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To assess the frequency and characteristics of complications of arteriovenous fistula (AVF) and their effect on fistula outcome.

To present the particular aspects of arteriovenous fistula (AVF) for hemodialysis in sub-Saharan Africa in terms of patients’ characteristics, patency and complication rates, as well as factors influencing them.

Purpose: Little is known about physician's knowledge of, and attitudes toward genetics in sub-Saharan Africa.Methods: Survey of 101 pre-clinical, 95 clinical medical students, and 110 physicians, in Cameroon.Results: The awareness of DNA diagnosis was poor: 0, 2.2, and 1.2%, respectively, for sickle cell anemia. The majority of the respondents considered genetic counseling as indispensable (97.6, 98.9 and 100%); and prenatal diagnosis as acceptable. The acceptance of medical abortion increased with the level of medical education (62.6, 74.7 and 90.7%). Sickle cell anemia was considered as a “serious disease” by a greater majority of respondents than Down syndrome (P < 0.001). But, in all three groups, the acceptance of termination of affected pregnancy “if the respondent's own child was affected” was lower for sickle cell anemia than Down syndrome (22.4 versus 40.2%, 10.8 versus 29.3% and 36.1 versus 70.4%).Conclusions: The data suggest a poor knowledge of genetic tests among medical students and physicians. This cohort appears to accept the principles of medical genetics. Our data emphasized a need to introduce genetics and to develop research on its ethical and social implications in Cameroon.

We describe our experience with a urethral lengthening-reimplantation operation for the correction of incontinence in 13 myelomeningocele children, 11 of whom had failed to achieve continence on a program of intermittent clean catheterization. The procedure involves lengthening the urethra by formation of a bladder tube, which is reimplanted back into the bladder through a submucosal tunnel. This procedure allows a catheter to be passed but prevents urine from leaking. All of the operated cases are included. All of the children are out of diapers and socially dry. Followup ranged from 8 to 36 months and the problems encountered are described.

Iliac artery-ureteral fistulas are uncommon, with less than 15 cases described in the literature. Ureterocolic fistulas have been described even less frequently. We report the first case of synchronous right ilioureteral and left ureterosigmoid fistulas associated with indwelling ureteral stents. The patient presented with massive sentinel gross hematuria, urosepsis and chronic anemia.