Place de la prescription médicamenteuse dans la prise en charge des pathologies bucco dentaires chez l'enfant au centre dentaire de l'université de Conakry

La prescription est l'acte par lequel le praticien ordonne au patient des produits officinaux ou des préparations magistrales en fonction du poids et de l'âge de l'enfant. L'objectif de cette étude était de Contribuer à l'amélioration de la prescription médicamenteuse chez l'enfant en consultation dentaire à Conakry. Il s'agit d'une étude descriptive menée dans le service dentaire de l'université de Conakry sur une période de 6 mois chez l'enfant âgé de 1 à 12 ans ayant reçu une prescription médicale pour la prise en charge de la pathologie bucco dentaire. Au cours de l'étude nous avons obtenu 38,7% de cas pulpite irréversible et 19,6% de cas de desmodontite. Cependant, 15% d'enfants de notre échantillon ont été prémédiqués ; les classes pharmaceutiques les plus utilisées étaient les antalgiques suivis des antibiotiques avec respectivement 43,5% et 40,3%. La prescription médicamenteuse après l'acte posé était dominée par 43,7% d'antalgiques, 39,6% d'antibiotiques et 16,5% d'anti inflammatoire non stéroïdiens. Le rapport de conformité des molécules prescrites avec le diagnostic posé se résumait à 55,4% de prescriptions conformes contre 44,6% de prescriptions non conformes

Utilisation de la boule de Bichat dans le traitement de la communication bucco-sinusienne iatrogène: à propos d'un cas

La communication bucco-sinusienne fait partie des complications per et post opératoires rencontrées au cours de l'avulsion des dents antrales, notamment les deuxièmes prémolaires et les premières molaires maxillaires. Nous rapportons le cas d'une jeune patiente de 23 ans, chez la quelle l'avulsion laborieuse de la 16 (première molaire maxillaire droite) a conduit à une communication bucco-sinusienne, dont la thérapeutique de première intention par lambeau de translation vestibulaire de plein épaisseur a échoué. La reprise chirurgicale associant le lambeau vestibulaire à la boule de Bichat, a permis la fermeture hermétique de la communication. Notre résultat a été comparé aux données actuelles de la littérature

Prise en charge de l'ostéopériostite chronique dentaire chez l'enfant: à propos d'un cas

L'ostéopériostite est un état inflammatoire aigu ou chronique du périoste et de l'os sous-jacent. Le but du traitement de l'adolescent est la dent causale d'avulser pour empêcher des complications septiques dentaires point de départ dentaire pour Staphylococcus aureus sensible à la méthicilline. Nous rapportons le cas d'une jeune fille de 10 ans anxieuse sans antécédents médicaux significatifs avec une ostéite de Garré évoluant depuis plusieurs mois. Le patient a été mis sous antibiotiques et examiné une semaine après la disparition des signes cliniques. Une technique, le type d'anesthésie Akinosi a été réalisée sous sédation consciente car l'anesthésie générale nécessite une préparation plus intense avant le traitement et une période de récupération plus longue après le traitement. Il a permis de pratiquer sans douleur à l'ouverture de pression de la chambre pulpaire de la première molaire mandibulaire gauche et de faciliter le drainage. L'avulsion de la dent causale se pratique alors en racine de séparation pour préserver le capital osseux

The osteoperiostitis is an acute or chronic inflammatory condition of the periosteum and the underlying bone. the goal of treatment of the teenager is avulsed causal tooth to prevent septic complications dental starting point for methicillin-sensitive staphylococcus aureus. we report the case of a young 10 year old girl anxious without significant medical history with osteitis of garré evolving for several months. The patient was put on antibiotics and review one week after resolution of clinical signs. one technique the type of anesthesia akinosi was performed under conscious sedition because general anesthesia requires a more intense preparation before treatment and a longer recovery period after treatment. it allowed to practice without pain to the pressure opening of the pulp chamber of the mandibular first molar left and facilitate drainage. the avulsion of the causal tooth is then practiced separation roots to preserve the bone capital.

Multiple responses optimization in the development of a headspace gas chromatography method for the determination of residual solvents in pharmaceuticals / 药物分析学报

An efficient generic static headspace gas chromatography (HSGC) method was developed, optimized and validated for the routine determination of several residual solvents (RS) in drug substance, using a strategy with two sets of calibration. Dimethylsulfoxide (DMSO) was selected as the sample diluent and internal standards were used to minimize signal variations due to the preparative step. A gas chroma-tograph from Agilent Model 6890 equipped with flame ionization detector (FID) and a DB-624 (30 m × 0.53 mm i.d., 3.00μm film thickness) column was used. The inlet split ratio was 5:1. The influ-encing factors in the chromatographic separation of the analytes were determined through a fractional factorial experimental design. Significant variables: the initial temperature (IT), the final temperature (FT) of the oven and the carrier gas flow rate (F) were optimized using a central composite design. Response transformation and desirability function were applied to find out the optimal combination of the chromatographic variables to achieve an adequate resolution of the analytes and short analysis time. These conditions were 30 °C for IT, 158 °C for FT and 1.90 mL/min for F. The method was proven to be accurate, linear in a wide range and very sensitive for the analyzed solvents through a comprehensive validation according to the ICH guidelines.

Le lymphangiome cervico-facial congenital de l'enfant au chu de conakry : analyse de trois cas

Le lymphangiome kystique est une tumeur vasculaire; benigne; rare; d'origine lymphatique. La forme principale est representee par le lymphangiome cervico-facial congenital de l'enfant. Sa pathogenese est inconnue. Cette malformation congenitale du systeme lymphatique est composee de formations kystiques developpees a partir d'endothelium lymphatique et remplies de lymphe et de sang. L'atteinte des voies aerodigestives superieures (VaDS) peut conduire a des complications graves; mettant en jeu le pronostic vital. nous presentons trois observations de lymphangiomes kystiques de diagnostic post natal. Le traitement etait chirurgical dans tous les cas consistant en exerese complete de la tumeur et le diagnostic confirme par l'examen histopathologique de la piece operatoire. apres un recul d'au moins 12 mois; aucune recidive locale n'a ete observee cependant la surveillance reste de mise

Avaliação de diferentes vias vacinais para vacinação contra o vírus da doença de Newcastle em aves de fundo de quintal / Assessment of different vaccination approaches against Newcastle disease virus in domestic backyard poultry

Foram avaliadas três vias de aplicação vacinal contra o vírus da doença de Newcastle em aves de criatório de fundo de quintal (AFQ) jovens e adultas. Um total de 135 AFQ foram distribuídas em tratamentos distintos de acordo com a via vacinal: via ocular (VO), água de bebida (VAB) e alimentar (VA). Cada tratamento foi representado por 40 aves (20 jovens e 20 adultas) e utilizou-se um grupo-controle de 15 aves não vacinadas. O programa de vacinação estabelecido constou de uma primovacinação e dois reforços vacinais, utilizando-se a cepa La Sota. Para aves jovens, os títulos obtidos pelas VO e VAB não diferiram aos 15, 45 e 140 dias, mas houve diferenças nos títulos das aves vacinadas pela VA. Nas aves adultas, a vacinação pela VO apresentou resultados mais elevados que as vacinações pelas VAB e VA na primeira resposta, aos 15 dias. Aos 45 dias, os títulos obtidos pela VAB foram mais baixos que os obtidos pela VO, e, aos 140 dias, não houve diferença entre as três vias avaliadas. Concluiu-se que as vacinações pelas VO e VAB constituem alternativas eficazes para vacinação de AFQ jovens e adultas.

Three ways of vaccination against Newcastle Disease Virus (NDV) were evaluated in young and adults domestic backyard poultry (DBP). A total of 135 DBP was submitted to three different administration routes of ND vaccine: eye-drop, drinking water, and feed. Each treatment consisted of 40 birds (20 young and 20 adult) and a control group of 15 unvaccinated birds. The treatment consisted of a first vaccination and two boosters, using La Sota strain. For young birds, the eye-drop and drinking water vaccinations presented no differences at 15, 45, and 140 days, differing from the titers obtained by birds treated by feed vaccination method. In the adult birds, the eye-drop administration presented higher titers than by drinking water and feed approaches in the first response to the vaccination at 15 days. At 45 days, the results obtained by the drinking water had lower titers than those from the eye-drop. The three vaccination methods presented no difference at 140 days. In conclusion, the vaccination by eye-drop and drinking water methods constituted an efficient alternative of vaccination for adult and young DBP against Newcastle virus.

The IFN-γ +874T/A polymorphism is associated with retinochoroiditis toxoplasmosis susceptibility

Toxoplasmosis is a worldwide zoonosis that generally produces an asymptomatic infection. In some cases, however, toxoplasmosis infection can lead to ocular damage. The immune system has a crucial role in both the course of the infection and in the evolution of toxoplasmosis disease. In particular, IFN-γ plays an important role in resistance to toxoplasmosis. Polymorphisms in genes encoding cytokines have been shown to have an association with susceptibility to parasitic diseases. The aim of this work was to analyse the occurrence of polymorphisms in the gene encoding IFN-γ (+874T/A) among Toxoplasma gondii seropositive individuals, including those with ocular lesions caused by the parasite, from a rural population of Santa Rita de Cássia, Barra Mansa, state of Rio de Janeiro, Brazil. Further, we verified which of these polymorphisms could be related to susceptibility to the development of ocular toxoplasmosis. This study included 34 individuals with ocular toxoplasmosis (ocular group) and 134 without ocular lesions (control group). The differences between A and T allele distributions were not statistically significant between the two groups. However, we observed that a higher frequency of individuals from the ocular group possessed the A/A genotype, when compared with the control group, suggesting that homozygocity for the A allele could enhance susceptibility to ocular toxoplasmosis in T. gondii infection.

Les lesions bucco-cervicales chez les malades atteints d'hemopathie maligne a l'hopital national Donka du CHU de Conakry

Les lesions bucco-cervicales observees au cours des hemopathies malignes peuvent revetir des aspects varies et plusieurs tissus comme la muqueuse buccale; les glandes salivaires; les os de la face peuvent etre concernes. Les objectifs de cette etude etaient d'evaluer l'etat bucco-cervical de malades souffrant d'hemopathies malignes et de decrire les lesions bucco-cervicales rencontrees. Une etude prospective de type descriptif a ete realisee de janvier 2004 - octobre 2006; dans les services de Stomatologie et de Chirurgie Maxillo-faciale et d'Hemato-Oncologie de l'Hopital National Donka du CHU de Conakry. Durant cette periode; 44 malades ont ete examines. Il s'agissait de 26 hommes et de 18 femmes qui avaient un Lymphome malin non Hodgkinien (21 cas); un Leucemie aigue (8 cas); un Lymphome malin Hodgkinien (8 cas); une Leucemie hronique lymphoide (4 cas) et une Leucemie chronique myeloide (3 cas). Les lesions bucco-cervicales couramment rencontrees ont ete: les adenopathies cervicales dans 27;27des cas; suivies des gingivites hyperplasiques: 20;45et des stomatites: 13;63des cas. Ainsi; les hemopathies malignes; s'accompagnent de lesions bucco-cervicales qui constituent parfois le signe revelateur de ces maladies. Une gingivite hyperplasique; des stomatites et des adenopathies cervicales sans cause evidente doivent attirer l'attention du stomatologiste. Ce dernier dans un cadre de collaboration interdisciplinaire peut contribuer a l'amelioration de l'etat de sante des patients atteints d'hemopathies malignes au stade precoce par la prise en charge appropriee des lesions bucco-cervicales

Le noma chez les enfants infectes par le VIH au CHU de Conakry: 5 cas

Les objectifs de cette etude etaient de decrire les aspects cliniques et therapeutiques chez 5 enfants atteints d'un noma revelateur d'une immunodepression par infection au VIH. Les malades ages entre 4 et 6 ans; ont ete recrutes entre fevrier 1999 et mai 2004. Le noma etait dans tous les cas localise au niveau de la region commisuro-jugale ou jugale. Les manifestations bucco-cervicales du VIH rencontrees etaient: la candidose et les adenopathies cervicales. Un traitement medical a base d'antibiotique (Ampiclline - 100mg/kg/jour en 3 prise par voie IV; Metronidazole 40 mg/kg/jour en 3 injections en intraveineuse par jour) combine a une chirurgie conservatrice a permis de limiter la destruction massive des tissus de la face et d'obtenir une cicatrisation des plaies par seconde intention. Tous les patients sont decedes d'infection opportuniste en l'absence de possibilite de traitement anti-retroviral et compte tenu du stade evolue du SIDA

Influência da estimulação elétrica nervosa transcutânea (TENS) associada ao alongamento muscular no ganho de flexibilidade / Influence of transcutaneous electrical nerve stimulation (TENS) associate with muscle stretching on flexibility gains

CONTEXTUALIZAÇÃO: O aumento da tolerância à dor provocada pelo alongamento é um fator importante no ganho de flexibilidade. A Estimulação Elétrica Nervosa Transcutânea (TENS) é uma importante terapia no tratamento da dor, porém seu uso durante alongamento não foi investigado. OBJETIVO: Avaliar o efeito da associação alongamento e TENS nos músculos isquiotibiais de mulheres saudáveis sobre ganho de flexibilidade. MATERIAIS E MÉTODOS: Trinta mulheres foram aleatoriamente distribuídas em três grupos (n=10): controle (C) e grupos de alongamento (Al e Al+TENS). Estes últimos foram submetidos a alongamento estático (três repetições de 30 segundos) por duas semanas, sendo um deles (Al+TENS) submetido à aplicação de TENS por dez minutos (100hz; 40µs) antes da manobra, com estimulação presente durante a mesma. A flexibilidade foi avaliada pela extensão passiva do joelho antes e após cada sessão, sendo retiradas fotografias para análise pelo software AUTOCAD. A dor percebida foi avaliada com uma Escala Numérica de 0 a 10 pontos. Os dados foram analisados mediante o teste t de Student, para amostras independentes e análise de variância, considerando nível de significância estatística o valor de p<0,05. RESULTADOS: Os grupos Al e Al+TENS tiveram aumento da ADM em relação ao C, mas nenhuma diferença foi encontrada entre os dois primeiros quanto: ganho de flexibilidade após duas semanas (Al+TENS: 17,53º±9,25/Al: 12,76º±8,75); ganho diário de flexibilidade (Al+TENS: 6,00º±1,79/Al: 5,20º±3,17); e dor percebida durante alongamento (mediana de cinco para ambos). CONCLUSÕES: O uso da TENS associada ao alongamento não promove maior ganho de flexibilidade muscular, em relação ao alongamento isolado.

BACKGROUND: Increased pain tolerance caused by stretching is an important factor in flexibility gains. Transcutaneous Electrical Nerve Stimulation (TENS) is therapeutic method for pain treatment, but its use during stretching has not been investigated. OBJECTIVE: To evaluate the effect of associating TENS with stretching to achieve flexibility gains for the hamstring muscles of healthy women. METHODS: Thirty women were randomized into three groups (n=10): one control (C) and two stretching groups (St and St+TENS). The stretching groups underwent static stretching (three repetitions of 30 seconds) for two weeks, and the other (St+TENS) underwent TENS application for ten minutes (100hz, 40µs) before the stretching, with the stimulation also being administered during the stretching. Flexibility was evaluated according to the passive knee extension before and after each session, and photographs were taken for analysis using the AUTOCAD software. Pain perception was evaluated on a numerical scale from 0 to 10 points. The data were analyzed using Student's t test for independent samples and analysis of variance, considering p<0.05 as the statistical significance level. RESULTS: The St and St+TENS groups increased their range of motion in relation to C, but there were no differences between these two groups, with regard to flexibility gain after two weeks (St+TENS: 17.53º±9.25; St: 12.76º±8.75); daily flexibility gain (St+TENS: 6.00º±1.79; St: 5.20º±3.17); and pain perception during stretching (median of five for both groups). CONCLUSIONS: The use of TENS associated with stretching did not provide extra gains in muscle flexibility, in relation to stretching alone.

Antibodies specific to infectious bronchitis in broilers in Ceará state, Brazil

The experiment was carried out to determine the antibody levels to infectious bronchitis virus (IBV) in 1120 broilers of two broiler flocks, both from the same parental flock and free from previous vaccination. Forty chicks of each line were alloted to the control group and the sera were tested by indirect ELISA. The vaccination program consisted on the administration of commercial vaccines against IBV at 10 and 25 days of age. Chicks with low levels of maternal antibodies (Mab) did not show significant titers to the first vaccinal stimulus. They presented a vaccinal response to the second vaccinal stimulus reaching the top around GMT 1100 at 45 days. Chicks with high Mab titers did not show significant titers to the primary and secondary vaccinal stimuli, reaching peak levels of GMT 500 at 45 days. No antibody response was detected after the primary vaccination at day 10. A delayed antibody response was detected after the secondary vaccination on day 25, indicating no previous priming. The maternal antibody titers can interfere on the response to the first and second vaccinal stimulus promoting the neutralization of the first vaccination and a different response to the second one, according to high or low maternal antibodies.

Utilizaram-se 1120 pintos de um dia de idade, de duas linhagens, não vacinados, para determinar os níveis de anticorpos para o vírus da bronquite infecciosa (VBI) em frangos de corte no estado do Ceará. Quarenta aves de cada linhagem, colocadas em boxes isolados e não vacinadas, foram usadas como controle. As aves vacinadas contra VBI aos 15 e 25 dias foram submetidas a coletas de sangue periódicas para avaliação, pelo ELISA indireto, dos títulos de anticorpos para VBI. As aves com baixos títulos de anticorpos maternos (AcM) não apresentaram títulos significativos ao primeiro estímulo vacinal; para o segundo estímulo, o pico de resposta de GMT 1100 ocorreu aos 45 dias. As com elevado título de AcM não responderam significativamente à primeira vacinação e o pico de resposta ao segundo estímulo de GMT 500 ocorreu aos 45 dias. Não se verificou resposta de anticorpos para o primeiro estímulo vacinal, observando-se resposta tardia somente para o segundo. Os AcM podem ter interferido tanto no primeiro quanto no segundo estímulo, promovendo neutralização da primeira vacinação e resposta diferenciada para a segunda de acordo com o nível, elevado ou baixo, de AcM.

Maladie de Wilson: etude de 6 formes neurologiques observees au CHU de Conakry

This rep o rt describes 6 cases of Wi l s o n 's disease observed at the Unive rsity Hospital Center in Conakry; Guinea. P resenting symptoms invo l ved ex t rapy ramidal syndrome in 4 cases; p s y chomotor ep i l epsy in 1; and confusional syndrome in 1 c a s e. Diagnosis was based on neuro p s y chic manife s t ations; Kayser- F l e i cher corneal ring; liver failure; and impaired copper metabolism. Brain CT-scan depicted normal fe at u res in 3 cases; s y m m e t ric hypodensity of the lenticular nu cleus in one; discrete ve nt ricular dilat ation of in one a and cortico-subcoetical atro p hy in one

Monitoria Acadêmica em Semiologia Médica: Descrição e Avaliação de uma Nova Experiência

Resumo: O presente artigo refala uma nova experiência de metodologia de ensino -aprendizagem descritas pelos próprios monitores, desenvolvida no curso de Medicina da Universidade Estadual de Londrina, junto à disciplina de Semiologia. Esta monitoria acadêmica caracterizou-se pelas seguintes inovações: 1) Autonomia do monitor na elaboração do programa de atividades e, 2) Avaliação concomitante do método, através de questionários elaborados pelos monitores, aplicados periodicamente com o objetivo de identificar e caracterizar os principais fatores, prejudiciais e/ou benéficos, a fim de otimizar tal atividade acadêmica. Os autores descrevem o processo de seleção dos monitores, atividades desenvolvidas, dificuldades encontradas, resultados obtidos, e concluem que a modalidade de ensino com a utilização de monitores, mostra-se de extrema utilidade e importância no processo de formação médica, propiciando a transmissão de conhecimentos, aquisição de raciocínio crítico e estímulo à futura carreira universitária.

Summary: This article describes a new experiences of teaching methodology developed by the Medical Anamnesis and Physical Diagnosis at the School of Medicine of Universidade Estadual de Londrina. This academic teaching methodology was caracterized by: 1) The independence of the monitors to determinate the schedule of the activities and, 2) Continuous evaluation of the method, applied periodically to identify the major problems in order to improve the teaching method. The authors describe the selecting process of the monitors, activities carried out, unexpected difficulties, results anel conclude that· the proposed methodology is extremely useful in Medical Education and play an important role in improving knowledge, reasoning and stimulating a future University carrier.