Steps of spermiogenesis in the ostrich (Struthio camelus).

Few studies describe the sequence of morphological events that characterize spermiogenesis in birds. In this paper, the clearly observable steps of spermiogenesis are described and illustrated for the first time in a commercially important ratite, the ostrich, based on light microscopy of toluidine blue-stained plastic sections. Findings were supplemented and supported by ultrastructural observations, PNA labeling of acrosome development, and immunocytochemical labeling of isolated spermatogenic cells. Spermiogenesis in the ostrich followed the general pattern described in non-passerine birds. Eight steps were identified based on changes in nuclear shape and contents, positioning of the centriolar complex, and acrosome development. Only two steps could be recognized with certainty during development of the round spermatid which contributed to the fewer steps recorded for the ostrich compared to that described in some other bird species. The only lectin that displayed acrosome reactivity was PNA and only for the first three steps of spermiogenesis. This suggests that organizational and/or compositional changes may occur in the acrosome during development and merits further investigation. Immunological labeling provided additional evidence to support the finding of previous studies that the tip of the nucleus in the ostrich is shaped by the forming acrosome and not by the microtubular manchette. To our knowledge, this is the first complete description of spermiogenesis in ostrich and one of few in any avian species. In addition to comparative reproduction and animal science, this work has implications for evolutionary biology as the reported germ cell features provide a bridge between reptile and ratite-avian spermatogenesis.

Nemaline myopathy in a six-month-old Pomeranian dog.

ABSTRACT: Nemaline myopathy - a clinically and genetically complex heterogenous group of disorders - is described uncommonly in humans and rarely in animals, and is characterised by progressive muscle weakness. The diagnosis is confirmed by histological and/or ultrastructural identification of subsarcolemmal, thread-like, rod-shaped structures called nemaline rod bodies within more than 40% of skeletal muscle fibres. These rods contain the Z-line protein, α-actinin, that can be effectively stained in skeletal muscles using Gomori or Masson trichrome and negatively stained with periodic acid-Schiff. Similar rod-like bodies have been found in smaller numbers in dogs with endocrine disorders and occasionally in other conditions in humans. This report is of a six-monthold Pomeranian dog which had progressive exercise intolerance over a two-month period associated with severe disuse muscle atrophy of the thoracic limbs, as well as gradual pelvic limb weakness and regurgitation of food. Baseline diagnostics ruled out endocrinopathies and after histological and ultrastructural evaluation of thoracic limb muscles and nerve biopsies confirmed nemaline myopathy. The clinical course, diagnostic test results, ultrastructure of skeletal muscle and peripheral nerve, gross necropsy findings and histopathology using various stains are described and illustrated.

The diurnal patterns of ruminal enzymatic activity and in vitro digestibility of starch, neutral detergent fiber, and protein.

The objective of this study was to determine whether diurnal patterns in starch, neutral detergent fiber (NDF) and protein digestibilities and amylolytic, fibrolytic, and proteolytic activities exist in dairy cows. Rumen fluid was collected from 4 ruminally cannulated Holstein dairy cows before the morning feeding and subsequently every 4 h for a 24-h period. Two of the cows were restricted from feed for 8 h overnight, and the other 2 continued to receive their feed ad libitum, to isolate and quantify the effects of changes in feeding behavior at night. After 2 runs the cows were crossed over between night feeding treatments. Rumen fluid was analyzed for enzymatic activity and in vitro starch, NDF, and nitrogen digestibility. Circadian rhythm analyses of enzymatic activity and in vitro digestibility were conducted by fitting the linear form of a cosine function with a 24-h period. Patterns were observed in activity for amylase, lichenase, endoglucanase, and xylanase, with the highest activities observed at the time points subsequent to milking and feed delivery. Protease activity was unaffected by either feeding treatment or possible feeding behavior. When fitted to a cosine function, all the parameters tested followed a daily pattern that was sensitive to the overnight availability of feed, although the parameters responded differently to the feeding treatment. The patterns displayed by in vitro digestibility results of starch, NDF, and nitrogen, across the various fluid collection time points, were highly variable. The time at peak (acrophase) observed in the enzymatic analysis did not correspond to those observed in the in vitro analysis. These results suggest that different interpretations should be given to enzymatic activities and in vitro digestibility values, and the time of rumen fluid collection relative to feeding time should be considered and reported when rumen fluid is used for research or commercial purposes. Maximum digestibility appears in fact to be reached around 4 to 5 h after the main ration delivery for NDF and starch and around ration delivery for protein.

Access to chloroquine in patients with rheumatic and musculoskeletal diseases attending rheumatology outpatient clinics during the COVID-19 pandemic.

Herbal medicines made from the bark of the Cinchona tree, and later quinine, have been widely used for centuries to treat medical conditions such as tropical malaria. More recently, chloroquine (CQ) and its synthetic derivatives have been used as antimalarials and to treat systemic lupus erythematosus, rheumatoid arthritis, and in the past 14 months or so, COVID-19 pneumonia. Anecdotal evidence and the erratic covering through social media of its potential efficacy in the treatment of COVID-19 pneumonia have resulted in the widespread off-label use of CQ in South Africa and worldwide. This study aimed to show that access to CQ as a chronic medication for rheumatic and musculoskeletal diseases was limited during the COVID-19 pandemic, and that this resulted in an increased incidence of flares in these patients, affecting their morbidity and potentially leading to mortality.

A novel HPLC method developed and validated for the detection and quantification of atorvastatin, fluvastatin, pitavastatin and pravastatin during transdermal delivery studies.

An HPLC method was developed and validated to quantify and identify several statins (atorvastatin, fluvastatin, pitavastatin and pravastatin) that were used during transdermal drug delivery. The method proved to be most effective with a Restek Ultra C18, 250 x 4.6 mm, 5 µm column, a flow rate of 1.0 ml/min, UV detection at 240 nm and injection volume of 10 µl. The mobile phase used was acetonitrile/Milli-Q® water with 0.1% orthophosphoric acid starting with 30% acetonitrile, which increased linearly to 70% (after 4 min) for up to 10 min and then re-equilibrated to start conditions. This HPLC method indicated linearity (correlation coefficient (R²) of 1) within the concentration range of 0.05-200.00 µg/ml and had an average recovery of 98-103%. Limit of detection (LOD) and limit of quantification (LOQ) showed that statins could still be identified at concentrations of 0.004-0.006 µg/ml with the exception of atorvastatin (quantifiable at 0.013-0.035 µg/ml). Specificity performed during method validation, confirmed that the method was suitable for accurate detection and quantification of the statins when included in the transdermal formulations with other excipients.

Ostrich ejaculate characteristics and male libido around equinox and solstice dates.

The study evaluated the effect of time of the year in which changes in photoperiod occurs on ostrich semen characteristics and male libido. Semen was collected for 5 days before, on and 5 days after winter solstice (21 June 2016), spring equinox (22 September 2016), summer solstice (21 December 2016) and autumn equinox (20 March 2017) in the southern hemisphere. Semen was collected from 10 South African Black ostrich males (average age ± standard deviation; 4.5 ± 2.27 years) using the dummy female. Semen volume, sperm concentration, total sperm per ejaculate, sperm motility traits, percentage of normal sperm, head and tail abnormalities and percentage of affected sperm in the hypo-osmotic swelling test (HOS) were evaluated. Male libido defined as the willingness of males to mount the dummy female was also recorded. Semen samples collected around summer solstice, spring and autumn equinox were higher in sperm concentration and sperm output compared with winter solstice (P < 0.05). Study periods did not influence semen volume, sperm motility traits, the percentage of normal sperm, head abnormalities and HOS. Tail abnormalities were higher around winter solstice than around spring equinox (P < 0.05). Male libido and the success of semen collection were significantly higher around spring equinox (P < 0.05). Changes in photoperiod in the southern hemisphere do not affect semen production in ostriches. However, high sperm output and male libido around spring equinox and summer solstice dates suggest that these periods may be preferred for semen collection for artificial insemination and storage purposes.

Breastfeeding support practices in designated workplaces in the Breede Valley sub-district, Western Cape, South Africa

Background. Globally, mothers have identified employment as one of the leading barriers to exclusive and continued breastfeeding. The workplace and employment setting has been highlighted as one component of an enabling environment for breastfeeding.Objectives. To assess breastfeeding support practices in designated workplaces in the Breede Valley sub-district, Western Cape, South Africa.Methods. A quantitative, cross-sectional design study was used. An online survey was conducted amongst human resource managers and/or company managers to determine breastfeeding support practices in designated workplaces.Results. Fourteen participants completed the online survey. Breastfeeding support practices in designated workplaces were limited and inadequate, with few supportive breastfeeding practices. Onsite or nearby crèche facilities (n=2; 14.3%), breastfeeding counsellors (n=1; 7.1%), promotion of the benefits of breastfeeding to employees (n=2; 14.3%) and provision of private space for expressing (n=2; 14.3%) were not common practices. Workplace breastfeeding policies (n=4; 28.6%) were not common practice, and were mostly found in the public sector. Forty-three percent of workplaces (n=6; 42.9%) did not provide time for expressing at work.Conclusion. There is an urgent need to create advocacy regarding the benefits of breastfeeding support in the workplace for employers, employees and society as well as the breastfeeding rights of women in the workplace. The legislated breastfeeding break times need to be monitored to ensure better compliance in workplaces

Determination of lovastatin, mevastatin, rosuvastatin and simvastatin with HPLC by means of gradient elution.

A novel HPLC method with UV detection was developed and validated in skin penetration (in vitro) studies to identify and quantify lovastatin, mevastatin, rosuvastatin and simvastatin. A Venusil XBP C18 (2), 150 x 4.6 mm, 5 µm column (Agela Technologies, Newark, DE) was used with gradient elution (start at 45 % acetonitrile and increase linearly to 90 % after 1 min; hold at 90 % until 6 min and then re-equilibrate at start conditions) and the mobile phase consisted of (A) Milli-Q ® water and 0.1% orthophosphoric acid, and (B) HPLC grade acetonitrile. The flow rate was set at 1 ml/min, 240 nm UV detection and an injection volume of 10 µl. Linearity was obtained over a range of 0.50-200.00 µg/ml and correlation coefficients ranging from 0.998-1.000 were obtained. Average recovery ranged from 95.9-100.6 %. The LOD and LOQ values obtained from the slope of a calibration curve and the standard deviation of the response ranged from 0.0138-0.0860 µg/ml and 0.0419-0.2615 µg/ml, respectively, where lovastatin and simvastatin could be detected at a concentration similar to the other statins, but could only be quantified at a higher concentration than the remaining statins. The specificity of the method was proved as accurate and quantification of statins was found, even within the incorporation of other compounds.

SLE pachymeningitis and multiple cranial nerve palsies: a case report and review of the literature.

Hypertrophic pachymeningitis (HP) is a relatively uncommon disease associated with focal or diffuse thickening of the dura mater secondary to underlying chronic inflammation. The link between systemic lupus erythematosus (SLE) and hypertrophic pachymeningitis (HP) is extremely rare, with only six other cases reported in the literature. We, however, report the first case of SLE pachymeningitis presenting with multiple cranial nerve palsies. The patient showed good response to steroids and cyclophosphamide therapy. One should maintain a high index of suspicion to make the diagnosis in patients with SLE presenting with neurological dysfunction. Prompt therapy prevents long-term neurological sequelae.

Sperm macrocephaly syndrome in the ostrich Struthio camelus: morphological characteristics and implications for motility.

Sperm macrocephaly syndrome (SMS) is characterised by a high percentage of spermatozoa with enlarged heads and multiple tails, and is related to infertility. Although this multiple sperm defect has been described in other mammalian species, little is known about this anomaly in birds. Morphological examination of semen from nine South African black ostriches (Struthio camelus var. domesticus) involved in an AI trial revealed the variable presence of spermatozoa with large heads and multiple tails. Ultrastructural features of the defect were similar to those reported in mammals except that the multiple tails were collectively bound within the plasmalemma. The tails were of similar length and structure to those of normal spermatozoa, and the heads were 1.6-fold longer, emphasising the uniformity of the anomaly across vertebrate species. Flow cytometry identified these cells as diploid and computer-aided sperm analysis revealed that they swim slower but straighter than normal spermatozoa, probably due to the increased drag of the large head and constrained movement of the merged multiple tails. The high incidence of this defect in one male ostrich indicates that, although rare, SMS can occur in birds and may potentially have an adverse effect on breeding programs, particularly for endangered species.

Burden, spectrum and outcomes of children with tuberculosis diagnosed at a district-level hospital in South Africa.

SETTING: The Khayelitsha subdistrict has the highest burden of reported tuberculosis (TB) cases in Cape Town, Western Cape Province, South Africa. OBJECTIVES: To characterise the TB burden, spectrum and treatment outcomes among children managed at a district-level hospital, the Khayelitsha District Hospital. DESIGN: Retrospective medical record review of all children (age <13 years) diagnosed with TB in January-July 2014. A lay health care worker completed daily surveillance and supported linkage to TB care. Symptoms and investigations at presentation, TB disease spectrum, referral pathways and outcomes were reported. RESULTS: Most children were aged 2 years (84/99, 85%), 18/96 (19%) were infected with the human immunodeficiency virus, 31/91 (34%) were malnourished and 80/99 (81%) had pulmonary TB only. The majority of the children (63/80, 79%) presented with cough of acute onset (<2 weeks). Only 5/36 (14%) eligible child contacts had documentation of receiving isoniazid preventive therapy. Twelve (13%) children had bacteriologically confirmed pulmonary TB. Overall, 93/97 (96%) children successfully continued TB care after hospital discharge. Favourable TB treatment outcomes were recorded in only 77 (78%) children. CONCLUSIONS: Children with TB managed at this district-level hospital were young, and frequently had acute symptoms and substantial comorbidities. Missed opportunities for TB prevention were identified. Linkage to care support resulted in excellent continuation of TB care; however, treatment outcomes could be further improved.

Genomic and epidemiological monitoring of yellow fever virus transmission potential.

The yellow fever virus (YFV) epidemic in Brazil is the largest in decades. The recent discovery of YFV in Brazilian Aedes species mosquitos highlights a need to monitor the risk of reestablishment of urban YFV transmission in the Americas. We use a suite of epidemiological, spatial, and genomic approaches to characterize YFV transmission. We show that the age and sex distribution of human cases is characteristic of sylvatic transmission. Analysis of YFV cases combined with genomes generated locally reveals an early phase of sylvatic YFV transmission and spatial expansion toward previously YFV-free areas, followed by a rise in viral spillover to humans in late 2016. Our results establish a framework for monitoring YFV transmission in real time that will contribute to a global strategy to eliminate future YFV epidemics.

What does an enabling environment for infant and young child nutrition look like at implementation level? Perspectives from a multi-stakeholder process in the Breede Valley Sub-District, Western Cape, South Africa.

BACKGROUND: Breede Valley is a sub-district of the Cape Winelands district, Western Cape Province, South Africa. The administrative capital of the district is situated in the semi-rural town Worcester. Findings of a baseline survey in Worcester revealed poor infant feeding practices and childhood under- and overnutrition, with particular concern over high levels of stunting and low dietary diversity. Maternal overweight and obesity was high. These characteristics made the site suitable to study multi-sectoral arrangements for infant and young child nutrition (IYCN). The purpose of this study was to explore elements of an enabling environment with key stakeholders aimed at improving IYCN at implementation level. METHODS: Focus group discussions and interviews were conducted with representatives from two vulnerable communities; local and district government; higher education institutions; business; and the media in the Breede Valley. Audio recordings were transcribed and data were analysed with the Atlas.TI software programme. RESULTS: The participants viewed knowledge and evidence about the first 1000 days of life as important to address IYCN. The impact of early, optimal nutrition on health and intellectual development resonated with them. The IYCN narrative in the Breede Valley could therefore be framed around nutrition's development impact in a well-structured advocacy campaign. Participants felt that capacity and resources were constrained by many competing agendas spreading public resources thinly, leaving limited scope for promotion and prevention activities. "People" were viewed as a resource, and building partnerships and relationships, could bridge some shortfalls in capacity. Conversations about politics and governance elicited strong opinions about what should be done through direct intervention, policy formulation and legislation. A lead government agency could not be identified for taking the IYCN agenda forward, due to its complexity. Participants proposed it should be referred to a local, informal, inter-governmental body where directors and senior managers meet to address issues of cross-cutting importance. CONCLUSION: The study illustrated that knowledge and evidence; politics and governance; and capacity and resources, elements of the international definition of an enabling environment, also apply at implementation level. In addition, our findings indicated that a people-centred approach is critical in shaping the enabling environment at this level.

Operational implementation and impact of The Union's online childhood TB training course in South Africa.

Novel, effective tuberculosis (TB) training strategies are needed in developing settings to scale up training and improve TB management at facility level. This study evaluated the feasibility of implementing an online childhood TB training course for community-based health-care workers in the Eastern Cape Province, South Africa, and measured its impact on knowledge. Training sessions were convened and participants completed the course independently. A total of 220 primary care participants completed pre- and post-training tests. The mean knowledge increase was 8% (95% confidence interval 7.0-8.8, P < 0.001). The course proved an acceptable, versatile option for decentralised training in childhood TB, provided that the technology requirements can be met.

De nouvelles stratégies efficaces de formation à la tuberculose (TB) sont requises dans les pays en développement afin d'accélérer la formation et d'améliorer la prise en charge de la TB au niveau des structures de santé. Cette étude a évalué la faisabilité de la mise en œuvre d'un cours de formation en ligne à la TB de l'enfant pour les travailleurs de santé en communauté dans la province du Cap Est, Afrique du Sud, et a mesuré l'impact sur les connaissances. Des séances de formation ont été organisées et les participants ont terminé le cours indépendamment. Un total de 220 participants travaillant en soins de santé primaires ont fait les tests avant et après la formation. L'augmentation moyenne des connaissances a été de 8% (intervalle de confiance 95% 7,0­8,8 ; P < 0,001). Le cours s'est avéré une option acceptable et souple pour une formation décentralisée à la TB de l'enfant si les exigences techniques le permettent.

En los entornos poco desarrollados se precisan estrategias de capacitación innovadoras y eficaces en materia de tuberculosis (TB) con el objeto de ampliar la escala de las iniciativas de formación y mejorar la coordinación asistencial de la TB en los establecimientos de salud. El objetivo del estudio fue evaluar la factibilidad de poner en práctica un curso de capacitación en línea sobre la TB en la niñez dirigido a los agentes de salud comunitarios en la Provincia Oriental del Cabo en Suráfrica y medir su repercusión sobre el nivel de conocimientos de los profesionales. Se convocaron sesiones de formación y luego los participantes completaron por su cuenta el curso. Doscientos veinte profesionales de atención primaria participantes completaron los cuestionarios antes y después de la capacitación. Se observó un progreso promedio de los conocimientos de 8% (intervalo de confianza del 95% 7,0­8,8; P < 0,001). Se demostró que el curso representa una opción aceptable y versátil de formación descentralizada sobre la TB en la niñez, siempre y cuando se puedan cumplir los requisitos tecnológicos.

Establishment and cryptic transmission of Zika virus in Brazil and the Americas.

Transmission of Zika virus (ZIKV) in the Americas was first confirmed in May 2015 in northeast Brazil. Brazil has had the highest number of reported ZIKV cases worldwide (more than 200,000 by 24 December 2016) and the most cases associated with microcephaly and other birth defects (2,366 confirmed by 31 December 2016). Since the initial detection of ZIKV in Brazil, more than 45 countries in the Americas have reported local ZIKV transmission, with 24 of these reporting severe ZIKV-associated disease. However, the origin and epidemic history of ZIKV in Brazil and the Americas remain poorly understood, despite the value of this information for interpreting observed trends in reported microcephaly. Here we address this issue by generating 54 complete or partial ZIKV genomes, mostly from Brazil, and reporting data generated by a mobile genomics laboratory that travelled across northeast Brazil in 2016. One sequence represents the earliest confirmed ZIKV infection in Brazil. Analyses of viral genomes with ecological and epidemiological data yield an estimate that ZIKV was present in northeast Brazil by February 2014 and is likely to have disseminated from there, nationally and internationally, before the first detection of ZIKV in the Americas. Estimated dates for the international spread of ZIKV from Brazil indicate the duration of pre-detection cryptic transmission in recipient regions. The role of northeast Brazil in the establishment of ZIKV in the Americas is further supported by geographic analysis of ZIKV transmission potential and by estimates of the basic reproduction number of the virus.

Clinical features and outcome of lupus myocarditis in the Western Cape, South Africa.

BACKGROUND: African American ethnicity is independently associated with lupus myocarditis compared with other ethnic groups. In the mixed racial population of the Western Cape, South Africa, no data exists on the clinical features/outcome of lupus myocarditis. OBJECTIVES: The objective of this study was to give a comprehensive description of the clinical features and outcome of acute lupus myocarditis in a mixed racial population. METHODS: Clinical records (between 2008 and 2014) of adult systemic lupus erythematosus (SLE) patients at a tertiary referral centre were retrospectively screened for a clinical and echocardiographic diagnosis of lupus myocarditis. Clinical features, laboratory results, management and outcome were described. Echocardiographic images stored in a digital archive were reanalysed including global and regional left ventricular function. A poor outcome was defined as lupus myocarditis related mortality or final left ventricular ejection fraction (LVEF) <40%. RESULTS: Twenty-eight of 457 lupus patients (6.1%) met inclusion criteria: 92.9% were female and 89.3% were of mixed racial origin. Fifty-three per cent of patients presented within three months after being diagnosed with SLE. Seventy-five per cent had severely active disease (SLE disease activity index ≥ 12) and 67.9% of patients had concomitant lupus nephritis. Laboratory results included: lymphopenia (69%) and an increased aRNP (61.5%). Treatment included corticosteroids (96%) and cyclophosphamide (75%); 14% of patients required additional immunosuppression including rituximab. Diastolic dysfunction and regional wall motion abnormalities occurred in > 90% of patients. LVEF improved from 35% to 47% (p = 0.023) and wall motion score from 1.88 to 1.5 (p = 0.017) following treatment. Overall mortality was high (12/28): five patients (17.9%) died due to lupus myocarditis (bimodal pattern). Patients who died of lupus myocarditis had a longer duration of SLE (p = 0.045) and a lower absolute lymphocyte count (p = 0.041) at diagnosis. LVEF at diagnosis was lower in patients who died of lupus myocarditis (p = 0.099) and in those with a persistent LVEF < 40% (n = 5; p = 0.046). CONCLUSIONS: This is the largest reported series on lupus myocarditis. The mixed racial population had a similar prevalence, but higher mortality compared with other ethnic groups (internationally published literature). Patients typically presented with high SLE disease activity and the majority had concomitant lupus nephritis. Lymphopenia and low LVEF at presentation were of prognostic significance, associated with lupus myocarditis related mortality or a persistent LVEF < 40%.

Outcome of culture-confirmed isoniazid-resistant rifampicin-susceptible tuberculosis in children.

SETTING: Isoniazid-resistant rifampicin-susceptible (HRRS) tuberculosis (TB) is the most prevalent form of drug-resistant TB globally, and may be a risk factor for poor outcomes, but has been poorly described in children. OBJECTIVE: To characterise the clinical presentation, treatment, and clinical and microbiological outcomes among children with culture-confirmed HRRS TB. DESIGN: Retrospective hospital-based cohort study. RESULTS: Of the 72 children included in the study, the median age was 50.1 months (IQR 21.5-102.5); 42% were male. Forty-four (51%) had a potential source case; only 13 were confirmed HRRS TB. Of 66 tested, 12 (17%) were human immunodeficiency virus (HIV) infected, and 36 (60%) of the 60 with pulmonary TB (PTB) had severe disease. Seventy children had treatment data; the median total duration of treatment was 11.3 months (IQR 9-12.3); 25 (36%) initiated treatment with a three-drug intensive phase; 52 (74%) received a fluoroquinolone. Of 63 children with known outcomes, 55 (88%) had a favourable outcome, 1 died and 3 had treatment failure. Ten had positive follow-up cultures at ⩾2 months after starting treatment. Older age (P = 0.008), previous anti-tuberculosis treatment (P = 0.023) and severe PTB (P = 0.018) were associated with failure to culture-convert at ⩾2 months. CONCLUSIONS: Although overall outcomes were good, prolonged culture positivity and cases of treatment failure emphasise the need for additional attention to the management of children with HRRS TB.

Body composition of rheumatoid arthritis patients in the City of Cape Town, South Africa.

Patients with rheumatoid arthritis (RA) tend to have a poor nutritional status. This study aimed to gather information on body composition in patients with RA in private and public health settings in the City of Cape Town, South Africa (SA). This cross-sectional study evaluated adults with RA. Information on demographics, comorbidities and medication was gathered. Anthropometrical measurements included weight, height, waist circumference and skinfolds and were used to calculate, interpret and classify body mass index (BMI), percentage body fat, waist circumference, fat mass index (FMI) and fat-free mass index (FFMI). Ethics approval for the execution of the study was obtained from the Health Research Ethics Committee of Stellenbosch University. The study included 251 participants [mean age, 54.7 years; ±standard deviation (SD) 13.6]. The mean BMI was 30.3 kg/m(2) (±SD 6.7) and 26.6 kg/m(2) (±SD 6.1) for women and men, respectively. BMI was used to classify obesity (45.9 %), overweight (26.8 %), normal weight (25.6 %) and underweight (1.6 %). Waist circumference classifications showed a substantially increased risk for metabolic complications in 127 participants (51.8 %) and an increased risk in 52 participants (21.2 %). Low fat-free mass (FFMI of <10th percentile) was seen in 24 participants (21 %), and obesity (FMI of >90th percentile) was seen in 31 (27 %). Rheumatoid cachexia was identified in 12 participants (10.3 %). Results indicate suboptimal nutritional status in patients with RA in the current setting. It highlights the importance of involving dietitians in the management of RA, with a view to reduce symptoms, improve quality of life, prevent cardiovascular disease and decrease overall medical costs.

Cold pleasure. Why we like ice drinks, ice-lollies and ice cream.

This review discusses how the ingestion of cold foods and drinks may be perceived as pleasant because of the effects of cooling of the mouth. The case is made that man has originated from a tropical environment and that cold stimuli applied to the external skin may initiate thermal discomfort and reflexes such as shivering and vasoconstriction that defend body temperature, whereas cold stimuli applied to the mouth are perceived as pleasant because of pleasure associated with satiation of thirst and a refreshing effect. Cold water is preferred to warm water as a thirst quencher and cold products such as ice cream may also be perceived as pleasant because oral cooling satiates thirst. The case is made that cold stimuli may be perceived differently in the skin and oral mucosa, leading to different effects on temperature regulation, and perception of pleasure or displeasure, depending on the body temperature and the temperature of the external environment.

In vivo/in vitro pharmacokinetic and pharmacodynamic study of spray-dried poly-(dl-lactic-co-glycolic) acid nanoparticles encapsulating rifampicin and isoniazid.

Poly-(dl-lactic-co-glycolic) acid (PLGA) nanoparticles were prepared by a double emulsion solvent evaporation spray-drying technique and coated with polyethylene glycol (PEG 1% v/v). The PLGA nanoparticles had a small size (229±7.6 to 382±23.9nm), uniform size distribution and positive zeta potential (+12.45±4.53mV). In vitro/in vivo assays were performed to evaluate the pharmacokinetic (PK) and pharmacodynamic (PD) performance of these nanoparticles following nanoencapsulation of the anti-tuberculosis drugs rifampicin (RIF) and isoniazid (INH). The results demonstrated the potential for the reduction in protein binding of these drugs by protection in the polymer core. Furthermore, in vitro efficacy was demonstrated using Mycobacterium tuberculosis (M. tb.) (strain H37Rv). Sustained drug release over seven days were observed for these drugs following once-off oral administration in mice with subsequent drug distribution of up to 10 days in the liver and lungs for RIF and INH, respectively. It was concluded by these studies combined with our previous reports that spray-dried PLGA nanoparticles demonstrate potential for the improvement of tuberculosis chemotherapy by nanoencapsulation of anti-tuberculosis drugs.