A double-blind, randomized, comparative study of the use of a combination of uridine triphosphate trisodium, cytidine monophosphate disodium, and hydroxocobalamin, versus isolated treatment with hydroxocobalamin, in patients presenting with compressive neuralgias

CONTEXT: This paper reports on the results of treatment of compressive neuralgia using a combination of nucleotides (uridine triphosphate trisodium [UTP] and cytidine monophosphate disodium [CMP]) and vitamin B(12). OBJECTIVES: To assess the safety and efficacy of the combination of nucleotides (UTP and CMP) and vitamin B(12) in patients presenting with neuralgia arising from neural compression associated with degenerative orthopedic alterations and trauma, and to compare these effects with isolated administration of vitamin B(12). METHODS: A randomized, double-blind, controlled trial, consisting of a 30-day oral treatment period: Group A (n=200) receiving nucleotides + vitamin B(12,) and Group B (n=200) receiving vitamin B(12) alone. The primary study endpoint was the percentage of subjects presenting pain visual analog scale (VAS) scores ≤20 at end of study treatment period. Secondary study endpoints included the percentage of subjects presenting improvement ≥5 points on the patient functionality questionnaire (PFQ); percentage of subjects presenting pain reduction (reduction in VAS scores at study end in relation to pretreatment); and number of subjects presenting adverse events. RESULTS: The results of this study showed a more expressive improvement in efficacy evaluations among subjects treated with the combination of nucleotides + vitamin B(12), with a statistically significant superiority of the combination in pain reduction (evidenced by VAS scores). There were adverse events in both treatment groups, but these were transitory and no severe adverse event was recorded during the study period. Safety parameters were maintained throughout the study in both treatment groups. CONCLUSION: The combination of uridine, cytidine, and vitamin B(12) was safe and effective in the treatment of neuralgias arising from neural compression associated with degenerative orthopedic alterations and trauma

Hidden danger: Unexpected scenario in the vector-parasite dynamics of leishmaniases in the Brazil side of triple border (Argentina, Brazil and Paraguay).

Every year about 3 million tourists from around the world visit Brazil, Argentina and Paraguay´s triple border region where the Iguaçu Falls are located. Unfortunately, in recent years an increasing number of autochthonous canine and human visceral leishmaniasis (VL) cases have been reported. The parasite is Leishmania (Leishmania) infantum and it is transmitted by sand flies (Phlebotominae). To assess the risk factors favorable for the establishment and spread of potential vectors the Centers for Disease Control and Prevention light trap (CDC-light trap) collections were made in the Foz do Iguaçu (FI) and Santa Terezinha de Itaipu (STI) townships and along two transects between them. Our study determined the Phlebotominae fauna, the factors that affect the presence and abundance of Lutzomyia longipalpis and Nyssomyia whitmani, the presence of L. infantum in different sand fly species and which Leishmania species are present in this region. Lutzomyia longipalpis was the prevalent species and its distribution was related to the abundance of dogs. Leishmania infantum was found in Lu. longipalpis, Ny. whitmani, Ny. neivai and a Lutzomyia sp. All the results are discussed within the Stockholm Paradigm and focus on their importance in the elaboration of public health policies in international border areas. This region has all the properties of stable VL endemic foci that can serve as a source of the disease for neighboring municipalities, states and countries. Most of the urban areas of tropical America are propitious for Lu. longipalpis establishment and have large dog populations. Pan American Health Organization´s initiative in supporting the public health policies in the border areas of this study is crucial and laudable. However, if stakeholders do not act quickly in controlling VL in this region, the scenario will inevitable become worse. Moreover, L. (Viannia) braziliensis found in this study supports the need to develop public health policies to avoid the spread of cutaneous leishmaniasis. The consequences of socioeconomic attributes, boundaries and frontiers on the spread of diseases cannot be neglected. For an efficient control, it is essential that urban planning is articulated with the neighboring cities

Number of positive traps (Nt) and number of sampled sand flies (Nsf) in each area and of each sand fly species.

<p>The number inside the parenthesis represents the percentage of positive traps and the percentage of each species in each area. A total of 123 traps in Foz do Iguaçu, 40 traps in the transect and 33 traps in the Santa Terezinha de Itaipu was assessed.</p

Network of influence of the public services, temperature and humidity, food supply, site, mesoscale, microscale on the abundance of <i>Nyyssomyia whitmani</i> and <i>Lutzomyia longipalpi</i>s.

<p>Network of influence of the public services, temperature and humidity, food supply, site, mesoscale, microscale on the abundance of <i>Nyyssomyia whitmani</i> and <i>Lutzomyia longipalpi</i>s.</p

Loadings of the variables public services, temperature and humidity, food supply, site, mesoscale, microscale analyzed in each group.

<p>Loadings of the variables public services, temperature and humidity, food supply, site, mesoscale, microscale analyzed in each group.</p

Phlebotominae sand fly distribution in the three survey areas (Foz do Iguaçu, Santa Terezinha de Itaipu and transects).

<p>Satellite image free downloaded from <a href="https://landsatlook.usgs.gov/" target="_blank">https://landsatlook.usgs.gov/</a>.</p

Number of traps (Nt) examined, and number (N) and percentage (within parentheses) of positive traps for <i>Lutzomyia longipalpis</i> and <i>Nyssomyia whitmani</i> in three habitats (rural, ruro-urban and urban) in Foz do Iguaçu, Santa Terezinha de Itaipu and two transects between these cities.

<p>Number of traps (Nt) examined, and number (N) and percentage (within parentheses) of positive traps for <i>Lutzomyia longipalpis</i> and <i>Nyssomyia whitmani</i> in three habitats (rural, ruro-urban and urban) in Foz do Iguaçu, Santa Terezinha de Itaipu and two transects between these cities.</p