Intra‑cardiac masses in adults: A review of echocardiogram records at two echocardiographic laboratories in Enugu, South‑East Nigeria

Background: Transthoracic echocardiography (TTE) is an excellent initial diagnostic technique used to evaluate and diagnose cardiac masses, even though transoesophageal echocardiography (TEE) provides superior image resolution and better visualization of cardiac masses, especially in patients with suboptimal transthoracic echocardiographic studies. TTE is the clinical procedure of choice for identification of left ventricular thrombi. TTE has greater than 90% sensitivity and greater than 85% specificity for detection of left ventricular thrombi and is probably superior to the sensitivity and specificity of TEE, especially for apical thrombi.Aims: The study aimed to identify the common types of cardiac masses and their commonest locations in the heart.Materials and Methods: We did a retrospective review of our echocardiogram reports from May 2003 to July 2012 to identify the frequency of intra‑cardiac masses in adults, as well as the gender distribution and commonest location of these masses.Results: There were 2,814 echo examinations in adults over this period, comprising 1,661 males (59.1%) and 1,153 females (40.9%). Intra‑cardiac masses were found in 20 of these patients representing 0.7% of the study population. Thrombi were the commonest masses noted in our study, and there were more masses in the atria than in the ventricles. The left heart chambers also had more masses than the right heart chambers. There was no sex difference in the frequency of cardiac masses.Conclusion: Intra‑cardiac masses are rare, and transthoracic echocardiography is still valuable in the diagnosis and initial characterization of cardiac masses.Keywords: Adults, echocardiography, intra‑cardiac masses, NigeriaNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Photostress Recovery Time Among Welders in Owerri Municipal Council, Southeast, Nigeria

Purpose: The photostress recovery time (PSRT) scores of welders were measured based on age, workexperience and welding-method.Methods: A quasi-experimental study was conducted among 50 purposively sampled welders, who had clear ocular media, healthy fundi and visual acuities of 6/6 or better in the tested eyes. The pre-bleach distant visual acuity of the right eye was determined with the Snellen’s visual acuity chart, while direct ophthalmoscopy was done to rule out media opacities, retinopathies and maculopathies. The  right eye was dazzled for 10 seconds with the light of a direct ophthalmoscope held at 2cm from the eye. The time required in seconds to read at least, three optotypes on the line directly above the baseline acuity was recorded as the PSRT.Results: The 22-31 years age group recorded the least mean PSRT (16±8.8seconds), followed by the 32-41 age group (19.9±6.8 seconds), while the 42-51 years category had the highest mean PSRT (31.4±10.5seconds). Age associated significantly (p˂0.05) with mean PSRT. Welders within the 1-12 years’ work experience had the least mean PSRT (15.9±8.1seconds) while those within the 25-36 years recorded the highest mean PSRT (33.4±9.3seconds). The observed difference in mean PSRT with years of work experience was statistically significant (p˂0.05). Gas welders had significantly (p˂0.05) higher mean PSRT (26.6±9.9secs) than electric arc welders (16.6±9.2secs).Conclusion: Gas welding, increasing age and work-experience were found to be predictive markers of elevated photostress recovery time (PSRT) among welders. This underscores the need for eye-care practitioners to routinize PSRT tests in the ocular assessment of welders. Keywords: Photostress recovery time (PSRT); electric-arc; gas welding; welders; age

Microbiological Assessment of Soil Contaminated with Refined Petroleum: A Case Study of Eluama in Isuikwuato LGA, Abia State, Nigeria

A microbiological assessment of soil polluted by refined petroleum was carried out in Eluama community, Isuikwuato LGA, Abia State, Nigeria between March and October, 2012. The aim of the study is to examine the long-term kinetics of refined petroleum oil contaminated soil in this area from pipeline vandalization in the year 2000 and to assess the extent of biodegradation with respect to length of time of the spill. The microbiological examination of the soil samples were conducted by serial diluting and then inoculating the soil samples on different growth media. Several microbiological and biochemical methods were applied in order to isolate and identify the microorganisms accustomed to the soil sample. An unpolluted farmland served as control. Results showed a decrease in microbial load of soil as distance approaches seepage area. The control has a total heterotrophic bacteria count of 22.3 x 106 CFU/ml which decreases towards the seepage area (4.1 x 106 CFU/ml)

Interactions between deformation and fluids in the frontal thrust region of the NanTroSEIZE transect offshore the Kii Peninsula, Japan: Results from IODP Expedition 316 Sites C0006 and C0007

Integrated Ocean Drilling Program (IODP) Expedition 316 Sites C0006 and C0007 examined the deformation front of the Nankai accretionary prism offshore the Kii Peninsula, Japan. In the drilling area, the frontal thrust shows unusual behavior as compared to other regions of the Nankai Trough. Drilling results, integrated with observations from seismic reflection profiles, suggest that the frontal thrust has been active since similar to 0.78-0.436 Ma and accommodated similar to 13 to 34% of the estimated plate convergence during that time. The remainder has likely been distributed among out-of-sequence thrusts further landward and/or accommodated through diffuse shortening. Unlike results of previous drilling on the Nankai margin, porosity data provide no indication of undercompaction beneath thrust faults. Furthermore, pore water geochemistry data lack clear indicators of fluid flow from depth. These differences may be related to coarser material with higher permeability or more complex patterns of faulting that could potentially provide more avenues for fluid escape. In turn, fluid pressures may affect deformation. Well-drained, sand-rich material under the frontal thrust could have increased fault strength and helped to maintain a large taper angle near the toe. Recent resumption of normal frontal imbrication is inferred from seismic reflection data. Associated decollement propagation into weaker sediments at depth may help explain evidence for recent slope failures within the frontal thrust region. This evidence consists of seafloor bathymetry, normal faults documented in cores, and low porosities in near surface sediments that suggest removal of overlying material. Overall, results provide insight into the complex interactions between incoming materials, deformation, and fluids in the frontal thrust region

Clinical reports of pulmonary metastasectomy for colorectal cancer: a citation network analysis

INTRODUCTION: Pulmonary metastasectomy for colorectal cancer is a commonly performed and well-established practice of similar to 50 years standing. However, there have been no controlled studies, randomised or otherwise. We sought to investigate the evidence base that has been used in establishing its status as a standard of care.METHODS: Among 51 papers used in a recent systematic review and quantitative synthesis, a citation network analysis was performed. A total of 344 publications (the 51 index papers and a further 293 cited in them) constitute the citation network.RESULTS: The pattern of citation is that of a citation cascade. Specific analyses show the frequent use of historical or landmark papers, which add authority. Papers expressing an opposing viewpoint are rarely cited.CONCLUSIONS: The citation network for this common and well-established practice provides an example of selective citation. This pattern of citation tends to escalate belief in a clinical practice even when it lacks a high-quality evidence base and may create an impression of more authority than is warranted.British Journal of Cancer (2011) 104, 1085-1097. doi: 10.1038/sj.bjc.6606060 www.bjcancer.comPublished online 8 March 2011 (c) 2011 Cancer Research U

Health workforce and governance: the crisis in Nigeria

Background In Nigeria, several challenges have been reported within the health sector, especially in training, funding, employment, and deployment of the health workforce. We aimed to review recent health workforce crises in the Nigerian health sector to identify key underlying causes and provide recommendations toward preventing and/or managing potential future crises in Nigeria. Methods We conducted a scoping literature search of PubMed to identify studies on health workforce and health governance in Nigeria. A critical analysis, with extended commentary, on recent health workforce crises (2010–2016) and the health system in Nigeria was conducted. Results The Nigerian health system is relatively weak, and there is yet a coordinated response across the country. A number of health workforce crises have been reported in recent times due to several months’ salaries owed, poor welfare, lack of appropriate health facilities and emerging factions among health workers. Poor administration and response across different levels of government have played contributory roles to further internal crises among health workers, with different factions engaged in protracted supremacy challenge. These crises have consequently prevented optimal healthcare delivery to the Nigerian population. Conclusions An encompassing stakeholders’ forum in the Nigerian health sector remain essential. The national health system needs a solid administrative policy foundation that allows coordination of priorities and partnerships in the health workforce and among various stakeholders. It is hoped that this paper may prompt relevant reforms in health workforce and governance in Nigeria toward better health service delivery in the country

Genome-wide asociation analysis identifies three psoriasis susceptibility loci

We carried out a meta-analysis of two recent psoriasis genome-wide asociation studies with a combined discovery sample of 1,831 affected individuals (cases) and 2,546 controls. One hundred and two loci selected based on P value rankings were foLowed up in a thrE-stage replication study including 4,064 cases and 4,685 controls from Michigan, Toronto, Newfoundland and Germany. In the combined meta-analysis, we identified thrE new susceptibility loci, including one at NOS2 (rs4795067, combined P = 4-10-11), one at FBXL19 (rs10782001, combined P = 9-10-10) and one near PSMA6-NFKBIA (rs12586317, combined P = 2-10-8). AL thrE loci were also aSociated with psoriatic arthritis (rs4795067, combined P = 1-10-5; rs10782001, combined P = 4-10-8; and rs12586317, combined P = 6-10-5) and purely cutaneous psoriasis (rs4795067, combined P = 1-10-8; rs10782001, combined P = 2-10-6; and rs12586317, combined P = 1-10-6). We also replicated a recently identified asociation signal near RNF114 (rs495337, combined P = 2-10-7)

Acquired resistance to oxaliplatin is not directly associated with increased resistance to DNA damage in SK-N-ASrOXALI4000, a newly established oxaliplatin-resistant sub-line of the neuroblastoma cell line SK-N-AS

The formation of acquired drug resistance is a major reason for the failure of anti-cancer therapies after initial response. Here, we introduce a novel model of acquired oxaliplatin resistance, a sub-line of the non-MYCN-amplified neuroblastoma cell line SK-N-AS that was adapted to growth in the presence of 4000 ng/mL oxaliplatin (SK-N-ASrOXALI4000). SK-N-ASrOXALI4000 cells displayed enhanced chromosomal aberrations compared to SK-N-AS, as indicated by 24-chromosome fluorescence in situ hybridisation. Moreover, SK-N-ASrOXALI4000 cells were resistant not only to oxaliplatin but also to the two other commonly used anti-cancer platinum agents cisplatin and carboplatin. SK-N-ASrOXALI4000 cells exhibited a stable resistance phenotype that was not affected by culturing the cells for 10 weeks in the absence of oxaliplatin. Interestingly, SK-N-ASrOXALI4000 cells showed no cross resistance to gemcitabine and increased sensitivity to doxorubicin and UVC radiation, alternative treatments that like platinum drugs target DNA integrity. Notably, UVC-induced DNA damage is thought to be predominantly repaired by nucleotide excision repair and nucleotide excision repair has been described as the main oxaliplatin-induced DNA damage repair system. SK-N-ASrOXALI4000 cells were also more sensitive to lysis by influenza A virus, a candidate for oncolytic therapy, than SK-N-AS cells. In conclusion, we introduce a novel oxaliplatin resistance model. The oxaliplatin resistance mechanisms in SK-N-ASrOXALI4000 cells appear to be complex and not to directly depend on enhanced DNA repair capacity. Models of oxaliplatin resistance are of particular relevance since research on platinum drugs has so far predominantly focused on cisplatin and carboplatin