Screening methods in alveolar echinococcosis: a follow-up study comparing Emc- and Emf-ELISA with Em2plus-ELISA and ultrasonography.

The purpose of the present study was to identify Echinococcus multilocularis infection in follow-up of 95 subjects initially seropostive by Emc-ELISA or Emf-ELISA antibody assays and to compare the utility of these assays with specific Em2plus-ELISA and ultrasound screening for E. multilocularis infection. At follow-up seven subjects were seropositive with both methods, while three were seropositive only with Emc-ELISA and 11 only with Emf-ELISA. All subjects were seronegative with Em2plus-ELISA. There were no manifestations of E. multilocularis infestation by ultrasonographic screening. Seropositivity on Emc-ELISA and Emf-ELISA screening tests does not appear to correlate with manifest alveolar echinococcosis identified by ultrasound. A recommendation for further follow-up of subjects found to be seropositive with Emc-ELISA and Emf-ELISA but with no sonographic evidence of disease is not justified at this time.

[Echinococcosis with special reference to lung involvement]. / Echinokokkose unter besonderer Berücksichtigung des Lungenbefalls.

In 31 patients with echinococciasis, the medical history, diagnostic and therapeutic aspects were evaluated. Six of these patients revealed an involvement of the lungs. Their symptoms--deteriorated general condition, pain in the chest, coughing or haemoptysis, were unspecific. Nineteen patients were submitted to surgery; ten patients received intermittent mebendazole. Treatment with this drug resulted in a stabilisation of the patient's condition. In inoperable patients, treatment with benzimidazolene should at least be attempted.

Pharmacokinetics of ofloxacin after parenteral and oral administration.

In 10 volunteers, the pharmacokinetics of ofloxacin [HOE 280, DL 8280; (+/-)-9-fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H -pyrido-[1,2,3-de] [1,4]benzoxacine-6-carboxylic acid] was determined after administration of 25, 50, 100, and 200 mg intravenously (30-min infusion) as well as 200 and 400 mg orally. Concentrations in serum and urine were measured by high-pressure liquid chromatography. Concentrations in serum following different parenteral ofloxacin dosages demonstrated dose dependency with long biological half-lives of 231 to 267 min. Pharmacokinetic parameters were calculated on the basis of open two- and three-compartment models, which yielded nearly identical results. High volumes of distribution (1.2 to 1.4 liters/kg of body weight) suggested effective diffusion into the extravascular space. High total and renal clearances indicated primarily renal excretion with additional elimination pathways, such as tubular secretion and extrarenal elimination. After oral administration, absorption was excellent, and the absolute bioavailability following 200 mg of ofloxacin could be calculated at greater than 0.95. Maximal concentrations in serum were attained 1.2 to 1.9 h after dosing; areas under the curve increased in proportion to dose between 200 and 400 mg of oral ofloxacin. The amount of known metabolites (demethyl and N-oxide compounds) excreted in urine reached only 4.3% (intravenously) and 4.0% (orally). Transient headaches in some volunteers were the only side effects registered.

Comparative pharmacokinetics of intravenous ofloxacin and ciprofloxacin.

In ten volunteers the pharmacokinetics of ofloxacin and ciprofloxacin were determined after crossover administration of 100 and 200 mg intravenously (30 min constant infusion). Concentrations in serum and urine were measured by HPLC. Concentrations in serum following parenteral ofloxacin dosages demonstrated dose dependency with long biological half-lives. Pharmacokinetic parameters were calculated on the basis of an open three-compartment model, which resulted in a high volume of distribution for both substances (166-246 1 for ofloxacin, 178-2611 for ciprofloxacin). AUC for ofloxacin was three times higher than that for ciprofloxacin. Approximately 80% of ofloxacin and 57% of ciprofloxacin were eliminated through the kidneys. Ciprofloxacin had a considerable amount of extrarenal clearance, whereas only 19% of ofloxacin were eliminated by extrarenal mechanisms. Only 4.3% of ofloxacin after iv dosing could be detected as metabolites in urine.

Impact of parental onchocerciasis and intensity of transmission on development and persistence of Onchocerca volvulus infection in offspring: an 18 year follow-up study.

This study analysed the impact and the extent by which parental Onchocerca volvulus infection, intensity of transmission of O. volvulus infective 3rd-stage larvae (L3) and anthropometric factors may influence the acquisition, development and persistence of O. volvulus infection in offspring. A total of 15290 individuals in 3939 families with 9640 children were surveyed for microfilariae of O. volvulus, and prevalence and level of O. volvulus infection in children aged 0 to 20 years from infected and non-infected parents were followed longitudinally for 18 years. Children from O. volvulus-infected mothers had not only a substantially higher risk to become infected; they also acquired infection earlier in life and developed higher infection levels. Multiple logistic regression analysis showed that maternal O. volvulus infection and children's age are the predominant predictors for patent O. volvulus infection, while the intensity of transmission, measured by the annual transmission potential (ATP) of O. volvulus L3, was less decisive. Longitudinal follow up of children showed that during vector control activities by the Onchocerciasis Control Programme (OCP) and in low-level transmission areas, infection persisted at higher levels in children from O. volvulus-positive mothers. In summary, the dominant risk factor for children to become infected is maternal onchocerciasis, and also age-associated factors will strongly impact on the development of patent O. volvulus infection in offspring.