WHO warns against steroids for H5N1 patients

first_imgApr 20, 2007 (CIDRAP News) – In the wake of a clinical conference, the World Health Organization (WHO) has modified its recommendations on treatment for patients with H5N1 avian influenza by strengthening a warning against corticosteroids and suggesting the option of using higher doses of oseltamivir in some cases, among other advice.The meeting, held in Antalya, Turkey, Mar 19 to 21, brought together clinicians, virologists, epidemiologists, and others to share their observations and unpublished data on treatment of H5N1 patients, the WHO said in a statement yesterday.Since the last clinical conference of its kind was held in Hanoi in May 2005, eight more countries have reported human H5N1 infections, the WHO said. The current WHO global avian flu count is 291 cases with 172 deaths in 12 countries, from Indonesia to Egypt and Nigeria. The disease is fatal in humans about 60% of the time.In previous treatment advice in May 2006, the WHO warned against routine use of corticosteroids except in the context of randomized trials. In its new statement, the agency said corticosteroids have not been effective, “and prolonged or high-dose corticosteroids can result in serious adverse effects in H5N1 patients, including opportunistic infections. Corticosteroids should not be used routinely, except for persistent septic shock with suspected adrenal insufficiency.”In line with the meeting discussions, the WHO offered these additional conclusions about treating H5N1 patients:Early treatment with oseltamivir (Tamiflu), recommended as the first-line medication for H5N1 infections, is useful for reducing mortality, and treatment is warranted even when the drug is started late, because evidence suggests prolonged virus replication.Modified regimens of oseltamivir treatment, including two-fold higher dosage, longer duration, and possibly combination therapy with amantadine (in countries where the H5N1 virus is susceptible to the drug), “may be considered on a case-by-case basis,” especially in patients who have pneumonia or worsening disease.Antibiotic prophylaxis should not be used. However, antibiotics are appropriate for the initial treatment of patients who have pneumonia, using evidence-based guidelines for treating community-acquired pneumonia. When possible, microbiologic studies should guide antibiotic use in H5N1 patients.Therapy for H5N1-associated acute respiratory distress syndrome (ARDS) should follow evidence-based guidelines for treating sepsis-associated ARDS and should involve mechanical ventilation with low tidal volume.The advance release of WHO’s updated clinical guidance comes as researchers from Southeast Asia and the United States are launching a study to determine if doubling the standard dose of oseltamivir will improve its effectiveness against H5N1 influenza or severe seasonal flu. As reported previously, the researchers, part of the Southeast Asia Influenza Clinical Research Network, hope to enroll 400 patients in the study over the next 2 years.The WHO first mentioned combining oseltamivir with amantadine therapy in its last treatment guideline update in May 2006. It said clinicians should use oseltamivir as first-line treatment but should consider adding one of the older antiviral drugs, amantadine or rimantadine, to the regimen if surveillance suggests local H5N1 strains are susceptible to them.That recommendation was based on data showing that some strains of H5N1, mostly those from China and Indonesia, were susceptible to the older drugs.In its statement yesterday, the WHO urged clinicians who modify current antiviral drug regimens to keep detailed records on the treatment and response.A more detailed report from the meeting will be published later in a scientific journal as updated WHO recommendations on H5N1 clinical management, the WHO said.See also:Apr 19 WHO summaryMar 29 CIDRAP News article “International network to study high-dose Tamiflu”May 22, 2006, CIDRAP News article “WHO sees role for older antivirals in some H5N1 cases”last_img read more

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Empty Wimbledon part of organizers’ 2021 plans

first_imgNext year’s Wimbledon Championships could be held without spectators amid the COVID-19 pandemic, the organizers of the grasscourt Grand Slam said on Friday.The tournament in England was canceled this year for the first time since World War Two due to the novel coronavirus, which has killed more than 43,000 people in the United Kingdom.It was the only Grand Slam, however, to be canceled in 2020 as the US Open in New York and the French Open in Paris were held in bio-secure environments after the Australian Open was held in normal circumstances at the beginning of the year. The All England Lawn Tennis Club (AELTC), organizers of the tournament, said they were broadly planning for three different scenarios – a full capacity Championships, a reduced capacity Championships, and a ‘behind closed doors’ Championships.”Staging The Championships in 2021 is our number one priority and we are actively engaged in scenario planning in order to deliver on that priority,” AELTC Chief Executive Sally Bolton said in a statement.The organizers would have learnt from the other Grand Slams and would also keep a close watch on the Australian Open, which is expected to be held in Melbourne in January.Wimbledon had an insurance policy in place for the pandemic in 2020 but will not have similar cover next year and another cancellation would have a major financial impact on the sport in United Kingdom.The pandemic, which has killed over a million people worldwide since emerging in China late last year, will force London into a tighter COVID-19 lockdown from midnight on Friday with the death toll in United Kingdom the highest in Europe.The AELTC said former player Jamie Baker has been appointed as head of professional tennis and tournament director for the Wimbledon Championships, which will be held between June 28 to July 11 next year.Topics :last_img read more

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Australian gas industry veteran offloading Gold Coast apartment

first_imgUnit 4/2 Lavarack Rd, Mermaid BeachAUSTRALIAN gas industry veteran Richard Cottee is offloading an apartment on the absolute beachfront on the Gold Coast.Cottee, who’s now managing director of Central Petroleum, was in a previous worklife MD of Queensland Gas when its market capitalisation went from millions to billions. His investment unit at 4/2 Lavarack Road, Mermaid Beach has hit the market with an asking price of more than $1 million.More from newsParks and wildlife the new lust-haves post coronavirus19 hours agoNoosa’s best beachfront penthouse is about to hit the market19 hours agoCentral Petroleum head Richard Cottee is a master negotiator. Picture: Emma Murray.It is listed through Luke Henderson And Cindy Katene of John Henderson Professionals Mermaid Beach who’re so confident that the property is good value that they’ve challenged potential buyers “to find better value on the beachfront”.Considering Cottee paid $1.1m for the unit a decade ago, it would be like buying at 2008 prices. The east-facing apartment has uninterrupted views of the beach and open plan living areas, plus there is direct access to the beach. The two-bedroom apartment is in a seven-storey tower in which there are only a dozen owners. Regular expenses in Cottee’s investment property include about $4,849 in council rates a year, over $1,094 annually for water, body corporate fees of $140 a week, and he currently has it tenanted at $715 a week. Great location on the coast.last_img read more

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Credit benchmarks too sensitive to interest rates, investors warn

first_img“Sticking to a benchmark mostly only makes the regulator feel better or the board which thinks this is the safer investment decision.”Gerald Moritz, founder and managing director of Moritz Consulting, agreed that benchmark duration was “too high”.The consultant warned: “I am not sure all Pensionskassen are fully aware of the risks in their fixed-income portfolios – and most of their members certainly do not fully understand these risks.”Moritz emphasised the continued importance of diversification “especially in credit risk management and duration”.“One problem will certainly arise from the ECB trying to put bought bonds back onto the market,” Moritz added.He noted that “in 2017, most pension funds were highly active in their asset allocation” and also in managing credit risks.“Sticking to a benchmark mostly only makes the regulator feel better or the board which thinks this is the safer investment decision.” Günther Schiendl, VBVAt the €6.8bn Valida Pension, Austria’s second largest Pensionskasse, head of asset management Arnd Münker said he expected the ECB to prepare for the first interest rate increase in 2019 and “stop buying bonds in September 2018”.“We already significantly reduced the risk from a change in interest rates in our portfolio by lowering exposure to euro government bonds and increasing the share of emerging market bonds,” said Münker.At the VBV, diversification into emerging market local currency debt brought the average overall duration in the fixed income/credit segment to around three years.“For the euro and the dollar interest rate sensitivity in that part of the portfolio, we have taken duration down to almost zero,” Schiendl added.For Schiendl products like risk-parity funds “only offer false security” as they can suffer extreme losses in some market phases – like the 10% drawdown in February. There is currently a mismatch between off-the-shelf benchmarks for credit portfolios and the actual duration required by a long-term investor like an Austrian Pensionskasse in fixed-income portfolios, according to experts.On average the standard benchmark duration is at least five years, but investors need shorter duration to reduce their portfolios’ sensitivity to interest rates. The European Central Bank (ECB) is expected to begin raising interest rates next year, after it finishes tapering bond purchases later in 2018.“The duration of the fixed income benchmarks currently does not match the market environment,” Günther Schiendl, CIO at the €6.9bn VBV Pensionskasse, told IPE. “We are absolute return investors as we have to achieve around 6% annually to match our liabilities target return.last_img read more

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Church’s new valuation methodology brings deficit reduction

first_imgThe £1.8bn (€2.1bn) Church of England Funded Pensions Scheme (CEFPS) has announced a significantly reduced funding deficit of £50m, compared with £236m at the last valuation, after changing its valuation method for liabilities.The funding position has improved further since the valuation was completed.The scheme previously used the “gilts plus” method, basing the discount rate for future pension payments on the yield from gilts plus a margin representing factors such as asset outperformance and the need for prudence.It has now switched to the asset-led funding method, basing the discount rate on the long-term return from its portfolio less a prudent “haircut”. The non-contributory defined benefit (DB) scheme provides funded benefits for service by Church of England clergy from 1 January 1998. Still open to new members, it has more than 20,000 participants, of whom around one-half are retired.Benefits relating to service before 1998 are paid by the Church Commissioners.The scheme is included in the £2.4bn portfolio of the Church of England Pensions Board (CEPB), which runs assets on behalf of three church pension schemes.At the end of 2018, around 87% of CEFPS assets were in a return-seeking pool, with the remaining in a liability-driven portfolio, including UK government bonds.The pension scheme’s return-seeking pool delivered a 7.9% pa return for the 15 years to 31 December 2018.At that date, the asset allocation of the return-seeking strategy was 65% invested in public equities (with a long-term target allocation of 35%), 11.4% in property, 10.1% in infrastructure equity and 4.9% in private loans.There was also a small amount in private equity (with a long-term target of 7%) and 3.6% in emerging market debt.However, illiquid assets will form a large part of the portfolio (around 65%) in five years’ time.“The change in discount rate has been highly transformatory to the funding levels of the CEFPS, as higher discount rates have lowered the valuation of liabilities”Pierre Jameson, chief investment officer for CEPBAaron Punwani, partner at LCP and scheme actuary to the CEFPS, said the CEFPS was in an unusual position, as a large scheme that is open to new members and with a policy of investing a higher proportion of its assets in long-dated illiquid investments and less in gilts than the typical scheme.Punwani said: “This lends itself to using the asset-led funding method, whereby the investment return assumptions are driven from the yields on the investments the scheme expects to hold over the long term, rather than purely from gilt yields. This closer alignment between the investment strategy and the actuarial valuation should result in a more stable funding position over time.”Pierre Jameson, chief investment officer for CEPB, said: “The change in discount rate has been highly transformatory to the funding levels of the CEFPS, as higher discount rates have lowered the valuation of liabilities.”Contributions on behalf of members are made by the fund’s “supporters” (the Church’s dioceses and the Church Commissioners for England).Following a consultation with supporters, contribution levels will be held at 39.9%, instead of rising to 50% had the valuation methodology remained unchanged. The deficit is expected to be cleared by 2023.Jameson said: “The supporters are very much in favour of the change in valuation methodology because it provides a significant dampening of volatility.”He added: “We feel this is a ground-breaking innovation for the pensions industry but it has always been within the guidance of the regulator, who has been consulted throughout the valuation process. Many UK DB schemes are now in run-off, but because we still have new money coming in, it is appropriate for us.”last_img read more

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Trio sets up competition for new LNG retrofitting solutions

first_imgIllustration; One of LNG powered vessels; Source: Wikimedia – under the CC BY 2.0 license; Image by: Alan JamiesonNanyang Technological University, DNV GL, and Shell have organized a competition for ideas to help reduce the cost of retrofitting an LNG fuel gas system to an existing ocean-going vessel.The trio set up the ‘Low-Cost LNG Retrofit (LCLR) Challenge’ to assist shipping companies to embrace cleaner fuels and reduce harmful emissions and adhering the International Maritime Organisation’s (IMO) guidelines on ship emissions that come into effect next year.Participants were encouraged to develop cost-effective and radical LNG fuel gas system designs and installation concepts that could be retrofitted to an existing vessel with a conventional fuel oil system.The competition attracted over 60 participants from NTU, the National University of Singapore, Singapore Institute of Technology, and Newcastle University Singapore with two teams from SIT and one from SIT-Newcastle University named as winners.Low Teck Seng, CEO of the National Research Foundation presented the prizes at the Singapore Maritime Technology Conference (SMTC) 2019 last week.The proposals by the teams outlined ways to reduce costs and streamline retrofitting operations such as using alternative materials to store LNG fuel, improved methods to install LNG fuel systems, and alternative methods to speed up retrofitting process.The proposals include using manganese-steel as a cheaper and viable alternative to the current nickel-based steels, factoring in the material’s tensile strength and feasibility to store LNG fuel at cryogenic temperatures – below 150 degrees Celsius.A panel of international experts from NTU, Shell, DNV GL, Keppel O&M, WinGD, Wartsila, Sembmarine, SMI, and the Maritime and Port Authority of Singapore judged all project proposals.last_img read more

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Alma A. Powers

first_imgAlma A. Powers, 87, of Greensburg, passed away on Monday, January 8, 2017 at her residence in Greensburg.Alma was born on January 11, 1930 in Hamburg, In to Bernard A. and Estella A. (Gurtz) Nobbe.Alma was a homemaker.  She was a very devoted member of St. Mary’s Catholic Church.She was married to Richard E. Powers on February 19, 1949 in Batesville and he preceded her in death on February 2, 2004.Alma is survived by 3 sons, Mike (Tori) Powers, Westport, Bill Powers, Greensburg, Rick Powers, Greensburg, 10 daughters, Pat (Bob) Dehner, Columbus, Barb Christianson, Greensburg, Ginny (Chuck) Rose, North Vernon, Marilyn (Dan) Helms, Westport, Kathy (Wade) Farr, Greensburg, Chris Helms, Greensburg, Carol Faris, Greensburg, Judy Anderson, Westport, Lisa (Paul) Sweezy, Batesville, Sandy Russell, Milan, 1 brother, Charles Jackson, Ohio, and 132 + grand, great grand, and great great grandchildren.Alma was preceded in death by her parents, husband, 2 brothers, Lou and Fred Nobbe, 1 sister, Mildred Reese, 3 granddaughters, Tina Christianson, Laura Allen, K.T. Rose, 2 grandsons, Eddie Rose, and Zach Coomer.A Rosary will start at 3:30 pm on Thursday at Porter-Oliger-Pearson Funeral Home followed by Visitation until 8:00 pm.Visitation will also be from 9-10am on Friday followed by a funeral mass 10 am at St. Mary’s Catholic Church with Rev. John Meyer officiating.Burial will follow at St. Mary’s Catholic Cemetery in Greensburg.Memorial contributions can be made to St. Mary’s Church or to the Alzheimer’s Association.Online condolences can be made at www.popfuneralhome.comlast_img read more

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Enyimba Draws Rwanda’s Rayon Sports in Q’final

first_imgCAF CONFEDERATION CUPNigeria’s last team standing in continental campaign this season Enyimba FC has been drawn against Rayon Sports of Rwanda in one of the quarter final matches of the CAF Confederation Cup.Enyimba will play the away match in the first leg of the encounter with Rayon Sports on September 16. To get to the quarter final, Rayon Sports defeated Young Africans of Tanzania 1-0 in the final Group D match to seal a historical qualification to the quarter-final round of the CAF Confederation Cup.In a game played on Wednesday at Stade de Kigali, Rayon Sports scored early in the 19th minute with a brilliant finish from Bonfils Caleb Bimenyimana, enabling the hosts to advance to the last eight of the lucrative club competition.The historical landmark for Rayon Sports started in May when Gor Mahia FC held them goalless in Kigali. It then went to Tanzania and also played a goalless draw two weeks later.In July, they lost 2-1 in Kigali at the hands of USM Alger before Rayon Sport and USM Alger played out a 1-all stalemate in Algerian capital.Then on August 19, Robert Oliveira’s side registered a vital 2-1 victory over Gor Mahia to register a total of two wins, three draws and one defeat.Should Enyimba knocks out Rayon the possibilities of playing CARA Brazzaville of Congo in the semi final is very imminent. Enyimba grabbed a last-gasp winner against the hard fighting Congolese at the newly refurbished Aba Stadium last Wednesday to book this quarter final ticket.Before dreaming of an encore with Enyimba, CARA too will need to overcome Raja Club Athletic of Morocco who they are paired against in this quarter-final.In the other pairings, Egypt’s El Masry will face USM Alger of Algeria while AS Vita of DR Congo takes on RS Berkane of Morocco in the last quarter-final fixture.The semis are slated for between October 3 and 24, while the final is fixed for November 25 and December 2.Share this:FacebookRedditTwitterPrintPinterestEmailWhatsAppSkypeLinkedInTumblrPocketTelegramlast_img read more

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Bahamas Defence Force Apprehends Cuban Migrants

first_imgNASSAU, Bahamas, CMC – Members of the Bahamas Defence Force (BDF) on Friday apprehended 11 Cuban migrants during a joint effort by members of the BDF and the United States Coast Guard.It’s reported that early Thursday, the security officials intercepted a small rustic vessel migrant vessel with 11 Cuban male migrants onboard in the Anguilla Cay area.The migrants were medically screened and were cleared to embark the vessel for transportation to the Coral Harbour Base.Upon their arrival at the base, the Cuban migrants were also examined by a surveillance team from the Ministry of Health, before eventual handover to Immigration Officials.The Cubans have been placed in quarantine before introduced to the general population at the Detention Center.last_img read more

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