[Spontaneous coronary artery dissection in young male patient with STEMI: Unsuccessful fibrinolysis]. / Dissection coronaire spontanée dans le SCA ST+ chez un homme jeune : échec de fibrinolyse.

Spontaneous coronary artery disease (SCAD) is a particular form of acute coronary syndrome affecting preferentially female patient with few or without traditional cardiovascular risk factors. Male patient is exceptionally concerned by SCAD. We report a case of a young male patient presenting with anterolateral STEMI in relation with SCAD of Left main and left anterior descending artery (LAD). He was initially managed by fibrinolysis, which is then complicated by cardiogenic choc. Coronary angiogram covered by intra-aortic balloon pump (IABP) showed an acute double occlusion of proximal LAD and the ostium of the left circumflex artery (LCX). After thrombus aspirations, the angiographic pattern recalled a SCAD, which is confirmed by OCT (Optical Coherence Tomography). The latter highlighted the intimal flap with true and false lumen involving both Left main and proximal LAD with huge thrombus burden. PCI was then performed successfully with implantation of 3 DES (Drug Eluting Stent). But given the cardiogenic shock persistence despite Dobutamin infusion and IABP, ECMO (Extracorporeal membrane oxygenation) was indicated. Unfortunately, the patient died of haemorrhage during ECMO implantation.

Estimation of enteric methane emission factors for Ndama cattle in the Sudanian zone of Senegal.

Methane (CH4) emission estimations for cattle in Sub-Saharan Africa (SSA) reflect limited production levels and diets that are high in cellulose forage. However, data on these livestock systems is lacking for their accurate evaluation. To provide guidance for climate change mitigation strategies in Senegal, it is necessary to obtain reliable estimates of CH4 emissions from Ndama cattle reared in grazing systems, which is the predominant cattle system in the country. The objective of this study was to determine the annual methane emission factor (MEF) for enteric fermentation of Ndama cattle following the IPCC Tier 2 procedure. Our estimated annual MEF at the herd scale was 30.8 kg CH4/TLU (30.7 kg CH4/head/yr for lactating cows and 15.1 kg CH4/head/yr for other cattle). These values are well below the default IPCC emission factor (46 and 31 kg CH4/head/yr for dairy and other cattle, respectively) proposed in the Tier 1 method for Africa. Our study showed that feed digestibility values differ with season (from 46 to 64%). We also showed that cattle lose weight and adapt to lower feed requirements during the long dry season, with a resulting major reduction in methane emissions. The results of this work provide a new framework to re-estimate the contribution of grazing systems to methane emissions in Africa.

Acute circulatory failure in two cardiology departments in Dakar: 44 cases.

INTRODUCTION: Acute circulatory failure is a life-threatening emergency whose prognosis depends on early management and aetiological diagnosis. The aim of our study was to assess the epidemiological, aetiological, therapeutic and prognostic aspects of acute circulatory failure in two cardiology departments in Dakar. METHODS: This was a longitudinal, multicentre, descriptive study over a period of six months from October 2014 to March 2015. We included all patients with acute circulatory failure (systolic blood pressure < 90 mmHg, oligoanuria, tachycardia, tachypnoea, onset of altered consciousness) either on admission or during hospitalisation during the study period. A long-term survival survey (six months to one year) was conducted on all included patients. RESULTS: Forty-four patients were enrolled. The average age was 54.9 years, ranging from 20 to 83 years. The gender ratio was 1.1. Acute circulatory failure occurred most often during hospitalisation (63%), with known cardiomyopathy in 47.7% of cases. Consciousness was impaired in 11 patients while oligoanuria was present in 27.3% of cases. Inflammatory syndrome was mostly found in 63.6% of cases and renal insufficiency and acute liver failure were reported in 45.5 and 29.5% of patients, respectively. Left ventricular dysfunction was the most common echocardiographic feature (70%). Acute circulatory failure was cardiogenic in most cases, with a predominance of advanced dilated cardiomyopathy (44.9%). Septic shock was found in 25% of patients, with pulmonary infection as the main location (20%). Nine per cent of patients had hypovolaemic shock. The most used inotropic drug was dobutamine in 79.5% of cases, followed by adrenaline (18.2%) and norepinephrine (4.5%). Intra-hospital mortality rate was high (52.3%) and one-year survival rate was 27.2%. Poor prognostic factors such as advanced age and renal impairment were associated with a higher overall mortality rate of 18 to 90%, with no statistical significance. CONCLUSIONS: Acute circulatory failure is a diagnostic and therapeutic emergency with a high mortality rate.

Secondary pool boiling effects.

A pool boiling phenomenon referred to as secondary boiling effects is discussed. Based on the experimental trends, a mechanism is proposed that identifies the parameters that lead to this phenomenon. Secondary boiling effects refer to a distinct decrease in the wall superheat temperature near the critical heat flux due to a significant increase in the heat transfer coefficient. Recent pool boiling heat transfer experiments using femtosecond laser processed Inconel, stainless steel, and copper multiscale surfaces consistently displayed secondary boiling effects, which were found to be a result of both temperature drop along the microstructures and nucleation characteristic length scales. The temperature drop is a function of microstructure height and thermal conductivity. An increased microstructure height and a decreased thermal conductivity result in a significant temperature drop along the microstructures. This temperature drop becomes more pronounced at higher heat fluxes and along with the right nucleation characteristic length scales results in a change of the boiling dynamics. Nucleation spreads from the bottom of the microstructure valleys to the top of the microstructures, resulting in a decreased surface superheat with an increasing heat flux. This decrease in the wall superheat at higher heat fluxes is reflected by a "hook back" of the traditional boiling curve and is thus referred to as secondary boiling effects. In addition, a boiling hysteresis during increasing and decreasing heat flux develops due to the secondary boiling effects. This hysteresis further validates the existence of secondary boiling effects.

[Micromethod for the identification of streptococcal, enterococcal and staphylococcal species]. / Microméthodes d'identification des Streptocoques, Enterocoques et des Staphylocoques.

The aim of this study was to set accurate and reliable methods in the identification of streptococcal, enterococcal and staphylococcal species. Micro CSB Strep and Staph system consists each of a strip with cupules containing dehydrated substrates for biochemical identification of bacterial species. Baye's theorem was used to validate tests. Reactions from micromethods were clear and easily read. Identification of 229 strains of streptococci and enterococci was correct for most species with 98.7% species with 99.3% sensitivity. 41 strains of staphylococci were also correctly identified with 85.2% of specificity and 97.68% of sensitivity.