[Characteristics of acute coronary syndromes in Sub-Saharan African women]. / Particularités des syndromes coronariens aigus chez la femme en Afrique subsaharienne.

INTRODUCTION: Acute coronary syndromes have been rarely studied in the female population in Sub-Saharan Africa. This Sub-Saharan serie has shown an increase in the prevalence of acute coronary syndromes among the female population, compared to previous studies. Through this retrospective study, we evaluated the epidemiological, clinical, paraclinical, therapeutic and evolutionary features of acute coronary syndromes on women at the Principal Hospital of Dakar. METHODOLOGY: This was a retrospective study of patients hospitalized for acute coronary syndrome over a period of 5 years from January 1st, 2010 to December 31st, 2014, at the Cardiology Department of the Principal Hospital of Dakar. RESULTS: The prevalence of diabetes and obesity was statistically higher for women than for men. Atypical symptomatology was much more apparent (P=0.0000), admission times at the emergency department for acute coronary syndromes were relatively longer (=0.005). Therapeutically, medical care was almost identical regardless of gender. CONCLUSION: In Senegal, acute coronary syndrome in women is characterized by the atypical symptomatology with delayed diagnosis and management. The fight against this reputedly masculine pathology requires a good awareness campaign.

[Resistance to acenocoumarol revealing a missense mutation of the vitamin K epoxyde reductase VKORC1: a case report]. / Résistance à l'acénocoumarol révélant une mutation faux sens Val66Met de la vitamine K époxyde réductase VKORC1 : à propos d'une observation.

A significant proportion of the interindividual variability of the response to vitamin K antagonist (VKA) treatment has been associated with genetic factors. Genetic variations affecting the vitamin K epoxide reductase complex subunit 1 (VKORC1) are associated with hypersensitivity or rarely with resistance to VKA. We report the case of a black women patient who presents a resistance to acenocoumarol. Despite the use of high doses of acenocoumarol (114 mg/week) for the treatment of recurrent pulmonary embolism, the International Normalized Ratio was below the therapeutic target. This resistance to acenocoumarol was confirmed by the identification of a missense mutation Val66Met of the vitamin K epoxide reductase.

[Pulmonary embolism: autopsy study of 73 cases in Senegal]. / L'embolie pulmonaire: étude nécropsique à propos de 73 cas.

INTRODUCTION: The Pulmonary emblism is a vascular disease which is characterized by the more or less complete obstruction of one or several pulmonary arteritis and/or their branches by an embol. Very polymorphic affection, mortal in the massiv form, it has in the average forms of the atypical or misleading aspects which make its clinical diagnosis difficult. The diagnostic strategy of the pulmonary embolism remains incompletely solved. The objectives of this work are: --to evaluate the prevalence with the autopsy of the pulmonary embolism and its distribution according to the age, --to appreciate the correlation enters the ante and the post-mortems diagnoses. PATIENTS AND METHODS: It is about a retrospective study, over 10 years period, having inclued the files of all the patients died in the various services of medicine or surgery of the university hospital of Aristide Le Dantec but also those transferred from outside of the hospital and at which the pulmonary diagnosis post-mortem of embolism was retained. RESULTS: Sixty thirteen (73) cases of pulmonary embolism had been found during autopsies during the period of study (10 ans), that is to say a prevalence of 1.9%. The average was 35 years. The most representative age bracket was that ranging beetwin 21 and 30 years is 36% of the studied population. On the 73 indexed patients, 30 (41%) were transferred from outside of the hospital and 43 (59%) came from the servicies of medecine and surgery with a prevalance of the service of cardiology (26%). The correlation beetween ante-mortems diagnosis and the anatomical result was 11% for the whole of the patients incleded in the study. However, it was 42% for the sub-grup of patients comming from the service of cardiology. CONCLUSION: The prevalence with the autopsy of pulmonary embolism is weak. The clinical diagnosis of this affection is difficult even in a specilised service with a high rate of negatif forgeries. This pathology is very under- evaluated even in these services.