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Public health aspects of visceral leishmaniasis in Montenegro

Open Journal of Clinical Diagnostics 2013年第4期3卷 195-201页

作者： Bogdanka andric Dragica Terzic Brankica Dupanovic Aleksandar andric University Medical School of Montenegro Podgorica Montenegro

leishmaniasis belongs to the parasitic communicable zoo noses, caused by members of leishmania species. The infected phlebotomies sand fly carries the parasites, which cause the different forms of disease. Retrospective/prospective review of records for documented cases of visceral leishmaniasis (Vl) in period from 1992 to 2012 in Montenegro shows 83 diagnostic cases, and 1 (1.20%) case with dermal leichmaniasis. with 3 (3.61%) deaths cases. Analyses of age show: 36 (43.37%) children and 47 (56.63%) adults. Examinations are based on epidemiological, clinical, hematological, patohystological and serological investigations. Infection can be sub-clinically or clinically manifested with acute, sub-acute, and chronic type. Incubation in clinically manifested infections ranges from several weeks to several months. In our study, the prevalence of general infective syndrome is registered in all of 83 manifested cases (100%). Enlarged spleen in 79 (95.18%) cases, enlarged liver in 37 (44.57%) cases, anemia in 49 (59.04%) cases, pancytopenia in 32 (38.55%) cases, and increased activity of serum aminotransferases in 37 (44.57%) cases. The diagnosis was confirmed by an analysis of bone marrow biopsy material by direct microscopy of serial sections colored by Romanowski and Giemsa s staining, and by immune-biochemical methods. Serological diagnostic is confirmed by using agglutination test. In Montenegro (in humans and dogs) two types of leishmania (l) (l. donovani, l. infantum were presented). As to therapy treatment, the common treating is with antimony drugs: glucantime is relatively satisfactory for a long time. During 2008 there were registered cases not responding to the therapy and those were manifested with relapses after therapy. In the first line of therapy, we used meglumine antimony (Glucantime) in 78 (93.97%) patients. Resistence developed in 7 (8.97%) during treatment, and relapse occurred in 5 (6.41%) patients. It was 1 (1.20%) patient treated with Miltefosine the

关键词： leishmaniasis Resistance Severity Diagnostic Difficulties

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Glucagon-like-1 receptor agonists and sodium/glucose cotransporter-2 inhibitors combination—are we exploiting their full potential in a real life setting?

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World Journal of Diabetes 2020年第11期11卷 540-552页

作者： Maja Cigrovski Berkovic Ines Bilic-Curcic Tomislav Bozek Davorka Herman Mahecic Sanja klobucarMajanovic Silvija Canecki-Varzic Jelena andric Srecko Marusic Anna Mrzljak Faculty of Medicine J.J.Strossmayer University OsijekOsijek 31000Croatia Department for Endocrinology Diabetes and Clinical PharmacologyClinical Hospital DubravaZagreb 10000Croatia Department of kinesiological Anthropology and Methodology Faculty of KinesiologyUniversity of ZagrebZagreb 10000Croatia Department of Endocrinology and Metabolism Disorders Clinical Hospital CenterOsijek 31000Croatia University Clinic for Diabetes“Vuk Vrhovac” Merkur University HospitalZagreb 10000Croatia School of Medicine University of ZagrebZagreb 10000Croatia Department for Endocrinology Diabetes and MetabolismUniversity Hospital Centre“Sestre milosrdnice”Zagreb 10000Croatia Department for Endocrinology Diabetes and MetabolismUniversity Hospital Centre RijekaSchool of MedicineUniversity of Rijeka51000 RijekaCroatia Department of Medicine Merkur University HospitalSchool of MedicineUniversity of ZagrebZagreb 10000Croatia

BACkGROUND The sodium/glucose cotransporter-2 inhibitors(SGlT-2i)and glucagon-like-1 receptor agonists(GlP-1RA)are antidiabetic agents effective both in hemoglobin A1c(HbA1c)reduction(with a low risk of hypoglycemia)and cardiovascular event *** patients with type 2 diabetes,the add-on value of combination therapy of GlP-1RA and an SGlT-2i seems *** To investigate whether the efficacy of GlP-1RA and SGlT-2i combination observed in randomized controlled trials translates into therapeutic benefits in the Croatian population during routine clinical practice and *** We included 200 type 2 diabetes patients with poor glycemic control and analyzed the effects of treatment intensification with(1)GlP-1RA on top of SGlT-2i,(2)SGlT-2i on top of GlP-1RA compared to(3)simultaneous addition of both *** primary study endpoint was the proportion of participants with HbA1cluded changes in fasting plasma glucose(FPG),prandial plasma glucose,lowdensity lipoprotein cholesterol,estimated glomerular filtration rate(eGFR),and cardiovascular(CV)incidents assessment over a follow-up period of 12 *** The majority of patients were over 65-years-old,had diabetes duration for more than 10 *** initial body mass index was 39.41±5.49 kg/m2 and HbA1c 8.32±1.26%.Around half of the patients in all three groups achieved target HbA1c below 7%.A more pronounced decrease in the HbA1c seen with simultaneous SGlT-2i and GlP-1RA therapy was a result of higher baseline HbA1c and not the effect of initiating combination *** number of patients achieving FPG below 7.0 mmol/l was significantly higher in the SGlT-2i group(P=0.021),and 5%weight loss was dominantly achieved in the simultaneous therapy group(P=0.044).A composite outcome(reduction of HbA1c below 7%(53 mmol/mol)with 5%weight loss)was achieved in 32.3%of total patients included in the *** 18.2%of patients attained composite outc

关键词： Sodium/glucose cotransporter-2 inhibitors Glucagon-like-1 receptor agonists Type 2 diabetes mellitus Body weight Glycemic control Cardiovascular complications

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levels of insecticide resistance to deltamethrin,malathion,and temephos,and associated mechanisms in Aedes aegypti mosquitoes from the Guadeloupe and Saint Martin islands(French West Indies)

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Infectious Diseases of Poverty 2017年第1期6卷 339-353页

作者： Daniella Goindin Christelle Delannay andric Gelasse Cedric Ramdini Thierry Gaude Frederic Faucon Jean-Philippe David Joël Gustave Anubis Vega-Rua Florence Fouque laboratory of Medical Entomology Unit Environment and HealthPasteur Institute of Guadeloupe97183 Les AbymesGuadeloupe Vector control Service Regional Health AgencyDothemareLes AbymesGuadeloupe Alpine Ecology laboratory(lECA) CNRSUMR 55532233 rue de la piscine BP5338041 GrenobleCedex 9France University of Grenoble Alpes GrenobleFrance Environmental and Systems Biology(BEeSy) University of Grenoble AlpesGrenobleFrance Vector Environment and Society Unit Special Programme for Research and Training in Tropical Diseases(TDR)World Health Organization20Avenue AppiaCH-1211 Geneva 27Switzerland

Background:In the Guadeloupe and Saint Martin islands,Aedes aegypti mosquitoes are the only recognized vectors of dengue,chikungunya,and Zika *** around 40 years,malathion was used as a mosquito adulticide and temephos as a *** the European Union banned the use of these two insecticide molecules in the first decade of the 21st century,deltamethrin and Bacillus thuringiensis *** are the remaining adulticide and larvicide,respectively,used in *** order to improve the management of vector control activities in Guadeloupe and Saint Martin,we investigated *** resistance to and mechanisms associated with deltamethrin,malathion,and ***:*** mosquitoes were collected from six different localities of Guadeloupe and Saint *** were used for malathion and temephos bioassays,and adult mosquitoes for deltamethrin bioassays,following World Health Organization *** resistance(kdr)genotyping for V1016I and F1534C mutations,and expression levels of eight enzymes involved in detoxification mechanisms were examined in comparison with the susceptible reference Bora Bora ***:Resistance ratios(RR50)calculated for *** larvae showed high resistance levels to temephos(from 8.9 to 33.1-fold)and low resistance levels to malathion(from 1.7 to 4.4-fold).Adult females displayed moderate resistance levels to deltamethrin regarding the time necessary to affect 50%of individuals,varying from 8.0 to *** investigations on adult mosquitoes showed high resistant allele frequencies for V1016I and F1534C(from 85 to 96%and from 90 to 98%,respectively),as well as an overexpression of the glutathione S-transferase gene,GSTe2,the carboxylesterase CCEae3a,and the cytochrome genes 014614,CYP6BB2,CYP6M11,and ***:*** populations from Guadeloupe and Saint Martin exhibit multiple resistance to organophosphates(temephos and malathion),and pyrethroids(deltamethrin

关键词： Aedes aegypti Mosquitoes Insecticide resistance Deltamethrin Malathion Temephos Guadeloupe Saint Martin

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