Neumonía intersticial inducida por bloqueo androgénico máximo como tratamiento de cáncer de próstata avanzado: Report of one case / Fatal interstitial lung disease associated with maximum androgen blockade

Maximum androgen blockade is the standard endocrine treatment for advanced prostate cancer. Interstitial lung disease in different degrees of severity, with low mortality and excellent response to treatment may appear with its use. We report a 77 years old patient with advanced prostate cancer who developed severe and progressive respiratory failure associated to bilateral pulmonary infiltrates, attributed to the direct effect of maximum androgen blockade. Despite the therapeutic efforts, the patient died. Lung pathology revealed Usual Interstitial Pneumonia.

Market survey of loiasis: prevalence and adverse reactions to ivermectin using a rapid procedure for loiasis / Encuesta de mercado de loiasis: prevalencia y reacciones adversas a la ivermectina usando un procedimiento rápido para la loiasis

OBJECTIVES: 1. To assess the levels of endemicity of loiasis in a total of 30 selected villages covering an area of 5.2 sq km in Owo, Akure North, Akure South, Ondo East, Ondo West and Ifedore local governments in Ondo State, Nigeria, using Rapid Assessment for loiasis technique. 2. To obtain information on adverse reactions which occurred during previous administrations of the drug ivermectin used for the treatment of loiasis and onchocerciasis in the study area. METHODS: Consent was obtained from the chairman of each local government village head and individuals were co-opted into the study. A total of 480 individuals were interviewed, 80 from each of the six local governments, during the regular scheduled community market days. Survey for Loa loa was carried out according to specifications in "Guidelines for rapid Assessment of Loa loa (TDR, 2002). RESULTS: Among the 480 respondents, 80 (16.7%) reported having had a history of loiasis while 11 (2.3%) had recent occurrence of the disease. The local name given to the disease in all the villages studied is "aran oju". Respondents in Ondo East local government had an eyeworm history of 23 (28.8%) and occurrence of loiasis was 02 (2.5%), these were the highest figures recorded. Using the SPSS version 10 package for data analysis, demographic factors of age and gender were not significant determinants of prevalence (> 0.05). Ondo East and Ifedore local governments had significant levels of loiasis prevalence (p < 0.05). Adverse reactions from the retrospective ivermectin administration was 04 (0.83%). This was statistically insignificant (p > 0.05). CONCLUSION: Market surveys in rural communities were considered to be cost effective and rapid in the determination of prevalence of any disease. Since less than 40% of the respondents in the study area reported having had a history of eyeworm, the entire area was classified as "low risk" as regards the administration of ivermectin.

OBJETIVOS: 1. Evaluar los niveles de endemicidad de loiasis en un total de 30 poblados seleccionados, que abarcan un area de 5.2 sq km in Owo, Akure North, Akure South, Ondo East, Ondo West y los gobiernos locales de Ifedore in Ondo State, Nigeria, usando una evaluación rápida para técnica de loiasis. 2. Obtener información acerca de las reacciones adversas que ocurrieron durante las administraciones previas del medicamento invermectina usado para el tratamiento de loiasis y onchocerciasis en el área de estudio. MÉTODOS: Se obtuvo el consentimiento del presidente de cada uno de los gobiernos locales de los poblados de cabecera, así como de los individuos cooptados para la realización del estudio. Se entrevistaron un total de 480 individuos, 80 de cada uno de los seis gobiernos locales, durante los días de mercado regularmente programados para la comunidad. Se llevó a cabo una encuesta de Loa loa de acuerdo con las especificaciones de las "Guías para la evaluación rápida de Loa loa". RESULTADOS: De los 480 encuestados, 80 (16.7%) reportaron haber tenido una historia de loiasis, mientras que 11 (2.3%) tuvieron padecimientos recientes de esta enfermedad. El nombre local dado a esta enfermedad en todos los poblados estudiados es "aran oju". Los encuestados en el gobierno local de Ondo East local tenían antecedentes de gusano ocular de 23 (28.8%) y la manifestación de loiasis fue 02 (2.5%). Estas fueron las cifras más altas registradas. Usando el paquete SPSS versión 10 para el análisis de datos, se observó que los factores demográficos de edad y sexo no fueron significativamente determinantes de la prevalencia (> 0.05). Los gobiernos locales de Ondo East y de Ifedore tuvieron niveles significativos de prevalencia de loiasis (p < 0.05). Las reacciones adversas de la administración de ivermectina retrospectiva fue 04 (0.83%). Esto fue estadísticamente significativo (p > 0.05). CONCLUSIÓN: Las encuestas de mercado en las comunidades rurales fueron consideradas costo-efectivas y rápidas en la determinación de la prevalencia de cualquier enfermedad. Puesto que menos del 40% de los encuestados en el área de estudio reportaron haber tenido una historia de gusano ocular, toda el área fue clasificada como de "bajo riesgo" en relación con la administración de la invermectina.

The community-based treatment of onchocerciasis in Shao, Kwara State, Nigeria.

Community acceptance of and compliance with annual ivermectin treatment in Shao, a sub-urban community in Kwara State, Nigeria, were remarkably high. Of 890 subjects from 204 randomly selected households, 832 (93.5%) had taken ivermectin at least once during the six-year treatment period. An average community acceptance rate (ACAR) of 88.77% (range 85.4 - 91.9%) was recorded during this period; a community compliance rate (CCR) of 74.76% was recorded. Overt refusals, covert refusals and those excluded from treatment were low and insignificant (p > 0.05). The mean compliance age was 37.47 +/- 16.52 years. Of the subjects studied, 40.67% reported adverse reactions to ivermectin during the first round of treatment (Tx1); this number decreased significantly (p < 0.05) to 15.43% during the sixth round of treatment (Tx6). Though considerable adverse reactions were reported in the community, these did not seem to have negatively affected acceptance of and compliance with annual ivermectin treatment; in some cases, the adverse reactions were believed by the villagers to demonstrate the efficacy and effectiveness of the drug. The community showed great awareness of the disease, its treatment with ivermectin and the distribution of the drug. On the basis of the high acceptance and compliance rates, it was concluded that Shao will benefit greatly from the current African Program for Onchocerciasis Control Strategy: Community-Directed Treatment with Ivermectin (CDTI) using Community-Directed Distributors (CDDs).

Comparison of ivermectin and albendazole treatment for gnathostomiasis.

Comparative treatment of ivermectin in 21 patients (Group 1) and albendazole in 49 patients (Group 2) of gnathostomiasis gave the cure at 95.2% and 93.8% respectively. The ELISA OD and eosinophil counts were reduction after treatment. Side effects in ivermectin were hypotention, dizziness, weakness and diuresis; and side effects of albendazole were nausia, dizziness and increased alkaline phosphatase in two cases. Ivermectin should be an effective drug againts gnathostomiasis and more convenient in treatment single dose.