Attraction of Stomoxys sp. to various fruits and flowers in Mali.

The attraction of three Stomoxys species to 26 fruits and 26 flowers of different plant species was investigated in two different sites in Mali during 2008. Stomoxys niger bilineatus Grunberg (Diptera: Muscidae) was attracted to a wider spectrum of species, significantly attracted by four fruits and eight flowers compared with control traps, whereas S. sitiens Rondani (Diptera: Muscidae) was attracted to six fruits and seven flowers of different plants, and S. calcitrans L. (Diptera: Muscidae) was only attracted to one fruit and three flowers. Cold anthrone assays showed a significantly higher prevalence of sugar feeding amongst all three species at the lagoon site than at the site near Mopti. The rhythm of activity study shows temporally separated blood- and sugar-feeding periods for S. niger bilineatus and S. sitiens, but not for S. calcitrans. A comparison between blood and sugar feeding throughout the day shows that sugar feeding activity is as frequent as blood feeding activity. Because not much is known about the preferred sugar sources for Stomoxys species in their natural habitats, the present study provides valuable information regarding the attraction capability of several plants with possible future implication for Stomoxys control strategies.

Giant cell tumour of the femoral neck: Failure of curettage-cavity filling cementation with screw fixation, a case report.

BACKGROUND: Giant cell tumours are common primary long bone tumours with femoral neck locations infrequent and notorious for pathological fractures. Treatment with simple curettage often results in local recurrence. Aggressive treatment that combines tumour resection with cement filling and internal fixation aims at preserving native joint function. CASE REPORT: The authors intend to illustrate the short falls of such conservative approach through a case report of a femoral neck giant cell tumour in a 37 year old patient. Patient had undergone curettage-cavity filling with screw fixation for a pathological femoral neck fracture. Total hip arthroplasty was undertaken following implant failure and severe hip impairment 3 years after initial surgery. CONCLUSION: Intralesional curettage and cavity cementation with internal fixation of giant cell tumour of the proximal femur allows joint preservation. Mechanical failure, local recurrence and degenerative changes hinder long term outcomes especially in the setting of pathological fractures. Further studies are required to delineate the benefits of joint sparing techniques vis-a-vis total hip replacement for giant cell bone tumours of the femoral neck.

Tobacco attributable deaths in South Africa.

BACKGROUND: In mid 1998, a question "Was the deceased a smoker five years ago?" was introduced on the newly revised South African death notification form. DESIGN: A total of 16,230 new death notification forms from 1998 have been coded, and comparison of the prevalence of smoking among those who died of different causes was used to estimate, by case-control comparisons, tobacco attributed mortality in South Africa. Cases comprised deaths from causes known (from other studies) to be causally associated with smoking, and controls comprised deaths from medical conditions expected to be unrelated to smoking. Those who died from external causes, and from diseases strongly related to alcohol consumption, were excluded. SUBJECTS: Reports were available from 5340 deceased adults (age 25+), whose smoking status was given by a family member. RESULTS: Significantly increased risks were found for deaths from tuberculosis (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.23 to 2.11), chronic obstructive pulmonary disease (COPD) (OR 2.5, 95% CI 1.9 to 3.4), lung cancer (OR 4.8, 95% CI 2.9 to 8.0), other upper aerodigestive cancer (OR 3.0, 95% CI 1.9 to 4.9) and ischaemic heart disease (OR 1.7, 95% CI 1.2 to 2.3). CONCLUSION: If smokers had the same death rate as non-smokers, 58% of lung cancer deaths, 37% of COPD deaths, 20% of tuberculosis deaths, and 23% of vascular deaths would have been avoided. About 8% of all adult deaths in South Africa (more than 20 000 deaths a year) were caused by smoking.

Evaluation of childhood exposure to di(2-ethylhexyl) phthalate from perfusion kits during long-term parenteral nutrition.

Leachability of the plasticizer di(2-ethylhexyl) phthalate (DEHP) from administration sets into intravenous parenteral emulsions containing fat was investigated. DEHP is added to polyvinyl chloride (PVC) to impart flexibility. However, DEHP is a lipid-soluble suspected carcinogen that is hepatotoxic and teratogenic in rodents, and has been shown to leach from PVC products containing lipophilic mixtures. Consequently, total parenteral nutrition (TPN) mixtures containing fat emulsions should be stored in ethylvinyl acetate (EVA) bags rather than PVC packs. However, while TPN bags are made of EVA, they contain PVC-DEHP residues and the lines used between TPN bags and venous catheters are made of PVC-DEHP. The present study quantified the amount of DEHP leached from bags and tubing that could potentially contaminate patients during home TPN. Four types of emulsions containing fat were studied. Levels of DEHP in the bag and at the outlet tubing were measured by high-performance liquid chromatography (HPLC). This was measured during simulated TPN at different times after starting perfusion, 1 day after reconstitution of solutions in the bags, and 1 week later after storage at 4 degrees C. Detectable and stable amounts of DEHP were found to leach from bags (0.2 +/- 0.008 mg to 0.7 +/- 0.02 mg) and DEHP content increased in the outlet tubing (0.8 +/- 0.09 mg to 2 +/- 0.07 mg) during simulated infusions. The same phenomenon was observed after 1 week of storage at 4 degrees C. DEHP extraction by TPN depends on the lipid content of each TPN preparation and the flow rate. These results suggest that children treated with prolonged TPN are regularly exposed to significant amounts of DEHP.

Re-examination of recent trends in under five mortality rates in Zimbabwe: evidence from the ZDHS, 1988.

Prior studies on infant and child mortality in Zimbabwe have questioned the low mortality found in Matabaleland South. It was suspected that it could be an artefact of data. Using the ZDHS data, this study has shown that the probability of dying before age five (q(5)) is indeed low in Matabeleland South. Also while all provinces experienced a temporary rise in mortality in the 1980's that of Matabeleland was experienced over the period 1980-82, a period marked by political turmoil. In the mid 1980's when things had normalised, mortality in Matabeleland South experienced a decline while other provinces experienced a temporary rise in q(5).

Social pathologies in Zimbabwe.

This paper looks at the trend of social pathologies (diseases and cause of death which are more social in origin than biological) in Zimbabwe over the past decade. The rate of increase was found to be very high, even by international standards. In order to find plausible explanations for this rapid rise, the Zimbabwean situation was compared to two different populations; the Navajo Indians in the United States whose rate of social pathologies was also high and the Island of Mauritius whose level of socio-economic development was similar to that Zimbabwe but whose rate of social pathologies was very low. It was concluded that the reason for the rise in social pathologies in Zimbabwe was due to both socio-economic development and excess alcohol consumption. Efforts to combat social pathologies, however, should first be directed towards the problem of excess alcohol consumption which is more directly related to social pathologies than socioeconomic development.

More recent trends in infant and child mortality in Zimbabwe and possible explanations.

The paper uses published results from the 1992 census to describe more recent trends in infant and child mortality in Zimbabwe. It is shown that the period 1986 to 1988 provided the turning point in the gradual decline in infant and child mortality in the provinces. After this period, several provinces experienced a slow-down in mortality decline while some even experienced reversals. Using correlation analysis, it was suggested that the factors which affected infant mortality could be the same ones affecting child mortality. The paper then proceeds to formulate hypotheses on possible explanations for the slow down in mortality decline.

Facteurs limitant l'acces aux medicaments anticancereux dans un CHU de Bamako; Mali

Ce travail dont l'objectif etait d'etudier les facteurs limitant l'acces des malades aux anticancereux au Mali; a ete conduit aupres de 30 usagers du service d'hematologie oncologie medicale et de la pharmacie du CHU du Point G; ainsi qu'aupres de pharmacies privees de Bamako. Le support d'enquete etait une fiche d'enquete preetablie et mis a la disposition des personnes enquetees. Les patients ages de 4 a 60 ans; se repartissant entre 9 femmes et 22 hommes ont ete pris en charge pour un cancer du sein (19 cas); une maladie de kaposi (5 cas); une leucemie (2 cas); une maladie de Hodgkin (2 cas); une drepanocytose (1 cas) ou un CMI (1 cas). Tres peu de prescriptions ont pu etre satisfaites par l'approvisionnement hospitalier a cause d'une politique pharmaceutique particuliere du CHU. L'acces des malades aux anticancereux dans les officines privees a ete limitee par l'insuffisance des stocks d'anticancereux et des officines qui en faisaient la commande; le cout eleve des medicaments quand ils etaient commandes et les difficultes geographiques d'acces aux lieux d'achat (longues distances a parcourir). L'inscription des anticancereux sur la liste des medicaments essentiels ainsi que la mise en oeuvre de financements alternatifs pourrait permettre l'acces d'un plus grand nombre de malades aux medicaments anticancereux au Mali

Epidemiologic and health transition in Mauritius.

PIP: A doctoral candidate used census data to develop age-standarized cause-specific death rates for Mauritius with which the candidate examined the epidemiologic and health transition between 1969 and 1986. External causes of injury, diseases of the digestive system, and diseases due to pregnancy and the puerperium were causes of death that basically did not change rankings for either males or females during the study period. Respiratory diseases, circulatory diseases, and infectious diseases changed their ranking by 1, Neoplasm for females, nutritional disorders for females, and all other causes for females changed their rankings by more than 1. The only causes of death that clearly decreased in ranking were infectious diseases for both males and females and all other causes of death. Diseases of the circulatory system for both genders were the only causes that increased consistently. The remaining causes fluctuated to various degrees--some peaked and then fell considerably while others fluctuated minimally. The shift from infectious diseases being the leading cause death to circulatory diseases was not clear. It came close in 1969-70 and 1972, but was not overt until after 1972. It became clear among females after 1974. Digestive causes of death began rising after 1972 and nutritional causes after 1973. Even though degenerative causes of death rose in the 1970s, they have recently begun to fall, suggesting that the mortality pattern is entering the 4th stage of the epidemiologic transition. Mauritians' attitude of 1-nation 1-people, also held by government, sustains their traditional access to free education and free medical services, resulting in a very literate population which uses medical services. In the early 1970s, the government focused on curative services, but by the late 1970s, it focused on preventive services. Mauritius tends to emphasize biomedicine, yet other medical systems exist. e.g., Chinese and Ayurvedic medicine.^ieng

Quantitative approaches to detect the fourth stage of the epidemiologic transition.

Widely diverse quantitative measures have been used to study the onset of the different stages of the epidemiologic transition, including the fourth stage. This report suggests additional methods for detecting the fourth stage of the epidemiologic transition that are more parsimonious than those previously used. While these methods are not new, they have potential for application in this area of research. An example of one of these methods is illustrated, using Canadian data.

Assessing the contribution of age-sex differentials in causes of death due to infectious and parasitic diseases to the trends in age-sex differentials in life expectancy in Mauritius.

This study applies two methodologies to Mauritian life tables and cause-of-death data: (1) the decomposition of sex differentials in life expectancy using Arriaga's approach and (2) the estimation of the effect of marginal reduction in deaths from infectious and parasitic diseases on life expectancy using Keyfitz's methodology on cause-specific entropy and that of Nanjo. The findings in this paper support earlier findings about the importance of the period 1969-1976 in the mortality transition in Mauritius, a period in which sex differentials in life expectancies reached a peak level. The results suggest that the driving force behind those sex differentials in life expectancy was the sex differential in mortality in infectious and parasitic diseases, first among the young (ages below 10 years) and second among the older population (ages above 50 years). If the decline in mortality due to infectious and parasitic diseases was differentially greater in the older ages compared to the younger ages, that difference would have gone a long way toward reducing the magnitude of the historic peak sex differential in life expectancy achieved in 1976.

Influence of cause-of-death structure on age patterns of mortality in Mauritius.

Over the period 1969-86, Mauritian mortality declined rapidly, accompanied by substantial change in its age pattern of mortality and cause-of-death structure. Using cause-of-death data for this period, this paper studies the influence of cause-of-death structure on age patterns of mortality. Infectious and parasitic diseases had marked influence on age patterns of mortality for young Mauritian males, while circulatory causes of death influenced the age pattern of mortality for older Mauritian males. For females, their unique age pattern of mortality remained unique, largely because of the uniform and smooth change in cause-of-death structure.

PIP: Trends in causes of death during 1969-86 and age-specific mortality rates are described for Mauritius based on census and vital statistics records. More detailed descriptions of causes of death was provided in a study by Bah; Bah and Teklu analyzed age patterns of mortality. In Mauritius life expectancy increased for males from 32.8 years during 1942-46 to 64.38 years during 1982-84; female life expectancy increased from 33.8 years to 71.23 years. Infectious diseases declined and circulatory diseases increased over time. Neoplasms, injuries, poisonings, and congenital malformations remained unchanged. Age patterns of mortality for males and females were affected by these changes in the incidence of infectious diseases and circulatory diseases. During 1969-86 the male pattern was characterized as a U shape that changed to a J shape. Prior to 1978 the pattern among young ages under 20 years followed the UN South Asian pattern, and among older ages after 1978, the UN Far Eastern pattern. Male infant mortality declined from 799.4 per 100,000 live births in 1969 to 122.8 in 1986. Female mortality by age had a unique pattern that did not fit any of the Coale and Demeny model life table patterns. Female mortality followed a U shape. The decline in mortality under the age of 5 years and over the age of 45 years was uniform. Age standardized death rates for males showed a uniform decline for infants and children under 10 years old. Age-specific mortality correlated with time for females was significant for all age groups except for ages over 60 years. Standardized cause-specific death rates correlated with time showed uniform decline for infectious diseases, respiratory diseases, and other diseases for males and females. Uniform increases were apparent for circulatory diseases and digestive system diseases. There was observed multicollinearity between causes of death. Factor analysis of causes showed neoplasms and circulatory diseases as prominent factors with rising trends, followed by infectious, respiratory, and other diseases and declining factors. Digestive diseases, congenital malformations. injuries, and nutritional disorders were third factors with greater fluctuations. Regression analysis of life table survivorship showed increases in survivorship for respiratory diseases and injuries and decreased survivorship for circulatory diseases.

Indirect estimation of cause of death structure in Africa and contemporary theories of mortality.

This paper is a critical assessment of techniques used for the estimation of cause of death structure in Africa in the light of contemporary theories of mortality. The technique mostly used for the indirect estimation of cause of death structure is based on the mortality experience in Western countries. With the marked differences in the epidemiologic transition experienced in Western countries and those being experienced in African countries, it is not very likely that an estimation of cause of death structure based on data from the former can accurately estimate cause of death structure in the latter. This argument is supported in the paper through a comparison of observed estimates of cause of death structure for some African populations with indirect estimates. It is proposed that a better approach is to use a residual method whereby one proceeds from nearly true estimates of cause of death rates to obtain estimates for unknown causes via the known general mortality.

High-performance liquid chromatographic determination of naltrexone in plasma of hemodialysis patients.

A simple, sensitive, selective and reliable reversed-phase high-performance liquid chromatographic (HPLC) method with UV detection is described for the determination of naltrexone in plasma samples. Naltrexone and the internal standard, naloxone, were isolated from plasma either with a liquid-liquid extraction method using ethyl acetate or with a solid-phase extraction method using Sep-Pack C18 cartridge before chromatography. The extracts were dried under a stream of nitrogen and the samples were reconstituted in the mobile phase, then 20 microL were injected on a Waters Symmetry C18 column (5 microm particle size, 4.6 x 150 mm). The mobile phase consisted of 0.06% triethylamine (pH 2.8)-acetonitrile (92:8, v/v) pumped at 1 mL/min. The peak-area ratio versus plasma concentration was linear over the range of 10-500 ng/mL and the detection limit was less than 8 ng/mL. Quantification was by ultra-violet detection at 204 nm. The present method was applied to the determination of the plasma concentration of naltrexone in dialyzed patients. Patients (n = 8) with severe generalized pruritus received 50 mg of naltrexone orally per day for 2 weeks. The variability in the therapeutic response in treated patients required plasma concentration investigations of this opioid antagonist.