Apport de la radiographie panoramique au diagnostic de la pathologie dentaire non traumatique : a propos de 81 cas

By this prospective survey of 6 months (April to October 2007), realized in the Dento maxillo facial Department of CHU Campus of Lomé, concerning 81 patients having benefited a dental panoramic x-ray, we want to determine the affections that the dental panoramic x-ray permits to put in evidence and to value its diagnostic contribution. On the epidemiological plan, we notice out of our survey a predominance of women (58%) and the age of our patients varied between 6 and 76 years. The most affected age group is located between 28 and 39 years. On the clinic plan, the pain (30.80%) and the swelling (16%) were the most frequent signs. On the radiological plan, a variety of lesions has been detected: the infectious lesions (32.10%) of which most representative were the perish-radicular infections (19.75%), the tumoral lesions (28.39%) of which most representative were the apico-dental cysts (18.52%), and the malformative lesions (27.16%) dominated by the dental malpositions (19.75%). At the term of this survey, it comes out again that a good equipment of the Dento maxillo facial Department in panoramic x-ray material, would permit to improve the quality of the diagnosis for a better handling of the patients. Par cette étude prospective de 6 mois (avril à octobre 2007) au service d’odontostomatologie du CHU campus de Lomé concernant 81 patients ayant bénéficié d’une radiographie panoramique dentaire, nousvoulons déterminer les affections que l’orthopantomogramme permet de mettre en évidence et évaluer son apport diagnostique.Au plan épidémiologique, une prédominance féminine (58%) se dégage de notre étude et l’âge de nos patients a varié entre 6 et 76 ans. La tranche d’âge la plus affectée se situe entre 28 et 39 ans.Sur le plan clinique, la douleur (30,80%) et la tuméfaction (16%) ont été les signes les plus fréquents. Au plan radiologique, une variété de lésions ont été mises en évidence : les lésions infectieuses (32,10%)dont les plus représentatives étaient les infections péri-radiculaires (19,75%), les lésions tumorales (28,39%) représentées majoritairement par les kystes apico-dentaires (18,52%), et les lésions malformatives (27,16%) dominées par les malpositions dentaires (19,75%). Au terme de cette étude, il ressort qu’un bon équipement des services d’odontostomatologie en matérielde radiographie panoramique, permettrait d’améliorer la qualité du diagnostic pour une meilleure prise en charge des patients

Predictors of Hospital Mortality and Left Ventricular Function Recovery After Aortic Valve Replacement for Severe and Isolated Aortic Stenosis with Left Ventricular Dysfunction

Objective: The aim of this study was to evaluate postoperative outcomes of AVR for isolated AS with severe left ventricular dysfunction and to identify predictors of hospital mortality and left ventricular function recovery. Methods: This retrospective bicentric study covers over a 15-year period between January 2000 and April 2016, 61 patients with isolated AS and severe left ventricular dysfunction who underwent AVR were enrolled. Results: Mean age was 58.21 plusmn 12.50 years. 70.5% of patients were in NYHA class III or IV. The mean left ventricular ejection fraction (LVEF) was 32.9 plusmn 5.6%, and the mean EuroSCORE was 12.20 plusmn 4.50. The hospital mortality was 11.50%. Multivariate logistic regression analysis found renal failure (OR = 8.98, CI [1.64 48.70], p = 0.03) and congestive heart failure (OR = 10.90, CI [2.4 59.83], p lt0.001) as related to the risk of hospital mortality. The median follow-up time was 38 [21 84] months. Late mortality was 7.7% due to non cardiovascular causes in all cases. The functional status and LVEF were significantly improved. In the multivariate analysis early postoperative LVEF (OR, 0.44 CI [0.14 0.75] p=0.006) and transprosthetic gradient (OR, -0.72 CI, [-1.42 -0.02] p=0.04) influence long term LVEF. Conclusions: Despite a high rate of hospital mortality, long term outcome of AVR for severe and isolated AS with left ventricular dysfunction is excellent. Preoperative renal failure and congestive heart failure are predictors of hospital mortality. Early postoperative LVEF and transprosthetic gradient influence left ventricular function recovery