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Prognosis Value of Two Gravity Scores in Patients Admited to the Intensive Care Unit at University Hospital of Parakou in Benin

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Open Journal of Anesthesiology 2020年第4期10卷 144-156页

作者： Blaise Adelin Tchaou Nvènonfon Charles Frédéric Tchégnonsi Hervé Philippe Minsili Bikolo Patrick Stéphane Kouomboua Mfin Martin Chobli Service d’Anesthésie-Réanimation et des Urgences Centre Hospitalier Universitaire et Départemental du Borgou/Alibori Parakou Benin

Introduction: The gravity of the clinical state of the patient of intensive care is linked to the existence of one or several lesions and visceral defaults putting its forecast into play. Objective: To determine the prognosis value of two general graveness’ scores of patients admitted to intensive care at University Hospital of Parakou in Benin. Patients and Methods: descriptive and analytical observational study data were collected from March 1st to June 30th, 2017. The SAPS II and APACHE II were calculated during first 24 hours of hospitalization to assess the clinical graveness and predict patient’s mortality. Results: We enrolled 185 patients representing 89.37% of admissions, majority were men (63.78%). Mean age was 38.89 ± 17.92 years (16 to 99), mean of hospitalization duration was 4.36 ± 2.2 days. Neurological failure was the most common disorder observed (58.37%). Mean SAPS II and APACHE II were 29.54 ± 19.04 and 14.24 ± 10.49 respectively. Mean predicted mortality of SAPS II and APACHE II was 19.12 ± 5.05 and 25.69 ± 5.00 respectively. The mortality rate was 25.95% and increased with severity scores. The sensibility of APACHE II and SAPS II score was 72.90% and 66.70% respectively. SAPS II score was found to be more specific (85.40%) than APACHE II (80.03%). Conclusion: Those severity patient scores accurately predicted the prognosis of patients in intensive care unit and should be integrated into our practice.

关键词： Indications of Gravities Prognosis Mortality Intensive Care

Bilateral Iris Coloboma Revealed by a decreased Vision: About the First Case in Togo Observed in Kara University Teaching Hospital

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Open Journal of Ophthalmology 2021年第4期11卷 249-252页

作者： Kokou Messan Amedome Codjo Rodrigue Abel Assavédo Yao Ako Patrick Mensah Kossi dzidzinyo Kokou Vonor Koffi didier Ayéna Komi Balo centre hospitalier Universitaire de Kara Kara Togo centre hospitalier départemental borgou-alibori Parakou Benin centre hospitalier Universitaire Sylvanus Olympio Lomé Togo centre hospitalier Régional de Kara Tomdè Kara Togo Hô pital Secondaire de Bè Lomé Togo

Background: Ocular coloboma is the product of an error in the fetal fissure closure, normally occurring between the fifth and sixth weeks of gestation [1]. It may involve the cornea, iris, zonula, ciliary body, choroid, retina and optic nerve. The incidence of this syndrome is 0.7 per 10,000 live-births [1]. The aim of this observation is to present the first case of bilateral coloboma of the iris [1]. This case was associated with an ametropia causing a decrease in visual acuity. Case Presentation: This was a clinical observation concerning a young 12-year-old patient who consulted for blurring of vision which had progressed for approximately 2 years. The ophthalmologic examination revealed an ametropia with a bilateral notch of the pupillary rim suggesting a bilateral coloboma. There was no association with another coloboma such as chorioretinal coloboma which is quite common and is accompanied frequently by visual symptoms. Conclusion: A visual impairment of the child can indicate ametropia. However, other congenital anomalies can be discovered as was the case in this clinical observation.

关键词： Coloboma Iris decreased Vision Kara Togo

Place of Ocular Ultrasound in the diagnosis of Optic disc druses in developing Countries: About a Case and Review of the Literature

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Open Journal of Ophthalmology 2021年第4期11卷 325-331页

作者： Kokou Messan Amedome Kokou Vonor Codjo Rodrigue Abel Assavédo Nidain Maneh Massaga dagbe Kossi dzidzinyo Koffi didier Ayéna Komi Balo centre hospitalier Universitaire de Kara Kara Togo centre hospitalier Régional de Kara Tomdè Kara Togo centre hospitalier départemental borgou-alibori Parakou Benin centre hospitalier Universitaire Campus de Lomé Lomé Togo centre hospitalier Universitaire Sylvanus Olympio de Lomé Lomé Togo Hô pital Secondaire de Bè Lomé Togo

Background: druses of the papilla constitute abnormal deposits of calcified hyaline material at the level of the head of the optic nerve. They can be superficial or deep. Aim: The aim of this study is to show the utility of ocular ultrasound in ophthalmology in underdeveloped countries for the characterization of optic disc druse. Case Presentation: Our study relates to a clinical observation of buried papillary druses diagnosed by ocular ultrasound. The ophthalmologic examination revealed an aspect of false papillary edema in the fundus. The ocular ultrasound revealed hyperechogenic deposits buried in the papillary margins, which suggests the deep papillary druses. Conclusion: Ocular ultrasound still has a prominent place in the diagnosis of certain eye conditions despite the new sophisticated means available to ophthalmology to date.

关键词： Ultrasound druses Hyperechoic Globe

Pediatric Hypertension in Two University Hospitals in Cotonou, Benin: Presentation, Etiology, Management and Outcome

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Open Journal of Pediatrics 2018年第1期8卷 74-85页

作者： Francis Lalya didier Adedemy Yevedo Tohodjede Marcelline d’Almeida Linda Ayedadjou Maroufou Jules Alao Pediatrics Unit Centre National Hospitalier Universitaire Hubert K. Maga (CNHU-HKM) Cotonou Benin Pediatrics Unit Centre Hospitalier Universitaire Départemental Borgou-Alibori Parakou Benin Pediatrics Unit Centre Hospitalier Universitaire de la Mère et de l’Enfant Lagune (CHU-MEL) Cotonou Benin

Background: Hypertension (HPT) is a major public health problem. Many studies have attempted to investigate HPT in school children. Few, however, have targeted hospital HPT. We conducted this study to describe the epidemiologic characteristics, etiologies, management, and outcome of hospital HPT in our setting. Methods: This was a prospective and descriptive study carried out from March 01 through June 30, 2017 in the pediatric departments of two university hospitals: centre National hospitalier Universitaire Hubert K. Maga and centre hospitalier Universitaire de la Mère et de L’Enfant Lagune of Cotonou, Benin. Every consecutive patient aged 3 to 18 years who was admitted to the two hospitals for any reason had his (her) BP measured. Every patient with HPT was reviewed for demographics, history and clinical examination, and laboratory investigations as appropriate. Management was done accordingly. Outcome was also recorded. Results: The hospital frequency of HPT was 1.98% (31 cases/1565 admissions). The male/female ratio was 1.06 (16 males, 15 females). Mean age was 8.5 years ± 4.39 (range, 3 to 16 years). 74.19% patients had Body mass index within -2Sd and +2Sd. Only one patient had BMI above +3Sd. The main etiologies found were renal: acute tubular necrosis (45.16%), acute glomerulonephritis (16.13%), and acute pyelonephritis (12.90%). diuretics (64.5%), were the main antihypertensive drugs used. A single drug therapy was used in 35.4%, a two-drug therapy in 32.2% and a three-drug therapy in 9.6% of cases. Length of hospital stay was more than one week in 70.97% of cases. Hospital death rate for HPT was 19.35%. The outcome was not known in one patient due to exit from hospital against medical advice. All the other patients fully recovered at one month post-discharge follow-up. Conclusion: HPT presents as a symptomatic disease in our hospitals;it has a renal etiology in most cases and has significant death rate despite treatment. Advocacy with health authorities mu

关键词： Hypertension Hospital Children Benin

Advanced gastric cancer:Current treatment landscape and future perspectives

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World Journal of Gastroenterology 2016年第8期22卷 2403-2414页

作者： Antonia digklia Anna dorothea Wagner departement d’Oncologie Centre Hospitalier Universitaire Vaudois

Gastric cancer currently ranks fourth in cancer-related mortality worldwide. In the western world, it is most often diagnosed at an advanced stage, after becoming metastatic at distant sites. Patients with advanced disease(locally advanced or metastatic) have a somber prognosis, with a median overall survival of 10-12 mo, and palliative chemotherapy is the mainstay of treatment. In recent years, novel approaches using inhibition of human epidermal growth factor receptor 2(HER2) have demonstrated significant improvements in progression-free and overall survival, compared with chemotherapy alone, in first-line treatment of patients with overexpression of HER2. In addition, both second-line chemotherapy and treatment with the vascular endothelial growth factor receptor-inhibitor ramucirumab demonstrated significant benefits in terms of overall survival, compared with best supportive care, in randomized studies. Moreover, ramucirumab in combination with chemotherapy demonstrated further significant benefits in terms of progression-free and overall survival, compared with chemotherapy alone, in second-line treatment for patients with metastatic gastric cancer. A recently published molecular classification of gastric cancer is expected to improve patient stratification and selection for clinical trials and provide a roadmap for future drug development. Nevertheless, despite these developments the prognosis of patients with advanced gastric cancer remains poor. In this review we discuss current standards of care and outline major topics of drug development in gastric cancer.

关键词： Gastric cancer Phase III Clinical trials Chemotherapy Targeted therapy Perspectives

Molecular predictors of gemcitabine response in pancreatic cancer

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World Journal of Gastrointestinal Oncology 2011年第11期3卷 153-164页

作者： Ioannis A Voutsadakis centre Pluridisciplinaire d'Oncologie Centre Hospitalier Universitaire Vaudois

Gemcitabine is one of the most used anti-neoplastic drugs with documented activity in almost all major localizations of *** pancreatic cancer treatment,gemcitabine occupies a prominent place as a first line chemotherapy,partly because of the paucity of other efficacious chemotherapy *** fact,only a minority of pancreatic cancer patients display a response or even stability of disease with the *** are currently no clinically applicable means of predicting which patient will derive a clinical benefit from gemcitabine although several proposed markers have been studied. These markers are proteins involved in drug up-take,activation and catabolism or proteins that define the ability of the cell to undergo apoptosis in response to the *** of these markers are reviewed in this *** also briefly discuss the possible role of stem cells in drug resistance to gemcitabine.

关键词： Pancreatic cancer Gemcitabine Chemotherapy drug resistance Metabolism Akt kinase Nuclear factor-κB

Targeted treatments for metastatic esophageal squamous cell cancer

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World Journal of Gastrointestinal Oncology 2013年第5期5卷 88-96页

作者： Antonia digklia Ioannis A Voutsadakis centre Pluridisci-plinaire d’Oncologie Centre Hospitalier Universitaire Vaudois

Squamous cell carcinoma, one of the two major subtypes of esophageal carcinomas, constitutes the great majority of tumors in the upper and middle third of the organ. declining in incidence in western countries, it continues to be a significant public health problem in the far east. Targeted treatments are novel therapies introduced in the clinical therapeutic armamentarium of oncology in the last 10-15 years. They represent a rational way of treating various cancers based on their molecular lesions. Although no such agent has been approved so far for the treatment of esophageal squamous cell carcinomas (ESCC), several are in clinical trials and several others have displayed pre-clinical activity that would justify the efforts and risks of pursuing their clinical development in this disease. This paper discusses some of these targeted agents in more advanced development in metastatic ESCC, as well as some promising drugs with pre-clinical or initial clinical data in the disease.

关键词： Esophageal carcinoma Squamous Targeted therapies Clinical trials Epidermal growth factor receptor Vascular endothelial growth factor receptor Mammalian target of rapamycin

Effect of serum γ-glutamyltranferase and albumin levels on the response to cardiac resynchronization therapy in the elderly

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Journal of Geriatric Cardiology 2020年第6期17卷 313-320页

作者： Maciej Kubala Alexis Hermida Otilia Buiciuc Pierre-Marc Lallemand Geneviève Bertaina Frédéric Anselme didier Klug Momar diouf Jean-Sylvain Hermida centre hospitalier Universitaire AmiensFrance centre hospitalier Régional Universitaire RouenFrance centre hospitalier Régional Universitaire LilleFrance

Background Several liver function tests have been identified as predictors of hospitalization for heart failure(HF) and death in patients with chronic HF. The relationship between serum γ-glutamyltranferase(GGT) and albumin(SA) levels with the response to cardiac resynchronization therapy(CRT) has not been reliably determined. The aim of the study was to evaluate the impact of liver function tests on the results of CRT in the elderly. Methods Baseline GGT and SA were assessed before CRT device implantation in the elderly(> 70-year-old) patients. The endpoints were:(1) CRT response defined as > 5% left ventricular ejection fraction improvement and no hospitalization for HF or cardiovascular death;(2) hospitalizations;and(3) mortality. Results Eighty of 138(58%) included patients were responders at nine months. Compared to responders, the SA levels were not significantly different(35.1 ± 5.4 vs. 33.6 ± 5.5 g/L, P = 0.103);but the GGT levels, higher(81.6 ± 69.3 vs. 54.7 ± 49.6 U/L, P = 0.013) in non-responders to CRT. GGT level was independently associated with non-response to CRT(P dictive of non-response [AUC = 0.65, 64% Sensitivity, 69% Specificity(95% CI: 0.56–0.74)]. GGT ≥ 55 U/L was also associated with higher risk of hospitalization for atrial fibrillation(AF)(95% vs. 83%, P = 0.024). Both SA and GGT had no impact on overall(P = 0.220, P = 0.723) mortality. Conclusions Higher level of GGT is an independent predictor of non-response to CRT in patients over age 70 years and is associated with higher risk of hospitalization for AF. Baseline serum levels of albumin and GGT and have no impact on mortality in elderly patients undergoing CRT.

关键词： Cardiac resynchronization therapy Heart failure Liver enzymes The elderly

Factors Associated with Non-Compliance among Patients with Chronic Kidney disease at the departmental University Hospital of borgou and alibori in Parakou (Benin)

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Open Journal of Nephrology 2023年第4期13卷 420-434页

作者： Coovi Nonwanou Ignace Tokpanoude Séraphin Ahoui damien Barikissou Georgia Elvire S. E. djossou Sayo djibo Gottfried Agballa Ireti Nethania Elie Ataigba Ismaël Landry Paraiso Omer Adjibode Benoit S. Agossoukpe Rodrigue S. Kakpo-Zannou Badirou Aguemon Unité de Santé Publique de la Faculté des Sciences de la Santé (FSS) Université d’Abomey-Calavi (UAC) Cotonou Bénin Association des Médecins Communautaires du Bénin (AMCB) Parakou Bénin Service de Néphrologie Centre Hospitalier Universitaire Départemental du Borgou Alibori (CHUD/B-A) Parakou Bénin Faculté de Médecine (FMP) Institut de Formation en Soins Infirmiers et Obstétricaux (IFSIO) Parakou Bénin Service de Psychiatrie Centre Hospitalier Universitaire Départemental du Borgou Alibori (CHUD/B-A) Parakou Bénin

Introduction: Therapeutic compliance in chronic kidney disease (CKd) represents a major challenge for the prevention of this condition, which is both a non-communicable disease (NCd) and a complication of other NCds. Non-adherence to treatment (NOT) is a factor in the poor prognosis of CKd in developing countries, particularly in Benin. The aim of this study was to evaluate therapeutic compliance (TC) and determine the factors associated with non-compliance in patients with chronic kidney disease undergoing treatment at the departmental University Hospital of borgou and alibori in Parakou (CHUd/B-A). Patients and Methods: This study was carried out in the Nephrology department of CHUd/B-A. It was a cross-sectional, descriptive study with analytical aims that ran from december 25, 2022 to March 15, 2023 and covered data from 2017 to 2022. It involved 345 patient records meeting the diagnosis of CKd according to the KdIGO 2012 criteria. NOT was defined by a Girerd score evaluation greater than or equal to 3. data processing and analysis were performed with R software version 4.3.0. Results: The mean age (Sd) of patients was 50 years (±14.9). The prevalence of NOT was 57.1%. Potential predictors of non-adherence were: monthly revenue (p = 0.009), mode of admission (p = 0.001), phytotherapy (p = 0.040), traditional treatment (p = 0.049) and quantity of drugs (p = 0.042). Conclusion: Therapeutic compliance among chronic kidney patients still needs to be improved through awareness-raising sessions.

关键词： Chronic Kidney disease Therapeutic Non-Adherence Girerd Assessment Chronic Renal Failure Benin