ABSTRACT
OBJECTIVE: to describe the course and the etiologic, prognostic, and therapeutic aspects of effusive pericarditis (EP) in Togo. MATERIAL ANDMETHODS: Prospective and longitudinal study conducted at the cardiology department of Sylvanus Olympio Teaching Hospital of Lome from February 1, 2011, to January 31, 2014, of patients hospitalized for EP, confirmed by Doppler echocardiography. RESULTS: The study included 38 patients. The hospital incidence rate of EP was 2.0%. The mean age was 42.5 ± 14.9 years (range: 16 to 73 years) with a sex ratio of 0.7. Exertional dyspnea, poor general condition, chest pain, and fever were the main symptoms. Pericardial effusion was abundant in 24 patients (63%). The Koch bacillus was identified on direct examination in five patients (13%) and only from sputum. HIV serology was positive in 18 patients (47%). Pericardial fluid was collected from 24 patients (63%). Pathology examinations of pericardial tissue found nonspecific inflammation in 5 patients and pericardial tuberculosis in 7. The causes of EP were: tuberculous (55%), idiopathic (16%), bacterial (8%), HIV-related (5%), uremic (5%), neoplastic (5%), lupus (3%), and rheumatic (3%). CONCLUSION: EFP is a frequent, serious, even deadly disease in Africa because of the HIV-AIDS pandemic. Treatment depends on the cause, most often tuberculosis.
Subject(s)
Pericardial Effusion , Pericarditis , Adolescent , Adult , Aged , Female , Humans , Longitudinal Studies , Male , Middle Aged , Pericardial Effusion/complications , Pericardial Effusion/diagnosis , Pericardial Effusion/etiology , Pericardial Effusion/therapy , Pericarditis/complications , Pericarditis/diagnosis , Pericarditis/etiology , Pericarditis/therapy , Prospective Studies , Togo , Young AdultABSTRACT
AIMS: The aim of the study was to analyze the epidemiologic, clinical and etiologic aspects of heart failures of the young age to 18 to 45 years. PATIENTS AND METHOD: It consisted of a cross-sectional study realized in hospitalization in the service of cardiologic of Teaching Hospital Sylvanus Olympio of Lomé on 35 months (January 2009 to November 2012). The completion of a Doppler echocardiography was necessary to include the patients in the study. RESULTS: The prevalence heart failure in the 45 years old young people to more was of 28.6%. The median age of the patients was of 36.5±3 years with a sex ratio of 10.7. Heart failure was total among 268 patients (71.3%). The electrocardiogram found 88 patients (23.4%) in complete arrhythmia by auricular fibrillation. Cardiac echography found a dilation of the left ventricle among 271 patients (72.1%), a systolic dysfunction of left ventricle among 213 patients (56.6%) and an intracavitary thrombus among 37 patients (9.8%). The etiologies were: hypertension 161 cases (42.8%), heart valve diseases 68 cases (18.1%), the peripartum cardiomyopathy 58 cases (15.4%), dilated cardiomyopathy 22 cases (5.8%), the alcoholism 12 cases (3.1%), ischaemic heart diseases 10 cases (2.7%), congenital heart diseases 10 cases (2.7%), the chronic pulmonary heart 8 cases (2.1%), the cardiothyreosis 7 cases (1.8%), the pericardial tamponnade 4 cases (1.1%) and myocarditis with VIH 4 cases (1.1%). Hospital lethality was of 16.4% (62 patients). CONCLUSION: Heart failure is a serious and frequent pathology in Africa. It affects young and active subjects. The causes are dominated by hypertension.
Subject(s)
Heart Failure , Adolescent , Adult , Age Factors , Cross-Sectional Studies , Female , Heart Failure/diagnosis , Heart Failure/epidemiology , Heart Failure/etiology , Hospitals, Teaching , Humans , Male , Middle Aged , Prevalence , Togo , Young AdultABSTRACT
Africans attach much importance to the fact that their children like to play. A child who is not hungry and refuses to play is not in good health. When a sick child wants to play again one can be sure that his health is improving. Thus, play can be a health indicator and can help to form a diagnosis. Moreover, the way the child plays is a mental health indicator. During games one can distinguish the leaders who are mentally well-balanced, those who try to cheat and who must be carefully watched, and those who are shy and withdrawn. The latter will have difficulties in adapting to a normal social life. The author also discusses what games can be put in the hands of children and rejects all arms such as rifles, guns, pistols or tanks. He ends by recalling that article 7 of the Rights of Children specifies that children must be given every opportunity to play and that games should have an educational value.