[Epidemiology of urologic cancers at the university teaching hospital of Cotonou, Benin. Review of about 158 cases of urologic cancers]. / Épidémiologie des cancers urologiques au Centre national hospitalier universitaire Hubert Koutoukou Maga Cotonou, Bénin. Analyse d'une série hospitalière de 158 cas.

OBJECTIVE: To study the epidemiological profile of urologic cancers in the department of urology at the teaching hospital of Cotonou. METHODOLOGY: We analysed the course of all urological cancer data over a 42-month period, from January the 1st 2008 to 30th June 2011. RESULTS: Urologic cancers were frequent in our hospital practice with a frequency of 17.38%. They are dominated by prostatic cancer (69%), the cancer of bladder (28.5%), the cancer of the kidney (8.5%) and cancers of the external genitals (testis and scrotum) which are marginal in our review. We did not report any case of penis cancer and urethral cancer. They occured at an advanced age with an average age 62.89±15.51 years. Urologic cancers were the prerogative of the subjects of male sex with a sex ratio of 9/10. Specific mortality rate which is attached to them was high. CONCLUSION: The epidemiologic profile of urologic cancers in our practice had some essential characteristic for the primary prevention. The improvement of the quality of data, the installation of a cancer register and the improvement of the technical skills will allowed a better approach of urologic cancer in our urology unit.

Evaluation de la qualité des soins et services à la clinique d'urologie et d'andrologie du CHU Hubert Maga de Cotonou

Objectif: L'évaluation de la qualité des soins et services dans la pyramide sanitaire est indispensable et intégrable aux normes et standards de santé des centres hospitaliers. Le but de ce travail est d'apprécier la qualité des soins et services à la Clinique d'Urologie et d'Andrologie de Cotonou. Matériel et méthodes: Le matériel d'étude utilisé est constitué par l'équipement et les prestataires de services de la Clinique d'Urologie et d'Andrologie du CHU Hubert MAGA de Cotonou. La méthode d'étude est rétrospective. La période couverte va du 1er Janvier 2001 au 31 Décembre 2002. L'hypothèse à corréler est « l'amélioration de la qualité des soins et services passe par l'évaluation des services ». Les variables étudiées sont celles du référentiel de l'OMS. Résultats: Les normes et standards évalués à la clinique d'Urologie et d'Andrologie du CHU Hubert MAGA de Cotonou affichent des indicateurs de satisfaction variable. Les indicateurs à améliorer sont les infrastructures (44%< S <72%), le matériel médico-technique (S=75%) et l'utilisation du service (S= 50%). Les autres ont un score 65%<S<100% jugés satisfaisants. Discussion: Les normes et standards évalués sont ceux du référentiel de l'OMS. Ainsi, l'équipement dénote d'une insuffisance d'infrastructure, de matériel médico-technique, de médicaments et de consommables. La performance du personnel est satisfaisante pour sa disponibilité et sa compétence technique. L'efficacité est moyenne quant à l'utilisation de services et suffisante pour les résultats de l'évolution. L'efficience est également moyenne quant au taux d'utilisation du bloc opératoire et à la productivité. L'organisation du service est satisfaisante dans son mécanisme de gestion et dans son organisation opérationnelle. La collaboration interpersonnelle est excellente entre prestataires et utilisateurs de services. L'hygiène est satisfaisante, l'hébergement est acceptable. La restauration répond à l'attente des utilisateurs et des prestataires. Conclusion: Tous les aspects des normes et standards de santé ne sont pas abordés. Les résultats obtenus sont propres au service, à son orientation future dans la stratégie et la tactique de l'assurance qualité de soins. Oui, les normes et standards influencent la qualité des soins et services

Novel amphiphiles with preorganized functionalities-formation of Langmuir-films and efficiency in mineral flotation.

Based on the principle of supramolecular preorganization, three different types of new oligofunctional surfactants have been designed and prepared differing in both the degree of conformational flexibility and the hydrophilic-lipophilic balance of their structures due to the chosen building blocks including rather rigid and shape-persistent backbones or a dendritic subunit. Surface-active properties of the oligofunctional surfactants involving critical micellization concentration, surface tension at cmc, effectiveness of surface tension reduction, and the efficiency of adsorption were determined by use of the surface tension isotherms, respectively. In particular the amino-acid-based amphiphiles show remarkable surface-active properties with the adsorption at the air/water interface and also the aggregation to micelles starting at very low concentration. By analysis of the surface pressure-surface area isotherms interesting information on the packing behavior and orientation of the amphiphilic molecules in relation to the molecular structure could be obtained. Moreover, limiting area and collapse pressure of the Langmuir-films were determined. Morphological observation of the dynamic process of monolayer compression at the air/water interface was carried out by Brewster angle microscopy illustrating several phase states visualized as snap shots. Furthermore, the effectiveness of the new surfactants acting as collecting agents in the process of flotation using the model mineral fluorite was studied. A surprisingly high recovery of the mineral was obtained for the surfactants with constricted flexibility. The flotation plots clearly manifest that bundling of surfactant subunits by tethering to an aromatic core or by dendritic branching is profitable, indicating that effects of preorganization of the oligofunctional surfactant molecules are important.

[Penile-perineal-scrotal gangrene. Epidemiologic, diagnostic, and therapeutic features. Report of 32 cases]. / Les gangrènes péno-périnéo-scrotales. Aspects épidémiologiques, diagnostiques et thérapeutiques. A propos de 32 cas.

The authors analyse the epidemiological, diagnostic and therapeutic aspects of peno-perineo-scrotal gangrene in the urology department of a university hospital of a developing African country. The frequency of this disease is low, four cases per year, and most patients (about 72%) are between the ages of 40 to 70 years. The authors identified urethral stricture (31.25%) and idiopathic causes as the main predisposing factors, and many pathogenic bacteria, including P. mirabilis, P. aeruginosa, S. aureus, K. pneumoniae etc., as decisive factors. The treatment of peno-perineo-scrotal gangrene must be both medical and surgical. In addition to the medical treatment currently performed in the department, the authors would like to combine hyperbaric oxygen therapy and, as in Japan, the use of argatroban to accelerate wound healing.

[Urethral diseases in children at surgical departments of the Cotonou Hospital. Apropos of 77 cases]. / La pathologie urétrale chez l'enfant dans les services chirurgicaux du CNHU de Cotonou. A propos de 77 cas.

Over a 6-year period in the surgical departments of Cotonou hospital, urethral diseases in children represented 20% of all infantile urological diseases and essentially consisted of urethral strictures (26 cases), hypospadias (22 cases), posterior urethral valves (12 cases), prolapsed urethral mucosa, the only disease observed in girls (9 cases). These diseases generally do not raise any diagnostic problems, but the real problem concerns follow-up of these children, who are usually lost to follow-up after discharge.

[Buschke-Loewenstein tumor. Apropos of 2 cases in Cotonou, Benin]. / Tumeur de Buschke-Loewenstein. A propos de deux cas vus à Cotonou, Bénin.

About two cases of Buschke-Loewenstein tumor--one of the penis in man infected with HIV and another of perianal area-, the authors insist on the relative frequency of Buschke-Loewenstein tumor in non-circumcised and homosexual groups. They emphasize the continuous precancerous spectrum of Buschke-Loewenstein tumor.

[Accidents of circumcision and excision in the African environment]. / Les accidents de la circoncision et de l'excision en mileu africain

PIP: The authors report on 15 cases of complications of male circumcision and female excision of the clitoris observed between April 1972 and January 1975 at the Lome and Dakar, Senegal, hospitals. Male and female circumcision is still widely practiced in most North-West African countries; unfortunately, these procedures are done mostly in totally unsanitary conditions, and at the hands of inexperienced people. Among the complications observed in this series there were, for male circumcision, 1 case of hemorrhage, 4 cases of partial or total amputation of the penis, 1 case of tetanus, 5 cases of urethral fistula, 1 deformation of the glans, and 3 cases of lymphoedema of the penis. For female excision the major complications are the coalescence of the labia majora with consequent partial closing of the vaginal orifice, and retention of the urine. Treatment of such lesions depends on the severity of each case; if it is often possible to open a vagina or to suture back an amputated penis it is not always possible to prevent infection or death by tetanus and/or hemorrhage. Since circumcision, female and male, is part of the North-West African cultural background care should be taken that every operation be performed in a hospital if possible, or at least at the hands of experienced personnel.^ieng