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Search Results: 1 - 10 of 267028 matches for " Jean Robert R Makulo "
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Chronic kidney disease among high school students of Kinshasa
Justine B Bukabau, Jean Robert R Makulo, Nestor M Pakasa, Eric P Cohen, Fran?ois B Lepira, Nazaire M Nseka, Patrick K Kayembe, Ernest K Sumaili
BMC Nephrology , 2012, DOI: 10.1186/1471-2369-13-24
Abstract: In an epidemiological cross sectional study, a random sample of 524 pupils (263 boys, mean age of 18.7 ± 1.4 years) from school environment of Kinshasa were studied. Recorded parameters of interest were anthropometric, proteinuria, serum creatinine and estimated glomerular filtration rate (eGFR) according to the Schwartz formula using uncalibrated creatinine levels from one random measurement. CKD was defined as the presence of kidney damage (daily proteinuria ≥ 300 mg) and/or reduced kidney function (eGFR < 60 ml/min/1.73 m2). Concordances between eGFR according to Schwartz, Cockcroft-Gault (C-G) indexed for BSA and modification of diet in renal disease (MDRD) study equations were computed using the kappa coefficient.The prevalence of CKD by the Schwartz formula was 1.5%. By stage, 0.8% had CKD stage 1 (proteinuria with normal eGFR) and 0.8% had CKD stage 3 (eGFR, 30 to 59 ml/min/1.73 m2). The prevalence of proteinuria ≥ 300 mg/day was 1% (one case had 2.7g/day). Agreement between eGFR according to Schwartz formula and the MDRD formula was excellent (kappa: 88.8%). Although correlations between all formulas were excellent (0.99; 0.87, and 0.89), agreement was poor between eGFR according to Schwartz and C-G indexed BSA equation (kappa: 52.7%) and, poorer with C-G unadjusted for BSA (kappa: 26.9%).In the large African city of Kinshasa, 2% of high school students have CKD. This high prevalence rate emphasizes the need for appropriate detection and prevention measures in this vulnerable young age population group.
Moderate Hypertriglyceridemia Revealed by Acute Chest Syndrome, a Milky Appearance Serum and Prior History of Recurrent Acute Pancreatitis in a Type 2 Diabetes Black Patient: A Case Report  [PDF]
Fran?ois Bompeka Lepira, Vita Eulethère Kintoki, Jean-Robert Risassi Makulo, Fabien Mbala Kintoki
World Journal of Cardiovascular Diseases (WJCD) , 2016, DOI: 10.4236/wjcd.2016.611046
Abstract: Although the “triglyceride paradox” states that hypertriglyceridemia is less frequent in Blacks and the risk of pancreatitis increases with severe hypertriglyceridemia, we herein report on a case of moderate hypertriglyceridemia revealed by an acute chest syndrome and a milky appearance serum in a 47-year-old type 2 diabetes black patient with prior history of recurrent acute pancreatitis. In addition to insulin therapy and coronary angioplasty, the combination of a statin and a fibrate resulted two months later in a substantial improvement in triglyceride levels and a normal serum appearance.
Prognostic Signification of Admission Hyperglycemia among Acute Stroke Patients in Intensive Care Units in Kinshasa, the Democratic Republic of the Congo  [PDF]
Josée K. Tshituta, Fran?ois B. Lepira, Fran?ois P. Kajingulu, Jean Robert R. Makulo, Ernest K. Sumaili, Pierre Z. Akilimali, Aliocha N. Nkodila, Freddy M. Mbuyi, Angèle I. Masewu, Stéphane Mutombo, Eric B. Amisi, Jean Pierre M. Ilunga, Wilfrid B. Mbombo, Patrick M. Mukuna, Adolphe M. Kilembe
World Journal of Cardiovascular Diseases (WJCD) , 2019, DOI: 10.4236/wjcd.2019.99060
Abstract:
BACKGROUND AND AIM: Although admission hyperglycemia has been reported to be associated with unfavorable outcomes in acute stroke, little is known about this association in sub-Saharan Africa. Therefore, the aim of the present study was to assess the prognostic significance of admission hyperglycemia in the acute phase of stroke in Congolese patients. METHODS: In a multicenter prospective cohort study, consecutive patients with acute stroke were examined in 5 Emergency Rooms or Intensive Care Units of Kinshasa between July 15th, 2017 and March 15th, 2018. The severity of stroke was assessed at admission using the Glasgow Coma Scale. Stress hyperglycemia was defined as random blood glucose levels at admission > 140 mg/dL in patients without known type 2 diabetes mellitus (T2DM). The endpoint was 10-day all-cause in-hospital mortality. Survival (time-to-death) curves were built using the Kaplan Meier methods. Cox proportional analysis was used to identify predictors of 10-day all-cause in-hospital mortality. The predictive performance of blood glucose level
The Atherogenic Dyslipidemia Ratio Log (Tg)/Hdl-C Was Not Associated with Urinary Albumin Excretion Rate (Uaer) and Increased Cardiovascular Risk in Black Patients with Type 2 Diabetes  [PDF]
M. F. Kajingulu, B. F. Lepira, I. N. F. Mbutiwi, J. R. R. Makulo, E. Bieleli, M. N. Nseka
World Journal of Cardiovascular Diseases (WJCD) , 2016, DOI: 10.4236/wjcd.2016.61003
Abstract: Objective: The objective is to assess the relationship of Log (TG)/HDL-c as surrogate estimate of atherogenic dyslipidemia with urinary albumin excretion rate and cardiovascular risk among black patients with type 2 diabetes. Patients and methods: A post-hoc analysis of data from 181 type 2 diabetes patients enrolled in a cross-sectional study of urinary albumin excretion rate seen at a tertiary healthcare. Microalbuminuria and macroalbuminuria were defined as ACR 30 - 299.9 mg/g and ACR ≥ 300 mg/g, respectively. Quartiles of Log (TG)/HDL-c were used as surrogate estimates of atherogenic dyslipidemia. Cardiovascular risk was assessed using WHO chart for estimation of CV risk in low and middle income countries. Comparisons across Log (TG)/HDL-c quartiles were performed using one way ANOVA and Chi square for trend as appropriate. P < 0.05 defined the level of statistical significance. Results: A high prevalence (69%) of atherogenic dyslipidemia (AD) was observed in the present case series of Black Africans with type 2 diabetes. Average total cholesterol levels showed significant (p = 0.010) trends towards lower values across quartiles of Log (TG)/ HDL-c. No significant trends were observed for average UAER and cardiovascular risk across quartiles of Log (TG)/HDL-c. Conclusion: Log (TG)/HDL-c as a surrogate estimate of atherogenic failed to predict cardiovascular risk in the present case series of black patients with type 2 diabetes.
RISN: An Efficient Sensor Network Overlay with Support for Autonomous and Distributed Applications  [PDF]
Evens Jean, Ingmar Rauschert, Robert T. Collins, Ali R. Hurson, Sahra Sedigh, Yu Jiao
Int'l J. of Communications, Network and System Sciences (IJCNS) , 2011, DOI: 10.4236/ijcns.2011.41001
Abstract: Once deployed, sensor networks are capable of providing a comprehensive view of their environment. However, since the current sensor network paradigm promotes isolated networks that are statically tasked, the full power of the harnessed data has yet to be exploited. In recent years, users have become mobile enti-ties that require constant access to data for efficient and autonomous processing. Under the current limita-tions of sensor networks, users would be restricted using only a subset of the vast amount of data being col-lected; depending on the networks they are able to access. Through reliance on isolated networks, prolifera-tion of sensor nodes can easily occur in any area that has high appeals to users. Furthermore, support for dy-namic tasking of nodes and efficient processing of data is contrary to the general view of sensor networks as subject to severe resource constraints. Addressing the aforementioned challenges requires the deployment of a system that allows users to take full advantage of data collected in the area of interest to their tasks. Such a system must enable interoperability of surrounding networks, support dynamic tasking, and swiftly react to stimuli. In light of these observations, we introduce a hardware-overlay system designed to allow users to efficiently collect and utilize data from various heterogeneous sensor networks. The hardware-overlay takes advantage of FPGA devices and the mobile agent paradigm in order to efficiently collect and process data from cooperating networks. The computational and power efficiency of the prototyped system are herein demonstrated. Furthermore, as a proof-of-concept, we present the implementation of a distributed and autonomous visual object tracker implemented atop the Reconfigurable and Interoperable Sensor Network (RISN) showcasing the network’s ability to support ad-hoc agent networks dedicated to user’s tasks.
Management Problems of Trans-Frontier Yellow Fever Cases in Burkina Faso 2010  [PDF]
Seydou Yaro, Aline R. Ouoba, Alidou Zango,rémi Rouamba, Aly Drabo, Soumeya Ouangraoua, Fati Samandoulougou-Kirakoya, Jean Macq, Annie Robert, Jean Bosco Ouedraogo
Advances in Infectious Diseases (AID) , 2013, DOI: 10.4236/aid.2013.32013
Abstract:

This last decade, Burkina Faso has been confronted with yellow fever confirmed cases, mainly from Western part of the country. In 2010, National Reference laboratory of yellow fever received 970 sera of suspected cases from the 65 Health Districts of the country. We found 11 positive results by ELISA test researching specific IgM against yellow fever. An aliquot of these eleven positive sera were sent to Dakar for confirmation by sero neutralization and RT-PCR. Eight have been confirmed by regional laboratory of Pasteur Institute of Dakar and three were classified as doubtful. Confirmed cases were manly notified by Sindou (4/8) and Mangodara (3/8) Health Districts and the last one came from Nongr-masson health District situated in the central part of the country. Three out of the four confirmed cases in Sindou Health District were resident from neighboring village in Ivory Cost. Conformed cases coming from neighboring villages of Ivory Cost were difficult to manage because of the relative lack of coordination between the two health centers responsible in two different countries. The three cases were not notified to Ivory Cost Health authorities and, in addition, they didn’t benefit from the Burkina Faso response plan. The goal of this work is to present results from National Reference yellow fever laboratory in 2010 in Burkina Faso and stressing trans-frontier cases management problems in order to suggest a multinational mechanism of response to fight against this disease more effectively.

Left Ventricular Structure, Geometry and Systolic Function among Hypertensive Black Patients with Reduced Kidney Function  [PDF]
B. C. Mpembe, F. B. Lepira, F. I. Mbutiwi, J. R. Makulo, E. V. Kintoki, M. P. Bayauli, J. R. M’Buyamba-Kabangu
World Journal of Cardiovascular Diseases (WJCD) , 2015, DOI: 10.4236/wjcd.2015.510032
Abstract: Objective: To assess the LV mass, geometry and systolic function in hypertensive patients with reduced kidney function. Methods: According to ASE guidelines, we estimated LV ventricular mass, geometry and systolic function in 155 consecutive hypertensive patients [51% women, mean age 51 ± 12 years, median duration of hypertension 7 years] with reduced kidney function (eGFR < 60 ml/min/1.73 m2 or dipstick proteinuria ≥ 1+). LVH was defined as LVMI >125 g/m2 in men, >110 g/m2 in non obese women or >51 g/m2.7 for obese men or women. Where appropriate, we used Student t, Mann Whitney, one way ANOVA or Chi square tests. A P value of 0.05 or less was considered significant. Results: Seventy four patients in the series (48%) had reduced kidney function (eGFR 30 ± 15 ml/min/1.73 m2). Compared to patients with relatively normal kidney function, non obese and obese patients with reduced kidney function had significantly greater LVM [271 (198 - 348) vs 276 (175 - 284) g/m2, p = 0.008] for non obese; LVM 72 (47 - 88) vs 54 (44 - 73) g/m2.7, p = 0.007 for obese] and lower EF (60 ± 14 vs 68 ± 13%, p < 0.001) was significantly lower. LVH of mainly concentric geometric pattern was present in 68 patients with reduced kidney function (92%). Conclusion: In the present case series, reduced kidney function was associated with increased LVM, concentric geometric pattern and impaired systolic function.
Sickle Cell Trait, Hemoglobin Levels and Anemia among Black Patients with Predialysis Chronic Kidney Disease: A Post Hoc Analysis  [PDF]
F. B. Lepira, T. K. Mukendi, F. I. N. Mbutiwi, J. R. Makulo, E. K. Sumaili, P. K. Kayembe, N. M. Nseka
World Journal of Cardiovascular Diseases (WJCD) , 2016, DOI: 10.4236/wjcd.2016.68029
Abstract: Objective: To assess the relationship between SCT, hemoglobin levels and anemia in CKD black patients. Method: A post-hoc analysis of data from 188 patients, enrolled in a cross-sectional study of sickle cell trait (SCT) and chronic kidney disease (CKD), was performed to assess the relationship between SCT, hemoglobin (Hb) levels and anemia defined as Hb < 12 g/dl in men and <11 g/dl in women. Student t test, Mann Whitney and Chi square test were used as appropriate for different comparisons. P < 0.05 defined the level of statistical significance. Results: SCT (HbAS) and normal hemoglobin (HbAA) were present in 39 (21%) and 149 (79%) CKD patients, respectively. Despite similar estimated GFR (eGFR) and age, HbAS patients had significantly lower Hb levels (8.8 ± 1.8 vs 10 ± 2.2 g/dl; p = 0.001) and a higher proportion of anemia (95% vs 72%, p = 0.001). In multiple linear regression analysis, eGFR, BMI, SBP and SCT emerged as independent determinants of Hb levels. The presence of SCT was associated with 1.185 g/dl decrease in Hb levels. Conclusion: In the present case series, SCT was associated with lower Hb levels suggesting its potential contribution to the pathogenesis of CKD-associated anemia.
Comparison of the Performance of Three Commonly Used Electrocardiographic Indexes for the Diagnosis of Left Ventricular Hypertrophy in Black Hypertensive Patients with Reduced Kidney Function Managed at a Tertiary Healthcare Hospital: A Post-Hoc Analysis  [PDF]
F. B. Lepira, C. M. B. Mpembe, F. I. N. Mbutiwi, J. R. Makulo, P. K. Kayembe, F. M. Kajingulu, E. V. Kintoki, J. R. M’buyamba-Kabangu
World Journal of Cardiovascular Diseases (WJCD) , 2017, DOI: 10.4236/wjcd.2017.74011
Abstract:
Background: Reduced kidney function in blacks is associated with an increased frequency of left ventricular hypertrophy. Given the unavailability of echocardiography in most developing countries, the diagnostic performance of current ECG indexes needs to be evaluated. Objective: To compare the diagnostic performance of 3 commonly used ECG indexes (Sokolow-Lyon, Cornell voltage and Cornell product) in black hypertensive patients. Methods: Electrocardiography and echocardiography estimated left ventricular mass of 155 consecutive hypertensive patients who participated from January 2012 to January 2013 to an echocardiographic cross-sectional study of left ventricular structure was analyzed to compare Cornell voltage and Cornell product indexes with Sokolow-Lyon voltage index as a reference. Reduced kidney function was defined as eGFR < 60 ml/min/1.730.05 m2. ROC curves in relation to LVH diagnosis were used to estimate the sensitivities and specificities of each index. P < 0.05 defined the level of the statistical significance. Results: The sensitivity and specificity were 43% and 85%, 23% and 77% and 26% and 77% for Sokolow-Lyon, Cornell voltage and Cornell product indexes, respectively. However, Sokolow-Lyon index (AUC; 95% CI: 0.64; 0.50 - 0.78) showed better performance than Cornell voltage (0.42; 0.25 - 0.59) and Cornell product (0.43; 0.28 - 0.59). Sokolow-Lyon index cut-point ≥ 37 mm corresponded to the highest Youden index (39.4% of sensitivity and 92.3% of specificity). Conclusion: Although the overall performance of the 3 ECG indexes versus echocardiography was low, Sokolow-Lyon index performed better than the two other indexes in diagnosing LVH.
Prevalence of Circadian Blood Pressure Patterns and Factors Associated with Non-Dipping among Black Patients with Untreated and Treated Hypertension: A Cross-Sectional Study  [PDF]
T. S. Mvunzi, Y. Lubenga, F. B. Lepira, J. R. Makulo, A. Nkodila, D. K. Kuntonda, Y. Samafundu, Y. M. Nlandu, Y. M. Engole, B. P. Kianu, F. Kintoki, D. Mupepe, N. Buila, R. M. Kongo, E. V. Kintoki
World Journal of Cardiovascular Diseases (WJCD) , 2017, DOI: 10.4236/wjcd.2017.711038
Abstract: Objective: To determine the prevalence of circadian BP patterns and to assess factors associated with the non-dipping pattern in untreated and treated hypertensive patients, studied separately. Methods: Clinical data and ABPM were obtained from 52 untreated and 168 treated hypertensive patients referred for ABPM to Monkole Hospital in Kinshasa. Twenty-four ABPM was performed using an oscillometric device. Non-dipping pattern encompasses non-dipping (nocturnal systolic BP dip less than 10% of daytime systolic BP) and reverse dipping (mean night SBP higher than the day SBP). Results: the prevalence of non-dipping pattern was 75% (63.5% non-dipping and 11.5% reverse dipping) and 70% (60.1% non-dipping and 10.1% reverse dipping) in untreated and treated hypertensive patients, respectively. Advanced age (adjusted OR 1.80; 95%CI 1.96 - 3.38; p = 0.015), female sex (adjusted OR 2.28; 95%CI 1.19 - 4.36; p = 0.013), diabetes (adjusted OR 5.06; 95%CI 1.38 - 6.95; p = 0.014), reduced kidney function (adjusted OR 3.10; 95%CI 1.50 - 6.43; p = 0.018), inflammation (adjusted OR 2.65; 95%CI 1.76 - 6.48; p = 0.031), LVH (adjusted OR 4.45; 95%CI 1.78 - 7.67;
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