3 research outputs found
Aspects diagnostiques et thĂ©rapeutiques des cancers de lâestomac en milieu oncologique Ă Conakry
Lâobjectif de ce travail Ă©tait dâanalyser les rĂ©sultats de la prise en charge diagnostique et thĂ©rapeutique des cancers de lâestomac Ă lâunitĂ© de chirurgie oncologique de Donka. Il sâagissait dâune Ă©tude observationnelle, rĂ©trospective de type descriptif de 2007 Ă 2016. Le profil Ă©pidĂ©miologique, les aspects anatomocliniques, le diagnostic, le bilan dâextension et les modalitĂ©s thĂ©rapeutiques ont Ă©tĂ© dĂ©crits et analysĂ©s. Nous avons colligĂ© 41 patients avec un Ăąge moyen de 53,8 ans. Le sexratio Ă©tait de 1,7. Les patients avaient consultĂ© pour Ă©pigastralgie (85,4%), vomissements (75,6%) et anorexie (26,8%) avec un dĂ©lai de consultation de 15,8 mois. Une masse Ă©pigastrique (61,0%), lâhĂ©patomĂ©galie (46,3%) et une ascite (31,7%) Ă©taients prĂ©sents. Lâaspect endoscopique Ă©tait bourgeonnant (37,5%) et dans 50,0%, le siĂšge Ă©tait antral. Ilsâagissait dâadĂ©nocarcinome (18 cas), de carcinomes gastriques (9 cas), de dysplasie de haut grade (1 cas) et de tumeur stromale gastro-intestinale (GIST) (1 cas). Les mĂ©tastases Ă©taient prĂ©sentes dans 27 cas (65,8%). Le traitement chirurgical a Ă©tĂ© rĂ©alisĂ© chez 20 patients (48,8%) avec un taux de rĂ©sĂ©cabilitĂ© de 55 % (11 cas). La gastrectomie des 4â5 avec curage de type D2 a Ă©tĂ© rĂ©alisĂ©e dans 18 cas (72,2%).La mortalitĂ© opĂ©ratoire Ă©tait de 2 cas(7,4%). Dix patients (24,4%) ont Ă©tĂ© lâobjet dâun traitement adjuvant dont 9 par chimiothĂ©rapie et 1 par radiothĂ©rapie.Les patients ont Ă©tĂ© suivis avec un dĂ©lai moyen de 43,8±8,6 mois [IC95% 27,0-60,0] au cours duquel 4 rĂ©cidives (9,7%) et 32 dĂ©cĂšs (78%) ont Ă©tĂ© enregistrĂ©s. Le cancer de lâestomac est frĂ©quent et de diagnostic tardif dans notre contexte. Le traitement chirurgical des formes prĂ©coces et la chimiothĂ©rapie pĂ©riopĂ©ratoire permettent dâamĂ©liorer le pronostic de ces cancers. Mots clĂ©s : cancers, estomac, diagnostic, traitement, Conakry. The aim was to analyze the results of the diagnostic and therapeutic management of stomach cancers at the Donka Oncology Surgery Unit. This was a retrospective study of the descriptive type from 2007 to 2016. The epidemiological profile, the anatomoclinical aspects, the diagnosis, the extension assessment and the therapeutic modalities were described and analyzed. We collected 41 patients with a mean age of 53.8 years. The sex ratio was 1.7. Patients had consulted for epigastralgia (85.4%), vomiting (75.6%) and anorexia (26.8%) with a consultation time of 15.8 months. An epigastric mass(61.0%), hepatomegaly (46.3%) and ascites (31.7%) were present. The endoscopic aspect was budding (37.5%) and in 50.0%, the seat was antral. These included adenocarcinoma (18 cases), gastric carcinomas (9 cases), high grade dysplasia (1 case) and gastrointestinal stromal tumors (GIST) (1 case). Metastases were present in 27 cases(65.8%). Surgical treatment was performed in 20 patients with a resectability rate of 55% (11 cases). Gastrectomy of 4/5 with D2- type dissection was performed in 18 cases(72.2%) and the operative mortality was 2 cases (7.4%). Ten patients (24.4%) received adjuvant therapy, 9 with chemotherapy and 1 with radiotherapy. Patients were followed after a mean delay of 43.8 ± 8.6 months [95% CI 27.0-60 , 0] in which 4 recurrences (9.7%) and 32 deaths (78.04%) were recorded. Stomach cancer is common and of late diagnosisin our context. Surgical treatment of early forms and perioperative chemotherapy could improve the prognosis of these cancers. Keywords: stomach cancer, diagnosis, treatment, Conakr
Global urban environmental change drives adaptation in white clover
Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural clines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale