Global viewpoints: proposals for the development of endourology in resource-limited countries in Africa.

Endourology plays an important role in modern urological practice. Compared to open surgery, it offers many advantages. In Africa, endourology is not widely practiced or non-existent in some referral centres.

Place of urolithiasis in the spectrum of urological pathologies, practices and use of endourological procedures in the management of calculi of the upper urinary tract: results of a survey of referral centres in Africa.

Our aim was to determine the current trend of endourology in the management of upper urinary tract calculi in Africa reference centres. We conducted an online multiple-choice questionnaire survey involving 46 centres from 27 countries using a structured well-designed Google Form (®) questionnaire. The questionnaires were distributed to the head of service through their emails.

Socio-demographic and reproductive determinants of cervical neoplasia in seven sub-Sahara African countries.

Background: Since most human papilloma virus (HPV) infections regress without any intervention, HPV is a necessary but may not be a solely sufficient cause of cervical intraepithelial neoplasia (CIN) and cervical cancer. Hence, the influence of cofactors on progression from cervical HPV infection to high-grade CIN and invasive cervical cancer has been a subject of intensive research.

Objective: We assessed the effect of socio-demographic and sexual reproductive factors on the prevalence of invasive cervical cancer and CIN diagnosed in cross-sectional cervical cancer screening projects carried out in seven sites of different sub-Saharan countries.

[What is your diagnosis? Hypochromic microcytic anemia with Evans syndrome or autoimmune thrombocytopenic purpura?].

We report a case of Evans syndrome associated with scleroderma in a 50-year-old woman admitted to the department of internal medicine of Yalgado Ouedraogo National Teaching Hospital in Burkina Faso. The interest of this case lies in on its mode of revelation: chronic bleeding that led to hypochromic microcytic anemia. The indirect antiglobulin test was positive.

[Calcified brain abscess: a case report].

Calcified brain abscesses are rare. A huge one is reported. A six years old feale had a fistula at the left frontal region for about three years.

[Reference values of 15 clinical blood constituent for African adult from Ougadougou (Burkina Faso)].

In order to establish reference values of biochemical profile of the adult (n = 559) in tropical sahelian area (Burkina Faso), assumed to be healthy, age between 15 and 50, 15 clinical blood constituents appearing among the most commonly explored were determined. Most constituents levels are influenced by sex et and age. The reference values stemming from the adult native of Burkina Faso were compared with those of the european adult and difference ares observed.

[Abruptio placentae: epidemiological, clinical and prognostic aspects with respect to a 177 case series].

Objective: A retrospective study based on 177 cases of abruptio placentae, and describing the epidemiological, clinical and prognosis aspects.

Patients And Methods: A hundred and seventy-seven cases, corresponding to 185 children, were registered over a five-year period in the department of gynecology and obstetrics of the CHNYO of Ouagadougou.

Results: Abruptio placentae occurrence rate was about 9.

[Epidemiological features of tumors of the skin and mucosal membranes in the department of dermatology at the Yalgado Ouedraogo National Hospital, Ouagadougou, Burkina Faso].

We conducted a retrospective study of the files of all patients seen from 1 January 1992 through 31 December 1996 with tumors of the skin and mucosal membranes at the Yalgado Ouédraogo National Hospital in order to determine the epidemiologic features of this disease. The records revealed 988 patients presented 1024 tumors, which could be classified into 33 categories. Most of the patients (60.

[Abdominal aortic aneurysm manifested by hematemesis in a 32 year old patient infected by HIV].

Aortic aneurysm is an uncommon in young patients. The purpose of this report is to describe a case of dissecting aortic aneurysm in a 32-year-old man with human immunodeficiency virus (HIV) infection. The presenting symptom was recurrent massive hematemesis.

[Intensive care in Africa: a report of the first two years of activity of the intensive care unit of Ouagadougou national hospital (Burkina Faso)].

Objective: Intensive care units (ICUs) are very expensive and their role and effectiveness in developing countries are discussed; yet, their performance in these countries was infrequently reported. We report the experience over the first two years of activity of the multidisciplinary intensive care unit of the Ouagadougou national hospital. The analysis of such experience raises the issues related to intensive care in a developing country in terms of technical and social efficiency.

[Radiography and ultrasonography in the management of bladder tumors: 71 cases at the National Hospital Center of Yalgado Ouedraogo (Burkina Faso)].

The bladder's cancer is frequent in West Africa. Urinary schistosomiasis endemicity helps to explain this high incidence. It is a pathology of late diagnosis, little or badly explored by imaging.

[Left ventricular hypertrophy in hypertensive African blacks: echocardiographic study of 452 patients].

Objective: The aim of this study was to define in a population of hypertensive Black African, the frequency of left ventricular hypertrophy (LVH), the different kind of LVH, and the factors of LVH occurring.

Methods: Clinical and echographic (according to Penn convention) data was collected in 452 consecutive hypertensive patients (193 women and 259 men). LVH was defined as an indexed left ventricular mass (ILVM) > 134 g/m2 in man and 110 g/m2 in woman.

[A case of pneumopericardium complicating a liver abscess in a patient infected with HIV].

Pneumopericardium usually occurs in a traumatic context or, more rarely, in the course of benign or malignant bronchial or oesophagogastric diseases. Although the idiopathic spontaneous form is even rarer, pneumopericardium complicating liver abscess is exceptional, and is facilitated by impaired immune defenses (alcoholism, immuno-depression). The authors report a case of liver abscess complicated by pneumopericardium in an HIV seropositive patient.

[Bronchopulmonary Kaposi's disease in 2 AIDS patients living in a zone of high tuberculosis/HIV prevalence].

The epidemic form of Kaposi's disease, called Kaposi-AIDS, was first described in 1981 by Hymmes in two young AIDS patients. Lung lesions are observed in 10 to 45% of patients with cutaneous Kaposi and are the second leading localization of visceral involvement after the digestive tract. Diagnosis and management of these visceral forms remains difficult.

[Routine electrocardiographic criteria for the diagnosis of left ventricular hypertrophy: performance in Black Africans].

Objective: To determine, in Black Africans, the performance of routine electrocardiographic criteria in the diagnosis of left ventricular hypertrophy (LVH).

Methods: Thirty voluntary healthy subjects and 154 patients were explored at echocardiography (according to Pen convention) and 12-lead electrocardiography (ECG). The performance of Lewis, Sokolow and Cornell (Cornell S1 for a threshold of 28 mm in men, and Cornell S2, for a threshold of 24 mm) criteria were defined by their sensitivity, specificity, positive and negative predictive values.

[Tuberculous spondylodiscitis with neurologic problems: results of surgical treatment].

The purpose of this study is to describe the outcome of surgical treatment for tuberculous spondylitis in 29 patients. These patients were part of an overall series of 67 cases of tuberculous spondylitis treated at the Traumatology and Orthopedic Department of the Yalgado-Ouedraogo National Hospital Center (YONHC) in Ouagadougou, Burkina Faso. Almost 90% of the 29 patients that underwent surgical treatment of tuberculous spondylitis associated with neurological manifestations were from poor rural areas.

[Warm saline enema for reduction of intestinal invagination under the ultrasonographic guidance: preliminary results apropos of 2 cases].

The authors describe the use of isotonic normal saline enema under US guidance in the treatment of acute uncomplicated intestinal intussusception in infants. The technique was successfully used in two patients aged respectively 18 and 16 months, with 11 and 9-month follow-up. The various steps of this technique and the results are analyzed and discussed.

[Primary pulmonary myxoid liposarcoma discovered fortuitously].

We report a fortuitous discovery of primary pulmonary myxoid liposarcoma in an HIV-positive patient. Primary pulmonary localizations are uncommon. Generally, pulmonary localizations are metastatic.

[Contribution of bronchial fibroscopy in pneumonology services in developing countries].

Bronchial fibroscopy is a recent investigation method that requires equipment and facilities difficult to implement in respiratory diseases units in developing countries. In Burkina Faso, this technique was introduced for the first time in February 1997. The purpose of this study was to determine the contribution of bronchial fibroscopy for the diagnosis of respiratory disease in countries with limited resources.

[Pityriasis rosea in secondary schools in Ouagadougou, Burkina Faso].

Background: Pityriasis rosea is a spontaneously regressive benign erythematous squamous dermatosis. A better understanding of this condition in developing countries would be useful.

Patients And Methods: We conducted a cross section study based on one-day surveys in Ouagadougou, Burkina Faso, secondary schools.

[Etiologies of ocular and eyelid trauma in Burkina Faso].

Purpose: To identify the epidemiological features of ocular traumas in Burkina Faso.

Methods: A retrospective study was conducted in the eye department of the National Hospital of Ouagadougou, from January 1995 to 31 December 1997. All cases of eye trauma during this period were included.

[Clinical, radiographic and ultrasonographic aspects of mediastinal nodular tuberculosis in the era of HIV infection].

Objective: The purpose of this study was to determine the clinical, radiographic, and ultrasonographic aspects of mediastinal nodal tuberculosis and ascertain its clinical course in the era of HIV infection.

Patients And Methods: We reviewed retrospectively 39 patients referred to the Ouédraogo Yalgado National Hospital Center and the National Anticancer Institute between February 1996 and December 1999 for mediastinal nodal tuberculosis. Endoscopic proof of tuberculosis was obtained in 30 cases (81.

[Huntington disease in Burkina Faso].

Four cases of Huntington's disease in two families seen in Burkino Faso, a country in western Africa, are described. All four patients were black Africans aged 43, 42, 38 and 33 years. The clinical presentation was typical with chorea and episodes of psychiatric disorders.

[Fetal weight gain curve for a cohort of 126 pregnant women at Ouagadougou, Burkino Faso].

We carried out a prospective study at Ouagadougou, from March 1 1997 to April 30 1998, in which we plotted curves of fetal weight gain, estimated by ultrasound biometry, with the aim of comparing our results to those of other authors and establishing a local chart. We established a growth curve from 936 fetal weights estimated during the follow up of 126 pregnant women. The mean age of the women included was 26 +/- 0,8 years and 52.

[Apropos of a case of rabies occurring despite vaccination after exposure].

Rabies is endemic in Sub-Saharan Africa. Control is based on vaccination of subjects at high-risk for exposure and prompt post-exposure treatment. However the severity of some animal bites and early mismanagement can lead to development of rabies despite post-exposure treatment.