Short Term Advantages of a Public-Private Partnership for Tuberculosis in Guinea Bissau: Reduction of Mortality and increased Diagnostic Capacity

Background: Tuberculosis (TB) is widespread in Africa, but weak health systems in developing countries, often display poor quality of care with delays in case identification, irrational therapy and drug shortage, clinical mismanagement, unnecessary expenditures for patients, reduced adherence and increased mortality. Public-private partnership has demonstrated to increase TB case detection, but less is known about its effects on quality of care, mortality and costs for hospitalized TB patients. Methods: Clinical outcomes and costs for TB patients at the TB National Reference Center of Bissau, in Guine Bissau, West Africa were determined during the first 5 months of the public-private management and compared to the ones of previous years when the hospitals was under  direct Government’s management. Results: 215 (2009) and 194 (2013) patients were admitted, respectively. Improvement (p<0.05) was observed in mortality reduction (21% vs 6%), analysis prescription and diagnosis (39% vs 100%), cause of death determination (50% vs 85%), treatment abandonment (15 vs 1). Direct costs for patients during TB diagnostic pathway and inpatient care were significantly reduced, 475 vs 0 USD. Conclusions: Public-private partnerships displays important short term benefits in National TB reference centers, even in post-conflict and low-resource countries. Further studies could aid in determining the overall long term benefits of  this type of cooperation and the specific characteristic of TB and concomitant hematologic and infectious diseases in TB admitted patients

Recent evolution of the Punta San Matteo serac (Ortles-Cevedale Group, Italian Alps)

This paper summarizes the main results of surveys carried out on the Punta San Matteo serac (Ortles-Cevedale Group, Italy). The monitoring campaigns mainly consisted in surveying the serac with a Total Station (over the period from July 2005 to November 2005) and with a laser scanner. The displacements of the unstable ice mass (about 12 m) and its geometry and volume (about 560,000 m') have been calculated. In addition several photographs collected during the field campaigns made it possible to describe the evolution of this unstable ice mass and recorded its partial collapse and gradual breaking into tiny parts. The air temperature trend was also evaluated; the serac displacements resulted not strongly correlated with temperature evolution and the main falling events occurred in the autumn and not in summer when air temperature reached the highest peaks

I-21 Current therapeutic guidelines in Duchenne Muscular Dystrophy to prolong life

Duchenne's myopathy is an X-linked disease with well defined evolutionary phases, characterized by degradation of the walking function, development of evolutive scoliosis and progressive decline of the respiratory function leading patients to premature death. In 1985 Y. Rideau in France carried out a new global therapeutic strategy for treatment of lower limb deformities, scoliosis deformity and progressive restrictive syndrome. The indication for surgery at the lower limbs is made very early, at the onset of the first signs of disease. The procedures are carried out at the same time and always bilaterally; they include: (i) hip section of superficial flexors; (ii) iliotibial band resection; (iii) subcutaneous tenotomy of semitendineous and gracilis; (iv) subcutaneous lengthening of Achilles tendons. In the post-operative period, the patient begins exercises of active and passive mobility in few days and after three weeks recovers his performances; ambulation will remain almost normal for several years. A comparison of two groups of patients, the first precociously operated on the lower limbs, the other one not operated, shows better performances in the operated group. The indications for surgical treatment of Duchenne scoliosis must be made after the loss of ambulation and not too late, to avoid the concurrent respiratory restrictive syndrome makes the patient inoperable. Over ten years ago, in Poitiers, a specific instrumentation for Duchenne scoliosis was created, providing for cylindrical rods fixed by peduncular screws at the sacro-lumbar level. On the dorso-lumbar level, the rod becomes flat to allow more flexibility of the trunk. The complications observed in a group of 55 patients operated for scoliosis, consisted in 2 cases of breaking of rods and 1 superficial infection. The surgery approach in DMD has the double aim to prolong the time of the autonomous ambulation and to avoid the evolution of scoliosis, limiting the harmful effects of the scoliosis on the respiratory function. However, the surgery alone is unable to prolong the life expectancy in these patients, without treating the restrictive respiratory syndrome, first by nasal ventilation and then by elective tracheotomy, essential for the survival of the patient

Discovery of new diketopiperazines inhibiting Burkholderia cenocepacia quorum sensing in vitro and in vivo

Burkholderia cenocepacia, an opportunistic respiratory pathogen particularly relevant for cystic fibrosis patients, is difficult to eradicate due to its high level of resistance to most clinically relevant antimicrobials. Consequently, the discovery of new antimicrobials as well as molecules capable of inhibiting its virulence is mandatory. In this regard quorum sensing (QS) represents a good target for anti-virulence therapies, as it has been linked to biofilm formation and is important for the production of several virulence factors, including proteases and siderophores. Here, we report the discovery of new diketopiperazine inhibitors of the B. cenocepacia acyl homoserine lactone synthase CepI, and report their anti-virulence properties. Out of ten different compounds assayed against recombinant CepI, four were effective inhibitors, with IC50 values in the micromolar range. The best compounds interfered with protease and siderophore production, as well as with biofilm formation, and showed good in vivo activity in a Caenorhabditis elegans infection model. These molecules were also tested in human cells and showed very low toxicity. Therefore, they could be considered for in vivo combined treatments with established or novel antimicrobials, to improve the current therapeutic strategies against B. cenocepacia

A (p,q)-deformed Landau problem in a spherical harmonic well: spectrum and noncommuting coordinates

A (p,q)-deformation of the Landau problem in a spherically symmetric harmonic potential is considered. The quantum spectrum as well as space noncommutativity are established, whether for the full Landau problem or its quantum Hall projections. The well known noncommutative geometry in each Landau level is recovered in the appropriate limit p,q=1. However, a novel noncommutative algebra for space coordinates is obtained in the (p,q)-deformed case, which could also be of interest to collective phenomena in condensed matter systems.Comment: 9 pages, no figures; updated reference