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)

Although human infection with Schistosoma mansoni is known to be widespread in Highland Ethiopia, no information is available on its public health impact. A sample of the inhabitants of two typical villages in the endemic region north of Lake Tana were studied by clinical and quantitative parasitologic methods. One village had a moderately high prevalence (43.3%), while the second, chosen for comparison, had a very low prevalence (10.7%). No evidence of severe hepatosplenic disease was found in 343 persons examined. Symptons and mild hepatomegaly compatible with S. mansoni infection were common, and in the high prevalence village complaints of abdominal pain and blood in the stool were significantly related to S. mansoni egg counts. However, all signs and symptoms compatible with S. mansoni infection, including hepatomegaly, were of greater or similar frequency in the village with the low prevalence of infection. The findings of minimal morbidity are compatible with the level of intensity of infection found in the area and are consistent with the findings from morbidity studies based on quantitative egg counts in other areas of the world.
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PMID:Morbidity from Schistosoma mansoni infections: an epidemiologic study based on quantitative analysis of egg excretion in two highland Ethiopian villages. 100 26

The intensity of infection with Schistosoma mansoni and its effects were investigated in a defined population living on three contiguous fazendas (subcounties) in a nonmalarious area of northeast Brazil near Salvador, Bahia. Quantitative stool egg counts (Bell technique) were performed on 363 of 417 individuals (90%) of all ages; physical examinations were done on 294 of 357 individuals (82%) 5 years of age and older. The maximum increase in prevalence was observed between the 1- to 4- and 5- to 9-year age groups, while the maximum increase in fecal egg count occurred between 5- to 9- and 10- to 14-year age groups. Highest egg counts were observed in the 10- to 14-year age group (geometric mean of 301 eggs per ml of stool) while the maximum prevalence (100%) was in the 20- to 24-year age group. In the fazenda with the lowest quantitative egg counts the age specific prevalence rates increased more slowly than in the fazendas with higher egg counts. In the study group nearly 50% of the total fecal egg output was accounted for by 22 individuals (6%) who had a mean age of 12.6 years. Egg counts for this selected group were all over 800 eggs per ml of stool with a mean of 1,514 eggs per ml of stool. In children under 15 years of age, the frequency of hepatomegaly and splenomegaly varied directly with the egg count; further, the degree of hepatomegaly was directly correlated with increasing egg counts. No splenic enlargement was noted in children not excreting eggs. In adults, on the other hand, neither splenomegaly nor hepatomegaly could be directly related to schistosomal infection per se. In children, neither the presence of infection with S. mansoni nor its intensity was reflected by altered anthropometric measurements. In the one fazenda tested the frequency of stools positive for occult blood correlated with increasing S. mansoni egg counts.
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PMID:The intensity and effects of infection with Schistosoma mansoni in a rural community in northeast Brazil. 125 89

In order to compare clinical versus ultrasound based diagnosis of Schistosoma mansoni induced periportal fibrosis (pF) 536 infected Sudanese schoolchildren underwent clinical and sonographical examination. A liver exceeding 3 cm in sternal line and a palpable spleen were considered pathological. Ultrasound criteria for age dependent organometry of a Central European cohort were used as reference. Based on clinical criteria 190 children (35.4%) had hepatomegaly, whereas according to ultrasound results the rate was only 11.4%. Splenomegaly was detected in 77 cases (14.4%) by clinical means, but in 196 by ultrasound (36.6%). The sensitivity of clinical parameters as indication of pF was around 50%. Results for ultrasound detected organomegaly were only slightly better. It was concluded that assessment of liver and spleen sizes was of limited value as an indication for pF and that a considerable discrepancy existed between clinical and ultrasound based assessment of hepato- and splenomegaly.
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PMID:Ultrasound versus clinical examination as indication for Schistosoma mansoni associated morbidity in children. 129 29

250 patients with fever, hepatomegaly and eosinophilia were investigated for parasitic infection by stool, urine, thick blood smear examination and sero-diagnosis (ELISA for anti-Toxocara and IFA for anti-Fasciola). Those with patent parasitic infections (41) and anti-Toxocara seropositivity (10) were excluded from follow up. The other were 3 months followed up. The detected infections were 10 Ascaris, 15 Strongyloides, 20 Toxocara, and 25 Schistosoma mansoni. Other 30 were positive for Fasciola eggs. No other infections were found in the remained 109 patients. IFA anti-Fasciola antibody titres were significantly higher among Fasciola group than any other groups. It is concluded that IFA anti-Fasciola antibody titre greater than or equal to 1/256 with ethanol fixed antigen sections is of value in diagnosis of acute fasciolitic hepatic syndrome.
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PMID:Indirect fluorescent antibody test in diagnosis of acute fasciolitic syndrome. 157 73

The efficacy of the highly selective antischistosomal combination chemotherapy with tubercidin (7-deazaadenosine) plus nitrobenzylthioinosine 5'-monophosphate (NBMPR-P), [el Kouni et al., Proc Natl Acad Sci USA 80: 6667-6670, 1983; el Kouni et al., Biochem Pharmacol 36: 3815-3821, 1987] was examined against chronic and advanced stages of schistosomiasis in mice. Administration of four successive daily doses of tubercidin (5 mg/kg/day) plus NBMPR-P (25 mg/kg/day) to Schistosoma mansoni-infected mice beginning 5, 6, 7 and 8 weeks post-infection and monitored for 22 weeks was very effective against the parasite. It resulted in a marked increase in survivorship of treated mice. Repetition of the dose-regimen after a 10-day rest period was even more effective. However, survivorship of infected animals decreased with the delay of therapy. Early treatment (5 weeks post-infection) resulted in 100% survival compared to 13% only for untreated animals. If therapy was instituted at 8 weeks post-infection, only 70% of the treated mice survived. Treated animals appeared healthy and were found to have less splenomegaly and hepatomegaly. Combination therapy also caused a significant reduction in the number of worms as well as the number of eggs in the liver and small intestine. However, these differences diminished as the treatment was delayed. The number of eggs in the liver was reduced from an average of 120,000 eggs per liver in untreated animals to approximately 16,000 eggs per liver when treated at 5 weeks post-infection. When treatment was delayed to 8 weeks post-infection, the reduction in liver egg count was not as dramatic (88,000 eggs per liver). Similarly, the number of eggs was reduced in the intestine from 1,759 to an average of 58 and 860 eggs per cm2 of the intestine when the mice were treated at 5 and 8 weeks post-infection respectively. However, some worms survived and resumed egg production after an extended period of recuperation. Histological examination indicated that combination therapy was effective in preventing the formation of new egg granulomas but not on pre-existing granulomas.
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PMID:Efficacy of combination therapy with tubercidin and nitrobenzylthioinosine 5'-monophosphate against chronic and advanced stages of schistosomiasis. 190 Jan 58

Five hundred thirty six Sudanese schoolchildren with Schistosoma mansoni infection were treated at random with either 20 mg or 40 mg/kg praziquantel. Seven months later 420 children could be reinvestigated by ultrasonography. Reduction of egg excretion and reversibility of sonographically-proven periportal fibrosis (PF) was not significantly different in the two groups. Schistosoma mansoni-induced PF grade II decreased from 22.9% to 6.7% and grade III from 5.2% to 1.6%. An increased prevalence of PF grade I, from 10% to 29.8% of the investigated patients, was observed. This increase was caused partly by a downshifting of patients who had PF II (n = 45) and PF III (n = 8) before therapy, but also by patients who developed PF I in the seven months after therapy (n = 56). The overall percentage of patients with PF before and after treatment was 38.1%. Of 420 children, 17.4% increased in their PF grade, 55% remained at the same level and 27.6% improved. Children younger than 11 years of age had a higher rate of complete reversibility than older ones. The percentage of patients with hepatomegaly decreased significantly (11.6% to 6.9%; p = 0.001). The rate of splenomegaly remained unchanged. It was concluded that within seven months therapy with praziquantel resulted in a considerable qualitative improvement of PF in Sudanese schoolchildren with S. mansoni infection.
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PMID:Ultrasonographical investigation of periportal fibrosis in children with Schistosoma mansoni infection: reversibility of morbidity seven months after treatment with praziquantel. 190 98

Parasitological, clinical, and sonographic examinations were performed on 309 school children in a village endemic for schistosomiasis mansoni. Data from the 255 denying treatment within the previous 2 years were analysed separately. On a single Kato examination 42% were uninfected; the remainder had light (26%), moderate (21%), or heavy (11%) infections with Schistosoma mansoni. Hepatomegaly (53%) and palpable spleens (35%) were common but clinical and parasitological findings often were unrelated. Abdominal sonography also demonstrated a high frequency of hepatomegaly (82%) and splenomegaly (49%). Sonographically determined liver span and spleen size correlated with the egg count. Sonographic lesions of periportal fibrosis of schistosomiasis mansoni with thickening of portal tracts and portal vein walls were frequently present and more common in infected than in uninfected children, and were correlated with the number of S. mansoni ova in the stool. Ultrasonographically detected periportal fibrosis was a reliable measurement of the prevalence and morbidity of schistosomiasis mansoni in this population, and provided very useful information, even when the parasitological and clinical findings were equivocal.
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PMID:Sonographic studies of schoolchildren in a village endemic for Schistosoma mansoni. 211 46

Morbidity due to infection with Schistosoma mansoni was investigated in a recently discovered highland focus around Lake Cohoha, Burundi. The distribution of the infection was very focal and morbidity patterns in populations from an endemic area A (prevalence 38%, mean egg load of positive subjects 231 eggs per gram [epg]), a less affected area B (16%, 90 epg) and a virtually non-endemic area C (5%, 45 epg), were compared; apart from schistosomiasis, the profiles of these populations were highly similar. The overall frequencies of diarrhoea were 36%, 25%, and 19%, respectively; of abdominal pain 86%, 78%, and 83%; of fatigue 7%, 2%, and 1%; of left lobe hepatomegaly 30%, 18%, and 9%; of right lobe hepatomegaly 18%, 10%, and 5%; of splenomegaly 18%, 10%, and 7%. Organomegaly was generally mild, even in area A. Within area A, the association between the presence of infection and diarrhoea, fatigue, hepatomegaly and splenomegaly was significant, but far less impressive than the results of the community-based comparison with areas B and C. The correlation with intensity was limited to an increased prevalence of diarrhoea and fatigue in the highest egg count group, and a more gradual increase (varying with age) in hepatomegaly and splenomegaly. The data are compared to other morbidity studies in subsaharan Africa, in particular one in the nearby Rusizi Plain. The lesser impact of malaria, the higher egg loads, the recent establishment of the focus and possibly parasite strain differences may account for the more apparent and more important schistosomiasis morbidity in the Cohoha focus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The morbidity of schistosomiasis mansoni in the highland focus of Lake Cohoha, Burundi. 212 66

A study of morbidity and side effects of treatment with praziquantel in relation to intensity of infection with Schistosoma mansoni was conducted in 406 infected individuals from a newly-settled village in Metekel, north-western Ethiopia. Each subject was submitted to a standardized medical history and abdominal palpation. The frequencies of hepatomegaly and splenomegaly were low, 2% and 3%, respectively. A positive association was found between egg load and a history of blood in the stool. Interviews on side effects were conducted on the day following treatment with praziquantel (40 mg/kg body weight). Positive correlations with egg load were found for several side effects, including abdominal pain, diarrhoea, headache, back pain, and vomiting. Unusual side effects involving swelling of various parts of the body confirm 2 previous reports from a different region in Ethiopia and should be investigated further.
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PMID:Schistosoma mansoni infection in a new settlement in Metekel district, north-western Ethiopia: morbidity and side effects of treatment with praziquantel in relation to intensity of infection. 251 35

This prospective study has shown that oxamniquine treatment controlled endemic schistosomiasis mansoni in a defined rural population in Castro Alves, north-east Brazil. Data before and after treatment spanning 11 years were collected for a cohort of 191 residents. Before treatment (1974-77), the cohort was heavily infected and the prevalence of associated hepatomegaly (greater than 86%) and splenomegaly (greater than 17%) was stable. The cohort was treated when oxamniquine became available in 1977; during the next 8 years, over 80% received further treatments from the Brazilian programme for the control of schistosomiasis. With treatment, the incidence of splenomegaly fell (10% to 2%) and the splenomegaly regression rate increased (43% to 91%). Declining disease rates were coincident with substantial falls in the prevalence and intensity of Schistosoma mansoni infections. The final prevalence rates for hepatomegaly (31%) and splenomegaly (3%) in Castro Alves approached the corresponding rates of 10% and 1% in a comparable uninfected control population.
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PMID:Manson's schistosomiasis in Brazil: 11-year evaluation of successful disease control with oxamniquine. 286 44


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