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1. Clinical mortality risk factors of variceal upper gastrointestinal bleeding in a Malagasy surgical intensive care unit

Author

Aurélia Rakotondrainibe, Nadia M.P. Rahanitriniaina, Harifetra M.R. Randriamizao, Jasper G. Raelison, Rado M. Ramanampamonjy, Andriambelo T. Rajaonera, and François Sztark

Subjects
Antananarivo, Clinical factors, Intensive care, Mortality, Variceal upper gastrointestinal bleeding, Medicine, Medicine (General), R5-920
Abstract

Background: Variceal upper gastrointestinal bleeding is a dreadful complication of portal hypertension with a significant morbidity and mortality. Different prognostic scores can be used. However, in the local context of Madagascar, the completion of paraclinical investigations can be delayed by the limited financial means of patients. Hence, determining clinical mortality risk factors of variceal upper gastrointestinal bleeding could be interesting. The aim of the study was to evaluate the clinical mortality risk factors of variceal gastrointestinal bleeding (VUGIB). Method: An observational, cohort retrospective study was conducted over an 8-year period (2010–2017), at the surgical intensive care unit of the J.R. Andrianavalona University Hospital, Antananarivo, in patients admitted for VUGIB confirmed by upper gastrointestinal endoscopy and whose clinical examination was performed at admission. The primary endpoint was intensive care unit (ICU) mortality. Univariate analysis and multivariate logistic regression analysis were performed to identify risk factors for ICU mortality, with OR defining odds ratio. A p value 120 bpm (OR = 2.91 [1.04–8.14], p = 0.041), and ascites (OR = 3.80 [1.85–7.81], p

Published
2020
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2. Use of spinal anaesthesia in neonates and infants in Antananarivo, Madagascar: a retrospective descriptive study

Author

Harifetra M. R. Randriamizao, Aurélia Rakotondrainibe, Lova D. E. Razafindrabekoto, Prisca F. Ravoaviarivelo, Andriambelo T. Rajaonera, and Mamy L. Andriamanarivo

Subjects
Spinal anesthesia, Newborns, Infants, Preterm, Ex prematures, Madagascar, Medicine, Biology (General), QH301-705.5, Science (General), Q1-390
Abstract

Abstract Objective The aim of this study was to present the first cases of spinal anesthesia, in newborns and infants, preterm/ex-prematures, in order to determine its feasibility and its potential harmlessness, in Antananarivo—Madagascar. Indeed, spinal anesthesia is a low cost technique and can limit respiratory complications, postoperative apnea a contrario with pediatric general anesthesia which can lead to perioperative risks. Results In a retrospective, descriptive, 7-year (2013 to 2019) period study, conducted in the University Hospital Joseph Ravoahangy Andrianavalona, 69 patients’ data files planned to have spinal anesthesia were recorded. These pediatric patients were predominantly male (sex ratio = 2.8) and 37 [28–52] days old. The smallest anesthetized child weighed 880 g; the youngest was 4 days old. Twenty-seven (27) of them were premature and 20.3% presented respiratory diseases. They were mostly scheduled for hernia repair (90%). Spinal anesthesia was performed, with a Gauge 25 Quincke spinal needle, after 2 [1–2] attempts with hyperbaric bupivacaine of 4 [3.5–4] mg. Failure rate was 5.8%. The heart rate was stable throughout perioperative period and no complications were observed.

Published
2020
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3. Surgical profile of chest penetrating wounds caused by stabbing in a low-income country: about 73 cases

Author

Narindra N.M. RAZAFIMANJATO, Guillaume O. TSIAMBANIZAFY, Manjakaniaina RAVOATRARILANDY, Henri J.C. RAZAFIMAHANDRY, Luc H. SAMISON, Andriambelo T. RAJAONERA, and Hanitrala J.L. RAKOTOVAO

Subjects
chest drainage, penetrating wound, stabbing, thoracotomy, video-thoracoscopy, Medicine, Medicine (General), R5-920
Abstract

Introduction. Penetrating wounds of thorax are frequent and require specific cares. The target of this study is to describe the epidemiological, clinical, therapeutic and progressive aspects of penetrating wounds of thorax by stabbing. Material and methods. This is a retrospective study of 73 patients with thoracic wounds by stabbing hospitalized at the Thoracic Surgery Department of University Hospital Center Joseph Ravoahangy Andrianavalona, Madagascar, from January 01, 2015 to January 31, 2018. Results. The mean age was 31.5 years, with a male predominance (89.04%). Most of the patients were in the tertiary sector (56.16%). Most of the cases were criminal assaults (by an unknown person = 91.78%). The thoracic lesions seen were fluid effusion in 58.9%, mixed in 32.88% and air in 6.85%. The association with limb trauma was the most common (16.44%). Chest drainage was performed in 67.12% of cases, thoracotomy in 1.37%. Evolution was favourable for most of the cases (90.41%). We found complications in 9.59% of the patients. Conclusions. Penetrating thoracic wounds by stabbing are frequent and represent an emergency, but patients often arrive late due to remoteness, financial problems, and neglect of chest wounds.

Published
2020
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4. Evolution postopératoire des patients sous assistance nutritionnelle en chirurgie digestive programmée au Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (2015-2017) [Postoperative evolution of patients undergoing nutritional assistance in digestive surgery programmed at the Joseph Ravoahangy Andrianavalona University Hospital (2015-2017)]

Author

Casimir FP. RAHANTASOA FINARITRA, Aurélia RAKOTONDRAINIBE, Fanjandrainy RASOAHERINOMENJANAHARY, Antsa F RAHAMEFY, Andriambelo T. RAJAONERA, and Luc H. SAMISON

Subjects
Chirurgie digestive, Complications postopératoires, Nutrition. Foods and food supply, TX341-641, Medicine (General), R5-920
Abstract

Résumé Introduction. La dénutrition préopératoire reste un facteur de risque indé-pendant des complications postopératoires, en chirurgie digestive. Une des clés de voûte de cette prise en charge reste l’anticipation de l’assistance nutritionnelle. Objectif. L’objectif était de déterminer le profil évolutif des patients, sous assistance nutrition-nelle (AN), selon la durée de cette dernière, en chirurgie digestive. Matériel et méthodes. Il s’agissait d’une étude observationnelle, rétrospective, mono-centrique de patients, sous assistance nutritionnelle, hospitalisés, en vue d’une chirurgie digestive, au CHU-JRA (2015-2017). L’échantillonnage était exhaustif. Les variables étudiées compre-naient les caractéristiques démographiques, le type et la durée de l’AN, l’indication chirurgicale, l’évolution à court et à moyen terme. Le critère de jugement principal était l’évolution du patient. Le critère de jugement secondaire était la durée de l’AN. Le test de corrélation Spearman a été utilisé, avec une valeur de p < 0,05 considérée comme significative. Résultats. Cinquante deux patients étaient retenus. L’âge médian était de 52,5 [16-82] ans, avec une répartition égale des genres (sex ratio = 0,5). L’AN de longue durée (d’au moins 6 jours) était constatée chez 12 cas (23%), contre 76% (39 cas), pour celle de courte durée (moins de 6 jours). La chirurgie carcinologique représentait 83% des patients sous AN de longue durée. La durée médiane de séjour en réanimation était de 3,5 [1-31] jours, avec une corrélation significative avec la durée de l’AN (R= 0,4 ; p=0,00541). La mortalité postopératoire était de 6% et la morbidité non chirurgicale était de 9% dans un tableau de défaillance respiratoire sévère. onclusion. L'assistance nutritionnelle à court terme, avec une alimentation précoce, a permis de réduire le nombre de complications postopératoires et de réduire la durée du séjour à l'hôpital. Néanmoins, un manque de réapprovisionnement pourrait prédire une com-plication précoce en chirurgie digestive. [Abstract Introduction. Preoperative malnutrition remains an independent risk factor for postoperative complications, in digestive surgery. The nutritional assistance (A) anticipation is primary. Objective. This study aimed to determine the evolutionary profile of patients undergoing NA, and according to its duration, in digestive surgery. Material and Methods. Observational, retrospective, single-center study was conducted on patients undergoing NA, hospitalized for digestive surgery, at CHU-JRA (2015-2017). Sampling was exhaustive. The studied variables included demographic characteristics, type, and NA duration, surgical indication, short- and medium-term outcome. The primary endpoint was the patient evolution. The secondary endpoint was the NA duration. The Spearman correlation test was used, with a p value < 0.05 considered as significant. Results. Fifty-two patients were selected. The median age was 52.5 [16-82] years, with an equal gender distribution (sex ratio = 0.5). Long term NA (at least 6 days) was observed in 12 cases (23%), compared to 76% (39 cases), for the short-term (less than 6 days). Oncological surgery accounted for 83% of long-term nutritional patients. The median duration of stay in ICU was 3.5 [1-31], with a significant correlation with the NA duration (R = 0.4 ; p = 0.00541). Postoperative mortality was 6%, and non surgical morbidity was 9%, in a severe respiratory failure chart. Conclusion. Short term nutritional assistance, with early feeding, results in fewer post-operative complications, and reduced the hospital stay duration. Nevertheless, a failure of replenishment could predict an early complication in digestive surgery.]

Published
2019
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5. [Severity Factors of Pulmonary Aspergilloma in the Surgical Intensive Care Unit of Joseph Ravoahangy Andrianavalona Hospital, Antananarivo, Madagascar]

Author

N N M, Razafimanjato, J M, Rakotoson, M, Ravoatrarilandy, R L, Andrianasolo, A T, Rajaonera, N E, Raveloson, and H J L, Rakotovao

Subjects
Adult, Male, Treatment Outcome, Critical Care, Madagascar, Humans, Female, Pulmonary Aspergillosis, Middle Aged, Lung, Hospitals, Retrospective Studies
Abstract

This retrospective study was designed to study the clinical profile, post-operative outcome with analysis of severity factors of pulmonary aspergilloma operated in our institute.During a 5-year period (June 2009 to June 2014), 34 patients underwent surgery for pulmonary aspergilloma and were admitted in the surgical intensive care unit of the CHU/JRA Antananarivo.The group consist of 23 male patients and 11 female patients with a mean age of 42 ± 9.9 years. In 29.4% of cases, it was a complex aspergilloma. The procedures performed were segmental resection (n = 3), lobectomy (n = 21), bi-lobectomy (n = 2), pneumonectomy (n = 7) and cavernostomy (n = 1). Median hospital stay was 4.5 ± 3 days. The postoperative lethality rate was 14.7% caused by respiratory failure, infection and underlying diseases. Main complications included bleeding, respiratory failures, and pulmonary infection.Factors associated to increased postoperative complications included: the ASA score, decreased preoperative lung function, urgent procedures, smoking, postoperative mechanical ventilation, bleeding, hyperleukocytosis and surgery duration.

Published
2020

6. Ascite urinaire, uropéritoine et péritonite urinaire chez l’enfant : conduite diagnostique et thérapeutique à propos de neuf observations à Madagascar

Author

A.H. Rambel, F. Raherinantenaina, T. Rajaonera, H.Y.H. Rantomalala, F.A. Hunald, T.M.A. Rajaonanahary, M.L. Andriamanarivo, H.N. Rakoto Ratsimba, J. Rakotosamimanana, and Felantsoa Auberlin Rakototiana

Subjects
Gynecology, medicine.medical_specialty, business.industry, Urology, Medicine, business
Abstract

Resume But Evaluer la frequence de la peritonite urinaire chez l’enfant et mettre en evidence ses modalites de prise en charge dans un pays a faibles ressources. Patients et methodes Nous avons observe retrospectivement neuf cas de peritonites urinaires colliges au service de reanimation chirurgicale du CHU d’Antananarivo, du 1 er janvier 2009 au 31 decembre 2012. Resultats La peritonite urinaire representait 0,5 % des urgences abdominales pediatriques et 5 % des urgences urologiques pediatriques. Trois etiologies etaient d’origine traumatique par rupture vesicale, une iatrogene, quatre secondaires a une uropathie obstructive, et une autre en rapport avec une cystolithotomie. Nous avons observe un nouveau cas de rupture traumatique du col vesical. Parmi les uropathies obstructives, il y avait deux cas de valves de l’uretre posterieur et deux cas d’anomalie de jonction pyelo-ureterale. Le tableau clinique etait domine par une fievre avec distension et defense abdominale. Le diagnostic etiologique etait peroperatoire et le traitement etait chirurgical sous couverture d’une antibiotherapie systemique. L’evolution etait compliquee de sepsis dans trois cas et une insuffisance renale aigue dans deux cas. Les suites operatoires etaient simples chez quatre enfants. Un enfant est decede de choc septique et defaillance multiviscerale. Conclusion Contrairement a l’ascite urinaire qui resultait d’une extravasation transperitoneale de l’urine, l’uroperitoine correspondait a une fistule uro-peritoneale. L’ascite urinaire etait une cause exceptionnelle de peritonite. A l’oppose, l’uroperitoine a entraine rapidement une peritonite. La peritonite urinaire etait une entite rare mais de pronostic severe chez l’enfant. Le diagnostic etiologique ne pouvait etre pose qu’en peroperatoire.

Published
2013
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7. Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

Author

null Author et al, R. M. Bateman, M. D. Sharpe, J. E. Jagger, C. G. Ellis, J. Solé-Violán, M. López-Rodríguez, E. Herrera-Ramos, J. Ruíz-Hernández, L. Borderías, J. Horcajada, N. González-Quevedo, O. Rajas, M. Briones, F. Rodríguez de Castro, C. Rodríguez Gallego, F. Esen, G. Orhun, P. Ergin Ozcan, E. Senturk, C. Ugur Yilmaz, N. Orhan, N. Arican, M. Kaya, M. Kucukerden, M. Giris, U. Akcan, S. Bilgic Gazioglu, E. Tuzun, R. Riff, O. Naamani, A. Douvdevani, R. Takegawa, H. Yoshida, T. Hirose, N. Yamamoto, H. Hagiya, M. Ojima, Y. Akeda, O. Tasaki, K. Tomono, T. Shimazu, S. Ono, T. Kubo, S. Suda, T. Ueno, T. Ikeda, H. Ogura, H. Takahashi, J. Kang, Y. Nakamura, T. Kojima, Y. Izutani, T. Taniguchi, M. O, C. Dinter, J. Lotz, B. Eilers, C. Wissmann, R. Lott, M. M. Meili, P. S. Schuetz, H. Hawa, M. Sharshir, M. Aburageila, N. Salahuddin, V. Chantziara, S. Georgiou, A. Tsimogianni, P. Alexandropoulos, A. Vassi, F. Lagiou, M. Valta, G. Micha, E. Chinou, G. Michaloudis, A. Kodaira, H. Imaizumi, M. V. De la Torre-Prados, A. Garcia-De la Torre, A. Enguix-Armada, A. Puerto-Morlan, V. Perez-Valero, A. Garcia-Alcantara, N. Bolton, J. Dudziak, S. Bonney, A. Tridente, P. Nee, G. Nicolaes, M. Wiewel, M. Schultz, K. Wildhagen, J. Horn, R. Schrijver, T. Van der Poll, C. Reutelingsperger, S. Pillai, G. Davies, G. Mills, R. Aubrey, K. Morris, P. Williams, P. Evans, E. G. Gayat, J. Struck, A. Cariou, N. Deye, B. Guidet, S. Jabert, J. Launay, M. Legrand, M. Léone, M. Resche-Rigon, E. Vicaut, A. Vieillard-Baron, A. Mebazaa, R. Arnold, M. Capan, A. Linder, P. Akesson, M. Popescu, D. Tomescu, C. L. Sprung, R. Calderon Morales, G. Munteanu, E. Orenbuch-Harroch, P. Levin, H. Kasdan, A. Reiter, T. Volker, Y. Himmel, Y. Cohen, J. Meissonnier, L. Girard, F. Rebeaud, I. Herrmann, B. Delwarde, E. Peronnet, E. Cerrato, F. Venet, A. Lepape, T. Rimmelé, G. Monneret, J. Textoris, N. Beloborodova, V. Moroz, A. Osipov, A. Bedova, Y. Sarshor, A. Pautova, A. Sergeev, E. Chernevskaya, J. Odermatt, R. Bolliger, L. Hersberger, M. Ottiger, M. Christ-Crain, B. Mueller, P. Schuetz, N. K. Sharma, A. K. Tashima, M. K. Brunialti, F. R. Machado, M. Assuncao, O. Rigato, R. Salomao, S. C. Cajander, G. Rasmussen, E. Tina, B. Söderquist, J. Källman, K. Strålin, A. L. Lange, J. S. Sundén-Cullberg, A. M. Magnuson, O. H. Hultgren, P. Van der Geest, M. Mohseni, J. Linssen, R. De Jonge, S. Duran, J. Groeneveld, R. Miller, B. K. Lopansri, L. C. McHugh, A. Seldon, J. P. Burke, J. Johnston, R. Reece-Anthony, A. Bond, A. Molokhia, C. Mcgrath, E. Nsutebu, P. Bank Pedersen, D. Pilsgaard Henriksen, S. Mikkelsen, A. Touborg Lassen, R. Tincu, C. Cobilinschi, Z. Ghiorghiu, R. Macovei, M. A. Wiewel, M. B. Harmon, L. A. Van Vught, B. P. Scicluna, A. J. Hoogendijk, A. H. Zwinderman, O. L. Cremer, M. J. Bonten, M. J. Schultz, N. P. Juffermans, W. J. Wiersinga, G. Eren, Y. Tekdos, M. Dogan, O. Acicbe, E. Kaya, O. Hergunsel, S. Alsolamy, G. Ghamdi, L. Alswaidan, S. Alharbi, F. Alenezi, Y. Arabi, J. Heaton, A. Boyce, L. Nolan, A. Dukoff-Gordon, A. Dean, T. Mann Ben Yehudah, C. Fleischmann, D. Thomas-Rueddel, C. Haas, U. Dennler, K. Reinhart, O. Suntornlohanakul, B. Khwannimit, F. Breckenridge, A. Puxty, P. Szturz, P. Folwarzcny, J. Svancara, R. Kula, P. Sevcik, L. Caneva, A. Casazza, E. Bellazzi, S. Marra, L. Pagani, M. Vetere, R. Vanzino, D. Ciprandi, R. Preda, R. Boschi, L. Carnevale, V. Lopez, M. Aguilar Arzapalo, L. Barradas, A. Escalante, J. Gongora, M. Cetina, B Adamik, D Jakubczyk, A Kübler, A. Radford, T. Lee, J. Singer, J. Boyd, D. Fineberg, M. Williams, J. Russell, E. Scarlatescu, G. Droc, S. Arama, M. Müller, M. Straat, S. S. Zeerleder, C. F. Fuchs, C. S. Scheer, S. W. Wauschkuhn, M. V. Vollmer, K. M. Meissner, S. K. Kuhn, K. H. Hahnenkamp, S. R. Rehberg, M. G. Gründling, S. Hamaguchi, E. Gómez-Sánchez, M. Heredia-Rodríguez, E. Álvarez-Fuente, M. Lorenzo-López, E. Gómez-Pesquera, M. Aragón-Camino, P. Liu-Zhu, A. Sánchez-López, A. Hernández-Lozano, M. T. Peláez-Jareño, E. Tamayo, D. O. Thomas-Rüddel, V. Adora, A. Kar, A. Chakraborty, S. Roy, A. Bandyopadhyay, M. Das, G. BenYehudah, M. Salim, N. Kumar, L. Arabi, T. Burger, P. Lephart, E. Toth-martin, C. Valencia, N. Hammami, S. Blot, J. L. Vincent, M. L. Lambert, J. Brunke, T. Riemann, I. Roschke, S. Nimitvilai, K. Jintanapramote, S. Jarupongprapa, D. Adukauskiene, D. Valanciene, G. Bose, V. Lostarakos, B. Carr, S. Khedher, A. Maaoui, A. Ezzamouri, M. Salem, J. Chen, D. R. Cranendonk, M. Day, G. Penrice, K. Roy, P. Robertson, G. Godbole, B. Jones, M. Booth, L. Donaldson, Y. Kawano, H. Ishikura, H. Al-Dorzi, M. Almutairi, B. Alhamadi, A. Crizaldo Toledo, R. Khan, B. Al Raiy, H. Talaie, J. A. Van Oers, A. Harts, E. Nieuwkoop, P. Vos, Y. Boussarsar, F. Boutouta, S. Kamoun, I. Mezghani, S. Koubaji, A. Ben Souissi, A. Riahi, M. S. Mebazaa, E. Giamarellos-Bourboulis, N. Tziolos, C. Routsi, C. Katsenos, I. Tsangaris, I. Pneumatikos, G. Vlachogiannis, V. Theodorou, A. Prekates, E. Antypa, V. Koulouras, N. Kapravelos, C. Gogos, E. Antoniadou, K. Mandragos, A. Armaganidis, A. R. Robles Caballero, B. Civantos, J. C. Figueira, J. López, A. Silva-Pinto, F. Ceia, A. Sarmento, L. Santos, G. Almekhlafi, Y. Sakr, S. Baharoon, A. Aldawood, A. Matroud, J. Alchin, S. Al Johani, H. Balkhy, S. Y. Yousif, B. O. Alotabi, A. S. Alsaawi, J. Ang, M. D. Curran, D. Enoch, V. Navapurkar, A. Morris, R. Sharvill, J. Astin, J. Patel, C. Kruger, J. O’Neal, H. Rhodes, J. Jancik, B. François, P. F. Laterre, P. Eggimann, A. Torres, M. Sánchez, P. F. Dequin, G. L. Bassi, J. Chastre, H. S. Jafri, M. Ben Romdhane, Z. Douira, M. Bousselmi, A. Vakalos, V. Avramidis, T. H. Craven, G. Wojcik, K. Kefala, J. McCoubrey, J. Reilly, R. Paterson, D. Inverarity, I. Laurenson, T. S. Walsh, S. Mongodi, B. Bouhemad, A. Orlando, A. Stella, G. Via, G. Iotti, A. Braschi, F. Mojoli, M. Haliloglu, B. Bilgili, U. Kasapoglu, I. Sayan, M. Süzer Aslan, A. Yalcin, I. Cinel, H. E. Ellis, K. Bauchmuller, D. Miller, A. Temple, C. E. Luyt, M. Singer, Y. Nassar, M. S. Ayad, A. Trifi, S. Abdellatif, F. Daly, R. Nasri, S. Ben Lakhal, F. Gul, A. Kuzovlev, A. Shabanov, S. Polovnikov, N. Kadrichu, T. Dang, K. Corkery, P. Challoner, G. Li Bassi, E. Aguilera, C. Chiurazzi, C. Travierso, A. Motos, L. Fernandez, R. Amaro, T. Senussi, F. Idone, J. Bobi, M. Rigol, C. J. Hodiamont, J. M. Janssen, C. S. Bouman, R. A. Mathôt, M. D. De Jong, R. M. Van Hest, L. Payne, G. L. Fraser, B. Tudor, M. Lahner, G. Roth, C. Krenn, P. Jault, J. Gabard, T. Leclerc, S. Jennes, Y. Que, A. Rousseau, F. Ravat, A. Eissa, S. Al-Harbi, T. Aldabbagh, S. Abdellatif., F. Paramba, N. Purayil, V. Naushad, O. Mohammad, V. Negi, P. Chandra, A. Kleinsasser, M. R. Witrz, J. F. Buchner-Doeven, A. M. Tuip-de Boer, J. C. Goslings, M. Van Hezel, A Boing, R Van Bruggen, N Juffermans, D. Markopoulou, K. Venetsanou, V. Kaldis, D. Koutete, D. Chroni, I. Alamanos, L. Koch, E. Walter, K. Maekawa, M. Hayakawa, S. Kushimoto, A. Shiraishi, H. Kato, J. Sasaki, T. Matauoka, T. Uejima, N. Morimura, A. Hagiwara, M. Takeda, O. Tarabrin, S. Shcherbakow, D. Gavrychenko, G. Mazurenko, V. Ivanova, O. Chystikov, C. Plourde, J. Lessard, J. Chauny, R. Daoust, L. Kropman, L. In het Panhuis, J. Konings, D. Huskens, E. Schurgers, M. Roest, B. De Laat, M. Lance, M. Durila, P. Lukas, M. Astraverkhava, J. Jonas, I. Budnik, B. Shenkman, H. Hayami, Y. Koide, T. Goto, R. Iqbal, Y. Alhamdi, N. Venugopal, S. Abrams, C. Downey, C. H. Toh, I. D. Welters, V. B. Bombay, J. M. Chauny, R. D. Daoust, J. L. Lessard, M. M. Marquis, J. P. Paquet, K. Siemens, D. Sangaran, B. J. Hunt, A. Durward, A. Nyman, I. A. Murdoch, S. M. Tibby, F. Ampatzidou, D. Moisidou, E. Dalampini, M. Nastou, E. Vasilarou, V. Kalaizi, H. Chatzikostenoglou, G. Drossos, S. Spadaro, A. Fogagnolo, T. Fiore, A. Schiavi, V. Fontana, F. Taccone, C. Volta, E. Chochliourou, E. Volakli, A. Violaki, E. Samkinidou, G. Evlavis, V. Panagiotidou, M. Sdougka, R. Mothukuri, C. Battle, K. Guy, J. Wijesuriya, S. Keogh, A. Docherty, R. O’Donnell, S. Brunskill, M. Trivella, C. Doree, L. Holst, M. Parker, M. Gregersen, J. Almeida, T. Walsh, S. Stanworth, S. Moravcova, J. Mansell, A. Rogers, R. A. Smith, C. Hamilton-Davies, A. Omar, M. Allam, O. Bilala, A. Kindawi, H. Ewila, A. Malamas, G. Ferreira, J. Caldas, J. Fukushima, E. A. Osawa, E. Arita, L. Camara, S. Zeferino, J. Jardim, F. Gaioto, L. Dallan, F. B. Jatene, R. Kalil Filho, F. Galas, L. A. Hajjar, C. Mitaka, T. Ohnuma, T. Murayama, F. Kunimoto, M. Nagashima, T. Takei, M. Tomita, K. Mahmoud, S. Hanoura, S. Sudarsanan, P. Sivadasan, H. Othamn, Y. Shouman, R. Singh, A. Al Khulaifi, I. Mandel, S. Mikheev, I. Suhodolo, V. Kiselev, Y. Svirko, Y. Podoksenov, S. A. Jenkins, R. Griffin, M. S. Tovar Doncel, A. Lima, C. Aldecoa, C. Ince, A. Taha, A. Shafie, M. Mostafa, N. Syed, H. Hon, F. Righetti, E. Colombaroli, G. Castellano, M. Hravnak, L. C. Chen, A. D. Dubrawski, G. C. Clermont, M. R. Pinsky, S. Gonzalez, D. Macias, J. Acosta, P. Jimenez, A. Loza, A. 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F. Francke, L. H. Huyghens, J. B. Bilsen, B. Nyamaizi, C. Dalrymple, A. Dobru, E. Marrinan, A. Ankuli, R. Struthers, R. Crawford, P. Mactavish, P. Morelli, M. Degiovanangelo, F. Lemos, V. MArtinez, J. Cabrera, A. Rutten, S. Van Ieperen, S. De Geer, M. Van Vugt, E. Der Kinderen, A. Giannini, G Miccinesi, T Marchesi, and E Prandi

Subjects
0301 basic medicine, 03 medical and health sciences, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, 030104 developmental biology, 0302 clinical medicine, business.industry, Intensive care, Emergency medicine, Medicine, Critical Care and Intensive Care Medicine, business
Published
2016
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8. [Urinary ascites, uroperitoneum and urinary peritonitis in children: management of nine case reports in Madagascar]

Author

F, Raherinantenaina, A H, Rambel, J, Rakotosamimanana, T M A, Rajaonanahary, T, Rajaonera, F A, Rakototiana, F A, Hunald, M L, Andriamanarivo, H Y H, Rantomalala, and H N, Rakoto Ratsimba

Subjects
Male, Rupture, Child, Preschool, Urinary Bladder, Madagascar, Ascites, Humans, Peritoneum, Peritonitis, Urine, Child, Retrospective Studies
Abstract

To evaluate the frequency of urinary peritonitis in children and to highlight its terms of management in a country with limited resources.We retrospectively observed nine case reports of urinary peritonitis collected in surgical reanimation service at the CHU of Antananarivo, from 1st January 2009 to 31 December 2012.Urinary peritonitis accounts 0.5% of all pediatric abdominal emergencies and 5% of pediatric urological emergencies collected in our service during study period. Three etiologies were traumatic bladder rupture, one bladder iatrogenic rupture, four secondary to obstructive uropathy and one other after cystolithotomy. We found a new case of posttraumatic transverse rupture of the bladder neck. Among obstructive uropathy observed, there were two cases of posterior urethral valves and two cases of ureteralpelvic junction obstruction. Clinical expression was dominated by fever, with abdominal distention and defense. In majority of cases, etiological diagnosis was made intraoperatively. The surgical treatment by laparotomy was performed under cover of systemic antibiotic therapy. Evolution was complicated with sepsis in three cases and acute renal failure in both cases. Surgical follow-up without complication were observed in four cases. A child has died to septic shock and multivisceral failure.Unlike urinary ascites resulting a transperitoneal extravasation of urine, uroperitoneum was a fistula between adominal cavity and content of the urinary tract. Urinary ascites was a rare cause of peritonitis. In contrast, uroperitoneum caused peritonitis quickly. Urinary peritonitis was a rare entity but severe prognosis in children. In majority of cases, etiological diagnosis was made intraoperatively.

Published
2013

9. Diversity and Implication of Symbiotic Bacteria in Aphids-Ants Relationships in Madagascar.

Author

Luttenschlager H, Noël G, Carpentier J, Glacet L, Ravelomanana A, Rakotonirina JC, Rajaonera T, and Francis F

Subjects
Animals, Madagascar, Spiroplasma physiology, Serratia physiology, Bacteria classification, Aphids microbiology, Aphids physiology, Symbiosis, Ants microbiology, Rickettsia
Abstract

Facultative bacteria in aphids provide their hosts with various physiological and ecological adaptations, such as resistance to thermal stress, parasitoids and entomopathogenic fungi. Furthermore, these symbionts possess the capacity to modulate the composition of honeydew, a substance that is particularly favored by numerous ant species. That's why we were interested in determining whether the presence of facultative bacteria in myrmecophilic aphids influences their relationship with mutualistic ants. In the vicinity of Antananarivo (Madagascar), the objectives of the study were to (i) determine the diversity of ants, aphids and symbionts and to (ii) assess the impacts of the identified symbiont on behavioural interactions of ants and aphids. We identified a total of four species (Serratia symbiotica, Rickettsia, Spiroplasma, Hamiltonella defensa) of facultative symbionts present in the three ant species (Camponotus maculate, Monomorium madecassum, Nylanderia gracilis) we tested and a total of six facultative symbionts (Serratia symbiotica, Rickettsia, Spiroplasma, Hamiltonella defensa, Regiella insecticola, Rickettsiella) among three of the five aphid species (Aphis citricidus, Aphis fabae, Aphis spiraecola, Macrosiphum euphorbiae, Rhopalosiphum maidis) we tested. Although our results did not show the involvement of symbionts on ant behaviour or their association with aphids, our study showed that the number of ants increases with the number of interactions, that Nylanderia gracilis are the ants with the most interactions and finally that ants observed on pesticide-treated plots have fewer interactions with aphids., Competing Interests: Declarations. Ethics Approval: The research permit was granted to us by the Ministry of Environment and Sustainable Development of Madagascar 151/23/MEDD/SG/DGGE/DAPRNE/SCBE.Re. Consent for Publication: All authors have read and agreed to the published version of the manuscript. Conflict of Interest: The authors declare no competing interests., (© 2025. Sociedade Entomológica do Brasil.)

Published
2025
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10. Contribution of Ultrasonography in the Diagnosis of Periportal Fibrosis Caused by Schistosomiasis.

Author

Andrianah GEP, Rakotomena D, Rakotondrainibe A, Rajaonarison Ny Ony LHN, Ranoharison HD, Ratsimba HR, Rajaonera T, and Ahmad A

Abstract

Background: Periportal fibrosis is one of the major complications of schistosomiasis infection. Specific images of this infection revealed by ultrasonography allow the assessment of the different stages. Our purpose is to describe the ultrasonographic appearances of periportal fibrosis due to schistosomiasis infection., Methods: The study was retrospective descriptive in the Medical Imagery Centre of CHUJRA., Results: A total of 29 patients showed upper and/or lower digestive hemorrhage and a positive result in schistosomiasis serology. The median age was 41.2 years. Male gender dominated with 54.7%. In 78.3% of the cases, the patients were farmers in schistosomiasis-endemic areas. On ultrasonography, 81.3% were found to present Stage III periportal fibrosis, 11.5% presented Stage II, and 7.2% presented Stage I. There was no case of portal thrombosis. Splenomegaly was found in 83.2% of the cases and hepatomegaly in 48.9% of the cases. Porto-systemic shunt was detected in 80.7% of the cases and ascites in 72.3%., Conclusion: Ultrasonography examination represents an important role in the diagnosis of periportal fibrosis, in its staging process, and allows the assessment of porto-systemic, hepatic, and splenic alterations., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Medical Ultrasound.)

Published
2020
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11. Epidemiological African day for evaluation of patients at risk of venous thrombosis in acute hospital care settings.

Author

Kingue S, Bakilo L, Ze Minkande J, Fifen I, Gureja Y, Razafimahandry HJ, Okubadejo N, Mvuala R, Oke DA, Manga A, Rajaonera T, Nwadinigwe C, Pay Pay E, and Rabearivony N

Subjects
Adult, Africa South of the Sahara epidemiology, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Prevalence, Retrospective Studies, Risk Factors, Venous Thrombosis prevention & control, Anticoagulants therapeutic use, Hospitals statistics & numerical data, Risk Assessment methods, Venous Thrombosis epidemiology
Abstract

Introduction: This study aimed to identify patients at risk for venous thromboembolism (VTE) among all patients hospitalised, and to determine the proportion of at-risk hospital patients who received effective types of VTE prophylaxis in sub-Saharan Africa (SSA)., Methods: A multinational, observational, cross-sectional survey was carried out on 1 583 at-risk patients throughout five SSA countries., Results: The prevalence of VTE risk was 50.4% overall, 62.3% in medical and 43.8% in surgical patients. The proportion of at-risk patients receiving prophylaxis was 51.5% overall, 36.2% in medical and 64% in surgical patients. Low-molecular weight heparin was the most frequently used prophylactic method in 40.2% overall, 23.1% in medical and 49.9% in surgical patients., Discussion: This study showed a high prevalence of VTE risk among hospitalised patients and that less than half of all at-risk patients received an American College of Clinical Pharmacy-recommended method of prophylaxis., Conclusion: Recommended VTE prophylaxis is underused in SSA.

Published
2014
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