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Bacteriological Profile of Infections Encountered in a Pneumology service in a Moderate-Income Country [Pneumology department of chu cocody (Côte d’Ivoire)]

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Open Journal of Respiratory diseases 2024年第1期14卷 1-11页

作者： Brou Jean Marcel Ahui Alitonde Eudoxie djegbeton Alima Kone Marc-Olivier Koffi Kouame Clarisse Elogne Mobio Nancy hermine Benjamin Kouraogo Erick Akouatia Constante Virginie Brou-Gode Kigninlman horo Boko Alexandre Kouassi Ngoran Koffi Pneumology service Teaching Hospital of Cocody Abidjan C&#244te d’Ivoire Medical School of Abidjan University Félix Houphou&#235t Boigny Abidjan C&#244te d’Ivoire Pasteur Institute of Cô te d’Ivoire Abidjan C&#244te d’Ivoire

Introduction: Infections represent a real public health problem aggravating the morbidity and mortality of hospitalized patients. Methods: This was a retrospective study with descriptive purposes over a period of 05 years, in the Pneumology department of the University hospital of cocody. Results: The average age in our population was 42 years. We observed a male predo- minance of 64.5%, with a sex ratio of 1.8. Medical history was dominated by hIV infection (23.5%), followed by tuberculosis (15.6%). Concerning lifestyle, smoking was found in 38% of cases. Symptoms progressed chronically in 80% of cases. An infectious syndrome was found in 75% of cases. Microbial culture was positive in 42% of cases. Pseudomonas aeruginosa and Klebsiella pneumoniae were encountered in 26.4% of cases each, followed by Echerichia coli in 10.4% of cases. Klebsiella pneumoniae in the first three years topped the list, but gradually. Pseudomonas aeruginosa maintained its leadership over the last three years. Pseudomonas aeruginosa isolates expressed a resistance rate of 9.8% to ceftazidime and 8.1% to imipenem;to aztreonam (36%), ticarcillin (33.3%) and levofloxacin. These strains were susceptible to fosfomycin (100%), mero- penem (96.6%) and amikacin (96%). For isolated strains of entero- bacteria- ceae, resistance was observed about ticarcillin (83.3%) and amoxicillin clavula- nic acid (71.2%). Streptococcaceae showed resistance to tetracycline (69.2%) and erythromycin (50%). Over the years there has been an increase in re- sistance to amoxicillin-clavulanic acid ceftriaxone. The death rate was 14%. Conclusion: The bacterial profile of infections is dominated by germs respon- sible for nosocomial infection with significant mortality.

关键词： Bacterial Pleural Pneumonia Nosocomial Infection Sub-Saharan Africa Antibiotic Therapy

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Faecal calprotectin and magnetic resonance imaging in detecting Crohn's disease endoscopic postoperative recurrence

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World Journal of gastroenterology 2018年第5期24卷 641-650页

作者： Pierre Baillet Guillaume Cadiot Marion Goutte Felix Goutorbe hedia Brixi Christine hoeffel Christophe Allimant Maud Reymond hélène Obritin-Guilhen Benoit Magnin Gilles Bommelaer Bruno Pereira Constance hordonneau Anthony Buisson Université Clermont Auvergne CHU Clermont-Ferrand Service de radiologie chu de Reims Service d’Hépato-Gastro Entérologie Université Clermont Auvergne Inserm 3iHP CHU Clermont-Ferrand Service d’Hépato-Gastro Entérologie Université Clermont Auvergne Inserm U1071 Ch de Bayonne Service d’Hépato-Gastro Entérologie chu de Reims Service de radiologie chu Clermont-Ferrand DRCI Unité de Biostatistiques

AIM To assess magnetic resonance imaging(MRI) and faecal calprotectin to detect endoscopic postoperative recurrence in patients with Crohn's disease(Cd).METhOdS From two tertiary centers, all patients with Cd who underwent ileocolonic resection were consecutively and prospectively included. All the patients underwent MRI and endoscopy within the first year after surgery or after the restoration of intestinal continuity [median = 6 mo(5.0-9.3)]. The stools were collected the day before the colonoscopy to evaluate faecal calprotectin level. Endoscopic postoperative recurrence(POR) was defined as Rutgeerts' index ≥ i2b. The MRI was analyzed independently by two radiologists blinded from clinical *** Apparent diffusion coefficient(AdC) was lower in patients with endoscopic POR compared to those with no recurrence(2.03 ± 0.32 vs 2.27 ± 0.38 × 10^(-3) mm^2/s, P = 0.032). Clermont score(10.4 ± 5.8 vs 7.4 ± 4.5, P = 0.038) and relative contrast enhancement(RCE)(129.4% ± 62.8% vs 76.4% ± 32.6%, P = 0.007) were significantly associated with endoscopic POR contrary to the magnetic resonance index of activity(Ma RIA)(7.3 ± 4.5 vs 4.8 ± 3.7; P = 0.15) and MR scoring system(P = 0.056). AdC dictive value(PPV) = 0.85, negative predictive value(NPV) = 0.65] and RCE > 100%(sensitivity = 0.75, specificity = 0.81, PPV = 0.75, NPV = 0.81) were the best cutoff values to identify endoscopic POR. Clermont score > 6.4(sensitivity = 0.61, specificity = 0.82, PPV = 0.73, NPV = 0.74), Ma RIA > 3.76(sensitivity = 0.61, specificity = 0.82, PPV = 0.73, NPV = 0.74) and a MR scoring system ≥ MR1(sensitivity = 0.54, specificity = 0.82, PPV = 0.70, and NPV = 0.70) demonstrated interesting performances to detect endoscopic POR. Faecal calprotectin values were significantly higher in patients with endoscopic POR(114 ± 54.5 μg/g vs 354.8 ± 432.5 μg/g; P = 0.0075). Faecal calprotectin > 100 μg/g demonstrated high perfor

关键词： Faecal calprotectin Magnetic resonance imaging Postoperative recurrence Crohn’s disease Clermont score Magnetic resonance index of activity

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Obscure bleeding colonic duplication responds to proton pump inhibitor therapy

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World Journal of gastroenterology 2013年第35期19卷 5940-5942页

作者： Jérémie Jacques Fabrice Projetti Romain Legros Virginie Valgueblasse Matthieu Sarabi Paul Carrier Fabien Fredon Stéphane Bouvier Véronique Loustaud-Ratti denis Sautereau service d’hépato-gastro-entérologie CHU Dupuytren

We report the case of a 17-year-old male admitted to our academic hospital with massive rectal *** childhood he had reported recurrent gastrointestinal bleeding and had two exploratory laparotomies 5and 2 years *** emergency abdominal computed tomography scan,gastroscopy and colonoscopy,performed after hemodynamic stabilization,were considered ***-dose intravenous proton pump inhibitor(PPI)therapy was initiated and bleeding stopped *** other massive rectal bleeds occurred 8 h after each cessation of PPI which led to a hemostatic laparotomy after negative gastroscopy and small bowel capsule *** showed long tubular duplication of the right colon,with fresh blood in the duplicated *** lower gastrointestinal bleeding is a difficult medical situation and potentially *** presence of ulcerated ectopic gastric mucosa in the colonic duplication explains the partial efficacy of PPI *** gastrointestinalbleeding responding to empiric anti-acid therapy should probably evoke the diagnosis of bleeding ectopic gastric mucosa such as Meckel’s diverticulum or gastrointestinal duplication,and gastroenterologists should be aware of this potential medical situation.

关键词： Colonic duplication gastro-intestinal duplication gastrointestinal bleeding hemostatic colorectal surgery Proton pump inhibitor therapy

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Reactivation of Tuberculosis during dual Therapy with Pegylated Interferon and Ribavirin for Chronic hepatitis C about a Case

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Open Journal of gastroenterology 2015年第7期5卷 83-87页

作者： d. Soro S. Koné A. Ouattara A. W. Ndjitoyap A. J. B. Okon d. diallo C. Assi K. E. Allah M. J. Lohoues Kouacou B. M. Camara service d’hépato-gastroentérologie CHU Cocody Abidjan Cote d’Ivoire

The infection by the virus of the hepatitis C can be associated with other infectious diseases, including the viral and bacterial infections of which the tuberculosis. The infection to Mycobacterium tuberculosis can remain latent during several years and show itself during a state of immunesuppression. The role of the antiviral treatment in the reactivation of the tuberculosis is debated. We bring back an observation of tubercular reactivation during dual therapy with pegylated interferon and ribavirin for a viral chronic hepatitis C. A virologique answer slow was obtained in the 40th week, as well as the reactivation of the tuberculosis. The tuberculosis was of ganglionic localization at our patient. The antituberculous treatment was established while maintaining the treatment. The evolution of the tuberculosis under treatment was favorable but for the VhC, we noted a virologique answer with premature relapse.

关键词： Chronic hepatitis C Virus Tuberculosis Treatment

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duodenal Metastases of Malignant Melanoma: One Case Report

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Open Journal of gastroenterology 2015年第8期5卷 111-114页

作者： Soro dramane Ouattara Amadou Okon Anassi Jean Baptiste Koné Siaka Assi Constant Allah-Kouadio Emile N’dah K. Justin Ndjitoyap Ndam Antonin Wilson diallo djeinabou Lohoues-Kouacou Marie Jeanne d’Arc Camara Benoit Mathieu service d’hépato-gastroentérologie CHU Cocody Abidjan Cote d’Ivoire service d’hépato-gastroentérologie CHU Bouaké Bouaké Cote d’Ivoire service d’Anatomie Pathologique CHU Cocody Abidjan Cote d’Ivoire

The duodenal metastases of a malignant melanoma are rare. We report a case at a 86-year-old, hypertense patient, without tumoral history, who was hospitalized in our department for a change of the general state and an anaemia ferriprive without found home (foyer) of display. In the clinical examination, we had found anemia syndrome, nodules under cutaneous about 2 cm in diameter at the level of the thorax, of the belly, the members and of the lower lip partners in a painless left adenopathy axillary about 3 cm in diameter and an absence of méléna in the rectal touch. The gastroscopy had highlighted polypoides ulcéro-bourgeonnantes hurts with a blackish pigmentation by places at the level of the bulb and of the second duodenum. In the histology of biopsie fragments, we noted a fuso-cellular proliferation and epithelioid with deposits of melanin. The positivity of antibodies anti-protein S100 and anti hMB45 in the immunohistochemical study allowed confirming the diagnosis. The gastroduodenal hurts, persons suffering from a liver complaint and lungworts in the scanner testify of a terminal metastatic scattering. The death arose two months later, in a picture of circulatory collapse further to a high digestive bleeding of big abundance.

关键词： duodenal Metastases Malignant Melanoma

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Caroli disease: A Case Report Observed at the cocody Teaching hospital of Abidjan (Cote d’Ivoire)

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Open Journal of gastroenterology 2017年第1期7卷 28-31页

作者： A. Ouattara S. Koné E. Allah-Kouadio d. Soro A. W. Ndjitoyap E. Kouadio K. A. Kanga C. d. Fanou M. J. Lohoues-Kouacou B. M. Camara service d’hépato-gastro entérologie chu cocody Abidjan C&#244te D’Ivoire service de Pédiatrie Médicale CHU Cocody Abidjan C&#244te D’Ivoire service d’Imagerie Médicale CHU Cocody Abidjan C&#244te D’Ivoire

Caroli disease is a rare affection. It’s commonly associated to polycystic kidneys. We report a case of a nine-year-old girl. She was hospitalized at the pediatric unit of the cocody Teaching hospital for an intermittent fever. during the clinical examination, we found a likely cirrhotic hepatomegaly associated to an edematous-ascitic syndrome. Biological exams showed an infectious syndrome with a hyperleukocytosis at 13.000 per mm3, a hyperneutrophilia at 9.600 per mm3. Serological viral markers of B, C and d hepatitis were negative. We saw an intra-hepatic cystic picture at the liver CT-scan with a vascular lesion at his center called a “dot sign”. The diagnosis of Caroli disease could be evocated.

关键词： Carolisyndrom Congenital Cystic dilation Cholangitis Liver CT-Scan

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Endoscopic hemostatic Treatment of Gastric Varices during Pregnancy by Injection of histoacryl

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Open Journal of gastroenterology 2014年第4期4卷 149-151页

作者： Nora Bousfiha Najoua Bousfiha Chahrazad Bouchikhi Abdelaziz Banani Adil Ibrahimi Nourdin Aqodad service d’hépato-gastro-entérologie CHU Hassan II Fès Maroc service de gynécologie-obstétrique 1 CHU Hassan II Fès Maroc

The occurrence of pregnancy is relatively rare in patients with portal hypertension, and has been reported as clinical cases. however, few studies have evaluated the effectiveness of injecting histoacryl during pregnancy. The choice of treatment for varicose bleeding during pregnancy has been described in the literature based on the elastic ligature. We report the second case, to our knowledge, of treatment of bleeding gastric varices by injection of histoacryl with good maternal and fetal development.

关键词： Gastric Varices Pregnancy hystoacryl

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Combined evaluation of biomarkers as predictor of maintained remission in Crohn's disease

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World Journal of gastroenterology 2019年第19期25卷 2354-2364页

作者： Elisa Sollelis Régine Minet Quinard Guillaume Bouguen Marion Goutte Félix Goutorbe damien Bouvier Bruno Pereira Gilles Bommelaer Anthony Buisson Inserm 3i hP CHU Clermont-Ferrand Service d’Hépato-Gastro Entérologie Université Clermont Auvergne Inserm U1071 M2i SH USC-INRA 2018 Université Clermont Auvergne Biochemistry laboratory University Hospital G.Montpied chu Rennes Univ Rennes INSERM CIC1414 Institut NUMECAN (Nutrition Metabolisms and Cancer) gastroenterology department Hospital of Bayonne Biostatistics Unit DRCI University Hospital

BACKGROUNd The individual performances and the complementarity of Crohn's disease(Cd)activity index(CdAI), C-reactive protein(CRP) and faecal calprotectin(Fcal) to monitor patients with Cd remain poorly inves-tigated in the era of "tight control"and "treat to target" *** To assess CdAI, CRP and Fcal variation, alone or combined, after 12 wk(W12) of anti-tumor necrosis factor(TNF) therapy to predict corticosteroids-free remission(CFREM = CdAI d Fcal h no therapeutic intensification and no surgery) at *** Cd adult patients needing anti-TNF therapy with CdAI > 150 and either CRP >2.9 mg/L or Fcal > 250 μg/g were prospectively *** Among the 40 included patients, 13 patients(32.5%) achieved CFREM at W52. In univariable analysis, CdAI d Fcal improvement at W12(Fcal ents with initial Fcal decrease of Fcal or normalization of Fcal(dictive of CFREM at W52. Combined endpoint(CdAI d CRP ≤ 2.9 mg/L and FCal improvement) at W12 was the best predictor of CFREM at W52 with positive predictive value = 100.0%(100.0-100.0)and negative predictive value = 87.1%(75.3-98.9). In multivariable analysis, Fcal improvement at W12 [odd ratio(OR) = 45.1(2.96-687.9); P = 0.03] was a better predictor of CFREM at W52 than CdAI d CRP he combined monitoring of CdAI, CRP and Fcal after anti-TNF induction therapy is able to predict favorable outcome within one year in patients with Cd.

关键词： Biomarkers Crohn's disease Faecal calprotectin Crohn's disease activity index C-reactive protein Tight control Anti-tumor necrosis factor

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Virological profile of hepatitis B infection in Black African hBsAg chronic carriers

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Open Journal of gastroenterology 2013年第2期3卷 113-118页

作者： Koffi Alain Attia Stanislas doffou Ya henriette Kissi demba Bangoura Seka Mondesir Pianiza Kouame Alassan Mahassadi Fulgence Yao Bathaix Mohamed Sayegh Thérèse N’dri-Yoman Clinique Médicale danga Cocody Abidjan Cote d’Ivoire service de Médecine et d’hépato-gastroentérologie CHU Yopougon Abidjan Cote d’Ivoire

Aims: 1) describe virological profile of patients followed-up for chronic hepatitis B virus (hBV);2) Search for a correlation between cirrhosis and virological profile of patients. Patients and Methods: Retrospective study about 75 hBsAg positive patients followed-up for at least one year in two medical structures of Abidjan. Studied parameters: clinical signs, biological check-up (serum transaminases every 3 months for at least one year, platelets count and prothrombin rate), abdominal echography, virological check-up (hBsAg, hBeAg, anti-hBe, total anti-hBc, anti-VhC and anti- hIV Ab, hBV dNA biannual quantification during at least one year). histological or biochemical evaluation of hepatic activity and fibrosis were realized in case of transaminases elevation or hBV dNA > 2000 IU/ml. Results: The mean age of our 75 patients (54 men) was 42.1 ± 11.54 years. hBV was fortuitously discovered in most of our patients (74.7% of the cases). The hBV inactive chronic carriage was 50.7%;hBeAg-positive and hBeAg-negative chronic hepatitis represented respectively 9.3% and 40% of the cases. Mean B viral load was 327.5 IU/ml in hBV inactive chronic carriers, 44,047,663 IU/ml in hBeAg-positive chronic hBV and 20,231,822 IU/ml in hBeAg-negative chronic hBV. Cirrhosis prevalence was significantly high- er in positive or negative hBeAg chronic hBV than in hBV inactive chronic carriers (32.4% vs. 5.3%, p = 0.008;OR = 8.6). Conclusion: Our patients’ virological profile was dominated by hBeAg-negative chronic hBV and hBV inactive chronic carriage. The risk of having cirrhosis was multiplied by 8.6 in case of active chronic hepatitis compared with hBV inactive chronic carriage.

关键词： hepatitis B Virus Virological Profile Cirrhosis

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Primary Malignant Bones Cancers in Cote d’Ivoire: Epidemiological and histopathological Aspects

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Open Journal of Pathology 2018年第2期8卷 51-59页

作者： Kone Samba J. N’dah Kouame R. Kouakou Konan A. Ngandjeu Nawé doukoure Brahima Bana Abdoulaye Eti Edmond Agoh Serge service de Traumatologie-chu de cocody Abidjan Cote d’Ivoire service d’Anatomie et Cytologie Pathologiques-chu de cocody Abidjan Cote d’Ivoire service de Stomatologie-chu de cocody Abidjan Cote d’Ivoire service de Rhumatologie-chu de cocody Abidjan Cote d’Ivoire

Primary bones cancers are rare and ubiquitous malignant tumors. Aim: Our study aimed was to describe the epidemiological and histopathological aspects of primary malignant bone cancers in Ivory Coast. Material and method: This is a retrospective and descriptive study of primary malignant bone cancers diagnosed over the period 1990 to 2013 (24 years). The studied parameters were: epidemiological aspects (frequency, age, sex, topography) and histological aspects. Results: Over the study period, primary malignant bone cancers accounted for 1.93% (n = 228) of cancers. The average age was 27.02 years with extremes of 2 and 85 years. The sex ratio was 1.65. They were in the skull and maxilla in 43.9% (n = 105), lower limbs (23.8%), spine and ribs (19.8%), pelvis (5.3%) and upper limbs (2.3%). The clinic was dominated by pain and alteration of general state. Radiology was variable depending on the histological type. In children, primary malignant bone cancers were found in the maxillary (77.9%) and the lower limb (15.8%). Burkitt’s lymphomas represented 36.4% (n = 66) of the histological types followed by 22.4% osteosarcomas (n = 51). In adults at histology, sarcomas were the most common (10%), followed by cancers of the hematopoietic and lymphatic organs (8.09%). Conclusion: Primary malignant bone cancers are rare in Ivory Coast. They most often affect male children with maxillofacial involvement and predominant lower extremity. Burkitt’s lymphoma and osteosarcoma are the often diagnosed histological types.

关键词： Cancers Bones Epidemiology histopathology Cote d’Ivoire

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