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Cameroon is officially a French English bilingual country, but it is actually highly multilingual with 286 local languages, all at various levels of standardisation. But from colonial times, and despite the Independence in 1960, none of the local languages has been granted an official status to be used in education, the administration or the public media. The two official languages of the country are still French and English, inherited from colonial times. These two languages are the ones mainly used in schools, the public administration, the official communication and the media.\ud Local languages in Cameroon therefore stand at a crossroads of contradictions in the 21st century: whereas the majority of Cameroonian communities still use them daily in their linguistic interactions and socio cultural communication primarily in the oral realm, those same languages paradoxically are absent in those key areas of community life that matter most, namely the educational arena, and the public administration and official discourses. To add to the contradictions and paradoxes, the vast majority of Cameroonians do not have any native fluency or mastery of those official languages that are ubiquitous in education and public communication.\ud This chapter examines the case of Ghɔmálá’, a Grassfields Bantu language from the West region of Cameroon, Africa, building its discussion on document analyses, field notes, and some data collected on the current teaching of Ghɔmálá’ within the local speech community in the West of Cameroon. Ghɔmálá’, which was adopted by UNESCO in the 1960s as one of nine languages of wider communication for Cameroon, is considered to be one of those Cameroonian languages that are thriving in comparison to the majority of the Cameroonian languages, and in terms of its print richness and use in formal education, i.e. schools and literacy classes.

Einfuhrung: Erlotinib (Tarceva®) ist ein oral wirksamer Tyrosinkinaseinhibitor, der den epidermalen Wachstumsfaktor (EGFR) hemmt. Ziel der vorliegenden Studie war die Beurteilung der Vertraglichkeit und Wirksamkeit einer Behandlung mit Erlotinib im klinischen Routinealltag bei Patienten mit fortgeschrittenem nicht-kleinzelligen Lungenkarzinom (NSCLC) nach Versagen einer vorangegangenen Chemotherapie. Methoden: In dieser prospektiven, nicht-interventionellen, multizentrischen Studie (ML20264) wurden u.a. Daten zu Ansprechrate, Ansprechdauer, Uberleben sowie unerwunschten Ereignissen (UE) einer Routinebehandlung mit Erlotinib bei Patienten mit fortgeschrittenem NSCLC dokumentiert. Ergebnisse: Daten von 941 Patienten wurden ausgewertet (Safety Set). Daten von 855 Patienten standen fur die Analyse der Wirksamkeit zur Verfugung bzw. von 312 Patienten mit >4 Behandlungszyklen. Mittleres Alter 65 Jahre, 61,5% Manner, 66,7% Raucher. Das mittlere Uberleben betrug 6,9 Monate (n=855) bzw. 11,4 Monate in der Gruppe mit >4 Zyklen (n=312). Die Ansprechrate war 16,7% bzw. 33,7% (>4 Zyklen). Bei 39,4% bzw. 52,9%(>4 Zyklen) der Patienten kam es zu einer Krankheitsstabilisierung (SD, stable disease); bei 30,3% bzw. 11,9% (>4 Zyklen) der Patienten kam es zu einer Krankheitsverschlechterung, Die Therapie mit Erlotinib wurde insgesamt gut vertragen. 6,7% der Patienten mussten die Therapie wegen eines UEs abbrechen. Die haufigsten UEs waren Rash (49,4%) und Diarrho (29,5%) mit leichtem bis mittlerem Schweregrad (Grad 1, 2). Bei

Knowledge of elbow collateral ligament length during passive motion is essential in understanding ligament physiology and pathology, such as tightness and instability.Five anatomical unembalmed specimens were passively placed in six flexion positions together with three forearm rotations, using equipment with gravity as motion force. These 18 positions were recorded using CT-scan. Three-dimensional data of ligament insertions were obtained through anatomical millimetre sections. Ligament length was measured in each position.In neutral rotation, the lateral collateral ligament was long between 0 degrees and 30 degrees as well as at 90 degrees, and short between about 60 degrees and 120 degrees of flexion. In pronation, it was long at about 0 degrees and between 60 degrees and 120 degrees, short at about 30 degrees of flexion. In supination, it was long at about 30 degrees and 90 degrees and short between 120 degrees and 150 degrees of flexion. In any forearm rotation, the highest length of the anterior bundle of the ulnar collateral ligament was measured at about 90 degrees, its smallest length between 120 degrees and 150 degrees of flexion, position at which the posterior bundle length was greatest.At 60 degrees of flexion, the collateral ligaments were slackened in any forearm rotations. Forearm rotation plays an indirect role in the posterolateral stability of elbow as it changes length of the lateral collateral ligament. This ligament can be tested passively at 90 degrees of flexion in supination, the anterior bundle of the ulnar collateral ligament between 0 degrees and 30 degrees in neutral rotation and the posterior bundle between 120 degrees and 150 degrees in neutral rotation.

Abstract #1159 Background: Bone pain is one of the most debilitating manifestations of metastatic bone disease (MBD) due to breast cancer (BC). Bisphosphonates (BP) effectively prevent skeletal related events (SRE) in MBD and independently reduce bone pain. As kidney is a main target organ of BP related toxicity, renal safety is of major importance for risk/benefit assessment of BPs. Ibandronate (IBA), a third generation amino-BP has shown its clinical efficacy and safety in randomized clinical trials (RCT). The present non interventional study (NIS) was initiated to verify those results under real life conditions. Patients and methods: This interim analysis is based on 1897 clinically evaluable BC patients with MBD, mean age 63.3 +11.9 years. 1219 (64 %) were BP-naive, 213 (11.2 %) had been pretreated with (IBA), 465 (24.5 %) with other BPs, mainly zoledronic acid (ZOL) (294; 15.5 %) and pamidronate (PAM) (157; 8.3 %). Mean duration [months + SD] of BP pretreatment was considerably longer for PAM (22.7 + 22.7) and ZOL (20 + 17.9) than for IBA (12.8 +11.9). After inclusion patients received 6 mg IBA i. v. every 4 weeks or 50 mg p. o. daily at the physician's discretion over 24 weeks, additionally to their individual cancer treatment. Pain status (10 point VAS), analgesic use (WHO escalation stages), renal function (serum creatinine; Creatinine clearance (CrCl) calc.), standard lab-data and SRE incidence were recorded at regular 4 weeks intervals. Results: Baseline pain score differed by BP pretreatment and was highest in BP-naive patients (3.5 + 2.4), compared to pretreated with other BPs (3.2 + 2.5) or IBA (2.8 + 2.2), being the lowest. Mean pain score gradually decreased by every visit, reaching its min. value at study end. This represented a pain reduction of 10 – 40 %, depending of BP pretreatment status, and was achieved in 66 % of total study population. In parallel, there was an overall reduction in analgesic use of 9.2 % (WHO staging), with an increase of 5 % in patients with no need for analgesics. Changes in renal function during the observation period were balanced across all subgroups, with 8 – 15 ml/min maximum change in CrCl and no severe renal adverse events had been reported; significantly more patients pretreated with ZOL (26 %) showed signs of decreased renal function at baseline (S-Crea < 1.2 mg/dl), compared to IBA- (11 %), PAM- (16 %) or without BP-pretreatment (8 %). There was no significant correlation between decreased renal function at baseline and BP-pretreatment duration. 6 cases of osteonecrosis of the jaw had been reported, in two of which IBA was the only BP involved. There were 11 % premature study terminations. In 99 % of the remaining patients IBA treatment was intended to be continued. Conclusion: In this interim analysis of a large scale NIS, IBA showed marked and sustained pain relief in BC patients with MBD without escalation of analgesic use and a renal safety profile comparable to results of RCTs. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1159.

S.A.M.U. 51 practises thrombolysis in patient's house associated with cardiologists of the University Hospital and of a Private Hospital, in indication and following for treatment. This way of working gives a large security for using this therapeutic to the whole population whatever the chosen hospital.

A case of Flumequine poisoning is described; a 13-year-old girl was admitted for a psychiatric syndrome. 3 hours after, seizures, coma, and metabolic disorders were observed. Infectious, encephalitic or diabetic diseases were suspected, but not confirmed. After 12 hours of a symptomatic treatment, the clinical status improved and the patient was discharged. At that time a tablet was found in her bedroom and a mas spectrographic analysis was positive for Flumequine. This case report is in agreement with previous observations and confirms the small therapeutic index of quinolone, and the absolute necessity to assess carefully a psychiatric diagnosis.