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Eradication Treatment of Helicobacter pylori Infection: Evaluation of Therapeutic Strategies in N’Djamena

Open Journal of Gastroenterology 2024年第2期14卷 59-67页

作者： mayanna Habkréo Ali mahamat moussa Tahir mahamat Saleh Djerabet Franckly Fany Haby mairé dehainssala Adama Ngaré mahamat Ali Hachim service de medecine interne et Gastroenterologie Centre Hospitalier Universitaire La Reference Nationale N’Djamena Tchad service de medecine interne Centre Hospitalier Universitaire La Renaissance N’Djamena Tchad service de médecine Hopital de l’Amitié Tchad-Chine N’Djamena Tchad

Background: Helicobacter pylori (Hp) infection is the most widespread bacterial infection in the world. The infection is generally acquired in childhood, but can persist into adulthood. Eradication therapy has undergone several modifications. The aim of this study was to evaluate the different therapeutic strategies used in the eradication of Helicobacter pylori infection in the Centre Hospitalier Universitaire La Reference Nationale of N’Djaména. Patients and methods: This was a prospective, descriptive analytical study spread over one year, from September 2021 to September 2022. Patients at least 15 years of age presenting with dyspeptic symptoms, seen consecutively in a hepato-gastroenterology consultation and with a positive stool test for H. pylori infection, were included in the study. Equally, 1/3 of patients were treated with dual or triple therapy. The remaining third received quadritherapy. Results: A total of 268 patients were included in the study (mean age 38.40 ± 14.66 with extremes of 16 and 80 years). males predominated in 58% of cases. Overall therapeutic efficacy was 88.9%. According to different therapeutic strategies, efficacy was 90.75% for dual therapy with PPI (Rabeprazole) and Amoxicillin. On the other hand, efficacy was 87% and 88.88% for PPI-based triple therapy and dual antibiotic therapy, and for PPI-based quadruple therapy and triple antibiotic therapy. Conclusion: H. pylori infection is a common disease in Chad. Dual therapy with rabeprazole combined with a high dose of amoxicillin over a period of at least two weeks showed similar if not better efficacy than triple or quadruple therapy.

关键词： Helicobacter pylori Therapeutic Strategies Eradication Dyspepsia Chad

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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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Dynamics in the Prevalence of Insulin Resistance between 2005 and 2023 in Type 2 Diabetics in South Kivu in the East of the democratic Republic of Congo: Cross-Sectional Studies

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Journal of Diabetes mellitus 2024年第1期14卷 28-40页

作者： Dieudonné masemo Bihehe Ahadi Birindwa Bwihangane Jean-Paulin mukonkole mbo Christian Tshongo muhindo michel Hermans Philippe Bianga Katchunga Hô pital général de référence de Panzi Faculté de Médecine Université Evangélique en Afrique Bukavu DR Congo Département de médecine interne Université de Kisangani Provine de la Tshopo DR Congo Département de médecine interne Université Catholique de Bukavu Bukavu DR Congo service d’endocrinologie et de diabétologie Cliniques universitaires Saint-Luc Université Catholique de Louvain Bruxelles Belgique Département de médecine interne Cliniques Universitaires de Bukavu Université Officielle de Bukavu Bukavu DR Congo

Aim: Sub-Saharan Africa is undergoing an epidemiological transition responsible for a change in the metabolic profile in favour of insulin resistance. The aim of this study was to assess the dynamics of the prevalence of insulin resistance and associated risk factors in diabetic patients in the democratic Republic of Congo between 2005 and 2023. method: We measured fasting blood glucose and insulin levels and looked for metabolic syndrome parameters (2009 criteria) in type 2 diabetes patients in 2005-2008 (n = 176) and in 2018-2023 (n = 303). The HOmA model was used to measure insulin sensitivity and islet β-cell secretory function. Results: Between 2005 and 2013, the trend was towards an increase in the prevalence of insulin resistance (from 13.1% to 50.8%;p Conclusion: This present study shows an increase in insulin resistance in Congolese urban areas and a persistence of atypical diabetes mellitus in Congolese rural areas, confirming the particularity of the pathophysiology of the disease in African areas currently influenced by the epidemiological transition. Further studies using an appropriate methodology are required.

关键词： Prevalence Diabetes mellitus Insulin Resistance metabolic Syndrome South Kivu

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massive abdominal muscle atrophy during prolonged mechanical ventilation: Implications for tracheostomy removal

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Journal of Intensive medicine 2024年第1期4卷 133-135页

作者： Pascal Beuret Florian michelin Audrey Tientcheu Laurane Chalvet Benedicte Philippon-Jouve Jean-Charles Chakarian Xavier Fabre service de Réanimation et Soins continus Centre Hospitalier de RoanneRoanneFrance

Introduction maintaining the functional integrity of respiratory muscles is crucial for critically ill patients to be weaned from mechanical ventilation and decannulated if *** of the diaphragm is frequent in patients under mechanical ventilation and has been associated with a longer duration of weaning.[1,2]Studies on expiratory muscles are *** recent studies demonstrated the feasibility and reproducibility of ultrasound in measuring the thickness of abdominal muscles,[3,4]with one study showing abdominal muscle atrophy in 22%of mechanically ventilated critically ill patients during the first week of mechanical ventilation.[4]

关键词： critically mechanical abdominal

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Associations between physical activity levels and ATPase inhibitory factor 1 concentrations in older adults

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Journal of Sport and Health Science 2024年第3期13卷 409-418页

作者： Jérémy Raffin Yves Rolland Annelise Genoux Guillaume Combes mikael Croyal Bertrand Perret Sophie Guyonnet Bruno Vellas Laurent O.martinez Philipe de Souto Barreto For the mAPT/DSA Group Institut du Vieillissement Gérontopôle de ToulouseCentre Hospitalo-Universitaire de ToulouseToulouse 31000France Centre d'Epidémiologie et de Recherche en Santédes Populations UnitéMixte de Recherche 1295Institut National de la Santéet de la Recherche MédicaleUniversitéToulouse-III-Paul-SabatierToulouse 31000France LimitAging Team Institut des Maladies Métaboliques et CardiovasculairesUnitéMixte de Recherche 1297Institut National de la Santéet de la Recherche MédicaleUniversitéToulouse III-Paul SabatierToulouse 31432France service de Biochimie Pôle de biologieHôpital de PurpanCentre Hospitalo-Universitaire de ToulouseToulouse 31300France L'Institut du Thorax Institut National de la Santéet de la Recherche MédicaleCentre National de la Recherche ScientifiqueCentre Hospitalo-Universitaire de NantesNantes UniversitéNantes 44000France BioCore US16Structure Fédérative de Recherche BonamyInstitut National de la Santéet de la Recherche MédicaleCentre National de la Recherche ScientifiqueCentre Hospitalo-Universitaire de NantesNantes UniversitéNantes 44000France Plate-forme de spectrométrie de masse Centre de Recherche en Nutrition HumaineOuestNantes 44000France 不详

Background:Adenosine triphosphatase inhibitory factor 1(IF1)is a key protein involved in energy ***1 has been linked to various agerelated diseases,although its relationship with physical activity(PA)remains ***,the apolipoprotein A-I(apoA-I),a PA-modulated lipoprotein,could play a role in this relationship because it shares a binding site with IF1 on the cell-surface ATP *** examined here the associations between chronic PA and plasma IF1 concentrations among older adults,and we investigated whether apoA-I mediated these ***:In the present work,1096 healthy adults(63.8%females)aged 70 years and over who were involved in the multidomain Alzheimer Prevention Trial study were ***1 plasma concentrations(square root of ng/mL)were measured at the 1-year visit of the multidomain Alzheimer Prevention Trial,while PA levels(square root of metabolic equivalent task min/week)were assessed using questionnaires administered each year from baseline to the 3-year *** linear regressions were performed to investigate the associations between the first-year mean PA levels and IF1 *** analyses were conducted to examine whether apoA-I mediated these *** linear regressions were carried out to investigate whether the 1-year visit IF1 concentrations predicted subsequent changes in ***:multiple linear regressions indicated that first-year mean PA levels were positively associated with IF1 concentrations(B=0.021;SE=0.010;p=0.043).mediation analyses revealed that about 37.7%of this relationship was mediated by apoA-I(B_(ab)=0.008;SE=0.004;p=0.023).Longitudinal investigations demonstrated that higher concentrations of IF1 at the 1-year visit predicted a faster decline in PA levels over the subsequent 2 years(time×IF1:B=0.148;SE=0.066;p=0.025).Conclusion:This study demonstrates that regular PA is associated with plasma IF1 concentrations,and it suggests that apoA-I partly med

关键词： Aging Apolipoprotein Bioenergetics Exerkine mitochondria

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High frequency of severe liver dysfunction in critically ill dengue patients in the French West Indies

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Journal of Intensive medicine 2024年第3期4卷 403-404页

作者： Laurent Camous Samuel markowicz Cecile Loraux Julien Jabot Jean David Pommier Réanimation médicale et Chirurgicale CHU de GuadeloupeChemin ChauvelLes Abymes97139 GuadeloupeFrance service de maladies infectieuses et tropicales CHU de GuadeloupeChemin ChauvelLes Abymes97139 GuadeloupeFrance service de microbiologie CHU de GuadeloupeChemin ChauvelLes Abymes97139 GuadeloupeFrance médecine Intensive et Réanimation Centre hospitalier universitaire de la Réunion 97460 Saint-PaulFrance Institut Pasteur de la Guadeloupe Morne Jolivière97183 AbymesFrance

dear Editor,dengue is a worldwide zoonosis,transmitted by mosquitoes and highly prevalent in tropical and subtropical *** recent years,its incidence has increased with a massive healthcare burden worldwide[1]and recent climatic changes have expanded the geographic range of the insect vector with described outbreaks in Europe.[2]most patients present pauci-symptomatic infections,but some patients could present severe manifestations with high reported mortality[[3],[4],[5]]and no specific *** bleeding,hemodynamic failure and various organ damage(cardiac,renal,neurological,and hepatic)are described in severe dengue(SD)patients.[5]In the future,intensivists worldwide will be increasingly treating SD and the spectrum of severe organ impairment should be well known.

关键词： patients mortality expanded

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Vitamin D, Parathyroid Hormone, Insulin Sensitivity and Islet β-Cell Secretory Function in Diabetic Patients from South Kivu in the democratic Republic of Congo: Cross-Sectional Study

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Journal of Diabetes mellitus 2024年第2期14卷 81-94页

作者： Dieudonne masemo Bihehe Ahadi Birindwa Bwihangane Jean-Paulin mukonkole mbo michel Hermans Philippe Bianga Katchunga Faculté de médecine H&#244pital Général de Référence de Panzi Université Evangélique en Afrique Bukavu DR Congo Département de Biologie Faculté des Sciences Université Officielle de Bukavu Bukavu DR Congo Département de médecine interne Université de Kisangani Kisangani DR Congo service d’endocrinologie et de Diabétologie Cliniques Universitaires Saint-Luc Université Catholique de Louvain Bruxelles Belgique Département de médecine interne Cliniques Universitaires de Bukavu Université Officielle de Bukavu Bukavu DR Congo

Background: The role of vitamin D and parathyroid hormone in the metabolic profile of type 2 diabetes mellitus in sub-Saharan Africa has not been adequately assessed. The aim of this study was to determine the prevalence of low vitamin D level and secondary hyperparathyroidism and their association with insulin sensitivity and β-cell secretory function among Congolese type 2 diabetics. methodology: Fasting glycaemia, fasting insulin, 25OH D3 and human parathyroid hormone (hPTH) were measured in one hundred and eighty-four type 2 diabetic patients followed as outpatients in South Kivu. Levels of 25OH D3 65 pg/ml defined low vitamin D and elevated parathyroid hormone levels, respectively. The HOmA model was used to measure insulin sensitivity and β-cell secretory function. Results: medians (IQR) were 25.3 (20.4 - 32.4) ng/ml for 25OH D3 and 53.7 (38.4 - 115.7) pg/ml for hPTH. 58.7% of diabetics had insulin resistance, 126 (68.5%) had low vitamin D and 80 (43.5%) had hyperparathyroidism. In multivariate analysis, hPTH (partial r = −0.28;p = 0.0002) and 25OH D3 (partial r = 0.16;p = 0.03) showed an independent association with insulin sensitivity after adjustment for body mass index and waist circumference. Finally, hPTH (partial r = 0.27;p = 0.0002) was the sole determinant of β-cell secretory function. Conclusions: This study confirms the high prevalence of low vitamin D level and secondary hyperparathyroidism and their association with insulin resistance and impaired islet β-cell secretory function among Congolese with type 2 diabetes mellitus. Vitamin D and calcium supplementation should be envisaged for cases of deficiency in this region.

关键词： Vitamin D Parathyroid Hormone Diabetes mellitus Insulin Resistance South Kivu

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Prevalence of depression and Anxiety in Patients with Autoimmune Disease: A Comparative Study with a Diabetic Population

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Open Journal of Internal medicine 2024年第2期14卷 159-166页

作者： michel Assane Ndour mouhamed Dieng Omar Boun Khatab Diouf Léon Birwe Boundia Djiba Ibrahima mané Diallo matar Ndiaye Nousradine mourno Tarsa Djiby Sow Anna Sarr demba Diedhiou maimouna Ndour mbaye service de mdecine interne Centre Hospitalier Abass Ndao Dakar Senegal service de mdecine interne Centre Hospitalier Aristide Le Dantec Dakar Senegal

Introduction: Systemic diseases are a variety of heterogeneous autoimmune and/or autoinflammatory diseases and syndromes usually affecting multiple systems and resulting from immune system dysregulation. We evaluated risk factors for depression and anxiety in an autoimmune disease cohort compared with diabetic patients. Patients and methods: We conducted an observational, cross-sectional, case-control survey comparing two groups: individuals with connective tissue disease (CTD) and diabetic controls who were followed within three Dakar University hospitals during the period from April to June 2023. Results: The sample comprised 106 participants, of whom 51 (48%) had CTD and 55 (52%) served as diabetic controls. In the CTD group, the majority had lupus (19) and rheumatoid arthritis (23). The CTD patients had a mean age of 41.0 years (SD 16.9), while the diabetic patients had a mean age of 55.9 years (SD 11.7), with a significant difference observed (p Conclusion: Compared to a chronic disease, devastating in Africa and evolving over the long term, autoimmune diseases are more strongly and more frequently associated with anxiety and depression. This is a factor to be taken into account in the holistic management of these patients.

关键词： Connective Tissue Disease Lupus Rhumatoid Arthritis Diabetes depression Anxiety Disability

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Prevalence and Factors Associated with Sharing of Human Immunodeficiency Seropositivity Status among Serodiscordant Couples in the City of Parakou (Benin)

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Open Journal of Epidemiology 2024年第1期14卷 1-18页

作者： Djossou Sègnon Eurydice Elvire Damien Georgia Barikissou meba Bio mamatou Tokpanoude Ignace Ahanhanzo-Glele Rhonel Ataigba Iretinethania Elie Agossoukpe Benoit Kakpo-Zannou Rodrigue Kamoutchoni Corneille Aguemon Badirou Unité de santé publique de la Faculté des Sciences de la santé (FSS) Universitéd’Abomey-Calavi (UAC) Cotonou Bénin Association des médecins Communautaires de Bénin (AmCB) Parakou Bénin Association Béninoise pour la Promotion de la Famille (ABPF) Parakou Bénin Centre d’Information de Prospective d’Ecoute et de Conseil sur les IST/VIH/Sida du Borgou et de l’Alibori (CIPEC/B-A) Parakou Bénin Institut de Formation enSoinsInfirmiers et Obstétricaux (IFSIO) Faculté de Médecine (FMP) Parakou Bénin service de Psychiatrie Centre HospitalierUniversitaireDépartemental du BorgouAlibori (CHUD/B-A) Parakou Bénin service de médecine interne H&#244pital Saint-Jean de Dieu de Boko N’Dali Bénin

Introduction: In serodiscordant couples, sharing serostatus is a crucial step in the HIV risk management process. The aim of this study was to determine the prevalence and factors associated with serostatus sharing among HIV serodiscordant couples in the city of Parakou. Setting and methods: This study was carried out in the city of Parakou, capital of northern Benin. It was a descriptive, analytical cross-sectional study with non-probability sampling for convenience. Socio-demographic data, as well as data on antecedents, behaviours, social and marital life, were collected using a questionnaire gave to the participants. Clinical and therapeutic data were collected from patients’ medical records and follow-up charts. Data were analyzed and processed using R 4.3.1 software. The significance level was set at 5%, and logistic regression was used to identify potential predictors of shared serostatus among serodiscordant couples in the city of Parakou in 2022. Results: A total of 299 participants in long-term serodiscordant relationships were included in our study. The average age of the subjects was 37.55 ± 10.25 years. Women were the infected partner in 80.27% of cases. The most common level of education was secondary (33.45%). most respondents (230 subjects, 76.92%) were married. The average duration of the couple’s relationship was 121.68 months ± 96.32. The most frequent screening circumstances were: Prevention of mother-to-child transmission (PmTCT) (50.84%) and hospital screening (26.09%). The infected partner shared his or her serostatus with his or her spouse in 47.83% of cases. Potential predictors of serostatus sharing within the couple were: marital status (p Conclusion: The sharing of serostatus within serodiscordant couples needs to be managed in a way that takes into account the social and marital characteristics of the couple.

关键词： Serodiscordance Sharing of Serostatus HIV Partner Benin

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Familial Forms of Spondyloarthritis Study of 100 Senegalese multiplex Families

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第3期14卷 132-143页

作者： Adama Bah Chiekh Ahamadou Bamba Diaw Dieynaba Sala Tamara Kane Adama Doucouré Siddiki Charifah Ramadhane Bouchrane Harine Abdel Aziz Garba Aissatou N’diaye mondukpe Joane Immanuelle Houansou Laurine marlyse Adogle Yaye Aminata Gueye moustapha Niasse Saidou Diallo service de Rhumatologie CHU Aristide Le Dantec Dakar Sngal service de Rhumatologie Hpital National Ignace Deen Conakry Conakry Guine service de mdecine interne Hpital Dalal Jamm de Dakar Dakar Sngal

Introduction: Spondyloarthritis (SpA) comprises a group of chronic inflammatory rheumatic diseases characterized by predominant axial involvement. These include ankylosing spondylitis (AS), reactive arthritis (ReA), psoriatic arthritis (PsA), arthritis associated with inflammatory bowel diseases (IBD), SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis), juvenile spondyloarthritis (JSPA), and undifferentiated SpA. Their exact cause is unknown but is believed to stem from a combination of factors. The first familial forms were described by de Blécourt et al. in 1961. The objective was to evaluate the epidemiological, clinical, therapeutic and evolutionary aspects of familial forms of SpA and in particular, to prove the severity of the disease in family members compared to index cases in the rheumatology department of the Aristide Le Dantec University Hospital in Dakar. methodology: This was a prospective, cross-sectional and descriptive study with an analytical aim on patients with the familial form of spondyloarthritis defined by the existence of at least one other family member with SpA outside the propositus, collected within the Aristide Le Dantec rheumatology department in Dakar over a period of 10 years between January 2012 and december 2021. There were two phases of study, the first of which consisted of collecting index cases with miserly SpA and the second of which consisted of family screening after consent. The data analysed were epidemiological, clinical, paraclinical, therapeutic and evolving. Results: Out of 100 families of 1905 members, 667 SpA patients included, i.e. a prevalence of 35%, including 225 (33.73%) men and 412 women (61.17%), i.e. a ratio of 1.8. The mean age at diagnosis among relatives was 26.3 years (range 13 and 80 years), 47.14 years among the propositus, in whom the mean age at onset was 36.26 years and that of relatives 49.9 years in the first degree, 15 years in the second degree and 1 year in the third degree.

关键词： Familial Forms of Spondyloarthritis Propositus Senegal

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