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High prevalence of undiagnosed chronic kidney disease among at-risk population in Kinshasa, the Democratic Republic of Congo
Ernest K Sumaili, Eric P Cohen, Chantal V Zinga, Jean-Marie Krzesinski, Nestor M Pakasa, Nazaire M Nseka
BMC Nephrology , 2009, DOI: 10.1186/1471-2369-10-18
Abstract: In a cross-sectional study, 527 people from primary and secondary health care areas in the city of Kinshasa were studied from a random sample of at-risk out-patients with hypertension, diabetes, obesity, or HIV+. We measured blood pressure (BP), blood glucose level, proteinuria, body mass index, and estimated glomerular filtration rate (eGFR by MDRD equation) using calibrated creatinine levels based on one random measurement. The associations between health characteristics, indicators of kidney damage (proteinuria) and kidney function (<60 ml/min/1.73 m2) were also examined.The prevalence of CKD in this study was 36%, but only 12% were aware of their condition. 4% of patients had stage 1 CKD, 6% stage 2, 18% stage 3, 2% stage 4, and 6% had stage 5. 24 hour quantitative proteinuria (>300 mg/day) was found in 19%. In those with the at-risk conditions, the % of CKD was: 44% in patients with hypertension, 39% in those with diabetes; 16% in the obese and 12% in those who were HIV+. 82% of those with a history of diabetes had elevated serum glucose levels at screening (≥ 126 mg/dl). Only 6% of individuals with hypertension having CKD had reduced BP to lower than 130/80 mmHg. In multivariate analysis, diabetes, proteinuria and hypertension were the strongest determinants of CKD 3+.It appears that one out of three people in this at-risk population has undiagnosed CKD and poorly controlled CKD risk factors. This growing problem poses clear challenges to this developing country. Therefore, CKD should be addressed through the development of multidisciplinary teams and improved communication between traditional health care givers and nephrology services. Attention to CKD risk factors must become a priority.Chronic Kidney Disease (CKD) is a worldwide health problem [1]. Indeed, the incidence and prevalence of CKD has increased in recent years in both developed and developing countries [2] including in Sub-Saharan Africa (SSA) [3]. In SSA, CKD affects mainly young adults in their
Profile of Aggressive and Chronic Periodontitis in Kinshasa Dental Hospitals, DR Congo  [PDF]
Em Kalala Kazadi, Steve Sekele Masin, Nyimi Bushabu Fidele, Isourady Bourley Jean Paul Sekele, Jacques Bolenge, Augustin Mantshumba, Ingaya Ediz Ekofo, Mulumba Hubert Ntumba
Open Journal of Stomatology (OJST) , 2017, DOI: 10.4236/ojst.2017.710038
Abstract: Periodontitis is a prevalent destructive gum disease, characterized by loss of tissues supporting the teeth. The two main forms, chronic and aggressive have not been assessed in Kinshasa, DR Congo. Aim: The aim of this study was to investigate the Prevalence and the pattern of chronic periodontitis (CP) and aggressive periodontitis (AP) in order to improve its management. Materials and Methods: A cross sectional study of 404 subjects attending the dental services of the four hospitals of Kinshasa city, from October 2013 to April 2014 was carried out. The plaque index (PlI), bleeding on probing (BOP), probing pocket depth (PPD) and frequency of tooth brushing (FTB) were the parameters assessed. The SPSS software version 20.0 was used. Results: Out of 404 patients examined, 322 (79.7%) had chronic periodontitis versus to 44 (10.9%) of aggressive periodontitis. The female was higher than males with a sex ratio of 1.49:1 and the age group between 20 and 29 was the most represented. PPP of ≥6 mm was found in 24.6%, 5 or 5.5 mm in 27.3% and PPP of 3.5 to 4.5 mm in 48.1% of patients with periodontitis. Significant difference was found between CP and AP according to age variable, p-value < 0.001. PlI for CP was 0.97 (SD ± 0.38) while that for AP was 0.90 (SD ± 0.43). No significant differences were found between PlI, p-value = 0.47; FTB (p = 0.055) and BOP of subjects with AP and those with CP (p = 0.105). Conclusion: The two main forms of periodontitis diseases are more prevalent in patients attending dental services in Kinshasa and affect male as well as female. Age remains an essential variable to distinguish between CP and AP.
Obesity and chronic kidney disease
Eknoyan,G.;
Nefrología (Madrid) , 2011,
Abstract: obesity is associated with the early onset of glomerulomegaly, hemodynamic changes of a hyperfiltering kidney, and increased albuminuria, which are potentially reversible with weight loss. however, pathologic lesions of focal segmental glomerulosclerosis develop in experimental models of sustained obesity, and are observed in morbidly obese humans presenting with massive proteinuria. in addition, several observational, cross sectional and longitudinal studies document that obesity is as an independent risk factor for the onset, aggravated course, and poor outcomes of chronic kidney disease, even after adjustment for confounding co-morbidities including metabolic syndrome, diabetes and hypertension, the major causes of chronic kidney disease. early dietary intervention to reduce weight, and where necessary bariatric surgery, should be considered in the management of overweight and obese chronic kidney disease (ckd) patients.
Attention deficit and hyperactivity disorder among school children in Kinshasa, Democratic Republic of Congo
E Kashala, T Tylleskar, I Elgen, K T Kayembe, K Sommerfelt
African Health Sciences , 2005,
Abstract: Objectives: To estimate the prevalence and determinants of attention deficit and hyperactivity disorder (ADHD) symptoms among school children in Kinshasa, an African urban setting. Methods: The 18-items of the Disruptive Behaviour Disorder rating scale (DBD), which is based on the Diagnostic and Statistical Manual for mental disorders 4th edition (DSM-IV), were used to investigate the presence of ADHD symptoms. Parents interviews, using a questionnaire specially designed for the study, were performed to identify socio-demographic characteristics. All children were subject to a clinical examination. Results: The estimated prevalence of DSM-IV ADHD symptoms was 6 %. Those with family health problems, younger age at start of primary school, good nutritional status and poor school performance more often had DSM-IV ADHD symptoms. Conclusions: ADHD symptoms are as common among school children in Kinshasa as elsewhere. The socio-demographic factors described as risk factors for ADHD in high-income countries were not identified in this study.
Chronic Kidney Failure
Tanr?verdi MH et al.
Konuralp Tip Dergisi , 2010,
Abstract: Chronic kidney failure (CKF) is a state of permanent decrease in glomerular filtration rate (GFR) that will cause established changes in kidney functions. This status usually occurs when GFR decreases below 25 ml/min. When GFR decreases as much as 75% of the normal value, failure in kidney functions proceeds even if the reason for this situation is abolished. CKF is a pathophysiological process that ends with decrease in nephron numbers and functions; it usually has many etiological factors which cause end stage renal disease (ESRD). ESRD is characterized with irreversible loss of renal functions and this constitutes a clinical state that requires renal replacement treatments such dialysis and transplantation in order to be protected from harmful and life threatening effects of uremia. Uremia occurs as a result of acute or chronic renal failure and it characterizes a clinical and laboratory syndrome that reflects a state of functional defect in all systems. In presented review, the etiology and clinical and laboratory features of CKF were discussed in the light of current literature.
Angiogenesis and chronic kidney disease
Yohei Maeshima, Hirofumi Makino
Fibrogenesis & Tissue Repair , 2010, DOI: 10.1186/1755-1536-3-13
Abstract: Further analysis of the involvement of angiogenesis-related factors in the development of CKD is required. Determining the disease stage at which therapy is most effective and developing an effective drug delivery system targeting the kidney will be essential for pro-or anti-angiogenic strategies for patients with CKD.The number of patients with chronic kidney disease (CKD) progressing to end-stage renal disease (ESRD) and requiring renal replacement therapy is increasing worldwide. CKD currently affects over 20 million adults in the USA and over 13 million adults in Japan [1,2]. Of the various renal disorders predisposing to CKD, including glomerulonephritis and hypertensive nephrosclerosis, diabetic nephropathy is the most frequent cause of ESRD development.Angiogenesis - the development of new blood vessels from pre-existing ones - is involved in physiological events and in pathological disorders including tumor growth and metastasis, proliferative retinopathy, rheumatoid arthritis, psoriasis and neointimal formation [3]. Angiogenesis is controlled by the balance between pro-angiogenic and anti-angiogenic factors. Angiogenesis-associated factors are involved in the development of the kidney [4-6]. Recent experimental studies have demonstrated the involvement of an imbalance of angiogenesis-related factors in the progression of CKD [7-13], and the potential therapeutic effects on CKD of modulating these factors have been identified [14-22]. Vascular endothelial growth factor (VEGF)-A, a potent pro-angiogenic factor, is involved in the development of the kidney [4,5], and also plays an important role in maintaining the glomerular capillary structure and in the repair process following injuries of glomerular endothelial cells and peritubular capillaries (PTC) [14,15,17]. Physiological levels of VEGF-A are also required for maintenance of the glomerular filtration barrier [23]. In the early stages of diabetic nephropathy, increases in the number of glomerular capilla
Ghrelin in Chronic Kidney Disease  [PDF]
Wai W. Cheung,Robert H. Mak
International Journal of Peptides , 2010, DOI: 10.1155/2010/567343
Abstract: Patients with chronic kidney disease (CKD) often exhibit symptoms of anorexia and cachexia, which are associated with decreased quality of life and increased mortality. Chronic inflammation may be an important mechanism for the development of anorexia, cachexia, renal osteodystrophy, and increased cardiovascular risk in CKD. Ghrelin is a gastric hormone. The biological effects of ghrelin are mediated through the growth hormone secretagogue receptor (GHSR). The salutary effects of ghrelin on food intake and meal appreciation suggest that ghrelin could be an effective treatment for anorexic CKD patients. In addition to its appetite-stimulating effects, ghrelin has been shown to possess anti-inflammatory properties. The known metabolic effects of ghrelin and the potential implications in CKD will be discussed in this review. The strength, shortcomings, and unanswered questions related to ghrelin treatment in CKD will be addressed. 1. Introduction The cachexia syndrome in patients with chronic kidney disease (CKD) consists of muscle wasting, anorexia, and increased elevated energy expenditure. Cachexia is an important risk factor for mortality in patients with CKD, which is 100-fold to 200-fold higher than in the general population. Cachexia, a common feature in many chronic inflammatory diseases, is distinct from malnutrition, which is defined as the consequence of insufficient nutrients [1]. Responses in malnutrition are adaptive, whereas those in cachexia are maladaptive. In malnutrition, such as in simple starvation, fats are preferentially utilized and lean body mass is preserved. In cachexia, muscle mass is wasted and fats are relatively underutilized. Anorexia, defined as the loss of desire for food, is prevalent in patients CKD. Anorexia in CKD patients can arise from decreased taste and smell of food, early satiety, dysfunctional hypothalamic membrane adenylate cyclase, increased brain tryptophan, and increased cytokine production. Anorexia reduces oral energy and protein intakes and contributes to the development of cachexia. Elevated resting energy expenditure was associated with increased mortality and cardiovascular death in CKD and was closely correlated with the prevalence of cachexia among these patients [2]. To date, there is no effective therapy for cachexia in CKD. Nutritional strategies such as caloric supplementation and appetite stimulants have been largely unsuccessful. Thus, there is an urgent need for the development of new therapeutic agents for this potentially fatal complication of CKD [3]. 2. Energy Metabolism in CKD New
Influence of Self-Esteem in the Withdrawal EPS Students from Catholic Schools of Humanities in Kinshasa  [PDF]
Aristide Ewamela, Paulin Mandoumou, Agnes Kena Lubika, Euloge Moboza Ndongo, Joachim Bongbele
Advances in Physical Education (APE) , 2016, DOI: 10.4236/ape.2016.63025
Abstract: In order to examine the influence of self-esteem on the disengagement of students in EPS, 305 girls and 456 boys from Catholic schools of humanities (experimental group), 116 girls and 133 boys from consular schools (control group) have answered the questionnaire from Ninot et al. (2000). The averages of the two groups were compared using student test. The results showed that subjects in the experimental group showed low values of global self-esteem, the physical value, strength, endurance and athletic competence. These results indicate a parallel disengagement significantly remarkable EPS for girls and boys in the experimental group compared to their counterparts in the control group. These results suggest that the low value of self-esteem is the disengagement factor in EPS within Catholic schools of humanities in Kinshasa.
Commitment to School and Students  [PDF]
?a?r? Tu?rul Mart
International Journal of Academic Research in Business and Social Sciences , 2013,
Abstract: Teaching necessitates passion, dedication, and commitment. Teachers, critical factors of any education system, play an important role in promoting education by enhancing the abilities of students through their work in schools. Commitment is highly related to teachers’ work performance. Teacher commitment deeply contributes to future of students and schools. Committed teachers make a difference to the success of the school and the learning of the students.
Fluorescence for high school students  [PDF]
Niek G. Schultheiss,Tom W. Kool
Physics , 2012,
Abstract: In a not obligatory series of lessons for high school students in the Netherlands we discuss the fluorescence aspects of anthracene. These lessons were developed because HiSPARC (High school Project on Astrophysics Research with Cosmics) detection of cosmic rays are available for different secondary schools. With the help of special designed scintillator detection stations, containing anthracene, cosmic rays can be detected. Fluorescence of anthracene is one of the topics discussed in these series of extra curricular lessons aimed at excellent pupils working on cosmic radiation within the HiSPARC - project.
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