ABSTRACT
O quinino foi o primeiro medicamento correntemente usado para tratar malária, tendo sido abandonado seu emprego principalmente após o início do emprego da cloroquina. A partir da década de 60 com o surgimento de resistência do P. falciparum à cloroquina voltou-se a utilizar o quinino isolado ou em associação para tratar tal infecção. Com o objetivo de avaliar clinicamente a resposta ao quinino de pacientes com malária por P. falciparum, analisamos os prontuários de 484 pacientes atendidos no Laboratório de Malária da SUCEN e acompanhados por pelo menos 28 dias, e que haviam recebido diferentes esquemas terapêuticos com quinino isolado ou em associação. Do total, 81,0% dos pacientes foram curados pelos esquemas empregados, sendo que dos restantes apenas 0,6% foram R2 e nenhum R3. Tais resultados mostram ainda que esquemas contendo quinino podem ser adequados para tratar malária por P. falciparum.
Quinine was the first antimalarial drug to be employed and also the first resistance was noticed to. After 1960 quinine urged to be reintroduced in routine therapy alone or in combination. Aiming at evaluating the effectiveness of different schedules we studied 484 patients seen at the Malaria Laboratory. We used quinine alone in 126 patients, quinine plus sulfadoxine and pyrimethamine in 119 patients and quinine plus tetracycline in 239 patients. The results shown that 81% of all patients were treated with success and only 0.6% were R2. and there is no R3. We emphasize a high resistance rate to quinine either alone (23.1%) or associated to sulfadoxine and pyrimethamine (37.8%). A higher resistance rate seen with the combination might be linked to the smaller dose of quinine used in that instance. It is worth noting the high cure rate with the quinine-tetracycline association.
Subject(s)
Adult , Humans , Antimalarials/administration & dosage , Malaria, Falciparum/drug therapy , Quinine/administration & dosage , Antimalarials/antagonists & inhibitors , Drug Evaluation , Time Factors , Remission Induction , Pyrimethamine/administration & dosage , Drug Therapy, Combination , Quinine/antagonists & inhibitors , Drug Resistance , Sulfadoxine/administration & dosage , Tetracycline/administration & dosageABSTRACT
The frequency and description of side effects secondary to the subcutaneous application of SPf66 malaria vaccine and placebo are reported for each dose of application in the participants of the vaccine efficacy trial in Brazil. Side effects evaluated two hours after each application were detected in 8.0 per cent, 30.2 per cent and 8.8 per cent, for the 1st, 2nd and 3rd dose, respectively, in the SPf66 group, and in 7.0 per cent, 8.5 per cent and 2.9 per cent in the placebo group. Local reactions such as mild inflammation, nodule and pain or erythema frequently accompanied by pruritus were the most common reactions detected in both groups (3.8 per cent, 29.1 per cent and 8.5 per cent in the SPf66 group and 4.0 per cent, 7.6 per cent and 2.5 per cent in the placebo group). Among vaccinees, local side effects after the 2nd dose were more frequent in females. Systemic side effects were expressed mainly through general symptoms referred by the participants and were most frequent after the 1st dose in both groups (4.3 per cent in the SPf66 group and 3.0 per cent in the placebo group). Muscle aches and fever were referred by few participants. No severe adverse reactions were detected for either dose of application or group.
Subject(s)
Male , Middle Aged , Adolescent , Adult , Animals , Child , Female , Humans , Plasmodium falciparum/immunology , Protozoan Proteins/immunology , Malaria Vaccines/adverse effects , Double-Blind MethodABSTRACT
This paper describes the study population and the study design of the phase III field trial of the SPf66 vaccine in Brazil. Assessment of validity and precision principles necessary for the appropriate evaluation of the protective effect of the vaccine are discussed, as well as the results of the preliminary analyses of the gathered data. The analytical approach for the estimation of the protective effect of the vaccine is presented. This paper provides the conceptual framework for future publications.
Subject(s)
Humans , Male , Female , Animals , Adult , Adolescent , Child , Middle Aged , Plasmodium falciparum/immunology , Protozoan Proteins/immunology , Malaria Vaccines/immunology , Vaccines, Synthetic/immunology , Brazil/epidemiology , Clinical Trials, Phase III as Topic , Disease Reservoirs , Malaria, Falciparum/mortality , Malaria, Falciparum/prevention & control , Rural Population/statistics & numerical data , Reproducibility of Results , Research Design , SurvivorsABSTRACT
Faz-se neste trabalho uma revisao critica sobre o uso de antibioticos durante a gestacao. Descrevem-se as alteracoes fisiologicas, proprias da gravidez, dos processos de absorcao, distribuicao, metabolismo e excrecao dos antimicrobianos.Apresentam-se as principais propriedades dos antibioticos que podem ser administrados com seguranca, tanto para a mae como para o feto, durante a gravidez, e discutem-se tambem as caracteristicas daqueles que sao contra-indicados, em determinados periodos ou durante qualquer fase da gestacao