Supra-treatment threshold neonatal jaundice: Incidence in HIV-exposed compared to non-exposed neonates at Queen Elizabeth Central Hospital in Blantyre, Malawi

INTRODUCTION: Jaundice is the yellowish pigmentation of the skin, sclera, and mucous membranes resulting from bilirubin deposition. Children born to mothers with HIV are more likely to be born premature, with low birth weight, and to become septic-all risk factors for neonatal jaundice. Further, there has been a change in the prevention of mother-to-child transmission (PMTCT) of HIV guidelines from single-dose nevirapine to a six-week course, all of which theoretically put HIV-exposed newborns at greater risk of developing neonatal jaundice.

AIM: We carried out a study to determine the incidence of severe and clinical neonatal jaundice in HIV-exposed neonates admitted to the Chatinkha Nursery (CN) neonatal unit at Queen Elizabeth Central Hospital (QECH) in Blantyre.

METHODS: Over a period of four weeks, the incidence among non-exposed neonates was also determined for comparison between the two groups of infants. Clinical jaundice was defined as transcutaneous bilirubin levels greater than 5 mg/dL and severe jaundice as bilirubin levels above the age-specific treatment threshold according the QECH guidelines. Case notes of babies admitted were retrieved and information on birth date, gestational age, birth weight, HIV status of mother, type of feeding, mode of delivery, VDRL status of mother, serum bilirubin, duration of stay in CN, and outcome were extracted.

RESULTS: Of the 149 neonates who were recruited, 17 (11.4%) were HIV-exposed. One (5.88%) of the 17 HIV-exposed and 19 (14.4%) of 132 HIV-non-exposed infants developed severe jaundice requiring therapeutic intervention (p = 0.378). Eight (47%) of the HIV-exposed and 107 (81%) of the non-exposed neonates had clinical jaundice of bilirubin levels greater than 5 mg/dL (p < 0.001).

CONCLUSIONS: The study showed a significant difference in the incidence of clinical jaundice between the HIV-exposed and HIV-non-exposed neonates. Contrary to our hypothesis, however, the incidence was greater in HIV-non-exposed than in HIV-exposed infants.

1.° Introductorium juvenum ad scientiam medicinae : authore Gerardo de Solo, gymnasii Montispessulani Professore. — 2.° Ejusdem practica supra nonum Almansoris.

Colbertinus

Fracturas supra-intercondíleas del fémur tratamiento con D.C.S. y resultados [por] José Antonio Monárrez Cárdenas

Tesis (Maestría en Ortopedia y Traumatología) U.A.N.L.

Supra cultura

Supra Cultura es una organización Cultural que tiene como propósito la circulación de las producciones artísticas en Colombia mediante una plataforma Digital. El proyecto analiza lo cultural buscando descentralizar la información mediante un portal Web que administre contenidos, difunda, dinamice y eduque mediante el material digital y multimedia; así productos tanto de la escena artística como Cultural Nacional que no tengan un espacio prioritario en los medios de comunicación tradicionales, en las áreas de arte y música serían los beneficiados.

El juicio de cuentas, primera institución del control fiscal de la administración púbica

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Sistemas supra-nacionales, educación de adultos y cambio social : observaciones socio-históricas en el contexto europeo.

Se consideran las prácticas de la educación de adultos en relación a los cambios sociales de la modernidad. Se plantean dos objetivos: avanzar en una relevante perspectiva de análisis institucional; y sostener la necesidad de incluir un concepto de sistemas estatales supranacionales en el análisis del desarrollo tras la Segunda Guerra Mundial. Se considera que las prácticas de educación de adultos están condicionadas por la reflexividad institucional de la modernidad, a la que el aparato educacional supraestatal contribuye crecientemente.

Importancia de la musculatura supra e infrahioidea en la biomec??nica mandibular

Resumen basado en el de la publicaci??n

Recent glacier retreat in the Caucasus Mountains, Russia, and associated increase in supraglacial debris cover and supra-/proglacial lake development

This paper reports changes in supraglacial debris cover and supra-/proglacial lake development associated with recent glacier retreat (1985-2000) in the central Caucasus Mountains, Russia. Satellite imagery (Landsat TM and ETM+) was used to map the surface area and supraglacial debris cover on six neighbouring glaciers in the Adylsu valley through a process of manual digitizing on a false-colour composite of bands 5, 4, 3 (red, green, blue). The distribution and surface area of supraglacial and proglacial lakes was digitized for a larger area, which extended to the whole Landsat scene. We also compare our satellite interpretations to field observations in the Adylsu valley. Supraglacial debris cover ranges from < 5% to > 25% on individual glaciers, but glacier retreat between 1985 and 2000 resulted in a 3-6% increase in the proportion of each glacier covered by debris. The only exception to this trend was a very small glacier where debris cover did not change significantly and remote mapping proved more difficult. The increase in debris cover is characterized by a progressive upglacier migration, which we suggest is being driven by focused ablation (and therefore glacier thinning) at the up-glacier limit of the debris cover, resulting in the progressive exposure of englacial debris. Glacier retreat has also been accompanied by an increase in the number of proglacial and supraglacial lakes in our study area, from 16 in 1985 to 24 in 2000, representing a 57% increase in their cumulative surface area. These lakes appear to be impounded by relatively recently lateral and terminal moraines and by debris deposits on the surface of the glacier. The changes in glacier surface characteristics reported here are likely to exert a profound influence on glacier mass balance and their future response to climate change. They may also increase the likelihood of glacier-related hazards (lake outbursts, debris slides), and future monitoring is recommended.

Synthesis, crystal structure and hydrolysis of a dinuclear copper(II) complex constructed by N2O donor Schiff base and 4,4 '-bipyridine: discrete supra-molecular ensembles vs. oligomers

The tridentate Schiff base ligand, 7-amino-4-methyl-5-aza-3-hepten-2-one (HAMAH), prepared by the mono-condensation of 1,2diaminoethane and acetylacetone, reacts with Cu(BF4)(2) center dot 6H(2)O to produce initially a dinuclear Cu(II) complex, [{Cu(AMAH)}(2) (mu-4,4'-bipyJ](BF4)(2) (1) which undergoes hydrolysis in the reaction mixture and finally produces a linear polymeric chain compound, [Cu(acac)(2)(mu-4,4'-bipy)](n) (2). The geometry around the copper atom in compound 1 is distorted square planar while that in compound 2 is essentially an elongated octahedron. On the other hand, the ligand HAMAH reacts with Cu(ClO4)(2) center dot 6H(2)O to yield a polymeric zigzag chain, [{Cu(acac)(CH3OH)(mu-4,4'-bipy)}(ClO4)](n) (3). The geometry of the copper atom in 3 is square pyramidal with the two bipyridine molecules in the cis equatorial positions. All three complexes have been characterized by elemental analysis, IR and UV-Vis spectroscopy and single crystal X-ray diffraction studies. A probable explanation for the different size and shape of the reported polynuclear complexes formed by copper(II) and 4,4'-bipyridine has been put forward by taking into account the denticity and crystal field strength of the blocking ligand as well as the Jahn-Teller effect in copper(II). (c) 2007 Elsevier Ltd. All rights reserved.

Supra-molecular assembly of a lumican-derived peptide amphiphile enhances its collagen-stimulating activity

C16-YEALRVANEVTLN, a peptide amphiphile (PA) incorporating a biologically active amino acid sequence found in lumican, has been examined for its influence upon collagen synthesis by human corneal fibroblasts in vitro, and the roles of supra-molecular assembly and activin receptor-like kinase ALK receptor signaling in this effect were assessed. Cell viability was monitored using the Alamar blue assay, and collagen synthesis was assessed using Sirius red. The role of ALK signaling was studied by receptor inhibition. Cultured human corneal fibroblasts synthesized significantly greater amounts of collagen in the presence of the PA over both 7-day and 21-day periods. The aggregation of the PA to form nanotapes resulted in a notable enhancement in this activity, with an approximately two-fold increase in collagen production per cell. This increase was reduced by the addition of an ALK inhibitor. The data presented reveal a stimulatory effect upon collagen synthesis by the primary cells of the corneal stroma, and demonstrate a direct influence of supra-molecular assembly of the PA upon the cellular response observed. The effects of PA upon fibroblasts were dependent upon ALK receptor function. These findings elucidate the role of self-assembled nanostructures in the biological activity of peptide amphiphiles, and support the potential use of a self-assembling lumican derived PA as a novel biomaterial, intended to promote collagen deposition for wound repair and tissue engineering purposes

Traços supra-segmentais da fono-articulação de mulheres no menacme e na pós-menopausa

A expressão verbal humana é vital nas relações interpessoais, possui elementos segmentais, supra-segmentais e para-lingüísticos, requer integração entre eventos corticais, neuromusculares, periféricos e, destes com outros sistemas. Influenciada por fatores hormonais, apresenta características diversificadas em mulheres no menacme e na pós-menopausa. Neste estudo foram investigadas relações entre características fono-articulatórias em mulheres no menacme e na pós-menopausa, estas verificadas nas variações de freqüência, intensidade, inflexões, ritmo e velocidade de fala. Foram examinadas 45 mulheres no menacme, com ciclos menstruais regulares e que não faziam contracepção hormonal; e 45 na pós-menopausa há 3 anos ou mais, sem reposição hormonal. As análises acústicas foram realizadas com o programa Motor Speech Profile. Os resultados demonstraram redução da velocidade de fala e aumento de duração de pausas, seguidos pela tendência ao agravamento da voz, modificações de ressonância na pós-menopausa e ainda, inexistiram variações significativas na intensidade. As diferenças entre os grupos parecem decorrer mais das particularidades na interação entre eventos corticais, subcorticais e neuromusculares e menos de mudanças isoladas em estruturas periféricas fono-articulatórias. O conhecimento das alterações da fala que ocorrem em mulheres na pós-menopausa auxiliará no planejamento de estratégias para melhorar a qualidade de vida deste grupo.

Registros alimentares em pacientes com diabete melito tipo 2 : avaliação de variabilidade e fatores associados ao sub- e supra registro

A avaliação e orientação de dieta em pacientes com diabete melito são importantes para o controle metabólico, prevenção e tratamento das complicações crônicas, sendo fundamental utilizar métodos acurados de avaliação dietética. O objetivo deste manuscrito foi revisar os principais instrumentos de inquérito alimentar e suas limitações, a variabilidade de ingestão protéica e lipídica nos inquéritos e possíveis fatores de interferência sobre a adequacidade destes instrumentos em pacientes diabéticos. Registro alimentar com pesagem de alimentos é o método de referência para avaliação de dietas. Poucos estudos analisaram em pacientes diabéticos a variabilidade de ingestão lipídica e protéica em inquéritos alimentares. Nestes, a variabilidade intra-individual de ingestão protéica variou de 11,9% a 27,1% e a lipídica de 8,1 a 27,7%, refletindo a utilização de diferentes instrumentos de avaliação. Também os fatores relacionados a vieses nos instrumentos de avaliação dietética foram pouco estudados. Foram associados ao sub-registro de ingestão energética: maior consumo de proteínas; menor consumo de gorduras e maior de carboidratos em mulheres; elevado índice de massa corporal e relato de aderência às orientações dietoterápicas prévias. Já o sub-registro e supra-registro de ingestão protéica foram positivamente associados ao mau controle glicêmico, sendo o supra-registro mais freqüente nos homens. Conclui-se que a avaliação da variabilidade de ingestão e os possíveis fatores interferentes em inquéritos alimentares em pacientes diabéticos dependem do instrumento utilizado e de fatores conhecidos de sub-e supra-registro alimentar. Estudos que promovam o aperfeiçoamento dos métodos de avaliação da dieta deverão facilitar a implementação e acompanhamento de estratégias dietoterápicas em pacientes diabéticos.