RESUMO
Of 1,118 patients with COVID-19 at a university hospital in Switzerland during October 2020-June 2021, we found 83 (7.4%) had probable or definite healthcare-associated COVID-19. After in-hospital exposure, we estimated secondary attack rate at 23.3%. Transmission was associated with longer contact times and with lower cycle threshold values among index patients.
Assuntos
COVID-19 , Infecção Hospitalar , COVID-19/epidemiologia , Infecção Hospitalar/epidemiologia , Humanos , Incidência , SARS-CoV-2 , Suíça/epidemiologia , Centros de Atenção TerciáriaRESUMO
Hepatitis B and C virus infections are a leading cause of death in HIV-positive patients. Furthermore, the management of these infections is complicated. Psychosocial problems and comorbidities are frequent barriers to the optimal management of these patients. Furthermore, the rapid changes in treatment strategies particularly in Hepatitis C make it difficult to treat patients outside specialized centers. An improvement in treatment uptake and efficacy can only be achieved through coordinated efforts between private care physicians and specialized centers.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Hepatite B Crônica/diagnóstico , Hepatite C Crônica/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Fármacos Anti-HIV/efeitos adversos , Fármacos Anti-HIV/uso terapêutico , Antivirais/uso terapêutico , Comorbidade , Estudos Transversais , Progressão da Doença , Quimioterapia Combinada , Diagnóstico Precoce , Intervenção Médica Precoce , Feminino , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/epidemiologia , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/epidemiologia , Humanos , Masculino , Resultado do TratamentoRESUMO
Treatment of hepatitis C is approaching a revolution. During the last years, many agents have been developed that directly interfere with the viral replication cycle. Therapy of hepatitis C will no longer need Interferon in the future. The new therapies will be shorter, more efficient and with fewer side effects. For patients, the burden of treatment will drop substantially. Even patients are traditionally classified who as "difficult to treat", such as cirrhotic patients, HIV/hepatitis C coinfected patients and patients after liver transplantation will have better chances of cure. For more patients to benefit from the new therapies, identification of infected individuals and diagnostic investigations have to be improved.
Le traitement de l'hépatite C s'approche d'une révolution. Pendant les dernières années, différents médicaments agissant directement sur le cycle de réplication ont été développés. La thérapie de l'hépatite C ne sera plus dépendante de l'interféron à l'avenir. Les nouvelles thérapies seront plus courtes et plus efficaces avec moins d'effets secondaires. La charge de la thérapie pour les patients va diminuer clairement. La chance d'être guéri va augmenter aussi pour les patients qui sont habituellement difficiles à traiter, comme les patients avec cirrhose, une co-infection de VIH ou une transplantation de foie. Pour que plus de patients puissent profiter des nouveaux médicaments, l'identification et l'évaluation diagnostique doivent être améliorées.
Assuntos
Hepatite C Crônica/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Antivirais/efeitos adversos , Antivirais/uso terapêutico , Comorbidade , Ensaios Clínicos Controlados como Assunto , Quimioterapia Combinada , Seguimentos , Previsões , Hepacivirus/efeitos dos fármacos , Humanos , Transplante de Fígado , Adesão à Medicação , Suíça , Replicação Viral/efeitos dos fármacosRESUMO
A 34-year-old man from Ethiopia had been suffering from inflammatory lower backpain for five months. The imaging showed multiple osteolytic lesions histologically corresponding to a granulomatous inflammation. Detection of multiresistant Mycobacteria Tuberculosis (MDR-TB) was delayed because of initially negative microbiological findings. During the therapy of MDR-TB, the patient developed different side effects. In this article we focus on the challenge to diagnose and treat MDR-TB also in a resource-rich setting as it is the case for Switzerland.