Taxa de infecção (tuberculose) em pacientes particulares brasileiros com DII: acompanhamento de 15 anos / Rate of infection (tuberculosis) in brazilians ibd private patients: follow-up 15 years

ABSTRACT Background: Latent tuberculosis (LTB) is a condition where the patient is infected with Mycobacterium tuberculosis but does not develop active TB. There's a possibility of tuberculosis (TB) activation following the introduction of anti-TNFs. Objective: To assess the risk of biological therapy inducing LTB during inflammatory bowel diseases (IBD) treatment over 15 years in a high-risk area in Brazil. Methods: A retrospective study of an IBD patients' database was carried out in a private reference clinic in Brazil. All patients underwent TST testing and chest X-ray prior to treatment, and once a year after starting it. Patients were classified according to the Montreal stratification and risk factors were considered for developing TB. Results: Among the analyzed factors, age and gender were risk factors for LTB. DC (B2 and P) and UC (E2) patients showed a higher number of LTB cases with statistical significance, what was also observed for adalimumab and infliximab users, compared to other medications, and time of exposure to them favored it significantly. Other factors such as enclosed working environment have been reported as risk. Conclusion: The risk of biological therapy causing LTB is real, so patients with IBD should be continually monitored. This study reveals that the longer the exposure to anti-TNFs, the greater the risk.

RESUMO Contexto: A tuberculose latente (TBL) é uma condição em que o paciente está infectado com Mycobacterium tuberculosis, mas não desenvolve tuberculose (TB) ativa. Existe a possibilidade de ativação da TB após a introdução de anti-TNFs. Objetivo: Avaliar o risco da terapia biológica induzindo TBL durante o tratamento de doenças inflamatórias intestinais (DII) ao longo de 15 anos em uma área de alto risco no Brasil. Métodos: Foi realizado um estudo retrospectivo de um banco de dados de pacientes com DII em uma clínica privada de referência no Brasil. Todos os pacientes foram submetidos a teste de TST e radiografia de tórax antes do tratamento e uma vez por ano após seu início. Os pacientes foram classificados de acordo com a estratificação de Montreal e foram considerados fatores de risco para o desenvolvimento de TB. Resultados: Entre os fatores analisados, a idade e o sexo foram fatores de risco para TBL. Os pacientes com doença de Crohn' (B2 e P) e colite ulcerativa (E2) apresentaram maior número de casos de TBL com significância estatística, o que também foi observado para usuários de adalimumab e infliximab, em comparação com outros medicamentos, e o tempo de exposição a eles favoreceu significativamente. Outros fatores, como ambiente de trabalho fechado, foram relatados como riscos. Conclusão: O risco da terapia biológica causar TBL é real, por isso os pacientes com DII devem ser monitorados continuamente. Este estudo revela que quanto maior a exposição aos anti-TNFs, maior o risco.

Estimation of Staute from Toe Lengths: An Evaluation of the Hausa Population in Nigeria Using Linear Modeling.

Background: Statue determination has remained a basic requirement in determining human identity and ethnicity. Usually in situations when whole anatomical structures are unavailable, forensic expert would be expected to rely on smaller structures such as the phalanges, patella ribs and other fragmentary bones. Aim: The present study evaluates toe anthropometry and its usability as predictors of the stature of the Hausa ethnic group in Nigeria. Methods: Six hundred and sixty four (664) subjects comprising of equal percentage of adult males and females were included in the study group. Toe lengths of both feet (coded as big toe or first toe [1T] to the fifth toes [5T]) were measured using a digital Vernier calliper with accuracy of 0.01mm while stature was taken using a stadiometer with accuracy of 0.1m. SPSS (IBM®) t-test was to evaluate gender difference in the measured dimensions; while SPSS and XLSTAT (2015) Automatic & Generalized Linear Modelling were used to determine the predictability of stature from the toe lengths. The significance level was set at 95% as P≤0.05 was considered significant. Results: The automatic (multiple) regression analysis showed that the males displayed significantly higher mean values than the females for all measured parameters (P<0.001). The general population regression formulae were derived and only three (3) variables (R2T, R5T and L3T) significant contributors to the models for stature prediction for the general Gp (R2=0.385, F[3, 660]=137.68, P<0.001) and female F (R2=0.137, F[3, 328]=17.367, P<0.001) population, while only the L.1T could predict male M stature (R2=0.139, F[1, 330] = 54.489, P<0.001). Single regression gender-specific formulae were derived for the measurements that provided significant R2 values. Conclusion: This study suggested that estimation of a stature of Hausa ethnic group could be made possible by using specific toe measurements. However, lengths of toe may not be so reliable in the estimation of stature, but could be used for sex discrimination in forensic investigation.

Estimation of staute from toe lengths: an evaluation of the Hausa population in Nigeria using linear modeling

Background: Statue determination has remained a basic requirement in determining human identity and ethnicity. Usually in situations when whole anatomical structures are unavailable, forensic expert would be expected to rely on smaller structures such as the phalanges, patella ribs and other fragmentary bones. Aim: The present study evaluates toe anthropometry and its usability as predictors of the stature of the Hausa ethnic group in Nigeria. Methods: Six hundred and sixty four (664) subjects comprising of equal percentage of adult males and females were included in the study group. Toe lengths of both feet (coded as big toe or first toe [1T] to the fifth toes [5T]) were measured using a digital Vernier calliper with accuracy of 0.01mm while stature was taken using a stadiometer with accuracy of 0.1m. SPSS (IBM®) t-test was to evaluate gender difference in the measured dimensions; while SPSS and XLSTAT (2015) Automatic & Generalized Linear Modelling were used to determine the predictability of stature from the toe lengths. The significance level was set at 95% as P ≤ 0.05 was considered significant. Results: The automatic (multiple) regression analysis showed that the males displayed significantly higher mean values than the females for all measured parameters (P<0.001). The general population regression formulae were derived and only three (3) variables (R2T, R5T and L3T) significant contributors to the models for stature prediction for the general Gp (R2=0.385, F[3, 660]=137.68, P<0.001) and female F (R2=0.137, F[3, 328]=17.367, P<0.001) population, while only the L.1T could predict male M stature (R2=0.139, F[1, 330] = 54.489, P<0.001). Single regression gender-specific formulae were derived for the measurements that provided significant R2 values. Conclusion: This study suggested that estimation of a stature of Hausa ethnic group could be made possible by using specific toe measurements. However, lengths of toe may not be so reliable in the estimation of stature, but could be used for sex discrimination in forensic investigation

Macrometric and micrometric study of sexual dimorphism in foramina of middle crania fossa of adult Nigerians / Estudio macrométrico y micrométrico del dimorfismo sexual en foramina de la fosa craneal media en nigerianos adultos

We have measured the longitudinal, transverse diameters of optic canal, foramen rotundum, foramen ovale, foramen spinosum, to serve as a handy guideline to surgeons, to enhance the accuracy of sexing the cranium for anthropometric/medico-legal studies and for comparative analyses of values of the Nigerian population with those of the Caucasians. A total of 100 adult dry skulls 81 male, 19 female from departments of Anatomy of some Nigerian Universities were used. Automatic vernier caliper with a precision of 0.1mm was used. Data analysis was performed with Graph Pad Prism 3.0. A comparison was made of the means of the dimension using Student's T-test and analysis of variance. Sizes of foramina were not significantly different from that of Caucasians Our results show significant sexual dimorphism in the following parameters, the right transverse diameter of the FR in males was found to be significantly different from the females at p<0.05, there was a significant difference between the means of the left and right sides of the foramen ovale. The distance between right ovale and spinosum in males and females was found to be significantly different in both sexes. The effect of side on longitudinal diameter of foramen ovale FO of males showed a significant difference between the means of the left and right sides of the foramen ovale. A comparism of the distance between left optical canal and foramen rotundum showed a significant difference between the values obtained for males and the females at p< 0.05.

Hemos medido el diámetro longitudinal y transversal del canal óptico, agujero redondo, el agujero oval, agujero espinoso, para que sirva como una guía útil para los cirujanos, para mejorar la exactitud de la determinación del sexo del cráneo para estudios antropométricos y médico-legales y para realizar análisis comparativos de valores de la población de Nigeria con los de la raza blanca. Fueron utilizados 100 cráneos adultos secos 81 cráneos masculinos, 19 femeninos de los departamentos de Anatomía de algunas Universidades de Nigeri. Se utilizó un calibrador vernier automático con una precisión de 0,1 mm. Los datos fueron analizados con el gráfico Pad Prism 3.0. Se realizó una comparación de los medios de la dimensión utilizando T de Student y el análisis de la varianza. Los tamaños de los agujeros no fueron significativamente diferentes de la de los caucásicos. Nuestros resultados muestran dimorfismo sexual significativo en los siguientes parámetros, el diámetro transversal del derecho de FR en los hombres resultó ser significativamente diferentes de las hembras con una p <0,05, hubo una diferencia significativa entre las medias de los lados izquierdo y derecho del foramen oval. La distancia entre la derecha y oval espinoso en hombres y mujeres resultó ser significativamente diferente en ambos sexos. El efecto de lado en el diámetro longitudinal del foramen oval DE de los hombres mostraron una diferencia significativa entre las medias de los lados izquierdo y derecho del foramen oval. Una comparación de la distancia entre el canal izquierdo y agujero redondo óptica mostró una diferencia significativa entre los valores obtenidos para los machos y las hembras de p <0,05.

Model Stature Estimation Formula for Adult Male Nigerians based on Metacarpal Bone Length

Background: Stature prediction formulas provide a method of preliminary identification of dead individuals from their skeletal remains. No such formula has been reported for indigenous Nigerian populations. Materials and Method: Twenty-five adult male cadavers with Nigerian identities were used to evaluate the relationship between stature and the length of the second and third metacarpal bones of both hands. Measurement of crown-heel length of each of the 25 cadavers in supine position was made and recorded in centimetres to the nearest 0.5cm as stature. Stature was adjusted for cadaver length by subtracting 2cm from each cadaver length. The second and third metacarpal bones were harvested from both hands of each cadaver. The midline length of each metacarpal bone was measured with a Helios dial calliper and recorded to the nearest tenth of a millimetre. Correlation and regression analysis were applied to determine the relationships. Results: Best association was noted with the right third metacarpal bone length (r2 = 0.502 P0.001) and the equation that best predicted stature was a quadratic equation based on the length of this bone.Conclusion: A model stature prediction formula is hereby presented for validation in indigenous adult male Nigerians. This formula would be very useful in forensic research

Haematological reference values for healthy adults in Port Harcourt; Nigeria

Background: Published reports of the basic haematological parameters of apparently healthy subjects in Port Harcourt; Nigeria are relatively scanty. This has resulted in an apparent unavailability of laboratory reference values for haematological parameters for the population. Aim: To determine the reference values of some basic haematological parameters in apparently healthy adult subjects in Port Harcourt; Nigeria. Methods: Two hundred and fifty apparently healthy adults consisting of 150 males and 100 females; aged between 15 and 55 years; residing in Port Harcourt were randomly selected via a cross sectional prospective study. The following haematological parameters were determined by the indicated methods: haematocrit (Hct) was determined using Hawksley micro-capillary centrifugation; haemoglobin concentration (Hbc) was determined using the cyanmethaemoglobin method; red blood cell count and white blood cell count were both determined manually using the improved Neubauer counting chamber; mean corpuscular volume (MCV); mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were calculated from the appropriate haematological parameters; erythrocyte sedimentation rate (ESR) was determined using the Westergren method. Results: The reference values; modes and ranges of all haematological parameters determined are presented. The mean values of haematocrit; haemoglobin concentration; red blood cell count; white blood cell count; mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) were found to be significantly higher in male subjects; while the mean values of mean corpuscular haemoglobin concentration (MCHC) and ESR were found to be significantly higher in female subjects (p 0.05). Conclusion: The present study reports reference values of basic haematological parameters for healthy adult residents of Port Harcourt; Nigeria. Significant gender variations possibly exist in the basic haematological parameters of the population under investigation

Atlanto-occipital gap in Nigerians: Its relationship to difficult intubation

Background: Half of persons living with HIV/AIDS are below 25 years and majority of the remaining are believed to have been infected in their youth. The impact of HIV on young people has continued to generate increasing global medical; social; economic; political and academic interests. Aim: This paper reviews the pattern of existing documentation on HIV/AIDS regarding young people in Nigeria in presentations on this subject at international meetings and conferences. Methods: The review relied on a bibliography of 364 presentations from 17 books of abstracts and several solicited submissions; spanning 18 years; collated; indexed and published by the Nigerian Institute of Medical Research and the National Action Committee on AIDS. A matrix was constructed to categorize and tally the abstracts by several technical themes against the characteristics of the young people; aged 10 to 24 years that they reported on. Results: Eighty-five (23.5) out of the 364 were articles on adolescent/youths; the 18-year period; giving a rate of 4.7 articles per year. Regarding the context; 67 (78.8) concerned adolescents/ youths of both sexes. About half (47 or 55.3) were conducted among schooling adolescents/youths; and 23 (27.1) involved out-of-school youths. Twenty-three (27.1) titles were socio-medical research exploring knowledge; attitude; behaviour and practice; while three (3.5) were studies of biomedical nature; involving serologic investigations. Reports of interventions accounted for over half (47 or 55.3) of the presentations; most of which were on HIV awareness and prevention programmes. Conclusion: A low rate of reports on HIV/AIDS specific to young people at international conferences was observed; which does not reflect the level of importance and impact of the infection on this group of individuals. Amongst them; socio-medical studies; and interventions featuring awareness and prevention among schooling youths predominate. Interventions involving testing; treatment and care; and bio-medical studies especially involving vulnerable non-schooling youths; remain a challenge that must be faced

Haemorheological parameters of umbilical cord blood of Nigerian newborns: correlation with maternal parameters

Background: Published reports of haemorheological values of umbilical cord blood in Nigerian newborns are relatively scanty. The present study therefore aimed to determine the values of some basic haemorheological parameters in the umbilical cord blood of Nigerian neonates and in the venous blood of their respective mothers. The study also aimed to determine if any significant differences or correlations exist in these haemorheological parameters between maternal and umbilical cord blood. Design: Cross sectional prospective study involving 60 subjects consisting of 30 newborn neonates and their respective mothers. Methods: The values of haematocrit; erythrocyte sedimentation rate; haemoglobin concentration; red blood cell count; white blood cell count; whole blood relative viscosity; relative plasma viscosity; fibrinogen concentration; mean corpuscular volume; mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration were determined in the umbilical cord blood of Nigeria neonates and in the respective mothers at the time of birth. Results: Significantly higher values of haematocrit; haemoglobin concentration; red blood cell count; whole blood relative viscosity and relative plasma viscosity and significantly lower values of erythrocyte sedimentation rates were found in umbilical cord blood compared to maternal blood (p0.05). Significant positive correlations were found only in the values of erythrocyte sedimentation rate (ESR); haemoglobin concentration; white blood cell count; whole blood relative viscosity and relative plasma viscosity between maternal and umbilical cord blood (p0.05). Both mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration showed a negative but non-significant correlation between maternal and umbilical cord blood (p0.05). Conclusion: The present study reports values of basic haemorheological parameters in maternal and umbilical cord blood of newborn Nigerian neonates and reports significant differences and correlations in these parameters between the two groups. This we hope would provide information on umbilical cord haemorheology for Nigerian neonatologist since up to the present time similar studies have been scanty

Facial; nasal; maxillary; mandibular; and oro-facial heights of adult Nigerians

Objective: The present study determined the normal mean values of facial; nasal; maxillary; mandibular and oro-facial heights in adult Nigerians. Methods: A total of 200 subjects consisting of 110 males and 90 females randomly selected from the student population of the University of Port Harcourt; Nigeria and whose ages ranged from 18 years to 42 years were recruited into the study. Each perameter was measured several times with a vernier sliding caliper until three consistent values were obtained. Results: The results obtained indicate a sexual dimorphism; with a significantly higher value of all the perameters in males compared to females (p0.05). Conclusion: The mean values of these perameters for Nigerians reported in the present study will provide baseline data for anthropologists; functional orthodontics; cosmetic plastic surgeons; and the otolaryngologist in Nigeria