Context and Object: Late nephrology case management for patients with chronic renal failure is consistently associated with high morbidity rate. The objectives of this study were to determine the factors associated wi...Context and Object: Late nephrology case management for patients with chronic renal failure is consistently associated with high morbidity rate. The objectives of this study were to determine the factors associated with late nephrology case management and to describe the evolution of patients depending on the time of care nephrology. Material and Methods: It was a 5-year prospective study, observational type, going from January 1st, 2010 to December 31th, 2014. We studied all the patients hospitalized with chronic renal failure with dialysis or not and we excluded the patients hospitalized for acute renal failure. Results: The study population includes 307 men (53.4%) and 268 women (46.6%) with a sex ratio of 1.14. Age population ranged between 15 and 85 years old with a mean of 44.4 ± 16.20 years old. Their profession was distributed as follows: 220 housewives (38.3%), 181 workers (31.5%), 104 civil servants (18.1%), 56 students (9.7%) and 14 unemployed (2.4%). Patients came from all regions of the country: Conakry: 389 patients (67.6%);Lower Guinea: 82 (14.3%);Middle-Guinea: 57 (9.9%);Upper Guinea: 31 (5.4%);Guinea Forest Region: 16 (2.8%). In this study population, 48 patients were admitted in emergency (8.3%);105 were scheduled (18.3%) and 422 were referred to the nephrology department (73.4%). Reasons for the emergency admission were acute pulmonary edema in 21 patients (43.7%), decompensated anemia in 13 patients (27.1%), loss of consciousness in 9 patients (18.7%) and malignant hypertension in 5 patients (10.4%). The reference patterns was uremic syndrome in 312 patients (54.3%), followed by high blood pressure in 247 patients (42.9%), an edematous syndrome in 234 patients (40.7%), oligoanuria in 222 patients (38.6%), morphological abnormalities on the renal ultrasound in 4 patients (0.7%). The functional symptoms were vomiting in 379 patients (65.9%), followed by dyspnea in 290 patients (50.4%), headaches in 287 patients (49.9%). Among them, 121 patients could handle alone, 431 were borne by their families and 23 were indigent;181 patients had consulted before 1 month of the beginning of the signs, 238 between 1 and 2 months and 156 after 2 months;48 were admitted in emergency, 105 were programmed by the Nephrology Department and 422 were referred to the other health structures of the country. Conclusion: Several factors contributed to the delay in treatment, among which: the low socioeconomic level, the delay of the reference of the patients, the long distance of the regions, the lack of Nephrology units in the country.展开更多
Patients with breast cancer will develop brain metastases in 15% - 25% of cases. Objective: To identify the profile of patients with breast cancer brain metastasis. Method: Retrospective study over 4 years in the onco...Patients with breast cancer will develop brain metastases in 15% - 25% of cases. Objective: To identify the profile of patients with breast cancer brain metastasis. Method: Retrospective study over 4 years in the oncology department of Treichville Hospital. All patients with breast carcinoma who had a brain metastasis during their cancer management were included. Results: 41 cases of breast carcinoma brain metastasis were collected. Patients were older than 40 years in 78% of cases. Family history of breast cancer was found in 7% of patients. More than 80% of patients had consulted with T3 and T4 tumor masses, with 100% of cases of node involvement. The brain was the second site of metastasis. The tumors were Triple negative in 48%, Her2 positive in 36% and luminal in 16%. Brain metastases were of late onset in the majority of cases (68%). They were clinically characterized by headaches (100%), most often included in an intracranial hypertension syndrome (52%). They were multiple (60%). Therapeutically, no surgery was performed on the metastases. Three patients received whole brain radiation therapy. All patients received systemic therapy. In terms of response, 30 cases of progression were observed after treatment and 2 cases of complete response were obtained. Survival from onset of brain metastasis was of 75% at 3 months and 2% at 12 months. Patients with longer survival rates were over 40 years old with triple negative breast cancer. Conclusion: Brain metastasis from breast cancer most often occurs in a particular clinical and pathological context in our countries.展开更多
Objective: Contribute to improving care for prostate cancer patients in Cote d’Ivoire by identifying the average time before the development of the hormone-resistance and inherent therapeutic strategies. Patients and...Objective: Contribute to improving care for prostate cancer patients in Cote d’Ivoire by identifying the average time before the development of the hormone-resistance and inherent therapeutic strategies. Patients and Method: It was a retro and prospective study over three years performed at the University Teaching Hospital of Treichville in Abidjan. 84 patients with metastatic prostate adenocarcinoma and resistant to hormone therapy were involved in the study. The analysis of clinical records enabled us to integrate different parameters in our study. Results: Our patients were relatively young (an average age of 61 years) and most of them belonged to the middle socio-economic class (50%). The resistance occurred within an average period of 9 months. The mixing of Docetaxel and Prednisone chemotherapy was the most used method of treatment (70% of cases). However, few patients (9.5%) received Abiraterone Acetate. Digestive and hematologic toxicities were noticed but they could be controlled by inherent treatment or disappear spontaneously. After nine months of treatment, 54.24% of patients who received specific treatment were alive, but high rates of mortality were observed as for patients who were only treated symptomatically. Conclusion: The relatively short average time before the development of hormone-resistance shows the aggressiveness of prostate adenocarcinoma from black Africans. The main therapeutic standard in our context remains Taxane-based chemotherapy with a good and fair tolerance.展开更多
Non-small cell lung cancer (NSCLC) is a heterogeneous group of malignancies including squamous cell carcinoma, adenocarcinoma, bronchioloalveolar carcinoma and large cell carcinoma. They are known to be of poor progno...Non-small cell lung cancer (NSCLC) is a heterogeneous group of malignancies including squamous cell carcinoma, adenocarcinoma, bronchioloalveolar carcinoma and large cell carcinoma. They are known to be of poor prognosis, despite a better understanding of bronchial oncogenesis. This descriptive retrospective study carried out over three years (January 2013 to December 31st, 2016) at the Oncology Department of the Treichville University Hospital in Abidjan was aimed to assess the efficacy of new treatments for NSCLC in Cote d’Ivoire and to specify their benefit in terms of quality of life, comfort and overall survival. This 77 patients study, found that NSCLC, the most frequent of which is squamous cell carcinoma, occurs in relatively young subjects, smokers (91%) diagnosed at a locally advanced or metastatic stage (89%). Cisplatin base multi-drug chemotherapy was mostly used (71%). Combined all treatments, there was a significant clinical gain. However, no complete response was observed. Hematological and digestive toxicities were seen in more than 30% of cases. Overall survival was of 9 months on average. This study is an advocate to optimize primary prevention policies for a cancer with poor prognosis despite the development of new treatments such as target therapies.展开更多
文摘Context and Object: Late nephrology case management for patients with chronic renal failure is consistently associated with high morbidity rate. The objectives of this study were to determine the factors associated with late nephrology case management and to describe the evolution of patients depending on the time of care nephrology. Material and Methods: It was a 5-year prospective study, observational type, going from January 1st, 2010 to December 31th, 2014. We studied all the patients hospitalized with chronic renal failure with dialysis or not and we excluded the patients hospitalized for acute renal failure. Results: The study population includes 307 men (53.4%) and 268 women (46.6%) with a sex ratio of 1.14. Age population ranged between 15 and 85 years old with a mean of 44.4 ± 16.20 years old. Their profession was distributed as follows: 220 housewives (38.3%), 181 workers (31.5%), 104 civil servants (18.1%), 56 students (9.7%) and 14 unemployed (2.4%). Patients came from all regions of the country: Conakry: 389 patients (67.6%);Lower Guinea: 82 (14.3%);Middle-Guinea: 57 (9.9%);Upper Guinea: 31 (5.4%);Guinea Forest Region: 16 (2.8%). In this study population, 48 patients were admitted in emergency (8.3%);105 were scheduled (18.3%) and 422 were referred to the nephrology department (73.4%). Reasons for the emergency admission were acute pulmonary edema in 21 patients (43.7%), decompensated anemia in 13 patients (27.1%), loss of consciousness in 9 patients (18.7%) and malignant hypertension in 5 patients (10.4%). The reference patterns was uremic syndrome in 312 patients (54.3%), followed by high blood pressure in 247 patients (42.9%), an edematous syndrome in 234 patients (40.7%), oligoanuria in 222 patients (38.6%), morphological abnormalities on the renal ultrasound in 4 patients (0.7%). The functional symptoms were vomiting in 379 patients (65.9%), followed by dyspnea in 290 patients (50.4%), headaches in 287 patients (49.9%). Among them, 121 patients could handle alone, 431 were borne by their families and 23 were indigent;181 patients had consulted before 1 month of the beginning of the signs, 238 between 1 and 2 months and 156 after 2 months;48 were admitted in emergency, 105 were programmed by the Nephrology Department and 422 were referred to the other health structures of the country. Conclusion: Several factors contributed to the delay in treatment, among which: the low socioeconomic level, the delay of the reference of the patients, the long distance of the regions, the lack of Nephrology units in the country.
文摘Patients with breast cancer will develop brain metastases in 15% - 25% of cases. Objective: To identify the profile of patients with breast cancer brain metastasis. Method: Retrospective study over 4 years in the oncology department of Treichville Hospital. All patients with breast carcinoma who had a brain metastasis during their cancer management were included. Results: 41 cases of breast carcinoma brain metastasis were collected. Patients were older than 40 years in 78% of cases. Family history of breast cancer was found in 7% of patients. More than 80% of patients had consulted with T3 and T4 tumor masses, with 100% of cases of node involvement. The brain was the second site of metastasis. The tumors were Triple negative in 48%, Her2 positive in 36% and luminal in 16%. Brain metastases were of late onset in the majority of cases (68%). They were clinically characterized by headaches (100%), most often included in an intracranial hypertension syndrome (52%). They were multiple (60%). Therapeutically, no surgery was performed on the metastases. Three patients received whole brain radiation therapy. All patients received systemic therapy. In terms of response, 30 cases of progression were observed after treatment and 2 cases of complete response were obtained. Survival from onset of brain metastasis was of 75% at 3 months and 2% at 12 months. Patients with longer survival rates were over 40 years old with triple negative breast cancer. Conclusion: Brain metastasis from breast cancer most often occurs in a particular clinical and pathological context in our countries.
文摘Objective: Contribute to improving care for prostate cancer patients in Cote d’Ivoire by identifying the average time before the development of the hormone-resistance and inherent therapeutic strategies. Patients and Method: It was a retro and prospective study over three years performed at the University Teaching Hospital of Treichville in Abidjan. 84 patients with metastatic prostate adenocarcinoma and resistant to hormone therapy were involved in the study. The analysis of clinical records enabled us to integrate different parameters in our study. Results: Our patients were relatively young (an average age of 61 years) and most of them belonged to the middle socio-economic class (50%). The resistance occurred within an average period of 9 months. The mixing of Docetaxel and Prednisone chemotherapy was the most used method of treatment (70% of cases). However, few patients (9.5%) received Abiraterone Acetate. Digestive and hematologic toxicities were noticed but they could be controlled by inherent treatment or disappear spontaneously. After nine months of treatment, 54.24% of patients who received specific treatment were alive, but high rates of mortality were observed as for patients who were only treated symptomatically. Conclusion: The relatively short average time before the development of hormone-resistance shows the aggressiveness of prostate adenocarcinoma from black Africans. The main therapeutic standard in our context remains Taxane-based chemotherapy with a good and fair tolerance.
文摘Non-small cell lung cancer (NSCLC) is a heterogeneous group of malignancies including squamous cell carcinoma, adenocarcinoma, bronchioloalveolar carcinoma and large cell carcinoma. They are known to be of poor prognosis, despite a better understanding of bronchial oncogenesis. This descriptive retrospective study carried out over three years (January 2013 to December 31st, 2016) at the Oncology Department of the Treichville University Hospital in Abidjan was aimed to assess the efficacy of new treatments for NSCLC in Cote d’Ivoire and to specify their benefit in terms of quality of life, comfort and overall survival. This 77 patients study, found that NSCLC, the most frequent of which is squamous cell carcinoma, occurs in relatively young subjects, smokers (91%) diagnosed at a locally advanced or metastatic stage (89%). Cisplatin base multi-drug chemotherapy was mostly used (71%). Combined all treatments, there was a significant clinical gain. However, no complete response was observed. Hematological and digestive toxicities were seen in more than 30% of cases. Overall survival was of 9 months on average. This study is an advocate to optimize primary prevention policies for a cancer with poor prognosis despite the development of new treatments such as target therapies.
