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在马里,吡喹酮治疗前后的器官肿大。一种可能与之相关的……

Organomegaly in Mali before and after praziquantel treatment. A possible association with .

作者信息

Stecher Chalotte Willemann, Madsen Henry, Wilson Shona, Sacko Moussa, Wejse Christian, Keita Adama D, Landouré Aly, Traoré Mamadou S, Kallestrup Per, Petersen Eskild, Vennervald Birgitte

机构信息

Department of Infectious Diseases, Aarhus University Hospital, Denmark.

Center for Global Health (GloHAU), Department of Public Health, Aarhus University, Denmark.

出版信息

Heliyon. 2017 Nov 14;3(11):e00440. doi: 10.1016/j.heliyon.2017.e00440. eCollection 2017 Nov.

Abstract

Continuous exposure to schistosome-infested water results in acute and chronic morbidity in all ages. We analysed occurence of organomegaly via ultrasonography and investigated a possible additive effect of dual-dose drug administration in 401 infected individuals from a highly endemic area in Mali. Mean intensity of infection at baseline (22.0 eggs per 10 ml) was reduced to 0.22 eggs per 10 ml 9 weeks after treatment (both treatments combined). Odds of persistent infection among those given dual-dose treatment was 41% of that in people given single dose (b = 0.41; p = 0.05; 95% CI 0.17-1.00), but after two years, 70.7% of the 157 participants, who completed the survey, were re-infected with no significant difference in prevalence and intensity of infection between treatment groups. Resolution of organomegaly occurred in all age groups after treatment. A novel association between infection and moderate portal vein enlargement was found in 35% (n: 55). Severe portal vein diameter enlargement was found in 3.2%. After two years, moderate hepatomegaly was present in 50.6%, moderate splenomegaly in 45.6% and moderate portal vein diameter enlargement in 19%. A subsequent dose of PZQ did not provide any additional long-term advantages.

摘要

持续接触受血吸虫感染的水会导致各年龄段出现急慢性发病情况。我们通过超声检查分析了器官肿大的发生率,并在来自马里一个高度流行地区的401名感染者中研究了双剂量药物给药可能产生的累加效应。治疗9周后(两种治疗方法联合使用),基线时的平均感染强度(每10毫升22.0个虫卵)降至每10毫升0.22个虫卵。接受双剂量治疗者持续感染的几率是接受单剂量治疗者的41%(b = 0.41;p = 0.05;95%置信区间0.17 - 1.00),但两年后,完成调查的157名参与者中有70.7%再次感染,各治疗组之间的感染患病率和强度无显著差异。治疗后所有年龄组的器官肿大均得到缓解。在35%(n = 55)的患者中发现感染与中度门静脉扩张之间存在一种新的关联。发现严重门静脉直径扩张的比例为3.2%。两年后,50.6%的患者存在中度肝肿大,45.6%存在中度脾肿大,19%存在中度门静脉直径扩张。后续一剂吡喹酮未带来任何额外的长期益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e63/5727379/9a4d661731e3/gr1.jpg

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