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Introduction Les accidents vasculaires cerebraux (AVC) constituent la premiere cause d’hospitalisation en neurologie en Afrique Subsaharienne. Objectifs Etudier la survie, les facteurs predictifs de deces per hospitalisation et le pronostic fonctionnel a court, moyen et long terme des AVC a l’hopital General de Douala. Methodes Nous avons mene une etude de cohorte prospective de janvier 2010 a decembre 2014 a l’hopital General de Douala. Etaient inclus dans l’etude, les patients âges de plus de 15 ans hospitalises pour AVC confirmes par l’imagerie cerebrale. Les hemorragies meningees et les thromboses veineuses cerebrales avaient ete exclues de l’etude. La survie a ete determinee par la methode de Kaplan Meier et les facteurs predictifs de deces intra-hospitalier determines par analyse univariee et multivariee selon le modele de Cox. Resultats Cinq cent un patients etaient inclus avec 59,88 % d’hommes et l’âge moyen des patients etait de 58,93 ± 13,19 ans. La mortalite hospitaliere etait de 24,8 %. Le score de Glasgow Discussion La mortalite hospitaliere des AVC etait similaire a celle de litterature. Les scores de Glasgow et de NIHSS ont ete rapportes par d’autres auteurs comme facteurs predictifs de deces postAVC. Conclusion Cette etude suggere que les accidents vasculaires cerebraux sont responsables d’une forte mortalite associee a des sequelles et par consequent d’un cout non negligeable pour la societe.

Purpose: To find the fastest and most effective/efficient method to economically deliver fractionated half-body irradiation (HBI) for widespread (WS), symptomatic, metastatic bone cancer. Methods and Materials: A Phase III trial with 3 HBI arms: (Arm A) Control (15 Gy/5 fractions/5 days); (Arm B) Hyperfractionation (HF) (8 Gy/2 fractions/1 day); (Arm C) Accelerated HF (12 Gy/4 fractions/2 days). Six countries randomized 156 patients (all with WS bone metastases): 51, 56, and 49 patients to Arms A, B, and C, respectively. There were 72 (46%) breast, 50 (32%) prostate, 9 (6%) lung, and 25 (16%) miscellaneous primary tumors. Initial performance status (PS) was 1–2 in 101 (65%) and PS 3–4 in 55 (35%). The lower, upper, and middle halves of the body were treated 79, 68, and 9 times. Results: Pain relief was seen in 91% of patients (45% complete [CR] and 46% partial [PR]) within 3–8 days. Overall (OS), median (MST), and pain-free (PFS) survival was 174, 150, and 122 days. Breast tumors had a higher OS (279 days) than that of other primary tumors, but when analyzed by treatment, was not significantly different than prostate tumors in Arm A. No survival differences were found in patients with PS 1–2 vs. 3–4, CR vs. PR, bone with/without visceral metastases, or by the number of metastases ( 15 bone lesions). Quality of life (QOL) assessed by the percent of the remaining life free of pain was 71%; furthermore significant improvements in PS, pain, and narcotic scores were seen after HBI. Toxicity was very acceptable (41% none, 50% mild/moderate, 12% severe but transitory); more was seen with upper HBI. Conclusion: In terms of response, time to response, OS, MST, PFS, QOL, and toxicity, schedules for Arms A and C were similar for all but prostate primaries. Schedule for Arm B, which delivered the lowest biologic dose in the shortest time, had significantly worse results in pain relief, OS, MST, PFS, and QOL. Results indicate that, for most primary tumor types (except prostate), delivering two HBI daily doses of 3 Gy in 2 consecutive days is as effective as delivering a daily dose of 3 Gy for 5 consecutive days. Thus, this is a faster and much more convenient HBI schedule for the palliation of pain in widespread cancer.