scholarly journals Buruli Ulcer: Review of a Neglected Skin Mycobacterial Disease

2017 ◽  
Vol 56 (4) ◽  
Author(s):  
Jeannette Guarner
Keyword(s):  
Clinical Presentation ◽  
Oral Treatment ◽  
Buruli Ulcer ◽  
Mycobacterium Ulcerans ◽  
World Health ◽  
Tissue Necrosis ◽  
Content Type ◽  
Skin Nodule ◽  
The World ◽  
Health Organization

ABSTRACTBuruli ulcer is caused byMycobacterium ulcerans. This neglected disease occurs in scattered foci around the world, with a higher concentration of cases in West Africa. The mycobacteria produce mycolactones that cause tissue necrosis. The disease presents as a painless skin nodule that ulcerates as necrosis expands. Finding acid-fast bacilli in smears or histopathology, culturing the mycobacteria, and performingM. ulceransPCR in presumptive cases confirm the diagnosis. Medical treatment with oral rifampin and intramuscular streptomycin or oral treatment with rifampin plus clarithromycin for 8 weeks is supported by the World Health Organization. This review summarizes the epidemiology, pathogenesis, clinical presentation, diagnostic tests, and advances in treatment.

scholarly journals High-Dose Rifamycins Enable Shorter Oral Treatment in a Murine Model ofMycobacterium ulceransDisease

2018 ◽  
Vol 63 (2) ◽  
pp. e01478-18 ◽  
Author(s):  
Till F. Omansen ◽  
Deepak Almeida ◽  
Paul J. Converse ◽  
Si-Yang Li ◽  
Jin Lee ◽  
...  
Keyword(s):  
Oral Treatment ◽  
Buruli Ulcer ◽  
Indirect Costs ◽  
Ceiling Effect ◽  
Mycobacterium Ulcerans ◽  
High Dose ◽  
Current Standard ◽  
Standard Regimen ◽  
Content Type ◽  
Dose Dependent

ABSTRACTBuruli ulcer (BU), caused byMycobacterium ulcerans, is a neglected tropical skin and soft tissue infection that is associated with disability and social stigma. The mainstay of BU treatment is an 8-week course of rifampin (RIF) at 10 mg/kg of body weight and 150 mg/kg streptomycin (STR). Recently, the injectable STR has been shown to be replaceable with oral clarithromycin (CLR) for smaller lesions for the last 4 weeks of treatment. A shorter, all-oral, highly efficient regimen for BU is needed, as the long treatment duration and indirect costs currently burden patients and health systems. Increasing the dose of RIF or replacing it with the more potent rifamycin drug rifapentine (RPT) could provide such a regimen. Here, we performed a dose-ranging experiment of RIF and RPT in combination with CLR over 4 weeks of treatment in a mouse model ofM. ulceransdisease. A clear dose-dependent effect of RIF on both clinical and microbiological outcomes was found, with no ceiling effect observed with tested doses up to 40 mg/kg. RPT-containing regimens were more effective onM. ulcerans. All RPT-containing regimens achieved culture negativity after only 4 weeks, while only the regimen with the highest RIF dose (40 mg/kg) did so. We conclude that there is dose-dependent efficacy of both RIF and RPT and that a ceiling effect is not reached with the current standard regimen used in the clinic. A regimen based on higher rifamycin doses than are currently being evaluated against tuberculosis in clinical trials could shorten and improve therapy of Buruli ulcer.

scholarly journals The changing epidemiology worldwide ofMycobacterium ulcerans

2018 ◽  
Vol 147 ◽  
Author(s):  
D. P. O'Brien ◽  
I. Jeanne ◽  
K. Blasdell ◽  
M. Avumegah ◽  
E. Athan
Keyword(s):  
Mycobacterial Infection ◽  
Mycobacterium Ulcerans ◽  
Health Interventions ◽  
World Health ◽  
Transmission Mechanisms ◽  
Current State ◽  
The World ◽  
Environmental Reservoir ◽  
Endemic Areas ◽  
Health Organization

AbstractMycobacterium ulceransis recognised as the third most common mycobacterial infection worldwide. It causes necrotising infections of skin and soft tissue and is classified as a neglected tropical disease by the World Health Organization (WHO). However, despite extensive research, the environmental reservoir of the organism and mode of transmission of the infection to humans remain unknown. This limits the ability to design and implement public health interventions to effectively and consistently prevent the spread and reduce the incidence of this disease. In recent years, the epidemiology of the disease has changed. In most endemic regions of the world, the number of cases reported to the WHO are reducing, with a 64% reduction in cases reported worldwide in the last 9 years. Conversely, in a smaller number of countries including Australia and Nigeria, reported cases are increasing at a rapid rate, new endemic areas continue to appear, and in Australia cases are becoming more severe. The reasons for this changing epidemiology are unknown. We review the epidemiology ofM. ulceransdisease worldwide, and document recent changes. We also outline and discuss the current state of knowledge on the ecology ofM. ulcerans, possible transmission mechanisms to humans and what may be enabling the spread ofM. ulceransinto new endemic areas.

scholarly journals Skin-specific antibodies neutralizing mycolactone toxin during the spontaneous healing of Mycobacterium ulcerans infection

2020 ◽  
Vol 6 (9) ◽  
pp. eaax7781 ◽  
Author(s):  
Mélanie Foulon ◽  
Amélie Pouchin ◽  
Jérémy Manry ◽  
Fida Khater ◽  
Marie Robbe-Saule ◽  
...  
Keyword(s):  
Healing Process ◽  
Buruli Ulcer ◽  
Mycobacterium Ulcerans ◽  
World Health ◽  
Immunomodulatory Activity ◽  
Spontaneous Healing ◽  
Specific Antibodies ◽  
Skin Ulcers ◽  
Chronic Skin ◽  
Health Organization

Buruli ulcer, a neglected tropical infectious disease, is caused by Mycobacterium ulcerans. Without treatment, its lesions can progress to chronic skin ulcers, but spontaneous healing is observed in 5% of cases, suggesting the possible establishment of a host strategy counteracting the effects of M. ulcerans. We reveal here a skin-specific local humoral signature of the spontaneous healing process, associated with a rise in antibody-producing cells and specific recognition of mycolactone by the mouse IgG2a immunoglobulin subclass. We demonstrate the production of skin-specific antibodies neutralizing the immunomodulatory activity of the mycolactone toxin, and confirm the role of human host machinery in triggering effective local immune responses by the detection of anti-mycolactone antibodies in patients with Buruli ulcer. Our findings pave the way for substantial advances in both the diagnosis and treatment of Buruli ulcer in accordance with the most recent challenges issued by the World Health Organization.

scholarly journals The clinical spectrum of Erdheim-Chester disease: an observational cohort study

2017 ◽  
Vol 1 (6) ◽  
pp. 357-366 ◽  
Author(s):  
Juvianee I. Estrada-Veras ◽  
Kevin J. O’Brien ◽  
Louisa C. Boyd ◽  
Rahul H. Dave ◽  
Benjamin H. Durham ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Age Of Onset ◽  
Observational Cohort Study ◽  
World Health ◽  
Key Points ◽  
The World ◽  
Observational Cohort ◽  
Health Organization ◽  
Erdheim Chester ◽  
Chester Disease

Key Points ECD varies in terms of age of onset, clinical presentation, manifestations, organ involvement, disease severity, and survival. ECD is a neoplasm and should be adopted by the field of hematology-oncology following the World Health Organization reclassification.

COVID-19 alters focus of cyberespionage

2020 ◽  
Keyword(s):  
Civil Society ◽  
World Health Organization ◽  
World Health ◽  
Research Institutions ◽  
Content Type ◽  
Pharmaceutical Firms ◽  
Civil Society Organisations ◽  
Multilateral Institutions ◽  
The World ◽  
Health Organization

Significance Calls by the UN and civil society organisations for a cyberspace ‘ceasefire’ have made little difference. Impacts Trust in multilateral institutions such as the World Health Organization will be undermined if they suffer cyberattacks. Post-pandemic, China is likely to experience a rise in cyber intrusions from upcoming cyber actors such as Vietnam. Although better prepared than research institutions, large pharmaceutical firms are not immune to cyberespionage.

scholarly journals Avibactam Restores the Susceptibility of Clinical Isolates of Stenotrophomonas maltophilia to Aztreonam

2017 ◽  
Vol 61 (10) ◽  
Author(s):  
Maria F. Mojica ◽  
Krisztina M. Papp-Wallace ◽  
Magdalena A. Taracila ◽  
Melissa D. Barnes ◽  
Joseph D. Rutter ◽  
...  
Keyword(s):  
Stenotrophomonas Maltophilia ◽  
Opportunistic Pathogen ◽  
Multidrug Resistant ◽  
World Health ◽  
Combination Therapies ◽  
Content Type ◽  
Medical Need ◽  
The World ◽  
Health Organization

ABSTRACT Stenotrophomonas maltophilia is an emerging opportunistic pathogen, classified by the World Health Organization as one of the leading multidrug-resistant organisms in hospital settings. The need to discover novel compounds and/or combination therapies for S. maltophilia is urgent. We demonstrate the in vitro efficacy of aztreonam-avibactam (ATM-AVI) against S. maltophilia and kinetically characterize the inhibition of the L2 β-lactamase by avibactam. ATM-AVI overcomes aztreonam resistance in selected clinical strains of S. maltophilia, addressing an unmet medical need.

scholarly journals Ten commonly asked questions about Covid-19 and lessons learned from Thailand

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Pramon Viwattanakulvanid
Keyword(s):  
Symptomatic Treatment ◽  
Lessons Learned ◽  
World Health ◽  
Health Crisis ◽  
Content Type ◽  
Treatment And Prevention ◽  
The World ◽  
Village Health Volunteers ◽  
Control And Prevention ◽  
Health Organization

PurposeAs the world faces a new health crisis threatening people with the spread of Covid-19, this study aims to summarize the key information of Covid-19 related to disease characteristics, diagnosis, treatment and prevention along with the lessons learned from Thailand.Design/methodology/approachThe narrative review was synthesized from various sources such as the World Health Organization; Centers for Disease Control and Prevention; Ministry of Public Health and other related news; articles in ScienceDirect, PubMed, Google Scholar; and the author's perspective regarding the lessons learned from Thailand with keywords of “Covid-19” and “Coronavirus” from January to August 2020. Google Trends was used to set common questions.FindingsCovid-19 is the seventh family of coronaviruses that cause various symptoms related to respiratory systems. The disease can be treated through general and symptomatic treatment, by using antiviral drugs. As of July 2020, there are four potential vaccine candidates ChAdOx1 nCoV-19, mRNA-1273, Ad5-nCOV and BNT162b1. The recommendations for Covid-19 prevention are physical distancing, face masks, eye protection and hand washing. Thailand is now considered as low-risk for Covid-19 possibly because of (1) soft policy by government actions, (2) village health volunteers, (3) integration of technology and (4) fact-based communications.Originality/valueThis study summarized the key points about Covid-19, clarified some misunderstandings and shared strategic actions from Thailand, which can be adapted according to the different capacities and situations in other countries.

Central America’s vaccine efforts face mixed prospects

2021 ◽  
Keyword(s):  
United States ◽  
Central America ◽  
The United States ◽  
Central American ◽  
World Health ◽  
Business Travel ◽  
Content Type ◽  
The World ◽  
Health Organization ◽  
Roll Out

Significance Elsewhere in the region, only Panama has so far received a first vaccine shipment, suggesting roll-outs initially will be patchy. Central American governments are sourcing their vaccines either through direct purchases from manufacturers or through programmes run by the World Health Organization (WHO). Impacts A black market is likely to emerge both for vaccines and vaccination certificates. Poorer countries will receive more vaccine support once roll-outs have advanced in wealthier countries globally, but this may take time. Vaccine roll-out in the United States will benefit Central America in terms of tourism, business travel and investment recovery.

Rare giant cell ependymoma in an octogenarian

2006 ◽  
Vol 105 (6) ◽  
pp. 908-911 ◽  
Author(s):  
Patrick B. Cooper ◽  
Matthew Katus ◽  
Leon Moores ◽  
Dennis Geyer ◽  
James G. Smirniotopoulos ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Giant Cell ◽  
Unusual Case ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Relevant Literature ◽  
World Health ◽  
Radiological Findings ◽  
The World ◽  
Health Organization

✓Ependymomas are glial tumors that occur most often in children. In adults, ependymomas most often appear in the spinal cord. The World Health Organization recognizes several rare ependymoma subtypes, including the giant cell ependymoma of the terminal filum. The authors describe an unusual case of a posterior fossa giant cell ependymoma in an 89-year-old man presenting with vertigo and disequilibrium. Only seven cases of this tumor have been reported in the literature to date. The authors discuss the clinical presentation, radiological findings, pathological considerations, and surgical intervention in this patient and review the relevant literature.

scholarly journals Increased Incidence of Invasive Haemophilus influenzae Disease Driven by Non-Type B Isolates in Ontario, Canada, 2014 to 2018

2021 ◽  
Author(s):  
Lisa R. McTaggart ◽  
Kirby Cronin ◽  
Chi Yon Seo ◽  
Sarah Wilson ◽  
Samir N. Patel ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
World Health ◽  
Type B ◽  
Content Type ◽  
Vaccination Programs ◽  
The World ◽  
Life Threatening ◽  
Low Incidence ◽  
Serotype B ◽  
Health Organization

H. influenzae can cause serious invasive, life-threatening disease and is considered 1 of 12 priority pathogens by the World Health Organization. Widespread vaccination against H. influenzae serotype b (Hib) has resulted in very low incidence of Hib in Ontario and other regions that have vaccination programs.

Sign in / Sign up

Export Citation Format

Share Document