Road to serenity: Individual variations in the efficacy of unobtrusive respiratory guidance for driving stress regulation.

Stress impacts driving-related cognitive functions like attention and decision-making, and may arise in automated vehicles due to non-driving tasks. Unobtrusive relaxation techniques are needed to regulate stress without distracting from driving. Tactile wearables have shown efficacy in stress regulation through respiratory guidance, but individual variations may affect their efficacy. This study assessed slow-breathing tactile guidance under different stress levels on 85 participants. Physiological, behavioral and subjective data were collected. The influence of individual variations (e.g., driving habits and behavior, personality) using logistic regression analysis was explored. Participants could follow the guidance and adjust breathing while driving, but subjective efficacy depended on individual variations linked to different efficiency in using the technique, in relation with its attentional cost. An influence of factors linked to the evaluation of context criticality was also found. The results suggest that considering individual and contextual variations is crucial in designing and using such techniques in demanding driving contexts. In this line some design recommendations and insights for further studies are provided.

[Mycoses and antifungals: What is the situation in Senegal in the current context?] / Mycoses et antifongiques : quelle est la situation du Sénégal dans le contexte actuel ?

In the context of increasing incidence of fungal infections worldwide, the availability of antifungal drugs was studied in Senegal, a country with limited resources where diagnosis of invasive fungal infections is not often established by lack of specialists and/or diagnostic tools. After a background on the country's situation with regard to fungal infections and the drug distribution network in Senegal, a compilation of the various available antifungals was presented before concluding with recommendations to prepare for a situation that could allow to treat appropriately invasive mycoses.

Tinea capitis in school children from Mauritania: A comparative study between urban and rural areas.

INTRODUCTION: In Mauritania, only an investigation carried out 26 years ago allows to report epidemiological findings about tinea capitis in Nouakchott. The objective of this study was to reactualize the tinea capitis epidemiological, clinical and mycological profile in school children and to compare this profile in urban and rural area. PATIENTS AND METHODS: All subscribed students in targeted schools and present during the investigation were examined clinically before samples collection. Mycological diagnosis was made by direct examination and culture in Sabouraud Dextrose Agar with chloramphenicol and supplemented with cycloheximide. The results were considered positive when culture with the presence of dermatophytes was obtained. RESULTS: Prevalence of tinea capitis among school children was 10.50% and it was more important in rural area (12.21%) than in urban area (9.52%). The age group ranged between 6 and 8 years was the most affected (13.58%). According to the gender, male (11.46%) were more affected than female (9.62%). Trichophytic tinea were predominant and Trichophyton soudanense was more isolated followed by Trichophyton rubrum, Trichophyton schoenleinii and Microsporum audouinii.

Use of MALDI-TOF MS for fungal species distribution of interdigital intertrigo in seafarers, Dakar, Senegal.

To determine fungal species distribution of interdigital intertrigo among seafarers in Dakar, Senegal, a cross-sectional study was carried out from May to August 2017 among seafarers clinically diagnosed with interdigital intertrigo. A questionnaire was filled to each patient before sampling the affected folds and transporting to Aristide Le Dantec University Hospital where mycological analyses were realized. Species identification by MALDI-TOF MS was performed in Marseille, France. In total, 169 men (21-66 years) were included. Few of them (3%) had a high level of education and the duration of the mycosis exceed 10 years for 88% of patients. Direct microscopic examination (ME) was positive in 34.3%. Among samples with positive ME, 58.6% had positive culture. An overall incidence of 30.2% was found. Patients with confirmed cases aged between 28 and 66 years. Among them, those between 36-50 years were predominant (52.9%). Those with a high level of education were less representative (2%). For 52.1% of patients, the duration of the mycosis was superior to 10 years. Furthermore, 57% of cases were significantly associated with other types of tinea pedis and/or onychomycosis (P=0.03). Culture was positive in 23.7% isolating 43 strains successfully identified at the species level by MALDI-TOF MS for 31 isolates: 20 Candida and 11 dermatophytes. The rest was identified only at the genus level belonged to Fusarium. In definitive, MALDI-TOF MS could be a useful tool for routine and fast identification of dermatophytes, yeasts and NDFF in clinical mycology laboratories.

Dermatophytic mycetoma of the scalp due to an atypical strain of Microsporum audouinii identified by MALDI-TOF MS and ITS sequencing.

Dermatophytic mycetoma of the scalp is a rarity, especially when not associated with tinea capitis. Here, we report a case of dermatophytic mycetoma of the scalp, that was not associated with tinea capitis, caused by an atypical Microsporum audouinii strain. To our knowledge, this is the second reported case, thirty-eight years after the first that was published in 1980.

MALDI-TOF MS identification of Malassezia species isolated from patients with pityriasis versicolor at the seafarers' medical service in Dakar, Senegal.

Pityriasis versicolor (PV) is a superficial mycosis caused by yeast of the genus Malassezia. The most common isolated Malassezia species in PV lesions differ among M. furfur, M. globosa and M. sympodialis. We purpose to determine the distribution of Malassezia species in PV patients at the seafarers' medical service in Dakar, Senegal and to examine whether any association between identified Malassezia species and patients' profile. From May 2017 to August 2017, first a questionnaire was filled to get informative data before collection of skin scrapings taken from most scaly site using sterile scalpel blade and application of scotch® for direct examination (DE). At the laboratory, DE, culture and identification by MALDI-TOF MS were done. One hundred patients with PV - all men - were included with a mean age of 34 years. Among seafarers, 81% were sailors. Clinical prevalence of PV was highest in aged adults patients with ages of 31 to 60 years (56%). Seafarers with high level of education were less representative with only 2%. The mean duration of the PV was 26.83 months. 20% of subjects suffered lesions in more than one location. The chest was the most affected anatomical site. Furthermore, possible predisposing factors associated with PV were also detected. DE was positive in 95% but culture growth only in 46%. MALDI-TOF MS analysis of the positive cultures could be performed in 84.8% (39/46). Only M. furfur was identified in 100% (39/39). In definitive, M. furfur is the only causative agent of PV in Dakar.

[Vulvovaginal candidiasis in pregnant women in the Mère et Enfant Hospital center in Nouakchott, Mauritania]. / Candidoses vulvo-vaginales chez les femmes enceintes au centre hospitalier Mère et Enfant de Nouakchott (Mauritanie).

AIM: To determine the prevalence and the associated risk factors of vulvovaginal candidiasis in pregnant women in Mauritania. PATIENTS AND METHOD: The study was carried out at the laboratory of the Mère et Enfant Center in Nouakchott, from November 1, 2016 to February 5, 2017. It concerned all pregnant women in the third trimester that came to the natal consultation at the gynecology service. These women must have given their informed consent in written form. After completing the survey to collect epidemiological and clinical data, a sample was collected to perform fresh direct examination and culture on Sabouraud-Chloramphenicol media. RESULTS: Two hundred pregnant women were included in the study. Culture on Sabouraud-Chloramphenicol media was positive in 52 patients corresponding to a prevalence of 26%. The germ tube test was positive for 61.5% of isolated Candida. Clinical signs are dominated by leucorrhea (56%), pelvic pain (25%) and vulvar pruritus (11%). Among women with positive culture, 55.76% had received local antifungal treatment in the form of an ovula during pregnancy. CONCLUSION: This study shows that vulvovaginal candidiasis is frequent in pregnant women attending gynecology at the Mère et Enfant Hospital Center in Nouakchott.

[Interdigital tinea pedis resulting from Fusarium spp. in Dakar, Senegal]. / Les intertrigos interorteils impliquant Fusarium spp. à Dakar (Sénégal).

INTRODUCTION: Fungal interdigital tinea pedis (ITP) is a common pathology mainly due to dermatophytes and yeasts. Fusarium sp. is rarely incriminated in the genesis of intertrigo. In Dakar, a recent study conducted in 2016 on fungal ITP showed that Fusarium were more involved in the etiology of ITP than dermatophytes, coming just after yeasts dominated by Candida. Following this, we wanted to draw attention to the increasing incidence of ITP resulting from Fusarium spp., in Dakar, Senegal, and to analyze the epidemiological and mycological particularities of these ITP due to Fusarium spp. PATIENTS AND METHODS: A retrospective study including all patients received at the laboratory for suspicion of ITP between January 1st, 2014 and June 30th, 2017 was conducted. Diagnosis was based on mycological examination, including direct examination and culture. Mycological analysis was considered positive when direct examination and culture were positive after at least one repeat. RESULTS: Twenty-nine cases of Fusarium ITP accounting for 44.6% of all ITP in the study period were diagnosed in 15 men and 14 women. The mean age of the patients was 48.4 years. Fusarium ITP were diagnosed in immunocompetent patients except in two diabetics. The mean duration of the lesions was 6.83 years. The most frequent species isolated belonged to the Fusarium solani complex with 19 cases. CONCLUSION: Fusarium ITP in a healthy subject requires regular monitoring because any subsequent decrease in immune defenses could lead to fatal hematogenous spread.

Cases of skin and nail candidiasis diagnosed at the parasitology and mycology laboratory of Le Dantec University Hospital in Dakar, 2008-2015.

INTRODUCTION: Candida infections are most frequently encountered on the skin and nails. Their proportions vary according to geoclimatic and sociocultural conditions. The objective of this study was to determine the prevalence of skin and/or nail candidiasis diagnosed in the parasitology and mycology laboratory of Le Dantec University Hospital in Dakar, Senegal. MATERIALS AND METHODS: This study included 994 patients with suspected skin and/or nail mycosis tested at the parasitology and mycology laboratory during the 8-year study period of 2008-2015. Each patient had both a direct examination and a mycological culture. RESULTS: The patients' median age was 34 with an interquartile range of 25 years. Of these 994 patients, 613 had confirmed skins and/or nail fungal infections. In descending order, the fungi isolated and identified from these mycoses were Candida (n= 387, 63.1%), dermatophytes (28.4%), and mold (8.5%). Thus Candida accounted for nearly two thirds of the skin and/or nail mycoses and had a prevalence rate among the patients with suspected skin or nail candidiasis of 38.9%. These skin/nail sites was more common among women (72%) than men (28%), and slightly more than half of them (50,1%) were adults aged 31 to 60 years. The duration of candidiasis exceeded a full year for 76.3%. Onychomycoses were found more frequently (65.24%) than epidermomycoses, and both sites were infected in 5.17%. Candida albicans was the species isolated most frequently, accounting for 80% of Candida specimens. CONCLUSION: Our results reinforce the importance of mycological confirmation of the diagnosis. The mycology laboratory has a crucial role in making the differential diagnosis with other dermatoses of similar clinical appearance and thus in guiding the choice of treatment.

[Plasmodium ovale wallikeri and Plasmodium ovale curtisi Malaria in Senegal in 2016]. / Le paludisme à Plasmodium ovale wallikeri et Plasmodium ovale curtisi au Sénégal en 2016.

Recently in Senegal, a case of Plasmodium ovale malaria had led to a diagnostic difficulty due to the ignorance of this parasite and the neglect of it. The objective of this study was to actively investigate cases of P. ovale malaria that would be misdiagnosed in the health centre structures of Senegal. The study was conducted in three areas that reflect different epidemiological strata of malaria. Microscopy was performed by microscopy experts on suspected malaria patients. The results were validated by Rougemont real-time PCR. Positive P. ovale cases were genotyped by nested PCR targeting the potra gene. A total of 406 samples were taken. Microscopy of Giemsa stained thick and thin smears recorded 228 cases of Plasmodium falciparum (97%), 3 cases of Plasmodium malariae (1.3%), and 4 cases of P. ovale (1.7%). The cases of P. ovale observed at microscopy were confirmed by real-time PCR. Genotyping of P. ovale revealed 3 cases of P. ovale wallikeri and 1 case of P. ovale curtisi. The prevalence of P. ovale malaria remains low in Senegal. However, malaria microscopists should be trained to recognize non-falciparum species in order to avoid the diagnostic delays and unnecessary investigations. National malaria control program should consider those species for the better management of malaria control in the country. Simplified molecular methods like, loop-mediated isothermal amplification (LAMP) may be useful to better characterize the epidemiology of non-falciparum malaria.

[Epidemiological, clinical and forensic physical violence against women in Tambacounda (Senegal)]. / Aspects épidémiologiques, cliniques et judiciaires des violences physiques faites aux femmes dans la région de Tambacounda (Sénégal).

INTRODUCTION: To contribute to the fight against physical violence against women, this work aimed to make a 10-year review of cases treated at the Regional Court of Tambacounda. METHODOLOGY: This observational, retrospective, descriptive and analytical study was conducted from 15 October 2014 to 15 April 2015. It covered all the court records of victims of intentional injury from 2006 to 2015. The data was entered and analyzed using Epi info 3.3.2 software. RESULTS: In all, 113 cases were treated. The mean age was 26.5±10.08 years for victims versus 32.5±13.8 years for the aggressors. The victims were all female, and 77.9% of offenders were male. The assaults took place mostly during the day (57.5%), and especially in the homes of victims (61.0%), in the street (16.8%) in the bush (12.4%). The consultation period was less than 24hours for 54.9% of the victims. Clinical examination differentiated: fractures (15%); contusions (13.5%); penetrating wounds (10.6%); bruises (9.7%); eye injuries (7.9%); broken teeth (7.9%); diffuse pains (7.1%), 6.2% polytrauma (6.2%), and 5.3% of trauma on pregnancies. Among the violence, 33.6% were domestic; 11.5% were associated with rape (7.1%); psychological violence (3.6%); rape and death threat (1.8%). Rape was statistically more common among child victims [OR=10.7 (3.2-35.5)] and/or educated victims [OR=5.8 (1.7-19.9)] and aggression in the bush [OR=7.5 (2.2 to 14.2)]. The attackers were lonely and imprisoned in 94.7% and 73.5% of cases respectively. The sentence was firm imprisonment for 89.2% of cases. CONCLUSION: In Tambacounda, health and judicial authorities should enhance public awareness concerning the risk of violence. The extension of this type of study to the national level would have enabled better orientation of control strategies against this scourge.

Diseases due to intestinale protozoa diagnosed at Le Dantec University Hospital in Dakar, Senegal, from 2011 to 2015.

To identify the protozoa responsible for intestinal parasitosis diagnosed at Le Dantec University Hospital in Dakar, Senegal. The retrospective study included 2578 patients for whom stool samples were analyzed from 2011 to 2015. The sex ratio was 1.1. Patients' mean age was 28.5 years, with a range of 11 days to 91 years. Direct examination and the Ritchie technique were performed to search for parasites. In total, 317 patients had intestinal protozoa, for a prevalence of 12.3 %. Infections involved one (91%) or two parasites (9%). The most common species found alone were Entamoeba coli (51.5%), E. histolytica/E. dispar (17 %), and Giardia intestinalis (10.5%). The most common associations were E. coli with G. intestinalis (3.6 %) and with E. histolytica (2.4%). These infections affected significantly more outpatients than inpatients (65 %, p = 0.0049) and slightly more women (51.1%, p = 0.22) than men. Adults accounted for 67% of the confirmed intestinal protozoa: 39% aged 31-60 years, 28% aged 15-30, and only 7% older than 60 (p = 0.5). Most of the protozoa isolated were non-pathogenic. However, health education should be promoted in addition to the mass treatment program already begun to limit and even halt the spread of these neglected diseases.

4-Week repeated dose oral toxicity study of N-ethyl-2-pyrrolidone in Sprague Dawley rats.

The solvent N-ethyl-2-pyrrolidone (NEP) was evaluated in a 4-week repeated dose study in rats. NEP diluted in distilled water was orally administered by gavage to male and female Sprague-Dawley rats at doses of 0 (vehicle control), 5, 50, and 250 mg/kg/day for 28 consecutive days. Transient decreases in the body weight and in the body weight gain of the males was observed during the first days of treatment at the 50 and 250 mg/kg/day doses. There was a marked increase in urine volume at the beginning of treatment in males and female rats at doses of 50 and 250 mg/kg/day. No biologically significant differences were observed in hematological and clinical chemistry values in males and females at necropsy. Histological examination revealed an increase in hyaline droplets in the renal tubules of the kidneys and hepatocellular centrilobular hypertrophy in the liver of males at 250 mg/kg/day. Cytochrome P450 concentration in liver microsomes was slightly increased at 250 mg/kg/day in males. The results of this study demonstrate that NEP has mild to no effects at doses up to 250 mg/kg/day when administered orally to rats for 28 days with males being more susceptible than females.

[Tinea unguium with Microsporum langeronii and Trichophyton soudanense revealing tinea capitis with M. langeronii]. / Onyxis de la main à Microsporum langeronii et Trichophyton soudanense révélant une teigne du cuir chevelu à M. langeronii.

A Senegalese lady of 17 years old presented right hand tinea unguium on all fingernails except the thumb lasting for 10 years. Mycological analysis showed with the direct examination 20% KOH mount numerous septate hyphae. Culture revealed Microsporum langeronii at a first time. The mycological analysis resumption with sampling scalp revealed a tinea capitis with M. langeronii then culture of nail pieces confirmed in a second time M. langeronii also associated with Trichophyton soudanense in the tinea unguium.

[Causative agents of superficial mycoses isolated in Dakar, Senegal: Retrospective study from 2011 to 2015]. / Champignons agents de mycoses superficielles isolés à Dakar (Sénégal) : une étude rétrospective de 2011 à 2015.

INTRODUCTION: Superficial fungal infections, particularly of the skin, scalp and nails are very common and have been reported worldwide. The most common causative agents of these mycoses are dermatophytes, yeasts and molds. However, these agents vary with time and depend on many factors including the geography. The objective of this study was to identify the causative agents of superficial mycoses diagnosed at the Le Dantec University Hospital in Dakar (Senegal). MATERIAL AND METHODS: The study concerned 1851 outpatients received in the parasitological and mycological laboratory of Le Dantec hospital during the period from January 2011 to December 2015. Every patient benefited from direct examination and mycological culture. RESULTS: Among the 1851 patients, 633 were confirmed with superficial mycoses and the prevalence was 34.2 %. The age of patients ranged from two months to 81 years with a mean age of 31 years. Superficial mycoses were found more in women (70.3 %) than men (29.7 %) and a little more than thirty-nine percent (39.3 %) were adults. The causative agents identified were: dermatophytes (58 %), yeast (36.7 %) and non-dermatophytic filamentous fungi (NDFF, 5.3 %). The most isolated species were: Candida albicans (26.9 %), Trichophyton soudanense (24.9 %) and T. rubrum (13.7 %). These fungi were responsible for different clinical aspects, isolated and other associated. Among the isolated clinical aspects, those affecting hair (tinea capitis) were by far the largest with 44.8 %, followed by tinea unguium (34.5 %). Associations were especially type of tinea capitis and tinea manuum (2.4 %) and toenails onychomycosis associated with interdigital tinea pedis (2.7 %). Tinea capitis agents were exclusively dermatophytes and the predominant agent was T. soudanense with 47,8 %. Tinea unguium agents were yeast (79 %), dermatophytes (18 %) or NDFF (3 %) and the most found species was C. albicans (63.9 %). Dermatophytes, yeasts and molds were respectively found more in children and young adults, older adults and young adults and older adults and the elderly. CONCLUSION: In definitive, these epidemiological data should enable better diagnostic and therapeutic management of superficial mycoses.

[Newborn and infant fractures secondary to traditional massage]. / Fractures du nouveau-né et du nourrisson secondaires au massage traditionnel.

The traditional massage of the newborn and young infant is an ancient practice in Africa and other regions. It has many benefits that are currently recognized, even in Western societies. However, it can be dangerous. We report two cases of fractures of the femur and clavicle that occurred in a 17-day-old newborn and a 1-month-old infant secondary to a traditional massage. In both cases, there was no concept of trauma or a history of osteogenesis imperfecta in the family or the presence of other fractures suggesting abuse. We concluded in a fracture caused by traditional massage in both cases. Given its many benefits as described in the literature, the traditional massage of young infants cannot be considered a harmful practice. However, it should be practiced with care to prevent the occurrence of such complications.

[Efficacy of sodium hydroxide at 2.5 %, chlorhexidine gluconate at 0.5 % and calcium hydroxide against Candida albicans]. / Étude de l'efficacité de l'hypochlorite de sodium à 2,5 %, de la chlorhexidine à 0,5 %, et de l'hydroxyde de calcium sur Candida albicans.

INTRODUCTION: Endodontic flora is dominated in the apical part of the channels by strict anaerobic and some facultative anaerobic bacteria but also by Candida yeasts, especially Candida albicans species that are involved in the maintenance and persistence of endodontic infections. Their elimination of the canal system in practice by chemo-mechanical methods of disinfection is not always guaranteed. Thus, this in vitro study was performed to determine the sensitivity of C. albicans with sodium hypochlorite (NaOCl) dosed at 2.5 %, the chlorhexidine digluconate 0.5 % and calcium hydroxide used in inter-session medication. METHODS: The diffusion method was used initially to test the sensitivity of C. albicans strains with the above products. Then a dilution technique has allowed us to determine the minimum inhibitory concentration of these active products on C. albicans. RESULTS: Strains from infected pulp teeth of patients showed a sensitivity of C. albicans to sodium hypochlorite to a minimum inhibitory concentration less than 70µg/mL and 30µg/mL for chlorhexidine. CONCLUSION: This study demonstrated a sensitivity of C. albicans to sodium hypochlorite and chlorhexidine.

Fungal interdigital tinea pedis in Dakar (Senegal).

Fungal interdigital tinea pedis (FITP) is the most frequent dermatomycosis in industrial countries. In African tropics, it's a rare motive of consultation and is discovered while complicated. The aims of this article were: to determine the frequency of interdigital tinea pedis among overall mycological analysis in our laboratory; to study epidemiological, clinical and mycological aspects of FITP in outpatients attending the Le Dantec mycology laboratory in Dakar. A total of 62 males (60%) and 42 females (40%), mean age: 43.15 years (range: 11-81 years), were received from January 2011 to December 2015 for suspicion of FITP. Skin specimens were taken from all patients for microscopy and fungal culture. The frequency of ITP represents 5.6% (104/1851) among our overall mycological analysis. FITP was confirmed in 68 patients (SPI=65.38%), mainly located between the 4th and 5th toes and 71 fungal species were isolated (CPI=68.27%). Among patients with confirmed FITP, there were 38 males (56%) and 30 females (44%). The prevalence was highest in patients between 44 and 54 years (26%). Candida albicans, Fusarium solani and Trichophyton interdigitale were shown to be the most common pathogens respectively for yeasts (39%), non-dermatophytic filamentous fungi (NDFF; 21%) and dermatophytes (11%). So FITP isn't a common reason for consultation in Dakar but its simple parasitic index (SPI) is still very high and dermatophytes formerly the main causative agents are being relegated to third place behind yeasts and NDFF.

[Presence of yeasts in primary endodontic infections and study of their susceptibility to disinfection with sodium hypochlorite at 2.5]. / Recherche de levures dans les primo-infections endodontiques et étude de leur sensibilité à une désinfection à l'hypochlorite de sodium à 2,5.

INTRODUCTION: Endodontic infections are characterized by their microbial polymorphism with the presence of pathogenic agents such as bacteria. The aim of this study was to investigate the presence of yeast in the root canals of teeth with pulp necrotic with or without apical periodontitis and to study the sensibility of these at disinfection at sodium hypochlorite to 2.5 %. METHODS: Root canal samples, taken with paper points before and after disinfection with sodium hypochlorite dosed at 2.5 % on 50 single rooted teeth in 38 patients, were seeded in petri dishes containing Sabouraud Chloramphenicol (SC) (Conda Laboratories, Madrid). These stains were incubated in an incubator at 37°C for 48hours. The presence of yeast was confirmed by white colonies on the entire circumference of the tip paper. The identification of species was done by macroscopic and microscopic examinations associated with Blastese test. RESULTS: The yeast colonies were isolated from 7 teeth (14 %) out of 50. All positive samples were from teeth with an open necrotic pulp (P<0.001). The only species found was Candida albicans. Immediate disinfection with sodium hypochlorite at 2.5 % did not show a complete elimination of yeasts. CONCLUSION: The results of this study show that the canal of necrotic teeth with or without apical periodontitis may shelter yeasts even after immediate disinfection with sodium hypochlorite 2.5 %.