Aspects Èpidémiologiques et Cliniques des Cervicalgies non Traumatiques en Consultation de Rhumatologie à Bouaké

Objectif : Etudier les caractéristiques épidémiologiques et diagnostiques des cervicalgies non traumatiques (CNT) chez une population noire d’Afrique sub-saharienne. Patients et méthodes : Etude rétrospective descriptive sur une période de six ans, de Janvier 2014 à Décembre 2019 portant sur les patients vus pour une CNT en consultation de rhumatologie à Bouaké en Côte d’ Ivoire. Résultats : Sur 4036 patients vus pour une affection rhumatologique, 130 avaient une CNT soit une fréquence de 3,2%. L’âge moyen des patients était de 54,03 ± 13,71 ans et le sex ratio de 0,8. Le groupe d’âge de 40 à 70 ans représentait 74,6 % des patients (97 cas). Les patients consultaient surtout pour une forte douleur à début progressif (56,2%), d’évolution chronique (63,9%), et une monoparésie brachiale était observée dans quatre cas (3,1%). Il s’agissait surtout d’une cervicalgie isolée (63,1%), parfois associée à une névralgie cervico-brachiale (9,2%), à une rachialgie dorsolombaire (18,5%) ou à une arthralgie périphérique (9,2%). La radiographie standard (94,6%) était l’imagerie la plus prescrite. Les diagnostics retenus étaient la cervicalgie commune (87,7%), la polyarthrite rhumatoïde (4,6%), le mal de Pott (3,1%), une métastase de cancer de la prostate (1,5%), et le myélome multiple (3,1%). Soixante-douze patients (55,4%) avaient entrepris une automédication avant la consultation avec des anti-inflammatoires dans 43,1% des cas et des antibiotiques dans 4,2%. Conclusion : La CNT n’est pas rare en consultation rhumatologique à Bouaké. Elle touche surtout les patients entre 40 et 70 ans et les femmes sont les plus concernées. La cervicalgie commune est le diagnostic le plus fréquent.   Objective: To study the epidemiological and diagnostic features of non-traumatic neck pain in a black sub-Saharan African population. Patients and methods: Retrospective descriptive study over a six-year period, from January 2014 to December 2019 covering patients seen for non-traumatic neck pain in rheumatology consultation in Bouaké, Côte d' Ivoire. Results: Of 4036 patients seen for a rheumatological condition, 130 had non-traumatic neck pain, a frequency of 3.2%. The mean age of patients was 54.03 ± 13.71 years, and the sex ratio was 0.8.  The 40-70 age group accounted for 74.6% of patients (97 cases). Patients mainly consulted for severe pain with progressive onset (56.2%), chronic evolution (63.9%), and brachial monoparesis was observed in four cases (3.1%). The pain was mainly isolated cervicalgia (63.1%), sometimes associated with cervicobrachial neuralgia (9.2%), dorsolumbar spinalgia (18.5%) or peripheral arthralgia (9.2%). Standard radiography (94.6%) was the most frequently prescribed imaging technique. The most common diagnoses were common neck pain (87.7%), rheumatoid arthritis (4.6%), Pott's disease (3.1%), prostatic metastasis (1.5%), and multiple myeloma (3.1%). Seventy-two patients (55.4%) had undertaken self-medication prior to consultation, with non-steroidal anti-inflammatory drugs in 43.1% of cases and antibiotics in 4.2%. Conclusion: Non-traumatic neck pain is not uncommon in rheumatology consultations in Bouaké. It mainly affects patients between 40 and 70 years of age, and women are most affected. Common cervicalgia is the most frequent diagnosis

Caractéristiques Epidémiologiques et Cliniques des Cervicalgies non Traumatiques en Consultation Rhumatologique dans la Ville de Bouaké, Côte d’ivoire

Objectif : Etudier les caractéristiques épidémiologiques et diagnostiques des cervicalgies non traumatiques chez une population noire d’Afrique sub-saharienne. Patients et méthodes :            Etude rétrospective descriptive sur une période de six ans, de Janvier 2014 à Décembre 2019 portant sur les patients vus pour une cervicalgie non traumatique en consultation de rhumatologie à Bouaké en Côte d’Ivoire.  Résultats : Sur 4036 patients vus pour une affection rhumatologique, 130 avaient une cervicalgie non traumatique soit une fréquence de 3,2%. L’âge moyen des patients était de 54,03 ± 13,71 ans et le sex ratio de 0,8. Le groupe d’âge de 40 à 70 ans représentait 74,6 % des patients (97 cas). Les patients consultaient surtout pour une forte douleur à début progressif (56,2%), d’évolution chronique (63,9%), et une monoparésie brachiale était observée dans quatre cas (3,1%). Il s’agissait surtout d’une cervicalgie isolée (63,1%), parfois associée à une névralgie cervico-brachiale (9,2%), à une rachialgie dorsolombaire (18,5%) ou à une arthralgie périphérique (9,2%). La radiographie standard (94,6%) était l’imagerie la plus prescrite. Les diagnostics retenus étaient la cervicalgie commune (87,7%), la polyarthrite rhumatoïde (4,6%), le mal de Pott (3,1%), une métastase de cancer de la prostate (1,5%), et le myélome multiple (3,1%). Soixante-douze patients (55,4%) avaient entrepris une automédication avant la consultation avec des anti-inflammatoires dans 43,1% des cas et des antibiotiques dans 4,2%. Conclusion : La cervicalgie non traumatique n’est pas rare en consultation rhumatologique à Bouaké. Elle touche surtout les patients entre 40 et 70 ans et les femmes sont les plus concernées. La cervicalgie commune est le diagnostic le plus fréquent   Objective: To study the epidemiological and diagnostic features of non-traumatic neck pain in a black sub-Saharan African population. Patients and methods: Retrospective descriptive study over a six-year period, from January 2014 to December 2019 covering patients seen for non-traumatic neck pain in rheumatology consultation in Bouaké, Côte d' Ivoire.Results: Of 4036 patients seen for a rheumatological condition, 130 had non-traumatic neck pain, a frequency of 3.2%. The mean age of patients was 54.03 ± 13.71 years, and the sex ratio was 0.8.  The 40-70 age group accounted for 74.6% of patients (97 cases). Patients mainly consulted for severe pain with progressive onset (56.2%), chronic evolution (63.9%), and brachial monoparesis was observed in four cases (3.1%). The pain was mainly isolated cervicalgia (63.1%), sometimes associated with cervicobrachial neuralgia (9.2%), dorsolumbar spinalgia (18.5%) or peripheral arthralgia (9.2%). Standard radiography (94.6%) was the most frequently prescribed imaging technique. The most common diagnoses were common neck pain (87.7%), rheumatoid arthritis (4.6%), Pott's disease (3.1%), prostatic metastasis (1.5%), and multiple myeloma (3.1%). Seventy-two patients (55.4%) had undertaken self-medication prior to consultation, with non-steroidal anti-inflammatory drugs in 43.1% of cases and antibiotics in 4.2%. Conclusion: Non-traumatic neck pain is not uncommon in rheumatology consultations in Bouaké. It mainly affects patients between 40 and 70 years of age, and women are most affected. Common cervicalgia is the most frequent diagnosis

Aspects Èpidémiologiques et Cliniques des Cervicalgies non Traumatiques en Consultation de Rhumatologie à Bouaké

Objectif : Etudier les caractéristiques épidémiologiques et diagnostiques des cervicalgies non traumatiques (CNT) chez une population noire d’Afrique sub-saharienne. Patients et méthodes : Etude rétrospective descriptive sur une période de six ans, de Janvier 2014 à Décembre 2019 portant sur les patients vus pour une CNT en consultation de rhumatologie à Bouaké en Côte d’ Ivoire. Résultats : Sur 4036 patients vus pour une affection rhumatologique, 130 avaient une CNT soit une fréquence de 3,2%. L’âge moyen des patients était de 54,03 ± 13,71 ans et le sex ratio de 0,8. Le groupe d’âge de 40 à 70 ans représentait 74,6 % des patients (97 cas). Les patients consultaient surtout pour une forte douleur à début progressif (56,2%), d’évolution chronique (63,9%), et une monoparésie brachiale était observée dans quatre cas (3,1%). Il s’agissait surtout d’une cervicalgie isolée (63,1%), parfois associée à une névralgie cervico-brachiale (9,2%), à une rachialgie dorsolombaire (18,5%) ou à une arthralgie périphérique (9,2%). La radiographie standard (94,6%) était l’imagerie la plus prescrite. Les diagnostics retenus étaient la cervicalgie commune (87,7%), la polyarthrite rhumatoïde (4,6%), le mal de Pott (3,1%), une métastase de cancer de la prostate (1,5%), et le myélome multiple (3,1%). Soixante-douze patients (55,4%) avaient entrepris une automédication avant la consultation avec des anti-inflammatoires dans 43,1% des cas et des antibiotiques dans 4,2%. Conclusion : La CNT n’est pas rare en consultation rhumatologique à Bouaké. Elle touche surtout les patients entre 40 et 70 ans et les femmes sont les plus concernées. La cervicalgie commune est le diagnostic le plus fréquent.   Objective: To study the epidemiological and diagnostic features of non-traumatic neck pain in a black sub-Saharan African population. Patients and methods: Retrospective descriptive study over a six-year period, from January 2014 to December 2019 covering patients seen for non-traumatic neck pain in rheumatology consultation in Bouaké, Côte d' Ivoire. Results: Of 4036 patients seen for a rheumatological condition, 130 had non-traumatic neck pain, a frequency of 3.2%. The mean age of patients was 54.03 ± 13.71 years, and the sex ratio was 0.8.  The 40-70 age group accounted for 74.6% of patients (97 cases). Patients mainly consulted for severe pain with progressive onset (56.2%), chronic evolution (63.9%), and brachial monoparesis was observed in four cases (3.1%). The pain was mainly isolated cervicalgia (63.1%), sometimes associated with cervicobrachial neuralgia (9.2%), dorsolumbar spinalgia (18.5%) or peripheral arthralgia (9.2%). Standard radiography (94.6%) was the most frequently prescribed imaging technique. The most common diagnoses were common neck pain (87.7%), rheumatoid arthritis (4.6%), Pott's disease (3.1%), prostatic metastasis (1.5%), and multiple myeloma (3.1%). Seventy-two patients (55.4%) had undertaken self-medication prior to consultation, with non-steroidal anti-inflammatory drugs in 43.1% of cases and antibiotics in 4.2%. Conclusion: Non-traumatic neck pain is not uncommon in rheumatology consultations in Bouaké. It mainly affects patients between 40 and 70 years of age, and women are most affected. Common cervicalgia is the most frequent diagnosis

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Articular manifestations in primary Sjögren's syndrome: clinical significance and prognosis of 188 patients.

International audienceOBJECTIVES: Articular manifestations (AMs) occurred in approximately 30-60% of patients with primary SS (pSS). We conducted the current study to describe clinical presentation, specific treatment and to report clinical outcome of pSS patients with AM in a large bicentric French cohort. METHODS: Clinical, biological and immunological features of 419 consecutive patients with pSS were recorded in order to describe the clinical and immunological course of pSS AM and to point out the impact of those rheumatological features on pSS evolution. RESULTS: A total of 188 patients with pSS (172 women, 16 men) exhibited AM. They preceded sicca symptoms in 32, were simultaneous to pSS diagnosis in 98 and followed diagnosis in 59 patients. Clinical presentation was polyarticular and concerned mostly peripheral joints (synovitis, n = 66). Symptoms responded readily to symptomatic treatment in 45 cases (24%). DMARDs or immunosuppressive treatments were introduced in 133 patients: HCQ (n = 111), corticosteroid (n = 53), MTX (n = 12), SSZ (n = 6), AZA (n = 3), LEF (n = 1), etanercept (n = 1) and allochrysine (n = 1). Only one case of RA was diagnosed during the evolution. Statistical analysis identified clinical and biological factors associated with AM (P < or = 0.05): RP, muscular manifestations, renal involvement, peripheral neuropathy, cutaneous vasculitis, and positivity of RF, anti-SSB antibodies and cryoglobulinaemia. Patients with AM at diagnosis were characterized by a multisystemic involvement at the end of the follow-up period (P < 0.001). CONCLUSION: Although AMs are frequent and usually mild in pSS, these manifestations are associated with a pluri-systemic involvement of pSS

Full-factor GLMM Output for VK5 <i>An</i>. <i>coluzzii</i>.

Effect of egg development (eggs vs no eggs), oocyst number, and their interactions on oocyst size. In this model, egg development and oocyst number were considered as fixed effects whereas parasite isolate, mosquito generation, and mosquito ID were set as random effects. Significant effects are in bold. (XLSX)</p

Additional information on <i>P</i>. <i>falciparum</i> isolates.

MSP1-genotyping results for P. falciparum isolates (p1-p6) used in infections with An. gambiae (An. gam), An. coluzzii (An. col), and/or VK5-collected An. coluzzii (VK5-An. col) (See also Methods). (XLSX)</p

Gametocytemia and COI for <i>P</i>. <i>falciparum</i> field isolates.

Gametocytemia and COI for P. falciparum field isolates.</p

Full-factor GLMM Output for <i>An</i>. <i>gambiae</i>.

Effect of treatment (dsGFP vs dsEcR), oocyst number, egg number, and their interactions on oocyst size. In this model, treatment, oocyst number and egg number were considered as fixed effects whereas parasite isolate and mosquito ID were set as random effects. Significant effects are in bold. (XLSX)</p

Oocyst prevalence and intensity for individual infections.

(A-B) The effects of EcR-silencing on the prevalence (Fisher’s Exact) and intensity (unpaired t-test and Mann-Whitney) of oocysts across individual infections for (A) An. coluzzii and (B) An. gambiae, compared to dsGFP-injected (Cntrl) females. P = oocyst prevalence. N = sample size. p# = parasite isolate. (TIF)</p