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Context: Poor adherence to treatment remains a major obstacle to efficient tuberculosis (TB) control in developing countries. Innovative strategies to improve access and adherence to treatment are needed.Objectives: To assess the effectiveness of a contextualized intervention strategy aimed at improving patients' adherence to treatment and to evaluate its impact on TB control in a resource-poor country in Africa with prevalent TB infection.Design, Setting, and Patients: A cluster randomized controlled trial, conducted between June 2003 and January 2005, at 16 government district health centers in Senegal. Patients older than 15 years with newly diagnosed sputum smear-positive pulmonary TB were randomly assigned to the intervention or control group.Intervention: The intervention strategy included reinforced counseling through improved communication between health personnel and patients, decentralization of treatment, choice of directly observed therapy (DOT) supporter by the patient, and reinforcement of supervision activities. In the control group, the usual TB control program procedures remained unchanged.Main Outcome Measure: Proportion of patients successfully completing the 8-month course of treatment and the proportion of patients defaulting from treatment.Results: A total of 1522 patients were recruited into the study. Treatment was successful for 682 (88%) of 778 patients recruited in the intervention group, and for 563 (76%) of 744 patients recruited in the control group (adjusted risk ratio [RR], 1.18; 95% confidence interval [CI], 1.03-1.34). The proportion of patients defaulting was reduced in the intervention group to 5.5% (n = 43) compared with 16.8% (n = 125) in the control group (adjusted RR, 0.43; 95% CI, 0.21-0.89).Conclusion: The intervention package based on improved patients counseling and communication, decentralization of treatment, patient choice of DOT supporter, and reinforcement of supervision activities led to improvement in patient outcomes compared with the usual TB control procedures. This approach may be generalized in the context of TB control programs in resource-poor countries.Trial Registration: clinicaltrials.gov Identifier: NCT00412009. [ABSTRACT FROM AUTHOR]

Twenty-five samples of soft plaque and calcified plaque deposits from human hearts or aorta were analyzed using inductively coupled plasma-mass spectrometry (ICP-MS). The determined elements were Ca, P, Na, K, Mg, Zn, Cu, Ba, Pb, Fe, Al, Si, and S. Results showed that the concentration of all elements in the soft plaque was at the micromolar level. In the calcified deposits, the concentrations of Ca and P were at least an order of magnitude higher than the soft plaque, but the other elements were at the same order of magnitude. In the calcified plaque the molar ratios of Ca/P suggested that a significant portion existed as hydroxyapatite Ca10(PO4)6(OH)3. However, their absolute concentrations indicated that this compound was not a major component of the plaque although it may play a major role in determining the crystal structure of the deposit. In some samples the Ca/P ratio was too high to conform to hydroxyapatite. In others it was too low. This indicated that both the calcium and phosphorus existed in other chemical forms which varied from sample to sample. In the soft tissue the P level was high indicating it existed primarily in chemical forms other than hydroxyapatite. The presence of homocysteine is often associated with heart disease. However, the low levels of sulfur indicate that although it may be present, it is not a major component of the plaque, but may nevertheless play an important role in its formation. [ABSTRACT FROM AUTHOR]

The plaque deposits in bypass arteries and native arteries from the same heart have been studied using solid state cross polarization nuclear magnetic resonance (CP/MAS NMR). Both 13C and 31P signals were observed. The samples are of interest because plaque in native arteries may have deposited during the lifetime of the patient. However, plaque in the bypass occurred since bypass surgery. It has been observed that the mature plaque in native arteries was more calcified than that in bypass arteries, especially if the latter had not matured to become significant in size. Results showed that the concentrations of carboxylate carbons present in cholesterol esters were similar in native and bypass arteries. However, the areas of the 13C peaks of the carboxylate compared to the sum of areas of all other 13C arteries indicated that the carboxylate was attached to five or six other carbons. From this we can calculate that the carboxylate to other carbon ratio in the remainder must be 1:4 or 1:3. This indicates large quantities of other organic compounds in the deposits. Studies of 31P showed that phosphorus existed primarily as hydroxyapatite in the crystalline native plaque. However, a large proportion existed as organic phosphorus in the bypass plaque. In addition, we studied the interactions of calcium with homocysteine and cholesterol. Calcium‐homocysteine and cholesterol‐homocysteine precipitates were characterized using 13C solid state NMR. Results showed that calcium appeared to interact with sulphur in the homocysteine which seemed to form dimers and polymers. [ABSTRACT FROM AUTHOR]

Capillary electrochromatographic (CEC) separations of unsaponifiable lipids, tocopherols (T), tocotrienols (T3), and plant sterols were studied under various conditions. Investigated stationary phases include pentafluorophenylsilica (PFPS), triacontylsilica (TCS), and octadecylsilica (ODS) phases. A baseline separation of four sterols (ergosterol, lanosterol, sitosterol and stigmasterol) on ODS was achieved and their elution order was found to be dictated by side-chain structures. CEC of the tocol-derived compounds on PFPS in aqueous methanol yielded the most satisfactory results with complete resolution of all components eluting in the order δT3>βT3>γT3>εP>αT3>δT>ζ2T>βT>γT>αT, while a reversal in elution of the εT–αT3 pair was observed in aqueous acetonitrile. CEC with a TCS phase in non-aqueous methanol led to a different elution pattern δT3>γT3>βT3>αT3εT>δT>(ζ2+γ)T>βT>αT, despite favorable resolution of the (γ–ζ2)T pair along with the observation of inseparable(β–γ)T and (β–γ)T3 pairs in non-aqueous dimethylformamide. Non-aqueous acetonitrile mobile phases provided unique selectivity for the (γ–ζ2)T pair and isomer separations on TCS. Variations in separation and retention factors of relevant antioxidant species with CEC variables were evaluated. Examples of CEC quantification of unsaponifiable fractions of rice bran oils and soybean oils are presented. [Copyright &y& Elsevier]

Abstract: Selecting a site that meets the technical requirements for a concentrating solar power plant (CSP) is a very critical exercise. This paper points out crucial factors and provides guidelines regarding the selection of suitable sites. It especially focuses on Sahelian countries which have their own climatic peculiarities. These countries, characterized by low access to electricity, are well endowed in solar resources. They are potentially good locations for concentrating solar power plants since their mean daily solar radiation exceeds 5.5kWh/m2. CSP presents therefore, a good opportunity for them to increase in a sustainable manner, their energy supply. The guidelines developed in this paper are applied to Burkina Faso as a case study. [Copyright &y& Elsevier]

Aim: to evaluate the contribution of laparoscopic surgery in the management of chronic abdominal pains which etiology is unspecified. Results: 52 patients suffering from chronic abdominal pain for 3 months have been listed. They were 36 women and 16 men, with a sex-ratio of 2.25. The pathologies found in laparoscopy were: 16 cases of adherences, 16 cases of gynaecological diseases, 6 cases of chronic appendicitis, 5 cases of chronic cholecystitis, 6 cases of abdominal tumors and 3 cases of intra uterine dispositif in abdomen. Conversion to laparotomy was not made and mortality was null. No lesion was found in 11.54% of cases. The mean duration of hospitalization was 2 days. The duration of follow-up of the patients was 18 months with a minimum of 6 months and a maximum of 24 months. No painful symptomatology was found in 6 months in 88.46% of the cases. A persistent stomach pains were found in 3% of the cases. 8.54% of the patients had an improvement of symptomatology. Conclusion: Chronic abdominal pains put a diagnosis problem in surgery. Laparoscopy is a reference technique to diagnose this pain and to discuss them. [ABSTRACT FROM AUTHOR]

Introduction Le VIH/sida est dans de nombreux pays un grave problème de santé pour les populations carcérales et constitue un sérieux défi pour les services pénitentiaires, les services de santé publique et les gouvernements nationaux. Objectifs Déterminer la prévalence de l’infection à VIH chez les détenus et d’en décrire les facteurs associés. Matériels et méthodes Il s’est agi d’une étude transversale à visée descriptive et analytique conduite de décembre 2015 à octobre 2016 chez 600 détenus suivis à partir d’un échantillon aléatoire, représentatif du niveau national, tiré directement à partir de la base de sondage prenant en compte l’effectif des sites dans leur exhaustivité. Des questionnaires préétablis renseignant sur les caractéristiques socio-démographiques et biologiques des détenus ont permis le recueil des données. L’analyse des données à été faite avec le logiciel SPSS 18. Résultats L’enquête a porté sur un échantillon aléatoire de 600 détenus parmi lesquels 593 ont accepté le prélèvement de sang pour le test du VIH. La série était composée en majorité d’hommes (89 %). L’âge moyen était de 35 ans. La proportion d’enquêtés scolarisés était de 60 %, plus élevée chez les hommes. Concernant le statut matrimonial, la proportion de détenus mariés était de 51,8 %. Presque les trois quarts (71,2 %) en étaient à leur première incarcération et 51,8 % en détention préventive. Les motifs d’incarcération étaient variés dominés par l’usage de drogue (35,3 %) alors que seuls 4,6 % affirmaient continuer à s’adonner à la drogue durant leur séjour carcéral. Parmi les détenus 97,8 % ont déjà eu une expérience sexuelle avec un âge moyen au premier rapport sexuel de 19 ans. Seuls 20,5 % des enquêtés ont déclaré avoir utilisé un préservatif lors de leur premier rapport sexuel. Le multi-partenariat est estimé 17,8 %. La prévalence de l’infection à VIH était élevée chez les détenus (2 %) par rapport à la moyenne nationale (0,7 %). Cette prévalence était associée au sexe féminin (4,5 %) ( p = 0,0124), à l’âge inférieur à 35 ans (2,5 %) ( p = 0,346), à la non scolarisation (2,5 %) ( p = 0,046),au statut matrimonial de divorcés (8,7 %) ( p = 0,044), à l’escroquerie comme motif de détention (5,7 %) ( p = 0,11) et à la profession de femme de ménage (12,5 %) ( p = 0,002) et de commerçant (3,5 %) ( p = 0,29) avant l’incarcération. Conclusion Les détenus sont très vulnérables face à l’infection à VIH d’où la nécessité de mener des actions efficaces de prévention et de prise en charge en milieu carcéral. [ABSTRACT FROM AUTHOR]