[Performance of users in tropical areas with the BI-RADS classification of breast lesions for predicting malignancy]. / Fiabilité des utilisateurs de la classification BI-RADS en milieu tropical pour la prédiction de la malignité des lésions mammaires.

OBJECTIVES: To evaluate the diagnostic performance of radiologists in Cameroon using the BI-RADS classification to interpret mammograms and ultrasound scans together for the prediction of malignant breast lesions. METHODS: This cross-sectional study took place at the Women's and Children's Hospital in Yaounde from July 2009 to April 2010 and included 211 women with breast lesions identified on mammograms during a breast screening campaign and subsequently assessed with ultrasonography and histology. The BI-RADS classifications of these lesions were compared to the corresponding histology results to evaluate the accuracy of predictions of malignancy from the mammograms and ultrasound scans interpreted with the BI-RADS system. The rate of malignancy in each ACR-classified category was also compared to the standard ACR categories as stipulated in the ACR classification. RESULTS: In all, 339 women aged from 16 to 78 years were screened, and lesions requiring biopsies were identified for 211. The age group included most often was the 41-50 year-old group (n = 98, 46.4%). Overall, 135 (64%) women had benign lesions and 76 (36%) malignant. Invasive carcinoma was found in 49 (65%) of the malignant lesions, in situ intraductal carcinoma in 23 (30%), and sarcoma in 4 (5%). Based on the BI-RADS classification, 124 (58.7%) breast lesions were classified as ACR2, 15 (7.1%) as ACR3, 44 (20.8%) as ACR4, and 28 (13.3%) as ACR5. Comparison of the BI-RADS classification and the histological findings showed that 19% of ACR2-classified lesions were malignant, 13% of those classified ACR3, 66% ACR4, and 75% ACR5. The global accuracy in the prediction of malignancy the BI-RADS classification was 77.3%. CONCLUSION: The accuracy of the radiologists using the BI-RADS classification in our hospital was good at 77.3%, although shortcomings in the evaluation and interpretation of some lesions resulted in a relatively high prevalence of malignant lesions in categories ACR2 and ACR3.

Profil radiologique des traumatismes metaphyso-epiphysaires des membres de l'enfant a Yaounde - Cameroun

OBJECTIFS :Rapporter la distribution des lesions radiologiques des traumatismes epiphyso-metaphysaires des membres de l'enfant a Yaounde : MeTHODES etude descriptive; hospitaliere realisee dans les services de radiologie et des urgences du Centre Hospitalier et Universitaire (CHUY) et de l'Hopital Central de Yaounde (HCY). Les radiographies standards de 100 enfants faites pour un traumatisme des membres durant la periode d'etude ont ete revues. Les lesions radiographiques ont ete regroupees selon la classification de SALTER-HARRIS. Les autres donnees recueillies etaient l'age; le sexe; l'etiologie de la lesion et les lesions associees du squelette.ReSULTATS : Il y avait 66 garcons (66) et 34 filles (34). L'age moyen des sujets etait de 11.5 ans (ecart type : 3.28). Le traumatisme etait du dans 62 des cas a un accident de la voie publique. Le membre superieur a ete trois plus atteint que le membre inferieur. Les fractures etaient en regle non ou peu deplacees (96; fermees et avec conservation de l'anatomie regionale normale. Selon la classification de Salter et Harris; 70) de sujets etaient de type II; 12 de type IV; 7 de type III; 6 de type I et 1) avaient des lesions significatives des parties molles; qui ont ete mises en evidence par echographie. CONCLUSION : Les lesions traumatiques metaphyso-epipysaires des membres de l'enfant interessent avant tout le garcon et elles sont dues a des accidents de la voie publique ou a des accidents sportifs. La majorite de lesions sont de type II. La radiographie standard et l'echographie sont suffisantes pour la prise en charge de ces lesions

Nuchal Translucency Thickness at 11-14 Weeks of Gestation in Cameroon

Objectives: To determine the prevalence of nuchal translucency at 11-14 weeks of pregnancy in the Cameroonian population. Compare our values of the nuchal translucency thickness to international reference valuesMaterial and Methods: Descriptive cross-sectional study including 332 Cameroonian women who received obstetric ultrasound between 11 and 14 weeks in four hospitals in Cameroon; from 1st January to 31 December 2012. Measurement of nuchal translucency was performed according to the recommendations of the Fetal Medicine Foundation. Results: 340 fetuses were examined. The median nuchal thickness was 1.5 mm (range: 0 - 9.7 mm). Abnormal nuchal thickness (? 3 mm) was 1.5(5/340) and was significantly predominant in the range of maternal age over 36 years. In 8.8(30/340) of cases; nuchal translucency was absent among which 46.7(14/30) were examined before 13 weeks.CONCLUSION: The prevalence of abnormal nuchal translucency thickness is 1.5 in our setting and is significantly higher in the range of maternal age over 36 years. There exists an early 'filling' of nuchal translucency (before 13 weeks) in some Cameroonian fetus

Aspects echographiques de la pathologie hypertrophique du corps thyroide a l'Hopital Militaire de Yaounde

Les auteurs procedent a une etude retrospective de 36 patients; porteurs d'une hypertrophie de la thyroide; sur un bilan clinique; echographique; hormonal; chirurgical et anatomo-pathologique. Ils notent comme beaucoup d'auteurs une absence de specificite entre les aspects cliniques echographiques et histologiques. Ils preconisent un examen echographique systematique pour le bilan d'une masse thyroidienne; car dans un contexte comme celui du Cameroun sans examen scintigraphique; l'echographie bien que non specifique est plus sensible que l'examen clinique; elle permet un bon bilan diagnostique; revelant des criteres de presomption de benignite ou de malignite. Associee a la cytoponction echo-guidee; elle ameliore la precision diagnostique; permettant un traitement plus efficace

Radiographic aspects of pulmonary tuberculosis in the adult in Yaounde; Cameroon

Radiographic aspects of newly detected and previously untreated pulmonary tuberculosis in 273 consecutive adult patients admitted into the chest unit of the Jamot Hospital in Yaounde over an 8 month period were reviewed. None of the patients had a normal admission chest X-ray image. Lesions localized only in the upper lung fields were seen in 21.3 percent of the cases. In contrast; 64.1 percent of the patients presented with a far advanced and extensive disease characterized by infiltrates with or without cavities occupying a whole lung field or more. Cavitary disease predominantly made of multiple large cavities was observed in 77.7 percent of the cases. Atypical images including pleural effusion; parenchymal nodules; lymphadenopathy and lower lung field disease were uncommon. Despite recent studies suggesting that pulmonary tuberculosis is presenting with atypical radiographic features more commonly than reported in the past; the chest X-ray manifestations of pulmonary tuberculosis in the series were predominantly characterized by a far advanced disease with multiple large cavities

Morbidite hospitaliere; lesions echoencephalographiques; et etat neurologique d'une population d'anciens petits poids de naissance a la sortie d'hopital

Les auteurs ont etudie; chez 152 anciens petits poids de naissance au moment de leur sortie d'hopital; l'etat neurologique; les lesions echoencephalographiques; et les relations avec la morbidite hospitaliere. Leur poids de naissance moyen etait de 1 685 g; leur age gestationnel moyen de 33 semaines; et leur age corrige moyen de 37;3 semaines. 7 nouveau-nes etaient hypotrophes a terme (4;6 pour cent). 26 etaient prematures et hypotrophes (17;10 pour cent); 119 etaient prematures et eutrophiques (78;30 pour cent). La morbidite hospitaliere etaient dominee par les hypothermies et les infections. Les hemorragies cerebrales etaient les lesions echographiques les plus frequentes (6;23 pour cent). 15 enfants avaient un examen neurologique anormal (9;87 pour cent); dont 5 presentaient une lesion cerebrale a l'echographie. Toutes les lesions hemorragiques etaient survenues chez les prematures d'age gestationnel compris entre 29 et 34 semaines. L'existence d'une lesion cerebrale a l'echographie exposait 7 fois plus a un risque d'anomalie neurologique. En conclusion; de nombreuses pathologies peuvent etre prevenues. Le depistage echographique des lesions doit etre precoce

[Incidence of peri- and intraventricular hemorrhages in a premature population at the Central Hospital of Yaounde (Cameroon)]. / Incidence des hémorragies péri- et intraventriculaires dans une population de prématurés à l'Hôpital Central de Yaoundé (Cameroun).

In Cameroon, prematurity is common but few studies have been carried out on periventricular and intraventricular hemorrhage in premature neonates. Seventy neonates born between 28 and 34 weeks gestational age were studied by cerebral ultrasonography. Thirty infants (42.8%) showed evidence of periventricular or intraventricular bleeding. This proportion was 58.3% in infants born between 28 and 31 weeks gestational age. All stage III (3 cases) and stage IV (2 cases) hemorrhages were bilateral. Bilateral bleeding was less common among patients with stage I (2 cases) or stage II (2 cases) hemorrhages. Among patients born between 32 and 34 weeks gestational age, only 34.8% had ventricular hemorrhage which was always stage I or II and usually unilateral (two stage I and one stage II bilateral bleeds). The incidence of periventricular and intraventricular hemorrhage is high in Yaoundé. Ultrasonographic evaluation should be routinely performed in infants born before 35 weeks gestational age.

La pleurasie tuberculeuse a Yaounde; Cameroun : aspects cliniques; radiologiques et biologiques

Les aspects radio-cliniques et paracliniques de la pleurasie tuberculeuse ont ete etudies chez 51 malades a Yaounde pendant une periode d'un an. La pleurasie tuberculeuse representait 60;7 pour cent de l'ensemble des causes d'epanchement peural observe pendant la meme periode chez des malades hospitalises et externes. Le debut de la pleurasie etait insidieux dans 90;2 pour cent des cas et les principaux symptomes fonctionnels etaient la toux; la douleur thoracique et la dyspnee

Interet de la thermographie dans le depistage du carconome lobulaire infiltrant du sein : a propos d'un cas

Les auteurs rapportent un cas de carcinome lobulaire infiltrant du sein a localisation bilaterale. La thermographie a ete l'examen clef; en permettant initialement une orientation diagnostique et pronostique; et en cours de surveillance; le depistage de l'atteinte du sein controlateral

[Purulent meningitis in children in Yaounde (Cameroon). Survey of complications using echoencephalography]. / Méningites purulentes de l'enfant à Yaoundé (Cameroun). Recherche des complications par l'échoencéphalographie.

Sixty-one infants aged 0 to 12 months with documented purulent meningitis underwent transfontanellar ultrasonography at the Yaounde Central Hospital. Twenty-eight (45.90%) infants had evidence of complications including communicating hydrocephalus (20 patients; 71.43%), ventriculitis (5; 17.86%), abscess with ventriculitis (2; 7.14%), and cerebral atrophy (1; 3.57%). An analysis of the main epidemiological, bacteriological and clinical parameters found no correlation between the presence of ultrasound evidence of complications and age, sex, or color of the CSF. Conversely, a close correlation was found with both the time elapsed between onset and initiation of treatment and the severity of clinical manifestations (coma, seizures). The authors, recommend routine ultrasound encephalography in infants with meningitis, improved information of parents, and close collaboration between pediatric radiologists and neurosurgeons.

Cerebral complications of purulent meningitis in children assessed by transfontanellar ultrasonography in Yaounde (Cameroon).

Sixty-one children, aged 0 to 12 months, all having meningitis confirmed by bacteriological and biochemical studies of CSF, were subjected to transfontanellar US exploration and clinical follow-up. Thirty-three (54.1%) children were normal, and 28 (45.9%) presented cerebral complications: hydrocephalus 20 cases (71.4%), ventriculitis 5 cases (17.9%), abscess and ventriculitis 2 cases (7.1%) and cerebral atrophy 1 case (3.6%). 36.1% of patients with purulent or turbid CSF presented with complications. 24.6% of complications were due to unidentified bacteria and 11.4% due to pneumococcus group. 90.9% patients with coma, and 76.4% with convulsion showed cerebral complications. The authors recommend routine us exploration of children with confirmed meningitis in tropical milieu.

[An echographic study of the urologic lesions of urinary bilharziasis in children in Barombi Kotto (Cameroon)]. / Etude échographique des lésions urologiques de la bilharziose urinaire chez les enfants de Barombi Kotto (Cameroun).

Ultrasonographic examination was performed on 212 school age children (152 proven Schistosomiasis, 60 normal) living in the endemic area of Barombi Kotto (Cameroon). 86.8% of urologic lesions were observed in the diseased group. 73 renal lesions were detected: these consisted of various degrees of dilatations. Urinary bladder lesions were present in 132 cases: they consisted of wall thickenings (84.9%), wall irregularities (79.6%) and localized hypertrophies (24.3%). 11 normal (18.4%) children presented with urologic complications. The prevalence of urologic lesions increased with the intensity of infection as measured by urinary egg output, but there seemed to be no direct relationship between the parasitic load and the severity of morbidity in the study. The authors recommend the use of ultrasonography as a public health tool for the diagnosis and control of disease complications in endemic areas.