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Asian Pacific Journal of Tropical medicine 2010年第2期3卷 141-144页

作者： Gyuse AN Bassey IE Udonwa NE Okokon IB Philip-Ephraim EE Department of Family medicine University of Calabar Teaching Hospital Department of Pathology University of Calabar Teaching Hospital Department of internal medicine University of Calabar Teaching Hospital

Objective:To determine the causes of death among human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS) patients as a step to planning strategies to improve mortality from this ***:This study retrospectively analyzed the mortality pattern of adult HIV/AIDS patients in the university of Calabar teaching hospital from January 2005 to December *** data were obtained from sexually transmitted infection/acquired immunodeficiency syndrome(STI/AIDS) clinic register,admissions and discharge/death registers as well as the patients’ case records and the hospitals monthly mortality *** obtained included age,sex,diagnosis and cause(s) of *** causes of death considered were the direct causes of death,since the originating antecedent cause of death is the same in all the patients,in this case,HIV/*** was analysed using Epi Info ***:The total number of mortalities during the study period was 350,100 were HIV positive representing 28.6%of all *** advanced HIV/AIDS disease was the leading cause of death in our study representing 27.0%,tuberculosis was the single leading cause of deaths in HIV/AIDS patients constituting about 24.0%of *** was followed by sepsis and septicaemia(13.0%), meningitis and encephalitis,and anaemia accounting for 11.0%,while respiratory diseases constituted 5.0%of the mortality *** highest number of deaths occurred in those aged between 21-50 years(82.0%).Conclusions:The study has shown that HIV/AIDS is a major cause of morbidity and mortality in our *** causes of death reflect the varied spectrum of infection and other forms of organ involvement that affect HIV/AIDS *** present dismal situation of adult patients living with HIV/AIDS calls for enhanced strategies to decrease the mortality trend observed in Nigeria and sub-Saharan Africa.

关键词： Mortality Pattern HIV/AIDS Adult Patients Tertiary health institution

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Instant evaluation of contrast enhanced endoscopic ultrasound helps to differentiate various solid pancreatic lesions in daily routine

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World Journal of Clinical Cases 2019年第1期7卷 19-27页

作者： Klaus Kannengiesser Reiner Mahlke Frauke Petersen Anja Peters Torsten Kucharzik Christian Maaser Department of General internal medicine and Gastroenterology University Teaching Hospital Lueneburg Department of Pathology University Teaching Hospital Lueneburg

BACKGROUND Contrast enhanced harmonic endoscopic ultrasound(CEH-EUS) is a spreading technique; some studies have shown its value in the diagnosis of pancreatic adenocarcinoma using quantitative *** To examine the value of CEH-EUS for differentiating various pancreatic lesions in everyday routine with qualitative and quantitative *** Data of 55 patients with pancreatic lesions who underwent CEH-EUS were analysed retrospectively. Perfusion characteristics were classified by the investigator qualitatively immediately upon investigation, quantitative analysis was performed later on. Samples from fine needle aspiration(EUS-FNA) or surgical specimen served as gold *** CEH-EUS showed 39 hypoenhanced lesions, 3 non-enhanced and 13 hyperenhanced lesions. Concordance of the investigators qualitative classification of peak contrast enhancement with quantitative analysis later on was 100%, while other parameters such as arrival time, time to peak or area under the curve did not show additional value. 34 of 39 hypoenhanced lesions were pancreatic adenocarcinoma; of the hyperenhanced lesions 4 were inflammatory, 3 neuroendocrine carcinomas, 1 lymphoma, 1 insulinoma and 4 metastases(2 of renal cell carcinoma, 2 of lung cancer). Non-enhanced lesions showed up as necroses. Sensitivity for the detection of pancreatic adenocarcinoma was 100%,specificity 87.2% for hypoenhancement alone; in otherwise healthy pancreatic tissue all hypoenhanced lesions were pancreatic adenocarcinoma(sensitivity and specificity 100%, PPV and NPV for adenocarcinoma 100%).CONCLUSION This study again shows the excellent value of CEH-EUS in everyday routine for diagnostics of various focal pancreatic lesions suggesting that qualitatively assessed hypoenhancement is highly predictive for adenocarcinoma. Additional quantitative analysis of perfusion parameters does not add diagnostic yield. In case of the various hyperenhanced pancreatic lesions in our data set, histologic samp

关键词： Endoscopic ultrasound Contrast enhanced endoscopic ultrasound Pancreatic adenocarcinoma Neuroendocrine carcinoma Pancreatic metastases Lymphoma

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Probiotics in hepatology

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World Journal of Gastroenterology 2011年第24期17卷 2890-2896页

作者： Jan Lata Jana Jurankova Marcela Kopacova Petr Vitek Department of internal medicine Faculty of Medicine and University HospitalOstrava University Department of Clinical Microbiology University Hospital Brno 2nd Department of medicine Charles University in PrahaFaculty of Medicine at Hradec KraloveUniversity Teaching Hospital

The paper provides a basic review of intestinal microflora and its importance in liver diseases. The intestinal microflora has many important functions, above all to maintain the microbial barrier against established as well as potential pathogens. Furthermore, it influences the motility and perfusion of the intestinal wall, stimu- lates the intestinal immune system and therefore also the so-called common mucosal immune system, reducing bacterial translocation and producing vitamins. Immune homeostasis at mucosal level results from a controlled response to intestinal luminal antigens. In liver cirrhosis, there are many changes in its function, mostly an increase in bacterial overgrowth and translocation. In this review, probiotics and their indications in hepatology are generally discussed. According to recent knowledge, these preparations are indicated in clinical practice only for cases of hepatic encephalopathy. Probiotics are able to decrease the permeability of the intestinal wall, and decrease bacterial translocation and endotoxemia in animal models as well as in clinical studies, which is extremely important in the prevention of complications of liver cirrhosis and infection after liver transplantation. Probiotics could limit oxidative and inflammatory liver damage and, in some situations, improve the histological state, and thus non-alcoholic steatohepatitis could be considered as another possible indication.

关键词： Intestinal microflora Probiotics Liver en-cephalopathy Non-alcoholic steatohepatitis Liver cirrhosis

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Electrocardiographic Analysis of Patients with Suspicion of Acute Coronary Syndrome in yaounde, Cameroon

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Open Journal of internal medicine 2023年第4期13卷 436-446页

作者： Kong Derick Njikeh Ngongang Ouankou Christian Boombhi Jerome Ntep Gweth Menanga Alain Patrick Ngu Blackett Kathleen Faculty of medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Department of internal medicine University Teaching Hospital Yaounde Cameroon Department of internal medicine General Hospital Yaounde Cameroon

Background: Ischemic heart disease (IHD) is the leading cause of death worldwide. IHD was thought to be an extremely rare occurrence in Sub-Saharan Africa, but the increasing economic development with changes in lifestyle has led to an increase in IHD risk factors which has motivated the interest of our study. Objectives: The aim was to study a group of patients with suspicion of acute coronary syndrome (ACS), in order to determine those with and without electrocardiographic diagnosis of ACS. Methods: It was an observational cross-sectional descriptive study over a period of six months, which included concerned patients who presented with retrosternal or precordial chest pain of onset being less than two weeks with at least one cardiovascular risk factor, in the cardiology units of three reference hospitals in yaounde. Ethical clearance and authorizations were obtained from the competent authorities. We used a preformed questionnaire to obtain information from the patients concerning the demographic data, clinical presentation and electrocardiographic findings. Results: We recruited 100 patients with suspicion of ACS. 56 patients presented with electrocardiographic diagnosis of ACS and 44 patients did not. The mean age was 60.6 ± 11.5 years with age limits of 32 - 85 years in patients with ACS and 55.3 ± 16.6 years with age limits of 19 - 90 years in patients without ACS. The predominant age group was 60 - 69 years in both groups. The sex ratio (male/female) was 0.6 in patients with ACS and 0.7 in patients without ACS. The main complaints presented in both groups were;chest pain, fatigue, dyspnea and palpitation. The frequent cardiovascular risk factors in both groups were hypertension, age and overweight/obesity. In patients with ACS, 55.4% presented with ST-segment elevated acute coronary syndrome (STE-ACS) and 44.6% presented with non-ST-segment elevated acute coronary syndrome (NSTE-ACS). The Antero-Septal territory represented 77.4% of patients with STE-ACS and

关键词： Chest Pain Cardiovascular Risk Factor Electrocardiogram Acute Coronary Syndrome

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Psychological Distress, Social Support and Medication Adherence in Patients with Ischemic Stroke in the Mainland of China

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Journal of Huazhong university of Science and Technology(Medical Sciences) 2015年第3期35卷 405-410页

作者：张洪钱海舟孟曙庆舒敏高永哲徐艳张胜名红梅熊荣红 Department of Neurology Zhongnan Hospital of Wuhan University teaching and Research Section of Neuropsychiatry Zhongnan Hospital of Wuhan University Department of internal medicine International Hospital of Mongolian Medicine

Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction（stroke group） in the Zhongnan hospital of Wuhan university from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers（control group） were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90（SCL-90）, the social support by the Social Support Rating Scale（SSRS）, and medication adherence by Morisky＇s self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group（P〈0.01）. Except two dimensions, paranoid ideation and psychoticism, mean scores of the rest dimensions（including somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety） of SCL-90 were significantly higher in the stroke group than those in the control group（P〈0.05, or P〈0.01）. The objective support, subjective support, support availability and total social support scores in the stroke group were significantly higher than those in the control group（P〈0.05, or P〈0.01）. Those in the ＂SCL-90 total scores 〉150 group＂ were significantly higher t

关键词： stroke psychological distress social support medication adherence

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Is rectal indomethacin effective in preventing of post-endoscopic retrograde cholangiopancreatography pancreatitis?

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World Journal of Gastroenterology 2014年第29期20卷 10151-10157页

作者： Zoltán Dbrnte Zoltán Szepes Ferenc Izbéki Judit Gervain László Lakatos Gyula Pécsi Miklós Ihász Lilla Lakner Erzsébet Toldy László Czakó Department of Gastroenterology and internal medicine Markusovszky Teaching Hospital 1st Department of medicine University of Szeged 1st Department of internal medicine Szent Gyrgy Regional Hospital Department of internal medicine Csolnoky Ferenc Regional Hospital Department of Gastroenterology Karolina Hospital Central Laboratory Markusovszky Teaching Hospital Institute of Diagnostics Faculty of Health SciencesUniversity of Pécs

AIM: To investigate the effectiveness of rectally administered indomethacin in the prophylaxis of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and hyperamylasaemia in a multicentre study.

关键词： Endoscopic retrograde cholangiopancreatography Post-endoscopic retrograde cholangiopancreatography pancreatitis Hyperamylasaemia Nonsteroidal anti-inflammatory drugs Indomethacin

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Parasympathetic Dysfunction in Black African Patients with Heart Failure:A Cross-Sectional Study in Sub-Saharan Africa

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World Journal of Cardiovascular Diseases 2020年第4期10卷 178-187页

作者： Ba Hamadou Sylvie Ndongo Amougou Ismaila Daouda Chris Nadege Nganou-Gnindjio Liliane Mfeukeu-Kuate Jerome Boombhi Ahmadou Musa Jingi Alain Menanga Samuel Kingue Department of medicine and Specialties Faculty of Medicine and Biomedical SciencesUniversity of Yaounde IYaoundeCameroon Cardiology unit Central Hospital of YaoundeYaoundeCameroon Cardiology unit University Teaching Hospital of YaoundeYaoundeCameroon Faculty of medicine and Biomedical Sciences University of Yaounde IYaoundeCameroon Cardiology unit Medicine BGeneral Hospital of YaoundeYaoundeCameroon

Background: Heart Failure (HF) is a major public health problem worldwide. Neurohormonal changes associated with HF are current therapeutic targets. The parasympathetic system in HF has not been well studied especially in black Africans. Aim: This study aimed to report on the prevalence and determinants of parasympathetic dysfunction in patients with heart failure in sub-Saharan Africa. Methods: We conducted a cross-sectional study between December 2017 and April 2018 in the outpatient and inpatient departments in two teaching hospitals in yaounde-Cameroon. Cases were patients with HF matched with controls without HF according to age, sex, and risk factors (hypertension, diabetes, and obesity). We assessed the parasympathetic function via the Deep Breathing Test using an electrocardiograph. Results: We recruited 35 patients in each group. The mean age was 57 ± 11.68 years. Vagal dysfunction was seen in 51.4% of cases and 11.4% of controls (aOR: 10.1 [95% CI: 2.7 - 38.3], p = 0.001). This risk increased with the severity of HF-aOR: 11.8, [95% CI: 1.8 - 77.9], p = 0.01 for dyspnea stage III-IV, and aOR: 9.27, [95% CI: 1.3 - 65.3], p = 0.025) for HF with reduced Ejection fraction. This risk was not associated with the classic cardiovascular risk factors. Conclusion: Parasympathetic dysfunction as assessed with the Deep Breathing Test was seen in over half of the patients with HF and this was associated with the severity and type of HF.

关键词： Heart Failure Parasympathetic Dysfunction Heart Rate Variability Deep Breathing Test

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Prevalence of parasitemia and associated immunodeficiency among HIV—malaria co—infected adult patients with highly active antiretroviral therapy

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Asian Pacific Journal of Tropical medicine 2013年第2期6卷 148-152页

作者： Caroline Edijana Omoti Chiedozie K.Ojide Patrick V.Lofor Emeka Eze Joy C Eze Department of Haematology and Blood Transfusion University of Benin Teaching HospitalBenin CityNigeria Department of Medical Microbiology University of Benin Teaching HospitalBenin CityNigeria Department of internal medicine University of Benin Teaching HospitalBenin CityNigeria

Objective:To investigate the malaria parasitemia,CD4~+ cell counts and some haematological indices among HIV-malaria co-infected adult patients with highly active antiretroviral therapy (HAART).Methods:A total of 342 adult HIV positive subjects were recruited at the consultant outpatient HIV/AIDS *** of Benin teaching hospital,Benin City,Nigeria between June 2011 to November *** samples were taken for malaria parasite count,CD4~+ cell count and other haematological ***:Out of the 342 adult HIV positive subjects a total of 254 patients(74.3%) were found to have malaria *** incidence of malaria parasitemia increased with advancing clinical stage of HIV infection and this was statistically significant(P=0.002).There was no statistical significance when gender was compared with the HIV-malaria status(P>0.05).Of the 254 co-infected patients,134(52.8%) had high parasitemia (>1.25×10~9/L).Sixty patients were found to be hyperparasitemic(>2.5 parasites/L).There was a significant association between CD4~+ cell count and having significant parasitemia(P0.05).Conclusions:The prevalence of parasitemia is high among the HIV/AIDS infected patients.

关键词： HIV Malaria HAART CD4~+

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Cardiovascular Disease Risk Associated to Chronic Inflammatory Rheumatic Diseases in Patients Seen in Rheumatology unit in yaounde, Cameroon

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Open Journal of Rheumatology and Autoimmune Diseases 2016年第1期6卷 13-21页

作者： Madeleine Singwe-Ngandeu Mickael Essouma Alain Patrick Menanga Vicky Jocelyne Ama Moor Caroline Ngoufack Sandrine Sa’a Lontsi Yolande Vanessa Ayi Efoua Thierry Ntandzi Faculty of medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Rheumatology unit Yaounde Central Hospital Yaounde Cameroon Cardiology unit Yaounde General Hospital Yaounde Cameroon Biochemistry Laboratory Yaounde University Teaching Hospital Yaounde Cameroun

Introduction: Even though there is a huge burden of both chronic inflammatory rheumatic diseases (CIRD) and cardiovascular diseases in Sub-Saharan Africa, no published study from this region has yet addressed the issue of cardiovascular diseases in a group including different CIRD to the best of our knowledge. Objective: We conducted this research with the aim to explore the association between CIRD and cardiovascular risk in a Cameroonian population based on the World Health Organization (WHO) and International Society for Hypertension (ISH) risk charts. Methods: This cross-sectional study included CIRD patients, followed at the rheumatology unit of the yaounde Central hospital, and, who were matched to non-CIRD subjects for sex, age and race. Cardiovascular risk factors were studied and subsequently the cardiovascular risk was estimated using the WHO/ISH risk charts. Analyses were performed in Epi-info and SPSS software and results were considered statistically significant for a p-value less than 0.05. Results: In total, 109 CIRD patients and 111 non-CIRD subjects were included. Their respective mean ages were 44.4 ± 15.2 years and 44.2 ± 15.1 years. Odds ratio 2.09, 95% confidence interval (CI) (1.07 - 4.08);high BMI OR 1.89, 95% CI (1.1 - 3.24);diabetes mellitus (p = 0.03) and physical inactivity (p < 0.001) were all markedly found in CIRD patients compared with controls. Ten (9.2%) CIRD patients had a past history of atherosclerotic cardiovascular events compared with no control (p < 0.001). The cardiovascular risk estimated with the WHO/ISH risk charts was low in 43 (79.6%) patients with CIRD versus 52 (88.1%) non-CIRD subjects. Conclusions: CIRD were associated with hypertension, excess overall adiposity, diabetes mellitus, and physical inactivity. A substantially increased proportion of CIRD patients with a past history of atherosclerotic cardiovascular events were noted. But the WHO/ISH risk charts broadly found a similar and globally decremented cardiovasc

关键词： Chronic Inflammatory Rheumatic Diseases Cardiovascular Risk Cardiovascular Risk Factors Cardiovascular Disease WHO/ISH Risk Charts Sub-Saharan Africa

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Relationship between retinopathy and cirrhosis

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World Journal of Gastroenterology 2005年第14期11卷 2193-2196页

作者： Colakoglu Onder Taskiran Bengur Dayi Selcuk Sozmen Bulent Unsal Belkis Maden Ahmet Pasa Eser Aslan S. Leyla Clinics of Gastroenterology Izmir Ataturk teaching and Research hospital IzmirTurkey 3rd Clinics of internal medicine Izmir Ataturk teaching and Research hospital Izmir Turkey Clinics of Ophthalmology Izmir Ataturk teaching and Research hospital IzmirTurkey 3rd Clinics of internal medicine Izmir Ataturk teaching and Research hospital IzmirTurkey Clinics of Ophthalmology 9th September university hospital IzmirTurkey

AIM: To evaluate ophthalmic disorders with special attention to retinopathy in cirrhotic patients. Vitamin A deficiency-related ophthalmopathy, xerophthalmia, and color blindness may be documented in cirrhosis due to various etiologies. Retinopathy is an obscure feature of cirrhosis. METHODS: Thirty-two cirrhotic patients, who were followed up by Clinics of Gastroenterology, Izmir Ataturk teaching and Research hospital, were enrolled to the study. Associated systemic diseases such as diabetes mellitus and hypertension were excluded. Thirty-two healthy volunteers took part as the control subjects. All participants had ophthalmologic examination in the same hospital. RESULTS: Five (15.6%) of the cirrhotic subjects had soft exudate in the retina. None of the control subjects had retinopathy (P＜0.05). Intraocular pressure (IOP) measured for both eyes were also significantly lower in the cirrhotics (P＜0.05 vs P = 0.01). There were no statistically significant differences between the two groups in terms of other ophthalmic pathologies. The ophthalmic findings did not show up any differences according to the etiology of cirrhosis. CONCLUSION: Soft exudates may develop in cirrhotic patients probably due to loss of synthetic function of liver and hemodynamic effects of portal hypertension. Retinopathy must be sought in cirrhosis because of its severe morbidity.

关键词： Cirrhosis Portal hypertension Retinopathy

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