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Climate change is one of the most pressing challenges faced by developing countries due to their lower adaptive capacity, with far-reaching impacts on agriculture. The mid-century period is widely regarded as a critical moment, during which adaptation is deemed essential to mitigating the associated impacts. This study presents future climate projections across Tanzania using the latest generation of global climate models (CMIP6) combined with a high-resolution regional climate model. The findings indicate that, the trends in temperature and precipitation in Tanzania from 1991 to 2020, minimum temperatures showed the highest variability with a trend of 0.3 °C, indicating significant fluctuations in minimum temperature over the decades. Maximum temperatures also showed high variability with a trend of 0.4 °C. There is a range of variability in precipitation per decade for different regions in Tanzania, with some regions experiencing significant decreases in precipitation of up to - 90.3 mm and - 127.6 mm. However, there were also regions that experienced increases in precipitation, although these increases were generally less than 4.8 mm over the decades. The projections of minimum and maximum temperatures from 2040 to 2071 under the Shared Socioeconomic Pathways (SSP) 2-4.5 and SSP 5-8.5 are projected to increase by 0.14 °C to 0.21 °C per decade, across different regions. The average projected precipitation changes per decade vary across regions. Some regions are projected to experience increases in precipitation. Other regions are projected to show decreases in precipitation within the range of - 0.6 mm to 15.5 mm and - 1.5 mm to 47.4 mm under SSP2-4.5 and SSP5-8.5 respectively. Overall, both scenarios show an increase in projected temperatures and precipitation for most regions in Tanzania, with some areas experiencing more significant increases compared to others. The changes in temperatures and precipitation are expected to have significant impacts on agriculture and water resources in Tanzania.
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Introduction: Ischaemia/reperfusion (I/R) may lead to acute kidney injury via the induction of oxidative stress. On the other hand, Moringa oleifera has been reported to exert antioxidant activities. This study was designed to assess whether or not Moringa oleifera-based feed supplement could prevent I/R-induced renal injury. Materials and methods: Renal I/R was induced by occluding the right renal artery for 30 min followed by a 2-h reperfusion. Results: Renal I/R led to increased absolute renal weight and renal organo-somatic weight index. Renal I/R also caused distortion of renal histoarchitecture and impaired renal function evidenced by elevated serum creatinine and blood urea nitrogen. In addition, renal I/R significantly elevated renal levels of hydrogen peroxide, MDA, and advanced oxidation protein products, but suppressed the levels of reduced glutathione, protein thiol, and non-protein thiol, and the activities of superoxide dismutase and glutathione peroxidase. In addition, renal I/R up-regulated myeloperoxidase activity and the renal levels of NO, TNF-α, and IL-6. Renal I/R also up-regulated Bax and caspase 3 expression in the kidney. Furthermore, I/R-driven structural and biochemical alterations were markedly inhibited by Moringa oleifera-based feed supplement. Discussion: These results suggest that Moringa oleifera-based feed supplement may preserve the gross and histoarchitectural integrity of the kidney as well as renal function via downregulation of Bax/caspase 3 signaling by targeting oxidative stress, inflammation and apoptosis in the kidney of I/R rat.
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Introduction: This study aimed at determining the predictive value (PV) of transrectal ultrasonic Doppler and elastographic features in prostate cancer (PCa) detection among patients in Lagos University Teaching Hospital. Materials and Methods: This prospective study involved patients that underwent evaluation for PCa. Participants had digital rectal examination (DRE), prostate-specific antigen (PSA) assay, and transrectal ultrasound-guided prostate biopsy using colour Doppler (CD) and elastography. All cores were sent for histopathology. Data were analysed using Statistical Package for the Social Sciences Version 22.0. CD and elastography PV in PCa detection and their relationships to the Gleason score (GS) were analysed (P < 0.05). Results: Seventy men (aged between 45 and 87 years) were enrolled. Forty-three (61.4%) patients had PCa with a mean age of 69.37 ± 8.22years. The sensitivity, specificity, positive PV (PPV), negative PV (NPV) and accuracy of CD were 8.50%, 97.44%, 64.10%, 66.42% and 66.31%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of elastography were 84.21%, 94.59%, 88.89%, 92.11% and 91.07%, respectively. Conclusion: There is a significant association between decreased elasticity (elastography) and PCa detection but a weak association between increased vascularity (CD) and PCa detection. A positive correlation exists between extent of prostatic stiffness and GS.
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Background Male infertility is one of the major reproductive health concerns, causing a lot of distress for couples globally. Others have looked into its connection to vitamin D deficiency, but their findings are conflicting. Aim This study aimed to determine the relationship between male infertility and vitamin D deficiency among Nigerians. Method This analytical cross-sectional study was conducted among 132 men. A purposive sampling technique was employed to recruit 66 participants in the study (men with infertility) and control groups (men with proven fertility). Descriptive statistics were conducted, while the association between vitamin D level and sperm parameters was assessed using bivariate and regression modeling. A two-tailed test of the hypothesis was assumed, and the level of statistical significance was set at a P-value < 0.05. Results None of the participants had a serum vitamin D deficiency. However, the overall serum vitamin D insufficiency rate was 15%. The median vitamin D level for the total study population (both fertile and infertile) was 37.52 ng/ml (IQR: 32.1 - 51.69). This study demonstrated no association between serum vitamin D levels and male infertility, as well as no association between serum vitamin D levels and the quality of semen parameters. Conclusion There was no significant association between vitamin D levels, male infertility, and seminal fluid parameters. However, larger multi-center studies are recommended to provide further insights into this conclusion.
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Grain growth is prevalent in nanocrystalline (NC) materials at low homologous temperatures. Solute element addition is used to offset excess energy that drives coarsening at grain boundaries (GBs), albeit mostly for simple binary alloys. This thermodynamic approach is considered complicated in multi-component alloy systems due to complex pairwise interactions among alloying elements. Guided by empirical and GB-segregation enthalpy considerations for binary-alloy systems, a novel alloy design strategy, the "pseudo-binary thermodynamic" approach, for stabilizing NC-high entropy alloys (HEAs) and other multi-component-alloy variants is proposed. Using Al25Co25Cr25Fe25 as a model-HEA to validate this approach, Zr, Sc, and Hf, are identified as the preferred solutes that would segregate to HEA-GBs to stabilize it against growth. Using Zr, NC-Al25Co25Cr25Fe25 HEAs with minor additions of Zr are synthesized, followed by annealing up to 1123 K. Using advanced characterization techniques- in situ X-ray diffraction (XRD), scanning/transmission electron microscopy (S/TEM), and atom probe tomography, nanograin stability due to coupling self-stabilization and solute-GB segregation effects is reported in HEAs up to substantially high temperatures. The self-stabilization effect originates from the preferential GB-segregation of constituent HEA-elements that stabilizes NC-Al25Co25Cr25Fe25 up to 0.5Tm (Tm-melting temperature). Meanwhile, solute-GB segregation originates from Zr segregation to NC-Al25Co25Cr25Fe25 GBs; this results in further stabilization of the phase and grain-size (≈14 nm) up to ≈0.58 and ≈0.64Tm, respectively.
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BACKGROUND: The control of asymptomatic malaria is considered a key aspect of malaria control. This study aimed to assess the knowledge and perception of asymptomatic malaria among people in Ho municipality of the Volta region. METHODS: A descriptive cross-sectional study involving questionnaire administration was conducted among randomly sampled residents of the Ho municipality of the Volta region of Ghana. Using SPSS version 25 statistical software, frequency distributions and proportions were computed for sociodemographic variables while knowledge and perception about asymptomatic malaria were computed into percentages and categorized into three levels based on Bloom's cut-off for further analysis. Findings with p-values <0.05 were considered statistically significant. RESULTS: Among the 200 participants, 197 (98.5%) were aware of malaria. The majority (116 [58.0%]) of the study participants agreed to the possibility of asymptomatic infection, but most (133 [66.5%]) of the community members did not know that asymptomatic individuals can still transmit infections. The majority of the participants (184 [92.0%]) showed interest in getting further education on asymptomatic malaria and a significant majority (180 [90.0%]) expressed a willingness to take treatment after testing positive without showing any symptoms. CONCLUSIONS: Asymptomatic malaria control can be achieved through a mass testing and treatment strategy, therefore improving the knowledge and perception about asymptomatic malaria might improve malaria control.
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Malaria , Humanos , Ghana/epidemiología , Estudios Transversales , Malaria/epidemiología , Malaria/diagnóstico , PercepciónRESUMEN
Background:Methicillin resistant S. aureus(MRSA) has become a major public health predicament worldwide. This is owing to its involvement in the evolution of MDR strains and difficulty in therapeutic management of infected patients. This study was conducted to investigate the prevalence of methicillin resistance Staphylococcus aureusamong patients in two health facilities in Akwa Ibom State, Nigeria.Materials and Methods:Clinical isolates of patients from University of Uyo Teaching Hospital (UUTH), Uyo and General Hospital, Ikot Abasi (GHIA) were investigated based on the strategic location of the hospitals. The study design was a descriptive cross-sectional study. Three hundred clinical samples were collected from male and female in and out-patients of all ages and processed using standard bacteriological methods. Detection of Staphylococcus aureusand MRSAstrains were done according to standard protocols while antibiotic susceptibility testing of MRSAisolates was conducted using Kirby-Bauer disc diffusion method and interpreted following the CLSI 2021 guidelines. Results:The prevalence of MRSAstrains in this study was 42.9%. Majority of patients with MRSAwere from UUTH (44%) closely followed by patients from GHIA(40%). High antibiotics resistant rates of MRSAwere recorded for ampicillin (96.6%), ciprofloxacin (73.3%), erythromycin (63.3%) and cotrimoxazole (60%). Gentamicin and ceftriaxone sensitivity rates were 53.3% and 63.4%, respectively. Conclusion:Health facilities in the state should institute effective antimicrobial stewardship, intensify surveillance and screening of Staphylococcus aureusfor MRSAstrains to guard against dissemination of multidrug resistant strains in both hospital and community settings because of the clinical implications
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Staphylococcus aureus Resistente a Meticilina , PrevalenciaRESUMEN
Background:Methicillin resistant S. aureus(MRSA) has become a major public health predicament worldwide. This is owing to its involvement in the evolution of MDR strains and difficulty in therapeutic management of infected patients. This study was conducted to investigate the prevalence of methicillin resistance Staphylococcus aureusamong patients in two health facilities in Akwa Ibom State, Nigeria.Materials and Methods:Clinical isolates of patients from University of Uyo Teaching Hospital (UUTH), Uyo and General Hospital, Ikot Abasi (GHIA) were investigated based on the strategic location of the hospitals. The study design was a descriptive cross-sectional study. Three hundred clinical samples were collected from male and female in and out-patients of all ages and processed using standard bacteriological methods. Detection of Staphylococcus aureusand MRSAstrains were done according to standard protocols while antibiotic susceptibility testing of MRSAisolates was conducted using Kirby-Bauer disc diffusion method and interpreted following the CLSI 2021 guidelines. Results:The prevalence of MRSAstrains in this study was 42.9%. Majority of patients with MRSAwere from UUTH (44%) closely followed by patients from GHIA(40%). High antibiotics resistant rates of MRSAwere recorded for ampicillin (96.6%), ciprofloxacin (73.3%), erythromycin (63.3%) and cotrimoxazole (60%). Gentamicin and ceftriaxone sensitivity rates were 53.3% and 63.4%, respectively. Conclusion:Health facilities in the state should institute effective antimicrobial stewardship, intensify surveillance and screening of Staphylococcus aureusfor MRSAstrains to guard against dissemination of multidrug resistant strains in both hospital and community settings because of the clinical implications.
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Staphylococcus aureus , Prevalencia , Staphylococcus aureus Resistente a Meticilina , Terapéutica , Clindamicina , Diagnóstico , Instituciones de SaludRESUMEN
Background: This study investigated the knowledge, attitude, and practices of residents in the Ho municipality towards intestinal helminth infections and their prevention. Method: A descriptive cross-sectional study involving questionnaire administration was conducted among randomly sampled residents of the Ho municipality of the Volta Region of Ghana. A minimum sample size of 400 was calculated for subjects using Yamane's formula for population. Pearson's chi-square analysis was done to determine any relationship between sociodemographic characteristics and the categories of knowledge, attitude, and practices. Results from data analysis were computed as frequencies and percentages. P < 0.05 is considered statistically significant. Results: Of the 400 participants, 343 (85.7%) were aware of intestinal helminths, but the majority had poor knowledge of its cause despite 50.5% (202) having good knowledge scores. Most participants (331, 82.8%) had a bad attitude toward preventing the disease. Most (335, 83.8%) of the community members still adhered to the poor practice of open defecation with the excuse of unavailable latrines, and some (143, 35.8%) believe that intestinal helminths are nothing to worry about. Conclusion: Health education should address the perceptions towards preventing intestinal helminthiasis and be complemented by making available public lavatories in the municipality to curb the unacceptable practice of open defecation.
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Background: Organophosphate (OP) pesticides have been associated with a decline in semen quality, although there are still considerable arguments about the magnitude of the association. Objective: This study provides a systematic review and meta-analysis of the impacts of OP pesticides on semen quality and male reproductive hormones. Methods: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocols. Strategic search was conducted using combined text words as search terms. The eligibility criteria were developed based on Population, Exposure, Comparator, Outcome, and Study designs (PECOS) framework. Relevant data were extracted, risk of bias was evaluated by The Office of Health Assessment and Translation (OHAT) tool, and certainty of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group guidelines. Quantitative meta-analysis was performed by using Review Manager. Results: A total of 766 male subjects (349 exposed to OP pesticides and 417 unexposed controls) were included in the meta-analysis. There was no significant difference in the ejaculate volume, seminal fluid volume, sperm multiple anomaly index, sperm, and leukocytes levels of the OP-exposed subjects compared to the control. In addition, OP pesticides exposure did not significantly affect serum concentrations of FSH, LH, and testosterone in subjects who were exposed to OP pesticides compared to their unexposed counterparts. However, we found a significant reduction in the sperm count, sperm concentration, progressive sperm motility, total sperm motility, and normal sperm morphology of OP pesticides-exposed subjects compared to the unexposed subjects. However, after subtype and sensitivity analyses, exposure to OP pesticides did not reduce sperm count. Also, after sensitivity analysis, OP pesticides exposure did not alter progressive sperm motility. Conclusion: This study demonstrates that OP pesticides exposure reduced sperm count, concentration, total and progressive motility, and normal sperm morphology, possibly via a testosterone-independent mechanism.
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Insecticidas , Semen , Humanos , Masculino , Análisis de Semen , Testosterona , Motilidad Espermática , Compuestos Organofosforados , Organofosfatos/toxicidadRESUMEN
Introduction and aim: Although the sense of smell in pigs is widely recognized as being highly developed, surprisingly little is known about their sensory ability. This study aimed to (a) identify which non-social odors pigs were able to detect and distinguish between, (b) investigate the types of behavior expressed when exploring odors and, (c) compare pigs' responses to the different odors to evaluate their interest in the odors. Methods: Growing pigs (N = 192) of crossbred commercial breeds were enrolled in the experiment (32-110 days of age, weighing 64.9 ± 10.1kg). Littermate pairs of opposite sex were tested in test pens with two odor insertion points in the pen wall, 55 cm apart. All pigs were habituated to the test pens and experimenters. Twelve odors were tested (eight essential oils and four synthetic perfumes) in groups of three odors, with each pig pair tested once with one set of three odors (all possible orders of the three odors were tested on 24 pairs in total), always against a non-odor control (demineralized water). In a test, each of the three odors were presented during three trials in a row (a total of 9 trials per test; trial duration: 1 min; inter-trial breaks: 2 min; total test duration: 25 min). Response variables included: duration of sniffing, feeding-related behavior (licking, biting and rooting), agonistic behavior (biting, displacement and pushing) and no approach of the odor or control, recorded throughout each 1-min odor presentation. Results: All pigs sniffed an odor less when repeatedly presented (LMM: all odors P < 0.05), and significantly longer at the subsequent presentation of a new odor [LMM (3rd vs. 1st presentations): P < 0.001]. Specific odor and odor type (essential oil vs. synthetic perfume) had no significant effect on sniffing duration. Overall, feeding-related behavior and agonistic behavior were expressed significantly more when pigs explored the odor compared with the control insertion point (Paired t-tests: P < 0.001), and specific odor only affected the expression of feeding-related behavior. Conclusion: Collectively, pigs express sniffing, agonistic, and feeding-related behavior when exploring odors, which suggests that pigs perceive odors of non-social origin as a resource. Odors may thus constitute relevant enrichment material for pigs.
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Background: Malnutrition is a problem that affects many children and therefore is the focus of multiple interventions worldwide. One intervention is community-based management of acute malnutrition (CMAM). Objective: This study assessed CMAM implementation quality in the Builsa North District of Ghana, and the satisfaction among both users and CMAM staff. Design: The study used a convergent mixed-method design involving in-depth interviews with CMAM staff and users, document reviews, and observations of the CMAM implementation. The data were collected across eight health care facilities in eight sub-districts. The data were qualitatively and thematically analysed in Nvivo software. Results: Several factors were found to adversely affect the quality of CMAM implementation. Significant factors included inadequate training of CMAM workers; religious belief systems; and a lack of implementation materials, such as ready-to-use therapeutic food (RUTF), CMAM registration forms/cards, and computers. These factors adversely affected programme quality, thus resulting in dissatisfaction among CMAM users and staff. Conclusion: This study established that the CMAM programme in the Builsa North District of Ghana is hindered by a lack of primary resources and logistics necessary for successful programme implementation. Most health facilities in the district lack such resources and are not delivering the intended results.
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Cold spray (CS) processing is a layer-by-layer solid-state deposition process in which particles at a temperature below their melting point are launched to sufficiently high velocities to adhere to a substrate (and previously deposited particles), forming coatings/parts. Despite being in existence for over four decades, particle bonding mechanisms in the CS process are unclear due to the complex particle-particle/carrier gas interactions that obscure assessment. This review evaluates recent findings from single-particle impact approaches that circumvent these complexities and further provide new insights on bonding mechanisms. Theories on the evolution of oxide layer breakup and delamination, adiabatic shear instability, jetting, melting, and interface solid-state amorphization that contributes to bonding are assessed and carefully reviewed. Although there is a unified condition in which bonding sets on, this study shows that no singular theory explains bonding mechanism. Rather, dominant mechanism is a function of the prevailing barriers unique to each impact scenario.
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Studies have implicated oxidative stress-sensitive signaling in the pathogenesis of stress-induced male infertility. However, apart from oxidative stress, gonadotropin inhibitory hormone (GnIH) plays a major role. The present study provides a detailed review of the role of GnIH in stress-induced male infertility. Available evidence-based data revealed that GnIH enhances the release of corticosteroids by activating the hypothalamic-pituitary-adrenal axis. GnIH also mediates the inhibition of the conversion of thyroxine (T4) to triiodothyronine (T3) by suppressing the hypothalamic-pituitary-thyroidal axis. In addition, GnIH inhibits gonadotropin-releasing hormone (GnRH), thus suppressing the hypothalamic-pituitary-testicular axis, and by extension testosterone biosynthesis. More so, GnIH inhibits kisspeptin release. These events distort testicular histoarchitecture, impair testicular and adrenal steroidogenesis, lower spermatogenesis, and deteriorate sperm quality and function. In conclusion, GnIH, via multiple mechanisms, plays a key role in stress-induced male infertility. Suppression of GnIH under stressful conditions may thus be a beneficial prophylactic and/or therapeutic strategy.
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Sistema Hipotálamo-Hipofisario , Infertilidad Masculina , Masculino , Humanos , Sistema Hipófiso-Suprarrenal , Semen , Gonadotropinas , Infertilidad Masculina/etiología , FertilidadRESUMEN
Viral infections have been a part of human existence to date, though viruses have posed a huge threat with various outbreaks lately. These threats are associated with reproductive health challenges, especially male infertility. The prime focus of this review is to highlight the mechanisms associated with viral infection-induced male infertility/subfertility and identify new treatment strategies with the aim to preserve male fertility. The reviewed data showed that viral infections stimulate inflammatory responses, resulting in the release of proinflammatory cytokines, which induces oxidative stress. This oxido-inflammatory cycle could continue in a vicious cycle and threaten male fertility. Existing data from human and experimental studies show that viral infection-induced oxido-inflammatory response results in testicular damage, atrophy of the seminiferous tubules and Sertoli cells, and reduced Leydig cell mass. This is accompanied by reduced circulatory testosterone, impaired spermatogenesis, reduced sperm motility, lipid peroxidation, DNA fragmentation and apoptosis of the sperm cells. Based on the available pieces of evidence, antioxidant therapy, in vivo and in vitro, may be beneficial and protects against the potential risk of male infertility from viral infection. It is, however recommended that more clinical studies be conducted to demonstrate the possible protective roles of antioxidants used as adjuvant therapy in viral infections, and in the in vitro treatment of semen samples for those utilizing semen washing and artificial reproductive techniques.
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Background and Aims: Several studies have shown that the length of ejaculatory abstinence alters sperm quality. However, the available data are conflicting and none seems to exist in a Nigerian population. The present study aims to compare the semen quality in normozoospermic and oligozoospermic semen samples of a homogenous Nigerian population, following varying ejaculatory abstinence days (EAD); less than 2, 2-3, and 3-7 days. Methods: The present retrospective study included 5165 semen samples collected over 5 years, from April 2015 to April 2020. Results: In normozoospermic samples, sperm count and total sperm count were significantly higher in prolonged EAD. In oligozoospermic patients, semen volume significantly increased with prolonged EAD, while sperm count, total sperm count, and progressive motility were significantly reduced with prolonged EAD. In addition, EAD and sperm volume positively correlated in oligozoospermic patients. Conclusion: Our findings indicate that EAD affects sperm quality in both normozoospermic and oligozoospermic men with varying impacts. Prolonged EAD increased sperm count and total sperm count in normozoospermic patients, while EAD increased semen volume but reduced sperm count, total sperm count, and progressive motility in oligozoospermic patients.
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Background: Topical antibiotics are frequently used to treat acne vulgaris. Their prolonged use, often for longer durations than recommended, has led to antibiotic resistance in Cutibacterium acnes (C. acnes), a bacterium implicated in acne pathophysiology. Bacteriophage (phage), which specifically target C. acnes by a different mechanism of action and do not harm potentially beneficial bacteria, may offer an alternative approach for improvement of the appearance of acne prone skin. Objectives: To identify and characterize C. acnes targeting phage, carry out a comprehensive preclinical safety evaluation of phages selected for further development and examine their safety, tolerability and ability to target facial C. acnes when applied topically in a cosmetic clinical study including participants with mild-to-moderate acne. Methods: Phages were isolated by conventional microbiological methods also used to examine their breadth of host range on different C. acnes strains and specificity to this bacterial species. Safety assessment of three selected phages was carried out by complete genomic analysis to assure the absence of undesired sequences and by ex vivo models employed to evaluate the safety, irritability and potential systemic bioavailability of phage applied topically. A randomized, controlled clinical study assessed safety, tolerability and efficacy in targeting facial C. acnes. Results: Wide host range phages that also target antibiotic resistant C. acnes were identified. Their genomes were shown to be free of undesired genes. The three-phage cocktail, BX001, was not irritant to human skin or ocular tissues in ex vivo models and did not permeate through human epidermis. In a cosmetic clinical study, topically applied BX001 was safe and well tolerated and reduced the facial burden of C. acnes. Conclusions: Combined in silico and ex vivo approaches successfully predicted the observed safety and efficacy of C. acnes targeting phage when these were topically administered in a well-controlled cosmetic clinical study.
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PURPOSE: There are limited reports of quality metrics in glioblastoma. We audited our adherence to quality indicators as proposed in the PRIME Quality Improvement study. METHODS: This is a retrospective audit of patients treated between 2017 and 2020. After postsurgical integrated diagnosis, patients received radiotherapy (RT) with concurrent and adjuvant temozolomide (TMZ). Multiparametric magnetic resonance imaging at predefined times guided management. Numbers with proportions for indices were calculated. Survival was estimated using the Kaplan-Meier method. RESULTS: One hundred six patients were consecutively treated. The median age was 55 years (interquartile range of 47-61 years) with a male preponderance (68%). Ninety-six (90.6%) patients underwent subtotal resection, and 10 (9.4%) biopsy alone. Isocitrate dehydrogenase was wild-type in 96 (91%), and O6-methylguanine-DNA methyltransferase was unmethylated in 70 (66.0%) patients. Telomerase reverse transcriptase promoter was mutated in 64 (60.4%), and TP53 was mutated in 22 (20.8%). Concurrent radiation and TMZ were planned for 104 (98.1%), and radiation alone for 2 (1.9%). The median time to concurrent RT-TMZ was 36 days (interquartile range 30-44 days). All patients planned for RT-TMZ completed treatment, but only 81 (76%) completed adjuvant TMZ. Sixty-three (59%) completed six cycles, 18 (17%) received less than six cycles, and 25 (24%) did not receive adjuvant TMZ. At a median follow-up of 24 months (range 21-31 months), the median (95% CI) progression-free survival and overall survival were 11 (95% CI, 9.4 to 13.0) and 20.0 (95% CI, 15 to 26) months, respectively. CONCLUSION: Our patients met quality indices in most domains; outcomes are comparable with global results. Metrics will be periodically evaluated to include new standards and assess continuous service appropriateness.
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Neoplasias Encefálicas , Glioblastoma , Antineoplásicos Alquilantes/uso terapéutico , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/terapia , Dacarbazina/uso terapéutico , Glioblastoma/tratamiento farmacológico , Glioblastoma/terapia , Humanos , Masculino , Persona de Mediana Edad , Indicadores de Calidad de la Atención de Salud , Estudios Retrospectivos , Temozolomida/uso terapéutico , Atención Terciaria de SaludRESUMEN
Brucellosis is widely distributed in more than 170 countries around the world, where it poses a huge threat to animal husbandry and human health. Brucellosis is a worldwide re-emerging zoonotic disease that poses serious public health problems in many developing countries including Kenya. However, prevalence of brucellosis has not been determined in Baringo County, Kenya, yet there is a continuous movement of cattle resulting from trade and grazing, thus predisposing many herds to brucellosis infection. We investigated the sero-prevalence of brucellosis in humans and domestic ruminants: sheep, goats, cattle and camels among livestock keeping communities in Baringo County, Kenya. In addition, we analyzed the seropositive samples for molecular detection of Brucella species. The study adopted a cross-sectional survey using quantitative data collection methods. The diagnosis was carried out using a competitive enzyme-linked immunosorbent assay (c-ELISA) and the real-time PCR assays. The sero-prevalence of brucellosis among human blood samples was 0.6% (n = 4/640) in Baringo County. About 22.30% (n = 143/640) of animal blood samples examined tested positive for Brucella genus-specific ELISA test. Cattle had a high prevalence of 22.88% (n = 93/322) followed by camels 20.00% (n = 21/105), goats 15.48% (n = 24/155) and subsequently sheep at 8.62% (n = 5/58). Overall, 7.5% (n = 6/80) of the seropositive samples amplified with the genus-specific primers. Brucella melitensis was detected in one out of the six genus positive samples, while none amplified with the B. abortus target. Even though there was high prevalence of brucellosis among livestock in Baringo County, the highest prevalence was invariably noted in cattle, followed by camels, goats and sheep, respectively. Livestock keepers had low prevalence of brucellosis. This implies that there was low risk of transmission of brucellosis between livestock keepers and their livestock.