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Lisk DR, Ngobeh F, Kumar B, Moses F, Russell JB. Stroke in Sierra Leonean Africans:Perspectives from a Private Health Facility. West Afr J Med 2020; 37:418-422. [PMID: 32835406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Several stroke studies in West Africans have demonstrated a high proportion of haemorrhagic stroke and poor outcomes. This may be due to the socioeconomic status of patients and inadequate clinical care. Outcomes may well be different if more informed patients treated in better facilities are studied. OBJECTIVE To study the pattern of stroke and stroke outcomes in African patients attending a private hospital in Sierra Leone METHODS: 150 consecutive African stroke patients admitted to a private hospital in Sierra Leone were studied. Demographic details, risk factors, clinical features including blood pressure were recorded. CT scans, ECG, serum cholesterol, and blood sugar were done. Patients were reviewed at day 30 and Rankin scores allocated. Two sample independent t-test was used to compare means, and chi square to compare variables. RESULTS Hypertension was the most common risk factor present in 77.6% of patients prior to admission with diabetes in 29.5%. Other risk factors include previous stroke (11.7%), smoking (6.3%), hypercholesterolemia (23.4%), high alcohol intake (28.8%) and lack of exercise according to self-evaluation (87.5%). 76.3% of patients had ischaemic and 18.2% haemorrhagic stroke. 41% of patients aged 50 years or less had haemorrhagic stroke and 9.3% of patients had atrial fibrillation. In-patient mortality was 10.6%. CONCLUSION Stroke types and outcomes are different from those generally reported from the sub-region. This may well be due to the population studied, and the level of care provided by a private facility. Socio-economic factors, literacy and clinical care are likely determinants of stroke types and outcomes in African patients. . More detailed studies to confirm the effects of socioeconomic factors on stroke pattern and outcomes in Africa are needed.
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Affiliation(s)
- D R Lisk
- Department of Internal Medicine,Faculty of Clinical Sciences,College of Medicine And Allied Health Sciences University of Sierra Leone
| | - F Ngobeh
- Department of Internal Medicine,Faculty of Clinical Sciences,College of Medicine And Allied Health Sciences University of Sierra Leone
| | - B Kumar
- Department of Internal Medicine,Choithrams Memorial Hospital,Freetown, Sierra Leone
| | - F Moses
- Department of Internal Medicine,Faculty of Clinical Sciences,College of Medicine And Allied Health Sciences University of Sierra Leone
| | - J B Russell
- Department of Internal Medicine,Faculty of Clinical Sciences,College of Medicine And Allied Health Sciences University of Sierra Leone
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Elston JWT, Moosa AJ, Moses F, Walker G, Dotta N, Waldman RJ, Wright J. Impact of the Ebola outbreak on health systems and population health in Sierra Leone. J Public Health (Oxf) 2018; 38:673-678. [PMID: 28158472 DOI: 10.1093/pubmed/fdv158] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J W T Elston
- Health Education Yorkshire and the Humber, University of Leeds, Willow Terrace Road, Leeds LS2 9JT, UK
| | - A J Moosa
- District Health Management Team, Primary Health Care, Moyamba, Moyamba, Sierra Leone
| | - F Moses
- District Health Management Team, Primary Health Care, Kabala, Koinadugu, Sierra Leone
| | - G Walker
- Doctors of the World (UK), 34th Floor, One Canada Square, London E14 5AA, UK
| | - N Dotta
- Medicos del Mundo, Conde de Vilches 15, 28028 Madrid, Spain
| | | | - J Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford BD9 6RJ, UK
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Hurwitz LK, Daniels A, Barkin JS, Petruff C, Gaertner E, Moses F. Preoperative diagnosis of intraductal papillary mucinous tumors of the pancreas by endoscopic pancreatic biopsy. Gastrointest Endosc 2001; 53:510-3. [PMID: 11275899 DOI: 10.1067/mge.2001.110085] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- L K Hurwitz
- Division of Gastroenterology, University of Miami School of Medicine and Mount Sinai Medical Center, Miami Beach, Florida 33140, USA
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Stamm C, Burkhalter CE, Pearce W, Larsen B, Willis M, Kikendall JW, Moses F, Rosen H, Wong RK. Benign colonic ulcers associated with nonsteroidal antiinflammatory drug ingestion. Am J Gastroenterol 1994; 89:2230-3. [PMID: 7977247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nonsteroidal antiinflammatory drugs can be associated with benign colonic ulcers. The ulcers are easily diagnosed by colonoscopy, and, if uncomplicated, they are best treated by cessation of the nonsteroidal antiinflammatory drugs. Benign colonic ulcers should be included in the differential diagnosis of any patient who presents with gastrointestinal complaints and is taking nonsteroidal antiinflammatory drugs.
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Affiliation(s)
- C Stamm
- Walter Reed Army Medical Center, Washington, D.C
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Abstract
Episiotomy is a well-established procedure in obstetric care worldwide. This article examines the available research and literature on episiotomy vs perineal tear to determine whether there is any evidence that episiotomy is indeed less traumatic than allowing the perineum to tear.
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Risby ED, Hsiao JK, Manji HK, Bitran J, Moses F, Zhou DF, Potter WZ. The mechanisms of action of lithium. II. Effects on adenylate cyclase activity and beta-adrenergic receptor binding in normal subjects. Arch Gen Psychiatry 1991; 48:513-24. [PMID: 1645514 DOI: 10.1001/archpsyc.1991.01810300025004] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
As part of a study of the effects of lithium carbonate on neurochemical function in man, platelet and lymphocyte adenylate cyclase activity and lymphocyte beta-adrenergic receptor binding characteristics were determined before and after 2 weeks of lithium treatment in 10 normal volunteers. Lithium had differential effects on platelet and lymphocyte adenylate cyclase activity. In platelets, basal and stimulated (guanyl imidodiphosphate [Gpp[NH]p] or cesium fluoride) adenylate cyclase activity was significantly augmented by lithium treatment. By contrast, in lymphocytes, Gpp(NH)p- and cesium fluoride-stimulated adenylate cyclase activity was unaffected, while basal activity was decreased modestly after lithium. These results are consistent with preclinical studies that suggest that lithium's effects on adenylate cyclase activity are specific with respect to tissue and brain region and that lithium may interfere with guanine nucleotide binding (G) protein function. Lithium treatment significantly increased the ratio of low- to high-affinity dissociation constants for agonist displacement of antagonist binding to lymphocyte beta-adrenergic receptors (thought to reflect coupling between the beta-adrenergic receptor and stimulatory G protein). Lithium had significant effects on measures associated with signal transduction that might be contrasted to its more subtle effects on neuronal function (norepinephrine release) and neuroendocrine systems (responses to serotoninergic challenge) in these same subjects (reported in a companion article). Lithium's primary site of action may be on signal transduction mechanisms. These effects subsequently may be manifested in changes in neurotransmitter function that may be important to lithium's mood-stabilizing actions.
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Affiliation(s)
- E D Risby
- Section on Clinical Pharmacology, National Institute of Mental Health, Bethesda, MD 20892
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van Schil P, Vanmaele R, Moses F, De Maeseneer M, De Bock L. Pseudoaneurysm of the posterior tibial artery as an early complication after Fogarty catheter thrombectomy. Eur J Vasc Surg 1990; 4:197-9. [PMID: 2351222 DOI: 10.1016/s0950-821x(05)80438-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
After angioplasty of the superficial femoral artery at Hunter's canal in a 65-year-old woman thrombosis developed and femoropopliteal bypass grafting was necessary. Four weeks later the graft occluded, successful thrombectomy was performed with a Fogarty catheter and the patient heparinised. Three days later a pseudoaneurysm developed on the posterior tibial artery which was excised and the artery which was longitudinally torn repaired with a vein graft giving good functional results. Complications after Fogarty balloon catheter thrombectomy are relatively rare but Pseudoaneurysms can occur after perforation or rupture of smaller vessels.
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Affiliation(s)
- P van Schil
- Department of General, Thoracic and Vascular surgery, Antwerp University Hospital, Edegem, Belgium
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Hoffman PL, Moses F, Tabakoff B. Selective inhibition by ethanol of glutamate-stimulated cyclic GMP production in primary cultures of cerebellar granule cells. Neuropharmacology 1989; 28:1239-43. [PMID: 2556655 DOI: 10.1016/0028-3908(89)90217-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In primary cultures of cerebellar granule cells of the rat, the accumulation of cyclic GMP was stimulated by glutamate, acting at the N-methyl-D-aspartate recognition site, and by atrial natriuretic factor. The response to glutamate was calcium-dependent, while the response to atrial natriuretic factor was not. Ethanol inhibited the accumulation of cyclic GMP in response to both glutamate and atrial natriuretic factor. However, the response to glutamate was much more sensitive to ethanol, with 30-40% inhibition occurring at 50 mM ethanol. Substantial inhibition of the response to atrial natriuretic factor was observed only at concentrations of ethanol of 200 mM or larger. The data suggest that a major site of action of ethanol in inhibiting the accumulation of cyclic GMP is the coupling of the glutamate receptor to soluble guanylate cyclase. The effect of ethanol on agonist-activated activity of guanylate cyclase may contribute to the pharmacological action of ethanol in vivo.
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Affiliation(s)
- P L Hoffman
- National Institute on Alcohol Abuse and Alcoholism, Division of Intramural Clinical and Biological Research, Bethesda, Maryland 20892
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Abstract
Measurements of calcium uptake and cyclic GMP production by cerebellar granule cells grown in primary culture demonstrated that ethanol preferentially inhibited N-methyl-D-aspartate (NMDA) receptor-gated cation channel function. Concentrations of ethanol as low as 10 mM inhibited NMDA-stimulated Ca2+ uptake by greater than 30%, and ethanol also inhibited NMDA-stimulated (Ca2+-dependent) cyclic GMP accumulation in a similar, dose-dependent manner. Responses to kainate were significantly less sensitive to ethanol. Studies using various concentrations of NMDA, as well as phencyclidine (PCP) and glycine, suggested that ethanol affected the "coagonist" binding site of the NMDA receptor-channel complex, rather than the PCP recognition site.
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Affiliation(s)
- P L Hoffman
- Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
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Ryan CJ, Deuster PA, Moses F, Smoak BL, Hofmann A, Villanueva VG. METABOLIC AND HORMONAL RESPONSES TO INGESTING WATER OR GLUCOSE POLYMER DURING A TWO HOUR RUN. Med Sci Sports Exerc 1989. [DOI: 10.1249/00005768-198904001-00548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Hoffman PL, Moses F, Luthin GR, Tabakoff B. Acute and chronic effects of ethanol on receptor-mediated phosphatidylinositol 4,5-bisphosphate breakdown in mouse brain. Mol Pharmacol 1986; 30:13-8. [PMID: 3014307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Phosphatidylinositol 4,5-bisphosphate (PIP2) breakdown was stimulated by agonists acting at muscarinic cholinergic and alpha 1-adrenergic receptors in mouse brain. Ethanol, in vitro, inhibited basal cerebral cortical PIP2 breakdown with a threshold concentration of 75-100 mM. Basal PIP2 breakdown in hippocampus and striatum was less sensitive to ethanol. A high concentration of ethanol (500 mM) increased the EC50 for carbachol stimulation of PIP2 breakdown in all three brain areas, but had no effect on the EC50 for norepinephrine. Following chronic ingestion of ethanol by mice, the EC50 for carbachol stimulation of PIP2 breakdown in cortex was decreased, and there was no change in striatum. These effects were consistent with previously observed increases in quinuclidinylbenzilate (QNB) binding in cortex, but not striatum, of mice fed ethanol chronically. However, in hippocampus, where chronic ethanol ingestion had also induced an increase in QNB binding, the EC50 for carbachol stimulation of PIP2 breakdown was increased. Binding studies using the specific M1 muscarinic cholinergic receptor antagonist, pirenzepine, revealed that the number of pirenzepine-binding sites was increased in cortex, but not hippocampus (or striatum) of ethanol-fed mice. These results support the hypothesis that high affinity pirenzepine-binding sites are coupled to PIP2 breakdown in mouse cortex. The changes in cerebral cortex represent one of the first demonstrations of a functional correlate of a change in receptor density in ethanol-treated animals. Increased sensitivity to cholinergic agonists in cortex may contribute to particular signs of ethanol withdrawal.
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El-Ahraf A, Willis WV, Moses F. Determination of the concentration of metals in animal feeds : Cadmium, chromium, copper, iron, magnesium, nickel, lead, and zinc in dairy cattle feed, manure, and processed manure. Biol Trace Elem Res 1983; 5:129-37. [PMID: 24263454 DOI: 10.1007/bf02916632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/1982] [Accepted: 12/21/1982] [Indexed: 10/21/2022]
Abstract
The concentrations of eight metals (Cd, Cr, Cu, Fe, Mn, Ni, Pb, and Zn) were determined by atomic absorption spectrophotometry for the following related materials: three products obtained by processing cattle manure-a cellulosic material resembling silage (CI), a water soluble protein-rich powder (CII), and a soil amendment product (CIII)-as well as dairy cattle feed rations containing CII and the resultant fresh feces; and the manure composites used to prepare the processed products. The concentrations of these metals generally increased in samples in the order feed, feces, CI, CII, and CIII. The metal concentrations in CI were comparable to literature values for silage; the metals in CII were present at higher concentrations, but not sufficient to limit its use as a feed ingredient. The potential health effects of feeding cattle rations containing CI or CII are discussed in the context of these results.
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Affiliation(s)
- A El-Ahraf
- Department of Health Science and Human Ecology, California State College, 92407, San Bernadino, CA
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Ryan CJ, Deuster PA, Moses F, Smoak BL, Hofmann A, Villanueva VG. METABOLIC AND HORMONAL RESPONSES TO INGESTING WATER OR GLUCOSE POLYMER DURING A TWO HOUR RUN. Med Sci Sports Exerc 1980. [DOI: 10.1249/00005768-198004001-00548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Moses F, Baska R, Graeber G, Kearny G, Deuster P. GASTROINTESTINAL BLEEDING DURING AN ULTRAMARATHON. Med Sci Sports Exerc 1980. [DOI: 10.1249/00005768-198004001-00465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Cessation of chronic ethanol administration, and elimination of ethanol from the body, results in a withdrawal syndrome in mice characterized by behavioural symptoms and hypothermia. During withdrawal, the accumulation rate of [14C] 5-hydroxytryptamine (5-HT) from [14C]tryptophan, was significantly lower in the brainstem of the ethanol-withdrawn animals than in controls. A similar pattern was seen in forebrain. When the rate of 5-HT accumulation was determined using pargyline, no differences occurred between control and ethanol-treated animals. The endogenous concentrations of tryptophan in plasma, and tryptophan, 5-HT and 5-hydroxyindoleacetic acid (5-HIAA) in brain were the same in ethanol-treated and control animals. It is suggested that the changes in accumulation of 14C-5-HT and 14C-5-HIAA in ethanol-withdrawn animals reflected alterations in electrical activity of serotoninergic neurons during withdrawal.
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Abstract
Tranylcypromine produces behavioral excitation while pargyline produces depression. Tranylcypromine increased brain tryptophan which led to an accumulation of tryptamine. The levels of tryptamine after tranylcypromine were found to be 3 times those found after pargyline.
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