Added Value of Mean Blood Pressure and Placental Growth Factor in the Early Detection of Pre-eclampsia among Gabonese Women.

OBJECTIVE: To evaluate the use of the Foetal Medicine Foundation (FMF) algorithm in routine practice for early pre-eclampsia (PE) screening in Libreville. MATERIALS AND METHODS: We conducted a cohort study on pregnant women within their 11-13 + 6 weeks of gestation (WG). We had measured mean blood pressure (MBP), placental growth factor (PlGF), soluble Fms-like tyrosine kinase 1, Uterine Artery Pulsatility Index (UtA-PI) and resistance index (UtA-RI). Statistical analyses were considered significant for P < 0.05. RESULTS: There were 30 participants. At the first quarter (T1), 36.7% of them were at high risk of PE according to the FMF algorithm and were consequently prescribed aspirin (100 mg/d). By the end of the observation period, we have found a 13% incidence of PE. MBP was higher in the higher risk PE group than in the lower risk group as early as the T1 (90 ± 6 vs. 81 ± 6 mmHg; P = 0.0007, threshold is >86 mmHg/area under the curve (AUC) = 0.86; P = 0.0012). It was the same for PlGF (58 ± 24 vs. 88 ± 38 pg/ml; P = 0.03; threshold is <71.98 pg/ml/AUC = 0.73; P = 0.03). At the second quarter (20-27 WG), biochemical markers did not change between the two groups. UtA-RI, UtA-PI and notch were unconclusive individually, but they are still very important for FMF algorithm application. CONCLUSION: Early detection of PE using the FMF algorithm is possible in routine practice in Gabon. MBP and PlGF levels at T1 seem to be very significant. However, the present study must continue to obtain the larger cohorts that would achieve more conclusive statistical analyses.

Effect of aqueous extracts of Ficus vogeliana Miq and Tieghemella africana Pierre in 7,12-Dimethylbenz(a)anthracene -induced skin cancer in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Skin cancer is the most common form of cancer responsible for considerable morbidity and mortality. Tieghemella africana and Ficus vogeliana are used in traditional medicine to treat cancers. AIM OF THE STUDY: Therefore, the aim of this study was to investigate the antioxidant, antiangiogenic and anti-tumor activities of these plant extracts. MATERIALS AND METHODS: To achieve it, phytochemical screening, antioxidant activity and antiangiogenic activity were assessed. Thereafter, the anti-tumor activity was determined using skin tumorigenesis induced by 7,12-dimethylbenz[a]anthracene. RESULTS: The phytochemical result analysis showed that both plant extracts were rich in polyphenols, alkaloids and terpene compounds and possessed good antioxidant activity based on DPPH radical scavenging (IC50 = 9.70 µg/mL and 4.60 µg/mL and AAI values of 5.20 and 10.88) and strong total antioxidant capacity (115.44 VtCE (mg)/g of dry plant extract and 87.37 VtCE (mg)/g of dry plant extract, respectively). Additionally, both plant extracts possessed antiangiogenic activities (IC50 = 53.43 µg/mL and 92.68 µg/mL, respectively), which correlated with significant antitumor activities when using 35 mg/kg (65.02% and 77.54%) and 70 mg/kg of extracts (81.07% and 88.18%). CONCLUSIONS: In summary, this study illustrates the promising usage of Tieghemella africana and Ficus vogeliana plant extracts in treating skin cancer. However, further characterization of the extracts must be performed to isolate the most active anticancer compound.

[Fetal distress: Information provided by lactate levels and antioxidant status, compared with the Apgar score]. / Souffrance foetale: pouvoir informant des lactates et du statut antioxydant versus le score d'Apgar.

The multitude of criteria used to assess fetal distress and the subjective character of the Apgar score led us to compare the information it provides with that from measurements of lactate and two principal antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx). We measured plasma lactates, SOD, and GPX from the umbilical cord blood of live-born children whose mothers had had at least three prenatal consultations. The correlation of these measurements with the 5-minute Apgar score was tested with the Spearman correlation coefficient. Lactate levels were correlated with the baby's blood glucose (r=0.212; p=0.0084), and GPx activity (r=0.179; p=0.0061), the Apgar score (r=0.258; p=0.001) and the mother's blood glucose (r=0.167; p=0.035). GPx was correlated not only with the lactate level but also with birth weight (r=0.205; p=0.000) and height (r=0.316; p=0.0056), while SOD was correlated only with the mother's blood glucose (r=0.161; p=0.046). In multivariate analysis, followed by stepwise analysis, lactate was the main variable associated with the Apgar score. It thus seems better able to replace the Apgar score than the antioxidant enzyme levels. GPx was higher in children of high birth weight and may make them better able to combat the free radicals due to anoxia or hypoxia.

[Plasma and erythrocyte membrane phospholipids in children with Plasmodium falciparum malaria: relation to blood parasite counts and lactate levels]. / Phospholipides plasmatiques et de la membrane érythrocytaire chez les enfants atteints de paludisme à Plasmodium falciparum.

BACKGROUND: Plasmodium falciparum infection modifies the distribution of phospholipids on both sides of the erythrocyte-plasma membrane. We sought to understand the action of the parasite on both plasma and membrane phospholipids and their relation to parasite counts in the blood. PATIENTS AND METHODS: We conducted this study from 1 February through 30 June 2007 in the Malaria Clinical Research Unit of the Libreville General Hospital Centre, measuring phospholipids in plasma and erythrocyte membranes of children affected by P. falciparum malaria and assessing their relation to blood parasites, lactates and hemoglobin. RESULTS: The study included 60 children. The mean blood parasite count was 1.07 x 105 per ml. Mean plasma phospholipids were 2.6+/-0.9 mmol/l and lactates 4.7+/-3.7 mmol/l. At the membrane level, we found 2.8+/-1.2 mmol/l of phospholipids per 106 red blood cells. Phospholipids in these two compartments were positively correlated with one another (r=0.392; p=0.023). Plasma phospholipids were also correlated positively with hemoglobin (r=0.36; p=0.032) and negatively with the number of parasites (r=0.442; p=0.002). The latter, in turn, was positively correlated with lactates (r=0.527; p=0.022) and negatively with membrane phospholipids (r=0.542; p=0.006). The mean hemoglobin level (8.9 g/dl) suggests permanent blood loss in these children, although they may be considered new malaria patients. The relations revealed here between membrane phospholipids, blood parasite counts, and lactate levels are due to the increased energy needs of erythrocytes, but also to the need to synthesize substances intended for cellular defense. P. falciparum thus leads to a decrease in plasma phospholipids, which could be estimated and correlated with blood parasites in a study with a wider range of parasite counts.

[Vitamin A in Gabonese children not receiving supplements: relation to ocular and nutritional diseases]. / Vitamine A chez les enfants gabonais non supplémentés : relation avec les pathologies oculaires et nutritionnelles.

To define vitamin A status in Gabonese children before the supplementation campaigns by UNICEF and the Gabonese Ministry of Health. We conducted an epidemiological, clinical and laboratory study at two of the main child health centers of Libreville and included 150 children aged from 0 to 156 months. We assessed their nutritional and ophthalmological status, their consumption of food rich in vitamin A and their blood levels of vitamin A (retinol). The latter was below the normal level (0.76 mmol/l) for 70% of the children. We observed the following eye diseases correlated with retinol levels: nyctalopia (16%), conjunctiva xerosis (6.7%), Bitot's spots (1.3%), corneal xerosis (3.3%), leukoma (0.7%) and blindness (1.3%). Moreover, 48.7% of the children had delayed growth, positively correlated with low retinol concentrations (0.643 mmol/l), 10% kwashiorkor and 19.9% marasmus. Among the mothers interviewed, 56% were unemployed and 69.3% knew little about vitamin A-rich food, which indeed is a rare part of the population's diet. This prospective study showed that the vitamin A deficiency is a major public health problem in Libreville. Supplementation campaigns are certainly necessary to fight it, but also and especially improved nutrition, including regular consumption of the vitamin A-rich food available in Gabonese market places.