HIV exposure and related newborn morbidity and mortality in the University Teaching Hospital of Yaoundé, Cameroon

Introduction: Few studies have established the role of maternal HIV infection on neonatal disease and death. In order to determine whether neonatal morbidity and mortality were associated to maternal HIV infection, a case-control study was conducted in the neonatal unit of the University Teaching Hospital of Yaoundé from July 2006 to December 2007. Methods: Babies born from HIV positive mothers were recruited as cases. For each case, two babies born from HIV negative mothers were selected as controls. Informed verbal consent was obtained from the mother before inclusion of the newborn in the study. Information on demographics, history of pregnancy, diseases and outcome of the newborns were extracted from patients’ files. The distribution of these parameters between cases and control was analyzed using chi-square. Association of demographics, clinical and paraclinical parameters with mortality was explored using univariate analysis and logistic regression. Data were analyzed using Epi Info version 3.5.1 Windows. Results: Out of 240 newborns enrolled, 80 were cases and were 160 controls. The mean age of cases was 1.69±2.73 days compared to 1.46±2.36 days for controls (p=0.26). Cases significantly differed from controls on mother’s marital status (p=0.02), level of education (p<0.001), number of prenatal consultations (p<0.001), anemia chemoprophylaxis (p=0.01) and drug abuse (p<0.001). Cases and controls were similar for prematurity, respiratory distress, sepsis, meningitis and urinary tract infection. The death rate was identical in both groups (p=0.52). Using Univariate analysis, risk factors associated to mortality in both groups were prematurity (p<0.001) and low birth weight (p<0.001). Conclusion: This study showed no statistical difference in morbidity and mortality between newborns from HIV positive and HIV negative mothers.Key words: HIV exposure, newborn, morbidity, mortality, Cameroo

Polygenicity and Epistasis Underlie Fitness-Proximal Traits in the Caenorhabditis elegans Multiparental Experimental Evolution (CeMEE) Panel

The deposited article is a pre-print version and it has not been submitted to peer reviewing. This article version was provided by bioRxiv and is the preprint first posted online Mar. 26, 2017. This publication hasn't any creative commons license associated. The deposited article version contains attached the supplementary materials within the pdf.Understanding the genetic basis of complex traits remains a major challenge in biology. Polygenicity, phenotypic plasticity and epistasis contribute to phenotypic variance in ways that are rarely clear. This uncertainty can be problematic for estimating heritability, for predicting individual phenotypes from genomic data, and for parameterizing models of phenotypic evolution. Here we report an advanced recombinant inbred line (RIL) quantitative trait locus (QTL) mapping panel for the hermaphroditic nematode Caenorhabditis elegans, the C. elegans multiparental experimental evolution (CeMEE) panel. The CeMEE panel, comprising 507 RILs at present, was created by hybridization of 16 wild isolates, experimental evolution for 140-190 generations, and inbreeding by selfing for 13-16 generations. The panel contains 22% of single nucleotide polymorphisms known to segregate in natural populations, and complements existing C. elegans mapping resources by providing fine resolution and high nucleotide diversity across >95% of the genome. We apply it to study the genetic basis of two fitness components, fertility and hermaphrodite body size at time of reproduction, with high broad sense heritability in the CeMEE. While simulations show we should detect common alleles with additive effects as small as 5%, at gene-level resolution, the genetic architectures of these traits does not feature such alleles. We instead find that a significant fraction of trait variance, approaching 40% for fertility, can be explained by sign epistasis with main effects below the detection limit. In congruence, phenotype prediction from genomic similarity, while generally poor (r2 < 10%), requires modeling epistasis for optimal accuracy, with most variance attributed to the rapidly evolving chromosome arms.National Science Foundation grant: (PHY-1125915); National Institutes of Health grants: (R25-GM-067110, R01-GM-089972, R01-GM-121828); Gordon and Betty Moore Foundation grant: (2919.01); Human Frontiers Science Program (RGP0045/2010); European Research Council grant: (FP7/2007-2013/243285); Agence Nationale de la Recherche grant: (ANR-14-ACHN-0032-01).info:eu-repo/semantics/publishedVersio

Breaking bad news in assisted reproductive technology : a proposal for guidelines

Background: The issue of breaking bad news in assisted reproductive technology (ART) has been only partially explored by literature, and although some recommendations are available, specific guidelines are lacking. The present study aimed to explore the applicability of the oncologic SPIKES Protocol to the ART context. Methods: Thirteen ART clinicians (7 gynecologists; 4 psychologists; 1 biologist; 1 obstetrician) completed the Critical Incidents Report (CIR) to describe the experience of delivering bad news in ART. The CIRs were first discussed with clinicians, then a focus group was created composed of 13 clinicians, one health communication expert and a patient to discuss the applicability of the six-step (SPIKES) Buckman Protocol to ART. The discussion was audiotaped, transcribed and analyzed with content analysis. Results: The SPIKES Protocol seems to fit ART consultations and participants found it practical and easy to understand. Some specificities were found for the ART context: the reiteration of bad news, the "patient" as a couple and the fact that ability to conceive is closely related to self-esteem, as well as to social and family identity. During the discussion of the SPIKES Protocol, participants highlighted the importance of: 1) providing a caring setting, by adding a reflection on the value of communication by phone; 2) exploring patients perceptions but also misinformation; 3) exploring patients desires and expectations, while balancing the need to be honest and clear; 4) applying Buckmans suggestions for delivering information, and integrating clinical aspects with psychosocial ones; 5) managing and legitimizing patients emotions, in particular anger; 6) having a strategy for follow-up and supporting couples to make meaning of the ART experience. Conclusion: The proposal of a shared protocol for giving bad news in ART could be the starting point for training and experimental studies

Differentiation syndrome in patients with acute promyelocytic leukemia treated with all- trans retinoic acid and anthracycline chemotherapy: Characteristics, outcome, and prognostic factors

Differentiation syndrome (DS) can be a life-threatening complication in patients with acute promyelocytic leukemia (APL) undergoing induction therapy with all- trans retinoic acid (ATRA). Detailed knowl- edge about DS has remained limited. We present an analysis of the incidence, char- acteristics, prognostic factors, and out- come of 739 APL patients treated with ATRA plus idarubicin in 2 consecutive trials (Programa Espanol de Tratamientos en Hematologíc [PETHEMA] LPA96 and LPA99). Overall, 183 patients (24.8%) ex- perienced DS, 93 with a severe form (12.6%) and 90 with a moderate form (12.2%). Severe but not moderate DS was associated with an increase in mortality. A bimodal incidence of DS was observed, with peaks occurring in the first and third weeks after the start of ATRA therapy. A multivariate analysis indicated that a WBC count greater than 5 x 109/L and an abnor- mal serum creatinine level correlated with an increased risk of developing severe DS. Patients receiving systematic pred- nisone prophylaxis (LPA99 trial) in con- trast to those receiving selective prophy- laxis with dexamethasone (LPA96 trial) had a lower incidence of severe DS. Pa- tients developing severe DS showed a reduced 7-year relapse-free survival in the LPA96 trial (60% vs 85%, P = .003), but this difference was not apparent in the LPA99 trial

Functional Divergence in the Genus Oenococcus as Predicted by Genome Sequencing of the Newly-Described Species, Oenococcus kitaharae

Oenococcus kitaharae is only the second member of the genus Oenococcus to be identified and is the closest relative of the industrially important wine bacterium Oenococcus oeni. To provide insight into this new species, the genome of the type strain of O. kitaharae, DSM 17330, was sequenced. Comparison of the sequenced genomes of both species show that the genome of O. kitaharae DSM 17330 contains many genes with predicted functions in cellular defence (bacteriocins, antimicrobials, restriction-modification systems and a CRISPR locus) which are lacking in O. oeni. The two genomes also appear to differentially encode several metabolic pathways associated with amino acid biosynthesis and carbohydrate utilization and which have direct phenotypic consequences. This would indicate that the two species have evolved different survival techniques to suit their particular environmental niches. O. oeni has adapted to survive in the harsh, but predictable, environment of wine that provides very few competitive species. However O. kitaharae appears to have adapted to a growth environment in which biological competition provides a significant selective pressure by accumulating biological defence molecules, such as bacteriocins and restriction-modification systems, throughout its genome

La dyspasie ectodermique anhydrotique : à propos d’un cas au Centre Mère et Enfant de la Foundation Chantal Biya, Youndé, Cameroun

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