Potential of Artesunate in the treatment of visceral leishmaniasis in dogs naturally infected by Leishmania infantum: Efficacy evidence from a randomized field trial

Leishmaniasis is among the world’s most neglected diseases. Dogs are the main reservoirs/hosts of Leishmania infantum, causative agent of both canine and human visceral leishmaniosis. Canine leishmaniasis (CanL) represents a public health problem as one of the most prevalent zoonotic diseases worldwide. Current therapeutics present drawbacks; thus, there is a need for more effective, safer, and cheaper drugs. The aim of this study was to evaluate and to compare the efficacy of oral administration of artesunate or meglumine antimoniate/allopurinol in dogs with clinical leishmaniasis. Forty-two dogs with naturally occurring clinical leishmaniasis were included in this open-label, simple randomized positive-control clinical field trial with 6 months of follow-up. Dogs received meglumine antimoniate 100 mg/kg/day and allopurinol 30 mg/kg/day for 28 days (control group, n = 26) or artesunate 25 mg/kg/day for 6 days (test group, n = 16). The animals were evaluated for their clinical evolution, parasite load (by qPCR) and humoral response at different time points: 0, 30, 90, and 180 days after treatment. Data analyses showed a significant improvement in both groups in clinical scores, parasitemia and antibody titers after treatment. Compared to the control group, the artesunate group showed significantly lower clinical score (P = 0.0001), lower parasitemia (P = 0.0001) and antibody titers after 6 months of follow-up. Compared to baseline values, a rapid, significant reduction (P < 0.012) in antibody levels, 2.28- versus 3.04-fold for the control versus artesunate groups, respectively, was observed 30 days after treatment. Antibody levels continued to decrease further in the artesunate group, where 58% of cases became seronegative at the 6-month follow-up. All qPCR-positive dogs were negative after treatment with artesunate, while 14.3% remained positive with the appearance of two new cases in the control group. Artesunate was well tolerated, and no side effects were recorded. Treatment failures were similar in both groups with 27.27% (6/22), including 18.18% (4/22) mortality in the control group, versus 26.66% (4/15), including 13.33% (2/15) mortality in the artesunate group. This is the first report showing the potential of artesunate in the treatment of dogs with clinical leishmaniasis. Artesunate showed higher efficacy than the current first-line treatment for CanL without any adverse effects. It could be a good alternative chemotherapy for CanL, and may be considered for further studies in human leishmaniases. Further clinical trials are needed to confirm these findings, to determine if there are relapses after treatment and if dogs remain infective to sandflies, to define the ideal therapeutic dosage and duration of treatment with artesunate.

Download Full-text

The treatment of chronic periodontitis by non-surgical periodontal therapy in association with diode laser compared to conventional non-surgical therapy

Journal of Advanced Health Care ◽

10.36017/jahc2003-008 ◽

2020 ◽

Author(s):

Bellia Loredana ◽

Ruggiero Roberta ◽

Nicolò Michele

Keyword(s):

Surgical Treatment ◽

Diode Laser ◽

Surgical Therapy ◽

Test Group ◽

Control Group ◽

Probing Depth ◽

Baseline Test ◽

Mechanical Therapy ◽

Non Surgical Treatment

Mechanical surface treatment and removal of the above and subgingival biofilm (Tartar ablation; SRP) are considered the most suitable tools for the treatment of periodontal inflammatory diseases, with the aim of destroying bacterial bioflim, reducing bacteria, and slowing down recolonization by pathogenic microorganisms. Often, however, the only S&RP are not enough, as there are patients who are experiencing relapses. Recently, laser therapy has been suggested as a potential tool to improve the outcome of periodontal non-surgical treatment. The objective of the following study was to evaluate the clinical healing of periodontal pockets treated with mechanical therapy, scaling and root planing, and diode laser application, compared to that obtained with non-surgical mechanical therapy alone. The study was designed as a randomized controlled clinical trial. Patients in the control group (13 patients) underwent conventional non-surgical therapy only, while patients in the test group (17 patients) were associated with conventional non-surgical treatment, a laser irradiation session. At baseline and after 6 months, the parameters of probing depth (PD), bleeding on probing (BOP), gingival recession (REC) were assessed The main variable of this study was the PD (probing depth) FMPS and FMBS at follow-up improved in both groups. The FMPS baseline test group 32.59 ± 6.74 - follow up 12.00 ± 3.16. The baseline of the control group showed 33.00 ± 9.55, the follow up 13.15 ± 4.85 The FMBS baseline test group found 24.29 ± 5.01 while at follow 9.65 ± 2.69. The baseline control group 30.31 ± 7.74, Follow up 11.08 ± 2.33. There is a statistical significance. (P.VALUE 0.0001) There were no significant differences between the groups in terms of PD, CAL and BOP at baseline and at follow-up. PD Test group 4,89±1,58 3,95±0,85 0,0001 Control group 5,02±1,57 4,01±0,86 CAL (mm)Test group 0,89±2,29 0,77±1,91 Control group 0,28±1,38 0,24±1,14 REC Test group 0,19±0,49 0,19±0,51 Control group 0,06±0,29 0,57±029 BOP Test group 51,2% 23,5% Control group 54,0% 20,9% The results showed differences in both baseline and follow-up for REC. Test group 0,19±0,49 0,19±0,51-Control group0,06±0,29 0,57±029 In intra-group analyzes, there are differences between baseline and follow-up for all values, except for REC in the control group. The diode laser can be used as an appropriate device for periodontal treatments, but it can offer additional and significant benefits if used according to appropriate protocols and parameters, and especially if associated with non-surgical, manual and ultrasound periodontal instrumentation, always site-specific , as it is a tool that does not replace traditional methods.

Download Full-text

Persistence of Antibodies to 2 Virus-Like Particle Norovirus Vaccine Candidate Formulations in Healthy Adults: 1-Year Follow-up With Memory Probe Vaccination

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz170 ◽

2019 ◽

Vol 220 (4) ◽

pp. 603-614 ◽

Cited By ~ 6

Author(s):

Robert L Atmar ◽

Frank Baehner ◽

Jakob P Cramer ◽

Eric Lloyd ◽

James Sherwood ◽

...

Keyword(s):

Vaccine Candidate ◽

Immunoglobulin A ◽

Primary Vaccination ◽

Immune Memory ◽

Virus Like Particle ◽

Memory Probe ◽

Antibody Titers ◽

Antibody Levels ◽

With Memory

AbstractBackgroundWe previously reported the tolerability and immunogenicity 1 month after intramuscular administration of 2 bivalent virus-like particle (VLP)–based candidate norovirus vaccine formulations in adults. We now describe the persistence of immunity and responses to a memory probe vaccination 1 year later.MethodsA total of 454 healthy men and women aged 18–49 years in 3 equal groups received placebo (saline) or 15/50 or 50/50 vaccine formulations (ie, 15 or 50 µg of GI.1 genotype VLPs, respectively, and 50 µg of GII.4c VLPs) with MPL and Al(OH)3. Immunogenicity and safety were assessed up to day 365, when 351 participants received a memory probe vaccination of 15 µg each of GI.1 and GII.4c VLPs with Al(OH)3.ResultsNo safety signals were detected up to 1 year after the first vaccination. Pan-immunoglobulin, immunoglobulin A, and histo-blood group antigen–blocking (HBGA) antibody levels among vaccinees waned but remained higher than levels before vaccination and levels in placebo recipients on days 180 and 365. Memory probe vaccination increased all antibody titers. Levels of HBGA antibodies to GI.1 but not GII.4c were higher after the first vaccination in candidate vaccine groups, compared with those in the placebo group.ConclusionLevels of antibodies to both candidate norovirus VLP formulations persisted above baseline levels for at least 1 year after primary vaccination. HBGA-blocking responses to the memory probe for GI.1 but not GII.4c displayed characteristics of immune memory.Clinical Trials RegistrationNCT02142504.

Download Full-text

Prospected Randomized Study of Two Y Devices in Continuous Ambulatory Peritoneal Dialysis (CAPD)

Peritoneal Dialysis International ◽

10.1177/089686088900900305 ◽

1989 ◽

Vol 9 (3) ◽

pp. 165-168 ◽

Cited By ~ 23

Author(s):

Giusto Viglino ◽

Adolfo Colombo ◽

Antonio Scalamogna ◽

Pier L. Cavalli ◽

Luisella Guerra ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Dwell Time ◽

Randomized Study ◽

Test Group ◽

Control Group ◽

Safety And Efficacy

To evaluate acceptability, safety, and efficacy of a y set with two short branches (TAs) filled with electrolytic chloroxidizer solution during the dwell time, 60 patients were randomly allocated to be treated with the traditional y set (TCs) or with the T AS. Twenty-three were new patients whereas the remaining 37 were patients already on continuous ambulatory peritoneal dialysis (CAPD) with the TCs. The follow-up was 416.5 months in the control group and 387.4 months in the test group. During the study period there were 6 peritonitis episodes in each group with an incidence of 1 episode every 69.4 patient-months in the control group and 1 episode every 64.6 patient-months in the test group. Twenty-four patients (80%) in the control group and 27 (90%) in the test group were free from peritonitis. The probability to remain free from peritonitis was respectively 87% and 83% in the test group and in control group after 12 months, 70% and 78% after 21 months. seventy -nine percent of the patients who used both systems preferred the T AS for better handling, lower encumbrance, and major safety. One patient preferred the TCs, three patients did not find any differences between the two devices.

Download Full-text

The Significance of Intraoperative First Metatarsal Traction Test in Hallux Valgus Surgical Decision Making

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000413 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0004

Author(s):

Li Xinyu ◽

Alan Yan

Keyword(s):

Decision Making ◽

Hallux Valgus ◽

Test Group ◽

Test Method ◽

Control Group ◽

First Metatarsal ◽

Reliable Assessment ◽

Correction Surgery ◽

Traction Test

Category: Bunion Introduction/Purpose: To investigate the significance of using an intraoperative first metatarsal traction test in hallux valgus correction surgery in decision making of the procedure choice and operation designs. Methods: From Jun 2015 to Jun 2016, correction surgery performed in patients with hallux valgus 40 cases with 68 feet. We used the intra-operative first metatarsal traction test to judge the grade of laxity of the 1st TMT and the factual IMA and thus help to make the decision of the level of osteotomy and or fusion. We adopted distal Chevon osteotomy (11 cases 16.2%) when the congruence of the surface of the 1st MPJ remains more than ½ under tension with the traction test. Proximal Scarf osteotomy (54 cases 79.4%) was used when the congruence was less than ½. While if there was a complete incongruent dislocation, Lapidus procedure (3 cases 4.4%) was carried out. We measured IMA and HVA in the patients preoperative, intraoperative, 3 days after operation and at 6 months’ follow-up. Same measurements were done on the 40 patients from the same time without traction test Results: Retrospective review of the 2 groups showing significant improvement (p<0.001) but more reliable larger correction of IMA angles in the intraoperative traction test group. The patients of the intraoperative traction test group had average higher satisfaction rate with more reliable improvement of symptoms and less postoperative complications. Significant improvement (P<0.001) and postoperative AOFAS score average of 93.2 was recorded in traction test method group vs. a 84.3 in control group. The traction test group largely retained the correction in half year follow up which is significant when comparing to the control Conclusion: The intraoperative traction test of first metatarsal objectively guided the decision making of procedure choice and operation design optimization. The traction test gave a reliable assessment of the laxity of first TMT thus avoiding inadequate correction of Hallux Valgus with improper surgical designs. The test can be potentially used as an objective intraoperative guidance in avoidance of inadequate correction with inappropriate surgical choices and thus maintain the correction in the long term with patient satisfaction

Download Full-text

Application of Rapid Rehabilitation Nursing in Thoracic Surgery Nursing

Journal of Healthcare Engineering ◽

10.1155/2021/6351170 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Hongliu Liang ◽

Jing Huang ◽

Jijia Tong ◽

Jinyue Wang

Keyword(s):

Thoracic Surgery ◽

User Satisfaction ◽

Test Group ◽

Recovery Process ◽

Nursing Intervention ◽

Control Group ◽

Controlled Trials ◽

Rehabilitation Process ◽

Data Comparison

To study the application effect of rapid rehabilitation nursing intervention in thoracic surgery nursing, this paper researches controlled trials. First, this paper sets up a control group and a test group. The control group uses traditional nursing methods for thoracic surgical nursing intervention, and the test group adds rapid rehabilitation nursing intervention based on traditional nursing intervention. In addition, the operation and rehabilitation conditions of the control group and the test group are the same. Moreover, this paper records rehabilitation information in real time, performs data processing through statistical methods, and conducts follow-up surveys on the rehabilitation process of patients. In addition, this paper compares nursing effects through data comparison and histogram comparison. From the research results, various parameters of the patient’s recovery process and the user satisfaction of the rapid rehabilitation can be seen. Furthermore, nursing is higher than those of the control group, which shows that the rapid rehabilitation nursing method can positively affect the nursing of thoracic surgery.

Download Full-text

Positive Result by Serology Indicates ActiveHelicobacter pylori Infection in Patients with Atrophic Gastritis

Journal of Clinical Microbiology ◽

10.1128/jcm.36.6.1808-1810.1998 ◽

1998 ◽

Vol 36 (6) ◽

pp. 1808-1810 ◽

Cited By ~ 22

Author(s):

Arto Kokkola ◽

Hilpi Rautelin ◽

Pauli Puolakkainen ◽

Pentti Sipponen ◽

Martti Färkkilä ◽

...

Keyword(s):

Breath Test ◽

Eradication Therapy ◽

Urea Breath Test ◽

Positive Serology ◽

Antibody Titers ◽

H Pylori ◽

Antibody Levels ◽

Ongoing Infection ◽

Corpus Gastritis

Patients with atrophic corpus gastritis and elevatedHelicobacter pylori antibody titers but13C-urea breath test (13C-UBT) and histology results negative for H. pylori were randomized into eradication therapy or follow-up only. Antibody levels decreased significantly in six out of seven patients in the eradication group, while in the follow-up group, the titers declined in only one out of eight patients. In patients with atrophic corpus gastritis, positive serology results may indicate an ongoing infection in spite of negative13C-UBT and histology results.

Download Full-text

Efficacy of nano-carbonate apatite dentifrice in relief from dentin hypersensitivity following non-surgical periodontal therapy: A randomized controlled trial

10.21203/rs.2.16742/v1 ◽

2019 ◽

Author(s):

Pei-Hui Ding ◽

Anna Dai ◽

Hua-Jiao Hu ◽

Jia-Ping Huang ◽

Jia-Mei Liu ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Test Group ◽

Periodontal Therapy ◽

Control Group ◽

Carbonate Apatite ◽

Dentine Hypersensitivity ◽

Randomized Controlled ◽

At Home

Abstract Background: Dentine hypersensitivity (DH) could occur or intensify after non-surgical periodontal therapy because of the exposure of dentine tubules. It has been demonstrated that nano-sized particles could seal these the dentine tubules. This randomized controlled trial aimed to investigate the efficacy of dentifrice containing nano-carbonate apatite (n-CAP) in reducing dentine hypersensitivity (DH) after non-surgical periodontal therapy. Methods: 48 periodontitis patients with DH were included in this clinical trial. After non-surgical periodontal therapy, patients included were randomized to test and control group and the respective dentifrices were applied at chairside, after which they were instructed to brush teeth with the allocated dentifrices twice a day at home. Periodontal parameters were recorded at baseline and the last follow-up. DH was measured by air-blast test and recorded by visual analogue scale (VAS) and Schiff sensitivity scale at baseline, after polishing (0 week) and 2/4/6 weeks. Results: 45 participants completed the follow-up. Periodontal parameters were improved and comparable between groups. Significant reduction in DH was observed in both groups at all time-points compared to baseline in terms of VAS and Schiff score. The test group achieved significantly greater relief from hypersensitivity compared with the control group after 4-week at-home use (for VAS, test group: 0.66 ± 0.68 versus control group: 0.84 ± 0.78, p = 0.005; for Schiff score, test group: 0.69 ± 0.71 versus control group: 0.97 ± 0.77, p < 0.001). Conclusions: Home-use of n-CAP based dentifrice provided a significantly better alleviation of DH following non-surgical periodontal therapy after 4 weeks compared to the control product. Trail registration: Chinese Clinical Trials Registry (No. ChiCTR-IPR-17011678, http://www.chictr.org.cn/, registered 16 June, 2017)

Download Full-text

The Association of the One-Abutment at One-Time Concept with Marginal Bone Loss around the SLA and Platform Switch and Conical Abutment Implants

Journal of Clinical Medicine ◽

10.3390/jcm11010074 ◽

2021 ◽

Vol 11 (1) ◽

pp. 74

Author(s):

Nasreen Hamudi ◽

Eitan Barnea ◽

Evgeny Weinberg ◽

Amir Laviv ◽

Eitan Mijiritsky ◽

...

Keyword(s):

Bone Loss ◽

Test Group ◽

Mucosal Barrier ◽

Control Group ◽

X Rays ◽

Marginal Bone Loss ◽

Bone Level ◽

The Difference ◽

The One

Objectives: Repeated abutment disconnection/reconnection may compromise the mucosal barrier and result in crestal bone level changes. The clinical significance of this phenomenon is not yet clear, as most studies on this topic are short-term. Therefore, the aim of the present study was to evaluate the influence of abutment disconnections and reconnections on peri-implant marginal bone loss over a medium-term follow-up period. Material and methods: Twenty-one patients (6 men and 15 women) with a mean age 66.23 ± 9.35 year at the time of implant placement were included. All patients who received two adjacent nonsubmerged implants were randomly assigned into one of the two groups: definitive multiunit abutments (DEFs) connected to the implant that were not removed (test group) or healing abutments (HEAs) placed at surgery, which were disconnected and reconnected 3–5 times during the prosthetic phase (control group). Peri-implant marginal bone levels (MBL) were measured through periapical X-rays images acquired immediately after the surgery (baseline), at 4–7 months immediately after prosthetic delivery, and at 1-year and 3-year follow-up visits. Results: No implant was lost or presented bone loss of more than 1.9 mm during the 3-year follow-up; thus, the survival and success rate was 100%. Peri-implant mucositis was noticed in 38.1% DEFs and 41.9% of HEAs at the 3-year follow-up assessment. At the end of 3 years, the MBL was −0.35 ± 0.69 mm for participants in the DEFs group and −0.57 ± 0.80 mm for the HEAs group, with significant statistical difference between groups. Conclusions: Immediate connection of the multiunit abutments reduced bone loss in comparison with 3–5 disconnections noted in the healing abutments 3 years after prosthetic delivery. However, the difference between the groups was minimal; thus, the clinical relevance of those results is doubtful.

Download Full-text

To Compare the Effect on IOP Following Primary Trabeculectomy with MMC 0.2% versus Trabeculectomy without MMC in Primary Open Angle Glaucoma

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i43b32577 ◽

2021 ◽

pp. 475-480

Author(s):

Zakaullah Gopang ◽

Shabeer Ahmed Bhutto ◽

Naeem Akhtar Katpar ◽

Arslan hassan Rajper ◽

Vijay Nagdev

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Test Group ◽

Control Group ◽

Open Angle ◽

Primary Procedure ◽

Group A ◽

Group B ◽

Medical University

Objective: To determine the effect on intraocular pressure following primary Trabeculectomy with MMC 0.2% versus Trabeculectomy without MMC in Primary Open Angle Glaucoma. Study Design: This is a prospective and experimental Study. Setting: Study carried out at Ophthalmology Department, Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from 01-03-2020 to 31-08-2020 (06 Months). Materials and Methods: The patients with primary open angle glaucoma were selected from glaucoma clinic after taking careful history and clinical examination. Patients selected for trabeculectomy into two groups. Group A includes 43 patients while Group B also includes 43 patients. Among Group A patients adjunctive MMC 0.2mg/ml for a period of 3 minutes was used during trabeculectomy as a primary procedure (Test Group) while Group B patients were operated without MMC 0.2% (Control Group). Follow-up period of 06 months was observed in both groups. The span of study was from 01-03-2020 to 31-08-2020. Results: The total of 86 Eyes of 86 patients of POAG were included in this study. Group A patients were operated for trabeculectomy with MMC while group B patients were operated for trabeculectomy without MMC. The mean IOP before surgery of Group-A was 25.39±2.42 mmHg while in Group-B it was 26.23±4.23mmHg. At day 1 of surgery in Group-A patients IOP was 13.20±3.05 mmHg while in Group-B patients IOP, was 14.09±4.04 mmHg. After 3 months in Group-A, IOP was 13.04±3.81 mmHg in Group-B IOP was 14.01±4.18 mmHg. Out of 43 patients in Group-A, 41(95.3%) were succeeded while in Group-B, 39(90.7%)were succeeded. Significant result was found for IOP reduction after 6 months of surgeryin group-A IOP was 13.48 + 2.86 mmHg while in group-B, IOP was 15.09 ±2.64 (P=0.754). Conclusion: Trabeculectomy with MMC as a primary procedure seems to be more effective than trabeculectomy without MMC.

Download Full-text

Therapeutic Efficacy of a Mixed Formulation of Conventional and PEGylated Liposomes Containing Meglumine Antimoniate, Combined with Allopurinol, in Dogs Naturally Infected with Leishmania infantum

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00234-20 ◽

2020 ◽

Vol 64 (7) ◽

Author(s):

Cristiano C. P. dos Santos ◽

Guilherme S. Ramos ◽

Renata C. De Paula ◽

Karen F. Faria ◽

Paulo O. L. Moreira ◽

...

Keyword(s):

Bone Marrow ◽

Leishmania Infantum ◽

Parasite Burden ◽

Mononuclear Phagocyte ◽

Clinical Staging ◽

Control Group ◽

Content Type ◽

Meglumine Antimoniate ◽

Pegylated Liposomes ◽

Pretreatment Period

ABSTRACT The treatment of dogs naturally infected with Leishmania infantum using meglumine antimoniate (MA) encapsulated in conventional liposomes (LC) in association with allopurinol has been previously reported to promote a marked reduction in the parasite burden in the main infection sites. Here, a new assay in naturally infected dogs was performed using a novel liposome formulation of MA consisting of a mixture of conventional and long-circulating (PEGylated) liposomes (LCP), with expected broader distribution among affected tissues of the mononuclear phagocyte system. Experimental groups of naturally infected dogs were as follows: LCP plus Allop, receiving LCP intravenously as 2 cycles of 6 doses (6.5 mg Sb/kg of body weight/dose) at 4-day intervals plus allopurinol at 30 mg/kg/12 h per os (p.o.) during 130 days (LCP+Allop); LC plus Allop, receiving LC intravenously as 2 cycles of 6 doses (6.5 mg Sb/kg/dose) plus allopurinol during 130 days (LC+Allop); Allop, treated with allopurinol only; and a nontreated control. Parasite loads were evaluated by quantitative PCR in liver, spleen, and bone marrow tissue and by immunohistochemistry in the ear skin, before treatment, just after treatment, and 4 months later. The LCP+Allop and LC+Allop groups, but not the Allop group, showed significant suppression of the parasites in the liver, spleen, and bone marrow 4 months after treatment compared to the pretreatment period or the control group. Only LCP+Allop group showed significantly lower parasite burden in the skin in comparison to the control group. On the basis of clinical staging and parasitological evaluations, the LCP formulation exhibited a more favorable therapeutic profile than the LC one, being therefore promising for the treatment of canine visceral leishmaniasis.

Download Full-text