Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in Bamako

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

Practice of Upper Gastrointestinal Endoscopy at the Mother-Child Hospital in Bamako/MALI: About 465 Cases

Introduction: Upper gastrointestinal (GI) endoscopy is an examination that involves exploring the upper part of the digestive tract using an endoscope. Our study was aimed to evaluate the practice of Upper GI endoscopy at the mother-child hospital in Mali. Patients and Methods: This was a descriptive retrospective study on reports of Upper GI endoscopy results in the digestive endoscopy unit at the mother-child hospital in Bamako from January to December 2018. Results: Endoscopy was performed in 465 patients including 231 males and 234 females. The sex ratio was 0.98. Patients were aged 46.69 years old on average with the extremes of 8 and 90 years old. Epigastralgia was the main referral in 50.5%. Endoscopy was normal in 24.7%. The main diagnostics were duodenogastric reflux in 32.5% and gastritis in 14.4%. Conclusion: The practice of Upper GI endoscopy at the mother-child hospital in Mali has allowed the exploration of the upper digestive tract to contribute to the diagnosis of esogastroduodenal lesions.

Factors Associated with Mother-to-Child Transmission of HIV at the Maternity Unit of the Castors Urban Health Center in Bangui

Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries. This study aims to take stock of the factors associated with HIV MCT at the level of peripheral health training. Patients and Methods: This was a descriptive and analytical retrospective study, over a five-year period from January 1st, 2017 to December 31st, 2021. The study population was represented by HIV-positive women and their cared infants in the Parent-Child Transmission Prevention Unit (PCTP) of the Castors Urban Health Center (CUHC). Results: 288 medical records were selected out of a total of 347 HIV-positive mothers followed. HIV seroprevalence in the population of women who received PreNatal Consultation (PNC) during the study period was 8.2%. The HIV MCT rate was 3.7%. HIV+ mothers followed were mostly young (average age of 28), not living in a couple (96.9%), poorly educated (58.7%) and not engaged in income-generating activity (58.4%). They had all received triple therapy and the period of initiation of antiretroviral (ARV) therapy was in the majority of cases during the first trimester. Factors associated with MCT were: primiparity (OR = 18.4 [5.55 - 61.05];Khi2 = 32.61;p < 0.001), late discovery of infection during large or after childbirth (OR = 0.03 [0.007 - 0.10];Khi2 = 55.22;p < 0.001), WHO Clinical Stage 2 and 3 (OR = 0.007 [0.001 - 0.03];Khi2 = 108.73;p < 0.001), CD4 count 200/mm3 (OR = 14.12 [4.03 - 57.20];Khi2 = 21.68;p < 0.001), viral load > 1000 copies/mm3 (OR = 8.85 [2.33 - 43.20];Khi2 = 10.46;p = 0.001), prolonged labor (OR = 12.33 [3.45 - 57.25];Khi2 = 18.47;p < 0.001), premature rupture of membranes (OR = 24.03 [6.97 - 96.01];Khi2 = 40.60;p 2 = 5.96;p = 0.014), and artificial or mixed breastfeeding (OR = 0.01 [0.002 - 0.043];Khi2 = 97.65;p Conclusion: Taking into account the risk factors for PCTP is essential if we want to achieve the goal of “Zero New Infections in Children by the year 2025”.

四川实施母子系统保健健康促进与健康传播项目2009年度效果评估

目的评估2009年度卫生部/联合国儿童基金会母子系统保健健康促进与健康传播项目在四川省项目县实施的效果。方法采用听汇报、查资料、现场考察等方式,对项目县项目执行情况进行评估;利用批质量抽样方法对项目地区目标人群母子保健服务核心信息知识知晓率和利用率进行评估。结果项目地区在项目的实施过程中,组织机构健全,管理规范。针对核心信息,通过开展多种形式的健康传播活动,目标人群母子保健服务核心信息知识知晓率和利用率基本达到年度目标要求。结论项目的实施符合各项目地区社会和目标人群的需求,通过项目的实施,可以增加群众的健康知识,改变不良卫生行为和意识,改善妇女儿童健康状况,减少疾病的发生率。同时,通过对县、乡、村各级健康骨干人员的能力培训,可提高项目执行能力,为项目的有效实施及可持续发展奠定坚实的基础。

宁波市母婴护理员职业培训体系的构建

基于家政服务员职业培训的宏观性导向和政策性扶持的社会背景,结合宁波市母婴护理员培训现状和主要存在问题,依据市场需求分析,构建宁波市母婴护理员职业培训体系。政府、高校、社会培训机构通力合作,在培训机制、课程体系、教学模式、考核体系等方面进行系列研究,探索出能提升综合职业素养、符合该职业教育特点的培训体系。

北京市昌平区回龙观地区806例高危孕妇高危因素分析

目的通过分析北京市昌平区回龙观地区806例高危孕妇高危因素,总结高危孕妇的社区系统管理经验,完善管理,保证母婴的安全健康。方法通过对北京回龙观社区卫生服务中心建立母子保健档案,并于2014年10月—2015年9月在京分娩的1 769名孕妇,按照北京市孕产妇高危因素分类标准,进行高危因素筛选和统计,分析孕妇高危因素。结果在1769名孕妇中,正户孕妇总数:472人,其中高危孕妇:290人。外地孕妇总数:1297人,其中高危孕妇516人。总共高危孕妇806人,高危妊娠发生率为45.56%(正户:孕妇或其丈夫为回龙观户籍。外地:夫妻双方均为外地户籍);其中,1种高危因素者占57.81%,2种高危因素者占22.58%,3种及3种以上的高危因素者占19.60%;导致高危妊娠前5位原因依次为:孕早期体重≤40 kg或≥70 kg、胎位异常和贫血,自然或人工流产≥2次,剖宫产史。结论通过母子保健档案的建立,对孕妇进行系统管理,分析高危因素,针对高危因素进行分级管理,重视孕早期宣教、产前诊察等,保证母婴的安全健康,提高人口素质。

Microbiology laboratory and the management of motherchild varicella-zoster virus infection

Varicella-zoster virus, which is responsible for varicella(chickenpox) and herpes zoster(shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella(particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times:(1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection;(2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear(atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation;(3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and(4) when the baby is born and it is necessary to confirm a diagnosis of varicella(and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn.

Review on Sons and Lovers

This essay centralizes on the analysis of the writing skills,the theme and my personal insights of Sons and Lovers,as well as my interpretation of the mother-son relationship in terms of feminism.Overall,hope it will provide a specific perspective of this renowned novel and arouse the readers'attention to interpret the novel themselves.

无人机航母系统的构建与应用

无人机是一种由无线电遥控设备或自身程序控制系统操纵的无人驾驶飞行器。目前无人机普遍存在任务能力单一,续航能力不足等缺点。本研究提出并构建了一种无人机航母集群协同工作模型和一种采用线缆供电方式的无人机航母系统。无人机航母系统采用子母机架构,无人机航母平台作为子无人机的空中停靠点和电力传送中转站,将来自地面电缆的电能通过电缆传送给各子无人机,进而实现无人机航母系统的空中长时间稳定工作,各子无人机挂载设备并在以无人机航母为圆心的范围内执行任务。利用其可长时间工作和高负载特性,无人机航母系统在应急信号基站快速搭建、反恐防暴、舞台舞美、农药喷洒、工厂监测等方面有较好的表现,可在一定程度上拓展民用无人机的应用场景。

空水两栖子母系统设计与研究

随着海洋、湖泊、河流等水域监测日益重要,迫切需要具有在复杂环境搜寻功能的机器人系统,而单种机器人平台受到限制。本项目消化吸收国内外变结构机器人先进技术,探索出了一套空水结构与子母协作的机器人系统。可解决当前单种机器人在水、陆、空三域搜寻定位的灵活性差、运动控制实时性、精度低及稳定性差、适应性弱和多功能运动模式受限等问题。

北京市妇幼保健信息系统的开发及存在的问题

介绍了北京市妇幼保健信息系统及其特点,分析了妇幼保健信息系统用户的需求,归纳总结了系统存在的问题并对系统功能进行了验证,提出了系统后续开发的建议。

Application of a rapid exchange extension catheter technique in type

BACKGROUND In transradial intervention procedures,poor back-up support and noncoaxial alignment of the guide catheter(GC)may result in failure of the balloon or stent to reach the targeted lesion.Methods to provide extra back-up support using the original GC and wire can improve procedural success with reduced complications.A rapid exchange guide extension catheter provides convenient and efficient back-up support while preserving the initial GC and inserted wire.AIM To evaluate the efficacy and safety of rapid exchange extension catheter in the treatment of type B2/C nonocclusive coronary lesions via the radial access.METHODS A total of 135 patients with type B2/C nonocclusive lesions who were treated via the transradial approach were enrolled in the study.The clinical characteristics,indications for use of the rapid exchange extension catheter,and procedural details and results were reviewed and analyzed.All procedure-related complications and major adverse cardiovascular events were recorded during the in-hospital stay and follow-up period.RESULTS The most common indication for the use of a rapid exchange extension catheter was vascular tortuosity(37.8%),followed by heavy calcification(28.9%),long lesions(20.0%),proximal stent(6.7%),in-stent restenosis(5.2%),and coronary origin anomalies(1.5%).The following technologies failed in passing targeted lesions before delivering the rapid exchange catheter:Multiple predilatation technique(57%),buddy wire technique(33.4%),balloon anchoring technique (5.9%), and cutting balloon modification (3.7%). The mean depth of the extensioncatheter intubation was 20.56 ± 13.05 mm, and the mean rapid exchange catheterservice time was 18.9 ± 9.7 min. The mean length and diameter of stents were 33.5± 14.4 mm and 2.75 ± 0.45 mm, respectively. The total rate of technique success(balloon or stent successful crossing of the target lesion with this technique) was94.8%.CONCLUSIONThe rapid exchange extension catheter technique showed acceptable safety andefficacy in the transradial coronary interventions of type B2/C nonocclusivecoronary lesions. We recommend this technique to assist in complex lesionintervention via radial access.

Predictors of Exclusive Breastfeeding Duration among Mothers Attending Immunization Clinic in a Tertiary Health Facility in Enugu, Nigeria

Background: Breastfeeding is cost effective means towards the realization of some key United Nations Sustainable Development Goals by the year 2030 particularly in resource limited settings. The objectives of the study were to evaluate the predictors of exclusive breastfeeding duration among mother and child pairs utilizing a tertiary immunization clinic facility. Methods: This was a cross-sectional descriptive study. Respondents were mother-and-child pairs who were recruited consecutively. Relevant maternal and child characteristics were collected using a semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences version 20.0 (p Results: Four hundred and twenty seven mother-child pairs were studied. Majority of the mothers have at least secondary education, 383 (80.7%). 407 (95.3%) of the mothers fully understood the actual meaning of EBF. 189 (42.7%) reported practicing EBF in their index child for six months. Maternal perception of insufficient milk production, 52/99 (52.5%) was the most common reason for practicing EBF for Maternal education and occupation and gender of the child were significantly associated with completion of EBF for 6 months among respondents. Conclusion: EBF duration in the current study is low and is significantly associated with maternal education, maternal occupation and gender of the child. Improving girl child education, complementing baby friendly hospital initiative with baby friendly community initiative should be adopted to improve EBF duration in our setting.

系统性护理干预对母婴分离高危妊娠产妇心理和睡眠质量的影响

目的探讨系统性护理干预对母婴分离高危妊娠产妇心理和睡眠质量的影响。方法收集我院2016年7月至2017年1月母婴分离高危妊娠产妇68例,随机分为对照组和试验组,每组34例。对照组接受常规护理,试验组接受系统性护理干预。比较两组产妇产后第1、7天的SDS及SAS评分、睡眠质量评分及护理满意度。结果产后第7天,试验组SAS、SDS评分显著低于对照组与产后第1天(P<0.05)。护理后,试验组产妇PSQI<8分的比例与护理满意比例高于对照组,差异显著(P<0.05)。结论对母婴分离高危妊娠产妇实施系统性护理可有效提高护理质量,值得临床推广使用。

危重孕产妇早期预警的研究进展

孕产妇危重病是导致我国母婴不良结局的主要来源,危重孕产妇的病情一般具有病情变化快的显著特点,孕产妇在发病前多数会伴有明显表征,若临床可以根据危重孕产妇的特有表征做到早发现早治疗,应该可以大幅度的改善母婴结局。英国医疗根据早期预警系统开发了危险产妇的早期预警系统,由于各类疾病的不同预警阀值,导致对于危重产妇的预警项目繁多,目前临床认为针对危重产妇的危险阀值可以包括,心率、呼吸频率、舒张压、收缩压及产妇的体温等,这些阀值与产妇危重病的发作息息相关。产妇危重病早期预警系统虽然可以对大部分疾病起到预警作用,但临床产妇危重病的种类繁多尚需大量临床研究及探索。

卫生系统在艾滋病母婴传播阻断工作中的障碍和需求分析

目的:了解重庆市卫生系统在艾滋病母婴传播阻断工作中的障碍和需求,为推进该工作提供依据。方法:在妇幼保健院、综合医院及疾病预防控制中心中选取相关的医护人员或者卫生服务者开展个人深入访谈。结果:重庆市艾滋病母婴阻断工作中存在的问题有:国家补助的监测费较少,部分医护人员对阻断工作的认识不够及职业暴露的担心,HIV感染的确诊时间过长,随访工作不完善,部分考核指标不合理以及卫生系统间的合作不够紧密等。结论:应适当增加监测费用,落实医护人员的培训,完善随访工作和考核体系,加强不同机构间的合作。

Correlation of Gut Microbiome Between ASD Children and Mothers and Potential Biomarkers for Risk Assessment

Variation of maternal gut microbiota may increase the risk of autism spectrum disorders(ASDs) in offspring. Animal studies have indicated that maternal gut microbiota is related to neurodevelopmental abnormalities in mouse offspring, while it is unclear whether there is a correlation between gut microbiota of ASD children and their mothers. We examined the relationships between gut microbiome profiles of ASD children and those of their mothers, and evaluated the clinical discriminatory power of discovered bacterial biomarkers. Gut microbiome was profiled and evaluated by 16S ribosomal RNA gene sequencing in stool samples of 59 mother–child pairs of ASD children and 30 matched mother–child pairs of healthy children. Significant differences were observed in the gut microbiome composition between ASD and healthy children in our Chinese cohort. Several unique bacterial biomarkers, such as Alcaligenaceae and Acinetobacter, were identified. Mothers of ASD children had more Proteobacteria, Alphaproteobacteria, Moraxellaceae, and Acinetobacter than mothers of healthy children. There was a clear correlation between gut microbiome profiles of children and their mothers; however, children with ASD still had unique bacterial biomarkers, such as Alcaligenaceae, Enterobacteriaceae, and Clostridium. Candidate biomarkers discovered in this study had remarkable discriminatory power. The identified patterns of mother–child gut microbiome profiles may be important for assessing risks during the early stage and planning of personalized treatment and prevention of ASD via microbiota modulation.

广西壮族自治区来宾市艾滋病母婴阻断项目效果评价

目的对艾滋病母婴阻断项目在广西来宾市的实施进行效果评估,为全市预防艾滋病母婴传播提供科学依据。方法在全市实施艾滋病母婴阻断技术,对凡参加孕检的孕产妇免费进行艾滋病咨询检测,对检出阳性者进行艾滋病母婴阻断(感染母亲及所生婴儿按艾滋病母婴阻断技术方案服用抗逆转录病毒药物、实行安全助产和人工喂养指导等)。结果 2010—2015年全市共有207 861例孕产妇参加艾滋病咨询检测,检测率99.17%(207 861/209 600),检出艾滋病抗体阳性325例,检出阳性率0.16%(325/207 861);对检出艾滋病抗体阳性的孕妇纳入艾滋病母婴阻断系统管理,通过卫生咨询指导,告知患者艾滋病的传播方式及其危害性、预防措施和伦理等知情选择,最后自愿选择终止妊娠87例,选择生育的238例;238例艾滋病抗体阳性者中有227例按艾滋病母婴阻断技术方案全程足量服用抗逆转录病毒药物,服药率95.38%(227/238);活产婴儿232例,按艾滋病母婴阻断技术方案全程足量服用抗逆转录病毒药物221例,服药率95.26%(221/232);而后按艾滋病母婴阻断技术方案对出生婴儿满42天和3个月进行艾滋病早期诊断,检出阳性1例,检出阳性率0.45%;最后对198例出生满18个月婴儿,进行艾滋病抗体检测,未捡出艾滋病抗体阳性者。结论孕产妇在进行正常孕产检时同时进行艾滋病咨询检测,对艾滋病的早期发现,可以取得事半功倍的效果;对检出艾滋病阳性孕妇及所生婴儿采取艾滋病母婴阻断综合性预防措施,是预防艾滋病母婴传播的有效方法。

Application advances of catheter modification in difficult coronary artery Intervention

Background Judkins catheter is widely used in recent years, for clinical angiography and intervention of most normal coronary arteries, but still incapable to deal with the problems caused by difficult coronary artery （DCA）. DCA may influence the procedure of diagnosis and intervention of ischemic heart disease （IHD）. To cope with different subtypes of DCA, catheters like Amplatz, EBU, Leya, etc. were born at that moment, but these stan- dard catheters are used just in special cases and have so many sequences that a local hospital may not be able to keep all of them available routinely at any time. To overcome this problem, some centers perform angiography and intervention using modified catheters based on their own condition and have obtained some experiences. Catheter modification techniques used in these years are reviewed, and are stated respectively based on dealing with different subtypes of DCA to provide practical guidance for clinical diagnosis and intervention for IHD patients having DCA.