ABSTRACT
Nasopharyngeal teratomas are rare tumours, responsible for a high birth mortality rate from acute respiratory distress. Palatine localization can lead to an embryopathogenic mechanical obstacle responsible for a cleft palate. The aim of this study was to update current knowledge concerning the management of this rare pathological association. We conducted a multicentre, retrospective study by case analysis. The inclusion criteria were patients of any age under care for a nasopharyngeal teratoma associated with a velopalatine cleft. The diagnosis of the teratoma was confirmed by histological analysis. Seven cases were included in the study: three cases from the University Hospital of Lille, one from the University Hospital of Caen, one from of the University Hospital of Toulouse, and two from of the University Hospital of Amiens. Approximately 30% of patients experienced acute respiratory distress at birth, necessitating oro- or nasotracheal intubation. The surgical excision was performed in the first 5 months of life for all patients and in a single operative time for 70%. There was no recurrence. Therapeutic management of nasopharyngeal teratomas associated with cleft palate at birth is multidisciplinary and is based on surgical excision. In the absence of other associated pathologies, the prognosis is favourable.
Subject(s)
Cleft Palate/complications , Nasopharyngeal Neoplasms/diagnostic imaging , Nasopharyngeal Neoplasms/surgery , Teratoma/diagnostic imaging , Teratoma/pathology , Teratoma/surgery , Female , Humans , Infant, Newborn , Magnetic Resonance Imaging/methods , Male , Respiratory Distress Syndrome , Retrospective Studies , Tomography, X-Ray Computed/methods , Treatment Outcome , Ultrasonography, Prenatal/methodsABSTRACT
UNLABELLED: In the labial palliative surgery of facial paralysis, it can persist asymmetry smile. OBJECTIVE: Evaluate the impact of an augmentation or reduction of the commissural course on the perception of a smile anomaly, and determine from which asymmetry threshold, the smile is estimated unsightly. MATERIAL AND METHOD: We took a picture of two people with a smile not forced; including one with a "cuspid smile", and the another one with a "Mona Lisa" smile. The pictures obtained were modified by the Photoshop software, to simulate an asymmetry labial smile. The changes were related to the move of the left labial commissure, the left nasolabial furrow, and the left cheek using under-correction and overcorrection, every 4 mm. Three pictures with under-correction and four pictures with over-correction were obtained. These smiles were shown to three groups of five people, which included doctors in smile specialties, doctors in other specialties, and non-doctors. Participants were then asked to indicate on which of the pictures, the smile seemed abnormal. RESULTS: Between -8 mm under-correction, and +8 mm over-correction, the asymmetry of the commissural course does not hinder the perception of smile. CONCLUSION: In the labial palliative surgery of facial paralysis, in the case of persistent asymmetry, there is a tolerance in the perception of "normality" of smile concerning the amplitude of the commissural course going up to 8 mm of asymmetric with under-correction or over-correction.
Subject(s)
Facial Paralysis/physiopathology , Photography , Smiling/physiology , Software , Facial Paralysis/surgery , Humans , Plastic Surgery ProceduresABSTRACT
L'etude; qui a recu le soutien de la Direction du Developpement et de la Cooperation de la Confederation Helvetique dans le cadre du Programme d'Appui Socio-Sanitaire Mali Suisse; s'est deroulee de fevrier a mars 2004. Le but etait d'evaluer l'impact d'un atelier de formation des prescripteurs sur les Medicaments Traditionnels Ameliores (MTA); realise en octobre 2001; sur la consommation des MTA dans les structures sanitaires du District de Kadiolo. L'etude a demande la collecte des donnees de consommation; a partir des fiches de stock des annees 2001; 2002 et 2003 du Depot Repartiteur du Centre de Sante de Reference et des Depots de Vente des Centres de Sante Communautaires. Pour evaluer l'appreciation des MTA; des enquetes ont ete menees aupres des prescripteurs et des utilisateurs. La consommation totale des MTA dans le CSRef et dans les 16 CSCom du Cercle a connu une augmentation progressive; en passant de 2.565.480 F CFA en 2001 a 4.307.760 F CFA en 2003. La consommation des MTA pendant l'annee 2003 a ete de 27;83 F CFA par habitant. Les MTA ont ete en general bien apprecies par les prescripteurs et par les consommateurs. Les differentes projections des donnees de consommation relevees a Kadiolo nous ont permis d'estimer le marche potentiel des MTA actuellement disponibles au Mali a une valeur comprise entre 414 et 560 millions de F CFA
Subject(s)
Consumer Behavior , Medicine, Traditional , Plants, MedicinalABSTRACT
Rapid diagnostic tests (RDT) are sometimes recommended to improve the home-based management of malaria. The accuracy of an RDT for the detection of clinical malaria and the presence of malarial parasites has recently been evaluated in a high-transmission area of southern Mali. During the same study, the cost-effectiveness of a 'test-and-treat' strategy for the home-based management of malaria (based on an artemisinin-combination therapy) was compared with that of a 'treat-all' strategy. Overall, 301 patients, of all ages, each of whom had been considered a presumptive case of uncomplicated malaria by a village healthworker, were checked with a commercial RDT (Paracheck-Pf). The sensitivity, specificity, and positive and negative predictive values of this test, compared with the results of microscopy and two different definitions of clinical malaria, were then determined. The RDT was found to be 82.9% sensitive (with a 95% confidence interval of 78.0%-87.1%) and 78.9% (63.9%-89.7%) specific compared with the detection of parasites by microscopy. In the detection of clinical malaria, it was 95.2% (91.3%-97.6%) sensitive and 57.4% (48.2%-66.2%) specific compared with a general practitioner's diagnosis of the disease, and 100.0% (94.5%-100.0%) sensitive but only 30.2% (24.8%-36.2%) specific when compared against the fulfillment of the World Health Organization's (2003) research criteria for uncomplicated malaria. Among children aged 0-5 years, the cost of the 'test-and-treat' strategy, per episode, was about twice that of the 'treat-all' (U.S.$1.0. v. U.S.$0.5). In older subjects, however, the two strategies were equally costly (approximately U.S.$2/episode). In conclusion, for children aged 0-5 years in a high-transmission area of sub-Saharan Africa, use of the RDT was not cost-effective compared with the presumptive treatment of malaria with an ACT. In older patients, use of the RDT did not reduce costs. The question remains whether either of the strategies investigated can be made affordable for the affected population.
Subject(s)
Malaria/diagnosis , Reagent Kits, Diagnostic/standards , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Animals , Child , Child, Preschool , Humans , Infant , Mali , Middle Aged , Plasmodium/isolation & purification , Predictive Value of Tests , Rural Health , Sensitivity and Specificity , Young AdultABSTRACT
Les auteurs de cet article presentent les resultats d'un essai clinique de type II d'une preparation galenique a base de poudre d'ecorce de tige de Pleleopsis suberosa; utilisee par les therapeutes traditionnels maliens dans le traitement des epigastralgies. Vingt Trois (23) malades ont participe a l'etude; selectionnes apres un examen fibroscopique confirmant le diagnostic d'ulcere gastroduodenal. Treize (13) des malades soit 56;52 pour cent ont completement cicatrise au bout de 30 jours de traitement. Le produit semble agir egalement sur les anorexies; les nausees et les vomissements. Le seul effet secondaire note semble etre la constipation
