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vrijdag 9 februari 2018

The Lancet: [Articles] Re-emergence of yaws after single mass azithromycin treatment followed by targeted treatment: ...

[Articles] Re-emergence of yaws after single mass azithromycin treatment followed by targeted treatment: a longitudinal study
The implementation of the WHO strategy did not, in the long-term, achieve elimination in a high-endemic community mainly due to the individuals who were absent at the time of mass treatment in whom yaws reactivated; repeated mass treatment might be necessary to eliminate yaws. To our knowledge, this is the first report of the emergence of azithromycin-resistant T p pertenue and spread within one village. Communities' surveillance should be strengthened to detect any possible treatment failure and biological markers of resistance.
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[Comment] Macrolide resistance in yaws
The study by Oriol Mitjà and colleagues in The Lancet1 shows that a single round of mass administration of azithromycin is insufficient to achieve yaws eradication. It also represents the first report of a mutation in both 23S rRNA genes of the yaws-causing spirochaete, Treponema pallidum subspecies pertenue (T p pertenue), causing macrolide resistance in five epidemiologically linked patients. The mutation, A2059G, was previously reported in a patient with syphilis (caused by T p pallidum) with spiramycin treatment failure;2 it is one of two macrolide-resistant mutations previously detected in T p pallidum (the other is A2058G).
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[Department of Error] Department of Error
Castaigne S, Pautas C, Terré C, et al. Effect of gemtuzumab ozogamicin on survival of adult patients with de-novo acute myeloid leukaemia (ALFA-0701): a randomised, open-label, phase 3 study. Lancet 2012; 379: 1508�C16―In table 1 of this Article, the Intermediate row under the Cytogenetics heading has been updated. This correction has been made to the online version as of Feb 8, 2018.
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[Articles] Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial
In patients with symptomatic COPD, severe or very severe airflow limitation, and an exacerbation history despite maintenance therapy, extrafine BDP/FF/G significantly reduced the rate of moderate-to-severe exacerbations compared with IND/GLY, without increasing the risk of pneumonia.
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[Comment] Filling the gaps in COPD: the TRIBUTE study
Chronic obstructive pulmonary disease (COPD) is a major public health problem because of its high prevalence (about 10% of the adult population), rising incidence (COPD is predicted to be the third global cause of death by 2020), and high associated personal, social, and economic costs.1 Regular physical activity, appropriate vaccination, and avoiding toxic exposures (eg, tobacco smoking) are important non-pharmacological approaches for the management of patients with COPD.1 Meanwhile, pharmacological treatment for COPD is fundamentally based on the use of inhaled drugs: long-acting bronchodilators (long-acting antimuscarinic agents, long-acting β2 agonists, or both), with or without inhaled corticosteroids.
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