No abstract

ObjectivesFemale genital fistula remains a public health concern in developing countries. From January 2007 to September 2013, the Fistula Care project, managed by EngenderHealth in partnership with the Ministry of Health and supported by USAID, integrated fistula repair services in the maternity wards of general hospitals in Guinea. The objective of this article was to present and discuss the clinical outcomes of 7 years of work involving 2116 women repaired in three hospitals across the country.MethodsThis was a retrospective cohort study using data abstracted from medical records for fistula repairs conducted from 2007 to 2013. The study data were reviewed during the period April to August 2014.ResultsThe majority of the 2116 women who underwent surgical repair had vesicovaginal fistula (n = 2045, 97%) and 3% had rectovaginal fistula or a combination of both. Overall 1748 (83%) had a closed fistula and were continent of urine immediately after surgery. At discharge, 1795 women (85%) had a closed fistula and 1680 (79%) were dry, meaning they no longer leaked urine and/or faeces. One hundred and fifteen (5%) remained with residual incontinence despite fistula closure. Follow-up at 3 months was completed by 1663 (79%) women of whom 1405 (84.5%) had their fistula closed and 80% were continent. Twenty-one per cent were lost to follow-up.ConclusionRoutine programmatic repair for obstetric fistula in low resources settings can yield good outcomes. However, more efforts are needed to address loss to follow-up, sustain the results and prevent the occurrence and/or recurrence of fistula.ObjectifsLa fistule génitale féminine reste un problème de santé publique dans les pays en développement. De janvier 2007 à septembre 2013, le projet Fistula Care, géré par Engender Health en partenariat avec le Ministère de la Santé et soutenu par l’USAID, a intégré les services de réparation de fistules dans les maternités des hôpitaux généraux en Guinée. L'objectif de cet article est de présenter et de discuter les résultats cliniques de sept années de travail impliquant 2116 femmes traitées dans trois hôpitaux à travers le pays.MéthodesIl s'agit d'une étude de cohorte rétrospective utilisant des données extraites des dossiers médicaux de réparations de fistules menées de 2007 à 2013. Les données de l’étude ont été analysées au cours de la période allant d'avril à août 2014.RésultatsLa majorité des 2116 femmes qui ont subi une réparation chirurgicale avaient une fistule vésico vaginale (n = 2 045, 97%) et 3% avaient une fistule recto vaginale ou une combinaison des deux. Au total, 1748 (83%) femmes ont eu leur fistule refermée et sont devenues continentes d'urine immédiatement après la chirurgie. À la sortie, 1795 femmes (85%) avaient une fistule fermée et 1680 (79%) étaient sèches, c'est à dire qu'elles n'avaient plus de fuite d'urine et/ou de matières fécales. 115 (5%) femmes avaient toujours une incontinence résiduelle malgré la fermeture de la fistule. Le suivi à trois mois a été complété par 1663 (79%) femmes dont 1405 (84,5%) on...

Secretion of luteinizing hormone is decreased when hens start to incubate their eggs and is increased after nest deprivation or hatching of the eggs. The purpose of this study was to determine whether decreased luteinizing hormone (LH) secretion during incubation in the domestic hen is associated with a decrease in hypothalamic chicken gonadotropin-releasing hormone-I (cGnRH-I) mRNA or peptide. A semiquantitative competitive PCR assay was developed to measure cGnRH-I mRNA. Hypothalamic mRNA was quantified as the amount of GnRH cDNA obtained by reverse transcription of cGnRH-I mRNA. The amount of hypothalamic cGnRH-I mRNA was significantly higher in laying than in incubating hens (38.7 ± 10.3 vs. 7.7 ± 1.6 × 10^–17 mol cDNA, p = 0.01, n = 8). The hypothalamic GnRH peptide content was not significantly different between laying and incubating hens in either the preoptic area (286.9 ± 24.01 vs. 269.3 ± 29.3 pg, n = 8) or the basal hypothalamus (1.67 ± 0.19 vs. 1.54 ± 0.21 ng, n = 8). Five days after incubating hens were deprived of their eggs, the resulting increase in LH secretion was associated with a significant increase in hypothalamic content of cGnRH-I mRNA (22.8 ± 2.2 vs. 6.7 ± 1.7 × 10^–17 mol cDNAp < 0.001, n = 8). These observations suggest that a decrease in the expression of the cGnRH-I gene is a major factor in maintaining depressed LH secretion in incubating domestic chickens.

White spot disease, caused by infection with white spot syndrome virus (WSSV), is a serious panzootic affecting prawn aquaculture. The disease has spread rapidly around the prawn-culturing regions of the world through a number of previously identified mechanisms. The ability to distinguish and trace strains of WSSV is of great benefit to identify, and then limit, the translocation routes of the disease. Here, we describe a novel genotyping method using 34 short tandem repeat regions of the viral genome concurrently. This technique is highly sensitive to strain differences when compared to previous methods. The efficacy of the described method is demonstrated by testing WSSV isolates from around the globe, showing regional genotypic differences. The differences in the genotypes were used to create a global minimum spanning network, and in most cases the observed relationships were substantiated with verification of transboundary movement. This novel panel of STR markers will provide a valuable epidemiological tool for white spot disease. We have applied this to an outbreak of the disease in Queensland, Australia, that occurred in 2016. While the results indicate that the source of this outbreak currently remains cryptic, the analyses have provided valuable insights with which to further study the origins of the strains involved.