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Biomedical subjects

C Sylla

Publications and source records attributed to C Sylla.

At least 37 records · Page 2Linked to original sources
PubMed1997

Results of renal transplantation in patients with Schistosoma infection.

PURPOSE: We evaluated the results of renal transplantation in patients infected with Schistosoma haematobium, as well as the risks of urological complications and post-transplant reinfection. MATERIALS AND METHODS: The outcome of 20 kidney transplants was retrospectively studied. Based on our experience and review of the literature, our clinical practice to prevent urological complications consisted of antischistosomal chemotherapy given at the pre-transplant evaluation, with endovesical ureteroneocystostomy preferred in case of bladder calcifications. A Foley catheter was maintained for 10 days. A transurethral bladder neck incision was performed before removal of the Foley catheter when bladder neck sclerosis was present. RESULTS: The 1 and 2-year patient survival rate was 93%, and 1 and 2-year graft survival rates were 88 and 81%, respectively, which were not different from those of a cohort of 167 patients without schistosomal infection. Surgical complications included 2 postoperative hemorrhages, 2 urinary leaks and 1 nonschistosomal related ureteral stricture. Post-transplant schistosomal infection never occurred when antischistosomal chemotherapy was given at the pre-transplant evaluation. CONCLUSIONS: Patients with schistosomal infection are suitable recipients for kidney transplantation, although they are at risk for urological complications. Unlike other infectious diseases, such as tuberculosis, the risk of recurrence due to reactivation of chronically hosted pathogens seems to be low or absent in patients who received antischistosomal chemotherapy at the pre-transplant evaluation. Long-term urological followup is recommended, including urethrocystoscopy, because of the theoretically increased risk for bladder malignancy.

Adult↗
PubMed1997

[Legal restitution of bodily harm in the traumatic rupture of the posterior urethra].

Medical experts are responsible for evaluation of the urinary and sexual sequelae following traumatic rupture of the posterior urethra. Only definite and direct damage is compensated by the courts, which demands a methodical and meticulous examination by the expert. Sexual damage can be evaluated by certain criteria including the results of intracavernous injections.

Disability Evaluation↗
PubMed1996

[Neurologic aspects of vesico-vaginal fistula of obstetrical origin].

OBJECTIVE: To study the electromyographic alterations of the urethral sphincter, perineal muscles and lower limbs observed in women with obstetric vesicovaginal fistula. METHODS: We compared a group of 22 women with obstetric vesicovaginal fistula with a control group of 10 women without fistula. Each woman underwent a neurological examination of the perineum and lower limbs and electromyography of the lower limbs and urethral sphincter. According to the classification proposed by MENSAH, the fistulas were classified as simple (54.5%), complex (31.8%) and complicated (13.6%). RESULTS: Twenty women with VVF presented a peripheral nerve lesion. Five of these patients had a clinical and electromyographic lesion; while the other fifteen patients had a subclinical lesion. 68.18% of the fistula patients presented a clinical neuropathy in the perineum. This lesion was detected on electromyography in all patients with fistula. The severity of this denervation lesion ranged from moderate (36.37%) to severe (63.63%). No neurological lesions were detected in the control group. The degree of denervation has more severe in young women (21-25 years) and in primiparous women. In contrast, the severity of denervation did not appear to be related to the history of the fistula. The risk of treatment failure increased proportionally to the severity of denervation. 73% of fistulas with severe denervation remained "unsuturable", or required multiple operations with disappointing results in the form of persistent vesicosphincteric dysfunction. CONCLUSION: Although the psychosocial impairment and upper urinary tract repercussions have been well evaluated, the peripheral neurological lesion has always been underestimated in the management of obstetric vesicovaginal fistulas. The authors consider that the fistula is only the apparent manifestation of "neurovesical damage", which remains the decisive factor in the prognosis and which largely explains the high frequency of treatment failure.

Adult↗
PubMed1996

[Pancreatic islet transplantation: isolation techniques and in vitro immunomodulation].

OBJECTIVES: To develop pancreatic islet isolation and purification techniques in order to be able to test two human pancreatic islet immunomodulation techniques on an in vitro model of allograft islet rejection. METHODS: Islet isolation was performed according to Ricordi's method, which was slightly modified during the study. Purification was performed according to the Euroficoll discontinuous gradient method on a Cobe 2991 centrifuge. The results of immunomodulation techniques (depletion of cells expressing class II HLA molecules, and immunomasking of HLA class I molecules) were assessed in vitro by mixed lymphocyte-islet cocultures (MLIC). RESULTS: Seventeen pancreatic islets were isolated then purified. Technical improvements increased the yield from 2,247 +/- 1,984 to 4,567 +/- 990 islet-equivalents per gram. The mean purity was 70 +/- 19% (40-90%). Immunomodulation by depletion of class II HLA molecules regularly inhibited (84%) MLIC in contrast with masking of class I antigens, which induced only a moderate (44%) and inconstant (4 experimentations out of 6) inhibition. CONCLUSION: The modifications made to the islet isolation method improved its yield and now allow the possibility of clinical applications. The results of mixed lymphocyte-islet cocultures suggest that the suppression of nonendocrine cells expressing class II HLA molecules on their surface reduces the immunogenicity of pancreatic islet grafts.

Graft Rejection↗
PubMed1996

[Epididymal manifestations of urogenital tuberculosis].

The morbidity of tuberculous epididymitis is due to the risk of male infertility secondary to vasal or epididymal obstruction or testicular necrosis. The aim of this study was to emphasize the epidemiological, clinical and therapeutical aspects of tuberculous epididymitis in adult. About eleven cases of epididymal localisation of urogenital tuberculosis, it appears that the diagnosis of the condition is rather difficult and often necessitate pathological exam of a specimen of epididymectomy. In other aspects, if antituberculous drugs are always effective in initial stages, surgery is usually radical, and rarely conservative. The latter procedures are vasovasostomy or vasoepididymostomy whose results are very hazardous.

Adult↗
PubMed1994

[Delayed emergency repair of traumatic ruptures of the posterior urethra].

The management of posterior urethral injuries is still a matter of controversies. Some authors recommend a primary or delayed emergency repair procedure, while others prefer late repair. The analysis of our series of fifteen cases showed that when patients are treated by delayed emergency operation, the results are usually good. However, when repair is performed later, results are less satisfactory, and the rate of impotence is higher. We conclude that delayed emergency repair operation is the procedure of choice in the management of ruptured posterior urethra.

Adolescent↗
PubMed1992

["In-dartos" orchidopexy in the treatment of cryptorchism].

Undescended testis is a common congenital abnormality. The main complications are infertility and venue of malignant testicular tumor. If early orchiopexy can prevent infertility, it remains a high risk of venue of a malignant tumor. So, the best technique of orchiopexy is that which allows an easy clinical follow-up of the undescended testis after surgical treatment, and doesn't involv the hematoseminal barrier. From the analysis of fourty cases of scrotal pouch orchiopexy and a review of the literature, it appears that this procedure is efficient and gives more than 90% of good results.

Adolescent↗
PubMed1992

["In-dartos" orchidopexy in the treatment of cryptorchism].

Maldescended testis is a common congenital abnormality. The main complications are infertility and venue of malignant testicular tumor. If early orchiopexy can prevent infertility, it remains a high risk of venue of a malignant tumor. So, the best technique of orchiopexy is that which allows and easy clinical follow-up of the maldescended testis after surgical treatment, and doesn't involve hematoseminal barrear. From the analysis of fourty cases of scrotal pouch orchiopexy and a review of the literature, it appears that this procedure is efficient and gives more than 90% of good results.

Adolescent↗
PubMedDate not supplied

[Prevalence of hypertension in Guinean rural areas].

OBJECTIVE: To determine the prevalence and awareness of HTA in Guinean rural populations with respect to age and gender. DESIGN AND SETTING: Cross-sectional survey in rural Guinea: Köpèrè-Döfili (400 inhabitants) and Töbölön (900 inhabitants). PARTICIPANTS: 188 subjects (81 in Köpèrè-Döfili and 107 in Töbölön), 15 years and older were visited in their homes between November 2000 and April 2001. METHODS: The blood pressures were measured with an electronic tensiometer "Philips HF305". Awareness of HTA and risk factors were determined by interviews. HTA was defined as mean SBP/DBP = 140/90 mmHg. RESULTS: Overall, 69% (56/81) in Köpèrè-Döfili and 27% (29/107) in Töbölön were hypertensive. Among these, only 2 (Köpèrè) and 6 patients (Töbölön) were aware of their condition. HTA was strongly gender dependent in Köpèrè where 98% (44/45) of the males were concerned. In Köpèrè-Döfili, the combined systolo-diastolic hypertension (SDH) was predominant (80%; 45/56) and was associated to the male gender (80%; 36/45). In the hypertensive population of Töbölön, the isolated PAD (DH) was mainly associated with the female group (47%, 8/17). The grade III HTA (PAS/PAD > or = 180/110 mmHg) concerned both gender (41%, 18/44 for males; 42%, 5/12 for females) in Köpèrè-Döfili and mainly the female group in Töbölön (29%, 5/17). Smoking was the most frequently associated risk factor in the studied population of Köpèrè-Döfili (70%) and Töbölön (45%). The smokers were predominantly female in Köpèrè-Döfili (89%, 32/36) or male in Töbölön (51%, 24/47). Among the smokers, the hypertensive individuals were 96% (24/25) of the males and 38% (12/32) of the females in Köpèrè, 29% (7/24) of the males and 38% (9/24) of the females in Töbölön. CONCLUSION: Hypertension is highly prevalent in two Guinean rural localities where less than 5% of the studied population were aware of their conditions, suggesting the nationwide demand for preventing and controlling HTA in Guinea.

Adolescent↗