An opinion survey of caregivers concerning caring for the elderly in Ilorin metropolis, Nigeria

The aim of this study was to determine the opinions of caregivers towards caring for the elderly in Ilorin. The caring patterns and relationships that exist between the elderly and caregivers, caregivers' attitudes, and ways to improve care of the elderly were also examined. This cross-sectional study using structured questionnaires was conducted in seven of 11 wards within Ilorin metropolis over a 6-month period. Of the respondents, 44.4% were daughters, 18.3% were sons and only 1.4% were employees to the elderly. The majority (90.7%) of respondents chose home as the place of care, and only 9.3% opted for institutional care. The majority (98.1%) of caregivers had a positive attitude towards caring for the elderly. Religious teaching was an important influence on this positive attitude. The difference between respondents with and without formal education concerning where to care for the elderly was not statistically significant (P > 0.05).     

Nonpalpable breast lesions: accuracy of prebiopsy mammographic diagnosis

Mammograms of 220 patients who underwent spot localization for removal of nonpalpable breast lesions were reviewed for accuracy of interpretation. Results of subsequent biopsy indicated malignancy in 77 cases. The interpretations of mammograms obtained before biopsy were incorrect in 71 cases (27 false-negative and 44 false-positive studies). Among the false-negative cases, 70% of the abnormalities were determined histologically to be noninfiltrative cancers. An aggressive screening program with preoperative localization and biopsy is needed in questionable cases, since mammographic signs of early or nonpalpable malignancy are often subtle and nonspecific.     

Child-OIDP index in Brazil: Cross-cultural adaptation and validation

Background  

Oral health-related quality of life (OHRQoL) measures are being increasingly used to introduce dimensions excluded by normative measures. Consequently, there is a need for an index which evaluates children's OHRQoL validated for Brazilian population, useful for oral health needs assessments and for the evaluation of oral health programs, services and technologies. The aim of this study was to do a cross-cultural adaptation of the Child Oral Impacts on Daily Performances (Child-OIDP) index, and assess its reliability and validity for application among Brazilian children between the ages of eleven and fourteen.     

Palmar fasciitis with polyarthritis syndrome in a patient with breast cancer

Palmar fasciitis and polyarthritis syndrome (PFPAS) is a rare paraneoplastic syndrome often associated with ovarian and pancreatic cancers, and rarely lung and breast cancers. A 39-year-old patient with breast cancer underwent neoadjuvant chemotherapy, radical mastectomy, and radiation therapy. Subsequently, the patient developed PFPAS coinciding with progression of the breast cancer. The rheumatological symptoms were severe causing significant distress and handicap. The patient had a partial response to treatment with corticosteroids. A literature review of PFPAS and its relation to breast cancer is discussed.     

Feeling trapped and being torn: Physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience

Background  

This study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection.     

尼日利亚Gwagwalada原发性开角型青光眼患者的社会人口学和临床特征

目的：探讨比较尼日利亚Gwagwalada原发性开角型青光眼(POAG)与非青光眼患者的临床社会人口学特征。

方法：横断面对比研究。共调查235例成年患者,其中96例POAG及139例非青光眼。记录患者年龄、性别、教育程度、职业、种族、青光眼家族史、眼痒、糖尿病和高血压情况。眼部检查包括视力、中央视野、杯盘比、前房角评估和眼压。

结果：平均年龄为49.88±13.75岁,其中男114例(48.5%)。POAG患者包括42个种族,其中伊博人(24/96,25.0%)和约鲁巴人(20/96,20.8%)最为常见。大多数POAG(74/96,77.1%)年龄在40-69岁之间。POAG(73/96,76.0%)有不同程度的视力障碍。POAG组与非青光眼组的对比如下：青光眼阳性家族史(34/96,35.4%)vs(25/139,18.0%; P=0.012); 糖尿病史(8/96,8.3%)vs(6/139,4.3%); 高血压病史(24/96,25.0%)vs(28/139,20.1%); 糖尿病合并高血压病史(1/96,1.0%)vs(4/139,2.9%; P=0.268); 使用抗糖尿病药物者(5/96,5.2%)vs(7/139,5.0%); 使用降压药者(24/96,25.0%)vs(23/139,16.5%); 联合使用抗糖尿病和抗高血压药物者(4/96,4.2%)vs(5/139,3.6%; P=0.328); 有眼痒症状者(18/96,18.7%)vs(37/139,26.6%; P=0.328); 视力障碍\〖右眼(RE)：51/96,53.1%; 左眼(LE)：60/96,62.5%\〗vs(RE：40/139,28.7%; LE：37/139,26.6%; P=0.000); 垂直杯盘比>0.4(RE：96/96,100%; LE：96/96,100%)vs(RE：131/139,94.2%; LE：124/139,89.2%)(RE：P=0.307; LE：P=0.006); 眼压>22 mmHg(RE：17/96,17.7%; LE：22/96,22.9%)vs(RE：2/139,1.4%; LE：2/139,1.4%; P=0.006)。大多数POAG患者(60/96,62.5%)正在服用抗青光眼药物,(23/96,24.0%)尚未开始用药,P=0.000。许多POAG(32/96,33.3%)正在服用β受体阻滞剂、前列腺素抑制剂和碳酸酐酶抑制剂的联合抗青光眼药物。

结论：青光眼具有与其他眼部疾病不同的临床社会人口学特征。许多参与者肯定了青光眼的家族史,大多数青光眼参与者正在接受抗青光眼治疗。包括失明在内的视力障碍与青光眼显著相关。该研究证实,开角型青光眼与高杯盘比和高眼内压有关。