Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Barrio San Antonio is a coastal settlement on the San Juanico straits in the municipality of Basey on the island of Samar, the Philippines. It has a population of approximately 1,900 in 320 households. Initially, 851 residents (45%) of 240 households participated in this survey to determine the prevalence and intensity of Schistosoma japonicum infection, and morbidity as indicated by associated hepatomegaly and splenomegaly. As a result of an initial single stool examination of 1 ml by a modified formalin concentration technique, 40% of this population was found to be infected. On subsequent examinations, with the addition of serologic techniques and recording the history of therapy, approximately 70% of this population was found to be infected with S. japonicum after the age of 10 years. If judged by the number of eggs produced per milliliter of feces, infection intensity in this population might be considered to be low. However, 25% (73 of 391 positives on single examination) exhibited schistosomal hepatomegaly or hepato-splenomegaly and had a mean egg count of 10.9. Those infected but without hepatomegaly had a slightly lower mean egg count of 8.4. Of the infected males with hepatomegaly, 75% were 19 years of age or less and 45% of these were producing less than 10 eggs/ml of stool. Of infected females with hepatomegaly, only 28% were 19 years of age or less, and 68% of these were producing less than 10 eggs/ml. Abdominal pain, distress, diarrhea, and dysentery were significantly more frequent in the infected than uninfected persons, and this frequency was related to egg output. The heights and weights of these infected individuals were less than those of the uninfected members of this population and significantly less than the Filipino norm. The small percentage of the infected population (6.6%) that were producing 51% of the eggs had a mean egg count of approximately 260 with a mean age of 33.7. In this group, 7 of the 22 individuals were in the age group 10--14 years and 15 were above 20 years of age. Although some individuals of Barrio San Antonio have sought therapy, this population and area have been largely unstudied and have not up to the present been involved in control or mass chemotherapy programs. The findings of this survey give an opportunity to determine the impact of such programs when they are instituted in this area.
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PMID:Schistosomiasis japonica in Barrio San Antonio, Basey, Samar , The Philippines. I. Epidemiology and morbidity. 31 24

We have identified specific ultrasonographic changes in Schistosoma japonicum-infected patients associated with serologic indicators of general liver function. An ultrasonographic examination concomitant with hematologic and biochemical serum analyses was performed on 102 patients at the Schistosomiasis Hospital in Leyte, The Philippines. The ultrasonographic liver images were classified into four patterns, according to the development of periportal fibrosis and the patterns of echogenic bands. Eleven cases with a long-term infection showed typical septal formation (network pattern). Other ultrasonographic changes in the portal system, such as the severity of splenomegaly, did not correlate with the age of the study patients or the duration of their infection; however, the production of collateral vessels was clear in the group of older patients. Among various hematologic and biochemical serum indicators of liver damage, the serum levels of total bile acid (TBA) and procollagen-III-peptide (P-III-P) strongly correlated with the development of hepatic fibrosis and protal hypertension. These findings suggest that the ultrasonographic liver patterns classified here, along with the changes in serum levels of TBA and P-III-P, provide useful indicators for field monitoring of S. japonicum infection.
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PMID:Ultrasonographic and serologic abnormalities in Schistosoma japonicum infection in Leyte, the Philippines. 153 90

We previously reported ultrasonographic and serologic abnormalities in 102 patients infected with Schistosoma japonicum in Leyte, The Philippines. These patients were subsequently treated with praziquantel (3 x 20 mg/kg), and changes in ultrasonographic images and the serum levels of liver function markers in 52 patients were followed up every three months for a period of 17 months. Improvement in the thickening of the portal vein wall and the intensity of echogenic bands was detected six months after treatment with praziquantel. The level of splenomegaly was also reduced in 42 patients who originally did not show the production of collateral vessels. A significant decrease in the serum total bile acid (TBA) level was detected in all patients six months after treatment with praziquantel. However, significant ultrasonographic changes could not be detected in the patients classified as type 3, with severe hepatic fibrosis caused by the long-term infection. These results clearly show that ultrasonographic examination, along with data on the serum TBA level, provides a sensitive tool to monitor the severity of hepatic fibrosis and portal hypertension caused by S. japonicum infection, as well as the improvement resulting from praziquantel treatment.
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PMID:Improvement of ultrasonographic and serologic changes in Schistosoma japonicum-infected patients after treatment with praziquantel. 153 91

Since the primary objective of mass chemotherapy in schistosomiasis control is reduction of schistosome-induced morbidity, it would be reasonable to assess the impact of a control program on the morbidity in a given population by investigating hepato-splenomegaly associated with schistosomiasis in a schistosomiasis endemic area. In this paper, the authors described the relationship between the prevalence, intensity and morbidity of Schistosoma japonicum infection in terms of stool egg count and ultrasonographically detectable hepatosplenomegaly in a community-based study. It was found that the epidemiological pattern of the infection in this study community was quite different from our usual understanding, that is, the prevalence remained relatively high (39.4%) when the intensity became lower. This unusual pattern might be resulted from intermittent and sporadic chemotherapy associated with frequent exposure of people to the infection in an area of high transmission. It was surprised to note that despite the praziquantel treatment carried out over the past years, the prevalence of hepatosplenomegaly induced by schistosomiasis in this community was still very high, suggesting that intermittent and sporadic chemotherapy might render little impact on schistosomiasis-induced morbidity. The investigation also showed that ultrasonography was a sensitive tool for assessing morbidity associated with schistosome infection.
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PMID:[Clinico-epidemiological investigation of schistosome-induced hepatosplenomegaly: a community-based study in Jishan, Xinjian County, Jiangxi]. 180 52

Misaka strain was isolated as the causative agent from a patient with spotted fever group rickettsiosis in Japan by using nude mice on Awaji Island, Hyogo in September 1988. The nude mice infected with the isolate showed weakness and splenomegaly and died in two or three weeks after the infection. The cyclophosphamide-treated mice infected with the isolate died between four and seven days after the infection. The infected normal mice recovered and acquired immunity. The infected adult male guinea pigs were feverish and showed swelling and redness of the scrotum between two and eight days after the infection, and recovered. The Misaka strain was propagated well in Vero cells in tissue culture. The rickettsial particles were seen as diplobacillary and diplococcal forms growing predominantly in the cytoplasm and occasionally in the nucleus of infected cells. The serological characteristics of the Misaka strain were analyzed by the cross-immunofluorescent antibody method. The Misaka strain, the Katayama strain first isolated in Tokushima in 1987, and the representative strains of spotted fever group rickettsiae in the world; R. rickettsii Smith, R. sibirica 246, R. conorii Moroccan, R. akari MK (Kaplan), R. australis Phillips, R. montana Tick and Thai TT-118 strains were used as antigens. And immune mouse serum samples against the Misaka, Katayama, 246, Phillips and TT-118 strains were used as antisera. The result revealed that these strains showed cross-reaction and share a common antigen of spotted fever group rickettsiae. Furthermore, it became obvious that the Misaka strain and the Katayama strain have the same serotype-specific antigen different from the strains of other spotted fever group rickettsiae using Anti-Katayama monoclonal antibodies.
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PMID:[The causative agent from a patient with spotted fever group rickettsiosis in Japan on Awaji Island, Hyogo]. 220 68

Schistosomiasis japonica remains endemic in several provinces south of the Yangtze River in China because of relatively sparse populations of human beings and dense populations of snails. We studied two brigades in a rural commune in Gui-chi County, Anhui Province, to determine the prevalence, intensity, and morbidity associated with this infection before concerted control efforts were instituted. Quantitative fecal examinations, histories, and physical examinations relevant to schistosomiasis japonica were performed in 96 per cent of the available population 2 to 65 years of age. The prevalence was 26.3 per cent in Brigade A (778 persons) and 14.4 per cent in Brigade B (1532 persons). Clinical symptoms and signs were compared among uninfected persons and persons at three levels of infection as determined by fecal egg output. Some increased weakness was seen only at the heaviest levels of infection; abdominal pain was not an important symptom. Hepatomegaly was somewhat more frequent in moderate and heavy infections, but splenomegaly was rare and unrelated to intensity of infection. Neither stool consistency nor occult blood was related to the presence or intensity of infection. Approximately 50 per cent of the population had been treated for schistosomiasis japonica, 25 per cent repeatedly.
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PMID:Morbidity in schistosomiasis japonica in relation to intensity of infection. A study of two rural brigades in Anhui Province, China. 665 48

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

We studied a community cohort of 193 individuals exposed to endemic Schistosoma japonicum infection in the Dongting Lake region of China to assess subclinical morbidity and the 2-year benefit of curative therapy (praziquantel) administered in 1996. Prevalence and intensity of S. japonicum infection before treatment were 28% and 192 eggs per gram faeces (epg), respectively. Two years after cure, 22% of the cohort were re-infected, but with a lighter intensity (67 epg). Sixty-four subjects (37%) showed significant improvement in ultrasound parenchyma images after treatment and 51 subjects (54%) showed significant improvement of periportal fibrosis. Left-lobe enlargement also reversed (P < 0.05) and splenomegaly reversed in 6 of 8 cases and developed in only 1. Two years post-treatment a dilated portal vein became less frequent, but the decline was not significant (16% vs 11%, P < 0.05). The serum levels of laminin and collagen IV associated with re-infection and intensity and hyaluronic acid levels correlated with ultrasound findings (P < 0.01). Overall, treatment induced a marked decrease in subclinical hepatosplenic morbidity attributable to S. japonicum although low-intensity re-infection after treatment remained relatively frequent. Stratified analysis and logistic models evaluated potential confounding factors for assessment of treatment effects on hepatic fibrosis. S. japonicum infection and moderate-heavy alcohol intake interacted: improvement in parenchymal morbidity was impeded among drinkers (P < 0.05). Chemotherapy focused on at-risk residents controls prevalent subclinical hepatic fibrosis but re-infection indicates the need for complementary control strategies.
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PMID:Two-year impact of praziquantel treatment for Schistosoma japonicum infection in China: re-infection, subclinical disease and fibrosis marker measurements. 1089 67

The literature on the assessment of morbidity due to Schistosoma mansoni infection is updated. Imaging techniques such as ultrasonography, echodoppler cardiography, computerized tomography (CT scan) and magnetic resonance imaging (MRI) introduced a new perspective, and expanded our knowledge on morbidity. Three well-defined syndromes caused by schistosomiasis mansoni have been described: the stage of invasion, acute schistosomiasis (Katayama fever), and chronic schistosomiasis. Complications of the acute and chronic syndromes have also been reported: pulmonary hypertension, neuroschistosomiasis, association with Salmonella, association with Staphylococci, viral hepatitis B, glomerulonephritis. In most individuals with hepatosplenic schistosomiasis the spleen is increased in size. Hepatosplenic schistosomiasis can, however, occur without splenomegaly. The definition of hepatosplenic schistosomiasis in endemic areas as the finding of S. mansoni eggs in the stools in an individual with hepatosplenomegaly is not satisfactory anymore. Many aspects of morbidity are expected to change after schistosomiasis control. Some are expected to change quickly (worm burden, Salmonella bacteremia, hepatosplenic schistosomiasis in children) whereas others shall remain for years (pulmonary hypertension, glomerulonephritis, neuroschistosomiasis). Intestinal schistosomiasis in individuals with low worm burdens is very difficult to diagnose and therefore laborious to control.
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PMID:Schistosoma mansoni: assessment of morbidity before and after control. 1099 26


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