Efficacité du Dakin Cooper Stabilisé® dans la prise en charge des plaies drépanocytaires

Objectif : Apprécier l'efficacité et la tolérance du Dakin Cooper Stabilisé® dans le traitement des plaies drépanocytaires.Patients et méthodes : Il s'agit d'une étude prospective descriptive sur 35 patients, ayant des plaies drépanocytaires, recrutés au centre de Dermatologie de Treichville (Abidjan, Côte d'Ivoire) de janvier 2010 à déceRésultat : La douleur a disparu chez 91,4% des patients, une semaine après le début du traitement. La guérison est survenue chez 80% des patients après six semaines.Conclusion : Le Dakin Cooper Stabilisé® est efficace en six semaines dans le traitement des plaies drépanocytaires et est bien toléré

Severe road traffic injuries in Kenya, quality of care and access

Background: Road traffic injuries (RTI) are on increase in developing countries. Health care facilities are poorly equipped to provide the needed services. Objective: Determine access and quality of care for RTI casualties in Kenya. Design: Cross-sectional survey Setting: 53 large and medium size private; faith-based and public hospitals. Participants: In-patient road traffic crash casualties and health personnel in the selected hospitals were interviewed on availability of emergency care and resources. Onsite verification of status was undertaken. Results: Out of 310 RTI casualties interviewed; 72.3; 15.6and 12.2were in public; faith-based and private hospitals; respectively. Peak age of the injured was 15-49 years. First aid was availed to 16.0of casualties. Unknown persons transported 76.5of the injured. Police and ambulance vehicles transported 6.1and 1.4; respectively. 51.9reached health facilities within 30 minutes of crash and medical care provided to 66.2within one hour. 40.8of recipient facilities were adequately prepared for RTI emergencies. Conclusions: Most RTI casualties were young and from poor backgrounds. Training of motorists and general public in first aid should be considered in RTI control initiatives. Availability of basic trauma care medical supplies in public health facilities was highly deficient

In-Hospital and Mid-Term Adverse Clinical Outcomes of a Direct Stenting Strategy Versus Stenting after Predilatation for the Treatment of Coronary Artery Lesions : Cardiovascular Topic

Background : Direct stenting without balloon dilatation may reduce procedural costs and duration; and hypothetically; the restenosis rate. This study was designed to compare the in-hospital and long-term outcomes of direct stenting (DS) versus stenting after pre-dilatation (PS) in our routine clinical practice. Methods : The 1 603 patients treated with stenting for single coronary lesions were enrolled into a prospective registry. Patients with acute myocardial infarction (MI) within the preceding 48 hours; and those with highly calcified lesions; total occlusions; or a lesion in a saphenous graft were excluded. The baseline; angiographic and procedural data; in-hospital outcomes and follow-up data were recorded in our database and analysed with appropriate statistical methods. Results : Eight hundred and fifty-seven patients (53.5) were treated with DS and 746 (46.5) underwent PS. In the DS group; lesions were shorter in length; larger in diameter and had lower pre-procedural diameter stenosis. Type C and diffuse lesions and drug-eluting stents were found less often (p 0.001). With univariate analysis; dissection and non-Q-wave MI occurred less frequently in this group (0.2 and 0.6vs 3.9 and 2.1; p 0.001 and p ; p = 0.79). With multivariate analysis; direct stenting reduced the risk of dissection (OR = 0.07; 95CI: 0.01-0.33; but neither the cumulative endpoint of MACE (OR = 1.1; 95CI = 0.58-2.11; p = 0.7) nor its constructing components were different between the groups. Conclusions : Direct stenting in the real world has at least similar long-term outcomes in patients treated with stenting after pre-dilatation; and is associated with lower dissection rates

Les plaies penetrantes de l'abdomen au CHU de Lome; a propos de 44 cas

Les auteurs rapportent les resultats d'une etude retrospective de 44 cas de plaies penetrantes de l'abdomen vue en 5 ans (Janvier 1990 a Decembre 1994) dans le service de chirurgie general du CHU Tokoin; dans le but d'en ressortir les problemes diagnostiques et therapeutiques. Les plaies penetrantes ont represente 0;73 pour cent des urgences abdominales chirurgicales durant la meme periode. La plupart des blesses etaient de sexe masculin (90;9 pour cent) et ages de 20 a 40 ans (70;5 pour cent). L'agent causal etait l'arme blanche dans 72;7 pour cent des cas. La lesion intra-abdominale etait cliniquement evidente dans 45;4 pour cent des cas; devant l'existence d'un choc hemorragique; d'un hemoperitoine ou d'une peritonite. Les plaies par armes a feu ont occasionne plus frequemment des lesions abdominales multiviscerales ainsi que des lesions extrathoraciques associees. Compte tenu de l'insuffisance de ressources humaines et materielles dans les services; l'attitude demeure la laparotomie systematique devant toutes les plaies penetrantes abdominales malgre un taux important de laparotomie blanche (40;9 pour cent). La lourde mortalite (15;9 pour cent) pourrait etre reduite par l'amelioration de mesures de reanimation