Marker of coxsackievirus-B4 infection in saliva of patients with type 1 diabetes.

BACKGROUND: Coxsackieviruses B (CV-B) are enteroviruses that have been reported to play a role in the pathogenesis of type 1 diabetes. Enteroviral RNA was detected in the gut mucosa of patients. The mucosal immunity is an interconnected network; therefore, the response to enteroviruses possibly present in the gastrointestinal mucosa can be reflected by specific antibodies in the saliva. In the present study, the anti-CV-B neutralizing activity of saliva samples from patients with type 1 diabetes was investigated. METHODS: Saliva samples were collected from patients and controls of 3 countries, and plasma was obtained from some of them. The anti-CV-B activity of clinical samples was determined by neutralization of the cytopathic effect induced by challenging viruses in vitro and expressed as titre value. RESULTS: Overall prevalence and levels of anti-CV-B4 activity of saliva were higher in patients (n = 181) than in controls (n = 135; P = .0002; titre values ≥ 16: odds ratio = 4.22 95% CI: 1.90-9.38 P = .0002). It has been shown that IgA1 played a role in this activity. There was no correlation between the saliva and the plasma anti-CV-B4 neutralizing activity. The neutralizing activity of saliva against CV-B1, CV-B2, CV-B3, and CV-B5 existed rarely, if at all. Increased levels of anti-CV-B4 activity were observed all along a 4 year follow-up period in patients but not in matched controls (P = .01). CONCLUSION: There is an anti-CV-B4 activity in saliva of patients with type 1 diabetes that may be a useful marker to study the role of CV-B in the pathogenesis of the disease.

[Arterial hypertension: epidemiological aspects and risk factors on pregnant and delivered woman]. / Hypertension artérielle: aspects epidémiologiques et facteurs de risque chez la gestante et l'accouchée.

OBJECTIVES: Determine frequency of hypertension in pregnancy and delivered women at the Teaching Hospital of Brazzaville and identify epidemiological aspects and risk factors. PATIENTS AND METHODS: A prospective and transversal study was realized from november 2004 to january 2005 in the Teaching Hospital of Brazzaville. Forty two patients (8 pregnant women, 34 delivered) with hypertension, have been enregistered among 825 admissions in the departments of gynecology and obstetric. Arterial hypertension was defined by a blood pressure at 140/ 90 mm Hg or above. RESULTS: Arterial hypertension constituted 5.1% of the total admissions. Average of the patients was 27 +/- 8 years (age range: 14 and 40 years). Two patients (4.8%) haven't been sent to school, 29 (69%) had the secondary level, twenty (47.8%) were housewives. Seventeen patients (40.5%) had realized 2 prenatal consultations at the most. Patients were divided in 4 groups: Chronic hypertension (n = 4), pre eclampsia surimposed on chronic hypertension (n = 4), pregnancy hypertension only (n = 15), preeclampsia (n = 19). Prim gravidity (38.1%) and family history of hypertension (40.4%) were the most frequent risk factors. Obesity, gemality, previous pre eclampsia represented respectively 14.3%, 9.5% and 4.8%.

[Treatment of hyperthyroidisms in Brazzaville Teaching Hospital, Congo]. / Prise en charge des hyperthyroïdies au CHU de Brazzaville, Congo.

Between January 1994 and December 2003, a total of 118 patients (MIF = 1/13) with thyrotoxicosis was studied at the endocrine and metabolic diseases unit of the Centre Hospitalier Universitaire de Brazzaville, in Congo. 72 patients (61%) had Graves' hyperthyroidism, 23 (19.6%) had toxic multinodular goitre while the rest had toxic adenoma (7.6%), and thyroiditis (4.2%). The mean age was 26.6 +/- 7.9 years for Graves' cases and 49.4 +/- 9.3 years for toxic multinodular goitre cases. The clinical presentation was similar to other reported series. Thirty-seven patients (31.3%) did not return after the first admission. All patients responded to carbimazole therapy and no major side-effect was recognized. Ten patients (8.5%/) underwent subtotal thyroidectomy, among them one developed hypothyroidism a year later. The result of this study shows that thyrotoxicosis is not a rare condition in Congo.

[Course of pulmonary tuberculosis in diabetics]. / Evolution de la tuberculose pulmonaire chez les diabétiques.

This retrospective study on the impact of diabetes on the course of pulmonary tuberculosis was conducted in 32 diabetic patients with tuberculosis treated at the Brazzaville University Hospital between January 1994 and December 1998. This group was compared with a control group of 100 non-diabetic patients with tuberculosis. HIV-positive patients were excluded from the study. Diabetes appeared to have an induction and aggravating effect on tuberculosis. Tuberculosis is more frequent in diabetics than in non-diabetics. Radiological signs of tuberculosis are more pronounced in diabetics. Treatment failure and death are also more frequent. Tuberculosis aggravates diabetes and increases the frequency of complications compared with diabetics without tuberculosis.

[Epidemiological and clinical aspects of the diabetic foot at the Central University Hospital of Brazzaville]. / Aspects épidémiologiques et cliniques du pied diabétique au CHU de Brazzaville.

This study was carried out in the Metabolic Disease Department of the University Hospital of Brazzaville, between January 1995 and December 1999. Our purpose was to define epidemiological and clinical aspects of trophic disorders of the lower limbs, as observed among 247 diabetic patients. Diabetic foot was observed in 86.2% of adult patients with diabetes type 2, and in 13.8% of patients with diabetes type 1. The average duration of diabetes was 8 years. In 2.8% of cases, diabetes was discovered as a result of trophic disorders. Among observed lesions, infectious foot prevailed (63.9%) and mal perforant was exceptional (1.2%). The mortality rate before surgical intervention was high (22.6%).

[Ketoacidosis coma auguring diabetes in black adults]. / Coma céto-acidosique inaugurant le diabète chez l'adulte noir.

A particular form revealing diabetes mellitus in the black race is described: adult's inaugural ketoacidosis requiring a temporary insulin treatment, followed by a variable remission stage. We present in this work the clinical and evolutive characters of this coma inaugurating diabetes mellitus from twenty seven (27) patients of the metabolic diseases departement (CHU-Brazzaville). Among adult patients presenting a ketoacidosis coma, the prevalence rate of inaugural form is forty two percent (42%). The evolution is marked by a remission stage varying between six months and seven years.

[Hypothyroidism among adults in Congo: report of 23 cases]. / L'hypothyroïdie chez l'adulte au Congo: à propos de 23 cas.

Four hundred and ninety six congolese patents with thyroid pathology were studied in CHU of Brazzaville, Congo, between July 1984 and June 1999. Twenty three patients (4.64%) had hypothyroidism. There were 22 females and 1 male. The mean age was 43.8+/-12.4 years. The clinical presentation was similar to other reported series. The most frequent etiology was the surgery of thyroid. This surgery was realized in 52.2% of cases for Graves disease. The idiopathic hypothroidism was discovered in 5 cases (21.7%). All patients respondedto L-thyroxine therapy and no major side effect was recognized.

Pancreatite chronique calcifiante et diabete sucre

La pancreatite chronique calcifiante (P.C.C.) est decrite comme une cause relativement frequente du diabete sucre (D.S.) en zone tropicale. L'etiologie dominante de cette P.C.C. est la malnutrition suivie de l'alcoolisme. Un seul element aide au diagnostic: c'est le cliche de l'abdomen sans preparation. 24 dossiers ont ete selectionnes parmi les malades hospitalises dans le service des maladies metaboliques et endocriniennes du C.H.U. de Brazzaville