Disability and perceived stress in primary care patients with major depression.

Background: Major depressive disorder (MDD) is highly prevalent in the Spanish primary care (PC) setting and the leading cause of disability in Spain. The aim of this study was to evaluate several key psychometric properties of the Sheehan Disability Scale (SDS) in patients with or without MDD and varying degrees of symptom severity using the Patient Health Questionnaire-9 (PHQ-9).

Method: A total of 1,704 PC patients participating in the PsicAP clinical trial completed the SDS and PHQ-9.

Clinical, ultrasonographic, and pathologic characteristics of patients with chronic right-lower-quadrant abdominal pain that may benefit from appendectomy.

Background: Chronic pains of the right lower quadrant of the abdomen (RLQA) remain a challenging problem worldwide, especially in areas with limited technical background; chronic appendicitis is still a subject of controversy. The aim of this study was to analyze the clinical and paraclinical data of patients with chronic pains of RLQA who had an appendectomy performed.

Methods: During a period of 4 years, all patients presenting with a chronic pain of the RLQA were selected for our study and underwent clinical assessment and systematic ultrasonography of the abdomen; these served as a basis of selecting candidates for appendectomy.

[Analysis of operative indications and outcomes in 238 re-operations after abdominal surgery in an economically disadvantaged setting].

Aim Of The Study: We analyse aspects of re-operative abdominal surgery in an economically disadvantaged environment with respect to indications, operative findings, treatment modalities, and outcomes.

Patients And Methods: Retrospective chart review over a seven-year period of patients requiring re-operative surgery during the same hospitalization or within 30 days of initial surgery.

Results: During the study period, 7714 laparotomies were performed.

Retained sponge after abdominal surgery: experience from a third world country.

Background: Retained abdominal sponge after surgery is a quite rare condition which can have heavy medico-legal consequences; its frequency is generally underestimated. Few reports of these conditions are available in African environment with specific technical and medico-legal background. We present our local experience of retained sponges after abdominal surgery and review current literature.

[Acute abdomens of parasitic origin: retrospective analysis of 135 cases].

Objective: To assess acute abdomens incidence of parasitic origin at Yaounde (Cameroon) and evaluate their different management modalities.

Materials And Methods: Retrospective study from January 1973 to December 2002 of patients managed at Department of Surgery, Central Hospital, Yaounde (Cameroon).

Results: Among 3464 acute abdomens managed by laparotomy during this period, 135 patients (3.

Incidence, case-fatality rate and clinical pattern of firearm injuries in two cities where arm owning is forbidden.

Objective: To review firearm injuries in five hospitals of Douala and Yaounde, both towns of Cameroon, a Sub-Saharan African country where ownership of firearm is forbidden.

Methods: This was a retrospective investigation carried out within the period January 1998 to December 2002. Records of the mortuaries, the emergency departments, the intensive care units, the operating rooms and the surgical units were all analysed to identify any injury caused by firearm.

[Traumatic jejuno-ileal ruptures: apropos of 18 cases at the Central Hospital of Yaounde].

Eighteen blunt small bowel traumas were reviewed in this retrospective study (1986-1996) concerning 12.8% of laparotomies for blunt abdominal trauma. The clinical presentation at admission was peritonitis (9 cases) or hemoperitoneum (4 cases) whereas 5 cases were diagnosed lately because of non specific signs at the beginning.

[Blunt trauma of the liver. An analysis of a series of 29 cases].

Twenty nine patients with blunt liver trauma were recorded in the Central Hospital of Yaounde between 1986 and 1996. The average age was 23.4 years, with the 20 to 25 and 5 to 15 age groups being the most affected.

[Developing cancer from a probable misdiagnosed pancreatic cystadenoma].

This paper reports the malignant transformation of a benign pancreatic cyst treated by internal drainage in a 30-year-old woman. The initial lesion was diagnosed on surgical biopsy of the cyst wall. The diagnosis of pancreatic carcinoma was made after one year of satisfactory course, by fine needle cytologic aspiration of the fibrous retraction of the cyst; at that time the patient had severe pancreatic pain with multinodular liver on ultrasonography.

[Liver trauma: analysis of 42 cases in Yaounde].

Forty-two cases of liver trauma were reviewed at the Central Hospital of Yaounde between 1984 and 1994. The mean patient age was 22 years, the most commonly involved age group being between 20 and 35 years. Trauma was blunt in 24 cases (57.

[A rare complication of inguinal hernia. Evisceration by rupture of the scrotum secondary to blunt trauma of the abdomen].

The authors present a case report of scrotal rupture with evisceration from abdominal contusion in a patient with a voluminous inguino-scrotal hernia. The mechanism and treatment of lesions are discussed.

[Primary abscess of the psoas. A common disease in tropical countries. Apropos of 87 cases].

Over a 4 years period, 87 cases of primary abscesses of the psoas were treated surgically at the Central Hospital in Yaoundé. The psoas muscle was involved in 10.17% of the cases with myositis.

[Ano-rectal injuries in civilian practice in Cameroon. 10 case reports].

At the Central Hospital of Yaoundé, Cameroon, 10 ano-rectal injuries were treated over a period of 5 years. There were the same number of men and women and all patients were young (range: 7 to 35 years). The cause was illegal abortion in 2 cases and impalement following a fall from a tree in 3.

[Typhoid perforations: experiences in a surgical setting in Cameroon. Apropos of 49 cases].

Over a period of 3 years, 49 typhoid perforations of the small intestine were treated at Yaoundé Central Hospital. These 34 men and 15 women with a mean age of 29.6 years presented sthenic peritonitis in 20 cases and more difficult to diagnose asthenic peritonitis in 29 cases.

[Diagnostic problems apropos of 2 clinical cases of lumbar Pott's disease].

Two cases of POTT's disease without radiological osteoarticular destructions have been diagnosed from a psoas and a dorsal abscess. Bacteriology and histology were negative at the beginning, then became positive after a long evolution of the wound. The recommendation is to think of POTT's disease when confronted with any paravertebral abscess, with or without radiological signs and to repeat the bacteriological and histological tests if necessary.

[Malaria and post operative fever in the University Hospital Center of Yaounde (Cameroon)].

This study from a series of 80 patients showed that the prevalence rate of malaria increased from 8% before to 15% after surgery in the tropics. The difference was not significant (p < 0.05).

[Hepatocellular adenoma with a high level of alpha fetoprotein. Apropos of a case observed in the Central hospital of Yaoundé, Cameroon].

The authors report a case of a young girl aged 23 years, suffering from hepato-cellular adenoma associated with a high level of alpha-foeto-protein. The patient after having been operated recovers and the level of alpha-foeto-protein returns to normal.

[Short-duration fatty meal loading for the assessment of intestinal malabsorption syndromes in children: preliminary study].

The determination of fecal fat gives a reliable index for studying fat intestinal absorption in children, but requires the collection of whole day stools for 3 consecutive days. To avoid stool collection constraint, the authors implemented a 3-point short-duration fatty meal test with determination of subsequent increase in serum levels of triglycerides and chylomicrons which then were compared to fasting values. Normal values were determined among control healthy children.

[Obstructive jaundice in Yaounde. Value of echography and transhepatic cholangiography in determining the cause].

The purpose of the study was to assess the clinical value of ultrasonography (US) and percutaneous transhepatic cholangiography (PTC) in the workup of obstructive jaundice in Yaoundé. From 3,000 ultrasonographic studies done between September 1987 and February 1990, the authors drew 37 cases of obstructive jaundice. 22 of them were explored with both US and PTC.

[Peritoneal tuberculosis. Apropos of 5 cases of acute abdomen recently operated at the Central Hospital of Yaoundé].

Tuberculosis has become a rare disease in developed countries. However, this is not the same in Third World countries where the prevalence rate is 20 to 50 times greater. The abdominal forms are relatively rare, but should also be looked for, because surgery, which would show the affection of more than one organ, permits the revelations of tuberculous granulomas, and also permits a more specific treatment of these patients.