Introduction: Undernutrition is a condition frequently encountered in pediatrics. It leads to an increased morbidity and mortality regardless of the underlying condition or other risk factors such as age. In countries...Introduction: Undernutrition is a condition frequently encountered in pediatrics. It leads to an increased morbidity and mortality regardless of the underlying condition or other risk factors such as age. In countries with limited resources such as ours, the diagnosis of undernutrition is often limited to the clinical presentation, and the contribution of biology is not often taken into account. Objectives: To establish the relationship between anthropometric parameters and biological markers in the diagnosis and classification of undernutrition and to assess the risk of infectious complications during undernutrition in children. Materials and Methods: A cross-sectional study conducted in Brazzaville among undernourished children aged 1 - 59 months between October 2018 and April 2019. Clinical diagnosis was based on WHO growth charts. The CRP, orosomucoid, albumin and transthyretin were obtained using the Cobas c311 analyzer, which enabled the calculation of Prognostic Inflammatory and Nutritional Index (PINI). The comparison of the means of the biological markers used the Student’s t-test, the risk of infectious complications the chi-square. The correlation of the diagnostic value of Z-score weight/height and PINI was also investigated. The significance level was set at 0.05. Results: Of the 95 children enrolled 63 (66.3%) were clinically severely malnourished, including 26 acute (41.3%) and 37 chronic (58.7%). The PINI revealed severe undernutrition in 85 children (89.4%) including 50 acute (58.8%) and 35 chronic (41.2%). CRP and orosomucoid were statistically higher in severe acute undernutrition (p Conclusion: Anthropometric parameters have a front-line advantage for assessing and classifying undernutrition. However, biological markers of undernutrition with PINI should be systematized in the diagnosis and management of undernutrition.展开更多
Background: Autoimmune diseases, which are among the leading causes of morbidity and mortality in the world, are pathologies caused by a dysfunction of the immune system. They can affect the central nervous system, th...Background: Autoimmune diseases, which are among the leading causes of morbidity and mortality in the world, are pathologies caused by a dysfunction of the immune system. They can affect the central nervous system, the peripheral nervous system or both nervous systems. Objectives: To describe the epidemiological, clinical, paraclinical, therapeutic and evolutive aspects of neurological disorders related to autoimmune diseases. Methods: This was a prospective cohort study. It was carried out from 1 January 2015 to 31 December 2019 (5 years). It focused on patients aged 15 years and above, who were hospitalized or followed as ambulatory patients for neurological disorders related to autoimmune diseases in the neurology department of the university teaching hospital in Brazzaville. Results: Among the 41 patients who fulfilled inclusion criteria, there were 29 (70.73%) women and 12 (29.27%) men. The average age of patients was 38.3 ± 13.8 years. An increase in the frequency of neurological disorders related to autoimmune diseases was observed every year. The main neurological disorders were neuromyelitis optica spectrum disorders (n = 14;34.15%), acute polyradiculoneuropathies (n = 13;31.71%), chronic polyradiculoneuropathies (n = 4;9.75%) and acute disseminated encephalomyelitis (n = 3;7.31%). The treatments administered, which consisted of corticosteroids and immunosuppressive drugs, had significantly improved the vital prognosis and functional status of patients (p = 0.025). Conclusion: In our study population, neurological disorders related to autoimmune diseases are rare. The neurological clinico-pathological entities diagnosed are similar to those reported in the literature. The therapeutic approaches used improve the quality of life of patients.展开更多
Background: To determine mortality causes and the associated factors. Patients and Method: This cross-sectional study was conducted from June 2014 to May 2015 (1 year) in the department of cardiology at University and...Background: To determine mortality causes and the associated factors. Patients and Method: This cross-sectional study was conducted from June 2014 to May 2015 (1 year) in the department of cardiology at University and teaching Hospital of Brazzaville. Patients admitted for cardiovascular diseases were included. Patients admitted for cardiovascular disease in other departments of the hospital, or without cardiovascular diseases were not included. Results: In total, 1035 patients, 605 women (5804%) were included. Mean age was 57.1 ± 7 years (range: 18 - 85 years). The patients were: elderly (n = 498, 48.1%), educated (n = 809, 78.1%), low-income (n = 253, 24.2%). The medical history of patients was: hypertension (n = 440, 42.5%), diabetes (n = 316, 30.5%), reduced physical activity (n = 154, 14.9%), excessive alcohol intake (n = 56, 5.4%). Heart failure was reported in 386 cases (37.3%). The mortality rate was 8% (n = 83);the mean age of deceased was 61.9 ± 7.3 years (p s in death were dilated cardiomyopathy (n = 37, 44.6%, OR 5, 95%CI 3.1 - 8, p -3.3, p = 0.002), atrial fibrillation (n = 24, 29%, OR 3.6, 95%CI 2.2 - 6, p - 9.8, p = 0.005). The associated death comorbidities were: acute respiratory infection (n = 44, 53%, OR 10.1, 95%CI 6.2 - 16, p - 10 p - 6.8, p Conclusion: Hypertension, heart failure and cardiomyopathies are the leading causes of mortality in the department of cardiology. Prevention and patient education in a low-income environment are essential elements to reduce this morbidity.展开更多
Background: Late Neonatal Bacterial Infection (LNNBI) is a clinical and biological manifestations related to penetration and growth of specific causative bacteria in bloodstream occurring on the 4<sup>th</sup...Background: Late Neonatal Bacterial Infection (LNNBI) is a clinical and biological manifestations related to penetration and growth of specific causative bacteria in bloodstream occurring on the 4<sup>th</sup>-28<sup>th</sup> day of life. LNNBI still represents an important cause of mortality and morbidity among infants. Objectives: To determine the frequency of late bacterial infections in newborns, to describe the clinical and biological profiles and to identify the main responsible germs. Methods: Descriptive study data collection, conducted over a period of 10 months at the Brazzaville Teaching Hospital, of interest to newborns admitted from the 4<sup>th</sup> day of life for suspicion of neonatal infection, and those admitted for any other pathology and having presented an infection 48 hours after hospitalization, and in whom a bacterial culture and/or an inflammatory assessment confirmed or suspected infection. Results: During the study period, 1682 newborns were hospitalized, and 86 were hospitalized for a late neonatal bacterial infection, i.e. a frequency of 5.1%. There were 67 (77.9%) community infections and 19 (22.1%) nosocomial infections. The frequency of nosocomial infection was 1.1%. The main signs were fever in 65 cases (75.6%), and respiratory distress in 37 cases (43%). The most frequent localizations were bacteremia 32 (37.2%), pulmonary 21 (24.4%), digestive and meningeal in 11 cases (12.8%) each. The most common germ Klebsiella in 10 (50%) newborns was resistant to the usual antibiotics. The evolution was favorable in 71 cases (82.5%), and death occurred in 12 cases (14%). Conclusion: Late neonatal bacterial infection is common. The main responsible germs are gram-negative bacilli, in particular Klebsiella multi-resistant.展开更多
Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determi...Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determine the prevalence of HIV, HCV and HBV co-infections in pregnant women at Bangui Community University Hospital and the cost of screening. Methods: A cross-sectional study involving consenting pregnant women who came for antenatal care was performed. HIV, HCV antibodies and HBV antigens were detected using Exacto Triplex<sup>?</sup> HIV/HCV/HBsAg rapid test, cross-validated by ELISA tests. Sociodemographic and professional data, the modes of transmission and prevention of HIV and both hepatitis viruses were collected in a standard sheet and analyzed using the Epi-Info software version 7. Results: Pregnant women aged 15 to 24 were the most affected (45.3%);high school girls (46.0%), and pregnant women living in cohabitation (65.3%) were the most represented. Twenty-five (16.7%) worked in the formal sector, 12.7% were unemployed housewives and the remainder in the informal sector. The prevalence of HIV, HBV, and HCV viruses was 11.8%, 21.9% and 22.2%, respectively. The prevalence of co-infections was 8.6% for HIV-HBV, 10.2% for HIV-HCV, 14.7% for HBV-HCV and 6.5% for HIV-HBV-HCV. All positive results and 10% of negative results by the rapid test were confirmed by ELISA tests. The serology of the three viruses costs 39,000 FCFA (60 Euros) by ELISA compared to 10,000 FCFA (15.00 Euros) with Exacto Triplex<sup>?</sup> HIV/HCV/AgHBs (BioSynex, Strasbourg, France). Conclusion: The low level of education and awareness of hepatitis are barriers to development and indicate the importance of improving the literacy rate of women in the Central African Republic (CAR). Likewise, the high prevalence of the three viruses shows the need for the urgent establishment of a national program to combat viral hepatitis in the CAR.展开更多
Objectives: To report an epidemiology study and prognosis for metastatic bone tumor. Methodology: It was a descriptive, transversal study on records of patients hospitalized in Rheumatology and Oncology-Radiotherapy d...Objectives: To report an epidemiology study and prognosis for metastatic bone tumor. Methodology: It was a descriptive, transversal study on records of patients hospitalized in Rheumatology and Oncology-Radiotherapy departments of the University Teaching Hospital of Brazzaville, Congo from 1 January 2005 to 31 July 2011 (7 years and 6 months). The diagnosis of bone metastasis was made because of the existence of bone pain, or pathological fracture, or bone swelling and a bone-condensing or mixed or osteolytic radiological image. The anatomo-pathological evidence was made after biopsy of the bone lesion or primary cancer. 3687 patients were hospitalized for active cancer, among them 81 had documented bone metastasis. Results: There were 60 men (74.1%) and 21 women (25.9%) with a sex ratio of 2.85. The average age was 53 years, ranging from 3 to 80 years. 75% of patients were more or equal to 50 years old at the discovery of the bone metastasis. Bone pain was the main mode of discovery (67.9% of cases). However, in 6.2% of cases, it was discovered incidentally. The metastasis was bone condensing in 50.7% of cases, osteolytic in 40.7% and mixed in 8.6%. They were unifocal in 25.9% and multifocal in 74.1% of cases. The Primary cancer most frequently found was that of the prostate in 55.6% of cases, breast in 20.7% and rhabdomyosarcoma in 4.9%. In 6.2% of cases, the primary site of cancer was unknown. The average survival was 25 months. Conclusion: The clinical and radiological presentation remains classic. Cancer of the prostate and breast are the main neoplasia responsible for bone metastasis in our series. The discovery of metastasis remains a major evolutionary step of cancer.展开更多
Introduction: Breast phyllodes are rare. Histologically, it is a fibro-epithelial tumour that differs from the fibro-adenoma by a more abundant and more cellular stroma. Observation: We report a case of a large breast...Introduction: Breast phyllodes are rare. Histologically, it is a fibro-epithelial tumour that differs from the fibro-adenoma by a more abundant and more cellular stroma. Observation: We report a case of a large breast phyllode tumour in a 42-year-old woman in the Obstetric and Gynaecology Department of Loandjili General Hospital. This tumor has evolved for 3 years. It is by discomfort due to chest pain. The clinical examination showed a voluminous right breast in the form of a calabash that hung down the body with a large collateral circulation, associated with an appearance of “orange peel”, and an axillary lymph node. In addition, there were necrotic areas and retraction of the nipple. In addition to the clinical characteristics, the ultrasound images and the histological analyses following the biopsy made it possible to evoke the diagnosis of phyllode tumour of the breast. The treatment consisted of a full right simple mastectomy with a 50 cm breast with a major axis that weighed 9465 grams, supplemented by homolateral axillary lymph node dissection. At the section of the tumour measuring 40 cm long, the sectional sections alternately showed solid and cystic areas. The histological examination confirmed the phyllode nature of the tumour with intermediate grade 2 malignancy. The lymph nodes showed an inflammatory appearance, with no signs of malignancy. Early post operation period was uneventful. The patient’s follow-up was annual, and the last check dated 09/01/2017 proved to be normal. Conclusion: The phyllode tumor is a rare pathology. In our environment, it can be greatly increased by the lack of diagnosis and early management. In all cases, any tumour of the breast operated, must benefit from an anatomo-pathological analysis, to determine the benign or malignant character of it, allowing proposing a plan of management better adapted.展开更多
This is the description of the prevention and the development of the sessions of hemodialysis in our center hemodialysis to not be contaminated coronavirus. Actions taking are: respect of the measures decreed by the s...This is the description of the prevention and the development of the sessions of hemodialysis in our center hemodialysis to not be contaminated coronavirus. Actions taking are: respect of the measures decreed by the state for prevention. Although these measures are difficult socio-cultural for Africans, they became normal after two weeks. The hemodialysis is made free during this period in our public center. Indeed, the session of hemodialysis was 10,000 francs Africans financial community (CFA in french) or 16.72 American dollar, from the declaration of the state of emergency it has become free. We do hemodialysis free and explanation of covid19 signs in hemodialysis patients systematically. Each patient had the explanation of the pathology and above all we did everything to de-stress the patients, because there is a global psychosis. Cleaning hand before entering the hemodialysis room, we have positioned front of the hospital and before the service and the front of room hemodialysis, seals for washing hands. We monitor the temperature before hemodialysis with a thermoflash or a mercury thermometer for each patient. We made a mandatory to wear masks for all patients during hemodialysis sessions. We shared the masks in loincloth with liners to all the patients a local manufacture.展开更多
INTRODUCTION: The objective of our study was to determine the epidemiological clinical and histological aspects of gynecological and breast cancers in Pointe-Noire. PATIENTS AND METHODS: This was a retrospective descr...INTRODUCTION: The objective of our study was to determine the epidemiological clinical and histological aspects of gynecological and breast cancers in Pointe-Noire. PATIENTS AND METHODS: This was a retrospective descriptive study that took place in the cancerology and internal medicine department during the period from January 1, 2012 to December 31, 2021, i.e. a period of 10 years. Women with histological diagnosis of gynecological and breast cancers were included in our study. The variables studied were: frequency, age, alcohol and tobacco consumption, histological type, stage of extension, location of cancer. Bivariate analysis was done between age and location of the tumour. The statistical test used was the KHI2 test. The results were statistically significant for a value of p RESULTS: We collected 400 files from women with cancer. Among the 400 files, 265 were represented by gynecological and breast cancers, that is a frequency of 65.43%. Among the 265 cases of gynecological and breast cancer identified during this study period, breast cancer represented the first rank with 52% frequency. Cervical cancer accounted for 41% followed by ovarian cancer (5%) and endometrial (2%). Cancer of vulva was represented by a single case. The average age of patients with gynecological and breast cancers during our study was 52 ± 12 years. The average age of patients with cancer of the breast, cervix, ovarian, endometrial was respectively 49 ± 11.97 years, 54.73 ± 12.91 years old, 50 ± 14 years, 67 ± 14.24 years, the age of the vulva cancer patient was 51 years old. The histological type of breast cancer was represented by infiltrating ductal adenocarcinoma in 91% of cases, invasive lobular carcinoma in 7% and sarcoma in 2%. Cervical cancers were represented by squamous cell carcinomas in 95% of cases and adenocarcinomas in 5% of cases. Vulva cancer was represented by squamous cell carcinoma, ovarian cancer was represented by epithelial tumors (adenocarcinoma) in 100% of cases. Endometrial cancers were represented by endometrial adenocarcinoma. All cancers were diagnosed at advanced stages (locoregional and metastatic stage). Patients over the age of 50 had more gynecological and breast cancers;but this result was not significant. CONCLUSION: Gynecological and breast cancers are frequent and constitute the first cancer of Congolese women in Pointe-Noire. Breast cancer is the first cancer followed by cancer of the cervix and ovaries. The histological types are those of the literature. Patients with gynecological and breast cancers consult at very advanced stages.展开更多
Introduction: The objective of our study was to determine the prevalence of hematological toxicity during breast cancer chemotherapy. Patients and Methods: This was a cross-sectional descriptive study that took place ...Introduction: The objective of our study was to determine the prevalence of hematological toxicity during breast cancer chemotherapy. Patients and Methods: This was a cross-sectional descriptive study that took place in the cancerology and internal medicine department during the period from January 1, 2021 to December 31, 2021, i.e. a period of 1 year. Were included in our study: patients with and histological diagnosis, and having received at least two cycles of chemotherapy and having presented hematological toxicity: anemia and/or neutropenia. The variables studied were: Age, level of study, socioeconomic level, stage of extension, type of chemotherapy, type of toxicity: neutropenia and anemia. Bivariate analysis was done between anemia, neutropenia and type of chemotherapy. Results: The average age of the patients was 50.35 ± 13.6 years. The extremes were 27 years and 79 years old. The most represented age group was the age group from 37 to 46 years with 18 cases or 33.33%. The most represented level study in our study was the primary level 63%, followed by secondary level 26% and the upper or superior level 11%. Metastatic stage of location was represented in 16.6% of cases, the local stage was represented in 16.7% of cases. The most common chemotherapy used was FAC protocol in 50% of cases, followed by FAC + DOCETAXEL in 47% of cases, AC protocol was used in 3% of cases. The most represented grade of neutropenia was grade 3 in 53% of cases, followed by grade 2 in 27% of cases and grade 1 in 20%. Grade 1 anemia was the most represented in 70% of cases, followed respectively by grade 2 in 27%. The majority of patients had received more than 3 courses of chemotherapy in 83% of cases. Grade 3 neutropenia was observed mostly in the advanced stages, 15 cases at the locoregional stage. Grade 1 anemia was most common in patients who received more than 3 courses of chemotherapy. The FAC chemotherapy protocol was responsible for more grade 3 anemia in 14 cases. FAC-type chemotherapy was associated with grade 3 and 2 neutropenia in 8 cases and 4 cases, but the results were not significant. FAC + DOCEAXEL type chemotherapy was also responsible for grade 3 and 2 neutropenia in 8 cases and 4 cases P > 5% respectively. Conclusion: Hematological toxicity in the context of our limited resources is dominated by anemia and neutropenia. The knowledge of this hematological toxicity is necessary for the limitation of the delay of chemotherapy.展开更多
Metabolic syndrome (MetS) and its components have been linked to elevated serum levels of inflammatory biomarkers such as C-reactive protein, interleukin-6, interleukin-1β and tumor necrosis factor alpha. The aim of ...Metabolic syndrome (MetS) and its components have been linked to elevated serum levels of inflammatory biomarkers such as C-reactive protein, interleukin-6, interleukin-1β and tumor necrosis factor alpha. The aim of our study was to address the association between MetS components with serum hs-CRP and IL-6 levels among Congolese adults. A total of 357 participants (aged 30 - 87 years) were included in this cross-sectional study. Anthropometrics were collected and fasting blood sampled for assessment of fasting blood glycaemia (FBG), lipids and inflammatory parameters using commercially available assays. NCEP-ATPIII criteria were used to define MetS. The Median (IQR) hs-CRP and IL-6 levels were higher in participants with MetS than in those without ([7 (4, 14) versus 6 (4, 8)] mg/L;p = 0.092 and [23.8 (20.9, 27.6) versus 22.3 (19.5, 25.0)] pg/mL;p = 0.002). hs-CRP and IL-6 levels were significantly higher in females with MetS than in those without, but not in males. Among participants, only TG was correlated with hs-CRP (r = 0.149, p = 0.007), and a significant correlation was observed between TG (r = 0.116, p = 0.037), FBG (r = 0.208, p = 0.000), HDL-C (r = −0.119, p = 0.034) and SBP (r = 0.143, p = 0.010) and IL-6. In males, hs-CRP levels were positively correlated with TG (0.316;p = 0.000), negatively with HDL-C (r = −0.290, p = 0.0022), without such correlations in females. In Ames, IL-6 levels were positively correlated with FBG (r = 0.202;p = 0.035), and negatively with HDL-C (r = −0.249, p = 0.009). Significant correlations between IL-6 levels and FBG (r = 0.214;p = 0.000) or SBP (r = 0.227, p = 0.000) were observed in females. Logistic regression analysis was carried out to identify the relationship between MetS components and hs-CRP or IL-6. Values of area under receiver-operating characteristic (ROC) curves suggest potential use of serum hs-CRP (AUC = 0.675) and IL-6 (AUC = 0.656) as diagnostic biomarkers of MetS. Combination of hs-CRP and IL-6 improved diagnosis accuracy, yielding a 0.698 ROC curve area. MetS components are associated with hs-CRP and IL-6 levels among adults Congolese. Combining the two biomarkers hs-CRP and IL-6 improves Mets diagnostic accuracy compared to hs-CRP or IL-6 alone.展开更多
Valsalva retinopathy is caused by a sudden increase in intra-thoracic or abdominal pressure, following forced expiration, with mouth and nose closed (Valsalva maneuver). We report a case of Valsalva retinopathy in a p...Valsalva retinopathy is caused by a sudden increase in intra-thoracic or abdominal pressure, following forced expiration, with mouth and nose closed (Valsalva maneuver). We report a case of Valsalva retinopathy in a pregnant woman. A 36 years old patient, pregnant at 24 weeks of amenorrhea, who consulted for sudden visual acuity decrease of the left eye, evolving since 24 hours after Valsalva maneuvers to calm down her panic and control her breathing. The refraction has demonstrated a decrease of visual acuity in the left eye to “can see a hand moving”, while the visual acuity remained normal in the right eye. Spontaneous evolution was marked by a fast and progressive reduction of hemorrhage and progressive recovery of vision in the left eye. Valsava retinopathy was first described in 1972 by Thomas Duane. Physical activity is usually found before it occurs. Many situations are usually associated to this occurrence among which: pregnancy, vomiting, weightlifting or trauma. Regression of this hemorrhage without sequelae is usual. But sometimes, we need a Nd:Yag laser treatment or surgery to evacuate the blood.展开更多
文摘Introduction: Undernutrition is a condition frequently encountered in pediatrics. It leads to an increased morbidity and mortality regardless of the underlying condition or other risk factors such as age. In countries with limited resources such as ours, the diagnosis of undernutrition is often limited to the clinical presentation, and the contribution of biology is not often taken into account. Objectives: To establish the relationship between anthropometric parameters and biological markers in the diagnosis and classification of undernutrition and to assess the risk of infectious complications during undernutrition in children. Materials and Methods: A cross-sectional study conducted in Brazzaville among undernourished children aged 1 - 59 months between October 2018 and April 2019. Clinical diagnosis was based on WHO growth charts. The CRP, orosomucoid, albumin and transthyretin were obtained using the Cobas c311 analyzer, which enabled the calculation of Prognostic Inflammatory and Nutritional Index (PINI). The comparison of the means of the biological markers used the Student’s t-test, the risk of infectious complications the chi-square. The correlation of the diagnostic value of Z-score weight/height and PINI was also investigated. The significance level was set at 0.05. Results: Of the 95 children enrolled 63 (66.3%) were clinically severely malnourished, including 26 acute (41.3%) and 37 chronic (58.7%). The PINI revealed severe undernutrition in 85 children (89.4%) including 50 acute (58.8%) and 35 chronic (41.2%). CRP and orosomucoid were statistically higher in severe acute undernutrition (p Conclusion: Anthropometric parameters have a front-line advantage for assessing and classifying undernutrition. However, biological markers of undernutrition with PINI should be systematized in the diagnosis and management of undernutrition.
文摘Background: Autoimmune diseases, which are among the leading causes of morbidity and mortality in the world, are pathologies caused by a dysfunction of the immune system. They can affect the central nervous system, the peripheral nervous system or both nervous systems. Objectives: To describe the epidemiological, clinical, paraclinical, therapeutic and evolutive aspects of neurological disorders related to autoimmune diseases. Methods: This was a prospective cohort study. It was carried out from 1 January 2015 to 31 December 2019 (5 years). It focused on patients aged 15 years and above, who were hospitalized or followed as ambulatory patients for neurological disorders related to autoimmune diseases in the neurology department of the university teaching hospital in Brazzaville. Results: Among the 41 patients who fulfilled inclusion criteria, there were 29 (70.73%) women and 12 (29.27%) men. The average age of patients was 38.3 ± 13.8 years. An increase in the frequency of neurological disorders related to autoimmune diseases was observed every year. The main neurological disorders were neuromyelitis optica spectrum disorders (n = 14;34.15%), acute polyradiculoneuropathies (n = 13;31.71%), chronic polyradiculoneuropathies (n = 4;9.75%) and acute disseminated encephalomyelitis (n = 3;7.31%). The treatments administered, which consisted of corticosteroids and immunosuppressive drugs, had significantly improved the vital prognosis and functional status of patients (p = 0.025). Conclusion: In our study population, neurological disorders related to autoimmune diseases are rare. The neurological clinico-pathological entities diagnosed are similar to those reported in the literature. The therapeutic approaches used improve the quality of life of patients.
文摘Background: To determine mortality causes and the associated factors. Patients and Method: This cross-sectional study was conducted from June 2014 to May 2015 (1 year) in the department of cardiology at University and teaching Hospital of Brazzaville. Patients admitted for cardiovascular diseases were included. Patients admitted for cardiovascular disease in other departments of the hospital, or without cardiovascular diseases were not included. Results: In total, 1035 patients, 605 women (5804%) were included. Mean age was 57.1 ± 7 years (range: 18 - 85 years). The patients were: elderly (n = 498, 48.1%), educated (n = 809, 78.1%), low-income (n = 253, 24.2%). The medical history of patients was: hypertension (n = 440, 42.5%), diabetes (n = 316, 30.5%), reduced physical activity (n = 154, 14.9%), excessive alcohol intake (n = 56, 5.4%). Heart failure was reported in 386 cases (37.3%). The mortality rate was 8% (n = 83);the mean age of deceased was 61.9 ± 7.3 years (p s in death were dilated cardiomyopathy (n = 37, 44.6%, OR 5, 95%CI 3.1 - 8, p -3.3, p = 0.002), atrial fibrillation (n = 24, 29%, OR 3.6, 95%CI 2.2 - 6, p - 9.8, p = 0.005). The associated death comorbidities were: acute respiratory infection (n = 44, 53%, OR 10.1, 95%CI 6.2 - 16, p - 10 p - 6.8, p Conclusion: Hypertension, heart failure and cardiomyopathies are the leading causes of mortality in the department of cardiology. Prevention and patient education in a low-income environment are essential elements to reduce this morbidity.
文摘Background: Late Neonatal Bacterial Infection (LNNBI) is a clinical and biological manifestations related to penetration and growth of specific causative bacteria in bloodstream occurring on the 4<sup>th</sup>-28<sup>th</sup> day of life. LNNBI still represents an important cause of mortality and morbidity among infants. Objectives: To determine the frequency of late bacterial infections in newborns, to describe the clinical and biological profiles and to identify the main responsible germs. Methods: Descriptive study data collection, conducted over a period of 10 months at the Brazzaville Teaching Hospital, of interest to newborns admitted from the 4<sup>th</sup> day of life for suspicion of neonatal infection, and those admitted for any other pathology and having presented an infection 48 hours after hospitalization, and in whom a bacterial culture and/or an inflammatory assessment confirmed or suspected infection. Results: During the study period, 1682 newborns were hospitalized, and 86 were hospitalized for a late neonatal bacterial infection, i.e. a frequency of 5.1%. There were 67 (77.9%) community infections and 19 (22.1%) nosocomial infections. The frequency of nosocomial infection was 1.1%. The main signs were fever in 65 cases (75.6%), and respiratory distress in 37 cases (43%). The most frequent localizations were bacteremia 32 (37.2%), pulmonary 21 (24.4%), digestive and meningeal in 11 cases (12.8%) each. The most common germ Klebsiella in 10 (50%) newborns was resistant to the usual antibiotics. The evolution was favorable in 71 cases (82.5%), and death occurred in 12 cases (14%). Conclusion: Late neonatal bacterial infection is common. The main responsible germs are gram-negative bacilli, in particular Klebsiella multi-resistant.
文摘Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determine the prevalence of HIV, HCV and HBV co-infections in pregnant women at Bangui Community University Hospital and the cost of screening. Methods: A cross-sectional study involving consenting pregnant women who came for antenatal care was performed. HIV, HCV antibodies and HBV antigens were detected using Exacto Triplex<sup>?</sup> HIV/HCV/HBsAg rapid test, cross-validated by ELISA tests. Sociodemographic and professional data, the modes of transmission and prevention of HIV and both hepatitis viruses were collected in a standard sheet and analyzed using the Epi-Info software version 7. Results: Pregnant women aged 15 to 24 were the most affected (45.3%);high school girls (46.0%), and pregnant women living in cohabitation (65.3%) were the most represented. Twenty-five (16.7%) worked in the formal sector, 12.7% were unemployed housewives and the remainder in the informal sector. The prevalence of HIV, HBV, and HCV viruses was 11.8%, 21.9% and 22.2%, respectively. The prevalence of co-infections was 8.6% for HIV-HBV, 10.2% for HIV-HCV, 14.7% for HBV-HCV and 6.5% for HIV-HBV-HCV. All positive results and 10% of negative results by the rapid test were confirmed by ELISA tests. The serology of the three viruses costs 39,000 FCFA (60 Euros) by ELISA compared to 10,000 FCFA (15.00 Euros) with Exacto Triplex<sup>?</sup> HIV/HCV/AgHBs (BioSynex, Strasbourg, France). Conclusion: The low level of education and awareness of hepatitis are barriers to development and indicate the importance of improving the literacy rate of women in the Central African Republic (CAR). Likewise, the high prevalence of the three viruses shows the need for the urgent establishment of a national program to combat viral hepatitis in the CAR.
文摘Objectives: To report an epidemiology study and prognosis for metastatic bone tumor. Methodology: It was a descriptive, transversal study on records of patients hospitalized in Rheumatology and Oncology-Radiotherapy departments of the University Teaching Hospital of Brazzaville, Congo from 1 January 2005 to 31 July 2011 (7 years and 6 months). The diagnosis of bone metastasis was made because of the existence of bone pain, or pathological fracture, or bone swelling and a bone-condensing or mixed or osteolytic radiological image. The anatomo-pathological evidence was made after biopsy of the bone lesion or primary cancer. 3687 patients were hospitalized for active cancer, among them 81 had documented bone metastasis. Results: There were 60 men (74.1%) and 21 women (25.9%) with a sex ratio of 2.85. The average age was 53 years, ranging from 3 to 80 years. 75% of patients were more or equal to 50 years old at the discovery of the bone metastasis. Bone pain was the main mode of discovery (67.9% of cases). However, in 6.2% of cases, it was discovered incidentally. The metastasis was bone condensing in 50.7% of cases, osteolytic in 40.7% and mixed in 8.6%. They were unifocal in 25.9% and multifocal in 74.1% of cases. The Primary cancer most frequently found was that of the prostate in 55.6% of cases, breast in 20.7% and rhabdomyosarcoma in 4.9%. In 6.2% of cases, the primary site of cancer was unknown. The average survival was 25 months. Conclusion: The clinical and radiological presentation remains classic. Cancer of the prostate and breast are the main neoplasia responsible for bone metastasis in our series. The discovery of metastasis remains a major evolutionary step of cancer.
文摘Introduction: Breast phyllodes are rare. Histologically, it is a fibro-epithelial tumour that differs from the fibro-adenoma by a more abundant and more cellular stroma. Observation: We report a case of a large breast phyllode tumour in a 42-year-old woman in the Obstetric and Gynaecology Department of Loandjili General Hospital. This tumor has evolved for 3 years. It is by discomfort due to chest pain. The clinical examination showed a voluminous right breast in the form of a calabash that hung down the body with a large collateral circulation, associated with an appearance of “orange peel”, and an axillary lymph node. In addition, there were necrotic areas and retraction of the nipple. In addition to the clinical characteristics, the ultrasound images and the histological analyses following the biopsy made it possible to evoke the diagnosis of phyllode tumour of the breast. The treatment consisted of a full right simple mastectomy with a 50 cm breast with a major axis that weighed 9465 grams, supplemented by homolateral axillary lymph node dissection. At the section of the tumour measuring 40 cm long, the sectional sections alternately showed solid and cystic areas. The histological examination confirmed the phyllode nature of the tumour with intermediate grade 2 malignancy. The lymph nodes showed an inflammatory appearance, with no signs of malignancy. Early post operation period was uneventful. The patient’s follow-up was annual, and the last check dated 09/01/2017 proved to be normal. Conclusion: The phyllode tumor is a rare pathology. In our environment, it can be greatly increased by the lack of diagnosis and early management. In all cases, any tumour of the breast operated, must benefit from an anatomo-pathological analysis, to determine the benign or malignant character of it, allowing proposing a plan of management better adapted.
文摘This is the description of the prevention and the development of the sessions of hemodialysis in our center hemodialysis to not be contaminated coronavirus. Actions taking are: respect of the measures decreed by the state for prevention. Although these measures are difficult socio-cultural for Africans, they became normal after two weeks. The hemodialysis is made free during this period in our public center. Indeed, the session of hemodialysis was 10,000 francs Africans financial community (CFA in french) or 16.72 American dollar, from the declaration of the state of emergency it has become free. We do hemodialysis free and explanation of covid19 signs in hemodialysis patients systematically. Each patient had the explanation of the pathology and above all we did everything to de-stress the patients, because there is a global psychosis. Cleaning hand before entering the hemodialysis room, we have positioned front of the hospital and before the service and the front of room hemodialysis, seals for washing hands. We monitor the temperature before hemodialysis with a thermoflash or a mercury thermometer for each patient. We made a mandatory to wear masks for all patients during hemodialysis sessions. We shared the masks in loincloth with liners to all the patients a local manufacture.
文摘INTRODUCTION: The objective of our study was to determine the epidemiological clinical and histological aspects of gynecological and breast cancers in Pointe-Noire. PATIENTS AND METHODS: This was a retrospective descriptive study that took place in the cancerology and internal medicine department during the period from January 1, 2012 to December 31, 2021, i.e. a period of 10 years. Women with histological diagnosis of gynecological and breast cancers were included in our study. The variables studied were: frequency, age, alcohol and tobacco consumption, histological type, stage of extension, location of cancer. Bivariate analysis was done between age and location of the tumour. The statistical test used was the KHI2 test. The results were statistically significant for a value of p RESULTS: We collected 400 files from women with cancer. Among the 400 files, 265 were represented by gynecological and breast cancers, that is a frequency of 65.43%. Among the 265 cases of gynecological and breast cancer identified during this study period, breast cancer represented the first rank with 52% frequency. Cervical cancer accounted for 41% followed by ovarian cancer (5%) and endometrial (2%). Cancer of vulva was represented by a single case. The average age of patients with gynecological and breast cancers during our study was 52 ± 12 years. The average age of patients with cancer of the breast, cervix, ovarian, endometrial was respectively 49 ± 11.97 years, 54.73 ± 12.91 years old, 50 ± 14 years, 67 ± 14.24 years, the age of the vulva cancer patient was 51 years old. The histological type of breast cancer was represented by infiltrating ductal adenocarcinoma in 91% of cases, invasive lobular carcinoma in 7% and sarcoma in 2%. Cervical cancers were represented by squamous cell carcinomas in 95% of cases and adenocarcinomas in 5% of cases. Vulva cancer was represented by squamous cell carcinoma, ovarian cancer was represented by epithelial tumors (adenocarcinoma) in 100% of cases. Endometrial cancers were represented by endometrial adenocarcinoma. All cancers were diagnosed at advanced stages (locoregional and metastatic stage). Patients over the age of 50 had more gynecological and breast cancers;but this result was not significant. CONCLUSION: Gynecological and breast cancers are frequent and constitute the first cancer of Congolese women in Pointe-Noire. Breast cancer is the first cancer followed by cancer of the cervix and ovaries. The histological types are those of the literature. Patients with gynecological and breast cancers consult at very advanced stages.
文摘Introduction: The objective of our study was to determine the prevalence of hematological toxicity during breast cancer chemotherapy. Patients and Methods: This was a cross-sectional descriptive study that took place in the cancerology and internal medicine department during the period from January 1, 2021 to December 31, 2021, i.e. a period of 1 year. Were included in our study: patients with and histological diagnosis, and having received at least two cycles of chemotherapy and having presented hematological toxicity: anemia and/or neutropenia. The variables studied were: Age, level of study, socioeconomic level, stage of extension, type of chemotherapy, type of toxicity: neutropenia and anemia. Bivariate analysis was done between anemia, neutropenia and type of chemotherapy. Results: The average age of the patients was 50.35 ± 13.6 years. The extremes were 27 years and 79 years old. The most represented age group was the age group from 37 to 46 years with 18 cases or 33.33%. The most represented level study in our study was the primary level 63%, followed by secondary level 26% and the upper or superior level 11%. Metastatic stage of location was represented in 16.6% of cases, the local stage was represented in 16.7% of cases. The most common chemotherapy used was FAC protocol in 50% of cases, followed by FAC + DOCETAXEL in 47% of cases, AC protocol was used in 3% of cases. The most represented grade of neutropenia was grade 3 in 53% of cases, followed by grade 2 in 27% of cases and grade 1 in 20%. Grade 1 anemia was the most represented in 70% of cases, followed respectively by grade 2 in 27%. The majority of patients had received more than 3 courses of chemotherapy in 83% of cases. Grade 3 neutropenia was observed mostly in the advanced stages, 15 cases at the locoregional stage. Grade 1 anemia was most common in patients who received more than 3 courses of chemotherapy. The FAC chemotherapy protocol was responsible for more grade 3 anemia in 14 cases. FAC-type chemotherapy was associated with grade 3 and 2 neutropenia in 8 cases and 4 cases, but the results were not significant. FAC + DOCEAXEL type chemotherapy was also responsible for grade 3 and 2 neutropenia in 8 cases and 4 cases P > 5% respectively. Conclusion: Hematological toxicity in the context of our limited resources is dominated by anemia and neutropenia. The knowledge of this hematological toxicity is necessary for the limitation of the delay of chemotherapy.
文摘Metabolic syndrome (MetS) and its components have been linked to elevated serum levels of inflammatory biomarkers such as C-reactive protein, interleukin-6, interleukin-1β and tumor necrosis factor alpha. The aim of our study was to address the association between MetS components with serum hs-CRP and IL-6 levels among Congolese adults. A total of 357 participants (aged 30 - 87 years) were included in this cross-sectional study. Anthropometrics were collected and fasting blood sampled for assessment of fasting blood glycaemia (FBG), lipids and inflammatory parameters using commercially available assays. NCEP-ATPIII criteria were used to define MetS. The Median (IQR) hs-CRP and IL-6 levels were higher in participants with MetS than in those without ([7 (4, 14) versus 6 (4, 8)] mg/L;p = 0.092 and [23.8 (20.9, 27.6) versus 22.3 (19.5, 25.0)] pg/mL;p = 0.002). hs-CRP and IL-6 levels were significantly higher in females with MetS than in those without, but not in males. Among participants, only TG was correlated with hs-CRP (r = 0.149, p = 0.007), and a significant correlation was observed between TG (r = 0.116, p = 0.037), FBG (r = 0.208, p = 0.000), HDL-C (r = −0.119, p = 0.034) and SBP (r = 0.143, p = 0.010) and IL-6. In males, hs-CRP levels were positively correlated with TG (0.316;p = 0.000), negatively with HDL-C (r = −0.290, p = 0.0022), without such correlations in females. In Ames, IL-6 levels were positively correlated with FBG (r = 0.202;p = 0.035), and negatively with HDL-C (r = −0.249, p = 0.009). Significant correlations between IL-6 levels and FBG (r = 0.214;p = 0.000) or SBP (r = 0.227, p = 0.000) were observed in females. Logistic regression analysis was carried out to identify the relationship between MetS components and hs-CRP or IL-6. Values of area under receiver-operating characteristic (ROC) curves suggest potential use of serum hs-CRP (AUC = 0.675) and IL-6 (AUC = 0.656) as diagnostic biomarkers of MetS. Combination of hs-CRP and IL-6 improved diagnosis accuracy, yielding a 0.698 ROC curve area. MetS components are associated with hs-CRP and IL-6 levels among adults Congolese. Combining the two biomarkers hs-CRP and IL-6 improves Mets diagnostic accuracy compared to hs-CRP or IL-6 alone.
文摘Valsalva retinopathy is caused by a sudden increase in intra-thoracic or abdominal pressure, following forced expiration, with mouth and nose closed (Valsalva maneuver). We report a case of Valsalva retinopathy in a pregnant woman. A 36 years old patient, pregnant at 24 weeks of amenorrhea, who consulted for sudden visual acuity decrease of the left eye, evolving since 24 hours after Valsalva maneuvers to calm down her panic and control her breathing. The refraction has demonstrated a decrease of visual acuity in the left eye to “can see a hand moving”, while the visual acuity remained normal in the right eye. Spontaneous evolution was marked by a fast and progressive reduction of hemorrhage and progressive recovery of vision in the left eye. Valsava retinopathy was first described in 1972 by Thomas Duane. Physical activity is usually found before it occurs. Many situations are usually associated to this occurrence among which: pregnancy, vomiting, weightlifting or trauma. Regression of this hemorrhage without sequelae is usual. But sometimes, we need a Nd:Yag laser treatment or surgery to evacuate the blood.
