27 research outputs found
A new chapter unfolds-an electronic-only journal
No full textComo algunos de nuestros lectores m\ue1s asiduos pueden saber, la historia de la Revista Panamericana de Salud P\ufablica/Pan American Journal of Public Health es a\ufan m\ue1s larga que su nombre. Se remonta a una era cuando los ministerios de salud y las escuelas de salud p\ufablica \u97claramente diferenciadas de las de medicina\u97 empezaban a formar parte de los gobiernos y las universidades latinoamericanas. En ese momento, la escritura cient\uedfica era todav\ueda un arte incipiente. Los descubrimientos de latinoamericanos tan destacados como Oswaldo Cruz y Carlos Finlay hab\uedan creado gran revuelo en la Convenci\uf3n Sanitaria Internacional de las Rep\ufablicas Americanas. Sus logros desataron las pasiones de generaciones sucesivas de investigadores para proseguir el progreso cient\uedfico por el bien com\ufan y ayudaron a consolidar un esp\uedritu de cooperaci\uf3n y solidaridad panamericana
Dengue y dengue hemorr\ue1gico en las Am\ue9ricas
No full textA pesar de que el dengue se conoce como entidad cl\uednica desde hace m\ue1s de dos siglos y del conocimiento acumulado en el transcurso de los \ufaltimos a\uf1os, esta arbovirosis contin\ufaa siendo hoy uno de los principales problemas de salud mundial y constituye uno de los mayores retos de salud p\ufablica en el milenio actual
Fissured legacies in Roysten Abel's In Othello
No full text© The Author(s) 2023. This document is the Published version of a Published Work that appeared in final form in Cahiers Élisabéthains: A Journal of English Renaissance Studies. To access the final edited and published work see https://doi.org/10.1177/01847678231164294In Othello (2003) offers both a critique and inadvertent affirmation of racial and colonial hierarchies and a reflection on the postcolonial nation. The film fosters Orientalist sensibilities via a fetishisation of ‘otherness’, in order to subvert it. It is a hybrid and ambivalent production in which the characters possess intersectional identities that are always multiple, in line with Hindu philosophy. This hybridity can also be observed in the mixture of traditions on which the film is based, and as such, it serves as a ‘rhizomatic interrelation’. The film shows how Shakespeare's play may provide a meditation on the Indian nation, where issue ssuch as transgressive romance, ostracisation, and gender roles remain unsettled.In Othello (2003) propose à la fois une déconstruction et une affirmation fortuite des hiérarchies raciales et coloniales ainsi qu’une réflexion sur la nation postcoloniale. Le film célèbre les sensibilités orientalistes à travers une fétichisation de l’altérité dans le but de la subvertir. Il s’agit d’une réalisation hybride et ambivalente dont les personnages sont dotés d’identités intersectionnelles qui sont toujours multiples, en cohérence avec la philosophie hindoue. Cette hybridité s’observe aussi dans le mélange de traditions dans lequel puise le film, opérant par là une « interconnexion en rhizome ». Le film illustre la manière dont la pièce de Shakespeare peut proposer un espace de réflexion sur la nation indienne, où des questions comme l’amour transgressif, l’ostracisme et les rôles genrés restent sensibles
Repurposed Antiviral Drugs for Covid-19 - Interim WHO Solidarity Trial Results.
Get PDFBACKGROUND
World Health Organization expert groups recommended mortality trials of four repurposed antiviral drugs - remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1a - in patients hospitalized with coronavirus disease 2019 (Covid-19).
METHODS
We randomly assigned inpatients with Covid-19 equally between one of the trial drug regimens that was locally available and open control (up to five options, four active and the local standard of care). The intention-to-treat primary analyses examined in-hospital mortality in the four pairwise comparisons of each trial drug and its control (drug available but patient assigned to the same care without that drug). Rate ratios for death were calculated with stratification according to age and status regarding mechanical ventilation at trial entry.
RESULTS
At 405 hospitals in 30 countries, 11,330 adults underwent randomization; 2750 were assigned to receive remdesivir, 954 to hydroxychloroquine, 1411 to lopinavir (without interferon), 2063 to interferon (including 651 to interferon plus lopinavir), and 4088 to no trial drug. Adherence was 94 to 96% midway through treatment, with 2 to 6% crossover. In total, 1253 deaths were reported (median day of death, day 8; interquartile range, 4 to 14). The Kaplan-Meier 28-day mortality was 11.8% (39.0% if the patient was already receiving ventilation at randomization and 9.5% otherwise). Death occurred in 301 of 2743 patients receiving remdesivir and in 303 of 2708 receiving its control (rate ratio, 0.95; 95% confidence interval [CI], 0.81 to 1.11; P = 0.50), in 104 of 947 patients receiving hydroxychloroquine and in 84 of 906 receiving its control (rate ratio, 1.19; 95% CI, 0.89 to 1.59; P = 0.23), in 148 of 1399 patients receiving lopinavir and in 146 of 1372 receiving its control (rate ratio, 1.00; 95% CI, 0.79 to 1.25; P = 0.97), and in 243 of 2050 patients receiving interferon and in 216 of 2050 receiving its control (rate ratio, 1.16; 95% CI, 0.96 to 1.39; P = 0.11). No drug definitely reduced mortality, overall or in any subgroup, or reduced initiation of ventilation or hospitalization duration.
CONCLUSIONS
These remdesivir, hydroxychloroquine, lopinavir, and interferon regimens had little or no effect on hospitalized patients with Covid-19, as indicated by overall mortality, initiation of ventilation, and duration of hospital stay. (Funded by the World Health Organization; ISRCTN Registry number, ISRCTN83971151; ClinicalTrials.gov number, NCT04315948.)
Identifying thresholds to classify moderate-to-heavy soil-transmitted helminth intensity infections for FECPAK(G2), McMaster, Mini-FLOTAC and qPCR
Get PDFAuthor summary The prevalence of moderate-to-heavy intensity (M&HI) infections is a key indicator for measuring the success of large-scale deworming programs for intestinal worms because they account for the majority of the worm attributable morbidity. Currently, intestinal worm infections are classified as M&HI when the number of worm eggs that are microscopically detected in stool using a standard diagnostic method exceeds a threshold set by the World Health Organization. Over the years, a variety of new promising diagnostic methods have been introduced for the diagnosis of intestinal worms. Although they have some important advantages over the current standard method, it is not clear whether they can reliably classify M&HI infections. This is because their test results either systematically indicate lower egg counts or are expressed in a unit other than eggs per gram of stool (e.g, concentration of worm DNA), warranting the need for method-specific thresholds. We defined method-specific thresholds and verified whether they increased the correct classification of M&HI infections. Overall, our results indicate that method-specific thresholds improved the classification of M&HI infections, but that further validation is required before they can be recommended for evaluating the occurrence M&HI infections in large-scale deworming programs.World Health Organization (WHO) has defined moderate-to-heavy intensity (M&HI) infections with soil-transmitted helminths (Ascaris lumbricoides,Trichuris trichiuraand the two hookworms,Ancylostoma duodenaleandNecator americanus) based on specific values of eggs per gram of stool, as measured by the Kato-Katz method. There are a variety of novel microscopy and DNA-based methods but it remains unclear whether applying current WHO thresholds on to these methods allows for a reliable classification of M&HI infections. We evaluated both WHO and method-specific thresholds for classifying the M&HI infections for novel microscopic (FECPAK(G2), McMaster and Mini-FLOTAC) and DNA-based (qPCR) diagnostic methods. For this, we determined method-specific thresholds that best classified M&HI infections (defined by Kato-Katz and WHO thresholds; reference method) in two multi-country drug efficacy studies. Subsequently, we verified whether applying these method-specific thresholds improved the agreement in classifying M&HI infections compared to the reference method. When we applied the WHO thresholds, the new microscopic methods mainly misclassified M&HI as low intensity, and to a lesser extent low intensity infection as M&HI. For FECPAK(G2), applying the method-specific thresholds significantly improved the agreement forAscaris(moderate -> substantial),Trichurisand hookworms (fair -> moderate). For Mini-FLOTAC, a significantly improved agreement was observed for hookworms only (fair -> moderate). For the other STHs, the agreement was almost perfect and remained unchanged. For McMaster, the method-specific thresholds revealed a fair to a substantial agreement but did not significantly improve the agreement. For qPCR, the method-specific thresholds based on genome equivalents per ml of DNA moderately agreed with the reference method for hookworms andTrichurisinfections. ForAscaris, there was a substantial agreement. We defined method-specific thresholds that improved the classification of M&HI infections. Validation studies are required before they can be recommended for general use in assessing M&HI infections in programmatic settings
Elimination of neglected diseases in Latin America and the Caribbean: A mapping of selected diseases
No full textRemdesivir and three other drugs for hospitalised patients with COVID-19: final results of the WHO Solidarity randomised trial and updated meta-analyses
Get PDFBackground The Solidarity trial among COVID-19 inpatients has previously reported interim mortality analyses for four repurposed antiviral drugs. Lopinavir, hydroxychloroquine, and interferon (IFN)-beta 1a were discontinued for futility but randomisation to remdesivir continued. Here, we report the final results of Solidarity and meta-analyses of mortality in all relevant trials to date.Methods Solidarity enrolled consenting adults (aged >= 18 years) recently hospitalised with, in the view of their doctor, definite COVID-19 and no contraindication to any of the study drugs, regardless of any other patient characteristics. Participants were randomly allocated, in equal proportions between the locally available options, to receive whichever of the four study drugs (lopinavir, hydroxychloroquine, IFN-beta 1a, or remdesivir) were locally available at that time or no study drug (controls). All patients also received the local standard of care. No placebos were given. The protocol specified primary endpoint was in-hospital mortality, subdivided by disease severity. Secondary endpoints were progression to ventilation if not already ventilated, and time-to-discharge from hospital. Final log-rank and Kaplan Meier analyses are presented for remdesivir, and are appended for all four study drugs. Meta-analyses give weighted averages of the mortality findings in this and all other randomised trials of these drugs among hospital inpatients. Solidarity is registered with ISRCTN, ISRCTN83971151, and ClinicalTrials.gov, NCT04315948.Findings Between March 22, 2020, and Jan 29, 2021, 14 304 potentially eligible patients were recruited from 454 hospitals in 35 countries in all six WHO regions. After the exclusion of 83 (0.6%) patients with a refuted COVID-19 diagnosis or encrypted consent not entered into the database, Solidarity enrolled 14 221 patients, including 8275 randomly allocated (1:1) either to remdesivir (ten daily infusions, unless discharged earlier) or to its control (allocated no study drug although remdesivir was locally available). Compliance was high in both groups. Overall, 602 (14.5%) of 4146 patients assigned to remdesivir died versus 643 (15.6%) of 4129 assigned to control (mortality rate ratio [RR] 0.91 [95% CI 0.82-1.02], p=0.12). Of those already ventilated, 151 (42.1%) of 359 assigned to remdesivir died versus 134 (38.6%) of 347 assigned to control (RR 1.13 [0.89-1.42], p=0.32). Of those not ventilated but on oxygen, 14.6% assigned to remdesivir died versus 16.3% assigned to control (RR 0.87 [0.76-0.99], p=0.03). Of 1730 not on oxygen initially, 2.9% assigned to remdesivir died versus 3.8% assigned to control (RR 0.76 [0.46-1.28], p=0.30). Combining all those not ventilated initially, 11.9% assigned to remdesivir died versus 13.5% assigned to control (RR 0.86 [0.76-0.98], p=0.02) and 14.1% versus 15.7% progressed to ventilation (RR 0.88 [0.77-1.00], p=0.04). The non-prespecified composite outcome of death or progression to ventilation occurred in 19.6% assigned to remdesivir versus 22.5% assigned to control (RR 0.84 [0.75-0.93], p=0.001). Allocation to daily remdesivir infusions (vs open-label control) delayed discharge by about 1 day during the 10-day treatment period. A meta-analysis of mortality in all randomised trials of remdesivir versus no remdesivir yielded similar findings.Interpretation Remdesivir has no significant effect on patients with COVID-19 who are already being ventilated. Among other hospitalised patients, it has a small effect against death or progression to ventilation (or both)
Putting health equity at heart of universal coverage—the need for national programmes of action
Get PDFBetter data on health disparities and commitment to interventions focused on the determinants of inequality are essential, argue Eric Friedman and colleagues
The End Of The Beginning. First Report of the Transition Monitoring Board of the Polio Programme
No full textThe Effect of Pomegranate Juice Supplementation on Oxidative Stress in Young Healthy Males
Get PDFBackground & Objectives: The intake of antioxidant supplementations can have key role in
prevention of oxidative stress in healthy individuals. Pomegranate has antioxidant effects and
may play a role in reduction of oxidative stress in healthy males. Therefore, this study
examined the effect of pomegranate juice supplementation on oxidative stress in young
healthy males.
Methods: In semi-experimental study, 14 healthy students living in Dormitories of Ardabil
University of Medical Sciences were included. Subjects were given one cup of pomegranate
juice supplementation per day for two weeks. Fasting blood samples were taken both at the
start and the end of 2-week period to measure the antioxidant enzyme activities such as
superoxide dismutase, glutathione peroxidase, paraoxonase-1, aryl esterase, and the values of
serum total antioxidant capacity, glutathione, and lipid profiles. Data were analyzed using
descriptive and paired t-tests.
Results: The level of serum total antioxidant capacity and activities of enzymes such as
superoxide dismutase, glutathione peroxidase, arylesterase, and standardized arylesterase
activity were significantly increased at the end of two weeks (p<0.05). The serum level of
malondialdehyde was significantly decreased after intervention (p<0.05). Changes were not
significant, although the serum levels of glutathione and HDL-cholesterol increased and LDLcholesterol
decreased at the end of two weeks period.
Conclusion: The results of this study showed that the pomegranate juice supplementation had
beneficial effects in helping body's antioxidant defense system and reduction of oxidative
stress in young healthy males. This study suggests that the pomegranate juice
supplementation can be useful against oxidative stress included in dietaries of young healthy
males
