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UK must end ‘unlawful’ administration of Chagos Archipelago ‘as rapidly as possible,’ top UN court rules

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The UK Government is “under an obligation” to end its administration of the Chagos Archipelago “as rapidly as possible” the International Court of Justice, the principal judicial body of the UN, stated in an Advisory Opinion released on Monday. The Opinion calls the continued administration of the archipelago “unlawful,” and “a wrongful act.”

Tensions escalate in Venezuela, civilians killed and injured: UN top officials lament excessive use of force by authorities

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As tensions escalated on Saturday at Venezuelan border and at various points along Venezuela’s borders with Colombia and Brazil, as well as within the country itself, resulting in the death and injury of various civilians, the United Nations chief, António Guterres, and the head of the UN human rights office (OHCHR), Michelle Bachelet, expressed their shock and appealed for calm.

Long term outcomes and prognostics of visceral leishmaniasis in HIV infected patients with use of pentamidine as secondary prophylaxis based on CD4 level: a prospective cohort study in Ethiopia

Medici Senza Frontiere - feed -

Long term outcomes and prognostics of visceral leishmaniasis in HIV infected patients with use of pentamidine as secondary prophylaxis based on CD4 level: a prospective cohort study in Ethiopia Diro, E; Edwards, T; Ritmeijer, K; Fikre, H; Abongomera, c; Kibret, A; Bardonneau, C; Soipei, P; Mutinda, B; Omollo, R; van Griensven, J; Zijlstra, EE; Wasunna, M; Alves, F; Alvar, J; Hailu, A; Alexander, N; Blesson, S BACKGROUND: The long-term treatment outcome of visceral leishmaniasis (VL) patients with HIV co-infection is complicated by a high rate of relapse, especially when the CD4 count is low. Although use of secondary prophylaxis is recommended, it is not routinely practiced and data on its effectiveness and safety are limited. METHODS: A prospective cohort study was conducted in Northwest Ethiopia from August 2014 to August 2017 (NCT02011958). HIV-VL patients were followed for up to 12 months. Patients with CD4 cell counts below 200/μL at the end of VL treatment received pentamidine prophylaxis starting one month after parasitological cure, while those with CD4 count ≥200 cells/μL were followed without secondary prophylaxis. Compliance, safety and relapse-free survival, using Kaplan-Meier analysis methods to account for variable time at risk, were summarised. Risk factors for relapse or death were analysed. RESULTS: Fifty-four HIV patients were followed. The probability of relapse-free survival at one year was 50% (95% confidence interval [CI]: 35-63%): 53% (30-71%) in 22 patients with CD4 ≥200 cells/μL without pentamidine prophylaxis and 46% (26-63%) in 29 with CD4 <200 cells/μL who started pentamidine. Three patients with CD4 <200 cells/μL did not start pentamidine. Amongst those with CD4 ≥200 cells/μL, VL relapse was an independent risk factor for subsequent relapse or death (adjusted rate ratio: 5.42, 95% CI: 1.1-25.8). Except for one case of renal failure which was considered possibly related to pentamidine, there were no drug-related safety concerns. CONCLUSION: The relapse-free survival rate for VL patients with HIV was low. Relapse-free survival of patients with CD4 count <200cells/μL given pentamidine secondary prophylaxis appeared to be comparable to patients with a CD4 count ≥200 cells/μL not given prophylaxis. Patients with relapsed VL are at higher risk for subsequent relapse and should be considered a priority for secondary prophylaxis, irrespective of their CD4 count.

Quando gli scienziati scomodi vengono cacciati...

Il Cambiamento - feed -

Peter Gøtzsche, uno dei padri fondatori della Cochrane Collaboration, ente di revisione scientifica e ricerca che si dice indipendente, è stato cacciato dai vertici dell'organizzazione dopo avere pubblicato affermazioni scomode su alcuni argomenti risultati tabù, come il tamiflu, la mammografia e la vaccinazione anti HPV. Giovanni Peronato, dell'associazione "No Grazie Pago Io", torna sull'argomento proponendo la libera traduzione di un'interessante analisi della giornalista scientifica Melanie Newman.

Diventeremo tutti zombie con il cellulare in mano?

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Dall'Italia alla Germania, dalla Corea alla Svezia: cresce il numero dei paesi dove vengono installati protezioni e segnali luminosi per evitare che tutti coloro che camminano fissando il cellulare vadano a sbattere o finiscano investiti. Per non parlare di chi telefona mentre è alla guida! Siamo un passo oltre la follia...

Severe post-kala-azar dermal leishmaniasis successfully treated with miltefosine in an Ethiopian HIV patient.

Medici Senza Frontiere - feed -

Severe post-kala-azar dermal leishmaniasis successfully treated with miltefosine in an Ethiopian HIV patient. Abongomera, C; Battaglioli, T; Adera, C; Ritmeijer, K Post-kala-azar dermal leishmaniasis (PKDL) is a neglected tropical disease characterized by a dermatosis which often appears after successful treatment of visceral leishmaniasis caused by Leishmania donovani. PKDL treatment options are few and have severe limitations. In East- Africa, the standard treatment of PKDL is with daily painful potentially toxic sodium stibogluconate injections, administered for a prolonged duration of 30-60 days. In the Indian subcontinent, PKDL is mainly treated with miltefosine, a safer orally administered drug. However, in East-Africa, there is very limited experience in the use of miltefosine for treatment of severe PKDL, with only one published case report. Here we report a severe PKDL case in an Ethiopian HIV patient successfully treated with oral miltefosine (100 milligrams/day for 28 days). Miltefosine was efficacious, safe and well tolerated, suggesting that it can play an important role in the treatment of severe PKDL also in East-African patients. Further research is warranted.

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