Microbiology of chronic suppurative otitis media at Queen Elizabeth Central Hospital, Blantyre, Malawi: A cross-sectional descriptive study

Background Chronic suppurative otitis media (CSOM) is still a significant health problem in developing countries. Therefore, it was pertinent to determine the local Malawian microbiology in order to guide adequate treatment, avoid complications, and provide records for future reference. Aim The study sought to determine the CSOM-causing microorganisms at Queen Elizabeth Central Hospital in Blantyre, Malawi, and establish their relationship signs and symptoms, and with the demographic pattern of the study. Methods This was a hospital-based cross-sectional descriptive study carried out at the ENT outpatient clinic and the Microbiology Department of Queen Elizabeth Central Hospital.The sample comprised 104 patients with unilateral or bilateral active CSOM, who met the inclusion criteria. All patients were evaluated through a detailed history and clinical examination. Pus samples from draining ears were collected by aspiration with a sterile pipette. The specimens were immediately sent for microbiological analysis. Data were analyzed using SPSS.version 20. Results The study found that Proteus mirabilis , Pseudomonas aeruginosa , and Staphylococcus aureus were the most prevalent aerobic bacteria, while Bacteroides spp. and Peptostreptococcus spp. were the commonest anaerobic bacteria causing CSOM. These CSOM-causing microorganisms were predominant among males aged 18 years and below. Some CSOMcausing microorganisms were—significantly more so than the others— characteristically associated with each of the following clinical features: quantity of pus drainage, mode of onset, otalgia, hearing loss, location of tympanic membrane perforation, and mucosal appearance.

Point-of-care lactate and creatinine analysis for sick obstetric patients at Queen Elizabeth Central Hospital in Blantyre, Malawi: A feasibility study

Background: To achieve good outcomes in critically ill obstetric patients, it is necessary to identify organ dysfunction rapidly so that life-saving interventions can be appropriately commenced. However, timely access to clinical chemistry results is problematic, even in referral institutions, in the sub-Saharan African region. Reliable point-of-care tests licensed for clinical use are now available for lactate and creatinine. Aim: We aimed to assess whether implementation of point-of-care testing for lactate and creatinine is feasible in the obstetric unit at the Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, by obtaining the opinions of clinical staff on the use of these tests in practice. Methods: During a two-month evaluation period nurse-midwives, medical interns, clinical officers, registrars, and consultants were given the opportunity to use StatStrip® and StatSensor® (Nova Biomedical, Waltham, USA) devices, for lactate and creatinine estimation, as part of their routine clinical practice in the obstetric unit. They were subsequently asked to complete a short questionnaire. Results: Thirty-seven questionnaires were returned by participants: 22 from nurse-midwives and the remainder from clinicians. The mean satisfaction score for the devices was 7.6/10 amongst clinicians and 8.0/10 amongst nurse-midwives. The majority of participants stated that the obstetric high dependency unit (HDU) was the most suitable location for the devices. For lactate, 31 participants strongly agreed that testing should be continued and 24 strongly agreed that it would influence patient management. For creatinine, 29 strongly agreed that testing should be continued and 28 strongly agreed that it would influence their patient management. Twenty participants strongly agreed that they trust point-of-care devices. Conclusions: Point-of-care clinical chemistry testing was feasible, practical, and well received by staff, and was considered to have a useful role to play in the clinical care of sick obstetric patients at this referral centre.

Elizabeth Mann

Elizabeth Mann

Étude de la médiane de permutations sous la distance de Kendall-Tau

La distance de Kendall-τ compte le nombre de paires en désaccord entre deux permuta- tions. La distance d’une permutation à un ensemble est simplement la somme des dis- tances entre cette permutation et les permutations de l’ensemble. À partir d’un ensemble donné de permutations, notre but est de trouver la permutation, appelée médiane, qui minimise cette distance à l’ensemble. Le problème de la médiane de permutations sous la distance de Kendall-τ, trouve son application en bio-informatique, en science politique, en télécommunication et en optimisation. Ce problème d’apparence simple est prouvé difficile à résoudre. Dans ce mémoire, nous présentons plusieurs approches pour résoudre le problème, pour trouver une bonne solution approximative, pour le séparer en classes caractéristiques, pour mieux com- prendre sa compléxité, pour réduire l’espace de recheche et pour accélérer les calculs. Nous présentons aussi, vers la fin du mémoire, une généralisation de ce problème et nous l’étudions avec ces mêmes approches. La majorité du travail de ce mémoire se situe dans les trois articles qui le composent et est complémenté par deux chapitres servant à les lier.

The Spanish Spoken in Cuba: Antecedents, Processes of Phonetic Variation, and Cubanisms- Lecture by Elizabeth Santana Cepero

The flyer promotes " The Spanish Spoken in Cuba: Antecedents, Processes of Phonetic Variation, and Cubanisms", a lecture by Elizabeth Santana Cepero on the Cuban variety of Spanish that results from historical and socoiolinguistic processes of transculturation and change. The lecture was conducted in Spanish and held on November 19,2015 at FIU Modesto A. Maidique Campus Green Library 220.

Lecture by Elizabeth Broun, given at Florida International University, January 7, 2000

Elizabeth Broun discusses various modernist artists from the Smithsonian's "Treasures Tour being exhibnited at the Frost at the time of the lecture including Joseph Stella, William H. Johnson, Marsden Hartley, Georgia O'Keeffe, David Hockney and others. Introduction by Dahlia Morgan.

Lecture by Dr. Elizabeth Sackler, given at Florida International University, November 9, 2007

Dr. Elizabeth A. Sackler discusses feminism and what it means to be a feminist as well as feminist art and the feminist art movement. She also discusses the Elizabeth A. Sackler Center for Feminist Art. Introduction by Dahlia Morgan.

Étude de la médiane de permutations sous la distance de Kendall-Tau

La distance de Kendall-τ compte le nombre de paires en désaccord entre deux permuta- tions. La distance d’une permutation à un ensemble est simplement la somme des dis- tances entre cette permutation et les permutations de l’ensemble. À partir d’un ensemble donné de permutations, notre but est de trouver la permutation, appelée médiane, qui minimise cette distance à l’ensemble. Le problème de la médiane de permutations sous la distance de Kendall-τ, trouve son application en bio-informatique, en science politique, en télécommunication et en optimisation. Ce problème d’apparence simple est prouvé difficile à résoudre. Dans ce mémoire, nous présentons plusieurs approches pour résoudre le problème, pour trouver une bonne solution approximative, pour le séparer en classes caractéristiques, pour mieux com- prendre sa compléxité, pour réduire l’espace de recheche et pour accélérer les calculs. Nous présentons aussi, vers la fin du mémoire, une généralisation de ce problème et nous l’étudions avec ces mêmes approches. La majorité du travail de ce mémoire se situe dans les trois articles qui le composent et est complémenté par deux chapitres servant à les lier.

The fact of metafiction in nineteenth-century children's literature : Nathaniel Hawthorne's A Wonder Book and Elizabeth Stoddard's Lolly Dinks's Doings

This article examines two American books for children: Nathaniel Hawthorne’s A Wonder Book for Girls and Boys (1851) and Elizabeth Stoddard’s Lolly Dinks’s Doings (1874). In both books, fairy tales or myths are framed by a contemporary American setting in which the stories is told. It is in these realistic frames with an adult storyteller and child listeners that metafictional features are found. The article shows that Hawthorne and Stoddard use a variety of metafictional elements. So, although metafiction has been regarded as a postmodernist development in children’s literature, there are in fact instances of metafiction in nineteenth-century American children’s literature.

Elaboração de um plano de intervenção para promoção do controle da pressão arterial em pacientes hipertensos na população da Unidade de Saúde da Família Santa Paula Elizabeth no município de Montes Claros em Minas Gerais

A Hipertensão Arterial Sistêmica (HAS) configura-se hoje como uma epidemia mundial, traduzindo-se em grande desafio para os sistemas de saúde em todo o mundo. O envelhecimento da população, a urbanização crescente e a adoção de estilos de vida pouco saudáveis como sedentarismo, dieta inadequada e obesidade são os grandes responsáveis pelo aumento da incidência e prevalência da hipertensão arterial sistêmica em todo o mundo. Esse trabalho se justifica pois um controle adequado da patologia é importante para a diminuição de internações por complicações agudas e crônicas, da morbimortalidade e dos gastos em saúde com essa moléstia. No Estratégia de Saúde da Família (ESF) Santa Paula Elizabeth vários pacientes não conhecem sobre a doença e suas complicações, dificultando seu acompanhamento. Objetivo: Elaboração de um projeto de intervenção com o intuito de melhorar os níveis pressóricos da população com Hipertensão Arterial Sistêmica em uma ESF. Utilizou-se a metodologia de revisão narrativa com as palavras-chave abaixo. Os nós críticos identificados foram os hábitos e estilo de vida dos pacientes, o nível de informação sobre a patologia, treinamento e capacitação dos profissionais de saúde e disponibilidade das medicações. As ações propostas são orientações quanto a dieta adequada e atividade física regular, criação de grupos operativos para hipertensos, palestras educativas, folder explicativo, capacitação dos agentes comunitários de saúde e medicações com quantidade adequada e recebimento regular para os pacientes. Espera-se através deste plano de ação aumentar o número de hipertensos controlados, melhorando a qualidade de vida desses pacientes.

[climacteric Syndrome In A Northeastern Brazilian City: A Household Survey].

To assess the prevalence of Climacteric Syndrome (CS) in women from a municipality of Northeastern Brazil which is less developed socioeconomically. A prospective household survey was performed in São Luís, Maranhão, Brazil with 1,210 climacteric women aged 45 to 60 years. Interviews were applied using previously tested standard questionnaires from April to July 2008. The severity of climacteric symptoms was analyzed by circulatory and psychological indexes and the latter were associated with menopausal status. Multiple correspondence analysis was used to assess the relation among climacteric symptoms. Most patients were 55 to 60 years old (35.3%), mulatto (37.9%), with 9-11 years of schooling (39.8%), with a partner (56%), Catholic (73.9%) and belonged to the socioeconomic class C (51.1%). The prevalence of CS was 85.9%, and hot flashes (56.4%) and sweating (50.4%) were the most prevalent symptoms. The most frequent psychological symptoms were nervousness (45%) and emotional liability (44.8%). The severity of vasomotor and psychological symptoms was significantly higher during the peri and postmenopausal period (p<0.05). Vaginal dryness (62.7%) was the most prevalent urogenital complaint. The prevalence of CS was high among women from São Luís, Maranhão, Brazil.

Design, Synthesis And Biological Evaluation Of Hybrid Bioisoster Derivatives Of N-acylhydrazone And Furoxan Groups With Potential And Selective Anti-trypanosoma Cruzi Activity.

Hybrid bioisoster derivatives from N-acylhydrazones and furoxan groups were designed with the objective of obtaining at least a dual mechanism of action: cruzain inhibition and nitric oxide (NO) releasing activity. Fifteen designed compounds were synthesized varying the substitution in N-acylhydrazone and in furoxan group as well. They had its anti-Trypanosoma cruzi activity in amastigotes forms, NO releasing potential and inhibitory cruzain activity evaluated. The two most active compounds (6, 14) both in the parasite amastigotes and in the enzyme contain the nitro group in para position of the aromatic ring. The permeability screening in Caco-2 cell and cytotoxicity assay in human cells were performed for those most active compounds and both showed to be less cytotoxic than the reference drug, benznidazole. Compound 6 was the most promising, since besides activity it showed good permeability and selectivity index, higher than the reference drug. Thereby the compound 6 was considered as a possible candidate for additional studies.

Botulinum Toxin--how A Poison Turned To A Fascinating Ally Against An Old Adversary.

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Pyrimidine-5'-nucleotidase Campinas, A New Mutation (p.r56g) In The Nt5c3 Gene Associated With Pyrimidine-5'-nucleotidase Type I Deficiency And Influence Of Gilbert's Syndrome On Clinical Expression.

Pyrimidine-5'-nucleotidase type I (P5'NI) deficiency is an autosomal recessive condition that causes nonspherocytic hemolytic anemia, characterized by marked basophilic stippling and pyrimidine nucleotide accumulation in erythrocytes. We herein present two African descendant patients, father and daughter, with P5'N deficiency, both born from first cousins. Investigation of the promoter polymorphism of the uridine diphospho glucuronosyl transferase 1A (UGT1A) gene revealed that the father was homozygous for the allele (TA7) and the daughter heterozygous (TA6/TA7). P5'NI gene (NT5C3) gene sequencing revealed a further change in homozygosity at amino acid position 56 (p.R56G), located in a highly conserved region. Both patients developed gallstones; however the father, who had undergone surgery for the removal of stones, had extremely severe intrahepatic cholestasis and, liver biopsy revealed fibrosis and siderosis grade III, leading us to believe that the homozygosity of the UGT1A polymorphism was responsible for the more severe clinical features in the father. Moreover, our results show how the clinical expression of hemolytic anemia is influenced by epistatic factors and we describe a new mutation in the P5'N gene associated with enzyme deficiency, iron overload, and severe gallstone formation. To our knowledge, this is the first description of P5'N deficiency in South Americans.