Child abuse: an underestimated health problem? A case report from Cameroon.

Physical abuse of children can be of varying nature. Children can be shaken, beaten, burnt, or cut by their parents or guardians. The incidence of trauma inflicted on children is underestimated in many countries, probably because clinical signs are misjudged, as this case report shows. This three-year-old boy was seen in several health facilities of Yaounde, Cameroon. He was treated erroneously for severe malaria and then for meningitis because he presented with neurologic signs, before the diagnosis of child abuse was made. This was confirmed after an imaging work-up revealed fractures of the skull and the leg. The diagnosis was therefore delayed by at least six weeks from the date of the first consultation. This case report demonstrates that child abuse is not well known in our environment, and it is therefore crucial to train those who provide health care to children to recognize it.

Prevalence des anomalies transitionnelles lombosacrees dans une population de sujets camerounais souffrant de lombalgies chroniques

INTRODUCTION :Les vertebres transitionnelles lombosacrees (VTLS) et le spina bifida occulta (SBO) peuvent entrainer des lombalgies en particulier chez des sujets jeunes. Du fait de leur origine genetique; leur distribution pourrait varier en fonction des races ; pourtant leur prevalence demeure largement inconnue en Afrique. OBJECTIFS : Determiner la prevalence des VTLS et du SBO chez des noirs africains souffrant de lombalgie chronique. PATIENTS ET MeTHODES 575 radiographies du rachis lombaire (incidences de face et de profil) de patients noirs africains souffrant de lombalgie chronique ont ete revues a la recherche de VTLS de SBO. Les VTLS ont ete classees selon le systeme de Castellvi. Les proportions d'anomalies par sexe ont ete comparees par le test de Fisher. ReSULTATS L'age median des sujets etait de 44 ans [15 a 80 ans] et le sex ratio femme/homme de 1.03. La prevalence globale des VTLS et du SBO etait de 13;6 et 2;1 respectivement. Les VTLS etaient plus frequentes dans la population masculine avec une predominance du type IIa. La frequence du SBO n'etait pas influencee par le sexe. CONCLUSION :La prevalence de VTLS et de SBO chez le sujet noir africain souffrant de lombalgies est similaire a celles retrouvees dans les series caucasiennes et asiatiques

Revascularization of traumatic renal artery dissection by endoluminal stenting: three cases.

Traumatic injury of renal arteries is rare and can induce renal dysfunction and hypertension. Management options include observation, nephrectomy, surgical repair, and, more recently, percutaneous angioplasty. We report three cases of renal artery thrombosis occurring in young multitrauma patients (mean age 28.7 years) treated with stenting. Immediate satisfactory results were obtained in all cases. Postprocedure anticoagulant and antiplatelet treatment were given according to associated contraindicating lesions. During follow-up, in-stent restenosis occurred in one patient and was treated successfully with a second stenting procedure. No renal dysfunction or hypertension was observed after 28.6 months follow-up. Percutaneous angioplasty is a valuable alternative to surgical treatment in selected patients.