201 research outputs found
Breaking the barriers: Migrants and tuberculosis
No full textTuberculosis (TB) can represent an important clinical and public health in developing and developed countries. Low- and middle-income countries are facing an epidemic which is difficult to address because of the drug-resistance spread and the association of TB with HIV/AIDS. High-income countries, whose TB incidence has decreased in the last decades, can be involved in new TB epidemic waves owing to social, healthcare, and economic hurdles and challenges. In particular, migrants coming from high TB incidence countries can represent a new epidemiological issue in the TB care and control in geographical areas where primary care and specialized centres are not equipped to face the clinical and public health issues associated with the TB disease. The healthcare management of individuals with a latent TB infection or the TB disease is heterogeneous and different policies are in place in Europe, and, specifically, in EU countries. Scientific evidence on how to early and efficiently detect TB cases is missing, as well as diagnostic tools to diagnose those who have latent TB infection do not show adequate accuracy. Countries like Greece and Italy have political difficulties in the management of migrants and the poor living conditions in the migration centres can increase the probability of Mycobacterium tuberculosis transmission. A clear advocacy and political commitment are urgently required. The current migration trends represent a threat from a human and a healthcare perspective. New homogeneous and target-oriented policies and strategies are needed to improve the health of the migrant and of the autochthonous populations. Editorial World Tuberculosis Day 2017: strengthening the fight against tuberculosis. I. Solovic (Slovakia) et al. Breaking the barriers: Migrants and tuberculosis. G. Sotgiu (Italy) et al. Tuberculosis elimination and the challenge of latent tuberculosis. A. Matteelli (Italy) et al., Italy The cursed duet today: Tuberculosis and HIV-coinfection. S. Tiberi (UK) et al. The challenge of the new tuberculosis drugs. S. Tiberi (UK) et al. Agents of change: The role of healthcare workers in the prevention of nosocomial and occupational tuberculosis. R. R. Nathavitharana (USA) et al
Delamanid and bedaquiline to treat multidrug-resistant and extensively drug-resistant tuberculosis in children: A systematic review
No full textThe new drugs delamanid and bedaquiline are increasingly used to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB). As evidence is lacking, the World Health Organization recommends their use under specific conditions in adults, delamanid only being recommended in children â¥6 years of age. No systematic review has yet evaluated the efficacy, safety and tolerability of the new drugs in children. A search of peer-reviewed, scientific evidence was performed, to evaluate the efficacy/effectiveness, safety, and tolerability of delamanid or bedaquiline-containing regimens in children with confirmed M/XDR-TB. We used PubMed and Embase to identify any relevant manuscripts in English until 31 December 2016, excluding editorials and reviews. Three out of 96 manuscripts retrieved satisfied the inclusion criteria, while 93 were excluded because dealing exclusively with adults (12: 4 on delamanid and 8 on bedaquiline), being recommendations or guidelines (8 manuscripts), reviews (17 papers) or other studies (56 papers). One of the studies retrieved reported evidence on 19 M/XDR-TB children, 16 of them treated under compassionate use with delamanid (13 achieving consistent bacteriological conversion) and 3 candidates for the drug. Two studies reported details on the first paediatric case treated (and cured) with a delamanid-containing regimen. Eight trials including children were also retrieved (clinicaltrials.gov). Although the methodology used in the study was rigorous, the results are limited by the paucity of the studies available in the literature on the use of new anti-TB drugs in children. In conclusion, more evidence is needed on the use of delamanid and bedaquiline in paediatric patients
Bone Marrow Stem Cell Treatment for Ischemic Heart Disease in Patients with No Option of Revascularization: A Systematic Review and Meta-Analysis
No full textPMCID: PMC3686792This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Is there a rationale for pulmonary rehabilitation following successful chemotherapy for tuberculosis?
No full textThe role of tuberculosis as a public health care priority and the availability of diagnostic tools to evaluate functional status (spirometry, plethysmography, and DLCO determination), arterial blood gases, capacity to perform exercise, lesions (chest X-ray and CT), and quality of life justify the effort to consider what needs to be done when patients have completed their treatment. To our knowledge, no review has ever evaluated this topic in a comprehensive manner. Our objective was to review the available evidence on this topic and draw conclusions regarding the future role of the “post-tuberculosis treatment” phase, which will potentially affect several million cases every year. We carried out a non-systematic literature review based on a PubMed search using specific keywords (various combinations of the terms “tuberculosis”, “rehabilitation”, “multidrug-resistant tuberculosis”, “pulmonary disease”, “obstructive lung disease”, and “lung volume measurements”). The reference lists of the most important studies were retrieved in order to improve the sensitivity of the search. Manuscripts written in English, Spanish, and Russian were selected. The main areas of interest were tuberculosis sequelae following tuberculosis diagnosis and treatment; “destroyed lung”; functional evaluation of sequelae; pulmonary rehabilitation interventions (physiotherapy, long-term oxygen therapy, and ventilation); and multidrug-resistant tuberculosis. The evidence found suggests that tuberculosis is definitively responsible for functional sequelae, primarily causing an obstructive pattern on spirometry (but also restrictive and mixed patterns), and that there is a rationale for pulmonary rehabilitation. We also provide a list of variables that should be discussed in future studies on pulmonary rehabilitation in patients with post-tuberculosis sequelae
Citizen (Dis)Empowerment in Urban Regeneration of Low-Income Neighbourhoods
No full textUrban decline and restructuring struggles in low-income and minority neighbourhoods have generated great concern among citizens and governments in the Netherlands, and many other West European countries. Since the 1970s a number of urban renewal policies and practices have tried to respond to the effects of socio-economic and political shifts; large scale deindustrialization, decline and decentralisation of employment in major cities, housing provision and welfare changes, as well as the evolution towards a multicultural society. The approaches undertaken have generated different degrees of power to make decisions at the local level. They have affected the relationship between the state and citizens, and have recently implied greater involvement of the private sector in urban renewal processes.UrbanismArchitectur
L’autotraduction légitimatrice : Lorenzo Cilda de Victor Manuel Rendón et le dédoublement de l’écrivain bilingue
No full textInternational audienceThe concept of bilingual writer, who creates as a double entity, is the consequence of the esthetical revolution engendered by Romanticism; the XXth century witnessed a lot of situations of bilingual writers, owing to an increased international mobility. This article deals with the case of Victor Manuel Rendon (1859-1939), born in Ecuador and educated in France, who became a writer in both France ans Spanish, his native tongue. Lorenzo Cilda, Rendon’s most achieved novel, in which can be found many autobiographical elements, is analysed from the point of view of differences and similarities of the French and Spanish text, as Rendon is the author of the translation himself
L’autotraduction légitimatrice : Lorenzo Cilda de Victor Manuel Rendón et le dédoublement de l’écrivain bilingue
No full textInternational audienceThe concept of bilingual writer, who creates as a double entity, is the consequence of the esthetical revolution engendered by Romanticism; the XXth century witnessed a lot of situations of bilingual writers, owing to an increased international mobility. This article deals with the case of Victor Manuel Rendon (1859-1939), born in Ecuador and educated in France, who became a writer in both France ans Spanish, his native tongue. Lorenzo Cilda, Rendon’s most achieved novel, in which can be found many autobiographical elements, is analysed from the point of view of differences and similarities of the French and Spanish text, as Rendon is the author of the translation himself
L’autotraduction légitimatrice : Lorenzo Cilda de Victor Manuel Rendón et le dédoublement de l’écrivain bilingue
No full textInternational audienceThe concept of bilingual writer, who creates as a double entity, is the consequence of the esthetical revolution engendered by Romanticism; the XXth century witnessed a lot of situations of bilingual writers, owing to an increased international mobility. This article deals with the case of Victor Manuel Rendon (1859-1939), born in Ecuador and educated in France, who became a writer in both France ans Spanish, his native tongue. Lorenzo Cilda, Rendon’s most achieved novel, in which can be found many autobiographical elements, is analysed from the point of view of differences and similarities of the French and Spanish text, as Rendon is the author of the translation himself
L’autotraduction légitimatrice : Lorenzo Cilda de Victor Manuel Rendón et le dédoublement de l’écrivain bilingue
No full textInternational audienceThe concept of bilingual writer, who creates as a double entity, is the consequence of the esthetical revolution engendered by Romanticism; the XXth century witnessed a lot of situations of bilingual writers, owing to an increased international mobility. This article deals with the case of Victor Manuel Rendon (1859-1939), born in Ecuador and educated in France, who became a writer in both France ans Spanish, his native tongue. Lorenzo Cilda, Rendon’s most achieved novel, in which can be found many autobiographical elements, is analysed from the point of view of differences and similarities of the French and Spanish text, as Rendon is the author of the translation himself
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