RESUMO
Individuals who are in close association or proximity with leprosy patients have a greater chance of acquiring the disease. However, the effectiveness of chemoprophylaxis in preventing leprosy in contacts of affected patients for optimal disease control remains unclear and a significant public health issue in developing countries such as India, Brazil, and Bangladesh. Electronic searches of Medline, EMBASE, CENTRAL, and LILACS up to October 2017 were conducted to identify eligible studies. Reference lists of potentially eligible studies were reviewed. We included randomized controlled trials (RCTs) comparing chemoprophylaxis with placebo for the prevention of leprosy infection in contacts of affected patients. A pair of reviewers independently screened eligible articles, extracted data, and assessed risk of bias. The GRADE approach was used to rate overall certainty of the evidence. Six RCTs including 52,483 participants proved eligible. Results suggested a statistically significantly reduction in clinical leprosy in contacts both, up to two years (Risk Ratio 2 (RR) 0.32, 95% Confidential Interval (CI) 0.17, 0.62; p < 0.0007; I =70%, p=0.07; low-certainty evidence) and 2 from two to five years of follow-up (RR 0.51, 95% CI 0.29, 0.89; p=0.02; I =80%, p < 0.0005; low-certainty evidence) with the use of chemoprophylaxis in comparison to placebo. However, results suggested a non2 significant reduction in clinical leprosy in contacts over five years (RR 0.77, 95% CI 0.46, 1.28; p =0.31; I =48%, p=0.16; low-certainty evidence). Low-certainty evidence shows that chemoprophylaxis is effective in the reduction of clinical leprosy in contacts up to two years and from two to five years. However, due to lowcertainty evidence there is no significant effect of chemoprophylaxis in contacts, over five years follow-up period.
RESUMO
BACKGROUND: The objective of this retrospective study was to evaluate the safety and efficacy of percutaneous microwave ablation (MWA) for treating lung metastases from nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: From December 2012 to November 2014, 17 patients (15 males, and two females, averaged 45.7 years old) with lung metastases from NPC accepted computed tomography (CT)‑guided percutaneous MWA. The average number of lung metastases was 1.7 (range: 1–4), and the biggest tumor diameter was 4.2 cm (range: 0.8–4.2 cm). Nineteen nodules located in the right lung and 10 nodules located in the left lung. A total of 29 ablation sites were performed to 29 lung metastases in 22 MWA sessions. Postoperative assessments of complete tumor necrosis rate, safety, local tumor progression, and survival period were carried out. RESULTS: Of the 29 lesions, complete response was achieved for 27 lesions; residual tumor was found in one lesion 3 months postoperatively; and another lesion was found enlarged 3‑month postoperatively with obvious enhancement. Four patients had a small amount of postoperative parenchyma bleeding and two patients had a small amount of pneumothorax. Six months after MWA treatment, new metastatic lesions appeared in six patients, five patients had new metastatic lesions inside the lung, and the other patient had metastatic lesions in the thoracic vertebra. The time for the appearance of new pulmonary metastases for the five patients was 4–20 months, averaged 7.2 months. CONCLUSION: CT‑guided MWA is a promising treatment alternative for local tumor control in selected patients with lung metastases from NPC.