330 research outputs found
In-Batch and In-Flow Synthesis of Thermo-responsive Polymeric Inorganic Nanoparticle Platforms for Cancer Therapy
No full textInorganic nanoparticles (INPs) possess unique optical, magnetic, and electronic features accounting for their wide applicability in fields ranging from opto-electronics to medicine to catalysis. When their hydrophobic surfaces are coated with polymers engineered to become responsive to stimuli like heat, pH, light etc., the resulting polymeric-INPs could be used as platforms to simultaneously mediate the diagnosis and treatment of tumors. To this end, using an in-batch Photo-induced Copper mediated atom transfer radical polymerization technique, the synthesis of a PEG-based thermo-responsive polymer (TR-polymer) grafted onto the surface of chalcopyrite NPs was pursued. On the resulting polymeric-inorganic nanoparticle platform (TR-CuFeS2) Doxorubicin, a chemotherapeutic drug, was loaded in the TR-polymer shell for a heat-mediated drug release while the CuFeS2 NP displayed high heating and tunable reactive oxygen species (ROS) generation upon irradiation with 808nm-NIR laser. Using this platform the multi-therapeutic effect was proven. Similarly, a multi-catechol polymer having PEG stabilizing side chains and furfuryl moieties was synthesized and grafted to the surface of Iron Oxide NPs. To the furfuryl groups, thermal labile fluorescein dyes were tagged as a model drug by Diels-Alder chemistry. The obtained platform under alternating magnetic field (AMF) of clinical use and at very low nanocube dose ([Fe] of 0.5 g/L) were leading to local hot spots which drives the release of the dye without macroscopic temperature change of the solution. Lastly, a novel protocol was developed to produce TR-polymer coated iron oxide nanocubes (TR-Cube) using in-flow processing technique. In comparison with the previous in-batch TR-Cube synthesis, the optimize in-flow synthesis conditions features a much shorter reaction time, easy post polymerization cleanup, and higher % yield of TR-cubes. Thus, the in-flow method is more feasible for large scale clinical production of TR-Cubes than the batch process
Economic Report for the WHO Technical Expert Group Meeting on Intermittent Preventive Treatment of Malaria in Children
No full textFor Intermittent Preventive Treatment of Malaria in Children (IPTc) to be accepted and sustainable as a malaria control strategy it must be affordable and cost effective as well as safe and acceptable. Thus, several of the IPTc studies have included an economic component. These studies range from randomised controlled trials to operational research studies. In addition, modelling was used to supplement the information available from the trials and to provide predictions where the trials could not, for practical reasons, provide estimates. Both financial and economic costs associated with IPTc delivery have been investigated to help forecast how introducing the intervention may impact health budgets, and to help determine the cost effectiveness of IPTc compared to other malaria interventions.
In this report we present the costs and cost-effective of IPTc using three different drug regimens and various delivery strategies. Across all studies, the financial cost per IPTc course range from US3.44 and the economic cost per course from US3.44. These costs are within the range of the costs associated with delivering existing malaria control interventions. The cost effectiveness of the intervention was comparable, but marginally higher than other prevention strategies, however possibilities exist for reducing the costs of IPTc by scaling up and by incorporating delivery of IPTc with the delivery of other interventions such as the distribution of Vitamin A or Community and Home Management of Malaria. Supervision, training and remuneration of CHWs and IPTc drug delivery have been identified as the main cost components and key determinants to the success of the delivery strategy. There is scope for the costs associated with supervision and training to be reduced if IPTc is integrated into existing routine activities. Alternatively, in settings where supervision and training of CHWs is weak, IPTc may offer an opportunity to strengthen both these important aspects of service delivery which will offer benefits beyond reducing malaria morbidity and mortality
Community-based screening and treatment for chronic hepatitis B in sub-Saharan Africa – Authors' reply
No full textComment on :Cost-effectiveness of community-based screening and treatment for chronic hepatitis B in The Gambia: an economic modelling analysis./Nayagam S, Conteh L, Sicuri E, Shimakawa Y, Suso P, Tamba S, Njie R, Njai H, Lemoine M, Hallett TB, Thursz M. Lancet Glob Health. 2016 Aug;4(8):e568-78. doi: 10.1016/S2214-109X(16)30101-2. PMID: 27443782 - Community-based screening and treatment for chronic hepatitis B in sub-Saharan Africa./Qin G, Shao JG. Lancet Glob Health. 2017 Jan;5(1):e34. doi: 10.1016/S2214-109X(16)30305-9. PMID: 27955780International audienceCorrespondenc
Cost implications of improving malaria diagnosis: findings from north-eastern Tanzania.
No full textBACKGROUND: Over diagnosis of malaria contributes to improper treatment, wastage of drugs and resistance to the few available drugs. This paper attempts to estimate the rates of over diagnosis of malaria among children attending dispensaries in rural Tanzania and examines the potential cost implications of improving the quality of diagnosis. METHODOLOGY/PRINCIPAL FINDINGS: The magnitude of over diagnosis of malaria was estimated by comparing the proportion of outpatient attendees of all ages clinically diagnosed as malaria to the proportion of attendees having a positive malaria rapid diagnostic test over a two month period. Pattern of causes of illness observed in a or=5 year age group in the lower transmission site (RR 14.0 95%CI 8.2-24.2). In the low transmission site the proportion of morbidity attributable to malaria was substantially lower in <2 year old cohort compared to children seen at routine care system. (0.08% vs 28.2%; p<0.001). A higher proportion of children were diagnosed with ARI in the <2 year old cohort compared to children seen at the routine care system ( 42% vs 26%; p<0.001). Using a RDT reduced overall drug and diagnostic costs by 10% in the high transmission site and by 15% in the low transmission site compared to total diagnostic and drug costs of treatment based on clinical judgment in routine health care system. IMPLICATIONS: The introduction of RDTs is likely to lead to financial savings. However, improving diagnosis to one disease may lead to over diagnosis of another illness. Quality improvement is complex but introducing RDTs for the diagnosis of malaria is a good start
A New Finding of a Tethered Cord in a Patient with Okamoto Syndrome
No full textWe report a boy with Okamoto syndrome who presented to us at 11 years and 3 months of age with bladder dysfunction and gait difficulties suggestive of tethered cord syndrome (TCS). To date, TCS has yet to be reported in the history of individuals with this syndrome (Table 1). The patient subsequently underwent filum terminale sectioning with neuromonitoring for release of his cord. This surgery is relatively safe (Michelson and Ashwal, 2004), and this patient showed a reversal of his TCS symptoms at follow-up clinical visits.Peer reviewed
Experiences of resettled refugees during the 2011 Queensland floods
No full textWith projected climatic changes it is expected that refugees and other forced migrants will increasingly spend protracted amounts of time in transit countries or will resettle in locations that experience ecological vulnerability. A submission to the Queensland Floods Commission Inquiry 2011 by MDA reported that the floods displaced about 70 refugee client families and that 30 families had ongoing complex needs at the time of the submission. The findings reported in this chapter are derived from a follow-up of a cohort of men from refugee backgrounds who participated in the 2008–10 SettleMEN project. The chapter provides an insight into the experiences of refugee migrants who experience environmental disaster in a site of settlemen
Clickable Polymer Ligand-Functionalized Iron Oxide Nanocubes: A Promising Nanoplatform for ‘Local Hot Spots’ Magnetically Triggered Drug Release
No full text[Image: see text] Exploiting the local heat on the surface of magnetic nanoparticles (MNPs) upon exposure to an alternating magnetic field (AMF) to cleave thermal labile bonds represents an interesting approach in the context of remotely triggered drug delivery. Here, taking advantages of a simple and scalable two-step ligand exchange reaction, we have prepared iron oxide nanocubes (IONCs) functionalized with a novel multifunctional polymer ligand having multiple catechol moieties, furfuryl pendants, and polyethylene glycol (PEG) side chains. Catechol groups ensure a strong binding of the polymer ligands to the IONCs surface, while the PEG chains provide good colloidal stability to the polymer-coated IONCs. More importantly, furfuryl pendants on the polymer enable to click the molecules of interest (either maleimide–fluorescein or maleimide–doxorubicin) via a thermal labile Diels–Alder adduct. The resulting IONCs functionalized with a fluorescein/doxorubicin-conjugated polymer ligand exhibit good colloidal stability in buffer saline and serum solution along with outstanding heating performance in aqueous solution or even in viscous media (81% glycerol/water) when exposed to the AMF of clinical use. The release of conjugated bioactive molecules such as fluorescein and doxorubicin could be boosted by applying AMF conditions of clinical use (16 kAm(–1) and 110 kHz). It is remarkable that the magnetic hyperthermia-mediated release of the dye/drug falls in the concentration range 1.0–5.0 μM at an IONCs dose as low as 0.5 g(Fe)/L and at no macroscopical temperature change. This local release effect makes this magnetic nanoplatform a potential tool for drug delivery with remote magnetic hyperthermia actuation and with a dose-independent action of MNPs
Cost-effectiveness of intermittent preventive treatment of malaria in infants (IPTi) for averting anaemia in Gabon : a comparison between intention to treat and according to protocol analyses
No full textABSTRACT: BACKGROUND: In Gabon, the impact of intermittent preventive treatment of malaria in infants (IPTi) was not statistically significant on malaria reduction, but the impact on moderate anaemia was, with some differences between the intention to treat (ITT) and the according to protocol (ATP) trial analyses. Specifically, ATP was statistically significant, while ITT analysis was borderline. The main reason for the difference between ITT and ATP populations was migration. METHODS: This study estimates the cost-effectiveness of IPTi on the reduction of anaemia in Gabon, comparing results of the ITT and the ATP clinical trial analyses. Threshold analysis was conducted to identify when the intervention costs and protective efficacy of IPTi for the ATP cohort equalled the ITT cost-effectiveness ratio. RESULTS: Based on IPTi intervention costs, the cost per episode of moderate anaemia averted was US11.30 (CI 95% 4.56, 26.66) using the ATP analysis. In order for the ATP results to equal the cost-effectiveness of ITT, total ATP intervention costs should rise from US134 or the protective efficacy should fall from 27% to 18.1%. The uncertainty surrounding the cost-effectiveness ratio using ITT trial results was higher than using the ATP results. CONCLUSIONS: Migration implies great challenges in the organization of health interventions that require repeat visits in Gabon. This was apparent in the study as the cost-effectiveness of IPTp-SP worsened when drop out from the prevention was taken into account. Despite such challenges, IPTi was both inexpensive and efficacious in averting cases of moderate anaemia in infant
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