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Biomedical subjects

B Wade

Publications and source records attributed to B Wade.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Etiopathogenic, ultrasonographic and prognostic features of postpartum cardiomyopathy].

Peripartum cardiomyopathy is a classic but uncommon entity in African women about which there is little etiologic understanding. From January 1990 to March 1996 a series of 30 cases of peripartum cardiomyopathy was collected at the Principal Hospital in Dakar, Senegal. Peripartum cardiomyopathy was defined as the occurrence of cardiac insufficiency in a woman with no previous history of heart disease, during the period between the second and twentieth weeks after delivery confirmed by ultrasound evidence of dilated cardiomyopathy. The overall incidence of peripartum cardiomyopathy during the study period was 30 out of 1200 deliveries. The mean age of the women in the study was 34 years and mean parity was 5.2. In 13.3% of cases births involved twins. There were no predisposing socio-economic or climatic factors. The clinical picture was severe cardiac failure in 80.3% of cases and left ventricular insufficiency in 16.6%. In all cases ultrasound findings were typical of dilated cardiomyopathy. Serum selenium and vitamin B1 levels were normal. Measurements of T CD4 and CD8 in eight patients were normal. Conversion enzyme inhibitors were administered to twenty patients. Complete remission was achieved in 14 patients, three patients died, and thirteen patients presented ultrasonic evidence of persistent dilated cardiomyopathy. One patient relapsed after a subsequent delivery. These findings are in agreement with previous reports concerning the clinical and prognostic features of peripartum cardiomyopathy in Africa.

Adolescent↗
PubMed1996

[Clinical exercise: recalcitrant diarrhea in the main hospital of Dakar ].

It's the case of a Senegalese man who presents a chronic rebel diarrhea with alteration of the general condition and a malabsorption. The aetiologic management has been very difficult to achieve after we have eliminated the infectious and parasitological causes. The clinical and epidemiological context with the histopathological arguments allowed us to establish the diagnosis of intestinal tuberculosis.

Aged↗
PubMed1995

[Annulo-aortic ectasia syndrome apropos of 4 cases].

The authors present four cases of annuloaortic ectasia recently observed in Dakar Principal Hospital; two cases are MARFAN's syndrome, one is complicated by aortic dissection. Third cause of aortic regurgitation, this disease must be diagnosed early on account of its bad prognosis with the risk of the dissection of the aorta and issue to cardiac insufficiency. The diagnosis is more often affirmed by transthoracic echocardiography. Treatment is surgical with low operative mortality and excellent long term result.

Adult↗
PubMed1993

The development of a measure of job satisfaction for use in monitoring the morale of community nurses in four trusts.

The development of the Measure of Job Satisfaction (MJS) for use in a longitudinal study of the morale of community nurses in four trusts is described. The review of previous studies focuses on the use of principal component analysis or factor analysis in the development of measures. The MJS was developed from a bank of items culled from the literature and from discussions with key informants. It was mailed to a one in three sample of 723 members of the community nursing forums of the Royal College of Nursing. A 72% response rate was obtained from those eligible for inclusion. Principal component analysis with varimax rotation led to the identification of five dimensions of job satisfaction; Personal Satisfaction, Satisfaction with Workload, Satisfaction with Professional Support, Satisfaction with Pay and Prospects and Satisfaction with Training. These factors form the basis of five subscales of satisfaction which summate to give an Overall Job Satisfaction score. Internal consistency, test-retest reliability, concurrent and discriminatory validity were assessed and were found to be satisfactory. The factor structure was replicated using data obtained from the first three of the community trusts involved in the main study. The limitations of the study and issues which require further exploration are identified and discussed.

Career Mobility↗
PubMed1993

Care manager/nurse manager: a blending of roles.

Excellent clinicians often are "promoted" to management positions. Lack of involvement in patient care can lead to diminished nurse manager satisfaction, so job enrichment and enhancement must be as important as efficiency and economy as healthcare undergoes reform. A study of 314 patients from 20 DRG categories revealed a statistically significant shortened length of stay and a savings of at least $552 per care-managed patient. Satisfaction was widespread among nurses, patients and physicians and a collaborative spirit developed between nurses and physicians. The blended care manager/nurse manager role alleviates much frustration and conflict and enriches the performance of the manager.

Delivery of Health Care↗
PubMed1991

The introduction of a new system of care delivery into a surgical ward in Sweden.

Action research is used to implement a change in the system of care delivery on a surgical ward in Sweden. Couched within a Lewinian framework the stages of change, the problems faced by staff and their solutions are described. The effects of the change to a system of care more closely resembling the Loeb model of primary nursing, in which accountability is for the duration of the shift, were closely monitored. Observation of registered nurses showed a three-fold increase in the time spent giving direct patient care. A significant increase in scores on a measure of "Intrinsic Job Satisfaction" was also found (P less than 0.01) together with increased scores on a measure of "Patient Focus" (P less than 0.001). These findings were sustained over time. The problems of evaluating a system of care which is based on a different philosophy are addressed.

Humans↗
PubMed1991

The development of a measure of job satisfaction for use in evaluating change in the system of care delivery.

The aim of the study was to produce a reliable, valid measure of job satisfaction in order to monitor the effect of a change in the method of care delivery. Principal components analysis of questionnaire responses by 121 nurses yielded two scales labelled "Intrinsic Job Satisfaction" and "Patient Focus". Cronbach's alpha was 0.88 and 0.82 respectively. Further analyses revealed significant differences in scores on both scales for different grades of staff and significant differences in scores on "Patient Focus" for nurses working in different specialties. Significant increases in scores on both scales were found for registered nurses following changes in organisation on a surgical ward. This increase was maintained over time. For enrolled nurses an increase in "Intrinsic Job Satisfaction" was less well maintained and no differences were found over time on "Patient Focus". The two scales are reliable and sufficiently sensitive to monitor the relationship between job satisfaction and system of care delivery for different grades of staff working in different specialties.

Employee Performance Appraisal↗
PubMed1991

The effects of a synthesis of nursing practice course on senior nursing students' self-concept and role perception.

This study investigated the effects of a Synthesis of Nursing Practice course on senior nursing students' self-concept and perception of role competencies. Seventy senior baccalaureate nursing students enrolled in the Synthesis of Nursing Practice course participated in the study during their last semester in the program. The Tennessee Self-Concept Scale was used to measure self-concept and the Slater Nursing Competencies Rating Scale was used to measure perception of role competencies. These instruments were administered at the beginning of the Synthesis of Nursing Practice course and immediately following completion of the course. A t-test was used to assess the differences between pre- and posttest group means. The study findings indicated a significant increase in the students' self-concept (p = .10) and perceived role competencies (p = .001). Implications of the findings for nursing education are discussed.

Clinical Competence↗
PubMed1991

[Tumor-like focal nodular hyperplasia. Apropos of 3 cases observed at the Dakar Central Hospital from 1986 to 1989].

Authors report three observations of Focal Nodular Hyperplasia, Tumor-like on two: senegalese female patients, 16 years and 37 years old, and a young senegalese man, 24 Years old. The mean age is about 25.5 years and oestro progestative intake has bean noted once. Diagnosis of Focal Nodular Hyperplasia was difficult and has been done twice after surgical intervention for chronic cholecystitis and blood peritonitis. The only complication reported, has been a rupture of nodular, causing the death of a patient. This benign tumor that never degenerates, does not need any particular treatment unless a stopping of oral contraception.

Adolescent↗
PubMed1990

[Crohn's disease. Apropos of 2 recent cases collected at the Dakar Central Hospital].

This report covers two cases of Crohn's Disease, one in a 27 year old Senegalese woman, the other in a 38 year old Senegalese man, both presenting abdominal pain, diarrhoea and loss of weight over several months. The ulcerated lesions were staged on the colon, respecting the rectum, and reached the ileum in one patient and the esophagus in the other. Following X-rays, endoscopy and consideration of the history, Crohn's Disease was diagnosed. Treatment with corticoids produced rapid improvement with the ulcers healing after one month. The unusualness of Crohn's Disease in Black Africans adds interest to these two observations.

Adrenal Cortex Hormones↗
PubMed1990

[Diagnostic suspicion. Clinical, epidemiological, radiological, and endoscopic aspects of bronchopulmonary cancer in Senegal. Apropos of 700 endoscopies performed at the Hôpital Principal de Dakar from 1987 to 1990].

700 bronchial fiber endoscopies were performed at Dakar Main Hospital over a period of 3 consecutive years. 40 broncho-pulmonary cancers were identified (34 epidermoids, 4 adeno-cancers, 2 small cell cancers) among the 80 suspect cases. Comparison of clinical, radiological and endoscopic data revealed the following information: 1. most frequently radiology showed retractile, pulmonary condensation syndrome (40 cases); 2. a large predominance of close, bulging tumours (45 times) in relation to endoscopic bronchial stenosis (22 times); 3. almost exclusive identification of bronchial epidermoid cancer in this series (34 times); 4. the masculine sex and use of tobacco remain 2 unavoidable elements in this pathology. Bronchial endoscopy, a simple, indispensible examination, allows the lesion to be visualized, and a biopsy, on its own or associated with endoscopic cysto-brushing and alveolus washing, can then furnish conclusive histological proof.

Adult↗
PubMed1989

[Campylobacter pylori and the gastric mucosa. Apropos of the detection of Campylobacter pylori in 12 patients with gastric mucosa lesions].

The authors report the results of systematic research on Campylobacter pylori during high endoscopy. Of the 60 patients examined, 12 were found to have the germ in their antral, gastric mucosa. All these patients had a history of chronic gastritis. They recall the role of this germ in creating chronic gastritis, and evoke the hypothesis that the mucosa becomes fragile facilitating the appearance of an ulcer.

Adult↗
PubMed1989

[Gelatinous disease of the peritoneum of appendiceal origin. Apropos of 2 Senegalese cases].

The authors report two cases of Peritoneum Gelatinous Sickness of appendicular origin, occurring in male adults aged 65 and 57. Laparoscopy practised on an extended abdomen showing non-homogeneous dullness confirmed the diagnosis in both cases. The laparotomy highlighted the gelatinous substance and led to appendicectomy aimed at the mucocele. They take this opportunity to discuss the unusualness of this affliction in Africa, and recall the clinical and etiological means and the diagnostical difficulties that this disease evokes.

Aged↗
PubMed1989

[Mucoid webs of the cervical esophagus. Apropos of 38 cases discovered during upper endoscopy at the Hôpital Principal of Dakar. Relationship to Plummer-Vinson syndrome].

Thirty-eight cervical esophageal mucous diaphragms were discovered in the course of 15,000 high endoscopies carried out over the past 5 years at Dakar General Hospital. Thirty-six of the sufferers were Black Senegalese. The 29 women and 9 men had an average age of 37 years. Dysphagia was diagnosed 29 times, and anemia 22 times. Endoscopic diagnosis readily shows the mucous diaphragm at the level of, or immediately below, KILLIAN's mouth. PLUMMER-VINSON's syndrome affected 16 of these patients. Treatment consists in collapsing the mucous diaphragm by putting the endoscope through it: this happened to 30 of the patients. Endoscopic surveillance is indispensable because of the risk of cancer, but is difficult to perform.

Adult↗
PubMed1989

[Importance of laparoscopy. Results of 600 examinations performed in the Internal Medicine Department of the Hôpital Principal of Dakar].

At Dakar General Hospital between 1984 and 1989, 402 men and 198 women aged between 7 and 82 years were examined by laparoscopy. This simple, rapid examination, well tolerated after simple premedication, should only be undertaken after complete diffusion of the pneumoperitoneum because of a major perforation risk: 2 deaths unfortunately occurred during the above series. CPF's and cirrhosis account for more than half the cases (52%) and Laparoscopy is most useful in exploring the peritoneal pathology. Laparoscopy led to 68 cases of tuberculosis, 28 of peritoneum carcinomatosis, and 11 of infectious peri-hepatitis being diagnosed, and remains a major examination method perfectly adapted to the hepato-peritoneal pathology so common in Black Africa.

Abdominal Neoplasms↗