Background: Type 2 diabetes (T2D) remains a major global public health problem. This complex metabolic disorder can lead to various complications, including cardiovascular diseases (leading cause of death) in T2D. Amo...Background: Type 2 diabetes (T2D) remains a major global public health problem. This complex metabolic disorder can lead to various complications, including cardiovascular diseases (leading cause of death) in T2D. Among the biochemical markers associated with increased risk for cardiovascular disease, homocysteine is currently one of the predictive markers under evaluation. We investigate the link between hyperhomocysteinemia and diabetes complications in DT2 population in Brazzaville. Methodology: We conducted a cross-sectional analytical study, from October to December 2022. One hundred and fifty participants were included, 100 patients T2D (34 with complications, 33 with comorbidities, 33 without), and 50 patients controls. Sociodemographic and clinical characteristics were collected. Homocysteine (Hcy) serum levels were measured using Sandwich ELISA method. Results: Study population was composed of 50% males and 50% females with sex ratio of 1;mean age was 52.2 ± 10.8 years (30 - 83). The prevalence of hyperhomocysteinemia (HHcy) was 36% (20% moderate Hcy, 15% intermediate and 1% severe). Mean Hcy concentration was 31.9 μmol/l (18 - 103). Age, gender and physical inactivity were strongly correlated to Hcy (OR of 3.5;9.4 and 3 respectively). Multivariate analysis showed that HHcy was a risk accelerator for degenerative complications (stroke: OR = 6.2;ischemic heart disease: 4.9;neuropathy: 9.2;retinopathy: 4.5 and peripheral arterial disease: 4.9). Conclusion: These findings suggest that hyperhomocysteinemia can be considered as a predictive marker to be taken into account in targeting cardiovascular risk in Congolese subjects with T2D.展开更多
Background: Neurocognitive impairments are common among stroke survivors. Despite their negative impact on daily life, their evolving, and determinants are not fully known in our context. To determine evolving charact...Background: Neurocognitive impairments are common among stroke survivors. Despite their negative impact on daily life, their evolving, and determinants are not fully known in our context. To determine evolving characteristics of post-stroke cognitive impairment in the 3rd month as well as determinants among Kinshasa’s adult survivors is the aim of this study. Methods: We sought to determine neurocognitive deficits in the 3rd month in a prospective single-group cohort study in 3 hospital centers in Kinshasa. Eighty-six adult stroke survivors with a neurological and neuroimaging computerized diagnosis of stroke were assessed using MOCA (Montreal Cognitive Assessment) in the first and the third months post-stroke. Results: Neurocognitive disorders ranged from 79.1% in the first month to 54.7% in the third month after stroke (with 4.7% with severe decline). Gender female [AOR = 86.3 (CI<sub>95%</sub>: 2.8 - 2643.7);p 0.01], Chronic hypertension ([AOR = 26.8 (CI<sub>95%</sub>: 2.55 - 282.55);p 0.01]), the pathological lipid profile [AOR = 8.7 (CI<sub>95%</sub>: 1.10 - 68.82);p = 0.04] and worse MOCA score at the first month ([AOR = 41.2 (CI<sub>95%</sub>: 8.13 - 2134.81);p = 0.021]) were identified as worse predictors of cognitive impairments at the third month post-stroke. Conclusion: Post-stroke cognitive impairment is common and decreases in the 3rd month post-stroke. Chronic hypertension, gender, lipid profile, and the first month MOCA score are predictors of worse cognitive performance in Kinshasa survivors. These findings suggested the role of early management in improving cognition and the control of stroke risk factors.展开更多
Background: The cardiovascular risk factors including type 2 diabetes mellitus (T2DM) are a public health problem in sub-Saharan Africa. The aim of this study is to determine the prevalence and factors associated with...Background: The cardiovascular risk factors including type 2 diabetes mellitus (T2DM) are a public health problem in sub-Saharan Africa. The aim of this study is to determine the prevalence and factors associated with stroke in T2DM patients admitted to the emergency Unit in Brazzaville. Patients and Methods: This is the preliminary findings of a cross-sectional study including patients with T2DM, admitted in Emergency Unit of University Hospital of Brazzaville from January to April 2011. One hundred and seven patients were included. Sex ratio was 1.5. Results: The mean age was 60.3 ± 10.2 years (range 40 - 80 years). Stroke story was noted in 5 cases (4.6%). The main pathologies were metabolic complications (n = 51;47.6%) and cardiovascular diseases (n = 36;33.6%), dominated by stroke (17 cases). Epidemiological factors associated with stroke were high standard living (OR = 3, 95% CI: 1.02 - 8.9, p = 0.03), polypharmacy (OR = 3.7, 95% CI: 1.27 - 10.8, p = 0.01), previous hospitalization (OR = 3.1, 95% CI: 1.07 - 8.9, p = 0.03), and the absence of antiplatelet therapy (OR = 4.2, 95% CI 1.2 to 15, p = 0.03). Clinical associated factors were coma (OR = 3.3, 95% CI 1.14 to 9.6, p = 0.02) and the presence of severe hypertension (OR = 4, 95% CI: 1.2 - 12, p = 0.02). Finally, prognostic factors were the transfer in intensive care unit (OR = 9.8, 95% CI: 2.7 - 34, p 0.001). Conclusion: The first cardiovascular complication in patients with T2DM admitted in emergency at University Hospital of Brazzaville is stroke. Primary prevention in high-risk patients is still inadequate.展开更多
Background and Objective: HIV infection is often associated with HBV and HCV infection, together leading to high morbidity and mortality in developing countries. The objective of this study is to describe the clinical...Background and Objective: HIV infection is often associated with HBV and HCV infection, together leading to high morbidity and mortality in developing countries. The objective of this study is to describe the clinical, biological, immunological and therapeutic profile of patients co-infected with HIV-HBV and/or HCV. Methods: A cross-sectional and descriptive study including 180 people living with HIV (PLWHIV) in the city of Kinshasa province was conducted. Socio-demographic, clinical, biological and serological characteristics were analyzed. Results: The frequency of HIV-HBV/HCV co-infection was 23.9%. The distribution of age and sex of patients did not differ significantly according to co-infection status. The notion of pedicure and manicure was significantly more observed in patients free from viral hepatitis (51.1% versus 32.6%, p = 0.034). The median duration of knowledge of the HIV status which was longer in the co-infected (4 years versus 2 years, p = 0.022). A lower median level of GPT was observed in co-infected compared to other patients (14 IU/L versus 20 IU/L, p = 0.041). Serum albumin (3.1 g/L versus 3.3 g/L, p = 0.034) and prothrombin (58.3% versus 65.6%, p = 0.045) were lower in HIV co-infected-VHB and/or VHC. The median INR was higher in co-infected than in other patients (1.6 versus 1.4;p = 0.009). Patients without therapy Antiretroviral (TARV) medication were more numerous in co-infected (20.9% versus 8.0%, p = 0.025). Conclusions: The profile of PLWHIV was dominated by the presence of pedicures and manicures with high transaminases and without anti-viral treatment.展开更多
文摘Background: Type 2 diabetes (T2D) remains a major global public health problem. This complex metabolic disorder can lead to various complications, including cardiovascular diseases (leading cause of death) in T2D. Among the biochemical markers associated with increased risk for cardiovascular disease, homocysteine is currently one of the predictive markers under evaluation. We investigate the link between hyperhomocysteinemia and diabetes complications in DT2 population in Brazzaville. Methodology: We conducted a cross-sectional analytical study, from October to December 2022. One hundred and fifty participants were included, 100 patients T2D (34 with complications, 33 with comorbidities, 33 without), and 50 patients controls. Sociodemographic and clinical characteristics were collected. Homocysteine (Hcy) serum levels were measured using Sandwich ELISA method. Results: Study population was composed of 50% males and 50% females with sex ratio of 1;mean age was 52.2 ± 10.8 years (30 - 83). The prevalence of hyperhomocysteinemia (HHcy) was 36% (20% moderate Hcy, 15% intermediate and 1% severe). Mean Hcy concentration was 31.9 μmol/l (18 - 103). Age, gender and physical inactivity were strongly correlated to Hcy (OR of 3.5;9.4 and 3 respectively). Multivariate analysis showed that HHcy was a risk accelerator for degenerative complications (stroke: OR = 6.2;ischemic heart disease: 4.9;neuropathy: 9.2;retinopathy: 4.5 and peripheral arterial disease: 4.9). Conclusion: These findings suggest that hyperhomocysteinemia can be considered as a predictive marker to be taken into account in targeting cardiovascular risk in Congolese subjects with T2D.
文摘Background: Neurocognitive impairments are common among stroke survivors. Despite their negative impact on daily life, their evolving, and determinants are not fully known in our context. To determine evolving characteristics of post-stroke cognitive impairment in the 3rd month as well as determinants among Kinshasa’s adult survivors is the aim of this study. Methods: We sought to determine neurocognitive deficits in the 3rd month in a prospective single-group cohort study in 3 hospital centers in Kinshasa. Eighty-six adult stroke survivors with a neurological and neuroimaging computerized diagnosis of stroke were assessed using MOCA (Montreal Cognitive Assessment) in the first and the third months post-stroke. Results: Neurocognitive disorders ranged from 79.1% in the first month to 54.7% in the third month after stroke (with 4.7% with severe decline). Gender female [AOR = 86.3 (CI<sub>95%</sub>: 2.8 - 2643.7);p 0.01], Chronic hypertension ([AOR = 26.8 (CI<sub>95%</sub>: 2.55 - 282.55);p 0.01]), the pathological lipid profile [AOR = 8.7 (CI<sub>95%</sub>: 1.10 - 68.82);p = 0.04] and worse MOCA score at the first month ([AOR = 41.2 (CI<sub>95%</sub>: 8.13 - 2134.81);p = 0.021]) were identified as worse predictors of cognitive impairments at the third month post-stroke. Conclusion: Post-stroke cognitive impairment is common and decreases in the 3rd month post-stroke. Chronic hypertension, gender, lipid profile, and the first month MOCA score are predictors of worse cognitive performance in Kinshasa survivors. These findings suggested the role of early management in improving cognition and the control of stroke risk factors.
文摘Background: The cardiovascular risk factors including type 2 diabetes mellitus (T2DM) are a public health problem in sub-Saharan Africa. The aim of this study is to determine the prevalence and factors associated with stroke in T2DM patients admitted to the emergency Unit in Brazzaville. Patients and Methods: This is the preliminary findings of a cross-sectional study including patients with T2DM, admitted in Emergency Unit of University Hospital of Brazzaville from January to April 2011. One hundred and seven patients were included. Sex ratio was 1.5. Results: The mean age was 60.3 ± 10.2 years (range 40 - 80 years). Stroke story was noted in 5 cases (4.6%). The main pathologies were metabolic complications (n = 51;47.6%) and cardiovascular diseases (n = 36;33.6%), dominated by stroke (17 cases). Epidemiological factors associated with stroke were high standard living (OR = 3, 95% CI: 1.02 - 8.9, p = 0.03), polypharmacy (OR = 3.7, 95% CI: 1.27 - 10.8, p = 0.01), previous hospitalization (OR = 3.1, 95% CI: 1.07 - 8.9, p = 0.03), and the absence of antiplatelet therapy (OR = 4.2, 95% CI 1.2 to 15, p = 0.03). Clinical associated factors were coma (OR = 3.3, 95% CI 1.14 to 9.6, p = 0.02) and the presence of severe hypertension (OR = 4, 95% CI: 1.2 - 12, p = 0.02). Finally, prognostic factors were the transfer in intensive care unit (OR = 9.8, 95% CI: 2.7 - 34, p 0.001). Conclusion: The first cardiovascular complication in patients with T2DM admitted in emergency at University Hospital of Brazzaville is stroke. Primary prevention in high-risk patients is still inadequate.
文摘Background and Objective: HIV infection is often associated with HBV and HCV infection, together leading to high morbidity and mortality in developing countries. The objective of this study is to describe the clinical, biological, immunological and therapeutic profile of patients co-infected with HIV-HBV and/or HCV. Methods: A cross-sectional and descriptive study including 180 people living with HIV (PLWHIV) in the city of Kinshasa province was conducted. Socio-demographic, clinical, biological and serological characteristics were analyzed. Results: The frequency of HIV-HBV/HCV co-infection was 23.9%. The distribution of age and sex of patients did not differ significantly according to co-infection status. The notion of pedicure and manicure was significantly more observed in patients free from viral hepatitis (51.1% versus 32.6%, p = 0.034). The median duration of knowledge of the HIV status which was longer in the co-infected (4 years versus 2 years, p = 0.022). A lower median level of GPT was observed in co-infected compared to other patients (14 IU/L versus 20 IU/L, p = 0.041). Serum albumin (3.1 g/L versus 3.3 g/L, p = 0.034) and prothrombin (58.3% versus 65.6%, p = 0.045) were lower in HIV co-infected-VHB and/or VHC. The median INR was higher in co-infected than in other patients (1.6 versus 1.4;p = 0.009). Patients without therapy Antiretroviral (TARV) medication were more numerous in co-infected (20.9% versus 8.0%, p = 0.025). Conclusions: The profile of PLWHIV was dominated by the presence of pedicures and manicures with high transaminases and without anti-viral treatment.
