La gigantomastie juvénile: à propos d’un cas à l’institut Joliotcurie de Dakar et revue de la literature

La gigantomastie juvénile ou hypertrophie mammaire virginale est une augmentation pathologique supérieure à 1500 cm3 du volume des deux seins chez l'adolescente. Elle entraine des répercussions psychologiques et physiques importantes. Les traitements médicaux sont décevants laissant la place à la chirurgie qui peut compromettre l'avenir fonctionnel des glandes mammaires. Nous rapportons le cas d'une jeune fille porteuse d'une gigantomastie juvénile. Il s'agissait d'une jeune fille de 15 ans porteuse d'une gigantomastie invalidante dont la prise en charge, essentiellement chirurgicale par une mammoplastie de réduction a été effectuée à l'Institut Joliot Curie de Dakar. La gigantomastie juvénile est rare. Elle est invalidante chez une patiente en pleine croissance avec des répercussions psychologiques et physiques. Le traitement est médical et chirurgical. Les grossesses sont possibles et les récidives ne sont pas rares.Pan African Medical Journal 2015; 2

La gigantomastie gravidique à l’Institut du Cancer de Dakar: à propos de 2 cas

La gigantomastie gravidique est une augmentation exagérée et invalidante de la taille des seins survenant pendant la grossesse chez une patiente aux seins préalablement normaux. Sa physiopathologie est mal cernée. Elle pose localement des problèmes trophiques et rend difficile la grossesse. Le traitement est médical anti hormonal et chirurgical sur la base d'une réduction mammaire. Il est difficile et peut compromettre l'avenir esthétique et fonctionnel de la glande mammaire. Nous rapportons 2 cas de gigantomasties gravidiques suivies et traitées à l'Institut Joliot Curie de Dakar.Pan African Medical Journal 2015; 2

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

PERCUTANEOUS DRAINAGE : AN EFFECTIVE AND LESS AGRESSIVE APPROACH FOR COMPLICATED DIVERTICULAR ABSCESS

Retroperitoneal abscess is a serious complication of diverticular disease. Its management involves several options, ranging from conservative management to surgery. Elective colectomy is most often thought to be mandatory after a percutaneous drainage given the high rate of recidive. However, in patients with high risk for surgery, percutaneous drainage is often the main therapeutic alternative. We report a case of a 80-year-old woman, who was diagnosed to have a retroperitoneal abscess complicating a sigmoid diverticulitis. Ultrasound-guided percutaneous drainage allowed to drain 1500cc of pus and gas. The cytobacteriological examination was positive for: Streptococcus spp and Alkalescens dispar. The therapeutic outcomes were uneventful and despite we did not realize a colectomy because the patient was at high risk for surgery, there was no recidive after a 2-year-follow-up period. Percutaneous drainage can be a therapeutic alternative in patients with high risk for surgery in diverticular abscess of big size