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1.
Medicine (Baltimore) ; 99(19): e19987, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384451

RESUMO

This study aimed to investigate the inner linkage and mechanism of Mycoplasma pneumoniae (MP) infection and Kawasaki disease (KD), as well as the risk factors of outcome in this cohort of patients.A retrospective study was performed in 210 patients diagnosed with KD complicated with community acquired pneumonia (CAP) in Children's Hospital, Zhejiang University School of Medicine from January 2014 to December 2017. They were divided into two groups based on MP infection: MP infection group (n = 97) and non-MP infection group (n = 113). We compared the variables of these two groups based on medical records.The MP infection group had higher ESR than the non-MP infection group. During hospitalization, the non-MP infection group had higher levels of WBC during hospital, LDH, PCT, and lower HB when compared to the MP infection group. No differences were found in the hs-CRP level, N%, PLT, ALT, CKMB, and cytokine levels (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) between MP and non-MP infection group. Likewise, no difference was found in fever duration or hospital stays between them. Totally 19 patients in the infection group had CAA with a rate of 19.59%; and 27 (23.89%) patients had CAA in the non-MP infection group. Unfortunately, no difference was found in CAA rate between the two groups.MP infection may occur simultaneously in children with Kawasaki disease. KD patients with MP infection tended to occur in older population. MP infection may not increase the risk of CAA, which still needs further large-scaled studies to confirm. Clinicians should be alert to KD patients with high level of ESR. MP should be screened and early treatment with macrolides should be given timely.


Assuntos
Sedimentação Sanguínea , Cardiopatias , Macrolídeos/administração & dosagem , Síndrome de Linfonodos Mucocutâneos , Pneumonia por Mycoplasma , Antibacterianos/administração & dosagem , Pré-Escolar , China/epidemiologia , Infecções Comunitárias Adquiridas/epidemiologia , Comorbidade , Citocinas/sangue , Intervenção Médica Precoce/métodos , Feminino , Cardiopatias/etiologia , Cardiopatias/prevenção & controle , Humanos , Lactente , Contagem de Leucócitos/métodos , Contagem de Leucócitos/estatística & dados numéricos , Masculino , Síndrome de Linfonodos Mucocutâneos/sangue , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/epidemiologia , Síndrome de Linfonodos Mucocutâneos/terapia , Pneumonia por Mycoplasma/sangue , Pneumonia por Mycoplasma/diagnóstico , Pneumonia por Mycoplasma/tratamento farmacológico , Pneumonia por Mycoplasma/epidemiologia , Estudos Retrospectivos , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos
2.
J Dairy Sci ; 103(1): 909-914, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31704021

RESUMO

The veal calf sector fears that a too-rapid and large decrease in antimicrobial use (AMU) as demanded by European authorities would increase mortality, causing economic and welfare issues. To determine whether this concern is justified, the relationship between AMU (total and different classes) and mortality in dairy-type white veal calves, managed by 2 large veal companies, was explored. A retrospective cohort study was performed on electronically collected antimicrobial consumption and mortality data from the largest Belgian veal practice during the period 2014 to 2016. Mixed linear [mortality (%) as continuous outcome] and generalized linear mixed models with binary outcome for event and trial approach were built to identify factors associated with mortality. Data consisted of 76 production cycles from 29 farms managed by 2 veal companies (1 and 2) and covering 45,001 calves. Average AMU was 30.1 ± 10.4 defined daily doses for animals per year (± standard deviation) and was higher in veal company 2 than in veal company 1 (35.9 ± 9.3 and 22.4 ± 5.7 defined daily doses for animals per year, respectively). In contrast, mean mortality was lower in veal company 2 (2.3 ± 1.4%) than in veal company 1 (4.1 ± 1.4%). Both models showed a positive association between AMU and mortality in veal company 1 and no association in veal company 2. The final linear model identified increasing herd size and the use of third- or fourth-generation cephalosporins as risk factors for mortality and the use of long-acting macrolides as a protective factor. The final logistic model identified an increased mortality risk with increased use of third- or fourth-generation cephalosporins and sulfonamides-trimethoprim and decreased mortality when using long-acting macrolides. Based on these data, at the current levels of AMU in Belgian veal calves, an increase in mortality when reducing AMU could not be evidenced. Differences in herd size and factors other than AMU likely better explain why one veal company faces almost double the mortality of another one. Abandoning the use of long-acting macrolides might have negative consequences for mortality under the current state of the industry. The most ethical way to further reduce AMU in veal calves is likely simultaneously monitoring AMU and animal welfare parameters, starting with, but not limited to, mortality.


Assuntos
Antibacterianos/farmacologia , Doenças dos Bovinos/mortalidade , Bem-Estar do Animal/ética , Animais , Antibacterianos/administração & dosagem , Bovinos , Doenças dos Bovinos/prevenção & controle , Uso de Medicamentos , Modelos Logísticos , Macrolídeos/administração & dosagem , Macrolídeos/farmacologia , Estudos Retrospectivos , Fatores de Risco
3.
An. pediatr. (2003. Ed. impr.) ; 91(5): 286-295, nov. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-186766

RESUMO

Introducción: La enfermedad invasiva por Streptococcus del grupo A (EISGA) es una infección grave en niños, habiéndose comunicado un aumento de incidencia en los últimos años. Objetivo: Evaluar las características y evolución de la EISGA en niños y determinar cambios en la incidencia o gravedad. Material y métodos: Estudio retrospectivo de niños ≤ 16 años evaluados en un hospital terciario pediátrico de Madrid y diagnosticados de EISGA (junio 2005-julio 2013). Se analizó la epidemiología, clínica, microbiología y tratamiento, evaluándose cambios a lo largo del periodo estudiado y parámetros asociados a gravedad. Resultados: Se incluyeron 55 niños con EISGA; 33 (60%) mujeres, con una mediana de 48,5 (20,5-88,9) meses. Los síndromes clínicos más frecuentes fueron celulitis/absceso subcutáneo (21,8%), absceso ORL (20%), neumonía (16,4%), infección osteoarticular (16,4%) y mastoiditis (12,7%). La incidencia de EISGA (casos/105 urgencias/año) aumentó de 5,6 (4,2-7,2) entre junio 2005-mayo 2009 a 18,9 (15,1-26) entre junio 2009-mayo 2013; p = 0,057. El 63,6% (n = 35) y el 18,2% (n = 10) de los pacientes precisaron cirugía e ingreso en UCIP, respectivamente. Los niños en UCIP fueron más pequeños (26,5 vs. 52,6 meses; p = 0,116), presentaron proteína C reactiva más elevada (24,5 vs. 10,7 mg/dl; p < 0,001) y mayor frecuencia de neumonía (60 vs. 7%; p < 0,001). En el análisis multivariante solo la proteína C reactiva fue factor de riesgo de ingreso en UCIP (OR: 1,14 [1,004-1,286]; p = 0,04). No hubo secuelas. Conclusiones: Se objetivó un aumento de la incidencia de EISGA en niños en nuestro medio, siendo la menor edad, la presencia de neumonía y la proteína C reactiva elevada los parámetros asociados a gravedad en esta serie


Introduction: Invasive group A streptococcal disease (iGASD) is a serious infection in children. Several studies have shown an increased incidence in the past years. Objective: To evaluate the characteristics and outcome of iGASD in children, and to determine changes in incidence or severity. Material and methods: A retrospective study was conducted on children ≤ 16 years evaluated in a tertiary paediatric hospital in Madrid, and diagnosed with iGASD (June 2005-July 2013). An analysis was made of the demographics, symptomatology, microbiology, and treatment. The changes throughout the period studied were evaluated, as well as parameters associated with disease severity. Results: The study included a total of 55 children with iGASD, with 33 (60%) females, and a median age of 48.5 (20.5-88.9) months. The most frequent clinical syndromes were cellulitis/subcutaneous abscess (21.8%), ENT abscess (20%), pneumonia (16.4%), osteoarticular infection (16.4%), and mastoiditis (12.7%). The incidence of iGASD (cases/105 emergencies/year) increased from 5.6 (4.2-7.2) between June 2005-May 2009 to 18.9 (15.1-26) between June 2009-May 2013; P = .057. Surgery and admission to PICU was required by 35 (63.6%) and 10 (18.2%) patients, respectively. Children in PICU were younger (26.5 vs 52.6 months, P = .116), had a higher C-reactive protein (24.5 vs 10.7 mg/dl, P < .001) and higher frequency of pneumonia (60 vs 7%, P < .001). In the multivariate analysis, only C-reactive protein was a risk factor for admission to PICU (OR: 1.14 [1.004-1.286], P = .04). There were no sequelae. Conclusions: An increased incidence of iGASD was observed in the children in this study. Lower age, pneumonia, and higher C-reactive protein were associated with disease severity in this series


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Streptococcus pyogenes/isolamento & purificação , Infecções Estreptocócicas/epidemiologia , Prognóstico , Infecções Estreptocócicas/microbiologia , Estudos Retrospectivos , Proteína C-Reativa , Fatores de Risco , Clindamicina/administração & dosagem , Macrolídeos/administração & dosagem
4.
Molecules ; 24(19)2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31591309

RESUMO

Ralstonia solanacearum (R. solanacearum)-induced bacterial wilt of the nightshade family causes a great loss in agricultural production annually. Although there has been some efficient pesticides against R. solanacearum, inaccurate pesticide releasing according to the onset time of bacterial wilt during the use of pesticides still hinders the disease management efficiency. Herein, on the basis of the soil pH change during R. solanacearum growth, and pH sensitivity of the Schiff base structure, a pH-sensitive oxidized alginate-based double-crosslinked gel was fabricated as a pesticide carrier. The gel was prepared by crosslinking oxidized sodium alginate (OSA) via adipic dihydrazide (ADH) and Ca2+. After loading tetramycin into the gel, it showed a pH-dependent pesticide releasing behavior and anti-bacterial activity against R. solanacearum. Further study also showed that the inhibition rate of the tetramycin-loaded gel was higher than that of industrial pesticide difenoconazole. This work aimed to reduce the difficulty of pesticide administration in the high incidence period of bacterial wilt and we believe it has a great application potential in nightshade production.


Assuntos
Antibacterianos/administração & dosagem , Macrolídeos/administração & dosagem , Ralstonia solanacearum/efeitos dos fármacos , Adipatos/síntese química , Adipatos/química , Alginatos/química , Alginatos/farmacologia , Antibacterianos/farmacologia , Cálcio/química , Concentração de Íons de Hidrogênio , Macrolídeos/química , Macrolídeos/farmacologia , Praguicidas/farmacologia , Doenças das Plantas/microbiologia , Bases de Schiff/química , Tabaco/efeitos dos fármacos
5.
Parasit Vectors ; 12(1): 444, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31506088

RESUMO

BACKGROUND: Moxidectin has previously shown limited efficacy (≤ 44.4%) against confirmed macrocyclic lactone (ML)-resistant Dirofilaria immitis strains at 3 µg/kg after single and multiple oral dosages. Three studies were conducted to evaluate higher oral moxidectin doses for efficacy against confirmed ML-resistant D. immitis strains. METHODS: Dogs were inoculated with 50 D. immitis L3 and randomly allocated to treatments. Study 1: 6 groups of dogs (n = 8) were inoculated with JYD-34 (Day - 30) and treated as follows: T01, negative control; T02-T05, moxidectin at 3, 6, 12 or 24 µg/kg, respectively, on Day 0 only; T06, moxidectin at 3 µg/kg on Days 0, 30 and 60. Study 2: 10 groups of dogs (n = 5) were inoculated (Day - 30) with either JYD-34 (T01, T03-05) or ZoeLA (T02, T06-T10) and treated as follows: T01 and T02, negative controls; T03-T05, moxidectin at 24, 40 or 60 µg/kg, respectively, on Days 0, 28 and 56; T06 and T09, moxidectin at 3 or 60 µg/kg on Day 0 only; T07, T08 and T10, moxidectin at 24, 40 or 60 µg/kg, respectively, on Days 0, 28 and 56. Study 3: 5 groups of dogs (n = 5) were inoculated with ZoeMO (Day - 28) and treated as follows: T01, negative control; T02, moxidectin at 3 µg/kg moxidectin on Day 0 only; T03-T05, moxidectin at 24, 40 or 60 µg/kg, respectively, on Days 0, 28 and 56. All dogs were necropsied for adult heartworm recovery ~ 4-5 months post-inoculation. RESULTS: All moxidectin-treated dogs showed significantly lower worm counts than controls. The efficacy of moxidectin administered once at 3 µg/kg was 19% (JYD-34), 44.4% (ZoeLA) and 82.1% (ZoeMO). Increasing both the dose and the number of dosages of moxidectin improved efficacy, with 100% protection obtained using three dosages of moxidectin at either 40 µg/kg (JYD-34, ZoeMO) or 60 µg/kg (ZoeLA). Three dosages of 24 µg/kg were also highly effective, providing ≥ 98.8% efficacy for all three strains. CONCLUSIONS: Increasing both the dose and number of consecutive monthly dosages of moxidectin improved the efficacy against ML-resistant heartworms. Based on these data and other technical considerations, the 24 µg/kg dose was considered the optimal dose for further commercial development.


Assuntos
Antinematódeos/administração & dosagem , Quimioprevenção/métodos , Dirofilaria immitis/isolamento & purificação , Dirofilariose/prevenção & controle , Doenças do Cão/prevenção & controle , Macrolídeos/administração & dosagem , Administração Oral , Animais , Dirofilaria immitis/efeitos dos fármacos , Cães , Relação Dose-Resposta a Droga , Carga Parasitária , Resultado do Tratamento
6.
Parasit Vectors ; 12(1): 445, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31506094

RESUMO

BACKGROUND: Dirofilaria immitis is a filarial parasite of dogs that can cause serious or fatal cardiopulmonary disease. Three studies were conducted to evaluate the efficacy and safety of monthly treatment with moxidectin in a chewable tablet product in combination with sarolaner and pyrantel to prevent heartworm disease in dogs after experimental challenge and in a clinical field study in the USA. METHODS: In two laboratory studies, dogs (8 per group) that had been inoculated 30 days prior with 50 third-stage D. immitis larvae were randomized to treatment on Day 0 with placebo or combination product, at the minimum dose of 24 µg/kg moxidectin, 2 mg/kg sarolaner and 5 mg/kg pyrantel (as pamoate salt). Study 2 also included groups treated with tablets containing moxidectin-alone (24 µg/kg) or sarolaner-alone (2 mg/kg). Efficacy was evaluated ~ 5 months after inoculation by adult heartworm counts at necropsy. In the field study, 410 dogs ≥ 8 weeks-old from 23 USA veterinary clinics were treated for 11 months with either combination product at 24-48 µg/kg moxidectin, 2-4 mg/kg sarolaner and 5-10 mg/kg pyrantel (n = 272) or Heartgard® Plus (ivermectin/pyrantel) at the label recommended dose rate (n = 138). Efficacy was evaluated on Day 330 using antigen and microfilaria testing to assess adult heartworm infection. RESULTS: In the laboratory studies, there were no heartworms recovered from any dog treated with the combination product or moxidectin alone and all dogs treated with placebo or sarolaner-alone were infected with 20-44 adult heartworms. In the field study, all dogs treated with the combination product tested negative for heartworm infection on Day 330, whereas two dogs treated with Heartgard® Plus tested positive. The Heartgard® Plus-treated dogs that tested heartworm positive were from the lower Mississippi River Valley region, where heartworm resistance has been confirmed to occur. The combination product was well tolerated in all studies. CONCLUSIONS: In laboratory studies, no heartworms were recovered from dogs treated with a single dose of the novel combination product containing moxidectin, sarolaner and pyrantel. Additionally, in the field study no dog tested positive for adult heartworm infection when dosed with the combination product monthly for 11 months, while two dogs treated with Heartgard® Plus tested positive.


Assuntos
Antinematódeos/administração & dosagem , Azetidinas/administração & dosagem , Quimioprevenção/métodos , Dirofilariose/prevenção & controle , Doenças do Cão/prevenção & controle , Macrolídeos/administração & dosagem , Pirantel/administração & dosagem , Compostos de Espiro/administração & dosagem , Administração Oral , Animais , Dirofilaria immitis/efeitos dos fármacos , Cães , Quimioterapia Combinada/métodos , Placebos/administração & dosagem , Resultado do Tratamento , Estados Unidos
7.
Parasit Vectors ; 12(1): 433, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492168

RESUMO

BACKGROUND: The safety of ProHeart® 12 (PH 12; extended-release injectable suspension; 10% moxidectin in glyceryl tristearate microspheres) was evaluated in four studies using Beagle dogs and one study using ivermectin-sensitive Collies. The recommended dose is 0.5 mg/kg subcutaneously once yearly. METHODS: Study 1: safety margin was evaluated as 3 treatments of PH 12 (0× (control); 1× (recommended dose); 3× (3 times recommended dose) and 5× (5 times recommended dose) in 12 months via clinical observations, body weights, food consumption, injection site observations, physical examinations, moxidectin tissue assay, pharmacokinetics, and clinical and anatomic pathology. Study 2: safety in breeding-age males was demonstrated by semen testing at 14-day intervals from Day 7 to Day 91 post-treatment (0× or 3×). Study 3: reproductive safety in females was demonstrated by monitoring dams and litters following treatments (0× or 3×) administered during breeding, gestation, or lactation. Study 4: safety in dogs surgically implanted with adult heartworms was evaluated by clinical and laboratory monitoring following treatment with 0× or 3× administered 61 days post-implantation. Study 5: safety in ivermectin-sensitive dogs (120 µg/kg SC) was by clinical monitoring for 1 week after administering 1×, 3× or 5×. RESULTS: Study 1: slight swelling clinically detectable at some 3× and 5× injection sites was characterized microscopically as granulomatous inflammation, like tissue responses to medical implants, interpreted as non-adverse. Pharmacokinetics were dose-proportional and there was little or no systemic accumulation. Residual moxidectin mean (range) at 1× injection sites after 1 year was 16.0% (0.045-37.6%) of the administered mass. Studies 2 and 3: no effects were identified in reproductive indices (females) or semen quality characteristics (males). Study 4: PH 12 produced marked reductions in circulating microfilariae and lower numbers of adult heartworms, but no adverse clinical signs were identified. Study 5: there were no abnormal clinical signs at 1×, 3× or 5× overdoses of PH 12 in ivermectin-sensitive dogs. CONCLUSIONS: PH 12 has a > 5× safety margin in both normal and ivermectin-sensitive dogs, has no effects on canine reproduction, and is well tolerated in heartworm-positive dogs. The only treatment-related finding was non-adverse, granulomatous inflammation at the injection site.


Assuntos
Antinematódeos/efeitos adversos , Preparações de Ação Retardada/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Injeções/efeitos adversos , Macrolídeos/efeitos adversos , Suspensões/efeitos adversos , Animais , Antinematódeos/administração & dosagem , Preparações de Ação Retardada/administração & dosagem , Doenças do Cão/tratamento farmacológico , Cães , Hidropericárdio/tratamento farmacológico , Macrolídeos/administração & dosagem , Suspensões/administração & dosagem , Resultado do Tratamento
8.
Nat Med ; 25(9): 1370-1376, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31406349

RESUMO

The MORDOR I trial1, conducted in Niger, Malawi and Tanzania, demonstrated that mass azithromycin distribution to preschool children reduced childhood mortality1. However, the large but simple trial design precluded determination of the mechanisms involved. Here we examined the gut microbiome of preschool children from 30 Nigerien communities randomized to either biannual azithromycin or placebo. Gut microbiome γ-diversity was not significantly altered (P = 0.08), but the relative abundances of two Campylobacter species, along with another 33 gut bacteria, were significantly reduced in children treated with azithromycin at the 24-month follow-up. Metagenomic analysis revealed functional differences in gut bacteria between treatment groups. Resistome analysis showed an increase in macrolide resistance gene expression in gut microbiota in communities treated with azithromycin (P = 0.004). These results suggest that prolonged mass azithromycin distribution to reduce childhood mortality reduces certain gut bacteria, including known pathogens, while selecting for antibiotic resistance.


Assuntos
Azitromicina/administração & dosagem , Infecções por Campylobacter/tratamento farmacológico , Microbioma Gastrointestinal/efeitos dos fármacos , Metagenômica , Campylobacter/efeitos dos fármacos , Campylobacter/patogenicidade , Infecções por Campylobacter/genética , Infecções por Campylobacter/mortalidade , Criança , Mortalidade da Criança , Pré-Escolar , Farmacorresistência Bacteriana/efeitos dos fármacos , Farmacorresistência Bacteriana/genética , Regulação Bacteriana da Expressão Gênica/efeitos dos fármacos , Humanos , Macrolídeos/administração & dosagem , Masculino , Nigéria/epidemiologia , Análise de Sequência de RNA
9.
Shanghai Kou Qiang Yi Xue ; 28(2): 207-217, 2019.
Artigo em Chinês | MEDLINE | ID: mdl-31384912

RESUMO

PURPOSE: The present meta analysis was designed to determine the effects of macrolides group of antibiotics as local drug delivery agents to scaling and root planing (SRP), compared with SRP alone or plus placebo. METHODS: Electronic and manual literature searches were conducted to select randomized controlled trials (RCTs) comparing SRP + macrolides versus SRP alone using the following databases: PubMed, Cochrane Library, Science Direct, EMbase, CNKI, Wanfang database and VIP data until August 2018. Two reviewers independently extracted the data and evaluated the methodological quality of the included studies. RevMan 5.3 was applied for meta analysis. RESULTS: Seven papers were obtained, which included 439 patients with chronic periodontitis.Meta analysis showed that in the two groups, the changes in probing depth(PD)[MD=0.77, 95%CI(0.48-1.05), P<0.00001], clinical attachment loss(CAL)[MD=0.74, 95%CI(0.39-1.10), P<0.0001],plaque index(PI)[MD=0.30, 95% CI(0.17-0.43), P<0.00001],modified sulcus bleeding index (mSBI)[MD=0.23, 95%CI(0.15-0.32), P<0.00001]at 3 month and 6 month of PD[MD=1.15, 95%CI(0.41-1.89), P=0.002] were significantly different, the difference of CAL[MD=0.92, 95%CI(0.43-1.40), P=0.0002], PI[MD=0.51, 95%CI(0.07-0.95), P=0.02] and mSBI[MD=0.18, 95%CI(0.07-0.29), P=0.002] was also significant (P<0.05). CONCLUSIONS: SRP combined with local macrolides adjuvant treatment for chronic periodontitis is effective in short-term observation.


Assuntos
Antibacterianos , Periodontite Crônica , Macrolídeos , Antibacterianos/administração & dosagem , Periodontite Crônica/tratamento farmacológico , Raspagem Dentária , Humanos , Macrolídeos/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Aplainamento Radicular
10.
J Zoo Wildl Med ; 50(2): 470-473, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31260217

RESUMO

Two nonrelated Goeldi's monkeys (Callimico goeldii) from the same enclosure developed multifocal alopecia with hyperkeratotic to ulcerative skin lesions on the lower abdomen and inner thighs. Necropsy samples of the first animal showed hyperplastic dermatitis together with in situ carcinoma and intralesional Demodex organisms. The second monkey developed similar lesions 2.5 yr later. Skin scrapings and biopsies also revealed Demodex mites within hyperplastic dermatitis. Long-term treatment with ivermectin, imidacloprid-moxidectin, and sarolaner resolved the demodicosis but skin lesions progressed to actinic keratosis and carcinoma. Both cutaneous neoplasia and demodicosis are rarely described in New World monkeys and these are the first reported cases in Goeldi's monkeys. Since the animals had access to ultraviolet (UV) light, as recommended for indoor-housed callitrichids, the skin tumors were likely UV-induced and the mites have settled particularly within impaired regions. Thus, apparent demodicosis can indicate cutaneous immunosuppression and might alert caretakers to adjust the UV regime.


Assuntos
Callimico , Carcinoma de Células Escamosas/veterinária , Infestações por Ácaros/veterinária , Doenças dos Macacos/etiologia , Neoplasias Cutâneas/veterinária , Raios Ultravioleta/efeitos adversos , Animais , Animais de Zoológico , Antibacterianos/uso terapêutico , Antiparasitários/administração & dosagem , Antiparasitários/uso terapêutico , Azetidinas/administração & dosagem , Azetidinas/uso terapêutico , Carcinoma de Células Escamosas/patologia , Combinação de Medicamentos , Feminino , Fluoroquinolonas/uso terapêutico , Inseticidas/administração & dosagem , Inseticidas/uso terapêutico , Ivermectina/uso terapêutico , Macrolídeos/administração & dosagem , Macrolídeos/uso terapêutico , Masculino , Infestações por Ácaros/tratamento farmacológico , Infestações por Ácaros/parasitologia , Doenças dos Macacos/parasitologia , Doenças dos Macacos/patologia , Neonicotinoides/administração & dosagem , Neonicotinoides/uso terapêutico , Nitrocompostos/administração & dosagem , Nitrocompostos/uso terapêutico , Neoplasias Cutâneas/etiologia , Compostos de Espiro/administração & dosagem , Compostos de Espiro/uso terapêutico
11.
Parasit Vectors ; 12(1): 330, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266521

RESUMO

BACKGROUND: Endoparasites are considered a major health problem of South American camelids as shown in a recent survey among German and Austrian camelid owners. Although prophylactic and therapeutic measures such as application of anthelmintics are commonly used, treatment efficacy is usually not assessed. Owners have expressed significant concerns regarding the effect of antiparasitic therapy, so this study aimed to evaluate the outcome of anthelmintic treatment in German alpaca herds with different drugs. RESULTS: Overall, 617 samples from 538 clinically healthy alpacas > 1 year-old from 27 farms (n = 11-157 animals/herd) were examined. The most common parasites detected by flotation were Eimeria spp. (75.1%) followed by strongylids (55.0%), Nematodirus spp. (19.3%), cestodes (3.1%) and Trichuris (2.7%). After initial coproscopical examination by flotation and strongylid egg quantification by the McMaster technique, positive animals excreting at least 150 eggs per gram of faeces were included in a faecal egg count reduction test (FECRT) using fenbendazole (n = 71 samples), moxidectin (n = 71) or monepantel (n = 66). Pre-treatment larval cultures (n = 23 positive pooled farm samples) revealed Haemonchus (87% of the farms), Cooperia (43.5%), Trichostrongylus (21.7%), Ostertagia (13.0%), Nematodirus and Oesophagostomum (4.3% each). Fenbendazole treatment reduced egg excretion by 45%, moxidectin by 91% and monepantel by 96%. On the farm level, 13/18 farms that used fenbendazole, 6/6 farms that used moxidectin and 2/5 farms that used monepantel had individual FECR values < 90% (fenbendazole) or < 95% (moxidectin, monepantel). Haemonchus and Cooperia were overrepresented on the farms with reduced treatment efficacy. CONCLUSIONS: Gastrointestinal strongylids are common in German alpacas and fenbendazole in particular was not sufficiently effective to reduce strongylid egg excretion. Although the FECRT could not unambiguously determine anthelmintic resistance in the present study, the finding that small ruminant strongylids, especially Haemonchus, are common in alpacas indicates that determination of effective anthelmintic doses, monitoring of efficacy and adapted (selective) treatment regimens must be implemented as part of sustainable deworming practices in this species in accordance with recommendations for ruminants.


Assuntos
Anti-Helmínticos/administração & dosagem , Camelídeos Americanos/parasitologia , Helmintíase Animal/prevenção & controle , Enteropatias Parasitárias/veterinária , Infecções por Strongylida/veterinária , Estrongilídios/efeitos dos fármacos , Aminoacetonitrila/administração & dosagem , Aminoacetonitrila/análogos & derivados , Animais , Fezes/parasitologia , Feminino , Fenbendazol/administração & dosagem , Haemonchus/efeitos dos fármacos , Helmintíase Animal/parasitologia , Enteropatias Parasitárias/parasitologia , Enteropatias Parasitárias/prevenção & controle , Macrolídeos/administração & dosagem , Masculino , Contagem de Ovos de Parasitas/veterinária , Infecções por Strongylida/parasitologia , Infecções por Strongylida/prevenção & controle
12.
Int J Chron Obstruct Pulmon Dis ; 14: 1289-1298, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31354258

RESUMO

Background: Chronic obstructive pulmonary disease (COPD) is currently the fourth largest fatal disease in the world, and is expected to rise to third place by 2020. Frequent acute exacerbations lead to increased mortality. Some suggestions for prophylactic use of macrolides in preventing COPD exacerbations have been raised, but there are still several issues that need to be addressed, such as target population, the course of treatment, therapeutic dose, and so on. Objective: To evaluate, via exploratory meta-analysis, the efficacy of long-term macrolide therapy at low doses in stable COPD. Methods: A systematic literature search was performed in PubMed, Embase, and Cochrane database from inception to March 28, 2019. Randomized controlled trials (RCT) which reported long-term use of macrolides in prevention of COPD were eligible. Results: A total of 10 articles were included in this study. It was found that there was a 23% relative risk reduction in COPD exacerbations among patients taking macrolides compared to placebo (P<0.01). The median time to first exacerbation was effectively prolonged among patients taking macrolides vs placebo (P<0.01). Sub-group analysis showed erythromycin was advantageous and older patients were less responsive to macrolides. Conclusions: Long-term low dose usage of macrolides could significantly reduce the frequency of the acute exacerbation of COPD. The treatment was well tolerated, with few adverse reactions, but it was not suitable for the elderly. It is recommended that this treatment regimen could be used in patients with GOLD grading C or D, because they have a higher risk of acute exacerbation and mortality. It needs to be further discussed whether this treatment should last for 12 months or longer.


Assuntos
Antibacterianos/administração & dosagem , Antibioticoprofilaxia , Macrolídeos/administração & dosagem , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Infecções Respiratórias/prevenção & controle , Antibacterianos/efeitos adversos , Progressão da Doença , Esquema de Medicação , Humanos , Macrolídeos/efeitos adversos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/microbiologia , Doença Pulmonar Obstrutiva Crônica/mortalidade , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/microbiologia , Infecções Respiratórias/mortalidade , Fatores de Tempo , Resultado do Tratamento
13.
Parasit Vectors ; 12(1): 369, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31349867

RESUMO

BACKGROUND: The efficacy of an extended-release injectable moxidectin (0.5 mg/kg) suspension (ProHeart® 12) (PH 12) in preventing the development of Dirofilaria immitis in dogs for 12 months was investigated in laboratory and field studies in the USA. METHODS: In each of two laboratory studies, 20 dogs ≥ 12 months of age were randomly allocated to receive a subcutaneous injection of saline or PH 12 on Day 0 and were then inoculated with 50 D. immitis third-stage larvae (L3) on Day 365. All dogs were necropsied ~ 5 months post-inoculation for adult worm counts. The field efficacy study included dogs ≥ 10 months of age from 19 veterinary clinics in the USA treated with either 20 monthly doses of Heartgard® Plus (HG Plus) (296 dogs) or two doses of PH 12 (297 dogs) on Days 0 and 365. Efficacy was determined on Days 365, 480 and 605 using adult HW antigen and microfilaria testing to assess adult HW infection. RESULTS: PH 12 was 100% effective in preventing HW disease in all three of these studies. In the laboratory studies, no PH 12-treated dogs had any adult HWs, whereas all control dogs in both studies had adult HWs [geometric mean, 30.2 (range, 22-37) for Study 1 and 32.6 (22-44) for Study 2]. In the field study, all dogs treated with PH 12 tested negative for adult HW infection on all test days (Days, 365, 480 and 605), whereas four dogs receiving HG Plus (positive control) tested positive for HWs during the study (three dogs on Day 365 and one dog on Day 480). All four dogs treated with HG Plus that subsequently tested positive for HWs during the field study were from the lower Mississippi River Valley region, where HW resistance to macrocyclic lactone preventives has been confirmed to occur. PH 12 was significantly better than HG Plus in preventing heartworm disease in the field study (P = 0.0367). PH 12 was well-tolerated in both laboratory and field studies. CONCLUSIONS: A single dose of ProHeart® 12 was 100% effective in preventing heartworm disease in dogs for a full year in both laboratory and field studies.


Assuntos
Dirofilaria immitis/efeitos dos fármacos , Dirofilariose/prevenção & controle , Doenças do Cão/prevenção & controle , Filaricidas/administração & dosagem , Macrolídeos/administração & dosagem , Animais , Preparações de Ação Retardada/administração & dosagem , Dirofilariose/parasitologia , Doenças do Cão/parasitologia , Cães , Feminino , Hospitais Veterinários/estatística & dados numéricos , Injeções Subcutâneas , Masculino , Distribuição Aleatória , Estados Unidos
14.
An. pediatr. (2003. Ed. impr.) ; 91(1): 21-29, jul. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-186693

RESUMO

Introducción y objetivos: aMycoplasma pneumoniae (MP) es uno de los agentes etiológicos más comunes de las neumonías adquiridas en la comunidad (NAC) en niños. Objetivo: describir las características clínicas y epidemiológicas, tratamiento y evolución de los pacientes con NAC por MP (NACM) en un hospital terciario de Valencia, España. Material y métodos: Se revisaron retrospectivamente las historias clínicas de los niños<14 años con NACM entre enero de 2010 y diciembre de 2015. Los pacientes con evidencia radiológica de neumonía y confirmación microbiológica de MP (PCR de exudado nasofaríngeo y/o anticuerpos IgM específicos frente a MP) se consideraron NACM. Resultados: Un total de 162 pacientes se diagnosticaron de NACM; mediana de edad de 6 años (rango intercuartílico: 4-9 años). La proporción de pruebas positivas para MP en pacientes con NAC, así como el uso empírico de macrólidos, aumentó progresivamente con la edad. Hubo un pico de casos en 2011 y en 2015, con un máximo de casos en julio, agosto, noviembre y diciembre. El patrón radiológico más frecuente fue el infiltrado segmentario (62,3%), mientras que 22 (13,6%) presentaron derrame pleural. Los niños con NACM desarrollaron una clínica leve, con poca elevación de parámetros inflamatorios. Se inició tratamiento empírico con un macrólido en el 68,5% de los casos. La necesidad de ingreso hospitalario fue inversamente proporcional a la edad del paciente. Conclusiones: Según este estudio, los niños con NAC de mayor edad tuvieron la mayor proporción de infección por MP, siendo poco sintomáticos y con escasa elevación de parámetros inflamatorios, pudiéndose beneficiar del tratamiento empírico con macrólidos. Por consiguiente, conocer la epidemiología de un área geográfica podría ser importante para el abordaje de las NAC en niños


Introduction and objectives: Mycoplasma pneumoniae (MP) is one of the most common etiological agents of community-acquired pneumonia (CAP) in children. We aimed to describe the clinical and epidemiological characteristics, treatment and outcome of children diagnosed with community-acquired MP pneumonia (CAMP) in a tertiary hospital in Valencia, Spain. Material and methods: Medical records of children <14 years with CAMP were retrospectively reviewed from January 2010 to December 2015. Patients with radiological evidence of pneumonia and microbiological confirmation of MP (PCR from nasopharyngeal swab and/or serum specific IgM) were considered CAMP. Results: One hundred and sixty two children were diagnosed with CAMP; median age 6 years (IQR: 4-9). The positive MP test rate among children with CAP progressively increased with age as did the empirical use of macrolides. There were two peaks of cases in 2011 and in 2015, being July, August, November and December the seasons with the higher number of cases. The most frequent radiological pattern was segmental infiltrate (62.3%) and 22 (13.6%) children had pleural effusion. It was noteworthy the mild symptomatology and low levels of inflammatory parameters that children with CAMP had. A macrolide was empirically initiated in 68.5% of cases. Hospital admission rate was inversely proportional to patient's age. Conclusions: According to this study, older, less symptomatic patients and with lower inflammatory parameters had the greatest rate of MP infection among children with CAP and thus they could benefit of empiric macrolide therapy. Therefore, knowing the epidemiology of a geographical area may be important for the management of CAP in children


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Antibacterianos/administração & dosagem , Infecções Comunitárias Adquiridas/epidemiologia , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia por Mycoplasma/epidemiologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Hospitalização/estatística & dados numéricos , Macrolídeos/administração & dosagem , Pneumonia por Mycoplasma/tratamento farmacológico , Estudos Retrospectivos , Espanha/epidemiologia
15.
Am J Gastroenterol ; 114(6): 900-906, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31095531

RESUMO

OBJECTIVES: Helicobacter pylori (H. pylori) guidelines, including the recent ACG clinical guideline, recommend avoiding clarithromycin-based triple therapy (TT-C) among patients with past macrolide exposure. Data to support this recommendation are scarce, and the impact of macrolide exposure on quadruple therapies is unclear. We aimed to determine the impact of macrolide exposure on the efficacy of H. pylori treatment in our region. METHODS: We searched the Clalit Health Services database to identify subjects aged 25-60 years who underwent the first-ever C-urea breath test between 2010 and 2015. Patients who underwent a previous H. pylori stool antigen test or gastroscopy were excluded. Pharmacy dispensation data were retrieved. RESULTS: We identified 7,842 subjects (36.1% male individuals, age: 40.3 ± 10.5 years), including 3,062 (39.0%) with previous macrolide exposure. The efficacy of TT-C was 74.3% and 82.4% among subjects with and without macrolide exposure, respectively (odds ratio (OR), 0.62; 95% confidence interval (CI), 0.55-0.70; P < 0.0001). TT success was adversely affected by exposure to clarithromycin (55.5%; OR, 0.31; 95% CI, 0.24-0.39; P < 0.0001), roxythromycin (74.4%; OR, 0.65; 95% CI, 0.58-0.74; P < 0.0001), and erythromycin (73.9%; OR, 0.72; 95% CI, 0.57-0.89; P < 0.01) but not by exposure to azithromycin. A greater time elapsed because exposure to clarithromycin and roxythromycin was associated with higher eradication (OR, 1.007; 95% CI, 1.002-1.012; P < 0.01 and OR, 1.004; 95% CI, 1.002-1.006; P < 0.0001). A higher dose of clarithromycin and roxythromycin was associated with a lower likelihood of successful eradication (OR, 0.99988; 95% CI, 0.99982-0.99996; P < 0.01 and OR, 0.99981; 95% CI, 0.99971-0.99992; P < 0.001). The efficacies of sequential and concomitant therapies were 82.7% and 81.3%, respectively, and were not significantly affected by macrolide exposure. CONCLUSIONS: TT-C is adversely affected by previous exposure to macrolide antibiotics. Sequential, concomitant, and bismuth-based treatment may be preferred in this setting.


Assuntos
Resistência Microbiana a Medicamentos , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/isolamento & purificação , Macrolídeos/administração & dosagem , Adulto , Bismuto/uso terapêutico , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Feminino , Seguimentos , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/patologia , Helicobacter pylori/efeitos dos fármacos , Humanos , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/microbiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Inibidores da Bomba de Prótons/uso terapêutico , Estudos Retrospectivos
16.
Medicine (Baltimore) ; 98(17): e15285, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31027086

RESUMO

BACKGROUND: Macrolide maintenance treatment remains controversial for patients with noncystic fibrosis (non-CF) bronchiectasis, we performed a meta-analysis to estimate the benefits and safety of macrolides therapy in adults and children with non-CF bronchiectasis. METHODS: PubMed, Embase, the Cochrane Library, and Web of Science databases were searched for all the randomized controlled trials of macrolides for treating non-CF bronchiectasis. The primary outcome was improvement of bronchiectasis exacerbations. Secondary outcomes included adverse events and macrolide resistance. RESULTS: A total of 10 studies involving 602 patients were included in the analysis. Pooled results showed that macrolide therapy significantly reduced the number of patients who suffered from exacerbations (RR = 1.56, 95% CI = 1.14-2.14, P = .006, I = 72%), number of patients who experienced at least 3 exacerbations (RR = 0.55, 95% CI = 0.39-0.77, P = .0005, I = 40%), average exacerbations per patient during the observation time (SMD = -0.69, 95% CI = -1.06 to -0.32, P = .0002, I = 60%), and bronchiectasis exacerbation-related admissions (RR = 0.46, 95% CI = 0.23-0.96, P = .04, I = 0%). Specified subgroup analyses of the number of patients free from exacerbations were further performed; macrolide therapy showed a significant benefit in both children (RR 5.03, 95% CI 2.02-12.50, P = .0005, I = 45%) and adults (RR = 1.66, 95% CI = 1.37-2.02, P < .00001, I = 79%); azithromycin showed a significant reduction on the number of patients who suffered from exacerbations (RR = 2.25, 95% CI = 1.67-3.02, P < .00001, I = 0%), was different from erythromycin (RR = 1.33, 95% CI = 0.92-1.94, P = .13, I = 0%) and roxithromycin (RR = 1.14, 95% CI = 0.97-1.35, P = .11, I = 0%). The pooled results also showed no higher risk of adverse events (RR = 0.98, 95% CI = 0.85-1.13, P = .80, I = 8%), even a lower risk of severe adverse events (RR = 0.53, 95% CI = 0.33-0.85, P = .009, I = 0%). However, a higher risk of macrolide resistance (RR = 3.59, 95% CI 2.6-4.96, P < .00001, I = 0%) was observed. CONCLUSION: For both children and adults with non-CF bronchiectasis, macrolide maintenance therapy can effectively reduce bronchiectasis exacerbations, especially for patients with more frequent exacerbations and needing hospital treatment. Azithromycin was more effective than other macrolides. Macrolide maintenance therapy did not increase the risk of adverse events, but may increase the risk of macrolide resistance.


Assuntos
Antibacterianos/uso terapêutico , Bronquiectasia/tratamento farmacológico , Macrolídeos/uso terapêutico , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Criança , Progressão da Doença , Farmacorresistência Bacteriana , Humanos , Macrolídeos/administração & dosagem , Macrolídeos/efeitos adversos , Fatores de Tempo
17.
Curr Drug Metab ; 20(4): 301-304, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30827233

RESUMO

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a systematic inflammatory disease, and smoking is an important risk factor for COPD. Macrolide can reduce COPD inflammation. However, the inflammatory mechanism of COPD remains unclear and the anti-inflammatory mechanism of Macrolide is complex and not exactly known. METHODS: We read and analysed thirty-eight articles, including original articles and reviews. RESULTS: The expression of Nrf2 was lower in COPD patients and might have a protective role against apoptosis caused by CSE-induced oxidative stress. Nrf2 may play an important role in COPD inflammation. Nrf2 is a key factor in downstream of PI3K/Akt and is involved in the regulation of oxidative stress and inflammatory response. Therefore, PI3K/Akt pathway may play an important role in the activation of Nrf2 and COPD inflammation. Macrolide reduces lung and systemic inflammation of COPD by regulating PI3K/Akt pathway. CONCLUSION: This review indicates that PI3K/Ak-Nrf2 may play an important role in COPD inflammation and macrolides may reduce lung and systemic inflammation of COPD by regulating PI3K/Akt-Nrf2 pathway. However, many crucial and essential questions remain to be answered. Further understanding of the mechanisms of macrolide efficacy and PI3K/Akt-Nrf2-mediated inflammatory responses may provide a new clue for exploring COPD treatment in the future.


Assuntos
Regulação da Expressão Gênica/efeitos dos fármacos , Inflamação/tratamento farmacológico , Macrolídeos/uso terapêutico , Fator 2 Relacionado a NF-E2/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Humanos , Inflamação/metabolismo , Macrolídeos/administração & dosagem , Fator 2 Relacionado a NF-E2/genética , Fosfatidilinositol 3-Quinases/genética , Proteínas Proto-Oncogênicas c-akt/genética , Doença Pulmonar Obstrutiva Crônica/metabolismo
18.
Sci Transl Med ; 11(483)2019 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-30867321

RESUMO

There is an urgent global need for a safe macrofilaricide drug to accelerate elimination of the neglected tropical diseases onchocerciasis and lymphatic filariasis. From an anti-infective compound library, the macrolide veterinary antibiotic, tylosin A, was identified as a hit against Wolbachia This bacterial endosymbiont is required for filarial worm viability and fertility and is a validated target for macrofilaricidal drugs. Medicinal chemistry was undertaken to develop tylosin A analogs with improved oral bioavailability. Two analogs, A-1535469 and A-1574083, were selected. Their efficacy was tested against the gold-standard second-generation tetracycline antibiotics, doxycycline and minocycline, in mouse and gerbil infection models of lymphatic filariasis (Brugia malayi and Litomosoides sigmodontis) and onchocerciasis (Onchocerca ochengi). A 1- or 2-week course of oral A-1535469 or A-1574083 provided >90% Wolbachia depletion from nematodes in infected animals, resulting in a block in embryogenesis and depletion of microfilarial worm loads. The two analogs delivered comparative or superior efficacy compared to a 3- to 4-week course of doxycycline or minocycline. A-1574083 (now called ABBV-4083) was selected for further preclinical testing. Cardiovascular studies in dogs and toxicology studies in rats and dogs revealed no adverse effects at doses (50 mg/kg) that achieved plasma concentrations >10-fold above the efficacious concentration. A-1574083 (ABBV-4083) shows potential as an anti-Wolbachia macrolide with an efficacy, pharmacology, and safety profile that is compatible with a short-term oral drug course for treating lymphatic filariasis and onchocerciasis.


Assuntos
Filariose Linfática/tratamento farmacológico , Filariose Linfática/microbiologia , Macrolídeos/administração & dosagem , Macrolídeos/uso terapêutico , Oncocercose/tratamento farmacológico , Oncocercose/microbiologia , Wolbachia/fisiologia , Administração Oral , Animais , Modelos Animais de Doenças , Filariose Linfática/sangue , Feminino , Macrolídeos/efeitos adversos , Masculino , Camundongos Endogâmicos BALB C , Camundongos SCID , Oncocercose/sangue , Resultado do Tratamento , Tilosina/sangue , Tilosina/síntese química , Tilosina/química , Tilosina/uso terapêutico
19.
Parasit Vectors ; 12(1): 124, 2019 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-30890165

RESUMO

BACKGROUND: Outdoor, early-biting, zoophagic behaviours by Anopheles farauti (s.s.) can compromise the effectiveness of bed nets for malaria control. In the Western Pacific region, pigs and dogs represent significant alternative blood sources for mosquitoes. Treating these animals with endectocides may impact mosquito survival and complement control measures. This hypothesis was explored using membrane feeding assays (MFAs), direct feeds on treated pigs, pharmacokinetic analyses and a transmission model. RESULTS: Ivermectin was 375-fold more mosquitocidal than moxidectin (24 h LC50 = 17.8 ng/ml vs 6.7 µg/ml) in MFAs, and reduced mosquito fecundity by > 50% at ≥ 5 ng/ml. Treatment of pigs with subcutaneous doses of 0.6 mg/kg ivermectin caused 100% mosquito mortality 8 days after administration. Lethal effects persisted for up to 15 days after administration (75% death within 10 days). CONCLUSION: The application of these empirical data to a unique malaria transmission model that used a three-host system (humans, pigs and dogs) predicts that the application of ivermectin will cause a significant reduction in the entomological inoculation rate (EIR = 100 to 0.35). However, this is contingent on local malaria vectors sourcing a significant proportion of their blood meals from pigs. This provides significant insights on the benefits of deploying endectocides alongside long-lasting insecticide-treated nets (LLINs) to address residual malaria transmission.


Assuntos
Anopheles/efeitos dos fármacos , Inseticidas/administração & dosagem , Ivermectina/administração & dosagem , Macrolídeos/administração & dosagem , Malária/prevenção & controle , Administração Cutânea , Animais , Comportamento Alimentar , Feminino , Fertilidade/efeitos dos fármacos , Inseticidas/sangue , Inseticidas/farmacocinética , Inseticidas/farmacologia , Ivermectina/sangue , Ivermectina/farmacocinética , Ivermectina/farmacologia , Macrolídeos/sangue , Macrolídeos/farmacocinética , Macrolídeos/farmacologia , Malária/transmissão , Modelos Biológicos , Controle de Mosquitos/métodos , Papua Nova Guiné , Distribuição Aleatória , Suínos
20.
Ital J Pediatr ; 45(1): 20, 2019 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-30717812

RESUMO

BACKGROUND: The association between macrolides use and subsequent occurrence of infantile hypertrophic pyloric stenosis (IHPS) is still debatable. The aim of this study was to conduct a systematic review and meta-analysis of the association between perinatal exposure to macrolides, mainly erythromycin, and the development of pyloric stenosis. METHODS: Original studies were identified using MEDLINE, Web of Science, Scopus, Google Scholar, and the Cochrane Library databases. Studies investigating the association between perinatal exposure to macrolides and pyloric stenosis were included. The most adjusted effect estimates were pooled using random-effects meta-analysis. The I2 and Egger's tests were used to assess heterogeneity and publication bias, respectively. RESULTS: Fourteen papers (12 retrospective cohort studies and two case-control studies) were included. For postnatal exposure, the overall estimate of seven cohort studies indicated a statistically significant association (RR = 3.17, 95% CI: 2.38-4.23; I2 = 10.0%) with no evidence of publication bias (Egger P = 0.81). For prenatal exposure, six cohort studies and two case-control studies were included. Meta-analysis demonstrated a statistically significant association in the cohort studies (OR = 1.47, 95% CI: 1.03-2.09; I2 = 29.3%), but not in the case-control studies (OR = 1.02, 95% CI: 0.66-1.58; I2 = 51.2%). The overall pooled result was not statistically significant. Only two studies were included for exposure through breastfeeding, and the estimates did not show a statistically significant association (OR = 1.31; 95% CI: 0.42-4.1; I2 = 69.1%). CONCLUSIONS: The study demonstrated good evidence of association between development of IHPS and direct postnatal exposure to macrolides. However, the evidence on the effects of prenatal exposure or postnatal maternal exposure (breastfeeding) is not conclusive.


Assuntos
Antibacterianos/administração & dosagem , Macrolídeos/administração & dosagem , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Estenose Pilórica Hipertrófica/epidemiologia , Feminino , Humanos , Recém-Nascido , Gravidez
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