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1.
Pan Afr Med J ; 31: 235, 2018.
Artigo em Francês | MEDLINE | ID: mdl-31447992

RESUMO

To determine the prevalence of the rhythmic disorders during ischemic stroke, and to identify the predictive factors of paroxysmal atrial fibrillation (PAF). It was about a cross-sectional study, descriptive and analytical, conducted to Brazzaville between january 2012 and december 2016. It related to a consecutive series of 267 patients victims of a transient ischemic attack (n = 17) or ischemic stroke (n = 250), documented by cerebral tomodensitometry or brain MRI. All these patients profited from a recording 24h Holter ECG, carried out within the framework of etiologic research. The principal recorded rhythmic anomalies were indexed and the logistic regression allowed the identification of the predictive factors of PAF. They were 164 men (61.4%) and 103 women (38.6%), old on average of 60.2 ± 12.1 years. The identified cardiovascular risk factors were hypertension (80.1%), diabetes (13.5%), and tobacco use (6.7%). The 24h Holter ECG, normal in 216 cases (81%), was pathological in 51 cases (19%). The principal recorded anomalies consisted into ventricular ectopic beats (n = 32), PAF (n = 7), supraventricular ectopic beats (n = 5), non-sustained ventricular tachycardia (n = 4), sustained ventricular tachycardia (n = 2), and type 2 atrio-ventricular block (n = 1). The frequency of PAF was 2.6%. In bivariate analysis, it was not noted correlation between PAF and sex (p = 0.55), hypertension (p = 0.42), diabetes (p = 0.64), and tobacco use (p = 0.61). In multivariate analysis, only the age was the predictive factor of PAF during ischemic stroke (p = 0.0134). It comes out from this preliminary study that the emboligenous arrhythmias are relatively rare during ischemic stroke in Brazzaville. PAF, though little attends, remains primarily correlated at the age. Its systematic research at the old subjects contributes to improve the assumption of responsibility.


Assuntos
Fibrilação Atrial/diagnóstico , Isquemia Encefálica/diagnóstico , Eletrocardiografia Ambulatorial/métodos , Acidente Vascular Cerebral/diagnóstico , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/epidemiologia , Arritmias Cardíacas/fisiopatologia , Fibrilação Atrial/complicações , Isquemia Encefálica/etiologia , Congo/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Modelos Logísticos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
2.
J Clin Microbiol ; 51(7): 2379-81, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23554207

RESUMO

Arginase serum levels were increased in human African trypanosomiasis patients and returned to control values after treatment. Arginase hydrolyzes l-arginine to l-ornithine, which is essential for parasite growth. Moreover, l-arginine depletion impairs immune functions. Arginase may be considered as a biomarker for treatment efficacy.


Assuntos
Arginase/sangue , Biomarcadores/sangue , Monitoramento de Medicamentos/métodos , Tripanossomíase Africana/tratamento farmacológico , Feminino , Humanos , Masculino , Soro/química , Resultado do Tratamento
3.
J Neurol Sci ; 305(1-2): 112-5, 2011 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-21470639

RESUMO

Gambian (Trypanosoma brucei gambiense) human African trypanosomiasis (HAT) evolves from the hemolymphatic stage 1, treated with pentamidine, to the meningoencephalitic stage 2, often treated with melarsoprol. This arseniate may provoke a deadly reactive encephalopathy. It is therefore crucial to diagnose precisely the stages of HAT, especially when clinical and biological examinations are doubtful. We present here the case of a 30-month old girl (E20 KOLNG) diagnosed with stage 1 HAT during a field survey in June 2007 in Congo. She was followed-up every six months for 18 months in a village dispensary facility at Mpouya. Her health status deteriorated in December 2008, although cerebrospinal fluid (CSF) white blood cell (WBC) count was normal. The child was hospitalized at Brazzaville and a daytime polysomnographic recording (electroencephalogram, electrooculogram, and electromyogram) was performed (Temec Vitaport 3® portable recorder) to avoid a new lumbar puncture. The child presented a complete polysomnographic syndrome of HAT with a major disturbance of the distribution of sleep and wake episodes and the occurrence of sleep onset REM periods (SOREMPs). The relapse at stage 2 was confirmed by a new CSF examination that showed an elevated WBC count (23cells·µL(-1)) with the presence of B lymphocytes. Melarsoprol treatment was undertaken. A post-treatment recording was immediately performed, showing the resolution of sleepwake pattern abnormalities. Another polysomnography, taken four months later, confirmed the normalization of sleep-wake patterns indicating healing. We therefore propose that polysomnography, being a non-invasive technique, should be used in children to alleviate burden caused by HAT staging procedures, especially regarding lumbar punctures in remote African villages.


Assuntos
Intoxicação por Arsênico/diagnóstico , Polissonografia/métodos , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/parasitologia , Trypanosoma brucei gambiense/efeitos dos fármacos , Tripanossomíase Africana/tratamento farmacológico , Intoxicação por Arsênico/parasitologia , Intoxicação por Arsênico/prevenção & controle , Pré-Escolar , Congo , Feminino , Humanos , Melarsoprol/administração & dosagem , Melarsoprol/efeitos adversos , Tripanossomicidas/administração & dosagem , Tripanossomicidas/efeitos adversos , Trypanosoma brucei gambiense/crescimento & desenvolvimento , Tripanossomíase Africana/complicações , Tripanossomíase Africana/parasitologia
4.
Trop Med Int Health ; 15(4): 454-61, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19807900

RESUMO

OBJECTIVES: In human African trypanosomiasis (HAT, sleeping sickness), staging of disease and treatment follow-up relies on white cell count in the cerebrospinal fluid (CSF). As B lymphocytes (CD19 positive cells) are not found in the CSF of healthy individuals but occur in neurological disorders such as multiple sclerosis, B lymphocyte count may be useful for field diagnosis/staging and therapeutic follow-up in HAT. METHODS: Seventy-one HAT patients were diagnosed and 50 were followed-up 6-24 months after treatment. White cell counts were used for conventional staging (stage 1, < or =5 cells/microl CSF, n = 42; stage 2, > or =20 cells/microl, n = 16) and intermediate stage (6-19 cells/microl, n = 13). Slides containing 1 microl of CSF mixed with Dynabeads CD19 pan B were examined microscopically to detect B cell rosettes (bound to at least four beads). RESULTS: Stage 1 patients exhibited zero (n = 37) or one CSF rosette/microl (n = 5), contrary to most stage 2 patients (14/16: > or =2 rosettes/microl). Intermediate stage patients expressed 0 (n = 9), 1 (n = 3) or 2 (n = 1) rosettes/microl of CSF. During follow-up, rosette counts correlated with white cell count staging but were much easier to read. CONCLUSION: B cell rosettes being easily detected in the CSF in field conditions may be proposed to replace white cell count for defining HAT stages 1 and 2 and limit uncertainty in treatment decision in patients with intermediate stage.


Assuntos
Linfócitos B/citologia , Tripanossomíase Africana/líquido cefalorraquidiano , Tripanossomíase Africana/diagnóstico , Anticorpos Antiprotozoários/líquido cefalorraquidiano , Antígenos CD19/imunologia , Biomarcadores/líquido cefalorraquidiano , Seguimentos , Humanos , Contagem de Linfócitos/métodos , Análise de Regressão , Formação de Roseta/métodos , Trypanosoma brucei gambiense/isolamento & purificação , Tripanossomíase Africana/classificação , Tripanossomíase Africana/imunologia
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