[Permanent disability and the insurance estimation process]. / Estimation de l'incapacite partielle permanente et du pretium doloris dans le cadre judiciaire et dans le cadre des procedures conseil d'assurances.

INTRODUCTION: The casualties are indemnified according to two processes. First by transaction on rate proposition of insurance physicians, and the second process on rate proposition by a medical expert assigned by law-court. Indemnification scale failure justifies the Interafrican Conference of insurance Markets code adoption. MATERIAL AND METHOD: Six insurance societies and the Automotive Guarantee Fund were debtors. Only 627 victims had been indemnified between 1986 and 2003. Expert valuations done at forensic medicine service were the support of the investigation. Inquired parameters were insurance societies, regulation type, aftermaths and the retained prejudices. The data collected on computer card have been analyzed by software Epi Info. RESULTS: The partial permanent inabilities fixed since its adoption differ to inabilities fixed before this adoption. Transaction process concerned 567 victims (90.4%). Sixty victims were indemnified by judicial way. According to process type, the rates fixed in judicial process were 61.6% middle permanent partial inabilities. After 1997, there have observed a decrease in the high and middle permanent partial inabilities in the two processes. The appreciation of the pretium doloris is more subjective but must repair the aftermaths. The middle pretium was majority in the two processes, before and after 1997 with a high decrease of the middle pretium in the transaction process (-15.07) and a small pretium increase of 10.98 points. CONCLUSION: A common scale code has decreased the judicial litigation concerning casualties in spite of scales' limits. Only the patients with important aftermaths arrive in the judicial process since 1997.

[Comparative review of the Senegalese and French deontology codes]. / Revue comparative des codes de déontologie sénégalais et français.

The medical deontology regroups duties of the physicians and regulate the exercise of medicine. The code of medical deontology of Senegal inspired of the French medical deontology code, has not been revised since its institution whereas the French deontology code knew three revisions. Comparing the two codes of deontology titles by title and article by article, this work beyond a parallel between the two codes puts in inscription the progress in bioethics that are to the basis of the revisions of the French medical deontology code. This article will permit an advocacy of the health professionals, in favor of a setting to level of the of Senegalese medical deontology code. Because legal litigation, that is important in the developed countries, intensify in our developing countries. It is inherent to the technological progress and to the awareness of the patients of their rights.

[Cancer of the uterine cervix in pregnancy: report of 50 cases]. / Cancer du col de l'utérus et grossesse: à propos de 50 cas.

Through a retrospective study of 50 cervix carcinoma during pregnancy, the authors determine the epidemiology, discuss the therapeutic and the pronostic. The mean age of patients were 36 years and the clinical staging of FIGO found : 3 stages Ia, 3 Ib, 7 IIa, 14 IIb, 7 IIIa, 7 IIIb, 4 IVa, 5 IVb The diagnosis of carcinoma was in 6 cases(12%) at first trimester, in 6 cases(12%) at midtrimester, in 13 cases(27%) at third trimester, in 19 cases(28%) after delivery. The termination of pregnancy was an abortion in 6 cases(12%). The treatment was: 29 delivery whose 12 followed bycolpohysterectomy,1 byconisation and 16 had not a colpohysterectomy. 5 cesarean section whose 2 followed by colpohysterectomy in the same time and 3 in the second time. The radiotherapy was neoadjuvant in 3 cases and adjuvant in 3 cases. The mortality was 4 % and the global survival at 5 years was 30%. The prognostic of the cervix carcinoma during pregnancy would get better by Pap test which must be systematic at the pregnant woman.

[Breast cancer and pregnancy: about 60 cases collected at the Cancer Institut of Dakar]. / Cancer du sein et grossesse: à propos de 60 cas colligés a l'Institut du Cancer de Dakar.

The purpose of this retrospective study of 60 breast carcinoma during pregnancy collected at the Cancer Institut of Dakar from 1962 to 1998 was to determine the epidemiology, the clinical appearance and to discuss the pathogeny, the diagnosis, the prognosis and the treatment. The mean of age of patients was 34.5 years. The number of parity was 5 and the first pregnancy at 20 years. The authors arrived at diagnosis in the post partum in 28 cases (47.45%), in the first trimester in 8 cases (13.55%), in the midtrimester in 13 cases (22.03%) and in the third trimester in 11 cases (18.64%). The polychemotherapy preceded the surgery in 30 cases and succeded in 16 cases. The hormonotherapy with Tamoxifen prescribed in 17 cases after the delivery. The mastectomy and axillary lymphadenectomy was realised in 26 cases in the post partum. The adjuvant radiotherapy was done in 12 cases. The mortality was 31% and the global survival at 2 years, 34.6%.

[Epidemiological and therapeutic aspects of rectal cancer in Senegal: 74 cases at the Cancer Institute of Dakar]. / Aspects épidémiologiques et thérapeutiques des cancers du rectum au Sénégal: à propos de 74 cas colligés a l'Institut du Cancer de Dakar.

Through a retrospective study of 74 cancer of rectum the autors determine the epidemiology, the anatomic appearance and discuss the treatment, the prognostic. The mean age of patients was 48 years and the Duke's staging found: 16 stages B, 46 stages C and 12 stages D. The pathological anatomy showed: 58 adenocarcinoma, 9 colloïdal adenocarcinoma, 4 epidermoïdal carcinoma, 2 lymphosarcoma, 1 anaplasic adenocarcinoma. The operability rate was 66.2%, the resectability was 40.8% and the sphincteral preserving was 8.1%. The radiotherapy preceded the surgery in 6 cases and associated the chemotherapy. The chemotherapy preceded the surgery thein 14 cases and succeeded in 2 cases. The mortality was 24.4% and the recidivation 35%. The global survival 5 years was 32%. The prognostic could better by an earlier diagnostic and a multidisciplinary treatment.