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Biomedical subjects

C Fall

Publications and source records attributed to C Fall.

At least 19 recordsLinked to original sources
PubMed2006

Design of a monitoring network and assessment of the pollution on the Lerma river and its tributaries by wastewaters disposal.

While the 2005 progress report of the United Nations Millennium Development Goals stresses out the need of a dramatic increase in investment to meet the sanitation target in the third world, it is important to anticipate about some parallel negative impacts that may have this optimistic programme (extension of sewer networks without sufficient treatment works). Research was initiated on Lerma River (Mexico), subjected to many rejects disposal, to design a monitoring network and evaluate the impact of wastewaters on its water quality. The discharges was inventorized, geo-positioned with a GPS and mapped, while the physico-chemical characteristics of the river water, its tributaries and main rejects were evaluated. Microtox system was used as an additional screening tool. Along the 60 km of the High Course of Lerma River (HCLR), 51 discharges, with a diameter or width larger than 0.3 m (including 7 small tributaries) were identified. Based on the inventory, a monitoring network of 21 sampling stations in the river and 13 in the important discharges (>2 m) was proposed. A great similitude was found between the average characteristics of the discharges and the river itself, in both the wet and dry seasons. Oxygen was found exhausted (<0.5 mg/L) almost all along the high course of the river, with COD and TDS average levels of 390 and 1980 mg/L in the dry season, against 150 and 400 mg/L in the wet season. In the dry season, almost all the sites along the river revealed some toxicity to the bacteria test species (2.9 to 150 TU, with an average of 27 TU). Same septic conditions and toxicity levels were observed in many of the discharges. Four of the six evaluated tributaries, as well as the lagoon (origin of the river), were relatively in better conditions (2 to 8 mg/L D.O., TU<1) than for the Lerma, acting as diluents and renewal of the HCLR flow rate. The river was shown to be quite a main sewer collector. The high surface water contamination by untreated wastewaters that is depicted in this research should be taken into account in the Millennium Goals strategies, by promoting treatment plan works simultaneously, when sewer networks in the third world would extend.

Aliivibrio fischeri↗
PubMed2003

[Economic contribution of gynecological and obstetrical ultrasound in an advanced strategy for the Zinguinchor region].

Aiming to strengthen the accessibility of ultrasound technology to rural populations, an advanced strategy ultrasound programme was implemented in the health districts of Sedhiou, Oussouye, Bignona and Ziguinchor all located within Casamance in Senegal. Within the first year of activity (January 1, 2001-December 31, 2001), the team from the regional health centre (RHC) was dispatched 56 times. Ultrasound scans were performed in the homes of 1,273 patients among which 192 were referred to the RHC for specialised follow-up and treatment. The financial benefit for the RHC totaled 3,120,000 francs; 2,612,500 francs for the district hospital; and 3,561,300 francs for the population at large. The advanced strategy for performing ultrasound scans has therefore been economically profitable at the community level as much as at the level of health structures. Through supporting the activities of the district hospitals, the RHC contributed technical support and increased the potential, not solely for the treatment of disease but for the health services overall. The revenue generated has given managers a greater possibility to improve health care and services. The decentralisation programme and reduction in the cost have decreased the unsatisfied needs in ultrasound services by making the technology more financially and geographically accessible. Thus, by saving input costs in terms of time, transportation and capital, the practice of ultrasound scans in district hospitals has been strengthened and has improved the capacity to provide care and treat the population's health problems. The continuation of this programme is advantageous, but necessitates two complementary actions: enhancing of the technical level and capacity of the district hospitals with the installation of ultrasound technology and equipment, and raising the level of knowledge by training staff in administering ultrasound scans.

Delivery of Health Care↗
PubMed2003

[Impact of the number of antenatal consultations on the morbidity and mortality of children and women in the health district of Ziguinchor].

In order to assess the impact of the number of antenatal consultations (CPN) on the foetal and maternal morbidity and mortality, a prospective survey has been carried out in 1999, in the health district of Ziguinchor, Senegal. The investigation was led in seven health facilities which offered obstetrical cares, from January 1 to march 31, over a sample of 862 delivered women and 870 newborns. The number of antenatal consultations was zero in 26 cases (3%), one in 130 cases (15%), two in 198 cases (23%), three in 302 cases, and more than three in 206 cases (24%). Three elements of the mothers' profile have a statistically significant influence on the number of antenatal consultations: the delivery facilities, the ethnic groups, and the caesarean antecedent. For the other elements, the test is not significant. The number of antenatal consultations has a statistically significant link with: eclampsia, abruptio placentae, distich and maternal death. Some elements of the mothers' profile seem to be a cause of morbidity and mortality of children and women. In fact, we have notice: a statistically significant link between the health facilities and the dystocy; and between ethnic groups and abruptio placentae; an impossibility of drawing conclusion for the other cases. In short, the eclampsia and the maternal death are the only elements which seem to be improved by an increasing number of CPN without any influence of external factors.

Adolescent↗
PubMed2002

[Outcome of early pregnancies at the Gynecological and Obstetrical Service of the Regional Hospital Center of Ziguinchor].

In order to evaluate the evolution and the issue of pregnancies among women who are less than 20 years old, a retrospective inquiry has been made in the gynecological and obstetrical service at the regional hospital center of Ziguinchor, in Senegal. It covered a period of three years from January 1st 1997 to December 31st 1999. It concerned 477 cases of patients received at the end of their pregnancy. The risks of morbidity and mortality were globally higher in the group of 13-17 than that of 18-19. The Khi2 test has confirmed a statistically significant difference (p < 0.05) for evacuation, hospitalizations, abortions and dead-born frequencies. For the study of the other parameters (causes of evacuations, length of stay in hospital, evolutive term, way of delivery, maternal death frequency and theircauses, and the types of dead-born), the frequencies haven't been significantly different. So, the risk of morbidity and mortality is higher with the pregnancy of adolescents who are less than 18 years old. Hence the interest of doing every thing to prevent pregnancies among adolescents by an appropriate contraceptive method and to look with priority after any pregnancy occurring among this age group.

Adolescent↗
PubMed2000

[An innovative training experience in public health at the Cheikh Anta Diop University of Dakar].

The Institute for Health and Development (ISED) at the University of Dakar, was created in 1987. Its mission is to fulfill the public health training needs of Senegalese health care professionals. ISED is responsible for a training program entitled "Certificat d'études Spéciales" (CES), the equivalent of a Masters of Public Health degree. The "CES" is a two-year program comprised of six modules, which last four months each. The ISED training approach stresses trainee responsibility above all. It is based on the trainee's professional tasks and is oriented toward the problems identified by the trainees themselves. In this sense it is highly adaptive and flexible. Each module is implemented in the same way; initially there is a 15 day residential phase for intensive theoretical courses, followed by an application period of 75 days in the trainee's work place, and then a final residential phase of 15 days for writing and presenting a technical report on the work in the field. This model allows trainees to bring together the theoretical and the practical. The trainers directly supervise each of these three phases. The two residential phases are conducted in the ISED training center, located in Mbour, 80 Km south of Dakar. 103 trainees are enrolled in the program in seven different classes. Of these trainees, 93 are health care specialists (85 physicians 7 pharmacists, 1 dentist). Ninety percent of previous graduates have been civil servants who work for the Ministry of Health in Senegal and the remaining 10% were from Burkina Faso and Togo. The training program is considered by all stockholders, beneficiaries, and relevant financial institutions, to be appropriate, beneficial and successful.

Certification↗
PubMed1999

Profiles of endogenous circulating cortisol and bone mineral density in healthy elderly men.

Exogenous glucocorticoids are known to increase the risk of osteoporosis. However, the contribution made by endogenous circulating cortisol concentrations to adult skeletal status remains unknown. We examined this issue in a sample of 34 healthy men, aged 61-72 yr. Venous blood samples were obtained under standard conditions every 20 min over a 24-h period. Measurements were made of serum cortisol and cortisol-binding globulin. Bone mineral density was measured at the lumbar spine and proximal femur using dual energy x-ray absorptiometry. Measurements were made at baseline and 4 yr later. There was a weak negative association between integrated cortisol concentration and lumbar spine bone density (r = -0.37; P < 0.05); similar relationships (P < 0.05) existed at three of five proximal femoral sites. There were also statistically significant positive associations between the trough cortisol concentration and bone loss rate at the lumbar spine (r = 0.38; P < 0.05), femoral neck (r = 0.47; P < 0.001), and the trochanteric region (r = 0.41; P = 0.02) over the 4-yr follow-up period. The cross-sectional relationships between cortisol concentration and bone density were removed by adjustment for body mass index, but the influence on bone loss rate remained significant after adjusting for adiposity, cigarette smoking, alcohol consumption, dietary calcium intake, physical activity, and serum testosterone and estradiol levels. These observations suggest that the endogenous cortisol profile of healthy elderly men is a determinant of their bone mineral density and their rate of involutional bone loss.

Aged↗
PubMed1999

[Occupational asthma in a Senegalese car sprayer. Diagnostic and medico-legal problems].

The industrial development policy adopted by African countries since their independence has contrasted with the relative rarity of occupational asthma in workers exposed to different situations and substances known to generate occupational asthma. Asthma occurring in a Senegalese car sprayer had persisted for twenty years before the its work-related nature was recognized. This observation demonstrates the need for: 1. Education to make health care personnel, as well as workers and employers, more aware of the clinical aspects of asthma. Educational programs should include diagnostic and preventive measures for respiratory occupational diseases including occupational asthma. 2. A registration system for occupational diseases so the occupational nature of diseases can acquire legal recognition. 3. Cooperative efforts between general practitioners, occupational physicians, physiologists and lung specialists in order to create reference laboratories where tests can be performed to confirm the diagnosis of occupational asthma, a disease which has not yet been included on the list of occupational diseases.

Asthma↗
PubMed1998

Programming of growth hormone secretion and bone mineral density in elderly men: a hypothesis.

Epidemiological studies suggest that retarded growth in infancy is associated with low adult bone mass. The mechanism underlying this association is unknown, but the programming of GH secretion or sensitivity by environmental influences during early development may play a role. We examined this issue in a sample of 37 healthy men, aged 63-73 yr, whose weight gain in infancy had been recorded. Venous blood samples were obtained under standard conditions every 20 min over a 24-h period. Measurements were made of the GH secretory profile, insulin-like growth factor I (IGF-I), IGF-binding protein-1 and -3, and GH-binding protein. Bone mineral density was measured at the lumbar spine and femoral neck using dual energy x-ray absortiometry. There was a statistically significant association between peak GH concentration (r = 0.46; P < 0.01) and fasting IGF-I concentration (r = 0.46; P < 0.01) with femoral neck bone density. After allowing for the peak GH concentration, median GH was negatively (P < 0.05) associated with bone mineral density. Weight at 1 yr was not related to peak GH, but was strongly related to the median GH concentration (r = 0.42; P = 0.01). These observations are consistent with a dual effect of GH secretion on bone density. High peak GH values drive IGF-I production and maintain bone mineralization in adult life. However, integrated GH secretion, after adjusting for the effect of pulse amplitude, is negatively associated with bone density in adult life. This particular characteristic of the GH secretory profile correlates with growth during infancy and might be programmed by environmental factors during intrauterine or early postnatal life.

Adult↗
PubMed1997

Polymorphisms of the vitamin D receptor, infant growth, and adult bone mass.

Family and twin studies have demonstrated a strong genetic component to the development of peak bone mass. Early fetal and infant environment has also been shown to influence bone mass through an effect on skeletal size and mineral content. We report a retrospective study that has examined whether early infant growth is regulated by genetic factors shown to be associated with bone mass. We have determined the vitamin D receptor (VDR) gene alleles for 66 women (mean age 65.5 years) on whom detailed birth records were available. There was a statistically significant trend (P = 0.04) for VDR genotype against weight at the age of 1 year, with the "tt" homozygote group having 7% higher weight. We conclude that early fetal or infant environment may interact with an individual's underlying genotype to program early skeletal growth, and that this may track through later life to influence adult characteristics. Further prospective studies are required, however, to fully clarify the precise environmental and genetic mechanisms underlying these findings.

Absorptiometry, Photon↗
PubMed1997

Growth in infancy and bone mass in later life.

OBJECTIVE: To examine the association between weight in infancy and bone mass during the seventh decade of life in a population based cohort for which detailed birth and childhood records were preserved. METHODS: 189 women and 224 men who were aged 63-73 years and were born in East Hertfordshire underwent bone densitometry by dual energy x ray absorptiometry. Measurements were also made of serum osteocalcin and urinary excretion of type 1 collagen cross linked N-telopeptide. RESULTS: There were statistically significant associations between weight at 1 year and bone mineral content (but not bone mineral density) at the spine (P < 0.02) and femoral neck (P < 0.01) among women, and spine (P < 0.03) among men. Although serum osteocalcin was negatively correlated with bone mineral density at both sites among men and women, infant weight was not significantly associated with either biochemical marker of bone turnover. CONCLUSIONS: These data confirm our previous observations that growth in infancy is associated with skeletal size in adulthood, and suggest that skeletal growth may be programmed during intrauterine or early postnatal life.

Aged↗
PubMed1997

The effects of genotype and infant weight on adult plasma levels of fibrinogen, factor VII, and LDL cholesterol are additive.

High circulating levels of cholesterol, particularly low density lipoprotein (LDL) cholesterol and the clotting factors fibrinogen and factor VII, are associated with increased risk of myocardial infarction. Variations in the plasma levels of these factors are determined in part by polymorphisms in the genes concerned and also by weight at 1 year (infant weight). We have looked at the possibility of interactions between these genetic factors and infant weight in a sample of 290 men and 192 women from Hertfordshire using the beta-fibrinogen G/A-455, factor VII R353Q, and ApoE polymorphisms. The rare allele frequencies of the three polymorphisms were 0.19 for beta-fibrinogen, 0.10 for factor VII, and 0.07 and 0.13 for the 2 and 4 alleles of ApoE, and these frequencies were not different in subjects of different infant weight. In this sample, the polymorphisms showed the expected effects on plasma levels of fibrinogen, factor VII, and LDL cholesterol. The A-455 allele was associated with higher fibrinogen levels but the effect was only statistically significant in women (p = 0.003). The R353 allele was associated with higher factor VII activity in both men and women (p < 0.0001 for both). The ApoE2 allele was associated with lower levels of LDL cholesterol (p = 0.03 in men, p = 0.006 in women), while the ApoE4 allele was associated with higher levels (p < 0.001 in men, not significant in women). In this sample of men and women the effect of low infant weight was only associated with significant effects on fibrinogen and LDL cholesterol in the group of men (p = 0.005 and p = 0.008 respectively). Compared with the E3E3 subjects, the LDL lowering effect of the E2 allele and the raising effect of the E4 allele was greater in those with low infant weight compared with those with high infant weight (low v high infant weight for E2: 12.7% v 9.4%; for E4 12.7% v 8.5%). Although in this sample the interactive effect did not reach statistical significance, the additive effect of ApoE genotype and low infant weight on determining plasma LDL cholesterol levels, if confirmed, may be of relevance in determining a person's future risk of atherosclerosis.

Adult↗
PubMed1997

Prenatal factors influencing long-term outcome.

Animal studies have shown that undernutrition before birth programmes persisting changes in a range of metabolic, physiological and structural parameters. Studies in humans have shown that men and women who had birth weights at the lower end of the normal range, who were thin or short at birth, or who were small in relation to placental size, have increased rates of coronary heart disease. This article suggests how fetal undernutrition at different stages of gestation may be linked to these patterns of early growth. Adaptations by the fetus to undernutrition are associated with changes in the concentrations of fetal placental hormones. Persisting changes in the level of hormone secretion and tissue sensitivity may link fetal undernutrition with adult disease.

Adult↗
PubMed1996

Growth in utero and cognitive function in adult life: follow up study of people born between 1920 and 1943.

OBJECTIVES: To examine the relation between fetal growth and cognitive function in adult life. DESIGN: A follow up study of men and women whose birth weights and other measurements of body size had been recorded at birth. SETTING: Hertfordshire, Preston, and Sheffield. SUBJECTS: 1576 men and women born in Hertfordshire, Sheffield, or Preston between 1920 and 1943. MAIN OUTCOME MEASURES: Intelligence quotient as measured by the AH4 test and amount of decline in cognitive function with age as estimated by the difference between score on the Mill Hill vocabulary test and score on the AH4 test. RESULTS: Score on the intelligence test was higher in people who had a large biparietal head diameter at birth, but it was not related to any other measure of body size or proportions. No association was found between decline in cognitive function and any measure of size or proportions at birth. CONCLUSION: Impaired fetal growth was not associated with poorer cognitive performance in adult life. Adaptations made by the fetus in response to conditions that retard its growth seem to be largely successful in maintaining brain development.

Adult↗
PubMed1996

Cigarette smoking and bone mineral density in the elderly.

OBJECTIVE: To test the hypothesis that cigarette smoking is associated with reduced bone mineral density in elderly men and women. DESIGN: Cross sectional study. SUBJECTS: These comprised 224 men and 186 women aged 61-73 years, born and resident in East Hertfordshire. MEASUREMENTS: Lumbar spine and femoral neck bone mineral density (BMD) were determined by dual energy x ray absorptiometry. RESULTS: After adjusting for potential confounding variables, men who were current smokers were found to have a lumbar spine BMD that was 7.3% (95% CI 0.4, 14.2) lower than men who had never smoked. Similarly, women who were current smokers had a BMD value that was 7.7% (95% CI 0.3, 15.6) lower than in women who had never smoked. The difference at the femoral neck was smaller and not statistically significant. For both men and women, each decade of smoking was associated with a reduction of 0.015 g/cm2 in BMD at the lumbar spine (95% CI: men 0.002, 0.027; women 0.003, 0.028). At the femoral neck the reduction in BMD was 0.011 g/cm2 (95% CI 0.003, 0.020) for men and 0.004 g/cm2 (95% CI -0.003, 0.012) for women with each decade of smoking. CONCLUSIONS: The results show an adverse effect of smoking on BMD which was most noticeable at the lumbar spine, and seemed stronger in men than women. This effect could not be explained by differences in life style between smokers and nonsmokers.

Absorptiometry, Photon↗
PubMed1993

Fetal growth and autoimmune thyroid disease.

To determine whether fetal and infant growth could influence susceptibility to autoimmune disease in adults, the occurrence of thyroid autoantibodies and autoimmune thyroiditis was studied in 305 women, aged 60-71, born in Hertfordshire and for whom details of birthweight, infant growth, and feeding were routinely recorded. Thyroglobulin autoantibody was detected in 37% of the women, thyroid peroxidase autoantibody in 41%, and autoimmune thyroiditis, defined as biochemical or clinical hypothyroidism in association with thyroid autoantibodies, in 5.6%. The proportion of women with thyroglobulin and thyroid peroxidase autoantibodies fell with increasing birthweight but was not related to weight at 1 year of age or the method of infant feeding. The prevalence of both autoantibodies rose with increasing adult body mass index but fell as the waist to hip ratio increased. These results demonstrate the importance of early environment in determining the susceptibility to autoimmune thyroid disease. The contrasting effects of adult body mass index and waist to hip ratio on antibody prevalence could be explained by their associations with different hormonal environments.

Aged↗