[Pain during peritoneum pinching, a pathognomonic sign of peritoneal disease. Clinical research. Semiological value]. / La douleur au pincement du péritoine, signe pathognomonique d'affection péritonéale. Recherche clinique. Valeur séméiologique.

Pain induced by pinching the peritoneum betrays a pathology of that membrane. It is absent when the peritoneum is perfectly healthy. Pain is elicited by a special palpation technique. Clinically and statistically, the presence of this pain is pathognomonic, but it does not inform on the aetiology. In the present study the most frequent causes of positive abdominal peritoneal pinching test were peritoneal tuberculosis, followed by portal hypertension with or without liver cirrhosis.

[Stopping persistent hiccups in the adult by endoscopic maneuver]. / Arrêt du hoquet persistant de l'adulte par manoeuvres endoscopiques.

Thirty-four patients with persistent hiccups (median duration 10 days) were treated by gentle endoscopic massage of the region of the cardia. Hiccups stopped in all cases. Its early recurrence in one patient only required a second massage, which was also effective. This simple technique is recommended for the treatment of persistent hiccups.

[Chronic gastritis and Helicobacter pylori infection on the Ivory Coast. A series of 277 symptomatic patients]. / Gastrite chronique et infection à Helicobacter pylori en Côte-d'Ivoire. Etude d'une série de 277 patients symptomatiques.

Only a few reports have established the importance of chronic gastritis and Helicobacter pylori infection in Africa. The aim of this study was to ascertain the prevalence of chronic gastritis and Helicobacter pylori infection in a symptomatic population in Abidjan, Côte-d'Ivoire. The study included 277 consecutive patients referred for gastroscopy. Two hundred nine patients complained of abdominal pain without gastroduodenal ulcer or cancer: 26 had a duodenal ulcer, 23 had a gastric ulcer, and 6 had gastric cancer. The remaining 14 patients underwent gastroscopy for various other reasons. Chronic gastritis was present in 89 percent of cases, of which 96 percent showed signs of activity. There were four cases of lymphocytic gastritis. Patients with antral chronic gastritis were older (39.43 +/- 14.3 years) than those with normal antral mucosa (33.7 +/- 12 years, P less than 0.05). Helicobacter pylori was present in 91.3 percent of cases, representing all patients with active chronic gastritis, and 60 percent of the patients with normal gastric mucosa. Chronic gastritis was present in 86 percent of patients with abdominal pain, in 100 percent of those with duodenal of gastric ulcer, and Helicobacter pylori were observed in 90, 100, and 91 percent of the same patient groups, respectively. This study demonstrates the high prevalence of chronic gastritis and the very high level of Helicobacter pylori infection in Ivorian patients complaining of various gastrointestinal symptoms. The usefulness and feasibility of therapeutic trials still have to be investigated.

[HIV1 seropositivity and B and D viruses in West Africa]. / Séropositivité VIH1, virus B et D en Afrique de l'Ouest.

This study was undertaken to investigate relationships between three widespread viruses in West Africa, i.e. HIV1 and viruses B and D, in Ivory Coast. Serologic tests for viruses B and D were carried out in a random sample of black adults of both sexes with asymptomatic HIV1 seropositivity. Coinfection by virus B or viruses B and D was a common finding. Coinfection with both viruses B and D, but not with virus B alone, was found to be significantly more frequent in these HIV1-infected adults than in a control group with acute viral hepatitis. Potential interactions between the HIV1 and viruses B and D as well as other viruses are discussed. These findings suggest that one or several cofactors acting alone or in combination play a major role in the clinical expression of HIV infection. The results of this study, together with the suggestion put forward by several investigators that B virus infection may increase the severity of AIDS, are evidence in support of the value of immunization against the B virus in the management of AIDS.

[Lupus disease in Abidjan. Apropos of 3 new case reports]. / La maladie lupique à Abidjan. A propos de 3 nouvelles observations.

Three new cases of systemic lupus erythematosus, all observed en 1986, are reported. So the incidence of this disease seems to be increased. Clinical features do not show any particularity and hyperthermia; cutaneous manifestations, arthralgia and renal impairment must be emphasized. Urinary infection is frequent. Among the biological features, antinuclear antibodies are positive in the three cases. Glucocorticosteroid therapy was efficient at short term, with unfortunately side effects which lead to stop the treatment.

[Acute disseminated lupus erythematosus in Ivory Coast (apropos of 9 cases)]. / Le lupus érythémateux aigu disséminé en Côte-d'Ivoire (a propos de 9 observations).

Nine cases of systemic lupus erythematosus (S.L.E.) among ivoirian Africans seen over a period of eleven years were studied. The pattern of clinical presentations is similar of that seen elsewhere. Photo-sensitivity is not described as in american Negroes. Death is usually due to severe infection. The incidence of the disease among populations of different african countries are compared. The low prevalence 0,18 p. mille may be a function of failure to diagnose the more mild cases.

[Echocardiography and cardiac localizations of rheumatoid polyarthritis in Africans]. / Echocardiographie et localisations cardiaques de la polyarthrite rhumatoïde chez l'Africain.

A lot of european authors demonstrate that echocardiography is the best examination to objective cardiac localizations in rhumatoïd arthritis (RA). Leleu, in a recent publication thinks that the rarity of systemic localizations during RA in Africans is characteristic. The authors examine the last 15 patients. They never find cardiac involvement and this seems to confirm the clinical impression about 50 previous cases.

[Sinus histiocytosis with massive lymphadenopathy or the Destombes-Rosai-Dorfman disease in the Ivory Coast]. / L'histiocytose sinusale avec lymphadénopathie massive ou maladie de Destombes, Rosai et Dorfman en Côte-d'Ivoire.

Sinusal histiocytosis with massive lymphadenopathy is a rare pathological entity since, as of 1983, only 200 cases have been published. Following the seminal description in 1965 by Destombes in Blacks, histological features of this disease were specified by Rosai and Dorfman in 1969 and 1972. We report three cases in young Ivorian subjects. The presenting finding is always chronically enlarged lymph nodes, but extranodal lesions are possible, most commonly involving the eye, salivary glands, upper respiratory tract, skin, bone, testis, and nervous system. Diagnosis can be ascertained only upon histologic examination of lymph node biopsy specimens which shows the three cardinal criteria, i.e. massive sinusal histiocytosis, lymphophagocytosis, and mature plasmocytosis. Although a few fatal cases have been reported, the disease usually runs a benign course, with exacerbations of variable duration. Great caution should therefore be taken in deciding upon management, particularly as regards corticosteroid therapy, radiotherapy or anticancer chemotherapy. Etiopathogeny of the disease is unsettled; there is general agreement as to the existence of a cellular immune dysfunction resulting in the lympho-histiocytic proliferation.

[Functional colonic pathology in the Ivory Coast]. / La pathologie fonctionnelle colique en Côte-d'Ivoire.

Functional colic disorders such as the irritable bowel syndrome are very common in Ivory Coast. Etiologic, clinical, biological and roentgenological features were studied in 100 randomized cases. Findings were compared to the features encountered in Caucasians. Psychologic factors, constipation and therapeutic problems that seem to be of significance for understanding functional colic conditions in Ivoirians and other West Africans are discussed.

[Epidemiology of colorectal cancer in the Ivory Coast]. / Réflexions sur l'épidémiologie du cancer colo-rectal en Côte-d'Ivoire.

Several epidemiologic studies using data from hospital departments and from the pathological department of the Abidjan University show that colorectal cancer is infrequent in Ivory Coast (2% of all cancers). The incidence of the various factors classically incriminated in colic carcinogenesis is analyzed and discussed: precancerous conditions (adenomas, polyps, inflammatory bowel disease), histogenesis (condition of the colic mucosa) and nutritional factors. Constipation, which is very common in spite of a high intake of fibers, cannot be regarded as a predisposing factor.

[Significance of the presence of Australia antigen in liver diseases seen in a department of internal medicine in Abidjan]. / Réflexions sur la signification de la présence de l'antigène Australia dans les hépatopathies observées dans un service de médecine interne à Abidjan.

The exact responsibility of the hepatitis B virus in hepatic diseases seen in Ivory Coast is difficult to specify for several reasons, particularly technical ones. Nevertheless, we have tried to determine the prevalence of the HB virus in hospital practice and in patients hospitalized for liver diseases (viral hepatitis, cirrhosis, primary liver cancer). Comparison of the results to the prevalence of the virus in the ivorian population and statistical processing has led us to moderate the influence of HB virus in the different hepatic disorders. In primary liver cancer, the role of aflatoxine whose carcinogenic potential is now well established has not been disproved.

[Pericarditis in adults in Abidjan. Study of one hundred observations (author's transl)]. / Les péricardites de l'adulte a Abidjan. Etude à propos de cent observations.

The goal of this work is to precise the respective aetiologic prevalence and the bases of diagnosis of pericarditis in Ivory Coast. The epidemiologic study has been done about 197 cases diagnosed between march 1972 and april 1978. These results are comparable to those collected previously in West Africa: the pericarditis is present in 1% of the patients admitted in the hospital and in 5.6% of the cardiovascular diseases of the unit of internal medicine in the Treichville Hospital (Abidjan). The semeiologic and evolutive study has been done with the 100 best documented records, with 90 acute and sub-acute pericarditis and 10 chronic pericarditis. The usual bases of diagnosis are used; the frequency of chest pain and signs of adiastole is emphasized. The aetiologic repartition is as follows: tuberculous 33%, septic 18%, benign acute pericarditis 15%, rheumatic 5%, uremic 13%, malignant 3%, undetermined 12%. These numbers are comparable to other author's numbers in West Africa. They confirm the important number of tuberculous and septic infections. These infections processus explain probably the frequency of constrictive pericarditis. However, the aetiology of constrictive pericarditis is often difficult to state precisely.U

[Hepatic manifestations in typhoid fever (author's transl)]. / Atteintes hépatiques au cours de la fièvre typhoïde.

Typhoid fever is always endemic in Ivory Coast. Among the various visceral injuries able to arrive during the course of the illness, a study of hepatic manifestations realized in 279 patients show, by the realization of systematic LBP, that, beside clinically and/or biologically certain forms, an hepatic injury is histologically constant. Aetiological, clinical, biological, diagnostic and therapeutic particularities connected with the hepatic localizations are considered and compared with findings of other authors. To remark, in Ivory Coast, on one hand the great predominance of Eberth bacillus aetiology, on the other hand the lack of statistically significative relation with drepanocytary waste. The pathogenic signification of the constancy of the hepatic injury and its peculiar histological pattern of non specific reactive hepatitis is discussed.