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Colorectal Cancer: Epidemiological, Clinical and Histopathological Aspects in Burundi  [PDF]
Rénovat Ntagirabiri, Richard Karayuba, Gabriel Ndayisaba, Sylvain Niyonkuru, Moebeni Amani
Open Journal of Gastroenterology (OJGas) , 2016, DOI: 10.4236/ojgas.2016.63011
Abstract: Colorectal cancer is a major cause of morbidity and mortality throughout the world. There is no study about colorectal cancer in our country. The aim of the study was to assess epidemiological, clinical, therapeutic and histological aspects of colorectal cancer over a 10-year period (1999-2008) in Kamenge university hospital, Bujumbura, Burundi, by a descriptive retrospective study. A total of 37 cases of colorectal cancer, 22 males (59.5%) and 15 females (40.5%), mean age 50.8 years, were retrieved over the period of the study. The colorectal cancer was revealed by a rectal bleeding in 21 patients (56.8%) and an occlusive syndrome in 5 patients (13.5%). All patients underwent surgery. According to Dukes’ stages: 27% were A, 27% B, 19% C and 27% stage D. Histopathologically, 18 cases (46.7%) were differentiated adenocarcinoma, 14 cases (37.8%) undifferentiated adenocarcinoma, 2 cases of lymphoma and 2 cases of leiomyosarcoma. All patients underwent surgery. The hospitalization stay was a mean of 27 days. The prognosis was poor with a mortality rate of 13.5% in the hospital. In conclusion, colorectal cancer deserves awareness as a public health problem in our country.
Expression of matrix metalloproteinase-9 in the neoplastic and interstitial inflammatory infiltrate cells in the different histopathological types of esophageal cancer.  [cached]
Barbara Mroczko,Miros?aw Koz?owski,Magdalena Groblewska,Marta Lukaszewicz
Folia Histochemica et Cytobiologica , 2009, DOI: 10.5603/4398
Abstract: Metalloproteinase-9 (MMP-9) is the proteolytic enzyme degrading type IV collagen, and plays important role in the invasiveness and metastatic potential of tumor cells. The aim of the current study was to compare the association between the intensity of MMP-9 expression in neoplastic cells and in the interstitial inflammatory infiltrate cells in esophageal cancer with clinicopathological features of esophageal cancer (EC) and in different histopatological types of EC, e.g. adenocarcinoma and esophageal squamous cell carcinoma. The study included 32 EC patients, 17 cases of squamous cell carcinoma and 15 cases of adenocarcinoma, verified histopatologically. The presence of MMP-9 in cancer tissue was investigated by immunohistochemistry on formalin-fixed, wax-embedded sections of esophageal cancers. The light microscopy was used to evaluate the expression of metalloproteinase-9 in cancer cells and in inflammatory infiltrate in the neoplastic interstitium in semi-quantitative scale. The expression of MMP-9 in cancer cells was positive in 81% of cases whereas in inflammatory cells - in 75% and increased with tumor stage, depth of tumor invasion (T factor) and lymph node metastases (N factor). In squamous cell cancer the MMP-9 expression in cancer cells and in inflammatory infiltrate was higher than those in adenocarcinoma. Mean value of MMP-9 expression in inflammatory cells was higher in early stages of EC, whereas mean expression of this enzyme in cancer cells increased with tumor stage. In conclusion, this is the first study comparing the expression of metalloproteinase-9 in cancer and inflamatory infiltrate cells in different histopatological types of esophageal cancer. We proved the synthesis of MMP-9 by cancer cells as well as by inflammatory cells and its correlation with tumor stage, tumor size, depth of tumor invasion and lymph node metastases. The results suggest the role of MMP-9 in esophageal tumorigenesis, although this issue requires further investigations.
Traditional justice in the reconciliation between Rwanda and Burundi
Antoni Castel
Revista CIDOB d'Afers Internacionals , 2009,
Abstract: This article reviews the use of traditional justice in two post-conflicts in the Great Lakes region: those of Rwanda and Burundi. In Rwanda, the government, led by the Rwanda Patriotic Front (FPR), has modernised and shaped for its own interests the gacaca, who are responsible for seeking justice for the victims of the 1994 genocide. In Burundi, the government has yet not deployed all the transitional justice mechanisms as envisaged in the Arusha agreement. The bushingantahe (the rehabilitation of whom is also envisaged in the agreement) have not yet been incorporated into transitional justice.
Esophageal Carcinogenesis  [PDF]
Naoki Watanabe, Masahito Shimizu, Takahiro Kochi, Yohei Shirakami, Takuji Tanaka
Open Journal of Pathology (OJPathology) , 2014, DOI: 10.4236/ojpathology.2014.44021
Abstract: Esophageal cancer is the sixth leading cause of cancer death and remains one of the least survivable cancers. Esophageal cancers show wide variations in incidence in different population, suggesting that environmental or lifestyle risk factors could be controlled to reduce risk of these diseases. There are two major histopathologic types (squamous cell carcinoma and adenocarcinoma) of esophageal epithelial malignancy. Recently, the rate of adenocarcinoma is increasing in developed countries: in the United States, 50% or more is adenocarcinoma and, in about 70%, the increase especially in a white male serves as adenocarcinoma. Esophageal adenocarcinoma develops in the lower esophagus. In contrast, in Japan, the increase in adenocarcinoma is not clear and most (90%) of esophageal cancers are squamous cell carcinoma. Such squamous cell carcinoma occurs onto the middle part esophagus mostly, and 60% or more of the whole esophagus cancer also develops in the middle and upper parts. These differences also influence the treatment results. The scope of this article is to discuss carcinogenesis in the esophagus by giving an overview about its histopathological characteristics and molecular mechanisms.
Bayesian modelling of the effect of climate on malaria in Burundi
Hermenegilde Nkurunziza, Albrecht Gebhardt, Jürgen Pilz
Malaria Journal , 2010, DOI: 10.1186/1475-2875-9-114
Abstract: This paper investigates the effects of climate on malaria in Burundi. For the period 1996-2007, real monthly data on both malaria epidemiology and climate in the area of Burundi are described and analysed. From this analysis, a mathematical model is derived and proposed to assess which variables significantly influence malaria incidences in Burundi. The proposed modelling is based on both generalized linear models (GLM) and generalized additive mixed models (GAMM). The modelling is fully Bayesian and inference is carried out by Markov Chain Monte Carlo (MCMC) techniques.The results obtained from the proposed models are discussed and it is found that malaria incidence in a given month in Burundi is strongly positively associated with the minimum temperature of the previous month. In contrast, it is found that rainfall and maximum temperature in a given month have a possible negative effect on malaria incidence of the same month.This study has exploited available real monthly data on malaria and climate over 12 years in Burundi to derive and propose a regression modelling to assess climatic factors that are associated with monthly malaria incidence. The results obtained from the proposed models suggest a strong positive association between malaria incidence in a given month and the minimum temperature (night temperature) of the previous month. An open question is, therefore, how to cope with high temperatures at night.In Burundi, malaria is a major public health issue in terms of both morbidity and mortality with around 2.5 million clinical cases and more than 15,000 deaths each year. During the last decade, for example, malaria cases increased from 550,000 cases in 1991 to 2.8 million in 2001 in a total population estimated at 7 million [1]. In 2001, Burundi was the country most affected by malaria in the world [2]. Malaria is the single main cause of mortality in pregnant women and children below five years of age. Malaria continues to ravage millions of rural Burun
Geo-additive modelling of malaria in Burundi
Hermenegilde Nkurunziza, Albrecht Gebhardt, Jürgen Pilz
Malaria Journal , 2011, DOI: 10.1186/1475-2875-10-234
Abstract: The analysis carried out in this work exploits real monthly data collected in the area of Burundi over 12 years (1996-2007). Semi-parametric regression models are used. The spatial analysis is based on a geo-additive model using provinces as the geographic units of study. The spatial effect is split into structured (correlated) and unstructured (uncorrelated) components. Inference is fully Bayesian and uses Markov chain Monte Carlo techniques. The effects of the continuous covariates are modelled by cubic p-splines with 20 equidistant knots and second order random walk penalty. For the spatially correlated effect, Markov random field prior is chosen. The spatially uncorrelated effects are assumed to be i.i.d. Gaussian. The effects of climatic covariates and the effects of other spatial determinants are estimated simultaneously in a unified regression framework.The results obtained from the proposed model suggest that although malaria incidence in a given month is strongly positively associated with the minimum temperature of the previous months, regional patterns of malaria that are related to factors other than climatic variables have been identified, without being able to explain them.In this paper, semiparametric models are used to model the effects of both climatic covariates and spatial effects on malaria distribution in Burundi. The results obtained from the proposed models suggest a strong positive association between malaria incidence in a given month and the minimum temperature of the previous month. From the spatial effects, important spatial patterns of malaria that are related to factors other than climatic variables are identified. Potential explanations (factors) could be related to socio-economic conditions, food shortage, limited access to health care service, precarious housing, promiscuity, poor hygienic conditions, limited access to drinking water, land use (rice paddies for example), displacement of the population (due to armed conflicts).In Buru
Power-Sharing, Conflict and Transition in Burundi: Twenty Years of Trial and Error Machtteilung, Konflikt und Wandel in Burundi: Zwanzig Jahre Versuch und Irrtum
Stef Vandeginste
Africa Spectrum , 2009,
Abstract: For the past twenty years, Burundi has experimented with powersharing as an instrument of political liberalisation, democratisation and conflict resolution. This contribution analyses the different meanings the concept of power-sharing has had throughout Burundi’s recent and extremely violent political transition, in particular during the lengthy peace process. It shows how national and international actors have found inspiration in the toolbox of consociationalism to negotiate and design the Arusha Peace and Reconciliation Agreement for Burundi signed in August 2000 and its posttransition Constitution. Power-sharing has been instrumental in achieving the – short-term – objective of war termination. It has also de-ethnicised political competition and reduced the (potentially) destabilising effect of elections. Measured against more ambitious state-building objectives (democracy, rule of law, accountable and effective governance), power-sharing has (so far) not been able to make a difference. Several factors and developments threaten the “survival” of the power-sharing model in Burundi. In Burundi wird seit zwanzig Jahren mit Power-Sharing als Instrument politischer Liberalisierung, Demokratisierung und Konfliktl sung experimentiert. Der vorliegende Beitrag analysiert, welche unterschiedlichen Bedeutungen das Konzept der Machtteilung in der jüngsten und extrem gewaltt tigen Entwicklungsphase Burundis angenommen hat, insbesondere w hrend des langwierigen Friedensprozesses. Er zeigt auf, inwieweit nationale und internationale Akteure sich bei der Aushandlung und Planung des Arusha-Abkommens zu Frieden und Vers hnung in Burundi, das im August 2000 unterzeichnet wurde, sowie der anschlie enden Verfassung am Instrumentarium der Konkordanzdemokratie bedient haben. Power-Sharing erwies sich als nützlich, das kurzfristige Ziel einer Beendigung des Krieges zu erreichen, und trug zur De-Ethnisierung des politischen Wettbewerbs und zur Reduktion (potenziell) destabilisierender Effekte w hrend der Wahlen bei. Gemessen an ambitionierteren Zielen im Sinne des State-Building, wie Demokratie, Rechtsstaatlichkeit, verantwortliche und effiziente Regierungsführung, hat Power-Sharing (bis jetzt) nicht wirklich zu einem Wandel geführt. In Burundi sind zudem verschiedene Faktoren und Prozesse zu beobachten, die das “überleben” des Machtteilungsmodells gef hrden.
Steakhouse syndrome causing large esophageal ulcer and stenosis  [cached]
Shotaro Enomoto,Kazuyuki Nakazawa,Kazuki Ueda,Yoshiyuki Mori
World Journal of Gastrointestinal Endoscopy , 2011, DOI: 10.4253/wjge.v3.i5.101
Abstract: A 66-year-old man developed dysphagia during dinner and was evaluated 2 d later in our hospital because of persistent symptoms. Upper gastrointestinal endoscopy showed no impacted food, but advanced esophageal cancer was suspected based on the presence in the upper esophagus of a large irregular ulcerative lesion with a thick white coating and stenosis. Further imaging studies were performed to evaluate for metastases, revealing circumferential esophageal wall thickening and findings suggestive of lung and mediastinal lymph node metastases. However, dysphagia symptoms and the esophageal ulcer improved after hospital admission, and histopathological examination of the esophageal mucosa revealed only nonspecific inflammation. At the time of symptom onset, the patient had been eating stewed beef tendon (Gyusuji nikomi in Japanese) without chewing well. Esophageal ulceration due to steakhouse syndrome was therefore diagnosed. The lung lesion was a primary lung cancer that was surgically resected. Although rare, steakhouse syndrome can cause large esophageal ulceration and stenosis, so care must be taken to distinguish this from esophageal cancer.
Identity and Cultural Diversity in Conflict Resolution and Democratisation for the African Renaissance: The Case of Burundi
P Ntahombaye, G Nduwayo
African Journal on Conflict Resolution , 2007,
Abstract: Since its independence in 1962, Burundi has witnessed conflicts and violence. A multitude of factors help explain these tragedies, which include the creation of a negative image of the ‘other'; an ever-strengthened fear of the ‘other'; the blood feud between the Hutus and the Tutsis; and an illusion of the dominance of a so-called ‘ethnic group'. The purpose of this paper is to underscore the part which the colonial state played with regard to the creation and intrumentalisation of ethnicity, based on racist ideologies. Since independence, the ruling elites continue to appropriate and radicalise this category. As result, they are not only able to enjoy political gains, but also simply perpetuate ethnicity with the help of an institutional framework, while pretending to fight it. The Burundi nation that was built on moral and social values such as Ubushingantahe, Ubuntu, Ubupfasoni, a love for a work well done, and the value of effort, finds itself in a trap. There is a crisis of these values, which resulted in the legitimatisation of negative forces as criteria for social promotion and access to power. The paper argues that because the Burundi issue is complex and multiform, the solution has to be complex and multiform as well. To this effect and to be able to make an impact, it has to draw from many registers: political, institutional and cultural (the value of unity and the institution of Ubushingantahe philosophy). The paper proposes a few political initiatives which are to be taken: advocacy on citizenry, participation in the culture of democracy, memory restitution through history, and depolitisation and demystification of ethnicity. From a socio-cultural perspective, the initiatives will be based on deepening dialogue and negotiation at all levels, rehabilitating the social and cultural values and customs likely to enhance social cohesion and peace, promoting rehabilitation of the bashingantahe institution in order to incorporate peaceful conflict resolution mechanisms and human rights into the educational system, designing an integrated national reconciliation programme, providing support to the cultural organisations which promote peace and human rights, and advocating for media involvement in all the above initiatives. African Journal on Conflict Resolution Vol. 7 (2) 2007: pp. 239-274
ESOPHAGEAL VARICES
MOAZZAM ALI ATIF
The Professional Medical Journal , 2008,
Abstract: Objectives To document the frequency of esophageal varices and their importance in a tertiary care hospital of SouthernPunjab. Design: Observational. Setting: Endoscopy unit of Sheikh Zayed Medical College/Hospital. Period: From Nov 2005 to May 2007.Materials & Methods The data of 500 patients who underwent upper GI endoscopy was analyzed. Demographic features, reasons for referraland endoscopic diagnoses were noted. Results: Among 500 patients, 57% were referred due to upper GI bleeding, 9% due to dysphagia, 8%due to persistent vomiting and 7% due to dyspeptic symptoms. Common endoscopic diagnoses were esophageal varices (44%). Conclusion:Major Endoscopic finding in our study was esophageal varices. Gastric or duodenal ulcers, congestive gastropathy, obstructive lesions ofesophagus and stomach were the next most common observations.
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