Liver stem cells: prospects for treatment of inherited and acquired liver diseases

It is now understood that there are three cell compartments which physiologically contribute to vertebrate liver parenchymal maintenance and regeneration after injury: mature liver cells (hepatocytes, cholangiocytes), intraorgan stem/progenitor cells (cells of the proximal biliary tree, periductal cells) and extraorgan stem cells (from the circulation and the bone marrow). All of these cell populations, as well as other, non-physiologic stem cells (e.g., mesenchymal stromal cells from the bone marrow, fetal hepatoblasts, embryonic stem [ES] cells), may be used therapeutically for treatment of inherited and acquired liver diseases. This article will summarise our current understanding of these various cell populations, and review possible approaches to their therapeutic use, including cell transplantation, bioartificial liver devices (BLDs), gene therapy and administration of exogenous factors to stimulate normal physiological responses to repair.     

Parental Depression and Associations with Parenting and Children’s Physical and Mental Health in a Sub-Saharan African Setting

Depression is one of the most prevalent mental health challenges in low- and middle-income countries. However, the mechanisms of parental depression on children’s development are understudied in these countries. This study examined the prevalence of parental depression, contextual predictors of parental depression, and the associations between parental depression, parenting and children’s development in one of the Sub-Saharan African countries-Uganda. Three hundred and three Ugandan parents of young children were recruited and interviewed. Results indicated that about 28 % of parents were depressed. Contextual factors such as low educational attainment, food insecurity, low social support, and high number of children were associated with parental depression. Structural equation modeling also indicated that Ugandan parents’ depression was associated with less optimal parenting, and higher problem behavior, lower social competence, and poorer physical health and school functioning in children. Results provide several cross cultural consistency evidence in associations among parental depression, parenting, and child development.     

Severe malaria in children in Papua New Guinea

The clinical features of severe falciparum malaria and risk factors for mortality were studied in 489 children admitted with malaria to Madang Hospital, Papua New Guinea. The most common severe manifestations of malaria were severe anaemia (22%) and coma (16%). Children with severe anaemia were younger than those with coma (median age 2.2 vs. 3.7 years) and had been ill for longer before admission (median 7 vs. 4 days, respectively). Although the clinical features of coma in Madang children with malaria resembled closely those reported in African children, mortality was lower (8% vs. 17-25%, respectively). Overall, 17 (3.5%) children died, most within 12 h of admission. A high level of plasma lactate (> or = 5 mmol/l) was common (20%) and was the major predictor of death in multiple regression analysis. Raised plasma creatinine and decreased plasma bicarbonate were also independent predictors of mortality. Coma was not predictive of death, although a high proportion of children with profound coma died. Investigation of the causes of acidosis in children with malaria is a high research priority. In view of the short time interval between admission and death in many children, emphasis must be placed on the prevention or early recognition and treatment of acidosis in the district health clinic as well as the central hospital.