ABSTRACT
OBJECTIVE: To analyse clinical and prognosis aspects of severe malaria in expatriates hospitalized between 1990 and 1999 in the intensive care unit in Abidjan. STUDY DESIGN: Retrospective survey. METHODS: According to the World Health Organization's criteria, the retrospective study of severe cases of malaria who received treatment and care at the intensive care unit. Epidemiological, clinical manifestations and evolution were analysed on each patients. RESULTS: 66 upon 927 expatriates hospitalised in the period of the study, had severe malaria with falciparum Plasmodium (7.12%). The average age was 42 years. Eleven patients took prophylactic treatment (17%). The clinical aspects were neurological (83%) followed by renal failure (48%), haemoglobinuria (48%) and hyperparasitemia (59%). During the hospitalisation we recorded 12 deaths (18%). The criteria that were associated with mortality in pejorative order were: coma (RR = 8.04), respiratory distress (RR = 5.06), metabolic acidosis (RR = 5.06), shock (RR = 3.67) and convulsions (RR = 2.86). CONCLUSION: Severe malaria was frequent and associated with high mortality in expatriates who are living in Africa. This study reinsists the necessity of prophylactic treatment to be reinforced in informing the travellers. This study showed frequency and mortality rate of survey of malaria and the criteria associated with high mortality rate.
Subject(s)
Malaria, Falciparum/epidemiology , Adolescent , Adult , Aged , Cote d'Ivoire/epidemiology , Electroencephalography , Female , Humans , Intensive Care Units , Malaria, Falciparum/parasitology , Malaria, Falciparum/therapy , Male , Middle Aged , Monitoring, Physiologic , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
Les auteurs rapportent une observation de peritonite aigue consecutive a une perforation colique lors d'un lavement baryte. L'accident est survenu chez un nourrisson de 5 mois presentant une invagination intestinale aigue. La precocite du diagnostic et du traitement encadre par une reanimation efficace; ont permis l'evolution favorable. Des complications (infection; desordre hydroelectrolytique; trouble hemodynamique) ont emaille cette evolution. Les auteurs font une revue de la litterature sur la question et attirent l'attention des praticiens (chirurgiens; radiologistes et reanimateurs) sur la gravite de l'accident; la necessite de son diagnostic et des difficultes de sa prise en charge tout au long de son evolution. Ils preconisent le suivi a long terme des malades vivants a la recherche de sequelles et de complications ulterieures et enoncent des mesures prophylactiques
Subject(s)
Gastric Lavage , Gastric Lavage/adverse effects , Intestinal Perforation , Peritonitis/diagnosisABSTRACT
Le bloc crural avec 6 ml Bupivacaine a 0;5 et 6 ml de Lidocaine a 2 pour cent a precede la rachianesthesie realisee avec 2 ml de Bupivacaine a 0;5 pour cent; 1ml de G 10 pour cent et 2 ml de Fentanyl. L'indication de cette rachianesthesie etait posee devant une chirurgie de la hanche chez des sujets du grand age (64 a 85 ans) et tares (ASA III). L'analgesie obtenue grace a cette association a ete precoce (6 min.); suffisante pour la chirurgie; et d'une duree prolongee jusque dans le post-operatoire (6h30). Ces auteurs conseillent donc un large usage de ce protocole simple; pas cher et interferant sur les tares preexistantes; surtout dans cette indication particuliere
Subject(s)
Aged , Anesthesia , Anesthesia/methods , Hip Prosthesis/methods , Hip/surgeryABSTRACT
From January 1983 to March 1984, 13 cases of pulmonary thrombo-embolic disease (PTE) were reported at the Abidjan cardiology Institute. Disease frequency is higher than usually reported in Africa. The reason is that angiography was carried out as soon as the clinical diagnosis was suspected. Radiologic examination allowed to locate with accuracy the level of the thrombosis. Under heparin, a favourable course of the disease was noted any time a phlebitis of lower extremity was involved. Two deaths occurred among the 13 cases. Few differences are noted in Africa and temperate zones as regard to disease behaviour. However, frequency of obstetrical and infectious aetiology is to be outlined.
