Limit of root canal obturation by gutta percha compaction technique in single rooted teeth. Clinical data apropos of 168 canals]

After the introduction of the lateral compactage of gutta percha in endodontic clinic of OdontoStomatology Institute of Dakar in 1995; the immediate evaluation of the quality and the limit of the canal obturation due to a prospective study on 157 monoradicular teeth so be 168 canals (11 supplementary canals) has shown that 75% of canals are of type I of Vertucci and that the apical limit of security is reached within 80.25% of cases. The manual step back canal preparation (79.17%) and the technique of canal obturation by lateral compactage of gutta percha [(64.88%); Apical limit of security: 59.52%] permit to obtain a densities (95.83%) and homogeneous (79.57%) canal obturation. The indication of gutta percha compactage on monoradicular teeth (hermetic and tridimensional root canal filling) must avail to apical curved roots of lateral incisive, the use of adapted instruments in case of canines (31 mm) and apical stop cone on necrotic pulp teeth.     

Prise en charge diagnostique et thérapeutique des tumeurs épithéliales malignes de l’ovaire dans le centre ouest-africain de lutte contre le cancer de Dakar

IntroductionEpithelial ovarian cancer are the most frequent of ovarian cancer, their prognosis is very bad. The aim of this study is to describe the diagnosis, the treatment and to assess the survival rate of the patients.MethodsIt was a retrospective study realized at the Cancer Institute of Dakar from December 2000 to January 2007. We have collected 117 patients with epithelial ovarian cancer. The mean age was 49 years. Patients were comprised: 22 stage I, 32 stage II, 35 stage III and 26 stage IV. Primary surgery was performed to 34 patients and the other patients were treated with chemotherapy and surgery. The survival rate was assessed by Kaplan-Meier method and the Logrank test had allowed to compare the survival among age and optimal surgery.ResultsOptimal surgery R0 was done in 20 cases and surgical resection R2 was performed in 45 cases. Pathological exam had found 65 serous cystadenocarcinoma, 28 mucinous cystadenocarcinoma and 21 endometrioid cystadenocarcinoma, one malignant tumor of Brenner. Overall survival at five years was 13.3%. The survival among optimal surgery was 16.3 and 2.3% for suboptimal surgery. There was no significant difference of the survival among patients who were less than 40 years old (P  =  0.334).ConclusionPrognosis of epithelial ovarian cancer is worse in Senegal as like as in the world. To improve the survival of our patients, we must detect the early diagnosis of these tumors and to introduce the neoadjuvant chemotherapy before optimal surgery.     

The midterm experience of tapered stent grafts in the endovascular management of iliac artery aneurysms with unfavorable anatomy

We report our experience and the midterm results of a modern technique for endovascular management of isolated iliac artery aneurysms (IAAs) with unfavorable neck anatomy, which involves the inversion of an iliac leg of a Zenith stent graft. Patients who underwent endovascular IAA repair from 2002 to 2010 were reviewed. A total of 12 patients, with a mean age of 77.6 years, underwent endovascular repair of 13 IAAs. Mean size of the aneurysms was 54.6 mm (range 34-133 mm). Mean proximal neck diameter was 18 mm (range 15-22 mm). In 7 patients, the length of the proximal neck was <15 mm (10-14 mm). Only 1 patient developed thrombosis of the stent graft immediately after the operation. Patients were followed up for a mean of 31.5 months (range 18-72 months). Our midterm results demonstrate the durability of this technique in the management of iliac aneurysms with unfavorable anatomy.     

Clinical investigation of a population recently infected with Schistosoma mansoni (Richard-Toll, Senegal)

Following the introduction of large-scale irrigation, an exceptional epidemic of intestinal schistosomiasis occurred in northern Senegal when a non-immune population was exposed to massive infection. Subjects infected with Schistosoma mansoni were followed up parasitologically and clinically from the onset of the epidemic. After the initial evaluation, patients received a health education session and were treated with praziquantel in a dose of 30 mg/kg. One year after this treatment, S. mansoni eggs were found in the stools of 227/301 subjects (75%). Twenty-three per cent of subjects excreted >400 eggs per gram (e.p.g.) and 11% excreted >1000 e.p.g. of faeces. Overall, the geometric mean was 191 e.p.g. of faeces in infected individuals. The prevalence of diarrhoea was reduced from 55 to 29%, the prevalence of bloody diarrhoea from 44 to 11% and the prevalence of abdominal discomfort from 66 to 41%. No hepatomegaly was found in these patients either before or one year after treatment. Splenomegaly was reduced from 30% (measured by ultrasound) to 3% (on clinical examination). Morbidity associated with S. mansoni infection was considerably reduced one year after treatment with praziquantel (30 mg/kg).     

CCR5 receptor expression is down-regulated in HIV type 2 infection: implication for viral control and protection

HIV-2 is known to display an attenuated phenotype in vivo with prolonged time to disease and decreased rate of transmission. Observational studies in Senegal have demonstrated protection from HIV-1 infection, although the putative mechanism for immunoprotection remains undefined. We evaluated HIV-2-seropositive women from a cohort of commercial sex workers in Dakar, Senegal and identified individuals with very low surface CCR5 receptor expression on CD4+ T cells. In vitro up-regulation of the CCR5 receptor was readily achieved. Down-regulation of the CCR5 was not correlated with activation markers (HLA-DR), beta-chemokine levels, or plasma viral loads. A correlation was observed with HIV-2-specific CD8+ T cell activity as measured by intracellular cytokine production. We postulate that down-regulation of the CCR5 receptor in HIV-2 infection contributes to slower disease course and to the protective mechanism against HIV-1 superinfection, mediated in part by HIV-2-specific cellular immune responses.