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[PMID]:29236929
[Au] Autor:Silva RED; Carvalho JP; Ramalho DB; Senna MCR; Moreira HSA; Rabello A; Cota E; Cota G
[Ad] Endereço:Centro de Referência em Leishmanioses, Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz-Fiocruz, Belo Horizonte, MG, Brasil.
[Ti] Título:Towards a standard protocol for antimony intralesional infiltration technique for cutaneous leishmaniasis treatment.
[So] Source:Mem Inst Oswaldo Cruz;113(2):71-79, 2018 Feb.
[Is] ISSN:1678-8060
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Despite its recognised toxicity, antimonial therapy continues to be the first-line drug for cutaneous leishmaniasis (CL) treatment. Intralesional administration of meglumine antimoniate (MA) represents an alternative that could reduce the systemic absorption of the drug and its side effects. OBJECTIVES This study aims to validate the standard operational procedure (SOP) for the intralesional infiltration of MA for CL therapy as the first step before the assessment of efficacy and safety related to the procedure. METHODS The SOP was created based on 21 trials retrieved from the literature, direct monitoring of the procedure and consultation with experts. This script was submitted to a formal computer-aided inspection to identify readability, clarity, omission, redundancy and unnecessary information (content validation). For criterion and construct validations, the influence of critical condition changes (compliance with the instructions and professional experience) on outcome conformity (saturation status achievement), tolerability (pain referred) and safety (bleeding) were assessed. FINDINGS The median procedure length was 12 minutes and in 72% of them, patients classified the pain as mild. The bleeding was also classified as mild in 96.6% of the procedures. Full compliance with the SOP was observed in 66% of infiltrations. Despite this, in 100% of the inspected procedures, lesion saturation was observed at the end of infiltration, which means that it tolerates some degree of modification in its execution (robustness) without prejudice to the result. CONCLUSIONS The procedure is reproducible and can be used by professionals without previous training with high success and safety rates.
[Mh] Termos MeSH primário: Antiprotozoários/administração & dosagem
Protocolos Clínicos/normas
Injeções Intralesionais
Leishmaniose Cutânea/tratamento farmacológico
Meglumina/administração & dosagem
Compostos Organometálicos/administração & dosagem
[Mh] Termos MeSH secundário: Seres Humanos
Injeções Intralesionais/efeitos adversos
Injeções Intralesionais/métodos
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Antiprotozoal Agents); 0 (Organometallic Compounds); 6HG8UB2MUY (Meglumine); 75G4TW236W (meglumine antimoniate)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE


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[PMID]:29287089
[Au] Autor:Ortiz D; Guiguemde WA; Hammill JT; Carrillo AK; Chen Y; Connelly M; Stalheim K; Elya C; Johnson A; Min J; Shelat A; Smithson DC; Yang L; Zhu F; Guy RK; Landfear SM
[Ad] Endereço:Department of Molecular Microbiology & Immunology, Oregon Health & Science University, Portland, Oregon, United States of America.
[Ti] Título:Discovery of novel, orally bioavailable, antileishmanial compounds using phenotypic screening.
[So] Source:PLoS Negl Trop Dis;11(12):e0006157, 2017 12.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Leishmaniasis is a parasitic infection that afflicts approximately 12 million people worldwide. There are several limitations to the approved drug therapies for leishmaniasis, including moderate to severe toxicity, growing drug resistance, and the need for extended dosing. Moreover, miltefosine is currently the only orally available drug therapy for this infection. We addressed the pressing need for new therapies by pursuing a two-step phenotypic screen to discover novel, potent, and orally bioavailable antileishmanials. First, we conducted a high-throughput screen (HTS) of roughly 600,000 small molecules for growth inhibition against the promastigote form of the parasite life cycle using the nucleic acid binding dye SYBR Green I. This screen identified approximately 2,700 compounds that inhibited growth by over 65% at a single point concentration of 10 µM. We next used this 2700 compound focused library to identify compounds that were highly potent against the disease-causing intra-macrophage amastigote form and exhibited limited toxicity toward the host macrophages. This two-step screening strategy uncovered nine unique chemical scaffolds within our collection, including two previously described antileishmanials. We further profiled two of the novel compounds for in vitro absorption, distribution, metabolism, excretion, and in vivo pharmacokinetics. Both compounds proved orally bioavailable, affording plasma exposures above the half-maximal effective concentration (EC50) concentration for at least 12 hours. Both compounds were efficacious when administered orally in a murine model of cutaneous leishmaniasis. One of the two compounds exerted potent activity against trypanosomes, which are kinetoplastid parasites related to Leishmania species. Therefore, this compound could help control multiple parasitic diseases. The promising pharmacokinetic profile and significant in vivo efficacy observed from our HTS hits highlight the utility of our two-step phenotypic screening strategy and strongly suggest that medicinal chemistry optimization of these newly identified scaffolds will lead to promising candidates for an orally available anti-parasitic drug.
[Mh] Termos MeSH primário: Antiprotozoários/farmacocinética
Avaliação Pré-Clínica de Medicamentos/métodos
Leishmania mexicana/efeitos dos fármacos
Leishmaniose Cutânea/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Oral
Animais
Antiprotozoários/administração & dosagem
Antiprotozoários/efeitos adversos
Antiprotozoários/química
Linhagem Celular
Química Farmacêutica
Descoberta de Drogas
Feminino
Seres Humanos
Leishmania mexicana/crescimento & desenvolvimento
Leishmaniose Cutânea/parasitologia
Macrófagos/parasitologia
Camundongos
Camundongos Endogâmicos BALB C
Fenótipo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antiprotozoal Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0006157


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[PMID]:29191699
[Au] Autor:Nieto-Meneses R; Castillo R; Hernández-Campos A; Maldonado-Rangel A; Matius-Ruiz JB; Trejo-Soto PJ; Nogueda-Torres B; Dea-Ayuela MA; Bolás-Fernández F; Méndez-Cuesta C; Yépez-Mulia L
[Ad] Endereço:Departamento de Parasitología, ENCB-IPN, 11340 Mexico City, Mexico; Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias-Pediatría, Instituto Mexicano del Seguro Social, 06720 Mexico City, Mexico.
[Ti] Título:In vitro activity of new N-benzyl-1H-benzimidazol-2-amine derivatives against cutaneous, mucocutaneous and visceral Leishmania species.
[So] Source:Exp Parasitol;184:82-89, 2018 Jan.
[Is] ISSN:1090-2449
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The identification of specific therapeutic targets and the development of new drugs against leishmaniasis are urgently needed, since chemotherapy currently available for its treatment has several problems including many adverse side effects. In an effort to develop new antileishmanial drugs, in the present study a series of 28 N-benzyl-1H-benzimidazol-2-amine derivatives was synthesized and evaluated in vitro against Leishmania mexicana promastigotes. Compounds 7 and 8 with the highest antileishmanial activity (micromolar) and lower cytotoxicity than miltefosine and amphotericin B were selected to evaluate their activity against L. braziliensis 9and L. donovani, species causative of mucocutaneous and visceral leishmaniasis, respectively. Compound 7 showed significantly higher activity against L. braziliensis promastigotes than compound 8 and slightly lower than miltefosine. Compounds 7 and 8 had IC values in the micromolar range against the amastigote of L. mexicana and L. braziliensis. However, both compounds did not show better activity against L. donovani than miltefosine. Compound 8 showed the highest SI against both parasite stages of L. mexicana. In addition, compound 8 inhibited 68.27% the activity of recombinant L. mexicana arginase (LmARG), a therapeutic target for the treatment of leishmaniasis. Docking studies were also performed in order to establish the possible mechanism of action by which this compound exerts its inhibitory effect. Compound 8 shows promising potential for the development of more potent antileishmanial benzimidazole derivatives.
[Mh] Termos MeSH primário: Antiprotozoários/farmacologia
Benzimidazóis/farmacologia
Leishmania braziliensis/efeitos dos fármacos
Leishmania donovani/efeitos dos fármacos
Leishmania mexicana/efeitos dos fármacos
[Mh] Termos MeSH secundário: Sequência de Aminoácidos
Anfotericina B/farmacologia
Animais
Antiprotozoários/toxicidade
Arginase/antagonistas & inibidores
Arginase/química
Benzimidazóis/síntese química
Benzimidazóis/química
Benzimidazóis/toxicidade
Linhagem Celular
Concentração Inibidora 50
Leishmania mexicana/enzimologia
Leishmaniose Cutânea/tratamento farmacológico
Leishmaniose Cutânea/parasitologia
Leishmaniose Mucocutânea/tratamento farmacológico
Leishmaniose Mucocutânea/parasitologia
Leishmaniose Visceral/tratamento farmacológico
Leishmaniose Visceral/parasitologia
Macrófagos/efeitos dos fármacos
Camundongos
Simulação de Acoplamento Molecular
Fosforilcolina/análogos & derivados
Fosforilcolina/farmacologia
Alinhamento de Sequência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiprotozoal Agents); 0 (Benzimidazoles); 107-73-3 (Phosphorylcholine); 53EY29W7EC (miltefosine); 7XU7A7DROE (Amphotericin B); EC 3.5.3.1 (Arginase)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE


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[PMID]:28468680
[Au] Autor:Ferraz R; Cunha CF; Pimentel MIF; Lyra MR; Pereira-Da-Silva T; Schubach AO; Da-Cruz AM; Bertho AL
[Ad] Endereço:Laboratory of Immunoparasitology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
[Ti] Título:CD3 CD4 CD8 (double negative) T lymphocytes and NKT cells as the main cytotoxic-related-CD107a cells in lesions of cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis.
[So] Source:Parasit Vectors;10(1):219, 2017 May 03.
[Is] ISSN:1756-3305
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cutaneous leishmaniasis (CL) is caused by Leishmania (Viannia) braziliensis, which infects dermal macrophages and dendritic cells, causing an intense immune-mediated-tissue inflammation and a skin ulcer with elevated borders that can heal spontaneously or after antimonial therapy. The resolution of lesions depends on an adaptive immune response, and cytotoxic cells seem to have a fundamental role in this process. The aim of this study is to better understand the role of cytotoxicity mediated mechanisms that occur during the immune response in the CL lesion milieu, considering distinct cytotoxic-related CD107a cells, such as CD8 , CD4 , CD4 CD8 (double-negative, DN) and CD4 CD8 (double-positive, DP) T lymphocytes, as well as NK and NKT cells. METHODS: Lesion derived cells were assessed for T cell subpopulations and NK cells, as well as CD107a expression by flow cytometry. In addition, cytometric bead array (CBA) was used to quantify cytokines and granzyme B concentrations in supernatants from macerated lesions. RESULTS: Flow cytometry analyses revealed that NKT cells are the major CD107a-expressing cell population committed to cytotoxicity in CL lesion, although we also observed high frequencies of CD4 and DN T cells expressing CD107a. Analysing the pool of CD107a -cell populations, we found a higher distribution of DN T cells (44%), followed by approximately 25% of NKT cells. Interestingly, NK and CD8 T cells represented only 3 and 4% of the total-CD107a -cell pool, respectively. CONCLUSIONS: The cytotoxicity activity that occurs in the lesion milieu of CL patients seems to be dominated by DN T and NKT cells. These findings suggest the need for a reevaluation of the role of classical-cytotoxic NK and CD8 T cells in the pathogenesis of CL, implicating an important role for other T cell subpopulations.
[Mh] Termos MeSH primário: Citotoxicidade Imunológica
Leishmaniose Cutânea/imunologia
Proteína 1 de Membrana Associada ao Lisossomo/imunologia
Células T Matadoras Naturais/imunologia
Subpopulações de Linfócitos T/imunologia
[Mh] Termos MeSH secundário: Adulto
Antígenos de Protozoários/imunologia
Biópsia
Brasil/epidemiologia
Citocinas/biossíntese
Citocinas/genética
Feminino
Citometria de Fluxo
Granzimas/análise
Seres Humanos
Leishmania braziliensis/imunologia
Leishmaniose Cutânea/epidemiologia
Proteína 1 de Membrana Associada ao Lisossomo/genética
Masculino
Meia-Idade
Pele/imunologia
Pele/parasitologia
Pele/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antigens, Protozoan); 0 (Cytokines); 0 (Lysosomal-Associated Membrane Protein 1); EC 3.4.21.- (GZMB protein, human); EC 3.4.21.- (Granzymes)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1186/s13071-017-2152-2


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[PMID]:28454881
[Au] Autor:Foroutan M; Khademvatan S; Majidiani H; Khalkhali H; Hedayati-Rad F; Khashaveh S; Mohammadzadeh H
[Ad] Endereço:Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran. Electronic address: m.foroutan@modares.ac.ir.
[Ti] Título:Prevalence of Leishmania species in rodents: A systematic review and meta-analysis in Iran.
[So] Source:Acta Trop;172:164-172, 2017 Aug.
[Is] ISSN:1873-6254
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Leishmaniasis are diverse group of diseases caused by numerous species of genus Leishmania. Herein we have contrived a systematic review and meta-analysis on the prevalence of Leishmania species in rodents of Iran. For this purpose, following the general methodology recommended for systematic reviews and meta-analysis, six English databases (PubMed, Science Direct, Scopus, Ovid, Web of Science and Google Scholar) and four Persian databases (Magiran, SID, Iran Doc and Iran Medex) were explored during January 1995 till June 2015. Papers were selected based on 8 pre-defined inclusion criteria. During the years, a total number of 4485 different rodents were captured; among which 1291 cases were Leishmania positive. The calculated weighted prevalence of Leishmania species in rodents was 23% (95% CI=18-28). Given geographical zones of Iran, the highest and lowest prevalence rate was belonged to North 50% (95% CI=40-61) and West 11% (95% CI=5-17), respectively. Rhombomys opimus (1766), Meriones lybicus (1258) and Tatera indica (488) were the three most abundant captured rodents, while the highest prevalence of Leishmania species was observed in Nesokia indica 48% (95% CI=42-54) and followed by R. opimus 39% (95% CI=30-47). Egger's regression test was performed to detect publication bias, which revealed it may not have a significant influence on overall weighted prevalence estimate (P=0.317). Meta-regression analysis demonstrated that there is no significant relationship between overall prevalence with sample size (P=0.1) and year of publication (P=0.7). The results showed remarkable prevalence of Leishmania species in rodent reservoirs. In future, adopting a suitable strategy for control and combat with rodents is necessary.
[Mh] Termos MeSH primário: Gerbillinae
Leishmania/isolamento & purificação
Leishmaniose Cutânea/veterinária
Doenças dos Roedores/parasitologia
[Mh] Termos MeSH secundário: Animais
Irã (Geográfico)/epidemiologia
Leishmania/classificação
Leishmaniose Cutânea/epidemiologia
Leishmaniose Cutânea/parasitologia
Prevalência
Doenças dos Roedores/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:29192424
[Au] Autor:Heras-Mosteiro J; Monge-Maillo B; Pinart M; Lopez Pereira P; Reveiz L; Garcia-Carrasco E; Campuzano Cuadrado P; Royuela A; Mendez Roman I; López-Vélez R
[Ad] Endereço:Department of Preventive Medicine and Public Health & Immunology and Microbiology, Rey Juan Carlos University, Avda. Atenas s/n, Alcorcón, Madrid, Spain, 28922.
[Ti] Título:Interventions for Old World cutaneous leishmaniasis.
[So] Source:Cochrane Database Syst Rev;12:CD005067, 2017 12 01.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cutaneous leishmaniasis, caused by a parasitic infection, is considered one of the most serious skin diseases in many low- and middle-income countries. Old World cutaneous leishmaniasis (OWCL) is caused by species found in Africa, Asia, the Middle East, the Mediterranean, and India. The most commonly prescribed treatments are antimonials, but other drugs have been used with varying success. As OWCL tends to heal spontaneously, it is necessary to justify the use of systemic and topical treatments. This is an update of a Cochrane Review first published in 2008. OBJECTIVES: To assess the effects of therapeutic interventions for the localised form of Old World cutaneous leishmaniasis. SEARCH METHODS: We updated our searches of the following databases to November 2016: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched five trials registers and checked the reference lists of included studies for further references to relevant randomised controlled trials (RCTs). We wrote to national programme managers, general co-ordinators, directors, clinicians, WHO-EMRO regional officers of endemic countries, pharmaceutical companies, tropical medicine centres, and authors of relevant papers for further information about relevant unpublished and ongoing trials. We undertook a separate search for adverse effects of interventions for Old World cutaneous leishmaniasis in September 2015 using MEDLINE. SELECTION CRITERIA: Randomised controlled trials of either single or combination treatments in immunocompetent people with OWCL confirmed by smear, histology, culture, or polymerase chain reaction. The comparators were either no treatment, placebo/vehicle, and/or another active compound. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and risk of bias and extracted data. We only synthesised data when we were able to identify at least two studies investigating similar treatments and reporting data amenable to pooling. We also recorded data about adverse effects from the corresponding search. MAIN RESULTS: We included 89 studies (of which 40 were new to this update) in 10,583 people with OWCL. The studies included were conducted mainly in the Far or Middle East at regional hospitals, local healthcare clinics, and skin disease research centres. Women accounted for 41.5% of the participants (range: 23% to 80%). The overall mean age of participants was 25 years (range 12 to 56). Most studies lasted between two to six months, with the longest lasting two years; average duration was four months. Most studies were at unclear or high risk for most bias domains. A lack of blinding and reporting bias were present in almost 40% of studies. Two trials were at low risk of bias for all domains. Trials reported the causative species poorly.Here we provide results for the two main comparisons identified: itraconazole (200 mg for six to eight weeks) versus placebo; and paromomycin ointment (15% plus 10% urea, twice daily for 14 days) versus vehicle.In the comparison of oral itraconazole versus placebo, at 2.5 months' follow up, 85/125 participants in the itraconazole group achieved complete cure compared to 54/119 in the placebo group (RR 3.70, 95% CI 0.35 to 38.99; 3 studies; 244 participants). In one study, microbiological or histopathological cure of skin lesions only occurred in the itraconazole group after a mean follow-up of 2.5 months (RR 17.00, 95% CI 0.47 to 612.21; 20 participants). However, although the analyses favour oral itraconazole for these outcomes, we cannot be confident in the results due to the very low certainty evidence. More side effects of mild abdominal pain and nausea (RR 2.36, 95% CI 0.74 to 7.47; 3 studies; 204 participants) and mild abnormal liver function (RR 3.08, 95% CI 0.53 to 17.98; 3 studies; 84 participants) occurred in the itraconazole group (as well as reports of headaches and dizziness), compared with the placebo group, but again we rated the certainty of evidence as very low so are unsure of the results.When comparing paromomycin with vehicle, there was no difference in the number of participants who achieved complete cure (RR of 1.00, 95% CI 0.86, 1.17; 383 participants, 2 studies) and microbiological or histopathological cure of skin lesions after a mean follow-up of 2.5 months (RR 1.03, CI 0.88 to 1.20; 383 participants, 2 studies), but the paromomycin group had more skin/local reactions (such as inflammation, vesiculation, pain, redness, or itch) (RR 1.42, 95% CI 0.67 to 3.01; 4 studies; 713 participants). For all of these outcomes, the certainty of evidence was very low, meaning we are unsure about these results.Trial authors did not report the percentage of lesions cured after the end of treatment or speed of healing for either of these key comparisons. AUTHORS' CONCLUSIONS: There was very low-certainty evidence to support the effectiveness of itraconazole and paromomycin ointment for OWCL in terms of cure (i.e. microbiological or histopathological cure and percentage of participants completely cured). Both of these interventions incited more adverse effects, which were mild in nature, than their comparisons, but we could draw no conclusions regarding safety due to the very low certainty of the evidence for this outcome.We downgraded the key outcomes in these two comparisons due to high risk of bias, inconsistency between the results, and imprecision. There is a need for large, well-designed international studies that evaluate long-term effects of current therapies and enable a reliable conclusion about treatments. Future trials should specify the species of leishmaniasis; trials on types caused by Leishmania infantum, L aethiopica, andL donovani are lacking. Research into the effects of treating women of childbearing age, children, people with comorbid conditions, and those who are immunocompromised would also be helpful.It was difficult to evaluate the overall efficacy of any of the numerous treatments due to the variable treatment regimens examined and because RCTs evaluated different Leishmania species and took place in different geographical areas. Some outcomes we looked for but did not find were degree of functional and aesthetic impairment, change in ability to detect Leishmania, quality of life, and emergence of resistance. There were only limited data on prevention of scarring.
[Mh] Termos MeSH primário: Antiprotozoários/uso terapêutico
Itraconazol/uso terapêutico
Leishmaniose Cutânea/terapia
Paromomicina/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Animais
Anti-Infecciosos/uso terapêutico
Antiprotozoários/administração & dosagem
Terapias Complementares/métodos
Crioterapia/métodos
Extremo Oriente
Feminino
Temperatura Alta/uso terapêutico
Seres Humanos
Itraconazol/administração & dosagem
Terapia a Laser
Leishmania major
Leishmania tropica
Masculino
Meia-Idade
Oriente Médio
Bases para Pomadas/administração & dosagem
Paromomicina/administração & dosagem
Fotoquimioterapia
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Antiprotozoal Agents); 0 (Ointment Bases); 304NUG5GF4 (Itraconazole); 61JJC8N5ZK (Paromomycin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD005067.pub5


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[PMID]:29261762
[Au] Autor:Bennis I; Belaid L; De Brouwere V; Filali H; Sahibi H; Boelaert M
[Ad] Endereço:National School of Public Health-Ministry of Health, Rabat, Morocco.
[Ti] Título:"The mosquitoes that destroy your face". Social impact of Cutaneous Leishmaniasis in South-eastern Morocco, A qualitative study.
[So] Source:PLoS One;12(12):e0189906, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To document the psychosocial burden of Cutaneous Leishmaniasis (CL) in rural communities in Southeastern Morocco. METHOD: Between March and April 2015, we conducted qualitative research in communities exposed to Leishmania major or L. tropica in Errachidia and Tinghir provinces. Twenty-eight focus groups discussions (FGDs) were realized, with a stratification by gender and tradition of medicine (users of folk versus professional medicine). Data were analyzed using content analysis. RESULTS: This rural population most exposed to CL in Morocco lacks access to health care in general and clearly points out there are other major public health issues that need to be resolved. Nonetheless, respondents consider the impact of CL lesions and scars as important and similar to that of burn scar tissue. Young women with CL scars in the face are stigmatized and will often be rejected for marriage in these communities. People usually try a long list of folk remedies on the active lesions, but none was felt adequate. There was a clear demand for better treatment as well as for treatment of the scars. CONCLUSIONS: The psycho-social impact of CL due to L.major and L.tropica is substantial, especially for young single women with facial scars. These generate social and self-stigma and diminish their marriage prospects. CL is well known, but not considered as a major health priority by these poor rural communities in South-eastern Morocco where gender discrimination is still an issue and access to basic health care is as neglected as CL. Early CL diagnosis and new treatment options with better skin outcomes are urgently needed.
[Mh] Termos MeSH primário: Culicidae/fisiologia
Leishmaniose Cutânea/epidemiologia
Leishmaniose Cutânea/psicologia
Pesquisa Qualitativa
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Animais
Cicatriz/patologia
Feminino
Geografia
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Masculino
Meia-Idade
Marrocos/epidemiologia
Aceitação pelo Paciente de Cuidados de Saúde
Percepção
Sexismo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189906


  8 / 5615 MEDLINE  
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Marzochi, Mauro Célio de Almeida
Texto completo SciELO Brasil
[PMID]:29211245
[Au] Autor:Brahim LR; Valete-Rosalino CM; Antônio LF; Pimentel MIF; Lyra MR; Paes LEC; Costa ADD; Vieira IF; Dias CMG; Duque MCO; Marzochi MCA; Schubach AO
[Ad] Endereço:Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Rio de Janeiro, RJ, Brasil.
[Ti] Título:Low dose systemic or intralesional meglumine antimoniate treatment for American tegumentary leishmaniasis results in low lethality, low incidence of relapse, and low late mucosal involvement in a referral centre in Rio de Janeiro, Brazil (2001-2013).
[So] Source:Mem Inst Oswaldo Cruz;112(12):838-843, 2017 Dec.
[Is] ISSN:1678-8060
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: American tegumentary leishmaniasis (ATL) is a non-lethal parasitic disease that presents with cutaneous (CL) and mucosal (ML) clinical forms. ATL treatment aims at healing the lesions and preventing the development of the late mucosal form. Systemic meglumine antimoniate (MA) therapy with 10-20 mg Sb5+/kg/day is the first choice of treatment. However, alternative therapies using 5 mg Sb5+/kg/day or intralesional (IL) MA are the usual regimens at the National Institute of Infectious Diseases (NIID), Rio de Janeiro, Brazil. OBJECTIVES: To evaluate lethality and the incidence of relapse and development of late ML in CL patients treated at NIID from 2001 until 2013. METHODS: Data were recovered from records of all ATL patients diagnosed during that period. FINDINGS: Out of 777 patients, 753 were treated with MA (96.9%). Of those, 89.1% received alternative therapy of 9.9% IL and 79.2% systemic 5 mg Sb5+/kg/day. Some patients required 1-3 additional courses of treatment, thus making a total of 997 courses; 85.2% of them were subjected to alternative therapies. Lethality was 0.1%, relapse incidence 5.8%, and late ML incidence 0.25%. As a final outcome for the 777 patients, 95.9% were cured, 0.1% died and 4.0% were not able to follow-up. MAIN CONCLUSIONS: Alternative MA schedules resulted in low lethality without increase of relapse or late ML incidence.
[Mh] Termos MeSH primário: Antiprotozoários/administração & dosagem
Leishmaniose Cutânea/tratamento farmacológico
Meglumina/administração & dosagem
Compostos Organometálicos/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Feminino
Seres Humanos
Incidência
Injeções Intralesionais
Leishmaniose Cutânea/mortalidade
Masculino
Meia-Idade
Recidiva
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiprotozoal Agents); 0 (Organometallic Compounds); 6HG8UB2MUY (Meglumine); 75G4TW236W (meglumine antimoniate)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


  9 / 5615 MEDLINE  
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[PMID]:29240765
[Au] Autor:Ponte-Sucre A; Gamarro F; Dujardin JC; Barrett MP; López-Vélez R; García-Hernández R; Pountain AW; Mwenechanya R; Papadopoulou B
[Ad] Endereço:Department of Physiological Sciences, Laboratory of Molecular Physiology, Institute of Experimental Medicine, Luis Razetti School of Medicine, Universidad Central de Venezuela, Caracas, Venezuela.
[Ti] Título:Drug resistance and treatment failure in leishmaniasis: A 21st century challenge.
[So] Source:PLoS Negl Trop Dis;11(12):e0006052, 2017 Dec.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Reevaluation of treatment guidelines for Old and New World leishmaniasis is urgently needed on a global basis because treatment failure is an increasing problem. Drug resistance is a fundamental determinant of treatment failure, although other factors also contribute to this phenomenon, including the global HIV/AIDS epidemic with its accompanying impact on the immune system. Pentavalent antimonials have been used successfully worldwide for the treatment of leishmaniasis since the first half of the 20th century, but the last 10 to 20 years have witnessed an increase in clinical resistance, e.g., in North Bihar in India. In this review, we discuss the meaning of "resistance" related to leishmaniasis and discuss its molecular epidemiology, particularly for Leishmania donovani that causes visceral leishmaniasis. We also discuss how resistance can affect drug combination therapies. Molecular mechanisms known to contribute to resistance to antimonials, amphotericin B, and miltefosine are also outlined.
[Mh] Termos MeSH primário: Resistência a Medicamentos
Leishmania/efeitos dos fármacos
Leishmania/patogenicidade
Leishmaniose/tratamento farmacológico
[Mh] Termos MeSH secundário: Anfotericina B/farmacologia
Anfotericina B/uso terapêutico
Antiprotozoários/farmacologia
Antiprotozoários/uso terapêutico
Quimioterapia Combinada
Seres Humanos
Leishmania/genética
Leishmania donovani/efeitos dos fármacos
Leishmania donovani/patogenicidade
Leishmaniose/imunologia
Leishmaniose/parasitologia
Leishmaniose Cutânea/tratamento farmacológico
Leishmaniose Visceral/tratamento farmacológico
Leishmaniose Visceral/parasitologia
Epidemiologia Molecular
Fosforilcolina/análogos & derivados
Fosforilcolina/farmacologia
Fosforilcolina/uso terapêutico
Falha de Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antiprotozoal Agents); 107-73-3 (Phosphorylcholine); 53EY29W7EC (miltefosine); 7XU7A7DROE (Amphotericin B)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171224
[Lr] Data última revisão:
171224
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0006052


  10 / 5615 MEDLINE  
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[PMID]:29187956
[Au] Autor:Elmehdi E; Zerkly B
[Ad] Endereço:Service de Traumatologie Orthopedie du Groupe Hospitalier Publique du Sud de l'Oise(GHPSO), bp60100 Creil, France.
[Ti] Título:[Leg ulcer revealing cutaneous leishmaniasis].
[Ti] Título:Ulcère de jambe révélant la leishmaniose cutanée..
[So] Source:Pan Afr Med J;27:287, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:Leishmaniases are parasitic diseases occurring in endemic tropical and subtropical areas and caused by protozoa of the genus leishmania, transmitted by a diptera (sand fly). We here report a case of topical cutaneous leishmaniasis discovered in a 15-year old boy with painless ulcer on his left leg, who had been staying in South Africa. Clinical examination showed painless non-itchy ulcer, occurred 1 month before, on the antero-internal part of his left leg with crusts and scars caused by insect bites, all evolving in a context of patient's general health status, without mucosal or visceral lesions. Skin biopsy allowed specific parasitologic diagnosis revealing topical zoonotic cutaneous leishmaniasis caused by L. major. The patient underwent topical treatment based on paramomycin and oral fluconazole resulting in ulcer healing at the end of 2 months.
[Mh] Termos MeSH primário: Úlcera da Perna/diagnóstico
Leishmaniose Cutânea/diagnóstico
Zoonoses/diagnóstico
[Mh] Termos MeSH secundário: Administração Tópica
Adolescente
Animais
Antiparasitários/administração & dosagem
Biópsia
Fluconazol/administração & dosagem
Seres Humanos
Úlcera da Perna/tratamento farmacológico
Úlcera da Perna/parasitologia
Leishmania major/isolamento & purificação
Leishmaniose Cutânea/tratamento farmacológico
Leishmaniose Cutânea/patologia
Masculino
Paromomicina/administração & dosagem
Resultado do Tratamento
Zoonoses/tratamento farmacológico
Zoonoses/parasitologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiparasitic Agents); 61JJC8N5ZK (Paromomycin); 8VZV102JFY (Fluconazole)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.287.13090



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