Erratum: Prostate cancer clinical characteristics and outcomes in Central Sudan.

[This corrects the article on p. 1 in vol. 14.].

Prostate cancer clinical characteristics and outcomes in Central Sudan.

BACKGROUND: Prostate cancer is the most common cancer among Sudanese men and most patients present at a late stage. Although the incidence of prostate cancer in Sudan is low compared to other African countries, studies on prostate cancer in Sudan are limited. This study addresses the clinical characteristics and outcomes of prostate cancer in Central Sudan and its prognostic factors. METHODOLOGY: This study was conducted prospectively at the Gezira Hospital for Renal Disease and Surgery and at the National Cancer Institute at the University of Gezira, Sudan, for an 11-year period. RESULTS: During the study period, 543 patients participated in the study. Each one underwent a clinical examination, digital rectal examination and radiological staging using magnetic resonance imaging or computed tomography and provided blood samples for prostate-specific antigen (PSA) testing. The mean (SD) age of patients was 72.6 (9.9) years. At diagnosis, the majority of patients experienced lower urinary tract symptoms (LUTS; 54%), bladder outlet obstructions (OU) without (18%) or with urine retention (14%), PSA median was 100 ng/mL and the mean was 269 ng/mL, locally advanced disease (45%) or distant metastasis (46%). The age-adjusted hazard ratio (HR) of mortality was twofold, comparing patients presented with OU to patients with LUTS. Patients diagnosed with locally advanced and castration resistance prostate cancer had five times the HR compared to patients diagnosed with organ-confined prostate. On the contrary, the HR increased sevenfold for patients with distant metastasis. Gleason score did not show a significant association with survival (p = 0.249). Similarly, there was no apparent dose-response association between the PSA levels at diagnosis (p = 0.460). CONCLUSION: The findings suggest that Sudanese men who are living in Central Sudan present at diagnosis with large tumours at late stages, and high PSA levels and Gleason scores. Improving awareness and building up the treatment capacity are key to achieving better outcomes.

LXR/RXR pathway signaling associated with triple-negative breast cancer in African American women.

BACKGROUND: Triple-negative breast cancer (TNBC) is more prevalent in African and African American (AA) women compared to European American (EA) women. African and AA women diagnosed with TNBC experience high frequencies of metastases and less favorable outcomes. Emerging evidence indicates that this disparity may in fact be the result of the uniquely aggressive biology of African and AA disease. PURPOSE: To understand the reasons for TNBC in AA aggressive biology, we designed the present study to examine the proteomic profiles of TNBC and luminal A (LA) breast cancer within and across patients' racial demographic groups in order to identify proteins or molecular pathways altered in TNBC that offer some explanation for its aggressiveness and potential targets for treatment. MATERIALS AND METHODS: Proteomic profiles of TNBC, LA tumors, and their adjacent normal tissues from AA and EA women were obtained using 2-dimensional gel electrophoresis and bioinformatics, and differentially expressed proteins were validated by Western blot and immunohistochemistry. Our data showed that a number of proteins have significantly altered in expression in LA tumors compared to TNBC, both within and across patients' racial demographic groups. The differentially overexpressed proteins in TNBC (compared to LA) of AA samples were distinct from those in TNBC (compared to LA) of EA women samples. Among the signaling pathways altered in AA TNBC compared to EA TNBC are innate immune signaling, calpain protease, and pyrimidine de novo synthesis pathways. Furthermore, liver LXR/RXR signaling pathway was altered between LA and TNBC in AA women and may be due to the deficiency of the CYP7B1 enzyme responsible for cholesterol degradation. CONCLUSION: These findings suggest that TNBC in AA women enriched in signaling pathways that are different from TNBC in EA women. Our study draws a link between LXR/RXR expression, cholesterol, obesity, and the TNBC in AA women.

[Diagnosis of hematochezia in Abidjan Cocody University Hospital (Ivory Coast)]. / Diagnostic des rectorragies au centre hospitalier universitaire de Cocody à Abidjan (Côte d'Ivoire)

AIM: To determine the prevalence of endoscopic lesions, according to age and location, in patients with rectal bleeding who underwent total colonoscopy. METHODS: Retrospective observational study examining records from the hepatogastroenterology department at the Cocody University Hospital (Abidjan) of colonoscopies for rectal examination from September 1, 1991, through August 15, 2007. The data collected and analyzed from the records included age, sex and colonoscopy results. A p value less than 0.05 was considered statistically significant. RESULTS: Of 1,158 colonoscopies, 270 (23.3%) were performed for hematochezia: 105 women (mean age: 48.8 years ± 19.9 years, range: 10-96 years) and 165 men (mean age: 46 ± 14.2, range: 21-83 years) with a sex-ratio (M/F) of 1.57. Because colorectal cancer seems to occur at a younger age in Africa, patients were divided into two groups (aged 45 years: 139 [51.5%] and above 45 years: 131 [48.5%]). The abnormalities found were consistent with anal pathologies (16.3%), polyps (10.4%), diverticular disease (11.1%), colorectal inflammatory lesions (21.5%) and carcinoma (7%). Diverticula were significantly more common in those older than 45 years and inflammatory lesions in the younger group (p < 10(-3)). More than two thirds of the significant lesions were found in the distal colon (p < 10(-3)). CONCLUSION: The predominance of distal colon lesions suggests that exploration by flexible sigmoidoscopy can be performed in patients with low to moderate risk of colorectal cancer, with total colonoscopy reserved for the population at high risk.

[Prevalence of HBs antigen carriage in a population of national Gendarmerie recruits in Ivory Coast in 2008]. / Prévalence du portage de l'antigène HBs dans une population de recrues de la Gendarmerie nationale de Côte d'Ivoire en 2008.

The purpose of this study was to determine the prevalence of HBsAg carriage in Ivorian gendarmerie recruits in 2008. This prevalence was 15.6%. It was highest in recruits aged 18 years (24%), in those who were married (33.3%) and in those who had had more than three sexual partners in the 6 months before the survey (19.4%). It was also higher in recruits who had never used condoms (20.6%) and in those who had undergone blood transfusions (27%). A policy of vaccination against HBV in the army, in teenagers and adults must be implemented to reduce HBsAg carriage in the army and in the Ivorian population.

[Prevalence of HBs antigen in blood donors in the Bouaké regional centre of blood transfusion in 2001]. / Prévalence de l'antigène HBs chez les donneurs de sang au centre régional de transfusion sanguine de Bouaké (Côte d'lvoire) en 2001.

A prospective cross-sectional study was conducted in the regional center of blood transfusion in Bouaké from December 1, 2001 to February 28, 2002. One thousand two hundred thirty one new blood donors were tested. HBs Antigen detection was made according to ELISA technique (Hepanostika HBs Ag Uni-Form II). HBs Antigen prevalence in blood donors in Bouaké was 12.5%. One hundred fifty four blood donors were tested positive and were divided into 131 males (85%) and 23 females (15%). Their average age was 27, 5 years old (18-65 years). HBs Antigen carriage rate was lower in females and students. They were mainly pupils (62%) and had risk factors of hepatitis B infection (intramuscular injection, multiple sexual partners, unsafe sex). HBs Antigen carriage rate in blood donors is high in Bouaké and justifies the systematic screening of this Antigen in any blood donor to reduce the transfusion risk. On the other hand, it is necessary to modify the blood collection strategy in order to make the most of the donation and to decrease the residual risk.

Computational modeling of cell adhesion and movement using a continuum-kinetics approach.

Adhesion of leukocytes to substrate involves the coupling of disparate length and timescales between molecular mechanics and macroscopic transport, and existing models of cell adhesion do not use full cellular information. To address these challenges, a multiscale computational approach for studying the adhesion of a cell on a substrate is developed and assessed. The cellular level model consists of a continuum representation of the field equations and a moving boundary tracking capability to allow the cell to change its shape continuously. At the receptor-ligand level, a bond molecule is mechanically represented by a spring. Communication between the macro/micro- and nanoscale models is facilitated interactively during the computation. The computational model is assessed using an adherent cell, rolling and deforming along the vessel wall under imposed shear flows. Using this approach, we first confirm existing numerical and experimental results. In this study, the intracellular viscosity and interfacial tension are found to directly affect the rolling of a cell. Our results also show that the presence of a nucleus increases the bond lifetime, and decreases the cell rolling velocity. Furthermore, it is found that a cell with a larger diameter rolls faster, and decreases the bond lifetime. This study shows that cell rheological properties have significant effects on the adhesion process contrary to what has been hypothesized in most literature.

[Materno-fetal transmission of hepatitis B virus in Ivory Coast. Plea for mass vaccination]. / Transmission materno-foetale du virus B de l'hépatite en Côte d'Ivoire. Plaidoyer pour la vaccination de masse.

BACKGROUND: Hepatitis B is a major public health problem in the developing countries of Africa and Asia because the prevalence of HBs antigen carriers is high. In Ivory Coast, the prevalence of HBs antigen carriers is more than 8% (6 to 29%). In these countries, in which hepatitis B is highly endemic, most infections with hepatitis B virus (HBV) occur during early childhood. The chronic carriage of HBV was found to be common in children, who played a key role in maintaining the high level of endemicity in these areas. Vaccines against HBV are effective and their introduction as part of the Expanded Program of Immunization (EPI), as recommended by the WHO, is feasible. OBJECTIVE: The aim of this study was to evaluate the prevalence of HBs antigen in pregnant women and to determine the rate of maternal transmission of HBV to the fetus, to demonstrate the importance of HBs antigen screening during pregnancy and the immunization of babies in the Ivory Coast. PATIENTS AND METHODS: Between August 1995 and February 1996, 395 women in the last three months of pregnancy (age 25 +/- 6.9 years) were screened for HBs antigen. Those testing positive were also screened for HBe antigen. Transmission of HBV in utero was studied with 322 mothers and their offspring. HBs antigen was assayed in the cord blood of the offspring of HBs antigen-positive mothers. If the test for HBs antigen was positive, HBe antigen was also assayed. Second-generation ELISA tests (MONOLISA HBs Ag and MONOLISA HBe Ag from Sanofi Pasteur) were used. Babies from HBs antigen-positive mothers were vaccinated at birth with three doses of GenHevac B.

Transmission in utero of the hepatitis B virus in ivory coast the case for mass vaccination

Background. Hepatitis B is a major public health problem in the developing countries of Africa and Asia because the prevalence of HBs antigen carriers is high. In Ivory Coast, the prevalence of HBs antigen carriers is more than 8% (6 to 29%). In these countries, in which hepatitis B is highly endemic, most infections with hepatitis B virus (HBV) occur during early childhood. The chronic carriage of HBV was found to be common in children, who played a key role in maintaining the high level of endemicity in these areas. Vaccines against HBV are effective and their introduction as part of the Expanded Program of Immunization (EPI), as recommended by the WHO, is feasible. Objective. The aim of this study was to evaluate the prevalence of HBs antigen in pregnant women and to determine the rate of maternal transmission of HBV to the fetus, to demonstrate the importance of HBs antigen screening during pregnancy and the immunization of babies in the Ivory Coast. Patients and methods. Between August 1995 and February 1996, 395 women in the last three months of pregnancy (age 25 6.9 years) were screened for HBs antigen. Those testing positive were also screened for HBe antigen. Transmission of HBV in utero was studied with 322 mothers and their offspring. HBs antigen was assayed in the cord blood of the offspring of HBs antigen-positive mothers. If the test for HBs antigen was positive, HBe antigen was also assayed. Second-generation ELISA tests (MONOLISA HBs Ag and MONOLISA HBe Ag from Sanofi Pasteur) were used. Babies from HBs antigen-positive mothers were vaccinated at birth with three doses of GenHevac B.

[Familial hepatocellular carcinoma in B or non-A non-B cirrhosis. Report of 4 families]. / Carcinomes hépato-cellulaires familiaux sur cirrhose B ou non A non B. A propos de 4 familles.

We report the cases of four families in whom 2 or 3 cases of hepatocellular carcinoma were observed. In the first family, the mother and 2 daughters had hepatocellular carcinoma. In 2 other families, 2 brothers had hepatocellular carcinoma. In the first three families, all patients with hepatocellular carcinoma, as well as other members of these three families, were chronic HBsAg carriers. In the fourth family, hepatocellular carcinoma developed in 2 brothers with HBsAg negative Mediterranean cirrhosis. Because of the high risk of hepatocellular carcinoma in chronic HBsAg carriers, it is conceivable that the occurrence of familial cases of hepatocellular carcinoma could be fortuitous. However, we cannot exclude the possibility of the familial predisposition to hepatocellular carcinoma. Therefore, it seems wise, when hepatocellular carcinoma develops in one patient in a family, to carefully monitor other members of this family, whether HBsAg positive or with non A non B chronic hepatitis, for the development of hepatocellular carcinoma.

Relative risk of hepatocellular carcinoma in HBsAg positive vs alcoholic cirrhosis. A cross-sectional study.

The etiological link between hepatitis B virus (HBV) infection and hepatocellular carcinoma (HCC) has been suggested on epidemiologic, serologic and molecular grounds. This link has, however, recently been questioned by prospective studies suggesting that HBV infection also causes cirrhosis and that whatever the cause of cirrhosis, the risk of developing HCC could be roughly similar. All male patients first admitted to Hôpital Beaujon with cirrhosis or HCC from 1983 to 1987 were included in a cross-sectional study. A total of 277 new patients with cirrhosis (but free of HCC) were admitted, of whom 55 were HBsAg positive, and 181 were alcoholic. During the same period, 117 new patients with HCC were admitted, 48 in association with alcoholic cirrhosis, 36 with HBsAg positive cirrhosis. The relative risk (odds ratio) of HCC was 2.5 (95% confidence interval, 1.46-4.37; p = 0.0011) in patients with HBsAg positive cirrhosis as compared to patients with alcoholic cirrhosis. HBsAg positive patients were significantly younger than their alcoholic counterparts (48 +/- 14 vs 54 +/- 10 years in the cirrhotic group; 49 +/- 12 vs 62 +/- 8 years in the HCC group). We conclude that, using the methodology of a cross-sectional study, the relative risk of HCC was about twice greater in HBV-associated than alcoholic cirrhosis. The results of longitudinal prospective studies examining this issue might be biased by selecting patients older than the mean age of HCC occurrence or excluding patients with HCC when present at first admission.

[Chronic calcifying pancreatitis in hospitals in the Ivory Coast]. / Pancréatite chronique calcifiante en milieu hospitalier en Côte d'Ivoire.

The authors report on 34 cases of chronic calcifying pancreatitis in Ivory Coast. Chronic calcifying pancreatitis is rare (0.24 P.C. of admitted patients) and appears mainly in man 40 years old, revealed by diabetes (73.5 P.C.). Principal aetiology was alcoholism, 50 P.C. Genuine tropical chronic calcifying pancreatitis exists in small number. It seems its physiopathological mechanism is not only nutritional.