Biomedical subjects
B Wade
Publications and source records attributed to B Wade.
[From suspicion to diagnosis. Clinical, epidemiological, radiological and endoscopic aspects of bronchopulmonary cancer in Senegal. Apropos of 700 endoscopies performed at the Principle Hospital of Dakar from 1987 to 1990].
700 bronchial endoscopies were performed over a period of three years at the Dakar "Hôpital Principal". 40 bronchopulmonary cancers were identified (34 epidermoid, 4 adenocarcinoma, 2 with "small cells") out of 80 suspect cases. When we examine the clinical, radiological, endoscopic features, we are able to classify the following as the most established facts: 1. Higher radiological frequency of the pulmonary retractile condensation syndrome (40 cases). 2. Main frequency of proximal granulated tumors (45) in comparison with endoscopic bronchial stenosis (22). 3. Identification almost exclusive of bronchial epidermoid cancer in that series (34). 4. Male sex and smoking are two unequivocal elements of that pathology. Bronchial endoscopy, absolutely necessary test easy to perform and to get, enables to visualize a lesion and to bring forward the indisputable histological evidence through the biopsy either alone or associated with endoscopic brushing and alveolar washing.
[The value of laparoscopy. Results of 600 studies performed in an internal medicine department at the General Hospital of Dakar].
600 laparoscopic examinations were performed in an Internal Medicine Department of the general Hospital Dakar (Senegal) from 1984 to 1989 in 402 males and 198 females aged from 7 to 82 years. This examination of simple and quick procedure well tolerated under simple premedication, should be performed only after diffusion of the pneumoperitoneum, per- foration being the major risk. Even if liver cell carcinoma and cirrhosis represent more than an half of the examined cases (52%) due to their high frequency, exploration of peritoneal pathology is the best indication for laparoscopy. Thanks to laparoscopy, 68 tuberculosis, 28 peritoneal carcinomatosis and 11 infectious peri-hepatitis were diagnosed. It remains a major examination perfectly adapted to studies of the so-frequent hepato-peritoneal pathology in Black Africa]
[Mucous diaphragm of the cervical esophagus. Apropos of 38 cases discovered during upper endoscopy at the General Hospital of Dakar. Relationship with the Kelly-Paterson or the Plummer-Vinson syndrome].
At the occasion of 15,000 high endoscopies performed during the past 5 years at the general Hospital of Dakar (Senegal) 38 mucous diaphragms of cervical esophagus were discovered. 36 patients are Black Senegalese; 29 females and 9 males with a mean age of 37. Dysphagia was present 29 times and anemia 22 times. Endoscopies diagnosis is easy, putting into light a mucous diaphragm at the level or immediately below Killian mouth. 18 of these cases have been classified as Kelly-Paterson syndrome. Performed in 30 patients, the treatment consists in breaking down the mucous diaphragm with an endoscope. It is difficult to keep on endoscopic monitoring, although it is essential because the risk of cancerisation.
Different models of care for the elderly.
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Focus on drugs: teaching the management of medication.
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Systemic lupus erythematosus and lupus syndromes in Senegal. A retrospective study of 30 patients seen over 10 years.
OBJECTIVE: To define the presenting manifestations, course and prognosis of systemic lupus erythematosus in Senegal. PATIENTS AND METHODS: Thirty cases of systemic lupus erythematosus and lupus syndromes seen over a ten-year period were reviewed retrospectively. Nineteen patients met American College of Rheumatology criteria for systemic lupus erythematosus. All 30 patients were Senegalese-born black women. Mean age at diagnosis was 30 years (range, 16-73 years). RESULTS: Polyarthritis was the most common presenting picture (n = 8), followed by discoid lupus (n = 6). Eight per cent of patients had at least a combination of skin and joint symptoms at diagnosis. Prevalences of organ involvement were as follows: skin, 97%; joints, 97%; kidneys, 57%; serous membranes, 43%; nervous system, 23% and blood, 83%. Mean symptom duration at diagnosis was 24 months in systemic lupus erythematosus patients and 43 months in lupus syndrome patients. This significant diagnostic delay explains why as many as five of the 30 patients (17%) died either before or within five months of treatment initiation. Eight patients (32% of treated patients) who had a favorable course under therapy were lost to follow-up after discharge. The overall mortality rate was 26%. Renal failure was the main cause of death, followed by infectious and neurologic complications. CONCLUSION: We anticipate that the reported prevalence of lupus in Senegal will rise in the near future as a result of improvements in diagnostic tools and of increased interest for lupus among physicians. We also hope that improved detection of mild and early forms, together with close long-term follow-up of patients, will translate into a better overall prognosis.