Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017536 (giardiasis)
 1,714 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A comparative evaluation was made of immunofluorescent serum antibodies against Giardia lamblia and enterobacteria isolated from the upper intestine of patients with severe giardiasis. The study was carried out on sera from 51 patients belonging to seven intestinal disease groups. Antibodies against Giardia and against some enterobacteria were present in all eight cases of giardiasis with malabsorption, and absent in all five cases of invasive amoebiasis and in six normal control sera. Bacterial antibodies were found in the other five groups of intestinal disease, in 29 out of 38 cases. Giardia antibodies were found in only two of the other groups, tropical sprue (two cases) and coeliac disease (two cases). Thus Giardia antibodies may not signify active giardiasis but they were of restricted distribution and were sometimes present at relatively high titre. Bacterial antibodies were widely distributed but always at low titre. Absorption experiments indicated that the two types of antibody did not cross-react.
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PMID:The specificity of serum antibodies to Giardia lamblia and to enterobacteria in gastrointestinal disease. 717 15

Metronidazole is a drug used for the treatment of trichomonal vaginitis, amebiasis, giardiasis, and certain anaerobic bacterial infections in humans. Acetamide and N-(2-hydroxyethyl)oxamic acid are metabolites of metronidazole in the rat, and we find small amounts of both metabolites in the urine of human patients taking the drug. Although acetamide is carcinogenic for rats, we do not believe that our finding further defines metronidazole's risk for humans. That risk can only be estimated from surveillance of people previously exposed to the drug.
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PMID:A metronidazole metabolite in human urine and its risk. 722 46

Antiprotozoan drugs of choice include: chloroquine for malaria; diiodohydroxyquin for asymptomatic intestinal amebiasis; metronidazole for acute amebic colitis, extraintestinal amebiasis and trichomoniasis; quinacrine for giardiasis; quinine-pyrimethamine-sulfadiazine for chloroquine-resistant falciparum malaria, and trimethoprim-sulfamethoxazole for pneumocystis pneumonia. Anthelmintic drugs of choice include: mebendazole for roundworm, pinworm, whipworm and hookworm infections; niclosamide for tapeworm infections, and thiabendazole for trichinosis.
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PMID:Antiparasitic drugs. 735 83

Metronidazole is unique among therapies approved for trichomonas vaginitis and is useful also in the treatment of amebiasis, giardiasis and anaerobic bacterial infections. It has recently proved to be effective antibacterial prophylaxis for colon surgery. In spite of these important therapeutic properties the drug is considered risky for human use because of laboratory evidence that is it tumorigenic and mutagenic. A large excess risk of human cancer as the result of prior metronidazole exposure can probably be excluded on the basis of evidence already available. However, with the risk uncertain the drug should be restricted to patients who clearly will benefit from it and these patients should receive the drug in the minimal dose which is effective. Nitro group reduction is implicated in most of the biological properties of metronidazole including its mutagenicity. Two metabolites of the reduction of metronidazole, acetamide and N-(2-hydroxyethyl)-oxamic acid, form in the intestinal flora and can be found in the excreta of conventional rats but not of germfree rats. Thus the worrisome reaction implicated in the mutagenicity of metronidazole occurs in the flora. These metabolites produced by the flora complement those described in Ernest Bueding's laboratory. Bueding's group postulates metabolites which are mutagenic, and thus probably not yet reduced, whereas we postulate that our metabolites indicate that reduction, and thus possibly a mutagenic reaction, has already occurred. The metabolites we describe which are indicative of the reduction of metronidazole are also found in the urine of patients who take the drug. This has several possible implications which bear investigation. One is that a reactive intermediate may form in the flora and enter mammalian tissues. The other is that metronidazole is metabolized in the human to acetamide which is a carcinogen in its own right. Thus this drug,with its increasing number of useful clinical properties, continues to show laboratory properties which have uncertain implications for human risk.
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PMID:Metronidazole: proven benefits and potential risks. 738 55

Metronidazole is currently approved for use against Trichomonas infection and amebiasis. It is also effective against giardiasis, "nonspecific vaginitis," and anaerobic infections and bactericidal against almost all obligately anaerobic organisms; Actinomyces, Arachnia, and Propionibacterium are exceptions. Metronidazole diffuses well into all tissues and penetrates the central nervous system well. It normally has only a relatively minor impact on the colonic flora. The drug is well tolerated. Adverse reactions include reversible neutropenia, peripheral neuropathy, and disulfiram-like reaction when taken with alcohol. Of more concern are its mutagenicity and carcinogenicity in some, but not all, animals. These are considered low risks, and follow-up studies of patients treated to date do not reveal an increased incidence of cancer, but physicians and patients must decide whether the benefit from therapy outweighs the potential risk. Metronidazole should only be used for approved indications, except in the research setting, and should not be used prophylactically, although it is effective.
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PMID:Metronidazole. 743 93

As a result of disposal problems related to the use of mercury compounds, many laboratories have considered switching from mercuric chloride-based Schaudinn's and polyvinyl alcohol (PVA) stool preservatives to other non-mercury-based preservatives. The primary use for PVA-preserved specimens is the permanent stained smear, the most important technique in the routine ova and parasite examination for the identification and confirmation of intestinal protozoa. A comparison of organism recovery and morphology of the intestinal protozoa was undertaken with PVA containing either a zinc sulfate base or the "gold standard" mercuric chloride base. Paired positive fecal specimens (106 from 64 patients) were collected and examined microscopically by the trichrome stain technique. There were 161 instances in which organism trophozoite and/or cyst stages were identified and 3 in which human cells were identified. Morphology, clarity of nuclear and cytoplasmic detail, overall color differences, and the ease or difficulty in detecting intestinal protozoa in fecal debris, as well as the number of patients with a missed diagnosis, were assessed from the permanent stained smear. Overall organism morphology of the intestinal protozoa preserved in zinc sulfate-PVA was not always equal in nuclear and cytoplasmic detail or range of color after permanent staining to that seen with mercuric chloride-PVA. However, the same organisms were usually identified in both specimens, with the exception of situations in which organism numbers were characterized as rare (no organisms per 10 oil immersion fields at x1,000 magnification but at least one organism in the smear) [9 of 161 (5.6%)] or the organism was missed because of poor morphologic detail [12 of 161 (7.5%)]. In only six of these cases [6 of 161 (3.7%)] did the results involve pathogens. The patient diagnosis was missed in four cases of amebiasis and two cases of giardiasis; in both situations the organism numbers were rare. There were no discrepant results with Dientamoeba fragilis. Overall agreement between the two PVA-based results was 87.0% (140 of 161); when the instances of rare organisms were disregarded, the overall agreement was 92.5% (149 of 161). On the basis of these findings, zinc-PVA is viable substitute for mercuric chloride-PVA used for trichrome permanent stained smears.
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PMID:Evaluation of intestinal protozoan morphology in polyvinyl alcohol preservative: comparison of zinc sulfate- and mercuric chloride-based compounds for use in Schaudinn's fixative. 767 2

Empirical antimicrobial therapy is indicated in patients with diarrhoea who have high fever and systemic toxicity, dysenteric disease, or travellers' diarrhoea. Antimicrobials are essential for those with severe shigellosis and amoebiasis. They are useful or possibly useful for other forms of diarrhoeal disease including amoebiasis (milder forms), campylobacteriosis, cholera, giardiasis, shigellosis, and diarrhoea due to a variety of other laboratory-defined bacterial enteropathogens. Furazolidone is useful in infantile giardiasis and mildly effective in other forms of bacterial diarrhoea. Trimethoprim/sulphamethoxazole is effective against Shigella spp. in ost parts of the world. Erythromycin is considered the treatment of choice for campylobacteriosis. For adults, the quinolone antimicrobials represent the most useful class of drugs for bacterial enteropathogens. Several dilemmas currently exist in the area. They include the lack of drugs for the therapy of trimethoprim-resistant shigellosis in children, overuse of antimicrobials in the developing world, and the potential for post-treatment prolongation of intestinal excretion of non-typhoid salmonellae. Antimicrobial chemoprophylaxis can be used in the rare person from an industrialized area during brief travels to a tropical region who has a serious underlying medical problem, cannot exercise care in what is eaten and drunk, and will have the purpose of the trip put at jeopardy should any illness develop (even that rendered short-term by effective therapy). For most people, therapy of illness is preferred to prophylaxis.
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PMID:Diarrhoeal disease: current concepts and future challenges. Antimicrobial therapy and prophylaxis. 810 47

A sample of 300 sexually-active adults was selected at random from patients, from the rural area of Malenga Makali, Tanzania, who were attending a dispensary because they had diarrhoea of at least 2 weeks' duration. The potential associations between the patient's health (in terms of the World Health Organization's clinical definition of AIDS), HIV-1 seroprevalence and malaria and other parasitic infections were then investigated. Although, HIV-1 seroprevalence was 20.6% overall, the level of seroprevalence was directly correlated with the distance between the patients' home villages and the nearest main road. Strict application of the clinical definition of AIDS gave 98.7% specificity, 46% sensitivity and a predictive value of 90.6% when validated by HIV-1 seropositivity. Although malaria infection was more common in HIV-1 seropositives than in the seronegatives, the intensity of the Plasmodium falciparum infections, intestinal amoebiasis and giardiasis did not appear to be correlated with HIV-1 infection. In contrast, intestinal infections with Cryptosporidium parvum and Isospora belli were virtually restricted to HIV-1 seropositive individuals who had had diarrhoea for a relatively long time.
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PMID:HIV-1 and parasitic infections in rural Tanzania. 812 20

BTI 2286E(+/-)-E-3-(4-methylsulphinylstyryl)-1,2,4-oxadiazole has demonstrated potent amoebicidal activity in a single-dose treatment against Entamoeba histolytica infection in the livers of golden hamsters and the caeca of mice, hamsters and rats. It has intra luminal activity against Entamoeba criceti, a natural infection in golden hamster, and anti-giardial activity against Giardia lamblia infection in suckling mice. BTI 2286E is more potent than metronidazole in extra intestinal, intra luminal amoebiasis models and has significant advantages in that it is non-mutagenic in the Ames test and has a shorter duration of effective treatment.
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PMID:Activity of a new oxadiazole compound, against experimental infections with Entamoeba histolytica and Giardia lamblia in animal models. 856 24

Secnidazole is structurally related to the commonly used 5-nitroimidazoles metronidazole and tinidazole. These drugs share a common spectrum of activity against anaerobic micro-organisms and they appear particularly effective in the treatment of amoebiasis, giardiasis, trichomoniasis and bacterial vaginosis. Secnidazole is rapidly and completely absorbed after oral administration and has a longer terminal elimination half-life (approximately 17 to 29 hours) than commonly used drugs in this class. in patients with intestinal amoebiasis or giardiasis, clinical or parasistological cure rates of 80 to 100% are achieved after treatment with a single dose of secnidazole 2g (30 mg/kg in children), similar to the response rates achieved with multiple dosage regimens of metronidazole or tinidazole. Patients with hepatic amoebiasis appears to respond well to 5- to 7-day therapy with secnidazole, but the efficacy of this drug regimen requires further evaluation in larger numbers of patients. After administration of a single dose of secnidazole, parasitological eradication was achieved in approximately 92 to 100% of patients with urogenital trichomoniasis. Patients with bacteria vaginosis respond at least as well to a single dose of secnidazole as to single-dose tinidazole, or single- or 7-day treatment with metronidazole; clinical improvement and/or microbiological evidence of cure was attained in approximately 59 to 96% of patients. In the clinical trials reviewed, secnidazole was well tolerated; most adverse events were gastrointestinal in nature and did not require treatment intervention or withdrawal from therapy. In summary, available evidence suggests that secnidazole is as efficacious as other 5-nitroimidazole drugs in the treatment of protozoal infections and bacterial vaginosis. The convenience and ease of administration associated with single-dose therapy, combined with a good tolerability profile, make secnidazole a suitable option to other single-dose treatments and an attractive alternative to multiple dosage regimens with other drugs in this class.
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PMID:Secnidazole. A review of its antimicrobial activity, pharmacokinetic properties and therapeutic use in the management of protozoal infections and bacterial vaginosis. 870 97


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