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1.
Pulmonology ; 2024 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-38614859

RESUMO

BACKGROUND: Dyspnoea is a common symptom of respiratory disease. However, data on its prevalence in general populations and its association with lung function are limited and are mainly from high-income countries. The aims of this study were to estimate the prevalence of dyspnoea across several world regions, and to investigate the association of dyspnoea with lung function. METHODS: Dyspnoea was assessed, and lung function measured in 25,806 adult participants of the multinational Burden of Obstructive Lung Disease study. Dyspnoea was defined as ≥2 on the modified Medical Research Council (mMRC) dyspnoea scale. The prevalence of dyspnoea was estimated for each of the study sites and compared across countries and world regions. Multivariable logistic regression was used to assess the association of dyspnoea with lung function in each site. Results were then pooled using random-effects meta-analysis. RESULTS: The prevalence of dyspnoea varied widely across sites without a clear geographical pattern. The mean prevalence of dyspnoea was 13.7 % (SD=8.2 %), ranging from 0 % in Mysore (India) to 28.8 % in Nampicuan-Talugtug (Philippines). Dyspnoea was strongly associated with both spirometry restriction (FVC

2.
West Afr J Med ; 40(12 Suppl 1): S35, 2023 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-38070139

RESUMO

Background: Triple-negative breast cancers (TNBC) have been particularly challenging to manage due to their lack of intrinsic cellular receptors, with the resultant relatively higher morbidity and mortality. Recently, the programmed cell death 1/programmed cell death ligand 1 (PD-1/PD- L1) immune checkpoint pathway has become the focus of immunotherapy, especially for TNBCs. This study aimed to determine the pattern of expression of PD-L1 in TNBC cases in Benin City. Methods: It was a 3-year retrospective study that involved the PD-L1 immunostaining of the TNBC cases that were diagnosed in the Department of Anatomical Pathology, University of Benin Teaching Hospital, Benin City, from January 1, 2017 to December 31, 2019. Result: Ninety-two cases of TNBC were tested for PD-L1 expression. Thirteen (14.1%) of the TNBC cases were PDL1 positive to varying degrees on tumour and immune cells. Diffuse tumoural PD-L1 staining was seen in 4 (30.8%) of the PD-L1 positive cases. PD-L1 expression was significantly associated with increasing age up to the fifth decade (p =0.030). All the PD-L1 positive TNBC were invasive breast carcinoma of no special type and mostly grade 2 tumours; however, there was no significant association between PD-L1 expression and histological subtype or grade. Conclusion: PD-L1 expression was shown to occur at a relatively low rate among TNBC cases in this environment and was significantly associated with increasing age. This study has shown that 14.1% (1 in 7) of our TNBC patients could benefit from immune checkpoint inhibitor therapy.


Assuntos
Neoplasias de Mama Triplo Negativas , Humanos , Apoptose , Antígeno B7-H1/metabolismo , Ligantes , Nigéria , Prognóstico , Estudos Retrospectivos , Neoplasias de Mama Triplo Negativas/metabolismo , Neoplasias de Mama Triplo Negativas/patologia
4.
West Afr J Med ; 39(8): 777-780, 2022 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-36057812

RESUMO

BACKGROUND: Reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has important public health implications pertaining to herd immunity and durability of protection from vaccines. A small but growing number of cases have been reported globally but none from Africa. This is due, in part, to adherence to definitions based on genetic sequencing, the capabilities of which are in short supply on the continent. METHODS: Based on epidemiological and clinical parameters, we report the first two cases of SARS-CoV-2 reinfection from a Nigerian tertiary hospital managing coronavirus disease 2019 (COVID-19) patients. RESULT: Two cases of SARS-CoV-2 reinfection were seen in December, 2020 and January, 2021. Both were males associated with a healthcare setting and aged 37 and 38 years respectively. The number of days between the first infection and the second ranged from 160-196 days. Symptoms ranged from mild to moderate and they recovered without sequelae. CONCLUSION: Public health action, including risk communication and reinfection surveillance backed by genomic sequencing, is advocated.


CONTEXTE: La réinfection par le coronavirus 2 du syndrome respiratoire aigu sévère (SRAS-CoV-2) a des implications importantes pour la santé publique en ce qui concerne l'immunité du troupeau et la durabilité de la protection contre les vaccins. Un nombre petit mais croissant de cas a été signalé dans le monde, mais aucun en Afrique. Cela est dû, en partie, au respect des définitions basées sur le séquençage génétique, dont les capacités sont rares sur le continent. MÉTHODES: Sur la base de paramètres épidémiologiques et cliniques, nous rapportons les deux premiers cas de réinfection par le SRAS-CoV-2 d'un hôpital tertiaire nigérian prenant en charge des patients atteints de la maladie à coronavirus 2019 (COVID-19). RÉSULTAT: Deux cas de réinfection par le SRAS-CoV-2 ont été observés en décembre 2020 et janvier 2021. Tous deux étaient des hommes associés à un établissement de soins de santé et âgés respectivement de 37 et 38 ans. Le nombre de jours entre la première infection et la seconde variait de 160 à 196 jours. Les symptômes variaient de légers à modérés et ils se sont rétablis sans séquelles. CONCLUSION: Une action de santé publique, y compris la communication des risques et la surveillance des réinfections appuyées par le séquençage génomique, est préconisée. MOTS CLÉS: COVID-19; SRAS-CoV-2; Réinfection; Nigeria; Pandémie.


Assuntos
COVID-19 , Reinfecção , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Nigéria/epidemiologia , Reinfecção/epidemiologia , SARS-CoV-2
5.
West Afr J Med ; 38(2): 109-113, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33641143

RESUMO

BACKGROUND: We assessed clinical parameters in patients confirmed to have COVID-19 in relation to arterial hypoxaemia and survival. METHODOLOGY: This was a retrospective chart review of patients who were confirmed positive for SARS-CoV-2 virus by Real Time-Polymerase Chain Reaction (RT-PCR) testing. Data extracted from patients' case files included patient demographics, presenting symptoms, provisional diagnoses, and outcomes of hospitalisation. Descriptive variables were summarized; proportions were compared using Chi-square tests, and independent predictors of mortality were assessed using multivariate regression analysis. A p-value of < 0.05 was considered as statistically significant. RESULTS: There were a total of 61 patients with positive RT-PCR testing: mean age ± SD (minimum - maximum) was 53.0 ± 18.5 (5 months - 90) years. Persons aged 60 years and above were the largest group (n=24, 39.3%). More than half were male (n=35, 57.4%); about 43% had one morbidity; 41.0% had at least two co-morbidities. The mean (SD) arterial oxygen saturation (SpO2) was 86.9% ± 16.7. Patients who were clinically dyspnoeic at presentation, and who had co-morbidities were significantly more hypoxaemic (p = 0.026 and 0.04, respectively). Significantly more patients who had normal oxygen saturation at presentation survived (p = 0.006). None of these variables was an independent predictor of mortality, however. CONCLUSION: Arterial hypoxaemia was significantly associated with dyspnoea and underlying disease, and normal oxygen saturation at presentation was significantly associated with survival. Hospital managers and clinicians may thus prioritize routine pulse oximetry, supplemental oxygen therapy and management of co-morbidities in the COVID-19 fight.


Assuntos
COVID-19 , Criança , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Oximetria , Oxigênio , Estudos Retrospectivos , SARS-CoV-2 , Centros de Atenção Terciária
6.
West Afr J Med ; 37(7): 715-720, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33296477

RESUMO

BACKGROUND: Information pertaining to the clinical characteristics of COVID-19 in sub-Saharan Africa remains sparse. In Nigeria, it is limited to few isolated reports and case series confined to the early phase of the outbreak. The objective of this study is to describe the presenting characteristics, co-morbidities and outcomes of Nigerian patients managed over a 3-month period in a tertiary hospital. METHODS: This was a descriptive cross-sectional study involving the total population of patients with laboratory confirmed diagnosis of COVID-19 in the University of Benin Teaching Hospital, Edo State, Nigeria from March 31 to June 30, 2020. Data was collected using a review of patients' records. Analysis was by IBM SPSS version 25.0. The level of significance was set at p < 0.05. RESULTS: A total of 173 patients with mean age (SD) 50.7± 20.1 years were managed. One hundred and five (60.7%) were males and the commonest age group was 20-39 years (34.7%). The commonest presenting symptoms were fever, cough and malaise found in 103 (71.5%), 101 (70.1%) and 63 (43.8%) patients respectively. Twenty-five (14.5%) patients had severe disease; 60 (34.7%) had underlying medical conditions mostly hypertension and diabetes mellitus. Outcome analyses showed 117 (67.6%) discharges, 45 (26.0%) deaths, 10 (5.8%) discharges against medical advice, and 1 (0.6%) transfer to another facility. Male sex (p=0.044), increasing age (p<0.001), presence of symptoms (p=0.010), presence of co-morbidities (p=0.010) and non-healthcare worker status (p< 0.001) were significantly associated with mortality. CONCLUSION: The first epidemiological and clinical summary of COVID-19 cases in Edo state, Nigeria over a three-month period is presented showing globally recognized patterns of male predilection and higher mortality with increasing age and co-morbidity.


Assuntos
COVID-19/terapia , Adulto , Fatores Etários , Idoso , COVID-19/mortalidade , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Pandemias , Fatores Sexuais , Adulto Jovem
7.
Int J Tuberc Lung Dis ; 23(11): 1131-1141, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31718748

RESUMO

Chronic obstructive pulmonary disease (COPD) is one of the top three causes of death worldwide, but governments and non-governmental organisations have not given its prevention and treatment the priority it requires. This is particularly true in low- and middle-income countries, where most of the people suffering from this disease live. The United Nations (UN) has targeted a reduction of premature deaths from non-communicable diseases (NCDs) by a third by 2030; however, a coordinated UN/World Health Organization (WHO) strategy to address the burden of COPD (one of the most important NCDs) is still lacking. To explore the extent of the problem and inform the development of policies to improve the situation, the Board of Directors of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) held a 1-day Summit. The key themes that emerged were the need to ensure accurate data on prevalence, raise awareness of the disease among the public, healthcare professionals and governments, including the fact that COPD aetiology goes beyond smoking (and other inhaled pollutants) and includes poor lung development in early life, and ensure that spirometry and both pharmacological and non-pharmacological therapies are available and affordable. Here, we present the actions that must be taken to address the impact of COPD. We believe that the WHO is particularly well-positioned to co-ordinate an attack on COPD, and GOLD will do all it can to help and rally support.


Assuntos
Países em Desenvolvimento , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/prevenção & controle , Atenção à Saúde/normas , Técnicas de Diagnóstico do Sistema Respiratório/normas , Saúde Global , Humanos , Guias de Prática Clínica como Assunto , Prevalência , Fatores de Risco , Organização Mundial da Saúde
8.
West Afr J Med ; 35(3): 173-179, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30387090

RESUMO

BACKGROUND: Impaired sleep is reportedly common in chronic obstructive pulmonary disease (COPD) and the impact of quality of sleep on health-related quality of life (HRQL) has been documented. Although factors affecting HRQL have been investigated in various studies, the impact of sleep quality on HRQL has not been previously investigated among patients with COPD in Nigeria. The purpose of this study was to determine the contribution of sleep quality as a factor affecting HRQL. We hypothesized that sleep quality is a determinant of HRQL. METHODOLOGY: Sixty patients with COPD were evaluated. HRQL was assessed using COPD Assessment Test (CAT). Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Lung function was assessed by spirometry, severity of dyspnea by the Modified Medical Research Council (MMRC) scale, and functional exercise capacity by the Six-Minute Walk Test (6MWT). In all the statistical tests, a p value of <0.05 was considered significant. RESULTS: The mean age of the study population was 70±8years. Forty-nine patients (81.7%) had poor quality of sleep (PSQI > 5). The mean CAT score of the study population was 19.40±7.5. Bivariate correlation shows that HRQL reduces with worsening sleep quality (r=0.705, p=<0.001). HRQL was also associated with COPD severity (P = 0.001), severity of dyspnea, exercise capacity and frequency of exacerbation (P = <0.001). Multiple regression analysis showed that quality of sleep was the best independent predictor of HRQL in our patients (p= <0.001). CONCLUSION: Results from this study suggest that health status is generally poor in patients with COPD and quality of sleep is a significant determinant of their HRQL.


Assuntos
Dispneia/etiologia , Nível de Saúde , Doença Pulmonar Obstrutiva Crônica/complicações , Qualidade de Vida , Transtornos do Sono-Vigília/etiologia , Sono/fisiologia , Idoso , Dispneia/psicologia , Tolerância ao Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Doença Pulmonar Obstrutiva Crônica/psicologia , Índice de Gravidade de Doença , Transtornos do Sono-Vigília/fisiopatologia , Transtornos do Sono-Vigília/psicologia , Inquéritos e Questionários
9.
Niger J Clin Pract ; 21(8): 1081-1085, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30074015

RESUMO

Endometriosis of the gastrointestinal tract is rare and occurs in <1% of all patients undergoing major gynecological surgeries. Bowel involvement has been reported in 3%-37% of all women of childbearing age with endometriosis. Total obstruction of the gastrointestinal tract occurs in <1% of cases of endometriosis with bowel obstruction. This case report is that of a 42-year-old female who presented with a 6-month history of change in bowel habits in favor of increasing constipation. This was associated with cyclical lower abdominal pains, abdominal swelling, and weight loss. Examination revealed hyperactive bowel sounds with scant fecal matter on rectal examination. An impression of intestinal obstruction was made and she had an emergency laparotomy. Dilated ileum and a hard, constricting cecal mass were found intraoperatively. She had a right hemicolectomy and ileo-transverse anastomosis, with progressive improvement postoperatively. Histology of the resected bowel segment confirmed cecal endometriosis. In conclusion, cecal endometriosis is a rare cause of intestinal obstruction. A high index of suspicion is required for diagnosis, especially if the woman is premenopausal with a history of abdominal pain that worsens with menstrual periods. Outcome is good with appropriate surgical intervention.


Assuntos
Doenças do Ceco/etiologia , Endometriose/patologia , Obstrução Intestinal/etiologia , Dor Abdominal/etiologia , Adulto , Alcaloides , Doenças do Ceco/patologia , Doenças do Ceco/cirurgia , Colectomia , Diagnóstico Diferencial , Endometriose/complicações , Endometriose/cirurgia , Feminino , Humanos , Obstrução Intestinal/patologia , Obstrução Intestinal/cirurgia , Piridinas , Resultado do Tratamento
10.
Niger J Clin Pract ; 20(5): 566-572, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28513515

RESUMO

INTRODUCTION: Adequate knowledge of asthma management and adherence to international guidelines are known to increase the quality of care offered by Physicians. We conducted this study to assess the level of asthma knowledge and quality of care among physicians practicing in Ondo State. METHODS: We conducted a cross sectional survey of 96 physicians from various specialties participating in a continuous professional development (CPD) lecture using adapted questionnaires. RESULT: Respondents ranged in age from 23-62years (42.5±19.4). There were more male (70%). The minority (17%) had additional postgraduate medical qualifications. There was a high distribution of correct answers for individual knowledge questions. The greatest areas of knowledge gaps appeared in diagnostic instruments, asthma severity and drugs. We observed gaps regarding the use of GINA guidelines (6%) and prescribing combined inhaled steroid and long acting bronchodilator for patients who are not controlled on inhaled steroid alone (29%). A large number of the respondents do not confirm the diagnosis of asthma by spirometry (32%). Only 8% of the respondents with high knowledge reported a corresponding high quality of Asthma care. CONCLUSION: We concluded that although physicians in South-West Nigeria appear to have good knowledge, there are areas of gap in the quality of asthma care with regards to standard guideline. There is need for constant training and re-training of physicians in order to keep them up to date with international guidelines. In addition, increase access to diagnostic facilities and adapting international guideline to local realities will help improve standard of Asthma care.


Assuntos
Asma/terapia , Conhecimentos, Atitudes e Prática em Saúde , Médicos/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Espirometria
11.
Int J Tuberc Lung Dis ; 19(1): 21-30, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25519786

RESUMO

BACKGROUND: Increasing access to essential respiratory medicines and influenza vaccination has been a priority for over three decades. Their use remains low in low- and middle-income countries (LMICs), where little is known about factors influencing use, or about the use of influenza vaccination for preventing respiratory exacerbations. METHODS: We estimated rates of regular use of bronchodilators, inhaled corticosteroids and influenza vaccine, and predictors for use among 19 000 adults in 23 high-income countries (HICs) and LMIC sites. RESULTS: Bronchodilators, inhaled corticosteroids and influenza vaccine were used significantly more in HICs than in LMICs, after adjusting for similar clinical needs. Although they are used more commonly by people with symptomatic or severe respiratory disease, the gap between HICs and LMICs is not explained by the prevalence of chronic obstructive pulmonary disease or doctor-diagnosed asthma. Site-specific factors are likely to influence use differently. The gross national income per capita for the country is a strong predictor for use of these treatments, suggesting that economics influence under-treatment. CONCLUSION: We still need a better understanding of determinants for the low use of essential respiratory medicines and influenza vaccine in low-income settings. Identifying and addressing these more systematically could improve the access and use of effective treatments.


Assuntos
Corticosteroides/uso terapêutico , Asma/epidemiologia , Broncodilatadores/uso terapêutico , Vacinas contra Influenza/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Corticosteroides/administração & dosagem , Idoso , Asma/diagnóstico , Asma/tratamento farmacológico , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , Prevalência , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Fatores Socioeconômicos , Inquéritos e Questionários , Vacinação/estatística & dados numéricos
12.
West Afr J Med ; 34(1): 32-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26902814

RESUMO

BACKGROUND: The knowledge ofPulmonologists in Nigeria regarding the management of chronic obstructive pulmonary disease (COPD) is modest and needs to be improved. Continuing Medical education programs have the potential to improve the knowledge of doctors. OBJECTIVES: To determine the impact of attendance at a COPDtraining on the level of knowledge of pulmonologists in Nigeria. METHODS: A Cross-sectional study conducted during the Nigerian Thoracic Society (NTS) annual conference held at Ile-Ife, Nigeria in November 2013. The participants included residents in respiratory medicine and qualified pulmonologists. The study instruments were pre-test and post-test questionnaires which comprised of the same set of questions. The pre-test was administered and retrieved before the start of the COPD symposium and the post-test immediately afterwards. The scores on the pre-test were compared with the scores on the post-test. RESULTS: There were 54pre-test and 46 post-test questionnaires. The maximum obtainable score was 25. The mean score±standard deviation on the pre-test was 13±6 and 17±5 on post-test (t=-3.9, p<0.001) translating to an improvement in knowledge from 52% to 68%. Assessment of airflow limitation using spirometry in the initial evaluation for COPD was correctly selected by 57.4% on pre-test and 65.2% on post-test (p=0.42). The knowledge of tuberculosis and environmental pollution were the least recognized risk factors for COPD and mood/anxiety disorder was the least recognized comorbid condition. CONCLUSION: The level of knowledge of pulmonologists in Nigeria about COPD is modest and participation at a CME program improved their knowledge.

13.
Allergy ; 69(9): 1205-14, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24841074

RESUMO

RATIONALE: There is conflicting evidence on whether patients with asthma experience an accelerated decline in lung function with age. We examined the association between postbronchodilator lung function, asthma, chronic rhinosinusitis (CRS), and atopy with age using a large European sample. METHODS: In 17 centers in 11 European countries, case-control studies were nested within representative cross-sectional surveys of adults aged less than 75 years. Representative samples of participants with asthma, CRS or both and controls were assessed for postbronchodilator ventilatory function, smoking history, atopy, and treatment. Multiple regression was used to assess the interactive effects of age and diagnostic group on decline in postbronchodilator ventilatory function. RESULTS: A total of 3337 participants provided adequate data (778 with asthma, 399 with CRS, 244 with both asthma and CRS and 1916 controls who had neither asthma nor CRS). Participants with asthma had lower FEV1 /FVC (-4.09% (95% CI: -5.02, -3.15, P < 0.001) and a steeper slope of FEV1 /FVC against age (-0.14%/annum [95%CI: -0.19, -0.08]) equivalent to smoking 1-2 packs of cigarettes per day. Those with atopy had a slope equivalent to controls. CONCLUSIONS: People with asthma have a steeper decline in postbronchodilator lung function with age, but neither CRS nor atopy alone were associated with such decline.


Assuntos
Obstrução das Vias Respiratórias/epidemiologia , Asma/complicações , Rinite/complicações , Sinusite/complicações , Adolescente , Adulto , Fatores Etários , Idoso , Estudos de Casos e Controles , Doença Crônica , Estudos Transversais , Coleta de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Adulto Jovem
14.
Ghana Med J ; 48(2): 85-90, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25667555

RESUMO

BACKGROUND: Health Related Quality of Life (HRQL) measures can capture the non-respiratory effects of Chronic Obstructive Pulmonary Disease (COPD). However the relationship with Peak Expiratory Flow (PEF) is not well understood. AIM: To determine the relationship of PEF and quality of life measurements in patients with COPD. SETTINGS AND DESIGN: A cross section of consecutive patients in a university clinic. METHODS: Stable patients with COPD defined by the Global Initiative on chronic Obstructive Lung Disease (GOLD) criteria, were recruited into the study. Spirometry was done using American Thoracic Society's standards and reference equations from African American norms of the US population. Quality of life was measured with the St George's Respiratory Questionnaire (SGRQ). RESULTS: Out of 50 patients recruited for the study, 48 provided complete data with acceptable spirometry and PEF data. The mean (SD) age and body mass index was 68.4 (8.9) years and 21.4 (4.6) kg/m(2) respectively and 96% of the patients were in moderate-severe stages of COPD using the GOLD criteria. Percent predicted PEF correlated with percent predicted FEV1; r= 0.559 p<0.001 and also showed a significant, though moderate correlation between PEF readings and SGRQ scores especially in the activity (r= -0.455 p< 0.01) and total scores (r=-0.415 p<0.01) for pre bronchodilator (BD) percent predicted PEF. In regression analysis, PEF was associated with SGRQ (-0.11 95% CI -0.19, -0.03) after adjusting for age, sex, height, smoking and disease severity. CONCLUSIONS: PEF correlates with SGRQ scores and may be a useful surrogate for HRQL in patients with COPD.


Assuntos
Pico do Fluxo Expiratório , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Qualidade de Vida , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Doença Pulmonar Obstrutiva Crônica/diagnóstico
15.
West Afr J Med ; 33(4): 285-7, 2014.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-26445074

RESUMO

We report a case of primary malignant fibrous histiocytoma of the breast in a 13-year old girl. She has had wide local excision of the tumour and six cycles of adjuvant cytotoxic chemotherapy. Four years after treatment, she was free from local recurrence; however, the presence of distant metastasis could not be assessed because of inadequate imaging investigations.

16.
Afr Health Sci ; 13(3): 694-702, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24250309

RESUMO

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a multi-systemic and progressive disease. However the determinants of its impact on health related quality of life are not well-studied or understood in Nigeria. OBJECTIVES: To assess the determinants of health related quality of life in COPD. METHODS: Patients with stable COPD were recruited consecutively from the outpatient clinics of a university hospital. Health Related Quality of Life (HRQL) was assessed using the St. George's Respiratory Questionnaire (SGRQ) and the Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC) were measured by a vitalograph spirometer. RESULTS: Fifty patients were recruited for this study (male = 60%). The mean (SD) age was 69 (9) years. The overall mean (SD) SGRQ scores was 45.9 (26.5), 50.6 (29.2), 29.7 (19.9), 38.8 (22.0) for the symptom, activity, impact and total scores respectively. After adjusting for age, sex and smoking, self-reported breathlessness independently predicted on average 25.2, 36.8, 13.65 and 22.9 points increase in SGRQ symptom, activity, impact and total scores respectively. Self-reported weight loss predicted 12.2 points increase in the impact subscale. CONCLUSIONS: Self-reported breathlessness and weight loss are independent predictors of low HRQL score in COPD.


Assuntos
Nível de Saúde , Doença Pulmonar Obstrutiva Crônica/psicologia , Qualidade de Vida , Inquéritos e Questionários , Idoso , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Capacidade Vital , Redução de Peso
17.
Niger Postgrad Med J ; 19(1): 19-24, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22430597

RESUMO

AIMS AND OBJECTIVES: The aim of this study is to determine the prevalence of oestrogen and progesterone receptors positivities among histologically diagnosed breast cancer cases at the University of Benin Teaching Hospital, Benin City, Nigeria. MATERIALS AND METHODS: Cases of breast carcinomas in the records of the Department of Histopathology, University of Benin Teaching Hospital, between 2003 and 2007 constitute the materials used for this study. Immunohistochemical staining was done using representative paraffin-embedded blocks (H&E slides assessment) and stained with oestrogen and progesterone antibodies manufactured by Dako Denmark (AS Denmark). RESULTS: A total of 135 cases were studied. The female to male ratio was 44:1 with an overall mean age of 48.3±13 years. Invasive ductal carcinoma, NOS (not otherwise specified) was the most common histological type (81.5%). Eighty per cent of cases were categorised as grades 2 and 3 tumours. The steroid hormone receptor positivity was 17%. Oestrogen and Progesterone receptor positivity were 14.1% and 9.6% respectively. There was a statistically significant association between hormone receptor status and the grade of tumour (?2 = 6.37, df = 2, p = 0.04). CONCLUSION: This study shows a relatively low steroid hormone receptor positivity of breast cancer in Benin. This finding portends a poor prognostic effect and it is consequently recommended that steroid hormone receptor status be determined before hormonal treatment in these patients. There is the need to determine the immunohistochemical patterns of breast cancer in other centres that treat breast cancer patients.


Assuntos
Neoplasias da Mama/metabolismo , Carcinoma/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Neoplasias da Mama Masculina/epidemiologia , Neoplasias da Mama Masculina/metabolismo , Neoplasias da Mama Masculina/patologia , Carcinoma/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Nigéria/epidemiologia , Prognóstico , Estudos Retrospectivos , Adulto Jovem
18.
East Afr Med J ; 89(12): 408-13, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26852453

RESUMO

BACKGROUND: Endoscopic biopsy of the gastric mucosa allows early diagnosis, grading, staging and classification of gastric diseases. Helicobacter pylori, has been recognized as a major aetiologic factor for chronic gastritis, benign gastric ulcers and gastric adenocarcinoma and lymphoma. The loco-regional variability in the prevalence of Helicobacter pylori and associated diseases in Nigeria, emphasise the need for evaluation of subsets of a heterogeneous population like ours. OBJECTIVE: To determine the frequency of helicobacter pylori in gastric endoscopic biopsies and document the pathology of gastric lesions commonly associated with Helicobacter pylori infection. DESIGN: Retrospective descriptive study. SETTINGS: University of Benin Teaching Hospital (UBTH), and Biogenics Histopathology Laboratory (a private Histopathology Laboratory), both based in Benin City, Niger Delta region of Nigeria. SUBJECTS: Endoscopic gastric biopsies recorded in the surgical pathology register of the department from 2005-2009 were studied and relevant demographic and clinical information extracted from the registers, original request cards and patient case files. The clinical data and slides processed from paraffin embedded tissue blocks of endoscopic biopsies of gastric lesions seen from year 2005 to 2009 were studied, analyzed and statistically presented. RESULTS: Total number of specimens studied was 142. Chronic gastritis was present in 117(82.39%) specimens; 9(6.34%) were benign gastric ulcers; 3(2.11%) were gastric polyps; and 11(7.75%) were gastric malignancies. Helicobacter pylori, was demonstrated in 55.6% of all specimens. The peak age for Chronic Gastritis and Gastric Cancer is the 6th decade. Amongst patients with chronic gastritis, inflammatory activity was present in 65%; atrophy in 53%; and intestinal metaplasia in 16.6%. All gastric malignancies seen were intestinal type adenocarcinomas. CONCLUSION: The spectrum of lesions diagnosed in gastric endoscopic biopsy specimens in Benin, their frequency and associations are largely comparable to what has been described elsewhere in Nigeria and Africa.


Assuntos
Mucosa Gástrica/patologia , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/patologia , Helicobacter pylori , Gastropatias/microbiologia , Gastropatias/patologia , Adenocarcinoma/microbiologia , Adenocarcinoma/patologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Biópsia , Criança , Pré-Escolar , Doença Crônica , Detecção Precoce de Câncer , Diagnóstico Precoce , Feminino , Mucosa Gástrica/microbiologia , Gastrite/microbiologia , Gastrite/patologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Hospitais de Ensino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Nigéria/epidemiologia , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Gastropatias/epidemiologia , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia , Úlcera Gástrica/microbiologia , Úlcera Gástrica/patologia
20.
Afr J Med Med Sci ; 40(2): 123-6, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22195379

RESUMO

A retrospective analysis of solid tumours in children less than 28days old over a 31 year period (1978-2008) was carried out at University of Benin Teaching Hospital (UBTH) to determine the incidence and histological patterns of such tumours. A total of 17 cases were seen during the study period: 16 cases (9 in males and 7 in females) were benign and 1 was malignant and it was recorded in the male gender. Vascular tumours (n=9), granular cell tumours (n=4), teratomas (n=2) and myxofibroma (n=1) were the histological types of benign tumours seen. The only malignant tumour encountered was a rhabdomyosarcoma. Head and neck was the commonest location of the tumours and most cases presented within 2 weeks of birth.


Assuntos
Hospitais de Ensino/estatística & dados numéricos , Neoplasias/epidemiologia , Neoplasias/patologia , Adolescente , Distribuição por Idade , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Neoplasias/classificação , Nigéria/epidemiologia , Estudos Retrospectivos , Distribuição por Sexo
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