A Comparative Study of Leptospirosis and Dengue in Thai Children

Two of the most common causes of acute febrile illnesses among children in the tropics are leptospirosis and dengue. Early in illness, these two conditions are often indistinguishable and rapid laboratory confirmation of the infecting pathogen is generally not available. An enhanced ability to distinguish leptospirosis from dengue in children would guide clinicians and public health personnel in the appropriate use of limited healthcare resources

Period-adding bifurcations and chaos in a periodically stimulated excitable neural relaxation oscillator

This is a pre-print. The definitive version: COOMBES, S. and OSBALDESTIN, A.H., 2000. Period-adding bifurcations and chaos in a periodically stimulated excitable neural relaxation oscillator. Physical Review E, 62(3), pp.4057-4066 Part B.The response of an excitable neuron to trains of electrical spikes is relevant to the understanding of the neural code. In this paper we study a neurobiologically motivated relaxation oscillator, with appropriately identified fast and slow coordinates, that admits an explicit mathematical analysis. An application of geometric singular perturbation theory shows the existence of an attracting invariant manifold which is used to construct the Fenichel normal form for the system. This facilitates the calculation of the response of the system to pulsatile stimulation and allows the construction of a so-called extended isochronal map. The isochronal map is shown to have a single discontinuity and be of a type that can admit three types of response: mode-locked, quasi-periodic and chaotic. The bifurcation structure of the system is seen to be extremely rich and supports period-adding bifurcations separated by windows of both chaos and periodicity. A bifurcation analysis of the isochronal map is presented in conjunction with a description of the various routes to chaos in this system

Evidence that in healthy young women, a six-cycle treatment with oral contraceptive containing 30 mcg of ethinylestradiol plus 2 mg of chlormadinone acetate reduces fat mass

Abstract: Background: We aimed to evaluate whether a six-cycle treatment with oral contraceptive containing 30 mcg of ethinylestradiol (EE2) plus 2 mg of chlormadinone acetate (CMA) (EE2+CMA) alters body weight (BW) and body composition of healthy young women with normal menstrual cycles. The results in treated subjects were compared to those obtained in nontreated women as control. Study Design: Multifrequency bioelectrical impedance analysis (MF-BIA) was performed in 48 healthy Young women during the follicular phase of their menstrual cycle. Of this group, 24 women were treated with EE2+CMA, and the MF-BIA was repeated at the third and sixth cycle of treatment. The remaining 24 women were submitted to the same examinations after three and six cycles without any treatment. Total body water (TBW), intracellular water (ICW), extracellular water (ECW), fat mass (FM) and fat-free mass (FFM) were calculated. Waist-to-hip ratio (WHR), BW, blood pressure, and the plasma concentrations of electrolytes were also measured at each visit. Results: Mean FM significantly (p<.05) decreased in the EE2+CMA group from basal levels of 14.23 +/- 1.03 to 13.51 +/- 1.09 and 12.71 +/- 1.02 kg at the third and sixth cycle of treatment, respectively. Stable values were seen in the control group. During observation, other parameters (BW, WHR, TBW, ECW, ICW, FFM) remained unchanged in all subjects. Conclusions: EE2+CMA reduces FM without altering TBW, ICIA, ECW. These preliminary results Suggest that progestational activity of CMA could balance both fluid retention and weight gain elicited by EE2. (C) 2009 Elsevier Inc. All rights reserved

Biosimilars vs originators: Are they the same?

Biological drugs have revolutionised the treatment of rheumatic diseases, and the recent expiry of the patents for many biological agents has generated considerable interest among pharmaceutical companies and regulatory agencies, and led to the marketing of highly similar, low-cost versions known as biosimilars. The increasing trend of switching patients from effective but expensive drugs to their biosimilar counterparts will have a considerable economic impact in the coming years. However, although this will greatly extend patient access the latest treatments, clinicians, scientific societies and the patients themselves have expressed a number of concerns about their long-term efficacy and safety, as well as the consequences of potentially multiple switches being dictated by economic pressure rather than medical needs. Thee aim of this review is to evaluate the pros and cons of choosing biosimilars, and whether and when they can really be considered clinically equivalent to the original drugs