BACKGROUND: The proportion of preventable trauma-related deaths may be a reflection of the quality of trauma care in a health institution. OBJECTIVE: To classify mortality in trauma patients in the emergency room and to determine the proportion of preventable trauma related mortality in a teaching hospital. METHODS: The records of patients who died in the emergency room following trauma from January 1996 to December 2005 were reviewed. Data extracted from the patients' records included the demographics, the mechanism of injury; and the duration of injury prior to presentation. The Probability of Survival (Ps) was calculated for each patient using the Revised Trauma Score (RTS). The RTS includes three physiologic parameters namely the Glasgow Coma Score [GCS], systolic blood pressure and respiratory rate which were recorded soon after the patient's presentation at the emergency department. RESULTS: There were 286 patients who died following trauma from January 1996 to December 2006. There was a male: female ratio of 3.4:1. Eighty-one percent were preventable deaths based on the revised trauma score while the panel review considered approximately 22% as preventable. Fifty-nine percent or 168 of the patients arrived in the hospital within six hours of sustaining injury. CONCLUSION: Despite access to emergency care within the first six hours (golden hours) the overall survival of our trauma patients is poor. The severity of the injuries, inadequate resuscitation, and missed injuries by medical personal are some of the factors associated with poor outcome of trauma care. WAJM 2011; 30(1): 9-13.
Very few cases of pheochromocytoma in functional accessory adrenal glands have been documented in literature. We present a twenty-four year old Nigerian female who presented with pheochromocytoma. Investigations revealed a suprarenal mass, which was diagnosed as an accessory gland adrenal tumour at surgery. This shows that accessory adrenal glands can be a basis for development of pheochromocytoma.
There is conflicting evidence on the role of lipid biomarkers in breast cancer (BC), and no study to our knowledge has examined this association among African women. We estimated odds ratios (ORs) and 95% confidence intervals (95% CI) for the association of lipid biomarkers—total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides—with odds of BC overall and by subtype (Luminal A, Luminal B, HER2-enriched and triple-negative or TNBC) for 296 newly diagnosed BC cases and 116 healthy controls in Nigeria. Each unit standard deviation (SD) increase in triglycerides was associated with 39% increased odds of BC in fully adjusted models (aOR: 1.39; 95% CI: 1.03, 1.86). Among post-menopausal women, higher total cholesterol (aOR: 1.65; 95% CI: 1.06, 2.57), LDL cholesterol (aOR: 1.59; 95% CI: 1.04, 2.41), and triglycerides (aOR: 1.91; 95% CI: 1.21, 3.01) were associated with increased odds of BC. Additionally, each unit SD increase in LDL was associated with 64% increased odds of Luminal B BC (aOR 1.64; 95% CI: 1.06, 2.55). Clinically low HDL was associated with 2.7 times increased odds of TNBC (aOR 2.67; 95% CI: 1.10, 6.49). Among post-menopausal women, higher LDL cholesterol and triglycerides were significantly associated with increased odds of Luminal B BC and HER2 BC, respectively. In conclusion, low HDL and high LDL are associated with increased odds of TN and Luminal B BC, respectively, among African women. Future prospective studies can definitively characterize this association and inform clinical approaches targeting HDL as a BC prevention strategy.
Background The association between obesity and breast cancer (BC) has been extensively studied among US, European and Asian study populations, with often conflicting evidence. However, despite the increasing prevalence of obesity and associated conditions in Africa, the continent with the highest age-standardized BC mortality rate globally, few studies have evaluated this association, and none has examined in relation to molecular subtypes among African women. The current analysis examines the association between body composition, defined by body mass index (BMI), height, and weight, and BC by molecular subtype among African women. Methods We estimated odds ratios (ORs) and 95% confidence intervals (95% CI) for the association between measures of body composition and BC and molecular subtypes among 419 histologically confirmed cases of BC and 286 healthy controls from the Mechanisms for Established and Novel Risk Factors for Breast Cancer in Women of Nigerian Descent (MEND) case-control study. Results Higher BMI (aOR: 0.79; 95% CI: 0.67, 0.95) and weight (aOR: 0.83; 95% CI: 0.69, 0.98) were associated with reduced odds of BC in adjusted models, while height was associated with non-statistically significant increased odds of BC (aOR: 1.07, 95% CI: 0.90, 1.28). In pre/peri-menopausal, but not post-menopausal women, both higher BMI and weight were significantly associated with reduced odds of BC. Further, higher BMI was associated with reduced odds of Luminal A, Luminal B, and HER2-enriched BC among pre/peri-menopausal women, and reduced odds of triple-negative BC among post-menopausal women. Conclusions Higher BMI and weight were associated with reduced odds of BC overall and by molecular subtype among West African women. Larger studies of women of African descent are needed to definitively characterize these associations and inform cancer prevention strategies.
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