Supply-side contribution to the lack of PBF impact on unmet need for family planning in Burkina Faso

Background

In 2020, about one in four women in Burkina Faso faced an unmet need for family planning (FP). Between 2013 and 2017, Burkina Faso implemented a performance-based financing (PBF) program to improve primary health care service provision (including FP) at rural health centers. Our prior work revealed that PBF did not lead to a reduction in unmet need for FP, in spite of FP being an explicitly targeted service. Our current study assesses supply-side factors that have likely contributed towards this lack of effect at population level, by examining changes in facility-based indicators relevant to the provision of FP induced by PBF.

Methods

We used facility-based survey data from 406 PBF and 117 control facilities collected before and after the PBF implementation. To compare changes in FP service provision, we examined changes in a number of relevant indicators including: a. the types of FP methods offered by facilities; b. trainings received by different FP providers; and c. available stocks of modern contraceptives. We relied on a difference-in-differences (DID) regression model to estimate the impact of PBF on these indicators.

Results

We observed a significant positive impact on the number of staff qualified to provide injectables, implants and IUDs (effect size 0.47, p 0.003) as well as the number of facilities offering IUDs (effect size 0.28, p 0.016) and a significant reduction in the number of facilities experiencing stock-outs of female condoms (effect size -0.09, p 0.007) and implants (effect size -0.03, p 0.042).

Conclusions

Given the significant positive impacts on the number of qualified staff, facilities providing IUDs and a reduction in stock-outs of female condoms and implants attributable to the PBF intervention without showing signs of negative effects on the indicators measured supply-side factors might not have been the main reason for the lack of effect of the PBF program on unmet need for FP.

Key messages

• Supply-side factors might not have been the main reason for the lack of effect of the PBF program on unmet need for FP.

• Further research is needed to explore other potential underlying reasons.

EnzymeML-a data exchange format for biocatalysis and enzymology

EnzymeML is an XML-based data exchange format that supports the comprehensive documentation of enzymatic data by describing reaction conditions, time courses of substrate and product concentrations, the kinetic model, and the estimated kinetic constants. EnzymeML is based on the Systems Biology Markup Language, which was extended by implementing the STRENDA Guidelines. An EnzymeML document serves as a container to transfer data between experimental platforms, modeling tools, and databases. EnzymeML supports the scientific community by introducing a standardized data exchange format to make enzymatic data findable, accessible, interoperable, and reusable according to the FAIR data principles. An application programming interface in Python supports the integration of software tools for data acquisition, data analysis, and publication. The feasibility of a seamless data flow using EnzymeML is demonstrated by creating an EnzymeML document from a structured spreadsheet or from a STRENDA DB database entry, by kinetic modeling using the modeling platform COPASI, and by uploading to the enzymatic reaction kinetics database SABIO-RK.

Redundant nerve roots in lumbar spinal stenosis: inter- and intra-rater reliability of an MRI-based classification

Purpose

Patients with central lumbar spinal stenosis (LSS) have a longer symptom history, more severe stenosis, and worse postoperative outcomes, when redundant nerve roots (RNRs) are evident in the preoperative MRI. The objective was to test the inter- and intra-rater reliability of an MRI-based classification for RNR.

Methods

This is a retrospective reliability study. A neuroradiologist, an orthopedic surgeon, a neurosurgeon, and three orthopedic surgeons in-training classified RNR on 126 preoperative MRIs of patients with LSS admitted for microsurgical decompression. On sagittal and axial T2-weighted images, the following four categories were classified: allocation (A) of the key stenotic level, shape (S), extension (E), and direction (D) of the RNR. A second read with cases ordered differently was performed 4 weeks later. Fleiss and Cohen’s kappa procedures were used to determine reliability.

Results

The allocation, shape, extension, and direction (ASED) classification showed moderate to almost perfect inter-rater reliability, with kappa values (95% CI) of 0.86 (0.83, 0.90), 0.62 (0.57, 0.66), 0.56 (0.51, 0.60), and 0.66 (0.63, 0.70) for allocation, shape, extension, and direction, respectively. Intra-rater reliability was almost perfect, with kappa values of 0.90 (0.88, 0.92), 0.86 (0.84, 0.88), and 0.84 (0.81, 0.87) for shape, extension, and direction, respectively. Intra-rater kappa values were similar for junior and senior raters. Kappa values for inter-rater reliability were similar between the first and second reads (p = 0.06) among junior raters and improved among senior raters (p = 0.008).

Conclusions

The MRI-based classification of RNR showed moderate-to-almost perfect inter-rater and almost perfect intra-rater reliability.

Patient demographics and MRI-based measurements predict redundant nerve roots in lumbar spinal stenosis: a retrospective database cohort comparison

Background

Up to 40% of patients diagnosed with lumbar spinal stenosis (LSS) show evidence of redundant nerve roots (RNR) of the cauda equina on their magnetic resonance images (MRI). The etiology of RNR is still unclear. Preoperative evidence of RNR is associated with a worse postsurgical outcome. Consequently, potential predictors of RNR could have a prognostic value. The aim was to test whether patient demographics and MRI-based measurements can predict RNR in LSS patients.

Methods

In a retrospective database-based cohort study the preoperative data of 300 patients, 150 with (RNR+) and 150 without (RNR-) evidence of RNR on their MRI were analyzed. Three independent researchers performed the MRI reads. Potential predictors were age, gender, body height (BH), length of lumbar spine (LLS), segmental length of lumbar spine (SLLS), lumbar spine alignment deviation (LSAD), relative LLS (rLLS), relative SLLS (rSLLS), number of stenotic levels (LSS-level), and grade of LSS severity (LLS-grade, increasing from A to D). Binomial logistic regression models were performed.

Results

RNR+ patients were 2.6 years older (p = 0.01). Weak RNR+ predictors were a two-years age increase (OR 1.06; p = 0.02), 3 cm BH decrease (OR 1.09; p = 0.01) and a 5 mm SLLS decrease (OR 1.34; p < 0.001). Strong RNR+ predictors were a 1% rLLS decrease (OR 2.17; p < 0.001), LSS-level ≥ 2 (OR 2.59; p = 0.001), LLS-grade C (OR 5.86; p = 0.02) and LLS-grade D (OR 18.4; p < 0.001). The mean rSLLS of RNR+ patients was 0.6% shorter (p < 0.001; 95% C.I. 0.4 to 0.8) indicating a disproportionate shorter lumbar spine.

Conclusions

We identified LSS severity grade and LSS levels as the strongest predictors of RNR. In addition to previous studies, we conclude that a shortened lumbar spine by degeneration is involved in the development of RNR.

How to do (or not to do)… Measuring health worker motivation in surveys in low- and middle-income countries

A health system's ability to deliver quality health care depends on the availability of motivated health workers, which are insufficient in many low income settings. Increasing policy and researcher attention is directed towards understanding what drives health worker motivation and how different policy interventions affect motivation, as motivation is key to performance and quality of care outcomes. As a result, there is growing interest among researchers in measuring motivation within health worker surveys. However, there is currently limited guidance on how to conceptualize and approach measurement and how to validate or analyse motivation data collected from health worker surveys, resulting in inconsistent and sometimes poor quality measures. This paper begins by discussing how motivation can be conceptualized, then sets out the steps in developing questions to measure motivation within health worker surveys and in ensuring data quality through validity and reliability tests. The paper also discusses analysis of the resulting motivation measure/s. This paper aims to promote high quality research that will generate policy relevant and useful evidence.

A retrospective analysis of bone mineral status in patients requiring spinal surgery

Background

Impaired bone quality is associated with poor outcome of spinal surgery. The aim of the study was to assess the bone mineral status of patients scheduled to undergo spinal surgery and to report frequencies of bone mineral disorders.

Methods

We retrospectively analyzed the bone mineral status of 144 patients requiring spinal surgery including bone mineral density by dual-energy X-ray absorptiometry (DXA) as well as laboratory data with serum levels of 25-hydroxyvitamin D (25-OH-D), parathyroid hormone, calcium, bone specific alkaline phosphate, osteocalcin, and gastrin. High-resolution peripheral quantitative computed tomography (HR-pQCT) was additionally performed in a subgroup of 67 patients with T-Score below − 1.5 or history of vertebral fracture.

Results

Among 144 patients, 126 patients (87.5%) were older than 60 years. Mean age was 70.1 years. 42 patients (29.1%) had suffered from a vertebral compression fracture. 12 previously undiagnosed vertebral deformities were detected in 12 patients by vertebral fracture assessment (VFA). Osteoporosis was present in 39 patients (27.1%) and osteopenia in 63 patients (43.8%). Only 16 patients (11.1%) had received anti-osteoporotic therapy, while 54 patients (37.5%) had an indication for specific anti-osteoporotic therapy but had not received it yet. The majority of patients had inadequate vitamin D status (73.6%) and 34.7% of patients showed secondary hyperparathyroidism as a sign for a significant disturbed calcium homeostasis. In a subgroup of 67 patients, severe vertebral deformities were associated with stronger deficits in bone microarchitecture at the distal radius compared to the distal tibia.

Conclusions

This study shows that bone metabolism disorders are highly prevalent in elderly patients scheduled for spinal surgery. Vertebral deformities are associated with a predominant deterioration of bone microstructure at the distal radius. As impaired bone quality can compromise surgical outcome, we strongly recommend an evaluation of bone mineral status prior to operation and anti-osteoporotic therapy if necessary.

[Comparison of patients with psoriasis vulgaris vs. psoriatic arthritis with regard to the reported quality of life]

The present study investigates possible differences in quality of life impairment of patients with psoriasis vulgaris and psoriatic arthritis. One hundred and sixteen patients who were admitted for inpatient rehabilitation to the Fachklinik Bad Bentheim were asked to fill in a self-assessment questionnaire. This questionnaire comprised the SF-12, the German version of the Health Assessment Questionnaire, questions regarding the occupational and the social situation as well as additional questions for identification of specific disease-related burden. Altogether, both groups exhibited impairments of the quality of life. As was to be expected, the arthritis patients suffered from considerably more functional impairment than the patients who only had skin involvement. Interestingly, however, the psychic burden attributable to the disease is equal in patients with isolated skin involvement in comparison to patients with additional arthritis. Summarizing, a different proportion between the extent of psychic and physical impairment is found in the two groups, which might be due to a different pattern of coping with the disease. Taking this aspect into account is imperative when assessing the severity of the disease.

Interobserver-variability of lung nodule volumetry considering different segmentation algorithms and observer training levels

OBJECTIVE

The aim of this study was to investigate the interobserver variability of CT based diameter and volumetric measurements of artificial pulmonary nodules. A special interest was the consideration of different measurement methods, observer experience and training levels.

MATERIALS AND METHODS

For this purpose 46 artificial small solid nodules were examined in a dedicated ex-vivo chest phantom with multislice-spiral CT (20 mAs, 120 kV, collimation 16 mm x 0.75 mm, table feed 15 mm, reconstructed slice thickness 1mm, reconstruction increment 0.7 mm, intermediate reconstruction kernel). Two observer groups of different radiologic experience (0 and more than 5 years of training, 3 observers each) analysed all lesions with digital callipers and 2 volumetry software packages (click-point depending and robust volumetry) in a semi-automatic and manually corrected mode. For data analysis the variation coefficient (VC) was calculated in per cent for each group and a Wilcoxon test was used for analytic statistics.

RESULTS

Click-point robust volumetry showed with a VC of <0.01% in both groups the smallest interobserver variability. Between experienced and un-experienced observers interobserver variability was significantly different for diameter measurements (p=0.023) but not for semi-automatic and manual corrected volumetry. A significant training effect was revealed for diameter measurements (p=0.003) and semi-automatic measurements of click-point depending volumetry (p=0.007) in the un-experienced observer group.

CONCLUSIONS

Compared to diameter measurements volumetry achieves a significantly smaller interobserver variance and advanced volumetry algorithms are independent of observer experience.

Lack of genetic association of the three more common polymorphisms of CARD15 with psoriatic arthritis and psoriasis in a German cohort

OBJECTIVE

To determine whether the three common independent sequence variants of the putative pleiotropic non-MHC autoimmune gene CARD15 influence disease susceptibility in large German cohorts of patients with psoriatic arthritis and psoriasis vulgaris, before and after stratification to HLA-C.

METHODS

DNA was obtained from 375 patients with psoriatic arthritis, 281 patients with psoriasis vulgaris without joint involvement, and 376 controls. The three variants of the CARD15 gene (R702W, G908R, leu1007fsinsC), and two single nucleotide polymorphisms of the HCR gene (HCR-325, HCR-2327) for HLA-C stratification were genotyped using allelic discrimination Taqman assays.

RESULTS

No significant differences in genotype frequencies were observed between controls and either the psoriatic arthritis or the psoriasis vulgaris patient population, even after stratification to HLA-C in both patient cohorts, or to the type of joint involvement within the psoriatic arthritis group.

CONCLUSIONS

The lack of genetic association between the most common Crohn's disease alleles of the CARD15 gene and psoriatic joint disease on large cohorts of white patients does not support a recently claimed role for CARD15 as the first non-MHC susceptibility gene in the pathogenesis of psoriatic arthritis, but confirms and extends previous studies in the case of psoriasis vulgaris.

Glucagon-like peptide 2 improves nutrient absorption and nutritional status in short-bowel patients with no colon

BACKGROUND & AIMS

Glucagon-like peptide 2 (GLP-2) is intestinotrophic, antisecretory, and transit-modulating in rodents, and it is mainly secreted from the intestinal mucosa of the terminal ileum and colon after food ingestion. We assessed the effect of GLP-2 on the gastrointestinal function in patients without a terminal ileum and colon who have functional short-bowel syndrome with severe malabsorption of wet weight (>1.5 kg/day) and energy (>2.3 MJ/day) and no postprandial secretion of GLP-2.

METHODS

Balance studies were performed before and after treatment with GLP-2, 400 microg subcutaneously twice a day for 35 days, in 8 patients (4-17 years from last bowel resection; 6 with Crohn's disease). Four patients received home parenteral nutrition (mean residual jejunum, 83 cm), and 4 did not (mean ileum resection, 106 cm). Biopsy specimens were taken from jejunal/ileal stomas, transit was measured by scintigraphy, and body composition was measured by dual-energy x-ray absorptiometry.

RESULTS

Treatment with GLP-2 improved the intestinal absorption of energy 3.5% +/- 4.0% (mean +/- SD) from 49.9% to 53.4% (P = 0.04), wet weight 11% +/- 12% from 25% to 36% (P = 0.04), and nitrogen 4.7% +/- 5.4% from 47.4% to 52.1% (P = 0.04). Body weight increased 1.2 +/- 1.0 kg (P = 0.01), lean body mass increased 2.9 +/- 1.9 kg (P = 0.004), fat mass decreased 1.8 +/- 1.3 kg (P = 0.007), and 24-hour urine creatinine excretion increased (P = 0.02). The time to 50% gastric emptying of solids increased 30 +/- 16 minutes from 89 to 119 minutes (P < 0.05). Small bowel transit time was not changed. Crypt depth and villus height were increased in 5 and 6 patients, respectively.

CONCLUSIONS

Treatment with GLP-2 improves intestinal absorption and nutritional status in short-bowel patients with impaired postprandial GLP-2 secretion in whom the terminal ileum and the colon have been resected.

A head-activator binding protein is present in hydra in a soluble and a membrane-anchored form

The neuropeptide head activator plays an important role for proliferation and determination of stem cells in hydra. By affinity chromatography a 200 kDa head-activator binding protein, HAB, was isolated from the multiheaded mutant of Chlorohydra viridissima. Partial amino acid sequences were used to clone the HAB cDNA which coded for a receptor with a unique alignment of extracellular modules, a transmembrane domain, and a short carboxy-terminal cytoplasmic tail. A mammalian HAB homologue with identical alignment of these modules is expressed early in brain development. Specific antibodies revealed the presence of HAB in hydra as a transmembrane receptor, but also as secreted protein, both capable of binding head activator. Secretion of HAB during regeneration and expression in regions of high determination potential hint at a role for HAB in regulating the concentration and range of action of head activator.

Time-dependent changes in the density and hemoglobin F content of biotin-labeled sickle cells

Sickle red blood cells (RBC) are subject to a number of important cellular changes and selection pressures. In this study, we validated a biotin RBC label by comparison to the standard 51Cr label, and used it to study changes that occur in sickle cells as they age. Sickle RBC had a much shorter lifespan than normal RBC, but the two labels gave equivalent results for each cell type. A variable number of sickle, but not normal, RBC disappeared from the circulation during the first few hours after reinfusion. The number of biotinylated sickle reticulocytes was decreased by 50% after 24 h and 75% after 48 h, with a gradual decrease in the amount of reticulum per cell. The labeled sickle cells exhibited major density increases during the first 4-6 d after reinfusion, with smaller changes thereafter. A small population of very light, labeled sickle RBC was essentially constant in number after the first few days. Fetal hemoglobin (HbF) content was determined in isolated biotinylated sickle RBC after reinfusion, allowing an estimate of lifespan for RBC containing HbF (F cells) and non-F cells. The lifespan of sickle biotinylated RBC lacking HbF was estimated to be approximately 2 wk, whereas F cells survived 6-8 wk.

Systematic isolation of peptide signal molecules regulating development in hydra: LWamide and PW families

To isolate new peptide signal molecules involved in regulating developmental processes in hydra, a novel screening project was developed. Peptides extracted from the tissue of Hydra magnipapillata were systematically purified to homogeneity using HPLC. A fraction of each purified peptide was examined by differential display-PCR for its ability to affect gene expression in hydra. Another fraction was used to determine the tentative structure using an amino acid sequence analyzer and/or a mass spectrometer. Based on the results, peptides of potential interest were selected for chemical synthesis, followed by confirmation of the identity of the synthetic with the native peptides using HPLC. Using this approach, 286 peptides have been isolated, tentative amino acid sequences have been determined for 95 of them, and 19 synthetic peptides identical to native ones were produced. The 19 synthetic peptides were active in a variety of biological tests. For example, Hym-54 stimulated muscle contraction in adult polyps of hydra and sea anemone, Anthopleura fuscoviridis, and induced metamorphosis of planula, the larval stage, into polyps in a marine hydrozoan species, Hydractinia serrata. Another peptide, Hym-33H, inhibited nerve cell differentiation in hydra and induced tissue contraction in planula of Hydractinia serrata. The evidence obtained so far suggests that hydra contains a large number (>350) of peptide signal molecules involved in regulating developmental or other processes in cnidaria. These peptides can be isolated and their functions examined systematically with the new approach developed in this study.

[Liver cirrhosis and chronic hepatic porphyria]

Chronic hepatic porphyrias (CHP) are associated with different degrees of liver damage. They range from minimal histological changes to cirrhosis and primary liver carcinomas. Forty patients with early stages of porphyrias were compared to 85 patients with clinically manifest porphyrias, Porphyria cutanea tarda. This comparison resulted in the fact that cirrhosis occurred more often in early (or latent) stages (65%) than in PCT (31%) confirmed by laparoscopy. Thus the severity of the liver disease does not depend on the duration and intensity of cutaneous symptoms or pathobiochemical syndromes but they more often depend on the long-term influence of so-called trigger factors, among them above all alcohol and iron overloading. We conclude that the proof of latent CHP has an index function for severer liver damage.

[Laminin P1 and procollagen III peptide in serum: activity parameters in chronic inflammatory joint diseases]

Chronic inflammatory arthritis causes progressive destruction of the joints. Non-specific parameters of inflammation are used in controls, because specific tests are not yet available. In this study, we determined parameters of connective tissue metabolism in 215 sera of patients with chronic inflammatory arthritis, since morphological changes in synovial tissue in these diseases are characterized by proliferation of mesenchymal cells and extracellular matrix. Serum concentration of procollagen-III-peptide (P-III-P) was increased in patients with a markedly progressive disease. Fragment P1 of the basement membrane component laminin was found to be enhanced in the serum of all groups of patients - even in the early stages of diseases. In addition, follow-up over 2 years showed a good correlation between the progression of the diseases and the serum concentration of the two parameters. Our results indicate that P-III-P and laminin P1 serum content specifically reflect the proliferation of mesenchymal tissue in rheumatic diseases of the joints. Determination of both parameters may therefore be useful in estimating the progression of the disease and the benefit of treatment.

The rare occurrence of a radiation-induced osteosarcoma in the clavicule after treatment of thyroid cancer

The authors report on a postirradiation osteosarcoma of the clavicule in a patient treated for thyroid cancer. The total absorbed dose to the right clavicule was estimated 149 Gy (60 Co and 18 MeV elektron beam). The findings are demonstrated on plain radiographs, CT-scan and bone scintigraphy. The literature on this subject is reviewed and the possible pathogenesis discussed.

The influence of paracetamol on the hepatic biosynthesis of lecithin

In paracetamol induced liver injury changes in the phospholipid components of microsomal membranes are usual. Direct incubation of paracetamol with subcellular fractions of human liver specimens did not alter the biosynthesis of lecithin. Preincubation of liver slices with paracetamol led to an increased synthesis of lecithin. The presence of intact cells and the integrity of hepatocellular function seem to be a prerequisite for the poisoning effects in vitro.

Drug intoxication: influence of hemoperfusion on human plasma fibronectin

Fibronectin is a glycoprotein belonging to the opsonic system and able to mediate phagocytosis by the reticuloendothelial system (RES). Severe intoxications are often followed by a diminished capacity of RES-clearance. Patients with severe drug intoxications have lower concentrations of fibronectin in plasma than healthy persons. Charcoal hemoperfusion lowers plasma fibronectin by an average of 4.7 mg/dl. Initial values below 15 mg/dl did not undergo a significant decrease in the case of hemoperfusion. Regarding these findings, determination of plasma fibronectin seems a useful parameter for monitoring RES function during treatment of drug-intoxicated patients by hemoperfusion.

[Treatment of acute liver failure by plasmapheresis]

Repeated plasmaphereses were done in 7 patients with acute hepatic failure (5 of them with coma stage IV and two with stage III). Acute liver insufficiency was induced by fulminant viral hepatitis in 4 cases, by drugs in one case, and was caused by a dystrophic exacerbation of liver cirrhosis in two further cases. Four of the 7 treated patients have survived. Beginning improvement of hepatic function was evidenced by an increase of factor VII and prothrombin in plasma. Significant lowering of bilirubin could be observed in all cases. While ammonia values decreased continuously in the four successfully treated patients while on plasmapheresis, the opposite behaviour was observed in the decreased patients. The influence of plasmapheresis on the pathologically altered aminoacid pattern in hepatic coma was investigated in two patients: Before treatment clearly to excessively increased values of methionine and aromatic aminoacids (phenylalanine and tyrosine) were seen. Branched-chain aminoacids leucine, isoleucine and valine were normal to moderately decreased. After termination of plasmapheresis methionine and aromatic aminoacids were significantly lower, branched-chain aminoacids were slightly below the initial values. Improvement of consciousness correlated with increase of the quotient (val+leu+ile)/(phe+tyr).

Successful treatment of paraquat poisoning: activated charcoal per os and "continuous hemoperfusion"

Ingestion of paraquat results in an extremely dangerous poisoning. The first aim is to clear the gastrointestinal tract by inducing emesis and performing gastric/gut lavage; as much activated charcoal as possible should be administered per os and as quickly as possible. The best measure to eliminate paraquat from blood and tissue is hemoperfusion with coated activated charcoal; it has to be performed in the sense of "continuous hemoperfusion" about 8 h/d over a period of 2-3 weeks. These measures give a chance to lower the lethality of paraquat poisoning.

Plasma fibronectin in man after a severe paraquat intoxication

Fibronectin is a cell surface glycoprotein and belongs to the opsonic system. It can be easily determined in human plasma by laser nephelometry. Patients in shock or with septicemia have extremely low concentrations of fibronectin in plasma which seems to correlate with a depression of the reticuloendothelial system (RES). Determination of fibronectin in human plasma may be a useful parameter for monitoring RES function. Severe intoxication with Paraquat causes a reduction of fibronectin and possibly influences RES function as well.

[Reduced plasma fibronectin in patients with sepsis and shock (author's transl)]

Plasma fibronectin concentrations were determined in 16 patients with sepsis and shock. In all patients a definite decrease was observed during the course of the disease which did not correlate with coagulative function. Fibronectin in plasma rose to normal levels with improvement in the clinical picture. It is possible that plasma fibronectin indicates the functioning of the reticuloendothelial system.

[The effect of silybin-dihemisuccinate on regulation disorders in phospholipid metabolism in acute galactosamine intoxication in the rat]

1. 24 h after application of 900 mg D-galactosamine/kg body weight, an increase of total lipids, triglycerides, phosphatidyl-choline and phosphatidic acid concentrations, and also a decrease of total phospholipids and phosphatidylethanolamine can be determined in the whole rat liver. After administration of [1-14C]-palmitate, specific radioactivity of phosphatidyl-choline is diminished without alteration of specific radioactivity of other lipid fractions. Prophylactic application of silybin-dihemisuccinate abolished completely decrease of phosphatidyl-ethanolamine and diminished increase of total lipids and triglyceride concentrations. 2. Specific radioactivity of total lipids in serum of galactosamine-intoxicated rats is enhanced, specific radioactivity of triglycerides and phospholipids is diminished, simultaneously, total lipids concentration is reduced. 3. In the microsomal fraction of galactosamine-injured livers, a decrease of specific radioactivity of total phospholipids and phosphatidyl-choline can be observed. Prophylactic administration of silybin abolishes diminution of specific radioactivity of phosphatidyl-choline partially. 4. Diminution of specific radioactivity of total lipids, total phospholipids and phosphatidyl-ethanolamine, induced by galactosamine intoxication in the mitochondrial fraction, is normalized by application of silybin. 5. Diminished triglyceride infiltration in siybin-treated rats may be based onnormalization of inhibited phosphatidyl-choline turnover.