[Angiomyolipoma of the psoas: a case report and literature review]. / Angiomyolipome du psoas : a propos d'un cas et revue de la litterature.

The psoas major muscle is one of the three muscle chiefs of the ilio-psoas muscle. The pathological processes concerning it are dominated by tumor lesions which are mostly malignant. The diagnostic approach is based on the clinic and the abdomino-pelvic scanner. If necessary, it will make it possible to direct a puncture and / or a biopsy. We report the observation of a 33-year-old patient admitted to the Bouaké University Hospital presenting with a mass in the left iliac fossa and an intermittent claudication of chronic evolution in whom the diagnosis of a psoas tumor was diagnosedthrough the abdomino-pelvic scanner and the pathology concluded to an angiomyolipoma.

Le muscle psoas major ou grand psoas est un des trois chefs musculaires du muscle ilio-psoas. Les processus pathologiques le concernant sont dominés par les lésions tumorales qui sont pour la plupart malignes.La démarche diagnostique s'appuie sur la clinique et l'imagerie médicale où le scanner abdomino-pelvien est un examen majeur. Il permettra le cas échéant de guider une ponction et ou une biopsie à visée étiologique et ou thérapeutique. Nous rapportons l'observation d'un patient de 33 ans admis au CHU de Bouaké (Côte d'Ivoire) présentant une masse de la fosse iliaque gauche et une claudication intermittente d'évolution chronique chez qui le diagnostic d'une tumeur du psoas a étésuspecté auscanner abdomino-pelvien et l'anatomo-pathologie a conclu àun angiomyolipome.

A Medico-Socio-Economic Analysis of TeleEKG in Ivory Coast.

Background: TeleEKG is gradually being integrated into the care offered to the most isolated Ivorian populations, however, no medico-socio-economic analysis of its impact has yet been conducted. Introduction: The aim of this study was to assess the medico-socio-economic impact of a teleEKG network in the provision of cardiology care in Ivory Coast. Methods: A retrospective study of the data transmitted by the 10 centers involved in the pilot phase of the teleEKG project from January 2015 to December 2017. Results: The average ratio between the cost to the patient of performing an electrocardiogram (EKG) according to the traditional practice and using a teleEKG was 3.8 ± 1.64. The distance avoided by the 6,045 patients was 1,074,090 km (average 177.7 km/patient). The 6,045 teleEKGs carried out over the period of the study produced a total revenue of 36,270,000 XOF (55,290 EUR) or an average revenue per site of 3,627,000 XOF (5,529 EUR). Dyspnea on exertion (22%), and hypertension (21%) were the main indications for performing the EKG, and left ventricular hypertrophy was the most common electrical anomaly detected (19.8%). Acute coronary syndrome with persistent ST segment elevation was diagnosed in 0.7% of cases (40 cases) and atrial fibrillation in 1.12% of cases (68 cases). Discussion: These results confirm the key role telemedicine can play in the treatment of heart conditions in rural populations and the economic sustainability of such telemedicine networks. Conclusions: teleEKG offers economic accessibility to cardiology care for isolated populations in Ivory Coast.

A 25-year experience with Carpentier-Edwards Perimount in the mitral position.

Data of 401 patients who underwent mitral valve replacement with the Carpentier-Edwards Perimount bioprosthesis between 1984 and 2009 were evaluated. Their mean age was 68.1 ± 10.4 years (range, 22-90 years) and 54.9% were female. The most common etiology was degenerative disease (33.2%) and 62.1% of patients had mitral insufficiency. Follow-up was 3,178 patient-years, and 96.8% complete; the mean follow-up was 8.9 ± 3.1 years. Overall survival at 25 years was 10.2% ± 3%. Late mortality was 2.48% per patient-year, and valve-related deaths occurred at 1.62% per patient-year. The actuarial freedom from reoperation due to structural valve deterioration at 20 years was 24.3% ± 2% for degenerative disease and 15% ± 1.4% for non-degenerative disease. For degenerative valve disease, the freedom from structural valve deterioration at 18-years was 39% ± 1% for recipients <60-years old and 66% ± 2% for those ≥60-years old. Our data confirm the excellent durability and low mortality associated with the Carpentier-Edwards Perimount for mitral valve replacement. The rate of calcification of the valve was unrelated to degenerative valve disease, but our findings suggest that this prosthesis gives better results in recipients ≥60-years old than in younger patients.

[Coronary artery bypass graft in adolescent suffering from homozygous familial hypercholesterolemia resistant to probucol therapy]. / Pontage aorto-coronarien chez un adolescent souffrant d'une hypercholesterolemie familiale homozygote resistante au probucol.

Homozygous familial hypercholesterolemia is a rare hypercholesterolemia representing 1 to 2% of hypercholesterolemia. It is a metabolic disorder coming from genetic trouble with a bad prognostic. Its probucol's therapy in an adolescent is subject of controversy. The authors report a new case diagnosed in an adolescent of 15-year-old followed after CABG in the Thoracic and cardiovascular surgery Department of National Heart Institute Imbaba-Cairo (Egypt).