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2.
Tidsskr Nor Laegeforen ; 139(13)2019 Sep 24.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-31556531

RESUMO

BACKGROUND: Febrile illness is a common clinical problem and frequently caused by bacterial and viral infections. When blood cultures are negative and symptoms persist despite empirical antibiotic treatment, clinicians must consider other differential diagnoses including malignancy, rheumatologic disease and parasitic infections. CASE PRESENTATION: A Norwegian male in his eighties experienced febrile illness during a stay in Southern Spain. Upon return to Norway, he was hospitalized with fever, weight-loss, enlarged spleen, pancytopenia and hypergammaglobulinemia. After failing to respond to broad-spectrum antibiotics and antifungals, he was diagnosed with visceral leishmaniasis and Leishmania infantum was confirmed by PCR and sequencing of spleen biopsy and blood. INTERPRETATION: With increasing migration and tourism, doctors in non-endemic countries should be familiar with visceral leishmaniasis.


Assuntos
Leishmaniose Visceral/diagnóstico , Idoso de 80 Anos ou mais , Anfotericina B/administração & dosagem , Anfotericina B/uso terapêutico , Antiprotozoários/administração & dosagem , Antiprotozoários/uso terapêutico , Artrite/parasitologia , Febre/parasitologia , Humanos , Leishmania infantum/crescimento & desenvolvimento , Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/complicações , Leishmaniose Visceral/tratamento farmacológico , Masculino , Pancitopenia/parasitologia , Espanha , Esplenomegalia/diagnóstico por imagem , Esplenomegalia/parasitologia , Tomografia Computadorizada por Raios X , Doença Relacionada a Viagens
3.
BMC Infect Dis ; 19(1): 822, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533666

RESUMO

BACKGROUND: Current guidelines and targets for soil-transmitted helminth (STH) control focus on school-based deworming for school-age children, given the high risk of associated morbidity in this age group. However, expanding deworming to all age groups may achieve improved STH control among both the community in general and school-age children, by reducing their risk of reinfection. This trial aims to compare school-based targeted deworming with community-wide mass deworming in terms of impact on STH infections among school-age children. METHODS: The CoDe-STH (Community Deworming against STH) trial is a cluster-randomised controlled trial (RCT) in 64 primary schools in Dak Lak province, Vietnam. The control arm will receive one round of school-based targeted deworming with albendazole, while in the intervention arm, community-wide mass deworming with albendazole will be implemented alongside school-based deworming. Prevalence of STH infections will be measured in school-age children at baseline and 12 months following deworming. The primary outcome is hookworm prevalence in school-age children at 12 months, by quantitative PCR. Analysis will be intention-to-treat, with outcomes compared between study arms using generalised linear and non-linear mixed models. Additionally, cost-effectiveness of mass and targeted deworming will be calculated and compared, and focus group discussions and interviews will be used to assess acceptability and feasibility of deworming approaches. Individual based stochastic models will be used to predict the impact of mass and targeted deworming strategies beyond the RCT timeframe to assess the likelihood of parasite population 'bounce-back' if deworming is ceased due to low STH prevalence. DISCUSSION: The first large-scale trial comparing mass and targeted deworming for STH control in South East Asia will provide key information for policy makers regarding the optimal design of STH control programs. TRIAL REGISTRATION: ACTRN12619000309189 .


Assuntos
Antiprotozoários/uso terapêutico , Helmintíase/tratamento farmacológico , Helmintos/isolamento & purificação , Solo/parasitologia , Albendazol/uso terapêutico , Ancylostomatoidea/isolamento & purificação , Animais , Criança , Análise Custo-Benefício , Feminino , Helmintíase/economia , Helmintíase/epidemiologia , Humanos , Masculino , Prevalência , Vietnã/epidemiologia
4.
An Bras Dermatol ; 94(3): 355-357, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365669

RESUMO

Pentavalent antimonials are the first-line drug treatment for American tegumentary leishmaniasis. We report on a patient with chronic renal failure on hemodialysis who presented with cutaneous lesions of leishmaniasis for four months. The patient was treated with intravenous meglumine under strict nephrological surveillance, but cardiotoxicity, acute pancreatitis, pancytopenia, and cardiogenic shock developed rapidly. Deficient renal clearance of meglumine antimoniate can result in severe toxicity, as observed in this case. These side effects are related to cumulative plasma levels of the drug. Therefore, second-line drugs like amphotericin B are a better choice for patients on dialysis.


Assuntos
Antiprotozoários/efeitos adversos , Leishmaniose Cutânea/complicações , Leishmaniose Cutânea/tratamento farmacológico , Antimoniato de Meglumina/efeitos adversos , Insuficiência Renal Crônica/complicações , Adulto , Anfotericina B/uso terapêutico , Antiprotozoários/uso terapêutico , Brasil , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , Leishmaniose Cutânea/patologia , Masculino , Diálise Renal
5.
Exp Parasitol ; 205: 107747, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31442454

RESUMO

Development of new chemotherapeutic agents is an essential issue in the treatment and control of a disease. This study aimed to evaluate the anti-leishmanial activity of amiodarone, an antiarrhythmic class III drug, against Leishmania major, the most prevalent etiological agent of cutaneous leishmaniasis in the old world. The proliferation of promastigotes and intracellular amastigotes in the absence or presence of amiodarone was estimated, in an in vitro study. For in vivo study, five weeks after infection of BALB/c mice with L. major, when the lesions appeared at the injection site, the mice were divided into four groups (n = 6 each); treatment was conducted for 28 consecutive days with vehicle, amiodarone at 40 mg/kg orally and glucantime at 60 mg/kg intraperitoneally. Therapy with amiodarone reduced the size of lesions compared to the untreated group after 12 days. Amiodarone decreased the parasite load and inflammatory responses, particularly the macrophages containing amastigotes, and enhanced granulation tissue formation in the dermis and subcutaneous area. The Tumor necrosis factor-α and Interleukin-6 levels were significantly lower in the cell culture supernatants of the inguinal lymph node in the amiodarone treated group compared to the vehicle and untreated groups. Amiodarone significantly increased the activity of glutathione peroxidase in comparison to the vehicle and untreated groups but did not affect the plasma levels of superoxide dismutase, malondialdehyde, adiponectin, and ferric reducing ability of plasma. Therefore, the anti- L. major activity and immunomodulatory effects of amiodarone reduced the parasitic load and enhanced wound healing in cutaneous leishmaniasis in BALB/c mice. Amiodarone reduced the lesion surface area, but it did not cure it completely.


Assuntos
Amiodarona/uso terapêutico , Antiprotozoários/uso terapêutico , Leishmania major/efeitos dos fármacos , Leishmaniose Cutânea/tratamento farmacológico , Adiponectina/sangue , Amiodarona/farmacologia , Animais , Antiarrítmicos/farmacologia , Antiarrítmicos/uso terapêutico , Antiprotozoários/farmacologia , Linhagem Celular , Feminino , Glutationa Peroxidase/metabolismo , Concentração Inibidora 50 , Interleucina-6/análise , Leishmania major/ultraestrutura , Leishmaniose Cutânea/parasitologia , Linfonodos/química , Linfonodos/imunologia , Macrófagos/parasitologia , Malondialdeído/sangue , Antimoniato de Meglumina/farmacologia , Antimoniato de Meglumina/uso terapêutico , Camundongos , Camundongos Endogâmicos BALB C , Carga Parasitária , Distribuição Aleatória , Pele/parasitologia , Pele/patologia , Pele/ultraestrutura , Superóxido Dismutase/metabolismo , Fator de Necrose Tumoral alfa/análise
6.
Parasitol Res ; 118(9): 2455-2466, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31402401

RESUMO

Echinococcus granulosus sensu lato and E. multilocularis are the causative agents of life-threatening cystic and alveolar echinococcoses (CE and AE), respectively, which lead to serious public health concerns across the globe. Benzimidazoles (BMZs) are the drugs of choice for the treatment of human CE and AE. Presently, the chemotherapeutic failures of BMZs against CE and AE are caused by their low aqueous solubility, poor absorption, and consequently their erratic bioavailability. Among the BMZ compounds used for CE/AE treatment, albendazole (ABZ) and mebendazole (MBZ) are the only drugs licensed for human use. Nevertheless, the administration of these BMZs for a long period of time leads to undesirable adverse effects. Therefore, there is an urgent need for designing new formulations of BMZs with increased bioavailability. To bridge these therapeutic gaps, nanoparticle enantiomers of ABZ and drug delivery systems based on nanostructured entities currently provide an interesting new formulation of already existing drugs to improve the pharmacokinetic effects of BMZs. This study provides an overview of the tested nanocompounds against E. granulosus and E. multilocularis, including their effective dose, type of nanoparticles (NPs), assay setting, and therapeutic outcomes. This review suggests that BMZ derivatives loaded in NPs can significantly improve the scolicidal and cysticidal activities compared with single BMZ. Moreover, BMZ-loaded polymeric NPs show a tendency to increase mortality rate against protoscoleces and microcysts compared with metallic formulations, nanoemulsions, lipid nanocapsules, solid lipid NPs, liposomes, and nanocrystals. In the future, the use of the newly structured entities, attained by bridging ligands to the modified surface of NPs, as well as the electromagnetically produced nanodrugs could be helpful for developing fine-tuned formulations as an alternative to the already existing drugs against these neglected parasitic infections.


Assuntos
Albendazol/uso terapêutico , Antiprotozoários/uso terapêutico , Equinococose/tratamento farmacológico , Echinococcus granulosus/efeitos dos fármacos , Echinococcus multilocularis/efeitos dos fármacos , Mebendazol/uso terapêutico , Animais , Disponibilidade Biológica , Sistemas de Liberação de Medicamentos , Desenho de Drogas , Equinococose/parasitologia , Humanos , Lipídeos , Nanocápsulas , Nanopartículas/química
7.
Vet Parasitol ; 273: 32-35, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31442890

RESUMO

This study looked to assess the stability of Cryptosporidium parvum genotypes in calves between the final day of treatment with the antiprotozoal halofuginone lactate and seven days post-treatment. Paired faecal samples were collected on the final day of treatment and seven days later from 54 calves across seven farms in South-west England. The presence of Cryptosporidium species was detected using polymerase chain reaction targeting the 18 s rDNA. The presence and genotype of C. parvum was determined by PCR and amplicon sequencing targeting the gp60 locus. On farms where C. parvum was detected at both sampling times there was a distinct genotype shift. Detection of gp60 genotype IIaA15G2R1 decreased from 40% to 7% while IIaA17G1R1 increased from 0% to 41%, supplemented by IIaA16G3R1 in one sample. A shift in C. parvum genotypes present in calves within a one week sampling timeframe has not been described prior to this study, indicating that the timeframe is likely suitable for observing variation in C. parvum populations and interactions with antiprotozoal control strategies.


Assuntos
Doenças dos Bovinos/parasitologia , Criptosporidiose/parasitologia , Cryptosporidium parvum/genética , Animais , Antiprotozoários/uso terapêutico , Bovinos , Doenças dos Bovinos/tratamento farmacológico , Criptosporidiose/tratamento farmacológico , Inglaterra , Fezes/parasitologia , Genes de Protozoários/genética , Genótipo , RNA Ribossômico 18S/genética
8.
Chirurg ; 90(10): 833-837, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31297548

RESUMO

Visceral leishmaniasis is a worldwide distributed infectious zoonotic disease caused by protozoan pathogens of the genus Leishmania which are transmitted by sandflies. The main hosts are dogs. The prevalence in Germany is low. Predominantly affected are migrants and travelers returning from Mediterranean countries. The main clinical symptoms are fever, hepatosplenomegaly and pancytopenia. The diagnosis is made by polymerase chain reaction of peripheral blood or direct detection of Leishmania in bone marrow aspirates. Lesions of the liver and spleen can easily be misinterpreted as numerous benign or malignant differential diagnoses. Treatment is always systemic with antiparasitic drugs. Immunosuppressed patients with HIV co-infection or after solid organ transplantation are prone to infection as well as atypical and severe courses.


Assuntos
Antiprotozoários/uso terapêutico , Leishmaniose Visceral , Animais , Cães , Alemanha , Infecções por HIV/complicações , Humanos , Hospedeiro Imunocomprometido , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/tratamento farmacológico , Leishmaniose Visceral/cirurgia , Fígado , Baço
10.
Int J Pharm Compd ; 23(4): 288-293, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31315079

RESUMO

Cutaneous leishmaniasis is the most common form of leishmaniasis with global incidence of about 1.5 million cases annually. The disease is endemic in Israel and caused by two types, leishmania major and leishmania tropica. The two types of cutaneous leishmaniasis in Israel are not life threatening, but the multiple skin lesions developed from the contaminated sand fly bites cause significant damage to the quality of life for a few months in patients with leishmania major and sometimes for more than a year in patients with leishmania tropica. Topical treatment for this localized skin disease is very attractive although only one medication is registered in Israel (15% paromomycin +12% methylbenzethonium chloride ointment), which is for the topical treatment of "leishmania major." Two significant disadvantages characterize this topical medication, 1) relatively low efficacy and 2) significant irritation and pain, which could result in failure of the registered treatment. This article (part 2 of a 3-part article), which also includes a compounded formulation, discusses the treatment option of paromomycin sulfate liposomal gel (free of the sensitizing methylbenzethonium chloride).


Assuntos
Leishmania tropica , Leishmaniose Cutânea , Antiprotozoários/administração & dosagem , Antiprotozoários/uso terapêutico , Humanos , Israel , Leishmaniose Cutânea/tratamento farmacológico , Qualidade de Vida
11.
J Zoo Wildl Med ; 50(2): 342-349, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31260199

RESUMO

Mountain bongo (Tragelaphus euryceros isaaci) from Kenya were exported to zoological institutions in North America and Europe in the 1970s and 1980s. In the following 20-30 years bongo numbers declined in Kenya and the Mountain Bongo Repatriation Project was launched. This resulted in 18 adult bongo, descendants of the original translocated bongo, being repatriated from the United States to Kenya in 2004. These newly arrived bongo were inadvertently exposed to heavy tick infestation on release in a conservancy on the slopes of Mount Kenya. Mortality and morbidity occurred during the third week after arrival. Theileria sp. infection was apparent from the history, clinical signs, and necropsy findings, and Theileria-like parasites were detected microscopically in samples from sick and dead animals. Four bongo died before the outbreak was controlled. In order to identify the Theileria parasite conclusively, molecular amplification techniques were used. A combination of reverse line blotting, with small subunit ribosomal RNA (SSU rRNA) polymerase chain reaction (PCR) amplification and nucleotide sequencing, identified the protozoan parasite Theileria taurotragi, suggesting this as the most probable cause of mortality and morbidity in the repatriated bongo.


Assuntos
Antílopes/parasitologia , Naftoquinonas/uso terapêutico , Theileria/isolamento & purificação , Theileriose/parasitologia , Animais , Antiprotozoários/uso terapêutico , Conservação dos Recursos Naturais , Surtos de Doenças/veterinária , Feminino , Quênia/epidemiologia , Masculino , Oxitetraciclina , Theileriose/tratamento farmacológico , Theileriose/epidemiologia , Theileriose/mortalidade
12.
Exp Parasitol ; 204: 107728, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31348915

RESUMO

BACKGROUND: Co-infection with Leishmania major and Schistosoma mansoni may have significant consequences for disease progression, severity and subsequent transmission dynamics. Pentavalent antimonials and Praziquantel (PZQ) are used as first line of treatment for Leishmania and Schistosoma infections respectively. However, there is limited insight on how combined therapy with the standard drugs impacts the host in comorbidity. The study aimed to determine the efficacy of combined chemotherapy using Pentostam (P) and PZQ in murine model co-infected with L. major and S. mansoni. METHODS: A 3 × 4 factorial design with three parasite infection groups (Lm, Sm, Lm + Sm to represent L. major, S. mansoni and L. major + S. mansoni respectively) and four treatment regimens [P, PZQ, P + PZQ, and PBS designating Pentostam (GlaxoSmithKline UK), Praziquantel (Biltricide®, Bayer Ag. Leverkusen, Germany), Pentostam + Praziquantel and Phosphate buffered saline] as factors was applied. RESULTS: Significant changes were observed in the serum Interferon gamma (IFN-γ), and Macrophage inflammatory protein-one alpha (MIP-1α) levels among various treatment groups between week 8 and week 10 (p < 0.05). There was increased IFN-γ in the L. major infected mice subjected to PZQ and PBS, and in L. major + S. mansoni infected BALB/c mice treated with P + PZQ. Subsequently, MIP-1α levels increased significantly in both the L. major infected mice under PZQ and PBS and in L. major + S. mansoni infected BALB/c mice undergoing concurrent chemotherapy with P + PZQ between 8 and 10 weeks (p < 0.05). In the comorbidity, simultaneous chemotherapy resulted in less severe histopathological effects in the liver. CONCLUSION: It was evident, combined first line of treatment is a more effective strategy in managing co-infection of L. major and S. mansoni. The findings denote simultaneous chemotherapy compliments immunomodulation in the helminth-protozoa comorbidity hence, less severe pathological effects following the parasites infection. Recent cases of increased incidences of polyparasitism in vertebrates call for better ways to manage co-infections. The findings presented necessitate intrinsic biological interest on examining optimal combined chemotherapeutic agents strategies in helminth-protozoa concomitance and the related infections abatement trends vis-a-vis host-parasite relationships.


Assuntos
Anti-Helmínticos/uso terapêutico , Antiprotozoários/uso terapêutico , Comorbidade , Leishmania major/patogenicidade , Leishmaniose Cutânea/complicações , Esquistossomose mansoni/complicações , Análise de Variância , Animais , Anti-Helmínticos/administração & dosagem , Gluconato de Antimônio e Sódio/administração & dosagem , Gluconato de Antimônio e Sódio/uso terapêutico , Antiprotozoários/administração & dosagem , Quimiocina CCL3/sangue , Modelos Animais de Doenças , Quimioterapia Combinada , Interferon gama/sangue , Leishmania major/efeitos dos fármacos , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/imunologia , Leishmaniose Cutânea/patologia , Fígado/parasitologia , Fígado/patologia , Camundongos , Camundongos Endogâmicos BALB C , Praziquantel/administração & dosagem , Praziquantel/uso terapêutico , Schistosoma mansoni/efeitos dos fármacos , Schistosoma mansoni/patogenicidade , Esquistossomose mansoni/tratamento farmacológico , Esquistossomose mansoni/imunologia , Esquistossomose mansoni/patologia
13.
Georgian Med News ; (289): 151-157, 2019 Apr.
Artigo em Russo | MEDLINE | ID: mdl-31215898

RESUMO

In this study, we studied the activity of three antibacterial drugs: Cefotaxime (Claforan, France), Ceftriaxone (Russia) and Doxycycline (Russia). The control group is a pentavalent antimony drug - Glucantim (France), which has been the "gold standard" for a long time in the treatment of any form of leishmaniasis. During the experiments, the leading positions of doxycycline and ceftriaxone established in vitro. Minimal doses of both drugs lead to absolute suppression of the mobility of the pathogen L. major. Increasing the therapeutic dose of drugs is not justified. Comparison of these drugs with the gold standard of therapy with meglumine antimonate (glucantim) showed their superiority in all indicators.


Assuntos
Antiprotozoários , Leishmaniose Cutânea , Antiprotozoários/uso terapêutico , Humanos , Leishmaniose Cutânea/tratamento farmacológico , Federação Russa
14.
J Vet Cardiol ; 23: 32-37, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31174727

RESUMO

A 4-year-old crossbreed dog presented with a two-day history of lethargy and abdominal effusion. Physical examination and echocardiography revealed pericardial effusion with cardiac tamponade. Pericardiocentesis was performed. Intracytoplasmic Leishmania amastigotes were found on cytological examination of the pericardial fluid. The animal was treated with N-methylglucamine antimoniate and allopurinol. After an initial favorable response, cardiac tamponade reoccurred one month later. The dog died during a pericardiectomy four months after the initial diagnosis. Histology confirmed the presence of chronic pericarditis. The presence of Leishmania amastigotes on cytological examination of pericardial effusion suggests a possible association between canine leishmaniasis and chronic pericarditis. This finding also supports the importance of cytological examination of pericardial fluid in areas endemic for canine leishmaniasis.


Assuntos
Doenças do Cão/parasitologia , Leishmaniose/veterinária , Derrame Pericárdico/veterinária , Alopurinol/uso terapêutico , Animais , Antiprotozoários/uso terapêutico , Tamponamento Cardíaco/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/fisiopatologia , Cães , Ecocardiografia/veterinária , Leishmania/isolamento & purificação , Leishmaniose/complicações , Leishmaniose/tratamento farmacológico , Antimoniato de Meglumina/uso terapêutico , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/parasitologia , Líquido Pericárdico/parasitologia
15.
BMC Infect Dis ; 19(1): 543, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31221089

RESUMO

BACKGROUND: Cysticercosis is an emerging and neglected tropical disease (NTD) that poses a serious public health concern worldwide. Disseminated cysticercosis (DCC) is an uncommon manifestation of cysticercosis, also found in China. CASE PRESENTATION: We report three cases of DCC in patients living in China, with different clinical and radiological presentations. All three patients had DCC with active ocular cysticercosis, including one patient with widespread DCC caused by direct ingestion of Taenia solium eggs. The intravitreal cysticercus cyst in this patient was completely extracted entirely by 23-gauge pars plana vitrectomy, and the cyst was oval in shape on the flat mount preparation. CONCLUSION: The clinical presentation of DCC is highly sophisticated. The diagnosis depended on the typical radiological presentations, biopsy and flat mount preparations of the cyst.


Assuntos
Cisticercose/diagnóstico , Adolescente , Adulto , Albendazol/uso terapêutico , Animais , Anticorpos/sangue , Anticorpos/líquido cefalorraquidiano , Antiprotozoários/uso terapêutico , Encéfalo/diagnóstico por imagem , Cisticercose/tratamento farmacológico , Cisticercose/parasitologia , Feminino , Humanos , Larva/fisiologia , Imagem por Ressonância Magnética , Masculino , Taenia solium/crescimento & desenvolvimento , Taenia solium/isolamento & purificação , Vitrectomia , Adulto Jovem
16.
Parasitol Int ; 72: 101945, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31228586

RESUMO

Three different Hepatozoon (Apicomplexa, Hepatozoidae) species have been described infecting domestic cats in Europe (i.e. H. felis, H. canis and H. silvestris), however, reports on clinical hepatozoonosis are uncommon and treatment protocols are not clearly defined. A six-year-old male European short-hair cat from Austria presented poor general condition, lethargy, anorexia, icterus, a painful abdomen, fever, ruffled hair and a tick infestation, and it had never left Austria. Laboratory tests revealed leukopenia, thrombocytopenia and increased serum levels of symmetric dimethylarginine (SDMA) and bilirubin. In May Grünwald-Giemsa-stained blood smears, structures resembling Hepatozoon gamonts were observed inside neutrophil granulocytes. A PCR targeting a fragment of the 18S rRNA gene of Hepatozoon spp. and DNA sequencing allowed the diagnosis of H. felis-DNA in blood samples. The cat was treated with imidocarb dipropionate (6 mg/kg body weight, repeated after 14 days) and doxycycline monohydrate (5 mg/kg body weight twice a day, p.o., for four weeks) and recovered completely. A broad haematological and biochemical laboratory control after six months showed all evaluated parameters under normal ranges. Coinfection with other feline pathogens (i.e. feline leukaemia virus, feline immunodeficiency virus, feline Coronavirus, Leishmania and Dirofilaria immitis) could not be detected. This study reveals the presence of H. felis in Austria and provides more evidence on the geographical distribution and pathogenicity of this parasite for domestic cats. To the authors' knowledge, this is the first autochthonous case of feline hepatozoonosis in Central Europe.


Assuntos
Doenças do Gato/diagnóstico , Doenças do Gato/parasitologia , Gatos/parasitologia , Coccidiose/veterinária , Eucoccidiida/isolamento & purificação , Animais , Antiprotozoários/uso terapêutico , Áustria , Doenças do Gato/tratamento farmacológico , Coccidiose/diagnóstico , Eucoccidiida/genética , Imidocarbo/uso terapêutico , Masculino , Reação em Cadeia da Polimerase , RNA Ribossômico 18S/genética , Análise de Sequência de DNA , Resultado do Tratamento
17.
PLoS Negl Trop Dis ; 13(6): e0007423, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31188834

RESUMO

BACKGROUND: The control of cutaneous leishmaniasis (CL) is facilitated by knowledge of factors associated with the treatment failures in endemic countries. The aim of this evaluation was to identify the potential risk determinants which might affect the significance of demographic and clinical characteristics for the patients with anthroponotic CL (ACL) and the outcome of meglumine antimoniate (MA) (Glucantime) treatment. METHODOLOGY/PRINCIPAL FINDINGS: This current was executed as a cohort spanning over a period of 5 years which centered in southeastern part of Iran. Altogether, 2,422 participants were evaluated and 1,391 eligible volunteer patients with ACL caused by Leishmania tropica were included. Overall, 1,116 (80.2%) patients received MA intraleisionally (IL), once a week for 12 weeks along with biweekly cryotherapy, while 275 (19.8%) patients received MA alone (20 mg/kg/day for 3 weeks) (intramuscular, IM). The treatment failure rate in ACL patients was 11% using IL combined with cryotherapy plus IM alone, whilst 9% and 18.5% by IL along with cryotherapy or IM alone, respectively. Multivariate logistic regression model predicted 5 major associated-risk determinants including male (odds ratio (OR) = 1.54, confidence interval (CI) = 1.079-2.22, p = 0.018), lesion on face (OR = 1.574, CI = 1.075-2.303, p = 0.02), multiple lesions (OR = 1.446, CI = 1.008-2.075, p = 0.045), poor treatment adherence (OR = 2.041, CI = 1.204-3.46, p = 0.008) and disease duration > 4 months (OR = 2.739, CI = 1.906-3.936, p≤0.001). CONCLUSIONS/SIGNIFICANCE: The present study is the original and largest cohort of ACL patients who treated with MA. A comprehensive intervention and coordinated action by the health authorities and policy-makers are crucial to make sure that patients strictly follow medical instructions. Early detection and effective therapy < 4 months following the onset of the lesion is critical for successful treatment of the patients. Since a significant number of patients are still refractory to MA, reducing man-vector exposure and development of new effective alternative drugs are essential measures against ACL due to L. tropica.


Assuntos
Antiprotozoários/uso terapêutico , Leishmania tropica/isolamento & purificação , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/epidemiologia , Antimoniato de Meglumina/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos de Coortes , Crioterapia/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Irã (Geográfico)/epidemiologia , Leishmaniose Cutânea/microbiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Falha de Tratamento , Adulto Jovem
18.
Turkiye Parazitol Derg ; 43(2): 55-59, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31204455

RESUMO

Objective: Cutaneous leishmaniasis (CL) is one of the common parasitic diseases in tropical and subtropical areas and is one of the important health problems in Iran. In order to investigate epidemiological aspects of CL disease in city of Aran va Bidgol in Isfahan province, this study was carried out in this central region of Iran. Methods: This cross-sectional study was conducted in over a period of eight years between 2009-2016. Direct smears were prepared from all patients and were examined by a light microscopy. The basic demographic and clinical data of patients with CL disease referred to health care centers were collected and then were analyzed by using the SPSS software. Results: Overall, 926 patients, including 542 (58.5%) males and 384 (41.5%) females with confirmed CL were identified. The CL disease was more common among males (58.5%). The highest and lowest incidence of the CL disease were estimated as 238.5 and 44.2 per 100000 people in 2009 and 2016, respectively. The highest incidence of the CL disease (26.3%) was observed in the age group of 0-9 years. Most of the cases (54%) were seen in autumn. More lesions (44.7%) were seen on the hands. Of the patients, 65.4% were treated by systemic glucantime regimen. Conclusion: According to the results of this investigation, although there is a trend of decrease in the incidence of the CL disease in this 8-year period, incidence of the CL disease is still high. This is an alarming condition and careful planning for control and prevention of the disease is highly recommended.


Assuntos
Doenças Endêmicas , Leishmaniose Cutânea/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antiprotozoários/administração & dosagem , Antiprotozoários/uso terapêutico , Criança , Pré-Escolar , Estudos Transversais , Crioterapia , Doenças Endêmicas/estatística & dados numéricos , Feminino , Humanos , Incidência , Lactente , Irã (Geográfico)/epidemiologia , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/terapia , Masculino , Antimoniato de Meglumina/administração & dosagem , Antimoniato de Meglumina/uso terapêutico , Microscopia , Pessoa de Meia-Idade , Ocupações , Estações do Ano , Software , Adulto Jovem
19.
Curr Top Med Chem ; 19(19): 1694-1711, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31237210

RESUMO

Molecular hybridization is a well-exploited medicinal chemistry strategy that aims to combine two molecules (or parts of them) in a new, single chemical entity. Recently, it has been recognized as an effective approach to design ligands able to modulate multiple targets of interest. Hybrid compounds can be obtained by linking (presence of a linker) or framework integration (merging or fusing) strategies. Although very promising to combat the multifactorial nature of complex diseases, the development of molecular hybrids faces the critical issues of selecting the right target combination and the achievement of a balanced activity towards them, while maintaining drug-like-properties. In this review, we present recent case histories from our own research group that demonstrate why and how molecular hybridization can be carried out to address the challenges of multitarget drug discovery in two therapeutic areas that are Alzheimer's and parasitic diseases. Selected examples spanning from linker- to fragment- based hybrids will allow to discuss issues and consequences relevant to drug design.


Assuntos
Doença de Alzheimer/tratamento farmacológico , Antiprotozoários/uso terapêutico , Antipsicóticos/uso terapêutico , Desenho de Drogas , Doenças Parasitárias/tratamento farmacológico , Animais , Química Farmacêutica , Humanos , Ligantes , Estrutura Molecular
20.
Graefes Arch Clin Exp Ophthalmol ; 257(7): 1481-1488, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31037491

RESUMO

PURPOSE: To prospectively report the perimetric defects during a 6-month follow-up (FU) in patients with initially active ocular toxoplasmosis (OT). METHODS: Twenty-four patients were studied, including 11 eyes with chorioretinal toxoplasmosis proven with a positive aqueous humor sample and 13 eyes with a biologically unproven, chorioretinal lesion. Automated 24-2 SITA-Standard visual fields were performed at baseline, at the first, and sixth months of FU. A composite clinical severity score was calculated from visual acuity (VA), severity of vitreitis, chorioretinal lesion size, location of the lesion in zone 1, the presence of an initial macular or papillary edema, and long-term scarring. This provided a relative cutoff level of severity. Nine eyes out of the 24 eyes were considered severe (3 unproven and 6 proven OT). RESULTS: Initial and final visual field parameters (mean deviation [MD] and pattern standard deviation [PSD]) were significantly correlated (r = 0.873; p < 0.001, and r = 0.890; p < 0.001, respectively). During FU, only foveal threshold [FT] was correlated with VA at baseline (r = 0.48; p = 0.01) and at the 6-month FU visit (r = 0.547; p = 0.004). The MD initial predictive value of clinical severity was 0.739 according to the ROC curve. At baseline, severe and nonsevere OT exhibited no significant difference in term of MD (p = 0.06) and PSD (p = 0.1). During the FU, taking into account all the data, MD, PSD, visual function index [VFI], and FT were associated with the severity of toxoplasmosis (p = 0.018, 0.05, 0.016, and 0.02, respectively): the unproven group had a faster recovery of MD during FU (p = 0.05). CONCLUSION: Visual field parameters better reflected the chorioretinal destruction related to the toxoplasmosis lesion and the functional repercussions than VA alone. Interestingly, MD at presentation could be a discriminating factor of severity in active OT, and each visual field parameter follow-up could be a support to manage patients with active OT, especially in the severe group.


Assuntos
Antiprotozoários/uso terapêutico , Infecções Oculares Parasitárias/fisiopatologia , Monitorização Fisiológica/métodos , Toxoplasmose Ocular/fisiopatologia , Testes de Campo Visual/métodos , Campos Visuais/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antiprotozoários/imunologia , Humor Aquoso/metabolismo , Humor Aquoso/parasitologia , DNA de Protozoário/análise , Infecções Oculares Parasitárias/diagnóstico , Infecções Oculares Parasitárias/tratamento farmacológico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Curva ROC , Fatores de Tempo , Toxoplasma/genética , Toxoplasma/imunologia , Toxoplasmose Ocular/diagnóstico , Toxoplasmose Ocular/tratamento farmacológico , Acuidade Visual , Adulto Jovem
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