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1.
Ann Cardiol Angeiol (Paris) ; 65(2): 99-102, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25702237

RESUMEN

Mitral subannular aneurysm is a rare heart disease that can have many different forms of clinical presentations. It was first described in young men of African descent and was later reported in other geographical areas of the world. The etiopathogenesis as per data from the literature can be congenital, acquired or idiopathic. We report the case of a 19-year-old male in whom we made the diagnosis of mitral subannular aneurysm. The evolution was fatal following a rupture of the aneurysm into the pericardium. Through this case report, we stress the importance of echocardiography in the diagnosis of this condition. In resource-limited countries, the prognosis is unfortunately often unfavorable especially the ruptured forms. Therefore, a high degree of suspicion is needed to make a prompt diagnosis and timely surgical intervention.


Asunto(s)
Aneurisma Cardíaco/complicaciones , Enfermedades de las Válvulas Cardíacas/complicaciones , Válvula Mitral , Pericardio , Adulto , Resultado Fatal , Aneurisma Cardíaco/etiología , Humanos , Masculino , Rotura Espontánea , Senegal
2.
Ghana Med J ; 49(1): 19-24, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26339080

RESUMEN

BACKGROUND: The global prevalence of diabetes and its complications is increasing worldwide. Its role in coronary heart disease has been linked with the presence of left ventricular hypertrophy (LVH). The present study aims to determine the prevalence of electrocardiographic left ventricular hypertrophy (ECG-LVH) in adult diabetic subjects, its epidemiological and clinical correlates. METHODS: A descriptive cross-sectional study involving 534 patients was conducted at the Edward Francis Small Teaching Hospital (formerly Royal Victoria Teaching Hospital), The Gambia. Four hundred and forty patients were included using a standard questionnaire. Anthropometry, laboratory investigations and electrocardiogram were carried out. We used the Lewis, Cornell, and Sokolow-Lyon Voltage criteria to define ECG-LVH. Minitab™ statistical software version 13.20 was used for analysis. RESULTS: 146 (35.2%) patients had ECG-LVH using all 3 criteria and this prevalence was higher among women being 116 (79.5%). A generally high prevalence of overweight (155/37.4%) and obesity (119/28.6%) was observed among study participants, and both clinic-day systolic and diastolic blood pressure (BP) were significantly higher in those with ECG-LVH. Poor diabetes control was observed in both groups. CONCLUSION: There was a high prevalence of ECG-LVH and it is especially so with combining multiple criteria, hence the need for screening. Clinic-day hypertension was associated with ECG-LVH hence the need for diagnosing and aggressive treatment of hypertension in patients with diabetes mellitus.


Asunto(s)
Cardiomiopatías Diabéticas/epidemiología , Electrocardiografía/estadística & datos numéricos , Hipertrofia Ventricular Izquierda/epidemiología , Adulto , Anciano , Antropometría , Glucemia/análisis , Estudios Transversales , Cardiomiopatías Diabéticas/sangre , Femenino , Gambia/epidemiología , Humanos , Hipertensión/complicaciones , Hipertrofia Ventricular Izquierda/sangre , Hipertrofia Ventricular Izquierda/etiología , Masculino , Persona de Mediana Edad , Sobrepeso/complicaciones , Prevalencia , Distribución por Sexo , Encuestas y Cuestionarios
3.
Bull Soc Pathol Exot ; 108(1): 32-5, 2015 Feb.
Artículo en Francés | MEDLINE | ID: mdl-25516291

RESUMEN

Congenital heart diseases are one of the major cardiovascular diseases in developing countries. Most prevalence studies were based on clinical examination of children with echocardiographic confirmation of suspected cases and underestimate its prevalence. The objective of this study was to investigate the prevalence of congenital heart disease in "daara" (Koranic schools) in the city of Dakar and its suburbs on the basis of clinical examination and Doppler echocardiography in school children. This cross-sectional survey was carried out from 9(th) August to 24(th) December 2011, and included a population of 2019 school children aged 5 to 18 years in 16 selected "daaras" under the Academic Inspectorate of Dakar and its suburbs. Anamnestic, clinical and echocardiographic data were recorded in a validated questionnaire. A p < 0.05 was considered to be statistically significant in bivariate analysis. 2 019 school children were included out of which 60.1% were male (sex-ratio: 0.66). The average age was 9.7 years (± 3.3 years). 18 cases of congenital heart diseases were detected being a prevalence of 8.9 per 1 000 (95 % CI: 1.8 to 7.9). This included 6 cases of inter-atrial septal aneurysm, 5 cases of peri-membranous ventricular septal defects, 4 cases of patent ductusarteriosus and 3 cases of tetralogy of Fallot. Factors correlated with the presence of congenital heart disease were ageless than 8 (p <0.001) and residence in the suburbs of Dakar (p <0.001). We also detected 10 cases of rheumatic valvular disease, a prevalence of 4.9 per 1 000 (95% CI: 2.4 to 9.1). Our study shows a high prevalence of congenital heart diseases, which is almost identical to the WHO estimates and that ultrasound screening is more sensitive than clinical screening. Reducing the prevalence of these diseases requires implementation of appropriate policies, focusing on awareness and early detection.


Asunto(s)
Cardiopatías Congénitas/epidemiología , Instituciones Académicas/estadística & datos numéricos , Adolescente , Niño , Preescolar , Estudios Transversales , Ecocardiografía Doppler , Femenino , Cardiopatías Congénitas/diagnóstico por imagen , Humanos , Islamismo , Masculino , Tamizaje Masivo , Prevalencia , Senegal/epidemiología
4.
Ann Cardiol Angeiol (Paris) ; 64(4): 300-4, 2015 Sep.
Artículo en Francés | MEDLINE | ID: mdl-24041339

RESUMEN

Pseudoaneurysm of the left ventricle is a rare late complication of myocardial infarction. So-called non-coronary forms have been described in young people. In this context, we report three cases. Mr. M.B., aged 20, consulted for chest pain associated with palpitations. Cardiovascular examination found a pulsatile, expanding precordial bulging and a mesocardiac systolo-diastolic murmur. We noted a sinus rhythm with ventricular extrasystoles on ECG. The chest radiograph showed cardiomegaly and aneurysmal deformation of the left lower heart border. Doppler echocardiography showed a large left ventricular apical pseudoaneurysm. Mrs. O.B., aged 23, was admitted for biventricular heart failure and in whom the examination found a systolic murmur in the apical area. ECG showed a regular sinus tachycardia, left atrial and ventricular hypertrophy. The chest radiograph showed cardiomegaly and aneurysmal deformation of left middle and lower heart borders. Doppler echocardiography showed a large left ventricular apical pseudoaneurysm. Mr. I.S., aged 24, admitted for the management of congestive heart failure. The patient had non-specific laboratory inflammatory signs, a sinus tachycardia and extrasystoles on the ECG. Chest radiography showed a discontinuation at the posterior arch of the sixth rib, a cardiomegaly and a neurismal dilatation of the left lower heart border. Doppler echocardiography showed a large apical pseudoaneurysm of the left ventricle.


Asunto(s)
Aneurisma Falso/diagnóstico , Aneurisma Cardíaco/diagnóstico , Aneurisma Falso/cirugía , Ecocardiografía Doppler , Electrocardiografía , Femenino , Aneurisma Cardíaco/cirugía , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/cirugía , Ventrículos Cardíacos/cirugía , Humanos , Masculino , Adulto Joven
5.
Ghana Med. J. (Online) ; 49(1): 19-24, 2014.
Artículo en Inglés | AIM (África) | ID: biblio-1262288

RESUMEN

Background: The global prevalence of diabetes and its complications is increasing worldwide. Its role in coronary heart disease has been linked with the presence of left ventricular hypertrophy (LVH). The present study aims to determine the prevalence of electrocardiographic left ventricular hypertrophy (ECG-LVH) in adult diabetic subjects; its epidemiological and clinical correlates.Methods: A descriptive cross-sectional study involving 534 patients was conducted at the Edward Francis Small Teaching Hospital (formerly Royal Victoria Teaching Hospital); The Gambia. Four hundred and forty patients were included using a standard questionnaire. Anthropometry; laboratory investigations and electrocardiogram were carried out. We used the Lewis; Cornell; and Sokolow-Lyon Voltage criteria to define ECG-LVH. MinitabTM statistical software version 13.20 was used for analysis.Results: 146 (35.2) patients had ECG-LVH using all 3 criteria and this prevalence was higher among women being 116 (79.5). A generally high prevalence of overweight (155/37.4) and obesity (119/28.6) was observed among study participants; and both clinic-day systolic and diastolic blood pressure (BP) were significantly higher in those with ECG-LVH. Poor diabetes control was observed in both groups.Conclusion: There was a high prevalence of ECGLVH and it is especially so with combining multiple criteria; hence the need for screening. Clinic-day hypertension was associated with ECG-LVH hence the need for diagnosing and aggressive treatment of hypertension in patients with diabetes mellitus


Asunto(s)
Adulto , Estudios Transversales , Diabetes Mellitus , Electrocardiografía , Hipertrofia
6.
Cardiovasc J Afr ; 23(10): e1-4, 2012 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-23192287

RESUMEN

INTRODUCTION: Permanent cardiac pacing is a technique whose indications have increased in the last 20 years. As with any foreign body, pacemaker implantation is associated with the risk of infection. The objective of this study was to describe the clinical, paraclinical and treatment options of infections secondary to pacemaker implantation at the Cardiology Department of the Aristide le Dantec Teaching Hospital (CHU Aristide le Dantec) in Dakar, Senegal. METHODS: We conducted a retrospective study over a period of three years (from January 2005 to December 2007) during which pacemaker implantation was carried out in 107 patients. All patients with local and/or systemic signs of infection were included in our study. RESULTS: The prevalence of infection in patients with pacemakers was 5.6% in our series and infection occurred in three women and three men, with a mean age of 66.2 years (range 23-83). The delay time for the onset of clinical signs of infection was 6.6 months, with a range of eight days to 12 months. The clinical signs were externalisation of the pacemaker with suppuration (five cases), fever (one case) and inflammatory signs (one case). Factors favouring the occurrence of infection were co-morbidity (four cases), pre-operative length of stay (average eight days), use of temporary cardiac pacing (three cases), the number of people in the theatre (average 4.5), postoperative haematoma (one case) and repeating the surgical procedure (three cases). Staphylococcus epidermidis (two cases), Staphylococcus aureus (two cases) and Klebsiella pneumonia (one case) were the organisms isolated at the local site. Transthoracic echocardiography showed no objective signs of endocarditis. The treatment was antibiotic therapy for an average duration of 50.4 days after debridement of the infected site (six cases). We noted four recurrences at six months and one death from sepsis at 12 months. CONCLUSION: Infections secondary to pacemaker implantation are rare but serious. Their management is difficult and requires the removal of the implanted material, hence the importance of prevention of infection, or the removal and re-implantation of the pacemaker at another site in cases of infection. This is particularly important in our region where pacemakers are very expensive.


Asunto(s)
Infecciones por Klebsiella/epidemiología , Klebsiella pneumoniae/aislamiento & purificación , Marcapaso Artificial/microbiología , Complicaciones Posoperatorias/epidemiología , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Staphylococcus epidermidis/aislamiento & purificación , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Contaminación de Equipos , Femenino , Humanos , Infecciones por Klebsiella/diagnóstico , Infecciones por Klebsiella/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/tratamiento farmacológico , Prevalencia , Implantación de Prótesis/efectos adversos , Estudios Retrospectivos , Senegal , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/tratamiento farmacológico , Adulto Joven
7.
J Mal Vasc ; 37(4): 195-200, 2012 Jul.
Artículo en Francés | MEDLINE | ID: mdl-22727602

RESUMEN

OBJECTIVES: The purpose of this study was to investigate the prevalence of peripheral arterial disease (PAOD) and cardiovascular risk factors associated with the ankle-brachial index (ABI) in Senegalese patients aged 40 years and over. METHODOLOGY: We prospectively studied a random sample of Senegalese aged 40 years and older, residing in the city of St.-Louis, Senegal. The ABI was measured with a portable doppler (DIADOP 50) using 4 and 8Hz dual frequency probes. The standards were: normal ABI 0.9 to 1.3; peripheral artery obstructive disease (PAOD) ABI less than 0.9; incompressible artery ABI greater than 1.3. Cardiovascular risk factors were also studied. RESULTS: Seven hundred and seventy-one subjects (mean age 57 ± 11.2 years, 559 women) were examined. Cardiovascular risk factors were: sedentary lifestyle (76.4%), hypertension (68%), obesity (32.1%), elevated LDL-cholesterolemia (27.8%), diabetes (18.3%) and tobacco smoking (6.9%). Ninety-three subjects (12.1%) had PAOD and 37 subjects (4.8%) had an incompressible artery. PAOD was significantly more common in sedentary subjects (P=0.008), in the elderly (P=0.0006) and in patients with a history of coronary artery disease (P=0.04). Smoking was not strongly associated with PAOD. CONCLUSION: PAOD is common in Senegalese and is associated with high prevalence of cardiovascular risk factors.


Asunto(s)
Índice Tobillo Braquial , Tamizaje Masivo , Enfermedad Arterial Periférica/diagnóstico por imagen , Adulto , Anciano , Comorbilidad , Enfermedad Coronaria/epidemiología , Estudios Transversales , Diabetes Mellitus/epidemiología , Dislipidemias/epidemiología , Femenino , Humanos , Hipertensión/epidemiología , Enfermedades Renales/epidemiología , Pierna/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Enfermedad Arterial Periférica/epidemiología , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Muestreo , Conducta Sedentaria , Senegal/epidemiología , Fumar/epidemiología , Accidente Cerebrovascular/epidemiología , Ultrasonografía
8.
J Hand Surg Am ; 18(3): 525-7, 1993 May.
Artículo en Inglés | MEDLINE | ID: mdl-8515030

RESUMEN

Although many incisions have been described for exposure of the palmar structures of the digits, all have some disadvantages. The digital palmar oblique exposure provides a direct approach to the flexor tendons in the fingers and palm and to the digital neurovascular bundles and has been used extensively at our clinic for more than 20 years. Flap tip necrosis, central migration of the incision, scar hypertrophy, and flexion contractures have not been problems with the use of this incision.


Asunto(s)
Mano/cirugía , Humanos , Métodos
9.
Issues Compr Pediatr Nurs ; 16(1): 51-60, 1993.
Artículo en Inglés | MEDLINE | ID: mdl-8244796

RESUMEN

Administrators, school nurses, and informed parents (N = 113) were queried by means of the Delphi Technique to determine priority health needs and barriers in two midwestern counties. Needs of health education and school nurses and barriers of restricted resources received top ranking by all participant groups. Descriptive measures were computed by using Kendall's tau.


Asunto(s)
Prioridades en Salud , Accesibilidad a los Servicios de Salud , Necesidades y Demandas de Servicios de Salud , Servicios de Salud Escolar , Niño , Técnica Delphi , Humanos , Medio Oeste de Estados Unidos
10.
Appl Microbiol ; 17(1): 145-9, 1969 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-4886856

RESUMEN

Infection of white rats with Francisella tularensis (Pasteurella tularensis) and Salmonella typhimurium and exposure to the endotoxin of S. typhimurium stimulated significant increases in various serum enzymes including aldolase, lactate dehydrogenase, phosphohexose isomerase, isocitrate dehydrogenase, and glutamate-oxalacetate transaminase. The rates of changes in enzymatic activity after infection were directly related to the size of infecting dose and to the type of infective agent employed. Tularemic infection stimulated excessive changes in enzyme activity, whereas salmonellosis and endointoxication elicited less pronounced alterations of relatively short duration. Changes observed in serum enzymes after exposure to these agents reflect the severe liver damage and extensive systemic involvement noted in tularemia as opposed to more localized and less intensive tissue damage occurring during salmonellosis and endointoxication.


Asunto(s)
Aspartato Aminotransferasas/sangre , Fructosa-Bifosfato Aldolasa/sangre , Glucosa-6-Fosfato Isomerasa/sangre , Isocitrato Deshidrogenasa/sangre , L-Lactato Deshidrogenasa/sangre , Infecciones por Pasteurella/enzimología , Salmonelosis Animal/enzimología , Animales , Endotoxinas , Francisella tularensis , Masculino , Infecciones por Pasteurella/sangre , Ratas , Salmonelosis Animal/sangre , Salmonella typhimurium
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