Experience with Rifabutin-Containing Therapy in 500 Patients from the European Registry on Helicobacter pylori Management (Hp-EuReg)

Background: First-line Helicobacter pylori (H. pylori) treatments have been relatively well evaluated; however, it remains necessary to identify the most effective rescue treatments. Our aim was to assess the effectiveness and safety of H. pylori regimens containing rifabutin. METHODS: International multicentre prospective non-interventional European Registry on H. pylori Management (Hp-EuReg). Patients treated with rifabutin were registered in AEG-REDCap e-CRF from 2013 to 2021. Modified intention-to-treat and per-protocol analyses were performed. Data were subject to quality control. Results: Overall, 500 patients included in the Hp-EuReg were treated with rifabutin (mean age 52 years, 72% female, 63% with dyspepsia, 4% with peptic ulcer). Culture was performed in 63% of cases: dual resistance (to both clarithromycin and metronidazole) was reported in 46% of the cases, and triple resistance (to clarithromycin, metronidazole, and levofloxacin) in 39%. In 87% of cases rifabutin was utilised as part of a triple therapy together with amoxicillin and a proton-pump-inhibitor, and in an additional 6% of the patients, bismuth was added to this triple regimen. Rifabutin was mainly used in second-line (32%), third-line (25%), and fourth-line (27%) regimens, achieving overall 78%, 80% and 66% effectiveness by modified intention-to-treat, respectively. Compliance with treatment was 89%. At least one adverse event was registered in 26% of the patients (most frequently nausea), and one serious adverse event (0.2%) was reported in one patient with leukope-nia and thrombocytopenia with fever requiring hospitalisation. Conclusion: Rifabutin-containing therapy represents an effective and safe strategy after one or even several failures of H. pylori eradication treatment

Empirical Second-Line Therapy in 5000 Patients of the European Registry on Helicobacter pylori Management (Hp-EuReg)

Background & Aims: After a first Helicobacter pylori eradication attempt, approximately 20% of patients will remain infected. The aim of the current study was to assess the effectiveness and safety of second-line empiric treatment in Europe. Methods: This international, multicenter, prospective, non-interventional registry aimed to evaluate the decisions and outcomes of H pylori management by European gastroenterologists. All infected adult cases with a previous eradication treatment attempt were registered with the Spanish Association of Gastroenterology–Research Electronic Data Capture until February 2021. Patients allergic to penicillin and those who received susceptibility-guided therapy were excluded. Data monitoring was performed to ensure data quality. Results: Overall, 5055 patients received empiric second-line treatment. Triple therapy with amoxicillin and levofloxacin was prescribed most commonly (33%). The overall effectiveness was 82% by modified intention-to-treat analysis and 83% in the per-protocol population. After failure of first-line clarithromycin-containing treatment, optimal eradication (>90%) was obtained with moxifloxacin-containing triple therapy or levofloxacin-containing quadruple therapy (with bismuth). In patients receiving triple therapy containing levofloxacin or moxifloxacin, and levofloxacin–bismuth quadruple treatment, cure rates were optimized with 14-day regimens using high doses of proton pump inhibitors. However, 3-in-1 single capsule or levofloxacin–bismuth quadruple therapy produced reliable eradication rates regardless of proton pump inhibitor dose, duration of therapy, or previous first-line treatment. The overall incidence of adverse events was 28%, and most (85%) were mild. Three patients developed serious adverse events (0.3%) requiring hospitalization. Conclusions: Empiric second-line regimens including 14-day quinolone triple therapies, 14-day levofloxacin–bismuth quadruple therapy, 14-day tetracycline–bismuth classic quadruple therapy, and 10-day bismuth quadruple therapy (as a single capsule) provided optimal effectiveness. However, many other second-line treatments evaluated reported low eradication rates. ClincialTrials.gov number: NCT02328131

Current threats faced by Neotropical parrot populations

Made available in DSpace on 2018-12-11T16:49:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-10-01Consejo Nacional de Investigaciones Científicas y TécnicasAgencia Nacional de Promoción Científica y TecnológicaPsittaciformes (parrots, cockatoos) are among the most endangered birds, with 31% of Neotropical species under threat. The drivers of this situation appear to be manifold and mainly of anthropogenic origin. However, this assessment is based on the last extensive consultation about the conservation situation of parrots carried out in the 1990s. Given the rapid development of anthropogenic threats, updated data are needed to strategize conservation actions. Using a population approach, we addressed this need through a wide-ranging consultation involving biologists, wildlife managers, government agencies and non-governmental conservation organizations. We gathered up-to-date information on threats affecting 192 populations of 96 Neotropical parrot species across 21 countries. Moreover, we investigated associations among current threats and population trends. Many populations were affected by multiple threats. Agriculture, Capture for the Pet Trade, Logging, each of them affected > 55% of the populations, suggesting a higher degree of risk than previously thought. In contrast to previous studies at the species level, our study showed that the threat most closely associated with decreasing population trends is now Capture for the local Pet Trade. Other threats associated with decreasing populations include Small-holder Farming, Rural Population Pressure, Nest Destruction by Poachers, Agro-industry Grazing, Small-holder Grazing, and Capture for the international Pet Trade. Conservation actions have been implemented on < 20% of populations. Our results highlight the importance of a population-level approach in revealing the extent of threats to wild populations. It is critical to increase the scope of conservation actions to reduce the capture of wild parrots for pets.Instituto Multidisciplinario sobre Ecosistemas y Desarrollo Sustentable CONICET—Universidad Nacional del Centro de la Provincia de Buenos AiresJustus-Liebig-Universität Giessen Department of Animal Ecology and SystematicsTexas A&M University Schubot Exotic Bird Health Center Department of Veterinary Pathobiology College of Veterinary MedicineSociedade de Pesquisa em Vida Selvagem e Educação AmbientalUniversidade Federal de SergipePrograma Lapa Verde Centro Científico TropicalFacultad de Ciencias Naturales y Museo Universidad Nacional de La PlataArea de Conservación Pacífico Central ACOPAC Programa de Vida SilvestreWildlife Conservation SocietyAarhus UniversityGrupo de Ecología Conservación de Islas A.C. (GECI)University of California Department of Environment Science Policy & ManagementUniversidad Nacional Federico VillarrealUniversidade Federal de GoiásInstituto Venezolano de Investigaciones CientíficasProyecto Selva de Pino ParanáUnidos por las Guacamayas A. C.SELVA: Investigación para la conservación en el NeotrópicoInstituto Nacional de Tecnología AgropecuariaUniversity of BrasíliaUniversidade Federal da Paraíba Centro de Ciências Exatas e da NaturezaCentro Nacional de Pesquisa e Conservação de Aves Silvestres/ICMBioUniversidade Federal do Pará Instituto de Ciências BiológicasGuyra ParaguayUniversity of Colorado Department of Integrative BiologyThe World Parrot TrustBirdsCaribbeanFundacion del RioUniversitat de BarcelonaSociedad Conservacionista Audubon de VenezuelaUniversidad de Sancti Spíritus ¨José Martí Pérez¨Estación Biológica de Doñana CSICFundación Pro-BosqueCompañeros en Vuelo PIF-SVInstituto de Investigaciones Marinas y Costeras CONICET—Universidad Nacional de Mar del PlataUniversity of North Texas Biological SciencesOne Earth ConservationInstituto Espaço SilvestreUniversidade do Estado do AmazonasNational Aviary Conservation and Field ResearchUniversity of Cape TownBirdlife InternationalPaso PacíficoUniversidade de Passo FundoBiola UniversityMinisterio del Ambiente y los Recursos Naturales (MARENA)Universidad Michoacana de San Nicolas de HidalgoFundação Universidade Federal de Mato Grosso do SulAQUASISFundación Botánica y Zoológica de BarranquillaProvitaCIT Jujuy CONICET—UNJuFundación de Ciencias para el Estudio y la Conservación de la Biodiversidad (INCEBIO)UNESP Instituto de Biociências de BotucatuUniversidad Nacional Autónoma de México Estación Biología Chamela Instituto de BiologíaVinculación Interdisciplinaria para el Desarrollo Ambiental y lo SocialMesserli Research Institute University of Veterinary MedicineMuseo Noel Kempff MercadoGobierno Autónomo Departamental de Santa CruzUniversidad Autónoma de SinaloaMuseu de Zoologia da Universidade de Sao Paulo (MZUSP)University of Freiburg Evolutionary Biology and Animal EcologyMuseu de História Natural Capão da ImbuiaFundação Neotropica do BrasilCEMAVE: Centro Nacional de Pesquisa para a Conservação das Aves SilvestresCORBIDIAsociación Fauna ForeverUniversity of San Francisco Xavier de ChuquisacaUniversidad Nacional Autónoma de México Museo de Zoología Facultad de CienciasU.S. Fish and Wildlife Service Puerto Rican Parrot Recovery ProgramEcho Parrots and PeopleCátedra de Ecología General y Recursos Naturales Universidad Nacional Arturo JauretcheFundación para la Investigación y Conservación de los Loros en Bolivia (CLB)Instituto de Bio y Geociencias del NOA CONICETLaboratorio Nacional de Análisis y Síntesis Ecológica Universidad Nacional Autónoma de MéxicoDepto. de Estudios Ambientales Universidad Simón BolívarUNESP Instituto de Biociências de BotucatuConsejo Nacional de Investigaciones Científicas y Técnicas: CONICET-PIP 112-201501-0598Agencia Nacional de Promoción Científica y Tecnológica: FONCyT-PICT 2015-228

Current threats faced by Neotropical parrot populations

Berkunsky I, Quillfeldt P, Brightsmith DJ, et al. Current threats faced by Neotropical parrot populations. Biological Conservation. 2017;214:278-287.Psittaciformes (parrots, cockatoos) are among the most endangered birds, with 31% of Neotropical species under threat. The drivers of this situation appear to be manifold and mainly of anthropogenic origin. However, this assessment is based on the last extensive consultation about the conservation situation of parrots carried out in the 1990s. Given the rapid development of anthropogenic threats, updated data are needed to strategize conservation actions. Using a population approach, we addressed this need through a wide-ranging consultation involving biologists, wildlife managers, government agencies and non-governmental conservation organizations. We gathered up-to-date information on threats affecting 192 populations of 96 Neotropical parrot species across 21 countries. Moreover, we investigated associations among current threats and population trends. Many populations were affected by multiple threats. Agriculture, Capture for the Pet Trade, Logging, each of them affected > 55% of the populations, suggesting a higher degree of risk than previously thought. In contrast to previous studies at the species level, our study showed that the threat most closely associated with decreasing population trends is now Capture for the local Pet Trade. Other threats associated with decreasing populations include Small-holder Farming, Rural Population Pressure, Nest Destruction by Poachers, Agro-industry Grazing, Small-holder Grazing, and Capture for the international Pet Trade. Conservation actions have been implemented on < 20% of populations. Our results highlight the importance of a population-level approach in revealing the extent of threats to wild populations. It is critical to increase the scope of conservation actions to reduce the capture of wild parrots for pets