Antimicrobial Stewardship Program: Time to be Focused in Speciality Settings of Leprosy Institute and Related Health Care Setup.

Leprosy, often known as Hansen's disease is a contagious chronic infectious disease caused by Mycobacterium leprae (M. leprae). Our methodology is easily repeatable in tertiary care settings with diagnostic accuracy resources and staff capable of building a stewardship team. Comprehensive antimicrobial policies and programmes are required to properly alleviate the initial issue.

[Dr Jean Languillon (1912-2003), a major unrecognized leprologist]. / Le Dr Jean Languillon (1912-2003), un léprologue majeur trop méconnu.

Languillon's contribution to the control of leprosy cannot be reduced to the manual of leprology which remains the reference for anyone working on this disease in sub-Saharan Africa. This would mean forgetting his works that established the immunological origin of leprosy and its cutaneous, adverse and neurological complications.Another major aspect, the importance of his contribution to the treatment of the disease, in particular through the development of polychimiotherapy (PCT), which has made Institut Marchoux in Bamako one of the five WHO's collaborating centers in the field of clinical research in leprosy.Languillon was also involved in a holistic approach of the disease by creating the first leprosy surgery unit and implementing physiotherapy, orthopedic care with appropriate equipment, and social rehabilitation… without forgetting preventive aspects of complications through the necessary regular administration of treatments, and control of patients spread over wide territories, by creating a corps of leprosy nurse monitors and leprosy specialists. These will provide essential support to the doctor most often in charge of a huge sector where the need of assistance was obvious.Languillon ended his African career by creating the ILAD, Institute of Applied Leprology in Dakar, which offers the full range of care, as he always advocated.Finally, he did not resist the call of Order of Malta which offered him to share his expertise in the different countries where the Order was involved.

Dr. Betty Clements: Breaking Gender Barriers in the Air Force and Neurology.

Women currently make up 45.9% of neurology residents and fellows, although little is known about the individual women who broke gender barriers to train as neurologists. Grace Elizabeth Betty Clements (1918-1965) was the first woman trainee at the Mayo Clinic to practice neurology and later became a founder of the Barrow Neurological Institute. Before paving the way for future women trainees in neurology, she served as a Women Airforce Service Pilot including flying atomic bomb planning missions during World War II. Following the war, her path to medicine included volunteering in the American Red Cross in the Philippines where she treated patients with Hansen disease (leprosy). Clements returned to her home state to complete medical school at the University of Nebraska before seeking neurologic training at the Mayo Clinic in 1954. Following additional training at Queen Square, she became a founder of the Barrow Neurological Institute in Phoenix, Arizona. Many early women in neurology have remarkable backgrounds that have equipped them for their career in medicine which Clements exemplifies.

Ancient and modern pathologies and therapies: St. Gallicanus Hospital in Rome between the 18th and 20th centuries.

St. Gallicanus Hospital in Rome, Italy, created by the will of Pope Benedict XIII (1649-1730) in 1725, was the first dermatologic hospital in the world. The strong bond between science and faith, humanitarian spirit and scientific research, and the profoundness and legacy of its entire history have all contributed to its legacy. We have traced its development by examining archival documents to understand the life of the institute and the diseases that were diagnosed and treated from the 18th century to the first half of the 20th century. Some of the main diseases were leprosy, mange, scabies, ringworm, and syphilis, which were widespread in Rome during the 18th and 19th centuries and were creating a mortal threat for much of the population. St. Gallicanus Hospital was dedicated to the diagnosis, treatment, and prevention of these diseases where possible. Special attention has been directed to syphilis and the use of penicillin therapy after its introduction in 1943, especially for curbing the extensive problems created by prostitution.

History of the Santa Maria and San Gallicano Dermatological Hospital.

The Santa Maria and San Gallicano Hospital represents one of the first dermatological centers founded in the world; since its establishment its aim is to treat widespread skin diseases such as leprosy, scabies, ringworm, prurigo and mange. Its construction began on March 14, 1725 with a ceremony held for the laying of the foundation stone. Its official inauguration, however, is dated October 6, 1726 when Pope Benedict XIII issued the Bonus ille Seal. The hospital's origins stem from the apostolic and charitable work by Father Emilio Lami, who was its first prior, and by the tenacious will of Cardinal Pietro Marcellino Corradini who was its protector. As can be seen by the marble plaque, still preserved and dated 1725, the health facility was intended for people with skin diseases. Venereal affections, such as syphilis and gonorrhea, were instead treated starting from the second half of the 19th century under the direction of Dr. Pietro Shilling and subsequently Dr. Gaetano Ciarrocchi. Since the 18th century, the hospital, built initially by architect Filippo Raguzzini, underwent expansion work including the construction of the "Nuova Corsia dei ragazzi tignoselli" ward, the "Anatomical Theater" of great artistic value and of the "Celtic Rooms." More recently, from the 1939, the hospital obtained, and still maintains today, the recognition as an Institute for Hospitalization and Care of a Scientific Nature (IRCCS); a clear indication of its authoritativeness and value during almost three centuries of history.

A propósito del aniversario ciento quince del Instituto Nacional de Higiene, Epidemiología y Microbiología / A propos of the one hundred and fifteenth anniversary of the National Institute of Hygiene, Epidemiology and Microbiology

Para referirse al desarrollo de la investigación científica y la formación de profesionales en las disciplinas de higiene, epidemiología, microbiología y nutrición en Cuba, hay que necesariamente remitirse a un centro que aún hoy es piedra angular para el sistema de salud pública cubano, el Instituto Nacional de Higiene, Epidemiología y Microbiología.1 El Instituto Nacional de Higiene, Epidemiología y Microbiología fue creado hace ya ciento quince años, en medio de la naciente política regional de salud internacional que hubo de enfrentar los efectos de la guerra, el comercio y los mosquitos, lo que caracterizó el tránsito sanitario del siglo XIX al XX en algunos países.1 Hitos que han marcado la historia del centro en estos últimos siglos: Creación de la Isla de Cuba en mayo de 1902, que a los pocos meses cambió su nombre a Laboratorio Nacional, como ejercicio de nacionalidad, resultado de una de las épocas más gloriosas de la salud pública cubana.2 Integración del laboratorio a la Junta Superior de Sanidad, (creada el mismo día), para atender todo lo relacionado con la lepra, el muermo, la tuberculosis, la vacuna y la higiene especial; como responsable se nombró al doctor Carlos Juan Finlay y Barrés, uno de los salubristas cubanos más renombrado de todos los...(AU)

Remembering Marcel Baltazard, Great Researcher and the French President of Pasteur Institute of Iran.

Dr. Marcel Baltazard (1908-1971), French scientist and former director of Pasteur Institute of Iran, is known in the international arena due to his research on the control of infectious diseases such as plague, rabies, relapsing fever, leprosy, smallpox and tuberculosis. Dr. Baltazard also played a significant role in the launch of vaccination against tuberculosis, cholera and smallpox. Dr. Baltazard's spent the first 13 years of academic life at Pasteur Institute of Casablanca, Morocco, and then 20 years at Pasteur Institute of Iran and over the last five years at Pasteur Institute of Paris. In this paper, the activities of this important and influential researcher in the field of health and medicine are addressed.

Estudios de susceptibilidad de cepas de Leishmania aethiopica frente a alcaloides de Galipea longiflora (Evanta) / Susceptibility studies on Leishmania aethiopica strains against total alkaloids from Galipea longiflora (Evanta)

El Instituto de Investigaciones Fármaco Bioquímicas (IIFB), de la Facultad de Ciencias Farmacéuticas y Bioquímicas, de la UMSA, desarrolla trabajos sobre la actividad leishmanicida, de los alcaloides totales (CAT) obtenidos de la corteza de la especie medicinal amazónica conocida como Evanta (Galipea longiflora) por los Pueblos Tacana, Tsimane y Mosetene. Como parte de las actividades del Proyecto UMSA-ASDI Biomoleculas de interés medicinal e industrial (antiparasitarios) hemos podido contar con la estadía, en el IIFB, de un investigador del Armauer Hansen Research Institute (AHRI) de Etiopia, lo que nos ha permitido desarrollar evaluaciones de CAT, Miltefocine y Amfotericina B, frente a cepas de Leishmania aethiopica, agente causante de las diversa formas de Leishmaniais cutánea en Etiopía. Un total de seis cepas, de L. aethiopica, fueron adaptadas a condiciones in vitro y mostraron un comportamiento homogéneo frente a CAT, cinco de estas cepas mostraron un valor promedio de IC50 = 8,68 ±1,56 mg/mL, valor algo inferior a los calculados para nuestras cepas de referencia, L. amazonensis y L. braziliensis con IC50 = 11,73 ± 4,32 mg/mL y IC50 = 12,28 ±- 2,95 mg/mL, respectivamente. Excepto por una cepa de L. aethiopica que mostro valores consistentemente más elevados que el resto con IC50= 14,37 ± 3,58 mg/mL. Como consecuencia de esta interacción científica, la Universidad Mayor de San Andrés (UMSA) ha firmado un Memorandum de Entendimiento para el desarrollo de investigaciones conjuntas, con el Armauer Hansen Research Institute (AHRI), dependiente del Ministerio de Salud de Etiopia y explorar la posibilidad de que nuestra experiencia de validación clínica con Evanta en el tratamiento de leishmaiasis cutánea, en Bolivia, podría ser replicada en Etiopía, donde se reportan entre 20,000 a 30,000 nuevos casos de Leismaniasis por año.

The Instituto de Investigaciones Fármaco Bioquímicas (IIFB), at the Faculty of Pharmaceutical and Biochemical Sciences, from UMSA, carry out work related to the leishmanicidal activity of the total alkaloids (CAT) obtained from the bark of the Amazonian medicinal species known as Evanta (Galipea longiflora) by the Tacana, Tsimane y Mosetene people. As part of the activities develop by the UMSA-ASDI Project Biomolecules of medicinal and industrial Interest (antiparasitic) we had a visit, in our laboratories at IIFB, of a researcher from The Armauer Hansen Research Institute (AHRI) from Ethiopia, during his stay we were able to carry out evaluations of CAT, Miltefocine and Anphotericin B, against strains of L. aethiopica, causative agent of the different manifestations of cutaneous leishmaniasis in Ethiopia. A total of six strains of L. aethiopica, were adapted to in vitro a conditions, at IIFB; and did show homogenous behavior against CAT. Five of the strains, showed an average calculated value for IC50 = 8.68 ±1.56 mg/mL, a value somewhat lower to the calculated for the reference strains L. amazonensis and L. braziliensis with IC50 = 11.73 ± 4.32 mg/mL and IC50 = 12.28 +/- 2.95 mg/mL, respectively. Except for one strain that showed values somewhat higher, to the other strains, consistently through our studies, with IC50 = 14.37 ± 3.58 mg/mL. As a consequence of our scientific interaction, the Universidad Mayor de San Andrés (UMSA) has signed a Memorandum of Understanding for the development of joint research with the Armauer Hansen Research Institute (AHRI) that belongs to the Ministry of Health in Ethiopia, and explore the possibilities to replicate the Bolivian clinical validation experience of Evanta in the treatment of cutaneous leishmaniasis, in Ethiopia where the annual incidence is estimated to be between 20, 000 to 30, 0000.

Trinta anos depois o lema continua vivo: Democracia é saúde, saúde é democracia / Thirty years later, the motto remains alive: Democracy is health, healthis democracy / /Después de trinta años, el lema permanece vivo: Democracia es salud,salud es democracia

Esta edição da Reciis homenageia dois acontecimentos importantes para a área da saúde, ocorridos há 30 anos, e que estão relacionados à sua trajetória: a 8ª Conferência Nacional de Saúde (CNS) e o nascimento do Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (Icict/Fiocruz)...

Research ethics review practices: experiences of the Armauer Hansen Research Institute/All Africa Leprosy and Tuberculosis Rehabilitation and Training Center Ethics Review Committee, Ethiopia.

The need for ethics review committees (ERCs) is imperative in the conduct of research to ensure the protection of the rights, safety and well-being of research participants. However, the capacities of most ERCs in Africa are limited in terms of trained experts, competence, resources as well as standard operating procedures. The aim of this report is to share experiences of one of the local institutional ERCs, the Armauer Hansen Research Institute (AHRI)/All Africa Leprosy and Tuberculosis Rehabilitation and Training Center (ALERT) Ethics Review Committee (AAERC), to other ERCs found in academic and research institutions in the Country. In this report, we used an empirical approach to review archived documents of the AAERC Secretariat to assess the Committee's strengths and weaknesses. The experiences of the AAERC in terms of its composition, routine work activities, learning practices and pitfalls that require general attention are summarized. In spite of this summary, the Committee strongly acknowledges the functions and roles of other ERCs in the Country. In addition, an independent assessment of the Committee's activity in general is warranted to evaluate its performance and further assess the level of awareness or oversights among researchers about the roles of ERCs.

Canada's neglected tropical disease research network: who's in the core-who's on the periphery?

BACKGROUND: This study designed and applied accessible yet systematic methods to generate baseline information about the patterns and structure of Canada's neglected tropical disease (NTD) research network; a network that, until recently, was formed and functioned on the periphery of strategic Canadian research funding. METHODOLOGY: MULTIPLE METHODS WERE USED TO CONDUCT THIS STUDY, INCLUDING: (1) a systematic bibliometric procedure to capture archival NTD publications and co-authorship data; (2) a country-level "core-periphery" network analysis to measure and map the structure of Canada's NTD co-authorship network including its size, density, cliques, and centralization; and (3) a statistical analysis to test the correlation between the position of countries in Canada's NTD network ("k-core measure") and the quantity and quality of research produced. PRINCIPAL FINDINGS: Over the past sixty years (1950-2010), Canadian researchers have contributed to 1,079 NTD publications, specializing in Leishmania, African sleeping sickness, and leprosy. Of this work, 70% of all first authors and co-authors (n = 4,145) have been Canadian. Since the 1990s, however, a network of international co-authorship activity has been emerging, with representation of researchers from 62 different countries; largely researchers from OECD countries (e.g. United States and United Kingdom) and some non-OECD countries (e.g. Brazil and Iran). Canada has a core-periphery NTD international research structure, with a densely connected group of OECD countries and some African nations, such as Uganda and Kenya. Sitting predominantly on the periphery of this research network is a cluster of 16 non-OECD nations that fall within the lowest GDP percentile of the network. CONCLUSION/SIGNIFICANCE: The publication specialties, composition, and position of NTD researchers within Canada's NTD country network provide evidence that while Canadian researchers currently remain the overall gatekeepers of the NTD research they generate; there is opportunity to leverage existing research collaborations and help advance regions and NTD areas that are currently under-developed.

Clinical, bacteriological and histopathological study of 62 referral relapse cases between Jan 2004 and Dec 2009 at the Foundation for Medical Research, Mumbai.

UNLABELLED: Sixty two patients with relapsed leprosy seen between Jan 2004 and Dec 2009 were studied using clinical, bacteriological and histopathological parameters. The findings thus obtained were correlated to parameters such as trend and source of referral, clinical characteristics at diagnosis, treatment received, other events during or after RFT and duration between cessation of treatment and relapse. FINDINGS: Referrals per year have doubled since 2006. Most patients were referred by NGOs (58%), followed by Govt. hospitals (16%) and then by GPs (25%); 76% had received one of the WHO - MDT regimens including 16 treated with 24 months or more MB - MDT, 23 with 12 months MB - MDT and eight with 6 months PB - MDT. Of the remaining 14 cases, four had received DDS mono-therapy, seven had single dose of Rifampicin, Ofloxacin and Minocycline (ROM) and four Rifampicin and Ofloxacin (RO) daily for 28 days. The average incubation time of relapse, defined as duration between cessation of treatment and relapse was (SD) + 6-4 years. 59% of patients had positive slit skin smears on relapse. Relapse for the second time occurred in six BL cases including five from group 2 and one RO treated patient and 11/23 cases from group 2 conferred to BT-BB leprosy. Clinical features at diagnosis and on relapse were comparable in 47% of cases. CONCLUSION: All leprosy patients, regardless of their type and MDT regime, carry 'risk of relapse'. A shorter treatment duration reduces the incubation time to relapse. In group 2 (treated with 12 months MB-MDT regime) 11/23 were BT-BB cases and 5/23 (21%) were relapse for the second time, which further supports our earlier documented findings and maybe the efficacy of WHO-MDT regime is poor in a small subset of patients.

[Interpreting Brazil as afflicted by disease and by the spirit of routine: the repercussion of Arthur Neiva and Belisário Penna's medical report (1917-1935)]. / Uma interpretação do Brasil como doença e rotina: a repercussão do relatório médico de Arthur Neiva e Belisário Penna (1917-1935).

The release of a report on the Oswaldo Cruz Institute's 1912 scientific voyage to North and Northeast Brazil, led by physicians Arthur Neiva and Belisário Penna, debate that found its way to the pages of magazines of the letters and sciences. The report used the images of disease, geographic and cultural isolation, illiteracy, poverty, and a vocation for backwardness to portray the people living in interior Brazil. These images of the sertão were extensively criticized in the periodical A Informação Goiana, published by local doctors who refused to see the interior defined as 'sickly' and 'backwards'. The article analyzes the ways in which the Neiva-Penna report distinguished itself becoming a reference for intellectual controversies surrounding the national question in Brazil.

[Infectious nature of leprosy, by Juan de Azúa]. / Contagiosidad de la lepra, por Juan de Azúa.

In this article by Juan de Azua, published in the second issue of Actas Dermosifiliográficas in 1909, the author reports his experience in 139 patients, most of them from Hospital San Juan de Dios, Madrid,Spain, and states he is sure that leprosy is a contagious disease. He discusses the factors related to contagion,which occurs in a closed and family environment, emphasizing socioeconomic factors such as hygiene and promiscuity. He considers direct contact to be important, though also recognizing indirect contact through drinks and food; he totally rejects a hereditary mechanism. Epidemiologically, he draws attention to the higher prevalence of the disease in Andalusia, though not forgetting "La Lepra de Ultramar [leprosy from distant lands]"-32 cases in Spaniards in Cuba and the Philippines. He believes isolation in hospitals or special sanatoriums, such as San Juan de Dios or San Lázaro in Santiago, Granada, and Seville, to be the best prophylaxis, and he considers it would be appropriate to create "Hospitals for poor lepers".

Uma interpretação do Brasil como doença e rotina: a repercussão do relatório médico de Arthur Neiva e Belisário Penna (1917-1935) / Interpreting Brazil as afflicted by disease and by the spirit of routine: the repercussion of Arthur Neiva and Belisário Penna's medical report (1917-1935)

A divulgação do relatório da viagem científica promovida pelo Instituto Oswaldo Cruz em 1912 ao Norte e Nordeste do Brasil, realizada por Arthur Neiva e Belisário Penna, suscitou debates e ocupou espaço em revistas de letras e ciências. No documento, as populações do interior do país foram caracterizadas pelas imagens de doença, isolamento, geográfico e cultural, analfabetismo, pobreza e vocação para regredir. Essas imagens do sertão foram criticadas no periódico A Informação Goiana, editado por médicos que não admitiam ser o interior definido como 'doente' e 'atrasado'. Este artigo analisa as formas pelas quais o relatório Neiva-Penna se destacou e tornou-se referência para controvérsias intelectuais sobre a questão nacional no Brasil.

The release of a report on the Oswaldo Cruz Institute's 1912 scientific voyage to North and Northeast Brazil, led by physicians Arthur Neiva and Belisário Penna, debate that found its way to the pages of magazines of the letters and sciences. The report used the images of disease, geographic and cultural isolation, illiteracy, poverty, and a vocation for backwardness to portray the people living in interior Brazil. These images of the sertão were extensively criticized in the periodical A Informação Goiana, published by local doctors who refused to see the interior defined as 'sickly' and 'backwards'. The article analyzes the ways in which the Neiva-Penna report distinguished itself, becoming a reference for intellectual controversies surrounding the national question in Brazil.

Informe del primer encuentro de la asociación ideal (iniciativa para las pruebas diagnósticas celebrado en el instituto de investigación Armauer Hansen, Alert, Addis Abada, Etiopía del 24-27 de octubre de 2004 / No disponible

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