83 research outputs found
Positron emission tomography in infections associated with immune dysfunction
No full textThis thesis explores the role of Positron Emission Tomography (PET) in infections associated with immune dysfunction. PET is a medical imaging technique that images biological processes in the body. Whole body PET provides 3-dimensional images which allows it to display infections from various regions and deep within the body cavity. The thesis examined three infections: Human immunodeficiency virus (HIV), tuberculosis (TB) and invasive fungal infections (IFIs). All three infections require treatment over long periods of time and usually require monitoring of the efficacy of the treatment or the side effects of some drugs. In HIV, PET can evaluate and follow-up infections and malignancies associated with HIV. The metabolic uptake in the lymph nodes reflects viral replication and allows staging of HIV. In TB and IFIs, PET provides detection of early sites of infection and all sites of disease in the body in a single examination, and allows monitoring of treatment of these infections. Monitoring of infections is useful in complex IFIs and TB, where traditional methods of monitoring are often suboptimal.PET was found to have a predictive value in both TB and IFIs, which can help clinicians consider different treatment options early in the course of infection. PET imaging is done with different tracers which allow evaluation of different biochemical processes in the body. In the thesis, the advantages of imaging TB with different tracers and the potential role of imaging hypoxia in TB were explored
Outcome of Radioiodine Therapy in a West African Population
No full textHyperthyroidism continues to be a pressing public health concern in West Africa. Its prevalence in Africa has been quoted as 1.2%-9.9%, with Graves' disease as its most common cause. Radioiodine-131 (RAI) therapy of hyperthyroidism recently commenced in two government hospitals in Ghana and Nigeria. This is a retrospective analysis of consecutive patients treated with RAI for primary hyperthyroidism at the National Centre for Radiotherapy and Nuclear Medicine (NCRNM) from 2008-2013, and in the University College Hospital (UCH) from 2006-2013. Cure was defined as euthyroidism or hypothyroidism occurring at 6 months post-RAI. Data were analysed using SPSS version 21 and Epi Info version, categorical data were evaluated with the Chi-square test and Fisher's exact test. 94 patients were studied, aged 20-74 years; 78 were females, and 16 were males. 38 were Ghanaian and 56 Nigerian. The presence of thyroid-associated ophthalmopathy (TAO) made cure less likely (χ2 P = 0.006, odds ratio = 0.118; 95% confidence interval, 0.027-0.518). Other factors assessed proved to be insignificant. Our findings suggest that hyperthyroid patients with TAO will benefit from a higher RAI dose than their counterparts without TAO
Exploring critical road project delay factors in Ghana
No full text
Purpose
The purpose of this paper is to investigate the causes of road construction delays in Ghana and identify appropriate mitigation measures.
Design/methodology/approach
The initial approach involved an empirical analysis of 48 road projects to quantify the extent of time. This was followed by a survey of the perception of road agency and donor partner officials of the critical causes of road project delays.
Findings
About 70 per cent of road projects experience delays and 52 per cent experience cost overruns. The average time overrun and cost overruns of road projects in Ghana was 17 months and US$1.15m (or 22.5 per cent), respectively. The five most critical causes of road construction delays were delay in finance and payment of completed work by owner (client-related); inadequate contractor experience (contractor-related); changes in scope by the owner during construction (client-related); delay to furnish and deliver the site to the contractor (client-related); and inflexible funding allocation for project items (donor-related).
Research limitations/implications
The most critical constraint of this study is the fact that findings are based on only the views of industry professional experts. It may be assumed that despite using broadly used terminology to refer to the causes of project delays, the interpretations by respondents may have differed from those intended. Further research could look at the correlation between time overrun and cost overrun using principle component analysis.
Practical implications
The identified delay factors are not unique to the road sector. From both academic and practical perspectives, the results emphasizes on the need for a holistic and integrated risk management model for the entire construction industry in Ghana.
Originality/value
The paper examined the causes of road project delays in the Ghanaian context and recommended remedial measures.
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Reply: Molecular Imaging of Bacteria in Patients Is an Attractive Fata Morgana, Not a Realistic Option
No full textGenesis 1:1-3 in Selected Akan Mother-tongues: A Grammatico-syntactic Analysis
No full textThe translation of the Bible message from the original language to a receptor language has been challenging due to the lack of equivalent words in the receptor language to convey the exact meaning of the original language. This can sometimes distort the original meaning and create ambiguity in the receptor community. In some Akan dialects such as Asante-Twi, Akuapim-Twi, and Bono-Twi, the translation of Genesis 1:1-3 presents recognizable translational challenges when compared with the Masoretic Text. For instance, all the selected Akan dialects translated the Hebrew word bereshit, “In the beginning,” as independent in relation to other parts of the first sentence. However, this paper argued that rendering bereshit, with no indication of the temporal dependent relationship function of the clause within the sentence thus without any circumstantial sense, limits the meaning of the sentence and is inconsistent with the source text. Employing grammatical and syntactical analysis, the paper identified some translational inconsistencies in the selected Akan mother-tongue Bibles and accordingly proposed alternative renderings for readers
Monitoring Response to Therapy
No full textMonitoring response to treatment is a key element in the management of infectious diseases, yet controversies still persist on reliable biomarkers for noninvasive response evaluation. Considering the limitations of invasiveness of most diagnostic procedures and the issue of expression heterogeneity of pathology, molecular imaging is better able to assay in vivo biologic processes noninvasively and quantitatively. The usefulness of F-18-FDG-PET/CT in assessing treatment response in infectious diseases is more promising than for conventional imaging. However, there are currently no clinical criteria or recommended imaging modalities to objectively evaluate the effectiveness of antimicrobial treatment. Therapeutic effectiveness is currently gauged by the patient's subjective clinical response. In this review, we present the current studies for monitoring treatment response, with a focus on Mycobacterium tuberculosis, as it remains a major worldwide cause of morbidity and mortality. The role of molecular imaging in monitoring other infections including spondylodiscitis, infected prosthetic vascular grafts, invasive fungal infections, and a parasitic disease is highlighted. The role of functional imaging in monitoring lipodystrophy associated with highly active antiretroviral therapy for human immunodeficiency virus is considered. We also discuss the key challenges and emerging data in optimizing noninvasive response evaluation. (C) 2017 Elsevier Inc. All rights reserved
New Imaging Tracers for the Infected Diabetic Foot (Nuclear and Optical Imaging)
No full textDiabetic Foot Infections (DFIs) are associated with increased morbidity, an economic burden on patients, their families and healthcare systems and increased mortality. Early diagnosis with prompt, appropriate and adequate treatment of the infected diabetic foot is crucial. The determination of DFIs, however, may be quite perplexing and invasive. Imaging is useful in the evaluation of certain cases of DFIs, especially in suspected instances with no overt clinical features, or in the diagnosis of osteomyelitis. Nuclear medicine imaging is currently used in the evaluation of DFIs; however, like all the imaging techniques now available, it has its limitations. Several radiopharmaceuticals presently available play useful roles in the management of DFIs, while new ones are being evaluated. Optical imaging techniques have recently demonstrated promising results in the evaluation of many infections including DFIs. Using the same molecule, a tracer can be labeled with a radioisotope or an optical imaging dye. This enables infections to be evaluated both pre-and intra-operatively when surgery is required in their management. In some cases, tracers have been simultaneously labeled with both a radioisotope and an optical imaging dye to produce a hybrid tracer. These new tracers potentially provide powerful and new opportunities in the management of DFIs. In this review, we briefly examine tracers that have been used in the evaluation of the infected diabetic foot. We then explore the potential of new imaging tracers currently under development for infection that may be useful in the management of DFIs
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