PubMed Health⌕ Search

Biomedical subjects

I le Roux

Publications and source records attributed to I le Roux.

10 recordsLinked to original sources
PubMed2001

A proposed vitamin A supplementation programme for South Africa--design, coverage and cost.

BACKGROUND: A national survey of the micronutrient status of preschool children in South Africa established that vitamin A deficiency is a significant public health problem, requiring urgent attention. A number of immediate and long-term interventions were recommended, including the introduction of a vitamin A supplementation programme and a food fortification programme. OBJECTIVES: The aim of the study was to assist in the development and implementation of a national vitamin A supplementation programme at primary health care facilities for mothers and children. This was achieved by determining the design, coverage and cost of a national primary health care facility vitamin A supplementation programme. METHODS: Based on an extensive review of the literature, the main components of a primary health care facility vitamin A supplementation programme were identified. The annual, recurrent costs of each of the programme components were estimated for the nine provinces in South Africa. Immunisation coverage rates were used as a proxy for estimating the coverage of the programme. RESULTS: The main components of the programme were identified as: promotion, training, purchase of vitamin A capsules, distribution of vitamin A capsules to primary health care facilities, distribution of capsules to the programme beneficiaries, and monitoring and evaluation. The programme would operate from primary health care facilities and would target all children between 6 and 24 months of age and newly delivered mothers. It was estimated that the programme would cover 74% of children and 95% of postpartum women nationally. The total annual, recurrent cost of the national programme was estimated at R16.4 million. The bulk of the costs would include personnel costs, comprising 68% of the total costs. Other costs included promotion (27%), vitamin A capsules (4%) and training (1%). The cost of the programme would vary significantly by province, but the provinces' average total cost per beneficiary would be similar. CONCLUSION: A primary health care facility vitamin A supplementation programme has been designed and accompanied by an estimated overall cost and coverage for implementation. The findings of the study showed that the programme would be financially feasible and would reach the majority of children under 24 months of age. It is recommended that further research be undertaken to extend the programme to the more 'hard to reach' population using other strategies such as mass immunisation campaigns.

Adolescent↗
PubMed1993

Control of neuronal morphogenesis by homeoproteins: consequences for the making of neuronal networks.

To test whether homeoproteins can act as genetic regulators in the processes of neurite growth, branching, guidance, and connectivity, the 60 amino acid homeodomain of Antennapedia was introduced in embryonic neurons in primary culture. It was hoped that this homeopeptide would bind to specific promoters and thus behave as a competitive inhibitor of endogenous homeoproteins. The introduction of the homeodomain in the nerve cells was made easy by its unexpected capability to translocate through the membranes and to accumulate within the nuclei. The presence of the homeodomain within the cells correlated with an increase in neurite growth and branching. The absence of activity of mutant peptides, still internalized but unable to bind with high affinity to homeoprotein cognate binding sites, strongly suggested that endogenous homeoproteins modulate neurite outgrowth and branching. Moreover, the efficient internalization of the homeobox peptide by live cells in culture raises the possibility that, in addition to their well-established role as cell-autonomous transcription factors, some homeoproteins may also exert paracrine functions. We examine how these hypotheses could modify our current views on the establishment and plasticity of neuronal networks.

Animals↗
PubMed1988

Sequential half-body irradiation as salvage therapy in chemotherapy-resistant multiple myeloma.

Fifteen patients with a median age of 58 years, having multiple myeloma resistant to conventional combinations of cytotoxic drugs, received sequential half-body irradiation as salvage therapy. Response was obtained in 53% (n = 8: group 1); this was objective in 40% (n = 6), being defined as 50% or greater reduction in paraprotein, clearance of light chains from the urine, or an unequivocal decrease in tumor bulk on an adequate marrow trephine biopsy; a further 13% (n = 2) just failed to meet these criteria but nevertheless had excellent subjective response. Median survival was 24 months. No objective or subjective improvement occurred in 47% (n = 7: group 2); median transient survival was 4 months. Short-term toxicity was limited to transient nausea in 30% (n = 5) and protracted pancytopenia in about one-half of the patients (n = 7), who remain dependent on intermittent RBC transfusions. Morbidity is only moderate, and the response rate of 53% in refractory patients suggests that sequential half-body irradiation has a definite place in managing patients with end-stage disseminated myelomatosis.

Adult↗
PubMed1987

Waldenstrom macroglobulinaemia treated with sequential hemibody irradiation.

A 40-year-old man presented with symptoms of anaemia and blurred vision. Waldenstrom macroglobulinaemia was diagnosed on the basis of plasmacytoid lymphocytes in the peripheral blood, extensive bone marrow involvement, and an IgM kappa monoclone in the plasma of 48 g/liter. Symptoms were immediately reversed by isovolaemic continuous-flow plasmapheresis coupled with red cell transfusion. Specific therapy was undertaken with sequential hemibody irradiation. At two years of follow-up the patient enjoys excellent health, has improved haematopoietic reserve in the bone marrow, and the only therapy required is intermittent plasmapheresis to control symptoms relating to rising viscosity. Thus, systemic irradiation, which is well tolerated and objectively reduces marrow tumour bulk, offers an alternative to chemotherapy in the palliative management of active macroglobulinaemia and may diminish but not prevent the need for intermittent plasmapheresis.

Adult↗
PubMed1986

Multiple blastic transformations in the course of chronic granulocytic leukaemia.

A 14-year-old boy with Philadelphia chromosome-positive chronic granulocytic leukaemia underwent morphologically distinctive blastic transformation on 3 separate occasions. The first was clearly lymphoblastic, the second was associated with meningeal leukaemia and was morphologically biphenotypic, expressing mixed myeloid and lymphoid features, while the third was characterised by extreme thrombocytosis and megakaryoblastic proliferation. The classical t(9:22) Philadelphia chromosome remained constant throughout the illness, but the additional cytogenetic changes that occurred with the first transformation were abolished with response to conventional therapy for lymphoblastic leukaemia. A total of 19 months of good-quality life was achieved, but on the third occasion, the boy died from intracranial haemorrhage before treatment could be initiated.

Adolescent↗
PubMed1985

The cost effectiveness of the Philani Nutrition Day Centre in Crossroads squatter camp, Cape Town.

One hundred and seventeen children aged 0-7 years who had been treated at Philani Nutrition Day Centre were sought in Crossroads squatter camp near Cape Town after discharge; 61 were traced and complete records were obtained for 42. Twenty-seven (64,2%) of the 42 were below the third percentile (weight for age, National Center for Health Statistics standards) at the time of admission to the centre and 3 (7,1%) were still below it at discharge 1-26 (mean 7,8) months later. Six (14,3%) were below the third percentile when they were traced 1-23 months (mean 10,3 months) later. Total attendances from 1982 to 1983 were estimated at 12 300 child-days. Expenditure on the centre for this period was estimated at R29 759, of which R20 282 (68,2%) was spent on salaries, R6 340 (21,3%) on food and R3 137 (10,5%) on sundries (including R2 500 on drugs). The estimated cost per child per day's attendance was R2,42. The duration of treatment was estimated to be 80 attendances for a severe and 32 attendances for a moderate case of undernutrition, giving an estimated cost of between R194 and R73 per child for complete treatment. We conclude that this expenditure: (i) benefited most of the children who were originally below the third percentile; (ii) sustained children not actually admitted to the centre by feeding them or their siblings, probably resulting in there being more food available at home; and (iii) prevented the (costly) admission to hospital of some children.

Ambulatory Care Facilities↗
PubMed1984

Megakaryoblastic transformation in myeloproliferative disorders.

Megakaryoblastic transformation, with cells showing characteristic morphology and ultrastructural cytochemistry, developed in two patients with agnogenic myeloid metaplasia or myelofibrosis, and in one with chronic granulocytic leukemia. From the onset of the leukemic phase, all three have followed a relatively benign clinical course, surviving for 48, 29, and 24 months, respectively; only hydroxyurea has been necessary to control thrombocytosis. This experience emphasizes that it is possible for a patient to have an improved quality of life with minimum chemotherapy. In contrast, megakaryoblastic leukemia or acute myelofibrosis, where splenomegaly and a leukoerythroblastic blood picture are typically absent, responds poorly to any form of chemotherapy, and survival is short.

Blood Cell Count↗