Pancreatic pseudocysts. Report of 13 cases at the Central University Hospital at Lome-Tokoin]

A prospective study done over a period of ten years in which a 13 dossiers of patients with pseudopancreatic cysts due to complication of acute pancreatitis, chronic pancreatitis and one pancreatic traumatism were collected. They were 12 male, one female with age incidence between 14 years and 60 years with an average age of 37 years. Twelve cases were confirmed by abdominal echography one case was diagnosed by indirect signs of oesophago-gastroduodenal transit. There were 4 cases of pseudocysts, 8 cases of retention cysts and one case post traumatic pseudocyst. Eleven patients were operated, 7 cases by cystojejunostomies on Y shape technique, one case with external drainage, and one case by pancreatectomy of the tail.     

Modulation of irinotecan with cyclosporine: a phase II trial in advanced colorectal cancer

Introduction: Despite the extensive clinical experience with irinotecan, significant concerns remain regarding its toxicity. In a phase I trial, we modulated irinotecan pharmacokinetics by inhibiting biliary excretion of SN-38, the active metabolite of irinotecan, using cyclosporine. The modulation appeared to decrease the gastrointestinal toxicity of irinotecan and suggested that irinotecan activity might also be retained. Hence, we conducted this phase II trial in patients with colorectal cancer (CRC) to further evaluate the toxicity and activity of irinotecan modulated with cyclosporine. Patients and Methods: Sixteen patients with 5-fluorouracil refractory CRC were treated. Cyclosporine (5 mg/kg) was administered as a 6-h infusion and irinotecan (60 mg/m²/day, 90-min infusion) was started 3 h after initiation of the Cyclosporine. Both agents were given weekly for 4 weeks, every 6 weeks. Responses were assessed every 12 weeks, and toxicity was monitored weekly. Results: Sixteen patients were evaluable for toxicity and 11 for response. There was 1 partial response (6%). Five patients had SD lasting a median of 12 weeks. Grade 3/4 diarrhea was observed in only 13% of the patients. Conclusion: Pharmacokinetic modulation of irinotecan using parenteral cyclosporine appears to decrease the incidence of diarrhea in CRC patients. Given the modest activity of irinotecan monotherapy, a larger study would be required to assess if the modulation improves the toxicity without compromising this activity. The available clinical data suggest that pharmacokinetic modulation of irinotecan should be evaluated further to define its optimal clinical utility.Two of the co-authors: Edem Agamah (owns shares of Pfizer) and Mark J. Ratain [Co-inventor on several patents (pending/issued) related to the modulation or irinotecan and/or its Pharmacogenetics] would like to declare their potential conflicts of interest.     

Feeding of red palm oil-supplemented diets to rats may impact positively on vitamin A status

The impact of feeding of dietary palm oil supplements on plasma vitamin A profile was investigated in animals. Four-week-old Wistar albino rats (n = 8 per group) were maintained for 28 days on standard rat food (4.7% fat by weight) supplemented (10%, 20% and 30% by weight) with red palm oil (RPO) and refined palm olein (REFPO). Plasma beta-carotene and vitamin A concentrations of rats fed RPO-based diets were higher than in rats fed REFPO and control diets. Animals fed 30% RPO-containing diets had lower plasma beta-carotene concentrations than those fed 20% RPO-containing diets. The results suggest that consumption of palm oil in moderate amounts enhances growth of tissues and bioavailability of beta-carotene, which may combat vitamin A deficiency in developing countries, in view of the fact that performed vitamin A in animal products (namely meat, liver, eggs and fatty fish) is out of the reach of economically deprived people.     

The effect of height on family income

The effect of height on earnings of adult males sampled in the second National Health and Nutrition Examination Survey, 1976–1980, was examined. Data were collected using the multistage probability sampling method. Information was available on medical history, physical examination, anthropometric dimensions, diet, and sociodemographic characteristics. Complete information was available on 4,563 males, aged 20–65 years. The correlation between family income and height was low (r = 0.13, P = 0.001). There was a secular trend for increasing mean height over time, so that younger individuals were taller than older ones even after correction for the decrease in stature caused by aging. After stratifying by age and race, education and marital status, but not height, were significantly associated with total family income. The weight-height ratio was significantly related to income of Whites but not of nonwhites. White males in the highest income category were significantly taller, heavier, more adipose, had higher levels of education, and were more often married than were their lowest income white counterparts. Among nonwhites, marital status and education alone differentiated highest from lowest income nonwhite males. Thus, at least for White males, appearance, that is, adiposity, together with education and marital status, are major factors relating to income.     

The impact of an intervention to change health workers' HIV/AIDS attitudes and knowledge in Nigeria: a controlled trial

The aim of the study was to improve health workers' skills and confidence in dealing with patients with HIV disease and increase attention to patients' human rights. A longitudinal controlled trial was carried out in which one Nigerian state served as the intervention site and the adjacent state served as the control site for an intervention and dissemination of training in clinical management, health education, and attitudinal change toward patients with HIV disease. The intervention group n=1072, control group n=480.Following initial questionnaire-defining focus groups, nurses, laboratory technologists and physicians in all base hospitals in the intervention state were trained by influential role models who attended the initial training. Data were collected in all sites pre-training and 1 y later. Hierarchical multiple regression analysis controlling for baseline data, and orthogonal factor analysis to define scales were used. Data showed significant positive changes after 1 y in the intervention group on perception of population risk assessment, attitudes and beliefs about people with HIV disease, less fear and more sympathy for and responsibility toward HIV patients, and an increase in self-perceived clinical skills. There was increased willingness to treat and teach colleagues about people with HIV. Clinician fear and discrimination were significantly reduced, and the climate of fear that was associated with HIV was replaced with a professional concern. There was increased understanding of appropriate psychosocial, clinical and human rights issues associated with HIV treatment and prevention. This intervention, targeting health workers in an entire state and using HIV/AIDS information, role modeling, diffusion of training and discussions of discrimination and human rights, significantly affected the perception of risk groups and behaviors, perceived skills in treatment and counseling, reduced fears and increased concern for people with HIV disease, and improved the climate of treatment and prevention of HIV disease compared with a control state.     

Newly diagnosed epileptic seizures: focus on an elderly population on the French island of Réunion in the Southern Indian Ocean

Purpose: To describe seizure types and risk factors among elderly people with newly diagnosed epileptic seizures living on La Réunion, a French Island in the Southern Indian Ocean. Methods: We describe an elderly population with newly diagnosed epileptic seizures using data from the EPIREUN study conducted between July 1, 2004 and June 30, 2005. The methodology is described in detail in the EPIREUN study report ( Mignard et al., 2009 ). Key Findings: There were 153 single unprovoked seizures (84.1%); their incidence was 278.1 [95% confidence interval (CI) 237.4–325.9] per 100,000. The incidence of newly diagnosed epilepsy was 125.4 (95% CI, 99.1–158.8) per 100,000. Twenty‐eight acute symptomatic seizures occurred (15.4%); the incidence was 50.9 (95% CI 35.1–73.7) per 100,000. The annual incidence of newly diagnosed epileptic seizure in the elderly was 330.8 (95% CI 286.1–382.6) per 100,000: 403.0 (95% CI 328.5–494.3) per 100,000 in men and 279.6 (95% CI, 227.4–343.8) per 100,000 in women. Sex had a significant (p = 0.014) effect on incidence: elderly men had a risk ratio of 1.44 compared to women of developing a newly diagnosed epileptic seizure. The etiology of single unprovoked seizure was as follows: stroke, 77 cases (50.3%); cryptogenic, 36 (23.5%); alcoholism, 10 (6.6%); a combination of several causes such as polypathology, 9 (5.9%); degenerative disease, 6 (4.0%); HIV infection, 2 (2.0%), and undetermined causes (2.7%). Most patients (170; 93.4%) were hospitalized, and 110 (60.8%) were treated. Among patients treated, 49 (44.5%) were given sodium valproate, 25 (22.7%) benzodiazepines, 12 (10.9%) phenytoin, 9 (8.2%) lamotrigine, 8 (7.3%) Trileptal, and 7 (6.4%) gabapentin. Significance: Our findings show that the incidences of newly diagnosed epileptic seizures and newly diagnosed epilepsy were high in the elderly population of La Réunion. These incidences were significantly higher in men than in women. These results may be attributable to the high incidence of cerebrovascular diseases and comorbidities in this population.     

The clinical benefit of medial support screws in locking plating of proximal humerus fractures: a prospective randomized study

Purpose  

The purpose of this study was to evaluate the clinical benefit of medial support screws for locking plating of proximal humerus fractures.     

Health outcomes following retirement: a comparative study of health and non-health pensioners in Ghana

Journal of Public Health - Occupation is a major determinant of health outcomes. Healthcare workers are assumed to know how to prevent diseases and live a healthy life. The aim of this study is to...