Efficacy and toxicity of sodium stibogluconate for mucosal leishmaniasis

Article Abstract:

Leishmaniasis a disease caused by infection with the tropical parasitic organism leishmania (generally transmitted by sandfly bites), which can result in acute lesions of the lining (mucosa) of the nose and mouth. If untreated, this condition can cause progressive erosion of the nasal and oral mucosa leading to perforation of the nasal septum, narrowing of the oral canal, hoarseness, and suffocation. The World Health Organization (WHO) has recommended antimony (a metallic element) injections for the treatment of this disease, but little is known of the efficacy and toxicity of this regimen. To evaluate this, 29 consecutive and otherwise healthy patients referred to a Peruvian regional hospital for leishmaniasis infection were treated with daily intravenous infections of antimony for 28 days in the form of sodium stibogluconate. Immediately following therapy, 88 percent (63 of 72) lesions were healed or greatly improved, none of the lesions tested positive for parasitic infestation, and 18 of 29 patients showed complete clinical remission. At the 12-month follow-up visit, 37 lesions had reappeared, 8 new lesions had developed, and 8 of the patients remained symptom-free. Mildly afflicted patients responded better to the therapy than did severely afflicted ones. Side effects consisted of electrocardiographic abnormalities (T-wave inversion in four patients), abnormal liver function (10 patients), and muscular pain (24 patients). These acceptable levels of toxicity, and the limited efficacy of the WHO-recommended treatment regimen, suggests that either longer treatment periods or combining antimony treatment with other antileishmanial agents should be considered. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Drug therapy, Antimony, Leishmaniasis

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War syndromes and their evaluation: from the U.S. Civil War to the Persian Gulf War

Article Abstract:

There does not seem to be a conclusive identifiable syndrome associated with war veterans. Researchers reviewed studies and publications that have addressed illnesses characteristic of war veterans from the US Civil War to the Persian Gulf War. Conditions commonly reported by war veterans include poor concentration and sleeping habits, fatigue, shortness of breath, headache, and forgetfulness. Established disorders found in war veterans include post-traumatic stress disorder and psychiatric disorders. Research has been limited by not having similar control groups, media biases, and war-time logistical issues.

Health aspects, Wars, War, Veterans

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Mefloquine compared with doxycycline for the prophylaxis of malaria in Indonesian soldiers: a randomized, double-blind, placebo-controlled trial

Article Abstract:

Doxycycline and mefloquine treatments both appear to be safe and effective in preventing malaria. The incidence of malaria was determined in 204 Indonesian soldiers given preventive treatment with either doxycycline, mefloquine, or placebo. None of the soldiers treated with mefloquine developed malaria. Ninety-nine percent of the soldiers treated with doxycycline were protected from developing malaria. Fifty-three of the 69 soldiers treated with placebo developed malaria. There were no significant side effects associated with doxycycline or mefloquine.

Prevention, Malaria, Doxycycline, Mefloquine

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