Suspicion Of Failure Research Articles

Plasmodium falciparum Multidrug Resistance-1 (pfmdr1) Gene Mutation in Adults Malaria Patients Attending Murtala Muhammad Specialist Hospital Kano, Northwest Nigeria

Suspicion of failure in the effectiveness of artemisinin-based combination therapies (currently the first-line treatment of malaria, worldwide) is leading to the unofficial use of alternative antimalarials, including chloroquine and sulfadoxine/pyrimethamine in Kano state northwestern Nigeria. To facilitate evidence-based resistance management, antimalarial resistance mutations were investigated in Plasmodium falciparum multidrug resistance-1 (pfmdr1) gene. Hundred adult patients comprising 43 males and 57 females were recruited for the study. The mean age of participants is 36.4 years, minimum and maximum ages were 16 and 60 years respectively, while 41% of them fall within the range of 16 to 30 years. Blood isolates were then analyzed for the presence of malaria parasite using microscopy, the results show a high prevalence of P. falciparum infection in the subject (30%). Pfmdr1 gene, a molecular marker of artemisinin resistance, was successfully sequenced in 21 out of 100 P. falciparum isolates collected from recruited participants. Pfmdr1 mutations were found in 19.5% (4/33) of the samples isolated. The prevalence of the Pfmdr1 N86Y allele was found in 4 samples whilst Y184F and D1246Y were not detected. A total of 4 non-synonymous mutations at codon N86Y were detected. The presence of these mutations highlights the challenges for malaria treatment in Kano state, northwestern Nigeria using antimalarials such as artemether lumefantrine, mefloquine, amodiaquine quinine and lumefantrine.

There's No Place Like Home(land) in American and Soviet Fantasy Cinema of 1939: The Wizard of Oz and Vasilisa the Beautiful

There's No Place Like Home(land) in American and Soviet Fantasy Cinema of 1939: <i>The Wizard of Oz</i> and <i>Vasilisa the Beautiful</i>

Polymorphism Analysis of pfmdr1 and pfcrt from Plasmodium falciparum Isolates in Northwestern Nigeria Revealed the Major Markers Associated with Antimalarial Resistance.

Suspicion of failure in the effectiveness of artemisinin-based combination therapies (currently the first-line treatment of malaria, worldwide) is leading to the unofficial use of alternative antimalarials, including chloroquine and sulfadoxine/pyrimethamine, across northern Nigeria. To facilitate evidence-based resistance management, antimalarial resistance mutations were investigated in Plasmodium falciparum multidrug resistance-1 (pfmdr1) and chloroquine resistance transporter (pfcrt), in isolates from Kano, northwestern Nigeria. Out of the 88 samples genotyped for pfmdr1 N86Y mutation using PCR/restriction fragment length polymorphism, one sample contained the 86Y mutation (86Yfrequency = 1.14%). The analysis of 610 bp fragments of pfmdr1 from 16 isolates revealed two polymorphic sites and low haplotype diversity (Hd = 0.492), with only 86 Y mutations in one isolate, and 184 F replacements in five isolates (184Ffrequency = 31.25%). The analysis of 267 bp fragments of pfcrt isolates revealed high polymorphism (Hd = 0.719), with six haplotypes and seven non-synonymous polymorphic sites. Eleven isolates (61.11%) were chloroquine-resistant, CQR (C72V73I74E75T76 haplotype), two of which had an additional mutation, D57E. An additional sequence was CQR, but of the C72V73M74E75T76 haplotype, while the rest of the sequences (33.33%) were chloroquine susceptible (C72V73M74N75K76 haplotype). The findings of these well characterized resistance markers should be considered when designing resistance management strategies in the northwestern Nigeria.

Thrust Control Systems of Propulsion and their Verification on Dynamically Positioned Vessels

Abstract Thrust vector control systems of propulsion systems of dynamic positioning vessels are commonly applied on vessels with DP2 and DP3 class of DP. It was submitted the ways of providing information to dynamic positioning operator DPO about detecting of suspicion of failure in specific thruster and shown the ways of response in such situations. In the case of failure and shut down one of working thrusters, it must be done the possibility assessment of continuation of DP system safe operation. If such situation is not possible, it should be considered the work of DP system on limitations. It was indicated on safety threats during operation of DP systems resulting from system failure or even the design faults. It commonly applies the failure mode and effect analysis (FMEA or FMECA) from the design phase through sea trials until to the verification process during operation. It allows the elimination of majority of faults in the DP systems. It was communicated the basic conditions of safe operation of vessels with DP systems and the examples of conditions which releasing the readiness signal of DP propulsion system elements. Observed development of control and automatics systems will result in increasing the safety of DP systems operation.

Mandatory Folic Acid Food Fortification to Prevent Neural Tube Defects: The Pro or Con Debate

Neural tube defects are the second most common congenital anomaly. Among the known risk factors, low levels of folic acid rank first as responsible for the majority of cases recorded worldwide. In 1986, the mandatory folic acid food fortification in the U.S.A. led to dramatic reduction of disease incidence, while for many people it was considered as one of the most successful interventions in the history of public health promotion. Despite the satisfactory results from all countries that adopted similar policies, a significant number of countries, including the EU, preferred alternative ways to address it, considering the very limited safety data for such an intervention. Today, after 20 years of mandatory fortification from a sufficiently representative sample (1/3 of the planet), the necessity to apply this at global level should probably be reviewed, since until now no correlation with unfavourable impacts has been demonstrated. Objective of the present review was to assess the necessity of mandatory folic acid food fortification in the context of congenital neural tube defects (NTDs) prevention. Material – Method : an extensive search in the electronic database PubMed was performed. Animal or in vivo studies and articles were excluded, due to the inability to draw conclusions that is frequently observed, as well as the strong suspicion of failure to respond to clinical data. Furthermore, part of the studies was derived from searches to the References of the articles of the aforementioned database. Conclusions : the decision of mandatory folic acid food fortification should be determined by specific factors as: disease prevalence, rates of planned pregnancies, efficiency of existing measures to decrease significantly the overall disease’s incidence and the folate level in the general population.

Tuberculosis multidrogorresistente en un hospital urbano marginal de lima 2006-2008

La tuberculosis es un problema de salud pública en el mundo y en el Perú, agravado por las formas multidrogo (TB-MDR) y extensivamente resistentes (TB-XDR). Los objetivos del estudio fueron describir la resistencia a las drogas antituberculosas y los factores de riesgo para TB-MDR en un establecimiento de Salud Urbano Marginal del 2006 al 2008. Es un estudio de reporte de casos realizado en el Hospital de Huaycán, distrito de Ate Vitarte, provincia de Lima. Los datos se obtuvieron del Libro de Registro y Seguimiento de Pacientes con TB-MDR, de las Tarjetas de Control de Tratamiento y de las Historias clínicas. Se reportaron 61 casos de TB-MDR, uno de TB-XDR y 7 monorresistentes; 38 fueron varones (55%) y 31 mujeres (45%); el grupo de edad más afectado fue de 15-34 años con 55 casos (79,6%). Los factores de riesgo más frecuentes fueron la sospecha de fracaso del esquema uno de tratamiento (SF1, 34 casos, 49%), el fracaso del esquema uno (F1, 14 casos, 20%) y el antecedente de haber sido contacto de un caso de TB-MDR (C-TB-MDR, 12 casos, 17%); 76% de los casos tuvieron resistencia entre 2 a 5 drogas y 13% entre 6 a 9. Se reportaron 32 patrones diferentes de resistencia a drogas. Todos los casos fueron tratados con esquemas individualizados, 41 casos fueron curados (59,4%), 16 abandonaron (23,2%) y 6 fallecieron (8,7%). Se concluye que la TB-MDR afecta a la población joven; entre los factores de riesgo se encuentran la sospecha de fracaso y el fracaso del esquema uno, y el haber tenido contacto con un paciente de TB-MDR; los perfiles de resistencia son múltiples y variados.

Endogenous reactivation and true treatment failure as causes of recurrent tuberculosis in a high incidence setting with a low HIV infection

To determine the relative frequencies of reinfection vs. reactivation or treatment failure in patients from a high tuberculosis incidence setting with a low prevalence of HIV infection. We performed DNA fingerprinting on serial isolates from one and multiple TB episodes from 97 retreatment patients; 35 patients had been previously cured, whereas 62 had not. DNA fingerprinting patterns of recurrence Mycobacterium tuberculosis isolates of 5 of the 35 previously cured patients did not match with those of the corresponding initial isolates, indicating reinfection. We did not document reinfection during treatment. Isolates from each of the remaining 30 previously cured patients had identical DNA fingerprinting results, indicating reactivation. DNA fingerprinting patterns of isolates from the 62 patients with persistently positive sputum smears were identical, suggesting treatment failure. These findings suggest that reinfection is not a common cause of relapse and treatment failure in this rural predominantly HIV-free population despite the high incidence of TB.

Trypanocidal failure suggested by PCR results in cattle field samples

The aim of this study was to assess, whether polymerase chain reaction (PCR) allows sensitive screening of treatment failure suspicions in areas, where drug resistance against African animal trypanosomosis (AAT) appears to be a problem. PCR was used to detect trypanosome infections prior to, 14 and 28 days after controlled treatment of 738 cattle from 10 villages in Kénédougou, Burkina Faso with isometamidium chloride and diminazene aceturate. Using three sets of primers, PCR was three–four times more sensitive and better at species identification, than standard microscopic examination. The better sensitivity and species specificity of PCR have important advantages for drug resistance studies in the field.

The Removal of Foreign Bodies from the Eye.

Burlington, Iowa, Aug. 25, 1902. To the Editor: —I would like to add a brief supplement to my remarks in the discussion of Dr. Sweet's paper at the Saratoga meeting. By reference to these remarks it will be seen that I reported a case of foreign body in the eye in which I felt that the x -ray photography was of the character criticised by Dr. Lippincott in the same discussion. My suspicion of failure in the x -ray work was borne out by the subsequent history of the case, which is as follows: On my return home the 1st of July I found that the eye was becoming soft and shrunken and had every sign of chronic cyclitis. I thereupon enucleated it. The foreign body, which was shown in the picture exhibited, as apparently high up in the globe or in the orbit (as the photographer said) was really