Diagnosis of tuberculosis in Ghana: The role of laboratory training

Objectives: The laboratory is considered the cornerstone of tuberculosis (TB) control programme. International review of Ghana’s programme in the late nineties identified the laboratory services as the weakestcomponent. Sputum smear microscopy (SSM) being the main method of diagnosing pulmonary TB in Ghana, the training objectives were to: (i) strengthen the knowledge and skills of laboratory personnel on SSM(ii) impart necessary techniques in biosafety and (iii) introduce a Quality Assurance (QA) system in order to strengthen SSM services.Methods: Personnel were selected for training during a nationwide situation analysis of SSM centres in 2000/2001. Four training sessions on SSM/QA were held between 2001/2004.Results: A total of 80 personnel were trained: 10 regional TB coordinators and 70 laboratory personnel. The participants upon return to their respective regions also organized training within their districts. This approach resulted in another 100 district TB coordinators and 200 laboratory personnel being trained. Improvement in smear preparation, staining and reading ability of the participants were observed during the post-test and subsequent visit to their respective laboratories. The training has led to strengthening of TB laboratory services in the country and has contributed to increase in case detection from 10,745 in 2000 to 11,827 in2004 and 14,022 in 2008. It was observed during the post-training follow-up and quarterly supervision visits that morale of the personnel was high.Conclusion: Continuous training and re-training of laboratory personnel on SSM and QA at regular intervals do play an important role for effective and efficient TB control programme

Mycobacterial species causing pulmonary tuberculosis At the korle bu teaching hospital, Accra,

Objective: Characterize mycobacterial species causing pulmonary tuberculosis (PTB) at the Korle-Bu Teaching Hospital in Ghana.Design: Sputum smear positive samples, two (2) from 70 patients diagnosed as having tuberculosis, after they had consented, were collected from the Korle-Bu Teaching Hospital Chest Clinic betweenJanuary and July 2003. Setting: Korle-Bu Teaching Hospital Chest Clinic, Accra. Results: Sixty-four mycobacterial isolates wereobtained and confirmed as members of Mycobacterium tuberculosis complex by colonial morphology and conventional biochemical assays. Fortyseven (73%) were M. tuberculosis, the human strain, 2 (3%) M. bovis, the bovine strain, 13 (20%) M. africanum I (West Africa type), and 2 (3%) M. africanum II (East Africa type). Conclusion: The results indicate that, there are various strains causing PTB at the Korle-BuTeaching Hospital and of great concern is M. bovis, which mostly causes extra-PTB in humans but found to cause PTB in this study. This calls for the need to conduct a nationwide survey using bothconventional and molecular techniques to characterize various mycobacterial species causing TB in Ghana. This will result in better understanding of the various strains circulating in the country andinform individual TB treatment regimen especially the inclusion or exclusion of pyrazinamide

Contribution of higher meson resonances to the electromagnetic π\pi-meson mass difference

Modifications of the DGMLY relation for calculation of electromagnetic $\pi$-meson mass difference based on the Chiral Symmetry Restoration phenomenon at high energies as well as the Operator Product Expansion of quark densities for vector ($\rho$) and axial-vector ($a_1$) meson fields difference are proposed. In the calculations higher meson resonances in vector and axial-vector channels are taken into account. It is shown that the inclusion of the first $\rho$ and $a_1$ radial excitations improves the results for electromagnetic $\pi$-meson mass difference as compared with the previous ones. Estimations on the electromagnetic $\rho$ and $a_1$-meson decay constants and the constant $L_{10}$ of effective chiral Lagrangian are obtained from the generalized Weinberg sum rules.Comment: Latex2e, 10 pages, submitted to Yad. Phy

Internal constraints and arrested relaxation in main-chain nematic elastomers

Abstract: Nematic liquid crystal elastomers (N-LCE) exhibit intriguing mechanical properties, such as reversible actuation and soft elasticity, which manifests as a wide plateau of low nearly-constant stress upon stretching. N-LCE also have a characteristically slow stress relaxation, which sometimes prevents their shape recovery. To understand how the inherent nematic order retards and arrests the equilibration, here we examine hysteretic stress-strain characteristics in a series of specifically designed main-chain N-LCE, investigating both macroscopic mechanical properties and the microscopic nematic director distribution under applied strains. The hysteretic features are attributed to the dynamics of thermodynamically unfavoured hairpins, the sharp folds on anisotropic polymer strands, the creation and transition of which are restricted by the nematic order. These findings provide a new avenue for tuning the hysteretic nature of N-LCE at both macro- and microscopic levels via different designs of polymer networks, toward materials with highly nonlinear mechanical properties and shape-memory applications

Multi-parametric assessment of the anti-angiogenic effects of liposomal glucocorticoids

Inflammation plays a prominent role in tumor growth. Anti-inflammatory drugs have therefore been proposed as anti-cancer therapeutics. In this study, we determined the anti-angiogenic activity of a single dose of liposomal prednisolone phosphate (PLP-L), by monitoring tumor vascular function and viability over a period of one week. C57BL/6 mice were inoculated subcutaneously with B16F10 melanoma cells. Six animals were PLP-L-treated and six served as control. Tumor tissue and vascular function were probed using MRI before and at three timepoints after treatment. DCE-MRI was used to determine Ktrans, ve, time-to-peak, initial slope and the fraction of non-enhancing pixels, complemented with immunohistochemistry. The apparent diffusion coefficient (ADC), T2 and tumor size were assessed with MRI as well. PLP-L treatment resulted in smaller tumors and caused a significant drop in Ktrans 48 h post-treatment, which was maintained until one week after drug administration. However, this effect was not sufficient to significantly distinguish treated from non-treated animals. The therapy did not affect tumor tissue viability but did prevent the ADC decrease observed in the control group. No evidence for PLP-L-induced tumor vessel normalization was found on histology. Treatment with PLP-L altered tumor vascular function. This effect did not fully explain the tumor growth inhibition, suggesting a broader spectrum of PLP-L activities

The role of steroids in the management of brain metastases: a systematic review and evidence-based clinical practice guideline

Do steroids improve neurologic symptoms in patients with metastatic brain tumors compared to no treatment? If steroids are given, what dose should be used? Comparisons include: (1) steroid therapy versus none. (2) comparison of different doses of steroid therapy. Target population These recommendations apply to adults diagnosed with brain metastases. Recommendations Steroid therapy versus no steroid therapy Asymptomatic brain metastases patients without mass effect Insufficient evidence exists to make a treatment recommendation for this clinical scenario. Brain metastases patients with mild symptoms related to mass effect Level 3 Corticosteroids are recommended to provide temporary symptomatic relief of symptoms related to increased intracranial pressure and edema secondary to brain metastases. It is recommended for patients who are symptomatic from metastatic disease to the brain that a starting dose of 4–8 mg/day of dexamethasone be considered. Brain metastases patients with moderate to severe symptoms related to mass effect Level 3 Corticosteroids are recommended to provide temporary symptomatic relief of symptoms related to increased intracranial pressure and edema secondary to brain metastases. If patients exhibit severe symptoms consistent with increased intracranial pressure, it is recommended that higher doses such as 16 mg/day or more be considered. Choice of Steroid Level 3 If corticosteroids are given, dexamethasone is the best drug choice given the available evidence. Duration of Corticosteroid Administration Level 3 Corticosteroids, if given, should be tapered slowly over a 2 week time period, or longer in symptomatic patients, based upon an individualized treatment regimen and a full understanding of the long-term sequelae of corticosteroid therapy. Given the very limited number of studies (two) which met the eligibility criteria for the systematic review, these are the only recommendations that can be offered based on this methodology. Please see “Discussion” and “Summary” section for additional details

ポップアップアーカイバルタグおよび超音波発信器で調べたエチゼンクラゲの遊泳深度

The swimming depths of 12 individual Nemopilema nomurai with bell diameters of 0.8-1.6 m were investigated using pop-up archival transmitting tags and ultrasonic pingers, and the validity of the research method was evaluated. The N. nomurai studied frequently showed vertical movement, with the swimming depth ranging from 0 to 176 m, The mean swimming depths of most individuals were less than 40 m. The swimming depths of N. nomurai in the northern Japan Sea in the winter were mostly deeper than those of this species in the southern Japan Sea in the autumn. This result suggests that the range of the depths almost depends on the vertical structure of the ocean. Swimming depths during the nighttime were significantly deeper than those during the daytime. More specifically, during the daytime, the swimming depths in the afternoon tended to be shallower than those in the morning, while during the nighttime, the swimming depths after midnight were deeper than those before midnight.エチゼンクラゲ計12個体の遊泳深度をポップアップタグや超音波発信器により調べるとともに，調査手法の妥当性を確認した。エチゼンクラゲは活発な鉛直移動を繰り返していた。遊泳深度は0～176m の範囲で，ほとんどの個体の平均遊泳深度は40m より浅かった。遊泳深度は秋の日本海南部よりも冬の日本海北部の方が深くなる傾向があり，基本的に滞在深度範囲は海洋の鉛直構造に依存していると推測された。遊泳深度は日中よりも夜間の方が深かった。日中には午前より午後の方が浅く，夜間には前半夜よりも後半夜の方が深くなる日周性が確認された