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Attachment theory has found renewed interest among psychotherapy researchers in last decades. There is growing evidence for the role of adult attachment as a predictor of treatment process and outcome. Attachment styles are hypothesized to remain stable over time, however, research also shows that internal models of self and others can be revised through interpersonal experiences that diverge significantly from the primary attachment figure. More recently a new concept has appeared and allows a better understanding of the nature of the bond between the patient and his therapist from attachment theory perspective, it is the concept of patient's attachment of the to the therapist. At first this article reviews the empirical evidence on the link between adult attachment styles, patient's attachment to therapist, therapeutic alliance, and outcome. Secondly, we will present results of an empirical study conducted in Algeria which aimed to examine the links between the patient's attachment to the therapist, the patient's adult attachment styles and the therapeutic alliance, to finally end with a discussion on the interest of the variable of the patient's attachment to the therapist for psychotherapy research and clinical intervention. [ABSTRACT FROM AUTHOR]

Summary Introduction Overall, peritoneal dialysis (PD) is increasingly indicated for refractory heart failure. The aim of this study was to analyze the characteristics and survival of PD patients with and without cardiorenal syndrome (CRS) in France. Methods This was a retrospective study that included all patients enrolled in the French Language Peritoneal Dialysis Registry (RDPLF) between 01/01/2010 and 01/12/2021. The cohort was divided into two groups to compare patients with and without CRS. Survival was analyzed by the Kaplan-Meier method, and the log-rank test was used to compare the two groups. Factors associated with mortality in both groups were identified with Cox regression analysis. Results 11,730 PD patients were included. Their mean age was 66.78±16.72 years. Of these patients, 766 (6.53%) were managed in PD for CRS and 10,964 for another initial kidney disease. Patients with CRS were older and had more comorbidities. Survival was significantly better in the group without CRS. The median survival times were 17.7±1.2 months and 49.6±0.7 months in patients with and without CRS, respectively. Multivariate Cox regression analysis revealed that age, male sex, diabetes, cardiovascular pathology, and lack of autonomy were factors associated with increased mortality in the group without CRS. In patients with CRS, only the variables age and history of liver disease were significantly associated with an increased risk of death. The number of peritonitis episodes with which a patient presented was significantly associated with a lower risk of death in both groups. Conclusion This nationwide study of a large number of patients treated with PD revealed the large differences in characteristics and survival between those with and without CRS. In particular, the two factors most related to mortality in the group with CRS were age and liver disease.

Cholesterol crystal embolisms disease (CED) is a systemic disease characterized by tissue ischemia and microinflammation related to occlusion of arterioles by microemboli from ulcerated atheromatous plaques. The kidney is one of the most affected organs, often requiring dialysis. Our study examines the outcomes of a cohort of patients with CED treated with peritoneal dialysis (PD). As anticoagulants can favor emboli, peritoneal dialysis may theoretically have an advantage. From the database of the French Language Peritoneal Dialysis Registry (RDPLF), between January 1, 1995, and December 31, 2021, we selected patients treated with PD for >90 days and with an age >18 years. On the basis of the variables of patient autonomy, diabetes, BMI, modified Charlson index, age, sex, pre-PD treatment, causes of death, causes of transfer to hemodialysis, and peritonitis, three types of survival were estimated (patient, technical, and composite). After adjustment by propensity scores and taking into account competitive risks, 2 groups of patients were constituted on the basis of baseline nephropathy: emboli group vs. control group. Patient survival and strict technical survival are not associated with the type of nephropathy (CED versus others). Composite technical survival (uncensored for deaths and transfers to hemodialysis) was only associated with cholesterol emboli nephropathy in the multivariate analysis adjusted for diabetes, autonomy, and age of the patient at the start of the dialysis treatment (p=0.011; 95% CI [0.736 [0.581-0.931]]). Our study from the RDPLF database shows no difference in technical and patient survival in a cohort of patients with CED vs. a control group. It also confirms that PD may represent an adequate choice in this pathology.

Abstract : Introduction: Peritoneal dialysis (PD) is as effective as hemodialysis and often provides a better quality of life for patients. Despite this, the replacement therapy remains little established in our country with a prevalence of less than 1% of patients with end-stage renal disease. The objective of this work is to report the development and complications of PD in our center. Patients and methods: This is a retrospective study including all patients on PD between October 2008 and March 2019. We noted their demographic and clinical data at their initiation in peritoneal dialysis and we followed their evolution to discuss infectious and mechanical complications as well as the causes of PD exit. Results: During the study period, 456 patients were admitted for end-stage renal disease. Among these patients, only 28 (6.1%) were put on PD including two diabetics. Their average age was 37.7 years with a sex ratio of 0.8. The average body surface area was 1.59 m² with an average residual renal function of 6.05 ml / min. PD was chosen as the first intention in 20 patients while 8 patients were on hemodialysis. The evolution was marked by a median survival of the technique of 18.5 months characterized by 8 episodes of peritonitis in 4 patients corresponding to a rate of 1 episode over 56 months. Regarding mechanical complications, we noted 9 omentum aspirations, 1 leak in one case and 1 umbilical hernia requiring surgical recovery in a patient. Out of 28 patients, 17 discharges were identified; 10 patients (67%) were transferred to hemodialysis, 4 died and only 3 patients (18%) were transplanted. The final transfer to hemodialysis was related to mechanical complications in 5 cases, loss of ultrafiltration in one case, repeated hydro-sodium overload in one case, peritonitis in one case and social reasons in two cases. Conclusion: PD is an effective technique which preserves residual renal function and quality of life but its prevalence remains low in the order of 6% of patients treated for end-stage renal disease. The complications are dominated in our context by the mechanical complications main cause of final transfer in hemodialysis.

INTRODUCTION: Intrauterine pathologies were traditionally evaluated by blind dilatation and curettage along with hysterosalpingography. Hysteroscopy is a veritable tool for evaluation of uterine cavity pathologies with an increasing availability in Nigeria. The study aims to report the diagnostic yield and therapeutic outcome of hysteroscopy in women with infertility from a Nigerian metropolis. METHODS: a retrospective cross-sectional study of consecutive cases of infertile women referred for hysteroscopy to an ambulatory care Endoscopy facility in Port Harcourt, Nigeria. The variables collated included age, parity, past gynaecological history, indication, hysteroscopy findings and interventions. Statistical analysis was performed using SPSS version 25. RESULTS: included in study were 75 patients undergoing a total of 124 hysteroscopic procedures. The age range of patients was 25 to 56 years (mean 40.7 ± 5.9 years). A positive diagnostic yield of 93.3% with non-visualization of intracavitary uterine pathology in 5 patients was recorded. The most common pathologies were submucous myoma-25(31.3%), endometrial polyps- 18(22.5%) and intrauterine adhesions-18(22.5%). There was no statistical difference between the mean age of patients with or without polyp, myoma and intrauterine adhesions (P = 0.185, P = 0.510 and P = 0.619 respectively) but a non-linear relationship between age and polyp detection (Eta2 = 0.024). Operative hysteroscopies were all performed on out- patient basis but staged in 30(40.0%) patients. CONCLUSION: benign uterine growths and intrauterine adhesions are frequent causes of uterine factor infertility. A high successful completion rate of hysteroscopic interventions was achieved.

INTRODUCTION: Road traffic injuries represent accounts for significant cause of morbidity and mortality around the globe, particularly in developing countries like Ethiopia. Poor pre-hospital care system and delays in hospitals before getting aids added to the woes of mortality. However, there are no study that determine the types of injury, management and outcome of road traffic accidents and associated factors in this study area. METHODS: a hospital based retrospective cross sectional study was conducted among patients attending to Adama Hospital Medical College with accidental injuries from January to December 2015. Data were retrieved from 556 patients registry selected by systematic random sampling from 11,120 injuries visiting the hospital. Data were coded, cleaned and entered to SPSS version 20 for analysis. Factors associated with the management outcome of injury related to road traffic accident were analyzed and statistical significance was declared with p = 0.05 with CI of 95%. RESULTS: out of 556 trauma victims, 304 (54.7%) were due to road traffic accidents followed by personal violence (24%) and falling accident (10.3%). The majorities (74.8%) of patients were male and urban residents (55%). Soft tissue injury was the most frequent type of injury (51%) followed by extremity fracture and dislocation (26%). Delay to come to hospital (over 24 hours), severity of injuries and management types were factors influencing management outcome of injuries related to traffic accidents. About 90.1%, 4.6% and 5.3% of the patients were discharged without any prominent disability, permanent disability and died respectively. CONCLUSION: road traffic accidents are preventable causes of morbidity and mortality. Practices of strict road safety measures and appropriate use of roadways by pedestrians should be in place, while establishing and strengthening early access to hospital and pre-hospital care to save life of injuries.

INTRODUCTION: Acute hemiplegia of childhood is a postnatally acquired nonspecific clinical response of the brain to various aetiological insults in a child who was neurologically normal at birth. This study aims at evaluating the aetiology and outcome of acute hemiplegia in children admitted into the University of Calabar Teaching Hospital (UCTH), Nigeria. METHODS: a 5-year retrospective review of all children admitted to the Neurology Unit of the Department of Paediatrics of UCTH with a diagnosis of acute hemiplegia. The demographic characteristics of the children and the clinical features were noted. Investigations including neuroimaging of the brain and haemoglobin genotype were documented. The outcomes of the patients were recorded as either dead, recovered with deficit or loss to follow up. Data obtained was analysed using the SPSS version 24. Simple tables were used to display the results in number and percentages. RESULTS: twenty-five children with diagnosis of hemiplegia were admitted. Associated clinical features were prolonged seizures (68%), speech defect (32%), cranial nerve deficit (36%) and loss of consciousness (12%). Viral encephalitis was the common aetiology in 11(44%) of the patients, followed by meningitis and sickle cell anaemia in 6(24%) patients each. Four(16%) of the patients recovered completely within the follow up period of three month, 19(76%) had varying degrees of weakness; 2(8%) died. Twelve (48%) were lost to follow-up. CONCLUSION: central nervous system infections and sickle cell disease as dominant aetiological factors of acute hemiplegia in Nigerian children. This calls for effective infection control and genetic counselling.

INTRODUCTION: as the life expectancy and weight of patients are increasing, more old and obese patients are undergoing total knee arthroplasty (TKA). TKA may lead to several perioperative complications. These include anesthesia-related risks, exacerbation of comorbid medical issues and complications of surgical procedure. We have no studies reporting medical complications following TKA among our population. This study aimed to evaluate perioperative complications of TKA and to identify the related risk factors. METHODS: it was a monocentric retrospective including 410 observations in the local TKA registry. Data of patients operated for primary unilateral TKA during the period from January 2014 to December 2017 were reviewed. All patients had standardized protocols of anesthesia and post operative care for three days following surgery. Multivariate logistic regression was used to identify the predicting factors for complications. RESULTS: incidence of perioperative complications was 37.1%. The most frequent were per operative hypotension (14.1%) and postoperative desaturation (21.7%, including pulmonary embolism in 2.4%). Multivariate logistic regression analysis identified: age 65 years (OR=1.9; p=0.006), respiratory diseases (OR=1.8; p=0.042) and general anesthesia (OR=2.8; p=0.009) as significant risk factors for any complications. Loss of autonomy (OR=4.8; p =0.001) and general anesthesia (OR=2.6; p=0.03) were significant risk factors for hypotension. Age 65 years (OR=2.6;p=0.001), female gender (OR=4.3;p=0.006) and respiratory diseases(OR=1.9;p=0.02) were associated with postoperative desaturation. CONCLUSION: this study highlighted hemodynamic and respiratory complications as the most common early complications in TKA. Age 65years, general anesthesia and respiratory diseases were significant risk factors.

INTRODUCTION: Focus has been put on strengthening surveillance systems in high tuberculosis (TB) burden countries, like Zambia, however inadequate information on factors associated with unfavourable TB treatment outcomes is generated from the system. We determined the proportion of tuberculosis treatment outcomes and their associated factors. METHODS: we defined unfavourable outcome as death, lost-to-follow-up, treatment-failure, or not-evaluated and favourable outcome as a patient cured or completed-treatment. We purposively selected a 1st level hospital, an urban-clinic and a peri-urban clinic. We abstracted data from TB treatment registers at these three health facilities, for all TB cases on treatment from 1st January to 31st December, 2015. We calculated proportions of treatment outcomes and analysed associations between unfavourable outcome and factors such as age, HIV status, health facility, and patient type, using univariate logistics regression. We used multivariable stepwise logistic regression to control for confounding and reported the adjusted odds ratios (AOR) and 95% confidence intervals (CI). RESULTS: we included a total of 1,724 registered TB patients, from one urban clinic 694 (40%), a 1st Level Hospital 654 (38%), and one peri-urban-clinic 276 (22%). Of the total patients, 43% had unfavourable outcomes. Of the total unfavourable outcomes, were recorded as treatment-failure (0.3%), lost-to-follow-up (5%), death (9%) and not evaluated (29%). The odds of unfavourable outcome were higher among patients = 59 years (AOR=2.9, 95%CI: 1.44-5.79), relapses (AOR=1.65, 95%CI: 1.15-2.38), patients who sought treatment at the urban clinic (AOR=1.76, 95%CI:1.27-2.42) and TB/HIV co-infected patients (AOR=1.56, 95%CI:1.11-2.19). CONCLUSION: unfavourable TB treatment outcomes were high in the selected facilities. We recommend special attention to TB patients who are = 59 years old, TB relapses and TB / HIV co-infected. The national TB programme should strengthen close monitoring of health facilities in increasing efforts aimed at evaluating all the outcomes. Studies are required to identify and test interventions aimed at improving treatment outcomes.

Acute disseminated encephalomyelitis (ADEM) is a rare cause of encephalitis in adults, characterized by inflammatory lesions in the white substance of the central nervous system (CNS). Initial clinical presentation may mimic severe CNS infection with fever, encephalopathy, seizures, or multiple sclerosis. The purpose of our study was to report the epidemiological, clinical, radiological, therapeutic and evolutionary features of ADEM and to determine the role of MRI sequences in the diagnosis, monitoring and prognosis of this disease. We conducted a retrospective study of the clinical and radiological records of 22 patients with ADEM followed up in the Department of Neurology over a period of 11 years (January 2006-January 2017). These patients underwent medical imaging at the Mohammed V Military Teaching Hospital, de Rabat. The average age of patients was 35 years (12-57 years). A recent infection was found in 31% of patients, while 4% of patients had recently undergone vaccination. Symptoms were dominated by focal neurologic deficit (72%). CT scan was normal in 78%. MRI showed hyperintense subtentorial and supratentorial white substance on FLAIR sequences in 70% of patients, without diffusion restriction in all cases, with enhancement of the lesions in 27% of cases and involvement of the cervical spinal cord in 68% of cases. Clinical and radiological outcome was favorable in all cases. [ABSTRACT FROM AUTHOR]

INTRODUCTION: There is a decline in child mortality rate globally, courtesy of the erstwhile Millennium Development Goals. However, under-five mortality is still high in the African sub-regions. The need to review the morbidity and mortality pattern among children admitted into private health settings, where 60% of the medical conditions of the masses are being attended to in the sub-regions, cannot be overemphasized. This study aimed at documenting the morbidity pattern and outcomes of admissions among children admitted into the Living Word Mission Hospital (LWMH), Aba, Nigeria. METHODS: this was a retrospective descriptive study over a 3 year period. The study population comprised of all children aged 1 month to 15 years that were admitted into the paediatric wards of the Living Word Mission Hospital, Aba, Nigeria. The age, gender, diagnoses and disease outcome of these patients, were all retrieved from the paediatric ward registers and hospital medical records. The data were analyzed using SPSS, version 20.0. RESULTS: there were 2278 paediatric medical cases admitted over the study period. Males were 1364 and females were 914, giving a male: female ratio of 1.5:1. More than 90% of these patients were aged less than 5 years. Severe malaria (31.1%), septicaemia (16.6%), bronchopneumonia (15.4%), uncomplicated malaria (11.9%), acute watery diarrhea (10.5%) and meningitis (3.7%) were the leading causes of admission. Mortality rate was 5.7%, with 87.5% of these deaths occurring in under-fives. Septicaemia (34.6%) and Severe malaria (23.2%) were the leading causes of death. CONCLUSION: there is a high rate of paediatric admissions at Living Word Hospital, Aba. The under-five population remains a vulnerable group to both childhood morbidity and mortality. Septicaemia, malaria, bronchopnuemonia and acute watery diarrhoea were the leading causes of morbidity and mortality. Childhood mortality at LWMH is lower than observed in most government hospitals in Nigeria.

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Trauma related to road traffic accident (RTA) are the leading cause of death among 15 to 29 years old; 20 to 50 million others are injured, sometimes even handicapped. The objective of this work was to study the therapeutic profile and the outcome of the traumatisms related to RTA at Matanda hospital. Methodology: This was a prospective descriptive cross-sectional study from the 1st January to 30th June 2016, involving 230 RTA patients received in the Surgery Department of Matanda Hospital in Butembo City. Results: Cranial trauma was more represented with 53%; followed by trauma of the lower limbs and facials respectively in 21.4 and 9.5%. 67.4% of patients had a hemoglobin test, 45.6% had a standard Xray, 16% had blood grouping, and 0.8% had abdominal ultrasound. The therapeutic attitude taken in the majority of cases was medical and surgical combined. Patients who spent less than 6 days in the hospital were more represented with 47.8% of cases. Infectious complications were observed in 9% of cases, followed by shock hemorrhagic by anemia in 7% of cases, vicious cal in 3.4% of cases, and joint stiffness in 0.9% of cases. 6 deaths or 2.6% of cases were found, all due to cranioencephalic trauma. Conclusion: The management of road traffic accidents is a public health problem in Butembo city following the lack of equipment in qualified personnel, adequate equipment for the diagnosis, resuscitation and management of neurosurgical trauma. [ABSTRACT FROM AUTHOR]

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé L’intervillite histiocytaire chronique est une pathologie placentaire rare ayant un pronostic obstétrical sévère et un taux de récurrence important. Les complications obstétricales sont le retard de croissance in utero, des fausses couches précoces récidivantes, des morts fœtales in utero et une prématurité par insuffisance placentaire. La caractérisation de l’extension et de l’intensité de l’intervillite chronique n’est actuellement pas standardisée. La récidive serait fréquente, mais il n’y pas de marqueur prédictif fiable de récidive disponible. Aucun traitement n’est actuellement validé, mais le recours à un traitement immunomodulateur peut être justifié par la physiopathologie évoquant une possible réaction de type allo-immune ou auto-immune, en particulier dans les formes avec des complications sévères et des lésions histologiques massives. Chronic intervillositis is a rare condition, which is associated with severe obstetrical outcome and high recurrence rate. Obstetrical adverse events are intrauterine growth restriction, recurrent early miscarriages, intrauterine deaths and prematurity by placental insufficiency. The determination of the extension and the intensity of the chronic intervillositis are not currently standardized. High rates of recurrence have been described, but actually there is no reliable predictive biomarker. No treatment is currently validated, but the use of immunomodulatory drugs could be justified by the possible autoimmune or allo-immune origin. The treatment should be particularly discussed in patients with recurrent and severe obstetrical adverse events and in the presence of severe and massive histological lesions. [ABSTRACT FROM AUTHOR]

Résumé Plusieurs modalités de traitement de l’insuffisance rénale chronique terminale sont aujourd’hui disponibles. La transplantation rénale à partir de donneurs vivants est la plus avantageuse pour les receveurs en termes de survie et de qualité de vie, en plus d’être la plus économiquement viable pour la société. Cette option soulève la question du devenir des donneurs vivants, sujets sains qui se soumettent à une procédure chirurgicale lourde. Plusieurs travaux ont été menés comparant le devenir de donneurs de rein à celui de sujets contrôles. Les critères d’évaluation étaient les potentielles complications de la néphrectomie à court comme à long termes : survenue d’une insuffisance rénale, d’une hypertension artérielle, d’une protéinurie, possibilité de grossesse ultérieure, qualité de vie, survie du patient. Les résultats des premières études ne mettaient pas en évidence de risque lié au don par rapport à celui existant dans la population générale. Mais depuis 2013, des publications ont rapporté l’existence d’un risque plus élevé d’insuffisance rénale chronique, voire de mortalité, chez les donneurs de rein comparés à des sujets contrôles sélectionnés comme des candidats au don. Le risque lié au don est estimé acceptable et minime, aux seules conditions d’une évaluation et d’une sélection rigoureuse des candidats et d’un suivi régulier des donneurs indispensable. Nowadays, several treatments exist to treat terminal chronic renal failure. Best results for the recipients are obtained with kidney transplantation concerning mortality and quality of life. Transplantation is also the cheaper option for society. Living kidney donation raises the issue of the becoming of the donor, an absolutely healthy subject who gets to a surgical procedure. The becoming of living kidney donors has been compared with the one of controls subjects in several studies. The evaluations focused on the complications of nephrectomy in the short and long-term: kidney failure, hypertension, proteinuria, possibility of pregnancy, quality of life, and mortality. The first results did not show any risk linked to kidney donation, compared to general population. However, since 2013, kidney donors were found at higher risk for kidney failure and even for mortality, compared with controls selected like donor candidates. The risk of kidney donation is nevertheless acceptable and minimal, on the condition of rigorous selection of candidates and regular follow-up. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Little is known about the pattern and outcome of Acute Kidney injury (AKI) in Sudan. This study aimed to determine the etiology andoutcome of AKI among Sudanese adults. METHODS: a retrospective cohort study was conducted in a tertiary level hospital, Soba University Hospital, Sudan. The medical records of all adults admitted to hospital from the 1 of January to 31st of December 2014 were reviewed. The diagnosis and severity of AKI was defined as per the Kidney Disease Improving Global Outcomes (KDIGO) recommendations. RESULTS: the medical records of 6769 patients were reviewed. AKI was diagnosed in 384patients (5.7%); being community acquired in 82.6% of cases. Sepsis, volume depletion, obstructive uropathy, heart failure, acute glomerulonephritis and severe malaria were the commonest causes of AKI diagnosed in 44%, 38.5%, 8.9%, 5.7%, 4.7% and 3.1% of patients, respectively. Following treatment complete renal recovery was seen in 35.7% of patients; whereas 31.2% of patients died. Predictors of increased risk of death were old age [OR 1.03, 95% CI (1.01-1.057); P=0.003], presence of chronic liver disease [OR 2.877, 95% CI (1.5-5.5); P=0.001], sepsis [OR 2.51, 95% CI (1.912-4.493);P=0.002] and the severity of AKI [OR 3.873, 95% CI(1.498-10.013);P=0.005]. CONCLUSION: AKI was diagnosed in 5.7% of adults admitted to hospital. Most patients were having community acquired AKI. Old age, the presence of chronic liver disease, sepsis, and the severity of AKI as per KDIQO staging were significant predictors of mortality.

INTRODUCTION: kidney transplant is the preferred renal replacement therapy for patients with end stage kidney disease. However management of patients with kidney transplant in resource poor countries is evolving and groaning under several mental, financial and infrastructural challenges. The objective of the study is to evaluate the management of patients with kidney transplant in a kidney care Centre in Nigeria. METHODS: this was a non-randomized prospective study. The study population were post-transplant patients presenting between 1st August 2010 and 31st December 2014.The biodata, pre and post-transplant details of these patients were documented. The data was analysed using SPSS Vs 17. RESULTS: a total of 47 patients were studied with M: F ratio of 4:1, the mean age was 45.4 , 13.6 years. Chronic glomerulonephritis, hypertension, diabetes mellitus and HIV related kidney disease were the commonest cause of CKD. Financial constraint delayed transplant in 66% and non-availability of donor in 17.2%. About 90% of the transplants were in India and 81% either financed the transplant either directly or through a relation. There was no cadaveric transplant and about 70% of the donors were not related. Tacrolimus, mycophenolate and prednisolone were most frequently used immunosuppressive combination. The one and three years graft survival were 95.3% and 67.6% respectively while corresponding patients survival were 97.7% and 82.4% respectively. Septicaemia, acute rejection and urinary tract infection were most common complications. CONCLUSION: management of patients with kidney transplant has good prospect despite the challenges.

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Invasive mechanical ventilation in onco-hematology patients has become relatively routine, and is now part and parcel of their care pathway. Nevertheless, specific complications and subsequent therapeutic possibilities require discussion. To a greater extent than with regard to other patient populations, cooperation between specialist and ICU physician is mandatory, the objective being to more comprehensively assess a therapeutic project before or during the period of invasive mechanical ventilation. After an overview of recent results concerning ventilated patients in intensive care, this review aims to describe the specific complications and factors associated with mortality in this population., (Copyright © 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

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Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Schizophrenia is a highly heritable psychotic disorder and high genetic loading is associated with early onset of the disease. The outcome of schizophrenia has also been linked with the age of onset as well as the presence of family history of the disease. Therefore families with patients with early onset Schizophrenia are subpopulations for genetic studies. We present 2 families with heavy genetic loading who have adolescents with schizophrenia.

INTRODUCTION: ileo-sigmoid knotting (ISK) is a rare cause of bowel obstruction in which the ileum twists around the sigmoid colon. It is associated with rapid bowel gangrene and a high mortality rate. Little has been published about this condition in Kenya. The objective is to determine the presentation, management, and outcome of patients with ISK. METHODS: a seven year (January 2008-December 2014) retrospective chart review of patients managed for ISK at Tenwek Hospital in Bomet, Kenya. RESULTS: a total of 61 cases were identified, with a mean age of 35.8 years (range 2-68), and mean symptom duration of 1.6 days (range 3 hours-7 days). Gangrene was noted to involve both the ileum and colon in 45 patients, the ileum only in 9 patients, and the sigmoid colon only in one. Resection and primary anastomosis was carried out in most cases of gangrenous ileum (48/54,89%) and gangrenous sigmoid colon (34/46, 74%), while resection and stoma was performed in 8 patients with gangrenous colon. Death occurred in 7 (11.5%) patients due to severe sepsis and multisystem organ failure. Morbidities were noted in 15 (24.6%) patients, including surgical site infection (8, 13.1%), respiratory insufficiency (4, 6.6%), fascial dehiscence (3, 4.9%) and anastomotic leak (2, 3.2%). The mean duration of hospitalization was 8.3 days (range 1-26).

INTRODUCTION: Obstructive uropathy can lead to irreversible kidney damage. The etiology largely determined by the patient's age can be benign or malignant. This study aimed at determining the profile and outcome of patients with obstructive uropathy in Cameroon. METHODS: A cross sectional study carried out in the urology unit of the Douala General Hospital, including patients with a diagnosis of obstructive uropathy seen from January 2004 to December 2013. Clinical profile, treatment and outcome data were obtained from patients records. RESULTS: Of the 229 patients included 69% were men, mean age 50 ,18 years. Associated comorbidities were hypertension, diabetes, and HIV. Mean haemoglobin 8,40 , 2,4g/dl, mean GFR 10,3 , 10ml/min and 94 (41%) patients needed emergency dialysis. Symptoms at presentation: asthenia (57%), anorexia (55%), loin pain (37%), vomiting (28%), oedema (20%), oliguria (33%), and anuria(15%). Urinary tract infection was present in 33 (15%) patients. Main aetiologies of obstruction: urolithiasis (35%), begnin prostatic hypertrophy (27%), prostatic cancer (12%), cervical cancer (16%), and congenital malformations (5%). Drainage was effective in 102 (45%) patients, 63 (28%) recovered completely, 91 (41%) were loss to follow up, 49 (22%) died and more women (p=0.02). Mortality was associated with prostatic cancer (p=0.000), cervical cancer (p=0.004) and radiotherapy (p=0.03). CONCLUSION: Patients with obstructive uropathy presented with significant impaired renal function. Main causes are urinary stones, prostatic hypertrophy, prostatic and cervical cancers. Renal recovery is poor, loss to follow up and mortality high. Specific strategies to target improvement in renal recovery and patient's survival are needed in this group of patients.

INTRODUCTION: childhood malignancies are now recognized as a growing global challenge, especially in resource poor settings. Although they constitute a smaller percentage of childhood illnesses in developing countries, compared with infectious diseases, the burden of cancer is still a tremendous problem on patients, families, the healthcare system, and the society. Data on the burden of childhood cancers across different regions is important, as there may be variations in incidences in different locations even within the same country. It will assist government agencies in better healthcare planning. METHODS: an eight year retrospective analysis of all cancers diagnosed in children below the age of 18 years at the study centre between January 2007 and December 2014 was carried out. Case folders of all children diagnosed with malignancies within the study period were retrieved and analyzed with respect to age, gender, morphological or histological type of cancer, treatment modality, and outcome.

INTRODUCTION: hypertensive disorders in pregnancy (HDP) are a major cause of maternal morbidity and mortality. We aimed at determining the trends in admission, profiles and outcomes of women admitted for preeclampsia and eclampsia to an intensive care unit (ICU) in Cameroon. METHODS: a retrospective study involving 74 women admitted to the ICU of the Douala General Hospital for severe preeclampsia and eclampsia from January 2007 to December 2014. Clinical profiles and outcome data were obtained from patient records. Statistical analysis was performed using SPSS version 20. RESULTS: of the 74 women admitted to ICU (72.5% for eclampsia), mean age was 30.2years and the majority (90.5%) were in aged 20-39 years. While overall trend in admission for HDP increased over the years, mortality remained stable. Mean gestational age (GA) on admission was 34.0 weeks (33.5 for preeclampsia vs 35.4 for eclampsia). Most patients presented with complications of which acute kidney injury was most frequent (66.7%). Visual problems were more common in patients with eclampsia compared to preeclampsia (p=0.01). HELLP syndrome and acute pulmonary oedema (APO) were predominant in patients with preeclampsia, while cerebrovascular accidents (CVA) occurred more in patients with eclampsia. Overall mortality was 24.3%. Presence of APO was associated with mortality in multivariable analysis (O.R.= 0.03, p=0,01). CONCLUSION: trends in admission for HDP were increasing with high but stable mortality rate. Patients presented late most of whom with complications. Interventions improving antenatal care services and multidisciplinary management approach may improve maternal outcome in patients with HDP.

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé Objectif L’objectif est de fournir les informations spécifiques d’un orage catécholaminergique lors d’un stress violent chez l’enfant. Patients et méthodes Deux observations cliniques chez des enfants ayant subi un traumatisme violent. Résultats Premier cas : un garçon âgé de 12 ans victime d’une noyade au stade 3 admis en réanimation pédiatrique le 02/08/2015. Il a été intubé, ventilé, sédaté aux benzodiazépines et au morphinomimétiques. L’exploration cardiaque a retrouvé une hypokinésie globale avec dyskinésie septale, une FES à 45 %, un léger sus-décalage du ST, une troponine I à 31,46 pg/mL, le NT-proBNB à 1291 pg/mL. L’enfant a été mis sous dobutamine initialement à 7 puis à 10 gamma/kg/min. L’évolution était favorable sur le plan cardiaque avec amélioration de la FES en 1 semaine. Deuxième cas : adolescente de 13 ans, victime d’une pendaison complète, admise le 06/08/2015 pour une encéphalopathie post-anoxique. Intubée, ventilée et sédatée aux morphiniques et benzodiazépines. L’exploration cardiaque a montré une hypokinésie septale avec une FES à 35 %, un allongement de l’espace QT à l’ECG, une troponine I ultra à 1,27 μg/L, le NT-proBNB à 215 pg/mL. L’adolescente était mise sous dobutamine jusqu’à 15 gamma/kg/min. L’évolution était marquée par l’amélioration de la fonction cardiaque sans trouble cinétique segmentaire au bout de 7 jours. Conclusion Nos 2 cas cliniques, suite à un traumatisme accidentel violent, représentent des observations d’un tableau simulant un syndrome de Tako-Tsubo sans douleurs angineuses objectivées, puisque nos 2 patients étaient sédatés, et, les anomalies échographiques se sont normalisées en moins d’une semaine. Objective To provide information specific to a catecholaminergic storm during a violent stress in children. Patients and methods Two clinical observations in children who suffered violent trauma. Results First case: a boy aged 12 years victim of a drowning in Stage 3 admitted to the pediatric intensive care 02.08.2015. He was intubated, ventilated, sedated with benzodiazepines and morphine. Cardiac exploration revealed a global hypokinesis with septal dyskinesia, a 45% FES offset a slight excess of ST, a troponin I to 31.46 pg/mL NT-proBNB to 1291 pg/mL. Dobutamine was set initially at 7 then 10 gamma/kg/min. The outcome was favorable on the heart level with improved SEF in 1 week. Second case: 13-year-old girl, victim of complete hanging, admitted on 06/08/2015 for a post-anoxic encephalopathy. Intubated, ventilated and sedated with morphine and benzodiazepines. Cardiac exploration showed septal hypokinesia with a 35% FES, a lengthening of the QT interval on the ECG, a troponin I in ultra 1.27 μg/L, NT-proBNB to 215 pg/mL. The child was put up 15 gamma dobutamine/kg/min. The evolution was marked by improved heart function without disturbance wall motion after 7 days. Conclusion Our 2 clinical cases following accidental trauma violating represent observations of a picture simulating a syndrome of Tako-Tsubo without anginal pain objectified as our 2 patients were sedated and ultrasound abnormalities returned to normal in less than a week. [ABSTRACT FROM AUTHOR]

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The tropical diabetes hand syndrome is a complication affecting patients with diabetes mellitus in the tropics, and consists of localized cellulitis, swelling and ulceration of the hands which may progress to fulminant sepsis and gangrene of the whole limb. It is associated with a poor outcome. We report a 32 year old woman with tropical diabetes hand infection with autoamputation of the digits, review the relevant literature, and highlight the need for prevention and early hospital presentation in diabetics with hand infection, in order to prevent potentially crippling or fatal complications.

INTRODUCTION: The use of coronary artery bypass surgery (CABG) with cardiopulmonary bypass (CPB) or without CPB technique (off-pump) can be associated with different mortality and morbidity and their outcomes remain uncertain. The goal of this study was to evaluate the early outcome of on-pump versus off-pump CABG. METHODS: We conducted a retrospective database review of 13866 patients (13560 patients undergoing on-pump CABG and 306 patients undergoing off-pump CABG) at Tehran Heart Center between January 2002 and January 2007. We compared preoperative, operative, and postoperative characteristics between them. RESULTS: In-hospital mortality in the on-pump group was 0.8% compared to 0.7% in the off-pump group (P=0.999) and in-hospital morbidity was 11.7% and 6.5%, respectively (OR: 1.533, 95%CI: 0.902-2.605, P=0.114). Postoperative atrial fibrillation was more prevalent in on-pump versus off-pump surgery (6.0% vs 3.0%, P=0.028), however there were no statistical significant differences in other postoperative complications with regard to cardiac arrest (P=0.733), prolonged ventilation (P=0.363), brain stroke (P=0.999), renal failure (P=0.525), and postoperative bleeding (P=0.999). The mean length of stay in hospital (P=0.156) and in ICU (P=0.498) was also similar between the two groups. CONCLUSION: The results from an Iranian population-based study showed similar early mortality and morbidity of off-pump CABG in comparison to on-pump surgery.

In some developing countries wire is still widely used in facial fractures internal fixation. This study presents the effectiveness and complications of wire osteosynthesis in a university teaching hospital in Burkina Faso and discusses some of its other benefits and disadvantages. Notes of 227 patients with facial fractures treated by wire internal fixation at department of stomatology and maxillofacial surgery of CHU Souro Sanou, Burkina Faso between 2006 and 2010 are reviewed retrospectively. A satisfactory treatment outcome was recorded in 91.2% of the 227 patients. Complications occurred in 8.8% of the patients who had operative site infection (3.1%), malocclusion (1.8%), sensory disturbance (1.8), facial asymmetry (1.3%), delayed bone union (0.9%) or enophtalmos (0.4%). The overall complications rate was 7.4% after mandibular osteosynthesis, 6.9% after Le Fort osteosynthesis and 6.5% after zygoma osteosynthesis. Post operative infections occurred irrespective to the surgical site. The other complications were more specific to the surgical site. Wire internal fixation may be a reasonable alternative for the surgical treatment of non-comminuted facial fractures and those without bone substance loss, in the setting of limited resources.

Ocular bee sting injury has caused several reactions in the eye but has rarely been reported among local African farmers, and Nigerians in particular. This case seeks to report the first ocular and external eye reactions following a honey bee sting of the eye through the sclera, highlighting the treatment and outcome. Oral interview, clinical examination and external photographs were used to obtain and document findings. Medical treatment was instituted as soon as subject presented. There was complete inflammatory resolution within a week, normal vision and no evidence of stinger migration after four weeks of follow up. The wound site healed with ciliary staphyloma. The role of physical properties, immunological and genetics interplay and the presumed pathogenesis is further discussed. Health education on early presentation and avoidance of harmful traditional eye medications should be promoted among the farming populations in our communities, in order to prevent blinding complications.

Résumé Les concentrés érythrocytaires sont conservés jusqu’à 42 jours après le prélèvement sanguin. Les banques de sang fournissent le concentré le plus vieux afin de réduire les pertes. De nombreux professionnels de la communauté médicale sont convaincus qu’il serait avantageux de transfuser du sang frais. L’objectif de l’étude ABLE était de vérifier si l’administration de concentrés érythrocytaires entreposés moins d’une semaine (sang frais) améliore le sort d’adultes transfusés en réanimation comparé au sort d’adultes recevant du sang distribué en fonction de la politique standard actuelle des banques de sang. Entre mars 2009 et mai 2014, 1211 patients ont été randomisés dans le groupe « sang frais », 1219 dans le groupe standard (durée de conservation de 6,1 ± 4,9 et 22,0 ± 8,4 jours respectivement, p < 0,001). La mortalité observée 90 jours après la randomisation (critère de jugement principal) fut de 448 (37,0 %) dans le groupe « sang frais » et de 430 (35,3 %) dans le groupe témoin (différence absolue du risque : 1,7 % ; intervalle de confiance à 95 %, −2,1 % à 5,5 %). Une analyse de survie a démontré un risque accru de mortalité du côté du groupe « sang frais » : le rapport de risque instantané ( hazard ratio ) était de 1,1 avec un intervalle de confiance à 95 % de 0,9 à 1,2 ( p = 0,38). Les mêmes tendances en défaveur du sang frais ont été observées pour tous les critères de jugement secondaires à une exception près. En conclusion, des concentrés érythrocytaires conservés moins de 7 jours n’améliorent pas le sort des adultes transfusés en réanimation comparativement à des concentrés conservés pendant 3 semaines en moyenne. Red blood cell units are stored up to 42 days post-collection. The standard policy of blood banks is to deliver the oldest units in order to limit blood wastage. Many caregivers believe that giving fresh rather than old units can improve the outcome of their transfused patients. The ABLE study aims to check if the transfusion of red blood cell units stored seven days or less (fresh arm) improve the outcome of transfused critically ill adults compared to patients who received units delivered according to the standard delivery policy (control arm). From March 2009 to May 2014, 1211 patients were allocated to the fresh arm, 1219 to the control arm (length of storage: 6.1 ± 4.9 and 22.0 ± 8.4 days respectively, P < 0.001). The primary outcome measure was 90-day all-cause mortality post-randomisation: there were 448 deaths (37.0%) in the fresh arm and 430 (35.3%) in the control arm (absolute risk difference: 1.7%; 95% confidence interval: −2.1% to 5.5%). In a survival analysis, the risk of death was higher in the fresh arm (hazard ratio: 1.1; 95%CI: 0.9 to 1.2), but the difference was not statistically significant ( P = 0.38). The same trend against the fresh arm was observed with all but one secondary outcome measures. The conclusion is that the transfusion of red blood cell units stored seven days or less does not improve the outcome of critically ill adults compared to the transfusion of units stored about three weeks (22.0 ± 8.4 days). [ABSTRACT FROM AUTHOR]

Résumé Les troubles de conversion ont une prévalence notable en population neuropédiatrique. Ils mobilisent de multiples professionnels de santé dans la prise en charge. Les données actuelles de la littérature sur le devenir des troubles de conversion sont limitées et la place des comorbidités ainsi que leur évolution ont rarement été évaluées chez les jeunes. Cette revue de la littérature étudie l’évolution des troubles de conversion en terme de guérison et les comorbidités psychiatriques associées chez les enfants et adolescents. La revue s’est faite à partir d’une recherche sur Pubmed et PsychInfo, où 11 études ont répondu aux critères d’inclusion : (i) trouble de conversion répondant aux critères du DSM, (ii) population pédiatrique, (iii) études longitudinales évaluant le devenir du trouble de conversion et/ou les comorbidités psychiatriques. La plupart des troubles de conversion chez les enfants et adolescents a évolué favorablement, avec disparition de la symptomatologie conversive, dans 70 à 92 % des cas, pour une durée de suivi variant de 1 à 6 ans. Les comorbidités psychiatriques associées au trouble concernaient entre 13 et 84 % des enfants et adolescents selon les études. Vingt-huit à 41 % de cette population pédiatrique a présenté un trouble psychiatrique à distance de la symptomatologie conversive. Les principales comorbidités retrouvées étaient des troubles anxieux et des troubles de l’humeur. Bien que les troubles de conversion évoluent majoritairement vers une guérison chez les enfants et adolescents, le pronostic de cette pathologie est plus sombre devant la persistance ou la survenue à distance de comorbidités psychiatriques. Summary Background Conversion disorders are significantly prevalent among neuropaediatric population. Their management requires deep somatic investigations and mobilizes many health professionals. Current literature presents limited amount of data regarding the futur of conversion disorders. Their associated comorbidities and their outcomes have rarely been studied in young people. However, conversion disorders are frequently associated to other psychiatric disorders as mood and anxious disorders. This literature review examines the evolution of conversion disorders in terms of healing and psychiatric comorbidity in children and adolescents. Methods This review was made from a search on PubMed and PsychInfo. Eleven studies met the inclusion criteria: (i) conversion disorder meet the criteria of the DSM, (ii) studied population of children aged between 5 and 18 (iii) longitudinal studies evaluating the outcomes of conversion disorder and/or psychiatric comorbidities at diagnosis and at 12 months of evolution (at least). Results The studies selected refer to samples ranging from 13 to 204 patients. Subjects included are aged from 6 to 18 years at the time of inclusion, with an average age of 12.2 years. Psychiatric or psychological cares, inpatient or outpatient, were proposed to a majority of included patients. Most conversion disorders in children and adolescents have evolved favorably, with disappearance of conversion symptoms for 70 to 92% of cases, after a follow-up period going from 1 to 6 years. Psychiatric comorbidities related to conversion disorder touched from 13% to 84% of children and adolescents, depending on the studies. In 28% to 41% of the pediatric population, psychiatric disorder appeared after the conversion symptoms. The most frequent comorbidities were found to be anxiety disorders and mood disorders. Conclusion The presence of psychiatric comorbidity at diagnosis does not seem to be associated with a more unfavorable evolution for the conversion disorder itself. More than three quarters of conversion disorders in children and adolescents move towards healing after a follow-up of at least 1 year, suggesting a good prognosis and a good development of this disorder. However, the emergence or persistence of psychiatric comorbidities, remote from conversion disorder, has an impact on the future of young and is an unfavorable sign. It is necessary to have a global vision of the patient, looking in particular for the associated comorbidities and taking into account the interactions with relatives, especially within his family and with his peers. Prospective studies in the longer-term future of these disorders are necessary regarding their complexity during pre- and post-pubertal. [ABSTRACT FROM AUTHOR]

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: Over 80% of stroke deaths occur in low-income and middle-income regions of the world. Identification of predictors of mortality is vital so that prompt therapeutic measures could be instituted to improve outcome. Previous studies have identified factors such as stroke severity, stroke type, older age, impairment of consciousness and hyperglycaemia as predictors of mortality for acute stroke but mortality remain high among patients hospitalized for acute stroke. The study objective was to determine the association between admission serum albumin levels and short-term outcome following acute ischaemic stroke in Nigerians. METHODS: Consecutive first-ever acute ischaemic stroke patients were prospectively enrolled between February 2009 and May 2010.Stroke severity at presentation was determined using National Institute of Heath Stroke Score (NIHSS). Admission serum chemistry including albumin, were measured. Patients were then followed up for 30 days and outcome measures applied at the end of the study were 30-day mortality and functional outcome using the Modified Rankin Scale (MRS) and graded as favourable(MRS 0-3) or unfavourable(MRS 4-6). Relationship between serum albumin and stroke outcome was determined. RESULTS: 75 acute stroke cases were studied. Mean age was 57.68 - 12.4years. Outcome was favourable in 48% while 30-day case fatality was 17.3%. The mean age (61.13years) of those with poor outcome was significantly higher than those with favourable outcome. Mean serum albumin (3.03g/dL) of those with favourable outcome was also significantly higher than (2.08g/dL) of those with unfavourable outcome (p=0.0001). Patients that died had significantly lower serum albumin (1.66g/dl) than survivors (p=0.0001).Receiver operating characteristics curve for optimal cut off point of serum albumin to predict survival or death within 30 days revealed area under the cure (AUC) of 0.870, p-value 0.0001, 95% C/I=0.759-0.982. Serum albumin of 1.55g /dL has sensitivity of 100% and specificity of 61.5%. NIHSS and serum albumin were predictors of poor outcome using multiple regression. CONCLUSION: Low admission serum albumin was an independent determinant of poor outcome.

Background: The MecoExpo study was conducted in Picardy, an agricultural region where pesticides are used. This study was designed to evaluate the relationship between parental and fetal exposure to pesticides. Neonatal anthropomorphic parameters were compared to parental pesticide exposure during pregnancy. Materials and methods: Parental exposure to pesticides was assessed by means of a validated questionnaire. In utero fetal exposure was assessed for the first time in France by means of neonatal meconium assays. Results: Nine-hundred and ninety-three mother-newborn pairs were included. A significant relationship was observed between maternal occupational exposure to pesticides and low birth weight for gestational age. An association was also observed between preterm birth and paternal exposure to pesticides. At least one pesticide was detected on meconium screening in 85% of newborns. The pesticides most frequently detected were organophosphorus and carbamate metabolites. These pesticides are commonly used for extensive field treatments in Picardy. Conclusion: A significant relationship was observed between maternal and paternal occupational exposure to pesticides and neonatal anthropomorphic parameters. Positive screening for pesticides in the meconium of newborns was assessed for the first time in France. [ABSTRACT FROM AUTHOR]

Résumé: Introduction: Le syndrome de Tako-Tsubo correspond à une dysfonction myocardique ventriculaire gauche réversible. Il existe peu de publications sur son évolution et l’objectif de cette étude est de décrire dans un centre hospitalier français le devenir à moyen terme des patients ayant présenté cette pathologie. Méthodes: Cette étude rétrospective a inclus 70 patients admis pour un syndrome de Tako-Tsubo à l’hôpital cardiologique du Haut-Lévèque entre novembre 2003 et janvier 2012. Les éléments pris en compte dans le suivi ont été : nombre d’évènements cardiovasculaires, récidive de syndrome de Tako-Tsubo, évolution électrocardiographique et échocardiographique. Résultats: Soixante-huit patients ont eu un suivi de 4,8±2,4ans. Le taux de survie était de 92 %, 39 patients (57 %) n’ont présenté aucune symptomatologie cardiovasculaire, 12 patients (18 %) ont de nouveau ressenti une ou plusieurs douleurs thoraciques et 4 (6 %) avaient une dyspnée stade II NYHA. Une patiente a présenté une récidive 6,5 années après, déclenchée par le même stress que la première fois. Chez 45 patients (64 %), l’ECG a évolué dans les premiers jours vers une négativation diffuse des ondes T. À moyen terme, 32 (54 %) patients avaient un ECG normal, 19 (32 %) présentaient une négativation des ondes T préférentiellement sur les dérivations précordiales et 2 (3 %) avaient une onde Q. Sur le plan échocardiographique, la fraction d’éjection du ventricule gauche s’est normalisée chez tous les patients avec des délais variables. Cependant, 4 patients gardaient une hypokinésie apicale. Conclusion: Cette étude montre que l’évolution à moyen terme est favorable en termes de mortalité cardiovasculaire et que les récidives sont rares. Cependant, elle met en évidence des anomalies électrocardiographiques et échocardiographiques persistantes. [ABSTRACT FROM AUTHOR]

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)