University Hospital Center Research Articles

Nodule de Soeur Marie Josèphe sur cancer ovarien: à propos d’un cas

Sister Mary Joseph’s tumor or nodule is a cutaneous ombilical metastasis of a visceral cancer. It is a rare tumor that constitutes the calling symptom of the cancer disease. Its incidence is from 1 to 3% of all abdominal and pelvic neoplasia. They bring up etiologic diagnosis issue, since the finding of the primitive cancer could be difficult et prognosis. We are reporting a case observed in the Hepato-gastro-enterology Unit of the University Hospital Center of Sino-Central African Friendship in Bangui. This observation will help us show the difficulties of early diagnosis and therapeutic care in a limited resources context.

Psychological distress among nurses: Exploring the role of support in the work-place in Morocco.

This study aimed to assess the psychological distress, specifically anxiety and depression, among nurses employed at University Hospital Center of Rabat in Morocco and tested the associations between support in the workplace and nurses' psychological well-being. A cross-sectional observational study was conducted at University Hospital Center of Rabat in Morocco, based on a prospective data collection employing an ad-hoc self-report questionnaire. 223 nurses were enrolled with a minimum of 1 year of practice in any care unit. Socio-demographic and professional characteristics of each participant were included. A validated tool was utilized to measure the support from superiors and colleagues in the workplace, while the Hospital Anxiety and Depression Scale (HADS) was employed to evaluate anxiety and depression. Univariate and multivariate analyses were conducted to explore the relationships between different independent and dependent variables. Significant socio-demographic and professional factors associated with increased anxiety included female gender, age over 41 years old, Baccalaureate level of education, intention to leave the hospital, and less support from superiors. Regarding the levels of depression, the Baccalaureate level of education was significantly associated with higher levels of depressive symptoms (β 2.444; CI [1.203, 3.686]). Our findings suggested that ensuring support from superiors was crucial for safeguarding the psychological well-being of nurses. Therefore, hospital managers should prioritize addressing the workplace support for professionals, and the organizational enhancement.

Feasibility of Sexual Health and Contraceptive Web Services for Adolescents and Young Adults: Retrospective Study of a Pilot Program on Reunion Island.

Sexual health indicators for adolescents and young adults (AYAs) aged between 13 and 25 years are particularly poor on Reunion Island. Access to accurate information as well as sexual health and contraceptive services are vital to maintaining sexual well-being. Teleconsultations offer a promising approach to addressing the sexual health and contraceptive needs of AYAs who are more susceptible to engaging in unprotected sexual intercourse. However, the literature on digital sexual health services for this demographic group is limited. This study aims to describe the feasibility of a pilot sexual health and contraceptive teleconsultation web service used by AYAs on Reunion Island. A descriptive, retrospective study was conducted at the Reunion Island University Hospital Center using a convenient sample. Eligible participants were informed about the program through various communication channels, including seminars for health care professionals, radio broadcasts, posters, flyers, press articles, videos, and social media posts. AYAs accessed a web-based platform named SEXTUOZE from December 15, 2021, to September 30, 2022, that offered sexual health information and teleconsultations. Data collected included participant and teleconsultation characteristics, patient satisfaction, and the quality of completeness of medical records. A total of 22 teleconsultations were scheduled and 7 were completed, all via synchronous video communication (duration: median 35 min). Overall, 4731 sessions were generated on the SEXTUOZE website. Reasons cited for accessing the web services were to seek sexual health advice (8/22, 36%), receive an initial birth control prescription (12/22, 55%), and inquire about condom prescriptions (2/22, 9%). While teleconsultation use for sexual health was initially low, it rose toward the end of the study period. Considering all elements of the implementation theory, future research should design interventions that not only are more operative and tailored but also ensure their adoption and sustainability in various health contexts.

Assessing humoral immunity in daily practice: A retrospective study in a pediatric tertiary center

The evaluation of humoral immunity is usually performed through the assessment of serum immunoglobulin levels, vaccine titer responses, and B-cell enumeration and phenotyping. We performed a retrospective study assessing humoral immunity in 469 pediatric patients referred at the Sainte-Justine University Hospital Center. Almost half of the patients had at least one abnormal humoral immunological parameter at their evaluation, with low vaccine response titer to protein antigen being the most frequent. Fifteen patients (3.2 %) had a proven monogenic IEI, and 21 patients (4.5 %) required Ig replacement. Besides the infectious burden, hypoIgG remains the only parameter associated with Ig replacement therapy after the age of 6 years. Low antibody titers against conjugate vaccines had low sensitivity and positive predictive values for starting Ig replacement. Our study highlights the challenge of evaluating the humoral function in the pediatric population with suspected IEI with significant age and sex-dependent variability between parameters.

Epidemiological profile of severe malaria and sickle cell disease in children at the mother and child university hospital center Jeanne Ebori foundation of libreville from 2020 to 2021

Background: Hemoglobinopathies represent the most common genetic diseases worldwide. In Gabon, the clinico-biological profile of patients with homozygous hemoglobin S or those with AS sickle cell traits, faced with this prevalence of serious malaria, remains unknown today. The objective was to evaluate the complications of severe malaria in SS homozygous sickle cell patients and those carrying AS sickle cell traits. Methods: This is an observational, retrospective study, with descriptive and analytical aims which took place from January 2020 to October 2021. The parameters studied were socio-demographic, clinical and paraclinical data, the diagnosis chosen, therapeutic data and evolution. Results: severe neurological form of malaria was the most common criterion with a frequency of 41.7%, followed by parasitic forms 35.8% and anemic forms 21.8%. Among AS heterozygotes, the most widespread severe form was the neurological form with a frequency of 63.2%, the anemic form 26.3% and parasitic at 10.5%. In homozygous SS subjects, the most widespread severe form was the anemic form with a frequency of 68.1% followed by neurological forms 27.7% and parasitic forms 4.2%. Abdominal pain, prostration, respiratory distress were the main signs in SS homozygotes. In heterozygotes, prostration, convulsion and clinical jaundice were the main signs. A total of 99.8% of our patients were cured. Conclusions: All the electrophoretic profiles identified were subject to this infection which mainly affects heterozygous AS subjects and subjects with the AA electrophoretic profile in its severe neurological form and homozygous SS subjects in its anemic form.

Prevalence and predictors of precancerous cervical lesions among women living with HIV in Libreville, Gabon

BackgroundHIV-infected women are at an increased risk of developing precancerous cervical lesions (PCL) than non-infected women. In Gabon, no data exists on the prevalence of PCL among women living with HIV. The aim of this study was to assess the prevalence and risk factors associated with the development of PCL among HIV-positive women in Libreville, Gabon.MethodologiesThis was a retrospective study carried out within the Gynecology and Obstetrics Department of University Hospital Center of Libreville (CHUL) from January to August 2016. It included women registered at the HIV Clinic of Nkembo, and screened for PCL or cervical cancer (CC). Descriptive statistics were used to characterize sociodemographic data and the prevalence of PCL. The chi square and odd-ratio tests were used to evaluate the associations between PCL, CD4 count, antiretroviral use, age at first sexual intercourse, number of sexual partner tobacco, and contraception use.ResultsAmong the 115 HIV-positive women recruited, 33 (28.70%; SD ± 0.45) were diagnosed with PCL. 79.1% of them were on antiretroviral therapy (ART), and the mean CD4 cell count value was 411.74 cells/mm3 (SD ± 241.77). Being on ART, age, number of sexual partners, contraceptive use and smoking were not risk-factors linked with the development of PCL. CD4 cell count was the only associated risk-factors (p-value: 0.02).ConclusionThe incidence of PCL among HIV-infected is high in Libreville, Gabon, especially among those with baseline CD4 counts < 200 cells/mm3. This study recommends screening for cervical cancer for all HIV-infected women.

Guideline-directed medical therapy patterns in heart failure with reduced ejection fraction: the OPTIMA-HF registry

Abstract Background/Introduction European guidelines strongly recommend an optimized pharmacological treatment in patients with heart failure with reduced ejection fraction (HFrEF) with a fast introduction of the four-pillars. Purpose Aim of the Optimization of Therapy in the Italian Management of Heart Failure [OpTIMa-HF] Registry was to collect data on HF patients to describe the current Italian population of HF patients with a specific focus on HFrEF treatment adherence and prescription rates, according to the most recent European Guidelines. Methods OPTIMA-HF is an observational, cross-sectional, multicenter, real-life study conducted in two different clinical settings: HF outpatients’ clinics of Italian University Hospitals and territorial Italian Cardiology outpatients’ services, that enrolled patients with chronic HFrEF receiving at least 1 oral medication for management of HF. Patients were characterized by baseline use and dose of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB)/angiotensin receptor neprilysin inhibitor (ARNI), beta-blocker, mineralocorticoid receptor antagonist (MRA) and sodium glucose co-transporter II inhibitor (SGLT2i). Patient-level factors associated with medication use were examined. Results Overall, 1390 patients from 29 ambulatory cardiology practices and university hospitals were included. Mean age was 69.5 ± 11.9 years, 24% were female, and median EF was 33 (28-37). Among enrolled patients, 72.2% were prescribed ARNI, 17.1% ACEI/ARB, 95% beta-blocker, 75.5% MRA and 63% SGLT2i therapy (Figure 1). Despite high prescription rates for each single class, a still not sufficient number of patients was on treatment with all four pillars, in particular 40.4% considering the presence ARNI and 6.2%. When medications were prescribed, few patients were receiving target doses of ACEI/ARB (31.7%), ARNI (16%), and beta-blocker (33.3%), whereas a higher proportion were receiving target doses of MRA therapy (38%), and all were receiving target dose for SGLT2i. Among patients eligible for all classes of medication, only 1.1% were simultaneously receiving target doses of ACE/ARB/ARNI, beta-blocker, MRA and SGLT2i. Prescription rates did not significantly differ between the type of center (University Hospital vs. territorial Cardiology outpatients’ services). As regards patients not on treatment with any of the four pillars, a small but still present amount of patients had no contraindications to these drugs (Figure 1). Conclusions In this contemporary outpatient HFrEF Italian registry, significant high prescription rates of the four-pillars were observed, however therapy combination rate is still not sufficient and drugs' titration need to be implemented to receive the greatest benefits from an optimized treatment. Strategies to improve guideline-directed use of HFrEF medications remain urgently needed, and these findings may inform targeted approaches to optimize outpatient medical therapy.

Prehospital point of care ultrasound in Helicopter Emergency Medical Services: a 5-year experience study in Belgium

IntroductionThe utilization of Clinical Ultrasound (CUS) in Helicopter Emergency Medical Services (HEMS) has become increasingly prevalent, reflecting its significant role in emergency care.MethodsThis descriptive, monocentric study, conducted at the Helicopter Medical Center (CMH) of Bra-sur-Lienne, Belgium, aimed to describe the use of CUS within HEMS and evaluate its potential impact on diagnostic accuracy, therapeutic interventions, and hospital destination decisions.ResultsOver a 5-year period, from January 2018 to December 2022, our retrospective analysis included 6,126 HEMS interventions, with CUS performed in 29.55% of cases. The study demonstrated that CUS led to therapeutic changes in 30.88% of instances and affected the hospital destination in 9% of cases, despite a potential bias toward directing patients to the University Hospital Center of Liège (CHU of Liège) due to operational constraints. The agreement between prehospital CUS findings and hospital imaging was substantial, with an 80.39% concordance rate, underscoring CUS's utility in enhancing prehospital diagnostic accuracy. We found no significant increase in on-scene time due to CUS usage, with most exams completed in &amp;lt;5 min.DiscussionOur findings highlight the interesting role of CUS in HEMS, facilitating more informed and confident medical decision-making in prehospital emergency care. However, variability in CUS application emphasize the need for standardized guidelines to optimize its use. The study's limitations include its retrospective, monocentric design and the focus on on-scene ultrasound evaluations. Future research should aim at a more extensive, prospective analysis to further validate the benefits of CUS in emergency medical services.

Screening of Klebsiella pneumoniae isolates reveals the spread of strong biofilm formers and class 1 integrons.

Klebsiella pneumoniae is a Gram-negative bacterium that can colonize, penetrate, and cause infections at several human anatomical locations. The emergence of hypervirulent K. pneumoniae and its ability to evade the immune system and develop antibiotic resistance has made it a key concern in the healthcare industry. The hypervirulent variants are increasingly involved in community-acquired infections. Therefore, it is pertinent to understand the biofilm formation potential among the clinical isolates. We acquired 225 isolates of K. pneumoniae from the Department of Microbiology, Symbiosis University Hospital and Research Centre (SUHRC), Pune, India over 1 year from March 2022- March 2023, and evaluated antimicrobial susceptibility, hypermucoviscous phenotype, virulence, and antimicrobial-resistant gene distribution in K. pneumoniae isolates and established a correlation between antimicrobial resistance and integrons. Most isolates were strong biofilm formers (76%). The isolates harbored one or more carbapenemase/ beta-lactamase encoding gene combinations. Hypermucoviscous (HMKP) isolates had considerably greater positive rates for iutA, magA, K2 serotype, rmpA, and rmpA2 than non-HMKP isolates. Isolates carrying integrons (43%) showed significantly more antibiotic resistance. The study reveals spread of strong biofilm formers with extensive virulence and antimicrobial-resistant genes, and integrons responsible for multi-drug resistance among the clinical isolates of K. pneumoniae in Pune, India, posing a threat to the public health and necessitating close surveillance, accurate diagnosis, control, and therapeutic management of infections.

Paragangliome et grossesse : une histoire mictionnelle palpitante

Objectives: Carrying out a pregnancy to term in a patient with a paraganglioma or pheochromocytoma (PPGL) results from a multidisciplinary challenge. The objective was to compare our therapeutic attitude with the existing literature and to identify optimal treatment.Methods: Description of a case of paraganglioma treated during pregnancy at the University Hospital Center of Caen (France) in 2024 and comparison with the literature.Results: We describe a patient with a family history of paraganglioma, in whom paravesical PPGL was discovered at 18 weeks of gestation. The symptoms were marked by episodes of palpitations and headaches during urination. The diagnosis was confirmed by a measurement of urinary metanephrines associated with magnetic resonance imaging. After initiation of alpha-blocker treatment, delivery was performed by cesarean section at 36 weeks of gestation. An excision was carried out by laparoscopy 2 months postpartum without intra- and post-operative complications.Conclusions: The absence of antenatal diagnosis of PPGL is the main risk factor increasing maternal and fetal mortality. Certain criteria such as a family history, the appearance of early or malignant arterial hypertension should suggest the diagnosis of PPGL. The initiation of alpha-blocker treatment upon diagnosis is essential. The curative therapy remains surgical excision. Its timing depends on its size, location, term of pregnancy and route of delivery. It is preferable to postpone it until postpartum in order to reduce the risk of complications.

Exploring the long-term disability outcomes in Trauma patients: study protocol

ObjectivesTrauma registries are essential tools for improving trauma care quality and efficiency, but many fail to capture long-term patient-reported outcome measures (PROMs). Focusing on these outcomes is crucial for understanding the extent of disability patients experience and identifying potential post-discharge interventions to optimize recovery. Studies reflecting the experience from low- and middle-income countries in this area are limited. Therefore, we aim to develop a digital trauma registry in Pakistan to prospectively capture patient-reported outcome measures at one, three, six, and twelve months post-injury.MethodsWe will develop and implement a digital trauma registry at two tertiary care facilities in Karachi, Pakistan: Aga Khan University Hospital and Jinnah Postgraduate Medical Center. The registry will include all admitted adult trauma patients (≥ 18 years). Data collection will be conducted digitally using tablets, with mortality, level of disability, functional status, and quality of life as primary outcomes. Follow-up data will be collected through telephone interviews with patients and caregivers. We will employ descriptive statistics to summarize participant’s socio-demographic and clinical characteristics. Additionally, we will perform survival analysis using Kaplan-Meier curves and Cox proportional hazard models and utilize mixed-effects linear regression to adjust for potential confounders for primary outcomes.DiscussionThe trauma registry will fill the current gap in knowledge regarding long-term outcomes among trauma patients in low- and middle-income countries (LMICs). This study will delineate future direction for capturing post-discharge data, enhancing our understanding of recovery, and informing the design of interventions aimed at improving long-term outcomes.

Human papillomavirus carriage in the semen of men consulting for infertility: prevalence and correlations with sperm characteristics.

We aim to study the semen carriage of human papillomavirus (HPV) and evaluate its association with patient characteristics. We conduct a single-center cohort study at Amiens University Hospital Center (Amiens, France). From May 1 to October 31, 2021, 461 men consulting for infertility and with semen analysis data were included. Each participant gave his written informed consent for the use of laboratory, demographic, clinical, and lifestyle data. A proportion of the semen samples were sent to a virology laboratory for HPV screening in a polymerase chain reaction (PCR) assay. In univariate and multivariate analyses with a logistic regression model, HPV+ and HPV- groups were compared with regard to semen characteristics (including the DNA fragmentation index and the sperm decondensation index) and demographic, clinical, and lifestyle variables. Semen HPV carriage was detected in 22.3% of the patients. High-oncogenic-risk HPV genotypes were predominant (57.6%). Multivariate analysis showed that HPV carriage was significantly associated with the presence of at least one abnormal spermogram dinging (according to the 6th World Health Organization criteria), with an adjusted odds ratio (OR) of 4.10 (95% confidence interval [CI]: 2.32-7.25, P < 0.001). A statistically significant association was also found for the type of infertility (OR: 1.61, 95% CI: 1.00-2.57, P = 0.05), the presence of varicocele (OR: 3.99, 95% CI: 1.48-10.71, P = 0.01), and a history of cryptorchidism, testicular ectopia, or monorchidism (OR: 3.54, 95% CI: 1.07-11.66, P = 0.04). Infection with a single HPV genotype or multiple HPV genotypes was significantly associated with at least one abnormal spermogram finding for all HPV oncogenic risk groups (OR: 3.93, 95% CI: 2.08-7.41, P < 0.001; and OR: 4.11, 95% CI: 1.58-10.68, P = 0.01, respectively). The association between sperm HPV carriage and the risk of infertility was statistically significant in a multivariate analysis (OR: 5.63, 95% CI: 3.16-10.01, P < 0.001) and after adjustment for the propensity score (OR: 6.10, 95% CI: 3.33-11.21, P < 0.001). Our results suggest that semen HPV carriage has an impact on male fertility. Sperm screening for HPV might be a useful addition to the work-up for male infertility.

Prevalence and Associated Factors of Central Sensitization in Patients with Chronic Inflammatory Rheumatic Disease.

Despite advances in the treatment of Chronic Inflammatory Rheumatic Disease (CIRD), pain remains a significant burden for patients and doctors. This study explored the prevalence and associated factors of central sensitization (CS) in patients with CIRD. This is a cross-sectional study that included patients with CIRD followed at the University Hospital Center in Tangier. Sociodemographic and clinical data were collected. Nociceptive pain was assessed by the Visual Analogue Scale (VAS), disease activity by DAS-28 and ASDAS, and CS by the validated Moroccan version of the Central Sensitization Inventory part A (CSI-A). The Pain Catastrophizing Scale (PCS) was used to assess pain-related catastrophic thoughts, and the PHQ-9 (Pain Health Questionnaire) was used to determine the severity of depressive symptoms. We included 189 patients; 107 (56.61%) had rheumatoid arthritis. The median duration of evolution of CIRD was 8 years, and the mean age was 47.49 ± 13.70 years, and 75.7% were women. The mean pain VAS was 4.77+-2.76, and 37.6% of patients were in remission. The mean central sensitization score was 37.42+- 16.75, with 44.9% having a CSI score≥40. In univariate and multivariate analysis, our study showed that central sensitization is associated with pain severity (β = 1.945(0.050-1.916), p = 0.039) and depression (β = 1.790(1.221-2.154), p ≤0.001)(8). A statistically significant correlation was found between the CSI-A score and pain VAS (r = 0.32, p <0.001). Our study showed that almost half of our patients with CIRD had CS. The main factors associated with CS in our patients were pain severity and depression. We also found a significant correlation between pain VAS and CSI.

Bacterial Meningitis in Children Aged from 0 to 15 Years Hospitalized in Paediatrics at the Gabriel Touré University Hospital Centre

Bacterial Meningitis in Children Aged from 0 to 15 Years Hospitalized in Paediatrics at the Gabriel Touré University Hospital Centre

Knowledge and practices of interventional radiology staff regarding radiation protection

Interventional radiology (IR) has become a widespread medical imaging technique, offering minimally invasive treatment options. However, IR procedures can expose patients and staff to substantial radiation risks, necessitating enhanced radiation protection practices. This study aimed to survey the knowledge and practices of interventional radiology staff regarding radiation protection. A cross-sectional study with a descriptive aim, based on a questionnaire was done. The study subjects were all healthcare personnel of all specialties having practiced in interventional radiology between 2019 and 2022 at the University Hospital Center of Rabat. The statistical processing was carried out using Microsoft Excel 2013® and the IBM SPSS Statistical program version 20 (IBM Inc. NY, USA). The results indicated that 59.4% of participants had not received any specific training in radiation protection, and 45% were unaware of the radiation-induced risks associated with interventional radiology procedures. Regarding safety practices, 75% of participants maintained a distance of at least 1 meter from the x-ray source, while only 6% used the lowest possible exposure settings. Concerning the use of radiation protection devices, 87.5% of participants wore a lead apron, 75% used a thyroid shield, 6.3% wore lead glasses, and 37.5% utilized suspended mobile screens, whereas 12.5% did not use any radiation protection devices. Additionally, 84% of participants wore their personal dosimeter, though not consistently. The knowledge and practices of most interventional radiology personnel are inadequate for effective radiation protection. Regular, ongoing training in radiation safety is essential to improve adherence to protection standards and enhance overall safety in clinical practice.

Bimalleolar Fractures in Adults: Epidemiological and Therapeutic Aspects at Kati University Hospital Center

The aim of this work was to study the epidemiological and therapeutic aspects of bimalleolar fractures in the Orthopedics-Traumatology Department of the Kati University Hospital Center. This was a descriptive retrospective study of a series of 63 recent bimalleolar fractures collected between June 1, 2016 and May 31, 2019. The mean age of the patients was 40.68±14.32 years with extremes of 18 and 75 years. The age group of 21 to 40 years was the most affected with 50.8% of cases. Male sex was predominant (sex ratio: 2). Road accidents and domestic accidents (falls) were the main etiologies of these fractures. Weber's C-Type was predominant with 49.2%. Fractures were open in 25.3% of cases. Treatment was surgical (66.7%) or orthopedic (33.3%). K-wire was the most used implant for both the lateral malleolus (28 cases) and the medial malleolus (19 cases). The evolution was favourable in 64 cases (62.74%). Infection was the most common secondary complication (9.5%). Overall algofunctional outcomes were good in 84.3%. Bimalleolar fractures are frequent and severe traumatic injuries. Their treatment should restore the anatomy and function of the ankle and prevent the harmful occurrence of complications.

Implementing Industry-Inspired Quality Practices in Healthcare: A Study From the Pathology Department of the University Hospital Center of Tangier.

In Morocco's public health sector, scientific research has produced only theoretical models of quality, with empirical studies sometimes producing practical recommendations. In contrast, benchmarks from the industrial sector demonstrate a much smoother and more effective implementation of a quality culture. This article considers practices inspired by the quality culture in the industrial sector, applying them in the Department ofPathological Anatomy and Cytology (ACP) of the University Hospital Center of Tangier (CHUT). The ACP department has demonstrated a strong commitment to fostering a dynamic quality culture in its professional activities, focusing on the advancement and regulation of pathology techniques to enhance procedures and deliver accurate diagnoses to patients. This approach could facilitate the implementation of quality systems management that would earn certification and/or accreditation. Our methodology applied the "Plan-Do-Check-Act" and "Standardize-Do-Check-Act" models to analyzethe initial quality and compare this with the Join Commission International standards chosen by CHUT. We then planned the implementation of corrective actions for each deviation and verified the efficiency of the action plan, and finally maintained a dynamic cycle.There was an implementation score of 60% in two years, mainly starting with the development and implementation of risk analysis for all activities of laboratory development and the implementation of specific Key Performance IndicatorsKPI and specific methods to manage all human resources items.

Prevalence of high-risk human papillomavirus genotypes and viral load correlated with squamous cell inflammation among women in Gabon

BackgroundHigh-risk genotypes of Human Papillomavirus are responsible for 90% of cases of cervical cancer worldwide. Inflammation of squamous cells is mainly linked to HPV. In Gabon, HPV is endemic and circulates among the female population. The study aimed to determine the prevalence of HR-HPV genotypes and to investigate the correlation between squamous cell inflammation and HPV viral load in infected women in Gabon.MethodsThe cross-sectional study was conducted at Libreville University Hospital Center (UHC) and National Public Health Laboratory from March to May 2024 among 399 women. Two cervical smears were taken. Genotype detection was carried out by multiplex fluorescence real-time PCR in the NPHL virology unit. Cytology was carried out in UHC’s anatomic-pathology laboratory. Data were analyzed by SPSS software. Graphs were plotted using Microsoft Excel 2016.ResultsThe prevalence of Human Papillomavirus was 26.1% (95% CI: 22-30.6). The prevalence of HR-HPV genotypes was 24.8%. The most common HR-HPV genotypes were HPV-16/52/18/35/56/58/53/68. The rate of multiple HPV infections was 29.8% and 95.2% for the HR-HPV infection rate. Viral load was significantly correlated with squamous cell inflammation (r = 0.977 and P = 0.001).ConclusionHR-HPV infection remains a concern in women, however early screening is necessary for optimal monitoring and management. HR-HPV viral load is a predictive marker of squamous cell inflammation.

Clinical research for saliva-based therapeutic drug monitoring of linezolid.

Linezolid is primarily used to treat of methicillin-resistant Staphylococcus aureus and multidrug-resistant tuberculosis infections. Thrombocytopenia due to linezolid usage is a concern, and therapeutic drug monitoring has been reported to be effective in its prevention. Plasma concentrations provide valuable information for treatment decisions; however, collecting plasma samples can be burdensome for both patients and healthcare providers. Therefore, there is interest in saliva as an alternative for monitoring, considering its potential to replace plasma samples. Patients hospitalized at Hokkaido University Hospital and Hokkaido Spinal Cord Injury Center between April 2022 and July 2024, who received oral or intravenous linezolid treatment, were enrolled. The concentrations of linezolid were simultaneously measured in plasma and saliva samples. We determined the concentration profiles of linezolid in the saliva and examined the correlation between saliva and plasma linezolid concentrations. Eighteen patients receiving linezolid were enrolled. The average of saliva/plasma (S/P) concentration ratios of linezolid were 1.018. A strong correlation was found between the salivary and plasma concentrations of linezolid (R= .833, P< .001). Notably, in patients receiving intravenous administration of linezolid, the correlation was even more pronounced (R= .885, P< .001). Additionally, when focusing on the S/P ratio of the trough concentrations in the morning and at night, the S/P ratios at night were much closer to 1.0. The concentrations of linezolid in plasma and saliva were similar, indicating their potential applicability in clinical settings. The monitoring of linezolid concentrations in saliva has been shown to be particularly suitable for patients receiving intravenous administration.

Patient Blood Management During Major Orthopaedic and Traumatological Surgery at Renaissance University Hospital Center in Chad

Patient Blood Management During Major Orthopaedic and Traumatological Surgery at Renaissance University Hospital Center in Chad