[Sternal tuberculosis: an unusual location of tuberculosis]. / Tuberculose sternale : une localisation inhabituelle de la tuberculose.

INTRODUCTION: Osteo-articular tuberculosis mainly affects the spine. Sternal localization is rare. CASE REPORT: A 43-year-old man, HIV negative and with a history of tuberculous pleurisy, was seen in a pulmonology consultation for abscesses of the chest wall. The thoracic CT scan revealed multiple antesternal and retrosternal abscesses as well as bone lesions in the sternum, ribs and vertebrae. The diagnosis of sternal tuberculosis was made by microscopy and Xpert MTB/RIF test performed on pus from the abscesses. The progress under anti-tuberculous treatment was favourable. CONCLUSION: Sternal involvement with tuberculosis is uncommon and rarely detected. The problem is mainly diagnostic. Its therapy is based on anti-tuberculous treatment.

[Cephalometric characteristics of black African children 3-6 years of age with nasal obstruction]. / Caractéristiques céphalométriques chez l'enfant mélano-africain âgé de 3 à 6 ans avec obstruction du cavum.

OBJECTIVE: To determine the cephalometric craniofacial characteristic of the child with chronic rhinopharyngeal obstruction. MATERIAL AND METHODS: It is about a comparative cross-sectional study with etiologic aiming including children of the 2 sexes, old from 3 to 6 years. The pathological subjects are represented by those presenting a chronic rhinopharyngeal obstruction due to the presence of hypertrophied tonsils (n = 29) and the "normal" subjects, those without any rhinopharyngeal obstruction (n = 30). Lateral cephalometric radiographs were obtained for each subject. The conventional landmarks were determined with the subject's head in neutral position. The two groups underwent cephalometric measurements. The cephalometric analysis was made starting from conventional landmarks resulting from soft tissues and osseous structures. Various statistical tests (test t of student, test of Kruskal Wallis, test of Mann-Whitney) were used for the exploitation of the cephalometric data. RESULTS: On the skeletal level, the length of the posterior cranial base was shorter at the pathological subjects than at the healthy subjects. Concerning the mandible, the height of the ramus and the length of the mandibular corpus are also weaker at the pathological subjects than at the witnesses. The hyoid bone is further away from the 3rd cervical vertebra and the craniocervical angle is more open at the pathological subjects, representing a modification of the slope of the cervical column. On the level of the rhinopharyngeal space, the average distances from the posterior nasal spine at the posterior edge of the rhinopharyngeal space and between the posterior nasal spine and the posterior base of the base of cranium are respectively of 19,43 +/- 4,78 mm and 37,56 +/- 2,95 mm. These measurements are not significantly different from those described in the literature. CONCLUSION: Our study highlighted skeletal modifications in children presenting a rhinopharyngeal obstruction. Even if they do not justify all the symptoms met, these modifications can represent a readjustment of the pharyngeal corridor aiming at facilitating the flow of airflow.

[Cranio-cervical posture and hyoid-mandibular-pharyngeal equilibrium in the presence of factors related to respiratory dysfunction]. / Posture crânio-cervicale et equilibre hyo-mandibulo- pharyngien en présence de facteurs liés a la dysfonction respiratoire.

AIM: The goal of this study is to know the modifications of the cranio-cervical posture which accompany the functional anomalies by the nasal breathe of black African children. MATERIAL AND METHOD: The study consists of a cephalometric comparison. Sixteen parameters measured on cephalograms of 98 schoolboys from 6 to 15 years were used. The children were divided into two groups according to their usual mode of breathing: 50 mouth-breathing children and 48 nasal breathers. The mode of breathing used three clinical tests: the mirror test, Rosenthal test and nasal reflex. RESULTS: The results show a significant difference of slope the cervical column between the two groups of children (t student). The oral breathers have the rhinopharyngeal airway dimensions more narrowed. The hyoid bone is more distant of the epiglottis and the mandible is more divergent. However, factor analysis of cephalometric variables suggested that craniocervical angulation (C2C4/SN) is independent of the other variables in oral breathers. Its dependence with is clear in nasal breathers. CONCLUSION: The children with predominantly mouth breathing exhibent a cranio-cervical hyperextension which could not closely be associated hyo-mandibulo-pharyngeal equilibrium.

[Treatment of class I malocclusion with severe dento-maxillary dysharmony in the permanent dentition of young black African patients]. / Traitement de la malocclusion de classe i avec dysharmonie dento-maxillaire severe chez le jeune patient Africain melanoderme en denture permanente.

Class I malocclusion with severe dental crowding can constitute a serious psychosocial and functional damage among young patients; from where orthodontic importance of the treatment. In the present study the authors present the treatment of two clinical cases whose initial problems are similar. They are two cases of class I malocclusion but whose certain diagnosed clinical factors have constrained in a case to control to the maximum anchoring on the level of the molars and in the other to control the dental axes. The final results are satisfactory because of the restoration of a physiological occlusion. Concomitantly we obtain a clear improvement of the smile.

[Cephalometric study of cranio-facial growth of 902 Black African children and adolescents aged 8 to 20]. / Etude céphalométrique de la croissance crânio-faciale de 902 enfants et adolescents mélano-africains agés de 8 a 20 ans.

Cephalometric studies of the growth are numerous and represent a contribution to the field of the anthropological knowledge of the stages of the cranio-facial growth and for a better adaptation of the orthodontic treatments. However, in Black Africa people there are very few studies of this kind. The purpose of this investigation is to analyze the growth of the cranial base, the maxillary skeletal region and mandibular skeletal region at the young African subjects. The sample of study consists of 386 girls and 516 boys in period of growth, old from 8 to 20 years, presumedly orthomorphic and having lateral cephalometric radiograph in occlusion. The statistical analysis of the data recorded on the layouts cephalometric (test U of Mann Whitney) announces the existence of a sexual dimorphism which is strongly significant around 9 years, 11 years and 17 years. Maxilla and mandible present different rates of growth while remaining active up to 20 years but the growth of the base of cranium seems to be stabilized earlier, after 11 years. The taking into account of these morphological variations are determining for the conduit of treatments more stable and adapted to our populations.

[Prevalence of rhino-pharyngeal disease in the presence of malocclusion in school children in the village of Abidjan]. / Prévalence des affections rhino-pharyngées en présence d'anomalie orthodontique chez les enfants scolarisés de la ville d'Abidjan.

An epidemiological survey of randomly selected school children led to Abidjan in three public schools made it possible to determine the prevalence of the rhinopharyngeal diseases in presence of malocclusions. It is an exploratory study jointly undertaken by two teams of specialists in ORL and Orthodontics within a sample of African schoolchildren old of 5 to 21 years. The results showed the presence of malocclusions in 73.30% of the cases (N = 220). The rhinopharyngeal diseases account for 38.3% (N = 115). At the subjects carrying a malocclusion the rhinopharyngeal diseases are 48.30% and they are dominated by the allergic chronic rhinitis (40%) followed obstructive hypertrophic tonsillitis (16.5%). However, these states which cause certainly a nasal obstruction involving an oral breathing do not cause inevitably malocclusion. We cannot thus affirm unambiguous a bond between malocclusions and rhinopharyngeal diseases (p > 0.05). They are nevertheless as many indications to question the patient on other symptoms and to refer to an ORL specialist. Our investigation being limited to the occlusal study, it seems essential to us to continue these analyses to detect the possible predisposition of certain patients to develop dento-skeletal anomalies in the presence of rhinopharyngic diseases.

[Quantification of initial malocclusion according to the mode of breathing in black African children]. / Quantification de la maloclusion initiale en fonction du mode de respiration chez l'enfant africain melanoderme.

The relations between the mode of breathing and the development of the malocclusions were the subject of many studies causing polemic sometimes (2, 3, 7, 9, 20). In fact the impact of the mode of breathing on occlusion is not clarified yet. The goal of this study is to quantify the dental characteristics, which constitute the malocclusion according to the mode of breathing. 100 African melanoderme children old from 6 to 15 years were subjected to a rhinologic evaluation based on the nostril reflex of GUDIN and the test of ROSENTHAL (12). Of this examination these children were left again in a group of 50 nasal respirators and in another group of 50 mouth breathers. Each child underwent a radiographic examination which was used to make a cephalometric analysis and a meeting of catch of dental prints. The statistical analysis of the data recorded on the dental casts and the layouts cephalometric (test t of student) indicate that the mode of breathing is not associated standard initial malocclusion. But, when the facial divergence, which is characteristic of mouth breathing increases, the initial malocclusion becomes significant.

[The aging face in Black Africans]. / Senescence faciale chez le Negro-Africain.

The face is the part of the human body that most reflects external marks of time. The change of this region concerns the body support as well as the musculo-cutaneous surface. In this survey, we have described its evolution during the life, in the Black African, particularly on the esthetical plane.

[Evaluation of the facial esthetics in an Ivory Coast population]. / Appreciation de l'esthetique faciale dans une population ivoirienne.

Nowadays aesthetic standards reflect a generalisation of western ones. We propose to outline an aesthetic concept about Ivorian face. A selected jury will have to judge fifty-three Ivorian faces, through photographs and also, we'll make the cephalometric analysis of flabby and osseous tissues. We expect then, to provide orthodontists with basic references whenever they have to establish treatment objectives, for Negro-African, (particularly Ivorian), patients with facial disharmony evaluated according to western norms.

[Treatment of protruding upper incisors using the Hawley appliance]. / Le traitement de la proalveolie incisive superieure par la plaque de Hawley.

Early treatment of upper protrused incisors prevents these teeth from traumatism. The plate of HAWLEY, properly used, is recognised for the correction of this malocclusion.

[Ivorian typology: study of the crown dimensions of the first permanent molar]. / Typologie ivoirienne: etude des dimensions coronaires de la premiere molaire permanente.

A dental morphology study is of great importance because it allows norms to be established which are adapted to the Ivorian situation. After a study of the canal morphology, we became involved in a study of the canal dimensions of the first permanent molars amongst Ivorian children. As a part of the 260 mouldings taken from 67 boys and 63 girls, we measured the following diametres: the diametre masio-distal (O-M-D) taken between the edge of the mesial bone and the edge of the distal bone. the biggest vestibulo-lingual coronary diametre (OV-LC). the diametre of the vestibulo-lingual at the level of the occlusal table (OV-LC). The data collected allowed us to reach the following conclusions: the first secondary molar with a M-D diametre (10.64 mm) is more important than the M-D diametre of its homologeous upper (10.15). however there is no significant difference between the OV-LC diametre of the first maxillary molar and that of the first mandibular molar. concerning the M-D or V-L diametres, the difference between the left side of the maxillary as with the mandibular is negligble. It's worth noting that the first permanent molar is smaller for girls when compared to boys, as well as their M-D diametres compared to their V-L. A comparative study between the TALLEC and MARSEILLIER plates showed that: the first upper molar for Ivorian children has a M-D diametre practically identical to that of European children, however the V-L and OV-LC diametres are smaller. the first bottom molar slightly bigger in all M-D and V-L diametres in Ivorian children in comparison to European children.

[Current dental practice in Ivory Coast. Study of population attitudes to oral health and oral health services]. / La pratique courante de la chirurgie dentaire en milieu ivoirien. Etude des attitudes de la population a l'égard de la santé bucco-dentaire et des services de santé bucco-dentaire.

The buccodental health in Africa is distinctive because of the weakness of substructure to supply the needs in dental cure. This study shows how the ivoirians take interest in buccodental care and health care. It notifies that: Firstly, patients only make an appointment with the dentist particularly when advanced lesions occur (92.76% of cases) as unbearable painful affections (acule pulpal inflammatory, phoenix abscess); bulky cellulitis. Secondly, they are inclined not to show up for their appointment, when painful symptoms disappear. Consequently the author recommend some therapeutic acts.

[Cartography of fluoride in the Ivory Coast (partial study)]. / Cartographie du fluor en Cote D'Ivoire (etude partielle).

The authors report on a study done in the Côte d'Ivoire, about the amount of fluoride in drinking water. The cartography of fluoride shows amounts lower than 0.7 ppm. This small amount of fluoride partially explains the increase in the number of dental caries in the Côte d'Ivoire.

[Caries of the first permanent molar in Ivory Coast children]. / A propos de l'atteinte carieuse de la premiere molaire permanente-au sein d'une population infantile ivoirienne.

The authors study dental decay in the first permanent molar among school children in Dimbokro (Côte d'Ivoire). The study, carried out on 1050 children aged between 7 to 16, revealed a low CAO index but a frequency index greater than 50%.

[A comparative study of the occlusal surface of the mandibular 1st and 2nd premolar in Ivory Coast]. / Etude comparative des tables occlusales des 1ere et 2eme premolaires mandibulaires en milieu ivoirien.

The first mandibular premolars are usually described as teeth with disproportionate cusp. The vestibular's is bulkier and higher than the lingual one. This study confronts this description with the clinical realities observed in Ivory Coast by comparing first mandibular premolars with the seconds. It points out: a slight difference of volume between the first and second mandibular premolars a less important disproportion between the lingual and vestibular cusp of the first mandibular premolar which morphology tends towards the second's.

[Ocular manifestations in rheumatoid arthritis: 24 cases in Abidjan]. / Manifestations oculaires au cours de la polyarthrite rhumatoide: a propos de 24 cas vues a Abidjan.

OBJECTIVE: Determine the prevalence and the main ocular manifestations in rheumatoid arthritis in Abidjan. PATIENTS AND METHODS: Prospective and descriptive study of 24 patients with rheumatoid arthritis fulfilling the criteria of the American College of Rheumatology, views from September 2003 to August 2004 in department of rheumatology at the University Hospital of Cocody. The patients performed an eye examination including: visual acuity examination at the slit lamp, ocular fundus, color vision and visual field. RESULTS: Ocular manifestations were observed in 9 of 24 patients representing a prevalence of 37.5%. There were 03 cases of decreased visual acuity, 03 cataract, 02 keratitis cases and 01 cases of anterior uveitis. No fundus abnormality in color vision and visual field was highlighted. These manifestations were found between 5 and 10 years (04 cases) and after 10 years (05 cases) of evolution of the disease. The term rheumatoid arthritis influenced the occurrence of ocular manifestations (P = 0.00). CONCLUSION: Ocular manifestations in rheumatoid arthritis are rare in our practice and were mainly affected by visual acuity, annexes and anterior segment of the eye.

OBJECTIF: Déterminer la prévalence et les principales manifestations oculaires au cours de la polyarthrite rhumatoïde à Abidjan. PATIENTS ET MÉTHODE: Etude prospective descriptive de 24 polyarthrites rhumatoïdes répondant aux critères de l'American College of Rheumatology, vues de Septembre 2003 à Août 2004 au service de rhumatologie du CHU de Cocody. Les patients ont effectué un examen ophtalmologique comprenant: acuité visuelle, examen à la lampe à fente, fond d'œil, vision des couleurs et champ visuel. RÉSULTATS: Les manifestations oculaires étaient observées chez 9 des 24 patients soit une prévalence de 37,5 %. Il s'agissait de 03 cas de baisse de l'acuité visuelle, 03 cas de cataracte, 02 cas de kératite et 01 cas d'uvéite antérieure. Aucune anomalie au fond d'œil, à la vision des couleurs et du champ n'a été mise en évidence. Ces manifestations ont été découvertes entre 5 et 10 ans (04 cas) et après 10 ans (05 cas) d'évolution de la maladie. La durée de la polyarthrite rhumatoïde influençait la survenue des manifestations oculaires (P=0,00). CONCLUSION: Les manifestations oculaires au cours de la polyarthrite rhumatoïde sont peu fréquentes dans notre pratique et étaient principalement des atteintes de l'acuité visuelle, des annexes et segment antérieur de l'œil.

Manifestations oculaires au cours de la polyarthrite rhumatoide: a propos de 24 cas vues a Abidjan

Objectif : Determiner la prevalence et les principales manifestations oculaires au cours de la polyarthrite rhumatoide a Abidjan. Patients et Methode : Etude prospective descriptive de 24 polyarthrites rhumatoides repondant aux criteres de l'American College of Rheumatology; vues de Septembre 2003 a Aout 2004 au service de rhumatologie du CHU de Cocody. Les patients ont effectue un examen ophtalmologique comprenant: acuite visuelle; examen a la lampe a fente; fond d'oil; vision des couleurs et champ visuel. Resultats : Les manifestations oculaires etaient observees chez 9 des 24 patients soit une prevalence de 37;5 . Il s'agissait de 03 cas de baisse de l'acuite visuelle; 03 cas de cataracte; 02 cas de keratite et 01 cas d'uveite anterieure. Aucune anomalie au fond d'oil; a la vision des couleurs et du champ n'a ete mise en evidence. Ces manifestations ont ete decouvertes entre 5 et 10 ans (04 cas) et apres 10 ans (05 cas) d'evolution de la maladie. La duree de la polyarthrite rhumatoide influencait la survenue des manifestations oculaires (P=0;00). Conclusion : Les manifestations oculaires au cours de la polyarthrite rhumatoide sont peu frequentes dans notre pratique et etaient principalement des atteintes de l'acuite visuelle; des annexes et segment anterieur de l'oeil

La hernie discale lombaire au CHU de Cocody (Abidjan): aspects epidemiologiques; cliniques; radiologiques et therapeutiques

Objectif : Decrire les caracteristiques epidemiologiques; cliniques; radiologiques et therapeutiques des hernies discales lombaires vues en hospitalisation rhumatologique a Abidjan.Patients et methode : Etude retrospective descriptive sur 7 ans menee au service de Rhumatologie (unite d'hospitalisation) du CHU de Cocody portant sur 39 dossiers. Ont ete inclus tous les dossiers de patients ayant une hernie discale lombaire de diagnostic scannographique. Une fiche d'enquete a permis de recueillir les donnees epidemiologiques; cliniques; radiologiques et therapeutiques. Resultats : La frequence hospitaliere de la hernie discale lombaire etait de 4;1 par rapport a l'ensemble des pathologies lombaires (948 cas). Elle predominait chez l'adulte masculin (56;4) ages de 49 ans en moyenne. Les patients provenant du secteur informel (commercants; ouvriers; cultivateurs.) predominaient (30;8). Ils rapportaient des antecedents douloureux lombaires (82;1). La hernie discale lombaire se manifestait par une lombosciatalgie (82;1) hyperalgique de trajet monoradiculaire L5 (38;9) ou S1 (30;6). La radiographie standard montrait un pincement discal (56;4). Elle etait normale dans 15;4 des cas. La tomodensitometrie lombaire revelait la predominance des formes posteromedianes (30;8) et posterolaterales (25;6). La strategie therapeutique etait basee sur le traitement medicamenteux (89;7) et physique. La neurochirurgie etait indiquee dans 10;3 des cas. Conclusion : La hernie discale lombaire est peu frequente en hospitalisation rhumatologique a Abidjan. Elle s'exprime par un syndrome lomboradiculaire hyperalgique et est dominee par les formes postero-medianes et postero-laterales. Le traitement conservateur est le plus souvent indique. La lutte contre la baisse de productivite passe par la prevention par l'ecole du dos