Diabetes mellitus type 2 in urban Ghana: characteristics and associated factors

BACKGROUND: Sub-Saharan Africa faces a rapid spread of diabetes mellitus type 2 (DM2) but its potentially specific characteristics are inadequately defined. In this hospital-based study in Kumasi, Ghana, we aimed at characterizing clinical, anthropometric, socio-economic, nutritional and behavioural parameters of DM2 patients and at identifying associated factors. METHODS: Between August 2007 and June 2008, 1466 individuals were recruited from diabetes and hypertension clinics, outpatients, community, and hospital staff. Fasting plasma glucose (FPG), serum lipids and urinary albumin were measured. Physical examination, anthropometry, and interviews on medical history, socio-economic status (SES), physical activity and nutritional behaviour were performed. RESULTS: The majority of the 675 DM2 patients (mean FPG, 8.31 mmol/L) was female (75%) and aged 40-60 years (mean, 55 years). DM2 was known in 97% of patients, almost all were on medication. Many had hypertension (63%) and microalbuminuria (43%); diabetic complications occurred in 20%. Overweight (body mass index > 25 kg/m2), increased body fat (> 20% (male), > 33% (female)), and central adiposity (waist-to-hip ratio > 0.90 (male), > 0.85 (female)) were frequent occurring in 53%, 56%, and 75%, respectively. Triglycerides were increased (≥ 1.695 mmol/L) in 31% and cholesterol (≥ 5.17 mmol/L) in 65%. Illiteracy (46%) was high and SES indicators generally low. Factors independently associated with DM2 included a diabetes family history (adjusted odds ratio (aOR), 3.8; 95% confidence interval (95%CI), 2.6-5.5), abdominal adiposity (aOR, 2.6; 95%CI, 1.8-3.9), increased triglycerides (aOR, 1.8; 95%CI, 1.1-3.0), and also several indicators of low SES. CONCLUSIONS: In this study from urban Ghana, DM2 affects predominantly obese patients of rather low socio-economic status and frequently is accompanied by hypertension and hyperlipidaemia. Prevention and management need to account for a specific risk profile in this population

Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy. European Society of Human Genetics and European Society of Human Reproduction and Embryology.

In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation - ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and provide an update of selected topics that have evolved since 2005

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Momentum distribution of charged particles in jets in dijet events in p(p)over-bar collisions at root s=1.8 TeV and comparisons to perturbative QCD predictions

Inclusive momentum distributions of charged particles in restricted cones around jet axes were measured in dijet events with invariant dijet masses in the range 80 to 600 GeV/c(2). Events were produced at the Fermilab Tevatron in p (p) over bar collisions with a center of mass energy of 1.8 TeV and recorded by the Collider Detector at Fermilab. The results were compared to perturbative QCD calculations carried out in the framework of the modified leading log approximation (MLLA) and assuming local parton-hadron duality. It was shown that the data follow theoretical predictions quite well over the whole range of the jet energies included in this analysis. We extracted the MLLA cutoff scale Q(eff) and found a value of 230+/-40 MeV. The theoretical prediction of E(jet)sin theta(c) scaling, where theta(c) is the cone opening angle, was experimentally observed for the first time. From the MLLA fits to the data, two more parameters were extracted: the ratio of parton multiplicities in gluon and quark jets, r=N-partons(g-jet)/N-partons(q-jet)=1.9+/-0.5, and the ratio of the number of charged hadrons to the number of predicted partons in a jet, K-LPHD(charged)=N-hadrons(charged)/N-partons=0.56+/-0.10

Search for a W(') boson decaying to a top and bottom quark pair in 1.8 TeV p(p)over-bar collisions

We report the results of a search for a W(') boson produced in p (p) over bar collisions at a center-of-mass energy of 1.8 TeV using a 106 pb(-1) data sample recorded by the Collider Detector at Fermilab. We observe no significant excess of events above background for a W(') boson decaying to a top and bottom quark pair. In a model where this boson would mediate interactions involving a massive right-handed neutrino (nu(R)) and have standard model strength couplings, we use these data to exclude a W(') boson with mass between 225 and 536 GeV/c(2) at 95\% confidence level for M(W)(')>M(nuR) and between 225 and 566 GeV/c(2) at 95\% confidence level for M(W)(')<M(nuR)

Search for the supersymmetric partner of the top quark in dilepton events from p(p)over-bar collisions at root s=1.8 TeV

We have searched for the supersymmetric partner of the top quark (stop) in 107 pb^{-1} of p-pbar collisions at \sqrt{s}= 1.8 TeV collected by the Collider Detector at Fermilab (CDF). Within the framework of the Minimal Supersymmetric extension of the Standard Model (MSSM) each of the pair-produced stops is assumed to decay into a lepton, bottom quark and supersymmetric neutrino. Such a scenario would give rise to events with two leptons, two hadronic jets, and a substantial imbalance of transverse energy. No evidence of such a stop signal has been found. We calculate a 95% confidence level (C.L.) upper limit on the stop production cross section, which excludes stop masses in the region (80<m_{\stop}<135 GeV/c^2) in the mass plane of stop versus sneutrino.Comment: 7 pages, 5 figures. Submitted to Physical Review Letter

Central pseudorapidity gaps in events with a leading antiproton at the Fermilab tevatron (p)over-barp collider

We report a measurement of the fraction of events with a large pseudorapidity gap Deltaeta within the pseudorapidity region available to the proton dissociation products X in (p) over bar +p--&gt;(p) over bar +X. For a final state (p) over bar of fractional momentum loss xi((p) over bar) and 4-momentum transfer squared t((p) over bar) within 0.063 is found to be 0.246+/-0.001 (stat)+/-0.042 (syst) [0.184+/-0.001 (stat)+/-0.043 (syst)]. Our results are compared with gap fractions measured in minimum bias (p) over barp collisions and with theoretical expectations

Search for associated production of Upsilon and vector boson in p(p)over-bar collisions at root(s)over-bar=1.8 TeV

We present a search for associated production of the Y(1S) and a vector boson in 83 pb(-1) of p (p) over bar collisions at roots=1.8 TeV collected by the CDF experiment in 1994-1995. We find no evidence of the searched signal in the data, and set upper limits to the production cross sections

Search for a W(') boson decaying to a top and bottom quark pair in 1.8 TeV p(p)over-bar collisions

We report the results of a search for a W(') boson produced in p (p) over bar collisions at a center-of-mass energy of 1.8 TeV using a 106 pb(-1) data sample recorded by the Collider Detector at Fermilab. We observe no significant excess of events above background for a W(') boson decaying to a top and bottom quark pair. In a model where this boson would mediate interactions involving a massive right-handed neutrino (nu(R)) and have standard model strength couplings, we use these data to exclude a W(') boson with mass between 225 and 536 GeV/c(2) at 95% confidence level for M(W)(')>M(nuR) and between 225 and 566 GeV/c(2) at 95% confidence level for M(W)(')<M(nuR)