Forty patients with a diagnosis of snake bite were studied at the Infectious and Parasitic Disease Service of the Faculty of Medicine of Botucatu. Thirty were males and 10 females, ranging in age from 16 to 70 years. All were farm laborers and 35 of them were bitten in the lower limbs. Two of the 9 patients seen more than 6 hours after the bite died. The low mortality rate (5%) observed could be explained by the early care provided, by the use of appropriate doses of anti-crotalus serum, parenteral hydration, urine alkalinization with sodium bicarbonate and induction of osmotic diuresis with a mannitol solution. Anatomopathological examination of one of the patients who died revealed extensive hepatic necrosis. The authors discuss the possibility of the effect of a factor of snake venom in the genesis of hepatic necrosis and in the increased transaminase levels.
The 2018 UN General Assembly (UNGA) Political Declaration on Tuberculosis was a turning point in global efforts to end the tuberculosis epidemic. 1,2 Ambitious targets were set for scaleup and rollout of diagnostic, treatment, and prevention services, political commitments, principles of equity and human rights, and financing implementation and research. Targets included diagnosing and treating an additional 40 million people with tuberculosis by 2022 and generating US$13 billion per year for tuberculosis care and prevention and US$2 billion per year for research and development. Is progress in achieving these targets on track? There has been some progress on action, accountability, and funding but it has been much slower than anticipated. For other targets, progress is not on track and challenges remain. Political commitment from the heads of state of some countries with a high burden of tuberculosis has been forthcoming. In 2019, the First Lady of Nigeria, Aisha Buhari, Tuberculosis Ambassador and Champion, convened tuberculosis stakeholder meetings and appointed the
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