Introduction: In serodiscordant couples, sharing serostatus is a crucial step in the HIV risk management process. The aim of this study was to determine the prevalence and factors associated with serostatus sharing am...Introduction: In serodiscordant couples, sharing serostatus is a crucial step in the HIV risk management process. The aim of this study was to determine the prevalence and factors associated with serostatus sharing among HIV serodiscordant couples in the city of Parakou. Setting and methods: This study was carried out in the city of Parakou, capital of northern Benin. It was a descriptive, analytical cross-sectional study with non-probability sampling for convenience. Socio-demographic data, as well as data on antecedents, behaviours, social and marital life, were collected using a questionnaire gave to the participants. Clinical and therapeutic data were collected from patients’ medical records and follow-up charts. Data were analyzed and processed using R 4.3.1 software. The significance level was set at 5%, and logistic regression was used to identify potential predictors of shared serostatus among serodiscordant couples in the city of Parakou in 2022. Results: A total of 299 participants in long-term serodiscordant relationships were included in our study. The average age of the subjects was 37.55 ± 10.25 years. Women were the infected partner in 80.27% of cases. The most common level of education was secondary (33.45%). Most respondents (230 subjects, 76.92%) were married. The average duration of the couple’s relationship was 121.68 months ± 96.32. The most frequent screening circumstances were: Prevention of mother-to-child transmission (PMTCT) (50.84%) and hospital screening (26.09%). The infected partner shared his or her serostatus with his or her spouse in 47.83% of cases. Potential predictors of serostatus sharing within the couple were: marital status (p Conclusion: The sharing of serostatus within serodiscordant couples needs to be managed in a way that takes into account the social and marital characteristics of the couple.展开更多
Connective tissue diseases (CTDs) are Autoimmune diseases (AIDs) characterized by the appearance of autoantibodies, which are diagnostic markers. Investigations of these autoantibodies play a major role in the managem...Connective tissue diseases (CTDs) are Autoimmune diseases (AIDs) characterized by the appearance of autoantibodies, which are diagnostic markers. Investigations of these autoantibodies play a major role in the management of several autoimmune diseases. The objective of this study was to describe the profile of anti-ENA antibodies according to the clinical symptoms of mixed CTDs in Conakry teaching Hospital. We performed a cross-sectional study during six months. A total of 20 patients was recruited and we measured antibodies using the ELISA technique. The mean age of our patients was 36.5 years, with a predominance of females. Cutaneous and rheumatological signs were the main clinical manifestations. SLP was the most frequent CTDs;the threshold of ENA antibodies positivity was higher in scleroderma with and SLP. Anti-ENA identification reveals the frequency of anti-SSA (83.33%), anti-U1RNP (66.66%) and anti-histone (50%) antibodies. Antinuclear antibodies (ANA) react with various components of the cell nucleus. Their detection is of major interest in the diagnosis of CTDs. Our results highlight the importance of determining the specificity of these antibodies to guide differential diagnosis.展开更多
<strong>Introduction:</strong> The periodic management of diabetes improves disease’s prognosis. We aimed to evaluate the quality of diabetes annual management and the effectiveness of its treatment in Ou...<strong>Introduction:</strong> The periodic management of diabetes improves disease’s prognosis. We aimed to evaluate the quality of diabetes annual management and the effectiveness of its treatment in Ouagadougou. <strong>Material and Method:</strong> It was a cross-sectional and descriptive study, from retrospective records in the internal medicine department, Yalgado Ouédraogo Teaching Hospital (CHU-YO). Diabetic patient’s (15 years old and more) files that were registered between January, 2012 and December, 2016 have been analyzed. Files containing less than 80% data were excluded. Data relating to the baseline characteristics of the patients, the therapeutic education dispensation, the clinical and paraclinical assessment of the initial and annual visits at the first year of patient’s follow-up have been collected. The 2007 diabetes management standards of the French “Haute Autorité de Santé” as well as the biological standards of the same instance have been used. The quantitative variables were expressed as means and standard deviations and qualitative variables were expressed as absolute and relative frequencies. <strong>Results:</strong> 317 patients, including 218 women (68.77%) were studied. The mean age of women was 51.67 ± 12.46 years, and that of men 55.71 ± 10.63. Diabetes was type 2 in 302 (95.26%) patients. The mean duration since the diagnosis of diabetes was 2.9 years. The completeness rate of therapeutic education at the annual visit was 10.46%. That of the clinical examinations was at best 38.17% and 44.23% for the measurement of weight and blood pressure;otherwise it was less than 5%. About the paraclinical data, apart from the measurement of the fasting blood glucose which completeness rate was 71.61%, that of the others exams were less than 10%. At the annual visit, the mean value of HbA1C was 7.5%, and the target for HbA1C was achieved in 47.90% patients. <strong>Conclusion:</strong> The quality of diabetes annual management is unsatisfying. A structural improvement and the adaptation of guidelines are needed.展开更多
<strong>Objectives:</strong> To evaluate the practice of self-care in diabetic patients monitored at the Kara Teaching Hospital, known as CHU Kara. <strong>Method:</strong> We conducted a quant...<strong>Objectives:</strong> To evaluate the practice of self-care in diabetic patients monitored at the Kara Teaching Hospital, known as CHU Kara. <strong>Method:</strong> We conducted a quantitative, descriptive and cross-sectional study of 40 diabetic patients monitored at the Kara CHU. The data collection took place from February 20 to May 28, 2018 and the data was collected anonymously. <strong>Results:</strong> Out of the forty (40) respondents, 60% were male with a sex ratio of 1.5 and an average age of 56.15 years. Two-thirds (2/3) of the patients did not have the blood glucose meter. More than half (52%) did not know the normal blood glucose value and 82.5% were on a low carbohydrate diet. Eighty-two point fifty percent (82.50%) were under Oral antidiabetic (ADO). Forty percent (40%) of patients often forgot their medication. Forty-seven point-fifty percent reported frequent episodes of hypoglycaemia with dizziness (58%), tremors (53%), hunger (53%), sweat (37%), tingling (26%) and the most common gestures were: sugar ingestion (53%) and glycemic control (26%). Eighty-five (85%) said they used to feel hyperglycemia with fatigue (76%), polyuria (65%), polydipsia (44%) the most common precursors and the most frequent interventions were taking hypoglycemic drugs (74%) and controlling blood glucose (24%). <strong>Conclusion:</strong> The practice of self-care remains risky for diabetic patients. Hence the need for the establishment of adequate therapeutic education programs.展开更多
Background: Although hepatocellular carcinoma was historically considered an important scourge in Middle Africa, there is no publication describing this disease in Chad. Methods: We conducted a retrospective analysis ...Background: Although hepatocellular carcinoma was historically considered an important scourge in Middle Africa, there is no publication describing this disease in Chad. Methods: We conducted a retrospective analysis of 219 patients with hepatocellular carcinoma (HCC) attending care at the University Reference Hospital of Ndjamena between 2007 and 2016. Results: This series of HCC was characterized by a male predominance (M:F = 2.4) with a mean tumor onset at the end of the fifth decade of life (49.9 ± 14.7 years). Tumors appear on a cirrhotic liver in 70% of cases and were already multifocal at diagnosis in two thirds of the patients. Alpha-fetoprotein was above the physiological threshold (10 ng/mL) in 73.4% of cases measured and above the so-called diagnostic level (400 ng/mL) in 53.4% of patients. The principal risk factor was chronic infection with hepatitis B virus, detected in 52.6% of cases. Patients seropositive for hepatitis C virus were infrequent (8.6%) and heavy alcohol intake was even less prevalent (5.9%). Remarkably, a very large subset of patients did not present any infectious or lifestyle risk factor (43.4%). Mean AFP values or fibrosis assessment scores are usually lower in these patients than in HBV-infected ones. Conclusions: The etiological spectrum of HCC is far from being fully established in Chad. Further epidemiological research is warranted to identify risk factors involved in a large proportion of cases. Exposure to aflatoxin B1 and dysmetabolic conditions affecting the liver have to be investigated as priority.展开更多
Introduction: In Senegal, there is very little data on primary hyperparathyroidism despite an overall upward epidemiological trend. The objective was to describe its epidemiological, clinical, therapeutic and evolutio...Introduction: In Senegal, there is very little data on primary hyperparathyroidism despite an overall upward epidemiological trend. The objective was to describe its epidemiological, clinical, therapeutic and evolutionary aspects. Materials and Methods: This was a cross-sectional, descriptive study, conducted over 5 years (from January 01, 2018 to December 31, 2022) at the National Abass Ndao Hospital Center and including all confirmed cases of primary hyperparathyroidism. Results: Twenty-nine patients were included with a female predominance (86.20%) and an average age of 48.10 ± 18.93 years. The discovery of hyperparathyroidism was fortuitous in 79.31% of cases. The main clinical manifestations were osteoarticular (62%) and urinary (34.5%). On average, serum calcium measured was 109.2 ± 7.92 mg/l, corrected serum calcium 111.3 ± 6.25 mg/l, urinary calcium 421.9 ± 96.45 mg/24h and parathormone at 145 ± 159.71 pg/ml. Among the patients, 25 had hypercalcemia (86.2%) and all had 24-hour hypercalciuria. The diagnosis was retained in view of the elevated parathyroid hormone (PTH) values in all patients. Cervical ultrasound objectified a parathyroid adenoma in 27.58% of cases and 12 patients or 46.2% had presented a scintigraphy in favor of a parathyroid adenoma. We found 01 cases of multiple endocrine neoplasia type 2. Bone densitometry performed in 10 patients found osteoporosis in 60% of cases (6 patients) and osteopenia in 40% of cases (4 patients). Surgical treatment was performed in 12 patients (41.4%). The histology of the surgical specimens was in favor of a parathyroid adenoma in all cases. Among the operated patients, the evolution was marked by a cure rate of 100%. Conclusion: The symptomatology of primary hyperparathyroidism remains mainly osteoarticular and urinary. Surgery has proven its effectiveness in our series. We insist on the systematic dosage of calcemia especially in women over 50 years and the promotion of morphological explorations.展开更多
Progressive familial intrahepatic cholestasis type 3 (PFIC3) is a rare cholestatic liver disease. Such liver disease can get worse by female hormone disorder. Albumin dialysis or Molecular Adsorbent Recirculating Syst...Progressive familial intrahepatic cholestasis type 3 (PFIC3) is a rare cholestatic liver disease. Such liver disease can get worse by female hormone disorder. Albumin dialysis or Molecular Adsorbent Recirculating System (MARS) has been reported to reverse severe cholestasis-linked pruritus. Here, we report the first use of MARS during a spontaneous pregnancy and its successful outcome in a patient with PFIC3 and intractable pruritus. Albumin dialysis could be considered as a pregnancy-saving procedure in pregnant women with severe cholestasis and refractory pruritus.展开更多
AIMTo describe factors associated with treatment failure and frequency of resistance-associated substitutions （RAS）.METHODSHuman immunodefciency virus （HIV）/hepatitis C virus （HCV） coinfected patients starting a...AIMTo describe factors associated with treatment failure and frequency of resistance-associated substitutions （RAS）.METHODSHuman immunodefciency virus （HIV）/hepatitis C virus （HCV） coinfected patients starting a first direct-acting antiviral （DAA） regimen before February 2016 and included in the French ANRS CO13 HEPAVIH cohort were eligible. Failure was defned as： （1） non-response [HCV-RNA remained detectable during treatment, at end of treatment （EOT）]; and （2） relapse （HCV-RNA suppressed at EOT but detectable thereafter）. Sequencing analysis was performed to describe prevalence of drug class-specifc RAS. Factors associated with failure were determined using logistic regression models.RESULTSAmong 559 patients, 77% had suppressed plasmaHIV-RNA 〈 50 copies/mL at DAA treatment initiation41% were cirrhotic, and 68% were HCV treatmentexperienced. Virological treatment failures occurred in22 patients and were mainly relapses （17, 77%） thenundefined failures （3, 14%） and non-responses （29%）. Mean treatment duration was 16 wk overall. Posttreatment NS3, NS5A or NS5B RAS were detected in10/14 patients with samples available for sequencinganalysis. After adjustment for age, sex, ribavirin useHCV genotype and treatment duration, low platelecount was the only factor signifcantly associated with ahigher risk of failure （OR： 6.5; 95%CI： 1.8-22.6）. CONCLUSIONOnly 3.9% HIV-HCV coinfected patients failed DAAregimens and RAS were found in 70% of those failingLow platelet count was independently associated withvirological failure.展开更多
Introduction: Electrolyte’s profile in non-acidosis diabetic ketosis is poorly specified. We aimed to determine the nature of diabetic ketosis decompensations as well as the profile of kalemia and factors associated ...Introduction: Electrolyte’s profile in non-acidosis diabetic ketosis is poorly specified. We aimed to determine the nature of diabetic ketosis decompensations as well as the profile of kalemia and factors associated with its disorders at diagnosis of acidosis compared to non-acidosis diabetic ketosis. Methods: The study was retrospective from 1 January 2010 to 31 December 2011 in Yalgado Ouédraogo teaching hospital. Diabetic in-patients suffering from simple ketosis, keto-acidosis or mixed decompensation, who achieved blood electrolytes assessment before intensive insulin therapy were included. Results: Sixty two patients were studied. The sex ratio was 0.7 and the mean age was 41.7 years. Keto-acidosis, simple ketosis and mixed decompensation were diagnosed respectively in 18 (29%), 32 (51.6%) and 12 (19.4%) patients. Kalemia was normal in 42 (67.7%), while hypokalemia and hyperkalemia were reported respectively in 11 (17.8%) and 9 (14.5%) patients. Kalemia was often normal in all types of ketosis decompensation and disorders of kalemia occurred more in patients with keto-acidosis (50%) than those with simple ketosis (21.9%);p = 0.04. Renal failure was diagnosed in 10 patients (50%) with and 2 (4.8%) without kalemia’s disorders;p = 0.0001. Seven patients (35%) with and 4 (9.5%) without kalemia’s disorders suffered from unconsciousness;p = 0.02. It happens more in hyperkalemia (44.4%) than in normal kalemia condition (9.5%);p = 0.02. Conclusion: If kalemia is often normal in all types of diabetic ketosis emergencies, hypokalemia is the most initial frequent potassium disorder.展开更多
BACKGROUND Sacubitril-valsartan has been shown to reduce hospitalizations and mortality in patients with heart failure(HF)and reduced ejection fraction.The PIONEER-HF trial demonstrated that initiation of the drug dur...BACKGROUND Sacubitril-valsartan has been shown to reduce hospitalizations and mortality in patients with heart failure(HF)and reduced ejection fraction.The PIONEER-HF trial demonstrated that initiation of the drug during acute HF hospitalization reduced NT-proBNP levels and a post-hoc analysis of the trial found a reduction in HF hospitalizations and deaths.Real-life studies in the elderly population are scarce.The aim of our study was to assess the effectiveness of sacubitril-valsartan versus angiotensin converting enzyme inhibitors(ACEI)in elderly patients who initiate this treatment during hospitalization for acute HF.METHODS We conducted a retrospective cohort study using the Spanish acute heart failure registry(RICA)comparing rehospitalizations and deaths at 3 months and 1 year among patients aged 70 years or older who had initiated treatment with sacubitrilvalsartan during hospitalization for acute HF versus those treated with ACEI.RESULTS One hundred and ninety-nine patients hospitalized between October 2016 and November 2020 were included,with a median age of 82 years and high rate of comorbidity.Of these,107 were treated with sacubitril-valsartan and 92 with ACEI.The adjusted OR for readmission for HF at 3 months was 0.906(95%CI:0.241-3.404)and for the combined variable readmission for HF or death at 3 months was 0.696(95%CI:0.224-2.167).The adjusted OR for HF readmission at one year was 0.696(95%CI:0.224-2.167).and for the combined variable HF readmission or death at one year 0.724(95%CI:0.325-1.612).CONCLUSION Treatment with sacubitril-valsartan initiated early in hospitalization for HF in elderly patients with high comorbidity was associated with a trend towards a reduction in readmissions and death due to HF compared to treatment with ACEI,which did not reach statistical significance either at 3 months or 1 year of follow-up.展开更多
Introduction: The extrinsic compression of the third portion of the duodenum between the superior mesenteric artery and the aorta defines superior mesenteric artery syndrome. It determines an acute or chronic high int...Introduction: The extrinsic compression of the third portion of the duodenum between the superior mesenteric artery and the aorta defines superior mesenteric artery syndrome. It determines an acute or chronic high intestinal obstruction pattern. We report the first observed case in Chad. Observation: HH was a 19 year-old woman with abdominal pain and intermittent postprandial vomiting since she was 5 years old. During last 11 months, post-prandial vomiting was more frequent, and non resolved after medical treatment. Unquantified weight loss was reported. Body mass index at hospitalization was 9.8. An injected abdominal scan demonstrated significant gastroduodenal distension, upstream of a stenosis of the third duodenal portion. Aorto-mesenteric space and angle were reduced. At laparotomy internal derivation by duodenojejunostomy was done. Postoperative situation was uneventful. Conclusion: Superior mesenteric artery syndrome determines an acute or chronic intestinal obstruction. Injected abdominal scan is fundamental for diagnosis. The treatment is firstly conservative but the need of surgery is common.展开更多
BACKGROUND Secondary forms and hypertension-mediated organ damage(HMOD) may differ between younger and older hypertensive patients.The aim of the present study was to explore the specificity of HMOD and secondary form...BACKGROUND Secondary forms and hypertension-mediated organ damage(HMOD) may differ between younger and older hypertensive patients.The aim of the present study was to explore the specificity of HMOD and secondary forms in patients≥ 65 years in comparison to younger ones in a contemporary cohort.METHODS We analysed 938 patients recruited between 2004 and 2014(Cardiology department,Croix-Rousse Hospital,Lyon)who had at baseline HMOD and secondary forms screening among them 190 were≥ 65 years.RESULTS The mean(2.1±0.8 vs.1.2±0.9,P <0.001) and frequency of HMOD(96.3% vs.72.9%,P <0.001) was higher in patients≥ 65 years than younger ones.Carotid femoral pulse wave velocity> 10 m/s was the most frequent HMOD in patients≥ 65 years(90.1%),while echocardiographic left ventricular hypertrophy was the most common in the younger patients(45.0%).Among ECG left ventricular indexes,only R wave in aVL lead was significantly more frequently observed in patients≥ 65 years(32.6%) than in younger ones(19.0%,P <0.001).The frequency of secondary hypertension was not significantly different between younger and older patients(respectively;30.5% vs.27.8%,P=0.487).The most frequent aetiology was primary aldosteronism regardless of age,followed by renovascular hypertension(6.3% vs.3.3%,P=0.038).Among older patients,3.2% were treated with adrenalectomy and 6.3% with percutaneous transluminal renal angioplasty.CONCLUSION Extensive screening of HMOD in older patients may be questionable as nearly all patients had one;aetiology must however be explored as a third of older patients had a secondary form.展开更多
Introduction: According to the WHO, Chad is located in an area of high endemicity for hepatitis B virus (HBV). The aim of this study was to analyze the virological profiles of chronic HBV carriers. Materials and Metho...Introduction: According to the WHO, Chad is located in an area of high endemicity for hepatitis B virus (HBV). The aim of this study was to analyze the virological profiles of chronic HBV carriers. Materials and Method: This was a retrospective and analytical study including outpatients with chronic HBV of any age received in Department of Internal Medicine and Gastroenterology of National General Reference Hospital of N’Djamena from 2013 to 2017. Results: During the study period, 401 chronic hepatitis B virus carriers (mean age was 35 years ± 11 years with sex ratio of 3.26) were seen in outpatient clinic with a frequency of 3.34% (401/11,988). HBeAg (+) patients were 12.8% and HBeAg negative 87.2%. HBeAg-negative patients were significantly older (p = 0.000) than those with HBeAg (+). The mean HBV-DNA level was higher in HBeAg (+) patients. The HBV-DNA level in HBeAg-positive patients was higher than in HBeAg-negative patients with a significant difference (p = 0.043). The mean ALT level was 45 IU/L in HBeAg (−) patients. It was 49 in HBeAg (+) patients. Conclusion: HBeAg (−) chronic hepatitis B is the most predominant form in our study. This observation is important because it can help to adapt the management strategies.展开更多
<span style="font-family:Verdana;"><strong>Background:</strong> A healthy diet is essential for optimal diabetes management. However, dietary habits vary from one region to another, making ...<span style="font-family:Verdana;"><strong>Background:</strong> A healthy diet is essential for optimal diabetes management. However, dietary habits vary from one region to another, making it challenging to standardize practices. <strong>Objective: </strong>To describe the diet habits of patients living with diabetes in Guinea. <strong>Methods:</strong> We conducted a dietary habits survey among 102 patients living with diabetes followed-up at the University Hospital of Conakry in Guinea between January and March 2012. Data were collected by individual interview on the basis of a three-item questionnaire: diabetes data, diet mode, and food composition. <strong>Results:</strong> In total, 85% of patients were consuming 3 meals daily;13.7% had a collation and 25% had snacking habits. The meal was individual in 82.4% and collective in 17.6% of patients. The main foods consumed daily were: rice (93.1%), fish (93.1%), palm oil (91.1%), bread (87.2%). Foods consumed regularly (2 to 3 times a week) were: meat (49%), eggs (23.5%), dairy products (34.3%), fruit (43.1%), vegetables (40.2%) and peanut oil (21.5%). The food bans reported were: regular sugar (100%), sodas (62.7%), peanuts (84.3%) and sweetened fruits (55.8%). <strong>Conclusion:</strong> Combining dietary recommendations and dietary habits is essential for appropriate management of diabetic patients. The assessment of local food glycemic indexes and the training of dietitians remains a challenge in our context.</span>展开更多
Introduction: Depression is common in HIV/AIDS. We aim to investigate the frequency and the grade of this mental disorder in partners and determine its influence on sexual dysfunctions in serodiscordant couples in Oua...Introduction: Depression is common in HIV/AIDS. We aim to investigate the frequency and the grade of this mental disorder in partners and determine its influence on sexual dysfunctions in serodiscordant couples in Ouagadougou. Patients/Method: This cross-sectional study was monitored from 1 January to 31 June 2010 in the internal medicine department of CHUYO, Ouagadougou. HIV-infected patients and their seronegative partners who gave their consent were included. Depression was diagnosed using the Beck Depression Inventory 13 items (BDI-13). Results: Eighty heterosexual and monogamous serodiscordant couples were studied. 31 (38.7%) HIV-infected and 23 (28.7%) seronegative partners were affected by depression;p = 0.18. The score of depression was 3.5 ± 2.1 in HIV-infected and 3.3 ± 1.6 in seronegative partners;p = 0.85. Depression was diagnosed in both partners in 13 couples (16.2%) and in only one partner in 28 couples (35%). Depression was diagnosed at least for one partner in 40 (51.3%) couples where sexual dysfunctions affected partner (s) and in 1 (50%) couple where no sexual dysfunction was reported. Conclusion: Psychological assessment is needed for a better management of HIV/AIDS in serodiscordant couples.展开更多
Background: In comparison to other forms of chronic liver diseases, cirrhosis is generally poorly studied in sub Saharan Africa. In Chad, more particularly, no data are available despite the burden of liver diseases c...Background: In comparison to other forms of chronic liver diseases, cirrhosis is generally poorly studied in sub Saharan Africa. In Chad, more particularly, no data are available despite the burden of liver diseases considered as the first cause of hospitalizations in the country. Methods: We conducted a retrospective analysis of 268 patients with liver cirrhosis attending care at the University Reference Hospital between 2007 and 2016. Results: This series of liver cirrhoses was characterized by a weak mal predominance (M:F = 1.7). The age of onset occurs significantly earlier in women than in men (40.6 ± 12.0 vs. 44.4 ± 13.4, p = 0.0171). The principal risk factor was persistent infection with hepatitis B virus (49% of cases) followed distantly by infection with hepatitis C virus (13%) and excessive alcohol consumption (10%). Men were more frequently carrying HBV surface antigen than women (65.6% vs 35.9% p = 0.0019). HBV-associated liver cirrhosis was overall more severe than diseases from other causes. A large proportion of cirrhosis (30%), observed primarily in women (48.1% vs 24.1%, p = 0.0036), was considered are cryptogenic. Conclusions: The etiological spectrum of liver cirrhosis remains to be properly defined in Chad. This lack of knowledge prevents the implementation of an efficient policy of prevention. A significant effort should be secured to characterize hitherto neglected infectious, lifestyle or genetic risk factors responsible of this form of terminal disease and improve subsequently liver health of local populations.展开更多
Introduction:la qualitéde vie des patients suivis pour une hémopathie maligne dépend non seulement du type de la maladie,de ses caractéristiques cliniques,biologiques et thérapeutiques,mais au...Introduction:la qualitéde vie des patients suivis pour une hémopathie maligne dépend non seulement du type de la maladie,de ses caractéristiques cliniques,biologiques et thérapeutiques,mais aussi de la santémentale du patient.L’objectif de notreétude est d’évaluer l’état psychologique des patients au diagnostic,de rechercher les facteurs associésàson altération et de préciser son impact sur la qualitéde vie des patients.Méthode:nous avons menéuneétude monocentrique transversale quiévalue la dépression,l’anxiétéet la qualitéde vie d’une population de patients atteints de syndromes lymphoprolifératifs sur une période de 22mois.Deux questionnaires ontétéutilisés au moment du diagnostic:le HADS pour rechercher la dépression et l’anxiétéet le SF12échelle pourévaluer la qualitéde vie liéeàla santé.Résultat:Les cent patients ont acceptéde répondre aux questionnaires.Ces patients sont suivis pour un lymphome malin non hodgkinien,une maladie de Hodgkin,et une leucémie lymphoïde chronique.Le sex-ratio(H/F)est de 1,08.La prévalence des symptômes anxieux est de 70%avec 95%CI(61,01%;78,99%)et des symptômes dépressifs de 76%avec 95%CI(49,4%;82,6%)des cas.En analyse univariée,le caractère féminin est associéaux symptômes anxieux(p=0,008),etàl’altération de qualitéde vie mentale(p=0,02).Alors qu’en analyse multivariée,Les symptômes anxio-dépressifs sont significativement associésàun score de qualitéde vie faible aussi bien mentale que physique.En plus les symptômes anxieux sont corrélés au sexe féminin(ORA=20,50;95%CI[1,58–264,48]);et la douleur(ORA=12,33;95%CI[1,07–141,77]).Conclusion:la recherche de comorbidités psychologiques doit faire partie du diagnostic initial de cette population vulnérable pour une meilleure qualitéde vie.展开更多
Gastrointestinal tuberculosis is a rare form of extrapulmonary tuberculosis and its diagnosis can be difficult. Aims-To analyze the diagnostic and therapeutic characteristics of gastrointestinal tuberculosis Methods-R...Gastrointestinal tuberculosis is a rare form of extrapulmonary tuberculosis and its diagnosis can be difficult. Aims-To analyze the diagnostic and therapeutic characteristics of gastrointestinal tuberculosis Methods-Retrospective study from 17 cases collected in 4 hospitals in Seine Saint-Denis between 1987 and 2002. Results-Seventeen cases and 19 localizations were collected: small intestine (N = 7), ileocecum (N = 6), colon (N = 4) and gastroduodenum (N = 2). Two patients had two localizations. Mean age was 43.9 years. Subjects from immigrant populations (76.5%)were preferentially affected. Twenty-three percent of patients (13 tested) were infected by human immunodeficiency virus. Weight-loss and general weakness (88%), abdominal pain (88%), fever (59%), nausea/vomiting (53%) were the predominant symptoms. The delay in diagnosis was 82 days (range: 7-180) and time before specific treatment 31.6 days (range: 7-90). Histological evidence of caseating granuloma was found in six patients. Mycobacterium tuberculosis was detected in six. Digestive imaging was abnormal in 15 patients. Mesenteric lymph nodes were the most common associated site of tuberculosis (N = 8, 47%). Mean duration of treatment was 8.2 months (range: 6-12). Thirteen patients were cured, three died and one was last to follow up. Conclusion-Gastrointestinal tuberculosis is not an uncommon diagnosis in the north-eastern Parisian area, especially among immigrant populations and immunodeficient patients. The most frequent localizations are the small intestine and ileocecum. Diagnosis can be made by pathology and/or bacteriology on endoscopic and/or surgical biopsy samples.展开更多
慢性丙型肝炎病毒(hepatitis C virus,HCV)感染是发达国家慢性肝病的首要病因,可导致肝硬化和肝细胞癌.慢性HCV感染是混合型冷球蛋白血症(mixed cryoglobulinemia,MC)的主要病因.MC是一种全身性血管炎,以血清中存在冷球蛋白(cryoglobuli...慢性丙型肝炎病毒(hepatitis C virus,HCV)感染是发达国家慢性肝病的首要病因,可导致肝硬化和肝细胞癌.慢性HCV感染是混合型冷球蛋白血症(mixed cryoglobulinemia,MC)的主要病因.MC是一种全身性血管炎,以血清中存在冷球蛋白(cryoglobulin,CG)(即II型混合型CG)为主要特征,可累及皮肤、肾和神经系统[1-3].II型MC含有单克隆免疫球蛋白IgM.展开更多
Introduction. The involvement of the peripheral nervous system in Behet’s d isease is very rare. Case report. We report a case of a 47-year-old man with a six-year history of Behet’s disease and a two-year histo...Introduction. The involvement of the peripheral nervous system in Behet’s d isease is very rare. Case report. We report a case of a 47-year-old man with a six-year history of Behet’s disease and a two-year history of peripheral n ervous system involvement. This patient presented with paraesthesia and weakness of the upper and lower limbs, diarrhea and erectile dysfunction. The electromyo gram showed evidence of an axonal sensorimotor neuropathy and the nerve biopsy s howed an axonal neuropathy. Routine blood tests were normal, there was no increa se of serum creatine kinase, aspartate aminotransfease or lactate dehydrogenase and no signs of hyperthyroidism. Fibroscopy and colonoscopy showed no signs of e ntero-Behet.The patient was treated with prednisone, cyclophosphamide and car bamazepine with an improvement of paraesthesia. Conclusion. The mechanism of the peripheral neuropathy in Behet’s disease is still unknown, it might be due t o vasculitis of the vasa nervorum or to the side effects of colchicine. Our repo rt is particular by the association of sensorimotor and autonomic involvement of peripheral neuropathy in a patient with Behet’s disease.展开更多
文摘Introduction: In serodiscordant couples, sharing serostatus is a crucial step in the HIV risk management process. The aim of this study was to determine the prevalence and factors associated with serostatus sharing among HIV serodiscordant couples in the city of Parakou. Setting and methods: This study was carried out in the city of Parakou, capital of northern Benin. It was a descriptive, analytical cross-sectional study with non-probability sampling for convenience. Socio-demographic data, as well as data on antecedents, behaviours, social and marital life, were collected using a questionnaire gave to the participants. Clinical and therapeutic data were collected from patients’ medical records and follow-up charts. Data were analyzed and processed using R 4.3.1 software. The significance level was set at 5%, and logistic regression was used to identify potential predictors of shared serostatus among serodiscordant couples in the city of Parakou in 2022. Results: A total of 299 participants in long-term serodiscordant relationships were included in our study. The average age of the subjects was 37.55 ± 10.25 years. Women were the infected partner in 80.27% of cases. The most common level of education was secondary (33.45%). Most respondents (230 subjects, 76.92%) were married. The average duration of the couple’s relationship was 121.68 months ± 96.32. The most frequent screening circumstances were: Prevention of mother-to-child transmission (PMTCT) (50.84%) and hospital screening (26.09%). The infected partner shared his or her serostatus with his or her spouse in 47.83% of cases. Potential predictors of serostatus sharing within the couple were: marital status (p Conclusion: The sharing of serostatus within serodiscordant couples needs to be managed in a way that takes into account the social and marital characteristics of the couple.
文摘Connective tissue diseases (CTDs) are Autoimmune diseases (AIDs) characterized by the appearance of autoantibodies, which are diagnostic markers. Investigations of these autoantibodies play a major role in the management of several autoimmune diseases. The objective of this study was to describe the profile of anti-ENA antibodies according to the clinical symptoms of mixed CTDs in Conakry teaching Hospital. We performed a cross-sectional study during six months. A total of 20 patients was recruited and we measured antibodies using the ELISA technique. The mean age of our patients was 36.5 years, with a predominance of females. Cutaneous and rheumatological signs were the main clinical manifestations. SLP was the most frequent CTDs;the threshold of ENA antibodies positivity was higher in scleroderma with and SLP. Anti-ENA identification reveals the frequency of anti-SSA (83.33%), anti-U1RNP (66.66%) and anti-histone (50%) antibodies. Antinuclear antibodies (ANA) react with various components of the cell nucleus. Their detection is of major interest in the diagnosis of CTDs. Our results highlight the importance of determining the specificity of these antibodies to guide differential diagnosis.
文摘<strong>Introduction:</strong> The periodic management of diabetes improves disease’s prognosis. We aimed to evaluate the quality of diabetes annual management and the effectiveness of its treatment in Ouagadougou. <strong>Material and Method:</strong> It was a cross-sectional and descriptive study, from retrospective records in the internal medicine department, Yalgado Ouédraogo Teaching Hospital (CHU-YO). Diabetic patient’s (15 years old and more) files that were registered between January, 2012 and December, 2016 have been analyzed. Files containing less than 80% data were excluded. Data relating to the baseline characteristics of the patients, the therapeutic education dispensation, the clinical and paraclinical assessment of the initial and annual visits at the first year of patient’s follow-up have been collected. The 2007 diabetes management standards of the French “Haute Autorité de Santé” as well as the biological standards of the same instance have been used. The quantitative variables were expressed as means and standard deviations and qualitative variables were expressed as absolute and relative frequencies. <strong>Results:</strong> 317 patients, including 218 women (68.77%) were studied. The mean age of women was 51.67 ± 12.46 years, and that of men 55.71 ± 10.63. Diabetes was type 2 in 302 (95.26%) patients. The mean duration since the diagnosis of diabetes was 2.9 years. The completeness rate of therapeutic education at the annual visit was 10.46%. That of the clinical examinations was at best 38.17% and 44.23% for the measurement of weight and blood pressure;otherwise it was less than 5%. About the paraclinical data, apart from the measurement of the fasting blood glucose which completeness rate was 71.61%, that of the others exams were less than 10%. At the annual visit, the mean value of HbA1C was 7.5%, and the target for HbA1C was achieved in 47.90% patients. <strong>Conclusion:</strong> The quality of diabetes annual management is unsatisfying. A structural improvement and the adaptation of guidelines are needed.
文摘<strong>Objectives:</strong> To evaluate the practice of self-care in diabetic patients monitored at the Kara Teaching Hospital, known as CHU Kara. <strong>Method:</strong> We conducted a quantitative, descriptive and cross-sectional study of 40 diabetic patients monitored at the Kara CHU. The data collection took place from February 20 to May 28, 2018 and the data was collected anonymously. <strong>Results:</strong> Out of the forty (40) respondents, 60% were male with a sex ratio of 1.5 and an average age of 56.15 years. Two-thirds (2/3) of the patients did not have the blood glucose meter. More than half (52%) did not know the normal blood glucose value and 82.5% were on a low carbohydrate diet. Eighty-two point fifty percent (82.50%) were under Oral antidiabetic (ADO). Forty percent (40%) of patients often forgot their medication. Forty-seven point-fifty percent reported frequent episodes of hypoglycaemia with dizziness (58%), tremors (53%), hunger (53%), sweat (37%), tingling (26%) and the most common gestures were: sugar ingestion (53%) and glycemic control (26%). Eighty-five (85%) said they used to feel hyperglycemia with fatigue (76%), polyuria (65%), polydipsia (44%) the most common precursors and the most frequent interventions were taking hypoglycemic drugs (74%) and controlling blood glucose (24%). <strong>Conclusion:</strong> The practice of self-care remains risky for diabetic patients. Hence the need for the establishment of adequate therapeutic education programs.
文摘Background: Although hepatocellular carcinoma was historically considered an important scourge in Middle Africa, there is no publication describing this disease in Chad. Methods: We conducted a retrospective analysis of 219 patients with hepatocellular carcinoma (HCC) attending care at the University Reference Hospital of Ndjamena between 2007 and 2016. Results: This series of HCC was characterized by a male predominance (M:F = 2.4) with a mean tumor onset at the end of the fifth decade of life (49.9 ± 14.7 years). Tumors appear on a cirrhotic liver in 70% of cases and were already multifocal at diagnosis in two thirds of the patients. Alpha-fetoprotein was above the physiological threshold (10 ng/mL) in 73.4% of cases measured and above the so-called diagnostic level (400 ng/mL) in 53.4% of patients. The principal risk factor was chronic infection with hepatitis B virus, detected in 52.6% of cases. Patients seropositive for hepatitis C virus were infrequent (8.6%) and heavy alcohol intake was even less prevalent (5.9%). Remarkably, a very large subset of patients did not present any infectious or lifestyle risk factor (43.4%). Mean AFP values or fibrosis assessment scores are usually lower in these patients than in HBV-infected ones. Conclusions: The etiological spectrum of HCC is far from being fully established in Chad. Further epidemiological research is warranted to identify risk factors involved in a large proportion of cases. Exposure to aflatoxin B1 and dysmetabolic conditions affecting the liver have to be investigated as priority.
文摘Introduction: In Senegal, there is very little data on primary hyperparathyroidism despite an overall upward epidemiological trend. The objective was to describe its epidemiological, clinical, therapeutic and evolutionary aspects. Materials and Methods: This was a cross-sectional, descriptive study, conducted over 5 years (from January 01, 2018 to December 31, 2022) at the National Abass Ndao Hospital Center and including all confirmed cases of primary hyperparathyroidism. Results: Twenty-nine patients were included with a female predominance (86.20%) and an average age of 48.10 ± 18.93 years. The discovery of hyperparathyroidism was fortuitous in 79.31% of cases. The main clinical manifestations were osteoarticular (62%) and urinary (34.5%). On average, serum calcium measured was 109.2 ± 7.92 mg/l, corrected serum calcium 111.3 ± 6.25 mg/l, urinary calcium 421.9 ± 96.45 mg/24h and parathormone at 145 ± 159.71 pg/ml. Among the patients, 25 had hypercalcemia (86.2%) and all had 24-hour hypercalciuria. The diagnosis was retained in view of the elevated parathyroid hormone (PTH) values in all patients. Cervical ultrasound objectified a parathyroid adenoma in 27.58% of cases and 12 patients or 46.2% had presented a scintigraphy in favor of a parathyroid adenoma. We found 01 cases of multiple endocrine neoplasia type 2. Bone densitometry performed in 10 patients found osteoporosis in 60% of cases (6 patients) and osteopenia in 40% of cases (4 patients). Surgical treatment was performed in 12 patients (41.4%). The histology of the surgical specimens was in favor of a parathyroid adenoma in all cases. Among the operated patients, the evolution was marked by a cure rate of 100%. Conclusion: The symptomatology of primary hyperparathyroidism remains mainly osteoarticular and urinary. Surgery has proven its effectiveness in our series. We insist on the systematic dosage of calcemia especially in women over 50 years and the promotion of morphological explorations.
文摘Progressive familial intrahepatic cholestasis type 3 (PFIC3) is a rare cholestatic liver disease. Such liver disease can get worse by female hormone disorder. Albumin dialysis or Molecular Adsorbent Recirculating System (MARS) has been reported to reverse severe cholestasis-linked pruritus. Here, we report the first use of MARS during a spontaneous pregnancy and its successful outcome in a patient with PFIC3 and intractable pruritus. Albumin dialysis could be considered as a pregnancy-saving procedure in pregnant women with severe cholestasis and refractory pruritus.
基金Supported by Inserm-ANRS(French National Institute for Health and Medical Research-ANRS/France REcherche Nord and Sud Sida-hiv Hépatites)
文摘AIMTo describe factors associated with treatment failure and frequency of resistance-associated substitutions （RAS）.METHODSHuman immunodefciency virus （HIV）/hepatitis C virus （HCV） coinfected patients starting a first direct-acting antiviral （DAA） regimen before February 2016 and included in the French ANRS CO13 HEPAVIH cohort were eligible. Failure was defned as： （1） non-response [HCV-RNA remained detectable during treatment, at end of treatment （EOT）]; and （2） relapse （HCV-RNA suppressed at EOT but detectable thereafter）. Sequencing analysis was performed to describe prevalence of drug class-specifc RAS. Factors associated with failure were determined using logistic regression models.RESULTSAmong 559 patients, 77% had suppressed plasmaHIV-RNA 〈 50 copies/mL at DAA treatment initiation41% were cirrhotic, and 68% were HCV treatmentexperienced. Virological treatment failures occurred in22 patients and were mainly relapses （17, 77%） thenundefined failures （3, 14%） and non-responses （29%）. Mean treatment duration was 16 wk overall. Posttreatment NS3, NS5A or NS5B RAS were detected in10/14 patients with samples available for sequencinganalysis. After adjustment for age, sex, ribavirin useHCV genotype and treatment duration, low platelecount was the only factor signifcantly associated with ahigher risk of failure （OR： 6.5; 95%CI： 1.8-22.6）. CONCLUSIONOnly 3.9% HIV-HCV coinfected patients failed DAAregimens and RAS were found in 70% of those failingLow platelet count was independently associated withvirological failure.
文摘Introduction: Electrolyte’s profile in non-acidosis diabetic ketosis is poorly specified. We aimed to determine the nature of diabetic ketosis decompensations as well as the profile of kalemia and factors associated with its disorders at diagnosis of acidosis compared to non-acidosis diabetic ketosis. Methods: The study was retrospective from 1 January 2010 to 31 December 2011 in Yalgado Ouédraogo teaching hospital. Diabetic in-patients suffering from simple ketosis, keto-acidosis or mixed decompensation, who achieved blood electrolytes assessment before intensive insulin therapy were included. Results: Sixty two patients were studied. The sex ratio was 0.7 and the mean age was 41.7 years. Keto-acidosis, simple ketosis and mixed decompensation were diagnosed respectively in 18 (29%), 32 (51.6%) and 12 (19.4%) patients. Kalemia was normal in 42 (67.7%), while hypokalemia and hyperkalemia were reported respectively in 11 (17.8%) and 9 (14.5%) patients. Kalemia was often normal in all types of ketosis decompensation and disorders of kalemia occurred more in patients with keto-acidosis (50%) than those with simple ketosis (21.9%);p = 0.04. Renal failure was diagnosed in 10 patients (50%) with and 2 (4.8%) without kalemia’s disorders;p = 0.0001. Seven patients (35%) with and 4 (9.5%) without kalemia’s disorders suffered from unconsciousness;p = 0.02. It happens more in hyperkalemia (44.4%) than in normal kalemia condition (9.5%);p = 0.02. Conclusion: If kalemia is often normal in all types of diabetic ketosis emergencies, hypokalemia is the most initial frequent potassium disorder.
文摘BACKGROUND Sacubitril-valsartan has been shown to reduce hospitalizations and mortality in patients with heart failure(HF)and reduced ejection fraction.The PIONEER-HF trial demonstrated that initiation of the drug during acute HF hospitalization reduced NT-proBNP levels and a post-hoc analysis of the trial found a reduction in HF hospitalizations and deaths.Real-life studies in the elderly population are scarce.The aim of our study was to assess the effectiveness of sacubitril-valsartan versus angiotensin converting enzyme inhibitors(ACEI)in elderly patients who initiate this treatment during hospitalization for acute HF.METHODS We conducted a retrospective cohort study using the Spanish acute heart failure registry(RICA)comparing rehospitalizations and deaths at 3 months and 1 year among patients aged 70 years or older who had initiated treatment with sacubitrilvalsartan during hospitalization for acute HF versus those treated with ACEI.RESULTS One hundred and ninety-nine patients hospitalized between October 2016 and November 2020 were included,with a median age of 82 years and high rate of comorbidity.Of these,107 were treated with sacubitril-valsartan and 92 with ACEI.The adjusted OR for readmission for HF at 3 months was 0.906(95%CI:0.241-3.404)and for the combined variable readmission for HF or death at 3 months was 0.696(95%CI:0.224-2.167).The adjusted OR for HF readmission at one year was 0.696(95%CI:0.224-2.167).and for the combined variable HF readmission or death at one year 0.724(95%CI:0.325-1.612).CONCLUSION Treatment with sacubitril-valsartan initiated early in hospitalization for HF in elderly patients with high comorbidity was associated with a trend towards a reduction in readmissions and death due to HF compared to treatment with ACEI,which did not reach statistical significance either at 3 months or 1 year of follow-up.
文摘Introduction: The extrinsic compression of the third portion of the duodenum between the superior mesenteric artery and the aorta defines superior mesenteric artery syndrome. It determines an acute or chronic high intestinal obstruction pattern. We report the first observed case in Chad. Observation: HH was a 19 year-old woman with abdominal pain and intermittent postprandial vomiting since she was 5 years old. During last 11 months, post-prandial vomiting was more frequent, and non resolved after medical treatment. Unquantified weight loss was reported. Body mass index at hospitalization was 9.8. An injected abdominal scan demonstrated significant gastroduodenal distension, upstream of a stenosis of the third duodenal portion. Aorto-mesenteric space and angle were reduced. At laparotomy internal derivation by duodenojejunostomy was done. Postoperative situation was uneventful. Conclusion: Superior mesenteric artery syndrome determines an acute or chronic intestinal obstruction. Injected abdominal scan is fundamental for diagnosis. The treatment is firstly conservative but the need of surgery is common.
文摘BACKGROUND Secondary forms and hypertension-mediated organ damage(HMOD) may differ between younger and older hypertensive patients.The aim of the present study was to explore the specificity of HMOD and secondary forms in patients≥ 65 years in comparison to younger ones in a contemporary cohort.METHODS We analysed 938 patients recruited between 2004 and 2014(Cardiology department,Croix-Rousse Hospital,Lyon)who had at baseline HMOD and secondary forms screening among them 190 were≥ 65 years.RESULTS The mean(2.1±0.8 vs.1.2±0.9,P <0.001) and frequency of HMOD(96.3% vs.72.9%,P <0.001) was higher in patients≥ 65 years than younger ones.Carotid femoral pulse wave velocity> 10 m/s was the most frequent HMOD in patients≥ 65 years(90.1%),while echocardiographic left ventricular hypertrophy was the most common in the younger patients(45.0%).Among ECG left ventricular indexes,only R wave in aVL lead was significantly more frequently observed in patients≥ 65 years(32.6%) than in younger ones(19.0%,P <0.001).The frequency of secondary hypertension was not significantly different between younger and older patients(respectively;30.5% vs.27.8%,P=0.487).The most frequent aetiology was primary aldosteronism regardless of age,followed by renovascular hypertension(6.3% vs.3.3%,P=0.038).Among older patients,3.2% were treated with adrenalectomy and 6.3% with percutaneous transluminal renal angioplasty.CONCLUSION Extensive screening of HMOD in older patients may be questionable as nearly all patients had one;aetiology must however be explored as a third of older patients had a secondary form.
文摘Introduction: According to the WHO, Chad is located in an area of high endemicity for hepatitis B virus (HBV). The aim of this study was to analyze the virological profiles of chronic HBV carriers. Materials and Method: This was a retrospective and analytical study including outpatients with chronic HBV of any age received in Department of Internal Medicine and Gastroenterology of National General Reference Hospital of N’Djamena from 2013 to 2017. Results: During the study period, 401 chronic hepatitis B virus carriers (mean age was 35 years ± 11 years with sex ratio of 3.26) were seen in outpatient clinic with a frequency of 3.34% (401/11,988). HBeAg (+) patients were 12.8% and HBeAg negative 87.2%. HBeAg-negative patients were significantly older (p = 0.000) than those with HBeAg (+). The mean HBV-DNA level was higher in HBeAg (+) patients. The HBV-DNA level in HBeAg-positive patients was higher than in HBeAg-negative patients with a significant difference (p = 0.043). The mean ALT level was 45 IU/L in HBeAg (−) patients. It was 49 in HBeAg (+) patients. Conclusion: HBeAg (−) chronic hepatitis B is the most predominant form in our study. This observation is important because it can help to adapt the management strategies.
文摘<span style="font-family:Verdana;"><strong>Background:</strong> A healthy diet is essential for optimal diabetes management. However, dietary habits vary from one region to another, making it challenging to standardize practices. <strong>Objective: </strong>To describe the diet habits of patients living with diabetes in Guinea. <strong>Methods:</strong> We conducted a dietary habits survey among 102 patients living with diabetes followed-up at the University Hospital of Conakry in Guinea between January and March 2012. Data were collected by individual interview on the basis of a three-item questionnaire: diabetes data, diet mode, and food composition. <strong>Results:</strong> In total, 85% of patients were consuming 3 meals daily;13.7% had a collation and 25% had snacking habits. The meal was individual in 82.4% and collective in 17.6% of patients. The main foods consumed daily were: rice (93.1%), fish (93.1%), palm oil (91.1%), bread (87.2%). Foods consumed regularly (2 to 3 times a week) were: meat (49%), eggs (23.5%), dairy products (34.3%), fruit (43.1%), vegetables (40.2%) and peanut oil (21.5%). The food bans reported were: regular sugar (100%), sodas (62.7%), peanuts (84.3%) and sweetened fruits (55.8%). <strong>Conclusion:</strong> Combining dietary recommendations and dietary habits is essential for appropriate management of diabetic patients. The assessment of local food glycemic indexes and the training of dietitians remains a challenge in our context.</span>
文摘Introduction: Depression is common in HIV/AIDS. We aim to investigate the frequency and the grade of this mental disorder in partners and determine its influence on sexual dysfunctions in serodiscordant couples in Ouagadougou. Patients/Method: This cross-sectional study was monitored from 1 January to 31 June 2010 in the internal medicine department of CHUYO, Ouagadougou. HIV-infected patients and their seronegative partners who gave their consent were included. Depression was diagnosed using the Beck Depression Inventory 13 items (BDI-13). Results: Eighty heterosexual and monogamous serodiscordant couples were studied. 31 (38.7%) HIV-infected and 23 (28.7%) seronegative partners were affected by depression;p = 0.18. The score of depression was 3.5 ± 2.1 in HIV-infected and 3.3 ± 1.6 in seronegative partners;p = 0.85. Depression was diagnosed in both partners in 13 couples (16.2%) and in only one partner in 28 couples (35%). Depression was diagnosed at least for one partner in 40 (51.3%) couples where sexual dysfunctions affected partner (s) and in 1 (50%) couple where no sexual dysfunction was reported. Conclusion: Psychological assessment is needed for a better management of HIV/AIDS in serodiscordant couples.
文摘Background: In comparison to other forms of chronic liver diseases, cirrhosis is generally poorly studied in sub Saharan Africa. In Chad, more particularly, no data are available despite the burden of liver diseases considered as the first cause of hospitalizations in the country. Methods: We conducted a retrospective analysis of 268 patients with liver cirrhosis attending care at the University Reference Hospital between 2007 and 2016. Results: This series of liver cirrhoses was characterized by a weak mal predominance (M:F = 1.7). The age of onset occurs significantly earlier in women than in men (40.6 ± 12.0 vs. 44.4 ± 13.4, p = 0.0171). The principal risk factor was persistent infection with hepatitis B virus (49% of cases) followed distantly by infection with hepatitis C virus (13%) and excessive alcohol consumption (10%). Men were more frequently carrying HBV surface antigen than women (65.6% vs 35.9% p = 0.0019). HBV-associated liver cirrhosis was overall more severe than diseases from other causes. A large proportion of cirrhosis (30%), observed primarily in women (48.1% vs 24.1%, p = 0.0036), was considered are cryptogenic. Conclusions: The etiological spectrum of liver cirrhosis remains to be properly defined in Chad. This lack of knowledge prevents the implementation of an efficient policy of prevention. A significant effort should be secured to characterize hitherto neglected infectious, lifestyle or genetic risk factors responsible of this form of terminal disease and improve subsequently liver health of local populations.
文摘Introduction:la qualitéde vie des patients suivis pour une hémopathie maligne dépend non seulement du type de la maladie,de ses caractéristiques cliniques,biologiques et thérapeutiques,mais aussi de la santémentale du patient.L’objectif de notreétude est d’évaluer l’état psychologique des patients au diagnostic,de rechercher les facteurs associésàson altération et de préciser son impact sur la qualitéde vie des patients.Méthode:nous avons menéuneétude monocentrique transversale quiévalue la dépression,l’anxiétéet la qualitéde vie d’une population de patients atteints de syndromes lymphoprolifératifs sur une période de 22mois.Deux questionnaires ontétéutilisés au moment du diagnostic:le HADS pour rechercher la dépression et l’anxiétéet le SF12échelle pourévaluer la qualitéde vie liéeàla santé.Résultat:Les cent patients ont acceptéde répondre aux questionnaires.Ces patients sont suivis pour un lymphome malin non hodgkinien,une maladie de Hodgkin,et une leucémie lymphoïde chronique.Le sex-ratio(H/F)est de 1,08.La prévalence des symptômes anxieux est de 70%avec 95%CI(61,01%;78,99%)et des symptômes dépressifs de 76%avec 95%CI(49,4%;82,6%)des cas.En analyse univariée,le caractère féminin est associéaux symptômes anxieux(p=0,008),etàl’altération de qualitéde vie mentale(p=0,02).Alors qu’en analyse multivariée,Les symptômes anxio-dépressifs sont significativement associésàun score de qualitéde vie faible aussi bien mentale que physique.En plus les symptômes anxieux sont corrélés au sexe féminin(ORA=20,50;95%CI[1,58–264,48]);et la douleur(ORA=12,33;95%CI[1,07–141,77]).Conclusion:la recherche de comorbidités psychologiques doit faire partie du diagnostic initial de cette population vulnérable pour une meilleure qualitéde vie.
文摘Gastrointestinal tuberculosis is a rare form of extrapulmonary tuberculosis and its diagnosis can be difficult. Aims-To analyze the diagnostic and therapeutic characteristics of gastrointestinal tuberculosis Methods-Retrospective study from 17 cases collected in 4 hospitals in Seine Saint-Denis between 1987 and 2002. Results-Seventeen cases and 19 localizations were collected: small intestine (N = 7), ileocecum (N = 6), colon (N = 4) and gastroduodenum (N = 2). Two patients had two localizations. Mean age was 43.9 years. Subjects from immigrant populations (76.5%)were preferentially affected. Twenty-three percent of patients (13 tested) were infected by human immunodeficiency virus. Weight-loss and general weakness (88%), abdominal pain (88%), fever (59%), nausea/vomiting (53%) were the predominant symptoms. The delay in diagnosis was 82 days (range: 7-180) and time before specific treatment 31.6 days (range: 7-90). Histological evidence of caseating granuloma was found in six patients. Mycobacterium tuberculosis was detected in six. Digestive imaging was abnormal in 15 patients. Mesenteric lymph nodes were the most common associated site of tuberculosis (N = 8, 47%). Mean duration of treatment was 8.2 months (range: 6-12). Thirteen patients were cured, three died and one was last to follow up. Conclusion-Gastrointestinal tuberculosis is not an uncommon diagnosis in the north-eastern Parisian area, especially among immigrant populations and immunodeficient patients. The most frequent localizations are the small intestine and ileocecum. Diagnosis can be made by pathology and/or bacteriology on endoscopic and/or surgical biopsy samples.
文摘慢性丙型肝炎病毒(hepatitis C virus,HCV)感染是发达国家慢性肝病的首要病因,可导致肝硬化和肝细胞癌.慢性HCV感染是混合型冷球蛋白血症(mixed cryoglobulinemia,MC)的主要病因.MC是一种全身性血管炎,以血清中存在冷球蛋白(cryoglobulin,CG)(即II型混合型CG)为主要特征,可累及皮肤、肾和神经系统[1-3].II型MC含有单克隆免疫球蛋白IgM.
文摘Introduction. The involvement of the peripheral nervous system in Behet’s d isease is very rare. Case report. We report a case of a 47-year-old man with a six-year history of Behet’s disease and a two-year history of peripheral n ervous system involvement. This patient presented with paraesthesia and weakness of the upper and lower limbs, diarrhea and erectile dysfunction. The electromyo gram showed evidence of an axonal sensorimotor neuropathy and the nerve biopsy s howed an axonal neuropathy. Routine blood tests were normal, there was no increa se of serum creatine kinase, aspartate aminotransfease or lactate dehydrogenase and no signs of hyperthyroidism. Fibroscopy and colonoscopy showed no signs of e ntero-Behet.The patient was treated with prednisone, cyclophosphamide and car bamazepine with an improvement of paraesthesia. Conclusion. The mechanism of the peripheral neuropathy in Behet’s disease is still unknown, it might be due t o vasculitis of the vasa nervorum or to the side effects of colchicine. Our repo rt is particular by the association of sensorimotor and autonomic involvement of peripheral neuropathy in a patient with Behet’s disease.
