Fototerapia para el tratamiento de la leishmaniasis cutánea

ResumenLa leishmaniasis es una enfermedad endémica en 98 países, con más de 350 millones de personas en riesgo de adquirir la infección y 12 millones de casos. Los antimonios pentavalentes, la anfotericina B y la miltefosina han sido el tratamiento de elección para todas las formas de leishmaniasis. Sin embargo, desventajas como el alto costo, la duración del tratamiento y los efectos tóxicos asociados, promueven la falta de cumplimiento del tratamiento o su abandono y la aparición de cepas resistentes o poco sensibles al medicamento. Estos factores han estimulado la búsqueda de alternativas terapéuticas que sean económicas, sin efectos adversos y con resultados cosméticos favorables. La fototerapia es un procedimiento en el cual un agente fotosensibilizador, al ser activado por luz da lugar a la producción de especies reactivas del oxígeno. Este tratamiento utilizado en varias formas de cáncer, herpes y otras enfermedades e infecciones localizadas, surge como una prometedora estrategia para la leishmaniasis cutánea, con amplias ventajas como bajo costo, fácil manejo y resolución total de la lesión, haciéndola favorable frente a otras alternativas de manejo de la enfermedad.AbstractLeishmaniasis is an endemic disease in 98 countries around the world, with 12 million cases and more than 350 million people at risk of acquiring infection. Available drugs such as pentavalent antimony, amphotericin B and miltefosine, have been the treatment of choice for all clinical forms of leishmaniasis. However, disadvantages such as high cost, duration of treatment and toxicity, promote non-adherence or neglect of treatment and the emergence of resistant or less sensitive to medicine. These problems have stimulated the search of new therapeutic alternatives that are affordable, without adverse effects and favorable cosmetic results. Phototherapy is a procedure in which an agent photosensitizer when activated by light leads to production reactive oxygen species. This therapy used in the treatment of various forms of cancer, herpes and other and localized infectious diseases, is emerging as a promising strategy for the treatment of cutaneous leishmaniasis with large advantages such as low cost, easy handling and total resolution injury, becoming a very promising alternative compared to the traditional treatment approaches

Genome-wide Analyses Identify KIF5A as a Novel ALS Gene

To identify novel genes associated with ALS, we undertook two lines of investigation. We carried out a genome-wide association study comparing 20,806 ALS cases and 59,804 controls. Independently, we performed a rare variant burden analysis comparing 1,138 index familial ALS cases and 19,494 controls. Through both approaches, we identified kinesin family member 5A (KIF5A) as a novel gene associated with ALS. Interestingly, mutations predominantly in the N-terminal motor domain of KIF5A are causative for two neurodegenerative diseases: hereditary spastic paraplegia (SPG10) and Charcot-Marie-Tooth type 2 (CMT2). In contrast, ALS-associated mutations are primarily located at the C-terminal cargo-binding tail domain and patients harboring loss-of-function mutations displayed an extended survival relative to typical ALS cases. Taken together, these results broaden the phenotype spectrum resulting from mutations in KIF5A and strengthen the role of cytoskeletal defects in the pathogenesis of ALS.Peer reviewe

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection