Post discharge management of heart failure patients: clinical findings at the first medical visit in a single-center study.

BACKGROUND: The Post Discharge Management of patients with heart failure impact significantly their incomes. This study aims to analyze the clinical findings and management at the first medical visit of these patients in our context. MATERIAL AND METHODS: This is a retrospective cross-sectional descriptive study on consecutive files of patients hospitalized for heart failure from January to December 2018 in our Department. We analyse data from the first post discharge medical visit including medical visit time, clinical conditions and management. RESULTS: Three hundred and eight patients (mean age: 53.4 ± 17.0 years, 60% males) were hospitalized on median duration of 4 days [1-22 days]. One hundred and fifty-three patients (49,67%) were presented at the first medical visit after 66.53 days[0.06-369] on average, 10 (3.24%) patients died before this first medical visit and 145 (47.07%) had been lost to follow-up. The re-hospitalization and treatment non-compliance rates were 9.4% and 3.6%, respectively. Male gender (p = 0.048), renal failure (p = 0.010), and Vitamin K antagonist (VKA) /direct oral anticoagulant (DOAC) (p = 0.049) were the main lost to follow-up factors in univariate analysis without statistic signification in multivariate analysis. Hyponatremia (OR = 2.339; CI 95% = 0.908-6.027; p = 0.020) and atrial fibrillation (OR = 2.673; CI 95% = 1.321-5.408; p = 0.012) were the major mortality factors. CONCLUSION: The management of patients with heart failure after discharge from hospital seems to be insufficient and inadequate. A specialized unit is required to optimize this management.

Virtual design of novel Plasmodium falciparum cysteine protease falcipain-2 hybrid lactone-chalcone and isatin-chalcone inhibitors probing the S2 active site pocket.

We report computer-aided design of new lactone-chalcone and isatin-chalcone (HLCIC) inhibitors of the falcipain-2 (PfFP-2). 3D models of 15 FP-2:HLCIC1-15 complexes with known observed activity (IC50exp) were prepared to establish a quantitative structure-activity (QSAR) model and linear correlation between relative Gibbs free energy of enzyme:inhibitor complex formation (ΔΔGcom) and IC50exp: pIC50exp = -0.0236 × ΔΔGcom+5.082(#); R2 = 0.93. A 3D pharmacophore model (PH4) derived from the QSAR directed our effort to design novel HLCIC analogues. During the design, an initial virtual library of 2621440 HLCIC was focused down to 18288 drug-like compounds and finally, PH4 screened to identify 81 promising compounds. Thirty-three others were added from an intuitive substitution approach intended to fill better the enzyme S2 pocket. One hundred and fourteen theoretical IC50 (IC50pre) values were predicted by means of (#) and their pharmacokinetics (ADME) profiles. More than 30 putative HLCICs display IC50pre 100 times superior to that of the published most active training set inhibitor HLCIC1.

[Pharmacist interventions on antibiotic prescriptions in outpatient pediatric unit in a teaching hospital of Côte d'Ivoire]. / Interventions pharmaceutiques sur les prescriptions d'antibiotiques en consultations externes de pédiatrie d'un centre hospitalier universitaire de Côte d'Ivoire.

OBJECTIVES: The objectives of our study were to analyse the prescriptions of antibiotics and assessing the relevance of pharmacist interventions (PI) in outpatient consultations in a pediatric unit of a Teaching Hospital of Abidjan, Côte d'Ivoire. METHODS: We conducted a cross-sectional descriptive study from May to December 2013. The analysis of antibiotic prescriptions was documented. The tool of PI classification validated by the French Society of Clinical Pharmacy was used. The PI rating was made by prescribers. This rating evolved from PI0 to PI3 depending on the severity of the clinical impact of the problem and to the severity of clinical consequences avoided by the PI. The relevance was evaluated by the PI acceptance rate by physicians and clinical evaluation of their impact. RESULTS: Our study included 150 patients with a mean age of 11.75 months and a sex ratio (M/F) of 2. The amoxicillin-clavulanic acid (27.2 %) and amoxicillin (22.3 %) were the most prescribed antibiotics. Sixty-three drug-related problems (DRPs) were detected on the antibiotic prescriptions. They were non-optimal drug administration plan (88.9 %) and underdose (11.1 %). The amoxicillin-clavulanic acid (61.9 %) and josamycin (17.4 %) were the most affected by these DRPs. PI were related to the precision of modes of drug administration (88.9 %) and dose adjustments (11.1 %). The prescribers accepted 93.7 % of PIs. All accepted PIs was rated PI1 (significant clinical impact). CONCLUSIONS: PIs performed on antibiotic prescription were relevant with a high rate of acceptance and a significant clinical impact.

Brain lesions in eclampsia: A series of 39 cases admitted in an Intensive Care Unit.

The aim of this study was to identify the encephalic lesions in the eclampsia occurrences. Within a period of 18 months, computed tomography (CT) of the brain was performed in all patients admitted in intensive care for eclampsia. These CTs were analyzed and intracerebral lesions were identified. Thirty-nine patients were included. We noted 10 cases of ischemic stroke, 9 cases of cerebral edema, and 3 cases of hemorrhagic stroke and subarachnoid hemorrhage. The CT scan came back to normal in 20 eclamptic patients. Overall, delays in obstetric and intensive care and time of completion of the CT were long. CT has allowed highlighting in patients with eclampsia varied intracerebral lesions. The early performance of the CT is therefore essential for a better support of patients.

Ibuprofen Lyell's Syndrome In An Eight-Year-Old Child.

Lyell's syndrome or toxic epidermal necrolysis (TEN) is a rare but serious drug-like toxiderma. Treated as a recent extensive burn in intensive care, its management must be urgent, and adapted in order to improve the vital prognosis of patients and reduce their mortality. We report a severe case of Lyell's syndrome occurring 24 hours after oral administration of an anti-inflammatory drug (ibuprofen) as a self-medication in an eight-year-old child.

Le syndrome de Lyell (nécrolyse épidermique toxique - NET) est une toxidermie médicamenteuse rare mais grave. Son prise en charge, urgente, doit être réalisée en CTB car elle s'approche de celle d'un brûlé. Nous rapportons le cas d'une NET survenue 24h après la prise orale, en automédication, d'ibuprophène.

Group-based and personalized care in an age of genomic and evidence-based medicine: a reappraisal.

This article addresses the philosophical and moral foundations of group-based and individualized therapy in connection with population care equality. The U.S. Food and Drug Administration (FDA) recently modified its public health policy by seeking to enhance the efficacy and equality of care through the approval of group-specific prescriptions and doses for some drugs. In the age of genomics, when individualization of care increasingly has become a major concern, investigating the relationship between population health, stratified medicine, and personalized therapy can improve our understanding of the ethical and biomedical implications of genomic medicine. I suggest that the need to optimize population health through population substructure-sensitive research and the need to individualize care through genetically targeted therapies are not necessarily incompatible. Accordingly, the article reconceptualizes a unified goal for modern scientific medicine in terms of individualized equal care.

[Tuberculosis in the elderly: Epidemiology and outcomes of ambulatory followed-up in Abidjan]. / La tuberculose du sujet âgé : épidémiologie et devenir des patients suivis en ambulatoire à Abidjan.

BACKGROUND: Very few works approach elderly's tuberculosis (TB) in developing countries. The aim of this study is to present elderly's TB epidemiology and the outcomes of the ambulatory follow-up of the tuberculous patients aged more than 65years old (TBE) compared to the TB among patients less than 65years old (TBY). METHODS: Our study is retrospective covering period of January 1999 to June 2006 activities of Adjamé's antituberculous center. It is a comparative study between patients of at least 65 years and patients of less than 65years when the diagnosis of TB was made. RESULTS: Among 36,923 cases of TB, the proportion of TBE is 2.33%. In case of TBE, the sex-ratio is 2.16 versus 1.50 among TBY (P<0.001). Localization of TB is pulmonary in 61.70% among TBE versus 67.26% among TBY (P=0.058). Among elderly's TB, the osteoarticular localization is more frequent. TB-VIH co-infection prevalence is estimated to 9.05% among elderly's TB versus 44.38% among patients of less than 65 years (P<0.001). The therapeutic success rate within elderly patients is 52.16% years versus 61.42% when it was patients of less than 65 years. The proportion of lost at follow-up and the rate of patient transfers within the elderly's TB are the most raised. CONCLUSION: The elderly's TB is rare with a more masculine predominance. TB-VIH co-infection is not important among elderly's TB. The aged patient follow-up must be improved.

High electrical energy harvesting performance of an integrated microbial fuel cell and low voltage booster-rectifier system treating domestic wastewater.

To harvest directly usable electrical energy from real domestic wastewater, a new power management system (PMS), transistor-based low voltage boosters followed by a voltage rectifier (LVBR), was developed and tested for its energy harvesting performance. Three air-cathode MFCs were individually linked with LVBs, which were electrically stacked in parallel and then connected with a single voltage rectifier (MFC-LVBR). The MFC-LVBR system could increase VMFCto 11.9 ± 0.6 V without voltage reversal, which was capable of charging a lithium-ion batteryand supercapacitor-based power banks. When the integrated MFC-LVBR system was linked with a lithium-ion battery, the highest normalized energy recovery (NERCOD) of 0.76 kWh/kg-COD (NERvolumeof 0.22 kWh/m3) was achieved with a minimal energy loss of 14.4%, whichwas much higher than those previously reported values.Furthermore, the electrical energy charged in the lithium-ion battery successfully powered a DC peristaltic pump requiring a minimum operating power of 0.46 W.

Effect of poised cathodic potential on anodic ammonium nitrogen removal from domestic wastewater by air-cathode microbial fuel cells.

Performances of anodic ammonia oxidation have been investigated for various bioelectrochemical systems at a wide range of poised anodic potentials in the literature. The effect of poised cathodic potential on ammonium nitrogen (NH4+-N) and total nitrogen (TN, sum of NH4+-N, NO2--N, and NO3--N) removal from domestic wastewater by single chamber air-cathode microbial fuel cells (MFCs) was investigated. Poising the air-cathode potential at +0.7 V vs. SHE significantly increased current generation (from 11 ± 1 mA to 22.8 ± 5 mA) and oxygen permeation into the MFC through the air-cathode (from 75.4 ± 1.2 g-O2/m3/d to 151 ± 3.7 g-O2/m3/d), which consequently resulted in a high NH4+-N removal rate of 150 ± 13 g-NH4+-N/m3/d and TN removal rate of 63 ± 16 g-TN/m3/d. These high NH4+-N and TN removal rates could be attributed to the enhancement of dual respiratory pathways: the electrode-assisted anodic and aerobic NH4+ oxidation.

Effects of wearing removable dentures and aging on palatal mucosa blood flow by laser doppler.

Aim: The purpose of this work is to analyze the effects of removable dental prostheses and aging on blood microcirculation in the palatal mucosa. Settings and Design: Blood flow was measured in two groups using the Laser Doppler Flowmeter at three specific anatomical sites: Retro incisive papilla, medial raphe, and Schroeder area. Materials and Methods: Group 1 included young, healthy dentulous individuals (mean age: 23 ± 3 years), and Group 2 contained elderly edentulous individuals (mean age: 62 ± 11.69 years). For Group 1, measurements were taken in a single session; for Group 2, the measurements were taken in two sessions: The first just before the prosthetic load (E1) and again 1 week after new dentures were provider (E2). Statistical Analysis Used: Statistical analyses were performed using SAS software, Version 9.4 of the SAS System for Windows, Copyright © 2017 SAS Institute Inc. (Cary, NC, USA). A P < 0.05 was classified as statistically significant. Results: Measurements of blood flow of the palatal mucosa showed that the healthy young dentulous participants had significantly lower perfusion unit values than the elderly edentulous participants at all three anatomical sites (P < 0.05). For Group 2, the comparisons between the measurements taken before (E1) and after (E2) new dentures were provided showed no significant differences. Conclusion: Our results indicate that the process of aging significantly modifies the blood flow of the palatal mucosa while wearing removable dental prostheses does not modify the blood flow of the palatal mucosa in a 1week period. These results are not influenced by systemic pathology (e.g., diabetes, cardiovascular diseases) or smoking.

Bioelectrochemical anoxic ammonium nitrogen removal by an MFC driven single chamber microbial electrolysis cell.

Nitrogen removal from wastewater is an indispensable but highly energy-demanding process, and thus more energy-saving treatment processes are required. Here, we investigated the performance of bioelectrochemical ammonium nitrogen (NH4+-N) removal from real domestic wastewater without energy-intensive aeration by a single chamber microbial electrolysis cell (MEC) that was electrically powered by a double chamber microbial fuel cell (MFC). Anoxic NH4+-N oxidation and total nitrogen (TN) removal rates were determined at various applied voltages (0-1.2 V), provided by the MFC. The MEC achieved a NH4+-N oxidation rate of 151 ± 42 g NH4+-N m-3 d-1 and TN removal rate of 95 ± 42 g-TN m-3 d-1 without aeration at the applied voltage of 0.8 V (the anode potential Eanode = +0.633 ± 0.218 V vs. SHE). These removal rates were much higher than the previously reported values and conventional biological nitrogen removal processes. Open and closed-circuit MEC batch experiments confirmed that anoxic NH4+-N oxidation was an electrochemically mediated biological process (that is, an anode acted as an electron acceptor) and denitrification occurred simultaneously without NO2- and NO3- accumulation. Moreover, ex-situ15N tracer experiment and microbial community analysis revealed that anammox and heterotrophic denitrification mainly contributed to the TN removal. Thus, the bioelectrochemical anodic NH4+-N oxidation was coupled with anammox and denitrification in this MFC-assisted MEC system. Taken together, our MFC-driven single chamber MEC could be a high rate energy-saving nitrogen removal process without external carbon and energy input and high energy-demanding aeration.

[Couple life and management of HIV infection in the pneumology department of the Teaching hospital center of Cocody, Abidjan, Côte d'Ivoire]. / Vie de couple et prise en charge de l'infection à VIH au service de pneumologie du CHU de Cocody, Abidjan, Côte d'Ivoire.

Introduction: The life of a couple is a place of emotional support. It can allow the management of patients infected with HIV on antiretroviral therapy to be optimized.The objective of our study was to analyze the impact of married life on the therapeutic follow-up of patients living with HIV. Methodology: We carried out a mono-centric, prospective, descriptive and analytical study in the care unit of patients living with HIV of the pneumology service of the Cocody Teaching Hospital in Abidjan. The investigation took place from September 1, 2015 to March 31, 2016. Results: We included 411 patients. The sex ratio was 0.51. The average age was 43.2 years with extremes of 19 and 69 years. The patients lived as a couple in 59.1% of cases. Couple life was associated with severe immunosuppression at 12 months in 23.3% (42/180) of cases [p = 0.043 OR = 1.735 (0.964 - 3.121)], the appearance of new opportunistic conditions between the 6th and the 12th month of treatment in 5.6% (13/232) of cases [p = 0.006; OR = 9.438 (1.222 - 72.890)], information sharing with the partner before the start of treatment in 92.4% (208/225) of cases [p = 0.035; OR = 1.976 (1.005-3886)] and the existence of sexual intercourse since the discovery of the disease in 92.6% (225/243) of cases [p < 0.001; OR = 14.423 (8.174 - 25.448)]. Sexual relationships were less protected among people living in a couple 65.9% (149/226) versus 78% (64/82) among others [p = 0.027; OR = 0.544 (0.301 - 0.923)]. The loss of the sexual partner at the onset of the disease was observed regardless of marital status (p = 0.203). Conclusion: The life of a couple negatively influences the management of HIV infection. It appears necessary to set up counseling and testing programs for couples.

Genomics and the conundrum of race: some epistemic and ethical considerations.

This article addresses the question of whether race is a biological category and whether it is permissible to use it in biomedicine. I suggest that instrumentalism, a view that race is a problem-solving tool rather than a concept with an objective referent in nature, may be more consistent with the available scientific evidence. I argue that, to be morally permissible, the instrumentalist use of race in research and medicine requires stringent guidelines. I then provide four normative rules to guide race research in the biomedical sciences. The paper gathers evidence from philosophy of science, genomics, legal history, and normative ethics in order to ground the biomedical use of race in a converging ethical and epistemic framework.

High voltage generation from wastewater by microbial fuel cells equipped with a newly designed low voltage booster multiplier (LVBM).

Although microbial fuel cells (MFCs) can produce renewable energy from wastewater, the generated power is practically unusable. To extract usable power from an MFC fed with wastewater, we newly developed a low voltage booster multiplier (LVBM), which is composed of a self-oscillating LVB and multistage voltage multiplier circuits (VMCs). The low output MFC voltage (ca. 0.4 V) was successfully boosted up to 99 ± 2 V, which was the highest voltage that has been ever reported, without voltage reversal by connecting an LVB with 20-stage VMCs. Moreover, the boosted voltage (81 ± 1 V) was stably maintained for > 40 h even after disconnecting the LVBM from the MFC. The energy harvesting efficiency of LVBM was > 80% when an LVB with 4-stage VMCs was charged to 9.3 V. These results clearly suggest that the proposed LVBM system is an efficient and self-starting energy harvester and storage for low-power generating MFCs.

[Epidemiology and mortality factors of acute intoxication in intensive care in Bouaké (Ivory Coast) from 2015 to 2018]. / Epidemiologie et facteurs de mortalite des intoxications aiguës en reanimation a Bouake (Cote d'Ivoire) de 2015 a 2018.

INTRODUCTION: Acute poisoning is a common reason for admission to intensive care. OBJECTIVE: To describe the epidemiological profile, to analyze the mortality factors of patients admitted to intensive care for acute intoxication. PATIENTS AND METHODS: A retrospective, descriptive and analytical study covering four years (from January 1, 2015 to December 31, 2018) .Includes patients admitted to intensive care in Bouaké for acute intoxication. The variables studied were: socio-demographic characteristics, intoxication characteristics, clinical, therapeutic, evolutionary and prognostic characteristics. RESULTS: Of a total of 1476 admissions during the study period, 131 patients were admitted for acute intoxication, with a hospital prevalence of 8.8%. The average age was 19 (range: 1 month to 70 years). The sex ratio was 0.84. The majority of poisonings occurred at home (94%). Psychiatric history was present in 11% of patients. The poisoning occurred in urban areas in 72% of cases. The place of intoxication was the family home in 94% of cases. The nature of the intoxication and the type of poison toxin depended on the age of the intoxicated patients. The average admission time was 7.38 hours ± 12 hours (range: 30 minutes to 72 hours). The poisoning was symptomatic in 93% of the patients. The clinical symptoms observed were: gastrointestinal (70%), respiratory (62%) and neurological (43%). Vomiting attempts associated with self-medication were performed in 69% of patients. The substances used for self-medication were: palm oil (80%) and milk (20%). The treatment in intensive care was initially symptomatic then secondarily adapted to the nature of the incriminated or suspected toxin. The use of tracheal intubation and mechanical ventilation was necessary for 10% of the patients. The average stay in hospital was 1.64 ± 1.5 days (range: 1 to 10 days). The lethality was 8%. The factors of poor prognosis were the existence of a cardiovascular collapse (p <0.001), the presence of a deep coma (p <0.001) and the use of mechanical ventilation (p <0. 001). CONCLUSION: Acute intoxication is a public health problem in Bouaké and requires preventive action.

INTRODUCTION: Les intoxications aiguës constituent un motif fréquent d'admission en réanimation. OBJECTIF: Décrire le profil épidémiologique, analyser les facteurs de mortalité des patients admis en réanimation pour intoxications aiguës. PATIENTS ET MÉTHODES: Etude rétrospective, descriptive et analytique, portant sur quatre ans (du 1er janvier 2015 au 31 décembre 2018).Etaient inclus les patients admis en réanimation à Bouaké pour une intoxication aiguë. Les variables étudiées étaient: les caractéristiques sociodémographiques, les caractéristiques de l'intoxication, les caractéristiques cliniques, thérapeutiques, évolutives et le pronostic. RÉSULTATS: Sur un total de 1476 admissions durant la période d'étude, 131 patients ont été admis pour une intoxication aiguë, soit une prévalence hospitalière de 8,8 %. L'âge moyen était de 19 ans (extrême : 1 mois et 70 ans). Le sex-ratio était de 0,84. La majorité des intoxications avaient eu lieu au domicile (94 %). Les antécédents psychiatriques étaient présents chez 11% des patients. Les intoxications avaient lieu en milieu urbain dans 72% des cas. Le lieu de l'intoxication était le domicile familial dans 94% des cas. La nature de l'intoxication et le type de toxique incriminé était fonction de l'âge des patients intoxiqués. Le délai moyen d'admission était de 7,38 heures ± 12heures (extrêmes: 30 mn et 72 heures). Les intoxications étaient symptomatiques chez 93% des patients. Les symptômes cliniques observés étaient : gastro-intestinaux (70%), respiratoires (62 %) et neurologique (43%). Des tentatives de vomissements associées à une automédication ont été réalisées chez 69% des patients. Les substances utilisées pour l'automédication étaient : l'huile de palme (80 %) et de lait (20%). Le traitement en réanimation était initialement symptomatique puis secondairement adapté à la nature du toxique incriminé ou suspecté. Le recours à l'intubation trachéale et à la ventilation mécanique a été nécessaire chez 10% des intoxiqués. Le séjour moyen en hospitalisation a été de 1,64±1,5 jours (extrêmes : 1 et 10 jours). La létalité était de 8 %. Les facteurs de mauvais pronostic étaient : l'existence d'un collapsus cardiovasculaire (p <0,001), la présence d'un coma profond (p <0,001) et la réalisation d'une ventilation mécanique (p <0,001). CONCLUSION: Les intoxications aiguës constituent un problème de santé publique à Bouaké et nécessite des actions de prévention.

[Characteristics of supposedly bacterial community acute pneumonia among HIV-positive patients: prospective preliminary study]. / Pneumonies communautaires d'allure bactérienne chez le sujet infecté par le VIH : étude préliminaire prospective.

INTRODUCTION: Community-acquired pneumonia (CAP) is the second leading cause of hospitalization in the respirology department in Abidjan after tuberculosis. Frequently associated with HIV infection, it has a high mortality rate of about 20% to 30%. The aim of this study is to identify the specificities and severity factors associated with bacterial CAP (BCAP) outcome in HIV-positive patients. METHODS: The authors conducted a prospective and comparative preliminary study on two groups of patients: 29 HIV-positive patients with BCAP and 21 HIV-negative patients with BCAP. All of the patients were hospitalized for BCAP with symptoms of severity according to the usual score of severity. RESULTS: The sociodemographic, clinical and paraclinical characteristics were similar in both groups. Failures and deaths were more frequent in the group with HIV infection. In particular, HIV infected patients with a body mass index under 18.5 and a rate of T CD4 lymphocytes lower than 200/mm(3) presented the least favourable evolution. CONCLUSIONS: A more extensive study should help define the appropriate severity criteria for BCAP associated with HIV infection.

[Removal of an intratracheobronchial foreign body opaque to X-rays in a child within a context of inadequate medical technical equipment]. / Extraction d'un corps étranger intratrachéobronchique radio-opaque chez un enfant dans un contexte de plateau sous-médicalisé.

Intratracheobronchial foreign bodies are common accidents in children. In developed countries, the removal of these intratracheobronchial foreign bodies is performed with flexible or rigid fiberoptic bronchoscopy. Resorting to surgery is rare. In the inadequate medical context described, suitable medical technical equipment doesn't exist. Removal alternatives are necessary in order to avoid sanitary evacuation which is not always within patients' means. In this study, the authors describe the removal of an intratracheobronchial foreign body opaque to X-rays with foreign body forceps. The forceps, passed through the orotracheal intubation probe, were guided by an image intensification system in a traumatology operating theatre.

[Survey of general dental practitioners in Abidjan on the use of the operatory field in dentistry]. / Enquête auprès des omnipraticiens d'Abidjan sur l'utilisation du champ opératoire en dentisterie.

Rubber dam is a standard operatory field in operative dentistry and endodontics. It is undoubtedly the most certain way to insure the success of therapeutics acts. Its use by Abidjan practitioners has been the subject of our study which aim is to underline the place of rubber dam in daily practice. Our investigations show that rubber dam is totally absent from practitioners acts. Generally cotton rolls constitute the most frequent mean used by practitioners to isolate the tooth in operative dentistry and endodontics. Only 23.9% of them associate saliva sucking up. Some cases of aspiration and swallowing file by accident by patients have been highlighted. Those results lead us to recommend the systematic use of rubber dam as the mean of efficiency and security which cannot be ignored in our practice.

Alleviating peanut allergy using genetic engineering: the silencing of the immunodominant allergen Ara h 2 leads to its significant reduction and a decrease in peanut allergenicity.

Peanut allergy is one of the most life-threatening food allergies and one of the serious challenges facing the peanut and food industries. Current proposed solutions focus primarily on ways to alter the immune system of patients allergic to peanut. However, with the advent of genetic engineering novel strategies can be proposed to solve the problem of peanut allergy from the source. The objectives of this study were to eliminate the immunodominant Ara h 2 protein from transgenic peanut using RNA interference (RNAi), and to evaluate the allergenicity of resulting transgenic peanut seeds. A 265-bp-long PCR product was generated from the coding region of Ara h 2 genomic DNA, and cloned as inverted repeats in pHANNIBAL, an RNAi-inducing plant transformation vector. The Ara h 2-specific RNAi transformation cassette was subcloned into a binary pART27 vector to construct plasmid pDK28. Transgenic peanuts were produced by infecting peanut hypocotyl explants with Agrobacterium tumefaciens EHA 105 harbouring the pDK28 construct. A total of 59 kanamycin-resistant peanut plants were regenerated with phenotype and growth rates comparable to wild type. PCR and Southern analyses revealed that 44% of plants stably integrated the transgene. Sandwich ELISA performed using Ara h 2-mAbs revealed a significant (P < 0.05) reduction in Ara h 2 content in several transgenic seeds. Western immunobloting performed with Ara h 2-mAb corroborated the results obtained with ELISA and showed absence of the Ara h 2 protein from crude extracts of several transgenic seeds of the T(0) plants. The allergenicity of transgenic peanut seeds expressed as IgE binding capacity was evaluated by ELISA using sera of patients allergic to peanut. The data showed a significant decrease in the IgE binding capacity of selected transgenic seeds compared to wild type, hence, demonstrating the feasibility of alleviating peanut allergy using the RNAi technology.

Black/white disparity in self-reported hypertension: the role of nativity status.

This study investigates the association between race and self-reported hypertension and whether this association varies with nativity status in the National Health Interview Survey, 1997-2005. Logistic regression was used to estimate the association between race and self-reported hypertension before and after adjusting for selected characteristics. The overall prevalence of hypertension was 25.3%, with non-Hispanic Blacks (30.6%) exhibiting higher prevalence than non-Hispanic Whites (24.4%, p<.01). In the adjusted analysis, non-Hispanic Blacks, regardless of their nativity status, had 47% (95% CI 1.40-1.54) greater odds of reported hypertension than non-Hispanic Whites. Foreign-born non-Hispanic Blacks with more than 10 years in the U.S. had 58% (95% CI 1.27-1.96) greater odds of reporting hypertension than their White counterparts. The finding of no effect for nativity but for length of stay for foreign-born with more than 10 years in the U.S. is important in itself, suggesting that there may be selection factors deleterious to foreign-born Blacks' health after entering the U.S.