[Assessment at distance of a self-measurement of blood pressure education program: The PEA]. / Évaluation à distance d'un programme d'éducation à l'automesure tensionnelle en Guadeloupe : le PEA.

Current recommendations advocate self-measurement of blood pressure (SMBP) for the diagnosis and monitoring of high blood pressure (HBP). The "PEA" is an education program of the HTA GWAD network. Its mission is to train hypertensive patients with SMBP. The objective of this study is to evaluate between 6 months to 1 year after the efficiency of this program on the theoretical and practical knowledge of patients, as well as their behavior towards hypertension. Hundred and twenty patients were included in the study. In an interview, their knowledge was assessed using a questionnaire. The acquisition of the technique, reading and figures transcription, purchase of a SMBP device were also evaluated. The average questionnaire score was 5.7/13 (σ=2.7) before the educational session, 9.5/13 (σ=1.9) 1 week after the educational session. This improvement persisted over time with 8.9/13 (σ=2.9) correct answers 6 months to 1 year later. Exactly 73.3% (n=88/120) had a self-measurement device. Among them, 44.3% (n=39/88) practiced SMBP before medical consultations and 10% systematically did it before each medical consultation. A number of 84.2% (n=101/120) mastered the technique and 76.7% (n=92/120) of patients knew how to transcribe figures. Reading and understanding figures were acquired by 61.7% (n=74/120) of patients. A high level of education was correlated with a high level of practice. PEA is a sustainable solid and stable education program. However, the practice of SMBP is not yet systematic and remains to be encouraged in some patients. Given this situation, the network offers improvements in its program: highlighting of objectives, calendar reminder, "coaching" nurse.

[Hypertension and cardiovascular risk associated with obstructive sleep apnea in adult in Guadeloupe (French West Indies)]. / Hypertension artérielle et risque cardiovasculaire associés au syndrome d'apnées obstructives du sommeil chez l'adulte en Guadeloupe.

BACKGROUND AND PURPOSE: In Guadeloupe, data on the relationships between arterial hypertension and obstructive sleep apnea are unavailable. The aim of this study was: to assess the frequency of hypertension and non-dipper pattern evaluated by 48-hour ambulatory blood pressure monitoring in an adult population identified obstructive sleep apnea/non-obstructive sleep apnea during overnight polygraphy ; to determine the cardio-metabolic factors associated with obstructive sleep apnea. DESIGN AND METHOD: A cross-sectional study was realized at Pointe-à-Pitre Hospital. Patients were referred for suspected sleep apnea to sleep specialist and performed a nocturnal polygraphy. Diagnosis was confirmed if the apnea-hypopnea index was ≥ 5. We obtained two groups: sleep apnea/non-sleep apnea. All patients underwent 48-hour ambulatory blood pressure monitoring. The cardio-metabolic factors were identified and assessed (fasten level of hs-CRP and Homa-IR index). RESULTS: A total of 204 patients were included. Mean age at diagnosis was 54 ± 10 years, 63% were women. OSA was present in 69.6% with a higher frequency in men than in women. Difference was not significant between the two groups for hypertension frequency (84.5% vs 77%; P=0.22), non-dipper pattern (77.5% vs 76%; P=0.79) and hs-CRP. Differences for age, snoring, body max index, mean waist circumference, Homa-IR index, obesity, dyslipidemia, and type 2 diabetes were significant. CONCLUSIONS: Our data highlight raised frequency of cardiovascular metabolic factors in patients with obstructive sleep apnea and confirm their high cardiovascular risk.

[Arterial pressure and urinary excretion of albumin in adults with sickle cell disease]. / Pression artérielle et excrétion urinaire d'albumine chez les patients drépanocytaires adultes.

OBJECTIVE: The increase of urinary albumin excretion could be associated with morbidity in patients with sickle cell disease. The objective of this study was to evaluate the relation between blood pressure and urinary albumin excretion, and to estimate the prevalence of hypertension according to the level of urinary albumin excretion. METHODS: A cross-sectional study was carried in 77 patients with sickle cell disease (48 patients with haemoglobin SS, 29 with haemoglobin SC) et 30 controls with haemoglobin AA. The patients with sickle cell disease were divided into 3 groups according to urinary albumin excretion: less than 30 mg daily (group I: normoalbuminuria); from 30 to 300 mg daily (group II: microalbuminuria); above 300 mg daily (group III: macroalbuminuria). All AA selected controls had normoalbuminuria (group IV). RESULTS: In normoalbuminuric patients, the average of blood pressure was significantly lower in patients with sickle cell disease than in controls (respectively 115.0 +/- 8.1 vs 132.1 +/- 15.1, p = 4.10(-6) for systolic pressure and 67.2 +/- 8.0 vs 78.8 +/- 9.8 mmHg, p = 10(-4) for diastolic pressure). There was a positive relation between urinary albumin excretion, even moderate (values < or = 300 mg daily) and blood pressure in SS patients (r = 0.40, p < 0.02 for systolic and r = 0.54, p < 0.01 for diastolic pressure) and in SC patients (r = 0.74, p < 0.001 and r = 0.58, p < 0.01). The prevalence of hypertension was 0% in group I, 25% in group II and 66% in group III. CONCLUSION: The positive association between blood pressure and urinary albumin excretion suggests that the latter should be taken into account in sickle cell disease's follow up.

[Genital Schistosoma mansoni bilharziasis in women: apropos of 2 cases in Guadeloupe]. / Bilharziose génitale de la femme à Schistosoma mansoni: à propos de deux cas en Guadeloupe.

Schistosoma mansoni is the only cause of bilharziasis in Guadeloupe (French West Indies). Ectopic ovarian and endometrial involvement is rare with only one case of bilharziasis of the endometrium having previously been described in the literature. This report describes two cases of Schistosoma mansoni bilharziasis revealed by genital tract involvement. In one case involvement was endometrial and led to metrorrhagia. Histological examination of the biopsy sample obtained by curettage of the endometrium demonstrated the presence of eggs with lateral spurs. In the other case ovarian involvement was detected during assessment for associated infertility and chronic pelvic pain. Celioscopic examination showed pelvic and perihepatic adhesions secondary to sexually transmissible infection. Histologic examination of an ovarian growth demonstrated the presence of Bilharzia eggs. Both patients underwent antiparasitic treatment using oxamniquine (Vansil) which led to the resolution of metrorrhagia in the first case.