Can visual cervical screening be sustained in routine health services? Experience from Mali, Africa.

OBJECTIVE: To assess the feasibility of sustaining visual cervical screening and treatment services in Mali, and to evaluate their performance and impact in improving the provision of cervical cancer control, following an initial cross-sectional study. DESIGN: Descriptive study. SETTING: Bamako area, Mali. POPULATION: Women aged 30-59 years. METHODS: Routine visual screening and treatment services were organised through two hospitals and 14 health centres. Patients with positive visual screening tests underwent colposcopy and/or directed biopsies, and ablative or surgical excision treatment was offered to those with cervical intraepithelial neoplasia (CIN). MAIN OUTCOME MEASURES: Test positivity, detection and treatment rates for CIN and the sustainability of screening services. RESULTS: Of the 14,141 women screened, 1682 (11.9%) were positive and were referred for further investigations and treatment. Over 75% of the screen-positive women underwent colposcopy and/or biopsy. CIN 1 was detected in 383 women, CIN 2 in 88, CIN 3 in 37 and invasive cervical cancer in 497. More than 80% of women with CIN and 35% of those with invasive cancer received treatment. The test performance characteristics and treatment coverage of routine screening were similar to those observed in the preceding cross-sectional study. CONCLUSION: Visual screening and treatment services are sustainable and effective in improving cervical cancer control provision by health services in Bamako, Mali. It is essential to organise and sustain several point-of-care services in order to extend cervical cancer prevention in low-income African countries.

[Contribution Of The Cytology In The Diagnosis And Evaluation Of The Pronostic Of Metastatic Ascites]. / Contribution De La Cytologie Au Diagnostic Et A L'Evaluation Du Pronostic Des Ascites Metastatiques Au Mali.

INTRODUCTION: Metastatsic tumoral ascites are characterised by the presence of cancerous cells in peritoneal fluid. They are frequent at an advanced stage of cancer. The goal of our work was to study cytology's contribution in the diagnosis of metastatic ascites at the teaching hospital of Point G. MATERIAL AND METHODS: It was a 3 years retrospective and prospective study, from January 2013 to December 2015. The study included every ascitic samples containing malignant cells at the teaching hospital of Point G. We looked for clinical informations in the patient's fold to find the primary cancer site, the histological diagnosis and the folllowup. RESULTS: We collected data from 213 patients with ascite. Among them, 61 where malignant (28.6 %). Sixty-six percent (66%) of our patients were women. The most represented range age was from 46 to 60 years with a mean of 57.7 years. Housewives were the most frequent among our patients with a rate of 50.8%. Ovarian cancer was the first site with metastatic ascite (26%). It was followed by liver and stomach with respectively 20% and 18%. Ascite was the first clinical manifestation in 36% patients with cancer. It was isolated in 78%. After 6 months, the mortality rate was 76.6%. CONCLUSION: The cytology of ascite liquid is an imortant test for the diagnostic of metastatic ascites.

INTRODUCTION: Les ascites métastatiques cancéreuses sont caractérisées par la présence de cellules cancéreuses métastatiques dans le liquide péritonéal. Elles sont fréquentes à un stade avancé des cancers. Il s'agissait de déterminer la contribution de la cytologie au diagnostic et à l'évaluation du pronostic des ascites métastatiques dans le service d'Anatomie et Cytologie Pathologiques du CHU du Point G. MATÉRIEL ET MÉTHODE: Notre étude s'est étendue de Janvier 2013 à Décembre 2015; soit une période de 3 ans. Elle était rétrospective et prospective incluant tous les patients dont l'étude cytologique des liquides d'ascitea mis en évidence des cellules malignes. Le dossier médical des patients a été exploité pour la recherche du site primitif et du diagnostic histologique éventuel et le suivi. RÉSULTATS: Sur 213 examens cytologiques de liquide d'ascite; 61 étaient malins, soit un taux de 28,64%. La tranche d'âge la plus répresentée était de 46 à 60 ans avec un âge moyen de 53,7 ± 14,7 ans. Le sexe féminin était dominant avec un taux de 66%. La profession la plus fréquente était les ménagères soit un taux de 50,82%. Le siège primitif le plus fréquent était l'ovaire (26%). Il était suivi par le foie et l'estomac avec respectivement 20% et 18%. L'ascite a été le signe révélateur du cancer dans 36% des cas. Elle était isolée dans 78%. Après 6 mois de suivi, le taux de mortalité était 75,6%. CONCLUSION: L'examen cytologique constitue un examen paraclinique dans le diagnoticdes ascites metastatiques cancéreuses.

[The Ileal Neobladder With The Hautmann Technic At The Urology Depatment Of University Hospital Pr. Bocar S. SALL Of Kati]. / Le Remplacement De Vessie Selon La Technique De Hautmann Au Service D'Urologie Du Chu Pr. Bocar S. SALL De Kati.

Radical cystectomy is the standard treatment for bladder tumors infiltrating the bladder muscle, for patients who have tumors without invasion of neighboring organs and without metastasis. After radical cystectomy, the urinary diversion is a challenge for any urologist. Ileal neo bladder is a rare surgery in our country. The ileal neo bladder is recommended in these patients. We report a case of ileal neo bladder in a 42-year-old woman with a bladder tumor. We discuss the clinical, diagnostic and therapeutic aspects.

La cystectomie totale constitue le traitement de référence des tumeurs de vessie infiltrant le muscle vésical, pour les patients qui ont une tumeur sans envahissement des organes voisins et sans métastase. Après la cystectomie, la dérivation des urines est un challenge pour tout urologue. Le remplacement de vessie est un geste rarement réalisé dans notre pays. Un remplacement de vessie par l'intestin est recommandé chez ces patients. Nous rapportons un cas de remplacement de vessie chez une femme de 42 ans ayant une tumeur de vessie. Nous discutons les aspects cliniques, diagnostiques et thérapeutiques.

Childhood brain tumors in Mali.

to assess epidemiologic and clinical aspects of childhood brain tumors in Mali. a retrospective, descriptive study of children aged 0-15 years with brain tumors, conducted in the pediatrics department of the Gabriel Touré University Hospital Center in Bamako, Mali, from January 31, 2007 to December 3, 2012. In all, 41 cases of brain tumors were recorded during this period (mean: 5.5 years old; range: 1-12 years). Brain tumors were most frequent in the children aged 2-5 years (53.7%) and among boys (53.7%). Late stage at presentation was relatively frequent (34.1%) with a mean time to diagnosis of 10 months. Features of elevated intracranial pressure were the most frequent mode of revelation of primary tumors (26.8%). Supratentorial tumors accounted for 83% of the cases, and gliomas were most frequently (29.3%) identified on computed tomography. Only five patients underwent surgical tumor removal. A broader study including the other hospitals in Bamako could help to assess more accurately the epidemiology of pediatric brain tumors in Mali.

[Case study of renal oncocytoma at the Kati hospital]. / Oncocytome renal a propos d'un cas a l'hopital De Kati.

Renal oncocytoma is a rare benign tumor of the kidney. This benign tumor of epithelial origin represents 5% of renal tumors. Preoperative diagnosis is difficult. The final diagnosis can only be made on the anatomical part; even imaging result can often be evocative. We report the case of a 41 year old patient with renal oncocytoma confirmed after radical nephrectomy for renal tumor.

L'oncocytome rénal est une tumeur bénigne rare du rein d'origine épithéliale représentant 5% des tumeurs rénales. Le diagnostic préopératoire est difficile. L'imagerie est souvent évocatrice. Le diagnostic final ne peut être fait que sur la pièce anatomique. L'exploration chirurgicale demeure la règle en absence d'une biopsie rénale pour obtenir un diagnostic histologique précis. Nous rapportons l'observation d'un patient âgé de 41 ans ayant l'oncocytome rénal confirmé après néphrectomie élargie pour tumeur rénale.

[Epidemiological characteristics and prognosis of gastric Cancer in urban areas of Mali]. / Les caracteristiques epidemiologiques et pronostiques du cancer de l'estomac en milieu urbain au Mali.

Stomach cancer remains a public health problem. It is increasingly found in our regions, probably because of the greater availability and improvement of diagnostic facilities.The goal of this work was to study the epidemiological characteristics and prognosis of gastric cancer in the hepato-gastroenterology and general surgery wards of the Gabriel Toure university hospital. METHODS: We conduct a descriptive retrospective study on patients from June 2008 to May 2009, and the enrollment of patients lasted from June 2009 to May 2010. RESULTS: We examined the records of 68 cases of gastric cancer in 115 cases of digestive cancers a frequency of 59.1%.The mean age of patients was 56.51 ± 14.8 years with extremes of 27 and 90 years. The sex ratio was 1.6 in favor for men. The social and professional groups (housewives and farmers) were the most represented with 50 cases (73.5%). Salting, smoking, consumption of tô (cereal dough) with potash were the most found risk factors in 80.9%, 94.2% and 80.6% of cases respectively. The localization of antro-pyloric site was most represented (60.3%). Adenocarcinoma was the most common histological type (94.1%), one case of Gastrointestinal Stromal Tumor (GIST), two cases of non hodgkin malignant lymphoma were found.The curative surgery was performed in 8.9% of our patients. The overall survival rate after any surgery with two-year follow-up was 9.4%. Post curative surgery survival was 83.3% at two years follow-up. CONCLUSION: Stomach cancer is common in our context, but its management is suffering from delayed diagnosis.

Le cancer de l'estomac reste un problème de santé publique.Il est de plus en plus constaté dans nos régions, du fait probablement de la disponibilité plus importante des moyens diagnostiques.Le but de ce travail était d'étudier les caractéristiques épidémiologiques et pronostiques du cancer de l'estomac dans les services d'hépato-gastroentérologie et de Chirurgie générale du CHU Gabriel Touré.Il s'agissait d'une étude rétrospective descriptive ayant porté sur les malades colligés de juin 2008 à mai 2009 et l'étude des dossiers de ces malades a duré de juin 2009 à mai 2010. Nous avons consulté les dossiers de 68 cas de cancers de l'estomac sur 115 cas de cancers digestifs soit une fréquence de 59,1%. L'âge moyen des patients était de 56,51±14,8 ans avec des extrêmes de 27 et 90 ans .Le sexratio était de 1,6 en faveur des hommes. Les couches socioprofessionnelles (ménagères et cultivateurs) étaient les plus représentées avec 50 cas soit 73,5%. La salaison, le fumage, la consommation de tô (pâte de céréales) avec potasse ont été les facteurs de risque les plus retrouvés dans respectivement 80,9%;94,2% et 80,6% des cas. Le siège antro-pylorique a été plus représenté (60,3%). L'adénocarcinome a été le type histologique le plus fréquent (94,1%), un cas de tumeur stromale, deux cas de lymphome malin non hogdkinien ont été retrouvés. La chirurgie à visée curative a été réalisée chez 8,9% de nos patients. Le taux de survie globale après toute chirurgie confondue à deux ans de suivi a été de 9,4%. La survie post chirurgie curative a été de 83,3% à deux ans de suivi. CONCLUSION: Le cancer de l'estomac est fréquent dans notre contexte mais sa prise en charge souffre du retard diagnostique.

[Epidemiology and prognosis of childhood cancers at Gabriel-Touré Teaching Hospital (Bamako, Mali)]. / Épidémiologie et pronostic des cancers pédiatriques au CHU Gabriel-Touré de Bamako (Mali).

UNLABELLED: Cancer today is being treated as a public health problem in Africa, as in developed countries. OBJECTIVE: The aim of this retrospective study was to evaluate the epidemiology and outcome of children treated in the Pediatric Oncology Unit of Gabriel Touré Teaching Hospital in Bamako (Mali), six years after it opened. METHODS: Retrospective study of the files of all children aged 15 and younger diagnosed with cancer and treated by chemotherapy between January 1, 2005, and December 31, 2010. RESULTS: The study included 690 children. Their mean age was 24 months. The time from observation of first symptoms to consultation was less than 3 months in 200 cases (29%), from 3 to 10 months in 256 (37.1%), and more than 10 months in 234 (33.9%). The five most common childhood cancers were malignant non-Hodgkin's lymphoma (NHL) (n=231, 33.5%), retinoblastoma (n=170, 24.6%), nephroblastoma (n=102, 14.8%), acute lymphoblastic leukemia (n=54, 7%), and Hodgkin's disease (n=34, 4%). Six years after the unit opened and after a mean follow-up of 3 years, we recorded 272 deaths (39.4%); at least 238 children are still alive (34.5%), with 180 cases (26.1%) lost to follow-up. CONCLUSION: Childhood cancer survival is still low in Mali, and the rate of loss to follow-up quite high.

[Colon amyloidosis secondary to tuberculosis: Case report and review of the literature]. / L'amylose colique secondaire a la tuberculose: A propos d'une observation et revue de la litterature.

The authors report the first case of amyloidosis diagnosed by histology and documented in Mali. The patient was a young lady of 31 years old who was hospitalized in internal medicine at the University Hospital of "Point G" for edema and ascites syndrome. She had a history of diarrhea, fever, vomiting, exercise dyspnea and diffused abdominal pain. The biological assessment such as HIV serology was negative. The research of Mycobacterium tuberculosis in sputum was positive. The diagnosis hypothesis of amyloidosis has been evoked and a biopsy of the rectal mucosa has been performed. The fragments showed by histology an acellular band between the basal membrane and the periglandular area. This band was stained in red by Rouge Congo. That confirmed the diagnosis of amyloidosis.

Les auteurs rapportent le premier cas d'amylose diagnostiqué à l'histologie et documenté au Mali. Il s'agissait d'une jeune dame de 31ans ayant été hospitalisée en médecine interne au CHU du «Point G" pour syndrome oedemato-ascitique. Elle a comme antécédent: une diarrhée, une fièvre, des vomissements, une dyspnée d'effort et des douleurs abdominales diffuses. Le bilan biologique y compris la sérologie VIH était sans particularité. La recherche de BAAR dans les crachats était positive. L'hypothèse diagnostique d'amylose a été évoquée et une biopsie de la muqueuse rectale a été effectuée. Les fragments présentaient à l'histologie une bande acellulaire entre la membrane basale et la zone périglandulaire. Cette bande a été colorée en rouge par le rouge Congo. Ceci a permis de confirmer le diagnostic d'amylose.

[Atypical fibrous epulis: Surgical treatment of 1 case]. / Epulis fibreuse remaniee: Prise en charge chirurgicale d'un cas.

Benign tumors are frequently encountered pathologies on the oral mucosa. They comprise a number of different lesions, including fibrous epulis. Its diagnosis is only possible by histological examination. We are presenting the case of a patient who consulted for an externalized maxillary swelling. Clinical examination showed an oval, painless swelling of solid consistency, independent of the alveolar bone, covered by a fibrous grayish membrane, prolonging the gingival fibro-mucosa at the vestibular level. The treatment was surgical excision of the tumor. Histological examination concluded that there was a lack of cytonuclear atypia and retained the diagnosis suggesting atypical fibrous epulis. We reviewed the clinical data, diagnosis and treatment of this type of tumor.

Les tumeurs bénignes sont des pathologies fréquemment rencontrées au niveau de la muqueuse buccale. Elles regroupent un ensemble de lésions dont l'épulis fibreuse. Le diagnostic positif de cette dernière n'est confirmé que par l'examen histologique.Nous rapportons le cas d'un patient ayant consulté pour une tuméfaction maxillaire extériorisée. L'examen clinique a permis de trouver une tuméfaction de forme ovalaire, indolore, de consistance ferme n'intéressant pas l'os alvéolaire, recouverte par une membrane grisâtre d'aspect fibreux, prolongeant la fibro-muqueuse gingivale au niveau vestibulaire. Le traitement réalisé fut l'exérèse chirurgicale de la tumeur. L'examen histologique a conclu en une absence d'atypie cytonucléaire et a retenu le diagnostic d'épulis fibreuse remaniée. Nous avons passé en revue les données cliniques, diagnostiques et thérapeutiques de ce type de tumeur.

[Upper gastrointestinal endoscopy during Kaposi's sarcoma to the Point G Hospital, Bamako (Mali): case study 20]. / Endoscopie Digestive Haute Au Cours De La Maladie De Kaposi Au CHU Du Point G, Bamako(Mali) : Etude De 20 Cas.

INTRODUCTION: Since the advent of HIV, Kaposi's sarcoma has become one of the most common opportunistic infections and the first cancer in patients with HIV. This cancerous disease occurs most often on the skin but also the viscera. Digestive localization was often observed during the search for other locations before the cutaneous form. No studies in Mali has focused on the upper gastrointestinal location. OBJECTIVES: To describe the epidemiological and clinical aspects of Kaposi's sarcoma in the upper gastrointestinal endoscopy. METHODS: This was a retrospective descriptive study from June 2005 to February 2009 in the center of endoscopy of the Point G Hospital including all patients seen in upper gastrointestinal endoscopy during the study period. RESULTS: 20 cases were reported from a total of 5068 endoscopy performed during this period a frequency of 0.39% hospital. These 20 cases were identified in all 31 patients with cutaneous localization of Kaposi's sarcoma is a frequency of 64.5%. The sex ratio was equal to 0.81. The average age was 36.8 years ± 8.92 years. The stomach and esophagus were found most locations. All patients were HIV positive. The CD4 count below 200 cells/mm3 was observed in 95% of patients.

Hodgkin lymphoma at the paediatric oncology unit of gabriel touré teaching hospital, bamako, mali: 5-year experience.

Introduction. The aim of this retrospective, unicentric study over 5 years is to describe the epidemiologic, pathologic, clinic and therapeutic aspects of children treated for Hodgkin lymphoma in our paediatric oncology unit. Patients and Methods. From January 2005 to December 2009, all children under 18 years of age, with Hodgkin lymphoma were included in this study. The treatment protocol was the GFAOP (Groupe Franco-Africain d'Oncologie Pédiatrique) Hodgkin lymphoma treatment protocol. Results. During the study period, 217 cancer cases were diagnosed in our centre. Of these cases, 7 were Hodgkin Lymphoma (LH) (0.04%). The mean age was 11.7 years. The sex-ratio was 6/1. 4% (5/7) of patients were stage IIB and 28.6% (2/7) stage IIIB of Ann-Arbor classification. There were 3 cases (42.8%) of sclero-nodular subtype, 2 cases (28.6%) of lymphocyte-rich classical HL subtype, 1 case (14.3%) of mixed cellularity and 1 case (14.3%) of lymphocyte depleted subtype. With a median followup of 37 months, 5 patients (71.4%) are alive, and 2 patients (28.6%) died. Conclusion. Broader multicentric studies are needed for more accurate data on this malignancy.

[Morbidity of the tumours of the sphere head and neck in Bamako]. / Morbidite par tumeurs de la sphere tete et cou a Bamako.

This work reports the results of one year (November 2004-October 2005) descriptive study of tumours located in the head and neck areas in the ENT department of the University-Hospital of Gabriel Toure in Bamako. Were included in the study patients whose files showed epidemiology data: age, sex, profession, residence and period of the medical checking, and exposition factors: anatomic location, results of histology and image data of the tumours. Where excluded from the study the patients whose file were not completed and those that have had eye and brain tumours From the data base of the department, a total of 60 cases of tumours were monitored and 25 others cases were excluded according to the criteria. Among the 60 cases, 24 tumours (40%) were malign and 36 were benign. Goiter was the most found benign tumor according to the results of the hystology analysis. In most cases (15 out of 36, 41.67%) the histology analysis showed an colloid adenoma Other rare tumors like rhinoscleroma (5 cases out of 36, 13.89%), nose invertus papilloma (2 cases out of 36, 5.55%) where found. These were easily diagnosed and treated. In the group of malign tumors, the pharyngolaryngeal cancer was the most found (11 cases out of 24) and the most predominant histology of these cancers was the epidermoid carcinoma. Two of these cancers were found in patients below fifteen years of age, but no other risk factors like expositions was noted in the files of these two patients. Other malign tumors have been found: nose and sinusal cancers and thyroid carcinoma. In most cases these tumors were diagnosed at an advanced stage.

[Laryngo-pharyngeal cancer at a health service of last resort in Mali: anatomo-clinical and therapeutic aspects]. / Les cancers laryngo-pharynges dans un service de sante de dernier recours au Mali: aspects anatomo-cliniques et thérapeutiques.

The purpose of this study is to describe the clinical, anatomic and therapeutic aspects of laryngitis--pharyngeal cancers in Mali. It was a prospective, descriptive and cross sectional study which was help in the ORL and cervical facial department of the university hospital center Gabriel TOURE between April 2006 and March 2007. The study looked at 18 patients hospitalized for larynx or hypo pharynx cancer, diagnostic was confirmed histologically. The parameters (age, other favorable features, clinical signs, endoscopic aspect of the tumor, histological type and treatment type) have been analyzed. Men were the most affected (66.7%), with an average age of 58.17 year old. Chronic smoking has been the most evocated factor of risk (55.17) with an average consumation of 39.5 P/A. A delay in consultation was noticed (60% with a period greater than 1 year after the first symptoms appear). The burgeoning aspect (66.7%) end the carcinoma epidemic type of the tumor (94.7%) have dominated the anatomy pathologic table. Only 27.8% of patients had surgery because of late diagnosis.

[Epidemiology and morphology of breast benign tumors in Mali: about 186 cases]. / Epidemiologie et morphologie des tumeurs benignes du sein au Mali: a propos de 186 cas.

BACKGROUND: Mammary tumors are frequent. Benign tumors are more frequent, and are characterized by a possibility of recurrence or malignant transformation. The aim of this study was to describe the epidemiological and morphological characteristics of breast benign tumors. METHODS: The authors have undertaken a retrospective study from January 1998 to December 2003. This study was led in the laboratory of pathology of the National Institute of Public Health, in surgical and gynecological services of Bamako. The study had concerned all benign tumors confirmed by histology. FINDINGS: In total, 186 benign tumors were diagnosed over 611 mammary pathologies (30.44%). The average age was 27.1 +/- 11.7 years. Sex ratio was 17.6 in favour of women. The main complaint was feeling a nodule in the breast (91.9%). The most affected breast was the right side (50.8%). Tumor sizes were variable, and the color changed through white to yellow. Histological aspects were: fibroadenoma (72%), lipoma (8.6%), tubular adenoma (5.9%), papilloma (5.4%), lactating adenoma (3.8%), phyllodes tumor (3.8%), and syringomatous tumor (0.5%). CONCLUSION: Benign tumors are frequent in mammary pathology. The patients need a follow-up because of the recurrence or the malignant transformation of these tumors.

[Extension of cervix cancer screening by visual methods to the community health centres in the district of Bamako]. / Extension du depistage du cancer du col uterin par inspection visuelle aux centres de sante communautaires du district de Bamako.

Cervix cancer remains a public health problem in developing countries. These results are an assessment for multicentric study based on visual inspection of the cervix after application of acetiq acid (VIA) and lugol's iodine (VILI). The aim of this study is to determine the feasibility and the impact of this screening in the community health centres "CSCOM" in the district of Bamako. It was a prospective and multicentric study through 8 CSCOM, 3 Reference Centres "CSRéf", Hôpital Gabriel Touré (HGT) and National Institute of Public Health (INRSP) in Bamako. During 28 months, 5016 women aged through 25-49 years were screened. After their consent and questionnaire filling, the patient is comfortably settled for visual test. The repartition of screened patients by health level is: CSCOM (19.24% : 965/5016), CSRéf (48.64% : 2440/5016), HGT (32.12% : 1611/5016). In general, the positivity of tests was: 5.2% (VIA) and 6.8% (VILI). The positive women at the CSCOM level were oriented to the CSRéf or the HGT for the colposcopy, possible biopsy or care. At all 177 biopsies were done, and histological diagnosis were: 67 dysplasias, 3 early invasive carcinomas, 69 invasive carcinomas and 38 inflammatory metaplasic lesions or nonconclusives aspects. Patients with dysplasias or cancers were treated by cryotherapy, loop electrosurgical excision procedure (LEEP), cold-knife conization or surgery. This study showed that screening of cervical cancer by visual inspection is workable at CSCOM level. We wish a large diffusion of the method to the whole of the country.

[AIDS related Kaposi's disease in Hospital area in Bamako]. / La Maladie de Kaposi au cours du VIH/Sida en milieu hospitalier de Bamako.

The goal of this prospective work were to describe the clinical, therapeutic and evolutionary aspects of Kaposi's disease occurring during AIDS in the infectious diseases service from October 1, 2004 to September 30, 2005. The diagnosis of the infection by the HIV was based on the positivity of serology with 2 fast tests. That of the Kaposi's disease was based on the clinical aspect and /or histological of the lesions. On these 2189 patients, 37 presented the Kaposi's disease that means a prevalence of 1.6%. They were 17 men and 20 women average age 39.5 years and heterosexuals in 97.30 % of the cases. Kaposi's disease limited on the skin and mucous were most represented within (48.65 %), followed by the skin limited (43.24 %) and mucous localization (8.11%). Papulo-nodulare feature was the major clinical founded to the physical examination in 54.05 %. The rate of average CD4 was 76 cellules/mm3 with the extreme one going from 1 to 512 cellules/mm3. It was favorable at 14 (43.75%) of the 32 patients having profited from antiretroviral treatment. The Kaposi's disease during the AIDS is relatively frequent with the service of the infectious diseases and the prognosis remains severe. However the antiretroviral therapy can improve the prognosis of the skin limited forms.

[Gastritis associated with duodeno-gastric reflux]. / Gastrite chronique et reflux duodeno-gastrique.

Our main objective was to study gastritis associated to duodeno-gastric reflux. It is about a longitudinal study case/witness, paired according to the sex and the age. It was unrolled from February 2005 to January 2006 in the digestive diseases department of the hospital Gabriél Touré, and endoscopic centers of Promenade des Angevins, and clinique Farako. The patients profited from an upper digestive endoscopy to appreciate endoscopic aspect of gastritis associated to bile in the stomach mucus lake. The gastric biopsies were systematic. This study included 50 patients having gastritis associated to bile in gastric mucus lake compared to 50 patients having gastritis associated to clearly gastric mucus lake. The sex-ratio was 1.26 in favour of men. The average age of the patients was of 41.30 +/- 15.43 years. On the symptomatic hand, fetid breath was significantly met in duodeno-gastric reflux (p = 0.013). Potash consumption in the "tô" (millet cake) was significantly reported in gastritis associated to bile in gastric mucus lake (p = 0.042). The endoscopic aspects were comparable. Histological aspects of nonatrophic chronic gastritis were significantly mint in witnesses as well into the antrum as into the fundus (p = 0.0001 and p = 0.00023). The reactional gastritis aspect was the prerogative of duodenogastric reflux (p ranging between 10(-6) and 3.10 (-6). Helicobacter pylori infection was found comparable in the two groups (p = 0.297). Dysplasia although rare was found only in gastritis associated to duodeno-gastric reflux. Gastritis associated to bile in gastric mucus does not se,nm to have specific clinical, endoscopic and histological presentation. However the presence of dysplasia must have an attentive monitoring.

[Anatomopathologic, clinical and radiologic aspects of benign tumors of the prostate in Mali, 759 cases]. / Aspects anatomopathologiques, cliniques et radiologiques des tumeurs benignes de la prostate au Mali, a propos de 759 cas.

The benign prostate tumours are dominated by prostatic adenomyoma. They are the first uro-genital pathology worldwide. The objective of this work is to describe the anatomo-pathological, clinical and radiological aspects of benign prostate tumours in Mali. It is a retrospective study which was conducted in Bamako (Mali) form January 1998 to December 2003. It has involved 759 patients who had histological confirmed prostate adenoma in the Department of Urology in Point G University Hospital. The patients were classified according to age, the clinical exam, the rate of prostate specific antigen (PSA), the sonogram, the macro and microscopic exam. The average age of the patients is 75.5 years. The apical part of the prostate is the area mostly involved. The adenomyoma is the most frequent histological type (98% of the cases). A very clear radiological and macroscopic disparity was noticed. "The night pollakiuria" was the primarily clinical sign in all patients; the prostate specific antigen (PSA) is high among more than 80%.