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)

An individual who has cystic fibrosis (CF) may suffer from gastrointestinal problems related to inadequately controlled intestinal absorption secondary to the pancreatic insufficiency. These include neonatal meconium ileus, distal intestinal obstruction syndrome (DIOS), constipation and acquired megacolon, rectal prolapse and rarely pancreatitis. If the intestinal malabsorption is well controlled with an effective pancreatic enzyme preparation, DIOS, constipation and rectal prolapse are infrequent. Persisting gastrointestinal symptoms should be investigated thoroughly to exclude other disorders not directly related to the cystic fibrosis; these include cows' milk intolerance, coeliac disease, giardiasis, Crohn's disease and intra-abdominal malignancy. Both appendicitis and intussusception may cause difficult diagnostic problems particularly in patients who may also have distal ileal obstruction syndrome.
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PMID:Cystic fibrosis: gastrointestinal complications. 145 4

A patient with common variable hypogammaglobulinemia (CVH) who presented with recurrent sinopulmonary infections, nodular lymphoid hyperplasia of the small bowel, and intestinal giardiasis was studied. A diffuse lymphocytic lymphoma with small bowel, skin, and hepatic involvement subsequently developed in the patient. Light microscopy of the tumor revealed tissue infiltration with mononuclear cells having the morphologic features of T-lymphocytes. The malignant lymphocytes had characteristics of T-suppressor/cytotoxic cells as established by the absence of surface immunoglobulin and Leu 3 surface markers, and the presence of OKT3 and OKT8 surface markers. Peripheral blood lymphocyte studies revealed an increased number of T-suppressor cells, a reversal of the helper-suppressor ratio, and a generalized state of hyporesponsiveness to mitogen and antigen stimulation. No evidence of retroviral reverse transcriptase activity was detected in cultures of peripheral blood lymphocytes. The association between CVH and a lymphoma composed of cells with T-suppressor/cytotoxic surface markers has not been previously reported. The postulated role of T-suppressor cells in the failure of immunoglobulin synthesis in some forms of CVH suggests that the finding of a T-suppressor/cytotoxic cell lymphoma complicating CVH may be more than fortuitous.
Cancer 1987 Jan 15
PMID:Common variable hypogammaglobulinemia complicated by an unusual T-suppressor/cytotoxic cell lymphoma. 294 34

Clinical, microbiological, and lifestyle patterns in homosexual men showing in vitro immunological abnormalities were studied and related to the susceptibility to human T-lymphotropic virus type III (HTLV-III) infection. In a cohort of male homosexual volunteers in Finland, 90% were HTLV-III antibody negative. Ten % of the HTLV-III negative cases showed decreased T-helper/suppressor cell ratios, mostly due to elevated numbers of T-suppressor cells. In this immunosuppressed group, more signs of diarrhea, intestinal giardiasis, genital warts, and hepatitis B were observed than in the other HTLV-III antibody-negative study subjects. The type of sexual practice was not associated with the in vitro immune abnormalities. During a follow-up of up to 16 months, 4 initially HTLV-III antibody negative cases showed seroconversion. Three of these had inverted T-helper/suppressor cell ratios prior to the seroconversion. It is concluded that persons showing in vitro immunosuppression are more susceptible to HTLV-III infection when being exposed to the virus or else alteration in T-cell subsets signals a pre-antibody-positive or early phase of HTLV-III infection.
Cancer Res 1985 Sep
PMID:Immunosuppression in homosexual men seronegative for HTLV-III. 316 Apr 58

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

The inner city population of the Los Angeles county has rapidly become largely Latino. The 3.3 million Latinos living in the county in 1990 had much higher poverty rates and lower educational attainment rates than Anglo (non-Hispanic white) or blacks. The health indicators of the three groups are compared for 1990. In birth outcome, although Latinos were the least likely to receive care in the first trimester, Latinos and Anglos had identical rates of low birth weight babies, and lower rates than blacks. Latino infant mortality was the lowest of the three. The age-adjusted death rates showed that Latinos have a lower overall death rate than Anglos or blacks, and lower specific rates for heart disease, cancer, AIDS and stroke. Latinos did have higher death rates than Anglos for accidents, homicides, cirrhosis and diabetes. Latinos had incidence rates of gonorrhoea and syphilis similar to Anglos and lower than blacks. The communicable disease rates for Latinos was many times higher than Anglos or blacks, including those for measles, shigellosis, giardiasis and hepatitis A. Implications for family medicine are discussed.
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PMID:Latino health in Los Angeles: family medicine in a changing minority context. 784 24

Infections, malignancies and autoimmune diseases are the most important causes of fever of unknown origin.A case report of a 80-year old patient is described, who was admitted to our hospital because of fever lasting more than 2 weeks, weight loss and lack of appetite. Physical examination did not provide any relevant information, laboratory tests revealed an elevation of inflammation markers and anemia. Serological tests for infectious and autoimmune diseases and cultures of stool, blood and urine were all negative. Imaging did not show any pathological findings, colonoscopy and gastroscopy were macroscopically normal. Surprisingly, histology showed massive giardiasis of the duodenum. After initiation of therapy with metronidazol, fever and inflammation markers declined and the patient could be discharged from hospital without complaints on the 15(th) day after admission. Giardia lamblia is one of the most common intestinal pathogens worldwide. Infection can cause acute diarrhea, but may also be responsible for chronic abdominal complaints or may stay asymptomatic. To our knowledge, giardiasis has not been described as differential diagnosis of fever of unknown origin so far. In synopsis of clinical presentation and outcome after antibiotic therapy, we postulate that Giardia lamblia was the relevant cause of fever and weight loss in this case. In patients presenting with these symptoms, Giardia lamblia should be considered as differential diagnosis.
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PMID:[Fever and weight loss as leading symptoms of infection with giardia lamblia]. 1185 1

In this paper, clinical data of 49 adult patients with agammaglobulinaemia (syn. hypogammaglobulinaemia), 15 cases of X-linked agammaglobulinaemia (XLA) and 34 of common variable immunodeficiency (CVID) are reviewed. Although immunoglobulin substitution largely abolished life-threatening respiratory tract infections, considerable infectious and non-infectious morbidity was still encountered in these patients. Almost all patients suffered from chronic or recurrent upper and lower airway infections, mainly caused by Haemophilus influenzae and pneumococci. The lower respiratory tract infections led to cumulative damage to the respiratory tract, especially in XLA patients. Also the incidence of infections outside the respiratory tract (giardiasis, Campylobacter jejuni infections) was more common in XLA patients than in CVID patients. Nodular lymphoid hyperplasia was only found in CVID. A variety of other non-infectious complications were seen especially in CVID. Neoplastic complications occurred in nine patients (two cases of thymoma, two colorectal cancer, one gastric carcinoma, two haematological malignancies, two cases of skin cancer). Six patients died (five XLA patients and one CVID patient, from infectious and non-infectious causes).
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PMID:Hypogammaglobulinaemia: cumulative experience in 49 patients in a tertiary care institution. 1216 71

In Japan parasitic diseases have been considered to be successfully controlled in the last 30 years. However, some parasitic diseases, such as food-borne zoonoses and/or larva migrans, are emerging and/or re-emerging in Japan. Furthermore, imported parasitic diseases like malaria are also gradually increasing. Unfortunately accurate numbers of parasitic diseases other than echinococcosis, malaria, amebiasis, giardiasis, or cryptosporidiosis are obscure in Japan because of the lack of a legal registration system. Since symptoms and diagnostic imaging patterns of parasitic diseases are non-specific and have similarities with other infectious diseases or cancer, parasitic diseases are sometimes overlooked or left misdiagnosed. In this review, the current status of parasitic diseases in Japan is briefly summarized based on the analysis of the accumulated cases seen in our department. We also outline the clinical features, differential diagnosis and treatment of representative parasitic diseases for the better understanding and management of the parasitic diseases in Japan.
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PMID:The current status of parasitic diseases in Japan. 1270 86

Almost all children living in endemic zones are infected by gastrointestinal parasites. However only 3 to 5% develop diarrhea directly related to parasite infection. Entamoeba hystolytica and Entamoeba dispar coexist in many areas. In the past Entamoeba dispar was called non-pathogenic ameba. The vegetating forms are microscopically identical and detection of wall differences using biochemical tests is unreliable. Thus since it is rarely possible to determine whether or not a vegetating ameba found in stools is hematophagous treatment using metronidazole is the only alternative. Failure of such treatment indicates that dysentery is probably due to a cause other than amibiasis, e.g., bacterial infection in most cases. Another protozoan commonly found in endemic areas is Giardia. Giardia can cause diarrhea and this is frequently the case in undernourished children. Giardia infection leads to severe atrophic villosity requiring appropriate specific treatment. In children cryptosporidioses may be asymptomatic or lead to diarrhea especially in cases associated with malnutrition or immunodeficiency related in particular to AIDS. Helminths are a rare cause of significant diarrhea except Anguillula in undernourished children. In children presenting severe malnutrition, anguilluliasis can lead to serious consequences and requires immediate treatment using ivermectin. To avoid severe diarrhea in children presenting immunodeficiency induced by corticotherapy or chemotherapy for cancer, prophylaxis is mandatory against anguilluliasis using ivermectin and usually against giardiasis using metronidazole.
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PMID:[Parasitic diarrhea in eutrophic and malnourished children]. 1476 99


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