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Biomedical subjects

A O Williams

Publications and source records attributed to A O Williams.

At least 37 records · Page 2Linked to original sources
PubMed1985

Recent developments in the care, treatment, and rehabilitation of the chronic mentally ill in Nigeria.

Nigeria, with a population estimated at 80 million, has fewer than 100 psychiatrists and psychologists and only 20 psychiatric facilities. Most chronic mental patients are cared for by their relatives, by traditional healers, or by religious healers affiliated with the new Christian churches, which have proliferated in recent years. Lack of organized social welfare services makes the family the only consistent source of social support for the mentally ill; patients who lose contact with their families often become homeless wanderers. Although the majority of the mentally ill in Nigeria are cared for outside the mental health system, recent developments, such as the establishment of mobile clinics and village-based psychiatric units, show great potential for advancing the treatment of chronic mental illness in Nigeria.

Chronic Disease↗
PubMed1985

Schizophrenia with good and poor outcome. I: Early clinical features, response to neuroleptics and signs of organic dysfunction.

Seventy-seven patients with diagnosis of schizophrenia (62) or schizoaffective disorder (15) were studied 2-20 years since onset of illness, when in a stable condition. The investigation included clinical assessment, measurement of plasma concentrations of neuroleptics and prolactin, computed tomography brain scan, neuropsychological and neurological examination. Outcome of illness was classified according to the presence of chronic psychiatric symptoms and social impairment, and response to neuroleptics according to the effect of treatment in the most recent psychotic episode. Neither outcome nor response to neuroleptics was related to duration of illness. The groups with good and poor outcome differed in premorbid adjustment, age at onset and symptoms of the initial episode, but not in drug bio-availability or prolactin response. Large cerebral ventricles and cognitive impairment, but not neurological 'soft' signs, were associated with unfavourable outcome. The three measures of organicity were not inter-related. No clinical differences were found between chronic patients with and without signs of organic dysfunction. The findings suggest that schizophrenia with good and unfavourable outcome may be separate sub-types. However, the role of organic factors in the latter group remains unclear.

Adult↗
PubMed1985

Schizophrenia with good and poor outcome. II: Cerebral ventricular size and its clinical significance.

Computer tomography brain scans were carried out on 40 patients with schizophrenia or schizo-affective disorder of 2-20 years duration. Ventricular-brain ratio (VBR) was significantly greater than that of the control group. In six patients the VBR exceeded the control mean + 2 s.d. Among the 13 whose VBR was more than 1 s.d. above the control mean, none had schizo-affective disorder, all but one had chronic illness, and patients with negative symptoms and those with premorbid schizoid traits were over-represented. VBR was unrelated to medical history, age, duration of illness, or neuroleptic treatment. It was not associated with neurological 'soft' signs or cognitive deficit. Among chronic patients, clinical features showed no association with ventricular size. The findings suggest that large ventricles may be related to a sub-type of chronic schizophrenia rather than to its particular clinical features.

Adult↗
PubMed1985

Schizophrenia with good and poor outcome. III: Neurological 'soft' signs, cognitive impairment and their clinical significance.

Fifty-six patients with RDC schizophrenia (42) or schizoaffective disorder (14), of two to 20 years' duration, were assessed for neurological 'soft' signs and cognitive impairment when in a stable condition--the 'outcome'. Neurological dysfunction (46% of 50 examined patients) was associated with a history of developmental abnormalities, but was unrelated to outcome, psychiatric symptoms, or treatment. Deficits in particular cognitive fields were related to two independent factors: overall severity of residual psychiatric disorder (outcome) and neurological dysfunction. There was no relationship between the size of the lateral brain ventricles on CT scan and either 'soft' signs or cognitive impairment. The findings do not provide evidence for an association between the presence of organic brain disorder (as indicated by the joint occurrence of neurological dysfunction and cognitive impairment) and either poor outcome or particular symptoms of schizophrenia.

Adult↗
PubMed1982

Cancer of the prostate and aging: an autopsy study in black men from Washington, DC, and selected African cities.

Age-related changes of arteries, veins, glands, and stroma in the prostate of black men from Washington, DC, and from Ibadan, Nigeria, and Accra, Ghana, West AFrica, were studied in a total of 795 consecutive, unselected prostate specimens removed at autopsy during a 7-year period (1973-1980). Except for age group 80 and over, aging changes in the prostate were more severe in all age groups in black men from Washington, DC, than in black men from Ibadan and Accra (P less than 0.01). However, when the intensity of age-dependent alterations was compared in either US or African black men with carcinoma and with no carcinoma, no significant differences were found. These findings do not support the idea that the aging process per se increases susceptibility to cancer.

Adult↗
PubMed1981

Blood hormone profiles in prostate cancer patients in high-risk and low-risk populations.

Epidemiologic data reveal that the incidence rate of prostate gland carcinoma among the black population in the United States (US) is several times higher than among Nigerians. A collaborative study between the two countries was undertaken, and blood hormone (testosterone [T], dihydrotestosterone [DHT], estrone [E1], estradiol [E2], and prolactin [P1]), total acid phosphatase (TP), and prostatic acid phosphatase (PAP) profiles in the two population groups were compared. In the US groups (patients and controls) there were significantly higher levels of T (P less than 0.01) and E1 (P less than 0.05) compared with the Nigerians. Also, the US patients had significantly higher levels of T (P less than 0.05) and E1 (P less than 0.01) compared with their matched controls. In the Nigerians T but not E1 levels were significantly lower (P less than 0.05) in patients compared with controls. DHT, E2, and P1 were not significantly different in patients and controls between and within the populations. Nigerian patients had higher levels (P less than 0.001) of TP and PAP compared with US patients. It is concluded that differences in blood hormone profiles in the two population groups are based on factors other than the genetic makeup of the populations.

Acid Phosphatase↗
PubMed1980

Characterization of prostatic carcinoma among blacks: a comparison between a low-incidence area, Ibadan, Nigeria, and a high-incidence area, Washington, DC.

A comparison of carcinoma of the prostate gland in a low-incidence Nigerian (Ibadan) population and a high-incidence U.S. Afro-American (Washington, D.C.) population was the purpose for this study, initiated in 1973. The frequency of carcinoma (micro- and invasive) was determined in consecutive necropsy cases from hospitals in Ibadan, Nigeria, Accra, Ghana and Washington, D.C. The results of these clinical, epidemiologic and morphologic studies are reported. Clinically, the peak incidence of carcinoma of the prostate in Nigerian males in Ibadan and in American males in Washington, D.C. was in the 65-74 age group. The median age of patients was 66.4 years in Ibadan and 69.2 years in Washington, D.C. Seventy-five percent of Nigerian and 49% of American patients were in stages III and IV. Overall, the distribution by grade of neoplasms in surgical material from Ibadan and Washington, D.C. was similar. Plasma testosterone and estrone levels were significantly higher (p < 0.05 and p < 0.001) in U.S. patients than in U.S. controls and higher (p < 0.001 and p < 0.05) in U.S. patients than in Nigerian patients with prostatic carcinoma. Plasma testosterone levels were significantly lower (p < 0.05) in Nigerian patients than in Nigerian controls. Estrone levels were not significantly different in Nigerian patients than controls. Nigerian patients were more sexually active throughout their lives than American patients; however, they reported a higher incidence of impotence than U.S. patients in the immediate 5 years preceding the diagnosis of prostatic carcinoma. Nigerian respondents (patients and controls) arrived at puberty later than their American counterparts. Within each of the two population groups, the factor with the highest relative risk ratio was lower urinary tract symtoms occurring 10 years or longer before the onset of the present complaints which led to the diagnosis of prostatic carcinoma. Nigerian and U.S. patients were more sexually active than controls. Microcarcinoma (incidental, latent) of the prostate gland occurred with a frequency of 11.8% and at an age-adjusted incidence rate (world standard) of 40.6 per 1000 necropsies in the sampled U.S. black male population. The age-adjusted incidence rate (world standard) for microcarcinoma in the combined West African (Accra and Ibadan) series (36.7/1000) was almost equal to the rate (40.6/1000) in the Washington, D.C. series.

Aged↗
PubMed1979

Extrahepatic portal hypertension due to congenital obstruction of the portal vein and associated gross hepatic lobulation.

A 10-233k old girl presented with splenomegaly and recurrent hematemesis from esophageal varices. Splenoportography revealed a dilated extrahepatic portion of the portal vein with nonvisualization of its intrahepatic tributaries. The child died following an episode of hematemesis and was found to have a dilated portal vein which ended blindly. In addition, there was abnormal lobulation of the inferior surface of the liver which was not cirrhotic. The portal vascular anomaly, which presumably was responsible for the portal hypertension, was probably due to failure of communication between the embryonic vitelline veins or to atresia of the portal vein secondary to pressure from the abnormal hepatic lobulation in utero. It would appear that congenital factors may be significant in the etiology and pathogenesis of some cases of extrahepatic portal hypertension in early life and recognition of such developmental anomalies is of importantance in management.

Female↗
PubMed1977

Jaundice associated with lobar pneumonia. A clinical, laboratory and histological study.

Twenty-eight patients with jaundice associated with lobar pneumonia have been studied. The epidemiological and clinical features were compared with 70 patients with lobar pneumonia without jaundice. Jaundice was associated with a predominance of males, a high incidence of right lower lobe consolidation and hepatic tenderness. Although the jaundiced patients remained pyrexial for longer it was not associated with a poor prognosis. There was no evidence of immunological deficiency although pneumococcal polysaccharide antigenaemia was commoner in jaundiced patients. Laboratory investigations showed evidence of haemolysis in the majority of jaundiced patients and the cause of this was found to be G6PD deficiency. Starch-yel electrophoresis demonstrated that the phenotype was A- in deficient patients. Hepatic function tests were unhelpful. Light and electron microscopical changes consistent with haemolysis were present in liver biopsies from G6PD deficient patients although hepatocellular damage and cholestasis were also present.

Adolescent↗
PubMed1976

Choriocarcinoma in Ibadan: clinicopathologic studies.

The host tissue reaction to choriocarcinoma was studied in 81 Nigerian patients. A mononuclear cellular reaction, observed in about 42 per cent of the patients, was composed mainly of lymphocytes, plasma cells, histiocytes, and eosinophils in varying quantities around tumor deposits. No correlation was found between the survival of the patients and the intensity of the cellular reaction. Late presentation by our patients for medical advice and treatment may partly account for the relatively poor response to chemotherapy. The syncytiotrophoblast appears to play a primary role in vascular invasion by the neoplastic trophoblast.

Choriocarcinoma↗
PubMed1976

Hodgkin's disease in American Negroes. Histologic classification of the disease in 143 untreated patients, and age distribution.

The Rye histologic classification of Hodgkin's disease has been applied to 143 previously untreated cases of Hodgkin's disease in Negro patients seen in four hospitals in Washington, D.C.,during a 16-year period (1959-1974). The frequencies and age distributions of histologic subtypes were compared with those in American and two African series. Those histologic subtypes associated with poor prognoses (mixed-cellularity and lymphocytic depletion) predominated in American Negroes and in Negroes from Ibadan, Nigeria, and Kampala, Uganda. In an American series from Connecticut (approximately 98% Caucasian) the histologic subtypes lymphocytic predominance and nodular sclerosis were preponderant. There were statistically significantly less of the nodular sclerosis subtype (P less than 0.005), and more of the mixed-cellularity subtype in American Negroes compared with the Connecticut series (P less than 0.001). In contrast to findings in predominantly Caucasian populations, there was a predilection of the nodular sclerosis subtype for males in American and in African Negroes. This study showed that Hodgkin's disease in American Negroes epidemiologically corresponds to the so-called "intermediate pattern" of the disease.

Adolescent↗
PubMed1976

Tumours within the spinal column.

Sixty-six cases of mass lesions compressing the spinal cord are presented. The masses were neoplastic in 86.36% of the cases. Epidural masses (80.30%) remain by far the largest group, consisting chiefly of Burkitt's lymphoma and various metastatic carcinomas. Only 6.06% of the lesions were intramedullary and the glioma/paraglioma remains virtually absent.

Adolescent↗
PubMed1976

Metastatic tumours of the brain and its enveloping structures in Ibadan, Nigeria.

Fifty-two cases of secondary tumours of the brain and its enveloping structures which were encountered at the University College Hospital (UCH), Ibadan, Nigeria bewteen January 1965 and December 1970 are reported. All lesions were hisologically verified, forty-six at autopsy and the remaining six from biopsy specimens of the skull deposits. There were forty females and twelve males; 77% of the subjects were in the third, fourth and fifth decades of life, 15% in the sixth and seventh, and the rest in first two decades. Thirty-four of the metastases were found in the substance of the brain and the remaining eighteen in its enveloping structures (the scalp, skull and dura-mater). Of the thirty-four brain secondaries, twenty-four (70%) originated from chorion carcinoma of the uterus, six from the lungs and two each from the breast and kidney. Metastases to the skull came from many sources--cervix, uterus, prostate, adrenals, liver, bladder colon and the thyroid gland. Of the later group, follicular thyroid carcinoma was the commonest single source of secondaries.

Adolescent↗
PubMed1976

Glucose-6-phosphate dehydrogenase deficiency and lobar pneumonia. Fine structure of the liver.

Ultrastructural changes appeared in liver biopsy specimens from eight patients with glucose-6-phosphate dehydrogenase deficiency who developed jaundice during the course of lobar pneumonia. The observed changed indicate that the hyperbilirubinemia and jaundice that develop in patients with glucose-6-phosphate dehydrogenase deficiency with lobar pneumonia are caused partly by hemolysis and partly by intrahepatic cholestasis. The cholestasis may be caused by a genetic predisposition in enzyme-deficient individuals; the hemolysis may be induced by pulmonary infection in individuals with an enzyme deficiency.

Capillaries↗
PubMed1975

Tumors of childhood in Ibadan, Nigeria.

Childhood cancer is fast becoming an important pediatric problem in several parts of Africa, with the progressive decline of infectious and nutritional diseases. The present study analyzes 1325 Nigerian children with neoplasms diagnosed over a 13-year period (1960-1972). It accounted for 12.5% of all tumors registered in our Cancer Registery over the period of study. The commonest type of malignant tumor in the Nigerian child was solid lymphoma, of which Burkitt's tumor predominated. The overall pattern of tumors in these children was strikingly different in certain aspects from what obtains in the Caucasian child. When four main groups of tumors were considered, the ratio frequency pattern in Nigerian children was one of high lymphoma, high orbital, low leukemia, low glioma type. In the Caucasian child, the ratio frequency pattern is usually one of high leukemia, high glioma, low lymphoma, low orbital type. The observed differences in frequencies of childhood tumors between population groups require further studies.

Adolescent↗