The prevalence of malignant pleural effusion is increasing worldwide, but prognostic biomarkers to plan treatment and to understand the underlying mechanisms of disease progression remain unidentified. The PROMISE study was designed with the objectives to discover, validate, and prospectively assess biomarkers of survival and pleurodesis response in malignant pleural effusion and build a score that predicts survival.
The Malaria Atlas Project has created a global map of the travel time to urban centers for the year 2015. Cities concentrate activities that promote human wellbeing including education, employment, and healthcare services. The accessibility map provides a useful dataset for identifying populations with limited access to cities and are thus at risk of being left behind.
Kartika Karaswati, Stuart Blacksell and colleagues reviewed the diagnostic accuracy of the available scrub typhus point-of-care tests, feasible to be used in resource limited settings. Although the available evidence is varied in methodology and quality, POCTs appear to have low false positive rates, thus confidence in interpreting a positive result can be high.
Researchers in Ireland, the UK, including Roman Fischer and Benedikt Kessler from the Target Discovery Institute and US have discovered a new metabolic process in the body that can switch off inflammation. “itaconate” – a molecule derived from glucose – “acts as a powerful off switch for macrophages”, thereby reducing inflammation. The discovery published in Nature offers more effective treatment of inflammatory diseases such as arthritis, inflammatory bowel disease and heart disease.
Blood from patients treated with ivermectin can kill mosquitos. Our results indicate that ivermectin mass drug administration to humans could be a potential malaria control tool to aid malaria elimination efforts in South America.
Primaquine is being promoted actively to block the transmission of falciparum malaria parasites between humans and mosquitoes to reduce the spread of highly resistant malaria ‘superbugs.’ In response, Bob Taylor and colleagues developed a primaquine dosing scheme based on age. This will be useful where there are no functioning weighing scales and when primaquine mass drug treatment will be given.
The malaria parasite is a major cause of illness and deaths throughout the tropics. To survive, the malaria parasite needs to be transmitted by mosquitos form person to person. In this paper Martin Rono and colleagues show at the cellular and molecular level how the parasite balances its investment between growing efficiently in humans and maximising the chances of being transmitted by mosquitos, depending on the local environment.
A recent study published by Prof Najib Rahman, Clinical Director, Oxford Respiratory Trials Unit explains how 15% of people with malignant effusion develop septations (pockets) within the fluid, which are difficult to treat. TIME3 was a randomised trial assessing the use of intrapleural fibrinolytic, showing no improvement in breathlessness but improved x-ray appearance and possible mortality benefit. This study provides high quality evidence for the rational use of this medication for patients.
Ethics guidelines have evolved to protect vulnerable groups such as pregnant women from research. This has resulted in a lack of research in these populations making them even more vulnerable because of the lack of evidence-based medical care. In this paper, Professor Phaik Yeong Cheah and her collaborators discuss how regulatory frameworks can sometimes lead to a generalized exclusion of pregnant women from research.
Technological potentials have raised high hopes on healthcare access in LMICs like India. However, five years of research by Dr Marco Haenssgen paint a less optimistic picture and show adverse consequences of mobile phone diffusion, which creates more competition and new divisions and leaves the poorest strata of population worse off than before.