RESUMO
Canine echinococcosis is caused by the adult tapeworm of Echinococcus granulosus. As intermediate hosts, humans and livestock become infected following ingestion of eggs that are passed in the faeces of dogs. Mature eggs develop into hydatid cysts in different organs, leading to hydatid disease, which is a serious public health problem. In the present study, we investigated the proportion of mature eggs of E. granulosus in 140 dogs from three regions of Tunisia. The results showed the predominance of immature E. granulosus eggs in infected dogs and the occurrence of a small proportion of oncospheres. The ability of immature eggs to infect humans and livestock is discussed.
Assuntos
Doenças do Cão/epidemiologia , Doenças do Cão/parasitologia , Equinococose/veterinária , Echinococcus granulosus/crescimento & desenvolvimento , Echinococcus granulosus/isolamento & purificação , Zigoto/crescimento & desenvolvimento , Animais , Cães , Equinococose/epidemiologia , Equinococose/parasitologia , Tunísia/epidemiologiaRESUMO
BACKGROUND AND AIM: Severe adverse events (AEs) compromise the outcome of direct antiviral agent-based treatment in patients with advanced liver fibrosis due to HCV infection. HEP3002 is an ongoing multinational programme to evaluate safety and efficacy of telaprevir (TVR) plus pegylated-interferon-α (PEG-IFNα) and ribavirin (RBV) in patients with advanced liver fibrosis caused by HCV genotype 1 (HCV-1). METHODS: 1782 patients with HCV-1 and bridging fibrosis or compensated cirrhosis were prospectively recruited from 16 countries worldwide, and treated with 12â weeks of TVR plus PEG-IFN/RBV, followed by 12 or 36â weeks of PEG-IFN and RBV (PR) alone dependent on virological response to treatment and previous response type. RESULTS: 1587 patients completed 12â weeks of triple therapy and 4â weeks of PR tail (53% cirrhosis, 22% HCV-1a). By week 12, HCV RNA was undetectable in 85% of naives, 88% of relapsers, 80% of partial responders and 72% of null responders. Overall, 931 patients (59%) developed grade 1-4 anaemia (grade 3/4 in 31%), 630 (40%) dose reduced RBV, 332 (21%) received erythropoietin and 157 (10%) were transfused. Age and female gender were the strongest predictors of anaemia. 64 patients (4%) developed a grade 3/4 rash. Discontinuation of TVR due to AEs was necessary in 193 patients (12%). Seven patients died (0.4%, six had cirrhosis). CONCLUSIONS: In compensated patients with advanced fibrosis due to HCV-1, triple therapy with TVR led to satisfactory rates of safety, tolerability and on-treatment virological response with adequate managements of AEs.
Assuntos
Antivirais/uso terapêutico , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Cirrose Hepática/virologia , Oligopeptídeos/uso terapêutico , Polietilenoglicóis/uso terapêutico , Ribavirina/uso terapêutico , Adulto , Idoso , Antivirais/efeitos adversos , Esquema de Medicação , Quimioterapia Combinada , Feminino , Seguimentos , Genótipo , Hepacivirus/genética , Hepatite C Crônica/complicações , Humanos , Interferon alfa-2 , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Oligopeptídeos/efeitos adversos , Estudos Prospectivos , Proteínas Recombinantes/uso terapêutico , Resultado do TratamentoRESUMO
INTRODUCTION: Central neurogenic hyperventilation (CNH) in an awake patient is a rare entity. OBSERVATION: We report here a 54-year-old patient who developed central neurogenic hyperventilation as the initial presentation of a primary central nervous system lymphoma located in the brainstem. CONCLUSION: The patient's hyperventilation resolved completely with chemotherapy for primary CNS lymphoma. Most of the cases reported in the literature are related to a diffuse tumor of the brainstem with an intriguing overrepresentation of primary CNS lymphoma. The pathogenesis of CNH is discussed.
Assuntos
Neoplasias do Tronco Encefálico/complicações , Hiperventilação/etiologia , Linfoma de Células B/complicações , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To evaluate the predictive impact of chromosome 1p/19q deletions on the response and outcome of progressive low-grade gliomas (LGG) treated with up-front temozolomide (TMZ) chemotherapy. METHODS: Adult patients with measurable, progressive LGG (WHO grade II) treated with TMZ delivered at the conventional schedule (200 mg/m(2)/day for 5 consecutive days, repeated every 28 days) were retrospectively evaluated for response by central review of MRI-s. Chromosome 1p and 19q deletions were detected by the loss of the heterozygosity technique (LOH). RESULTS: A total of 149 consecutive patients were included in this retrospective, single center observational study. The median number of TMZ cycles delivered was 14 (range 2 to 30). Seventy-seven patients (53%) experienced an objective response (including 22 [15%] cases of partial response and 55 [38%] cases of minor response), 55 (37%) patients had stable disease, and 14 (10%) had a progressive disease. The median time to maximum tumor response was 12 months (range 3 to 30 months). The median progression-free survival (PFS) was 28 months (95% CI: 23.4 to 32.6). Material for genotyping was available for 86 patients. Combined 1p/19q LOH was present in 42% of the cases and was significantly associated with a higher rate (p = 0.02) and longer objective response to chemotherapy (p = 0.017), and both longer PFS (p = 4.10(-5)) and overall survival (p = 0.04). CONCLUSION: Low-grade gliomas respond to temozolomide and loss of chromosome 1p/19q predicts both a durable chemosensitivity and a favorable outcome.