A versatile platform for generating engineered extracellular vesicles with defined therapeutic properties

1. Download : Download high-res image (144KB)
2. Download : Download full-size image

     

Acceptability of condom promotion and distribution among 10 to 19 year-old adolescents in Mpwapwa and Mbeya rural districts, Tanzania

ABSTRACT: BACKGROUND: The HIV/AIDS pandemic remains a leading challenge for global health. Although condoms are acknowledged for their key role on preventing HIV transmission, low and inappropriate use of condoms persists in Tanzania and elsewhere in Africa. This study assesses factors affecting acceptability of condom promotion and distribution among Tanzanian adolescents. METHODS: Data were collected in 2011 as part of a larger cross-sectional survey on condom use among 10-19 year-olds in Mpwapwa and Mbeya rural districts of Tanzania using a structured questionnaire. Associations between acceptability of condom promotion and distribution and each of the explanatory variables was tested using Chi Square. Multivariate logistic regression model was used to examine independent predictors of the acceptability of condom promotion and distribution using STATA (11) statistical software at 5% significance level. RESULTS: Mean age of the 1,327 adolescent participants (50.5% being males) was 13.5 years (SD=1.4). Acceptance of condom promotion and distribution was found among 37% of the adolescents. Being sexually active and aged 15-19 was the strongest predictor of the acceptability of condom promotion and distribution (OR=7.78, 95% CI 4.65-12.99). Others were; not agreeing that a condom is effective in preventing transmissions of STIs including HIV (OR=0.34, 95% CI 0.20-0.56), being a resident of Mbeya rural district (OR=1.67, 95% CI 1.28-2.19), feeling comfortable being seen by parents/guardians holding/buying condoms (OR=2.20, 95% CI 1.40-3.46) and living with a guardian (OR=1.48, 95% CI 1.08-2.04). CONCLUSION: Acceptability of condom promotion and distribution among adolescents in Mpwapwa and Mbeya rural is low. Effect of sexual activity on the acceptability of condom promotion and distribution is age-dependent and was the strongest. Feeling comfortable being seen by parents/guardians buying or holding condoms, perceived ability of condoms to offer protection against HIV/AIDS infections, district of residence and living arrangements also offered significant predictive effect. Knowledge of these factors is vital in designing successful and sustainable condom promotion and distribution programs in Tanzania. Key words Acceptability, condom promotion and distribution, adolescents, Tanzania.     

Late-onset capsular block syndrome

We describe two patients with late-onset capsular block syndrome who presented 6?years and 4?years, respectively, after cataract surgery and were successfully treated with Nd:YAG capsulotomy.     

Recurrent orbitofrontal cholesterol granuloma: a case report

Orbitofrontal cholesterol granuloma is a rare entity that has a predilection for men in their fourth or fifth decade and occurs almost exclusively within the frontal bone overlying the lacrimal fossa. Surgery by drainage and curettage is virtually curative in all cases and recurrence is very rare. We describe the case of a 77-year-old man with recurrent orbitofrontal cholesterol granuloma 11 years after surgery, presumably due to subtotal curettage. The potential use of an endoscope to aid complete removal of lesion is discussed.     

Obstructive sleep apnea and the incidence and mortality of gastrointestinal cancers: a systematic review and meta-analysis of 5,120,837 participants

BackgroundEmerging evidence has shown higher overall cancer incidence in patients with obstructive sleep apnea. Gastrointestinal cancers, including esophageal, stomach, liver, pancreas, and colorectal cancers account for 26% of incident cancers. However, the link between gastrointestinal cancers and obstructive sleep apnea is still unclear. We performed a systematic review and meta-analysis (registered PROSPERO CRD42021220836) to investigate the association between obstructive sleep apnea and incidence of gastrointestinal cancer.MethodsWe searched four electronic databases (PubMed, Embase, Cochrane Library, Scopus) and included studies published from inception till 15th November 2020 reporting the association of obstructive sleep apnea with gastrointestinal cancer incidence. Extracted data was meta-analyzed in a random-effects model.ResultsA total of seven studies were included, forming a combined cohort of 5,120,837 patients. Studies which adjusted for demographics and comorbidities were included in meta-analysis. Among four studies with 7–11 years of median follow-up, patients with obstructive sleep apnea experienced increased incidence of colorectal cancer (HR 1.70, 95% CI: 1.48–1.96, I²=22%). Pancreatic cancer incidence was nominally increased in three studies (HR 1.36, 95% CI: 0.88–2.09, I²=96), though this was not statistically significant. There was no association between obstructive sleep apnea and liver cancer incidence among three studies (HR 0.99, 95% CI: 0.81–1.22, I²=84). However, the lack of a statistically significant relationship between obstructive sleep apnea and pancreatic cancer in our meta-analysis does not necessarily imply the true absence of an association.ConclusionsAn increased risk of colorectal cancer was seen in patients with obstructive sleep apnea among studies with long-term follow-up. Further research is required to explore the utility of incorporating obstructive sleep apnea screening into colorectal cancer screening guidelines to identify high-risk individuals and to confirm a possible association of obstructive sleep apnea with pancreatic cancer.PROSPERO RegistrationCRD42021220836     

Serum creatinine to absolute lymphocyte count ratio effectively risk stratifies patients who require intensive care in hospitalized patients with coronavirus disease 2019

Patients with preexisting kidney disease or acute kidney injury had poorer outcomes in coronavirus disease 2019 (COVID-19) illness. Lymphopenia was associated with more severe illness. Risk stratification with simple laboratory tests may help appropriate site patients in a cost-effective manner and ease the burden on healthcare systems. We examined a ratio of serum creatinine level to absolute lymphocyte count at presentation (creatinine-lymphocyte ratio, CLR) in predicting outcomes in hospitalized patients with COVID-19. We analyzed 553 consecutive polymerase chain reaction-positive SARS-COV-2 hospitalized patients. Patients with end-stage kidney disease were excluded. Serum creatinine and full blood count (FBC) examination were obtained within the first day of admission. We examined the utility of CLR in predicting adverse clinical outcomes (requiring intensive care, mechanical ventilation, acute kidney injury requiring renal replacement therapy or death). An optimized cutoff of CLR > 77 was derived for predicting adverse outcomes (72.2% sensitivity, and 83.9% specificity). Ninety-seven patients (17.5%) fell within this cut off. These patients were older and more likely to have chronic medical conditions. A higher proportion of these patients had adverse outcomes (13.4% vs 1.1%, P < .001). On receiver operating curve analyses, CLR predicted patients who had adverse outcomes well (area under curve [AUC] = 0.82, 95%CI 0.72–0.92), which was comparable to other laboratory tests like serum ferritin, C-reactive protein and lactate dehydrogenase. Elevated CLR on admission, which may be determined by relatively simple laboratory tests, was able to reasonably discriminate patients who had experienced adverse outcomes during their hospital stay. This may be a simple and cost-effective means of risk stratification and triage.     

SPECIFIC PRECIPITATION AND MOUSE PROTECTION IN TYPE I ANTIPNEUMOCOCCUS SERA

1. A rapid and simple method is given for the approximate determination of the specifically precipitable protein in Type I antipneumococcus sera. 2. It is shown that a close parallel exists between the specifically precipitable protein and the number of mouse protection units in a wide variety of Type I antipneumococcus sera. 3. Owing to the consistent results obtained and the rapidity, simplicity, and economy of the method, its use is proposed instead of the mouse protection test as a basis for the titration of standard sera and the comparison of others with a standard. 4. A method is given for conveniently preparing highly purified specific polysaccharide of Type I pneumococcus.     

A STUDY OF THE MECHANISM OF RECOVERY FROM LOBAR PNEUMONIA

Employing a method devised for the investigation of natural immunity and experimental pneumococcus infection, a study has been made of the serum immune changes occurring during the course of lobar pneumonia due to Pneumococcus Types I and II and Group IV, in man. It was found that at the time of crisis or lysis the blood serum acquired constantly the property of promoting pneumococcus killing to a relatively marked degree. Other evidences of antipneumococcus reaction—mouse protection, opsonins, and agglutinins—were also demonstrable in the blood at this time. These immune changes appeared in the majority of cases at the beginning of recovery and failed to occur when the disease terminated fatally. The fact that these observations in human cases are practically identical with previous findings in the experimental disease in cats, enhances considerably the significance of the development of serum immune bodies at the time of crisis since in the experimental animal it was possible to show that the acquisition of passive immunity was associated with greatly increased antipneumococcus resistance.