Rectal dihydroartemisinin versus intravenous quinine in the treatment of severe malaria: A randomised clinical trial

Objective: To compare the clinical efficacy and safety of rectal dihydroartemisinin (DATM- Cotecxin) and intravenous quinine in the treatment of severe malaria in children and adults.Setting: Moi Teaching and Referral Hospital, Eldoret, Kenya between July and November1998.Patients: A total of sixty seven patients aged two to sixty years with severe malaria were studied.Design: This was an open randomised comparative clinical trial.Outcome measures: These were parasite clearance time, fever clearance time, efficacy and the side effect profile of the two drugs.Results: The two groups were comparable on admission on the clinical and laboratory parameters. The parasite clearance time was shorter in the rectal DATM group than quinine group. There was no statistical difference on the fever clearance time and cure rates in thetwo groups. The adverse reaction profile was better with rectal DATM than with quinine, tinnitus observed more in the quinine group.Conclusion: Rectal DATM is faster in parasite clearance than quinine and is a safe and convenient alternative to quinine in the treatment of severe malaria

Određivanje aflatoksina, okratoksina A, fumonizina i zearalenona u žitaricama i krmivu primjenom kompetetivnoga direktnog imunoenzimatskog testa (CD-ELISA) i tankoslojne kromatografije (TLC)

Aspergillus, Penicillium, and Fusarium species frequently contaminate crops. For this reason mycotoxins such as afl atoxins (AFs), ochratoxin A (OTA), fumonisins (FBs), and zearalenone (ZEA) are found in food and feed in a wide range of concentrations, depending on environmental and storage conditions. Consumption of mycotoxin-contaminated food and feed has been associated with acute and chronic poisoning and carcinoma. The aim of this study was to determine the incidence and co-occurrence of AFs (B1+B2+G1+G2), OTA, FBs (B1+B2+B3), and ZEA in 37 samples of cereals and feed randomly collected in 2007 from households of an endemic nephropathy (EN) area in Croatia. The mycotoxins were determined using the competitive direct ELISA test (CD-ELISA) in combination with thin-layer chromatography (TLC). The most frequent mycotoxin was ZEA (92 %, mean 318.3 μg kg-1), followed by FBs (27 %, 3690 μg kg-1), AFs (24.3 %, 4.6 μg kg-1), and OTA (16.2 %, 9.8 μg kg-1). Levels of AFs, ZEA, and FBs detected by CD-ELISA signifi cantly correlated with the TLC results. However, only one OTA-positive sample was confi rmed by TLC due to its high limit of detection. The levels of these mycotoxins were below the permissible limit for animal feed. Twenty-nine percent of cereals were contaminated with FBs, OTA, or ZEA in mass fractions above the permissible limit for humans. Co-occurrence of two toxins varied between 4.2 % and 54 % and of three between 4.2 % and 7.6 %. Prolonged co-exposure to AFs, OTA, FBs, and ZEA might increase the risk of various chronic diseases.Vrste plijesni iz rodova Aspergillus, Penicillium i Fusarium česti su kontaminanti usjeva te na takvim supstratima tvore mikotoksine. Stoga su žitarice i krmiva često kontaminirana afl atoksinima (AFs), okratoksinom A (OTA), fumonizinima (FBs) i zearalenonom (ZEA) u različitim koncentracijama ovisno o mikroklimatskim uvjetima na polju i u skladištu. Konzumiranje hrane kontaminirane mikotoksinima često je povezano s akutnim ili kroničnim trovanjima, ali i s razvojem karcinoma. Cilj ovog rada bio je odrediti istodobnu pojavnost AFs (B1+B2+G1+G2), OTA, FBs (B1+B2+B3) i ZEA u uzorcima žitarica i krme (N=37) koji su nasumično skupljeni u individualnim domaćinstvima na području endemske nefropatije (EN) u Hrvatskoj (2007). Za određivanje navedenih mikotoksina korišten je kompetitivni direktni ELISA-test (CD-ELISA) u kombinaciji s tankoslojnom kromatografi jom (TLC). Najzastupljeniji mikotoksin bio je ZEA (92 %, srednja koncentracija 318.3 μg kg-1), nakon čega slijede FBs (27 %, 3690 μg kg-1), AFs (24.3 %, 4.6 μg kg-1) te OTA (16.2 %, 9.8 μg kg-1). Koncentracije AFs, FBs i ZEA određene CD-ELISA-testom statistički značajno koreliraju s rezultatima dobivenim s TLC. OTA je potvrđen metodom TLC samo u jednom uzorku zbog visokog limita detekcije. Dokazane koncentracije su ispod razina dopuštenih za krmiva, dok je 29 % uzoraka žitarica sadržavalo FBs, OTA ili ZEA u koncentracijama iznad dopuštenih u hrani za ljude. Kokontaminacija s dvama odnosno trima toksinima varirala je između 4.2 % i 54 % odnosno između 4.2 % i 7.6 %. Dugotrajni unos AFs, OTA, FBs i ZEA putem hrane može povećati rizik od razvoja različitih kroničnih bolesti zbog njihova mogućega sinergističkog djelovanja

La Iglesia de la Cristiandad ante las culturas jóvenes

El problema de la inculturación del cristianismo está a la orden del día. Especialmente en las Iglesias jóvenes es tema de numerosos interrogantes y tomas de posición más o menos acertados. ¿Cómo ver tan sólo una moda en la respuesta a una de las cuestiones que los obispos de África estiman fundamental para la evangelización del mundo contemporáneo? Los obispos de África y Madagascar que tomaron parte en los trabajos del Sínodo mundial de obispos de 1974, después de reflexionar detenidamente sobre los problemas de la evangelización, declaraban concretamente: "Toda acción para construir nuestras Iglesias debe desarrollarse en una referencia constante a nuestras comunidades. A partir de estas comunidades aportaremos a la cita de la catolicidad no sólo nuestras experiencias culturales y artísticas específicas...sino también un pensamiento teológico propio que se esfuerza por responder a las cuestiones planteadas por nuestros diversos contextos históricos y por la evolución actual de nuestras sociedades; un pensamiento teológico a la vez fiel a la tradición auténtica de la Iglesia, atento a la vida de nuestras comunidades cristianas y respetuoso para con nuestras tradiciones, nuestras lenguas, es decir nuestras filosofías". En este concepto de la evangelización, los obispos de África y de Madagascar "consideran totalmente superada una cierta teología de la adaptación y se pronuncian a favor de una teología de la encarnación. Las jóvenes Iglesias de África y Madagascar no pueden sustraerse a esta exigencia fundamental. En efecto, admitiendo el pluralismo teológico en la unidad de la fe, deben alentar con todos sus medios la investigación teológica africana. Una teología africana abierta a las aspiraciones fundamentales de los pueblos africanos hace que el cristianismo se encarne eficazmente en la vida de los pueblos del Continente negro"

Clinical and field epidemiological investigations of kala-azar (visceral leishmaniasis) in West Pokot District of Kenya

In IDL-1097