A research aimed at overcoming the problematic issue of resi | Figure 1
PedroPharmacist
Pharmacist
A research aimed at overcoming the problematic issue of resistance to drugs used in the treatment of tuberculosis has been developed by researchers from five institutions, including Fiocruz Minas. The idea is to use bioinformatics to understand what happens to the mutating bacteria that are mutated and to resist the antibiotics used to combat them, and then to identify them, analyze their effects on the patient's body, and think about new forms of treatment for him.
According to researcher Douglas Pires (Fiocruz Minas), one of the main problems encountered today in the fight against tuberculosis is the time doctors take to confirm that the drug is not working. Thus, one of our main objectives is to speed up this diagnosis, identifying the mutations responsible for the resistance as soon as possible, so that the treatment can be reassessed and modified, given the characteristics of the bacterium that is causing the disease.
Douglas and one other Australian researcher have created an online platform being fed by a database of England with samples of patients from around the world who have developed resistance to these drugs, including Brazilians. This information will be sent to the University of São Paulo (USP) and to the University of Cambridge, where they will be validated by groups participating in the project.
Source: Oswaldo Cruz Foundation.
Background
Epilepsy is a disorder in which unexpected electrical discharges from the brain cause seizures. Approximately one‐third of patients with epilepsy continue to have seizures, despite treatment with presently used (older) antiepileptic drugs (AEDs). In addition, the older AEDs have a lot of adverse effects. Therefore, the development of effective new therapies for the treatment of drug‐resistant seizures is of considerable importance. As a result, a range of new AEDs has been developed as 'add‐on' treatments. Lamotrigine is one of these drugs.
Aims of the review
This review aimed to determine the effects of lamotrigine on seizures, adverse effects, cognition (ability to learn and understand) and quality of life compared to placebo controls, when used as an add‐on treatment for people with focal epilepsy that would not respond to existing AEDs. For this update, we did not identify any new studies to add, and thus, the conclusions remain unchanged. The review included 14 randomised controlled trials with a total number of 1806 participants.
Results
Lamotrigine, used in combination with other AEDs in patients who have drug‐resistant focal epilepsy can decrease the frequency of seizures further. However, adding lamotrigine to the usual treatment is more often associated with an increase in adverse effects such as unsteadiness (ataxia), dizziness, double vision (diplopia), and nausea.
Certainty of the evidence
We assessed the trials with regards to risk of bias and overall we judged them as low to unclear. We rated the certainty of the evidence as high to moderate.
Conclusions
Further high‐quality research is needed to fully evaluate the efficacy and tolerability of lamotrigine and compare it with other newer AEDs. The evidence is current to 9 March 2020.
Why is improving the diagnosis of pulmonary tuberculosis important?
In 2018, at least one million children became ill with tuberculosis and around 200,000 died. When detected early and effectively treated, tuberculosis is largely curable. Xpert MTB/RIF and Xpert Ultra are World Health Organization‐recommended tests that simultaneously detect tuberculosis and rifampicin resistance in adults and children with tuberculosis symptoms. Rifampicin is an important anti‐tuberculosis drug. Not recognizing tuberculosis early may result in delayed diagnosis and treatment, severe illness, and death. A false tuberculosis diagnosis may result in anxiety and unnecessary treatment.
What is the aim of this review?
To determine the accuracy of tests in symptomatic children for diagnosing pulmonary tuberculosis, tuberculous meningitis, lymph node tuberculosis, and rifampicin resistance.
What was studied in this review?
Xpert MTB/RIF and Xpert Ultra, with results measured against culture and a composite reference standard (benchmarks), recognizing that neither reference is perfect in children.
What are the main results in this review?
A total of 49 studies were included. For pulmonary tuberculosis, we analysed 299 data sets including information describing nearly 70,000 children.
Brazilian researchers develop a test that detects zika, dengue and chikungunya at the same time.
The test was developed by the Bio-Manguinhos laboratory of the Oswaldo Cruz Foundation (Fiocruz) in conjunction with the Molecular Biology Institute of Paraná, under the coordination of the Ministry of Health. From the patient's blood it is possible to identify the RNA of the three viruses and allows Determine which of the arboviruses transmitted by the Aedes aegypti mosquito is present in the sample. The technique used in the test is real-time PCR, and a complete diagnosis of the three viruses can be made for partial diagnoses of one or two of them, separately, and such a test makes possible the diagnosis in the initial phase of infection. The patient's blood is added to a gauge particle, which consists of a virus with similar characteristics, produced and patented by Fiocruz, but without infectious potential. The result is obtained in five hours.
Source: Oswaldo Cruz Foundation (Fiocruz)
A @DrsWithoutBorders medic attends to a Multi-Drug Resistant Tuberculosis (MDR-TB) patient in Mankayane hospital, Swaziland.
Swaziland is a country with one of the highest rates of TB and MDR-TB worldwide. In Swaziland, MSF is supporting the Ministry of Health to improve the diagnosis and treatment of HIV and TB, especially for drug-resistant forms of TB. A typical form of TB requires a six-month treatment regimen made up of four different antibiotic drugs. The current treatments for patients with MDR / XDR-TB are extremely difficult to endure. In most cases, patients face a minimum of nine months of treatment, usually closer to two years, during which they must swallow more than 10,000 pills in addition to six to eight months of painful injections. Debilitating side effects range from nausea, joint pains and gastro-intestinal problems to irreversible deafness and psychosis. #tb #worldtbday #tuberculosis
Patient case examples:
A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.
A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back.
She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.
A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days.
Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.