Focus: Preventive Medicine: Firearm Injury Among Children and Adolescents in Nigerian Civilian Trauma Setting: Prevalence,Pattern, and Implications for Prevention

Firearm injury in children and adolescents and the morbidity associated with it is an appreciable burden in resource-limited settings, though it is under-reported. This study aimed to determine its prevalence and pattern in Nigerian civilian trauma setting. We undertook a retrospective study of all the patients with firearm injury aged 19 years or under who visited the Emergency Department (ED) of two tertiary hospitals in Nigeria over a period of 15 years. Of the 46,734 children and adolescents seen in the ED, firearm injury was the reason for the visit in 56 of them, giving a prevalence of 1.2 per 1000 ED attendance (95% CI: 0.9-1.6). The male-to-female ratio was 1.8:1, and the mean age was 13.98 ± 5.6 years. The preponderance of firearm injury was in the rural areas, during the dry season, at home, and in the daytime. Armed robbery (20, 35.7%) and communal clash (7, 12.5%) were the two topmost incidents leading to gunshot wounds. Armed robbery-related gunshot occurred mostly on the roads and at nighttime and involved predominantly 15-19-year-olds. Lower extremity was the topmost anatomical region involved. The majority (67%) had no pre-hospital care; the mean and median injury-hospital arrival interval respectively was 352 hrs and 4.2 hrs. Wound infection was the topmost complication. The mean hospital length of stay was 22.6 days. One (1.8%) of the patients died on the third day of hospital admission. Educational campaigns for prevention intensified during the dry season should highlight the risk of firearm injury to this age group and emphasize the importance of proper supervision and guidance of vulnerable children and adolescents. Improving the rates of pre-hospital care and early presentation of victims to the hospital should be considered in tertiary injury prevention strategies.     

Micronized Resveratrol Shows Anticonvulsant Properties in Pentylenetetrazole-Induced Seizure Model in Adult Zebrafish

Neurochemical Research - Epilepsy affects 50 million people around the world, and the patients experience cognitive, psychological and social consequences. Despite the considerable quantity of...     

Validation of manual semen collection methods and sperm evaluation in living freshwater stingrays (Potamotrygon falkneri) kept in ex situ conditions

Environmental Biology of Fishes - The Potamotrygon from the Potamotrygonidae family is a freshwater stingray that is native to and distributed throughout South American watersheds. The degradation...     

Lifetime Costs and Outcomes of Repair of Tetralogy of Fallot Compared to Natural Progression of the Disease: Great Ormond Street Hospital Cohort

Background

Tetralogy of Fallot is a congenital heart disease that requires surgical repair without which survival through childhood is extremely rare. The aim of this paper is to use data from the mandatory follow-up of patients with Tetralogy of Fallot to model the health-related costs and outcomes over the first 55-years of life.

Method

A decision analytical model was developed to establish costs and outcomes for patients up to 55 years after diagnosis and first repair of Tetralogy of Fallot compared to natural progression. Data from Adult Congenital Heart Disease (ACHD) centres that follow up Tetralogy of Fallot patients and Great Ormond Street Hospital (GOSH), London, United Kingdom (UK) medical records was used to establish the cost and effectiveness of current interventions. Data from a Czech cohort was used for the natural, no intervention condition.

Results

The average cost per patient of a repair for Tetralogy of Fallot was £26,938 (SE = £4,140). The full life time cost per patient, with no discount rate, was £65,310 (95% CI £64,981–£65,729); £56,559 discounted (95% CI £56,159–£56,960). Patients with a repair had an average of 35 Quality Adjusted Life Years (QALYs) per patient over 55 years undiscounted and 20.16 QALYs discounted. If the disorder was left to take its natural course, patients on average had a total of 3 QALYs per patient with no discount rate and 2.30 QALYs discounted.

Conclusion

A model has been developed that provides an estimate of the value for money of an expensive repair of a congenital heart disease. The model could be used to test the cost-effectiveness of making amendments to the care pathway.     

Genetic Variants in Hormone-Related Genes and Risk of Breast Cancer

Sex hormones play a key role in the development of breast cancer. Certain polymorphic variants (SNPs and repeat polymorphisms) in hormone-related genes are associated with sex hormone levels. However, the relationship observed between these genetic variants and breast cancer risk has been inconsistent. We conducted a case-control study nested within two prospective cohorts to assess the relationship between specific genetic variants in hormone-related genes and breast cancer risk. In total, 1164 cases and 2111 individually-matched controls were included in the study. We did not observe an association between potential functional genetic polymorphisms in the estrogen pathway, SHBG rs6259, ESR1 rs2234693, CYP19 rs10046 and rs4775936, and UGT1A1 rs8175347, or the progesterone pathway, PGR rs1042838, with the risk of breast cancer. Our results suggest that these genetic variants do not have a strong effect on breast cancer risk.     

Evaluation of the Psychometric Properties of the Functional Assessment of Cancer Therapy-Cervix Questionnaire in Brazil

Background

Although cervical cancer is ​​the second most common tumor among Brazilian women, studies that evaluate the quality of life of these women are still scarce. This situation is explained by the lack of specific and validated tools for this purpose in Portuguese (Brazil). The aim of this study was to evaluate the psychometric properties of the Portuguese version of the FACT-CX (Functional Assessment of Cancer Therapy-Cervix) questionnaire in a population of Brazilian women with cervical cancer.

Methods

The psychometric properties of the FACT-CX questionnaire were tested in a sample of 100 women diagnosed with cervical cancer who were previously treated in the Barretos Cancer Hospital. We analyzed the internal consistency (Cronbach''s alpha), reproducibility (intraclass correlation coefficient - ICC), confirmatory factor analysis, convergent validity (correlation with the SF-36 questionnaire), and discriminant validity by disease stage and two questions related to self-perception of health was also performed.

Results

The scales had Cronbach´s alpha coefficients ranging from 0.61 to 0.80. However, three scales did not have a statistically significant coefficient greater than 0.70. The ICC ranged from 0.68 to 0.82 and all considered satisfactory. Factor analysis did not generate consistent components. The FACT-G and FACT-CX total scores had good internal consistency and reproducibility, and also correlated well with the General Health and Vitality scales of the SF-36. However, only two FACT-CX scales had a significant correlation with SF-36. Discriminant analysis showed that FACT-CX failed to discriminate groups according to clinical stage but was able to divide the women according to the self-perception of health.

Conclusion

FATC-CX total score had good internal consistency, reproducibility and discriminant validity. In addition, it correlated well with General Health and Vitality scales of SF-36. However, three scales had questionable internal consistency and only two had significant correlation with SF-36.     

Varicella Vaccination Alters the Chronological Trends of Herpes Zoster and Varicella

Background

Population studies on trends of varicella and herpes zoster (HZ) associated with varicella zoster vaccination and climate is limited.

Methods

This study used insurance claims data to investigate the chronological changes in incident varicella and HZ associated with varicella zoster vaccination. Poisson regression was used to estimate the occurrence of varicella associated with the occurrence of HZ and vice versa by year, season, sex, temperature, and sunny hours.

Results

The varicella incidence declined from 7.14 to 0.76 per 1,000 person-years in 2000–2009, whereas the HZ incidence increased from 4.04 to 6.24 per 1,000 person-years. Females tended to have a higher risk than men for HZ (p<0.0001) but not varicella. The monthly mean varicella incidence was the lowest in September (160 cases) and the highest in January (425 cases), while the mean HZ incidence was lower in February (370 cases) and higher in August (470 cases). HZ was negatively associated with the incidence of varicella before and after the varicella zoster vaccination (p<0.001), increased 1.6% within one week post-vaccination. The effect of temperature on HZ was attenuated by 18.5% (p<0.0001) in association with vaccination. The varicella risk was positively associated with sun exposure hours, but negatively associated with temperature only before vaccination.

Conclusions

The varicella vaccination is effective in varicella prevention, but the incidence of HZ increases after vaccination. HZ has a stronger association with temperature and UV than with seasonality while varicella risk associated with temperature and UV is diminished.     

In vitro Leishmanicidal and Cytotoxic Activities of the Glycoalkaloids from Solanum lycocarpum (Solanaceae) Fruits

Leishmaniasis is an infection caused by a protozoan parasite of the genus Leishmania and is the second most prevalent parasitic protozoal disease after malaria in the world. We report the in vitro leishmanicidal activity on promastigote forms of Leishmania amazonensis and cytotoxicity, using LLCMK₂ cells, of the glycoalkaloids from the fruits of Solanum lycocarpum, determined by colorimetric methods. The alkaloidic extract was obtained by acid‐base extraction; solamargine and solasonine were isolated by silica‐gel chromatography, followed by reversed‐phase HPLC final purification. The alkaloidic extract, solamargine, solasonine, as well as the equimolar mixture of the glycoalkaloids solamargine and solasonine displayed leishmanicidal activity against promastigote forms of L. amazonensis, whereas the aglycone solasodine was inactive. After 24 and 72 h of incubation, most of the samples showed lower cytotoxicities (IC₅₀ 6.5 to 124 μM ) as compared to leishmanicidal activity (IC₅₀ 1.1 to 23.6 μM ). The equimolar mixture solamargine/solasonine was the most active with an IC₅₀ value of 1.1 μM , after 72 h. Likewise, solamargine was the most active after 24 h with an IC₅₀ value of 14.4 μM , both in comparison with the positive control amphotericin B.     

Assessing Global Marine Biodiversity Status within a Coupled Socio-Ecological Perspective

People value the existence of a variety of marine species and habitats, many of which are negatively impacted by human activities. The Convention on Biological Diversity and other international and national policy agreements have set broad goals for reducing the rate of biodiversity loss. However, efforts to conserve biodiversity cannot be effective without comprehensive metrics both to assess progress towards meeting conservation goals and to account for measures that reduce pressures so that positive actions are encouraged. We developed an index based on a global assessment of the condition of marine biodiversity using publically available data to estimate the condition of species and habitats within 151 coastal countries. Our assessment also included data on social and ecological pressures on biodiversity as well as variables that indicate whether good governance is in place to reduce them. Thus, our index is a social as well as ecological measure of the current and likely future status of biodiversity. As part of our analyses, we set explicit reference points or targets that provide benchmarks for success and allow for comparative assessment of current conditions. Overall country-level scores ranged from 43 to 95 on a scale of 1 to 100, but countries that scored high for species did not necessarily score high for habitats. Although most current status scores were relatively high, likely future status scores for biodiversity were much lower in most countries due to negative trends for both species and habitats. We also found a strong positive relationship between the Human Development Index and resilience measures that could promote greater sustainability by reducing pressures. This relationship suggests that many developing countries lack effective governance, further jeopardizing their ability to maintain species and habitats in the future.