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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gastrointestinal Schistosomiasis and Amebiasis are uncommon in the western world, while such infections are frequent in the African community. In addition to the problems associated with the clinical symptoms of these parasitic infections, it is important to stress the increase in cancer of the Gastro-Intestinal (GI) tract. In this study we evaluate the prevalence of cancer in patients affected by chronic inflammatory diseases caused by the above named parasites. In three years, from January 2000 to December 2003, we observed a total of 1199 subject. Of these, 950 presented with complaints of diarrhoea, vomiting, abdominal pain, melena, hematemesis, rectal discharges and alteration of bowel habits. A total of 818 patients were evaluated in Uganda (Mulago and Arua hospitals) and 381 at Luisa Guidotti Hospital in Zimbabwe. An exhaustive clinical history was collected for each patient and then physical and laboratory examinations were performed. The clinical files of all patients previously admitted to the respective hospitals were obtained and the information taken from these files was then integrated with our clinical findings. Subjects who were found free of gastro-intestinal disease after examinations and did not have a clinical history of infective GI disease but presented with other pathologies, were regarded as control group. The control group was composed of 249 subjects. The subjects who were positive on examination underwent further investigations. The number of patients affected by schistosomiasis and amebiasis were 221 and 224 respectively. The number of patients who suffered from aspecific enterocolitis was 454, intestinal tuberculosis was present in 21 patients and we found 30 patients with esophageal candidiasis. Patients who had the above mentioned GI diseases were then divided into 3 groups. First group was composed of patients who had a clinical history of infective GI diseases and were re-admitted for similar symptoms, and on examination were positive for the presence of the same infective GI diseases. Such patients were placed in the Chronic group. The second group was formed of patients who had previously undergone treatment for infective GI diseases but on readmission were found free of infective GI disease, and this group was described as the Cured group. They had symptoms associated with other pathologies. A third group, which we described as the Acute group was composed of patients who did not have any previous case of GI infection and were admitted for the first time. Such patients were found positive on examination for infective GI diseases. In the 950 patients, we found a total of 45 tumors. The tumors were prevalent (42 tumors) in the chronic group. In 34 patients the tumor was in the colo-rectal region, in 3 patients in the stomach, in 4 patients in the esophagus and 1 patient had cancer in the small bowel. Our results show a strong association between the chronic infection of the GI tract and the likelihood to develop tumors. However, it is not clear which biological mechanisms are implicated in such transformations. They may depend on the chronic inflammation of the GI mucous which permits the entrance of carcinogenic materials or on the effects of mutagenic products produced by the parasites or both.
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PMID:Risk of cancer onset in sub-Saharan Africans affected with chronic gastrointestinal parasitic diseases. 1656 65

Schistosomiasis is a chronic worm infection caused by a species of trematodes, the Schistosomes. We may distinguish a urinary form from Schistosomes haematobium and an intestinal-hepatosplenic form mainly from Schistosomes mansoni characterized by nausea, meteorism, abdominal pain, bloody diarrhea, rectal tenesmus, and hepatosplenomegaly. These infections represent a major health issue in Africa, Asia, and South America, but recently S mansoni has increased its prevalence in other continents, such as Europe countries and North America, due to international travelers and immigrants, with several diagnostic and prevention problems. We report a case of a 24-year-old patient without HIV infection, originated from Ghana, admitted for an afebrile dysenteric syndrome. All microbiologic studies were negative and colonoscopy revealed macroscopic lesions suggestive of a bowel inflammatory chronic disease. Since symptoms became worse, a therapy with mesalazine (2 g/d) was started, depending on the results of a bowel biopsy, but without any resolution. The therapy was stopped after 2 wk when the following result was available: a diagnosis of ""intestinal schistosomiasis" was done (two Schistosoma eggs were detected in the colonic mucosa) and this was confirmed by the detection of Schistosoma eggs in the feces. Therapy was therefore changed to praziquantel (40 mg/kg, single dose), a specific anti-parasitic agent, with complete recovery. Schistosomiasis shows some peculiar difficulties in terms of differential diagnosis from the bowel inflammatory chronic disease, as the two disorders may show similar colonoscopic patterns. Since this infection has recently increased its prevalence worldwide, it has to be considered in the differential diagnosis of our patients with gastrointestinal symptoms.
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PMID:A case of bowel schistosomiasis not adhering to endoscopic findings. 1643 15

We report a case of the Mazzotti reaction in a 13-year-old Liberian refugee after presumptive treatment of schistosomiasis and strongyloidiasis with ivermectin, praziquantel and albendazole. The patient was hospitalized with fever, urticaria, abdominal pain and angioedema. Twelve hours after treatment with intravenous methylprednisolone he had complete resolution of his symptoms.
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PMID:Mazzotti reaction after presumptive treatment for schistosomiasis and strongyloidiasis in a Liberian refugee. 1707 43

Schistosomiasis is a common parasitic disease in the tropical and subtropical regions of Africa, Asia, South America and the Caribbean. It is the second most common parasitic infection of humans after malaria. Acute and chronic clinical presentations of S. monsoni are well described. Presentation as a pseudotumor is considered rare. We present a case of a 58-year-old Nigerian who presented with recurrent abdominal pain and abdominal mass of one-year duration. Stool was negative for schisostomal eggs, but histological specimen obtained from surgical resection of part of the caecum showed S. mansoni. The case was treated successfully by excisional biopsy and praziquantel therapy. A review of the literature is discussed.
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PMID:Schistosomiasis--An unusual cause of abdominal pseudotumor. 1691 40

We report a case of sigmoid colonic carcinoma associated with deposited ova of Schistosoma japonicum. A 57-year old woman presented with a 10-mo history of left lower quadrant abdominal pain and a 2-mo history of bloody stools. She had a significant past medical history of asymptomatic schistosomiasis japonica and constipation. A colonoscopy showed an exophytic fragile neoplasm with an ulcerating surface in the sigmoid colon. During the radical operative procedure, we noted the partially encircling tumor was located in the distal sigmoid colon, and extended into the serosa. Succeeding pathological analysis demonstrated the diagnosis of sigmoid colonic ulcerative tubular adenocarcinoma, and showed deposited ova of Schistosoma japonicum in both tumor lesions and mesenteric lymph nodes. Three days after surgery the patient returned to the normal bowel function with one defecation per day. These findings reveal that deposited schistosome ova play a possible role in the carcinogenesis of colorectal cancer.
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PMID:Sigmoid colonic carcinoma associated with deposited ova of Schistosoma japonicum: a case report. 1700 14

Severe liver disease due to Schistosoma mekongi was frequent in northern Cambodia. Between 1995 and 2002, seven rounds of mass chemotherapy (praziquantel) reduced infection from 50% to below 3%. In 2002, we assessed hepatosplenic morbidity by historical, clinical and ultrasonographic investigations in adults (older than 14 years) from endemic (n=342) and non-endemic (n=103) areas (Kratie province). Clinical hepatomegaly (25 vs. 0%), splenomegaly (55 vs. 0%), reported blood in stool (41 vs. 20%) and abdominal pain (78 vs. 57%) were significantly higher in the endemic area. In this area, significantly more subjects reported a family history of death due to schistosomiasis (12 vs. 0%); 63% (vs. 0%) reported having at least three treatments of praziquantel in previous years; and only 11% (vs. 99%) had normal liver ultrasonographic examination. Periportal fibrosis with portal hypertension was diagnosed in 46% (vs. 0%) of people in this area; 18% (vs. 0%) and 5% (vs. 0%) of portal hypertension was classified as moderate and severe, respectively. People aged between 24 and 35 years were mostly affected. There was no gender difference. The pathology in the endemic district is most probably residual morbidity of S. mekongi infections. Contributions of co-infections (hepatitis) cannot be excluded. Careful monitoring of the affected communities is required.
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PMID:Liver morbidity due to Schistosoma mekongi in Cambodia after seven rounds of mass drug administration. 1756 42

This paper describes ethnopharmacological knowledge on the uses of Erythrina senegalensis DC (Fabaceae) in traditional medicine in three different areas (Dioila, Kolokani and Koutiala) in Mali. Data were collected using interviews of traditional healers selected randomly. The main reported diseases for which E. senegalensis was used by the traditional healers were amenorrhea, malaria, jaundice, infections, abortion, wound, and body pain (chest pain, back pain, abdominal pain etc). The fidelity level (which estimates the agreement of traditional healers on the same area about a reported use of the plant) was calculated to compare the results from the three areas. Certain differences were noticed, the most striking was the fact that amenorrhea was the most reported disease in Dioila and Kolokani with 21% of agreement for both areas, while this use was not reported in Koutiala at all. Similarities existed between the three areas on the use of the plant against malaria and infections, although with different degree of agreement among the healers. We also report the results of a literature survey on compounds isolated from the plant and their biological activities. A comparison of these results with the ethnopharmacological information from Mali and other countries showed that some of the traditional indications in Mali are scientifically supported by the literature. For instance, the use of E. senegalensis against infectious diseases (bilharzias, schistosomiasis, pneumonia etc.) is sustained by several antibacterial and antifungal compounds isolated from different parts of the plant. The comparison also showed that pharmacologists have not fully investigated all the possible bioactivities that healers ascribe to this plant.
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PMID:Ethnopharmacological uses of Erythrina senegalensis: a comparison of three areas in Mali, and a link between traditional knowledge and modern biological science. 1832 74

Schistosomal appendicitis is rarely reported in developed countries. In this article we report a case series of schistosomal appendicitis at our community teaching hospital. In this retrospective study, we conducted a thorough database search for schistosomiasis in patients who had undergone appendectomy for acute appendicitis from 1995 to 2005. Of 1690 total appendectomies performed during this period, three cases of schistosomal appendicitis were identified. Data obtained included patient demographics, laboratory investigations, and pathological specimen. All patients belong to the African American race, are between the ages of 20 and 40 (mean 29.3 +/- 9.5) years, and had onset of symptoms <24 hours in duration. Sudden onset of right lower abdominal pain with leucocytosis (14.1 +/- 1.4 x 10(3)) is a common feature. All patients underwent appendectomy and each was found to have an enlarged and inflamed appendix intraoperatively. Histopathology revealed transmural inflammation predominantly with neutrophils and scanty eosinophils. Schistosomal granulations are present in all layers of appendix including serosa. All patients had an uneventful postoperative recovery. Schistosomal appendicitis is an uncommon condition especially in developed countries like the United States. However, with recent changes in global migration, schistosomiasis should be considered as one of the causes for appendicitis, especially in the African American population.
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PMID:Schistosomiasis: a rare cause of acute appendicitis in the African American population in the United States. 1837 86

Summary Aims The coinfection of the VIH and the schistosomiasis is affections brought back in schistosomiasis endemic area. We valued the level of morbidity partner to the schistosomiasis in hospital yard to patients hospitalized without distinction of immunological statute of patients. Patients and Methods Our study was retrospective and prospective. We included all patients hospitalized to internal Medicine and infectious diseases carriers of schistosomiasis to the mucous rectal biopsy and parasitologic exam of stools and urines between January 1998 and July 2005. Results Twenty-four patients were included in the survey of which 15 of masculine sex (62,50%) and 9 of feminine sex (37,50%). The sex ratio (H/F) = 1,66. The most tainted professions were pupils, peasants and housewives. Ten patients had benefited from the VIH tracking (41,66%) and 6 patients were seropositive for the VIH (25%). Sixty fifteen percent of patients accommodated Schistosoma haematobium (18 cases), 20,83% Schistosoma mansoni (5 cases) and 1 patient had a mixed infection. It doesn't exist a statistically difference between the frequency of species met (p = 0,061) . The main motives of hospitalization were the fever (12,50%), the hepatomegaly and splenomegaly, the ascite, the abdominal pain associated to the diarrhea and the diarrhea associated to an anemic syndrome with 8,20% for each of these motives. The most frequent clinical symptomatology was diarrhea (12,50%). The underlying pathologies more associated were the opportunist infections of the VIH (8,30%) the cirrhosis (12,50%), a syndrome amoebic dysentery syndrome (8,30%), a hepatic granuloma (8,30%). In the group of patients HIV positive the symptomatology was made of chronic and /or of glair - bloody diarrhea. One alone patient with a rate of CD4 = 279/mm3 presented prurigos in bouquet on the right flank. All patients without immunological statute distinction answered favorably to the treatment by the praziquantel. Conclusion The schistosomiasis stays even frequent in hospital yard of Bamako. The best understanding of the interaction between HIV and schistosomiasis is a pledge of the success of struggle programs in endemic area of schistosomiasis and of VIH.
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PMID:Schistomiasis morbidity to hospital ward of hospital of point g in Bamako - Mali. 1961 72

To determine the pattern of lower gastrointestinal disease in the Eastern region of Saudi Arabia we analysed 1907 colorectal biopsies obtained from 1590 consecutive patients (1256 males & 334 females), evaluated during a 13 year period (1983-1996) in a tertiary care teaching hospital. The age range was 6-81 years with a mean of 37 + 15. During the same period 6874 new patients were seen in the Gastroenterology Clinics. Saudi Arabs constituted 970 (61 %) of all patients. The remaining 620 (39%) were non-Saudi, mostly of Arab origin from neighbouring countries. The most common presenting symptom for referral was abdominal pain (1193 patients, 75%) followed by diarrhea (636 patients, 40%). The most frequent histologic diagnosis was a normal mucosa followed by non specific proctocolitis accounting respectively for 37.9% and 37.4% of all cases. These were followed by schistosomiasis, 113 (7.1%), adenocarcinoma, 91 (5.7%) and ulcerative colitis, 91 cases with a relative frequency of 5.7% and a calculated prevalence of 1.3%. Of significance was the encounter of 14 cases of Crohn's disease amounting to 0.9% of all cases with a calculated prevalence of 0.2%. A minority of 83 patients (5.2%) were cases of either a benign polyp, diverticular disease, tuberculosis, ischaemia, lymphoma, pseudomembranous colitis (PMC), eosinophilic gastroenteritis or malacoplakia. These data show that although a "normal mucosa" and "nonspecific proctocolitis" were the dominant diagnoses, significantly, ulcerative colitis and Crohn's disease exist and should be considered in the differential diagnosis of lower GI disease.
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PMID:The pattern of lower gastrointestinal disease in the eastern region of Saudi Arabia: a retrospective analysis of 1590 consecutive patients. 1986 25


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