[Presumption of sleep apnea in a black African hypertensive population: Importance of the Epworth sleepiness scale in the diagnostic approach]. / Présomption d'apnées du sommeil dans une population d'hypertendus Noirs africains : intérêt de l'échelle de somnolence diurne d'Epworth dans l'approche diagnostique.

INTRODUCTION: Sleep apnea syndrome (SAS) is very little described in the hypertensive black African. PURPOSE: To screen sleep apnea syndrome using the rating scale of Epworth daytime sleepiness, and to investigate the determinant factors and to infer therapeutic consequences. METHOD: This is a retrospective and prospective study with descriptive and analytical purpose that focused on 200 hypertensive outpatients of the Cardiology Institute of Abidjan. The primary endpoint studied was the SAS. The diagnostic approach of SAS was performed using the rating scale of Epworth daytime sleepiness. RESULTS: The prevalence of sleep apnea was 45%. The average age of sleep apnea carriers was 56.1 years, with a male predominance (60%). The determinant factors of sleep apnea syndrome were male gender (60% versus 40%, P=0.021), obesity (77.8% versus 62.7%, P<0.0001), diabetes (26.7% versus 15.5%, P=0.5) and dyslipidemia (54.4% versus 27.3%, P=0.0009). Life in urban areas, occupation and smoking were not correlated with SAS in our series. The control of hypertension was better in non-apneic patients compared to apneic patients (63.6% versus 38.9%, P=0.04). The visceral impact of hypertension in apneic patients was highly significant (77.8% versus 41.7%, P=0.014). Therapeutically, it was noted the preferential prescription of combination therapy in apneic patients compared to non-apneic patients (82.3% versus 74.4%).

[Peripheral arterial disease of the lower limbs in African diabetic patients: ultrasonography and determining factors]. / Artériopathie des membres inférieurs du diabétique noir africain: aspects ultrasoniques et facteurs déterminants.

INTRODUCTION: Diabetic peripheral arterial disease (PAD) of the lower limbs is underdiagnosed. METHODOLOGY: This was a prospective study conducted over a six-month period from November 2012 to April 2013. A total of 308 diabetic patients were included from three diabetes centers in Abidjan (Ivory Coast). AIM: To screen for PAD of the lower limbs in a diabetic population and to identify the determining factors. RESULTS: Among the 308 patients, the ankle-brachial index (ABI) was<0.9 in 68 (22.07%) patients considered to have PAD; the ABI was>1.3 in 56 (18.2%) patients who had suspected mediacalcosis. The average age of the PAD patients was 60.2 years. Female gender predominated (55.9%). The mean duration of diabetes was 9.6 years: 97.1% type 2 diabetes. The other cardiovascular risk factors in this population were hypertension (58.8%) and dyslipidemia (40.9%). Smoking was present in 29.4% of patients and obesity in 23.9%. PAD of the lower limbs was mild in 46 patients (67.6%), moderate in 16 (23.5%) and severe in 6 (8.8%). Duplex Doppler commonly showed lesions of the tibial arteries. Determining factors of diabetic PAD of the lower limbs were hypertension (58.8% vs 36.6%; OR=2.46; 95% CI: 1.13-5.36; P=0.034) and dyslipidemia (40.9% vs 8.3%; OR=7.6; 95% CI: 2.31-25.08; P=0.0009). For mediacalcosis, male gender (71.5% vs 39.7; OR=0.26 95% CI/0.10-0.64. P=0.004) was the only factor identified. CONCLUSION: Hypertension and dyslipidemia were predictive factors for diabetic PAD of the lower limbs in our African population.

Solution equilibria and structural characterisation of the palladium(II) and mixed metal complexes of peptides containing methionyl residues.

Palladium(II) complexes of the peptides GlyMet, GlyMetGly and GlyGlyMet containing methionyl residues were studied by potentiometric and 1H NMR spectroscopic methods. The coordination of terminal amino and deprotonated amide nitrogen and thioether sulfur donor atoms was suggested in the mono complexes of GlyMet and GlyMetGly. The fourth coordination site of these complexes can be occupied by solvent molecule, chloride or hydroxide ions or by another ligand molecule in the bis or mixed ligand complexes. The second ligand coordinates monodentately via the thioether function in acidic media and the amino group under neutral or basic conditions. The stoichiometry of the major species formed in the palladium(II)-GlyGlyMet system is [PdH(-2) L]- and this is coordinated by the amino, two-amide and the thioether donor functions. Thioether bridged mixed metal complexes formed in the reaction of [Pd(dien)]2+ and [Cu(GlyMetH(-1))] or [Ni(GlyMetGlyH(-2))]- also have been detected by spectroscopic techniques.

[Malignant melanoma in the Ivory Coast. Epidemiologic and histo-prognostic aspects. Report of 195 cases]. / Mélanomes malins en Côte-d'Ivoire aspects épidémiologiques et histopronostiques. A propos de 195 cas.

Malignant melanomas (MM) are rare tumors of very bad prognosis. Few studies have precised the anatomopathological aspects and prognosis of these tumors in Africa and especially in Côte d'Ivoire. This has prompted us to review 195 cases of MM diagnosed in our laboratories in order to precise their epidemiological and anatomical features. Biopsies and/or surgical specimens fixed in 10% buffered formalin have been studied using the paraffin embedding methods and staining with hematoxylin and eosin, Masson's trichrome and Fontana. 117 men (60%) and 78 women (40%) with a medium age of 57 years were studied. Cutaneous MM were predominant (174 cases, 93%) with 57.8% located on the foot. Non classified (38.2%) and nodular (33.6%) forms were more frequent with only 19% of acral lentiginous melanomas. The prognosis of our cases was poor with 71% of levels IV or V according to Clark and Mihm, Breslow's thickness superior to 3 mm in 93% of cases and ulceration in 91.3%. Our study emphasizes the poor prognosis of MM in Côte d'Ivoire. These tumors are frequent in the elderly and located predominantly on the foot.