Risk of obstructive sleep apnea among senegalese dialysis patients.

Obstructive sleep apnea syndrome (OSAS) is a common condition in patients undergoing chronic dialysis and is associated with increased cardiovascular morbidity and mortality. This study aimed to determine the prevalence and risk factors of OSAS in Senegalese dialysis patients. In a cross-sectional study including 128 patients (75 men and 53 women) dialyzed since ≥6 months in four dialysis units. Data were collected during the dialysis session in the units. OSAS was assessed with the Berlin Questionnaire. Factors associated with OSAS risk were identified by multivariate logistic regression. The mean age of patients was 46.8 ± 16.9 ¥16-85 years). OSAS was found in 53 patients (overall prevalence of 41.4%) with predominance among individuals aged ≥50 years (52.6%). Hypertension and diabetes were more frequent in patients with OSAS, while the prevalence of obesity and sedentary was not different. The majority of patients were not aware of their disease before the survey, and none was treated. After multivariate regression analysis, age >50 years [odds ratio (OR) = 1.09, P = 0.02], neck circumference >45 cm (OR= 1.25, P= 0.03), and daytime hypersomnia (OR = 1.18, P= 0.02) were significantly associated with OSAS. This study showed that OSAS is frequent among Senegalese dialysis patients but is usually under-diagnosed. Older age, excessive daytime sleepiness, and neck circumference are the main associated factors.

Assessment of Major Posttransplant Complications Risk Among Potential Recipients of Kidney Transplant in Saint-Louis, Senegal.

INTRODUCTION: Recipients of kidney transplants are a very heterogeneous population and the risk of posttransplantation complications markedly varies according to the recipient's status. Scoring systems that predict survival outcome after kidney transplantation can help physicians improve risk stratification among recipients and make the best therapeutic decisions. This study aimed to assess the 1-year risk of major adverse events in potential recipients of kidney transplant at Saint-Louis University Hospital. MATERIAL AND METHODS: We performed a cross-sectional study including 65 patients with end-stage renal disease who were treated in the hemodialysis unit at Saint-Louis University Hospital. Scoring was based on a simple clinical tool with 4 items (age, cardiopulmonary factors, functional status, and metabolic parameters) reported to predict risk of severe adverse events during the first posttransplant year. RESULTS: The mean age of patients in years ± SD was 46.9 ± 23.5 and 53% were male. Median dialysis duration was 29.9 months and the main causes of kidney disease were hypertension and diabetes. A history of coronary artery disease was present in 22.3% of patients, and 33.5% had a high cardiovascular risk. According to the clinical score, 63.8% of potential recipients of kidney transplant presented a high risk of adverse events and 12.5% had a low risk of developing major complications during their first year posttransplantation. CONCLUSIONS: This study shows that based on a simple pretransplant clinical assessment, two-thirds of our patients are at high risk for major adverse events during their first posttransplantation year. Such information could be invaluable during the counseling of donor and recipient couples.

[Megaesophagus revealed by pleurisy]. / Méga-œsophage révélé par une pleurésie.

We report the case of a 65-year old patient without a history of alcohol consumption and cigarette smoking but with a history of gastrœsophageal reflux disease for which he had never been examined. He was admitted to the Department of Pneumology for exploration of a dry hacking cough causing insomnia associated with diffuse heaviness in his right chest evolving over a month in a context of evening and night fever without weight loss. Clinical and radiological examination showed right pleural effusion syndrome. Radiographic follow-up after evacuating pleural effusion by puncture showed inhomogeneous opacity occupying nearly all the right lung (A). Chest CT scan objectified thoracic megaesophagus associated with non-specific pleuro-pulmonary disease. The patient underwent upper gastrointestinal endoscopy that didn't show suspect cancer signs. Pleuro-pulmonary disease outcome was favorable after amoxicillin treatment.