Les urgences andrologiques en milieu urbain au Cameroun : aspects cliniques et thérapeutiques

Goal

Describe clinical and therapeutic aspects of andrologic emergencies in an urban area, received in a university teaching hospital in Cameroon.

Methodology

We prospectively studied during 36 months all andrologic emergencies received at Laquintinie Hospital of Douala.

Results

We had a total of 291 patients. The mean age was 42.50 years. Most of our patients?? age was between 0 and 45 years. The most frequent lesion was genito-urinary trauma (51.50%) and uro-genital infections (23.71%). Priapism and torsion of the spermatic cord were also frequent. We carried out 185 emergency surgical interventions. Exploration and suture of wounds of the external genitalia (38.91%) and the exploratory scrototomy (21.62%) were the main emergency procedures.

Conclusion

Genito-urinary trauma are the most encountered andrologic emergencies in an urban area of Cameroon. Priapism and torsion of the spermatic cord were not rare.     

Les complications urinaires des traumatismes du bassin: aspects anatomocliniques et thérapeutiques au CHU de Conakry, Guinée

Objective

To stick out the anatomoclinic aspects and to evaluate the therapeutic results of a series of some pelvic trauma complications is followed at the Urology-Andrology ward in the teaching hospital of Conakry.

Material and method

It’s about a retrospective examined joining together 52 cases of some pelvic trauma complications in a period of five years.

Results

The pelvic trauma complications were representing 3% of whole the hospitalisations during the period of study. The mean age of our patients was 33 years with extremes of 10 and 63 years. The traumas were due to accidents on the public road in 54.9% of cases. In terms of clinics, the symptomatology was essentially constituted by the acute retention of urines with 80.7% of cases and the hemorrhage (hematury and uretrorragy). The main trauma was a back urethral lesion with 82.7% of cases. All the patients profited a surgical treatment. The therapeutics has been judged after an average relapse of 52 months in terms of urinary and sexual complications. Thus, in terms of urinary complications results have been judged good in 59.6% of cases, less in 17.3% and bad in 23.7% of cases. In terms of sexual, we remarked 53.8% of good result, 25% of medium results and 21.2% (N = 11) of bad results.

Conclusion

Management of urinary complication after pelvic trauma is controversy. Thus, we insist on more necessary collaboration between urologist and orthopedist because the stabilisation of the pelvic trauma is very interesting to the management.     

Système sémantiquement interopérable de sélection semi-automatique des patients éligibles aux essais thérapeutiques en cancérologie

Automatic Selection of clinical Trial based on Eligibility Criteria (ASTEC) project is to automate, so as to make it systematic, the search of cancer clinical trials, by reusing the patient data contained into an oncologic electronic health record. ASTEC project tackles two major scientific challenges for medical informatics: 1) the syntactic and semantic interoperability between information systems. The oncologic electronic medical records and the recruitment decision system must be interoperable. The ASTEC project proposes a framework of syntactico-semantic interoperability based on international standards. Generic methods of mediation and reasoning based on ontologies are developed to match data from the electronic medical records to the inclusion/exclusion criteria of clinical trials; 2) a decision support system for recruitment. We have developed inference methods on the electronic medical records adapted to the data structure as well as the eligibility criteria. this paper, we present and justify our choices, concerning the medical process in oncology and the scientific and technical aspects. Furthermore the system will be evaluated in real time. The aim is to demonstrate a significative improvement of the prescreening rate of patient.     

Les urgences urologiques au centre hospitalier national de Nouakchott : aspects épidémiologiques, cliniques et thérapeutiques

Objective

To present the epidemiological, clinical and therapeutic features of urological emergencies in Mauritania, West Africa.

Material and methods

The authors conducted a 5-year retrospective study that analyzed the epidemiological, clinical and therapeutic features of all urological emergencies admitted to the urology department of Nouakchott Central Hospital.

Results

There were 1,200 urological emergencies. The mean age of the patients was 58.8 years (range one month-94 years). These patients had an age ≥60 years in 50.7% of the cases The sex ratio (M: F) was 20: 32. The most frequent illnesses were urinary retention (53%) and genitourinary system infections, which represented 16.8% of the cases. The gangrenes of male external genitalia (Fournier’s gangrene) accounted for 4.3% of the cases and priapism 1.8%. In emergency, 300 surgical operations were performed. The most performed procedures were the installation of a suprapubic catheter (59.7%) and debridement of a gangrene of male external genitalia (16%).

Conclusion

The most frequent urological emergency in our country was acute urinary retention. Serious illnesses, like gangrene of male external genitalia (Fournier’s gangrene) and priapism, are not rare there.     

Évaluation en laboratoire de la toxicité pourDiaeretiella rapae [Hym.: Aphidiidae] des pesticides utilisés en traitement des parties aériennes des plantes

Une méthode d'appréciation de la toxicité pourDiaeretiella rapae M'Intosh des pesticides utilisés en serre, à l'aide de tests de laboratoire de longue durée est décrite. Elle comporte l'étude de l'action sur les stades internes au puceron du parasite et la mise en évidence de la toxicité initiale et de la persistance d'action des résidus pour les adultes. 9 pesticides ont été testés parmi lesquels des insecticides, des aphicides spécifiques, des acaricides spécifiques et des fongicides. Le Bénomyl, le Mancozèbe, le Dicofol et le Tétradifon ne montrent qu'une toxicité très faible. Le Pirimicarbe, l'Isolane et la Phosalone montrent une toxicité moyenne, leur persistance d'action étant assez faible. Par contre le Vamidothion et le Fundal forte se révèlent extrêmement toxiques, surtout par leur très longue persistance d'action. Summary A method for measuring the toxicity of pesticides used in glasshouses toDiaeretiella rapae M'Intosh with long range laboratory tests is described. It includes the study of the pesticide action on parasite instars inside the aphid and the demonstration of the initial toxicity as well as the persistence of action of the residues against adults. Nine pesticides were tested among which insecticides, specific aphicides and miticides and also fungicides. Benomyl, Mancozeb, Dicofol and Tetradifon show only a very low toxicity. Pirimicarbe, Isolane and Phosalone with a short persistence of action have a medium toxicity. In the contrary Vamidothion and Fundal forte with a long persistence of action show very high toxicicity.

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Avec la collaboration technique de Mme A.Gredt.     

Les profils de composition en oligoéléments des pollens,marqueurs potentiels en cladistique végétale

In botany tentative attempts have been made to classify species, based not on the plant as a whole, but on a particular character, for example pollen characteristics. Pollen, which is involved in the transmission of male genetic information during sexual reproduction, is of particular interest in distinguishing plants and their relationships.

These characters, observed in photon- and scanning electron- microscopy are symmetry, form, number and position of germinating areas. Being genetically stable for a given species, they identify a plant.

Recently, a novel character has been added: the concentration of elements in the exine, determined by electron probe micro-X-ray analysis. It is interesting to follow relationship of plant species, based on the mineral composition of their pollen as a whole, taking into account both plastic and oligoelements, obtained via an inductive coupled plasma spectrometer. Samples of pollen from different plant species, at distinct taxonomic levels, were analyzed; the results were submitted to a normalisation procedure and the standard patterns obtained were investigated by means of a number of numerical techniques (clustering and factor analysis). The aim was to establish if elements could be considered as chemical markers in plant cladistics. The mineral composition in a given species appeared quite stable and this furnished a convenient identification-critorion.

This approach further allows a chemo-taxonomy of species, in as much as organization of families, and perhaps orders, would conform to the phylogenetic proximity-criterion. Hence, we found clusters including pollen of Gramineae, Coniferae, Betulaceae…

This methodology, that should be completed and corroborated on a wider range of samples would provide an original responsee to the problems of identification and classification encountered in a pollen bank. It follows that:

Hence, the working hypothesis that the chemical markers and, in particular, oligo-elements, complete pollen typologies based on morphological and structural characters, appears quite reasonable.

In conclusion, this paper brings a complement to the mineral composition of the exine.

En botanique, des tentatives ont été faites pour classer les espèces non plus à partir d'individus pris dans leur intégralité, mais sur la base d'une de leurs particularités, par exemple à partir des caractéristiques offertes par les pollens. Ainsi, le pollen, dont le rôle est de transmettre l'information génétique mâle de la plante au moment de la reproduction sexuée, présente des caractères de premier ordre utilisables pour distinguer les différentes plantes et pour situer leur parenté et leur filiation.

Ces caractères, que l'on observe en microscopies photonique et électronique à balayage sont la symétrie, la forme, le nombre et la position des zones germinatives. Pour une espèce génétiquement stable, ils constituent la carte d'identité de la plante.

Il est intéressant de continuer à explorer la voie de la structuration des espèces végétales basée sur la connaissance chimique du pollen en déterminant sa composition en oligo-éléments par l'utilisation d'un spectromètre à plasma à couplage inductif. Ainsi, des échantillons de pollens appartenant à diverses espèces végétales situées à différents niveaux taxinomiques ont été analysés et les résultats normalisés sous forme de profils standard ont été soumis à différentes techniques d'analyse statistique mathématique (classification automatique et analyse factorielle). Le but de cette approche est d'apprécier l'aptitude des éléments minéraux à être des marqueurs chimiques en cladistique végétale.

Les résultats obtenus ont permis de constater la relative stabilité du profil en composition minérale au sein d'une même espèce végétale, ce qui donne accès à un critère d'identification commode.

Cette approche permet d'autre part une chimiotaxinomie des plantes étudiées.

Cette approche méthodologique semble susceptible d'apporter une réponse originale aux problèmes de conservation. Les pollens conservés doivent avoir la même composition minérale que les pollens frais.

— the pattern of pollen composition of oligo-elements, calcium and magnesium is a marker in plant cladistics. Since a typology depending on proximity is found between plant species, families and orders.

— an unknown pollen sample may be located, tentatively, on the base of a described model of pollen relation (shortest connexion network — Prim algorithm — and pollen of Bactris-oil palm and Phoenix dactylifera).     

Une médecine du fonds des âges : trépanations,amputations et tatouages thérapeutiques au Néolithique

The first shepherds and peasants of the European Neolithic period, between VIth century and IIth millennium BC, had acquired serious medical knowledge. The cranial trepanations and the amputation of members accomplished successfully testify perfectly controlled surgical techniques, which indicate a transmissible knowledge. Tattoos towards a therapeutic end reveal however that the medicine of this time still remained under the influence of rituals and magic.     

Enquête nationale en médecine nucléaire : radiopharmaceutiques et activités utilisés en 2007 dans le secteur public

The Institute for radiation protection and nuclear safety (IRSN) and the National institute for health surveillance (InVS) have been collaborating since 2003 to provide updated data on medical exposure of the French population related to medical diagnosis. In this framework, a survey was carried out by IRSN in 2009 within all the 127 departments of nuclear medicine belonging to public hospitals. The rate of participation was high (72% of the departments). The first objective of this survey was to estimate the activity of these nuclear medicine departments (numbers and types of examination, according to their code in the French common classification for medical care). The second objective was to collect data related to the dose delivered to the patient for each type of examination. This article details this second part of the survey and presents, for the 32 most frequent types of examination, the radionuclide used and its chemical form, the average administered activity per examination and the activity range for the responding departments. When a French dose reference level exists, this survey showed that the average administered activity is in agreement with it, excepted for the ^99mTc thyroid scintigraphy with an administered activity close to twice the dose reference level (DRL). The dispersion of administered activity between the departments for a same type of examination depends on the type of examination, and is comprised between 2 and 10 for a 70 kg patient.     

Traumatismes fermés des bourses: stratégie de prise en charge

Introduction

Blunt scrotal trauma is increasingly frequent, but surgical exploration of these cases of trauma remains controversial. The objectives of this study were to assess the diagnostic value of clinical examination and ultrasound in testicular trauma and to analyse the complications of the various treatments proposed (surgical and medical treatments), in order to more clearly define the place of medical or surgical treatment in this form of trauma in young adults.

Patients and Methods

130 cases of blunt scrotal trauma were managed between 1993 and 2004. In the absence of clinical and ultrasound criteria of severity (haematocele, very large intratesticular haematoma, rupture of the tunica albuginea), medical treatment consisting of rest, anti-inflammatory drugs, and testicular support was instituted. Surgical exploration was performed when serious lesions of the testis were suspected. Scrotal ultrasound was performed in 68 patients and 46 of them underwent scrotal exploration. The sensitivity and specificity of scrotal ultrasound were determined by comparing radiological findings with definitive intraoperative findings. The immediate morbidity and long-term sequelae were analysed.

Results

The mean age of the patients was 24 years (range: 4 to 73 years). The clinical features were dominated by pain (73.8%) and scrotal swelling (89.2%). The sensitivity of testicular ultrasound was 34.7% for testicular rupture, 100% for testicular contusions, 33.3% for intratesticular hematoma and 76.9% for haematocele. Medical and surgical treatments were instituted in 29.2% and 70.7% of cases, respectively. With a mean follow-up of 8 months, chronic pain and testicular atrophy were observed in 18% and 5.5% of cases, respectively.

Conclusion

In the absence of signs of severity, medical treatment with regular surveillance remains justified. However, in the presence of doubtful clinical or ultrasound findings, surgical exploration must be performed as soon as possible     

Les bases cytologiques de la théorie du ≪crossing-over≫: Étude sur la spermatogénèse et l'ovogénèse des calliphorinae

Sans résumé     

Les statuettes féminines en ivoire des faciès gravettiens et post-gravettiens en Europe centrale et orientale : modes de fabrication et de représentation

During the Upper Palaeolithic, especially in Gravettian times, the hunter-gatherer societies had an economy closely linked with the exploitation of two local species in Eastern Europe: reindeer and woolly mammoth. The ivory objects are rich archives about their ways of life and their collective imagination, as in particular the ivory female statuettes show. These figurines, also called “Venus”, are one of the cultural characteristics of the Gravettian sites. To date, although they are more numerous in Eastern Europe, they were discovered, in a variable number, also in site of Central and Western Europe; today, we have no clue that this cultural tradition crossed the Pyrenees. The corpus of pieces from the Gravettian sites of the Russian Plain (dated between 25,000 and 21,000 B.P.) is the more informative about technological know-how of the Gravettian craftsmen. He consists in the leading material of this paper, completed with some data about Epigravettian and Magdalenian statuettes. Whereas the Gravettian figurines show figurative female representations, those of the later cultural facies are more stylized. In a technological point of view, there is a close link between the choice of blanks within the mammoth tusk and the morphology of the statuettes, whatever the period of time considered.     

Les réponses des Ongulés du Pléistocène Supérieuraux changements climatiques en Aquitaine (Sud-Ouest de la France): Quelques exemples

Range displacements by pleistocene ungulates, strongly linked to climatic variations, are apparent based on regional-scale examination of faunal assem-blages; either species appearances or disappearances, or variability in relative species frequencies is evidence for such displacement. Appearances and disappearances of species most often occur with major climatic changes, while frequency variations characterize environmental changes of lesser magnitude.Whenever it is possible to examine processes offaunal change in detail, it becomes evident that they were typically progressive even though they may appear abrupt on a geologic scale. In particular, the disappearance of a species occurs only after populations attempt to adapt to new environmental conditions on a regional level. Adaptative responses may not be successful when climatic shifts are great, involving significant alteration of the extant biosphere, but they may be successful when climatic variability is less radical or when change occurs slowly enough to allow animal populations to develop adequate new adaptative strategies. An example of successful adaptation is provided by the wurmian reindeer. The most humid periods during the early recent Wurm stadial, along with the very dry “inter Laugerie-Lascaux” phase, produced a temporary decrease in relative reindeer frequencies in Aquitaine faunal assemblages. The sharp cold of the Pleniglacial (22000–13500 BP), in contrast, led to a reduction in mean stature of reindeers.