Immunogenicity of PvCyRPA, PvCelTOS and Pvs25 chimeric recombinant protein of Plasmodium vivax in murine model.

In the Americas, P. vivax is the predominant causative species of malaria, a debilitating and economically significant disease. Due to the complexity of the malaria parasite life cycle, a vaccine formulation with multiple antigens expressed in various parasite stages may represent an effective approach. Based on this, we previously designed and constructed a chimeric recombinant protein, PvRMC-1, composed by PvCyRPA, PvCelTOS, and Pvs25 epitopes. This chimeric protein was strongly recognized by naturally acquired antibodies from exposed population in the Brazilian Amazon. However, there was no investigation about the induced immune response of PvRMC-1. Therefore, in this work, we evaluated the immunogenicity of this chimeric antigen formulated in three distinct adjuvants: Stimune, AddaVax or Aluminum hydroxide (Al(OH)3) in BALB/c mice. Our results suggested that the chimeric protein PvRMC-1 were capable to generate humoral and cellular responses across all three formulations. Antibodies recognized full-length PvRMC-1 and linear B-cell epitopes from PvCyRPA, PvCelTOS, and Pvs25 individually. Moreover, mice's splenocytes were activated, producing IFN-γ in response to PvCelTOS and PvCyRPA peptide epitopes, affirming T-cell epitopes in the antigen. While aluminum hydroxide showed notable cellular response, Stimune and Addavax induced a more comprehensive immune response, encompassing both cellular and humoral components. Thus, our findings indicate that PvRMC-1 would be a promising multistage vaccine candidate that could advance to further preclinical studies.

Difficulty resuming driving in acute acquired brain injury: Retrospective observational study using discriminant analysis.

OBJECTIVES: We hypothesized that neuropsychological testing and history of falls would be associated with difficulty resume driving after acute acquired brain injury (ABI). This study aimed to analyze ABI facing difficulties in resuming driving in the acute phase. METHODS: We retrospectively analyzed 63 patients receiving assistance in driving-resumption after ABI. Patients were categorized into two groups: driving-resumption-possible and driving-resumption-difficult. Discriminant analysis delineated characteristics of patients experiencing driving-resumption difficulty. Additionally, significant predictors were analyzed using ROC curves. RESULTS: 42 patients were able to resume driving, and 21 experienced difficulties in driving resumption. Factors predicting difficulty returning to driving were age, history of falls, TMT Part B, and ROCF. Furthermore, cut-off values for each were 72 years, 148 seconds for TMT Part B, and 29.5 points for ROCF. CONCLUSIONS: Patients with advanced age, history of falls, delayed TMT Part B, and poor ROCF outcomes may face challenges in resuming driving after ABI. These factors may serve as a valuable metric to assess driving resumption difficulties after ABI.

Decidual production of interferon lambda in response to ZIKV persistence: Clinical evidence and in vitro modelling.

Zika virus (ZIKV) infections during pregnancy can result in Congenital Zika Syndrome (CZS), a range of severe neurological outcomes in fetuses that primarily occur during early gestational stages possibly due to placental damage. Although some placentas can maintain ZIKV persistence for weeks or months after the initial infection and diagnosis, the impact of this viral persistence is still unknown. Here, we aimed to investigate the immunological repercussion of ZIKV persistence in term placentas. As such, term placentas from 64 pregnant women diagnosed with Zika in different gestational periods were analyzed by ZIKV RT-qPCR, examination of decidua and placental villous histopathology, and expression of inflammation-related genes and IFNL1-4. Subsequently, we explored primary cultures of term decidual Extravillous Trophoblasts (EVTs) and Term Chorionic Villi (TCV) explants, as in vitro models to access the immunological consequences of placental ZIKV infection. Placenta from CZS cases presented low IFNL1-4 expression, evidencing the critical protective role of theses cytokines in the clinical outcome. Term placentas cleared for ZIKV showed increased levels of IFNL1, 3, and 4, whether viral persistence was related with a proinflammatory profile. Conversely, upon ZIKV persistence placentas with decidual inflammation showed high IFNL1-4 levels. In vitro experiments showed that term EVTs are more permissive, and secreted higher levels of IFN-α2 and IFN-λ1 compared to TCV explants. The results suggest that, upon ZIKV persistence, the maternal-skewed decidua contributes to placental inflammatory and antiviral signature, through chronic deciduitis and IFNL upregulation. Although further studies are needed to elucidate the mechanisms underlying the decidual responses against ZIKV. Hence, this study presents unique insights and valuable in vitro models for evaluating the immunological landscape of placentas upon ZIKV persistence.

Unleashing Fungicidal Forces: Exploring the Synergistic Power of Amphotericin B-Loaded Nanoparticles and Monoclonal Antibodies.

Fungal infections cause 1.7 million deaths annually, which can be attributed not only to fungus-specific factors, such as antifungal resistance and biofilm formation, but also to drug-related challenges. In this study, the potential of Amphotericin (AmB) loaded polymeric nanoparticles (AmB-NPs) combined with murine monoclonal antibodies (mAbs) (i.e., CC5 and DD11) was investigated as a strategy to overcome these challenges. To achieve this goal, AmB-NPs were prepared by nanoprecipitation using different polymers (polycaprolactone (PCL) and poly(D,L-lactide) (PLA)), followed by comprehensive characterization of their physicochemical properties and in vitro biological performance. The results revealed that AmB-loaded NPs exhibited no cytotoxicity toward mammalian cells (baby hamster kidney cells-BHK and human monocyte cells-THP-1). Conversely, both AmB-NPs demonstrated a cytotoxic effect against C. albicans, C. neoformans, and H. capsulatum throughout the entire evaluated range (from 10 µg/mL to 0.1 µg/mL), with a significant MIC of up to 0.031 µg/mL. Moreover, the combination of AmB-NPs with mAbs markedly intensified antifungal activity, resulting in a synergistic effect that was two to four times greater than that of AmB-NPs alone. These findings suggest that the combination of AmB-NPs with mAbs could be a promising new treatment for fungal infections that is potentially more effective and less toxic than current antifungal treatments.

Real Clinical Practice of Combined Atezolizumab Plus Chemotherapy in Patients With Small Cell Lung Cancer.

BACKGROUND/AIM: Atezolizumab, an anti-PD-L1 antibody, has been increasingly administered in combination with chemotherapy to patients with small cell lung cancer (SCLC). This study aimed to determine how patients with extensive disease (ED) -SCLC responded to atezolizumab with chemotherapy and found factors affecting long-term response and survival. PATIENTS AND METHODS: This study focused on patients with SCLC who were treated with a combination of atezolizumab and chemotherapy in Japan between 2019 and 2023. Patient information and tumor response were analyzed, along with adverse events. We compared data and estimated survival probabilities. RESULTS: In our clinical trial, 95 patients with SCLC who received this treatment had a median progression-free survival of 6.0 months and a median overall survival of 15.0 months. Immune-related adverse events were observed in 13.7% of the patients, with grade 3 or higher in 5.3%. The efficacy and immune-related adverse events associated with this treatment regimen were comparable to those reported in previous clinical trials. Progression-free survival >2 years was observed in a small number of patients (5.3%). CONCLUSION: Our research will offer important insights for the future care of patients with extensive-stage SCLC by utilizing atezolizumab in combination with chemotherapy. Accumulation and confirmation of clinical practice results will have important implications for the future implementation of this therapy.

Profiles, diagnostic process, and patterns of care of patients with stage III non-small cell lung cancer: A French national study.

BACKGROUND: The management of stage III non-small-cell lung cancer (NSCLC) remains heterogeneous and complex, even after the approval of immune checkpoint inhibitors post-chemoradiotherapy (CRT). This observational study from France evaluated real-world practices in managing stage III NSCLC. METHODS: Between 2020 and 2022, we conducted a physician practice survey in 41 medical centers across France, and retrospectively analyzed aggregated information from 417 consecutive charts of patients with stage III NSCLC. We collected information on diagnostic and staging procedures, biomarker testing, surgical and non-surgical treatments, and follow-up. RESULTS: According to the physician survey, diagnostic workup of stage III NSCLC primarily relied on positron emission tomography/computed tomography and brain magnetic resonance imaging, performed for the majority of patients in 100 % and 78 % of centers, respectively. Of 417 patient charts, 414 were evaluable with 53 % of patients having stage IIIA disease, 37 % IIIB, and 10 % IIIC. The most common node involvement was N2 (59 %). Programmed death-ligand 1 testing was conducted for 98 % of patients. Invasive staging (mediastinoscopy or endobronchial ultrasound) was performed in 41 % of patients, of whom 83 % had N2 or N3 nodal involvement. Surgical resection was offered to 120 patients (29 %), with 85 % achieving R0 resection. In 292 charts of patients with unresectable stage III NSCLC, 190 patients (65 %) were offered CRT followed by consolidation immunotherapy. Within these patients, concurrent CRT was more frequently employed (52 %) than sequential CRT (13 %). CONCLUSIONS: Diagnostic procedures and treatment modalities in French medical centers generally align with clinical guidelines for stage III NSCLC, except for invasive staging that was less commonly performed than expected.

Cambios en Mecánica Respiratoria en Usuarios Pediátricos en Ventilación Mecánica Post Cirugía de Cardiopatía Congénita Sometidos a Kinesiología Respiratoria versus Succión Endotraqueal. Revisión Estructurada / Changes in Respiratory Mechanics in Pediatric Users on Mechanical Ventilation Post Congenital Heart Disease Surgery Undergoing Respiratory Kinesiology versus Endotracheal Suction. Structured Review

Introducción. Las cardiopatías congénitas (CC) en Chile corresponden a la segunda causa de muerte en menores de 1 año, requiriendo cirugías paliativas y/o correctivas el 65% de estas. En el post operatorio frecuentemente se utiliza ventilación mecánica invasiva (VM) y succión endotraqueal (SET) para remover secreciones. Sin embargo, la kinesiología respiratoria (KTR) ha mostrado mejoras significativas en la distensibilidad toracopulmonar (Cest) y resistencia de vía aérea (Rva) en otros grupos de usuarios pediátricos y adultos en VM. Objetivo. Comparar los cambios en la Cest y Rva en usuarios pediátricos en VM post cirugía de cardiopatía congénita (CCC) sometidos a KTR versus SET exclusiva. Métodos. Revisión sistemática de estudios publicados en bases de datos PUBMED, PeDro, Scielo y Google Scholar que comparan el uso de KTR ó SET sobre los cambios en mecánica ventilatoria en usuarios pediátricos en VM post cirugía de cardiopatía congénita, limitados a inglés, español y portugués, excluyendo a sujetos con traqueostomía o con oxigenación por membrana extracorpórea. Se utilizó guía PRISMA para la selección de artículos. Se revisaron 397 artículos y se seleccionó 1 artículo extra de los artículos sugeridos. Se eliminó 1 artículo por duplicidad. Por títulos y resúmenes se seleccionaron 2 artículos, los cuales al leer el texto completo fueron retirados debido a que la población no correspondía a cardiópatas. Resultados. El final de artículos seleccionados fue de 0 artículos, debido a lo cual se removió el operador Booleano "NOT", y se removió la población de cardiopatías. De este modo quedaron 2 artículos seleccionados para la revisión cualitativa final donde se compara KTR versus SET, y KTR en kinesiólogos especialistas y no especialistas, mostrando ambos aumento en la Cest y disminución de la Rva a favor de la KTR, hasta los 30 minutos post intervención. Conclusiones. No se encontraron artículos que demuestren cambios en Cest y Rva con el uso de KTR + SET versus SET exclusiva, en usuarios pediátricos ventilados posterior a CCC. Con la remoción de filtros seleccionamos 2 artículos que demuestran aumento de Cest y disminución de Rva en sujetos pediátricos en VM, uno comparando con SET, y por grupos de especialistas y no especialistas en respiratorio. Se sugieren estudios primarios para evaluar los efectos de esta intervención en esta población.

Introduction. Congenital heart diseases (CHD) are the second general cause for children death under 1 year. In Chile, approximately 65% CHD need surgery, could was palliative or corrective. In the postoperative period, invasive mechanical ventilation (MV) is frequently used as a life support method, but it is associated with complications. Tracheal suction (SET) is regularly used to remove secretions; however, respiratory chest physiotherapy (KTR) has shown significant improvements in thoraco-pulmonary compliance and airway resistance in other groups of pediatrics and adult's users in MV. Objetive. to compare changes in thoraco-pulmonary compliance and airway resistance in pediatric subjects under mechanical ventilation after congenital heart disease surgery comparing chest physiotherapy and exclusive tracheal suction. Methods. systematic review of studies published in PUBMED, PeDro, Scielo and Google Scholar databases who compares KTR or SET use on changes in ventilatory mechanics in pediatric users under MV after congenital heart disease surgery, limited to English, Spanish and Portuguese languages, excluding user with tracheostomy or extracorporeal membrane of oxygenation. It was use the PRISMA guide to articles selection. A search was carried out, with a total of 397 articles reviewed (English: PubMed = 3, PeDro = 8, Scholar = 383; Spanish: Scholar = 3, Scielo = 0; and Portuguese: Scielo = 0). One extra article was selected from the suggested articles, and 1 article was eliminated due to duplication. By titles and abstracts, 2 articles were selected, but the population did not correspond to heart disease. Results. the final selected articles were 0 articles. By this reason, it were removed: Boolean operator "NOT", and congenital heart disease population. Thus, 2 articles were selected for the final qualitative review where it was compares KTR versus SET, and KTR by specialist and non-specialist. Both articles shown improvement in compliance and resistance until 30 minutes post intervention. The CC population was in a 40 to 60% range in both studies. Conclusions. it was no found articles that demonstrate changes in compliance and resistance in the airway with the use of KTR + SET versus exclusive SET in pediatric users after CCC connected to MV. After filter remotion, we found 2 studies shown improves in increase compliance and reduce resistance in pediatric user in MV, ones comparing with SET, and the other one comparing between specialists in respiratory pediatric physiotherapy and not specialists. It suggests to made primary clinical studies about this intervention in CC population.

A randomized controlled trial on the effectiveness of mirror therapy in improving strength, range of movement and muscle activity, in people with carpal tunnel syndrome.

BACKGROUND: There is little information on the potential effects of mirror therapy (MT) on motor recovery in individuals with Carpal Tunnel Syndrome (CTS). PURPOSE: To compare the effectiveness of a MT protocol versus a therapeutic exercise (TE) protocol, in improving strength, range of motion (ROM), muscle activity, pain, and functionality in patients with CTS. STUDY DESIGN: Randomized clinical trial. METHODS: Thirty-nine participants with unilateral CTS were divided into two groups: (i) MT group (n = 20) that followed an exercise protocol applied to the unaffected hand reflected in a mirror, and (ii) TE group (n = 19) that followed the same exercise protocol using the unaffected hand but without a mirror. Strength, wrist ROM, muscle activity, pain and functionality, were assessed at baseline (T0), after treatment (T1) and one month after treatment (T2). RESULTS: At T1, the MT group showed significantly higher wrist flexion-extension ROM compared to TE (p = 0.04, d = 0.8), maintained at T2 (p = 0.02, d = 0.8). No significant changes were observed in ulnar-radius deviation, pronosupination, or fatigue following either MT or TE (p > 0.05). MT exhibited enhanced handgrip strength at T1 (p = 0.001, d = 0.7), as well as an increase in the extensor carpi radialis (ECR) and flexor carpi radialis (FCR) maximum muscle activity (p = 0.04, d = 1.0; p = 0.03, d = 0.4). At T1, both groups decreased pain (p = 0.002, d = 1.1; p = 0.02, d = 0.7), and improved functionality (p < 0.001, d = 0.8; p = 0.01, d = 0.5) (MT and TE respectively). DISCUSSION: MT led to enhancements in wrist flexion-extension movement, handgrip strength and functionality unlike TE. MT notably increased muscle activity, particularly in the ECR and FCR muscles. CONCLUSIONS: MT is a favorable strategy to improve wrist flexion-extension ROM, handgrip strength, ECR and FCR muscle activity, and functionality in people with unilateral CTS.

Immune response induced by standard and fractional doses of 17DD yellow fever vaccine.

The re-emergence of yellow fever (YF) urged new mass vaccination campaigns and, in 2017, the World Health Organization approved the use of the fractional dose (FD) of the YF vaccine due to stock shortage. In an observational cross-sectional investigation, we have assessed viremia, antibodies, soluble mediators and effector and memory T and B-cells induced by primary vaccination of volunteers with FD and standard dose (SD). Similar viremia and levels of antibodies and soluble markers were induced early after immunization. However, a faster decrease in the latter was observed after SD. The FD led to a sustained expansion of helper T-cells and an increased expression of activation markers on T-cells early after vaccination. Although with different kinetics, expansion of plasma cells was induced upon SD and FD immunization. Integrative analysis reveals that FD induces a more complex network involving follicular helper T cells and B-cells than SD. Our findings substantiate that FD can replace SD inducing robust correlates of protective immune response against YF.

Inflammatory myofibroblastic tumor directly invading the right first rib treated with oral steroids: a case report.

BACKGROUND: We present a case of an inflammatory myofibroblastic tumor cured with a short period of steroid administration, a treatment previously unreported for such cases. CASE PRESENTATION: A 49-year-old man had a chief complaint of chest pain for more than 3 days. Computed tomography (CT) revealed a tumoral lesion suspected to have infiltrated into the right first rib and intercostal muscles, with changes in lung parenchymal density around the lesion. The maximal standardized uptake value on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography was high (16.73), consistent with tumor presence. CT-guided biopsy revealed an inflammatory myofibroblastic tumor with no distant metastases. Surgery was indicated based on the disease course. However, he had received an oral steroid before the preoperative contrast-enhanced CT scan due to a history of bronchial asthma, and subsequent CT showed that the tumor shrank in size after administration; he has been recurrence-free for more than a year. CONCLUSIONS: Surgery is still the first choice for inflammatory myofibroblastic tumors, as the disease can metastasize and relapse; however, this condition can also be cured with a short period of steroid therapy.

Effects of a low-pressure hyperbaric oxygen therapy on psychological constructs related to pain and quality of life in women with fibromyalgia: A randomized clinical trial.

BACKGROUND AND OBJECTIVES: Self-reported psychological variables related to pain have been posited as the major contributors to the quality of life of fibromyalgia (FM) women and should be considered when implementing therapeutic strategies among this population. The aim of this study was to explore the effect of low-pressure hyperbaric oxygen therapy (HBOT) on psychological constructs related to pain (i.e., pain catastrophism, pain acceptance, pain inflexibility, mental defeat) and quality of life in women with FM. METHODS: This was a randomized controlled trial. Thirty-three women with FM were randomly allocated to a low-pressure hyperbaric oxygen therapy group (HBOTG) (n=17), who received an 8-week intervention (5 sessions per week), and a control group (CG) (n=16). All women were assessed at baseline (T0) and upon completion of the study (T1) for self-perceived pain intensity, pain catastrophism, pain acceptance, pain inflexibility, mental defeat and quality of life. RESULTS: At T1, the HBOTG improved across all variables related to pain (i.e. self-perceived pain intensity, pain catastrophism, pain acceptance, pain flexibility, mental defeat) (p<0.05) and quality of life (p<0.05). In contrast, the CG showed no improvements in any variable. Furthermore, significant differences between the groups were found in quality of life (p<0.05) after the intervention. CONCLUSIONS: HBOT is effective at improving the psychological constructs related to pain (i.e. pain catastrophism, pain acceptance, pain flexibility, mental defeat) and quality of life among women with FM. Clinical Trial Link Clinical Trials gov identifier (NCT03801109).

Design and validation of a decision support checklist for efficient resource allocation in research projects during proposal preparation.

PURPOSE: This article presents the design and validation of evaluation criteria checklist aimed at facilitating decision-making processes regarding participation in research projects and allocation of resources before the preparation of research proposals. MATERIALS AND METHODS: A multidisciplinary team developed a comprehensive evaluation focusing on the proposal preparation phase of research projects. A Delphi survey method was used to establish a connection between the relevance of the project and the possible success of research proposals. Assessment criteria were agreed upon, each assigned specific weights. The results of the survey were applied to a database of 62 proposals for which our research group sought funding during 2020-2021. The method was validated using the funding body's outcomes (approval or rejection) of the submitted proposals as the ground truth per project type (national, European and regional). RESULTS: The results of the survey generated a checklist of 8 criteria (excellence, impact, and efficiency aspects) that effectively assess the possibility of success of research proposals during the preparatory phase. For national projects, the tool validation demonstrated a sensitivity of 100% and a specificity of 76.19%; European projects exhibited a sensitivity of 100% and a specificity of 53.84%; and regional projects showed a sensitivity of 80% and a specificity of 30%. CONCLUSIONS: By establishing an agreed set of evaluation criteria, the developed comprehensive index enables a more precise decision support tool for the participation in research proposals and the allocation of necessary resources. This control system saves valuable time and effort for research groups while enhancing the overall efficiency of available resources.

Effects of mirror neuron activation therapies on functionality in older adults: Systematic review and meta-analysis.

PURPOSE: To identify the effects of mirror neuron activation (MNAT) combined or not with physical exercise (PE) in healthy older adults, on functionality, balance, gait velocity and risk of falls. METHODS: A systematic electronic search was performed in PubMed/MEDLINE, Cochrane, and Embase databases. RESULTS: Thirteen randomized controlled trials were included in the qualitative analysis, and eleven in the quantitative analysis. All studies showed fair to high quality and the most frequent high-risk bias was "Blinding of participants and personnel". Compared to the control condition, higher improvement was shown in older people who received MNAT, on functionality (1.57 [0.57, 2.62], balance (1.95 [1.32, 2.572]), and gait velocity (1.20 [0.30, 2.11]). Compared to PE, MNAT combined with PE does not improve functionality. More studies are needed to assess MNAT effectiveness in the rest of the outcomes. CONCLUSIONS: Neuron system activation through MNAT improves relevant abilities in older adults, with better results when including functional activities. However, the beneficial effects on these variables of adding MNAT to a PE program are controversial.

Plaque Reduction Neutralization Test (PRNT) Accuracy in Evaluating Humoral Immune Response to SARS-CoV-2.

Massive vaccination positively impacted the SARS-CoV-2 pandemic, being a strategy to increase the titers of neutralizing antibodies (NAbs) in the population. Assessing NAb levels and understanding the kinetics of NAb responses is critical for evaluating immune protection. In this study, we optimized and validated a PRNT50 assay to assess 50% virus neutralization and evaluated its accuracy to measure NAbs to the original strain or variant of SARS-CoV-2. The optimal settings were selected, such as the cell (2 × 105 cells/well) and CMC (1.5%) concentrations and the viral input (~60 PFU/well) for PRNT-SARS-CoV-2 with cut-off point = 1.64 log5 based on the ROC curve (AUC = 0.999). The validated PRNT-SARS-CoV-2 assay presented high accuracy with an intraassay precision of 100% for testing samples with different NAb levels (low, medium, and high titers). The method displays high selectivity without cross-reactivity with dengue (DENV), measles (MV), zika (ZIKV), and yellow fever (YFV) viruses. In addition, the standardized PRNT-SARS-CoV-2 assay presented robustness when submitted to controlled variations. The validated PRNT assay was employed to test over 1000 specimens from subjects with positive or negative diagnoses for SARS-CoV-2 infection. Patients with severe COVID-19 exhibited higher levels of NAbs than those presenting mild symptoms for both the Wuhan strain and Omicron. In conclusion, this study provides a detailed description of an optimized and validated PRNT50 assay to monitor immune protection and to subsidize surveillance policies applied to epidemiologic studies of COVID-19.

Relationship between neck kinematics and neck dissability index. An approach based on functional regression.

Numerous studies use numerical variables of neck movement to predict the level of severity of a pathology. However, the correlation between these numerical variables and disability levels is low, less than 0.4 in the best cases, even less in subjects with nonspecific neck pain. This work aims to use Functional Data Analysis (FDA), in particular scalar-on-function regression, to predict the Neck Disability Index (NDI) of subjects with nonspecific neck pain using the complete movement as predictors. Several functional regression models have been implemented, doubling the multiple correlation coefficient obtained when only scalar predictors are used. The best predictive model considers the angular velocity curves as a predictor, obtaining a multiple correlation coefficient of 0.64. In addition, functional models facilitate the interpretation of the relationship between the kinematic curves and the NDI since they allow identifying which parts of the curves most influence the differences in the predicted variable. In this case, the movement's braking phases contribute to a greater or lesser NDI. So, it is concluded that functional regression models have greater predictive capacity than usual ones by considering practically all the information in the curve while allowing a physical interpretation of the results.

Effects of an Oral Stimulation Program on Feeding Outcomes in Preterm Infants: A Systematic Review and Meta-Analysis.

AIMS: To review the literature on the effects of unimodal sensorimotor stimulation protocols on feeding outcomes in very preterm and moderate to late preterm infants (PIs). METHODS: Five databases were searched up to April 2022. Studies comparing unimodal sensorimotor stimulation protocols based on the combination of manual oral stimulation with NNS against usual care in PIs, on-time transition to full oral feeding (FOF), feeding efficacy, length of hospital stay, and/or body weight gain. RESULTS: Eleven studies were included. Compared to usual care, unimodal sensorimotor stimulation protocols based on manual oral stimulation combined with NNS demonstrated to be more effective in decreasing time transition to FOF (standardized mean difference [95%CI] - 1.08 [-1.74, -0.41]), improving feeding efficacy (2.15 [1.18, 3.13]) and shortening length of hospital stay (-0.35 [-0.68, -0.03]). However, the proposed intervention was not effective in improving weight gain (0.27 [-0.40, 0.95]). There were no significant differences according to gestational age (p > .05). CONCLUSIONS: Based on fair-to-high quality evidence, unimodal sensorimotor stimulation protocols combined with NNS reduce time transition to FOF, improve feeding efficacy, and shorten the length of hospital stay; yet the proposed intervention yielded no significant effects on body weight gain when compared to usual care in PIs.

Organisation et le fonctionnement de la surveillance épidémiologique de la rougeole dans le district sanitaire de Yopougon-est, Côte d'Ivoire de janvier 2022 à juin 2022 / NA

La rougeole est une maladie infantile banale, peut être mortelles quand elle est sous-estimée. Nous avons initié cette étude dont l'objectif général est d'analyser le système de surveillance épidémiologique de la rougeole dans le district sanitaire de Yopougon-Est.MéthodesNous avons procédé à une évaluation normative de la surveillance épidémiologique de la rougeole réalisée en 6 (Six) mois dans ledit district sanitaire. Les critères de sélection nous ont permis de sélectionner 30 personnels de santé impliqués dans la surveillance de la rougeole. RésultatsLes médecins étaient les plus représentés (40%), suivi des infirmiers (33,3%). Les agents avaient plus de 3 ans de service (73,3%). Plus de la moitié des agents étaient formés (56%) la moyenne d'année de service était de 5,33 ans.Dans notre étude, 93,3 % des agents connaissaient la définition d'un cas de rougeole. Les seuils d'alerte et épidémique étaient connus par 56,6% des agents enquêtés. La disponibilité des registres de consultation, fiche de notification hebdomadaire de cas au niveau des structures de santé étaient de 86,7 %. Pour la transmission des données, 70% des enquêtés avaient déclarés que les rapports se transmettaient au district hebdomadairement.Les prélèvements de sang avaient été réalisés chez tous les cas suspects (100%). Les cas confirmés de rougeole représentaient 26,8 % des échantillons.ConclusionLa rougeole est une maladie de l'enfance qui est évitable par la vaccination. Cependant à défaut de vaccination, il est impérieux de mettre en place une organisation pour la détection des cas de rougeole afin d'éviter des épidémies

Etude du paiement électronique des agents de santé: cas de la campagne de vaccination contre la rougeole et la rubéole en Côte d'Ivoire / NA

La motivation des agents de santé à travers le paiement à temps et complet constitue l'un des éléments clés pour atteindre de bonne couverture vaccinale. Notre objectif était de décrire le paiement électronique utilisé lors de la campagne rubéole-rougeole et d'apprécier la satisfaction du personnel de santé. Nous avons réalisé une étude transversale à visée analytique qui s'est déroulée en Côte d'Ivoire du 15 janvier au 18 février 2019. La population d'étude était constituée des acteurs impliqués à la fois dans la campagne de vaccination contre la rougeole- rubéole en 2018 et dans le paiement électronique. Une recherche documentaire et des entretiens structurés ont permis le recueil des données. Les données ont été analysées à partir du logiciel R studio© version 2021. Le système assurant le paiement électronique se composait des autorités sanitaires, d'un opérateur privé de téléphonie mobile, d'un partenaire technique et financier et des agents de santé bénéficiaires. Un système de critères d'identification, des listes de validation et de vérification à plusieurs niveaux de la pyramide sanitaire a été mis en place. Un peu moins de trois quarts des acteurs du niveau primaire ont été satisfaits par ce mode de paiement. Le paiement électronique constitue un procédé pour améliorer le paiement des agents de santé durant les campagnes de vaccination. Des leçons d'un tel système de paiement devraient être tirées pour un déploiement à grande échelle.

Motivating healthcare workers through timely and complete payment is one of the key elements to achieve high vaccination coverage. Our objective was to describe the use of electronic payment during the measles-rubella campaign and assess the satisfaction of healthcare personnel. We conducted a cross-sectional analytical study in Côte d'Ivoire from January 15 to February 18, 2019. The study population consisted of individuals involved in both the measles-rubella vaccination campaign in 2018 and electronic payment. Data collection was done through documentary research and structured interviews. The data were analyzed using R Studio© software version 2021. The electronic payment system involved health authorities, a private mobile network operator, a technical and financial partner, and the beneficiary healthcare workers. A system of criteria for identifying lists, validation, and multilevel verification within the healthcare pyramid was established. Just under three-quarters of primarylevel actors were satisfied with this payment method. Electronic payment presents an opportunity to improve healthcare worker payment during vaccination campaigns. Lessons from such a payment system should be drawn for large-scale deployment.

First Presentation of Pheochromocytoma As Acute Myocarditis in Otherwise Young Healthy Man.

Phaeochromocytoma is indeed a rare and frequently misunderstood neuroendocrine tumor originating from chromaffin cells in the adrenal medulla. Its clinical presentation often includes paroxysmal hypertension, palpitations, headache, and diaphoresis, which can easily be mistaken for common medical conditions. Timely diagnosis and precise localization are paramount for ensuring the best possible outcomes for patients. In this case report, we describe an unusual presentation of phaeochromocytoma in a 36-year-old man who presented with acute myocarditis. This atypical manifestation underscores the diagnostic challenges associated with phaeochromocytoma, as its symptoms can mimic various other cardiac and non-cardiac conditions. Vigilant clinical evaluation and a multidisciplinary approach are essential for promptly recognizing and managing such cases, thus optimizing patient care and prognosis.

Pericardial Effusion as the Initial Presentation of Systemic Lupus Erythematosus in a 37-Year-Old Female.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can affect various organs and systems in the body, leading to a wide range of clinical manifestations. Pericardial effusion, which is an accumulation of excessive fluid in the pericardial sac surrounding the heart, can be one of the early presentations of SLE in some individuals. When it occurs in young females, it can be particularly concerning, as SLE predominantly affects women of childbearing age. In this case report, we describe pericardial effusion as the initial presentation of SLE in a 37-year-old mother of four children. Importantly, early diagnosis and consistent follow-up are critical for improving the prognosis and quality of life for individuals with SLE.