The Frequency and Incidence of QT Prolongation with Extended Use of Bedaquiline or Delamanid in a Large, Multi-Country MDR/RR-TB Cohort.

Background: The 2022 WHO guidelines on multi-drug/rifampicin resistant tuberculosis (MDR/RR-TB) recommend six months of bedaquiline (Bdq) in the all-oral 9-month shorter regimen and six months or longer for Bdq and delamanid (Dlm) in the 18-20-month longer regimen. However, lack of evidence on extended treatment using Bdq or Dlm has limited their use to six months. We examine the frequency and incidence of QT prolongation based on duration of Bdq and/or Dlm use in longer regimens.

Preparation to provide healthcare in disasters in public hospitals in the district of Lima, Peru.

Objective: To assess the safety and degree of preparation of public hospitals in the district of Lima to provide healthcare in the event of disaster by studying their structural and nonstructural safety and their compliance with the established standards for the organization of the hospital's Emergency Operations Centers (EOCs).

Design: A cross-sectional observational study of 20 out of the 38 public hospitals in the district of Lima was conducted. The hospitals were selected based on the criteria of being state-run, having complete information on open access safety indicators, and belonging to Categories II and III according to the Peruvian Ministry of Health classification, equivalent to the usual secondary and tertiary levels of specialization hospitals.

Simultaneous onset of acute myocardial infarction, bicuspid aortic stenosis, and cardiac transthyretin amyloidosis-A clinically complex confluence.

The coexistence of bicuspid aortic valve disease and coronary artery disease is well-established, but the identification of cardiac amyloidosis in this population has surged with advancing imaging techniques, introducing complexities in patient management. This case report emphasizes the pivotal role of multimodality imaging in accurately diagnosing three concurrent pathologies.

Human T Lymphotropic virus-1 associated gastrointestinal histoplasmosis in Peru.

We report a 72-year-old patient with chronic diarrhoea and histologic evidence of gastrointestinal histoplasmosis. He had no history of HIV or of taking immunosuppressive drugs. The patient was found to be a carrier of Human T-lymphotropic virus-1, a condition associated with inflammatory, lymphoproliferative, and opportunistic infectious diseases.

Hashimoto's encephalopathy presenting with neurocognitive symptoms: a case report.

Introduction: Hashimoto's encephalopathy is a neurological disorder of unknown cause associated with thyroid autoimmunity. The disease occurs primarily in the fifth decade of life and may present in two types - a sudden vasculitic type or a progressive subacute type associated to cognitive dysfunction, confusion and memory loss.

Case Presentation: We report the case of a 62-year-old Hispanic woman, previously healthy, who developed a subacute onset of declining upper brain function.

Hygiene hypothesis and prevalence of glomerulonephritis.

The hygiene hypothesis was proposed to explain the marked increase in allergies that has been observed in industrialized (Westernized) societies. This hypothesis proposes that early and frequent exposure to bacterial and other antigens, such as is common in developing nations, leads to a normal Th1 response, but that better public hygiene and less infections observed in industrialized nations may lead to persistence of the Th2 phenotype and thereby increase our risk for developing allergies. Infection early in life with measles or hepatitis A virus, immunization with bacille Calmette-Guérin, certain gastrointestinal bacteria (lactobacillus), and environmental endotoxin exposure may protect individuals from developing allergy in adulthood.