SHIGELLA DYSENTERIAE AND SH. FLEXNERI SEROTYPE PREVALENCE AND SEASONAL DISTRIBUTION IN ADDIS ABABA, ETHlOPIA

ABSTRACT A total of 945 Shigella strains were isolated from stool specimens received at the National Research Institute of Health, between January 1978 and I£cember 1985. Seven hundred and ftfty-two strains, belonging to Shigella dysenteriae and Sh. flexneri, were further identified to serotype level, and the results analysed in respect to their annual fluctuation over an 8-year period. Their seasonal distributon was also noted. Members of Sh. dysenteriae serotypes constituted 24.3% of total Shigella isolates. Within Sh. dysenteriae serotypes, type 1 followed by type 2 were dominant until 1984, when type 3 predominated. In 1985, types 1,2 and 3 were equally represented. Members of Sh. flexneri comprised 56.3% of total Shigella isolates. Unti11981, type 1 was dominant, followed by types 2 and 4, in that order. Since then, however, type 1 gave way to type 2, as the dominant Shigella flexneri serotype in Addis Ababa area. The internationally rare serotype 5 was encountered only once ,on 1981.Shigella infections were comparatively common during the months of April to June, and around the month of September. Its incidence was lowest at the height of the rainy season (July, August) and during the colder months of the year (December to january). The seasonal fluctuation of Shigella seemed to be influenced more by Sh. flexneri than by Sh. dysenteriae

Study of montelukast in children with sickle cell disease (SMILES): a study protocol for a randomised controlled trial

BACKGROUND: Young children with sickle cell anaemia (SCA) often have slowed processing speed associated with reduced brain white matter integrity, low oxygen saturation, and sleep-disordered breathing (SDB), related in part to enlarged adenoids and tonsils. Common treatments for SDB include adenotonsillectomy and nocturnal continuous positive airway pressure (CPAP), but adenotonsillectomy is an invasive surgical procedure, and CPAP is rarely well-tolerated. Further, there is no current consensus on the ability of these treatments to improve cognitive function. Several double-blind, randomised controlled trials (RCTs) have demonstrated the efficacy of montelukast, a safe, well-tolerated anti-inflammatory agent, as a treatment for airway obstruction and reducing adenoid size for children who do not have SCA. However, we do not yet know whether montelukast reduces adenoid size and improves cognition function in young children with SCA. METHODS: The Study of Montelukast In Children with Sickle Cell Disease (SMILES) is a 12-week multicentre, double-blind, RCT. SMILES aims to recruit 200 paediatric patients with SCA and SDB aged 3-7.99 years to assess the extent to which montelukast can improve cognitive function (i.e. processing speed) and sleep and reduce adenoidal size and white matter damage compared to placebo. Patients will be randomised to either montelukast or placebo for 12 weeks. The primary objective of the SMILES trial is to assess the effect of montelukast on processing speed in young children with SCA. At baseline and post-treatment, we will administer a cognitive evaluation; caregivers will complete questionnaires (e.g. sleep, pain) and measures of demographics. Laboratory values will be obtained from medical records collected as part of standard care. If a family agrees, patients will undergo brain MRIs for adenoid size and other structural and haemodynamic quantitative measures at baseline and post-treatment, and we will obtain overnight oximetry. DISCUSSION: Findings from this study will increase our understanding of whether montelukast is an effective treatment for young children with SCA. Using cognitive testing and MRI, the SMILES trial hopes to gain critical knowledge to help develop targeted interventions to improve the outcomes of young children with SCA. TRIAL REGISTRATION: ClinicalTrials.gov NCT04351698 . Registered on April 17, 2020. European Clinical Trials Database (EudraCT No. 2017-004539-36). Registered on May 19, 2020

Cardiopoietic cell therapy for advanced ischemic heart failure: results at 39 weeks of the prospective, randomized, double blind, sham-controlled CHART-1 clinical trial

Cardiopoietic cells, produced through cardiogenic conditioning of patients' mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort