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Biomedical subjects

A Kane

Publications and source records attributed to A Kane.

At least 19 recordsLinked to original sources
PubMed2006

Radiotherapy for metastatic melanoma presenting in pregnancy.

We describe the study of a patient with metastatic melanoma to axillary nodes presenting during pregnancy. The factors considered in her management are discussed, including issues related to staging, the decision not to terminate the pregnancy and the relative efficacy and fetal toxicity of the available treatment options. An overview of the known effects of radiotherapy on the fetus is presented and the technical alterations that were used to decrease the toxicity of radiotherapy are discussed.

Adult↗
PubMed2005

[Cardiovascular events in the course of tetanus: a prospective study on 30 cases in the infectious diseases clinic, in the Fann teaching hospital, Dakar].

OBJECTIVES: This prospective study had for aim to determine the frequency and characteristics of cardiovascular events in the course of tetanus. PATIENTS AND METHODS: From September to December 2002, we studied all patients over 4 years of age presenting with tetanus without any documented underlying disease. RESULTS: Thirty cases were included (mean age 36+/-20 years; sex-ratio 2.3). Seventy-three per cent had a mild-gravity tetanus (stage II of Mollaret) upon admission. One hundred and seventeen ECG were recorded and 93.3% of the patients had more than one abnormality: arrhythmia (24 cases), prolonged QT interval (23 cases), ventricular hypertrophia (17 cases), and atrial hypertrophia (4 cases) especially left (3 cases), failure of AV conduction (3 cases), ST segment depression (3 cases), left and right axis deviation (3 cases), baseline undulation (3 cases) and repolarization disturbances (1 case). All patients had a normal Doppler echocardiographic examination. The mean hospitalization stay was 11.6+/-1.4 days and complications were noted in 60%; sinus tachycardia in apyrexia (5 cases), instable BP (5 cases), excessive sweatiness in apyrexia (1 case), and access of bradycardia with sudden cardiac arrest (2 cases). 8 patients died (26.7%). Six patients with cardiac autonomic dysfunction died, the case fatality rate being statistically higher in this group (P=0.007). A prolonged QT interval, sinus tachycardia and left ventricular hypertrophia were statistically more frequent at the acute phase of the illness. CONCLUSION: The case fatality rate of tetanus is still high, due among others to autonomic dysfunctions.

Adolescent↗
PubMed2005

[Pyoderma gangrenosum in dakar: about 14 cases].

From January 1990 to December 2001, we undertook a retrospective study in the dermatology department of Aristide le Dantec hospital in order to assess the epidemiologic, clinical and evolutionary profiles of pyoderma gangrenosum (P.G). All files of patients diagnosed with PG were reviewed. The diagnosis was based on clinical and histological aspects. Fourteen files of patients with PG were reviewed. They were constituted of 8 males and 6 females, with a median age of 24.5 (extreme 4 and 54 years). Paediatric forms represented 30 % of the cases. The typical aspect with an ulceration with elevated edge comprising of purulent hutchs was observed in all the cases. The localization on the level of the lower limbs was noted among 12 patients (85.7 %). The PG was associated to chronic ulcerative colitis (1 case), rheumatoid spondylitis (1 case) and rheumatoid arthritis in all cases. After 11 weeks treatment by oral corticothérapy at the daily posology of 1 mg/kg/, cicatrization of cutaneous lesions were noted in all the cases. Five reccurences were observed. P.G remains a rare pathology with no difference on races and regions . this is particularly true on children. Our serie, is remarkable by the high frequency of its paediatric forms. As for clinical and evolutive aspects as well as associated pathologies, findings are comparable with those described other series

Adrenal Cortex Hormones↗
PubMed2005

[Active rheumatic heart disease: findings from an 17-case series in the University Hospital Center of Dakar, Senegal].

This report is based on retrospective review of the charts of 18 patients with pre-existing active rheumatic heart disease compiled over a period of two years (January 2000 to December 2001). The purpose of this study was to determine the incidence of acute degenerative joint disease, to describe the clinical features and natural course of the disease, and to highlight the main points in the fight against degenerative joint disease and rheumatic heart disease. The prevalence of active rheumatic disease was 3.7%. Mean patient age was 15.5 years (range: 8 to 25 years). Female sex was predominant with 13 girls and 4 boys (sex ratio: 3.25). The most common clinical symptoms were migratory polyarthritis involving large joints in 14 cases (82.3%) and left heart insufficiency in 13 (76.4%). Additional clinical findings included oscillating fever in 8 cases (47.05%), tooth decay in 11 (73.3%), and poor buccodental hygiene in 14 (93.3%). Blood tests to evaluate inflammation demonstrated high values in all patients with mean ASLO titer of 950 UI/l, mean serum fibrin level of 7.8 g/l, and mean C-reactive protein level of 28.5 mg/l. The erythrocyte sedimentation rate was high in 15 cases (88.2%). In addition to showing heart valve disease, electrocardiography demonstrated first-degree atrioventricular block in 1 case. Chest x-ray revealed cardiomegaly in 15 cases (88.2%). Doppler ultrasonography of the heart showed isolated rheumatoid disease in 11 cases (64.7%). All patients responded favourably to treatment with corticosteroids and penicillin. The incidence of recurrence of active disease was high (70.5%) thus supporting use of high loading doses. Rheumatic heart disease is a public health problem in Africa and requires appropriate preventive measures.

Adolescent↗
PubMed2004

[Electrocardiographic recording of long duration (Holter) of 24 hours during idiopathic cardiomyopathy of the peripartum].

The idiopathic myocardiopathy of the peripartum (IMPP) is a frequent disease in the Soudano-Sahelian zone of Africa whose evolution is loaded with many complications hemodynamic, thrombo-embolic and rhythmic. The prevalence and the meaning of the rhythm disorders are unknown. The aims of this prospective study are to measure and to describe the prevalence of the anomalies observed in Holter ECG of 24 hours. It's about a description cross-sectional study realized at the Cardiology Department (CHU Dakar) and 19 patients with IMPP were included, from October 2000 to July 2002. A recording ECG of 24 hours (Holter) was realized on all the patients. The average age was 29.4+/-6.9 years with a low socio-economic level (100%). The diagnosis of IMPP done before childbirth in 4 cases (21%) and the post partum on 15 patients (78.9%). The dyspnea was constant, the chest pain in 12 cases (63.1%) and palpitations in 8 cases (42%). The average rate of hemoglobin was of 10.85+/-2.05 g/dL. The standard electrocardiogram recorded a sinusal tachycardia (68.4%), a cavitary hypertrophy (78.8%), and disorders of the repolarization (47.3%). The cardiac echo-Doppler noted a cavitary dilatation (84.2%), a constant alteration of the left ventricular systolic function with a fraction of average ejection of 29.7+/-10.3%. The anatomy of the valves was normal. The recording Holter ECG of 24 hours recorded a sinusal tachycardia in 17 cases (89.4%), ventricular extrasystoles on 7 patients (36.8%), 4 cases of ventricular tachycardia non-sustained and double ventricular extrasystole on 1 patient, auricular extrasystoles in 4 cases (21%) and 1 case of auriculo-ventricular block of the first degree. The study of heart rate variability founded a mean value of 106 ms.

Adult↗
PubMed2004

[A new case of rhinoscleroma with skin extension].

Scleroma is a chronic and specific granulomatous disease of bacterial origin. Klebsialla rhinoscleromatis, a gram-negative bacillus. The majority of cases affect the upper airways, particularly the nose, thus justifying the term of rhinoscleroma. Extension to the palate, the upper lip and the skin is possible. A new case of rhinoscleroma with skin extension is reported. To us, this is the second case in Senegal (Casamance). Epidemiological, clinical, bacteriological and histological aspects of the disease are reviewed. Under suitable antibiotic, evolution is currently favorable.

Adult↗
PubMed2004

[Tricuspid valve stenosis. A prospective study of 35 cases].

Authors report the results of prospective and longitudinal study. The aims of this study were to evaluate among 35 patients, prevalence, diagnosis and treatment aspects of tricuspid stenosis (TS), as well as evolution and pronostical factors. The prevalence of TS was about 4.2%. The main clinical signs were: dyspnoea (94.2%), jugular veinus pulses (42.8%), superior cave syndrom (68.8%), diastolic rumble (74.3%). ECG showed sinus rhythm (51.4%), a right atrial hypertrophy (48.5%). Echocardiography showed tricuspid leaflets thickened (82.8%), a right atrial hypertrophy (48.5%), a mean gradient between right atrial and right ventricle: 8.6 +/- 3.14 mmHg (65.7%) and mean tricuspid area about 1.41 +/- 0.83 cm2 (continuous equation); about 1.74 +/- 1.29 cm2 (Hatle formula) and 1.11 0.84 cm2 (simplified Hatle formula). Aetiology was only rheumatic fever. After a follow-up of 8.53 +/- 6.06 months, the mortality rate was 28.5%. Complications were irreducible heart failure (24 cases), liver failure (2 cases) and stroke (3 cases). Factors associated with mortality were: severity of tricuspid stenosis and pulmonary hypertension, importance of dyspnea and heart failure (p < 0.041).

Adolescent↗
PubMed2003

[Management of mycetoma in West-Africa].

Mycetoma is still endemic in the northern areas of West-Africa. This infection is more common in males, rural inhabitants, between 20 and 40 years of age. Mycetoma is generally easy to identify on clinical presentation, it is a chronic subcutaneous inflammatory tumor with discharging sinuses. The commonest affected site is the foot (70%), leg, knee, thigh, hand and arm are the most frequent extrapodal localizations. Diagnosis must be confirmed by the presence of grains at direct and histological examinations. It is indispensable to distinguish actinomycetoma (caused by aerobic bacteria) and eumycetoma (caused by fungi) as their treatments are different. The main etiological agents in West-Africa: Streptomyces somaliensis, Actinomadura pelletieri, Actinomadura madurae (actinomycetes), Madurella mycetomatis and Leptosphaeria sp (fungi) can be identified in most cases by histological examination of the grain. In the West Sahelian belt actinomycetoma is more frequent than eumycetoma except in Mauritania. When a mycetoma is diagnosed it is fundamental to determine as precisely as possible the extent of the lesion. Bone involvement is the major complication and must be systematically investigated by radiology. Mycetoma has characteristic ultrasonographic features, ultrasonographic technique appears to be very useful in medical centers where no mycological tests can be done. Ultrasonography is also an accurate technique to delimit the extent of the process. Computed tomography is also sensitive to assess the extent of mycetoma in soft tissues and can detect early bone involvement but is more onerous than ultrasonography. Ketoconazole or itraconazole in combination with surgery is recommended for eumycetoma patients. Actinomycetoma responds to antibacterial agents, different therapeutic schemes can be proposed and depend on the etiological agent.

Africa, Western↗
PubMed2003

[Pheochromocytoma in Dakar: report of nine cases].

Pheochromocytoma is a catecholamine-secreting neoplasm of chromaffin tissue. The most common symptom is hypertension but there are incidentally discovered forms at imaging. From 1981 to 1998, the authors observed nine pheochromocytomas through three hospitals in Dakar. This study included seven male and two female patients. The average age was 31.61 years. Hypertension was present in 77% of the cases. Headache, palpitations and sweating were the authors most frequent symptoms, occuring in 55% of cases. Measurement of vanillyl mandelic acid level in six cases and urinary metanephrines in three cases made the diagnosis. There were six adrenal and three extra adrenal pheochromocytomas with two malignant tumors features. In our countries, measurement of urinary metanephrines and computed tomography processing may improve detection of pheochromocytomas.

Adrenal Gland Neoplasms↗
PubMed2003

[The athlete's heart: an echocardiographic case-control study on Senegalese athletes].

The aim of this work is to study the echocardiographic parameters of male trained athletes. It is about a case-control study comparing 3 groups: basketball players, cyclists and not sports healthy subjects. All the subjects benefited from an echocardiography (time motion, two-dimensional and pulse Doppler). The mean age is of 23.5 years for the cyclists group, 24 years for the basketball players and of 26.2 years for the control group. Compared with the control group, the left ventricular telediastolic dimensions, left ventricular mass index and the pulmonary flow velocity are higher in athletes group. The basketball players have a higher left ventricular diameter and parameter of systolic function than cyclists group. The septal diameter is higher in the cyclists group. This study finds some differencies in Senegalese athletes in the characteristics of the standard athletic heart syndrome.

Adult↗
PubMed2003

[Role of transesophageal echocardiography in the diagnosis of aortic dissection. Report of 5 cases].

Aortic dissection is medical and surgical emergency. About 5 cases, the authors emphasized the role of transesophageal echocardiography in the diagnosis of aortic dissection. For all patients we realized a clinical examination, electrocardiogram, chest X ray, thoracic and transesophageal echocardiography and laboratory studies. Echocardiography were performed by an apparatus Hewlett Packard sonos 1000 with colour doppler and multiplanar transesophageal. Transesophageal echocardiography made the diagnosis by showing dilatation of aorta, intimal flap, false channel; this exam also allow to classify the aortic dissection.

Adult↗
PubMed2003

[Left atrial myxoma. Report of 2 cases operated in Senegal].

Cardiac tumours are rare and are dominated by left atrial myxoma. The authors report 2 cases of left atrial myxoma operated in the Cardiology department of Dakar (Senegal). Clinical signs were heart failure, cardiac sounds mimicking mitral valve disease and alteration of general state. The electrocardiogram showed sinus rhythm in 1 case and atrial flutter in the second case. The chest-x-ray show cardiac enlargement. Diagnosis was suggested by echocardiography and confirmed by anatomy. Evolution was favourable in one case and the other patient died.

Female↗
PubMed2002

[Role of elastic compression in the treatment of postphlebitic leg ulcers at the University Hospital of Dakar: report of 20 cases].

Varicose disease and venous thrombosis were reputed exceptional among black africans and almost all leg ulcers were called "tropical". We have treated 20 cases of postphlebitic ulcers in the teaching hospital of Dakar between march 1989 and december 1992. There were 12 men and 8 women. Mean age was 40 years (24 to 60 years). The initial venous thrombosis dated at mean 8 +/- 3 years. It was confirmed in a hospital in 10 cases and found in the medical history of all patients. All patients presented leg ulcers with non systematised venous varicose and trophic troubles. The ulcers treated only by dressings lasted a duration of 4 months (2 weeks to 9 months) without healing. In view of this failure we have added an ambulatory elastic contention with elastic bandage putted on at hospital after that biweekly dressing until cicatrisation followed by putting elastic socking with degressive compression. We have observed a quickly cicatrisation in mean time of 4 weeks (2 to 6 weeks) with good tolerance of socking. Only 3 patients showed recurrence. Elastic contention has a great place in the treatment of postphlebitic ulcers which are not that exceptional among black Africans.

Adult↗
PubMed2002

[Subvalvular left ventricular aneurysm. Report of 2 cases].

The authors report both Senegalese's cases of subvalvular left ventricular aneurysm (SVLVA). The aim of the study was to describe the clinical and paraclinical aspects of this disease. Mitral regurgitation an heart failure were constant. Beyond cardiomegaly observed in both patients, one of them presented vaulting of the left ventricle. In the two cases, electrocardisgram showed sinus rhythm, and biology an inflammatory syndrome. One patient had also tuberculosis. Transthoracic echocardiography showed an aneurysm situated in a mitral subvalvular position, thrombosed in one case. Medical treatment with furosemid and digoxin has been administrated. One patient received also drugs against tuberculosis. Surgery of aneurysm had not been possible. During the evolution, we have observed persistence of heart failure in one patient. The other one died, probably after a cerebral embolism. Autopsy confirmed the echocardiographic aspects and integrity of myocardium and coronary arteries.

Child↗
PubMed2002

[Post myocardial infarction septal rupture. Report of 2 cases].

The authors report 2 cases of post myocardial infarction septal-rupture. There were one woman and one man aged respectively of 52 and 69 years. Risk factors were diabetes associated in one case with hypertension, and in the other case with tobacco addict. Both patients presented a ventricular septal defect murmur, and cardiac failure. Myocardial infarction (MI) was inaugural, semi-recent, and concemed interventricular septum or circumference of myocardium. Cardiac enzymes were high. Echocardiography showed a left ventricular apical aneurysm, and septal rupture. An abnormal blood flow pattern from left to right ventricle was visualized at Döppler. Medical treatment of Ml and cardiac failure were administrated. Surgery had not been possible. Both patients died respectively after 36 days and 4 days by cardiogenic shock.

Aged↗
PubMed2001

Reperfusion of specific brain regions by raising blood pressure restores selective language functions in subacute stroke.

We report a series of six single subject studies examining the effects of pharmacological blood pressure elevation on regional brain perfusion and language function. Previous reports indicate that hypoperfusion of specific brain regions, as delineated by magnetic resonance perfusion weighted imaging (PWI), is associated with disruption of selective lexical functions. On this basis, we hypothesized that reperfusion of the same regions, in the absence of infarct in that region, would restore the associated lexical function. We present five patients with impaired lexical-semantics associated with poor perfusion, but not infarction, of Brodmann's area 22 (BA 22), and one patient with impaired lexical-semantics and a superimposed deficit in retrieving the phonological representations of words, associated with poor perfusion Brodmann's area 37 (BA 37) as well as BA 22. Each patient was treated with induced blood pressure elevation to increase perfusion of the ischemic and dysfunctional tissue. Daily testing of naming and comprehension, with stimulus sets matched for frequency, familiarity, and length, showed improved lexical-semantics in the patients who showed reperfusion of BA 22 and improved oral naming (but not lexical-semantics) in the patient who showed reperfusion of BA 37. These cases illustrate that loss of function with hypoperfusion of a circumscribed area of the brain, and recovery of the same function with improved perfusion of that brain region, can reveal brain/language relationships prior to reorganization after brain injury.

Acute Disease↗