RESUMO
In black Africa, and particularly in Togo, management of thyreotoxicosis is not simple. The intervention of several specialists and effective patient collaboration is needed. In a majority of cases, the patient's apprehensions, financial problems, and taboos prevent correct management. We report 30 cases of thyreotoxicosis in 82 patients with thyroid disease seen over a 5-year period in the Internal Medicine and Cardiology Department of the Lomé teaching hospitals. Graves' disease was the most frequent (83.33%), followed by multinodular goiter (10%) and toxic nodule (6.67%). Diagnosis was strictly clinical in 53.33% of the cases. The main complication was cardiothyreosis in 46.67% of the patients. Drug treatment was used. Short-term results (4 - 6 weeks) was favorable in 96.67% of the cases. A percentage (65.41%) were lost to follow-up after discharge. The main impairment encountered for the management of thyreotoxicosis was financial and economical difficulties not specific to the disease. Other problems included the lack of diagnostic and therapeutic means and insufficient cooperation between the surgeon, the cardiologist and the endocrinologist.
Assuntos
Necessidades e Demandas de Serviços de Saúde , Tireotoxicose/terapia , Adulto , Carbimazol/uso terapêutico , Fármacos Cardiovasculares/uso terapêutico , Países em Desenvolvimento , Quimioterapia Combinada , Exoftalmia/etiologia , Feminino , Seguimentos , Bócio Nodular/epidemiologia , Doença de Graves/epidemiologia , Cardiopatias/diagnóstico , Cardiopatias/etiologia , Hospitalização , Hospitais Universitários , Humanos , Hipnóticos e Sedativos/uso terapêutico , Relações Interprofissionais , Iodo/uso terapêutico , Masculino , Equipe de Assistência ao Paciente , Sudorese , Tireoidectomia , Tireotoxicose/tratamento farmacológico , Tireotoxicose/epidemiologia , Tireotoxicose/cirurgia , Togo/epidemiologia , Tremor/etiologiaRESUMO
Currently, echography coupled with Doppler is a primary technique in the diagnosis of congenital heart disease. Since September 1993, the pediatric ward of the Tokoin teaching hospital of Lome has been equipped with this technology. During the following 23 months, there were 299 examinations with Doppler-echocardiography among the consultations of 15,082 children. Eighty-two cases of congenital heart defects were detected in 73 children, aged between 3 days and 13 years, of whom 79.4% were between 7 days and 30 months old. In all cases, either pulsed or continuous Doppler-echocardiography was performed at the request of doctors treating symptoms suggestive of cardiac disease, such as heart murmur (67%) and cyanopathy (22%). The noncyanotic cardiopathies found were ventricular septal defects (24%), patent ductus arteriosus (21%), interatrial septal defects (18%) and atrioventricular canal defects (9%). The most frequent cyanotic cardiopathy detected was Fallot's tetralogy (19.5%). Thus, early diagnosis and management of congenital heart disease is facilitated by systematic examination of newborns and sustained collaboration between pediatricians, obstetricians and cardiologists.
Assuntos
Ecocardiografia Doppler , Cardiopatias Congênitas/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Cianose/diagnóstico por imagem , Comunicação Atrioventricular/diagnóstico por imagem , Feminino , Sopros Cardíacos/diagnóstico por imagem , Comunicação Interventricular/diagnóstico por imagem , Departamentos Hospitalares , Hospitais de Ensino , Humanos , Lactente , Recém-Nascido , Masculino , Pediatria , Tetralogia de Fallot/diagnóstico por imagem , Togo , Ultrassonografia Doppler de PulsoRESUMO
INTRODUCTION: High blood pressure is a public health problem for which the assumption of responsibility remains especially difficult in older subjects. Generally, it is associated with other cardiovascular risk factors. The objective of this study is to determine the prevalence of high blood pressure in older subjects in a particular environment and to evaluate the cardiovascular risk among these patients. METHODOLOGY: This is a longitudinal exploratory study undertaken on 1485 hypertensive subjects of 50 years of age or older, selected from 1999 patients received in three health professional training centers of the community of Lomé, between June 1, 2004 and June 30, 2007. Information had been collected using a card of investigation. Classifications of high blood pressure were those of the JVCVII and the European Society of Cardiology. The data analysis had been made by computer tools. RESULTS: The prevalence high blood pressure was of 74.29%. We had noted a female prevalence (63.8%) with a sex ratio of 0,57 and one middle age of 62.08±9.3 years. Dyspnea (45.9%), chest pains (16.2%) and palpitations (13.2%) were the principal found symptoms. The various listed risk factors were: dyslipidemia (58.1%), obesity (36.12%), alcoholism (16.7%) and diabetes (10.6%). The complications were cardiac (87.81%), ocular (79.8%), renal (19.86%), neurological (4.92%) and arterial (0.99%). The cardiovascular risk was very high at 58.05% of the patients. The mortality rate was of 1.9%. CONCLUSION: High blood pressure is the most frequent cardiovascular risk factor in our country from 50 years of age. Assumption of responsibility for it is by information, education of the population and requires the mobilization of all the social components.
Assuntos
População Negra/estatística & dados numéricos , Hipertensão/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Índice de Massa Corporal , Complexos Cardíacos Prematuros/epidemiologia , Dor no Peito/epidemiologia , Complicações do Diabetes/epidemiologia , Dislipidemias/complicações , Dispneia/epidemiologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/etiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Prevalência , Estudos Prospectivos , Fatores de Risco , Distribuição por Sexo , Inquéritos e Questionários , Togo/epidemiologiaRESUMO
UNLABELLED: Arterial hypertension is a real health problem worldwide. The goal of this survey is to evaluate its prevalence and risk in hospital environment. It was a prospective and multi-centred survey which took place in the cardiology department in Kpalimé hospital from the 4th August 2005 to the 4 th July 2006 then a period of almost ten months. Our survey allowed us count 584 people suffering from hypertension out of 2641 patients which makes a prevalence of 22%. Distribution according to the global sample gave a predominance of 56.3 % for women against 43.7% for men. The age of our patients varied between 20 years and 95 years with an average of 53.4 years +/- 15.02. According to the age the group which was more touched was the one between 46 and 69 years. Distribution according to social and professional segments was dominated by the housewives (27.9%), the civil servants (17.8 %) and the trade men (14.0%). Symptomatology is dominated by a dyspnea during an physical effort (28.8%), signs having no relation with AHT (20.2%) and headache (19.5%). Factors for most frequent risk were: obesity (56.8%), consumption of alcohol (22.1%) and dyslipidemia (13.4%). The rate of morbidity is about 59.5% and the mortality is about 11%. CONCLUSION: AHT in Togo is a real problem of public health. It occurs in the poorest social segments, causing a problem of medical care. The prevention remains the most efficient mean to avoid sickness and should be necessarily based on a real change of attitude by the authorities and the medical staff as the sensibilization of the population.
Assuntos
Hospitais Urbanos/estatística & dados numéricos , Hipertensão/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Comorbidade , Complicações do Diabetes/epidemiologia , Dislipidemias/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/diagnóstico , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Fumar/epidemiologia , Togo/epidemiologia , População Urbana/estatística & dados numéricos , Adulto JovemRESUMO
UNLABELLED: According to the WHO, cardiovascular disease such as arterial hypertension and ischemic heart disease will be the main non-communicable diseases in developing countries in the next decades. In Togo, there is no statistic on this disease on this day. Our objectives were to study the epidemiological aspects and to describe the risk factors of this affection in our surroundings. It is about a multicentric transverse study from June 1st, 2004 to May 31, 2007, in 3 sanitary formations of the city of Lomé. RESULTS: The frequency of ischemic heart disease was 11, 46%. There was a feminine predominance with a sex-ratio of 0.71. The average age of the patients was about 55.3 +/- 13.4 years with extremes of 18 and 95 years. The cardiovascular risk factors were: dyslipidaemia (76.9%), hypertension (75.3%), left ventricular hypertrophy (72.8%), abdominal obesity (71.1%), hyperuricemia (50.5%), hyperglycemia (41.9%) of which overt diabetes (29%) and smoking (3%). There was a feminine predominance at the hypertensive and the obese. The women accumulated more modifiable risk factors than the men. The middle risk indication was of 2.34 +/- 0.9 at the men and 2.55 +/- 0.8 at the women. The different clinical forms were: stable angina (71.2%), unstable angina (1.7%) and myocardial infarction (5.2%); silent ischemia represented 21.9%. The antero-septal territory was the more reached in case of myocardial infarction and the antero-lateral territory in case of ischemia. CONCLUSION: A sanitary politic centered on the eviction of the risk factors should help to reduce the prevalence of this affection for a long time in our surroundings.
Assuntos
Isquemia Miocárdica/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Togo , Adulto JovemRESUMO
Due to the recent establishment of the emergencies Units in Black Africa, their epidemiological aspects are not well known. Our aims was to describe the epidemiology of this desease in Togo. Through a retrospective analysis we study over a period of 42 mouths. From January first, 2001 to June 30th, 2004. It was carried out exclusively at CHU-Campus, the hospital of Lomé Campus, the second national medical center of reference. Included were all the patients with cardio-vascular emergency cases. We have studied the epidemilogical aspects according to the age, sex, profession, morbidity, and mortality. The treatment of results have been done by Computer. The registered emergency cases were 733 il all with is a frequency of the patients admitted at CHU-CAMPUS. The average age is 56 +/- 13 years with extreme ages from 20 to 97 years. The age group most affected is between 30 and 69 years--The ratio according to the sex is 1.09 in favour of men. Housewives are the professional category most affected (42.3%). Constitute the essential of the cardiovascular emergency cases with a ratio of the 78.3%. The mortality is 17.1% which in most registered between 30 and 69 years. The morbidity ratio is 64.1% We have to keep in mind that cardio-vascular emergency cases are very frequent in Togo. A very active population of young people is concerned. The poor are the most threatened. Henceforth the establishment and equipment of cardiological units are absolutely necessary, for they constitute the only solution by which the level of morbi-mortality can be reduced.
Assuntos
Doenças Cardiovasculares/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/mortalidade , Emergências , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Togo , Adulto JovemRESUMO
We report an observation of a double left thrombosis intraventriculaire and atrium at a subject 45 years. The diagnosis was made by the transthoracic two-dimensional echocardiography which showed a dilated cardiomyopathy and two bulky thrombi in the left ventricle and atrium. As the chirurgical treatment is not accessible, we use the medical treatment: anticoagulant treatment associated on the low salt diet, with diuretic and the inhibitors of the enzyme of conversion, the evolution was favourable without embolic accident.
Assuntos
Cardiopatias/patologia , Trombose/patologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The cardiopathies occupy a place of choice in CVA (cerebro vascular accident) but in Togo no work have been done in this sector to realize it. Our work had for an objective to determine the prevalence of the association of cardiopathy and CVA (cerebro vascular accident). To determine the prevalence of embologenic cardiopathies. It was about a retrospective study on 91 files on 1102 cases of CVA (cerebro vascular accident) admitted from 1st January 2001 to 31st December 2005 in cardiological and neurological units in CHU Campus Lomé. The prevalence was of 8,25%, the average age was 59,19 years +/- 11,45. The sex ratio was 1,06. The principal affections found were embologenic cardiopathies 89,01% among which we can note troubles of the rhythm (41,75%), Ischaemia cardiopathies (27,47%), The valvulopathies (23,07%), The endocarditis (8,87%). The principal cardiovascular risk factors was arterial hypertension (60,43%), dyslipidémia (51,65%) and alcool (31,87%). The mortality rate was 27,47% and the morbidity rate was (50,55%), The association of the cardiopathies and C.V.A (cerebro vascular accident) constitute a public health problem in Togo. The embologenic cardiopathies occupy in this sector a preponderant place. The early prevention of this association must have for a target surely rhumatismal cardiopathy than arterial hypertension and its risk factors.