Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During 1991-1992 in the Gorduras district of Belo Horizonte, the capital of Minas Gerais State in Brazil, data on 451 persons over 2 years old who carried Schistosoma mansoni eggs, as detected on at least 1 of 4 slides, were compared with data on 465 same-age persons who were free of such eggs to describe the epidemiology of schistosomiasis in this urban area. The schistosome host, Biomphalaria glabrata, was present at all 11 monitored points along streams. Snails infected with S. mansoni were found at 6 points. Sewerage was entering the streams at 2 points. 92.7% of households had a piped water supply. 89.4% had a sewerage system. 20% of the 3049 sampled peoples had schistosomiasis. The geometric mean of S. mansoni eggs stood at 70.8 eggs/gram. Only 4.7% of persons infected with S. mansoni eggs had bloody stools. Less than 3% had a hardened enlarged liver. No one had splenomegaly or splenectomy. Signs and symptoms independently associated with S. mansoni infection included bloody stools (odds ratio [OR] = 8), palpable hardened liver at the middle clavicular line (OR = 5.5), and palpable hardened liver at the middle sternal line (OR = 8). Sociodemographic variables and reasons for water contact independently associated with S. mansoni infection were age (OR = 7.1 for 10-19 years; OR = 3.3 for =or + 20 years), being male (OR = 3.1), swimming and/or playing in water (OR = 2.2 for =or- 2 times/month; OR = 3 for 2 times/month), and living in Belo Horizonte (OR = 2.5). There was no association between infection and water supply. These findings suggest a need for schistosomiasis control measures centering on water contacts for leisure in this area.
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PMID:Urban schistosomiasis: morbidity, sociodemographic characteristics and water contact patterns predictive of infection. 902 38

Forty-three patients who fulfilled the international criteria for prolonged fever were exposed to thorough history taking, clinical and laboratory investigations. The latter included urine and stool examination, urine and blood culture, haemogram, liver and renal function tests, chest X-ray, tuberculin test, bone marrow, liver biopsy, blood films, serological tests including ELISA, IHA and IFA for detection of schistosomiasis, toxoplasmosis and malaria. Parasitic infections were detected in 30/43 (69.7%), 55.8% of whom had pure parasitic infection and 14% had in addition other causes. The majority of cases with positive etiology were coming from rural areas. The pattern of fever was predominantly intermittent especially with malaria and schistosomal cases. Fever of 21-41 days duration was noted in 70% of patients and 23.3% lasted up to more than 56 days. Visceromegaly (hepatomegaly and/or splenomegaly) was observed in all patients except one case. Lymphadenopathy was detected in ten cases, six of whom were visceral leishmaniasis. The IHA test for leishmaniasis detected ten cases at titres of 256, 512 and 1024 reciprocally. The dot-ELISA gave seropositivity in only 8/10 cases diagnosed by IHA test. So eight cases of VL were diagnosed by two serological tests at high titres. The detection of seropositive cases of visceral leishmaniasis in the studied area, suggests a focus or foci and warrants epidemiological study to establish the actual situation. Generally speaking, parasitic aetiology should be in mind in any case of FUO in Dakahlia. Serological tests are valuable, simple and safe tools for conforming the diagnosis of schistosomiasis, leishmaniasis, toxoplasmosis and malaria.
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PMID:Epidemiological, clinical and laboratory studies on parasitic infections as a cause of fever of undetermined origin in Dakahlia Governorate, Egypt. 909 26

This paper uses a mathematical framework to predict the long-term consequences of chemotherapy for the age distribution of schistosomiasis morbidity. The framework incorporates a previously validated transmission model, which is here extended to capture effects on 2 forms of Schistosoma mansoni morbidity: early disease exemplified by hepatomegaly and late disease exemplified by Symmer's fibrosis. The main aim of this analysis is to show how such an approach could be used to explore the probable public health consequences of decades of control. It is suggested that this procedure could usefully inform current approaches to the design of long-term control programmes.
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PMID:Modelling the dynamic effects of community chemotherapy on patterns of morbidity due to Schistosoma mansoni. 919 75

In this study we examined 1,909 individuals (53% males and 47% females) to determine the current status of Schistosoma japonicum among the people in five fishing villages situated on two islands (large, Qingshan island; small, Niangashan island) in the Dongting Lake region in Hunan Province, the People's Republic of China. The results of this study indicate that the overall prevalence for schistosomiasis on the two islands is 16%. Two distinct peaks in prevalence (29%) were observed at 25-35 years of age and again at 45-55 years of age for both the large and small islands. On the small island the overall prevalence (24%) varied significantly (P < 0.01) from the large island (15%). Fishermen had the highest prevalence (22.4%) among all the occupational groups examined but students produced the highest worm intensity (geometric mean = 69 eggs per gram [epg] of feces). There was a significant difference (P < 0.01) in the prevalence of schistosomiasis between males and females. In general, males had a much higher prevalence (22%) than females (8.9%). When the study populations were classified as uninfected, lightly infected (10-100 epg), moderately infected (101-400 epg), and heavily infected (> 401 epg) with S. japonicum, the distribution pattern was similar for each of the five villages. The majority (76-88%) of the population remains uninfected. Lightly infected individuals had the highest prevalence (7-12%) followed by moderately infected individuals (1-9%). Only a very small percentage of the population was heavily infected (0-2%). Hepatomegaly along the midsternal line (MSL > or = 3) was commonly seen in both uninfected (21%) and infected individuals (1939%). Subjects heavily infected with S. japonicum reported significantly higher (P < 0.05) cases of liver enlargement when compared with those uninfected. The reported cases of abdominal pain for both uninfected (9%) and infected individuals (4-19%) was relatively high. Lightly and moderately infected individuals reported significantly (P < 0.05 and P < 0.01, respectively) more episodes of abdominal pain than those uninfected. The occurrence of diarrhea was low (5%) for uninfected individuals but this clinical feature was significantly (P < 0.01) more prevalent in both the lightly and heavily infected categories (8-17%).
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PMID:Epidemiologic features of Schistosoma japonicum among fishermen and other occupational groups in the Dongting Lake region (Hunan Province) of China. 931 40

We examined three Chinese villages (one farming village and two fishing villages) in an area highly endemic for schistosomiasis japonica in order to study the prevalence, intensity of infection and the associated morbidities before the implementation of adequate control strategies. Socio-economic status, medical histories including the frequency and type of water contact, physical examinations, parasitological examinations and questionnaires relevant to the knowledge of schistosomiasis were performed on a random sample of 1542 individuals (45% female; 55% male). The prevalence of Schistosoma japonicum was 9.4% in the farming village and 16.5 and 26.2% in the fishing villages. Eighty-three percent of the infected population had light infections (8-100 eggs per gram stool (epg)) and only 6% had heavy infections (> 400 epg). Both the prevalence and intensity of infection varied significantly (P < 0.01) with the frequency of water contact. All the morbidity indicators (weakness, inability to work, diarrhoea, hepatomegaly and splenomegaly) were significantly higher (P < 0.01) among those infected with S. japonicum. Knowledge of schistosomiasis, in general, was unsatisfactory in all three villages; 12.4% of the population was infected when their knowledge of schistosomiasis was good, whereas 26.6% of the population was infected when their knowledge was poor. Further, it appears that schistosomiasis control based on selective chemotherapy (praziquantel) of randomly selected stool-positive individuals was ineffective in significantly reducing the prevalence of S. japonicum and its associated clinical manifestations in the villages under study.
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PMID:An evaluation of Schistosoma japonicum infections in three villages in the Dongting lake region of China. I. Prevalence, intensity and morbidity before the implementation of adequate control strategies. 935 4

The effectiveness of schistosomiasis control strategies implemented in 1991 were evaluated in a 1995-96 epidemiological study involving 1656 persons from two fishing villages on Qingshan Island in China's Hunan Province. In 1991, the prevalences of Schistosoma japonicum, Ascaris lumbricoides, A. duodenale, and Trichuris trichiura were 17.5%, 90.9%, 0.3%, and 46.5%, respectively. By 1996, these prevalences had dropped to 14.6%, 26.8%, 0.2%, and 4.0%, respectively. Despite an overall reduction in S. japonicum incidence, especially in the 5-9 and 55-59 year age groups, the proportion of moderate and heavy intensity infection was higher in 1996 than 1991, suggesting current dosages of praziquantel should be increased among the severely infected. Also recorded were reductions in S. japonicum-related morbidity--including weakness, hepatomegaly, diarrhea, and splenomegaly--among infected and uninfected persons. Since 1991, treatment coverage has increased for those aged 20 years and under and decreased among those older than 60 years. Recommended to ensure further public health advances are expanded treatment opportunities for humans, initiation of treatment of domestic animals and bovines, initiation of mollusciding in newly identified snail-positive habitats before the peak transmission period, and expanded health education programs.
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PMID:An examination of current control strategies for Asian schistosomiasis in the Dongting lake region of China. II. A five year follow-up survey on Qingshan island. 935 5

The paper describes the endemic situation of schistosomiasis japonica in Fanhu village, Poyang Lake region, China and the effect of the strategy of combining annual mass chemotherapy with health education on schistosomiasis control in the community. The results showed that the prevalence of infection with schistosome reduced form 26.0% in 1992 to 10.7% in 1994, the intensity of infection in residents decreased from 1.92 in 1992 to 0.55 in 1994 and the condition of hepatomegaly, splenomegaly and liver fibrosis also improved after chemotherapy in the individuals in the case prospective study. Moreover, the future strategies of schistosomiasis control in this area have been suggested according to the transmission of schistosomiasis in the lake region and the effect of anti-schistosomiasis control indifferent populations.
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PMID:Impact mass chemotherapy with praziquantel on schistosomiasis control in Fanhu village, People's Republic of China. 944 5

Inflammatory pseudotumor of the liver is uncommon in children. Only 14 cases have been reported in the literature. The underlying etiology is unclear but traumatic and infectious factors may be implicated. This report describes an inflammatory pseudotumor that was observed in a 9-year-old child from the Ivory Coast one year after traumatic injury of the right hypochondrium. Clinical findings were limited to non-febrile but painful hepatomegaly with weight loss. Laboratory tests were consistent with an inflammatory process. Ultrasonography revealed a poorly delimited, heterogeneous area approximately 5 cm in diameter at the level of the VI segment which had been resected. Histology documented the presence of fibro-inflammatory tissue with granulomatous inclusions. At the center of the lesion was a foreign body corresponding to a Schistosoma mansoni egg. In this case the mechanism underlying inflammatory pseudotumor could have involved either bilharziasis or trauma. A review of the literature allows the authors to enumerate the main features of this uncommon benign tumor of the liver in children.
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PMID:[Inflammatory pseudo-tumor of the liver in a child: case report]. 951 56

Brazil has a young population and areas of endemic mansoni schistosomiasis where Wilson's disease might be easily misdiagnosed in patients erroneously classified as having either the hepatosplenic or the hepatointestinal form of the helminthiasis. Twenty five patients with the "hepatic form" of Wilson's disease (14 males and 11 females) were investigated in Belo Horizonte, MG; the mean age was 13.7 years (3 to 22). Nineteen had hepatomegaly (76%) and nine splenomegaly (36%). Twenty two (88%) had cirrhosis. The Kaiser-Fleisher ring was detected in fifteen (60%). Four (16%) had clear neurological abnormalities. Eleven (44%) had ascitis and/or jaundice. Ninety one point three per cent and 92% had low ceruloplasmin and copper serum levels respectively. Eighty four point two per cent showed an increased 24 hours urinary copper excretion; seven patients in whom hepatic copper was determined had increased values. Six out of nine had at least a ten fold increase in 24 hours urinary copper excretion following penicillamine use ("penicillamine test"). Three out of 19 patients (15.8%) had mansoni schistosoma ova in stools examination, a common prevalence in our population. Their biopsies showed inactive cirrhosis without schistosomiasis-associated alterations. At least fourteen patients (56%) could be misdiagnosed as having hepatointestinal or hepatosplenic schistosomisis when in fact they suffered from Wilson's disease with or without asymptomatic intestinal schistosomiasis, losing the chance of an early treatment. The follow-up time of 22 patients was 52 months (1 to 96); eight (36.3%) died, four from bleeding esphageal varices, three from terminal hepatic failure and one from fulminant liver failure. The majority of the patients, including those who died, had abandomned the use of penicillamine or had taken it irregularly, due mainly to its highly expensive cost. A 17 year old patient underwent a successful liver transplant in 1989.
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PMID:[Wilson's disease ("hepatic form") in a region endemic for schistosomiasis mansoni: clinical presentation of 25 patients]. 971 8

Two hundred and fifty two blood donors HBsAg positive (mean age = 32.6, 91, 7% male) were searched into a transversal study to determine their clinical, laboratorial and histological characteristics. It was also compared the positiviness and negativiness of the serologic markers HBeAg, anti-Hbe and IgM anti-HBc with the values of serum aminotransferases. Hepatomegaly and splenomegaly were detected in 9.9% (25/252) and in 2.4% (6/252) respectively. In 17.5% (44/251) and 28.3% (71/251) the AST and ALT were respectively, over 50 UI/I. The positive frequencies of the various serologic markers of hepatitis B virus in 120 patients were: anti-HBc total in 89.5% (102/114), HBeAg in 25.7% (28/109) anti-Hbe in 67.3% (66/98), IgM anti-HBc in 40.8% (49/120); anti-Delta in 0.0% (0.66). Thirty one patients were submitted to liver biopsy, due do clinical alteration and/or of the aminotransferases. The hystological findings were: normal liver in 16.1% (5/31), non specific hystological alterations in 22.6% (7/31), persistent chronic hepatitis in 22.6% (7/31), active chronic hepatitis in 6.5% (2/31), cirrhosis in 12.9% (4/31), alcoholic hepatitis in 3.2% (1/31), lobular chronic hepatitis in 3.2% (1/31) and alterations exclusively due to schistosomiasis in 12.9% (4/31). Schistosomiasis elements (granuloma and/or Symmers fibrosis) were also notived in 7 patients. The comparative analysis of positiveness and negativeness of the serologic markers with the aminotransferases ("t" test of Student) showed significative difference of the averages (p < 0.05) only in relation to the simultaneous positeveness and negativeness of the HBeAg and IgM anti-HBc (average of AST = 56.11 and ALT = 78.00 when HBeAg and IgM anti-HBc were positive; average of AST = 24.25 and ALT = 27.00 when HBeAg and IgM anti-HBc were negative). According to this study the conclusion are: 1) The presence of two markers (HBeAg and IgM anti-HBc) and not only one determinant of viral replication in asymptomatic HBsAg carriers can strongly indicate a significant biochemical activity suggestive of hepatocellular lesion. 2) The presence of HBeAg in 25.7% (28/109) clearly shows the high rate of carriers with a potential of infectivity. 3) The results of hepatic histology shows that the majority of our patients had either normal liver or mild histological alterations. It is important to notice that only the cases with elevated aminotransferases were submitted to liver biopsies. The alterations caused by schistosomiasis shows, as is well known, the high prevalence of the parasitism in our surroundings. 4) The clinical aspects of the patients studied did not show significant alterations. Risk factors to get the infection were low. The hematologic and biochemical parameters (except aminotransferases) were either normal or just slightly abnormal. It was not detected a statistically significant difference. 5) The co-infections by delta virus was null.
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PMID:[Clinical, laboratory and liver histology of HBsAg-positive volunteer blood donors in Belo Horizonte, State of Minas Gerais, Brazil]. 1041 47


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