Assessment of Lung Function Parameters in Nigerian Males with Diabetes

Despite scarce information on the implications of diabetes for pulmonary function; existing evidence suggests that the respiratory system might also be affected by diabetes. We therefore conducted a crosssectional study of pulmonary function in male Nigerian diabetes patients using spirometric indices. Seventy-six male diabetes patients aged 27-80 years were studied at the Endocrinology and Diabetes Clinic at the Obafemi Awolowo University Teaching Hospital; Ile-Ife; Nigeria. Overall; all lung function parameters/volumes studied were significantly lower in the diabetes patients compared with predicted values p=0.000. Patients' ages correlated negatively with all spirometric indices but there was no significant relationship between lung function and fasting blood sugar; body mass index; or diabetic microvascular complications. The implications of abnormal lung function parameters for respiratory disease in diabetes are unclear. Routine tests of pulmonary function are not presently indicated in Nigerian diabetes patients

The Pattern of Foreign Body Impactions in the Tracheobronchial Tree in University of Port Harcourt Teaching Hospital

Background: Foreign body aspiration in the tracheobronchial tree usually presents as emergency. The diagnosis is often delayed. Aim: To determine the pattern of foreign body aspiration in the tracheobronchial tree in the University of Port Harcourt Teaching Hospital (UPTH) and to highlight the factors responsible for the morbidity and the unusually high mortality associated with this accident especially in the paediatric age group. Methods: This was a retrospective study of patients from the ENT Surgery department of UPTH over a ten-year period from January 1995 to December 2004. The Clinics record of attendance; augmented by ward and theatre records formed the material resource for this study. Extracted data was analysed using descriptive statistics. Results: Twenty-eight patients presented with foreign body aspirated in the tracheobronchial tree. Only 11 case notes were retrieved. There were 5 males (45.5) and 6 females (54.5) with a M: F ratio of 1:1.3. The age range was 1 to 45 years with a median age of 6 years. Children below 10 years made up the bulk (63.3). Groundnut was the commonest foreign body inhaled (45.5) while the right main bronchus was the site of lodgment in 9 patients (81.8). The outcome of treatment by the specialists showed a success rate of 63.3and mortality of 36.4. Conclusion: Foreign body in the tracheobronchial tree could be managed with better prognosis in the pediatric age group if the clinicians of first contact had a high index of suspicion and referred cases promptly

Predictors of Survival in Infants with Congenital Diaphragmatic Hernia - Systemic Oxygenation Status Versus Dynamic Compliance of the Respiratory System

Objective. To compare whether early measurement of blood gases and/or dynamic compliance of the respiratory system (CRSdyn) predicts outcome in high-risk infants with unilateral congenital diaphragmatic hernia (CDH). Patients and methods. A retrospective study was performed at Tygerberg Children's Hospital between January 1992 and August 2001. High-risk infants with unilateral CDH; who presented with respiratory distress within 6 hours of birth; were included. Patients with other lethal congenital abnormalities were excluded. The first arterial blood gas value after endotracheal intubation was documented and the arterial-alveolar oxygen tension (a:A) ratio was calculated. CRSdyn was measured within 24 hours of birth. The ability of these measurements to predict outcome (survival or death during the newborn period) was determined. Results. Seventeen of 40 infants with CDH were categorised as high risk and included in the study. Eight of them (47) survived the neonatal period. The best single predictors of outcome were; in order; partial pressure of oxygen in arterial blood (PaO2); a:A ratio and dynamic compliance of the respiratory system standardised for body weight (CRSdyn/kg). The specificity and sensitivity at a PaO2 cut-off of 19.3 kPa were 7/8 (95confidence interval (CI): 0.473 - 0.997) and 9/9 (95CI: 0.634 - 1.000) respectively. Results for a:A ratio were cut-off 0.321; specificity 6/8 (95CI: 0.349 - 0.968); and sensitivity 9/9 (95CI: 0.634 - 1.000). Results for CRSdyn/kg were cut-off 0.259; specificity 6/8 (95CI: 0.349 - 0.968); and sensitivity 9/9 (95CI: 0.634 - 1.000). A linear discriminant function based on the 3 best single predictors was found to be no more effective than the first PaO2. Conclusions. Early oxygenation status predicts outcome better than the CRSdyn/kg in infants with unilateral CDH. However; both measurements predict outcome with high accuracy

Urgences pneumologiques dans le service des urgences medicales du CHU de Cocody : a propos de 137 cas

Cette etude prospective et transversale porte sur les urgences pneumologiques dans le service des urgences medicales du CHU de Cocody : a propos de 137 cas et s'est deroulee du 1er Mars au 31 Mai 2005.Son objectif general est de repertorier les types de pathologies respiratoires rencontres aux urgences medicales et de preciser les moyens de prise en charge mis en route. Il en ressort les conclusions suivantes:AU PLAN EPIDEMIOLOGIQUE:L'incidence des pathologies respiratoires est 16;73pour cent des cas.L'age moyen des patients est de 38;51 ans.Le sex-ratio est 1;01.AU PLAN CLINIQUE:Le delai de consultation depasse un mois chez 43;83pour cent des patients.Les antecedents de pathologie respiratoire et d'infection a VIH sont observes dans respectivement 32;12pour cent et 06;57pour cent des cas.La toux et la dyspnee sont les signes retrouves chez plus de la moitie des patients. La detresse respiratoire est observee chez 55;12pour cent des patients.L'examen physique revele une predominance de syndrome de condensation et du syndrome pleural comme principaux signes physiques.AU PLAN PARACLINIQUE:La radiographie pulmonaire est l'examen le plus demande.Les lesions parenchymateuses representent 9O;59pour cent des anomalies radiographiques.L'anemie est retrouvee chez 71;57pour cent des patients.AU PLAN ETIOLOGIQUE:La tuberculose est la pathologie la plus frequemment retrouvee.Les pneumopathies aigues occupent le second rang.AU PLAN THERAPEUTIQUE:Le traitement symptomatique est marque par le recours a l'oxygenotherapie. Le traitement etiologique fait appel principalement aux antibiotiques.AU PLAN EVOLUTIF ET PRONOSTIQUE:L'evolution est favorable chez 73;27pour cent des patients.Le taux de mortalite est de 16;83pour cent des cas.AU PLAN DE L'ORGANISATION DES SOINS:Le delai d'intervention du pneumologue excede 24 heures dans 45;54pour cent des cas et les protocoles therapeutiques initialement institues subissent des modifications chez 50;50pour cent des patients

Corps etrangers des voies respiratoires au Togo : problemes diagnostiques

L'etude de 36 cas de corps etrangers des voies respiratoires inferieures a permis de mettre en evidence les problemes diagnostiques. Le diagnostic n'est rapidement evoque que devant un syndrome de penetration (16;66 pour cent des cas). L'examen clinique est normal dans 38;88 pour cent des cas a la phase post-critique. Les corps etrangers etant radio-transparents dans la grande majorite des cas (52;78 pour cent); les signes radiologiques indirects ont eu une grande valeur diagnostique dans 16;66 pou cent des cas. L'endoscopie s'impose devant toute pathologie broncho-pulmonaire trainante ou repondant mal au traitement