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Open Journal of Gastroenterology 2024年第9期14卷 322-329页

作者： Zanga Damien Ouattara Stève Léonce Zoungrana Saïdou Santi Emeline Agathe Carama Fabien Dembele Bafima Désiré Diarra alain bougouma Department of Gastroenteroly Ouahigouya Regional University Hospital Ouahigouya Burkina Faso Department of Neurology Bogodogo University Hospital Ouagadougou Burkina Faso Department of Gastroenterology Yalgado Oudraogo University Hospital Center Ouagadougou Burkina Faso

Megaloblastic pernicious anemia is an autoimmune disorder, considered rare in African context. The objective of this study was to report four clinical cases collected at the CHUR/OHG, and to review the literature. The study population consisted of two men and two women. The clinical manifestations were mainly neurological and hematological. The neurological signs were mainly paresthesia. One patient presented memory problems. On the biological level, macrocytic anemia and vitamin B12 deficiency were reported in two cases prior to treatment while the other two without serological assay of vitamin B12 were put on trial treatment. Anti-intrinsic factor antibodies were positive in three patients. The Schilling test was not used. Upper gastrointestinal endoscopy revealed atrophic fundic gastritis in all four patients who received treatment through intramuscular injection of hydroxocobalamin (vitamin B12). The evolution was favorable after one month of treatment in all cases. The literature review is dominated by clinical case reports, the largest cohorts of which are from the Maghreb.

关键词： Anemia Pernicious Megaloblastic Vitamin B12

Incomplete Situs Inversus Revealed by Acute Pain of the Right Hypochondrium

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Open Journal of Gastroenterology 2022年第10期12卷 263-270页

作者： Alice Nanelin Guingané Julien Sawadogo Adjirata Koama Bénilde Marie-Ange Tiemtoré-Kambou Roger Sombié alain bougouma Service d’hépato-gastroentérologie CHU Bogodogo Ouagadougou Burkina Faso Service de chirurgie générale et digestive du CHU-YO Ouagadougou Burkina Faso Service de radiologie CHU Bogodogo Ouagadougou Burkina Faso Service d’hépato-gastroentérologie CHU-YO Ouagadougou Burkina Faso

Situs inversus is an abnormal placement of the thoracic and/or abdominal organs that are inverted right/left from normal. It is a rare congenital malformation often discovered in childhood. In adults, it can lead to misdiagnosis. Clinical case: A 35-year-old female patient, seen in a hepatogastroenterology consultation for acute spontaneous pain in the right hypochondrium. She had no particular clinical history. A diagnosis of hepatopathy was suspected. Abdominal and pelvic CT scans showed the left liver, stomach and spleen in the right hypochondrium, but with the heart in place, suggesting incomplete situs inversus. The evolution in our patient was spontaneously resolved with analgesics and antispasmodics, which leads us to believe that the volvulus was probably partial and without other complications. Conclusion: In developing countries, antenatal diagnosis of situs inversus is rare and is usually made during a pathology that leads the patient to a medical consultation. CT is one of the key paraclinical examinations for its diagnosis as genetic tests are not widely available.

关键词： Situs Inversus Abdominal Pain Hypochondrium Abdominal CT Scan

Liver Damage during Dengue Fever in Ouagadougou

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Open Journal of Gastroenterology 2022年第9期12卷 221-231页

作者： Alice Nanelin Guingané Judith Ouango Abdoulaye Sourabié Christiane Couna Bere Roger Sombié alain bougouma Abdel Karim Sermé Aboubacar Coulibaly Sosthène Somda Department of Hepato-Gastroenterology CHU Bogodogo Burkina Faso Hepato-Gastroenterology Department CHU Yalgado Ouédraogo Burkina Faso

Dengue fever is widespread in all tropical and subtropical areas of the world and is the main public health problem posed by arboviroses. In Burkina Faso, an outbreak of dengue serotype “DENV-2”, which is responsible for severe forms of dengue, has been reported. In this study, we will discuss liver damage during this disease. The aim of this study was to describe the sociodemographic, diagnostic, therapeutic and evolutionary aspects of dengue patients with hepatic cytolysis. Patients and Methods: This was a prospective cross-sectional study of dengue disease in 2 facilities in the city of Ouagadougou. The study was spread over a period of 3 months from August to November 2019. The study population consisted of all patients hospitalised for dengue with a positive AgNS1 and/or IgM rapid diagnostic test (RDT) and presenting signs of liver damage. Results: During our study period we recruited 134 patients with dengue fever of which 93 or 69.4% had at least one elevated transaminase. The sex ratio was 1.90 and the average age was 35 years. Symptoms of liver damage were rare with right hypochondrial pain in 4.30% of cases and jaundice in 1.07% of cases. Dengue haemorrhagic fever was found in 5 patients. IgG was negative in 77.42%. The majority of patients (44% or 47.31%) had at least one transaminase value elevated to the upper limit of normal (ULN);and a minority, 14 patients or 15.06%, had transaminases above 10 ULN. A small proportion of patients had hepatocellular failure 26.92% with a lowered prothrombin level. Ninety-four per cent (94.62%) of the patients received analgesics. Level 1 analgesic (paracetamol) was the most widely administered, particularly in 76 patients (86.36%). More than half of the patients (57.14%) had a length of stay of less than or equal to 3 days and the outcome was favourable in 91.40%. Conclusion: Dengue virus causes alterations in the liver parenchyma. The degree of liver damage is variable. As clinical symptoms are almost non-existent, th

关键词： Dengue Fever Liver Damage Cytolysis Hemorrhagic Fever

Prevention of Mother-to-Child Transmission of Hepatitis B in the Urban District Health Baskuy Burkina Faso

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Open Journal of Gastroenterology 2016年第6期6卷 175-187页

作者： Alice Nanelin Guingané Nicolas Meda Roger Sombié Christiane Béré/Somé Lydie Sia Rose Ido/Da Issa Guiraud alain bougouma Service d’Hépatogastroentérologie CHU-Yalgado Ouédraogo Ouagadougou Burkina Faso Aix Marseille University IRD UMR-S912 Marseille France Faculty of Health Sciences (UFR-SDS) University of Ouaga I Pr Joseph Ki-Zerbo Ouagadougou Burkina Faso Centre MURAZ Bobo-Dioulasso Burkina Faso Institute of Research on Health Sciences Ouagadougou Burkina Faso

Few studies have been conducted on the epidemiology in pregnancy in sub-Saharan Africa. This study aimed to improve the care of pregnant women infected with hepatitis B virus (VHB) and their newborns in the urban district health. Method: This study was conducted from 01/09/2014 to 01/09/2015. Study involved three types of data collection: a collection of data from health facilities involved in the project;repeated cross-sectional survey among health personnel;a pros- pective study of pregnant women identified positive for HBsAg and followed at the University Hospital Yalgado Ouédraogo (CHU-YO). Knowledge assessment was made among health staff and pregnant women using a knowledge score. Construction of the score came after a factorial analysis of multiple correspondences on population health workers surveyed in the first round (N = 119) on one hand and all pregnant women (N = 266) on the other hand. This had identified among the 79/19 questions, those that discriminated best knowledge of paramedics and pregnant women. For pregnant women, this score was then dichotomized from the center and logistic regression was performed to determine the sociodemographic, medical and obstetric characteristics that influenced it (p value < 005). Results: Health staff had been surveyed twice (N = 119/100). In general, the level of knowledge was good on targeted knowledge, both before and after training. No health worker routinely offered screening for hepatitis B among pregnant women attending antenatal clinics. Altogether 266 pregnant women HBsAg-positive were referred and followed CHU-YO. Half of the patients had a score lower than 2/17. Univariate analysis showed that variables such as education level influenced significantly the level of knowledge. Women with higher levels of education had a higher level of knowledge about the disease, compared to those of primary level [OR = 1.63;[1.34 to 1.99], p value < 0,001]. Newborns during the study period numbered 128 and the vaccine was

关键词： Hepatitis B Paramedics Knowledge Practices Pregnant Women Immunization Newborn

Clinical Efficacy of Prolonged First-Line Treatment against Helicobacter pylori in Ouagadougou

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Open Journal of Gastroenterology 2022年第7期12卷 161-169页

作者： Nô mawendé Inès Compaore Couna Christiane Some Nanelin Alice Guingane Tegwinde Rebeca Compaore Marie Nina Compaore Roger Sombie alain bougouma Service of Medicine and Medical Specialties Medical Center with Surgical Antenna El Fateh-Suka Ouagadougou Burkina Faso Service of Hepato-Gastroenterology of Yalgado Ouedraogo University Hospital Center Ouagadougou Burkina Faso Service of Hepato-Gastroenterology of the University Hospital Center of Bogodogo Ouagadougou Burkina Faso LABIOGENE Laboratory of Molecular Biology and Genetic University of Ouagadougou Ouagadougou Burkina Faso Epidemiology/Health Science Center of Houston Houston United States of America

Background: Helicobacter pylori (H. pylori) infection is a public health concern. In fact, due to bacterial resistance, treatment strategy is a challenge. It is then more recommended to prolong first-line treatment. In order to be acceptable, the clinical efficacy of treatment must be higher than 90%. Aim: We aimed to assess the outcome of prolonged first-line treatment among adults. Patients and Methods: The study was cross-sectional among adults and patients were treated for H. pylori eradication for the first time during 10 to 14 days. Recruitment was made from March 2019 in six private polyclinics and two hospitals of the city of Ouagadougou. We used monoclonal antigen (Ag) test on the stool samples for diagnostic and for the patients follow up. Chi squared (X2) tests and ANOVA for the comparison of percentages and means were determined using with STATA® software program in the bilateral 95% confidence interval for the statistical analysis. Results: In the different medical centers for 19 months, 365 patients were compiled. The sex-ratio was 0.64. The average age was 43.55 years. The treatment efficacy was 92.88%. Treatment efficacy was better with p-value -3 depending on prescriber: gastroenterologist (94.07%), general practitioner (75%);compliance before treatment: excellent (95.88%) or bad (50%);number of consultations: ≥four (94.35%), three (96.32%), two (78.85%). Triple therapies efficacy was 90.81%;p = 0.19. Quadritherapy efficacy was 95%;p = 0.5. Conclusion: This research is a contribution to the advent of national or African recommendations.

关键词： Helicobacter pylori Treatment Efficacy Triple Therapies Quadritherapy

Patient Experience at Endoscopy Centers in Three West African Countries during the COVID-19 Pandemic

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Open Journal of Gastroenterology 2023年第4期13卷 161-169页

作者： Alice Nanelin Guingané Euloge Houndonougbo Jamila Abdouramane Soli Léonce Steve Zoungrana Sandrine Soudré Aboubacar Coulibaly Sosthène Somda Roger Sombié Appolinaire Sawadogo alain bougouma Service d’hépato-Gastroentérologie CHU Bogodogo Ouagadougou Burkina Faso Service d’hépato-Gastroentérologie Hopital saint jean de Dieu Tanguiéta Bénin Service d’hépato-Gastroentérologie Hopital général de référence de Niamey Niamey Niger Service d’hépato-Gastroentérologie CHU Ouahigouya Ouagadougou Burkina Faso Service d’hépato-Gastroentérologie CHU Tengandogo Tengandogo Burkina Faso Service d’hépato-Gastroentérologie CHU Yalgado Ouédraogo Ouagadougou Burkina Faso Service d’hépato-Gastroentérologie CHU Sourou Sanou Bobo-Dioulasso Burkina Faso

Corona virus infection and the risk of contagiousness to medical personnel or patients during endoscopy necessitated further measures in the endoscopy rooms. The objective of this study was to assess the experience of patients in endoscopy rooms during the COVID-19 epidemic in West Africa. Patients and Methods: This was a multicenter cross-sectional study that took place over a period of 3 months (June to August 2020) in endoscopy centers in Burkina Faso, Benin and Niger. An online questionnaire was sent to patients who had performed upper digestive endoscopies, in 8 digestive endoscopy centers including private, public and religious structures. Depending on the choice of patients, questionnaires were either sent electronically or completed in the endoscopy room with the help of field investigators. The choice of centers was random from the list of centers and descriptive analyses were carried out. Results: A total of 294 patients responded to the online questionnaire. There were 37 lower and 257 upper gastrointestinal endoscopies. The female sex represented 52.1%. The wait times for obtaining an endoscopy appointment were considered satisfactory by 281 patients 95.6%. In the endoscopy departments, 112 patients, or 38.1%, were questioned about the risk factors for contamination of SARS-CoV-2. Among the risk factors found, 6 patients (2.0%) would have traveled abroad in the 2 weeks preceding the examination, 4 patients 1.4% had already been in contact with a subject at risk. The most frequent symptoms were chest pain (80 cases;27.2%), flu-like syndrome (29 cases;9.9%), cough (40 cases;13.6%), fever (46 cases;15.6%). In contrast, ageusia (7 cases;2.4%) and anosmia (5 cases;1.7%) were only found in very few patients. Twenty-two patients (7.5%) felt highly exposed to COVID-19 during the endoscopy examination and 144 patients (48.9%) rated the examination as satisfactory. Conclusion: Gastrointestinal symptoms initially described as rare are being reported with increasing

关键词： Endoscopy COVID-19 Patients Exposure Symptoms

Treatment of HBeAg-Negative Chronic Hepatitis B Patients with Nucleos(t)ide Analogues in Burkina Faso

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Open Journal of Gastroenterology 2016年第12期6卷 387-396页

作者： Kounpiélimé Sosthène Somda Abdel Karim Sermé Aboubacar Coulibaly Steve Léonce Zoungrana Inès Compaoré Serges Kouamou Damien Ouattara Roger Sombié alain bougouma Hepato-Gastroenterology Unit Teaching Hospital Yalgado Ouédraogo Ouagadougou Burkina Faso Gastroenterology Unit UFR/SDS CUP Ouahigouya Burkina Faso

The treatment of chronic hepatitis B (CHB) has increased significantly in recent years. In patients affected by HBeAg-negative CHB, it is necessary to distinguish the inactive carriers (low viral DNA 2000 IU/mL, normal ALT, histological lesions absent or minimal) who does not need treatment, and patients suffering from active CHB (DNA > 2000 IU/ml, high transaminases or fluctuating, significant fibrosis and/or necro-inflammatory activity > 1) who must be treated. The main purpose of treatment is to obtain a long-lasting viral suppression to improve the histological lesions and reduce the risk of evolution towards cirrhosis, liver failure and hepatocellular carcinoma (HCC). It about an indefinite treatment (unless HBsAg seroclearance) expensive and often inaccessible for the majority of our patients. Our study aimed to report the results of four years follow-up of HBeAg-negative patients treated by Nucleos(t)ide analogues (NAs) in Ouagadougou (Burkina Faso). It was a clinical observational study with 133 patients including 95 men;the average age was 41.2 years, completing the criteria of treatment. One hundred and twelve patients were treated by tenofovir (TDF), fourteen by lamivudine and seven co-infected HIV/HBV patients by Atripla® (combination TDF, Emtricitabine and Efavirenz). Virological and biochemical responses were respectively 100% and 94% after 4 years. The rate of HBsAg seroclearance was 1.5%. Twelve of fourteen patients (85.7%) had lamivudine resistance and no cases of resistance in the TDF and Atripla® groups. One co-infected patient developed HCC during treatment. Among patients treated by TDF, two cases of hypophosphatemia were noticed and no case of kidney failure. The treatment of CHB is certainly progressing;updated guidelines (EASL, AASLD) exist but should be adapted to the African context.

关键词： Chronic Hepatitis B HBeAg-Negative Nucleos(t)ide Analogues Tenofovir Lamivudine Burkina Faso

Viral Hepatitis B under Tenofovir in Ouagadougou (Burkina Faso)

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Open Journal of Gastroenterology 2021年第8期11卷 141-150页

作者： Soudré Sandrine Marie-Odile Bobilwindé Napon Fahosiata Zoungrana Steve Léonce Ouattara Zanga Damien Koura Mali Guingané Nanelin Alice Somda Sosthène Coulibaly Aboubacar Beni Da Nathalie Salou Rodrigue bougouma alain Sombié Arsène Roger Hepato-Gastroenterology Unit of the University Hospital Tengandogo Burkina Faso Africa Hepato-Gastroenterology Unit of the University Hospital Ouahigouya Burkina Faso Africa Gastroenterology Service of the University Hospital Souro Sanou Bobo-Dioulasso Burkina Faso Africa Gastroenterology Service of the University Hospital Bogodogo Ouagadougou Burkina Faso Africa Gastroenterology Service of the University Hospital Yalgado Ouédraogo Ouagadougou Burkina Faso Africa

Introduction: The treatment of viral hepatitis B is based on nucleotide analogs(s). In Burkina Faso, tenofovir is the most widely used because of its effectiveness and cost. The aim of this study was to describe viral hepatitis B under tenofovir in Ouagadougou. Material and Method: This was a longitudinal study, carried out in the outpatient department of the University Hospital of Tengandogo from May 1, 2013 to September 31, 2020, i.e. a period of seven (07) years and five (05) months. All patients with chronic hepatitis B virus who had been taking tenofovir for at least one year were included in the study. Cases of hepatocellular carcinoma and co-infections with hepatitis D, C and human immunodeficiency viruses were excluded from the study. Results: Of 321 patients with hepatitis B, 120 were on tenofovir and 34 were included in our study. These were 24 men and 10 women with an average age of 39 years. Hepatitis B was most often discovered following systematic or voluntary screening (44.1%) or pain in the right hypochondrium (23.5%). The mean initial viral load was 7.9 log. Ten patients had moderate compliance and four were non-compliant. No side effects were reported in 91.3% of cases. The virologic response was complete in 72.7% of patients after six months. Nine out of ten patients showed a biochemical response after 16 months. A histological response was observed in 19/27 patients within a mean of 26.7 months. HBs seroconversion was found in 2/24 patients. Conclusion: Tenofovir is effective in the treatment of viral hepatitis B, but HBs seroconversion is rarely achieved.

关键词： Viral Hepatitis B Tenofovir Compliance Tolerance Efficacy

Differential colour-ring loss among Dalmatian Pelican(Pelecanus crispus) colonies and its consequence on survival estimates

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Avian Research 2024年第1期15卷 66-71页

作者： Anastasios Bounas Giorgos Catsadorakis Dionyssia Hatzilacou Theodoros Naziridis Jocelyn Champagnon alain J.Crivelli Department of Biological Applications and Technology University of IoanninaIoanninaGreece Society for the Protection of Prespa Agios GermanosGreece Natural Environment and Climate Change Agency 207 Mesogeion Ave.11525AthensGreece Natural Environment and Climate Change Agency Kerkini BranchKerkiniGR-62055Kato PoroiaGreece Tour du Valat Research Institute for Conservation of Mediterranean Wetlands13200ArlesFrance

The analysis of bird ringing data often comes with some potential sources of error and bias,as ring wear and/or loss could affect mark-recapture analyses and produce erroneous estimates of ***,ring wear and loss rates may differ between and within species based on the habitat they use or the species’ life-history traits and behaviour as well as the type of the *** this study we use resighting data from a long-term double marking experiment to directly estimate the rate of colour-ring loss among different Dalmatian Pelican colonies over time,evaluate any possible factors that could contribute to differential ring loss and assess how it may bias the results of mark-resighting *** on 14,849 resightings from 1275 individuals and using multi-state continuous-time hidden Markov models(HMMs) we showed that probability of ring loss was markedly different among colonies,ranging from 0.10 to 0.42 within the first year of marking,whereas the cumulative probability of losing a ring after ten years ranged 0.64 to *** rates are among the highest estimated when compared to previous studies in *** approach assessing the intra-specific variance in ring loss provided several factors potentially involved,such as the use of glue and the fledgling age accuracy and we could further hypothesise the effect of environmental ***,our results showed that ring loss can be a significant challenge for the assessment of the species’ population dynamics using mark-recapture methods as survival was consistently underestimated when not accounting for ring loss and varied significantly among different colonies.

关键词： Bias Capture-mark-recapture Colour-ring Double-marking Hidden Markov models

Stepping up after spinal cord injury:negotiating an obstacle during walking

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Neural Regeneration Research 2025年第7期20卷 1919-1929页

作者： alain Frigon Charly G.Lecomte Department of Pharmacology-Physiology Faculty of Medicine and Health SciencesUniversitéde SherbrookeCentre de recherche du Centre Hospitalier Universitaire de SherbrookeSherbrookeQCCanada

Every day walking consists of frequent voluntary modifications in the gait pattern to negotiate *** spinal cord injury,stepping over an obstacle becomes *** over an obstacle requires sensorimotor transformations in several structures of the brain,including the parietal cortex,premotor cortex,and motor *** information and planning are transformed into motor commands,which are sent from the motor cortex to spinal neuronal circuits to alter limb trajectory,coordinate the limbs,and maintain *** spinal cord injury,bidirectional communication between the brain and spinal cord is disrupted and animals,including humans,fail to voluntarily modify limb trajectory to step over an ***,in this review,we discuss the neuromechanical control of stepping over an obstacle,why it fails after spinal cord injury,and how it recovers to a certain extent.

关键词： biomechanics locomotion neurophysiology obstacle negotiation spinal cord injury