[Prescribing habits of physical activity by cardiac physicians in Côte d'Ivoire]. / Habitudes de prescription de l'activité physique par des médecins cardiologues en Côte d'Ivoire.

Regular physical activity (PA) has multiple health benefits that contribute to the prevention and management of many non-communicable diseases such as cardiovascular disease. However, a large proportion of the world's population is not active enough to benefit its health. Despite the potential of physicians to increase the level of PA practice in both primary and secondary prevention, there appears to be little intervention in this direction during medical consultations. What is the situation in Côte d'Ivoire? We conducted a prospective study that focused on the description and analysis of the practice of PA awareness and prescribing of Côte d'Ivoire cardiologist physicians and to examine the extent to which their socio-cultural characteristicsdemographics, their personal PA practices, barriers and needs influenced their PA prescribing in primary or secondary prevention settings. The results showed a high rate of overweight and obesity (64 %) and a low level of PA (40 %). We noted a high rate of locating (90 %) and advising AP (92 %). High blood pressure (98 %) and obesity (94 %) were the major conditions for which physicians prescribed PA. They were mainly about walking (94 %) and through oral counselling (80 %). Among the brakes identified were mainly the lack of knowledge about PA prescribing, lack of consultation time and lack of motivation of patients in 48 %, 44 % and 34 % of cases respectively. In terms of the needs expressed to promote the prescription of PA, it was mainly the personal conviction of the physician of the interest of prescribing an PA (80 %), of the organization of training on the prescription of PA (78 %) and completion of patient handouts (56 %).

[Current aspects of neuromeningeal cryptococcosis in adults infected with HIV in the internal medicine service of the University Hospital of Treichville Abidjan (Cote d'Ivoire)]. / Aspects actuels de la cryptococcose neuroméningée chez des sujets adultes infectés par le VIH dans le service de médecine interne du CHU de Treichville d'Abidjan (Côte d'Ivoire).

OBJECTIVES: To determine the prevalence of neuromeningeal cryptococcosis (NMC) and reporting sociodemographic, clinical, paraclinical aspects and outcome of patients. METHODS: It was a retrospective study concerning 22 HIV positive patients hospitalized between 2006 to and 2009 in the internal medicine service of University Hospital of Treichville for NMC. RESULTS: The prevalence of NMC in patients infected with HIV was 0.6%. The mean age was 35±4.5 years old. The sex-ratio was 0.5. The average time evolution of the symptomatology was 10±2.1 days. The installation of the disease was progressive (86.4%). The main signs were fever (100%) and headache (95.4%). The cerebrospinal fluid was inflammatory aspect (95.4%) with low glucose (91%), hyper lymphocytosis(100%). There were Cryptococcus neoformans in direct exam by China ink (72.7%) and culture on Sabouraud (100%). Treatment was injectable amphoterin B in monotherapy (54.5%) followed by fluconazole per os (45.5%). The mortality was 54.5%. CONCLUSION: This study shows a reduction of NMC prevalence in our service in relation with tritherapy.

[Histoplasma capsulatum histoplasmosis: apropos of 1 case observed in the internal medicine department of the CHU of Treichville (Abidjan)]. / Histoplasmose à Histoplasma capsulatum: à propos d'un cas observé dans le service de médecine interne du CHU de Treichville (Abidjan).

The advent of AIDS has resulted in an increase in diseases which were previously rare. In HIV-infected subjects, histoplasmosis takes a disseminated and particularly severe form, with a fatal outcome in our country, the more so because the clinical presentation resembles tuberculosis and is generally treated as such. The authors report a case of disseminated histoplasmosis in a patient dually-reactive to HIV-1 and HIV-2, in whom the clinical presentation was fever, mediastinal lymphadenopathy and pulmonary infiltrates. The diagnosis of histoplasmosis was made at autopsy.

[Etiologic aspects of nephrotic syndrome in Black African adults in a hospital setting in Abidjan]. / Aspects étiologiques des syndromes néphrotiques de l'adulte noir africain en milieu hospitalier à Abidjan.

We studied nephrotic patients hospitalised in internal medicine service at Treichville Teaching hospital from September 1986 to February 1993 for precising the aetiological aspects of black adult patients and their evolutive biological, clinical and epidemiological profile. Secondary Nephrotic syndrome represented 18% of the whole patients with Nephrotic syndrome hospitalised during the same period. In aetiological field it was about: diabetic nephropathy 11 cases (33%); lupus nephritis 7 cases (21%); renal amyloidosis 5 cases (15%); HIV nephropathy 5 cases (15%); schistosomiasis nephrotic syndrome 1 case (3%); pregnancy nephrotic syndrome 1 case (3%); cryoglobulinemia 1 case (3%); malignancy nephrotic syndrome 1 case (3%); nephrosclerosis 1 case (3%).

[Chronic renal insufficiency in Côte d'Ivoire: study of 800 hospital cases]. / L'insuffisance rénale chronique en Côte d'Ivoire: étude de 800 cas hospitaliers.

We report a retrospective study of 800 cases of chronic renal failure (CRF) admitted in the Internal Medical Department at Teaching Hospital of Treichville in Abidjan from January 1990 to December 1990 for precising the etiological, radiological, biological, clinical and epidemiological aspects of this entity in our practice. Kidney renal failure represents 5.8% of the whole patients hospitalised at the same period. 61% of patients were less 45 years old with a weak or mild socio-economic status (92%). In clinical field, 84% of our patients had a variety signs and symptoms which referred to a late uremic state in 41% of cases. Chronic glomerulonephritis (49.1%) and nephrosclerosis (25.4%) were the two main revealed causes. In therapeutical field, 95% of our patients did not receive any treatment in dialysis. Only 5% of patients could be treated by dialysis. The analysis of the results has permitted us to describe clinical particularities of CRF in black African patient.

[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.

Hypertension et grossesse

Les auteurs rapportent les aspects cliniques biologiques et therapeutiques actuels de l'hypertension arterielle au cours de la grossesse

[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.

[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.

[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.

[Hepatic amebiasis: recent aspects. One hundred and sixty one case reports (author's transl)]. / L'amibiase hépatique: aspects actuels. Cent soixante et une observations.

The authors describe their experience of 16l patients (151 adults and 10 children) with hepatic amebiasis. Diagnosis and treatment were carried out at the Treichville Hospital University Center in Abidjan over a three-year period, from September 1976 to November 1979. Diagnosis was established without question in all cases. The indirect immunofluorescence reaction was particularly helpful. All patients were treated by metronidazole or it's derivatives. Semiology, course and therapy are described in detail. A comparison is made with cases published in the literature during the last 15 years. Most of the classical pictures were encountered in this study. The clinical picture may be misleading, for instance when it is suggestive of cancer or when jaundice is present. Immunology is particularly interesting in atypical forms. The authors insist on the unvarying and high morbidity due to this disease which accounts for 2% of all hospitalizations. Prognosis has improved, the mortality rate among adults was 4.5%. A fall in the number of surgical procedures was recorded. Only 10% of the patients underwent surgery. The therapeutic principles advocated by the authors are described. They can be used even when echotomography is not available, as is usually the case in regions where the disease is endemic.