[Practical implementation and usefulness of guidelines for the management of syncope: a professional practice study]. / Application pratique et intérêt des recommandations de prise en charge des syncopes : évaluation de pratiques professionnelles.

AIMS: To assess the practical implementation of international guidelines and their impact on syncope management in a 500-bed general hospital. PATIENTS AND METHODS: Three groups of 63 consecutive patients admitted for syncope to the emergency care unit (ECU) were studied: group 1, before the guidelines delivered to the practitioners, group 2 immediately after the diffusion of guidelines and group 3, one year later. The study evaluates the mean duration of stay (MDS) and the relevance of the diagnostic strategy. RESULTS: In group 1 compared to group 2, MDS were respectively 6.8±5.5 and 5.4±2.8 days (P=0.07) and the unexplained syncope number respectively 22% and 24% (P=0.8). The search of orthostatic hypotension became more systematic (13% versus 86% in group 1 and 2 respectively, P<0.001). The agreement (kappa coefficient) between initial and final diagnostic increased in 0.34 to 0.44. One year later MDS in group 3 was 7.1±4.7 days (P=0.8 versus group 1 and P=0.015 versus group 2) with only 6.3% systematic search for orthostatic hypotension (P<0.001). CONCLUSIONS: Guidelines optimize the syncope management in the ECU and the agreement between the emergency and discharge diagnostic without change of unexplained syncope and. MDS tend to be shorter when guidelines are actively implemented. Nevertheless, the positive impact of guidelines implementation is of limited duration.

[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%.

Aspects anatomopathologiques, cliniques et radiologiques des tumeurs bénignes de la prostate au Mali à propos de 759 cas

Les tumeurs bénignes de la prostate sont dominées par l'adénomyome de la prostate, il constitue la première pathologie urologique dans le monde. Le but de ce travail est de décrire les aspects anatomopathologiques, cliniques et radiologiques des tumeurs bénignes de la prostate au Mali. Il s'agit d'une étude rétro et prospective qui s'est déroulée à Bamako (Mali) de janvier 1998 à décembre 2003, elle a concerné 759 patients porteurs d'un adénome de la prostate histologiquement prouvé et admis dans le service d'urologie du CHU du point G. Ces patients ont été appariés selon l'âge, l'examen clinique, le taux de l'antigène prostatique spécifique (PSA), l'examen échographique et l'examen macroscopique et microscopique. L'âge moyen de nos patients est de 71,5 ans, la partie crâniale de la prostate est la plus atteinte, l'adénomyome est le type histologique le plus fréquent(98% des cas). Une discordance radiologique et macroscopique très marquée a été notée. La pollakiurie nocturne est le signe clinique évocateur chez tous nos patients et l'antigène prostatique spécifique (PSA) est élevé chez plus de 80%

Evaluation of invermectin distribution in Benin, Côte d'Ivoire, Ghana and Togo: estimation of coverage of treatment and operational aspects of the distribution system.

Invermectin distribution by the Onchocerciasis Control Programme (OCP) was assessed in Benin, Côte d'Ivoire, Ghana and Togo, in terms of the proportion of villages which had been treated and the proportion of villagers in each village treated in the last round who had actually received treatment. These proportions were evaluated both for treatment in the last round of ivermectin distribution and for treatment since the beginning of the drug's distribution in each country. During the last treatment round, 97 (74.6%) of the 130 selected villages investigated in the four countries had received ivermectin treatment, and 67.2% of the members of these 97 treated communities had taken ivermectin. In general, higher percentages of the members of treated villages in Côte d'Ivoire and Ghana had been treated [with mean (S.D.) percentage values of 72.0 (5.2) and 71.6 (4.6), respectively] than in those of Togo [61.8 (5.6)] or Benin [64.2 (4.6)]. Overall, 893 (26.1%) of those interviewed had never received treatment since the beginning of ivermectin distribution but 29.4% had received all the annual treatments. The main reason for non-treatment during the last treatment round was absence from village (54.5% of those not treated), followed by non-eligibility (i.e. pregnant women and young children; 12.2%), refusal to take treatment (2.6%), and shortage of drugs (1.9%). Community approval for the programme was demonstrated when all treated individuals, including those who were absent at the last treatment round, said they would take the ivermectin during the next treatment. During the last treatment round, members of the community assisted in the distribution of the ivermectin tablets in 69 (71.1%) of the 97 treated villages which were investigated. Although only 26 (26.8%) of these 97 villages preferred community-based distribution of ivermectin to the 'mobile' method, it is believed that, with good education and efficient organization, the communities could be encouraged to undertake community distribution.

[Assignment of Bamanan given names]. / De l'imposition des prenoms Bamanan.

PIP: Given names in the traditional Bamanan area of Mali are in the domain of the sacred, and are specific to the individual. The beliefs and practices surrounding naming--sacrifices, incantatory formulas, and prayers--attest to its importance. Naming customs differ in different places. In the Bamanan zone of southern Mali, the name is given in a ceremony a week or 2 after birth. Many of the traditional naming customs and even names are disappearing under the influence of Islam, Catholicism, or Protestantism. Among traditional given names, 2 major categories were distinguished, those reflecting birth order and those reflecting important events. Names reflecting birth order have become rare. Most names reflecting events are intended to be happy or propitious for the infant. Names are also given for the days of the week, for children of mothers who have lost several preceding children, for children resulting from adulterous unions, and for those born during organized activities of secret societies. Some children are named to honor ancestors.^ieng