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  1. Article ; Online: Comparison of burst versus ramp antitachycardia pacing therapy for ventricular tachycardia: A meta-analysis.

    de Sousa, Marcos R / Cota, Gláucia F / Burger, Achim L / Pezawas, Thomas

    Journal of cardiovascular electrophysiology

    2021  Volume 32, Issue 3, Page(s) 842–850

    Abstract: Current guidelines recommend at least one attempt of defibrillator antitachycardia pacing (ATP) therapy, showing preference for burst therapy. The objective of this study is to compare ramp versus burst ATP therapy proportion of success and acceleration ... ...

    Abstract Current guidelines recommend at least one attempt of defibrillator antitachycardia pacing (ATP) therapy, showing preference for burst therapy. The objective of this study is to compare ramp versus burst ATP therapy proportion of success and acceleration in treating spontaneous or induced ventricular tachycardia (VT). The review protocol was previously published in PROSPERO. Data synthesis and measures of heterogeneity (I
    MeSH term(s) Cardiac Pacing, Artificial ; Defibrillators, Implantable ; Electric Countershock ; Humans ; Tachycardia, Ventricular/diagnosis ; Tachycardia, Ventricular/therapy
    Language English
    Publishing date 2021-01-28
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1025989-2
    ISSN 1540-8167 ; 1045-3873
    ISSN (online) 1540-8167
    ISSN 1045-3873
    DOI 10.1111/jce.14908
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  2. Article ; Online: A Randomized, Controlled, Noninferiority, Multicenter Trial of Systemic vs Intralesional Treatment With Meglumine Antimoniate for Cutaneous Leishmaniasis in Brazil.

    Lyra, Marcelo R / Oliveira, Liliane F A / Schubach, Armando O / Sampaio, Raimunda N R / Rodrigues, Bruna C / Hueb, Marcia / Cota, Gláucia / Silva, Rosiana E / Francesconi, Fabio / Pompilio, Maurício A / França, Adriana O / Amato, Valdir S / Souza, Regina M / Oliveira, Raquel V C / Valete, Cláudia M / Pimentel, Maria I F

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2023  Volume 77, Issue 4, Page(s) 574–582

    Abstract: Background: Meglumine antimoniate (MA) remains the main treatment for cutaneous leishmaniasis (CL). Uncontrolled studies suggest that intralesional MA (IL-MA) may be noninferior and safer than systemic MA (S-MA).: Methods: Multicenter, randomized, ... ...

    Abstract Background: Meglumine antimoniate (MA) remains the main treatment for cutaneous leishmaniasis (CL). Uncontrolled studies suggest that intralesional MA (IL-MA) may be noninferior and safer than systemic MA (S-MA).
    Methods: Multicenter, randomized, controlled, open-label, phase 3 clinical trial to evaluate the efficacy and toxicity of IL-MA in 3 infiltrations at 14-day intervals compared with S-MA (10-20 mg Sb5+/kg/day, 20 days) for CL, with noninferiority margin of 20%. Primary and secondary outcomes were definitive cure at day 180 and epithelialization rate at day 90 of treatment, respectively. A 2-year follow-up was performed to assess relapses and emergence of mucosal lesions. Adverse events (AEs) were monitored according to the Division of AIDS AE grading system.
    Results: We evaluated 135 patients. The cure rates (95% confidence interval) for IL-MA and S-MA treatment were, respectively, 82.8% (70.5-91.4) and 67.8% (53.3-78.3) per protocol (PP) and 70.6% (58.3-81.0) and 59.7% (47.0-71.5) per intention to treat (ITT). The epithelialization rates of the IL-MA and S-MA treatment were, respectively, 79.3% (66.6-88 + 8) and 71.2% (57.9-82.2) PP and 69.1% (55.2-78.5) and 64.2% (50.0-74.2) ITT. AEs in the IL-MA and S-MA groups were, respectively, clinical, 45.6% and 80.6%; laboratory, 26.5% and 73.1%; and electrocardiogram, 8.8% and 25.4%. Ten participants in the S-MA group and 1 in the IL-MA group were discontinued due to severe or persistent AEs.
    Conclusions: IL-MA provides a similar cure rate and results in less toxicity compared with S-MA and may be used as first-line therapy for CL patients.
    Clinical trials registration: REBEC: RBR-6mk5n4.
    MeSH term(s) Humans ; Meglumine Antimoniate/therapeutic use ; Meglumine Antimoniate/adverse effects ; Antiprotozoal Agents/adverse effects ; Meglumine/adverse effects ; Brazil ; Treatment Outcome ; Organometallic Compounds/adverse effects ; Leishmaniasis, Cutaneous/drug therapy
    Chemical Substances Meglumine Antimoniate (75G4TW236W) ; Antiprotozoal Agents ; Meglumine (6HG8UB2MUY) ; Organometallic Compounds
    Language English
    Publishing date 2023-04-27
    Publishing country United States
    Document type Randomized Controlled Trial ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciad253
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  3. Article ; Online: Blood transfusion in the care of patients with visceral leishmaniasis: a review of practices in therapeutic efficacy studies.

    Dahal, Prabin / Singh-Phulgenda, Sauman / Wilson, James / Cota, Glaucia / Ritmeijer, Koert / Musa, Ahmed / Alves, Fabiana / Stepniewska, Kasia / Guerin, Philippe J

    Transactions of the Royal Society of Tropical Medicine and Hygiene

    2024  

    Abstract: Blood transfusion remains an important aspect of patient management in visceral leishmaniasis (VL). However, transfusion triggers considered are poorly understood. This review summarises the transfusion practices adopted in VL efficacy studies using the ... ...

    Abstract Blood transfusion remains an important aspect of patient management in visceral leishmaniasis (VL). However, transfusion triggers considered are poorly understood. This review summarises the transfusion practices adopted in VL efficacy studies using the Infectious Diseases Data Observatory VL clinical trials library. Of the 160 studies (1980-2021) indexed in the IDDO VL library, description of blood transfusion was presented in 16 (10.0%) (n=3459 patients) studies. Transfusion was initiated solely based on haemoglobin (Hb) measurement in nine studies, combining Hb measurement with an additional condition (epistaxis/poor health/clinical instability) in three studies and the criteria was not mentioned in four studies. The Hb threshold range for triggering transfusion was 3-8 g/dL. The number of patients receiving transfusion was explicitly reported in 10 studies (2421 patients enrolled, 217 underwent transfusion). The median proportion of patients who received transfusion in a study was 8.0% (Interquartile range: 4.7% to 47.2%; range: 0-100%; n=10 studies). Of the 217 patients requiring transfusion, 58 occurred before VL treatment initiation, 46 during the treatment/follow-up phase and the time was not mentioned in 113. This review describes the variation in clinical practice and is an important initial step in policy/guideline development, where both the patient's Hb concentration and clinical status must be considered.
    Language English
    Publishing date 2024-05-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 441375-1
    ISSN 1878-3503 ; 0035-9203
    ISSN (online) 1878-3503
    ISSN 0035-9203
    DOI 10.1093/trstmh/trae018
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  4. Article: Donor-Derived Tuberculosis: A Case Report and the Role of Communication Gaps in Transplantation Safety.

    Clemente, Wanessa T / Faria, Luciana C / Cota, Gláucia F / Amado, Leandro Ricardo de Navarro / Oliveira, Jaqueline G F / de Miranda, Silvana Spíndola / Cançado, Omar Lopes / Romanelli, Roberta M C / Lima, Agnaldo S / Frade, Luiza Bastos / Lucas, Fernando / Sanches, Marcelo Dias

    Case reports in transplantation

    2021  Volume 2021, Page(s) 8816426

    Abstract: Donor-derived tuberculosis (DD-TB) accounts for less than 5% of TB cases and is considered a rare event. In the transplant setting, the frequency of active TB is estimated to be 20 to 74 times higher than that in the general population, and it is ... ...

    Abstract Donor-derived tuberculosis (DD-TB) accounts for less than 5% of TB cases and is considered a rare event. In the transplant setting, the frequency of active TB is estimated to be 20 to 74 times higher than that in the general population, and it is associated with high mortality. In this context, the main strategy to minimize the risk of DD transmission is to identify high-risk donors. Despite screening recommendations, failures may result in a breakdown of safety that ends in the transmission of potentially fatal diseases. This report describes a case of DD-TB and emphasizes communication gaps that may occur between organ procurement organizations and transplant centers. Failure in reporting results, lack of exchanging information regarding recipients from the same donor, and inefficient communication between organ procurement organizations and transplant centers are lacks that may be prevented by a more efficient approach towards screening protocols and communication.
    Language English
    Publishing date 2021-04-17
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2627657-4
    ISSN 2090-6951 ; 2090-6943
    ISSN (online) 2090-6951
    ISSN 2090-6943
    DOI 10.1155/2021/8816426
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  5. Article ; Online: Predictors of visceral leishmaniasis relapse in HIV-infected patients: a systematic review.

    Cota, Gláucia F / de Sousa, Marcos R / Rabello, Ana

    PLoS neglected tropical diseases

    2011  Volume 5, Issue 6, Page(s) e1153

    Abstract: Background and objectives: Visceral leishmaniasis (VL) is a common complication in AIDS patients living in Leishmania-endemic areas. Although antiretroviral therapy has changed the clinical course of HIV infection and its associated illnesses, the ... ...

    Abstract Background and objectives: Visceral leishmaniasis (VL) is a common complication in AIDS patients living in Leishmania-endemic areas. Although antiretroviral therapy has changed the clinical course of HIV infection and its associated illnesses, the prevention of VL relapses remains a challenge for the care of HIV and Leishmania co-infected patients. This work is a systematic review of previous studies that have described predictors of VL relapse in HIV-infected patients.
    Review methods: We searched the electronic databases of MEDLINE, LILACS, and the Cochrane Central Register of Controlled Trials. Studies were selected if they included HIV-infected individuals with a VL diagnosis and patient follow-up after the leishmaniasis treatment with an analysis of the clearly defined outcome of prediction of relapse.
    Results: Eighteen out 178 studies satisfied the specified inclusion criteria. Most patients were males between 30 and 40 years of age, and HIV transmission was primarily via intravenous drug use. Previous VL episodes were identified as risk factors for relapse in 3 studies. Two studies found that baseline CD4+ T cell count above 100 cells/mL was associated with a decreased relapse rate. The observation of an increase in CD4+ T cells at patient follow-up was associated with protection from relapse in 5 of 7 studies. Meta-analysis of all studies assessing secondary prophylaxis showed significant reduction of VL relapse rate following prophylaxis. None of the five observational studies evaluating the impact of highly active antiretroviral therapy use found a reduction in the risk of VL relapse upon patient follow-up.
    Conclusion: SOME PREDICTORS OF VL RELAPSE COULD BE IDENTIFIED: a) the absence of an increase in CD4+ cells at follow-up; b) lack of secondary prophylaxis; and c) previous history of VL relapse. CD4+ counts below 100 cells/mL at the time of primary VL diagnosis may also be a predictive factor for VL relapse.
    MeSH term(s) Adult ; CD4 Lymphocyte Count ; Chemoprevention/methods ; Female ; HIV Infections/complications ; HIV Infections/immunology ; Humans ; Leishmaniasis, Visceral/diagnosis ; Male ; Recurrence ; Risk Factors
    Language English
    Publishing date 2011-06-07
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
    ZDB-ID 2429704-5
    ISSN 1935-2735 ; 1935-2727
    ISSN (online) 1935-2735
    ISSN 1935-2727
    DOI 10.1371/journal.pntd.0001153
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  6. Article ; Online: Predictors of visceral leishmaniasis relapse in HIV-infected patients

    Gláucia F Cota / Marcos R de Sousa / Ana Rabello

    PLoS Neglected Tropical Diseases, Vol 5, Iss 6, p e

    a systematic review.

    2011  Volume 1153

    Abstract: BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL) is a common complication in AIDS patients living in Leishmania-endemic areas. Although antiretroviral therapy has changed the clinical course of HIV infection and its associated illnesses, the ... ...

    Abstract BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL) is a common complication in AIDS patients living in Leishmania-endemic areas. Although antiretroviral therapy has changed the clinical course of HIV infection and its associated illnesses, the prevention of VL relapses remains a challenge for the care of HIV and Leishmania co-infected patients. This work is a systematic review of previous studies that have described predictors of VL relapse in HIV-infected patients. REVIEW METHODS: We searched the electronic databases of MEDLINE, LILACS, and the Cochrane Central Register of Controlled Trials. Studies were selected if they included HIV-infected individuals with a VL diagnosis and patient follow-up after the leishmaniasis treatment with an analysis of the clearly defined outcome of prediction of relapse. RESULTS: Eighteen out 178 studies satisfied the specified inclusion criteria. Most patients were males between 30 and 40 years of age, and HIV transmission was primarily via intravenous drug use. Previous VL episodes were identified as risk factors for relapse in 3 studies. Two studies found that baseline CD4+ T cell count above 100 cells/mL was associated with a decreased relapse rate. The observation of an increase in CD4+ T cells at patient follow-up was associated with protection from relapse in 5 of 7 studies. Meta-analysis of all studies assessing secondary prophylaxis showed significant reduction of VL relapse rate following prophylaxis. None of the five observational studies evaluating the impact of highly active antiretroviral therapy use found a reduction in the risk of VL relapse upon patient follow-up. CONCLUSION: SOME PREDICTORS OF VL RELAPSE COULD BE IDENTIFIED: a) the absence of an increase in CD4+ cells at follow-up; b) lack of secondary prophylaxis; and c) previous history of VL relapse. CD4+ counts below 100 cells/mL at the time of primary VL diagnosis may also be a predictive factor for VL relapse.
    Keywords Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2011-06-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
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  7. Article ; Online: An immunoproteomics approach to identify

    Machado, Amanda S / Ramos, Fernanda F / Oliveira-da-Silva, João A / Santos, Thaís T O / Tavares, Grasiele S V / Costa, Lourena E / Lage, Daniela P / Teixeira-Ferreira, André / Perales, Jonas / Fernandes, Ana Paula / Moreira, Ricardo L F / Duarte, Mariana C / Tupinambás, Unaí / Caligiorne, Rachel B / Cota, Gláucia F / Coelho, Eduardo A F / Ludolf, Fernanda

    Parasitology

    2020  Volume 147, Issue 9, Page(s) 932–939

    Abstract: The co-infection between visceral leishmaniasis (VL) and human immunodeficiency virus (HIV) has increased in several countries in the world. The current serological tests are not suitable since they present low sensitivity to detect the most of VL/HIV ... ...

    Abstract The co-infection between visceral leishmaniasis (VL) and human immunodeficiency virus (HIV) has increased in several countries in the world. The current serological tests are not suitable since they present low sensitivity to detect the most of VL/HIV cases, and a more precise diagnosis should be performed. In this context, in the present study, an immunoproteomics approach was performed using Leishmania infantum antigenic extracts and VL, HIV and VL/HIV patients sera, besides healthy subjects samples; aiming to identify antigenic markers for these clinical conditions. Results showed that 43 spots were recognized by antibodies in VL and VL/HIV sera, and 26 proteins were identified by mass spectrometry. Between them, β-tubulin was expressed, purified and tested in ELISA experiments as a proof of concept for validation of our immunoproteomics findings and results showed high sensitivity and specificity values to detect VL and VL/HIV patients. In conclusion, the identified proteins in the present work could be considered as candidates for future studies aiming to improvement of the diagnosis of VL and VL/HIV co-infection.
    MeSH term(s) Adult ; Brazil ; Coinfection/diagnosis ; Female ; HIV Infections/diagnosis ; Humans ; Leishmania infantum/isolation & purification ; Leishmaniasis, Visceral/diagnosis ; Male ; Middle Aged ; Proteomics/methods ; Protozoan Proteins/analysis
    Chemical Substances Protozoan Proteins
    Language English
    Publishing date 2020-04-20
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 207627-5
    ISSN 1469-8161 ; 0031-1820
    ISSN (online) 1469-8161
    ISSN 0031-1820
    DOI 10.1017/S0031182020000578
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  8. Article ; Online: Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison.

    Cota, Gláucia F / de Sousa, Marcos R / Fereguetti, Tatiani Oliveira / Rabello, Ana

    PLoS neglected tropical diseases

    2013  Volume 7, Issue 5, Page(s) e2195

    Abstract: Objective: We conducted a systematic literature review with indirect comparison of studies evaluating therapeutic efficacy and toxicity associated to visceral leishmaniasis (VL) therapy among HIV infected individuals.: Main outcome measurements: The ... ...

    Abstract Objective: We conducted a systematic literature review with indirect comparison of studies evaluating therapeutic efficacy and toxicity associated to visceral leishmaniasis (VL) therapy among HIV infected individuals.
    Main outcome measurements: The outcomes of interest were clinical and parasitological cure, mortality, and adverse events.
    Methods: PRISMA guidelines for systematic reviews and Cochrane manual were followed. Sources were MEDLINE, LILACS, EMBASE, Web of Knowledge databases and manual search of references from evaluated studies. We included all studies reporting outcomes after VL treatment, regardless of their design. Study quality was evaluated systematically by using the Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Comprehensive Meta-Analysis software v.2.2.048 was used to perform one-group meta-analysis of study arms with the same drug to estimate global rates of success and adverse events with each drug. These estimates were used, when possible, to indirectly compare treatment options, adjusted for CD4 count. Direct comparison was pooled when available.
    Results: Seventeen studies reporting five treatment regimens and outcome of 920 VL episodes occurring in HIV infected individuals were included. The main outstanding difference in outcome among the treatment regimens was observed in mortality rate: it was around 3 times higher with high-dose antimony use (18.4%, CI 95% 13.3-25%), indirectly compared to lipid formulations of amphotericin B treatment (6.1%, CI 95% 3.9-9.4%). It was observed, also by indirect comparison, higher rates of clinical improvement in study arms using amphotericin B than in study arms using pentavalent antimonial therapy (Sb(v)). The parasitological cure, an outcome that presented some degree of risk of selection and verification bias, had rates that varied widely within the same treatment arm, with high heterogeneity, hampering any formal comparison among drugs. One direct comparison of amphotericin and antimoniate was possible combining results of two studies and confirming the superiority of amphotericin.
    Conclusions: Available evidence suggests that amphotericin is superior to antimony treatment. Death rate using antimoniate high dose is unacceptably high. Randomized controlled trials are necessary to compare different formulations and doses of amphotericin, alternative therapies and drug combinations.
    MeSH term(s) Adolescent ; Adult ; Aged ; Amphotericin B/therapeutic use ; Antimony/therapeutic use ; Antiprotozoal Agents/adverse effects ; Antiprotozoal Agents/therapeutic use ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Female ; HIV Infections/complications ; Humans ; Leishmaniasis, Visceral/drug therapy ; Male ; Middle Aged ; Survival Analysis ; Treatment Outcome ; Young Adult
    Chemical Substances Antiprotozoal Agents ; Amphotericin B (7XU7A7DROE) ; Antimony (9IT35J3UV3)
    Language English
    Publishing date 2013-05-02
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
    ZDB-ID 2429704-5
    ISSN 1935-2735 ; 1935-2727
    ISSN (online) 1935-2735
    ISSN 1935-2727
    DOI 10.1371/journal.pntd.0002195
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients

    Gláucia F Cota / Marcos R de Sousa / Tatiani Oliveira Fereguetti / Ana Rabello

    PLoS Neglected Tropical Diseases, Vol 7, Iss 5, p e

    a systematic review with indirect comparison.

    2013  Volume 2195

    Abstract: We conducted a systematic literature review with indirect comparison of studies evaluating therapeutic efficacy and toxicity associated to visceral leishmaniasis (VL) therapy among HIV infected individuals.The outcomes of interest were clinical and ... ...

    Abstract We conducted a systematic literature review with indirect comparison of studies evaluating therapeutic efficacy and toxicity associated to visceral leishmaniasis (VL) therapy among HIV infected individuals.The outcomes of interest were clinical and parasitological cure, mortality, and adverse events.PRISMA guidelines for systematic reviews and Cochrane manual were followed. Sources were MEDLINE, LILACS, EMBASE, Web of Knowledge databases and manual search of references from evaluated studies. We included all studies reporting outcomes after VL treatment, regardless of their design. Study quality was evaluated systematically by using the Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Comprehensive Meta-Analysis software v.2.2.048 was used to perform one-group meta-analysis of study arms with the same drug to estimate global rates of success and adverse events with each drug. These estimates were used, when possible, to indirectly compare treatment options, adjusted for CD4 count. Direct comparison was pooled when available.Seventeen studies reporting five treatment regimens and outcome of 920 VL episodes occurring in HIV infected individuals were included. The main outstanding difference in outcome among the treatment regimens was observed in mortality rate: it was around 3 times higher with high-dose antimony use (18.4%, CI 95% 13.3-25%), indirectly compared to lipid formulations of amphotericin B treatment (6.1%, CI 95% 3.9-9.4%). It was observed, also by indirect comparison, higher rates of clinical improvement in study arms using amphotericin B than in study arms using pentavalent antimonial therapy (Sb(v)). The parasitological cure, an outcome that presented some degree of risk of selection and verification bias, had rates that varied widely within the same treatment arm, with high heterogeneity, hampering any formal comparison among drugs. One direct comparison of amphotericin and antimoniate was possible combining results of two studies and confirming the superiority of amphotericin.Available evidence suggests that amphotericin is superior to antimony treatment. Death rate using antimoniate high dose is unacceptably high. Randomized controlled trials are necessary to compare different formulations and doses of amphotericin, alternative therapies and drug combinations.
    Keywords Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: ChimLeish, a new recombinant chimeric protein evaluated as a diagnostic and prognostic marker for visceral leishmaniasis and human immunodeficiency virus coinfection.

    Galvani, Nathalia C / Machado, Amanda S / Lage, Daniela P / Freitas, Camila S / Vale, Danniele L / de Oliveira, Daysiane / Ludolf, Fernanda / Ramos, Fernanda F / Fernandes, Bruna B / Luiz, Gabriel P / Mendonça, Débora V C / Oliveira-da-Silva, João A / Reis, Thiago A R / Tavares, Grasiele S V / Chaves, Ana T / Guimarães, Nathalia S / Tupinambás, Unaí / Cota, Gláucia F / Humbert, Maria V /
    Martins, Vívian T / Christodoulides, Myron / Coelho, Eduardo A F / Machado-de-Ávila, Ricardo A

    Parasitology research

    2021  Volume 120, Issue 12, Page(s) 4037–4047

    Abstract: Visceral leishmaniasis (VL) is a neglected tropical disease of global importance caused by parasites of the genus Leishmania, and coinfection with human immunodeficiency virus (HIV) is common in countries where both diseases are endemic. In particular, ... ...

    Abstract Visceral leishmaniasis (VL) is a neglected tropical disease of global importance caused by parasites of the genus Leishmania, and coinfection with human immunodeficiency virus (HIV) is common in countries where both diseases are endemic. In particular, widely used immunological tests for VL diagnosis have impaired sensitivity (Se) and specificity (Sp) in VL/HIV coinfected patients and there is also cross-reactivity with other endemic diseases, e.g., Chagas disease, malaria, and tuberculosis. To develop new antigens to improve the diagnosis of VL and VL/HIV coinfection, we predicted eight specific B-cell epitopes of four Leishmania infantum antigens and constructed a recombinant polypeptide chimera antigen called ChimLeish. A serological panel of 195 serum samples was used to compare the diagnostic capabilities of ChimLeish alongside the individual synthetic peptides. ChimLeish reacted with sera from all VL and VL/HIV coinfected patients [Se = 100%; Sp = 100%; area under the curve (AUC) = 1.0]. Peptides showed lower reactivities (Se = 76.8 to 99.2%; Sp = 67.1 to 95.7%; AUC between 0.87 and 0.98) as did a L. infantum antigenic preparation used as an antigen control (Se = 56.8%; Sp = 69.5%: AUC = 0.45). Notably, ChimLeish demonstrated a significant reduction (p < 0.05) of anti-ChimLeish antibodies after treatment and cure of a small number of patients. Although only a limited serological panel was tested, preliminary data suggest that ChimLeish should be evaluated in larger sample studies for the diagnosis of VL and VL/HIV coinfection.
    MeSH term(s) Antigens, Protozoan/genetics ; Coinfection/diagnosis ; HIV/genetics ; HIV Infections/complications ; Humans ; Leishmania infantum ; Leishmaniasis, Visceral/diagnosis ; Prognosis ; Recombinant Fusion Proteins
    Chemical Substances Antigens, Protozoan ; Recombinant Fusion Proteins
    Language English
    Publishing date 2021-10-19
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 284966-5
    ISSN 1432-1955 ; 0932-0113 ; 0044-3255
    ISSN (online) 1432-1955
    ISSN 0932-0113 ; 0044-3255
    DOI 10.1007/s00436-021-07342-1
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