Hypoxaemia in hospitalised under-five Nigerian children with pneumonia.

BACKGROUND: Hypoxaemia constitutes a possible complication of severe respiratory illness which is often under-reported in developing countries. Therefore, the current study was carried out to determine the prevalence and clinical predictors of hypoxaemia in hospitalized under-five children with pneumonia in Ilorin, Nigeria. METHODS: This is a descriptive cross-sectional study of 200 children aged between two months and five years with pneumonia recruited consecutively. Socio-demographic, clinical and laboratory data were obtained. The pulse oximetry measurement was recorded after a stable reading for at least one minute while the child was breathing room air. Hypoxaemia was defined as an arterial oxygen saturation of less than 90%. Data was analyzed using the SPSS 20.0 software. RESULTS: The male/female ratio was 1.5:1.The prevalence of hypoxaemia in the children with pneumonia was 41.5%.Using a linear regression analysis, the clinical features that were significantly associated with hypoxaemia were restlessness, lower chest wall indrawing, bronchial breath sounds and tender hepatomegaly (p<0.05 each). Restlessness had a sensitivity of 22.9%, specificity of 91.5%, while chest wall indrawing had a sensitivity of 86.7% and specificity of 53.3%. Bronchial breath sound had a sensitivity of 16.9%, a specificity of 95.7% whereas tender hepatomegaly had a sensitivity of 48.2% and specificity of 82.9%. CONCLUSION: There is a high local burden of pneumonia-associated hypoxaemia. Restlessness, chest wall indrawing, bronchial breath sounds and tender hepatomegaly could be useful in detecting pneumonia-related hypoxemia in poorly equipped health facilities.

Short- and long-term electrical performance of the 5086MRI pacing lead.

BACKGROUND: Owing to potential patient harm, magnetic resonance imaging (MRI) in patients with cardiac implantable electronic devices has traditionally been contraindicated. Following the EnRhythm MRI SureScan Study, an MR conditional pacemaker with modified leads was approved by the Food and Drug Administration. Electrical and handling characteristics of MR conditional pacing leads compared with those of traditional leads have not been established. OBJECTIVE: To compare short- and long-term performance of the Medtronic 5086MRI lead with that of the Medtronic 5076 lead. METHODS: Patients (n = 466) implanted with 2 5086MRI leads (EnRhythm MRI Study) and 316 patients implanted with 2 5076 leads in 2 prospective clinical investigations were analyzed. RESULTS: Electrical characteristics were stable in both groups at implant and at 12 months and were clinically acceptable throughout. Ventricular capture thresholds were slightly higher at 12 months for the 5086MRI lead than for the 5076 lead (0.93 ± 0.47 V vs 0.74 ± 0.42 V; P < .001). Ventricular sensing amplitudes for the 5086MRI lead were lower at implant (9.0 ± 4.7 mV vs 13.9 ± 6.9 mV; P < .001) and 12 months (9.8 ± 4.8 mV vs 15.4 ± 7.5 mV; P < .001) than for the 5076 lead. There was no statistical difference in lead handling. At 12 months, the estimated right atrial lead-related complication-free survival rate was 99.3% for the 5086MRI lead and 99.6% for the 5076 lead (log-rank P = .65), and the estimated right ventricular lead-related complication-free survival rates were 98.5% and 100% (log-rank P = .03). Acute lead dislodgments occurred in 12 patients with the 5086MRI leads (2.6%) compared with 2 patients with 5076 leads (0.6%) (p = .05) than in 0.6% of the patients with the 5076 lead (P = .05). CONCLUSIONS: The 5086MRI lead demonstrates clinically acceptable electrical characteristics while providing safe access to MR-guided diagnostics. However, compared with the 5076 lead, the 5086MRI lead exhibits lower ventricular sensing, slightly higher ventricular capture thresholds, and higher acute lead dislodgement rate.

Profiling of cAMP and cGMP phosphodiesterases in isolated ventricular cardiomyocytes from human hearts: comparison with rat and guinea pig.

AIMS: Phosphodiesterases (PDEs) are key enzymes controlling cAMP and cGMP levels and spatial distribution within cardiomyocytes. Despite the clinical importance of several classes of PDE inhibitor there has not been a complete characterization of the PDE profile within the human cardiomyocyte, and no attempt to assess which species might best be used to model this for drug evaluation in heart disease. MAIN METHODS: Ventricular cardiomyocytes were isolated from failing human hearts of patients with various etiologies of disease, and from rat and guinea pig hearts. Expression of PDE isoforms was determined using RT-PCR. cAMP- and cGMP-PDE hydrolytic activity was determined by scintillation proximity assay, before and after treatment with PDE inhibitors for PDEs 1, 2, 3, 4, 5 and 7. Functional effects of cAMP PDEi were determined on the contraction of single human, rat and guinea pig cardiomyocytes. KEY FINDINGS: The presence and activity of PDE5 were confirmed in ventricular cardiomyocytes from failing and hypertrophied human heart, as well as PDE3, with ventricle-specific results for PDE4 and a surprisingly large contribution from PDE1 for hydrolysis of both cAMP and cGMP. The total PDE activity of human cardiomyocytes, and the profile of inhibition by PDE1, 3, 4, and 5 inhibitors, was modelled well in guinea pig but not rat cardiomyocytes. SIGNIFICANCE: Our results provide the first full characterisation of human cardiomyocyte PDE isoforms, and suggest that guinea pig myocytes provide a better model than rat for PDE levels and activity.

Modeling the walking patterns of Reciprocating Gait Orthosis users with a novel Lower Limb Paralysis Simulator.

A mechanical Lower Limb Paralysis Simulator (LLPS) was developed for able-bodied persons to model the gait of Reciprocating Gait Orthosis (RGO) users. The purpose of this study was to determine if able-bodied subjects ambulating with the LLPS exhibited gait characteristics typical of RGO users. Five able-bodied persons were trained to ambulate with the LLPS and underwent a motion gait analysis. LLPS users were found to exhibit gait patterns that were characteristic of RGO-assisted gait.

Demonstration of balanced coherent detection using polymer optical waveguide integrated distributed traveling-wave photodetectors.

We have demonstrated balanced coherent detection using distributed balanced traveling-wave photodetectors integrated with single mode polymer optical waveguides. Balanced distributed traveling-wave photodetectors having 3 dB bandwidth of 20 GHz exhibited 20 dB signal to noise ratio improvement measured at 15 GHz modulation frequency in a balanced coherent detection demonstration.

Identification of molecular markers and signaling pathway in endometrial cancer in Hong Kong Chinese women by genome-wide gene expression profiling.

Endometrial cancer is the third most common gynecologic malignancy and the ninth most common malignancy for females overall in Hong Kong. Approximately 80% or more of these cancers are endometrioid endometrial adenocarcinomas. The aim of this study was to reveal genes contributing to the development of endometrioid endometrial cancer, which may impact diagnosis, prognosis and treatment of the disease. Whole-genome gene expression analysis was completed for a set of 55 microdissected sporadic endometrioid endometrial adenocarcinomas and 29 microdissected normal endometrium specimens using the Affymetrix Human U133 Plus 2.0 oligonucleotide microarray. Selected genes of interest were validated by quantitative real-time-polymerase chain reaction (qRT-PCR). Pathway analysis was performed to reveal gene interactions involved in endometrial tumorigenesis. Unsupervised hierarchical clustering displayed a distinct separation between the endometrioid adenocarcinomas and normal endometrium samples. Supervised analysis identified 117 highly differentially regulated genes (>or=4.0-fold change), which distinguished the endometrial cancer specimens from normal endometrium. Twelve novel genes including DKK4, ZIC1, KIF1A, SAA2, LOC16378, ALPP2, CCL20, CXCL5, BST2, OLFM1, KLRC1 and MBC45780 were deregulated in the endometrial cancer, and further validated in an independent set of 56 cancer and 29 normal samples using qRT-PCR. In addition, 10 genes were differentially regulated in late-stage cancer, as compared to early-stage disease, and may be involved in tumor progression. Pathway analysis of the expression data from this tumor revealed an interconnected network consisting of 21 aberrantly regulated genes involved in angiogenesis, cell proliferation and chromosomal instability. The results of this study highlight the molecular features of endometrioid endometrial cancer and provide insight into the events underlying the development and progression of endometrioid endometrial cancer.

Demonstration of a 1/4-cycle phase shift in the radiation-induced oscillatory magnetoresistance in GaAs/AlGaAs devices.

We examine the phase and the period of the radiation-induced oscillatory magnetoresistance in GaAs/AlGaAs devices utilizing in situ magnetic field calibration by electron spin resonance of diphenyl-picryl-hydrazal. The results confirm a f-independent 1/4-cycle phase shift with respect to the hf=j variant Planck's over 2pi omega(c) condition for j>/=1, and they also suggest a small ( approximately 2%) reduction in the effective mass ratio, m(*)/m, with respect to the standard value for GaAs/AlGaAs devices.

Personality type and success among female naval academy midshipmen.

There are relatively few studies regarding factors that predict success among female midshipmen at the U.S. Naval Academy (USNA). This study examined the personality characteristics of 1,568 women admitted to USNA between 1988 and 1996 to evaluate whether personality type was predictive of success vs. attrition. Participants completed the Myers-Briggs Type Indicator as well as a demographic questionnaire upon admission. Indicators of performance were gathered at graduation. Results indicated that most women at USNA are extroverts. Extroverted-Sensing-Thinking-Judging types were more likely to graduate, whereas Feeling and Perceiving themes were associated with dropping out. Previous military service and higher Scholastic Aptitude Test Math scores were also predictive of success at USNA. In general, the Myers-Briggs Type Indicator was not a good predictor of academic or military success at USNA. Among women who graduate, Scholastic Aptitude Test (Verbal and Math) scores appear to be the best predictors of both academic and military ratings.

Parental control, trait anxiety, and satisfaction with life in college students.

Research on developmental psychopathology has highlighted the role of parental behavior in subsequent development of pathology in children and adolescents. Although parental psychological control has been an area of interest to researchers, the connection between psychological control and anxiety has not been well established. We administered measures of perceived parental control and acceptance (separate forms for mother and father), trait anxiety, and satisfaction with life to 202 undergraduate students. Analysis indicated that perception of parents (both mother and father) as psychologically controlling was significantly positively correlated with trait anxiety and significantly negatively correlated with satisfaction with life. This held even after the effects of psychological control by the other parent were statistically eliminated.

Mentoring experiences among Navy midshipmen.

Previous research suggests that mentor relationships are facilitative of career success, career satisfaction, and retention in organizations. Yet, little research has been done to explore the prevalence or function of mentor relationships in military populations. In this study, preliminary data were collected regarding the prevalence of mentor relationship experiences among 576 third year midshipmen at the U.S. Naval Academy. Only 40% of respondents had ever experienced a mentor relationship. Most mentors were senior military personnel, and 87% were male. Most relationships were mutually initiated, and they tended to last for several years. Although both career and psychosocial mentor functions were present in these relationships, psychosocial functions were most notable and most highly correlated with positive appraisals of mentor relationships. Midshipmen viewed mentoring as extremely important and rated their own mentor relationships as extremely positive. Implications for further research on mentoring are discussed.

Comparative structure, proximal promoter elements, and chromosome location of the human eosinophil major basic protein genes.

Human eosinophil major basic protein (MBP) is strongly implicated as a mediator of disease, especially bronchial asthma. We recently isolated a highly divergent human homologue of MBP (MBPH). Given human MBP's importance in disease and the restricted expression of it and human MBPH, we isolated the 4.6-kb human MBPH gene (HGMW-approved symbol PRG3). Comparisons among the human MBP (PRG2), human MBPH, and murine MBP-1 (mMBP-1; Prg2) genes suggest that the human MBP and mMBP-1 genes are more closely related than either is to the human MBPH gene. Proximal promoters of these three genes show conservation of potential binding sites for IK2 and STAT and of a known GATA site. However, a known C/EBP site is altered in the human MBPH gene's proximal promoter. The human MBP and MBPH genes localized to chromosome 11 in the centromere to 11q12 region. Thus, the human MBP and MBPH genes have diverged considerably, probably following a gene duplication event. Furthermore, the identified conserved and distinct proximal promoter elements likely contribute to the eosinophil-restricted and relatively reduced transcription of the human MBPH gene.

Bacterial pathogens and outcome determinants of childhood pyogenic meningitis in Ilorin, Nigeria.

Empirical antimicrobial therapy remainsjustifiable in childhood pyogenic meningitis (CPM), but the continuing efficacy in a particular setting requires periodic microbiological surveillance. It was this need that informed the present five-year retrospective study of consecutive admissions for CPM at the Emergency Paediatric Unit (EPU) of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Of the 71 cerebro-spinal fluid [CSF] analyses, 41 (57.6%) were Gram-smear positive (GSP). Gram-positive cocci (GPC) were identified in 23 (56.1%) smears, while 14 (34.2.%) had Gram-negative bacilli (GNB). Only three (7.3%) had Gram-negative diplococci (GND). Despite corroborative biochemical findings, the remaining 30 (42.3%), including two with tuberculous meningitis proved smear-negative. GPC cases had a mean age of 4.49 +/- 5.3yrs, GNB, 3.06 +/- 4.8yrs and GND, 4.47 +/- 4.9yrs. CSF isolates were made in 28 (39.4%) cases. Streptococcus pneumoniae accounted for a predominant 22 (78.6%) (P = 0.00), Haemophilus influenzae for 2 (7.1%), and Neisseria meningitidis for only 1 (3.5%) case. Whereas Strept. pneumoniae and H. influenzae isolates were uniformly sensitive to each of sultamicillin, cefuroxime, ceftriaxone and ceftazidime, 7.7% of Strept. pneumoniae were resistant to crystalline penicillin, 6.7% to ampicillin, and 69.2% to chloramphenicol; one of the two H. influenzae isolates was chloramphenicol-resistant. Amongst the 30 (42.3%) fatal cases, the length of stay was significantly shorter in GNB-positive cases (P = 0.045). Mortality was significantly higher amongst cases with purulent/turbid CSF at admission (P = 0.03), and in those with CSF protein of >150mg/dl (P = 0.02) and glucose <1mg/dl (P = 0.047). The present aetiological preponderance of GPC and Strept. pneumoniae in our study population, the high case-fatality, and the emerging resistance profile suggest the need for exploring additional control options including vaccination. We emphasize the need for periodic auditing of local antimicrobial policies in CPM.

Perception of parental acceptance in women with binge eating disorder.

The authors contribute to the validating literature for binge eating disorder (BED) by examining perceptions of parents and satisfaction with life among obese women with and without BED. Participants were female patients, recruited through a private medical clinic, who were assigned to groups on the basis of body mass index (BMI) and scores on the Questionnaire on Eating and Weight Patterns (QEWP; R. L. Spitzer et al., 1992). Groups consisted of (a) obese women with BED (n = 32), (b) obese women who had no eating disorders (n = 51), and (c) nonobese women with no eating disorders (n = 30). All participants completed the Parental Acceptance/Rejection Questionnaire (PARQ; R. P. Rohner, 1986), the Satisfaction with Life Scale (SWLS; J. Fischer & K. Corcoran, 1994), and the Beck Depression Inventory (BDI; A. T. Beck & R. A. Steer, 1987). Obese women with BED perceived their fathers as more rejecting than did women in the other groups. Moreover, obese women with BED perceived their fathers as significantly more rejecting than their mothers. The BED group indicated lower satisfaction with life and higher levels of depression than the groups without eating disorders. These findings further validate the diagnostic category of BED. Obese women with BED appear to be a distinct subgroup of the obese population. The results indicate a need for further assessment of the father-daughter relationship in connection to BED and other eating disorders.

The role of objective personality inventories in suicide risk assessment: an evaluation and proposal.

Objective personality assessment instruments offer a comparatively underutilized source of clinical data in attempts to evaluate and predict risk for suicide. In contrast to focal suicide risk measures, global personality inventories may be useful in identification of long-standing styles that predispose persons to eventual suicidal behavior. This article reviews the empirical literature regarding the efficacy of established personality inventories in predicting suicidality. The authors offer several recommendations for future research with these measures and conclude that such objective personality instruments offer only marginal utility as sources of clinical information in comprehensive suicide risk evaluations. Personality inventories may offer greatest utility in long-term assessment of suicide risk.

Acute laryngotracheobronchitis in Nigerian children.

In a prospective study of cases of severe acute respiratory infections seen at the University College Hospital, Ibadan over a 30-month period, 39 cases were found to have acute upper airway obstruction; out of this number, acute laryngotracheobronchitis (croup) accounted for 35 (90%). The ages of the 35 ranged from 2 to 53 months with 86% being less than 3 years old, while there was a male preponderance (M:F ratio, 1.7:1). Croup was associated with bronchopneumonia in 29%, measles in 2.9%, and with both in 40% of the 35 cases. The mean respiratory rate in patients in whom croup co-existed with measles and pneumonia was significantly higher than that in patients with croup alone (P < 0.001). Six (55%) of the eleven viral identifications made were Parainfluenza virus types 1-3, while Respiratory syncytial virus was identified in three patients. Of the 18 blood cultures done, only one was positive, yielding Klebsiella pneumoniae in a two-year old undernourished child with associated measles and bronchopneumonia. Mortality was 11%; all the four children who died had associated bronchopneumonia, which complicated measles infection in three. The findings in this study support the view that antibiotic therapy is not routinely indicated in the management of croup. Furthermore, measles and bronchopneumonia were identified as indicators of poor prognosis requiring extra care in management.

Personality characteristics of future military leaders.

Relatively little is known about the personality characteristics of military personnel, particularly those who are most successful in military careers. This study evaluated the personality characteristics of 530 third-year midshipmen at the U.S. Naval Academy. Participants completed the Hogan Personality Inventory and a demographic questionnaire. Class ranking data were also obtained as an indicator of success at the Naval Academy. The results indicated that compared with national norms, midshipmen scored somewhat higher on scales of ambition, sociability, intellectance, and school success and lower on scales of adjustment, likability, and prudence. Ambition, prudence, intellectance, and school success were each significantly positively correlated with class standing. The implications of these findings for understanding personality correlates of success in military leadership are discussed.

Learning ethics the hard way: facing the ethics committee.

This article describes an approach to enhancing the value of case study material in teaching professional ethics in psychology. The mock committee approach involves a series of hearings convened by students who rotate membership on a class ethics committee. Members of the class participate randomly as psychologists accused of various ethical violations. While the class observes, formal complaint hearings occur that result in official rulings and the setting of appropriate penalties and remedial requirements. The larger class then joins in active feedback and exchange with the committee to highlight and discuss salient ethical issues. We present and discuss student evaluation data for this technique and comment on the potential advantages of this teaching approach.