RESUMEN
BACKGROUND: Hepatitis B virus (HBV) infection is an endemic infection in Nigeria. Health care workers (HCWs) are at risk of occupational exposures to HBV-infected blood and body fluids. OBJECTIVE: To determine the prevalence and determinants of HBV vaccine coverage among HCWs in two teaching hospitals in Nigeria. METHODS: This cross-sectional study was undertaken in 2011 and 2012 in two teaching hospitals in Jos, North-Central Nigeria, and Yenagoa, South-South Nigeria. A self-administered structured questionnaire was administered to HCWs to obtain socio-demographic data and history of HBV vaccination. RESULTS: Out of 290 HCWs who participated in the study, 185 (64.5%) had received at least one dose of HBV vaccine; 105 (36.2%) had full coverage of three doses. Professional category and previous training in infection control were independently associated with HBV vaccination. House officers and laboratory scientists were more likely to be unvaccinated than resident doctors, consultant doctors and nurses. Full vaccine coverage was associated with younger age and shorter years of professional experience. CONCLUSION: We observed a generally low rate of HBV vaccine coverage among HCWs in Nigeria. Establishment of policies on compulsory HBV vaccination of all HCWs in Nigeria is recommended.
Asunto(s)
Personal de Salud/estadística & datos numéricos , Vacunas contra Hepatitis B/administración & dosificación , Vacunación/estadística & datos numéricos , Adulto , Anciano , Estudios Transversales , Femenino , Hepatitis B/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Prevalencia , Encuestas y CuestionariosRESUMEN
Data on baseline hepatic function of HIV and hepatitis B virus (HBV) co-infected patients are limited in sub-Saharan Africa. We assessed liver function test (LFT) abnormalities in Nigerian patients with HIV/HBV co-infection to highlight the impact of HIV on HBV-related liver disease in sub-Saharan Africa. A cross-sectional study involving 100 HIV/HBV co-infected patients and 100 age- and sex-matched HBV mono-infected controls. Blood testing for HIV antibodies, CD4+ cell count, hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), LFTs, platelet count, fasting blood glucose and lipid profile were carried out. Non-invasive hepatic fibrosis scores (aspartate aminotransferase-platelet ratio index [APRI] and FIB-4) were also calculated. Co-infected patients had deranged liver enzymes more than the controls (77% versus 64%, P = 0.04). The predominant patterns of enzyme derangement in co-infected patients were either predominantly ↑ALP (30% versus 4%, P < 0.0001) or mixed (30% versus 15%, P = 0.01) but predominantly ↑AST/ALT in the controls (25% versus 9%, P = 0.003). Co-infected patients had higher fibrosis scores for both APRI (P = 0.002) and FIB-4 (P = 0.0001). On further analysis, LFT abnormalities and fibrosis scores were only significantly higher in co-infected patients in the immune clearance and HBeAg-negative chronic hepatitis phases. LFT abnormalities are common in Nigerians with HBV infection and co-infection with HIV negatively impacts on hepatic function.
Asunto(s)
Coinfección , Infecciones por VIH/complicaciones , Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis B/complicaciones , Pruebas de Función Hepática/métodos , Adulto , Biomarcadores/sangre , Recuento de Linfocito CD4 , Estudios de Casos y Controles , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática , Femenino , Infecciones por VIH/sangre , Infecciones por VIH/virología , Seronegatividad para VIH , Hepatitis B/sangre , Hepatitis B/virología , Virus de la Hepatitis B/aislamiento & purificación , Hospitales de Enseñanza , Humanos , Hígado/inmunología , Hígado/virología , Masculino , Persona de Mediana Edad , Nigeria , Factores Socioeconómicos , Carga ViralRESUMEN
The effects of hypertension on resting and reflex cardiovascular function were investigated in this study. Blood pressure, heart rate and electrocardiogram were recorded in male and female control subjects and hypertensive Nigerian patients. Blood pressure was measured, using the sphygmomanometer/auscultatory method. Heart rate was determined from palpating the radial pulse or from the resting electrocardiograph. The systolic and diastolic blood pressures were high in the hypertensive patient (160.90 + 2.06 mmHg and 110.8 + 1.95 mmHg respectively compared with control subjects (119.3 + 2.05 and 73.58 + 1.09mmHg). Pulse pressure and mean arterial pressures were also higher in the hypertensive patients. Heart rate was higher in the hypertensive compared to the control groups (86.93 + 2.83 cf 71 + 1.35 beats per minute). ECG analysis showed that the intervals were lower in the controls than in the hypertensive group except for PR intervals (0.21 + 0.01 cf 0.23 + 0.01 sec). The amplitude of the waves was also lower in the control group than the hypertensive group. Cardiovascular response to exercise assessed from the post-exercise recovery graph showed that the aggregate recovery (6min after) was lower in the hypertensive subjects (22% cf 28%) than in controls. This suggests that the baroreflex sensitivity was higher in the control than in the hypertensive subjects. Results from this study suggest that in hypertension there may be increased heart rate, altered electrocardiograph readings indicating ventricular hypertrophy and delay in ventricular conduction. In hypertension baroreflex sensitivity may be reduced.
Asunto(s)
Presión Sanguínea/fisiología , Electrocardiografía/tendencias , Frecuencia Cardíaca/fisiología , Hipertensión/epidemiología , Hipertensión/fisiopatología , Adulto , Electrocardiografía/métodos , Prueba de Esfuerzo/métodos , Femenino , Humanos , Hipertensión/diagnóstico , Masculino , Nigeria/epidemiologíaRESUMEN
Background: Until recently; availability of anti-retroviral therapy (ART) in Nigeria has been limited to government and university based programs. Through the United States' President's Emergency Plan For AIDS Relief (PEPFAR); additional funding has become available for the treatment of HIV-positive patients. Objective: To report the expansion of HIV-1 screening; enrollment in an ART program; and treatment outcomes over twelve months among HIV-positive patients at a nonprofit; non-governmental faith-based clinic providing free and holistic care in Jos City; Plateau State; Nigeria. Design: This was a retrospective analysis of HIV-1 screening and ART received by patients at Faith Alive Foundation Hospital (FAFH). From January through December 2005; voluntary counseling and testing (VCT) was freely available to all patients who requested it. Also beginning in December 2004; HIV-1 infected patients were enrolled in an expanded HIV/AIDS program at FAFH; where patients in clinical stages 3 or 4 based on World Health Organiza- tion (WHO) clinical classification; or had a CD4+ cell count of less than 200/ ml; were initiated on a simplified highly active ART (HAART) regimen through PEPFAR funding. Data from the first six quarters of the FAFH-PEPFAR ART program are presented here. Additionally; analysis of 645 patients who have received ART for one year; including changes in CD4+ cell count from baseline is shown. Results: In 2005; a total of 7672 persons received VCT and 3869 (50.4) HIV-1 positive results were found. From October 2004 to March 2006; the total number of patients enrolled in the FAFH HIV/AIDS program rose from 1330 to 5946 people. Over the same period; the number of patients who received ART increased from 302 to 1667. A majority of patients received an oral ART regimen consisting of generic nevirapine; lamivudine; and stavudine. The number of patients initiated on ART each quarter ranged from 57-578; and the number of deaths of patients on ART was between 12 and 21 people per quarter. Analysis of 645 patients initiated on ART during the first quarter of the FAFH-PEPFAR ART program revealed that the median CD4+ cell count at baseline was 106/ml and the median increase was 173/ml (median time of follow-up; 7.0 months). Conclusions: Comprehensive HIV/AIDS care has been significantly expanded at FAFH; a free and holistic medical center in Jos; Nigeria. Cumulative data from the first year of this PEPFAR-funded ART program indicated that promising outcomes are achievable through delivery of care at this faith-based medical center
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Programas Controlados de Atención en Salud , OrganizacionesRESUMEN
OBJECTIVE: Because the causes of nutritional rickets in tropical countries are poorly understood, we conducted a case-control study to determine factors associated with rickets in Nigerian children. STUDY DESIGN: We compared 123 Nigerian children who had rickets with matched control subjects. Dietary, demographic, anthropometric, and biochemical data were collected to assess factors related to calcium and vitamin D status, which might predispose children to rickets. RESULTS: Mean (+/- SD) daily dietary calcium intake was low in both children with rickets and control children (217 +/- 88 mg and 214 +/- 77 mg, respectively; P =.64). Children with rickets had a greater proportion of first-degree relatives with a history of rickets (14.6% vs 3.1%; P <.001), a shorter mean duration of breast-feeding (16.0 vs 17.3 months; P =.041), and a delayed age of walking (14 vs 12 months; P <.001). Among children with rickets, biochemical features suggestive of calcium deficiency included hypocalcemia, extremely low calcium excretion, and elevated 1, 25-dihydroxyvitamin D and parathyroid hormone values. Median 25-hydroxyvitamin D concentrations were 32 and 50 nmol/L (13 and 20 ng/mL) in children with rickets and control children, respectively (P <.0001). Only 46 subjects with rickets (37%) had 25-hydroxyvitamin D values <30 nmol/L (12 ng/mL). CONCLUSIONS: Vitamin D deficiency appears unlikely to be the primary etiologic factor of rickets in African children. Moreover, low dietary calcium intake alone does not account for rickets. Insufficient dietary calcium probably interacts with genetic, hormonal, and other nutritional factors to cause rickets in susceptible children.
Asunto(s)
Raquitismo/etiología , Vitamina D/análogos & derivados , Adolescente , Antropometría , Calcio/deficiencia , Calcio/orina , Calcio de la Dieta/administración & dosificación , Estudios de Casos y Controles , Niño , Preescolar , Conducta Alimentaria , Femenino , Humanos , Hipocalcemia/complicaciones , Masculino , Nigeria , Hormona Paratiroidea/sangre , Fósforo/administración & dosificación , Raquitismo/metabolismo , Estadísticas no Paramétricas , Vitamina D/sangreRESUMEN
RICOM-1013-J (Ricinus communis var minor) administered orally once to each of 12 women volunteers at a dose of 2.5-2.7 g per 8 months, protected against pregnancy over a period of 7-8 months of study. A study of the effect of a contraceptive dose (20 mg/kg) on metabolic parameters in rat (food and water in-take, urine and faecal output and body weight) over a period of 4 months showed a slight decrease in all the parameters in the first 1-8 weeks. This effect was reversible attaining pretreatment levels from week 16. The LD(50) in an acute toxicity test in mice was 63.1 +/- 16.0 g/kg s.c. Determination of blood urea, sodium (Na(+)), potassium (K(+)), chloride (Cl(-)) and bicarbonate (HCO$_¿3¿ ¿-¿$)as a measure of renal function and alkaline phosphatase (ALP), transaminases (GPT and GOT) and transpeptidases (GGT) as a measure of liver function showed that liver function profiles in pretreated rats were not significantly different from control (p < 0.05) on day 21 to day 150. However, serum levels of ALP and GGT at day 120 to day 150 were moderately but significantly elevated (p > 0.05) compared with the control. There were no significant changes in renal function profiles in pretreated rats (p < 0.05) compared with the control. The results of the liver and renal function profiles in women volunteers showed that there were no significant (p < 0.05) changes in renal functions on day 206 following RICOM-1013-J administration. However, serum levels of ALP and GGT showed a slight rise in about 70% of volunteers, whereas bilirubin and transaminases levels were normal. The present results indicate a very high efficacy and margin of safety of RICOM-1013-J in women volunteers. The increase in ALP and GGT in both animal and women volunteers suggest mild intrahepatic cholestatic changes which may be attributed to an oestrogenic effect of RICOM-1013-J.
Asunto(s)
Anticonceptivos Femeninos/farmacología , Fitosteroles/farmacología , Adulto , Animales , Peso Corporal/efectos de los fármacos , Anticonceptivos Femeninos/efectos adversos , Diuresis/efectos de los fármacos , Conducta de Ingestión de Líquido/efectos de los fármacos , Heces , Conducta Alimentaria/efectos de los fármacos , Femenino , Humanos , Pruebas de Función Renal , Pruebas de Función Hepática , Masculino , Ratones , Ratones Endogámicos BALB C , Fitosteroles/efectos adversos , Embarazo , Ratas , Ratas WistarRESUMEN
The seeds of Ricinus communis Linn, RICOM-1013-J, administered as a single oral dose of 2.3-2.5 g once per 12 months protected against pregnancy in 50 women volunteers for a period of one year. The antifertility and contraceptive efficacy of the seed was demonstrated in this study. Clinical observation revealed very minimal side effects. Some of the side effects investigated included headache, nausea, vomiting, weight gain, loss of appetite, raised blood pressure and dysmenorrhoea. Furthermore, both the renal and liver functions were not affected as revealed by urea, electrolyte and creatinine values as well as total bilirubin, conjugated bilirubin, serum albumin, total protein and transaminases values when compared with control values. In addition cholesterol and phospholipids were not significantly altered. When all these results are considered together, it seems unlikely that the antifertility and contraceptive efficacy of RICOM-1013-J is due to hormonal mechanisms alone since side effects, renal and liver function, and cholesterol effects attributable to oestrogen and/or progesterone were minimal in the volunteers.
Asunto(s)
Anticonceptivos Femeninos/uso terapéutico , Fitosteroles/uso terapéutico , Colesterol/sangre , Femenino , Humanos , Pruebas de Función Renal , Pruebas de Función Hepática , Fitosteroles/administración & dosificación , Triglicéridos/sangreRESUMEN
In a previous study of rachitic children in Jos, Nigeria we concluded that inadequate dietary intake of calcium was the primary contributing factor to the development of their rickets. The objective of the present study was to determine the effect of calcium supplementation in 10 children with radiographically and biochemically proven rickets from the same geographical area. Rachitic children were provided with calcium supplements of 1000 mg/day for a period of 3 months. Serum and urine samples were obtained at baseline and at 24 hours, 1 week, 4 weeks, and 12 weeks after initiation of supplementation. Serum calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D were measured at each time point. Dietary recalls obtained at two separate times were used to estimate usual daily intakes of calcium and phosphorus. Ten non-rachitic age-matched controls from the same geographical area were recruited for comparison. Nine of 10 rachitic subjects had radiographic evidence of healing after 3 months of calcium therapy. Although serum calcium concentrations returned to control levels, other biochemical data indicated that the rickets of these subjects may have been multifactorial in aetiology, pointing to a possible defect in the synthesis of 25-hydroxyvitamin D.
Asunto(s)
Calcio de la Dieta/uso terapéutico , Raquitismo/dietoterapia , Antropometría , Calcio de la Dieta/metabolismo , Niño , Preescolar , Dieta , Humanos , Lactante , Nigeria , Radiografía , Raquitismo/diagnóstico por imagen , Raquitismo/metabolismo , Estadísticas no ParamétricasRESUMEN
BACKGROUND: Nutritional rickets remains prevalent in many tropical countries despite the fact that such countries have ample sunlight. Some postulate that a deficiency of dietary calcium, rather than vitamin D, is often responsible for rickets after infancy. METHODS: We enrolled 123 Nigerian children (median age, 46 months) with rickets in a randomized, double-blind, controlled trial of 24 weeks of treatment with vitamin D (600,000 U intramuscularly at enrollment and at 12 weeks), calcium (1000 mg daily), or a combination of vitamin D and calcium. We compared the calcium intake of the children at enrollment with that of control children without rickets who were matched for sex, age, and weight. We measured serum calcium and alkaline phosphatase and used a 10-point radiographic score to assess the response to treatment at 24 weeks. RESULTS: The daily dietary calcium intake was low in the children with rickets and the control children (median, 203 mg and 196 mg, respectively; P=0.64). Treatment produced a smaller increase in the mean (+/-SD) serum calcium concentration in the vitamin D group (from 7.8+/-0.8 mg per deciliter [2.0+/-0.2 mmol per liter] at base line to 8.3+/-0.7 mg per deciliter [2.1+/-0.2 mmol per liter] at 24 weeks) than in the calcium group (from 7.5+/-0.8 [1.9+/-0.2 mmol per liter] to 9.0+/-0.6 mg per deciliter [2.2+/-0.2 mmol per liter], P<0.001) or the combination-therapy group (from 7.7+/-1.0 [1.9+/-0.25 mmol per liter] to 9.1+/-0.6 mg per deciliter [2.3+/-0.2 mmol per liter], P<0.001). A greater proportion of children in the calcium and combination-therapy groups than in the vitamin D group reached the combined end point of a serum alkaline phosphatase concentration of 350 U per liter or less and radiographic evidence of nearly complete healing of rickets (61 percent, 58 percent, and 19 percent, respectively; P<0.001). CONCLUSIONS: Nigerian children with rickets have a low intake of calcium and have a better response to treatment with calcium alone or in combination with vitamin D than to treatment with vitamin D alone.
PIP: A randomized, double-blind, controlled trial was conducted to compare the efficacy of calcium, vitamin D, and a combination of both in the treatment of nutritional rickets among Nigerian children. Subjects included 123 Nigerian children with the deformity characteristics of rickets. For each child who was enrolled, a parent or guardian was asked to recruit a control child with the same sex, age, weight, and who had no clinical signs of rickets. Children with rickets were under treatment for 24 weeks with vitamin D (600,000 U intramuscularly at enrollment and at 12 weeks), calcium (1000 mg daily), or a combination of both. Then the serum calcium and alkaline phosphates were measured and a 10-point radiographic score was used to assess the response to the 24-week treatment. The results revealed a low dietary calcium intake in children with rickets and in control children. Children under vitamin D treatment appeared to have a small increase in the mean serum calcium concentration when compared to children under calcium treatment or a combination of both vitamin D and calcium. A greater proportion of children in the calcium and combination-therapy groups than in the vitamin D group reached the combined end point of a serum alkaline phosphates concentration of 350 U/liter or less and radiographic evidence of nearly complete healing of rickets. Overall, compliance ranged from 92% to 96% across the three groups. Since Nigerian children with rickets had low calcium intake, treatment should focus on dietary supplementation with calcium or a combination of calcium and vitamin D.
Asunto(s)
Calcio/uso terapéutico , Raquitismo/tratamiento farmacológico , Vitamina D/uso terapéutico , Fosfatasa Alcalina/sangre , Calcio/administración & dosificación , Calcio/sangre , Calcio de la Dieta/administración & dosificación , Preescolar , Método Doble Ciego , Quimioterapia Combinada , Femenino , Humanos , Masculino , Nigeria , Raquitismo/sangreRESUMEN
OBJECTIVE: To determine the prevalence of vitamin D deficiency in young Nigerian children residing in an area where nutritional rickets is common. STUDY DESIGN: A randomized cluster sample of children aged 6 to 35 months in Jos, Nigeria. RESULTS: Of 218 children evaluated, no child in the study had a 25-hydroxyvitamin D (25-OHD) concentration <10 ng/mL (the generally held definition of vitamin D deficiency). Children spent an average of 8.3 hours per day outside of the home. Twenty children (9.2%) had clinical findings of rickets. Children with clinical signs of rickets were more likely to be not currently breast fed and have significantly lower serum calcium concentrations than those without signs of rickets (9.1 vs 9.4 mg/dL, respectively, P =.01). Yet, 25-OHD levels were not significantly different between those children with clinical signs of rickets and those without such clinical signs. CONCLUSION: Vitamin D deficiency was not found in this population of young children in whom clinical rickets is common. This is consistent with the hypothesis that dietary calcium insufficiency, without preexisting vitamin D deficiency, accounts for the development of clinical rickets in Nigerian children.
PIP: Deficiencies of either calcium or vitamin D can cause nutritional rickets. Findings are reported from a study conducted to assess the prevalence of vitamin D deficiency in young Nigerian children living in an area where nutritional rickets is common. A random sample of 218 children aged 6-35 months in Jos, Nigeria, was evaluated. The children were of mean age 22 months. No child had a 25-hydroxyvitamin D (25-OHD) concentration of less than 10 ng/ml, the generally held definition of vitamin D deficiency. Children spent an average of 8.3 hours/day outside of the home, and 20 children (9.2%) had clinical findings of rickets. Children with clinical signs of rickets were more likely to be not currently breast-fed and have significantly lower serum calcium concentrations than those with no signs of rickets. 25-OHD levels were not significantly different between children with clinical signs of rickets and those without such clinical signs. The failure to find vitamin D deficiency in this population of young children in whom clinical rickets is common is consistent with the hypothesis that dietary calcium insufficiency, without preexisting vitamin D deficiency, accounts for the development of rickets in Nigerian children.
Asunto(s)
Calcio/deficiencia , Raquitismo/etiología , Deficiencia de Vitamina D/epidemiología , Lactancia Materna , Calcio/sangre , Calcio de la Dieta/administración & dosificación , Preescolar , Análisis por Conglomerados , Estudios Transversales , Enfermedades Carenciales/complicaciones , Enfermedades Carenciales/diagnóstico , Enfermedades Carenciales/epidemiología , Femenino , Humanos , Lactante , Masculino , Nigeria/epidemiología , Prevalencia , Raquitismo/sangre , Deficiencia de Vitamina D/complicacionesRESUMEN
OBJECTIVES: Biochemical markers of bone turnover were measured in the sera of 16 controls and 10 children with calcium-deficiency rickets, during a 12-week course of calcium supplementation (1 g CaCO3/d) that was effective in healing the bone lesions of the rachitic children. DESIGN AND METHODS: Serum levels of crosslinked N-telopeptides of bone collagen (NTx), parathyroid hormone (PTH), alkaline phosphatase (ALP), and urinary deoxypyridinoline (LP) were assayed at baseline and during the course of calcium therapy and compared with data of the 16 non-rachitic controls. RESULTS: Calcium therapy suppressed serum NTx and PTH levels in the rachitic children within 24 h; however, after the first week, PTH and NTx levels increased to the extent that at 12 weeks both were elevated when compared with controls or to baseline levels. Serum levels of NTx and PTH were correlated in the controls and experimental subjects (r = 0.63, p < 0.001). CONCLUSIONS: The rate of bone resorption, as estimated by serum NTx concentration, is increased during the healing of rachitic lesions.
Asunto(s)
Cloruro de Calcio/uso terapéutico , Calcio/deficiencia , Calcio/uso terapéutico , Colágeno/sangre , Hormona Paratiroidea/sangre , Péptidos/sangre , Raquitismo/tratamiento farmacológico , Fosfatasa Alcalina/sangre , Aminoácidos/orina , Biomarcadores/sangre , Biomarcadores/orina , Huesos/metabolismo , Calcio/sangre , Niño , Preescolar , Colágeno Tipo I , Creatinina/orina , Ensayo de Inmunoadsorción Enzimática/métodos , Femenino , Alimentos Fortificados , Humanos , Masculino , Nigeria , Fósforo/sangre , Radioinmunoensayo/métodos , Valores de Referencia , Análisis de Regresión , Raquitismo/sangre , Raquitismo/orina , Factores de TiempoRESUMEN
The purpose of this study was to determine if the growth retardation often associated with sickle cell anaemia could be related in part to a deficiency of essential fatty acids. We reported recently that children with sickle cell disease in Jos, Nigeria have lower levels of serum amino acids and higher levels of urinary amino acids than their healthy counterparts. In the current study, we determined that the serum phospholipids of children with sickle cell anaemia did not deviate in the proportions of the essential fatty acids, linoleic and alpha-linolenic they contain compared to controls. However, their serum phospholipid profiles were significantly different in the proportions of four other fatty acids. Specifically, the phospholipids of children with sickle cell anaemia contained 19 per cent more palmitic acid (P = 0.006), 22 per cent more oleic acid (P = 0.014), 18 per cent less arachidonic acid (P = 0.008), 51 per cent less eicosapentaenoic acid (P = 0.0008), and 43 per cent less decosahexaenoic acid (P = 0.001). These data show that children with sickle cell anaemia are not deficient in essential fatty acids, but that the fatty acid elongation and desaturation pathway is somehow disturbed in this disease.
Asunto(s)
Anemia de Células Falciformes/sangre , Ácidos Grasos Insaturados/sangre , Trastornos del Crecimiento/etiología , Anemia de Células Falciformes/complicaciones , Estudios de Casos y Controles , Niño , Ácidos Grasos Insaturados/química , Femenino , Trastornos del Crecimiento/sangre , Humanos , Masculino , Nigeria , Fosfolípidos/sangre , Fosfolípidos/química , Estadísticas no ParamétricasRESUMEN
Neonates with sickle cell disease (SCD) are of normal size at birth in terms of height and weight. However, by the sixth month of life their growth begins to lag significantly behind that of non-sicklers. We hypothesize that such growth retardation could be explained, at least in part, by the increased excretion of free amino acids in the urine of children with SCD. It is well established that in SCD there are abnormalities in the proximal tubules where amino acids are reabsorbed. We collected serum and urine samples from 13 patients with SCD (age range, 10 months to 14 years), and 17 age-and gender-matched controls, and analysed these specimens for free amino acids and creatinine. The SCD population was less well nourished than the controls, as evidenced by the lower serum prealbumin levels in the former group (91.3 v. 127 mg/l, P = 0.01). The serum concentrations of all of the essential amino acids were significantly reduced (21-47 per cent, P < 0.01) in the SCD subjects, as were those of most of the non-essential amino acids (exceptions: alanine, glutamic acid, proline). The urine concentrations of seven of the essential amino acids (indexed to creatinine) were increased in the SCD children. The greatest difference in urinary amino acid excretion was seen with methionine; the SCD subjects excreted 3.6-fold more methionine than the controls. These data indicate that reduced levels of serum amino acids resulting from increased urinary loss of these amino acids in children with SCD could contribute to the decreased growth rates one sees in children with this genetically inherited hematologic disorder.
Asunto(s)
Aminoácidos/sangre , Aminoácidos/orina , Trastornos del Crecimiento/etiología , Rasgo Drepanocítico/sangre , Rasgo Drepanocítico/orina , Estudios de Casos y Controles , Niño , Preescolar , Creatinina/sangre , Creatinina/orina , Femenino , Humanos , Lactante , Masculino , Nigeria , Rasgo Drepanocítico/complicacionesRESUMEN
OBJECTIVES: We measured the levels of the pyridinoline crosslinked carboxyterminal telopeptide of type I collagen (ICTP) and osteocalcin (OC) in the serum of 12 rachitic and 27 healthy Nigerian children, and compared the performance of these relatively new markers of bone metabolism with established laboratory parameters of skeletal disease. DESIGN AND METHODS: Active rickets was diagnosed on the basis of clinical and biochemical criteria. Serum calcium and phosphorus concentration and alkaline phosphatase activity were determined using clinically accepted methods. Radioimmunoassay was performed to quantify parathyroid hormone, 1-,25-dihydroxyvitamin D, OC, and ICTP. RESULTS: The rachitic children had statistically significant serum elevations of ICTP and osteocalcin as compared with age- and sex-matched controls. Serum levels of ICTP correlated with alkaline phosphate activity. CONCLUSIONS: As a marker of abnormal bone metabolism, ICTP performs at least as well as alkaline phosphate. ICTP and OC are valuable additions to the growing repertoire of bone markers.
Asunto(s)
Colágeno/sangre , Osteocalcina/sangre , Péptidos/sangre , Raquitismo/sangre , Factores de Edad , Fosfatasa Alcalina/sangre , Biomarcadores/sangre , Huesos/química , Huesos/metabolismo , Calcio/sangre , Niño , Preescolar , Colágeno/metabolismo , Colágeno Tipo I , Dieta , Humanos , Lactante , Análisis por Apareamiento , Nigeria , Hormona Paratiroidea/sangre , Fosfatos/sangre , Raquitismo/diagnóstico , Vitamina D/sangreRESUMEN
In three randomised, multicentre studies, azithromycin treatment (1g) as a single dose was administered to patients with uncomplicated gonococcal and non-gonococcal urethritis attending STD Research Laboratories in Lagos, Jos and Ibadan; between January 1989 and December, 1990. One hundred and eighty three patients, comprising 106 males and 77 females who had infections were evaluable at the end of the treatment. Of these 71% of the N. gonorrhoeae isolates were penicillinase producers (PPNG), while 39% were non-PPNG. One hundred and fourteen (95%) of 120 patients with gonococcal urethritis including 104 cases due to penicillinase producing Neiserria gonorrhoeae (PPNG) were clinically and bacteriologically cured with a single 1g dose of azithromycin. Fifty-four (90%) out of 60 patients with non-gonococcal urethritis were cured whilst administered the same dose of azithromycin. The side effects reported for azithromycin were mainly mild and moderate gastro-intestinal complaints and there were no major abnormalities in laboratory parameters. It is concluded that azithromycin was efficacious and safe for the treatment of uncomplicated gonococcal and non-gonococcal infections and may improve patient compliance.
Asunto(s)
Azitromicina/administración & dosificación , Azitromicina/uso terapéutico , Gonorrea/tratamiento farmacológico , Uretritis/tratamiento farmacológico , Administración Oral , Adolescente , Adulto , Azitromicina/efectos adversos , Femenino , Enfermedades Gastrointestinales/inducido químicamente , Gonorrea/microbiología , Humanos , Masculino , Persona de Mediana Edad , Penicilinasa , Resultado del Tratamiento , Uretritis/microbiologíaRESUMEN
The effects of thyroidectomy and thyroxine on serum calcium concentration were studied in adult albino Wistar strain rats using the technique described by Baginski et al. (1973) as used by Lorentz [10]. Thyroidectomy decreased serum calcium concentration from 2.28 +/- 0.02 mmol/l to 1.61 +/- 0.01 mmol/l. Chronic administration of thyroxine (6-8 micrograms/100 g body wt/day) for 35 days caused an increased serum calcium concentrations from 2.28 +/- 0.02 mmol/l to 2.98 +/- 0.05 mmol/l. These findings suggest that thyroidectomy and the dose of thyroxine used affected calcium metabolism in rats.