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1.
West Afr J Med ; 36(2): 138-143, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385600

RESUMO

BACKGROUND: Holistic ward round (HWR) is a polyadic, multiphasic, holistic model of neurosurgical patient care. It is a multidisciplinary ward round where all healthcare providers involved in patients care, the patients, the relations, as well as clergymen (depending on the patients' faith and need) collectively work to review patient's condition and make decisions in the patient's best interest. OBJECTIVES: The study assessed the effectiveness of the holistic model of care and identified the challenges facing this model of healthcare delivery. METHODS: The study was qualitative in design and In-depth Interviews (IDIs) were conducted with eighteen (18) participants who were purposively selected. They include neurosurgeons, nurses, medical social workers and physiotherapists. The data were thematically content analysed with the help of ATLAS.ti (v.7) software. RESULTS: The study found that patients and relations have immensely benefitted from the model of care through psychosocial support. The major challenges facing HWR were logistic, timing and common problems found in the Nigerian healthcare system. CONCLUSION: It was concluded that for HWR to effectively help spinal cord injured patients further, the healthcare providers, patients and their families require support in different forms from outside the hospital.


Assuntos
Saúde Holística , Equipe de Assistência ao Paciente , Assistência ao Paciente , Assistência Centrada no Paciente/métodos , Adulto , Feminino , Hospitais Universitários , Humanos , Relações Interprofissionais , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Neurocirurgiões , Neurocirurgia , Nigéria , Fisioterapeutas , Pesquisa Qualitativa , Assistentes Sociais
2.
Niger J Physiol Sci ; 34(1): 107-113, 2019 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-31449279

RESUMO

Traumatic brain injury (TBI) is a complex process resulting into structural brain damage and functional deficits as a result of an external mechanical force. This study aimed to investigate the possible ameliorative effect of Raphia hookeri ethanol extract (RHEE) on induced acute traumatic brain injury in rats. The choice of the plant was based on its reported anti-oxidative property. Thirty-six female Wistar rats were divided into six groups of six animals each. I: CONTROL - distilled water orally; II: RHEE - 100 mg/kg RHEE; III: Sharp trauma brain injury (STBI); IV: STBI+RHEE; V: Blunt trauma brain injury (BTBI); VI: BTBI+RHEE.  Brain injury was inflicted using modified weight drop technique on experimental day 1 while RHEE was given orally by gavage for 7 days post-injury. Blood was collected serially 24hrs, 72hrs and 7 days post-trauma for full blood count and differentials of the white blood cells. On day nine, rats were euthanized and brain harvested for biochemical and histological analyses. Trauma significantly (p<0.05) reduced the relative brain weight of rats compared with the control. Lymphocyte count increased while neutrophils reduced in all traumatized rats compared with control group. Both BTBI and STBI significantly (p<0.05) elevated MDA and significantly (p<0.05) reduced the level of GSH, the activities of SOD and CAT enzymes compared with control group. Histologically, the extent of haemorrhage into the subarachnoid and brain parenchyma in STBI and BTBI groups was reduced in the BTBI+RHEE and STBI+RHEE groups. Administration of RHEE reduced oxidative damage and ameliorated neuronal damage in sharp and blunt brain injuries.

3.
World Neurosurg ; 84(4): 1090-4, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26074431

RESUMO

OBJECTIVE: There is a dearth of information on operated cases of spinal tumors in patients in sub-Saharan Africa. The objective of this study was to evaluate the histologic pattern, anatomic distribution, and extent and outcome of surgery of Nigerian patients with spinal tumors. METHODS: This retrospective study comprised a cohort of Nigerians who underwent surgery for spinal tumors. Data obtained included patient demographics, duration of symptoms, anatomic location, imaging findings, Frankel grading before and after surgery, and type and outcome of surgery. Univariate analysis was performed, and results were compared with results from other parts of the world. RESULTS: There were 59 patients (male-to-female ratio 1:1.1) with a bimodal age distribution. The highest (20.34%) incidence was seen in the 20-29 age group. More than half (58.06%) of the patients presented with a duration of symptoms of at least 6 months (duration of symptoms was >12 months in 35.48%). Motor deficit was present in 97.73% of patients at presentation. Functional grading was Frankel A in 38.10% of patients, Frankel C in 26.19%, Frankel B in 16.67%, Frankel D in 16.67%, and Frankel E in 2.38%. The tumors were mostly in the thoracic region (65.45%), and 58% were extradural in location. Gross total tumor excision was performed in 50.88% of the cases, and subtotal resection was performed in 24.56%. Spinal stabilization was performed in 17.86% with spinous process wiring and vertical strut being the most common method of stabilization (80%) among this group. Metastasis was the most common histologic tumor type (23.21%). Meningioma accounted for 12.50% of tumors, and ependymoma, astrocytoma, and hemangioma each accounted for 7.14%. The most common source of metastasis was the prostate (38.46%). Postoperatively, 45% of patients improved neurologically, 52.5% remained the same, and 2.5% deteriorated. There was no perioperative mortality. CONCLUSIONS: Metastasis was the most common histologic type of spinal tumor in this study, and the most common location was extradural. The outcome was satisfactory in most cases with neurologic function remaining the same or improving after surgery in most patients.


Assuntos
Procedimentos Neurocirúrgicos/métodos , Neoplasias da Coluna Vertebral/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/etiologia , Nigéria , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/patologia , Neoplasias da Coluna Vertebral/secundário , Coluna Vertebral/cirurgia , Resultado do Tratamento , Adulto Jovem
4.
J Neurosci Rural Pract ; 6(2): 216-20, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25883483

RESUMO

OBJECTIVE: This study was designed to evaluate the relationship between injury severity, admission Random Blood Glucose [RBG] and management outcome in a cohort of Nigerian patients with Head Injury [HI]. MATERIALS AND METHODS: RBG was determined at admission, twenty four hours as well as seventy two hours after admission in patients with head injury. Severity of injury was graded using Glasgow Coma Scale (GCS). Outcome of management was determined by Glasgow Outcome Score at discharge. Serum glucose level of ≥ 11.1 mmol/l was taken as hyperglycaemia. Analyses of variance [ANOVA] was used to determine level of significance and a P value of < 0.05 was considered significant. RESULTS: There were 146 male and 30 female patients (range: 2 years to 78 years; mean; 34.4 years, SD: 16.4 years). Most (36.4%) of the patients had severe HI. Only 2.5% of the patients had hyperglycaemia at admission. Death occurred in 25% of the patients, moderate disability occurred in 30.1% and good outcome occurred in 35.8%. Hyperglycaemia occurred in one patient each in mild and severe head injuries and in two patients with moderate head injury. All the patients with hyperglycaemia had favourable outcome. CONCLUSION: Random blood glucose of ≥ 11.1 mmol/l was not common at admission in head injured patients in this cohort of patients and the value was not associated with severe injury or poor outcome.

5.
Niger J Med ; 23(3): 230-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25185380

RESUMO

Eighty two (82) consecutive patients who presented with mechanical brain injury to the Accident and Emergency department of our hospital and were assessed with cranial Computerized Tomographic Scan between November 2005 and April 2006 were included in the study. Demographic data were obtained at admission. Clinical severity of head injury was assessed by the Glasgow Coma Scale Score just before cranial CT while morphologic severity was assessed using features on the same post-resuscitation cranial CTwith which theTCDB (Traumatic Coma Databank) grade and CT-HISAS (computerizedTomographic-Head injury Severity Assessment Scale) score were assessed. Both the TCDB and CT-HISAS scores were correlated with short-term outcomes using the Glasgow outcome score. Pearson's correlation coefficient, ANOVA and regression models were used as appropriate for statistical tests of significance.The age range of Patients was between 3 months and 86 years with a mean of 26.8 years and median of 25.9 years +/- 1.9 years (95% CL). There were more males (74.4%) than females (25.6%). There was a negative correlation between Post resuscitation GCS and CT-HISA score (p = -0.0141). However, although patients with non-functional outcome based on Glasgow Outcome score had higher CT-HISA scores, this relationship was not statistically significant. From our study, brain morphology on cranial CT using the CT-HISA Scale predicts clinical severity and outcome.We believe this study that CT-HISA may find useful application in assessment of teleradiologically transferred CT images of patients as well as research in mechanical brain trauma.


Assuntos
Traumatismos Craniocerebrais/diagnóstico por imagem , Escala de Gravidade do Ferimento , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Criança , Feminino , Escala de Coma de Glasgow , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Retrospectivos , Telerradiologia
6.
Niger Postgrad Med J ; 21(1): 61-5, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24887254

RESUMO

AIMS AND OBJECTIVES: . This is a review of the initial experience with surgical management of upper cervical spine injuries. MATERIALS AND METHODS: The clinical case notes of patients surgically managed for UCSI were analysed for aetiology, presentation, duration of symptoms before presentation and surgery, pre- and post-operative Frankel grading, nature of injury and type of surgery. RESULTS: Eleven male and one female patients (mean age; 41.8 years; range 22-58 years) with UCSI were managed surgically. All the patients were involved in road traffic crashes. The case distribution were odontoid peg fracture [type II] alone (2 cases), hangman fracture alone (5 cases), both C1/2 subluxation and odontoid peg fracture (4 cases) and complex C2 injury (1 case). The surgical management includes C1 posterior ring excision and occipitocervical fusion [C0 - C4] (one patient), modified Gallie fusion alone (six patients), combined modified Gallie fusion and Rogers interspinous wiring (three patients). One patient each had C1/C2 interspinous wiring and combined modified Gallie fusion and occipito-cervical fusion [C0 - C4]. Post-operatively, two patients improved from Frankel C to D, 2 patients from C to E and one patient from D to E. The other patients with Frankel D and E injuries pre-operatively remained in status quo post-operatively. Eleven of the patients were discharged home on progressive ambulation with one having neck stiffness and one patient died 7 weeks post- surgery. CONCLUSION: Odontoid peg and hangman fractures were the most common indications for upper cervical spine surgery for trauma in our unit, and the post- operative outcome appears satisfactory.


Assuntos
Vértebras Cervicais/lesões , Vértebras Cervicais/cirurgia , Acidentes de Trânsito , Adulto , Vértebras Cervicais/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Processo Odontoide/lesões , Radiografia , Estudos Retrospectivos , Traumatismos da Coluna Vertebral/diagnóstico por imagem , Traumatismos da Coluna Vertebral/cirurgia , Adulto Jovem
7.
Childs Nerv Syst ; 29(7): 1131-5, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23595806

RESUMO

INTRODUCTION: Although modern neuroimaging has facilitated early care of brain tumors in children worldwide, there are, however, few published reports on clinical profile, treatment, and outcome of brain tumors in children from our subregion. PURPOSE: We aimed to retrospectively study the clinical profile and outcome of pediatric brain tumors in a tertiary referral center from a developing country. METHODS: Forty pediatric patients with histologically verified brain tumors managed by the authors over a 13-year period (May 1994-April 2006) were studied. Patients' data from clinical, radiological, and pathology records were analyzed using the statistical package for social sciences version 16. RESULTS: The mean age was 9.75 years (range 1-15 years). Twenty-two males, 18 females. Common presenting symptoms were headaches (23 patients, 57.5%) and seizures (15 patients, 37.5%). Hyperreflexia (72.5%) and focal motor deficits (62.5%) were the most common neurologic signs. The mean interval from onset of symptoms to neurosurgical diagnosis was 13.4 months (95% CI). All patients had tumor resection, while 11 (27.5%) patients received adjuvant radiotherapy. Hydrocephalus occurred in 19 (47.5%) patients and was associated with early presentation (X2 = 10.65, p < 0.01). Low-grade astrocytoma (25%) and medulloblastoma (25%) were the most common tumors. Survival at 1 and 5 years were 56 and 47%, respectively. CONCLUSION: Focal motor signs and elevated intracranial pressure are the salient presenting features of brain tumors in children seen in Nigeria. Those of them with hydrocephalus are likely to present early. The outcome for pediatric brain tumors remains poor.


Assuntos
Astrocitoma/terapia , Neoplasias Encefálicas/terapia , Meduloblastoma/terapia , Procedimentos Neurocirúrgicos , Radioterapia Adjuvante , Adolescente , Astrocitoma/complicações , Astrocitoma/diagnóstico , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico , Neoplasias Cerebelares/complicações , Neoplasias Cerebelares/diagnóstico , Neoplasias Cerebelares/terapia , Criança , Pré-Escolar , Países em Desenvolvimento , Feminino , Cefaleia/etiologia , Humanos , Hidrocefalia/etiologia , Lactente , Masculino , Meduloblastoma/complicações , Meduloblastoma/diagnóstico , Nigéria , Prognóstico , Reflexo Anormal , Estudos Retrospectivos , Convulsões/etiologia , Taxa de Sobrevida , Centros de Atenção Terciária
8.
West Afr J Med ; 29(4): 230-4, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20931509

RESUMO

BACKGROUND: In the present era of microscopic and neuroendoscopic procedures, the surgical anatomy of the skull base vessels has gained increased significance. The pattern of the vertebrobasilar arterial complex and the posterior circle of Willis (COW) in Nigerians has not been previously reported despite various variants of these complexes existing in different populations. OBJECTIVE: To review and document the size, distribution and anomalies of the vertebrobasilar territory and posterior COW pattern in a Nigerian set of brains. METHODS: The target population for this study was a group of Nigerian adults 18 years and above. Specimens from patients with an ante-mortem or post-mortem evidence of meningitis or atherosclerosis were excluded. The size, distribution and anomalies of the vertebrobasilar artery, its branches, and the posterior COW were defined in 50 brains. RESULTS: The male: female ratio was 1.9:1 and a mean age of 44 years. Statistical analysis showed significant differences between the sizes of posterior inferior cerebellar arteries and anterior inferior cerebellar arteries (Student's t=-30.189; p-value= 0.000). Fifty-six percent of the brains had no anomalies. Thirty anomalies were noted in posterior COW compared with six in the vertebrobasilar territory. There were no aneurysms in all the specimens studied. CONCLUSION: Anomalies in the region of the posterior COW are commoner than the vertebrobasilar territory and the region of the posterior communicating artery is the most common site of anomalies in the posterior COW territory. These variations should be taken into account during skull base and carotid surgeries, and cerebral angiography.


Assuntos
Artéria Basilar/anatomia & histologia , Encéfalo/irrigação sanguínea , Malformações Vasculares do Sistema Nervoso Central/patologia , Círculo Arterial do Cérebro/anatomia & histologia , Adulto , Distribuição por Idade , Idoso , Artéria Basilar/cirurgia , Encéfalo/anatomia & histologia , Círculo Arterial do Cérebro/anormalidades , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Adulto Jovem
9.
Afr J Med Med Sci ; 38 Suppl 2: 61-5, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20229740

RESUMO

Proper policy implementation is the building block of every group, organization and society. Like every edifice, it requires proper, clear and distinct purpose, plan, materials and masons, to borrow a leaf from Aristotle's four causes. There are always challenges associated with this very important endeavour, but there are peculiarities to it in the context of Nigeria as a developing nation and with respect to cancer prevention and management as a complex and sophisticated activity. This work seeks to clarify and comment on the concepts of policy, administration, cancer treatment and prevention, and then highlight challenges to successful implementation of cancer treatment and prevention policy in Nigeria and propose some solutions.


Assuntos
Implementação de Plano de Saúde/organização & administração , Política de Saúde , Neoplasias/prevenção & controle , Administração em Saúde Pública , Tomada de Decisões Gerenciais , Humanos , Neoplasias/terapia , Nigéria , Política Organizacional , Formulação de Políticas , Administração em Saúde Pública/métodos
10.
Int. j. morphol ; 26(4): 1023-1027, Dec. 2008. ilus
Artigo em Inglês | LILACS | ID: lil-532941

RESUMO

The histology of the middle cerebral artery (MCA) in Nigerian Africans has not been previously studied. One hundred MCAs obtained at autopsy from fifty adult Nigerians were studied. The vessels were processed and stained with Ehrlich's haematoxylin and eosin, elastic Van Gieson and Masson's trichrome stains. Early branches were given off before the perforators in two middle cerebral arteries, and there was one accessory MCA, making an incidence of anomalies of 3 percent. No aneurysm was observed in any of the cases. The internal elastic laminas were well developed but the external elastic laminas of the vessels were poorly developed. Close to the bifurcations the tunica media tapered gradually and at the bifurcations, the tunica media was completely deficient being replaced by the tunica adventitia (Forbus raphé). The tunica adventitia was thicker at the bifurcations (0.21mm) compared to other sites of the vessel. The average thickness of the MCA tunica media at its origin was 0.12mm while that of the tunica adventitia was O.lOmm. These results are similar to what has been described in the literature for Caucasians. It buttresses the assertion that anatomical anomalies of the MCA are rare. The seemingly low frequency of MCA aneurysms in Nigerian Africans is not due to its anomalies or histology.


La histología de la arteria cerebral media (ACM) de los africanos de Nigeria no ha sido previamente estudiada. Fueron examinadas 100 ACM, obtenidas en autopsias de 50 individuos nigerianos adultos. Las arterias fueron procesadas y teñidas con hematoxilina y eosina de Ehrlich, Van Gieson para fibras elásticas y tricrómico de Masson. Ramas proximales se originan antes de la división en dos arterias cerebrales medias, y había una ACM accesoria, constituyendo una incidencia de anomalías del 3 por ciento. No se observó aneurisma en ninguno de los casos. La lámina elástica interna estaba bien desarrollada, pero la lámina elástica externa de los vasos estaba pobremente desarrollada. Cerca de la bifurcación la túnica media es gradualmente cónica, la túnica media es totalmente deficiente siendo sustituida por la túnica adventicia (Forbus raphé). La túnica adventicia es más gruesa en las bifurcaciones (0.21mm) en comparación con otros lugares del buque. El grosor medio de la túnica media de ACM en su origen fue 0.12mm mientras que el de la túnica adventicia de O.lOmm. Estos resultados son similares a los que han sido descritos en la literatura para Caucásicos. Es importante la afirmación que las anomalías anatómicas de la ACM son raras. La aparentemente baja frecuencia de los aneurismas de ACM en nigerianos africanos no es debido a sus anomalías o a la histología.


Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Aneurisma Intracraniano/patologia , Artéria Cerebral Média/anormalidades , Artéria Cerebral Média/patologia , Grupo com Ancestrais do Continente Africano , Nigéria , Medição de Risco
11.
Afr J Med Med Sci ; 37(1): 87-91, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18756861

RESUMO

Parkinsonism is a neurodegenerative clinical disorder characterized by varying combinations and degrees of rest tremor, rigidity, slowing of voluntary movements and postural instability. Amongst the aetiologic factors, massive post-craniotormy haematoma has not been previously considered. This report is to arouse the suspicion that vascular displacement in the midbrain resulting from a massive unilateral intracranial haematoma could lead to the unusual complication of Parkinsonism. This is the report of a 55-year old retired male banker, without any previously identifiable risk factor except for his age, who developed Parkinsonism following a huge acute extradural haematoma that complicated a craniotomy for the excision of a haemorrhagic convexity meningioma. The patient was placed on medical treatment resulting in a slow but progressive neurological improvement. Reports of Parkinsonism following post-tumour excision are probably, very rare. We, hereby, report a case of Parkinsonism complicating a gross total excision of a convexity meningioma.


Assuntos
Neoplasias Encefálicas/cirurgia , Craniotomia/efeitos adversos , Meningioma/cirurgia , Doença de Parkinson Secundária/etiologia , Antiparkinsonianos/uso terapêutico , Neoplasias Encefálicas/diagnóstico , Hematoma/diagnóstico , Hematoma/etiologia , Hematoma/cirurgia , Humanos , Hemorragias Intracranianas/diagnóstico , Hemorragias Intracranianas/etiologia , Hemorragias Intracranianas/cirurgia , Levodopa/uso terapêutico , Masculino , Meningioma/diagnóstico , Pessoa de Meia-Idade , Doença de Parkinson Secundária/tratamento farmacológico , Hemorragia Pós-Operatória/diagnóstico , Hemorragia Pós-Operatória/etiologia , Hemorragia Pós-Operatória/cirurgia , Tomografia Computadorizada por Raios X
12.
West Afr J Med ; 27(1): 32-6, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18689301

RESUMO

BACKGROUND: Traumatic extradural haematoma is a rare condition and treatment in a majority of cases is by operative evacuation. Outcome from treatment is influenced by several factors. OBJECTIVE: To evaluate the operative treatment of traumatic extradural haematoma in our centre and assess the impact on outcome of some of the historical factors. METHODS: A retrospective study of cases managed January 1993-February 2004 using records from the Emergency Room, Wards, Theatre and Radiology Unit. Only the cases definitively diagnosed as extradural haematoma resulting from trauma and had operative evacuation, were recruited. The Glasgow Coma Scale was used to measure the severity of injury; whereas postoperative outcome was considered good in those with minimal or no neurological deficits. Collated data were analyzed and the patients were divided into 3 groups--good, moderate and fatal (poor) based on the outcome; the impact of the various historical factors was compared among the groups. Statistical analysis was done using the chi-square test and p-value of 0.05 or less was considered significant. RESULTS: Majority of the patients were young, with mild head injury and good outcome, and a surprisingly long mean preoperative time lag of 123.1 hours. Outcome was good in 24 (64.9%), moderate 6 (16.2%) and fatal 7 (18.9%). There were skull fractures in 26 (70.3%), but there was no significant difference in outcome among those with and those without fractures. CONCLUSION: Age of the patient and severity of head injury (a reflection of concomitant brain injuries), more than other factors appear to dominantly prognosticate outcome from operative evacuation in our service.


Assuntos
Traumatismos Craniocerebrais/complicações , Hematoma Epidural Craniano/cirurgia , Procedimentos Neurocirúrgicos/métodos , Adolescente , Adulto , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/cirurgia , Feminino , Seguimentos , Hematoma Epidural Craniano/diagnóstico , Hematoma Epidural Craniano/etiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Índices de Gravidade do Trauma , Resultado do Tratamento
13.
Int. j. morphol ; 26(1): 69-74, 2008. tab
Artigo em Inglês | LILACS | ID: lil-558575

RESUMO

The anti-inflammatory effect of dexamethasone on the irradiated kidneys of adult Wistar rats (Rattus norvegicus) was studied. Eighteen adult Wistar rats were, after acclimatization, randomly divided into 3 groups of 6 animals per group. The control group had normal saline, receiving neither drugs nor radiation. The second group received normal saline and radiation. The third group received pretreatment with dexamethasone at 1mg/kg body weight/day for 2 days followed by radiation. Radiation was delivered to the animals as a single fraction of 2.5 Gy of gamma rays from Cobalt-60 source, using an AECL Theatron 780-C Teletherapy machine. After exposure to the different interventions, the animals were sacrificed on the 14th post-irradiation day and the kidneys dissected out from each animal. The renal tissues were subjected to histological processing, and then studied using an eyepiece objective ruler calibrated with a 2mm stage micrometer for histomorphometric studies. The result of the study showed that all irradiated animals suffered weight loss by the 14th day post-irradiation (p<0.05) irrespective of the additional treatment with dexamethasone and this was statistically significant. Histomorphometry showed that the maximum width of the glomerular capsule was significantly greater in the radiation groups than in the control at p<0.05. The maximal glomerular diameter was significantly greater in irradiated animals compared with the control animals at p<0.05. The outcome of this study showed that the intraperitoneal administration of dexamethasone at 1mg/kg body weight/day for 2 days prior to treatment with irradiation did not prevent weight loss nor ameliorate the swelling of the nephrons resulting from the effect of radiation injury to the Wistar rat.


Fue estudiado el efecto anti-inflamatorio de la dexametasona en riñones irradiados de 18 ratas Wistar adultas (Rattus norvegicus). Luego de la aclimatización, aleatoriamente se dividieron en 3 grupos de 6 animales por grupo. El grupo control recibió una solución salina normal, sin recibir drogas ni radiación. El segundo grupo recibió solución salina normal y radiación. El tercer grupo recibió tratamiento previo con dexametasona con 1 mg / kg de peso corporal / día, durante 2 días, seguido de radiación. Los animales fueron expuestos a radiación con una fracción independiente de 2.5 Gy de rayos gamma por una fuente de Cobalto-60, usando una máquina de teleterapia AECL Theatron 780-C. Después de la exposición a las diferentes intervenciones, los animales fueron sacrificados el día 14 post-irradiación y los riñones de cada uno de los animales fueron disecados. Los tejidos renales fueron sometidos a procesamiento histológico, y luego se estudiaron utilizando un objetivo ocular milimetrado calibrado a 2mm para el estudio histomorfométrico. Se demostró que todos los animales irradiados sufrieron pérdida de peso 14 días después de ésta (p <0.05), independientemente de los tratamientos adicionales con dexametasona , siendo estadísticamente significativo. La histomorfometría mostró que el ancho máximo de la cápsula glomerular fue significativamente mayor en los grupos irradiados que en el control en p <0.05. El diámetro máximo del glomérulo fue significativamente mayor en los animales irradiados en comparación con los animales control p <0.05. Los resultados de este estudio mostraron que la administración intraperitoneal, de 1 mg / kg de peso corporal / día durante 2 días, de dexametasona antes de comenzar el tratamiento con irradiación, no impide la pérdida de peso ni permite aliviar el edema de los nefrones, injuria producto de la radiación a las Ratas Wistar.


Assuntos
Animais , Ratos , Anti-Inflamatórios/uso terapêutico , Dexametasona/uso terapêutico , Nefrite/tratamento farmacológico , Lesões Experimentais por Radiação/tratamento farmacológico , Nefrite/etiologia , Ratos Wistar , Rim , Rim/efeitos da radiação , Rim/patologia
14.
Int. j. morphol ; 24(2): 221-229, jun. 2006. ilus, tab
Artigo em Inglês | LILACS | ID: lil-432805

RESUMO

RESUMEN: Se estudió el efecto neuroprotector de la dexametasona, sobre el cerebelo post-natal en desarrollo irradiado de ratas Wistar. 75 neonatos de 1 día de edad fueron separados en 3 grupos; el grupo control no recibió ni drogas ni irradiación, un grupo irradiado y el otro irradiado con aplicación de dexametasona. Esta droga fue administrada una hora antes de la exposición de 5Gray (5Gy) de rayos gamma. El tejido cerebelar de cada grupo con 5, 9, 14, 21 y 25 días fueron procesados para estudios histológicos e histomorfométricos. El resultado del estudio demostró que la sola irradiación redujo significativamente el grosor de la capa granular externa, en los grupos con 5 y 14 día,s con un p0,05; la capa molecular en los ejemplares de 5, 9, 14 y 21 días con un p0,05 y la capa granular en las ratas de 5,9,14 y 25 días, con un p0,05. Cuando se combinó la dexametasona con irradiación, se observó un grosor significativamente diferente en la capa granular externa, en especímenes con 5, 9 y 14 días; en la capa molecular en los animales de 5, 14 y 21 días y en la capa granular en los que tenían 5 y 14 días, al compararlos con el grupo irradiado, con un p>0,05. El diámetro de las células de Purkinje (capa de Purkinje) aunque fue significativamente reducido en el grupo irradiado de 14 y 21 días, no fue significativamente diferente cuandos se administró dexametasona a los animales irradiados de 5, 9, 14, 21 y 25 días con un p0,05. Histológicamente, las células de la capa molecular, en el grupo irradiado de 9 y 14 días, fueron marcadamente gliosadas comparadas con las medianamente marcadas en los grupos control e irradiados-dexametasona. Hubo distorsión de la monocapa de Purkinje, con algunas células encontradas en la capa molecular o en la capa de Purkinje, en el grupo irradiado de 5, 9, 14 y 25 días. De los resultados de este estudio, se puede afirmar que la administración de 0,005 ml de dexametasona intraperitonealmente, una hora antes de una exposición a una irradiación, parece proteger el desarrollo del cerebelo de la rata, de lesiones producidas por irradiación.


Assuntos
Animais , Recém-Nascido , Ratos , Cerebelo/crescimento & desenvolvimento , Cerebelo , Cerebelo/efeitos da radiação , Dexametasona/administração & dosagem , Dexametasona/uso terapêutico , Irradiação Craniana , Irradiação Craniana/veterinária , Córtex Cerebral , Córtex Cerebral/efeitos da radiação , Ratos Wistar/crescimento & desenvolvimento
15.
West Afr J Med ; 25(1): 69-74, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16722363

RESUMO

INTRODUCTION: The central nervous system (CNS) is an important site of HIV infection. As many as one quarter of AIDS patients present with neurological symptoms and up to 75% of the patients may have CNS abnormalities at autopsy. Under these circumstances therefore, differential diagnoses in HIV-positive patients with neurological symptoms constitute a management challenge. OBJECTIVE: To describe the pattern of cranial computed tomographic (CT) findings in neurosurgical patients with HIV infection. STUDY DESIGN: Retrospective analysis. PATIENTS AND METHOD: A total of 1907 patients were admitted from October 1996 to October 2001. Sixteen patients were positive for HIV using the Western blot. We reviewed their biodata, clinical features and cranial CT findings. RESULTS: There were 10 male and 6 female patients. Twelve patients had cranial CT. Four patients had lesions that could be attributed to direct infection by HIV virus. Two patients had lesions that suggested immunosuppression from HIV infection. Diffuse breakdown in blood brain barrier (BBB) with contrast enhancement as well as mass effect that was disproportional to the enhancing lesion were common findings in three patients. The other lesions seen on cranial CT could not be directly linked to HIV infection. CONCLUSION: Apart from the diffuse breakdown in blood brain barrier with disproportional mass effect, our findings were similar to previous reports. Further study with a larger population of patients and, especially, biopsy of the CNS lesion will be needed to confirm our findings.


Assuntos
Encefalopatias/diagnóstico por imagem , Encefalopatias/etiologia , Infecções por HIV/complicações , Adulto , Idoso , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Estudos Retrospectivos , Crânio/diagnóstico por imagem , Tomografia Computadorizada por Raios X
16.
Niger Postgrad Med J ; 13(1): 69-72, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16633384

RESUMO

BACKGROUND AND OBJECTIVE: Poverty, drug resistance and the advent of human immunodeficiency virus infection (HIV) have led to a recent upsurge in the incidence of tuberculosis including intracranial tuberculosis. In this article, we report 3 patients who had solitary brain tuberculomas and were otherwise healthy to underscore the importance of continuing vigilance for this disease. CASE REPORTS: Three patients (57 years, female; 52 years, male; 7 years male) presented to our unit with features of intracranial tumours. They were all HIV negative with no previous history of tuberculosis. Cranial computed tomography scans demonstrated uniformly contrast enhancing falcine supratentorial masses in the adult patients and a cerebellar hemispheric lesion with peripheral contrast enhancement in the paediatric patient INTERVENTION: All the patients had gross total tumour excision. The histology confirmed a tuberculoma. They all had antituberculous therapy after histological confirmation. The outcome was good in all the patients. CONCLUSION: Intracranial tuberculoma can occur in otherwise healthy individuals and should always be considered in the differential diagnosis of solitary intracranial mass lesions in sub-Saharan Africans so that minimally invasive procedures can be used to establish the correct diagnosis.


Assuntos
Cerebelo , Imunidade Celular , Tuberculoma Intracraniano/diagnóstico por imagem , Antituberculosos/uso terapêutico , Criança , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Tomografia Computadorizada por Raios X , Tuberculoma Intracraniano/imunologia
17.
Int. j. morphol ; 24(1): 99-104, Mar. 2006.
Artigo em Inglês | LILACS-Express | ID: lil-626833

RESUMO

The well-known fact that history writers always seem wiser than the subjects on whom they write is the most logical inherent proof that history is rich in lessons. The history of Anatomy is not an exception. It is full of imperative lessons in the Art and Science of the discipline of Anatomy, which following generations ought to learn. We present a defined brief survey with this in mind.


El hecho bien conocido que los historiadores siempre parecen ser más sensatos que los sujetos sobre quienes escriben, es la más lógica prueba que la historia es rica en lecciones. La historia de la Anatomía no es la excepción. Ella está llena de lecciones imperativas en el arte y ciencia, de la cual generaciones venideras deberían aprender. Presentamos un breve reconocimiento sobre lecciones de la Historia de la Anatomía.

18.
Afr J Med Med Sci ; 35(2): 165-8, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17209313

RESUMO

Maxillofacial injuries are fairly common and they are usually found in association with multiple injuries. The proximity of the face to the craniospinal axis results in significant association between maxillofacial trauma and craniospinal injuries. Previous studies have enumerated this association but the injury types, classifications and influences of the concomitant injuries on the outcome of management are sketchy. In this study, road traffic accident was the commonest cause of maxillofacial and concomitant c raniospinal injuries: mild closed head injuries was the commonest concomitant injury occurring in almost 60% of the cases whilst mandibular fracture was the maxillofacial injury frequently encountered. The average duration of hospitalization in patients with maxillofacial trauma and concomitant mild head injury was 19 days but it was much higher (average 34.9 days) in patients with concomitant spinal injuries. The high incidence of head injury would suggest that maxillofacial units are best cited in hospitals with functional neurosurgical services.


Assuntos
Traumatismos Craniocerebrais/epidemiologia , Traumatismos Maxilofaciais/complicações , Crânio/lesões , Traumatismos da Coluna Vertebral/epidemiologia , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Traumatismos Craniocerebrais/complicações , Traumatismos Craniocerebrais/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Traumatismos Maxilofaciais/epidemiologia , Traumatismos Maxilofaciais/terapia , Pessoa de Meia-Idade , Traumatismos da Coluna Vertebral/complicações , Traumatismos da Coluna Vertebral/terapia , Resultado do Tratamento
19.
Niger Postgrad Med J ; 13(4): 370-2, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17203114

RESUMO

INTRODUCTION: Reports of penetrating injuries of the cranium have been mainly craniocerebral or faciocerebral, craniocerebellar projectiles are few. CASE: We present a case of a 23 year old Nigerian with a craniofacial penetrating injury by a hunting arrow. The trajectory of the arrow through the facial skeleton across the craniocervical junction into the posterior fossa makes this unique in the literature. Successful operative retrieval by a joint team of neurosurgeons and otorhinolaryngologists, problems of delayed presentation and inadequate diagnostic facilities are highlighted. CONCLUSION: The morbidity-free outcome of surgical removal despite the delay in presentation and management in our practice setting with limited facilities are the salient points of this presentation.


Assuntos
Bochecha/lesões , Bochecha/cirurgia , Traumatismos Cranianos Penetrantes/cirurgia , Ferimentos Penetrantes/cirurgia , Adulto , Bochecha/diagnóstico por imagem , Humanos , Masculino , Nigéria , Crânio/cirurgia , Tomografia Computadorizada por Raios X
20.
Afr J Med Med Sci ; 35(4): 489-93, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17722819

RESUMO

An unusual case of malignant schwannoma with involvement of the forehead, external nose, right nasal cavity, paranasal sinus system (bilateral frontal sinus, right ethmoidal sinus), right orbit and anterior cranial fossa is reported in a Nigerian. Malignant schwannomas of the paranasal sinus are extremely rare, as only 20 well-documented cases have been previously published in English literature. No report in black Africans has been found in extant literature. The clinical features of this tumour are presented with detailed management. The patient had a wide surgical resection of the lesion with reconstruction of the resultant fronto-nasal defect using forehead musculofascial flap plus full thickness skin graft and adjuvant radiotherapy with satisfactory outcome. The good result of combined surgery and radiation regimens in this case demonstrates the usefulness of adjuvant radiation therapy in this condition.


Assuntos
Cavidade Nasal/patologia , Neurilemoma/diagnóstico , Neurilemoma/cirurgia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/cirurgia , Adolescente , Feminino , Humanos , Nigéria , Tomografia Computadorizada por Raios X
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