Introduction of routine zinc therapy for children with diarrhoea: evaluation of safety

On 8 May 2004, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommended routine administration of zinc in the management of children, aged less than five years, with acute diarrhoea. In making the recommendation, WHO and UNICEF also suggested careful monitoring for adverse events associated with routine administration of zinc, particularly unusual or excess vomiting. The study assessed, in a phase IV trial, i.e. post-marketing surveillance of zinc, the occurrence of adverse events during the first hour after the administration of the first dose of zinc in children with acute or persistent diarrhoea. The study was conducted at the Dhaka Hospital of ICDDR,B and at an outpatient clinic operated by a local health NGO-Progoti Samaj Kallyan Protisthan (PSKP), Dhaka, Bangladesh. Eligible children, aged 3-59 months, were treated with 20 mg of zinc sulphate provided in a dispersible tablet formulation. The children were observed for 60 minutes following the initial treatment with zinc for adverse events, with particular attention given to vomiting or regurgitation. During the one-year observation period, 42,440 children (male 57% and female 43%) received zinc, and 20,246 (47.8%) of them were observed. Regurgitation and/or vomiting occurred in 4,392 (21.8%) of the children; 90.8% of these children had vomiting only once, 8.7% twice, and 0.5% more than twice. No children revisited the hospital for recurrent vomiting following their discharge. A significant proportion of infants and children may experience vomiting or regurgitation, usually once, following the administration of the first dose of zinc. This is a transient phenomenon that did not impact on continuation of treatment with zinc.     

Disparities in the use of mobile phone for seeking childbirth services among women in the urban areas: Bangladesh Urban Health Survey

Background

In Bangladesh, similar to its other South Asian counterparts, shortage of health workers along with inadequate infrastructure constitute some of the major obstacles for the equitable provision of reproductive healthcare services, particularly among the marginalized and underserved neighbourhoods. However, given the rapidly expanding broadband communication and mobile phone market in the country, the application of eHealth and mHealth technologies offer a window of opportunities to minimise the impact of socioeconomic barriers and promote the utilization of maternal healthcare services thereby. In the present study we aimed to investigate 1) the prevalence of usage of mobile phones for seeking childbirth services, 2) neighbourhood and socioeconomic disparities in the use, and 3) association between using mobile phones and the uptake of postnatal care among mothers and neonates.

Methods

Data for the present study came from Bangladesh Urban Health Survey 2013. Study subjects were 9014 married women aged between 15 and 49 years.

Results

The overall rate of use of mobile phone was highest in City Corporation non-Slum areas (16.2%) and lowest in City Corporation Slum areas (7.4%). The odds of using mobile for seeking childbirth services were significantly higher among those who were living in non-slum areas, and lower among those who never attended school and lived in poorer households. Results also indicated that women in the slum areas who used mobile phone for childbirth service seeking, were 4.3 times [OR?=?4.250;95% CI?=?1.856–9.734] more likely to receive postnatal care for themselves, and those from outside the city-corporation areas were 2.7 times [OR?=?2.707;95% CI?=?1.712–4.279] more likely to receive postnatal care for the newborn.

Conclusion

Neighbourhood, educational and economic factors were significantly associated with the mobile phone utilization status among urban women. Promoting access to better education and sustainable income earning should be regarded as an integral part to the expansion of mHealth for maternal healthcare seeking behaviour.

     

Aging and Engaging: A Pilot Randomized Controlled Trial of an Online Conversational Skills Coach for Older Adults

ObjectiveCommunication difficulties negatively impact relationship quality and are associated with social isolation and loneliness in later life. There is a need for accessible communication interventions offered outside specialty mental health settings.DesignPilot randomized controlled trial.SettingAssessments in the laboratory and intervention completed in-home.ParticipantsTwenty adults age 60 and older from the community and a geriatric psychiatry clinic.InterventionA web-based communication coach that provides automated feedback on eye contact, facial expressivity, speaking volume, and negative content (Aging and Engaging Program, AEP), delivered with minimal assistance in the home (eight brief sessions over 4–6 weeks) or control (education and videos on communication).MeasurementsSystem Usability Scale and Social Skills Performance Assessment, an observer-rated assessment of social communication elicited through standardized role-plays.ResultsNinety percent of participants completed all AEP sessions and the System Usability Scale score of 68 was above the cut-off for acceptable usability. Participants randomized to AEP demonstrated statistically and clinically significant improvement in eye contact and facial expressivity.ConclusionThe AEP is acceptable and feasible for older adults with communication difficulties to complete at home and may improve eye contact and facial expressivity, warranting a larger RCT to confirm efficacy and explore potential applications to other populations, including individuals with autism and social anxiety.     

Photochemical inactivation of viruses and bacteria in platelet concentrates by use of a novel psoralen and long-wavelength ultraviolet light

BACKGROUND: A photochemical treatment process has been developed for the inactivation of viruses and bacteria in platelet concentrates. This process is based on the photochemical reaction of a novel psoralen, S- 59, with nucleic acids upon illumination with long-wavelength ultraviolet light (UVA, 320–400 nm). STUDY DESIGN AND METHODS: High levels of pathogens were added to single-donor platelet concentrates containing 3 to 5 × 10(11) platelets in 300 mL of 35-percent autologous plasma and 65-percent platelet additive solution. After treatment with S-59 (150 microM) and UVA (0-3 J/cm2), the infectivity of each pathogen was measured with established biologic assays. In vitro platelet function after photochemical treatment was evaluated during 7 days of storage by using a panel of 14 assays. The in vivo recovery and life span of photochemically treated platelets were evaluated after 24 hours of storage in a primate transfusion model. RESULTS: The following levels of pathogen inactivation were achieved:>10(6.7) plaque-forming units (PFU) per mL of cell-free human immunodeficiency virus (HIV),>10(6.6) PFU per mL of cell-associated HIV,>10(6.8) infectious dose (ID50) per mL of duck hepatitis B virus (a model for hepatitis B virus),>10(6.5) PFU per mL of bovine viral diarrhea virus (a model for hepatitis C virus),>10(6.6) colony-forming units of Staphylococcus epidermidis, and>10(5.6) colony-forming units of Klebsiella pneumoniae. Expression of integrated HIV was inhibited by 0.1 microM S- 59 and 1 J per cm2 of UVA. In vitro and in vivo platelet function were adequately maintained after antiviral and antibacterial treatment. CONCLUSION: Photochemical treatment of platelet concentrates offers the potential for reducing transfusion-related viral and bacterial diseases.     

Improved specific loss power on cancer cells by hyperthermia and MRI contrast of hydrophilic FexCo1‐xFe2O4 nanoensembles

Ferrite‐based ferri/superparamagnetic nanoparticles can be rapidly heated by an external alternating magnetic field (AMF) to induce tissue necrosis of the adjacent microenvironment, but in addition provide magnetic resonance imaging (MRI) contrast utilizing enhanced water relaxivity. Here we characterized nanoensembles of Fe‐Co mixed spinel ferrites (i.e. Fe_xCo_1‐xFe₂O₄, where x ranges from 0.2 to 0.8) synthesized by chemical co‐precipitation. With nanoensembles of increasing Co content the saturation magnetization improved, while lattice parameter remained relatively constant. MRI water (transverse) relaxivity at 11.7 T was also boosted with increasing Co content. Efficiency of AMF‐induced heating was quite comparable for the nanoensembles with either chitosan or polyethylene glycol (PEG) coating except for PEG‐coated Fe_0.2Co_0.8Fe₂O₄, which was twice as less efficient as others. While toxicity of the nanoensembles with either coating examined on 9L tumor cell cultures showed no significant differences, upon AMF exposure (i.e. heat‐induced necrosis) Fe_xCo_1‐xFe₂O₄ composition with different values of x showed quite dramatic effects on cell death of tumor cells with both coatings. This study lays the ground work for further characterization of other mixed spinel ferrites, and in addition we expect that chitosan and PEG coated Fe_xCo_1‐xFe₂O₄ of all the compositions will have good potential for preclinical applications in vivo. Copyright © 2016 John Wiley & Sons, Ltd.     

Effects of sub-chronic donepezil on brain Abeta and cognition in a mouse model of Alzheimer’s disease

Rationale

Acetylcholinesterase inhibitors (AChEIs) are approved to treat the symptoms of mild to moderate Alzheimer’s disease by restoring acetylcholine levels at synapses where the neurotransmitter has been depleted due to neurodegeneration. This assumption is challenged by more recent clinical studies suggesting the potential for disease-modifying effects of AChEIs as well as in vitro studies showing neuroprotective effects. However, few preclinical studies have assessed whether the improvement of cognitive symptoms may be mediated by reductions in Abeta or Tau pathology.

Objectives

The objective of the present study was to determine whether short-duration treatment with donepezil could improve spatial learning and memory in transgenic mice overexpressing mutant human amyloid precursor protein (hAPP) and presenilin 1 (PS1) (Dewachter et al., J Neurosci 20(17):6452–6458, 2000) after amyloid pathology has fully developed, consistent with early stages of Alzheimer’sdisease in humans. In parallel, the effect of donepezil treatment on brain amyloid, Tau, and glial endpoints was measured.

Results

This study showed a significant improvement in reference memory in hAPP/PS1 mice along with dose-dependent reductions in brain amyloid-β (Aβ).

Conclusion

These results suggest that the observed cognitive improvement produced by donepezil in Alzheimer’s disease may be due, at least in part, to reduction of brain Aβ.