Cardiovascular Disorders in Cirrhosis at the Brazzaville Teaching Hospital in 2022

Cirrhosis is a liver disease that can lead to cardiovascular lesions that are often asymptomatic but potentially fatal. Objective: The aim of this study was to evaluate electrical and echographic cardiovascular abnormalities during cirrhosis at the Brazzaville University Hospital. Patients and Methods: We conducted a cross-sectional analytical study over a 2-year period at the Brazzaville Universitary Hospital. Cirrhotic patients at least 18 years of age who had undergone electrocardiogram and echocardiography were included. Patients with cardiac cirrhosis, hepatocellular carcinoma or spontaneous bacterial peritonitis were excluded. The outcome variables were cardiac electrical and echographic abnormalities. Data were analyzed using Epi info 7.2 software. Pearson’s chi-square, Fisher’s exact and Student’s exact tests were used to compare proportions and means at a significance level of 0.05. Results: A total of 76 cirrhotic patients were recruited out of 186 patients, i.e. 40.9% of cirrhotic patients. There were 48 men and 28 women, for a sex ratio of 1.7. The median age was 56 (IQR 41.5 - 69.0). QTc prolongation, microvoltage and sinus tachycardia were the most frequent electrical disorders, respectively in 19 (29.7%), 11 (17.2%) and 11 (17.2%) cases. Electrical disorders were statistically related to cirrhosis stage (p = 0.0364). The most frequent ultrasound disorders were left ventricular systolic failure 11 (28.9%) and dilated cardiomyopathy 8 (21.1%). Seven (9.2%) patients had high pulmonary arterial pressure. Death, observed in 12 cases (15.8%), was statistically linked to the presence of echocardiographic disorders (p = 0.0089) and congestive heart failure (p = 0.0001). Conclusion: The search for cardiac disorders should be systematic during decompensated cirrhosis to detect potentially fatal abnormalities.

Profile of patients with pancreatic cancer and diabetes mellitus at the University Hospital of Brazzaville

Introduction: pancreatic cancer a poor prognosis disease for which there is no screening. Its association with diabetes is not uncommon and may influence the evolutionary profile. The aim of this study was to describe the profile of diabetic patients who could benefit from pancreatic cancer screening. Methods: we conducted a retrospective cross-sectional study in the gastroenterology department of the University Hospital of Brazzaville, from January 2010 to December 2019. Epidemiological variables (age, sex, alcoholism, smoking), tumor variables (symptoms, site, size, density, extension) and time of occurrence of both entities were analyzed using Epi info software. Results: A total of 35 patients were hospitalized for pancreatic cancer, of whom 17 were men and 15 women, for a sex ratio of 1.21. The mean age of the patients was 60.3 ± 13 years. Fifteen patients (43.75%) were diabetic, all classified as type 2. Among them, the diagnosis of diabetes of 10 patients (66.7%) preceded pancreatic cancer diagnosis and delay between the two pathologies was on average 3.4 years ± 5.3 months. Diabetes was observed in 11 patients older than 60 years. The difference was significant (OR = 4.8;95% CI [1.1 - 22.8];p = 0.0226). The other epidemiological variables studied were not related to the two pathologies. Conclusion: we propose a screening for pancreatic cancer when diabetes is discovered to patients from 60 years old, whatever their sex, especially during the first 3 years after the discovery of diabetes.