Am J Clin Nutr 2009; 89: 1031″
“Study Design Retrospective

Am J Clin Nutr 2009; 89: 1031″
“Study Design. Retrospective investigation of muscle changes selleck products in patients suffering from chronic whiplash-associated disorders (WAD).

Objectives. To quantitatively compare the presence of muscle alterations (fatty infiltrate [MFI] and cross-sectional area [CSA]) in the anterior musculature

of the cervical spine in a cohort of chronic whiplash patients (WAD II) and healthy control subjects across muscle and cervical segmental level.

Summary of Background Data. Magnetic resonance imaging can be regarded as the gold standard for muscle imaging. There is little knowledge about in vivo features of anterior neck muscles in patients suffering from chronic WAD and how muscle structure differs across the factors of muscle, vertebral level, age, self-reported pain and disability, body mass index, and duration of symptoms.

Methods. click here Reliable magnetic resonance imaging measures for MFI and CSA were performed for the anterior cervical muscles bilaterally in 109 female subjects (78 WAD, 31 healthy control; 18-45 years, 3 months to 3 years postinjury). The measures were performed on all subjects for the longus capitis and colli and the sternocleidomastoid


Results. The WAD subjects had significantly larger MFI and CSA for the anterior muscles compared to healthy control subjects (all P < 0.0001). In addition, the amount of MFI varied by both cervical level and muscle, with the longus

capitis/colli having the largest amount of fatty infiltrates at the C2-C3 level (P < 0.0001). MFI was inversely related to age, self-reported pain/disability, and body mass index but directly proportional to duration of symptoms.

Conclusion. There is significantly greater MFI and CSA in the anterior neck muscles, especially in the deeper longus capitis/colli muscles, in subjects with chronic WAD when compared to healthy controls. Future studies are required to investigate the relationships between muscular morphometry and symptoms in patients suffering from acute and chronic WAD.”
“In this study, styrene maleic anhydride copolymer (SMA2000, JAK inhibitor Styrene : Maleic Anhydride 2 : 1) is grafted and/or crosslinked with epoxidized methyl oleate, epoxidized soybean oil, methyl ricinoleate (MR), castor oil (CO), and soybean oil diglyceride. Base catalyzed epoxy-anhydride and alcohol-anhydride polyesters were synthesized by using the anhydride on SMA, the epoxy or secondary alcohol groups on the triglyceride based monomers. The characterizations of the products were done by DMA, TGA, and IR spectroscopy. SMA-epoxidized soy oil and SMA-CO polymers are crosslinked rigid infusible polymers. SMA-epoxidized soy oil and SMA-CO slioxved T(g)’s at 70 and 66 degrees C, respectively. Dynamic moduli of the two polymers were 11.73 and 3.34 Mpa respectively.


Conclusion The scoliotic model created



Conclusion. The scoliotic model created

by scapula-to-contralateral ilium tethering procedure in bipedal rats can preferably simulate the human scoliosis.”
“Pharmacodynamic (PD) assays should be used before advancing new drugs to clinical trials. Most PD assays measure the response to drugs in tissue, Fludarabine mw a procedure which requires tissue biopsies. The M30-Apoptosense (R) ELISA is a PD biomarker assay for the quantitative determination of caspase-cleaved cytokeratin 18 (CK18) released from apoptotic carcinoma cells into blood. We here demonstrate that whereas the M30-Apoptosense (R) ELISA assay detects human caspase-cleaved CK18, the mouse and rat CK18 caspase cleavage products are detected with low affinity. The M30-Apoptosense (R) ELISA therefore facilitates the determination of drug-induced apoptosis in human tumour xenografts in rodents using plasma samples, largely independently from host toxicity. Increases of caspase-cleaved CK18 were observed in plasma from different carcinoma xenograft models in response to anticancer drugs. The appearance caspase-cleaved CK18 in plasma was found to reflect formation of the caspase-cleaved epitope in FaDu head-neck carcinomas

and in cultured cells. The M30-Apoptosense (R) assay allows determination of tumour response in blood from xenograft models and from patients, providing a powerful tool for translational studies of anticancer drugs.”
“Intermittent rhythmic delta activity is a typical EEG pattern that was originally described by W.A. Cobb in 1945 (J Neurol Neurosurg Psychiatr 1945;8:65-78). It may be ERK inhibitor solubility dmso classified into three distinct forms according to the main cortical region involved on the EEG: frontal (FIRDA), temporal (TIRDA), and occipital (OIRDA) intermittent delta activity. This article is a review of the main aspects of these patterns, with a special focus on EEG features and problems that may be encountered during interpretation of these patterns. In contrast to FIRDA and OIRDA, TIRDA is highly indicative of ipsilateral pathology. OIRDA and TIRDA are highly correlated with epilepsy,

whereas FIRDA is a rather nonspecific EEG pattern. (C) 2010 Elsevier Inc. All rights reserved.”
“Identification of individuals with catatonic disorder secondary to a general medical condition (CD-GMC) may affect both acute and long-term patient management. The authors performed a 20-year retrospective cohort analysis of all patients meeting DSM-IV-TR criteria for catatonic subtypes seen at our institution. Encephalitis was the most common etiologic diagnosis among patients with CD-GMC, and lumbar puncture the test most likely to affect acute management. Univariate logistic-regression analysis utilizing Bonferroni correction for multiple comparisons yielded absence of a psychiatric history and history of clinical seizure as variables increasing the likelihood of a diagnosis of CD-GMC.

This view has been changed due to increasing evidence that langua

This view has been changed due to increasing evidence that language per se is impaired in schizophrenia, especially its semantic, discursive, and pragmatic aspects. Schizophrenia is currently considered by some authors as a “”language related human specific disease”"

or “”logopathy”", and the neuroanatomical and genetic correlates of the language impairment in these patients are under investigation. Such efforts AC220 may lead to a better understanding about the pathophysiology of this devastating mental disease. We present some current concepts related to FTD as opposed to primary neurolinguistic abnormalities in schizophrenia.”

and language delay in children is associated with increased difficulty with reading, writing, attention, and socialization. Although physicians should be alert to parental concerns and to whether children are KU-57788 nmr meeting expected developmental milestones, there currently is insufficient evidence to recommend for or against routine use of formal screening instruments in primary care to detect speech and language delay. In children not meeting the expected milestones for speech and language, a comprehensive developmental evaluation is essential, because atypical language development can be a secondary characteristic of other physical and developmental problems that may first manifest as language problems. Types of primary speech and language delay include developmental speech and language delay, expressive language disorder, and receptive language disorder. Secondary speech and language delays are attributable to another condition such as hearing loss, intellectual disability, autism spectrum disorder, physical speech MEK inhibitor problems, or selective mutism. When speech and language delay is suspected, the primary care physician should discuss this concern

with the parents and recommend referral to a speech-language pathologist and an audiologist. There is good evidence that speech-language therapy is helpful, particularly for children with expressive language disorder. (Am Fam Physician. 2011;83(10):1183-1188. Copyright (c) 2011 American Academy of Family Physicians.)”
“Purpose of review

Ablation is a treatment option for selected patients with atrial fibrillation that is being used more frequently, increasing the importance of awareness of both its risks and benefits. This review discusses the thromboembolic and bleeding risks during ablation, strategies to minimize these risks and use of long-term oral anticoagulation post ablation.

Methods: A retrospective review was performed of all coagulopathi

Methods: A retrospective review was performed of all coagulopathic patients (international normalized ration >1.5 or platelets <100,000 per mu L) admitted for at least 72 hours to the surgical PARP inhibitor intensive care units of a tertiary care center between January 2008 and January 2009. Patients were divided into

two groups based on providing (group 1) or withholding (group 2) chemical prophylaxis. The incidence of VTE was then compared between the two groups.

Results: A total of 513 patients were included in the study: 241 patients in group 1 and 272 patients in group 2. The overall incidence of VTE was 16.4%. The incidence of VTE in the patients who received chemical prophylaxis was 17.0%, whereas the incidence in patients without chemical prophylaxis was 15.8% (p = 0.72).

Conclusion: Coagulopathic critically ill surgical patients remain at significant risk for VTE. Unfortunately, chemical VTE prophylaxis does not seem to decrease this risk. Further research is warranted to investigate the nature of this increased risk of VTE and the reason chemical VTE prophylaxis

has no benefit.”
“Radiation therapy is a critical component of the multidisciplinary management of invasive breast cancer. In appropriately selected patients, radiation not only improves local control, sparing patients the morbidity check details and distress of local recurrence, but it also improves survival by preventing seeding and reseeding of distant metastases from persistent reservoirs of locoregional disease. In recent years, considerable progress has been made toward improving our ability to select patients most likely to benefit from radiotherapy and to administer treatment in ways that maximize clinical benefit while minimizing toxicity and burden. This article reviews the role of radiation therapy in invasive breast cancer management, both after

breast-conserving surgery and after mastectomy. It focuses particularly on emerging evidence that helps to define the clinical situations in which radiotherapy is indicated, the Flavopiridol concentration appropriate targets of treatment, and optimal approaches for minimizing both the toxicity and the burden of treatment, all in the context of the evolving surgical and systemic management of this common disease. It includes a discussion of new approaches in breast cancer radiotherapy, including hypofractionation and intensity modulation, as well as a discussion of promising avenues for future research. CA Cancer J Clin 2014;64:135-152. ((c)) 2013 American Cancer Society.”
“The thermal behavior of two wood species treated with ionic liquid, 1-butyl-3-methylimidazolium tetrafluoroborate, was investigated using thermogravimetry/differential scanning calorimetry/Fourier transform infrared spectroscopy/mass spectrometry coupled methods in order to elucidate the ionic liquid effect on the wood thermal behavior. It was pointed out that the ionic liquid-treated wood samples show degradation in two processes.

More specifically, we examined the potential interaction of COMT

More specifically, we examined the potential interaction of COMT genotype and PTSD diagnosis on fear-potentiated startle during fear conditioning and extinction and COMT DNA methylation levels (as determined using genomic DNA isolated from whole blood). Participants were recruited from medical and gynecological selleck chemicals llc clinics of an urban hospital in Atlanta, GA, USA. We found that individuals with the Met/Met genotype demonstrated higher fear-potentiated startle to the CS-(safety signal) and during extinction of the CS+ (danger signal) compared to Val/Met and Val/Val genotypes. The PTSD+ Met/Met genotype group had the greatest

impairment in fear inhibition to the CS- (p = 0.006), compared to Val carriers. In addition, the Met/Met genotype was associated with DNA methylation at four CpG sites, two of which were associated with impaired fear inhibition to the safety signal. These results suggest that multiple differential mechanisms for regulating COMT function – at the level of protein structure via the Val158 Met genotype and at the level of gene regulation via differential methylation – are associated with impaired fear inhibition in PTSD.”
“Reversed-phase preparative HPLC analyses of the methanol extract of the aerial parts of Stachys lavandulifolia

afforded a new phenylethanoid glycoside, 4,3`,4`-trimethoxy-lavandulifolioside A, named lavandulifolioside B, together with three other known phenylethanoid

glycosides, lavandulifolioside Selleckchem PLX3397 A, verbascoside and leucosceptoside A, and an iridoid glycoside 5-O-beta-allopyranosyloxy-aucubin selleck products (5-O-beta-allopyranosyl-monomelittoside). While the structures of the known compounds, except the iridoid glycoside, were established by direct comparison of their spectroscopic data with respective literature data, lavandulifolioside B and 5-O-beta-allopyranosyloxy-aucubin were identified comprehensively by extensive 1D and 2D NMR analyses. The distribution of the isolated compounds within the genus Stachys has been discussed.”
“Background: The role of the clinical nurse/midwife specialist and advanced nurse/midwife practitioner is complex not least because of the diversity in how the roles are operationalised across health settings and within multidisciplinary teams.

This aim of this paper is to use The SCAPE Study: Specialist Clinical and Advanced Practitioner Evaluation in Ireland to illustrate how case study was used to strengthen a Sequential Explanatory Design.

Methods: In Phase 1, clinicians identified indicators of specialist and advanced practice which were then used to guide the instrumental case study design which formed the second phase of the larger study. Phase 2 used matched case studies to evaluate the effectiveness of specialist and advanced practitioners on clinical outcomes for service users.

The presence of a sarcomatous component is associated with an agg

The presence of a sarcomatous component is associated with an aggressive behavior, metastasis, and poor prognosis. We present a case of a spermatocytic seminoma with rhabdomyosarcomatous transformation in a long-standing testicular swelling in a 55-year-old male.”
“The aim of our study was to explore the

pain processing network in patients with migraine during trigeminal nociceptive stimulation. Sixteen patients with episodic migraine without aura and 16 healthy controls performed functional magnetic resonance imaging during thermal GDC-0994 stimuli (at 41, 51 and 53A degrees C). Patients with migraine showed a greater activation in the perigenual part of anterior cingulate cortex at 51A degrees C and less activation in the bilateral somatosensory cortex at 53A degrees C compared to healthy controls. There were no differences in experimental pain perception between groups. Our findings demonstrate a functional reorganization of cerebral areas known to be involved in pain processing in patients with migraine.”
“Protection of the small intestine from mucosal injury induced by nonsteroidal anti-inflammatory drugs

including acetylsalicylic acid is a critical issue in the field of gastroenterology. Polaprezinc an anti-ulcer JPH203 supplier drug, consisting of zinc and L-carnosine, provides gastric mucosal protection against various irritants. In this study, we investigated the protective effect of polaprezinc on acetylsalicylic acid-induced apoptosis of the RIE1 rat intestinal epithelial buy MDV3100 cell line. Confluent rat intestinal epithelial cells were incubated with 70 mu M polaprezinc for 24 h, and then stimulated with or without 15 mM acetylsalicylic acid for a further 15 h. Subsequent cellular viability was quantified by fluorometric assay based on cell lysis and staining. Acetylsalicylic acid-induced cell death was also qualified by fluorescent microscopy of Hoechst33342 and propidium iodide. Heat shock proteins 70 protein expression after adding polaprezinc or acetylsalicylic acid was assessed by western blotting. To investigate the role of Heat shock protein 70,

Heat shock protein 70-specific small interfering RNA was applied. Cell viability was quantified by fluorometric assay based on cell lysis and staining and apoptosis was analyzed by fluorescence-activated cell sorting. We found that acetylsalicylic acid significantly induced apoptosis of rat intestinal epithelial cells in a dose- and time-dependent manner. Polaprezinc significantly suppressed acetylsalicylic acid-induced apoptosis of rat intestinal epithelial cells at its late phase. At the same time, polaprezinc increased Heat shock protein 70 expressions of rat intestinal epithelial cells in a time-dependent manner. However, in Heat shock protein 70-silenced rat intestinal epithelial cells, polaprezinc could not suppress acetylsalicylic acid -induced apoptosis at its late phase.

“The exposure assessment was carried out for Staphylococcu

“The exposure assessment was carried out for Staphylococcus aureus in kimbab by predicting growth of S. aureus and the production of enterotoxin using Food MicroModel (R) program. Environmental parameters selected were pH 5.5, Aw 0.999, and storage temperatures in the range of 10 to 30 degrees C. It was predicted that 6.3 hr could be a critical time for enterotoxin production while kimbab was stored at 30 degrees C. Mild case scenario JQ-EZ-05 concentration analysis showed that enterotoxin could not be produced if kimbab was kept at 10 degrees C during preparation

and distribution and then left at 25 degrees C for 4 hr before consumption. In the worst case scenario, the keeping time at 25 degrees C was assumed to be 7.0 hr. The level of S. aureus in the worst case was predicted to be 6.8×10(6) CFU/g which is lower than the critical level (7.8×10(6) CFU/g) for toxin production.”
“1-acetoxy-5, 7-dihydroxycassa-11,13(15)-diene-16,12-lactone, a new cassane-type diterpene was isolated from Caesalpinia crista. The structure of this compound was elucidated by analysis Selleck PF 00299804 of NMR spectra, and the relative configuration was established by NOE experiment. The new compound was evaluated for antitumour activity against T47D, DU145 and showed significant inhibitory activities.”
“Shifted hysteresis loops characteristic of the exchange bias effect between a ferromagnet and an antiferromagnet are demonstrated in structures

formed by a 2.5 nm Cr layer deposited on top of an array of Fe nanoislands (Cr/Fe-nanoislands). This effect evidences the persistence of antiferromagnetic (AF) order for Cr layers much thinner than the thickness reported in the literature. The field shift measured is found to increase for the smallest island sizes, which can be related with the enhancement of the Fe-nanoisland surface to

volume ratio. The comparative study between superconducting proximity effects in Nb/Cr/Fe-nanoislands and Nb/normal metal/Fe-nanoisland hybrids (where the normal metals used are Al and Pt) confirms the presence of AF order in the 2.5 nm Cr spacer layer. A much shorter penetration depth of the Cooper pairs into the AF Cr layers than in the normal metal Pt and Al spacer layers is deduced.”
“Essential oils of anise, bastard cardamom, cinnamon, dill, mace, zedoary, prikhom, and bitter ginger were determined for their antimicrobial and antioxidant activities. Of all, cinnamon oil had the highest antibacterial activity. The most sensitive bacteria was Bacillus cereus (0.5mg/mL minimum inhibitory concentration, MIC). Anise, cinnamon, dill, and prikhom exhibited strong antifungal activity against Rhodotorula glutinis, Aspergillus ochraceus, and Fusarium moniliforme. Two oil combinations: i) cinnamon and mace oils and ii) cinnamon and prikhom oils showed a synergistic effect against Staphylococcus aureus, Pseudomonas fluorescens, and Salmonella Rissen (0.

The evaluation of patient showed findings of large airway inflamm

The evaluation of patient showed findings of large airway inflammation with tracheal wall thickening and mucosal irregularities. The etiology was investigated and was diagnosed as tracheobronchitis that is a rare extraintestinal manifestation of ulcerative colitis. She was treated with systemic corticostreoids and rapid clinical improvement was detected. (C) 2010 European Crohn’s and Colitis Organisation. Published by Elsevier B.V. All rights reserved.”
“A selleck kinase inhibitor new 2,5-diketopiperazine, (R)-2-(2-(furan-2-yl)-oxoethyl)-octahydropyrrolo[1,2-a]pyrazine-1,4-dione, and seven known compounds

were isolated from the ethyl acetate extract of liquid fermentation broth of Armillaria mellea. The structures of the isolated compounds were established from NMR and HR-MS data. The absolute configuration of the new compound was established by comparing the experimental electronic circular dichroism (ECD) spectrum with the calculated ECD data.”
“A 20-year old man with ulcerative colitis (UC)

and primary sclerosing cholangitis (PSC) was diagnosed with a rectal non-Hodgkin’s lymphoma (NHL) at surveillance endoscopy while being in remission on infliximab therapy. Further staging identified a diffuse large B-cell NHL, EBV negative restricted to the rectal submucosa (stage IA). Until now, there has not been any evidence of an increased PF-6463922 purchase risk of NHL in patients with UC nor of an increased risk of lymphoproliferative disorders in IBD patients. Hence, the role of concomitant PSC in the pathogenesis of intestinal NHL is unclear. However, IBD patients treated with purine analogues and with anti-TNF are at risk of NHL, especially hepatosplenic T-cell lymphoma. The management of this particular young patient is further complicated by the possibility of a future colectomy due to intractable disease which compromises the use of radiotherapy for this localized disease. (C) 2010 European Crohn’s and Colitis Organisation. Published by Elsevier B.V. All rights reserved.”
“A new di-O-prenylated flavone, named 7,3-di-(,-dimethylallyloxy)-5-hydroxy-4-methoxyflavone

(1), was isolated from the culture BTK inhibitor broth of the endophytic actinomycete Streptomyces sp. MA-12 isolated from the root of the semi-mangrove plant Myoporum bontioides A. Gray. The structure of 1 was determined by comprehensive spectroscopic methods, including 1D and 2D NMR experiments (COSY, HMQC, and HMBC). Primary bioassays showed that 1 at concentration of 0.25mM had moderate inhibitory activity against three plant pathogenic fungi including Colletotrichum musae, Gibberella zeae (Schweinitz) Petch, and Penicillium citrinum Thom.”
“Anti-TNF-alpha antibodies are widely used. The indications for their usage are still increasing. With their emerging use, their infectious complications are seen more often. We describe the first case of a pneumonia with Legionella pneumophila in a pregnant women with Crohn’s disease, during treatment with anti-TNF-alpha antibodies.

(C) 2009 American Institute of Physics [doi: 10 1063/1 3240203]“

(C) 2009 American Institute of Physics. [doi: 10.1063/1.3240203]“
“Headache is the most frequent presenting symptom of cerebral venous thrombosis (CVT), most commonly associated with other manifestations. It has been described as its only clinical presentation

in 15 % of patients. There is no typical pattern of headache in CVT. The objective of this study was to study the characteristics of headache as the sole manifestation of CVT. From a prospective study of 30 consecutive patients diagnosed with CVT over 18 months, we selected those who presented with headache only: they had a normal neurological Momelotinib clinical trial examination, no papilloedema and no blood or any parenchymal lesion on CT scan. All were submitted to a systematic etiological workup and a structured questionnaire about the characteristics of headache was provided. Headache was the sole manifestation of CVT in 12 patients; it was diffuse or bilateral in the majority. Seven patients referred worsening with sleep/lying down, Valsalva maneuvers or straining. There was no association

between the characteristics AG-014699 cost of headache and extension of CVT. Time from onset to diagnosis was significantly delayed in these patients presenting only with headache. In our series, 40 % of patients presented only with headache. There was no uniform pattern of headache apart from being bilateral. There was a significant delay of diagnosis in these patients. Some characteristics of headache should raise the suspicion of CVT: recent persistent headache, thunderclap headache or pain worsening with straining,

sleep/lying down or Valsalva maneuvers even in the absence of papilloedema or focal signs.”
“Background: Prior studies have yielded inconsistent results on bradyarrhythmias requiring a permanent pacemaker (PPM) after cardiac transplant. This study evaluated the predictors for PPM requirement, long-term outcomes, and influence of implant timing and device programming on prognosis after cardiac transplant.

Methods: This study NU7441 prospectively evaluated 1,307 recipients from 1985 to 2007 at Cleveland Clinic by structured follow-up and compared the outcomes of patients with and without bradyarrhythmias requiring PPM after transplantation. The primary end point was all-cause mortality or retransplant.

Results: Recipients, aged 50 +/- 15 years (donors, 33 +/- 14 years), were monitored 82 +/- 59 months, with PPM indicated in 106 (8.1%), including 61 (57.5%) early and 44 (42.5%) late. Biatrial technique strong]), predicted PPM requirement (OR [odds ratio], 2.61; 95% confidence interval [CI], 1.63-4.20; p < 0.001), and survival/retransplant outcomes were comparable between those with early, late, and no PPM requirement: 5-year primary event-free rate was 80.4% (early) vs 72.6% (late; p = 0.480) and 80.4% (early) vs 73.2% (none, p = 0.550) and 72.6% (late) vs 73.2% (none; p = 0.960). Excess atrial fibrillation was noted among PPM recipients (PPM, 12.3% vs no PPM, 6.3%; p = 0.02) with high initial DDD programming in 92.

Patients with CRC (70 women and 61 men) were matched for gender a

Patients with CRC (70 women and 61 men) were matched for gender and age to 206 healthy ICG-001 molecular weight controls. The mean age of the two groups was 62 years. Meat intake, cigarette smoking and alcohol drinking were assessed using a specific frequency questionnaire. The body mass index was also calculated. DNA was extracted from peripheral blood; RsaI polymorphism genotypes were evaluated

by PCR-RFLP and 96-bp insertion genetic polymorphisms were evaluated by specific primers. The distributions of CYP2E1 RsaI c1/c1, c1/c2 and c2/c2 genotypes were 90.2, 9.2 and 0.6%, respectively, in controls and 83.9, 13.7 and 2.4% in CRC cases. Allele c2 was associated with increased risk for CRC [odds ratio (OR) = 1.88, 95% confidence interval (95%CI) = 1.02-3.45]. The CYP2E1 RsaI c2/c2 genotype was associated with an increased risk for rectal cancer (OR = 3.23, 95% CI = 1.26-9.03). The 96-bp insertion was slightly

more frequent in the CRC group (9.3 vs 11.4%, P = 0.19), especially in females (6.4 MS-275 Epigenetics inhibitor vs 11.5%, P = 0.34). Smoking, alcohol drinking or high intake of red meat and CYP2E1 polymorphisms were not associated with increased risk for CRC. The 96-bp insertion was marginally more frequent (P = 0.07) in undernourished CRC subjects. We concluded that the risk for CRC is higher among individuals with allele c2. The CYP2E1 RsaI c2/c2 genotype was associated with an increased risk for rectal cancer.”

Malaria case management is one of the key strategies to control malaria. Various studies have demonstrated the feasibility of home management of malaria (HMM). However, data on the costs and effectiveness of artemisinin-based combination therapy (ACT) and rapid diagnostic tests via HMM is limited.

Method: Cost-effectiveness of home management versus health facility-based management of uncomplicated malaria in two rural districts in Zambia was analysed from a providers’ perspective. The sample click here included 16 community health workers (CHWs) and 15 health facilities. The outcome measure was the cost per case appropriately diagnosed and treated. Costs of scaling-up HMM nationwide were estimated based on the CHW utilisation rates observed in the study.

Results: HMM was more cost effective than facility-based management of uncomplicated malaria. The cost per case correctly diagnosed and treated was USD 4.22 for HMM and USD 6.12 for facility level. Utilization and adherence to diagnostic and treatment guidelines was higher in HMM than at a health facility.

Conclusion: HMM using ACT and RDTs was more efficient at appropriately diagnosing and treating malaria than the health facility level. Scaling up this intervention requires significant investments.