Basic Clinical Parasitology
TL;DR: The clinical parasitology text, designed for medical student and practicing physician, meets the author's objectives quite well, with emphasis placed on pathology, symptomatology, diagnosis, and prevention of various parasitic diseases.
Abstract: The clinical parasitology text, designed for medical student and practicing physician, meets the author's objectives quite well. Emphasis is placed on pathology, symptomatology, diagnosis, and prevention of various parasitic diseases. Therapy is handled briefly, and only established methods of treatment are presented. A number of chemotherapeutic agents accepted in foreigh countries, but still not approved by the Food and Drug Administration, are listed. From the standpoint of preventive medicine, life cycles are presented pictorially. Illustrations are quite profuse and most useful, although to keep this volume reasonably priced almost all are black and white and rather small in size. The student is provided with a list of more extensive texts for reference. Bibliographies were omitted for brevity and economy. A notable through small omission is the failure to list theAnopheles balabacensusas an important vector in the transmission of malaria in Southeast Asia. This thorough and up to date
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Journal Article•
TL;DR: Intestinal parasites cause significant morbidity and mortality and therapy includes luminal and tissue amebicides to attack both life-cycle stages.
Abstract: Intestinal parasites cause significant morbidity and mortality. Diseases caused by Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica occur in the United States. E. vermicularis, or pinworm, causes irritation and sleep disturbances. Diagnosis can be made using the "cellophane tape test." Treatment includes mebendazole and household sanitation. Giardia causes nausea, vomiting, malabsorption, diarrhea, and weight loss. Stool ova and parasite studies are diagnostic. Treatment includes metronidazole. Sewage treatment, proper handwashing, and consumption of bottled water can be preventive. A. duodenale and N. americanus are hookworms that cause blood loss, anemia, pica, and wasting. Finding eggs in the feces is diagnostic. Treatments include albendazole, mebendazole, pyrantel pamoate, iron supplementation, and blood transfusion. Preventive measures include wearing shoes and treating sewage. E. histolytica can cause intestinal ulcerations, bloody diarrhea, weight loss, fever, gastrointestinal obstruction, and peritonitis. Amebas can cause abscesses in the liver that may rupture into the pleural space, peritoneum, or pericardium. Stool and serologic assays, biopsy, barium studies, and liver imaging have diagnostic merit. Therapy includes luminal and tissue amebicides to attack both life-cycle stages. Metronidazole, chloroquine, and aspiration are treatments for liver abscess. Careful sanitation and use of peeled foods and bottled water are preventive.
181 citations
TL;DR: The effect of bevacizumab in two patients with choroidal neovascularisation (CNV) secondary to pathological myopia, which was refractory to other treatment is described.
Abstract: Bevacizumab (Avastin, Genentech) is a recombinant humanised, full length, anti-VEGF monoclonal antibody that binds all isoforms of VEGF-A. It has been shown to prolong survival of patients with advanced colon cancer when combined with 5-fluorouracil.1 In this report, we describe the effect of bevacizumab in two patients with choroidal neovascularisation (CNV) secondary to pathological myopia, which was refractory to other treatment.
### Patient 1
AM is a 36 year old white man who was diagnosed with subfoveal CNV caused by pathological myopia (right eye = −11.50 D, left eye = −11.50 D) in his left eye in September 2002 for which he received three photodynamic therapy (PDT) treatments. He developed subfoveal CNV in his right eye in June 2003 and received one PDT treatment combined with an intravitreous injection of 4 mg of triamcinolone acetonide. In May 2004, he presented with recurrent subfoveal CNV in his right eye and refused PDT. Off-label use of bevacizumab was discussed and after informed consent, the patient decided to proceed.
Just before treatment in July 2004, best corrected visual acuity (VA) was 20/40 in the right eye and 20/25 in the left eye. There was a ring of hyperpigmentation centred on the fovea with a surrounding ring of subretinal blood and substantial subretinal fluid in the right eye (fig 1A). An optical coherence tomography (OCT) scan through the centre of the fovea confirmed the presence of extensive subretinal fluid (fig 1B, asterisks) with subretinal tissue in the centre of the fovea (arrowheads). An OCT map showed severe thickening and subretinal fluid throughout the centre of the macula (foveal thickness 510 μm, macular volume 9.29 mm3). In the left eye, there were pigmentary changes and no subretinal blood or fluid (foveal thickness, 201 μm). In the right eye, the early phase of a fluorescein angiography (FA) …
147 citations
TL;DR: Several of the immune derangements and impairments seen in HIV infection, and considered by many to be the “specific” effects of HIV, can be found in helminth-infected but HIV-noninfected individuals and can be accounted for by the chronic immune activation itself.
Abstract: Chronic immune activation is one of the hallmarks of human immunodeficiency virus (HIV) infection. It is present also, with very similar characteristics, in very large human populations infested with helminthic infections. We have tried to review the studies addressing the changes in the immune profiles and responses of hosts infected with either one of these two chronic infections. Not surprisingly, several of the immune derangements and impairments seen in HIV infection, and considered by many to be the “specific” effects of HIV, can be found in helminth-infected but HIV-noninfected individuals and can thus be accounted for by the chronic immune activation itself. A less appreciated element in chronic immune activation is the immune suppression and anergy which it may generate. Both HIV and helminth infections represent this aspect in a very wide and illustrative way. Different degrees of anergy and immune hyporesponsiveness are present in these infections and probably have far-reaching effects on the ability of the host to cope with these and other infections. Furthermore, they may have important practical implications, especially with regard to protective vaccinations against AIDS, for populations chronically infected with helminths and therefore widely anergic. The current knowledge of the mechanisms responsible for the generation of anergy by chronic immune activation is thoroughly reviewed.
146 citations
TL;DR: This study supports the emerging concept of the role of B. hominis as an intestinal parasite causative of human disease as well as the existence of eosinophilia in symptomatic patients.
Abstract: Purged stools from 389 patients were evaluated microscopically for the presence of Blastocystis hominis. A total of five or more B. hominis cells per 40X field were observed in 43 patients (11%), and B. hominis was the only intestinal parasite present in 23 (6%) of these patients. Of the 23 patients, 19 had symptoms which included abdominal discomfort (15 patients), anorexia (10 patients), diarrhea (9 patients), and flatus (9 patients). The remaining four patients were asymptomatic. The proportion of eosinophils in the peripheral blood ranged from 4 to 12% in 11 (58%) of the symptomatic patients. Absolute eosinophil counts were greater than 250/microliter in 8 patients and greater than 400/microliter in 5 patients. Eosinophilia was not observed in the remaining symptomatic or asymptomatic patients. This study supports the emerging concept of the role of B. hominis as an intestinal parasite causative of human disease.
145 citations
TL;DR: As some factors associated with the tropical environment can modify the expression of atopic disease, various indicators of allergic reactivity were compared between allergic and non‐allergic subjects of different socio‐economic level in Caracas, Venezuela.
Abstract: Summary
As some factors associated with the tropical environment can modify the expression of atopic disease, various indicators of allergic reactivity were compared between allergic and non-allergic subjects of different socio-economic level in Caracas, Venezuela (Lat. 10°N). The socio-economic levels considered were high (HSEL), medium-high (MSEL) or low (LSEL). As generally found in temperature climates, in the HSEL the total serum IgE levels of allergic patients were significantly greater than those of nonallergic individuals (geometric means of 274 vs 126 IU/ml, respectively), as were also the specific serum IgE antibody levels (55.6 vs 23.8% positive, respectively, for house dust). These results correlated closely with the skin-test reactivity of these subjects (60.3 vs 17.5% positive for house dust). In this group, the degree of intestinal helminthic infection was low (5.6% positive for Ascaris). In contrast, for the MSEL where the degree of parasitic infection was higher (13.0%), the total serum IgE levels were elevated in both allergic and non-allergic subjects (602 vs 363 IU/ml). Similarly, positivity for specific IgE antibody was high, and comparable between allergies and non-allergies of this group (61.5 vs 54.2%), as was also the case for skin-test reactivity (71.9 vs 60.4%). In the LSEL, parasitic infection was prevalent (47.6%), and the total serum IgE levels were markedly elevated, with little difference occurring between allergic and non-allergic individuals (2269 vs 1981 IU/ml). The positivity for specific IgE antibody was high, and effectively independent of the allergic state (75.6 vs 53.7%), but in contrast the skin test reactivity was relatively low (22.0 vs 9.8%). The lack of correlation between skin test and specific IgE results in this group appeared to have
98 citations
References
More filters
Journal Article•
TL;DR: Intestinal parasites cause significant morbidity and mortality and therapy includes luminal and tissue amebicides to attack both life-cycle stages.
Abstract: Intestinal parasites cause significant morbidity and mortality. Diseases caused by Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica occur in the United States. E. vermicularis, or pinworm, causes irritation and sleep disturbances. Diagnosis can be made using the "cellophane tape test." Treatment includes mebendazole and household sanitation. Giardia causes nausea, vomiting, malabsorption, diarrhea, and weight loss. Stool ova and parasite studies are diagnostic. Treatment includes metronidazole. Sewage treatment, proper handwashing, and consumption of bottled water can be preventive. A. duodenale and N. americanus are hookworms that cause blood loss, anemia, pica, and wasting. Finding eggs in the feces is diagnostic. Treatments include albendazole, mebendazole, pyrantel pamoate, iron supplementation, and blood transfusion. Preventive measures include wearing shoes and treating sewage. E. histolytica can cause intestinal ulcerations, bloody diarrhea, weight loss, fever, gastrointestinal obstruction, and peritonitis. Amebas can cause abscesses in the liver that may rupture into the pleural space, peritoneum, or pericardium. Stool and serologic assays, biopsy, barium studies, and liver imaging have diagnostic merit. Therapy includes luminal and tissue amebicides to attack both life-cycle stages. Metronidazole, chloroquine, and aspiration are treatments for liver abscess. Careful sanitation and use of peeled foods and bottled water are preventive.
181 citations
TL;DR: The effect of bevacizumab in two patients with choroidal neovascularisation (CNV) secondary to pathological myopia, which was refractory to other treatment is described.
Abstract: Bevacizumab (Avastin, Genentech) is a recombinant humanised, full length, anti-VEGF monoclonal antibody that binds all isoforms of VEGF-A. It has been shown to prolong survival of patients with advanced colon cancer when combined with 5-fluorouracil.1 In this report, we describe the effect of bevacizumab in two patients with choroidal neovascularisation (CNV) secondary to pathological myopia, which was refractory to other treatment.
### Patient 1
AM is a 36 year old white man who was diagnosed with subfoveal CNV caused by pathological myopia (right eye = −11.50 D, left eye = −11.50 D) in his left eye in September 2002 for which he received three photodynamic therapy (PDT) treatments. He developed subfoveal CNV in his right eye in June 2003 and received one PDT treatment combined with an intravitreous injection of 4 mg of triamcinolone acetonide. In May 2004, he presented with recurrent subfoveal CNV in his right eye and refused PDT. Off-label use of bevacizumab was discussed and after informed consent, the patient decided to proceed.
Just before treatment in July 2004, best corrected visual acuity (VA) was 20/40 in the right eye and 20/25 in the left eye. There was a ring of hyperpigmentation centred on the fovea with a surrounding ring of subretinal blood and substantial subretinal fluid in the right eye (fig 1A). An optical coherence tomography (OCT) scan through the centre of the fovea confirmed the presence of extensive subretinal fluid (fig 1B, asterisks) with subretinal tissue in the centre of the fovea (arrowheads). An OCT map showed severe thickening and subretinal fluid throughout the centre of the macula (foveal thickness 510 μm, macular volume 9.29 mm3). In the left eye, there were pigmentary changes and no subretinal blood or fluid (foveal thickness, 201 μm). In the right eye, the early phase of a fluorescein angiography (FA) …
147 citations
TL;DR: Several of the immune derangements and impairments seen in HIV infection, and considered by many to be the “specific” effects of HIV, can be found in helminth-infected but HIV-noninfected individuals and can be accounted for by the chronic immune activation itself.
Abstract: Chronic immune activation is one of the hallmarks of human immunodeficiency virus (HIV) infection. It is present also, with very similar characteristics, in very large human populations infested with helminthic infections. We have tried to review the studies addressing the changes in the immune profiles and responses of hosts infected with either one of these two chronic infections. Not surprisingly, several of the immune derangements and impairments seen in HIV infection, and considered by many to be the “specific” effects of HIV, can be found in helminth-infected but HIV-noninfected individuals and can thus be accounted for by the chronic immune activation itself. A less appreciated element in chronic immune activation is the immune suppression and anergy which it may generate. Both HIV and helminth infections represent this aspect in a very wide and illustrative way. Different degrees of anergy and immune hyporesponsiveness are present in these infections and probably have far-reaching effects on the ability of the host to cope with these and other infections. Furthermore, they may have important practical implications, especially with regard to protective vaccinations against AIDS, for populations chronically infected with helminths and therefore widely anergic. The current knowledge of the mechanisms responsible for the generation of anergy by chronic immune activation is thoroughly reviewed.
146 citations
TL;DR: This study supports the emerging concept of the role of B. hominis as an intestinal parasite causative of human disease as well as the existence of eosinophilia in symptomatic patients.
Abstract: Purged stools from 389 patients were evaluated microscopically for the presence of Blastocystis hominis. A total of five or more B. hominis cells per 40X field were observed in 43 patients (11%), and B. hominis was the only intestinal parasite present in 23 (6%) of these patients. Of the 23 patients, 19 had symptoms which included abdominal discomfort (15 patients), anorexia (10 patients), diarrhea (9 patients), and flatus (9 patients). The remaining four patients were asymptomatic. The proportion of eosinophils in the peripheral blood ranged from 4 to 12% in 11 (58%) of the symptomatic patients. Absolute eosinophil counts were greater than 250/microliter in 8 patients and greater than 400/microliter in 5 patients. Eosinophilia was not observed in the remaining symptomatic or asymptomatic patients. This study supports the emerging concept of the role of B. hominis as an intestinal parasite causative of human disease.
145 citations
TL;DR: As some factors associated with the tropical environment can modify the expression of atopic disease, various indicators of allergic reactivity were compared between allergic and non‐allergic subjects of different socio‐economic level in Caracas, Venezuela.
Abstract: Summary
As some factors associated with the tropical environment can modify the expression of atopic disease, various indicators of allergic reactivity were compared between allergic and non-allergic subjects of different socio-economic level in Caracas, Venezuela (Lat. 10°N). The socio-economic levels considered were high (HSEL), medium-high (MSEL) or low (LSEL). As generally found in temperature climates, in the HSEL the total serum IgE levels of allergic patients were significantly greater than those of nonallergic individuals (geometric means of 274 vs 126 IU/ml, respectively), as were also the specific serum IgE antibody levels (55.6 vs 23.8% positive, respectively, for house dust). These results correlated closely with the skin-test reactivity of these subjects (60.3 vs 17.5% positive for house dust). In this group, the degree of intestinal helminthic infection was low (5.6% positive for Ascaris). In contrast, for the MSEL where the degree of parasitic infection was higher (13.0%), the total serum IgE levels were elevated in both allergic and non-allergic subjects (602 vs 363 IU/ml). Similarly, positivity for specific IgE antibody was high, and comparable between allergies and non-allergies of this group (61.5 vs 54.2%), as was also the case for skin-test reactivity (71.9 vs 60.4%). In the LSEL, parasitic infection was prevalent (47.6%), and the total serum IgE levels were markedly elevated, with little difference occurring between allergic and non-allergic individuals (2269 vs 1981 IU/ml). The positivity for specific IgE antibody was high, and effectively independent of the allergic state (75.6 vs 53.7%), but in contrast the skin test reactivity was relatively low (22.0 vs 9.8%). The lack of correlation between skin test and specific IgE results in this group appeared to have
98 citations