Directly observed treatment of tuberculosis in Hong Kong.

OBJECTIVE: To evaluate the local use of out-patient directly observed treatment (DOT) for tuberculosis (TB) control. SETTING: Seventeen government chest clinics managing around 80% of TB patients in Hong Kong. METHOD: A retrospective cohort. TB patients registered for treatment from 1 July to 31 August 2000 were followed up for 2 years. Baseline socio-demographic and clinical characteristics were correlated with adherence to DOT, mode of treatment and treatment outcomes. RESULTS: Of 988 patients, respectively 142, 140 and 21 switched to non-DOT within 2 months, 2-6 months and after 6 months. More Chinese patients than ethnic minorities switched to non-DOT within the first 2 months (15.2% vs. 0%, P = 0.001). Geographical inconvenience (31.7%) was the primary reason for switching initially, with increasing proportions giving no specific reason after the second month. Patients staying on DOT in the first 2 months had a significantly higher cure rate than those not on DOT, in both univariate (92.7% vs. 83.9%, P = 0.002) and multivariate analysis (OR = 2.5, P = 0.001). Subsequent switching, intermittent or daily regimen did not appear to affect the outcome. CONCLUSION: Significant numbers of patients failed to stay on DOT, and those staying initially had a better outcome.     

Enhanced ferromagnetism of ZnO@Co/Ni hybrid core@shell nanowires grown by electrochemical deposition method

The hybrid structure of ZnO NWs with the presence of different dopants recently has drawn many interests from researchers due to the possibility to integrate multiple functionalities into one single structure. In this article, we investigated the morphology, crystal structure and ferromagnetism of the ZnO@Co/Ni hybrid core@shell NWs prepared by a facile electrochemical deposition method. The results show that a thin layer of Ni and Co coated on the surface of ZnO NWs (confirmed by XRD, EDS, TEM and Raman scattering) can create a significant improvement of ferromagnetic property in such hybrid core@shell NWs. In which, for the coating time of 10, 15, 20 min, the value of M_s is around 0.67, 0.88 and 2.56 emu g⁻¹ for ZnO@Co NWs, and about 0.013, 0.022 and 0.031 emu g⁻¹ for ZnO@Ni NWs, respectively, in comparison with the number of 0.016 emu g⁻¹ for pure ZnO NWs. Interestingly, we also found the temperature dependence of ferromagnetism of such Co/Ni coated ZnO NWs. These results reveal the possibility to employ such hybrid core@shell NWs for many applications, e.g. spin field effect transistors.

Facile electrochemical synthesis of ZnO@Co and ZnO@Ni hybrid core@shell nanowires with enhanced ferromagnetism.     

New experimental melting properties as access for predicting amino-acid solubility

The properties of melting are required for the prediction of solubility of solid compounds. Unfortunately, direct determination of the enthalpy of fusion and melting temperature by using conventional DSC or adiabatic calorimetry is often not possible for biological compounds due to decomposition during the measurement. To overcome this, fast scanning calorimetry (FSC) with scanning rates up to 2 × 10⁴ K s⁻¹ was used in this work to measure the melting parameters for l-alanine and glycine. The enthalpy of fusion and melting temperature (extrapolated to zero heating rate) were Δ_fusH = (22 ± 5) kJ mol⁻¹ and T_fus = (608 ± 9) K for l-alanine, and Δ_fusH = (21 ± 4) kJ mol⁻¹ and T_fus = (569 ± 7) K for glycine. These melting properties were used in the modeling framework PC-SAFT to predict amino-acid solubility in water. The pure-component PC-SAFT parameters and one binary parameter were taken from literature, in which these parameters were fitted to solubility-independent thermodynamic properties such as osmotic coefficients or mixture densities. It was shown that this allowed accurately predicting amino-acid solubility in water over a broad temperature range. The combined methodology of PC-SAFT and FSC proposed in this work opens the door for predicting solubility of molecules that decompose before melting.

New experimental melting properties combined with PC-SAFT allow quantitative solubility predictions of amino acids in water.     

Multiphasic changes in systemic VEGF following intravitreal injections of ranibizumab in a child

Purpose

To investigate whether intravitreal ranibizumab injections administered to a child alter systemic plasma levels of total and free VEGF 165.

Methods

A 9-year-old child sustained a choroidal rupture from blunt trauma. He subsequently developed a secondary choroidal neovascular membrane, which was treated with five ranibizumab injections over a period of 8 months. Peripheral venous blood samples were taken at each visit over a period of 12 months and plasma was extracted. Plasma VEGF 165 levels were determined using enzyme-linked immunosorbent assay and were assayed both pre- and post-immunodepletion to remove complexed VEGF.

Results

Plasma VEGF 165 levels proved labile following intravitreal injection of ranibizumab. Levels increased by 30% above baseline following the first intravitreal ranibizumab injection, but then returned to baseline despite two subsequent injections. There was then a rebound increase of 67% in total plasma VEGF levels following a further injection, which remained above baseline for 12 weeks despite two further intravitreal ranibizumab injections. Baseline levels were re-attained 26 weeks after the final injection.

Conclusions

These results suggest intravitreal ranibizumab injections can cause significant, multiphasic changes in systemic VEGF levels. This may be of particular clinical significance in children as VEGF is known to be vital in the development of major organs, in addition to its role in the maintenance of normal organ function in adults.     

Impacts and patterns of disturbed gastrointestinal function in critically ill patients

Disordered upper gastrointestinal tract motility occurs frequently in intensive care unit patients and often represents a substantial treatment challenge. In addition to specific complications such as pulmonary aspiration and diarrhea, abnormal gastrointestinal motility is a limiting factor for delivery and success of enteral nutrition. The pathophysiologies involved are incompletely understood because of the difficulties of making measurements of gastrointestinal function in critically ill patients. With the recent development of techniques that overcome some of these difficulties, the prospects are brighter for significant advances in this field.