Primary immunodeficiency in Hong Kong and the use of genetic analysis for diagnosis

Objectives. To review the management of primary immunodeficiency and discuss recent advances in genetic analysis. Design. Retrospective study. Setting. University teaching hospital, Hong Kong. Patients. Children diagnosed with primary immunodeficiency and followed up in the immunology clinic during the period 1988 to 2003. Main outcome measures. Demographic data, co-morbidities and treatment of patients, outcome and complications; identification of disease by genetic mutations. Results. Medical records of a total of 117 patients (72 male, 45 female) diagnosed with primary immunodeficiency in the Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong during the past 15 years (1988-2003) were reviewed. All patients were followed up in the immunology clinic. Some patients had been referred from the private sector or other hospitals for immunological workup. Six categories of primary immunodeficiency were identified: predominantly humoral defect (n=50), predominantly cellular defect (n=22), combined humoral and cellular defect (n=5), phagocytic defect (n=18), complement disorders (n=4), and others (n=18). Although infection was the underlying cause of most co-morbidities and mortality, autoimmune (n=7) and allergic (n=23) manifestations were common. In addition, three patients developed lymphoma. Recent advances in the genetic diagnosis of several types of primary immunodeficiency were also reviewed: X-linked Wiskott-Aldrich syndrome, X-linked chronic granulomatous disease, X-linked agammaglobulinaemia, X-linked lymphoproliferative syndrome, leukocyte adhesion disease type I, and X-linked hyperimmunoglobulin M syndrome. This provides an invaluable means of understanding the molecular basis of primary immunodeficiency and has important clinical applications. Conclusions. Co-morbidities like autoimmune disease and allergic disease are common in patients with primary immunodeficiency and should be carefully evaluated. Likewise, a diagnosis of primary immunodeficiency should be considered when evaluating patients with these conditions. Rapid progress in the field of molecular genetics will enable definite and early diagnosis, and more importantly, potential curative therapy to be administered.published_or_final_versio

Sexuality, Contraception And Unintended Pregnancy Among Female Student Nurses In Calabar, Nigeria

Background – There has been increased concern on human sexuality, especially with respect to contraception and the control of sexually transmissible infections. There is need to identify the sociodemographic characteristics that influence sexual behaviour and contraceptive use among young women. Methods – A descriptive cross sectional study that focused on the socio-demographic characteristics, sexuality, knowledge and use of modern contraceptive technology as well as interventions taken in the event of inadvertent pregnancy was conducted. A structured, close- ended questionnaire was randomly administered to 195 female nursing students with 60, 65 and 70 of them in their first, second and third year respectively. Results – Majority (76.7%) of the students were in the age bracket of 20 – 24years. While 65.6% of them were sexually active, only 54.9% had knowledge of family planning. Condom was the commonest contraceptive used (37.4%) and the main reasons were that of effectiveness (31.8%) and safety (30.3%). There was a significant relationship between respondents with multiple sexual partners and incidence of unwanted pregnancies (p=0.003). The majority (51.2%) of those with unwanted pregnancies resorted to induced abortion. Conclusion – In view of the high prevalence of induced abortion among the respondents, current nursing training programmes need to be reviewed to meet the peculiar reproductive health needs of female student nurses. Key words – Sexuality, Contraception, unintended pregnancy, school of nursing

Quality Of Antenatal Care In Rural Southern Tanzania: A Reality Check.

Counselling on the danger signs of unpredictable obstetric complications and the appropriate management of such complications are crucial in reducing maternal mortality. The objectives of this study were to identify gaps in the provision of ANC services and knowledge of danger signs as well as the quality of care women receive in case of complications. The study took place in the Rufiji District of Tanzania in 2008 and was conducted in seven health facilities. The study used (1) observations from 63 antenatal care (ANC) sessions evaluated with an ANC checklist, (2) self-assessments of 11 Health workers, (3) interviews with 28 pregnant women and (4) follow-up of 12 women hospitalized for pregnancy-related conditions.Blood pressure measurements and abdominal examinations were common during ANC visits while urine testing for albumin or sugar or haemoglobin levels was rare which was often explained as due to a lack of supplies. The reasons for measuring blood pressure or abdominal examinations were usually not explained to the women. Only 15/28 (54%) women were able to mention at least one obstetric danger sign requiring medical attention. The outcomes of ten complicated cases were five stillbirths and three maternal complications. There was a considerable delay in first contact with a health professional or the start of timely interventions including checking vital signs, using a partograph, and detailed record keeping. Linking danger signs to clinical and laboratory examination results during ANC with the appropriate follow up and avoiding delays in emergency obstetric care are crucial to the delivery of coordinated, effective care interventions

Microservice Transition and its Granularity Problem: A Systematic Mapping Study

Microservices have gained wide recognition and acceptance in software industries as an emerging architectural style for autonomic, scalable, and more reliable computing. The transition to microservices has been highly motivated by the need for better alignment of technical design decisions with improving value potentials of architectures. Despite microservices' popularity, research still lacks disciplined understanding of transition and consensus on the principles and activities underlying "micro-ing" architectures. In this paper, we report on a systematic mapping study that consolidates various views, approaches and activities that commonly assist in the transition to microservices. The study aims to provide a better understanding of the transition; it also contributes a working definition of the transition and technical activities underlying it. We term the transition and technical activities leading to microservice architectures as microservitization. We then shed light on a fundamental problem of microservitization: microservice granularity and reasoning about its adaptation as first-class entities. This study reviews state-of-the-art and -practice related to reasoning about microservice granularity; it reviews modelling approaches, aspects considered, guidelines and processes used to reason about microservice granularity. This study identifies opportunities for future research and development related to reasoning about microservice granularity.Comment: 36 pages including references, 6 figures, and 3 table

Optical Astronomy in Post-Apartheid South Africa: 1994 to 2004

The progress of optical astronomy in post-apartheid South Africa is discussed. Particular emphasis is given to the socio-political climate which embraced the idea of a 10-m class telescope as a flagship project that would lead to widespread development in science, technology and education - not only in South Africa, but across the subcontinent.Comment: 19 pages, 5 figures, to appear in: Organizations and Strategies in Astronomy, Vol. 5 (Ed.) A. Heck, Kluwer Acad. Pub

Pharmacological screening of some traditionally-used antimalarial plants from the Democratic Republic of Congo compared to their ecological taxonomic equivalence in Madagascar

Hydro-alcoholic extracts of some plant species growing in two different geographical regions (Democratic Republic of Congo and Madagascar) were evaluated for their inhibitory effects on two malaria parasites strains (P. falciparum FcM29 & P. yoelii subsp nigeriensis) and cytotoxicity towards leukaemia P- 388 cell lines. Results indicate that, the antiplasmodial activity of tested plants varied geographically. Plants growing in continent ecosystem are more active in vitro while their ecological equivalence inhabiting island ecosystems are more active in vivo. It would be conclude that, the development of phytomedicines from plants of different geographical regions selected by bioguided fractionation would allow the populations to reduce the health care cost. The chemotaxonomic approach has also permitted us to detect moderate antiplasmodial activities in Neobegua mahafaliensis, a plant species not previously reported as antimalarial in the traditional medicine knowlegde of Madagascar. The use of a pharmacological property such as the antimalarial activity, in this study, in order to establish genetic filiations between the plants species is an original approach. Keywords: Malaria, medicinal plants, cytotoxicity, Dem. Rep. of Congo, Madagascar, phenotypic marker, genetic filiatio

Women undergoing endovascular thoracoabdominal aortic aneurysm repair differ significantly from their male counterparts preoperatively and postoperatively

OBJECTIVE: A rational approach to the management of aortic aneurysm disease relies on weighing the risk of aneurysm rupture against the complications and durability of operative repair. In men, seminal studies of infrarenal aortic aneurysm disease and its endovascular management can provide a reasoned argument for the timing and modality of surgery, which is then extrapolated to the management of thoracoabdominal aortic aneurysms (TAAAs). In contrast, there is less appreciation for the natural history of TAAA disease in women and its response to therapy. METHODS: We used a retrospective cohort design of women, all men, and matched men, fit for complex endovascular thoracoabdominal aneurysm repair at two large aortic centers. We controlled for preoperative anatomic and comorbidity differences, and assessed technical success, postoperative renal dysfunction, spinal ischemia, and early mortality. Women and matched men were reassessed at follow-up for long-term durability and survival. RESULTS: Assessing women and all men undergoing complex endovascular aortic reconstruction, we demonstrate that these groups are dissimilar before the intervention with respect to comorbidities, aneurysm extent, and aneurysm size; women have a higher proportion of proximal Crawford extent 1, 2, and 3 aneurysms. Matching men and women for demographic and anatomic differences, we find persistent elevated perioperative mortality in women (16%) undergoing endovascular thoracoabdominal aneurysm repair compared with matched men (6%); however, at the 3-year follow-up, both groups have the same survival. Furthermore, women demonstrate more favorable anatomic responses to aneurysm exclusion, with good durability and greater aneurysm sac regression at follow-up, compared with matched men. CONCLUSIONS: Women and unmatched men with TAAA disease differ preoperatively with respect to aneurysm extent and comorbidities. Controlling for these differences, after complex endovascular aneurysm repair, there is increased early mortality in women compared with matched men. These observations argue for a careful risk stratification of women undergoing endovascular thoracoabdominal aneurysm treatment, balanced with women's good long-term survival and durability of endovascular aneurysm repair

Étude de l’activité antifalcemiante et de la thermo- et photo-dégradation des anthocyanes de Centella asiatica, Thomandersia hensii et Maesopsis eminii

Lfactivite antifalcemiante des feuilles de Centella asiatica (L.) Urb. et  Thomandersia hensii De Wild. & T. Durand et des ecorces de la tige de Maesopsis eminii Engl. ; trois plantes utilisees en medicine traditionnelle contre la drepanocytose dans la ville de Kisangani (RD Congo), a ete testee en utilisant le test dfEmmel. Les resultats obtenus ont montre une activite antifalcemiante importante in vitro pour les trois plantes. Cette activite serait due aux anthocyanes. Les concentrations minimales de  normalisation des drepanocytes obtenus sont de lfordre de 8µ/ml pour les anthocyanes de ces trois plantes. Les spectres des anthocyanes ont montre une sensibilite a lumiere UV et a la chaleur indiquant que ces pigments sont instables vis-a-vis de ces deux parametres.c 2013 International Formulae Group. All rights reserved.Mots cles : Drepanocytose, Test dfEmmel, Concentration Minimale de Normalisation, Taux de normalisatio

Intimate partner violence among older Chinese women

Forum Theme: Excellence in Nursing Practice, Education and Research across Life SpanConcurrent Session 1: Family and Community Health: no. CSI-1published_or_final_versio

Evaluation in vitro de l’activité antifalcémiante et effet antioxydant des extraits d’Uapaca heudelotii Baill. (Euphorbiaceae)

En République Démocratique du Congo, comme dans de nombreux pays Africains, la drépanocytose ou anémie SS est l’une des causes majeures de morbidité et de mortalité et constitue un grave problème de Santé Publique. Dans cette partie du continent, la prévalence estimée varie entre 15 et 20% et est parmi les plus élevée en Afrique. En Afrique subsaharienne, plus de 80% d’enfants atteints de l’Anémie SS meurent avant l’âge de cinq ans. A ce jour, bien que quelques moyens thérapeutiques permettent d’améliorer le pronostic de la drépanocytose notamment l’allogreffe, il s’avère que ces moyens sont coûteux et hors de portée des pays pauvres. Les moyens les plus utilisés, notamment les transfusions sanguines répétées, prédisposent les malades à un risque d’infections au VIH/SIDA. Cependant, en RD Congo, plusieurs travaux relatifs à l’utilisation des plantes médicinales contre la drépanocytose ont été rapportés dans la littérature. C’est dans ce cadre que cette étude a été réalisée en vue d’évaluer l’activité antifacémiante des écorces de tige d’Uapaca heudelotii Baill. , une plante médicinale dont la convergence d’utilisation ethnomédicale par l’homme et le bonobo (Pan paniscus) est bien établie, en recourant au test d’Emmel. Les résultats expérimentaux obtenus indiquent un taux de normalisation supérieur à 97% et une nette réduction du taux de méthémoglobine en solution aqueuse. Ceci montre que les extraits totaux méthanoliques d’écorces de tige d’Uapaca heudelotii Baill. possèdent une activité antidrépanocytaire. Ainsi, la pharmacopée des grands singes (Zoopharmacognosie) peut constituer une source des nutraceutiques anti-drépanocytaires.Mots clés: Drépanocytose, Nutraceutiques, Zoopharmacognosie, Uapaca  heudelotii Baill., République Démocratique du Congo