Browsing by Autor "Jaime Alberto Restrepo Soto"

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    Case Report: COVID-19 Misdiagnosed as a Drug Reaction to Miltefosine
    (American Society of Tropical Medicine and Hygiene, 2021) Jaime Alberto Restrepo Soto; María Isabel Méndez; Jonathan Berman
    We present case reports of two patients treated with miltefosine for mucocutaneous leishmaniasis whose gastrointestinal symptoms were initially diagnosed as a drug reaction and only later recognized as due to COVID-19. Gastrointestinal symptoms of COVID-19 are unusual, whereas gastrointestinal adverse drug reactions are very common. These reports exemplify that this infrequent presentation of COVID-19 is likely to be ascribed to a more common etiology such as a gastrointestinal drug reaction.
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    FASCIOLA HEPÁTICA EN BOLIVIA: 44 AÑOS DE EVOLUCIÓN DE HIPERENDEMIA A PRE ELIMINACIÓN
    (2023) Juan Sergio Mollinedo; Zoraida Aymara Mollinedo; Patrícia Gutiérrez; Pavel Elvin Mollinedo; Pavel Sergio Mollinedo; José Magne; Wilson Gironda; Jaime Alberto Restrepo Soto
    Antecedentes.A partir del año 1978, se comenzó a documentar una prevalencia muy elevada de infección humana por Fasciola hepática en el Altiplano de Bolivia, país donde nunca había sido señalada la enfermedad.Materiales y Métodos.Nuestro objetivo es presentar una descripción general cronológica de los estudios.La revisión retrospectiva destaca la literatura gris realizada antes de 1990 y las investigaciones encontradas en bases de datos electrónicos a partir de 1989.Resultados.Tuvieron que transcurrir más de cuarenta años para encontrar respuesta al registro de infección por Fasciola hepática en humanos con prevalencias alrededor del 70%, para que mediante siete campañas de administración masiva de medicamentos (MDA) disminuyan a menos del 2%; este proceso cronológico de estudios es presentado en cuatro periodos sucesivos: 1º periodo : Caracterizada por registros clínico quirúrgico de ocasionales pacientes tratados en hospitales en la ciudad de La Paz.2º periodo (1978)(1979)(1980)(1981)(1982)(1983)(1984)(1985)(1986)(1987)(1988)(1989)(1990)(1991): Primeras encuestas coprológicas y serológicas que registran la hiperendemia y el área geográfica.3º periodo (1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997): Estudios epidemiológicos, parasitológicos, malacológicos, pruebas de diagnóstico, tratamiento, definición del área hiperendemica y su vigilancia.4º periodo (2008-2020): Campañas de MDA.Conclusiones.La amplia investigación colaborativa con la Universidad de Valencia, dilucido particulares aspectos de la infección humana a gran altitud; describiendo la zona de hiperendemia más importante a nivel mundial, motivando campañas de MDA con donaciones de medicamentos, permitiendo ingresar en una etapa de pre-eliminación, restando ampliar las iniciativas para mejorar el agua de consumo, educación, saneamiento, higiene y el control y tratamiento de los animales.
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    Treatment of New World Mucosal Leishmaniasis: Randomized Comparison of Glucantime®, Liposomal Amphotericin B, and Miltefosine
    (American Society of Tropical Medicine and Hygiene, 2026) Jaime Alberto Restrepo Soto; Paula Soto; David Paz; Daniela Rivero; Martha Sánchez; María Clara Arteaga; Jonathan Berman
    New World Mucosal Leishmaniasis (ML) is predominantly caused by Leishmania braziliensis. We performed the first randomized trial of the three recommended agents for this disease-intravenous pentavalent antimony (Sb), intravenous liposomal amphotericin B (LAMB), oral miltefosine-with 24-month follow-up. Upon study enrollment, disease was scored by the number of sites (oro-nasal-palate, pharynx, larynx) and degree of disease at each site (maximum score = 60.) Our criterion for "cure" was ≥90% diminution in the enrollment score. Cure rates were 20/40 (50%) for Sb, 18/40 (45%) for LAMB, and 23/40 (57%) for miltefosine. Cure was highly dependent on whether the patient was being treated for the first time (39/55 = 71% cure) or undergoing repeat treatment (22/63 = 35% cure). The primary reason for the low cure rate for repeat patients was laryngeal disease at enrollment. For all patients, naïve patients, and repeat patients, the miltefosine cure rate was highest but not statistically so. A curative score at 2-6 months of follow-up had a predictive value of 94% for cure. It is notable that 14 of the 57 treatment failures (25%) were attributable to relapses occurring more than 24 months after therapy completion. Myalgias/arthralgias/general bodily discomfort occurred for LAMB and Sb patients; diarrhea and motion sickness occurred for miltefosine patients; Electrocardiogram abnormalities (occasionally severe) were seen in LAMB and Sb patients. When choosing a treatment of a ML patient, cure rates in part based on disease location and absence/presence of previous treatment, route of administration, tolerability, and cost should be considered. Patients should be followed for ≥2 years.