Etiology in 16 cases of toxic epidermal necrolysis and Stevens-Johnson syndrome admitted within 8 months in a teaching hospital

published_or_final_versio

The role of transesophageal echocardiography in the diagnosis and management of children and young adults with valvar diseases of the left heart

Summary The role of transesophageal echocardiography in the diagnosis and management of left-sided cardiac valvar disease in children and young adults was assessed in terms of whether additional information (over transthoracic echocardiography) could be obtained, and whether the added information contributed to the better management of the patients. Between January 1991 to August 1992, 27 consecutive patients were studied. Their age ranged from 2.5 to 20 years (mean 12.7), with body weights ranging between 12 and 60 kg (mean 35.6). Twelve of the children suffered from atrioventricular valvar disease, 13 had predominant aortic valvar lesions and two had mixed valvar pathologies. Additional information was obtained by transesophageal over that of transthoracic echocardiography in 18 children (67%). Transesophageal echocardiography clarified the etiologies or mechanism of valvar regurgitation in eight and seven children with atrioventricular and aortic pathologies, respectively. The technique correctly diagnosed severe mitral regurgitation underestimated by conventional technique, detected a missed eccentric aortic regurgitant jet and convincingly excluded bacterial vegetations in one case each. The investigation contributed to the better management of three children (11%) by providing information that allowed the appropriate choice of therapy. Transesophageal echocardiography, therefore, is a useful technique for the diagnosis and management of valvar disease of the left heart in children and young adults.published_or_final_versio

Lack of activated protein C resistance in healthy Hong Kong Chinese blood donors--correlation with absence of Arg506-Gln mutation of factor V gene.

published_or_final_versio

High incidence of thrombophilia detected in Chinese patients with venous thrombosis

Venous thromboembolism is rare in Chinese. To determine the incidence and disease profile of thrombophilia in Chinese patients with thrombosis, 52 unselected Chinese patients with documented venous thrombosis were studied for the presence of thrombophilia. Levels of antithrombin III (AT III), protein C (PC) and protein S (PS) as well as the presence of acquired lupus anticoagulant (LA) and anticardiolipin antibody (ACA) were investigated. Thirty patients were found to be abnormal. These consisted of 5 AT III deficiencies, 9 PC deficiencies, 10 PS deficiencies, 1 combined PC and PS deficiency (all in the heterozygous range), and 5 patients with LA and/or ACA. When the patients with LA and/or ACA are excluded, the incidence of hereditary thrombophilia is 25/47 i.e. 53.2% which is much higher than those reported in studies of Caucasian patients selected under strict criteria. Family studies performed in 16 cases of hereditary thrombophilia revealed involvement in 11 cases (68.7%); a total of 36 heterozygous family members were affected, most of which remain asymptomatic. Although 35 events predisposing to thrombosis (27 pregnancies, 1 oral contraceptive consumption and 7 surgical operations) were identified among these index patients, and the heterozygous family members, thrombosis was observed on only 6 occasions (17.1%). The data suggest that pregnancy and surgery do not carry the same degree of thrombotic risk in Chinese as in the Caucasian population with heterozygous AT III, PC and PS deficiency.published_or_final_versio

Analysis of 137 obstetric fistula cases seen at three fistula centres in northwest Nigeria

Objectives: To determine the contributory factors to development of obstetric fistula and to determine the knowledge and practice of modern contraception among fistula patients.Design: Descriptive hospital cross-sectional study.Setting: Three fistula centres in north west Nigeria.Subjects: All obstetric fistula patients that met the inclusion criteria.Results: Of 137 cases of obstetric fistula patients that satisfied the inclusion criteria, 88% had only Vesico-vaginal fistula, while 10% and 2% had recto-vaginal fistula, and combined vesico vaginal fistula and recto-vaginal fistula respectively. All the patients had early marriage (before age 20 years) with median ages at first marriage of 15 years and at presentation in hospital of 16 years. Majority (93.4%) of the patients developed fistula during the first delivery. Approximately two-third of the patients had no form of education. Only 42.3% of the patients received antenatal care and 86% delivered at home. Only 28% of the patients was aware of modern contraception and 2% had used modern contraceptive before developing fistula. All the patients expressed willingness to use modern contraception after fistula repair.Conclusion: This study shows that child marriage, low education, unskilled birth attendance and low contraceptive uptake are common among the obstetric fistula patients in north west Nigeria. Public advocacy and formulation of laws and policies to protect girls from early marriage, girl child education to secondary school level be encouraged, public education on the importance of and utilisation of maternity and modern family planning services

Investigating the Campylobacter jejuni Transcriptional Response to Host Intestinal Extracts Reveals the Involvement of a Widely Conserved Iron Uptake System.

Campylobacter jejuni is a pathogenic bacterium that causes gastroenteritis in humans yet is a widespread commensal in wild and domestic animals, particularly poultry. Using RNA sequencing, we assessed C. jejuni transcriptional responses to medium supplemented with human fecal versus chicken cecal extracts and in extract-supplemented medium versus medium alone. C. jejuni exposed to extracts had altered expression of 40 genes related to iron uptake, metabolism, chemotaxis, energy production, and osmotic stress response. In human fecal versus chicken cecal extracts, C. jejuni displayed higher expression of genes involved in respiration (fdhTU) and in known or putative iron uptake systems (cfbpA, ceuB, chuC, and CJJ81176_1649-1655 [here designated 1649-1655]). The 1649-1655 genes and downstream overlapping gene 1656 were investigated further. Uncharacterized homologues of this system were identified in 33 diverse bacterial species representing 6 different phyla, 21 of which are associated with human disease. The 1649 and 1650 (p19) genes encode an iron transporter and a periplasmic iron binding protein, respectively; however, the role of the downstream 1651-1656 genes was unknown. A Δ1651-1656 deletion strain had an iron-sensitive phenotype, consistent with a previously characterized Δp19 mutant, and showed reduced growth in acidic medium, increased sensitivity to streptomycin, and higher resistance to H2O2 stress. In iron-restricted medium, the 1651-1656 and p19 genes were required for optimal growth when using human fecal extracts as an iron source. Collectively, this implicates a function for the 1649-1656 gene cluster in C. jejuni iron scavenging and stress survival in the human intestinal environment.IMPORTANCE Direct comparative studies of C. jejuni infection of a zoonotic commensal host and a disease-susceptible host are crucial to understanding the causes of infection outcome in humans. These studies are hampered by the lack of a disease-susceptible animal model reliably displaying a similar pathology to human campylobacteriosis. In this work, we compared the phenotypic and transcriptional responses of C. jejuni to intestinal compositions of humans (disease-susceptible host) and chickens (zoonotic host) by using human fecal and chicken cecal extracts. The mammalian gut is a complex and dynamic system containing thousands of metabolites that contribute to host health and modulate pathogen activity. We identified C. jejuni genes more highly expressed during exposure to human fecal extracts in comparison to chicken cecal extracts and differentially expressed in extracts compared with medium alone, and targeted one specific iron uptake system for further molecular, genetic, and phenotypic study

The J-triplet Cooper pairing with magnetic dipolar interactions

Recently, cold atomic Fermi gases with the large magnetic dipolar interaction have been laser cooled down to quantum degeneracy. Different from electric-dipoles which are classic vectors, atomic magnetic dipoles are quantum-mechanical matrix operators proportional to the hyperfine-spin of atoms, thus provide rich opportunities to investigate exotic many-body physics. Furthermore, unlike anisotropic electric dipolar gases, unpolarized magnetic dipolar systems are isotropic under simultaneous spin-orbit rotation. These features give rise to a robust mechanism for a novel pairing symmetry: orbital p-wave (L=1) spin triplet (S=1) pairing with total angular momentum of the Cooper pair J=1. This pairing is markedly different from both the $^3$He-B phase in which J=0 and the $^3$He-$A$ phase in which $J$ is not conserved. It is also different from the p-wave pairing in the single-component electric dipolar systems in which the spin degree of freedom is frozen

New Applications of Electrochemically Produced Porous Semiconductors and Nanowire Arrays

The growing demand for electro mobility together with advancing concepts for renewable energy as primary power sources requires sophisticated methods of energy storage. In this work, we present a Li ion battery based on Si nanowires, which can be produced reliable and cheaply and which shows superior properties, such as a largely increased capacity and cycle stability. Sophisticated methods based on electrochemical pore etching allow to produce optimized regular arrays of nanowires, which can be stabilized by intrinsic cross-links, which serve to avoid unwanted stiction effects and allow easy processing

Exploring the impacts of anthropogenic emission sectors on PM2.5 and human health in South and East Asia

To improve poor air quality in Asia and inform effective emission-reduction strategies, it is vital to understand the contributions of different pollution sources and their associated human health burdens. In this study, we use the WRF-Chem regional atmospheric model to explore the air quality and human health benefits of eliminating emissions from six different anthropogenic sectors (transport, industry, shipping, electricity generation, residential combustion, and open biomass burning) over South and East Asia in 2014. We evaluate WRF-Chem against measurements from air quality monitoring stations across the region and find the model captures the spatial distribution and magnitude of PM2.5 (particulate matter with an aerodynamic diameter of no greater than 2.5 µm). We find that eliminating emissions from residential energy use, industry, or open biomass burning yields the largest reductions in population-weighted PM2.5 concentrations across the region. The largest human health benefit is achieved by eliminating either residential or industrial emissions, averting 467 000 (95 % uncertainty interval (95UI): 409 000–542 000) or 283 000 (95UI: 226 000–358 000) annual premature mortalities, respectively, in India, China, and South-east Asia, with fire prevention averting 28 000 (95UI: 24 000–32 000) annual premature mortalities across the region. We compare our results to previous sector-specific emission studies. Across these studies, residential emissions are the dominant cause of particulate pollution in India, with a multi-model mean contribution of 42 % to population-weighted annual mean PM2.5. Residential and industrial emissions cause the dominant contributions in China, with multi-model mean contributions of 29 % for both sectors to population-weighted annual mean PM2.5. Future work should focus on identifying the most effective options within the residential, industrial, and open biomass-burning emission sectors to improve air quality across South and East Asia

Using Latent Class Analyses to Examine Health Disparities among Young Children in Socially Disadvantaged Families during the COVID-19 Pandemic

Rising income inequality is strongly linked to health disparities, particularly in regions where uneven distribution of wealth and income has long been a concern. Despite emerging evidence of COVID-19-related health inequalities for adults, limited evidence is available for children and their parents. This study aimed to explore subtypes of families of preschoolers living in the disadvantaged neighborhoods of Hong Kong based on patterns of family hardship and to compare their patterns of parenting behavior, lifestyle practices, and wellbeing during the COVID-19 pandemic. Data were collected from 1338 preschoolers and their parents during March to June 2020. Latent class analysis was performed based on 11 socioeconomic and disease indicators. Multivariate logistic regressions were used to examine associations between identified classes and variables of interest during the COVID-19 pandemic. Four classes of family hardship were identified. Class 1 (45.7%) had the lowest disease and financial burden. Class 2 (14.0%) had the highest financial burden. Class 3 (5.9%) had the highest disease burden. Class 4 (34.5%) had low family income but did not receive government welfare assistance. Class 1 (low hardship) had lower risks of child maltreatment and adjustment problems than Class 2 (poverty) and Class 3 (poor health). However, children in Class 1 (low hardship) had higher odds of suffering psychological aggression and poorer physical wellbeing than those in Class 4 (low income), even after adjusting for child age and gender. The findings emphasize the need to adopt flexible intervention strategies in the time of large disease outbreak to address diverse problems and concerns among socially disadvantaged families