Effectiveness and Safety of Amphotericin B Deoxycholate, Amphotericin B Colloidal Dispersion, and Liposomal Amphotericin B as Third-Line Treatments for Cutaneous and Mucocutaneous Leishmaniasis: A Retrospective Study.

Cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis (MCL) are endemic diseases in America, especially in some countries such as Colombia. Among the therapeutic options is amphotericin B (AB). Nevertheless, its lipid-associated formulations have better safety profiles and effectiveness in other diseases, so far with no comparative studies in CL or MCL. We conducted a retrospective descriptive study describing the effectiveness and adverse effects of AB deoxycholate (ABD), AB colloidal dispersion (ABCD), and liposomal AB (LAB) as third-line treatments for CL and MCL. The effectiveness of LAB (88.5%) was greater than those of ABCD (66.6%) and ABD (80.8%). There were also fewer adverse effects in the LAB group (46.2%) than in the ABD (96.1%) and ABCD (80.9%) groups. LAB is an alternative for the treatment of CL and MCL in patients with therapeutic failure to first- and second-line drugs; findings suggest it might be less toxic and more effective than ABD and ABCD.

Zinc bioavailability in rats fed a plant-based diet: a study of fermentation and zinc supplementation.

BACKGROUND: Zinc deficiency is a significant problem, in developing countries and in vegetarians, which can be caused by plant-based diets. Thus, dietary strategies, such as fermentation, to improve zinc bioavailability of diets should be investigated. OBJECTIVE: To improve zinc bioavailability in a plant-based diet by the inclusion of fermented food. DESIGN: Cassava tubers were fermented and made to replace the unfermented cassava in a basal plant-based diet, and compared with plant-based diets with and without zinc supplement. The zinc bioavailability of the diets was evaluated in Wistar rats that were fed these diets for 28 days. The evaluation was for zinc apparent absorption (ZnAA), serum zinc levels, and zinc deposits in liver and femur; in addition, the feed efficiency ratio (FER) of the diets and femur weight (FW) of the rats were evaluated. RESULTS: During the cassava fermentation, lactic acid increased and pH decreased (from 6.8 to 3.9), which is favorable for native phytase activity, resulting in a 90.2% reduction of phytate content in cassava. The diet containing fermented cassava showed significantly higher levels of ZnAA, FER, and FW (p<0.001). Moreover, the zinc levels in serum and femur were significantly higher (p<0.001) compared with the results of the diet with unfermented cassava. The results clearly show a higher zinc bioavailability in the diet containing fermented cassava and are comparable with the results obtained with the plant-based diet with zinc supplement. CONCLUSIONS: In conclusion, the fermentation of cassava reduces the phytate content. The diet containing the fermented cassava represents a better nutritional alternative than the diet with unfermented cassava and is comparable with the zinc-supplemented diets.

First report on ototoxicity of meglumine antimoniate.

INTRODUCTION: Pentavalent antimonials are the first drug of choice in the treatment of tegumentary leishmaniasis. Data on ototoxicity related with such drugs is scarcely available in literature, leading us to develop a study on cochleovestibular functions. CASE REPORT: A case of a tegumentary leishmaniasis patient, a 78-year-old man who presented a substantial increase in auditory threshold with tinnitus and severe rotatory dizziness during the treatment with meglumine antimoniate, is reported. These symptoms worsened in two weeks after treatment was interrupted. CONCLUSION: Dizziness and tinnitus had already been related to meglumine antimoniate. However, this is the first well documented case of cochlear-vestibular toxicity related to meglumine antimoniate.

First report onoototoxicity of meglumine antimoniate / Primeiro relato de ototoxicidade pelo antimoniato de meglumina

Introduction: Pentavalent antimonials are the first drug of choice in the treatment of tegumentary leishmaniasis. Data on ototoxicity related with such drugs is scarcely available in literature, leading us to develop a study on cochleovestibular functions. Case Report: A case of a tegumentary leishmaniasis patient, a 78-year-old man who presented a substantial increase in auditory threshold with tinnitus and severe rotatory dizziness during the treatment with meglumine antimoniate, is reported. These symptoms worsened in two weeks after treatment was interrupted. Conclusion: Dizziness and tinnitus had already been related to meglumine antimoniate. However, this is the first well documented case of cochlear-vestibular toxicity related to meglumine antimoniate.

Introdução: Antimoniais pentavalentes são os fármacos de primeira escolha no tratamento da leishmaniose tegumentar. Dados de ototoxicidade relacionados a tais fármacos são escassos na literatura, o que nos levou a desenvolver um estudo de funções cócleo-vestibulares. Relato de caso: Relatamos caso de paciente masculino de 78 anos com leishmaniose tegumentar, que apresentou aumento significativo dos limiares auditivos com zumbido e tontura rotatória grave durante o tratamento com antimoniato de meglumina. Os sintomas pioraram até duas semanas após a interrupção do tratamento. Conclusão: Tontura e zumbido já tinham sido associados ao antimoniato de meglumina. Entretanto, este é o primeiro caso bem documentado de toxicidade cócleo-vestibular relacionado ao antimoniato de meglumina.