Background: Venous thromboembolic disease (VTE) is a clinical entity whose two clinical manifestations are deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a frequent and severe disease in Cameroon, thus ...Background: Venous thromboembolic disease (VTE) is a clinical entity whose two clinical manifestations are deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a frequent and severe disease in Cameroon, thus constituting a significant public health problem. We aimed to describe VTE management in the Yaoundé Emergency Center, in particular the use of thrombolysis. Methods: This was a retrospective study on patients hospitalized at the Yaoundé Emergency Center for DVT and/or PE from January 1, 2015, to December 31, 2020. We collected clinical signs, paraclinical signs, risk factors of VTE, and management methods from each patient. Results: We recruited 106 participants. Dyspnea was the most frequent symptom;PE was the most common form of VTE in eight patients on 10. Obesity and high blood pressure were the main cardiovascular risk factors. The main clinical signs were oedema and pain in the limb for DVT, dyspnea, and tachycardia for PE. Heparinotherapy was the most commonly used management modality. Thrombolysis was performed in 7.5% of participants, especially in the case of hypotension or massive PE. Conclusion: In VTE management, thrombolysis remains the least used therapeutic modality in our context. Heparinotherapy remains the basis of the therapy.展开更多
<strong>Background:</strong><span style="white-space:normal;font-family:;" "=""> Various thyroid abnormalities have been reported during heart failure (HF). The present ...<strong>Background:</strong><span style="white-space:normal;font-family:;" "=""> Various thyroid abnormalities have been reported during heart failure (HF). The present study aimed to evaluate the burden, type, and associated factors of thyroid disorders in Cameroonian patients with heart failure. <b>Materials and Methods:</b> We conducted a cross-sectional study from January to May 2020, involving volunteer adults followed for heart failure at the Yaoundé Central Hospital. Those receiving treatment that could cause thyroid dysfunction were excluded. Thyroid hormone levels (TSH, free T3, and free T4) were measured by enzyme-linked immunosorbent assay. <b>Results: </b>A total of 63 patients (30 women;47.6%) were included. The median age was 65 (IQR: 56 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 70) years. The main etiology of heart failure was hypertension</span><span style="white-space:normal;font-family:;" "=""> (52.4%) followed by valvular heart disease (14.3%). Thyroid dysfunction was seen in 38 (60.3%, [95% CI: 47.2 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 72.4]) patients, of which 30 (79%) had hypothyroidism and 8 (21%) had hyperthyroidism. The most frequent thyroid dysfunction was Low T3 syndrome in 27% (95% CI: 16.6 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 39.7) of the study population followed sub-clinical hypothyroidism in 19.1% (95% CI: 10.3 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 30.9) of patients. Patients with HF and reduced ejection fraction (HFrEF) were more likely to have hypothyroidism than those with preserved ejection fraction (OR: 3.5, [95% CI: 1.2 - 9.9], p = 0.016). Also, patients with more than one hospital admission in the past 12 months were more likely to have hypothyroidism (OR: 5.3, [95% CI: 1.3 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 21.5], p = 0.013). <b>Conclusion: </b>The burden of thyroid dysfunction was high in this group of patients with HF. These were mainly low T3 syndrome and sub-clinical hypothyroidism. These were associated with heart failure with reduced ejection fraction and those with more than one hospitalization within the past 12-months</span><span style="white-space:normal;font-family:;" "="">.</span>展开更多
Management of thromboembolic disease in an acute bleeding circumstance like haemorrhagic stroke is a real challenge in low-income settings. We report a case of a 37-year-old woman who was treated in the neurologic ser...Management of thromboembolic disease in an acute bleeding circumstance like haemorrhagic stroke is a real challenge in low-income settings. We report a case of a 37-year-old woman who was treated in the neurologic service for a haemorrhagic stroke that occurred one week after a caesarean section. Six weeks after her discharge, she presented signs of bilateral deep vein thrombosis and pulmonary embolism confirmed by venous Doppler ultrasound and a thoracic angiography respectively. Transthoracic cardiac ultrasound showed right ventricular dysfunction with a clot in the right atrium. Considering the high risk of complications due to anticoagulant treatment, surgical treatment and a vena cava filter were proposed. But it could not be performed because it was not accessible. After a multidisciplinary consultation meeting and informed consent of the patient, anticoagulant treatment was the preferred expectation. Three weeks after the beginning of the anticoagulant therapy, the evolution was favourable, and the patient was discharged.展开更多
文摘Background: Venous thromboembolic disease (VTE) is a clinical entity whose two clinical manifestations are deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a frequent and severe disease in Cameroon, thus constituting a significant public health problem. We aimed to describe VTE management in the Yaoundé Emergency Center, in particular the use of thrombolysis. Methods: This was a retrospective study on patients hospitalized at the Yaoundé Emergency Center for DVT and/or PE from January 1, 2015, to December 31, 2020. We collected clinical signs, paraclinical signs, risk factors of VTE, and management methods from each patient. Results: We recruited 106 participants. Dyspnea was the most frequent symptom;PE was the most common form of VTE in eight patients on 10. Obesity and high blood pressure were the main cardiovascular risk factors. The main clinical signs were oedema and pain in the limb for DVT, dyspnea, and tachycardia for PE. Heparinotherapy was the most commonly used management modality. Thrombolysis was performed in 7.5% of participants, especially in the case of hypotension or massive PE. Conclusion: In VTE management, thrombolysis remains the least used therapeutic modality in our context. Heparinotherapy remains the basis of the therapy.
文摘<strong>Background:</strong><span style="white-space:normal;font-family:;" "=""> Various thyroid abnormalities have been reported during heart failure (HF). The present study aimed to evaluate the burden, type, and associated factors of thyroid disorders in Cameroonian patients with heart failure. <b>Materials and Methods:</b> We conducted a cross-sectional study from January to May 2020, involving volunteer adults followed for heart failure at the Yaoundé Central Hospital. Those receiving treatment that could cause thyroid dysfunction were excluded. Thyroid hormone levels (TSH, free T3, and free T4) were measured by enzyme-linked immunosorbent assay. <b>Results: </b>A total of 63 patients (30 women;47.6%) were included. The median age was 65 (IQR: 56 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 70) years. The main etiology of heart failure was hypertension</span><span style="white-space:normal;font-family:;" "=""> (52.4%) followed by valvular heart disease (14.3%). Thyroid dysfunction was seen in 38 (60.3%, [95% CI: 47.2 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 72.4]) patients, of which 30 (79%) had hypothyroidism and 8 (21%) had hyperthyroidism. The most frequent thyroid dysfunction was Low T3 syndrome in 27% (95% CI: 16.6 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 39.7) of the study population followed sub-clinical hypothyroidism in 19.1% (95% CI: 10.3 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 30.9) of patients. Patients with HF and reduced ejection fraction (HFrEF) were more likely to have hypothyroidism than those with preserved ejection fraction (OR: 3.5, [95% CI: 1.2 - 9.9], p = 0.016). Also, patients with more than one hospital admission in the past 12 months were more likely to have hypothyroidism (OR: 5.3, [95% CI: 1.3 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 21.5], p = 0.013). <b>Conclusion: </b>The burden of thyroid dysfunction was high in this group of patients with HF. These were mainly low T3 syndrome and sub-clinical hypothyroidism. These were associated with heart failure with reduced ejection fraction and those with more than one hospitalization within the past 12-months</span><span style="white-space:normal;font-family:;" "="">.</span>
文摘Management of thromboembolic disease in an acute bleeding circumstance like haemorrhagic stroke is a real challenge in low-income settings. We report a case of a 37-year-old woman who was treated in the neurologic service for a haemorrhagic stroke that occurred one week after a caesarean section. Six weeks after her discharge, she presented signs of bilateral deep vein thrombosis and pulmonary embolism confirmed by venous Doppler ultrasound and a thoracic angiography respectively. Transthoracic cardiac ultrasound showed right ventricular dysfunction with a clot in the right atrium. Considering the high risk of complications due to anticoagulant treatment, surgical treatment and a vena cava filter were proposed. But it could not be performed because it was not accessible. After a multidisciplinary consultation meeting and informed consent of the patient, anticoagulant treatment was the preferred expectation. Three weeks after the beginning of the anticoagulant therapy, the evolution was favourable, and the patient was discharged.