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Papers by Joseph Andy

CRC Press eBooks, Oct 22, 2023

Transactions of The Royal Society of Tropical Medicine and Hygiene, 1986

A detailed study of the coronary arteries of 111 consecutive necropsies at Ile-Ife, Nigeria is re... more A detailed study of the coronary arteries of 111 consecutive necropsies at Ile-Ife, Nigeria is reported. Coronary occlusive disease occurred in eight (7.2%) subjects and involved less than 50% of luminal size in five, and greater than 50% of luminal size in three subjects. Previous medical history was available in four of eight subjects and all four had hypertension. All three subjects with greater than 50% luminal occlusion were hypertensive patients and professionals, one was additionally diabetic and a heavy smoker and serum cholesterol (available in one) was 250 mg/ml. The mean age of the subjects with moderate and severe disease was 54 (range 35 to 71) years. Thus coronary occlusive disease among Nigerians occurred in elderly, affluent and hypertensive patients exposed to Western diets and habits.

PubMed, Sep 1, 1974

... JOSEPH J. ANDY, MD, RAYMOND A. LLOYD, MD, and CHARLES L. CURRY, MD, Division of Cardiovascula... more ... JOSEPH J. ANDY, MD, RAYMOND A. LLOYD, MD, and CHARLES L. CURRY, MD, Division of Cardiovascular Diseases, Department of Medicine, Howard University College of Medicine and Freedmen&#x27;s ... 9. TALBERT, J. L. and AG MORROW, N. P. COLLINS and JW GILBERT. ...

PubMed, Dec 1, 1977

A 10-year analysis of 113 cases of staphylococcal endocarditis seen in two Washington, D.C., hosp... more A 10-year analysis of 113 cases of staphylococcal endocarditis seen in two Washington, D.C., hospitals is presented. 96% of the cases occurred in parenteral drug addicts, but 4% complicated septicemia from known foci of infection. Coagulase positive staphylococcus was responsible for 97% of the infection, and the rest were caused by coagulase negative staphyloccus. Except in four patients with previously known cardiac murmurs, infection occurred on normal valves in these patients. Infection was isolated to the tricuspid valve in 71%, to the mitral valve in 6% and to the aortic valve in 3.5% of our cases; and more than one cardiac valve was affected in the remaining patients. All patients were treated with antibiotics based on bacterial sensitivity testing. The mortality from isolated tricuspid endocarditis was 5%, from isolated mitral endocarditis 33%, and from isolated aortic valve endocarditis 100%. The overall mortality was 18%. The better prognosis documented for acute tricuspid endocarditis is related to the much less severe haemodynamic consequences of acute tricuspid regurgitation, and the probably milder consequences of septic pulmonary embolism compared with coronary or cerebral embolism.

American Journal of Cardiology, Jul 1, 1977

Echocardiographic observations are described in 25 opiate addicts with active infective endocardi... more Echocardiographic observations are described in 25 opiate addicts with active infective endocarditis involving apparently previously normal valves. Infective endocarditis was isolated to the tricuspid valve in 11 patients, involved both right- (tricuspid valve) and left-sided valves in 7 and was isolated to the left-sided valves in 7 (mitral valve in 6). Twenty patients (80%) had tricuspid valve regurgitation, 12 had mitral regurgitation, 3 had aortic regurgitation and none had pulmonary valve regurgitation. Considering the 75 cardiac valves (excluding the pulmonary) in the 25 patients, echocardiographic abnormalities consistent with active infective endocarditis were detected in 26 (74%) of the 35 clinically incompetent valves but in none of the 40 competent valves. Comparison of the 20 incompetent tricuspid valves with the 12 incompetent mitral valves indicated that (1) the echocardiogram was less sensitive in detecting tricuspid valve lesions, (2) rupture of tricuspid valve chordae tendineae was absent or not detectable, and (3) tricuspid valve vegetations tended to be larger.

International Journal of Cardiology, Sep 1, 1983

Complete heart block of recent onset is reported and is attributed to chronic cbloroquine abuse. ... more Complete heart block of recent onset is reported and is attributed to chronic cbloroquine abuse. Total blood chloroquine was more than two times higher in this patient than in 4 patients following therapeutic doses of chloroquine, and chloroquine basic metabolities were also proportionally higher in this patient's blood. Chronic chloroquine toxicity reportedly causes cardiomyopathy and skeletal myopathy [ 11. Recently complete heart block has been reported in chronic chloroquine toxicity [2]. We report a patient with complete heart block from chronic chloroquine abuse in whom total chloroquine and its metabolites were assayed in the blood.

American Heart Journal, Aug 1, 1977

Sympathomimetic agents are frequently used in the treatment of refractory cardiac failure. '-~ Ho... more Sympathomimetic agents are frequently used in the treatment of refractory cardiac failure. '-~ Howeverl available agents are limited by their tendency to produce potentially deleterious changes in heart rate, rhythm, and blood pressure. '-' "~ A substance that provides an isolated increase in myocardial contractility should prove clinically valuable. Dobutamine was synthesized by Tuttle and Mills ~. s and early animal studies demonstrated that in the dose range of 5 to 20 tLg/Kg./min., it is selectively inotropic? A comparative study of the effects of dopamine (the only other selective sympathomimetic agent 4) and dobutamine in dogs showed that dobutamine increased cardiac output to a'greater extent than does dopamine. TM The present study was designed to evaluate the effectiveness and safety of dobutamine in patients with severe congestive heart failure. Methods The effect of dobutamine was assessed hemodynamically, echocardiographically, and by measurement of the systolic time intervals. Seventeen

PubMed, Oct 1, 1989

A combined retrospective and prospective review of 150 children and 28 adult Nigerian empyema tho... more A combined retrospective and prospective review of 150 children and 28 adult Nigerian empyema thoracis patients was conducted between 1978 and 1986. Comorbidity requiring additional treatment was present in 145 patients (82.5%) while 175 patients (98.3%) had no, low or medium family income. In addition to medical management 161 out of 178 patients (90.4%) had tube thoracostomy while eight (4.4%) and seven (3.9%) respectively required additional minor and major thoracic procedures for failure of tube thoracostomy and arrest of, or failure to achieve, progressive pulmonary re-expansion and resolution of concomitant illness. Mean period of in-patient care was 30.5 days +/- 30.3. In spite of limitation of resources and poor clinical condition of most patients reduction of onset-diagnosis and diagnosis-treatment intervals and our overall management significantly reduced the perioperative mortality from 15.1% during the retrospective study period to 4.8% during the prospective period for a 9% overall perioperative mortality rate.

Nigerian Postgraduate Medical Journal

Rheumatic heart disease is one of the commonest causes of heart disease in Nigeria. Previous stud... more Rheumatic heart disease is one of the commonest causes of heart disease in Nigeria. Previous studies on rheumatic heart disease in Nigeria were either clinical or retrospective echocardiographic studies. This study was aimed at determining the burden of chronic rheumatic mitral valve disease, pattern of valvular involvement, severity and associated valvular lesions, using echocardiography. Between May, 2004 and April 2005, patients with symptomatic rheumatic heart disease, seen in the cardiac clinics of University of Nigeria Teaching Hospital, Enugu, were recruited for the study. The patients were investigated non-invasively with M-mode, Two-dimensional, Pulsed wave, Continuous wave and colour flow Doppler echocardiographic techniques in order to assess the mitral and other intracardiac valves for evidence of rheumatic heart disease. There were a total of 55 patients, 39 (70.9%) females and 16 (29.1%) males with a mean age of 29.34 +/- 11.57 years. Mitral valve disease was found in 54 (98.2%) and isolated aortic valve disease in 1 (1.8%) of cases. Mitral regurgitation occurred in 64.8%, mixed mitral valve disease in 25.9% and pure mitral stenosis in 9.3%. Mitral valve disease was associated with aortic valve disease in 33.3%, with tricuspid valve disease in 24.1% and with functional pulmonary incompetence in 9.3% of cases. Rheumatic heart disease in Nigeria is essentially a disease of the mitral valve as seen elsewhere in the world. Echocardiography should be done routinely for patients with rheumatic heart disease to facilitate accurate diagnosis and definitive treatment.

Annals of Tropical Paediatrics, 1990

Urban Nigerian school children are reported to have a higher systolic blood pressure and diastoli... more Urban Nigerian school children are reported to have a higher systolic blood pressure and diastolic blood pressure than rural community school children until the age of 11-12 years when this difference tends to disappear. We evaluated 874 urban day-school children and 674 rural community school children aged 5-16 (mean 11.9) years in south-eastern Nigeria to confirm this changing pattern, and to assess the contributions of some known factors to the differences as well as the changing pattern. This study confirmed the changing pattern of urban/rural blood pressure of school children. Differences in weight, height and Body Mass Index (BMI), though important, appeared insufficient to explain this pressure difference and the changing pattern. Urban children aged 12-14 years were found to excrete more sodium and (unexpectedly) more potassium in their 24-h urine samples. The observed urban/rural blood pressure difference appears to be sustained by a multiplicity of factors, including differences in weight, BMI, height, electrolytes (especially sodium) consumption, and increased exposure to Western-type education.

Current Therapeutic Research, 1994

... Nigeria) PLC, Ikeja, La-1115AMLODIPINE FOR HYPERTENSIONgos, Nigeria, for initiating and suppo... more ... Nigeria) PLC, Ikeja, La-1115AMLODIPINE FOR HYPERTENSIONgos, Nigeria, for initiating and supporting the trial and providing thestudy drugs.References:1. Swartz A, Van Zwieten PA, Matlib MA, Millard RW. ... Am JCardiol 1989; 64:6I-9I.3. Burges RA, Dodd MG, Gardiner DG. ...

Acta Tropica, 1998

There should be a recognisable trend between the incidence of hypereosinophilia and the duration ... more There should be a recognisable trend between the incidence of hypereosinophilia and the duration of tropical endomyocardial fibrosis (EMF), if the hypothesis, that EMF is the burnt out phase of eosinophil associated heart disease, is correct. We tested this hypothesis in a prospective study of 89 consecutive EMF cases over an 18 year period at two Nigerian locations (Ife in South West and Calabar in South East). We carefully dated the duration of EMF symptoms at first presentation and screened for hypereosinophilia (eosinophilia &amp;amp;amp;amp;amp;gt; or = 1500/mm3), and their causes. When no cause was identified for hypereosinophilia we gave a therapeutic trial with diethylcarbamazine to the patients. An eosinophil count &amp;amp;amp;amp;amp;gt; or = 1000/mm3 was recorded in 80% of 24 cases seen within 6 months; 55% of 46 cases seen 0-24 months; 54% of 18 cases seen 25-48 months and 21% of 25 cases seen more than 49 months of onset of symptoms: while the respective distribution of eosinophil count &amp;amp;amp;amp;amp;gt; or = 1500/mm3 for similar periods were 66, 44, 27 and 21%. This reflects a highly significant (P &amp;amp;amp;amp;amp;lt; 0.001) inverse relationship between hypereosinophilia and the duration of EMF and strengthens the concept that EMF (without eosinophilia) represents the late stage of eosinophilic heart disease. The localisation of endemic EMF to the low-lying tropical rain forest Zone and its predominant occurrence among rural dwellers and farmers suggest a vector borne etiologic agent. Microfilaria was the most likely cause of hypereosinophilia in the cases presented.

Cardiovascular Journal of Africa, 2018

Background: Diabetes mellitus (DM) is a risk factor for left ventricular (LV) dysfunction, and mi... more Background: Diabetes mellitus (DM) is a risk factor for left ventricular (LV) dysfunction, and microalbuminuria is frequently associated with DM. This study aimed to compare LV function among normotensive type 2 diabetes (T2DM) patients with normoalbuminuria, those with microalbuminuria, and healthy controls. Methods: This was a cross-sectional study conducted at the diabetes and cardiology clinics of the

Journal of Hypertension: Open Access, 2012

Nsakashalo-Senkwe et al. [17] and Siziya et al. [18]. We highlight briefly the methods that were ... more Nsakashalo-Senkwe et al. [17] and Siziya et al. [18]. We highlight briefly the methods that were used in the survey below.

Copyright © 2014 Okon Ekwere Essien et al. This is an open access article distributed under the C... more Copyright © 2014 Okon Ekwere Essien et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Death from coronary artery disease (CAD) has been until recently considered rare in Nigeria. We present a report of a study of CADwith its predisposing cardiovascular (CVD) risk factors in South South Nigeria.Methods. We examined the autopsy reports of 747 coroner cases and 41 consecutive clinically diagnosed cases of ischemic heart disease seen in South South Nigeria. Results. CADwas diagnosed in 13 (1.6%) of 747 autopsies.They were predominantly males, urban residents, and of high social class with combination of CVD risk factors of hypertension, alcohol use, diabetes mellitus, cigarette smoking, poor physical activities,

European Journal of Preventive Medicine, 2019

To compare left ventricular (LV) geometry patterns among normotensive type 2 diabetics (NT2DM) wi... more To compare left ventricular (LV) geometry patterns among normotensive type 2 diabetics (NT2DM) with normoalbuminuria, NT2DM with microalbuminuria and healthy controls. A cross-sectional study conducted at the medical outpatient department of a Teaching Hospital from January 2013 to March 2014. Sixty-three normoalbuminuric NT2DM, 71 microalbuminuric NT2DM and fifty-nine healthy controls were recruited. Microalbuminuria was tested for using Micral test strips (Roche, Germany). Trans-thoracic echocardiography was carried out on all subjects. Relative wall thickness (RWT), left ventricular mass index (LVMI) and LV geometry patterns were compared among the three groups. The three groups were age and sex-matched and appropriate statistical tests were used for comparisons with p<0.05. The proportions of abnormal LV geometry (33.3% vs 71.4% vs 84.5%), LVMI and RWT showed a significant stepwise increase from healthy controls through normoalbuminuric NT2DM and to microalbuminuric NT2DM (all p<0.01). Concentric remodeling (CR) was the commonest pattern among the three groups. Left ventricular mass index and RWT correlated significantly with duration of DM and body mass index (all p< 0.01). Microalbuminuria showed a strong direct association with abnormal LV geometry (OR 3.27, 95% CI 1.63-6.57, p<0.01) while duration of DM was found to be an independent predictor of LV geometry remodeling (OR 1.23, 95% CI 1.02-1.49, p = 0.03) among normotensive diabetics. Although CR was the commonest pattern across the three patient groups, those with microalbuminuria had the highest proportion and risk of LV remodeling. Early screening and prompt treatment of microalbuminuria in NT2DM is hereby recommended.

African journal of medicine and medical sciences, 2010

Mural thrombi and thromboemboli are very common in idiopathic hypereosinophilic syndrome (HES), w... more Mural thrombi and thromboemboli are very common in idiopathic hypereosinophilic syndrome (HES), whose cardiac pathology is indistinguishable from endomyocardial fibrosis (EMF). Although mural thrombi are common in EMF cases, and post mortem embolic infarcts are frequently seen; clinical recognition of thromboembolism in EMF is unusual. We report here 4 cases of clinically recognized thromboembolism among 106 consecutive cases of EMF (including a case with a sudden onset of vascular occlusion and a below knee infarction and auto-amputation of the right leg). Two of the 4 cases had hypereosinophilia that was probably induced by microfilaria. The mechanisms of mural thrombosis and thromboembolic infarcts in EMF cases are discussed, and the possibility shown that helminth induced eosinophilic myocarditis can induce similar acute mural thrombosis and thromboembolism. The place of anticoagulant therapy in EMF is discussed.

African journal of medicine and medical sciences

It has been shown that chronic African endomyocardial fibrosis (E.m.f.) is most likely the burnt-... more It has been shown that chronic African endomyocardial fibrosis (E.m.f.) is most likely the burnt-out phase of parasite-induced hypereosinophilia. It has also been shown that African E.m.f. and Loffler's heart disease are pathologically identical. The mechanism by which these parasites and/or eosinophilia are associated with endomyocardial damage remains, however, unknown. The parasites which have been associated with induction of eosinophilia in E.m.f. include filariasis; trichinosis; ascariasis and hookworm and schistosomiasis. These parasites are known to produce neurologic, cardiac, pneumonic, hepatic and dermal damage during the migration of their larvae; at which time eosinophilia is usually most severe. The tissue damage induced by larval migration of these parasites appears comparable to findings seen in the hypereosinophilic syndrome. The evidence from our observations and this review suggests that the cardiac damage induced by larval migration, like the neurologic, pneu...