This retrospective study, the first of its kind in Mauritania, was carried out at the military hospital of Nouakchott. We sought to approximate the epidemio-logical, anatomopathological profile of Ear, Nose and Throat...This retrospective study, the first of its kind in Mauritania, was carried out at the military hospital of Nouakchott. We sought to approximate the epidemio-logical, anatomopathological profile of Ear, Nose and Throat (ENT) and cervico-facial (CF) cancers in Mauritania. Over a period of two years, from January 1, 2019 to December 31, 2020, we noted 36 histologically confirmed cases, they represented 15.47% of all patients consulted in ENT and CF cancers affected the age group between 25 and 70 years, the age group most affected was that of 50 and 59 years, with 33.33% of cases. More affected in the proportion of 2 men to women, which can be explained by the risk factors mainly found in men, including smoking. First rank was cancers of the upper aero-digestive tract, the pharyngolarynx in head. Histologically, ENT and CF cancers were dominated by squamous cell carcinomas 78%, well ahead of papillary carcinomas 8% and vesicular thyroid carcinomas 5%, UCNTs, adenosquamous carcinomas and lymphomas each represented 3%.展开更多
The study is to identify trends and levels of antibiotic resistance of some common Gram-negative strains over time. The samples were collected from Vietnam Military Hospital 103 between 2014 and 2019. A total of 405 &...The study is to identify trends and levels of antibiotic resistance of some common Gram-negative strains over time. The samples were collected from Vietnam Military Hospital 103 between 2014 and 2019. A total of 405 <i>Acinetobacter baumannii</i>., 528 <i>Pseudomonas aeruginosa</i>, 741 <i>Escherichia coli</i>, and 352 <i>Klebsiella pneumoniae</i> strains were identified and antimicrobial susceptibility was by Vitek system and Etest method. The multi-drug resistance (MDR) was major proportion of four common bacteria. In particular, there is a tendency to shift from MDR to Extended drug resistance (XDR) or possibly Pan drug resistant (pPDR). <i>A. baumannii</i> had the highest level of antibiotic resistance, namely, carbapenem (61.5% - 82.5%) and cephalosporin (72.7% - 88.7%). <i>P. aeruginosa</i> resisted most of commonly antibiotics, ranging from 50% to 70%. <i>E. coli</i> had a high resistance with antibiotics like ampicillin (87.2% - 97.6%) and the 3rd generation cephalosporins (up to 79.6%). <i>K. pneumoniae</i> resisted carbapenem from 14.7% to 44.4%, and other antibiotics with the higher rate of 40%. The collected data will be a prerequisite for further studies on mechanisms and factors related to antibiotic resistant bacteria, in order to find out a rational and effective using strategy of antibiotics.展开更多
Burn injuries have been and remain a very significant source of mortality and morbidity in low- and middle-income countries. As a country in this category, Ghana, is not exempted. Ghana has a population of 31 Million ...Burn injuries have been and remain a very significant source of mortality and morbidity in low- and middle-income countries. As a country in this category, Ghana, is not exempted. Ghana has a population of 31 Million with only 21 Plastic Reconstructive and Burn surgeons. Moreover, the country can boast of only 3 major Burn centres. This notwithstanding the country in particular and Africa, in general, carries an extraordinary burden of Burn injuries with devastating consequences. Burn data from the 37 Military Hospital were analyzed from March 2018 to September 2019—a period of 18 months. In all, 217 burn cases were seen representing about 2.1% of all trauma and surgical cases. Our burn data analyzed the peculiarities of epidemiology, types of burn, the pattern of injuries, and the outcome of burn care at the 37 Military Hospital. Flame is emerging as the predominant cause of burns, most frequently occurring from the use of Liquid Petroleum Gas. In the pediatric population, however, the most frequent cause of burns is hot water burns. The mortality rate among the burn population was 1.8% (4 mortalities). This paper aims to point out management methods adopted by our unit which helped to improve burn outcomes and to reduce mortality.展开更多
<strong>Introduction:</strong> Coblation<sup>®</sup> is a low temperature-controlled tissue ablation technique widely used in human surgery. Its development in otorhinolaryngology has allo...<strong>Introduction:</strong> Coblation<sup>®</sup> is a low temperature-controlled tissue ablation technique widely used in human surgery. Its development in otorhinolaryngology has allowed a spectacular advance in the management of diseases of the nasal and oral cavities. The objective of our work was to study the indications for radiofrequency in ENT, to describe the technical aspects and to evaluate the results of his practice at the HMO. <strong>Patients and Methods: </strong>This is a retrospective study carried out in the ENT and Head and Neck Surgery department of the Ouakam Military Hospital (MHO) over a period of 3 years (from January 2015 to the end of December 2017), involving 37 patients who received radiofrequency treatment in the ENT sphere. <strong>Results:</strong> The study was carried out on 37 patients. The sex ratio of 0.19. The mean age of the patients was 33.3 years. The indications were dominated by chronic caseous cryptic tonsillitis with or without halitosis with 24 cases (64.9%) followed by recurrent tonsillitis in 5 cases (13.5%) then we have obstructive hypertrophy of the palatal tonsils with syndrome sleep apnea (OSAS) in 4 cases (10.8%) followed by nasal obstruction (hypertrophy of the inferior turbinates) and hypertrophy of the soft palate and uvula in 2 cases (5.4%). The complication rate was 8.1% and dominated by transient dysgeusia in 1 case or 2.7%, uvula edema in 1 case or 2.7% and bleeding in 1 case or 2.7%. The postoperative follow-up was done one week, 1 month, 3 months, 6 months and 12 months after radiofrequency. Volumetric reduction begins to set in from 1 month (62.5%) and becomes maximum in 3 months (74.3%). <strong>Conclusion:</strong> Coblation<sup>®</sup> is a controlled tissue ablation technique at low temperature, patented by ArthroCare<sup>®</sup> Corporation in 1997. Very widespread in human surgery. Its development in otorhinolaryngology was later, but allowed a spectacular advance in the management of diseases of the nasal and oral cavities.展开更多
Urinary tract infection （UTI） remains one of the most common bacterial infections seen in hospitalized patients of all ages. Prevalence of UTIs increases with age and is often accompanied by higher resistance rates....Urinary tract infection （UTI） remains one of the most common bacterial infections seen in hospitalized patients of all ages. Prevalence of UTIs increases with age and is often accompanied by higher resistance rates. The aim of this study was to determine the degree of resistance of most common enterobacterial uropathogens isolated from patients at Central Military Hospital and compare this resistance with the results found by the North America and Europe Study for Monitoring Antimicrobial Resistance Trends （SMART） study during 2009-2010.展开更多
Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and manag...Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and management of foreign bodies in the lower airways. Methodology: This was a descriptive study with retrospective data collection conducted over a 6-year period (January 1, 2014, to December 31, 2019) in the ENT and Head and Neck Surgery Department of Donka National Hospital. Results: We observed a prevalence of 1.79%. The average age was 5.71 years, with a sex ratio of 1.2. However, 82.61% of the cases originated from rural areas. We noted that 78.83% of patients were referred after visiting 1 to 2 healthcare facilities (75.36%). The consultation delay was 3 days. Penetration syndrome was present in 98.56% of cases. The foreign body incidents occurred during play in 54.84% and during meals in 29.09% of cases. Radiographs were performed in 93.9% of cases. Endoscopy was used for both diagnostic and therapeutic purposes in all patients. The foreign bodies were located in the trachea (37.68%), larynx (26.08%), and bronchi (21.73%). Non-organic foreign bodies were predominant (52.17%). Postoperative outcomes were uncomplicated in 95.98% of cases, and the lethality rate was 2.85%. Conclusion: The pathway of patients with foreign bodies in the airways remains unpredictable in our context due to parental hesitations. Early management reduces morbidity and mortality rates.展开更多
The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of...The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of automated external defibrillator are increasing,the likelihood of survival to hospital discharge is no more than 8%.To date,various devices and methods have been utilized in the initial CPR approach targeting to improve survival and neurological outcomes in OHCA patients.The aim of this review is to discuss strategies that facilitate resuscitation,increase the chance to achieve return to spontaneous circulation and improve survival to hospital discharge and neurological outcomes in the prehospital setting.展开更多
Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent compl...Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.展开更多
In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing...In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.展开更多
Background: Zinner syndrome represents a rare congenital malformation of the urinary tract. It comprises a constellation of Wolffian duct anomalies and is almost exclusively encountered as a classic triad of seminal v...Background: Zinner syndrome represents a rare congenital malformation of the urinary tract. It comprises a constellation of Wolffian duct anomalies and is almost exclusively encountered as a classic triad of seminal vesicle cysts, ejaculatory duct obstruction and renal agenesis. Patients can be either asymptomatic or symptomatic. Recently, minimally invasive surgical techniques have emerged, superseding traditional surgery for select symptomatic cases. Our case highlights the finding of a rare clinical syndrome that was incidentally detected during a routine mass screening of military recruits in the Greek Armed Forces.Case presentation: Herein, we present a case of a 19-year-old male who reported having a solitary right kidney when examined in a military training center of Northern Greece. No additional clinical information was available;thus, referral to a tertiary urology department for further investigation ensued. Imaging studies, namely, computed tomography and magnetic resonance imaging, revealed left renal aplasia, multiple left seminal vesicle cysts, and ejaculatory duct obstruction. Laboratory values and urinalysis were within normal range. Semen analysis was significant for cryptozoospermia. Our patient remained asymptomatic during the entire hospitalization. Long-term follow-up was recommended. Nevertheless, he declined further investigation and sought treatment in a private practice setting.Conclusions: This article aims to present the incidental diagnosis of a rare syndrome in a military setting. Population screening conducted in the armed forces permits the identification of undiagnosed diseases that warrant further investigation. To the best of our knowledge, this was the first report of Zinner syndrome in a military recruit and the second case cited of a Greek patient in the published literature. Regular follow-up is the key to timely intervention in conservatively managed cases.展开更多
Background: To explore the relationship between acute stress, social support and sleep disorder in grass-root military personnel, and construct the relational model through structural equation modeling. Methods: A tot...Background: To explore the relationship between acute stress, social support and sleep disorder in grass-root military personnel, and construct the relational model through structural equation modeling. Methods: A total of 2,411 grass-root military personnel were randomly selected by cluster sampling, and administered the Chinese Military Personnel Sleep Disorder Scale, Military Acute Stress Scale and Social Support Rating Scale.Results: The total score of acute stress scale was positively correlated with the total score and factor scores of sleep disorder scale(r=0.209~0.465, P【0.01); The total score of social support scale was positively correlated with the total score of acute stress scale and the total score and factor scores of sleep disorder scale(r=0.356~0.537, P【0.01). The analysis of mediating effects showed that lack of social support partially mediated between acute stress and the factors of sleep disorder. The analysis of structural equation model showed that acute stress not only had a direct effect on sleep disorder(the path coefficient was 0.29, P=0.000), but also on lack of social support(the path coefficient was 0.39, P=0.000); lack of social support had a direct effect on sleep disorder(the path coefficient was 0.48, P=0.000).Conclusions: Acute stress and lack of social support are two significant factors of sleep disorder in grass-root military personnel. Well-established social support could alleviate sleep disorder induced by acute stress. Lack of social support was a partial mediator between acute stress and sleep disorder.展开更多
AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily ad...AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected. RESULTS： The overall prevalence of GSD among this study-population was 5.3%, including 1.7% （n=40） having a single stone, 2.3% （n = 55） having multiple stones, and 1.3% （n = 31） having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age （P〈 0.0001）. Females exhibited a greater prevalence of multiple stones than did males （3.0% vs 1.7%, P= 0.04）. Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD： older age （40-49 years vs 〈40 years, OR= 1.63 [95% CI： 0.76-3.48], 50-59 years vs 〈40 years, OR=4.93 [95% CI： 2.43-9.99], 60-69 years vs 〈40 years, OR = 6.82 [95% CI： 3.19-14.60], ≥70 years vs 〈40 years, OR= 10.65 [95% CI： 4.78-23.73]）, higher BMI （≥27 kg/m^2 vs 〈24 kg/m^2, adjusted OR= 1.74 [95% CI： 1.04-2.88]）, and higher FPG （≥ 126 mg/dL vs 〈110 mg/dL, OR= 1.71, 95% CI： 1.01-2.96）. CONCLUSION： Older age （≥50 years）, obesity （BMI ≥ 27 kg/m^2）, and type 2 diabetes （FPG ≥126 mg/dL） are associated with the prevalence of GSD.展开更多
Because of its simplicity,reliability,and replicability,the Masquelet induced membrane technique(IMT)has become one of the preferred methods for critical bone defect reconstruction in extremities.Although it is now us...Because of its simplicity,reliability,and replicability,the Masquelet induced membrane technique(IMT)has become one of the preferred methods for critical bone defect reconstruction in extremities.Although it is now used worldwide,few studies have been published about IMT in military practice.Bone reconstruction is particularly challenging in this context of care due to extensive soft-tissue injury,early wound infection,and even delayed management in austere conditions.Based on our clinical expertise,recent research,and a literature analysis,this narrative review provides an overview of the IMT application to combat-related bone defects.It presents technical specificities and future developments aiming to optimize IMT outcomes,including for the management of massive multi-tissue defects or bone reconstruction performed in the field with limited resources.展开更多
AIM:To evaluate the performance of the specific French Vittel "Pre-Hospital(PH) resuscitation" criteria in selecting polytrauma patients during the pre-hospital stage and its potential to increase the positi...AIM:To evaluate the performance of the specific French Vittel "Pre-Hospital(PH) resuscitation" criteria in selecting polytrauma patients during the pre-hospital stage and its potential to increase the positive predictive value(PPV) of pre-hospital trauma triage.METHODS: This was a monocentric prospective cohort study of injured adults transported by emergency medi-cal service to a trauma center. Patients who met any of the field trauma triage criteria were considered "triage positive". Hospital data was statistically linked to prehospital records. The primary outcome of defining a "major trauma patient" was Injury Severity Score(ISS) > 16. RESULTS: There were a total of 200 injured patients evaluated over a 2 years period who met at least 1 triage criterion. The number of false positives was 64 patients(ISS < 16). The PPV was 68%. The sensitivity and the negative predictive value could not be evaluated in this study since it only included patients with positive Vittel criteria. The criterion of "PH resuscitation" was present for 64 patients(32%),but 10 of them had an ISS < 16. This was statistically significant in correlation with the severity of the trauma in univariate analysis(OR = 7.2; P = 0.005; 95%CI: 1.6-31.6). However,despite this correlation the overall PPV was not significantly increased by the use of the criterion "PH resuscitation"(68% vs 67.8%).CONCLUSION: The criterion of "pre-hospital resuscitation" was statistically significant with the severity of the trauma,but did not increase the PPV. The use of "prehospital resuscitation" criterion could be re-considered if these results are confirmed by larger studies.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Colorectal cancer represents a major health problem in the </span>...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Colorectal cancer represents a major health problem in the </span><span style="font-family:""><span style="font-family:Verdana;">world today, the 3</span><sup><span style="font-family:Verdana;">rd</span></sup><span style="font-family:Verdana;"> most common cancer and the 2</span><sup><span style="font-family:Verdana;">nd</span></sup><span style="font-family:Verdana;"> in terms of mortality. Despite of the fact that the incidence rate remains the lowest in Africa, it is still a provider of a stronger lethality in most western countries. In Cameroon according to WHO 2018, 421 new cases (4.5% of all cancers) and 451 deaths (4.3% of all cancers) were registered. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> Determine the prognostics factors and the survival of patients suffering from colorectal cancer followed up in Douala. </span><b><span style="font-family:Verdana;">Patients and Method</span></b><span style="font-family:Verdana;">: This was a retrospective cohort study over a period from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2009 to December 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2018. All patients with histo</span><span style="font-family:Verdana;">logically proven colorectal cancer, at the gastroenterological, oncological, </span><span style="font-family:Verdana;">anatomopathological, radiotherapy and surgery Department of Laquintinie and General Hospitals of Douala were included. The data collected were recorded and analyzed by SPSS version 25 and Excel 2016 statistical computer software. Survival was determined by the Kaplan Meier method and the search </span><span style="font-family:Verdana;">for prognostic factors was carried out using the Cox proportional hazards mod</span><span style="font-family:Verdana;">el. The significance level was p = 0.05. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The median survival was 43 months CI: [35,255</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">50,745]. Survival at 1 year, 2 years, 3 years, 4 years and 5 years was 79.6%, 61.5%, 46.3%, 22.6%, 12.2% respectively. In multivariate analysis</span><span style="font-family:Verdana;">,</span><span style="font-family:""><span style="font-family:Verdana;"> the low degree of differentiation (HR = 16.278, p = 0.007), the presence of synchronous metastases or stage IV patients (HR = 42.004;p = 0.011) were independent factors of poor prognosis while curative surgery (HR = 0.172;p = 0.001) was an independent factor of good prognosis. </span><b><span style="font-family:Verdana;">Conclu</span><span style="font-family:Verdana;">sion: </span></b><span style="font-family:Verdana;">In our study, the median overall survival was 43 months and the surviv</span><span style="font-family:Verdana;">al at 1 year, 2 years, 3 years, 4 years and 5 years was respectively;79.6%, 61.5%;46.3%;22.6%;12.2%. The low degree of differentiation and the presence of synchronous metastases were factors of poor prognosis while curative surgery is a factor of good prognosis.展开更多
<strong>Aims:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""><strong> </strong>To determine the cardiovascular and cerebrovascula...<strong>Aims:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""><strong> </strong>To determine the cardiovascular and cerebrovascular prognosis at 5 years of patients who underwent an ischemic stroke in Senegal. <b>Methods:</b> We performed a descriptive, retrospective and exhaustive study conducted at Principal Hospital of Dakar. We included all patients hospitalized at Principal Hospital of Dakar from 2013 to 201</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">9</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> for an ischemic stroke confirmed by a cerebral CT-Scanner or by magnetic resonance imaging, and who survived the acute phase. <b>Results: </b>Overall, one</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">hundred and seventy-one (171) patients were gathered. Ninety-six (96) male patients account for 56.14% and seventy-five (75) female patients account for 43.86%</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">,</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> with a sex</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ratio of 1.28. Patients’mean age was 66.33 ±</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""></span><span style="white-space:normal;font-size:10pt;font-family:;" "="">13.99 years. Twenty-one (21) young patients (12.35%), aged less than 50 years, presented with an ischemic stroke. Myocardial infarction was found in a female patient (0</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">.</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">6%) 3 months after she experienced an ischemic stroke, nine (9) patients (5.29%) underwent a recurrence of the ischemic stroke with a mean recurrence period of 8 months and extremes rang</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ing</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> from 1 to 24 months. Five (5) patients (2.92%) developed dementia with a score less than 28. A 30 years old patient presented with epilepsy 12 months after the ischemic stroke accounting </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">for </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">0.58%. We registered ninety (90) deaths that occurred in a mean period of 24 months ±</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">9.8 after they presented their ischemic stroke, standing for 52.63% amongst which thirty</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">five (35) accounting for 39% were female patients and fifty</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">five patients (55) representing 61% were male patients. Mortality-related factors included: advanced age, past medical history of heart surgery, known </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">as </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">dys</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">lipidemia, physical inactivity, obesity and recurrent ischemic stroke. <b>Conclusion:</b> Long</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">term prognosis of ischemic stroke remains unclear in Senegal. </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">Therefore</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">,</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> a strategy for primary prevention is highly crucial and </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">it </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">requires the control of risk factors in general and that of high blood pressure in particular.</span>展开更多
Background: A reduction in mortality associated with wine drinking compared to beer drinking has been suggested in the past. A recent meta-analysis could not confirm the observed differential effect. Other characteris...Background: A reduction in mortality associated with wine drinking compared to beer drinking has been suggested in the past. A recent meta-analysis could not confirm the observed differential effect. Other characteristics not related to specific components of beer and wine must play a role in the relationship between wine and mortality, thereby explaining the differential protective results.Methods: A military population was selected to investigate the lifestyle differences between beer and wine drinkers. A food-frequency questionnaire was used to register alcohol and food consumption, together with questionnaires for health-related and lifestyle characteristics. Three dietary patterns were characterized by the Healthy Eating Index 2010, the Mediterranean Diet Score and a pattern obtained by principal component analysis.Results: In the multivariate analysis, beer consumption decreased with increasing age, military rank, physical activity and dietary pattern scores. Beer consumption increased with total energy intake and with smoking.Conclusion: Wine consumption was associated with a healthier lifestyle compared with beer consumption. Those differences must be taken into account when relating types of alcoholic beverage consumption with health-related outcomes.展开更多
The objective of the research was to determine the relation between nut consumption and dietary patterns described by Healthy Eating Index, Mediterranean Diet Score and principal component analysis. In a cross-section...The objective of the research was to determine the relation between nut consumption and dietary patterns described by Healthy Eating Index, Mediterranean Diet Score and principal component analysis. In a cross-sectional study, 1852 military men were contacted by mail. Using food-frequency questionnaires, nut consumption was recorded and stratified in weekly versus less than weekly. Three dietary indices were calculated and stratified in quintiles. For principal component analysis, the healthiest dietary pattern rich in fruits and vegetables was selected as Healthy Dietary Pattern. The highest quintiles of Healthy Eating Index, Mediterranean Diet Score and Healthy Dietary Pattern were systematically associated with the highest weekly consumption of nuts. The highest quintiles were also associated with the lowest intake of saturated fat, i.e. between 10 and 12 energy-percent compared with 17 to 19 energy-percent for the lowest quintiles. The mean daily nut consumption was less than 6 g a day, which is beneath the recommended quantity for cardiovascular protection. Nut consumption was associated with the healthiest dietary pattern, independently of the used method to determine the dietary pattern. Regular nut consumption seems to be a component of a cluster of several healthy behaviors.展开更多
<strong>Introduction:</strong> <span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Petroleum ingestion is a health pro...<strong>Introduction:</strong> <span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Petroleum ingestion is a health problem in Africa and can be responsible for significant mortality. </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:Verdana;">Improving the management </span><span style="font-family:Verdana;">of accidental petroleum ingestion in children, describe the socio-demographic</span><span style="font-family:Verdana;"> characteristics, clinical, therapeutic and evolutionary profile of children hospitalized for accidental ingestion of petroleum and identify the factors asso</span><span><span style="font-family:Verdana;">ciated with the occurrence of petroleum pneumopathy. </span><b><span style="font-family:Verdana;">Patients and Me</span></b></span><b><span style="font-family:Verdana;">thods: </span></b><span style="font-family:Verdana;">We conducted a cross-sectional analytical study with retrospective collection from January 2016 to December 2015, </span><i><span style="font-family:Verdana;">i.e.</span></i><span style="font-family:Verdana;"> in 24 months in the Pediatric Intensive Care and Infant Pediatrics departments at the University Hospital of Brazzaville. We included children who accidentally ingested petroleum. The variables studied were epidemiological, clinical, therapeutic, radiological and evolutionary. The statistical tests used were Pearson’s Chi</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> and Odds ratio. The materiality threshold was set at 5%. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 8013 children hospitalized, 78 (1%) had accidentally ingested petroleum, including 49 (62.8%) boys and 29 (37.3%) girls with an average age of 20 months. They were between 13 and 30 months old n = 44 (56.4%). The mothers were between 25 and 35 years old n = 49 (62.8%), no profession n = 31 (39.7%) and secondary </span><span style="font-family:Verdana;">education level n = 49 (62.8%). The mode of ingestion was self-ingestion</span><span style="font-family:Verdana;"> (75.6%). The place of occurrence was the family home (92.3%). The motive of admission was breathlessness n = 59 (75.6%). An auscultation anomaly was noted n = 46 (59%), a pneumopathy n = 43 (55.1%). The treatment consisted of oxy</span><span style="font-family:Verdana;">gen therapy n = 51 (65.4%), antibiotic therapy n = 70 (89.7%). The factors</span><span style="font-family:Verdana;"> associated with the occurrence of a pneumopathy were: maneuvers performed and the existence of a cough. The lethality was 3.8%. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The high frequency of accidental petroleum ingestions in children with an outcome often marked by pulmonary complications and the related case fatality rate requires primary preventive measures that rely on information, communication </span><span style="font-family:Verdana;">for behavior change with an emphasis on careful storage of toxic products </span><span style="font-family:Verdana;">and to refrain from harmful actions when faced with petroleum intoxication.</span></span></span></span>展开更多
Introduction: Hypercalcemia is the most common metabolic complication in myeloma. The aim of this study was to evaluate the management strategy of hypercalcemia in myeloma at the nephrology department of Louis Pasteur...Introduction: Hypercalcemia is the most common metabolic complication in myeloma. The aim of this study was to evaluate the management strategy of hypercalcemia in myeloma at the nephrology department of Louis Pasteur hospital of Chartres. Patients and Methods: We carried a retrospective study of patients treated for myeloma-related hypercalcemia between January 1, 2019 to December 31, 2021. The clinical, paraclinical, therapeutic and evolutive characteristics were studied. Results: Eight patients were included in this study with a median age of 67 years [41 - 85] and a sex ratio (M/F) of 1. A quarter of patients were known with chronic kidney disease. Four patients (50%) had symptoms of hypercalcemia. Biologically, the mean hemoglobin was 9.8 ± 2.7 g/dl, all patients had an acute kidney injury with a mean creatinine level of 364.1 ± 173.3 mmol/l, a mean serum calcium of 3.42 ± 0.59 mmol/l and three quarter of patients had bone lesions. Five patients (62.5%) were rehydrated with a mean volume of saline of 2700 ± 836.7 ml/24h. Seven patients (87.5%) received biphosphonates and none received diuretics. The mean normalization time of the serum calcium was 5 days. Conclusion: Hypercalcemia is frequent in malignancy and represents a poor prognosis factor of the disease. A well-conducted therapeutic strategy allows rapid normalization.展开更多
文摘This retrospective study, the first of its kind in Mauritania, was carried out at the military hospital of Nouakchott. We sought to approximate the epidemio-logical, anatomopathological profile of Ear, Nose and Throat (ENT) and cervico-facial (CF) cancers in Mauritania. Over a period of two years, from January 1, 2019 to December 31, 2020, we noted 36 histologically confirmed cases, they represented 15.47% of all patients consulted in ENT and CF cancers affected the age group between 25 and 70 years, the age group most affected was that of 50 and 59 years, with 33.33% of cases. More affected in the proportion of 2 men to women, which can be explained by the risk factors mainly found in men, including smoking. First rank was cancers of the upper aero-digestive tract, the pharyngolarynx in head. Histologically, ENT and CF cancers were dominated by squamous cell carcinomas 78%, well ahead of papillary carcinomas 8% and vesicular thyroid carcinomas 5%, UCNTs, adenosquamous carcinomas and lymphomas each represented 3%.
文摘The study is to identify trends and levels of antibiotic resistance of some common Gram-negative strains over time. The samples were collected from Vietnam Military Hospital 103 between 2014 and 2019. A total of 405 <i>Acinetobacter baumannii</i>., 528 <i>Pseudomonas aeruginosa</i>, 741 <i>Escherichia coli</i>, and 352 <i>Klebsiella pneumoniae</i> strains were identified and antimicrobial susceptibility was by Vitek system and Etest method. The multi-drug resistance (MDR) was major proportion of four common bacteria. In particular, there is a tendency to shift from MDR to Extended drug resistance (XDR) or possibly Pan drug resistant (pPDR). <i>A. baumannii</i> had the highest level of antibiotic resistance, namely, carbapenem (61.5% - 82.5%) and cephalosporin (72.7% - 88.7%). <i>P. aeruginosa</i> resisted most of commonly antibiotics, ranging from 50% to 70%. <i>E. coli</i> had a high resistance with antibiotics like ampicillin (87.2% - 97.6%) and the 3rd generation cephalosporins (up to 79.6%). <i>K. pneumoniae</i> resisted carbapenem from 14.7% to 44.4%, and other antibiotics with the higher rate of 40%. The collected data will be a prerequisite for further studies on mechanisms and factors related to antibiotic resistant bacteria, in order to find out a rational and effective using strategy of antibiotics.
文摘Burn injuries have been and remain a very significant source of mortality and morbidity in low- and middle-income countries. As a country in this category, Ghana, is not exempted. Ghana has a population of 31 Million with only 21 Plastic Reconstructive and Burn surgeons. Moreover, the country can boast of only 3 major Burn centres. This notwithstanding the country in particular and Africa, in general, carries an extraordinary burden of Burn injuries with devastating consequences. Burn data from the 37 Military Hospital were analyzed from March 2018 to September 2019—a period of 18 months. In all, 217 burn cases were seen representing about 2.1% of all trauma and surgical cases. Our burn data analyzed the peculiarities of epidemiology, types of burn, the pattern of injuries, and the outcome of burn care at the 37 Military Hospital. Flame is emerging as the predominant cause of burns, most frequently occurring from the use of Liquid Petroleum Gas. In the pediatric population, however, the most frequent cause of burns is hot water burns. The mortality rate among the burn population was 1.8% (4 mortalities). This paper aims to point out management methods adopted by our unit which helped to improve burn outcomes and to reduce mortality.
文摘<strong>Introduction:</strong> Coblation<sup>®</sup> is a low temperature-controlled tissue ablation technique widely used in human surgery. Its development in otorhinolaryngology has allowed a spectacular advance in the management of diseases of the nasal and oral cavities. The objective of our work was to study the indications for radiofrequency in ENT, to describe the technical aspects and to evaluate the results of his practice at the HMO. <strong>Patients and Methods: </strong>This is a retrospective study carried out in the ENT and Head and Neck Surgery department of the Ouakam Military Hospital (MHO) over a period of 3 years (from January 2015 to the end of December 2017), involving 37 patients who received radiofrequency treatment in the ENT sphere. <strong>Results:</strong> The study was carried out on 37 patients. The sex ratio of 0.19. The mean age of the patients was 33.3 years. The indications were dominated by chronic caseous cryptic tonsillitis with or without halitosis with 24 cases (64.9%) followed by recurrent tonsillitis in 5 cases (13.5%) then we have obstructive hypertrophy of the palatal tonsils with syndrome sleep apnea (OSAS) in 4 cases (10.8%) followed by nasal obstruction (hypertrophy of the inferior turbinates) and hypertrophy of the soft palate and uvula in 2 cases (5.4%). The complication rate was 8.1% and dominated by transient dysgeusia in 1 case or 2.7%, uvula edema in 1 case or 2.7% and bleeding in 1 case or 2.7%. The postoperative follow-up was done one week, 1 month, 3 months, 6 months and 12 months after radiofrequency. Volumetric reduction begins to set in from 1 month (62.5%) and becomes maximum in 3 months (74.3%). <strong>Conclusion:</strong> Coblation<sup>®</sup> is a controlled tissue ablation technique at low temperature, patented by ArthroCare<sup>®</sup> Corporation in 1997. Very widespread in human surgery. Its development in otorhinolaryngology was later, but allowed a spectacular advance in the management of diseases of the nasal and oral cavities.
文摘Urinary tract infection （UTI） remains one of the most common bacterial infections seen in hospitalized patients of all ages. Prevalence of UTIs increases with age and is often accompanied by higher resistance rates. The aim of this study was to determine the degree of resistance of most common enterobacterial uropathogens isolated from patients at Central Military Hospital and compare this resistance with the results found by the North America and Europe Study for Monitoring Antimicrobial Resistance Trends （SMART） study during 2009-2010.
文摘Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and management of foreign bodies in the lower airways. Methodology: This was a descriptive study with retrospective data collection conducted over a 6-year period (January 1, 2014, to December 31, 2019) in the ENT and Head and Neck Surgery Department of Donka National Hospital. Results: We observed a prevalence of 1.79%. The average age was 5.71 years, with a sex ratio of 1.2. However, 82.61% of the cases originated from rural areas. We noted that 78.83% of patients were referred after visiting 1 to 2 healthcare facilities (75.36%). The consultation delay was 3 days. Penetration syndrome was present in 98.56% of cases. The foreign body incidents occurred during play in 54.84% and during meals in 29.09% of cases. Radiographs were performed in 93.9% of cases. Endoscopy was used for both diagnostic and therapeutic purposes in all patients. The foreign bodies were located in the trachea (37.68%), larynx (26.08%), and bronchi (21.73%). Non-organic foreign bodies were predominant (52.17%). Postoperative outcomes were uncomplicated in 95.98% of cases, and the lethality rate was 2.85%. Conclusion: The pathway of patients with foreign bodies in the airways remains unpredictable in our context due to parental hesitations. Early management reduces morbidity and mortality rates.
文摘The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of automated external defibrillator are increasing,the likelihood of survival to hospital discharge is no more than 8%.To date,various devices and methods have been utilized in the initial CPR approach targeting to improve survival and neurological outcomes in OHCA patients.The aim of this review is to discuss strategies that facilitate resuscitation,increase the chance to achieve return to spontaneous circulation and improve survival to hospital discharge and neurological outcomes in the prehospital setting.
文摘Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.
基金supported by the Research Funds of the Center for Big Data and Population Health of IHM(grant number JKS2022015)the Key Scientific Research Fund of the Anhui Provincial Education Department(grant number2023AH050610)the Anhui Natural Science Foundation(grant number 1808085QH252)。
文摘In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.
文摘Background: Zinner syndrome represents a rare congenital malformation of the urinary tract. It comprises a constellation of Wolffian duct anomalies and is almost exclusively encountered as a classic triad of seminal vesicle cysts, ejaculatory duct obstruction and renal agenesis. Patients can be either asymptomatic or symptomatic. Recently, minimally invasive surgical techniques have emerged, superseding traditional surgery for select symptomatic cases. Our case highlights the finding of a rare clinical syndrome that was incidentally detected during a routine mass screening of military recruits in the Greek Armed Forces.Case presentation: Herein, we present a case of a 19-year-old male who reported having a solitary right kidney when examined in a military training center of Northern Greece. No additional clinical information was available;thus, referral to a tertiary urology department for further investigation ensued. Imaging studies, namely, computed tomography and magnetic resonance imaging, revealed left renal aplasia, multiple left seminal vesicle cysts, and ejaculatory duct obstruction. Laboratory values and urinalysis were within normal range. Semen analysis was significant for cryptozoospermia. Our patient remained asymptomatic during the entire hospitalization. Long-term follow-up was recommended. Nevertheless, he declined further investigation and sought treatment in a private practice setting.Conclusions: This article aims to present the incidental diagnosis of a rare syndrome in a military setting. Population screening conducted in the armed forces permits the identification of undiagnosed diseases that warrant further investigation. To the best of our knowledge, this was the first report of Zinner syndrome in a military recruit and the second case cited of a Greek patient in the published literature. Regular follow-up is the key to timely intervention in conservatively managed cases.
基金supported by the special fund of applied military mental health project of the China, the Prevention and Treatment Centre for Psychological Diseases of PLA in the PLA 102nd Hospital, Public Health Division of Joint Logistics Department of Nanjing Military Command
文摘Background: To explore the relationship between acute stress, social support and sleep disorder in grass-root military personnel, and construct the relational model through structural equation modeling. Methods: A total of 2,411 grass-root military personnel were randomly selected by cluster sampling, and administered the Chinese Military Personnel Sleep Disorder Scale, Military Acute Stress Scale and Social Support Rating Scale.Results: The total score of acute stress scale was positively correlated with the total score and factor scores of sleep disorder scale(r=0.209~0.465, P【0.01); The total score of social support scale was positively correlated with the total score of acute stress scale and the total score and factor scores of sleep disorder scale(r=0.356~0.537, P【0.01). The analysis of mediating effects showed that lack of social support partially mediated between acute stress and the factors of sleep disorder. The analysis of structural equation model showed that acute stress not only had a direct effect on sleep disorder(the path coefficient was 0.29, P=0.000), but also on lack of social support(the path coefficient was 0.39, P=0.000); lack of social support had a direct effect on sleep disorder(the path coefficient was 0.48, P=0.000).Conclusions: Acute stress and lack of social support are two significant factors of sleep disorder in grass-root military personnel. Well-established social support could alleviate sleep disorder induced by acute stress. Lack of social support was a partial mediator between acute stress and sleep disorder.
文摘AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected. RESULTS： The overall prevalence of GSD among this study-population was 5.3%, including 1.7% （n=40） having a single stone, 2.3% （n = 55） having multiple stones, and 1.3% （n = 31） having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age （P〈 0.0001）. Females exhibited a greater prevalence of multiple stones than did males （3.0% vs 1.7%, P= 0.04）. Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD： older age （40-49 years vs 〈40 years, OR= 1.63 [95% CI： 0.76-3.48], 50-59 years vs 〈40 years, OR=4.93 [95% CI： 2.43-9.99], 60-69 years vs 〈40 years, OR = 6.82 [95% CI： 3.19-14.60], ≥70 years vs 〈40 years, OR= 10.65 [95% CI： 4.78-23.73]）, higher BMI （≥27 kg/m^2 vs 〈24 kg/m^2, adjusted OR= 1.74 [95% CI： 1.04-2.88]）, and higher FPG （≥ 126 mg/dL vs 〈110 mg/dL, OR= 1.71, 95% CI： 1.01-2.96）. CONCLUSION： Older age （≥50 years）, obesity （BMI ≥ 27 kg/m^2）, and type 2 diabetes （FPG ≥126 mg/dL） are associated with the prevalence of GSD.
文摘Because of its simplicity,reliability,and replicability,the Masquelet induced membrane technique(IMT)has become one of the preferred methods for critical bone defect reconstruction in extremities.Although it is now used worldwide,few studies have been published about IMT in military practice.Bone reconstruction is particularly challenging in this context of care due to extensive soft-tissue injury,early wound infection,and even delayed management in austere conditions.Based on our clinical expertise,recent research,and a literature analysis,this narrative review provides an overview of the IMT application to combat-related bone defects.It presents technical specificities and future developments aiming to optimize IMT outcomes,including for the management of massive multi-tissue defects or bone reconstruction performed in the field with limited resources.
文摘AIM:To evaluate the performance of the specific French Vittel "Pre-Hospital(PH) resuscitation" criteria in selecting polytrauma patients during the pre-hospital stage and its potential to increase the positive predictive value(PPV) of pre-hospital trauma triage.METHODS: This was a monocentric prospective cohort study of injured adults transported by emergency medi-cal service to a trauma center. Patients who met any of the field trauma triage criteria were considered "triage positive". Hospital data was statistically linked to prehospital records. The primary outcome of defining a "major trauma patient" was Injury Severity Score(ISS) > 16. RESULTS: There were a total of 200 injured patients evaluated over a 2 years period who met at least 1 triage criterion. The number of false positives was 64 patients(ISS < 16). The PPV was 68%. The sensitivity and the negative predictive value could not be evaluated in this study since it only included patients with positive Vittel criteria. The criterion of "PH resuscitation" was present for 64 patients(32%),but 10 of them had an ISS < 16. This was statistically significant in correlation with the severity of the trauma in univariate analysis(OR = 7.2; P = 0.005; 95%CI: 1.6-31.6). However,despite this correlation the overall PPV was not significantly increased by the use of the criterion "PH resuscitation"(68% vs 67.8%).CONCLUSION: The criterion of "pre-hospital resuscitation" was statistically significant with the severity of the trauma,but did not increase the PPV. The use of "prehospital resuscitation" criterion could be re-considered if these results are confirmed by larger studies.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Colorectal cancer represents a major health problem in the </span><span style="font-family:""><span style="font-family:Verdana;">world today, the 3</span><sup><span style="font-family:Verdana;">rd</span></sup><span style="font-family:Verdana;"> most common cancer and the 2</span><sup><span style="font-family:Verdana;">nd</span></sup><span style="font-family:Verdana;"> in terms of mortality. Despite of the fact that the incidence rate remains the lowest in Africa, it is still a provider of a stronger lethality in most western countries. In Cameroon according to WHO 2018, 421 new cases (4.5% of all cancers) and 451 deaths (4.3% of all cancers) were registered. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> Determine the prognostics factors and the survival of patients suffering from colorectal cancer followed up in Douala. </span><b><span style="font-family:Verdana;">Patients and Method</span></b><span style="font-family:Verdana;">: This was a retrospective cohort study over a period from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2009 to December 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2018. All patients with histo</span><span style="font-family:Verdana;">logically proven colorectal cancer, at the gastroenterological, oncological, </span><span style="font-family:Verdana;">anatomopathological, radiotherapy and surgery Department of Laquintinie and General Hospitals of Douala were included. The data collected were recorded and analyzed by SPSS version 25 and Excel 2016 statistical computer software. Survival was determined by the Kaplan Meier method and the search </span><span style="font-family:Verdana;">for prognostic factors was carried out using the Cox proportional hazards mod</span><span style="font-family:Verdana;">el. The significance level was p = 0.05. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The median survival was 43 months CI: [35,255</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">50,745]. Survival at 1 year, 2 years, 3 years, 4 years and 5 years was 79.6%, 61.5%, 46.3%, 22.6%, 12.2% respectively. In multivariate analysis</span><span style="font-family:Verdana;">,</span><span style="font-family:""><span style="font-family:Verdana;"> the low degree of differentiation (HR = 16.278, p = 0.007), the presence of synchronous metastases or stage IV patients (HR = 42.004;p = 0.011) were independent factors of poor prognosis while curative surgery (HR = 0.172;p = 0.001) was an independent factor of good prognosis. </span><b><span style="font-family:Verdana;">Conclu</span><span style="font-family:Verdana;">sion: </span></b><span style="font-family:Verdana;">In our study, the median overall survival was 43 months and the surviv</span><span style="font-family:Verdana;">al at 1 year, 2 years, 3 years, 4 years and 5 years was respectively;79.6%, 61.5%;46.3%;22.6%;12.2%. The low degree of differentiation and the presence of synchronous metastases were factors of poor prognosis while curative surgery is a factor of good prognosis.
文摘<strong>Aims:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""><strong> </strong>To determine the cardiovascular and cerebrovascular prognosis at 5 years of patients who underwent an ischemic stroke in Senegal. <b>Methods:</b> We performed a descriptive, retrospective and exhaustive study conducted at Principal Hospital of Dakar. We included all patients hospitalized at Principal Hospital of Dakar from 2013 to 201</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">9</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> for an ischemic stroke confirmed by a cerebral CT-Scanner or by magnetic resonance imaging, and who survived the acute phase. <b>Results: </b>Overall, one</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">hundred and seventy-one (171) patients were gathered. Ninety-six (96) male patients account for 56.14% and seventy-five (75) female patients account for 43.86%</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">,</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> with a sex</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ratio of 1.28. Patients’mean age was 66.33 ±</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""></span><span style="white-space:normal;font-size:10pt;font-family:;" "="">13.99 years. Twenty-one (21) young patients (12.35%), aged less than 50 years, presented with an ischemic stroke. Myocardial infarction was found in a female patient (0</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">.</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">6%) 3 months after she experienced an ischemic stroke, nine (9) patients (5.29%) underwent a recurrence of the ischemic stroke with a mean recurrence period of 8 months and extremes rang</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ing</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> from 1 to 24 months. Five (5) patients (2.92%) developed dementia with a score less than 28. A 30 years old patient presented with epilepsy 12 months after the ischemic stroke accounting </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">for </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">0.58%. We registered ninety (90) deaths that occurred in a mean period of 24 months ±</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">9.8 after they presented their ischemic stroke, standing for 52.63% amongst which thirty</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">five (35) accounting for 39% were female patients and fifty</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">five patients (55) representing 61% were male patients. Mortality-related factors included: advanced age, past medical history of heart surgery, known </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">as </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">dys</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">lipidemia, physical inactivity, obesity and recurrent ischemic stroke. <b>Conclusion:</b> Long</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">term prognosis of ischemic stroke remains unclear in Senegal. </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">Therefore</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">,</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> a strategy for primary prevention is highly crucial and </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">it </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">requires the control of risk factors in general and that of high blood pressure in particular.</span>
文摘Background: A reduction in mortality associated with wine drinking compared to beer drinking has been suggested in the past. A recent meta-analysis could not confirm the observed differential effect. Other characteristics not related to specific components of beer and wine must play a role in the relationship between wine and mortality, thereby explaining the differential protective results.Methods: A military population was selected to investigate the lifestyle differences between beer and wine drinkers. A food-frequency questionnaire was used to register alcohol and food consumption, together with questionnaires for health-related and lifestyle characteristics. Three dietary patterns were characterized by the Healthy Eating Index 2010, the Mediterranean Diet Score and a pattern obtained by principal component analysis.Results: In the multivariate analysis, beer consumption decreased with increasing age, military rank, physical activity and dietary pattern scores. Beer consumption increased with total energy intake and with smoking.Conclusion: Wine consumption was associated with a healthier lifestyle compared with beer consumption. Those differences must be taken into account when relating types of alcoholic beverage consumption with health-related outcomes.
文摘The objective of the research was to determine the relation between nut consumption and dietary patterns described by Healthy Eating Index, Mediterranean Diet Score and principal component analysis. In a cross-sectional study, 1852 military men were contacted by mail. Using food-frequency questionnaires, nut consumption was recorded and stratified in weekly versus less than weekly. Three dietary indices were calculated and stratified in quintiles. For principal component analysis, the healthiest dietary pattern rich in fruits and vegetables was selected as Healthy Dietary Pattern. The highest quintiles of Healthy Eating Index, Mediterranean Diet Score and Healthy Dietary Pattern were systematically associated with the highest weekly consumption of nuts. The highest quintiles were also associated with the lowest intake of saturated fat, i.e. between 10 and 12 energy-percent compared with 17 to 19 energy-percent for the lowest quintiles. The mean daily nut consumption was less than 6 g a day, which is beneath the recommended quantity for cardiovascular protection. Nut consumption was associated with the healthiest dietary pattern, independently of the used method to determine the dietary pattern. Regular nut consumption seems to be a component of a cluster of several healthy behaviors.
文摘<strong>Introduction:</strong> <span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">Petroleum ingestion is a health problem in Africa and can be responsible for significant mortality. </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:Verdana;">Improving the management </span><span style="font-family:Verdana;">of accidental petroleum ingestion in children, describe the socio-demographic</span><span style="font-family:Verdana;"> characteristics, clinical, therapeutic and evolutionary profile of children hospitalized for accidental ingestion of petroleum and identify the factors asso</span><span><span style="font-family:Verdana;">ciated with the occurrence of petroleum pneumopathy. </span><b><span style="font-family:Verdana;">Patients and Me</span></b></span><b><span style="font-family:Verdana;">thods: </span></b><span style="font-family:Verdana;">We conducted a cross-sectional analytical study with retrospective collection from January 2016 to December 2015, </span><i><span style="font-family:Verdana;">i.e.</span></i><span style="font-family:Verdana;"> in 24 months in the Pediatric Intensive Care and Infant Pediatrics departments at the University Hospital of Brazzaville. We included children who accidentally ingested petroleum. The variables studied were epidemiological, clinical, therapeutic, radiological and evolutionary. The statistical tests used were Pearson’s Chi</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> and Odds ratio. The materiality threshold was set at 5%. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 8013 children hospitalized, 78 (1%) had accidentally ingested petroleum, including 49 (62.8%) boys and 29 (37.3%) girls with an average age of 20 months. They were between 13 and 30 months old n = 44 (56.4%). The mothers were between 25 and 35 years old n = 49 (62.8%), no profession n = 31 (39.7%) and secondary </span><span style="font-family:Verdana;">education level n = 49 (62.8%). The mode of ingestion was self-ingestion</span><span style="font-family:Verdana;"> (75.6%). The place of occurrence was the family home (92.3%). The motive of admission was breathlessness n = 59 (75.6%). An auscultation anomaly was noted n = 46 (59%), a pneumopathy n = 43 (55.1%). The treatment consisted of oxy</span><span style="font-family:Verdana;">gen therapy n = 51 (65.4%), antibiotic therapy n = 70 (89.7%). The factors</span><span style="font-family:Verdana;"> associated with the occurrence of a pneumopathy were: maneuvers performed and the existence of a cough. The lethality was 3.8%. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The high frequency of accidental petroleum ingestions in children with an outcome often marked by pulmonary complications and the related case fatality rate requires primary preventive measures that rely on information, communication </span><span style="font-family:Verdana;">for behavior change with an emphasis on careful storage of toxic products </span><span style="font-family:Verdana;">and to refrain from harmful actions when faced with petroleum intoxication.</span></span></span></span>
文摘Introduction: Hypercalcemia is the most common metabolic complication in myeloma. The aim of this study was to evaluate the management strategy of hypercalcemia in myeloma at the nephrology department of Louis Pasteur hospital of Chartres. Patients and Methods: We carried a retrospective study of patients treated for myeloma-related hypercalcemia between January 1, 2019 to December 31, 2021. The clinical, paraclinical, therapeutic and evolutive characteristics were studied. Results: Eight patients were included in this study with a median age of 67 years [41 - 85] and a sex ratio (M/F) of 1. A quarter of patients were known with chronic kidney disease. Four patients (50%) had symptoms of hypercalcemia. Biologically, the mean hemoglobin was 9.8 ± 2.7 g/dl, all patients had an acute kidney injury with a mean creatinine level of 364.1 ± 173.3 mmol/l, a mean serum calcium of 3.42 ± 0.59 mmol/l and three quarter of patients had bone lesions. Five patients (62.5%) were rehydrated with a mean volume of saline of 2700 ± 836.7 ml/24h. Seven patients (87.5%) received biphosphonates and none received diuretics. The mean normalization time of the serum calcium was 5 days. Conclusion: Hypercalcemia is frequent in malignancy and represents a poor prognosis factor of the disease. A well-conducted therapeutic strategy allows rapid normalization.
