Poly sensibilisation dans le cadre d'un eczéma de contact des mains chez une aide-ménagère dans le nord du Bénin / Poly sensitization in the context of hand contact eczema in a household helper in northern Benin

L'eczéma des mains est fréquent. Son étiologie est souvent multifactorielle comprenant les facteurs environnementaux et des facteurs individuels prédisposants. Il pose des problèmes de diagnostic étiologique en particulier dans un contexte de poly sensibilisation. Observation Il s'est agi d'une employée de maison âgée de 17 ans sans antécédents allergiques connus. Elle a développé un eczéma bilatéral des mains six mois après embauche. Le patch test avec la batterie standard européenne a montré une poly sensibilisation à plusieurs allergènes contenus dans les détergents et désinfectants. Le patch test aux gants est revenu négatif mais n'exclut pas son implication dans la survenue des lésions devant le caractère bilatéral et symétrique des lésions. Une réorientation professionnelle a été proposée devant le jeune âge de la travailleuse Conclusion La connaissance des allergènes en cause au cours d'un eczéma est un atout pour une meilleure prise en charge du patient mais leur identification n'est pas toujours aisée. La réorientation professionnelle lorsqu'elle est possible assure la guérison.

Introduction: Hand eczema is common. Its etiology is often multifactorial, including environmental factors and individual predisposing factors. It poses problems of etiological diagnosis, particularly in the context of poly sensitization. Observation: This case involved a 17-year-old domestic worker with no known allergic history. She developed bilateral hand eczema six months after hiring. The patch test with the standard European battery showed poly-sensitization to several allergens contained in detergents and disinfectants. The glove patch test came back negative, but did not rule out its involvement in the lesions, given the bilateral and symmetrical nature of the lesions. In view of the young age of the worker, a vocational reorientation was carried out. Conclusion: Knowledge of the allergens involved in eczema is an asset for better patient management, but identifying them is not always easy. When possible, professional reorientation ensures recovery

[ATTITUDES AND PRACTICES OF HEALTH PROFESSIONALS REGARDING BLOOD EXPOSURE ACCIDENTS (BSE) IN PARAKOU IN 2022]. / Attitude et Pratique des Professionnels de la santé sur les Accidents d'Exposition au Sang (AES) à Parakou en 2022.

Introduction: Les professionnels de la santé sont souvent victimes d'AES au cours des activités de soin. Objectif: Étudier les attitudes et pratiques des soignants sur les AES dans la commune de Parakou en 2022. Méthodes: Il s'est agi d'une étude transversale descriptive à visée analytique avec recueil prospectif des données réalisée du 1eravril au 30 juin 2022. Étaient inclus dans l'étude, les professionnels de la santé des établissements sanitaires publics et privés ainsi que les étudiants en médecine. Les données ont été saisies grâce au logiciel Epi-Data 3.1 puis apurées et vérifiées dans le logiciel STATA MP 14. Le seuil de significativité était de 0,05. Résultats: Au total 791 professionnels de la santé avaient participé à l'étude dont 465 (58,8 %) de travailleurs et 326 (41,2 %) étudiants. L'âge moyen était de 32,2 ans ± 8,9 avec des extrêmes de 19 ans et 62 ans. Il y avait plus de femmes 60,4 % pour 39,6 % d'hommes, la sex-ratio étant de 0,7. La prévalence des AES du personnel soignant était de 116 (25 %) et celle des étudiants de 79 (24,2 %) (p=0,819). La piqûre était la principale cause d'AES (79,3 %) du personnel soignant et (72,2 %) des étudiants. Les gestes incriminés étaient les injections (98,7 %), les prélèvements sanguins (40,5 %) et le recapuchonnage d'aiguille (25,3 %). Pour la prise en charge, le rinçage à l'eau (54,3 %), le lavage au savon (50,9 %) et la désinfection à l'eau de javel (48,3 %) étaient les principaux gestes adoptés. La déclaration d'AES avait été effective pour 50 (43,1 %) du personnel soignant et pour 22 (27,9 %) d'étudiants. Le patientsource était connu dans 80,0 % des cas. La catégorie professionnelle (p = 0,000), l'âge (p= 0,005) et le corps du personnel soignant (p = 0,008) étaient associés de façon significative à l'attitude et pratique sur les AES. Conclusion: Les AES constituent une menace réelle pour les professionnels de la santé. Une bonne attitude et pratique est gage d'une prise en charge adéquate.

Épidemiologie de l'obésité et profil lipidique chez les professionnels de la santé à Parakou (Bénin) en 2015

L'objectif de l'étude est de déterminer la prévalence de l'obésité et le profil lipidique chez le personnel administratif et soignant des hôpitaux de Parakou en 2015. Elle était descriptive transversale étalée sur deux mois. Les données ont été collectées sur la base d'un questionnaire, du calcul l'IMC, et de dosages des lipides sanguins. Le taux de participation était 63,33% et la sex-ratio à 0,86. La prévalence du surpoids était 31,82% et celle de l'obésité 22,42%. Le surpoids et l'obésité étaient surtout observés chez les femmes. La dyslipidémie globale est notée chez 151(45,76%) sujets. La prise de poids a été significativement associé au sexe (p=0,00). L'obésité est un problème de santé publique en milieu hospitalier à Parakou. Les femmes sont les plus à risque. Le taux de dyslipidémie déterminée n'est pas négligeable

Troubles musculosquelettiques chez les employés au tri de billets d'une l'agence camerounaise de la Banque des Etats de L'Afrique Centrale (BEAC) au Cameroun en 2016

Objectif : Certains secteurs d'activités, à l'instar du secteur bancaire peuvent sembler exempts de risque pour la santé des travailleurs. Nous avons effectué une étude en vue d'évaluer les troubles musculosquelettiques chez les trieuses dans l'agence de la Banque des États de l'Afrique Centrale à Nkongsamba (Cameroun). Méthode d'étude : Il s'agissait d'une étude transversale descriptive et analytique qui s'est déroulée sur quatre mois de Juin à Octobre 2016, portant sur les employés impliqués dans les activités de tri bancaire. La collecte des données est faite grâce à un questionnaire inspiré du questionnaire standard de l'INRS et une grille d'observation des opérations selon la checklist OSHA. Les données recueillies par le questionnaire ont été traitées par les logiciels Epi-info 7.2.0.1. Résultats : Tous les participants à l'étude sont de sexe féminin. La moyenne d'âge est 40,1 ans. La tranche d'âge 35-40 ans était prépondérante. L'ancienneté moyenne est de 10,4 ans ; avec des extrêmes de 2 ans et 30 ans. Elles sont à 90,6% droitières. La fréquence des troubles musculosquelettiques était 81,2%. Le siège prédominant était le bas du dos, suivi du poignet et du cou. Les moins de 35 ans n'éprouvaient de troubles musculosquelettiques. Les TMS croissaient avec l'ancienneté dans l'activité ; au-delà de 10 années dans l'activité, la présence de TMS est quasiconstante. Conclusion : Les TMS sont importants dans l'activité de tri de billets de banque. Des mesures relativement simples et facilement applicables sont à mettre en oeuvre pour y remédier

[Assessment of nurses' workload in a hospital in Benin]. / Evaluation de la charge de travail des infirmiers dans un hopital au Benin.

The importance of nursing work is well established in the treatment of patients. But the weakness of the nurse-patient ratio and lack of proper equipment create a workload for these nurses and can impact on the quality of care. The objective of this study was to assess the nursing workload during night shifts in a hospital in Benin. A prospective observational study of the work of nurses in the general medical service of this hospital was conducted. A comprehensive and systematic analysis of this work was done and resulted in the identification of the tasks performed, the analysis of postures and the evaluation of the average distance walked by nurses. Performing care tasks occupy more than one third of the working time and approximately 3 minutes were spent per tasks. The postures in static muscular work and standing / walking posture represent more than half of the working time. The brightness measured is about 110 Lux and nurses walked more than 2.5 km during their night shift. In conclusion, the nursing work combines several tasks that create a considerable workload. The improvement of the work conditions will decrease the workload and will contribute to better care for patients.

L'importance du travail infirmier n'est plus à démontrer dans la prise en charge des patients. Mais la faiblesse du ratio infirmier-patient et le manque de matériel adéquat créent une charge de travail à ces infirmiers et peut altérer la qualité des soins. L'objectif de ce travail a été d'évaluer la charge de travail infirmier au cours d'un travail de nuit dans un hôpital au Bénin. Une étude prospective observationnelle du travail des infirmiers dans le service de médecine générale de cet hôpital a été réalisée. Une analyse globale et systématisée de ce travail a permis de répertorier les différentes tâches réalisées, d'analyser les postures adoptées et d'évaluer la distance moyenne parcourue par les infirmiers. La réalisation des soins occupe plus du 1/3 du temps de travail et environ 3 minutes sont passées par tâches. Le travail musculaire statique et la posture debout/marche représentent plus de la moitié du temps de travail. L'éclairage mesuré est de 110 Lux et les infirmiers parcourent en moyenne plus de 2,5 Km. En conclusion le travail infirmier associe plusieurs tâches qui créent une certaine charge de travail dans un environnement physique peu éclairé. L'amélioration des conditions de travail contribuerait à une préservation de la santé des infirmiers et une meilleure qualité de soins.

The prevalence of byssinosis among cotton workers in the north of Benin.

BACKGROUND: Cotton is the main agricultural export product in Benin. Cotton dust is thus present in the air during the handling and processing of cotton. This dust contains a mixture of substances including ground up plant matter, fibres, bacteria, fungi, soil, pesticides, noncotton matter, and other contaminants. While cotton processing is decreasing in industrialized countries, it is increasing in developing countries. Cotton processing, particularly in the early processes of spinning, can cause byssinosis. OBJECTIVE: To determine the respiratory effects of cotton dust exposure among cotton mill workers in Benin. METHODS: In a cross-sectional study, 109 workers exposed to cotton dust and 107 unexposed workers were studied. The International Commission on Occupational Health (ICOH) questionnaire was used for data collection on respiratory symptoms. For each worker, crossshift pulmonary function was performed with a dry spirometer. Based on the severity of respiratory symptoms and spirometry byssinosis was defined and classified according to the criteria of Schilling, et al. RESULTS: The mean ± SD age of the exposed and unexposed workers was 46.3 ± 7.8 and 37.0 ± 8.3 years, respectively (p<0.001). The mean FEV1 predicted value for the exposed and unexposed workers was 76.3% and 77.3%, respectively. The prevalence of grade 3 byssinosis was 21.1% (95% CI: 13.4-28.9) in exposed workers and 8.4% (95% CI: 3.1-13.7) in unexposed workers (p=0.006). On Mondays, the exposed workers had more respiratory symptoms than unexposed workers; for grade 3 byssinosis, the prevalence was 13.8% in exposed and 4.7% in unexposed workers (p=0.011). CONCLUSION: The prevalence of respiratory symptoms and byssinosis among cotton mill workers in Benin is high and needs prompt attention of health care workers and policymakers.

Is bisphosphonate-related osteonecrosis of the jaw an infection? A histological and microbiological ten-year summary.

The role of infection in the etiology of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is poorly understood. Large-scale epidemiological descriptions of the histology and microbiology of BRONJ are not found in the literature. Herein, we present a systematic review of BRONJ histology and microbiology (including demographics, immunocompromised associations, clinical signs and symptoms, disease severity, antibiotic and surgical treatments, and recovery status) validating that infection should still be considered a prime component in the multifactorial disease.

Glial cells have heart: rH1 Na+ channel mRNA and protein in spinal cord astrocytes.

Astrocytes in vitro express several distinct voltage-sensitive sodium currents, including tetrodotoxin (TTX)-resistant in non-stellate astrocytes and TTX-sensitive currents in stellate astrocytes. However, the molecular identity of the underlying channels, and the mechanisms that regulate their expression, have yet to be identified. Since spinal cord astrocytes in vitro express sodium currents that are nearly ten-fold greater that those of astrocytes derived from other regions, we used reverse transcription polymerase chain reaction (RT-PCR), in situ hybridization, and immunocytochemistry to search for a sodium channel mRNA and protein corresponding to a TTX-resistant channel in these cells. RT-PCR did not detect transcripts for SNS, which is known to encode a TTX-resistant current in dorsal root ganglion neurons. However, RT-PCR demonstrated the presence of rH1 mRNA in cultured spinal cord astrocytes derived from postnatal day 0 (P0) Sprague Dawley rats at 7 days in vitro and in also intact spinal cords of P0 and P7 rats. Hybridization signal for rH1 mRNA was detected by in situ hybridization cytochemistry in most non-stellate and, at varying levels, in stellate astrocytes in these cultures. Immunocytochemical studies, utilizing a polyclonal antibody (R-12) generated against a conserved polypeptide sequence of sodium channels, demonstrated sodium channel immunoreactivity in non-stellate and stellate astrocytes in these cultures. Spinal cord cultures reacted with a rH1-specific polyclonal antibody also showed rH1 immunostaining in non-stellate and stellate astrocytes, although the intensity of the rH1 immunoreactivity in both astrocyte morphologies was attenuated compared to that observed with the R-12 generic sodium channel antibody. The presence of rH1 mRNA and protein in non-stellate astrocytes in vitro provides a possible correlate for the TTX-resistant current that has been recorded in these cells. Since TTX-resistant current is not present in stellate astrocytes, the presence of rH1 mRNA and protein in these cells suggests, in addition, that post-translational mechanisms participate in the control of sodium channel expression in these cells.

NGF has opposing effects on Na+ channel III and SNS gene expression in spinal sensory neurons.

Following sciatic nerve transection, the expression of sodium channel III (alpha-III) transcripts increases and SNS (alpha-SNS) transcripts decreases in small (< 25 microns diameter) dorsal root ganglion (DRG) neurons, which may reflect an interruption of retrograde transport of peripherally derived factor(s) involved in the regulation of these channels. To test the hypothesis that the neurotrophin nerve growth factor (NGF), which is abundant in peripheral targets, participates in the modulation of the expression of these sodium channel transcripts, we examined the hybridization signal of alpha-SNS and alpha-III mRNAs in small DRG neurons from adult rats that had been dissociated and maintained for 7 days in the absence or presence of exogenous NGF. Neurons maintained in control (no added NGF) cultures showed changes in alpha-III and alpha-SNS hybridization signal similar to those induced by axotomy, with increased alpha-III mRNA levels and decreased alpha-SNS mRNA levels, compared with those observed in small DRG neurons at 1 day in vitro. The addition of exogenous NGF to DRG cultures attenuated these alterations in transcript levels, decreasing alpha-III mRNA and increasing alpha-SNS mRNA expression. These results suggest that NGF participates in the regulation of membrane excitability in small DRG neurons by pathways that include opposing effects on different sodium channel genes.

Schwann cells modulate sodium channel expression in spinal sensory neurons in vitro.

In order to study the factors that govern the expression of sodium channel alpha-, beta1- and beta2-subunits, the influence that Schwann cells (SC) exert in the expression of sodium channels in DRG neurons was examined with in situ hybridization, immunocytochemistry, and patch clamp recording. The expression of sodium channel alpha-, beta1-, and beta2-subunit mRNAs in DRG neurons isolated from E15 rats cultured in defined medium in the absence (control) or presence of SC, or in SC-conditioned medium, was examined with isoform-specific riboprobes for sodium channel alpha-subunits I, II, III, NaG, Na6, hNE/PN1, SNS, and beta1- and beta2-subunits. DRG neurons cultured in the presence of SC displayed a significant (P < 0.05) increase in the hybridization signal for NaG, Na6, SNS, and Na beta2 mRNAs in comparison to control DRG neurons. In contrast, in SC-conditioned medium, only the hybridization signal for SNS mRNA was significantly increased. The upregulation of sodium channel mRNAs in DRG neurons co-cultured with SC was paralleled by an increase in sodium channel immunoreactivity of these cells. An increase in the mean sodium current density in DRG neurons in the presence of SC was also observed. These results demonstrate that a SC-derived factor selectively upregulates sodium channel alpha- and beta-subunit mRNAs in DRG neurons isolated from E15 rats that is reflected in an increase in functional sodium channels in these cells. This culture system may allow elucidation of the SC factor(s) that modulate the expression of sodium channels in DRG neurons.

Evaluation of anaesthetic regimens in guineapigs.

To establish reliable methods of chemical restraint and anaesthesia for mildly painful procedures in guineapigs, we compared the effects of the following anaesthetics and combinations of anaesthetics: tiletamine-zolazepam (two dosages), pentobarbital, methoxyflurane, ketamine-xylazine (three dosages), and ketamine-xylazine with methoxyflurane. Tiletamine-zolazepam induced a short period of chemical restraint but lacked analgesic effects at the doses tested. Although pentobarbital induced prolonged chemical restraint, the loss of responsiveness to painful stimuli was brief. Methoxyflurane alone induced transient anaesthesia and analgesia. Ketamine-xylazine combinations induced analgesia and chemical restraint of comparable durations, and some dosages were suitable for mildly painful procedures. The addition of methoxyflurane significantly potentiated the anaesthetic and analgesic properties of the high dosage ketamine-xylazine combination.

Toxocara titres in maternal and cord blood.

Fifty-two pairs of maternal and cord blood samples were examined for evidence of Toxocara canis antibodies. All the mothers in the study delivered normal babies at term. Seventeen (33%) of the mothers had Toxocara antibody titres of 1:50 or greater. No IgM isotype anti-Toxocara antibody was detected in the cord blood samples, evidence that transplacental toxocaral infection had not occurred. In the toxocara antibody-positive group it was found that six of 17 mothers (35%) had previously miscarried compared with three of 35 (8.6%) of the toxocara-negative mothers (P = 0.044).

Sodium channel mRNA in the B104 neuroblastoma cell line.

B104 neuroblastoma cells are excitable, but the ion channels underlying electrogenesis in these cells have not been identified. RT-PCR, restriction enzyme analysis and in situ hybridization were used to study sodium channel mRNAs in B104 cells. High levels of sodium channel alpha-subunit mRNAs III, NaG and Na6 and beta 1-subunit mRNA were detected by RT-PCR in B104 cells. Low levels of types I and II alpha-subunit mRNAs were also present. In situ hybridization with subtype-specific riboprobes detected sodium channel alpha-subunit mRNAs III, NaG and Na6 and beta 1-subunit mRNA in B104 cells; analysis of the percentage of B104 cells expressing each alpha-subunit mRNA subtype suggests that some cells express the mRNAs for several alpha-subunits.

Monitoring sweetener consumption in Great Britain.

A comprehensive survey of the consumption of intense sweeteners in Great Britain in 1988 quantified the levels of usage of different sweeteners and identified their distribution between food categories and population subgroups. Saccharin was found to be the most widely used intense sweetener. Beverages were the most common source of intense sweeteners. The quantities consumed of all sweeteners were found to be below the Acceptable Daily Intake (ADI) values established by the Joint FAO/WHO Expert Committee on Food Additives, the European Commission Scientific Committee for Food or the UK Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment.

An analysis of staining methods for the detection of Cryptosporidium spp. oocysts in water-related samples.

The ability of five staining techniques, originally developed for the rapid identification of Cryptosporidium spp. oocysts in faecal samples, to detect oocysts in water and water-related samples was assessed. All the stains used (modified Ziehl Neelsen, auramine-phenol (Lempert), Wright-Giemsa, safranin-methylene blue and FITC-labelled monoclonal antibody) stained oocysts after storage in water for 2 months at 4 degrees C (71-89% of control values). Storage of oocysts below 0 degrees C greatly reduced the staining ability of auramine-phenol. With the exception of oocysts stored in raw and final waters, the histochemical stains proved less useful in detecting oocysts than the monoclonal antibody. Organisms of similar size and shape took up these stains, causing confusion in interpretation. Cold Ziehl Neelsen and the FITC-labelled monoclonal antibody were best at identifying oocysts from a waterborne outbreak. Screening with a fluorescent antibody, followed by confirmation with cold Ziehl Neelsen, where possible, are the currently recommended procedures for the detection of oocysts in water-related samples.

Natural cytolytic activity in mice with natural or induced cellular defects. I. Differential ability of in vitro interleukin-2 addition to augment natural cytolytic function.

The ability of in vitro addition of recombinant interleukin 2 (rIL-2) to differentially enhance natural cytotoxicity was assessed using cells from mice with natural and induced cellular defects. In vivo treatment with most immunosuppressive or cytoreductive agents, anti-asialo-GM1 antibody, or gamma irradiation dramatically reduced in vitro cytotoxicity against natural killer (NK) sensitive targets by direct reduction in either percentage specific lysis or lytic units per spleen. In most cases, in vitro addition of rIL-2 (at concentrations causing augmented NK function in cells from naive Balb/C mice) enhanced cytotoxic activity of cells from treatment groups to a normal value but not within the rIL-2-enhanced range of nontreated animals. Additionally, cytotoxic activity of cells from animals treated with certain drugs or gamma irradiation could be augmented by rIL-2 when measured by percentage lysis but not lytic units per spleen. In vivo treatment with cyclosporin A did not affect natural cytotoxic activity and addition of rIL-2 augmented the NK activity in a similar fashion to the profile of naive cells. In experiments using cells from beige (C57Bl/6-bg) mice which have a natural defect in NK activity against YAC-1 targets, addition of rIL-2 (at concentrations causing augmented natural cytotoxic function in cells from C57Bl/6 mice) could not effectively enhance in vitro natural cytotoxic function.

Effector cell sensitivity to sugar moieties. III. Inhibition by monosaccharides of interleukin-2 enhanced natural killing against viral and nonviral tumor target cells.

Human NK cells recognize multiple target antigens. The ligands (antigens) involved in this interaction have not been clearly identified. Previously, we have shown that some monosaccharides inhibit NK mediated cytolysis in a concentration-dependent fashion and that NK cell activity involves recognition of carbohydrate structures on target cells via receptors on the effector cell surface. Using human IL-2 or recombinant IL-2, we have found that monosaccharides inhibit IL-2 enhanced functional activity in a concentration-dependent fashion; that increased expression of endogenous monosaccharide binding receptors on effector cells occurs after treatment with IL-2; and that greater quantities of monosaccharide were required to obtain equivalent inhibition of IL-2 enhanced NK activity. Our data reinforces the growing belief that effector cells express receptors with different sugar specificities and that quantitative differences in sugar specificities is a likely reason for NK cells having heterogeneous polyclonal activity.

Protective effect(s) of rIL-2 modulation. I. The effects of chemotherapeutic/cytotoxic agents on human natural killer cells and lymphokine-activated killer cells.

This study investigated whether in vitro immunotherapy with rIL-2 which augments human natural cytotoxicity and generation of lymphokine-activated killer cells diminished or inhibits the severity of therapeutically induced human in vitro NK immunosuppression. We demonstrate that rIL-2 induces a rapid and potent enhancement of cytolytic killing and that pretreatment of effector cells for one hour with rIL-2 yields effector cells which are more resistant to drug-induced immunosuppression. Additionally, we demonstrate cells pretreated for 24 hours with rIL-2 were less sensitive to drug inhibitory effects than rIL-2 non-treated or one hour pretreated effector cells. Our data suggest prophylactic treatment with IL-2 for drug induced immunosuppression is feasible.