Publications by authors named "Victor Eyenga"

7 Publications

  • Page 1 of 1

Complications of arteriovenous fistula for hemodialysis: an 8-year study.

Ann Vasc Surg 2012 Jul 24;26(5):680-4. Epub 2012 Apr 24.

Department of Surgery, Yaoundé General Hospital, Yaoundé, Cameroon.

Background: To assess the frequency and characteristics of complications of arteriovenous fistula (AVF) and their effect on fistula outcome.

Methods: We retrospectively reviewed 628 AVFs constructed from November 2002 to October 2010 to record the complications and their management options. The association between age, sex, comorbidities (HIV, hypertension, and diabetes), fistula type, and complications was sought.

Results: Most patients were males (73.7%). The mean age was 45.3 years. Comorbidities seen included diabetes mellitus (22.12%), hypertension (83.12%), and HIV infection (9.87%). AVFs constructed were mainly radiocephalic (68%) and brachiocephalic (24.9%). The median follow-up period was 275 days. The cumulative patency rate was 76% and 51% at 1 year and 2 years, respectively. Altogether, 211 complications occurred in 16% of the AVFs. Among them, 36.96% were severe, 25.11% moderate, and 43.91% minor. With respect to the time of occurrence, 63.98% were late complications, 12.79% immediate, and 23.22% early. Aneurysms, failure to mature, and thrombosis were the most frequent complications occurring in 26.54%, 14.69%, and 12.79% of cases, respectively. The management options for the complications included the creation of a new access in 36.96%, a temporary catheter before a new AVF in 10.52%, and nonoperative management in 43.12%. We found no adverse effect of comorbid factors such as diabetes mellitus (χ(2) = 3.58, P > 0.05) or HIV-positive status (χ(2) = 0.64, P > 0.05) on the complication rate.

Conclusion: This study shows an overall frequency of complications of 16%. These results show the potential for low complication rate of AVF in selected population.
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http://dx.doi.org/10.1016/j.avsg.2011.09.014DOI Listing
July 2012

Surgical repair of a giant pseudoaneurysm of the right common carotid artery following a gunshot.

Ann Vasc Surg 2011 Feb 6;25(2):268.e3-6. Epub 2010 Oct 6.

Department of Surgery, Yaounde General Hospital, Yaounde, Cameroon.

Common carotid pseudoaneurysms are very rare. The authors report a case of a 18-year-old patient with 11 cm large posttraumatic pseudoaneurysm of the right common carotid artery caused by a gunshot in the neck. The patient also had a right hemiplegia, secondary to the left sylvian artery stroke and aphasia. A surgical repair was undertaken with an approach including a total sternotomy. The aneurysm was excluded and a saphenous vein patch was used to repair the 2-cm defect on the arterial wall. The postoperative period was uneventful. This is probably the largest carotid artery aneurysm ever described. The potential hazards of an aneurysm of the common carotid artery indicate that surgical treatment is warranted particularly in a patient with a past history of controlateral stroke.
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http://dx.doi.org/10.1016/j.avsg.2010.07.029DOI Listing
February 2011

[Results of surgical management of spinal neurinomas and neurofibromas at Yaounde].

Tunis Med 2008 Jul;86(7):704-6

Unité de Neurochirurgie, Hôpital Général de Yaoundé, Cameroun.

Background: Spinal neurinomas and neurofibromas are poorly studied in Sub-Saharan Africa.

Aim: The objective of this study was to report the results of the surgical management of these tumours in Yaoundé.

Methods: This was a retrospective study done at the Yaoundé General and Yaoundé Central Hospitals from the 1st of January 1995 to the 1st of January 2005. The inclusion criteria: medical files which had the results of pre and post operatory clinical examinations, neuroradiologic and histopathologic examinations, the post operatory report. The follows up of at least six months. The functional outcome was evaluated using the Karnofsky scale.

Results: Of the 62 patients operated for an intraspinal tumor, 12 (19.35%) were selected (nine neurinomas, two neurofibromas, one neurofibrosarcoma). The mean age was 40.66 years +/- 13.20 with a sex ratio of 0.71. The average duration of symptoms before the diagnosis was 17.83 months +/- 5.81; the most frequent symptom was radicular pain (six cases). Five patients were paraplegic. The average Karnofsky score was 50.00 +/- 12.79 before surgery and 70.83 +/- 23.53 after. The situation of the tumor was cervical (four cases), dorsal (six cases) and lumbar (two cases). The tumor was extradural, intradural, intra and extradural in six, four and two cases respectively. Tumor excision was macroscopically complete in nine cases and partial in three. Five patients were well enough after treatment to continue their professional activities.

Conclusion: The diagnosis of neurinomas and neurofibromas are late in our environment, resulting to poor surgical results.
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July 2008

[Osgood-Schlatter disease: a report of 2 cases].

Mali Med 2007 ;22(4):52

Département de chirurgie et spécialités Faculté de Médecine et des Sciences biomédicales (FMSE;), Université de Yaoundé I--Cameroun.

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June 2009

The management of musculoskeletal infection in HIV carriers.

Acta Orthop Belg 2004 Aug;70(4):355-60

University Hospitals of Yaoundé, Cameroon.

Over a three-year period, the authors prospectively implemented a protocol for management of musculoskeletal sepsis (MSS) in HIV carriers in Yaounde, Cameroon. The diagnosis of MSS was based on conventional criteria. HIV carriage was screened by an ELISA test and confirmed with the Western Blot technique. The immune status was based on CD4 lymphocyte count by flow cytometry; patients were classified as non-immunodepressed (NID), mildly immunodepressed (MID), or severely immunodepressed (SID) based on their CD4 lymphocyte count, as the latter was respectively over 500, between 200 and 500 or less than 200 per ml. Infection was treated by surgical debridement followed by a long-course targeted antibiotic therapy. All SID patients and some MID patients with AIDS-related symptoms also had standard antiretroviral (ARV) therapy. Thirty-one of 294 patients seen with musculoskeletal sepsis during the study period and tested for HIV were found to be HIV carriers. Their mean age was 33 years; the male/female ratio was 1.58. The following clinical pictures were observed: chronic osteomyelitis (COM) in 32.3% of the cases, septic arthritis (SA) in 38.7%, soft tissue infection (STI) in 25.8%; the last case was a severe leg complication of Buruli Ulcer (BU). Among these 31 patients, 38.7% were classified as SID (5 COM, 4 SA, 2 STI and the BU patient), 25.8% as MID (2 COM, 4 SA, 2 STI) and 35.5% as NID (3 COM, 6 SA, 2 STI). The organisms involved were not specific. Fifteen patients were managed conventionally, while the other 16 had the usual treatment associated with ARV therapy. The immediate outcome of MSS was good in 29 patients, after a mean hospital stay of five weeks; in two cases of septic arthritis of the knee, a second debridement was needed, due to persistent drainage, and the sinuses all closed. Three months after discharge, one patient with COM of the humerus developed a low-flow fistula which was closed after a revision sequestrectomy. After one year, none of the patients complained of any symptom suggesting reactivation of their MSS. There is no evidence that HIV carriage is in itself a high risk factor for musculoskeletal sepsis; the incidence of HIV carriage was indeed virtually similar in the 294 patients with MSS and in the general population, i.e. around 10%. However, in order to improve the outcome following musculoskeletal infections in patients with HIV, their management should take into account their immune status, based on a CD4 lymphocyte count. NID patients should be treated as any other patients with MSS, while SID should have additional standard ARV treatment. For those who are MID, the indication for antiretroviral therapy should depend on the presence of one or more AIDS-related signs.
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August 2004

[Neurologic disturbances in human immunodeficiency virus carriers in Yaoundé].

Sante 2003 Jul-Sep;13(3):155-8

Faculté de médecine et des sciences biomédicales, Université de Yaoundé I, BP 1364, Yaoundé, Cameroon.

Neurological manifestations are frequent with the acquired immunodeficiency syndrome (AIDS). They can be seen at the onset of the illness but more often they are found during its terminal phase. The aim of this study is to describe the neurological complications observed in AIDS as well as the evolution in the intensive care unit of the Yaounde General Hospital, Republic of Cameroon. This prospective study was carried out during a two-year period at the intensive care unit. All patients who were HIV-positive and who presented a neurological disorder diagnosed during the interrogation and clinical examination were included in this study. In these patients, the following paraclinical examinations were performed: ocular fundi, CD4 lymphocytes titre, toxoplasmosis serology, lumbar tap, and cerebral scan. A diagnosis was made and the patients were treated accordingly. The appreciation of the evolution was done in relation with the clinical state and the mortality observed in the service. We recruited 51 patients in all, aged 38 years on average (+/- 7 years). There were 31 women and 20 men. The neurological disorders observed were 26 states of coma, 14 agitations with mental confusion, 6 meningitis syndromes, 5 hallucinations. The titre of CD4 showed an average of 146/mm3 (+/- 12). Toxoplasmosis serology was positive for 6 patients. The cerebrospinal fluid revealed 2 cases of purulent meningitis. The ocular fundi showed 5 cases of papillary oedema. The cerebral scan showed 8 cases of cerebral abscess, 4 cases of cerebral tumour and 6 cases of cerebral toxoplasmosis. These paraclinical findings have enabled us to establish the following classification of the patients: cerebral tumors (n=4); bacterial meningitis (n=2); aseptic meningitis (n=10); cerebral toxoplasmosis (n=6); sub-acute encephalopathy (n=21); cerebral abscess (n=8). These patients were treated according to the diagnosis. The clinical evolution was marked by recovery in 14 patients with improved clinical state and by mortality in 34 patients. Many neurological disorders exist in HIV infections. These complications vary according to the stage of the illness. They are caused either by opportunistic infections, by tumours or by the virus itself. The most frequent complication in our service is sub-acute encephalitis, which induces coma. This is due to the fact that the intensive care unit receives terminal patients coming from other services. This late recruitment of patients also explains the high mortality rate.
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February 2004
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