Contribution de l’échographie dans le dépistage et le diagnostic des cancers du sein : une expérience de Yaoundé, Cameroun

L’objectif de cette étude était de rechercher la contribution de l’échographie dans le dépistage et le diagnostic des lésions mammaires à Yaoundé, Cameroun. Il s’agissait de décrire les anomalies cliniques, échographiques, éventuellement anatomopathologiques pour des lésions suspectes et les confronter. L’étude était transversale descriptive sur une période de 12 mois ; constituée de 103 femmes âgées de 45 ans et plus. La moyenne d’âge a été de 53 ans. La douleur mammaire était le principal symptôme (21,4%). Les anomalies échographiques ont été retrouvées chez 43 femmes (41,7%). Les plus fréquentes ont été les nodules tissulaires (29,1%). Les lésions d’allure bénigne (ACR2) ont été retrouvées chez 26 (25,24%) femmes et celles suspectes de malignité (ACR3, ACR4, et ACR5) chez 17 (16,5%) dont 14 ont bénéficié d’une biopsie. L’examen anatomopathologique a révélé 8 cas de carcinomes (57,14%). L’échographie bien conduite dans un contexte socio-économique défavorisé oriente le diagnostic de cancer du sein

Connaissances en matière de radioprotection : enquête auprès des personnels des services hôspitaliers de radiodiagnostic, radiothérapie et médecine nucléaire a Yaoundé Cameroun

L’utilisation médicale des rayonnements ionisants est devenue la source d’irradiation la plus importante à l’échelle mondiale. Les connaissances et aptitudes des professionnels utilisateurs de ces rayonnements déterminent la mise en œuvre des mesures de radioprotection recommandées par les organismes internationaux et nationaux. La situation de la radioprotection dans les pays africains est préoccupante en raison de la faiblesse des lois, règlements et organismes de radioprotection. Nous rapportons les résultats d’une enquête effectuée dans des services hospitaliers détenteurs de sources de rayonnements ionisants à Yaoundé, capitale du Cameroun. Plus de la moitié des professionnels enquêtés ont un niveau moyen de connaissances des principes et normes de radioprotection et plus de 80 % n’ont jamais bénéficié d’une formation continue en matière de radioprotection

Breast Cancer Profile in a Group of Patients Followed up at the Radiation Therapy Unit of the Yaounde General Hospital, Cameroon

Objective. To describe the profile of breast cancer in the patients attending the radiation therapy unit of Yaounde General Hospital. Method. From 1989 to 2009, we conducted a descriptive retrospective study based on the register and medical records of patients. Results. During the study period, 531 breast cancer patients were recorded of which 0.75% were male. Age range was 18 to 82 years, with a mean of 45.17 years. Out of these, 66.1% were less than 50 years old and 31.9% less than 40. Self detection was the discovery method in most cases (95.34% of patients). Mean delay before presentation at hospital was 10.35 months, and 54.94% had used traditional medicine before medical evaluation. Metastasis and locally advanced breast cancer at diagnosis were present in 08.13% and 62.78%, respectively. Mastectomy was used in 88.08% of patients. Conclusion. The study reinforces the position occupied by late presentation and advanced stage at diagnosis of breast cancer profile in developing countries

Analysis Of Road Transport Impact On Rural Development In Nigeria : A Study On Akure North Local Government Area, Ondo State

Rural transportation is a significant channel of ensuring effective movement of rural people and the collection and exchange of goods and services to enhance rural economy and development in Nigeria. This study was aimed at assessing road transportation impact on rural development, with a view to determine the contributions of road transport to rural development. Eight settlements were selected randomly in the study area with total population of 2,651 (1991 population census). This was projected to year 2015 and amounted to 4,794 at which 5% was taken as sample size. This translated to 240. Therefore, 240 questionnaires were administered in the study area. Systematic Sampling technique was used for the questionnaire administration. Findings from the study revealed that the rural roads are in poor condition which has influence on the cost of transporting farm produce and economy of the area. Recommendations were made to improve the existing road condition of the study area Local Government Council should be equipped with finance, personnel and equipment to manage and maintain rural roads to ensure effective movement and Federal and State Governments should embark on various policiessuch as upgrading and maintenance of rural road, rural empowerment and development, rural infrastructure improvement and development towards enhancing rural development in Nigeria

Compressions Medullaires Lentes (Cml) D\'origine Tumorale Et Pseudo-Tumorale A Yaounde (Cameroun)

But Décrire les aspects cliniques, diagnostics, thérapeutiques et histologiques des compressions médullaires lentes (et de la queue de cheval) d\'origine tumorale et pseudo-tumorale à Yaoundé. Patients et méthodes Tous les dossiers des patients opérés d\'une compression médullaire lente d\'origine tumorale ou pseudo-tumorale à l\'Hôpital Central de Yaoundé entre le premier janvier 2000 et le 31 octobre 2005 ont été revus. Résultats Soixante-sept (67) dossiers ont été retenus. Le sexe masculin était prédominant (64%). La moyenne d\'âge était de 41,3 ans (extrêmes: 11 et 70 ans). L\'atteinte médullaire était complète au moment de la chirurgie chez 27% des patients. L\'imagerie par résonance magnétique étant indisponible dans notre milieu, la myélographie (38%) et le myéloscanner (47,8%) représentaient les explorations diagnostiques de choix. Les étiologies étaient dominées par les métastases (23,7%), les lymphomes (17,9%), les neurinomes (11,9%) et les méningiomes (10,4%). Les métastases étaient le plus souvent d\'origine prostatique. La chirurgie était le traitement de base et le mode de prélèvement rachidien pour le diagnostic histologique dans tous les cas. Quarante-huit pour cent des patients ont été traités par radiothérapie et/ ou chimiothérapie. La pulpectomie était le traitement adjuvant de choix dans les métastases d\'origine prostatique. Conclusion La particularité du profil étiologique des compressions médullaires lentes tumorales et pseudo-tumorales à Yaoundé est la rareté des métastases d\'origine pulmonaire et mammaire, la fréquence relative de l\'origine hépatocellulaire comparée aux séries occidentales. Une prise en charge multidisciplinaire dès la phase pré opératoire permettrait une meilleure codification du traitement adjuvant dont l\'accès reste limité dans notre environnement. Purpose The aim of this study was to describe the clinical, diagnostic, therapeutic and histological aspects of neoplastic and neoplastic-like spinal cord and cauda equina compressions in Yaounde. Patients and methods We retrospectively analysed the files of all patients operated for a neoplastic or neoplastic-like spinal cord compression at the Yaounde Central Hospital from January 1, 2000 to October 31, 2005. Results A total of 67 files were selected. The male sex was predominant (64%). The mean age was 41.3 years (range: 11 to 70 years). Spinal cord compression was complete in 27% of patients at the time of diagnosis. Myelography (38%) and computerised myelography (47.8%) were found to be the most appropriate imaging techniques. Magnetic Resonance Imaging is not yet available in our environment. The most predominant histological types were metastasis (23.7%), lymphoma (17.9%), neurinoma (11.9%) and meningioma (10.4%). Metastases were mostly from the prostate. Surgery was the basic treatment and also served for biopsy and histological confirmation of diagnosis in all cases. Forty-eight per cent had radiotherapy or chemotherapy done. Pulpectomy was the preferred adjuvant therapy for prostate metastases. Conclusion The hallmarks of neoplastic and neoplastic-like spinal cord compressions in Yaounde are the scarcity of lung and breast metastases and the relatively high frequency of liver metastases as compared to western series. A multidisciplinary approach to management, right from the preoperative phase would improve the standardisation of adjuvant treatment which is still limited in our context. Keywords: Progressive cord compressions, tumours, pulpectomy. African Journal of Neurological Sciences Vol. 26 (1) 2007: pp. 14-2

Sentinel Lymph Node Biopsy In The Management Of Breast Cancer: Is it feasible in low- resource countries?

Axillary lymph node dissection (ALND) has been traditionally a routine component of the management of breast cancer. However ALND is associated with a significant increased risk of long term arm morbidity (lymphoedema, pain, numbness and motion restriction).Sentinel lymph node biopsy (SLNB) is a less invasive alternative to ALND for axillary staging of breast cancer. The concept of SLNB is based on identification and excision of the sentinel lymph node (SLN) by probe guided gamma detector after peritumour injection of radio active substance (Tec99) and/or visualisation of these node(s) after peritumour injection of vital blue dyes (patent blue, iso sulfur blue) in the clinically lymph node negative and early breast carcinoma (T1 and small T

Acoustic lens improves superficial in-plane ultrasound-guided procedures - The significance of the beam width artefact

Study objective: The three-dimensional shape of the ultrasound beam produces a thicker scan plane than most users assume. Viewed longitudinally, a needle placed lateral to a vessel just outside the central scanning plane can be displayed incorrectly in the ultrasound image as if placed intravascularly. This phenomenon is called the beam width artefact, also known as the elevation or slice thickness artefact. The goal of this study was to demonstrate the potential negative effect of the beam width artefact on the performance of in-plane ultrasound-guided vascular access procedures, and to provide a solution. Design: Randomized, double-blinded study Setting: Department of anaesthesiology and intensive care of a teaching hospital Participants: 31 experienced (anesthesiologists and intensivists) and 36 inexperienced (anesthetic nurses) ultrasound users Interventions: We developed an acoustic lens that narrows the scan plane to reduce the beam width artefact. The lens was tested in a simulated vascular access study. Measurements: The primary endpoint was first pass success. Secondary endpoints were the number of punctures and needle withdrawals, procedure time, needle visibility and operator satisfaction. Main results: First pass success was highly enhanced using the acoustic lens, with a success rate of 92.5% versus 68.7% without the lens (difference 23.8, 95% confidence interval 11.0–35.3, p < 0.001). The total number of punctures needed to obtain intravenous access was also reduced using the lens (1.10 versus 1.38, difference 0.27, 95% CI 0.11–0.43, p = 0.002). Procedure time, needle withdrawals, needle visibility and satisfaction were similar. Both inexperienced and experienced users benefited from the acoustic lens. Conclusions: The beam width artefact has a significant effect on the performance of ultrasound-guided needle-based procedures. The efficacy of in-plane superficial vascular access procedures can be enhanced by narrowing the imaging plane using an acoustic lens

Acoustic lens improves superficial in-plane ultrasound-guided procedures - The significance of the beam width artefact

STUDY OBJECTIVE: The three-dimensional shape of the ultrasound beam produces a thicker scan plane than most users assume. Viewed longitudinally, a needle placed lateral to a vessel just outside the central scanning plane can be displayed incorrectly in the ultrasound image as if placed intravascularly. This phenomenon is called the beam width artefact, also known as the elevation or slice thickness artefact. The goal of this study was to demonstrate the potential negative effect of the beam width artefact on the performance of in-plane ultrasound-guided vascular access procedures, and to provide a solution. DESIGN: Randomized, double-blinded study SETTING: Department of anaesthesiology and intensive care of a teaching hospital PARTICIPANTS: 31 experienced (anesthesiologists and intensivists) and 36 inexperienced (anesthetic nurses) ultrasound users INTERVENTIONS: We developed an acoustic lens that narrows the scan plane to reduce the beam width artefact. The lens was tested in a simulated vascular access study. MEASUREMENTS: The primary endpoint was first pass success. Secondary endpoints were the number of punctures and needle withdrawals, procedure time, needle visibility and operator satisfaction. MAIN RESULTS: First pass success was highly enhanced using the acoustic lens, with a success rate of 92.5% versus 68.7% without the lens (difference 23.8, 95% confidence interval 11.0-35.3, p < 0.001). The total number of punctures needed to obtain intravenous access was also reduced using the lens (1.10 versus 1.38, difference 0.27, 95% CI 0.11-0.43, p = 0.002). Procedure time, needle withdrawals, needle visibility and satisfaction were similar. Both inexperienced and experienced users benefited from the acoustic lens. CONCLUSIONS: The beam width artefact has a significant effect on the performance of ultrasound-guided needle-based procedures. The efficacy of in-plane superficial vascular access procedures can be enhanced by narrowing the imaging plane using an acoustic lens