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Cerebral Malaria: Epidemiological, Clinical and Prognosis Aspects in the anesthesia-resuscitation department CHU Ignace Deen

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Open Journal of Emergency Medicine 2023年第4期11卷 162-173页

作者： Abdoulaye Touré Amadou Yalla Camara Almamy Bangoura M’mah Lamine Camara Mohamed Soumah Saramba Nabe department of anesthesia-resuscitation University Hospital of Ignace Deen of Conakry Conakry Guinea department of Medical and Surgical Emergency Donka University Hospital Conakry Guinea department of anesthesia-resuscitation Donka University Hospital Conakry Guinea

Objective: To describe the epidemiological, clinical, paraclinical and prognostic aspects of cerebral malaria received in the anesthesia-resuscitation department. Methodology: This was a prospective descriptive type study carried out in the anesthesia-resuscitation department over a period of three (03) months (June 01 to August 31, 2022). All patients admitted for cerebral malaria were included. Sociodemographic, clinical and prognostic parameters were studied. Results: We collected 25 cases out of 105 admitted patients (23.8%). The average age was 27.6 ± 9.5 years with extremes of 11 and 50 years. The sex ratio was 0.7 (M/F). Students and housewives were in the majority, i.e. 52% and 24%. Neurological disorders were found on admission in all patients, dominated by impaired consciousness at 100% followed by convulsion (60%), prostration (44%), confusion (36%) associated with deep coma in (68%). Gross hemoglobinuria was present in (84%) of cases. On the blood count, anemia was present in (70%) of the patients followed by thrombocytopenia in more than half of the cases (60%) and transfusion was necessary in 19 cases. P Falciparum malaria was found in all patients (100%), the average parasite density was 60342.8 ± 30425.6 trophozoites/μl with extremes of 9000 to 100000 trophozoites/μl. All our patients were treated with intravenous injectable artesunate. Transfusion was performed in 76% of our patients. Eighty percent of the patients had benefited from dialysis. High oxygen therapy was performed in (92%) of cases. The average duration of hospitalization was 5.74 ± days with extremes of 1 to 17 days. Mortality was 48%. Conclusion: Cerebral malaria can take different clinical forms, the most important of which is cerebral involvement. Prompt initiation of appropriate resuscitation can reduce mortality.

关键词： Cerebral Malaria Mortality resuscitation

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Chest Trauma at the Emergency department of the Gabriel TouréUniversity Hospital Bamako, Mali

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Open Journal of Emergency Medicine 2021年第2期9卷 18-24页

作者： Almeimoune Abdoulhamidou Diop Madane Thierno Mangane Moustapha Démbele Seidou Alaji Coulibaly Mahamadoun Sogoba Youssouf Abdoulaye Chiad Mahamadoun Cisse Harouna Sangare Sidy Yattara Ogalat Enyengue Murielle Ingrid Kassogue André Diallo Boubacar Amadou Bah Madiassa Konaté Yoro B. Sidibe Diango Djibo Mahamane department of anesthesia Resuscitation and Emergency Medicine at CHU Gabriel Toure Bamako Mali Bamako Faculty of Medicine and Odontostomatology Bamako Mali resuscitation anesthesia Service CHU IOTA Bamako Mali anesthesia and Intensive Care Unit CHU Luxembourg Bamako Mali Neurosurgery department The Gabriel Touré University Hospital Bamako Mali Emergency department The Hospital of Mali Bamako Mali department of anesthesia Resuscitation and Emergency Medicine at CHU Point G Bamako Mali General Surgery department The University Hospital of Gabriel Toure Bamako Mali

In Mali, chest injuries remain a real public health problem and are associated with heavy morbidity and mortality. Faced with a resurgence of urban civil violence and the explosion of road accidents, we decided to conduct this study in order to describe the epidemiological, clinical and therapeutic aspects of thoracic trauma in the emergency department. Method and Material: This is a descriptive prospective study over a period of one year in the emergency department of the CHU Gabriel Touré. Including all patients admitted for thoracic trauma. Analysis and Entry: Data were entered and analyzed on SPSS software version 20.0. The test was significant for a p value Results: We recorded 21,090 appeals in our structure among which 1284 patients were suspected of thoracic trauma. The diagnosis of thoracic trauma was retained in 119 (0.56%) patients. All patients were transported to the emergency room without prehospital medicalization. Clinical presentation was dominated by dyspnea in 54.6% of patients, however pain was the almost constant symptom in conscious victims. Various traumatic mechanisms had caused these lesions of the thorax, of which road traffic accidents represented half of the causes, followed by urban civil violence in 28.6% of patients. Landslides and falls from a great height were responsible for 19.5% of chest injuries. Open chest trauma was the type of lesion found in a third of the cases. This type of injury was exclusively due to blows and injuries during the brawls. Standard chest radiography was performed as the first intention in 60% of patients compared to 10.9% for the pleuropulmonary ultrasound. Thirteen patients required ventilatory assistance after orotracheal intubation. The average length of stay was 65.23 hours. During the period of our study, the overall mortality was 1.85% in the emergency departments with a lethality specific to chest trauma of

关键词： Chest Trauma Emergencies Bamako Mali

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Spatial transcriptomics combined with single-nucleus RNA sequencing reveals glial cell heterogeneity in the human spinal cord

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Neural Regeneration Research 2025年第11期20卷 3302-3316页

作者： Yali Chen Yiyong Wei Jin Liu Tao Zhu Cheng Zhou Donghang Zhang department of Anesthesiology West China HospitalSichuan UniversityChengduSichuan ProvinceChina Laboratory of anesthesia and Critical Care Medicine National-Local Joint Engineering Research Center of Translational Medicine of AnesthesiologyWest China HospitalSichuan UniversityChengduSichuan ProvinceChina department of Anesthesiology Longgang District Maternity&Child Healthcare Hospital of Shenzhen City(Longgang Maternity and Child Institute of Shantou University Medical College)ShenzhenGuangdong ProvinceChina department of Anesthesiology Affiliated Hospital of Zunyi Medical UniversityZunyiGuizhou ProvinceChina

Glial cells play crucial roles in regulating physiological and pathological functions,including sensation,the response to infection and acute injury,and chronic neurodegenerative *** cells include astrocytes,microglia,and oligodendrocytes in the central nervous system,and satellite glial cells and Schwann cells in the peripheral nervous *** the greater understanding of glial cell types and functional heterogeneity achieved through single-cell and single-nucleus RNA sequencing in animal models,few studies have investigated the transcriptomic profiles of glial cells in the human spinal ***,we used high-throughput single-nucleus RNA sequencing and spatial transcriptomics to map the cellular and molecular heterogeneity of astrocytes,microglia,and oligodendrocytes in the human spinal *** explore the conservation and divergence across species,we compared these findings with those from *** the human spinal cord,astrocytes,microglia,and oligodendrocytes were each divided into six distinct transcriptomic *** the mouse spinal cord,astrocytes,microglia,and oligodendrocytes were divided into five,four,and five distinct transcriptomic subclusters,*** comparative results revealed substantial heterogeneity in all glial cell types between humans and ***,we detected sex differences in gene expression in human spinal cord glial ***,in all astrocyte subtypes,the levels of NEAT1 and CHI3L1 were higher in males than in females,whereas the levels of CST3 were lower in males than in *** all microglial subtypes,all differentially expressed genes were located on the sex *** addition to sex-specific gene differences,the levels of MT-ND4,MT2A,MT-ATP6,MT-CO3,MT-ND2,MT-ND3,and MT-CO_(2) in all spinal cord oligodendrocyte subtypes were higher in females than in ***,the present dataset extensively characterizes glial cell heterogeneity and offers a valuable resource for explo

关键词： astrocyte glial cell human microglia oligodendrocyte sex differentiation single-nucleus RNA sequencing spatial transcriptomics species variation spinal cord

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Sleep as a window to understand and regulate Alzheimer's disease:emerging roles of thalamic reticular nucleus

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Neural Regeneration Research 2025年第6期20卷 1711-1712页

作者： Haoqi Sun Shiqian Shen Robert J.Thomas M.Brandon Westover Can Zhang department of Neurology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Center for Translational Pain Research Department of AnesthesiaCritical Care and Pain MedicineMassachusetis General HospitalHarvard Medical SchoolBostonMAUSA Division of Pulmonary Critical Care and Sleep MedicineDepartment of MedicineBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Genetics and Aging Research Unit McCance Center for Brain HealthMass General Institute for Neurodegenerative DiseaseDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA

Introduction:Alzheimer 's disease(AD) is a common neurodegenerative disorder and the primary cause of dementia. Considerable evidence supports the “amyloid hypothesis,” stating that the pathogenesis of AD is primarily caused by the deposition of amyloid-β(Aβ), which drives tau phosphorylation, neuroinflammation, and neurodegeneration in the brain. The amyloid hypothesis is strengthened by the significant and moderate benefit of lecanemab, a humanized antibody through an anti-amyloid mechanism,showing slowed clinical decline(van Dyck et al.,2023). The recent positive results of anti-amyloid trials have brought back focus on the amyloid hypothesis through biochemical, genetic, and pharmacological approaches(Zhang, 2023).

关键词： Alzheimer inflammation hypothesis

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Noninvasive Respiratory Strategies in Patients with Acute Hypoxemic Respiratory Failure and COVID-19 in Gabon: A Prospective Observational Study

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Open Journal of Emergency Medicine 2024年第1期12卷 18-27页

作者： Ghislain Edjo Nkilly Raphael Okoue Ondo Fernande Manga Stéphane Oliveira Jean Marcel Mandji-Lawson Romain Tchoua department of Emergency anesthesia resuscitation Omar Bongo Ondimba Army Training Hospital Libreville Gabon department of anesthesia and resuscitation Libreville University Hospital Center Libreville Gabon department of anesthesia and resuscitation Akanda Army Training Hospital Libreville Gabon

Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique that could reduce the need for tracheal intubation and mortality in patients with respiratory failure due to COVID-19 admitted to intensive care units (ICUs) of Military’s Hospital (HIAOBO) in Gabon. Design, Setting, and Participants-Methodology: Prospective observational study over 10 months (January 2021-October 2021). We included patients admitted to intensive care for SARS Cov2 pneumonia who had benefited from available ventilatory support: high concentration face mask, High Flow Nasal cannula (HFNC), NIV (Non Invasive Ventilation), Continuous Positive Airway Pressure (CPAP). The choice was guided by the clinical condition, and the choice of the prescribing physicians. Recourse to mechanical ventilation was decided when faced with a Glasgow score of less than 13, an SpO2/FiO2 ratio ≤ 300, a FR ≥ 35/min, the impossibility of drainage of secretions. Main Outcomes and Measures: The primary outcome was the proportion of patients requiring intubation. The secondary outcomes were mortality in ICU. Results: The sample included 97 patients, the average age was55.6 years, hypertension was the main comorbidity (51.1%). Mean respiratory rate (RR) was 30.8 cycles/min, admission SpO2 was 83%, respiratory alkalosis was present in 63% of patients, mean CT involvement was 51%.Respiratory support was NIV (56.7%), CPAP (21.65%), high concentration face mask (18.55%). Sixteen percent (16%) of patients were intubated, 93% of them following failure of NIV. Mortality was 30%, mechanical ventilation was an independent risk factor for mortality. Conclusions: Non Invasive Ventilation, CPAP, and high-concentration face mask were frequently used in patients with COVID-related acute respiratory failure. The CPAP has reduced the need for intubation. Mechanic

关键词： Respiratory Failure COVID 19-Intensive Care Units Military Hospital Gabon

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Outcome of the Post-Operative Patients’ Admissions in the Field of resuscitation in Mali

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Open Journal of Anesthesiology 2020年第3期10卷 73-79页

作者： Samaké Broulaye Massaoulé Beye Seydina Alioune Tchaou Blaise Adélin Kassogué André Tall Fadima Koureissi Keita Mohamed Service of anesthesia resuscitation Academic Hospital Gabriel Touré Bamako Mali Service of anesthesia resuscitation Academic Hospital Point G. Bamako Mali Service of anesthesia Resuscitation and Emergencies Academic Hospitable Center and Department of the Bourgou/Alibori Parakou Benin Service of anesthesia resuscitation Academic Hospital Kati Bamako Mali

Introduction: In spite of the use of the less and less invasive and the more and more effective techniques and the use of fast rehabilitation conditions of the patients in surgery, the post-operative complications (POC) stay the main reasons of admission in resuscitation service. Objective: To determine the post-operative outcome of the patients admitted in resuscitation. Patient and method: It was about a retrospective and transverse survey from June 2017 to May 2018 in the service of polyvalent resuscitation of the academic hospital center of Gabriel Touré. Have been included the patients operated for surgical or obstetric gynecology—pathologies admitted in resuscitation for post-operative complications established or potential precocious or late. The used statistical test was the Chi2 with p Results: During the period, 514 patients have been admitted in resuscitation of which 140 cases of post-operatively represented 27.2% of the admissions. Under hospitalization 35.7% of patients have presented a complication. The middle age of patients was 37.72 ± 20.9 years. The sex ratio was 0.70. The middle length of interventions was 122 ± 83 min with extremes going from 20 to 434 min. The predominant admission motive was hemodynamic instability. The delay of appearance intervening of the complications was 3 days in 94%. The predominant complications were: respiratory (32%), infectious (28%) and Cardiovascular (20%). The middle length of hospitalization was of 3.36 ± 2.90 days. The death rate was 15%. The complications were related age, the class of Alteme?er, the ASA, and the perioperative undesirable events with p Conclusion: The post-operative admissions in resuscitation are frequent including several factors of morbi-mortality. A better management per and postoperative of the patients operated would reduce the death rate. The profile mark is the one of a patient admitted for hemodynamic instability.

关键词： Post-Operative Admission Outcome resuscitation Academic Hospital Gabriel Touré

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Dosage Formula in anesthesia for Manual Intrauterine Aspiration Post-Abortion in Resource-Limited Settings

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Pharmacology & Pharmacy 2024年第4期15卷 71-80页

作者： Serge Ibula Rivain Iteke Berthe Barhayiga Doddie Tsansya Roger Cishugi Jean Jacques Kalongo Sandra Sagboze Jean Paul Cikwanine Dieudonné Sengeyi ISTM/Bukavu anesthesia-resuscitation Section CIMAC Hospital Center in Goma Goma The Democratic Republic of the Congo department of anesthesia-resuscitation University of Lubumbashi Lubumbashi The Democratic Republic of the Congo department of anesthesia-resuscitation University of Kinshasa Kinshasa The Democratic Republic of the Congo department of Gyneco-Obstetrics University of Kinshasa Kinshasa The Democratic Republic of the Congo anesthesia-resuscitation department Panzi Hospital Bukavu The Democratic Republic of the Congo

Setting: Provincial General Reference Hospital of Bukavu, General Reference Hospital of Panzi, General Reference Hospital of Ciriri, General Reference Hospital of Nyatende and Biopharm Hospital Center. Objective: Contribute to the improvement of the anesthetic ECP of patients benefiting from MVA for incomplete abortion, Describe the methodology used for adoption of the dosage formula in anesthesia for MVA, present the mathematical demonstration leading to the dosage formula in anesthesia for MVA. Materials and Methods: Our study was descriptive by mathematical demonstration of obtaining the equilibrium constant of the dosage formula of bipuvacaine 0.1% and Fentanyl 50 µg% adapted to the weight and specific size of patients treated anesthetically in MVA cases for incomplete abortion. We also carried out an operational research by first determining the interval where our equilibrium constant is included and secondly by means of the ends of the intervals found correlated to the ends of intervals of possible weights and sizes in the being normal human female of childbearing age to arrive at the real numerical value of the equilibrium constant of the BUKAVU Dosage Formula in the case of anesthesia for MVA during the management of incomplete abortions. Results: TWO-STAGE OPERATIONAL RESEARCH: • Determination of the interval where the equilibrium constant x = −0.95 x x by crossing the means between the extremes of volumes of anesthetic drugs giving a satisfactory sensory block without hemodynamic disturbance and the extremes of normal weight and height for women of childbearing age. We ended up with X = 0.37. Conclusion: At the end of our study which had the general objectives of contributing to the improvement of the anesthetic PEC of patients receiving MVA for incomplete abortion and specific objectives of describing the methodology used for adoption of the dosage formula in anesthesia for MVA and present the mathematical demonstration which resulted in the dosage formul

关键词： Dosage anesthesia Intrauterine Aspiration DR Congo

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Prognosis of the Patients in resuscitation Field in Mali

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Open Journal of Anesthesiology 2019年第12期9卷 213-220页

作者： Broulaye Massaoule Samake Andre Kassogue Blaise Adelin Tchaou Aichata Konate Fadima Koureissi Tall Lassina Goita Seydina Alioune Beye Hamadoun Dicko Mamadou Karim Toure Mohamed Keita Dieneba Doumbia Service of anesthesia and resuscitation Teaching Hospital Gabriel Toure BamakoMali Service of anesthesia Resuscitation and EmergenciesAcademic Hospitable Center and Department of the Bourgou/AliboriParakouBenin Service of anesthesia Resuscitation and Emergency of the Academic Hospitable Center of KatiKatiMali Service of anesthesia Resuscitation and the Emergencies of the Center Hospitable Academic Point GBamakoMali Service of anesthesia resuscitation and Emergency of the Academic Hospitable Center Luxemburg BamakoMali

Introduction:The patients whose vital prognosis is immediately threatened by one or several serious organs failures and consecutive to various pathologies are admitted in resuscitations(IUC).The rates of morbi-mortality are raised in ***:To study the prognostic *** and Methods:It was about a transverse survey from January 2015 to April 2016 in the unit of polyvalent resuscitation of the service of anesthesia resuscitation of the academic hospital center of Gabriel *** included all patient admitted for medico-surgical pathologies of more than three hours of *** was about a consecutive recruitment of *** Chi^(2) and Fisher tests were used for the comparison of our results with a p value=0.05 considered as *** consent of the patients or parents was *** survey didn’t include a potentially dangerous ***:During the period,624 patients have been collected of which:50.4%were medical pathologies,19.4%surgical pathologies and 30.2%of gynéco-obstetric *** least a complication had occurred in 11.2%.Mortality was of 27%.The sex-ratio was of *** middle age was of 31.88±17,2 years with extremes of 2 years and 80 *** met complications were:the scab,the syndrome of acute respiratory distress(ARD),the urinary infection,the pneumopathie,the shock,thrust hypertensive,stops cardio circulatory with respectively 35.1%,26.6%,22.3%,6.4%and 3.2%.The middle length of stays was of 4.83±5.32 days with extremes of 1 day to 29 ***:The complications under hospitalization in unit(IUC)of resuscitation in Mali are a major challenge in term of prevention and *** potentially non serious pathologies complicate themselves and compromise the vital prognosis.

关键词： Morbimortality resuscitation Academic Hospitable Center Mali

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Practice of Pediatric Spinal anesthesia in a Country with Limited Means: Example of Togo

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Open Journal of Anesthesiology 2023年第2期13卷 32-45页

作者： Essohanam Tabana Mouzou Sarakawabalo Assenouwe Pikabalo Tchetike Eyram Yoan Makafui Amekoudi Tchaa Hodabalo Towoezim resuscitation anesthesia department at the Kara-CHU Kara Togo CHU-Sylvanus Olympio anesthesia resuscitation department in Lome Lome Togo Medical resuscitation and Nephrology Service of the CHU-Kara Kara Togo CHU-Kara Traumatology department Kara Togo

Introduction: The practice of spinal anesthesia in pediatric surgery is declining, especially in countries with limited means. What about in our context? Objective: To evaluate the practice of spinal anesthesia in pediatric surgery in Togo. Framework and method of study: This was a prospective study from November 2017 to May 2018 in pediatric surgery at CHU SO de Lomé, in the operating room and hospital ward of CHU Kara. The surgical, anesthesiological and evolutionary aspects of the patients were analyzed. Results: Sixty children were selected for the study who had an indication for sub-umbilical surgery. The male sex was predominant (73.3%). 47 (78.30%) patients were operated on for scheduled surgery. Hernia repair was the most performed surgical intervention (43.30%). The mean duration of the surgery was 78 ± 35.9 minutes. Most of the patients were ASA 1 (98.30%). The local anesthetic used was 0.5% isobaric Bupivacaine. Fentanyl was the predominant adjuvant (55%). The most widely used lumbar puncture needle was 25 Gauge with 75 millimeters in length (63.30%). Diazepam was the most widely used sedative (50%). The predominant spinal anesthesia protocol was spinal anesthesia alone (60%). Only one patient had hypotension (1.70%). Conclusion: The fairly satisfactory pediatric spinal anesthesia in Togo remains poorly performed. Its promotion involves the training of anesthesia practitioners and the strengthening of the technical platform.

关键词： Pediatric Surgery Spinal anesthesia Togo

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Dexmedetomidine mitigates isoflurane-induced neurodegeneration in fetal rats during the second trimester of pregnancy

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Neural Regeneration Research 2017年第8期12卷 1329-1337页

作者： Zhi-yuan Su Qing Ye Xian-bao Liu Yu-zhong Chen Hong Zhan Shi-yuan Xu department of anesthesia The Third Affiliated Hospital of Guangzhou Medical University department of anesthesia Zhujiang Hospital of Southern Medical University

Dexmedetomidine has significant neuroprotective effects. However, whether its protective effects can reduce neurotoxicity caused by isoflurane in fetal brain during the second trimester of pregnancy remains unclear. In this study, timed-pregnancy rats at gestational day 14 spontaneously inhaled 1.5% isoflurane for 4 hours, and were intraperitoneally injected with dexmedetomidine at dosages of 5, 10, 20, and 20 μg/kg 15 minutes before inhalation and after inhalation for 2 hours. Our results demonstrate that 4 hours after inhaling isoflurane, 20 μg/kg dexmedetomidine visibly mitigated isoflurane-induced neuronal apoptosis, reversed downregulation of brain-derived neurotrophic factor expression, and lessened decreased spatial learning and memory ability in adulthood in the fetal rats. Altogether, these findings indicate that dexmedetomidine can reduce neurodegeneration induced by isoflurane in fetal rats during the second trimester of pregnancy. Further, brain-derived neurotrophic factor participates in this process.

关键词： nerve regeneration dexmedetornidine isoflurane fetal rat apoptosis brain-derived neurotrophic factor behavior neuroprotection neurodegeneration neural regeneration

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