Sarcopenia diagnosed using masseter muscle area predictive of early mortality following severe traumatic brain injury

Traumatic brain injury（TBI）represents a global pandemic and is currently a leading cause of injury related death worldwide.Unfortunately,those who survive initial injury often suffer devastating functional,social,and economic consequences.

Early Mortality (120 Days) amongst Incident Hemodialysis with End Stage Kidney Disease: A 5-Year Retrospective Study

Background: End stage kidney failure (ESKF) is a major public health problem worldwide. Haemodialysis is the principal method in its management, and is associated with high mortality mostly owing to cardiovascular disease (CVD). In Cameroon, data on its predictors is lacking. Objectives: This study aimed at determining the 120 day mortality, causes of death and its predictors and amongst incident haemodialysis patients with end stage kidney disease in Cameroon. Methods: We retrospectively reviewed medical records of patients admitted for ESKF who started haemodialysis between January 2016 and December 2020 (5 years) and who died within 120 days. For these patients, the variables collected were: age, gender, comorbidities, dialysis parameters, para-clinical parameters, cause of death. The causes of death were registered as stated by the attending physician. Data were analysed using SPSS 20. A p-value Results: Out of 1012 incident patients, 258 died giving a mortality rate of 25.5%. Of these, 59.7% were males. The mean age (SD) was 46.52 (15.6) years. The main causes of death included sepsis (45.61%), CVD (12.86%), and severe anaemia (9.94%);and were comparable between males and females except for anaemia which was more prevalent in females (p = 0.003). Catheters related infections (77.9%), and chest infections (9.0%) were the main sources of sepsis while sudden death (76.2%), myocardial infarction (9.5%), and heart failure (9.5%) were the main cardiovascular causes of death. Hypertension (65%), CVD (35.6%), and diabetes (9.19%) were the main comorbidities associated to death. The main vascular access was central venous catheter 96%. CVD (p = 0016, aOR;4.107), Albumin ≤ 3.5 g/dl (p = 0.015, aOR;23.083), and Creatinine > 20 mg/dl (p = 0.024, aOR;5.649) were independent predictors of mortality. Conclusion: One in four patients on haemodialysis died early. CVD, hypoalbuminemia and late initiation were predictors of mortality. Majority of patients die from preventable causes, with sepsis from catheter being the most frequent.

The prediction of early mortality in off-pump coronary artery bypass surgery:SinoSCORE versus EuroSCORE

Objective To compare the validation of the Sino System for Coronary Operative Risk Evaluation (SinoSCORE) with the European system for cardiac operative risk evaluation (EuroSCORE) in patients undergoing off-pump coronary artery bypass (OPCAB) surgery in China. Methods Data of patients who underwent OPCAB between 2004 and 2005 in

Investigation of the risk factors associated with early mortality of the rapid two-stage arterial switch operation

Objective To investigate the risk factors associated with early mortality of the rapid two-stage arerial switch operation,which has a significantly higher overall mortality than that of ASO procedure for D-TGA with an intact ventricular septum. Methods The data we reviewed involving patients who underwent rapid two-stage switch operations from September,2002 to September,2007 in our center,13 patients were male and 8

Risk Factors of Early Neonatal Deaths in Pediatric Teaching Hospital in Bangui, Central African Republic

Background: The neonatal mortality rate in the Central African Republic (CAR) is 42.3 per 1000 live births in 2017, indicating that CAR is with the highest number of newborn deaths. Objective: The objective is to clarify the risk factors of neonatal deaths in this area. Methodology: A case-control study with retrospective data collection. Targets were newborns >7 days, hospitalized and dead (cases), and newborns admitted after the respective case during the study period and discharged before the 7th day of life. This study was carried out between 2016 and 2018 in the neonatal unit of the “Complexe Hospitalier Universitaire Pédiatrique de Bangui” (CHUPB), the only national hospital for newborns care in the CAR. Results: We included 902 newborns, with 451 cases of early neonatal death and 451 controls. 4168 newborns were admitted to the neonatology unit with 621 early death cases;a lethality rate of 14.9%. Early neonatal deaths factors were: newborns with low birth weight (OR = 22.59;95% CI [15.93 - 32.04]; P < 0.001);mothers who did not attend antenatal care (OR = 5.54;95% CI [3.95 - 7.79];P < 0.001), home delivery (OR = 0.70;95% CI [0.03 - 0.15];P < 0.001);young maternal age < 25 years (OR = 2.08;95% CI [1.58 - 2.73];P < 0.001);non-medical transport (OR = 2.14;95% CI [1.03 - 4.46];P = 0.03);origin from remote areas (OR = 5.25;95% CI [3.95 - 6.98];P < 0.001);isolated prematurity (P < 0.01);anoxo-ischemic encephalopathy (OR = 12.72;95% CI [6.54 - 34.73];P < 0.01);delivery by cesarean section (OR = 0.59;95% CI [0.41 - 0.84];P < 0.001);preterm delivery (OR = 29.36;95% CI [20.12 - 42.81];P < 0.001), and maternal lower education (OR = 5.65;95% CI [4.08 - 7.81];P < 0.001). Conclusion: The early neonatal mortality rate remains high in this area. Controlling the factors mentioned above might lead to improving the survival of newborns.

Impact of Coronary Artery Anatomy in Arterial Switch Operation:In-hospital and Post-discharge Outcomes

Objective The influence of the coronary artery anatomy on the prognosis of patients receiving an arterial switch operation(ASO)is currently controversial,and the risk factors for this operation may change in more complicated patients.This study aimed to investigate the influence of coronary artery anomalies on the in-hospital and post-discharge outcomes of ASO in patients with transposition of the great arteries(TGA)and Taussig-Bing anomaly(TBA).Methods We retrospectively reviewed 206 patients who underwent ASO from January 2007 to December 2019.The median age at operation was 33[interquartile range(IQR):20–71]days.Median follow-up time was 7.2 years(IQR:4.0–10.3 years).Results Coronary anomalies were present in 86 patients(41.7%),with 9(4.4%)of them having a single coronary artery.Additional coronary features included intramural courses in 5(2.4%)patients,ostial stenosis in 1(0.5%)patient,and accessory coronary artery orifices in 5(2.4%)patients.There were 32(15.5%)in-hospital deaths and 8(4.6%)post-discharge deaths,yielding an overall survival of 81.3%,80.7%and 79.9%at 1,5 and 10 years,respectively.Mortality due to ASO has been drastically decreased since 2013.Patients with a single coronary artery had higher rate of in-hospital mortality,but this finding was not statistically significant.The earlier surgical era(OR:2.756)and a longer cardiopulmonary bypass time(OR:2.336)were significantly associated with in-hospital mortality,while coronary patterns were not.An intramural coronary artery(HR:10.034)and a patient age of older than 1 year at the time of ASO(HR:9.706)were independent predictors of post-discharge mortality.Conclusion ASO remains the procedure of choice for TGA with coronary anomalies with acceptable in-hospital and post-discharge outcomes in terms of overall survival and freedom of reoperation.However,intramural coronary artery is an independent risk factor for post-discharge mortality.Timely surgery within the 1st year of life helps improve overall midterm survival of ASO.

Association between single nucleotide polymorphisms of nLvALF1 and PEN2-1 genes and resistance to Vibrio parahaemolyticus in the Pacific white shrimp Litopenaeus vannamei

Vibrio parahaemolyticus carrying a plasmid encoding the PirAvp and PirBvp toxins is the causative agent of acute hepatopancreatic necrosis disease(AHPND)in penaeid shrimps.In the Pacific white shrimp farming industry,one possible strategy to reduce economic loss due to AHPND is the development of a shrimp line resistant to the disease.In this study,we identified single nucleotide polymorphisms(SNPs)in the Litopenaeus vannamei anti-lipopolysaccharide factor 1(nLvALF1)and penaeidin 2-1(PEN2-1)genes,and we analyzed the associations between these SNPs and resistance/susceptibility to V.parahaemolyticus infection in the Pacific white shrimp.Postlarvae(PL20)shrimp from a local hatchery in Prachuap Khiri Khan Province were challenged with an isolate of VPAHPND and mortality was observed for 14 days.DNA was extracted from susceptible(died within 6 days)and resistant(survived the challenge)shrimp(45 individuals/group)and used for PCR amplifications of nLvALF1(397 bp)and PEN2-1(637 bp)gene fragments.PCR products were sequenced by direct sequencing and SNPs were identified from sequencing chromatograms.Nine and seven SNPs were identified in nLvALF1 and PEN2-1 gene fragments,respectively.Analyses of allele frequencies in susceptible and resistant samples using Chi-square tests revealed that four and six SNPs in nLvALF1 and PEN2-1,respectively,were associated with resistance/susceptibility to V.parahaemolyticus infection(P<0.05).The SNPs in the candidate genes identified here are potential DNA markers for breeding V.parahaemolyticus-resistant Pacific white shrimp in the study population;however,further validation will be required if these SNPs are to be used across populations.