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Visceral Leishmaniasis at the national Reference University Hospital Center of n’Djamena (Chad): Epidemiological, Clinical, Diagnostic, Therapeutic and Prognostic Aspects

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Advances in Infectious Diseases 2024年第2期14卷 478-486页

作者： Joseph Mad-Toïngué Mahamat Ali Ahmat Oumaïma Mahamat Djarma Alifa Adjibera Philippe Ali Mahamat Moussa ngakoutou Rangar Choua Ouchemi Mahamat Ali Bolti Djiddi Ali Sougoudi Mamissou Didi Mahamat Doungous Atim service des Maladies Infectieuses CHU de Référence Nationale N’Djamena Chad service de gastroentérologie et Médecine Interne CHU de Référence Nationale N’Djamena Chad service de Pneumologie et Phtisiologie CHU de Référence Nationale N’Djamena Chad service de chirurgie viscérale CHU de Référence Nationale N’Djamena Chad service de Médecine CHU de la Renaissance N’Djamena Chad

Introduction: leishmaniasis is a group of parasitic diseases caused by a parasite of the genus Leishmania transmitted by the bite of an infected vector called a sandfly. There are four forms. Visceral leishmaniasis is the most severe form. The aim of our work is to study the epidemiological, clinical, diagnostic, therapeutic and prognostic aspects of the disease in the Infectious Diseases department of the Centre Hospitalier Universitaire de Référence nationale in n'Djaména. Methodology: Patients were recruited on the basis of clinical signs suggestive of visceral leishmaniasis, i.e. prolonged fever, splenomegaly and altered general condition. Biological confirmation was performed with a rapid diagnostic test using recombinant K39 parasite antigen, which is known to have good specificity and sensitivity. Epidata version 3.1 software was used to process patient data. Results: From 05/04/21 to 15/12/23, 153 positive cases were managed. The mean age of patients was 18 years, with a sex ratio of 9.2. Of these patients, 103 (67.3%) had recently stayed at gold mining sites. Patients testing positive were treated with sodium stibogluconate combined with paromomycin for 17 days. The mortality rate was 13.2%. Conclusion: Leishmaniasis is a serious and little-known disease in Chad. In order to respond to the disease, it is necessary to reinforce the capacities of health structures and to carry out appropriate actions in the outbreaks.

关键词： Visceral Leishmaniasis gold Mining Sites Chad

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Evaluating pediatric ureteropelvic junction obstruction:Dynamic magnetic resonance urography vs renal scintigraphy 99mtechnetium mercaptoacetyltriglycine

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World Journal of Radiology 2024年第3期16卷 49-57页

作者： Yousuf Al-Shaqsi Matthieu Peycelon Annabel Paye-Jaouen Elisabeth Carricaburu Anca Tanase Christine grapin-Dagorno Alaa El-ghoneimi department of Pediatric Surgery Sultan Qaboos University HospitalMuscat 123Oman service de chirurgie Viscérale et Urologie Pédiatrique Hôpital Universitaire Robert-DebréAssistance-Publique Hôpitaux de ParisParis 75019France Centre de Références Maladies Rares Malformations Rares des Voies Urinaires(MARVU)Paris 97019France Facultéde Médecine Universitéde ParisParis 75006France service d’Imagerie Pédiatrique Hôpital Universitaire Robert-DebréAssistance-Publique Hôpitaux de ParisParis 75019France UniversitéParis 13 Sorbonne Paris CitéParis 75013France

BACKgROUnD Ureteropelvic junction obstruction(UPJO)is a common congenital urinary tract disorder in children.It can be diagnosed as early as in utero due to the presence of hydronephrosis or later in life due to symptomatic occurrence.AIM To evaluate the discrepancy between dynamic contrast-enhanced magnetic resonance urography(dMRU)and scintigraphy 99m-technetium mercaptoacetyltriglycine(MAg-3)for the functional evaluation of UPJO.METHODS Between 2016 and 2020,126 patients with UPJO underwent surgery at Robert debréHospital.Of these,83 received a prenatal diagnosis,and 43 were diagnosed during childhood.Four of the 126 patients underwent surgery based on the clinical situation and postnatal ultrasound findings without undergoing functional imaging evaluation.Split renal function was evaluated preoperatively using scintigraphy MAg-3(n=28),dMRU(n=53),or both(n=40).In this study,we included patients who underwent surgery for UPJO and scintigraphy MAg-3+dMRU but excluded those who underwent only scintigraphy MAg-3 or dMRU.The patients were divided into groups A(ncy)and B(>10%discrepancy).We examined the discrepancy in split renal function between the two modalities and investigated the possible risk factors.RESULTS The split renal function between the two kidneys was compared in 40 patients(28 boys and 12 girls)using scintigraphy MAg-3 and dMRU.Differential renal function,as determined using both modalities,showed a difference ofn 31 children and>10%in 9 children.Calculation of the relative renal function using dMRU revealed an excellent correlation coefficient with renal scintigraphy MAg-3 for both kidneys.COnCLUSIOn Our findings demonstrated that dMRU is equivalent to scintigraphy MAg-3 for evaluating split renal function in patients with UPJO.

关键词： Uteropelvic junction obstruction Scintigraphy 99m-technetium mercaptoacetyltriglycine Magnetic resonance imaging Dynamic contrast-enhanced magnetic resonance urography

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Rib Osteosynthesis for Sub-Acute Management of a Flail Chest in a Tertiary Centre in a Low-Middle Income Country of Sub-Saharan Africa: Case Report at Douala Laquintinie Hospital

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Open Journal of Thoracic Surgery 2024年第1期14卷 1-16页

作者： Fabrice Stéphane Arroye Betou nyankoue Mebouinz Ferdinand guy Aristide Bang Kobe Folkabo Zephany Banga nkomo Douglas Moussa Seck Diop Abdoul Lahad Mbeng Marcella derboise Christelle Biyouma noel Essomba Souleyman Diatta Handy Eone Daniel Arthur Essomba Hassan ndiaye Maurice Aurelien Sosso department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences (FMBS) University of Yaoundé (UYI) Yaoundé Cameroon department of Surgery and Affiliated Disciplines Douala Laquintinie Hospital Douala Cameroon department of Surgery and Specialties Yaoundé General Hospital Yaoundé Cameroon department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences (FMPS) University of Dschang Dschang Cameroon service de chirurgie Thoracique et Cardiovasculaire Centre Hospitalier Universitaire de Fann Faculté de Médecine de Pharmacie et d’Odontologie Université de Cheikh Anta Diop Dakar Sénégal UFR des Sciences de la Santé Ziguinchor Sénégal

Background: Costal fracture surgical is still a debate, therefore we shall select between early and delay surgical management. Case Report: We are reporting two cases of post road traffic clash delay ribs fractures osteosynthesis involving a 63-year-old man with multistage fractures on the left and pulmonary pinning of one of the costal arches, complicated by a homolateral haemothorax and a 41-year-old man with a bilateral flail chest. Conclusion: The simple postoperative course and the immediate postoperative improvement in the patient’s clinical respiratory condition enabled us to discuss the time frame for management, in this case the indication for early or later surgery.

关键词： Flail Chest Fixation Plate Rib Fracture Osteosynthesis

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Appendicular Peritonitis in the general Surgery department of gabriel TOURE CHU

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Surgical Science 2022年第1期13卷 9-14页

作者： Maïga Amadou Diakité Ibrahima Bah Amadou Diallo Aly Boubacar Traoré Bathio Moussa Diassana Sidibé Boubacar Yoro Koné Tani Doumbia Arouna Adama Traoré Amadou Saye Zakari Saadé Oumou Hélène Kanté Lassana Konaté Madiassa dembélé Souleymane Samaké Moussa dembélé Bakary Tientigui Traoré Alhassane Togo Adégné service de chirurgie générale H&#244pital de Sikasso Sikasso Mali service de chirurgie générale CHU Gabriel Tour&#233 Bamako Mali

The appendicular peritonitis is complications of acute appendicitis which are characterized by the diffusion of the infectious process to the peritoneal cavity thus carrying out a generalized or located purulent peritonitis. It can appear from the start or follow the stage of appendicular abscess. n>n>Our objectives were to determine the frequency, to describe the clinic and para clinic aspects, to identify the principal germs and their sensitivities to antibioticsn>n> andn>n> to describe the operative continuations.n>n> n>n>Our prospective and descriptive study focused on patients treated for appendicular peritonitis, from January 1st to December 31st 2016, in the General Surgery Department of the Hospital of Sikasso.n>n>n> n>n>During the period of our study, 31 cases of appendicular peritonitis were collected, whichn>n> n>n>n style="font-family:Verdana;">n style="font-family:Verdana;">n style="font-family:Ver

关键词： Appendicular Peritonitis Surgical Emergencies Hospital of Sikasso

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Role of near-infrared fluorescence in colorectal surgery

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World Journal of gastroenterology 2021年第31期27卷 5189-5200页

作者： Elodie Zocola Jeremy Meyer niki Christou Emilie Liot Christian Toso nicolas Christian Buchs Frederic Ris Medical School University of GenevaGenève 1205Switzerland Division of Digestive Surgery University Hospitals of GenevaGenève 1205Switzerland service de chirurgie Digestive Endocrinienne et GénéraleCHU de LimogesLimoges Cedex 87025France

near-infrared fluorescence(nIRF)is a technique of augmented reality that,when applied in the operating theatre,allows the colorectal surgeon to visualize and assess bowel vascularization,to identify lymph nodes draini... 详细信息

关键词： Fluorescence Enhanced reality Anastomotic leak Ureter Anastomosis

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Meso-Rex bypass for the management of extrahepatic portal vein obstruction in adults(with video)

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Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 25-32页

作者： Martin Brichard Samuele Iesari Jan Lerut Raymond Reding Pierre goffette Laurent Coubeau service de chirurgie et Transplantation Abdominale Cliniques Universitaires Saint-LucUniversitéCatholique de Louvain10 Avenue HippocrateBrussels 1200Belgium Pôle de chirurgie Expérimentale et Transplantation Institut de Recherche Expérimentale et CliniqueUniversitéCatholique de LouvainBrusselsBelgium department of Clinical Sciences and Applied Biotechnology University of L’AquilaL’AquilaItaly department of general Surgery and Kidney Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilanItaly service de Radiologie et Imagerie médicale Cliniques Universitaires Saint-LucUniversitéCatholique de LouvainBrusselsBelgium

Background:Extrahepatic portal vein obstruction(EHPVO)results in severe portal hypertension(PHT)leading to severely compromised quality of life.Often,pharmacological and endoscopic management is unable to solve this problem.Restoring hepatic portal flow using meso-Rex bypass(MRB)may solve it.This procedure,uncommon in adult patients,is considered the treatment of choice for EHPVO in children.Methods:From 1997 to 2018,8 male and 6 female adults,with a median age of 51 years(range 22-66)underwent MRB procedure for EHPVO at the University Hospitals Saint-Luc in Brussels,Belgium.Symp-toms of PHT were life altering in all but one patient and consisted of repetitive gastro-intestinal bleedings,sepsis due to portal biliopathy,and/or severe abdominal discomfort.The surgical technique consisted in interposition of a free venous graft or of a prosthetic graft between the superior mesenteric vein and the Rex recess of the left portal vein.Results:Median operative time was 500 min(range 300-730).Median follow-up duration was 22 months(range 2-169).One patient died due to hemorrhagic shock following percutaneous transluminal interven-tion for early graft thrombosis.Major morbidity,defined as Clavien-Dindo score≥III,was 35.7%(5/14).Shunt patency at last follow-up was 64.3%(9/14):85.7%(6/7)of pure venous grafts and only 42.9%(3/7)of prosthetic graft.Symptom relief was achieved in 85.7%(12/14)who became asymptomatic after MRB.Conclusions:Adult EHPVO represents a difficult clinical condition that leads to severely compromised quality of life and possible life-threatening complications.In such patients,MRB represents the only and last resort to restore physiological portal vein flow.Although successful in a majority of patients,this procedure is associated with major morbidity and mortality and should be done in tertiary centers expe-rienced with vascular liver surgery to get the best results.

关键词： Meso-Rex bypass Extrahepatic portal vein obstruction Extrahepatic portal hypertension Portal vein thrombosis Surgical procedure

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Lateral lymph node dissection for low rectal cancer: Is it necessary?

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World Journal of gastroenterology 2019年第31期25卷 4294-4299页

作者： niki Christou Jeremy Meyer Christian Toso Frédéric Ris nicolas Christian Buchs service de chirurgie Digestive Endocrinienne et GénéraleCHU de LimogesLimoges Cedex 87042France Division of Digestive Surgery University Hospitals of GenevaGenève 1211Switzerland Unit of Surgical Research University of GenevaGenève 1206Switzerland

Rectal cancer constitutes a major public health issue.Total mesorectal excision has remained the gold standard treatment for mid and low rectal tumors since its introduction in the late 1980s.Removal of all lymph nodes located in the mesorectum has indeed improved pathological and oncological outcomes.However,when cancer spreads to the lateral lymph nodes(located along the iliac and obturator arteries)Western and Japanese practices differ.Where the Western guidelines consider this condition as an advanced form of the disease and use neoadjuvant radiochemotherapy liberally,the Japanese guidelines define it as a local disease and proceed to lateral lymph node dissection with or without neoadjuvant treatment.Herein,we review the current literature regarding both therapeutic strategies,with the aim of contributing to potential improvements in treatment and outcome for patients with low and mid rectal cancer.

关键词： Total mesorectum excision Mesorectal resection Lateral node metastasis Extended lymphadenectomy

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Advanced nonmetastatic hepatocellular carcinoma: curative surgery may be an option

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Hepatobiliary Surgery and nutrition 2022年第6期11卷 870-872页

作者： Julie Leclerc Ahmet Ayav service de chirurgie cancerologique digestive hepato-bilio-pancreatique et colo-rectaleCHRU NancyNancyFrance

In this multicentric retrospective study(1),the authors aimed to compare surgery versus Sorafenib(SOR)for the treatment of advanced nonmetastatic hepatocellular carcinoma(HCC).Data were collected from two Italian regi... 详细信息

关键词： surgery hepatocellular metastatic

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Comparison of alternative arterial anastomosis site during liver transplantation when the recipient’s hepatic artery is unusable

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Hepatobiliary Surgery and nutrition 2022年第1期11卷 1-12页

作者： Jean Marie Beaurepaire Francesco Orlando giovanni Battista Levi Sandri Caroline Jezequel Edouard Bardou-Jacquet Christophe Camus Mohamed Lakehal Veronique desfourneaux Aude Merdrignac Elodie gaignard Alexandre Thobie Damien Bergeat Bernard Meunier Michel Rayar CHU Rennes Service de Chirurgie Hépatobiliaire et DigestiveRennesFrance UniversitéRennes 1 Facultéde MédecineRennesFrance CHU Rennes Service des Maladies du FoieRennesFrance InSERM CIC 1414RennesFrance CHU Rennes Service de Maladies Infectieuses et Réanimation MédicaleRennesFrance

Background:Few studies have analyzed outcomes of liver transplantation(LT)when the recipient hepatic artery(HA)was not usable.Methods:We retrospectively evaluated the outcomes of LT performed using the different alternative sites to HA.Results:Between 2002 and 2017,1,677 LT were performed in our institution among which 141(8.4%)with unusable recipient HA were analyzed.Four groups were defined according to the site of anastomosis:the splenic artery(SA group,n=26),coeliac trunk(CT group,n=12),aorta using or not the donor’s vessel(Ao group,n=91)and aorta using a vascular prosthesis(Ao-P group,n=12)as conduit.The median number of intraoperative red blood cell transfusions was significantly increased in the Ao and Ao-P groups(5,5,8.5 and 16 for SA,CT,Ao and Ao-P group respectively,P=0.002),as well as fresh frozen plasma(4.5,2.5,10,17 for the SA,CT,Ao and Ao-P groups respectively,P=0.001).Hospitalization duration was also significantly increased in the Ao and Ao-P groups(15,16,24,26.5 days for the SA,CT,Ao and Ao-P groups respectively,Pnce of early allograft dysfunction(EAD)(P=0.07)or arterial complications(P=0.26)was not statistically different.Level of factor V,InR,bilirubin and creatinine during the 7th postoperative days(POD)was significantly improved in the SA group.no difference was observed regarding graft(P=0.18)and patient(P=0.16)survival.Conclusions:In case of unusable HA,intraoperative and postoperative outcomes are improved when using the SA or CT compared to aorta.

关键词： Liver transplantation(LT) hepatic artery(HA) arterial anastomosis splenic artery(SA)

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World Journal of gastroenterology 2016年第2期22卷 490-500页

作者： Hussein Akil Aurélie Perraud Marie-Odile Jauberteau Muriel Mathonnet Laboratoire Homéostasie Cellulaire et Pathologies(LHCP-EA3842) Facultéde Médecine et de PharmacieFédération de Recherche GEIST87025 LimogesFrance service de chirurgie Digestive Générale et EndocrinienneCHU de Limoges87042 LimogesFrance service d’Immunologie CHU de Limoges87042 LimogesFrance

Colorectal cancer(CRC) is the second most common cause of cancer-related death in western countries. Approximately one-quarter of newly diagnosed patients for CRC have metastases, and a further 40%-50% experience disease recurrence or develop metastases after all standard therapies. Therefore, understanding the molecular mechanisms involved in the progression of CRC and subsequently developing novel therapeutic targets is crucial to improve management of CRC and patients' long-term survival. Several tyrosine kinase receptors have been implicated in CRC development, progression and metastasis, including epidermal growth factor receptor(EgFR) and vascular EgFR. Recently, tropomyosin-related kinase B(Trk B), a tyrosine kinase receptor, has been reported in CRC and found to clearly exert several biological and clinical features, such as tumor cell growth and survival in vitro and in vivo, metastasis formation and poor prognosis. Here we review the significance of Trk B and its ligand brain derived-neurotrophic factor in CRC. We focus on their expression in CRC tumor samples, and their functional roles in CRC cell lines and in in vivo models. Finally we discuss therapeutic approaches that can lead to the development of novel therapeutic agents for treating Trk B-expressing CRC tumors.

关键词： Colorectal cancer Tyrosine kinase receptor B Brain-derived neurotrophic factor Therapeutic targets Cell survival

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