bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of different erythrocyte lysing procedures on flow cytometric determination of CD34+ cells in umbilical cord blood transplants
Authors: Cassens  , Gutensohn  , Garritsen  , Kelsch  , Kuehnl  , Sibrowski  
Published: March 2003

Since the correct determination of CD34+ cells is of great clinical importance for successful transplantation with haematopoietic progenitor cells (HPCs) from cord blood, we investigated the influence of different erythrocyte lysing techniques on the quantification of CD34+ cells in umbilical cord blood.Flow cytometric determinations of CD34+ cells were performed from 20 cord blood samples, using three different erythrocyte lysing procedures and two monoclonal CD34 antibodies (n = 360).Flow cytometric analysis showed characteristic patterns of the forward (FSC) and side (SSC) scatter light properties for the leucocyte subsets for each of the investigated erythrocyte lysing procedures, indicating that these reagents cause different morphological changes on leucocytes. Furthermore, significant differences of CD34+ cell counts were obtained for identical samples using different lysing techniques (P = 0.001 and P = 0.002). In some cases, a more than 100% difference was found comparing different erythrocyte lysing procedures. In contrast, the determination of CD34+ cells by two CD34 antibodies showed a good reproducibility without significant differences between both antibodies for each of the erythrocyte lysing techniques.We conclude that the erythrocyte lysing procedure represents a very critical and important step for accurate determination of CD34+ cells in whole blood samples. Especially for the quantification of HPCs in cord blood transplants, this influence may be of high clinical relevance.
Glycophorin A mutation Ala65  →  Pro gives rise to a novel pair of MNS alleles ENEP (MNS39) and HAG (MNS41) and altered Wrb expression: direct evidence for GPA/band 3 interaction necessary for normal Wrb expression
Authors: Poole  , Banks  , Bruce  , Ring  , Levene  , Stern  , Overbeeke  , Tanner  
Published: March 2003

We report here a novel Glycophorin A (GPA) mutation Ala65 → Pro which gives rise to a low‐incidence antigen HAG, lack of a high‐incidence antigen ENEP and aberrant expression of the high‐incidence Wrb antigen. Anti‐ENEP was identified in the serum of a transfused male patient (E.H.) who was homozygous for a GPA Ala65 → Pro mutation and possessed a novel low‐incidence antigen which we have called HAG. An unrelated HAG‐positive individual, heterozygous for the Ala65 → Pro mutation, has also been identified. Anti‐HAG was present in several multispecific antisera to low‐incidence antigens and in one monospecific serum.Normal expression of the Wrb antigen depends on the presence of amino acid Glu658 of band 3 and on the presence of GPA. However, a specific epitope on GPA has not previously been implicated. DNA sequence analysis of band 3 from patient E.H. was normal in the region of Wra/Wrb polymorphism with homozygous presence of Glu658 and therefore the abnormal Wrb expression results from the Ala65 → Pro mutation in GPA.The ENEP and HAG antigens have been assigned the MNS blood group system numbers 002.039 and 002.041, respectively, by the ISBT Working Party on Terminology for Red Cell Surface Antigens.
Platelet washing to prevent recurrent febrile reactions to leucocyte‐reduced transfusions
Authors: Vo T. D. , Cowles J. , Heal J. M. , Blumberg N. 
Published: March 2003

Symptoms of fever and/or rigours after transfusion continue to occur commonly in patients receiving platelets leucocyte‐reduced after storage. A cohort of 24 consecutive patients who had experienced severe or repeated febrile nonhaemolytic reactions to post‐storage leucocyte‐reduced platelet transfusions were treated with saline‐washed, post‐storage leucocyte‐reduced platelets. The frequency of reactions declined from 20% of transfusions (n = 191) to 0·6% (n = 331) after instituting saline‐washed, post‐storage leucocyte‐reduced platelet transfusions. These results support the hypothesis that substances present in the supernatant of stored platelet concentrates mediate febrile nonhaemolytic transfusion reactions, and provide one strategy for preventing their occurrence.
Sensitive ELISA dipstick test for the detection of chloroquine in urine under field conditions
Authors: Schwick P. , Eggelte T. A. , Hess F. , Tueumuna T. T. , Payne D. , Nothdurft H. D. , Von Sonnenburg F. , Löscher T. 
Published: March 2003

Summary Objective To evaluate a new enzyme‐linked immunosorbent assay (ELISA) dipstick test for detecting chloroquine (CQ) in urine in a malaria‐endemic region of north‐western Namibia. Method Urine samples from 92 patients attending the outpatient department of Kamhaku Hospital with suspected malaria infection were tested for CQ with both the Dill‐Glazko test and the ELISA dipstick test. Results were compared to the history of CQ intake as documented in the patients' health passes. Results The dipstick test proved an easy‐to‐handle and very sensitive tool for the detection of CQ with a lower limit of detection at 120 nmol/l. It showed high agreement with the history of CQ intake within the last 6 months. The specificity in a negative control group was 100%. The Dill‐Glazko test was far less sensitive and specific with a lower detection limit of 150 μmol/l. Conclusion The dipstick test can be used in pharmacological studies to evaluate the use of CQ, and as an inclusion criterion for in vivo and in vitro sensitivity tests, whereas the Dill‐Glazko test is appropriate to test compliance during and a few days after CQ intake.
Independent evaluation of onchocerciasis rapid assessment methods in Benue State, Nigeria
Authors: Whitworth JAG , Gemade EII 
Published: March 2003

Summary objective  To evaluate the prevalence of palpable nodules or skin depigmentation as rapid indicators of onchocerciasis epidemicity in at‐risk communities. method  We examined data collected in Benue State on 11035 individuals in 32 villages to evaluate these rapid assessment methods. results  The prevalence of palpable nodules correlates more closely with microfilarial prevalence (r= 0.68, P < 0.001) and community microfilarial load (r= 0.64, P < 0.001) than the prevalences of skin depigmentation or other potential rapid indicators. The recommended cut‐off value for palpable nodules of 20% or more in males aged > 20 years had a sensitivity of 94% and specificity of 50% compared to a cut‐off of 40% or more for microfilarial prevalence in all ages. This would mean that in these 32 villages 17 of 18 would have been correctly identified for treatment, and a further 7 at lesser risk would have been targeted for treatment. conclusions  Skin snipping and parasitological examination can be replaced by the simpler method of palpating onchocercal nodules to identify communities at serious risk of onchocerciasis. This has important operational benefits for onchocerciasis control programmes.
Is orphan drug status beneficial to tropical disease control? Comparison of the American and future European orphan drug acts
Authors: Trouiller P. , Battistella C. , Pinel J. , Pecoul B. 
Published: March 2003

Summary objectives To quantify past outcomes of tropical pharmacology research and development (R & D) and to assess past benefits of the American orphan drug act and potential benefits of the future European orphan drug regulation on tropical diseases. methods This paper presents two analyses: a 1983–97 retrospective study of the United States Orphan Drug Act concerning rare diseases and a prospective study of the European Proposal for a Regulation Concerning Orphan Drugs and its possible impact on tropical diseases. results Different programmes have in the past tried to stimulate R & D in this area, but results remain limited. Of 1450 new chemical entities marketed between 1972 and 1997, 13 were specifically for tropical diseases and considered as essential drugs. Between 1983 & 1997, the US Orphan Drug Act approved 837 drugs and marketing of 152 new molecular entities (NMEs). Three NMEs have been designated for malaria and human African trypanosomiasis. Seven others, already commonly used in tropical diseases, received either orphan designation or an orphan approval for another indication. Pharmaceutical companies benefit from the US framework only when the US market exclusivity clause was applicable. Future European orphan drug regulation appears to be similar to the US Orphan Drug Act. conclusion The orphan drug programmes relating to rare diseases have met with some success. Considering tropical diseases rare diseases seems inadequate to boost pharmaceutical R & D. However, some provisions of the European text may be relevant to tropical diseases, admitting the need for a more specific rule for evaluations of this kind of drug and recognizing the existence of ‘diseases of exception’.
The eosinophilic response and haematological recovery after treatment for Plasmodium falciparum malaria
Authors: Camacho Luis H. , Wilairatana Polarat , Weiss Günter , Mercader Marco A. , Brittenham Gary M. , Looareesuwan Sornchai , Gordeuk Victor R. 
Published: March 2003

SummaryTo examine a possible relationship between the immune response and haematological recovery after acute falciparum malaria, we followed peripheral blood eosinophil counts and haemoglobin concentrations for 4 weeks after starting effective treatment in 70 adult Thai patients. Eosinophils are induced by Th‐2 cytokines as well as other stimuli. Eosinophil counts were elevated in only 8 (11%) of the subjects at presentation, but were increased in 65 (93%) by day 7. Eosinophil counts then decreased markedly by day 14, followed by a second increase until day 28. A significant positive correlation was found between peak eosinophil counts on day 7 and the haemoglobin concentration on day 28, both in 16 subjects without stool parasites (r = 0.65, P = 0.006) and in 54 patients with stool parasites (r = 0.32; P = 0.0019). These results suggest that a robust eosinophilic response shortly after completing antimalarial therapy predicts a good recovery from malaria‐associated anaemia.
Validity of data‐derived algorithms for ascertaining causes of adult death in two African sites using verbal autopsy
Authors: Quigley Maria A. , Chandramohan Daniel , Setel Philip , Binka Fred , Rodrigues Laura C. 
Published: March 2003

Summary background  Verbal autopsy (VA) is used to ascertain causes of death using information obtained from bereaved relatives. Causes of death can be ascertained from VA questionnaires by a panel of physicians or from predefined algorithms. In a previous study, we developed data‐derived algorithms using VA data from 796 adult deaths in hospitals in Tanzania, Ethiopia, and Ghana (primary sites). These computerized algorithms accurately estimated the cause‐specific mortality fractions (CSMFs) for deaths due to injuries, meningitis, TB/AIDS and diarrhoeal diseases in the primary sites. Since the same data were used to generate and to validate the algorithms, the accuracy of our algorithms may have been overestimated. We report here on the validity of the algorithms when they were applied to VA data from two secondary sites in Ghana and Tanzania. Here, ‘validity’ is taken to mean the degree to which the algorithms replicated the physician‐generated CSMF for major causes of death, when applied to the same VA data.methods  VA interviews were conducted in two secondary sites: in Navrongo, Ghana, on 406 adult deaths, where three local physicians independently reviewed the questionnaires and assigned a cause of death. In Morogoro, Tanzania, VA interviews were conducted on 209 adult deaths, and a panel of physicians independently reviewed the VA questionnaires together with the hospital death certificates or hospital records to determine the cause of death. The CSMF obtained using each algorithm was compared with the CSMF obtained using physician review.results  For injuries and meningitis, the algorithms and physician review estimated a similar CSMF in the Morogoro and Navrongo data. For TB/AIDS, the algorithm estimated a similar CSMF as the physicians in Morogoro. The algorithm for diarrhoeal diseases did not agree closely with the physicians in Morogoro or Navrongo.conclusions  In general, our data‐derived algorithms for assigning causes of death due to injuries, meningitis, and TB/AIDS estimated a similar CSMF as the physicians in the secondary sites. Recommendations for further validation and refinement are discussed. Computerized algorithms offer a potentially quick, affordable, and feasible method for assigning causes of death in mortality surveillance or studies using VA.
Single small enhancing CT lesion in Thai patients with acute symptomatic seizures: a clinico‐radiological study
Authors: Yodnopaklow Praphan , Mahuntussanapong Arunee 
Published: March 2003

Summary OBJECTIVE   To identify the frequency of single small enhancing CT lesion cases (SSECTL) in a provincial hospital in Thailand and verify a set of clinico‐radiological criteria for the diagnosis of benign SSECTL.METHODS   All patients who fulfilled the following criteria were recruited: acute symptomatic focal seizures with or without secondary generalization; minimal or no neurological deficit; no evidence of raised intracranial pressure; no evidence of systemic disease; CT scan showing SSECTL of < 20 mm diameter. After recruitment, patients received antiepileptic drugs and other symptomatic treatment. A CT scan of the brain was repeated every 2 weeks until the lesion had significantly resolved, which was defined as a 50% decrease in size. A CT scan was then taken every 4 weeks until the lesion had completely disappeared or turned into a calcified spot. The data from all other patients presenting with seizures and solitary enhancing lesion on the CT scan who did not fulfil the inclusion criteria were also reviewed.RESULTS   972 patients with seizure disorder were recruited. 110 patients (11.3%) presented with seizure and solitary enhancing lesion on the CT scan, 22 of whom (20%) fulfilled the inclusion criteria. 20 of the 22 patients had SSECTL with a spontaneous resolution: 14 (70%) within 4 weeks and 18 (90%) within 8 weeks. Two patients had a progressive course. One patient with a solitary enhancing CT lesion > 20 mm had spontaneous resolution. 87 patients had another diagnoses. The diagnostic criteria for benign SSECTL were 95.23% sensitive, 97.75% specific, had a positive predictive value of 90.91% and a negative predictive value of 98.86%.CONCLUSION   SSECTL is not uncommon in our provincial hospital. The clinico‐radiological criteria proposed by Rajshekhar (1991) are valid and reliable in predicting a benign outcome. CT follow‐up within the first 4 weeks is critical.
Cost‐effectiveness of management strategies for acute urethritis in the developing world
Authors: Crabbé François , Vuylsteke Bea , de Clerck Miguel , Laga Marie 
Published: March 2003

Summary objective  To recommend a cost‐effective approach for the management of acute male urethritis in the developing world, based on the findings of a theoretical study. methods  A model was developed to assess the cost‐effectiveness of three urethritis management strategies in a theoretical cohort of 1000 men with urethral syndrome. (1) All patients were treated with cefixime and doxycycline for gonococcal urethritis (GU) and nongonococcal urethritis (NGU), respectively, as recommended by WHO. (2) All patients were treated with doxycycline for NGU; treatment with cefixime was based on the result of direct microscopy of a urethral smear. (3) All patients were treated with cotrimoxazole or kanamycin for GU and doxycycline for NGU. Cefixime was kept for patients not responding to the first GU treatment. Strategy costs included consultations, laboratory diagnosis (where applicable) and drugs. The outcome was the rate of patients cured of urethritis. Cost‐effectiveness was measured in terms of cost per cured urethritis. results  Strategy costs in our model depended largely on drug costs. The first strategy was confirmed as the most effective but also the most expensive approach. Cefixime should cost no more than US$ 1.5 for the strategy to be the most cost‐effective. The second strategy saved money and drugs but proved a valuable alternative only when laboratory performance was optimal. The third strategy with cotrimoxazole was the least expensive but a low follow‐up visit rate, poor treatment compliance or lower drug efficacy limited effectiveness. Maximizing compliance by replacing cotrimoxazole with single‐dose kanamycin had the single greatest impact on the effectiveness of the third strategy. conclusion  Our model suggested that a cost‐effective approach would be to treat gonorrhoea with a single‐dose antibiotic selected from locally available products that cost no more than US$ 1.5.
Effect of aggressive prolonged diethylcarbamazine therapy on circulating antigen levels in bancroftian filariasis
Authors: Freedman David O. , Plier D. Adam , De Almeida Adriana B. , De Oliveira Ana Luna , Miranda Janaina , Braga Cynthia 
Published: March 2003

BACKGROUND Single dose diethylcarbamazine (DEC) as used in control programmes is effectively microfilaricidal for periods of up to a year or more but has incomplete ability to kill Wuchereria bancrofti adult parasites. These regimens can be effective in breaking transmission by suppression of circulating microfilariae available to mosquito vectors. Whether prolonged or aggressive therapy with DEC has a significant effect on adult worms, which may live up to 12 years or more, and is important in the context of the treatment of individual patients, is still incompletely understood. METHODS In order to investigate the adulticidal effect of aggressive therapy, DEC was given at 6 mg/kg/day for 12‐day courses at 0, 6, 12, and 18 months and Og4C3 antigenaemia followed over two years in 38 CAg + Brazilians in a W. bancrofti endemic area. RESULTS At two year follow‐up, the median level of antigenaemia was 21% of the pre‐treatment value. 92% of individuals had antigen levels < 50% of pretreatment values, but only 26% had completely cleared antigenaemia. The clearance rate at 24 months was only 12% (3/26) in the asymptomatic CAg + patients but 58% (7/12) in those with clinical manifestations of filariasis. The latter individuals cleared significantly more antigen (median of 0% pretreatment antigenaemia vs. 26%; P=0.02) than asymptomatic but infected individuals. CONCLUSION Aggressive repeated therapy with DEC alone is ineffective in consistently eradicating adult W. bancrofti, especially in infected but asymptomatic individuals. Prolonged courses of combination therapy with other antifilarial drugs should be investigated for treatment of individual patients with the means to pursue aggressive personal medical care.
Has directly observed treatment improved outcomes for patients with tuberculosis in southern Thailand?
Authors: Pungrassami Petchawan , Johnsen Søren P. , Chongsuvivatwong Virasakdi , Olsen Jørn 
Published: March 2003

OBJECTIVE To validate the practice of directly observed treatment (DOT) and evaluate its effect on treatment outcomes. METHODS This follow‐up study conducted in 24 districts in southern Thailand included 411 new, smear‐positive, pulmonary tuberculosis (TB) patients who started treatment between February and September 1999. Patients and/or their observers were interviewed about their actual DOT practice during the first 2 months of treatment. Treatment outcomes were evaluated at the end of the second month and at the end of treatment. RESULTS Of 411 patients, 379 were assigned to DOT but only 68 practised strict DOT for every dose during the first 2 months. Adjusted odds ratios (ORs) for `no sputum conversion' and `unsuccessful treatment' were 1.1 (95% CI 0.6–2.1) and 1.3 (95% CI 0.6–2.8), respectively, for those who practised strict DOT vs. the rest. CONCLUSIONS Actual practice of DOT was quite different from what was intended at the assignment. Practice of strict DOT during the first 2 months was not associated with sputum conversion or treatment success in this study area.
A seroepidemiological study of human cysticercosis in West Cameroon
Authors: Nguekam J. P. , Zoli A. P. , Zogo P. O. , Kamga A. C. T. , Speybroeck N. , Dorny P. , Brandt J. , Losson B. , Geerts S. 
Published: March 2003

SummaryWe studied the occurrence of human cysticercosis in 4993 individuals from three rural communities of Menoua Division, West Province of Cameroon. Circulating antigens of Taenia solium metacestodes were detected in 0.4%, 1.0% and 3.0% of the serum samples taken in Bafou, Bamendou and Fonakekeu, respectively, and examined using a monoclonal antibody‐based enzyme‐linked immunosorbent assay. This test detects only carriers of living cysticerci and gives thus a good idea of the presence of active cysticercosis. The percentage of persons infected with cysticercosis increased with age. Twenty‐two of the 34 seropositives underwent computed tomography (CT) of the brain. Thirteen of them were CT‐scan positive, which shows that neurocysticercosis was present in 59.1% of the tested seropositive persons. No living cysticerci were detected among 20 seronegative people. About 20.6% of the seropositives had a history of or current taeniasis against only 1.9% of the seronegatives. Based on these figures and on the data on porcine cysticercosis (prevalence: 11%) and human taeniasis (prevalence: 0.13%) collected in the same region, we conclude that T. solium cysticercosis is an endemic, but overlooked public health problem in West Cameroon.
Reduced prevalence of Plasmodium falciparum infection and of concomitant anaemia in pregnant women with heterozygous G6PD deficiency
Authors: Mockenhaupt Frank P. , Mandelkow Jantina , Till Holger , Ehrhardt Stephan , Eggelte Teunis A. , Bienzle Ulrich 
Published: March 2003

SummaryGlucose‐6‐phosphate dehydrogenase (G6PD) deficiency confers protection against malaria in children, yet its role in malaria in pregnancy is unknown. In a cross‐sectional study among 529 pregnant Ghanaian women, Plasmodium falciparum infection, anaemia and G6PD genotypes were assessed. Of these, 30.4% were heterozygous and 2.6% were homozygous for G6PD deficiency. The prevalence of P. falciparum infection decreased from 66% in G6PD‐normal women to 58% in heterozygotes, and to 50% in individuals with homozygous G6PD deficiency (, P = 0.04). Multivariate analysis revealed that in multigravid women but not in primigravidae, heterozygous G6PD deficiency was associated with a reduced risk of P. falciparum infection (Odds ratio (OR), 0.6; 95% confidence interval (95% CI), [0.4–0.9]). This protection against infection was limited to the third trimenon of pregnancy. In addition, heterozygous G6PD deficiency was associated with a reduced risk of anaemia among infected multigravidae (OR, 0.5 [0.3–1.0]). Pregnancy is a period of high vulnerability to malaria. The results of this study provide evidence for protection against malaria in pregnancy caused by heterozygous G6PD deficiency. This advantage, even if confined to multigravid women, may contribute to the selection of G6PD variants in malaria‐endemic regions.