Control of sheep gastrointestinal nematodes using the combination of Duddingtonia flagrans and Levamisole Hydrochloride 5% / Controle de nematódeos gastrintestinais de ovinos utilizando a combinação de Duddingtonia flagrans e Cloridrato de Levamisole 5%

Abstract The objective was to evaluate the action of D. flagrans pellets in association with Levamisole Hydrochloride 5% for controlling sheep gastrointestinal nematodes in the northeastern Brazil. Three groups of six sheep each were formed: group 1 received 3 g of the pellets (0.6 g of D. flagrans mycelium) for each 10 kg b.w., twice a week for six months, and deworming with Levamisole Hydrochloride 5% when EPG ≥ 1500; group 2 received a dosage of Levamisole Hydrochloride 5% when EPG ≥ 1500; and group 3 received 3 g of pellets without fungi for each 10 kg b.w., twice a week for six months. EPG counts, larval cultures, packed cell volume (PCV) and weighing were performed every 15 days; monthly, samples of grass from each paddock were collected. The mean EPG of the groups began to statistically differ from day 30 (p < 0.05). Group 1 required less deworming with Levamisole Hydrochloride 5% and showed superiority of PCV values ​​throughout the experiment (p < 0.05). There was a significant reduction (p < 0.05) in L3 recovery in the group 1 paddock from day 30 onwards. The use of D. flagrans pellets in association with Levamisole Hydrochloride 5% was effective for controlling gastrointestinal nematodes.

Resumo O objetivo foi avaliar a ação de péletes de Duddingtonia flagrans em associação ao Cloridrato de Levamisole 5% no controle de nematódeos gastrintestinais de ovinos no Nordeste do Brasil. Foram formados três grupos de seis animais cada: grupo 1 recebeu 3 g de péletes (0,6 g de micélio de D. flagrans) para cada 10 kg p.v., duaz vezes por semana durante seis meses, e vermifugações com Cloridrato de Levamisole 5% quando OPG > 1500; grupo 2 recebeu uma dosagem de Cloridrato de Levamisole 5% quando OPG ≥ 1500; e grupo 3 recebeu 3 g de péletes sem fungos para cada 10 kg de p.v., duas vezes por semana durante seis meses. Contagens de OPG, coproculturas, de volumes globulares (VG) e pesagens foram realizadas a cada 15 dias. Mensalmente, amostras de pasto de cada piquete eram coletadasa. A média de OPG dos grupos começou a diferir estatisticamente a partir do dia 30 (p < 0,05). O grupo 1 necessitou de menos vermifugações com Cloridrato de Levamisole 5% e demonstrou superioridade nos valores de VG durante todo o experimento (p < 0,05). Houve redução significativa (p < 0,05) nas L3 recuperadas no piquete do grupo 1 a partir do dia 30. Em conclusão, a utilização de péletes de D. flagrans em associação ao Cloridrato de Levamisole 5% foi eficaz no controle de nematódeos gastrintestinais de ovinos.

Assessment of serum interleukin-8 as a sensitive serological marker in monitoring the therapeutic effect of levamisole in recurrent aphthous ulcers: A randomized control study.

Aim: The study was designed to evaluate the serum interleukin‑8 (IL‑8) levels in patients with recurrent aphthous ulcer (RAU) and monitor the immunomodulation and altered IL‑8 levels by levamisole before therapy and after levamisole therapy. Materials and Methods: This study was carried as a randomized case‑control study involving a study group of 30 patients diagnosed as RAUs and given levamisole (vermisole 150 mg, od for 1st 3 days of 3 weeks in a month and for 3 months with a gap of 1 week) and these patients were recalled after 3 months and were subjected for estimation of serum IL‑8 levels. Control group had 20 age and sex matched individuals with no systemic illness and were not given any levamisole. Good compliance was reported at the end of the study. Results: Mild gastric irritation was reported and when severe it was managed by H1 blocker. Patients were reviewed after 3 months. The follow‑up data at each visit with respect to each other and to base‑line values was calibrated using a Students t‑test. Highly significant comparisons were obtained in the serum IL‑8 between study and control groups before the onset of levamisole (t = 6.53, P ≤ 0.001). IL‑8 levels reduced by 72% after levamisole was instituted in RAU patients and comparison was highly significant for before and after levamisole onset (t = 5.54, P ≤ 0.001). Conclusion: This study points to the effectiveness of levamisole as an effective adjunct therapy in the routine management of RAU.

Síndrome de Roberts asociado con inmunodeficiencia / Roberts syndrome associated with immunodeficiency

El síndrome de Roberts es una enfermedad genética de transmisión autosómica recesiva extremadamente rara. Se caracteriza clínicamente por retardo pre y posnatal del crecimiento, acortamiento severo de los miembros con defectos radiales, oligodactilia y anomalías craneofaciales, causada por mutación en el gen ESCO2, el cual codifica para una acetiltransferasa involucrada en la regulación de la cohesión de las cromátides hermanas. Hasta donde se conoce, no se ha descrito en este síndrome ningún déficit del sistema inmunológico. Se presenta el caso de un niño de 1 año y medio de edad, con síndrome de Roberts, con procesos infecciosos recurrentes, algunos severos, desde el primer año de vida. En los estudios inmunológicos se observó disminución de los niveles de IgA, del número de linfocitos T CD3 positivos y de los CD4 positivos, con cuantificación normal de células B, así como alteración de la función opsonofagocítica. Se diagnosticó una inmunodeficiencia combinada asociada con un defecto de la fagocitosis. La identificación de una inmunodeficiencia asociada con este síndrome genético sugiere que corresponde con una enfermedad genéticamente heterogénea y la utilidad de la valoración inmunológica en los pacientes con defectos genéticos e infecciones recurrentes

Roberts syndrome is an extremely rare genetic disease of autosomal recessive. It is clinically characterized by pre and postnatal growth delaying, severe limb shortening, radial defects, oligodactyly, and craniofacial anomalies caused by mutation in the ESCO2 gene. This mutation encodes an acetyltransferase involved in regulating cohesion of sister chromatids. To our knowledge, no deficit of the immunological system has been described in this syndrome. We present here, a case of a one year and a half boy, with Roberts syndrome, recurrent infectious processes, some of them severe, since his first year of life. Immunological studies showed decreased levels of IgA, decreased number of CD3 positive T lymphocytes and decreased CD4 positive; they also showed cells with normal B quantification and opsonophagocytic function impairment. A combined immunodeficiency associated with defective phagocytosis was diagnosed. Identifying an immunodeficiency associated with this genetic syndrome suggests that it corresponds to a genetically heterogeneous disease. This also shows the usefulness of the immunological assessment in patients with genetic defects and recurrent infections

Levamisol não previne lesões de estomatite aftosa recorrente: um ensaio clínico randomizado, duplo-cego e controlado por placebo / Levamisole does not prevent lesions of recurrent aphthous stomatitis: a double-blind placebo-controlled clinical trial

OBJETIVO: Avaliar a eficácia e a segurança do levamisol no tratamento profilático da afta recorrente, utilizando um protocolo de estudo duplo-cego. MÉTODOS: Quatorze pacientes receberam doses decrescentes de levamisol por via oral por seis meses (dose inicial de 150mg três vezes por semana). Dez pacientes receberam placebo. As avaliações foram mensais. RESULTADOS: Houve tendência à diminuição do número de crises nos dois grupos, mas sem diferenças entre ambos. O número de lesões diminuiu significantemente nos grupos levamisol e placebo, mas na comparação entre eles a diferença não foi significante. A duração das lesões diminuiu significantemente no grupo placebo, porém ao compará-lo com o grupo levamisol a diferença não foi significante durante todo o tratamento. A intensidade da dor foi significantemente menor nos dois grupos, mas ao compará-los a dor foi significantemente menor no grupo placebo. A avaliação global final mostrou melhora em 50 por cento dos pacientes do grupo levamisol e em 70 por cento do Placebo, sem diferença significante entre os dois tratamentos. Não foi observada diferença na frequência de efeitos colaterais entre os grupos. CONCLUSÃO: Levamisol, como usado nesse protocolo, é uma droga segura. Comparado ao placebo, levamisol não é efetivo no tratamento profilático da afta recorrente. O efeito placebo é importante em desordens nas quais fatores emocionais afetam a recorrência ou a expressão de sintomas.

OBJECTIVE: to utilize a double-blind protocol to provide clarification about the safety and effectiveness of levamisole in the treatment of recurrent aphthous stomatitis. METHODS: Fourteen patients took a decreasing dose of oral levamisole for six months (initial dose 150mg three times a week) and ten others were placebo control patients. All were evaluated monthly. RESULTS: The number of crises had a tendency to decrease in both groups, but without a difference between groups. The number of lesions diminished significantly in the two groups, but upon comparison the difference was not significant. Duration of the lesions diminished significantly in the placebo, however when compared to the levamisole group, difference was not significant during treatment. The intensity of pain was significantly lower in the two groups, but upon comparison, pain was significantly lower in the placebo group. The final global evaluation showed improvement in 50 percent of patients of the levamisole group and in 70 percent of the placebo, without a significant difference between treatments. No difference in the frequency of collateral effects was observed between groups. CONCLUSIONS: Levamisole, as used in this protocol, is a safe drug. When compared with the placebo, levamisole is not effective in the prophylactic treatment of recurrent aphthous stomatitis. The placebo effect is important in diseases where emotional factors affect recurrence or expression of symptoms.

Management of steroid sensitive nephrotic syndrome: revised guidelines.

JUSTIFICATION: In 2001, the Indian Pediatric Nephrology Group formulated guidelines for management of patients with steroid sensitive nephrotic syndrome. In view of emerging scientific evidence, it was felt necessary to review the existing recommendations. PROCESS: Following a preliminary meeting in March 2007, a draft statement was prepared and circulated among pediatric nephrologists in the country to arrive at a consensus on the evaluation and management of these patients. OBJECTIVES: To revise and formulate recommendations for management of steroid sensitive nephrotic syndrome. RECOMMENDATIONS: The need for adequate cortico-steroid therapy at the initial episode is emphasized. Guidelines regarding the initial evaluation, indications for renal biopsy and referral to a pediatric nephrologist are updated. It is proposed that patients with frequently relapsing nephrotic syndrome should, at the first instance, be treated with long-term, alternate-day prednisolone. The indications for use of alternative immunosuppressive agents, including levamisole, cyclophosphamide, mycophenolate mofetil and cyclosporin are outlined. The principles of dietary therapy, management of edema, and prevention and management of complications related to nephrotic syndrome are described. These guidelines, formulated on basis of current best practice, are aimed to familiarize physicians regarding management of children with steroid sensitive nephrotic syndrome.

Dermatopatía asociada a leucoencefalopatía posterior reversible inducida por levamisol / Dermatopathy associated with levamisole induced reversible posterior leukoencephalopathy

Levamisol es una droga antihelmíntica con propiedades inmunomoduladoras que estimula la formación de anticuerpos y aumenta la respuesta T, la respuesta neutrofílica y laquimiotaxis. Se utiliza en dermatología para el tratamiento de verrugas planas, eritema multiforme, úlceras aftosas, vitíligo y,conjuntamente con prednisolona, en el liquen plano.Con el uso prolongado del medicamento se han comunicadoefectos adversos dermatológicos, como erupciones liquenoides,ulceraciones y vasculitis.Comunicamos el caso de una niña de 9 años que desarrolló uncuadro de erupción cutánea y leucoencefalopatía reversible con un tratamiento breve de levamisol pero con dosis elevadas.

Levamisole is an antihelmintic drug that stimulates antibodies formation increasing both T response, and neutrophilic response, and quimiotaxis. It is used in dermatology for the treatment of plane warts, erythema multiforme, aphtous ulcers and, with prednisone, in lichen planus. With prolonged use this drug has been implicated in adverse dermatological reactions as lichenoid eruptions, ulcers and vasculitis. We present a 9-years old girl who developed a cutaneous eruption and a reverse leucoencephalopathy with a short treatment but high doses of the drug.

MONRATE: A descriptive tool for calculation and prediction of re-infection of Ascaris lumbricoides (Ascaridida: Ascarididae)

The study presents an interactive descriptive tool (MONRATE) for calculating and predicting reinfection rates and time of Ascaris lumbricoides following mass chemotherapy. The implementation was based on the theoretical equation published by Hayashi in 1977, for time-prevalence: Y=G [1-(1-X)N-R] as modified by Jong-Yil in 1983. Using the Psuedo-Code of the MONRATE tool, the calculated monthly reinfection rates (X) for the LGAs are (names are locations in Nigeria in a region predominately populated by the Yoruba speaking tribes of Nigeria whose traditional occupations are agriculture and commerce): Ewekoro (1.6 %), Odeda (2.3 %), Ado-odo/Otta (2.3 %), Ogun Waterside (3.8 %) and Obafemi/Owode (4.2 %). The mathematical mean of ‘X’ values in the study areas for Ogun State was 2.84. The calculated reinfection time (N months) for the LGAs are varied such as Ado-odo/Otta (12.7), Ogun Waterside (21.8), Obafemi/Owode (22.92), Odeda (25.45), and Ewekoro (25.9). The mean value for N in Ogun State was 21.75. The results obtained from MONRATE were compared with those obtained using the mathematical equation and found to be the same. Rev. Biol. Trop. 55 (3-4): 755-760. Epub 2007 December, 28.

Se presenta una herramienta descriptiva e interactiva (MONRATE) para calcular y predecir las tasas y tiempo de reinfección con Ascaris lumbricoides tras un tratamiento de quimioterapia. Nos basamos en la ecuación propuesta por Hayashi en 1977 para el tiempo de prevalencia: Y=G [1- (1-X)N-R], según la modificó Jong-Yil en 1983. Utilizando el código Psuedo de la herramienta de MONRATE, las tasas de reinfección mensuales (X) para varios sitios de Nigeria, África, son: Ewekoro (1.6 %), Odeda (2.3 %), Ado-odo/Otta (2.3 %), Ogun Waterside (3.8 %) y Obafemi/ Owode (4.2 %). El promedio matemático de los valores de "X" en el área de estudio del Estado de Ogun fue 2.84. El tiempo de reinfección calculado (N meses) para LGAs es variado: Ado-odo/Otta (12.7), Ogun Waterside (21.8), Obafemi/Owode (22.92), Odeda (25.45) y Ewekoro (25.9). El valor promedio para N en el Estado de Ogun fue 21.75. Los resultados del programa MONRATE son iguales a los producidos por la ecuación.

Parotiditis crónica recidivante con trastornos inmunológicos asociados / Parotiditis chronic recidivante with immune inconveniences associates

En el departamento de ultrasonido diagnóstico fue atendida una paciente, de tres años de edad, que presentaba inflamación de ambas glándulas parótidas y que había presentado varios episodios de dolor, tumefacción unilateral o bilateral y fiebre. Había sido valorada en varias ocasiones por pediatría y había recibido múltiples tratamientos con antibióticos. Se le indicó ultrasonido de partes blandas y se valoró por inmunología. Se encontró un retardo en la fagocitosis y una disminución de la inmunidad celular. Se puso tratamiento con inmunomoduladores y antihistamínicos.

A 3-year-old female patient with swelling of both parotid glands that had presented various episodes of pain, unilateral or bilateral tumefaction and fever was seen at the diagnostic ultrasound department. She had been evaluated on several occasions by the pediatric department and had received multiple treatments with antibiotics. An ultrasound of soft tissues was indicated and she was assessed at the immunology service. A phagocytosis retardation and a reduction of cellular immunity were found. A treatment with immunomodulators and antihistamines was applied.

A case of Moniliformis moniliformis (Acanthocephala) infection in Iran

Only a few cases of Acanthocephala infections have been reported in humans, and Moniliformis moniliformis is the most common species around the world. We report here a case of infection with M. moniliformis, which passed in the stool of a 2-year-old girl in Iran. The patient had abdominal pain, diarrhea, vomiting, and facial edema. According to her mother, the patient had habit of eating dirt and once a cockroach was discovered in her mouth. In stool examination, eggs of M. moniliformis were not found. She was treated with levamisole and the clinical symptoms reduced within 2 weeks. The specimen contained 2 pieces of a female worm with a total length of 148 mm lacking the posterior end. The spiral musculature of the proboscis receptacle and the shape of the trunk allowed its generic determination. Previously 2 cases of M. moniliformis infection were reported in Iran. This is the 3rd case of M. moniliformis infection in Iran.

Difficult-to-treat nephrotic syndrome: management and outcome.

A retrospective study was performed in 68 patients diagnosed as having idiopathic nephrotic syndrome with steroid-dependent, steroid-resistant or frequent relapse subtypes at the Department of Pediatrics, Siriraj Hospital during Jan 1996-Dec 2004. Male to female ratio was 3.3:1 and mean age (+/- SD) was 8.4 +/- 3.5 years. Mean follow up time (+/- SD) was 47.4 +/- 30.5 months. Renal biopsy was done in 60 patients, showing IgM nephropathy in 73.3%. Fifty-four patients (79.4%) received cyclophosphamide at a dose (+/- SD) of 2.2 +/- 0.5 mg/kg/d for 11.6 +/- 3.4 weeks. Negative proteinuria at 1 year was found in 70% and prednisolone was discontinued in 52%. Leucopenia was found in 9.2%. At last follow up, 34% of the patients were still in remission. Enalapril was prescribed in 50 patients for 12.4 +/- 10.0 months. Thirty-six patients also received cyclophosphamide. Remission at 1 year was achieved in 66% and prednisolone discontinued in 28%. Twelve patients (24%) were still in remission at last follow up. The results of 3 regimens: cyclophosphamide, enalapril, and cyclophosphamide plus enalapril were compared using chi-square test. Remission was significantly better in cyclophosphamide group (p = 0.014). Dipyridamole was prescribed in 14 patients due to thrombocytosis. Only 2 of 14 patients achieved remission although 11 patients received cyclophosphamide plus enalapril, and another 2 patients received only cyclophosphamide. Complications included hypertension (44%), cataract (40%), glaucoma (15%), short stature (17.6%), and obesity (5.9%). Recurrent infection was found in 69%, including dental caries (16.29%), urinary tract infection (14.7%), intestinal parasitic infestration (10.3%), respiratory tract infection (8.8%), and skin infection (7.4%). Chronic renal failure was found in 3 patients and portal vein thrombosis was found in 1 patient. We suggest that cyclophosphamide should be used as first line drug in difficult-to-treat nephrotic syndrome patients. Enalapril may be beneficial in some patients. Thrombocytosis may be associated with poor response to both medications. Difficult-to-treat patients also need long-term follow up and surveillance for complications due to disease and/or treatment.

First report of a family with Lynch syndrome type II in Puerto Rico

Colorectal cancer (CRC) incidence in Puerto Rico has increased prodigiously since incidence figures were first recorded in 1950. Implications for hereditary nonpolyposis colorectal cancer (HNPCC) in concert with this increased CRC incidence are discussed. A family with the Amsterdam-positive criteria of the Lynch syndrome II variant, identified in the eastern area of Puerto Rico, is described. As far as we can determine, this is the first such report of this disorder in Puerto Rico

Actualización en liquen plano oral / Update in oral lichen planus

El liquen plano LP es un desorden inflamatorio del epitelio escamoso estratificado relativamente común. Las lesiones pueden afectar la piel y membranas mucosas. El Liquen Plano Oral LPO, usualmente, presenta una morfología y distribución característica, pudiendo mostrar una disposición confusa de patrones y formas de tal manera que otros desórdenes pueden simularlo clínicamente. El LP es probablemente de origen multifactorial, algunas veces es inducido por drogas o materiales dentales, a menudo idiopático y con una inmunopatogénesis que involucra a las células T en particular. La etiopatogénesis parece ser compleja con interaccioes entre factores genéticos, ambientales y de estilo de vida, aunque en la actualidad se han aclarado varios aspectros acerca de los mecanismos involucrados y han surgido nuevas asociaciones interesantes con otras enfermedades. El manejo del LP aún no es satisfactorio, pues hasta ahora no existe un tratamiento definitivo y aunque no hay método curativo disponible, la inmunomodulación puede controlar la condición. Clásicamente se ha considerado como una entidad premaligna, pero estudios recientes sugieren que existe una condición conocida como displasia liquenoide que requiere diagnóstico diferencial con el LP. Se precisa más investigación en los aspectos genéticos, ambientales, potencial maligno, asociación con otros desórdenes y más estudios clínicos acerca de su terapia

Modelo experimental para avaliaçäo da resposta imune em ovinos / Experimental model for immune response evaluation in sheep

O presente trabalho procurou analisar uma metodologia de avaliação da resposta imune em ovinos mantidos em condições experimentais. Foram empregados cinqüenta ovinos adultos divididos em cinco grupos experimentais. Os animais foram tratados com levamisol (grupo I), parapoxvirus (Grupo II) e dexametasona (grupo III). Os grupos IV e V foram usados com controle. A resposta imune celular foi analisada pelo teste da tuberculina após sensibilização prévia pelo BCG. A resposta imune humoral foi analisada pelo teste de soroaglutinação em placa após a sensibilização pela vacina contra a brucelose. A sensibilização prévia de ovinos com BCG e com a vacina contra a brucelose pôde ser posteriormente comprovada, todavia, não foi possível demonstrar diferenças nestas respostas em animais tratados com levamisol, parapoxvirus e dexametasona.

Inmunomoduladores. Respuesta al tratamiento en niños desnutridos menores de 1 año de edad / Immunomodulators. Respose of under one-year old malnourished infants to immunomodulatory therapy

Para valorar la utilidad del uso de inmunomoduladores en el tratamiento de niños desnutridos menores de 1 año de edad, se estudiaron 0 niños ingresados en el Servicio de Nutrición del Hospital Pediátrico Docente "Dr. Ángel Arturo Aballí",entre abril de 1996 y marzo de 1997. Se observó una disminución significativa de la incidencia y gravedad de las intercurrencias infecciosas, después del empleo de inmunomoduladores. Esta reducción se manifestó con mayor intensidad cuando se combinaron varios de ellos. Se obtuvo un incremento conjunto del índice ponderal y del área tímica al concluir la terapéutica. No se encontraron diferencias significativas entre los grupos tratados con factor de transferencia y biomodulina T. De los resultados de este estudio se deriva la importancia de incluir a los inmunomoduladores en el arsenal terapéutico de los niños desnutridos

Tratamento de parasitoses intestinais / Intestinal parasitosis treatment

Os autores apresentam um trabalho de revisão sobre tratamento de parasitoses intestinais, onde expõem de forma racional e adaptada ao nosso meio as parasitoses mais freqüentes. Também relatam os aspectos epidemiológicos e os métodos de diagnóstico laboratorial recomendados de acordo com o parasita. Fazem uma revisão detalhada das drogas antiparasitárias nos seus aspectos farmacológicos e apresentam uma proposta de conduta terapêutica em situações especiais como estrongiloidíase disseminada, neurocisticercose e na sub-oclusão intestinal por ascaridíase (au)

Effect of wide spectrum anti-helminthic drugs upon Schistosoma mansoni experimentally infected mice

Mebendazol, albendazol, levamisol e tiabendazol säo antihelminticos ativos contra diversas espécies de nematodeos. As duas primeiras drogas säo igualmente eficientes no tratamento de infecçöes por cestodeos; todavia, näo apresentam atividade comprovada no caso de infecçöes por trematodeos. No presente trabalho testou-se o efeito desses antihelminticos na recuperaçäo de exemplares adultos S. mansoni, bem como sobre a produçäo e liberaçäo de ovos desse trematodeo, em modelo representado por camundongos experimentalmente infectados. Camundongos Balb/c, infectados com 80 cercarias de S. mansoni, foram divididos em tres lotes e cada um subdividido em quatro grupos, correspondentes a cada droga testada...

Nuevos aportes clínico-patológicos y terapéuticos en leishmaniasis / New development on the clinical, pathological and therapeutics aspects of leishmaniasis

La leshmaniasis es producida por un protozoo, trasmitida por muchos mosquitos hematófagos (Lutzomia brasiliensis), artrópodos (Rhipicephalus turanicus) y probablemente triatomideos (Triatoma infestans, Pansterongilus infestans). En Bolivia existen tres formas de leishmaniasis: cutánea, mucocutánea y visceral, producidas por el mismo agente etiológico, con tres diferentes fases evolutivas relacionadas con mecanismos inmunológicos dependientes de muchos factores. Las tres responden a diversas drogas, a veces inespecíficas, que son empleadas para otras enfermedades (plasmodios, trichomonas, giardias, hongos y bacilos de Koch). Las sales antimoniales pentavalentes son las más comúnmente usadas, con resultados variables, a veces adversos, por su toxicidad, ineficacia ineficiencia y, sobre todo, resistencia y difícil manejo. Se ha demostrado que la L. cutánea tratada con glucantime, anfotericina B y otros presenta posteriormente lesiones mucocutáneas. Por otro lado, leishmaniosos que curaron espontáneamente han mostrado lesiones secundarias en forma ocasional. Lo que demuestra que en esta enfermedad existe una falla inmunológica, razón por la que usamos un inmunomodulador (DECARIS-clorhidrato de levamisol-, que es un antiparasitario), con buenos resultados (95 por ciento de éxito), sobre todo por su bajo costo, uso cómodo y efectos colaterales mínimos. Finalmente concluimos que en el momento actual no existe un leishmanicida eficaz para el tratamiento de esta enfermedad. El tratamiento inmunológico parece ser muy prometedor

Avaliaçäo da reaçäo de Mitsuda em pacientes virchovianos inativos antes e após imunoterapia / Assessment of the Mitsuda reaction in lepromatous patients inactive before and after immunotherapy

Neste estudo investigou-se o potencial imunomodulador do levamisole e da mistura BCG/Mycobacterium leprae em pacientes virchovianos inativos, utilizando como parâmetro a reaçao de Mitsuda. Vinte pacientes, classificados como Mitsuda histologicamente negativos há 10 anos, foram divididos em três grupos: cinco pacientes que foram somente reavaliados frente a mitsudina: oito pacientes que receberam levamisole e, sete que receberam a mistura de BCG vivo mais M. leprae morto. Os resultados mostraram que: 1) o levamisole nao alterou a reatividade à mitsudina em nenhum dos casos estudados; 2) as modificaçoes da reatividade verificadas com o uso da mistura (tres casos) ou aquelas que ocorreram espontaneamente (tres casos) foram sempre de pequena amplitude e refletiram variaçoes próprias de pacientes com algum grau de resistência ao Mycobacterium leprae.