Treatment of hypertension in rural Cambodia: results of a 6-year programme

This study was aimed to describe the outcomes of a hypertension treatment programme in two outpatient clinics in Cambodia. We determined proportions of patients who met the optimal targets for blood pressure (BP) control and assessed the evolution of mean systolic and diastolic BP (SBP/DBP) over time. Multivariate analyses were used to identify predictors of BP decrease and risk factors for LTFU. A total of 2858 patients were enrolled between March 2002 and June 2008 of whom 69.2% were female, 30.5% were aged >/=64years and 32.6% were diabetic. The median follow-up time was 600 days. By the end of 2008, 1642 (57.4%) were alive-in-care, 8 (0.3%) had died and 1208 (42.3%) were lost to follow-up. On admission, mean SBP and DBP were 162 and 94 mm Hg, respectively. Among the patients treated, a significant SBP reduction of 26.8 mm Hg (95% CI: 28.4-25.3) was observed at 6 months. Overall, 36.5% of patients reached the BP targets at 24 months. The number of young adults, non-overweight patients and non-diabetics reaching the BP targets was more. Older age (>64 years), uncontrolled DBP (>/=90 mm Hg) on last consultation and coming late for the last consultation were associated with LTFU, whereas non-diabetic patients were 1.5 times more likely to default than diabetics (95% CI: 1.3-1.7). Although the definite magnitude of the BP decrease due to antihypertension medication over time cannot be assessed definitely without a control group, our results suggest that BP reduction can be obtained with essential hypertension treatment in a large-scale programme in a resource-limited setting

Effects of HLA single chain trimer design on peptide presentation and stability

MHC class I “single-chain trimer” molecules, coupling MHC heavy chain, β2-microglobulin, and a specific peptide into a single polypeptide chain, are widely used in research. To more fully understand caveats associated with this design that may affect its use for basic and translational studies, we evaluated a set of engineered single-chain trimers with combinations of stabilizing mutations across eight different classical and non-classical human class I alleles with 44 different peptides, including a novel human/murine chimeric design. While, overall, single-chain trimers accurately recapitulate native molecules, care was needed in selecting designs for studying peptides longer or shorter than 9-mers, as single-chain trimer design could affect peptide conformation. In the process, we observed that predictions of peptide binding were often discordant with experiment and that yields and stabilities varied widely with construct design. We also developed novel reagents to improve the crystallizability of these proteins and confirmed novel modes of peptide presentation

An Overview of the Medicine and Humanities International Program, an International Educational Initiative

International audienceBackground: In a changing world, with increasing disparity, health care burden, and innovation, medical students are benefiting from a well-rounded, collaborative, and humanistic style of medicine, in order to stay grounded, flexible, and resilient. We present the first Medicine and Humanities International Program (MHIP). The medical faculties of Lyon University (France), Ottawa University (Canada), Shanghai University of Traditional Chinese Medicine (China) and Shanghai Jiao Tong University (China) established a professional partnership in 2016, with the purpose of raising awareness for medical humanities.Method: The first MHIP Summer School was held in Ottawa in July 2017. It introduced a variety of course work, group activity, and experiential learning, allowing students to work together to address the role of humanities within medicine, as ell as critically thinking upon the social determinants of health and its impact on health. The 2017 Summer School gathered 7 students. The themes included the history of medicine, philosophy, arts, literature and the humanities. Students also earned about Traditional Chinese Medicine (TCM) and its holistic approach towards healthcare. Survey responses were collected from each course, to collect information on student experience and preliminary results show strong satisfaction with highlights on the cultural richness of the experience. Results: This school allowed students and instructors to forge long-lasting professional networks, paving the way for research, work collaboration, and increased learning. This was represented by work done by three medical students, in their 8-week project in Shanghai, conducting an observational field report and comparison of the medical curricula across the four medical faculties and writing a report for each faculty. Opportunities for clinical exchange internships were also created. The next Summer School will be organized in Lyon in July 2018, adding a fifth faculty (Saint-Etienne, France) to the MHIP. Conclusion: The MHIP is an opportunity to explore new approaches to medical training, as well as new educational methods that could be implemented in medical curricula. This school promotes intercultural exchange, professional collaboration, and learning between future physicians and researchers from across the world

Effects of HLA single chain trimer design on peptide presentation and stability.

MHC class