Evaluation of the effectiveness of three therapeutic protocols used in the treatment of visceral canine leishmaniosis

Leishmaniasis is a tropical and subtropical disease caused by an intracellular protozoan transmitted by a bite from a vector, mainly from the genera Phlebotomus and Lutzomyia, and affects humans and other mammals, especially dogs. The main objective in controlling canine visceral leishmaniasis is to reduce the number of human cases by reducing its prevalence in dogs. In Brazil, glucantime antimoniate and Amphotericin B, utilized for treating the disease in humans, are prohibited so that only miltefosine, which is not employed for treatment of humans, is permitted for use in dogs. This work aimed to evaluate the efficacy of three different therapeutic protocols employed in the treatment of dogs naturally infected with visceral leishmaniasis. Fifty-six (56) dogs, of both sexes, were treated and evaluated utilizing three treatment protocols. The following protocols were utilized: association of several drugs; miltefosine associated with allopurinol; and immunotherapy with anti- Leishmania vaccine associated with Allopurinol. Immunotherapy was the most efficient protocol, followed by an association of drugs and miltefosine. The use of these protocols diminishes the constant relapses of the disease. Associations of therapeutic protocols produced clinical improvement of patients even with presentation of subsequent negative serology. However, the study did not include aspects related to hemoparasitoses, thus a further study is required

Prevalence, incidence and distribution of citrus variegated chlorosis in Bahia, Brazil

Citrus variegated chlorosis (CVC) is one of the most important diseases for Brazilian citriculture. It is caused by Xylella fastidiosa subsp. pauca, a xylem limited, cycadelid and budwood transmitted bacterium. In Bahia, the second most important citrus region in Brazil, CVC has been present since 1997. Our objectives were to characterize the regional spatial pattern of CVC and to establish a relationship between epidemiological variables and horticultural practices, as well as to evaluate whether control measures used so far have been effective and, based on that, to conceive suitable control measures. A series of surveys were performed in two regions of Bahia State (Recôncavo Baiano and Litoral Norte), along with a survey of horticultural and control practices associated with sampled groves. CVC was restricted to Litoral Norte region, especially to three municipalities along the border between Bahia and Sergipe States. The mean CVC incidence in these municipalities followed a gradient, higher in the countryside and decreasing along the coast. Presence and dissemination of CVC was related to poor nursery practices, a massive use of a susceptible orange variety, and an extreme concentration of orange groves in high incidence municipalities, as well as to the absence of specific CVC control. Considering that CVC was not found in Recôncavo Baiano, this region could be considered a "CVC free zone" by the local government. Copyright by the Brazilian Phytopathological Society.EC/ICA4-CT-2001-10005CNPqFAPES

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049