Polyradiculopathies in the neurology department of the Cocody University Hospital, Abidjan, Ivory Coast: epidemiological and clinical profiles and outcomes over a six-year period.

Polyradiculoneuropathies (PRNs) are inflammatory disorders of the peripheral nervous system. They are diffuse in general, sparing neither the proximal portions of the elements of this system, where they predominate, nor the cranial nerves. To describe the epidemiological and diagnostic profiles, as well as the course, of patients with PRN in the Cocody university hospital center (Abidjan) neurology department over the past six years. This retrospective single-center study describes PRN cases and their course during the 6-year period of 2009-2014 in this neurology department. Among 5319 cases seen in the neurology department over the study period, 58 patients met our criteria, i.e., 1.1%. More patients were men: 55.2% for a sex ratio of 1.23. They included 4 cases of ethanol poisoning, 2 cases of undecompensated diabetes, and one reaction to vaccination for yellow fever (AAV). The electroneuromyographic tracing supported a finding of demyelination in 55.1%, axonal loss in 25.9% and both in 19%. PRN is a relatively common pathology that is often overlooked. Etiological investigation was difficult in our setting. Early management can improve the prognosis of this disorder.

[Gayet-Wernicke's encephalopathy. A study of 13 cases observed in a refugee population hospitalized at the Conakry Teaching Hospital]. / Encéphalopathie de Gayet-Wernicke. Etude de 13 observations dans une population de patients réfugiés hospitalisés pour affections neurologiques au CHU de Conakry.

The authors report 13 cases of Gayet-Wernicke's encephalopathy observed in 13 patients of a refugee population. 11 presented the classical triad: oculomotor signs, cerebral ataxia and state of confusion and in 2 patients, only 2 symptoms were noted. The etiological factors: chronic alcoholism, malnutrition, uncontrollable vomiting, HIV and tuberculosis were identified. The outcome was evaluated on the basis of the disappearance of symptoms after treatment with 500 mg of thiamine in 7 patients, 1 death and 5 patients progressed toward Korsakoff amnesic syndrome.

[Two cases of cryptococcal meningitis revealed by an ischemic stroke]. / Accident vasculaire cérébral ischémique révélateur de cryptococcose neuroméningée: à propos de deux cas.

The usual clinical expression of neuromeningeal cryptococcosis is a meningoencephalitis. We report two cases of neurocryptococcosis which have been revealed by an unusual clinical aspect: an ischemic stroke with a vasculitis mechanism. The two patients had a positive reaction for the HIV and we discussed the responsibility of the HIV or the Cryptococcus in the occurrence of the cerebral infarct.

[Peripheral facial paralysis revealing HIV infection in black African populations]. / Paralysie faciale peripherique revelatrice d'une infection par le VIH chez le noir Africain.

INTRODUCTION: Peripheral facial paralysis (PFP), a frequent complication during infection with the human immunodeficiency virus (HIV), is a major cause of morbidity for these patients. The aim of this study was to show the place of unilateral PFP in the discovery of HIV infection in tropical areas. MATERIAL AND METHODS: This is a descriptive cross-sectional study with prospective data collection over a 12-month period, in the ENT departments of the Ignace Deen National Hospital and Neurology Hospital of the Sino-Guinean Friendship Hospital (CHU de Conakry). RESULTS: Of the 2517 patients received during the study period, 64 had PFP, a prevalence of 2.54%. HIV serology was performed in 56 patients, 24 of whom had a positive serological reaction, a prevalence of 42.86%. The young adult population was the most exposed, with an average age of 34.5 years. There were 9 men and 15 women, or a sex ratio of 0.6. In 70.83% of cases, the consultation period occurred between the 1st and 3rd week. Unilateral facial asymmetry and persistent opening of the palpebral fissure were the main clinical signs. A total of 75% of our patients were infected with HIV1. CD4 levels ranged from 175 to 400/mm3. All our patients had received PFP and HIV treatments. The evolution was marked by a complete recovery with no sequelae of PFP in 62.5% of cases. CONCLUSION: The occurrence of isolated PFP in apparently healthy adults should suggest seroconversion to HIV. The prognosis of these PFPs is often good despite the delay in diagnosis.

INTRODUCTION: La paralysie faciale périphérique (PFP), complication fréquente au cours de l'infection par le virus de l'immunodéficience humaine (VIH), constitue une cause importante de morbidité chez ces patients. Le but de cette étude était de montrer la place de la PFP unilatérale dans la découverte de l'infection par le VIH en zone tropicale. MATÉRIEL ET MÉTHODES: Il s'agit d'une étude transversale descriptive avec collecte des données prospective, sur une période de 12 mois, réalisée dans les services d'ORL de l'Hôpital National Ignace Deen et de Neurologie de l'hôpital de l'amitié Sino-Guinéenne (CHU de Conakry). RÉSULTATS: Sur les 2517 patients reçus en consultation durant notre période d'étude, 64 présentaient une PFP soit une prévalence de 2,54%. La sérologie VIH avait été réalisée chez 56 patients, dont 24 avaient eu une réaction sérologique positive, soit une prévalence 42,86 %. La population adulte jeune était la plus exposée, avec un âge moyen de 34,5 ans. Il s'agissait de 9 hommes et 15 femmes, soit un sex-ratio de 0,6. Le délai de consultation était, dans 70,83% des cas, situé entre la 1ère et 3ème semaine. L'asymétrie faciale unilatérale et la persistance d'ouverture de la fente palpébrale étaient les principaux signes cliniques. Au total 75 % de nos patients étaient porteurs du VIH1. Le taux de CD4 variait entre 175 et 400/mm3. Tous nos patients avaient bénéficié d'un traitement de la PFP et du VIH. L'évolution avait été marquée par la récupération totale et sans séquelle la PFP dans 62,5% des cas. CONCLUSION: La survenue d'une PFP isolée chez l'adulte apparemment en bonne santé, doit faire évoquer une séroconversion au VIH. Le pronostic de ces PFP est souvent bon malgré le retard diagnostic.

Relationship between blood antioxidants and occupational exposure to polycyclic aromatic hydrocarbons in coke oven workers.

BACKGROUND: We investigated if blood Cu++/Zn++ superoxide dismutase, glutathione peroxidase, and catalase activities are increased and total plasma antioxidant concentration is decreased in coke oven workers exposed to polycyclic aromatic hydrocarbons. METHODS: Ninety-six coke oven workers participated in the study. Nonexposed workers (n = 105) were randomly sampled among power plant workers in the same age range. The examination included a questionnaire on health status, occupational history, smoking, and dietary habits. Blood samples completed the examination. Coke oven workers were classified into low-, middle-, and high-exposure groups based on the benzo[a]pyrene (B[a]P) air concentrations and were further classified into the categories "topside" and "non-topside," according to their proximity to the ovens. RESULTS: Erythrocyte glutathione peroxidase activity increased with age (r = 0.18, P = 0.061) in power plant workers, whereas plasma glutathione peroxidase activity decreased with age (r = -0.18, P = 0.068) and erythrocyte glutathione peroxidase activity was inversely correlated with the number of cigarettes per day (r = -0.28, P = 0.08) in coke oven workers. Comparison of blood antioxidant enzyme activities and total plasma antioxidant concentration between coke oven and power plant workers showed that erythrocyte glutathione peroxidase activity was significantly lower in coke oven workers, even after adjustment for potential confounding factors. No differences were found either in other blood antioxidant enzyme activities or in total plasma antioxidant concentration between coke oven and power plant workers. Moreover, no trends toward decreased glutathione peroxidase activity among the three subgroups of B[a]P exposure were observed, and no differences either in blood antioxidant enzyme activities or in total plasma antioxidant concentration between the two groups of job categories were found. CONCLUSIONS: Production of reactive oxygen species seems not to be increased in coke oven workers.

The use of jet-injectors in BCG vaccination.

In mass vaccination programmes, the jet-injection of vaccine may have considerable operational advantages over the classical techniques. The technical performance of two models of jet-injector, the Dermo-Jet and the Ped-O-Jet, in BCG vaccination was assessed in a number of studies which are reviewed by the authors. It is shown that the jet-injectors do not administer the full dose for which they are calibrated and that the size of the vaccination lesion varies more than after vaccination by syringe.By increasing the dosage considerably, the results of vaccination by jet-injection may be improved to a certain extent but the risk of unpleasant reactions is also increased.