Biomedical subjects

P Zabsonré

Publications and source records attributed to P Zabsonré.

4 recordsLinked to original sources

PubMed2002

[Knowledge and perception of cardiovascular risk factors in Africa South of the Sahara].

The objectives of our study were to evaluate the perception and the knowledge of cardiovascular risk factors (CVRF) by the population and their management by health care workers (HCW) in Burkina Faso. The survey targeted specific socio-professional groups representative of Burkina Faso. The survey team administrated a questionnaire and measured some constants. The sampling method was empiric selection by quotas. The sample was composed of 2,000 subjects: 1,073 men, 927 women, 1,800 represents of the general population and 200 HCW. Of 1,800 non health workers, 1,475 had ever heard about hypertension. The representation of hypertension as "a disease" decreased with instruction level while its reprentation "a risk factor" increased with instruction level (p < 0.001). The main sources of information on CVRF were talks with parents and friends, radio broadcasting and discussion with HCW. One hundred and forty of 200 HCW defined hypertension as an elevation of blood pressure, mainly systolic (130 cases) according to WHO criteria. Hypertension was classified after alcohol, tobacco smoking, obesity as the fourth CVRF. One hundred and seventy seven of 302 cases of hypertension were previously unknown: 97 of the 125 old cases were treated and 74 had not normal blood pressure levels. Hypertension and other CVRF are not well-known in Burkina Faso population and are not well-managed by HCW. Political decision makers and donor institutions should pay more attention on the public health problem represented by hypertension and other CVRF in developing countries because of they are not communicable.

Adult↗

PubMed2002

[Study of variations in preload on the new echocardiography parameters of diastolic function in health subjects].

The standard Doppler indices of transmitral filling are changed by variations in preload, relaxation and left ventricular compliance. Recent work in the literature suggests that the new parameters of diastolic function [mitral flux propagation speed in colour TM. (Vp) and tissue Doppler mitral ring velocities (Ea)] are independent of loading conditions. The objective of this work was to study the effect of modifications in the preload on Vp and Ea in normal subjects. Therefore, we have studied various Doppler echocardiographic measurements performed at rest, during a Trendelenberg manoeuvre at 60 degrees, and after sublingual administration of trinitrate in 25 healthy young (2 +/- 8 years) male volunteers. The end diastolic volume increased from 126 +/- 25 ml in the resting state to 145 +/- 24 ml during the Trendelenberg (p = 0.009) then decreased after trinitrate to 121 +/- 28 ml. The peak of the E wave increased from 88 +/- 12 cm/s in the resting state to 90 +/- 15 cm/s during the Trendelenberg and decreased to 70 +/- 11 cm/s after trinitrate (p < 0.0001). The peak Ea annular velocities of the septal and lateral walls were 22 +/- 4 cm/s and 15 +/- 1.6 cm/s in the resting state, without variation during the Trendelenberg (22 +/- 5 cm/s and 15 +/- 2 cm/s) but with a significant reduction after trinitrate to 19 +/- 5 cm/s and 13 +/- 2 cm/s (p = 0.02 and p = 0.002). In contrast, no significant variation was noted in Vp (60 +/- 14 cm/s in the resting state, 62 +/- 12 cm/s during the Trendelenberg and 59 +/- 14 cm/s after trinitrate). We conclude that Vp is not significantly affected by preload whereas Ea is not independent of the loading conditions.

Adult↗

PubMed2001

[Fibrinolysis in myocardial infarction with EKG elevation. Optimization of myocardial reperfusion by treatment with antithrombotic agents].

In the case of acute coronary syndrome with prolonged ST elevation on ECG showing an acute coronary obstruction, the urgent institution of fibrinolysis is a widely validated treatment. Since the first placebo controlled studies with streptokinase until the development of bolus administration rt-PA varieties, fibrinolytic agents have lowered mortality. Associated anti-thrombotic drugs are multiplying in parallel. Their association is recognised as necessary in order to avoid early reocclusions which worsen the prognosis of infarction, the fibrinolysis triggering a harmful prothrombotic effect, notably due to the clot thrombin re-exposed during thrombolysis. Aspirin has an essential place formally demonstrated in ISIS 2. Non-fractionated heparin has more complex effects and its administration protocol in association with fibrinolysis has recently been reviewed with a reduction in dosage because prolonged clotting times during fibrinolysis have provoked a distinct increase in the risk of intracranial haemorrhage. The low molecular weight heparins seem to have become the adjuvant treatment of choice following publication of the ASSENT-3 trial. Pentasaccharide seems attractive. The place of hirudine and its derivatives in the acute phase of MI appear limited after the results of the HERO-2 trial, associating hirulog and streptokinase, with the earlier studies also having been disappointing. The GPIIbIIIa blockers in association with a half dose of fibrinolysis do not aggravate the intracerebral haemorrhagic risk before 75 years old and clearly reduce hospital morbidity in infarction, at the price however of an increase in transfusions.

Aspirin↗

PubMed2001

[Anticoagulation in mechanical valve prostheses. A difficult situation].

Although long-term anticoagulant therapy in patients with mechanical valve prostheses is well codified, a number of difficult situations persists because of the high thromboembolic risk. The protocols of anticoagulation suggested in these situations are controversial as there are no large scale prospective therapeutic trials. However, modern protocols take more and more into account the thromboembolic risk in each individual case. The authors review the most common situations: the early postoperative period for which no precise consensus exists in the literature; anticoagulation in extra-cardiac surgery, a common situation for which the protocols remain very debatable; anticoagulation in pregnancy, a special situation because of the risk of embryopathy with oral anticoagulant therapy and the risk of thromboembolism with heparin; anticoagulation in cases of thromboembolic complications; anticoagulation during infectious endocarditis; anticoagulation during serious haemorrhage.

Anticoagulants↗