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INTRODUCTION: Diabetes is a chronic hyperglycemia which can be discovered with specific organic complications particularly affecting the eyes, kidneys, nerves, heart and vessels. Globally, the prevalence of stroke in people with diabetes is approximately 10%. OBJECTIVE: Study the epidemiological and clinical aspects of stroke in patients with type 2 diabetes. METHODOLOGY: We made a descriptive and analytical study by a retrospective survey over a period of 10 years, in the department of internal medicine at the university Hospital ofPoint G. We focused on all hospitalized patients with type 2 diabetes, in whom the diagnosis of stroke was retained. RESULTS: At the end of the study 24 patients out of 492 diabetes hospitalized in to the period met our inclusion criteria, representing a frequence of 4.9%. The mean age was 64.67 ± 13.409 years with a sex-ratio of 1.4. The reason for hospitalization was muscle weakness in 54.2% of patients. Eighty-seven point five percent (87.5%) of patients were already known to have diabetes before the weakness. Stroke was the mode of discovery of diabetes in 12.5%. Over 70% of our patients had hyperglycemia at the time of admission. Ischemic stroke was seen in 75% of patients. CONCLUSION: Stroke is a great complication of diabetes witch, can be a way discovery of type 2 diabetes.
INTRODUCTION: Le diabète est une hyperglycémie chronique qui peut être découvert avec des complications organiques spécifiques touchant particulièrement les yeux, les reins, les nerfs, le cÅur et les vaisseaux.L'AVC en ai une de ces complications. À l'échelle mondiale, la prévalence de l'AVC chez les diabétiques est d'environ 10%. OBJECTIF: Étudier les aspects épidémiologiques et cliniques de l'accident vasculaire cérébral chez les patients diabétiques de type 2. MÉTHODOLOGIE: Il s'agissait d'une étude descriptive et analytique sur la base d'une enquête rétrospective de 10 ans, dans le service de médecine interne du CHU du Point G. Elle a porté sur tous les patients diabétiques de type 2 hospitalisés dans le service de médecine interne, chez qui le diagnostic de l'AVC a été retenu. RÉSULTATS: Au terme del'étude 24 patients répondants à nos critères sur 492 diabétiques soit une fréquence de 4,9%. L'âge moyen était de 64,67 ± 13,409 ans avec un sex-ratio de 1,4. Le motif d'hospitalisation était un déficit moteur chez 54,2% des patients. Quatre-vingt-sept virgule cinq pourcent (87,5%) des patients étaient déjà connus diabétiques avant le déficit. L'AVC a été le mode de découverte du diabète chez 12,5%. Plus de 70% de nos patients avaient une hyperglycémieau moment à l'admission. L'AVC ischémique était observé chez 87,5% des patients. CONCLUSION: L'AVC est une complication redoutable du diabète, il peut être le mode de découverte d'un diabète de type 2.
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INTRODUCTION: Diabetes is a chronic hyperglycemia which can be discovered with specific organic complications particularly affecting the eyes, kidneys, nerves, heart and vessels. Globally, the prevalence of stroke in people with diabetes is approximately 10%. OBJECTIVE: Study the epidemiological and clinical aspects of stroke in patients with type 2 diabetes. METHODOLOGY: We made a descriptive and analytical study by a retrospective survey over a period of 10 years, in the department of internal medicine at the university Hospital ofPoint G. We focused on all hospitalized patients with type 2 diabetes, in whom the diagnosis of stroke was retained. RESULTS: At the end of the study 24 patients out of 492 diabetes hospitalized in to the period met our inclusion criteria, representing a frequence of 4.9%. The mean age was 64.67 ± 13.409 years with a sex-ratio of 1.4. The reason for hospitalization was muscle weakness in 54.2% of patients. Eighty-seven point five percent (87.5%) of patients were already known to have diabetes before the weakness. Stroke was the mode of discovery of diabetes in 12.5%. Over 70% of our patients had hyperglycemia at the time of admission. Ischemic stroke was seen in 75% of patients. CONCLUSION: Stroke is a great complication of diabetes witch, can be a way discovery of type 2 diabetes.
INTRODUCTION: Le diabète est une hyperglycémie chronique qui peut être découvert avec des complications organiques spécifiques touchant particulièrement les yeux, les reins, les nerfs, le coeur et les vaisseaux.L'AVC en ai une de ces complications. À l'échelle mondiale, la prévalence de l'AVC chez les diabétiques est d'environ 10%. OBJECTIF: Étudier les aspects épidémiologiques et cliniques de l'accident vasculaire cérébral chez les patients diabétiques de type 2. MÉTHODOLOGIE: Il s'agissait d'une étude descriptive et analytique sur la base d'une enquête rétrospective de 10 ans, dans le service de médecine interne du CHU du Point G. Elle a porté sur tous les patients diabétiques de type 2 hospitalisés dans le service de médecine interne, chez qui le diagnostic de l'AVC a été retenu. RÉSULTATS: Au terme del'étude 24 patients répondants à nos critères sur 492 diabétiques soit une fréquence de 4,9%. L'âge moyen était de 64,67 ± 13,409 ans avec un sex-ratio de 1,4. Le motif d'hospitalisation était un déficit moteur chez 54,2% des patients. Quatre-vingt-sept virgule cinq pourcent (87,5%) des patients étaient déjà connus diabétiques avant le déficit. L'AVC a été le mode de découverte du diabète chez 12,5%. Plus de 70% de nos patients avaient une hyperglycémieau moment à l'admission. L'AVC ischémique était observé chez 87,5% des patients. CONCLUSION: L'AVC est une complication redoutable du diabète, il peut être le mode de découverte d'un diabète de type 2.
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INTRODUCTION: Surgical site infections (SSI) are frequent and dangerous in the surgical ward. They represent an obsession for the surgeon. The objectives were to determine the frequency of ISOs and risk factors, to identify the germs and to study their sensitivity to different antibiotics. MATERIALS AND METHODS: This was a cross-sectional study with prospective data collection, performed at the general surgery department of the Bocar Sidy Sall University Hospital Center (Kati CHU) from January 2015 to December 2018. RESULTS: During this period of study we recorded 55 cases of ISO out of 650 operated patients with a frequency of 8.46%. 450 patients were operated on the cold operating program (69.23%) and 200 patients on emergency (30.77%). The average age was 39, the sex ratio was 2.66. Among the 55 cases of ISO, 60% of these patients were operated in emergency and 40% in the operating program. The most common strains found were Escherichia coli (E. coli) in 38.3% of cases, Staphylococcus aureus in 23.4% and Klebsiella pneumonia in 13.3%. Hemoglobin levels were normal in 70% of cases. 4 of our patients or 7.27% were diabetic. We did not have any cases of obesity. Of the 55 cases of ISO, 66% were of class 3 and 4 of Altemeier, 59% were of ASA score 2 and ASA 3, 55% were of score 2 of NNISS (National Nosocomial Infection Surveillance System), 5.45% were NNISS score 3 or 3 cases and these 3 cases developed ISO. The ISOs were parietal in 49 cases, ie 89%. The recovered germs were 100% sensitive to imipenem. The most informative interventions of the ISOs were peritonitis 25 cases (45.45%), intestinal occlusions 12 cases (21.82%), appendicular abscess 8 cases (14.55%). We had 2 death cases, 3.64%, the average hospital stay was 13 days. CONCLUSION: Escherichia coli was the common germ found in the ISO in general surgery at Kati BSS Hospital. The usual resistance to antibiotics must provoke effective preventive actions.
INTRODUCTION: Les infections du site opératoires (ISO) sont fréquentes et redoutables, au service de chirurgie. Elles représentent une hantise pour le chirurgien. Les objectifs étaient de déterminer la fréquence des ISO et les facteurs de risque, d'identifier les germes et étudier leur sensibilité aux différents antibiotiques. MATÉRIELS ET MÉTHODES: il s'agissait d'une étude transversale avec recueil prospectif des données, réalisée au service de chirurgie générale du Centre Hospitalier Universitaire Bocar Sidy Sall (CHU BSS) de Kati allant de janvier 2015 à décembre 2018. Elle a concerné tous les patients opérés dans le service pendant cette période d'étude. N'ont pas été inclus dans cette étude les cas de biopsie. RÉSULTATS: Au cours de cette période d'étude nous avons enregistré 55 cas d'ISO sur 650 malades opérés soit une fréquence de 8,46%. 450 malades ont été opérés au programme opératoire à froid (69,23%) et 200 malades en urgence (30,77%). L'âge moyen était de 39 ans, le sex-ratio à 2,66. Parmi les 55 cas d'ISO, 60% de ces malades ont été opérés en urgence et 40% au programme opératoire. Les différentes souches les plus retrouvées étaient l'Escherichia coli (E. coli) dans 38,3% des cas, le staphylococcus aureus dans 23,4%, klebsiella pneumonia dans 13,3%. Le taux d'hémoglobine était normal dans 70% des cas. 4 de nos patients soit 7,27% étaient diabétiques. Nous n'avions pas enregistré de cas d'obésité. Parmi les 55 cas des ISO, 66 % étaient de classe 3 et 4 d'Altemeier, 59% étaient de score ASA 2 et ASA 3, 55% étaient de score 2 de NNISS (National Nosocomial Infection Surveillance System), 5,45% étaient de score 3 de NNISS soit 3 cas et ces 3 cas ont développé des ISO. Les ISO étaient pariétales dans 49 cas soit 89%. Les germes retrouvés étaient sensibles à 100% à l'imipénème. Les interventions les plus pourvoyeuses des ISO étaient les péritonites 25 cas (45,45%), les occlusions intestinales 12 cas (21,82%), les abcès appendiculaires 8 cas (14,55%). Nous avions enregistré 2 cas de décès soit 3,64%, la durée moyenne d'hospitalisation a été de 13 jours. CONCLUSION: L'Escherichia coli était le germe fréquemment rencontré dans les ISO en chirurgie générale au CHU BSS de Kati. La résistance aux antibiotiques usuels doit susciter des actions préventives efficaces.
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The aim of this study was to analyze the epidemiologic, etiologic, and therapeutic aspects of open wounds of the Achilles tendon managed in the Donka University Hospital. This 3-year prospective included all patients admitted for an Achilles tendon injury. Closed injuries, suppurating wounds, and those that occurred more than 24 hours before admission were excluded. Surgical treatment consisted in debridement and tendon repair, with plaster cast protection for 6 weeks. The study included 36 patients with a mean age of 23.4 years, 29 of whom were male. The primary cause was traffic accidents (n = 21), mainly due to motorcycle taxis (n = 18). The mean follow-up was 9 months. Infection (7 cases) and skin necrosis (5 cases) were the main postoperative complications. The functional result, evaluated by the McComis score, was excellent in 20 cases, good or satisfactory in 10, and poor in 6 cases. Open injuries of the Achilles tendon are common in Guinea-Conakry and mostly due to motorcycle taxis. Outcome of surgical treatment depends on the severity of the injury. Infection and skin necrosis are frequent complications, and their management is challenging in this setting.
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Tendão do Calcâneo/lesões , Tendão do Calcâneo/cirurgia , Tendão do Calcâneo/patologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Guiné , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , Prognóstico , Estudos Prospectivos , Pele/patologia , Infecção da Ferida Cirúrgica/etiologia , Toxoide Tetânico/administração & dosagem , Adulto JovemRESUMO
INTRODUCTION: The aim of this study was to determine the sociodemographic, therapeutic, pathological and clinical aspects of patients with maxillary ameloblastoma at the University Hospital of Odonto-Stomatology (CHU OS) of Bamako. MATERIALS AND METHOD: We performed a retrospective and prospective study over three years (January 2007 - December 2010), examining cases of maxillary ameloblastoma, as confirmed by clinical, associated with radiology or anatomic pathology. Data was collected from medical records, then entered and analyzed using Epiinfo. RESULTS: Tumor lesions were found in 55 men and 43 women with a sex ratio of 1.27. Housewives represented the majority of cases with 35.7%. Maxillary radiography was performed on 96% of patients and biopsy in 66.3% of cases. The most common anatomical location was mandibular in 89.80% of cases, with the preferred area being the mandibular symphysis in 34.7% of cases. Conservative surgery was performed in 50% of patients and radical surgery in 26.5% of cases. CONCLUSION: This study has shown a high frequency of maxillary ameloblastoma, and the fundamental benefits of early treatment, in order to minimize recidivism.
INTRODUCTION: L'objectif de cette étude était, d'évaluer les aspects sociodémographiques, cliniques, anatomopathologiques et thérapeutiques, des patients présentant des améloblastomes des maxillaires, au Centre Hospitalier Universitaire d'Odonto Stomatologie (CHU OS) de Bamako. MATÉRIELS ET MÉTHODE: Nous avons réalisé une étude rétrospective et prospective sur une période de trois ans (de Janvier 2007 à Décembre 2010), sur des cas d'améloblastomes des maxillaires, confirmés par un examen clinique, associé ou à la radiologie, ou à l'anatomopathologie. Les données ont été recueillies à partir des dossiers médicaux, saisies et analysées avec le logiciel Epiinfo. RÉSULTATS: Les lésions tumorales ont concerné 55 hommes et 43 femmes avec un sex-ratio de 1,27. Les femmes au foyer ont été les plus représentées soit 35,7% des cas. La radiographie des maxillaires a été effectuée chez 96% des patients et la biopsie dans 66,3% des cas. La localisation anatomique la plus fréquente a été mandibulaire dans 89,80% des cas, et la zone de prédilection a été la symphyse mandibulaire dans 34,7% des cas. La chirurgie conservatrice a été réalisée chez 50% des patients et la chirurgie radicale dans 26,5% des cas. CONCLUSION: Cette étude montre une fréquence élevée de l'améloblastome des maxillaires, et un intérêt capital pour une prise en charge précoce, dans un souci de minimiser les récidives.
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Insecticide resistance is one of the primary threats to the recent gains in malaria control. This is especially true in Guinea, where long-lasting insecticidal nets are currently the primary vector control intervention. To better inform the national malaria control program on the current status of insecticide resistance in Guinea, resistance bioassays were conducted, using Anopheles gambiae s.l. Giles, in three sites. Molecular analyses were also done on An. gambiae s.l. to determine the species and find whether the target-site mutations kdr and Ace1R were present. Susceptibility tests revealed resistance to DDT and pyrethroids, although mosquitoes were susceptible to deltamethrin in two of the three sites tested. Mosquitoes were susceptible to bendiocarb, except in Kissidougou, Guinea. The kdr-west mutation was widespread and the frequency was 60% or more in all sites. However, the Ace1R mutation was present in low levels. Insecticide susceptibility should continue to be monitored in Guinea to ensure insecticide-based vector control methods remain effective.
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Anopheles/fisiologia , Resistência a Inseticidas , Inseticidas/farmacologia , Animais , Anopheles/genética , Feminino , Marcadores Genéticos , Guiné , Proteínas de Insetos/genética , Proteínas de Insetos/metabolismo , Controle de MosquitosRESUMO
The purpose of this report is to describe a case of appendicitis in the left iliac fossa. Clinical presentation involved pain in the right iliac fossa with all classical signs of appendicitis. Anomalous location of the appendix was suspected on the basis of a special clinical feature and the patient's family history. Confirmation was achieved by colic contrast enema before surgical treatment.
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Apendicite/diagnóstico , Apendicite/patologia , Apêndice/anormalidades , Dor Abdominal , Adulto , Apendicectomia , Apendicite/cirurgia , Apêndice/diagnóstico por imagem , Colo/diagnóstico por imagem , Meios de Contraste , Enema , Humanos , Masculino , RadiografiaRESUMO
Renal oncocytoma is a rare benign tumor of the kidney. This benign tumor of epithelial origin represents 5% of renal tumors. Preoperative diagnosis is difficult. The final diagnosis can only be made on the anatomical part; even imaging result can often be evocative. We report the case of a 41 year old patient with renal oncocytoma confirmed after radical nephrectomy for renal tumor.
L'oncocytome rénal est une tumeur bénigne rare du rein d'origine épithéliale représentant 5% des tumeurs rénales. Le diagnostic préopératoire est difficile. L'imagerie est souvent évocatrice. Le diagnostic final ne peut être fait que sur la pièce anatomique. L'exploration chirurgicale demeure la règle en absence d'une biopsie rénale pour obtenir un diagnostic histologique précis. Nous rapportons l'observation d'un patient âgé de 41 ans ayant l'oncocytome rénal confirmé après néphrectomie élargie pour tumeur rénale.
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A large-scale malaria intervention programme using insecticide-treated bed nets and chemoprophylaxis administered to children was introduced into a rural area of The Gambia. The operation was carried out using the existing primary health care (PHC) service in the region. Training of the village health workers, sensitization of the communities, and implementation of net impregnation and the drug delivery programme are described. This delivery system resulted in over 90% of nets being treated with insecticide and 80% of children receiving over 90% of their tablets during the rainy season. There was considerable variation in the distribution of permethrin on a bed net and between individual nets, which is likely to facilitate the spread of insecticide resistance in the local mosquito populations. Bed nets made from heavier fabrics tended to absorb more insecticide than those made from lighter materials. Four months after dipping, 89% of the insecticide had been lost from treated nets. This was probably due mainly to women washing their nets, an activity carried out on average once every 2 months during the rainy season. The high number of insecticide-treated bed nets in the study area demonstrated that a malaria control programme operated through a PHC system can be implemented successfully.
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Inseticidas , Malária/prevenção & controle , Controle de Mosquitos/métodos , Piretrinas , Antimaláricos/uso terapêutico , Criança , Feminino , Gâmbia , Humanos , Higiene , Malária/tratamento farmacológico , Masculino , Permetrina , Saúde da População RuralRESUMO
The effects of insecticide-impregnated bed nets on mortality and morbidity from malaria have been investigated during one malaria transmission season in a group of rural Gambian children aged 6 months to 5 years. Sleeping under impregnated nets was associated with an overall reduction in mortality of about 60% in children aged 1-4 years. Mortality was not reduced further by chemoprophylaxis with Maloprim given weekly by village health workers throughout the rainy season. Episodes of fever associated with malaria parasitaemia were reduced by 45% among children who slept under impregnated nets. The addition of chemoprophylaxis provided substantial additional benefit against clinical attacks of malaria; 158 episodes were recorded among 946 children who slept under impregnated nets but who also received chemoprophylaxis. Chemoprophylaxis reduced the prevalence of splenomegaly and parasitaemia at the end of the malaria transmission season by 63% and 83% respectively. Thus, insecticide-impregnated bed nets provided significant protection in children against overall mortality, mortality attributed to malaria, clinical attacks of malaria, and malaria infection. The addition of chemoprophylaxis provided substantial additional protection against clinical attacks of malaria and malaria infection but not against death.
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Antimaláricos/uso terapêutico , Dapsona/uso terapêutico , Inseticidas , Malária/mortalidade , Controle de Mosquitos/métodos , Pirimetamina/uso terapêutico , Pré-Escolar , Cloroquina/uso terapêutico , Combinação de Medicamentos , Gâmbia/epidemiologia , Humanos , Higiene , Lactente , Malária/prevenção & controle , Morbidade , Saúde da População Rural , Estações do AnoRESUMO
To clarify the therapeutic role of US-guided in the treatment of amebic liver abscess, three different approach to amebic liver abscess were tested in 228 patients (187 males and 31 females) along 3 years. In a west african endemic area (in Abidjan). All cases were correctly diagnosed by clinical and sonographic findings, and by the pus after percutaneous or chirurgical drainage. The three modes of therapy utilized segregated three distinct group. The first group consisted of 80 patients who were treated medically by metromidazole and ampicillin administered orally. In them, 33 patients have noncollected abscess with a diameter ranged from 2.3 to 12.7 cm (mean 6.6 cm), 23 patients have a collected abscess with a diameter less than 10 cm ranged from 4.1 to 9.7 cm (mean 7.1 cm), 24 patients have a collected abscess with a diameter equal or exceeding 10 cm ranged from 10 to 22.5 cm (mean 14.3 cm). In the second group, there were 124 patients, and they were treated with combined US-guided percutaneous evacuation and medical therapy. In them, 22 patients have a collected abscess with a diameter less than 10 cm ranged from 4.9 to 9.5 cm (mean 7.4 cm), and 102 patients have a collected abscess with a diameter equal or greater than 10 cm (measured 10 cm to 27.5, mean 15.3). There were twenty four patients in the last group, they were treated by open chirurgical drainage because they have an abdominal ruptured abscess. The results with each form of therapy were assessed clinically and by abdominal ultrasound.(ABSTRACT TRUNCATED AT 250 WORDS)
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Drenagem , Abscesso Hepático Amebiano/terapia , Adolescente , Adulto , Idoso , Assistência Ambulatorial , Terapia Combinada , Feminino , Seguimentos , Hospitalização , Humanos , Abscesso Hepático Amebiano/complicações , Abscesso Hepático Amebiano/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ruptura Espontânea , Fatores de TempoRESUMO
Drinking and problem drinking were studied in 43 tuberculosis patients with the following results. The results of the KAST (Kurihama Alcoholism Screening Test) revealed that 10% of the patients were severe problem drinkers (diagnosed as alcohol dependent syndrome), 7% of the patients had drinking problems and 17% were potential problem drinkers. These percentages are higher than those of the general adult population. In the cases having higher KAST scores, the time between the onset of subjective symptoms and the first medical examination were long, but the time between the first medical examination and diagnosed tuberculosis was short. Severe tuberculosis patients showed higher KAST scores. It was assumed that tuberculosis patients who drink too heavily or are problem drinkers, were apt to put off consulting a physician, and as a result, the condition of tuberculosis would be more severe when they finally did see a physician. In the field of tuberculosis prevention and medical treatment, professionals should pay more attention to drinking and alcoholism. The need to stay sober is important in both preventing relapses and supporting recovery from tuberculosis.
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Consumo de Bebidas Alcoólicas , Tuberculose Pulmonar , Adulto , Idoso , Idoso de 80 Anos ou mais , Alcoolismo/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tuberculose Pulmonar/complicaçõesRESUMO
Ultrasound scans were used to study 23 cases of abdominal contusion in children, between January 1992 and December 1993. Thirteen boys and 10 girls were studied. They were all aged between 4 and 14 years, with a mean age of 6 years. The main causes of their injuries were road accidents (12 cases) and play (11 cases). Ultrasound scans were normal in 6 patients and pathological in 17 patients. The most frequently observed injuries were visceral effects (12 cases), almost always associated with hemoperitoneum. In three cases, hemoperitoneum was detected in the absence of visceral effects. The spleen (4 cases) and the liver (4 cases) were the most frequently injured organs. The other injuries detected included renal hematoma, bladder rupture and parietal hematoma. Diagnosis on the basis of ultrasound scans was found to be incorrect in three cases where diagnosis was repeated after the scan. One case involved a blocked perforation of the rectum, one a benign cyst and the other a mesenteric cyst. Despite these misdiagnoses, ultrasound scanning is a highly sensitive and specific method for examination of contusions in children. It is very useful and often sufficient for accurate diagnosis, particularly in units with only modest technical support.
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Traumatismos Abdominais/diagnóstico por imagem , Contusões/diagnóstico por imagem , Traumatismos Abdominais/etiologia , Acidentes de Trânsito , Adolescente , Criança , Pré-Escolar , Contusões/etiologia , Côte d'Ivoire , Diagnóstico Diferencial , Estudos de Avaliação como Assunto , Feminino , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Hemoperitônio/diagnóstico por imagem , Hemoperitônio/etiologia , Humanos , Perfuração Intestinal/diagnóstico por imagem , Perfuração Intestinal/etiologia , Rim/diagnóstico por imagem , Rim/lesões , Fígado/lesões , Masculino , Reto/diagnóstico por imagem , Reto/lesões , Estudos Retrospectivos , Ruptura , Sensibilidade e Especificidade , Baço/diagnóstico por imagem , Baço/lesões , Ultrassonografia , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/lesõesRESUMO
A prospective study of 100 newborns and young babies suffering from purulent meningitis was carried out over a period of 11 months in the radiology department of CHU in Treichville. All the children included in the study were hospitalised in the pediatric department of the CHU. We found cerebral complications in 76% of cases. The most frequent complication was ventricular dilation which occurred in 82.6% of cases. Pericerebral bleeding occurred in 9.3%, cerebral ischemia in 3.5%, brain abscesses in 2.3% and ventriculitis in 2.3% of cases. Our study demonstrated the two important uses of trans-fontanelle ultrasound scans in the study of meningitis: (i) in diagnosis, for the detection of cerebral complications; (ii) in treatment, interventional use of ultrasound makes it possible to evacuate intra-cranial septic fluids.
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Suturas Cranianas/diagnóstico por imagem , Meningites Bacterianas/diagnóstico por imagem , Côte d'Ivoire , Humanos , Lactente , Recém-Nascido , Meningites Bacterianas/complicações , Meningites Bacterianas/terapia , Estudos Prospectivos , Reprodutibilidade dos Testes , Supuração , Ultrassonografia , Saúde da População UrbanaRESUMO
Little published data exist on the morbidity and mortality associated with poor trauma care in developing countries. This report highlights our experience with iatrogenic limb gangrene related to fracture management by traditional bonesetters. Children with bonesetter's gangrene were identified from a prospectively recorded paediatric surgery database at the Regional Hospital of Kaolack in Central Senegal. 21 children were treated for bonesetter's gangrene during a 18-month period (January 2007 up to June 2008). The average age was 10 years (range, 5 to 15 years). Bonesetter's gangrene was more common in boys (90.5%) and occurred almost exclusively in children from rural areas where access to health care was limited. 16 children underwent proximal extremity amputation. Complications included one case of tetanus. Bonesetter's gangrene is a preventable complication that results from a failure of child health planners to recognize the importance of basic trauma care. Management of fractures should be considered an essential component of child health programs in developing countries.
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Amputação Cirúrgica/estatística & dados numéricos , Braquetes/efeitos adversos , Extremidades/irrigação sanguínea , Fraturas Ósseas/terapia , Gangrena/etiologia , Isquemia/etiologia , Medicinas Tradicionais Africanas/efeitos adversos , Contenções/efeitos adversos , Acidentes por Quedas , Adolescente , Bambusa , Criança , Pré-Escolar , Países em Desenvolvimento , Feminino , Fraturas Ósseas/complicações , Gangrena/epidemiologia , Gangrena/cirurgia , Humanos , Isquemia/cirurgia , Masculino , Estudos Prospectivos , População Rural , SenegalRESUMO
OBJECTIVE: The objective of this study was to determine the frequency of peritonitis by typhoid ileal perforation in the teaching hospitals of Bamako and Kati. PATIENTS AND METHODS: We conducted a retrospective study over a 24 years period (1984-2007). Every patient admitted and operated in urgency for peritonitis by ileal perforation were listed and included in this study. RESULTS: During the study period, 1868 acute peritonitis were operated on in the three major health centres of Bamako and Kati. We collected data concerning 543 typhoid ileal perforations which represented 29.0% of all peritonitis. The peritonitis by typhoid perforation constituted 28.5% of the peritonitis in the teaching hospital of the Point G, 30.6% in the Gabriel Touré teaching hospital and 6.4% in the teaching hospital of Kati. Among the peritonitis by typhoid perforation, 56.7% were listed in the Point G teaching hospital, 43.0% in the Gabriel Torre teaching hospital and 0.3% in the Kati teaching hospital. Between 1984-2004 we collected data from two hundred and fifty seven (257) patients suffering from peritonitis by typhoid ileal perforation, a total of 24.4% of the peritonitis recorded. Between 2005-2007, the data for two hundred eighty six (286) patients suffering from peritonitis by typhoid ileal perforation was collected, a total of 35% of the peritonitis recorded. The typhoid ileum perforation remains the 2nd overall cause of generalized peritonitis after that of appendicular origin. CONCLUSION: Peritonitis by typhoid ileum perforation has seen a significant increase from 2004 in the teaching hospitals of Bamako and Kati.
BUT: L'objectif de ce travail était de déterminer la fréquence de la péritonite par perforation iléale d'origine typhique dans les CHU de Bamako et de Kati. PATIENTS ET MÉTHODES: Nous avons réalisé une étude rétrospective sur une période de 24 ans (19842007). Tous les malades admis et opérés en urgence pour une péritonite par perforation iléale ont été recensés et inclus dans cette étude. RÉSULTATS: Durant la période d'étude, 1868 péritonites aiguës ont été opérées dans les trois grandes structures de santé de Bamako et Kati. Nous avons colligé 543 perforations iléales d'origine typhique soit 29,0 % des péritonites. La péritonite par perforation typhique a constitué 28,5% des péritonites au CHU du Point G, 30,6% au CHU Gabriel Touré et 6,4% au CHU de Kati. Parmi les péritonites par perforation typhique, 56,7% ont été recensés au CHU du Point « G ¼, 43,0% au CHU Gabriel Touré et 0,3% au CHU Kati. De 19842004 nous avons colligé deux cent cinquante sept (257) malades souffrant d'une péritonite par perforation iléale d'origine typhique soit 24,4% des péritonites. Entre 20052007, deux cent quatre vingt six (286) malades ont été colligés soit une fréquence de 35%. La perforation iléale d'origine typhique reste globalement la 2ème cause de péritonite généralisée après celle d'origine appendiculaire. CONCLUSION: La péritonite par perforation iléale d'origine typhique a connu une augmentation importante à partir de 2004 dans les CHU de Bamako et de Kati.
RESUMO
It is a retrospective study of descriptive type on a 4 years period, from April 1, 1999 to March 31, 2003. The aim was to determine factors bound to morbidity and mortality of renal affections in the Conakry University Hospital Center Nephrology Unit. The study was based on 606 hospitalized patients of whom 21 dialysed. The study's references were age, sex, renal affections frequency, mortality, associated pathologies, hospitalization period, death hours and other factors of cardio-vascular risks (tobacco, alcohol). Patients having answered to the selection criteria were 365 men (60.23%) and 241 women (39.77%) with a sex ratio of 1.51. The average age was 44 +/- 17 years old with extremes of 15 and 95 years old; 16.34% of the patients were aged less than 25 years and 14.03% were more than 65 years old. According to the charge taking, 462 (76.24%) were at their neighbors' charge, only 144 (23.76%) could take themselves in charge for their medical care. According to the received treatment before hospitalization, 357 had consumed decoctions of leaves and roots, 86 consulted a health center. The average period of hospitalization was 13 +/- 9 days with extremes of 1 and 80 days. Nicotine addiction was observed with 183 patients of whom 181 were men and alcoholism with 134 patients of whom 122 were men. Renal affections were chronic renal failure (51%), arterial hypertension (30.36%), chronic kidney disease (8.09%), intense renal failure (7.59%), urinary infections (1.65%), intense kidney disease (0.99%) and kidney cancer (0.33%). Among them, 130 deaths were observed (21.45%). According to the period going on before the medical check up, 24 death occurred 2 weeks after the first symptom, and 106 after more than a month. Considering the hours, 33 death (25.38%) occurred between 8 a.m. and 4 p.m. and 63 deaths (48.47%) between 4 p.m. and 8 a.m.; in 34 cases, the hour was not specified. Mortality was due to chronic renal failure in 97 cases (74.61%), to arterial hypertension in 19 cases (14.62%) and to other affections in 14 cases (0.77%). Infections, diabetes, arterial hypertension and anemia sickle cells were renal risk factors. Morbidity and mortality factors were numerous and varied: medical check up delay, traditional cure, patients 'weak turnover, lack of medical care, lack of required equipment and the absence of popular health education.
Assuntos
Hospitalização/estatística & dados numéricos , Hospitais Universitários/estatística & dados numéricos , Nefropatias/epidemiologia , Unidade Hospitalar de Urologia/estatística & dados numéricos , Injúria Renal Aguda/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Anemia Falciforme/complicações , Complicações do Diabetes , Feminino , Guiné/epidemiologia , Humanos , Hipertensão/complicações , Nefropatias/etiologia , Nefropatias/mortalidade , Falência Renal Crônica/epidemiologia , Neoplasias Renais/epidemiologia , Masculino , Pessoa de Meia-Idade , Pielonefrite/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fumar/efeitos adversos , Taxa de SobrevidaRESUMO
During a 5 year period, 137 patients with suspected acute aortic dissection were screened by CT. The radiologic diagnosis of dissection was made in 54 cases and eliminated in 76. There were seven false-negative CT examinations. Surgical and angiographic correlations or clinical follow-up were obtained with all patients.
Assuntos
Aneurisma Aórtico/diagnóstico por imagem , Dissecção Aórtica/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Doença Aguda , Adulto , Idoso , Aorta Torácica/diagnóstico por imagem , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Humanos , Iotalamato de Meglumina , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Computed tomography with contrast enhancement permits noninvasive follow-up of patients treated for aortic dissection. We used CT to examine 52 patients with aortic dissections for up to 14 years postoperatively. The mean interval between surgery and CT was 32 months. Computed tomography demonstrated the aortic graft in 45 patients. Persistent patency of a false lumen was observed in 40 cases. In one case, CT demonstrated extension of the dissection. No rupture or thoracic pseudoaneurysm was noted in our series.