The efficacy of halofantrine in the treatment of acute malaria in nonimmune travelers

A multicenter prospective trial was performed to investigate the efficacy and the tolerability of halofantrine in nonimmune patients with malaria imported from areas with drug-resistant falciparum parasites (mainly Africa). Forty-five of the 74 subjects were treated with a one-day regimen (3 x 500 mg) of halofantrine, and the other 29 received the same regimen with an additional treatment on day 7. In the second group, a 100% efficacy rate was demonstrated, but in the group receiving the one-day regimen, four recrudescences were observed in patients with falciparum malaria. Only five mild adverse reactions were seen, which disappeared spontaneously after the end of the treatment. We conclude that halofantrine is highly effective in curing malaria in nonimmune subjects. The treatment scheme for such persons should include an additional treatment on day 7 for nonimmune individuals. This drug was well tolerated in our patients, indicating that halofantrine will be useful in the treatment of multidrug-resistant malaria in nonimmune persons

Halofantrin zur Behandlung der importierten Malaria bei nicht-immunen Reisenden

Im Rahmen einer prospektiven Multizenterstudie wurden die Wirksamkeit (Kriterien: Heilungsrate, Zeit bis zur Entfieberung oder Parasitenfreiheit) und Verträglichkeit (Kriterien: klinische Nebenwirkungen, veränderte Laborparameter) von Halofantrin bei 96 nicht-immunen Malaria-Patienten (71 Männer, 25 Frauen, mittleres Alter 34,3 [21-62] Jahre) untersucht, die aus Hochresistenzgebieten nach Deutschland oder in die Schweiz zurückgekehrt waren. 63 Patienten wurden mit einer Eintagestherapie behandelt (dreimal 500 mg Halofantrin); die folgenden 33 Patienten erhielten einen zusätzlichen Therapiezyklus nach einer Woche. In der zweiten Gruppe war die Therapie in allen Fällen wirksam, während bei der Eintagestherapie fünf von 41 Patienten (12,2 %) mit Malaria tropica einen Rückfall erlitten. Die Zeit bis zur Entfieberung betrug 45 Stunden, die Zeit bis zur Parasitenfreiheit 66 Stunden. Bei fünf Behandelten kam es unter der Therapie zu leichten Transaminasenanstiegen, die jedoch spontan innerhalb weniger Tage zurückgingen und am ehesten infektionsbedingt waren. - Bei guter Verträglichkeit ist Halofantrin für die Therapie und Stand-by-Therapie von multiresistenten Plasmodien-Infektionen geeignet. Die Behandlung muß nach 7 Tagen wiederholt werden.The efficacy (criteria: cure rate, time to resolution of fever or absence of parasites) and safety (criteria: clinical side effects, altered laboratory parameters) of halofantrin were investigated in a multi-centre study of 96 non-immune patients (71 men, 25 women, mean age 34.3 [21-62] years) with malaria imported from regions of high resistance into Germany or Switzerland. The initial 63 patients received one-day treatment (three doses of 500 mg halofantrin), while the last 33 patients received an additional course of treatment one week later. Treatment was curative in all patients in the second group, but relapses occurred in five of the 41 patients (12.2 %) with falciparum malaria who received one-day therapy. Fever resolved after a mean of 45 hours and parasites were absent after a mean of 66 hours. There were small increases in transaminase values (most probably because of the infection) in five patients, but all became normal again within a few days. - Halofantrin is a safe drug and is suitable for both therapy and stand-by therapy of resistant Plasmodium infections. Treatment should be repeated after 7 days

Non-response in a survey of physicians on end-of-life care for the elderly

<p>Abstract</p> <p>Background</p> <p>Physicians are quite often surveyed with the aim to investigate their opinions regarding provision and improvement of health care. However, in many cases response rates tend to be rather low. The aim of the study is to reflect methodological aspects regarding survey conduction and to analyse factors that cause physicians to take part in a study on delivering end-of-life care for the elderly.</p> <p>Methods</p> <p>N = 4,727 physicians in Lower Saxony, Germany, received a standardised questionnaire on their attitudes about end-of-life care for the elderly. Non-responders were asked to state the reasons for non-participation. Comparison of the sociodemographic characteristics between responders and non-responders, and evaluation of the reasons for non-participation were made.</p> <p>Results</p> <p>The response rate to the questionnaire on end-of-life care for the elderly was 40% (n = 1,892). Of the non-responders to the questionnaire, 12.8% (n = 364) stated the reasons for non-participation. Overall, the response rate to the questionnaire varied with specialty and location of the practice: radiotherapists answered significantly more frequently than other categories of physician (e.g. general practitioners) and physicians in rural areas significantly more frequently than their colleagues in urban areas. The reasons most frequently given for non-participation were "Not concerned with the subject" and "No time".</p> <p>Conclusions</p> <p>The varying rates of response indicate that the survey was not sufficiently relevant to all groups of physicians, or that the awareness of the topic may be partly underdeveloped.</p

Experimental Observation of Quantum Chaos in a Beam of Light

The manner in which unpredictable chaotic dynamics manifests itself in quantum mechanics is a key question in the field of quantum chaos. Indeed, very distinct quantum features can appear due to underlying classical nonlinear dynamics. Here we observe signatures of quantum nonlinear dynamics through the direct measurement of the time-evolved Wigner function of the quantum-kicked harmonic oscillator, implemented in the spatial degrees of freedom of light. Our setup is decoherence-free and we can continuously tune the semiclassical and chaos parameters, so as to explore the transition from regular to essentially chaotic dynamics. Owing to its robustness and versatility, our scheme can be used to experimentally investigate a variety of nonlinear quantum phenomena. As an example, we couple this system to a quantum bit and experimentally investigate the decoherence produced by regular or chaotic dynamics.Comment: 7 pages, 5 figure

Differential Requirements for Clathrin-dependent Endocytosis at Sites of Cell–Substrate Adhesion

Little is known about the influences of cell–substrate attachment in clathrin-mediated endocytosis. We find that cell–substrate adhesion reduces the rate of endocytosis. In addition, we demonstrate that actin assembly is differentially required for efficient endocytosis, with a stronger requirement for actin dynamics at sites of adhesion

Loudness-dependent behavioral responses and habituation to sound by the longfin squid (Doryteuthis pealeii)

Author Posting. © The Author(s), 2016. This is the author's version of the work. It is posted here by permission of Springer for personal use, not for redistribution. The definitive version was published in Journal of Comparative Physiology A 202 (2016): 489-501, doi:10.1007/s00359-016-1092-1.Sound is an abundant cue in the marine environment, yet we know little regarding the frequency range and levels which induce behavioral responses in ecologically key marine invertebrates. Here we address the range of sounds that elicit unconditioned behavioral responses in squid Doryteuthis pealeii, the types of responses generated, and how responses change over multiple sound exposures. A variety of response types were evoked, from inking and jetting to body pattern changes and fin movements. Squid responded to sounds from 80-1000 Hz, with response rates diminishing at the higher and lower ends of this frequency range. Animals responded to the lowest sound levels in the 200-400 Hz range. Inking, an escape response, was confined to the lower frequencies and highest sound levels; jetting was more widespread. Response latencies were variable but typically occurred after 0.36 s (mean) for jetting and 0.14 s for body pattern changes; pattern changes occurred significantly faster. These results demonstrate that squid can exhibit a range of behavioral responses to sound include fleeing, deimatic and protean behaviors, all of which are associated with predator evasion. Response types were frequency and sound level dependent, reflecting a relative loudness concept to sound perception in squid.This work was supported by WHOI’s Ocean Life Institute.2017-05-2