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Background: Trauma is a real public health issue, being the third leading cause of death in the world. Blunt Abdominal Trauma (BAT) represents a significant part of these traumas and constitutes a diagnostic and therapeutic challenge. The aim of this study is to determine the epidemiological and clinical profile of BAT in the Department of General Surgery at Aristide Le Dantec Hospital. Patients and methods: This was a retrospective and cross-sectional study from January 2012 to March 2017. Patients who were more than 15 years old with BAT were included. The studied parameters were: age, gender, delay of admission, etiology of the trauma, clinical signs, organ injury, type of treatment and evolution. Results: Thirty-seven patients were included. The mean age was 34.8 years ± 13.5. There were 35 men and 2 women. The etiologies were dominated by road traffic accidents (54.1%, n = 20) and assaults (21.4%, n = 8). Abdominal pain was found in all patients (100%, n = 37). It was associated with vomiting and fever in 32.4% (n = 12) and 27% (n = 10), respectively. There was no hemodynamic instability in the majority of cases (89.2%, n = 33). The most frequently injured organ was the spleen (16.2%, n = 6) followed by the liver and intestines each in 13.5% of cases (n = 5). Extra abdominal injury was noted in 32.4% of the cases (n = 12). Conclusions: The patient profile in our study was a young man victim of a road traffic accident. The most injured organ was the spleen followed by the liver. A good knowledge of this profile can be helpful to reduce the incidence and mortality associated with these injuries.

Colonic adenomatous polyposis is defined by the presence of more than 100 polyps in the lumen of the colon or rectum. The risk of progression to a colorectal cancer is 100%. The relative rarity of this condition in sub-Saharan Africa explains the problems associated with its management. The aim of this study is to report the diagnostic difficulties and therapeutic implications of colonic adenomatous polyposis at in a surgical setting in Dakar. This is a descriptive retrospective study from January 2012 to December 2015 including patient with colonic adenomatous polyposis confirmed by colonoscopy and histology. In total, 4 patients were included in the study. The mean consultation time was 13.7 years ± 11.8. The mean age was 44.3 years ± 2.8. The sex ratio was 3. Due to their silent symptomatology, colonic adenomatous polyposis is most often found in our context at the stage of complications (metastatic cancer, occlusion, perforation peritonitis). Genetic tests essential for the diagnosis are unavailable in our context. This could explain the relative rarity of this condition in sub-Saharan Africa and the problems associated with its management. Improving the prognosis will necessarily involve the improvement of means both for diagnosis and treatment.

La tumeur de Buschke-Lowenstein (TBL) ou le condylome acumine geant (CAG) est une entite clinique rare atteignant moins de 0,1 % de la population generale. Transmise essentiellement par voie sexuelle, elle est liee a l’infection a Human Papilloma Virus (HPV). Elle peut degenerer en carcinome epidermoide de l’anus plus particulierement chez les personnes infectees par le VIH. Nous rapportons l’observation d’un patient porteur de VIH, avec notion d’homosexualite, recu pour lesions condylomateuses acuminees ano-perineales geantes. L’objectif est de decrire les aspects cliniques, therapeutiques et evolutifs de cette affection.

Objectives: To assess the quality of prenatal monitoring of pregnant women with a previous cesarean delivery and determine the maternal and neonatal prognosis in an African setting. Patients and methods: This prospective, descriptive, and analytical study took place at Roi Baudouin Health Center in Dakar (Senegal) and examined the records of women giving birth from November 1, 2009 to August 31, 2010. It included all women admitted for delivery at 22 weeks of gestation or more, with at least one previous cesarean, and a prenatal consultation record booklet. Women with uterine scars from a gynecological intervention were excluded. The study included a qualitative analysis of the record booklets and an interview of patients. Results: Women with previous cesareans accounted for 12.5% of all women giving birth during the study period. The average age of the women in our study was 28 years, their mean parity was 3, and their mean number of prenatal examinations 3 (range: 1 to 5). Most prenatal care was provided by midwives (95.1%). The clinical characteristics were rarely completed. Not all women had undergone the laboratory tests required, and fewer than half (40.7%) had had a third-trimester ultrasound. In all, 109 (28.1%) had been referred to the hospital as an appropriate structure for their delivery. Complications of labor were observed in 28.3% of the cases. In 73% of these cases, women had repeat cesareans; 26% had vaginal deliveries. The performance of the recommended prenatal check-up was significantly correlated to how early prenatal care began (p = 0.001) and the level of the structure providing prenatal care (p = 0.027). Conclusion: Reducing maternal and fetal morbidity and mortality due to uterine scars requires that women be made aware of the relevant issues and that healthcare providers refer them appropriately and early.

Background: Electronic Health Records (EHRs) have an important role in medical decision making and are considered as being a major part of medical support system. To ensure this role effectively, the information must be easily found, even in voluminous and large number of EHRs. This requires to develop search capabilities for EHR information retrieval (IR). Methods: To perform this, we propose a data model adapted to IR. The data analysis of EHRs of the Rouen University Hospital led us to consider them as being a set of informational elements linked by temporal and conceptual relationships. This model consists of two main entities to manage the information elements and their metadata. After implementation, we have evaluated the capacity of the proposed model to take into account all data from the EHRs and its adaptation to IR. Results: We have performed 25 queries on EHR (20 correspond to single patient and 5 to multi-patients). The results in 19 cases (including 3 partial results) were evaluated as successful. These results confirm the ability of the model to take into account most of relevant data of EHR in IR and clearly show the differences in complexity of queries between the initial and our model of IR. Conclusion: The preliminary evaluation of the data model we have developed has shown its adaptation to IR in EHR. Nevertheless, further work on larger sets is needed to confirm this.

Background: Information retrieval becomes more relevant thanks to document (semi)automatic indexation with terminologies adapted to the domain. Being interested in the medical domain, we used the main health terminologies available in French in two different contexts: (a) during the health resource indexation process and (b) during the information retrieval. Methods: Within the CISMeF catalog (French acronym of Catalogue et index des Sites Medicaux Francophones), we have evolved from a monoterminological world (based on the MeSH thesaurus) to a multi-terminological universe (based on ICDIO, CCAM, SNOMED terminologies and ATC classification). This new structure allows us to make the information retrieval in two different contexts: to retrieve (a) reports from the electronic health record (EHR) of patients and (b) resources from a health portal (such as CISMeF). Results: Both contexts share the same representation meta-model, however, they differ during the information retrieval, according to the size and the nature of the corpus, the role of dates and the query, which can include both structured and unstructured elements in EHR. Conclusion: In 2008, the information retrieval has already become multi-terminological in the Drug Information Portal and will become available in the catalog CISMeF at the beginning of 2009.

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