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1.
West Afr J Med ; 39(1): 39-44, 2022 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-35157404

RESUMO

BACKGROUND: The study evaluated the effect of multiple blood transfusions on the prevalence of iron load and its effects on organ functions in patients with sickle cell anaemia (SCA). METHODOLOGY: Sixty-seven multiply transfused SCA subjects and 58 non-multiply transfused SCA controls were investigated. Serum ferritin, insulin, growth hormone (GH), thyroid stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4) were measured by the ELISA method while plasma alanine transaminase (ALT) was measured spectrophotometrically. RESULTS: The median serum ferritin level was 364.97 (142.5-579.3) ng/ml and that of ALT was 12.20 (7.4-16.7) IU/l in the subjects and were significantly higher compared with 115.31 (81.3-285.6) ng/ml and 7.74(5.9-9.9) IU/l obtained in the controls (p <0.001 in each case). TSH was significantly lower 1.45 (0.4-2.9) µIU/ml in subjects compared with 2.12 (0.7-3.6) µIU/ml obtained in the controls (p = 0.034). The mean values for T4 in the subjects was 10.19 ± 1.5 µg/dl and was significantly higher compared with that of the controls of 9.57 ± 1.5 µg/dl (p = 0.026). However, there were no significant differences in the mean values of T3, GH and Insulin between the cases and the controls. There was a strong correlation between serum ferritin level and the number of units of blood transfused in the subjects (r = 0.575, p < 0.001). CONCLUSION: The study found high serum ferritin level in multiply transfused SCA patients and which also correlated with the number of blood units transfused.


CONTEXTE: L'étude a évalué l'effet des transfusions sanguines multiples sur la prévalence de la charge ferreuse et sur les fonctions fonctions organiques chez les patients atteints d'anémie falciforme (ACS). MÉTHODOLOGIE: Soixante-sept sujets atteints d'anémie falciforme transfusés à plusieurs reprises et 58 témoins SCA non multitransfusés ont été étudiés. Le serum ferritine, de l'insuline, de l'hormone de croissance (GH), de la thyréostimuline (TSH), la triiodothyronine (T3) et la thyroxine (T4) ont été mesurées par la méthode ELISA, tandis que l'alanine transaminase (ALT) du plasma a été mesurée par spectrophotométrie. RÉSULTATS: Le taux médian de ferritine sérique était de 364,97 (142,5-579,3) ng/ml et celui de l'ALT était de 12,20 (7,4-16,7) UI/l chez les sujets et étaient significativement plus élevés par rapport aux 115,31% (81,3-285,6) ng/ml et 7,74(5,9-9,9) UI/l obtenus chez les témoins (p <0,001 dans chaque cas). La TSH était significativement plus basse : 1,45 (0,4-2,9) µUI/ml chez les sujets par rapport aux 2,12 (0,7-3,6) µUI/ml obtenus chez les témoins (p = 0,034). Les valeurs moyennes de la T4 chez les sujets étaient de 10,19 ± 1,5 µg/ dl et était significativement plus élevée comparée à celle des contrôles de 9,57 ± 1,5 µg/dl (p = 0,026). Cependant, il n'y avait pas de différences significatives différences significatives dans les valeurs moyennes de T3, GH et Insuline entre les cas et les témoins. Il y avait une forte corrélation entre le taux de ferritine sérique ferritine et le nombre d'unités de sang transfusées chez les sujets (r = 0,575, r = 0,575). (r = 0,575, p < 0,001). CONCLUSION: L'étude a révélé un taux de ferritine sérique élevé chez patients atteints de SCA ayant reçu des transfusions multiples et qui était également en corrélation avec le nombre d'unités de sang transfusées. MOTS CLÉS: Anémie drépanocytaire, Transfusion sanguine multiple, Sérum transferrine, surcharge en fer, dysfonctionnement des organs.


Assuntos
Anemia Falciforme , Sobrecarga de Ferro , Transfusão de Sangue , Ferritinas , Humanos , Fígado
2.
Artigo em Inglês | MEDLINE | ID: mdl-34430871

RESUMO

BACKGROUND: Post-tuberculosis (TB) lung disease is a recognised cause of chronic respiratory disease, and its impact on health-related quality of life (HRQoL) has not been extensively described. OBJECTIVES: To describe the clinical profile, spirometry impairment and impact of post-TB lung disease on HRQoL among patients attending two tertiary hospitals in Lagos, Nigeria. METHODS: We conducted a cross-sectional study and obtained data through interviews, chart reviews and physical examination. We measured dyspnoea severity using the Medical Research Council (MRC) scale, HRQoL with the St George's respiratory questionnaire (SGRQ) and performed spirometry. Univariate regression was used to explore the associations between selected variables and HRQoL. RESULTS: A total of 59 participants were recruited and their median (interquartile range (IQR)) age was 45 (36 - 60) years. The most frequent symptom was cough (93.2%; n=55) and sputum production (91.5%; n=54). Less than two-thirds of the participants (62.4%; n=38) had received treatment for TB on more than one occasion, 50.8% (n=30) had moderate to very severe dyspnoea on the MRC scale and 88.7% (n=47/53) had abnormal spirometry with the mixed pattern predominating in 56.6% (n=30) of the participants. The mean (standard deviation (SD)) SGRQ component score for symptoms was 43.89 (18.66), followed by activity (42.50 (22.68)), impact (29.41 (17.82)) and total components (35.78 (17.25)). Dyspnoea, cough, sputum production and weight loss were associated with worsened HRQoL. CONCLUSION: Post-TB lung disease was characterised by a high symptom burden, severe spirometry impairment and poor HRQoL. There is a need for increased recognition and development of guidelines for diagnosis and treatment of post-TB lung disease and for further studies to explore preventive strategies.

3.
West Afr J Med ; 36(2): 116-121, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385596

RESUMO

BACKGROUND: Hand hygiene (HH) practices are emphasized as the single most important way of reducing HealthCare-Associated Infection (HCAIs). This study was done to assess the compliance with hand hygiene and knowledge about standard HH practices by health care workers as well as to assess the availability of HH materials in the largest tertiary Hospital in Nigeria. METHODS: A cross-sectional, observational study involving consecutive observations during routine patient care in various units of the University College Hospital (UCH), Ibadan; using a checklist and compliance forms adapted from the WHO guidelines was done. HH knowledge scores were categorized as < 4 = poor, 4-6=fair and >7 = good. RESULTS: A total of 559 HH opportunities were identified and overall compliance was 30.4% (170/ 559). Compliance differed by units: Neonatology SCBU (68.2%), Intensive Care Unit (41.8%), Obstetrics & Gynaecology (39.4%), Adult emergency (26.7%), Children emergency (24.6%), Medicine (22.4%), Surgery (14.9%) and Paediatrics (12.8%). Nurses were more likely to practice hand hygiene (33.2%) compared to doctors (29.0%) [c2 = 33.270, CI= 95%, P<0.001]. Female HCWs had higher hand hygiene compliance (30.6% vs. 25.4%) [c2= 2.129, CI= 95%, P= 0.345]. Soap and water were employed more (95.5%) compared to alcohol-based hand rub (4.5%). Only 12.1% had good HH knowledge scores (>7). CONCLUSION: Poor HH compliance is observed at the facility and is attributable to inadequate education, poor knowledge of standard HH practices and unavailability of HH materials in most of the units. A multidimensional approach is advocated to tackle these issues.


Assuntos
Infecção Hospitalar , Fidelidade a Diretrizes , Higiene das Mãos , Adulto , Criança , Estudos Transversais , Feminino , Pessoal de Saúde , Humanos , Nigéria , Centros de Atenção Terciária/normas
4.
Niger J Clin Pract ; 22(5): 692-700, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31089025

RESUMO

BACKGROUND AND OBJECTIVE: Doctors' knowledge contributes to practice and quality of care rendered to patients. To assess the knowledge and practice assessment and self reported barriers to guideline-based management among doctors. SUBJECTS AND METHODS: This was a cross-sectional study among doctors from various part of the country attending a continuing medical education (CME) program in Lagos, Nigeria. We used a self-administered, pretested, semistructured, validated questionnaire based on the Global Initiative for Asthma (GINA) guideline. RESULTS: Of the 98 participants, 41 (42%) and 18 (18.4%) had good level of asthma knowledge and practice, respectively. There was no relationship between level of knowledge and practice and the level of knowledge was not associated with the practice (X2 = 6.56, P = 0.16). The most reported barriers to good guideline-based practice were the unavailability of diagnostic and treatment facilities (44.3%), poor medication adherence (25.7%), and high cost of asthma medications (18.6%). CONCLUSION: The level of asthma knowledge and practice, respectively, among doctors in Nigeria is low and there is no relationship between level of knowledge and practice. Unavailability of diagnostic and treatment facilities, poor medication adherence, and high cost of medications are important barriers to good practice. There is a need to improve asthma education among doctors in Nigeria. Addressing barriers to good practice is essential for the translation of knowledge into practice.


Assuntos
Asma/tratamento farmacológico , Competência Clínica , Fidelidade a Diretrizes , Conhecimentos, Atitudes e Prática em Saúde , Médicos/normas , Adulto , Idoso , Estudos Transversais , Custos de Medicamentos , Feminino , Instalações de Saúde/provisão & distribuição , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Nigéria , Guias de Prática Clínica como Assunto , Autorrelato , Inquéritos e Questionários , Adulto Jovem
5.
Int J Tuberc Lung Dis ; 23(4): 474-481, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31064627

RESUMO

SETTING Nigeria is a high tuberculosis (TB) burden country. However, there is limited evidence on implementation of tuberculous infection prevention and control (TBIC) practices in Nigeria. OBJECTIVE To assess TBIC practices, and barriers to their implementation, in TB-DOTS centres in Lagos State, Nigeria. DESIGN A descriptive cross-sectional study was used to assess 112 TB-DOTS centres in primary and secondary health facilities in Lagos State using mixed methods. Quantitative data comprised a survey and measurement of the air exchange rate in a subsample of centres. The qualitative aspect comprised focus-group discussions to highlight health care workers' (HCWs') perceptions of TBIC guidelines and barriers to their implementation. RESULTS The majority of the DOTS centres had a dedicated TBIC officer, while a fifth (21%) had documented TBIC plans. About 57% of DOTS centres had staff that had been trained on TBIC and 37% provided some form of personal respiratory protection (face masks/tissue papers) for staff or patients. The air exchange rate was adequate in 21% of centres. The HCWs' perception of being at risk of contracting TB was reported to affect the way they relate to TB patients. The key barrier to implementing TBIC was the design of DOTS centres. CONCLUSION TBIC measures at study centres were inadequate. Institutional commitment, renovation of existing and appropriate design of new DOTS centres in the future to improve TBIC implementation is recommended. .


Assuntos
Antituberculosos/administração & dosagem , Terapia Diretamente Observada , Pessoal de Saúde/estatística & dados numéricos , Tuberculose/prevenção & controle , Atitude do Pessoal de Saúde , Estudos Transversais , Grupos Focais , Humanos , Nigéria , Inquéritos e Questionários
6.
Artigo em Inglês | MEDLINE | ID: mdl-34541499

RESUMO

BACKGROUND: Asthma is a common chronic illness affecting young people. Asthma management at schools may be influenced by teachers' knowledge of the condition and the availability of treatment facilities. OBJECTIVES: To assess the knowledge of secondary school teachers in Lagos, Nigeria, regarding asthma and to evaluate management options available at schools. METHODS: A descriptive cross-sectional study was conducted. Schools were selected by proportional sampling of the educational districts, followed by stratified single-stage cluster sampling. All consenting teachers in the 54 selected schools were recruited. A self-administered questionnaire was used for data collection. A composite score was calculated, with 32 as the maximum possible. Knowledge was regarded as poor if scores were <16, fair for scores between 16 and 21, and good if scores were ≥22. RESULTS: Results show that 475 (48.1%) of the respondents had poor knowledge, 414 (41.9%) had fair knowledge, and only 99 (10%) had good knowledge. Better knowledge about asthma was associated with personal experience (χ² =16.466; p=0.001) or history of a family member with the condition (χ² =6.412; p=0.04). Of the 54 schools surveyed, only 9 (16%) had a school clinic, while a school nurse was available at only 4 (7.41%) of the schools. None of the schools had access to a nebuliser in case of an asthma emergency. CONCLUSION: Teachers in secondary schools in Lagos have unsatisfactory knowledge about asthma and are not equipped to support affected students during an asthma episode.

7.
BMC Infect Dis ; 16: 126, 2016 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-26980191

RESUMO

BACKGROUND: Tuberculosis infection among health care workers is capable of worsening the existing health human resource problems of low--and middle-income countries. Tuberculosis infection control is often weakly implemented in these parts of the world therefore, understanding the reasons for poor implementation of tuberculosis infection control guidelines are important. This study was aimed at assessing tuberculosis infection control practices and barriers to its implementation in Ikeja, Nigeria. METHODS: A cross-sectional study in 20 tuberculosis care facilities (16 public and 4 private) in Ikeja, Lagos was conducted. The study included a facility survey to assess the availability of tuberculosis infection control guidelines, the adequacy of facilities to prevent transmission of tuberculosis and observations of practices to assess the implementation of tuberculosis infection control guidelines. Four focus group discussions were carried out to highlight HCWs' perceptions on tuberculosis infection control guidelines and barriers to its implementation. RESULTS: The observational study showed that none of the clinics had a tuberculosis infection control plan. No clinic was consistently screening patients for cough. Twelve facilities (60%) consistently provided masks to patients who were coughing. Ventilation in the waiting areas was assessed to be adequate in 60% of the clinics while four clinics (20%) possessed N-95 respirators. Findings from the focus group discussions showed weak managerial support, poor funding, under-staffing, lack of space and not wanting to be seen as stigmatizing against tuberculosis patients as barriers that hindered the implementation of TB infection control measures. CONCLUSION: Tuberculosis infection control measures were not adequately implemented in health facilities in Ikeja, Nigeria. A multi-pronged approach is required to address the identified barriers to the implementation of tuberculosis infection control guidelines.


Assuntos
Instalações de Saúde/estatística & dados numéricos , Tuberculose Pulmonar/prevenção & controle , Estudos Transversais , Humanos , Controle de Infecções , Governo Local , Nigéria/epidemiologia , Avaliação de Resultados em Cuidados de Saúde , Fatores de Risco , Inquéritos e Questionários , Tuberculose Pulmonar/epidemiologia
8.
Niger J Clin Pract ; 19(2): 233-6, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26856287

RESUMO

BACKGROUND: Video-assisted thoracic surgery (VATS) is well established. Its application in Nigeria has however been limited and not been reported. The aim of this study was to describe our institutional experience and challenges with VATS. MATERIALS AND METHODS: This was a retrospective cross-sectional study of all patients that underwent VATS in our institution between March 2008 and June 2013. Data were extracted from a prospectively maintained database. RESULTS: Two hundred and sixty-one patients were assessed as potential VATS cases. VATS was initiated in 26 patients, but completed in 25 patients (9.6%) as there was one case of conversion of a planned VATS bullectomy due to the failure of one lung ventilation. There were 12 males and 13 females. Mean age was 40.7 ± 13.9 years. The indication was interstitial lung disease in 9 patients (36%), malignant pleural effusion in 6 patients (24%), spontaneous pneumothorax in 5 patients (20%), indeterminate pulmonary nodule in 2 patients (8%), pleural endometriosis in 2 patients (8%) and bronchogenic cyst in one patient (4%). Procedures performed were lung biopsy in 13 patients (52%), pleural biopsy and pleurodesis in 6 patients (24%), bullectomy and pleurodesis in 5 patients (20%) and excision of bronchogenic cyst in one patient (4%). Mean hospital stay was 4 ± 0.7 days. There were no complications and no mortalities. CONCLUSION: VATS is being performed in our institution with successful outcomes. The use of VATS in Nigeria is encouraged. The relatively high cost of VATS is, however, a major limitation to more widespread use.


Assuntos
Pneumopatias/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Adulto , Idoso , Estudos Transversais , Feminino , Hospitais de Ensino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Nigéria , Ventilação Monopulmonar , Pleurodese/métodos , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
10.
J Prev Med Hyg ; 55(2): 42-5, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25916018

RESUMO

INTRODUCTION: Nigeria is a country saddled with a high tuberculosis (TB) and human immunodeficiency virus (HIV) burden but the possible combination of these communicable diseases with diabetes mellitus (DM) has been overlooked. We undertook to determine the burden of HIV and DM in persons with TB by documenting the prevalence rates of these disorders. METHODS: This is a cross-sectional Study that was conducted within 54TB/DOT centers in Lagos State. A total of 3,376 persons with TB who were on antiTB drugs were screened for HIV and DM using standardized tests. Statistical analysis was performed using Students t test and chi square. RESULTS: The frequency of occurrence of DM in TB and that of HIV in TB were comparable (4.8% Vs 3.5%). The Study subjects with DM were older, had higher waist circumference measurements and had higher proportions of hypertension compared to the subjects without DM. The combination of HIV and DM in TB was found in (0.3%). We also noted that DM in TB and HIV in TB occurred more frequently in the third and fourth decades of life. CONCLUSION: This study demonstrated the potential co existence of HIV, DM and Tuberculosis. It is therefore important that these two diseases are sought for in patients with TB considering the changing epidemiology of these diseases particularly in developing countries like Nigeria.


Assuntos
Coinfecção/epidemiologia , Diabetes Mellitus/epidemiologia , Infecções por HIV/epidemiologia , Tuberculose Pulmonar/epidemiologia , Adulto , Fatores Etários , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Nigéria/epidemiologia , Tuberculose/epidemiologia , Circunferência da Cintura , Adulto Jovem
11.
Afr J Med Med Sci ; 42(1): 33-8, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23909092

RESUMO

BACKGROUND: Asthma and obesity have considerable impact on public health. There is increase prevalence of both conditions worldwide. This study was undertaken to determine the prevalence of obesity among asthma patients as well as determine the effect of body mass index (BMI) on asthma severity and pulmonary functions. METHODS: The study was conducted at the asthma clinic of the medical outpatient of Lagos State University Teaching Hospital, Ikeja. Ethical clearance was obtained from the hospital's research and ethics committee. Non probability sampling method was used with consecutive asthma patients diagnosed by the respiratory physicians according to NHLBI guideline recruited into the study. The weight, height and pulmonary function tests were carried out using standard methods. Acarefully designed interviewer administered questionnaire were used to collect information on the socio demographic characteristics of the patient, asthma symptoms, control use of rescue medications and emergency visits. RESULTS: One hundred and fifty eight (158) asthma patients participated in the study. There were 63 (39.9%) males and 95 (60.1%) females. The prevalence of obesity was 53.8%. The mean age of respondents was 46.48 +/- 17.16 years. Age, educational level and employment status were related to the body mass index while gender and duration of asthma were not. There was no difference in the severity of asthma and utilization of emergency services across the BMI categories. The obese asthmatics generally recorded lower lung function volumes compared with the non-obese asthmatic groups. CONCLUSION: Prevalence of obesity is high among the asthmatics studied. There is no difference in asthma severity across the BMI categories. Pulmonary functions are lower in obese asthmatics.


Assuntos
Asma/epidemiologia , Índice de Massa Corporal , Obesidade/epidemiologia , Adulto , Análise de Variância , Asma/fisiopatologia , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Obesidade/fisiopatologia , Prevalência , Índice de Gravidade de Doença , Inquéritos e Questionários
12.
Nig Q J Hosp Med ; 22(4): 282-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-24568065

RESUMO

BACKGROUND: Kidney transplantation is a popular modality of RRT in the developed world. OBJECTIVE: To assess the willingness of the general population of Nigerians across the country to donate a kidney METHODS: This is a multiregional, cross sectional, questionnaire based study. One thousand Three hundred respondents participated in the study. This study was carried out in four major Towns and cities across Nigeria between January 2009 and December 2010. The locations are Birnin Kebbi in the north, Ilorin in the middle belt, Iddo Ekiti in the south and Lagos, the economic capital of Nigeria. The respondents were randomly selected within the four localities. Those below the age of 16 or above the age of 65 years were excluded from the study RESULTS: There were 727 (55.9%) males. The mean age (S.D) of respondents was 39.5 (10.7) years. The largest population of participants, 494 (38.3%) were non health workers and 692 (53.2%) of them were Muslims. Eight hundred and fifty eight (66%) of the participants were willing to donate a kidney. Twenty five percent (25% were not willing and 115 (8.9%) were not sure. Majority of those who were unwilling to donate a kidney, 325 (99.4%) will not change their minds even if they were to be given incentives CONCLUSION: Nigerians are willing to donate a kidney irrespective of geographical location, religion or gender and many are willing to do so altruistically.


Assuntos
Transplante de Rim/psicologia , Doadores Vivos/psicologia , Obtenção de Tecidos e Órgãos , Adolescente , Adulto , Fatores Etários , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Características de Residência , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
13.
Afr. j. respir. Med ; 8(1): 15-17, 2012. ilus
Artigo em Inglês | AIM (África) | ID: biblio-1257929

RESUMO

Spirometry is a non-invasive tool of importance in respiratory medicine. There is an enormous burden ofpulmonary disease worldwide, including in Nigeria.This retrospective study was done to determine the utilisation of spirometry services in the Lagos StateUniversity Teaching Hospital (LASUTH). It determined the sources of referral, indications, and pattern of pulmonary abnormalities.This is a retrospective study. An audit was done on the data collected at the Pulmonary Function Laboratory of the LASUTH between September 2006 and October 2011. Spirometry was done using the Gold Standard Vitalograph spirometer. The demographic characteristics of the patients who had spirometry as well as FEV1, (forced expiratory volume in 1 second)FVC (forced vital capacity), and their predicted values were noted.A total of 849 patients had spirometry done over the 5-year period. Slightly more than half were male patients. The mean age of the patient was 50±19 years. There was a steady increase in the number of spirometry tests performed from 2006 reaching a peak in 2009. Thereafter, a sharp decline was seen in 2010 with a steady rise in the first 10 months of 2011.The most common indication for spirometry was in the evaluation and assessment of asthma in 487 patients (57%). Most of the referrals for spirometry were from the medical department of the hospital representing 532 (63%) patients; 202 (24%) of the request were from the general out-patient department by family physicians, while 115 (13%) came from the surgical department. The outcome of the ventilatory abnormalities showed that 372 (44%) had normal ventilatory indices, 206 (24%) had obstructive patterns,169 (20%) had mixed type, while restrictive patterns were seen in 102 (12%).We concluded that although spirometry is frequently used in our clinical practice, this can be improved upon


Assuntos
Hospitais , Medicina , Nigéria , Espirometria , Ensino
15.
West Afr J Med ; 27(3): 155-9, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19256320

RESUMO

BACKGROUND: There are several internationally accepted guidelines for the management of asthma. OBJECTIVE: To examine the utilization of these guidelines in the management of asthmatics as well as the use of inhaler devices among the asthmatics presenting for specialist assessment and treatment in Lagos, Nigeria. METHODS: One hundred and six consecutive patients with physician-diagnosed asthma referred on account of poor control for specialist review participated in the study between April 2006 and March 2007. The setting was the Chest Clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos. The patients aged between 13 and 64 years were interviewed about asthma control using previous hospitalization, frequency of night-time symptoms, and frequency of attendance at The Emergency Unit. Their knowledge of medications was assessed. Inhaler techniques were directly observed. RESULTS: Fifty two (49.1%) had previous hospitalization for asthma. Fifty (47.2%) had weekly nighttime symptoms. Forty-eight (45.3%) had exacerbations requiring treatment at the emergency room in the week preceeding the interview. The metered dose inhaler was the commonest drug delivery device, in use by 72 (67.9%) of the patients. Thirty-two (30.2%) used diskus. Only 10 (10.6%) used nebulisers at any point. The inhaler technique was rated as good by thirty-four (47.2%) out of the seventy-two respondents and poor by thirty-eight (52.8%). Only thirty-four satisfactorily performed all steps. One hundred respondents (943%) skipped their medications. Majority of the asthmatics did not receive any health education about their condition. Possession of peak flow meter and use were low among the patients with only 22 (20.8%) having one. CONCLUSION: Asthma control is poor among the patients in Lagos, Nigeria. Poor knowledge of disease, medication use and inhaler techniques contribute significantly to this problem.


Assuntos
Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Broncodilatadores/uso terapêutico , Fidelidade a Diretrizes , Padrões de Prática Médica/estatística & dados numéricos , Administração por Inalação , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nebulizadores e Vaporizadores , Nigéria , Cooperação do Paciente , Educação de Pacientes como Assunto , Inquéritos e Questionários
16.
J Invertebr Pathol ; 75(3): 218-25, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10753598

RESUMO

When parasitized by the Ichneumonid parasitoid Campoletis sonorensis, larvae of the Noctuid moth, Heliothis virescens, are unable to mount an effective immune response against parasitoid eggs. Defensive melanization of plasma and cellular encapsulation of parasite eggs are dramatically inhibited by infection with the symbiotic immunosuppressive C. sonorensis ichnovirus (CsIV). This study demonstrates that the CsIV-mediated inhibition of melanization is associated with reduction in the enzymatic activity and protein titer of key enzymes in the melanization pathway, phenoloxidase, dopachrome isomerase, and DOPA decarboxylase. Inhibition of the synthesis of key melanization enzymes leads to reductions in the melanization substrates l-dihydroxyphenylalanine, N-acetyldopamine, and N-beta-alanyl dopamine from millimolar to nanomolar levels in parasitized larvae. By contrast, concentration of a precursor catecholamine, dopamine, rises fourfold in these larvae. Thus in CsIV-infected larvae, enzymatic deficiencies in the melanization pathway lead to reduced concentrations of specific enzyme substrates, causing failure of melanization in parasitized insects.


Assuntos
Mariposas/enzimologia , Mariposas/parasitologia , Vespas/fisiologia , Animais , Arilamina N-Acetiltransferase/metabolismo , Catecol Oxidase/metabolismo , Catecolaminas/análise , Dopa Descarboxilase/metabolismo , Precursores Enzimáticos/metabolismo , Interações Hospedeiro-Parasita , Oxirredutases Intramoleculares/metabolismo
17.
Exp Appl Acarol ; 20(7): 369-80, 1996 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-8771770

RESUMO

The effects of different temperatures and relative humidities (RHs) were tested on various reproductive parameters of Ornithodoros turicata, an argasid tick that inhabits gopher tortoise burrows in Florida, USA. The pre-oviposition, oviposition and incubation periods of the ticks decreased as temperature increased. These periods were also affected by the RH. The number of eggs oviposited was affected significantly by the combined effect of temperature and RH. Fewer eggs were laid by ticks in the 24 degrees C regimes and the 27 degrees C/95% RH regime compared to those in the other temperature/RH groups. There was an inverse relationship between the number of eggs oviposited and the percentage of hatched larvae that was correlated with the temperature and RH. Ticks reared at 27 degrees C/90% RH and 30 degrees C/90% RH laid more eggs than those reared in the other combinations of temperature and humidity but fewer larvae hatched from these eggs. The reproductive fitness index (RFI) values were highest in females held in the 24 degrees C groups and the 30 degrees C/95% RH group, although significantly more larvae hatched at the lower temperatures. The optimum reproductive conditions for O. turicata under laboratory conditions appear to be 24 degrees C and 90-95% RH. While mating occurred at all temperatures, none of the females laid eggs at 22 degrees C. The ticks may move preferentially to low temperatures when not feeding to remain above the critical equilibrium humidity and/or below the critical metabolic level necessary for prolonged survival. However, most female ticks oviposited after 45 days when moved to 27 degrees C/95% RH. Ornithodoros turicata females may have a limited capability to delay oviposition until an optimal microenvironment for egg deposition can be located in the burrow.


Assuntos
Carrapatos/fisiologia , Animais , Ecologia , Feminino , Umidade , Oviposição , Óvulo/fisiologia , Reprodução , Comportamento Sexual Animal , Temperatura
18.
Int J Parasitol ; 26(6): 629-35, 1996 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8875308

RESUMO

The effects of photoperiod on the feeding, development and quiescent behavior of the burrow-dwelling soft tick, Ornithodoros turicata (Dugès) were investigated. Ticks were assigned randomly to either continuous darkness (DD), a short-day photoperiod (L:D 10:14), a long-day photoperiod (L:D 14:10) or constant light (LL). Ticks reared under constant light succumbed to much higher mortality than those reared under the other conditions. However, photoperiod did not induce quiescent behavior in O. turicata; the ticks were active and fed regularly throughout the study. Also, ticks reared in continuous darkness developed more slowly than those reared under short-day or long-day conditions. In contrast, pre-oviposition period was significantly longer for ticks reared in long-day conditions. Egg-hatch success was significantly higher for ticks reared in continuous darkness than for those reared under the photoperiods. The stage-specific effects of photoperiod on O. turicata are adaptive; these ticks very likely utilize photoperiod information to predict seasonal conditions.


Assuntos
Carrapatos/crescimento & desenvolvimento , Carrapatos/efeitos da radiação , Animais , Escuridão , Comportamento Alimentar/efeitos da radiação , Feminino , Luz , Oviposição/efeitos da radiação , Fotoperíodo , Tartarugas/parasitologia , Aumento de Peso/efeitos da radiação
19.
Exp Appl Acarol ; 19(2): 103-15, 1995 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-7656729

RESUMO

The rate of oxygen consumption was investigated in fed larval, nymphal and adult Ornithodoros turicata ticks and in starved nymphal and adult ticks. Oxygen consumption rate of fed adult ticks increased with increasing temperature. The metabolic rate of adult ticks was affected by starvation whereby starved adult ticks showed a significantly lower oxygen consumption than their fed counterparts. The oxygen consumption rate of fed female ticks was significantly higher than that of fed males but, there was no significant difference between the oxygen consumption rates of starved female versus starved male ticks. Oxygen consumption of fed larvae was significantly greater than those of fed first through third instar nymphs. Fed and starved nymphal ticks as well as fed adult ticks ventilated continuously. In contrast, starved adults ventilated discontinuously. The ability to reduce metabolic rate, plus the capability to ventilate discontinuously allow O. turicata adults to cope with prolonged starvation.


Assuntos
Carrapatos/metabolismo , Animais , Feminino , Masculino , Consumo de Oxigênio/fisiologia , Temperatura
20.
J Food Prot ; 56(10): 868-873, 1993 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31113158

RESUMO

The application of ultraviolet light (UV-C, 254 nm) hormesis on fruits and vegetables to stimulate beneficial responses is a new method for controlling storage rots and extending the shelf-life of fruits and vegetables. The present study was aimed at treating tomatoes ( Lycopersicon esculentum ) with different UV-C dosages (1.3 to 40 KJ/m2) to induce resistance to black mold ( Alternaria alternata ), gray mold ( Botrytis cinerea ), and Rhizopus soft rot ( Rhizopus stolonifer ). These diseases were effectively reduced when tomatoes were inoculated following UV-C irradiation. UV-C treated tomatoes were firmer in texture and less red in color than the control tomatoes, indicating a delay in ripening. Slower ripening and resistance to storage rots of tomatoes are probably related. The positive effect of UV-C on tomatoes decreased as treatments were performed at stages of increased ripeness.

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