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2.
Rev. chil. pediatr ; 91(5): 749-753, oct. 2020. graf
Article in Spanish | LILACS | ID: biblio-1144274

ABSTRACT

INTRODUCCIÓN: La malaria congénita (MC) es la infección por Plasmodium spp adquirida in útero o durante el parto y sus manifestaciones clínicas son inespecíficas. Puede causar enfermedad grave en la embaraza da y en el recién nacido. OBJETIVO: describir dos casos de MC causados por Plasmodium falciparum, diagnóstico diferencial de sepsis en recién nacidos de gestantes que hayan visitado o residan en áreas endémicas para malaria. CASOS CLÍNICOS: Neonatos de sexo femenino, nacidos en área no endémica para malaria, diagnosticados con sepsis neonatal y tratados con antibióticos sin respuesta clínica. Después de la primera semana de vida la gota gruesa identificó trofozoítos de Plasmodium falciparum y los neonatos recibieron tratamiento con quinina intravenosa con mejoría. Las madres de las recién nacidas tuvieron malaria en el embarazo, una de ellas recibió tratamiento y estaba asintomática y otra tenía malaria complicada al momento del parto. CONCLUSIONES: La MC puede causar enfermedad neonatal grave con manifestaciones clínicas inespecíficas y similares a la sepsis, el tratamiento oportuno disminuye el riesgo de malaria complicada. Es un diagnóstico diferencial en recién nacidos de mujeres con malaria durante el embarazo o gestantes que visiten o residan en áreas endémicas.


INTRODUCTION: Congenital malaria (CM) is a Plasmodium spp infection acquired in utero or during delivery with nonspecific clinical manifestations. Plasmodium falciparum can cause severe illness in pregnant wo men and newborns. OBJECTIVE: to describe two cases of CM caused by Plasmodium falciparum, di fferential diagnosis of sepsis in newborns of pregnant women who live in or have visited endemic malaria zones. CLINICAL CASES: Female neonates born in a non-endemic malaria area, diagnosed with neonatal sepsis and treated with antibiotics without clinical response. After the first week of life, the peripheral blood smear identified trophozoites of Plasmodium falciparum thus the newborns were treated with intravenous quinine, improving their condition. The mothers of the two newborns who had malaria in pregnancy, one of them received treatment and she was asymptomatic, and the other one had severe malaria at the time of delivery. CONCLUSIONS: CM can cause severe neonatal disease with non-specific, sepsis-like clinical manifestations in which early treatment decreases the risk of complicated malaria. It is a differential diagnosis in newborns of women with a history of malaria during pregnancy or pregnant women visiting or living in endemic malaria areas.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Young Adult , Malaria, Falciparum/congenital , Malaria, Falciparum/diagnosis , Pregnancy Complications, Parasitic/diagnosis , Pregnancy Complications, Parasitic/drug therapy , Neonatal Sepsis/diagnosis , Malaria, Falciparum/transmission , Infectious Disease Transmission, Vertical , Diagnosis, Differential , Neonatal Sepsis/parasitology , Antimalarials/therapeutic use
3.
Brasília; s.n; 17 jun. 2020.
Non-conventional in Portuguese | PIE, LILACS, BRISA, PIE | ID: biblio-1100423

ABSTRACT

O Informe Diário de Evidências é uma produção do Ministério da Saúde que tem como objetivo acompanhar diariamente as publicações científicas sobre tratamento farmacológico e vacinas para a COVID-19. Dessa forma, são realizadas buscas estruturadas em bases de dados biomédicas, referente ao dia anterior desse informe. Não são incluídos estudos pré-clínicos (in vitro, in vivo, in silico). A frequência dos estudos é demonstrada de acordo com a sua classificação metodológica (revisões sistemáticas, ensaios clínicos randomizados, coortes, entre outros). Para cada estudo é apresentado um resumo com avaliação da qualidade metodológica. Essa avaliação tem por finalidade identificar o grau de certeza/confiança ou o risco de viés de cada estudo. Para tal, são utilizadas ferramentas já validadas e consagradas na literatura científica, na área de saúde baseada em evidências. Cabe ressaltar que o documento tem caráter informativo e não representa uma recomendação oficial do Ministério da Saúde sobre a temática. Foram encontrados 15 artigos.


Subject(s)
Humans , Pneumonia, Viral/drug therapy , Coronavirus Infections/drug therapy , Betacoronavirus/drug effects , Technology Assessment, Biomedical , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Heparin/therapeutic use , Lincomycin/therapeutic use , Azithromycin/therapeutic use , Ritonavir/therapeutic use , Angiotensin II Type 2 Receptor Blockers/therapeutic use , Lopinavir/therapeutic use , Interferon beta-1a/therapeutic use , Interferon beta-1b/therapeutic use , Interferon alpha-2/therapeutic use , Hydroxychloroquine/therapeutic use , Medicine, Chinese Traditional , Anti-Bacterial Agents/therapeutic use , Antimalarials/therapeutic use , Nitric Oxide/therapeutic use
4.
Brasília; s.n; 13 maio 2020.
Non-conventional in Portuguese | PIE, LILACS, BRISA, PIE | ID: biblio-1097393

ABSTRACT

Essa é uma produção do Departamento de Ciência e Tecnologia (Decit) da Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde (SCTIE) do Ministério da Saúde (Decit/SCTIE/MS), que tem como missão promover a ciência e tecnologia e o uso de evidências científicas para a tomada de decisão do SUS, tendo como principal atribuição o incentivo ao desenvolvimento de pesquisas em saúde no Brasil, de modo a direcionar os investimentos realizados em pesquisa pelo Governo Federal às necessidades de saúde pública. Informar sobre as principais evidências científicas descritas na literatura internacional sobre tratamento farmacológico para a COVID-19. Além de resumir cada estudo identificado, o informe apresenta também uma avaliação da qualidade metodológica e a quantidade de artigos publicados, de acordo com a sua classificação metodológica (revisões sistemáticas, ensaios clínicos randomizados, entre outros). Foram encontrados 15 artigos e 10 protocolos.


Subject(s)
Pneumonia, Viral/drug therapy , Coronavirus Infections/drug therapy , Betacoronavirus/drug effects , Renin-Angiotensin System , Ribavirin/therapeutic use , Steroids/therapeutic use , Technology Assessment, Biomedical , Methylprednisolone/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Sulbactam/therapeutic use , Cefoperazone/therapeutic use , Chloroquine/therapeutic use , Plasmapheresis/instrumentation , Adrenal Cortex Hormones/therapeutic use , Azithromycin/therapeutic use , Disease Progression , Ritonavir/therapeutic use , Lopinavir/therapeutic use , Glucocorticoids/therapeutic use , Hydroxychloroquine/therapeutic use , Anticoagulants/therapeutic use , Antimalarials/therapeutic use
5.
Mem. Inst. Oswaldo Cruz ; 115: e200229, 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1135249

ABSTRACT

Malaria and tuberculosis are no longer considered to be neglected diseases by the World Health Organization. However, both are huge challenges and public health problems in the world, which affect poor people, today referred to as neglected populations. In addition, malaria and tuberculosis present the same difficulties regarding the treatment, such as toxicity and the microbial resistance. The increase of Plasmodium resistance to the available drugs along with the insurgence of multidrug- and particularly tuberculosis drug-resistant strains are enough to justify efforts towards the development of novel medicines for both diseases. This literature review provides an overview of the state of the art of antimalarial and antituberculosis chemotherapies, emphasising novel drugs introduced in the pharmaceutical market and the advances in research of new candidates for these diseases, and including some aspects of their mechanism/sites of action.


Subject(s)
Humans , Tuberculosis/drug therapy , Malaria/drug therapy , Antimalarials/therapeutic use , Antitubercular Agents/therapeutic use , Tuberculosis/diagnosis , Neglected Diseases , Malaria/diagnosis
6.
Rev. cuba. med. trop ; 71(2): e350, mayo.-ago. 2019. graf
Article in English | LILACS, CUMED | ID: biblio-1093563

ABSTRACT

It has been demonstrated that proteases play crucial roles in Plasmodium falciparum infection and therefore have been considered as targets for the development of new therapeutic drugs. The aim of this study was to describe the specific proteolytic activity profile in all blood stages of P. falciparum isolated parasites in order to explore new antimalarial options. For this purpose, we used the fluorogenic substrate Z-Phe-Arg-MCA (Z: carbobenzoxy, MCA: 7-amino-4-methyl coumarine) and classic inhibitors for the different classes of proteolytic enzymes, such as phenylmethylsulfonyl fluoride (PMSF), 1.10-phenantroline, pepstatin A and E64 to study the inhibition profiles. As expected, due to the high metabolic activity in mature stages, the substrate was mostly degraded in the trophozoite and schizont, with specific activities ~ 20 times higher than in early stages (merozoite/rings). The major actors in substrate hydrolysis were cysteine proteases, as confirmed by the complete hydrolysis inhibition with E64 addition. Proteolytic activity was also inhibited in the presence of PMSF in all but the schizont stage. However, PMSF inhibition was the result of unspecific interaction with cysteine proteases as demonstrated by reversion of inhibition by dithiotreitol (DTT), indicating that serine protease activity is very low or null. To our knowledge, this is the first report aiming to describe the proteolytic profile of P. falciparum isolated parasites at all the erythrocytic cycle stages. The results and protocol described herein can be useful in the elucidation of stage specific action of proteolysis-inhibiting drugs and aid in the development of antimalarial compounds with protease inhibitory activity(AU)


e ha demostrado que las proteasas desempeñan funciones vitales en la infección por Plasmodium falciparum, y por lo tanto se consideran dianas en la elaboración de nuevos medicamentos terapéuticos. El objetivo del estudio era describir el perfil de actividad proteolítica específica de todas las etapas sanguíneas de parásitos aislados de P. falciparum con vistas a explorar nuevas opciones antimaláricas. Con ese propósito, utilizamos el sustrato fluorogénico Z-Phe-Arg-AMC (Z: carbobenzoxi, AMC: 7-amino-4-metilcumarina) e inhibidores clásicos para las diferentes clases de enzimas proteolíticas, tales como el fluoruro de fenilmetilsulfonilo (PMSF), 1,10-fenantrolina, pepstatina A y E64 para estudiar los perfiles de inhibición. Como se esperaba, debido a la elevada actividad metabólica de las etapas de madurez, el sustrato fue degradado mayormente en el trofozoíto y el esquizonte, con actividad específica ~ 20 veces superior a la de las etapas tempranas (merozoíto/ anillos). Los principales actores en la hidrólisis del sustrato fueron las cisteínas proteasas, lo que fue confirmado por la inhibición completa de la hidrólisis con la adición de E64. La actividad proteolítica también fue inhibida en presencia de PMSF en todas las etapas excepto el esquizonte. Sin embargo, la inhibición del PMSF fue resultado de una interacción inespecífica con las cisteínas proteasas, según lo demuestra la reversión de la inhibición con el ditiotreitol (DTT), lo que indica que la actividad de la serina proteasa es muy baja o inexistente. Que sepamos, este es el primer informe dirigido a describir el perfil proteolítico de parásitos aislados de P. falciparum en todas las etapas del ciclo eritrocítico. Los resultados y el protocolo que aquí se describen pueden ser útiles para dilucidar la acción específica de los medicamentos inhibidores de proteólisis en cada etapa, así como contribuir al desarrollo de compuestos antimaláricos con actividad inhibidora de la proteasa(AU)


Subject(s)
Humans , Peptide Hydrolases/therapeutic use , Plasmodium falciparum/metabolism , Antimalarials/therapeutic use
7.
Rev. Soc. Bras. Med. Trop ; 52: e20170412, 2019. tab, graf
Article in English | LILACS | ID: biblio-1041539

ABSTRACT

Abstract INTRODUCTION Uric acid is one of the compounds associated with the inflammatory process in malaria. It acts as an indicator of cellular damage by activating the immune response and inflammatory process. METHODS: We measured serum concentrations of uric acid in 60 symptomatic patients before and after treatment for malarial infections caused by Plasmodium vivax. RESULTS: Lower serum concentrations of uric acid were found during the acute phase of P. vivax malaria compared to those in its convalescent phase (p < 0.0001). CONCLUSIONS: Patients in the acute phase of malaria had lower uric acid levels than those in its convalescent phase.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Aged , Young Adult , Uric Acid/blood , Malaria, Vivax/blood , Antimalarials/therapeutic use , Biomarkers/blood , Acute Disease , Malaria, Vivax/drug therapy , Middle Aged
8.
Rev. Soc. Bras. Med. Trop ; 52: e20180453, 2019. tab, graf
Article in English | LILACS | ID: biblio-1041531

ABSTRACT

Abstract INTRODUCTION: Concern regarding the cardiotoxicity of antimalarials has been renewed because of their potential to cause QT/QTc interval prolongation related to torsade de pointes (TdP). Artemisinin-piperaquine (AP) is considered an effective artemisinin-based combination therapy (ACT) for malaria. METHODS: This study involved a retrospective analysis of clinical data of 93 hospitalized malaria patients who had received AP orally. Electrocardiograms (ECGs) were obtained at specific time points in the original study. RESULTS: Some cases of QT prolongation were observed. However, no TdP was found. CONCLUSIONS: AP may cause QT interval prolongation in some malaria patients but may not lead to TdP.


Subject(s)
Humans , Male , Female , Adult , Quinolines/adverse effects , Long QT Syndrome/chemically induced , Malaria, Falciparum/drug therapy , Artemisinins/adverse effects , Antimalarials/adverse effects , Quinolines/therapeutic use , Long QT Syndrome/diagnosis , Retrospective Studies , Artemisinins/therapeutic use , Drug Therapy, Combination , Electrocardiography , Middle Aged , Antimalarials/therapeutic use
9.
Rev. Soc. Bras. Med. Trop ; 52: e20190163, 2019.
Article in English | LILACS | ID: biblio-1041528

ABSTRACT

Abstract Artemisinin-based combination therapy (ACT) is recommended by the World Health Organization for the treatment of uncomplicated malaria. Currently, there appears to be a downward trend in the efficacy of ACT in some parts of sub-Saharan Africa because some patients have been positive for Plasmodium parasite 3 days after artemether-lumefantrine treatment. We reported three cases of possible parasite resistance to artemether-lumefantrine therapy. All subjects had complete parasite clearance when treated with other antimalarial drugs. This observation necessitates the urgent need to re-evaluate artemether-lumefantrine medication in Nigeria since it is one of the most commonly used ACT drug.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Malaria, Falciparum/drug therapy , Artemether, Lumefantrine Drug Combination/therapeutic use , Antimalarials/therapeutic use , Treatment Failure , Artemether, Lumefantrine Drug Combination/adverse effects , Middle Aged , Antimalarials/adverse effects
10.
Rev. Soc. Bras. Med. Trop ; 52: e20190014, 2019. tab
Article in English | LILACS | ID: biblio-1041595

ABSTRACT

Abstract INTRODUCTION: Malaria is the main cause of death by infection among travelers and is preventable through a combination of chemoprophylaxis and personal protective measures. METHODS: Travelers were interviewed by phone 28-90 days after returning, to assess adherence to pre-travel advice for malaria prevention. RESULTS: A total 57 travelers were included. Adherence to chemoprophylaxis was significantly higher among participants prescribed mefloquine (n=18; 75%) than doxycycline (n=14; 45%). Adherence to mosquito repellent and bed net use was 65% and 67%, respectively. CONCLUSIONS: Adherence to malaria prophylaxis was lower than expected. Further studies testing innovative approaches to motivate travelers' compliance are required.


Subject(s)
Humans , Male , Female , Adult , Mefloquine/therapeutic use , Doxycycline/therapeutic use , Medication Adherence/statistics & numerical data , Pre-Exposure Prophylaxis/statistics & numerical data , Malaria/prevention & control , Malaria/drug therapy , Antimalarials/therapeutic use , Travel , Middle Aged
11.
Rev. cuba. med ; 57(2)abr.-jun. 2018. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-985556

ABSTRACT

La glomerulonefritis colapsante es una enfermedad poco frecuente que puede estar asociada a distintas causas, una de ellas son las enfermedades autoinmunes y dentro de estas el lupus eritematoso sistémico (LES). De manera frecuente se presenta con un cuadro de severas alteraciones renales que tienden a progresar la enfermedad renal terminal, con escasa respuesta a los tratamientos. Se presenta un caso de glomerulonefritis colapsante asociado a lupus eritematoso sistémico que tuvo una respuesta completa al tratamiento de inducción con la combinación de glucocorticoides, antimaláricos y mofetil micofenolato iniciado precozmente por el diagnóstico temprano realizado por biopsia renal(AU)


Collapsing glomerulonefritis is a slightly frequent disease that can be associated to different causes. Autoimmune diseases are part of those, and inside these, the systemic lupus erythematosus (SLE). It frequently appears with manifestations of severe renal alterations that tend to develop the renal terminal disease, with scanty response to the treatments. It is presented a case of collapsing glomerulonefritis associated to systemic lupus erythematosus that had a complete response to the treatment of induction with the combination of glucocorticoids, antimalarials and mycophenolate mofetil used prematurely after the early diagnosis performed by renal biopsy(AU)


Subject(s)
Humans , Biopsy/methods , Glomerulonephritis/etiology , Glucocorticoids/therapeutic use , Lupus Erythematosus, Systemic , Mycophenolic Acid/therapeutic use , Antimalarials/therapeutic use
12.
Rev. cuba. salud pública ; 44(2)abr.-jun. 2018. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1042976

ABSTRACT

Introducción: La malaria constituye la primera causa de morbilidad y mortalidad en Angola y se desconocen las características de la prescripción de antipalúdicos en los hospitales. Objetivo: Caracterizar la prescripción de antipalúdicos en pacientes internados en hospitales centrales y provinciales de Angola. Método: Estudio de Utilización de Medicamentos, tipo indicación-prescripción, con elementos de esquema terapéutico. La muestra fue de 2 634 pacientes. La variable principal: evaluación de la prescripción, se operacionalizó como adecuada o no en función de la indicación, pauta terapéutica y contraindicaciones. Resultados: Predominó la malaria complicada (66,6 por ciento) y el sexo femenino en niños (51,7 por ciento) y adultos (51,0 por ciento). Se indicaron 4 518 prescripciones. La quinina endovenosa (20,4 por ciento) fue el tratamiento más utilizado en la malaria complicada y la quinina tabletas (26,5 por ciento) en la malaria simple. El 94,8 por ciento de las prescripciones no presentaron contraindicaciones, mientras que el 69,0 por ciento fueron adecuadas en su selección y el 65,1 por ciento en la pauta terapéutica. La evaluación de la prescripción resultó ser adecuada (55,0 por ciento). La malaria complicada presentó mayor número de prescripciones no adecuadas (47,5 por ciento). Conclusiones: Existe prescripción irracional de antipalúdicos, con mayor repercusión en la malaria complicada. Persiste una baja utilización de derivados de la artemisina, por lo que se incumple lo establecido en la Guía de Tratamiento de la Malaria(AU)


Introduction: The characteristics of the prescription of antimalarials in hospitals, where malaria is the first cause of mortality and morbidity, are unknown. Objective: To characterize the prescription of antimalarials in patients admitted to central and provincial hospitals in Angola. Methods: A Study of Drug's Use was made, type indication-prescription, with elements of a therapeutic scheme. The sample was of 2 634 patients. The main variable (evaluation of the prescription) was operationalized in adequate or not according to the indication, therapeutic guideline and contraindications. Absolute frequency and percentage were used as summary measures. Results: The most represented patients were adults (54.1 percent) and those admitted in general hospitals (82.6 percent). Complicated malaria was predominant (66.6 percent) and female sex in children (51.7 percent) and adults (51.0 percent). There were 4 518 prescriptions. Intravenous quinine (20.4 percent) was the most used treatment in complicated malaria and quinine tablets (26.5 percent) in simple malaria. 94.8 percent of the prescriptions had no contraindications, while 69.0 percent were adequate in their selection and 65.1 percent in the therapeutic regimen. The evaluation of the prescription was adequate (55.0 percent). Complicated malaria had a greater number of inappropriate prescriptions (47.5 percent). Conclusions: The existence of irrational prescription of antimalarials is evidenced with more repercussion in complicated malaria. There is still a low use of artemisinin derivatives, in breach of the Guide for Malaria's Treatment(AU)


Subject(s)
Humans , Male , Female , Artemisinins/therapeutic use , Hospitals , Malaria/mortality , Antimalarials/therapeutic use , Epidemiology, Descriptive , Cross-Sectional Studies , Angola
13.
Rev. Soc. Bras. Clín. Méd ; 16(1): 2-6, 20180000. tab, ilus
Article in Portuguese | LILACS | ID: biblio-884974

ABSTRACT

OBJETIVO: Avaliar se o bem-estar global de pacientes com lúpus eritematoso sistêmico é afetado pelo uso de antimaláricos. MÉTODOS: Estudo transversal observacional analítico, realizado com 118 indivíduos do sexo feminino, sendo que 51 faziam uso de antimaláricos por, no mínimo, 2 anos (Grupo 1), 17 não utilizavam esse método terapêutico (Grupo 2) e 50 não tinham lúpus eritematoso sistêmico (Grupo 3). Dados epidemiológicos, clínicos e sorológicos das pacientes lúpicas foram obtidos por meio da análise de prontuários médicos, e a qualidade de vida foi avaliada pelo questionário Medical Outcomes Study Short-Form Health Survey version 2 (SF-12v2). RESULTADOS: O uso de antimaláricos foi associado à menor ocorrência de psicose e lesões renais, apesar de levar a uma frequência maior de convulsões. Quanto à percepção individual da qualidade de vida, não houve diferença significativa entre os três grupos. Porém, quando considerado o tabagismo entre as usuárias de antimaláricos, o SF-12v2 de saúde mental de fumantes foi menor do que de não fumantes. CONCLUSÃO: Pacientes lúpicas em uso de antimaláricos tiveram menor incidência de psicose e glomerulonefrite, mas não houve diferença significativa em relação à qualidade de vida e ao uso de antimaláricos, com exceção de fumantes em uso da medicação, que tiveram escore do SF-12v2 de saúde mental menor do que não fumantes em uso da mesma medicação.(AU)


OBJECTIVE: To evaluate whether global quality of life of Systemic Lupus Erythematosus patients is affected by the use of antimalarials. METHODS: This is an observational, analytical cross-sectional study carried out with 118 female individuals, of whom 51 have been on antimalarials for at least 2 years (group 1), 17 were not using this therapy (group 2), and 50 did not have Systemic Lupus Erythematosus (group 3). Epidemiological, clinical and serological data of Systemic Lupus Erythematosus patients were obtained through the review of medical records, and quality of life was assessed using the SF-12 questionnaire. RESULTS: Antimalarial use was associated with a lower occurrence of psychosis and renal lesions, although it led to a higher prevalence of seizures. Regarding the individual perception of quality of life, there was no significant difference among the 3 groups. However, when smoking habits were considered among antimalarial users, mental health score in the SF-12 was lower in smokers than in non-smokers. CONCLUSION: Systemic Lupus Erythematosus female patients using antimalarials had a lower incidence of psychosis and glomerulonephritis, but no significant differences were found regarding antimalarial use and quality of life, except for the group of smokers using antimalarials, who had lower mental scores in the SF-12 than non-smokers using the same medication.(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Antimalarials/therapeutic use , Chloroquine/therapeutic use , Hydroxychloroquine/therapeutic use , Lupus Erythematosus, Systemic/drug therapy , Quality of Life
14.
Rev. Hosp. Ital. B. Aires (2004) ; 37(4): 157-159, dic. 2017. ilus
Article in Spanish | LILACS | ID: biblio-1096381

ABSTRACT

El eritema polimorfo solar es la fotodermatosis más frecuente y suele aparecer en primavera con la primera exposición intensa al sol. Sus manifestaciones cutáneas son variadas y el diagnóstico se basa en la clínica junto al antecedente de exposición solar. En los casos leves, la fotoprotección suele ser suficiente para el control de la enfermedad, pero en formas más graves se requieren otras terapéuticas, como corticoides, antihistamínicos, o fototerapia, que genera una "fotoadaptación" de las áreas de piel afectadas. Presentamos un caso típico de erupción polimorfa solar que respondió de forma adecuada a medidas de fotoprotección. (AU)


The polymorphic solar eruption is the most frequent photodermatosis, and usually appears in spring with the first intense exposure to the sun. It has multiple cutaneous manifestations, and its diagnosis is based on the clinic and the antecedent of solar exposition. In mild cases, photoprotection is usually enough to control the disease, but in more severe forms, other therapies are required, such as corticosteroids, antihistamines, or phototherapy to generate a "photo-adaptation" of the affected skin areas. We present a typical case of polymorphic solar eruption that responded adequately to photoprotection measurements. (AU)


Subject(s)
Humans , Female , Adult , Photosensitivity Disorders/diagnosis , Sunlight/adverse effects , Erythema/diagnosis , Phototherapy , Photosensitivity Disorders/immunology , Photosensitivity Disorders/pathology , Quality of Life , Seasons , Sunscreening Agents/therapeutic use , Azathioprine/therapeutic use , Thalidomide/therapeutic use , Ultraviolet Rays/adverse effects , Ultraviolet Therapy , Adrenal Cortex Hormones/therapeutic use , Cholecalciferol/therapeutic use , Erythema/etiology , Erythema/immunology , Erythema/pathology , Histamine Antagonists/therapeutic use , Antimalarials/therapeutic use
15.
Rev. panam. salud pública ; 41: e100, 2017. tab
Article in English | LILACS | ID: biblio-961682

ABSTRACT

ABSTRACT Objective To identify factors associated with timely treatment of malaria in the Brazilian Amazon. Malaria, despite being treatable, has proven difficult to control and continues to be an important public health problem globally. Brazil accounted for almost half of the 427 000 new malaria cases notified in the Americas in 2013. Methods This was a cross-sectional study using secondary data on all notified malaria cases for the period from 2004 - 2013. Timely treatment was considered to be all treatment started within 24 hours of symptoms onset. Multivariate logistic regression was used to identify independent factors associated with timely treatment. Results The proportion of cases starting treatment on a timely basis was 41.1%, tending to increase in more recent years (OR = 1.40; 95%CI: 1.37 - 1.42 in 2013). Furthermore, people starting within < 24 hours were more likely to: reside in the states of Rondônia (OR = 1.50; 95%CI: 1.49 - 1.51) or Acre (OR = 1.53; 95%CI: 1.55 - 1.57); be 0 - 5 years of age (OR = 1.39; 95%CI: 1.34 - 1.44) or 6 - 14 years of age (OR = 1.34; 95%CI: 1.32 - 1.36); be indigenous (OR = 1.41; 95%CI: 1.37 - 1.45); have a low level of schooling (OR = 1.20; 95%CI: 1.19 - 1.22); and be diagnosed by active detection (OR = 1.39; 95%CI: 1.38 - 1.39). Conclusion In the Brazilian Amazon area, individuals were more likely to have timely treatment of malaria if they were young, residing in Acre or Rondônia states, have little schooling, and be identified through active detection. Identifying groups vulnerable to late treatment is important for preventing severe cases and malaria deaths.


RESUMEN Objetivo Determinar los factores asociados con el tratamiento oportuno de la malaria en la Amazonia brasileña. La malaria, a pesar de que es tratable, ha resultado difícil de controlar y sigue siendo un problema importante de salud pública mundial. En Brasil se notificaron casi la mitad de los 427 000 nuevos casos de malaria en la Región de las Américas en el 2013. Métodos Se realizó un estudio transversal que utilizó datos secundarios de todos los casos notificados de malaria en el período 2004-2013. Se entendió como tratamiento oportuno todo tratamiento iniciado en las 24 horas posteriores a la aparición de los síntomas. Para determinar los factores independientes asociados con el tratamiento oportuno, se usó el método de regresión logística multifactorial. Resultados La proporción de casos en los que se inició el tratamiento oportunamente fue de 41,1%, con una tendencia ascendente en los últimos años (razón de posibilidades [OR] = 1,40; IC 95%: 1,37 - 1,42 en el 2013). Además, en las personas que comenzaron el tratamiento menos de 24 horas después de la aparición de los síntomas era mayor la probabilidad de que residieran en los estados de Rondônia (OR = 1,50; IC 95%: 1,49 - 1,51) o Acre (OR = 1,53; IC 95%: 1,55 - 1,57); también era mayor la probabilidad de que tuvieran entre 0 y 5 años (OR = 1,39; IC 95%: 1,34 - 1,44) o entre 6 y 14 años (OR = 1,34; IC 95%: 1,32 - 1,36); fueran indígenas (OR = 1,41; IC 95%: 1,37 - 1,45); tuvieran un nivel bajo de escolarización (OR = 1,20; IC 95%: 1,19 - 1,22) y hubieran sido diagnosticadas por detección activa (OR = 1,39; IC 95%: 1,38 - 1,39). Conclusiones En la zona de la Amazonia brasileña, era más probable que las personas que iniciaban oportunamente el tratamiento contra la malaria fueran jóvenes, residieran en los estados de Acre o Rondônia, tuvieran un nivel bajo de escolarización y fueran detectadas mediante la detección activa. La identificación de los grupos vulnerables al tratamiento tardío es importante para prevenir los casos graves y las muertes por malaria.


RESUMO Objetivo Identificar os fatores associados ao tratamento precoce da malária na Amazônia brasileira. Embora seja tratável, a malária tem sido difícil de controlar e continua a representar um importante problema de saúde pública em escala mundial. Em 2013, o Brasil registrou quase a metade dos 427.000 novos casos de malária notificados nas Américas. Métodos Este foi um estudo transversal que utilizou dados secundários sobre todos os casos de malária notificados no período de 2004 a 2013. O tratamento precoce foi definido como todo tratamento iniciado nas primeiras 24 horas desde o surgimento dos sintomas. Utilizamos a regressão logística multivariada para identificar fatores independentes associados ao tratamento precoce. Resultados A proporção de casos que iniciaram tratamento precoce foi de 41,1%, tendendo a aumentar em anos mais recentes (odds ratio [OR] = 1,40; IC 95%: 1,37 - 1,42 em 2013). Além disso, as pessoas que iniciaram o tratamento em menos de 24 horas tiveram maior probabilidade de: residir nos estados de Rondônia (OR = 1,50; IC 95%: 1,49 - 1,51) ou Acre (OR = 1,53; IC 95%: 1,55 - 1,57); ter entre 0 e 5 anos de idade (OR = 1,39; IC 95%: 1,34 - 1,44) ou entre 6 e 14 anos de idade (OR = 1,34; IC 95%: 1,32 - 1,36); ser indígena (OR = 1,41; IC 95%: 1,37 - 1,45); ter um baixo nível de escolaridade (OR = 1,20; IC 95%: 1,19 - 1,22); e ser diagnosticado por meio da detecção ativa (OR = 1,39; IC 95%: 1,38 - 1,39). Conclusão Na região da Amazônia brasileira, as pessoas têm uma maior probabilidade de receber tratamento precoce para a malária se forem jovens, residirem nos estados do Acre ou de Rondônia, tiverem um baixo nível de escolaridade e forem identificadas através da detecção ativa. A identificação de grupos vulneráveis ao tratamento tardio é importante para prevenir os casos graves e as mortes decorrentes da malária.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Cross-Sectional Studies , Malaria/therapy , Antimalarials/therapeutic use , Brazil/epidemiology
16.
An. bras. dermatol ; 91(5,supl.1): 87-89, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837963

ABSTRACT

Abstract Lupus tumidus is considered a rare subtype of chronic cutaneous lupus erythematosus, characterized by erythema and bright urticarial erythematous-violaceous lesions that leave no scars after regression. Histopathology reveals perivascular and periannexal lymphohistiocytic infiltrates in the papillary and reticular dermis and interstitial mucin deposition. Treatment is based on photoprotection, topical corticosteroids and antimalarials. We report two cases of lupus tumidus, which deserve attention for their low frequency in the literature, in addition to their relevance as a differential diagnosis among dermatologic disorders.


Subject(s)
Humans , Female , Middle Aged , Skin/pathology , Lupus Erythematosus, Cutaneous/pathology , Biopsy , Lupus Erythematosus, Cutaneous/drug therapy , Prednisone/therapeutic use , Chloroquine/therapeutic use , Treatment Outcome , Glucocorticoids/therapeutic use , Mucins , Antimalarials/therapeutic use
17.
Rev. chil. infectol ; 33(4): 468-471, ago. 2016.
Article in Spanish | LILACS | ID: biblio-830117

ABSTRACT

Relapsing Plasmodium vivax malaria is due to activation of dormant intrahepatic parasitic forms known as hypnozoits. Primaquine is the only available drug effective against hypnozoits and, alongside a schizonticidal drug, constitutes the radical treatment of malaria. Failure of radical treatment is frequently attributed to inadequate dosing, poor adherence, or reinfection. However, several cases of radical treatment failure without these factors have been reported, inferring that metabolic properties of the host or tolerance mechanisms of the parasite may be implied. A case of malaria due to Plasmodium vivax acquired in the Amazonic region, treated outside endemic area, with multiple relapses despite adequate radical treatment is described.


La infección por Plasmodium vivax se caracteriza por la formación de hipnozoítos que permanecen quiescentes en los hepatocitos del hospedero y son responsables de las recaídas de la malaria. Primaquina es el único fármaco en uso para la erradicación de los hipnozoítos y asociado a un agente esquizonticida, constituye el tratamiento radical. Las fallas al tratamiento radical están relacionados con una dosificación subóptima, adherencia inadecuada y reinfección. Sin embargo, cuando estos factores están ausentes, se han postulado mecanismos propios del metabolismo del hospedero y de tolerancia del parásito. Se describe un caso de malaria por P. vivax adquirido en la región amazónica asistido fuera de la zona endémica, con múltiples recaídas a pesar del tratamiento radical adecuado.


Subject(s)
Humans , Male , Adult , Plasmodium vivax , Mefloquine/therapeutic use , Malaria, Vivax/drug therapy , Antimalarials/therapeutic use , Recurrence , Treatment Failure
18.
Journal of the Egyptian Society of Parasitology. 2016; 46 (1): 35-48
in English | IMEMR | ID: emr-180158

ABSTRACT

The majority of world's population-live in areas at risk of malaria transmission. Malaria is a serious Anopheles-borne disease that causes symptoms like the flu, as a high fever, chills, and muscle pain also, anemia, bloody stools, coma, convulsion, fever, headache, jaundice, nausea, sweating and vomiting. Symptoms tend to come and go in cycles. Apart from Anopheles vector, malaria could be transmitted nosocomial, blood transfusion or needle-stick injury Some types of malaria may cause more serious damage problems to heart, lungs, kidneys, or brain. These types can be deadly. The primary factors contributing to the resurgence of malaria are the appearance of drug-resistant strains of the parasite, the spread of insecticideresistant strains of the mosquito and the lack of licensed malaria vaccines of proven efficacy. In rare cases, people can get malaria if they come into contact with infected blood as in blood transfusion or needle-stick injury also nosocomial and congenital malaria was reported. This is a mini-review of malaria with information on the lethal to humans, Plasmodium falciparum, together with other recent developments in the field


Subject(s)
Humans , Antimalarials/therapeutic use , Travel
19.
Colomb. med ; 46(4): 183-191, Oct.-Dec. 2015. tab
Article in English | LILACS | ID: lil-774952

ABSTRACT

Objective: To compare efficacy and safety of primaquine regimens currently used to prevent relapses by P. vivax. Methods: A systematic review was carried out to identify clinical trials evaluating efficacy and safety to prevent malaria recurrences by P. vivax of primaquine regimen 0.5 mg/kg/day for 7 or 14 days compared to standard regimen of 0.25 mg/kg/day for 14 days. Efficacy of primaquine according to cumulative incidence of recurrences after 28 days was determined. The overall relative risk with fixed-effects meta-analysis was estimated. Results: For the regimen 0.5 mg/kg/day/7 days were identified 7 studies, which showed an incidence of recurrence between 0% and 20% with follow-up 60-210 days; only 4 studies comparing with the standard regimen 0.25 mg/kg/day/14 days and no difference in recurrences between both regimens (RR= 0.977, 95% CI= 0.670 to 1.423) were found. 3 clinical trials using regimen 0.5 mg/kg/day/14 days with an incidence of recurrences between 1.8% and 18.0% during 330-365 days were identified; only one study comparing with the standard regimen (RR= 0.846, 95% CI= 0.484 to 1.477). High risk of bias and differences in handling of included studies were found. Conclusion: Available evidence is insufficient to determine whether currently PQ regimens used as alternative rather than standard treatment have better efficacy and safety in preventing relapse of P. vivax. Clinical trials are required to guide changes in treatment regimen of malaria vivax.


Objetivo: Comparar la eficacia y seguridad de los esquemas de primaquina actualmente usados para prevenir las recaídas de malaria por P. vivax. Métodos: A través de una revisión sistemática se identificaron ensayos clínicos que evaluaran la eficacia y seguridad para prevenir recurrencias por P. vivax del régimen de primaquina 0.5 mg/Kg/día por 7 o 14 días comparado al régimen estándar de 0.25 mg/Kg/día por 14 días. Se determinó la eficacia de primaquina con la incidencia acumulada de recurrencias posterior a 28 días. Se estimó el riesgo relativo global con un meta-análisis de efectos fijos. Resultados: Se identificaron 7 ensayos clínicos para el régimen 0.5 mg/Kg/día/7 días que mostraron una incidencia de recurrencias entre 0% y 20% con un seguimiento de 60 a 210 días; solo 4 estudios compararon con el régimen estándar y no se encontraron diferencias en las recurrencias entre ambos esquemas (RR= 0.977; IC 95%= 0.670-1.423). Se identificaron tres ensayos clínicos que usaron el esquema 0.5 mg/Kg/día/14 días con una incidencia de recurrencias entre 1.8% y 18.0% para 330 a 365 días; solo un estudio comparó con el régimen estándar (RR= 0.846; IC 95%= 0.484-1.477). Se encontró alto riesgo de sesgo y diferencias en la conducción de los estudios incluidos. Conclusión: No hay suficiente evidencia para determinar si los regímenes de primaquina usados como alternativas al tratamiento estándar tienen mejor eficacia para prevenir las recaídas de P. vivax. Se requieren ensayos clínicos para orientar los cambios en el esquema de tratamiento de este tipo de malaria.


Subject(s)
Humans , Antimalarials/therapeutic use , Malaria, Vivax/prevention & control , Plasmodium vivax , Primaquine/therapeutic use , Secondary Prevention/methods , Artemisinins/therapeutic use , Chloroquine/therapeutic use , Drug Administration Schedule , Recurrence
20.
Mem. Inst. Oswaldo Cruz ; 110(4): 560-565, 09/06/2015. graf
Article in English | LILACS | ID: lil-748861

ABSTRACT

A rapid decrease in parasitaemia remains the major goal for new antimalarial drugs and thus, in vivo models must provide precise results concerning parasitaemia modulation. Hydroxyethylamine comprise an important group of alkanolamine compounds that exhibit pharmacological properties as proteases inhibitors that has already been proposed as a new class of antimalarial drugs. Herein, it was tested the antimalarial property of new nine different hydroxyethylamine derivatives using the green fluorescent protein (GFP)-expressing Plasmodium berghei strain. By comparing flow cytometry and microscopic analysis to evaluate parasitaemia recrudescence, it was observed that flow cytometry was a more sensitive methodology. The nine hydroxyethylamine derivatives were obtained by inserting one of the following radical in the para position: H, 4Cl, 4-Br, 4-F, 4-CH3, 4-OCH3, 4-NO2, 4-NH2 and 3-Br. The antimalarial test showed that the compound that received the methyl group (4-CH3) inhibited 70% of parasite growth. Our results suggest that GFP-transfected P. berghei is a useful tool to study the recrudescence of novel antimalarial drugs through parasitaemia examination by flow cytometry. Furthermore, it was demonstrated that the insertion of a methyl group at the para position of the sulfonamide ring appears to be critical for the antimalarial activity of this class of compounds.


Subject(s)
Animals , Mice , Rats , Antimalarials/therapeutic use , Malaria/drug therapy , Parasitemia/drug therapy , Plasmodium berghei/drug effects , Disease Models, Animal , Flow Cytometry , Green Fluorescent Proteins , In Vitro Techniques , Malaria/parasitology , Parasitemia/parasitology
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