Articles: disease.
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Aust N Z J Obstet Gynaecol · May 1989
Abruptio placentae at the University of Nigeria Teaching Hospital, Enugu: a 3-year study.
A total of 81 cases of abruptio placentae treated in a 3-year period at the University of Nigeria Teaching Hospital, Enugu is reported. The incidence of 0.44% found in the study is low when compared to reports from Europe. ⋯ Management was by rapid and adequate resuscitation by blood transfusion and delivery as soon as the diagnosis was made. The absence of maternal mortality amongst mothers who received antenatal care at the University Teaching Hospital emphasizes the need for adequate antenatal and intrapartum care in order to eliminate the complications of this obstetrical enigma.
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The World Health Organization (WHO) clinical case definition for paediatric AIDS was tested during a 1-month period on 221 consecutive hospitalized children in Kigali, Rwanda. Relevant clinical features not included in the WHO case definition were also evaluated. Thirty-four out of the 221 children (15.4%) were HIV seropositive. ⋯ Those signs and symptoms contributing the most to the regression were: respiratory distress, chronic diarrhoea and generalized lymphadenopathy. Based on these findings, we propose a simplified clinical case definition for paediatric AIDS in Africa with better sensitivity, specificity and PPV than the WHO case definition. Further work is needed using this approach to develop case definitions useful for epidemiological surveillance and for case management.
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The appearance of myocardial infarctions in fertile women is to agree upon the concept of cardiovascular risk factors. Women without diabetes showed in 3 age groups up to 49 years 2.5-3.1 factors and with diabetes 4.4-4.8 factors, such as smoking, hyperlipoproteinaemia, hypertension, obesity, oral contraceptives, hyperuricaemia and diabetes mellitus, respectively. ⋯ A critical indication for oral contraceptives is recommended, if already one of the factors, such as smoking, hyperlipoproteinaemia, hypertension, obesity or diabetes mellitus is present, or, if possible, its removal before ordination. Also low-dose oral contraceptives must be regarded as a potential risk factor up to further clarification.
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Many symptoms in outpatient practice are poorly understood. To determine the incidence, diagnostic findings, and outcome of 14 common symptoms, we reviewed the records of 1,000 patients followed by house staff in an internal medicine clinic over a three-year period. The following data were abstracted for each symptom: patient characteristics, symptom duration, evaluation, suspected etiology of the symptom, treatment prescribed, and outcome of the symptom. Cost estimates for diagnostic evaluation were calculated by means of the schedule of prevailing rates for Texas employed by the Civilian Health and Medical Program of the Uniformed Services for physician reimbursement. ⋯ The classification, evaluation, and management of common symptoms need to be refined. Diagnostic strategies emphasizing organic causes may be inadequate.