We bring you the latest news from the healthcare about the health care in the United Kingdom.

donderdag 26 oktober 2017

The Lancet: [Review] The WHO public health approach to HIV treatment and care: looking back and looking ahead

[Review] The WHO public health approach to HIV treatment and care: looking back and looking ahead
In 2006, WHO set forth its vision for a public health approach to delivering antiretroviral therapy. This approach has been broadly adopted in resource-poor settings and has provided the foundation for scaling up treatment to over 19·5 million people. There is a global commitment to end the AIDS epidemic as a public health threat by 2030 and, to support this goal, there are opportunities to adapt the public health approach to meet the ensuing challenges. These challenges include the need to improve identification of people with HIV infection through expanded approaches to testing; further simplify and improve treatment and laboratory monitoring; adapt the public health approach to concentrated epidemics; and link HIV testing, treatment, and care to HIV prevention.
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[Review] Protection of the house against Chagas disease, dengue, leishmaniasis, and lymphatic filariasis: a systematic review
In light of the recent Zika virus outbreak, vector control has received renewed interest. However, which interventions are efficacious and community effective and how to best deliver them remains unclear. Following PRISMA guidelines, we did a systematic review to assess evidence for applied vector control interventions providing protection against Chagas disease, dengue, leishmaniasis, and lymphatic filariasis at the household level. We searched for published literature and grey literature between Jan 1, 1980, and Nov 30, 2015, and updated our search on April 2, 2017, using databases including the Cochrane, Embase, LILACS, PubMed, Web of Science, and WHOLIS.
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[Articles] Prolonged versus short-term intravenous infusion of antipseudomonal β-lactams for patients with sepsis: a systematic review and meta-analysis of randomised trials
Prolonged infusion of antipseudomonal β-lactams for the treatment of patients with sepsis was associated with significantly lower mortality than short-term infusion. Further studies in specific subgroups of patients according to age, sepsis severity, degree of renal dysfunction, and immunocompetence are warranted.
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[Personal View] Surveillance for control of antimicrobial resistance
Antimicrobial resistance poses a growing threat to public health and the provision of health care. Its surveillance should provide up-to-date and relevant information to monitor the appropriateness of therapy guidelines, antibiotic formulary, antibiotic stewardship programmes, public health interventions, infection control policies, and antimicrobial development. In Europe, although the European Antimicrobial Resistance Surveillance Network provides annual reports on monitored resistant bacteria, national surveillance efforts are still fragmented and heterogeneous, and have substantial structural problems and issues with laboratory data.
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[Comment] β-lactam prolonged infusion: it's time to implement!
In the Lancet Infectious Diseases, Konstantinos Z Vardakas and colleagues1 show that prolonged (extended or continuous) infusion of antipseudomonal β-lactams reduced mortality compared with intermittent dosing in a systematic review of randomised controlled trials (RCTs).
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