Linezolid-containing regimens for the treatment of drug-resistant tuberculosis in South African children.

BACKGROUND: Treatment options for drug-resistant tuberculosis (DR-TB) are limited. Linezolid has been successfully used to treat DR-TB in adults, but there are few case reports of its use in children for TB. The reported rate of adverse events in adults is high. METHODS: We conducted a retrospective review of children with DR-TB treated with linezolid-containing regimens from February 2007 to March 2012 at two South African hospitals. RESULTS: Seven children (three human immunodeficiency virus [HIV] infected) received a linezolid-containing regimen. All had culture-confirmed DR-TB; five had previously failed second-line anti-tuberculosis treatment. Four children were cured and three were still receiving anti-tuberculosis treatment, but had culture converted. None of the non-HIV-infected children experienced adverse events while receiving linezolid. Three HIV-infected children had adverse events, one of which was life-threatening; linezolid was permanently discontinued in this case. Adverse events included lactic acidosis (n = 1), pancreatitis (n = 2), peripheral neuropathy (n = 1) and asymptomatic bone marrow hypoplasia (n = 1). CONCLUSION: Linezolid-containing regimens can be effective in treating children with DR-TB even after failing second-line treatment. Adverse events should be monitored, especially in combination with medications that have similar adverse effects. Linezolid remains costly, and a reduced dosage and duration may result in fewer adverse events and lower cost

Standard costing and scientific management

Many have suggested that scientific management had a direct influence on the development of standard costing. This paper examines the relationship between these concepts in broad terms. While it is concluded that no direct relationship exists between scientific management and standard costing, the existence of an indirect relationship is acknowledged. Scientific management does not require any specific type of accounting system and standard costing does not require a certain type of management organization to operate. However, certain reports developed for the scientifically managed enterprise, when added to the germs of standard costing that existed, expedited the evolution of standard costing

An outbreak of pertussis in Bloemfontein, South Africa, 2008–2009

Background: In April 2008, the first case of pertussis since 1998 was diagnosed in the Free State province. The outbreak that occurred over a 12-month period is described in this article.Method: This is a case series of 18 children diagnosed with pertussis in Bloemfontein, Free State province, between April 2008 and March 2009. The clinical diagnosis was confirmed by means of a Bordetella polymerase chain reaction test done on a nasal swab. Data were collected from every child with a confirmed diagnosis of pertussis.Results: Eighteen cases of pertussis were diagnosed in the 12-month period; 15 in the public sector and three in the private sector. A peak of cases was observed in the autumn and early winter months. Twelve infants were under six months of age and were thus regarded as ”pre-vaccinated”. Fourteen children required admission to hospital, of whom five required intensive care. No deaths occurred. The cost of managing these children was high.Conclusions: Pertussis is not commonly diagnosed in South Africa. Young children are worst affected by the disease. Ongoing surveillance is needed. A vaccination plan to prevent pertussis in South Africa requires consideration

Factors influencing a mother's choice of feeding after discharge of her baby from a neonatal unit

Objective. To assess feeding methods chosen by mothers of babies who spent time in a neonatal unit.  Factors influencing this decision were investigated.Design. Descriptive study.Methods. Mothers were interviewed on the day they took their babies home. Basic demographic data on mother and baby were collected from the hospital records.Setting. The neonatal unit, Pelonomi Hospital, Bloemfontein from May 1996 to May 1998.Subjects. Eighty-one mothers of babies admitted to the neonatal unit.Outcome measures. At discharge 60% of mothers intended to breast-feed their babies exclusively the  next day. The mother's decision to breasHeed her baby at home was significantly associated with her decision before delivery (P = 0.0050). Otherfactors positively associated with the decision to breast-feed exclusively at home were a significantly higher birth weight of the baby (P < 0.0008) and gestational age of the baby (P < 0.0005). The only hospital practice positively associated with this decision was the frequency with which mothers saw their babies during their stay in the unit (P = 0.0153). Mothers' knowledge of how to increase breast-milk supply was very poor.Conclusions. Infants with a lower weight and gestational age, who stayed in the unit longer, were less  likely to be breast-fed after discharge from the neonatal unit. The mothers' experience in the unit did not seem to alter their choice of feeding method decided upon before delivery. This suggests that efforts to promote breast-feeding in the neonatal unit were either ineffectual or inadequate. In order to remedy this situation it is necessary to keep the motherinfant pair together (lodger mothers) and to promote  breastfeeding before and after delivery. It would also be necessary to train staff in the management of lactation problems

Pertussis in children in Bloemfontein, South Africa: A 7-year retrospective review

Background. Pertussis vaccination in the 1950s was associated with a decrease in the incidence of pertussis. A resurgence of pertussis has been documented, mainly in well-resourced countries since the 1990s. The burden of pertussis has not been well described in South Africa (SA). Epidemiological data are important for rational implementation of vaccination strategies.Objective. To describe the morbidity and mortality of children with pertussis admitted to public sector hospitals in Bloemfontein, SA.Methods. A retrospective descriptive hospital-based study of children diagnosed with pertussis by polymerase chain reaction testing from April 2008 to March 2015.Results. One hundred and eighty-three laboratory results confirmed pertussis; 105/183 children (57.4%) were <18 weeks old. Clinical data, available for 154/183 cases (84.2%), showed that 141/154 children (91.6%) were admitted to hospital, of whom one-third required intensive care. Hospital admission was associated with young age (p<0.001). The median hospital stay was 9.0 days (interquartile range 6 - 14.5), and hospital stay was longer for children aged <18 weeks than for those aged ≥18 weeks (p=0.006; 95% confidence interval 1 - 5 days). Of the 154 children, 139 (90.3%) had a cough, which lasted ≤7 days in 110/137 cases (80.3%). The total white cell count was ≥20.0 × 109/L in 58/144 cases (40.3%). Eight children (5.2%) died.Conclusions. This case series highlights the importance of pertussis as a problem in children. Most children had a history of cough lasting ≤7 days. Young infants were most severely affected, requiring prolonged hospital stay, often with admission to a paediatric intensive care unit

Das Employee Portal als Instrument des internen Marketing : Analyse der Kosten und Benefits

Internetportale haben als integrative Geschäftsmodelle im eBusiness in den letzen Jahren eine rasante Verbreitung erfahren. Getrieben von diesem Erfolg versuchen nun Unternehmen, das ursprüngliche Portalkonzept in die unternehmenseigene IT-Umgebung (Intranet) zu übertragen. Auf diese Weise entsteht mit sog. Employee Portalen ein neuer Portaltypus. Mit dem Einsatz von Employee Portalen verfolgen Unternehmen das Ziel, eine leistungsfähige Technologie zur Schaffung von sog. personalisierten Arbeitsplätzen am Desktop eines jeden Mitarbeiters bereitzustellen. Das Portal versorgt als Front-end des virtuellen Arbeitsplatzes den Mitarbeiter mit allen Informationen, Anwendungen, Interaktionsmöglichkeiten und Services, die er für die Erfüllung seiner Aufgaben benötigt. Die Neuartigkeit dieses Konzeptes wirft viele offene Fragen für Anwender und Softwareanbieter auf. Darunter fällt einerseits die Entwicklung eines empirisch abgesicherten Nutzenmodells für Employee Portale, andererseits die Bestimmung des ROI einer Portalimplementierung (Portal Value). Wie die empirische Untersuchung zeigt, ergibt sich der Nutzen grundsätzlich zunächst aus den Kosten und Benefits als den konkurrierenden Effekten eines Employee Portals. Die Benefits lassen sich weiter in eine qualitative und eine quantitative Dimension unterteilen. Die qualitativen Benefits werden durch die Komponenten „Mitarbeiterzufriedenheit“, „Kundenzufriedenheit“ und „strategische Wettbewerbsvorteile“ repräsentiert. Demgegenüber verkörpern die „Zeitersparnis“ und die „Prozesskostensenkung“ die quantitativen Benefits. Aus den Kosten und den Benefits ergibt sich der Wert eines Portals im Sinne des Return on Portal Investment (ROPI). Die ROPI-Analyse stellt ein wichtiges Instrument dar, um Entscheidungen bzgl. einer Portalinvestition zu unterstützen. Die Befragung von Employee Portal-Anwendern zeigt, dass in den meisten Fällen eine Amortisierung der Portalinvestitionen noch im ersten Jahr zu erwarten ist

Pertussis in children in Bloemfontein, South Africa: A 7-year retrospective review

Background. Pertussis vaccination in the 1950s was associated with a decrease in the incidence of pertussis. A resurgence of pertussis has been documented, mainly in well-resourced countries since the 1990s. The burden of pertussis has not been well described in South Africa (SA). Epidemiological data are important for rational implementation of vaccination strategies.Objective. To describe the morbidity and mortality of children with pertussis admitted to public sector hospitals in Bloemfontein, SA.Methods. A retrospective descriptive hospital-based study of children diagnosed with pertussis by polymerase chain reaction testing from April 2008 to March 2015.Results. One hundred and eighty-three laboratory results confirmed pertussis; 105/183 children (57.4%) were <18 weeks old. Clinical data, available for 154/183 cases (84.2%), showed that 141/154 children (91.6%) were admitted to hospital, of whom one-third required intensive care. Hospital admission was associated with young age (p<0.001). The median hospital stay was 9.0 days (interquartile range 6 - 14.5), and hospital stay was longer for children aged <18 weeks than for those aged ≥18 weeks (p=0.006; 95% confidence interval 1 - 5 days). Of the 154 children, 139 (90.3%) had a cough, which lasted ≤7 days in 110/137 cases (80.3%). The total white cell count was ≥20.0 × 109/L in 58/144 cases (40.3%). Eight children (5.2%) died.Conclusions. This case series highlights the importance of pertussis as a problem in children. Most children had a history of cough lasting ≤7 days. Young infants were most severely affected, requiring prolonged hospital stay, often with admission to a paediatric intensive care unit.

Serumproteom-Untersuchung bei Dialysepatienten

In großen klinischen Studien zeigten sich, in Abhängigkeit von der verwendeten Dialysemembran, Unterschiede im klinischen Outcome bei Dialysepatienten. In der vorliegenden Studie wurden eine Low-Flux-Membran (F6 HPS, Polysulfon, Fresenius) mit einer High-Flux-Membran (FX 60, Helixone, Fresenius) bezüglich postdialytische Serumproteomveränderungen im Cross-over-Design verglichen. In die Studie wurden 16 Dialysepatienten und 10 gesunde Probanden als Vergleichsgruppe eingeschlossen. Die Umstellungszeit auf die jeweils andere Membran betrug 10 Wochen. Die Serumproben wurden zwei-dimensional chromatographisch (Größenausschlusschromatographie Superdex-Säule; Ionenaustauschchromatographie DEAE-Cellulose) aufgetrennt und die Proteinkonzentrationen wurden verglichen. Anschließend erfolgte mit Hilfe von ESI- und MALDI-Massenspektrometrie die Proteinidentifikation in ausgewählten Fraktionen. Es zeigten sich höhere Proteinkonzentrationen von Immunglobulin G und Haptoglobin nach der Dialyse mit einer Low-Flux-Membran. Die Ergebnisse könnten Hinweis dafür sein, dass es im Rahmen einer Therapie mit einer Low-Flux-Membran zu ausgeprägteren immunologischen Prozessen kommt

non linear behaviour of electrical parameters in porous water saturated rocks a model to predict pore size distribution

SUMMARY In this paper, two separate but related goals are tackled. The first one is to demonstrate that in some saturated rock textures the non-linear behaviour of induced polarization (IP) and the violation of Ohm's law not only are real phenomena, but they can also be satisfactorily predicted by a suitable physical-mathematical model, which is our second goal. This model is based on Fick's second law. As the model links the specific dependence of resistivity and chargeability of a laboratory sample to the injected current and this in turn to its pore size distribution, it is able to predict pore size distribution from laboratory measurements, in good agreement with mercury injection capillary pressure test results. This fact opens up the possibility for hydrogeophysical applications on a macro scale. Mathematical modelling showsthatthechargeabilityacquiredinthefieldundernormalconditions,thatisatlowcurrent, will always be very small and approximately proportional to the applied current. A suitable field test site for demonstrating the possible reliance of both resistivity and chargeability on current was selected and a specific measuring strategy was established. Two data sets were acquired using different injected current strengths, while keeping the charging time constant. Observed variations of resistivity and chargeability are in agreement with those predicted by the mathematical model. These field test data should however be considered preliminary. If confirmedbyfurtherevidence,thesefactsmayleadtochangingtheprocedureofacquiringfield measurements in future, and perhaps may encourage the design and building of a new specific geo-resistivity meter. This paper also shows that the well-known Marshall and Madden's equations based on Fick's law cannot be solved without specific boundary conditions