Health related quality of life, reoperation rate and function in patients with diabetes mellitus and hip fracture--a 2 year follow-up study.

INTRODUCTION: Diabetes mellitus confers an increased risk of hip fractures. There is a limited knowledge of how the outcome after a hip fracture in patients with diabetes affect Health Related Quality of Life (HRQoL). The primary aim of this study was to evaluate HRQoL. Secondary aims were reoperation rate, complications and functions in patients with diabetes followed for 2 years after a hip fracture. MATERIALS AND METHODS: Out of 2133 patients diabetes was present in 234 patients (11%). Main outcome measurements were HRQoL evaluated with EuroQoL 5-Dindex score, reoperation rate, surgical and medical complications, function as walking ability, daily activities, living condition and pain. RESULTS: Preoperatively, patients with diabetes mellitus had more pain (p=0.044), co-morbidities, reduced health status (p=0.001) and more often used a walking frame (p=0.014) than patients without diabetes, whereas Katz ADL index, cognition and body mass index did not differ. There was no difference in fracture type, surgical method or reoperation between the two groups or between patients with insulin treated or oral treated diabetes. The EQ-5Dindex score decreased from 0.64 at admission to 0.45 at 4 months, 0.49 at 12 months and 0.51 at 24 months with similar results for patients with and without diabetes. During the first postoperative year there was not more medical complications among patients with diabetes, however cardiac (p=0.023) and renal failure (p=0.032) were more frequent in patients with diabetes at 24 months. Patients with diabetes more often had severe hip pain at 4 months (p=0.031). At 12 months more diabetic patients were living independently (p=0.034). There was no difference in walking ability, ADL and living condition between the groups at 24 months. CONCLUSION: The findings of this study indicate that patients with diabetes mellitus had more pain, co-morbidities, reduced health status preoperatively than patients without diabetes. Hip fracture patients with diabetes mellitus have more hip pain at 4 months. Cardiac and renal failure was more frequent in patients with diabetes at 24 months but otherwise we found a comparable re-operation rate, function and deterioration of Health Related Quality of Life as patients without diabetes within 2 years after a hip fracture.

Anorectal diseases in Western Nigerian adults. A field survey.

A survey of anorectal diseases in parts of Western Nigeria was performed by examining 336 adults in various locations. It was concluded that anorectal diseases are more common among the population than is suggested in reviews of hospital cases--a fact largely due to poor health awareness and consequently poor hospital attendance. The fairly generally high prevalence of these diseases does, in fact, mirror holoendemic conditions such as schistosomiasis, amebiasis, and intestinal tuberculosis. In spite of known western influence on food preparation and dietary habits, particularly among the urban dwellers, it is probably too early to expect any impact on bowel habits and large-bowel and anorectal diseases. In view of the significant association, the author suggests than any disturbance in bowel action should prompt a thorough investigation for anorectal diseases.

Chemodectomas: a review of 17 cases.

Seventeen cases of chemodectomas seen in the University College Hospital, Ibadan, are presented. Eight of them (48%) are carotid body tumors, while six (36%) are glomus jugulare. The rest are subglottic, abdominal and multicentric. The sex distribution for the two major types is equal for males and females; but they all seem to appear in younger age groups. Operative mortality has been exclusive to carotid body tumors (50% for this group), while bleeding is the leading postoperative complication in all the cases. The embryology, pathophysiology and clinical presentation of chemodectomas are discussed and it is suggested that, in the management of this condition, the advantages of operation should be weighed against morbidity and mortality risks.

Radiological evaluation of anal fistulae: a prospective study of fistulograms.

A review of 33 fistulograms in a four-year study is presented. Four types of communicating tracts have emerged: single (58%), branched (18%), fistulous abscess (15%) and compound (9%). This classification has formed the basis of selection of operative treatment in all the cases. Diminished lumbo-sacral angle was also found in most of the anal fistula cases and this establishes a possible association between the pathology of anal fistula and the low back syndrome.

Decay of methyl green-pyroninophilia in Burkitt's lymphoma.

The spontaneous decay of methyl green-pyroninophilia in Burkitt's lymphoma was studied at four temperatures (0 degrees C to 56 degrees C) in four biopsies using Kurnick's method. The decay is temperature and time related and is presumably due to intrinsic enzymatic action, probably ribonuclease. Imprints from tumor tissue preserved at 0 degrees C lose pyroninophilia by six hours; from tumor preserved at room temperature pyroninophilia, in most instances, would have been lost by three hours, from tumor tissue maintained at 37 degrees C, by two hours in most instances and by 15 minutes at 56 degrees C in most instances. The absence of pyroninophilia after these intervals at the appropriate temperatures should not detract from the diagnosis of Burkitt's Lymphoma.

Dermatofibrosarcoma protruberans: analysis of eight cases in an African population.

Eight cases of dermatofibrosarcoma protruberans seen in the University College Hospital, Ibadan, Nigeria between 1960 and 1972 are reviewed. The condition is rare in this population and affects young adults of both sexes. All were treated by wide excision and skin grafting with no recurrence at follow-up. The apparently low incidence being reported may be due in part to the inconsistent histological pattern of the lesion. Clinicians are urged to be more aware of this condition when a cutaneous, nodular or multiobulated tumor is encountered.

Anal fistula: a review of 82 cases.

Eighty-two cases of anal fistula have been retrospectively reviewed, and their clinical presentations, pathology, and management presented. Most of the fistulas were primary and, except for the four cases due to tuberculosis, there does not seem to have been any underlying systemic or gastrointestinal causative factor. A preoperative fistulogram is essential in the management of this condition.

Dermatofibrosarcoma protuberans in the parotid gland--a case report.

A recurrent dermatofibrosarcoma protuberans (storiform fibrocytic histiocytoma) in the parotid gland of a 50-year-old Nigerian male is reported. Recent knowledge of the histiogenetic origin of the tumor is mentioned.