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Molecular diagnosis of Chagas disease:a systematic review and meta-analysis

Infectious Diseases of Poverty 2023年第5期12卷 93-93页

作者： Guillermo Pascual-Vázquez Montserrat Alonso-Sardón Beatriz Rodríguez-Alonso Javier Pardo-Lledías Angela Romero Alegría Pedro Fernández-Soto Juan Luis Muñoz Bellido Antonio Muro Moncef Belhassen-García Infectious and Tropical Diseases Group (E-INTRO) Biomedical Research Institute of Salamanca (IBSAL) Tropical Diseases Research Center of the University of Salamanca (CIETUS) Faculty of Pharmacy University of Salamanca Salamanca Spain Area of Preventive Medicine Epidemiology and Public Health Department of Biomedical and Diagnostic Sciences Faculty of Medicine E-INTRO IBSAL CIETUS University of Salamanca Salamanca Spain Internal Medicine Service University Health Care Complex of Salamanca (CAUSA) E-INTRO IBSAL CIETUS Salamanca Spain Internal Medicine Department Hospital Marqués de Valdecilla University of Cantabria IDIVAL (Valdecilla Research Institute) Santander Spain Internal Medicine Service CAUSA. E-INTRO IBSAL CIETUS Salamanca Spain Infectious and Tropical Diseases Group (E-INTRO) IBSAL. CIETUS. Faculty of Pharmacy University of Salamanca Salamanca Spain Microbiology and Parasitology Service CAUSA IBSAL CIETUS CSIC Department of Biomedical and Diagnostic Sciences University of Salamanca Salamanca Spain Internal Medicine Service. Infectious Diseases Section CAUSA IBSAL CIETUS University of Salamanca Salamanca Spain

Background The complexity of the Chagas disease and its phases is impossible to have a unique test for both phases and a lot of different epidemiological scenarios.Currently,serology is the reference standard technique;occasionally,results are inconclusive,and a different diagnostic technique is needed.Some guidelines recommend molecular testing.A systematic review and meta-analysis of available molecular tools/techniques for the diagnosis of Chagas disease was performed to measure their heterogeneity and efficacy in detecting Trypanosoma cruzi infection in blood samples.Methods A systematic review was conducted up to July 27,2022,including studies published in international databases.Inclusion and exclusion criteria were defined to select eligible studies.Data were extracted and presented according to PRISMA 2020 guidelines.Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2(QUADAS-2).A random-effects model was used to calculate pooled sensitivity,specificity,and diagnostic odds ratio(DOR).Forest plots and a summary of the receiving operating characteristics(SROC)curves displayed the outcomes.Heterogeneity was determined by I^(2)and Tau^(2)statistics and P values.Funnel plots and Deek's test were used to assess publication bias.A quantitative meta-analysis of the different outcomes in the two different clinical phases was performed.Results We identified 858 records and selected 32 papers.Studies pertained to endemic countries and nonendemic areas with adult and paediatric populations.The sample sizes ranged from 17 to 708 patients.There were no concerns regarding the risk of bias and applicability of all included studies.A positive and nonsignificant correlation coefficient(S=0.020;P=0.992)was obtained in the set of studies that evaluated diagnostic tests in the acute phase population(ACD).A positive and significant correlation coefficient(S=0.597;P<0.000)was obtained in the case of studies performed in the chronic phase population(CCD).This resulted in high heterogeneity between

关键词： Chagas disease Trypanosoma cruzi Molecular diagnosis Polymerase chain reaction Loop-mediated isothermal amplification

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Loiasis in sub-Saharan migrants living in Spain with emphasis of cases from Equatorial Guinea

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Infectious Diseases of Poverty 2020年第1期9卷 82-89页

作者： Sabino Puente German Ramírez-Olivencia Mar Lago Mercedes Subirats Francisco Bru Eugenio Pérez-Blazquez Marta Arsuaga Concepción Ladron de Guevara Fernando de la Calle-Prieto Belén Vicente Montserrat Alonso-Sardón Moncef Belhassen-Garcia Antonio Muro Unidad de Medicina Tropical.Servicio de Medicina Interna.Hospital La Paz-Carlos III MadridSpain Unidad de Aislamiento de Alto Nivel.Sección de Enfermedades Infecciosas.Servicio de Medicina Interna.Hospital Central de la Defensa Gómez Ulla MadridSpain Microbiología.Hospital La Paz-Carlos III MadridSpain Dermatología MadridSpain Servicio de Oftalmología.Hospital Universitario 12 de Octubre Universidad Complutense de MadridMadridSpain Laboratorio de Inmunología Parasitaria y Molecular.cietus.IBSAL Facultad de FarmaciaUniversidad de SalamancaAvenida Donantes de Sangre s/n37007 SalamancaSpain Área de Medicina Preventiva y Salud Pública IBSALCIETUSUniversidad de SalamancaSalamancaSpain Servicio de Medicina Interna.Sección de Enfermedades Infecciosas.CAUSA.IBSAL.cietus Universidad de SalamancaPaseo San Vicente 58-18237007 SalamancaSpain

Background:Loiasis is an uncommon and poorly understood parasitic disease outside endemic areas of Africa.The aim of this study was to describe the clinical and biological patterns and treatment of imported loiasis by sub-Saharan migrants diagnosed in Madrid,Spain.Methods:A retrospective study was conducted with sub-Saharan immigrants seen at the Tropical Medicine Unit of the Carlos III Hospital in Madrid,Spain,a reference center,over 19 years.Categorical variables were expressed as frequency counts and percentages.Continuous variables were expressed as the mean and standard deviation(SD)or median and interquartile range(IQR:Q3–Q1).Chi-square tests were used to assess the association between categorical variables.The measured outcomes were expressed as the odds ratio(OR)with a 95%confidential interval.Continuous variables were compared by Student’s t-tests or Mann-Whitney U tests.Binary logistic regression models were used.P<0.05 was considered a statistically significant difference.Results:One hundred thirty-one migrants from tropical and subtropical areas with loiasis were identified.Forty-nine patients were male(37.4%).The migrants’mean age(±SD)was 42.3±17.3 years,and 124(94.7%)were from Equatorial Guinea.The median time(IQR)between arrival in Spain and the first consultation was 2(1–7)months.One hundred fifteen migrants had eosinophilia,and one hundred thirteen had hyper-IgE syndrome.Fifty-seven patients had pruritus(43.5%),and thirty patients had Calabar swelling(22.9%).Seventy-three patients had coinfections with other filarial nematodes(54.2%),and 58 migrants had only Loa loa infections(45.8%).One hundred two patients(77.9%)were treated;45.1%(46/102)patients were treated with one drug,and 54.9%(56/102)patients were treated with combined therapy.Adverse reactions were described in 14(10.7%)migrants.Conclusions:Our patients presented early clinical manifestations and few atypical features.Thus,physicians should systematically consider loiasis in migrants with a typical presentation.However,considering that 7

关键词： Loa loa Loiasis Tropical medicine Clinical study Immigrant Imported disease Spain

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Imported Mansonella perstans infection in Spain

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Infectious Diseases of Poverty 2020年第4期9卷 158-158页

作者： Sabino Puente Mar Lago Mercedes Subirats Ismael Sanz-Esteban Marta Arsuaga Belén Vicente Montserrat Alonso-Sardon Moncef Belhassen-Garcia Antonio Muro Unidad de Medicina Tropical Servicio de Medicina InternaHospital La Paz-Carlos IIIMadridSpain Microbiología Hospital La Paz-Carlos IIIMadridSpain Facultad de Fisioterapia Universidad Europea de MadridMadridSpain Laboratorio de Inmunología Parasitaria y Molecular CIETUSIBSALFacultad de FarmaciaUniversidad de Salamanca37007SalamancaSpain Área de Medicina Preventiva y Salud Pública IBSALCIETUSUniversidad de SalamancaSalamancaSpain Servicio de Medicina Interna Sección de Enfermedades InfecciosasCAUSAIBSALCIETUSUniversidad de SalamancaPaseo San Vicente 58-18237007SalamancaSpain

Background Mansonella perstans infection can be considered one of the most neglected tropical infectious diseases.Very few studies have reported on the clinical picture caused by infection with this nematode.Therefore,our study was aimed to describe the clinical patterns and treatment of imported M.perstans infection by migrants from Africa.Methods The present study evaluated a large cohort of migrants who have been diagnosed,examined and treated for imported M.perstans infection at a Spanish reference center(Hospital Carlos III Tropical Medicine Unit,Madrid,Spain)over a 19-year period.Most patients voluntarily attend the emergency unit or are referred from primary care or general hospitals in Madrid.Chi-square test was used to compare the association between categorical variables.The continuous variables were compared by Student’s t-test or the Mann–Whitney test.The corresponding regression models were used for multivariate analysis.Results Five hundred three cases of migrants from tropical and subtropical areas with M.perstans infection were identified.Two hundred sixty-four patients were female(52.5%).The mean age(±SD)was 44.6±18.2 years(range:16–93 years).The mean time(±SD)between the arrival in Spain and the first consultation was 8.6±18.0 months.The major origin of the patients was Equatorial Guinea(97.6%).Regarding the clinical picture,257 patients were asymptomatic(54.7%)and 228 were symptomatic(45.3%);190 patients had pruritus(37.8%),50(9.9%)had arthralgia,18 patients had Calabar-like swelling(3.6%),and 15(3%)had abdominal pain.Four hundred forty-two(87.9%)migrants had hyper-IgE,and 340(67.6%)had eosinophilia.One hundred ninety-five patients had coinfections with other filarial nematodes(38.8%),and 308 migrants had only M.perstans infection(61.2%).Four hundred thirty-seven cases(86.9%)had been treated with anti-filarial drugs;292 cases were treated with one anti-filarial drug,and 145 cases were treated with combined anti-filarial therapy.Additionally,20(4%)cases received steroids and 38(7.6%)cases receiv

关键词： Mansonellosis Mansonella perstans Clinical study Immigrant Imported diseases Spain

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<i>Angiostrongylus costaricensis</i>: Systematic Review of Case Reports

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Advances in Infectious Diseases 2014年第1期4卷 36-41页

作者： Angela Romero-Alegría Moncef Belhassen-García Virginia Velasco-Tirado Ana Garcia-Mingo Lucia Alvela-Suárez Javier Pardo-Lledias Miguel Cordero Sánchez Department of Internal Medicine CAUSA IBSAL Salamanca Spain Department of Internal Medicine CAUSA IBSAL Salamanca Spain cietus University of Salamanca Salamanca Spain Department of Internal Medicine General Hospital of Palencia “Río Carrión” Palencia Spain

Introduction: Abdominal angiostrongyliasis is an infrequently diagnosed disease because it is little known and is usually well tolerated. Methods: We carried out a systematic review with PubMed as a search engine for the MedLine database, and we analysed the clinical, epidemiological and analytical parameters of this disease. Results: In total, reports of 27 case have been found, together with a series of 116 patients, which were later augmented up to 194 patients. In the results, we have observed a predominance of male patients, and Costa Rica, Brazil and the United States as the main countries of origin. Typical symptoms include abdominal pain on the right iliac fossa, with leukocytosis and eosinophilia. Discussion: There are some serological diagnostic methods, although lack of standardization leads to most of the diagnoses being reached via pathology. Surgery is the usual treatment approach. Although there are medical options, this is a controversial subject because of the low number of cases published in the literature, which implies an absence of solid studies.

关键词： Angiostrongylus costaricensis Abdominal Angiostrongyliasis Acute Abdomen Eosinophilia

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Disseminated infection due to Mycobacterium bovis after intravesical BCG instillation

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World Journal of Clinical Cases 2014年第7期2卷 301-303页

作者： Sara Marquez-Batalla Esther Fraile-Villarejo Moncef Belhassen-García Nieves Gutierrez-Zubiaurre Miguel Cordero-Sánchez Servicio de Medicina Interna (CAUSA) IBSALUniversidad de Salamanca37007 SalamancaSpain Servicio de Medicina Interna Seccion de Enfermedades InfecciosasComplejo Asistencial Universitario de Salamanca (CAUSA)Instituto de investigacion Biomedica de Salamanca (IBSAL)Universidad de Salamanca37007 SalamancaSpain Servicio de Microbiologia (CAUSA)CIETUSIBSAL37007 SalamancaSpain

Intravesical bacillus Calmette-Guerin(BCG) instillation has been adopted for the treatment of patients with superficial bladder cancer. Severe adverse events due to local instillation of BCG are uncommon, with an overall rate of serious complications of less than 5%. We report the case of an immunocompetent adult patient with multi-system effects, namely pneumonitis, granulomatous hepatitis and meningitis, who responded well to standard treatment for Mycobacterium bovis. This case highlights the importance of a thorough assessment of this type of patient.

关键词： Tuberculosis Mycobacterium bovis Bladder cancer Bacillus Calmette-Guerin

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