Inflammatory lumbar radiculalgia in Ouagadougou: posterior facet arthritis due to tuberculosis.

Posterior facet arthritis is rarely described. The authors report a case of arthritis of the posterior lumbar facet in a woman consulting for back pain associated with relative functional impairment. Modern imaging, in slices, enables better examination of the posterior arch and better diagnosis of pathologies. Tuberculosis is one of the conditions affecting the posterior lumbar facet, and its characteristics on MRI are well-defined. This case shows that tuberculosis is a not uncommon cause of posterior facet arthritis and should be considered even before the appearance of clinical and bacteriological signs to avoid catastrophic situations for the patient.

[Abdominal pain and fever with urinary symptoms]. / Douleur abdominale fébrile associée à des signes urinaires.

A man consults for abdominal pain and fever. The diagnosis is suspected on a plain abdominal radiograph.

Un homme consulte pour des douleurs abdominales et une fièvre. Le diagnostic est évoqué sur une radiographie de l'abdomen sans préparation.

[Management of brain abscesses in era of computed tomography in sub-Saharan Africa: a review of 112 cases]. / Prise en charge médico-chirurgicale des abcès du cerveau à l'ère du scanner en Afrique sub-saharienne: à propos de 112 cas.

PATIENTS AND METHOD: The authors report a retrospective study conducted on 112 cases of cerebral abscesses collected over a period of 12 years from the medical records of the department of neurosurgery at the Yalgado Ouedraogo university teaching hospital, Ouagadougou-Burkina Faso. RESULTS: The analyses were conducted on the epidemiological, clinical and prognostic aspects of the cases. The mean age of the patients (73 men and 39 women) was 26 years. The primary mode of infection ranged from cranial injuries (25%) to meningitis (17.9%) and sinusitis (15.2%). Bacteria were isolated from 16.1% cases; staphylococci and streptococci were the most frequent bacteria identified. The main clinical symptoms were motor deficit (75.9%), fever (74.1%) and headache (66.1%). Diagnosis was performed by CT scan in all cases. Fifty-three patients were treated using antibiotics alone; this medical treatment was completed by surgery in 59 cases. The results showed that 37.5% of the patients in fact fully recovered while some sequelae were identified in 49.1%. The mortality rate was 13.4%. DISCUSSION AND CONCLUSION: Consciousness disorders were in most cases responsible for the patient's death. Moreover multiple and/or voluminous abscesses were factors of the poor functional prognosis. Due to the high mortality rate and the frequency of sequelae, the authors emphasize the need of prevention by using adequate and sufficient antibiotics during primary infections.

Effects of nesfatin-1 on food intake and LH secretion in prepubertal gilts and genomic association of the porcine NUCB2 gene with growth traits.

Nesfatin-1, a product of the nucleobindin 2 (NUCB2) gene, purportedly plays important roles in whole-body energy homeostasis. Experiments were conducted to determine how NUCB2 expression in fat depots may be controlled in the pig and to test the hypothesis that nesfatin-1 regulates appetite and LH secretion in the gilt. Prepubertal gilts were used to study expression of NUCB2 in fat and the effects of intracerebroventricular (i.c.v.) injection of nesfatin-1 on food intake and pituitary hormone secretion. Growing pigs (gilts and barrows at 22 wk of age, n = 1,145) or sexually mature gilts (n = 439) were used to test association of SNP in the NUCB2 gene with growth traits. The expression of NUCB2 was similar for subcutaneous fat compared with perirenal fat. An i.c.v. injection of the melanocortin-4 receptor agonist [Nle4, d-Phe7]-α-melanocyte-stimulating hormone did not alter expression of NUCB2 mRNA in the hypothalamus but reduced (P = 0.056) NUCB2 mRNA expression in subcutaneous fat. Short-term (7 d) submaintenance feeding reduced (P < 0.05) BW and did not alter expression of mRNA for NUCB2, visfatin, or leptin but increased (P < 0.05) expression of adiponectin mRNA in fat. Central injection of nesfatin-1 suppressed (P < 0.001) feed intake. Secretion of LH was greater (P < 0.01) after i.c.v. injection of nesfatin-1 than after saline. Single nucleotide polymorphisms in the porcine NUCB2 gene were not associated with adiposity of growing pigs or age at puberty in gilts but were associated (P < 0.05) with BW at puberty. These data indicate that NUCB2 is expressed in fat depots of the pig and that the level of expression is sensitive to stimulation of appetite-regulating pathways in the hypothalamus. It is confirmed herein that nesfatin-1 can regulate appetite in the pig and affect the gonadotropic axis of the prepubertal pig. Association of SNP in the porcine NUCB2 gene with BW at puberty suggests that regulation of appetite by nesfatin-1 in the pig affects growth, which may have important consequences for adult phenotypes.

[Risk factors associated with osteoarthritis of the knee in a rheumatology outpatient clinic in Ouagadougou, Burkina Faso]. / Facteurs de risque associés à la gonarthrose en consultation de rhumatologie à Ouagadougou (Burkina Faso).

The purpose of this transverse prospective study was to assess risk factors associated with osteoarthritis (OA) of the knee observed in a rheumatology outpatient clinic in Ouagadougou, Burkina Faso. All patients presenting osteoarthritis of the knee diagnosed according to the clinical and radiological criteria of the American College of Rheumatology (ACR) were recruited over a 9-month period from November 2006 to July 2007. A total of 118 patients including 108 women were studied. Mean patient age was 55.7 +/- 10.8 years. Pain and disability scores assessed using theLequesne index were greater than 8 in 87.3% of patients. Hydarthrosis was observed in 56.5% of patients. The most common associated risk factors for development of osteoarthritis of the knee were obesity (42.4%), menopause in women (66.7%), history of OA (43.2%), and previous knee injury (19.5%). The most common associated risk factors for progression of osteoarthritis of the knee were Heberden nodes (19.5%) and genu varum (52.5%). The risk factors for development and progression of osteoarthritis of the knee in the subsahalian population of Ouagadougou are the same as in the Caucasian population of industrialized countries. An unexpected finding in this black African population was the high prevalence of Heberden nodes.

[Radiographic and ultrasonographic diagnosis of a left thoracic mass]. / Diagnostic radiologique et échographique d'une masse thoracique gauche.

A chest roentgenogram of a 69-year-old man undergoing a check-up before prostate surgery showed a mass in the antero-inferior zone of the lung, just above the diaphragm. At ultrasonography, it was considered to be a thoracic ectopic kidney. This radiological case illustrates the place of this anomaly in the differential diagnosis of lung solitary mass, which can be explored with ultrasonography when retroperitoneal herniation is suspected.

[Non-Hodgkin lymphoma as a cause of intra-hepatic periportal low attenuation at computed tomography]. / Le lymphome malin non-hodgkinien est une cause d'hypodensité péri-portale intra-hépatique au scanner.

The authors report two cases of non-Hodgkin lymphoma in non immunodeficient subjects characterized by periportal low attenuation at CT. Both patients showed gallbladder wall thickening. The different causes of periportal abnormalities are presented and discussed.

[Lumbar canal stenosis in Ouagadougou: aetiological, clinical aspects and prognosis regarding 80 cases]. / Le canal lombaire étroit à Ouagadougou: aspects étiologiques, cliniques et pronostiques sur une étude de 80 cas.

The authors report their experience about 80 cases operated for lumbar spinal stenosis. Etiological clinical aspects and prognosis are studied. Lumbar arthrosis (83.8%) is the most frequent aetiology. The mean age is 50.7 years. Men are most affected than women (sex-ratio 2/1). Heavy work has a part to play in the genesis, in effect it tends to low the age of symptomatic stenosis. Lumbar and radicular pains are the most frequent symptoms (82.5%). Neurogenic intermittent claudication is less frequent (65%). Heavy cases with neurologic complications are frequent (32.5%). Surgical results are satisfactory in 74.3% of the cases. The authors insist in the interest of extensive laminectomy, respecting however as much as possible, the structure of stability of the vertebral column.

[Myocardial localization of a disseminated cysticercosis. Echocardiographic diagnosis of a case]. / Localisation myocardique d'une cysticercose disséminée. Diagnostic échocardiographique d'un cas.

Cysticercosis (cysticercus cellulosoe) is a parasitic infestation of human by a larval form of Taenia solium. The localisations are mostly the central nervous system, skeletal muscles and subcutaneous tissue, but other organs can be concerned. Myocardial cysticercosis is an extremely rare infection. We report a case of myocardial cysticercosis in a 37 year old patient who presented a disseminated form. The myocardium involvement is diagnosed by echocardiography. The clinical and echographic evolution was favourable after a treatment with albendazole. The other cardiovascular manifestations described in the literature are discussed.

[Features of hysterosalpingography performed in Burkina Faso]. / Particularités des hystérosalpingographies réalisées en milieu Burkinabé

PURPOSE: The goal of this study was to describe the distinctive hysterosalpingographic features of women with infertility in Burkina Faso. MATERIALS AND METHODS: We performed a retrospective study of 1019 women who were referred for infertility between January 1996 to June 1997 at the National Hospital Centre of Ouagadougou. Clinical and radiological features were reviewed and statistical data analysed on the software EPI Info 5.0. RESULTS: The mean age of the patients was 28+/-0,3 years. Primary infertility was found in 34.4% and secondary infertility in 65.6%. Abnormalities on plain film were present in 6.9% of the cases. Hysterosalpingography was abnormal in 62.1% of the cases. Tubal abnormalities were found in 62% and uterine lesions in 38.3%. The main hysterosalpingographic abnormalities were tubal obstructions, hydrosalpinx, uterine fibromas, and trauma sequelae in 25,9%, 25,3%, 16,5% and 10% of cases respectively. Seventy one percent of tubal and uterine lesions represent outcomes of chronic infections and underground abortions. CONCLUSION: In Burkina Faso, hysterosalpingographic abnormalities are characterized by the predominance of infectious and traumatic sequelae. Such a frequency could be reduced by active politics against underground abortion and information about genital infections.

[Radiography and ultrasonography in the management of bladder tumors: 71 cases at the National Hospital Center of Yalgado Ouedraogo (Burkina Faso)]. / Radiographie et échographie dans la prise en charge des tumeurs de la vessie: à propos de 71 cas au Centre hospitalier national Yalgado Ouedraogo (Burkina Faso).

The bladder's cancer is frequent in West Africa. Urinary schistosomiasis endemicity helps to explain this high incidence. It is a pathology of late diagnosis, little or badly explored by imaging. Through a retrospective survey of 71 patients' files aged in average of 51.7 years, all having a bladder's tumour which is clinically shown by an haematuria, the major symptom, often by a pelvic volume, and who have all gone through an abdominal echography and/or intravenous urography (IVU) and/or retrograde urethrocystography (UCR), we have tried to point out the role of imaging in the caring of this pathology in our working context. Imaging, with a 98.5% sensibility for sonography and 100% for IVU, took part in all the cases to the diagnosis, to the search of urinary signs of reflux, associated signs authorizing a diagnostic orientation, but was excluded from the evolutive follow-up due to the poverty of our populations. So, despite some limits specific to the survey, particularly the absence of historadiological comparison for all the files, echography and IVU with cystography have always led to malignancy diagnosis. Therefore they should be requested for any patient consulting for haematuria.

[Laryngo-tracheo-bronchial foreign bodies in children at the University Hospital Center of Ouagadougou (analysis of 96 cases)]. / Les corps étrangers laryngo-trachéo-bronchiques chez l'enfant au CHU de Ouagadougou (une analyse de 96 observations).

Over a 10-year period, a series 96 patients were treated for laryngotracheal and bronchial foreign bodies in the ENT department of the Ouagadougou University Hospital Center (Burkina Faso). The purpose of this study was to analyze the epidemioclinical features and therapeutic pitfalls encountered in that series and to propose measures to improve management. The age of patients ranged from 10 months to 14 years. The male-female ratio was 1.7. Anamnesis documented foreign body aspiration was obtained in 77% of cases. The foreign body was organic in 78 cases (81.2%) including vegetal material in 56 cases. Management was delayed due to late diagnosis since only 59.3% of the patients were admitted to the hospital within the 48 first hours. Endoscopic removal was performed in all cases but such procedures remain challenging in developing countries due to a lack of proper anesthetic facilities, skilled personnel and adequate equipment. Tracheostomy was performed in 10.4% of cases mainly in patients with foreign bodies located in larynx. One patient died during extraction. In addition to providing more information and education on prevention of laryngotracheal and bronchial foreign bodies, better management requires better training of medical personnel and improvement of technical facilities.

[Primary pulmonary myxoid liposarcoma discovered fortuitously]. / Liposarcome myxoïde pulmonaire primitif de découverte fortuite.

We report a fortuitous discovery of primary pulmonary myxoid liposarcoma in an HIV-positive patient. Primary pulmonary localizations are uncommon. Generally, pulmonary localizations are metastatic. There is a male predominance and diagnosis is generally made around 40 years of age. The two main features of liposarcoma are the large tumor size and the complex histology that evolves over time. Pathology findings are rarely reproducible and vary from one pathologist to another. Macroscopically, liposarcomas can mimic benign tumors. The risk of recurrence is high after simple enucleation due to microscopic extracapsular extensions. Surgery remains the predominant treatment. Wide complete excision, if possible, provides long-term survival.

[Warm saline enema for reduction of intestinal invagination under the ultrasonographic guidance: preliminary results apropos of 2 cases]. / Désinvagination intestinale par lavement au sérum salé isotonique tiédi sous contrôle échographique: résultats préliminaires à propos de deux cas.

The authors describe the use of isotonic normal saline enema under US guidance in the treatment of acute uncomplicated intestinal intussusception in infants. The technique was successfully used in two patients aged respectively 18 and 16 months, with 11 and 9-month follow-up. The various steps of this technique and the results are analyzed and discussed. It is a valuable alternative to surgical treatment or hydrostatic reduction with opaque x-ray contrast under fluoroscopic guidance.

[Fetal weight gain curve for a cohort of 126 pregnant women at Ouagadougou, Burkino Faso]. / Courbe foetale de croissance pondérale à Ouagadougou (Bukina Faso). A propos d'une cohorte de 126 gestantes.

We carried out a prospective study at Ouagadougou, from March 1 1997 to April 30 1998, in which we plotted curves of fetal weight gain, estimated by ultrasound biometry, with the aim of comparing our results to those of other authors and establishing a local chart. We established a growth curve from 936 fetal weights estimated during the follow up of 126 pregnant women. The mean age of the women included was 26 +/- 0,8 years and 52.4% were of the mean socioeconomic level. We identified significant differences between our weight gain curve and those of other authors. The factors involved in this difference are unclear but may be nutritive, ecological and ethnic in nature. Further work is required to produce local charts, to optimize the estimation of fetal weight.

[Ultrasound foetal biometry in the town of Ouagadougou, Burkina Faso. Report of a cohort of 126 pregnant women]. / Biom¿etrie foetale ultrasonore dans la ville de Ouagadougou, Burkina Faso. A propos d'une cohorte de 126 gestantes.

PURPOSE: This inquiry on the ultrasound fetal biometry in the town of Ouagadougou aimed to study the fetal growth through the ultrasound biometry in order to compare it with other authors's works and to lay down a local chart. PATIENTS AND METHODS: This prospective study led from March 1997 to April 1998 The follow-up of 126 pregnant women allowed to lay down the graphs of following elements: biparietal diameter, cephalic circumference, transverse abdominal diameter, abdominal circumference and femur. RESULTS: The average age of the subjects was 26 years old+/-0.8 and 52.4% of them belonged to an average socio-economic level. All the studied parameters were closely connected with the age of pregnancy. The DAT and the abdominal circumference presented the greatest correlation (0.998). The comparison of our growth graphs with those of others authors led to notice significant differences as well as with African, European and American graphs. CONCLUSION: There is a need to lay down local charts in order to have a best estimation of the pregnancy age and the fetal growth.