scholarly journals A Mycobacterium tuberculosis Specific IgG3 Signature of Recurrent Tuberculosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Stephanie Fischinger ◽  
Deniz Cizmeci ◽  
Sally Shin ◽  
Leela Davies ◽  
Patricia S. Grace ◽  
...  
Keyword(s):  
South Africa ◽  
Mycobacterium Tuberculosis ◽  
Protective Immunity ◽  
Potential Role ◽  
Recurrent Disease ◽  
Humoral Response ◽  
Correlates Of Protection ◽  
Previously Treated ◽  
Recurrent Tuberculosis

South Africa has the highest prevalence of HIV and tuberculosis (TB) co-infection globally. Recurrent TB, caused by relapse or reinfection, makes up the majority of TB cases in South Africa, and HIV infected individuals have a greater likelihood of developing recurrent TB. Given that TB remains a leading cause of death for HIV infected individuals, and correlates of TB recurrence protection/risk have yet to be defined, here we sought to understand the antibody associated mechanisms of recurrent TB by investigating the humoral response in a longitudinal cohort of HIV co-infected individuals previously treated for TB with and without recurrent disease during follow-up, in order to identify antibody correlates of protection between individuals who do not have recurrent TB and individuals who do. We used a high-throughput, “systems serology” approach to profile biophysical and functional characteristics of antibodies targeting antigens from Mycobacterium tuberculosis (Mtb). Differences in antibody profiles were noted between individuals with and without recurrent TB, albeit these differences were largely observed close to the time of re-diagnosis. Individuals with recurrent TB had decreased Mtb-antigen specific IgG3 titers, but not other IgG subclasses or IgA, compared to control individuals. These data point to a potential role for Mtb-specific IgG3 responses as biomarkers or direct mediators of protective immunity against Mtb recurrence.

Use of gemcitabine plus vinorelbine (GV) to treat advanced and metastatic non-small cell lung cancer (NSCLC) in second line after recurrent disease

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e19104-e19104
Author(s):  
M. B. Gamaz ◽  
K. Bouzid
Keyword(s):  
Advanced Nsclc ◽  
Squamous Cell Cancer ◽  
Recurrent Disease ◽  
Cell Cancer ◽  
Objective Response ◽  
Second Line ◽  
First Line ◽  
Stage Disease ◽  
Previously Treated

e19104 Background: Docetaxel is approved as second-line monotherapy in advanced NSCLC. In this study, we evaluate the efficacy, safety and survival of gemcitabine + vinorelbine in patients with advanced NSCLC previously treated with platine salts + taxane. Methods: From January 2007 to October 2008, twenty three patients with NSCLC stage IIIB or IV who received platine salts + taxane in first line were treated in second line with (GV) gemcitabine (G) 1,250 mg/m2 D1 and D8 + vinorelbine (V) 25 mg/m2 D1 and D8 every three weeks. Twenty one male and 2 female, median age was 59.3 (range 40 -71) years. Twelve (12) patients had IIIB stage and 11 patients had IV stage disease. Squamous cell cancer was found in 12 patients, adenocarcinoma in 11 patients. Results: No objective response were observed, stable disease was achieved in 7 (30.4 %) patients, and disease progression was observed in 16 (69.5 %) patients. Toxicities grade ¾ was 15 %, mainly hematological (leucopenia and anemia). Median follow up was 14 months, median TTP was 6 months and median survival was 7.1 months. Conclusions: Gemcitabine + Vinorelbine could be another alternative for treatment of NSCLC in second line after recurrent disease when first line chemotherapy is platine + docetaxel. No significant financial relationships to disclose.

Knowledge about Newborn Discharge Follow-up in Cape Town, South Africa

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 393A-393A
Author(s):  
KaWing Cho ◽  
Jean P Milambo ◽  
Leonidas Ndayisaba ◽  
Charles Okwundu ◽  
Abiola Olowoyeye ◽  
...  
Keyword(s):  
South Africa ◽  
Cape Town

Nonsurgical Endodontik Retreatment of Maxillary First Premolar

DENTA ◽  
2017 ◽  
Vol 11 (1) ◽  
pp. 88
Author(s):  
Yongki Hadinata W ◽  
Karlina Samadi
Keyword(s):  
Root Canal ◽  
Radiographic Examination ◽  
Periapical Lesion ◽  
First Choice ◽  
Periapical Abscess ◽  
Dental Hospital ◽  
Conservative Dentistry ◽  
Previously Treated ◽  
Endodontic Retreatment

<p><strong><em>Background :</em></strong><em> There are some factors can cause endodontic failure such as inadequate in cleaning or shaping step, non hermetic obturation, or poor restoration, which can cause bacteria multiply. <strong>Purpose :</strong> To report the management of endodontic failure with nonsurgical treatment. <strong>Case :</strong> 46-year-old woman came to Airlangga Dental Hospital Conservative Dentistry Department to treat her upper right tooth which show symptomatic pain in the last 2 weeks. The tooth has been treated and crowned with porcelain fused to metal about 10 years ago. Clinical examination show the presence of fistula on premolar buccal gingiva, react to percussion.  Radiographic examination show not hermetic obturation in one root canal and radiolucency in the periapical area. The diagnosis for maxillary first premolar is previously treated tooth with chronic periapical abscess.. <strong>Treatment :</strong> Crown and post was removed from the tooth, and endodontic retreatment was done. Follow up 6 months after the retreatment show no reaction to percussion, and radiographic examination show no enlargement periapical lesion. <strong>Conclusion :</strong> Nonsurgical endodontic retreatment always become the first choice to resolve endodontic failure for previously treated tooth.</em></p><p><strong><em>Keywords :</em></strong><em> endodontic failure, maxillary first premolar, nonsurgical endodontic retreatment</em></p><p><strong><em>Correspondence:</em></strong><em> Yongki Hadinata W., drg. PPDGS Ilmu Konservasi Gigi Fakultas Kedokteran Gigi Universitas Airlangga, Surabaya. Jl. Mayjen. Prof. Dr. Moestopo No. 47, Surabaya.</em></p>

scholarly journals Evaluation of adherence monitoring system using evriMED with a differentiated response compared to standard of care among drug-sensitive TB patients in three provinces in South Africa: a protocol for a cluster randomised control trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Noriah Maraba ◽  
Catherine Orrell ◽  
Candice M. Chetty-Makkan ◽  
Kavindhran Velen ◽  
Rachel Mukora ◽  
...  
Keyword(s):  
South Africa ◽  
Treatment Success ◽  
Standard Of Care ◽  
Treatment Completion ◽  
Phone Call ◽  
Randomised Control Trial ◽  
Improve Medication Adherence ◽  
Tb Treatment ◽  
Differentiated Care

Abstract Background South Africa has achieved drug-susceptible TB (DS-TB) treatment success of only 77% among people with new and previously treated TB. Alternative approaches are required to improve medication adherence and treatment completion to limit transmission, TB relapse and the development of resistance. This study aims to implement and evaluate the use of adherence medication monitors (Wisepill evriMED 1000) with a differentiated response to patient care, among DS-TB patients in three provinces of South Africa. Methods In total, 18 public health clinics across three provinces were selected. Clinics were randomised to intervention or standard of care clinics. In each clinic, approximately 145 DS-TB patients are being enrolled to reach a total of 2610. All patients have their daily adherence monitored using medication monitors. In the intervention arm, patients are receiving medication monitor reminders and differentiated care in response to adherence data. This weekly review of daily real-time monitoring will be undertaken from a central database. The differentiated care model includes automated SMS reminders with a missed dose, research staff-initiated phone call to the patient with a second or third missed dose, a home visit if four or more doses are missed, and motivational counselling if four or more doses are missed repeatedly. Fidelity of the intervention will be measured through process evaluation. Patients in control clinics will receive medication monitors for adherence tracking, standard of care TB education, and normal clinic follow-up procedures. The primary outcome is the proportion of patients by arm with >80% adherence, as measured by the medication monitor. The feasibility and acceptability of the intervention will be assessed by in-depth interviews with patients, stakeholders, and study staff. A cost effectiveness analysis of the intervention and standard of care clinics will be conducted. Significance This trial will provide evidence for the use of an intervention, including medication monitors and differentiated care package, to improve adherence to TB treatment. Improved adherence should also improve TB treatment completion rates, thus reducing loss to follow-up rates, and TB relapse among people with TB. The intervention is intended to ultimately improve overall TB control and reduce TB transmission in South Africa. Trial registration Pan African Trial Registry PACTR201902681157721. Registered on 11 February 2019.

scholarly journals Teaching Mathematics during the COVID-19 Lockdown in a Context of Historical Disadvantage

2021 ◽  
Vol 11 (4) ◽  
pp. 177
Author(s):  
Brantina Chirinda ◽  
Mdutshekelwa Ndlovu ◽  
Erica Spangenberg
Keyword(s):  
South Africa ◽  
South African ◽  
Mathematics Teachers ◽  
Education System ◽  
Teaching And Learning ◽  
Face To Face ◽  
Global Pandemic ◽  
Education Community ◽  
South African Education

The COVID-19 global pandemic widely affected education across the world and engendered unprecedented scenarios that required expeditious responses. In South Africa, the pandemic came on top of pre-existing inequalities in the education system. Using a qualitative research method of exploratory and descriptive nature, this study engaged a social justice framework to explore the teaching and learning of mathematics during the COVID-19 lockdown in a context of historical disadvantage. A sample of twenty-three Grade 12 mathematics teachers at various public secondary schools in Gauteng, South Africa was used in the study. The teachers were selected through purposive sampling. A Google-generated open-ended questionnaire and follow-up telephonic interviews were used to collect data. Data were analysed thematically in five steps. The findings revealed that the WhatsApp platform is a valuable tool that can support the teaching and learning of mathematics beyond the classroom in the contexts of historical disadvantage. The findings also provided insights into how mathematics teachers became learners themselves during emergency remote teaching (ERT) as they had to adapt to digital teaching, find solutions to unfamiliar problems and acquire knowledge from a larger mathematics education community around the globe. The article discusses these findings and teachers’ challenges of transitioning from traditional face-to-face classrooms to ERT and how they were addressed. At the time of publishing the article, most learners in South Africa had started going to school on a rotational basis. Nonetheless, the study reported in this article is of importance as ERT in the context of historical disadvantage has foregrounded issues of inequality in the South African education system that must be dealt with urgently.

scholarly journals Early clinical experience with the p48MW HPC and p64MW HPC flow diverters in the anterior circulation aneurysm using single anti-platelet treatment

2021 ◽  
pp. 159101992110295
Author(s):  
Pervinder Bhogal ◽  
Andrey Petrov ◽  
Ganbaatar Rentsenkhu ◽  
Baatarjan Nota ◽  
Erdenebat Ganzorig ◽  
...  
Keyword(s):  
Clinical Results ◽  
Dome Height ◽  
Anterior Circulation ◽  
Post Procedure ◽  
Neurological Morbidity ◽  
Procedural Complications ◽  
Previously Treated ◽  
Flow Diverters ◽  
Overall Mortality

Background The p64MW HPC and p48MW HPC flow diverters have reduced thrombogenicity due to hydrophilic coating. The purpose of this study was to evaluate its safety and efficacy in Mongolian patients under single antiplatelet therapy (SAPT) with prasugrel. Materials and methods We performed a retrospective review of patients enrolled into our prospectively maintained database to identify all patients treated with either the p48MW HPC or p64MW HPC under SAPT. We recorded baseline demographics, aneurysm size and location, procedural complications, angiographic and clinical results. Results 24 patients, (female = 21, 87.5%), age 48.2 ± 11.6 years (range 25–63) underwent treatment of 30 aneurysms with either p64MW HPC or p48MW HPC. All aneurysms were saccular with dome width 8.2 ± 6.5 (range 1.6–26.0 mm) and dome height 7.6 ± 6.7 (range 1.6–30.0 mm). None of the aneurysms were previously treated. The average PRU was 54.6 ± 31.2 (range 1–127) on pre-operative VerifyNow testing. Angiographic follow-up was available for 13 patients (17 aneurysms), 183 ± 36 days post-procedure, at which point 64.7% of aneurysms (n = 11/17) were completely occluded and 11.8% (n = 2/17) had only neck remnants resulting in 76.5% of aneurysms being adequately occluded A single intra-operative complication (4.2%) occurred however all patients were mRS ≤1 at last follow-up. There were two post-operative complications neither of which resulted in permanent neurological morbidity. There were no instances of post-operative aneurysmal rupture or delayed parenchymal haemorrhage. The overall mortality was 0%. Conclusion The efficacy and safety of p64MW HPC coated devices under SAPT is similar to uncoated flow diverters that require DAPT.

scholarly journals Severe hypercalcaemia early after kidney transplantation in two patients with severe secondary hyperparathyroidism previously treated with etelcalcetide

2021 ◽  
Author(s):  
Guillaume Dachy ◽  
Jean-Michel Pochet ◽  
Laura Labriola ◽  
Antoine Buemi ◽  
Valentine Gillion ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Significant Proportion ◽  
High Serum ◽  
Mineral And Bone Disorder ◽  
Parathyroid Adenomas ◽  
Bone Disorder ◽  
Previously Treated ◽  
Severe Hypercalcaemia

Abstract Cinacalcet and, more recently, etelcalcetide revolutionized the treatment of chronic kidney disease–mineral and bone disorder (CKD–MBD). Kidney transplant (KT) usually improves CKD–MBD. However, a significant proportion of KT recipients have high serum calcium levels, not requiring any treatment. We report two patients previously treated with etelcalcetide who developed severe (&gt;3.3 mmol/L) hypercalcaemia in the early post-KT course, requiring parathyroidectomy. Pathological studies showed parathyroid adenomas and hyperplasia. One patient had a graft biopsy showing numerous intratubular calcium phosphate crystals. These observations should prompt pharmacovigilance studies and careful follow-up of KT recipients previously treated with etelcalcetide.

Rapid growth of myxoid leiomyosarcoma of the vulva during pregnancy: a case report

2004 ◽  
Vol 14 (1) ◽  
pp. 172-175 ◽  
Author(s):  
A. R. Di Gilio ◽  
G. Cormio ◽  
L. Resta ◽  
C. Carriero ◽  
V. Loizzi ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Smooth Muscle ◽  
Case Report ◽  
Lymph Node ◽  
Cesarean Section ◽  
Recurrent Disease ◽  
Node Dissection ◽  
Smooth Muscle Tumors ◽  
Vulvar Mass

Smooth muscle tumors arising in the vulva are rare. Leiomyosarcoma is the most common variant of vulvar sarcoma, and very few cases have been reported during pregnancy. A 36-year-old woman presented with a progressively enlarging vulvar mass during pregnancy, diagnosed as a Bartholin's gland cyst. The lesion was resected at 38 weeks of gestation during cesarean section and diagnosis of myxoid leiomyosarcoma of the vulva was made. Six weeks later the patients were referred to our center and submitted to wide vulvar excision with groin lymph node dissection that revealed the presence of a small residual focus of leiomyosarcoma. At 30 months of follow-up the patient was well without any sign of recurrent disease. Leiomyosarcoma should be included in the differential diagnosis of vulvar masses; progressively enlarging vulvar lesion should be biopsied even during pregnancy. Leiomyosarcoma should be considered in the differential diagnosis of vulvar mass.

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