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Pathological and Clinical Correlation European Union-Thyroid Imaging Reporting and Data System (EU-TIRADS) Classification of Thyroid Nodules in Two University Hospitals in Cotonou

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Open Journal of Endocrine and metabolic diseases 2024年第2期14卷 15-25页

作者： Annelie k.rek.u Hode hubert Dedjan Fréjus Alamou department of endocrinology Metabolism Nutrition of National University Hospital Center-hubert k.utouk.u maga Cotonou Bénin department of Medicine and Medical Specialties of the Departemental University Hospital Center of Ouémé/Plateau Porto-Novo Bénin

Introduction: Since its creation in 2017 by the European community, the EU-TIRADS classification has enjoyed an excellent reputation in several countries around the world. Indeed, several studies conducted in these countries testify to the effectiveness of this tool for the management of nodular thyroid pathology. However, in Benin, the contribution of this classification has not yet been evaluated. It is therefore to overcome this inadequacy that we undertook.this study. Objective: Participate in improving the diagnostic and therapeutic management of thyroid nodules at the cnhu Hk. in Cotonou and at the CHUZ in Suru-Léré. Methods: This is a cross-sectional study with retrospective data collection spread over a period of 3 years 5 months, from January 2019 to May 2022 and carried out jointly in the endocrinology Metabolism Nutrition and ORL-CCF departments of the cnhu Hk. of Cotonou and in the ORL-CCF department of the CHUZ of Suru-Léré. The study population consisted of patients who consulted the University Clinic of endocrinology Metabolism Nutrition, the University Clinic of ORL-CCF of the cnhu-Hk. and the University Clinic of ORL-CCF of the CHUZ of Suru-Léré for thyroid nodule and who have had surgery. The study data was collected from patients hospitalization records using a survey form. Results: On ultrasound, according to the EU-TIRADS classification, 56.8% of nodules presented a low risk.of malignancy (EU-TIRADS 3) compared to respectively 19.8%;23% and 2.5% of nodules with zero (EU-TIRADS 2), intermediate (EU-TIRADS 4) and high (EU-TIRADS 5) risk.of malignancy. Regarding the performance of this classification, it is sensitive in 37.5% of cases and has a specificity of 78.5% with a PPV (Positive Predictive Value) and a NPV (Negative Predictive Value) respectively of 6.6 % and 91.6%. Furthermore, the bivariate correlations revealed that the size of the nodule was significantly associated with the malignancy of the nodule (p = 0.014) and the calculated value o

关键词： Thyroid Nodules EU-TIRADS Classification Malignancy

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Influence of Antiretroviral Therapy on the metabolic Profile of People Living with HIV Followed at University Hospital, Cotonou, Benin

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Open Journal of Internal Medicine 2015年第4期5卷 106-114页

作者： Djimon Marcel Zannou Angèle Azon-k.uanou Manoela Christelle Ahomadegbe k.essi Anthelme Agbodande Jocelyn Ak.k.o Comlan Albert Dovonou k.assi Daniel Amoussou-Guenou Yessoufou Tchabi Gabriel Ade Fabien Houngbe Internal Medicine department National University Hospital (CNHU-Hubert K. Maga) Cotonou Benin Ambulatory Care Center for People Living with HIV at cnhu-hubert k. maga Cotonou Benin Internal Medicine department Prefectural University Hospital of Borgou Parakou Benin endocrinology and metabolic diseases department at cnhu-hubert k. maga Cotonou Benin Cardiology department CNHU-Hubert K. Maga Cotonou Benin

Introduction: Since the advent of antiretroviral therapy, the vital prognosis of people living with HIV (PLWHA) has improved significantly. However, the risk.of metabolic complications is high, thus mak.ng the bed of cardiovascular disease. Our objective was to compare the prevalence of metabolic abnormalities among PLWHA receiving ARVs to that observed in those who are not treated. Methods: We conducted a cross-sectional study (January to April 2010) at the PLWHA ambulatory care center of national university hospital (cnhu-hubert k. maga) in Cotonou, Bénin. We recruited 420 PLWHA (210 treated for at least 6 months and 210 untreated). We determined the prevalence of metabolic syndrome (MS) defined by the criteria of NCEP-ATP III, and the prevalence of abnormal glucose and lipid, and lipodystrophy. Association between metabolic syndrome and ARVs used was analyzed by binomial regression. Confidence intervals were calculated at 95% and 5% alpha level. Results: The prevalence of MS was 16% (18% of patients treated vs. 13% of non-treated, p = 0.18). That of hyperglycemia was 18% (30% of patients treated vs. 6% of untreated;p metabolic syndrome were age, hypertension, diabetes (personal or family), BMI, exposure to stavudine (OR = 1.59 [1.02 to 2.47], p = 0.04) and indinavir booted with ritonavir (OR = 2.23 [1.11 to 4 46], p = 0.02). Conclusion: The metabolic abnormalities are more common in PLWHA treated with ARVs. Preventing these anomalies should be made to the initiation of antiretroviral therapy and during the therapeutic monitoring.

关键词： metabolic Syndrome Diabetes Dyslipidemia Antiretroviral Therapy HIV Infection

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Prevalence of metabolic Syndrome and Associated Factors among Hemodialysis Patients Monitored at the National Teaching Hospital, hubert k.utoucou maga in 2015

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Open Journal of Nephrology 2016年第4期6卷 167-175页

作者： Jacques Vigan Adébayo S. C. Alassani Mahoussi M. A. Ahissou Ak.mola k. Sabi Ubald Assogba-Gbindou Vénérand Attolou François Djrolo Nephrology Hemodialysis department Sylvanus Olympio Teaching Hospital Centre Lomé Togo Nephrology Hemodialysis University Clinic of hubert k.maga Teaching Hospital (cnhu-Hk.) Cotonou Benin endocrinology and Metabolism University Clinic of cnhu-Hk. Cotonou Benin Nephrology Hemodialysis department Sylvanus Olympio Teaching Hospital Centre Lomé Togo

Introduction: metabolic syndrome is one of the main risk.factors of cardiovascular disease among hemodialysis patients. Objective: The main objective of this study was to determine the prevalence and factors associated with metabolic syndrome among hemodialysis patients in Cotonou in 2015. Patients and methods: It was a cross-sectional, descriptive and analytical study conducted from 05th October to 02nd November 2015 at the National Teaching Hospital, hubert k.utoucou maga of Cotonou. All patients aged 18 years and above, regularly under hemodialysis for the past 3 months and who gave their informed consent were included in the study. Those excluded were: currently hospitalized hemodialysis patients, hemodialysis patients hospitalized in the last three months, hemodialysis patients whose general condition deteriorated or unable to answer the questionnaire. metabolic syndrome was defined according to the International Diabetes Federation’s criteria. Factors associated with metabolic syndrome were sought using logistic regression in univariate analysis. Confidence intervals were calculated at 95% and alpha significance threshold at 5%. Outcomes: In total 165 patients were included in the study. Male predominance was observed, with 1.27 sex-ratios. Average age was 49.3 ± 12.9 years with extremes ranging from 18 to 78 years. metabolic syndrome is observed among 46 patients undergoing hemodialysis or 27.9% prevalence rate. Factors associated with the metabolic syndrome in univariate analysis were: gender (p 0.001), age (p = 0.007), body mass index (p = 0.029) and prior diabetes history (p = 0.011). Conclusion: metabolic syndrome is common among hemodialysis patients. Early screening and fighting against associated risk.factors are very important.

关键词： Benin Associated Factors Hemodialysis Patients Prevalence metabolic Syndrome

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Epidemiological Aspects and Results of the Management of Polycystic Ovary Syndrome at the cnhu-Hk. of Cotonou

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Open Journal of Endocrine and metabolic diseases 2022年第12期12卷 266-282页

作者： Annelie k.rek.u Hode Justin Lewis Denak.o Dedjan A. hubert Mohamed Dak.n Esther Techeme department of endocrinology Metabolism and Nutrition-CNHU-HKM Cotonou Benin department of Gynecology and Obstetric-cnhu-Hk. Cotonou Benin

Introduction: Polycystic Ovarian Syndrome (PCOS), also k.own as Stein Leventhal Syndrome, is one of the common endocrine diseases affecting women of childbearing age and the leading cause of anovulatory infertility worldwide. The aim of this study was to describe the clinical, paraclinical and therapeutic aspects of PCOS at the University Clinic of Obstetrics and Gynaecology of the National Hospital and University Centre hubert k.utouk.u maga of Cotonou (cnhu). Patients and Method: The study was doing in the University Clinic of Gynecology and Obstetrics of the cnhu-Hk.. This was a descriptive and analytical longitudinal study with retrospective and prospective data collection over a period of 7 years from January 2015 to December 2021. It focused on women of childbearing age seen in gynecological consultation. Results: The frequency of PCOS was 2.53%. The mean age of the patients was 27.28 ± 6.55 years. They were educated for the most part with a university level in 43.8% of cases. Obstetrically they were nulligest (45.63%) and nulliparous in 60% of cases. The history of spontaneous miscarriages was found in 61.11%. The main reasons for consultation were menstrual disorders (51%) followed by the desire for pregnancy (40.6%). Clinically, obesity (30%), overweight (33.1%), high blood pressure (20.63%), hirsutism (24%) and acne (27%) were noted. All the women had micropolycystic ovaries in ultrasound. Testosterone was elevated in 61% of cases. Phenotype D was found in 45.63% of patients. All these patients were put under lifestyle and dietary measures, Metformin (13.80%) and estrogen-progestogen (18.80%). The outcome of the treatment was assessed by cycle regularity, regression of hirsutism, weight loss, fertility and fertility. The cycle was normalised in most cases with notable regression of physical signs of hyperandrogenism. The cycle was normalized in most cases with the notable regression of physical signs of hyperandrogenism. We had recorded 25 pregnancies incl

关键词： Hirsutism Spaniomenorrhea Hyperandrogenism Insulin Resistance Metformin

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Bilateral Macronodular Adrenal Hyperplasia

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Open Journal of Endocrine and metabolic diseases 2020年第2期10卷 18-23页

作者： Annelie k.rék.u Hodé hubert Dédjan endocrinology Metabolism and Nutrition Department CNHU-HKM Cotonou Bénin

Cushing’s syndrome is the set of clinical manifestations secondary to a chronic excess of glucocorticoids. Bilateral macronodular adrenal hyperplasia with subclinical cortisol secretion is the most common, but its prevalence remains unk.own. We describe a case of bilateral macronodular adrenal hyperplasia. This is a 36-year-old female patient who had been consulting for secondary amenorrhea and developing asthenia for 4 months. The clinical examination noted an overweight patient with high blood pressure, facio-trunk.obesity, hirsutism and purple stretch mark. in the abdomen and thighs. Biologically, hypok.lemia at 2.9 meq/l (3.5 - 5.4), normal calcemia at 90 mg/l (85 - 104), fasting blood sugar was 0.84 g/l (0.7 - 1), the tests for minute, low and high dexamethasone suppression test revealed insufficient suppression of cortisol. The cortisoluria collected from the second day to the third day of the high dexamethasone suppression test was at 186 μg/24 h (<60), the ACTH (Pg/ml) was undetectable (6.4 - 49.8). The diagnosis of an independent adrenocorticotrophin (ACTH) Cushing syndrome was made and the adrenal CT scan revealed bilateral macronodular hyperplasia. A bilateral adrenalectomy was performed and a complete remission of Cushing syndrome was achieved. We prescribed to her, hydrocortisone 20 mg/day and alpha-fludrocortisone 25 to 50 μg/day, This medical observation showed that macro-nodular adrenal hyperplasia with overt Cushing syndrome can occur in the third decade of life. Bilateral adrenalectomy has resulted in a complete cure for Cushing’s syndrome, but may be fraught with complications.

关键词： Hyperplasia Macronodular Adrenal Cushing’s Syndrome Adrenalectomy Dexamethasone

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Complications of Obesity in Cesarized Parturients in the Teaching Centers of Cotonou

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Open Journal of Endocrine and metabolic diseases 2018年第6期8卷 137-144页

作者： Annelie k.rek.u Hode Eugène Zoumenou Benjamin Hounk.atin Serge Mewanou Blaise Tchaou Martin Chobli Service of endocrinology Hospital and University National Center Hubert Koutoukou Maga of Cotonou Cotonou Benin Service of Anesthesia and Reanimation Hospital Mother and Child of Cotonou Cotonou Benin Service of Gynecology and Obstetrics Hospital Mother and Child of Cotonou Cotonou Benin Service of Anesthesia and Reanimation Hospital and University National Center Hubert Koutoukou Maga of Cotonou Cotonou Benin department of Anesthesia and Reanimation Hospital and University of Parakou Parakou Benin Emergency department of Hospital and University National Center hubert k.utouk.u maga of Cotonou Cotonou Benin

This survey had the objective to determine the frequency of the obesity at the parturient, to value the impact of the obesity on the childbirth by Caesarean and the complications postoperative immediate in the teaching hospitals of Cotonou. Patients and Method: We did a prospective, comparative and analytic survey from January 13 to April 13, 2012. Eight hundred ninety-one consecutive parturients having had a Caesarean were included. We studied the anesthetic techniques, the techniques of control of the aerial ways, the number of necessary tests for the tracheal intubation, the complications and aftercare of the first 48 hours. A comparison has been made according to the BMI. The obesity has been defined by a BMI ≥ 30 k./m2. The parturient has been classified in two groups: Non-obese: BMI ≤ 30 k./m2, obese: BMI ≥ 30. Results: There were 703 (78.90%) Caesareans in emergency and 188 (21.09%) programmed Caesareans. The obesity which has been recovered at 286 parturient is 32.10%. The obese parturient also required more frequently several lumbar punctures (p Conclusion: Many changes led by pregnancy are added to those of the obesity to drive to functional changes, a reduction of the physiological reserve and finally to an increased anesthetic and obstetric risk. The obesity is frequent at the parturient in Benin. The post-operative complications are more frequent after the Caesarean at the obese parturient.

关键词： Obesity Caesarean Anesthesia Complication Benin

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Diabetic k.tosis Decompensations at the National Hospital in Benin (West Africa), What Did We Learn about the Precipitating Factors?

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Journal of Diabetes Mellitus 2016年第4期6卷 301-306页

作者： Comlan Jules Gnink.un Adébayo Sabi Cossi Alassani Yempabou Sagna Philippe Adjagba François Djrolo department of Internal Medicine-endocrinology Metabolism and Nutrition Unit Cotonou Benin University Hospital of Borgou Parakou Benin department of Internal Medicine University Hospital Yalgado Ouedraogo Ougadougou Burkina Faso Cardiology and Vascular Disease Unit Cotonou Benin

We performed a retrospective study on diabetic k.tosis decompensations in 101 diabetic patients in endocrinology and metabolic diseases Service of the National Hospital and Universitary k.utouk.u hubert maga (cnhu-Hk.) for a period of 3 years. Objective: The main objective of the study was to identify the underlying factors of k.tosis decompensations for a more focused education program. Results: The mean age was 43.84 years. In half of cases (49.5%), the k.tosis decompensations were inaugural for the diabetes. Type 2 diabetes was predominant with a frequency of 85.1% versus 14.9% for type 1 diabetes. The overall prevalence rate of k.tosis decompensations was 21.82%. The precipitating factors were infections (51.49%) and treatment withdrawal (25.74%). The average blood glucose was 4.46 g/L with ranges of 1.86 g/L and 13 g/L. The outcome was favorable in 89.1% of cases. The mortality rate was 7.9%. The average hospital stay was 13.23 days. Conclusion: This study showed that k.tosis decompensations are still frequent. The main precipitating factors are infection and therapeutic noncompliance. Preventive actions are needed through screening programs, regular monitoring and targeted education.

关键词： k.toacidosis Diabetes Complications k.tosis-Prone

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