Comparison of the repercussions of cLBP in four French-speaking countries.

INTRODUCTION: Sociocultural factors may influence the impact of chronic low back pain (cLBP) on patients. The goal of this study was to compare pain and disability levels, and psychobehavioural parameters in four French-speaking countries in patients with cLBP. METHODS: Two hundred and seventy-eight patients were included: 83 in France, 36 in Morocco, 75 in the Ivory Coast and 84 in Tunisia. Demographic data were collected; pain was assessed using a visual analogue scale (VAS), disability with the Quebec scale, psychobehavioural factors by the hospital anxiety depression scale (HAD), the fear and avoidance beliefs questionnaire (FABQ) and the coping strategy questionnaire (CSQ). A Student t-test was used to compare means. Anova (covariance) was used to test for a "Country Effect", i.e. the incidence of country on outcomes. OUTCOMES: There was no difference in disability levels between countries. A "country effect" was found (p<0.001) for pain (F=2.707), anxiety (F=3.467), depression (F=5.137), fear and avoidance beliefs regarding professional activity (F=1.974) and physical activity (F=5.076), strategy of distraction, dramatization, efforts to ignore pain, prayer, seeking social support and reinterpretation (p<0.01). Pain level was higher in Morocco (p<0.05); anxiety, depression, fear and avoidance beliefs about physical activities were higher in Tunisia (p<0.05) and fear and avoidance beliefs about professional activities were higher in the Ivory Coast (p<0.01). Among the coping strategies used, distraction, dramatization, prayer and search for social support were used more in the Ivory Coast; reinterpretation in Tunisia; seeking social support was less common in France. CONCLUSION: In this population of patients with cLBP, despite similar disability levels across the four French-speaking countries, there were considerable variations in pain level and psychobehavioural repercussions.

[Cerebellum abscess: first demonstration of undiagnosed infective endocarditis in an adult with corrected transposition arteries]. / Abcès du cervelet révélant une greffe oslérienne sur une transposition corrigée des gros vaisseaux chez l'adulte.

Neurological complications occur in approximately 30% of all patients with infective endocarditis and represent a major factor associated with an increased mortality rate. Third of these complications is represented by cerebral embolism, followed by mycotic aneurysm, meningitis or meningoencephalitis. Brain abscesses are rare; their localization to the cerebellum is exceptional. A case of cerebellum abscess occurring in a 34-year-old patient with non-operated corrected transposition of the great arteries is reported. Occurrence of this abscess was the first demonstration of undiagnosed infective endocarditis.