A Pattern of Blood Pressure and Family Function in Adult Hypertensive Patients Attending a Tertiary Hospital in a Rural Area

Hypertension (high blood pressure) is common and chronic. Early detection, coupled with the sincere dedication to treatment plans will delay/prevent complications. Late detection, lack of motivation for treatment, unhealthy lifestyle and poor adherence to medications and follow-up visits leads to early onset of complications. Motivation to adhere to therapeutic plans occurs in families with good function, and consequently good support to the hypertensive.This descriptive and cross-sectional study was carried out in the outpatient clinic of a tertiary healthcare facility in a rural area of Edo state, Nigeria. A semi-structured, interviewer-administered questionnaire was used to obtain socio-demographic information, anthropometric parameters, the presence of risk factors for HTN, and relevant information on management. The Smilkstein,s Family System APGAR Item tool was used to assess a family member’s perception of family functioning, by examining his/her satisfaction with family relationships. Data were entered into a spreadsheet and analyzed using IBM-SPSS version 2.1. Out of the 151 participants in the study, 61.6% were females and 45.7% were in the age group 40-59 years, with the mean age 56.97±12.49 years. Majority of the respondents were civil servants (34.4%), had up to the tertiary level of education (39.1%), and were married (84.8%). Most of the respondents (78.8%) had controlled BP (<140/90mmHg). According to the Smilkstein,s Family System APGAR item scoring, 69.6% of the respondents were from highly functional families, while only 5.3% were from dysfunctional families. Seventy five (75) respondents from the highly functional families had controlled BP, while only six participants from the dysfunctional families had controlled BP. There was the significant association between blood pressure and age, and also  between blood pressure and frequency of drug intake. However, there was no significant association between blood pressure and family function, sex, educational level, exercise and clinic attendance.Findings from this study show that the control of HTN in primary care population is good. Family involvement in the management of patients with HTN, is of paramount importance to the Family Physician, to enable him/her care for them adequately

The establishment of a fungal consortium in a new winery

International audienceThe biodiversity and evolution of fungal communities were monitored over a period of 3 vintages in a new winery. Samples were collected before grape receipt and 3 months after fermentation from 3 different wine related environments (WRE): floor, walls and equipment and analyzed using Illumina Mi-Seq. Genera of mold and filamentous fungi (294), non-enological (10) and wine-associated yeasts (25) were detected on all WREs before the arrival of the first harvest. Among them, genera like Alternaria and Aureobasidium persisted during two vintages. Therefore, these genera are not specific to winery environment and appear to be adapted to natural or anthropic environments due to their ubiquitous character. Some genera like Candida were also detected before the first harvest but only on one WREs, whereas, on the other WREs they were found after the harvest. The ubiquitous character and phenotypic traits of these fungal genera can explain their dynamics. After the first harvest and during 3 vintages the initial consortium was enriched by oenological genera like Starmerella introduced either by harvest or by potential transfers between the different WREs. However, these establishing genera, including Saccharomyces, do not appear to persist due to their low adaptation to the stressful conditions of winery environment

Difficult or impossible facemask ventilation in children with difficult tracheal intubation: a retrospective analysis of the PeDI registry

Background: Difficult facemask ventilation is perilous in children whose tracheas are difficult to intubate. We hypothesised that certain physical characteristics and anaesthetic factors are associated with difficult mask ventilation in paediatric patients who also had difficult tracheal intubation. Methods: We queried a multicentre registry for children who experienced “difficult” or “impossible” facemask ventilation. Patient and case factors known before mask ventilation attempt were included for consideration in this regularised multivariable regression analysis. Incidence of complications, and frequency and efficacy of rescue placement of a supraglottic airway device were also tabulated. Changes in quality of mask ventilation after injection of a neuromuscular blocking agent were assessed. Results: The incidence of difficult mask ventilation was 9% (483 of 5453 patients). Infants and patients having increased weight, being less than 5th percentile in weight for age, or having Treacher-Collins syndrome, glossoptosis, or limited mouth opening were more likely to have difficult mask ventilation. Anaesthetic induction using facemask and opioids was associated with decreased risk of difficult mask ventilation. The incidence of complications was significantly higher in patients with “difficult” mask ventilation than in patients without. Rescue placement of a supraglottic airway improved ventilation in 71% (96 of 135) of cases. Administration of neuromuscular blocking agents was more frequently associated with improvement or no change in quality of ventilation than with worsening. Conclusions: Certain abnormalities on physical examination should increase suspicion of possible difficult facemask ventilation. Rescue use of a supraglottic airway device in children with difficult or impossible mask ventilation should be strongly considered