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Query: UMLS:C0042961 (volvulus)
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Water samples were collected from breeding sites of species of the Simulium (Edwardsellum) damnoslm complex in Upper Volta, Liberia and Cameroon during the dry season; and in Tanzania and Kenya at various seasons during a period of two years. The following 20 factors were analysed at 45 breeding sites: water temperature, current velocity, pH value, conductivity free carbon dioxide, oxygen content, calcium, magnesium, potassium, sodium, alkalinity, chloride, sulphate, nitrite, nitrate, ammonium, phosphate, silicate, total iron and organic substance (consumption of potassium permanganate). A number of notable differences in the chemical composition of the water of the breeding sites of 13 S. damnosum complex species were found, particularly with regard to the pH and conductivity. On the basis of these differences the various species can be divided into three main groups: Group I: 3 species (S. sanctipauli, S. yahense, "Menge"); breeding in sites with pH values always below 7 and conductivity values below 50 mumhos. Group II: 8 species (S. sirbanum, S. sudanense, S. damnosum s.s., S. squamosum, "Sanje", "Nkusi", "Nyamagasani", "Jovi"); breeding in watercourses with neutral, weakly acid or weakly alkaline reactions and conductivity values ranging from 50 to 150 mumhos. Group III: 2 species ("Kibwezi", "Kisiwani"); breeding in watercourses characterized by highly alkaline reactions with pH values between 7.7 and 10 and by conductivity values between 400 and 950 mumhos. The vectors of Onchocerca volvulus are included in group I and II only.
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PMID:The hydro-chemical and physical conditions of the environment of the immature stages of some species of the simulium (Edwardsellum) damnosum complex (Diptera). 1 1

The assessment of morbidity caused by chronic parasitic infections in the populations of endemic areas has remained difficult and controversial. Contributing to this predicament is the frequent occurrence of multiple infections with agents that can cause a wide range of clinical manifestations, from the frequent symptomless carrier state to overt disease with more or less specific clinical manifestations. In the interpretation of the complex morbidity patterns found in rural populations of tropical countries, it is often difficult to make a clear determination of cause and effect. The situations is further complicated by the low degree of pathognomicity of the clinical manifestations of even the advanced stages of certain parasitic diseases. The paper gives examples that illustrate the interaction between endemic malaria and schistosomiasis as important causes of hepatosplenomegaly. Also shown in the paper are the inter-relationships between the nutritional status and the number of multiple infections with parasites found in African villages as well as the association between habitual coca leaf chewing, malnutrition and hookworm disease in a Peruvian community of mixed ethnic origin. The paper describes micro-epidemiological features of poly-parasitism by comparing the prevalence and intensity of infection with Onchocerca volvulus, Schistosoma mansoni and S; haematobium between sub-groups in the village population who have different sources of domestic water supply. In two African villages with endemic schistosomiasis where mass treatment will be administered, only 25% of the residents with parasitologically confirmed S. haematobium infection and 12% of those with S. mansoni had single infection; the remaining majority had at least one additional patent parasitic infection of public health importance.
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PMID:Epidemiology of poly-parasitism. IV. Combined effects on the state of health. 72 41

The effect of various substances on the output of Onchocerca volvulus microfilariae in the urine was investigated in volunteers infected with the Cameroon forest and Sudan-savanna strains of the parasite. Output of microfilariae in the urine tended to be higher during periods of normal activity than during sleep. During waking hours, the rate of output remained generally steady, but in some patients occasional showers of microfilariae appeared in the urine, possibly associated with the intake of food and drink. Drinking 1.2-2.5 litres water produced a shower of microfilariae in the urine of some subjects. This began within an hour of drinking and its onset preceeded that of the diuresis. Thiazide diuretics, acting on the convoluted tubules, produced no increase in microfilaruria. In savanna subjects intravenous injection of DT TAB vaccine caused pyrexia, and simultaneously large numbers of microfilariae appeared in the urine. There was no associated diuresis, and no increase in the concentration of microfilariae in the venous blood. In forest subjects DT TAB caused no increase in microfilaruria. In all subjects 25-50 mg diethylcarbamazine (DEC) caused large numbers of microfilariae to appear in the urine on day 0, within a few hours of the first dose; and there was an increased output of urine over the first 24 hours. Microfilaruria declined sharply on day 1 of treatment, but in subjects developing a high microfilaraemia, it rose again on day 2, and declined more slowly thereafter. Betamethazone, given in conjunction with DEC, appeared to slow the rate of destruction of microfilariae in the skin and lymph glands, and to prolong the duration of microfilaraemia and microfilaruria. The findings suggest that there is a reservoir of microfilariae in the glomerular capillaries, which fills slowly by accumulating microfilariae from the circulating blood. The microfilariae probably enter the urine by penetrating the glomerular capillary.
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PMID:Factors influencing the passage of Onchocerca volvulus microfilariae into the urine. 121 33

In this study Onchocerca gutturosa was compared with O. volvulus in an ELISA test to detect Onchocerca-specific IgG and IgG subclasses. The test was developed and standardized to detect Onchocerca-specific IgG and IgG subclasses in sera of onchocerciasis patients and endemic controls. Onchocerca volvulus and O. gutturosa crude water-soluble antigens showed no significant difference in detecting onchocerca-specific IgG antibody (T = 1.88, P greater than 0.05). The levels of IgG subclasses varied greatly. IgG4 showed the highest detected mean level (0.84 +/- 0.59) and the other three subclasses showed considerably lower mean levels (IgG1 = 0.27 +/- 0.16, IgG2 = 0.24 +/- 0.17, IgG3 = 0.28 +/- 0.12). The status and score of skin lesions were found to have significant effect on the IgG and IgG subclasses levels (all P less than 0.001). IgG4 showed a positive correlation with the microfilarial (Mf) load (r = 0.21, P less than 0.03). IgG3 levels have a significant negative correlation with the Mf load (r = -0.23, P less than 0.02). The biological significance of these IgG and IgG subclasses in onchocerciasis is discussed.
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PMID:The profile of IgG and IgG subclasses of onchocerciasis patients. 157 89

Savanna species of the Simulium damnosum complex, the major vectors of the blinding savanna type of onchocerciasis, were considered to be rare in Liberia, until the dry season of 1988. In 1988 they became a serious nuisance, biting people at the Bong iron ore mine within the rain forest zone. S. damnosum s.str. and S. sirbanum were found breeding, in association with S. adersi a non man-biting savanna species, in a stream emerging from the mine's tailings pond. The local forest species were extremely rare in this stream. The water of the stream was characterized by an increased hardness and higher temperatures in comparison with those of natural watercourses in the area. The mass occurrence of flies was probably related to expansions of the tailings ponds, when rich nutrition was provided for the blackfly larvae by the decaying forests submerged by the rising water levels. The phenomenon did not recur in 1989 when only a few savanna flies were caught, and none were seen in the dry season of 1990. Although it is not known why the artificial environment of the tailings ponds was so attractive for the savanna species the events clearly demonstrated that savanna flies seasonally invading the area, possibly aided by the northeasterly harmattan winds, can become established in the rain forest zone if suitable conditions are met. No infections with Onchocerca volvulus were found in more than 1000 flies caught by vector collectors but, after experimental infection with the local forest strain, a few parasites developed to the infective stage. As yet there is no evidence that the occurrence of savanna flies in the rain forest zone of Liberia was of epidemiological significance.
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PMID:A temporary focus of savanna species of the Simulium damnosum complex in the forest zone of Liberia. 180 Nov 41

Acute large bowel obstruction can be the result of mechanical causes (such as colorectal cancer) or motility disturbances, the latter being termed colonic pseudo-obstruction. Whatever the aetiology, the pathophysiology of large bowel obstruction has clinical significance. Changes in motility augmented by increased colonic blood flow may play a role in dissemination of tumour cells and/or bacteria. Intravascular fluid depletion, especially shortly after intestinal decompression, has important haemodynamic implications. The diagnosis is often confirmed on plain abdominal X-ray, but water-soluble contrast studies are important in distinguishing a mechanical obstruction (which almost always requires an operation) from a pseudo-obstruction (which can usually be managed without surgery). Mortality and morbidity may be reduced by optimization of the patient's condition both before and after the operation using intensive care facilities and by careful timing of surgery. The surgical management of malignant large bowel obstruction is best directed by a senior surgeon. For tumours up to and including the splenic flexure, an extended right hemicolectomy is advisable since it offers adequate removal of the tumour and allows an immediate safe ileocolic anastomosis. More distal tumours should be resected if possible, and there is much to recommend on-table irrigation and immediate anastomosis, although a colostomy with a mucous fistula or Hartmann's procedure still have a place. Endoscopic diagnosis and decompression enables definitive surgery to be undertaken electively and several techniques are being evaluated. Non-operative reduction of sigmoid volvulus by rigid or flexible endoscopy is achieved with high success rates, but is not recommended for caecal volvulus. Resection is usually necessary in both to prevent recurrence. Mortality of colonic volvulus is closely related to bowel viability. Uncomplicated colonic pseudo-obstruction may be managed medically or by endoscopic decompression. It often occurs in association with systemic medical conditions, which need to be treated vigorously. Surgery is indicated if there are signs of impending or frank perforation, or if non-operative measures fail.
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PMID:True and false large bowel obstruction. 193 30

Diagnosis of the acute sigmoid volvulus is made by opacification of the colon by water-soluble chemicals. Therapeutic attitude is oriented by the results of an emergency colonoscopy. An emergency laparotomy is indicated when the mucosae presents an ischemic or necrotic aspect; a resection without anastomosis is performed according to Bouilly-Volkman's intervention in the best cases, Hartman's one in others. A normal colonoscopy authorizes a medical treatment with attempt of detorsion by passage of a flatus tube per rectum. A controlled success permits a delayed intervention ten days after with resection and anastomosis. Failure of medical treatment returns the surgical approach in emergency circumstances]
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PMID:[Current therapeutic attitude in volvulus of the pelvic colon in tropical areas]. 262 17

An in vitro study of the antinematodal action of two groups of compounds which act on the receptor complex of the inhibitory neurotransmitter, Gamma-aminobutyric acid (GABA) in mammalian systems is described. The compounds, Ivermectin and two benzodiazepines, Diazepam and a water soluble Midazolam were tested singly or in combination against two microfilarial parasites Onchocerca lienalis (closely related to Onchocerca volvulus) and Brugia pahangi. The combination of ivermectin and diazepam at a concentration of 0.1 microgram/ml and 33 micrograms/ml respectively achieved the same effect on microfilarial motility as when ivermectin was given at 1 microgram/ml alone or diazepam at 66 micrograms/ml alone. Similarly when the combination of ivermectin at 0.1 microgram/ml and midazolam at 10 micrograms/ml was used it achieved the same effect as ivermectin at 1 microgram/ml alone or midazolam at 33 micrograms/ml alone. This showed that both benzodiazepines had a synergistic effect on the activity of ivermectin. The microfilariae of B. pahangi were insensitive to both groups of compounds at all concentrations used.
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PMID:The efficacy of 22,23-dihydroavermectin B1 (Ivermectin) acting singly or in combination with a benzodiazepine on microfilariae of Onchocerca species and Brugia pahangi (an in vitro study). 277 29

The authors describe their experience after treatment of 59 cases of volvulus of the pelvic colon. This disorder is frequent in West Africa and affects the protein deficient malnourished population. A definite predominance of volvulus occurred during the dry season between December and April, perhaps related to a diet richer in cellulose or deficient in water. There was a delay in presentation at the Hospital Center; necrosis of the twisted loop, the age of the patient and multiple associated conditions all contributed to the severity of this condition. Treatment had three aims: removal of the obstruction, reestablishment of continuity and avoidance of recurrence. Indications were dictated by the patient's general condition and the vascular status of the loop of bowel. It is reasonable to attempt reduction via intubation if the loop of bowel appears viable. Success enables a colectomy to be performed after a preparation, while failure necessitates surgical correction of ideally colectomy in a one stage procedure. On the other hand, a gangrenous loop necessitates colectomy without untwisting, with closure of the distal end using the Hartmann technique and with reestablishment of continuity 3 weeks later.
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PMID:[Volvulus of the pelvic colon. Apropos of 59 cases in the western Africa savannah area]. 280 24

Human onchocerciasis is found along the Nile in Northern Sudan, on the border with Ethiopia and in the Southern and Western Sudan--all areas where there is fast flowing water suitable for S. damnosum S.L. (in Sudan, the only fly in which the O. volvulus has been found) to breed. Epidemiological studies of this disease are still in progress however it is clear that in the huge area between Bahr El-Arabe and the white Nile, which is the most serious focus with blindness rates equalling or exceeding those in the worst affected foci elsewhere in Africa. Infection rates and parasite populations are highest in villages situated on rivers--near the probable breeding sites. Intensity of infection is generally highest in skin snip taken from the pelvi region, where the palpable nodules are more frequent. Microfilariae are commonly detected in the anterior chamber of the eye and in the peripheral blood. Fundus oculi lesions have been also detected in significant numbers causing impairment of vision and blindness, specially in the group of old people. Males are more commonly infected than females. These data provide a reasonable, though far from complete, account of the present situation concerning the importance and severity of onchocerciasis in this part of Sudan.
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PMID:[Onchocerciasis in Sudan: epidemiological situation in the south-west]. 343 81


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