[Phacoalternative Cataract Surgery At The Bartimée Clinic In Conakry (Guinea)]. / Chirurgie De La Cataracte Par Phacoalternative A La Clinique Bartimee A Conakry (Guinee).

The purpose of this work was to evaluate the results of phacoalternative. METHOD: This was a four-month analytical descriptive study. Our variables were socio-demographic, clinical, paraclinical and evolving. Patients operated by Phacoalternative during the study, having consented, were included. Not included were the operated patients who did not follow up. RESULT: The average age was 61.37 ± 8.3 years, the sex ratio 1.06 of which 63.9% came from Conakry, 57.6% were out of school and 39.9% were housewives. Diabetes was the most common comorbidity 23.75%. The fundus was inaccessible in 66.4%. The average biometrics were 22.60D. The right eye was more operated on or 53.5%. The most common postoperative complication was the 4.5% cloudy cornea. There were no complications at D1 in 88.3% and at D14 in 98.8%. The mean of preoperative Astigmatism 1.07D < to the mean of postoperative astigmatism 1.6D.Preoperative visual acuity was < 1/10 in 78.8%, between 1/10 - 2/10 in 11.5% and ≥ 3/10 in 9.7%. Postoperative visual acuity was < 1/10 in 2.0%, between 1/10 - 2/10 in 10.0% and ≥ 3/10 in 88.0%. CONCLUSION: The phacoalternative is the ideal method. However, the acquisition of Phacoemulsifiers could improve these results.

Le but de ce travail était d'évaluer les résultats de la phacoalternative. METHODE: Il s'agissait d'une étudedescriptiveanalytiquede quatre mois.Nosvariables étaient socio-démographiques, cliniques, paracliniques et évolutives.Ont été inclus, les patients opérés par Phacoalternative pendant l'étude, ayant consenti. N'étaient pas inclus, les patients opérés n'ayant pas respectéle suivi. RÉSULTAT: L'âge moyen était de 61,37 ± 8,3 ans, le sex-ratio 1,06 dont 63,9% provenaient de Conakry, 57,6% étaient non scolarisé et 39,9% étaient ménagères. L'hypertension artérielle était la comorbidité la plus fréquente 23,75%. Le fond d'œil était inaccessible chez 66,4%. La moyenne de la biométrie était 22,60D. L'œil droitétait plus opéré soit 53,5%. La complication post-opératoire la plus fréquente était la cornée trouble 4,5%. Il n'y avait pas de complication à J1 chez 88,3% et à J14 chez 98,8%. La moyenne d'Astigmatisme pré-opératoire 1,07D < à la moyenne d'astigmatisme post-opératoire 1,6D. L'acuité visuelle pré-opératoire était < 1/10 chez 78,8%, comprise entre 1/10 - 2/10 chez 11,5% et ≥ 3/10 chez 9,7%. L'acuité visuelle post-opératoire était < 1/10 chez 2,0%, comprise entre 1/10 - 2/10 chez 10,0% et ≥ 3/10 chez 88,0%. CONCLUSION: La phacoalternative est la méthode idéale. Cependant, l'acquisition de Phacoémulsificateurs pourrait améliorer ces résultats.

Effects of different dietary ω-6/3 polyunsaturated fatty acids ratios on infarct size and the limbic system after myocardial infarction.

Changes in dietary omega-6/3 polyunsaturated fatty acids (PUFA) ratios affect anti- and proinflammatory equilibrium. As reperfused myocardial infarction (MI) is an inflammatory pathology that alters the cell integrity of the myocardium but also of other tissues, such as the hippocampus and amygdala, attenuation of the inflammation could be helpful in maintaining cell integrity after MI. Therefore, we hypothesized that a decrease in the dietary omega-6/3 PUFA ratio, without altering the diet content in total fat, proteins, or carbohydrates, will result in a reduction of infarct size and a diminution of postreperfusion apoptosis observed in the amygdala and hippocampus. Male Sprague-Dawley rats were fed 1 of 3 diets containing different omega-6/3 PUFA ratios for 2 weeks (5:1; 1:1; 1:5). Then, myocardial ischemia was induced by left anterior descending coronary artery occlusion for 40 min, followed by reperfusion. Cardioprotective mechanisms were studied in the myocardium at 15 min of reperfusion, along with myocardial infarct size after 24 h of reperfusion. Apoptosis was evaluated in the hippocampus and the amygdala. We found that infarct size was significantly reduced by 32% in groups 1:5 and 1:1 vs. group 5:1. Akt activity was higher in groups 1:5 and 1:1 compared with group 5:1. Caspase-3 enzymatic activity doubled in area CA1 and the dentate gyrus (DG) in group 5:1 compared with groups 1:1 and 1:5. In addition, caspase-8 enzymatic activity was increased in the DG at 24 h, and caspase-9 was enhanced in CA1 at 24 h in group 5:1 vs. groups 1:1 and 1:5. These results demonstrate that the increase in the dietary omega-3 PUFA, at the expense of omega-6 PUFA, reduces infarct size and helps to inhibit apoptosis in the limbic system after MI.

Tumor necrosis factor-alpha participates in apoptosis in the limbic system after myocardial infarction.

This study was designed to determine the role of tumor necrosis factor-alpha (TNFalpha) in apoptosis observed in the myocardium and limbic system after myocardial ischemia. PEG sTNFRI, a recombinant, human, soluble p55 Type 1 TNF receptor (3 mg/kg) or vehicle (saline) was administered s.c. to male Sprague-Dawley rats on days 5, 3 and 1 before myocardial ischemia. The animals were then subjected, under anesthesia, to left anterior descending coronary artery occlusion for 40 min, followed by 15-min or 72-h reperfusion. Caspase-3 and -8 activities as well as terminal dUTP nick-end labelling-positive cells were examined in the myocardium (subendocardial and subepicardial regions), lateral (LA) and medial amygdala (MA) and hippocampus (CA1, CA3, dentate gyrus (DG)). After 15 min of reperfusion, the subendocardial and CA1 regions presented an increase in caspase-3 activity, whereas caspase-8 activity appeared to be augmented in the DG. PEG sTNFRI inhibited caspase-8 activation in the DG. After 72 h of reperfusion, plasma TNFalpha levels were reduced in the treated groups. The DG, CA1, CA3 and MA showed an increment of caspase-8 activity, which was reversed by PEG sTNFRI, except in the MA. Furthermore, caspase-3 activity was increased in the CA1, DG, LA and MA. These results indicate that TNFalpha contributes to apoptosis via activation of the extrinsic pathway in the limbic system after myocardial infarction, which is not the case in the myocardium.

Behavioural signs of depression and apoptosis in the limbic system following myocardial infarction: effects of sertraline.

Depression is diagnosed in 15-30% of patients following myocardial infarction (MI) and this may also be observed in the rat. We measured the effects of the antidepressant sertraline on behavioural and biochemical events following MI in a rat model. Following surgery, MI rats and sham controls were treated with sertraline (10 mg/kg, i.p.) or saline. Subgroups of rats were tested for behavioural depression 14 days after surgery. Apoptosis was estimated in other rats by measuring caspase-3 activity and TUNEL positive cells (3 days after surgery) in limbic structures (amygdale, hippocampus, hypothalamus, frontal and prefrontal cortices). Bax/Bcl-2 ratio was measured 14 days after surgery. Behavioural signs of depression (decreased sucrose intake and forced swimming time) were found in saline-treated MI rats but not in sertraline-treated rats. Compared with controls, caspase-3 activity and TUNEL positive cells were significantly increased in most limbic structures of MI rats. High prefrontal Bax/Bcl-2 ratio in MI rats correlated with low forced swimming time. Apoptosis was not found in sertraline-treated MI rats. These results establish the bases of a rat model of depression following MI and show for the first time that a selective serotonin reuptake inhibitor prevents both behavioural and biochemical markers in this model.

Apoptosis time course in the limbic system after myocardial infarction in the rat.

Apoptosis is known to occur in the limbic system after myocardial infarction (MI) in the rat. Our study was designed to evaluate the time course dynamics of this phenomenon in limbic areas. Apoptosis, i.e., caspase-3 activity and the number of terminal dUTP nick-end labelling-positive cells, as well as brain-derived neurotrophic factor (BDNF) were quantitated in sham-operated controls and MI rats 1, 2 and 7 days after surgery. Both apoptosis parameters were increased throughout, although in different structures: the CA1 region of the hippocampus and the medial amygdala at day 1, the CA1 region of the hippocampus and the lateral amygdala at day 2, and the frontal cortex at day 7. At day 2, BDNF was decreased in the prefrontal cortex and medial amygdala, whereas it was elevated in the dentate gyrus of the hippocampus; at day 7, BDNF was reduced in the frontal cortex and posterior hypothalamus but was augmented in the medial amygdala. These data indicate that post-MI apoptosis in the limbic system is a dynamic process occurring mainly in the hippocampus and amygdala during the first days after MI. The fact that BDNF was increased as early as 2 days after MI suggests that neurogenesis can occur rapidly in selected limbic regions after MI.