RESUMO
The global epidemic of diabetes and tuberculosis poses challenges to the control of both diseases. Patients with tuberculosis and diabetes experience worse clinical manifestations, increased risk of treatment failure, recurrence, and death. Diabetes is also associated with risk for latent tuberculosis infection. Management of hyperglycemia reduces the risk and improves the outcome of tuberculosis in diabetic patients. Recent epidemiological studies from Taiwan have provided new and important information on the benefits of metformin in tuberculosis. When addressing the issue of multidrug-resistant tuberculosis, a shortened anti-tuberculous therapeutic regime seems a feasible approach for better cure rates, with less loss-to-follow.
RESUMO
In the last decades, systems have been developed to measure more efficiently and objectively the medical services offered to the community. For this purpose, patients are grouped according to their pathology to facilitate comparison of functionality, costs, and quality among groups. For congenital heart diseases and their surgical treatment we have methods to establish risk stratification (RACHS-1 and Aristotle), which have allowed us to predict the surgical results taking account the congenital heart disease, the kind of repair, as well as factors, such as weight, age, and associated anomalies. We believe that both systems complement each other and that they constitute a first step for Mexico to have a reliable database to allow making comparisons among results of the different health institutes. The purpose is to affect the institutional and national health policies and to assess an instrument that might serve for comparison with foreign specialized centers.