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Sensorineural Hearing Loss in Multidrug-Resistant Tuberculosis Patients in Kinshasa (Democratic Republic of Congo): Prospective Cohort Study of Therapeutic Regimen with Aminoglycoside versus Bedaquiline

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Journal of Tuberculosis Research 2023年第3期11卷 109-119页

作者： Mireille A. Mpwate Eddy M. Mbambu Christian N. Matanda Gabriel M. Lema michel K. Kaswa Murielle L. Aloni Nicole M. Anshambi Fabrice M. Matuta Luc L. Lukasu Dominique M. Mupepe Serge K. Mpwate Pierre Z. Akilimali Zacharie M. Kashongwe Richard N. Matanda Department of Otorhinolaryngology University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo National Tuberculosis Control Program in the Democratic Republic of Congo Kinshasa Democratic Republic of Congo Provincial Coordination for the Fight against Tuberculosis Kinshasa Democratic Republic of Congo Multidrug-Resistant Tuberculosis Unit “Centre d’Excellence Damien” Damien Foundation Kinshasa Democratic Republic of Congo Division of Cardiology Department of Internal Medicine University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo Department of Anatomy-Pathology University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo Kinshasa School of Public Health Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of Congo Pneumology Unit Department of Internal Medicine University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo

Context: Multidrug-resistant tuberculosis (MDR-TB) remains a major public health problem in developing countries such as the Democratic Republic of Congo (DRC), which continues to face the emergence of MDR-TB cases. Because of the ototoxic effects of AGs, the World Health Organization (WHO) has recommended the introduction of the bedaquiline regimen. However, very few data are available regarding the susceptibility of bedaquiline to induce hearing loss, hence the present study set out to compare the AG-based regimen and the bedaquiline-based regimen in the occurrence of hearing loss in MDR-TB patients. Methods: This is a prospective multicenter cohort study that included 335 MDR-TB patients, performed in Kinshasa (DRC) during the period from January 2020 to January 2021. Sociodemographic, clinical, biological and audiometric data were analyzed using Stata 17. Repeated-measures analysis of variance was used to compare changes in the degree of hearing loss over time between the two groups of patients on AG and bedaquiline regimens. The double-difference method was estimated using regression with fixed-effects. A p value < 0.05 was considered the threshold for statistical significance. Results: The degree of hearing loss was similar between the two groups at the first month [AGs (28 dB) vs BDQ (30 dB);p = 0.298]. At six months, the mean degree of hearing loss was significantly greater in the aminoglycoside regimen group [AGs (60.5 dB) vs BDQ (44 dB);p < 0.001]. The double difference was significant, with a greater increase in hearing loss in the AGs group (diff-in-diff 18.3;p < 0.001). After adjustment for age and serum albumin, the group receiving the AG-based regimen had a 2-point greater worsening than those with bedaquiline at the sixth month (diff-in-diff 19.8;p Conclusion: Hearing loss is frequent with both treatment regimens, but more marked with the Aminoglycoside-based regimen. Thus, bedaquiline should also benefit for audiometric monitoring in future MDR-TB p

关键词： Multidrug-Resistant Tuberculosis Aminoglycosides Bedaquiline Hearing Loss

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Continuous Spinal Anesthesia in Precarious Patients: An Experience in Lubumbashi DR Congo

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Open Journal of Anesthesiology 2023年第11期13卷 226-233页

作者： Wasso Milinganyo Eddy Timothée Dontaine Sagboze Zalambo Sandra Kibonge Mukakala Augustin Zirhumana Namegabe Franck Somwa Muhemedi Lucien Mukalay Banza Yves Tshisuz Nawej Christian Nguz A. Kutshid Nathan Kanyanda Nafatalewa Dimitri Ilunga Banza Mannix Mulewa Umba Deogracias Manika Muteya michel Mbuyi Musanzayi Sébastien Arung Kalau Willy Iteke Fefe Karl-Rivain Department of Anesthesia and Critical Care University Clinics of Lubumbashi Lubumbashi DR Congo Department of Surgery Great Hospital of Charleroi Charleroi Belgium Department of Surgery University Clinics of Lubumbashi Lubumbashi DR Congo Department of Surgery Medicine School Official University of Bukavu Bukavu DR Congo Department of Anesthesia and Critical Care Diamant Medical Center Lubumbashi DR Congo

Background: Continuous spinal anesthesia (CSA) is an underused technique in modern anesthesia practice. Compared with other techniques of neuraxial anesthesia, CSA allows incremental dosing of an intrathecal local anesthetic for an indefinite duration, whereas traditional single-shot spinal anesthesia (SSA) usually involves larger doses, a finite, unpredictable duration, and greater potential for detrimental hemodynamic effects including hypotension, and epidural anesthesia via a catheter may produce lesser motor block and suboptimal anesthesia in sacral nerve root distributions. It is indicated in elderly patients undergoing lower limbs and sub umbilical surgery. Aim: This work aims to highlight the advantages of CSA on hemodynamic stability and as an alternative to heavy anesthetic procedures in already fragile patients. Case presentation: Our cases were two elderly patients, both of them with past stories of cardiac diseases. Both of them were undergoing amputation indicated for wet gangrene on lower limbs. They had unstable hemodynamics states due to inflammatory state. They were all rated ASA 3. CSA was performed with low doses of local anesthetics and maintenance by reinjections of mixture with the same doses. The interventions took place without major incidents and all patients survived. Conclusion: CSA is an underused technique in modern anesthesia. However, there is renewed interest due to the quality of the blocs and the hemodynamics stability. We report a case series of 2 elderly patients with past stories of cardiac diseases undergoing amputation for dry gangrene that had been operated under CSA.

关键词： Continuous Spinal Anesthesia (CSA) Precarious Patient Dry Gangrene Elderly Subject DR Congo

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Honey Dressing of Cutaneous Wounds on Limbs in the Traumatology Orthopaedics Department of Bouaké University Hospital

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Open Journal of Orthopedics 2024年第9期14卷 411-420页

作者： Achié Jean-Régis Akobe Aya Adélaide Natacha Kouassi Ibrahim Soumahoro Zolopégué Marcel Soro Sedy Louess De Randolphe Akpro Bakary Traoré Almamy Kamate Axel Fabrice Essehin Yao Aboh Ganyn Robert Arnaud Assere Lanciné Kaba Kouamé Innocent M’bra Loukou Blaise Yao Bada Justin Léopold Niaoré Sery Koffi Léopold Krah michel Kodo Orthopaedics-Traumatology Department of the University Hospital of Bouak Bouak Ivory Coast Plastic and Reconstructive Surgery Department of the University Hospital of Bouak Bouak Ivory Coast

The study evaluated the effectiveness of honey dressings in healing recent skin wounds with soft tissue loss on limbs. Conducted over a year with 60 patients, results showed a significant reduction in wound size and early healing, with complete recovery on average within 29 days. The study supports honey as a viable wound treatment.

关键词： Healing Honey Limbs Loss of Substances

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Profile of Full-Term Births in Maternity Wards of Public Hospitals in Douala Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 705-720页

作者： Henri Essome Merlin Boten Bounyom Astrid Ndolo Kondo Ingrid Doriane Ofakem Ilick Fulbert Mangala Nkwele Irène Cyrielle Edjoa Mboe michel Roger Ekono Alphonse Ngalame Nyong Robert Tchounzou Moustapha Bilkissou Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Théophile Nana Njamen Valère Mve Koh Pascal Foumane Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon Faculty of Medicine and Pharmaceutical Sciences of Sangmelima University of Ebolowa Ebolowa Cameroon

Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.

关键词： Profile Delivery Term Malaria Douala

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Screening of Myocardial Cardiotoxicity Induced by Anticancer Chemotherapy and the Importance of Global Longitudinal Strain

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World Journal of Cardiovascular Diseases 2024年第6期14卷 381-391页

作者： Marguerite Téning Diouf Fatou Aw Hussein Khadra Sophie Ba Doudou Diouf michel Ngonar Sarr Joseph Salvador Mingou Malick Ndiaye Simon Antoine Sarr Momar Dioum Aliou Alassane Ngaide Serigne Mor Beye Simon Manga Alain Affangla Youssou Diouf Khadimu Rassoul Diop Malick Bodian Mohamed Leye Mouhamadou Bamba Ndiaye Alassane Mbaye Adama Kane Maboury Diao Abdoul Kane Cardiology Department of the Dalal Jamm Hospital Dakar Senegal Cardiology Department Hospital Aristide Le Dantec Dakar Senegal Cardiology Department Hospital Fann Dakar Senegal UFR2S Saint Louis Saint Louis Senegal UFR Ziguinchor Ziguinchor Senegal Training and Research in Health Sciences Unit University of Thies Thies Senegal Cardiology Department Hospital General Idrissa Pouye Dakar Senegal

Introduction: The improvement of survival in patients with cancer and the expansion of therapeutic options have led to the emergence of a new profile of cardiotoxicity, specifically associated with antimitotic agents. Our study aimed to assess the incidence of chemotherapy-induced myocardial toxicity in patients with cancer. Patients and Methods: We conducted a looking-forward longitudinal cohort study including all patients admitted to the Cardiology departments of Aristide le Dantec Hospital and Dalal Jamm National Hospital Centre for apre-chemotherapy check-up. The included patients did not undergo any pre-existing cardiopathy. Results: Over a period of two years ranging from January 2019 to December 2021, a total of 37 patients were included in the study. Notably, there was a female predominance (92%) with an average age of 49.7 years ± 13.69. Breast cancer accounted for 70% of the neoplasms. Laboratory findings revealed moderate anemia in 19 patients (51%). At inclusion, the left ventricle (LV) was of normal size (LV diastole at 44.46 ± 4.97 mm). The systolic function of the left ventricle was normal in all patients, with an average ejection fraction (EF) of 63.1% ± 5.80 and a mean global longitudinal strain (GLS) of −20.4% ± 2.58. The most commonly used agents were anthracyclines. During follow-up, 3 patients (8.1%) developed clinical symptoms of left heart failure, and LV dysfunction on echocardiography was observed in 5 (13.5%) patients, with a significant decrease in EF Conclusion: The incidence of cardiac toxicity is not negligible, hence the importance of early screening. Strain imaging is an essential tool that should be performed as part of the assessment before chemotherapy and re-evaluated during treatment.

关键词： Cancer Chemotherapy Global Longitudinal Strain Cardiotoxicity

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后危机时代的公共财政管理

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金融发展研究 2018年第12期 37-39页

作者：马尔科·坎贾诺特里萨·克瑞斯汀米歇尔·拉扎尔王宇(译) 不详中国人民银行研究局

公共财政管理有助于制定财政政策,并为财政政策的有效实施提供各类工具,其主要目标是维持财政状况的可持续性、实现资源有效配置以及促进公共产品和公共服务的公平分配。公共财政管理的创新包括强化财政责任的新法律框架、财政规则、中... 详细信息

公共财政管理有助于制定财政政策,并为财政政策的有效实施提供各类工具,其主要目标是维持财政状况的可持续性、实现资源有效配置以及促进公共产品和公共服务的公平分配。公共财政管理的创新包括强化财政责任的新法律框架、财政规则、中期预算框架、新的财政风险管理技术、绩效预算等,这些改革在过去20年中得以推行。全球金融危机后预算制度和财政透明度受到重视,制度安排的关键是政府应充分、全面地认识公共财政的当前状况和未来发展。

关键词：公共财政管理财政政策预算制度财政透明度

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AB034. In vivo laser-mediated retinal ganglion cell optoporation using Kv1.1 conjugated gold nanoparticles

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Annals of Eye Science 2018年第1期 440-440页

作者： Ariel M.Wilson Javier Mazzaferri Éric Bergeron Sergiy Patskovsky Santiago Costantino michel Meunier Przemyslaw Sapieha Department of Engineering Physics École PolytechniqueMontrealQCCanada Department of Biochemistry Hôpital Maisonneuve-RosemontMontrealQCCanada

Background:There is a current void in efficient,cell-specific,retinal drug delivery systems,thus developing a safe,effective,selective drug delivery system would open novel therapeutic *** previously demonstrated that femtosecond(fs)laser irradiation can transfect DNA plasmids into cultured cells in the presence of gold nanoparticles(AuNPs).These AuNPs locally amplify laser energy at a submicron range creating transient pores allowing exogenous genetic material or cell impermeable dyes to enter the ***,we sought out to selectively optoporate retinal cells in vivo with functionalized AuNPs and a 800 nm femtosecond(fs)***:The cell-surface Kv1.1 voltage-gated channel was chosen to selectively target retinal ganglion cells(RGC)in the rat ***-capped spherical 100 nm AuNPs functionalized with orthopyridyl-disulfide-poly(ethylene glycol)(5 kDa)-N-hydroxysuccinimide(OPSS-PEG-NHS)conjugated to a Kv1.1 monoclonal antibody were injected intravitreally in Sprague Dawley rats 3 hours prior to irradiation,concomitantly to a FITC-dextran dye to detect *** eyes of anesthetized rats were placed in the beam path of a laser system consisting of an 800 nm,100 fs laser and a Heidelberg Spectralis HRA ophthalmoscope for fundus *** rat retina was irradiated at powers ranging from 20-750 mW,the eyes fixed in 4%paraformaldehyde,dissected,rinsed,mounted and imaged by confocal ***:Our novel laser system coupled to a Heidelberg ophthalmoscope allowed for a clear visualisation of the rat ocular fundus.A timecourse of AuNP intravitreal injections revealed that optimal nanoparticle dispersion on the retinal surface occurred at 3 hours post *** Kv1.1-AuNP and FITC-dextran intravitreal injection and incubation,irradiation at 120-750 mW resulted in FITC uptake by retinal ***:Since living biological tissues absorb energy very weakly at 800 nm,this non-invasive tool may provide a safe,cost effecti

关键词： Nanoparticle laser optoporation

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