The incidence rate and histological characteristics of intimal hyperplasia in elastase-induced experimental abdominal aortic aneurysms in mice

Intimal hyperplasia(IH)is a negative vascular remodeling after arterial injury.IH occasionally occurs in elastase-induced abdominal aortic aneurysm(AAA)mouse models.This study aims to clarify the incidence and histological characteristics of IH in aneurysmal mice.A retrospective study was conducted by including 42 male elastaseinduced mouse AAA models.The IH incidence,aortic diameters with or without IH,and hyperplasia lesional features of mice were analyzed.Among 42 elastase-induced AAA mouse models,10 mice developed mild IH(24%)and severe IH was found in only 2 mice(5%).The outer diameters of the AAA segments in mice with and without IH did not show significant difference.Both mild and severe IH lesions show strong smooth muscle cell positive staining,but endothelial cells were occasionally observed in severe IH lesions.There was obvious macrophage infiltration in the IH lesions of the AAA mouse models,especially in mice with severe IH.However,only a lower numbers of T cells and B cells were found in the IH lesion.Local cell-secreted matrix metalloproteinases(MMP)2 was highly expressed in all IH lesions,but MMP9 was only overexpressed in severe lesions.In conclusion,this study is the first to demonstrate the occurrence of aneurysmal IH and its histological characteristics in an elastaseinduced mouse AAA model.This will help researchers better understand this model,and optimize it for use in AAA-related research.

Primary Left Atrial Intimal Sarcoma Disguised as Functional Mitral Stenosis: A Case Study

A 66-year-old female with a 1-month history of increasing fatigue, dyspnea on exertion, and palpitations presented with clinical signs of heart failure. Chest computed tomography (CT) revealed a large, mobile left atrial (LA) mass attached to the mitral valve causing severe mitral stenosis and mitral regurgitation. The mass was surgically debulked and the mitral valve was replaced. Pathology revealed a poorly differentiated malignant spindle cell neoplasm with diffuse nuclear positivity of MDM2 and multifocal positivity of CDK4, consistent with intimal sarcoma. This case seeks to describe an uncommon presentation of a rare malignancy, and the surgical and medical management of the disease.

Misdiagnosis of primary intimal sarcoma of the pulmonary artery as chronic pulmonary embolism: A case report

BACKGROUND Primary intimal sarcoma of the pulmonary artery is a rare malignant tumor originating from the pulmonary artery,which has a low incidence rate and is easily misdiagnosed as pulmonary embolism.There is no standard protocol for the treatment of primary intimal sarcoma of the pulmonary artery.CASE SUMMARY This study reports a patient with primary intimal sarcoma of the pulmonary artery who was admitted to our hospital in 2017.The clinical characteristics,diagnosis,treatment and outcome of the patient were retrospectively analyzed.The patient was a Chinese Han male aged 44 years.He had three consecutive episodes of syncope,and was thus admitted to a local hospital.Computed tomography pulmonary angiography showed multiple lesions with abnormal densities in the pulmonary trunk,left pulmonary artery,mediastinum and pericardium,which were consistent with recurrence after tumor resection.He underwent surgery,and was pathologically diagnosed with intimal sarcoma of the pulmonary artery.He relapsed 3 mo after surgery,and apatinib was administered.His condition was stable after 4 mo,with tolerable and controllable adverse reactions.He subsequently died 19 mo after surgery.CONCLUSION Primary intimal sarcoma of the pulmonary artery has no specific clinical or imaging manifestations.The diagnosis of this disease depends on histopathology and immunohistochemistry,and has a poor clinical prognosis.Surgical treatment is currently a favorable option for primary intimal sarcoma of the pulmonary artery,and targeted therapy may provide new insights for the development of effective treatment methods.

Intimal sarcoma of the pulmonary artery with multiple lung metastases: Long-term survival case

Pulmonary artery intimal sarcoma(PAIS) is a rare tumor with a very poor prognosis. Clinical and radiological findings usually mimic thromboembolic disease, leading to diagnostic delays. The treatment of choice is surgery, and adjuvant chemotherapy and radiotherapy have limited results. We report the case of a 48-year-old male patient, initially suspected with pulmonary thromboembolism. The angio-CT revealed a filling defect in the pulmonary artery trunk. The patient underwent surgery, resulting in with complete resection of the mass with a diagnosis of PAIS. The tumor progressed rapidly in the lung, requiring surgery of multiple lung metastases. The patient was treated with stereotactic body radiation therapy(SBRT) on two occasions for new pulmonary lesions. In the last follow-up(4 years after initial diagnosis), the patient was disease-free. In conclusion, SBRT proved to be an alternative treatment to metastasectomy, allowing palliative chemotherapy to be delayed or omitted, which may result in improved quality of life.

Experimental study on autogenous vein cuff alleviating arterial intimal hyperplasia

Objective: To explore the alleviation of arterial intimal hyperplasia and improvement of outflow by inserting an autogenous vein cuff between poly tetraflu oroethylene (PTFE) graft and arteri al an astomosis. Methods: Twenty-four hindlimbs of 12 mongrel dogs were randomly divided into control group and experimental group. Sole PTFE bypasses were made in the control group, an autologous vein cuff was inserted in the distal anastomosis in the experimental group. Eight weeks after operation, angiography was made and specimens were harvested, histomorphological studies under microscope and picture analysis with computer were carried out, scanning electromicroscopy on the vein cuff was made. Results: Angiography demonstrated the patency of control and experimental group was 16. 7% and 66. 7%, respectively; Computer gave the intimal thickness: (483. 5 ± 67. 3) μm and (147. 4 ± 38. 6) μm, respectively; no obvious change was seen in medial thickness; area of intimal hyperplasia was (5217 ± 1 123) (pixel) and (31 17 ± 890) (pixel), respectively, accounting (80. 9 ± 17. 2)% and (47. 7 ± 13. 7)% of the sectional area of vessel lumen. The interpositional vein was arteriolization. Conclusion: The interpositional autologous vein cuff can obviously mitigate the arterial intimal hyperplasia after PTFE bypasses, improving postoperative patency of vascular surgery.

Reducing intimal hyperplasia in vein grafts harvested by a no-touch harvesting technique

Objective To investigate the effect of no-touch harvesting technique in reducing vein graft intimal hyperplasia. Methods This longitudinal trial compared graft angiostenosis of two groups undergoing jugular vein to carotid artery interposition grafting in rabbit model. Conventional group:12 rabbits had their veins stripped,distended,and stored in heparinized saline solution. No-touch group:12 rabbits had veins removed with surrounding tissues,but were not distended,and stored in heparinized blood. The grafts were removed 4 weeks following grafting,and morphometry and immunohistochemistry assessment were performed. Results The intimal thickness,degree of angiostenosis and proliferation index of vascular smooth muscle cells of no-touch group were significantly reduced (P<0.01) compared with those of the conventional group. The proliferating cell nuclear antigen positive-staining cells were significantly increased (P<0.01) in the conventional group compared with whose in the no-touch group. Conclusion Harvesting the vein graft with no-touch harvesting technique could significantly reduce intimal hyperplasia of the vein graft.

Effects of extravascular trestle model coated phosphorus radioisotope on intimal hyperplasia in autologous vein grafts

Objective: To design an extravascular trestle model coated phosphorus-32, an isotope radiating beta rays, and investigate its effects on intimal hyperplasia of autologous vein grafts. Methods: ETA cDNA was used as a gene probe specific to vascular SMCs on the basis of in situ hybridization. The femoral veins were transplanted reversely into colateral femoral arteries in rabbits, and the animals were divided into control, chemical agents and phosphorus-32 groups. The morphometry was applied to calculate the ETA cDNA expression and intimal thickness. Spearman correlation method was utilized to investigate their relationship. Results: Intimal thickness in grafts of phosphorus-32 group was markedly reduced. Additionally, intimal ETA gene expression was also decreased in beta rays group. The values increased at a slower rate significantly different from that of control and aspirin groups (P<0.01). The correlation of ETA cDNA expression and intimal thickness exhibited a strongly positive relation. Conclusion: Beta rays in extravascular model could remarkably inhibit intimal thickening and SMC proliferation. The correlation is an indirect evidence indicating that intimal hyperplasia composed of SMCs proliferation. It suggests that ETA cDNA expression could be a quantitative estimation of vascular SMC because of its specifics.

Effects of 3,3',4',5,7-pentamethylquercetin on intimal hyprerplasia vein grafts

Objective Pentamethylquercetin (PMQ) has a role in cardiovascular protection.We investigate the effects of 3,3 ’,4 ’,5,7 pentamethylquercetin,a derivative of PMQ,on intimal hyperplasia of the vein grafts in rats both in vivo and in vitro. Methods The proliferation of vascular smooth muscle cells (VSMC) was induced with Ang Ⅱ (0.1 μmol/L,24 h) while PMQ was administrated at six different dosages (0.1,0.3,1,3,10 and 30 μmoL/L).

A bio-instructive parylene-based conformal coating suppresses thrombosis and intimal hyperplasia of implantable vascular devices

Implantable vascular devices are widely used in clinical treatments for various vascular diseases. However, current approved clinical implantable vascular devices generally have high failure rates primarily due to their surface lacking inherent functional endothelium. Here, inspired by the pathological mechanisms of vascular device failure and physiological functions of native endothelium, we developed a new generation of bioactive parylene (poly(p-xylylene))-based conformal coating to address these challenges of the vascular devices. This coating used a polyethylene glycol (PEG) linker to introduce an endothelial progenitor cell (EPC) specific binding ligand LXW7 (cGRGDdvc) onto the vascular devices for preventing platelet adhesion and selectively capturing endogenous EPCs. Also, we confirmed the long-term stability and function of this coating in human serum. Using two vascular disease-related large animal models, a porcine carotid artery interposition model and a porcine carotid artery-jugular vein arteriovenous graft model, we demonstrated that this coating enabled rapid generation of self-renewable “living” endothelium on the blood contacting surface of the expanded polytetrafluoroethylene (ePTFE) grafts after implantation. We expect this easy-to-apply conformal coating will present a promising avenue to engineer surface properties of “off-the-shelf” implantable vascular devices for long-lasting performance in the clinical settings.

Novel mutation of the cyclin-dependent kinase 4 gene in a Chinese patient with intimal sarcoma of the pulmonary artery

The long arm of human chromosome 12 contains a region that has been found to be amplified in a number of different tumors, including osteosarcomas and soft tissue sarcomas. There are more than 5 genes located in this area such as CDK2, CDK4, WNT1, MDM2 and WNTIOb. CDK4 gene consists of eight exons, of which the start codon is located in the beginning of exon 2 and the stop codon in the a member of the Ser-Thr catalytic domain extends beginning of exon 8. CDK4 is protein kinase family and its from amino acid 6 to 295.

Rutaecarpine Inhibits Intimal Hyperplasia in A Balloon-Injured Rat Artery Model

Objective： To investigate the effect and potential mechanisms of rutaecarpine （Rut） in a rat artery balloon-injury model. Methods： The intimal hyperplasia model was established by rubbing the endothelia with a balloon catheter in the common carotid artery （CCA） of rats. Fifty rats were randomly divided into five groups, ie. sham, model, Rut （25, 50 and 75 mg/kg） with 10 rats of each group. The rats were treated with or without Rut （25, 50, 75 mg/kg） by intragastric administration for 14 consecutive days following injury. The morphological changes of the intima were evaluated by hematoxylin-eosin staining. The expressions of proliferating cell nuclear antigen （PCNA） and smooth muscle （SM） oL-actin in the ateries were assayed by immunohistochemical staining. The mRNA expressions of c-myc, extracellular signal-regulated kinase 2 （ERK2）, MAPK phosphatase-1 （MKP-1） and endothelial nitric oxide synthase （eNOS） were determined by real-time reverse chain reaction. The protein expressions of MKP-1 and phosphorylated ERK2 （p-ERK2） were examined by Western blotting. The plasma contents of nitric oxide （NO） and cyclic guanosine 3＇,5＇-monophosphate （cGMP） were also determined. Results： Compared with the model group, Rut treatment significantly decreased intimal thickening and ameliorated endothelial injury （P〈0.05 or P〈0.01）. The positive expression rate of PCNA was decreased, while the expression rate of SM α -actin obviously increased in the vascular wall after Rut （50 and 75 mg/kg） administration （P〈0.05 or P〈0.01）. Furthermore, the mRNA expressions of c-myc, ERK2 and PCNA were downregulated while the expressions of eNOS and MKP-1 were upregulated （P〈0.05 or P〈0.01）. The protein expressions of MKP-1 and the phosphorylation of ERK2 were upregulated and downragulated after Rut （50 and 75 mg/kg） administration （P〈0.05 or P〈0.01）, respectively. In addition, Rut dramatically reversed balloon injury-induced decrease of NO and cGMP in the plasma （P〈0.05 or P〈0.01）. Conclusion： Rut could inhibit the balloon injury-induced carotid intimal hyperplasia in rats, possibly mediated by promotion of NO production and inhibiting ERK2 signal transduction pathways.

Heparin-derived oligosaccharide inhibits vascular intimal hyperplasia in balloon-injured carotid artery

The aims of the present study were to determine the effects of heparin-derived oligosaccharides(HDOs) on vascular intimal hyperplasia(IH) in balloon-injured carotid artery and to elucidate the underlying mechanisms of action. An animal model was established by rubbing the endothelia within the common carotid artery(CCA) in male rabbits. The rabbits were fed a high-cholesterol diet. Arterial IH was determined by histopathological changes to the CCA. Serum lipids were detected using an automated biochemical analysis. Expressions of mR NAs for vascular endothelial growth factor(VEGF), basic fibroblast growth factor(bF GF), vascular cell adhesion molecule-1(VCAM-1), monocyte chemoattractant protein-1(MCP-1), scavenger receptor class B type I(SR-BI), and ATP-binding cassette transporter A1(ABCA-1) were analyzed using reverse transcription polymerase chain reaction assays. Expressions of VEGF, VCAM-1, MCP-1, SR-BI and ABCA-1 proteins were analyzed by Western blotting. Enzyme-linked immunosorbent assays were used to quantify expression levels of VEGF and b FGF. Our results showed that administration of HDO significantly inhibited CCA histopathology and restenosis induced by balloon injury. The treatment with HDOs significantly decreased the m RNA and protein expression levels of VEGF, b FGF, VCAM-1, MCP-1, and SR-BI in the arterial wall; however, ABCA-1 expression level was elevated. HDO treatment led to a reduction in serum lipids(total cholesterol, triglycerides, high-density and low-density lipoproteins). Our results from the rabbit model indicated that HDOs could ameliorate IH and underlying mechanism might involve VEGF, b FGF, VCAM-1, MCP-1, SR-BI, and ABCA-1.

Pulmonary artery intimal sarcoma diagnosed by percutaneous transcatheter aspiration

Pulmonary artery intimal sarcoma （PALS） is a very rare but lethal disease, firstly described by Mandelstarnmin 1923.1 Since then, less than 300 cases have been reported worldwide. Due to similar clinical presentations, it is very difficult to distinguish with pulmonary thromboembolism （PTE）, leading to inappropriate treatments such as anticoagulation and thrombolysis.2-5Although with improvement of imaging modalities, the diagnosis of PAIS is still based on pathological examination, and the majority of specimens are taken by surgery or autopsy.

Programmable dual responsive system reconstructing nerve interaction with small-diameter tissue-engineered vascular grafts and inhibiting intimal hyperplasia in diabetes

Small-diameter tissue-engineered vascular grafts(sdTEVGs)with hyperglycemia resistance have not been constructed.The intimal hyperplasia caused by hyperglycemia remains problem to hinder the patency of sdTEVGs.Here,inspired by bionic regulation of nerve on vascular,we found the released neural exosomes could inhibit the abnormal phenotype transformation of vascular smooth muscle cells(VSMCs).The transformation was a prime culprit causing the intimal hyperplasia of sdTEVGs.To address this concern,sdTEVGs were modified with an on-demand programmable dual-responsive system of ultrathin hydrogels.An external primary Reactive Oxygen Species(ROS)-responsive Netrin-1 system was initially triggered by local inflammation to induce nerve remolding of the sdTEVGs overcoming the difficulty of nerve regeneration under hyperglycemia.Then,the internal secondary ATP-responsive DENND1A(guanine nucleotide exchange factor)system was turned on by the neurotransmitter ATP from the immigrated nerve fibers to stimulate effective release of neural exosomes.The results showed nerve fibers grow into the sdTEVGs in diabetic rats 30 days after transplantation.At day 90,the abnormal VSMCs phenotype was not detected in the sdTEVGs,which maintained long-time patency without intima hyperplasia.Our study provides new insights to construct vascular grafts resisting hyperglycemia damage.

Mithramycin inhibits intimal hyperplasia of vein grafts after transplantation of the jugular vein to the abdomainal aorta in rats

Objective: The intimal hyperplasia caused by migration and proliferation of the smooth muscle cells play a most important role in the stenosis of the vein grafts. This study is to explore how the C myc oncogene and its protein contribute to the intimal hyperplasia after the jugular vein is transplanted to the abdominal aorta and to assess the effect of Mithramycin on the intimal hyperplasia. Methods: In 60 Wistar rats, a 0.8 cm segment of the right jugular vein graft was interposed at the level of the abdominal aorta. The experiment group received Mithramycin (150 μg/kg IP) 1 h before and after the operation. The control group received normal saline, specimens of vein graft at 2 and 6 h postoperatively were subjected respectively to in situ hybridization. The vein grafts 4 weeks after operation were perfusion fixed. The specimens were stained with hemotoxylin eosin and the computer morphologic analysis system was used to evaluate the degree of intimal thickening. Immunohistochemistry studies of muscle specific α actin, C myc protein and 5 Bromodeoxyuridine were performed. Results: The areas of neointimal and the ratios of neointimal to medial area were significantly smaller and lower in the Mithramycin treated than in the control rats (P< 0.05 ). The 5 Brdu labeling rate between the two groups were also different significantly (P< 0.05 ). Muscle specific α actin showed that the smooth muscle cells formed the most area of myointimal hyperplasia. Steady state C myc mRNA level was increased from 2 h to 6 h postoperatively. The positive rate of the placebo treated group was higher significantly than that of the Mithramycin treated group (P< 0.05 ). Conclusions: Mithramycin may effectively inhibits transcription of C myc in proliferating vascular smooth muscle cells and could be useful in the prevention of restenosis after vascularization. These results support the hypothesis that systemic administration of Mithramycin might immediately prevent intimal proliferation.

Atomically bonding Na anodes with metallized ceramic electrolytes by ultrasound welding for high-energy/power solid-state sodium metal batteries

A solid-state sodium metal battery has cut a striking figure in next-generation large-scale energy storage technology on account of high safety,high energy density,and low cost.Nevertheless,the large interfacial resistance and sodium dendrite growth originating from the poor interface contact seriously hinder its practical application.Herein,a modified ultrasound welding was proposed to atomically bond Na anodes and Au-metalized Na_(3)Zr_(2)Si_(2)PO_(12) electrolytes associated with the in situ formation of Na–Au alloy interlayers.Thereupon,intimate Na_(3)Zr_(2)Si_(2)PO_(12)-Au/Na interfaces with a low interfacial resistance(~23Ωcm^(2))and a strong dendrite inhibition ability were constructed.The optimized Na symmetric battery can cycle steadily for more than 900 h at 0.3 mA cm^(-2) under a low overpotential(<50 mV)of Na electroplating/stripping and deliver a high critical current density of 0.8 mAcm^(-2) at room temperature.By incorporating the above interface into the solid-state Na metal battery,taking three-dimensional Na_(3)V_(2)(PO_(4))_(3) as the cathode,the full battery offers a high energy density of 291 Wh kg^(-1) at a high power density of 1860Wkg^(-1).A pouch-type solid-state sodium metal full battery based on a ceramic electrolyte was assembled for the first time,and it lit a 3 V LED lamp.Such a strategy of the ultrasound welding metalized solid-state electrolyte/Na interface by engineering the Na-Au interlayer would pave a new pathway to engineer a low-resistance and highly stable interface for high-energy/density solid-state sodium metal batteries.

Mediating role of physical activity in the relationship between psychological distress and intimate relationships among stroke patients

BACKGROUND Stroke patients often experience psychological distress,which can impact their intimate relationships with spouses,subsequently influencing their treatment and recovery.Physical activity is considered a key rehabilitation method for stroke patients.This paper aims to analyze whether psychological distress affects intimate relationship between spouses through physical activity.AIM To explore the mediating effect of physical activity between psychological distress and intimate relationship in stroke patients.METHODS A total of 256 stroke patients who underwent treatment at the First People’s Hospital of Shangqiu between July 2021 and July 2022 were enrolled in this study.The participants completed questionnaires,including the Kessler Psychological Distress Scale(K10),the Quality of Relationship Index(QRI),International Physical Activity Questionnaire,and a general information questionnaire.Data analysis were performed using SPSS 23.0.The Harman test was employed to detect common method deviations,and Spearman correlation was used for correlation analysis.The mediating effect was assessed using Process 3.4.1,with significance testing of the regression coefficients conducted using the bias-corrected percentile Bootstrap method(5000 iterations,95%confidence interval).Statistical significance was set at P<0.05.RESULTS The results showed that patients scored an average of 21.61±6.44 points on the K10,32.40±6.19 points on the QRI;the median physical activity level according to the International Physical Activity Questionnaire was 1861(566,2846)MET·min/w.The level of physical activity(the physical activity intensity of the patients reflected by the Interna-tional Physical Activity Questionnaire-Long Form scale)negatively correlated with psychological distress and intimacy(P<0.05),and positively correlated with each other(P<0.05),with the correlation stronger at lower physical activity levels compared to higher ones.The mediating effect of physical activity between psychological distress and intimate relationship was calculated to be 40.23%.Bootstrap analysis further validated the results.The mediating effect of psychological distress on intimate relationships through physical activity level was-0.284,with a confidence interval of-0.409 to-0.163,excluding 0,confirming a significant mediating effect of psychological distress on intimate relationships.CONCLUSION Physical activity significantly affects relationship between psychological distress and intimate relationships among stroke patients.Addressing the role of physical activity may have implications for improving patient outcomes and rehabilitation strategies.

Relationship between Intimate Partner Violence and Quality of Life among Females Attending the HIV Clinic of a Teaching Hospital in North Central, Nigeria

Background: Intimate partner violence is a serious public health concern worldwide and is linked with serious mental and physical health consequences. Despite its commonality and attendant consequences, proper public healthcare intervention is rudimentary. The aim of this study was to assess the relationship between quality of life associated with intimate partner violence among females attending the HIV Clinic at Jos University Teaching Hospital, Jos, Plateau, Nigeria. Methods: This study employed a cross-sectional design and data was collected from 174 female patients attending the HIV Clinic who met the inclusion criteria with the aid of a 73-item semi-structured interviewer-administered questionnaire. This captured socio-demographic characteristics, knowledge and attitude towards intimate partner violence and their experiences of violence and quality of life using the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF). Results: Almost half of the respondents, 85 (48.9%) rated their quality of life as good. Respondents experiencing IPV reported poorer quality of life compared to those not experiencing partner violence in all the domains and it was statistically significant in the physical health (p Conclusion: IPV is common among females attending the HIV/AIDS Clinic and those affected reported significantly poorer quality of life.

HIV Status Disclosure Rate to a Sexual Partner, Associated Factors and Outcomes among Pregnant Women in PMTCT Care in Two Large HIV Facilities in Abuja, Nigeria

HIV status disclosure to partners is critical in improving the health and well-being of mother-infant dyad in the prevention of HIV transmission from mother to child (PMTCT) program. This study assesses the HIV disclosure rate to intimate partners, associated factors, and outcomes among women in the PMTCT program in two large HIV clinics in Abuja, Nigeria. A descriptive cross-sectional study employed a multi-stage sampling technique in selecting 220 pregnant women enrolled in PMTCT care in two clinics. Outcomes measures include HIV status disclosure to intimate partner, women’s viral suppression status (suppressed < 1000 copies/mL, unsuppressed ≥ 1000 copies/mL), and previous MTCT experience. Exposure variables include the participant’s socio-demographic characteristics and HIV care history. Data were presented using frequency tables. Simple and multivariate logistic regression was done to ascertain the predictors of HIV status disclosure and assess the association between HIV disclosure, viral suppression, and MTCT experience at a p-value of less than 0.05. Only 205 (96.7%) entries were completed and analyzed A larger percentage of the participants were married women, 158 (77.1%), within the age group 26 - 35 years (53.3%). Women’s HIV status disclosure rate to intimate partners was 49.3% (101/205). Factors associated with HIV disclosure rate to intimate partners at the univariate level were the participant’s age, Christian religion [COR: 1.80, 95%CI: 1.04 - 3.21, p = 0.04], full employment [COR: 1.92, 95%CI: 1.10 - 3.34, p = 0.02], HIV positivity prior to PMTCT enrollment [COR: 2.88, 95%CI: 1.26 - 6.59, p < 0.01], duration on antiretroviral therapy [COR: 1.07, 95%CI: 1.01 - 1.13, p = 0.03], and knowledge of partner’s HIV status [COR: 0.20, 95%CI: 0.08 - 0.51, p < 0.01]. Only HIV positivity prior to PMTCT enrollment [AOR: 3.27, 95%CI: 1.23 - 8.70, p < 0.01] and awareness of the partner’s HIV status, [AOR: 0.17, 95%CI: 0.06 - 0.49, p < 0.01] were significant predictors of HIV status disclosure after controlling for confounder. The two study outcomes;women’s viral suppression and MTCT experience were not significantly associated with participants’ HIV status disclosure to intimate partners. Our study shows that HIV disclosure to intimate partners is still a big challenge among pregnant women in PMTCT settings in Nigeria, with awareness of the partner’s HIV status and the type of patient enrollment in the PMTCT setting being the two strong predictors of pregnant women’s HIV disclosure status to partners.

A Review of Index Case Testing Induced Intimate Partner Violence and Electronic Management of Information in HIV Care

Intimate Partner Violence (IPV) is a form of Gender Base Violence (GBV) where an intimate partner perpetrates violence. In the HIV care continua which has the aim of achieving epidemic control based on the goals defined by UNAIDS, 95% of people living with HIV (PLHIV) have to know their HIV status, 95% initiated ARV treatment and 95% are virally suppressed in order to achieve epidemic control. One of the evidence-based strategies used for achieving an optimal number of PLHIV who know their HIV status is the Index Case Testing Strategy (ICT). While the ICT strategy helps the achievement of epidemic control, its implementation increases the incidence of IPV among either serodiscordant or concordant couples. Tackling information about IPV is very sensitive. A review of the literature on the management of HIV patient information has shown that shifting from paper-based management of HIV patient information to computerized Electronic Medical Records (EMR) systems, using software such as OPEN MRS has significantly improved the management of HIV patient information with high-level confidentiality of patient information. The reviews showed that the EMR systems put in place to manage HIV patient information need to integrate the stages used for the management of IPV among PLHIV.