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Liver Enzyme Elevations in Plasmodium falciparum Volunteer Infection Studies: Findings and Recommendations.

Malaria volunteer infection studies (VISs) accelerate new drug and vaccine development. In the induced blood-stage malaria (IBSM) model, volunteers are inoculated with erythrocytes infected with Plasmodium falciparum. Observations of elevated liver enzymes in the IBSM model with new chemical entities (NCEs) promoted an analysis of available data. Data were reviewed from eight IBSM studies of seven different NCEs, plus two studies with the registered antimalarial piperaquine conducted between June 2013 and January 2017 at QIMR Berghofer, Brisbane, Australia. Alanine aminotransferase (ALT) was e

Triple therapy with artemether-lumefantrine plus amodiaquine versus artemether-lumefantrine alone for artemisinin-resistant, uncomplicated falciparum malaria: an open-label, randomised, multicentre trial.

BACKGROUND: Late treatment failures after artemisinin-based combination therapies (ACTs) for falciparum malaria have increased in the Greate … (10 mg base per kg/day), both given orally as six doses over 3 days. All received a single dose of primaquine (0·25 mg/kg) 24 h after the start of study treatment to limit transmission of the parasite. Parasites were genotyped, identifying artemisinin resistance. The primary outcome was Kaplan-Meier 42-day PCR-corrected efficacy against recrudescence of the …

[Lessons from the Malaria Vector Control Program Based on Indoors Residual Spraying with DDT or Dieldrin in the Pilot Zone of Bobo-Dioulasso: Failure or Success?].

During five years, from 1953, a village scale indoors residual spraying (IRS) was done in the pilot zone of Bobo-Dioulasso, Burkina Faso, wi … aria control policy from vector control to mass drug chemotherapy (with several drugs, chloroquine, primaquine, pyriméthamine etc) without complete stop of transmission either. In fact, such vector control operations by DDT may have different analysis; in one side they can be considered an entomological success but, in another side, the actual reduction of p …

Medicine manipulation: An alternative to mitigate therapeutic gaps in the Brazilian Unified Health System?

Despite the various initiatives carried out in Brazil and in the world, the challenge of offering essential medicines in adequate presentations remains, especially to the public affected by diseases considered neglected and the pediatric population, for whom the therapeutic options remain limited. The main objective of this study was to evaluate the production of manipulated medicines as a strategy to mitigate therapeutic and access gaps to essential medicines within the Brazilian public health system, called the Unified Health System (SUS). The evaluation, carried out between 2020 and 2021, i

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… gondii, in co-infection with HIV (alternative regimen); Treatment of dermatitis herpetiformis. | Infantile Chloroquine phosphate | 50 mg/5 mL Oral solution | Treatment of acute malaria caused by P. malaria, P. vivax and P. ovale (for infections caused by P. vivax and P. ovale, there is subsquent use of primaquine … fever and other rickettsiosis; Secondary infection by bothropic accident. | 7.56 | 29 | 1 month | 1,173.63 Chloroquine phosphate 50 mg/5 mL Oral solution | Treatment of acute malaria caused by P. malaria, P. vivax and P. ovale (for infections caused by P. vivax and P. ovale, there is subsquent use of primaquine …

Quantification of glucose-6-phosphate dehydrogenase activity by spectrophotometry: A systematic review and meta-analysis.

BACKGROUND: The radical cure of Plasmodium vivax and P. ovale requires treatment with primaquine or tafenoquine to clear dormant liver stages. Either drug can induce haemolysis in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency, necessitating screening. The reference diagnostic method for G6PD activity is ultraviolet (UV) spectrophotometry; however, a universal G6PD activity threshold above which these drugs can be safely administered is not yet defined. Our study aimed to quantify assay-based variation in G6PD spectrophotometry and to explore the diagnostic implications o…

Malaria surveillance--United States, 2009.

PROBLEM/CONDITION: Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the … ment drug regimen, of which 39% were among cases with either a P. vivax or P. ovale infection where primaquine was not taken. Among all the reasons for travel, travelers visiting friends and relatives (VFR) and missionaries were the groups with the lowest proportion of chemoprophylexis use. INTERPRETATION: A notable increase in the number of malaria cases w …

Epidemiology, Risk Factors, and Prophylaxis Use for Pneumocystis jirovecii Pneumonia in the Non-HIV Population: A Retrospective Study in Québec, Canada.

BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) remains a significant threat in immunocompromised cases. Recent data on epidemiology and risk factors for PJP in non-HIV cases are scarce, and guidelines on appropriate prophylaxis are lacking. METHODS: In this multicenter retrospective trial, all non-HIV adult cases admitted to hospitals in Québec City, Canada, between January 2011 and January 2021 with a diagnosis of PJP were assessed for eligibility. RESULTS: An overall 129 cases of PJP were included. More than two-thirds had an underlying hematologic disease or an autoimmune/inflammatory

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… including a calcineurin inhibitor | 2 | 0 Others | 0 | 0 No underlying conditions identified | 0 | 2 No immunosuppressive agent | 0 | 2 Total | 32 | 21 An overall 110 patients (85.2%) were treated with trimethoprim-sulfamethoxazole (TMP-SMX) for their infection, while 14 (10.9%) received a combination of primaquine … | No. (%) Pharmacologic therapies | First-line treatment | TMP-SMX | 110/129 (85.2) Primaquine + clindamycin | 14/129 (10.9) Atovaquone | 2/129 (1.55) Pentamidine | 1/129 (0.78) No antimicrobial/palliative care | 2/129 (1.55) Adverse events under TMP-SMX prompting a change to other antimicrobials …

The paradoxical relationship between ligamentum flavum hypertrophy and developmental lumbar spinal stenosis.

Genomic sequencing of worldwide butterfly fauna followed by phylogenetic analysis of protein-coding genes informs butterfly classification throughout the taxonomic hierarchy, from families to species. As a rule, we attribute the same taxonomic rank to more prominent clades of comparable divergence (i.e., at the same level in the tree). For species delimitation, we use criteria based on relative genetic differentiation and the extent of gene exchange between populations. We analyze the current taxonomic classification of butterflies in the light of genomic phylogenies and encounter clades that

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… Agents causing oxidant stress in G6PD deficient individuals include fava beans and drugs such as aspirin, primaquine and quinine [ 4 ]. … Moreover, the endemicity of malaria means that drugs such as quinine, primaquine, and amodiaquine that predispose G6PD deficient to oxidant stress may be routinely prescribed to malaria patients. …

Re-estimation of the burden of serious fungal diseases in Uganda.

BACKGROUND: It is of utmost importance to monitor any change in the epidemiology of fungal diseases that may arise from a change in the number of the at-risk population or the availability of local data. OBJECTIVE: We sought to update the 2015 publication on the incidence and prevalence of serious fungal diseases in Uganda. METHODS: Using the Leading International Fungal Education methodology, we reviewed published data on fungal diseases and drivers of fungal diseases in Uganda. Regional or global data were used where there were no Ugandan data. RESULTS: With a population of ~45 million, w

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… resistance to cotrimoxazole, mediated by mutations in the dihydropteroate synthase (DHPS) enzymes, the main target of sulfamethoxazole, which inhibits the synthetic pathway of folate, has emerged due to widespread use of the drug in both HIV and non-HIV populations. 87 , 88 The anti-malarial agent, primaquine … . 91 However, data on the utilization of rapid diagnostic tests for G6PD deficiency in the larger context of patients with PCP who would need primaquine for second-line treatment are scarce and are a subject for critical review and further research. …

Arterolane-piperaquine-mefloquine versus arterolane-piperaquine and artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Kenyan children: a single-centre, open-label, randomised, non-inferiority trial.

BACKGROUND: Triple antimalarial combination therapies combine potent and rapidly cleared artemisinins or related synthetic ozonides, such as … of bodyweight) were administered once daily. All patients received 0·25 mg/kg of bodyweight of oral primaquine at hour 24. All patients were admitted to Kilifi County Hospital for at least 3 consecutive days and followed up at day 7 and, thereafter, weekly for up to 42 days. The primary endpoint was 42-day PCR-corrected efficacy, defined as the absence of tr …

An Observational Analysis of a Large Cohort of Pneumocystis jirovecii Pneumonia.

BACKGROUND: Pneumocystis jirovecii pneumonia (PCP) is increasingly seen in patients who are non-HIV immunocompromised hosts, yet modern risk factors and outcomes are poorly recognized and defined. METHODS: A retrospective review was conducted of adult patients who met criteria for proven or probable PCP from 2017 to 2024 across a large academic multicenter health system. The primary outcome was mortality among cohorts, defined by etiology of immunosuppression through univariate and age-adjusted logistic regression. Secondary analyses included trends in annual diagnoses and testing patterns.

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… . (%) Final treatment regimen a | Atovaquone | 114 (16.3) Trimethoprim/sulfamethoxazole | 538 (76.7) Clindamycin/primaquine | 33 (4.7) Pentamidine | 5 (0.7) None b | 11 (1.6) Treated with steroids | 497 (70.9) Empiric treatment | 124 (17.7) Degree of hypoxemia | None | 87 (12.4) Nasal cannula | 295 …

Critically Ill Immunosuppressed Host

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… ; or ▪ Atovaquone 1500 mg PO QD; or ▪ TMP-SMX 1 DS PO TIW | For severe PCP : ▪ Pentamidine 4 mg/kg QD infused over at least 60 minutes, some specialists reduce dose to 3 mg/kg IV QD because of toxicities For mild-to-moderate PCP: ▪ Dapsone 100 mg PO QD and TMP 15 mg/kg/day PO (3 divided dose); or ▪ Primaquine … Parenteral trimetrexate or clindamycin-primaquine could be used as salvage regimens as well. Patients who have not improved after 14 to 21 days of therapy with specific chemotherapy plus corticosteroids have an exceedingly poor prognosis. …

Haematological Diseases in the Tropics

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Mass drug administration for malaria.

BACKGROUND: Mass drug administration (MDA), defined as the empiric administration of a therapeutic antimalarial regimen to an entire populat … is with a limited number of studies, we were unable to detect any evidence of additional benefit of primaquine in moderate- and high-transmission settings. Plasmodium species In studies that reported species-specific outcomes, the same interventions resulted in a larger impact on Plasmodium falciparum compared to P. vivax. AUTHORS' CONCLUSIONS: MDA appears …

Novel Strategies for Cancer Combat: Drug Combination Using Repurposed Drugs Induces Synergistic Growth Inhibition of MCF-7 Breast and HT-29 Colon Cancer Cells.

Our group developed a new model of drug combination consisting of the use of antineoplastic drugs and different repurposed drugs, having demonstrated that antimalarial and central nervous system (CNS) drugs have a promising anticancer profile as standalone agents, as well as in combined regimens. Here, we evaluated the anticancer profiles of two different CNS drugs (edaravone and quetiapine), both alone and in combination with antineoplastic agents for breast and colon cancer, to explore whether these repurposed drugs could synergistically enhance the anticancer potential of chemotherapeutic d

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… . | 3.24 Primaquine | N.D. | 29.90 Pyronaridine | 2.43 | 1.39 Tafenoquine | N.D. | 2.60 3.2.1. …

Infectious Diseases

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… Chloroquine–primaquine for non-falciparum NEJM 2008 359:6 www.phac-aspc.gc.ca/publicat/ccdr-rmtc/09vol35/35s1/index-eng.php Rickettsial Infections (Outside of North America) pathophysiology —African tick typhus ( Rickettsia africae ), Mediterranean tick typhus (R. conorii), and scrub typhus ( Orientia …

Infectious Diseases

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… Chloroquine–primaquine for non-falciparum NEJM 2008 359:6 www.phac-aspc.gc.ca/publicat/ccdr-rmtc/09vol35/35s1/index-eng.php TYPHOID FEVER pathophysiology —acquired after exposure to food or water contaminated by Salmonella typhi clinical features —mainly in developing countries. …

Respiratory Tract Infections: Sinusitis, Bronchitis, and Pneumonia

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… Oral atovaquone, primaquine plus clindamycin, and parenteral pentamidine may be given to patients who are intolerant of sulfa-containing regimens. …

Pneumonia in Transplant Recipients: A Comprehensive Review of Diagnosis and Management.

Transplant recipients have an increased risk of complications, including graft dysfunction and infections, which can be life-threatening if not recognized early. Pneumonia ranks as one of the most frequent complications in both solid organ and hematopoietic stem cell transplants. Clinical symptoms manifest late during infections in immunocompromised patients. An aggressive approach centered on early confirmatory diagnosis and a low threshold for empiric therapy is often the most effective strategy. The isolation of a pathogen in an upper airway sample does not necessarily mean the same organis

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… For patients with sulfa allergies, alternatives such as clindamycin/primaquine are available. In severe cases, adjunctive steroids are recommended. Prophylactic options include TMP-SMX, atovaquone, dapsone, or pentamidine [ 75 ]. …