Estrogens are thought to play a critical role in prostate carcinogenesis. It has been suggested that polymorphisms of genes encoding enzymes involved in estrogen metabolism are risk factors for ...prostate cancer. However, few studies have been performed on populations of African ancestry, which are known to have a high risk of prostate cancer.
We investigated whether functional polymorphisms of CYP17, CYP19, CYP1B1, COMT and UGT1A1 affected the risk of prostate cancer in two different populations of African ancestry.
In Guadeloupe (French West Indies), we compared 498 prostate cancer patients and 565 control subjects. In Kinshasa (Democratic Republic of Congo), 162 prostate cancer patients were compared with 144 controls. Gene polymorphisms were determined by the SNaPshot technique or short tandem repeat PCR analysis. Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI).
The AA genotype and the A allele of rs4680 (COMT) appeared to be inversely associated with the risk of prostate cancer in adjusted models for both Afro-Caribbean and native African men. For the A allele, a significant inverse association was observed among cases with low-grade Gleason scores and localized clinical stage, in both populations.
These preliminary results support the hypothesis that polymorphisms of genes encoding enzymes involved in estrogen metabolism may modulate the risk of prostate cancer in populations of African ancestry.
Objective To determine factors contributing to recurrence and successful treatment of obstetric fistula (OF). Materials and Methods Data were collected from OF patients in Saint Luc Hospital Kisantu ...(DR of Congo) between 2007 and 2013. Patients underwent surgical treatment and were evaluated after a follow-up period of 3 months. Successful treatment was defined as no or dry pads whereas recurrence was defined as the persisting need for wearing incontinence pads immediately after the surgery or after a period of dryness. Fistula classification was done according to Waaldijk. Univariate and multivariate analyses were performed using logistic regression, corrected for preoperative and intraoperative OF characteristics. Results Median age of 166 OF patients was 29.11 ± 9. 6 years (range 5-61). The majority of OF was type I (57.2%) followed by type III (20.5 %). There were 20.5% who showed vaginal fibrosis during surgical treatment. The most common location of fistula was pericervical (39.8%). The global recurrence rate at 3 months was 28.3%, with type IIBb (100%) as most the common recurring, followed by IIAb (66.67%) and IIAa (41.18%). There were 71.7%, 15.7%, 12%, and 0.6% patients who were considered completely cured, partially cured (downstaged), persistent, and upstaged, respectively. OF patients with fibrosis were 68% less likely (odds ratio 0.32, 95% confidence interval 0.14-0.73; P = .0065) to be dry in comparison to those without fibrosis. Patients with urethral fistula were 73% less likely (odds ratio 0.27, 95% confidence interval 0.11-0.63; P = .0024) to be dry compared to other locations. Conclusion This study showed that fibrosis and urethral location are independent risk factors for fistula recurrence or persistence following surgical fistula repair.
Cette étude a comparé les composants chimiques des calculs du haut et du bas appareil urinaire chez des patients congolais, et identifié les facteurs associés aux différents types de calculs. Les ...calculs extraits du haut appareil urinaire de 119 patients et les calculs extraits du bas appareil urinaire de 75 autres patients ont été analysés par spectrophotométrie infrarouge. Parmi 119 patients présentant des calculs du haut appareil, l’âge variait de 10 à 81 ans, avec une moyenne (écart-type) de 45,8 (13,6) ans. Les hommes étaient plus nombreux (55,5 %) que les femmes. La whewellite était le corps majoritaire prépondérant. Parmi les 75 patients présentant des calculs du bas appareil urinaire, l’âge variait de 4 à 87 ans, avec une moyenne (écart-type) de 51,6 (21,6) ans. Les hommes étaient prépondérants (89,3 %). La whewellite (44 %) et l’acide urique anhydre (22,7 %) étaient les corps majoritaires les plus importants. Dans l’ensemble, les facteurs associés à l’oxalate de calcium étaient le siège au niveau du haut appareil urinaire (4,95 ; IC 95 % 2,35–10,44) et le petit diamètre des calculs (3,03 ; IC 95 % 1,45–6,25) ; la résidence à Kinshasa (0,05 ; IC 95 % 0,01–0,29) était associée au phosphate de calcium. Au niveau du haut appareil urinaire, le siège (0,19 ; IC 95 % 0,06–0,63) et le petit diamètre des calculs (0,10 ; IC 95 % 0,03–0,38) étaient associés aux calculs d’infection. Le jeune âge des patients (0,26 ; IC 95 % 0,09–0,71) et le siège au niveau du haut appareil urinaire (0,23 ; IC 95 % 0,07–0,68) étaient associés aux calculs uriques. Le profil épidémiologique et chimique des calculs du haut appareil diffère de celui des calculs du bas appareil urinaire. Plusieurs facteurs sont associés à la composition chimique et cristalline des calculs en République Démocratique du Congo.
To compare the chemical composition of the upper and lower urinary tract stones in Congolese patients, and to identify factors associated with the different types of stones. Stones from 119 patients originating from the upper tract and 75 from the lower tract were analyzed by infrared spectrophotometry. Among 119 patients with upper tract stones, age ranged from 10 to 81 years with a mean (SD) of 45.8 (13.6) years; males were the majority (55.5%). The main types of stones identified were whewellite (79%). For the 75 patients with lower apparatus stones, age ranged from 4 to 87 years with a mean (SD) of 51.6 (21.6) years; the majority were males (89.3%). The main types of stones were whewellite (44%) and anhydrous uric acid (22.7%). Overall, the factors associated with calcium oxalate included: site 4.95 (95% CI 2.35-10.44) and diameter 3.03 (95% CI 1.45–6.25); patient's place of residence 0.05 (95% CI 0.01–0.29) was associated with calcium phosphate. Infection stones were associated with; site 0.19 (95% CI 0.06–0.63) and diameter 0.10 (95% CI 0.03–0.38). Finally, age 0.26 (95% CI 0.09–0.71) and stone site 0.23 (95% CI 0.07–0.68) were associated with uric stones. The epidemiological and chemical profile of upper and lower tract stones were different. Several factors were associated with the chemical and crystalline composition of stones in the Democratic Republic of Congo.
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