Control of Echinococcus granulosus in Uruguay: evaluation of different treatment intervals for dogs.

This study attempted control of transmission of Echinococcus granulosus from dogs to sheep in different areas in the Department of Florida, Uruguay, by treating dogs with praziquantel at intervals of 6, 12 and 16 weeks. The 6-week interval was based on the prepatent period of infection with E. granulosus, the 12- and 16-week intervals were based on the rate of reinfection with tapeworms in dogs in the area. Dogs had become reinfected with E. granulosus between 2 and 4 months after treatment, whereas they became reinfected with the Taenia spp. tapeworms within 2 months of treatment. One year after the start of treatments sentinel lambs were born and grazed the farms in the three treatment areas. Approximately, 15 months later when the sentinel lambs were killed and examined for parasites the six weekly treatments had stopped the transmission of E. granulosus to the sentinel lambs. Treatment of dogs at 12- and 16-week intervals failed to stop transmission of E. granulosus but both the numbers of farms and the numbers of sheep infected with E. granulosus were lower where dogs received 12 weekly treatments compared with dogs receiving 16 weekly treatments and a fourth area where dogs had received no treatments (chi(2)P=0.002). Lambs continued to become infected with the Taenia spp. tapeworms in all the areas. Control was complicated by large changes in the dog population. From a starting population of 1164 dogs in the three treated areas, 832 new dogs, most of these adult hunting dogs, entered the population and 793 dogs were lost from the population.

Disorders of thyroid hormones in non-insulin-dependent diabetes mellitus

INTRODUCTION: In a previous study of patients with non-insulin-dependent diabetes mellitus (NIDDM) of less than 5 years' duration at the HCQ "Hermanos Ameijeiras", Cuba, we found abnormal values of T3 at iniitial evaluation. It was proved that the cause was an increase in the activity of the enzyme catalysing the process of peripheral deiodination of T4 to T3. OBJECTIVE: To examine these variables in a larger sample. SUBJECTS AND METHODS: One hundred and forty patients with NIDDM of 1-25 years' duration being treated by diet, and/or oral hypoglycaemic agents, were studied T3, T4, and insulin were measured by radio-immunoassay; glucose, by glucose-oxidase; cholesterol, triglycerides and HDL-cholestrol by the Trinder method; LDL and VLDL by the Ellefson formula; glycosylated haemoglobin by ion exchange chromatography, and microalbuminuria by an immuno-colorimetric semiquantitative method. The sample was divided into 5 groups: 1-2 years, 3-4 years, 5-6 years, 7-15 years, and more than 15 years' duration of diabetes mellitus. RESULTS: The results confirmed the previous findings that there was a marked increase in T3 (4.87, 4.49, 3.1, 2.8, 2.9 mmol/l, respectively) in the time of evolution but diminishing progressively as the time of evolution increases and normalizing in the 5-6 year group. There were no notable differences in T4 in the 5 groups of healthy controls (102, 113, 96, 94, 99 mmol/l). The blood glucose levels were higher than in the healthy population but a point of inflection was noted in the 5th -6th year of evolution (8.6, 8.2. 7.02, 8.4, 8.3 mmol/l). The insulin values were noted to have a greater variation between 1-2 years and 3-4 years, supposedly a treatment effect as in the 1-2 year group. There were patients who had not started treatment but the insulin in the 3-4 year group decreased with the introduction of treatment (48.7, 17.9, 32.1, 36.6, 39.5 mU/ml). Glycosylated haemoglobin showed a point of inflection in the 5th-6th year (7.2, 6.3, 8.2, 7.9, 8.5 percent). Lipid metabolism indicators, cholesterol (4.7, 5.2, 5.6, 5.74, 5.5 mmol/l), triglyceride (1.34, 2.01, 1.33, 1.95, 1.65 mmol/l) and low density lipoprotein (2.99, 3.14, 3.97, 3.95, 3.63 mmol/l) progressively increased with time of evolution. Microalbuminuria behaved the same (25, 12.4, 14.5, 33.4, 27.3 mg/l), showing a higher value at 1-2 years and diminishing between 3 and 6 years but increasing thereafter.(Au)

Yoga exercise versus traditional exercise in the control of non-insulin diabetes mellitus - Poster presentation

The sample population was selected from 3 municipals of Havana City. The population size was selected using the programme EP16 with the option statcalc. From a population size of 17,068 diabetics, a sample size of 100 diabetics was calculated as the minimum population size required to obtain a confidence level of 95 percent. Patients were divided into two groups (yoga and traditional group) and were matched according to the following criteria: Age +/- 5 years, Sex, Type of treatment, Evolution of NIDDM, BMI. The two groups of 63 diabetics were matched according to the criteria described above and were then grouped as "yoga exercise group" and "traditional exercise group". Biochemical analysis was done at the start of the investigation, and included: HDL - C Tryglyceride, LDL - C, Total cholesterol, Glycated haemoglobin, Insulinic receptors, Microalbuminuria, Blood glucose, quantification of T3, T4 Insulin, GH, and TSH, Oxidative stress enzymes serum, creatinine. The Second Stage: Both groups had similar diet and practised their respective physical exercise at the same duration and frequency for periods of 3 and 6 months. The biomedical analysis was done at these intervals. The biochemical analysis at the start showed: In most cases there were alterations in lipid metabolism, renal function as seen as hyperlipidaemia and hypercortisolaemia and a reduction in the union and internalization of insulin in the receptors of lymphocytes. There was a correlation between GH and T4. These findings show that it is necessary to deepen the investigation of these patients as there exists a difference in the laboratory results and the clinical manifestations of endocrine metabolc diseases.(AU)

Risk factors associated with human cystic echinococcosis in Florida, Uruguay: results of a mass screening study using ultrasound and serology.

Sonographic evidence of asymptomatic Echinococcus granulosus lesions in the liver was found in 156 of 9,515 persons in the Department of Florida, Uruguay. The sensitivity of ELISA and latex agglutination serology compared with ultrasound was 47.6% and 28.1%, respectively, and specificity was > 85%. There was a significant positive association between positive sonography and a personal history of previous but treated Echinococcus infection while those that were seropositive but ultrasound-negative were significantly more likely to have a personal history of infection or a history of infection in their family. Prevalence of infection increased significantly with age. There was no correlation between echinococcosis and dog ownership or home slaughter of sheep but offal disposal was important, with an increased prevalence of infection of 3.2%, 2.8%, and 3.1%, respectively, in persons feeding offal to dogs or burying or burning it compared with a prevalence of 0.8-1.5% in those using other methods of disposal. Almost half the population, when questioned, seemed to have sound knowledge about E. granulosus and described correct treatment of E. granulosus in dogs but this did not affect prevalence. There was a significant positive association between infection and the presence of a fenced fruit/vegetable garden and use of rural waters, particularly the cachimba (a small dam) and the aljibe (a cistern or tank) that collect rainwater from the ground surface and roofs, respectively.

Rates of reinfection with Echinococcus granulosus, Taenia hydatigena, taenia ovis and other cestodes in a rural dog population in Uruguay.

A survey was undertaken to determine both the prevalence of, and reinfection rates with Echinococcus granulosus and other cestodes in the Department of Florida, Uruguay. Baseline prevalence was determined in 303 rural dogs which then, in 4 groups, were re-examined 2, 4, 8 or 12 months later. Baseline prevalences for E. granulosus, Taenia hydatigena, Taenia ovis and Dipylidium caninum were 13.2, 13.9, 2.3 and 13.2%, respectively. The frequency distribution of E. granulosus was over-dispersed. Dogs in the population became infected with E. granulosus between 2 and 4 months after treatment (prevalences at 2, 4, 8 and 12 months were 0, 6.8, 18.6 and 27.9%, respectively). There was no indication that there was a predisposition of dogs to infection with the Odds Ratio being 1.0. Dogs were infected with T. hydatigena and D. caninum within 2 months and with T. ovis between 2 and 4 months after treatment. The implications of these different rates of reinfection in the dog population on anthelmintic control strategies against cystic echinococcosis are discussed.

Transmission dynamics of Echinococcus granulosus, Taenia hydatigena and Taenia ovis in sheep in Uruguay.

A base-line survey was carried out on the transmission dynamics of Echinococcus granulosus, Taenia hydatigena and Taenia ovis in sheep in the Department of Florida, Uruguay. Mean life expectancy at birth of the sheep population in this Department was estimated at 3.5 and 4.8 years for male and female sheep, respectively. Both intensity and prevalence of E. granulosus infection increased with age providing no evidence that immunity was acquired in the population. This revealed that E. granulosus was only relatively stable and in an equilibrium endemic steady state with an estimate of the basic reproduction ratio (Ro) of about 1.2. The mature larval population in sheep was over-dispersed with parameter k, from fitting a negative binomial, being 0.199 and 0.556 in 42- and 54-month-old sheep, respectively. The mean number of cysts increased by 1.05 cysts per year and the infection pressure was calculated as 0.174 infections per year, implying that each infection consisted of 693.6 eggs to produce 6.03 cysts. Neither intensity nor prevalence of infection with T. hydatigena or T. ovis increased with age. This indicated that immunity was acquired to reinfection by both parasites and they were in an equilibrium hyperenedemic steady state with an estimated Ro of 4.2-5.8. Viability and fertility of E. granulosus, and viability of T. hydatigena cysts in the older age groups were low. The effects of the different transmission levels of the parasites on potential control strategies are discussed.