PAMJ Clinical Medicine最新文献

{"title":"Rhabdomyosarcome de la vessie : à propos d’une observation chez un sujet âgé","authors":"A. Sarr, A. Keita, O. Sow, D. Diouf, C. Ondo, A. Ndiath, M. Ndiaye, B. Mboup, El Hadj Malick Diaw, B. Sine, A. Thiam, B. Diao, P. Fall, A. Ndoye","doi":"10.11604/pamj-cm.2020.4.116.26806","DOIUrl":"https://doi.org/10.11604/pamj-cm.2020.4.116.26806","url":null,"abstract":"Les rhabdomyosarcomes sont des tumeurs mesenchymateuses rares le plus souvent decrits chez l´enfant. Nous rapportons un cas diagnostique au stade metastatique chez un patient de 77 ans. Le traitement a consiste a une chimiotherapie.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122616090","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":"Anosmie : alerte COVID-19","authors":"Siham Alaoui Rachidi, Ilham Alaoui Rkain","doi":"10.11604/pamj-cm.2020.4.105.25612","DOIUrl":"https://doi.org/10.11604/pamj-cm.2020.4.105.25612","url":null,"abstract":"L´anosmie est un symptome frequent en cas d´infection au SARS-CoV-2 responsable du COVID-19. Elle peut etre le symptome initial de la maladie ou rester isolee chez certains patients pauci symptomatiques. Dans le contexte de pandemie actuelle, tout patient presentant une anosmie nouvelle est considere comme etant infecte par le SARS-CoV-2 jusqu´a preuve du contraire. Nous rapportons le cas d´une patiente de 60ans qui consultait pour anosmie associee a des myalgies evoluant depuis 03 jours. A l´examen, elle etait febrile a 38.5, dyspneique (spO2 a 90 % a l'air ambiant). Une TDM thoracique (A,BC)a ete realisee montrant des lesions typiques de penumopathie Covid faites de foyers de condensation en verre depoli (A,B)avec des bronchectasies et des reticulations (A, C). Un prelevement naso-pharynge a ete fait pour etude PCR et la patiente fut mise sous traitement selon le protocole national de prise en charge du Covid. Elle a repris son sens d´olfaction au bout de 10jours avec remission complete du 20 eme jours. L´anosmie est dorenavant un symptome specifique de l´infection Covid 19. Elle peut etre le signe d´alerte d´un debut de l´infection et doit faire entreprendre un depistage immediat. L´evolution naturelle de l´anosmie semble favorable dans la plupart des cas.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120962631","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":"Desmoid tumor of the abdominal wall: case report","authors":"K. Achehboune, H. Baybay, K. Issoual, S. Elloudi, F. Mernissi","doi":"10.11604/pamj-cm.2020.4.78.22201","DOIUrl":"https://doi.org/10.11604/pamj-cm.2020.4.78.22201","url":null,"abstract":"Desmoid tumors are rare fibrous tumors of the soft tissues. Develops on the abdominal wall, in the abdomen, or extra-abdominal. Parietal location is very common among women. Hormonal factors are incriminated. They are rare lesions without any metastatic potential a strong tendency to invade locally and to recur. Hormonal factors are incriminated in this pathology. Imaging can characterize these tumors and their reports and guide the biopsy that is the key to diagnosis. The treatment is based on first-line surgery, but in cases where excision margins are reached, local recurrence or unresectable tumors, other therapeutic alterations are needed such as radiotherapy and chemotherapy and others. We report a periumbilical case in perimenopause.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"292 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122199159","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":"Neuromyelite optique de devic (nmo) (à propos d’un cas)","authors":"S. Afkir, R. Abdi, S. Chariba, A. Maadan, R. Sekhsoukh","doi":"10.11604/pamj-cm.2020.4.71.24421","DOIUrl":"https://doi.org/10.11604/pamj-cm.2020.4.71.24421","url":null,"abstract":"La neuromyelite optique de Devic (NMO) ou syndrome de Devic est une entite rare. Elle est caracterisee par l´association d´une atteinte medullaire severe, d´installation subaigue et d´une neuropathie optique aigue, uni- ou bilaterale. Nous rapportons l´observation d´une femme âgee de 20 ans, admise pour une baisse brutale de l´acuite visuelle de l´œil droit. Les potentiels evoques visuels ont montre un allongement des latences, en accord avec une nevrite optique retrobulbaire. L´imagerie par resonance magnetique (IRM) a revele des anomalies de signal medullaire et peri ventriculaire. La patiente a recu un bolus de la methylprednisolone, relayee par la prednisone associe a un immunosuppresseur: antiCD20. L´evolution a ete favorable avec correction de l´acuite visuelle. La NMO est une pathologie rare. C´est une entite clinique distincte le pronostic visuel et neurologique depend de la severite de l´atteinte, des rechutes et de la precocite du traitement.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115887585","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":"Adenoid cystic carcinoma of head and neck","authors":"F. Dhouib, W. Siala, S. B. Hassine, N. Fourati, W. Mnejja, B. Hammami, J. Daoud","doi":"10.11604/pamj-cm.2020.3.132.24624","DOIUrl":"https://doi.org/10.11604/pamj-cm.2020.3.132.24624","url":null,"abstract":"Adenoid cystic carcinoma is a relatively rare tumor of head and neck. Due to lack of high-quality evidence, optimal treatment still controversial and continues to evolve over time. We conducted a retrospective review of 26 patients with adenoid cystic carcinoma of head and neck treated between 1993 and 2015 in the radiation oncology center of Habib Bourguiba Hospital, Sfax, Tunisia. Demographic, clinical, treatment, and survival details of the patients were collected and analyzed. Disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan-Meier method. The mean age of patients in the study was 51 years (range:16-73 years), with a male preponderance (54%vs.46%). The most commonly primary disease sites were the parotid glands (34.6%), the oral cavity (19.66%) and the submandibular glands (11.5%). More than half the patients presented with earlier-stage disease (T1/2:73%); most had a negative nodal status (92.3%). Twenty-four patients (92.4%) received surgery with adjuvant RT; one (3,8%) RT only and another (3.8%) surgery only. Forteen (53.8%) patients had positive margins and no additional patients had close margins. Perineural invasion (PNI) was documented in 8 (32%) patients. The median time to any recurrence was 21 months (range:3-204 months). Five-year overall survival and disease-free survival rates were 62% and 53%. Solid histological subtype, positive surgical margins, PNI and advanced stages were predictors of poor outcome in adenoid cystic carcinoma of head and neck. Surgery followed by adjuvant radiotherapy remains the treatment of choice that may provide local control and prolong patient survival.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131959875","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":"Rivaroxaban induced retro peritoneal hematoma: a rare complication of direct oral anticoagulants (DOACs)","authors":"Bouaiyda Ayoub, Chouikh Chakib, Grine Ali, Jeddab Achraf, Mounir Khalil, Balkhi Hicham","doi":"10.11604/pamj-cm.2020.3.124.24674","DOIUrl":"https://doi.org/10.11604/pamj-cm.2020.3.124.24674","url":null,"abstract":"Direct oral anticoagulants have revolutionized the management of patients requiring long-term anticoagulation, as they are easy to handle, do not require biological monitoring, the dosage is standardized and hemorrhagic events are rare. Hemorrhagic events under this type of anticoagulation are rare and may involve several locations. We are going to present the case of a patient followed for non-valvular atrial fibrillation on rivaroxaban who presented to the emergency department with intense left lumbar pain with hemodynamic instability, and whose investigations came back in favor of a retroperitoneal hematoma, this type of hemorrhagic event related to rivaroxaban, to our knowledge and the first in the literature, we are going to present the case of this patient by detailing the management and the difficulties envisaged during her management.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114815329","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":"Ectopia lentis in Marfan syndrome","authors":"N. Taouri, N. Boutimzine","doi":"10.11604/pamj-cm.2020.3.20.23575","DOIUrl":"https://doi.org/10.11604/pamj-cm.2020.3.20.23575","url":null,"abstract":"","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"144 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127299584","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":"Étude de la dysfonction diastolique du ventricule gauche chez les hémodialysés chroniques au Centre National d´Hémodialyse de Donka","authors":"Barry Ibrahima Sory, Diakité Foucény, Camara Abdoulaye, Samoura Aly, T. Moussa, Baldé Mamadou Saliou, Koivogui Kokoulo, Koivogui Diarra, Bah Alpha Boubacar, Baldé Mamadou Dadhi, Condé Mamadi, Bah Alpha Oumar, Kaba Mohamed Lamine","doi":"10.11604/pamj-cm.2020.3.14.22317","DOIUrl":"https://doi.org/10.11604/pamj-cm.2020.3.14.22317","url":null,"abstract":"CLes affections cardiaques dans leur ensemble sont la cause la plus frequente de morbidite et de mortalite chez les patients insuffisants renaux chroniques traites par dialyse. Les principales anomalies morphologiques des cardiomyopathies peuvent s'accompagner d'une alteration de la fonction systolique ou diastolique avec comme consequence clinique une insuffisance cardiaque, un trouble du rythme, voire la mort subite. L´objectif de cette etude etait de determiner la frequence de la dysfonction diastolique chez les patients hemodialyses chroniques. Il s´agissait d´une etude transversale de type descriptif d´une duree de 4 mois allant du 1er Mai au 31 Aout 2017. Cette etude a ete realisee au centre national d´hemodialyse de Donka (CNHD). Etaient inclus dans cette etude tout patient hemodialyse chronique ayant beneficie d´une echographie Doppler cardiaque ayant mis en evidence une dysfonction diastolique du VG. La dysfonction diastolique du VG etait retenue chez tous patient ayant un rapport E/A 10 et une FEVG ≥50% evaluee par la methode Simpson biplan. Selon la classification de Redfield. Sur 87 patients ayant beneficie de l´echographie Doppler cardiaque, 32 avaient une dysfonction diastolique soit 36,78%. L´âge moyen de nos patients etait de 50,62±13,06 ans avec des extremes de 18 et 70 ans. La tranche d´âge la plus representee etait celle de 58-67 ans. La dysfonction diastolique du ventricule gauche etait moderee chez 17 patients (53,13%), et moyenne chez 15 patients (46,87%). Il ressort clairement de cette etude que les nephropathies glomerulaires et interstitielles sont les plus frequemment rencontrees et responsables d´une dysfonction diastolique de moderee a moyenne du VG. En Guinee, l´evaluation echo cardiographique chez les hemodialyses n´est pas un examen systematique a cause du cout. Cependant sa realisation permet de classer les patients a haut risque de faire un œdeme aigu du poumon ou de chute tensionnelle en cours de seances d´hemodialyse. Ut and paste your abstract here. Spell out Greek characters (i.e: alpha, beta).","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"553 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123515040","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":"Rupture utérine spontanée sur utérus sain: a propos d´un cas et revue de la littérature","authors":"Elkarkri Chourouk, Ammouri Safaa, L. Amina, Zeraidi Najia, Baidada Aziz","doi":"10.11604/pamj-cm.2020.3.8.22498","DOIUrl":"https://doi.org/10.11604/pamj-cm.2020.3.8.22498","url":null,"abstract":"La rupture uterine est une complication rare du travail qui met en jeu le pronostic vital de la mere et celui du fœtus ainsi que le devenir obstetrical de la femme. Elle est plus frequente en cas d´uterus cicatriciel et tres rare en cas d´uterus sain. Nous presentons un cas rare de rupture uterine spontanee sur uterus sain chez une patiente de 28ans sans antecedents pathologiques notables diagnostiquee apres six heures de son accouchement par hemorragie du post partum. Nous discutons a travers ce cas et la revue de la litterature, l´extreme prudence qu´il faut garder meme en cas d´uterus non cicatriciel ainsi que les signes d´appel cliniques, les facteurs de risque, la methodologie diagnostique et la prise en charge therapeutique de cette entite rare mais potentiellement grave.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115031167","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":"Ramsay-Hunt syndrome","authors":"Ilyass Anouar, N. Hjira","doi":"10.11604/pamj-cm.2020.2.166.21253","DOIUrl":"https://doi.org/10.11604/pamj-cm.2020.2.166.21253","url":null,"abstract":"A 27-year-old man consulting in the emergency room for an acute facial paralysis with deafness and vertigo for 4 days. Physical examination shows clustered vesicles in the external auditory canal without any oral involvement. Laboratory investigations and computed tomography imaging were unremarkable. Thus, we diagnosed herpes zoster octicus (RHS, type 2). Treatment consists in the combination of antiviral drugs (valaciclovir 3 g/day) and corticosteroids (methylprednisolone 80 mg/day) with topical antibiotics for crusty lesions of the ear. The patient was finally referred to the otorhinolaryngology department for the management of facial paresis. Ramsay Hunt syndrome (RHS) is a localized herpes zoster infection involving the seventh nerve and geniculate ganglia, resulting in hearing loss, vertigo, and facial nerve palsy and remains one of the major causes of atraumatic peripheral facial paralysis. Immunodeficiency states, particularly HIV infection, should be considered in younger patients, severe cases and patients with a history of specific risk behavior. In our patient, HIV serology was negative.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122770302","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}