Strokes are common around the world and especially in sub-Saharan Africa. They are responsible for severe sequelae and the majority of deaths. In Gabon, no study on stroke mortality has been conducted. Objective: To d...Strokes are common around the world and especially in sub-Saharan Africa. They are responsible for severe sequelae and the majority of deaths. In Gabon, no study on stroke mortality has been conducted. Objective: To determine short, medium, long-term mortality and factors associated with long-term stroke mortality. Method: Our study took place in the Neurology Department of the University Hospital Center of Libreville (UHCL). It was a historical cohort study with descriptive and analytical purposes covering the period from June 1 to August 31, 2018 and taking into account hospitalized patients from January 1, 2013 to December 31, 2017. We conducted a comprehensive systematic recruitment of patients with stroke, 18 years old and more, and had been agreed to give information. We included all patients meeting the inclusion criteria. The data was gathered using Epi-Info 7 software. The CHI-2 test was used for the comparison of frequencies and the Student’s test, for comparison of means. Multivariate analysis with logistic regression allowed us to look for factors associated with long-term mortality. A result was statistically significant for a p 0.05 value. Results: At 3 months, 28 patients (18.1%) died, at 6 months thirty-one patients or 20.1% died. At 5 years old, fifty-three patients or 34.4% had died. The factors associated with long-term mortality, if the lost of sight were all alive were tobacco (p = 0.01) and stroke (p = 0.008). If all those who were lost to sight had died, no factor was associated with 5-year mortality. Conclusion: Stroke mortality must not be taken for granted, it can be underestimated because of the large number of lost sight. Measures must be put in place to strengthen post-stroke monitoring. .展开更多
Introduction: Multiple sclerosis is a multifactorial disease, with many factors still unknown to this day. Studies on migrants play a significant role in the epidemiological and etiological research of this condition....Introduction: Multiple sclerosis is a multifactorial disease, with many factors still unknown to this day. Studies on migrants play a significant role in the epidemiological and etiological research of this condition. Objective: This paper aims to study the impact of migration on the risk of developing multiple sclerosis. Methodology: A narrative review of the literature based on 80 articles retrieved from PubMed, Web of Science, Google Scholar, and ScienceDirect databases, using the following keywords: “multiple sclerosis”, “migration”, “migrants,” and “immigrants”, published from 1962 to 2022. Results: This review suggests that migration is a risk factor for multiple sclerosis. It supports the existence of an “age at migration” effect and highlights the particular role of environmental factors. The trend also points to an increased risk for second-generation immigrants compared to initial studies. Conclusion: Concepts regarding migrants and the risk of developing multiple sclerosis have evolved significantly over the past three decades. The older theory that those migrating after age 15 retain the risk of their country of birth is now less widely accepted, especially in cases of migration to high-prevalence regions, as they may influence future disease risk even into adulthood.展开更多
Background: Tolosa Hunt Syndrome is an inflammatory condition of unknown etiology of the cavernous sinus and superior orbital fissure. Because of the difficulty in establishing histological evidence, his diagnosis is ...Background: Tolosa Hunt Syndrome is an inflammatory condition of unknown etiology of the cavernous sinus and superior orbital fissure. Because of the difficulty in establishing histological evidence, his diagnosis is based on a set of arguments established by the International Headache Society. MRI allows indirect visualization of the granuloma and plays a key role in diagnosis and follow-up. Aim: To illustrate High-field MRI contribution in Tolosa-Hunt Syndrome (THS). Cases Presentation: Two patients, a 25-year-old female and a 40-year-old male were recruited in this retrospective case report study at the Radiology service of Fann University Hospital (Dakar Senegal). The first patient has been suffering from a right retro-orbital pain and diplopia for 2 months and the second from a painful oculomotor nerve palsy for 3 months. Blood tests, lumbar puncture, thyroid hormone levels and an infectious screen were done. Screening for converting enzymes, and serum antibodies were also done. They underwent a high field MRI (Siemens 1.5T) with T1, T2, FLAIR, T2*, diffusion B1000, TOF polygon, CISS 3D and T1 gadolinium sequences in the 3 planes space. No significant abnormality was detected in blood tests or CSF analysis. Screening for converting enzymes and serum antibodies screen were also negative. For each patient, MRI examinations showed a non tumoral thickening of the right cavernous sinus, suggesting a granulomatous involvement. Tolosa Hunt Syndrome was evoked firstly. They were put on corticotherapy at high doses with a spectacular regression of symptoms. The Criteria of the International Headache Society of THS were met in both patients. Conclusion: High-field MRI is a significant diagnostic tool in the assessment of painful ophthalmoplegia. It allows a direct visualization of the granuloma of the cavernous sinus and assesses its course throughout the disease.展开更多
文摘Strokes are common around the world and especially in sub-Saharan Africa. They are responsible for severe sequelae and the majority of deaths. In Gabon, no study on stroke mortality has been conducted. Objective: To determine short, medium, long-term mortality and factors associated with long-term stroke mortality. Method: Our study took place in the Neurology Department of the University Hospital Center of Libreville (UHCL). It was a historical cohort study with descriptive and analytical purposes covering the period from June 1 to August 31, 2018 and taking into account hospitalized patients from January 1, 2013 to December 31, 2017. We conducted a comprehensive systematic recruitment of patients with stroke, 18 years old and more, and had been agreed to give information. We included all patients meeting the inclusion criteria. The data was gathered using Epi-Info 7 software. The CHI-2 test was used for the comparison of frequencies and the Student’s test, for comparison of means. Multivariate analysis with logistic regression allowed us to look for factors associated with long-term mortality. A result was statistically significant for a p 0.05 value. Results: At 3 months, 28 patients (18.1%) died, at 6 months thirty-one patients or 20.1% died. At 5 years old, fifty-three patients or 34.4% had died. The factors associated with long-term mortality, if the lost of sight were all alive were tobacco (p = 0.01) and stroke (p = 0.008). If all those who were lost to sight had died, no factor was associated with 5-year mortality. Conclusion: Stroke mortality must not be taken for granted, it can be underestimated because of the large number of lost sight. Measures must be put in place to strengthen post-stroke monitoring. .
文摘Introduction: Multiple sclerosis is a multifactorial disease, with many factors still unknown to this day. Studies on migrants play a significant role in the epidemiological and etiological research of this condition. Objective: This paper aims to study the impact of migration on the risk of developing multiple sclerosis. Methodology: A narrative review of the literature based on 80 articles retrieved from PubMed, Web of Science, Google Scholar, and ScienceDirect databases, using the following keywords: “multiple sclerosis”, “migration”, “migrants,” and “immigrants”, published from 1962 to 2022. Results: This review suggests that migration is a risk factor for multiple sclerosis. It supports the existence of an “age at migration” effect and highlights the particular role of environmental factors. The trend also points to an increased risk for second-generation immigrants compared to initial studies. Conclusion: Concepts regarding migrants and the risk of developing multiple sclerosis have evolved significantly over the past three decades. The older theory that those migrating after age 15 retain the risk of their country of birth is now less widely accepted, especially in cases of migration to high-prevalence regions, as they may influence future disease risk even into adulthood.
文摘Background: Tolosa Hunt Syndrome is an inflammatory condition of unknown etiology of the cavernous sinus and superior orbital fissure. Because of the difficulty in establishing histological evidence, his diagnosis is based on a set of arguments established by the International Headache Society. MRI allows indirect visualization of the granuloma and plays a key role in diagnosis and follow-up. Aim: To illustrate High-field MRI contribution in Tolosa-Hunt Syndrome (THS). Cases Presentation: Two patients, a 25-year-old female and a 40-year-old male were recruited in this retrospective case report study at the Radiology service of Fann University Hospital (Dakar Senegal). The first patient has been suffering from a right retro-orbital pain and diplopia for 2 months and the second from a painful oculomotor nerve palsy for 3 months. Blood tests, lumbar puncture, thyroid hormone levels and an infectious screen were done. Screening for converting enzymes, and serum antibodies were also done. They underwent a high field MRI (Siemens 1.5T) with T1, T2, FLAIR, T2*, diffusion B1000, TOF polygon, CISS 3D and T1 gadolinium sequences in the 3 planes space. No significant abnormality was detected in blood tests or CSF analysis. Screening for converting enzymes and serum antibodies screen were also negative. For each patient, MRI examinations showed a non tumoral thickening of the right cavernous sinus, suggesting a granulomatous involvement. Tolosa Hunt Syndrome was evoked firstly. They were put on corticotherapy at high doses with a spectacular regression of symptoms. The Criteria of the International Headache Society of THS were met in both patients. Conclusion: High-field MRI is a significant diagnostic tool in the assessment of painful ophthalmoplegia. It allows a direct visualization of the granuloma of the cavernous sinus and assesses its course throughout the disease.
