Malaria in pregnancy and its consequences for the infant in rural Malawi

Maternal malaria and anaemia, pregnancy and infant outcomes are reviewed among a cohort of mothers and their babies living in Chikwawa district, southern Malawi. Overall, 4104 women were screened at first antenatal visit and 1523 at delivery. Factors independently associated with moderately severe anaemia (MSA; < 8 g haemoglobin/dl) in primigravidae were malaria (relative risk = 1.9; 95% confidence interval = 1.6-2.3) and iron deficiency (relative risk = 4.2; 95% confidence interval = 3.5-5.0). Only iron deficiency was associated with MSA in multigravidae. After controlling for antimalarial use, parasitaemia was observed in 56.3% of the HIV-infected primigravidae and 36.5% of the non-infected (P = 0.04). The corresponding figures for multigravidae were 23.8% and 11.0%, respectively (P = 0.002). Over 33% of the infants born alive to primigravidae were of low birthweight (LBW; < 2500 g), and 23.3% of all newborns had foetal anaemia (< 12.5 g haemoglobin/dl cord blood). LBW was significantly associated in primigravidae with pre-term delivery, placental malaria and frequency of treatment with sulfadoxine-pyrimethamine (SP), and in multigravidae with pre-term delivery, adolescence, short stature and MSA. LBW was significantly reduced with a second SP treatment in primigravidae, and with iron-folate supplementation in multigravidae. Mean haemoglobin concentrations were significantly lower in the infant who had been LBW babies than in the others, and significantly associated with parity, peripheral parasitaemia at delivery and placental malaria. At 1 year post-delivery, life status was known for 364 (80.7%) of the 451 infants enrolled in the follow-up study. Independent risk factors for post-neonatal mortality were maternal HIV infection, LBW, and iron deficiency at delivery. This study identifies priorities for improving the health of pregnant women and their babies in this rural area of Malawi.     

Real and pseudo late asthmatic reactions after submaximal exercise challenge in patients with bronchial asthma. A new definition for late asthmatic responses after exercise challenge

The late asthmatic reaction after exercise challenge remains a controversial issue. In this study, 21 patients recorded peak expiratory flow rate (PEFR) on two control days without performing exercise. There was no difference between both control days when PEFR at 1 h was compared with baseline PEFR and when PEFR at 4 to 13 hours was compared with baseline PEFR. After analyzing variation coefficients of baseline PEFR on a control day and exercise day, PEFR was not allowed to differ more than 15.3 percent in the same patient when comparing exercise day and control day for the late fall in PEFR in the study. In 17 of 81 patients, a late asthmatic reaction after exercise challenge was present when PEFR fall was greater than or equal to 20 percent compared with baseline PEFR value. In eight of the 17 patients, a real late asthmatic reaction to exercise challenge was present with a PEFR fall greater than or equal to 20 percent on at least three successive time points and who had a PEFR fall greater than or equal to 20 percent compared with corresponding clocktime on a control day. The late asthmatic reaction to exercise challenge is characterized not as a nonspecific epiphenomenon, but as a fall in PEFR of greater than or equal to 20 percent compared with baseline PEFR value and with corresponding clocktime on a control day on at least three successive time points. Graphic illustration of airway responses following exercises may facilitate the detection of a late asthmatic response.     

隐神经-大隐静脉营养血管远端蒂复合瓣移植修复小腿、踝足部创伤

目的:在显微解剖学基础上,观察隐神经-大隐静脉营养血管远端蒂复合瓣移植修复小腿、踝足部创伤的临床效果。方法:选择2004-05/2007-04由解放军南京军区福州总医院骨科、解放军第97医院骨科、解放军第107医院骨科采用隐神经-大隐静脉营养血管远端蒂复合瓣移植修复小腿、踝足部组织缺损48例,患者对治疗均知情同意。其中皮瓣修复小腿、踝周及足部的创面感染、缺损23例;肌皮瓣修复小腿上段、下段的溃疡、骨髓炎和骨钢板外露12例,跟骨内侧骨髓炎5例;骨皮瓣修复伴有胫骨缺损和跟骨骨不连的创面8例。术后定期随访,观察隐神经-大隐静脉营养血管远端蒂皮瓣移植修复术后的存活情况及骨皮瓣的骨愈合、功能情况。结果:48例患者术后均有程度不同的皮瓣肿胀,其中3例皮瓣远侧边缘少量坏死,经换药愈合;皮瓣部分坏死植皮1例。伤口Ⅰ期愈合44例,Ⅱ期愈合4例。所有病例经5￣15个月随访,创面及骨不连修复,外形满意。结论:隐神经-大隐静脉营养血管远端蒂皮瓣、复合瓣用于外伤造成的小腿远端骨缺损、骨不连、大的死腔以及踝足部的缺损创面修复,具有快捷方便,抗感染力强,成活率高和愈合快的优点。     

A novel long non-coding RNA regulates the integrin,ITGA2 in breast cancer

Breast Cancer Research and Treatment - ITGA2 encodes the integrin, α2 which mediates metastatic progression, and is a predictor of poor prognosis and chemoresistance in breast cancer....