Clinical epidemiology, diagnosis and treatment of visceral leishmaniasis in the Pokot endemic area of Uganda and Kenya.

Between 2000 and 2010, Médecins Sans Frontières diagnosed and treated 4,831 patients with visceral leishmaniasis (VL) in the Pokot region straddling the border between Uganda and Kenya. A retrospective analysis of routinely collected clinical data showed no marked seasonal or annual fluctuations. Males between 5 and 14 years of age were the most affected group. Marked splenomegaly and anemia were striking features. An rK39 antigen-based rapid diagnostic test was evaluated and found sufficiently accurate to replace the direct agglutination test and spleen aspiration as the first-line diagnostic procedure. The case-fatality rate with sodium stibogluconate as first-line treatment was low. The VL relapses were rare and often diagnosed more than 6 months post-treatment. Post-kala-azar dermal leishmaniasis was rare but likely to be underdiagnosed. The epidemiological and clinical features of VL in the Pokot area differed markedly from VL in Sudan, the main endemic focus in Africa

www.fevertravel.ch: an online study prototype to evaluate the safety and feasibility of computerized guidelines for fever in returning travellers and migrants

Following the paper publication of practice guidelines for the management of febrile patients returning from the tropics, we constructed a consultation website that comprises a decision chart and specific diagnostic features providing medical diagnostic assistance to primary care physicians. We then integrated a research component to evaluate the implementation of these computerized guidelines. This study website has the same interface as the consultation website. In addition, one is able to record: (i) the pathway followed by the physician through the decision chart, (ii) the diagnostic tests performed, (iii) the initial and final diagnoses as well as outcome and (iv) reasons for non-adherence when the physician diverges from the proposed attitude. We believe that Internet technology is a powerful medium to reach physicians of different horizons in their own environment, and could prove to be an effective research tool to disseminate practice guidelines and evaluate their appropriateness. Here we describe the design, content, architecture and system implementation of this interactive study prototype aimed at integrating operational research in primary care practice. [Authors]]]> Emigration and Immigration; Fever; Guidelines as Topic; Internet; Travel eng oai:serval.unil.ch:BIB_4BBC99034368 2022-05-07T01:17:24Z ehelvetica openaire documents phdthesis urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_4BBC99034368 Usage conditionnel et inconditionnel des droits humains dans la vie quotidienne Anex, Emmanuelle Université de Lausanne, Faculté des sciences sociales et politiques info:eu-repo/semantics/doctoralThesis phdthesis 2018 fre https://serval.unil.ch/resource/serval:BIB_4BBC99034368.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_4BBC990343683 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_4BBC990343683 info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_4BA5F44A285D 2022-05-07T01:17:24Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_4BA5F44A285D A double-blind, placebo-controlled study of citalopram with and without lithium in the treatment of therapy-resistant depressive patients: a clinical, pharmacokinetic, and pharmacogenetic investigation Baumann, Pierre Nil, Rico Souche, Alain Montaldi, Stefano Baettig, Dominique Lambert, Susanne Uehlinger, Claude Kasas, Anton Amey, Marlyse Jonzier-Perey, Michèle info:eu-repo/semantics/article article 1996 Journal of Clinical Psychopharmacology, vol. 16, pp. 307-314 one$; TBOK eng oai:serval.unil.ch:BIB_4BA60F08CDFC 2022-05-07T01:17:24Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_4BA60F08CDFC Busulfan Pharmacokinetics in Adenosine Deaminase-Deficient Severe Combined Immunodeficiency Gene Therapy. info:doi:10.1016/j.bbmt.2020.07.004 info:eu-repo/semantics/altIdentifier/doi/10.1016/j.bbmt.2020.07.004 info:eu-repo/semantics/altIdentifier/pmid/32653625 Bradford, K.L. Liu, S. Krajinovic, M. Ansari, M. Garabedian, E. Tse, J. Wang, X. Shaw, K.L. Gaspar, H.B. Candotti, F. Kohn, D.B. info:eu-repo/semantics/article article 2020-10 Biology of blood and marrow transplantation, vol. 26, no. 10, pp. 1819-1827 info:eu-repo/semantics/altIdentifier/eissn/1523-6536 urn:issn:1083-8791 <![CDATA[The pharmacokinetics of low-dose busulfan (BU) were investigated as a nonmyeloablative conditioning regimen for autologous gene therapy (GT) in pediatric subjects with adenosine deaminase-deficient severe combined immunodeficiency disease (ADA SCID). In 3 successive clinical trials, which included either γ-retroviral (γ-RV) or lentiviral (LV) vectors, subjects were conditioned with BU using different dosing nomograms. The first cohort received BU doses based on body surface area (BSA), the second cohort received doses based on actual body weight (ABW), and in the third cohort, therapeutic drug monitoring (TDM) was used to target a specific area under the concentration-time curve (AUC). Neither BSA-based nor ABW-based dosing achieved a consistent cumulative BU AUC; in contrast, TDM-based dosing led to more consistent AUC. BU clearance increased as subject age increased from birth to 18 months. However, weight and age alone were insufficient to accurately predict the dose that would consistently achieve a target AUC. Furthermore, various clinical, laboratory, and genetic factors (eg, genotypes for glutathione-S-transferase isozymes known to participate in BU metabolism) were analyzed, but no single finding predicted subjects with rapid versus slow clearance. Analysis of BU AUC and the postengraftment vector copy number (VCN) in granulocytes, a surrogate marker of the level of engrafted gene-modified hematopoietic stem and progenitor cells (HSPCs), demonstrated gene marking at levels sufficient for therapeutic benefit in the subjects who had achieved the target BU AUC. Although many factors determine the ultimate engraftment following GT, this work demonstrates that the BU AUC correlated with the eventual level of engrafted gene-modified HSPCs within a vector group (γ-RV versus LV), with significantly higher levels of granulocyte VCN in the recipients of LV-modified grafts compared to recipients of γ-RV-transduced grafts. Taken together, these findings provide insight into low-dose BU pharmacokinetics in the unique setting of autologous GT for ADA SCID, and these dosing principles may be applied to future GT trials using low-dose BU to open the bone marrow niche

Integrating mental health into primary care for displaced populations: the experience of Mindanao, Philippines

ABSTRACT

Discussing age-related functional decline in family medicine: a qualitative study that explores both patient and physician perceptions

Background: evaluating a patient's functional status and screening for geriatric syndromes by general practitioners (GPs) are increasingly encouraged. This study aimed to explore how older people and GPs define and perceive autonomy and functional decline, patients' propensity to discuss age-related issues and integration of such topics into routine medical consultations. Methods: this qualitative study was conducted in Western Switzerland with older people followed in primary care practices and who participated in a trial assessing the effectiveness of a screening and management tool for geriatric syndromes to prevent functional decline. We interviewed 15 participants (patients &gt;= 75 years old) and five GPs about their screening experience. We used semi-structured grids for data collection and an inductive thematic approach for data analysis

Trends in COVID-Related Activity in Sentinel Family Medicine Practices: An Observational Study

Objectives: During the COVID pandemic, data collected in family medicine were scarce. The COVID-FM project aimed to monitor trends of COVID-related activity in family medicine practices of the canton of Vaud, Switzerland, during the year 2021.Methods: Practitioners were invited to join an ad hoc sentinel surveillance system. Online data collection was based on daily activity reports and monthly questionnaires. Participants categorized daily counts of consultations and phone calls into predefined categories. Data were reported and discussed on a weekly basis with public health authorities.Results: On the target of 50 physicians, 37 general physicians from 32 practices finally constituted the COVID-FM sentinel network, contributing to 901 practice-weeks of surveillance in family medicine and 604 in paediatrics. In paediatrics, COVID-related activity corresponded mostly to COVID-19 diagnostic consultations (2911/25990 face-to-face consultations = 11.2%) while in family medicine, other COVID-related topics—such as questions on vaccination—predominated (4143/42221 = 9.8%).Conclusion: COVID-related consultations constituted an important part of primary care practices’ activity in 2021. Monitoring COVID-related activity in primary care provided health authorities with valuable information to guide public health action

Burden of visceral leishmaniasis in villages of eastern gedaref state, Sudan: an exhaustive cross-sectional survey.

Since December 2009, Médecins Sans Frontières has diagnosed and treated patients with visceral leishmaniasis (VL) in Tabarak Allah Hospital, eastern Gedaref State, one of the main endemic foci of VL in Sudan. A survey was conducted to estimate the VL incidence in villages around Tabarak Allah