RESUMEN

Tuberculosis (TB) affects more than 10 million people each year. We have contested this burden with a paradoxically slow development of treatments, as compared to other infectious diseases. This review aims to update health care professionals on the last developments for the management of TB. The combination of drugs established more than 40years ago is still adequate to cure most people affected by TB. However, with the generalisation of regimens based on rifampicin and isoniazid for (only) 6months, resistance emerged. Resistant cases needed long treatments based on injectable drugs. Now, after an exciting decade of research, we can treat resistant TB with oral regimens based on bedaquiline, nitroimidazoles, and linezolid for (only) 6months, and we may soon break the 6-month barrier for treatment duration. However, these improvements are not enough to end TB without an engagement of people affected and their communities to achieve adherence to treatment, transmission control, and improve socioeconomic determinants of health.

Asunto(s)

Antituberculosos , Tuberculosis Resistente a Múltiples Medicamentos , Humanos , Antituberculosos/uso terapéutico , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Quimioterapia Combinada , Tuberculosis/tratamiento farmacológico

RESUMEN

BACKGROUND: This retrospective, observational study of a routine clinical practice reports the feasibility and efficiency of home-based pulmonary rehabilitation (PR), including transcutaneous neuromuscular electrical stimulation (NMES) or usual endurance physical exercise (UEPE), on exercise tolerance, anxiety/depression, and health-related quality of life (HRQoL) in patients with COPD. METHODS: Seventy-one patients with COPD participated in home-based PR with NMES (Group NMES [GNMES]), while 117 patients participated in home-based PR with the UEPEs (Group UEPE [GUEPE]). NMES was applied for 30 minutes twice a day, every day. The endurance exercises in GUEPE began with a minimum 10-minute session at least 5 days a week, with the goal being 30-45 minutes per session. Three upper and lower limb muscle strengthening exercises lasting 10-15 minutes were also proposed to both the groups for daily practice. Moreover, PR in both the groups included a weekly 90-minute session based on an educational needs assessment. The sessions comprised endurance physical exercise for GUEPE, NMES for GNMES, resumption of physical daily living activities, therapeutic patient education, and psychosocial support to facilitate health behavior changes. Before and after PR, functional mobility and physical exercise capacity, anxiety, depression, and HRQoL were evaluated at home. RESULTS: The study revealed that NMES significantly improved functional mobility (-18.8% in GNMES and -20.6% in GUEPE), exercise capacity (+20.8% in GNMES and +21.8% in GUEPE), depression (-15.8% in GNMES and -30.1% in GUEPE), and overall HRQoL (-7.0% in GNMES and -18.5% in GUEPE) in the patients with COPD, regardless of the group (GNMES or GUEPE) or severity of airflow obstruction. Moreover, no significant difference was observed between the groups with respect to these data (P>0.05). CONCLUSION: Home-based PR including self-monitored NMES seems feasible and effective for severely disabled COPD patients with severe exercise intolerance.

Asunto(s)

Tolerancia al Ejercicio , Servicios de Atención a Domicilio Provisto por Hospital , Músculo Esquelético/inervación , Enfermedad Pulmonar Obstructiva Crónica/terapia , Calidad de Vida , Estimulación Eléctrica Transcutánea del Nervio/métodos , Actividades Cotidianas , Anciano , Terapia Combinada , Depresión/prevención & control , Depresión/psicología , Terapia por Ejercicio , Femenino , Conocimientos, Actitudes y Práctica en Salud , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Contracción Muscular , Fuerza Muscular , Educación del Paciente como Asunto , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/psicología , Recuperación de la Función , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Factores de Tiempo , Estimulación Eléctrica Transcutánea del Nervio/efectos adversos , Resultado del Tratamiento

RESUMEN

BACKGROUND: Rotaviruses are the major cause of severe dehydrating diarrhea in children throughout the world. Enzyme immunoassays (EIAs) have been the standard method for detection of rotavirus in stool specimens since the 1980s. The World Health Organization (WHO) Rotavirus Surveillance Network has proposed including three EIA kits in the WHO-GSM (Global Management System/Système Mondial de Gestion) catalog for easy procurement of EIA kits by participating rotavirus surveillance network laboratories. OBJECTIVES: In this study, we conducted a comparative analysis of 3 commercially available enzyme immunoassay kits: Premier™ Rotaclone® (Meridian Bioscience, Inc.), ProSpecT™ (Oxoid, Ltd.) and RIDASCREEN® (R-biopharm AG) for rotavirus diagnostics. STUDY DESIGN: Using reverse-transcriptase-PCR (RT-PCR) as the gold standard, the 3 EIA kits were evaluated by testing a stool panel consisting of 56 rotavirus-positive and 54 rotavirus negative samples. RESULTS: The sensitivities of the Premier™ Rotaclone®, ProSpecT™ and RIDASCREEN® kits were 76.8%, 75% and 82.1%, respectively, but did not differ significantly. The specificity of all the 3 kits was 100%. The use of RT-PCR as a gold standard lowered the observed sensitivity of all 3 EIA kits but helps to reduce equivocal results that can be seen when another EIA or other non-molecular methods are used as the reference assay in comparison studies. CONCLUSION: Our study found that all three kits are suitable for use by rotavirus surveillance programs.

Asunto(s)

Antígenos Virales/análisis , Técnicas de Laboratorio Clínico/métodos , Heces/virología , Infecciones por Rotavirus/diagnóstico , Rotavirus/inmunología , Preescolar , Humanos , Técnicas para Inmunoenzimas/métodos , Lactante , Juego de Reactivos para Diagnóstico , Sensibilidad y Especificidad

RESUMEN

The North American Species Survival Plan (SSP) for the Cheetah Acinonyx jubatus has developed a cooperative and comprehensive research plan for the long-term management of the species. Networking with zoos, field biologists and scientists, the SSP has managed the captive population from a situation that was clearly not self-sustaining into a well-defined, growing population. This paper describes the development of the SSP and its long-range goals.