Ischemic stroke susceptibility gene in a Northern Han Chinese population

Interleukin-18 gene promoter polymorphisms are potential risk factors for ischemic cerebrovascular disease, and the –607C allele may increase ischemic stroke risk in the Han Chinese population. In the present study, we recruited 291 patients with ischemic cerebrovascular disease from the Affiliated Hospital of Qingdao University Medical College, China, and 226 healthy controls. Both patients and controls were from the Han population in northern China. Immunoresonance scattering assays detected increased serum amyloid A protein, C-reactive protein, and interleukin-18 levels in ischemic cerebrovascular disease patients compared with healthy controls. Analysis of the –607C/A （rs1946518） polymorphism in the interleukin-18 gene promoter showed ischemic cerebrovascular disease patients exhibited increased frequencies of the CC genotype and C alleles than healthy controls. Genotype and allele frequencies of the interleukin-18 –137G/C （rs187238） polymorphism and the –13T/C （rs11024595） polymorphism in the 5＇-flanking region of serum amyloid A, showed no significant difference between the two groups. Multivariate logistic regression analysis on the interleukin-18 promoter A/C genetic locus, for correction of age, gender, history of smoking, hypertension, diabetes mellitus, hypercholesteremia, and an ischemic stroke family history, showed ischemic cerebrovascular disease risk in individuals without the A allele （C homozygotes） was 2.2-fold greater than in A allele carriers. Overall, our findings suggest that the –13T/C （rs11024595） polymorphism in the 5′-flanking region of serum amyloid A has no correlation with ischemic cerebrovascular disease, but the C allele of the –607C/A （rs1946518） polymorphism in the interleukin-18 promoter is a high-risk factor for ischemic cerebrovascular disease in the Han population of northern China. In addition, the A allele is likely a protective gene for ischemic cerebrovascular disease.

Post-Exposure Prophylaxis against HBV and HIV Infection in Health Care Workers

Healthcare Workers (HCWs) are constantly at risk of exposure to viral infections such as hepatitis B virus (HBV), human immune deficiency virus (HIV) and hepatitis C virus (HCV). We aim at demonstrating the results of a three-year period of a surveillance program in Iran with the prospective follow-up of HCWs exposed to blood-borne viruses. HCWs who had experienced an occupational exposure to HBV, HCV or HIV from September 2005 to 2008 were enrolled in the study. Age, gender, route of exposure, type of fluid, type of virus, job, department, working shift, work experience, wearing gloves when exposed, history of HBV vaccination and the serum level of anti HBs antibody were recorded for all participants through an individual interview. Serum samples were taken from both HCWs and the sources of exposure and were tested by enzyme linked immunosorbent assay (ELISA). The data were gathered through questionnaires completed by a nurse under the supervision of a specialist of infectious diseases. In this study, 100 HCWs who were occupationally exposed to HIV, HCV or HBV were included. Most exposures had occurred among nurses (35%), followed by residents (29%), interns (18%), housekeepers (7%), the lab staff (6%), and specialists (5%). Most of the exposures had occurred in emergency (21%) and surgical (20%) wards. The most common route of exposure was percutaneous injuries (77%) and the most common cases had contacted with needles and angiocaths (71.1%) during injection or opening vein routes (21%). Establishing a surveillance system for registering the occurrence of occupational hazardous exposures, performing prophylactic measures and following up the exposed is a necessity in hospitals so that the number of exposures and occupational diseases among the HCWs can be decreased.

Role of <i>Helicobacter pylori</i>Infection in Recurrent Abdominal Pain of the Child in Brazzaville

The Helicobacter pylori (Hp) infection is a public health problem, especially in developing countries. However, the responsibility of Hp for the occurrence of recurrent abdominal pain is still unclear. Objectives: To determine the prevalence of Helicobacter pylori (Hp) infection in children with recurrent abdominal pain (RAP) in Brazzaville and to establish the relationship between Hp infection and RAP. Patients and Methods: We conducted a cross-sectional case-control study, between March and September 2018, including 106 children with RAP and 218 children without RAP, aged 2 to 17 years old, received in health centres in Brazzaville. All the children were subjected to detection of Hp fecal antigen by qualitative immuno-chromatography in the faeces. Results: The prevalence of Hp infection among children with RAP in Brazzaville was 43.4%. The female sex was most represented in both populations, with a sex ratio of 0.84 in the infected population. Compared with controls, these were children with a mean age of 8.13 ± 4.57 years. Infected children with RAP were unschooled in 66.7% (n = 31) of cases (p < 0.05). Those using potty were 63% (n = 29). Handwashing before meals and after using the toilet was not done in 66.7% (n = 31) and 56.5% (n = 26) of cases, respectively. The proportions were almost similar in the control population. The epigastric site of pain was found in 51.8% of children infected with RAP, the association between Hp infection and the site of pain was statistically significant (p = 0.009). The epidemiological factors influencing Hp infestation in children were identical in both groups, those factors were: age (OR = 0.61;p < 0.04), education level (OR = 0.35;p < 0.01) of the children and guardian’s age (OR = 1.22;p < 0.03), type of toilet (OR = 2.37;p < 0.02) and hand washing (OR = 1;p < 0.01). No statistically significant association was found between Hp infection and RAP (p = 0.10). Conclusion: Hp infection is common among children with RAP in Brazzaville. It is favoured by young age and lack of hygiene. The cause and effect relationship between Hp and RAP has not been found. Nevertheless, the search for Hp fecal antigen in children with RAP should be recommended in order to improve the management of this pathology.

Tako-Tsubo Cardiomyopathy—The Role of Physical and Emotional Stressors:Two Case Report

Introduction: Tako-Tsubo cardiomyopathy describes a form of acute and reversible left ventricular dysfunction with a clinical presentation, ECG and cardiac biomarkers that makes it indistinguishable from acute coronary syndrome. Case Presentation: The authors present two cases of tako-tsubo cardiomyopathy in postmenopausal women, the first case following an emotional stressful event and a second case following a blood transfusion and probably associated with intravenous catecholamine perfusion. Both had unobstructed coronary arteries and regional wall-motion abnormalities typical of this syndrome. Conclusions: Tako-tsubo cardiomyopathy is a condition often misdiagnosed. A clinical presentation suggestive of acute coronary syndrome in a postmenopausal woman without history of coronary disease and in whom a precipitating stressful event can be found should lead the physician to suspect the diagnosis of tako-tsubo cardiomyopathy. This syndrome associated with blood transfusion has rarely been described.

A Potential Functional Cure in Chinese HBeAg-negative Chronic Hepatitis B Patients Treated with Peg-interferon Alpha-2a

Background and Aims:Data are limited on the use of pegylated-interferon alpha-2a(peg-IFNα)in Chinese patients with chronic hepatitis B virus(HBV)infection(CHB).We evaluated the effectiveness and safety of peg-IFNαin Chinese patients with hepatitis B envelope antigen-negative CHB in routine clinical practice.Methods:In this prospective,multicenter,observational,non-interventional cohort study,patients were assessed for up to 1 year after peg-IFNαtreatment cessation.Treating physicians established the dosing and treatment duration according to Chinese clinical practice.Effectiveness of peg-IFNαtreatment was measured by the percentage of:patients with HBV DNA<2000 IU/mL and loss of hepatitis B surface antigen(commonly known as HBsAg);HBV DNA level at end of treatment(EOT),and 6 months and 1 year posttreatment;and time course change in quantitative HBV DNA and HBsAg.Results:At EOT,6 months posttreatment,and 1 year posttreatment,the percentage of patients with HBV DNA<2000 IU/mL was 90.0%,81.8%,and 82.2%,and that of patients with HBsAg loss was 6.5%,9.4%,and 9.5%,respectively.The HBV DNA level decreased from 5.61 log IU/mL at baseline to 2.48 log IU/mL at EOT and 2.67 log IU/mL at 1 year posttreatment.The HBsAg level decreased from 3.08 log IU/mL at baseline to 2.24 log IU/mL at EOT and 2.10 log IU/mL at 1 year posttreatment.The incidence of adverse events was 52.0%.Conclusions:Peg-IFNαhas the potential to provide functional cure(HBsAg loss)for CHB and is well tolerated in hepatitis B envelope antigen-negative CHB patients in routine clinical practice in China.