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

donderdag 15 maart 2018

The Lancet: [Comment] Predicting outcome and improving treatment for Lassa fever

[Comment] Predicting outcome and improving treatment for Lassa fever
Lassa virus (LASV) is a rodent-borne arenavirus that causes viral haemorrhagic fever. LASV has been estimated to infect over 300 000 individuals per year across west Africa, causing over 3000 deaths.1 The case fatality rate of Lassa fever has ranged from 15% to 50% in patients admitted to hospital, with a recent multi-year study in Sierra Leone reporting a 69% case fatality rate.2 Despite this high annual mortality, LASV has been largely underappreciated regarding its contribution to the overall burden of microbial infections in west Africa.
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[Articles] Sustained transmission of high-level azithromycin-resistant Neisseria gonorrhoeae in England: an observational study
Sustained transmission of a successful HL-AziR clone was seen across England. Mutation 2059A→G was found in isolates with lower azithromycin MICs. Azithromycin exposure might have provided the selection pressure for one or two mutated copies of the 23S rRNA gene to recombine with wild-type copies, leading to three or four mutated copies and the HL-AziR phenotype. HL-AziR could emerge in isolates with low azithromycin MICs and eliminate the effectiveness of azithromycin as part of dual therapy for the treatment of gonorrhoea.
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[Personal View] Precision medicine for drug-resistant tuberculosis in high-burden countries: is individualised treatment desirable and feasible?
Treatment for drug-resistant tuberculosis is largely delivered through standardised, empirical combination regimens in low-resource, high-burden settings. However, individualised treatment, guided by detailed drug susceptibility testing, probably results in improved individual outcomes and is the standard of care in well-resourced settings. Driven by the urgent need to scale up treatment provision, new tuberculosis drugs, incorporated into standardised regimens, are being tested. Although standardised regimens are expected to improve access to treatment in high-burden settings, they are also likely to contribute to the emergence of resistance, even with good clinical management.
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[Comment] Cholera control: one dose at a time
Cholera continues to harm the most vulnerable people worldwide.1 As an indicator of human progress, the sustained or new presence of the disease in any region is a stark reminder of how far we, as a society, have to go to reach Sustainable Development Goal 6: ensuring availability and sustainable management of water and sanitation for all.2 Diarrhoeal diseases are a major source of preventable morbidity and mortality, and in 2015 claimed the lives of more than 1·3 million people, of whom 499 000 were children younger than 5 years.
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[Articles] Efficacy of a single-dose regimen of inactivated whole-cell oral cholera vaccine: results from 2 years of follow-up of a randomised trial
A single dose of the inactivated whole-cell OCV offered protection to older children and adults that was sustained for at least 2 years. The absence of protection of young children might reflect a lesser degree of pre-existing natural immunity in this age group.
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