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clinical and Therapeutic Aspects of Migraine in Brazzaville

World Journal of Neuroscience 2024年第1期14卷 56-71页

作者： Motoula Latou Happhia Dinah Boubayi Josue Diatewa Prince Eliot Galieni Sounga Bandzouzi Ghislain Armel Mpandzou Héloïse Stéphanie Ongoly Ikora Karen Lise Obondzo Aloba Paul Macaire Ossou-Nguiet Faculty of Health Sciences Marien Ngouabi University Brazzaville The Republic of the Congo Department of Neurology Brazzaville University Hospital Brazzaville The Republic of the Congo Department of Neurology Loandjili General Hospital Pointe-Noire The Republic of the Congo

Introduction: Migraine is the most common primary headache, and can cause significant disability. There are two types, migraine without aura and migraine with aura. The diagnosis of migraine is essentially clinical. Worldwide prevalence was estimated at 11.6% in 2009. In Africa, it is estimated at 10.4%. Objective: To describe the clinical and therapeutic aspects of migraine in Brazzaville. Patients and Methods: This was a door-to-door cross-sectional study conducted from 1st May to 1 st July 2018 in the city of Brazzaville. Subjects over 18 with clearly expressed consent were included. The questionnaire covered demographic characteristics, diagnostic criteria for migraine according to the IHS, treatments taken. The degree of disability was determined using the Migraine Disability Assessment Scale (MIDAS). Statistical analysis was performed using SPSS 22.0 for MAC. Results: Of the 1017 subjects interviewed in this study, 115 (39.9%) had migraine, including 73 women (63.47%) and 42 men (36.52%). In the group of migraine sufferers, the number of cases of definite migraine was 61 (53.04%) and that of probable migraine 54 (46.95%). For 81 migraine sufferers (70.43%), stress was the triggering factor. The frequency of attacks was weekly and monthly for 30 (26.1%) and 19 (16.5%) sufferers respectively. The location of the migraine was unilateral in 38% of cases and tilted in 24.3%. The intensity of the attack was described as moderate and severe in 41.7% and 57.4% of subjects respectively. Phonophobia/photophobia accompanied the migraine in 65.2% of cases. One hundred and eight subjects were treated. Of these, 106 (98.1%) were on medication. Eleven (10.37%) had received a medical prescription, and ninety-seven (89.8%) were self-medicating. Five and three subjects were under the care of a general practitioner and a neurologist respectively. Conclusion: Migraine is a frequent pathology in Brazzaville. Its preponderance among young people and women calls for the implementation of effective prevention

关键词： Migraine clinic Therapeutics Brazzaville

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Eyelid Wounds: Epidemiological, clinical and Etiological Aspects

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Open Journal of Ophthalmology 2024年第1期14卷 55-62页

作者： Aly Mbara Ka Jean Pierre Diagne Aissatou Aw El Hadji Malick Sy Soda Mbaye Hawo Madina Diallo Audrey Samra Aboubacry Sadikh Sow Joseph Matar Mass Ndiaye Ousmane Ndiaga Senghor Lamine Ndiaye Mohamed Ndiaye Serigne Sohibou Gaye Papa Amadou Ndiaye Ophthalmology Department of Abass Ndao Hospital Dakar Senegal Ophthalmology Department of Aristide Le Dantec Hospital Dakar Senegal

Purpose: The aim is to show epidemiological, clinical and etiological characteristics of palpebral wounds. Methodology: This was a retrospective study focusing on patients with an eyelid wound, over a 10-year period from 2012 to 2021. We collected and analyzed the data using Excel. Results: The frequency of eyelid wounds was 0.1%. The average age of our patients was 19.38 years with a range of 1 and 62 years. The sex ratio was 3.7. Eighty-one percent of patients lived in Dakar. Fifty-seven percent (57%) of patients consulted less than 24 hours after the trauma and 7% of patients on D1. The circumstances were brawls (11%), domestic accidents (9%), road accidents (6%), and work accidents (6%). We noted 1 case of dog bite. Thirteen patients presented with post-traumatic decreased visual acuity. Involvement of the isolated upper eyelid was noted in 40% of cases and both eyelids in 15% of cases. Involvement of the lacrimal ducts was noted in 17% of cases, and that of the free edge in 21% of cases. Eyelid wounds were associated with eyeball damage in 21% of cases. Various associated lesions were observed. Ninety-one percent of patients received surgical treatment. Three cases of superinfections, 1 case of conjunctival granuloma and 1 case of phthysis of the eyeball with postoperative retinal detachment were noted. Conclusion: Eyelid sores are relatively common in our context. They require rapid surgical treatment in order to preserve the functional and aesthetic prognosis. .

关键词： Eyelid Wounds Epidemiology clinic Etiologies

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Multi-disciplinary clinic models for the management of non-alcoholic fatty liver disease

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Hepatobiliary Surgery and Nutrition 2022年第4期11卷 586-591页

作者： Mirko Zoncapè Antonio Liguori Emmanuel A.Tsochatzis University College London(UCL)Institute for Liver and Digestive Health Royal Free Hospital and UCLLondonUK Liver Unit Division of General Medicine CDepartment of Internal MedicineUniversity and Azienda Ospedaliera Universitaria Integrata of VeronaVeronaItaly Department of Traslational Medicine and Surgery Fondazione Policlinico Universitario Agostino Gemelli IRCCSUniversitàCattolica del Sacro CuoreRomeItaly

In recent years,there has been an increasing interest in the implementation of multi-disciplinary clinic(MDC)models in the medical field,in an effort to improve coordination of care due to the increasing complexity of medical practice.It is therefore unsurprising that there is such interest in non-alcoholic fatty liver disease(NAFLD),which is now the most prevalent liver disease worldwide.

关键词： clinic liver NAFLD

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Diabetes knowledge and self-care practices among people living with type 2 diabetes mellitus in a diabetes clinic in Southwestern Nigeria

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Journal of Integrative Nursing 2022年第4期4卷 239-244页

作者： Timothy Titilayo FAMAKINWA Oyeninhun Abimbola OLUWATOSIN Joel Olayiwola FARONBI Funmilola Adenike FAREMI Adeyemi OGUNLEYE Chinma Stella ADERETI Matthew Idowu OLATUBI Department of Nursing Science Obafemi Awolowo UniversityIle-IfeOsun StateNigeria Department of Nursing University of IbadanIbadanOyo StateNigeria Department of Chemical Pathology University of Medical Sciences Teaching HospitalOndoOndo StateNigeria Department of Nursing Science Bowen UniversityIwoOsun StateNigeria

Objective:The objective of this study is to assess the knowledge and self-care practices of people living with type 2 diabetes mellitus(T2DM).Materials and Methods:The study was conducted in a clinic in Southwestern Nigeria.It adopted a cross-sectional design.The sample consists of 107 people living with T2DM.Data were collected using Diabetes Knowledge Questionnaire and Revised Self-care Inventory Scale.Results:The mean diabetes knowledge of the participants was 16.2±3.0 and 70.1%had inadequate knowledge of T2DM.The mean diabetes self-care practice score among the participants was 49.9±4.9,and 89.7%reported poor diabetes self-care practice.There is no significant difference in the knowledge of diabetes between male(16.42±3.42)and female(16.12±2.8)participants(t=0.45;P=0.65),and no significant difference in self-care practice of male(49.23±4.51)and female(50.06±5.07)participants(t=0.75,P=0.46).In addition,there is no correlation between age and knowledge of diabetes(r=-0.18,P=0.07)and self-care practices(r=0.08,P=0.38)of participants.No significant relationship was found between knowledge of diabetes and diabetes selfcare practices(χ^(2)=1.605,P=0.448)Conclusion:Knowledge of diabetes and self-care practices of people living with T2DM in this study were poor.Effort should be directed at improving their diabetes knowledge and self-care practices.

关键词： Adherence clinic knowledge self-care practices type 2 diabetes mellitus type 2 diabetes

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Evaluation of clinical outcomes in an interdisciplinary abdominal pain clinic: A retrospective, exploratory review

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World Journal of Gastroenterology 2019年第24期25卷 3079-3090页

作者： Amanda D Deacy Craig A Friesen Vincent S Staggs Jennifer V Schurman Division of Gastroenterology Children’s Mercy Kansas CityUMKC School of MedicineKansas CityMO 64108United States Division of Developmental and Behavioral Sciences Children’s Mercy Kansas CityUMKC School of MedicineKansas CityMO 64108United States Biostatistics and Epidemiology Health Services and Outcomes ResearchChildren’s Mercy Kansas CityUMKC School of MedicineKansas CityMO 64108United States

BACKGROUND Pediatric functional gastrointestinal disorders(FGIDs)are common and wellaccepted to be etiologically complex in terms of the contribution of biological,psychological,and social factors to symptom presentations.Nonetheless,despite its documented benefits,interdisciplinary treatment,designed to address all of these factors,for pediatric FGIDs remains rare.The current study hypothesized that the majority of pediatric patients seen in an interdisciplinary abdominal pain clinic(APC)would demonstrate clinical resolution of symptoms during the study period and that specific psychosocial variables would be significantly predictive of GI symptom improvement.AIM To evaluate outcomes with interdisciplinary treatment in pediatric patients with pain-related FGIDs and identify patient characteristics that predicted clinical outcomes.METHODS Participants were 392 children,ages 8-18[M=13.8;standard deviation(SD)=2.7],seen between August 1,2013 and June 15,2016 in an interdisciplinary APC housed within the Division of Gastroenterology in a medium-sized Midwestern children's hospital.To be eligible,patients had to be 8 years of age or older and have had abdominal pain for≥8 wk at the time of initial evaluation.Medical and psychosocial data collected as part of standard of care were retrospectively reviewed and analyzed in the context of the observational study.Logistic regression was used to model odds of reporting vs never reporting improvement,as well as to differentiate rapid from slower improvers.RESULTS Nearly 70%of patients followed during the study period achieved resolution on at least one of the employed outcome indices.Among those who achieved resolution during follow up,43%to 49%did so by the first follow up(i.e.,within roughly 2 mo after initial evaluation and initiation of interdisciplinary treatment).Patient age,sleep,ease of relaxation,and depression all significantly predicted the likelihood of resolution.More specifically,the odds of clinical resolution were 14%to 16%lower per additional year of patien

关键词： Pediatric functional gastrointestinal disorders Integrated care Behavioral health consultation Treatment outcomes Abdominal pain clinic

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Pediatric food allergy clinic:a way to improve the quality of service

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World Journal of Pediatrics 2021年第2期17卷 109-110页

作者： Zakaria Barsoum South West Acute Hospital-Paediatric Department 124 Irvinestown RdEnniskillen BT746DNNorthern Ireland

Paediatric food allergy is a common problem with a preva-lence of 5%across the UK[1].There are increasing demands of developing allergy services across the health care system in the UK.Establishing new allergy services among district hospitals,run by paediatricians with a special interest in allergy is recommended.Allergy clinics are multi-discipli-nary in their design with emphasis on the role of dieticians and asthma nurses in the management of allergy.clinicians should always think about tools to improve the quality of allergy clinics.We propose an allergy pro forma to be used in food allergy clinics to improve the quality of the service(Supplementary material 1).

关键词： allergy nurse clinic

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Being accompanied to liver discharge clinic: An easy measure to identify potential liver transplant candidates among those previously considered ineligible

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World Journal of Hepatology 2019年第4期11卷 370-378页

作者： Jordan Sack Nilofar Najafian Angela DeLisle Simona Jakab Department of Internal Medicine Yale University School of Medicine Northeast Medical Group Yale New Haven Health Section of Digestive Diseases Yale University School of Medicine

BACKGROUND Patients with cirrhosis deemed ineligible for liver transplantation are usually followed in general hepatology or gastroenterology clinics, with the hope of reevaluation once they meet the appropriate criteria. Specific strategies to achieve liver transplant eligibility for these patients have not been studied.AIM To assess clinical and sociodemographic factors associated with future liver transplant eligibility among patients initially considered ineligible.METHODS This is a retrospective study of patients with cirrhosis considered non-transplant eligible, but without absolute contraindications, who were scheduled in our transitional care liver clinic(TCLC) after discharge from an inpatient liver service.Transplant candidacy was assessed 1 year after the first scheduled TCLC visit.Data on clinical and sociodemographic factors were collected.RESULTS Sixty-nine patients were identified and the vast majority were Caucasian men with alcoholic cirrhosis. 46 patients(67%) presented to the first TCLC visit. Seven of 46 patients that showed to the first TCLC visit became transplant candidates,while 0 of 23 patients that no-showed did(15.2% vs 0%, P = 0.08). Six of 7 patients who showed and became transplant eligible were accompanied by family orfriends at the first TCLC appointment, compared to 13 of 39 patients who showed and did not become transplant eligible(85.7% vs 33.3%, P = 0.01).CONCLUSION Patients who attended the first post-discharge TCLC appointment had a trend for higher liver transplant eligibility at 1 year. Being accompanied by family or friends during the first TCLC visit correlated with higher liver transplant eligibility at 1 year(attendance by family or friends was not requested). Patient and family engagement in the immediate post-hospitalization period may predict future liver transplant eligibility for patients previously declined.

关键词： Cirrhosis Transitional clinic Transplant listing Support Family

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Hepatocellular carcinoma staging systems: Hong Kong liver cancer vs Barcelona clinic liver cancer in a Western population

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World Journal of Hepatology 2019年第9期11卷 678-688页

作者： Laura Bainy Rodrigues de Freitas Larisse Longo Deivid Santos Ivana Grivicich Mário Reis Alvares-da-Silva Graduate Program in Gastroenterology and Hepatology Universidade Federal do Rio Grande do SulPorto AlegreRS 90035-003Brazil Experimental Hepatology and Gastroenterology Laboratory Center for Experimental ResearchHospital de Clínicas de Porto AlegrePorto AlegreRS 90035-003Brazil School of Medicine Universidade Federal do Rio Grande do SulPorto AlegreRS 90035-003Brazil Graduate Program in Health-Applied Cellular and Molecular Biology ULBRA.CanoasRS 92425-900Brazil Department of Gastroenterology Hospital de Clínicas de Porto AlegrePorto AlegreRS 90035-003Brazil

BACKGROUND Despite being the world’s most widely used system for staging and therapeutic guidance in hepatocellular carcinoma(HCC)treatment,the Barcelona clinic liver cancer(BCLC)system has limitations,especially regarding intermediate-grade(BCLC-B)tumors.The recently proposed Hong Kong liver cancer(HKLC)staging system appears useful but requires validation in Western populations.AIM To evaluate the agreement between BCLC and HKLC staging on the management of HCC in a Western population,estimating the overall patient survival.METHODS This was a retrospective study of HCC patients treated at a university hospital in southern Brazil between 2011 and 2016.Demographic,clinical,and laboratory data were collected.HCC staging was carried out according to the HKLC and BCLC systems to assess treatment agreement.Overall survival was estimated based on the treatment proposed in each system.RESULTS A total of 519 HCC patients were assessed.Of these,178(34.3%)were HKLC-I;95(18.3%)HKLC-IIA;47(9.1%)HKLC-IIB;29(5.6%)HKLC-IIIA;30(5.8%)HKLCIIIB;75(14.4%)HKLC-IV;and 65(12.5%)HKLC-V.According to the BCLC,25(4.9%)were BCLC-0;246(47.4%)BCLC-A;107(20.6%)BCLC-B;76(14.6%)BCLCC;and 65(12.5%)BCLC-D.The general agreement between the two systems was 80.0%-BCLC-0 and HKLC-I(100%);BCLC-A and HKLC-I/HKLC-II(96.7%);BCLC-B and HKLC-III(46.7%);BCLC-C and HKLC-IV(98.7%);BCLC-D and HKLC-V(41.5%).When sub-classifying BCLC-A,HKLC-IIB,HKLC-IIIA and HKLC-IIIB stages according to the up-to-7 in/out criterion,13.4,66.0,100 and 36.7%,respectively,of the cases were classified as up-to-7 out.CONCLUSION In a Western population,the general agreement between the two systems was 80.0%,although in BCLC-B cases the agreement was low,suggesting that some individuals could be candidates for the curative treatment recommended by the HKLC.The authors suggest that the BCLC system should be routinely employed,although for BCLC-B cases it should be associated with the HKLC system.

关键词： Barcelona clinic liver cancer staging system Hepatocellular carcinoma Hong Kong liver cancer staging system

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Systematic review of the outcomes of surgical resection for intermediate and advanced Barcelona clinic Liver Cancer stage hepatocellular carcinoma:A critical appraisal of the evidence

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World Journal of Hepatology 2018年第6期10卷 433-447页

作者： Ye Xin Koh Hwee Leong Tan Weng Kit Lye Juinn Huar Kam Adrian Kah Heng Chiow Siong San Tan Su Pin Choo Alexander Yaw Fui Chung Brian Kim Poh Goh Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingapore 169608Singapore Center for Quantitative Medicine Duke-NUS Graduate Medical SchoolSingapore 169857Singapore Department of General Surgery Hepatopancreatobiliary ServiceChangi General HospitalSingapore 529889Singapore Department of Medical Oncology National Cancer Centre SingaporeSingapore 169610Singapore Duke-NUS Graduate Medical School Singapore 169857Singapore

AIM To perform a systematic review to determine the survival outcomes after curative resection of intermediate and advanced hepatocellular carcinomas(HCC).METHODS A systematic review of the published literature was performed using the PubM ed database from 1 st January 1999 to 31 st Dec 2014 to identify studies that reported outcomes of liver resection as the primary curative treatment for Barcelona clinic Liver Cancer(BCLC) stage B or C HCC. The primary end point was to determine the overall survival(OS) and disease free survival(DFS) of liver resection of HCC in BCLC stage B or C in patients with adequate liver reserve(i.e., Child's A or B status). The secondary end points were to assess the morbidity and mortality of liver resection in large HCC(defined as lesions larger than 10 cm in diameter) and to compare the OS and DFS after surgical resection of solitary vs multifocal HCC.RESULTS We identified 74 articles which met the inclusion criteria and were analyzed in this systematic review. Analysis of the resection outcomes of the included studies were grouped according to(1) BCLC stage B or C HCC,(2) Size of HCC and(3) multifocal tumors. The median 5-year OS of BCLC stage B was 38.7%(range 10.0-57.0); while the median 5-year OS of BCLC stage C was 20.0%(range 0.0-42.0). The collective median 5-year OS of both stages was 27.9%(0.0-57.0). In examining the morbidity and mortality following liver resection in large HCC, the pooled RR for morbidity [RR(95%CI) = 1.00(0.76-1.31)] and mortality [RR(95%CI) = 1.15(0.73-1.80)] were not significant. Within the spectrum of BCLC B and C lesions, tumors greater than 10 cm were reported to have median 5-year OS of 33.0% and multifocal lesions 54.0%.CONCLUSION Indication for surgical resection should be extended to BCLC stage B lesions in selected patients. Further studies are needed to stratify stage C lesions for resection.

关键词： Barcelona clinic Liver Cancer Hepatocellular carcinoma Hepatectomy Milan criteria

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Catania flatfoot score:A diagnostic-therapeutic evaluation tool in children

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World Journal of Orthopedics 2023年第10期14卷 755-762页

作者： Andrea Vescio Gianluca Testa Alessia Caldaci Marco Sapienza Vito Pavone Department of General Surgery and Medical Surgical Specialties Section of Orthopaedics and TraumatologyA.O.U.Policlinico“Rodolico-San Marco”University of CataniaCatania 95123Italy

BACKGROUND Flexible flatfoot(FFF)is a very common condition in children,but no evidencebased guidelines or assessment tools exist.Yet,surgical indication is left to the surgeon’s experience and preferences.AIM To develop a functional clinical score for FFF[Catania flatfoot(CTF)score]and a measure of internal consistency;to evaluate inter-observer and intra-observer reliability of the CTF Score;to provide a strong tool for proper FFF surgical indication.METHODS CTF is a medically compiled score of four main domains for a total of twelve items:Patient features,Pain,clinical Parameters,and Functionality.Each item refers to a specific rate.Five experienced observers answered 10 case reports according to the CTF.To assess inter-and intra-observer reliability of the CTF score,the intra-class correlation coefficients’(ICCs)statistics test was performed,as well as to gauge the correlation between the CTF score and the surgical or conservative treatment indication.Values of 75%were chosen as the score cut-off for surgical indication.Sensitivity,specificity,positive likelihood ratio(PLHR),negative likelihood ratio(NLHR),positive predictive value(PPV),and negative predictive value(NPV).RESULTS Overall interobserver reliability ICC was 0.87[95%confidence interval(CI):0.846-0.892;Pclinical research,survey studies,and clinical practice.Moreover,the 75%cutoff is an important threshold for surgical indication and helps in the decision-making

关键词： Pes planus Score Assessment clinic Surgery Outcome Reparability

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