Six hundred and ninety-three patients with kala-azar were seen in Khartoum, Sudan, from January 1989 to February 1990. They were almost exclusively from the Nuer tribe, originating from the western Upper Nile province in southern Sudan, an area not known previously to be endemic for kala-azar. Because of the civil war in southern Sudan no treatment was available locally and massive migration to northern Sudan occurred; many died on the way. All age groups were affected; there was a slight male preponderance (56%). In the clinical presentation, marked generalized lymphadenopathy was prominent (84%). Splenomegaly was absent in 4% of cases. Patients usually showed anaemia, leucopenia and/or thrombocytopenia. 623 patients were treated with sodium stibogluconate, 10 mg/kg for 30 d; relapse occurred in 4% and death in 12%. Latterly, 70 patients were treated with sodium stibogluconate at 2 x 10 mg/kg for 15 d, with relapse in 6% and death in 6%. The difference between the 2 regimens in the number of relapses and deaths was not significant. The outbreak may have been caused by a combination of factors: the introduction of the parasite from an endemic area to a non-immune population, the presence of malnutrition caused by loss of cattle and unavailability of other food sources, and possibly an ecological change in favour of the sandfly vector.
The leishmaniases are a complex of vector-borne diseases caused by protozoan parasites of the genus Leishmania. LEISHDNAVAX is a multi-antigen, T-cell epitope-enriched DNA vaccine candidate against human leishmaniasis. The vaccine candidate has been proven immunogenic and showed prophylactic efficacy in preclinical studies. Here, we describe the safety testing of LEISHDNAVAX in naive mice and rats, complemented by the demonstration of tolerability in Leishmania-infected mice. Biodistribution and persistence were examined following single and repeated intradermal (i.d.) administration to rats. DNA vectors were distributed systemically but did not accumulate upon repeated injections. Although vector DNA was cleared from most other tissues within 60 days after the last injection, it persisted in skin at the site of injection and in draining lymph nodes. Evaluation of single-dose and repeated-dose toxicity of the vaccine candidate after i.d. administration to naive, non-infected mice did not reveal any safety concerns. LEISHDNAVAX was also well tolerated in Leishmania-infected mice. Taken together, our results substantiate a favorable safety profile of LEISHDNAVAX in both naive and infected animals and thus, support the initiation of clinical trials for both preventive and therapeutic applications of the vaccine.
No abstract
Spectrally selective X-ray imaging provides improved material and tissue discrimination in comparison to state-of-art dual energy technologies that are commonly used in medical, industrial, and security applications. Cadmium Telluride (CdTe) and Cadmium Zinc Telluride (CdZnTe) based line scanners and small size two-dimensional X-ray sensors are emerging to the market, but the need for large scale panels is axiomatic. In this study, a seamless CdTe tile was developed that enables the implementation of large-sized, energy selective X-ray detector panels. The developed tile consists of a 64 × 64 pixel array (with 150 µm pitch) with a necessary substrate, ASIC, and CdTe crystal. The performance of the constructed seamless tile was characterized by focusing on spectral resolution and stability. In addition, a simple pixel trimming method that automates the equalization of each energy selective pixel was developed and analyzed.The obtained results suggest that the proposed concept of seamless (tileable) detector structures is a feasible approach to scale up panel sizes. The seamless tile shows comparable spectral resolution and stability performance with commercial CdTe sensors. The effect of tile to tile variation, the realization of a largescale panel, as well as the charge sharing performance, were left out of the scope and are to be studied in the next phase.
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