Le traitement du rétinoblastome au CHU de Brazzaville

La pathologie cancéreuse de l'enfant représente 7%, d'après les données du registre des cancers de Brazzaville(RCB). Une étude rétrospective a été menée, allant du 1er Janvier 2000 au 31 Décembre 2008. Nous avons ainsi rassemblé 292 cas des cancers observés chez l'enfant de 0 à 14 ans, dont 74 cas de rétinoblastome soit une fréquence 25,3%. Cette localisation occupe ainsi la première place des cancers solides de l'enfant. Nous n'avons pas observé de différences dans les deux sexes. L'âge moyen au moment du diagnostic était de 4,29 ans. Le diagnostic était clinique dans 58,5% (43 cas), à l'examen du fond d'œil 21,6% (16 cas),à l'échographie 16,2%(12 cas), et la confirmation anatomie pathologie 4 % (3 cas). La localisation était unilatérale 83,7% (62 cas), bilatérale dans 8,1% (6 cas) non précisée dans 9,5 % (7 cas). La chimiothérapie était utilisée dans 61,8% (45 cas), l'énucléation dans 13,5% (10 cas), chimiothérapie associée à l'énucléation 10,8% (8 cas), et non précisée 14,9% (11 cas). La moyenne de survie était de 4,65 mois avec des extrêmes de 1 à 9 mois en raison du retard de diagnostic et des difficultés d'accès au traitement

[Human immunodeficiency virus associated arthritis in Congo Brazzaville]. / Les arthrites liées au virus de l'immunodéficience humaine au Congo Brazzaville.

OBJECTIVE: The authors report epidemiologic, clinical, para clinical, and evolutive aspects of arthritis related to HIV in an AIDS endemic country. MATERIAL AND METHODS: A retrospective study was made in the rheumatology department of the Brazzaville University Teaching Hospital during 15 years and 6 months, on 3.042 in-patients among whom 306 (10%) were positive for HIV, 220 (7.2%) presented with a rheumatologic manifestation, and 158 (71.8%) with HIV related arthritis. RESULTS: The 158 patients included 91 men (57.6%), 67 women (42.4%), average 34.5 years of age, ranging from 15 to 61, all heterosexual. 99 patients (62.7%) were in the B stage, 40 (25.3%) in the C stage, and 19 (12.2%) in the A stage. Arthritis was polyarthritis (83.5%) or oligoarthritis (16.5%), symmetrical (97.5%), prevailing on the lower limbs (99.3%) with involvement of the great toe in 23% of cases. There was an important inflammatory syndrome with an erythrocyte sedimentation rate exceeding 100 mm for the 1st hour in 63.3% of the cases. Rhumatoid factors were negative. Synovial fluid was sterile, without microcrystals, and inflammatory. X-rays were normal. This non-destructive arthritis, evolved by successive bouts, and resolved in 2 to 5 weeks with NSAIDs and did not meet Amor nor European spondyloarthropathy criteria. CONCLUSION: Arthritis related to HIV represents the principal expression of nonseptic rheumatologic HIV manifestations in Congo.

[Orbital diseases in Brazzaville University Hospital (Congo)]. / Profil des affections orbitaires au Centre Hospitalier et Universitaire de Brazzaville, Congo.

PURPOSE: The aim of our study was to determine the occurrence of different orbital diseases. PATIENTS AND METHODS: The authors report the results of a retrospective survey of 704 patients examined over 9 years, from January 1981 to December 1989. We used J. Rootman's physiopathologic classification. The inclusion criteria included clinical examination, essential paraclinical explorations, and X-rays. Data frequencies and homogeneity were analyzed with the chi 2 test. RESULTS: Orbital diseases made up 7.04+/-0.02% of the eye pathologies found. A male prevalence was noted (p<0.05). The distribution according to age groups was characterized by a bimodal curve with a peak at very early childhood and another at the 30s and 40s (p<0.05). Etiologies were as follows: inflammatory diseases and exophthalmia (61.7%), trauma and structural lesions (24.7%), degenerative diseases (3.7%), tumors (3.7%), and blood and vascular diseases (2.4%). Inflammations and orbital injuries occur more often among men and exophthalmia among women (p<0.05). According to age, inflammations, injuries, degenerative diseases, and malformations occur between 0 and 20 years, and inflammations, degenerative diseases, injuries, and tumors occur with greater frequency after 20 years (p<0.05). DISCUSSION: Inflammations, injuries, and tumors are the principal diseases of the orbit diagnosed. The different occurrences of tumors and specific inflammations observed in this study are related to the inadequate means of complementary examinations and the difficult access to health care centers in African countries.