Dietary monoglyceride supplementation to support intestinal integrity and host defenses in health-challenged weanling pigs.

Frequent incidence of postweaning enterotoxigenic Escherichia coli (ETEC) diarrhea in the swine industry contributes to high mortality rates and associated economic losses. In this study, a combination of butyric, caprylic, and capric fatty acid monoglycerides was investigated to promote intestinal integrity and host defenses in weanling pigs infected with ETEC. A total of 160 pigs were allotted to treatment groups based on weight and sex. Throughout the 17-d study, three treatment groups were maintained: sham-inoculated pigs fed a control diet (uninfected control [UC], n = 40), ETEC-inoculated pigs fed the same control diet (infected control [IC], n = 60), and ETEC-inoculated pigs fed the control diet supplemented with monoglycerides included at 0.3% of the diet (infected supplemented [MG], n = 60). After a 7-d acclimation period, pigs were orally inoculated on each of three consecutive days with either 3 mL of a sham-control (saline) or live ETEC culture (3 × 109 colony-forming units/mL). The first day of inoculations was designated as 0 d postinoculation (DPI), and all study outcomes reference this time point. Fecal, tissue, and blood samples were collected from 48 individual pigs (UC, n = 12; IC, n = 18; MG, n = 18) on 5 and 10 DPI for analysis of dry matter (DM), bacterial enumeration, inflammatory markers, and intestinal permeability. ETEC-inoculated pigs in both the IC and MG groups exhibited clear signs of infection including lower (P < 0.05) gain:feed and fecal DM, indicative of excess water in the feces, and elevated (P < 0.05) rectal temperatures, total bacteria, total E. coli, and total F18 ETEC during the peak-infection period (5 DPI). Reduced (P < 0.05) expression of the occludin, tumor necrosis factor α, and vascular endothelial growth factor A genes was observed in both ETEC-inoculated groups at the 5 DPI time point. There were no meaningful differences between treatments for any of the outcomes measured at 10 DPI. Overall, all significant changes were the result of the ETEC infection, not monoglyceride supplementation.

Infection caused by the bacterium known as enterotoxigenic Escherichia coli (ETEC) is a common disruptor of weaned pigs' health, leading to economic losses for the producers. To determine if nutritional supplementation could help protect against these losses, weaned pigs were assigned to one of three treatments: 1) uninfected and fed a standard nursery pig diet, 2) infected with ETEC and fed the same standard diet, or 3) infected with ETEC and fed the standard diet supplemented with a combination of butyric, caprylic, and capric fatty acid monoglycerides. Growth performance was tracked throughout the 17-d study and health outcomes were measured at the peak and resolution of ETEC infection. At the peak-infection time point, pigs that were infected with ETEC had lower fecal moisture content, greater fecal bacterial concentrations, and elevated body temperatures compared with uninfected pigs. Additionally, infection reduced expression of genes related to inflammation, angiogenesis, and the intestinal barrier during the peak-infection period. Overall, all significant changes were the result of the ETEC infection, and there were no meaningful differences observed between the different treatments.

Longitudinal Studies of Aging in Sub-Saharan Africa: Review, Limitations, and Recommendations in Preparation of Projected Aging Population.

Background and Objectives: The United Nations has projected a 218% increase in older people in Sub-Saharan Africa (SSA) between 2019 and 2050, underscoring the need to explore changes that would occur over this time. Longitudinal studies are ideal for studying and proffering solutions to these changes. This review aims to understand the breadth and use of longitudinal studies on aging in the SSA regions, proffering recommendations in preparation for the projected aging population. Research Design and Methods: This paper is the third of a four-part series paper of a previous systematic mapping review of aging studies in SSA. We updated the search (between 2021 and 2023) and screened the titles/abstracts and full-text articles by a pair of independent reviewers. Data were extracted using a standardized data-charting form, identifying longitudinal studies in SSA. Results: We identified 193 studies leveraging 24 longitudinal study data sets conducted at 28 unique sites. The World Health Organization's Study on Global AGEing and Adult Health (WHO-SAGE) (n = 59, 30.5%) and Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (n = 51, 26.4%) were the most used longitudinal data sets. Four studies used more than one longitudinal study data set. Eighteen of the longitudinal study data sets were used only in 1-4 studies. Most (n = 150, 77.7%) of the studies used a cross-sectional analytical approach. Discussion and Implications: Longitudinal studies on aging are sparingly being utilized in SSA. Most analyses conducted across the longitudinal data set were cross-sectional, which hindered the understanding of aging changes that occurred over time that could better inform aging policy and interventions. We call for funding bodies, such as WHO-SAGE, to develop funding competitions that focus on conducting longitudinal analyses, such as structural equation modeling, highlighting changes occurring among the aging population in SSA.

Profile and Correlates of Sleep Quality and Obstructive Sleep Apnoea among Young Persons in Ibadan, Southwestern Nigeria.

BACKGROUND: Sleep breathing disorders (SDB), especially obstructive sleep apnoea (OSA), are poorly studied in the young population. This study aimed to determine the prevalence of OSA and its associated risk factors among young persons. METHODS: A cross-sectional study design was used, and participants aged 16-35 years were recruited from five tertiary institutions in Ibadan, South Western, Nigeria. The study used a structured questionnaire, stadiometer, weighing scale, tape measure, and digital blood pressure machine to collect data. Patient Health Questionnaire (PHQ 9), Generalized Anxiety Disorder-7(GAD-7), and Pittsburgh sleep quality index (PSQI) were used to assess depression, anxiety, and sleep quality respectively. To assess the risk of OSA, we used both the STOP-Bang questionnaire and the NOSAS score. The Statistical Package for the Social Sciences version 23 was used to analyse the data, and statistical significance was set at <0.05. RESULTS: A total of 354 participants were included in this report with a mean age of 21.2±3.5 years. The female: male ratio was 1.9:1. The mean ±standard deviation of PSQI, GAD-7 score and PHQ-9 were 2.2±1.1, 12.4±5.1 and 15.0±5.4 respectively. The following percentages of participants were found to be at low, intermediate, and high risk for OSA: 94.1%, 5.6%, and 0.3%, respectively. This study showed that age and GAD-7 score were independently associated with the PSQI score while age, body mass index, neck cuff size and PHQ-9 score for OSA score. CONCLUSION: There is a burden of OSA among this population of young people; and modifying anthropometric and psychosocial factors can help mitigate the risk of OSA outcomes.

CONTEXTE: Les troubles respiratoires du sommeil (TRS), en particulier l'apnée obstructive du sommeil (AOS), sont peu étudiés chez la population jeune. Cette étude visait à déterminer la prévalence de l'ASO et ses facteurs de risque associés chez les jeunes. MÉTHODES: Un schéma d'étude transversale a été utilisé, et les participants âgés de 16 à 35 ans ont été recrutés dans cinq institutions tertiaires à Ibadan, au sud-ouest du Nigeria. L'étude a utilisé un questionnaire structuré, une toise, une balance, un ruban à mesurer et un tensiomètre numérique pour collecter les données. Le questionnaire Patient Health Questionnaire (PHQ-9), le Generalized Anxiety Disorder-7 (GAD-7) et l'index de qualité du sommeil de Pittsburgh (PSQI) ont été utilisés pour évaluer la dépression, l'anxiété et la qualité du sommeil respectivement. Pour évaluer le risque d'AOS, nous avons utilisé à la fois le questionnaire STOP-Bang et le score NOSAS. Le logiciel Statistical Package for the Social Sciences version 23 a été utilisé pour analyser les données, et la signification statistique a été fixée à <0,05. RÉSULTATS: Un total de 354 participants ont été inclus dans cette étude avec un âge moyen de 21,2±3,5 ans. Le ratio femmes : hommes était de 1,9:1. Les moyennes ± écart-type du PSQI, du score GAD-7 et du PHQ-9 étaient respectivement de 2,2±1,1, 12,4±5,1 et 15,0±5,4. Les pourcentages suivants de participants étaient classés à faible, intermédiaire et haut risque d'AOS: 94,1 %, 5,6 % et 0,3 %, respectivement. Cette étude a montré que l'âge et le score GAD-7 étaient associés de manière indépendante au score PSQI, tandis que l'âge, l'indice de masse corporelle, la circonférence du cou et le score PHQ-9 étaient associés au score ASO. CONCLUSION: Il existe un fardeau de l'ASO parmi cette population de jeunes; et la modification des facteurs anthropométriques et psychosociaux peut aider à atténuer le risque de résultats d'ASO. MOTS-CLÉS: Apnée obstructive du sommeil; Troubles Respiratoires du Sommeil ; Épidémiologie ; Trouble du sommeil.

Molecular characterization of non-aureus staphylococci and Mammaliicoccus from Hipposideros bats in Southwest Nigeria.

Bats are not only ecologically valuable mammals but also reservoirs of zoonotic pathogens. Their vast population, ability to fly, and inhabit diverse ecological niches could play some role in the spread of antibiotic resistance. This study investigated non-aureus staphylococci and Mammaliicoccus colonization in the Hipposideros bats at Obafemi Awolowo University, Ile-Ife, Nigeria. Pharyngeal samples (n = 23) of the insectivorous bats were analyzed, and the presumptive non-aureus staphylococcal and Mammaliicoccus isolates were confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The isolates were characterized based on antibiotic susceptibility testing and whole-genome sequencing (WGS). Six bacterial genomes were assembled, and three species were identified, including Mammaliicoccus sciuri (n = 4), Staphylococcus gallinarum (n = 1), and Staphylococcus nepalensis (n = 1). All the isolates were resistant to clindamycin, while the M. sciuri and S. gallinarum isolates were also resistant to fusidic acid. WGS analysis revealed that the M. sciuri and S. gallinarum isolates were mecA-positive. In addition, the M. sciuri isolates possessed some virulence (icaA, icaB, icaC, and sspA) genes. Multi-locus sequence typing identified two new M. sciuri sequence types (STs) 233 and ST234. The identification of these new STs in a migratory mammal deserves close monitoring because previously known ST57, ST60, and ST65 sharing ack (8), ftsZ (13), glpK (14), gmk (6), and tpiA (10) alleles with ST233 and ST234 have been linked to mastitis in animals. Moreover, the broad host range of M. sciuri could facilitate the dispersal of antibiotic resistance genes. This study provides evidence of the importance of including migratory animals in monitoring the development and spread of antibiotic resistance.

Mathematical investigation of normal and abnormal wound healing dynamics: local and non-local models.

The movement of cells during (normal and abnormal) wound healing is the result of biomechanical interactions that combine cell responses with growth factors as well as cell-cell and cell-matrix interactions (adhesion and remodelling). It is known that cells can communicate and interact locally and non-locally with other cells inside the tissues through mechanical forces that act locally and at a distance, as well as through long non-conventional cell protrusions. In this study, we consider a non-local partial differential equation model for the interactions between fibroblasts, macrophages and the extracellular matrix (ECM) via a growth factor (TGF-$ \beta $) in the context of wound healing. For the non-local interactions, we consider two types of kernels (i.e., a Gaussian kernel and a cone-shaped kernel), two types of cell-ECM adhesion functions (i.e., adhesion only to higher-density ECM vs. adhesion to higher-/lower-density ECM) and two types of cell proliferation terms (i.e., with and without decay due to overcrowding). We investigate numerically the dynamics of this non-local model, as well as the dynamics of the localised versions of this model (i.e., those obtained when the cell perception radius decreases to 0). The results suggest the following: (ⅰ) local models explain normal wound healing and non-local models could also explain abnormal wound healing (although the results are parameter-dependent); (ⅱ) the models can explain two types of wound healing, i.e., by primary intention, when the wound margins come together from the side, and by secondary intention when the wound heals from the bottom up.

Evaluation of antimicrobial usage in companion animals at a Veterinary Teaching Hospital in Nigeria.

This study investigated various qualitative and quantitative indices of antimicrobial use (AMU) in companion animals (CAs) at a Veterinary Teaching Hospital (VTH-A) and its annex (VTH- B) from 2019 to 2021. For 694 documented animals, antimicrobial administrations (AADs) were 5, 278 times, of which 98.8% (5217) and 1.2% (61) were in dogs and cats respectively. At the VTH- A, oxytetracycline (1185 times, 22.5%) was mostly administered in dogs and metronidazole (26 times, 0.5%) in cats. Similarly, at VTH- B, oxytetracycline was administered 895 times (17.0%) in dogs while amoxicillin was given 7 times (0.1%) in cats. The prescription diversity (PD) was estimated at 0.73 and 0.82 in VTH-A and VTH-B respectively. The quantity of antimicrobials (AMs) used was 10.1 kg (A, 6.2 kg and B, 3.9 kg). Oxytetracycline administrations and quantity of metronidazole (P < 0.0001) were higher than other Active Ingredients (AIs). Furthermore, 16.5% of AIs were classified as Critically Important Antibiotics (CIA) with the highest priority, while enrofloxacin, ciprofloxacin, and azithromycin fell under the World Health Organisation (WHO) Watch group. The In-Depth Interview (IDI) indicated that the high frequency of oxytetracycline administrations was linked with being the first choice for blood parasite treatment by the clinicians at the hospital. The quantity of metronidazole used was perceived to be higher due to the clinicians' preference for the treatment of acute gastroenteritis, its wider dose range, and the frequency of administration (bi-daily). The study provides baseline data on AMU indices in CAs, for the development of antimicrobial stewardship (AMS) and communication training, and policy modifications to enhance antimicrobial therapy optimization in tertiary veterinary hospital care in Nigeria.

Modelling Keloids Dynamics: A Brief Review and New Mathematical Perspectives.

Keloids are fibroproliferative disorders described by excessive growth of fibrotic tissue, which also invades adjacent areas (beyond the original wound borders). Since these disorders are specific to humans (no other animal species naturally develop keloid-like tissue), experimental in vivo/in vitro research has not led to significant advances in this field. One possible approach could be to combine in vitro human models with calibrated in silico mathematical approaches (i.e., models and simulations) to generate new testable biological hypotheses related to biological mechanisms and improved treatments. Because these combined approaches do not really exist for keloid disorders, in this brief review we start by summarising the biology of these disorders, then present various types of mathematical and computational approaches used for related disorders (i.e., wound healing and solid tumours), followed by a discussion of the very few mathematical and computational models published so far to study various inflammatory and mechanical aspects of keloids. We conclude this review by discussing some open problems and mathematical opportunities offered in the context of keloid disorders by such combined in vitro/in silico approaches, and the need for multi-disciplinary research to enable clinical progress.

Clinical Characteristics, Management, and Six-Month Outcomes after Discharge of Patients Admitted for Acute Heart Failure in Ibadan, Nigeria.

BACKGROUND: The burden of acute heart failure (AHF) is on the increase globally however, there are few studies on AHF in Nigeria and among black populations. OBJECTIVE: This study described the clinical profile, conventional management and six-months outcome after discharge of patients admitted for acute heart failure at the University College Hospital, Ibadan, Nigeria. METHODS: The study was a prospective study of 160 consecutive AHF patients. Socio-demographic details, clinical history, basic laboratory parameters electrocardiographic and echocardiographic parameters were assessed. They were followed-up for six-months after discharge to ascertain death or readmission. RESULTS: The mean ± standard deviation (SD) age of all the patients was 58.0 ±15.1 years. Those aged 60 years and above constituted about half of the participants. Males comprised 59.3% and hypertension was the most common risk factor (77.5%). One hundred and thirty-four subjects (83.8%) were in New York Heart Association functional classes III or IV. The most common AHF type was heart failure with reduced ejection fraction and mostly presented de novo. The mean duration of admission was 11 days while intrahospital mortality and mortality at 6 months after discharge were 6.3% and 25.6% respectively. CONCLUSION: This study provided a real-world data of AHF at UCH, Ibadan, Nigeria. It showed AHF was predominantly associated with hypertension. There was high mortality among these AHF subjects. There is a need for more strategy in our environment for preventing AHF and its adverse outcomes.

CONTEXTE: Le fardeau de l'insuffisance cardiaque aiguë (ICA) est en augmentation dans le monde entier ; cependant, il existe peu d'études sur l'ICA au Nigeria et parmi les populations noires. OBJECTIF: Cette étude décrit le profil clinique, la prise en charge conventionnelle et le résultat six mois après la sortie des patients admis pour une insuffisance cardiaque aiguë à l'University College Hospital, Ibadan, Nigeria. MÉTHODES: L'étude était une étude prospective de 160 patients consécutifs souffrant d'insuffisance cardiaque aiguë. Les détails sociodémographiques, l'histoire clinique, les paramètres de laboratoire de base, les paramètres électrocardiographiques et échocardiographiques ont été évalués. Ils ont été suivis pendant six mois après leur sortie de l'hôpital pour vérifier le décès ou la réadmission. RÉSULTATS: L'âge moyen ± écart-type (ET) de tous les patients était de 58,0 ±15,1 ans. Les personnes âgées de 60 ans et plus constituaient environ la moitié des participants. Les hommes représentaient 59,3 % et l'hypertension était le facteur de risque le plus fréquent (77,5 %). Cent trente-quatre sujets (83,8 %) appartenaient aux classes fonctionnelles III ou IV de la New York Heart Association. Le type d'AHF le plus fréquent était l'insuffisance cardiaque avec fraction d'éjection réduite et se présentait le plus souvent de novo. La durée moyenne d'admission était de 11 jours tandis que la mortalité intrahospitalière et la mortalité à 6 mois après la sortie étaient respectivement de 6,3% et 25,6%. CONCLUSION: Cette étude a fourni des données réelles de l'AHF à l'UCH, Ibadan, Nigeria. Elle a montré que l'AHF était principalement associée à l'hypertension. Il y avait une mortalité élevée parmi ces sujets AHF. Il y a un besoin de plus de stratégie dans notre environnement pour prévenir l'AHF et ses résultats défavorables. Mots-clés: Insuffisance cardiaque. Insuffisance cardiaque aiguë, Nigeria, Hypertension, Maladie cardiovasculaire.

PREDICTORS OF ACUTE HEART FAILURE OUTCOMES AT UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA.

Background: Studies of acute heart failure (AHF) outcomes suggest that there are different predictors of mortality depending on region, ethnicity, and gender. Objective: The purpose of this study was to identify predictors of six months' post discharge outcome among AHF patients in a Nigerian tertiary hospital. Methods and Materials: This study was a prospective observational study conducted at the cardiology unit of the Department of Medicine at the University College Hospital Ibadan. One hundred and sixty AHF participants ≥ 18 years old were recruited. Results: The mean age of the cohort was 58.0±15.1 years and most were males (59.4%). The independent predictors for death outcome after six months of discharge for AHF and the adjusted hazard ratio) (95% CI) were male gender 2.77 (1.17 -6.56); p =0.020 ; systolic blood pressure (mmHg) 0.98 (0.96 - 0.99); p = 0.011 ; and the presence of hepatomegaly 2.58 (1.02 - 6.51); p = 0.045 . Independent predictors for readmission or rehospitalization within 6 months after discharge were presence of right abdominal pain adjusted HR (95% CI): 2.07(1.14 - 3.76), p=0.017; SBP 0.98(0.96 - 0.99), p=0.005. Independent predictors for composite endpoint were male gender: adjusted HR: 2.08 (1.16 - 3.72), p= 0.014 and pericardial effusion and tamponade: 5.31(1.79 - 15.74), p=0.003 . Conclusion: The study provided an insight into the factors contributing to outcomes six-month after admission in a tertiary centre in South-Western Nigeria, and it highlighted the predictive role of systolic blood pressure.

Black People Narrate Inequalities in Healthcare Systems that Hinder COVID-19 Vaccination: Evidence from the USA and the UK.

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global health emergency. As a novel condition, there is no known definitive treatment for the condition, except for the use of vaccines as a control measure. In the literature, the issue of inequalities in healthcare systems has been documented as a hindrance to COVID-19 vaccination; however, the specific inequalities in healthcare systems that hinder COVID-19 vaccination are poorly understood. Guided by the fundamental cause theory (FCT), this study aims to address this gap among Black people, a minority group vulnerable to inequalities in healthcare systems. Thirty-five Black people (age range = 21-58 years) residing in either the United States of America (USA) or the United Kingdom (UK) participated in this study. Qualitative data were collected and analyzed using thematic analysis. Most USA participants and a few UK participants narrated that no inequalities in healthcare systems hinder them from receiving COVID-19 vaccines. Contrarily, most UK participants and a few USA participants narrated inequalities in healthcare systems that hinder them from receiving COVID-19 vaccines. These are mistrust of the healthcare system, health policies regarding COVID-19 vaccination, historical factors (such as historical abuse of Black bodies by health professionals), residential location, and dissatisfaction with health services. In terms of what governments must do to correct these inequalities, participants recommended the need for acknowledgment and community engagement. This is the first international collaboration to examine this problem. Important implications for theory, healthcare systems, and COVID-19 vaccination program planning are highlighted. Finally, there are members of other minority groups and vulnerable communities who are not Black people. Such groups could face unique inequalities that hinder COVID-19 vaccination. Therefore, future studies should include such groups.

Description of Staphylococcal Strains from Straw-Coloured Fruit Bat (Eidolon helvum) and Diamond Firetail (Stagonopleura guttata) and a Review of their Phylogenetic Relationships to Other Staphylococci.

The phylogenetic tree of the Staphylococcus aureus complex consists of several distinct clades and the majority of human and veterinary S. aureus isolates form one large clade. In addition, two divergent clades have recently been described as separate species. One was named Staphylococcus argenteus, due to the lack of the "golden" pigment staphyloxanthin. The second one is S. schweitzeri, found in humans and animals from Central and West Africa. In late 2021, two additional species, S. roterodami and S. singaporensis, have been described from clinical samples from Southeast Asia. In the present study, isolates and their genome sequences from wild Straw-coloured fruit bats (Eidolon helvum) and a Diamond firetail (Stagonopleura guttata, an estrildid finch) kept in a German aviary are described. The isolates possessed staphyloxanthin genes and were closer related to S. argenteus and S. schweitzeri than to S. aureus. Phylogenetic analysis revealed that they were nearly identical to both, S. roterodami and S. singaporensis. We propose considering the study isolates, the recently described S. roterodami and S. singaporensis as well as some Chinese strains with MLST profiles stored in the PubMLST database as different clonal complexes within one new species. According to the principle of priority we propose it should be named S. roterodami. This species is more widespread than previously believed, being observed in West Africa, Southeast Asia and Southern China. It has a zoonotic connection to bats and has been shown to be capable of causing skin and soft tissue infections in humans. It is positive for staphyloxanthin, and it could be mis-identified as S. aureus (or S. argenteus) using routine procedures. However, it can be identified based on distinct MLST alleles, and "S. aureus" sequence types ST2470, ST3135, ST3952, ST3960, ST3961, ST3963, ST3965, ST3980, ST4014, ST4075, ST4076, ST4185, ST4326, ST4569, ST6105, ST6106, ST6107, ST6108, ST6109, ST6999 and ST7342 belong to this species.

Comparative Analysis of Left Ventricular Geometry in Adult Nigerians with and without Chronic Kidney Disease: Results from Ibadan CRECKID STUDY.

BACKGROUND: Chronic kidney disease (CKD) is associated with increased risk of cardiovascular morbidity and mortality. Left ventricular hypertrophy (LVH) is considered the strongest independent predictor of cardiovascular disease and events among CKD patients. We reported the echocardiographic left ventricular geometry in CKD patients compared to non-CKD hypertensive and apparently healthy controls in Ibadan. MATERIALS AND METHODS: A total of 683 participants in the CRECKID STUDY comprising 220(32.2%) CKD patients, 281(41.1%) non-CKD hypertensive patients and 182(26.6%) healthy controls were included in this analysis. Basic demographic and clinical information with echocardiographic parameters were obtained. RESULTS: Study participants in the non-CKD hypertensive group were on average older than the CKD and the healthy controls (56.2±13.1 vs 47.2±14.6, and 46.8±13.3 years, respectively; p<0.01). Compared with other groups, greater proportions of participants with CKD were men (40.5% vs.38.1% and 21.3%; p<0.0001). The left atrial and left ventricular dimensions were significantly higher in CKD compared with others. LVH was significantly more prevalent among CKD patients (68.2%) compared to hypertensive (43.9%) and normotensive (19.5%) group (p<0.01). The participants with CKD had a greater proportion of abnormal LV geometry with concentric LVH predominating (p<0.0001). Having LVH was associated with lower mean estimated glomerular filtration rate (eGFR) (40.6±37.71 vs 67±37.38, p<0.0001). CONCLUSION: In our study, patients with CKD had the highest prevalence of abnormal LV geometry and functions. A unit decrease in eGFR was associated with increased left ventricular mass. Early detection and prompt management of abnormal LV geometry may help in reducing adverse cardiovascular outcome in patients with CKD.

CONTEXTE: L'insuffisance rénale chronique (MRC) est associée àrisque accru de morbidité et de mortalité cardiovasculaires. Gauche l'hypertrophie ventriculaire (LVH) est considérée comme la plus forte prédicteur indépendant des maladies cardiovasculaires et des événements chez Patients atteints d'IRC. Nous avons rapporté l'échocardiographie ventriculaire gauche géométrie chez les patients atteints d'IRC par rapport aux patients hypertendus non atteints d'IRC etcontrôles apparemment sains à Ibadan. MATÉRIAUX ET MÉTHODES: Un total de 683 participants à la ÉTUDE CRECKID portant sur 220 (32.2%) patients atteints d'IRC,281 (41.1 %) patients hypertendus non atteints d'IRC et 182 (26.6 %) en bonne santé ont été inclus dans cette analyse. Démographie et clinique de base des informations avec des paramètres échocardiographiques ont été obtenues. RÉSULTATS: Participants à l'étude dans le groupe hypertendu non atteint d'IRC étaient en moyenne plus âgés que l'IRC et les témoins sains(56.2±13.1 vs 47.2±14.6 et 46.8±13.3 ans, respectivement; p<0.01). Par rapport à d'autres groupes, plus grande proportion de participants avec l'IRC étaient des hommes (40.5 % contre 38.1 % et 21.3 %; p<0.0001). Les dimensions auriculaire gauche et ventriculaire gauche étaient significativement plus élevées chez CKD par rapport à d'autres. La LVH était significativement plus répanduechez les patients atteints d'IRC (68.2 %) par rapport aux patients hypertendus (43.9 %) et le groupe normotensif (19.5 %) (p<0.01). Les participants avec CKD avait une plus grande proportion de géométrie LV anormale avec LVH concentrique prédominante (p<0.0001). Avoir LVH était associé à un débit de filtration glomérulaire estimé moyen plus faible (DFGe)(40.6±37.71 contre 67±37.38, p<0,0001). CONCLUSION: Dans notre étude, les patients atteints d'IRC avaient le plus haut prévalence d'une géométrie et de fonctions LV anormales. Une diminution unitaire de Le DFG était associé à une augmentation de la masse ventriculaire gauche. Tôt la détection et la gestion rapide de la géométrie LV anormale peuvent aider à réduire les résultats cardiovasculaires indésirables chez les patients atteints de CKD. Mots-clés: Maladie rénale chronique, Hypertensives, ventriculaire gauche géométrie.

Skin and nasal colonization of coagulase-negative staphylococci are associated with atopic dermatitis among South African toddlers.

BACKGROUND: Skin colonization with coagulase-negative staphylococci (CoNS) is generally beneficial, but recent investigations suggest its association with flares and atopic dermatitis (AD) severity. However, this relationship remains unclear. OBJECTIVE: To assess patterns of staphylococcal colonization and biofilm formation in toddlers with and without AD from rural and urban South African settings. METHODS: We conducted a cross-sectional study of AD-affected and non-atopic AmaXhosa toddlers from rural Umtata and urban Cape Town, South Africa. CoNS isolates were recovered from lesional, nonlesional skin samples and the anterior nares of participants. Identification of the staphylococci was achieved by MALDI-TOF mass spectrometry. The microtiter plate assay assessed in-vitro biofilm formation. RESULTS: CoNS and S. aureus commonly co-colonized nonlesional skin among cases (urban: 24% vs. 3%, p = 0.037 and rural 21% vs. 6%, p<0.001), and anterior nares in urban cases (24% vs. 0%, p = 0.002) than the control group. S. capitis colonization on nonlesional skin and anterior nares was positively associated with more severe disease in rural (48.3±10.8 vs. 39.7±11.5, P = 0.045) and urban cases (74.9±10.3 vs. 38.4±13, P = 0.004), respectively. Biofilm formation was similar between cases and controls, independent of rural-urban living. CONCLUSION: CoNS colonization is associated with AD and disease severity and may be implicated in AD exacerbations. Studies are needed to understand their underlying pathological contribution in AD pathogenesis.

Metabotropic glutamate receptor 5 blockade attenuates pathological cardiac remodelling in pulmonary arterial hypertension.

Pulmonary arterial hypertension (PAH) is characterized by cardiac remodelling. Glutaminolysis plays a crucial role in PAH-induced remodelling. The metabotropic glutamate receptor 5 (mGluR5) may mediate this process. This study investigated whether or not the blockade of mGluR5 may attenuate PAH-induced pathological cardiac remodelling. Pulmonary arterial hypertension was induced by intraperitoneally injecting male Sprague-Dawley (SD) rats with 60 mg/kg of monocrotaline (MCT). 3-((2-Methyl-4-thiazolyl)ethynyl)pyridine (MTEP) (10 mg/kg intraperitoneally) was used as a therapeutic intervention to block mGluR5. Cardiac functions were assessed with right heart catheterization and electrocardiography. Alterations in protein expressions and inflammatory markers were investigated using western blot and enzyme-linked immunosorbent assay (ELISA), respectively. Increased right ventricular systolic pressure (RSVP), elevated protein expressions of mGluR5, collagen types I and III and cartilage intermediate layer protein 1 (CILP1), enhanced phosphorylation of phosphatidylinositol 3-kinase (PI3K), AKT and p38 mitogen-activated protein kinase (P38MAPK), increased angiopoietin 2 (Ang 2) and vascular endothelial growth factor-α (VEGF) protein expressions and elevated serum levels of interleukin 6 (IL-6) and tumour necrotic factor α (TNF-α) were observed in MCT-induced PAH rats. MTEP improved hemodynamics and right ventricular hypertrophy. MTEP also attenuated MCT-induced elevations in the protein expressions of mGluR5, collagen types I and III, CILP1, Ang 2 and VEGF and decreased PI3K, AKT and P38MAPK phosphorylations and inflammatory cytokine levels. Metabotropic glutamate receptor 5 blockade using MTEP ameliorates PAH-induced pathological right cardiac remodelling via inhibiting the signalling cascade involving PI3K/AKT, P38MAPK, Ang 2 and VEGF.

BURDEN OF ERECTILE DYSFUNCTION AMONG HEART FAILURE PATIENTS IN A CENTRE IN THE SOUTH-WESTERN NIGERIA: A PILOT STUDY.

Background: Erectile dysfunction (ED) is a common problem among heart failure (HF) patients but is usually ignored in busy clinics in developing countries like Nigeria. Evidence abound that it has a great impact on the quality of life, survival, and prognosis of HF patients. Objective: This study sought to evaluate the burden of ED among HF patients at the University College Hospital, Ibadan. Methods: This pilot cross-sectional study was conducted in the Cardiology clinic of the Medical Outpatient Unit of the Department of Medicine, University College Hospital, Ibadan. Consenting male patients with chronic HF were consecutively recruited into the study between June 2017 and March 2018. The International Index of Erectile Function-version five (IIFE-5) was used to access the presence and degree of ED. Statistical analysis was done with SPSS version 23. Results: A total of 98 patients were recruited with a mean± standard deviation (SD) age of 57.6 ±13.3 years, and age range of 20-88 years. The majority of the participants were married (78.6%), and the mean ± SD duration of HF diagnosis was 3.7 ±4.6years. The overall frequency of ED was 76.5%, and those with previous self-reported ED were 21.4%. Mild erectile dysfunction, mild to moderate erectile dysfunction, moderate erectile dysfunction, and severe erectile dysfunction were present in 24(24.5%), 28(28.6%), 14(14.3%), and 9(9.2%) respectively. Conclusion: Erectile dysfunction is common among chronic heart failure patients in Ibadan. Therefore, adequate attention is needed for this sexual health issue among males with heart failure to improve their quality of care.

Assessment of geoelectric properties and localized geology as indicators on cocoa (Theobroma cacao) yield in a part of southwestern Nigeria.

The need to establish a sound scientific basis for subsoil studies using a geoelectric method for locating sites best suited for cocoa (Theobroma cacao) production is highly expedient considering recent scientific trends. An integration of geoelectrical and geological investigation was carried out with a view to assessing the relationship between subsoil parameters and cocoa production output on fifteen (15) selected farm-sites across different communities in Ondo State, currently ranking as highest producer of Cocoa in Nigeria. This is with the aim of delineating the subsurface geological sequences, determining their geoelectric parameters, identifying the composition of subsurface layers and soils best related for high yield of cocoa. The studied sites which are located on the Precambrian Basement complex and the Dahomey Basin, southwestern Nigeria, showed from the geoelectric sections a total of between three to five (3-5) subsoil layers comprising the topsoil, the weathered or fractured basement/cretaceous sediments layers, and imfinite depth basement bedrock. The well-drained clayey loam/loamy and clayey sand/sandy clay weathered/partially weathered subsoil groups coincided with high cocoa produce data zones. Granite Gneiss - Grey Gneiss and Charnockites rock groups make up the geology in these areas. While the weathered - partially weathered columns that are characterized as sands and plastic clay subsoils within the Schist/Granite Gneiss rock groups coincided with areas where cocoa are reported to have short life span and cocoa produce data is low. We concluded that fairly thick subsoil spectrum from the topsoil to weathered - partially weathered column, formed from the weathered products from rock units including Grey Gneiss - Charnockite rocks, make up the most important underlying lithologic units most suitable for optimal cultivation of cocoa crop in the study area.

An Outbreak of Arboviral Infection in a Region with Background Malaria Endemicity from Northwestern Nigeria: An Investigation Report.

INTRODUCTION: Arboviruses are a group of infectious agents transmitted by blood-sucking arthropods from one vertebrate host to another. The agents include Dengue fever and West Nile Virus, amongst others. However, Dengue fever is now the world's fastest-spreading tropical disease, with the annual number of cases increasing 30-fold in the last 50 years. Cases of an unknown febrile illness were reported in Sokoto, northwestern Nigeria, in the last quarter of 2016. We investigated to verify the existence of the outbreak and described the socio-demographic characteristics and management outcome of the cases seen. METHODS: We conducted a descriptive, cross-sectional study and an analytical case control study. For the descriptive study, we defined suspected and confirmed cases of outbreak using established protocol. Cases were identified using stimulated passive and active surveillance. For each suspected case, we collected information on age, sex, residence and time of onset. We described the outbreak by time, place and person. Blood specimens were collected and submitted to the reference laboratory for detection of viral agents. We conducted a case-control study with 185 cases and 370 controls. Information on the socio-demographics and risk factors for arboviral infection and malaria among the cases and controls was collected. RESULTS: The outbreak of febrile illness in Sokoto started on the 3rd of October, 2016. A total 1477 cases were line listed (3rd Oct-11th November 2016) and 16 deaths (case fatality rate: 1.1% reported). The most affected areas were urban slums in two urban Local Government Areas (LGA) - Sokoto North and Sokoto South. Laboratory analysis revealed Dengue, West Nile and Malaria in increasing order from the representative samples. There were 57 (43.2%) respondents in the age-group 21-30 among the cases, while 99 (53.5%) of them were males. Cases living in a bushy neighborhood (OR=1.6, 95% CI=1.1-2.4), keeping waste bins in their houses (OR=1.5, 95% CI=1.0-2.1), having uncovered well or uncovered water containers (OR=3.6, 95% CI=2.1- 6.0) were more likely to develop arboviral infection or malaria compared to controls. Having window nets (OR=0.3, 95% CI=0.2-0.5) was found to be a protective factor against arboviral infection or malaria among the cases. CONCLUSIONS: The outbreak of febrile illness in Sokoto was linked to arboviral agents (Dengue virus and West Nile virus) in a malaria-endemic zone. We draw attention to the fact that arboviral infections can coexist with malaria in our region especially in an outbreak setting.

INTRODUCTION: Les arbovirus sont un groupe d'agents infectieux transmis par des arthropodes hématophages d'un hôte vertébré à un autre. Ces agents comprennent, entre autres, la fièvre de la Dengue et le virus du Nil occidental. Cependant, la dengue est aujourd'hui la maladie tropicale qui se propage le plus rapidement dans le monde, le nombre annuel de cas ayant été multiplié par 30 au cours des 50 dernières années. Des cas d'une maladie fébrile inconnue ont été signalés à Sokoto, dans le nord-ouest du Nigeria, au cours du dernier trimestre 2016. Nous avons enquêté pour vérifier l'existence de cette épidémie et décrit les caractéristiques sociodémographiques et le résultat de la prise en charge des cas vus. MÉTHODES: Nous avons mené une étude descriptive, transversale et une étude analytique cas-témoins. Pour l'étude descriptive, nous avons défini les cas suspects et confirmés d'épidémie en utilisant le protocole établi. Les cas ont été identifiés en utilisant une surveillance passive et active stimulée. Pour chaque cas suspect, nous avons recueilli des informations sur l'âge, le sexe, le lieu de résidence et le moment de l'apparition des symptômes. Nous avons décrit l'épidémie par temps, lieu et personne. Des échantillons de sang ont été prélevés et soumis au laboratoire de référence pour la détection des agents viraux. Nous avons mené une étude cas-témoins avec 185 cas et 370 témoins. Des informations sur les données sociodémographiques et les facteurs de risque d'infection par les arbovirus et le paludisme ont été recueillies parmi les cas et les témoins. RÉSULTATS: L'épidémie de maladie fébrile à Sokoto a commencé le 3 octobre 2016. Au total, 1477 cas ont été répertoriés (du 3 octobre au 11 novembre 2016) et 16 décès (taux de létalité : 1,1% rapporté). Les zones les plus touchées étaient les bidonvilles urbains dans deux zones urbaines de gouvernement local (LGA) - Sokoto Nord et Sokoto Sud. Les analyses de laboratoire ont révélé la présence de la dengue, du virus du Nil occidental et du paludisme par ordre croissant dans les échantillons représentatifs. Parmi les cas, 57 (43,2 %) étaient âgés de 21 à 30 ans, tandis que 99 (53,5 %) d'entre eux étaient des hommes. Les cas vivant dans un quartier broussailleux (OR=1,6, IC 95%=1,1-2,4), gardant des poubelles dans leurs maisons (OR=1,5, IC 95%=1,0-2,1), ayant un puits non couvert ou des récipients d'eau non couverts (OR=3,6, IC 95%=2,1- 6,0) étaient plus susceptibles de développer une infection arbovirale ou le paludisme par rapport aux témoins. Le fait de posséder des moustiquaires de fenêtre (OR=0,3, IC 95 %=0,2-0,5) s'est avéré être un facteur de protection contre l'infection à arbovirus ou le paludisme chez les cas. CONCLUSIONS: L'épidémie de maladie fébrile à Sokoto a été liée à des agents arboviraux (virus de la dengue et virus du Nil occidental) dans une zone où le paludisme est endémique. Nous attirons l'attention sur le fait que les infections arbovirales peuvent coexister avec le paludisme dans notre région, en particulier dans le cadre d'une épidémie. MOTS-CLÉS: Fièvre, Paludisme, Arbovirus, Epidémie.

Pregnancy-associated Acute Myocardial Infarction (PAMI): Case Report.

Cardiovascular diseases are recognised complications of pregnancy, however, pregnancy-associated acute myocardial infarction (PAMI) is uncommon. Pregnancy is known to increase risk of myocardial infarction even in the absence of traditional risk factors for atherosclerotic vascular disease. Our patient presented with acute chest pain two weeks after delivery and her electrocardiogram was in keeping with STelevation myocardial infarction (STEMI). Coronary angiography revealed coronary artery dissection and she was managed conservatively. Various pathophysiological mechanisms of PAMI have been described in literature including spontaneous coronary artery dissection (SCAD) found in our case. The diagnosis is often missed and earlier reported cases were diagnosed at autopsy. Therefore, we report this case as a learning tool. Also, there is a need for a high index of suspicion in pregnant patients presenting with features suggestive of aortic dissection, and its diagnosis should be thought of in peripartum women presenting with acute chest pain.

Les maladies cardiovasculaires sont des complications reconnues de la grossesse, cependant, l'infarctus aigu du myocarde associé à la grossesse (IPAM) est rare. La grossesse est connue pour augmenter le risque d'infarctus du myocarde même en l'absence de facteurs de risque traditionnels de maladie vasculaire athéroscléreuse. Notre patiente s'est présentée avec une douleur thoracique aiguë deux semaines après l'accouchement et son électrocardiogramme était conforme à l'infarctus du myocarde avec élévation de l'échelle (STEMI). La coronarographie a révélé une dissection de l'artère coronaire et elle a été gérée de manière conservatrice. Divers mécanismes physiopathologiques de PAMI ont été décrits dans la littérature, y compris la dissection spontanée des artères coronaires (SCAD) trouvée dans notre cas. Le diagnostic est souvent manqué et les cas signalés antérieurement ont été diagnostiqués à l'autopsie. Par conséquent, nous rapportons ce cas comme un outil d'apprentissage. En outre, il existe un besoin d'un indice de suspicion élevé chez les patientes enceintes présentant des caractéristiques suggérant une dissection aortique, et son diagnostic doit être envisagé chez les femmes en péripartum présentant une douleur thoracique aiguë.

Glutaminolysis: A Driver of Vascular and Cardiac Remodeling in Pulmonary Arterial Hypertension.

Pulmonary arterial hypertension (PAH) is a decimating ailment described by chronic precapillary pulmonary hypertension, an elevated mean pulmonary arterial pressure with a normal pulmonary capillary wedge pressure, and a raised pulmonary vascular resistance resulting in increased right ventricular afterload culminating in heart failure and death. Current PAH treatments regulate the vasodilatory/vasoconstrictory balance of pulmonary vessels. However, these treatment options are unable to stop the progression of, or reverse, an already established disease. Recent studies have advanced a metabolic dysregulation, featuring increased glutamine metabolism, as a mechanism driving PAH progression. Metabolic dysregulation in PAH leads to increased glutaminolysis to produce substrate to meet the high-energy requirement by hyperproliferative and apoptosis-resistant pulmonary vascular cells. This article explores the role of glutamate metabolism in PAH and how it could be targeted as an anti-remodeling therapeutic strategy.

Molecular epidemiology of Staphylococcus aureus in African children from rural and urban communities with atopic dermatitis.

BACKGROUND: Staphylococcus aureus has been associated with the exacerbation and severity of atopic dermatitis (AD). Studies have not investigated the colonisation dynamics of S. aureus lineages in African toddlers with AD. We determined the prevalence and population structure of S. aureus in toddlers with and without AD from rural and urban South African settings. METHODS: We conducted a study of AD-affected and non-atopic AmaXhosa toddlers from rural Umtata and urban Cape Town, South Africa. S. aureus was screened from skin and nasal specimens using established microbiological methods and clonal lineages were determined by spa typing. Logistic regression analyses were employed to assess risk factors associated with S. aureus colonisation. RESULTS: S. aureus colonisation was higher in cases compared to controls independent of geographic location (54% vs. 13%, p < 0.001 and 70% vs. 35%, p = 0.005 in Umtata [rural] and Cape Town [urban], respectively). Severe AD was associated with higher colonisation compared with moderate AD (86% vs. 52%, p = 0.015) among urban cases. Having AD was associated with colonisation in both rural (odds ratio [OR] 7.54, 95% CI 2.92-19.47) and urban (OR 4.2, 95% CI 1.57-11.2) toddlers. In rural toddlers, living in an electrified house that uses gas (OR 4.08, 95% CI 1.59-10.44) or utilises kerosene and paraffin (OR 2.88, 95% CI 1.22-6.77) for heating and cooking were associated with increased S. aureus colonisation. However, exposure to farm animals (OR 0.3, 95% CI 0.11-0.83) as well as living in a house that uses wood and coal (OR 0.14, 95% CI 0.04-0.49) or outdoor fire (OR 0.31, 95% CI 0.13-0.73) were protective. Spa types t174 and t1476, and t272 and t1476 were dominant among urban and rural cases, respectively, but no main spa type was observed among controls, independent of geographic location. In urban cases, spa type t002 and t442 isolates were only identified in severe AD, t174 was more frequent in moderate AD, and t1476 in severe AD. CONCLUSION: The strain genotype of S. aureus differed by AD phenotypes and rural-urban settings. Continued surveillance of colonising S. aureus lineages is key in understanding alterations in skin microbial composition associated with AD pathogenesis and exacerbation.