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BACKGROUND: Tungiasis is a neglected tropical disease caused by the adult female sand flea (Tunga penetrans). Dogs are considered important reservoirs of T. penetrans in Brazil. The aim of this study was to determine the monthly insecticidal efficacy of a single oral administration of fluralaner at a dose of 10-18 mg/kg (Bravecto® 1-Month, also registered as Defenza® in some countries; MSD Animal Health) in dogs naturally infested with T. penetrans. METHODS: This clinical trial was conducted in a rural community located in Ilhéus, Bahia, Brazil. A total of 64 dogs were selected and distributed in a completely randomized design between a treated group (TG) that received one single dose of Bravecto® 1-Month (Defenza®) and a negative control group (CG) that received no treatment. Each group was composed of 32 dogs. The evaluations took place on days 0, 7 ± 2, 14 ± 2, 21 ± 2, 28 ± 2, 35 ± 2, and 42 ± 2 post treatment, in which the dogs were inspected to evaluate the infestation stage and classify lesions associated with tungiasis. The primary efficacy was determined from the percentage of treated dogs free of fleas (stage II and III lesions) after administration of the formulation at each evaluation time. Secondary efficacy was based on the number of active lesions (stages II and III) in each group at each evaluation time. The clinical condition of the animals was defined based on the Severity Score for Acute Dog Tungiasis (SCADT), which is related to the number and severity of lesions. RESULTS: The primary efficacy of the product was greater than 95.0% from days 7 to 21 and reached 100.0% between days 28 and 42, with a significant association between treatment and infestation decline (P < 0.025) between days 7 and 42. Secondary drug efficacy was greater than 99.9% from days 7 to 21, reaching 100.0% between days 28 and 42 (P < 0.05). The treated dogs also scored lower on the SCADT than the control animals did during the entire clinical evaluation period (P < 0.05). CONCLUSIONS: A single administration of Bravecto® 1-Month (Defenza®) was effective in eliminating Tunga penetrans infestations, as well as in preventing parasitism for at least 42 days after treatment.
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Enfermedades de los Perros , Insecticidas , Isoxazoles , Tunga , Tungiasis , Animales , Perros , Brasil , Isoxazoles/administración & dosificación , Isoxazoles/uso terapéutico , Enfermedades de los Perros/tratamiento farmacológico , Enfermedades de los Perros/parasitología , Femenino , Insecticidas/administración & dosificación , Insecticidas/uso terapéutico , Tunga/efectos de los fármacos , Tungiasis/tratamiento farmacológico , Tungiasis/veterinaria , Tungiasis/parasitología , Administración Oral , Masculino , Método Doble Ciego , Resultado del TratamientoRESUMEN
Introduction: COVID-19 has greatly affected society by limiting the functioning of sectors of the economy and public services. Considering the essential character of many of these services, especially public security, it is necessary to understand how the disease has affected different groups within the population so that public policies for facing this problem can be implemented. Objectives: To identify and describe the profile of military police officers affected by COVID-19. Methods: This is a descriptive observational study with a quantitative approach, based on secondary data. The electronic medical records of 737 military police officers affected by COVID-19 were accessed; sociodemographic, biological, and professional data were collected, as well as data on disease progression. Data were analyzed using Bioestat® software, v5.3. Results: The peak of the COVID-19 contagion curve happened first among military police officers of the state of Alagoas than in the general population, and a positive effect of social distancing was observed in the containment of disease spread. Moreover, specialized operations units had a higher contagion rate in view of the higher level of exposure linked to their work activities. Conclusions: This study described the profile of military police officers affected by COVID-19, which can substantiate the adoption of public policies and new strategies to fight this disease among officers in Alagoas, thus ensuring the continuity of the service provided to society.
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The sand flea Tunga penetrans is one of the zoonotic agents of tungiasis, a parasitic skin disease of humans and animals. The dog is one of its main reservoirs. This negatively controlled, randomized, double-masked clinical trial evaluated the therapeutic and residual efficacy of fluralaner for treatment of dogs naturally infested with T. penetrans. Sixty-two dogs from an endemically affected community in Brazil were randomly assigned to either receive oral fluralaner (Bravecto chewable tablets) at a dose of 25 to 56 mg fluralaner/kg body weight, or no treatment (31 dogs per group). Dogs were clinically examined using a severity score for acute canine tungiasis (SCADT), parasitological examinations as defined by the Fortaleza classification, and pictures of lesions on days 0 (inclusion and treatment), 7 ± 2, 14 ± 2, 21 ± 2, 28 ± 2, 60 ± 7, 90 ± 7, 120 ± 7 and 150 ± 7. The percentage of parasite-free dogs after treatment was >90% between days 14 and 90 post-treatment with 100% efficacy on study days 21, 28 and 60. Sand flea counts on fluralaner treated dogs were significantly lower (p<0.025) than control dogs on all counts from day 7 to 120. The number of live sand fleas on treated dogs was reduced by > 90% on day 7, > 95% on days 14 and 90, and 100% from day 21 to 60, and with a significant difference between groups from day 7 to 120. From day 7 to day 120, mean SCADT scores were significantly reduced in treated dogs with a mean of 0.10 compared to 1.54 on day 120 in untreated dogs. Therefore, a single oral fluralaner administration is effective for treating and achieving long lasting (> 12 weeks) prevention for tungiasis in dogs.
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Enfermedades de los Perros , Insecticidas , Tungiasis , Animales , Brasil/epidemiología , Enfermedades de los Perros/parasitología , Perros , Insecticidas/uso terapéutico , Isoxazoles , Tunga , Tungiasis/tratamiento farmacológico , Tungiasis/epidemiología , Tungiasis/veterinariaRESUMEN
BACKGROUND: Oxygen-uptake efficiency slope (OUES) is an objective measure of functional capacity that does not require a maximal effort but is considerably dependent on anthropometric variables and requires the generation of an appropriate reference value in children. This study aimed to establish normal reference values for OUES/kg in children with and without congenital heart diseases. Besides that, reference values are presented secondarily for OUES per body surface area (OUES/BSA). DESIGN: Cross-sectional. METHODS: Six hundred and seventy-six children and adolescents performed a maximal cardiopulmonary exercise test (305 healthy controls and 371 individuals with congenital heart defect), between four and 21 years old (481 males and 195 females, with a mean age of 12 years). RESULTS: The OUES reference value for the classification of children and adolescents with normal functional capacity (>80% of predicted maximum oxygen uptake) was 34.63 (sensitivity 77% and specificity 83%, p < 0.05). Regarding the body surface area, considering healthy patients and those with heart disease, the cutoff value of the OUES/BSA was 1151 with sensitivity of 79% and specificity of 79%. CONCLUSIONS: OUES/kg may be an important marker tool in the differentiation between preserved or abnormal functional capacity in children and adolescents with and without congenital heart disease, even at the submaximal level of exercise.
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Prueba de Esfuerzo/normas , Tolerancia al Ejercicio , Cardiopatías Congénitas/diagnóstico , Consumo de Oxígeno , Adolescente , Factores de Edad , Estudios de Casos y Controles , Niño , Preescolar , Estudios Transversales , Femenino , Estado de Salud , Cardiopatías Congénitas/fisiopatología , Humanos , Masculino , Valor Predictivo de las Pruebas , Estudios Prospectivos , Valores de Referencia , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
BACKGROUND/PURPOSE: Although troponin I (TnI) elevation and myocardial injury after percutaneous coronary interventions (PCI) are frequent findings, their prognoses remain controversial. We aimed to determine the association between any or ≥5 times TnI elevation after elective PCI and subsequent one year mortality rates and long term survival. METHODS: Consecutive patients admitted for elective PCI between January 2013 and December 2014 were retrospectively analyzed by chart review in two hospitals in Rio de Janeiro. Only patients with post-PCI TnI measurements were included. Clinical, angiographic and procedural characteristics were correlated with any or ≥5 times TnI elevation, as well as 1year mortality and long term survival. RESULTS: A total of 407 interventions were included in the analysis. Post-PCI TnI elevation was observed in 74.7% of cases and ≥5 times elevations occurred in 41.3%. Age≥70years, female gender and multistenting were predictors of enzyme elevation. Prior aspirin or hypoglycemic therapy were protective factors. One year mortality was significantly associated with any TnI elevation (6.6% vs 1.05%, p=0.035) and values ≥5 times above the normal limit predicted the highest mortality rates (8.13% vs 3.14%, p=0.031). Survival of patients with single vessel disease was also adversely affected by ≥5 times enzyme elevation (log-rank: p=0.039). CONCLUSION: Troponin I elevation after elective PCI is frequent and associated with progressively higher mortality rates at 1year. A cutoff value ≥5 times the 99th percentile, currently defined as myocardial injury, appears to be an even more significant predictor of this outcome, even in lower risk subgroups.