Recall of lost-to-follow-up pre-antiretroviral therapy patients in the Eastern Cape: Effect of mentoring on patient care

Background. In 2011 an experienced HIV nurse from the UK was deployed for 3 months to act as a mentor to nurses learning to initiate antiretroviral therapy (ART) in primary care clinics in a small town in the Eastern Cape, South Africa.Methods. A review of existing pre-ART patient files (N=286) was carried out and lost-to-follow-up (LTFU) HIV patients were recalled.Results. Only 24% of patients had attended the clinics within the preceding 6 months and 20% had not attended for longer than 2 years. Two lay counsellors visited 222 patients to encourage them to return to care; 65/286 (23%) were untraceable, 11/286 (4%) had relocated, 30/286 (10%) declined, and 8/286 (3%) had died. In the 6 weeks following recall, 51/286 patients (18%) returned to the clinics. CD4 count testing was repeated and screening for tuberculosis (TB) and other opportunistic infections was performed for all patients; ART was initiated in 13/51 (25%), 1 patient tested positive for TB, and isionazid (INH) prophylaxis was initiated in 23/51 (45%). The cost of recall was R130/patient. Within 6 months, all clinics began providing full ART services, 17 professional nurses were mentored and they initiated ART in 55 patients.Conclusions. Mentoring plays an important role in professional nurse training and support. Recall of LTFU patients is feasible and effective in improving ART services in rural settings

Multiple sclerosis in South Africa

Since there are no well-documented epidemiological studies on multiple sclerosis (MS) in South Africa, we devised a questionnaire to determine qualitative data. Responses were obtained from 430 patients: 91% had magnetic resonance imaging (MRI) scans, 64% had lumbar punctures and 49% had evoked potentials to establish the diagnosis of MS. A total of 71% of the respondents were aged 30 - 59 years, 73% were female, and 89% were white. In terms of MS type, 46% had relapsing-remitting MS, 13 % secondary progressive MS, 12% primary progressive MS, 12% benign MS, and 17% not known. Disease-modifying treatment was not used by 32% of respondents, and 30% were treated with methotrexate and 22% with interferon beta. These findings are similar to those in the literature, except for the under-utilisation of interferons as disease-modifying treatment. South African Medical Journal Vol. 98 (5) 2008 pp. 391-39

In vitro effects of an in silico-modelled 17β-estradiol derivative in combination with dichloroacetic acid on MCF-7 and MCF-12A

OBJECTIVES : To investigate anti-proliferative properties of a novel in silico-modelled 17β-oestradiol derivative (C9), in combination with dichloroacetic acid (DCA), on MCF-7 and MCF-12A cells. MATERIALS AND METHODS : xCELLigence system was employed to determine optimal seeding number for cells, and crystal violet assay was used to assess cell number and to determine IC50 value (24 h) for combination treatment. Light and fluorescent microscopy techniques were used to morphologically detect types of cell death. Flow cytometry was used to analyse cell cycle and apoptosis. RESULTS : Optimal seeding number for 96-well plates was determined to be 5000–10 000 cells ⁄ well for both MCF-7 and MCF-12A cells. IC50 for MCF-7 cells of the combination treatment after 24 h was 130 nM of C9 in conjunction with 7.5 mM of DCA (P < 0.05). In contrast, the same concentration inhibited cell population growth by only 29.3% for MCF- 12As after 24-h treatment (P < 0.05). Morphological studies revealed lower cell density of both types of combination-treated cells. Flow cytometric analyses demonstrated increase in sub-G1 phase in combination- treated MCF-7 cells. CONCLUSIONS : These results demonstrate that the novel 17β-oestradiol derivative C9, in combination with DCA is a potent anti-proliferation treatment, with properties of selectivity towards tumourigenic cells. Thus, this warrants further studies as a potential combination chemotherapeutic agent for further cancer cell lines.This research was supported by grants from the Medical Research Council of South Africa (AL343, AS536), the Cancer Association of South Africa (AS201), the National Research Foundation (NRF) (AL239), the RESCOM of University of Pretoria and the Struwig-Germeshuysen Cancer Research Trust of South Africa (AN074).http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2184

Stevens’ Cure (Umckaloabo)—the vindication of a patent medicine

Stevens’ Cure (Umckaloabo) emerged as a patent medicine claiming to treat tuberculosis in the United Kingdom at the beginning of the 20th century. However, due to its identity being shrouded in secrecy, it was never truly accepted by the medical community. It was “rediscovered” in the 1970s and subsequently developed into a very popular and successful phytopharmaceutical for the treatment of upper respiratory tract infections. Whether Stevens’ Cure contained the same ingredient(s) as the modern Umckaloabo has not yet been demonstrated. We attempted to elucidate for the first time the identity of the original ingredient by comparative analysis of historical product samples. Three historical samples of Stevens’ Cure were compared with Pelargonium sidoides DC. and P. reniforme Curt. root per UPLC-MS analysis. We confirm that the ingredient–P. sidoides DC.—is indeed the same as used in modern phytotherapy. We also attribute the first ethnopharmacological record of P. sidoides DC. being used for the treatment of tuberculosis to C. H. Stevens, the “creator” of Umckaloabo

Diversity and similarity of benthic fauna off Oregon

Samples of benthic organisms off the coast of Oregon, taken from depths varying from 50 to 2900 meters, have been analyzed in terms of diversity at a given station, and similarity and ecological distance to other stations. Estimates of epifauna abundance were also made. In the analysis an important distinction is made between diversity, abundance, and variety indices; the three measures are considered independent pieces of information relevant to the ecological structure of the population of interest. Two types of sampling gear were used. Large epifauna were sampled with a beam trawl. Polychaetous infauna were sampled with an anchor-box dredge. The diversity index chosen is Simpson's index; the measures of similarity and ecological distance are related. These measures are preferred because of their ease in calculation and basic simplicity. In addition these measures may be interpreted as estimates of well-defined population parameters (as Simpson has pointed out) which have straightforward probabilistic interpretation. A valid measure of diversity is one piece of relevant information necessary for elucidating the sufficient parameters of ecological systems. Therefore the methodology presented has broad application to studies of population structure

In vitro evaluation of a novel antimitotic estradiol analog and dichloroacetic acid on breast adenocarcinoma and breast non-tumorigenic cells

In vitro evaluation of a novel antimitotic estradiol analog and dichloroacetae, which restore mitochondrion function in breast adenocarcinoma and breast non-tumorigenic cells, will contribute to the field of combination therapy in cancer.This paper was initially delivered at the Annual Congress of the Biological Sciences Division of the South African Academy for Science and Art, ARC-Plant Protection Research Institute, Roodeplaat, Pretoria, South Africa on 01 October 2010.am201