[Klippel-Trenaunay Syndrome In Black African: Clinical And Therapeutic Particularities About One Cas Report]. / Syndrome De Klippel-Trenaunay Du Noir Africain : Particularites Cliniques Et Therapeutiques A Propos D'Un Cas.

The authors report a case of a syndrome of KlippelTrenaunay revealed by the venous malformations and osteoalodystrophyof the rightlower limb in the Teaching Hospital of Bouake. Surgery consisted in a vast stripping associated with a right crossectomy. The histological examination of the venous maze was favorable to an angioma. Postoperative outcome was simple. After a drop of 14 months, the patient presents an occasional myalgia arising in the effort. This observation raises the problem of the post-operative evolution of the congenital varicose veins.

Les auteurs rapportent un cas d'un syndrome de Klippel-Trenaunayrévélé par des malformations variqueuses systématisées et une ostéodystrophieavec un reflux ostial important du membre inférieur droit au CHU de Bouaké. La chirurgie classique a consisté à un éveinage étendu associé à une crossectomie droite. L'examen histologique des lacis veineux était favorable à l'existence d'un angiome. Les suites opératoires ont été simples. Après un recul de 14 mois, le patient présente une myalgie intermittente survenant à l'effort de marche. Cette observation pose le problème de l'évolution postopératoire des varices congénitales.

Syndrome de Klippel-Trenaunay du noir africain : particularités cliniques et thérapeutiques à propos d'un cas

Les auteurs rapportent un cas d'un syndrome de Klippel­Trenaunayrévélé par des malformations variqueuses systématisées et une ostéodystrophie avec un reflux ostial important du membre inférieur droit au CHU de Bouaké. La chirurgie classique a consisté à un éveinage étendu associé à une crossectomie droite. L'examen histologique des lacis veineux était favorable à l'existence d'un angiome. Les suites opératoires ont été simples. Après un recul de 14 mois, le patient présente une myalgie intermittente survenant à l'effort de marche. Cette observation pose le problème de l'évolution postopératoire des varices congénitales

Performance of rapid tests and algorithms for HIV screening in Abidjan, Ivory Coast.

Seven rapid diagnosis tests (RDTs) of HIV were evaluated by a panel group who collected serum samples from patients in Abidjan (HIV-1 = 203, HIV-2 = 25, HIV-dual = 25, HIV = 305). Kit performances were recorded after the reference techniques (enzyme-linked immunosorbent assay). The following RDTs showed a sensitivity of 100% and a specificity higher than 99%: Determine, Oraquick, SD Bioline, BCP, and Stat-Pak. These kits were used to establish infection screening strategies. The combination with 2 or 3 of these tests in series or parallel algorithms showed that series combinations with 2 tests (Oraquick and Bioline) and 3 tests (Determine, BCP, and Stat-Pak) gave the best performances (sensitivity, specificity, positive predictive value, and negative predictive value of 100%). However, the combination with 2 tests appeared to be more onerous than the combination with 3 tests. The combination with Determine, BCP, and Stat-Pak tests serving as a tiebreaker could be an alternative to the HIV/AIDS serological screening in Abidjan.

[Thyroid localization of myxofibrosarcoma: first case in Africa]. / Myxofibrosarcome à localisation thyroïdienne: première observation en Afrique.

This case report describes a 45-year-old woman who was treated for a bulky ulcerated thyroid tumor with an offensive odor. The tumor had been ongoing for approximately 20 years. The patient had familial medical history of goiter. Histopathological diagnosis of the surgical specimen demonstrated myxofibrosarcoma associated with a classic thyroid tumor (vesicular adenoma). Based on this case, the author reviews the literature describing this rare soft-tissue tumor that is usually located on the extremities. Surgical treatment consists of radical tumor excision. A multidisciplinary therapeutic approach is necessary for efficient management by ensuring proper coordination of adjunctive treatment.

Newborn hearing screening in a developing country: results of a pilot study in Abidjan, Côte d'ivoire.

OBJECTIVE: To investigate the feasibility of neonatal hearing impairment in newborn babies in Abidjan, Côte d'Ivoire. METHODS: It is a cross-sectional study in which all infants aged from 3 to 28 days, attending for Bacille Calmette-Guerin (BCG) immunization in primary care centers or hospitalized in neonatal intensive care units (NICU), between July 2007 and March 2008, were included. Screening followed a two-stage strategy with transient evoked otoacoustic emissions (TEOAE). Infants referred after the second-stage screening were scheduled for diagnostic evaluation by diagnostic auditory brainstem response (ABR). The variables analyzed were: screening coverage, referral rates; return rates for second-stage screening and diagnostic evaluation, incidence of permanent hearing loss and age at diagnosis. RESULTS: 1306 newborns, of a total of 1495, were successfully screened, giving a screening coverage of 87.4%. The average age was 4.5 days (S.D.: 2.7), with 5.85 days (S.D.: 3.17) for the immunization group and 3.20 days (S.D.: 0.40) for the neonatal unit group. In total, 286 out of the 1306 infants (21.9%) were referred after the first-stage screening; out of which 193 (67.5%) return for the second stage. After the second-stage screening, 48 (16.8%) were scheduled for diagnostic evaluation (45 from NICU and 3 from primary care centers). The overall referral rate for diagnostic evaluation was 3.7% (48/1306). Only 18.75% of those referred (9/48) returned for evaluation, and seven of them (77.8%) were confirmed with hearing loss (2 from immunization group and 5 from neonatal unit group). The prevalence of permanent hearing loss in this screened population was 5.96 per 1000 (7/1174 babies who completed the screening) [95% I.C.: 5.62-6.30 per 1000]. The mean age at diagnosis was 22 weeks (S.D.: 8.3). The reasons for non-completed screening were, according to 62 mothers: no financial means, absence of hearing loss, fear of spouse reactions, lack of information about this test and deafness. CONCLUSION: The incidence of permanent and early hearing impairment identified by this screening program was about 6 per 1000. Routine hearing screening of infants for the early detection of hearing loss is necessary in Côte d'Ivoire. It is possible to implement such a hearing screening, targeting all newborns, in primary health care centers and neonatal intensive care units.

[Radiologic aspects of traumatic lesions of the cervico-occipital junction]. / Les aspects radiologiques des lesions traumatiques de la charniere cervico-occipitale.

INTRODUCTION: Traumatic lesions of cervical spine are common, but those of the cervico-occipital junction are less frequent but more serious. PURPOSE: Evaluate the radiological aspects of cervico occipital Junction traumatisms. METHODS: It is a retrospective study of 32 files of cervico occipital junction traumatisms, collected from January 1995 to December 2004. Imaging methods used were: conventional radiography and computed tomography. RESULTS: Cervico occipital junction traumatisms were less common. They account for 12.7% of cervical spine traumatisms and 0.64% of the admissions. Patients mean age was of 36 years with a male predominance of 81%. Main etiologies were public highway accidents (66%), falls (7%), sports accidents (6%). Bone lesions were most frequent, dominated by fractures of the axis (58%), followed by those of the atlas (24%) and of the occipital bone (5%). Dislocations were observed in 10 patients. Basilar print was observed in two patients who deceased. Polytrauma was observed in 34% of the patients. CONCLUSION: Cervico occipital junction traumatisms are severe and uncommon in hospitals because of their high lethality. CT is most effective for analyzing lesions.