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)

For the 2-year period 1989-1990, 16 states reported 26 outbreaks due to water intended for drinking; an estimated total of 4,288 persons became ill in these outbreaks. Giardia lamblia was implicated as the etiologic agent for seven of the 12 outbreaks in which an agent was identified. The outbreaks of giardiasis were all associated with ingestion of unfiltered surface water or surface-influenced groundwater. An outbreak with four deaths was attributed to Escherichia coli O157:H7, the only bacterial pathogen implicated in any of the outbreak investigations. An outbreak of remitting, relapsing diarrhea was associated with cyanobacteria (blue-green algae)-like bodies, whose role in causing diarrheal illness is being studied. Two outbreaks due to hepatitis A and one due to a Norwalk-like agent were associated with use of well water. Eighteen states reported a total of 30 outbreaks due to the use of recreational water, which resulted in illness for an estimated total of 1,062 persons. These 30 reports comprised 13 outbreaks of whirlpool- or hot tub-associated Pseudomonas folliculitis; 13 outbreaks of swimming-associated gastroenteritis, including five outbreaks of shigellosis; one outbreak of hepatitis A associated with a swimming pool; and three cases of primary amebic meningoencephalitis caused by Naegleria. The national surveillance of outbreaks of waterborne diseases, which has proceeded for 2 decades, continues to be a useful means for characterizing the epidemiology of waterborne diseases.
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PMID:Waterborne-disease outbreaks, 1989-1990. 177 Sep 24

Seven cases of Budd-Chiari syndrome are reported in children. The mode of onset was fulminant in one case with rapidly lethal liver failure, acute in 5 cases with rapid appearance of hepatomegaly and ascites and insidious in one case, with isolated hepatomegaly. Hepatomegaly, which is a constant sign, was present in the 7 patients. Ascites and collateral venous circulation were present in 6, splenomegaly in 2 and moderate jaundice in one only. Liver function tests, deeply abnormal in the patient with fulminant liver failure, was only slightly abnormal in the 6 others. Diagnosis was corroborated by ultrasonography, cavography, hepatic veins angiography and liver biopsy in 6 patients and by post mortem examination in the 7th. Etiologic investigations did not allow finding the cause of Budd-Chiari syndrome. However, this series can be distinguished by associated total villous atrophy in 3 cases, psoriasis in one, hepatitis B in one, hepatitis A and intestinal giardiasis in one. Portasystemic shunts were performed in 3 patients. One died in the immediate postoperative period, the 2 others are presently in good health with a 5 and 6 1/2 year-follow-up. One patient died rapidly from fulminant liver failure. Another, untreated, died 16 years after the onset of the disease, from an unknown cause. Two patients are lost to follow-up.
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PMID:[Budd-Chiari syndrome in children. Apropos of 7 cases]. 206 74

This overview provides a discussion of the special concerns of sexually transmitted diseases (STDs) for women, particularly because of its asymptomatic character; screening; primary prevention; e.g., abstinence, selection of sexual partners restriction of sexual activities, use of barriers (condoms, vaginal spermicides, diaphragm in conjunction with spermicides), and vaccines; and the role of the gynecologist in StD prevention. Gonorrhea and chlamydial infection are usually asymptomatic STD infections in women; long term sequelae are pelvic inflammatory disease (PID), infertility, and pregnancy complications. There is an increased risk of cervical cancer. Infection is lifelong for herpes simplex virus (HSV) and HIV and malingering for chronic hepatitis B (HPB). Genital human papillomavirus (HPV) and HSV infections cannot be identified serologically. The fetus can be fatally or severely affected by STDs. Abstinence is the only effective prevention for STDs. Likelihood of infection may be reduced by limiting partners, but how partners are chosen and knowledge of infection is a more important determinant. Partners need to be asked about current symptoms, history of STDs, multiple partners, and history of known STD partners, as well as past history of homosexual activity, intravenous drug use, hemophilia, and previous exposure to high-risk persons for STDs. Visible genital warts or lesions, wartlike growths, ulcers, or rash need explanations. Avoidance of oral anal and digital anal activity reduces transmission of hepatitis A, giardiasis, amebiasis, and shigellosis. Any mechanical barrier that remains intact should reduce the risk of STD; barriers specifically covering the cervix are excellent. Condom use is effective when used as follows: 1) at the onset of sexual activity, 2) without petroleum jelly or baby oil on latex, 3) with care of fingernails which may tear holes, 4) with complete withdrawal of the penis before complete detumescence, and 5) with a withdrawal hold at the base of the penis. Spermicides, such as nonoxynol 9, are effective against STDs. Diaphragm use with spermicide may be effective because of the spermicide. There is a reduced risk of transmission of HSV or HPV to a partner. Vaccines are only available for hepatitis B. Obstetrics and gynecology residency training in STDs in unavailable in 4 out of 5 medical schools, and gynecologists are ethically obligated to accurately inform about STD diagnosis, treatment, and diagnosis.
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PMID:Avoiding sexually transmitted diseases. 209 42

Patients infected by Salmonella, Shigella, Giardia, Campylobacter, Yersinia, and Hepatitis A virus were interviewed during a 15-month period to evaluate the benefit of intensive follow-up, to assess the proportion of cases who had contact with children less than four years of age, and to determine risk factors. Of 746 reported infections, we interviewed 345 patients (46%) and identified 199 other ill people. Follow-up of sporadic, passively reported cases required considerable resources, but no large outbreaks were uncovered. Investigation of patients [N = 103 (43%)] who had contact with children less than four years of age, or children who attended daycare centers often resulted in identification of additional illness, especially for cases of giardiasis. Primary health care providers can play a key role in reducing enteric disease by increasing efforts to identify illness among daycare and family contacts of their patients.
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PMID:Epidemiologic surveillance of enteric diseases in Alaska--value of case investigation. 235 45

Homosexual men are at increased risk for traditional sexually transmitted anorectal infections (gonorrhea, syphilis, venereal warts, herpes and chlamydial infection) and enteric infections characterized by a low infecting inoculum (hepatitis A and B, amebiasis, giardiasis, shigellosis and campylobacteriosis). Infections account for most of the gastrointestinal symptoms in homosexual men seen at sexually transmitted disease clinics, but asymptomatic and polymicrobial infections are also common. Distinguishing three syndromes-proctitis, proctocolitis and enteritis-is clinically useful because these syndromes correlate with specific microorganisms and modes of transmission. A careful anoscopic examination, rectal Gram's stain, cultures for gonorrhea and chlamydia, VDRL and darkfield examination of suspicious lesions should be routinely done when sexually active homosexual men present with unexplained gastrointestinal symptoms. Based on the history, physical examination and initial laboratory studies, patients can usually be classified as having proctitis, proctocolitis or enteritis. This distinction facilitates selection of both confirmatory diagnostic tests and antimicrobial therapy. The effectiveness of empiric treatment regimens for asymptomatic sexual contacts or for symptomatic patients in whom microbiological tests are pending has not been studied.
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PMID:Anorectal and enteric infections in homosexual men. 383 33

Due to the number of sexual encounters and variety of practices, men who have homosexual experiences have increased incidence and prevalence rates of many diseases. Diseases that are covered here include hepatitis A and B, syphilis, gonorrhea, condylomata accuminata, herpes simplex, AIDS (acquired immune-deficiency syndrome) and several enteric diseases, namely amebiasis, giardiasis, shigellosis and salmonellosis. An overview of each disease is included along with diagnostic testing and treatment regimens. This report concludes with a system of risk assignment and recommendations for frequency of sexually transmitted disease screening.
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PMID:Sexually transmitted diseases in homosexual men. 668 65

The prevalence of most sexually transmitted diseases is disproportionately increased in gay men and paradoxically decreased in lesbian women. The spectrum of diseases seen in gay men include a variety of enteric infections including hepatitis A, shigellosis, salmonellosis, Campylobacter enteritis, amebiasis, giardiasis, and enterobiasis as well as the more common sexually transmitted diseases. Hepatitis B is endemic in gay male populations. The patterns of sexual behavior are the major factors contributing to this unique epidemiology and pathology. Increased sexual activity explained by the unrestrained cultural expectation of maleness, the functional overlap during sex between the genital-urinary and gastrointestinal systems, and anonymous sexual activity are all significant epidemiologic components.
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PMID:Hepatitis and other sexually transmitted diseases in gay men and in lesbians. 689 98

In addition to gonorrhea and syphilis, both of which may develop primarily at anorectal or pharyngeal sites, a number of conditions, including Neisseria meningitidis urethritis, nonspecific urethritis, anorectal herpes, condyloma acuminatum, amebiasis, giardiasis, shigellosis, typhoid fever, enterobiasis, and hepatitis A and B, have been identified as being transmitted by male homosexual contact. Proctologic complications of anal intercourse include allergic reactions to anal lubricants, prolapsed hemorrhoids, and fistulas, and fissures. Rectosigmoid tears may result from fist, forearm, and foreign body penetration of the bowel. Physicians can best help their homosexual patients by accepting them and their relationships nonjudgmentally and by understanding their special health needs.
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PMID:Sexually transmitted diseases and traumatic problems in homosexual men. 699 80

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

Many classes of pathogens excreted in feces are able to initiate waterborne infections. There are bacterial pathogens, including enteric and aquatic bacteria, enteric viruses, and enteric protozoa, which are strongly resistant in the water environment and to most disinfectants. The infection dose of viral and protozoan agents is lower than bacteria, in the range of one to ten infectious units or oocysts. Waterborne outbreaks of bacterial origin (particularly typhoid fever) in the developing countries have declined dramatically from 1900s. Therefore, some early bacterial agents such as Shigella sonnei remains prevalent and new pathogens of fecal origin such as zoonotic C. jejuni and E. coli O157:H7 may contaminate pristine waters through wildlife or domestic animal feces. The common feature of these bacteria is the low inoculum (a few hundred cells) that may trigger disease. The emergence in early 1992 of serotype O139 of V. cholerae with epidemic potential in Southeast Asia suggests that other serotypes than V. cholerae O1 could also getting on epidemic. Some new pathogens include environmental bacteria that are capable of surviving and proliferating in water distribution systems. Other than specific hosts at risk, the general population is refractory to infection with ingested P. aeruginosa. The significance of Aeromonas spp. in drinking water to the occurrence of acute gastroenteritis remains a debatable point and has to be evaluated in further epidemiological studies. Legionella and Mycobacterium avium complex (MAC) are environmental pathogens that have found an ecologic niche in drinking and hot water supplies. Numerous studies have reported Legionnaires' disease caused by L. pneumophila occurring in residential and hospital water supplies. M. avium complex frequently causes disseminated infections in AIDS patients and drinking water has been suggested as a source of infection; in some cases the relationship has been proven. More and more numerous reports show that Helicobacter pylori DNA can be amplified from feces samples of infected patients, which strongly suggests fecal-to-oral transmission. Therefore, it is possible that H. pylori infection is waterbome, but these assumptions need to be substantiated. Giardiasis has become the most common cause of human waterborne disease in the U.S. over the last 30 years. However, as a result of the massive outbreak of waterborne cryptosporidiosis in Milwaukee, Wisconsin, affecting an estimated 403,000 persons, there is increasing interest in the epidemiology and prevention of new infection disease caused by Cryptosporidium spp. as well as monitoring water quality. The transmission of Cryptosporidium and Giardia through treated water supplies that meet water quality standards demonstrates that water treatment technologies have become inadequate, and that a negative coliform no longer guarantees that water is free from all pathogens, especially from protozoan agents. Substantial concern persists that low levels of pathogen occurrence may be responsible for the endemic transmission of enteric disease. In addition to Giardia and Cryptosporidium, some species of genera Cyclospora, Isospora, and of family Microsporidia are emerging as opportunistic pathogens and may have waterborne routes of transmission. More than 15 different groups of viruses, encompassing more than 140 distinct types can be found in the human gut. Some cause illness unrelated with the gut epithelium, such as Hepatitis A virus (HAV) and Hepatitis E virus (HEV). Numerous large outbreaks have been documented in the U.S. between 1950 and 1970, and the incidence rate has strongly declined in developing countries since the 1970s. Hepatitis E is mostly confined to tropical and subtropical areas, but recent reports indicate that it can occur at a low level in Europe. A relatively small group of viruses have been incriminated as causes of acute gastroenteritis in humans and fewer have proven to be true etiologic agents, including rotavirus, calicivirus, astrovirus, and some enteric adenovirus. These enteric viruses have infrequently been identified as the etiologic agents of waterborne disease outbreaks, because of inadequate diagnostic technology, but many outbreaks of unknown etiology currently reported are likely due to viral agents. Actually, Norwalk virus and Norwalk-like viruses are recognized as the major causes of waterborne illnesses world-wide. The global burden of infectious waterborne disease is considerable. Reported numbers highly underestimate the real incidence of waterborne diseases. The most striking concern is that enteric viruses such as caliciviruses and some protozoan agents, such as Cryptosporidium, are the best candidates to reach the highest levels of endemic transmission, because they are ubiquitous in water intended for drinking, being highly resistant to relevant environmental factors, including chemical disinfecting procedures. Other concluding concerns are the enhanced risks for the classic group of debilitated subjects (very young, old, pregnant, and immunocompromised individuals) and the basic requirement of to take specific measures aimed at reducing the risk of waterborne infection diseases in this growing, weaker population.
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PMID:Microbial agents associated with waterborne diseases. 1254 97


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