[Vascular age and cardiovascular risk in hypertensive patients followed at the heart institute]. / Âge vasculaire et risque cardiovasculaire chez les patients hypertendus suivis à l'institut de cardiologie d'Abidjan.

OBJECTIVE: To calculate the vascular age of hypertensive patients and assess the risk at 10 years of occurrence of an absolute cardiovascular event in outpatient consultation of the Abidjan Heart Institute. PATIENTS AND METHODOLOGY: Cross-sectional study with descriptive and analytical purposes from June 2021 to September 2021, i.e. 4 months in patients at least 30 years of age followed in the outpatient department for arterial hypertension without cardiovascular complications. Data were collected using a questionnaire. We considered the parameters established in the D'Agostino chart for the calculation of vascular age. Each parameter was weighted and the total points obtained corresponded to the vascular age. The cardiovascular risk at 10 years was also obtained from another abacus established by D'Agostino by cross-referencing the total points of each patient with pre-established data. RESULTS: Three hundred hypertensive people were included in this study. The calendar average age was 62.0 ± 10 years with extremes of 30 and 95 years. The gender distribution showed female predominance and there was no significant difference in vascular age by sex. The mean vascular age of all patients was 73.4 ± 9.9 years. The mean difference between actual and vascular age was 11.4 years. Dyslipidemia (p = 0.0002), diabetes (p = 0.0004) and unstandardized BP (p = 0.0000) significantly influenced vascular age. There was no significant difference between smokers and non-smokers (p = 0.1349). All men had a greater than 30% risk of having a cardiovascular accident while women before the age of 35 had no risk. Over the age of 60, almost all patients (both men and women) had a greater than 30% risk of having a cardiovascular accident at 10 years. CONCLUSION: The calculation of vascular age made it possible to assess arterial aging and calculate the probability at 10 years of occurrence of a cardiovascular event. This study also highlights the importance of cardiovascular risk and vascular age assessment for management adaptation and therapeutic education.

Methodology for the objective and rapid determination of the performance criteria of an NH3-NaSCN absorption refrigeration system.

This work is a computer-aided methodological description for the rapid and objective analysis of the performance criteria of an absorption refrigerator. It can be used as a tool for a simulation platform to improve the parameters for the optimal operation of the present system. Sometimes, some of the obstacles of the original method related to the analysis of the performance criteria of absorption machines may come from the number of equations and the complexity of the calculation of NH3 mass fraction of NH3-NaSCN solution. The method consists of a characteristic matrix that allows to quickly determine the NH3 mass fraction of NH3-NaSCN solution in relation to the performance criteria: COP (coefficient of performance), ECOP (exergetic efficiency) and CR (circulation ratio).This could facilitate the algorithm and the direct calculation of NH3 mass fraction of NH3-NaSCN solution in contrast to the original model. For this reason, an easily reproducible flow chart has been proposed.•Transformation of complex mathematical models into easy to code models.•Elaboration of a characteristic matrix for the determination of concentrations.•Development of a platform for the simulation of performance criteria.

[Evolution of epidemiology and management of acute coronary syndromes in Abidjan : A cross-sectional study of 1011 patients.] / Évolution de l'épidémiologie et de la prise en charge des syndromes coronariens aigus à Abidjan : étude transversale de 1011 patients.

BACKGROUND: To assess the evolution of the epidemiology and management of patients hospitalized to Abidjan Heart Institute for acute coronary syndrome (ACS). METHODS: Cross-sectional study comparing two periods: from January 2002 to December 2009 (period 1) and from January 2010 to December 2016 (period 2), including all patients aged 18 years old, admitted to Intensive Care Unit of Abidjan Heart Institute for ACS. RESULTS: One thousand eleven (1011) patients were included among the 6784 patients admitted to Intensive Care Unit of Abidjan Heart Institute for a cardiovascular disease. The overall prevalence of ACS was 14.9%. The prevalence in period 2 was significantly higher than in period 1 (22.6% and 7.3% respectively, p < 0.001). Diabetes (33.5%, p < 0.001) significantly, and smoking (30.7%, p = 0.30) had the largest rises from period 1 to period 2. ST-segment Elevation Myocardial Infarction was the main clinical presentation during both periods. The median time to treatment (p = 0.46) and length of hospital stay (p <0.001) decreased during period 2. Percutaneous coronary intervention (PCI) was performed in 173 patients (22.6%) during the period 2 and 42 patients (5.5%) underwent primary PCI. The rate of fibrinolysis increased significantly between the two periods (9.5%, p <0.001). In-hospital death increased during period 2 (10.4%, p = 0.07). CONCLUSION: The burden of ACS and its related mortality have risen alarmingly past years in Côte d'Ivoire. Healthcare policies should help improve the management and outcomes of patients.

[Burden of comorbidities in heart failure patients hospitalized at the Abidjan Heart Institute]. / Poids des comorbidités chez les insuffisants cardiaques hospitalisés à l'Institut de cardiologie d'Abidjan.

OBJECTIVE: The aim of our work was to appreciate the importance of comorbidities of heart failure individually and globally in patients hospitalized at the Cardiology Institute of Abidjan. PATIENTS AND METHODS: This was a prospective cohort study of adult heart failure patients hospitalized from January to December 2015, and followed up over 12 months. Co-morbidities were analysed through their prevalence, their relationship with the etiologies, and their impact on the prognosis. RESULTS: Three hundred and two patients (mean age: 55.5±16.9 years, 61.6 % male) were recruited. High blood pressure, anaemia and kidney dysfunction were the most common co-morbidities (48 %, 43.7 % and 41.3 % respectively). There was an average of 3.4±1.8 comorbidities per patient with an increase in the number of comorbidities with age (P<0.05) and a more frequent association with hypertensive and ischemic heart disease (P<0.001). During the one-year follow-up, 96 patients died. Apart from hepatic dysfunction (RR=1.97, 95 % CI [1,19-3.25], P=0.008, a high score of Charlson index appeared as a risk factor of death as much in univariate analysis (RR=4.15 95 % CI [2.32-7.41], P<0.001), as in multivariate analysis according to the Cox model (RR=2.48. 95 % CI [1.08-5.09], P=0.03) confirmed by Kaplan Meier curves (P<0.001). CONCLUSION: Comorbidities are common in our heart failure patients and significantly affect their prognosis.

Preliminary study of the social and demographic profile of street food in Côte d'Ivoire: Eaters of garba.

The study aims to establish the sociodemographic profile of consumers of garba (a street food sold in Côte d'Ivoire), understand its frequency of consumption, and develop a typology of its consumers. We interviewed 547 consumers at 10 points of sale. A factorial analysis of the data collected was performed and a decision tree produced for the social and demographic variables, followed by a multiple correspondence analysis (MCA) and then a hierarchical ascending clustering (HAC). Garba is consumed more by men (70.6%), students (42%), and single people (68.2%). The consumers are mainly Christian (51.7%) or Muslims (35.8%). The principal deciding factors explaining the frequency of individual consumption are age, occupation, and marital status. Four classes of consumers are defined according to the socioprofessional category of the individuals. Garba is highly consumed in 47% of cases, moderately consumed in 35.1% of cases and poorly consumed in 17.9%. Garba is frequently consumed by all sociodemographic levels. Its consumers can be divided into four classes. In view of its high frequency of consumption, a study of its nutritional quality is necessary to ensure guarantee consumer health.

Infarctus du myocarde a coronaires saines chez un sujet apres consommation de marijuana

"Introduction. Encore appele ""Cannabis""; la marijuana est la drogue illicite la plus consommee dans le monde avec des effets psychoactifs et medicinaux. Sa consommation peut avoir des consequences gravissimes. L'objectif de ce travail etait de rapporter un cas d'un homme de 32 ans; sans risque cardiovasculaire. Cas clinique et commentaire. Nous rapportons le cas d'un patient de 32 ans; sans facteur de risque cardiovasculaire; admis aux urgences de l'Institut de Cardiologie d'Abidjan pour une douleur thoracique infarctoide prolongee survenue cinq heures auparavant. L'interrogatoire retrouvait une prise de marijuana une heure avant le debut de la douleur. Les elements cliniques et l'electrocardiogramme avaient permis de retenir le diagnostic de syndrome coronarien aigu avec sus-decalage persistant du segment ST. Une revascularisation coronaire par thrombolyse a ete realisee; avec des suites simples. La coronarographie a retrouve des coronaires saines. L'hypothese retenue etait un spasme coronaire prolonge; du a la consommation de marijuana. Conclusion. Ce cas clinique doit attirer l'attention des praticiens et de la population sur les consequences cardiovasculaires possibles inherentes a la consommation de marijuana "

Infarctus du myocarde a coronaires saines chez un sujet jeune apres consommation de marijuana

"Introduction. Encore appele "" Cannabis ""; la marijuana est la drogue illicite la plus consommee dans le monde avec des effets psychoactifs et medicinaux. Sa consommation peut avoir des consequences gravissimes. L'objectif de ce travail etait de rapporter un cas d'un homme de 32 ans; sans risque cardiovasculaire.Cas clinique et commentaire. Nous rapportons le cas d'un patient de 32 ans; sans facteur de risque cardiovasculaire; admis aux urgences de l'Institut de Cardiologie d'Abidjan pour une douleur thoracique infarctoide prolongee survenue cinq heures auparavant. L'interrogatoire retrouvait une prise de marijuana une heure avant le debut de la douleur. Les elements cliniques et l'electrocardiogramme avaient permis de retenir le diagnostic de syndrome coronarien aigu avec sus-decalage persistant du segment ST. Une revascularisation coronaire par thrombolyse a ete realisee; avec des suites simples. La coronarographie a retrouve des coronaires saines. L'hypothese retenue etait un spasme coronaire prolonge; du a la consommation de marijuana. Conclusion. Ce cas clinique doit attirer l'attention des praticiens et de la population sur les consequences cardiovasculaires possibles inherentes a la consommation de marijuana."

[Prevalence of obesity in school children in Ivory Coast]. / Prévalence de l'obésité en milieu scolaire en Côte d'Ivoire.

BACKGROUND: According to the World Health Organization, an increased prevalence of hypertension in children is observed since several years due to an epidemic of childhood obesity. What is the extent of this epidemic in our African context? METHOD: We conducted a prospective descriptive study of pupils encountered in primary and secondary schools of the district of Abidjan from May 3 to June 1st 2010. A sample of 2038 pupils aged 6 to 18 years was randomly selected. Overweight in pupils was assessed by body mass index (BMI). RESULTS: There were 1182 girls (58%) and 856 boys (42%) whose average age was 12.7±3.6 years. The average weight was 42.6kg±16 (range 14.6 to 106.2kg), the average size was 1.48m±0.19 (range 1 to 1.95m). BMI was 17.2kg/m(2)±3.7 (range 14.6-35.7). The prevalence of obesity was of 5%. In addition, 4% of the students were overweight, 39% extremely thin, 25% thin and 27% normal. Obesity was more common in girls (6.8%) than boys (1.8%). The prevalence of obesity in hypertensives was 16%. BMI influenced the systolic and diastolic blood pressure in both sexes (P<0.001 in both cases). CONCLUSION: Childhood obesity exists in a country like the Ivory Coast where wealthness is far from generalized. A well-organized management of childhood obesity is necessary to avoid complications such as hypertension.

Micro-anatomie de la fosse temporale et de la region petroclivale : apport dans la voie intradurale medio temporale de l'Apex Petreux

En raison des complications observees lors des voies transoropharyngee; suboccipitale et extradurale de l'apex petreux; nous proposons a la lumiere d'une etude anatomique et histologique de fosses temporales; une voie intradurale mediotemporale de l'apex petreux. Quinze tetes humaines d'adultes ont ete injectees au latex colore puis dissequees sous magnification optique. Des coupes histologiques ont ete etudiees sur six fosses temporales. Le nerf grand petreux etait des son emergence a la face antero-superieure de la partie petreuse de l'os temporal; engaine par une dure mere propre tres adherente a la face profonde de la dure mere temporale. Il longeait le versant anterieur de l'artere carotide interne horizontale intra petreuse et s'engageait sous le cavum trigeminal. Cette artere decrivait un genou separe de la cochlee de 3;63mm+/-l; 71. La dure mere profonde du cavum trigeminal adherait a la gaine duro-periostee de cette artere sur 5;36 mm en moyenne dans le sens rostrocaudal. L'artere meningee moyenne situee entre dure mere encephalique et dure mere periostee de la fosse temporale; donnait une branche dorsale pour le tiers lateral du ganglion trigeminal. De nombreux lacs veineux basaux ont ete observes sur les fosses temporales entre dure mere encephalique et dure mere periostee. La presence de ces elements anatomiques explique les complications liees aux differentes voies d'acces a la region petroclivale. Ainsi les complications propres a la pharyngotomie posterieure sont l'apanage de la voie transoropharyngee. La voie suboccipitale est limitee en avant par le plan des nerfs craniens. Le decollement de la dure mere temporale; la section de l'artere meningee moyenne et des nerfs petreux que requiert la voie extradurale subtemporal expliquent bien les complications liees a cette voie. La voie intradurale vise a eviter ces complications. Le trigne oculopetroclivotrochleaire est la cle de la petrectomie anterieure en cours intradurale. Des meningiomes petroclivaux ont ete totalement reseques par cette voie avec une faible morbidite post-operatoire