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1.
Arch. argent. pediatr ; 118(5): e476-e479, oct 2020. tab, ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1122530

RESUMO

El 25 % de la población mundial se encuentra infectada por Ascaris lumbricoides. La ascaridiosis hepatobiliar ocurre en zonas con alta endemicidad y gran carga parasitaria, y genera desde intensa inflamación hasta fibrosis. Se presenta a un paciente de 2 años, que consultó por distensión abdominal y tos de 1 mes de evolución asociada a fiebre en las últimas 72 h. Se realizó una ecografía abdominal que evidenció áscaris en la vía biliar, en el estómago y en el intestino delgado, y una radiografía de tórax con infiltrado inflamatorio intersticial, asociado a hiperleucocitosis con hipereosinofilia y gamma-glutamiltranspeptidasa elevada. Se administró un tratamiento antibiótico, antihelmíntico, sin lograr la eliminación de los parásitos de la vía biliar, por lo que se requirió su extracción mediante colangiografía percutánea


Twenty five percent of the world population is affected by Ascaris lumbricoides. Hepatobiliary ascariasis occurs in areas with high endemicity and great amount of parasitic load, generating intense inflammation to fibrosis. We report a two-year-old patient that consults about abdominal distension and cough of one month of evolution associated with 72 hours of fever. Abdominal ultrasound is performed, which shows bile duct, stomach, small intestine with ascaris and chest x-ray with interstitial inflammatory infiltrate, associated with hyperleukocytosis with hypereosinophilia and elevated gamma-glutamyl transpeptidase. Antibiotic, anthelminthic treatment is administered, without achieving the elimination of the bile duct parasites, requiring their removal by percutaneous cholangiography.


Assuntos
Humanos , Pré-Escolar , Ascaríase/diagnóstico por imagem , Ductos Biliares , Doenças Parasitárias , Ascaríase/terapia , Colangiografia , Colangite
2.
Adv Exp Med Biol ; 1274: 203-222, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32894512

RESUMO

The lipid kinases that generate the lipid signalling phosphoinositides have been established as fundamental signalling enzymes that control numerous aspects of how cells respond to their extracellular environment. In addition, they play critical roles in regulating membrane trafficking and lipid transport within the cell. The class I phosphoinositide kinases which generate the critical lipid signal PIP3 are hyperactivated in numerous human pathologies including cancer, overgrowth syndromes, and primary immunodeficiencies. The type III phosphatidylinositol 4-kinase beta isoform (PI4KB), which are evolutionarily similar to the class I PI3Ks, have been found to be essential host factors mediating the replication of numerous devastating pathogenic viruses. Finally, targeting the parasite variant of PI4KB has been established as one of the most promising strategies for the development of anti-malarial and anti-cryptosporidium strategies. Therefore, the development of targeted isoform selective inhibitors for these enzymes are of paramount importance. The first generation of PI3K inhibitors have recently been clinically approved for a number of different cancers, highlighting their therapeutic value. This review will examine the history of the class I PI3Ks, and the type III PI4Ks, their relevance to human disease, and the structural basis for their regulation and inhibition by potent and selective inhibitors.


Assuntos
1-Fosfatidilinositol 4-Quinase/antagonistas & inibidores , Doenças do Sistema Imunitário/tratamento farmacológico , Neoplasias/tratamento farmacológico , Doenças Parasitárias/tratamento farmacológico , Fosfatidilinositol 3-Quinases/metabolismo , Inibidores de Fosfoinositídeo-3 Quinase/uso terapêutico , Doenças da Imunodeficiência Primária/tratamento farmacológico , Viroses/tratamento farmacológico , 1-Fosfatidilinositol 4-Quinase/metabolismo , Animais , Humanos , Doenças do Sistema Imunitário/enzimologia , Neoplasias/enzimologia , Doenças Parasitárias/enzimologia , Inibidores de Fosfoinositídeo-3 Quinase/farmacologia , Doenças da Imunodeficiência Primária/enzimologia , Viroses/enzimologia
3.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(4): 331-334, 2020 Jul 27.
Artigo em Chinês | MEDLINE | ID: mdl-32935503

RESUMO

With the rapid development of molecular biology, the isothermal amplification technique has been used for the nucleic acid detection of parasites and other pathogens due to its high efficiency and rapid and simple procedures, and has become an important tool to promote the field detection and control of parasitic diseases. Recombinase-aided isothermal amplification assay (RAA), a novel isothermal amplification technique, which is simple and easy to perform, rapid for field detection, no need for high-end equipment, and rapid field detection, may amplify the target gene fragments within 5 to 20 min under an isothermal condition (usually 37 to 42 ℃) and achieve a real-time observation of the amplification results. RAA has been successfully employed for the nucleic acid detection of a wide range of parasites and other pathogens to date, and has shown a high sensitivity and specificity. Notably, such an assay is suitable for the large-scale field detection in non-lab environments, and is therefore considered to have a potential value of application in rapid field detections.


Assuntos
Técnicas de Amplificação de Ácido Nucleico , Doenças Parasitárias , Parasitologia , Primers do DNA , Humanos , Doenças Parasitárias/diagnóstico , Doenças Parasitárias/prevenção & controle , Parasitologia/métodos , Recombinases , Sensibilidade e Especificidade
4.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(4): 432-435, 2020 Feb 24.
Artigo em Chinês | MEDLINE | ID: mdl-32935525

RESUMO

Macrophages are important members of innate immunity and play an extremely important role in the host defense against pathogenic infections, tumors, and allergic diseases. Macrophages have a high degree of plasticity, and may be polarized into classical activated macrophages (M1 macrophages) and alternative activated macrophages (M2 macrophages) under the stimulation of different environments. M1 macrophages are found to promote inflammatory responses, which facilitates the clearance of pathogens, while M2 macrophages may inhibit inflammatory responses, which facilitates the survival and reproduction of pathogens. This review summarizes the role of macrophage polarization in parasitic infections, so as to provide insights into the prevention and treatment of parasitic diseases.


Assuntos
Ativação de Macrófagos , Doenças Parasitárias , Humanos , Ativação de Macrófagos/imunologia , Macrófagos/citologia , Macrófagos/imunologia , Doenças Parasitárias/imunologia
5.
Parasitol Res ; 119(10): 3145-3164, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32748037

RESUMO

Parasites and bacteria have co-evolved with humankind, and they interact all the time in a myriad of ways. For example, some bacterial infections result from parasite-dwelling bacteria as in the case of Salmonella infection during schistosomiasis. Other bacteria synergize with parasites in the evolution of human disease as in the case of the interplay between Wolbachia endosymbiont bacteria and filarial nematodes as well as the interaction between Gram-negative bacteria and Schistosoma haematobium in the pathogenesis of urinary bladder cancer. Moreover, secondary bacterial infections may complicate several parasitic diseases such as visceral leishmaniasis and malaria, due to immunosuppression of the host during parasitic infections. Also, bacteria may colonize the parasitic lesions; for example, hydatid cysts and skin lesions of ectoparasites. Remarkably, some parasitic helminths and arthropods exhibit antibacterial activity usually by the release of specific antimicrobial products. Lastly, some parasite-bacteria interactions are induced as when using probiotic bacteria to modulate the outcome of a variety of parasitic infections. In sum, parasite-bacteria interactions involve intricate processes that never cease to intrigue the researchers. However, understanding and exploiting these interactions could have prophylactic and curative potential for infections by both types of pathogens.


Assuntos
Infecções Bacterianas/complicações , Filarioidea/microbiologia , Doenças Parasitárias/complicações , Schistosoma haematobium/microbiologia , Wolbachia/crescimento & desenvolvimento , Animais , Antibacterianos/uso terapêutico , Artrópodes/microbiologia , Humanos , Parasitos/microbiologia , Probióticos/uso terapêutico , Simbiose , Neoplasias da Bexiga Urinária/microbiologia , Neoplasias da Bexiga Urinária/parasitologia , Neoplasias da Bexiga Urinária/patologia
6.
Public Health ; 186: 116-118, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32805663

RESUMO

OBJECTIVE: This study was conducted to determine the presence, type, and rate of parasitic contamination in Iranian currencies. STUDY DESIGN: This was a cross-sectional study. METHODS: Coins and banknotes of different denominations were randomly collected from sellers and markets in Tabriz, Northwest of Iran, for examining parasitic contamination. RESULTS: Entamoeba coli and Giardia intestinalis were the most identified species of parasites in this study. Other parasites detected were Cryptosporidium parvum, Ascaris lumbricoides, Entamoeba histolytica, Fasciola hepatica, and Toxocara cati. A high rate of parasitic contamination was found in banknotes compared with coins, and a statistically significant association was found between parasitic contamination and the apparent condition of the currencies. The notes of lower denominations showed the highest contamination rates. The highest parasitic contamination was found in coins and banknotes obtained from public toilet services, butchers, and beggars. CONCLUSIONS: The findings emphasize the role of circulating coins and banknotes in the risk of pathogenic parasite transmission.


Assuntos
Fômites , Numismática , Parasitos , Doenças Parasitárias/transmissão , Animais , Estudos Transversais , Cryptosporidium , Transmissão de Doença Infecciosa , Entamoeba , Giardia lamblia , Humanos , Irã (Geográfico) , Projetos Piloto
7.
PLoS One ; 15(8): e0237313, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32841255

RESUMO

BACKGROUND: Data on morbidity and mortality are essential in assessing disease burden, monitoring and evaluation of health policies. The aim of this study is to describe the causes of morbidity and mortality in the wards of University of Calabar Teaching Hospital (UCTH). METHODS: The study took a retrospective approach evaluating causes of morbidity and mortality from 2012-2017. Causes of death were documented based on International Classification of Disease 10 (ICD-10). Data were retrieved from health records department, UCTH. RESULTS: Overall, 2,198 deaths were recorded out of the 49,287 admissions during the study period giving a mortality rate of 4.5% comprising 1,152 (52.4%) males and 1,046 (47.6%) females. A greater number of males were admitted via accident and emergency. Age group 15-45 years had the highest number of admissions (57.9%) and deaths (37.7%), while age group >65 years recorded the highest number of deaths per admission (9.7% mortality rate). The broad leading causes of death were infectious and parasitic disease and diseases of the circulatory system (cardiovascular diseases) accounting for 22.7% and 15.8% of all deaths, respectively. However, diseases of the circulatory system recorded the highest number of deaths per admission (13.7% mortality rate). Overall, infectious diseases were the chief cause of mortality in adults while conditions originating from perinatal period were the major cause of death in children. Septicemia (6.0%), stroke (4.2%), liver diseases (4.1%), tuberculosis (3.7%), diabetes (3.6%) and HIV/AIDS (3.4%) were the specific leading cases of deaths. Sepsis, chronic diseases of the tonsil and adenoids and malaria were the specific leading causes of death in children, while sepsis, stroke and liver diseases were the leading cause of death in adults. CONCLUSION: Most causes of deaths in this study are preventable. This study revealed double burden of communicable and non-communicable diseases.


Assuntos
Doenças Transmissíveis/epidemiologia , Doenças não Transmissíveis/epidemiologia , Doenças Parasitárias/epidemiologia , Adolescente , Adulto , Idoso , Causas de Morte , Criança , Pré-Escolar , Doenças Transmissíveis/mortalidade , Feminino , Hospitalização , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Morbidade , Nigéria , Doenças não Transmissíveis/mortalidade , Doenças Parasitárias/mortalidade , Centros de Atenção Terciária , Adulto Jovem
8.
PLoS One ; 15(7): e0236514, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32706826

RESUMO

BACKGROUND: Parasitic infections remain widespread in developing countries and constitute a major public health problem in many parts of sub-Saharan Africa. It is prevalent among children under 5 years and pregnant women; however, studies among the later high risk group is limited in the northern part of Ghana. Here, we evaluated the prevalence and associated factors of parasitic infections among pregnant women at first antenatal care visit in northern Ghana. METHODS: This was a cross-sectional study conducted at the Department of Obstetrics and Gynecology, Bolgatanga Regional Hospital, Upper East Region-Ghana. A total of 334 consecutive consenting pregnant women were included. Questionnaires were administered to obtain socio-demographic data. Venous blood, stool and urine samples were collected for parasite identification using microscopy. Factors associated with parasitic infections were evaluated using regression models. Statistical analysis was performed using R. RESULTS: Parasitic infections identified were giardiasis (30.5%), P. falciparum malaria (21.6%) and schistosomiasis (0.6%). Polyparasitic infection was identified in 6.6% of the population. Increasing age [Age of 20-29 years: AOR = 0.16, 95% CI (0.06-0.38); Age of 30-39 years: AOR = 0.21, 95% CI (0.08-0.50); Age >39 years: AOR = 0.30, 95% CI (0.11-0.83)] was associated with lower odds whiles presence of domestic animals [AOR = 1.85, 95% CI (1.01-3.39)], being in the second trimester of pregnancy [AOR = 2.21, 95% CI (1.17-4.19)], having no formal education [AOR = 3.29, 95% CI (1.47-7.35)] and basic education as the highest educational level [AOR = 6.03, 95% CI (2.46-10.81)] were independent predictors of increased odds of giardiasis. Similarly, having no formal education [AOR = 2.88, 95% CI (1.21-8.79)] was independently associated with higher odds of P. falciparum malaria. The use of insecticide treated net (ITN) [AOR = 0.43, 95% CI (0.21-0.89)] and mosquito repellent [AOR = 0.09, 95% CI (0.04-0.21)] were independent predictors of lower odds of P. falciparum malaria. CONCLUSION: Giardiasis and P. falciparum malaria are common among pregnant women in northern Ghana. The major associated factors of giardiasis are lack of or low level of formal education, the presence of domestic animals and being in the second trimester of pregnancy. Increasing age confers protection against giardiasis. Likewise, lack of formal education is an associated factor for P. falciparum malaria among pregnant women in northern Ghana. The use of ITN and mosquito repellents reduce the risk of P. falciparum malaria. Given the possible role of parasitic infections in adverse pregnancy outcomes, our findings highlight the need for regular screening and treatment of infected women in the northern parts of Ghana. Public health education and improving socio-economic status could help reduce the risk of parasitic infections among pregnant women in the region.


Assuntos
Doenças Parasitárias/diagnóstico , Adolescente , Adulto , Estudos Transversais , Escolaridade , Feminino , Gana/epidemiologia , Giardíase/diagnóstico , Giardíase/epidemiologia , Humanos , Mosquiteiros Tratados com Inseticida , Malária Falciparum/diagnóstico , Malária Falciparum/epidemiologia , Razão de Chances , Doenças Parasitárias/epidemiologia , Doenças Parasitárias/parasitologia , Gravidez , Complicações Parasitárias na Gravidez/diagnóstico , Complicações Parasitárias na Gravidez/epidemiologia , Segundo Trimestre da Gravidez , Gestantes , Cuidado Pré-Natal , Prevalência , Esquistossomose/diagnóstico , Esquistossomose/epidemiologia , Adulto Jovem
9.
Proc Biol Sci ; 287(1930): 20201017, 2020 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-32605431

RESUMO

Seasonal disease and parasitic infection are common across organisms, including humans, and there is increasing evidence for intrinsic seasonal variation in immune systems. Changes are orchestrated through organisms' physiological clocks using cues such as day length. Ample research in diverse taxa has demonstrated multiple immune responses are modulated by photoperiod, but to date, there have been few experimental demonstrations that photoperiod cues alter susceptibility to infection. We investigated the interactions among photoperiod history, immunity and susceptibility in laboratory-bred three-spined stickleback (a long-day breeding fish) and its external, directly reproducing monogenean parasite Gyrodactylus gasterostei. We demonstrate that previous exposure to long-day photoperiods (PLD) increases susceptibility to infection relative to previous exposure to short days (PSD), and modifies the response to infection for the mucin gene muc2 and Treg cytokine foxp3a in skin tissues in an intermediate 12 L : 12 D photoperiod experimental trial. Expression of skin muc2 is reduced in PLD fish, and negatively associated with parasite abundance. We also observe inflammatory gene expression variation associated with natural inter-population variation in resistance, but find that photoperiod modulation of susceptibility is consistent across host populations. Thus, photoperiod modulation of the response to infection is important for host susceptibility, highlighting new mechanisms affecting seasonality of host-parasite interactions.


Assuntos
Sistema Imunitário/fisiologia , Doenças Parasitárias , Fotoperíodo , Smegmamorpha/imunologia , Adaptação Fisiológica , Animais , Doenças Transmissíveis , Doenças dos Peixes/imunologia , Peixes , Interações Hospedeiro-Parasita , Humanos , Imunidade , Masculino , Reprodução , Estações do Ano , Smegmamorpha/parasitologia , Trematódeos
10.
Am J Trop Med Hyg ; 103(3): 1150-1153, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32588796

RESUMO

Some recent studies suggest ongoing transmission of parasitic diseases in the American South; however, surveys in Mississippi children are lacking. We enrolled 166 children (median age 8 years, range 4-13 years) from the Mississippi Delta region and carried out multi-parallel real-time polymerase chain reaction (PCR) for Necator americanus, Ascaris lumbricoides, and Strongyloides stercoralis on their stool samples. Dried blood spots were obtained for multiplex serology antibody detection. Of 166 children, all reported having flushable toilets, 11% had soil exposure, and 34% had a pet dog or cat. None had prior diagnosis or treatment of parasitic disease. Multi-parallel real-time PCRs were negative on the 89 stool DNA extracts available for testing. Dried blood spot testing of all 166 children determined the seroprevalence of IgG antibodies to Toxocara spp. (3.6%), Cryptosporidium (2.4%), S. stercoralis, Fasciola hepatica, and Giardia duodenalis (all 0%). In conclusion, parasitic infections and exposure were scarce in this population. Larger studies of at-risk populations are needed.


Assuntos
Parasitos/imunologia , Doenças Parasitárias/epidemiologia , Adolescente , Animais , Gatos , Criança , Pré-Escolar , Cães , Monitoramento Epidemiológico , Feminino , Humanos , Masculino , Mississippi/epidemiologia , Parasitos/genética , Parasitos/isolamento & purificação , Doenças Parasitárias/parasitologia , Projetos Piloto , Estudos Soroepidemiológicos
11.
Washington, D.C.; OPAS; 2020-06-17.
em Português | PAHO-IRIS | ID: phr-52299

RESUMO

Estas Pranchas para o diagnóstico de parasitos intestinais destinam-se a servir tanto como orientação para pro­fissionais de laboratório e de campo em países endêmicos quanto como material de ensino para estudantes e estagiários. Contêm orientações sobre a escolha da preparação para os diferentes métodos copromicroscópicos e a principal técnica de coloração para o diagnóstico de parasitos intestinais (nematoides, trematódeos, cestódeos e protozoários). As fotomicrografi­as mostram a aparência e as características diagnósticas dos diversos parasitos nas diferentes preparações. As pranchas foram produzidas em formato plastifi­cado impermeável, resistente e fácil de usar na bancada. São recomendadas para todos os profissionais de saúde que atuam na rotina de diagnóstico de parasitoses intestinais.


Assuntos
Parasitos , Doenças Inflamatórias Intestinais , Doenças Parasitárias , Microscopia
12.
Washington, D.C.; OPS; 2020-06-17.
em Espanhol | PAHO-IRIS | ID: phr-52295

RESUMO

Esta segunda edición de Medios auxiliares para el diagnóstico de las parasitosis intestinales tienen por objeto servir tanto de manual dirigido a los trabajadores de laboratorio y sobre el terreno en países con endemicidad, como de material didáctico para los estudiantes y las personas en formación. En este documento se ofrece orientación para elegir la preparación en los diferentes métodos copromicroscópicos y la técnica de tinción principal para el diagnóstico de los parásitos intestinales (nematodos, trematodos, cestodos y protozoos). Las microfotografías presentan la apariencia y las características diagnósticas de los diferentes parásitos en las diversas preparaciones. Los medios auxiliares se elaboraron en un formato plastificado impermeable que es sólido y fácil de usar en la mesa de laboratorio. Se recomienda su uso a todos los profesionales de salud que se ocupan del diagnóstico corriente de las parasitosis intestinales.


Assuntos
Doenças Parasitárias , Materiais de Ensino , Técnicas e Procedimentos Diagnósticos , Microscopia , Enteropatias , Enteropatias Parasitárias
13.
Artigo em Inglês | PAHO-IRIS | ID: phr-52234

RESUMO

[RESUMEN]. Introducción. La enfermedad de Chagas o tripanosomiasis americana es causada por el protozoo flagelado Trypanosoma cruzi, transmitido principalmente por insectos vectores (denominados popularmente en las diferentes zonas de la Región de las Américas “vinchucas”, “pitos”, “chinches”, “chirimachas” o “kissing bugs”). El parásito es transmitido por vía transplacentaria, transfusiones y, menos frecuentemente, por vía oral o trasplante de órganos. La implementación de políticas públicas y el manejo de la condición clínica requiere ser fortalecido debido a las dificultades diagnósticas y terapéuticas que presenta esta parasitosis sistémica. Para contribuir con ello, la Organización Panamericana de la Salud (OPS) desarrolló una guía para el manejo de la tripanosomiasis americana. Objetivos. Sintetizar las recomendaciones incluidas en la Guía para el diagnóstico y el tratamiento de la enfermedad de Chagas, publicada por la Organización Panamericana de la Salud en 2018, con el fin de presentar el adecuado diagnóstico y tratamiento de la enfermedad de Chagas y abordar aspectos sobre su implementación. Métodos. Se llevó a cabo una síntesis de la guía y sus recomendaciones. Adicionalmente, se realizó una búsqueda sistemática en PubMed, Lilacs, Health Systems Evidence, Epistemonikos y literatura gris de estudios desarrollados en las Américas con el fin de identificar barreras, facilitadores y estrategias de implementación. Resultados. Se presentan 10 recomendaciones aplicables a pacientes adultos y pediátricos con sospecha de enfermedad de Chagas, exposición a T. cruzi y diagnóstico confirmado de enfermedad de Chagas aguda, crónica y congénita. Se identificaron reportes que abordaron aspectos de implementación. Conclusiones. Las recomendaciones buscan proveer estrategias para el diagnóstico y tratamiento oportunos de la enfermedad de Chagas, así como consideraciones para su implementación.


[ABSTRACT]. Introduction. Chagas disease or American trypanosomiasis is caused by the flagellate protozoan Trypanosoma cruzi, transmitted mainly by insect vectors (popularly known in the different areas of the Region of the Americas as “kissing bugs”, “pitos”, “chinches”, or “chirimachas” or “vinchuchas”). The parasite is transmitted via the placenta and in transfusions, and less frequently, orally or during organ transplantation. Because it was necessary to strengthen the implementation of public policies and the management of clinical conditions, given the diagnostic and therapeutic difficulties that this systemic parasitosis presents, the Pan American Health Organization (PAHO) developed guidance for the management of American trypanosomiasis. Objectives. Synthesize the recommendations included in the Guide for Diagnosis and Treatment of Chagas Disease, published (in Spanish only) by the Pan American Health Organization in 2018, in order to present the proper diagnostic methods and treatment for Chagas disease and to address aspects of its implementation. Methods. A summary was made of the guide and its recommendations. In addition, a systematic search was conducted in PubMed, Lilacs, Health Systems Evidence, Epistemonikos, and the gray literature for studies carried out in the Americas, in order to identify barriers, facilitators, and implementation strategies. Results. Ten recommendations are made. These are applicable to adult and pediatric patients with suspected Chagas disease, exposure to T. cruzi, or a confirmed diagnosis of acute, chronic, or congenital Chagas disease. Reports that addressed aspects of implementation were identified. Conclusions. The recommendations seek to provide strategies for the timely diagnosis and treatment of Chagas disease, as well as considerations for the implementation of such strategies.


[RESUMO]. Introdução. A doença de Chagas (ou tripanossomíase americana) é uma infecção causada pelo protozoário flagelado Trypanosoma cruzi, comumente transmitido por insetos vetores (popularmente conhecidos na Região das Américas como “barbeiro”, ‘’chupão’’, ‘’vinchuca’’, “pito”, “chinche”, “chirimacha” ou “kissing bug”). O parasita é transmitido por via transplacentária, transfusão de sangue e, menos comumente, por via oral ou transplante de órgãos de doadores infectados. A implementação de políticas públicas e o manejo clínico devem ser reforçados diante das dificuldades de diagnóstico e terapêutica para esta doença parasitária sistêmica. Em apoio a este propósito, a Organização Pan-Americana da Saúde (OPAS) elaborou um guia para o manejo da doença de Chagas. Objetivos. Sintetizar as recomendações contidas no Guía para el diagnóstico y el tratamiento de la enfermedad de Chagas (guia de diagnóstico e tratamento da doença de Chagas, disponível apenas em espanhol), publicado pela Organização Pan-Americana da Saúde em 2018, com o propósito de apresentar o diagnóstico e o tratamento adequados da doença de Chagas e abordar aspectos relativos à implementação. Métodos. Foi realizada uma síntese do guia e das recomendações apresentadas. Foi também conduzida uma busca sistemática nas bases de dados PubMed, LILACS, Health Systems Evidence e Epistemonikos e na literatura cinzenta de estudos realizados na Região das Américas visando identificar barreiras, facilitadores e estratégias de implementação. Resultados. O guia oferece 10 recomendações para pacientes adultos e pediátricos com suspeita de doença de Chagas, exposição ao T. cruzi e diagnóstico confirmado de doença de Chagas aguda, crônica e congênita e discute aspectos relativos à implementação. Conclusões. As recomendações visam fornecer estratégias para o diagnóstico e o tratamento de forma oportuna da doença de Chagas e são feitas considerações para a implementação destas estratégias.


Assuntos
Doença de Chagas , Trypanosoma cruzi , Medicina Baseada em Evidências , Doenças Parasitárias , Diagnóstico , Terapêutica , América , Doença de Chagas , Medicina Baseada em Evidências , Doenças Parasitárias , Diagnóstico , Terapêutica , América , Doença de Chagas , Medicina Baseada em Evidências , Doenças Parasitárias , Terapêutica
14.
Am J Trop Med Hyg ; 103(2): 572-577, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32484155

RESUMO

The COVID-19 pandemic, caused by SARS-CoV-2, have surpassed 5 million cases globally. Current models suggest that low- and middle-income countries (LMICs) will have a similar incidence but substantially lower mortality rate than high-income countries. However, malaria and neglected tropical diseases (NTDs) are prevalent in LMICs, and coinfections are likely. Both malaria and parasitic NTDs can alter immunologic responses to other infectious agents. Malaria can induce a cytokine storm and pro-coagulant state similar to that seen in severe COVID-19. Consequently, coinfections with malaria parasites and SARS-CoV-2 could result in substantially worse outcomes than mono-infections with either pathogen, and could shift the age pattern of severe COVID-19 to younger age-groups. Enhancing surveillance platforms could provide signals that indicate whether malaria, NTDs, and COVID-19 are syndemics (synergistic epidemics). Based on the prevalence of malaria and NTDs in specific localities, efforts to characterize COVID-19 in LMICs could be expanded by adding testing for malaria and NTDs. Such additional testing would allow the determination of the rates of coinfection and comparison of severity of outcomes by infection status, greatly improving the understanding of the epidemiology of COVID-19 in LMICs and potentially helping to mitigate its impact.


Assuntos
Infecções por Coronavirus/epidemiologia , Malária/epidemiologia , Doenças Parasitárias/epidemiologia , Pneumonia Viral/epidemiologia , Sindemia , Betacoronavirus , Coinfecção/epidemiologia , Coinfecção/parasitologia , Coinfecção/virologia , Países em Desenvolvimento , Humanos , Doenças Negligenciadas/epidemiologia , Pandemias , Medicina Tropical
15.
Ann Parasitol ; 66(2): 125-133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32530589

RESUMO

Parasitic zoonosis (PZs) have a cosmopolitan significant impact on public health but they are often omitted in discussions, especially in developing countries. Zoonotic parasites include protozoa, cestodes, nematodes, trematodes and arthropods, and notably in African and Arabian countries have a high prevalence among livestock and man. Through this comprehensive review, we summarize the extant published research of the most significant zoonotic parasites present in some countries of Arabic world and we identify the epidemiology and risk factors for significant infections and suggest some effective control measures. This review might help the researches, governments about the zoonotic impact of these neglected infections for future considerations and application for real control programs.


Assuntos
Parasitos , Doenças Parasitárias , Zoonoses , Animais , Humanos , Gado/parasitologia , Oriente Médio/epidemiologia , Parasitos/classificação , Parasitos/fisiologia , Doenças Parasitárias/epidemiologia , Doenças Parasitárias/parasitologia , Doenças Parasitárias/prevenção & controle , Doenças Parasitárias em Animais/epidemiologia , Doenças Parasitárias em Animais/parasitologia , Doenças Parasitárias em Animais/prevenção & controle , Prevalência , Fatores de Risco , Zoonoses/epidemiologia , Zoonoses/parasitologia
16.
Ann Biol Clin (Paris) ; 78(3): 299-313, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32540816

RESUMO

The diagnosis of parasitic and fungal infections, historically based on the detection of these pathogens using direct diagnosis (macro/microscopic examination, culture) or serological methods, has considerably evolved in the last decades, especially with the development of molecular approaches and mass spectrometry. These techniques, as well as most analyses of parasitic and fungal serology, are mostly the preserve of Hospital University Centers Parasitology-Mycology laboratories. In 2016, the French association of medical parasitology and mycology teachers and hospital practitioners (Anofel) has provided a Catalogue of rare analyses, regularly updated and freely accessible on the Anofel website (https://anofel.net/). This tool, which hinges on 4 parts (parasitology, parasitic serology, mycology, and fungal serology), aims to provide information on all available analyses, and a list of hospital laboratories able to undertake them. It is complementary to the other reference works that were developed by our association, including the Guide of analyses and methods in parasitology and mycology, published in 2018, and the eANOFEL pictures and videos database, freely accessible online (http://www.eanofel.fr). In this article, we draw-up a state-of-the-art of the most specialized techniques available in the parasitology-mycology laboratories and presented in the Catalogue of rare analyses of the Anofel collegium, and their interest for the diagnosis of these infections.


Assuntos
Técnicas e Procedimentos Diagnósticos , Micologia/métodos , Micoses/diagnóstico , Doenças Parasitárias/diagnóstico , Parasitologia/métodos , Serviços de Laboratório Clínico/normas , Serviços de Laboratório Clínico/estatística & dados numéricos , Técnicas e Procedimentos Diagnósticos/tendências , Humanos , Laboratórios Hospitalares/normas , Laboratórios Hospitalares/estatística & dados numéricos , Micologia/tendências , Micoses/microbiologia , Doenças Parasitárias/parasitologia , Parasitologia/tendências
17.
Int J Antimicrob Agents ; 56(2): 106037, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32479893

RESUMO

Ivermectin (IVM) is a robust antiparasitic drug with an excellent tolerance and safety profile. Historically it has been the drug of choice for onchocerciasis and lymphatic filariasis global elimination programs. IVM is an oral insecticide and is a standard treatment against intestinal helminths and ectoparasites. The current humanitarian crisis in Venezuela is a regional public health threat that requires immediate action. The public health system in Venezuela has crumbled because of a 70% shortage of medicines in public hospitals, low vaccination campaigns, and the mass exodus of medical personnel. Herein we discuss the repurposing of IVM to attenuate the burden imposed by the most prevalent neglected tropical diseases (NTDs) in Venezuela, including soil-transmitted helminths, ectoparasites and, possibly, vector-borne diseases, such as malaria. In addition, novel experimental evidence has shown that IVM is active and efficacious in vitro against Chagas disease, Leishmaniases, arboviruses, and SARS-CoV-2. In crisis-hit Venezuela, all these infectious diseases are public health emergencies that have long been ignored and require immediate attention. The versatility of IVM could serve as a powerful tool to tackle the multiple overlapping endemic and emergent diseases that currently affect Venezuela. The repurposing of this multipurpose drug would be a timely therapeutic approach to help mitigate the tremendous burden of NTDs nationwide.


Assuntos
Antiparasitários/uso terapêutico , Reposicionamento de Medicamentos , Ivermectina/uso terapêutico , Doenças Parasitárias/tratamento farmacológico , Humanos , Venezuela
18.
Surgery ; 168(2): 305-312, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32471653

RESUMO

BACKGROUND: Owing to substantial costs and increasing interest in the nonoperative management of appendicitis, the necessity of routine histopathologic examination of appendectomy specimens is being questioned. The aim of this study was to determine whether routine histopathologic examination after appendectomy for suspected appendicitis should still be performed. METHODS: PubMed, Embase, Web of Science, and the Cochrane Library were searched for studies listing the histopathologic diagnoses after appendectomy for suspected appendicitis. Main outcomes were the incidence of histopathologically proven aberrant findings, the ability of surgeons to recognize unexpected appendiceal pathology intraoperatively, and the percentage of aberrant findings resulting in a change of postoperative management. A meta-analysis was performed using a random-effects model. RESULTS: Twenty-five studies with 57,357 patients were included. The pooled percentage of aberrant findings was 2.52% (95% confidence interval 1.81-3.51). Neoplasms were found in 0.71% (95% confidence interval 0.54-0.94). Findings of the intraoperative assessment by the surgeon were reported for 82 of the 2,718 (3.0%) unexpected diagnoses, with great variation between studies. The impact on postoperative management was described for 237 of 2,718 (8.7%) aberrant findings. Of these, 166 (70.0%) resulted in a change of postoperative management. CONCLUSION: Based on current evidence, it remains unclear how many of the unexpected appendiceal pathologies with clinical consequences can be identified intraoperatively by the surgeon. Until reliable data on the safety and potential cost savings of a selective policy becomes available, we advise sending appendectomy specimens routinely for histopathologic examination.


Assuntos
Apendicectomia , Apendicite/cirurgia , Apêndice/patologia , Erros de Diagnóstico , Diagnóstico Ausente , Neoplasias do Apêndice/diagnóstico , Apendicite/diagnóstico , Endometriose/diagnóstico , Feminino , Granuloma/diagnóstico , Humanos , Período Intraoperatório , Doenças Parasitárias/diagnóstico , Cuidados Pós-Operatórios
19.
Int J Nanomedicine ; 15: 2957-2969, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32425527

RESUMO

Experimental and epidemiological evidence shows that parasites, particularly helminths, play a central role in balancing the host immunity. It was demonstrated that parasites can modulate immune responses via their excretory/secretory (ES) and some specific proteins. Extracellular vesicles (EVs) are nano-scale particles that are released from eukaryotic and prokaryotic cells. EVs in parasitological studies have been mostly employed for immunotherapy of autoimmune diseases, vaccination, and diagnosis. EVs can carry virulence factors and play a central role in the development of parasites in host cells. These molecules can manipulate the immune responses through transcriptional changes. Moreover, EVs derived from helminths modulate the immune system via provoking anti-inflammatory cytokines. On the other hand, EVs from parasite protozoa can induce efficient immunity, that makes them useful for probable next-generation vaccines. In addition, it seems that EVs from parasites may provide new diagnostic approaches for parasitic infections. In the current study, we reviewed isolation methods, functions, and applications of parasite's EVs in immunotherapy, vaccination, and diagnosis.


Assuntos
Vesículas Extracelulares/metabolismo , Interações Hospedeiro-Parasita/imunologia , Imunoterapia/métodos , Parasitos/citologia , Animais , Doenças Autoimunes/terapia , Citocinas/metabolismo , Vesículas Extracelulares/química , Vesículas Extracelulares/classificação , Humanos , Imunidade , Parasitos/patogenicidade , Doenças Parasitárias/diagnóstico , Vacinação , Vacinas/imunologia , Fatores de Virulência/metabolismo
20.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(2): 203-207, 2020 Apr 26.
Artigo em Chinês | MEDLINE | ID: mdl-32458614

RESUMO

Recently, the incidence of infectious diseases continues to decline in many developed countries; however, the incidence of autoimmune diseases and allergic asthma appears a tendency towards a rise over years. "Hygiene hypothesis" provides new insights into the treatment of autoimmune disorders and allergic diseases based on parasitic infections. Increasing evidence shows that parasitic infections may effectively inhibit the development of diabetes, multiple sclerosis, inflammatory bowel disease, rheumatoid arthritis and allergic asthma. There are complex mechanisms underlying the relationship between parasitic infections and "hygiene hypothesis", among which regulatory T (Treg) cells and Th17 cells are becoming a hot topic of research. This paper reviews the progresses in the research on the relationship between parasitic infections and "hygiene hypothesis", and summarizes the roles of Treg cells and Th17 cells in the interplay between parasitic infections and "hygiene hypothesis".


Assuntos
Hipótese da Higiene , Doenças Parasitárias , Doenças Autoimunes/imunologia , Doenças Autoimunes/parasitologia , Humanos , Higiene , Doenças Parasitárias/imunologia , Células Th17/imunologia
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