Major risk factors and histopathological profile of treatment failure, relapse and chronic patients with anthroponotic cutaneous leishmaniasis: A prospective casecontrol study on treatment outcome and their medical importance

Over the last years, there has been a remarkable increase in the number of unresponsive patients with anthroponotic cutaneous leishmaniasis (ACL) reported worldwide. The primary objective of this study was to explore the role of demographic, clinical and environmental risk related-factors in the development of treatment failure, relapse and chronic cases compared to responsive patients with ACL. Moreover, molecular, histopathological and immunohistochemical (IHC) findings between these forms were explored. This work was undertaken as a prospective and case-control study in southeastern Iran. Culture media and nested PCR were used to identify the causative agent. Univariate multinomial and multiple multinomial logistic regression models and the backward elimination stepwise method were applied to analyze the data. A P<0.05 was defined as significant. Also, for different groups, skin punch biopsies were used to study the histopathological and immunohistochemical (IHC) profile. All samples showed that L. tropica was the only etiological agent in all unresponsive and responsive patients with ACL. Data analysis represented that 8 major risk factors including nationality, age groups, occupation, marital status, history of chronic diseases, duration of the lesion, the lesion on face and presence of domestic animals in the house were significantly associated with the induction of unresponsive forms. The histopathological and immunohistochemical findings were different from one form to another. The present findings clearly demonstrated a positive relation between ACL and distinct demographic, clinical and environmental risk determinants. Knowledge of the main risk factors for ACL infection is crucial in improving clinical and public health strategies and monitor such perplexing factors. Negligible data are present related to anthroponotic cutaneous leishmaniasis (ACL) treatment outcome and resultant unresponsiveness risk determinants. The role of demographic, clinical, and environmental risk associated-factors in the development of treatment failure, relapse, and chronic forms of ACL has not been studied. We carried out a case-control study for a period of 4 years (2015-2019) using culture media and nested PCR to identify the causative agent. Afterward, we analyzed the data by univariate multinomial and multiple multinomial logistic regression models and the backward elimination stepwise method. Also, we examined skin punch biopsies to study the histopathological and immunohistochemical (IHC) profile for different comparative groups. The findings identified 8 major risk factors were significantly associated with the creation of unresponsive forms. Clinical practitioners and health surveillance systems should be aware of and monitor such perplexing factors. Awareness of the major determinants for unresponsiveness to the treatment of ACL is critical to improving clinical strategies and public health measures. These multidisciplinary approaches need to address specific barriers that directly affect the treatment outcome. © 2021 Bamorovat et al

Silagem da parte aérea de cultivares de mandioca Aerial part silage of cassava cultivars

Foram avaliadas as silagens da parte aérea de três cultivares de mandioca, sendo determinados os parâmetros produtivos, fermentativos e bromatológicos com fracionamento de carboidratos e da fração nitrogenada, digestibilidade in vitro e macro minerais. Adotou-se o delineamento experimental de blocos ao acaso, com três repetições por tratamento, sendo os resultados submetidos à ANOVA e as médias comparadas pelo teste de Tukey a 5% de probabilidade de erro. O cultivar "FRITA" apresentou a maior produção por unidade de área, enquanto os parâmetros fermentativos de todos os cultivares demonstraram a boa qualidade das silagens produzidas. Os cultivares "S 60-10" e "Fepagro RS 13" apresentaram maiores teores de proteína bruta, sendo que o "FRITA" teve menor valor da fração C dos carboidratos em relação ao "S 60-10". O "Fepagro RS 13" e o "S 60-10" mostraram maiores quantidades da fração A da proteína. Considerando que os cultivares estudados apresentaram diferenças significativas em alguns parâmetros, recomenda-se a continuidade de avaliações, procurando-se identificar cultivares que conciliem maior produtividade e valor nutricional. O cultivar "Fepagro RS 13" apresentou o melhor equilíbrio entre produtividade e qualidade para a produção de silagem.<br>Silages of aerial part of three cultivars of cassava were evaluated. The produtive, fermentative, bromatological parameters were determined as well the in vitro digestibility, the mineral elements, the carbohydrates and nitrogen fractions. The experimental design was blocks at random, with three repetitions per treatment, being the results submitted to ANOVA and the averages compared by Tukey’s Test to 5% of mistake probability. The cultivar FRITA showed the highest production per unit of area, while the fementative parameters for all cultivars demonstrated silages with good quality. The S 60-10 and Fepagro RS 13 showed the larger contents of crude protein, the FRITA had smaller value of the fraction C of the carbohydrates than S 60-10. Fepagro RS 13 and the S 60-10 showed larger quantities of the fraction A of the protein. Considering that cultivars studied showed differences in some parameters, it is recommended the continuity of evaluations trying to identify cultivars that conciliate larger productivity and nutritional value. The cultivar Fepagro RS 13 presented the best balance between yield and quality for silage making