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Biomedical subjects

O A Adebo

Publications and source records attributed to O A Adebo.

At least 37 records · Page 2Linked to original sources
PubMed1990

Implication of altered pulmonary function in pneumonectomy for tuberculous destroyed lung.

Twelve patients undergoing pneumonectomy for tuberculous destroyed lung were studied to determine the value of preoperative spirometry in the assessment of their pulmonary reserve, and prediction of their post-operative morbidity. Preoperatively, the functional losses were evidenced by mean values of FVC of 56.4%, FEV1 of 48.9% and PEFR of 65.8%--all expressed as percentage of predicted normals. No significant alteration occurred in pulmonary function post-pneumonectomy. All patients were in Class 1 (HYHA) pre- and post-operatively. It is concluded that operability in these patients cannot be based on spirometry alone but must include the preoperative assessment of clinical (symptomatic) stage and cardiovascular status.

Adolescent↗
PubMed1989

Spontaneous pneumothorax in adult Nigerians.

A 6-year study was carried out in our hospital practice to determine the prevalence of spontaneous pneumothorax. Thirty patients with 32 episodes of pneumothorax were diagnosed. Tuberculosis was encountered in 9(30%) patients while no specific cause was found in 12(40%) patients. This study indicates that spontaneous pneumothorax is uncommon in the Nigerian, while the tuberculosis aetiology may be a pointer to the overall high prevalence of the disease in the community.

Adolescent↗
PubMed1989

Surgical treatment of persistent ductus arteriosus at the University College Hospital, Ibadan.

Seventy-seven patients aged from 5 days to 30 years underwent surgical correction of persistent ductus arteriosus (PDA) between July 1975 and December 1985. Forty-seven percent presented before 5 years of age while 20% were aged above 15 years. The male:female ratio was 1:2. Additional cardiovascular anomaly was present in 14 patients, 8 of which were ventricular septal defect. Majority presented with congestive heart failure and or failure to thrive. Surgical closure was effected by ligation in 67 cases, division and suture in 5 and unspecified in 5 cases. Operative mortality was 2(2.1%) cases. Complications with superficial wound infections occurred in a minority of patients. We conclude that despite a large left to right shunt in most patients, attested to by their symptomatic status, and late presentation surgical closure can be accomplished with minimal morbidity and mortality in centres with limited facilities.

Adolescent↗
PubMed1988

Post-operative wound infection in thoracic patients: a preliminary report.

A retrospective study of 37 patients undergoing pulmonary resection, between 1975 and 1980, was performed to establish the incidence of wound infection and to determine contributory factors. Sixteen patients had suppurative lung disease while 11 had pulmonary tuberculosis. The majority of the patients received prophylactic antibiotic (Ampicillin and Cloxacillin) given intramuscularly or intravenously, prior to thoracotomy, and continued for several days post-operatively. Twenty of the 37 cases (54%) developed wound infection, defined as any purulent wound drainage in the post-operative period. The patients with infection (group A) did not differ from those without (group B) as regards presence of pyorrhoea or haemoptysis, the duration of operation or the quantity of blood infused during surgery. A significant difference in the duration of chest intubation was identified between group A (6 +/- 1.3 days) and group B (3 +/- 1.5 days) (P less than 0.001). The implication of the results towards the modification of post-operative management of patients is discussed.

Humans↗
PubMed1986

Osteomyelitis of the ribs in Ibadan.

Sixteen patients with pyogenic osteomyelitis of the ribs are reported; ages ranged from 3 months to 42 years and 10 were female. Right sided ribs were affected in 10 cases and single ribs in 12. Antecedent causes included empyema thoracis (56%) and blunt chest trauma (19%). Fourteen out of 16 patients presented with discharging chest wall sinuses and five patients had associated swellings on the chest wall. The duration of symptoms ranged from two to 36 months. The most common microorganism isolated was Staphylococcus aureus (50%). Rib excision (with drainage of the empyema in two cases) was curative in all 16 cases in this study.

Adult↗
PubMed1984

Surgical treatment of ruptured mitral valve chordae. A comparison between valve replacement and valve repair.

Sixty-five patients were treated for ruptured mitral valve chordae from January, 1976, to December, 1981; 21 patients underwent valve reconstruction (group A) and 44 underwent valve replacement (group B). Both groups had a mean age of 62 years with an overall male: female ratio of 2:1. Eighty-one percent of group A and 73% of group B presented in clinical class III/IV (NYHA). Chordal rupture was spontaneous in 76% (group A) and 61% (group B) respectively, with posterior leaflet chordal involvement in most patients. The operative mortality was 6.8% (3 deaths) in group B with no early death in group A (p less than 0.001). More than 85% of both groups were in class I/II (NYHA) postoperatively. The actuarial survival at 5 years was 85% in group A and 78% in group B. No emboli occurred in group A while an actuarial incidence of freedom from emboli of 76% at 5 years was observed in group B (p less than 0.046). One patient (4.8%) in group A was reoperated for failed valve repair. The patients with repaired valves were assessed by echocardiography. The peak rates of dimension change of the left ventricular cavity were in the normal range in all but 3 patients, while the left ventricular and end-diastolic dimensions were significantly reduced (p less than 0.005). We conclude that valve reconstruction provides an improved functional result in patients with ruptured mitral chordae in addition to an increased event-free survival.

Actuarial Analysis↗
PubMed1984

Developmental anomalies of the lung in Nigerian children.

Five cases of developmental lung anomalies occurring in Nigerian children are reported; three were congenital lobar emphysema while two were scimitar syndromes. The radiological features demonstrated in each case effectively excluded the common causes of pulmonary disorders. Three patients were treated surgically with successful results in two. We believe that an increased awareness in our tropical setting would result in improved detection of these treatable but rare conditions.

Female↗
PubMed1983

Conservative surgery for mitral valve disease: clinical and echocardiographic analysis of results.

Eighty-five patients underwent mitral valve reconstruction by the Carpentier method from January 1976 to December 1981. Concomitant procedures were performed in 30 patients (aortic valve replacement in 23, coronary revascularisation in six, and tricuspid valve repair in seven). Before operation 76 patients (89%) were in clinical class II or III (New York Heart Association) and atrial fibrillation was present in 50. Thirty-six patients had valvular incompetence, while 26 had pure stenosis. The aetiology was rheumatic in 57 cases and dysplastic in 21. The patients were assessed for clinical improvement, durability of valve repair, thromboembolism, and survival. There was one death, an operative mortality rate of 1.2%, and 63 of 74 patients followed for one to six years were in clinical class I after operation. The actuarial survival was 92% with a 93% incidence of freedom from thromboemboli at five years. Six patients had embolic episodes, four of whom had aortic valve replacement. Three patients had a repeat operation 16-20 months later, a valve failure rate of 6.7%. Nineteen patients with ruptured chordae had postoperative echocardiographic assessment of myocardial and mitral valve functions; the peak rates of dimension changes of the left ventricular cavity (indicative of flow across the mitral valve) fell to normal in most patients, and the left ventricular end-diastolic dimensions decreased significantly from 6.4 (1.53) to 5.09 (1.31) cm (mean and SD)--p less than 0.05. Our results confirm that reconstructive mitral surgery is able to restore and maintain normal valve function in addition to providing satisfactory relief of symptoms.

Adolescent↗
PubMed1983

Unruptured amoebic liver abscess presenting as acute abdomen.

Unruptured amoebic liver abscess is usually not regarded as a surgical emergency. At University College Hospital, Ibadan, in a two-year period from June 1975 to May 1977, six cases of unruptured amoebic liver abscess underwent emergency exploratory laparotomy because they presented as cases of acute abdomen. The initial diagnoses made by senior physicians included perforated duodenal ulcer, intestinal obstruction, cholecystitis and appendicitis. All patients had persistent draining sinuses after surgery for periods ranging from one to five months. Neither the trophozoites nor the cystic forms of Entamoeba histolytica were present in the "abscess" which was essentially necrotic liver tissue. The diagnosis of amoebic liver abscess was based on clinical features: typical "anchovy" or chocolate-coloured aspirate from the liver, response to anti-amoebic therapy and serological studies.

Abdomen, Acute↗
PubMed1982

Suppurative diseases of the lung and pleura: a continuing challenge in developing countries.

A retrospective study of 1,150 consecutive patients with thoracic and cardiovascular diseases seen at the University College Hospital, Ibadan, Nigeria, over a five-year period (January, 1975, to December, 1979) showed that 42% (481 patients) were treated for suppurative diseases of the lung and pleura, notably empyema thoracis, lung abscess, and bronchiectasis. Of these, 336 or 70% were treated for empyema thoracis, most of whom were less than 2 years old. Seventy-five patients (16%) had lung abscess, 53 of whom were treated medically with 8 deaths, while 22 had emergency resection for massive hemoptysis with 9 deaths. Of the 70 patients with bronchiectasis, 37 were treated medically with 2 deaths, while 33 were treated surgically with 5 deaths. These data demonstrate that infectious diseases of the lung and pleura remain the greatest challenge to the thoracic surgeons in tropical, developing countries who are often handicapped by inadequate facilities, lack of drugs, illiteracy, poverty, superstitious beliefs, and poor environmental hygiene.

Adolescent↗
PubMed1981

Purulent pericarditis: a continuing surgical challenge.

This report presents a prospective series of 12 patients with a diagnosis of purulent pericarditis who were treated between April 1978 and September 1979 by the cardiothoracic surgical unit at the University College Hospital, Ibadan, Nigeria. These patients were studied to determine the adequacy of a therapeutic protocol consisting of systemic antibiotics and pericardiostomy tube drainage. All patients were in the pediatric age group with an average age of 6¾ years. Bronchopneumonia was the antecedent focus of sepsis in eight patients, with pyomyositis in four (33 percent). Two patients expired prior to surgery.No mortality or significant morbidity occurred in the ten patients who underwent pericardiostomy.The results of this series combined with the initial experience reported in 1978 by the same authors confirm the described protocol as the treatment of choice in their environment.

Anti-Bacterial Agents↗
PubMed1981

Management of tuberculous destroyed lung in Nigeria.

Between 1969 and 1979, 20 patients under-went pneumonectomy for tuberculous destroyed lungs (TDL) at the University College Hospital (UCH), Ibadan, Nigeria. Their ages ranged from 9 to 57 years, with an average age of 24 years. The left lung was involved in 16 patients (80 percent) and the right lung in four patients (20 percent). All patients had received treatment for pulmonary tuberculosis (PTB) for over three years, and all patients had negative cultures of acid-fast bacilli (AFB) at the time of operation. Pulmonary function studies were performed in 15 patients, bronchography in 18, and pulmonary angiography in four. Ninteen patients had elective resection because of mild to moderate hemoptysis without mortality. The only death occurred in a 37-year-old man who had emergency resection because of massive hemoptysis. He died intraoperatively of cardiac arrest. One patient developed bronchopleural fistula (BPF), empyema, and wound infection. The fistula closed spontaneously following prolonged chest drainage and pleural irrigation with antibiotics and antituberculous drugs. As a result of our experience with pulmonary tuberculosis in our environment, the authors now recommend elective resection for patients with TDL in order to prevent massive hemoptysis which may prove fatal.

Adolescent↗