10 research outputs found
Kyste hydatique pancréatique: à propos d’un cas
La localisation pancréatique du kyste hydatique est rare, même dans les pays ou la maladie hydatique sévit à l'état endémique. Il ne représentant que moins de 1% de l'ensemble des localisations .La symptomatologie souvent insidieuse après une longue évolution, dépend du siège du kyste hydatique, ce qui peut expliquer les difficultés du diagnostic, prêtant à confusion avec les autres lésions kystiques du pancréas. Elle touche exceptionnellement l'enfant. Nous rapportons une observation survenue chez une patiente de 20 ans, victime il y'a 3 ans d'un traumatisme fermé de l'abdomen, qui présentait depuis 2 mois des épigastralgies isolées, avec ictère. A travers cette observation et une revue de la littérature, nous discutons les difficultés diagnostiques et les modalités du traitement chirurgical de cette localisation inhabituelle de la maladie hydatique
Occlusion intestinale aiguë par trichobézoard à double localisation gastrique et jéjunale : aspect tomodensitométrique
Receptor-defined subtypes of breast cancer in indigenous populations in Africa: a systematic review and meta-analysis.
BACKGROUND: Breast cancer is the most common female cancer in Africa. Receptor-defined subtypes are a major determinant of treatment options and disease outcomes but there is considerable uncertainty regarding the frequency of poor prognosis estrogen receptor (ER) negative subtypes in Africa. We systematically reviewed publications reporting on the frequency of breast cancer receptor-defined subtypes in indigenous populations in Africa. METHODS AND FINDINGS: Medline, Embase, and Global Health were searched for studies published between 1st January 1980 and 15th April 2014. Reported proportions of ER positive (ER+), progesterone receptor positive (PR+), and human epidermal growth factor receptor-2 positive (HER2+) disease were extracted and 95% CI calculated. Random effects meta-analyses were used to pool estimates. Fifty-four studies from North Africa (n=12,284 women with breast cancer) and 26 from sub-Saharan Africa (n=4,737) were eligible. There was marked between-study heterogeneity in the ER+ estimates in both regions (I2>90%), with the majority reporting proportions between 0.40 and 0.80 in North Africa and between 0.20 and 0.70 in sub-Saharan Africa. Similarly, large between-study heterogeneity was observed for PR+ and HER2+ estimates (I2>80%, in all instances). Meta-regression analyses showed that the proportion of ER+ disease was 10% (4%-17%) lower for studies based on archived tumor blocks rather than prospectively collected specimens, and 9% (2%-17%) lower for those with ≥ 40% versus those with <40% grade 3 tumors. For prospectively collected samples, the pooled proportions for ER+ and triple negative tumors were 0.59 (0.56-0.62) and 0.21 (0.17-0.25), respectively, regardless of region. Limitations of the study include the lack of standardized procedures across the various studies; the low methodological quality of many studies in terms of the representativeness of their case series and the quality of the procedures for collection, fixation, and receptor testing; and the possibility that women with breast cancer may have contributed to more than one study. CONCLUSIONS: The published data from the more appropriate prospectively measured specimens are consistent with the majority of breast cancers in Africa being ER+. As no single subtype dominates in the continent availability of receptor testing should be a priority, especially for young women with early stage disease where appropriate receptor-specific treatment modalities offer the greatest potential for reducing years of life lost. Please see later in the article for the Editors' Summary