ABSTRACT
RESUMEN Los diversos trastornos malignos de los tejidos humanos afectan a una gran proporción de personas de Colombia y el mundo, lo que ha llevado al incremento de los tratamientos farmacológicos para estas enfermedades, sin que se tenga claro el real beneficio para los pacientes que los reciben. Además, se tienen dudas sobre la calidad de la evidencia en la que se basan las instituciones que avalan los tratamientos anti-cáncer con medicamentos, como son la Food and Drug Administration (FDA) y la European Medicines Agency (EMA). Este trabajo tuvo como objetivo conocer cómo se realizan los estudios de eficacia y la forma en que se aprueban los tratamientos con medicamentos que se ofrecen a las personas con cáncer; se realizó una revisión narrativa, que se basó en la formulación de preguntas que guiaron el desarrollo de los temas que se incluyeron en ella. Se hizo la búsqueda de la información en Pubmed de una forma estructurada, no sistemática. Se incluyeron artículos publicados en inglés y español, sin restricción por fecha de publicación.
SUMMARY Several malignant disorders of human tissues affect a large proportion of people in Colombia and worldwide, which has led to an increase in pharmacological treatments for these diseases, without the real benefit being clear to the patients who receive them. Furthermore, there are doubts about the quality of the evidence on which the institutions that support anticancer treatments with medications are based, such as the Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Our objective was to know how efficacy studies are carried out and how treatments with medications offered to people with cancer are approved. A narrative review was carried out, which was based on the formulation of questions that guided the development of the topics that were included. The search strategy was done in PubMed in a structured but non-systematic way. Articles published in english and spanish were included, without restriction by publication date.
Subject(s)
Humans , Pharmaceutical Preparations , Neoplasms , EffectivenessABSTRACT
BACKGROUND: Despite great achievements by insecticide-treated nets (ITNs) and indoor residual spraying (IRS) in reducing malaria transmission, it is unlikely these tools will be sufficient to eliminate malaria transmission on their own in many settings today. Fortunately, field experiments indicate that there are many promising vector control interventions that can be used to complement ITNs and/or IRS by targeting a wide range of biological and environmental mosquito resources. The majority of these experiments were performed to test a single vector control intervention in isolation; however, there is growing evidence and consensus that effective vector control with the goal of malaria elimination will require a combination of interventions. METHOD AND FINDINGS: We have developed a model of mosquito population dynamic to describe the mosquito life and feeding cycles and to optimize the impact of vector control intervention combinations at suppressing mosquito populations. The model simulations were performed for the main three malaria vectors in sub-Saharan Africa, Anopheles gambiae s.s, An. arabiensis and An. funestus. We considered areas having low, moderate and high malaria transmission, corresponding to entomological inoculation rates of 10, 50 and 100 infective bites per person per year, respectively. In all settings, we considered baseline ITN coverage of 50% or 80% in addition to a range of other vector control tools to interrupt malaria transmission. The model was used to sweep through parameters space to select the best optimal intervention packages. Sample model simulations indicate that, starting with ITNs at a coverage of 50% (An. gambiae s.s. and An. funestus) or 80% (An. arabiensis) and adding interventions that do not require human participation (e.g. larviciding at 80% coverage, endectocide treated cattle at 50% coverage and attractive toxic sugar baits at 50% coverage) may be sufficient to suppress all the three species to an extent required to achieve local malaria elimination. CONCLUSION: The Vector Control Optimization Model (VCOM) is a computational tool to predict the impact of combined vector control interventions at the mosquito population level in a range of eco-epidemiological settings. The model predicts specific combinations of vector control tools to achieve local malaria elimination in a range of eco-epidemiological settings and can assist researchers and program decision-makers on the design of experimental or operational research to test vector control interventions. A corresponding graphical user interface is available for national malaria control programs and other end users.
Subject(s)
Anopheles/physiology , Malaria/prevention & control , Mosquito Control/methods , Animals , Ecosystem , Mosquito Vectors , Sexual Behavior, AnimalABSTRACT
Toxic epidermal necrolysis is the most severe form of drug-induced skin reaction and includes denudation of >30% of total body surface area. The mechanism of disease is not completely understood, but immunologic mechanisms, cytotoxic reactions, and delayed hypersensitivity seem to be involved. We report a case of cephazolin-induced toxic epidermal necrolysis treated with intravenous immunoglobulin and N-acetylcysteine with excellent response.
ABSTRACT
La micosis fungoide (MF) es el subtipo más común de linfoma cutáneo de células T, con una frecuencia estimada en la infancia de 0.5% a 5% del número total de casos, siendo los estados de mancha y placa los que se encuentran con mayor frecuencia en este grupo etáreo.
Subject(s)
Child , Lymphoma, T-Cell, Cutaneous , Mycosis FungoidesABSTRACT
La pustulosis aguda exantemática generalizada es una rara erupción pustulosa aséptica, manifestación en el 90% de los casos de una reacción adversa a los medicamentos. Cerca del 50% de los medicamentos implicados incluye los antibacterianos y un 10% los antimicóticos, dentro de los cuales la terbinafina encabeza la lista.
Subject(s)
Antifungal Agents , Drug Eruptions , ExanthemaABSTRACT
Antecedentes: La paniculitis es una manifestación rara de la gota.Objetivos: Revisar los aspectos clínicos e histopatológicos más importantes de la paniculitis por cristales de monourato sódico.Materiales y métodos: Observación clínica de paciente afecto de gota poliarticular asociada a tofos diseminados, nódulos subcutáneos fistulizados y úlceras en los miembros inferiores. El estudio histopatológico de un nódulo fistulizado mostró una reacción granulomatosa del tipo cuerpo extraño con estructuras filamentosas en forma de aguja intensamente birrefringentes, en su interior, en la dermis profunda y el tejido celular subcutáneo.Conclusiones: La paniculitis por cristales de monourato sódico es una manifestación rara de la gota, caracterizada clínicamente por la presencia de nódulos subcutáneos fistulizados o no y úlceras de los miembros inferiores. (AU)
