RNA quality control factors nucleate Clr4/SUV39H and trigger constitutive heterochromatin assembly.

In eukaryotes, the Suv39 family of proteins tri-methylate lysine 9 of histone H3 (H3K9me) to form constitutive heterochromatin. However, how Suv39 proteins are nucleated at heterochromatin is not fully described. In the fission yeast, current models posit that Argonaute1-associated small RNAs (sRNAs) nucleate the sole H3K9 methyltransferase, Clr4/SUV39H, to centromeres. Here, we show that in the absence of all sRNAs and H3K9me, the Mtl1 and Red1 core (MTREC)/PAXT complex nucleates Clr4/SUV39H at a heterochromatic long noncoding RNA (lncRNA) at which the two H3K9 deacetylases, Sir2 and Clr3, also accumulate by distinct mechanisms. Iterative cycles of H3K9 deacetylation and methylation spread Clr4/SUV39H from the nucleation center in an sRNA-independent manner, generating a basal H3K9me state. This is acted upon by the RNAi machinery to augment and amplify the Clr4/H3K9me signal at centromeres to establish heterochromatin. Overall, our data reveal that lncRNAs and RNA quality control factors can nucleate heterochromatin and function as epigenetic silencers in eukaryotes.

Degassing of early-formed planetesimals restricted water delivery to Earth.

The timing of delivery and the types of body that contributed volatiles to the terrestrial planets remain highly debated1,2. For example, it is unknown if differentiated bodies, such as that responsible for the Moon-forming giant impact, could have delivered substantial volatiles3,4 or if smaller, undifferentiated objects were more probable vehicles of water delivery5-7. Here we show that the water contents of minerals in achondrite meteorites (mantles or crusts of differentiated planetesimals) from both the inner and outer portions of the early Solar System are ≤2 µg g-1 H2O. These are among the lowest values ever reported for extraterrestrial minerals. Our results demonstrate that differentiated planetesimals efficiently degassed before or during melting. This finding implies that substantial amounts of water could only have been delivered to Earth by means of unmelted material.

Pregnancy and COVID-19.

There are many unknowns for pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. Clinical experience of pregnancies complicated with infection by other coronaviruses e.g., Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome, has led to pregnant woman being considered potentially vulnerable to severe SARS-CoV-2 infection. Physiological changes during pregnancy have a significant impact on the immune system, respiratory system, cardiovascular function, and coagulation. These may have positive or negative effects on COVID-19 disease progression. The impact of SARS-CoV-2 in pregnancy remains to be determined, and a concerted, global effort is required to determine the effects on implantation, fetal growth and development, labor, and neonatal health. Asymptomatic infection presents a further challenge regarding service provision, prevention, and management. Besides the direct impacts of the disease, a plethora of indirect consequences of the pandemic adversely affect maternal health, including reduced access to reproductive health services, increased mental health strain, and increased socioeconomic deprivation. In this review, we explore the current knowledge of COVID-19 in pregnancy and highlight areas for further research to minimize its impact for women and their children.

Physiology of the Endometrium and Regulation of Menstruation.

The physiological functions of the uterine endometrium (uterine lining) are preparation for implantation, maintenance of pregnancy if implantation occurs, and menstruation in the absence of pregnancy. The endometrium thus plays a pivotal role in reproduction and continuation of our species. Menstruation is a steroid-regulated event, and there are alternatives for a progesterone-primed endometrium, i.e., pregnancy or menstruation. Progesterone withdrawal is the trigger for menstruation. The menstruating endometrium is a physiological example of an injured or "wounded" surface that is required to rapidly repair each month. The physiological events of menstruation and endometrial repair provide an accessible in vivo human model of inflammation and tissue repair. Progress in our understanding of endometrial pathophysiology has been facilitated by modern cellular and molecular discovery tools, along with animal models of simulated menses. Abnormal uterine bleeding (AUB), including heavy menstrual bleeding (HMB), imposes a massive burden on society, affecting one in four women of reproductive age. Understanding structural and nonstructural causes underpinning AUB is essential to optimize and provide precision in patient management. This is facilitated by careful classification of causes of bleeding. We highlight the crucial need for understanding mechanisms underpinning menstruation and its aberrations. The endometrium is a prime target tissue for selective progesterone receptor modulators (SPRMs). This class of compounds has therapeutic potential for the clinical unmet need of HMB. SPRMs reduce menstrual bleeding by mechanisms still largely unknown. Human menstruation remains a taboo topic, and many questions concerning endometrial physiology that pertain to menstrual bleeding are yet to be answered.

Treatment of Uterine Fibroid Symptoms with Relugolix Combination Therapy.

BACKGROUND: Uterine fibroids are a common cause of heavy menstrual bleeding and pain. Treatment with the combination of relugolix (an oral gonadotropin-releasing hormone-receptor antagonist), estradiol, and norethindrone acetate, administered once daily, may have efficacy in women with uterine fibroids and heavy bleeding while avoiding hypoestrogenic effects. METHODS: We conducted two replicate international, double-blind, 24-week, phase 3 trials involving women with fibroid-associated heavy menstrual bleeding. Participants were randomly assigned in a 1:1:1 ratio to receive once-daily placebo, relugolix combination therapy (40 mg of relugolix, 1 mg of estradiol, and 0.5 mg of norethindrone acetate), or delayed relugolix combination therapy (40 mg of relugolix monotherapy, followed by relugolix combination therapy, each for 12 weeks). The primary efficacy end point in each trial was the percentage of participants with a response (volume of menstrual blood loss <80 ml and a ≥50% reduction in volume from baseline) in the relugolix combination therapy group, as compared with the placebo group. Key secondary end points were amenorrhea, volume of menstrual blood loss, distress from bleeding and pelvic discomfort, anemia, pain, fibroid volume, and uterine volume. Safety and bone mineral density were assessed. RESULTS: A total of 388 women in trial L1 and 382 in trial L2 underwent randomization. A total of 73% of the participants in the relugolix combination therapy group in trial L1 and 71% of those in trial L2 had a response (primary end point), as compared with 19% and 15%, respectively, of those in the placebo groups (P<0.001 for both comparisons). Both relugolix combination therapy groups had significant improvements, as compared with the placebo groups, in six of seven key secondary end points, including measures of menstrual blood loss (including amenorrhea), pain, distress from bleeding and pelvic discomfort, anemia, and uterine volume, but not fibroid volume. The incidence of adverse events was similar with relugolix combination therapy and placebo. Bone mineral density was similar with relugolix combination therapy and placebo but decreased with relugolix monotherapy. CONCLUSIONS: Once-daily relugolix combination therapy resulted in a significant reduction in menstrual bleeding, as compared with placebo, and preserved bone mineral density in women with uterine fibroids. (Funded by Myovant Sciences; LIBERTY 1 [L1] and LIBERTY 2 [L2] ClinicalTrials.gov numbers, NCT03049735 and NCT03103087, respectively.).

Analysis of Cation Composition in Dolomites on the Intact Particles Sampled from Asteroid Ryugu.

Characterization of the elemental distribution of samples with rough surfaces has been strongly desired for the analysis of various natural and artificial materials. Particularly for pristine and rare analytes with micrometer sizes embedded on specimen surfaces, non-invasive and matrix effect-free analysis is required without surface polishing treatment. To satisfy these requirements, we proposed a new method employing the sequential combination of two imaging modalities, i.e., microenergy-dispersive X-ray fluorescence (micro-XRF) and Raman micro-spectroscopy. The applicability of the developed method is tested by the quantitative analysis of cation composition in micrometer-sized carbonate grains on the surfaces of intact particles sampled directly from the asteroid Ryugu. The first step of micro-XRF imaging enabled a quick search for the sparsely scattered and micrometer-sized carbonates by the codistributions of Ca2+ and Mn2+ on the Mg2+- and Fe2+-rich phyllosilicate matrix. The following step of Raman micro-spectroscopy probed the carbonate grains and analyzed their cation composition (Ca2+, Mg2+, and Fe2+ + Mn2+) in a matrix effect-free manner via the systematic Raman shifts of the lattice modes. The carbonates were basically assigned to ferroan dolomite bearing a considerable amount of Fe2+ + Mn2+ at around 10 atom %. These results are in good accordance with the assignments reported by scanning electron microscopy-energy-dispersive X-ray spectroscopy, where the thin-sectioned and surface-polished Ryugu particles were applicable. The proposed method requires neither sectioning nor surface polishing; hence, it can be applied to the remote sensing apparatus on spacecrafts and planetary rovers. Furthermore, the non-invasive and matrix effect-free characterization will provide a reliable analytical tool for quantitative analysis of the elemental distribution on the samples with surface roughness and chemical heterogeneity at a micrometer scale, such as art paintings, traditional crafts with decorated shapes, as well as sands and rocks with complex morphologies in nature.

Optimisation of vitamin D status in global populations.

Vitamin D is important for musculoskeletal health. Concentrations of 25-hydroxyvitamin D, the most commonly measured metabolite, vary markedly around the world and are influenced by many factors including sun exposure, skin pigmentation, covering, season and supplement use. Whilst overt vitamin D deficiency with biochemical consequences presents an increased risk of severe sequelae such as rickets, osteomalacia or cardiomyopathy and usually warrants prompt replacement treatment, the role of vitamin D supplementation in the population presents a different set of considerations. Here the issue is to keep, on average, the population at a level whereby the risk of adverse health outcomes in the population is minimised. This position paper, which complements recently published work from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases, addresses key considerations regarding vitamin D assessment and intervention from the population perspective. This position paper, on behalf of the International Osteoporosis Foundation Vitamin D Working Group, summarises the burden and possible amelioration of vitamin D deficiency in global populations. It addresses key issues including screening, supplementation and food fortification.

Reversal of the Parallel Drift Frequency in Anomalous Transport of Impurity Ions.

It is found that, in the studies of heavy ion transport with gyrokinetic simulations, the ion parallel drift frequency can reverse sign in velocity space when the amplitude variation of the electrostatic potential fluctuation is strong along the magnetic field line. As a result, the particle transport related to the parallel dynamics is strongly enhanced. It is noted that, while parallel gradient of the fluctuation amplitude can be instigated by a large magnetic shear or safety factor in a tokamak, the generic mechanism is independent of its cause, which suggests broader applications to kinetic plasma problems. Some relevant topics are briefly addressed in the end.

Tracing Photoinduced Hydrogen Migration in Alcohol Dications from Time-Resolved Molecular-Frame Photoelectron Angular Distributions.

The recent implementation of attosecond and few-femtosecond X-ray pump/X-ray probe schemes in large-scale free-electron laser facilities has opened the way to visualize fast nuclear dynamics in molecules with unprecedented temporal and spatial resolution. Here, we present the results of theoretical calculations showing how polarization-averaged molecular-frame photoelectron angular distributions (PA-MFPADs) can be used to visualize the dynamics of hydrogen migration in methanol, ethanol, propanol, and isopropyl alcohol dications generated by X-ray irradiation of the corresponding neutral species. We show that changes in the PA-MFPADs with the pump-probe delay as a result of intramolecular photoelectron diffraction carry information on the dynamics of hydrogen migration in real space. Although visualization of this dynamics is more straightforward in the smaller systems, methanol and ethanol, one can still recognize the signature of that motion in propanol and isopropyl alcohol and assign a tentative path to it. A possible pathway for a corresponding experiment requires an angularly resolved detection of photoelectrons in coincidence with molecular fragment ions used to define a molecular frame of reference. Such studies have become, in principle, possible since the first XFELs with sufficiently high repetition rates have emerged. To further support our findings, we provide experimental evidence of H migration in ethanol-OD from ion-ion coincidence measurements performed with synchrotron radiation.

Does vaginal surgery for correction of pelvic organ prolapse improve urinary function? A prospective cohort study.

INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) is caused by an imbalance in the stability of the pelvic organs, resulting in loss of support. The most common types of POP, anterior and apical, are associated with lower urinary tract symptoms (LUTS) such as bladder outlet obstruction and detrusor overactivity (DO). Vaginal surgery may improve LUTS and overall urinary symptoms. We assessed urodynamic (UD) parameters and urinary symptoms before and after vaginal surgery for POP correction. METHODS: A prospective cohort of 59 women with symptomatic anterior and/or apical POP associated with urinary symptoms and with indications for vaginal surgery were included. POP surgeries included anterior colporrhaphy and vaginal hysterectomy with culdoplasty (VH) and with/without concomitant posterior colporrhaphy and mid-urethral sling (MUS). All participants underwent UD evaluation and answered urinary symptom questionnaires pre- and 3 months post-surgery. RESULTS: Anterior colporrhaphy was performed in all patients: 45.7% with associated VH and 54.2% with concomitant MUS. Preoperative ICIQ-OAB score >8 points was significantly associated with DO (p<0.02) and decreased after surgery (9±4.3 to 3.2±3.0, p<0.001). All other questionnaires demonstrated improvements in urinary symptoms. Stress urinary incontinence rate decreased from 59.6% to 21% (p<0.001). Post-void residual (PVR) volume and Valsalva maneuver also decreased (p<0.001). CONCLUSIONS: Pelvic organ prolapse surgery reduced the prevalence of urgency symptoms, and all questionnaires on urinary symptoms showed clinically significant improvement. Vaginal surgery for POP, even combined with MUS, significantly reduced PVR volume and improved urgency symptoms.

The impact of musculoskeletal ill health on quality of life and function after critical care: a multicentre prospective cohort study.

Physical disability is a common component of post-intensive care syndrome, but the importance of musculoskeletal health in this population is currently unknown. We aimed to determine the musculoskeletal health state of intensive care unit survivors and assess its relationship with health-related quality of life; employment; and psychological and physical function. We conducted a multicentre prospective cohort study of adults admitted to intensive care for > 48 h without musculoskeletal trauma or neurological insult. Patients were followed up 6 months after admission where musculoskeletal health state was measured using the validated Musculoskeletal Health Questionnaire score. Of the 254 participants, 150 (59%) had a musculoskeletal problem and only 60 (24%) had received physiotherapy after discharge. Functional Comorbidity Index, Clinical Frailty Scale, duration of intensive care unit stay and prone positioning were all independently associated with worse musculoskeletal health. Musculoskeletal health state moderately correlated with quality of life, rs = 0.499 (95%CI 0.392-0.589); anxiety, rs = -0.433 (95%CI -0.538 to -0.315); and depression, rs = -0.537 (95%CI -0.631 to -0.434) (all p < 0.001). Patients with a musculoskeletal problem were less physically active than those without a problem (median (IQR [range]) number of 30 min physical activity sessions per week 1 (0-3.25 [0-7]) vs. 4 (1-7 [0-7]), p < 0.001, respectively). This study found that musculoskeletal health problems were common after intensive care unit stay. However, we observed that < 25% of patients received physical rehabilitation after discharge home. Our work has identified potential high-risk groups to target in future interventional studies.

Diagnostic Accuracy of Mammographic Findings in Patients 35 Years and Older Presenting with Palpable Breast Lump in University of Benin Teaching Hospital, Benin City.

BACKGROUND: Mammography has become an invaluable tool for diagnosing breast lesions and detecting early breast cancer in women of 35 years and above. AIMS: To correlate the mammography Breast Imaging Reporting and Data System (BI-RADS) categories with the histology in breast lesions and to determine the predictive values, sensitivity, specificity and accuracy of mammography. PATIENTS AND METHOD: This was a one- year prospective study carried out from March 2015 to February 2016. Consecutive female patients of 35 years and above with breast lesions at the University of Benin Teaching Hospital, Benin-City were recruited. Patients with fungating breast lesions and those who declined recruitment were excluded. All patients had mammography and core biopsy of the breast lesion which was examined histologically. RESULTS: A total of 101 patients were studied. Five patients had bilateral breast lesions making a total of 106 biopsies that were performed. The mean age of patients with benign breast disease was 47.0 ± 4.9 years while those with malignant breast disease was 49.9 ± 8.5 years; P-value was 0.080 which was not statistically significant. Fibrocystic disease 6 (5.6%) was the most common benign disease while invasive ductal carcinoma was the most common malignant breast disease 84(79.2%). BI-RADS 5 correlated mostly with malignant breast disease (97.0%); P value < 0.001 and was statistically significant. CONCLUSION: This study showed that mammography is useful in the diagnosis of breast lesions in women who are 35 years and older. Patients with BI-RADS category 3, 4 and 5 had an increasing correlation with malignant breast disease.

CONTEXTE: La mammographie est devenue un outil inestimable pour diagnostiquer les lésions mammaires et détecter précocement le cancer du sein chez les femmes de 35 ans et plus. OBJECTIFS: Corréler les catégories du Breast Imaging Reporting and Data System (BI-RADS) de la mammographie avec l'histologie des lésions mammaires et déterminer les valeurs prédictives, la sensibilité, la spécificité et la précision de la mammographie. PATIENTES ET MÉTHODE: Il s'agit d'une étude prospective d'un an réalisée de mars 2015 à février 2016. Les patientes consécutives de 35 ans et plus présentant des lésions mammaires à l'Hôpital Universitaire de Benin, à Benin-City, ont été recrutées. Les patientes présentant des lésions mammaires fungiques et celles qui ont refusé de participer à l'étude ont été exclues. Toutes les patientes ont subi une mammographie et une biopsie au trocart de la lésion mammaire, qui a été examinée histologiquement. RÉSULTATS: Un total de 101 patientes ont été étudiées. Cinq patientes présentaient des lésions mammaires bilatérales, soit un total de 106 biopsies réalisées. L'âge moyen des patientes atteintes de maladie mammaire bénigne était de 47,0 ± 4,9 ans, tandis que celui des patientes atteintes de maladie mammaire maligne était de 49,9 ± 8,5 ans ; la valeur P était de 0,080, ce qui n'était pas statistiquement significatif. La maladie fibrokystique 6 (5,6%) était la maladie bénigne la plus fréquente, tandis que le carcinome canalaire infiltrant était la maladie mammaire maligne la plus fréquente 84 (79,2%). Le BIRADS 5 corrélait principalement avec les maladies mammaires malignes (97,0%) ; la valeur P était < 0,001 et était statistiquement significative. CONCLUSION: Cette étude a montré que la mammographie est utile dans le diagnostic des lésions mammaires chez les femmes de 35 ans et plus. Les patientes ayant des catégories BI-RADS 3, 4 et 5 présentaient une corrélation croissante avec les maladies mammaires malignes. MOTS-CLÉS: Mammographie, Lésion mammaire féminine, Histologie, Corrélation, Précision diagnostique.

An Evaluation of Knowledge, Attitude, and Practice of Accelerated Orthodontics amongst Orthodontists.

BACKGROUND: Accelerated orthodontic teeth movement are procedures carried out to increase the rate of tooth movement thereby reducing treatment time. There are numerous techniques currently available to accelerate orthodontic treatment time, but evidence is still needed to determine the degree to which orthodontists accept and practice accelerated orthodontics. The present study is aimed at assessing the knowledge of Orthodontists on the practice of accelerated orthodontics; as well as their willingness to adopt it as a treatment option for their patients. METHODOLOGY: Ethical approval was obtained before the commencement of the study. The study population comprised all orthodontists practicing in Nigeria. Questionnaires were administered physically to the orthodontists at their annual general meeting. E-mails were further used to distribute the questionnaire to the orthodontists who were absent from the annual meeting. The questionnaire obtained information on respondents' biodata, knowledge, attitude, and practice of accelerated orthodontic treatment procedures.Statistical analysis was performed using IBM SPSS software version 27. The level of significance was 0.05 for all statistical analysis. RESULTS: The study participants comprised 60 respondents, with a mean age of 34.18 years and a male-to-female ratio of 1.3:1. A Majority of them were satisfied with treatment time/duration (61.7%), they had a good knowledge of accelerated orthodontics (83.3%) with piezocision (75%) and micro-osteoperforation (63.3%) being the most popular. All orthodontists were interested in accelerated orthodontics, if it offered up to 30% reduction in treatment time. Major limitations to the practice included unavailability of technique materials (50%), insufficient knowledge (41.7%) and cost (35%). CONCLUSION: Most orthodontists did not routinely practice accelerated orthodontics despite adequate knowledge. They were willing to offer accelerated orthodontic treatment (AOT) if patients were willing to pay an additional fee. The less invasive methods were more accepted.

CONTEXTE: Les mouvements dentaires orthodontiques accélérés sont des procédures réalisées pour augmenter la vitesse de déplacement des dents, réduisant ainsi le temps de traitement. Il existe de nombreuses techniques actuellement disponibles pour accélérer le temps de traitement orthodontique, mais des preuves sont encore nécessaires pour déterminer dans quelle mesure les orthodontistes acceptent et pratiquent l'orthodontie accélérée. La présente étude vise à évaluer les connaissances des orthodontistes sur la pratique de l'orthodontie accélérée, ainsi que leur volonté de l'adopter comme option de traitement pour leurs patients. MÉTHODOLOGIE: L'approbation éthique a été obtenue avant le début de l'étude. La population étudiée comprenait tous les orthodontistes exerçant au Nigeria. Des questionnaires ont été administrés physiquement aux orthodontistes lors de leur assemblée générale annuelle. Des courriels ont ensuite été utilisés pour distribuer le questionnaire aux orthodontistes absents de l'assemblée annuelle. Le questionnaire a recueilli des informations sur les données biographiques des répondants, ainsi que sur leurs connaissances, attitudes et pratiques en matière de traitement orthodontique accéléré. L'analyse statistique a été réalisée à l'aide du logiciel IBM SPSS version 27. Le niveau de signification était de 0,05 pour toutes les analyses statistiques. RÉSULTATS: Les participants à l'étude étaient au nombre de 60, avec un âge moyen de 34,18 ans et un ratio hommes-femmes de 1,3:1. La majorité d'entre eux étaient satisfaits du temps/durée du traitement (61,7 %), ils avaient de bonnes connaissances en orthodontie accélérée (83,3 %) avec la piezocision (75 %) et la micro-ostéoperforation (63,3 %) étant les plus populaires. Tous les orthodontistes étaient intéressés par l'orthodontie accélérée, si elle offrait une réduction allant jusqu'à 30 % du temps de traitement. Les principales limitations à la pratique comprenaient l'indisponibilité des matériaux de technique (50 %), le manque de connaissances (41,7 %) et le coût (35 %). CONCLUSION: La plupart des orthodontistes ne pratiquaient pas systématiquement l'orthodontie accélérée malgré des connaissances adéquates. Ils étaient prêts à proposer un traitement orthodontique accéléré (TOA) si les patients étaient prêts à payer des frais supplémentaires. Les méthodes moins invasives étaient plus acceptées. MOTS-CLÉS: Orthodontie accélérée, orthodontiste, temps de traitement, piezocision.

First and Second Waves of Covid-19: A Comparative Study of the Clinical Presentation and Outcome among Hospitalized Patients in Lagos Nigeria.

OBJECTIVE: Nigeria experienced many waves of the COVID-19 pandemic. This study compared the clinical presentations and mortality among hospitalized patients during the first and second waves of the pandemic in Lagos State, Nigeria. METHODS: A retrospective cohort study was conducted. Deidentified medical records of laboratory-confirmed COVID-19 patients admitted into 15 isolation centers in Lagos, Nigeria between February 27, 2020, and September 30, 2020 (first wave) and October 1, 2020, and April 30, 2021 (second wave) were reviewed. IBM Statistics version 25 was used for data analysis. RESULTS: More patients were hospitalized during the first wave of the pandemic. The mean age of patients was higher during the second wave (54.5±15.8 years vs. 42.2±15.5 years, p <0.001). More patients admitted during the second wave had comorbidities (56.0% vs 28.6%, p <0.001), were symptomatic (90.8% vs 52.0%, p <0.001), had severe COVID-19 disease (58.9% vs 25%, p <0.001) and died (14.9% vs 6.4%, p<0.001) compared with the first wave. The odds of death increased with age and severity of COVID-19 disease during the first and second waves. CONCLUSION: A higher proportion of the patients admitted in Lagos, Nigeria during the second wave were older, had comorbidities, and had severe COVID-19 disease than the first wave. Despite the fewer hospitalized patients, there were more deaths during the second wave.

OBJECTIF: Le Nigeria a connu plusieurs vagues de la pandémie de la COVID-19. Cette étude a comparé les présentations cliniques et la mortalité chez les patients hospitalisés lors des première et deuxième vagues de la pandémie dans l'État de Lagos, Nigeria. MÉTHODES: Une étude de cohorte rétrospective a été réalisée. Les dossiers médicaux déidentifiés des patients atteints de la COVID-19 confirmée par laboratoire, admis dans 15 centres d'isolement à Lagos, Nigeria, entre le 27 février 2020 et le 30 septembre 2020 (première vague) et entre le 1er octobre 2020 et le 30 avril 2021 (deuxième vague), ont été examinés. IBM Statistics version 25 a été utilisé pour l'analyse des données. RÉSULTATS: Un plus grand nombre de patients ont été hospitalisés lors de la première vague de la pandémie. L'âge moyen des patients était plus élevé lors de la deuxième vague (54,5±15,8 ans vs. 42,2±15,5 ans, p <0,001). Un plus grand nombre de patients admis lors de la deuxième vague avaient des comorbidités (56,0% vs. 28,6%, p <0,001), étaient symptomatiques (90,8% vs. 52,0%, p <0,001), avaient une forme grave de la maladie à la COVID-19 (58,9% vs. 25%, p <0,001) et sont décédés (14,9% vs. 6,4%, p<0,001) par rapport à la première vague. Les chances de décès ont augmenté avec l'âge et la gravité de la maladie à la COVID-19 lors des première et deuxième vagues. CONCLUSION: Une proportion plus élevée des patients admis à Lagos, Nigeria, lors de la deuxième vague étaient plus âgés, avaient des comorbidités et présentaient une forme grave de la maladie à la COVID-19 par rapport à la première vague. Malgré un nombre moindre de patients hospitalisés, il y a eu plus de décès lors de la deuxième vague. MOTS-CLÉS: Présentation Clinique, Covid-19, Première Vague, Mortalité, Nigeria, Deuxième Vague.

Has Treatment Seeking Behaviour Changed in People Living with Epilepsy? Experience of People Living with Epilepsy Attending Adult Neurology Clinics in Enugu.

BACKGROUND: Over the years efforts has been made through public health education to change the knowledge, attitude and practice of epilepsy and seizures among the populace in Nigeria. One surrogate method of reviewing the impact of these educational interventions includes changes in treatment-seeking behavior of People Living With Epilepsy and the reasons for their choices of treatment. METHODS: This was a cross-sectional descriptive study. Data were collected from People Living With Epilepsy attending the medical outpatient clinics in two tertiary hospitals in Enugu, Enugu State southeast Nigeria. RESULTS: A total 276 people living with epilepsy were recruited with a mean age of 30.1 years and a median age of 25 years. After the onset of epilepsy, 76(27.5%) and 70(25.4%) visited general hospitals and teaching hospitals respectively, while prayer houses and traditional healing centers were first visited by 54(19.6%) and 40(14.5%) respectively. As a second choice of care 9(3.3%) and 13(4.7%) visited prayer houses and traditional healing centers. Only 42(15.2%) selected their treatment center because they were confident of getting a cure however, this was highest for those that visited traditional healing centers 11(27.5%). The age of onset of epilepsy positively correlated with selecting orthodox treatment at the choice of care, while occupational status negatively correlated with selecting orthodox care at the same period. CONCLUSIONS: Health care seeking behaviors among PLWE in Southeast Nigeria might have changed over the years as more people living with epilepsy were more likely to select orthodox treatment compared to non-orthodox means of treatment.

CONTEXTE: Au fil des ans, des efforts ont été déployés par le biais de l'éducation en santé publique pour changer les connaissances, les attitudes et les pratiques concernant l'épilepsie et les crises d'épilepsie parmi la population au Nigeria. Une méthode indirecte pour examiner l'impact de ces interventions éducatives comprend les changements dans le comportement de recherche de traitement des personnes vivant avec l'épilepsie et les raisons de leurs choix de traitement. MÉTHODES: Il s'agit d'une étude descriptive transversale. Les données ont été collectées auprès de personnes vivant avec l'épilepsie fréquentant les cliniques de consultations externes médicales dans deux hôpitaux tertiaires à Enugu, dans l'État d'Enugu, au sud-est du Nigeria. RÉSULTATS: Au total, 276 personnes vivant avec l'épilepsie ont été recrutées, avec un âge moyen de 30,1 ans et un âge médian de 25 ans. Après le début de l'épilepsie, 76 (27,5 %) et 70 (25,4 %) ont consulté respectivement des hôpitaux généraux et des hôpitaux universitaires, tandis que les lieux de prière et les centres de guérison traditionnelle ont été les premiers consultés par respectivement 54 (19,6 %) et 40 (14,5 %). Comme deuxième choix de soins, 9 (3,3 %) et 13 (4,7 %) ont consulté des lieux de prière et des centres de guérison traditionnelle. Seuls 42 (15,2 %) ont choisi leur centre de traitement parce qu'ils étaient confiants d'obtenir une guérison, cependant, ce taux était le plus élevé pour ceux qui ont consulté les centres de guérison traditionnelle (11 soit 27,5 %). L'âge de début de l'épilepsie était positivement corrélé avec la sélection d'un traitement orthodoxe comme choix de soins, tandis que le statut professionnel était négativement corrélé avec la sélection de soins orthodoxes au même moment. CONCLUSIONS: Les comportements de recherche de soins parmi les personnes vivant avec l'épilepsie dans le sud-est du Nigeria ont peut-être changé au fil des ans, car davantage de personnes vivant avec l'épilepsie étaient plus susceptibles de choisir un traitement orthodoxe par rapport aux moyens de traitement non orthodoxes. MOTS-CLÉS: Épilepsie, Comportement de recherche de soins, Guérisseurs traditionnels, Lieux de prière, Médecine orthodoxe, sud-est du Nigeria.

Microtensile Bond Strength of Self-Etch Adhesives on Dentin Treated with Chlorhexidine.

AIM: To evaluate the microtensile bond strength of self-etching adhesive systems in dentin treated with 2% chlorhexidine digluconate (CHX). MATERIALS AND METHODS: The occlusal surfaces of 20 human molars were removed and divided into eight groups: 1A, Clearfil SE adhesive (SE) with self-etching technique (TS); 1B, SE with TS and previous application of CHX; 2A, Scotchbond Universal (SBU) adhesive with TS; 2B, SBU adhesive with TS and previous application of CHX; 1C, SE with total-etching technique (TT); 1D, SE with TT and previous application of CHX; 2C, SBU with TT; 2D SBU with TT and previous application of CHX. Composite resin (5mm) was applied on the hybridized surface. Samples were subjected to microtensile test and evaluated on Scanning Electron Microscope (SEM) and with energy-dispersive X-ray (EDX). RESULTS: Low values of bond strength were observed in groups 1A (39,77±11,56) and 2A (40,84±12,49) comparing with 1B (22,86±5,18) and 2B (27,02±5,58). TS group presented adhesive type remover fracture while TT groups presented cohesive at the top of hybrid layer. EDX revealed the presence of CHX crystals for TS, which was not found in the TT. CONCLUSION: The previous application of chlorhexidine on dentin decreased the bond strength of adhesive systems on self-etching technique.

Pattern and value of Sperm DNA Fragmentation Index and its correlation with spermiogram in infertile South West Nigerian Men.

Semen analysis has been used for a long time to assess male fertility due to its limitations sperm DNA fragmentation index (DFI), which describes the sperm DNA's condition, is an appropriate criterion for assessing male fertility. This study evaluated the pattern and value of DFI of infertile men in the South West of Nigeria. This is a cross-sectional and descriptive study that recruited two hundred and eighty-seven (287) patients from two fertility centers in Lagos, Nigeria. The Sperm DFI was determined using the Sperm chromatin structure assay (SCSA) test. The descriptive and inferential statistics of the study were carried out using R packages (R version 4.2.0) with the help of R functions using compiled code. The result showed that the mean age sperm concentration, total motility morphology, and DFI were as follows 42.96±7.09years, 40.18±4.19×106 per ml, 49%±19%, 56±17%, and 15.78±8.52 respectively. There is a significant negative correlation between sperm concentration and DFI at a P-value of 0.0018 with a regression model of Coefficient of determination is 0.305. The DFI value of infertile men negatively correlates with sperm concentration, thus increase sperm production may improve sperm quality.

[Idiopathic membranous nephropathy with focal segmental sclerosis].

AIM: To evaluate the clinical and pathological features and prognosis of idiopathic membranous nephropathy (IMN) with focal segmental sclerosis (FSGS) in a group of Russian patients. MATERIALS AND METHODS: 101 patients with morphologically verified IMN were enrolled in our single-center cohort retrospective study. The patients were divided into IMN group and IMN+FSGS group. The primary and secondary outcomes were analyzed in 59 patients, which had follow-up data for period more than 6 months. RESULTS: At the time of renal biopsy the median age was 46.0 (33.0; 55.0) years and the median follow-up was 6.8 (4.0; 15.6) months. Secondary FSGS was revealed in 15 (14.9%) patients with IMN. The IMN and IMN+FSGS groups did not differ in gender, age of onset IMN and age of renal biopsy. In the IMN+FSGS group proteinuria was higher and estimated glomerular filtration rate was lower than that in the IMN group (p<0.05). The systolic arterial pressure and creatinine levels in the IMN+FSGS group were slightly higher than in the IMN group, but the difference was not significant. Anti-PLA2R positivity was similar in both groups. Chronic kidney disease (CKD) progression was observed in 10/52 (19.2%) and 5/7 (71.4%) patients in IMN and IMN+FSGS groups, respectively. In a multivariate Cox regression model, age of renal biopsy (odds ratio - OR 1.12, 95% confidence interval - CI 1.03-1.22; р=0.07), FSGS (OR 0.05, 95% CI 0.01-0.34; р=0.002) и response to initial course of immunosuppression (OR 0.33, 95% CI 0.12-0.95; р=0.039) were associated with the CKD progression. CONCLUSION: In patients with IMN secondary FSGS is associated with a greater severity of proteinuria and a decrease in estimated glomerular filtration rate, and is also an independent factor of the CKD progression.

[Outpatient treatment and quality of life of patients with interstitial cystitis and Hunners lesion: cohort cross-sectional study].

AIM: To assess the quality of life of patients with interstitial cystitis (IC) and to study effective options used to control symptoms on outpatient basis. MATERIALS AND METHODS: The results of a descriptive prospective cross-sectional cohort study are presented. The medical charts of patients who were treated in the City Clinical Hospital named after Spasokukotsky from 2021 to 2023 were analyzed. Eighty inpatient medical charts of various patients with a final diagnosis of IC with Hunner's lesion were identified. Only 53 patients were interviewed due to the inclusion/exclusion criteria. Respondents were asked to complete a survey consisting of 15 questions. The survey was carried out online for patients who did not require surgical treatment at the time of the study, and offline for patients admitted for repeated surgical treatment. RESULTS: The average age of respondents was 59.011.1 years. 58% (31) of patients noted the presence of constant pain in the pelvic area during the day, while 85% (45) of patients reported pain outside the bladder area, in the urethra and perineum. The intensity of pain in the pelvic area was 4.9 (2.3-5.6) points. Higher pain scores 6.24 (5.8-9.0) were observed in 47% (25) of patients admitted for repeat surgical treatment. 62% (33) of patients had a titer of bacteria in a urine test above 104, while 51% (27) of patients experienced relief of symptoms after taking antibacterial drugs. For the treatment and symptomatic relief, the following are most often used: pentosan sodium polysulfate (26%, n=14), antibacterial drugs of the nitrofuran group (25%, n=13), amitriptyline (15%, n=8), non-steroidal anti-inflammatory drugs (11%, n=6) patients. 23% (12) of respondents received intravesical therapy. The time from the onset of symptoms to the final diagnosis was 48 (24-96) months. CONCLUSIONS: Although infection is a criterion for excluding the diagnosis of IC, more than 62% of patients have positive urine culture. The results obtained indicate the need to improve existing approaches to the diagnosis of IC, as well as to develop treatment algorithms for painful bladder syndrome to control symptoms.