myocardial infarction

The purpose of this prospective randomized trial was to compare the efficacy of propranolol and amiodarone in suppressing ventricular arrhythmias during the first 6 months following myocardial infarction (MI). 97 patients were treated with either amiodarone (n = 48) or propranolol (n = 49) starting on the 9th day following MI. Holter monitoring was carried out on four occasions: on D7, D21, D90 and D180. There was no statistical difference in the incidence of 'major' arrhythmias (an average of at least 10 ventricular premature complexes (VPCs) h-1, multiform or paired VPCs or runs) between the two groups on D7. A significant difference in favour of amiodarone became apparent at D180 (P = 0.04). Patients were also classified according to whether treatment failed or was successful. 'Success' was recorded when arrhythmias remained minor or became minor (less than 10 uniform VPCs h-1) and 'failure' when arrhythmias remained major or became major, or when patients were withdrawn because of side-effects, or lost to follow-up. The difference remained in favour of amiodarone (P = 0.03 at D21; P = 0.05 at D90; P = 0.06 at D180). Evaluation of the percentage reduction in the number of VPCs at D21, D90 or D180 compared with D7 showed superiority of amiodarone at D90 (P less than 0.01) and D180 (P less than 0.04). In this study, the overall effect of amiodarone on ventricular arrhythmias following MI was shown to be superior to that of propranolol.