Spatio-Temporal Determinants of Dengue Epidemics in the Central Region of Burkina Faso.

The aim of this study was to analyze the spatio-temporal distribution and determinants of the 2017 dengue epidemic in Burkina Faso. A principal component analysis of meteorological and environmental factors was performed to reduce dimensions and avoid collinearities. An initial generalized additive model assessed the impact of the components derived from this analysis on dengue incidence. Dengue incidence increased mainly with relative humidity, precipitation, normalized difference vegetation index and minimum temperature with an 8-week lag. A Kulldoff Satscan scan was used to identify high-risk dengue clusters, and a second generalized additive model assessed the risk of a health area being at high risk according to land-use factors. The spatio-temporal distribution of dengue fever was heterogeneous and strongly correlated with meteorological factors. The rural communes of Sabaa and Koubri were the areas most at risk. This study provides useful information for planning targeted dengue control strategies in Burkina Faso.

Covalent Labeling with Diethylpyrocarbonate for Studying Protein Higher-Order Structure by Mass Spectrometry.

Characterizing a protein's higher-order structure is essential for understanding its function. Mass spectrometry (MS) has emerged as a powerful tool for this purpose, especially for protein systems that are difficult to study by traditional methods. To study a protein's structure by MS, specific chemical reactions are performed in solution that encode a protein's structural information into its mass. One particularly effective approach is to use reagents that covalently modify solvent accessible amino acid side chains. These reactions lead to mass increases that can be localized with residue-level resolution when combined with proteolytic digestion and tandem mass spectrometry. Here, we describe the protocols associated with use of diethylpyrocarbonate (DEPC) as a covalent labeling reagent together with MS detection. DEPC is a highly electrophilic molecule capable of labeling up to 30% of the residues in the average protein, thereby providing excellent structural resolution. DEPC has been successfully used together with MS to obtain structural information for small single-domain proteins, such as ß2-microglobulin, to large multi-domain proteins, such as monoclonal antibodies.

Measuring the Energy Barrier of the Structural Change That Initiates Amyloid Formation.

Obtaining kinetic and thermodynamic information for protein amyloid formation can yield new insight into the mechanistic details of this biomedically important process. The kinetics of the structural change that initiates the amyloid pathway, however, has been challenging to access for any amyloid protein system. Here, using the protein ß-2-microglobulin (ß2m) as a model, we measure the kinetics and energy barrier associated with an initial amyloidogenic structural change. Using covalent labeling and mass spectrometry, we measure the decrease in solvent accessibility of one of ß2m's Trp residues, which is buried during the initial structural change, as a way to probe the kinetics of this structural change at different temperatures and under different amyloid forming conditions. Our results provide the first-ever measure of the activation barrier for a structural change that initiates the amyloid formation pathway. The results also yield new mechanistic insight into ß2m's amyloidogenic structural change, especially the role of Pro32 isomerization in this reaction.

Correction: The use of ion-selective membranes to study cation transport in hybrid organic-inorganic perovskites.

Correction for 'The use of ion-selective membranes to study cation transport in hybrid organic-inorganic perovskites' by Emily C. Smith et al., Phys. Chem. Chem. Phys., 2019, 21, 20720-20726.

The use of ion-selective membranes to study cation transport in hybrid organic-inorganic perovskites.

Using a methylammonium selective membrane in conjunction with electrochemical impedance spectroscopy, we measured ion migration in methylammonium lead triiodide (MAPbI3) with a millisecond (ms) time constant under illumination. These values were consistent with the reported values of ionic conduction in thin-film perovskite solar cells. We monitored an electrochemical impedance response arising from ionic conductivity through MAPbI3 and a methylammonium selective layer. We could fit this complex impedance response to an intuitive circuit model, which revealed an ionic species moving on a ms time scale. Electrospray ionization mass spectrometry (ESI-MS) revealed direct chemical evidence of methylammonium diffusion into the ion-selective layer. We found no experimental evidence indicating the mobility of lead ions or protons, suggesting that the mobile species observed under illumination is likely methylammonium.

Recovery of brain function after cardiac arrest, case report and review.

Cerebral hypoxia during cardiac arrest is the leading cause of mortality and morbidity in survival victims. To reduce cerebral damage, studies focus on finding effective treatments during the resuscitation period. Our report focuses on a 36-year-old police officer who had had two cardiac arrests (one at home and one at the hospital). After acute treatment, his cardiac and brain functions recovered impressively. Neuropsychological results were normal except for mild anomia. He also reported some retrograde memory loss. Surprisingly, he also reported an improvement in a very specific capacity, his episodic memory. We here review the possible causes and mechanisms that may have affected his memory abilities.

[Pseudoxanthoma elasticum beyond skin, eyes and vessels]. / Le pseudoxanthome elastique au-delà de la peau, de l'oeil et des vaisseaux.

The main clinical manifestations of pseudoxanthoma elasticum (PXE) alter small arteries, the eyes and the skin. At the microanatomical level, the feature in common is an alteration of the elastic fibres that appear dystrophic and in part calcified. The disease is genetically transmitted as an autosomal recessive trait. The gene coding for the MRP6 protein is often mutated. Thus PXE appears as a metabolic disease conveyed by serum.

[Post-thermal burn bullous pemphigoid]. / Le cas clinique du mois. Pemphigoïde bulleuse après brûlure thermique.

In rare instances, some injuring physical factors such as thermal burns can be at the origin of bullous pemphigoid lesions. The early lesions are most often restricted to the injured skin area. Secondary generalization is the natural evolution to be expected. However, once the episode is resolved, recurrence is exceptional. When the natural history of bullous pemphigoid differs from the regular type, the peculiar condition of development of these lesions does not change any of the diagnostic clinical and histological criteria, as well as the therapeutic procedures to follow.

[Cutaneous manifestations of parvovirus B19 infection]. / Manifestations cutanées de l'infection par le parvovirus B19.

The human parvovirus B19 is a small single-strand DNA virus with specific tropism for the membranous receptor P expressed on erythrocytes and endothelial cells. About 60 - 70 % of the adult population is parvovirus B19 seropositive. The contamination usually occurs through droplets from the nasopharyngeal airways. The major systemic infections present as episodes of aplastic anemia and development of hydrops fetalis. Arthropathies, encephalitis, or glomerulonephritis are less frequently encountered. This review focuses on its cutaneous manifestations including erythema infectiosum, and the purpuric syndromes whose principal manifestation is the papulo-purpuric gloves and socks syndrome. Several other cutaneous manifestations have been reported to be associated with the parvovirus B19 without however strong evidence. These include vasculitis, erythema nodosum, the lupus eythematosus-like syndrome, some vesiculo-pustular eruptions, pityriasis lichenoides and scleroderma.

[Arsenical poisoning: how and why to diagnose it]. / Les intoxications arsénicales: comment et pourquoi les diagnostiquer.

Arsenic is an ubiquitary element which has been widely used for centuries in different fields such as medicine, agriculture or industry. Acute or chronic exposure to As can lead to various dermatological and systemic disorders with a possibe latency over decades. The dermatological signs of As intoxication are important to detect since one of the potential complications is carcinoma.

[Paroxysmal iatrogenic acne and the epidermal growth factor receptor inhibitors (EGFR)]. / Acné iatrogène paroxystique et les inhibiteurs du récepteur du facteur de croissance épidermique (EGFR).

Paroxysmal drug-induced acne is a peculiar condition recognized for decades in dermatology. It can be induced by a variety of drugs. In recent years, the epidermal growth factor receptor inhibitors used in oncology have shown this type of adverse effects. The pathogenic mechanism is likely related to the EGF implication in the rupture of the microcomedo wall resulting in the perifollicular inflammatory reaction typical for acne. Other cutaneous adverse effects have been reported with anti-EGFR drugs including paronychia and xerosis. The dermatological treatments of these drug-induced disorders must be adequately targeted.

[Cutaneous cancers after organ transplantation]. / Cancers cutanés après transplantation d'organe, un revers de médaille.

Drug-induced immunosuppression is the necessary corollary of organ transplantation. This situation is responsible for an increased risk of both infection and neoplasia. Cutaneous carcinomas are the most frequent malignancies developing after organ transplantation. The usual squamous to basal cell carcinoma ratio is increased and reversed compared to the general population. Carcinomas primarily result from the combination of cumulative sun exposure, fair skin phototype and effects of immunosuppressive drugs. These treatments impair the systemic immunosurveillance and may exert a direct carcinogenic effect. The severity of these carcinomas is due to their multiplicity and to the occurrence of more aggressive lesions. Prevention relies on a strict adherence to sun protection after transplantation, and on refined immunosuppressive strategies. The treatment of the neoplastic lesions is based on their early and complete excision with histological control of the nature of the neoplasm, the safety surgical margins, and the determination of prognostic factors.

[How I explore...cheilitis]. / Comment j'explore...une chéilite.

A cheilitis is an inflammatory disease confined to the lips. Several origins are recognized. Their nature is often different in children and adults. Some are spongiotic due to irritation or allergic reaction. Other lesions are keratotic and can evolve to leucoplasia and epidermoid carcinoma.

The anti-inflammatory effect of inhaled nitric oxide on pulmonary inflammation in a swine model.

Cardiopulmonary bypass (CPB) is associated with an inflammatory process that leads to lung injury. In this study, we hypothesized that inhaled nitric oxide (INO) possesses the ability to modulate CPB-induced inflammation. Fifteen male pigs were randomly divided into 3 groups: Sham, CPB+LPS (CPB and lipopolysaccharide), and CPB+LPS+INO. INO (20 parts per million) was administered for 24 h after anesthesia. CPB was performed for 90 min, and LPS was infused (1 microg/kg) after CPB. Bronchoalveolar lavage (BAL) fluid and blood were collected at T0 (before CPB), at 4 h, and at 24 h. At 24 h, BAL interleukin-8 (IL-8) levels were not increased as expected in the CPB+LPS group compared with the Sham group, but they were reduced significantly in the CPB+LPS+INO group. Cell hypo reactivity observed in the groups receiving LPS also seemed to downregulate endothelial nitric oxide synthase NOS protein expression relative to the Sham group. Nitrite and nitrate (NOx) concentrations were decreased significantly in the groups without INO. Moreover, animals treated with INO showed higher rates of pulmonary apoptosis compared with their respective controls. These results demonstrate that NOx production is reduced after CPB and that INO acts on the inflammatory process by diminishing neutrophils and their major chemoattractant, IL-8. INO also increases cell apoptosis in the lungs under inflammatory conditions, which may explain, in part, how it resolves pulmonary inflammation.

[Perforation of the nasal septum in cocaine abusers]. / Perforation de la cloison nasale dans un contexte d'inhalation de cocaïne.

Cocaine has been used for centuries for its stimulating and euphoric effects, but it also possesses vasoconstrictive and thrombotic properties. The cocaine-induced lesions depend mainly on the method of administration. In the present case, in which cocaine was nasally inhaled, the perforation of the cartilaginous nasal septum propably result from a combination of factors, including the topical effects and the complications linked to the use of the drug. This clinical observation corresponds to a high level of the progressive nasal pathology associated with cocaine abuse.

Treatment of pulmonary hypertension during surgery with nitric oxide and vasodilators.

PURPOSE: To describe the effects of the combination of several therapies on the pulmonary circulation and cardiac function in a patient with severe pulmonary hypertension. CLINICAL FEATURES: We report the case of a female patient with chronic secondary pulmonary hypertension and cardiac failure who underwent right hemicolectomy under general anesthesia. Insertion of a pulmonary artery catheter before the operation revealed pulmonary artery pressure (PAP) of 55/24 mm Hg which was lowered moderately by 40 parts per million (ppm) inhNO. During surgery, the patient presented an episode of atrial fibrillation with a slow, irregular heart rate of 45-50 min(-1) and variable systemic pressure. A dipyridamole DPD (0.2 mg x kg(-1)) bolus stabilized systemic pressure and increased heart rate and cardiac output. However, PAP did not change. Nitroglycerine infusion was started at 10 mg x hr(-1) shortly after the initiation of DPD. The patient responded favourably to combined inhNO, intravenous DPD and NTG therapy with a marked and sustained reduction of PAP and a systemic hemodynamic stability. CONCLUSION: We conclude that: 1) in combination with inhNO, DPD does not augment the inhNO-induced decrease in PAP; 2) DPD improves the hemodynamic profile and elevates cardiac output; 3) therapeutic combination (inhaled NO, NTG, DPD) has a potent effect on pulmonary pressure in cardiac failure patients.

Nitric oxide inhalation in the treatment of primary graft failure following heart transplantation.

BACKGROUND: Primary graft failure from right or left ventricular insufficiency remains a serious cause of early death following heart transplantation. Inhaled nitric oxide (NO) is a potent pulmonary vasodilator that could decrease pulmonary pressure and improve right ventricular function. METHODS: Two cases of early graft failure following orthotopic heart transplantation were treated with NO inhalation. The treatment consisted of inhalation of 20 ppm of NO, introduced 4 to 6 hours following transplantation, in 2 patients supported with high doses of inotropic agents and vasopressors in addition to the intra-aortic balloon pump. RESULTS: In the first and second cases, NO inhalation resulted in a decrease in pulmonary artery pressure, in a decrease in pulmonary vascular resistance and in an increase in cardiac index. In the second patient, systemic oxygenation improved markedly 30 minutes after initiation of NO. In the 2 patients, NO inhalation, mechanical ventilation and the intra-aortic balloon pump were weaned 4 days following transplantation. CONCLUSION: Primary graft failure from donor ischemic damage, reperfusion injury or pulmonary hypertension remains a serious complication. The use of an intra-aortic balloon pump, inotropic agents and of inhaled NO appears to offer the best support for recovery of donor heart function. Primary graft failure from right or left ventricular insufficiency remains a serious cause of early mortality following heart transplantation. Ischemic damage of donor heart, reperfusion injury or pulmonary hypertension are the main causes of early graft failure. Although the cause is multifactorial, treatment of primary organ failure remains difficult with dismal results. The objective of the present study was to review the result of 2 patients with donor right heart failure following heart transplantation treated with inhaled nitric oxide (NO).