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Management of massive haemoptysis
VO Adegboye, AO Adebo
Nigerian Journal of Surgical Research , 2002,
Abstract: Background: This study compares two management techniques in the treatment of massive haemotysis. Method: All patients with massive haemoptysis treated between January 1969 and December 1980 (group 1) were retrospectively reviewed and those prospectively treated between January 1981 and August 1999 (group II) were analysed. Group I patients had emergency bronchoscopy and surgery while group II patients had interval conservative care before bronchoscopy and definitive surgical management. Results: Both groups have comparative age and sex distribution and infective pulmonary diseases dominated as causes of massive haemoptysis. Recurrent haemoptysis occurred in 15 patients (22.7%) of group II during preoperative waiting period. In group I, bronchoscopy was abandoned in 5 patients and was immediately fatal in 1 patient. No such experiences in group II. The number of pneumonectomies were 12 out of 18 procedures (66.7%) for group I and 19 out of 68 procedures (27.9%) in group II. There were 5 lobectomies (27.8%) in group I and 49 (72.5%) in group II. Operative mortality was 72.2% for group I and 7.4% for group II. Conclusion: Initial unduly prolonged, conservative therapy followed by appropriately timed operative intervention produced the best outcome.
Yellow nail syndrome and bronchiectasis
VO Adegboye, JK Ladipo, OA Adebo
Nigerian Journal of Surgical Research , 2002,
Abstract: The Yellow Nail Syndrome includes slow growing, opaque yellow nails with exaggerated lateral curvature, associated with lymphoedema and chronic respiratory disorders. The nail changes may precede the lymphoedema by a number of years. Bronchiectasis may be the only chronic respiratory disorder; others include chronic bronchitis, pleural effusions and chronic sinusitis. Two illustrative cases show the combinations of some of these clinical features in two black Africans.
Case Report: Mediastinal teratomas: CT evaluation in 2 patients
MO Obajimi, CO Akinsanya, VO Adegboye
Nigerian Journal of Surgical Research , 2002,
Abstract: This is a report of 2 males aged 48 years and 50 years respectively presenting with persistent cough. Computed tomography showed posterior and anterior mediastinal masses respectively. Needle aspiration and cytology confirmed teratoma, with sarcomatous change in the first patient. Due to advanced disease only radiotherapy was offered but the patient died after a few courses. The other patient had excision of the mass, confirmed to be a benign teratoma. Computed tomography is invaluable in the diagnosis of mediastinal teratomas.
Palliation for transposition of great arteries
VO Adegboye, SI Omokhodion, O Ogunkunle, AI Brimmo, OA Adepo
Nigerian Journal of Surgical Research , 2003,
Abstract: Background: At the University College Hospital Ibadan we have no facility for total surgical correction of transportation of the great arteries (TGA). This prospective study reviews the palliative procedures we have used in the management of TGA. Method: Patients with the diagnosis of TGA were evaluated for morphological type. The choice of palliative procedure was made in some of the patients with morphological type in mind. No fixed criteria were used for allocating patients to Blalock-Hanlon (B-H), atrial septectomy while pulmonary banding (PB) and Blalock-Taussig (B-T) shunt have definite indications. Results: Fourteen consecutive patients with TGA were palliated. The ages of these patients ranged between 3 to 11 months (6.8 ± 2.4 months), there were 8 males to 6 females (1.3:1). Six patients had B-H atrial septectomy and 2(33.3%) died within 48 hours, 4 patients had B-T shunt and there were no mortality, 4 patients had PB and 2 (50.0%) died within 72 hours. The overall operative mortality was 28.6%. All the 10 survivors had improvement of their clinical features and fall in packed cell volume during the period of follow-up, which lasted 5 to 13 months (mean 9.3 ± 1.2 months). All patients had delayed wound healing. Conclusion: Appropriate and timely palliative surgery has a place in patients with TGA as an interim care. Key Words: Palliative surgery, transposition, great arteries Nigerian Journal of Surgical Research Vol.5(1&2) 2003: 129-133
The place of clinical features and standard chest radiography in evaluation of mediastinal masses
VO Adegboye, AI Brimmo, OA Adebo, OO Ogunseyinde, MO Obajimi
West African Journal of Medicine , 2003,
Abstract: One hundred and five primary mediastinal masses were seen between 1975 and 1998, at the Cardiothoracic surgical Unit of the University College Hospital Ibadan. These were studied to establish the importance of clinical features and plain chest radiography in preoperative evaluation of these masses. The sources of information were unit's record, cancer registry and the patients case note. The age range of the 75 male patients was 3 to 80 years (mean 35.2 ± 22.1 year) and for the 30 female patients was 2.5 to 70 years (mean 30.9 ± 18.6 years). Anterosuperior mediastinal masses were the most common (63.8%) followed by posterior mediastinal masses (22.9%). Middle mediastinal masses made up the remaining (13.3%). The most common primary mediastinal tumour was lymphoma (21.9%) next to which were thymus gland neoplasia and thymus cysts/hyperplasia (18.1%). Endocrine tumours (mainly goiters) constituted 17.1% of the masses. On the whole, 45 (42.9%) of the mediastinal tumours were malignant and 60 (57.1%) were benign. Eighty one patients (77.1%) were symptomatic at presentation, 24 patients (22.9%) were asymptomatic. Malignancy was more associated with symptoms in this series (82.2%) and benigh lesion were more frequently (70.8%) asymptomatic. Cervical lymphadenopathy (78.6%), was more frequent in patients with malignant lesion. Tracheal deviation (60.3%) and neurological signs (78.9%) were more frequent in benign disease. Superior vena cava syndrome was more frequently associated with primary malignant mediastinal tumours. All masses (100%) were visualized on plain chest x-ray. On the basis of clinical features and chest x-ray, majority of patients (76.2%) with primary mediastinal masses had exploratory thoracotomy, sternotomy or biopsy of their mediastinal mass.
Patency of the Ductus Arteriosus in Newborns: Experience in a Special Care Baby Unit
SI Omokhodion, AM Baiyeroju-Agbeja, VO Adegboye, A Adeyemo, IA Lagunju
Nigerian Journal of Paediatrics , 2001,
Abstract: A prospective cohort study of infants admitted into the Special Care Baby Unit, University College Hospital, Ibadan, has revealed a 24.5 per cent prevalence of patency of the ductus arteriosus (PDA) among 97 infants, who were admitted over a six-month period. The major factor predisposing to PDA was prematurity (p=0.014). A higher incidence of PDA (35 per cent) was found among the preterm infants, and of these preterm infants, the very low birth weight (VLBW) infants were found to be more highly susceptible to PDA (p = 0.028). The mean birth weight of the preterm infants who developed PDA in the study was 1447g, while that of those preterm infants without PDA was 1835g. There was no relationship between the sex of the infants and the development of PDA. A strong association was however, found between respiratory distress and PDA (p<0.001). Nine of the hospital mortalities recorded occurred in the preterm infants and more than half of them (55.5 per cent) had PDA. Thus, prematurity is a risk factor for PDA and the presence of a PDA appears to increase the risk for mortality for such infants. Evidence for PDA should be sought in all premature infants and prompt and aggressive management of those infants who show signs of decompensation from PDA is recommended to reduce mortality from this disease. Nigerian Journal of Paediatrics 2001; 29:61. pp. 61-67
Experience with the Management of Congenital Diaphragmatic Hernia at the University College Hospital, Ibadan
VO Adegboye, SI Omokhodion, O Ogunkunle, MO Obajimi, AI Brimmo, OA Adebo
Nigerian Journal of Paediatrics , 2002,
Abstract: A retrospective review of 44 cases of congenital diaphragmatic hernia (CDH) treated at the Cardiothoracic Surgical Unit, University College Hospital (UCH), Ibadan, between August 1976 and May 1999, was carried out. Thirty (68.2 per cent) of the 44 were males and 14 (13.8 per cent) were females. The patients were analysed in three groups: 31 patients who underwent surgery were analysed as two groups: inborn (born within UCH), 10 patients, and outborn (born elsewhere), 21 patients; the third group consisted of 13 patients who were not operated upon. All the inborn patients and 18 (85.7 per cent) of the outborn had left-sided defects; the remaining three of the outborn had right-sided defects. Eleven (84.6 per cent) of those who didn't undergo surgery, had left-sided defects while the remaining 15.4 per cent had bilateral defects. The three groups had comparable gestational ages (inborn vs outborn, p> 0.05; inborn vs unoperated, p> 0.05; outborn vs unoperated, p>0.05) and birth weights ( inborn vs outborn, p>0.05; inborn vs unoperated, p>0.05; outborn vs unoperated, p> 0.05). Those who did not undergo surgery had lower Apgar scores and higher incidence of associated congenital malformations than the patients who underwent surgical repairs. The differences in the mean of 5 minute Apgar scores among the three groups were not statistically significant (p> 0.05). Age at surgery was higher in the outborn (mean 55.5 ± 42.2 hours) than the inborn (mean 9.2 ± 3.9 hours) patients. The difference between the mean age at surgery was statistically significant (p< 0.05). Majority of those requiring operation (24 patients, 77.4 per cent) had repair by thoracotomy, while the remaining seven (22.6 per cent) had repair by the abdominal approach. Most of the patients had primary repair while two required diaphragmatic patches with dacron. Sixty per cent of the inborn patients required post-operative ventilation compared with only 23.8 per cent of the outborn. Survival was 71.4 per cent for the outborn and 40 per cent for the inborn. It is concluded that CDH is a disease with a range of severity. The higher survival rate among the more mature outborns suggest a natural selection of those with minimum respiratory impairment.
Pattern of pericardial diseases in HIV positive patients at University College Hospital, Ibadan, Nigeria
U Abubakar, PO Adeoye, OA Adebo, VO Adegboye, EB Kesieme, EK Okonta
Southern African Journal of HIV Medicine , 2011,
Abstract: Rationale. Pericarditis has been reported as the most common cardiac complication of HIV disease, followed by pericardial effusion. Methods. A retrospective review was conducted of all 68 patients treated for pericardial diseases between August 2003 and July 2008 at University College Hospital, Ibadan, Nigeria. HIV-positive patients (N=42) were compared with those who were HIV negative (N=26). Results. More male than female patients presented with pericardial disease, and the HIV-positive patients were younger than those who were HIV negative. Pericardial effusion was the commonest mode of presentation, accounting for 20 HIV-positive patients (47.7%) and 13 HIV-negative patients (50%). Pericardiostomy was the commonest surgical intervention performed in HIV-positive patients (N=15), while the majority of HIV-negative patients had pericardiocentesis. Conclusion. Pericardial effusion was the commonest cardiac presentation in HIV-positive patients in our setting. We recommend that patients with pericardial effusion be investigated for HIV infection.
Coarctation of the Aorta: Experience at the University College Hospital, Ibadan
VO Adegboye, O Ogunkunle, SI Omokhodion, AI Brimmo, OA Adebo, OO Ogunseyinde, MO Obajimi
Nigerian Journal of Paediatrics , 2002,
Abstract: Between May 1977 and June 1998, 697 patients with congenital heart diseases were admitted to the cardiothoracic surgical unit (CTSU) at the University College Hospital, Ibadan. Eighteen (2.6 per cent) of the patients with 19 coarctations of the aorta (CoA) were retrospectively studied. The age range of all the patients with CoA was 18 days to 30 years (mean 7.2±8.2 years), but for the 15 patients who underwent surgery, it was one month to 30 years (mean 8.6±8.3 years). Three patients died preoperatively of congenital cardiac anomalies associated with infantile CoA. There were 16 thoracic and two abdominal CoA, while one patient had recurrent CoA. Resection and end-to-end anastomosis was performed in four patients, dacron tube interposition graft in three, and dacron patch graft in four patients. Other procedures were employed in five patients. Operative mortality was 25 per cent. Operative deaths occurred in two infants with isolated CoA, a neonate who had associated pulmonary hypertension and a 17-year old who had surgery for re-coarctation. Complications of surgery included post-operative haemorrhage in two patients, intra-operative hemorrhage in one and hoarseness of the voice in four patients. Paradoxical hypertension occurred in three patients, graft occlusion and wound dehiscence occurred together in one patient and two patients had chylothorax. It is concluded that CoA is a surgically correctable congenital anomaly which is probably less frequently diagnosed locally. Nigerian Journal of Paediatrics 2002;29:27-33.
Sparse Additive Gaussian Process with Soft Interactions  [PDF]
Garret Vo, Debdeep Pati
Open Journal of Statistics (OJS) , 2017, DOI: 10.4236/ojs.2017.74039
Abstract: This paper presents a novel variable selection method in additive nonparametric regression model. This work is motivated by the need to select the number of nonparametric components and number of variables within each nonparametric component. The proposed method uses a combination of hard and soft shrinkages to separately control the number of additive components and the variables within each component. An efficient algorithm is developed to select the importance of variables and estimate the interaction network. Excellent performance is obtained in simulated and real data examples.
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