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Biomedical subjects

A Kane

Publications and source records attributed to A Kane.

At least 55 records · Page 3Linked to original sources
PubMed2000

[Chronic cor pulmonale: a study of 34 cases in the Dakar University Hospital Center Cardiology Department].

The authors report the results of a study on patients with chronic cor pulmonale hospitalized in the Departement of Cardiology (Dakar), from 1990 to 1998. The hospital prevalence is 0.9% with a male predominance (73.5%). The clinical signs were dominated by dyspnea and cough. The right heart failure is noted in 85.29% of cases. As far as the biological factor is concerned, it exists an polycythemia about 75% of cases, hypoxia (88.8%), hypercapnia (55.5%) and a respiratory acidoses (55.5%). The spirometry showed in 66% of cases, a mixed syndrom with obstructive predominance. The echocardiography showed in all cases right heart dilatation with pulmonary hypertension. The etiological factors are dominated by tobacco (21 cases). The hospital evolution has been favorable in 19 cases underoxygentherapy, lowdosediuretic, expectorant, bronchodilatators and salt restriction. However, 14 patients have died.

Academic Medical Centers↗
PubMed2000

[Peripartum heart failure: the underestimated role of frequent diseases in the Sudan-Sahelian area].

Peripartum cardiomyopathy is rare in developped countries, but still frequent in Africa. It is defined as a heart failure occurring during peripartum, without any underlying etiology. Authors present 3 cases showing that heart failure before or after delivery may be due to causes which are frequent in the Sahelian area but generally misdiagnosed. Anemia, hypertension and rheumatic fever were the causes of heart failure in these 3 patients, but they were not apparent when the initial diagnosis was made. These observations emphasize that, despite the complex hypothesis trying to explain heart failure during the peripartum period, one should think about some frequent causes which can be misdiagnosed because of the pregnant state or the heart failure itself.

Adult↗
PubMed2000

[Biventricular thrombus complicating peripartum cardiomyopathy. A case report].

The authors report a case of a biventricular thrombus complicating peripartum cardiomyopathy in a 38 years old female. The diagnosis was done by bidimensionnal transthoracic echocardiography which showed 2 thrombi in the apical region of the right ventricle and in the anterior and lateral wall of the left ventricle. With treatment associating salt restriction, diuretics and angiotensin-converting-enzyme- inhibitors, the evolution was good: the thrombi disappeared at the first month for the left ventricular thrombi and after 45 days for the rignt ventricular thrombi. The patient didn't experience any embolic complication.

Adult↗
PubMed1999

Direct versus indirect signs of traumatic aortic injury revealed by helical CT: performance characteristics and interobserver agreement.

OBJECTIVE: The purpose of this study was to evaluate the relative value of and interobserver agreement on direct versus indirect (hematoma) signs of traumatic aortic injury using helical CT. MATERIALS AND METHODS: From April 1994 through January 1997, 40 patients who were suspected to have traumatic aortic injury and who underwent contrast-enhanced helical CT had subsequent proof or exclusion of aortic injury. All available CT scans of these patients were combined with CT scans of 13 randomly chosen patients that had been initially interpreted as negative, and clinical follow-up showed no evidence of aortic injury. Two emergency radiologists and a nonemergency radiologist who were unaware of clinical outcome performed independent review of these cases to evaluate for mediastinal hematoma, periaortic hematoma, and direct signs of aortic injury. RESULTS: Direct signs of injury were seen on helical CT by both emergency radiologists in all 17 cases of aortic injury with no false-positive interpretations. The nonemergency radiologist failed to observe subtle direct signs in two cases of aortic injury, but patient management would not have been adversely affected. All observers had more false-negative interpretations for both mediastinal hematoma and periaortic hematoma than for direct signs. Interobserver agreement was higher for direct signs (kappa = .93) than for either mediastinal hematoma (kappa = .65) or periaortic hematoma (kappa = .71). CONCLUSION: In this study, helical CT revealed direct signs of traumatic aortic injury that were more accurate and more often observed than were indirect signs. Emphasis on direct signs should improve confidence in using helical CT to evaluate traumatic aortic injury.

Adolescent↗
PubMed1999

Unsafe injections in the developing world and transmission of bloodborne pathogens: a review.

Unsafe injections are suspected to occur routinely in developing countries. We carried out a literature review to quantify the prevalence of unsafe injections and to assess the disease burden of bloodborne infections attributable to this practice. Quantitative information on injection use and unsafe injections (defined as the reuse of syringe or needle between patients without sterilization) was obtained by reviewing the published literature and unpublished WHO reports. The transmissibility of hepatitis B and C viruses and human immunodeficiency virus (HIV) was estimated using data from studies of needle-stick injuries. Finally, all epidemiological studies that linked unsafe injections and bloodborne infections were evaluated to assess the attributable burden of bloodborne infections. It was estimated that each person in the developing world receives 1.5 injections per year on average. However, institutionalized children, and children and adults who are ill or hospitalized, including those infected with HIV, are often exposed to 10-100 times as many injections. An average of 95% of all injections are therapeutic, the majority of which were judged to be unnecessary. At least 50% of injections were unsafe in 14 of 19 countries (representing five developing world regions) for which data were available. Eighteen studies reported a convincing link between unsafe injections and the transmission of hepatitis B and C, HIV, Ebola and Lassa virus infections and malaria. Five studies attributed 20-80% of all new hepatitis B infections to unsafe injections, while three implicated unsafe injections as a major mode of transmission of hepatitis C. In conclusion, unsafe injections occur routinely in most developing world regions, implying a significant potential for the transmission of any bloodborne pathogen. Unsafe injections currently account for a significant proportion of all new hepatitis B and C infections. This situation needs to be addressed immediately, as a political and policy issue, with responsibilities clearly defined at the global, country and community levels.

Adult↗
PubMed1999

Transmission of hepatitis B, hepatitis C and human immunodeficiency viruses through unsafe injections in the developing world: model-based regional estimates.

Thousands of millions of injections are delivered every year in developing countries, many of them unsafe, and the transmission of certain bloodborne pathogens via this route is thought to be a major public health problem. In this article we report global and regional estimates of the number of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections that may occur from unsafe injections in the developing world. The estimates were determined using quantitative data on unsafe injection practices, transmission efficiency and disease burden of HBV, HCV and HIV and the prevalence of injection use obtained from a review of the literature. A simple mass-action model was used consisting of a generalized linear equation with variables accounting for the prevalence of a pathogen in a population, susceptibility of a population, transmission efficiency of the pathogen, proportion of injections that are unsafe, and the number of injections received. The model was applied to world census data to generate conservative estimates of incidence of transmission of bloodborne pathogens that may be attributable to unsafe injections. The model suggests that approximately 8-16 million HBV, 2.3-4.7 million HCV and 80,000-160,000 HIV infections may result every year from unsafe injections. The estimated range for HBV infections is in accordance with several epidemiological studies that attributed at least 20% of all new HBV infections to unsafe injections in developing countries. Our results suggest that unsafe injections may lead to a high number of infections with bloodborne pathogens. A major initiative is therefore needed to improve injection safety and decrease injection overuse in many countries.

Cross Infection↗
PubMed1998

Endocranial capacity in an early hominid cranium from Sterkfontein, South Africa.

Two- and three-dimensional computer imaging shows that endocranial capacity in an approximately 2.8- to 2.6-million-year-old early hominid cranium (Stw 505) from Sterkfontein, South Africa, tentatively assigned to Australopithecus africanus, is approximately 515 cubic centimeters. Although this is the largest endocranial capacity recorded for this species, it is still markedly less than anecdotal reports of endocranial capacity exceeding 600 cubic centimeters. No australopithecine has an endocranial capacity approaching, let alone exceeding, 600 cubic centimeters. Some currently accepted estimates of early hominid endocranial capacity may be inflated, suggesting that the tempo and mode of early hominid brain evolution may need reevaluation.

Animals↗
PubMed1998

[Cardiac thyrotoxicosis and left ventricular thrombosis, a case report].

Authors report about a left ventricular thrombus as a complication of thyrotoxic heart disease, on a 45 years old woman. Clinical state featured signs of thyrotoxicosis, global cardiac failure and hypertension. The electrocardiogram showed a left axis deviation, the chest X-ray a cardiac enlargement (cardio-thoracic index = 0.55) on behalf of left movement of heart walls and severe left ventricule dysfunction (Ejection fraction about 18%). This exam also found a big thrombus at he left ventricule apex. The treatment disappearance of the thrombosis and improvement of cardiac failure signs and echographic parameters. Authors discuss circumstances leading to thrombosis in thyrotoxic heart disease, and the usefulness of anticoagulant drug therapy.

Echocardiography↗
PubMed1998

[Short- and medium-term results of cavo-pulmonary anastomosis].

UNLABELLED: The authors report the medium term results of total cavo-pulmonary connections in 50 patients treated between 1988 and 1997. POPULATION: the cardiac lesions were single ventricle (n = 27), tricuspid atresia (n = 11), mitral atresia (n = 2), pulmonary atresia with intact septum (n = 2) or more complex lesions (n = 8). The mean age at surgery was 75 +/- 6 months. There were no operative deaths but two early reoperations were required. After surgery, oxygen saturation increased from 76 to 91% (p = 0.001). Early complications included: 11 mild cardiac failures, 19 pericordial or pleural effusions and 6 supraventricular arrhythmias. At medium term (average follow-up of 59 months), there were no fatalities and all were in NYHA Classes I and II. Cyanosis was observed in 12 patients: right-to-left atrial shunt (n = 7), 2 of which were closed percutaneously, shunt from the azygos system to the suprahepatic veins in 5 cases with Kawashima, 2 of which were reoperated, pulmonary arterio-venous fistula (n = 3). Six patients had arrhythmias and 3 had regressive thromboses. At the end of follow-up, 8 patients remained cyanotic, 4 had antiarrhythmic therapy and 2 had mild ventricular dysfunction. In conclusion, the results of total cavo-pulmonary connections are satisfactory at short and medium term and may be proposed for patients with complex univentricular cardiac malformations.

Aged↗
PubMed1998

[Left ventricular aneurysm in human immunodeficiency virus infection: a case report].

The authors report the case of a 30 year old man with a left ventricular aneurysm who was seropositive to HIV 1 and HIV 2. The patient was stage IVC 1 (AIDS related complex) by the "Center for Disease Control" classification. The clinical presentation was pyrexia, loss of weight, micropolyadenopathy and cardiac failure. The electrocardiogramme showed low voltage in the peripheral leads with a QS morphology in S2, S3 and aVF and abrasion, of the R wave in the precordial leads. Doppler echocardiography demonstrated a large left ventricular aneurysm with a wide neck. Despite treatment with a diuretic, angiotensin converting enzyme inhibitor and anticoagulants, the patient died suddenly. Autopsy confirmed the wide necked left ventricular aneurysm. This would appear to be the first report of this form of cardiac disease during HIV infection. However, a simple coincidence of the two pathologies cannot be excluded.

Adult↗
PubMed1998

[Echocardiographic parameters in hyperthyroidism with and without cardiothyreosis].

There has been little research done on the differences between hyperthyroidie patients who exhibit cardiothyrosis and those who do not. The objective of this research was to elucidate the variations in echocardiographic parameters that exist between these two groups, in order to determine practical implications. A prospective study on 37 subjects was performed: 20 in group I (without cardiothyreosis) and 17 in group II (exhibiting cardiothyreosis). In both groups, women were predominant. Left ventricular diameters and volumes were statistically higher in group II (p < 0.0007). The left ventricular end systölic stress was also higher (140.10(3) +/- 37 vs 131.10(3) +/- 51 dynes/cm2. p < 0.05). There was no significance between the two groups in shortening fraction, ejection fraction and mean rate of circumferential fiber shortening. The E/A ratio of the mitral flow was higher in group II (1.98 +/- 1.3 vs 1.3 +/- 0.7, p < 0.05), but the isovolumetric relaxation time and the deceleration time of the E wave were similar in both groups. Left ventricular systolic dysfunction was observed in 5 patients of each group. Relaxation abnormalities were found in 10% of the subjects in group 1 and 33.3% in group II. Significant valvular regurgitation was observed only in group II (8 cases of mitral, 1 case of tricuspid and I case of aortic regurgitation). Given that cardiovascular perturbations may be different during the stages of the hyperthyroidism, different therapeutic approaches may thus be considered, facilated by appropriate echocardiographic examination.

Adult↗
PubMed1998

[Arterial pressure and body mass index of children and adolescents in a rural area of Thiadiaye, Senegal].

The purpose of this study is to assess the profile of blood pressure and body mass index of children and adolescents in a rural area in Africa. It is a prospective study concerning a sample of 465 children and adolescents in the district of Thiadiaye (Senegal). The ration boys/girls was 1.02. Blood pressure was higher in girls. The prevalence of hypertension was 5.1% for the children and 1.5% for adolescents. There was no significative variation in body mass index for children whereas we were noted an augmentation with age in adolescence. The parameters of corpulence are higher in girls in adolescence. The prevalence of obesity was 3% in children and 2.4% for adolescents. There was no correlation between blood pressure and body mass index. This study show many particularities in rural area as for as blood pressure and body mas index of children and adolescent are concerned.

Adolescent↗
PubMed1998

[Survey of smoking in the rural area of Thiadiaye, Senegal].

The objective of this article is to study the place of tobacco addiction in a rural area in Senegal. We have performed a transversal and domicillary study on a sample of adults and adolescents of the district of Thiadiaye (Senegal). The mean age of the studied population is 39 +/- 8.5 years (extremes: 12 and 100 years). The sex ratio is 0.85%. The prevalence of tobacco addict was 24.07%, 9% of the teenagers and 32% of the adults were smokers. Tobacco use was more frequent among men (89% 5%) than women (10.5%) (p < 10(-7)). The most common form was traditional tobacco: 62.1%. Cigarette was smoked in 14.4% of cases. The mean duration of tobacco use was 13 +/- -12.2 years. The mean consumption per day of traditional tobacco was 5.1 +/- 4, whereas the mean number of cigarettes per day is 12.3 +/- -7. Our study shows that tobacco occupies an important place in rural area in Senegal where coexist with traditional habits, a modern tobacco use represented by cigarette smoking.

Adolescent↗
PubMed1998

[Evolutive aspects of systemic lupus erythematosus in Dakar. Apropos of 30 cases].

To determine the characteristics of evolution of systemic lupus erythematosus (SLE), the authors studied 30 cases retrospectively. All were black women aged from 16 to 73 years (with a mean of 30 years) at the time of diagnosis. Dermatological manifestations consisting in discoid lupus or alopecia inaugurated the disease in 12 cases, joint symptoms in 10 cases. Polyarthritis was the most common inaugural manifestation, followed by discoid lupus. Corticosteroids therapy alone or associated to chloroquine or immunosuppressor led to good results; 88% of patients who received treatment had good outcomes in the first 5 months after diagnosis. After this time lapse, 6 cases of complications related to the corticosteroids therapy occurred. After one year, 5 patients presented one or more flare-ups and had to be re-hospitalized; 8 others were lost to the follow-up. The overall mortality rate was 27% (8 cases out of 30). Causes of death were first renal failure (3/8) followed by infectious complications (2/8). The management of SLE could be improved by a close follow-up and providing the patients and their family with adequate information.

Adolescent↗
PubMed1997

[Cardiovascular manifestations in systemic scleroderma].

OBJECTIVES: Patients with systemic scleroderma often have latent heart disease which could play an important role in morbidity and mortality. We therefore conducted a prospective study of cardiovascular manifestations in patients with systemic scleroderma. PATIENTS AND METHODS: A prospective cross-sectional study included 29 patients with systemic scleroderma who underwent a complete cardiovascular work-up including physical examination, electrocardiogram, chest x-ray and Doppler-echocardiogram from July 1993 to February 1996. RESULTS: Hypertension was observed in 6 patients (20.7%) and was positively correlated with age (p = 0.007). Raynaud syndrome was also found in 6 patients (20.6%). Heart disease was observed in 14 patients (48.3%) and was positively correlated with age and lack of treatment for scleroderma (p = 0.008). Myocardial disease was the most frequent (11 patients, 37.9%), followed by pericardial disease and valve disease (4 cases each, 13.8%). Rhythm and conduction disorders were found in 2 (6.9%) and 8 (27.6%) of the patients. CONCLUSION: Cardiovascular manifestations are frequent but often latent in patients with systemic scleroderma. This finding emphasizes the importance of routine cardiovascular work-up in all patients with scleroderma.

Adolescent↗
PubMed1997

[Echocardiographic parameters in normal pregnant women].

The authors report the results of a transverse prospective study of 80 normal women, divided into 4 groups of 20: control group, 1st trimester of pregnancy, 2nd trimester of pregnancy, 3rd trimester of pregnancy. These groups were comparable in terms of age, height and haemoglobin level. No significant difference was observed in terms of obstetric profile between the various groups of women. The results did not reveal any difference concerning the morphology of cardiac structures, the parameters of left ventricular diastolic filling and the frequency of valvular regurgitation. On the other hand, diameters and cavity volumes, left ventricular mass, left ventricular ejection fraction, and maximal antegrade aortic and pulmonary blood flow rates were higher during pregnancy; these increases were less marked when the measurements were performed in the dorsal supine position compared to those observed in the left lateral supine position.

Adult↗