Background: Neoadjuvant chemotherapy (NAC) is one of the treatment options for breast cancer. Its aim is to significantly reduce the size of the tumour in preparation for surgery. The aim of this work is to analyze th...Background: Neoadjuvant chemotherapy (NAC) is one of the treatment options for breast cancer. Its aim is to significantly reduce the size of the tumour in preparation for surgery. The aim of this work is to analyze the conditions of clinical and radiological evaluation of NAC at the Yalgado Ouédraogo University Hospital (CHUYO). Patients and Methods: This was a descriptive cross-sectional study based on the medical records of patients followed up in the cancer department of the CHUYO from 1 January 2013 to 31 December 2021. All patients followed for histologically proven, non-metastatic breast cancer and having received at least one course of NAC were included in this study. The variables were related to the socio-demographic characteristics of the patients, the indications, the protocols of NAC and the sequences of evaluation of the tumour response (clinical, radiological and anatomopathological). Results: We collected 105 cases. The average age of the patients concerned was 44 years. The most frequent histological type was non-specific invasive carcinoma in 97.1% of cases. Immunohistochemically, triple-negative patients accounted for 51.4%. At the initial stage, all patients underwent clinical exploration. Clinical measurement of the tumour was performed in 70.5% of cases. The radiological size of the tumour was determined by ultrasound in 59.1% of cases. One patient had a breast MRI. Thirty-one patients were lost to follow-up after the initial evaluation. At mid-term and at the end of treatment, clinical tumour size was performed in 38.6% and 45.6% of cases respectively. There was no breast imaging performed at mid- and end-of-treatment. CT scans were performed in all cases at baseline, mid-term and end of treatment for extension assessment but did not mention the breast tumour. The tumour response rate was not recorded. Conclusion: Clinical assessment of tumour response is almost always empirical and not quantified. Medical imaging examinations are prescribed sparingly so as not to compromise the regularity of treatment and patient assessment.展开更多
Background:The lack of safe water and sanitation contributes to the rampancy of diarrhea in many developing countries.Methods:This study describes the design of a cluster-randomized trial in Idiofa,the Democratic Repu...Background:The lack of safe water and sanitation contributes to the rampancy of diarrhea in many developing countries.Methods:This study describes the design of a cluster-randomized trial in Idiofa,the Democratic Republic of the Congo,seeking evidence of the impact of improved sanitation on diarrhea for children under four.Of the 276 quartiers,18 quartiers were randomly allocated to the intervention or control arm.Seven hundred and-twenty households were sampled and the youngest under-four child in each household was registered for this study.The primary endpoint of the study is diarrheal incidence,prevalence and duration in children under five.Discussion:Material subsidies will be provided only to the households who complete pit digging plus superstructure and roof construction,regardless of their income level.This study employs a Sanitation Calendar so that the mother of each household can record the diarrheal episodes of her under-four child on a daily basis.The diary enables examination of the effect of the sanitation intervention on diarrhea duration and also resolves the limitation of the small number of clusters in the trial.In addition,the project will be monitored through the‘Sanitation Map’,on which all households in the study area,including both the control and intervention arms,are registered.To avoid information bias or courtesy bias,photos will be taken of the latrine during the household visit,and a supervisor will determine well-equipped latrine uptake based on the photos.This reduces the possibility of recall bias and under-or over-estimation of diarrhea,which was the main limitation of previous studies.Trial registration:The study was approved by the Institutional Review Board of the School of Public Health,Kinshasa University(ESP/CE/040/15;April 13,2015)and registered as an International Standard Randomized Controlled Trial(ISRCTN:10,419,317)on March 13,2015.展开更多
文摘Background: Neoadjuvant chemotherapy (NAC) is one of the treatment options for breast cancer. Its aim is to significantly reduce the size of the tumour in preparation for surgery. The aim of this work is to analyze the conditions of clinical and radiological evaluation of NAC at the Yalgado Ouédraogo University Hospital (CHUYO). Patients and Methods: This was a descriptive cross-sectional study based on the medical records of patients followed up in the cancer department of the CHUYO from 1 January 2013 to 31 December 2021. All patients followed for histologically proven, non-metastatic breast cancer and having received at least one course of NAC were included in this study. The variables were related to the socio-demographic characteristics of the patients, the indications, the protocols of NAC and the sequences of evaluation of the tumour response (clinical, radiological and anatomopathological). Results: We collected 105 cases. The average age of the patients concerned was 44 years. The most frequent histological type was non-specific invasive carcinoma in 97.1% of cases. Immunohistochemically, triple-negative patients accounted for 51.4%. At the initial stage, all patients underwent clinical exploration. Clinical measurement of the tumour was performed in 70.5% of cases. The radiological size of the tumour was determined by ultrasound in 59.1% of cases. One patient had a breast MRI. Thirty-one patients were lost to follow-up after the initial evaluation. At mid-term and at the end of treatment, clinical tumour size was performed in 38.6% and 45.6% of cases respectively. There was no breast imaging performed at mid- and end-of-treatment. CT scans were performed in all cases at baseline, mid-term and end of treatment for extension assessment but did not mention the breast tumour. The tumour response rate was not recorded. Conclusion: Clinical assessment of tumour response is almost always empirical and not quantified. Medical imaging examinations are prescribed sparingly so as not to compromise the regularity of treatment and patient assessment.
文摘Background:The lack of safe water and sanitation contributes to the rampancy of diarrhea in many developing countries.Methods:This study describes the design of a cluster-randomized trial in Idiofa,the Democratic Republic of the Congo,seeking evidence of the impact of improved sanitation on diarrhea for children under four.Of the 276 quartiers,18 quartiers were randomly allocated to the intervention or control arm.Seven hundred and-twenty households were sampled and the youngest under-four child in each household was registered for this study.The primary endpoint of the study is diarrheal incidence,prevalence and duration in children under five.Discussion:Material subsidies will be provided only to the households who complete pit digging plus superstructure and roof construction,regardless of their income level.This study employs a Sanitation Calendar so that the mother of each household can record the diarrheal episodes of her under-four child on a daily basis.The diary enables examination of the effect of the sanitation intervention on diarrhea duration and also resolves the limitation of the small number of clusters in the trial.In addition,the project will be monitored through the‘Sanitation Map’,on which all households in the study area,including both the control and intervention arms,are registered.To avoid information bias or courtesy bias,photos will be taken of the latrine during the household visit,and a supervisor will determine well-equipped latrine uptake based on the photos.This reduces the possibility of recall bias and under-or over-estimation of diarrhea,which was the main limitation of previous studies.Trial registration:The study was approved by the Institutional Review Board of the School of Public Health,Kinshasa University(ESP/CE/040/15;April 13,2015)and registered as an International Standard Randomized Controlled Trial(ISRCTN:10,419,317)on March 13,2015.
