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1.
Rev. Assoc. Med. Bras. (1992) ; 68(2): 206-211, Feb. 2022. tab
Article in English | LILACS | ID: biblio-1365345

ABSTRACT

SUMMARY OBJECTIVE: A multicentric, cross-sectional study was carried out to determine the prevalence and risk factors for Coronavirus disease 2019 in medical students and residents from four universities and affiliated hospitals in Brazil. METHODS: A survey about contamination risk and symptoms was sent to all participants through email and WhatsApp. Prevalence was measured by the self-report of positive polymerase chain reaction or serological test. Univariate and multivariate analyses were performed, and odds ratio and 95% confidence interval were calculated. RESULTS: Prevalence of infection by Sars-CoV-2 was 14.9% (151/1011). The disease was more prevalent in residents and interns than in undergraduate students. Contact with an infected relative outside the hospital or with colleagues without using personal protective equipment was associated with higher contamination. Contact with patients without wearing goggles and higher weekly frequency of contact were the two factors independently associated with the infection by Coronavirus disease 2019 in the multivariate analysis. CONCLUSIONS: Medical students, interns, and residents have a higher prevalence of Coronavirus disease 2019 than the general population, in which the last two groups are significantly at higher risk. Contacting patients at a higher weekly frequency increases the risk for infection. The use of goggles should be reinforced when contacting patients.


Subject(s)
Humans , Students, Medical/statistics & numerical data , COVID-19/diagnosis , COVID-19/etiology , COVID-19/prevention & control , COVID-19/epidemiology , Internship and Residency/statistics & numerical data , Schools, Medical/statistics & numerical data , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Academic Medical Centers/statistics & numerical data , Personal Protective Equipment , SARS-CoV-2
2.
Health sci. dis ; 23(11): 41-45, 2022. figures, tables
Article in French | AIM | ID: biblio-1399200

ABSTRACT

Introduction. Les gonalgies, souvent invalidantes, conduisent à un handicap fonctionnel altérant la qualité de vie des patients. L'objectif du travail était de décrire le profil épidémiologique des patients gonalgiques suivis dans le service de médecine Physique du Centre Hospitalier Universitaire d'Owendo (CHUO). Patients et méthodes. Nous avons mené une étude transversale descriptive, avec recueil rétrospectif de janvier à décembre 2021 dans le service de Médecine Physique et de Réadaption du CHUO. Résultats. Au total, 122 patients ont été retenus. L'âge moyen était de 44,54 ans. Le sexe féminin prédominait à 65,5%, les patients résidaient majoritairement en zone urbaine (90.9%). La population était célibataire à 51,3%, fonctionnaire pour 25,9%, avec une couverture sociale à 95,9%. Seul 50% pratiquait une activité physique régulière. L'HTA constituait l'antécédent médical le plus fréquent (27%). L'indice de masse corporelle moyen était de 27,59. Le délai moyen de prise en charge était de 63 jours (IQR 42,25), la moyenne de séances prescrites était de 15,66 et celles des séances effectuées était de 13,93. L'atteinte était dégénérative à 50% et traumatique à 41% des cas. Le traitement antalgique était initié concomitamment à la kinésithérapie dans 86% des fois, le palier OMS 1 était le plus fréquent (61,7%). Les mesures hygiéno-diététiques et d'économie articulaire ont été appliquées respectivement dans 70,6 et 90,2 % des cas. L'évolution a été favorable dans 80,3% des cas. Conclusion. La gonalgie touche majoritairement les femmes. Son évolution est favorable après un traitement de rééducation bien conduit.


Introduction. Gonalgia is often disabling and may lead to a functional disability altering the quality of life of patients. The aim of this study was to describe the epidemiological profile of gonalgic patients in the Physical Medicine department of the Owendo University Teaching Hospital (CHUO). Patients and methods. We conducted a descriptive cross-sectional study, with retrospective data collection from January to December 2021 in the Physical Medicine and Rehabilitation Department of the CHUO. Results. A total of 122 patients were included. Their average age was 44.54 years. Women represented 65.5% of cases and the patients resided mainly in urban areas (90.9%). The patients were single (51.3%), while 25.9% were civil servants and 95.9% had social security coverage. Only 50% practised regular physical activity. High blood pressure was the most frequent medical history (27%). The average body mass index was 27.59. The median time to treatment was 63 days (IQR 42.25). The average number of sessions prescribed was 15.66 and the average number of sessions performed was 13.93. The etiology was degenerative in 50% of cases and traumatic in 41% of cases. An analgesic treatment was initiated concomitantly with physiotherapy in 86% of cases, with WHO level 1 being the most frequent (61.7%). Hygienic were applied in 70.6% and and dietary measures in 90.2% of cases. The outcome was favorable in 80.3% of cases. Conclusion. Gonalgia mainly affects women. Its evolution is favorable after a well conducted rehabilitation treatment


Subject(s)
Humans , Male , Female , Epidemiology , Joint Diseases , Knee , Academic Medical Centers
3.
Article in French | AIM | ID: biblio-1412157

ABSTRACT

Objectif. Notre étude avait pour objectif de dégager le profil épidémiologique, clinique, histopathologique, thérapeutique et évolutif des cancers rénaux dans le centre anti cancer Annaba Algérie. Patients et méthodes. Etude rétrospective incluant 50 cas de cancers rénaux traités au sein des services d'oncologie médicale CHU Annaba entre janvier 2008 et octobre 2016. Résultats. Il s'agissait de 30 hommes et de 20 femmes. L'âge moyen de découverte était de 51 ans (extrêmes : 23-79 ans). Le facteur de risque le plus fréquemment observé était le tabagisme (58 %) suivi par l'hypertension artérielle (40 %). La douleur lombaire était le signe révélateur le plus fréquemment noté chez 48 % des patients. Le diagnostic a été basé sur la tomodensitométrie chez 100 % des patients. 54 % des tumeurs étaient localisées dans le rein droit. 42 % des patients étaient de groupe pronostique intermédiaire. La néphrectomie était pratiquée chez 90 % des patients. Le type histologique prédominant était le carcinome rénal à cellule claire (70 %), le grade de Fuhrman prédominant (grade 2 et 3) (36%). 86 % des patients étaient métastatique. 37.2 % des patients avaient 2 sites métastatiques. Parmi les 50 malades, 43 avaient reçu un traitement systémique versus 7 une surveillance. En 1ère ligne un inhibiteur de tyrosine kinase a était administré chez 41 malades (sunitinib (35pts) /sorafénib (6pts)), chimiothérapie associée à un anti angiogenèse chez deux malades. Sunitinib schéma (4/2) a était utilisé chez 19 pts versus (2/1) chez 14 pts, une réduction de dose a été pratiquée chez 18 pts. Les effets secondaires les plus rencontrés ont était l'asthénie (14 tous grades/09 grade 3et 4), syndrome main/pied (08 tous grades/05 grades 3 et 4), mucite (11 pts), neutropénie (8 pts), hypertension artérielle (5 pts), hypothyroïdie (5 pts). Neuf malades avaient reçu une 2ème ligne de traitement, un malade une 3ème ligne thérapeutique. L'évolution des malades était : 14 % (surveillance) ,4 % (RC) ,14 % (RP), (MP) ,60 % décédés. La médiane de survie globale était de 38,5 mois avec des extrêmes de 3 et de 74 mois. Conclusion. Le cancer rénal dans notre population était rencontré chez le sujet de la cinquième décennie avec prédominance masculine, la symptomatologie clinique était polymorphe dominée par des signes urologiques, la majorité des patients ont été métastatiques. Presque la totalité avait bénéficié d'une néphrectomie. Les inhibiteurs de tyrosine kinase ont été le traitement de choix de première ligne chez la majorité des malades avec une amélioration significative de la survie globale mais au prix d'une toxicité importante.


Subject(s)
Humans , Male , Female , Therapeutics , Epidemiology , Disease Progression , Disease Management , Early Detection of Cancer , Kidney Neoplasms , Diagnosis , Academic Medical Centers
4.
Bull. méd. Owendo (En ligne) ; 20(51): 6-12, 2022. tables
Article in French | AIM | ID: biblio-1378024

ABSTRACT

Introduction : Les urgences péniennes sont multiples et variées. Elles peuvent mettre en jeu le pronostic fonctionnel sexuel du patient. L'objectif de notre étude était de rapporter les aspects cliniques et thérapeutiques des urgences péniennes au CHU de Libreville. Matériel et Méthodes : Nous avons réalisé une étude rétrospective de janvier 2016 à décembre 2020 au service d'urologie du CHU de Libreville. Les variables comprenaient les données sociodémographiques, cliniques et thérapeutiques des patients pris en charge pour une urgence pénienne. Résultats : Durant cette période, 63 patients ont été pris en charge pour urgences péniennes. L'âge moyen était de 27±17,3 ans avec des extrêmes de 1 et 90 ans. Les urgences péniennes les plus fréquentes étaient le priapisme (55,5%) et la fracture de verge (15,9%). Le délai moyen de consultation en urologie était de 121 343,3 heures pour une médiane de 10 heures tandis que celui de prise en charge était de 34,3±74,6 pour une médiane de 2 heures. Les principaux gestes effectués étaient la ponction des corps caverneux (n=29, 46%) suivie de l'albuginorraphie (n=9, 14,3%) et du shunt caverno spongieux (n=9, 14,3%). Conclusion : Les urgences péniennes sont relativement fréquentes. Elles sont dominées par le priapisme et la fracture de verge dans notre contexte. Le pronostic fonctionnel sexuel est bon mais le délai de prise en charge demeure encore long.


Introduction: Penile emergencies are multiple and varied. They can jeopardize the patient's functional sexual prognosis. The objective of our study was to report the clinical and therapeutic aspects of penile emergencies at the University Hospital of Libreville. Material and Methods: We conducted a retrospective study from January 2016 to December 2020 at the Urology Department of the CHU of Libreville. Variables included sociodemographic, clinical and therapeutic data of patients managed for a penile emergency. Results: During this period, 63 patients were managed for penile emergencies. The mean age was 27±17.3 years with extremes of 1 and 90 years. The most frequent penile emergencies were priapism (55.5%) and penile fracture (15.9%). The mean time to consultation in urology was 121,343.3 hours with a median of 10 hours, while the mean time to management was 34.3±74.6 with a median of 2 hours. The main procedures performed were corpora cavernosa puncture (n=29, 46%) followed by albuginorraphy (n=9, 14.3%) and cavernospongiosus shunt (n=9, 14.3%). Conclusion: Penile emergencies are relatively frequent. They are dominated by priapism and penile fracture in our context. The sexual functional prognosis is good but the delay of management remains long.


Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Aged, 80 and over , Penile Diseases , Priapism , Surgical Procedures, Operative , Academic Medical Centers , Erectile Dysfunction
5.
Afr. j. health sci ; 35(3): 332-342, 2022. figures, tables
Article in English | AIM | ID: biblio-1380186

ABSTRACT

Acute Kidney Injury (AKI) is considered one of the main public health problems. The effective management of these alterations is based on the early detection of renal lesions. The objective of this study was to evaluate the contribution of the Cystatin C (CysC) assay in the early diagnosis of acute kidney injury (AKI) in children hospitalized in pediatric intensive care units in Brazzaville. MATERIALS AND METHODS Sixty children at high risk of developing AKI were included. Consent form signed was obtained from parents, socio-demographic data, weight and height of children recorded. Creatinine (Cr), CysC and urea were assayed in serum 24 hours after admission. Glomerular filtration clearance was estimated using serum creatinine and CysC. Glomerular filtration rate (GFR) was calculated from CysC and Cr. The diagnostic accuracy was determined by comparing the results of CysC to those of Cr (considered as a reference biomarker). RESULTS The median age was 5 years (with extremes ranging from 1 month to 17 years). Cr, CysC, urea, and GFR/Cr (mean ± standard deviation [range]) were 0.94±1.17 (0.2­ 1.4 mg/dl), 0.14 ± 0.062 (0.053-0.095 mg/l), 46.65±47.75 (15.0­45.0 mg/dl), 81.85±31.90 (≥190 ml/min per 1.73 m2 , respectively. The level of CysC in patients with ARL was significantly higher than that of children with normal renal function (p<0.001). Our results show that the performance of serum CysC in detecting AKI early was superior to that of serum Cr in children hospitalized in pediatric intensive care units in Brazzaville


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Creatinine , Early Diagnosis , Cystatin C , Acute Kidney Injury , Diagnosis , Academic Medical Centers
6.
Malawi med. j. (Online) ; 34(2): 143-150, Jul 11, 2022. Tables
Article in English | AIM | ID: biblio-1397948

ABSTRACT

This special communication discusses the current legal and ethical requirements for informed consent to medical treatment of adults in Malawi. It analyzes the scope of the laws and code of ethics on professional discipline, including criminal privilege for surgeries and clarifies when insufficient disclosures entitle patients to compensation under civil law. Inconsistencies and uncertainties in the law are made apparent. It evaluates to which degree disclosure standards of other Commonwealth jurisdictions (e.g. the case of Montgomery) would be suitable for the health care setting of a country like Malawi that is characterized by shortages of resources, high illiteracy rates and a communitarian cultural context. Doctor-patient communication is not alien to African culture and part of sufficient informed consent. In order to balance the need for efficiency in health care delivery, accountability for quality care, fairness and effective patient-doctor communication the authors suggest to adopt the reasonable patient test only, if a defence of heavy workload on case-to-case basis is introduced at the same time. This does not dispense the need for organisational diligence on part of the institutional health care provider within its capacity


Subject(s)
Patient Rights , Academic Medical Centers , Ethics , Jurisprudence , Malpractice , DNA Damage , Nursing, Private Duty , Workload , Civil Defense , Disclosure
7.
Ethiopian Journal of Health Sciences ; 32(5): 929-936, 5 September 2022. Tables
Article in English | AIM | ID: biblio-1398383

ABSTRACT

Glaucoma is the predominant cause of irreversible blindness, particularly the late presentation. The purpose of this study is to identify the risk factors associated with late presentation in Jimma University Medical Center METHODS: A case-control study was done among patients newly diagnosed to have open angle glaucoma (of any type) at Jimma University Medical Center from July 2014 ­ January 2019. Cases were patients/eyes diagnosed to have any type of open angle glaucoma with advanced glaucomatous disc features, whereas controls were patients diagnosed with early and moderate stages of glaucoma. RESULTS: There were 205 (116 cases and 89 controls) participants. The mean age of the participants at the time of diagnosis was 58.3±13.4yrs. Family history of blindness, presenting IOP, type of glaucoma and age were independently associated with late presentation. Patients with family history of blindness had late advanced glaucoma five times higher than those with no family history of blindness. The presence of late glaucoma among patients with presenting intra ocular pressure < 30mmHg is lower than those having ≥30mmHg (Adjusted Odds Ratio= 0.136). Primary open-angle glaucoma patients were less likely to present with advanced glaucoma than pseudo exfoliative glaucoma patients (Adjusted Odds Ratio=0.39). The chance of presenting with late glaucoma was increased by 3.4% for every one-year increment of age. CONCLUSIONS: Presence of family history of blindness, high presenting intraocular pressure, pseudo exfoliative glaucoma and old age are risk factors for late presentation of glaucoma


Subject(s)
Glaucoma , Risk Factors , Delayed Diagnosis , Labor Presentation , Glaucoma, Open-Angle , Academic Medical Centers
8.
Rev. invest. clín ; 73(4): 259-264, Jul.-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1347573

ABSTRACT

Background: Patients with monoclonal gammopathy of undetermined significance (MGUS) have clinical features including older age, presence of medical comorbidities, susceptibility to infections, and thrombotic tendencies which are relevant when assessing their risk during the coronavirus disease (COVID-19) pandemic. Objective: To study the vulnerability of patients with MGUS during the COVID-19 pandemic, we assessed the local management of MGUS patients and their clinical outcomes. Methods: Retrospective chart reviews were performed for all patients with MGUS seen at a university medical center clinic (2014-2020). Results: A total of 228 MGUS patients were included; 211 patients are alive, 7 patients died before the pandemic, and 10 patients died since the pandemic declaration. The mean age and the overall survival (OS) of the patients who died before versus during the pandemic were 83.0 versus 75.2 years, p = 0.4, and OS 40.6 versus 53.2 months, p = 0.3, respectively. One patient died of COVID-19. Nine patients had venous thromboembolisms (VTE), all of which occurred before the pandemic onset. Conclusions: There were no significant differences found in the mean age or OS of the MGUS patients who died before versus after the pandemic onset. An increase in VTE rates was not seen. Study results are limited by small patient numbers.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Monoclonal Gammopathy of Undetermined Significance/therapy , Venous Thromboembolism/epidemiology , COVID-19 , Monoclonal Gammopathy of Undetermined Significance/mortality , Monoclonal Gammopathy of Undetermined Significance/epidemiology , Survival Rate , Retrospective Studies , Age Factors , Vulnerable Populations , Academic Medical Centers , Venous Thromboembolism/etiology
9.
Ann. Univ. Mar. Ngouabi ; 21(1): 51-57, 2021. figures, tables
Article in French | AIM | ID: biblio-1401472

ABSTRACT

But: Identifier les causes de réhospitalisation pour insuffisance cardiaque (IC) Patients et méthode: cette étude transversale a été menée entre avril 2014 et mars 2015 dans le service de cardiologie du centre hospitalier universitaire de Brazzaville (République du Congo). Ont été inclus, les patients ayant des antécédents d'hospitalisation pour IC. Résultats: Quatre-vingt-onze patients, 54 femmes (59,3%) ont été inclus. Le sexe-ratio était de 0,7. La fréquence de réhospitalisation pour IC était de 19%. L'âge moyen était de 62 ± 16 ans (extrêmes: 24-89 ans). Le nombre moyen de réadmissions était de 2 ± 0,8 (extrêmes: 1 à 5), les réhospitalisation fréquentes (supérieur à 3) étaient de 33 (36,2%). Les patients présentaient un statut socioéconomique faible dans 59 cas (64,8%), et une hypertension artérielle dans 40 cas (43,9%). L'examen physique a retrouvé : une insuffisance cardiaque globale 77 cas (84,6%), une insuffisance cardiaque droite exclusive 5 cas (5,5%). Les causes de l'insuffisance cardiaque étaient: la cardiopathie hypertensive 40 cas (43,9%), la cardiomyopathie dilatée 28 cas (30,8%) et les valvulopathies 9 cas (10%). Les principales causes de réhospitalisation étaient: les écarts du régime hyposodé 64 cas (70,3%), la mauvaise observance du traitement 56 cas (61,5%), la grippe 15 cas (16,5%), la fibrillation atriale 12 cas (13,2%), débit de filtration glomérulaire réduite 12 cas (13,2%). La durée moyenne d'hospitalisation était de 11 ± 6,4 jours (extrêmes: 2-29). Le décès a été enregistré dans 5 cas (5,5%). Conclusion: L'absence de respect pour un régime pauvre en sodium et une mauvaise adhésion au médicament ont été les principales causes de réhospitalisation pour IC à Brazzaville. À cet égard, il est nécessaire de promouvoir l'éducation thérapeutique et d'améliorer l'accès au traitement.


Background: to identify the causes of readmission for heart failure (HF) Methods: this cross-sectional study was conducted in April 2014 to march 2015 in the department of cardiology, University Hospital of Brazzaville (Republic of the Congo). We had included, the patients who had a history of hospitalization for HF. Results: Ninety-one patients, 54 women (59.3%) were included. Sex-ratio was 0.7. The frequency of readmission for HF was 19%. The mean age was 62±16 years (range: 24-89). The average number of readmission was 2±0.8 (range: 1-5), the history of readmission ≥ 3, were 33 (36.2%). The patients were low socio-economic status in 59 cases (64.8%). In examination, patients were in congestive HF (n=77, 84.6%), right-sided HF (n=5). The causes of HF were: hypertensive heart disease (n=40, 43.9%), dilated cardiomyopathy (n=28, 30.8%), and valvular heart disease (n=9). The main causes of readmission were: excessive salt intake (n=64, 70.3%), poor drug-adherence (n=56, 61.5%), influenza (n=15, 16.5%), atrial fibrillation (n=12, 13.2%), reduced estimate glomerular filtration rate (n=12, 13.2%). The average length of hospitalization was 11±6.4 days (range: 2-29). The death was recorded in 5 cases (5.5%). Conclusion: No respect of low sodium diet and poor drug adherence, were the most causes of readmission for HF at Brazzaville. In regard of this facts, promoting therapeutic education is needed, and increasing access to treatment


Subject(s)
Humans , Male , Patient Readmission , Patient Compliance , Medication Adherence , Heart Failure , Cardiomyopathy, Dilated , Academic Medical Centers , Heart Diseases , Heart Valve Diseases
10.
Article in French | AIM | ID: biblio-1353553

ABSTRACT

Introduction : Les candidoses systémiques sont des affections graves responsables d'une mortalité élevée. L'objectif de ce travail est de décrire l'épidémiologie des candidoses systémiques dans les services à haut risque au CHU et au CAC de BATNA. Patients et méthodes : Il s'agit d'une étude prospective descriptive durant une période de trois ans (1er janvier 2016 au 31 décembre 2018). Les patients inclus sont ceux ayant au moins un prélèvement profond positif á Candida spp. Résultats : Un total de 69 cas de candidoses systémiques correspondant à 75 isolats et concernant 63 patients a pu être analysé. L'incidence globale était de 2,62 cas pour 1000 admissions. Les principaux motifs d'hospitalisation étaient les hémopathies malignes et le choc septique. La présence d'une colonisation ( 2 sites), une antibiothérapie á large spectre, d'un cathéter intra vasculaire, une corticothérapie, une chimiothérapie, une neutropénie étaient les facteurs de risque les plus retrouvés. L'analyse des souches isolées a montré la prédominance des espèces non albicans. L'index de colonisation ≥ 0,5 a été significativement associé au risque de candidose systémique. L'utilisation des Azolés a été associée á un taux de mortalité le plus élevé (19%). Le taux de mortalité est significativement élevé 51%. Conclusion : Les facteurs de risque et un index de colonisation ≥ 0,5 dans les services á haut risque constituent un facteur prédictif de candidose systémique. La prise en charge thérapeutique doit être instaurée pour réduire le taux de mortalité et éviter les complications liées á ces infections.


Background: Systemic candidiasis are serious conditions responsible for high mortality. The objective of this work is to describe the epidemiology of systemic candidiasis in high-risk departments at the UHC and the ACC of BATNA. Patients and methods: This is a descriptive prospective study over a period of three years (January 1, 2016 to December 31, 2018). The patients included are those with at least one positive deep sample for Candida spp. Results: 69 cases of systemic candidiasis corresponding to 75 isolates and concerning 63 patients could be analyzed. The overall incidence was 2.62 cases per 1,000 admissions. The main reasons for hospitalization were hematologic malignancies and septic shock. The presence of colonization ( 2 sites), broad-spectrum antibiotic therapy, an intravascular catheter, corticosteroid therapy, chemotherapy, neutropenia were the most common risk factors. Analysis of the isolated strains showed the predominance of nonalbicans species. Colonization index ≥ 0.5 was significantly associated with the risk of systemic candidiasis. Azole's use was associated with the highest mortality rate (19%). The mortality rate is significantly high 51%. Conclusion. Risk factors and a colonization index ≥ 0.5 in high-risk wards are a predictor of systemic candidiasis. Therapeutic care must be instituted to reduce the mortality rate and avoid complications linked to these infections


Subject(s)
Humans , Male , Female , Candida albicans , Disease Management , Invasive Fungal Infections , Azoles , Risk Factors , Academic Medical Centers
12.
Rev. invest. clín ; 72(2): 103-109, Mar.-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1251841

ABSTRACT

ABSTRACT Background: The left atrial appendage (LAAp) resection is an effective treatment approach to reduce the risk of thromboembolism in patients with atrial fibrillation. Objective: To study was to study the impact of removing atrial appendages in the production of natriuretic peptides (NPs) in conditions of volume overload and to develop an experimental model of LAAp resection. Materials and Methods: In a swine model of ischemic heart failure (HF), serum NP levels were measured before (Basal-1A) and after (Basal-1B) a fluid overload. Animals were grouped as follows: (0) preserved appendages, (1) resected LAAp, and (2) both atrial appendages resected. Levels of NP were measured before (2A) and after a fluid overload (2B). Results: Furin levels were higher in Group 0-2A than in Group 2-2A, and a significant increase was found in Group 0-2B compared to Groups 1-2B and 2-2B. Corin levels increased in Basal-1B versus Basal-1A. Atrial NP (ANP) decreased in Basal-1B compared to Basal-1A. After HF induction, ANP increased in Groups 2-2A and 2-2B. Conclusions: Resection of atrial appendages drastically modifies the natriuretic mechanisms of cardiac homeostasis, especially after a fluid overload challenge. Herein, we describe the face and predictive validation of an animal model of atrial appendage resection useful to investigations in translational medicine.


Subject(s)
Animals , Male , Atrial Appendage/surgery , Atrial Appendage/metabolism , Disease Models, Animal , Heart Failure/surgery , Heart Failure/metabolism , Homeostasis , Swine , Natriuretic Peptides/biosynthesis , Natriuretic Peptides/physiology , Academic Medical Centers
13.
Niger. J. Dent. Res ; 5(2): 136-144, 2020. ilus
Article in English | AIM | ID: biblio-1266998

ABSTRACT

Objective: Full complement and replacement of lost teeth improves oral health and quality of life. The objective of this study was to assess the level of awareness of factors that can prevent premature loss of teeth and the reason for non-replacement of missing/lost teeth among nurses in a tertiary health institution. Methods: This study was a descriptive cross-sectional study, 251 nurses of the Jos University Teaching Hospital participated. Self-administered questionnaires were used for data collection. Analysis of data was done with IBM SPSS version 23.0. Results: The mean age of the 251 nurses was 38±9.88. 174(69.3%) were females while 77(30.7%) were males. Out of 91(36.3%) that had missing teeth, 16(17.6%) actually replaced their missing teeth with the majority of them representing 81.3% adopting removable acrylic partial denture as modality. Among the 75(82.4%) that did not replace their missing teeth, the reason for the non-replacement by the majority- 40.0% was that they didn't feel replacement was necessary. Conclusion: The awareness level on factors that can prevent premature loss of teeth was observed to be high among the participants, but many have missing teeth that needed replacement. Majority did not replace their missing teeth as a result of low level of awareness of the consequences and probably due to financial challenges and because of the non-coverage of prosthetic treatments by the National Health Insurance Scheme 'NHIS' in Nigeria


Subject(s)
Academic Medical Centers , Denture, Partial, Removable , Nigeria , Nurses , Oral Health , Quality of Life , Replantation , Tooth Loss
14.
Ann. afr. méd. (En ligne) ; 13(4): 3861-3866, 2020. tab
Article in French | AIM | ID: biblio-1259098

ABSTRACT

Contexte et objectif. L'ampleur réelle des néphropathies congénitales est peu connue en Afrique et notamment en Guinée. L'objectif de cette étude était de déterminer la fréquence des néphropathies congénitales rencontrées. Méthodes. Cette étude documentaire de type descriptif sur la néphropathie congénitale, a été conduite entre les 1er janvier 2007 et 30 juin 2012, dans les services de pédiatrie et de chirurgie pédiatrique de Donka. Les paramètres d'intêret englobaient les données épidémiologiques, cliniques et paracliniques. Résultats. Parmi les 34.448 dossiers colligés, 26 présentaient une néphropathie congénitale. Il s'agissait des néphroblastomes (n=17), des syndromes de jonction pyélo-urétérale (n=6), d'une hydronéphrose sur rein multikystique gauche (n=1), d'un rein multikystique en ptose (n=1) et d'une ectopie rénale (n=1). Le sexe masculin était prépondérant (21/26) avec un sexe ratio de 4,2/1. Les enfants de 29 jours à 2 ans étaient les plus touchés. Conclusion. Les néphropathies congénitales sont paraissent moins fréquentes dans cette institution hospitalière, à cause du manque d'un plateau technique diagnostique optimal. Le diagnostic précoce des néphropathies congénitales devrait être fait dans la période prénatale ce qui permettrait une meilleure prise en charge des enfants affectés


Subject(s)
Academic Medical Centers , Guinea , Kidney Diseases/diagnosis , Kidney Diseases/epidemiology , Multicystic Dysplastic Kidney , Wilms Tumor
15.
MedUNAB ; 23(3): 423-433, 26/11/2020.
Article in Spanish | LILACS | ID: biblio-1141196

ABSTRACT

Introducción. El Síndrome de Burnout afecta mundialmente a más de 100,000,000 personas, con prevalencia entre 47 y 76% en médicos residentes. El objetivo de este trabajo fue determinar la relación entre el Síndrome de Burnout y los niveles de proteína C-reactiva ultrasensible en médicos residentes de un hospital universitario en Caracas, Venezuela. Metodología. Estudio transversal y descriptivo. El instrumento de recolección de datos, así como el test Maslach Burnout Inventory, fueron enviados en formato electrónico. Posteriormente, se seleccionó dos submuestras, a quienes se les determinó la concentración de proteína C-reactiva ultrasensible Resultados. La muestra inicial fue de 174 residentes, de los cuales 57 (32.8%) presentaban Burnout. Los residentes positivos para la presencia del síndrome tenían niveles más elevados de proteína C-reactiva ultrasensible (>0.50mg/dl) (р=0.001) con respecto al grupo sin Burnout. Igualmente, los residentes de género femenino (р=0.046), aquellos que dormían menos de 8 horas al día (р=0.032) y que estaban sometidos a estrés familiar (р=0.036) presentaron una asociación estadísticamente significativa para desarrollar el síndrome de bornout. Finalmente, se evidenció cómo los residentes de menor edad tenían mayores puntajes en la subescala despersonalización (p=0.036). Discusión. El estrés crónico (entre ellos el Síndrome de Bornout) puede activar de manera continua ejes fisiológicos estresores (hipotálamo-hipófisis- suprarrenal y simpático-adrenal); conllevando a la producción de citosinas y proteínas de fase aguda (como proteína C-reactiva ultrasensible), promoviendo un estado proinflamatorio en el individuo y el desarrollo de patologías crónicas. Conclusiones. El síndrome de bornout y las variables sociodemográficas/laborales representan una condición de estrés crónico que pueden asociarse entre sí y conducir al desarrollo de distintas enfermedades a largo plazo. Cómo citar. González-Moret YA, Guzmán Cuárez NE. Relación entre niveles de proteína c-reactiva y síndrome de burnout en médicos de postgrado. MedUNAB. 2020;23(3): 423-433. doi: https://doi.org/10.29375/01237047.3870


Introduction. Burnout Syndrome affects over 100,000,000 people worldwide, with a prevalence of between 47% and 76% in resident physicians. This project's objective is to determine the relationship between Burnout Syndrome and ultrasensitive C-reactive protein in resident physicians in a university hospital in Caracas, Venezuela. Methodology. Cross-sectional and descriptive study. The data collection tool, as well as Maslach Burnout Inventory test, were sent digitally. Two sub-samples were subsequently collected, whose concentration of us ultrasensitive C-reactive protein was determined. Results. The initial sample was 174 residents, of which 57 (32.8%) had Burnout. Residents who tested positive for the syndrome had higher levels of us-CRP (>0.50mg/dl) (р=0.001) with respect to the group without Burnout. Moreover, female residents (р=0.046), those who slept less than 8 hours every day (р=0.032) and those who were subject to family stress (р=0.036) demonstrated a statistically significant association with developing Burnout Syndrome. Finally, it was evident how younger residents had higher scores on the Depersonalization Subscale (p=0.036). Discussion. Chronic stress (among which is burnout syndrome) can continuously activate physiological stress axes (hypothalamic-pituitary-suprarenal and sympathetic-adrenal), which leads to producing cytosines and acute-phase proteins (such as ultrasensitive C-reactive protein), promoting a proinflammatory state in individuals and the development of chronic pathologies. Conclusion. Burnout Syndrome and sociodemographic/work variables represent a chronic stress condition and can be related to each other. They may lead to developing various long-term diseases. Cómo citar. González-Moret YA, Guzmán Cuárez NE. Relación entre niveles de proteína c-reactiva y síndrome de burnout en médicos de postgrado. MedUNAB. 2020;23(3): 423-433. doi: https://doi.org/10.29375/01237047.3870


Introdução. A Síndrome de Burnout afeta mais de 100 milhões de pessoas em todo o mundo, com uma prevalência de 47-76% em médicos residentes. O objetivo deste trabalho foi determinar a relação entre a síndrome de burnout e os níveis de proteína C-reativa ultrassensível em médicos residentes de um hospital universitário em Caracas, Venezuela. Metodologia. Trata-se de um estudo transversal e descritivo. O instrumento de coleta de dados, assim como o teste Maslach Burnout Inventory, foram enviados em formato eletrônico. Posteriormente, foram selecionadas duas subamostras, nas quais foi determinada a concentração de níveis de proteína C-reativa. Resultados. A amostra inicial foi de 174 residentes, dos quais 57 (32.8%) apresentaram Burnout. Os residentes positivos para a presença da síndrome apresentaram níveis mais elevados de níveis de proteína C-reativa (> 0.50mg/dl) (р = 0.001) em comparação com o grupo sem Burnout. Da mesma forma, residentes do sexo feminino (р = 0.046), aqueles que dormiam menos de 8 horas por dia (р = 0.032) e aqueles que foram submetidos a estresse familiar (р = 0.036) apresentaram uma associação estatisticamente significativa para o desenvolvimento da síndrome de burnou. Por fim, evidenciou-se que os residentes mais jovens apresentaram escores mais elevados na subescala de despersonalização (p = 0.036). Discussão. O estresse crônico (incluindo a síndrome de burnout) pode ativar continuamente os eixos fisiológicos dos estressores (hipotálamo-hipófise-suprarrenal e simpático-adrenal), levando à produção de citocinas e proteínas de fase aguda (como níveis de proteína C-reativa), promovendo um estado pró-inflamatório no indivíduo e o desenvolvimento de patologias crônicas. Conclusão. A síndrome de burnout e as variáveis sociodemográficas/laborais representam uma condição de estresse crônico que podem estar associadas entre si e levar ao desenvolvimento de diferentes doenças a longo prazo. Cómo citar. González-Moret YA, Guzmán Cuárez NE. Relación entre niveles de proteína c-reactiva y síndrome de burnout en médicos de postgrado. MedUNAB. 2020;23(3): 423-433. doi: https://doi.org/10.29375/01237047.3870


Subject(s)
Burnout, Professional , Acute-Phase Proteins , Cytokines , Depersonalization , Academic Medical Centers
17.
Article in Spanish | LILACS-Express | LILACS, SaludCR | ID: biblio-1389047

ABSTRACT

Resumen Español: El objetivo general de esta investigación consistió en estimar la prevalencia y los patrones de consumo de alcohol en universitarios de licenciatura de medicina de la UNIBE entre febrero-marzo 2015. La población en estudio correspondió con 231 estudiantes de licenciatura matriculados en la carrera de medicina en el periodo de febrero a marzo del año 2015 en la Universidad Iberoamericana (UNIBE). Para este cálculo se consideró un intervalo de confianza del 95%, una prevalencia esperada del 20% y nivel alfa del 5 %. La estimación de la muestra fue de n= 120 individuos. La selección se hizo por muestreo sistemático. Con el presente trabajo se logró estimar la prevalencia del consumo de alcohol en estudiantes de licenciatura UNIBE, que corresponde con un 68.9%. De acuerdo con los resultados del presente estudio es posible afirmar que la prevalencia de consumo de alcohol es alta en la población universitaria estudiada. Además se halló que los patrones de consumo que tienen los estudiantes incluyen: 1) frecuencia de consumo corresponde con menos de 1 vez al mes, 2) la edad de inicio más frecuente corresponde con 18 años o incluso menos, 3) ocasiones de consumo la principal razón corresponde con momentos especiales y 4) bebida más consumida corresponde con la cerveza y no existen diferencias significativas entre sexos. Dentro de los desafíos futuros que nacen a partir de este estudio se encuentran: la búsqueda de intervenciones destinadas a disminuir la dependencia alcohólica y potenciar el consumo de alcohol responsable, en estudiantes de medicina.


Inglés The main objective of this investigation was to estimate the prevalence and consumption pattterns of alcohol in bachelor´s students of medicine at UNIBE between the months of January and March 2015. The population consisted of 231 bachelor students enrolled in the career of medicine between February and March at Iberoamerican University (UNIBE). For this calculation a confidence interval of 95% and an estimated prevalence of 20% were used, with an alpha level of 5%. The estimation of the sample was n= 120 individuals. The selection was made with systematic sampling. With this investigation it was possible to estimate the prevalence of alcohol consumption in the population of bachelor medical students at UNIBE, which corresponds with 68.9%, which show that the alcohol prevalence is high in this population. Also it was found that the consumption patterns of alcohol among students include:1) frequency of consumption at least once a month, 2) the age of onset which was more frequent was 18 years or less, 3) the main reason of consumption was special occasions, and 4) the beverage mostly consumed corresponds with beer and there were no significant differences between sexes. Within the future challeges that come out of this investigation is the search of interventions destined to reduce the alcoholic dependence and potentiate the responsible consumption of alcohol amongst medical students.


Subject(s)
Humans , Male , Female , Adult , Alcohol Drinking/epidemiology , Academic Medical Centers , Costa Rica , Medicine
18.
Rev. invest. clín ; 71(4): 265-274, Jul.-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1289695

ABSTRACT

Abstract Background There is no specific antiviral treatment for parvovirus B19 (PVB19) infection. Objective The objective of this study was to study the treatment and outcome of PVB19 infection in kidney transplant recipients (KTR) at our institution, and cases published in the medical literature. Methods We conducted a retrospective review of PVB19 infection in KTR at an academic medical center over a 16-year period and summarized the data on its treatment and outcome in 120 KTR in the medical literature. Results In our cohort of eight patients, the median time to the onset of PVB19 disease was 7.2 weeks after transplantation. All patients had severe aregenerative anemia (mean hemoglobin (Hb) of 6.2 ± 1.0 g/dl); all were treated with a reduction in their immunosuppressive regimen and the administration of single-dose intravenous immunoglobulin (IVIG) (mean total dosage of 0.87 ± 0.38 g/kg). The median time to anemia improvement (Hb >10 g/dl) was 3-week post-treatment. No recurrences were documented during follow-up (median 25 months). Among 128 patients (including our cohort of 8 and 120 reported in literature), therapeutic strategies included: 43% IVIG alone, 39% IVIG and reduced immunosuppression, 9% reduction of immunosuppression, and 9% conservative therapy. Clinical relapses were observed in 35% of 71 reported cases. Conclusions In KTR, decreasing immunosuppression and the administration of low-dose immunoglobulin seem to be not worse than the standard dose in PVB19 infection.


Subject(s)
Humans , Male , Female , Young Adult , Kidney Transplantation/methods , Immunoglobulins, Intravenous/administration & dosage , Erythema Infectiosum/therapy , Immunosuppressive Agents/administration & dosage , Recurrence , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Erythema Infectiosum/etiology , Academic Medical Centers
19.
Yonsei Medical Journal ; : 223-229, 2019.
Article in English | WPRIM | ID: wpr-742515

ABSTRACT

PURPOSE: To investigate the overall cancer risk and risk for specific cancers in rheumatoid arthritis (RA) patients in Korea by comparing cancer incidence between RA patients and the general population. MATERIALS AND METHODS: Individuals diagnosed with RA between 1996 and 2009 who underwent treatment at the Daegu Catholic University Medical Center were retrospectively examined. 1885 patients with RA were included in the analyses. Occurrence of cancer and death during follow up was ascertained by linking medical records to the Korean Central Cancer Registry and national death certificates. For comparing cancer incidence between RA patients and general population, standardized incidence ratios (SIR) were calculated. The 95% confidence intervals (CIs) of SIRs were calculated using the shortcut method introduced by Vandenbroucke. RESULTS: The total follow-up time was 10218.9 person-years. During follow up, 100 patients (31 men and 69 women) were diagnosed with cancer. Both men and women had greater risks of having malignancy, although cancer risk was greater in men. Men showed increased risks of lung cancer (SIR=5.46, 95% CI: 2.60–9.36) and leukemia (SIR=16.7, 95% CI: 1.58–47.9). Women showed increased risks of thyroid cancer (SIR=1.75, 95% CI: 1.02–2.68), cervical cancer (SIR=3.65, 95% CI: 1.65–6.42), non-Hodgkin's lymphoma (SIR=6.47, 95% CI: 2.04–13.4), and gallbladder cancer (SIR=3.87, 95% CI: 1.01–8.60). Disease-modifying anti-rheumatic drugs usage and cancer were not related: the relative risks of developing malignancy were not elevated for each medicine. CONCLUSION: The overall cancer incidence was increased in Korean men and women with RA. Increased risk of specific malignancy differed according to sex.


Subject(s)
Academic Medical Centers , Antirheumatic Agents , Arthritis, Rheumatoid , Death Certificates , Female , Follow-Up Studies , Gallbladder Neoplasms , Humans , Incidence , Korea , Leukemia , Lung Neoplasms , Lymphoma, Non-Hodgkin , Male , Medical Records , Methods , Retrospective Studies , Thyroid Neoplasms , Uterine Cervical Neoplasms
20.
Article in English | WPRIM | ID: wpr-742146

ABSTRACT

BACKGROUND/AIMS: Surgical resection or ablation is recommended for the treatment of early hepatocellular carcinoma (HCC), whereas transarterial chemoembolization (TACE) is frequently used in early HCC ineligible for curative resection. We evaluated the clinical effects and safety of radiofrequency ablation (RFA) shortly after TACE in patients with Barcelona clinic liver cancer (BCLC) stage A HCC. METHODS: Sixty-seven BCLC stage A HCC patients who failed to achieve complete response to TACE as either a first line treatment and who subsequently received RFA at the Konkuk University Medical Center from January 2005 to December 2017 were included. Evaluation indices included treatment response, overall survival rate, recurrence-free survival, prognostic factors, and procedure-related complications. RESULTS: Median follow-up was 46.9 months. Fifty-four (80.6%) patients were of Child-Pugh class A, and 13 (19.4%) were of class B. Modified UICC stages were I in 10 (14.9%), II in 46 (68.7%), and III in 11 (16.4%) patients. In the 67 study subjects, cumulative recurrence-free survival rates were 86.8%, 55.9% and 29.7% at 1, 3, and 5 years, respectively, and overall survival rates were 100%, 93.4%, and 83.5% at 1, 3, and 5 years, respectively. Tumor size significantly predicted recurrence. No treatment-related death occurred. CONCLUSIONS: Combination of RFA was an efficient and safe treatment for BCLC stage A HCC patients that failed to achieve complete response to initial TACE. We suggest TACE plus RFA be considered as a curative option for early HCC patients ineligible for curative resection of RFA.


Subject(s)
Academic Medical Centers , Carcinoma, Hepatocellular , Catheter Ablation , Follow-Up Studies , Humans , Liver Neoplasms , Liver , Recurrence , Survival Rate , Treatment Outcome
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