Right upper pulmonary vein metastasis from hepatocarcinoma

Metastatic tumor involvement of the heart is uncommon but may occur with all types of primary neoplasms. We report the case of a 51-year-old male who developed a massive mass involving the upper right pulmonary vein. The tumor was removed and the final pathology report disclosed metastatic hepatocellular carcinoma. Hepatocellular carcinoma affecting the pulmonary veins is a very rare condition.

[Sacroiliac joint disorders in Abidjan: epidemiological, clinical, radiological and etiological characteristics]

BACKGROUND

The sacroiliac joint remains unknown in sub-Saharan Africa. Studies about the sacroiliac diseases are rare Aim : Describe the epidemiological, clinical, radiological and etiological characteristics of sacroiliac joint diseases in Abidjan Methods : Retrospective and descriptive study concerning 17 patients hospitalized from February 2003 to April 2010 in the department of rheumatology of university hospital center of Cocody (Abidjan) for buttock pain or others functional signs evoking sacroiliac joint which were attested by radiographic lesions. We were interested on the epidemiological, clinical and radiological characteristics and the etiologies in the sacroiliac disease.

RESULTS

The hospital prevalence of sacroiliac diseases was 0.55% corresponding in 17 of 3067 rheumatological diseases. The female sex predominated (82.35%) and the mean age of 25.58 years. Gyneco-obstetric events were the predominant risk factors (47.05%). Sacroiliac damage was manifested by inflammatory pain (64.7%) localized at the buttock or lumbar spine, radiating to the thigh (52.9%) and was accompanied by functional disability (82.2%) and fever was not present every time (64.7%). The physical findings were the tripod sign positive (58.8%), the monopodal backing positive (41.2%) and palpation painful of sacroiliac joint. The standard radiograph revealed a blurring aspect and widening of joint space associated with demineralization (68.4%), a joint space narrowing and erosion of articular banks (23.5%). The etiologies found were bacterial arthritis (82.3%) mainly pyogenic (70.58%), osteoarthritis (11.7%) and ankylosing spondylitis (5.9%).

CONCLUSION

Sacroiliac joint diseases are rare in rheumatology practice in Abidjan, concern younger subjects and are dominated by pyogenic sacroiliitis.

[Ocular manifestations in rheumatoid arthritis: 24 cases in Abidjan]

OBJECTIVE

Determine the prevalence and the main ocular manifestations in rheumatoid arthritis in Abidjan.

PATIENTS AND METHODS

Prospective and descriptive study of 24 patients with rheumatoid arthritis fulfilling the criteria of the American College of Rheumatology, views from September 2003 to August 2004 in department of rheumatology at the University Hospital of Cocody. The patients performed an eye examination including: visual acuity examination at the slit lamp, ocular fundus, color vision and visual field.

RESULTS

Ocular manifestations were observed in 9 of 24 patients representing a prevalence of 37.5%. There were 03 cases of decreased visual acuity, 03 cataract, 02 keratitis cases and 01 cases of anterior uveitis. No fundus abnormality in color vision and visual field was highlighted. These manifestations were found between 5 and 10 years (04 cases) and after 10 years (05 cases) of evolution of the disease. The term rheumatoid arthritis influenced the occurrence of ocular manifestations (P = 0.00).

CONCLUSION

Ocular manifestations in rheumatoid arthritis are rare in our practice and were mainly affected by visual acuity, annexes and anterior segment of the eye.

[Clinical, biological, therapeutic and evolving profile of patients with HIV infection hospitalized at Infectious and tropical diseases unit in Abidjan (Ivory Coast)]

The objective of this study is to describe the clinical, biological, therapeutic and evolving current profile of hospitalized patients with HIV infection in the cohort of the Infectious and Tropical Diseases Unit (ITDU) in the aim to improve their care management. This is a retrospective study, conducted on medical data of hospitalized cases of patients with HIV infection in the ITDU at the teaching hospital of Treichville (Abidjan) from 2006 to 2007. During the two years, 447 patients were included in the study. Their average age was 39 years [18 years-86 years] and sex ratio was 0.69. Of the 447 patients, 35% were unemployed and 67% were new patients who had never undergone antiretroviral therapy (ART). The duration of drug exposure was less than 6 months in 59% of treated patients. The average time to initiate ART was seven weeks. Among naive patients 41.9% were lost to follow up, 35.9% were waiting for treatment and 22.1% waiting for baseline biological test to initiate ART. At the initiation of ART, 79.6% of patients had a CD4 count less than 200/mm(3). The reasons of hospitalization defining AIDS were dominated by tuberculosis (34.2%), cerebral toxoplasmosis (17.9%) and neuromeningeal cryptococcosis (8%). The main reasons of hospitalization in classifying non-AIDS were pyelonephritis (6.5%), bacterial pneumonia (5.4%) and undetermined infectious encephalitis (4.9%). Hospital mortality was 24.4%. The leading causes of death were tuberculosis (22.9%), cerebral toxoplasmosis (20.2%), undetermined infectious encephalitis (18.3%) and cryptococcal meningitis (13.7%). The profile of PLHIV in hospital is characterized by profound immunosuppression due to late diagnosis and high mortality associated with severe opportunistic infections and late initiation of ART.

[Prevalence of HBs antigen carriage in a population of national Gendarmerie recruits in Ivory Coast in 2008]

The purpose of this study was to determine the prevalence of HBsAg carriage in Ivorian gendarmerie recruits in 2008. This prevalence was 15.6%. It was highest in recruits aged 18 years (24%), in those who were married (33.3%) and in those who had had more than three sexual partners in the 6 months before the survey (19.4%). It was also higher in recruits who had never used condoms (20.6%) and in those who had undergone blood transfusions (27%). A policy of vaccination against HBV in the army, in teenagers and adults must be implemented to reduce HBsAg carriage in the army and in the Ivorian population.

Antisickling properties of divanilloylquinic acids isolated from Fagara zanthoxyloides Lam. (Rutaceae)

Fagara zanthoxyloides Lam. (syn. Zanthoxylum zanthoxyloides) (Rutaceae) is the most cited Fagara species for the treatment and the prevention of sickle cell disease crisis. Sickle cell anemia (SCA) is a public health problem in many countries particularly in Africa. The present study was designed to evaluate the antisickling properties of three isomeric divanilloylquinic acids (3,4-O-divanilloylquinic acid or burkinabin A; 3,5-O-divanilloylquinic acid or burkinabin B and 4,5-O-divanilloylquinic acid or burkinabin C) identified previously by LC/MS/NMR analysis in the root bark of F. zanthoxyloides [Ouattara et al., 2004. LC/MS/NMR analysis of isomeric divanilloylquinic acids from the root bark of Fagara zanthoxyloides Lam. Phytochemistry 65, 1145-1151]. The three isomers showed interesting antisickling properties which increased from burkinabins A to C.

Familial aggregation in giant cell arteritis and polymyalgia rheumatica: a comprehensive literature review including 4 new families

OBJECTIVE

To review personal and published observations of giant cell (temporal) arteritis (GCA) or polymyal-gia rheumatica (PMR) with familial or conjugal aggregation and emphasise on epidemiological, clinical and genetic features of such cases.

METHODS

We pooled data obtained from all cases of GCA or PMR with familial aggregation recruited in the department since 1976 and those from reports of familial or conjugal GCA or PMR published in the French-English literature since 1970.

RESULTS

During the study period, we diagnosed 460 patients (128 with isolated PMR, 227 with isolated GCA, 105 with PMR/CGA). No conjugal couples were observed in the whole series. No familial cases were identified among PMR patients, whereas the prevalence of familial GCA was 1 in 83 (1 in 250 to 500 expected by chance), as we identified 4 patients (brother-brother, sister with history of affected sister, and daughter with priory affected mother). An additional pair of sisters with TA, recruited several months after diagnosis, is also presented. Pooling data from 85 patients (74 with GCA) including our patients, representing 32 families and 8 conjugal pairs, enabled us to draw the following observations: 1) partial or full agreement in the clinical picture (GCA, PMR, or GCA/PMR) was observed in 96% of the siblings pairs, suggesting a common pathogenic mechanism; 2) five kindred were described in whom at least three members were affected; 3) the lag between manifested diseases in familial or conjugal pairs averaged 5.7 years, with synchronous or close disease occurrence in only 26% of the pairs; 4) 18 of 32 assessed patients (56%) carried the DR4 antigen.

CONCLUSION

Our survey on familial aggregation of GCA and PMR accumulated data pointing to a genetic predisposition. However, environmental contagious factors could have trigger synchronous disease onset in up to one-fourth of the cases.

[Lumbar nerve root pain with fever in tropical area: posterior spinal tuberculosis]

The purpose of this report is to describe the case of tuberculosis osteitis of the posterior vertebral arch in a 35-year-old man with recent history of pulmonary tuberculosis. Clinical findings were pain due to bilateral inflammation of the lumbar nerve roots, fistulised cold abcess and motor deficit in both lower extremities. The tomodensitometry demonstrated a lytic bone lesion involving the spinous process of the second lumbar vertebra in association with spondylitis and a large paravertebral abscess with calcification typical of tuberculosis. Cure was achieved by a single 12-month course of appropriate treatment.

[Cerebral thrombophlebitis: parotidectomy complication in a child]

INTRODUCTION

Onset of cerebral thrombophlebitis following parotidectomy in a child is reported.

OBSERVATION

A seven-year-old boy presenting apparently benign tumefaction in the right parotid gland area had undergone a conservative right total parotidectomy. The histological examination of the operative specimen suggested a diffuse neurofibroma as part of a clinical picture of Recklinghausen's neurofibromatosis. The immediate postoperative follow-up was marked by a pyramidal syndrome in the left hemibody, with the CT scan showing thrombophlebitis. After treatment combining an anticoagulant, a vasodilator and an antibiotic, the patient progressed toward partial recovery of left hemibody motor activity.

COMMENTS

This cerebral vascular accident is related to the angiodysplasia encountered in Recklinghausen's disease. Anticoagulants initialized rapidly are the only demonstrated therapy to improve the prognosis in this type of complication.

[Multinodular goitre with widespread vasculitis of thyroid arteries revealing temporal giant cell arteritis]

We describe a 62-year-old woman with slowly growing usual nodular goitre in whom diffuse giant cell arteritis (GCA) of the thyroid arteries was found upon thyroidectomy, revealing otherwise unsuspected biopsy-proven temporal arteritis. To our knowledge, this association had been previously reported in only three instances. In each case, GCA of the thyroid arteries appeared clinically silent, did not produce significant glandular dysfunction, and was uncovered thanks to a planned thyroidectomy for nodular goitre. These observations highlight that thyroid artery involvement by GCA, even widespread, as in our patient, may be overlooked clinically and may produce little or no thyroid dysfunction.

[Prevalence of HBs antigen in blood donors in the Bouaké regional centre of blood transfusion in 2001]

A prospective cross-sectional study was conducted in the regional center of blood transfusion in Bouaké from December 1, 2001 to February 28, 2002. One thousand two hundred thirty one new blood donors were tested. HBs Antigen detection was made according to ELISA technique (Hepanostika HBs Ag Uni-Form II). HBs Antigen prevalence in blood donors in Bouaké was 12.5%. One hundred fifty four blood donors were tested positive and were divided into 131 males (85%) and 23 females (15%). Their average age was 27, 5 years old (18-65 years). HBs Antigen carriage rate was lower in females and students. They were mainly pupils (62%) and had risk factors of hepatitis B infection (intramuscular injection, multiple sexual partners, unsafe sex). HBs Antigen carriage rate in blood donors is high in Bouaké and justifies the systematic screening of this Antigen in any blood donor to reduce the transfusion risk. On the other hand, it is necessary to modify the blood collection strategy in order to make the most of the donation and to decrease the residual risk.

Head-and-neck swelling: an under-recognized feature of giant cell arteritis. A report of 37 patients

OBJECTIVE

To describe the frequency of occurrence and characteristics of head-and-neck swelling (HNS) in temporal (giant cell) arteritis (TA).

METHODS

We analyzed the charts of patients with HNS retrieved from a single department series of 260 consecutive patients with TA and reviewed the published French-English literature. Patients with a swelling limited to the temporal fossa were excluded.

RESULTS

A history of HNS was elicited in 17 patients in our series (i.e. 6.5%) and in 20 previously published patients. The swelling was an inaugural feature in most cases and was often transient. Ear-nose-and-throat (ENT )symptoms were observed in 80% of the cases, including jaw claudication or pain upon opening mouth in 22, causing trismus in 10. Two patients had permanent visual impairment and 1 had sudden hearing loss. The temporal artery biopsy yielded giant cell arteritis (GCA) in all the patients but 2. The HNS was often painful and mainly involved mainly the orbital region and face, particularly the lower part of the cheeks and maxillae, less often the neck and, rarely, the forehead and tongue. Concurrent localized limb swellings were also observed in 3 patients. The HNS disappeared in all the patients, either spontaneously or under steroid treatment, and recurred only in 6 patients.

CONCLUSION

HNS is not exceptional in untreated TA and is strongly associated with ENT symptoms and a positive TAB, but not with visual loss or stroke. Such characteristics imply in these cases a prominent, widespread involvement of the external carotid artery system by giant cell arteritis.

Radiosensitization of Escherichia coli and Salmonella Typhi in ground beef

The radiosensitization of two pathogenic bacteria, Escherichia coli and Salmonella Typhi, was evaluated in the presence of thyme and its principal essential oil constituents (carvacrol and thymol) in ground beef. Ground beef was inoculated with E. coli or Salmonella Typhi (10(5) CFU/g), and each compound was added separately at various concentrations (0 to 3.5%, wt/wt). The antimicrobial potential of carvacrol, thymol, and thyme was evaluated in unirradiated meat by determining the MIC in percentage (wt/wt) after 24 h of storage at 4 +/- 1 degree C. Results showed a MIC of 0.88 +/- 0.12%, 1.14 +/- 0.05%, and 2.33 +/- 0.32% for E. coli in the presence of carvacrol, thymol, and thyme, respectively. MICs of 1.15 +/- 0.02%, 1.60 +/- 0.01%, and 2.75 +/- 0.17% were observed for Salmonella Typhi in the presence of the same compounds, respectively. The best antimicrobial compound (i.e., carvacrol) was selected and added to the sterilized ground beef along with ascorbic acid (0.5%, wt/wt) and tetrasodium pyrophosphate (0.1%, wt/wt). Meat samples (10 g) were packed in air and then irradiated in a 60Co irradiator at doses of 0 to 0.7 kGy for the determination of E. coli radiation D10 and 0 to 2.25 kGy for the determination of Salmonella Typhi radiation D10. Addition of carvacrol increased the relative sensitivity of both bacteria 2.2 times. The radiation D10 was reduced from 0.126 +/- 0.0039 to 0.057 +/- 0.0015 kGy for E. coli and from 0.519 +/- 0.0308 to 0.235 +/- 0.0158 kGy for Salmonella Typhi. The addition of tetrasodium pyrophosphate did not affect significantly (P > 0.05) the radiosensitization of either bacterium. However, the presence of ascorbic acid in the media reduced significantly (P < or = 0.05) the radiosensitivity of both bacteria. An additive effect of carvacrol addition and packaging under modified atmosphere conditions (60% O2-30% CO2-10% N2) was also observed on bacterial radiosensitization at 4 degrees C. Compared with the control packed under air, modified atmosphere packaging conditions in the presence of carvacrol and tetrasodium pyrophosphate improved the relative sensitivity of E. coli by 2.7 times and Salmonella Typhi by 9.9 times.

[Retrospective analysis of 30 cases of mandibular ameloblastoma operated in the Ivory coast from 1992 to 2000]

OBJECTIVE

We analyzed a retrospective series of 30 cases of ameloblastoma operated in the Ivory coast from 1992 to 2000.

PATIENTS AND METHODS

The following techniques were used--temporary reconstructions via the endobuccal approach using a Peri prothesis in 27 cases and a resin coated Peri prosthesis in one;-- definitive reconstructions using iliac bone grafts in 3 cases and rib grafts in 14. These reconstructions were performed in a second operation via a cutaneous approach to replace the Peri prosthesis. Thirteen patients were lost to follow-up for this second phase. Mean follow-up ranged from 6 months to 13 months (mean 9.9 months).

RESULTS

Satisfactory outcome was acchevied when mouth opening was greater than 10 mm and patients with an acceptable cosmetic result no longer complained of mastication or phonation problems. There were four postoperative infections after bone graft reconstruction (two of them were immediate reconstruction). The resin coated Peri prosthesis led to a skin ulceration.

DISCUSSION

This study demonstrated the interest of mandibular reconstruction in undermedicalized countries where indications are dominated by reconstruction after resection for ameloblastoma. The large number of patients lost to follow-up before the second stage bone grafts points out the need for immediate reconstruction using autologous bone. Further study in a larger series would be needed to determine the cause of failure after immediate reconstruction.

[Chronic low back pain at a public transportation company in Senegal]

The aims of this study were to appreciate the prevalence of chronic low back pains in a public transport's company, to state characteristics and to identify categories of workers involved and medico-legal consequences. It is a cross sectional study. which used medical records of the occupational clinic. All workers who complained of low back pain in the past three years following the study were selected. Characteristics of workers, types of injuries, occupational and medico-legal consequences were looked out. Sixty nine cases were collected, they were exclusively males. 54 % of them were bus drivers, and 29% conductors. X rays abnormalities were found in 31.64%. Exposure to vibration due to damaged roads and decayed vehicles seems to be main etiologic factors. From a occupational and medico-legal standpoint, two patients were reported for workers compensation, three patients were reclassified in another job. Undamaged roads, ergonomic design of bus' seats, and medical screening during placement and routine medical examination are key issues in preventing low back pains.

Combined effect of antimicrobial coating and gamma irradiation on shelf life extension of pre-cooked shrimp (Penaeus spp.)

The present study was conducted to evaluate the combined effect of low-dose gamma irradiation and antimicrobial coating on the shelf life of pre-cooked shrimp (Penaeus spp.). Antimicrobial coatings were obtained by incorporating various concentrations of thyme oil and trans-cinnamaldehyde in coating formulations prepared from soy or whey protein isolates. Coated shrimps were stored at 4 +/- 1 degrees C under aerobic conditions and were periodically evaluated for aerobic plate counts (APCs) and Pseudomonas putida. Sensory evaluations were performed for appearance, odor, and taste using a hedonic test. Results showed that gamma irradiation and coating treatments had synergistic effects (p < or = 0.05) in reducing the APCs and P. putida with at least a 12-day extension of shelf life. Without irradiation, the inhibitory effects of the coating solutions were closely related to the concentration of thyme oil and trans-cinnamaldehyde. No detrimental effects of gamma irradiation on organoleptic parameters (appearance, odor, and taste) were observed. However, incorporation of thyme oil and trans-cinnamaldehyde reduced the acceptability scores for taste and odor.

Mechanical and barrier properties of cross-linked soy and whey protein based films

Sterilized biofilms based on soy protein isolate (SPI, S system) and a 1:1 mixture of SPI and whey protein isolate (WPI, SW system) were achieved through the formation of cross-links by means of gamma-irradiation combined with thermal treatments. The effect of the incorporation of carboxymethylcellulose (CMC) and poly(vinyl alcohol) was also examined. gamma-Irradiation combined with thermal treatment improved significantly the mechanical properties, namely, puncture strength and puncture deformation, for all types of films. Irradiated formulations that contain CMC behave more similarly as elastomers. CMC showed also significant improvements of the barrier properties, namely, water vapor permeability, for irradiated films of the S system and for non-irradiated films of the SW system.

Combined effect of ascorbic acid and gamma irradiation on microbial and sensorial characteristics of beef patties during refrigerated storage

The present study was undertaken to evaluate the effect of ascorbic acid concentrations (0.03 to 0.5%) and irradiation doses (0.5 to 4 kGy) on microbial growth, color coordinates (L, a, and b), and sensory characteristics (taste and odor) of beef patties during storage at 4 +/- 1 degrees C. Ascorbic acid was also compared to citric acid at a similar pH value in order to differentiate the effects of ascorbic acid from those of pH reduction. Results showed significant reduction (p< or = 0.05) of aerobic plate counts (APCs) and total coliforms, and a significant interaction (p< or = 0.05) between ascorbic acid and irradiation dose was observed. The irradiation treatment had detrimental effects on redness, yellowness, and hue angle values of meat. However, incorporation of ascorbic acid into the meat before irradiation resulted in significant (p< or = 0.05) stabilization of color parameters. The color improvement obtained with ascorbic acid was not related to the pH reduction. Also, no significant detrimental effect on taste or odor was found in irradiated samples containing ascorbic acid.

Epidemiology and features of knee osteoarthritis in the Ivory Coast

We retrospectively studied 369 cases of knee osteoarthritis in 240 patients seen at the Cocody Teaching Hospital in Abidjan, Ivory Coast, from November 1984 through March 1989. There were 126 cases (34.14%) of patellofemoral osteoarthritis, 104 cases (28.18%) of femorotibial osteoarthritis and 139 cases (37.66%) of global knee osteoarthritis (defined as patellofemoral and femorotibial osteoarthritis in the same joint). There was a marked female bias (80.42% of patients). Onset was earlier in patellofemoral osteoarthritis (51.25 years) than in femorotibial osteoarthritis (57.85 years). Half the patients (51.25%) were housewives. The Akan and Mandé ethnic groups contributed 61.54% and 33.03% of patients, respectively. Obesity was present in 19.04% of cases of patellofemoral osteoarthritis and in 10.57% of cases of femorotibial osteoarthritis. Of the patients with femorotibial osteoarthritis, 20.20% had a history of arthritis of the knee and of those with global knee osteoarthritis, 12.23% reported a prior injury to the knee. Varus deformity was found in 24.03% and valgus deformity in 19.23% of the patients with femorotibial osteoarthritis.

Antibacterial activity of selected fatty acids and essential oils against six meat spoilage organisms

The antibacterial activity of selected fatty acids and essential oils was examined against two gram-negative (Pseudomonas fluorescens and Serratia liquefaciens) and four gram-positive (Brochothrix thermosphacta, Carnobacterium piscicola, Lactobacillus curvatus, and Lactobacillus sake) bacteria involved in meat spoilage. Various amounts of each preservative were added to brain heart infusion or MRS (deMan, Rogosa and Sharpe) agars, and the minimum inhibitory concentration was determined for each organism. Essential oils were analysed by gas-liquid chromatography to determine the concentration of selected components commonly found in spices. B. thermosphacta, P. fluorescens and S. liquefaciens were not affected by fatty acids, and generally overcame the inhibitory effect of essential oils after 24 h of exposure. Among the fatty acids, lauric and palmitoleic acids exhibited the greatest inhibitory effect with minimum inhibitory concentrations of 250 to 500 micrograms/ml, while myristic, palmitic, stearic and oleic acids were completely ineffective. For essential oils, clove, cinnamon, pimento, and rosemary were found to be the most active. The 1/100 dilution of those oils inhibited at least five of the six tested organisms. A relationship was found between the inhibitory effect of essential oils and the presence of eugenol and cinnamaldehyde.

[Torsades de pointes in a patient under long-term maprotiline therapy. Apropos of a case]

The authors report the case of a patient who presented with wave burst arrhythmia related to long-term treatment with maprotiline. This case is interesting, as few cases of this type of complication have been reported in patients receiving long-term tetracyclic antidepressants, and the development of such a complication indicates the need for regular electrocardiographie surveillance of patients treated with heterocyclic antidepressants. Lastly, prolonged intensive care monitoring is required in the case of maprotiline-induced wave burst arrhythmia.

[Acute bacterial pneumonia in retroviral infections. Epidemiologic, clinical, radiologic, bacterial and developmental aspects]

From a prospective study starting January 8 to 1990 October 20, the authors discuss 70 cases of acute pneumopathy, supposed to be bacteriologic in patients infected by HIV. The observed pneumopathies are more frequent in young adults, with a pic between 20 to 40 (67.15 p.c). The positivity rate of hemocultures was estimated at 17.14 p.c. with a clear predominance of non typhic Salmonellae. The evolution observed, generally favourable at 72.85 p.c was fatal in 17.15 p.c.