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Are Tuberculosis Patients Managed According to the National Guidelines in Lagos State Nigeria?

International Journal of Clinical Medicine 2016年第1期7卷 16-24页

作者： Olusola Adedeji Adejumo Olusoji James Daniel Mustapha Gidado Andrew Folarin Otesanya esther Ngozi Adejumo Ebunoluwa O. Jaiyesimi oluwatoyin esther idowu Olumuyiwa O. Odusanya Department of Community Health and Primary Health Care Lagos State University Teaching Hospital Ikeja Lagos Nigeria Department of Community Medicine and Primary Care Olabisi Onabanjo University Teaching Hospital Sagamu Nigeria KNCV Tuberculosis Foundation/TB CARE I Project Abuja Nigeria Medical Services Department Central Bank of Nigeria Lagos Nigeria Department of Medical Laboratory Science Babcock University Ilisan-Remo Nigeria Department of Community Health and Primary Health Care College of Medicine Lagos Lagos State University Lagos Nigeria

Setting: Private and public tuberculosis (TB) treatment centers in Lagos State, Nigeria. Objective: To compare adherence of private and public providers of directly observed treatment short course (DOTS) in the Lagos State TB control program, Nigeria (LSTBLCP) with the national TB guidelines. Design: A retrospective review of treatment cards of TB patients managed within the first and second quarter of 2012 in 34 DOTS facilities {23 public, 7 private for profit (PFP), and 4 private not for profit (PNFP)} involved in the private public mix of the LSTBLCP. Results: Of the 1896 treatment cards reviewed, 1524 (80.4%), 132 (7.0%) and 240 (12.6%) were from public, PFP and PNFP DOTS facilities, respectively. About 19%, 25% and none of the patients managed at the public, PNFP, and PFP DOTS facilities were treated in full adherence with the national guidelines respectively. A significantly higher proportion of adults and sputum smear positive TB patients were treated in full adherence with the national guidelines (p < 0.05). Treatment success was associated with full adherence with the national guidelines. Conclusion: There is a need to reorient health care providers in public and private health facilities in Lagos State Nigeria to ensure full adherence with the national TB guidelines.

关键词： Adherence National Guidelines Health Workers DOTS Facilities

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New therapeutic approaches to metastatic gastroenteropancreatic neuroendocrine tumors:A glimpse into the future

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World Journal of Gastrointestinal Oncology 2017年第1期9卷 4-20页

作者： esther Una Cidon Department of Medical Oncology Royal Bournemouth HospitalBournemouthDorset BH5 2AZUnited Kingdom

Neuroendocrine(NE) gastroenteropancreatic tumors are a heterogeneous group of neoplasias arising from neuroendocrine cells of the embryological gut. Their incidence have increased significantly over the past 3 decades probably due to the improvements in imaging and diagnosis. The recent advances in molecular biology have translated into an expansion of therapeutic approaches to these patients. Somatostatin analogs, which initially were approved for control of hormonal syndromes, have recently been proven to inhibit tumor growth. Several new drugs such as antiangiogenics and others targeting mammalian target of rapamycin pathways have been approved to treat progressive pancreatic neuroendocrine tumors(NETs) although their role in nonpancreatic is still controversial. The treatment of NETs requires a coordinated multidisciplinary approach. The management of localized NETs primarily involves surgical resection followed by surveillance. However, the treatment of unresectable and/or metastatic disease may involve a combination of surgical resection, systemic therapy, and liver-directed therapies with the goal of alleviating symptoms of peptide release and controlling tumor growth. This article will review the current therapeutic strategies for metastatic gastroenteropancreatic NETs and will take a glimpse into the future approaches.

关键词： Gastroenteropancreatic neuroendocrine tumors Peptide receptor radionuclide therapy Somatostatin analogs Octreotide Transarterial chemoembolization Carcinoid syndrome Setotonin Chromogranin

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Synthesis, characterisation and microbial studies of [bis(1,10-phenanthroline) (ethylenediamine) copper(II)] diperchlorate and its bromide analogue

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Open Journal of Inorganic Chemistry 2013年第1期3卷 26-33页

作者： Oluwayemi O. esther Onawumi idowu O. Adeoye Funmi A. Adekunle Department of Pure and Applied Chemistry Ladoke Akintola University of Technology Ogbomoso Nigeria

Two new tris-chelate-complexes have been synthesized and characterized with elemental and spectroscopic methods. IR and thermal studies correlate with the structures of the complex in the solid state. The structure of [Cu(en)(phen)2] was determined with X-ray data using single crystal X-ray diffractometer while the molecular structure of [Cu(en) (phen)2] 2Br - 2Phen·8H2O was deduced from the used characterization methods. [Cu(en)(phen)2]· crystallizes as orthorhombic with space group Pbcn. Both complexes have distorted octahedral geometry. Microbial activities of these complexes against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Streptoccocus pyogeneous, Candida albicans, and Aspergillus niger were also reported.

关键词： Tris-Chelate Complexes X-Ray Data Electronic Spectra Microbial Studies

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Vasoactive intestinal peptide secreting tumour:An overview

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World Journal of Gastrointestinal Oncology 2022年第4期14卷 808-819页

作者： esther Una Cidon Department of Medical Oncology University Hospitals DorsetBournemouth BH77DWDorsetUnited Kingdom

Vasoactive intestinal peptide(VIP)secreting tumour(VIPoma)is a rare functional neuroendocrine tumour that typically arises from pancreatic islet *** present as sporadic,solitary pancreatic neoplasias with an estimated incidence of one in ten million individuals per *** around 5%of VIPomas are associated with multiple endocrine neoplasia type I *** VIP secretion produces a clinical syndrome characterized by refractory watery diarrhoea,hypokalemia and metabolic *** coupled with elevated plasma levels of VIP are *** majority of VIPomas are malignant and have already metastasized at the time of diagnosis(60%).Metastases occur most frequently in the liver,or regional lymph nodes,lungs,kidneys and *** reports of skin metastases have been *** surgical resection continues to be the only potentially curative ***,when the neoplasia cannot be excised completely,surgical debulking may provide palliative *** palliative options have included recently the peptide receptor radionuclide therapy which has shown to be effective and *** article will review all aspects of pancreatic VIPomas highlighting aspects such as clinical presentation,diagnosis and management.

关键词： VIPoma Octreotide Secretory diarrhoea Multiple endocrine neoplasia Vasoactive intestinal peptide Vermer-Morrison syndrome

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Small mammal diversity of Mt. Kenya based oncarnivore fecal and surface bone remains

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Zoological Research 2019年第1期40卷 61-69页

作者： Ogeto Mwebi esther Nguta Veronica Onduso Ben Nyakundi Xue-Long Jiang esther N.Kioko Osteology Section Department of Zoology National Museums of Kenya Kunming Institute of Zoology Chinese Academy of Sciences Sino-African Joint Research Center Chinese Academy of Sciences

Ecological dynamics and faunal diversity documentation is normally conducted by direct observation and trapping of live animals. However,surveys of carnivore scat prey and surface bone remains, which are relatively inexpensive, can provide complementary data that expand carnivore diet breadth and may improve accuracy regarding inferences of the ecological dynamics of a given ecosystem. We used this inexpensive method to document species diversity variation with elevation on the leeward(Sirimon) and windward(Chogoria)areas of Mt. Kenya. Bone and fecal specimens were opportunistically collected by walking 2 km in opposite directions from transect points selected at 200-m intervals along the elevational gradient of the study areas. We collected a total of 220 carnivore fecal and owl pellet specimens from both study sites, which were mainly deposited by the spotted hyena(Crocuta crocuta), leopard(Panthera pardus),serval(Leptailurus serval), genet(Genetta sp.), and Mackinder's Cape owl(Bubo capensis mackinderi).Serval scats were the most common, followed by those of the spotted hyena. Scats and bones were found at the lowest density at the lowest elevations,peaked at mid-higher elevations, and then declined at the highest elevations. Based on skeletal analysis only, there were more species in Sirimon(19) than in Chogoria(12). Small fauna(rodents to duiker size bovids) formed the bulk of the identified remains,representing 87.9% of the Sirimon fauna and 90.9% of the Chogoria fauna. The genus Otomys was the dominant prey of the owl and serval in both sites. Three giraffe teeth were found at 3 500 m a.s.l. in Chogoria on the edge of Lake El is, suggesting that it is an occasional visitor to such high elevations. This study underscores the value of fecal and bone surveys in understanding the diet and diversity of mammals in ecological ecosystems,but such surveys should be complemented with analysis of hairs found in scats to obtain a more complete list of carnivore prey at M

关键词： Ecological dynamics Faunal diversity Scats Pellets Mt.Kenya

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Unexplained liver laceration after metastasis radiofrequency ablation

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World Journal of Gastroenterology 2009年第40期15卷 5103-5105页

作者： esther Ua Javier Trueba Jose Manuel Montes Medical Oncology Service Clinical University Hospital of Valladolid Radiology Service Clinical University Hospital of Valladolid

Many studies have established the role of radiofrequency (RF) ablation as a minimally invasive treatment for liver metastases. Although relatively safe, several complications have been reported with the increased use of RF ablation. We describe here a case of unexplained liver laceration after a RF procedure. A woman who presented a solitary metachronous liver metastasis underwent RF ablation treatment for this lesion. Six hours later the patient displayed fatigue and pallor. Emergency blood tests showed a haemoglobin level of < 7 g/dL and markedly elevated transaminase levels. A computed tomography examination revealed two areas of liver laceration with haematoma, one of them following the path of the needle and the other leading away from the f irst. Following a blood transfusion, the patient was haemodynamically stable and completely recovered 24 h later. The patient remained in bed for 1 wk. No surgical intervention was required, and she was discharged 1 wk later.

关键词： Colon cancer Liver haemorrhage Liver laceration Liver metastases Radiofrequency ablation

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Systemic treatment of hepatocellular carcinoma:Past,present and future

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World Journal of Hepatology 2017年第18期9卷 797-807页

作者： esther Una Cidon Department of Medical Oncology Royal Bournemouth HospitalBournemouth BH7 7DWUnited Kingdom

Hepatocellular carcinoma(HCC) is a common neoplasia which represents the second leading cause of cancer related death. Most cases occur in developing countries, but its incidence is rising in Western countries due to hepatitis C. Although hepatitis therapies have evolved and the HCC screening has increased in several areas, 40% present with advanced disease which is only amenable for palliative systemic treatment. HCC continues posing a challenge, in part due to the inherent chemoresistance of this neoplasia, the pharmacologic challenges due to an ill liver, difficulty in assessing radiological responses accurately, etc. Traditional chemotherapy have shown some responses without clear survival benefit, however, sorafenib demonstrated advantages in survival in advanced HCC when liver function is kept and recently immunotherapy seems to be a promising approach for some patients. This article will briefly expose the most relevant systemic treatment modalities to offer a general view from the past to the future.

关键词： Hepatocellular carcinoma Alphafetoprotein Sorafenib Nivolumab MEK

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Phase Transformation under Continuous Cooling Conditions in Medium Carbon Microalloyed Steels

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Journal of Materials Science & Technology 2014年第5期30卷 511-516页

作者： Manuel Gomez Lucia Rancel esther Escudero Sebastian F.Medina National Centre for Metallurgical Research CENIM-CSICAv.Gregorio del Amo 828040 MadridSpain

Several 35CrMo4 and 38MnV7 steels with different additions of Ti and V were manufactured by electroslag remelting. The influence of the alloying and microalloying elements on phase transformation at different cooling rates was studied and the continuous cooling transformation diagrams were plotted. In order to optimize the heat treatment and improve the mechanical properties, the range of cooling rates leading to a fully bainitic microstructure （without ferrite, pearlite and especially without martensite） was determined. Bainite and martensite transformation start temperatures （Bs, Ms） were also established and compared with the values predicted by empirical equations. The important role of precipitates （especially V carbonitride particles） on final microstructure and mechanical properties was assessed.

关键词： Microalloyed steel Phase transformation Precipitation Dilatometry Continuous cooling transformation diagram

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Challenges and prospects in bridging precision medicine and artificial intelligence in genomic psychiatric treatment

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World Journal of Psychiatry 2024年第8期14卷 1148-1164页

作者： Uchenna esther Okpete Haewon Byeon Department of Digital Anti-aging Healthcare(BK21) Inje UniversityGimhae 50834South Korea

Precision medicine is transforming psychiatric treatment by tailoring personalized healthcare interventions based on clinical,genetic,environmental,and lifestyle factors to optimize medication *** study investigates how artificial intelligence(AI)and machine learning(ML)can address key challenges in integrating pharmacogenomics(PGx)into psychiatric *** this integration,AI analyzes vast genomic datasets to identify genetic markers linked to psychiatric ***-driven models integrating genomic,clinical,and demographic data demonstrated high accuracy in predicting treatment outcomes for major depressive disorder and bipolar *** study also examines the pressing challenges and provides strategic directions for integrating AI and ML in genomic psychiatry,highlighting the importance of ethical considerations and the need for personalized *** implementation of AI-driven clinical decision support systems within electronic health records is crucial for translating PGx into routine psychiatric *** research should focus on developing enhanced AI-driven predictive models,privacy-preserving data exchange,and robust informatics systems to optimize patient outcomes and advance precision medicine in psychiatry.

关键词： Precision medicine Psychiatric treatment Genomic data Machine learning Deep learning Clinical decision making Data privacy Review

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Gemcitabine-induced haemolytic uremic syndrome,although infrequent,can it be prevented:A case report and review of literature

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World Journal of Clinical Cases 2018年第12期6卷 531-537页

作者： esther U Cidon Pilar A Martinez Tamas Hickish Department of Medical Oncology Royal Bournemouth and Christchurch Hospital NHS Foundation Trust Department of Oncology Clinical University HospitalValladolid Department of Medical Oncology Royal Bournemouth and Christchurch Hospital NHS Foundation Trust and Bournemouth University

Gemcitabine is an antineoplastic used to treat several malignancies including pancreatic cancer. Its toxicity profile is well known with myelotoxicity, increased vascular permeability and peripheral oedema as most frequent adverse events. However, several cases of acute renal failure have been reported and haemolytic uremic syndrome(HUS) seems to be the underlying process. The cause of HUS remains unknown but its consequences can be lethal. Therefore, a high grade of suspicion is crucial to diagnose it and promptly treat it. This hopefully will reduce its morbidity. HUS is characterized by progressive renal failure associated with microangiopathic haemolytic anaemia and thrombocytopenia. The primary event is damage to endothelial cells and thrombotic microangiopathy(TMA) is the histopathological lesion. TMA affects mainly renal microvasculature. However, some cases evolve with central nervous or cardiovascular systems involvement. We present here a case of gemcitabine-induced HUS, with renal and cardiovascular system affected at the time of diagnosis which to our knowledge this is the first time of such case to be reported.

关键词： Thrombocytopenia Haemolytic uremic syndrome Thrombotic microangiopathy Gemcitabine Microangiopathic haemolytic anaemia

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