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Mesenteric cysts have been documented as a rare occurrence in children. They are mostly renowned to be benign intra-abdominal tumors with no known etiology. The symptoms are non-specific ranging from being asymptomatic to an acute abdomen. Most of the diagnoses are made below the age of 10 years with devoid of reports for the early neonatal occurrences. We report a case of an early neonatal mesenteric cyst in a 5-day-old female patient who presented with signs of intestinal obstruction markedly by abdominal distension, vomiting, and absolute constipation. Abdominal X-ray showed evidence of small bowel obstruction while abdominal ultrasound and computed tomography (CT) scan were used to reach the diagnosis of a mesenteric cyst, all laboratory baseline investigations were within a normal range. On laparotomy a 12 by 13 cm cyst that was firmly adhering to the proximal ileal wall was meticulously dissected, complete cystectomy was done with no segmental resection. Histopathologically there were no signs of malignancy and the patient successfully recovered with no signs of recurrences after being followed for a year and a half. Being a rare case in the early neonatal period with unspecific presentations; mesenteric cyst should be considered as one of the diagnoses best to be managed by surgical excision to prevent recurrences.
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Obstrucción Intestinal , Laparotomía , Quiste Mesentérico , Tomografía Computarizada por Rayos X , Humanos , Quiste Mesentérico/diagnóstico , Quiste Mesentérico/cirugía , Quiste Mesentérico/patología , Femenino , Recién Nacido , Laparotomía/métodos , Obstrucción Intestinal/etiología , Obstrucción Intestinal/cirugía , Obstrucción Intestinal/diagnóstico , Ultrasonografía , Estudios de Seguimiento , Vómitos/etiología , Estreñimiento/etiología , Radiografía AbdominalRESUMEN
BACKGROUND: One of the main limitations of radiation therapy is the resistance of tumor cells. This study aimed at evaluating the relationship between the expression of epidermal growth factor receptor (EGFR) and echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) and tumor radiosensitivity in patients with non-small cell lung cancer. METHODS: Medical case files, pathological results for EGFR and EML4-ALK, and computerized tomography scans of patients with NSCLC treated with thoracic radiation therapy were analyzed. RESULTS: The sample size was 101 patients with mean age 58.43 ± 9.89 years. Statistically significant differences were observed in the mean reduction of long tumor diameter during the early treatment phase in EGFR-positive versus EGFR-negative patients (p value = 0.04) and in short tumor diameter during the late treatment phase in EGFR-positive versus EGFR-negative patients (p value = 0.04). CONCLUSION: Patients with overexpression of EGFR mutations are more radiosensitive during the early treatment phase, and EML4-ALK mutations were less radiosensitive regardless of phases.
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Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Anciano , Quinasa de Linfoma Anaplásico/genética , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Receptores ErbB/genética , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/radioterapia , Proteínas Asociadas a Microtúbulos/genética , Persona de Mediana Edad , Mutación , Proteínas de Fusión Oncogénica/genéticaRESUMEN
The aim of this study was to screen for and determine the prevalence, severity and determinants of anaemia in pregnant women attending antenatal clinics in south of Tanzania. In this facility-based cross-sectional descriptive study, pregnant women attending antenatal clinics were selected through a convenient non-probability sampling in one district hospital in south of Tanzania. Interviews using standardized questionnaires were conducted, physical examination and determination of haemoglobin levels done. Data analysis was done using SPPS V20.0. A total of 356 pregnant women werw included in this analysis. Their mean mean age was 24.5 ±2.4 years. The mean haemoglobin level was 10.74 ± 1.39g/dL and the point-prevalence of anemia in pregnancy was 46.3%. Pregnant women who had severe anaemia were 14(8.5%), while maternal education status, woman's occupation, religion, family average monthly income, breastfeeding patterns and parity were all found to be statistically significant independent predictors for maternal anemia in pregnancy. Anaemia in pregnancy is a serious public health problem in south of Tanzania. We recommend strengthening measures to prevent anaemia in pregnant and women of reproductive age in the study area.
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Anemia/epidemiología , Complicaciones Hematológicas del Embarazo/epidemiología , Atención Prenatal/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , Escolaridad , Femenino , Humanos , Embarazo , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Tanzanía/epidemiología , Adulto JovenRESUMEN
INTRODUCTION: Gestational diabetes mellitus (GDM) is a potential risk factor for both maternal and foetal complications during pregnancy. This study aimed to determine the prevalence and factors associated with GDM among pregnant women in Southern Tanzania. METHODS: A cross-sectional study was conducted among 612 randomly selected pregnant women attending routine antenatal clinics in Southern Tanzania from September to October 2017. Detailed medical and gynaecological history was taken using pre-tested questionnaires. Blood samples were collected for fasting and oral glucose tolerance tests. We diagnosed GDM using the World Health Organization 2013 diagnostic criteria for diabetes mellitus. We performed statistical analysis using SPSS v24.0. Possible associations and statistical significance were measured using odds ratio at 95% confidence interval, and p-values of <0.05 were considered statistically significant. RESULTS: The mean age and standard deviation of the study subjects was 24.5±6.9 years. The prevalence of GDM was 4.3%. GDM was significantly associated with: being overweight or obese (p<0.001), past history of pre-term delivery (p<0.001), past history of stillbirths (p<0.001), history of macrosmia (p<0.001), alcohol consumption (p=0.001), and having a first degree relative with diabetes mellitus (p<0.001). CONCLUSION: Prevalence of Gestational Diabetes Mellitus is low in this study setting. We recommend close attention to at risk women to prevent development of GDM. FUNDING: None declared.
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Diabetes Gestacional/epidemiología , Obesidad/complicaciones , Resultado del Embarazo/epidemiología , Adolescente , Adulto , Glucemia/análisis , Estudios Transversales , Diabetes Gestacional/diagnóstico , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Obesidad/epidemiología , Embarazo , Mujeres Embarazadas , Prevalencia , Factores de Riesgo , Población Rural , Mortinato/epidemiología , Encuestas y Cuestionarios , Tanzanía/epidemiología , Adulto JovenRESUMEN
Introduction: Neonatal sepsis is one of the most common causes of neonatal morbidity and mortality in developing countries.Objective: This study aimed to determine the prevalence and factors associated with neonatal sepsis among hospitalized new-borns at Ruvuma, southern Tanzania.Methods: A facility-based retrospective study was conducted at Songea Regional Referral hospital in Ruvuma, during August-October, 2018. A standardized questionnaire was used to collect demographic, obstetric and clinical information from medical case files of patients. Neonatal sepsis was diagnosed clinically. Data were analysed using SPSS version 24.0. Chi square test was used to assess relationship between outcome and exposure variables. Multivariate logistic regression was used to measure association after controlling for confounders, and P-values of <0.05 were statistically significant.Results: Medical case files of 263 neonates were reviewed. Of these, 131(49.8%) had sepsis. Factors associated with neonatal sepsis were prematurity (AOR=2.2; 95%CI. 1.3 3.6, p=0.002), age of more than a week (AOR=2.2; 95%CI. 1.0 4.6, p=0.04), intravenous cannulation after birth (AOR=6.3; 95%CI. 2.1 19.0, p=0.002), and resuscitation with nasal oxygen prongs (AOR=1.7; 95%CI. 1.1 2.9, p=0.02).Conclusions: Neonatal sepsis is relatively common among neonates in Ruvuma and is associated with maternal and health services related factors. The findings underscore the importance of routine assessment and close monitoring of neonates
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Niño Hospitalizado , Recién Nacido , Sepsis Neonatal/epidemiología , Sepsis Neonatal/mortalidad , Factores de Riesgo , TanzaníaRESUMEN
OBJECTIVE: The purpose of this study is to evaluate the association between PET/CT CFR and biomarkers combined in confirming the diagnosis of coronary microvascular dysfunction. RESULTS: A total of 28 patients (21 males and 7 females) were included in this descriptive observational study (both qualitative and quantitative). The mean patient age was 55.50 ± 10.21 years (range 27-70 years) and the median was 56.5 years (range 49-63 years). All patients underwent Echo, CAG and PET/CT scan. Chest tightness was the most common symptom in our study. Most patients had normal blood pressure (n = 18, 64.3%) while only (n = 10, 37.5%) had hypertension, and (n = 1, 3.6%) had diabetes mellitus. The mean HDL in CMVD (n = 25) and non-CMVD (n = 3) were 1.30 ± 0.39 and 1.08 ± 0.95, respectively, indicating that the difference between the groups was statistically significant (p = 0.04). Similarly, the mean HBA1c- (glycated haemoglobin) in CMVD (n = 25) and non-CMVD (n = 3) were 5.6 ± 0.53 and 5.0 ± 0.26, respectively, with (p = 0.03). Our findings managed to show the association between biomarkers and PET/CT CFR in confirming the diagnosis of coronary microvascular dysfunction.
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Biomarcadores/sangre , Enfermedad de la Arteria Coronaria , Circulación Coronaria/fisiología , Diabetes Mellitus , Hipertensión , Microcirculación/fisiología , Tomografía Computarizada por Tomografía de Emisión de Positrones , Anciano , Comorbilidad , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/fisiopatología , Diabetes Mellitus/sangre , Diabetes Mellitus/diagnóstico por imagen , Diabetes Mellitus/epidemiología , Diabetes Mellitus/fisiopatología , Femenino , Fluorodesoxiglucosa F18 , Humanos , Hipertensión/sangre , Hipertensión/diagnóstico por imagen , Hipertensión/epidemiología , Hipertensión/fisiopatología , Masculino , Persona de Mediana EdadRESUMEN
INTRODUCTION: Superficial skin fungal infections are among the neglected communicable diseases in many developing countries. Schoolchildren are among the most affected groups in Southern Tanzania. The main objective of this study was to determine the magnitude and associated risk factors of superficial skin fungal infections among primary schoolchildren in Southern Tanzania. METHODS: A cross-sectional descriptive community-based study was conducted in October 2017 in a public primary school in Songea Municipal, Southern Tanzania. A sample of 500 pupils was interviewed and a physical examination performed to assess for the presence of clinically suspected skin fungal infections. Data were analyzed by SPSS v21 (IBM Corp., Armonk, NY, US). RESULTS: A total of 500 pupils (52.40% males) with a mean age of 9.92±1.13 years were recruited. The point-prevalence of skin fungal infections was 35.20%. Tinea capitis was the leading suspected skin fungal disease found in 73 (80.22%) pupils. Age between 10 and 12 years and sharing of a bed with more than three people were significantly associated with the development of superficial skin fungal infections (p<0.05). CONCLUSION: Our findings indicate that the magnitude of superficial skin fungal infections among schoolgoing children in this study area is moderately high. We recommend the provision of health education programs for preventing and controlling diseases in schoolchildren, with the aim to reduce long-term morbidity and the socioeconomic impact.
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OBJECTIVE: To improve current knowledge of coronary flow reserve and non-obstructive coronary artery disease in terms of definition, features and clinical implications of measurement of coronary flow reserve (CFR), is an integrated measure of focal, diffuse, and small vessel coronary artery disease, can also be explained as a calculated ratio of hyperaemic to rest absolute myocardial blood flow. Non-obstructive coronary artery disease is defined as atherosclerotic plaque that does not obstruct blood flow or result in anginal symptoms. We also aimed at knowing the significance of PET in diagnosing coronary microvascular disease. RESULTS: In our study 92% were between 41 and 60 years. 83% were males and 17% females, more patients had hypertension about 50%, few had diabetes mellitus about 16%, while those with both hypertension and diabetes mellitus were 17%. About 83% had ST segment and T wave changes on ECG. All patients and controls had normal coronaries on coronary angiography TIMI 3 flow. On further investigation by Positron emission tomography/CT we found out 58% had abnormal CFR and 42% had normal coronary flow reserve. Our findings indicate PET/CT coronary flow reserve concept provides a platform for the diagnosis of non-obstructive coronary artery disease in patients with signs and symptoms of ischemia without angiographic obstructive CAD.
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Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Adulto , Angiografía Coronaria , Circulación Coronaria , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tomografía de Emisión de Positrones , Adulto JovenRESUMEN
Introduction Anemia is a significant public health problem among children and women globally. It is one of the most common causes of deaths among children admitted to hospitals in sub-Saharan Africa. Case fatality rates of 6 percent to 18 percent have been reported even in facilities that have blood transfusions services. The purpose of this study was to evaluate the magnitude, severity, and morphological types of anemia among hospitalized children under five years of age in the southern part of Tanzania. Methods A cross-sectional, hospital-based, retrospective analysis was conducted in February 2016 using hospital records of 303 children aged 0-59 months admitted to St. Benedict Ndanda Referral Hospital, Mtwara, Tanzania between 1 July 2015 and 31 December 2015. Results The mean hemoglobin (Hb) level of the study population was 7.87 ± 2.84 g/dL, the median was 8.00g/dL, the interquartile range (IQR) was 4.40g/dL, and the prevalence of anemia was 83.17 percent. The magnitude of mild, moderate, and severe anemia was 9.13 percent, 44.84 percent, and 46.03 percent, respectively, and about half of all anemic children had normocytic anemia. Conclusion Severe anemia is a common health problem among hospitalized children under five years of age in the study area. We recommend screening all admitted children under the age of five for anemia, and clinicians should pay attention to and put more emphasis on intervention strategies for anemia when treating children admitted for other diseases.
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BACKGROUND: Previous studies have demonstrated that endoscopic ultrasound-fine needle aspiration (EUS-FNA) is a reliable tool for diagnosing pancreatic lesions; however, the reported sensitivity and specificity vary greatly across studies. The aim of this study was to pool the existing literature and assess the overall performance of EUS-FNA in the diagnosis of solid pancreatic lesions. METHODS: A systematic search of MEDLINE, Cochrane Database for Systematic Reviews, and EMBASE was performed to identify original and review articles published between January 1995 and January 2014 that reported the accuracy of EUS-FNA in the diagnosis of pancreatic masses. Quality of the included studies was assessed using the quality assessment of diagnosis accuracy studies score tool. Meta-DiSc software was used to calculate the pooled sensitivity and specificity, positive and negative likelihood ratios, and to construct the summary receiver operating characteristics curve. RESULTS: Twenty studies involving a total of 2,761 patients were included in the study. The pooled sensitivity and specificity of EUS-FNA in the diagnosis of solid pancreatic lesions were 90.8 % [95 % confidence interval (CI), 89.4-92 %] and 96.5 % (95 % CI, 94.8-97.7 %), respectively. The positive and negative likelihood ratios were 14.8 (95 % CI, 8.0-27.3) and 0.12 (95 % CI, 0.09-0.16), respectively. The overall diagnostic accuracy was 91.0 %. CONCLUSIONS: Our findings suggest that EUS-FNA has high sensitivity and specificity in the diagnosis of solid pancreatic lesions.
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Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patología , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/efectos adversos , Femenino , Humanos , Masculino , Curva ROC , Sensibilidad y EspecificidadRESUMEN
INTRODUCTION: To evaluate the diagnostic performance of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in monitoring the response of breast cancers to neoadjuvant chemotherapy. METHODS: Articles published in medical and oncologic journals between January 2000 and June 2012 were identified by systematic MEDLINE, Cochrane Database for Systematic Reviews, and EMBASE, and by manual searches of the references listed in original and review articles. Quality of the included studies was assessed by using the quality assessment of diagnosis accuracy studies score tool. Meta-DiSc statistical software was used to calculate the summary sensitivity and specificity, positive predictive and negative predictive values, and the summary receiver operating characteristics curve (SROC). RESULTS: Fifteen studies with 745 patients were included in the study after meeting the inclusion criteria. The pooled sensitivity and specificity of FDG-PET or PET/CT were 80.5% (95% CI, 75.9%-84.5%) and 78.8% (95% CI, 74.1%-83.0%), respectively, and the positive predictive and negative predictive values were 79.8% and 79.5%, respectively. After 1 and 2 courses of chemotherapy, the pooled sensitivity and false-positive rate were 78.2% (95% CI, 73.8%-82.5%) and 11.2%, respectively; and 82.4% (95% CI, 77.4%-86.1%) and 19.3%, respectively. CONCLUSIONS: Analysis of the findings suggests that FDG-PET has moderately high sensitivity and specificity in early detection of responders from nonresponders, and can be applied in the evaluation of breast cancer response to neoadjuvant chemotherapy in patients with breast cancer.
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Antineoplásicos/uso terapéutico , Neoplasias de la Mama/diagnóstico , Fluorodesoxiglucosa F18 , Terapia Neoadyuvante , Tomografía de Emisión de Positrones , Radiofármacos , Tomografía Computarizada por Rayos X , Neoplasias de la Mama/tratamiento farmacológico , Quimioterapia Adyuvante , Monitoreo de Drogas , Femenino , Humanos , Pronóstico , Curva ROCRESUMEN
INTRODUCTION: The aim of this study is to explore the feasibility of a triple-fused reporter gene, termed TGF [herpes simplex virus type 1 thymidine kinase (HSV1-tk), enhanced green fluorescent protein (eGFP) and firefly luciferase (Fluc)], to monitor stem cells using multimodality molecular imaging. METHODS: A recombinant adenovirus vector carrying the triple-fused reporter gene (Ad5-TGF) was constructed. Bone marrow mesenchymal stem cells (BMSCs) were transfected with different virus titers of Ad5-TGF [multiplicities of infection (MOIs) were 0, 50, 100, 150, 200 and 250]. The mRNA and protein expressions of HSV1-tk, eGFP and Fluc in the transfected BMSCs were evaluated using polymerase chain reaction and Western blot. After the transfection of the BMSCs with different virus titers of Ad5-TGF (MOIs were 25, 50, 75, 100 and 125), their uptake rates of (131)I-FIAU were measured. Whole-body fluorescence, bioluminescence and micro-positron emission tomography (PET) images were acquired 1 day after the transfected BMSCs were injected into the left forelimb of rats. RESULTS: After the transfection with different titers of Ad5-TGF, the positive transfection rate reached a peak (70%) when the MOI was 100. HSV1-tk, eGFP and Fluc mRNA and protein were detected in the Ad5-TGF-transfected BMSCs, which implies their successful transfection and expression. The BMSCs uptake of (131)I-FIAU increased with the adenovirus titer and incubation time and reached a plateau (approximately 5.3%) after 3 h. Strong signals were observed in the injected left forearms in the fluorescence, bioluminescence and micro-PET images. CONCLUSIONS: A triple-fused reporter gene, TGF, can be used as a multifunctional molecular probe for multimodality imaging.
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Genes Reporteros/genética , Trasplante de Células Madre Mesenquimatosas , Células Madre Mesenquimatosas/metabolismo , Adenoviridae/genética , Animales , Arabinofuranosil Uracilo/análogos & derivados , Arabinofuranosil Uracilo/metabolismo , Transporte Biológico , Células de la Médula Ósea/citología , Proteínas Fluorescentes Verdes/genética , Herpesvirus Humano 1/enzimología , Herpesvirus Humano 1/genética , Luciferasas de Luciérnaga/genética , Células Madre Mesenquimatosas/diagnóstico por imagen , Imagen Molecular , Cintigrafía , Ratas , Ratas Sprague-Dawley , Timidina Quinasa/genética , TransfecciónRESUMEN
PURPOSE: The aim of this study was to identify molecular markers associated with differentiated thyroid carcinoma (DTC) patients and to determine whether there was a correlation between clinicopathological features or molecular markers and the outcome of radioiodine therapy. PATIENTS AND METHODS: We retrospectively reviewed the records of 68 patients with papillary thyroid carcinoma (PTC) and 6 patients with follicular thyroid carcinoma (FTC), who underwent iodine treatment. All patients were divided into a cured group (no evidence for disease) and a noncured group (presence of residual or recurrent disease). Immunohistochemical analysis of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER)-2 (C-erbB-2), ephrin receptor (EphA-2), and sodium-iodide symporter (NIS) was performed in all DTC specimens (68 PTCs, 6 FTCs) and in 14 follicular adenoma specimens. RESULTS: Male patients and patients with lymph node and distant metastases had poorer prognosis. Overexpression of ER, PR, HER-2, EphA-2, and NIS was observed in 50.0% (37), 73.0% (54), 52.7% (39), 67.5% (50), and 70.3% (52) of DTC patients, respectively, and was significantly higher than in follicular adenoma patients (0%, 7.14%, 14.29%, 35.7%, and 35.7%, respectively). However, in patients with DTC, no significant difference in the expression of any marker was seen between the cured group and noncured group. CONCLUSIONS: Male gender, and lymph node and distant metastases were found to be poor prognostic factors for patients with DTC. Higher expressions of ER, PR, HER-2, EphA-2, and NIS were associated with DTC, but were not correlated with the effectiveness of radioiodine treatment.