Isolated limb perfusion with melphalan as treatment for regionally advanced melanoma of the limbs: results of 60 patients treated in Finland during 2007-2018.

Isolated limb perfusion (ILP) is widely accepted as treatment for recurrent melanoma limited to the limbs. The use of ILP has decreased in recent years with the introduction of potentially effective new systemic therapies. We evaluated retrospectively if ILP still may be a treatment option in locally advanced melanoma. In Finland, ILP is centralized to the Comprehensive Cancer Center of Helsinki University Hospital. We included all ILP patients treated at our hospital between 2007 and 2018. Clinical factors and treatment outcomes were retrospectively evaluated. Altogether 60 patients received ILP. Toxicity was mostly transient. The overall response rate was 77% with 35% complete responses and 42% partial responses. The median progression-free survival (PFS) was 6.1 months (range 0.6-116.5 months) and the median melanoma-specific survival (MSS) was 29.9 months (range 3.5-138.7 months). Patients with CR had superior median PFS (19.7 months, range 2.5-116.5 vs. 4.5 months, range 0.6-39.7 months, P = 0.00003) and median MSS (median MSS not reached vs. 25.9 months, range 3.5-98.7 months, P = 0.0005) compared to other responders. Younger patients (<69 years) had longer median MSS (47.2 months, range 3.5-138.7 vs. 25.9 months, range 8.4-125.4 months, P = 0.015) compared to patients over 69 years. Treatment outcomes of Finnish ILP patients were comparable to earlier studies and some long-term survivors were observed in the group of complete responders. Median PFS and OS were longer for patients achieving a CR. Treatment was well-tolerated also among older patients.

Screening African rice (Oryza glaberrima) for tolerance to abiotic stresses: I. Fe toxicity.

Iron (Fe) toxicity is recognized as one of the most widely spread soil constraints for rice production especially in West Africa. Oryza glaberrima the cultivated rice species that originated from West Africa is well-adapted to its growing ecologies. The aim of this study was to identify the promising O. glaberrima accessions tolerant to Fe toxicity from the 2106 accessions held at the AfricaRice gene bank. The screenings were conducted over a four-year period and involved evaluating the entries under Fe-toxic field conditions in West Africa, selecting good yielding accessions and repeating the testing with newly selected lines. Three accessions (TOG 7206, TOG 6218-B and TOG 7250-A) were higher yielding than O. sativa checks under stress but with similar yields under control conditions. These accessions yielded over 300 g/m2 under both Fe toxicity and control conditions. In conclusion, these materials could be used as donors in breeding programs for developing high yielding rice varieties suited to Fe toxicity affected areas in West Africa.

Knowledge of Childhood Autism and Challenges of Management among Medical Doctors in Kaduna State, Northwest Nigeria.

Autism is a neurodevelopmental disorder with serious implications in childhood. There is a significant gap in the identification and provision of health and social services for autism in Africa. The knowledge of autism among health care providers and identifying challenges associated with its management could facilitate bridging the gap and ensuring better outcomes. A self-administered tool, the Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaire, was used in assessing knowledge of autism among 175 medical doctors (participants) attending an annual scientific meeting in northwest Nigeria. Other parameters assessed were sociodemographic and professional characteristics of the participants and challenges encountered in the management of autism. Out of 175 questionnaires distributed, 167 (95.4%) were returned. Good knowledge (KCAHW score ≥15) was significantly associated with being a paediatrician or psychiatrist and practicing in a tertiary health facility (P < 0.05), while poor knowledge (KCAHW score <15) was significant among general practitioners (P < 0.05). The highest knowledge gap was associated with onset of autism and its comorbidities (KCAHW Domain 4) while the least was concerning communication impairments (KCAHW Domain 2). Major challenges encountered in autism management were dearth of specialist services, cost of evaluation, and poor caregiver perspectives of autism.

Arm area measurements as indices of nutritional reserves and body water in African newborns.

Although application of non-invasive techniques for early evaluation of body water, calorie and protein reserves has been available for more than two decades, there is a dearth of information on the evaluation of extracellular water, protein and calorie reserves in the African newborn. A cross-sectional study of arm area measurements was undertaken in 510 term new-born infants consisting of 318 infants who were normal weight term infants (NWTI) with a mean birth weight of 2898.5 +/- 287.7 g and 192 low birth weight term infants (LBWTI) with a mean birth weight of 2176.5 +/- 194.7 g. The triceps skin fold thickness (TSF), the arm fat area (AFA), percentage of arm area (AFA%) and arm water area (AWA) were significantly greater in females than males weighing > 2500 g at birth (P < 0.05), though the mean birth weight and mid-upper arm circumference (MUAC) were similar (P > 0.05). With the exception of AFA%, all measured and calculated indices were significantly lower in LBWTI than in the NWTI irrespective of sex (P < 0.05). The measurements may aid detection of newborns at risk of developing malnutrition in an area of the world where childhood undernutrition is common.