Annales Africaines de Medecine最新文献

{"title":"Application de pediatric sequential organ failure assessment (pSOFA) chez les enfants diagnostiqués de Sepsis selon les critères SIRS : Une série des cas de l’hôpital Saint Joseph","authors":"Jacques Balekelayi wa Balekelayi, Joseph Mabiala Bodi, Victoire Audray Bikoumou, Ariane Mankiele Keto, Mamy-gloire Manzi Monkoti, Thideline Mankanga Mabela, Agathe Maku Fwani, Stéphanie Mikalo Mbambi, Karem Efombola Itokua, Jennyfer Misengabu Lembalemba, Valerie Bolingo Bola, Celestin Ndosimao Nsibu","doi":"10.4314/aamed.v16i4.11","DOIUrl":"https://doi.org/10.4314/aamed.v16i4.11","url":null,"abstract":"Context and objective. The burden of sepsis using the Pediatric Sequential Organ Failure Assessment (pSOFA) in sub-Saharan Africa is not known. The aim of the present study was to determine the frequency of sepsis applying the pSOFA score in children.&#x0D; Methods. This was a case series including children aged between 1 and 15 years, previously suspected of sepsis by means of the Systemic Inflammatory Response Syndrome (SIRS) criteria, using the pSOFA score (≥ 2), in the Pediatric Emergency Department of Saint Joseph Hospital / Kinshasa.&#x0D; Results. Ninety-two children were enrolled. Males predominated (53.3 %). Their median age was 4.5 years. Clinical signs on admission were marked by fever (97.8%) and physical asthenia (60.8 %). The pSOFA sepsis test showed that 39.1% of patients had sepsis, while 60.9 % were misdiagnosed (pSOFA < 2). The frequency of sepsis according to pSOFA was 7.2 % of all admissions.&#x0D; Conclusion. The pSOFA score allowed sepsis to be diagnosed in only one child out of four, compared with the SIRS score, which tends to overestimate it.&#x0D; Contexte et objectif. Le fardeau du sepsis utilisant le Pediatric Sequential Organ Failure Assessment (pSOFA) en Afrique subsaharienne n’est pas connu. L’objectif de la présente étude était de déterminer la fréquence du sepsis appliquant le score pSOFA chez les enfants.&#x0D; Méthodes. C’était une série des cas incluant les enfants âgés entre 1 et 15 ans, préalablement suspectés de sepsis au moyen des critères SIRS, en utilisant le score pSOFA (≥ 2), au service des urgences pédiatriques de l’hôpital Saint Joseph / Kinshasa.&#x0D; Résultats. Nonante deux enfants ont été examinés. Le sexe masculin était prépondérant (53,3 %). Leur âge médian était de 4,5 ans. Les signes cliniques à l’admission étaient marqués par la fièvre (97,8 %) et l’asthénie physique (60,8 %). La mise en évidence du sepsis pSOFA a montré que 39,1% des patients avaient sepsis alors que 60,9 % étaient diagnostiqués à tort (pSOFA < 2). La fréquence de sepsis selon pSOFA était de 7,2 % sur l’ensemble d’admission.&#x0D; Conclusion. Le score pSOFA a permis de diagnostiquer le sepsis seulement chez un enfant sur quatre par rapport au score de SIRS qui a tendance à le surestimer.","PeriodicalId":31055,"journal":{"name":"Annales Africaines de Medecine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135470078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grossesse môlaire hydatiforme partielle invasive avec métastases pulmonaires et vaginales : À propos d’un cas","authors":"Hamidou Soumana Diaouga, Maimouna Chaibou Yacouba, Rahamatou Madeleine Garba, Maina Oumara, Houegbelo Laurent Lazare, Nafiou Idi, Madi Nayama","doi":"10.4314/aamed.v16i4.14","DOIUrl":"https://doi.org/10.4314/aamed.v16i4.14","url":null,"abstract":"&#x0D; Partial hydatidiform molar pregnancy is a product of conception with molar villi surrounding an amniotic cavity with an embryo. It has 69 chromosomes (most often XXY, XXX, XYY) and correspond to the triploid syndrome (embryonic mole). For several years, the partial hydatidiform molar pregnancy has been considered a benign entity that does not require strict monitoring like that of the complete molar pregnancy, but the appearance of cases of transformation of the partial hydatiform mole into an invasive molar pregnancy or choriocarcinoma questioned this strategy. From these facts the treatment and monitoring of partial molar pregnancy must be carried out with the same rigor as for the complete molar pregnancy. We report a case of invasive partial molar pregnancy with pulmonary and vaginal metastases.&#x0D; La grossesse môlaire hydatiforme partielle désigne un produit de conception avec des villosités molaires entourant une cavité amniotique pourvue d’un embryon. Elle comporte 69 chromosomes (le plus souvent XXY, XXX, XYY) et correspondent au syndrome triploïde (môle embryonnée). Depuis plusieurs années, la grossesse môlaire hydatiforme partielle a été considérée comme une entité bénigne qui ne nécessite pas une surveillance stricte comme celle de la grossesse môlaire complète, mais l’apparition des cas de transformation de la grossesse môlaire partielle en une grossesse môlaire invasive ou choriocarcinome ; a remis en question cette stratégie. De ces faits le traitement et la surveillance des môles partielles doivent être conduit avec la même rigueur que pour la grossesse môlaire complète. Nous rapportons un cas de grossesse molaire partielle invasive avec métastases pulmonaires et vaginales.","PeriodicalId":31055,"journal":{"name":"Annales Africaines de Medecine","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135428084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of poor prognosis requiring intubation in COVID-19 patients admitted in Intensive Care Unit: a Congolese observational study","authors":"Patrick Boloko, Jean-Robert Makulo, Yannick Nlandu, Yves Mboloko, Yannick Engole, Giscard Kabaluka, Patrick Kobo, Pally Mafuta, Joseph Tsangu, John Nsiala, Médard Bula Bula, Madone Mandina, Roger Wumba, Rodolphe Ahmed, Justine Bukabau","doi":"10.4314/aamed.v16i4.2","DOIUrl":"https://doi.org/10.4314/aamed.v16i4.2","url":null,"abstract":"Context and objective : In intensive care units (ICU), clinicians have little information to identify COVID-19 patients at high risk of poor prognosis requiring intubation. Considering the clinical and biological parameters of the patients during their admission to ICU, we determined the incidence of a pejorative evolution requiring intubation, and secondarily we searched among the starting parameters, which were predictors of the intubation during follow-up. Methods : We conducted a monocentric retrospective cohort study of adult patients admitted for moderate, severe or critical COVID-19/WHO clinical classification, during the first two waves of the pandemic in Kinshasa/DR Congo. Our primary end point was the incidence of intubation. Potential predictors of intubation were determined by the Cox regression analysis. The relative risk of death was assessed according to treatment with mechanical ventilation (intubation). Results : We included 219 patients (average age of 56.8 ±15.2 years; 75 % men), respectively 37 % in the 1st and 63 % in the 2nd wave of the pandemic. Cumulative incidence of intubation was 24% (1st wave: 26% vs 2nd wave: 24%). One-third of intubations were performed on the first 3 days versus two-thirds beyond the third day. The Cox's regression model showed that among data from the 1st day of ICU admission, those predicting intubation were: age (Hazard ratio: 1.025, CI 95%: 1.005-1.044), obesity (HR: 4.808; CI 95%: 2.660-8.696), corticosteroid therapy (HR: 0.313, CI 95%: 0.102-0.965), ROX index < 4.88 (HR: 2.024, CI 95 %: 1.003-4.080) and black race (HR: 0.502, CI 95%: 0.272-0.928). In total, 54 deaths (25 % of patients) were recorded with a higher relative risk (18.8) in intubated patients. Conclusion : A quarter of COVID-19 patients admitted to ICU could worsen and be intubated. The majority of intubations were performed after the third day of admission and mortality was high. The predictors of intubation that have been identified can help anticipate management by being proactive. Contexte et objectif: Dans les unités de soins intensifs (USI), les cliniciens disposent de peu d'informations pour identifier les patients COVID-19 à haut risque de mauvais pronostic nécessitant une intubation. L’objectif de la présente étude était de rechercherl'incidence d'une évolution péjorative nécessitant une intubation, et les prédicteurs de l'intubation au cours du suivi. Méthodes: C’était une étude de cohorte rétrospective monocentrique de patients adultes admis pour une classification clinique COVID-19/OMS modérée, sévère ou critique, durant les deux premières vagues de la pandémie à Kinshasa/RD Congo. Le critère de jugement principal était l'incidence de l'intubation. Les prédicteurs potentiels de l'intubation ont été déterminés par l'analyse de régression de Cox. Le risque relatif de décès a été évalué en fonction du traitement par ventilation mécanique (intubation). Résultats: Deux cent dix-neuf patients étaient enrôlés (âge moyen de 56","PeriodicalId":31055,"journal":{"name":"Annales Africaines de Medecine","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135470079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of children with autism spectrum disorders: a cross-sectional study of cases attended at three centers specializing in neurodevelopmental disorders in Kinshasa, Democratic Republic of Congo (DRC)","authors":"Davin Mbeya Mpaka, Adelin Makubu N’situ, Thierry Matonda-Ma-Nzuzi, Ally Omba Ndjukendi, Joachim Ebwel Mukau, Gilbert Lelo Mananga, Daniel E-Andjafono Luwa Okitundu, Guy Makila Bumoko, Valentin Malanda Ngoma, Luck Lukusa, Anick Vogel, Espérance Kashala-Abotnes, Samuel Ma-miezi Mampunza","doi":"10.4314/aamed.v16i4.3","DOIUrl":"https://doi.org/10.4314/aamed.v16i4.3","url":null,"abstract":"Context and objective. Autism spectrum disorders (ASD) in sub-Saharan African (SSA) countries are poorly studied. The aim of the present study was to describe the socio-demographic and clinical characteristics of children with autism and to identify associated factors. &#x0D; Methods. This was a cross-sectional study of children with ASD attended at three specialized centers in Kinshasa. We confirmed a ASD diagnosis through clinical observation using Diagnostic and Statistical Manuel of Mental Disorders four Text Revision (DSM-VI-TR) criteria and standardized autism diagnostic tools. We analyzed socio-demographic and clinical characteristics and main comorbidities of ASD. The comparison of proportions was done using Pearson’s chi-square test. One-way ANOVAs were calculated to test differences in averages. &#x0D; Results. A total of 120 children (72.5 % male) were examined. Their mean age at diagnosis was 7.83 ± 3.4 years, while parents were alerted at 1.8 ±0.78 years. Language delays were the main alert sign (54%) and the main symptom (62%). Social interaction disorders (11.7 %) were under-reported by parents. The core signs of ASD were disorders of social interaction (90.5%), behavior (80%) and language (62.5%). The main ASD symptoms were associated with epilepsy (p=0.027), cerebral palsy (p=0.026) and hearing impairment (p=0.045). &#x0D; Conclusion. The diagnostic and language delay co-occurring with epilepsy and hearing impairment are the main clinical features of autism in the DRC. This study suggests that screening children for autism and its main comorbidities using a multidisciplinary approach should be a priority in Kinshasa.&#x0D; Contexte et objectif. Les troubles de spectre de l’autisme (TSA) en Afrique subsaharienne (ASS) sont très peu étudiés. L’objectif de la présente étude était d’examiner les caractéristiques socio-démographiques et clinique des enfants avec autisme et d’identifier les facteurs associés.&#x0D; Méthodes. Il s’agissait d’une étude transversale des enfants avec TSA des trois centres spécialisés à Kinshasa. Le diagnostic de l’autisme était confirmé par l’observation cliniques selon les critères diagnostic and Statistical Manuel of Mental Disorders four Text Revision (DSM-VITR) et les outils diagnostiques standardisés de childhood autism rating scale (CARS) and Autism Diagnostic Interview, Revised (ADI-R). Les paramètres d’intérêt englobaient les données sociodémographiques et cliniques ainsi que les principales comorbidités. La comparaison des proportions a été faite à l’aide test du chi-carré de Pearson. Des ANOVA à sens unique ont été calculées pour tester les différences de moyennes.&#x0D; Résultats. Au total, 120 enfants (sexe masculin 72,5 %) ont été examinés. Leur âge moyen au moment du diagnostic était de 7,83 ± 3,4 ans alors que les parents étaient alertés à 1,8 ±0,78 ans. Les retards de langage étaient le principal signe d'alerte (54 %) et le principal symptôme (62 %). Les troubles des interactions sociales (","PeriodicalId":31055,"journal":{"name":"Annales Africaines de Medecine","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135470083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphométrie et variantes anatomiques des artères digestives vues au Scanner","authors":"Miora Lovatiana Randrianalison, Lova Hasina Ny Ony Narindra Rajaonariso, Emmylou Gabrielle Prisca Andrianah, Hasina Dina Ranoharison, Luc Hervé Samson, Ahmad Ahmad","doi":"10.4314/aamed.v16i4.4","DOIUrl":"https://doi.org/10.4314/aamed.v16i4.4","url":null,"abstract":"Context and objective. Digestive arteries mainly the celiac trunk and the superior mesenteric artery present many anatomical variations especially at their origin. The aim of the present study was to illustrate the typical variant and the anatomical variations of digestive arteries visualized in computed tomography (CT).&#x0D; Methods. A transversal study was carried out on patients who were referred to 2 medical imaging centers in Antananarivo between november 2016 and february 2017 for abdominal CT examination. Images were obtained without and after contrast agent administration during the arterial phase. The celiac trunk and its pattern branching, the superior mesenteric artery and the inferior mesenteric artery, were analyzed.&#x0D; Results. A total of 155 patients were retained for the study. A lot of anatomical variations of digestive arteries were frequently observed, including the absence of celiac trunk (3 cases), the hepato-splenic trunk (12 cases), the hepato-gastric trunk (2 cases), thegastro-splenic trunk (5 cases) and the celiacomesenteric trunk (1 case). For the hepatic artery, types I (121 cases), II (13 cases), IV (1 case), V (3 cases) and IX (3 cases) of the Michels classification, as well as unclassified variations (14 cases) were found. In addition, 1 case of an inferior mesenteric artery arising from the superior mesenteric artery was observed.&#x0D; Conclusion. The fndings underscore the importance and the necessity of the CT exam before any surgical procedure including digestive vasculature.&#x0D; Les artères digestives essentiellement le tronc coeliaque et l’artère mésentérique supérieure présentent plusieurs variantes anatomiques notamment au niveau de leur origine. L’objectif de cette étude était d’illustrer l’anatomie normale ainsi que les variantes anatomiques des artères digestives vues au scanner. Nous avons réalisé une étude transversale portant sur les scanners avec coupesabdominales sans et avec injection de produit de contraste iodé au temps artériel. Le tronc coeliaque et ses branches, l’artère mésentérique supérieure et l’artère mésentérique inférieure ont été étudiés. Nous avons collecté 155 patients. Plusieurs variantes anatomiques fréquentes et multiples ont été retrouvées, dont l’absence de tronc coeliaque (3 cas), le tronc hépato-splénique (12 cas), le tronc hépato-gastrique (2 cas), le tronc gastro-splénique (5 cas) et le tronc coeliacomésentérique (1 cas). Pour l’artère hépatique, il existait les types I (121 cas), II (13 cas), IV (1 cas), V (3 cas) et IX (3 cas) selon la classification de Michels, ainsi que d’autres variantes non classifiées (14 cas). Nous avons trouvé également une artère mésentérique moyenne reliant l’artère mésentérique supérieure de l’artère mésentérique inférieure. Cela justifie l’importance et la nécessité de la réalisation du scanner avant tout acte chirurgical impliquantles artères digestives.&#x0D; Les artères digestives essentiellement le tronc coeliaque et l’artère mésentériq","PeriodicalId":31055,"journal":{"name":"Annales Africaines de Medecine","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135428258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mort in utero tardive : fréquence, facteurs associés et méthodes de déclenchement du travail à Kisangani, République Démocratique du Congo","authors":"Teddy Habiragi Matega, Noel Otuli Labama, Frederic Yabila Kanilame, Mike- Antoine Alongo Maindo, Jean-Jeannot Syhalikyolo Juakali, Gédéon Bosunga Katenga","doi":"10.4314/aamed.v16i4.9","DOIUrl":"https://doi.org/10.4314/aamed.v16i4.9","url":null,"abstract":"Context and objective. Late fetal death (LFD) refers to spontaneous in utero death (IUD) at 28 weeks of age or more, but before the onset of labor, which is a tragedy for the mother, her family members and caring staff. This study seeks to determine its frequency, associated factors, and methods of labor induction in Kisangani. &#x0D; Methods. This was a cross-sectional, multicentric descriptive study conducted in 3 hospitals in Kisangani covering a 3-year period. Data collection of LFD cases from 28 weeks was retrospective. The collected data were encoded on an Excel 2013 sheet and analyzed using EPI-INFO 7.2.2.6 Software. &#x0D; Results. The frequency of LFD was 6.48%. The main associated factors were upper urinary tract infection (35.4%), malaria (27.5%) and hypertension (27.5%). The rate of participation in prenatal consultations was only 63.5%. The methods of labor induction used were misoprostol (42.7 %), oxytocin solution (17.7 %) or both combined (25 %). Cesarean section was indicated at a rate of 26,4%.&#x0D; Conclusion. The frequency of LFD in Kisangani is high. Pyelonephritis, malaria and hypertension are the main associated factors. Misoprostol and oxytocin are the most commonly used methods of labor induction. Regular follow-up of prenatal consultations would reduce the rate of LFD.&#x0D; Contexte et objectif. La mort fœtale tardive fait référence à la mort in utéro (MIU) de survenue spontanée à partir de 22 semaines d’aménorrhée (SA), mais avant tout début du travail d’accouchement, ce qui constitue une tragédie pour la mère, les membres de la famille et du personnel soignant. La présente étude a déterminé l’ampleur, les facteurs associés et les méthodes de déclenchement artificiel du travail d’accouchement sur MIU. &#x0D; Méthodes : Il s’est agi d’une étude transversale descriptive, multicentrique menée dans 3 hôpitaux de Kisangani, pendant une période de 3 ans. La collecte des données était rétrospective, des cas de MIU à partir de 28 SA. &#x0D; Résultats : La fréquence de MIU tardive était de 6,48%. Les principaux facteurs associés étaient l’infection urinaire (35,4%), le paludisme sur grossesse (27,5%) et l’hypertension artérielle gravidique (27,5%). Le taux de participation aux consultations prénatales (CPN) n’était que de 63,5 %. Les méthodes de déclenchement artificiel du travail d’accouchement utilisées étaient le Misoprostol (42,7%), l’ocytocine (17,7%) soit les deux combinées (25%). La césarienne était indiquée à un taux de 26,4%.&#x0D; Conclusion : la fréquence de MIU tardive est élevée à Kisangani. L’infection urinaire, le paludisme et l’hypertension artérielle en constituaient les principaux facteurs associés. Le Misoprostol était la méthode de déclenchement du travail les plus utilisées. Un suivi régulier des CPN pourrait réduire le taux de MIU.","PeriodicalId":31055,"journal":{"name":"Annales Africaines de Medecine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135428259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension maligne à l’hôpital Fousseyni Daou de Kayes, au Mali : aspects épidémio-cliniques et pronostiques","authors":"Aboubacar Sidiki Fofana, Magara Samake, Seydou SY, Sah dit Baba Coulibaly, Amadou Maiga, Modi Sidibe, Hamadoun Yattara, Saharé Fongoro","doi":"10.4314/aamed.v16i4.6","DOIUrl":"https://doi.org/10.4314/aamed.v16i4.6","url":null,"abstract":"Context and objective. Malignant hypertension (MHT) is rare in developed countries, but remains a public health problem in sub-Saharan Africa. The aim of this study was to describe the epidemiological profile and prognostic factors of MHT in Kayes Hospital. Methods. A retrospective study was conducted using the medical records of patients admitted at the Nephrology Unit of the Fousseyni Daou Hospital in Kayes between January 1, 2016 and June 30, 2022. Hypertensive or normotensive patients under treatment with stage II or III (according to the Kirkendall classification) hypertensive retinopathy (HR) associated with one or more other visceral impairments and having a complete medical file were included in the study. Results. A total of 117 cases of MHT were collected out of 7011 files reviewed, 53.8% of which were men (63 cases). The mean age was 39.47 years. The mean admission blood pressure was 187/114 mmHg. HR was stage II and III in 59.8% and 40.2% of cases respectively. Renal failure was found in 93.1% of the patients (109 cases) of which 63.7% were chronic kidney disease (CDK) versus 36.7% acute kidney injury. Left ventricular hypertrophy was found in 80.4% of cases. The overall outcome of the patients was favourable in 59% (69 cases) versus 31.6% (37 cases) of death and 9.4% (11 cases) of discharge against medical advice. Factors associated with risk of death were mainly stage III HR, dyslipidaemia, end-stage CKD and hyponatremia. Conclusion. MHT remains a public health problem in Mali and preferentially affects young subjects Contexte et objectif. L’hypertension artérielle maligne (HTAM) est un problème de santé publique en Afrique sub-saharienne. L’objectif de cette étude était de décrire le profil épidémio-clinique et les facteurs pronostiques de l’HTAM à Fousseyni DAOU de Kayes. Méthodes. Nous avons réalisé une étude rétrospective et descriptive du 1er janvier 2016 au 31 juin 2022 à l’unité de néphrologie de l’hôpital Fousseyni Daou de Kayes. Étaient inclus, les patients hypertendus ou normotendus sous traitement hospitalisés avec une rétinopathie hypertensive (RH) de stade II ou III (selon la classification de Kirkendall) associée à une ou plusieurs autres atteintes viscérales et ayant un dossier médical complet. Résultats. Au total 117 cas d’HTAM ont été enregistrés sur 7011 dossiers examinés, dont 53,8% d’hommes (63 cas). L’âge moyen était de 39,47 ans. La moyenne de la pression artérielle à l’admission était de 187/114 mmHg. La RH était de stade II et III dans 59,8% et 40,2% des cas. L’insuffisance rénale était retrouvée chez 93,1% des patients (109 cas) dont 63,7% d’insuffisance rénale chronique (IRC) contre 36,7% d’insuffisance rénale aiguë (IRA). L’hypertrophie ventriculaire gauche a été retrouvée dans 80,4% des cas. L’issue globale des patients a été favorable dans 59% (69 cas) contre 31,6% (37 cas) de décès et 9,4% (11 cas) de sortie contre avis médical. Les facteurs associés au risque de décès étaient surtout la RH stade ","PeriodicalId":31055,"journal":{"name":"Annales Africaines de Medecine","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135428255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Goutte tophacée Sévère : Une observation clinique particulière","authors":"I. Chabchoub, R. B. Salah, O. Frikha, F. Frikha, S. Marzouk, Z. Bahloul","doi":"10.4314/aamed.v16i3.12","DOIUrl":"https://doi.org/10.4314/aamed.v16i3.12","url":null,"abstract":"Tophaceous gout is the osteoarticular and cutaneous expression of chronic hyperuricaemia that can occur years after recurrent attacks of acute inflammatory arthropathies. This metabolic complication is increasingly rare. We report the particular observation of a patient with \"historical\" tophaceous gout and severely handicapped by polyarticular involvement and skin tophi. \u0000French Abstract \u0000La goutte tophacée est l'expression ostéo-articulaire et cutanée d'une hyperuricémie chronique qui peut survenir des années après des crises récurrentes d'arthropathies inflammatoires aiguës. Cette complication métabolique est de plus en plus rare. Nous rapportons l’observation particulière d’un patient présentant une goutte tophacée « historique » sévèrement handicapé par l’atteinte polyarticulaire et les tophi cutanés. \u0000Mots-clés: Tophus, goutte, arthropathie goutteuse","PeriodicalId":31055,"journal":{"name":"Annales Africaines de Medecine","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82185856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolutionary trend of the significant decrease in histopathological conditions associated with neglected tropical diseases at the Kinshasa University Hospital in 51 years: Fake or reality?","authors":"EK Sumaili","doi":"10.4314/aamed.v16i3.1","DOIUrl":"https://doi.org/10.4314/aamed.v16i3.1","url":null,"abstract":"No abstract.","PeriodicalId":31055,"journal":{"name":"Annales Africaines de Medecine","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75533424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspects épidémiologique, clinique et anatomopathologique des tumeurs bénignes du sein aux Cliniques Universitaires de Kinshasa","authors":"Pierre Joseph Amasa Ingala, Blanchard Tadika Ibanda, Arsène Lobota Mputu","doi":"10.4314/aamed.v16i3.6","DOIUrl":"https://doi.org/10.4314/aamed.v16i3.6","url":null,"abstract":"Context and objective. Benign breast tumors (BBT) are poorly documented in our country. The aim of the present study was to describe the clinical and anatomopathological profile of BBT. \u0000Methods.This was a series of cases of BBT followed at the Kinshasa University Hospital (CUK) between 1996 and 2020. The variables of interest included socio-demographic profile, gyneco-obstetrical history, complaints and clinical aspects for the patients; and senological, anatomopathological, therapeutic aspects and associated factors for the tumors. Multivariate logistic regression method was used to search for factors associated with BBT. \u0000Results. Out of 682 medical records collected for senological problems, 231 cases had a presumptive diagnosis of BBT and only 70 cases were histologically confirmed, i.e. a frequency of BBT of 10.2%. Their mean age was 27.8 ± 13.8 years, 76.5% were nulliparous, 17.6 % had breast-fed. Fibroadenoma was more frequent (68.5%) followed by fibrocystic disease (20.0%). In univariate analysis, age less than 40 years [crude OR 4.00 (1.18-13.54), p=0.026], nulliparity [5.17 (1.44-18.57), p=0.012] and lack of breastfeeding [0.16 (0.04- 0.63), p=0.009] were associated with fibroadenoma while age greater than 40 years [4.50 (1.23-16.45); p=0.023], marriage [5.22 (1.47-18.55); p=0.011], multiparity [5.89 (1.53- 22.63); p=0.010)] and breastfeeding [6(1.55- 23.30); p=0.010)] to fibrocystic disease. No factor emerged as an independent determinant of BBT. Conclusion. BBT, although poorly diagnosed in this tertiary institution, shows some similarity with data in the literature \u0000French Abstract \u0000Contexte et objectif Les données sur les tumeurs bénignes du sein (TBS) sont peu documentées dans nos contrées. La présente étude avait pour objectif de décrire le profil clinique et anatomopathologique des TBS. \u0000Méthodes) aspects cliniques et, pour les tumeurs : les aspects sénologique, anatomopathologique, thérapeutique et les facteurs associés. Nous avons recouru à la méthode de régression logistique multi variée pour rechercher les facteurs associés aux TBS. \u0000Résultats Sur 682 dossiers médicaux colligés pour problems sénologiques, 231 cas portaient le diagnostic présomptif de TBS et seulement 70 cas étaient confirmés histologiquement soit une fréquence des TBS de 10,2 %. Leur âge moyen était de 27,8 ± 13,8 ans, 76,5 % étaient nullipares, 17,6 % avaient allaité. Le fibroadénome était plus fréquent (68,5%) suivi de la maladie fibrokystique (20,0 %). En analyse univariée, l’âge inférieur à 40 ans [OR brut 4,00 (1,18-13,54), p=0,026], la nulliparité [5,17 (1,44-18,57), p=0,012] et l’absence d’allaitement [0,16 (0,04-0,63), p=0,009] étaient associés au fibroadénome tandis que l’âge supérieur à 40 ans [4,50 (1,23-16,45); p=0,023], le mariage [5,22 (1,47-18,55); p=0,011], la multiparité [5,89 (1,53-22,63); p=0,010)] et l’allaitement [6(1,55-23,30) ; p=0,010)] à la maladie fibrokystique. Aucun facteur n’a émergé comme determinant indépendant de TBS. \u0000Conclus","PeriodicalId":31055,"journal":{"name":"Annales Africaines de Medecine","volume":"249 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84618128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}