Gestational Diabetes in Melanesia and Appropriateness of Current Screening and Diagnostic Tests

Abstract@#In low-resource settings such as Melanesia, gestational diabetes often goes undiagnosed due to many factors, including the unsuitability of current tests. Ideally a gestational diabetes test for low-resource settings should meet criteria related to acceptability, test performance and operational characteristics, with minimal impositions on individual patients or the wider health system. None of the six tests recommended in country-specific gestational diabetes guidelines in Melanesia (2-hour oral glucose tolerance test, glucose challenge test, fasting plasma glucose, random plasma glucose, 2-hour postprandial glucose and glycated haemoglobin) meet criteria related to these attributes. Additionally, each Melanesian country has different, complex algorithms that use multiple tests in different combinations. With a high and increasing burden of diabetes mellitus (and therefore assumed gestational diabetes), Melanesian health practitioners and policymakers should be aware of the limitations of recommended tests for gestational diabetes and be open to alternative technologies that may be more appropriate.

An Experimental Study of Oral Mucosal Wound Healing following Scalpel and Diode Laser Incisions in Guinea Pigs: Clinical and Histological Observations

Introduction: The available data regarding scalpel and diode laser incisions wound healing is variable, scarce and needs more clarification especially in normal healthy tissues. Hence, this study was aimed to evaluate clinical and histologic parameters of wound healing with scalpel and diode laser on oral mucosa of Guinea pigs. Materials and Methods: This is an experimental study conducted on four male Guinea pigs. Laser and scalpel incisions were made on the right buccal mucosa of each guinea pig approximately 5mm deep and 10 mm in length and both the incisions were placed 10 mm apart using No#11Bard Parker blades and diode laser (640 wavelength) under general anesthesia. Punch biopsies of both the incisions were obtained and compared for clinical changes such as ease of working, intra-operative bleeding, color and approximation of wound edges and histological changes such as epithelial proliferation, inflammation, angiogenesis, and fibrosis on day 1, 3 and 7. Results: Clinically, scalpel wounds showed better healing than laser wounds although laser incisions provided bloodless surgical field. There was no significant difference in inflammation, angiogenesis and fibrosis between scalpel and diode laser incisions on both day 3 and 7 except for the epithelization which was comparatively early and better in scalpel wounds than the diode laser wounds. Conclusion: Diode lasers provide bloodless surgical field with better visibility than scalpel without any difference in oral mucosal wound healing. Considering the clinical benefits, the diode lasers could be a superior alternative to conventional scalpel technique.

Inhibitory effect of blue light intervention on lens-induced myopia development in guinea pigs and the mechanism of cone density change / 中华实验眼科杂志

Objective:To observe the effects of blue light intervention on the development of optical defocus-induced myopia in guinea pigs and investigate its underlying mechanisms.Methods:Forty-eight normal-grade two-week-old tricolor guinea pigs were randomly divided into a blue light group and a white light group, with 24 animals in each group.The right eye of guinea pigs was fitted with a -5.00 D lens to establish an optical defocus model as the experimental eye, while the left eye served as the control without any covering.Before the experiment and after 8-week intervention, the refractive power of guinea pigs was measured by streak retinoscopy.The anterior chamber depth, lens thickness, and axial length were measured by A-scan ultrasonography.Corneal curvature radius was determined using a keratometer.After 8-week intervention, the guinea pigs were euthanized through overanesthesia, and the right eyeballs were enucleated and the retinas were isolated.The density of S and M cone cells of the guinea pig retinal sections were observed via immunofluorescence staining.The expression of retinal retinoic acid was assessed by high-performance liquid chromatography.The expressions of retinoic acid receptor (RAR-β) in the retina and matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase-2 (TIMP-2), and type Ⅰ collagen in the sclera were detected by real-time fluorescence quantitative PCR.Changes in scleral thickness were observed through hematoxylin-eosin staining.The use and care of the animals complied with Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.The study protocol was approved by the Ethics Committee of Eye and ENT Hospital of Fudan University (No.2022ETKLD10032).Results:After 8 weeks of intervention, guinea pigs in the blue light group showed (0.63±0.12)D of relative hyperopia and a deceleration of axial elongation by (0.08±0.00)mm compared with the white light group in the right eye.In the left eye, guinea pigs in the blue light group showed (0.42±0.09)D of relative hyperopia and a deceleration of axial elongation by (0.08±0.00)mm compared with the white light group.The guinea pigs in blue light group showed (1.52±0.09)D of myopia in the right eye compared with the left eye, with an increase in axial elongation of (0.06±0.00)mm.The guinea pigs in white light group showed (1.66±0.07)D of myopia in the right eye compared with the left eye, with an increase in axial elongation of (0.13±0.00)mm, and the differences were statistically significant (all at P<0.05). The density of M cone cells was lower and density of S cone cells was higher in the blue light group in the dorsal and ventral sides of the retinal sections compared with the white light group, showing statistically significant differences ( t=32.33, 52.23, 42.09, 25.02; all at P<0.05). The deceleration of myopia progression in the blue light group was strongly positively correlated with the increase in S cone cell density on the ventral side ( r=0.95, P<0.01). The expression levels of retinoic acid, RAR-β, and MMP-2 were decreased, and expression levels of TIMP-2 and type Ⅰ collagen were increased in blue light group compared with the white light group, showing statistically significant differences ( t=18.73, 7.45, 3.72, 6.19, 9.03; all at P<0.05). The scleral thickness in the blue light group was (125.0±7.8)μm, which was significantly thicker than (102.0±6.3)μm in the white light group ( t=26.93, P<0.05). Conclusions:Blue light intervention can inhibit the progression of defocus-induced myopia in guinea pigs.Refractive power changes in guinea pigs may be influenced by alterations in retinal cone cell density, retinoic acid expression, and scleral collagen expression.

Digital measurement of corneal curvature and eccentricity of guinea pigs using Python / 中华实验眼科杂志

Objective:To investigate an accurate and quantitative method to measure the eyeball morphological parameters of guinea pigs through a method that combines programmed digital techniques and mathematical geometric principles.Methods:Twenty-two three-week-old clean-grade male tricolor guinea pigs were selected and sacrificed by anesthesia overdose.Eyeballs were enucleated.The horizontal and sagittal images of the eyeball were taken with the high-speed photographic model of 13 million pixels macro meter, and the pictures were imported into pycharm programming software.Using the pre-written analysis program of Python 3.9, the conversion coefficient between the photo pixel and the actual length was obtained by a scale, and then the corneal surface was fitted by arc fitting and conic curve fitting.The results of arc fitting were converted to calculate the corneal radius of curvature.The corneal eccentricity was calculated according to the general conic equation (Ax 2+ Bxy+ Cy 2+ Dx+ Ey+ F=0). The corneal asphericity was evaluated by curve fitting between the central 3-mm and the whole cornea.The use and care of the animals complied with Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.The study protocol was approved by the Ethics Committee of Shanghai Public Health Clinical Center (No.2022-A009-01). Results:The digital method of Python programming can show the corneal contour of guinea pigs completely and clearly.In the transverse plane, there was no significant difference in the corneal curvature measurements among the digital fitting in central 3-mm cornea, digital fitting in whole cornea and curvature meter ( F=1.693, P=0.190). In the sagittal plane, there was a significant difference in the corneal curvature measurements among the three methods ( F=3.500, P=0.030), and the corneal curvature measurements of the whole cornea measured by the curvature meter were significantly greater than those measured by the digital fitting ( P<0.05). There was no statistical significance in the measurements of corneal curvature radius among the three methods in the transverse plane and the sagittal plane ( F=1.817, P=0.170; F=2.050, P=0.133). The horizontal and sagittal corneal eccentricity measured by digital fitting in central 3-mm cornea were 0.55±0.15 and 0.53±0.17, which were lower than 0.66±0.10 and 0.64±0.14 measured by digital fitting in whole cornea, and the differences were statistically significant ( t=-4.860, -5.210; both at P<0.01). Conclusions:It is feasible to use Python programming digital method to measure the corneal curvature and eccentricity of guinea pigs.

Effects of traditional korean medicine Lurong Dabu Decoction on TLR4/WNT-5A signaling pathway in guinea pigs with cough variant asthma / 中国药理学通报

Aim To discuss the mechanism of Lurong Dabu Decoction on cough variant asthma. Methods Guinea pigs were divided into normal group(CON), model group(OVA), Lurong Dabu Decoction high-dose group(HIGH),low-dose group(LOW), and dexamethasone group(DEX)at random. The CVA model was established by smoking plus injection of OVA, aluminum hydroxide solution and nebulized inhalation to stimulate cough. Gguinea pigs were dissected 24 hours after the last challenge to obtain alveolar lavage fluid(BALF)and lung tissues. Immunoadsorption(ELISA)method was applied to detect the types of inflammatory cells and the content of inflammatory cytokines in BALF; HE and Masson staining of the middle lobe of the left lung were used to observe the pathological changes in lung tissues; immunohistochemical staining was used to observe TLR4 and WNT-5A protein expression and distribution of lung tissues; the protein extracted from the upper lobe of the left lung was used to measure the level of TLR4 and WNT-5A protein in lung tissues by Western blot; immunofluorescence was employed to measure the fluorescence intensity of TLR4 and WNT-5A in lung tissues; flow cytometry was used to detect IL-4 and IFN-γ in guinea pig lung tissues. Results Lurong Dabu Decoction could improve guinea pig airway inflammation, inhibit collagen fiber deposition, reduce the content of IL-4, IL-5, and IL-13 in BALF, and inhibit the protein expression of TLR4 and WNT-5A in lung tissues and increase IFN-γ levels in lung tissues while decreasing IL-4 levels. Conclusion Lurong Dabu Decoction may inhibit the occurrence of CVA through TLR4/WNT-5A signaling pathway.

Single - nucleotide polymorphisms of artemisinin resistance - related Pfubp1 and Pfap2mu genes in Bioko Island, Equatorial Guinea from 2018 to 2020 / 中国血吸虫病防治杂志

Objective To investigate the prevalence of single nucleotide polymorphisms (SNPs) of artemisinin resistance-related Pfubp1 and Pfap2mu genes in Plasmodium falciparum isolates from Bioko Island, Equatorial Guinea, so as to to provide baseline data for the formulation of malaria control strategies in Bioko Island. Methods A total of 184 clinical blood samples were collected from patients with P. falciparum malaria in Bioko Island, Equatorial Guinea from 2018 to 2020, and genomic DNA was extracted. The Pfubp1 and Pfap2mu gene SNPs of P. falciparum were determined using a nested PCR assay and Sanger sequencing, and the gene sequences were aligned. Results There were 159 wild-type P. falciparum isolates (88.83%) from Bioko Island, Equatorial Guinea, and 6 SNPs were identified in 20 Pfubp1-mutant P. falciparum isolates (11.17%), in which 4 non-synonymous mutations were detected, including E1516G, K1520E, D1525E, E1528D. There was only one Pfubp1gene mutation site in 19 Pfubp1-mutant P. falciparum isolates (95.00%), in which non-synonymous mutations accounted for 68.42% (13/19). D1525E and E1528D were identified as major known epidemic mutation sites in the Pfubp1 gene associated with resistance to artemisinin-based combination therapies (ACTs). At amino acid position 1525, there were 178 wild-type P. falciparum isolates (99.44%) and 1 mutant isolate (0.56%), with such a mutation site identified in blood samples in 2018, and at amino acid position 1528, there were 167 wild-type P. falciparum isolates (93.30%) and 12 mutant isolates (6.70%). The proportions of wild-type P. falciparum isolates were 95.72% (134/140), 79.25% (126/159) and 95.83% (161/168) in the target amplification fragments of the three regions in the Pfap2mu gene (Pfap2mu-inner1, Pfap2mu-inner2, Pfap2mu-inner3), respectively. There were 16 different SNPs identified in all successfully sequenced P. falciparum isolates, in which 7 non-synonymous mutations were detected, including S160N, K199T, A475V, S508G, I511M, L595F, and Y603H. There were 7 out of 43 Pfap2mu-mutant P. falciparum isolates (16.28%) that harbored only one gene mutation site, in which non-synonymous mutations accounted for 28.57% (2/7). For the known delayed clearance locus S160N associated with ACTs, there were 143 wild-type (89.94%) and 16 Pfap2mu-mutant P. falciparum isolates (10.06%). Conclusions Both Pfubp1 and Pfap2mu gene mutations were detected in P. falciparum isolates from Bioko Island, Equatorial Guinea from 2018 to 2020, with a low prevalence rate of Pfubp1 gene mutation and a high prevalence rate of Pfap2mu gene mutation. In addition, new mutation sites were identified in the Pfubp1 (E1504E and K1520E) and Pfap2mu genes (A475V and S508G).

Effect of Dahuang Lingxian prescription on the scf/c-kit signaling pathway in gallbladder interstitial cells of Cajal in a guinea pig model of cholesterol gallstone / 临床肝胆病杂志

Objective To investigate the expression levels of scf and c-kit under the regulation of Dahuang Lingxian prescription and the possible mechanism of its effect on gallbladder dynamics, and to provide a theoretical basis for Dahuang Lingxian prescription in preventing the development and recurrence of cholesterol gallstone. Methods A total of 45 specific pathogen-free healthy male guinea pigs were randomly divided into normal group, model group, and traditional Chinese medicine (TCM) group. The guinea pigs in the normal group were fed with normal diet, and those in the model group and the TCM group were fed with high-fat lithogenic diet. After 8 weeks of feeding, 5 guinea pigs were randomly selected from each group, and successful modeling was determined if gallstone was observed with the naked eye in more than 4 guinea pigs. After successful modeling, the guinea pigs in the TCM group were given Dahuang Lingxian prescription by gavage, and those in the model group were given an equal volume of normal saline by gavage. After 8 consecutive weeks of administration by gavage, gallbladder tissue samples were collected, and HE staining was used to observe the pathological changes of gallbladder tissue; Western blot was used to measure the expression level of tumor necrosis factor-α (TNF-α) in gallbladder tissue; immunohistochemistry was used to measure the protein expression levels of scf and c-kit in gallbladder smooth muscle tissue. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference multiple comparison method was used for further comparison between two groups. Results HE staining showed marked inflammation of gallbladder tissue in the model group, and compared with the model group, the TCM group had a significantly lower degree of inflammation. Western blot showed that the model group had the highest expression level of TNF-α in gallbladder tissue, followed by the TCM group and the normal group ( P < 0.05); immunohistochemistry showed that compared with the model group, the normal group and the TCM group had significantly higher protein expression levels of scf and c-kit in gallbladder smooth muscle tissue ( P < 0.05). Conclusion Dahuang Lingxian prescription can enhance the dynamic function of the gallbladder, possibly by upregulating the scf/c-kit signaling pathway in interstitial cells of Cajal in gallbladder.

Advances in experimental myopic guinea pig models / 国际眼科杂志(Guoji Yanke Zazhi)

The prevalence of myopia is increasing year by year, seriously affecting the public's quality of life. To date, various animal models of myopia have been established to explore the pathogenesis of myopia. Guinea pigs have obvious advantages in myopia research. At present, guinea pigs are the most common myopia animal model in Asian laboratories, but different modeling methods have their own advantages and disadvantages. Understanding different modeling methods is conducive to selecting appropriate animal models and matching different research purposes, which makes the research results more persuasive. In this paper, the different modeling methods and characteristics of guinea pig myopia model in recent years, as well as the changes of ocular histomorphology in guinea pigs are briefly reviewed, with a view to providing some reference for further study of the molecular mechanism of myopia occurrence and development and finding new treatment strategies.

Spatial and temporal analysis of tuberculosis incidence in Guinea-Bissau, 2018 to 2020 / Análisis espacial y temporal de la incidencia de tuberculosis en Guinea-Bissau, 2018 a 2020 / Análise espacial e temporal da incidência da tuberculose em Guiné-Bissau, 2018 a 2020

ABSTRACT Objective: to analyze the epidemiological profile, spatial and temporal distribution of tuberculosis in Guinea-Bissau from 2018 to 2020. Methods: an ecological study, carried out in Guinea-Bissau, considering new cases of tuberculosis. Spatial analysis of areas was used to verify tuberculosis distribution in the country, and time series were used to identify incidence evolution over the years of study. Results: a total of 6,840 new cases of tuberculosis were reported. Tuberculosis incidence rate in the country ranged from 36.8 to 267.7 cases/100,000 inhabitants, with emphasis on the regions of Bissau and Biombo (over 90 cases/100,000). By using time series, it was possible to observe an increase in case incidence over the years of study. Conclusions: the study made it possible to identify the epidemiological profile of tuberculosis in Guinea-Bissau, spatial distribution heterogeneity, in addition to identifying the disease evolution over the years of investigation.

RESUMEN Objetivo: analizar el perfil epidemiológico, distribución espacial y temporal de la tuberculosis en Guinea-Bissau, de 2018 a 2020. Métodos: estudio ecológico, realizado en Guinea-Bissau, considerando nuevos casos de tuberculosis. Se utilizó análisis espacial de áreas para verificar la distribución de la tuberculosis en el país y series de tiempo para identificar la evolución de la incidencia a lo largo de los años de estudio. Resultados: se notificaron 6.840 nuevos casos de tuberculosis. La tasa de incidencia de tuberculosis en el país varió de 36,8 a 267,7 casos/100.000 habitantes, con énfasis en las regiones de Bissau y Biombo (más de 90 casos/100.000). Con el uso de series de tiempo, fue posible observar un aumento en la incidencia de casos a lo largo de los años del estudio. Conclusiones: el estudio permitió identificar el perfil epidemiológico de la tuberculosis en Guinea-Bissau, la heterogeneidad de la distribución espacial, además de identificar la evolución de la enfermedad a lo largo de los años de investigación.

RESUMO Objetivo: analisar o perfil epidemiológico, a distribuição espacial e temporal da tuberculose em Guiné-Bissau, no período de 2018 a 2020. Métodos: estudo ecológico, realizado em Guiné-Bissau, considerando os casos novos de tuberculose. Empregaram-se análise espacial de áreas, para verificar a distribuição da tuberculose no país, e séries temporais, para identificar a evolução da incidência ao longo dos anos de estudo. Resultados: foram notificados 6.840 casos novos de tuberculose. A taxa de incidência da tuberculose no país variou de 36,8 a 267,7 casos/100.000 habitantes, com destaque para as regiões de Bissau e Biombo (superior a 90 casos/100.000). Com o uso de séries temporais, foi possível observar um aumento na incidência dos casos ao longo dos anos do estudo. Conclusões: o estudo permitiu identificar o perfil epidemiológico da tuberculose em Guiné-Bissau, a heterogeneidade da distribuição espacial, além de identificar a evolução da doença ao logo dos anos de investigação.

Cotidiano de pessoas que vivem com VIH em Bissau, Guiné-Bissau: perspectivas, desafios e vulnerabilidades / Vida diaria de las personas que viven con VIH en Bissau, Guinea-Bissau: perspectivas, desafíos y vulnerabilidades / The daily life of people living with HIV in Bissau, Guinea-Bissau: perspectives, challenges and vulnerabilities

RESUMO Objetivo compreender as perspectivas e desafios no cotidiano de pessoas após a descoberta do viver com VIH em Bissau, Guiné-Bissau, tendo em vista diferentes contextos de vulnerabilidade. Método estudo exploratório-descritivo, que utilizou entrevista semiestruturada com 16 pessoas vivendo com VIH, acompanhadas em um hospital de Bissau. Empregou-se técnica de análise de conteúdo temática. Os relatos dos participantes foram analisados a partir de duas categorias empíricas: A descoberta, os impactos e os desafios de viver com VIH; e Experiência com o antirretroviral: recomeço e perspectivas. Resultados sinalizaram que os desafios iniciam com a revelação do diagnóstico que, geralmente, desperta uma diversidade de sentimentos e comportamentos. O estigma e a discriminação estimulam a adoção do sigilo sobre o status sorológico, resultando na fragilidade de suporte emocional no enfrentamento à soropositividade. A terapia antirretroviral foi vislumbrada como esperança para o enfrentamento da doença. A vulnerabilidade social foi a dimensão que mais se destacou, e violações dos direitos humanos foram constatadas. Conclusão e implicações para a prática o estudo permite compreender as perspectivas, desafios e vulnerabilidades de pessoas que vivem com VIH. O viver com VIH merece atenção especial por parte dos profissionais de saúde que atuam no cuidado dessas pessoas, destacando-se como contribuição a relevância de um cuidado de saúde integral, em que a ética e a subjetividade estejam presentes.

RESUMEN Objetivo este estudio cualitativo tuvo como objetivo comprender perspectivas y desafíos en la vida cotidiana de las personas que viven con VIH en Bissau, Guinea-Bissau, considerando diferentes contextos de vulnerabilidad. Método estudio exploratorio-descriptivo, que utilizó una entrevista semiestructurada con 16 personas que viven con el VIH, seguido en un hospital de Bissau. Se utilizó la técnica de análisis de contenido temático. Los informes de los participantes se analizaron a partir de dos categorías empíricas: El descubrimiento, los impactos y los desafíos de vivir con el VIH; y La experiencia antirretroviral: un nuevo comienzo y perspectivas. Resultados los resultados indicaron que los desafíos comienzan con la divulgación del diagnóstico, que generalmente suscita una diversidad de sentimientos y conductas. El estigma y la discriminación fomentan la adopción del secreto sobre el estado serológico, lo que resulta en un apoyo emocional débil para hacer frente a la seropositividad. La terapia antirretroviral es una esperanza para hacer frente a la enfermedad. La vulnerabilidad social fue la dimensión que más se destacó y se encontraron violaciones a sus derechos humanos. Conclusión e implicaciones para la práctica el estudio permite comprender las perspectivas, los desafíos y las vulnerabilidades de las personas que viven con el VIH. Vivir con VIH merece especial atención por parte de los profesionales de la salud que actúan en el cuidado de estas personas, destacando como aporte la relevancia de la atención integral en salud, en la que la ética y la subjetividad están presentes.

ABSTRACT Objective to understand perspectives and challenges in the daily lives of people after the discovery of living with HIV in Bissau, Guinea-Bissau, considering different contexts of vulnerability. Method an exploratory-descriptive study conducted through semi-structured interviews with sixteen people living with HIV attending a hospital in the city of Bissau. We used the thematic content analysis technique. Participants' reports were analyzed following two empirical categories: Discovery, impacts and challenges of living with HIV; and Experience with antiretroviral therapy: new beginning and perspectives. Results the results indicate that the challenges start with the disclosure of diagnosis, which arouses a diversity of feelings and behaviors. Stigma and discrimination encourage the adoption of confidentiality about serological status, which increases the fragility of emotional support in coping with seropositivity. Antiretroviral therapy was seen as a hope for coping with the disease. Social vulnerability was the dimension that stood out the most, and human rights violations involving people living with HIV were verified. Conclusion and implications for practice the study makes it possible to understand the perspectives, challenges and vulnerabilities of people living with HIV. Living with HIV deserves special attention from health professionals who work in the care of these people, highlighting as a contribution the relevance of comprehensive health care, in which ethics and subjectivity are present.

Trichophyton benhamiae, un dermatofito zoofílico emergente en Argentina con reservorio en cobayos: descripción de 7 casos en un hospital de la Ciudad Autónoma de Buenos Aires / Trichophyton benhamiae, an emergent zoonotic pathogen in Argentina associated with Guinea pigs: Description of 7 cases in Buenos Aires

Resumen Trichophyton benhamiae es un dermatofito zoofílico. Puede causar tinea corporis, tinea faciei y tinea capitis. Se caracteriza por producir lesiones inflamatorias, sobre todo en niños. El objetivo de esta publicación es describir 7 casos clínicos de pacientes pediátricos atendidos entre julio del 2019 y enero del 2020 en nuestra institución. A los pacientes se les solicitó estudio micológico convencional, con posterior confirmación con MALDI-TOF MS y secuencia-ción del ADN ribosomal. Se aisló e identificó T. benhamiae como agente etiológico; el nexo epidemiológico fue el contacto con cobayos. Estas son las primeras descripciones de infecciones causadas por T. benhamiae en Argentina. Al realizar estudios micológicos convencionales, este agente puede confundirse con otros dermatofitos, por lo tanto, se requieren herramientas como MALDI-TOF MS o la secuenciación para llegar a un diagnóstico definitivo. Es importante contar con datos epidemiológicos, como el contacto con mascotas no tradicionales, para una presunción diagnóstica adecuada.

Trichophyton benhamiae is a zoonotic dermatophyte that can cause tinea corporis, tinea faciei and tinea capitis, producing inflammatory lesions, especially in children. In this publication, we describe 7clinical cases of pediatric patients that occurred in our institution between July 2019 and January 2020. All patients underwent a conventional mycological study. The identification of fungi isolates was confirmed by MALDI-TOF MS and sequencing of the ribosomal DNA. T. benhamiae was identified as the etiological agent, whose epidemiological link in all cases was the contact with Guinea pigs. This is the first description of infections caused by T. benhamiae in Argentina. This dermatophyte can be misidentified as other more frequent dermatophytes when performing conventional studies. Molecular technology should be used to reach a definitive diagnosis. It is important to have epidemiological data from patients such as contact with non-traditional pets, especially Guinea pigs, for an adequate presumptive diagnosis of this dermatophytosis.

Cochlear implantation in an animal model documents cochlear damage at the tip of the implant / Implante coclear em um modelo animal documenta o dano coclear na extremidade do implante

Abstract Introduction: Electrocochleography has recently emerged as a diagnostic tool in cochlear implant surgery, purposing hearing preservation and optimal electrode positioning. Objective: In this experimental study, extra-cochlear potentials were obtained during cochlear implant surgery in guinea pigs. The aim was to determine electrophysiological changes indicating cochlear trauma after cochleostomy and after electrode implantation in different insertion depths. Methods: Normal-hearing guinea pigs (n = 14) were implanted uni- or bilaterally with a multichannel electrode. The extra-cochlear cochlear nerve action potentials were obtained in response to acoustic stimuli at specific frequencies before and after cochleostomy, and after introduction of the electrode bundle. After the electrophysiological experiments, the guinea pigs were euthanized and microtomography was performed, in order to determine the position of the electrode and to calculate of the depth of insertion. Based on the changes of amplitude and thresholds in relation to the stimulus frequency, the electrophysiological data and the position obtained by the microtomography reconstruction were compared. Results: Cochleostomy promoted a small electrophysiological impact, while electrode insertion caused changes in the amplitude of extra-cochlear electrophysiological potentials over a wide range of frequencies, especially in the deepest insertions. There was, however, preservation of the electrical response to low frequency stimuli in most cases, indicating a limited auditory impact in the intraoperative evaluation. The mean insertion depth of the apical electrodes was 5339.56 μm (±306.45 - 6 inserted contacts) and 4447.75 μm (±290.23 - 5 inserted contacts). Conclusions: The main electrophysiological changes observed during surgical procedures occurred during implantation of the electrode, especially the deepest insertions, whereas the cochleostomy disturbed the potentials to a lesser extent. While hearing loss was often observed apical to the cochlear implant, it was possible to preserve low frequencies after insertion. © 2020 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

Resumo Introdução: A eletrococleografia surgiu recentemente como uma ferramenta diagnóstica na cirurgia de implante coclear, objetiva a preservação da audição e o posicionamento ideal dos eletrodos. Objetivo: Determinar as alterações eletrofisiológicas indicativas de trauma coclear após a cocleostomia e após o implante do eletrodo em diferentes profundidades de inserção. Método: Neste estudo experimental, potenciais extracocleares foram obtidos durante a cirurgia de implante coclear em cobaias. Cobaias com audição normal (n = 14) foram implantadas uni- ou bilateralmente com eletrodo multicanal. Os potenciais de ação do nervo coclear extracoclear foram obtidos em resposta a estímulos acústicos em frequências específicas antes e após a cocleostomia e após a introdução do feixe de eletrodos. Após os experimentos eletrofisiológicos, as cobaias foram submetidas à eutanásia e a microtomografia foi feita para determinar a posição do eletrodo e calcular a profundidade de inserção. Com base nas mudanças de amplitude e limiares em relação à frequência do estímulo, os dados eletrofisiológicos e a posição obtida na reconstrução microtomográfica foram comparados. Resultados: A cocleostomia promoveu um pequeno impacto eletrofisiológico, enquanto a inserção do eletrodo causou alterações na amplitude dos potenciais eletrofisiológicos extra-cocleares em uma ampla faixa de frequências, especialmente nas inserções mais profundas. Houve, entretanto, preservação da resposta elétrica aos estímulos de baixa frequência na maioria dos casos, indicou um impacto auditivo limitado na avaliação intraoperatória. A profundidade média de inserção dos eletrodos apicais foi 5339,56 μm (± 306,45 - 6 contatos inseridos) e 4447,75 μm (± 290,23 - 5 contatos inseridos). Conclusão: As principais alterações eletrofisiológicas observadas durante os procedimentos cirúrgicos ocorreram durante o implante do eletrodo, especialmente nas inserções mais profundas, enquanto a cocleostomia alterou os potenciais em menor grau. Embora a perda auditiva seja frequentemente observada em posição apical ao implante coclear, foi possível preservar as baixas frequências após a inserção.

A rapid assessment of health system preparedness and response to the COVID-19 pandemic in Guinea

Epidemic-prone diseases have high adverse impacts and pose important threats to global health security. This study aimed to assess levels of health facility preparedness and response to the COVID-19 pandemic in Guinea. This was a cross-sectional study in public and private health facilities/services across 13 Guinean health districts. Managers and healthcare workers (HCWs) from departments in each facility/service were interviewed. Descriptive statistics and comparisons were presented using Pearson's Chi-Squared Test or Fischer exact test. Totally, 197 managers and 1020 HCWs participated in the study. Guidance documents and dedicated spaces for management/isolation of suspected COVID-19 cases were available only in 29% and 26% of facilities, respectively. Capacities to collect (9%) and safely transport (14%) samples were low. Intensive care units (5%), dedicated patient beds (3%), oxygenators (2%), and respirators (0.6%) were almost lacking. While 36% of facilities/services had received infection prevention and control supplies, only 20% had supplies sufficient for 30 days. Moreover, only 9% of HCWs had received formal training on COVID-19. The main sources of information for HCWs were the media (90%) and the internet (58%). Only 30% of HCWs had received personal protective equipment, more in the public sector (p<0.001) and in Conakry (p=0.022). This study showed low levels of preparedness of health facilities/services in Guinea and highlighted a lack of confidence among HCWs who felt unsafe at their workplace. Better governance to improve and maintain the capacity of the Guinean health system to respond to current and future epidemics is needed.

Assessing Preventative Maintenance and Sustainability of Oxygen Concentrators in Health Facilities in Papua New Guinea

@#The lifespan of medical equipment depends on preventative maintenance. Properly functioning oxygen concentrators are the only practical sources of oxygen in many Low & Middle Income Countries and their use reduces mortality in hospitalised children. We provided 82 concentrators with pulse oximeters, split flow meters, oxygen tubing, and an oxygen analyser to 38 health facilities. Training and instructions on how to perform preventative maintenance were provided. The concentrators were monitored for three years after they were installed, by assessing the proportion of concentrators still producing optimal oxygen at greater than 85% purity, the proportion that underwent weekly maintenance checks, and the proportion that were faulty and repaired. A logbook for weekly documentation of performance, maintenance, faults and repairs, was employed. Faults were additionally identified by a biomedical engineer during the visits. Twenty nine oxygen concentrators underwent regular maintenance checks, 25 (86.2%) of which had a median of 30 (IQR: 9 - 65) checks. Twenty-four were functioning well throughout the three years. One concentrator was used for 23,807 hours before requiring repair. Fourteen (24%) of the 58 concentrators used at the start of the programme had problems, two were repaired, and 12 were replaced. Concentrator failure was mostly caused by excessive movement, dust, and leaking in the internal tubing. Routine preventative maintenance, thorough documentation of performance and reporting of problems, and having access to clinicians and a knowledgeable biomedical engineer are essential for oxygen concentrator longevity in health care facilities in low-resource settings.

Gravidez indesejada na adolescência em Guiné-Bissau / Unwanted teenage pregnancy in Guinea-Bissau

Contexto: como em outros países, principalmente aqueles considerados subdesenvolvidos, a Guiné-Bissau, localizado na África Subsaariana, enfrenta altas taxas de gravidez na adolescência, muitas vezes não planejada ou desejada. Objetivo geral: analisar e descrever o fenômeno da gravidez indesejada de adolescentes guineenses. Processo metodológico: trata- se de um estudo qualitativo, descritivo, que utilizou pesquisa bibliográfica e documental e reflexões da autora sobre suas vivências no país; cujas análises se deram na perspectiva da hermenêutica-dialética. Resultados e discussão: a literatura sobre a persistência do fenômeno indica que ele é multicausal, pois contempla aspectos psicológicos, econômicos, sociais, culturais, políticos, religiosos e ambientais. Entre os riscos de gravidez na adolescência são citadas: complicações decorrentes de aborto inseguro; mortalidade infantil e materna e outros considerando a maternidade anterior à faixa etária com menos de 19 anos. Reflexos na vida das meninas que engravidam são deletérios: desistência dos estudos, pouca probabilidade de inserção no mercado de trabalho; impossibilidade de realizar projeto de vida fora da maternidade, limitando sua realização mais plena como mulher e cidadã. Contribuem também: a provável inexistência e/ou inoperância de políticas públicas de saúde destinadas aos jovens/adolescentes, em termos de serviços de saúde sexual e reprodutiva e de educação em saúde, não disponibilização de contraceptivos e informações mais abrangentes. Considerando- se tal quadro, utilizando os conhecimentos do campo teórico-prático da saúde coletiva, propõe- se a educação em saúde, por meio de atuação lúdica, caracterizando-a como projeto social - ativismo social. A proponente é enfermeira e vai retomar a experiência como ex-escoteira para atuação fora do ambiente escolar ou dos serviços de saúde, em eventos de escotismo, pois não tem vínculo com Estado guineense. Considerações finais: as análises acerca do fenômeno apresentam um cenário repleto de possíveis entraves - de origem cultural, religiosa, social, política, psicológica, econômica e ambiental - para o enfrentamento da gravidez indesejada na adolescência. No entanto, entende-se que é possível pensar em atuações criativas, amigáveis e construídas de forma compartilhada com adolescentes, que sejam significativas e considerem suas experiências proporcionando maior conhecimento acerca do fenômeno e questões afins.

Context: as in other countries, especially those considered underdeveloped, Guinea-Bissau, located in Sub-Saharan Africa, faces high rates of teenage pregnancy, often unplanned or unintended. General objective: to analyze and describe the phenomenon of unwanted pregnancy in Guinean adolescents. Methodological process: this is a qualitative, descriptive study that used bibliographic and documentary research and the author's reflections on her experiences in the country; whose analyzes took place from the perspective of hermeneutics- dialectics. Results and discussion: the literature on the persistence of the phenomenon indicates that it is multicausal, as it includes psychological, economic, social, cultural, political, religious and environmental aspects. Among the risks of teenage pregnancy are: complications resulting from unsafe abortion; infant and maternal mortality and others considering maternity before the age group under 19 years. Effects on the lives of girls who become pregnant are deleterious: dropping out of studies, low probability of entering the job market; impossibility of carrying out a life project outside of motherhood, limiting her fullest fulfillment as a woman and citizen. The following also contribute: the probable inexistence and/or ineffectiveness of public health policies aimed at young people/adolescents, in terms of sexual and reproductive health services and health education, non-availability of contraceptives and more comprehensive information. Considering this framework, using knowledge from the theoretical-practical field of collective health, health education is proposed, through playful activities, characterizing it as a social project - social activism. The applicant is a nurse and will resume her experience as a former Girl Scout to work outside the school environment or health services, in Scouting events, as she has no link with the Guinean State. Final considerations: the analyzes about the phenomenon present a scenario full of possible obstacles - of cultural, religious, social, political, psychological, economic and environmental origin - to face unwanted pregnancy in adolescence. However, it is understood that it is possible to think of creative, friendly and shared actions with adolescents, which are meaningful and consider their experiences providing greater knowledge about the phenomenon and related issues.

Sarcoma de Kaposi en pacientes que viven con el VIH en Guinea Ecuatorial / Kaposi sarcoma in patients living with HIV in Equatorial Guinea

Introducción: El sarcoma de Kaposi es una neoplasia oportunista asociada a la inmunodepresión causada por VIH, que se relaciona con la infección por VHH tipo 8. Objetivo: Describir la presentación del sarcoma de Kaposi en personas que viven con VIH en Guinea Ecuatorial. Métodos: Se realizó un estudio descriptivo de carácter retrospectivo para identificar la prevalencia y las características epidemiológicas y clínicas del sarcoma de Kaposi en las personas que viven con VIH que acuden a las unidades de referencia para el manejo de casos en Guinea Ecuatorial. Se revisaron las historias clínicas de una muestra aleatoria y representativa de 338 pacientes del grupo que ha recibido tratamiento en las unidades de referencia para enfermedades infecciosas de Bata, desde enero de 2007 a febrero de 2012. Resultados: Se identificaron 40 pacientes diagnosticados de sarcoma de Kaposi (prevalencia del 11, 83 por ciento). La mediana de la edad al diagnóstico de sarcoma de Kaposi fue de 43 años, siendo la ratio del sexo de 1/1. La media de linfocitos CD4 al diagnóstico fue de 166 (rango 21-375) y la frecuencia de afectación oral fue de 45 por ciento. En la mayoría de los pacientes (94,6 por ciento) la observación del sarcoma de Kaposi fue anterior al inicio del tratamiento antirretroviral. Las cifras de linfocitos T CD4/mm3 inferiores a 100 aparecían sobre todo en pacientes menores de 30 años, y esto era especialmente frecuente en el grupo de mujeres (OR 11, p <0,04, Ic 95 por ciento 0,8-148). Conclusiones: El sarcoma de Kaposi es una neoplasia prevalente en personas que viven con VIH seguidas en las unidades de referencia en Guinea Ecuatorial. En mujeres menores de 30 años podría existir un diagnóstico tardío(AU)

Introduction: Kaposi sarcoma is an opportunistic neoplasm associated to the immunosuppression caused by HIV and related to infection by HHV-8. Objective: Describe the presentation of Kaposi sarcoma in people living with HIV in Equatorial Guinea. Methods: A retrospective descriptive study was conducted to identify the prevalence and the clinical and epidemiological characteristics of Kaposi sarcoma in people living with HIV attending reference units for the management of cases in Equatorial Guinea. A review was carried out of the medical records of a random sample representative of 338 patients from the group receiving treatment at Bata reference unit for infectious diseases from January 2007 to February 2012. Results: A total 40 patients diagnosed with Kaposi sarcoma were identified (prevalence of 11,83 percent). Mean age at Kaposi sarcoma diagnosis was 43 years, with a 1/1 sex ratio. The mean CD4 lymphocyte count at diagnosis was 166 (range 21-375), whereas the frequency of oral damage was 45 percent. In most patients (94.6 percent) detection of Kaposi sarcoma was prior to the start of antiretroviral therapy. CD4 T lymphocyte levels / mm3 below 100 were mainly found in patients aged under 30 years, a fact particularly frequent among women (OR 11, p< 0.04, CI 95% 0.8-148). Conclusions: Kaposi sarcoma is a neoplasm prevailing in people living with HIV who attend reference units in Equatorial Guinea. Late diagnosis could exist among women aged under 30 years(AU)

Inclusion of different levels of inulin on productive parameters and intestinal morphology in fattening guinea pigs (Cavia porcellus) / Efeito da inclusão de diferentes níveis de inulina nos parâmetros produtivos e na morfologia intestinal em cobaias de engorda (Cavia porcellus)

ABSTRACT: This study evaluated the effect of the three inulin levels (0.1%, 0.2%, 0.4%) supplemented as a substitute for an antibiotic growth promoter (AGP, zinc bacitracin) and control in guinea pigs raised for human consumption. Fifty 14-day-old male guinea pigs were used. Productive parameters (weight gain, total dry matter intake, and feed conversion ratio (FCR)) and intestinal morphology of the duodenum, jejunum, and ileum at slaughter (70 days of age) were evaluated. An inverse relationship was observed between inulin levels and FCR (linear effect; P = 0.006). There was no statistically significant effect of the treatments on total dry matter intake and weight gain (P > 0.05). A linear effect of the inulin level on the villi's length (VL), villi's width (VW), and length/depth ratio (VL/DC) in the duodenum; VW in the jejunum; and VL in the ileum (P <0 .05) was reported. In conclusion, a linear effect of the increasing doses of inulin was found on the FCR and the morphological parameters of the duodenum's integrity, and no differences in the effects of the inulin added to the diet and the treatment with AGP were found.

RESUMO: O objetivo do estudo foi avaliar o efeito da suplementação na dieta de cobaias com inulina, em níveis crescentes (0,1%, 0,2%, 0,4%) como substituto para um antibiótico promotor de crescimento (AGP, bacitracina de zinco) além do grupo controle (dieta padrão). Foram utilizados 50 porquinhos-da-índia machos com 14 dias de idade. Os parâmetros produtivos foram avaliados do desmame aos 70 dias de idade e os parâmetros morfológicos intestinais foram avaliados no duodeno, jejuno e íleo no momento do abate. Foi encontrado um efeito linear do nível de inulina sobre na taxa de conversão alimentar (FCR; P = 0,006), indicando que em níveis mais elevados de inulina o FCR diminui. Não houve diferença significativa entre os grupos quando avaliado o efeito dos diferentes tratamentos sobre o consumo de ração e ganho de peso corporal (P > 0,05). Um efeito linear do nível de inulina foi encontrado no comprimento das vilosidades (VL), na largura das vilosidades (VW) e na relação comprimento / profundidade (VL/DC) no duodeno, sobre a VW no jejuno; e no VL no íleo (P < 0,05). Em conclusão, um efeito linear do aumento do nível de inulina foi encontrado na taxa de conversão alimentar e nos parâmetros morfológicos da integridade do duodeno, além disso, não houve diferença entre a adição de inulina na dieta e o tratamento com um antibiótico promotor de crescimento.

Inequities and inequalities in health and some Public Health Proposals that may improve inequities and inequalities in accessing Primary Healthcare Services in Papua New Guinea

@#Inequity and inequality in accessing primary healthcare services can be created by systemic and structural barriers in a health system. A recent review of Papua New Guinea’s (PNG) health system revealed that there are inequities and inequalities in primary healthcare service access. This disparity is magnified in the rural and remote regions of the country. One of the main reasons for this has been the chronic shortage in government funding. This paper presents an overview of inequities and inequalities in health and suggests some public health approaches that may improve primary healthcare service access in PNG

Efficacy of levofloxacin and moxifloxacin in the treatment of experimentally infected guinea pigs with Yersinia pestis / 中华地方病学杂志

Objective:To observe the efficacy of levofloxacin and moxifloxacin in the treatment of experimental plague in guinea pigs.Methods:A total of 70 SPF guinea pigs, female, weighing 250 to 300 g, were selected and randomly divided into 7 groups according to body weight by random number table. There were 10 guinea pigs in each group: levofloxacin 24, 48, 72 h groups, moxifloxacin 24, 48, 72 h groups (drug treatment was carried out after being infected with Yersinia pestis for 24, 48 and 72 h, respectively) and control group (without treatment). Experimentally infected plague model was established through guinea pigs subcutaneous injection of 141 strains of Yersinia pestis [1 × 10 7 colony forming unit (CFU)]; referring to the adult dose in the "National Pharmacopoeia of the People's Republic of China", the daily dose of guinea pigs was converted by Shi Xinyou's animal conversion coefficient method for treatment, the doses of levofloxacin and moxifloxacin in each guinea pig were 12.0 and 9.6 mg/d, respectively for 9 days. The guinea pigs were killed 9 days after drug withdrawal for bacteriological examination and pathological observation, and the cure rate was calculated. Results:The cure rates of levofloxacin 24, 48 and 72 h groups were 100.0% (10/10), 70.0% (7/10) and 6/6, respectively. The cure rates of moxifloxacin 24, 48 and 72 h groups were 100.0% (10/10), 100.0% (10/10) and 5/7, respectively, and the cure rate of animals in the control group was 0 (0/10). Compared with the control group, there were significant differences in the efficacy of moxifloxacin 24, 48 and 72 h groups and levofloxacin 24, 48 and 72 h groups ( P < 0.05). There was no significant difference between the two drugs at the same starting time ( P > 0.05). Conclusion:The effects of levofloxacin and moxifloxacin on animal plague infection are ideal and the two drugs can be used as a substitute for streptomycin in plague treatment under special circumstances.

Inhibiting effect of retinal Sigma-1 receptor antagonist on the form deprivation myopia in guinea pigs and its mechanism / 中华实验眼科杂志

Objective:To investigate the role and mechanism of retinal Sigma-1 receptor antagonist N, N-diethyl-2-[4-methoxy-3-(2-phenylethoxy)phenyl]ethanaminehydrochloride (NE-100) in the formation of form deprivation myopia (FDM) in guinea pigs.Methods:Eighty-five 21-day-old guinea pigs were selected, and 36 of them were randomly divided into normal control group, occluded 14-day group and occluded 11-day group, with 12 in each group.The right eyes of guinea pigs in the occluded 14-day group were covered with translucent eye shield for consecutive 14 days, and guinea pigs in the occluded 11-day group were treated in the same way for consecutive 11 days plus 3 days without cover, and guinea pigs in the normal control group were not covered.The other 49 guinea pigs were randomly divided into FDM group ( n=10), FDM+ NE-100 6 μg group ( n=12), FDM+ NE-100 60 μg group ( n=10), FDM+ NE-100 600 μg group ( n=9), and FDM+ saline group ( n=8). The right eyes in each group received 100 μl peribulbar injection of NE-100 6 μg, 60 μg and 600 μg or saline once a day according to grouping.Ocular refraction and axial dimensions were measured using eccentric infrared photorefractor and A-scan ultrasonography, respectively.Corneal curvature was measured with keratometer.Immunohistochemical staining and Western blot were used to detect the expression levels of Sigma-1 receptor protein, and retinal dopamine content was evaluated by high-performance liquid chromatography with electrochemical detection.This study was approved by an Ethics Committee of the Department of Laboratory Animal Science of Central South University (No.2020sydw0084). The use and care of experimental animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals in China. Results:There were statistical significant differences in diopter and axial length among the normal control group, occluded 14-day group and occluded 11-day group ( F=147.81, 160.10; both at P<0.01). Compared with the normal control group, the relative myopia was the deepest and the axial length was the longest in the occluded 14-day group, then the occluded 11-day group, showing significant differences between them (all at P<0.05). In the normal control group, Sigma-1 protein was mainly expressed in retinal ganglion cells (RGCs), photoreceptor inner segment and the inner nuclear layer.In the occluded 14-day group, Sigma-1 protein staining was enhanced in RGCs and photoreceptor inner segment.Sigma-1 staining positive cells in the inner nuclear layer were increased significantly and were also seen in the inner and outer plexiform layers, especially in Müller cells, in which the expression levels of Sigma-1 receptor protein were significantly increased.Compared with the occluded 14-day group, the Sigma-1 receptor protein expression levels in the retina of the occluded 11-day group was significantly decreased ( P<0.01). The diopters of guinea pigs in the FDM+ NE-100 6 μg, 60 μg and 600 μg groups were lower than those in the FDM group, and the diopters of FDM+ NE-100 60 μg and 600 μg guinea pigs were lower than those in the FDM+ NE-100 6 μg group, and the differences were statistically significant (all at P<0.05). The dopamine content in the retina of the FDM+ NE-100 60 μg group was (0.74±0.09) ng/mg, which was significantly higher than (0.57±0.10) ng/mg in the FDM group, with a significant difference between them ( t=15.18, P<0.01). Conclusions:Sigma-1 receptor antagonist inhibits FDM formation, which may be associated with the elevation of dopamine content in retina.