Posology in children oral liquid medication studies in Liberia

The determination and implementation of appropriate dose(s) and dosing in children for effective therapeutic outcome devoid of medication errors is a concern to health practitioners and regulatory authorities. This study surveyed children oral medications on the Liberian pharmaceutical market for appropriate dose, dosing and delivery devices. In the qualitative work, caregivers were interviewed and surveys were conducted in pharmacies for oral medications and the quantitative phase involved the evaluation of the delivery devices. The result of the survey showed that 95.7% of caregivers followed instructions provided at the point of dispensing or as on label of product. Survey result showed that 56% of the oral medicinal products have specific direction for usage while 73% have the inscription “as directed by the physician”, either alone or in combination with specific direction for use. Medicines with delivery device as cup were 80.94% and those with teaspoons were 1.79%, while 17.28% do not have any form of delivery device. And 53.11% of the medicinal products provided instruction for delivery of the  medicines in “teaspoonful”, though they did not contain teaspoon neither were the cups graduated in “teaspoonful” format. Volume calibration of the various “5.0 ml” teaspoons showed statistically significant differences (P< 0.05), while the cups volume capacities at 5.0 ml was found to be 5.200 ± 0.326 ml. The large volume cups showed significant  differences (P<0.05) at the 5.0 ml graduation and only 25.5% of the mothers were able to accurately measure out 5.0 ml in the cups.Keywords: Medication error, posology, delivery devices, medical error, children oral medication

Lack of utility of chimerism studies obtained 2-3 months after myeloablative hematopoietic cell transplantation for ALL.

Lineage-specific chimerism studies are commonly obtained at several time points after nonmyeloablative hematopoietic cell transplantation to assess the tempo and degree of engraftment, and to monitor graft rejection. For patients who receive myeloablative transplants, the value of frequent chimerism analyses using sensitive molecular techniques is less certain. In this study, a retrospective analysis was performed to assess the transplant outcome of 89 adult patients with ALL who had chimerism studies of unfractionated BM cells or peripheral blood subsets performed approximately 80 days after transplantation. These patients received unmanipulated, myeloablative transplants using either HLA-identical or HLA-mismatched, related or unrelated donor stem cells. Incomplete donor engraftment was present only in the CD3+ peripheral blood T cells in a small percentage of patients. There was no correlation of mixed chimerism with transplant outcome. Routine 'day 80' chimerism studies in this group of patients who receive intensive, myeloablative conditioning regimens are not recommended

Microturbulence in O supergiants

We investigate the role of classical microturbulence in the non-LTE He i/He ii line formation problem for luminous O-type stars. We find that the shapes and strengths of certain saturated He i lines, in particular the triplets λλ4471, 4713 and the singlet λ4921, are sensitive to microturbulent velocities in excess of 5 km s−1. Weaker lines, including most of the He i singlets, are effectively independent of this parameter, as are the Fowler series He ii lines λλ4199, 4541, 5411. We show that this behaviour is due to interaction between direct line-broadening effects in the radiative transfer, and indirect changes in the atmospheric structure and the populations of absorbing states. Using an analysis of high-resolution, high signal-to-noise ratio observations of the O9.7 supergiant HD 152003 as an illustrative example, we show how the introduction of microturbulence in non-LTE models allows consistent fits to be obtained for all blue-region He i lines — including the strong triplets λλ4026, 4713, 4471 — at an assumed solar helium abundance, thereby offering a resolution to the problem of the ‘generalized dilution effect’ described by Voels et al. We argue that by extension this result may also have implications for the so-called ‘helium discrepancy’ identified in OB-type stars by Herrero et al

Are HIV-positive presumptive tuberculosis patients without tuberculosis getting the care they need in Zimbabwe?

SETTING: Emakhandeni Clinic provides decentralised and integrated tuberculosis (TB) and human immunodeficiency virus (HIV) care in Bulawayo, Zimbabwe. OBJECTIVES: To compare HIV care for presumptive TB patients with and without TB registered in 2013. DESIGN: Retrospective cohort study using routine programme data. RESULTS: Of 422 registered presumptive TB patients, 26% were already known to be HIV-positive. Among the remaining 315 patients, 255 (81%) were tested for HIV, of whom 190 (75%) tested HIV-positive. Of these, 26% were diagnosed with TB and 71% without TB (3% had no TB result recorded). For the 134 patients without TB, antiretroviral treatment (ART) eligibility data were recorded for 42 (31%); 95% of these were ART eligible. Initiation of cotrimoxazole preventive therapy (CPT) and ART was recorded for respectively 88% and 90% of HIV-positive patients with TB compared with respectively 40% and 38% of HIV-positive patients without TB (P < 0.001). CONCLUSION: Presumptive TB patients without TB had a high HIV positivity rate and, for those with available data, most were ART eligible. Unlike HIV-positive patients diagnosed with TB, CPT and ART uptake for these patients was poor. A 'test and treat' approach and better service linkages could be life-saving for these patients, especially in southern Africa, where there are high burdens of HIV and TB

Management and treatment outcomes of patients enrolled in MDR-TB treatment in Viet Nam.

SETTING: The programmatic management of drug-resistant tuberculosis (TB) in Viet Nam has been rapidly scaled up since 2009. OBJECTIVES: To document the annual numbers of patients enrolled for multidrug-resistant tuberculosis (MDR-TB) treatment during 2010-2014 and to determine characteristics and treatment outcomes of patients initiating treatment during 2010-2012. DESIGN: A retrospective cohort study using national reports and data from the national electronic data system for drug-resistant TB. RESULTS: The number of patients enrolled annually for MDR-TB treatment increased from 97 in 2010 to 1522 in 2014. The majority of patients were middle-aged men who had pulmonary disease and had failed a retreatment regimen; 77% had received ⩾2 courses of TB treatment. Favourable outcomes (cured and treatment completed) were attained in 73% of patients. Unfavourable outcomes included loss to follow-up (12.5%), death (8%) and failure (6.3%). Having had ⩾2 previous treatment courses and being human immunodeficiency virus-positive were associated with unfavourable outcomes. CONCLUSION: Increasing numbers of patients are being treated for MDR-TB each year with good treatment outcomes under national programme management in Viet Nam. However, there is a need to increase case detection-currently at 30% of the estimated 5100 MDR-TB cases per year, reduce adverse outcomes and improve monitoring and evaluation

The growth in newspaper coverage of tobacco control in China, 2000-2010

<p>Abstract</p> <p>Background</p> <p>Media coverage of tobacco-related issues can potentially shape individual beliefs, attitudes and behaviors about tobacco use. This study aims to describe news coverage of tobacco control related issues in Chinese newspapers from 2000 to 2010.</p> <p>Methods</p> <p>All 1149 articles related to tobacco control were extracted from the Database of Chinese Important Newspapers and content analyzed for the period Jan 1, 2000 to Dec 31, 2010. The changing pattern of tobacco control topic, article type, viewpoint, and article origin, and their relationship were analysed.</p> <p>Results</p> <p>News coverage of tobacco control related issues increased significantly (<it>p </it>< 0.01) from 2000 to 2010, with news coverage being relatively intensive in May and June (<it>p </it>< 0.01), around World No Tobacco Day. 24.9% (n = 286) of all articles focused on secondhand smoke, 25.3% (n = 291) warned about the dangers of active smoking, and 10.0% (n = 115) focused on prevention and cessation programs and campaigns. Tobacco control topics varied significantly between national vs city/regional newspapers (<it>χ</it>²= 24.09, <it>p </it>= 0.002) and article types (<it>χ</it>²= 193.35, <it>p </it>< 0.001). Articles in national newspapers had more coverage of the dangers of tobacco and on enforcing bans on tobacco-advertising. News stories centered around monitoring tobacco use and smoke free activity, while editorials focused on enforcing bans on tobacco-advertising, youth access and programs and campaigns. Letters to editors focused on the dangers of smoking, raising tax, and smoking cessation. More articles (50.4%) took an anti-tobacco position (compared with 10.5% which were pro-smoking), with the amount of negative coverage growing significantly across the decade. National articles tended to lean toward anti-tobacco, however, local articles tended mix of pro-tobacco and neutral/balance positions. Editorials seemed to be more anti-tobacco oriented, but letters to the editor tended to show a mix of anti-tobacco and pro-tobacco positions.</p> <p>Conclusion</p> <p>Chinese newspapers are giving increasing attention to tobacco control, but coverage remains lower than in the USA and Australia. Health workers need to give higher priority to efforts to increase news coverage beyond the present concentration around World No Tobacco Day and to develop strategies for making tobacco control issues more newsworthy to both national and local news outlets.</p

Improved genetically-encoded, FlincG-type fluorescent biosensors for neural cGMP imaging.

Genetically-encoded biosensors are powerful tools for understanding cellular signal transduction mechanisms. In aiming to investigate cGMP signaling in neurones using the EGFP-based fluorescent biosensor, FlincG (fluorescent indicator for cGMP), we encountered weak or non-existent fluorescence after attempted transfection with plasmid DNA, even in HEK293T cells. Adenoviral infection of HEK293T cells with FlincG, however, had previously proved successful. Both constructs were found to harbor a mutation in the EGFP domain and had a tail of 17 amino acids at the C-terminus that differed from the published sequence. These discrepancies were systematically examined, together with mutations found beneficial for the related GCaMP family of Ca(2+) biosensors, in a HEK293T cell line stably expressing both nitric oxide (NO)-activated guanylyl cyclase and phosphodiesterase-5. Restoring the mutated amino acid improved basal fluorescence whereas additional restoration of the correct C-terminal tail resulted in poor cGMP sensing as assessed by superfusion of either 8-bromo-cGMP or NO. Ultimately, two improved FlincGs were identified: one (FlincG2) had the divergent tail and gave moderate basal fluorescence and cGMP response amplitude and the other (FlincG3) had the correct tail, a GCaMP-like mutation in the EGFP region and an N-terminal tag, and was superior in both respects. All variants tested were strongly influenced by pH over the physiological range, in common with other EGFP-based biosensors. Purified FlincG3 protein exhibited a lower cGMP affinity (0.89 μM) than reported for the original FlincG (0.17 μM) but retained rapid kinetics and a 230-fold selectivity over cAMP. Successful expression of FlincG2 or FlincG3 in differentiated N1E-115 neuroblastoma cells and in primary cultures of hippocampal and dorsal root ganglion cells commends them for real-time imaging of cGMP dynamics in neural (and other) cells, and in their subcellular specializations