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Cold Agglutinin Disease Prevalence and Immunoglobulin M levels in Patients with Splenomegaly from Endemic Areas for Malaria in Rwanda

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Open Journal of Internal Medicine 2020年第4期10卷 326-336页

作者： Shikama Felicien Masaisa Florence Nkusi Eugene Ntirenganya cyprien Devon Hale Butare University Teaching Hospital Huye Rwanda Kigali University Teaching Hospital Kigali Rwanda Butaro Hospital Burera Rwanda University of Utah School of Medicine Salt Lake City Utah USA

Background: Inhabitants from malaria endemic zones often present with enlarged spleen, mainly due to hyper reactive malarial splenomegaly (HMS), and it is seen more commonly associated with elevated levels of Immunoglobulin M (IgM). Cold agglutinin disease is an acquired autoimmune hemolytic anemia (AIHA) that is usually due to cold-reacting IgM autoantibodies directed against red cell antigens. The study was conducted in response to the observed high frequency of transfusion dependent anemia in patients with splenomegaly from malaria endemic zones in southern province of Rwanda. The objectives of this study were to determine the prevalence of cold agglutinin disease and to assess the distribution of IgM antibodies among these patients. Methodology: This was a descriptive, cross-sectional study conducted over a period of six months from June 2016 to December 2016. The study enrolled adult population from malaria endemic areas of the southern province of Rwanda with unexplained splenomegaly. Blood samples for testing IgM levels, cold agglutinin, FBC, and markers of hemolysis were collected from peripheral health settings and analyzed at the laboratory of Butare University Teaching Hospital. Results: During the study period, we enrolled 188 participants with enlarged spleen. One hundred twenty-five (66%) were females and 34% were males. The mean (±SD) age of the study participants was 35.6 ± 15.2 years. Out of 188 participants, only 4.8% were found with significantly positive Cold Agglutinin Titer (CAT) (≥1:64) and 84% of participants were found to have elevated serum IgM level. Hemoglobin level, white blood count and platelets count decrease with severity of splenomegaly, while IgM level increases with spleen size. Conclusion: Among patients with splenomegaly from malaria endemic areas, IgM levels correlate with the stages of splenomegaly while cold agglutinin disease plays a small role in the etiolo

关键词： Cold Agglutinin Hyperreactive Malarial Splenomegaly Malarial Endemic Areas Rwanda

不同剂量多巴酚丁胺对正常心肌纵向收缩期峰值应变的影响

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中国超声医学杂志 2012年第2期28卷 177-180页

作者：毕小军 cyprien MBA MBA 邓又斌华中科技大学同济医学院附属同济医院超声影像科

目的探讨不同剂量多巴酚丁胺对正常人纵向收缩期峰值应变的影响。方法对11例冠状动脉造影正常或狭窄0.05)。结论正常心肌节段的纵向收缩期峰值应变随着多巴酚丁胺负荷剂量的增加而增加,但当剂量达到40μg/(kg·min)时,开始恢复到静息水... 详细信息

目的探讨不同剂量多巴酚丁胺对正常人纵向收缩期峰值应变的影响。方法对11例冠状动脉造影正常或狭窄0.05)。结论正常心肌节段的纵向收缩期峰值应变随着多巴酚丁胺负荷剂量的增加而增加,但当剂量达到40μg/(kg·min)时,开始恢复到静息水平或有所降低。

关键词：超声心动描记术多巴酚丁胺二维应变成像负荷试验正常心肌

大剂量多巴酚丁胺负荷试验结合二维应变成像技术早期诊断冠心病的价值

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中华超声影像学杂志 2011年第2期20卷 116-120页

作者： cyprien MBA MBA 邓又斌毕小军王文璇刘蓉朱英华中科技大学同济医学院附属同济医院超声影像科武汉430030

目的探讨大剂量多巴酚丁胺负荷试验结合二维应变成像技术早期诊断冠心病的价值.方法对临床可疑的冠心病患者28例进行大剂量多巴酚丁胺负荷试验,分别在静息状态及各级负荷状态下观察室壁运动情况,测定左室各心肌节段心内膜下心肌的纵... 详细信息

目的探讨大剂量多巴酚丁胺负荷试验结合二维应变成像技术早期诊断冠心病的价值.方法对临床可疑的冠心病患者28例进行大剂量多巴酚丁胺负荷试验,分别在静息状态及各级负荷状态下观察室壁运动情况,测定左室各心肌节段心内膜下心肌的纵向收缩期峰值应变,比较大剂量多巴酚丁胺负荷试验目测法及大剂量多巴酚丁胺负荷试验结合二维应变成像技术诊断缺血心肌的敏感性和特异性;计算正常组、冠心病组缺血节段和非缺血节段的纵向收缩期峰值应变平均值并进行组内及组间比较,利用ROC曲线下面积评价纵向收缩期峰值应变预测缺血心肌的敏感性和特异性.结果冠心病组多巴酚丁胺剂量为40μg·kg^-1·min^-1时目测法检出室壁运动异常6例（共20个节段）,通过计算纵向收缩期峰值应变检出缺血心肌15例（共148节段）;冠心病组大多数缺血节段纵向收缩期峰值应变较正常组及非缺血节段相同负荷状态明显减低（P＜0.05）;大剂量多巴酚丁胺负荷试验目测法和大剂量多巴酚丁胺负荷试验结合二维应变成像技术诊断缺血心肌的敏感性分别为35.3%和88.2%（P＜0.01）,特异性分别为100%和100%（P＞0.05）、准确性分别为60.7%和92.8%（P＜0.01）.多巴酚丁胺剂量为40μg·kg^-1·min^-1时以纵向收缩期峰值应变绝对值≤14.9%为截断值,预测缺血心肌节段的敏感性和特异性分别为83.3%和91.7%.结论大剂量多巴酚丁胺负荷试验结合二维应变成像技术可以提高检出缺血心肌的敏感性,定量评价心肌收缩功能的微小改变,发现隐匿性心肌缺血,为临床诊断早期冠心病患者提供了无创性新方法 .

关键词：超声心动描记术多巴酚丁胺冠状动脉疾病心肌缺血二维应变成像

心肌灌注造影在多巴酚丁胺负荷前后早期诊断冠心病的价值研究

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心肌灌注造影在多巴酚丁胺负荷前后早期诊断冠心病的价值研究

多巴酚丁胺负荷超声心动图结合心肌灌注造影早期诊断冠心病的价值

中华医学会第十三次全国超声医学学术会议

作者：毕小军邓又斌 cyprien MBA MBA 朱英黎春雷华中科技大学附属同济医院超声科

目的探讨心肌灌注造影(MCE)技术在大剂量多巴酚丁胺负荷(DSE)前后早期诊断冠心病的价值。方法对临床可疑冠心病患者的38例,进行大剂量多巴酚丁胺负荷试验,分别在静息状态和试验终止的即刻实行MCE。对每次MEC后各心肌节段灌注状态进行评...

目的探讨心肌灌注造影(MCE)技术在大剂量多巴酚丁胺负荷(DSE)前后早期诊断冠心病的价值。方法对临床可疑冠心病患者的38例,进行大剂量多巴酚丁胺负荷试验,分别在静息状态和试验终止的即刻实行MCE。对每次MEC后各心肌节段灌注状态进行评估。以冠状动脉造影为金标准评价大剂量DSE前后,心肌灌注状态目测法诊断冠心病的敏感性和特异性。结果DSE时,所有患者中,9例

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中华超声影像学杂志 2011年第8期20卷 652-655页

作者：毕小军邓又斌 cyprien MBA MBA 刘蓉朱英黎春雷华中科技大学同济医学院附属同济医院超声影像科武汉430030

目的探讨大剂量多巴酚丁胺负荷超声心动图（DSE）结合心肌灌注造影（MCE）技术早期诊断冠心病的价值。方法对临床可疑冠心病的38例患者进行大剂量多巴酚丁胺负荷试验，分别在静息状态和试验终止的即刻实行MCE检查。并在静息状态及各级... 详细信息

目的探讨大剂量多巴酚丁胺负荷超声心动图（DSE）结合心肌灌注造影（MCE）技术早期诊断冠心病的价值。方法对临床可疑冠心病的38例患者进行大剂量多巴酚丁胺负荷试验，分别在静息状态和试验终止的即刻实行MCE检查。并在静息状态及各级负荷状态下观察室壁运动（wM）情况；对每次MEC后各心肌节段灌注状态进行评估。大剂量DSE时，以冠状动脉造影为金标准比较WM目测法和心肌灌注状态目测法诊断冠心病的敏感性和特异性。结果DSE时，9例（24％）患者达到峰值负荷水平，22例（58％）达到中级负荷水平。DSE终止时，通过心肌灌注状态目测法及wM目测法诊断有心肌缺血患者的例数分别为24例（89％）及15例（52％）（P〈0．01）。同时，通过上述两组方法评估心肌缺血，并根据相应缺血心肌节段所对应冠脉分支准确判断病变血管的敏感性分别为71％及41％（P〈0．01）。结论大剂量DSE结合心肌灌注造影可以提高检出缺血心肌的敏感性，发现隐匿性心肌缺血，为临床诊断早期冠心病患者提供了无创性新方法。

关键词：超声心动描记术多巴酚丁胺微气泡冠状动脉心肌缺血

大剂量多巴酚丁胺负荷试验结合二维应变成像早期诊断冠心病

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大剂量多巴酚丁胺负荷试验结合二维应变成像早期诊断冠心病

Knowledge, Attitude and Practice of General Practitioners on Circumcision and Its Complications in the District Hospitals of the Center Region

第十届全国超声心动图学术会议

作者： cyprien MBA MBA 邓又斌毕小军王文璇刘蓉朱英华中科技大学同济医学院附属同济医院超声影像科

目的探讨大剂量多巴酚丁胺负荷超声心动图结合二维应变成像(2DSI)技术早期诊断冠心病的价值。方法选取临床可疑冠心病患者28例,进行大剂量多巴酚丁胺负荷超声心动图(DSE)检查,初始剂量为5μg/(kg·min),每隔3 min增加输注速度至10、20... 详细信息

目的探讨大剂量多巴酚丁胺负荷超声心动图结合二维应变成像(2DSI)技术早期诊断冠心病的价值。方法选取临床可疑冠心病患者28例,进行大剂量多巴酚丁胺负荷超声心动图(DSE)检查,初始剂量为5μg/(kg·min),每隔3 min增加输注速度至10、20、30和40μg/(kg·min),最大剂量时如仍不能达到目标心率,采用阿托品1 mg静脉推注。常规记录静息状态及各级负荷状态下左室心尖位二维动态图像,转入Echo PAC工作站,分别在静息状态及各级负荷状态下观察室壁运动情况,测定左室各心肌节段心内膜下心肌的纵向收缩期峰值应变(SLpeak-sys),按Judkins法冠状动脉造影检查结果将患者分为正常组和冠心病组(缺血节段及非缺血节段),计算各组的SLpeak-sys平均值,并进行组内及组间比较,利用ROC曲线下面积评价SLpeak-sys预测缺血心肌的敏感性和特异性。比较大剂量DSE目测法及大剂量DSE结合2DSI诊断缺血心肌的敏感性和特异性。结果患者均顺利完成大剂量DSE检查并达到最大负荷剂量。去除图像不佳、难以分析的节段,参与分析的节段为冠心病组17例共264个节段(其中缺血节段180个、非缺血节段84个)和正常组11例共174个节段。冠心病组与正常组心率、收缩压较同组静息状态增加,差异有统计学意义。静息状态下,正常组、冠心病组非缺血节段及缺血节段SLpeak-sys差异无统计学意义。小剂量多巴酚丁胺时,正常组、冠心病组非缺血节段及缺血节段SLpeak-sys均增加,大多数节段在多巴酚丁胺剂量20μg/(kg·min)时达到峰值,个别节段多巴酚丁胺剂量30μg/(kg·min)时达到峰值,峰值SLpeak-sys与同组静息状态比较,差异有统计学意义,组间比较差异无统计学意义。冠心病组多巴酚丁胺剂量40μg/(kg·min)时目测法检出室壁运动异常6例(共20个节段),计算SLpeak-sys以后,检测缺血心肌15例(共148节段);冠心病组大多数缺血节段SLpeak-sys较正常组及非缺血节段相同负荷状态减低(P0.05),准确度分别为60.7%和92.8%(P<0.01)。以多巴酚丁胺剂量40μg/(kg·min)时SLpeak-sys绝对值≤-14.97为截断值,预测缺血心肌节段的敏感性和特异性分别为83.3%和91.7%。ROC曲线下面积为0.917(P=0.001)。结论大剂量DSE结合2DSI可以提高检出缺血心肌的敏感性,在大剂量DSE状态下,2DSI能通过测定SLpeak-sys的变化,定量评价心肌收缩功能的微小改变,发现隐匿性心肌缺血,克服了传统的组织多普勒技术的缺点,为临床早期诊断冠心病提供了无创性新方法。

关键词：超声心动描记术多巴酚丁胺二维应变成像冠心病心肌缺血

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Open Journal of Urology 2021年第12期11卷 509-517页

作者： Binyom Pierre René Achille Mbassi cyprien Zaré Gueswendé Larba. Hermann Belemlilga Nassirou Yabré Namory Keita Higher Institute of Medical Technology (ISTM) Yaoundé Cameroon Department of General and Visceral Surgery Sour&#244 Sanou University Teaching Hospital Bobo-Dioulasso Burkina Faso

Background: The complication rate of circumcision in medical settings is between 0.4% and 2.0%. Circumcision accidents constituted 2.0% of urological emergencies at the Yaoundé Central Hospital. Aim: To assess the level of knowledge, attitudes and practices of general practitioners on circumcision and its complications in Central Region District Hospitals. Population and Methods: We conducted a multicenter descriptive cross-sectional study the CAP (Knowledge, Attitudes and Practices) type. Which took place from March 9 to June 30, 2021 (16 weeks). We included 138 physicians. The variables collected were: socio-demographic characteristics, knowledge about circumcision and its complications, attitudes towards circumcision and its complications, practices towards circumcision and its complications. Results: In our study, the median age of the study population was 29 years, the sex ratio (M/F) was 0.8. The median ideal age to perform circumcision was 12 months. In our study, 94.9% of general practitioners clearly identified bleeding disorders as a contraindication for circumcision. The material needed to be used to perform a circumcision was ignored by 81.2% of general practitioners. The global knowledge assessment showed that 68.9% of participants had unsatisfactory knowledge about circumcision and its complications. Before circumcision, 91.3% general practitioners first recommended effective disinfection of the operating field, and 83.3% used sterile equipment. Faced with a hemorrhage, 61.6% of general practitioners proposed surgical exploration in the face of rebellious bleeding. 60.2% of general practitioners had bad attitudes towards circumcision and its complications. In our study, 49.2% of the general practitioners questioned did not know the normal procedure for performing a circumcision. Forty-one (29.7%) general practitioners had never performed a circumcision. The median occurrence of a compl

关键词： Knowledge Attitude Practice Circumcision Posthectomy

应变率成像结合大剂量多巴酚丁胺负荷试验评价早期冠心病左室心肌舒张功能

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应变率成像结合大剂量多巴酚丁胺负荷试验评价早期冠心病左室心肌...

Epidemiological, Etiological, Therapeutic and Evolutionary Aspects of Acute Surgical Abdomens Operated at the University Hospital of Bobo-Dioulasso

第十届全国超声心动图学术会议

作者： cyprien MBA MBA 邓又斌毕小军王文璇朱美华华中科技大学同济医学院附属同济医院超声影像科

目的探讨应变率成像(SRI)结合大剂量多巴酚丁胺负荷超声心动图(DSE)评价早期冠心病患者左室心肌舒张功能变化。方法对临床可疑的冠心病患者28例,进行大剂量DSE检查,初始剂量为5μg/(kg·min),每隔3 min增加输注速度至10、20、30和40μg/... 详细信息

目的探讨应变率成像(SRI)结合大剂量多巴酚丁胺负荷超声心动图(DSE)评价早期冠心病患者左室心肌舒张功能变化。方法对临床可疑的冠心病患者28例,进行大剂量DSE检查,初始剂量为5μg/(kg·min),每隔3 min增加输注速度至10、20、30和40μg/(kg·min),最大剂量时如仍不能达到目标心率,采用阿托品1 mg静脉推注。常规记录静息状态及各级负荷状态下左室心尖位二维动态图像,转入Echo PAC工作站,测定左室各心肌节段心内膜下心肌舒张早期峰值应变率(SRe)和舒张晚期峰值应变率(SRa),按Judkins法冠状动脉造影检查结果将患者分为正常组和冠心病组(缺血节段及非缺血节段),计算各组的SRe、Sra和SRe/Sra平均值,并进行组内及组间比较,利用ROC曲线下面积评价SRe预测缺血心肌舒张功能异常的敏感性和特异性。结果患者均顺利完成大剂量DSE检查并达到最大负荷剂量。去除图像不佳、难以分析的节段,参与分析的节段为冠心病组17例264个节段(其中缺血节段180个、非缺血节段84个)和正常组11例174个节段。缺血心肌节段的SRe在小剂量Dob时增加,多巴酚丁胺剂量为20μg/(kg·min)时,SRe值达到最大,与静息状态比较,差异有统计学意义(P<0.05);SRe在多巴酚丁胺剂量为30和40μg/(kg·min)时均降低,与正常组、非缺血节段同一负荷节段比较差异有统计学意义(P<0.05)。各组SRa随着多巴酚丁胺量的增加而增加,但只在峰值负荷40μg/(kg·min)时才较同组静息状态显著增高(P<0.05)。以多巴酚丁胺剂量40μg/(kg·min)时SRe≤1.70为截断值,预测缺血心肌舒张功能异常的敏感性和特异性分别为88.9%和83.3%,ROC曲线下面积为0.921(P=0.0001)。结论大剂量DSE可以诱发早期冠心病心肌缺血,降低左室心肌舒张功能,SRI可以定量评价左室局部心肌舒张功能,SRe是反映心肌舒张功能的敏感指标。大剂量DSE结合SRI评价早期冠心病左室心肌舒张功能,可以为临床诊断、治疗和检测冠心病病程提供依据。

关键词：超声心动描记术多巴酚丁胺应变率冠心病心肌缺血

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Surgical Science 2018年第1期9卷 1-7页

作者： cyprien Zaré Hermann Belemlilga Edgard Ouangre Maurice Zida Bakary Gustave Sanon Drissa Barro Nassirou Yabre Si Simon Traore Department of General and Digestive Surgery of the University Hospital Center Souro Sanou Bobo-Dioulasso Burkina Faso Service of General and Visceral Surgery CHUYO Ouagadougou Burkina Faso

Surgical acute abdomens represent a significant proportion of surgical emergencies in terms of frequency, morbidity and mortality. The aim of our study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of acute surgical abdomens operated in the surgical emergency department of the Centre Hospitalier Universitaire Souro Sanou (CHUSS). This was a retrospective descriptive study of 426 cases of surgical acute abdomens operated in the CHUSS surgical emergency department from 1 January to 31 December 2015. These 426 cases accounted for 24.14% of the emergency interventions carried out in the CHUSS surgical emergency department. These were 314 (73.7%) men and 112 (26.3%) women with an average age of 30 years. Among the causes, there were 187 (43.9%) cases of acute generalized peritonitis, 71 (16.7%) cases of acute intestinal occlusions, 49 (11.5%) cases of acute appendicitis, 38 (9.4%) cases of strangulated parietal hernias, 16 (3.8%) cases of abdominal contusions, and 15 (3.5%) cases of penetrating wounds of the abdomen. The appendectomy was the most performed gesture with 112 (26.3%) cases. The time to surgery was greater than 48 hours in 29 (6.8%) cases. Complications were observed in 68 (16%) cases with 35 (8.2%) cases of parietal infections, 18 (4.2%) cases of postoperative peritonitis. The death occurred in 37 (8.7%) patients. The average hospital stay was 8.7 days. Improving the prognosis of acute surgical abdomens requires early diagnosis and treatment, as well as better postoperative follow-up.

关键词： Surgical Emergencies Abdomen Bobo-Dioulasso