Are Any Changes in Carotid Intima-Media Thickness Associated with Cardiometabolic Risk Among Adult Bantu Central African Hypertensive Patients from Monkole and Biamba Marie Mutombo Hospitals?

Background: Several classic/traditional risk factors are associated with intima-media thickness (IMT), a novel risk of cardio metabolic risk (CMR) in the literature but not in Kinshasa, a megacity prone to CMR. Thus, the objective of this study was to evaluate potential correlations between inflammation, kidney function, psychological stress, hemodynamics, and changes in IMT. Methods: This cross-sectional study was carried out between 2018 and 2021 within Monkole and Biamba Marie Mutombo Hospitals, respectively, and randomly selected from 10 health structures from East and West of Kinshasa, Capital of Democratic Republic Congo (DRC). A random sample of adult hypertensive Bantu Central Africans was examined after bivariate correlations and multiple linear regression. Results: Out of 280 patients with 140 men and 140 women aged 62 ± 11 years, the mean carotid intima-media thickness (CIMT) was 1.06 ± 0.5 mm and 73% (n = 204) patients had uncontrolled hypertension. After controlling for confounders, 52.9% variations (R2) of CIMT were independently and significantly (P = 0.037) predicted by CRP, 24-hour proteinuria, urinary albumin/creatinine ratio, duration of hypertension, heart rate, hip circumference, and psychological stress with Equation Y = 0.717 + 0.87 × CRP + 0.02 × 24 H - proteinuria + 0.005 × urinary albumin/creatinine ratio + 0.05 × duration of hypertension + 0.001 × heart rate + 0.006 × hip circumference + 0.017 × psychological stress. Conclusion: There is an urgent need to control inflammation, impaired renal function, cardiac rhythm, peripheral obesity, longer duration of hypertension management, and stress, which are emerging as specific novel determinants of the subclinical atherosclerosis for those Bantu Central African hypertensive patients.

[Postoperative ureterocolonic fistula: a case report]. / Fistule urétérocolique postopératoire.

Postoperative ureterocolonic fistula is exceptional: only one case has been published over the last 32 years. The authors report a case of postoperative ureterocolonic fistula observed after right hysteroadnexectomy in a 38-year-old woman with a solitary right kidney. This patient initially presented with anuria and fever followed by urine-smelling liquid diarrhoea. In a context of inadequate urological imaging equipment, the diagnosis of ureterocolonic fistula was suspected on the basis of the specific features of the diarrhoea, ultrasound which revealed ureterohydronephrosis above a pelvic obstacle, and normal cystography. Surgical exploration demonstrated a ureterosigmoidfistula. This case represents the 20th case of ureterocolonic fistula reported in the literature, including 2 postoperative cases.