Gorgas course 2019

On day two we have further talks about Tuberculosis, Dr. Evans gave a fantastic talk on tuberculosis, he spent a great time helping us understand the issues of transmission as well as who is considered high risk. Patients malnourished being a large risk factor for active TB and even showed some data that if you look at population attributable fraction, malnourishment is a greater risk of disease over HIV! He had mentioned that patients that have been treated for latent TB but re-exposed, may not be protected, hence the idea of treating people in highly endemic areas might not be cost effective. We had another talk on presentations of TB by Dr.Gotuzzo. He was also great. Reviewed positive skin test (which varies from Canada, US, WHO), but 5 mm positive in HIV, recent contact, fibrotic change son CXR, organ transplant on immunosuppressed patients. Cases today 47 yo male from a coast city but lives in Lima, has previously travelled to the Jungle last year. He is known HIV, issues ...

Day 1 was awesome. I met more of my classmates and everyone has a pretty interesting story. We have small groups for case rounds and a separate small groups for labs to meet more people.  Really great lecture on Malaria, that went over finer details of pathophys. I really liked how he talked about how the definitive host is the mosquito, and how gametes are picked up, goes to abdo of mosquito, come together for ookinete which penetrates intestinal cell, comes out as an oocyst which then makes 8000 motile sporozoites which migrate to salivary glands.  Further reminder of PfEMP-1 of P. falciparum to ICAM causing cyto-adherence and sequestration. Stages of the parasite in humans are: ring trophozoite, ameboid trophozoite (P.vivax), and band (P. malariae, P. Knowlesi), immature then mature schizont, and then gametocytes. Maurer's clefts are found in  P. Falciparum. P. falciparum develop in the bone marrow. ...