Audit of efficacy of CoartemTM to clear plasmodium falciparum malaria parasitaemia at single forty-two day follow-up

Background; A study, which included a follow-up study, was undertaken to assess the efficacy of CoartemTM tablets (20 mg artemether and 120 mg lumefantrine – Novartis South Africa (Pty) Ltd) to clear plasmodium falciparum malaria parasitaemia at a single 42-day follow-up, with 42 days being chosen in order to detect early emergence of resistance. The study was done at Ndumo Clinic and Mosvold Hospital in the Ingwavuma District of KwaZulu-Natal, South Africa in January/February 2002. Method: The study included 37 patients presenting to Ndumo Clinic and two presenting to Mosvold Hospital with uncomplicated malaria diagnosed by symptoms and a positive immunochromographic test (ICT) for plasmodium falciparum. The main outcome measures were done using a Trophozoite count on thick film and polymerase chain reaction parasite analysis of blood spot at day 42. Results: Only 31 of the 37 recruited patients were confirmed to be suffering from malaria by polymerase chain reaction (PCR). Of the 31, 24 returned for follow-up. One patient had parasitaemia at day 33, but tested negative at day 42 after re-treatment with Coartem™. It was not determined whether this patient was suffering from a recrudescence or re-infection of falciparum malaria. All the other returning patients tested negative for falciparum malaria on blood film and PCR examination. Conclusions : CoartemTM still appears to be an effective treatment for falciparum malaria. Regular assessment of its efficacy is desirable. For full text, click here:SA Family Pract 2004;46(6): 21-2

Foxn1 Regulates Lineage Progression in Cortical and Medullary Thymic Epithelial Cells But Is Dispensable for Medullary Sublineage Divergence

The forkhead transcription factor Foxn1 is indispensable for thymus development, but the mechanisms by which it mediates thymic epithelial cell (TEC) development are poorly understood. To examine the cellular and molecular basis of Foxn1 function, we generated a novel and revertible hypomorphic allele of Foxn1. By varying levels of its expression, we identified a number of features of the Foxn1 system. Here we show that Foxn1 is a powerful regulator of TEC differentiation that is required at multiple intermediate stages of TE lineage development in the fetal and adult thymus. We find no evidence for a role for Foxn1 in TEC fate-choice. Rather, we show it is required for stable entry into both the cortical and medullary TEC differentiation programmes and subsequently is needed at increasing dosage for progression through successive differentiation states in both cortical and medullary TEC. We further demonstrate regulation by Foxn1 of a suite of genes with diverse roles in thymus development and/or function, suggesting it acts as a master regulator of the core thymic epithelial programme rather than regulating a particular aspect of TEC biology. Overall, our data establish a genetics-based model of cellular hierarchies in the TE lineage and provide mechanistic insight relating titration of a single transcription factor to control of lineage progression. Our novel revertible hypomorph system may be similarly applied to analyzing other regulators of development

Assessing the Quality of Permanent Sample Plot Databases for Growth Modelling in Forest Plantations

Informed plantation management requires a good database, since the quality of information depends on the quality of data, growth models and other planning tools. There are several important questions concerning permanent plots: how many plots, where to put them, and how to manage them. Plot measurement procedures are also important. This paper illustrates graphical procedures to evaluate existing databases, to identify areas of weakness, and to plan remedial sampling. Two graphs, one of site index versus age, another with stocking versus tree size, may provide a good summary of the site and stand conditions represented in the database. However, it is important that these variables, especially site index, can be determined reliably. Where there is doubt about the efficacy of site index estimates, it is prudent to stratify the database according to geography, soil/geology or yield level (total basal area or volume production). Established permanent plot systems may sample a limited range of stand conditions, and clinal designs are an efficient way to supplement such data to provide a better basis for silvicultural inference. Procedures are illustrated with three data sets: teak plantations in Burma, Norway spruce in Denmark, and a clinal spacing experiment in India

Phase II study of weekly oxaliplatin plus infusional fluorouracil and folinic acid (FUFOX regimen) as first-line treatment in metastatic gastric cancer

Oxaliplatin plus fluorouracil/folinic acid (5-FU/FA) every 2 weeks has shown promising activity in advanced gastric cancer. This study assessed the efficacy and safety of weekly oxaliplatin plus 5-FU/FA (FUFOX regimen) in the metastatic setting. Patients with previously untreated metastatic gastric cancer received oxaliplatin (50 mg m−2) plus FA (500 mg m−2, 2-h infusion) followed by 5-FU (2000 mg m−2, 24-h infusion) given on days 1, 8, 15 and 22 of a 5-week cycle. The primary end point of this multicentre phase II study was the response rate according to RECIST criteria. A total of 48 patients were enrolled. Median age was 62 years and all patients had metastatic disease, with a median number of three involved organs. The most common treatment-related grade 3/4 adverse events were diarrhoea (17%), deep vein thrombosis (15%), neutropenia (8%), nausea (6%), febrile neutropenia (4%), fatigue (4%), anaemia (4%), tumour bleeding (4%), emesis (2%), cardiac ischaemia (2%) and pneumonia (2%). Grade 1/2 sensory neuropathy occurred in 67% of patients but there were no episodes of grade 3 neuropathy. Intent-to-treat analysis showed a response rate of 54% (95% CI, 39–69%), including two complete responses. At a median follow-up of 18.1 months (range 11.2–26.2 months), median survival is 11.4 months (95% CI, 8.0–14.9 months) and the median time to progression is 6.5 months (95% CI, 3.9–9.2 months). The weekly FUFOX regimen is well tolerated and shows notable activity as first-line treatment in metastatic gastric cancer

Landscape history, time lags and drivers of change : urban natural grassland remnants in Potchefstroom, South Africa

The history of the landscape directly affects biotic assemblages, resulting in time lags in species response to disturbances. In highly fragmented environments, this phenomenon often causes extinction debts. However, few studies have been carried out in urban settings. To determine if there are time lags in the response of temperate natural grasslands to urbanization. Does it differ for indigenous species and for species indicative of disturbance and between woody and open grasslands? Do these time lags change over time? What are the potential landscape factors driving these changes? What are the corresponding vegetation changes? In 1995 and 2012 vegetation sampling was carried out in 43 urban grassland sites. We calculated six urbanization and landscape measures in a 500 m buffer area surrounding each site for 1938, 1961, 1970, 1994, 1999, 2006, and 2010. We used generalized linear models and model selection to determine which time period best predicted the contemporary species richness patterns. Woody grasslands showed time lags of 20-40 years. Contemporary open grassland communities were, generally, associated with more contemporary landscapes. Altitude and road network density of natural areas were the most frequent predictors of species richness. The importance of the predictors changed between the different models. Species richness, specifically, indigenous herbaceous species, declined from 1995 to 2012. The history of urbanization affects contemporary urban vegetation assemblages. This indicates potential extinction debts, which have important consequences for biodiversity conservation planning and sustainable future scenarios.Peer reviewe

Long-Term Impact of War on Healthcare Costs: An Eight-Country Study

PMCID: PMC3251588This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Psychologie der Kreativität

Ein kleiner Streifzug durch die psychologische Kreativitätsforschung befasst sich mit den Möglichkeiten der Erfassung kreativer Prozesse, ihrer Manifestation, den Determinanten, der Frage nach der Notwendigkeit zu kreativem Denken und schließlich Erkenntnissen darüber, wie kreatives Denken gefördert werden kann