[Paederus dermatitis: A retrospective study of 74 cases occurring in 2008 in Guinea-Conakry]. / Dermatite àPaederus : étude rétrospective de 74 cas survenus en 2008 à Conakry, Guinée.

BACKGROUND: Paederus dermatitis is an unusual form of contact dermatitis caused by pederine, a secretion of insects belonging to the genus Paederus. These insects are found worldwide, although the concentration is higher in tropical and subtropical areas. Diagnosis is based on the presence of typical clinical features (erythematobullous lesions of sudden onset with a stinging, burning sensation on exposed areas of the body) combined with a compatible epidemiological context. In West Africa, more particularly in Guinea-Conakry, paederus dermatitis is common at the end of the rainy season. Our aim is to define the clinical and epidemiological characteristics of this disease. PATIENTS AND METHODS: Herein we report data from a series of cases of paederus dermatitis among French expatriates living in Guinea-Conakry and attending the sociomedical center of the French Embassy at Conakry between October 20 and December 12, 2008. RESULTS: Seventy-four patients with the disease were included in the study (age range: 2-66; sex-ratio: 1:1). Most presented one or two lesions, with 36% of lesions situated on the face and neck region. Three patients presented with oculoconjunctival involvement. Complete remission occurred spontaneously within 8 to 10 days in 90% of patients. Systemic antibiotic therapy was initiated in less than 3% of patients. CONCLUSION: Preventive measures to repel the insects remain vital, in conjunction with curative methods (e.g. immediate cleansing of skin coming into contact with the irritant substance).

Ferrocene-chloroquine analogues as antimalarial agents: in vitro activity of ferrochloroquine against 103 Gabonese isolates of Plasmodium falciparum.

The in vitro activities of ferrochloroquine, chloroquine, quinine, mefloquine, halofantrine, amodiaquine, primaquine, atovaquone and artesunate were evaluated against Plasmodium falciparum isolates from children with uncomplicated malaria from Libreville (Gabon), using an isotopic, micro, drug susceptibility test. The IC(50) values for ferrochloroquine were in the range 0.43-30.9 nM and the geometric mean IC(50) for the 103 isolates was 10.8 nM (95% CI 8.6-13.5 nM), while the geometric means for chloroquine, quinine, mefloquine, amodiaquine and primaquine were 370 nM, 341 nM, 8.3 nM, 18.1 nM and 7.6 microM, respectively. Ferrochloroquine was active against P. falciparum isolates, 95% of which showed in vitro resistance to chloroquine. Weak positive significant correlations were observed between the responses to ferrochloroquine and that to chloroquine, amodiaquine and quinine, but too low to suggest cross-resistance. There was no significant correlation between the response to ferrochloroquine and those to mefloquine, halofantrine, primaquine, atovaquone or artesunate. Ferrochloroquine may be an important alternative drug for the treatment of chloroquine-resistant malaria.

[Primary volvulus of the small intestine without malrotation. Apropos of 7 cases]. / Volvulus primitif du grêle sans malrotation. A propos de sept observations.

We report seven cases of complete volvulus of the small bowel without malrotation seen from 1973 through 1986. The clinical setting is always the same in this condition: the infant exhibits no clinical anomalies during the symptom-free interval between birth and the volvulus (4 h to 35 d, m = 7 d in our series). Onset is extremely sudden, with a complete, proximal obstruction, early and abundant passage of blood per rectum, and above all a severe shock that fails to respond to resuscitation. Roentgenograms contribute little to the diagnosis and surgery should never be delayed to perform complementary investigations of any kind. Indeed, the only effective treatment is unwinding the volvulus within the first six hours following onset, for beyond that time irreversible necrosis of the entire small bowel and occasionally colon occurs. Five infants died because they were seen too late and operated on 36 hours on average after the onset of symptoms. The two survivors had an early operation that prevented total necrosis of the small bowel. However, this pattern seems to vary according to the degree of cecum anchorage: a fixed cecum results in a very tight volvulus with complete, early ischemia and usually irreversible necrosis of the small bowel beyond the sixth hour (9/9 published cases); an even slightly mobile cecum results in a looser volvulus, with less severe ischemia, more delayed necrosis, and a possibility of complete recovery (5/6 published cases).(ABSTRACT TRUNCATED AT 250 WORDS)