[Managing pain in children with cancer in Africa: a survey from the French-African Pediatric Oncology group]. / Prise en charge de la douleur de l'enfant atteint de cancer en Afrique : état des lieux au sein du Groupe franco-africain d'oncologie pédiatrique.

INTRODUCTION: The French-African Pediatric Oncology group (GFAOP) has contributed to a significant improvement in the prognosis of pediatric cancers in Africa through the development of therapeutic protocols adapted to local conditions. In parallel, the development of supportive care such as pain management, is now a major priority of our group. OBJECTIVE: The main objective of this study was to evaluate the management of pain in children with cancer in sub-Saharan Africa. METHODOLOGY: A questionnaire was sent to both the doctor and nurse responsible for each of the 8 pilot units (PUs). RESULTS: All physicians and 2 nurses answered the questionnaire. Human resources (3 doctors and 4 nurses per PU) were modest compared to the size of the pediatric population (71 million) and the mean number of 102 cases of cancer/year per PU. Only six physicians had received specific training in pediatric oncology. Morphine was available in only 5 of the 8 PUs; major limitations for its prescription were mainly inconsistent availability (62.5%), fear of side effects (50%), and regulations (37.5%). During the curative phase, more than half of the parents had to buy analgesics when leaving the PU. Pain assessment relied mainly on clinical evaluation (8/8), but was generally concordant with parents' assessment. The majority of patients experienced pain at diagnosis and at a higher degree at relapse, cancer being the predominant etiology. Pain related to other causes such as medical procedures, mucositis, and neuropathic pain was detected; however, its management remained inadequate. Only 2 of 8 PUs had a written protocol for pain management. These deficiencies can be explained by limited resources, both human and financial, but also by cultural factors such as endurance against pain still advocated by many African traditions. CONCLUSION: In recent years, pain prevention and relief, whatever its origin, have become a priority for all medical teams, especially for children with cancer. With its profound sociocultural changes, Africa is no exception. All teams in our group are aware of the situation and hope for major improvement in pain management in the near future through increased resources and training.

[Bessef Hogen's disease, or exostosis disease, with spinal cord compression: a case in the service of the Paediatric CHU Ouedraogo, Ouagadougou, BF]. / La Maladie de Bessef Hogen ou Maladie Exostosante Avec Compression Medullaire: A Propos d'un Cas Dans le Service de Pediatrie du chu Yalgado Ouedraogo, Ouagadougou, B.F.

CA, 14 old years, female, born last uterine siblings of 9 children, 4 died of various causes, was admitted in the pediatric service of CHU-YO for functional impairment of the lower limbs. Physical examination revealed swelling and deformation harsh, uneven surfaces, the circumferential upper and lower limbs and lumbar spine associated with spastic paraplegia. Sphincter disturbances accompany this clinical picture. The radiographic bone marrow hypertrophy individually with images of exostosis at the epiphyses. Multiple exostosis or BESSEF Hogen's disease is rare and has a reserve functional prognosis because of outcome of low spinal cord compression and vascular compression. We felt it appropriate to bring this case discovered during our clinical practice because of its rarity and the risk of malignant degeneration.

CA, âgée de 14 ans, de sexe féminin, dernière née d'une fratrie utérine de 9 enfants dont 4 sont décédés de causes diverses, est admise dans le service de pédiatrie du CHU-YO pour impotence fonctionnelle des membres inférieurs. L'examen physique révèle des déformations et des tuméfactions dures, à surfaces irrégulières, circonférentielles aux membres inférieurs et supérieurs et au rachis dorsolombaire associées à une paraplégie spasmodique. Des troubles sphinctériens accompagnent ce tableau clinique.La radiographie osseuse individualise une hypertrophie osseuse avec des images d'exostose au niveau des épiphyses.Affection rare, l'exostose ou maladie des exostoses multiples de BESSEF HOGEN a un pronostic fonctionnel réservé du fait des compressions médullaires basses et vasculaires. Nous avons jugé opportun de rapporter ce cas découvert lors de notre pratique clinique à cause de sa rareté et du risque de dégénérescence maligne.

High proportions of n-6 polyunsaturated fatty acids in mature milk of mothers in Ouagadougou, Burkina Faso.

UNLABELLED: Milk from 101 mothers living in Ouagadougou (Burkina Faso) showed a mean lipid content of 33.42 g/l and a fatty acid composition strongly related to the mothers' dietary habits: high proportions of linoleic acid (19.80%), n-6 long-chain polyunsaturated fatty acids (1.90%), and 8:0-14:0 saturated fatty acids (26.94%). CONCLUSION: The proportions of alpha-linolenic acid (0.45%) and n-3 long-chain polyunsaturated fatty acids (0.44%) were low. The 18:2/18:3 and n-6/n-3 long-chain polyunsaturated fatty acids ratios (53:1 and 5:1, respectively) were well above recommendations.