[Effects of Covid-19 Pandemic on the Vaccine Activities on a Reference Immunization Center in Treichville, Côte D'ivoire]. / Effets de la Pandémie à Covid-19 sur les Activités Vaccinales D'un Centre de Vaccination de Référence de Treichville en Côte D'ivoire.

Introduction: Since March 11, 2020, Côte d'Ivoire has been affected by the coronavirus epidemic, declared that same day as pandemic by WHO. March 11, 2021, one year after the pandemic, Côte d'Ivoire has notified 36,824 cases of Covid-19 patients and among them 211 have died. As of May 31, 2020, Côte d'Ivoire had already notified 2,833 cases and 33 deaths. At that time, false rumors were circulating in Africa about the setting up of clinical trials on candidate vaccines. The impact of these rumors on the overall use of health services had to be measured and in particular on vaccination centers. Objectives: The objective of this study was to determine the effects of the pandemic on the activities of the immunization services of the National Institute of Public Hygiene in Abidjan, which comprises four departments: International Vaccination Center, Community Vaccination Service, Rabies Center, and Vaccination Unit of the Expanded Program on Immunization. The study was based on activity reports of the immunization services. Results: At the International Vaccination Center, activities fell by about 50% in March, 86% in April and 82% in May in comparison with 2018 and 2019. Activities of Community Vaccination Service decreased by about 26% in March and 99% in April and May. At the Rabies Control Center, this reduction was estimated at 38% in April and 45% in May. The highest losses were for yellow fever and meningitis vaccines. Conclusion: The drop in attendance at vaccination services could increase the risk of epidemics, especially yellow fever, which are recurrent in Abidjan. Intensive awareness and catch-up actions should be carried out and further studies performed to assess the impact of the pandemic on immunization activities.

Absceso frío tuberculoso de pared torácica. A propósito de un caso / Cold tuberculous abscess of thoracic wall. A case report

Mujer de 62 años con leucemia linfática crónica que acude a consultas de cirugía torácica por aparición de una masa en la pared anterior izquierda del tórax de unos diez días de evolución, con leve dolor local. No asocia otra clínica. A la exploración se palpa una masa en pared anterior izquierda, de unos 10-12 cm de diámetro, adherido a planos profundos, de consistencia dura y no rodadera. En la ecografía se objetiva una solución de continuidad de partes blandas que coincide con la tumoración. La tomografía computarizada (TC) de tórax muestra engrosamiento pleural izquierdo con extensión extratorácica hacia la mama homolateral y derrame pericárdico. Ante la sospecha de recaída de su enfermedad se realiza PAAF (punción aspiración con aguja fina), que resulta inespecífica, por lo que se decide biopsia quirúrgica. Durante la intervención quirúrgica se biopsia la masa y se aprecia drenaje espontáneo de material purulento. Se toman cultivos, en los cuales se observan BAAR (bacilos ácido-alcohol resistentes), tratándose de un absceso frío tuberculoso

A 62-year-old woman with chronic lymphatic leukemia who attended consultations for thoracic surgery due to the appearance of mass in the left anterior wall with slight local pain about ten days ago. She does not refer other symptoms. On examination, a mass is palpable in the left anterior wall adhered to deep layers, of about 10-12 cm in diameter, of hard consistency and not rolling. On ultrasound, a soft tissue continuity solution was found that coincides with the tumor. The chest computerized tomography scan (CT) shows left pleural thickening with extrathoracic extension towards homolateral breast and pericardial effusion. FNAP (fine-needle aspiration) is performed if there is a suspicion of relapse of the disease, which is nonspecific, so it is decided to perform surgical biopsy. During the surgical procedure, biopsy of the mass is performed and spontaneous drainage of purulent material is observed. Cultures are taken. Acid-fast bacilli are found in the cultures, as in the case of a cold tuberculous abscess

Traqueobroncopatía osteocodroplástica. Causa de hemoptisis en paciente joven / Osteocodroplastic tracheobroncopathy. Cause of hemoptisis in a young patient

Describimos el caso de un varón de raza caucásica de 42 años que acude a Urgencias por hemoptisis sin repercusión hemodinámica. El paciente no refiere ningún antecedente de interés. Se le realiza angio-tomografía computarizada (angioTC) , la cual descarta tromboembolismo pulmonar y punto de sangrado activo. El paciente es ingresado para completar estudio y vigilancia. Se descartan causas infecciosas y vasculares de la hemoptisis, por lo que tras un nuevo episodio de hemoptisis se decide trasladar a la UCI. Tras dos fibrobroncoscopias, donde se aprecia una mucosa en empedrado del árbol traqueobronquial y tras la toma de biopsias, se concluye que el diagnóstico es compatible con traqueobroncopatía osteocondroplástica

We describe the case of a 42-year-old caucasian male who went to the Emergency room for hemoptysis without hemodynamic repercussion. The patient does not refer any antecedent of interest. Angio-computerized tomography (angioCT) is performed, which rules out pulmonary thromboembolism and active bleeding point. The patient is admitted to complete study and surveillance. Infectious and vascular causes of hemoptysis are ruled out, so after a new episode of hemoptisis, it is decided to move to the ICU. After two fibrobronchoscopies, showing a cobblestone mucosa of the tracheobronchial tree and after taking biopsies, it is concluded that the diagnosis is compatible with osteochondroplastic tracheobronchopathy

[Correlation of the manifestations of tuberculosis and the degree of immunosuppression in patients with HIV]. / Corrélations des manifestations de la tuberculose pulmonaire avec le degré d'immunodépression au VIH.

CONTEXT: Correlation of the manifestations of tuberculosis and the degree of immunosuppression in patients with HIV. BACKGROUND: The advent of HIV has contributed to the increase in the number of people with tuberculosis. The clinical and paraclinical of TB/HIV co-infected are polymorphic and function of immune status. OBJECTIVES: To determines the clinical and paraclinical characteristics of TB related to different levels of CD4 lymphocytes. METHODOLOGY: A retrospective case series based on analysis of 450 patients with both TB/HIV co-infections. It focused on the records of patients with pulmonary smear-positive (TPM +) with a positive HIV status. The effect of immunosuppression was analyzed in groups based on the CD4 count (<200/mm(3), of 200-350/mm(3) and>350/mm(3)), in a chronological fashion from April to September 2010 until there were 150 patients in each CD4 group. RESULTS: Among the 450 patients, 71.1% were between 25 and 45years old. The clinical signs were more significant as the level of CD4 fell. The clinical signs were predominantly fever (93%) and weight loss (62.7%). Pulmonary cavitation (59.3%), infiltrates (38.7%) and the location of the lesions at the lung apex (72%) were more common in the third group patients. By contrast, extra pulmonary lesions (mediastinal lymphadenopathy, pleurisy) and normal x-ray (9.3%) were more frequent in patients of the first group. The scarcity of cavitations (22.3% compared to 59.3% CD4>350) and the increase in associated lesions became more marked if patients were immunocompromised. Hematologic, hepatic, renal disorders were more frequent and severe in the most immunocompromised patient group. CONCLUSION: HIV-associated tuberculosis has an atypical clinical, radiological, biological presentation and is more severe when there is significant immunosuppression.

[Clinical manifestations related to kitchen biomass smoke in African women]. / Manifestations cliniques liées à la fumée de cuisine chez les femmes en milieu africain.

CONTEXT: Fires of wood and charcoal play an essential part in the cooking of food in Africa. These fires emit thick smoke that has definite health consequences. OBJECTIVES: To determine the clinical manifestations related to kitchen smoke and to identify the type of fire most often incriminated. METHODS: It was a transverse study comparing the clinical features in women using three types of fire: wood, charcoal and gas. We questioned 200 women in each group who used one type of fire exclusively for five days a week for at least five years. RESULTS: Clinical manifestations associated with the smoke were reported in all the women using wood as opposed to 98.5% using charcoal and 45.5% using gas. More than 80% had physical signs. These comprised 89.1% upper respiratory and 77% pulmonary signs. Upper respiratory signs were the most common, mainly sneezing and nasal obstruction. At the pulmonary level, a predominance of signs was found in women using wood fires (47.3%) and charcoal (36.2%), the difference being statistically significant. The signs included chronic cough, chest pain and dyspnoea. Wheezes were found in 15% of the women. CONCLUSION: Cooking smoke exposes women to complications which are most frequently associated with the use of wood or charcoal.

Effects of levulinic acid on 5-aminolevulinic acid production in heterotrophic cultures of Chlorella regularis YA-603.

To investigate the effects of levulinic acid (LA) on extracellular 5-aminolevulinic acid (ALA) accumulation, a heterotrophic culture of Chlorella regularis YA-603 in basal medium containing 0 to 60 mM of LA was carried out. It was found that the extracellular and total ALA concentrations increased, while the chlorophyll (CHL) concentration was the same above initial LA concentrations of 30 mM, with an increasing initial LA concentration up to 50 mM. In the presence of an initial LA concentration of 60 mM, however, the specific growth rate decreased markedly. This suggested that excessive LA exerted a negative effect on ALA production because it also directly affected cellular growth. The relationship between the initial LA and total ALA concentrations mentioned above indicates that LA could promote the ALA-producing activity. Kinetic analysis revealed that an LA concentration of between 30 to 50 mM in the culture broth gave the maximum specific production rate of ALA ((q(ALA))max). When LA was added repeatedly to maintain this optimum range of LA concentration, (q(ALA))max could be maintained at a relatively high level for a longer period, and the maximum concentration of ALA reached 3.86 mM.

Effect of glycine on 5-aminolevulinic acid biosynthesis in heterotrophic culture of Chlorella regularis YA-603.

Chlorella regularis strain YA-603 was previously found to exhibit a comparatively high growth rate and improved 5-aminolevulinic acid (ALA) productivity when cultured heterotrophically. Although the universal tetrapyrrole precursor ALA is synthesized from glutamate in algae and higher plants, in this study the addition of glutamate to the medium did not enhance ALA production in the heterotrophic culture of C. regularis YA-603. On the other hand, the addition of glycine, which is a precursor of ALA biosynthesis via the Shemin pathway in animal cells and some bacteria, enhanced both the specific growth rate and ALA production. Moreover, when a second glycine addition was made during the culture, the ALA concentration increased by about 1.5 times compared to that obtained with one glycine addition. From these results, it is suggested that the Shemin pathway contributes to ALA production, and that addition of glycine in the heterotrophic culture of C. regularis YA-603 can significantly increase the amount of ALA produced.