BRAFV600E mutation as a predictor of thyroid malignancy in indeterminate nodules: A systematic review and meta-analysis.

BACKGROUND: Thyroid nodules are usually diagnosed using fine-needle aspiration (FNA). The sensitivity limitations of FNA result in 10-30% of nodules being classified as "indeterminate". The BRAFV600E mutation is associated with papillary thyroid carcinoma (PTC). We conducted a systemic review and meta-analysis to evaluate the diagnostic utility of the BRAFV600E mutation in indeterminate nodules. METHOD: PUBMED and EMBASE were searched for studies testing for the BRAFV600E involving indeterminate nodules (Thy3a, Thy3f, Thy4) and containing information on final surgical histopathology. Thirty two studies involving 3150 indeterminate nodules were included in the analysis. RESULTS: The overall sensitivity and specificity for BRAFV600E for the diagnosis of thyroid malignancy was 0.40 (95% CI: 0.32-0.48) and 1.00 (95% CI: 0.98-1.00) respectively. The diagnostic odds ratio (DOR) was 205.4 (95% CI: 40.1-1052). With a Fagan plot, the post-test probability of thyroid cancer, given a negative mutation was 6%, but this rose to 92% with a positive result. On subgroup analysis, for Thy3a nodules, the pooled sensitivity and specificity for thyroid malignancy was 0.21 (95% CI: 0.13-0.34) and 1.00 (95% CI: 0.98-1.00). For Thy3f nodules, the pooled sensitivity and specificity was 0.09 (95% CI: 0.03-0.20) and 1.00 (95% CI: 0.05-1.00) respectively. For Thy4 nodules, the corresponding sensitivity and specificity was 0.58 (95% CI: 0.5-0.64) and 0.99 (95% CI: 0.95-1.00) respectively. CONCLUSIONS: Despite a high specificity for thyroid cancer, BRAFV600E mutation has a low overall sensitivity and therefore has a limited diagnostic value as a single screening test.

Physical activity profile of senior civil servants in Lagos, Nigeria: need for effective strategies for improvement.

AIMS AND OBJECTIVES: To investigate the profile of physical activity (PA) among Lagos State senior civil servants (LSCSs). SUBJECTS AND METHODS: A cross-sectional survey in which 305 LSCSs (163 men, 142 women) with age range 25 65 years, in five ministries of the LSCS was carried out in May of 2011. The Global Physical Activity Questionnaire (GPAQ) was used to assess respondents' PA at work, for transport, and during leisure time during the last 7 days. RESULTS: Overall, 56.7% of the respondents (58.3% men and 54.9% women) were active; equivalent to 43.3% inactive respondents (41.7% men and 54.9% women). In spite of the high prevalence of physical inactivity in the women, gender was not significantly associated with PA levels (p = 0.718). However, the educational status and cadre of respondents were significantly associated with PA levels (p < 0.05). CONCLUSION: The findings of this study showed that close to half of LSCSs were physically inactive. There was no significant difference between the PA levels of men and women but educational status and cadre were associated with the PA levels of respondents. The results provided by this study suggests the need for the Lagos State government and stakeholders to formulate polices, plan programmes and interventions for LSCSs to get more physically active.

Physical activity level, nutritional intake, functional status and quality of life of geriatric individuals in Lagos, South-West, Nigeria: a cross sectional survey.

BACKGROUND: Participation in physical activity (PA) and healthy nutrition are important factors that affects muscle and bone strength and the resultant functioning in the activities of daily living (ADL) skills including the overall quality of life (QoL) of geriatric individuals. However, the relationships between all these parameters are yet to be fully documented and studies from developing countries are lacking. OBJECTIVE: This study was designed to investigate the relationships between PA level, frequency of nutritional intake of food rich in calcium, magnesium, phosphorus, vitamin D and the basic ADL, instrumental ADL and QoL of geriatric individuals in Lagos, Nigeria. METHODS: A cross-sectional study involving 394 geriatric individuals. A combination of standardized questionnaires which assessed the socio-demographic parameters, PA level, frequency of intake of food rich in calcium, magnesium, phosphorus, vitamin D, ADL skills, and QoL of the geriatric individuals was used. Data was analyzed using descriptive statistics and Pearson's chi-square. RESULTS: The highest proportion (35.5%) of participating geriatric individuals was at the active PA level. PA level was statistically associated with QoL, basic and instrumental ADL, (X2 = 199.57, p = 0.001; X2 = 87.07, p = 0.000; and X2 = 164.53, p = 0.001 respectively). There was also an association between frequency of intake of food rich in calcium, magnesium, phosphorus, vitamin D and the basic ADL (X2 = 97.43, p = 0.001), instrumental ADL (X2 = 151.56, p = 0.001) and QoL (X2 = 250.21, p = 0.001) of the studied geriatric individuals. CONCLUSION: The study demonstrated that an increase in PA level and regular intake of food rich in calcium, magnesium, phosphorus, vitamin D were associated with optimal functional status and better QoL in geriatric individuals. Educational programmes on the importance of participation in regular PA and healthy nutrition are imperative and recommended for geriatric individuals.

Congenital amputation involving the hands and feet: a case report.

BACKGROUND: Congenital amputation of the limbs is not uncommon. However, it is very rare when this involves both the upper and lower limbs. METHOD: This is a case report of a child who presented with congenital amputation involving both the upper and lower limbs. RESULTS: The patient was a 10-day-old baby girl that was delivered by a 21-year-old woman. She is the first and only child of the woman, whose pregnancy was uneventful and was carried to term. There is no family history of congenital anomalies. The findings on examination were: amputation of the index, middle and ring fingers at the level of metacarpophalangeal joints on both hands and a partial amputation (at the level of the middle phalanx) of the left little finger. There were forefoot amputations on both lower limbs. Scars were noticed over the amputation stumps with no associated congenital anomaly. CONCLUSION: Congenital amputation involving all limbs as an isolated entity is a rare condition; the cause of which is probably as a result of congenital amniotic bands.

Additive effects of ciprofloxacin on the in-vitro activity of chloroquine against a clinical isolate of Plasmodium falciparum.

As chloroquine and ciprofloxacin each possess substantial inhibitory activity against the schizonts of Plasmodium falciparum, it seems possible that a combination of the two drugs may be clinically useful. The effects on the erythrocytic stages of P. falciparum of combined treatment with chloroquine and ciprofloxacin were therefore evaluated in vitro, using the World Health Organization's standardized micro test. When used alone, the median inhibitory concentration (IC(50)) of chloroquine against the schizonts in the assay mixtures was found to be 7.75 microg/ml, whereas the corresponding value for ciprofloxacin was markedly lower, at 3.35 microg/ml. When they were used together, however, there was marked and statistically significant mutual enhancement of schizont inhibition by the two drugs, indicating that a chloroquine-ciprofloxacin combination may be useful clinically, in the treatment and management of P. falciparum malaria.