Deep neck space infections in Adolescents

Adolescent deep neck space infection is an important pathology that often requires hospitalization for antimicrobial therapy. The aim of the study was to identify the inciting organisms and their resistance profiles in the adolescent population of patients with deep neck space infection. We performed a single-center cross-sectional retrospective analysis of patients between 10 and 16 years of age, with deep neck space infections. From the 319 cases of deep neck space infections that presented over the study period, nine patients met the criteria to be included in the study. The mean age being 11.8 years. The microbiology of the specimens revealed mainly Staphylococcus and Streptococcus species and in some patients microscopy and culture showed no predominant bacteria. There was an overall 86% resistance of organisms to penicillin and ampicillin but most organisms were sensitive to amoxicillin-clavulanic acid Deep neck space infections in adolescents can initially be managed with amoxicillin-clavulanic acid, source control and surgical drainage if required. Culture directed therapy can be initiated after microbiology results. The spaces involved are similar to adults with 44% of patients having deep neck abscess secondary odontogenic infection. The microbiology however is similar to that of children with Streptococcus and staphylococcus species being the most predominant

THE NEXUS AMONG INTER-FIRM COOPETITION, COOPERATION COOPETITION AND DIGITAL FINANCIAL INCLUSION: A CONCEPTUAL ANALYSIS

The purpose of this study is to empirically review literature on inter-firm coopetition and how it affects digital financial inclusion. Further, the paper is focusing on Sub-Saharan Africa as it is one of the regions of the world that is affected by lack of access and usage of financial services.  The article provides a review of literature that demonstrates the effect of the simultaneous use of competition and cooperation on firm performance and subsequently financial inclusion, in order to determine the current state of knowledge and provide direction for further research. The specific objectives this study are to: empirically review articles on inter-firm coopetition; review articles on digital financial inclusion; and review articles that concern the relationship between inter-firm coopetition and digital financial inclusion.  The main sources of this literature review were peer reviewed journal articles, edited academic books, articles in professional journals, and statistical data from government websites, and website material from professional associations. A narrative literature review approach was used to search and synthesis peer reviewed journal articles, edited academic books, articles in professional journals, and statistical data from government websites, and website material from professional associations. The study  identified six gaps in the literature as proposed by Miles, (2017) as follows: a population gap since literature on inter-firm coopetition’s applicability to the Sub-Saharan region is scanty; an evidence gap as studies on the welfare effects of inter-firm coopetition have been few, and thus there is rarely much evidence to analyse this subject area; a knowledge gap since it was observed that there is limited knowledge regarding how inter-firm coopetition could affect digital financial inclusion; a practical-knowledge conflict gap, since the use of digital financial services has increased digital financial inclusion by lower than desired levels, and hence the need for further interventions such as the use of the inter-firm coopetition strategy; a methodological gap as most of the literature reviews in coopetition studies use systematic reviews with very few using the narrative review; an empirical gap since evidence on the effect of inter-firm coopetition and digital financial inclusion.  This review found that inter-firm coopetition in relation to its effects on financial inclusion is rarely researched. Further, the literature provided limited evidence of coopetition studies in SSA. This is despite the literature showing that inter-firm coopetition has positive results for firm performance. This literature is specifically from western and eastern countries of the world. This review forms a basis for a study to investigate the effects of inter-firm coopetition on digital financial inclusion in sub-Saharan Africa, specifically Zambia. The findings contribute to literature on business relationships and models which have the capacity to accelerate digital financial inclusion. Keywords: Bank, Collaboration, Competition, Cooperation, FinTech, Inter-firm coopetition, Mobile Network Operators (MNO); Inter-Firm Coopetition,  Digital Financial Services Providers (DFSPs), Financial Inclusion; Digital Financial Inclusion; Financial Technologies; FinTech DOI: 10.7176/JESD/14-12-09 Publication date:June 30th 202

Evolution of Sialendoscopy in clinical practice: Survey of attending practitioners

Sialendoscopy is a relatively new technique that is safe, minimally invasive and effective as a diagnostic as well as a therapeutic tool for the management of deep seated, proximal, salivary ductal obstruction. However, more than 20 years since its inception it is still not in mainstream use worldwide. Objectives Our aim of this study was to ascertain the awareness of sialendoscopy amongst the medical fraternity in South Africa. More specifically, to determine whether it was frequently used amongst practitioners and the type of cases managed using sialendoscopy. Methods An exploratory survey design involving 100 practitioners was used to collect data, using an online survey involving 10 closed-ended multiple choice questions. Results The results of the study revealed that while practitioners saw patients who could benefit from sialendoscopy, most practitioners did not feel comfortable performing the procedure independently, and as such, most patients were referred on to other professionals for management. The majority of attending practitioners believed that they would benefit from further practical and theoretical training in the field of sialendoscopy, illustrating the need for continued professional development in this area

Treatment patterns and clinical outcomes with pazopanib in patients with advanced soft tissue sarcomas in a compassionate use setting: results of the SPIRE study.

Background A named patient program (NPP) was designed to provide patients with advanced soft-tissue sarcoma (aSTS) access to pazopanib, a multitargeted tyrosine kinase inhibitor. The SPIRE study was a retrospective chart review of participating patients.Patients and methods Eligibility criteria for the NPP and SPIRE mirrored those of the pivotal phase-III study, PALETTE, which compared pazopanib with placebo in patients ≥18 years with aSTS and whose disease had progressed during or following prior chemotherapy or were otherwise unsuitable for chemotherapy. Outcomes of interest included treatment patterns, treatment duration, relative dose intensity, progression-free survival (PFS), overall survival (OS), clinical benefit rate, adverse events (AEs) and reasons for treatment discontinuation.Results A total of 211 patients were enrolled (median age 56 years; 60% female). Most patients received pazopanib in second- and third-line therapy (28.0% and 28.4%, respectively), followed by fourth line (19.0%) and ≥ fifth line (18.5%). The median duration of pazopanib treatment was 3.1 months (95% CI: 2.8-3.8), with a mean daily dose of 715 mg equating to 92% of recommended dose. Median OS was 11.1 months and clinical benefit rate was 46%. There was evidence of some clinical benefit across most histological subtypes. At study end, 40% of patients were alive and of these, 18% remained on pazopanib. Thirteen percent (13%) of patients discontinued pazopanib due to AEs.Conclusions The SPIRE study demonstrated activity of pazopanib in heavily pretreated aSTS patients in a compassionate use setting. No new safety concerns were noted. Reassuringly, the relative dose intensity of pazopanib was 92%

Over-expression of ST3Gal-I promotes mammary tumorigenesis

Changes in glycosylation are common in malignancy, and as almost all surface proteins are glycosylated, this can dramatically affect the behavior of tumor cells. In breast carcinomas, the O-linked glycans are frequently truncated, often as a result of premature sialylation. The sialyltransferase ST3Gal-I adds sialic acid to the galactose residue of core 1 (Galβ1,3GalNAc) O-glycans and this enzyme is over-expressed in breast cancer resulting in the expression of sialylated core 1 glycans. In order to study the role of ST3Gal-I in mammary tumor development, we developed transgenic mice that over-express the sialyltransferase under the control of the human membrane-bound mucin 1 promoter. These mice were then crossed with PyMT mice that spontaneously develop mammary tumors. As expected, ST3Gal-I transgenic mice showed increased activity and expression of the enzyme in the pregnant and lactating mammary glands, the stomach, lungs and intestine. Although no obvious defects were observed in the fully developed mammary gland, when these mice were crossed with PyMT mice, a highly significant decrease in tumor latency was observed compared to the PyMT mice on an identical background. These results indicate that ST3Gal-I is acting as a tumor promoter in this model of breast cancer. This, we believe, is the first demonstration that over-expression of a glycosyltransferase involved in mucin-type O-linked glycosylation can promote tumorigenesis