APOE E4 is associated with impaired self-declared cognition but not disease risk or age of onset in Nigerians with Parkinson's disease

The relationship between APOE polymorphisms and Parkinson's disease (PD) in black Africans has not been previously investigated. We evaluated the association between APOE polymorphic variability and self-declared cognition in 1100 Nigerians with PD and 1097 age-matched healthy controls. Cognition in PD was assessed using the single item cognition question (item 1.1) of the MDS-UPDRS. APOE genotype and allele frequencies did not differ between PD and controls (p > 0.05). No allelic or genotypic association was observed between APOE and age at onset of PD. In PD, APOE ε4/ε4 conferred a two-fold risk of cognitive impairment compared to one or no ε4 (HR: 2.09 (95% CI: 1.13-3.89; p = 0.02)), while APOE ε2 was associated with modest protection against cognitive impairment (HR: 0.41 (95% CI 0.19-0.99, p = 0.02)). Of 773 PD with motor phenotype and APOE characterized, tremor-dominant (TD) phenotype predominated significantly in ε2 carriers (87/135, 64.4%) compared to 22.2% in persons with postural instability/gait difficulty (PIGD) (30/135) and 13.3% in indeterminate (ID) (18/135, 13.3%) (p = 0.037). Although the frequency of the TD phenotype was highest in homozygous ε2 carriers (85.7%), the distribution of motor phenotypes across the six genotypes did not differ significantly (p = 0.18). Altogether, our findings support previous studies in other ethnicities, implying a role for APOE ε4 and ε2 as risk and protective factors, respectively, for cognitive impairment in PD

The utility of neuroimaging in the management of dementia

Dementia is a syndrome of progressive dysfunction of two or more cognitive domains associated with impairment of activities of daily living. An understanding of the pathophysiology of dementia and its early diagnosis is important in the pursuit of possible disease modifying therapy for dementia. Neuroimaging has greatly transformed this field of research as its function has changed from a mere tool for diagnosing treatable causes of dementia to an instrument for pre-symptomatic diagnosis of dementia. This review focuses on the diagnostic utility of neuroimaging in the management of progressive dementias. Structural imaging techniques like computerized tomography scan and magnetic resonance imaging highlights the anatomical, structural and volumetric details of the brain; while functional imaging techniques such as positron emission tomography, arterial spin labeling, single photon emission computerized tomography and blood oxygen level-dependent functional magnetic resonance imaging focuses on chemistry, circulatory status and physiology of the different brain structures and regions

Evaluating the Impact of Primary Nursing Practice on the Quality of Nursing Care: A Nigerian Study .

NoThis paper is abstracted from an action research project on promoting family-centred care in Nigeria through the practice of Nigerian Primary Nursing (NMPN). This article will present results of comparative evaluation of the impact of primary nursing on the quality of care received by patients in a 37-bedded acute medical-surgical, mixed sex ward in a specialist hospital in eastern Nigeria. A total of 44 nurses' interactions with 10 patients in the pre-NMPN period and 58 nurses' interactions with eight patients in the post-NMPN period were assessed using QUALPACS (Quality Patient Care Scale.). Results showed a significant improvement in the quality of nursing care with primary nursing practice. The greatest improvement in quality of nursing appeared to be in the elements that address the individual needs of the patient, while the smallest improvements were in the area of physical care--elements of routine, technical nursing care. Implications of the study and recommendations for further studies are made

Aetiology of invasive bacterial infection and antimicrobial resistance in neonates in sub-Saharan Africa: a systematic review and meta-analysis in line with the STROBE-NI reporting guidelines

Background: Aetiological data for neonatal infections are essential to inform policies and programme strategies at various levels, but such data are scarce from sub-Saharan Africa. We therefore conducted a systematic review and meta-analysis of available data from the African continent since 1980, with a focus on regional differences in aetiology and antimicrobial resistance (AMR) in the last decade (2008 – 2018). Methods: We included data for microbiologically confirmed invasive bacterial infection including meningitis and AMR among neonates in sub-Saharan Africa and assessed the quality of scientific reporting according to Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI) checklist. We calculated pooled proportions for reported bacterial isolates and AMR. Findings: We included 151 studies comprising data from 84534 neonates from 26 countries, almost all of which were hospital-based. Of the 82 studies published between 2008 and 2018, insufficient details were reported regarding most STROBE-NI items. Regarding culture positive bacteraemia/sepsis, S aureus, Klebsiella spp and E coli accounted for 25% (95% CI 21 – 29%) 21%, (16 – 27%) and 10% (8 – 10%) respectively. For meningitis, the predominant identified causes were Group B streptococcus 25% (16 – 33%), S pneumoniae 17% (9 – 26%), and S aureus 12% (3 – 25%). Resistance to WHO recommended β-lactams was reported in >68% of 904 cases and to aminoglycosides in 27% of 1176 cases. Interpretation: Hospital-acquired neonatal infections and AMR are a major burden in Africa, and improved surveillance is required. More population-based neonatal infection studies are also needed, and all studies should be reported according to standardised reporting guidelines, such as STROBE-NI to aid comparability and reduce research wastage