Aim
To evaluate effect and costs of pertussis vaccination at Vietnam National Children's Hospital.
Methods
Pertussis cases were defined by positive laboratory tests of children under 5 years January ...2015‐June 2018, and data on patient characteristics, clinical data and hospitalisation costs were collected through patient records.
Results
Of 909 inpatients, 400 (44%) were <2 months, the age for first DPT vaccination, and mechanical ventilation was more common than in children >2 months (9% vs 4%, OR = 2.3, CI 1.3‐3.9), as well as persistent cough (99%), violent cough (87%) and pneumonia (91%). Comparing non‐vaccinated (172 cases, 19%) and DPT vaccinated patients >2 months of age hospitalisation was 106‐fold higher (149.6 vs 1.39 per 100 000 population), and proportion of severe patients, length of hospital stay and hospitalisation costs were significantly greater (23.9% vs 12.8%; 13 vs 10 days; 826 USD vs 582 USD, CI 23‐423, P = .03).
Conclusion
Incidence and proportion of complications among under 2‐month infants were higher than in older patients. DPT vaccination protects children from pertussis infection, and in case of pertussis infection decreases severity. Results indicate that the Ministry of Health should consider adding a booster vaccine for pregnant women in an extended vaccination programme.
CO2 efflux at the water–air interface is an essential component of the riverine carbon cycle. However, the lack of spatially resolved CO2 emission measurements prohibits reliable estimation of the ...global riverine CO2 emissions. By deploying floating chambers, seasonal changes in river water CO2 partial pressure (pCO2) and CO2 emissions from the Dong River in south China were investigated. Spatial and temporal patterns of pCO2 were mainly affected by terrestrial carbon inputs (i.e., organic and inorganic carbon) and in-stream metabolism, both of which varied due to different land cover, catchment topography, and seasonality of precipitation and temperature. Temperature-normalized gas transfer velocity (k600) in small rivers was 8.29 ± 11.29 and 4.90 ± 3.82 m d-1 for the wet season and dry season, respectively, which was nearly 70 % higher than that of large rivers (3.90 ± 5.55 m d-1 during the wet season and 2.25 ± 1.61 m d-1 during the dry season). A significant correlation was observed between k600 and flow velocity but not wind speed regardless of river size. Most of the surveyed rivers were a net CO2 source while exhibiting substantial seasonal variations. The mean CO2 flux was 300.1 and 264.2 mmol m-2 d-1 during the wet season for large and small rivers, respectively, 2-fold larger than that during the dry season. However, no significant difference in CO2 flux was observed between small and large rivers. The absence of commonly observed higher CO2 fluxes in small rivers could be associated with the depletion effect caused by abundant and consistent precipitation in this subtropical monsoon catchment.
Left ventricular hypertrophy (LVH) caused by cardiac variant Fabry disease (FD) is typically late-onset and may mimic LVH caused by abnormal loading conditions. We aimed to determine the prevalence ...of FD in a non-selective patient population of everyday practice presenting with LVH, including those with hypertension and valve disease. We measured plasma alpha-galactosidase A activity using dried blood spot tests in 499 (age = 66 ± 13 years; 336 men) Hong Kong Chinese patients with LVH defined as maximal LV septal/posterior wall thickness ≥13 mm on echocardiography. Patients with low enzyme activity underwent mutation analysis of the GLA gene. Eight (age = 53−74 years; all men) unrelated patients (1.6%) had low plasma alpha-galactosidase A activity (0.57 ± 0.27 μmol/L wb/hr) and all were confirmed to have the GLA IVS4 + 919G > A mutation. FD patients presented with heart failure (n = 5), heart block (n = 2), ventricular tachycardia (n = 1), chest pain (n = 3), and/or murmur (n = 1). Uncontrolled hypertension (n = 4) and/or severe mitral/aortic valve pathology (n = 2) were frequent. Ethnic subgroups included Teochew (n = 5), Canton (n = 2), and Wenzhou (n = 1). Endomyocardial biopsy (n = 6) revealed hypertrophic myocytes with vacuolization and dense lamellar bodies. Late-onset IVS4 + 919G > A FD is prevalent among Chinese LVH patients, and should be considered as a cause of LVH in adult patients even when hypertension and/or valve pathology are present.
Measurements of Ag radiotracer diffusion in shear bands of deformed bulk metallic glass, Pd40Ni40P20, Joachim Bokeloh, Sergiy V. Divinski, Gerrit Reglitz, and Gerhard Wilde, Phys. Rev. Lett. 107, ...235503 (2011). have found a colossal enhancement of diffusion coefficient by more than eight orders of magnitude than in undeformed Pd40Ni40P20. Suggestion was made by Bokeloh et al. that enhanced diffusion occurs in high-mobility pathways originating from some excess free volume distribution inside the shear bands. Although plausible, this qualitative suggestion does not allow quantitative calculation of the enhancement. The impasse is avoided by using the Coupling Model to calculate the maximum of the enhancement of diffusivity possible in high-mobility pathways of the shear bands. Within the range of eight to ten orders of magnitude, the calculated maximum enhancement is capable to account for the experimental observation.
Abstract Multifocal electroretinography (mfERG) is an investigation that can simultaneously measure multiple electroretinographic responses at different retinal locations by cross-correlation ...techniques. mfERG therefore allows topographic mapping of retinal function in the central 40–50° of the retina. The strength of mfERG lies in its ability to provide objective assessment of the central retinal function at different retinal areas within a short duration of time. Since the introduction of mfERG in 1992, mfERG has been applied in a large variety of clinical settings. This article reviews the clinical applications of mfERG based on the currently available evidence. mfERG has been found to be useful in the assessment of localized retinal dysfunction caused by various acquired or hereditary retinal disorders. The use of mfERG also enabled clinicians to objectively monitor the treatment outcomes as the changes in visual functions might not be reflected by subjective methods of assessment. By changing the stimulus, recording, and analysis parameters, investigation of specific retinal electrophysiological components can be performed topographically. Further developments and consolidations of these parameters will likely broaden the use of mfERG in the clinical setting.
There is scarce information regarding hospital-acquired infections (HAIs) among children in resource-constrained settings. This study aims to measure prevalence of HAIs in Vietnamese pediatric ...hospitals.Monthly point prevalence surveys (PPSs) in 6 pediatric intensive care units (ICUs) in 3 referral hospitals during 1 year.A total of 1363 cases (1143 children) were surveyed, 59.9% male, average age 11 months. Admission sources were: other hospital 49.3%, current hospital 36.5%, and community 15.3%. Reasons for admission were: infectious disease (66%), noninfectious (20.8%), and surgery/trauma (11.3%). Intubation rate was 47.8%, central venous catheter 29.4%, peripheral venous catheter 86.2%, urinary catheter 14.6%, and hemodialysis/filtration 1.7%. HAI was diagnosed in 33.1% of the cases: pneumonia (52.2%), septicemia (26.4%), surgical site infection (2%), and necrotizing enterocolitis (2%). Significant risk factors for HAI included age under 7 months, intubation and infection at admission. Microbiological findings were reported in 212 cases (43%) with 276 isolates: 50 Klebsiella pneumoniae, 46 Pseudomonas aeruginosa, and 39 Acinetobacter baumannii, with carbapenem resistance detected in 55%, 71%, and 65%, respectively. Staphylococcus aureus was cultured in 18 cases, with 81% methicillin-resistant Staphylococcus aureus. Most children (87.6%) received antibiotics, with an average of 1.6 antibiotics per case. Colistin was administered to 96 patients, 93% with HAI and 49% with culture confirmed carbapenem resistance.The high prevalence of HAI with carbapenem resistant gram-negative strains and common treatment with broad-spectrum antibiotics and colistin suggests that interventions are needed to prevent HAI and to optimize antibiotic use.
to identify the antenatal taboos commonly practised by pregnant Hong Kong Chinese women; to explore the health beliefs behind these taboos; and to examine how pregnant women perceived and reacted to ...the cultural tradition.
general ethnography and in-depth interviews, followed by a quantitative self-reported survey.
Antenatal clinic of a university-affiliated hospital in Hong Kong.
consecutive samples of 60 women for in-depth interviews, and 832 women for the survey.
an inventory on the adherence and attitude towards antenatal taboos, and the Beck Depression Inventory that measures severity of depression.
antenatal taboos were still commonly observed by contemporary Chinese women. Miscarriage, fetus malformation and fetal ill-health were the key cultural fears that drove contemporary Chinese women to observe the traditional taboos. About one-quarter and one-tenth of the women, respectively, felt unhappy and disputed with their families about the taboos. These women had significantly higher levels of depression in late pregnancy and during childbirth.
health-care practitioners should be aware of the benefits and risks of traditional antenatal taboos on maternal health. Although some taboos can be socio-morally protective, the tension created by the observation of cultural tradition in modernity may impair maternal psychological well-being. Health-care providers in Western countries should be vigilant of the complex cultural tension faced by migrant Chinese mothers.
The light-organ symbiosis between the squid Euprymna scolopes and the luminous bacterium Vibrio fischeri offers the opportunity to decipher the hour-by-hour events that occur during the natural ...colonization of an animal's epithelial surface by its microbial partners. To determine the genetic basis of these events, a glass-slide microarray was used to characterize the light-organ transcriptome of juvenile squid in response to the initiation of symbiosis. Patterns of gene expression were compared between animals not exposed to the symbiont, exposed to the wild-type symbiont, or exposed to a mutant symbiont defective in either of two key characters of this association: bacterial luminescence or autoinducer (AI) production. Hundreds of genes were differentially regulated as a result of symbiosis initiation, and a hierarchy existed in the magnitude of the host's response to three symbiont features: bacterial presence > luminescence > AI production. Putative host receptors for bacterial surface molecules known to induce squid development are up-regulated by symbiont light production, suggesting that bioluminescence plays a key role in preparing the host for bacteria-induced development. Further, because the transcriptional response of tissues exposed to AI in the natural context (i.e., with the symbionts) differed from that to AI alone, the presence of the bacteria potentiates the role of quorum signals in symbiosis. Comparison of these microarray data with those from other symbioses, such as germ-free/conventionalized mice and zebrafish, revealed a set of shared genes that may represent a core set of ancient host responses conserved throughout animal evolution.
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