Efficiency of HAART in the prevention of mother to children HIV-1 transmission at Saint Camille medical centre in Burkina Faso,West Africa

Objective:To evaluate efficiency of HAART in the prevention of mother to child HIV transmission.Methods:A longitudinal study was conducted on 1 300 women attending the antenatal service at Saint Camille Medical Centre from September 2010 to July 2011.The HIV status of mothers was determined by rapid tests and EUSA.Discordant results were confirmed by real-time PCR.PCR was used to determine HIV status of children born from HIV-positive mothers.Results:Among 1 300 pregnant women tested for HIV,378 were seropositive.Mothers were predominantly housewives(69.7%),and their mean age was(28.32±0.15) years.The overall prevalence of HIV transmission from mother to child was 4.8%(18/378).This prevalence differed significantly from 0.0%(0/114) to 6.8%(18/264) in children born from mothers under HAART and those with mothers under New Prophylactic Protocol(ACT + 3TC + NVP),respectively(P【 0.01).Children’s mortality rate during the medical follow up was 1.3%(5/378).Among 16 women with HIV dubious status by ELISA,the Real Time PCR confirmed 2/16(12.5%) as HIV positive. Conclusions:The protocol of prevention of mother to children HIV transmission(PMTCT) is effective.The rate of HIV vertical transmission is significantly reduced.Early diagnosis determined by PCR of children born from HIV- positive mother is necessary and recommended in the context of PMTCT in Burkina Faso.We also found that PCR is an effective tool to confirm HIV status in pregnant women.

Enteric parasites prevalence at Saint Camille Medical Centre in Ouagadougou,Burkina Faso

Objective:To assess the prevalence of parasitic infections among patients attending Saint Camille Medical Centre and to estimate co-parasitic infections rates.Methods:From January to December 2009,stool samples were collected from 11 728 persons,aged from five months to 72 years and suffering from gastroenteritis.After macroscopic description,the stools were examined by light microscopy to search for the presence of parasites.Results:From the 11 728 analyzed stools,6 154(52.47%) were infected with at least one parasite.Protozoan frequently encountered were:Giardia intestinalis(43.47%),Entamoeba histolytica/Entamoeba dispar(30.74%) and Trichomonas irUestinalis(21.72%),while Hymenolepis nana(2.25%) was the most common helminth.Co-infections occurred in 22.34%cases.Within the multi-infected samples,dual and triple infections accounted for 71.18%and 20.00%,respectively.Giardia irUestinalis for protozoan and Hymenolepis nana for helminths were the most implicated co-infections.Conclusions: This study confirms that intestinal parasites are still a public health problem in Burkina Faso.To reduce the incidence of parasitic infections,it is necessary to promote the education of people so that they practice the rules of individual and collective hygiene.

Exploring the influences of education,intelligence and income on mental disorders

Background Previous studies have shown that educational attainment(EA),intelligence and income are key factors associated with mental disorders.However,the direct effects of each factor on major mental disorders are unclear.Aims We aimed to evaluate the overall and independent causal effects of the three psychosocial factors on common mental disorders.Methods Using genome-wide association study summary datasets,we performed Mendelian randomisation(MR)and multivariable MR(MVMR)analyses to assess potential associations between the 3 factors(EA,N=766345;household income,N=392422;intelligence,N=146808)and 13 common mental disorders,with sample sizes ranging from 9907 to 807553.Inverse-variance weighting was employed as the main method in the MR analysis.Results Our MR analysis showed that(1)higher EA was a protective factor for eight mental disorders but contributed to anorexia nervosa,obsessive-compulsive disorder(OCD),bipolar disorder(BD)and autism spectrum disorder(ASD);(2)higher intelligence was a protective factor for five mental disorders but a risk factor for OCD and ASD;(3)higher household income protected against 10 mental disorders but confers risk for anorexia nervosa.Our MVMR analysis showed that(1)higher EA was a direct protective factor for attention-deficit/hyperactivity disorder(ADHD)and insomnia but a direct risk factor for schizophrenia,BD and ASD;(2)higher intelligence was a direct protective factor for schizophrenia but a direct risk factor for major depressive disorder(MDD)and ASD;(3)higher income was a direct protective factor for seven mental disorders,including schizophrenia,BD,MDD,ASD,post-traumatic stress disorder,ADHD and anxiety disorder.Conclusions Our study reveals that education,intelligence and income intertwine with each other.For each factor,its independent effects on mental disorders present a more complex picture than its overall effects.

Factors Associated with Renal Impairment in Patients on Tenofovir for Chronic Hepatitis B in Yaoundé (Cameroon)

Background: Tenofovir (TFV) is widely used to treat patients with hepatitis B virus (HBV) infection. But kidney abnormalities are the main concern using this drug. Few studies have described the renal impairment due to the TFV in chronic hepatitis B (CHB) in Sub-Saharan Africa. The objective was to evaluate factors associated with renal impairment observed in patients on TFV for CHB. Method: It was a hospital based cross sectional prospective study carried out from June 2023 to July 2023 in Yaoundé (Cameroon) and included any patient treated with TFV for CHB during at least a period of 6 months. For each participant, we collected in the medical report socio-demographic data, clinical data, baseline creatinine, treatment information (type of TFV which was Disoproxil Fumarate (TDF) or Alafenamide (TAF), duration). Then, we collected blood samples to measure serum creatinine and phosphate levels and urine dipstick analysis. Factors associated with renal impairment were assessed with the Odds Ratio. A p value of Results: A total of 60 participants were included. The median age was 44 years [36-55] and median duration of TFV therapy was 17.5 months [11.7-25.7]. The prevalence of reduced eGFR (Conclusion: Kidney function was impaired in some patients receiving TFV for CHB. It should be monitored, particularly after 36 months and for those receiving TDF prodrug.

Causal associations between major depressive disorder and COVID-19

Background We aimed to evaluate whether major depressive disorder(MDD)could aggravate the outcomes of coronavirus disease 2019(COVID-19)or whether the genetic liability to COVID-19 could trigger MDD.Aims We aimed to assess bidirectional causal associations between MDD and COVID-19.Methods We performed genetic correlation and Mendelian randomisation(MR)analyses to assess potential associations between MDD and three COVID-19 outcomes.Literature-based network analysis was conducted to construct molecular pathways connecting MDD and COVID-19.Results We found that MDD has positive genetic correlations with COVID-19 outcomes(rg:0.10–0.15).Our MR analysis indicated that genetic liability to MDD is associated with increased risks of COVID-19 infection(odds ratio(OR)=1.05,95%confidence interval(CI):1.00 to 1.10,p=0.039).However,genetic liability to the three COVID-19 outcomes did not confer any causal effects on MDD.Pathway analysis identified a panel of immunity-related genes that may mediate the links between MDD and COVID-19.Conclusions Our study suggests that MDD may increase the susceptibility to COVID-19.Our findings emphasise the need to increase social support and improve mental health intervention networks for people with mood disorders during the pandemic.

Shared genetics and bidirectional causal relationships between type 2 diabetes and attention-deficit/hyperactivity disorder

Background Type 2 diabetes(T2D)is a chronic metabolic disorder with high comorbidity with mental disorders.The genetic links between attention-deficit/hyperactivity disorder(ADHD)and T2D have yet to be elucidated.Aims We aim to assess shared genetics and potential associations between ADHD and T2D.Methods We performed genetic correlation,two-sample Mendelian randomisation and polygenic overlap analyses between ADHD and T2D.The genome-wide association study(GWAS)summary results of T2D(80154 cases and 853816 controls),ADHD2019(20183 cases and 35191 controls from the 2019 GWAS ADHD dataset)and ADHD2022(38691 cases and 275986 controls from the 2022 GWAS ADHD dataset)were used for the analyses.The T2D dataset was obtained from the DIAGRAM Consortium.The ADHD datasets were obtained from the Psychiatric Genomics Consortium.We compared genome-wide association signals to reveal shared genetic variation between T2D and ADHD using the larger ADHD2022 dataset.Moreover,molecular pathways were constructed based on large-scale literature data to understand the connection between ADHD and T2D.Results T2D has positive genetic correlations with ADHD2019(rg=0.33)and ADHD2022(rg=0.31).Genetic liability to ADHD2019 was associated with an increased risk for T2D(odds ratio(OR):1.30,p<0.001),while genetic liability to ADHD2022 had a suggestive causal effect on T2D(OR:1.30,p=0.086).Genetic liability to T2D was associated with a higher risk for ADHD2019(OR:1.05,p=0.001)and ADHD2022(OR:1.03,p<0.001).The polygenic overlap analysis showed that most causal variants of T2D are shared with ADHD2022.T2D and ADHD2022 have three overlapping loci.Molecular pathway analysis suggests that ADHD and T2D could promote the risk of each other through inflammatory pathways.Conclusions Our study demonstrates substantial shared genetics and bidirectional causal associations between ADHD and T2D.

Adhesive hydrogels in osteoarthritis:from design to application

Osteoarthritis(OA)is the most common type of degenerative joint disease which affects 7%of the global population and more than 500 million people worldwide.One research frontier is the development of hydrogels for OA treatment,which operate either as functional scaffolds of tissue engineering or as delivery vehicles of functional additives.Both approaches address the big challenge:establishing stable integration of such delivery systems or implants.Adhesive hydrogels provide possible solutions to this challenge.However,few studies have described the current advances in using adhesive hydrogel for OA treatment.This review summarizes the commonly used hydrogels with their adhesion mechanisms and components.Additionally,recognizing that OA is a complex disease involving different biological mechanisms,the bioactive therapeutic strategies are also presented.By presenting the adhesive hydrogels in an interdisciplinary way,including both the fields of chemistry and biology,this review will attempt to provide a comprehensive insight for designing novel bioadhesive systems for OA therapy.

异羟基洋地黄毒甙元(Digoxigenin)标记的探针在乙型肝炎病毒核酸杂交中的应用

应用异羟基洋地黄毒甙元标记的探针,检测了人和鸭的血清及肝脏中的乙型肝炎病毒核酸,并与^(32)P标记的同位素探针做了比较。结果证明,该探针的特异性和敏感性与同位素探针一致(0.2pg)。它可用于各种核酸杂交试验,如打点杂交、Southern和Northern转印杂交试验等。恰当地从标本中提取待测核酸,是应用该探针的重要条件。

基于阵列波导光栅的边缘滤波温度解调系统

为克服传统阵列波导光栅解调系统体积大、价格昂贵等问题,提出了以窄带光源为输入光源,采用边缘滤波和阵列波导光栅相结合的解调方案,实现对增敏封装后的光纤光栅温度传感器进行温度解调实验。以窄带光源作为输入,通过边缘滤波的方法使得温度传感器反射谱的中心波长偏移程度与解调光路输出光强的变化相对应,利用阵列波导光栅的波分复用实现多传感器同时测量,实现了多传感器多通道的分布式测量,实验结果表明:解调系统的波长解调范围为1545.30 nm~1560.50 nm,对35℃~42℃的温度范围进行检测,波长解调精度为±5.34 pm,温度测量误差可达±0.1℃。

人类免疫缺陷病毒感染细胞的Rer蛋白依赖性凋亡引导

目的:以人类免疫缺陷病毒(HIV)调节蛋白Rev与Rev反应区(RRE)的高亲和性建立引导HIV感染细胞凋亡的结构。方法:用分子克隆技术合成含RRE和肿瘤坏死因子受体-1(TNF-R1)的Rev依赖性凋亡引导质粒,流式细胞仪检测质粒表达。结果:新质粒pDM128-TNF-R1(pT128)HindIII内切有3.1、2.7、1.0和0.87kb片段;聚合酶链反应(PCR)法检测示TNF-R1的1360bp片段。DNA测序法确认其准确性。单纯Hup60TNF-R1在pDC302(pT60)转染Hela,TNF-R1表达可明显杀伤Hela(P<0.01),Rev存在时,pT128也能表达TNF-R1杀伤Hela(P<0.01),但不及pT60的作用(P<0.01);无Rev时,pT128不表达TNF-R1,不杀伤Hela(P>0.01)。单纯Rev不杀伤Hela(P>0.01)。pT128与pRev共转,TNF-R1表达较pT60慢(P<0.01),40h后才接近单纯pT60。结论:新质粒具有Rev依赖性表达作用,进而引导Rev表达细胞凋亡。

Rev依赖性人类免疫缺陷病毒检测结构的合成与表达

目的 利用人类免疫缺陷病毒 (HIV)低变异的调节蛋白Rev与Rev反应区 (RRE)的高亲和性 ,尝试合成一种不受变异影响的特异性病毒表达检测结构。方法 采用分子克隆技术合成含有RRE和增强的绿荧光蛋白 (EGFP)的Rev依赖性荧光表达质粒 ,采用流式细胞仪检测新质粒的表达功能。结果 新合成的质粒pDM 12 8 EGFP (pE12 8)含氨苄青霉素受体 (AmpR)选择子、SV40 启动子、EGFP基因及HIV 1 RRE片段 ,BssSI酶切后产生 3 .6、1.9和 1.5kb片断 ,HindⅢ酶切后产生 3 470、2 72 5和 879bp 3个片断 ,PCR扩增提示EGFP基因完整插入。pE12 8在Hela细胞中显示Rev依赖性表达 ,pRev不存在时 ,几乎没有EGFP表达 ;pRev存在时 ,EGFP显著表达 (P <0 .0 1)。绿荧光Hela细胞百分比随pRev比例的增加而渐次增加。结论 pE12 8能特异、敏感、快速和直观地检测HIV的表达 ,对反映HIV的感染性及病情的转归及对获得性免疫缺陷综合征 (AIDS)

Endoscopic retrograde cholangiopancreatography-induced and non-endoscopic retrograde cholangiopancreatographyinduced acute pancreatitis:Two distinct clinical and immunological entities?

Acute pancreatitis(AP) is common gastrointestinal disease of varied aetiology. The most common cause of AP is gallstones, followed by alcohol abuse as an independent risk factor. With the increased need for invasive techniques to treat pancreatic and bile duct pathologies such as endoscopic retrograde cholangiopancreatography(ERCP), AP has emerged as the most frequent complication. While severe AP following ERCP is rare(0.5%), if it does develop it has a greater severity index compared to non-ERCP AP. Development of a mild form of AP after ERCP is not considered a clinically relevant condition. Differences in the clinical presentation and prognosis of the mild and severe forms have been found between non-ERCP AP and postendoscopic pancreatitis(PEP). It has been proposedthat AP and PEP may also have different immunological responses to the initial injury. In this review, we summarise the literature on clinical and inflammatory processes in PEP vs non-ERCP AP.

异羟基洋地黄毒甙元(Digoxigenin)标记的RNA探针在丁型肝炎病毒核酸杂交中的应用

应用异羟基洋地黄毒甙元(Digoxigenin)标记的RNA探针,检测了人和黑猩猩血清及肝脏中丁型肝炎病毒核酸,并与^(32)P标记同一探针做了比较。结果表明,异羟基洋地黄毒甙元标记的RNA探针的杂交效果与同位索探针一致(同源cDNA0.2pg),可用于人和动物血清及肝脏标本内HDV核酸的检测。

Antimicrobial resistance of abnormal vaginal discharges microorganisms in Ouagadougou,Burkina Faso

Objective:To assess the prevalence of bacterial strains and fungal strains infecting the vaginal tract and test their sensitivity to antibiotics in women attending Saint Camille Medical Centre in Ouagadougou.Methods:From January 2008 to December 2009,a total of 2000 vaginal swabs were cultivated for bacterial and fungal identification and isolation.Furthermore,bacterial strains were tested for their susceptibility to several antibiotics used in routine in the centre. Results:The results revealed that microbial isolation and identification was attempted for 1536/2000 sample,a positivity rate of 76.80%.Candida albicans(48.76%),followed by Escherichia coli(16.67%),Streptococcus agalactiae(8-14%) and Staphylococcus aureus(7.55%) were the major agents of genital tract infections in patients.Mycoplasma hominis and Ureaplasma urealyticum combined accounted for less than 7%.Trichomonas vaginalis was identified in 1.04%coses.The antimicrobial tests revealed that the microorganisms developed resistance to several antibiotics including beta lactams.However,antibiotics such as cefamenzol,ciprofloxacin and norfloxacin were still active on these bacteria.Conclusions:The results reveal that many sexually active women are infected by one or more microbial pathogens,probably because of the lock of hygiene or the adoption of some risky behaviors,such as not using condoms or having multiple sexual partners.Efforts should be made to address these points in the country.

Role of virtual reality simulation in endoscopy training

Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simula-tors and the long-term benefits of their use are also discussed.

Contribution of pancreatic enzyme replacement therapy to survival and quality of life in patients with pancreatic exocrine insufficiency

The objective of this study was to analyze the current evidence for the use of pancreatic enzyme replacement therapy (PERT) in affecting survival and quality of life in patients with pancreatic exocrine insufficiency (PEI). Systematic searches of the literature were performed using the PubMed database. Articles were selected for inclusion if they reported findings from trials assessing the effects of PERT on quality of life, survival, malabsorption, growth parameters (such as height, body weight and body mass index), or gastrointestinal symptoms (such as abdominal pain, stool consistency and flatulence). PERT improved PEI-related malabsorption and weight maintenance in patients with cystic fibrosis, chronic pancreatitis, pancreatic cancer, and post-surgical states. In patients with chronic pancreatitis, PERT improved PEI-related symptoms and quality of life measures. Several small retrospective studies have also suggested that PERT may have a positive impact on survival, but long-term studies assessing this effect were not identified. PERT is effective for treating malnutrition and supporting weight maintenance, and it is associated with improved quality of life and possibly with enhanced survival in patients with PEI. However, there is evidence that not all patients with PEI receive adequate PERT. Future work should aim to assess the long-term effects of PERT on the survival of patients with PEI.

Ehealth:Low FODMAP diet vs Lactobacillus rhamnosus GG in irritable bowel syndrome

AIM:To investigate the effects of a low fermentable,oligosaccharides,disaccharides,monosaccharides and polyols diet(LFD)and the probiotic Lactobacillus rhamnosus GG(LGG)in irritable bowel syndrome(IBS).METHODS:Randomised,unblinded controlled trial on the effect of 6-wk treatment with LFD,LGG or a normal Danish/Western diet(ND)in patients with IBS fulfilling Rome III diagnostic criteria,recruited betweenNovember 2009 and April 2013.Patients were required to complete on a weekly basis the IBS severity score system(IBS-SSS)and IBS quality of life(IBS-QOL)questionnaires in a specially developed IBS web selfmonitoring application.We investigated whether LFD or LGG could reduce IBS-SSS and improve QOL in IBS patients.RESULTS:One hundred twenty-three(median age 37years,range:18-74 years),90(73%)females were randomised:42 to LFD,41 to LGG and 40 to ND.A significant reduction in mean±SD of IBS-SSS from baseline to week 6 between LFD vs LGG vs ND was revealed:133±122 vs 68±107,133±122 vs 34±95,P<0.01.Adjusted changes of IBS-SSS for baseline covariates showed statistically significant reduction of IBS-SSS in LFD group compared to ND(IBS-SSS score75;95%CI:24-126,P<0.01),but not in LGG compared to ND(IBS-SSS score 32;95%CI:18-80,P=0.20).IBS-QOL was not altered significantly in any of the three groups:mean±SD in LFD 8±18 vs LGG 7±17,LFD 8±18 vs ND 0.1±15,P=0.13.CONCLUSION:LFD is efficacious for patients with IBS.

Ehealth monitoring in irritable bowel syndrome patients treated with low fermentable oligo-, di-, mono-saccharides and polyols diet

In the present study we report on changes in irritable bowel syndrome-severity scoring system(IBS-SSS)and irritable bowel syndrome-quality of life(IBS-QoL)in 19 IBS patients,aged 18 to 74 years(F/M:14/5),during 12 wk registering their symptoms on the webapplication(www.ibs.constant-care.dk).During a control period of the first 6-wk patients were asked to register their IBS-SSS and IBS-QoL on the web-application weekly without receiving any intervention.Thereafter,low fermentable oligo-,di-,mono-saccharides and polyols(FODMAP)diet(LFD)was introduced for the next6 wk while continuing the registration.Though a small sample size a significant improvement in disease activity(IBS-SSS)was observed during both the control period,median:278(range:122-377),P=0.02,and subsequently during the LFD period,median:151(range:29-334),P<0.01.The IBS-QoL solely changed significantly during the LFD period,median:67(37-120),P<0.01.The significant reduction in disease activity during the control period shows a positive effect of the web-application on IBS symptoms when presented as a"traffic light".However adding the diet reduced IBSSSS to<150,inactive to mild symptoms.In the future results from larger scale trials are awaited.

Benign retroperitoneal schwannoma presenting as colitis:A case report

We report a case of a patient presenting with clinical,radiological and endoscopic features of colitis due to a compressive left para-aortic mass. Total open surgical excision was performed,which resulted in complete resolution of colitis. Histopathology and immunohistochemistry revealed benign retroperitoneal schwannoma. These neural sheath tumors rarely occur in the retroperitoneum. They are usually asymptomatic but as they enlarge they may compress adjacent structures,which leads to a wide spectrum of non-specific symptoms,including lumbar pain,headache,secondary hypertension,abdominal pain and renal colicky pain. CT and MR findings show characteristic features,but none are specific. Schwannoma can be isolated sporadic lesions,or associated with schwannomatosis or neurofibromatosis type Ⅱ (NF2). Although they vary in biological and clinical behavior,their presence is,in nearly every case,due to alterations or absence of the NF2 gene,which is involved in the growth regulation of Schwann cells. Both conditions were excluded by thorough mutation analysis. Diagnosis is based on histopathological examination and immunohistochemistry. Total excision is therapeutic and has a good prognosis. Schwannomatosis and NF2 should be excluded through clinical diagnostic criteria. Genetic testing of NF2 is probably not justified in the presence of a solitary retroperitoneal schwannoma.

Slacklining and stroke: A rehabilitation case study considering balance and lower limb weakness

To ascertain the effectiveness of slacklining as a supplementary therapy for elderly stroke patients who are functionally non-progressing. This case study involved an 18-mo prospective observation of the management of an 87-year-old female stroke-patient of the left hemisphere with reduced balance, reduced lower limb muscular activation, hypertonia, and concurrent postural deficits. This entailed the initial acute care phase through to discharge to home and 18-mo final status in her original independent living setting. The introduction of slacklining as an adjunct therapy was made 12 mo post incident. Slacklining involves balance retention on a tightened band where external environmental changes cause a whole-body dynamic response to retain equilibrium. It is a complex neuromechanical task enabling individualized self-developed response strategies to be learned and adapted. This facilitates the innate process of balance retention, lower-limb and core muscle activation, and stable posture through a combination of learned motor skills and neurological system down regulation. Individuals adopt and follow established sequential motor learning stages where the acquired balance skillsare achieved in a challenging composite-chain activity. Slacklining could be considered an adjunct therapy for lower limb stroke rehabilitation where function is compromised due to decreased muscle recruitment, decreased postural control and compromised balance. Initial inpatient rehabilitation involved one-month acute-care, one-month rehabilitation, and one-month transitional care prior to home discharge. A further six months of intensive outpatient rehabilitation was provided with five hourly sessions per week including:supervised and self-managed hydrotherapy, plus one individual and two group falls' prevention sessions. These were supported by daily home exercises. At 12 mo post incident, recovery plateaued, then regressed following three falls. Rehabilitation was subsequently modified with the hydrotherapy retained and the group sessions replaced with an additional individual session supplemented with slacklining. The slacklining followed stages one and two of a standardized five-stage protocol. Self-reported functional progression resumed with improvement by 14 mo which further increased and was sustained 18 mo(Students' t test P < 0.05). Slacklining's external stimulations activate global-body responses through innate balance, optimal postural and potentially down-regulated reflex control. Incorporated into stroke rehabilitation programs, slacklining can provide measurable functional gains.