Analysis of trends in total and aidsrelated deaths certified at Mosvold Hospital, Ingwavuma, KwaZulu-Natal, from 2003 to 2008

Objectives. To analyse mortality trends from deaths registered at Mosvold Hospital, Ingwavuma, KwaZulu-Natal, and possible impact of programmes to treat and prevent HIV infection. Design. Longitudinal study of death certifications from 2003 to 2008. Setting. Mosvold Hospital mortuary, Ingwavuma. Subjects. Counterfoils of form 83/BI-1663, Notification/Register of Death/Stillbirths (Republic of South Africa, Department of Home Affairs), completed at Mosvold Hospital from January 2003 to December 2008. Outcome measures. Age at death, cause of death, patterns of deaths grouped by age, gender and cause of death. Results. AIDS-related deaths were the cause of 53% of deaths, particularly affecting the 20 - 59-year and under-5 age groups. Since 2005 there has been a decline in deaths in the 20 - 59 age group and an increase in average age at death. Conclusions. The decrease in mortality from 2005 may be associated with antiretroviral roll-out reducing mortality from AIDS-related illnesses

Impact of HIV/AIDS on deaths certified at Mosvold Hospital, Ingwavuma, Northern KwaZulu- Natal from January to August 2003

An analysis of the causes of death certified at Mosvold Hospital, Ingwavuma demonstrates the impact of HIV/AIDS in the region. HIV/AIDS appears to be responsible for about 45% of registered deaths in both males and females after the age of nine years. There is a significant difference in the mean age at death between males and females succumbing to the disease after the age of nine years: the average age at death of females from HIV/AIDS is 35 years, and the average age for males is 40 years. The younger average age of death from HIV/AIDS in females, together with a higher expected age of death from non-HIV causes, means that females lose considerably more years of life due to HIV/AIDS than males. The figures for this part of northern KwaZulu-Natal indicate a higher impact of HIV/AIDS on deaths than in previous assessments for South Africa as a whole.SA Fam Pract 2005;47(1): 51-5

Audit of efficacy of CoartemTM to clear plasmodium falciparum malaria parasitaemia at single forty-two day follow-up

Background; A study, which included a follow-up study, was undertaken to assess the efficacy of CoartemTM tablets (20 mg artemether and 120 mg lumefantrine – Novartis South Africa (Pty) Ltd) to clear plasmodium falciparum malaria parasitaemia at a single 42-day follow-up, with 42 days being chosen in order to detect early emergence of resistance. The study was done at Ndumo Clinic and Mosvold Hospital in the Ingwavuma District of KwaZulu-Natal, South Africa in January/February 2002. Method: The study included 37 patients presenting to Ndumo Clinic and two presenting to Mosvold Hospital with uncomplicated malaria diagnosed by symptoms and a positive immunochromographic test (ICT) for plasmodium falciparum. The main outcome measures were done using a Trophozoite count on thick film and polymerase chain reaction parasite analysis of blood spot at day 42. Results: Only 31 of the 37 recruited patients were confirmed to be suffering from malaria by polymerase chain reaction (PCR). Of the 31, 24 returned for follow-up. One patient had parasitaemia at day 33, but tested negative at day 42 after re-treatment with Coartem™. It was not determined whether this patient was suffering from a recrudescence or re-infection of falciparum malaria. All the other returning patients tested negative for falciparum malaria on blood film and PCR examination. Conclusions : CoartemTM still appears to be an effective treatment for falciparum malaria. Regular assessment of its efficacy is desirable. For full text, click here:SA Family Pract 2004;46(6): 21-2

Audit of failure rate of sulfadoxine/pyrimethamine combined with chloroquine to treat falciparum malaria at single fourteen-day follow-up

Objective. To assess the failure rate of the present first line treatment regime for uncomplicated falciparum malaria of sulfadoxine/pyrimethamine combined with chloroquine. Design. A before-after study1 Setting. Ndumo Clinic, Ingwavuma District, South Africa, October 2000 Study Group. 55 patients presenting to Ndumo clinic with uncomplicated malaria and malaria trophozoites visible on thin film. Main outcome measures:Trophozoite count on thick film at day 14. Results. 15 out of 37 patients who returned for follow-up still had trophozoites on thick film. Symptoms of most patients at day 0 and day 14 were mild, parasite counts before and after treatment were low, and trophozoites were atypical. Conclusions. There appears to be an unacceptably high day 14 failure rate with the combination of sulfadoxine/pyrimethamine and chloroquine.The mildness of symptoms, low parasite counts and atypical trophozoites suggest immunity to falciparum malaria amongst the local population. With few antimalarials to chose from, the difficult question as to future treatment of uncomplicated malaria arises. Keywords: Falciparum malaria, chloroquine, sulfadoxine, pyrimethamine SA Fam Prac Vol.25(3) 2002: 4-

Cellular mechano-environment regulates the mammary circadian clock

Circadian clocks drive B24 h rhythms in tissue physiology. They rely on transcriptional/ translational feedback loops driven by interacting networks of clock complexes. However, little is known about how cell-intrinsic circadian clocks sense and respond to their microenvironment. Here, we reveal that the breast epithelial clock is regulated by the mechano-chemical stiffness of the cellular microenvironment in primary cell culture. Moreover, the mammary clock is controlled by the periductal extracellular matrix in vivo, which contributes to a dampened circadian rhythm during ageing. Mechanistically, the tension sensing cell-matrix adhesion molecule, vinculin, and the Rho/ROCK pathway, which transduces signals provided by extracellular stiffness into cells, regulate the activity of the core circadian clock complex. We also show that genetic perturbation, or age-associated disruption of self-sustained clocks, compromises the self-renewal capacity of mammary epithelia. Thus, circadian clocks are mechano-sensitive, providing a potential mechanism to explain how ageing influences their amplitude and function

UK-68,798, A Class III Antiarrhythmic Drug with Antifibrillatory Properties

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74787/1/j.1527-3466.1992.tb00244.x.pd

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV

The performance of muon reconstruction, identification, and triggering in CMS has been studied using 40 inverse picobarns of data collected in pp collisions at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection criteria covering a wide range of physics analysis needs have been examined. For all considered selections, the efficiency to reconstruct and identify a muon with a transverse momentum pT larger than a few GeV is above 95% over the whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4, while the probability to misidentify a hadron as a muon is well below 1%. The efficiency to trigger on single muons with pT above a few GeV is higher than 90% over the full eta range, and typically substantially better. The overall momentum scale is measured to a precision of 0.2% with muons from Z decays. The transverse momentum resolution varies from 1% to 6% depending on pseudorapidity for muons with pT below 100 GeV and, using cosmic rays, it is shown to be better than 10% in the central region up to pT = 1 TeV. Observed distributions of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO

Performance of the CMS Cathode Strip Chambers with Cosmic Rays

The Cathode Strip Chambers (CSCs) constitute the primary muon tracking device in the CMS endcaps. Their performance has been evaluated using data taken during a cosmic ray run in fall 2008. Measured noise levels are low, with the number of noisy channels well below 1%. Coordinate resolution was measured for all types of chambers, and fall in the range 47 microns to 243 microns. The efficiencies for local charged track triggers, for hit and for segments reconstruction were measured, and are above 99%. The timing resolution per layer is approximately 5 ns