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J Andoh

Publications and source records attributed to J Andoh.

13 recordsLinked to original sources
PubMed1997

Western blot analysis in patients with hypocaeruloplasminaemia.

Inherited copper toxic disease, Wilson's disease, is an autosomal recessive disorder arising from a defect in biliary copper excretion. Although there are several pathognomonic clinical features, such a multisystem disease can be difficult to diagnose, particularly in the early stages of copper toxicity. Even measurements of serum copper and caeruloplasmin, the major copper-transporting protein typically reduced in Wilson's disease, may mimic other metabolic conditions such as Menke's disease and chronic active hepatitis. We have previously shown that the major biliary isoform of copper-transporting protein is 125 kDa caeruloplasmin, and this is always absent in the bile of Wilson's disease patients. In this paper we describe Western blot analysis of molecular species of caeruloplasmin in hypocaeruloplasminaemia, which can distinguish between the overlap which occurs in Wilson's disease homozygotes, heterozygotes and other conditions mimicking Wilson's disease. This may be useful for identifying patients with low plasma caeruloplasmin concentrations, and hepatic or neurological clinical features which may also be found in Wilson's disease.

Adult↗
PubMed1997

The neuropathology of HIV-infected African children in Abidjan, Côte d'Ivoire.

In an autopsy study of HIV-infected children in Abidjan, Côte d'Ivoire, the neuropathology of 76 HIV-1- and 2 HIV-2-positive children was compared with that of 77 frequency-matched HIV-negative children, in whom the systemic pathology was also known. Seventy of the 78 HIV-seropositive children were confirmed as HIV-infected, as determined by combined serology, IgA Western blots and clinicopathological criteria. The HIV-negative children showed a high background level (n = 49, 64%) of neuropathological abnormalities, including nonspecific inflammatory infiltrates, micromineralization, and bacterial and lymphocytic meningitis. In the HIV-positive children, HIV encephalitis was found in 4 (6%), cytomegalovirus in 2 (3%), toxoplasmosis in 3 (4%) and measles encephalitis in one (1%). Bacterial meningitis was equally common in both groups, but cerebral malaria was less common (n = 2, 3%) in HIV-positive than in HIV-negative children (n = 11, 14%). The low prevalence of HIV encephalitis may reflect comparatively early death in HIV infection in Africa as compared with our experience in Europe and the US.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Disease in children infected with HIV in Abidjan, Côte d'Ivoire.

OBJECTIVE: To document the range of disease in African children infected with HIV. DESIGN: Necropsy results in consecutive children aged 1 month or more who were HIV positive and in children who were HIV negative for comparison; IgA western blots on serum samples from children under 2 years of age who were positive for HIV-1 to test the validity of routine HIV serology. SETTING: Largest hospital in Abidjan, Côte d'Ivoire. SUBJECTS: 78 children who were HIV positive and 77 children who were HIV negative on whom a necropsy was performed; their median ages at death were 18 and 21 months respectively. 36 HIV positive children and 29 HIV negative children were 1-14 months old; 42 HIV positive and 48 HIV negative children were > or = 15 months old. MAIN OUTCOME MEASURES: Cause of death and prevalence of diseases confirmed pathologically. RESULTS: Respiratory tract infections were more common in HIV positive than in HIV negative children (73 (94%) v 52 (68%); P < 0.05), and were aetiologically heterogeneous. Pneumocystis carinii pneumonia was found in 11 out of 36 (31%) HIV positive children aged < 15 months, but in no HIV negative children. Among older children measles was more common in HIV positive children (8/42 (19%) v 2/48 (4%); P < 0.06). Pyogenic meningitis was present in similar proportions of HIV positive and HIV negative children aged < 15 months (7/36 (19%) and 7/29 (24%)). In HIV positive children tuberculosis (1/78), lymphocytic interstitial pneumonitis (1/78), and HIV encephalitis (2/78) were rare. CONCLUSIONS: There is greater overlap between diseases associated with HIV infection and other common health problems in African children than there is in adults. Compared with adults, HIV positive children had a high prevalence of P carinii pneumonia and a low prevalence of tuberculosis. Measles, but not malaria, was associated with HIV infection.

AIDS Dementia Complex↗
PubMed1996

Clinical spectrum of human immunodeficiency virus disease in children in a west African city. Project RETRO-CI.

OBJECTIVES: To determine the prevalence of HIV infection in children and to compare diagnostic syndromes and outcomes in HIV-positive and HIV-negative children. METHODS: Consecutive children hospitalized in Abidjan's three university hospitals were examined, tested for HIV infection and followed to discharge. Admission or discharge diagnoses and outcome (survived or died) were compared in HIV-positive and HIV-negative children. RESULTS: The prevalence of HIV infection in the 4480 children hospitalized for the first time was 8.2%; the highest age-specific rate (11.2%) was in children ages 15 to 23 months. Six clinical syndromes accounted for more than 80% of admissions in HIV-positive and -negative children (all ages combined): respiratory infection; malnutrition; malaria; anemia; diarrhea; and meningitis. The dominant syndromic diagnoses in HIV-positive children were respiratory infection (26.1%) and malnutrition (25.8%); in HIV-negative children they were malaria (30.4%) and respiratory infection (19.1%). The overall mortality rate in HIV-positive children was 20.8%, compared with 8.7% in HIV-negative children (relative risk, 2.4; 95% confidence interval, 1.9 to 3.1); the highest death rate (28.1%) was in children younger than 15 months. CONCLUSIONS: Clinical syndromes associated with HIV infection in African children are difficult to recognize without access to HIV serology. Respiratory infection and malnutrition were the dominant clinical syndromes in HIV-positive children in Abidjan. Greater overlap exists between the clinical presentations of HIV-associated disease and other common health problems in African children than in adults.

AIDS Serodiagnosis↗
PubMed1992

[Etiology of splenomegaly in children in the tropics. 178 cases reviewed at the university hospital center of Abidjan-Cocody (Ivory Coast)].

Discovery of an enlarged spleen in a child requires steps to identify the etiology. One hundred and seventy-eight patients seen over a four-year period (1985-1988) at the Cocody Teaching Hospital were reviewed. The incidence of splenic enlargement among pediatric inpatients was 1.6%. Males (n = 106) were more often affected than females (n = 72). Slightly over half the children (54.49%) were 0 to 5 years of age. The main clinical presenting features were fever (90%), anemia (72%), a decline in general health (36.50%), enlargement of the liver (33.50%), jaundice (26.50%), and enlarged lymph nodes (7%). Type II of Hackett's classification accounted for most cases (61.80%), followed by Type III (14%). Main etiologies included malaria (53%), salmonella infections (15%), sickle cell anemia (14%), schistosomiasis (9%), AIDS (3%), and thalassemia (2%). Malignancies (leukemia, lymphoma) were relatively infrequent. More than one etiology was found in 13 cases. The distribution of etiologies by age group was determined and a strategy for investigating children with splenic enlargement in tropical countries was developed.

Adolescent↗
PubMed1989

Silent myocardial ischemia during Holter monitoring in ischemic heart disease.

The purpose of this study was to investigate the frequency and characteristics of silent myocardial ischemia in patients with proven ischemic heart disease using ambulatory ECG monitoring, and to clarify possible mechanisms for the absence of symptoms during these attacks. A total of 182 patients, including 78 patients with stable effort angina (EA), 12 with unstable angina (UA), and 92 with prior myocardial infarction (MI), were examined. During daily activities, 43% and 56% of all transient ST-segment depression observed was asymptomatic in patients with EA and MI, respectively. In addition, 74% of all ischemic episodes were asymptomatic in patients with UA. In patients with EA, 35% exhibited both symptomatic and asymptomatic attacks, and the duration and magnitude of ST-segment depression were greater for symptomatic attacks than for asymptomatic attacks. On the other hand, in patients with MI, 55% had only asymptomatic attacks. When asymptomatic episodes in patients who had only asymptomatic attacks were compared with symptomatic episodes in patients who had only symptomatic attacks, asymptomatic episodes tended to be associated with a greater magnitude of ST depression. They were also significantly longer in duration than the symptomatic episodes. All patients with UA had both symptomatic and asymptomatic episodes, and the magnitude and duration were significantly greater during the former. These results lead us to conclude that: (1) silent myocardial ischemia is observed frequently in patients with EA and MI during daily activities. In particular, patients with MI tend to have more severe silent ischemia. (2) In patients with EA and UA, the severity of ischemia is a fundamental factor in determining the presence or absence of pain during an ischemic attack.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1987

Geographic variations in elderly hospital and surgical discharge rates, New York State.

Hospital and surgical discharges for 1981, as recorded by the uniform hospital discharge data of New York State, were aggregated by county of residence and converted into age-sex adjusted rates. Elderly hospital discharge and surgery rates in New York State, 1981, varied 2.4- and 2-fold, respectively. Discharge rates of elderly with specific surgical procedures showed even greater variation. However, proportions of highly complex and non-elective procedures performed on the elderly were similar in counties with high and low surgical rates. A multiple regression model consisting of independent dimensions of county demographic and medical resources characteristics plus a proxy variable for surgical practice styles was applied to hospital and surgery rates. Variations in elderly surgical discharge rates were found to be related to the supply of medical resources and to surgical practice styles.

Aged↗
PubMedDate not supplied

[Long-lasting remission of Burkitt's disease in African children. Apropos of 6 cases].

Long complete remission in six cases of Burkitt's lymphoma in African children is reported. Complete remissions over eighteen months free of disease are considered as recovery because relapses are rare after this period. These remissions are obtained as well as in stage I and stages III-IV. If classic chemotherapy (cyclophosphamide and methotrexate) is effective, aggressive chemotherapy with several antimitotic drugs is recommended in the poor prognosis forms and relapses. Central nervous system chemoprophylaxis, radiation and maintenance chemotherapy are discussed. Prognosis improvement of Burkitt's lymphoma in African children needs early diagnosis and more aggressive treatment with less damage.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Significance of para-aortic lymph node dissection in patients with advanced and recurrent gastric cancer.

Among 243 patients who underwent radical gastrectomy for advanced gastric cancer, 19 patients underwent radical gastrectomy with extended lymphadenectomy including cancer-positive para-aortic lymph nodes. Their prognosis was unexpectedly good, with a mean postoperative survival time of 24.1 months and a 2-year-survival rate of 42.4 percent. Another 4 patients developed para-aortic lymph node recurrence detected by computed tomographic scan during a follow-up examination. These 4 patients were treated with macroscopic curative dissection of the para-aortic lymph nodes. Although 2 of the 4 patients died within 6 months after re-operation, the prognosis of the other two patients was rather good when treated with active combination chemotherapy consisting of 5-fluorouracil, adriamycin and cisplatin. Dissection of para-aortic lymph nodes is considered of valuable in the treatment of advanced gastric cancer, and dissection of the para-aortic lymph node recurrence may also be valid when combined with potent chemotherapy.

Adult↗