bluuebunny/crossref_metadata_2025_split huggingface dataset:
PO 8409 SERUM HYALURONIC ACID: A POTENTIAL DIAGNOSTIC MARKER FOR SCHISTOSOMAL PERIPORTAL FIBROSIS INSCHISTOSOMA MANSONI-ENDEMIC AREAS
Authors: Haile Filimon M , Hagos Elsa , Berhe Nega , Myrvang Bjørn , Gunderse Svein G 
Published: April 2019

BackgroundSchistosoma mansoni-induced infection is one of the most prevalent infections worldwide with serious public health and economic impact. Morbidity and mortality associated withS. mansoniis mainly the result of periportal fibrosis (PPF) which can be diagnosed using ultrasonography. As ultrasound equipment is not readily available inS. mansoni-endemic areas, serum markers like hyaluronic acid (HA) have been used as an alternative means of diagnosing PPF.MethodsA cross-sectional study was conducted with the aim of determining the importance of serum HA as a marker for schistosomal PPF in in 55 patients found inS. mansoni-endemic areas in northeastern Ethiopia and 20 non-endemic controls. PPF was determined using portable ultrasound equipment and graded according to the ‘Niamey protocol’. Serum HA concentration was determined using commercially available ELISA kit.ResultsThe mean concentration of HA in the sera of the cases was significantly higher than the controls (p<0.001). The concentration of HA also increased significantly as the pattern of PPF became severe while serum HA concentration positively correlated with PPF scores (ρ=0.6438, p<0.001). HA concentration of 27.9 µg/liter of serum differentiated moderate cases of PPF from advanced cases with a sensitivity, specificity, positive predictive value and negative predictive value of 85.71%, 75.61%, 60.5%, 93.9%, respectively (p<0.001). In conclusion, serum HA concentrations could be used as a potential marker for schistosomal PPF and to assess its severity in patients found inS. mansoni-endemic areas.ConclusionBased on our results, serum HA concentrations could be used as an alternative, non-invasive potential marker for schistosomal PPF and to assess its severity in patients found inS. mansoni-endemic areas.
PO 8414 EVALUATION OFMYCOBACTERIUM TUBERCULOSISCOMPLEX (MTBC) CULTURE METHODS INMYCOBACTERIUM AFRICANUM-ENDEMIC REGION OF WEST AFRICA
Authors: Faburay Alieu K , Mendy Francis S , Gibba Sarjo A , Lamin Modou , Sambou Basil , Mendy Alieu , Faal-Jawara Tutty I , Gehre Florian , Sutherland Jayne , Kampmann Beate , Secka Ousman 
Published: April 2019

BackgroundWith the endemicMycobacterium africanum(Maf), West African laboratories use glycerol and pyruvate in separate LJ cultures (LJG and LJP) for isolation of MTBC. The aim of this work is to evaluate if combining both glycerol and pyruvate in a single LJ medium (LJGP) will lead to comparable growth characteristics and time to detection in comparison to LJG, LJP and MGIT 960.MethodTotal of 118 smear-positive sputum samples were processed using 4% NaOH-NALC decontamination method. The decontaminated samples were inoculated parallel on LJG, LGP, MGIT 960 and LJGP. Positive cultures were confirmed using Ziehl-Neelsen staining method. MTBC identification was done using the Capilia TBNeo kit and spoligotyping used for speciation.ResultsThe recovery rate for LJG, LJP, LJPG and MGIT was found to be 73.7% (87/118), 82.2% (96/118), 83.9% (99/118) and 93.2% (110/118) respectively. No significant agreement was observed between the LJPG and MGIT 960 with Kappa values of −0.105 (p-value=0.199). However, there was significant agreement between LJGP and LJG and LJP with Kappa value of 0736 (p-value<0.001) and 0.756 (p-value<0.001), respectively. There were 70 Euro-American, 34 Maf, 9 East-Asian, 2Indo-Oceanic, 2 East-African-Indian and 1M. Bovis. LJGP have better Maf recovery rate, 85.3% (29/34) in comparison to MGIT 960, 79.4% (27/34), LJP, 76.5% (26/34) and LJG, 61.8% (21/34). Seven of the 8 MGIT negatives that were LJPG positive wereM. africanumand 1M. bovis.ConclusionLJPG has a better detection rate and time to positivity compared to LJG and LJP and was shown to have a better Maf recovery than other LJ methods and MGIT 960. It is evident that LJGP is a promising culture tool for Maf-endemic West African countries that will not only increase MTBC recovery rate in combination with MGIT, but also leads to better detection of Maf.
PO 8417 RISING TRENDS IN TB MORTALITY AMID DECLINE IN CASES NOTIFIED IN A RURAL COUNTY IN KENYA: COHORT STUDY
Authors: Ngari Moses , Abdullahi Osman , Sanga Deche , Katana Geoffrey , Willetts Annie 
Published: April 2019

BackgroundDespite introduction of rapid and accurate diagnostic tools and aggressive treatment for tuberculosis (TB), it is still a global health problem. In 2016, globally, 1.7 million people died of TB, 95% from resource-poor countries. This study aimed to estimate changing trends in all-cause mortality rate and identify features associated with mortality among suspected TB patients on treatment.MethodsA cohort study of patients registered in a TB surveillance system from 2012 to 2016 and followed up for six months during TB treatment. The outcome was all-cause mortality within six months of TB treatment. The exposures examined were demographic and clinical features at the time of starting TB treatment.ResultsA total of 10,717 participants, median (IQR) age 33 (24–45) years, of which 3163 (30%) were HIV-infected were included in the analyses. During follow-up of 5175.5 person-years (PY), 585/10,717 (5.5%) participants died; mortality rate was 12.2 (95% CI 11.3,13.3) deaths per 100PY. The yearly mortality rate increased from 7.79 (95% CI 6.35, 9.54) in 2012 to 17.73 (95% CI 14.93, 21.06) in 2016 per 100PY (Ptrend<0.001) but the number of suspected-TB notifications declined from 2610 (24%) in 2012 to 1689 (16%) in 2016 (Ptrend=0.02). 77% of all deaths occurred by month three. Mortality among HIV-infected participants was higher (325/3163; 10.3%) than among HIV-non-infected participants (251/7413; 3.4%; p<0.001). Old age, being a female, type of TB diagnosis used, body mass index (BMI) <18.5, HIV status and year of diagnosis were associated with mortality in the multivariate regression model.ConclusionThis large population level TB study identifies an alarming trend of patients dying within months of starting treatment. These early deaths could be due to late diagnosis and multidrug-resistance. The study warrants further investigation to go beyond already established indicators which remained constant (including HIV co-infection), to explore host, disease or health system related factors that may explain the observed trend.
PO 8421 LITERATURE REVIEW OF BIOMARKERS FOR HUMAN AFRICAN TRYPANOSOMIASIS POST-TREATMENT FOLLOW-UP
Authors: Ngay Lukusa , Lejon Veerle , Ngoyi Mumba 
Published: April 2019

IntroductionHuman African trypanosomiasis (HAT) is caused byTrypanosoma brucei gambienseandrhodesienseand is transmitted to humans by tsetse flies in sub-Saharan Africa. To detect cure or treatment failure, patients are followed up after treatment integrating the use of biomarkers in blood or cerebrospinal fluid (CSF).MethodsA systematic review of the literature according to the PRISMA Statement for Reporting Systematic Reviews was done, focusing on biological markers for HAT post-treatment follow-up. Articles were retrieved from PubMed (https://www.ncbi.nlm.nih.gov/pubmed/) by using keywords: Human African Trypanosomiasis, Biomarkers, Follow up, Post treatment.ResultsA panel of biomarkers is used to detect relapses or to confirm recovery. For post-treatment follow-up, an examination of the CSF is performed. White blood cell counts in CSF with a defined cut-off value have been proven to be the most accurate to assess the treatment outcome. The intrathecal immunoglobulin M synthesis is a specific and sensitive parameter for the detection of CNS involvement in cases of HAT caused byT. brucei gambiense. The decrease of trypanosome-specific antibodies concentrations in CSF could be a good parameter for definite cure. High CSF IL-10 levels during treatment follow-up indicate recurring CNS inflammation and treatment failure. An increase of Neopterin in CSF and the presence of trypanosome spliced leader RNA in the blood have a high potential as predictors for treatment failure but need further validation.ConclusionNew biomarkers for post-treatment follow-up in HAT should 1) have high diagnostic specificity and sensitivity; 2) be applicable in field conditions; 3) preferentially be performed on blood and thus avoid the painful lumbar puncture during post-treatment control visits; and 4) shorten the follow-up period.
PO 8430 A GEOSPATIAL APPROACH TO PREDICTING DIARRHEA PREVALENCE IN NIGERIA
Authors: Adetunde Oluwasegun 
Published: April 2019

BackgroundNigeria ranks second globally only behind India in under-five mortality prevalence. In Nigeria, 108.8 children die per 1000 live births before their 5th birthday. It is of note that diarrhoea (15.3% prevalence) is the second leading cause of under-five mortality in Nigeria after pneumonia. General poor hygiene and nutritional status are contributory factors to diarrhea.MethodsData was collected for severe acute malnutrition (SAM) using the weight for height z-value (WHZ) and/or oedema criteria. In addition, data on diarrhoea prevalence, oral rehydration salt therapy (ORST), improved source of drinking water and improved sanitation were collected. These were obtained for 36 states and federal capital territory (FCT) from the National Bureau of Statistics headquarters in FCT, Abuja for 2015. Correlation analysis was first carried out to determine relationships followed by geographically weighted regression analysis (GWR). GWR was used to predict under-five mortality pattern and accuracy mapped.ResultsObserved correlation coefficients to diarrhoea prevalence were 0.59,–0.49, −0.35 and −0.63 for SAM, ORST, improved drinking water access, and improved sanitation, respectively. R2varied across states, though positive, from 0.29 in Akwa Ibom to 0.95 in Kebbi states. Standard deviation of residuals in the regression model ranged from −3.89 to 3.33 in Borno and Gombe states respectively, while Sokoto and Bauchi had 0.006 and 0.024 respectively, thus having the best accuracy in predictions across all states in the country. Both correlation and GWR were at p<0.05.ConclusionThe results obtained support literature, confirming the inverse relationship between ORST prevalence, improved drinking water access and improved sanitation to diarrhea prevalence. It also supports the already confirmed positive relationship between poor nutrition of children and susceptibility to diarrhoea. The study however expanded knowledge by incorporating geocomputation to predict diarrhoea prevalence.
PO 8444 CHARACTERISATION OF PATHOGENS CAUSING DIARRHOEA IN CHILDREN UNDER FIVE IN LAMBARÉNÉ, GABON
Authors: Manouana Gédéon P , Matsougou Gedeon Bingoulou , Byrne Natalie , Hofmann Philipp , Ngwese mirabeau Mbong , A Nguema Moure Pau , Zinsou Jeannot Fréjus , Dejon Agobe Jean Claude , R Adegbite Bayode , R Edoa Jean , J Honkpehedji Yabo , Mccall Matthew B.B. , S Alabi Abraham , Eibach Daniel , G Kremsner Peter , Borrmann Steffen , A Adegnika Ayola 
Published: April 2019

BackgroundDiarrhoeal disease remains the second leading cause of death in children under five years, being associated with about 525,000 deaths every year. The most common pathogens worldwide areShigellaspp/EIEC, rotavirus, adenovirus 40/41, ST-ETEC andCryptosporidiumspp. Public health interventions rely on estimates of pathogen-specific burden for prioritisation. Sadly, comprehensive data on the aetiology of diarrhoea in children is lacking for Gabon. This study aimed to identify the spectrum of pathogens found in Lambaréné, Gabon and provide baseline data on their prevalence, needed for implementation of effective control measures.MethodsA cross-sectional study was conducted at Albert Schweitzer and Georges Rawiri Regional hospitals in Lambaréné from February 2017 to February 2018. A consecutive sample of children under 5 year old with diarrhoea or a history of diarrhoea within the previous three days were prospectively studied. A single stool sample was collected from each study participant and processed using commercial rapid immunoassays to detect antigens of rotavirus, adenovirus, andCryptosporidiumspp. Multiplex PCR was used forCryptosporidiumspp.,Giardia lamblia and Cyclospora cayetanensisdetection, and characterisation ofE. colistrains.ResultsOut of 188 participants who provided stool samples, one or more pathogens could be detected in 34.6% of the cases. The most prevalent parasites wereGiardia lamblia(14.9%),Cryptosporidiumspp. (11.7%), andCyclospora cayetanensis(2.7%). Enteric viruses also were identified in these children: 10.6% and 1.6% of rotavirus and adenovirus, respectively. Multiple pathogens were detected in 5.3% of samples.ConclusionThis analysis of the causes of diarrhoea in children under 5 years of age in our setting showed three main pathogens:Giardia lamblia,Cryptosporidiumspp. and rotavirus. Our study confirms major agents of acute diarrhoeal diseases in children, highlights research needs (Cryptosporidium) and supports the introduction of new tools such as the implementation of the rotavirus vaccine in the national immunisation programme.
How does surgery compare to sham surgery or physiotherapy as a treatment for tendinopathy? A systematic review of randomised trials
Authors: Challoumas Dimitrios , Clifford Christopher , Kirwan Paul , Millar Neal L 
Published: April 2019

PurposeTo assess the effectiveness of surgery on all tendinopathies by comparing it to no treatment, sham surgery and exercise-based therapies for both mid-term (12 months) and long-term (> 12 months) outcomes.MethodsOur literature search included EMBASE, Medline, CINAHL and Scopus. A combined assessment of internal validity, external validity and precision of each eligible study yielded its overall study quality. Results were considered significant if they were based on strong (Level 1) or moderate (Level 2) evidence.Results12 studies were eligible. Participants had the following types of tendinopathy: shoulder in seven studies, lateral elbow in three, patellar in one and Achilles in one. Two studies were of good, four of moderate and six of poor overall quality. Surgery was superior to no treatment or placebo, for the outcomes of pain, function, range of movement (ROM) and treatment success in the short and midterm. Surgery had similar effects to sham surgery on pain, function and range of motion in the midterm. Physiotherapy was as effective as surgery both in the midterm and long term for pain, function, ROM and tendon force, and pain, treatment success and quality of life, respectively.ConclusionWe recommend that healthcare professionals who treat tendinopathy encourage patients to comply with loading exercise treatment for at least 12 months before the option of surgery is seriously entertained.
Questionnaire survey assessing the leisure-time physical activity of hospital doctors and awareness of UK physical activity recommendations
Authors: Cuthill Jennifer A , Shaw Martin 
Published: April 2019

ObjectiveThe UK Government Physical Activity Recommendations suggest that adults should aim for 150 min of physical activity each week to maintain health. We assessed the total volume, frequency, intensity and type of exercise taken by hospital doctors in association with their specialty, age and knowledge of the specific components of the recommendations.MethodsAn anonymous paper-based questionnaire was distributed to doctors working in the two largest teaching hospitals in Glasgow. 332 questionnaires were analysed with a response rate of 60.3%.Results239 (72%) doctors felt they exercised regularly with 212 (63.9%) meeting the recommended volume of cardiovascular activity, similar to an age and sex-matched cohort of the general Scottish population. Only 78 (23.5%) doctors achieved the recommended muscle-strengthening activities. 108 (35.5%) doctors were aware recommendations for activity existed but only 45 (13.6%) were able to state the recommended duration of activity per week. Doctors who were aware of the recommendations were more likely to personally achieve them (OR 1.802, 95% CI 1.104 to 2.941) although other additional factors may contribute.ConclusionAlthough this was a small study in two hospitals, our results suggest that hospital doctors are as active as the general public in the UK of a similar age. Eight years after implementation, knowledge of specific components of the current physical activity recommendations remains poor. Efforts to improve this prior to graduation, combined with improving confidence and competence in counselling practices and enhancing the opportunities for doctors to exercise, could translate into improved healthcare promotion.
Palliative urinary diversion in patients with malignant ureteric obstruction due to gynaecological cancer
Authors: Perri Tamar , Meller Elad , Ben-Baruch Gilad , Inbar Yael , Apter Sara , Heyman Lee , Dotan Zohar , Korach Jacob 
Published: April 2019

ObjectivesTo identify factors aiding the selection of patients with gynaecological cancer with malignant urinary obstruction who are least likely to benefit from palliative urinary diversion (UD), and to create a risk-stratification model for decision-making.MethodsThis historic cohort study comprised 74 consecutive patients with urinary obstruction resulting from gynaecological malignancies. All underwent palliative UD by percutaneous nephrostomy (PCN). Using the Cox proportional hazards regression model and Kaplan-Meier curves with the log-rank test, we developed a prognostic score identifying candidates least likely to benefit from the intervention.ResultsThe median follow-up was 4.72 (range 0–5.71) years. Hydronephrosis was diagnosed in most patients on recurrent or persistent disease (81%). It was bilateral in 37.8%. Intervention-related complications included urinary sepsis (8%), catheter dislodgment requiring replacement (17%) and gross haematuria necessitating blood transfusions (13%). After PCN, conversion to an internal ureteral stent was feasible in 46%. The median survival was 11.13 (range 0–67) months. Two patients died within a month of UD. Multivariate analysis identified diabetes mellitus (DM), poor Eastern Cooperative Oncology Group (ECOG) performance status >1 and ascites as significant negative survival factors. A prognostic index based on those factors identified the short-term and long-term survivors. Risk factor-based mortality HRs were 11.37 (95% CI 4.12 to 31.37) with one factor, 26.57 (95% CI 9.14 to 77.26) with two factors and 67.25 (95% CI 15.6 to 289.63) with three factors (all with p<0.0001).ConclusionsOur proposed prognostic index, based on ascites, ECOG performance status and DM, might help select patients with gynaecological cancer least likely to benefit from palliative UD.
Very long-term prognosis in patients with right ventricular apical pacing for sick sinus syndrome
Authors: Nakasuka Kosuke , Ishibashi Kohei , Kamijima Ayako , Kamakura Tsukasa , Wada Mitsuru , Inoue Yuko , Miyamoto Koji , Okamura Hideo , Nagase Satoshi , Noda Takashi , Aiba Takeshi , Yasuda Satoshi , Ohte Nobuyuki , Kusano Kengo 
Published: April 2019

ObjectiveThe impact of right ventricular (RV) apical pacing on very long-term cardiac prognosis is little known. In this study, we retrospectively evaluated the relationship between RV apical pacing and cardiovascular events (CEs) in patients with sick sinus syndrome (SSS) and left ventricular ejection fraction (LVEF) >35%.MethodsTotal of 532 consecutive pacemaker recipients with SSS and LVEF >35% were divided into two groups according to the mean cumulative per cent RV apical ventricular pacing (mean %VP) (<50%; non-VP group vs ≥50%; VP group) and occurrence of CE was compared using Kaplan-Meier analysis between two groups. Cox hazard model was used to assess predictors of CE after adjusting explanatory variables such as age, atrial fibrillation (AF) and structural heart disease (SHD).ResultsMean %VP was 86.0% and 8.2% in VP and non-VP groups, respectively (p<0.001). During mean follow-up of 13.4±7.0 years, CE occurred in 131 patients and more frequently in VP than non-VP group (p<0.001). However, the VP group was no longer associated with CE after taking into account other variables in multivariate analysis, which revealed AF (HR (HR)=2.08), SHD (HR=4.97), low LVEF (HR=0.98 for every 1% increase) and high age (HR=1.03 for every year of age) were independent predictors for CE. Regarding patients with SHD and/or AF and those aged ≥75 years, Kaplan-Meier curves showed both groups had similar prognosis.ConclusionsCardiac prognosis of patients with RV apical pacing was poor, but after adjusting for other predictors of CE, RV apical pacing was not a prognostic factor in patients with SSS with LVEF >35%.
Predictors of early mortality after transcatheter aortic valve implantation
Authors: Kjønås Didrik , Dahle Gry , Schirmer Henrik , Malm Siri , Eidet Jo , Aaberge Lars , Steigen Terje , Aakhus Svend , Busund Rolf , Rösner Assami 
Published: April 2019

ObjectivesTo investigate whether preoperative echocardiographic evaluation of ventricular function, especially right ventricular systolic and diastolic parameters including speckle-tracking analysis, could aid in the prediction of 30-day mortality after transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis.MethodsThis is a prospective observational cohort study including 227 patients accepted for TAVI at the University Hospital of North Norway and Oslo University Hospital from February 2010 through June 2013. All patients underwent preoperative transthoracic echocardiography with retrospective speckle-tracking analysis. Primary endpoint was all-cause 30-day mortality.ResultsAll-cause 30-day mortality was 8.7 % (n = 19). Independent predictors of 30-day mortality were systolic pulmonary arterial pressure (SPAP) > 60 mm Hg (HR: 7.7, 95% CI: 1.90 to 31.3), heart failure (HR: 2.9, 95% CI: 1.1 to 7.78), transapical access (HR: 3.8, 95% CI: 1.3 to 11.2), peripheral artery disease (HR: 6.0, 95% CI: 2.0 to 18.0) and body mass index (HR: 0.73, 95% CI: 0.61 to 0.87). C-statistic for the model generated was 0.91 (95% CI: 0.85 to 0.98). Besides elevated SPAP, no other echocardiographic measurements were found to be an independent predictor of early mortality.ConclusionExcept for elevated systolic pulmonary artery pressure, our data suggests that clinical rather than echocardiographic parameters are useful predictors of 30-day mortality after TAVI.
Implementing guidelines for governance, oversight of AI, and automation
Authors: Carrier Ryan 
Published: April 2019

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