Prevalence and risk factors associated to pruritus in Plasmodium vivax patients using chloroquine in the Brazilian Amazon

Chloroquine-induced pruritus has been described as a common adverse event in African patients being treated for Plasmodium falciparum malaria, and has been associated with treatment discontinuation in this setting. In Latin America, where Plasmodium vivax is the most common species causing malaria and chloroquine is still used as the first-line schizonticidal for treating this parasite infection, there are no reports on chloroquine-induced pruritus. This study aimed to estimate the frequency of pruritus and associated risk factors in P. vivax-infected patients treated with chloroquine in a reference centre in the Brazilian Amazon. In this cross-sectional study, patients who were prescribed with chloroquine for the treatment of microscopy-confirmed P. vivax infection in the past five days were actively asked about the occurrence of any level of pruritus and potential risk factors were investigated. Univariable and multivariable logistic regression was performed for the analysis of possible risk factors in two sets of patients: (1) all the patients interviewed and (2) restricted to patients with previous use of chloroquine. Among the 510 patients interviewed, 20.4% (95%CI: 16.9–23.9%) developed any level of pruritus during treatment with chloroquine. Most episodes of pruritus occurred during the first two days of treatment and the most common location was hands and feet. In multivariate analysis performed in the entire population, the only risk factors independently associated to pruritus were allergy history (adjusted odds ratio [AOR]: 1.83; 95%CI 1.02–3.31; p = 0.044) and high parasitaemia (AOR: 1.96: 95%CI 1.22–3.13; p = 0.005). In the analysis restricted to the 215 patients with previous use of chloroquine, previous chloroquine-induced pruritus was a strong predictor of pruritus occurrence (AOR: 11.84: 95%CI 3.15–44.47; p < 0.001). Two patients (0.4%) interrupted treatment due to the severity of pruritus. Pruritus is a common adverse event in patients being treated with chloroquine for P. vivax malaria in the Brazilian Amazon. Host–parasite interaction may play a relevant role in the development of pruritus and concurs with the finding of strong association of pruritus with high parasitaemia and allergy history. Patients with previous chloroquine-induced pruritus had a high risk for developing pruritus. Due to its high frequency, this side effect cannot be neglected as it can have major implications on patients’ compliance to treatment hampering elimination efforts in the region.     

Prenatal express-diagnosis by the method of QF-PCR and automatic microelectroforesis with microarrays

The modern molecular-genetic methods have been implementing actively into the medical practiee.They improve diagnostic accuracy,help to prognosticate the course of oncological diseases,optimize the res...     

Is the risk for cardiovascular disease increased in all phenotypes of the polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a common disorder in women of reproductive age, affecting around 10% of them. Polycystic ovary syndrome is considered to be related to increased risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). There are 2 definitions for PCOS: one adopted in 1990 (classical PCOS with phenotypes A and B) and the other in 2003 (Rotterdam criteria with 4 phenotypes A to D). The latter is a wider definition including the 1990 phenotypes. There is mounting data suggesting that phenotypes C and D are not actually related to increased CVD risk, and thus screening for CVD risk factors of intervening for primary CVD prevention in young women is not cost-effective. There is an increasing number of suggestions to return to the 1990 criteria plus some metabolic parameters to identify real CVD risk in this population. However, such a strategy needs verification by large, prospective studies.     

Comparative effects of rosuvastatin and atorvastatin on glucose metabolism and adipokine levels in non-diabetic patients with dyslipidaemia: a prospective randomised open-label study

Aims: The impact of statins on glucose metabolism and adipokines remains controversial. We compared the effects of rosuvastatin and atorvastatin on glucose homeostasis, insulin sensitivity (IS), adiponectin and leptin levels as well as systemic inflammation in non‐diabetic patients with dyslipidaemia. Methods: Thirty‐six patients were randomly assigned to 10 mg/day of rosuvastatin (n = 18) or 20 mg/day of atorvastatin (n = 18) for 12 weeks. Total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C), non‐HDL‐C, triglycerides (TG), fasting plasma glucose, insulin, homeostasis model assessment‐insulin resistance (HOMA‐IR), quantitative IS check index (QUICKI), adiponectin, leptin and high‐sensitivity C‐reactive protein (hsCRP) were measured at baseline and after 4 and 12 weeks. Results: Both statins significantly lowered TC, LDL‐C, non‐HDL‐C and TG compared with baseline. Only rosuvastatin caused a significant reduction in insulin and HOMA‐IR levels (?35%, p = 0.005 and ?33%, p = 0.011 respectively) and a significant increase in QUICKI (+11%, p = 0.003) at 12 weeks. In terms of adipokines and hsCRP, no difference was observed after 4 and 12 weeks of treatment with either statin. Conclusions: Rosuvastatin compared with atorvastatin resulted in significant improvements in IS indices. No significant changes in adiponectin, leptin or hsCRP levels were observed at 4 and 12 weeks of treatment with either statin.     

Genetic diversity of NS5A protein from hepatitis C virus genotype 3a and its relationship to therapy response

Background  

The quasispecies nature of HCV may have important implications for viral persistence, pathogenicity and resistance to antiviral agents. The variability of one of the viral proteins, NS5A, is believed to be related to the response to IFN therapy, the standard treatment for infection. In this study we analyzed the quasispecies composition of NS5A protein in patients infected with HCV genotype 3a, before IFN therapy.