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Pandemics Old and New – TB and AIDS in Africa
CF Heyns
African Journal of Urology , 2004,
Abstract: No available African Journal of Urology Vol.10(3) 2004: 169-174
Is prostate cancer more common and more aggressive in African men?
CF Heyns
African Journal of Urology , 2008,
Abstract: The highest prostate cancer incidence and mortality rates in the world have been reported among Black African-American men (AAM) living in the United States of America. These rates are significantly higher for AAM compared to White (Caucasian) American men (CAM). However, prostate cancer is not the only malignancy which is more common in AAM compared to White American men or women. Although prostate cancer has the highest Black/White mortality ratio, it is not the only malignancy which has a higher mortality in AAM compared to CAM. Numerous reports have shown that AAM present with higher grade and stage tumors, higher serum PSA levels, and that they are less likely to receive definitive or curative treatment and have a worse prognosis compared with CAM. It has been suggested that prostate cancer is not only more common, but also more biologically aggressive in AAM compared with CAM. Hypotheses attempting to explain this include genetic differences, dietary factors, higher testosterone levels or increased androgen receptor activity. However, the majority of reports from the USA indicate that, when controlled for major prognostic factors, the outcome for clinically localized as well as advanced prostate cancer does not depend on race. Several studies have indicated that socio- economic factors, decreased awareness of prostate cancer and limited access or decreased utilization of health care contribute to the poorer outcomes in AAM. Earlier studies have suggested that prostate cancer is relatively rare among indigenous Black men living in Africa. However, cancer incidence data in Africa are likely to underestimate the true rates because of underdiagnosis and underreporting. The frequency distribution of cancers in African countries, as well as more recent data indicate that prostate cancer is not rare among Black men living in Africa and that the incidence is probably similar to that of White men, although not as high as that reported for Black men living outside Africa. It is well documented that African men with prostate cancer present with more advanced disease and that palliative rather than curative treatment is used in the majority of patients. There are no reliable age-adjusted prostate cancer mortality rates available for African countries. However, there is as yet no evidence that prostate cancer in Black men living inside Africa is biologically more aggressive than in other populations. Africain Journal of Urology Vol. 14 (2) 2008: pp. 66-74
Critical appraisal of biosimilar filgrastim (Nivestim ) for febrile and chemotherapy-induced neutropenia
Waller CF
Biosimilars , 2012, DOI: http://dx.doi.org/10.2147/BS.S17420
Abstract: itical appraisal of biosimilar filgrastim (Nivestim ) for febrile and chemotherapy-induced neutropenia Review (2364) Total Article Views Authors: Waller CF Published Date August 2012 Volume 2012:2 Pages 1 - 11 DOI: http://dx.doi.org/10.2147/BS.S17420 Received: 14 March 2012 Accepted: 02 June 2012 Published: 20 August 2012 Cornelius F Waller Freiburg University Medical Center, Department of Hematology/Oncology, Freiburg, Germany Abstract: Recombinant granulocyte colony-stimulating factor (filgrastim) stimulates the proliferation and differentiation of hematopoietic stem and progenitor cells committed to neutrophil and granulocyte lineages. Filgrastim has been used as an adjunct to chemotherapy for ameliorating neutropenia, one of the major side effects of chemotherapy in cancer patients. Its use has led to reduction of infections and hospital admissions for patients with cancer undergoing chemotherapy. In addition, filgrastim has multiple other indications in hematology and oncology. Following the European Union patent expiry of Neupogen (filgrastim; Amgen Inc) in 2006, a biosimilar filgrastim has been developed (Nivestim ; Hospira). In accordance with the requirements of the European Medicines Agency, Nivestim has been studied in a development program that included preclinical studies, two Phase I clinical trials, and one Phase III clinical study. Preclinical studies showed pharmacodynamic as well as pharmacokinetic bioequivalence with the original product, Neupogen. Two randomized, single-center, Phase I trials compared both the pharmacokinetic, pharmacodynamic, and safety profiles of Nivestim and Neupogen in healthy volunteers. In both studies, 90% confidence intervals for the primary endpoints were within the predefined range (0.80–1.25) necessary to demonstrate bioequivalence. Nivestim was well tolerated, with no additional safety concerns over Neupogen. Bioequivalence was demonstrated in a randomized, double-blind multicenter Phase III trial of 279 patients with breast cancer receiving myelosuppressive chemotherapy. The mean duration of severe neutropenia in cycle 1, the primary endpoint, was similar between Nivestim (1.6 days, n = 165) and Neupogen (1.3 days, n = 85), meeting predefined criteria for bioequivalence. Secondary endpoints supporting bioequivalence included the mean time to recovery of absolute neutrophil count and incidence of febrile neutropenia. The most common treatment-related adverse event with Nivestim was grade 1–2 bone pain. As a result of these preclinical and clinical trials, Nivestim was approved by the European Medicines Agency and in Australia for prevention of febrile neutropenia and treatment of neutropenia in cancer patients treated with cytotoxic chemotherapy (except in patients with myelodysplastic syndromes and chronic myelogenous leukemia). Nivestim is also indicated for the treatment of myelosuppression after bone marrow transplantation, of neutropenia in patients with human immunodeficiency virus, and of
L’écrivain et le Développement National
CF Uzoho
UJAH: Unizik Journal of Arts and Humanities , 2011,
Abstract: La plupart des lecteurs ne voient que l’aspect divertissant de la littérature. Nous allons montrer dans cet article que le r le de l’écrivain n’est pas seulement celui de divertir le public ou le lecteur. Dans une large mesure, l’écrivain est censé être un agent très utile dans le développement global de l’humanité en général. à travers ses oeuvres littéraires, il doit être capable d’emmener des transformations qui peuvent améliorer la condition humaine dans toutes ramifications. Par là, il doit par sa capacité créative, créer les oeuvres littéraires qui touchent aux besoins sociopolitiques de la société et ainsi contribuant au développement national. Notre point de concentration ici, c’est d’examiner la position de l’écrivain (en tant que créateur artistique) vis-à-vis le développement national.
Caractérisation des Personnages en Théatre Sartrien Vis-à-Vis de L’idéologie Sartrienne
CF Uzoho
UJAH: Unizik Journal of Arts and Humanities , 2011,
Abstract: Généralement, on considère Jean-Paul Sartre comme le symbole de la littérature fran aise du 20e siècle particulièrement en ce qui concerne la littérature engagée. Toutes ses oeuvres se portent sur les problèmes de l’existence humaine dont il était question tout au long du 20e siècle et même jusqu'à nos jours. On note que la plupart d’ouvrages critiques sur Sartre sont surtout sur ses oeuvres théoriques et romanesques; ses oeuvres théatrales n’ont pas été assez abordées. Dans cette communication, il nous convient de concentrer sur son oeuvre théatrale. D’ailleurs, le théatre pour Sartre est comme un ‘laboratoire’ pour l’expérimentation de ses idées philosophiques et politiques basant surtout sur l’existentialisme athée. On constate que chez Sartre, il s’agit essentiellement de théatre d’idéologie qui a le mérite d’illustrer et de mettre en scène, la quasitotalité des thèmes sartriens déjà soulevés dans ses oeuvres théoriques et romanesques. Nous nous appuierons surtout sur trois oeuvres théatrales de Sartre, à savoir, Huis clos, Les mouches et Les mains sales puisque les trois pièces font bien ressortir l’objectif de notre étude, à savoir, la conformité ou la non-conformité du héros sartrien par rapport à l’idéologie existentialiste sartrienne.
A Bibliometric Analysis of Research Publications Funded Partially by the Cancer Association of South Africa (CANSA) during a 10-year Period (1994-2003)
CF Albrecht
South African Family Practice , 2009,
Abstract: Background: The objective of this study was to establish the quantity and quality of research publications outputs by grant recipients of the Cancer Association of South Africa (CANSA) over a 10-year period (1994–2003). Methods: Peer-reviewed publications in the PubMed database that were related to CANSA grants and were, published between 1994 and 2003 were counted per grantee in 2005, and the mean impact factor of all publications for 2005 was obtained from the Institute for Scientific Information (ISI). Results: Over the 10-year period, 129 different researchers from 10 different institutions conducted 192 projects that yielded 570 relevant peerreviewed publications that are recorded in the PubMed database. CANSA grants totalled R28.2 million and the mean impact factor of all the publications was 3.8. The number of publications per grantee, over the period analysed, varied considerably, from zero to 79, with 10% of the grantees publishing more than 10 (one per year). A significant group of 36% did not publish at all. Most of the studies (64%) concerned aspects of cancer biology and therapy, while only 26% of the projects involved issues relating to the prevention, epidemiology and social aspects of cancer. Conclusions: Because grants from CANSA are partial and do not pay for the major components of most research projects, such as salaries, the data obtained here is insufficient to create a benchmark for the cost of an average, peer-reviewed cancer research publication in South Africa. Nevertheless, it can be concluded that, on average, a contribution of about R50 000 from CANSA (value from 1994 to 2003) contributed to the appearance of one peer-reviewed cancer research publication with an average impact factor of 3.8 in the period under study. The most popular subjects of research were cancer biology and treatment. In order to bring about more balance in the future, more attention needs to be focused on the prevention, early detection, epidemiology and social aspects of cancer.
Avantaje si dezavantaje ale procedurilor stocate
Sirbu CF
Scientific Annals of the Alexandru Ioan Cuza University of Iasi : Economic Sciences Series , 2005,
Abstract:
Prophylaxis of venous thromboembolism in medical patients: too much or too little?
Christiansen CF
Clinical Epidemiology , 2012,
Abstract: Christian Fynbo ChristiansenDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus, DenmarkAbstract: Venous thromboembolism (VTE) is a potentially serious complication occurring in 1%–2% of hospitalized medical patients. Despite this low absolute risk, as many as 82% of medical patients are considered to be at increased risk of developing VTE and are eligible for medical thromboprophylaxis. In this commentary, The author will discuss the main findings of a recent paper published in Clinical Epidemiology that questions the large proportion of individuals who are eligible for medical thromboprophylaxis, and also discuss the potential implications for the prevention of VTE. The recent paper demonstrated that when a population is divided into high- and low-risk groups, the maximum absolute risk depends on the inverse of the proportion of patients that is considered to be high risk. Consequently, even an effective treatment will only result in a small reduction in the absolute risk when the high-risk group comprises the largest proportion of this population. For medical thromboprophylaxis, this implies that even patients considered to be at high-risk for developing VTE have a maximum absolute VTE risk of 2% when the overall risk is 1.6%. Therefore, even an effective preventive initiative will only result in a small risk reduction. This small potential benefit should be weighed against potential harms associated with prophylaxis, mainly bleeding events. Still, there may be a reasonable overall balance between prevention of pulmonary embolism and major bleeding, mainly because major bleeding events are rare. Nonetheless, this discussion underscores that future risk prediction models should aim to predict the benefits and harms in individual patients in order to provide optimal care for the right patients.Keywords: comment, epidemiology, prevention, risk factors, venous thromboembolism
Clamp ablation of the testes compared to bilateral orchiectomy as androgen deprivation therapy for advanced prostate cancer
Zarrabi, AD;Heyns, CF;
International braz j urol , 2011, DOI: 10.1590/S1677-55382011000300008
Abstract: purpose: burdizzo clamp ablation of the testes (cat) may provide an incisionless, cost-effective form of androgen deprivation therapy (adt) in men with adenocarcinoma of the prostate (acp) who find bilateral orchiectomy (bo) unacceptable or can not afford medical adt. the aim of this study was to compare cat with bo as primary adt in men with acp. materials and methods: written, informed consent was obtained from men with locally advanced or metastatic acp. patients were prospectively randomized to bo (n = 9) or cat (n = 10) under local anaesthesia, and were evaluated 3 and 7 days, 6 weeks and 3 months post-procedure. the protocol was approved by the local institutional ethics committee. statistical analysis was performed using student's, mann-whitney's and fisher's tests. results: mean duration of the procedure was significantly longer for bo than cat (16.9 vs. 10.9 minutes). mean pain scores during and after the procedure did not differ significantly. serum testosterone decreased significantly on days 3 and 7 after cat, but increased at 6 weeks, and was significantly higher than after bo. serum luteinizing hormone increased significantly from day 3 after bo and from day 7 after cat. serum prostate specific antigen decreased significantly after bo, but not after cat. minor complications were more common after bo (89%) than cat (40%). in the 9 men who did not achieve castrate levels of testosterone after cat, bo was performed. conclusions: cat was quicker to perform and had a lower complication rate, but was not as effective as bo in achieving castrate serum testosterone levels.
Daily feeding activity of Bryconamericus microcephalus (Characiformes, Characidae) from Córrego Andorinha, Ilha Grande - RJ
Mazzoni, R.;Rezende, CF.;
Brazilian Journal of Biology , 2009, DOI: 10.1590/S1519-69842009000200021
Abstract: the present study was conducted at the córrego andorinha on the eastern slope of ilha grande and aimed to determine the alimentary daily rhythm of bryconamericus microcephalus. fishes were sampled at a 4 hours interval over a 24 hours period during winter 2002 and summer 2003. gut fullness was determined according to a numerical scale ranging from 0 (empty gut) to 3 (full gut). no differences were registered for the daily ration estimates between seasons. it is concluded that b. microcephalus is a diurnal feeding species, as the high values of gut fullness occurred between 11:00 am and 3:00 pm.
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