Risk factors for antimony treatment failure in American Cutaneous Leishmaniasis in Northwestern-Argentina.

BACKGROUND: To date, there is no specific literature available on the determinants for therapeutic failure (TF) with meglumine antimoniate (MA) in Northwestern-Argentina. This study aimed to identify epidemiological, clinical, and treatment-related factors that could be involved in TF. METHODOLOGY/PRINCIPAL FINDINGS: We performed a case-control study. Cases were represented by patients who showed TF after administration of the first course of MA treatment, whereas, controls were determined as patients who evolved towards healing after the first MA cycle received. Crude Odds Ratios and their corresponding 90% confidence intervals (CI) were calculated, and risk factors were then tested by multivariate analysis using logistic binary regression. Three hundred and eighty-four patients with a presumptive diagnosis of ACL were recruited, and 153 with a positive diagnosis were selected. We included in the study 71 patients, who underwent specific treatment with MA, presented complete data on response to treatment, and had a minimum post-treatment follow-up of 6 months in cutaneous leishmaniasis, and 12 months in mucosal leishmaniasis. Of these, 34 (47.9%) presented TF. In the initial analysis, TF was significantly associated with the geographical area of disease acquisition (p = 0.036), the presence of mucosal lesions (p = 0.042), the presence of concomitant skin and mucosal lesions (p = 0.002), and lesion age ≥ 6 months (p = 0.018). Risk factors influencing TF in the final multivariate model included the geographical area where the disease was acquired (adjusted Odd Ratio 8.062; 95% CI 1.914-33.959; p = 0.004), and lesion age ≥ 6 months (adjusted Odd Ratio 10.037; 95% CI 1.383-72.843; p = 0.023). CONCLUSIONS/SIGNIFICANCE: The results of the present study suggest the existence of some risk factors linked to TF in Northwestern-Argentina, which deserve further investigation. Herein we recorded a high percentage of TF and we described clinical and epidemiological characteristics associated with TF that could be taken into account improving the clinical management of patients.

Positive and Negative Affect Schedule (PANAS): Psychometric Properties and Discriminative Capacity in Several Chilean Samples.

We evaluated the factor structure, reliability, and discriminative capacity of the Positive and Negative Affect Schedule (PANAS) questionnaire in four different samples: two general adult populations (N = 1,548, N = 964), one adolescent population (N = 1,044), and young people with depressive symptomatology (N = 307). Exploratory factor analyses (EFAs) were performed with subsamples from Studies 1 (n = 773) and 2 (n = 527), finding that the two- and three-factor solutions had a good fit. In a confirmatory factor analysis, the two-factor solution resulted in an adequate fit in a second set of subsamples from both studies (n = 775, n = 517). In Study 3, we found good convergent and divergent validity with adequate and significant correlations found for depression (Beck's Depression Inventory), anxiety (State-Trait Anxiety Inventory), and neuroticism and extroversion (Big Five Inventory). In Study 4, the results of an EFA performed in a subsample (n = 154) found that the two- and three-factor solutions were appropriate with the former solution being confirmed in a second subsample (n = 153). Reliability was α = .85 for positive affect and α = .87 for negative affect. The PANAS questionnaire showed adequate indicators of validity and reliability in adult and adolescent populations as well as in a sample with depressive symptoms.

Propiedades psicométricas del cuestionario de bienestar sexual subjetivo en jóvenes y adultos chilenos / Psychometric properties of the sexual subjetive well-being scale in young and adults Chilean

El presente estudio evalúa las propiedades psicométricas del cuestionario de bienestar sexual subjetivo en jóvenes y adultos chilenos residentes en Santiago de Chile. Se aplicó la versión de la escala traducida al español a una muestra de 661 jóvenes y adultos con edades comprendidas entre 18 y 54 años que no reportaron alguna enfermedad mental o física. El 49% de la muestra estuvo conformada por mujeres y el 51% por hombres. Las propiedades psicométricas y confiabilidad fueron evaluadas mediante análisis factorial exploratorio y alpha de Cronbach. La estructura factorial óptima del cuestionario fue la de un factor con 4 ítems y presenta una confiabilidad adecuada (α= .73), aunque el ítem 4 presenta cargas factoriales bajas. Los resultados indican que la versión chilena del cuestionario de bienestar sexual subjetivo es un instrumento autoadministrado válido y confiable para evaluar el bienestar en el ámbito sexual de mujeres y hombres sin reporte de enfermedad física o mental.

The present study evaluates the psychometric properties of subjective sexual well-being questionnaire in young and adult Chileans who residing in Santiago. The version of the scale translated into Spanish, was applied to a sample of 661 young and adults people between the ages of 18 and 54 who did not report any mental or physical illness. 49% of the sample was women and 51% of men. The psychometric properties and reliability were evaluated by exploratory factorial analysis and Cronbach's alpha. The optimal factorial structure of the questionnaire was one factor with 4 items and had adequate reliability (α = .73), although item 4 had low factor loadings. The results indicate that the version of the subjective sexual well-being questionnaire is a valid and reliable self-administered instrument to evaluate the sexual well-being of women and men without reports of physical or mental illness.

Clinical and epidemiological features of leishmaniasis in northwestern-Argentina through a retrospective analysis of recent cases.

Leishmaniasis is a parasitic disease caused by hemoflagellates of the genus Leishmania and is transmitted to humans by the bite of infected phlebotomine sandflies. Depending on the Leishmania species, the disease has different clinical forms including cutaneous, mucocutaneous, and visceral manifestations. Previous studies performed in endemic zones of northwestern-Argentina, during epidemic outbreaks, have been important for detecting patients suffering from the acute phase of the disease, but have not given a complete representation of the clinical and epidemiological features in the region. Furthermore, due to the resurgence of leishmaniasis worldwide and in particular the large increase of international tourism to the region, it seems pertinent to update the current epidemiological and clinical profile of leishmaniasis in northwestern-Argentina. Here we present a retrospective analysis of 95 Leishmania positive cases, presenting between 2000 and 2014. Patients were derived from hospitals and diagnosed in our lab at the University of Salta, located in a non-endemic area in Salta, Argentina. We detected numerous extensive mucocutaneous cases (34/95, 35.8%) distinct from mucosal affected patients, some instances originating in locations with no previously reported human cases. Additionally patients suffering from concomitant diseases, besides leishmaniasis, were assessed. These included Chagas disease, syphilis, deep mycoses, tuberculosis, toxoplasmosis and intestinal parasitosis. This study updates the clinical and epidemiological features of leishmaniasis in northwestern-Argentina, and discusses the implications and management strategy for patients who acquire the disease in this region.