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Biomedical subjects

Stephen W Bickler

Publications and source records attributed to Stephen W Bickler.

4 recordsLinked to original sources
PubMed2006

Tropical enteropathy protects against Western diseases in environments of poor sanitation.

This hypothesis suggests that tropical enteropathy protects against Western diseases in environments of poor sanitation, and that the absence of tropical enteropathy contributes to the increased incidence of Western diseases in settings of improved sanitation. The hypothesis is supported by four observations: (1) The prevalence of tropical enteropathy is inversely related to the incidence of Western diseases, (2) The bowel is a major immune and neuroendocrine organ, and inflammation of the gut results in profound local and systemic changes, (3) Tropical enteropathy can account for the subtle clinical differences observed between individuals living in third world environments and industrialized societies, and (4) The concept that tropical enteropathy protects against Western diseases in environments of poor sanitation is consistent with the observations upon which the "Hygiene and Fetal Origins Hypotheses" are based. Identifying tropical enteropathy as a mechanism that protects against Western diseases in environments of poor sanitation creates a new testable hypothesis for some of the most common non-communicable diseases of industrialized societies.

Developed Countries↗
PubMed2003

Need for paediatric surgery care in an urban area of The Gambia.

The report evaluates the need for paediatric surgical care in an urban area of sub-Saharan Africa. Seven hundred and forty-one children were treated for surgical problems from January through December 1997. The most common surgical problems were injuries (67.1%), congenital anomalies (15.0%) and surgical infections (6.7%). Forty-six per cent of children presenting with a surgical problem required a surgical procedure, 68.2% of which were classified as minor. The annual presentation rate for all surgical conditions was 543 per 10,000 children aged 0-14 years. The estimated cumulative risk for all surgical conditions is 85.4% by age 15 years. Our data suggest surgical diseases commonly affect children living in Banjul. Surgical care should be an essential component of child health programmes in developing countries.

Adolescent↗
PubMed2003

Pediatric trauma at a government referral hospital in The Gambia.

OBJECTIVE: To determine the pattern of childhood injuries at a government referral hospital in sub-Saharan Africa. METHODS: Twenty-nine month hospital based study at the Royal Victoria Hospital (RVH) in Banjul, The Gambia. Children with injuries were identified from a prospectively recorded pediatric surgery database. Rate of pediatric trauma presenting to RVH was calculated for an urban population of 270,540 (32.3% aged 0-14 years) living within 25 km of the hospital. RESULTS: From January 1996 to June 1998, 798 children aged 0-14 years were admitted for treatment of injuries. Injuries accounted for 4.8% of all pediatric admissions. Burns (38.7%), fractures (20.9%), head injuries (16.2%) and soft tissue injuries (9.4%) were the most common injuries--together responsible for 85% of admissions and 74% of total hospital days. Average length of stay was 20.6 days, with injuries accounting for 16,696 total hospital days. Seventeen percent of injured children required a surgical procedure. The most common surgical procedures were burn contracture release (20%), reduction of fracture and dislocations (20%) and skin grafts (18.7%). In hospital mortality was 5.5%, with 71% of deaths related to burns. The annual cases of trauma presenting to RVH from the Greater Banjul Area was 181 admissions, 3317 hospital days, 28 surgical procedures and 7 deaths per 100,000 children aged 0-14 years. CONCLUSION: Childhood injuries, particularly burns place a significant burden on inpatient services. While accounting for a small fraction of pediatric admissions, injuries account for long hospital stays and surgical procedures.

Adolescent↗