What pulmonologists need to know about extrapulmonary tuberculosis.

Extrapulmonary tuberculosis (EPT) can affect all organs. Its diagnosis is often challenging, especially when the lung is not involved. Some EPT locations, such as when the central nervous system is involved, are a medical emergency, and some have implications for treatment options and length.

A 44-Year-Old Man With Acute Chest Pain.

A 44-year-old man consulted in April 2020 for a 1-week persistent left lateral chest pain, increased with deep breathing and change of position. He had left lower limb pain without redness or swelling 2 weeks before presentation. He did not complain of shortness of breath, cough, hemoptysis, syncope, fever, nor general status alteration.

Screening for comorbidities in COPD.

Due to growing recognition of comorbidities, COPD is no longer considered a disease affecting only the respiratory system. Its management now entails the early diagnosis and treatment of comorbidities. However, although many studies have examined the impact of comorbidities on the evolution of COPD and patients' quality of life, very few have explored the means to systematically identify and manage them.

[Celiac disease: special features in Africa. Description of 8 cases in Djibouti (horn of Africa)].

Celiac disease is poorly documented in intertropical Africa. The purpose of this retrospective report was to describe 8 cases observed at the Groupement Medico-Chirurgical of Bouffard Hospital in Djibouti (Horn of Africa) between January 2003 and January 2006. There were 5 females and 3 males ranging in age from 9 months to 17 years old (mean age: 48 months).

[Management of Grave's disease in the tropics (experience at Bouffard Army Hospital Center in Djibouti].

Based on their experience in managing Grave's disease at the Bouffard Army Hospital Center within the local health care context in Djibouti, the authors advocate surgery as the first line treatment. Medical and economical factors supporting this preference are discussed so that readers can adapt them to his own local context.

[Adults with sickle cell anemia in Senegal. Clinical study of 40 homozygote subjects].

While the well-documented life expectancy of patients with homozygous sickle cell anemia (SS) is 40 years in industrialized countries, this question remains unanswered in black Africa. The purpose of this prospective study was to establish the clinical phenotype for Senegal. A severity score based on 12 clinical, laboratory, radiological, and prognostic findings was calculated and correlated with age and hemoglobin F level.

[Thyroid cardiac diseases in the African hospital milieu: experience of the Principal Hospital of Dakar, Senegal].

The incidence of cardiomyopathy associated with hyperthyroidism in black Africa is unclear. A prospective study was carried out at the Principal Hospital in Dakar, Senegal to systematically screen for thyrocardiac disease using cardiologic examinations including electrocardiography and ultrasound in a series of 15 men and 35 women with hyperthyroidism. Cardiac manifestations were detected in 3 men and 8 women including right ventricular insufficiency in 9 cases, left ventricular insufficiency and angor in one.

[General surgery and closed mitral commissurotomy: when necessity makes the rules].

Since emergency transfer of patients from Africa to European cardiovascular facilities is difficult, surgeons at the Principal Hospital in Dakar, Senegal, have reevaluated closed mitral commissurotomy. The purpose of this study was to ascertain patient selection criteria, optimal operative conditions, immediate and middle-term outcome, and cost of closed mitral commissurotomy. From June 1995 to March 1998, closed mitral commissurotomy was carried out on 21 patients (13 women and 8 men).

[Pulmonary manifestations of schistosomiasis].

Bilharziosis or schistosomiasis is the third leading endemic parasitic disease in the world, following malaria and ambiasis. More than 300 million individuals are infested. Schistomosomes are blood flukes which live in the perivisceral veins.

[Cardiac manifestations of polymyositis. Apropos of 2 Senegalese cases].

Introduction: Polymyositis cardiac involvement varies between 37% and 70%. EXEGENESIS: The authors report two cases of polymyositis with myocardial involvement observed in Senegal; the first case is a cardiac failure revealing an acute polymyositis occurring in a 44-year-old woman; the second case is a 34-year-old woman who had polymyositis with tachycardia and dyspnea: in the two cases echocardiography showed a left ventricular concentric hypertrophy with preserved systolic function and altered diastolic function; clinical and echocardiographic resolution were obtained by corticosteroid medication.

Conclusion: Myocardial localization is the most common polymyositis cardiac involvement; clinical symptomatology is rare (3.

[Closed-heart mitral commissurotomy: our experience at the Main Hospital in Dakar].

Confronted with difficulties of medical evacuation to cardiovascular surgical hospitals in Europe, the authors decided to bring up to date closed heart mitral commissurotomy. The aim of the study was to estimate possibility to select patients, to operate them safety to appreciate the results in medium and short time and the intervention's cost. 8 women and 7 men had a closed heart mitral commissurotomy from June 1995 to January 1997 in Dakar Principal Hospital; inclusion criteria were a symptomatic mitral stenosis with area less 1.

[Etiopathogenic, ultrasonographic and prognostic features of postpartum cardiomyopathy].

Peripartum cardiomyopathy is a classic but uncommon entity in African women about which there is little etiologic understanding. From January 1990 to March 1996 a series of 30 cases of peripartum cardiomyopathy was collected at the Principal Hospital in Dakar, Senegal. Peripartum cardiomyopathy was defined as the occurrence of cardiac insufficiency in a woman with no previous history of heart disease, during the period between the second and twentieth weeks after delivery confirmed by ultrasound evidence of dilated cardiomyopathy.

[Annulo-aortic ectasia syndrome apropos of 4 cases].

The authors present four cases of annuloaortic ectasia recently observed in Dakar Principal Hospital; two cases are MARFAN's syndrome, one is complicated by aortic dissection. Third cause of aortic regurgitation, this disease must be diagnosed early on account of its bad prognosis with the risk of the dissection of the aorta and issue to cardiac insufficiency. The diagnosis is more often affirmed by transthoracic echocardiography.

[Lyme's disease, a possible cause of isolated acute myocarditis].

The frequency of cardiac lesion in patients with other signs of Lyme disease has been estimated at 8 percent. The usual manifestation of myocardial involvement is a varying degree of atrioventricular block or more diffuse signs of myocarditis. Autopsy or intramyocardial biopsy provides a histological diagnosis of myocarditis.

[Geographical distribution and pathogenesis of chronic calcifying pancreatitis in tropical zones. Results of a multicenter survey in French-speaking Black Africa].

Chronic calcifying pancreatitis (CCP) is rare in countries with low alcohol consumption except in some tropical countries where malnutrition is widespread (southwest India) and in which CCP occurs in young non-alcoholics. In Black Africa sporadic cases of CCP have been reported in English-speaking countries (Uganda, Nigeria). The purpose of this study was to: a) assess the geographical distribution of CCP in French-speaking Africa; b) estimate the relative proportion of alcoholic CCP (ACCP) and juvenile tropical pancreatitis (JCCP).