Postprandial glycemia in healthy subjects: Which probiotic dairy food is more adequate?

The consumption of probiotic-enriched dairy products has been associated with many health benefits, including anti-hyperglycemic activity. The effect on health is dependent on the type of probiotic culture used and the dairy product consumed. This study evaluated the effect of different probiotic-enriched dairy matrices (Minas Frescal cheese, Prato cheese, and whey dairy beverage) containing Lactobacillus casei on in vitro and in vivo anti-hyperglycemic activity. For this purpose, in vitro anti-hyperglycemic activity was determined by the inhibition of α-glucosidase and α-amylase activities, and a human study was performed with healthy individuals (n = 15, consumption of bread as a control; bread + Minas Frescal cheese; bread + Prato cheese; bread + dairy beverage) to assess the effects of different probiotic foods on postprandial glycemia. In vitro data showed that Prato cheese presented the highest lipid (36.9 g/100 g) and protein (26.5 g/100 g) contents as well as the highest α-amylase (60.7%) and α-glucosidase (52.6%) inhibition. The consumption of Prato cheese resulted in a lesser increase in blood glucose level (13 mg/dL) compared with the consumption of bread alone (19 mg/dL), Minas Frescal cheese (20 mg/dL), and whey dairy beverage (30 mg/dL), with glycemic indices similar to that observed for the control. The present results demonstrated a good correlation between in vitro and in vivo data, in which the type of dairy matrix affects the anti-hyperglycemic activity. It is concluded that the consumption of probiotic Prato cheese can contribute to the reduction of postprandial glycemia in healthy individuals.

Fermented whey dairy beverage offers protection against Salmonella enterica ssp. enterica serovar Typhimurium infection in mice.

Fermented whey dairy beverages are dairy products obtained by fermentation from a mixture of milk and whey. These beverages have important health benefits, which could be improved with the addition of probiotic cultures. This study assessed the protective effect of the cosupplementation of a probiotic culture (Lactobacillus casei 01) with a fermented whey dairy beverage against infection by Salmonella enterica ssp. enterica serovar Typhimurium in a murine model. Two fermented whey dairy beverages were prepared: conventional (FWB; starter culture) and probiotic (PFWB; starter and probiotic cultures). In the first set of experiments, Balb/C female mice were treated with FWB or PFWB, challenged with Salmonella Typhimurium, and analyzed for clinical signs, weight loss, and mortality for 20 d postinfection. In the second set of experiments, mice were treated with FWB or PFWB, challenged with Salmonella Typhimurium, and killed on d 10 postinfection. The liver, colon, and ileum were used for myeloperoxidase, eosinophil peroxidase, and histological analysis and translocation to the liver. The contents from the small intestine were used for secretory IgA determination. The FWB treatment showed a better effect on animal survival (70%), translocation of the pathogen to the liver (2 out of 10), histopathology (fewer lesions), and inflammation than PFWB, which presented 50% animal survival, translocation in 5 out of 10 animals, and higher lesions. The control group presented 40% animal survival, translocation in 6 out of 10 animals, and severe lesions. Therefore, FWB was deemed to have a greater protective effect against Salmonella Typhimurium infection in the murine model compared with PFWB.

Perceptibility and Acceptability of Surface Gloss Variation Under Different Illuminants.

OBJECTIVE: The purpose of this study was to evaluate the influence of different illuminants on the perceptibility and acceptability of surface gloss variations and to determine limiting values. METHODS: Eight composite resin specimens and one human tooth specimen were polished to obtain composite resin specimens with different gloss units (GU) of 10, 20, 30, 40, 50, 60, 70, and 80 and a human tooth specimen of 80 GU. Sixty observers compared the surface gloss of the specimens in a light booth. For perceptibility testing, the specimens were randomly positioned two at a time. The acceptability of the gloss variation was determined by comparing the composite resin specimens with the tooth specimen. The observers answered specific questions to determine the level and perceptibility and acceptability limits of gloss variations. All analysis was done with two illuminants (D65 and fluorescent light) used randomly. Data were submitted to a nonlinear probit model and nonlinear probit regression estimation (α=0.05). RESULTS: Significant differences in illuminants were observed for perceptibility (p<0.001) and acceptability (p=0.045). The perceptibility limit for D65 was 7.0 GU and 6.8 GU for fluorescent illuminant. The acceptability limit for D65 was 34.2 GU and 37.1 GU for fluorescent illuminant. CONCLUSIONS: More accurate perceptibility and acceptability judgments of the surface gloss of composite resin were made when the specimens were illuminated with D65 light.

Perceptibility and Acceptability of Surface Gloss Variations in Dentistry.

OBJECTIVE: To assess the visual perception of observers regarding perceptibility and acceptability of surface gloss variations of resin composites and to determine the limit of perceptibility and acceptability of gloss variations. METHODS: Eight resin composite specimens and one human tooth specimen were fabricated. The resin specimens were polished to reach a surface gloss, in gloss units (GUs), of 10 GU, 20 GU, 30 GU, 40 GU, 50 GU, 60 GU, 70 GU, and 80 GU, and the human tooth specimen had a surface gloss of 80 GU. Sixty observers were selected to compare the surface gloss of the specimens in a light booth. For the perceptibility assessment, specimens were randomly displayed two at a time. Each observer performed a total of 144 observations. Observers answered two specific questions for determining the level and limit of perceptibility of gloss variations. The acceptability limit of gloss was determined by comparing the resin specimens with the tooth specimen. The observations were performed with dental practice scenarios (illuminant conditions, visualization field, and observers' education). Data were submitted to a nonlinear probit model and nonlinear regression estimation probit (5%). RESULTS: Differences in perceptibility and acceptability were observed for surface gloss variations (ΔGU) (p<0.001). Perceptibility increased with ΔGU (10<20<30<40<50=60=70), while acceptability decreased with ΔGU (0=10>20>30>40>50>60=70). Acceptability and perceptibility limits were 6.4 GU and 35.7 GU, respectively. CONCLUSIONS: Perceptibility and acceptability of surface gloss are influenced by gloss variations. A variation of 6.4 GU was required for 50% of observers to notice gloss variations. Concerning acceptability, observers required a variation of 35.7 GU to consider differences in gloss not acceptable.

Urban schistosomiasis: morbidity, sociodemographic characteristics and water contact patterns predictive of infection.

BACKGROUND: Schistosomiasis (Schistosoma mansoni) is classically described as a rural disease that occurs in areas with poor sanitary conditions. This cross-sectional study was undertaken in a suburban area of a large industrialized city in Brazil (Belo Horizonte), aiming at examining epidemiological characteristics of schistosomiasis in an urban setting. METHODS: A simple random sample of 658/1896 dwellings was selected and 3049/3290 (92.7%) residents were submitted to stool examination. Of 518 eligible infected cases and 518 uninfected controls, 87.1% and 89.9% participated in the study, respectively. RESULTS: The prevalence of S. mansoni infection was 20%, predominantly low egg counts in stools; no cases of splenomegaly were found. Signs and symptoms associated with infection were bloody stools (odds ratio [OR] = 8.0) and hardened palpable liver at the middle clavicular and at the middle sternal life (OR = 5.5 and 8.0 respectively). Sociodemographic variables and water contacts predictive of infection were age (10-19 and > or = 20 yrs; OR = 7.1 and 3.3, respectively), gender (male; OR = 3.1), contacts for swimming and/or playing (twice a month or less and more than twice a month; OR = 2.2 and 3.0, respectively) and residence in Belo Horizonte (born in the City; OR = 2.5). Ninety per cent of dwellings had a piped water supply; no association between water supply and infection was found. CONCLUSION: Our results emphasize the need for schistosomiasis control measures focusing on water contacts for leisure purposes in this industrialized urban area.

PIP: During 1991-1992 in the Gorduras district of Belo Horizonte, the capital of Minas Gerais State in Brazil, data on 451 persons over 2 years old who carried Schistosoma mansoni eggs, as detected on at least 1 of 4 slides, were compared with data on 465 same-age persons who were free of such eggs to describe the epidemiology of schistosomiasis in this urban area. The schistosome host, Biomphalaria glabrata, was present at all 11 monitored points along streams. Snails infected with S. mansoni were found at 6 points. Sewerage was entering the streams at 2 points. 92.7% of households had a piped water supply. 89.4% had a sewerage system. 20% of the 3049 sampled peoples had schistosomiasis. The geometric mean of S. mansoni eggs stood at 70.8 eggs/gram. Only 4.7% of persons infected with S. mansoni eggs had bloody stools. Less than 3% had a hardened enlarged liver. No one had splenomegaly or splenectomy. Signs and symptoms independently associated with S. mansoni infection included bloody stools (odds ratio [OR] = 8), palpable hardened liver at the middle clavicular line (OR = 5.5), and palpable hardened liver at the middle sternal line (OR = 8). Sociodemographic variables and reasons for water contact independently associated with S. mansoni infection were age (OR = 7.1 for 10-19 years; OR = 3.3 for =or + 20 years), being male (OR = 3.1), swimming and/or playing in water (OR = 2.2 for =or- 2 times/month; OR = 3 for 2 times/month), and living in Belo Horizonte (OR = 2.5). There was no association between infection and water supply. These findings suggest a need for schistosomiasis control measures centering on water contacts for leisure in this area.

Anthropometric measures in relation to Schistosomiasis mansoni and socioeconomic variables.

A cross-sectional study of anthropometric measures and their association with socioeconomic variables, infection by Schistosoma mansoni, intensity of infection and splenomegaly was carried out in an endemic area for schistosomiasis in Brazil (Comercinho), using multiple logistic regression methods. Eighty-seven per cent of all 1.5-14.4 year-old children in the area participated in the study. Children below the 5th percentile (USA Ten State Survey) for height-for-age, weight-for-age and arm muscle area-for-age were compared to those greater than the 5th percentile. There was no association between low anthropometric measures and schistosomiasis or socioeconomic variables in children under five years of age. For the 4.4-14.4 year-old children, poor condition of the heads of family and poorer housing were independently associated with low height and arm muscle area. Heavy excretion of S. mansoni eggs (greater than or equal to 500 epg) was related to low height, and splenomegaly was the variable which showed the strongest association with low height, weight and arm muscle area (odds ratios adjusted for socioeconomic variables were 6.4, 3.5 and 3.7 respectively). This indicates that there is a biological component for low anthropometric measures in the severe form of schistosomiasis and this reinforces the need for public health measures to prevent the development of splenomegalies in endemic areas.

Immune responses during human Schistosomiasis mansoni. VIII. Differential in vitro cellular responsiveness to adult worm and schistosomular tegumental preparations.

The proliferative responses of peripheral blood mononuclear cells from patients with Schistosoma mansoni infections were studied in response to heterogeneous schistosomal antigenic preparations derived from whole adult worms, cercariae or schistosomula, and soluble tegumental preparations from adult worms or schistosomula. The use of these preparations was standardized with a Brazilian patient population, and comparisons were made between previously used and newly, variously prepared antigenic preparations. Responses of cells from these intestinal/ambulatory patients were generally strong to whole adult worm antigens and low to moderate to whole cercarial or schistosomular materials. Although most patients responded well to whole worm extracts, they were not stimulated by the soluble adult tegumental preparation. In contrast, the responses to the soluble schistosomular tegumental material were vigorous. These responses were usually much higher than to whole schistosomula-derived materials. Thus it appears, using these particular preparations, that human schistosomal patient lymphocytes recognize and are stimulated by schistosomular tegumental antigens but they do not demonstrate good reactivity when exposed to an adult worm tegumental preparation.

Abdominal ultrasonography in acute clinical schistosomiasis mansoni.

Abdominal ultrasonography was performed on eight children and four adults with acute schistosomiasis mansoni, 12 chronically infected patients, and 12 noninfected individuals from the endemic area, who were paired by age and sex with the acute group. In all acute patients, lymphadenomegaly as well as liver and spleen enlargement were detected. Lymph nodes surrounding the portal vein and the hepatic artery in the hepatic hilus were visualized. In the children, the right lobe of the liver was statistically significantly larger in the acute group than in the noninfected group. The portal and splenic vein diameters were significantly larger in children with acute schistosomiasis than in the chronically infected and negative control groups. The left hepatic lobe and a longitudinal scan of the spleen in acute adult patients were statistically significantly larger than in the chronically infected and negative control groups. Ultrasonography is shown to be a useful tool for the differential diagnosis of acute schistosomiasis mansoni.

Efficacy of alternating therapy with oxamniquine and praziquantel to treat Schistosoma mansoni in children following failure of first treatment.

Two hundred children infected with Schistosoma mansoni were treated with either 20 mg/kg oxamniquine or 60 mg/kg praziquantel. Cure rates (about 85%) were similar as was the percentage reduction (80%) in egg counts in uncured children. Treatment with the alternative drug of children not cured with the first treatment resulted in negative stools in 11 of 12 cases examined one month after the second round of therapy. In order to minimize the risk of the development of drug resistance, our data suggest that infected patients be treated with one drug, and therapeutic failures with another. Evidence from experiments in mice with isolates obtained after failures of one treatment in children suggests that therapeutic failure does not necessarily indicate the presence of drug-resistant schistosomes. The value of using mice to assess drug resistance in schistosomes is questioned.

Immune responses during human schistosomiasis. XII. Differential responsiveness in patients with hepatosplenic disease.

Thirty-four hospitalized patients and 12 ambulatory patients, all with hepatosplenic schistosomiasis mansoni were evaluated in regard to their peripheral blood mononuclear (PBMN) cell responses to schistosomal antigenic preparations and compared with groups of 40 patients with the hepatointestinal form and 39 patients with the more common, chronic intestinal form of schistosomiasis mansoni. PBMN cell blastogenic responses were measured upon exposure to schistosomal egg antigens (SEA), adult worm antigens (SWAP) and a cercarial antigenic preparation (CERC). All groups had some individuals who did not respond to some or all of these preparations. In the hospitalized hepatosplenic group greater than 50% did not respond to SEA. Analysis of the responses in each group revealed that all responders could be subdivided into moderate and high responders. High responders to SEA had experimental minus control values of greater than 8,000 counts per minute (CPM). For SWAP and CERC, this arbitrary cut-off value was greater than 25,000 CPM and greater than 11,000 CPM, respectively. The percent of high SEA responders in the groups differed considerably. This was 23% in the chronic intestinal group, 40% in the chronic hepatointestinal group, 67% for ambulatory hepatosplenic patients and 20% for hospitalized hepatosplenic patients. Previous studies had demonstrated that 94% of patients with early (2-3 month) acute schistosomiasis mansoni were high responders to SEA and none were nonresponders. Furthermore, at the other end of the spectrum, 100% of former schistosomiasis mansoni patients (treated and cured 7-35 years previously) were high responders to SEA. None were nonresponders to any of the antigen preparations. It is proposed that during acute infection all patients express vigorous responses to SEA. Upon continued infection most patients (75%) modulate this florid response. However, continued high responders comprise 40% of the chronic hepatointestinal cases and almost 70% of the ambulatory hepatosplenic patients. These latter 2 groups may likely represent early forms of the severe clinical disease found in the hospitalized hepatosplenic patient population. Fifty percent of the hospitalized group appear anergic and no longer respond to SEA, while only 20% are high responders. Long after chemotherapy it appears that the anti-SEA regulatory mechanisms of former chronic patients have subsided, leaving strong anti-SEA responsiveness.

Idiotypic/anti-idiotypic interactions in schistosomiasis and Chagas' disease.

Immunoaffinity-purified antibodies against soluble Schistosoma mansoni egg antigens (SEA) were isolated from the sera of patients with schistosomiasis mansoni. Similarly, antibodies against Trypanosoma cruzi epimastigote antigens were obtained from sera of patients with Chagas' disease. These antibody preparations were used in culture to demonstrate the presence of anti-idiotypic T lymphocytes in peripheral blood mononuclear cell preparations from patients with either schistosomiasis mansoni or Chagas' disease, or with both of these infections. Only cells from patients with schistosomiasis or both infections proliferated upon exposure to the anti-SEA antibodies. Conversely, only cells from patients with Chagas' disease or both infections responded to anti-epimastigote antibodies. Western blot analysis of SEA and epimastigote antigens, developed by patients' sera or by immunoaffinity-purified antibody preparations, substantiated that anti-SEA immunoaffinity-purified antibodies only reacted with components of SEA, and anti-epimastigote immunoaffinity-purified antibodies only reacted with components of epimastigote antigenic preparation. These studies demonstrate the presence of anti-idiotypic T lymphocytes in the peripheral blood of patients with schistosomiasis or Chagas' disease which are specific for idiotypes generated during these infections.

Evaluation of natural killer activity in human schistosomiasis.

Natural killer (NK) activity was assayed in peripheral blood mononuclear cells of patients with schistosomiasis, of patients following treatment, and of uninfected control subjects. The patient populations were from villages in the Qalyub Province, Egypt and around Belo Horizonte , Brazil. NK activity was assayed by the cytotoxicity of 51Cr-labelled K562 target tumor cells. In neither infected population were significant alterations from normal levels found in the percent cytotoxicity per 10(6) cells, or in the lytic units that expressed 25% cytotoxicity. Likewise, prior treatment (2 and 6 months previously) did not alter the group NK activity detected. Similarly, in the Egyptian study there was no difference in the percentage of large granular lymphocytes between the infected and uninfected groups. In parallel studies in Egyptian and Brazilian schistosomiasis patients we did not find any evidence that this chronic infection consistently altered circulating NK activity.

The role of nutritional status and insulin-like growth factor in reduced physical growth in hepatosplenic Schistosoma mansoni infection.

The influence of nutritional status and hormonal growth activity on the impaired somatic development of adolescents with the hepatosplenic clinical form of Schistosoma mansoni infection (HS), the intestinal form with high (IH) or low (IL) egg output and non-infected (NI) individuals was evaluated (in Comercinho, Minas Gerais State, Brazil, in 1996-97) by measuring body mass index (BMI), insulin-like growth promoting factor (IGF-I) and its carrier protein (IGFBP-3). BMI, IGF-I and IGFBP-3 concentrations were significantly lower in the HS group compared with the IH and the NI groups, irrespective of age. BMI did not remain associated with the clinical form in the bi-variate model that included IGF-I and BMI or IGFBP-3 and BMI, suggesting that in these groups IGF-I and IGFBP-3 levels were related to the clinical form but independent of nutritional status. It is suggested that physical growth impairment in hepatosplenic S. mansoni infection results from the synergistic action of both hepatic damage and nutritional restriction.

Dot-dye-immunoassay and dot-ELISA for the serological differentiation of acute and chronic schistosomiasis mansoni using keyhole limpet haemocyanin as antigen.

Two immunoassays, dot enzyme-linked immunosorbent assay (dot-ELISA) and dot-dye immunoassay (dot-DIA), using soluble egg antigen and keyhole limpet haemocyanin as antigens, were evaluated for the serological differentiation of 25 acute and 37 chronic patients infected with Schistosoma mansoni and 20 non-infected individuals, in comparison with ELISA. Efficiency was 92.7%, 90.0% for ELISA, dot-ELISA and dot-DIA, respectively. Dipstick dot-ELISA and dot-DIA are described and shown to be reliable cheap and simple methods for the serological differentiation of acute and chronic schistosomiasis.

A clinico-epidemiological survey of schistosomiasis mansoni in a hyperendemic area in Minas Gerais State (Comercinho, Brazil). I. Differences in the manifestations of schistosomiasis in the town centre and in the environs.

A cross-sectional survey of schistosomiasis was done in Comercinho (Minas Gerais State, Brazil). Faecal (Kato-Katz technique) and physical examinations were performed on 90% and 79% of the population (1474 inhabitants), respectively. The rate of infection with Schistosoma mansoni was 70%, the geometric mean of eggs was 334/g of faeces and 7% of the infected individuals had splenomegaly. The rate of infection, faecal egg counts and the rate of splenomegaly were significantly higher in the environs (zones 3 and 4) of the town than in the central areas (zones 1 and 2) of Comercinho. This difference seemed to be determined by the social differences existing between the population in the central area and the environs; in the environs the heads of families were predominantly manual workers (73 and 94% respectively), only 10 and 3% of the houses had piped water supply and less than 14% were of better quality.

Levels of the schistosome circulating anodic and cathodic antigens in serum of schistosomiasis patients from Brazil.

Serum levels of 2 schistosome circulating antigens, the circulating anodic antigen (CAA) and the circulating cathodic antigen (CAA), were determined in persons infected with Schistosoma mansoni in Brazil. Sensitive monoclonal antibody-based enzyme-linked immunosorbent assays were used to measure levels of the 2 antigens. The study group consisted of 38 individuals with intestinal schistosomiasis, and 20 persons with the hepatosplenic form of the disease. Age and intensity of infection were comparable for the 2 groups. CAA was detected in 65.5% of all patients' sera and CCA was found in the serum of 82.8% of all patients. CAA levels correlated well with the egg output, as determined by duplicate Kato-Katz smears; CCA was significantly positively correlated with egg output in patients with intestinal schistosomiasis only. Whereas no significant difference was found between CAA titre in patients with intestinal schistosomiasis and those with the hepatosplenic form, a significantly higher CCA titre was found in patients with hepatosplenomegaly compared to patients with intestinal schistosomiasis.

Analysis of anti-keyhole limpet haemocyanin antibody in Brazilians supports its use for the diagnosis of acute schistosomiasis mansoni.

Antibody (immunoglobulin (Ig) G) to the haemocyanin of the keyhole limpet (KLH) (Megathura crenulata), which shares a well defined carbohydrate epitope with the surface of schistosomula of Schistosoma mansoni, was determined by enzyme-linked immunosorbent assay (ELISA) in the sera of Brazilians with acute schistosomiasis. Of 53 such individuals tested, 51 had a level of KLH reactivity in excess of the mean +2 standard deviations of that exhibited by chronically infected individuals. This difference in reactivity allowed the acute cases to be readily identified by visual inspection of ELISA plates. The levels of IgG in patients with hepatointestinal and hepatosplenic schistosomiasis, as well as in non-infected, seropositive residents of endemic areas and infected children from endemic areas, were not statistically different from those of intestinal patients. Significant levels of anti-KLH IgG were not detected in patients with leishmaniasis, Chagas disease, ancylostomiasis or ascariasis. The results support the use of KLH as a means of rapidly and easily identifying individuals with acute schistosomiasis.

The control of the schistosome-transmitting snail Biomphalaria glabrata by the plant Molluscicide Euphorbia splendens var. hislopii (syn milli Des. Moul): a longitudinal field study in an endemic area in Brazil.

Under laboratory conditions, latex from Euphorbia splendens has shown promise as a plant molluscicide for control of Biomphalaria species, intermediate hosts for Schistosoma mansoni. The purpose of this study was to evaluate its efficiency under field conditions. Application of filtered latex at 12 ppm to one stream in an endemic rural area in Minas Gerais state, Brazil, in September 1995, did result in a reduction in snail density as compared to an untreated stream but the snail population recovered quickly. However, two applications with a two-week interval of unfiltered E. splendens latex at 5 ppm in November 1996 in the same stream resulted in complete disappearance of B. glabrata and snails did not reappear until the 14th month after the applications. In the control stream, without treatment, the snails were found during all months. Laboratory studies confirmed that unfiltered latex is a more potent molluscicide than filtered latex. Considering the advantages of the latex such as its low toxicity to other aquatic animals and its photobiodegradability, as well as the simple method of application, this natural product is promising as an effective molluscicide.

Identification of factors and groups at risk of infection with Schistosoma mansoni: a strategy for the implementation of control measures?

A fourteen year schistosomiasis control program in Peri-Peri (Capim Branco, MG) reduced prevalence from 43.5 to 4.4%; incidence from 19.0 to 2.9%, the geometric mean of the number of eggs from 281 to 87 and the level of the hepatoesplenic form cases from 5.9 to 0.0%. In 1991, three years after the interruption of the program, the prevalence had risen to 19.6%. The district consists of Barbosa (a rural area) and Peri-Peri itself (an urban area). In 1991, the prevalence in the two areas was 28.4% and 16.0% respectively. A multivariate analysis of risk factors for schistosomiasis indicated the domestic agricultural activity with population attributive risk (PAR) of 29.82%, the distance (< 10m) from home to water source (PAR = 25.93%) and weekly fishing (PAR = 17.21%) as being responsible for infections in the rural area. The recommended control measures for this area are non-manual irrigation and removal of homes to more than ten meters from irrigation ditches. In the urban area, it was observed that swimming at weekly intervals (PAR = 20.71%), daily domestic agricultural activity (PAR = 4.07%) and the absence of drinking water in the home (PAR = 4.29%) were responsible for infections. Thus, in the urban area the recommended control measures are the substitution of manual irrigation with an irrigation method that avoids contact with water, the creation of leisure options of the population and the provision of a domestic water supply.(ABSTRACT TRUNCATED AT 250 WORDS)

Validity of selected clinical signs and symptoms in diagnosis of Schistosoma mansoni infection.

Sensitivity, specificity and positive predictive values of selected clinical signs and symptoms in the diagnosis of Schistosoma mansoni infection were evaluated in 403 individuals (69% of inhabitants over 1 year of age) in an endemic area in Brazil (Divino). Highest sensitivity (13%) was found for blood in stools. Specificity over 90% was found for blood in stools, palpable liver with normal consistency and palpable hardened liver at middle clavicular (MCL) or middle sternal lines (MSL). Hardened liver at MSL (83%) or MCL (75%), and blood in stools (78%) presented higher positive predictive values for S. mansoni infection, while palpable liver with normal consistency at MCL (45%) or MSL (48%) presented smaller values. Enlarged liver without specification of its consistency has been traditionally used as an indicator of the infection in areas where malaria or Kala-azar are not endemic. Our results demonstrate that the probability that a person with blood in stools or hardened palpable liver is infected is higher than among those with palpable liver with normal consistency.