Contributions of pulmonary hypertension to HIV-related cardiac dysfunction

AbstractBackground/AimTo evaluate the prevalence of pulmonary hypertension among patients living with HIV/AIDS and to determine its contribution to cardiac dysfunction.MethodA hospital based cross sectional study was carried out over a 6-month period at the Jos University Teaching Hospital. The subjects were 200 confirmed HIV positive patients, ≥18 years of age who consented to the study. Physical examination, laboratory investigations, 2 dimensional and Doppler echocardiography were conducted on the subjects.ResultsThe mean age of the patients was 38 ± 9 years, and there were 142 females (71%).Females were younger, mean age 36 ± 8 years versus 41 ± 10 years for males (p-value <0.01). The median CD4 cell count was 312 cells/μl, there were no homosexual or intravenous drug user among the subjects.Eight of the subjects had pulmonary hypertension, with a case prevalence of 4%, and this had no relationship to CD4 cell count. Both systolic and diastolic functions were worse in subjects with pulmonary hypertension, with a negative correlation between mean pulmonary arterial systolic pressure (mPASP) and parameters like ejection fraction (r = −0.28, p-value 0.0003), fractional shortening (r = −0.21, p-value 0.003), deceleration time (r = −0.13. p-value 0.09).ConclusionImmune-suppression affects the cardiac function adversely and coexisting pulmonary hypertension contributes to poor systolic and diastolic function in affected patients. The subtle nature of presentation of pulmonary hypertension and other cardiac dysfunctions in HIV/AIDS patients demand a high-index of suspicion and early intervention if detected, to ensure better care for these emerging threats to our patients

Association of HIV-induced immunosuppression and clinical malaria in Nigerian adults

Background: Despite the growing body of evidence on the interaction between HIV and malaria in sub-Saharan Africa, there is a dearth of data on clinical malaria in HIV-infected patients in Nigeria. We determined the burden of clinical malaria in HIV-infected adult Nigerians and further investigated the association between their immunological status and the rates of clinical malaria. Methods: Ninety seven antiretroviral treatment-naïve HIV-infected adults were enrolled in a cross-sectional study from August to December, 2009. The participants had a complete clinical evaluation, thick and thin blood films for malaria parasites and CD4 cell count quantification. Clinical malaria was defined as having fever (temperature ≥ 37.5oC or history of fever within 48 hours) and a malaria parasite density above the median value obtained for subjects with co-existing fever and parasitaemia. Results: Clinical malaria was diagnosed in 10 out of 97 patients (10.3%). Lower CD4 cell counts were associated with increasing rates of clinical malaria which was 0% at CD4 cell count of ≥ 500, 2.6% at 200-499 and 30% a

Classical Kaposi’s Sarcoma in a Nigerian Farmer: A Case Report

Stavovi studenata i učenika o fizici i učenju fizike kao i pristup rješavanju fizikalnih problema istražuju se različitim anketama od kojih su najpoznatije CLASS (engl. Colorado Learning Attitudes about Science Survey) i AAPS (engl. Attitudes and Approaches to Problem Solving). Publicirani rezultati pokazuju da se stavovi studenata, osobito u prvim godinama studija, značajnije razlikuju od stavova stručnjaka. U osječkoj regiji, AAPS anketom su ispitani učenici srednjih škola (343 učenika) kao i studenti tehničkih fakulteta i Odjela za fiziku Sveučilišta u Osijeku (541 student). Dobiveni podaci statistički su analizirani s obzirom na spol i program srednjoškolskog obrazovanja učenika i studenata. Pored toga, izjave u anketi raspodijeljene su u tri kategorije: Primjena konceptualnoga razumijevanja; Strategije rješavanja zadataka; Individualni pristup i odnos pri rješavanju zadataka (motivacija, upornost, samopouzdanje). Dobiveni stavovi ispitanika analizirani su unutar svake od predloženih kategorija. Rezultati statističke analize ne pokazuju značajnu razliku u stavovima učenika i studenata s obzirom na spol, dok razlika postoji kada se analiziraju stavovi prema vrsti srednjoškolskog obrazovanja kao i unutar pojedine kategorije. Prokomentirani su razlozi koji utječu na dobivene rezultate te predložena neka od mogućih rješenja.Attitudes of students about physics and physics learning as well as approach to solving physical problems are explored by various surveys, most notably the CLASS (Learning Discipline on Scientific Research) and AAPS (Attitudes and Problem Solving Approaches). The published results show that attitudes of students, especially in the first years of study, differ significantly from attitudes of experts. In the Osijek region, high school students (343 students) and students of the technical faculty and the Department of Physics of the University of Osijek (541 students) surveyed the AAPS survey. The obtained data were statistically analyzed with regard to gender and secondary education of high school students and technical faculty students. In addition, the statements in the survey are divided into three categories: Applying Conceptual Understanding; Task Solving Strategies; Individual approach and relationship in task solving (motivation, persistence, self-confidence). The attitudes of respondents were analyzed within each of the proposed categories. The results of statistical analysis do not show a significant difference in the attitudes of students and students with regard to gender, whereas there is a difference when analyzing attitudes by type of secondary education as well as within certain categories. There are commented reasons that affect the obtained results and suggested some of the possible solutions

Implications of asymptomatic malaria infections on hematologic parameters in adults living with HIV in malaria-endemic regions with varying transmission intensities

Objectives: HIV and malaria coinfection impacts disease management and clinical outcomes. This study investigated hematologic abnormalities in malaria-asymptomatic people living with HIV (PLHIV) in regions with differing malaria transmission. Methods: Study participants were enrolled in the African Cohort Study: two sites in Kenya, one in Uganda, and one in Nigeria. Data was collected at enrollment and every 6 months. Logistic regression estimated odds ratios for associations between HIV/malaria status and anemia, thrombocytopenia, and leucopenia. Results: Samples from 1587 participants with one or more visits comprising 1471 (92.7%) from PLHIV and 116 (7.3%) without HIV were analyzed. Parasite point prevalence significantly differed across the study sites (P <0.001). PLHIV had higher odds of anemia, with males at lower odds compared to females; the odds of anemia decreased with age, reaching significance in those ≥50 years old. Participants in Kisumu, Kenya had higher odds of anemia compared to other sites. PLHIV had higher odds of leucopenia, but malaria co-infection was not associated with worsened leucopenia. The odds of thrombocytopenia were decreased in HIV/malaria co-infection compared to the uninfected group. Conclusion: Hematological parameters are important indicators of health and disease. In PLHIV with asymptomatic malaria co-infection enrolled across four geographic sites in three African countries, abnormalities in hematologic parameters differ in different malaria transmission settings and are region-specific

2012年から2016年にかけてナイジェリア南東部で検出されたラッサウイルスの遺伝学的解析

Lassa virus (LASV) is endemic in parts of West Africa where it causes Lassa fever (LF), a viral hemorrhagic fever with frequent fatal outcomes. The diverse LASV strains are grouped into six major lineages based on the geographical location of the isolated strains. In this study, we have focused on the lineage II strains from southern Nigeria. We determined the viral sequences from positive cases of LF reported at tertiary hospitals in Ebonyi and Enugu between 2012 and 2016. Reverse transcription-polymerase chain reaction (RT-PCR) showed that 29 out of 123 suspected cases were positive for the virus among which 11 viral gene sequences were determined. Phylogenetic analysis of the complete coding sequences of the four viral proteins revealed that lineage II strains are broadly divided into two genetic clades that diverged from a common ancestor 195 years ago. One clade, consisting of strains from Ebonyi and Enugu, was more conserved than the other from Irrua, although the four viral proteins were evolving at similar rates in both clades. These results suggested that the viruses of these clades have been distinctively evolving in geographically separate parts of southern Nigeria. Furthermore, the epidemiological data of the 2014 outbreak highlighted the role of human-to-human transmission in this outbreak, which was supported by phylogenetic analysis showing that 13 of the 16 sequences clustered together. These results provide new insights into the evolution of LASV in southern Nigeria and have important implications for vaccine development, diagnostic assay design, and LF outbreak management.長崎大学学位論文 学位記番号:博(医歯薬)甲第1107号 学位授与年月日:平成30年12月5日Author: Olamide K. Oloniniyi, Uche S. Unigwe, Sayaka Okada, Mayuko Kimura, Shota Koyano, Yukiko Miyazaki, Michael O. Iroezindu, Nnenna A. Ajayi, Chinedu M. Chukwubike, Nneka M. Chika-Igwenyi, Anne C. Ndu, Damian U. Nwidi, Haruka Abe, Shuzo Urata, Yohei Kurosaki, Jiro YasudaCitation: PLoS Neglected Tropical Diseases, 12(11), e0006971; 2018Nagasaki University (長崎大学)課程博