St. Joseph Hospital

Objective: To assess epidemiological aspects of paediatric cataracts among children who attended a secondary Eye clinic in Kinshasa, Democratic Republic of the Congo (DRC). Methods: A cross-sectional study was conducted in the Eye Department in Kinshasa. One hundred and seventeen children with bilateral cataracts aged from 0.5 to 16 years and their mothers were recruited in the study. Children with unilateral and traumatic cataracts were not included in the study. Data were collected during the period from February 2021 to March 2021. A pre-tested questionnaire was administrated to mothers to evaluate sociodemographics, the history of pregnancy, and a perinatal history of the child. The blood samples for both children and their mothers were collected for antibodies titration. At the same time, the following parameters, namely: age at surgery, type of cataract, associated ocular and systemic lesions. Rubella and toxoplasmosis IgG results were recorded. Results: The mean age was 7.37±4.28 years (min: 0.5 years, max:16 years). Cataract was congenital and infantile in 58.1% and 41.9% of children respectively. Aetiology of cataract was found idiopathic in 74 children, infectious in 16 children and genetic in 16 children . Then it was isolated in 50.4% and associated to one ocular abnormality in 34.2% of children. Rubella IgG antibody was positive in 26.5% of children. Conclusion: Paediatric cataract was the mostly congenital, idiopathic and isolated. Rubella infection was present in almost a quarter of children with cataract. Rubella vaccination can be used to reduce the burden of childhood cataract in Kinshasa.

Introduction:Stroke remains a leading cause of cardiovascular mortality and disability in the United States, with diabetes serving as a major comorbidity that exacerbates outcomes and economic burden. Individuals affected by both diabetes and stroke experience heightened risks of death, disability, and healthcare utilization. This study examines national trends in diabetes and stroke-related mortality from 1999 to 2024, stratified by demographic and geographic factors.Methods:Mortality data were extracted from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research Multiple Cause of Death database. Deaths were identified using International Classification of Diseases, 10th Revision codes for diabetes mellitus and stroke, defined as deaths in which both conditions were listed on the death certificate, either as underlying or contributing causes. Both crude and age-adjusted mortality rates (AAMRs) per 100 000 were calculated, standardized to the 2000 US population. Temporal patterns were assessed using Joinpoint regression to estimate annual percent change with 95% confidence intervals. Analyses were further stratified by age, sex, race, ethnicity, urbanization, and census region.Results:Between 1999 and 2024, 617 059 deaths were attributed to the combined burden of diabetes and stroke. National AAMR declined from 10.4 to 7.0 per 100 000, showing significant decreases until 2018, followed by an increase during 2018–2021 and subsequent decline through 2024. Mortality remained higher among men, non-Hispanic Black individuals, rural populations, and residents of Southern states.Conclusion:Although long-term mortality declined, recent reversals and enduring disparities emphasize the urgent need for integrated prevention and equitable public health strategies.

Abstract Background Evidence shows that a recent fracture is the leading risk factor for another. The Irish Fracture Liaison Service (FLS) identifies assesses, treats and monitors those age 50+ years who present with a new ‘fragility’ (low-trauma) fracture. The Irish FLS Database reports on secondary fracture prevention standards across Ireland. Its 3rd national report with a facilities audit has been recently published. The International Osteoporosis Foundation’s “Capture the Fracture” framework provides 11 key performance indicators (KPIs), widely adopted by FLSs globally. Two of these KPIs address falls: falls risk assessment, and strength and balance exercise referrals, the latter being the leading intervention for falls prevention. Methods To examine the pattern of engagement in strength and balance programmes, data collected in 2023 from the 3rd Irish FLS Annual Report and Facilities Audit were analysed, focusing on referral patterns and access to strength and balance programmes, along with sixteen-week follow-up data where available. Results In 2023, FLS data showed that of 3,770 fragility fractures, 51% were assessed for falls risk by the FLS, i.e. only half the cohort, with rates varying from 2-90%. Of these, one third were referred or advised to self-refer to strength and balance programmes. At 16 weeks, only 56% were contactable. Of these, only 21% had started a programme, with four hospitals reporting no patient participation in exercise at 16 weeks. The facilities audit showed geographic disparity: five of six Dublin hospitals reported access to such programmes, while none of the FLS’s outside Dublin reported awareness, despite availability through councils and community organisations. Conclusion The Irish FLS’s show significant variability in access to, and awareness of strength and balance exercise programmes, particularly outside Dublin. The audit concludes that national strategies to improve access, referral pathways, and awareness are needed.

Combretum adenogonium, Combretum glutinosum, and Combretum paniculatum, are indigenous oleaginous species of West Africa. This study was designed to assess the nutritional, physicochemical, and phenolic profiles of seeds and seed fats from three native oleaginous Combretum Loefl. species in West Africa. The AOAC and AOCS methods were used to determine the nutritional composition and physicochemical characteristics of the seeds and seed fats. The seeds of C. paniculatum had the highest fat (42.20 %), protein (26.50 %), and ash (4.17 %) contents. The dominant fatty acids identified in the seed fats of the three species were oleic acid (38.31-8.16 %), palmitic acid (27.52-22.48 %), myristic acid (23.82-11.04 %), and linoleic acid (19.15-8.46 %). C. paniculatum seed fat had the highest saponification value (218.19 mg KOH/g), oxidative stability index (3.78h), and phenolic content (15.78 mg EAG/100g). The seed fat of C. paniculatum showed the highest potential for use in cosmetics and as a frying oil in the food industry.

Background: Severe mitral regurgitation (MR) in cardiogenic shock (CS) presents unique therapeutic challenges, especially in patients with prohibitive surgical risk. Transcatheter edge-to-edge repair (TEER) with MitraClip offers a less invasive alternative, yet optimal strategies for hemodynamic support in this setting remain unclear. Methods: We conducted a retrospective study of patients undergoing MitraClip implantation for severe MR and CS between 2018 and 2024 at a tertiary academic center. Of 440 screened cases, 47 met CS criteria and were stratified based on receipt of periprocedural Impella support. Clinical, procedural, and survival outcomes were compared between Impella-supported and unsupported cohorts using appropriate statistical methods. Results: Among the 47 patients, 24 received Impella support and 23 did not. The Impella group had greater illness severity, including higher rates of preprocedural intubation (75.0% vs. 43.5%) and SCAI stage D shock (50.0% vs. 13.0%). Despite these differences, procedural success was 100% in both groups. In-hospital (8.3% vs. 8.7%), 30-day (12.5% vs. 8.7%), and 1-year mortality (25.0% vs. 26.0%) were similar between Impella and non-Impella patients, respectively. Impella recipients had longer hospital stays (median 18 vs. 11 days; p=0.032) and higher 1-year readmission rates (55.0% vs. 21.7%; p=0.024), reflecting baseline acuity. There were no differences in major procedural complications or re-intervention rates. Conclusions: MitraClip implantation in CS patients supported with Impella is feasible and safe. Despite significantly worse hemodynamic profiles, outcomes were comparable to those without mechanical support. These findings suggest a potential role for tailored Impella use in expanding TEER to critically ill patients and underscore the need for prospective studies to guide support strategies in high-risk MR intervention.

Background:Tendon injuries pose significant clinical challenges because of poor vascularity and complex biomechanics, often leading to suboptimal healing. While surgical advancements and rehabilitation protocols have improved outcomes, delayed healing and high retear rates remain prevalent. Vitamin D, a key regulator of musculoskeletal health, may influence tendon healing through extracellular matrix remodeling, inflammation modulation, and cell proliferation. However, its effect on tendon repair remains unclear, with most studies focusing on rotator cuff tendons. This scoping review synthesizes current evidence on vitamin D’s role in tendon healing and identifies gaps in the literature.Purpose/Hypothesis:The purpose of this scoping review is to evaluate the available literature on vitamin D’s role in tendon healing and its influence on postoperative recovery. It was hypothesized that vitamin D deficiency is associated with poorer healing outcomes and increased failure rates.Study Design:Scoping review; Level of evidence, 4.Methods:A systematic search of Embase, OVID Medline, and Emcare databases was conducted through November 2024. Eligible studies included observational studies and randomized controlled trials assessing vitamin D status in adults undergoing tendon repair. Two independent reviewers screened and extracted data, resolving discrepancies with a third reviewer. Study quality was evaluated using the methodological index for non-randomized studies score. Given the heterogeneity of studies, results were synthesized narratively, focusing on evidence gaps across different tendons.Results:A total of 10 studies met inclusion criteria, with the majority focusing on rotator cuff repairs (n = 8). Vitamin D deficiency was consistently associated with poorer postoperative outcomes, including delayed healing, higher retear rates, and decreased functional recovery. Mechanistic studies suggested that vitamin D enhances healing through extracellular matrix remodeling and inflammation modulation. However, the overall quality of evidence was low, with most studies being retrospective. Notably, half of the studies relied on the same large administrative database, leading to potential patient overlap and limiting independent conclusions. Research on vitamin D’s role in healing other tendons, such as the Achilles, patellar, and flexor tendons, was lacking.Conclusion:Although evidence suggests vitamin D may support tendon healing, particularly in rotator cuff repair, studies remain low quality and limited to a single tendon group. Future prospective cohort studies and randomized controlled trials are needed to establish causality, assess its effects across various tendons, and determine optimal supplementation strategies.

ABSTRACT Introduction: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by thrombocytopenia in the absence of another cause. Our aim is to analyze mortality trends related to ITP in the United States (US) population from 1999 to 2022. Methods: We extracted age-adjusted mortality rates (AAMR) per 100,000 population for ITP-related deaths in the United States from 1999 to 2022 using the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) database from 1999 to 2022. AAMRs were stratified by year, gender, race or ethnicity, and geographical distribution. Joinpoint regression was used to calculate annual percent change (APC) and average annual percent change (AAPC) through the Joinpoint Regression Program (V 5.1.0, National Cancer Institute). Results: From 1999 to 2022, a total of 17,069 ITP-related deaths occurred in the US. Males exhibited a higher overall AAMR (0.22) in comparison to females (0.17). NH Whites exhibited the highest overall AAMR (0.20). Stratification by geographical location revealed non-metropolitan areas to have a higher overall AAMR (0.24) than metropolitan areas (0.19). The Midwest exhibited the highest overall AAMR (0.22). Vermont (0.37), Rhode Island (0.35), and North Dakota (0.32) were among the states with the highest overall AAMR, whereas states on the other end of the spectrum included Nevada (0.13), the District of Columbia (0.14) and Louisiana (0.15). Conclusion: The disparities identified in our analysis, particularly among NH Whites, the elderly, and residents of the Midwest and rural areas, suggest underlying healthcare access issues, potential genetic predispositions, and regional differences in treatment strategies.