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“A significant percentage of patients undergoing resective surgery for medically refractory epilepsy have persistent

or recurrent disabling seizures. In these patients, the objective of seizure freedom justifies the consideration of repeat resective surgery. In this report, the available published experience with repeat resective surgery is analyzed. The reoperated patients are subdivided into three categories: patients with residual medial temporal structures, patients with an unresected or partially resected structural/mass (non-glioma) lesion and patients with non-lesional neocortical epilepsy. This analysis indicates that the chance of achieving seizure freedom is significant, although lower than with the initial surgery. The chance of significant morbidity (particularly significant neurologic deficit) is low, although higher than with the initial surgery. A proper evaluation can identify appropriate Volasertib chemical structure candidates for a resective reoperation. Palliative surgical options should be strongly considered for all patients, especially for those with lower chance of seizure freedom and/or elevated risk of morbidity. (C) 2010 Published by Elsevier Inc.”
“Background: Effective mass drug administration (MDA) with anti-malarial drugs can clear the human infectious Acadesine reservoir for malaria and thereby interrupt malaria transmission. The likelihood of success of MDA depends on the

intensity and seasonality of malaria transmission, the efficacy of the intervention in rapidly clearing all malaria parasite stages and the degree to which symptomatic and asymptomatic parasite carriers participate in the intervention. The impact of MDA with the gametocytocidal drug combination sulphadoxine-pyrimethamine check details (SP) plus artesunate (AS) plus primaquine (PQ, single dose 0.75 mg/kg) on malaria transmission was determined in an area of very low and seasonal malaria transmission in northern Tanzania.

Methods: In a cluster-randomized trial in four villages in Lower Moshi, Tanzania, eight clusters (1,110 individuals; cluster size 47- 209) were randomized to observed treatment with SP+AS+PQ

and eight clusters (2,347 individuals, cluster size 55- 737) to treatment with placebo over three days. Intervention and control clusters were 1km apart; households that were located between clusters were treated as buffer zones where all individuals received SP+AS+PQ but were not selected for the evaluation. Passive case detection was done for the entire cohort and active case detection in 149 children aged 1-10 year from the intervention arm and 143 from the control arm. Four cross-sectional surveys assessed parasite carriage by microscopy and molecular methods during a five-month follow-up period.

Results: The coverage rate in the intervention arm was 93.0% (1,117/1,201). Parasite prevalence by molecular detection methods was 2.2-2.