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  1. Strongyloides stercoralis seroprevalence in Vietnam.

    PubMed

    Diep, Nguyen Thi Ngoc; Thai, Pham Quang; Trang, Nghiem Nguyen Minh; Jäger, Julia; Fox, Annette; Horby, Peter; Phuong, Hoang Vu Mai; Anh, Dang Duc; Mai, LE Thi Quynh; VAN Doorn, H Rogier; Nadjm, Behzad

    2017-11-01

    Strongyloidiasis is a neglected tropical disease caused by the roundworm Strongyloides stercoralis affecting 30-100 million people worldwide. Many Southeast-Asian countries report a high prevalence of S. stercoralis infection, but there are little data from Vietnam. Here, we evaluated the seroprevalence of S. stercoralis related to geography, sex and age in Vietnam through serological testing of anonymized sera. Sera (n = 1710, 1340 adults and 270 children) from an anonymized age-stratified serum bank from four regions in Vietnam between 2012 and 2013 were tested using a commercial Strongyloides ratti immunoglobulin G ELISA. Seroreactivity was found in 29·1% (390/1340) of adults and 5·5% (15/270) of children. Male adults were more frequently seroreactive than females (33·3% vs. 24·9%, P = 0·001). The rural central highlands had the highest seroprevalence (42·4% of adults). Seroreactivity in the other regions was 29·9% (Hue) and 26·0% and 18·2% in the large urban centres of Hanoi and Ho Chi Minh City, respectively. We conclude that seroprevalence of S. stercoralis was high in the Vietnamese adult population, especially in rural areas.

  2. Intestinal immune cells in Strongyloides stercoralis infection.

    PubMed Central

    Trajman, A; MacDonald, T T; Elia, C C

    1997-01-01

    BACKGROUND: Strongyloides stercoralis can cause a wide spectrum of disease in man, ranging from a chronic asymptomatic infection to a hyperinfective, often fatal syndrome. In rodents, spontaneous expulsion of Strongyloides spp occurs after experimental infection. Mast cells, goblet cells, and eosinophils have been identified as possible effectors of this expulsion. AIMS: To investigate intestinal histopathology and mucosal immunity in immunocompetent patients with chronic S stercoralis infection. METHODS: Jejunal biopsies were performed in 19 immunocompetent patients with a positive stool examination for S stercoralis and few or no symptoms, and in seven healthy controls. Specimens were processed for histopathological analysis and stained by the immunoperoxidase technique, using the following monoclonal antibodies: CD2, CD3, CD4, CD8, anti-T cell receptor (TcR) gamma/delta, RFD1 and RFD7 (two different macrophage markers), Ki67+ (proliferating) cells, antihuman leucocyte antigen (HLA)-DR, and anticollagen IV. In addition, CD25+ cells, mast cells, IgE expressing cells, calprotectin containing cells, and neutrophil elastase positive cells were stained by the alkaline phosphatase method. RESULTS: Jejunal morphology and the numbers of different T cell subsets, mast cells, IgE expressing cells, eosinophils, and goblet cells were unaffected by S stercoralis infection. Conversely, the numbers of mature macrophages and dividing enterocytes in the crypts were reduced significantly. Crypt enterocytes did not express HLA-DR in both groups. The expression of HLA-DR by villus enterocytes was also comparable in patients and controls. There were no activated (CD25+) cells in the mucosa of either patients or controls. CONCLUSIONS: Compared with seven healthy uninfected volunteers, a group of 19 Brazilians with clinically mild strongyloides infection showed no abnormality of mucosal structure and no increase in non-specific inflammatory cells. Likewise, there was no increase in

  3. A possible origin population of pathogenic intestinal nematodes, Strongyloides stercoralis, unveiled by molecular phylogeny.

    PubMed

    Nagayasu, Eiji; Aung, Myo Pa Pa Thet Hnin Htwe; Hortiwakul, Thanaporn; Hino, Akina; Tanaka, Teruhisa; Higashiarakawa, Miwa; Olia, Alex; Taniguchi, Tomoyo; Win, Soe Moe Thu; Ohashi, Isao; Odongo-Aginya, Emmanuel Igwaro; Aye, Khin Myo; Mon, Mon; Win, Kyu Kyu; Ota, Kei; Torisu, Yukari; Panthuwong, Siripen; Kimura, Eisaku; Palacpac, Nirianne M Q; Kikuchi, Taisei; Hirata, Tetsuo; Torisu, Shidow; Hisaeda, Hajime; Horii, Toshihiro; Fujita, Jiro; Htike, Wah Win; Maruyama, Haruhiko

    2017-07-07

    Humans and dogs are the two major hosts of Strongyloides stercoralis, an intestinal parasitic nematode. To better understand the phylogenetic relationships among S. stercoralis isolates infecting humans and dogs and to assess the zoonotic potential of this parasite, we analyzed mitochondrial Cox1, nuclear 18S rDNA, 28S rDNA, and a major sperm protein domain-containing protein genes. Overall, our analyses indicated the presence of two distinct lineages of S. stercoralis (referred to as type A and type B). While type A parasites were isolated both from humans and dogs in different countries, type B parasites were found exclusively in dogs, indicating that the type B has not adapted to infect humans. These epidemiological data, together with the close phylogenetic relationship of S. stercoralis with S. procyonis, a Strongyloides parasite of raccoons, possibly indicates that S. stercoralis originally evolved as a canid parasite, and later spread into humans. The inability to infect humans might be an ancestral character of this species and the type B might be surmised to be an origin population from which human-infecting strains are derived.

  4. Corticosteroid-induced asthma: a manifestation of limited hyperinfection syndrome due to Strongyloides stercoralis.

    PubMed

    Sen, P; Gil, C; Estrellas, B; Middleton, J R

    1995-09-01

    Inadequate therapeutic response to parenteral corticosteroids in patients with acute bronchial asthma is infrequent. We report four patients whose bronchial asthma symptoms worsened after treatment with parenteral corticosteroids. All had larvae of Strongyloides stercoralis in the stool. The new attack or the exacerbation of asthma appeared to be precipitated by systemic corticosteroid administration. The paradoxic therapeutic response of asthma to glucocorticoides was the major pulmonary manifestation of Strongyloides superinfection; there was no evidence of other organ involvement. Individuals with new onset of bronchial asthma or worsening of asthmatic episodes concurrent with the use of systemic corticosteroids should have thorough investigation for possible superinfection due to Strongyloides stercoralis. This is particularly important for patients who have resided in areas where intestinal helminthic infections are endemic. Discontinuance of steroid therapy or reduction in dosage of parenteral steroids appears necessary. Treatment with thiabendazole appears to be effective in patients with limited hyperinfection syndrome.

  5. Strongyloides stercoralis Infection in Alcoholic Patients

    PubMed Central

    Pacheco, Flavia T. F.; Souza, Joelma N.; Silva, Mônica L. S.; Inês, Elizabete J.; Soares, Neci M.

    2016-01-01

    The course of Strongyloides stercoralis infection is usually asymptomatic with a low discharge of rhabditoid larva in feces. However, the deleterious effects of alcohol consumption seem to enhance the susceptibility to infection, as shown by a fivefold higher strongyloidiasis frequency in alcoholics than in nonalcoholics. Moreover, the association between S. stercoralis infection and alcoholism presents a risk for hyperinfection and severe strongyloidiasis. There are several possible mechanisms for the disruption of the host-parasite equilibrium in ethanol-addicted patients with chronic strongyloidiasis. One explanation is that chronic ethanol intake stimulates the hypothalamic-pituitary-adrenal (HPA) axis to produce excessive levels of endogenous cortisol, which in turn can lead to a deficiency in type 2 T helper cells (Th2) protective response, and also to mimic the parasite hormone ecdysone, which promotes the transformation of rhabditiform larvae to filariform larvae, leading to autoinfection. Therefore, when untreated, alcoholic patients are continuously infected by this autoinfection mechanism. Thus, the early diagnosis of strongyloidiasis and treatment can prevent serious forms of hyperinfection in ethanol abusers. PMID:28105424

  6. Strongyloides stercoralis and relatives: recent advances in general and molecular biology.

    PubMed

    Lok, James B

    2014-12-01

    Human strongyloidiasis is a threat to global health, presenting significant challenges in diagnosis and clinical management. The imperative to incorporate strongyoidiasis more fully into control programs for soil-transmitted helminths is increasingly recognized. The unique life cycles of S. stercoralis and congeneric species contain both free-living and parasitic generations, and transcriptomic methods have recently identified genes of potential importance to parasitism in these parasites. Proteomics recently revealed stage-specific secreted proteins that appear crucial to the host-parasite interaction. A comprehensive genome sequencing project for Strongyloides spp. is now nearing completion. Recent technical advances in transgenesis for S. stercoralis and S. ratti , including the first establishment of stable transgenic lines, promise to advance functional evaluations of genes expressed in conjunction with crucial life cycle events. Studies employing these methods recently bolstered the hypothesis that S. stercoralis uses cellular signaling pathways homologous to three that regulate dauer larval development in Caenorhabditis elegans to regulate morphogenesis and development of its infective third-stage larva. The free-living generation of Strongyloides makes classical genetics formally possible. Recent advances, such as a genetic map of S. ratti and a molecular genetic and karyotypic analysis of sex determination in S. papillosus , will greatly facilitate this approach. Advanced methods for study of chemosensation in C. elegans were recently applied to discover numerous host attractant molecules that mediate host finding and contact by infective third-stage larvae of Strongyloides spp. Finally, nucleic acid-based diagnostic methods have recently come to the fore as alternatives to parasitological and immunodiagnostic techniques.

  7. E. coli Meningitis Presenting in a Patient with Disseminated Strongyloides stercoralis

    PubMed Central

    Gomez, Juliana B.; Maque, Yvan; Moquillaza, Manuel A.; Anicama, William E.

    2013-01-01

    Introduction. Spontaneous Escherichia coli meningitis is an infrequent condition in adults and is associated with some predisposing factors, including severe Strongyloides stercoralis (SS) infections. Case Presentation. A 43-year-old Hispanic man, with history of travelling to the jungle regions of Peru and Brazil two decades ago, and who received prednisone due to Bell's palsy for three weeks before admission, presented to the Emergency Department with diarrhea, fever, and hematochezia. A week after admission he developed drowsiness, meningeal signs, abdominal distension, and constipation. A cerebrospinal fluid culture showed extended spectrum β-lactamase producing E. coli. A colonoscopy was performed and showed pancolitis. Three days after the procedure the patient became unstable and developed peritoneal signs. He underwent a laparotomy, which ended up in a total colectomy and partial proctectomy due to toxic megacolon. Three days later the patient died in the intensive care unit due to septic shock. Autopsy was performed and microscopic examination revealed the presence of multiple Strongyloides larvae throughout the body. Conclusion. Strongyloides stercoralis infection should be excluded in adults with spontaneous E. coli meningitis, especially, if gastrointestinal symptoms and history of travelling to an endemic area are present. Even with a proper diagnosis and management, disseminated strongyloidiasis has a poor prognosis. PMID:24324900

  8. E. coli Meningitis Presenting in a Patient with Disseminated Strongyloides stercoralis.

    PubMed

    Gomez, Juliana B; Maque, Yvan; Moquillaza, Manuel A; Anicama, William E

    2013-01-01

    Introduction. Spontaneous Escherichia coli meningitis is an infrequent condition in adults and is associated with some predisposing factors, including severe Strongyloides stercoralis (SS) infections. Case Presentation. A 43-year-old Hispanic man, with history of travelling to the jungle regions of Peru and Brazil two decades ago, and who received prednisone due to Bell's palsy for three weeks before admission, presented to the Emergency Department with diarrhea, fever, and hematochezia. A week after admission he developed drowsiness, meningeal signs, abdominal distension, and constipation. A cerebrospinal fluid culture showed extended spectrum β -lactamase producing E. coli. A colonoscopy was performed and showed pancolitis. Three days after the procedure the patient became unstable and developed peritoneal signs. He underwent a laparotomy, which ended up in a total colectomy and partial proctectomy due to toxic megacolon. Three days later the patient died in the intensive care unit due to septic shock. Autopsy was performed and microscopic examination revealed the presence of multiple Strongyloides larvae throughout the body. Conclusion. Strongyloides stercoralis infection should be excluded in adults with spontaneous E. coli meningitis, especially, if gastrointestinal symptoms and history of travelling to an endemic area are present. Even with a proper diagnosis and management, disseminated strongyloidiasis has a poor prognosis.

  9. Diagnosis of Strongyloides stercoralis by morphological characteristics combine with molecular biological methods.

    PubMed

    Wang, Li-Fu; Xu, Lian; Luo, Shi-Qi; Xie, Hui; Chen, Wei; Wu, Zhong-Dao; Sun, Xi

    2017-04-01

    Strongyloidiasis is one of the neglected tropical diseases caused by infection with the nematode Strongyloides genus and distributed worldwide. Strongyloidiasis can be fatal in immunosuppressed patients induced hyperinfection or disseminated strongyloidiasis. Unfortunately, until now, due to the unspecific clinical symptom in infected individuals and the low sensitivity diagnosis of strongyloidiasis, many patients were misdiagnosed every year. Furthermore, the larvae of the Strongyloides stercoralis (S. stercoralis) is similar to other nematodes such as hookworm, Trichostrongylus increased the difficulty of diagnosis. In this case, the patient is a 63-year-old male person, who had a nearly 30 years medical history of asthma and emphysema, and 4-5-year medical history of diabetes. The sputum examination found some parasite larvae, then we identify the larvae using clinical observation and morphological characteristics combine with examined cytochrome oxidase subunit 1 (COX1) and 18S rRNA genes by PCR, sequence analysis and finally classified by phylogenetic analysis, the larvae were diagnosed as S. stercoralis. Our results showed that diagnosis with strongyloidiasis by morphological characteristics combine with molecular biological methods can improve the sensitive of diagnosis and provide a final diagnosis for the disease in the clinics.

  10. Strongyloides stercoralis hyperinfection associated with impaired intestinal motility disorder

    PubMed Central

    Figueira, Cláudia Frangioia; Cos, Lynda Dorene; Ussami, Edson Yassushi; Otoch, José Pinhata; Felipe-Silva, Aloisio

    2015-01-01

    Infection by Strongyloides stercoralis is a highly prevalent helminthiasis, which is mostly distributed in the tropical and subtropical regions of the world. Although a substantial number of cases are asymptomatic or paucisymtomatic, severe and life-threatening forms of this infection still occur and not infrequently is lately diagnosed. Gram-negative bacteria septicemia, which frequently accompanies the severe helminthiasis, contributes to the high mortality rate. Severe infection is invariably triggered by any imbalance in the host's immunity, favoring the auto-infective cycle, which increases the intraluminal parasite burden enormously. Clinical presentation of severe cases is varied, and diagnosis requires a high suspicion index. Acute abdomen has been reported in association with S. stercoralis infection, but intestinal necrosis is rarely found during the surgical approach. The authors report the case of a man who sought the emergency unit with recent onset abdominal pain. Clinical and imaging features were consistent with obstructive acute abdomen. Scattered adhesions and a necrotic ileal segment with a tiny perforation represented the surgical findings. The patient outcome was unfavorable and respiratory distress required an open lung biopsy. Both surgical specimens showed S. stercoralis infection. Unfortunately the patient underwent multiple organ failure and septicemia, and subsequently died. The authors call attention to the finding of intestinal necrosis and impaired intestinal motility disorder as possibilities for the diagnosis and risk factor, respectively, for a severe infection of S. stercoralis. PMID:26484331

  11. Ivermectin versus albendazole or thiabendazole for Strongyloides stercoralis infection

    PubMed Central

    Henriquez-Camacho, Cesar; Gotuzzo, Eduardo; Echevarria, Juan; White, A Clinton; Terashima, Angelica; Samalvides, Frine; Pérez-Molina, José A; Plana, Maria N

    2016-01-01

    Background Strongyloidiasis is a gut infection with Strongyloides stercoralis which is common world wide. Chronic infection usually causes a skin rash, vomiting, diarrhoea or constipation, and respiratory problems, and it can be fatal in people with immune deficiency. It may be treated with ivermectin or albendazole or thiabendazole. Objectives To assess the effects of ivermectin versus benzimidazoles (albendazole and thiabendazole) for treating chronic strongyloides infection. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register (24 August 2015); the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE (January 1966 to August 2015); EMBASE (January 1980 to August 2015); LILACS (August 2015); and reference lists of articles. We also searched the metaRegister of Controlled Trials (mRCT) using 'strongyloid*' as a search term, reference lists, and conference abstracts. Selection criteria Randomized controlled trials of ivermectin versus albendazole or thiabendazole for treating chronic strongyloides infection. Data collection and analysis Two review authors independently extracted data and assessed risk of bias in the included trials. We used risk ratios (RRs) with 95% confidence intervals (CIs) and fixed- or random-effects models. We pooled adverse event data if the trials were sufficiently similar in their adverse event definitions. Main results We included seven trials, enrolling 1147 participants, conducted between 1994 and 2011 in different locations (Africa, Southeast Asia, America and Europe). In trials comparing ivermectin with albendazole, parasitological cure was higher with ivermectin (RR 1.79, 95% CI 1.55 to 2.08; 478 participants, four trials, moderate quality evidence). There were no statistically significant differences in adverse events (RR 0.80, 95% CI 0.59 to 1.09; 518 participants, four trials, low quality evidence). In trials comparing ivermectin with thiabendazole

  12. Different but overlapping populations of Strongyloides stercoralis in dogs and humans-Dogs as a possible source for zoonotic strongyloidiasis.

    PubMed

    Jaleta, Tegegn G; Zhou, Siyu; Bemm, Felix M; Schär, Fabian; Khieu, Virak; Muth, Sinuon; Odermatt, Peter; Lok, James B; Streit, Adrian

    2017-08-01

    Strongyloidiasis is a much-neglected soil born helminthiasis caused by the nematode Strongyloides stercoralis. Human derived S. stercoralis can be maintained in dogs in the laboratory and this parasite has been reported to also occur in dogs in the wild. Some authors have considered strongyloidiasis a zoonotic disease while others have argued that the two hosts carry host specialized populations of S. stercoralis and that dogs play a minor role, if any, as a reservoir for zoonotic S. stercoralis infections of humans. We isolated S. stercoralis from humans and their dogs in rural villages in northern Cambodia, a region with a high incidence of strongyloidiasis, and compared the worms derived from these two host species using nuclear and mitochondrial DNA sequence polymorphisms. We found that in dogs there exist two populations of S. stercoralis, which are clearly separated from each other genetically based on the nuclear 18S rDNA, the mitochondrial cox1 locus and whole genome sequence. One population, to which the majority of the worms belong, appears to be restricted to dogs. The other population is indistinguishable from the population of S. stercoralis isolated from humans. Consistent with earlier studies, we found multiple sequence variants of the hypervariable region I of the 18 S rDNA in S. stercoralis from humans. However, comparison of mitochondrial sequences and whole genome analysis suggest that these different 18S variants do not represent multiple genetically isolated subpopulations among the worms isolated from humans. We also investigated the mode of reproduction of the free-living generations of laboratory and wild isolates of S. stercoralis. Contrary to earlier literature on S. stercoralis but similar to other species of Strongyloides, we found clear evidence of sexual reproduction. Overall, our results show that dogs carry two populations, possibly different species of Strongyloides. One population appears to be dog specific but the other one is

  13. Occurrence of and risk factors for Strongyloides stercoralis infection in South-East Asia.

    PubMed

    Schär, Fabian; Giardina, Federica; Khieu, Virak; Muth, Sinuon; Vounatsou, Penelope; Marti, Hanspeter; Odermatt, Peter

    2016-07-01

    The soil-transmitted nematode, Strongyloides stercoralis is one of the most-neglected of all neglected tropical diseases. It is globally distributed, favouring the humid, wet climates of the tropics and subtropics. Inadequate sanitary conditions promote the spread of S. stercoralis infection. In South-East Asia, many countries provide the ideal ecological and economic setting for high S. stercoralis infection rates. Yet, in most of these countries, little is known about the actual prevalence and distribution of S. stercoralis. One reason for this lack of knowledge pertains to the time- and resource-intensive diagnostic methods used to detect S. stercoralis infection. The Koga Agar culture method and the Baermann method are considered to be the best coprological diagnostic methods for field settings today. Both detect the parasite with high sensitivity. This sensitivity can be increased further by examining stool samples for several consecutive days, thereby increasing the chances of detecting low-intensity chronic infections. Diagnostic challenges, however, lead to the omission of S. stercoralis in studies of soil-transmitted helminths and few studies focus on S. stercoralis, specifically. These factors lead to an underreporting of the nematode's prevalence, not only in South-East Asia but worldwide. We have reviewed the scientific literature of the last 25 years and estimated country-wide prevalence rates for South-East Asia. We aim to summarise what is known today about the prevalence of S. stercoralis in South-East Asia, as well as to ascertain the risk factors and diagnostic methods most commonly applied. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Strongyloides stercoralis and hookworm co-infection: spatial distribution and determinants in Preah Vihear Province, Cambodia.

    PubMed

    Forrer, Armelle; Khieu, Virak; Schär, Fabian; Vounatsou, Penelope; Chammartin, Frédérique; Marti, Hanspeter; Muth, Sinuon; Odermatt, Peter

    2018-01-12

    Strongyloides stercoralis and hookworm are two soil-transmitted helminths (STH) that are highly prevalent in Cambodia. Strongyloides stercoralis causes long-lasting infections and significant morbidity but is largely neglected, while hookworm causes the highest public health burden among STH. The two parasites have the same infection route, i.e. skin penetration. The extent of co-distribution, which could result in potential high co-morbidities, is unknown in highly endemic settings like Cambodia. The aim of this study was to predict the spatial distribution of S. stercoralis-hookworm co-infection risk and to investigate determinants of co-infection in Preah Vihear Province, North Cambodia. A cross-sectional survey was conducted in 2010 in 60 villages of Preah Vihear Province. Diagnosis was performed on two stool samples, using combined Baermann technique and Koga agar culture plate for S. stercoralis and Kato-Katz technique for hookworm. Bayesian multinomial geostatistical models were used to assess demographic, socioeconomic, and behavioural determinants of S. stercoralis-hookworm co-infection and to predict co-infection risk at non-surveyed locations. Of the 2576 participants included in the study, 48.6% and 49.0% were infected with S. stercoralis and hookworm, respectively; 43.8% of the cases were co-infections. Females, preschool aged children, adults aged 19-49 years, and participants who reported regularly defecating in toilets, systematically boiling drinking water and having been treated with anthelmintic drugs had lower odds of co-infection. While S. stercoralis infection risk did not appear to be spatially structured, hookworm mono-infection and co-infection exhibited spatial correlation at about 20 km. Co-infection risk was positively associated with longer walking distances to a health centre and exhibited a small clustering tendency. The association was only partly explained by climatic variables, suggesting a role for underlying factors, such as

  15. Status and Risk Factors of Strongyloides stercoralis Infection in Rural Communities of Xayaburi Province, Lao PDR.

    PubMed

    Senephansiri, Phasouk; Laummaunwai, Porntip; Laymanivong, Sakorn; Boonmar, Thidarut

    2017-10-01

    The present study was performed to reveal the current status and risk factors of Strongyloides stercoralis infections in the villages of Kenethao district, Xayaburi Province, Lao PDR. Fecal specimens were collected and examined for S. stercoralis using Koga-agar plate culture technique. Among 516 individuals, the prevalence of S. stercoralis and hookworm infection was 44.2% and 17.1%, respectively. Co-infection was detected in 13.2% of the cases. The prevalence did not significantly differ between males and females (P=0.193). However, the prevalence of S. stercoralis infection increased significantly with age (P=0.041). Of the risk factors examined, both performing farming activities (P=0.001) and walking barefoot when going outside of the house (P=0.003) showed significant correlations with S. stercoralis infections. Our results suggest that S. stercoralis is highly endemic in this area. The National Helminth Control Program of Lao PDR should take actions to control S. stercoralis infection. In addition, provision of health education about the benefits of wearing shoes would be important for reducing infection in the study area. Moreover, the application of high-sensitivity diagnostic approaches is needed to obtain the true impact of S. stercoralis infections in all rural communities in order to provide surveillance activities in Lao PDR.

  16. Strongyloides stercoralis is associated with significant morbidity in rural Cambodia, including stunting in children

    PubMed Central

    Forrer, Armelle; Khieu, Virak; Schär, Fabian; Hattendorf, Jan; Marti, Hanspeter; Neumayr, Andreas; Char, Meng Chuor; Hatz, Christoph; Muth, Sinuon

    2017-01-01

    Background Strongyloides stercoralis is a soil-transmitted nematode that can replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and highly prevalent in Cambodia. The extent of morbidity associated with S. stercoralis infection is difficult to assess due to the broad spectrum of symptoms and, thus, remains uncertain. Methodology/Principal findings Clinical signs were compared among S. stercoralis infected vs. non-infected participants in a cross-sectional survey conducted in 2012 in eight villages of Northern Cambodia, and before and after treatment with a single oral dose of ivermectin (200μg/kg BW) among participants harboring S. stercoralis. Growth retardation among schoolchildren and adolescents was assessed using height-for-age and thinness using body mass index-for-age. S. stercoralis prevalence was 31.1% among 2,744 participants. Urticaria (55% vs. 47%, OR: 1.4, 95% CI: 1.1–1.6) and itching (52% vs. 48%, OR: 1.2, 95% CI: 1.0–1.4) were more frequently reported by infected participants. Gastrointestinal, dermatological, and respiratory symptoms were less prevalent in 103 mono-infected participants after treatment. Urticaria (66% vs. 11%, OR: 0.03, 95% CI: 0.01–0.1) and abdominal pain (81 vs. 27%, OR: 0.07, 95% CI: 0.02–0.2) mostly resolved by treatment. S. stercoralis infection was associated with stunting, with 2.5-fold higher odds in case of heavy infection. Conclusions/Significance The morbidity associated with S. stercoralis confirmed the importance of gastrointestinal and dermatological symptoms unrelated to parasite load, and long-term chronic effects when associated with malnutrition. The combination of high prevalence and morbidity calls for the integration of S. stercoralis into ongoing STH control measures in Cambodia. PMID:29059195

  17. Occurrence of Strongyloides stercoralis in Yunnan Province, China, and Comparison of Diagnostic Methods

    PubMed Central

    Steinmann, Peter; Zhou, Xiao-Nong; Du, Zun-Wei; Jiang, Jin-Yong; Wang, Li-Bo; Wang, Xue-Zhong; Li, Lan-Hua; Marti, Hanspeter; Utzinger, Jürg

    2007-01-01

    Background Strongyloides stercoralis is a neglected soil-transmitted helminth species, and there is a lack of parasitologic and epidemiologic data pertaining to this parasite in China and elsewhere. We studied the local occurrence of S. stercoralis in a village in Yunnan province, China, and comparatively assessed the performance of different diagnostic methods. Methodology/Principal Findings Multiple stool samples from a random population sample were subjected to the Kato-Katz method, an ether-concentration technique, the Koga agar plate method, and the Baermann technique. Among 180 participants who submitted at least 2 stool samples, we found a S. stercoralis prevalence of 11.7%. Males had a significantly higher prevalence than females (18.3% versus 6.1%, p = 0.011), and infections were absent in individuals <15 years of age. Infections were only detected by the Baermann (highest sensitivity) and the Koga agar plate method, but neither with the Kato-Katz nor an ether-concentration technique. The examination of 3 stool samples rather than a single one resulted in the detection of 62% and 100% more infections when employing the Koga agar plate and the Baermann technique, respectively. The use of a mathematical model revealed a ‘true’ S. stercoralis prevalence in the current setting of up to 16.3%. Conclusions/Significance We conclude that S. stercoralis is endemic in the southern part of Yunnan province and that differential diagnosis and integrated control of intestinal helminth infections needs more pointed emphasis in rural China. PMID:17989788

  18. Methylprednisolone acetate induces, and Δ7-dafachronic acid suppresses, Strongyloides stercoralis hyperinfection in NSG mice.

    PubMed

    Patton, John B; Bonne-Année, Sandra; Deckman, Jessica; Hess, Jessica A; Torigian, April; Nolan, Thomas J; Wang, Zhu; Kliewer, Steven A; Durham, Amy C; Lee, James J; Eberhard, Mark L; Mangelsdorf, David J; Lok, James B; Abraham, David

    2018-01-02

    Strongyloides stercoralis hyperinfection causes high mortality rates in humans, and, while hyperinfection can be induced by immunosuppressive glucocorticoids, the pathogenesis remains unknown. Since immunocompetent mice are resistant to infection with S. stercoralis , we hypothesized that NSG mice, which have a reduced innate immune response and lack adaptive immunity, would be susceptible to the infection and develop hyperinfection. Interestingly, despite the presence of large numbers of adult and first-stage larvae in S. stercoralis -infected NSG mice, no hyperinfection was observed even when the mice were treated with a monoclonal antibody to eliminate residual granulocyte activity. NSG mice were then infected with third-stage larvae and treated for 6 wk with methylprednisolone acetate (MPA), a synthetic glucocorticoid. MPA treatment of infected mice resulted in 50% mortality and caused a significant >10-fold increase in the number of parasitic female worms compared with infected untreated mice. In addition, autoinfective third-stage larvae, which initiate hyperinfection, were found in high numbers in MPA-treated, but not untreated, mice. Remarkably, treatment with Δ7-dafachronic acid, an agonist of the parasite nuclear receptor Ss -DAF-12, significantly reduced the worm burden in MPA-treated mice undergoing hyperinfection with S. stercoralis Overall, this study provides a useful mouse model for S. stercoralis autoinfection and suggests a therapeutic strategy for treating lethal hyperinfection.

  19. Histopathology of gastric and duodenal Strongyloides stercoralis locations in fifteen immunocompromised subjects.

    PubMed

    Rivasi, Francesco; Pampiglione, Silvio; Boldorini, Renzo; Cardinale, Loredana

    2006-12-01

    Strongyloidiasis is a worldwide parasitic infection affecting approximately 75 million people. In Italy, it was more prevalent in the past among rural populations of irrigated areas. To determine the histopathologic alterations of the gastric and duodenal mucosa associated with the presence of Strongyloides stercoralis parasites. Fifteen cases of strongyloidiasis were observed in immunocompromised patients during a recent 6-year period in Italy. S. stercoralis was found histologically in gastric biopsies (10 cases), in a gastrectomy (1 case), and in duodenal biopsies (9 cases). In 5 cases the parasite was present both in gastric and duodenal biopsies. Four patients were affected by lymphoma, 2 by multiple myeloma, 2 by gastric carcinoma, 1 by chronic myeloid leukemia, 1 by sideroblastic anemia, 1 by colorectal adenocarcinoma, 1 by chronic idiopathic myelofibrosis, 1 by chronic gastritis, 1 by gastric ulcers, and 1 by rheumatoid arthritis in corticosteroid therapy. No patient was affected by human immunodeficiency virus infection. Strongyloidiasis was not clinically diagnosed. Histologic examination revealed several sections of S. stercoralis larvae, many eggs, and some adult forms. All the parasites were located in the gastric and/or the duodenal crypts. Eosinophils infiltrating into the lamina propria were found in all cases; their intensity was correlated with the intensity of the infection. Histologic diagnosis of strongyloidiasis must be taken into consideration when examining both gastric and duodenal biopsies in immunocompromised patients, to avoid the development of an overwhelming infection of the parasite, which is dangerous for the life of the patient.

  20. Prevalence of Strongyloides stercoralis and Other Intestinal Parasite Infections in School Children in a Rural Area of Angola: A Cross-Sectional Study.

    PubMed

    de Alegría, María Luisa Aznar Ruiz; Colmenares, Karen; Espasa, Mateu; Amor, Arancha; Lopez, Isabel; Nindia, Arlette; Kanjala, Joaquina; Guilherme, Domingas; Sulleiro, Elena; Barriga, Begoña; Gil, Eva; Salvador, Fernando; Bocanegra, Cristina; López, Teresa; Moreno, Milagros; Molina, Israel

    2017-10-01

    Strongyloides stercoralis is widely distributed in the tropics and subtropics. The aim of this study was to determine the prevalence of S. stercoralis and other intestinal parasites and identify the risk factors for infection with S. stercoralis in a rural area of Angola. A cross-sectional study was conducted in school-age children (SAC) in Cubal, Angola. A questionnaire collecting clinical and epidemiological variables was used, and two stool samples were collected. A concentration technique (Ritchie) and a technique for detection of larvae migration (Baermann) were performed. Of 230 SAC, 56.1% were female and the mean age was 9.3 years (SD 2.45). Severe malnutrition, according to body mass index (BMI)-for-age, was observed in 20.4% of the SAC, and anemia was found in 59.6%. Strongyloides stercoralis was observed in 28 of the 230 (12.8%) SAC. Eggs of other helminths were observed in 51 (22.2%) students: Hymenolepis spp. in 27 students (11.7%), hookworm in 14 (6.1%), Schistosoma haematobium in four (1.7%), Enterobius vermicularis in four (1.7%), Ascaris lumbricoides in three (1.3%), Taenia spp. in two (0.9%), and Fasciola hepatica in one (0.4%). Protozoa were observed in 17 (7.4%) students. Detection of S. stercoralis was higher using the Baermann technique versus using formol-ether (11.3 vs. 3%). Overall prevalence of S. stercoralis in the school population of 16 studied schools in the municipal area of Cubal was greater than 10%. This fact must be considered when designing deworming mass campaigns. The use of specific tests in larvae detection is needed to avoid overlooking this parasite.

  1. Strongyloides stercoralis infection increases the likelihood to detect Trypanosoma cruzi DNA in peripheral blood in Chagas disease patients.

    PubMed

    Salvador, Fernando; Sulleiro, Elena; Piron, Maria; Sánchez-Montalvá, Adrián; Sauleda, Silvia; Molina-Morant, Daniel; Moure, Zaira; Molina, Israel

    2017-11-01

    In a previous study performed by our group, Strongyloides stercoralis infection in patients with Chagas disease was associated with higher proportion of Trypanosoma cruzi DNA detection in peripheral blood. The aim of the study was to confirm this association in a larger cohort of patients. Cross-sectional study of all patients with Chagas disease diagnosed from 2005 to 2015 during blood donation at the Catalan Blood Bank. Demographic data and T. cruzi RT-PCR were collected. S. stercoralis infection diagnosis was based on a serological test. Two hundred and two blood donors were included. T. cruzi RT-PCR was positive in 72 (35.6%) patients, and S. stercoralis serology was positive in 22 (10.9%) patients. Patients with positive S. stercoralis serology had higher proportion of positive T. cruzi RT-PCR than those with negative serology (54.5% vs. 33.3%, P = 0.050), and the difference increased when taking a serological index cut-off of 2.5, which increases the specificity of the test to detect a confirmed strongyloidiasis (60% vs. 33%, P = 0.017). Patients with Chagas disease with positive S. stercoralis serology had higher proportion of positive T. cruzi RT-PCR in peripheral blood than those with negative serology, which reflects the potential immunomodulatory effects of S. stercoralis in T. cruzi co-infected patients. © 2017 John Wiley & Sons Ltd.

  2. Patterns of detection of Strongyloides stercoralis in stool specimens: implications for diagnosis and clinical trials.

    PubMed Central

    Dreyer, G; Fernandes-Silva, E; Alves, S; Rocha, A; Albuquerque, R; Addiss, D

    1996-01-01

    Reported efficacies of drugs used to treat Strongyloides stercoralis infection vary widely. Because diagnostic methods are insensitive, therapeutic trials generally require multiple negative posttreatment stool specimens as evidence of drug efficacy. However, only a single positive stool specimen is usually required for study enrollment. To determine the reproducibility of detection of S. stercoralis larvae in the stool, 108 asymptomatic infected men submitted 25 g of fresh stool once a week for eight consecutive weeks for examination by the Baermann technique. During the 8-week study, 239 (27.7%) of 864 stool specimens were positive for S. stercoralis. Rates of detection of larvae in the stool specimens ranged from eight of eight specimens in 3 (2.8%) men to none of eight specimens in 36 (33.3%) men. Of 43 men for whom S. stercoralis was detected in at least two of the first four stool specimens, only 1 (2.3%) man tested negative on all of the next four specimens. In comparison, of 29 men who had detectable larvae in only one of the first four specimens, 22 (75.9%) tested negative on all of the next four samples. Thus, if these 29 men had been enrolled in a therapeutic trial between the first and second sets of four specimens, the efficacy of a drug with no activity against this parasite would have been estimated to be 76%. These data suggest that patterns of S. stercoralis detection vary widely among infected persons and that intermittent larval shedding can lead to inflated estimates of drug efficacy. Before a patient is entered in a clinical trial of drug efficacy, four consecutive stool specimens should be examined for S. stercoralis; only persons with two or more positive specimens should be enrolled. PMID:8880521

  3. RNAseq Analysis of the Parasitic Nematode Strongyloides stercoralis Reveals Divergent Regulation of Canonical Dauer Pathways

    PubMed Central

    Stoltzfus, Jonathan D.; Minot, Samuel; Berriman, Matthew; Nolan, Thomas J.; Lok, James B.

    2012-01-01

    The infectious form of many parasitic nematodes, which afflict over one billion people globally, is a developmentally arrested third-stage larva (L3i). The parasitic nematode Strongyloides stercoralis differs from other nematode species that infect humans, in that its life cycle includes both parasitic and free-living forms, which can be leveraged to investigate the mechanisms of L3i arrest and activation. The free-living nematode Caenorhabditis elegans has a similar developmentally arrested larval form, the dauer, whose formation is controlled by four pathways: cyclic GMP (cGMP) signaling, insulin/IGF-1-like signaling (IIS), transforming growth factor β (TGFβ) signaling, and biosynthesis of dafachronic acid (DA) ligands that regulate a nuclear hormone receptor. We hypothesized that homologous pathways are present in S. stercoralis, have similar developmental regulation, and are involved in L3i arrest and activation. To test this, we undertook a deep-sequencing study of the polyadenylated transcriptome, generating over 2.3 billion paired-end reads from seven developmental stages. We constructed developmental expression profiles for S. stercoralis homologs of C. elegans dauer genes identified by BLAST searches of the S. stercoralis genome as well as de novo assembled transcripts. Intriguingly, genes encoding cGMP pathway components were coordinately up-regulated in L3i. In comparison to C. elegans, S. stercoralis has a paucity of genes encoding IIS ligands, several of which have abundance profiles suggesting involvement in L3i development. We also identified seven S. stercoralis genes encoding homologs of the single C. elegans dauer regulatory TGFβ ligand, three of which are only expressed in L3i. Putative DA biosynthetic genes did not appear to be coordinately regulated in L3i development. Our data suggest that while dauer pathway genes are present in S. stercoralis and may play a role in L3i development, there are significant differences between the two species

  4. RNAseq analysis of the parasitic nematode Strongyloides stercoralis reveals divergent regulation of canonical dauer pathways.

    PubMed

    Stoltzfus, Jonathan D; Minot, Samuel; Berriman, Matthew; Nolan, Thomas J; Lok, James B

    2012-01-01

    The infectious form of many parasitic nematodes, which afflict over one billion people globally, is a developmentally arrested third-stage larva (L3i). The parasitic nematode Strongyloides stercoralis differs from other nematode species that infect humans, in that its life cycle includes both parasitic and free-living forms, which can be leveraged to investigate the mechanisms of L3i arrest and activation. The free-living nematode Caenorhabditis elegans has a similar developmentally arrested larval form, the dauer, whose formation is controlled by four pathways: cyclic GMP (cGMP) signaling, insulin/IGF-1-like signaling (IIS), transforming growth factor β (TGFβ) signaling, and biosynthesis of dafachronic acid (DA) ligands that regulate a nuclear hormone receptor. We hypothesized that homologous pathways are present in S. stercoralis, have similar developmental regulation, and are involved in L3i arrest and activation. To test this, we undertook a deep-sequencing study of the polyadenylated transcriptome, generating over 2.3 billion paired-end reads from seven developmental stages. We constructed developmental expression profiles for S. stercoralis homologs of C. elegans dauer genes identified by BLAST searches of the S. stercoralis genome as well as de novo assembled transcripts. Intriguingly, genes encoding cGMP pathway components were coordinately up-regulated in L3i. In comparison to C. elegans, S. stercoralis has a paucity of genes encoding IIS ligands, several of which have abundance profiles suggesting involvement in L3i development. We also identified seven S. stercoralis genes encoding homologs of the single C. elegans dauer regulatory TGFβ ligand, three of which are only expressed in L3i. Putative DA biosynthetic genes did not appear to be coordinately regulated in L3i development. Our data suggest that while dauer pathway genes are present in S. stercoralis and may play a role in L3i development, there are significant differences between the two species

  5. Eosinophilic acute appendicitis caused by Strongyloides stercoralis and Enterobius vermicularis in an HIV-positive patient.

    PubMed

    Cruz, Dennis Baroni; Friedrisch, Bruno Kras; Fontanive Junior, Vilmar; da Rocha, Vívian Wünderlich

    2012-03-27

    A 29 year old female HIV-positive patient presented in emergency with acute right lower quadrant abdominal pain, fever, tenderness and positive Blumberg sign. Laboratorial tests revealed eosinophilia, anaemia and leukocytosis. She underwent exploratory laparotomy followed by appendectomy. The pathological analysis of the appendix revealed acute appendicitis, accentuated eosinophilia and infestation by Strongyloides stercoralis and Enterobius vermicularis. She did well after surgery and adequate treatment. To the authors' knowledge, this is the first case of eosinophilic acute appendicitis caused by these two parasitic worms reported in the medical literature.

  6. Eosinophilic acute appendicitis caused by Strongyloides stercoralis and Enterobius vermicularis in an HIV-positive patient

    PubMed Central

    Cruz, Dennis Baroni; Friedrisch, Bruno Kras; Fontanive Junior, Vilmar; da Rocha, Vívian Wünderlich

    2012-01-01

    A 29 year old female HIV-positive patient presented in emergency with acute right lower quadrant abdominal pain, fever, tenderness and positive Blumberg sign. Laboratorial tests revealed eosinophilia, anaemia and leukocytosis. She underwent exploratory laparotomy followed by appendectomy. The pathological analysis of the appendix revealed acute appendicitis, accentuated eosinophilia and infestation by Strongyloides stercoralis and Enterobius vermicularis. She did well after surgery and adequate treatment. To the authors’ knowledge, this is the first case of eosinophilic acute appendicitis caused by these two parasitic worms reported in the medical literature. PMID:22605801

  7. Extracellular traps are associated with human and mouse neutrophil and macrophage mediated killing of larval Strongyloides stercoralis.

    PubMed

    Bonne-Année, Sandra; Kerepesi, Laura A; Hess, Jessica A; Wesolowski, Jordan; Paumet, Fabienne; Lok, James B; Nolan, Thomas J; Abraham, David

    2014-06-01

    Neutrophils are multifaceted cells that are often the immune system's first line of defense. Human and murine cells release extracellular DNA traps (ETs) in response to several pathogens and diseases. Neutrophil extracellular trap (NET) formation is crucial to trapping and killing extracellular pathogens. Aside from neutrophils, macrophages and eosinophils also release ETs. We hypothesized that ETs serve as a mechanism of ensnaring the large and highly motile helminth parasite Strongyloides stercoralis thereby providing a static target for the immune response. We demonstrated that S. stercoralis larvae trigger the release of ETs by human neutrophils and macrophages. Analysis of NETs revealed that NETs trapped but did not kill larvae. Induction of NETs was essential for larval killing by human but not murine neutrophils and macrophages in vitro. In mice, extracellular traps were induced following infection with S. stercoralis larvae and were present in the microenvironment of worms being killed in vivo. These findings demonstrate that NETs ensnare the parasite facilitating larval killing by cells of the immune system. Copyright © 2014 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

  8. Extracellular traps are associated with human and mouse neutrophil and macrophage mediated killing of larval Strongyloides stercoralis

    PubMed Central

    Bonne-Année, Sandra; Kerepesi, Laura A.; Hess, Jessica A.; Wesolowski, Jordan; Paumet, Fabienne; Lok, James B.; Nolan, Thomas J.; Abraham, David

    2014-01-01

    Neutrophils are multifaceted cells that are often the immune system’s first line of defense. Human and murine cells release extracellular DNA traps (ETs) in response to several pathogens and diseases. Neutrophil extracellular trap (NET) formation is crucial to trapping and killing extracellular pathogens. Aside from neutrophils, macrophages and eosinophils also release ETs. We hypothesized that ETs serve as a mechanism of ensnaring the large and highly motile helminth parasite Strongyloides stercoralis thereby providing a static target for the immune response. We demonstrated that S. stercoralis larvae trigger the release of ETs by human neutrophils and macrophages. Analysis of NETs revealed that NETs trapped but did not kill larvae. Induction of NETs was essential for larval killing by human but not murine neutrophils and macrophages in vitro. In mice, extracellular traps were induced following infection with S. stercoralis larvae and were present in the microenvironment of worms being killed in vivo. These findings demonstrate that NETs ensnare the parasite facilitating larval killing by cells of the immune system. PMID:24642003

  9. Spatial distribution of soil-transmitted helminths, including Strongyloides stercoralis, among children in Zanzibar.

    PubMed

    Knopp, Stefanie; Mohammed, Khalfan A; Simba Khamis, I; Mgeni, Ali F; Stothard, J Russell; Rollinson, David; Marti, Hanspeter; Utzinger, Jürg

    2008-11-01

    A programme periodically distributing anthelminthic drugs to school-aged children for the control of soiltransmitted helminthiasis was launched in Zanzibar in the early 1990s. We investigated the spatial distribution of soiltransmitted helminth infections, including Strongyloides stercoralis, in 336 children from six districts in Unguja, Zanzibar, in 2007. One stool sample per child was examined with the Kato-Katz, Koga agar plate and Baermann methods. The point prevalence of the different helminth infections was compared to the geological characteristics of the study sites. The observed prevalences for Trichuris trichiura, Ascaris lumbricoides, hookworm and S. stercoralis were 35.5%, 12.2%, 11.9% and 2.2%, respectively, with considerable spatial heterogeneity. Whilst T. trichiura and hookworm infections were found in all six districts, no A. lumbricoides infections were recorded in the urban setting and only a low prevalence (2.2%) was observed in the South district. S. stercoralis infections were found in four districts with the highest prevalence (4.0%) in the West district. The prevalence of infection with any soil-transmitted helminth was highest in the North A district (69.6%) and lowest in the urban setting (22.4%). A. lumbricoides, hookworm and, with the exception of the North B district, S. stercoralis infections were observed to be more prevalent in the settings north of Zanzibar Town, which are characterized by alluvial clayey soils, moist forest regions and a higher precipitation. After a decade of large-scale administration of anthelminthic drugs, the prevalence of soil-transmitted helminth infections across Unguja is still considerable. Hence, additional measures, such as improving access to adequate sanitation and clean water and continued health education, are warranted to successfully control soil-transmitted helminthiasis in Zanzibar.

  10. Ivermectin versus albendazole or thiabendazole for Strongyloides stercoralis infection.

    PubMed

    Henriquez-Camacho, Cesar; Gotuzzo, Eduardo; Echevarria, Juan; White, A Clinton; Terashima, Angelica; Samalvides, Frine; Pérez-Molina, José A; Plana, Maria N

    2016-01-18

    Strongyloidiasis is a gut infection with Strongyloides stercoralis which is common world wide. Chronic infection usually causes a skin rash, vomiting, diarrhoea or constipation, and respiratory problems, and it can be fatal in people with immune deficiency. It may be treated with ivermectin or albendazole or thiabendazole. To assess the effects of ivermectin versus benzimidazoles (albendazole and thiabendazole) for treating chronic strongyloides infection. We searched the Cochrane Infectious Diseases Group Specialized Register (24 August 2015); the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE (January 1966 to August 2015); EMBASE (January 1980 to August 2015); LILACS (August 2015); and reference lists of articles. We also searched the metaRegister of Controlled Trials (mRCT) using 'strongyloid*' as a search term, reference lists, and conference abstracts. Randomized controlled trials of ivermectin versus albendazole or thiabendazole for treating chronic strongyloides infection. Two review authors independently extracted data and assessed risk of bias in the included trials. We used risk ratios (RRs) with 95% confidence intervals (CIs) and fixed- or random-effects models. We pooled adverse event data if the trials were sufficiently similar in their adverse event definitions. We included seven trials, enrolling 1147 participants, conducted between 1994 and 2011 in different locations (Africa, Southeast Asia, America and Europe).In trials comparing ivermectin with albendazole, parasitological cure was higher with ivermectin (RR 1.79, 95% CI 1.55 to 2.08; 478 participants, four trials, moderate quality evidence). There were no statistically significant differences in adverse events (RR 0.80, 95% CI 0.59 to 1.09; 518 participants, four trials, low quality evidence).In trials comparing ivermectin with thiabendazole, there was little or no difference in parasitological cure (RR 1.07, 95% CI 0.96 to 1.20; 467

  11. Genome-Wide Analyses of Individual Strongyloides stercoralis (Nematoda: Rhabditoidea) Provide Insights into Population Structure and Reproductive Life Cycles.

    PubMed

    Kikuchi, Taisei; Hino, Akina; Tanaka, Teruhisa; Aung, Myo Pa Pa Thet Hnin Htwe; Afrin, Tanzila; Nagayasu, Eiji; Tanaka, Ryusei; Higashiarakawa, Miwa; Win, Kyu Kyu; Hirata, Tetsuo; Htike, Wah Win; Fujita, Jiro; Maruyama, Haruhiko

    2016-12-01

    The helminth Strongyloides stercoralis, which is transmitted through soil, infects 30-100 million people worldwide. S. stercoralis reproduces sexually outside the host as well as asexually within the host, which causes a life-long infection. To understand the population structure and transmission patterns of this parasite, we re-sequenced the genomes of 33 individual S. stercoralis nematodes collected in Myanmar (prevalent region) and Japan (non-prevalent region). We utilised a method combining whole genome amplification and next-generation sequencing techniques to detect 298,202 variant positions (0.6% of the genome) compared with the reference genome. Phylogenetic analyses of SNP data revealed an unambiguous geographical separation and sub-populations that correlated with the host geographical origin, particularly for the Myanmar samples. The relatively higher heterozygosity in the genomes of the Japanese samples can possibly be explained by the independent evolution of two haplotypes of diploid genomes through asexual reproduction during the auto-infection cycle, suggesting that analysing heterozygosity is useful and necessary to infer infection history and geographical prevalence.

  12. Survival in a case of diffuse alveolar hemorrhage due to Strongyloides stercoralis hyperinfection.

    PubMed

    Steinhaus, Daniel A; Gainor, Justin F; Vernovsky, Inna; Winsett, Julie; Beer, Dennis J

    2012-01-01

    Strongyloides stercoralis is an intestinal nematode endemic to tropical and sub-tropical regions. Although infection is typically asymptomatic or self-limited, immunocompromised individuals can develop a severe form of disease marked by hyperinfection. Pulmonary involvement accompanies hyperinfection in a majority of cases, though manifestations range from asymptomatic infiltrates to diffuse alveolar hemorrhage (DAH) and respiratory failure. When complicated by DAH, the hyperinfection syndrome is usually fatal. We report a case of a 65-year-old Guatemalan woman with chronic inflammatory demyelinating polyneuropathy (CIDP) treated with chronic steroids who presented with Escherichia coli urosepsis. She was initially treated with antibiotics and corticosteroids. She subsequently developed DAH due to disseminated strongyloidiasis. She was treated with oral and subcutaneous ivermectin and had complete recovery.

  13. Strongyloides Stercoralis Infection Among Human Immunodeficiency Virus (HIV)-Infected Patients in the United States of America: A Case Report and Review of Literature.

    PubMed

    Vazquez Guillamet, Laia Jimena; Saul, Zane; Miljkovich, Goran; Vilchez, Gabriel Alejandro; Mendonca, Nikolai; Gourineni, Venkata; Lillo, Nicholas; Pinto, Marguerite; Baig, Aurengzaib; Gangcuangco, Louie Mar

    2017-04-03

    BACKGROUND Strongyloides stercoralis infection is endemic in subtropical and tropical regions but is reported rather sporadically in temperate countries. In the USA, the highest rates of infection are from the southeastern states, predominantly among immigrants. There is paucity of case reports on S. stercoralis infection among HIV-infected patients who were born and raised in the USA. CASE REPORT A 61-year-old male with known HIV infection (CD4 count: 235 cells/uL, undetectable HIV RNA, on antiretroviral therapy) presented with a 3-month history of diarrhea. He was initially diagnosed to have diarrhea secondary to norovirus and later with Escherichia coli. He was treated with levofloxacin but the diarrhea persisted. Stool PCR, Clostridium difficile enzyme-linked immunoassay, cryptosporidium and giardia antigen, cyclospora and isospora smear, and fecal microscopy were all negative. Peripheral blood eosinophil count was 1,000 eosinophils/mcL. Colonic biopsies revealed fragments of S. stercoralis larvae within the crypts. The patient was treated with ivermectin with improvement of symptoms. Social history revealed that he was born and raised in the northeastern USA. He was a daily methamphetamine user and engaged in anal sex with men. He denied travel to endemic areas, except for a visit to Japan more than 30 years ago. CONCLUSIONS Our case highlights that S. stercoralis may be an underdiagnosed/under-reported cause of chronic diarrhea among HIV-infected patients. What makes this case peculiar is that the patient was born and raised in the continental USA, absence of recent travel to endemic areas, and relatively high CD4 counts. Parasitic infections, such as S. stercoralis, should be considered among HIV-infected patients with persistent diarrhea and eosinophilia regardless of ethnicity or recent travel history.

  14. Strongyloides stercoralis age-1: a potential regulator of infective larval development in a parasitic nematode.

    PubMed

    Stoltzfus, Jonathan D; Massey, Holman C; Nolan, Thomas J; Griffith, Sandra D; Lok, James B

    2012-01-01

    Infective third-stage larvae (L3i) of the human parasite Strongyloides stercoralis share many morphological, developmental, and behavioral attributes with Caenorhabditis elegans dauer larvae. The 'dauer hypothesis' predicts that the same molecular genetic mechanisms control both dauer larval development in C. elegans and L3i morphogenesis in S. stercoralis. In C. elegans, the phosphatidylinositol-3 (PI3) kinase catalytic subunit AGE-1 functions in the insulin/IGF-1 signaling (IIS) pathway to regulate formation of dauer larvae. Here we identify and characterize Ss-age-1, the S. stercoralis homolog of the gene encoding C. elegans AGE-1. Our analysis of the Ss-age-1 genomic region revealed three exons encoding a predicted protein of 1,209 amino acids, which clustered with C. elegans AGE-1 in phylogenetic analysis. We examined temporal patterns of expression in the S. stercoralis life cycle by reverse transcription quantitative PCR and observed low levels of Ss-age-1 transcripts in all stages. To compare anatomical patterns of expression between the two species, we used Ss-age-1 or Ce-age-1 promoter::enhanced green fluorescent protein reporter constructs expressed in transgenic animals for each species. We observed conservation of expression in amphidial neurons, which play a critical role in developmental regulation of both dauer larvae and L3i. Application of the PI3 kinase inhibitor LY294002 suppressed L3i in vitro activation in a dose-dependent fashion, with 100 µM resulting in a 90% decrease (odds ratio: 0.10, 95% confidence interval: 0.08-0.13) in the odds of resumption of feeding for treated L3i in comparison to the control. Together, these data support the hypothesis that Ss-age-1 regulates the development of S. stercoralis L3i via an IIS pathway in a manner similar to that observed in C. elegans dauer larvae. Understanding the mechanisms by which infective larvae are formed and activated may lead to novel control measures and treatments for strongyloidiasis

  15. Strongyloides stercoralis age-1: A Potential Regulator of Infective Larval Development in a Parasitic Nematode

    PubMed Central

    Stoltzfus, Jonathan D.; Massey, Holman C.; Nolan, Thomas J.; Griffith, Sandra D.; Lok, James B.

    2012-01-01

    Infective third-stage larvae (L3i) of the human parasite Strongyloides stercoralis share many morphological, developmental, and behavioral attributes with Caenorhabditis elegans dauer larvae. The ‘dauer hypothesis’ predicts that the same molecular genetic mechanisms control both dauer larval development in C. elegans and L3i morphogenesis in S. stercoralis. In C. elegans, the phosphatidylinositol-3 (PI3) kinase catalytic subunit AGE-1 functions in the insulin/IGF-1 signaling (IIS) pathway to regulate formation of dauer larvae. Here we identify and characterize Ss-age-1, the S. stercoralis homolog of the gene encoding C. elegans AGE-1. Our analysis of the Ss-age-1 genomic region revealed three exons encoding a predicted protein of 1,209 amino acids, which clustered with C. elegans AGE-1 in phylogenetic analysis. We examined temporal patterns of expression in the S. stercoralis life cycle by reverse transcription quantitative PCR and observed low levels of Ss-age-1 transcripts in all stages. To compare anatomical patterns of expression between the two species, we used Ss-age-1 or Ce-age-1 promoter::enhanced green fluorescent protein reporter constructs expressed in transgenic animals for each species. We observed conservation of expression in amphidial neurons, which play a critical role in developmental regulation of both dauer larvae and L3i. Application of the PI3 kinase inhibitor LY294002 suppressed L3i in vitro activation in a dose-dependent fashion, with 100 µM resulting in a 90% decrease (odds ratio: 0.10, 95% confidence interval: 0.08–0.13) in the odds of resumption of feeding for treated L3i in comparison to the control. Together, these data support the hypothesis that Ss-age-1 regulates the development of S. stercoralis L3i via an IIS pathway in a manner similar to that observed in C. elegans dauer larvae. Understanding the mechanisms by which infective larvae are formed and activated may lead to novel control measures and treatments for

  16. Tribendimidine and albendazole for treating soil-transmitted helminths, Strongyloides stercoralis and Taenia spp.: open-label randomized trial.

    PubMed

    Steinmann, Peter; Zhou, Xiao-Nong; Du, Zun-Wei; Jiang, Jin-Yong; Xiao, Shu-Hua; Wu, Zhong-Xing; Zhou, Hui; Utzinger, Jürg

    2008-01-01

    Tribendimidine is an anthelminthic drug with a broad spectrum of activity. In 2004 the drug was approved by Chinese authorities for human use. The efficacy of tribendimidine against soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) has been established, and new laboratory investigations point to activity against cestodes and Strongyloides ratti. In an open-label randomized trial, the safety and efficacy of a single oral dose of albendazole or tribendimidine (both drugs administered at 200 mg for 5- to 14-year-old children, and 400 mg for individuals > or = 15 years) against soil-transmitted helminths, Strongyloides stercoralis, and Taenia spp. were assessed in a village in Yunnan province, People's Republic of China. The analysis was on a per-protocol basis and the trial is registered with controlled-trials.com (number ISRCTN01779485). Both albendazole and tribendimidine were highly efficacious against A. lumbricoides and, moderately, against hookworm. The efficacy against T. trichiura was low. Among 57 individuals who received tribendimidine, the prevalence of S. stercoralis was reduced from 19.3% to 8.8% (observed cure rate 54.5%, p = 0.107), and that of Taenia spp. from 26.3% to 8.8% (observed cure rate 66.7%, p = 0.014). Similar prevalence reductions were noted among the 66 albendazole recipients. Taking into account "new" infections discovered at treatment evaluation, which were most likely missed pre-treatment due to the lack of sensitivity of available diagnostic approaches, the difference between the drug-specific net Taenia spp. cure rates was highly significant in favor of tribendimidine (p = 0.001). No significant adverse events of either drug were observed. Our results suggest that single-dose oral tribendimidine can be employed in settings with extensive intestinal polyparasitism, and its efficacy against A. lumbricoides and hookworm was confirmed. The promising results obtained with tribendimidine against S

  17. Detrimental Effect of Water Submersion of Stools on Development of Strongyloides stercoralis

    PubMed Central

    Anamnart, Witthaya; Pattanawongsa, Attarat; Intapan, Pewpan Maleewong; Morakote, Nimit; Janwan, Penchom; Maleewong, Wanchai

    2013-01-01

    Strongyloidiasis is prevalent in Thailand, yet its prevalence in the south is lower than in other parts of the country. This might be due to the long rainy season in the south resulting in stool submersion in water inhibiting worm development. In this study, the effect of water submersion of fecal samples on development of Strongyloides stercoralis was investigated. Ten ml of a 1∶5 fecal suspension were placed in 15-ml tubes, 35-mm dishes, and 90-mm dishes producing the depths of 80 mm, 11 mm and 2 mm-suspensions, respectively. The worm development was followed at 1/6, 4, 6, 8, 10, 12, 14, 16, 24, and 36 h, by determining the number of filariform larva (FL) generated from agar-plate cultures (APC). Fecal suspensions kept in tubes and 35-mm dishes showed a decline in FL yield relative to incubation time and reached zero production 14 h after incubation. In contrast, the number of FL generated from the suspension kept in 90-mm dishes remained stable up to 36 h. Cumulatively, all tubes and 35-mm dishes became negative in APC after 14 h while 90-mm dishes remained APC-positive up to 36 h. Adding more water or stool suspension to dishes resulted in a decreased number of FL. Mechanical aeration of the suspensions in tubes restored an almost normal FL yield. It appears that the atmospheric air plays a significant role in growth and development of S. stercoralis in the environment and may be one of factors which contribute to a lower prevalence of human strongyloidiasis in the south of Thailand. PMID:24358173

  18. Immunization with the recombinant antigen Ss-IR induces protective immunity to infection with Strongyloides stercoralis in mice.

    PubMed

    Abraham, David; Hess, Jessica A; Mejia, Rojelio; Nolan, Thomas J; Lok, James B; Lustigman, Sara; Nutman, Thomas B

    2011-10-19

    Human intestinal infections with the nematode Strongyloides stercoralis remain a significant problem worldwide and a vaccine would be a useful addition to the tools available to prevent and control this infection. The goal of this study was to test single antigens for their efficacy in a vaccine against S. stercoralis larvae in mice. Alum was used as the adjuvant in these studies and antigens selected for analysis were either recognized by protective human IgG (Ss-TMY-1, Ss-EAT-6, and Ss-LEC-5) or were known to be highly immunogenic in humans (Ss-NIE-1 and Ss-IR). Only mice immunized with the Ss-IR antigen demonstrated a significant decrease of approximately 80% in the survival of larval parasites in the challenge infection. Antibodies, recovered from mice with protective immunity to S. stercoralis after immunization with Ss-IR, were used to locate the antigen in the larvae. Confocal microscopy revealed that IgG from mice immunized with Ss-IR bound to the surface of the parasites and observations by electron microscopy indicated that IgG bound to granules in the glandular esophagus. Serum collected from mice immunized with Ss-IR passively transferred immunity to naïve mice. These studies demonstrate that Ss-IR, in combination with alum, induces high levels of protective immunity through an antibody dependent mechanism and may therefore be suitable for further development as a vaccine against human strongyloidiasis. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Prevalence of Strongyloides stercoralis infection and other soil-transmitted helminths by cross-sectional survey in a rural community in Gisagara District, Southern Province, Rwanda

    PubMed Central

    Tuyizere, Aloys; Ndayambaje, Alphonse; Bayingana, Claude; Ntirenganya, Cyprien; Dusabejambo, Vincent; Hale, DeVon C

    2018-01-01

    Abstract Background Strongyloides stercoralis is one of the most neglected tropical diseases. Sparse, dated central African and Rwandan data on seroprevalence are available to guide public health efforts and clinical care. Methods In February 2016 we conducted a community-based cross-sectional study among 539 asymptomatic participants in a rural area in the Gisagara District, Southern Province, Rwanda. Direct faecal smear (DFS) and modified Koga agar plate culture (APC) were used to detect S. stercoralis infection in a single stool sample. Data on other soil-transmitted helminths diagnosed by DFS were also recorded. Results Four intestinal helminth infections were diagnosed, with S. stercoralis (17.4%) and hookworms (8.2%) seen most often. APC, compared with DFS, increased the diagnosis rate for S. stercoralis from 1.9% to 17.4% (p<0.01). The prevalence was higher in farmers and those with lower socio-economic status. Females were less often infected than males (odds ratio 0.6 [95% confidence interval 0.3 to 0.9], p=0.02). Conclusions S. stercoralis is highly prevalent among the general population in a rural area of Gisagara District, Southern Province, Rwanda. Access to effective diagnosis and treatment is needed for this neglected disease. PMID:29726969

  20. Comparison of Nested Polymerase Chain Reaction and Real-Time Polymerase Chain Reaction with Parasitological Methods for Detection of Strongyloides stercoralis in Human Fecal Samples

    PubMed Central

    Sharifdini, Meysam; Mirhendi, Hossein; Ashrafi, Keyhan; Hosseini, Mostafa; Mohebali, Mehdi; Khodadadi, Hossein; Kia, Eshrat Beigom

    2015-01-01

    This study was performed to evaluate nested polymerase chain reaction (PCR) and real-time PCR methods for detection of Strongyloides stercoralis in fecal samples compared with parasitological methods. A total of 466 stool samples were examined by conventional parasitological methods (formalin ether concentration [FEC] and agar plate culture [APC]). DNA was extracted using an in-house method, and mitochondrial cytochrome c oxidase subunit 1 and 18S ribosomal genes were amplified by nested PCR and real-time PCR, respectively. Among 466 samples, 12.7% and 18.2% were found infected with S. stercoralis by FEC and APC, respectively. DNA of S. stercoralis was detected in 18.9% and 25.1% of samples by real-time PCR and nested PCR, respectively. Considering parasitological methods as the diagnostic gold standard, the sensitivity and specificity of nested PCR were 100% and 91.6%, respectively, and that of real-time PCR were 84.7% and 95.8%, respectively. However, considering sequence analyzes of the selected nested PCR products, the specificity of nested PCR is increased. In general, molecular methods were superior to parasitological methods. They were more sensitive and more reliable in detection of S. stercoralis in comparison with parasitological methods. Between the two molecular methods, the sensitivity of nested PCR was higher than real-time PCR. PMID:26350449

  1. A Coproantigen Diagnostic Test for Strongyloides Infection

    PubMed Central

    Sykes, Alex M.; McCarthy, James S.

    2011-01-01

    Accurate diagnosis of infection with the parasite Strongyloides stercoralis is hampered by the low concentration of larvae in stool, rendering parasitological diagnosis insensitive. Even if the more sensitive agar plate culture method is used repeated stool sampling is necessary to achieve satisfactory sensitivity. In this manuscript we describe the development of a coproantigen ELISA for diagnosis of infection. Polyclonal rabbit antiserum was raised against Strongyloides ratti excretory/secretory (E/S) antigen and utilized to develop an antigen capture ELISA. The assay enabled detection of subpatent rodent S. ratti and human S. stercoralis infection. No cross-reactivity was observed with purified E/S from Schistosoma japonicum, the hookworms Ancylostoma caninum, A. ceylanicum, nor with fecal samples collected from rodents harboring Trichuris muris or S. mansoni infection. Strongyloides coproantigens that appear stable when frozen as formalin-extracted fecal supernatants stored at −20°C remained positive up to 270 days of storage, whereas supernatants stored at 4°C tested negative. These results indicate that diagnosis of human strongyloidiasis by detection of coproantigen is an approach worthy of further development. PMID:21347447

  2. Hyperinfection with Strongyloides in a HIV-negative elderly male

    PubMed Central

    Girija, S; Kannan, Suresh; Jeyakumari, D; Gopal, R

    2012-01-01

    Strongyloides stercoralis is an intestinal nematode producing mild infection in the immunocompetent and fatal hyperinfection syndrome in the immunocompromised. An elderly HIV-negative male presented with symptoms of chronic respiratory disease and vague abdominal symptoms. Examination of sputum and stools showed larvae of S. stercoralis. Bacterial and fungal causes of respiratory infections were ruled out. The patient responded to oral ivermectin. PMID:23508878

  3. High prevalence of Strongyloides stercoralis in school-aged children in a rural highland of north-western Ethiopia: the role of intensive diagnostic work-up.

    PubMed

    Amor, Aranzazu; Rodriguez, Esperanza; Saugar, José M; Arroyo, Ana; López-Quintana, Beatriz; Abera, Bayeh; Yimer, Mulat; Yizengaw, Endalew; Zewdie, Derejew; Ayehubizu, Zimman; Hailu, Tadesse; Mulu, Wondemagegn; Echazú, Adriana; Krolewieki, Alejandro J; Aparicio, Pilar; Herrador, Zaida; Anegagrie, Melaku; Benito, Agustín

    2016-12-01

    Soil-transmitted helminthiases (hookworms, Ascaris lumbricoides and Trichuris trichiura) are extremely prevalent in school-aged children living in poor sanitary conditions. Recent epidemiological data suggest that Strongyloides stercoralis is highly unreported. However, accurate data are essential for conducting interventions aimed at introducing control and elimination programmes. We conducted a cross-sectional survey of 396 randomly selected school-aged children in Amhara region in rural area in north-western Ethiopia, to assess the prevalence of S. stercoralis and other intestinal helminths. We examined stools using three techniques: conventional stool concentration; and two S. stercoralis-specific methods, i.e. the Baermann technique and polymerase chain reaction. The diagnostic accuracy of these three methods was then compared. There was an overall prevalence of helminths of 77.5%, with distribution differing according to school setting. Soil-transmitted helminths were recorded in 69.2%. Prevalence of S. stercoralis and hookworm infection was 20.7 and 54.5%, respectively, and co-infection was detected in 16.3% of cases. Schistosoma mansoni had a prevalence of 15.7%. Prevalence of S. stercoralis was shown 3.5% by the conventional method, 12.1% by the Baermann method, and 13.4% by PCR, which thus proved to be the most sensitive. Our results suggest that S. stercoralis could be overlooked and neglected in Ethiopia, if studies of soil-transmitted helminths rely on conventional diagnostic techniques alone. A combination of molecular and stool microscopy techniques yields a significantly higher prevalence. In view of the fact that current control policies for triggering drug administration are based on parasite prevalence levels, a comprehensive diagnostic approach should instead be applied to ensure comprehensive control of helminth infections.

  4. Strongyloides stercoralis hyperinfection syndrome: a case series and a review of the literature.

    PubMed

    Geri, Guillaume; Rabbat, Antoine; Mayaux, Julien; Zafrani, Lara; Chalumeau-Lemoine, Ludivine; Guidet, Bertrand; Azoulay, Elie; Pène, Frédéric

    2015-12-01

    Strongyloides stercoralis may lead to overwhelming infestation [Strongyloides hyperinfection syndrome (SHS)]. We aimed at describing a case series of patients admitted in intensive care unit (ICU) with SHS and report a literature review of such cases. Retrospective multicenter study of 11 patients admitted to the ICU of tertiary hospitals with SHS between 2000 and 2013. Literature review with Pubmed retrieved 122 cases. Logistic regression analysis was performed to identify predictive factors of ICU mortality and shock occurrence. 133 patients [median age 53 (39, 64), 72.2 % males] were included. Underlying immunosuppression was present in 127 patients, mostly long-term corticosteroid treatment in 111 (83.5 %) patients. Fever (80.8 %), respiratory (88.6 %), and gastrointestinal (71.2 %) symptoms were common clinical manifestations. Shock occurred in 75 (57.3 %) patients and mechanical ventilation was required in 89 (67.9 %) patients. Hypereosinophilia and a concomitant bacterial infection were observed in 34 (34.3 %) and 51 (38.4 %) patients, respectively. The in-ICU mortality rate was 60.3 %. Predictive factors of ICU mortality were shock occurrence [Odds ratio (OR) 18.1, 95 % confidence interval (95 % CI) 3.03-107.6, p < 0.01] and mechanical ventilation (OR 28.1, 95 % CI 3.6-217, p < 0.01). Hypereosinophilia (OR 0.21, 95 % CI 0.06-0.7, p = 0.01) and a concomitant bacterial infection (OR 4.68, 95 % CI 1.3-16.8, p = 0.02) were independent predictors of shock occurrence. SHS remains associated with a poor outcome, especially when associated with shock and mechanical ventilation. Deterioration to shock is often related to concomitant bacterial infection. The poor outcome of established SHS pleads for a large application of antiparasitic primary prophylaxis in at-risk patients.

  5. Rapid detection of Opisthorchis viverrini and Strongyloides stercoralis in human fecal samples using a duplex real-time PCR and melting curve analysis.

    PubMed

    Janwan, Penchom; Intapan, Pewpan M; Thanchomnang, Tongjit; Lulitanond, Viraphong; Anamnart, Witthaya; Maleewong, Wanchai

    2011-12-01

    Human opisthorchiasis caused by the liver fluke Opisthorchis viverrini is an endemic disease in Southeast Asian countries including the Lao People's Democratic Republic, Cambodia, Vietnam, and Thailand. Infection with the soil-transmitted roundworm Strongyloides stercoralis is an important problem worldwide. In some areas, both parasitic infections are reported as co-infections. A duplex real-time fluorescence resonance energy transfer (FRET) PCR merged with melting curve analysis was developed for the rapid detection of O. viverrini and S. stercoralis in human fecal samples. Duplex real-time FRET PCR is based on fluorescence melting curve analysis of a hybrid of amplicons generated from two genera of DNA elements: the 162 bp pOV-A6 DNA sequence specific to O. viverrini and the 244 bp 18S rRNA sequence specific to S. stercoralis, and two pairs of specific fluorophore-labeled probes. Both O. viverrini and S. stercoralis can be differentially detected in infected human fecal samples by this process through their different fluorescence channels and melting temperatures. Detection limit of the method was as little as two O. viverrini eggs and four S. stercoralis larvae in 100 mg of fecal sample. The assay could distinguish the DNA of both parasites from the DNA of negative fecal samples and fecal samples with other parasite materials, as well as from the DNA of human leukocytes and other control parasites. The technique showed 100% sensitivity and specificity. The introduced duplex real-time FRET PCR can reduce labor time and reagent costs and is not prone to carry over contamination. The method is important for simultaneous detection especially in areas where both parasites overlap incidence and is useful as the screening tool in the returning travelers and immigrants to industrialized countries where number of samples in the diagnostic units will become increasing.

  6. Importance of a Rapid and Accurate Diagnosis in Strongyloides Stercoralis and Human T-Lymphotropic Virus 1 Co-infection: A Case Report and Review of the Literature.

    PubMed

    Quintero, Olga; Berini, Carolina A; Waldbaum, Carlos; Avagnina, Alejandra; Juarez, María; Repetto, Silvia; Sorda, Juan; Biglione, Mirna

    2017-01-01

    Strongyloides (S.) stercoralis and Human T-Lymphotropic Virus 1 (HTLV-1) share some endemic regions such as Japan, Jamaica, and South America and are mostly diagnosed elsewhere in immigrants from endemic areas. This co-infection has not been documented in Argentina although both pathogens are endemic in the Northwest. We present a case of S. stercoralis and HTLV-1 co-infection with an initial presentation due to gastrointestinal symptoms which presented neither eosinophilia nor the presence of larvae in stool samples in a non-endemic area for these infections. A young Peruvian woman living in Buenos Aires attended several emergency rooms and finally ended up admitted in a gastroenterology ward due to incoercible vomiting, diarrhea, abdominal pain, fever, and weight loss. Gastrointestinal symptoms started 3 months before she returned to Argentina from a trip to Peru. She presented malnutrition and abdominal distension parameters. HIV-1 and other immunodeficiencies were discarded. The serial coproparasitological test was negative. Computed tomography showed diffuse thickening of duodenal and jejunal walls. At the beginning, vasculitis was suspected and corticosteroid therapy was initiated. The patient worsened rapidly. Skin, new enteral biopsies, and a new set of coproparasitological samples revealed S. stercoralis . Then, HTLV-1 was suspected and infection was confirmed. Ivermectin and albendazole were administrated, until the stool sample remained negative for 2 weeks. Larvae were not observed in fresh stool, Ritchie method, and agar culture 1 week post-treatment. Although she required initial support with parenteral nutrition due to oral intolerance she slowly progressed favorably. It has been highly recommended to include a rapid and sensitive PCR strategy in the algorithm to confirm Strongyloides infection, which has demonstrated to improve early diagnosis in patients at-risk of disseminated strongyloidiasis.

  7. Importance of a Rapid and Accurate Diagnosis in Strongyloides Stercoralis and Human T-Lymphotropic Virus 1 Co-infection: A Case Report and Review of the Literature

    PubMed Central

    Quintero, Olga; Berini, Carolina A.; Waldbaum, Carlos; Avagnina, Alejandra; Juarez, María; Repetto, Silvia; Sorda, Juan; Biglione, Mirna

    2017-01-01

    Strongyloides (S.) stercoralis and Human T-Lymphotropic Virus 1 (HTLV-1) share some endemic regions such as Japan, Jamaica, and South America and are mostly diagnosed elsewhere in immigrants from endemic areas. This co-infection has not been documented in Argentina although both pathogens are endemic in the Northwest. We present a case of S. stercoralis and HTLV-1 co-infection with an initial presentation due to gastrointestinal symptoms which presented neither eosinophilia nor the presence of larvae in stool samples in a non-endemic area for these infections. A young Peruvian woman living in Buenos Aires attended several emergency rooms and finally ended up admitted in a gastroenterology ward due to incoercible vomiting, diarrhea, abdominal pain, fever, and weight loss. Gastrointestinal symptoms started 3 months before she returned to Argentina from a trip to Peru. She presented malnutrition and abdominal distension parameters. HIV-1 and other immunodeficiencies were discarded. The serial coproparasitological test was negative. Computed tomography showed diffuse thickening of duodenal and jejunal walls. At the beginning, vasculitis was suspected and corticosteroid therapy was initiated. The patient worsened rapidly. Skin, new enteral biopsies, and a new set of coproparasitological samples revealed S. stercoralis. Then, HTLV-1 was suspected and infection was confirmed. Ivermectin and albendazole were administrated, until the stool sample remained negative for 2 weeks. Larvae were not observed in fresh stool, Ritchie method, and agar culture 1 week post-treatment. Although she required initial support with parenteral nutrition due to oral intolerance she slowly progressed favorably. It has been highly recommended to include a rapid and sensitive PCR strategy in the algorithm to confirm Strongyloides infection, which has demonstrated to improve early diagnosis in patients at-risk of disseminated strongyloidiasis. PMID:29270152

  8. The Transcriptome Analysis of Strongyloides stercoralis L3i Larvae Reveals Targets for Intervention in a Neglected Disease

    PubMed Central

    Marcilla, Antonio; Garg, Gagan; Bernal, Dolores; Ranganathan, Shoba; Forment, Javier; Ortiz, Javier; Muñoz-Antolí, Carla; Dominguez, M. Victoria; Pedrola, Laia; Martinez-Blanch, Juan; Sotillo, Javier; Trelis, Maria; Toledo, Rafael; Esteban, J. Guillermo

    2012-01-01

    Background Strongyloidiasis is one of the most neglected diseases distributed worldwide with endemic areas in developed countries, where chronic infections are life threatening. Despite its impact, very little is known about the molecular biology of the parasite involved and its interplay with its hosts. Next generation sequencing technologies now provide unique opportunities to rapidly address these questions. Principal Findings Here we present the first transcriptome of the third larval stage of S. stercoralis using 454 sequencing coupled with semi-automated bioinformatic analyses. 253,266 raw sequence reads were assembled into 11,250 contiguous sequences, most of which were novel. 8037 putative proteins were characterized based on homology, gene ontology and/or biochemical pathways. Comparison of the transcriptome of S. strongyloides with those of other nematodes, including S. ratti, revealed similarities in transcription of molecules inferred to have key roles in parasite-host interactions. Enzymatic proteins, like kinases and proteases, were abundant. 1213 putative excretory/secretory proteins were compiled using a new pipeline which included non-classical secretory proteins. Potential drug targets were also identified. Conclusions Overall, the present dataset should provide a solid foundation for future fundamental genomic, proteomic and metabolomic explorations of S. stercoralis, as well as a basis for applied outcomes, such as the development of novel methods of intervention against this neglected parasite. PMID:22389732

  9. Radiolabeling of infective third-stage larvae of Strongyloides stercoralis by feeding ( sup 75 Se)selenomethionine-labeled Escherichia coli to first- and second-stage larvae

    SciTech Connect

    Aikens, L.M.; Schad, G.A.

    1989-10-01

    A technique is described for radiolabeling Strongyloides stercoralis larvae with ({sup 75}Se)selenomethionine. Cultures of an auxotrophic methionine-dependent stain of Escherichia coli were grown in a medium containing Dulbecco's modified Eagle's medium supplemented with 5% nutrient broth, amino acids, and ({sup 75}Se)selenomethionine. When the {sup 75}Se-labeled bacterial populations were in the stationary phase of growth, cultures were harvested and the bacteria dispersed on agar plates to serve as food for S. stercoralis larvae. Use of nondividing bacteria is important for successful labeling because the isotope is not diluted by cell division and death of larvae attributable to overgrowth by bacteria ismore » prevented. First-stage S. stercoralis larvae were recovered from feces of infected dogs and reared in humid air at 30 C on agar plates seeded with bacteria. After 7 days, infective third-stage larvae were harvested. The mean specific activity of 6 different batches of larvae ranged from 75 to 330 counts per min/larva with 91.8 +/- 9.5% of the population labeled sufficiently to produce an autoradiographic focus during a practicable, 6-wk period of exposure. Labeled infective larvae penetrated the skin of 10-day-old puppies and migrated to the small intestine, where the developed to adulthood.« less

  10. First molecular identification and report of genetic diversity of Strongyloides stercoralis, a current major soil-transmitted helminth in humans from Lao People's Democratic Republic.

    PubMed

    Laymanivong, Sakhone; Hangvanthong, Bouasy; Insisiengmay, Bounnaloth; Vanisaveth, Viengxay; Laxachack, Pinnakhone; Jongthawin, Jurairat; Sanpool, Oranuch; Thanchomnang, Tongjit; Sadaow, Lakkhana; Phosuk, Issarapong; Rodpai, Rutchanee; Maleewong, Wanchai; Intapan, Pewpan M

    2016-08-01

    Strongyloidiasis is a major soil-transmitted helminth (STH) disease that affects people worldwide. We present updated data on prevalence in the Lao People's Democratic Republic (Lao PDR) in 2015, arising from a community cross-sectional helminthiasis survey. Fecal samples were collected from 327 individuals across three provinces in Lao PDR (Luang Prabang in the north, Khammouane in the center, and Champasack in the south). Agar plate culture and Kato-Katz methods were used to examine duplicate stool samples from each participant to detect Strongyloides stercoralis and co-infecting helminths. Overall prevalences of S. strercoralis human hookworm, Taenia spp., Trichuris trichiura, Ascaris lumbricoides, and Enterobius vermicularis were 41.0, 28.1, 4.9, 4.0, 1.5, and 0.9 %, respectively. The prevalence of miscellaneous trematodiases (including opisthorchiasis) was 37.9 % and of Schistosoma mekongi infection was 0.3 %. Strongyloidiasis is a current major STH disease in Lao PDR. We also report the molecular-phylogenetic identification of S. stercoralis adult males collected from 40 representative human strongyliodiasis fecal samples. DNA was extracted, amplified, and sequenced from a portion of the mitochondrial cox1 gene and the nuclear 18S ribosomal DNA. Phylogenetic analyses indicated that all specimens sequenced belonged to S. stercoralis (Bavay, 1876) Stiles and Hassall, 1902. The cox1 sequences exhibited great diversity (24 haplotypes) in Lao PDR. This is the first molecular identification and report of genetic diversity of S. stercoralis in humans from Lao PDR. An effective parasite control program is needed to reduce the serious health impacts.

  11. Albendazole and ivermectin for the control of soil-transmitted helminths in an area with high prevalence of Strongyloides stercoralis and hookworm in northwestern Argentina: A community-based pragmatic study.

    PubMed

    Echazú, Adriana; Juarez, Marisa; Vargas, Paola A; Cajal, Silvana P; Cimino, Ruben O; Heredia, Viviana; Caropresi, Silvia; Paredes, Gladys; Arias, Luis M; Abril, Marcelo; Gold, Silvia; Lammie, Patrick; Krolewiecki, Alejandro J

    2017-10-01

    Recommendations for soil-transmitted helminth (STH) control give a key role to deworming of school and pre-school age children with albendazole or mebendazole; which might be insufficient to achieve adequate control, particularly against Strongyloides stercoralis. The impact of preventive chemotherapy (PC) against STH morbidity is still incompletely understood. The aim of this study was to assess the effectiveness of a community-based program with albendazole and ivermectin in a high transmission setting for S. stercoralis and hookworm. Community-based pragmatic trial conducted in Tartagal, Argentina; from 2012 to 2015. Six communities (5070 people) were enrolled for community-based PC with albendazole and ivermectin. Two communities (2721 people) were re-treated for second and third rounds. STH prevalence, anemia and malnutrition were explored through consecutive surveys. Anthropometric assessment of children, stool analysis, complete blood count and NIE-ELISA serology for S. stercoralis were performed. STH infection was associated with anemia and stunting in the baseline survey that included all communities and showed a STH prevalence of 47.6% (almost exclusively hookworm and S. stercoralis). Among communities with multiple interventions, STH prevalence decreased from 62% to 23% (p<0.001) after the first PC; anemia also diminished from 52% to 12% (p<0.001). After two interventions S. stercoralis seroprevalence declined, from 51% to 14% (p<0.001) and stunting prevalence decreased, from 19% to 12% (p = 0.009). Hookworm' infections are associated with anemia in the general population and nutritional impairment in children. S. stercoralis is also associated with anemia. Community-based deworming with albendazole and ivermectin is effective for the reduction of STH prevalence and morbidity in communities with high prevalence of hookworm and S. stercoralis.

  12. Prevalence of Strongyloides stercoralis and Other Intestinal Parasites among Institutionalized Mentally Disabled Individuals in Rasht, Northern Iran

    PubMed Central

    SAEIDINIA, Amin; TAVAKOLI, Ilnaz; NAGHIPOUR, Mohammad Reza; RAHMATI, Behnaz; GHAVAMI LAHIJI, Hossein; SALKHORI, Omid; ASHRAFI, Keyhan

    2016-01-01

    Background: We aimed to determine the status of strongyloidiasis in mentally disabled population in the institutional places in Rasht City, the capital of Guilan Province, northern Iran. Methods: This cross-sectional study was conducted in 8 institutions for mentally retarded population in Rasht in 2013. Before collecting the samples, a questionnaire was filled out for each participant by an expert person. A single stool sample was obtained from each of the 173 subjects and examined using direct wet mount, formalin-ether concentration technique and agar plate culture method. Results: A total of 173 mentally disabled individuals aged 2–57 (25.69±11.56) yr old were studied. Stool examination showed that 51 (29.5%) cases were infected with at least one parasite. Of 173 studied cases only 10 (5.8%) individuals were infected with pathogenic parasites, of which 2 (1.2%) cases were infected with Strongyloides stercoralis and 8 (4.6%) with Giardia lamblia. On the other hand, 42 (24.3%) of the studied population were infected with non-pathogenic intestinal protozoa such as Blastocystis hominis (n=29, 16.8%), Entamoeba coli (n=16, 9.2%) and Endolimax nana (n=4, 2.3%). Mixed protozoal infections were observed in 8 (4.6%) individuals. Conclusion: The prevalence rate of S. stercoralis in mentally disabled individuals in Rasht was somewhat higher than those of normal population of the province. The same picture was seen when the prevalence of G. lamblia and non-pathogenic protozoa in normal and mentally disabled populations were compared. PMID:28127364

  13. Modulation of CD4+ and CD8+ T Cell Function and Cytokine Responses in Strongyloides stercoralis Infection by Interleukin-27 (IL-27) and IL-37.

    PubMed

    Anuradha, Rajamanickam; Munisankar, Saravanan; Bhootra, Yukthi; Dolla, Chandrakumar; Kumaran, Paul; Nutman, Thomas B; Babu, Subash

    2017-11-01

    Strongyloides stercoralis infection is associated with diminished antigen-specific Th1- and Th17-associated responses and enhanced Th2-associated responses. Interleukin-27 (IL-27) and IL-37 are two known anti-inflammatory cytokines that are highly expressed in S. stercoralis infection. We therefore wanted to examine the role of IL-27 and IL-37 in regulating CD4 + and CD8 + T cell responses in S. stercoralis infection. To this end, we examined the frequency of Th1/Tc1, Th2/Tc2, Th9/Tc9, Th17/Tc17, and Th22/Tc22 cells in 15 S. stercoralis -infected individuals and 10 uninfected individuals stimulated with parasite antigen following IL-27 or IL-37 neutralization. We also examined the production of prototypical type 1, type 2, type 9, type 17, and type 22 cytokines in the whole-blood supernatants. Our data reveal that IL-27 or IL-37 neutralization resulted in significantly enhanced frequencies of Th1/Tc1, Th2/Tc2, Th17/Tc17, Th9, and Th22 cells with parasite antigen stimulation. There was no induction of any T cell response in uninfected individuals following parasite antigen stimulation and IL-27 or IL-37 neutralization. Moreover, we also observed increased production of gamma interferon (IFN-γ), IL-5, IL-9, IL-17, and IL-22 and decreased production of IL-10 following IL-27 and IL-37 neutralization and parasite antigen stimulation in whole-blood cultures. Thus, we demonstrate that IL-27 and IL-37 limit the induction of particular T cell subsets along with cytokine responses in S. stercoralis infections, which suggest the importance of IL-27 and IL-37 in immune modulation in a chronic helminth infection. Copyright © 2017 American Society for Microbiology.

  14. Albendazole and ivermectin for the control of soil-transmitted helminths in an area with high prevalence of Strongyloides stercoralis and hookworm in northwestern Argentina: A community-based pragmatic study

    PubMed Central

    Juarez, Marisa; Vargas, Paola A.; Cajal, Silvana P.; Cimino, Ruben O.; Heredia, Viviana; Caropresi, Silvia; Paredes, Gladys; Arias, Luis M.; Abril, Marcelo; Gold, Silvia; Lammie, Patrick; Krolewiecki, Alejandro J.

    2017-01-01

    Background Recommendations for soil-transmitted helminth (STH) control give a key role to deworming of school and pre-school age children with albendazole or mebendazole; which might be insufficient to achieve adequate control, particularly against Strongyloides stercoralis. The impact of preventive chemotherapy (PC) against STH morbidity is still incompletely understood. The aim of this study was to assess the effectiveness of a community-based program with albendazole and ivermectin in a high transmission setting for S. stercoralis and hookworm. Methodology Community-based pragmatic trial conducted in Tartagal, Argentina; from 2012 to 2015. Six communities (5070 people) were enrolled for community-based PC with albendazole and ivermectin. Two communities (2721 people) were re-treated for second and third rounds. STH prevalence, anemia and malnutrition were explored through consecutive surveys. Anthropometric assessment of children, stool analysis, complete blood count and NIE-ELISA serology for S. stercoralis were performed. Principal findings STH infection was associated with anemia and stunting in the baseline survey that included all communities and showed a STH prevalence of 47.6% (almost exclusively hookworm and S. stercoralis). Among communities with multiple interventions, STH prevalence decreased from 62% to 23% (p<0.001) after the first PC; anemia also diminished from 52% to 12% (p<0.001). After two interventions S. stercoralis seroprevalence declined, from 51% to 14% (p<0.001) and stunting prevalence decreased, from 19% to 12% (p = 0.009). Conclusions Hookworm’ infections are associated with anemia in the general population and nutritional impairment in children. S. stercoralis is also associated with anemia. Community-based deworming with albendazole and ivermectin is effective for the reduction of STH prevalence and morbidity in communities with high prevalence of hookworm and S. stercoralis. PMID:28991899

  15. Strongyloides stercoralis-infected dogs as a model for human disseminated strongyloidiasis

    SciTech Connect

    Aikens, L.M.

    1989-01-01

    The route of migration of Strongyloides stercoralis third-stage infective larvae was explored in primary and autogenous infections in the dog. Larvae was radiolabeled by one of two means: (1) by culture of the free-living L3 stage in a nutrient medium, deficient in methionine, supplemented with ({sup 75}Se)Selenomethionine, and (2) by feeding of ({sup 75}Se)Selenomethionine-labeled bacteria to microbiverous L1 and L2 stages. Third-stage labeled larvae were then injected into 10-day-old pups either subcutaneously, to study primary migration, or into the distal ileum, to study autogenous migration. At intervals after infection pups were killed and whole body compressed organ autoradiography done onmore » individual tissues to determine organ-specific larval transit sites. Autoradiographic recoveries were analyzed in the context of a series of mathematical models designed to test migratory route hypotheses. Postulated routes of migration for primary infections included (1) the Null Hypothesis or Scramble Route in which larvae migrate to the intestines by any available route, (2) the Classical Pulmonary Route in which larvae migrate sequentially from skin, to blood, to lungs, to the trachea, esophagus and intestines, and (3) the Head Migration Route in which larvae move from caudal to cranial sites within the skin and muscle before entering the intestines. Postulated routes for autoinfective migration reiterated 1 and 2 above. Least squares comparisons, of calculated models to observed autoradiographic distributions, led us to conclude that there was no reason to reject the simplest assumption that larvae move by any available route to the definitive site in both forms of migration. Sampling through tracheostomy sites in 14 pups for larval migrants confirmed this conclusion.« less

  16. The Genomic Basis of Parasitism in the Strongyloides Clade of Nematodes

    PubMed Central

    Hunt, Vicky L.; Tsai, Isheng J.; Coghlan, Avril; Reid, Adam J.; Holroyd, Nancy; Foth, Bernardo J.; Tracey, Alan; Cotton, James A.; Stanley, Eleanor J.; Beasley, Helen; Bennett, Hayley M.; Brooks, Karen; Harsha, Bhavana; Kajitani, Rei; Kulkarni, Arpita; Harbecke, Dorothee; Nagayasu, Eiji; Nichol, Sarah; Ogura, Yoshitoshi; Quail, Michael A.; Randle, Nadine; Xia, Dong; Brattig, Norbert W.; Soblik, Hanns; Ribeiro, Diogo M.; Sanchez-Flores, Alejandro; Hayashi, Tetsuya; Itoh, Takehiko; Denver, Dee R.; Grant, Warwick; Stoltzfus, Jonathan D.; Lok, James B.; Murayama, Haruhiko; Wastling, Jonathan; Streit, Adrian; Kikuchi, Taisei; Viney, Mark; Berriman, Matthew

    2016-01-01

    Soil transmitted nematodes, including Strongyloides, cause one of the most prevalent Neglected Tropical Diseases. Here we compare the genomes of four Strongyloides spp., including the human pathogen S. stercoralis, and their close relatives that are facultatively parasitic (Parastrongyloides trichosuri) and free-living (Rhabditophanes sp). A significant paralogous expansion of key gene families – astacin-like and SCP/TAPS coding gene families – is associated with the evolution of parasitism in this clade. Exploiting the unique Strongyloides life cycle we compare the transcriptome of its parasitic and free-living stages and find that these same genes are upregulated in the parasitic stages, underscoring their role in nematode parasitism. PMID:26829753

  17. Shiga toxin producing E coli bloodstream infection secondary to Strongyloides penetration through intestinal mucosa

    PubMed Central

    Cyr, Sancta; Nagpal, Avish; Sohail, Muhammad Rizwan

    2013-01-01

    A 51-year-old woman with diabetes, who immigrated to the USA 22 years ago from Laos, was admitted to the hospital for evaluation of fever, abdominal pain, vomiting and diarrhoea. A workup for acute gastroenteritis revealed a positive stool PCR for Shiga toxin-producing Escherichia coli. Two sets of blood cultures drawn at admission were positive for E coli. A review of her previous medical records revealed the presence of eosinophilia, up to 20%, 14 years prior to that was never investigated. Therefore, stool samples were examined and two of three specimens were positive for Strongyloides stercoralis larvae, confirming the diagnosis of Strongyloides hyperinfection syndrome. PMID:24022903

  18. Elevated Systemic Levels of Eosinophil, Neutrophil, and Mast Cell Granular Proteins in Strongyloides Stercoralis Infection that Diminish following Treatment.

    PubMed

    Rajamanickam, Anuradha; Munisankar, Saravanan; Bhootra, Yukthi; Dolla, Chandra Kumar; Nutman, Thomas B; Babu, Subash

    2018-01-01

    Infection with the helminth parasite Strongyloides stercoralis ( Ss ) is commonly clinically asymptomatic that is often accompanied by peripheral eosinophilia. Granulocytes are activated during helminth infection and can act as immune effector cells. Plasma levels of eosinophil and neutrophil granular proteins convey an indirect measure of granulocyte degranulation and are prominently augmented in numerous helminth-infected patients. In this study, we sought to examine the levels of eosinophil, neutrophil, and mast cell activation-associated granule proteins in asymptomatic Ss infection and to understand their kinetics following anthelmintic therapy. To this end, we measured the plasma levels of eosinophil cationic protein, eosinophil-derived neurotoxin, eosinophil peroxidase, eosinophil major basic protein, neutrophil elastase, myeloperoxidase, neutrophil proteinase-3, mast cell tryptase, leukotriene C4, and mast cell carboxypeptidase-A3 in individuals with asymptomatic Ss infection or without Ss infection [uninfected (UN)]. We also estimated the levels of all of these analytes in infected individuals following definitive treatment of Ss infection. We demonstrated that those infected individuals have significantly enhanced plasma levels of eosinophil cationic protein, eosinophil-derived neurotoxin, eosinophil peroxidase, eosinophil major basic protein, elastase, myeloperoxidase, mast cell tryptase, leukotriene C4, and carboxypeptidase-A3 compared to UN individuals. Following the treatment of Ss infection, each of these granulocyte-associated proteins drops significantly. Our data suggest that eosinophil, neutrophil, and mast cell activation may play a role in the response to Ss infection.

  19. Studies on prevalence of Strongyloides infection in Holambra and Maceió, Brazil, by the agar plate faecal culture method.

    PubMed

    Kobayashi, J; Hasegawa, H; Soares, E C; Toma, H; Dacal, A R; Brito, M C; Yamanaka, A; Foli, A A; Sato, Y

    1996-01-01

    Prevalence of Strongyloides stercoralis infection in three areas of Brazil was surveyed by a recently developed faecal culture method (an agar plate culture). The Strongyloides infection was confirmed in 11.3% of 432 subjects examined. The diagnostic efficacy of the agar plate culture was as high as 93.9% compared to only 28.5% and 26.5% by the Harada-Mori filter paper culture and faecal concentration methods, when faecal samples were examined simultaneously by these three methods. Among the 49 positive samples, about 60% were confirmed to be positive only by the agar plate culture. These results indicate that the agar plate culture is a sensitive new tool for the correct diagnosis of chronic Strongyloides infection.

  20. Albendazole Stimulates the Excretion of Strongyloides stercoralis Larvae in Stool Specimens and Enhances Sensitivity for Diagnosis of Strongyloidiasis▿

    PubMed Central

    Anamnart, Witthaya; Pattanawongsa, Attarat; Intapan, Pewpan Maleewong; Maleewong, Wanchai

    2010-01-01

    We succeeded in stimulation of excretion of Strongyloides stercoralis larvae in stool by oral administration of a single dose of 400 mg albendazole to strongyloidiasis patients. This result overcame the false-negative results of stool examination due to low larval numbers. Stool samples were collected from 152 asymptomatic strongyloidiasis patients in the morning, prior to eating. After breakfast, they were given a dose of 400 mg albendazole, and stool samples were collected the following morning. Agar plate culture (APC), modified formalin-ether concentration technique (MFECT), and direct-smear (DS) methods were used to examine stool specimens within 3 h after defecation. The results before and after albendazole was taken were compared. All APCs that were positive became negative after albendazole administration, while MFECT showed a 1.4- to 18.0-fold increase in larval numbers in 97.4% (148/152) of the samples. The DSs were positive in 3 out of 3 smears at a larval number of ≥45 larvae per g (lpg) of stool, and in 1or 2 out of 3 smears at a larval number between 35 and 44 lpg. At a larval number of <35 lpg, the DS became negative. Interestingly 90.5% (19/21) of the samples that were negative by all methods before albendazole administration became positive by MFECT after the treatment. Thus, MFECT can be effectively used for diagnosis of strongyloidiasis with prior administration of albendazole to the subject. PMID:20844212

  1. Strongyloides hyperinfection following hematopoietic stem cell transplant in a patient with HTLV-1-associated T-cell leukemia.

    PubMed

    Alpern, Jonathan D; Arbefeville, Sophie S; Vercellotti, Gregory; Ferrieri, Patricia; Green, Jaime S

    2017-02-01

    Strongyloides stercoralis has the potential to cause accelerated autoinfection in immunocompromised hosts. Screening tests for strongyloidiasis may be falsely negative in the setting of immunosuppression. We report a case of Strongyloides hyperinfection syndrome in a patient with human T-lymphotropic virus type 1-associated T-cell leukemia early after hematopoietic stem cell transplant. The diagnosis was made by stool ova and parasite examination, despite a negative screening enzyme-linked immunosorbent assay. Because of anticipated prolonged neutropenia, an extended course of treatment was utilized. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Accuracy of five serologic tests for the follow up of Strongyloides stercoralis infection.

    PubMed

    Buonfrate, Dora; Sequi, Marco; Mejia, Rojelio; Cimino, Ruben O; Krolewiecki, Alejandro J; Albonico, Marco; Degani, Monica; Tais, Stefano; Angheben, Andrea; Requena-Mendez, Ana; Muñoz, José; Nutman, Thomas B; Bisoffi, Zeno

    2015-02-01

    Traditional faecal-based methods have poor sensitivity for the detection of S. stercoralis, therefore are inadequate for post-treatment evaluation of infected patients who should be carefully monitored to exclude the persistence of the infection. In a previous study, we demonstrated high accuracy of five serology tests for the screening and diagnosis of strongyloidiasis. Aim of this study is to evaluate the performance of the same five tests for the follow up of patients infected with S. stercoralis. Retrospective study on anonymized, cryo-preserved samples available at the Centre for Tropical Diseases (Negrar, Verona, Italy). Samples were collected before and from 3 to 12 months after treatment. The samples were tested with two commercially-available ELISA tests (IVD, Bordier), two techniques based on a recombinant antigen (NIE-ELISA and NIE-LIPS) and one in-house IFAT. The results of each test were evaluated both in relation to the results of fecal examination and to those of a composite reference standard (classifying as positive a sample with positive stools and/or at least three positive serology tests). The associations between the independent variables age and time and the dependent variable value of serological test (for all five tests), were analyzed by linear mixed-effects regression model. A high proportion of samples demonstrated for each test a seroreversion or a relevant decline (optical density/relative light units halved or decrease of at least two titers for IFAT) at follow up, results confirmed by the linear mixed effects model that showed a trend to seroreversion over time for all tests. In particular, IVD-ELISA (almost 90% samples demonstrated relevant decline) and IFAT (almost 87%) had the best performance. Considering only samples with a complete negativization, NIE-ELISA showed the best performance (72.5% seroreversion). Serology is useful for the follow up of patients infected with S. stercoralis and determining test of cure.

  3. Discordances Between Serology and Culture for Strongyloides in an Ethiopian Adopted Child With Multiple Parasitic Infections

    PubMed Central

    Soriano-Arandes, Antoni; Sulleiro, Elena; Zarzuela, Francesc; Ruiz, Edurne; Clavería, Isabel; Espasa, Mateu

    2016-01-01

    Abstract Rationale: infectious diseases screening of international adoptees is complex because of the concurrence of different pathogens in a child at same time. We describe an international adopted child born at Ethiopia infected by 5 different pathogens (Hymenolepis nana, Giardia intestinalis, Entamoeba histolytica, Strongyloides stercoralis, and Trichuris trichiura), 2 of them S. stercoralis and E. histolytica with a capacity to develop severe clinical complications if not detected promptly with appropriate diagnosis tests. Concerns of the patient: according to the screening protocol a stool sample is always processed for culture addressed to find out protozoan and helminthic pathogens but not specifically for S. stercoralis. Only, when eosinophilia is detected 3 serial stool samples are collected to rule out intestinal parasitic infection including S. stercoralis. Interventions: in our case, S. stercoralis would not have been detected if we had followed the protocol because eosinophilia was absent and its specific serology was negative. Fortunately, the initial inclusion of the feces charcoal culture for S. stercoralis allowed us to detect this infection. Outcomes: discordances between direct methods such as culture and indirect as serology or antigen test forces us to be very cautious before ruling out S. stercoralis or E. histolytica infection, respectively. Also, if a child from tropical areas has persistent symptoms (such as diarrhea or fever) that have not been treated we have to rule out other infections that have not been detected yet. Main lessons: The introduction of different sequencing tests and the insistence to find out pathogens such as S. stercoralis or E. histolytica was determinant to be able to cure this symptomatic child and to prevent potential severe clinical forms in case of immunosuppression. PMID:26962825

  4. Validation of DESS as a DNA Preservation Method for the Detection of Strongyloides spp. in Canine Feces.

    PubMed

    Beknazarova, Meruyert; Millsteed, Shelby; Robertson, Gemma; Whiley, Harriet; Ross, Kirstin

    2017-06-09

    Strongyloides stercoralis is a gastrointestinal parasitic nematode with a life cycle that includes free-living and parasitic forms. For both clinical (diagnostic) and environmental evaluation, it is important that we can detect Strongyloides spp. in both human and non-human fecal samples. Real-time PCR is the most feasible method for detecting the parasite in both clinical and environmental samples that have been preserved. However, one of the biggest challenges with PCR detection is DNA degradation during the postage time from rural and remote areas to the laboratory. This study included a laboratory assessment and field validation of DESS (dimethyl sulfoxide, disodium EDTA, and saturated NaCl) preservation of Strongyloides spp. DNA in fecal samples. The laboratory study investigated the capacity of 1:1 and 1:3 sample to DESS ratios to preserve Strongyloides ratti in spike canine feces. It was found that both ratios of DESS significantly prevented DNA degradation compared to the untreated sample. This method was then validated by applying it to the field-collected canine feces and detecting Strongyloides DNA using PCR. A total of 37 canine feces samples were collected and preserved in the 1:3 ratio (sample: DESS) and of these, 17 were positive for Strongyloides spp. The study shows that both 1:1 and 1:3 sample to DESS ratios were able to preserve the Strongyloides spp. DNA in canine feces samples stored at room temperature for up to 56 days. This DESS preservation method presents the most applicable and feasible method for the Strongyloides DNA preservation in field-collected feces.

  5. Discordances Between Serology and Culture for Strongyloides in an Ethiopian Adopted Child With Multiple Parasitic Infections: A Case Report.

    PubMed

    Soriano-Arandes, Antoni; Sulleiro, Elena; Zarzuela, Francesc; Ruiz, Edurne; Clavería, Isabel; Espasa, Mateu

    2016-03-01

    infectious diseases screening of international adoptees is complex because of the concurrence of different pathogens in a child at same time. We describe an international adopted child born at Ethiopia infected by 5 different pathogens (Hymenolepis nana, Giardia intestinalis, Entamoeba histolytica, Strongyloides stercoralis, and Trichuris trichiura), 2 of them S. stercoralis and E. histolytica with a capacity to develop severe clinical complications if not detected promptly with appropriate diagnosis tests.Concerns of the patient: according to the screening protocol a stool sample is always processed for culture addressed to find out protozoan and helminthic pathogens but not specifically for S. stercoralis. Only, when eosinophilia is detected 3 serial stool samples are collected to rule out intestinal parasitic infection including S. stercoralis. in our case, S. stercoralis would not have been detected if we had followed the protocol because eosinophilia was absent and its specific serology was negative. Fortunately, the initial inclusion of the feces charcoal culture for S. stercoralis allowed us to detect this infection. discordances between direct methods such as culture and indirect as serology or antigen test forces us to be very cautious before ruling out S. stercoralis or E. histolytica infection, respectively. Also, if a child from tropical areas has persistent symptoms (such as diarrhea or fever) that have not been treated we have to rule out other infections that have not been detected yet.Main lessons: The introduction of different sequencing tests and the insistence to find out pathogens such as S. stercoralis or E. histolytica was determinant to be able to cure this symptomatic child and to prevent potential severe clinical forms in case of immunosuppression.

  6. Chemoattraction and chemorepulsion of Strongyloides stercoralis infective larvae on a sodium chloride gradient is mediated by amphidial neuron pairs ASE and ASH, respectively.

    PubMed

    Forbes, W M; Ashton, F T; Boston, R; Zhu, X; Schad, G A

    2004-03-25

    Depending on its concentration, sodium chloride acts as either an attractant or a repellant to the infective larvae (L3i) of Strongyloides stercoralis. On a concentration gradient, L3i are attracted to 0.05 M NaCl, but repelled by 2.8M. To test the hypothesis that amphidial neurons ASE and ASH might mediate attraction and repulsion, respectively, these neurons, and control neurons as well, were ablated in hatchling larvae with a laser microbeam. After the larvae attained infectivity (L3i), they were tested on a NaCl gradient. When placed at low salinity, 73.5% of normal controls migrated "up" the gradient, while 26.4% crawled randomly. In contrast, only 20.6% of ASE-ablated L3i migrated "up" the gradient, while 79.4% migrated randomly. Ablation-control ASK-ablated L3i (58.8%) migrated "up" the gradient while 41.1% crawled randomly. When placed at a region of high salinity, 100% of normal control L3i migrated "down" the gradient, whereas 62.5% of ASH-ablated L3i migrated randomly, the remaining 37.5% migrating "down" the gradient. In sharp contrast with ASH-ablated L3i, 94.1% of ablation-control larvae, i.e. ASK-ablated L3i, migrated "down" the gradient. Migration behavior of ASE- and ASH-ablated L3i was significantly different (P < 0.001) from that of ASK-ablated L3i and normal controls. It is noteworthy that 87.5% of ASE-ablated L3i that failed to exhibit chemoattractive behavior were actively chemorepelled from high salinity. Also, 70.0% of ASH-ablated L3i that failed to be chemorepelled from high salinity were capable of chemoattractive behavior, indicating that the worms had retained their behavioral responses except for those associated with the targeted neurons.

  7. Genetic characterization of Strongyloides spp. from captive, semi-captive and wild Bornean orangutans (Pongo pygmaeus) in Central and East Kalimantan, Borneo, Indonesia.

    PubMed

    Labes, E M; Nurcahyo, W; Wijayanti, N; Deplazes, P; Mathis, A

    2011-09-01

    Orangutans (Pongo spp.), Asia's only great apes, are threatened in their survival due to habitat loss, hunting and infections. Nematodes of the genus Strongyloides may represent a severe cause of death in wild and captive individuals. In order to better understand which Strongyloides species/subspecies infect orangutans under different conditions, larvae were isolated from fecal material collected in Indonesia from 9 captive, 2 semi-captive and 9 wild individuals, 18 captive groups of Bornean orangutans and from 1 human working with wild orangutans. Genotyping was done at the genomic rDNA locus (part of the 18S rRNA gene and internal transcribed spacer 1, ITS1) by sequencing amplicons. Thirty isolates, including the one from the human, could be identified as S. fuelleborni fuelleborni with 18S rRNA gene identities of 98·5-100%, with a corresponding published sequence. The ITS1 sequences could be determined for 17 of these isolates revealing a huge variability and 2 main clusters without obvious pattern with regard to attributes of the hosts. The ITS1 amplicons of 2 isolates were cloned and sequenced, revealing considerable variability indicative of mixed infections. One isolate from a captive individual was identified as S. stercoralis (18S rRNA) and showed 99% identity (ITS1) with S. stercoralis sequences from geographically distinct locations and host species. The findings are significant with regard to the zoonotic nature of these parasites and might contribute to the conservation of remaining orangutan populations.

  8. Altered levels of memory T cell subsets and common γc cytokines in Strongyloides stercoralis infection and partial reversal following anthelmintic treatment.

    PubMed

    Rajamanickam, Anuradha; Munisankar, Saravanan; Bhootra, Yukti; Dolla, Chandra Kumar; Thiruvengadam, Kannan; Nutman, Thomas B; Babu, Subash

    2018-05-01

    CD4+ and CD8+ T cells are central players in immunity to helminth infections. However, the role of T cell subsets in human helminth infections is not well understood. In addition, the common γc cytokines, IL-2, IL-4, IL-7, IL-9 and IL-15 play an important role in the maintenance of these CD4+ and CD8+ T cell subsets. To examine the major T cell subsets and their association with the common γc cytokines, the absolute numbers of CD4+ and CD8+ naïve, central memory, effector memory and effector cells and the plasma levels of IL-2, IL-4, IL-7, IL-9 and IL-15 were measured in Strongyloides stercoralis (Ss) infected (INF, n = 60), helminth-uninfected (UN, n = 58) and in post treatment INF individuals. Ss infection is characterized by significantly increased absolute numbers of naïve and decreased absolute numbers of central and effector memory CD4+ T cells in comparison to UN individuals. No significant difference in the numbers of CD8+ T cell subsets was observed between the groups. The numbers of naïve cells and central memory CD4+ T cells were significantly reversed after anthelmintic treatment. Circulating levels of IL-2, IL-7 and IL-15 were significantly diminished, whereas the levels of IL-4 and IL-9 were significantly increased in INF compared to UN individuals. Following anthelminthic treatment, IL-2, IL-7 and IL-15 levels were significantly increased, while IL-4 and IL-9 levels were significantly decreased. Our data also showed a significant positive correlation between the levels of IL-7 and the numbers of central and effector memory CD4+ T cells. Ss infection is characterized by alterations in the absolute numbers of CD4+ T cell subsets and altered levels of common γc cytokines IL-2, IL-4, IL-7, IL-9 and IL-15; alterations which are partially reversed after anthelmintic treatment.

  9. [Strongyloides infections in former prisoners of war in South-East Asia in the second World War; additional information from serological diagnosis].

    PubMed

    Polderman, A M; Verweij, J J; Vetter, J C; Verburg, G P; de Geus, A

    1994-06-04

    To analyse the efficacy of ELISA serology in patients with Strongyloides infection acquired during World War II and maintained through repeated autoinfection. Descriptive. Laboratory of Parasitology, Faculty of Medicine, Leiden, the Netherlands. Parasitological and clinical data on 193 ex-prisoners of war (South-east Asia) were presented previously (1990) by Verburg and De Geus. ELISA using L-3 S. ratti antigen was carried out with sera of these patients and the results were compared with those of repeated stool examinations using Baermann's method. All subjects harbouring larvae in repeated stool examinations (26) were positive in serology. In 21 out of 167 patients in whom no larvae could be demonstrated, specific antibodies were detected. Anamnestic information together with data on eosinophilia and IgE levels suggested that the majority of these subjects were actually infected. The serological prevalence of infection with Strongyloides stercoralis was 33% for those imprisoned in Burma and 4% for those who were prisoners of war in the former Netherlands East Indies. In the group of subjects studied, in whom Strongyloides infection was apparently maintained through a process of autoinfection for a period of over 40 years, serology appears a sensitive and specific diagnostic tool. Larvae could be detected in no more than 26 out of 47 serologically positive subjects.

  10. Strong-LAMP: A LAMP Assay for Strongyloides spp. Detection in Stool and Urine Samples. Towards the Diagnosis of Human Strongyloidiasis Starting from a Rodent Model.

    PubMed

    Fernández-Soto, Pedro; Sánchez-Hernández, Alicia; Gandasegui, Javier; Bajo Santos, Cristina; López-Abán, Julio; Saugar, José María; Rodríguez, Esperanza; Vicente, Belén; Muro, Antonio

    2016-07-01

    Strongyloides stercoralis, the chief causative agent of human strongyloidiasis, is a nematode globally distributed but mainly endemic in tropical and subtropical regions. Chronic infection is often clinically asymptomatic but it can result in severe hyperinfection syndrome or disseminated strongyloidiasis in immunocompromised patients. There is a great diversity of techniques used in diagnosing the disease, but definitive diagnosis is accomplished by parasitological examination of stool samples for morphological identification of parasite. Until now, no molecular method has been tested in urine samples as an alternative to stool samples for diagnosing strongyloidiasis. This study aimed to evaluate the use of a new molecular LAMP assay in a well-established Wistar rat experimental infection model using both stool and, for the first time, urine samples. The LAMP assay was also clinically evaluated in patients´ stool samples. Stool and urine samples were obtained daily during a 28-day period from rats infected subcutaneously with different infective third-stage larvae doses of S. venezuelensis. The dynamics of parasite infection was determined by daily counting the number of eggs per gram of feces from day 1 to 28 post-infection. A set of primers for LAMP assay based on a DNA partial sequence in the 18S rRNA gene from S. venezuelensis was designed. The set up LAMP assay (namely, Strong-LAMP) allowed the sensitive detection of S. venezuelensis DNA in both stool and urine samples obtained from each infection group of rats and was also effective in S. stercoralis DNA amplification in patients´ stool samples with previously confirmed strongyloidiasis by parasitological and real-time PCR tests. Our Strong-LAMP assay is an useful molecular tool in research of a strongyloidiasis experimental infection model in both stool and urine samples. After further validation, the Strong-LAMP could also be potentially applied for effective diagnosis of strongyloidiasis in a clinical

  11. Organ donor screening practices for Strongyloides stercoralis infection among US organ procurement organizations.

    PubMed

    Abanyie, Francisca A; Valice, Emily; Delli Carpini, Kristin W; Gray, Elizabeth B; McAuliffe, Isabel; Chin-Hong, Peter V; Handali, Sukwan; Montgomery, Susan P; Huprikar, Shirish

    2018-03-07

    Targeted donor screening for strongyloidiasis performed at the time of organ procurement can prevent this life-threatening donor-derived infection. The Association of Organ Procurement Organizations surveyed members to determine the number of US organ procurement organizations (OPOs) performing donor screening for Strongyloides infection and their screening practices. All 58 OPOs responded to the survey. Only 6 (10%) currently screen donors for strongyloidiasis; most OPOs started 6-36 months before the survey and one started 6 years prior. All used risk-based criteria to determine which donors to screen, though the criteria varied among OPOs. A median of 56 donors have been screened at each OPO since initiating their screening programs, with a median of 2 infected donors (range 0-13) identified. Overall, 53 organs have been transplanted from 22 infected donors, including hearts, lungs, kidneys, and livers. Of 52 OPOs not currently screening, 20 had considered screening and one plans to start screening in the near future. Of those considering risk-based screening, most had not decided on the criteria. Uncertainty about the benefits of and guidelines for screening and misconceptions about the interpretation of test results were concerns shared by non-screening OPOs. Continued education and advocacy on the importance of targeted donor screening are needed. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

  12. Dexamethasone Effects in the Strongyloides venezuelensis Infection in A Murine Model

    PubMed Central

    Machado, Eleuza R.; Carlos, Daniela; Sorgi, Carlos A.; Ramos, Simone G.; Souza, Daniela I.; Soares, Edson G.; Costa-Cruz, Julia M.; Ueta, Marlene T.; Aronoff, David M.; Faccioli, Lúcia H.

    2011-01-01

    The aim of this study was to investigate the immunomodulatory effects of glucocorticoids on the immune response to Strongyloides venezuelensis in mice. Balb/c mice were infected with S. venezuelensis and treated with Dexamethasone (Dexa) or vehicle. Dexa treatment increased circulating blood neutrophil numbers and inhibited eosinophil and mononuclear cell accumulation in the blood, bronchoalveolar, and peritoneal fluid compared with control animals. Moreover, Dexa decreased tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-3 (IL-3), IL-4, IL-5, IL-10, and IL-12 production in the lungs and circulating immunoglobulin G1 (IgG1), IgG2a, and IgE antibody levels while increasing the overall parasite burden in the feces and intestine. Dexa treatment enhanced the fertility of female nematodes relative to untreated and infected mice. In summary, the alterations in the immune response induced by Dexa resulted in a blunted, aberrant immune response associated with increased parasite burden. This phenomenon is similar to that observed in S. stercoralis-infected humans who are taking immunosuppressive or antiinflammatory drugs, including corticosteroids. PMID:21633034

  13. Strong-LAMP: A LAMP Assay for Strongyloides spp. Detection in Stool and Urine Samples. Towards the Diagnosis of Human Strongyloidiasis Starting from a Rodent Model

    PubMed Central

    Gandasegui, Javier; Bajo Santos, Cristina; López-Abán, Julio; Saugar, José María; Rodríguez, Esperanza; Vicente, Belén; Muro, Antonio

    2016-01-01

    Background Strongyloides stercoralis, the chief causative agent of human strongyloidiasis, is a nematode globally distributed but mainly endemic in tropical and subtropical regions. Chronic infection is often clinically asymptomatic but it can result in severe hyperinfection syndrome or disseminated strongyloidiasis in immunocompromised patients. There is a great diversity of techniques used in diagnosing the disease, but definitive diagnosis is accomplished by parasitological examination of stool samples for morphological identification of parasite. Until now, no molecular method has been tested in urine samples as an alternative to stool samples for diagnosing strongyloidiasis. This study aimed to evaluate the use of a new molecular LAMP assay in a well-established Wistar rat experimental infection model using both stool and, for the first time, urine samples. The LAMP assay was also clinically evaluated in patients´ stool samples. Methodology/Principal Findings Stool and urine samples were obtained daily during a 28-day period from rats infected subcutaneously with different infective third-stage larvae doses of S. venezuelensis. The dynamics of parasite infection was determined by daily counting the number of eggs per gram of feces from day 1 to 28 post-infection. A set of primers for LAMP assay based on a DNA partial sequence in the 18S rRNA gene from S. venezuelensis was designed. The set up LAMP assay (namely, Strong-LAMP) allowed the sensitive detection of S. venezuelensis DNA in both stool and urine samples obtained from each infection group of rats and was also effective in S. stercoralis DNA amplification in patients´ stool samples with previously confirmed strongyloidiasis by parasitological and real-time PCR tests. Conclusions/Significance Our Strong-LAMP assay is an useful molecular tool in research of a strongyloidiasis experimental infection model in both stool and urine samples. After further validation, the Strong-LAMP could also be potentially

  14. Maltreatment of Strongyloides infection: case series and worldwide physicians-in-training survey.

    PubMed

    Boulware, David R; Stauffer, William M; Hendel-Paterson, Brett R; Rocha, Jaime Luís Lopes; Seet, Raymond Chee-Seong; Summer, Andrea P; Nield, Linda S; Supparatpinyo, Khuanchai; Chaiwarith, Romanee; Walker, Patricia F

    2007-06-01

    Strongyloidiasis infects hundreds of millions of people worldwide and is an important cause of mortality from intestinal helminth infection in developed countries. The persistence of infection, increasing international travel, lack of familiarity by health care providers, and potential for iatrogenic hyperinfection all make strongyloidiasis an important emerging infection. Two studies were performed. A retrospective chart review of Strongyloides stercoralis cases identified through microbiology laboratory records from 1993-2002 was conducted. Subsequently, 363 resident physicians in 15 training programs worldwide were queried with a case scenario of strongyloidiasis, presenting an immigrant with wheezing and eosinophilia. The evaluation focused on resident recognition and diagnostic recommendations. In 151 strongyloidiasis cases, stool ova and parasite sensitivity is poor (51%), and eosinophilia (>5% or >400 cells/microL) commonly present (84%). Diagnosis averaged 56 months (intra-quartile range: 4-72 months) after immigration. Presenting complaints were nonspecific, although 10% presented with wheezing. Hyperinfection occurred in 5 patients prescribed corticosteroids, with 2 deaths. Treatment errors occurred more often among providers unfamiliar with immigrant health (relative risk of error: 8.4; 95% confidence interval, 3.4-21.0; P <.001). When presented with a hypothetical case scenario, US physicians-in-training had poor recognition (9%) of the need for parasite screening and frequently advocated empiric corticosteroids (23%). International trainees had superior recognition at 56% (P <.001). Among US trainees, 41% were unable to choose any parasite causing pulmonary symptoms. Strongyloidiasis is present in US patients. Diagnostic consideration should occur with appropriate exposure, nonspecific symptoms including wheezing, or eosinophilia (>5% relative or >400 eosinophils/microL). US residents' helminth knowledge is limited and places immigrants in iatrogenic

  15. Maltreatment of Strongyloides infection: Case series and worldwide physicians-in-training survey

    PubMed Central

    Boulware, David R.; Stauffer, William M.; Hendel-Paterson, Brett R.; Rocha, Jaime Luís Lopes; Seet, Raymond Chee-Seong; Summer, Andrea P.; Nield, Linda S.; Supparatpinyo, Khuanchai; Chaiwarith, Romanee; Walker, Patricia F.

    2007-01-01

    Background Strongyloidiasis infects hundreds of millions of people worldwide and is an important cause of mortality from intestinal helminth infection in developed countries. The persistence of infection, increasing international travel, lack of familiarity by healthcare providers, and potential for iatrogenic hyperinfection, all make strongyloidiasis an important emerging infection. Design & Methods Two studies were performed. A retrospective chart review of Strongyloides stercoralis cases identified through microbiology laboratory records from 1993–2002 was conducted. Subsequently, 363 resident physicians in 15 training programs worldwide were queried with a case scenario of strongyloidiasis presenting an immigrant with wheezing and eosinophilia. The evaluation focused on resident recognition and diagnostic recommendations. Results In 151 strongyloidiasis cases, stool ova and parasite sensitivity is poor (51%), and eosinophilia (>5% or >400 cells/μL) commonly present (84%). Diagnosis averaged 56 months (Intra-quartile range: 4 to 72 months) after immigration. Presenting complaints were non-specific, although 10% presented with wheezing. Hyperinfection occurred in five patients prescribed corticosteroids with two deaths. Treatment errors occurred more often among providers unfamiliar with immigrant health (Relative Risk of Error: 8.4; 95% CI: 3.4 to 21.0; P<0.001). When presented a hypothetical case scenario, U.S. physicians-in-training had poor recognition (9%) of the need for parasite screening and frequently advocated empiric corticosteroids (23%). International trainees had superior recognition at 56% (P<0.001). Among U.S. trainees, 41% were unable to choose any parasite causing pulmonary symptoms. Conclusions Strongyloidiasis is present in U.S. patients. Diagnostic consideration should occur with appropriate exposure, non-specific symptoms including wheezing, or eosinophilia (>5% relative or >400 eosinophils/μL). U.S. residents’ helminth knowledge is

  16. Occurrence of strongyloidiasis among patients with HTLV-1/2 seen at the outpatient clinic of the Núcleo de Medicina Tropical, Belém, State of Pará, Brazil.

    PubMed

    Furtado, Karen Cristini Yumi Ogawa; Costa, Carlos Araújo da; Ferreira, Louise de Souza Canto; Martins, Luisa Carício; Linhares, Alexandre da Costa; Ishikawa, Edna Aoba Yassui; Batista, Evander de Jesus Oliveira; Sousa, Maisa Silva de

    2013-01-01

    This study investigated the occurrence of Strongyloides stercoralis infestation and coinfection with HTLV-1/2 in Belém, Brazil. S. stercoralis was investigated in stool samples obtained from individuals infected with HTLV-1/2 and their uninfected relatives. The frequency of S. stercoralis was 9% (9/100), including six patients infected with HTLV-1 (14.3%), two patients infected with HTLV-2 (11.1%), and one uninfected relative. Two cases of hyperinfestation by S. stercoralis were characterized as HTLV-1. These results support the need for the routine investigation of S. stercoralis in patients with HTLV-1, in an attempt to prevent the development of severe forms of strongyloidiasis.

  17. Transrenal DNA-based diagnosis of Strongyloides stercoralis (Grassi, 1879) infection: Bayesian latent class modeling of test accuracy.

    PubMed

    Krolewiecki, Alejandro J; Koukounari, Artemis; Romano, Miryam; Caro, Reynaldo N; Scott, Alan L; Fleitas, Pedro; Cimino, Ruben; Shiff, Clive J

    2018-06-01

    For epidemiological work with soil transmitted helminths the recommended diagnostic approaches are to examine fecal samples for microscopic evidence of the parasite. In addition to several logistical and processing issues, traditional diagnostic approaches have been shown to lack the sensitivity required to reliably identify patients harboring low-level infections such as those associated with effective mass drug intervention programs. In this context, there is a need to rethink the approaches used for helminth diagnostics. Serological methods are now in use, however these tests are indirect and depend on individual immune responses, exposure patterns and the nature of the antigen. However, it has been demonstrated that cell-free DNA from pathogens and cancers can be readily detected in patient's urine which can be collected in the field, filtered in situ and processed later for analysis. In the work presented here, we employ three diagnostic procedures-stool examination, serology (NIE-ELISA) and PCR-based amplification of parasite transrenal DNA from urine-to determine their relative utility in the diagnosis of S. stercoralis infections from 359 field samples from an endemic area of Argentina. Bayesian Latent Class analysis was used to assess the relative performance of the three diagnostic procedures. The results underscore the low sensitivity of stool examination and support the idea that the use of serology combined with parasite transrenal DNA detection may be a useful strategy for sensitive and specific detection of low-level strongyloidiasis.

  18. Occurrence of strongyloidiasis in privately owned and sheltered dogs: clinical presentation and treatment outcome.

    PubMed

    Paradies, Paola; Iarussi, Fabrizio; Sasanelli, Mariateresa; Capogna, Antonio; Lia, Riccardo Paolo; Zucca, Daniele; Greco, Beatrice; Cantacessi, Cinzia; Otranto, Domenico

    2017-07-20

    The increasing number of reports of human infections by Strongyloides stercoralis from a range of European countries over the last 20 years has spurred the interest of the scientific community towards this parasite and, in particular, towards the role that infections of canine hosts may play in the epidemiology of human disease. Data on the epidemiology of canine strongyloidiasis is currently limited, most likely because of the inherent limitations of current diagnostic methods. Faecal samples were collected directly from the rectal ampulla of 272 animals of varying age and both genders living in Apulia, southern Italy. Dogs included were either privately owned (n = 210), living in an urban area but with unrestricted outdoor access (Group 1), or shelter dogs (n = 62 out of ~400) hosted in a single shelter in the province of Bari in which a history of diarrhoea, weight loss, reduced appetite and respiratory symptoms had been reported (Group 2). Strongyloides stercoralis infection was diagnosed by coproscopy on direct faecal smear and via the Baermann method. Six of 272 dogs were positive for S. stercoralis at the Baermann examination; all but one were from the shelter (Group 2) and displayed gastrointestinal clinical signs. The only owned dog (Group 1) infected with S. stercoralis, but clinically healthy, had been adopted from a shelter 1 year prior to sampling. Five infected dogs were treated with fenbendazole (Panacur®, Intervet, Animal Health, 50 mg/kg, PO daily for 5 days), or with a combination of fenbendazole and moxidectin plus imidacloprid spot-on (Im/Mox; Advocate® spot-on, Bayer). Post-treatment clearance of infection was confirmed in three dogs by Baermann examination, whereas treatment failure was documented in two dogs by Baermann and/or post-mortem detection of adult parasites. This study describes, for the first time, the presence of S. stercoralis infection in sheltered dogs from southern Italy. Data indicate that S. stercoralis infection

  19. Strongyloidiasis in an institution for mentally retarded adults.

    PubMed

    Braun, T I; Fekete, T; Lynch, A

    1988-03-01

    A serologic and epidemiologic survey was undertaken to explain the high incidence of eosinophilia (14.1%) in nine of 64 residents of a facility for mentally retarded adults in Pennsylvania. Seven residents had antibodies to Strongyloides stercoralis as determined by an IgG enzyme-linked immunosorbent assay system (10.9%) and five (71.4%) of this subset had persistent eosinophilia, suggesting a strong association. Sex, race, age, ward, degree of retardation, and medication were not associated with eosinophilia. Stool examination revealed S stercoralis larvae in two residents with S stercoralis antibodies and eosinophilia. Follow-up studies after thiabendazole treatment of the residents with S stercoralis antibodies showed resolution of eosinophilia and disappearance of S stercoralis antibodies in most. Eosinophilia in an adult institutional setting may be associated with strongyloidiasis, even in a nonendemic area. The enzyme-linked immunosorbent assay for antibody to S stercoralis may be useful in diagnosing or monitoring therapy of strongyloidiasis.

  20. Epidemiology of human toxocariasis in northern Italy.

    PubMed

    Genchi, C; Di Sacco, B; Gatti, S; Sangalli, G; Scaglia, M

    1990-12-01

    Sera from both clinically healthy adults (2112) and adult patients (471) were tested to assess the main risk factors for Toxocara infection in humans in Northern Italy. The patient group included 257 adult epileptics, 76 Strongyloides stercoralis-infected adult patients and 142 institutionalized mentally retarded adult patients. The overall seroprevalence in healthy population was 3.98%. No significant differences in seroprevalence were observed for sex, residence (urban or rural) or dog ownership, while seroprevalence significantly increased with age (18- greater than 51 years). Highest seroprevalence values were found in outdoor or soil-related workers. The seroprevalence was 4.35% in adult epileptics, 9.21% in Strongyloides stercoralis-infected patients and 14.47%-10.61% among institutionalized mentally retarded patients. These findings suggest that the prevalent source of human toxocariasis is the environmental contamination by infectious eggs of the parasite.

  1. Disseminated strongyloidiasis in a immunocompromised host.

    PubMed

    Mundkur, Suneel C; Aroor, Shrikiran; Jayashree, K

    2011-12-01

    Strongyloidiasis in an immunocompromised patient has the potential to be life threatening. We describe a boy who was on steroids for acute demyelinating myelitis and receiving antibiotics for E. coli UTI and meningitis. He developed anasarca, malabsorption, malnutrition and left ventricular failure. Duodenal biopsy revealed abundant rhabditiform larvae of Strongyloides stercoralis. The diagnosis went unsuspected and proved fatal. This emphasizes the need to have a high index of suspicion and early intervention for S. stercoralis in immunosuppressed persons who present with refractory gastrointestinal symptoms.

  2. SURVEY OF HOUSE RAT INTESTINAL PARASITES FROM SURABAYA DISTRICT, EAST JAVA, INDONESIA THAT CAN CAUSE OPPORTUNISTIC INFECTIONS IN HUMANS.

    PubMed

    Prasetyo, R H

    2016-03-01

    The purpose of this study was to investigate the prevalence of house rat zoonotic intestinal parasites from Surabaya District, East Java, Indonesia that have the potential to cause opportunistic infection in humans. House rat fecal samples were collected from an area of Surabaya District with a dense rat population during May 2015. Intestinal parasites were detected microscopically using direct smear of feces stained with Lugol's iodine and modified Ziehl-Neelsen stains. The fecal samples were also cultured for Strongyloides stercoralis. Ninety-eight house rat fecal samples were examined. The potential opportunistic infection parasite densities found in those samples were Strongyloides stercoralis in 53%, Hymenolepis nana in 42%, Cryptosporidium spp in 33%, and Blastocystis spp in 6%. This is the first report of this kind in Surabaya District. Measures need to be taken to control the house rat population in the study area to reduce the risk of the public health problem. Keywords: zoonotic intestinal parasites, opportunistic infection, house rat, densely populated area, Indonesia

  3. Strongyloidiasis Current Status with Emphasis in Diagnosis and Drug Research

    PubMed Central

    Minori, Karen

    2017-01-01

    Strongyloidiasis is a parasitic neglected disease caused by the nematode Strongyloides stercoralis affecting 30 to 100 million people worldwide. Complications, strongly associated with alcoholism, organ transplants, and HTLV-1 virus, often arise due to late diagnosis, frequently leading to patient death. Lack of preemptive diagnosis is not the only difficulty when dealing with this parasite, since there are no gold standard diagnostic techniques, and the ones used have problems associated with sensitivity, resulting in false negatives. Treatment is also an issue as ivermectin and benzimidazoles administration leads to inconsistent cure rates and several side effects. Researching new anti-Strongyloides drugs is a difficult task since S. stercoralis does not develop until the adult stages in Mus musculus (with the exception of SCID mice), the main experimental host model. Fortunately, alternative parasite models can be used, namely, Strongyloides ratti and S. venezuelensis. However, even with these models, there are other complications in finding new drugs, which are associated with specific in vitro assay protocol steps, such as larvae decontamination. In this review, we highlight the challenges associated with new drug search, the compounds tested, and a list of published in vitro assay methodologies. We also point out advances being made in strongyloidiasis diagnosis so far. PMID:28210503

  4. Strongyloides seroprevalence before and after an ivermectin mass drug administration in a remote Australian Aboriginal community

    PubMed Central

    Currie, Bart J.; Cheng, Allen C.; McCarthy, James; Carapetis, Jonathan R.; Holt, Deborah C.; Page, Wendy; Shield, Jennifer; Gundjirryirr, Roslyn; Mulholland, Eddie; Ward, Linda; Andrews, Ross M.

    2017-01-01

    Background Strongyloides seroprevalence is hyper-endemic in many Australian Aboriginal and Torres Strait Islander communities, ranging from 35–60%. We report the impact on Strongyloides seroprevalence after two oral ivermectin mass drug administrations (MDAs) delivered 12 months apart in a remote Australian Aboriginal community. Methods Utilizing a before and after study design, we measured Strongyloides seroprevalence through population census with sequential MDAs at baseline and month 12. Surveys at months 6 and 18 determined changes in serostatus. Serodiagnosis was undertaken by ELISA that used sonicated Strongyloides ratti antigen to detect anti-Strongyloides IgG. Non-pregnant participants weighing ≥15 kg were administered a single 200 μg/kg ivermectin dose, repeated after 10–42 days if Strongyloides and/or scabies was diagnosed; others followed a standard alternative algorithm. A questionnaire on clinical symptoms was administered to identify adverse events from treatment and self-reported symptoms associated with serostatus. Findings We surveyed 1013 participants at the baseline population census and 1060 (n = 700 from baseline cohort and 360 new entrants) at month 12. Strongyloides seroprevalence fell from 21% (175/818) at baseline to 5% at month 6. For participants from the baseline cohort this reduction was sustained at month 12 (34/618, 6%), falling to 2% at month 18 after the second MDA. For new entrants to the cohort at month 12, seroprevalence reduced from 25% (75/297) to 7% at month 18. Strongyloides positive seroconversions for the baseline cohort six months after each MDA were 2.5% (4/157) at month 6 and 1% at month 18, whilst failure to serorevert remained unchanged at 18%. At 12 months, eosinophilia was identified in 59% of baseline seropositive participants and 89% of seropositive new entrants, compared with 47%baseline seronegative participants and 51% seronegative new entrants. Seropositivity was not correlated with haemoglobin or any

  5. Bacteriophage-Fused Peptides for Serodiagnosis of Human Strongyloidiasis

    PubMed Central

    Feliciano, Nágilla Daliane; Ribeiro, Vanessa da Silva; Santos, Fabiana de Almeida Araújo; Fujimura, Patricia Tiemi; Gonzaga, Henrique Tomaz; Goulart, Luiz Ricardo; Costa-Cruz, Julia Maria

    2014-01-01

    Background Strongyloidiasis, a human intestinal infection caused by the nematode Strongyloides stercoralis, is frequently underdiagnosed and although its high prevalence is still a neglected parasitic disease because conventional diagnostic tests based on parasitological examination (presence of Strongyloides larvae in stool) are not sufficiently sensitive due to the low parasitic load and to the irregular larval output. There is an urgent need to improve diagnostic assays, especially for immunocompromised patients with high parasitic load as consequence of self-infection cycle, which can disseminate throughout the body, resulting in a potentially fatal hyperinfection syndrome often accompanied by sepsis or meningitis. Methods/Principal Findings We have performed Phage Display technology to select peptides that mimic S. stercoralis antigens, capable of detecting a humoral response in patients with strongyloidiasis. The peptides reactivity was investigated by Phage-ELISA through different panels of serum samples. We have successfully selected five peptides with significant immunoreactivity to circulating IgG from patients' sera with strongyloidiasis. The phage displayed peptides C9 and C10 presented the highest diagnostic potential (AUC>0.87) with excellent sensitivity (>85%) and good specificity (>77.5%), suggesting that some S. stercoralis antigens trigger systemic immune response. Conclusions/Significance These novel antigens are interesting serum biomarkers for routine strongyloidiasis screenings due to the easy production and simple assay using Phage-ELISA. Such markers may also present a promising application for therapeutic monitoring. PMID:24874206

  6. Bacteriophage-fused peptides for serodiagnosis of human strongyloidiasis.

    PubMed

    Feliciano, Nágilla Daliane; Ribeiro, Vanessa da Silva; Santos, Fabiana de Almeida Araújo; Fujimura, Patricia Tiemi; Gonzaga, Henrique Tomaz; Goulart, Luiz Ricardo; Costa-Cruz, Julia Maria

    2014-01-01

    Strongyloidiasis, a human intestinal infection caused by the nematode Strongyloides stercoralis, is frequently underdiagnosed and although its high prevalence is still a neglected parasitic disease because conventional diagnostic tests based on parasitological examination (presence of Strongyloides larvae in stool) are not sufficiently sensitive due to the low parasitic load and to the irregular larval output. There is an urgent need to improve diagnostic assays, especially for immunocompromised patients with high parasitic load as consequence of self-infection cycle, which can disseminate throughout the body, resulting in a potentially fatal hyperinfection syndrome often accompanied by sepsis or meningitis. We have performed Phage Display technology to select peptides that mimic S. stercoralis antigens, capable of detecting a humoral response in patients with strongyloidiasis. The peptides reactivity was investigated by Phage-ELISA through different panels of serum samples. We have successfully selected five peptides with significant immunoreactivity to circulating IgG from patients' sera with strongyloidiasis. The phage displayed peptides C9 and C10 presented the highest diagnostic potential (AUC>0.87) with excellent sensitivity (>85%) and good specificity (>77.5%), suggesting that some S. stercoralis antigens trigger systemic immune response. These novel antigens are interesting serum biomarkers for routine strongyloidiasis screenings due to the easy production and simple assay using Phage-ELISA. Such markers may also present a promising application for therapeutic monitoring.

  7. Diverse Host-Seeking Behaviors of Skin-Penetrating Nematodes

    PubMed Central

    Castelletto, Michelle L.; Gang, Spencer S.; Okubo, Ryo P.; Tselikova, Anastassia A.; Nolan, Thomas J.; Platzer, Edward G.; Lok, James B.; Hallem, Elissa A.

    2014-01-01

    Skin-penetrating parasitic nematodes infect approximately one billion people worldwide and are responsible for some of the most common neglected tropical diseases. The infective larvae of skin-penetrating nematodes are thought to search for hosts using sensory cues, yet their host-seeking behavior is poorly understood. We conducted an in-depth analysis of host seeking in the skin-penetrating human parasite Strongyloides stercoralis, and compared its behavior to that of other parasitic nematodes. We found that Str. stercoralis is highly mobile relative to other parasitic nematodes and uses a cruising strategy for finding hosts. Str. stercoralis shows robust attraction to a diverse array of human skin and sweat odorants, most of which are known mosquito attractants. Olfactory preferences of Str. stercoralis vary across life stages, suggesting a mechanism by which host seeking is limited to infective larvae. A comparison of odor-driven behavior in Str. stercoralis and six other nematode species revealed that parasite olfactory preferences reflect host specificity rather than phylogeny, suggesting an important role for olfaction in host selection. Our results may enable the development of new strategies for combating harmful nematode infections. PMID:25121736

  8. Failure of Ivermectin per Rectum to Achieve Clinically Meaningful Serum Levels in Two Cases of Strongyloides Hyperinfection

    PubMed Central

    Bogoch, Isaac I.; Khan, Kamran; Abrams, Howard; Nott, Caroline; Leung, Elizabeth; Fleckenstein, Lawrence; Keystone, Jay S.

    2015-01-01

    Two cases of Strongyloides hyperinfection are presented. Ivermectin was initially administered orally and per rectum pending the availability of subcutaneous (SC) preparations. In neither case did rectal suppositories of ivermectin achieve clinically meaningful serum values. Clinicians should use SC preparations of ivermectin as early as possible in Strongyloides hyperinfection and dissemination. PMID:25918215

  9. Targeted mutagenesis in a human-parasitic nematode

    PubMed Central

    Gang, Spencer S.; Castelletto, Michelle L.

    2017-01-01

    Parasitic nematodes infect over 1 billion people worldwide and cause some of the most common neglected tropical diseases. Despite their prevalence, our understanding of the biology of parasitic nematodes has been limited by the lack of tools for genetic intervention. In particular, it has not yet been possible to generate targeted gene disruptions and mutant phenotypes in any parasitic nematode. Here, we report the development of a method for introducing CRISPR-Cas9-mediated gene disruptions in the human-parasitic threadworm Strongyloides stercoralis. We disrupted the S. stercoralis twitchin gene unc-22, resulting in nematodes with severe motility defects. Ss-unc-22 mutations were resolved by homology-directed repair when a repair template was provided. Omission of a repair template resulted in deletions at the target locus. Ss-unc-22 mutations were heritable; we passed Ss-unc-22 mutants through a host and successfully recovered mutant progeny. Using a similar approach, we also disrupted the unc-22 gene of the rat-parasitic nematode Strongyloides ratti. Our results demonstrate the applicability of CRISPR-Cas9 to parasitic nematodes, and thereby enable future studies of gene function in these medically relevant but previously genetically intractable parasites. PMID:29016680

  10. Strongyloides fuelleborni kellyi and other intestinal helminths in children from Papua New Guinea: associations with nutritional status and socioeconomic factors.

    PubMed

    King, Sarah E; Mascie-Taylor, C G Nicholas

    2004-01-01

    This survey examined the prevalence and intensity of Strongyloides fuelleborni kellyi and other intestinal helminths in children 5 years of age or under living near Kanabea, Papua New Guinea. Of 179 samples, 27% of the children tested positive for Strongyloides, with 81% of these children being a year or less in age. Overall, 68% of the children had one or more infections including Ascaris lumbricoides and hookworm (Necator americanus) as well as Strongyloides. Egg counts in the stools ranged from 100 to 98,300 eggs/ml for Strongyloides, 100 to 59,200 eggs/ml for Ascaris and 100 to 3400 eggs/ml for hookworm. There were significant associations between Strongyloides intensity and weight for age and weight for height such that children with higher intensities had, on average, lower z-scores. Relationships between the prevalence of helminth infections and socioeconomic factors were also observed. Logistic regression models showed that children living farther away from Kanabea (more than 2 hours' walking distance), in smaller households (5 or less people) and with uneducated mothers best predict children with Strongyloides. Two of these variables also predicted the presence of hookworm: maternal education and household size. However, in contrast to Strongyloides, a larger household size (6 or more people) was significantly associated with the presence of hookworm. House type was associated with the prevalence of Ascaris, with children living in houses with tin roofs being less likely to have Ascaris than those living in traditional houses. In addition, maternal education was associated with Ascaris intensity in those children with infection, such that the mean intensities were greater in children of uneducated mothers.

  11. Molecular diagnosis of strongyloidiasis in a population of an endemic area through nested-PCR.

    PubMed

    Sharifdini, Meysam; Keyhani, Amir; Eshraghian, Mohammad Reza; Beigom Kia, Eshrat

    2018-01-01

    This study is aimed to diagnose and analyze strongyloidiasis in a population of an endemic area of Iran using nested-PCR, coupled with parasitological methods. Screening of strongyloidiasis infected people using reliable diagnostic techniques are essential to decrease the mortality and morbidity associated with this infection. Molecular methods have been proved to be highly sensitive and specific for detection of Strongyloides stercoralis in stool samples. A total of 155 fresh single stool samples were randomly collected from residents of north and northwest of Khouzestan Province, Iran. All samples were examined by parasitological methods including formalin-ether concentration and nutrient agar plate culture, and molecular method of nested-PCR. Infections with S. stercoralis were analyzed according to demographic criteria. Based on the results of nested-PCR method 15 cases (9.7%) were strongyloidiasis positive. Nested-PCR was more sensitive than parasitological techniques on single stool sampling. Elderly was the most important population index for higher infectivity with S. stercoralis . In endemic areas of S. stercoralis , old age should be considered as one of the most important risk factors of infection, especially among the immunosuppressed individuals.

  12. SEROEPIDEMIOLOGY OF STRONGYLOIDIASIS IN THE PERUVIAN AMAZON

    PubMed Central

    YORI, PABLO P.; KOSEK, MARGARET; GILMAN, ROBERT H.; CORDOVA, JULIANNA; BERN, CARYN; CHAVEZ, CESAR BANDA; OLORTEGUI, MARIBEL PAREDES; MONTALVAN, CARMEN; SANCHEZ, GRACIELA MEZA; WORTHEN, BEVELLE; WORTHEN, JAMES; LEUNG, FAY; ORÉ, CARLOS VIDAL

    2006-01-01

    A stool and serosurvey for Strongyloides stercoralis was conducted in a community in the Peruvian Amazon region. Strongyloidiasis stercoralis was identified in the stool of 69 (8.7%) of 792 participants. Six hundred nine sera were tested using by an enzyme-linked immunosorbent assay (ELISA), which had a sensitivity of 92% and a specificity of 94%; 442 (72%) were positive. In multivariable logistic regression models, having S. stercoralis in stool was associated with hookworm in the same specimen (odds ratio [OR] = 4.44, 95% confidence interval [CI] = 2.02-9.79), occasionally or never wearing shoes (OR = 1.89, 95% CI = 1.10-3.27), and increasing age (OR = 1.012 for each one-year increase, 95% CI = 1.00-1.03). Similarly, occasionally or never wearing shoes (OR = 1.54, 95% CI = 1.01-2.37) and increasing age (OR = 1.04 for each one-year increase, 95% CI = 1.02-1.06) were associated with an increased risk of a positive S. stercoralis ELISA result. The ELISA had a negative predictive value of 98% and is an excellent screening test for strongyloidiasis. PMID:16407351

  13. Medical Surveillance Monthly Report (MSMR). Volume 2, Number 5, May 1996

    DTIC Science & Technology

    1996-05-01

    Medical Surveillance Activity, Directorate of Epidemiology and Dis- ease Surveillance, United States Army Cen- ter for Health Promotion and Preventive...Microbiologic and Epidemiologic Investigation. JAMA. 1992; 267:2047. 3. Schuchat A, Deaver KA, Wenger JD, et al. Role of Foods in Sporadic Listeriosis Case...Editorial Comment:Strongyloides stercoralis is a nematode parasite that is found in most tropical and sub-tropical areas of the world and is highly prevalent

  14. Pathogenic micro-organisms and helminths in sewage products, Arabian Gulf, country of Bahrain.

    PubMed Central

    Amin, O M

    1988-01-01

    Fecal and sludge samples from the Arabian Gulf country of Bahrain contained poliomyelitis and coxackie viruses, coliform bacteria, Escherichia coli, Salmonella spp., Shigella sonni, fecal streptococci, Balantidium coli, Ascaris lumbricoides and Hymenolepis nana eggs, and Strongyloides stercoralis. Sludge produced in the central sewage treatment plant is used for agricultural purposes and poses a threat to public health. Recommendations to reduce the potential health hazards are made. PMID:3341504

  15. Seroepidemiological trend of strongyloidiasis in the Bolivian Chaco (1987-2013) in the absence of disease-specific control measures.

    PubMed

    Spinicci, Michele; Macchioni, Fabio; Mantella, Antonia; Gabrielli, Simona; Roselli, Mimmo; Rojo Mayaregua, David; Monasterio Pinckert, Joaquín; Gamboa Barahona, Herlan; Paredes, Grover Adolfo; Halkyer, Percy; Cancrini, Gabriella; Olliaro, Piero; Montresor, Antonio; Bartoloni, Alessandro

    2017-11-01

    The prevalence of Strongyloides stercoralis infections is grossly underestimated because infections go mostly undetected, although they can persist for a lifetime due to the auto-infective cycle. In the Bolivian Chaco, the prevalence of soil-transmitted nematodes dropped dramatically in the past 25 years, but the mebendazole used for preventive chemotherapy has no effect on S. stercoralis. Meanwhile, the prevalence of intestinal protozoan infections remains unchanged. We compared S. stercoralis seroprevalence in rural communities of the Bolivian Chaco from 1987 to 2013. Sera collected during two previous serosurveys, conducted in the Chaco region in 1987 and 2013, were tested for S. stercoralis using a commercial assay (Bordier-ELISA, Bordier Affinity Products, Switzerland). Overall, 355 sera were analysed, 122 from the 1987 survey and 233 from the 2013 survey. Seropositivity for S. stercoralis was significantly more prevalent in 1987 (19/122, 16% in 1987 vs. 15/233, 6% in 2013, P = 0.006), accounted for by a drop from 17% to 3% in people under 26 years of age. Multivariate analysis showed a significant association between seropositivity for S. stercoralis and age in the 2013 population (OR 1.03 for each one-year increase, 95%CI 1.00-1.05, P = 0.04), but none in 1987. The significant reduction in S. stercoralis seroprevalence in Bolivian Chaco cannot be explained by preventive chemotherapy or improved social-sanitary conditions. As the drop is seen in younger generations, it is consistent with little transmission occurring. However, the risk of transmission still exists, as prevalence is persistently high in older individuals, who present a potential reservoir due to the lifelong nature of S. stercoralis infections. © 2017 John Wiley & Sons Ltd.

  16. Stage-specific excretory/secretory small heat shock proteins from the parasitic nematode Strongyloides ratti: putative links to host’s intestinal mucosal defense system

    PubMed Central

    Younis, Abuelhassan Elshazly; Geisinger, Frank; Ajonina-Ekoti, Irene; Soblik, Hanns; Steen, Hanno; Mitreva, Makedonka; Erttmann, Klaus D.; Perbandt, Markus; Liebau, Eva; Brattig, Norbert W.

    2013-01-01

    SUMMARY In search of molecules involved in the interaction of intestinal nematodes and mammalian mucosal host cells, we performed mass spectrometry to identify excretory/secretory proteins (ESP) from Strongyloides ratti. In addition to other peptides, we detected in the ESP of parasitic female stage peptides homologous to the Caenorhabditis elegans heat shock protein-17, named Sra-HSP-17.1 (~19 kDa) and Sra-HSP-17.2 (~ 18 kDa) with 49% amino acid identity. The full-length cDNAs (483 bp and 474 bp, respectively) were identified and the genomic organization analyzed. To allow further characterization, the proteins were recombinantly expressed and purified. Profiling of transcription by qRT-PCR and of protein by ELISA in various developmental stages revealed parasitic female-specific expression. The sequence analysis of both DNA and amino acid sequence showed two genes share a conserved alpha-crystallin domain and variable N-terminals. The Sra-HSP-17 proteins showed the highest homology to the deduced small heat-shock protein sequence of the human pathogen S. stercoralis. We observed strong immunogenicity of both proteins, leading to high IgG responses following infection of rats. Flow cytometric analysis indicated the binding of Sra-HSP-17s to the monocytes/macrophage lineage but not to peripheral lymphocytes or neutrophils. A rat intestinal epithelial cell line showed dose dependent binding to Sra-HSP-17.1, but not to Sra-HSP-17.2. Exposed monocytes released IL-10 but not TNF-alpha in response to Sra-HSP-17s, suggesting a possible involvement of secreted female proteins in host immune responses. PMID:21762402

  17. Determining intestinal parasitic infections (IPIs) in inmates from Kajang Prison, Selangor, Malaysia for improved prison management.

    PubMed

    Angal, Lorainne; Mahmud, Rohela; Samin, Sajideh; Yap, Nan-Jiun; Ngui, Romano; Amir, Amirah; Ithoi, Init; Kamarulzaman, Adeeba; Lim, Yvonne A L

    2015-10-29

    The prison management in Malaysia is proactively seeking to improve the health status of the prison inmates. Intestinal parasitic infections (IPIs) are widely distributed throughout the world and are still gaining great concern due to their significant morbidity and mortality among infected humans. In Malaysia, there is a paucity of information on IPIs among prison inmates. In order to further enhance the current health strategies employed, the present study aims to establish firm data on the prevalence and diversity of IPIs among HIV-infected and non-HIV-infected individuals in a prison, an area in which informed knowledge is still very limited. Samples were subjected to microscopy examination and serological test (only for Strongyloides). Speciation for parasites on microscopy-positive samples and seropositive samples for Strongyloides were further determined via polymerase chain reaction. SPSS was used for statistical analysis. A total of 294 stool and blood samples each were successfully collected, involving 131 HIV positive and 163 HIV negative adult male inmates whose age ranged from 21 to 69-years-old. Overall prevalence showed 26.5% was positive for various IPIs. The IPIs detected included Blastocystis sp., Strongyloides stercoralis, Entamoeba spp., Cryptosporidium spp., Giardia spp., and Trichuris trichiura. Comparatively, the rate of IPIs was slightly higher among the HIV positive inmates (27.5%) than HIV negative inmates (25.8%). Interestingly, seropositivity for S. stercoralis was more predominant in HIV negative inmates (10.4%) compared to HIV-infected inmates (6.9%), however these findings were not statistically significant. Polymerase chain reaction (PCR) confirmed the presence of Blastocystis, Strongyloides, Entamoeba histolytica and E. dispar. These data will enable the health care providers and prison management staff to understand the trend and epidemiological situations in HIV/parasitic co-infections in a prison. This information will further

  18. Structural and functional characterization of a novel scFv anti-HSP60 of Strongyloides sp.

    PubMed Central

    Levenhagen, Marcelo Arantes; de Almeida Araújo Santos, Fabiana; Fujimura, Patrícia Tiemi; Caneiro, Ana Paula; Costa-Cruz, Julia Maria; Goulart, Luiz Ricardo

    2015-01-01

    Phage display is a powerful technology that selects specific proteins or peptides to a target. We have used Phage Display to select scFv (single-chain variable fragment) clones from a combinatorial library against total proteins of Strongyloides venezuelensis. After scFv characterization, further analysis demonstrated that this recombinant fragment of antibody was able to bind to an S. venezuelensis antigenic fraction of ~65 kDa, present in the body periphery and digestive system of infective larvae (L3), as demonstrated by immunofluorescence. Mass spectrometry results followed by bioinformatics analysis showed that this antigenic fraction was a heat shock protein 60 (HSP60) of Strongyloides sp. The selected scFv was applied in serodiagnosis by immune complexes detection in serum samples from individuals with strongyloidiasis using a sandwich enzyme-linked immunosorbent assay (ELISA), showing sensitivity of 97.5% (86.84–99.94), specificity of 98.81 (93.54–99.97), positive likelihood ratio of 81.60 and an area under the curve of 0.9993 (0.9973–1.000). Our study provided a novel monoclonal scFv antibody fragment which specifically bound to HSP60 of Strongyloides sp. and was applied in the development of an innovative serodiagnosis method for the human strongyloidiasis. PMID:25994608

  19. Efficacy and Safety of Single and Double Doses of Ivermectin versus 7-Day High Dose Albendazole for Chronic Strongyloidiasis

    PubMed Central

    Suputtamongkol, Yupin; Premasathian, Nalinee; Bhumimuang, Kid; Waywa, Duangdao; Nilganuwong, Surasak; Karuphong, Ekkapun; Anekthananon, Thanomsak; Wanachiwanawin, Darawan; Silpasakorn, Saowaluk

    2011-01-01

    Background Strongyloidiasis, caused by an intestinal helminth Strongyloides stercoralis, is common throughout the tropics. It remains an important health problem due to autoinfection, which may result in hyperinfection and disseminated infection in immunosuppressed patients, especially patients receiving chemotherapy or corticosteroid treatment. Ivermectin and albendazole are effective against strongyloidiasis. However, the efficacy and the most effective dosing regimen are to be determined. Methods A prospective, randomized, open study was conducted in which a 7-day course of oral albendazole 800 mg daily was compared with a single dose (200 microgram/kilogram body weight), or double doses, given 2 weeks apart, of ivermectin in Thai patients with chronic strongyloidiasis. Patients were followed-up with 2 weeks after initiation of treatment, then 1 month, 3 months, 6 months, 9 months, and 1 year after treatment. Combination of direct microscopic examination of fecal smear, formol-ether concentration method, and modified Koga agar plate culture were used to detect strongyloides larvae in two consecutive fecal samples in each follow-up visit. The primary endpoint was clearance of strongyloides larvae from feces after treatment and at one year follow-up. Results Ninety patients were included in the analysis (30, 31 and 29 patients in albendazole, single dose, and double doses ivermectin group, respectively). All except one patient in this study had at least one concomitant disease. Diabetes mellitus, systemic lupus erythrematosus, nephrotic syndrome, hematologic malignancy, solid tumor and human immunodeficiency virus infection were common concomitant diseases in these patients. The median (range) duration of follow-up were 19 (2–76) weeks in albendazole group, 39 (2–74) weeks in single dose ivermectin group, and 26 (2–74) weeks in double doses ivermectin group. Parasitological cure rate were 63.3%, 96.8% and 93.1% in albendazole, single dose oral ivermectin

  20. Strongyloidiasis in Canadian Far East war veterans

    PubMed Central

    Proctor, Eileen M.; Isaac-Renton, Judith L.; Robertson, William B.; Black, William A.

    1985-01-01

    A survey was done of Canadians who had been interned by the Japanese during World War II to assess the prevalence of latent infection with Strongyloides stercoralis in this group. Packages containing three mail-in kits and a questionnaire were sent to 992 men, 694 (70%) of whom responded. Larvae were found in the stool specimens of four of the respondents. Examination of stool specimens after formalin-ether concentration was the most successful method of detecting Strongyloides larvae. The Baermann concentration technique yielded negative results in all four men. Three of the four cases of strongyloidiasis were detected after sampling of three fecal specimens. In the fourth case additional specimens were requested on the basis of data derived from the questionnaire. The most frequently cited clinical manifestations were abdominal pain, weight loss, diarrhea and rashes. PMID:4052898

  1. A protocol for chemical mutagenesis in Strongyloides ratti.

    PubMed

    Guo, Li; Chang, Zisong; Dieterich, Christoph; Streit, Adrian

    2015-11-01

    Genetic analysis using experimentally induced mutations has been a most valuable tool in the analysis of various organisms. However, genetic analysis of endoparasitic organisms tends to be difficult because of the limited accessibility of the sexually reproducing adults, which are normally located within the host. Nematodes of the genera Strogyloides and Parastrongyloides represent an exception to this because they can form facultative free-living sexually reproducing generations in between parasitic generations. Here we present a protocol for the chemical mutagenesis of Strongyloides ratti. Further we evaluate the feasibility of identifying the induced mutations by whole genome re-sequencing. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Geophagy as risk behaviour for gastrointestinal nematode infections among pregnant women attending antenatal clinics in a humid tropical zone of Nigeria.

    PubMed

    Ivoke, Njoku; Ikpor, Nnenna; Ivoke, Obinna; Ekeh, Felicia; Ezenwaji, Ngozi; Odo, Gregory; Iyaji, Florence; Onoja, Uwakwe; Eyo, Joseph

    2017-03-01

    Geophagy is wide spread among pregnant women in Ebonyi State, Nigeria. The aim of this study was to assess intestinal nematode infections among geophagous pregnant women in Southern Ebonyi State, Nigeria. Pregnant women were aged 17-45 years at gestational ages of ≥ 14 to 24 weeks on hospital enrolment were sampled. Data on geophagy was collected using structured questionnaire. Gastrointestinal nematode status of the participants was determined by stool analyses. Soil types ingested were examined for intestinal nematode ova / larvae. The prevalence of geophagy (46.4%) was associated with socio-demographic characteristics. Ascaris lumbricoides and hookworm were associated with geophagy while Trichuris trichiura and Strongyloides stercoralis had no association. Prevalence of A. lumbricoides, T. trichiura and S. stercoralis differed significantly (p<0.05) between geophagous and non-geophagous women. The soil types consumed had eggs / larvae of A. lumbricoides and T. trichiura . Geophagy is a risk behaviour directly associated with A. lumbricoides , hookworm, T. trichiura , and to a lesser extent S. stercoralis infection among pregnant women. Sensitization and mass education of pregnant women on the dangers of geophagy is needed. Furthermore, deworming of pregnant women should be integrated into the healthcare delivery system of the State.

  3. Opportunistic and non-opportunistic intestinal parasites in HIV/ AIDS patients in relation to their clinical and epidemiological status in a specialized medical service in Goiás, Brazil.

    PubMed

    Barcelos, Natane Barbosa; Silva, Lorena de Freitas E; Dias, Regyane Ferreira Guimarães; Menezes Filho, Hélio Ranes de; Rodrigues, Rosângela Maria

    2018-03-08

    Patients infected with the Human Immunodeficiency Virus (HIV) often have opportunistic infections, among which strongyloidiasis and coccidiosis are the most common parasitic infections that aggravate their health status. This study examined the prevalence of intestinal parasites, particularly of Strongyloides stercoralis and intestinal coccidia in patients with the Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) who were treated at the Specialized Assistance Service (SAE) of Jataí, State of Goiás, Brazil, and analyzed its correlation with clinical, laboratory, and socio-epidemiological parameters. A total of 270 stool samples were analyzed by the Lutz technique, Rugai's method, Agar Plate Culture, Ritchie's method and specific staining, Ziehl-Neelsen modified technique, Kinyoun's method and the rapid safranin method. The prevalence of intestinal parasites was 28.88% including 3.8% of S. stercoralis, Cryptosporidium sp. and Cystoisospora belli. There was a significant positive correlation between intestinal parasites and the clinical status and the use of antiretroviral therapy (ART), smoking, CD4+ lymphocyte counts and sexual orientation. In conclusion, the widespread use of antiretroviral therapy and health assistance contributed to the low prevalence of S. stercoralis and coccidiosis in patients with HIV/ AIDS who were followed up at the SAE.

  4. Disseminated Strongyloidiasis in an Immunodeficient Patient (Pemphigus Vulgaris) Due to Corticosteroid Therapy: A Case Report

    PubMed Central

    NAJJARI, Mohsen; EBRAHIMIPOUR, Mohammad; KAHEH, Amir; KARIMAZAR, Mohammadreza

    2016-01-01

    Strongyloidiasis is a frequent misdiagnosed parasitic infection in the world that caused by Strongyloides stercoralis. In Iran, the disease is predominantly reported from warm and humid climate provinces. The patient was a 54-yr-old man, originated from Khuzestan Province with a history of pemphigus and diabetes that was treated with high-dose of corticosteroid drugs before admission in a non-private hospital in Shiraz, Iran in 2014. After different primary diagnosis and administrating of several drugs, endoscopy and histopatholgical biopsy revealed a massive S. stercoralis infection in the duodenal mucosa and gastric wall. In spite treating with anti-helminthic drugs in the last days, due to using different steroid drugs, clinical manifestations of the patient were exacerbated and he was expired on the seventeenth day due to severe dyspnea. Physicians’ awareness and using various diagnosis methods like serology, endoscopy, and biopsy should be considered in the endemic areas. In suspicious cases, anthelmintic drugs should be started before the initiation of immunosuppressive therapy. PMID:28127349

  5. Soil-transmitted Helminthiasis in the United States: a systematic review--1940-2010.

    PubMed

    Starr, Michelle C; Montgomery, Susan P

    2011-10-01

    The epidemiology of soil-transmitted helminth infections (hookworm, Trichuris trichiura, Ascaris lumbricoides, and Strongyloides stercoralis) in the United States is poorly understood. To gain understanding of the status of disease, a systematic review was performed to assess the prevalence of soil-transmitted helminth infections in the United States. Of all studies reviewed, 14 were designated as high-quality. High-quality studies were published from 1942 to 1982 and showed that infection was prevalent throughout the southern United States and Appalachia as recently as 1982, finding that hookworm (19.6%), T. trichiura (55.2%), A. lumbricoides (49.4%), and S. stercoralis (3.8%) affected significant percentages of the population. However, because the most recent high-quality studies were published over 25 years ago, the literature does not provide sufficient data to assess current endemic transmission. Because the status of disease remains unclear, there is a need for additional studies to determine if soil-transmitted helminths remain endemic in the United States.

  6. Streptococcus gallolyticus meningitis in adults: report of five cases and review of the literature.

    PubMed

    van Samkar, A; Brouwer, M C; Pannekoek, Y; van der Ende, A; van de Beek, D

    2015-12-01

    We describe the incidence and patient characteristics of Streptococcus gallolyticus meningitis. We identified S. gallolyticus meningitis in a nationwide cohort of patients with community-acquired bacterial meningitis, and performed a systematic review and meta-analysis of all reported adult cases in the literature. Five cases were identified (0.3%) in a cohort of 1561 episodes of bacterial meningitis. In one patient, bowel disease (colon polyps) was identified as a predisposing condition for S. gallolyticus infection, whereas no patients were diagnosed with endocarditis. In a combined analysis of our patients and 37 reported in the literature, we found that the median age was 59 years. Predisposing factors were present in 21 of 42 patients (50%), and mainly consisted of immunosuppressive therapy (seven patients), cancer (four patients), and alcoholism (four patients). Colon disease was identified in 15 of 24 patients (63%) and endocarditis in five of 27 patients (18%). Co-infection with Strongyloides stercoralis was identified in 14 of 34 patients (41%), ten of whom were infected with human immunodeficiency virus or human T-lymphotropic virus. Outcomes were described for 37 patients; eight died (22%) and one (3%) had neurological sequelae. S. gallolyticus is an uncommon cause of bacterial meningitis, with specific predisposing conditions. When it is identified, consultation with a cardiologist and gastroenterologist is warranted to rule out underlying endocarditis or colon disease. Stool examinations for Strongyloides stercoralis should be performed in patients who have travelled to or originate from endemic areas. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  7. Anthelmintic Therapy Modifies the Systemic and Mycobacterial Antigen-Stimulated Cytokine Profile in Helminth-Latent Mycobacterium tuberculosis Coinfection.

    PubMed

    Anuradha, Rajamanickam; Munisankar, Saravanan; Bhootra, Yukthi; Dolla, Chandrakumar; Kumaran, Paul; Nutman, Thomas B; Babu, Subash

    2017-04-01

    Helminth infections are known to modulate cytokine responses in latent tuberculosis (LTB). However, very few studies have examined whether this modulation is reversible upon anthelmintic therapy. We measured the systemic and mycobacterial (TB) antigen-stimulated levels of type 1, type 2, type 17, and regulatory cytokines in individuals with LTB and with or without coexistent Strongyloides stercoralis infection before and after anthelmintic therapy. Our data reveal that individuals with LTB and coexistent S. stercoralis infection have significantly lower levels of systemic and TB antigen-stimulated type 1 (gamma interferon [IFN-γ], tumor necrosis factor alpha [TNF-α], and interleukin-2 [IL-2]) and type 17 (IL-17A and/or IL-17F) cytokines and significantly higher levels of systemic but not TB antigen-stimulated type 2 (IL-4 and IL-5) and regulatory (transforming growth factor beta [TGF-β]) cytokines. Anthelmintic therapy resulted in significantly increased systemic levels of type 1 and/or type 17 cytokines and in significantly decreased systemic levels of type 2 and regulatory (IL-10 and TGF-β) cytokines. In addition, anthelmintic therapy resulted in significantly increased TB antigen-stimulated levels of type 1 cytokines only. Our data therefore confirm that the modulation of systemic and TB antigen-stimulated cytokine responses in S. stercoralis -LTB coinfection is reversible (for the most part) by anthelmintic treatment. Copyright © 2017 American Society for Microbiology.

  8. Diagnosis of soil-transmitted helminthiasis in an Amazonic community of Peru using multiple diagnostic techniques.

    PubMed

    Machicado, Jorge D; Marcos, Luis A; Tello, Raul; Canales, Marco; Terashima, Angelica; Gotuzzo, Eduardo

    2012-06-01

    An observational descriptive study was conducted in a Shipibo-Conibo/Ese'Eja community of the rainforest in Peru to compare the Kato-Katz method and the spontaneous sedimentation in tube technique (SSTT) for the diagnosis of intestinal parasites as well as to report the prevalence of soil-transmitted helminth (STH) infections in this area. A total of 73 stool samples were collected and analysed by several parasitological techniques, including Kato-Katz, SSTT, modified Baermann technique (MBT), agar plate culture, Harada-Mori culture and the direct smear examination. Kato-Katz and SSTT had the same rate of detection for Ascaris lumbricoides (5%), Trichuris trichiura (5%), hookworm (14%) and Hymenolepis nana (26%). The detection rate for Strongyloides stercoralis larvae was 16% by SSTT and 0% by Kato-Katz, but 18% by agar plate culture and 16% by MBT. The SSTT also had the advantage of detecting multiple intestinal protozoa such as Blastocystis hominis (40%), Giardia intestinalis (29%) and Entamoeba histolytica/E. dispar (16%). The most common intestinal parasites found in this community were B. hominis, G. intestinalis, H. nana, S. stercoralis and hookworm. In conclusion, the SSTT is not inferior to Kato-Katz for the diagnosis of common STH infections but is largely superior for detecting intestinal protozoa and S. stercoralis larvae. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  9. Strongyloidiasis in Latin American immigrants: a pilot study.

    PubMed

    Ostera, G; Blum, J; Cornejo, C; Burgula, S; Jeun, R; Bryan, P E; Mejia, R

    2017-03-01

    The United States of America (USA) has the largest international population of any nation in the world. Immigrants from Latin American countries, where intestinal parasites are endemic, comprise more than half of this population. This study aims to determine the prevalence of strongyloidiasis, a potentially deadly parasitic infection, in foreign-born individuals. We conducted a cross-sectional study in Washington, DC, to determine the seroprevalence of Strongyloides stercoralis infection using an NIE-ELISA IgG antibody assay. Multi-parallel quantitative real-time polymerase chain reaction (qPCR) was performed in stool samples of NIE-ELISA-positive patients to investigate possible polyparasitism. The NIE-ELISA assay detected an S. stercoralis prevalence of 4.2% in a group of 119 volunteers. Combining NIE-ELISA and qPCR detected a parasite prevalence of 5.0%. Our results underscore the relevance of systematic testing for gastrointestinal parasites in individuals from endemic regions. It also makes a case for a survey in the USA to identify immigrants' risk for strongyloidiasis and other gastrointestinal parasitic infections.

  10. [Enteroparasite determination in Lactuca sativa from farms dedicated to its production in Pasto, Colombia].

    PubMed

    Polo, Giovanni Andrés; Benavides, Carmenza Janneth; Astaiza, Juan Manuel; Vallejo, Dario Antonio; Betancourt, Patricia

    2016-12-01

    Currently, vegetables like lettuce are widely recommended as part of the daily diet given their high nutritional value; however, while consumers feel attracted to the benefits provided by the vegetable, they may also be exposed to parasitic intestinal infections. To determine the presence or absence of enteroparasites in lettuce (Lactuca sativa) grown in the rural area in the municipality of Pasto, and to analyze associated factors based on the characterization of the lands. We conducted a descriptive double blind cross-sectional study. We took a total of 105 samples from 21 properties from June to December, 2013, and we processed them by sedimentation and flotation tests. Additionally, the owners were surveyed in order to obtain information about the possible variables influencing the occurrence of enteroparasites. We detected contamination in 100% of the lettuce samples and we found parasite eggs and larvae as follows: 95.25% with Entamoeba spp. cysts; 71.43% with Isospora spp. oocysts; 61.90% with Strongyloides stercoralis larvae (L3); 28.57% with Toxocara spp. eggs, and 4.76% with Eimeria spp. oocysts. Using the chi-square test we found association between Entamoeba spp. and ditches (p=0.008), dogs (p=0.008) and septic tanks (p=0.029); between Isospora spp. and compost (p=0.0001), dogs (p=0.0001) and slugs (p=0.002); between S. stercoralis and handling (p=0.003), and between Toxocara spp. and no use of biodigesters (p= 0.002). We found contamination with enteroparasites in lettuce samples from growing areas in the municipality of Pasto with animal and human sources as their main reservoirs, although others were present in the environment.

  11. Immunocytochemistry of mucosal changes in patients infected with the intestinal nematode Strongyloides stercoralis.

    PubMed Central

    Coutinho, H B; Robalinho, T I; Coutinho, V B; Almeida, J R; Filho, J T; King, G; Jenkins, D; Mahida, Y; Sewell, H F; Wakelin, D

    1996-01-01

    AIM: To investigate the immunopathological changes in duodenal tissues induced by strongyloidiasis and to relate these to degrees of clinical severity. METHODS: Tissues taken from 21 patients showing mild, moderate or severe symptoms of strongyloidiasis, and from non-infected controls, were sectioned and stained immunocytochemically for IgA, secretory component (SC) and HLA-DR. Immunopathology was assessed by changes in numbers, intensity and distribution of stained cells. RESULTS: Parasitised individuals showed villous atrophy and crypt hyperplasia. There was notable infiltration of the lamina propria by IgA positive plasma cells and of the epithelium by intraepithelial lymphocytes. Infection was also associated with increased expression of SC and decreased expression of HLA-DR in epithelial cells. Changes in all parameters correlated with degree of clinical severity. CONCLUSIONS: Profound mucosal changes are induced by strongyloidiasis. Some are analogous to those seen in coeliac disease, but others seem quite unusual. It is likely that these changes are functionally related to the immunopathophysiological consequences of infection seen in patients with severe disease. Images PMID:9038754

  12. Specific IgA and IgG antibodies in paired serum and breast milk samples in human strongyloidiasis.

    PubMed

    Mota-Ferreira, Daniela M L; Gonçalves-Pires, Maria do Rosário F; Júnior, Alvaro Ferreira; Sopelete, Mônica C; Abdallah, Vânia O S; Costa-Cruz, Julia M

    2009-02-01

    Strongyloidiasis, caused by the nematode Strongyloides stercoralis, is one of the major worldwide parasitic infections in humans. Breastfeeding may offer a potential protection against this infection. Feces, serum and milk samples were obtained from 90 lactating women from Clinical Hospital of Universidade Federal de Uberlândia, Brazil. The fecal samples were collected for parasitological diagnosis and the serum and milk samples were examined for specific S. stercoralis IgA and IgG antibodies using the indirect fluorescent antibody test (IFAT) and enzyme-linked immunosorbent assay (ELISA). Fecal examination showed that the rate of prevalence of S. stercoralis infection in the lactating women was 4.4%. IFAT manifested a 16.7% positivity rate for specific IgA antibody in serum and a 28.9% rate in milk samples; specific IgG was 41.1% in serum and 25.5% in milk samples. According to ELISA the positivity rate for specific IgA antibody was 21.1% in serum and 42.2% in milk samples; specific IgG was 40% in serum and 18.9% in milk samples. In serum samples, these immunological tests showed a concurrence of 91.1% and 94.4%, respectively, in detecting specific IgA and IgG antibodies. In milk samples, they showed a concurrence of 70% and 78.9%, respectively, in detecting specific IgA and IgG antibodies. There was a statistically significant difference between concordant and discordant results of immunological tests (P<0.0001). IFAT and ELISA highly concurred in their detection of specific S. stercoralis IgA and IgG antibodies in serum and in milk samples reconfirming prior studies that the serological method is a complement to the direct diagnosis of the parasite, and suggesting that immunological methods using milk samples can also be helpful. Furthermore, in endemic areas, infants may acquire antibodies to S. stercoralis from breast milk, possibly, contributing to the enhancement of specific mucosal immunity against this parasite.

  13. A simple modification of the Baermann method for diagnosis of strongyloidiasis.

    PubMed

    Hernández-Chavarría, F; Avendaño, L

    2001-08-01

    The diagnosis of Strongyloides stercoralis infections is routinely made by microscopic observation of larvae in stool samples, a low sensitivity method, or by other, most effective methods, such as the Baermann or agar culture plate methods. We propose in this paper a practical modification of Baermann method. One hundred and six stool samples from alcoholic patients were analyzed using the direct smear test, agar culture plate method, the standard Baermann method, and its proposed modification. For this modification the funnel used in the original version of the method is substituted by a test tube with a rubber stopper, perforated to allow insertion of a pipette tip. The tube with a fecal suspension is inverted over another tube containing 6 ml of saline solution and incubated at 37 degrees C for at least 2 h. The saline solution from the second tube is centrifuged and the pellet is observed microscopically. Larva of S. stercoralis were detected in six samples (5.7%) by the two versions of the Baermann method. Five samples were positive using the agar culture plate method, and only in two samples the larva were observed using direct microscopic observation of fecal smears. Cysts of Endolimax nana and Entamoeba histolytica/dyspar were also detected in the modification of Baermann method. Data obtained by the modified Baermann method suggest that this methodology may helps concentrate larvae of S. stercoralis as efficiently as the original method.

  14. The prevalence and diversity of intestinal parasitic infections in humans and domestic animals in a rural Cambodian village.

    PubMed

    Schär, Fabian; Inpankaew, Tawin; Traub, Rebecca J; Khieu, Virak; Dalsgaard, Anders; Chimnoi, Wissanuwat; Chhoun, Chamnan; Sok, Daream; Marti, Hanspeter; Muth, Sinuon; Odermatt, Peter

    2014-08-01

    In Cambodia, intestinal parasitic infections are prevalent in humans and particularly in children. Yet, information on potentially zoonotic parasites in animal reservoir hosts is lacking. In May 2012, faecal samples from 218 humans, 94 dogs and 76 pigs were collected from 67 households in Dong village, Preah Vihear province, Cambodia. Faecal samples were examined microscopically using sodium nitrate and zinc sulphate flotation methods, the Baermann method, Koga Agar plate culture, formalin-ether concentration technique and Kato Katz technique. PCR was used to confirm hookworm, Ascaris spp., Giardia spp. and Blastocystis spp. Major gastrointestinal parasitic infections found in humans included hookworms (63.3%), Entamoeba spp. (27.1%) and Strongyloides stercoralis (24.3%). In dogs, hookworm (80.8%), Spirometra spp. (21.3%) and Strongyloides spp. (14.9%) were most commonly detected and in pigs Isospora suis (75.0%), Oesophagostomum spp. (73.7%) and Entamoeba spp. (31.6%) were found. Eleven parasite species were detected in dogs (eight helminths and three protozoa), seven of which have zoonotic potential, including hookworm, Strongyloides spp., Trichuris spp., Toxocara canis, Echinostoma spp., Giardia duodenalis and Entamoeba spp. Five of the parasite species detected in pigs also have zoonotic potential, including Ascaris spp., Trichuris spp., Capillaria spp., Balantidium coli and Entamoeba spp. Further molecular epidemiological studies will aid characterisation of parasite species and genotypes and allow further insight into the potential for zoonotic cross transmission of parasites in this community. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Chemokinetic behavior of the infective third-stage larvae of Strongyloides ratti on a sodium chloride gradient.

    PubMed

    Tobata-Kudo, H; Higo, H; Koga, M; Tada, I

    2000-09-01

    The movements of the infective third-stage larvae (L3) of a rodent parasitic nematode Strongyloides ratti were examined on a sodium chloride (NaCl) gradient set up on agarose plates. The movements of larvae were followed by observing their tracks on the surface of the agarose. The direction of movement depended on the NaCl concentration at the point of their initial placement on the gradient. Larvae placed at between 230 and 370 mM NaCl tended to migrate towards areas of lower concentration. On the other hand, when placed at concentrations less than 20 mM NaCl, larvae tended to migrate initially towards higher concentrations but did not linger in areas where the concentration was over approximately 80 mM NaCl. It seems that S. ratti L3, tested in vitro, prefer regions with a concentration of NaCl below 80 mM NaCl. Two typical chemokinetic behaviors are seen; a unidirectional avoidance movement when initially placed in unfavorable environmental conditions and a random dispersal movement when placed within an area of favorable conditions. Track patterns were straight in the avoidance movement but included multiple changes of direction and loops in the dispersal movement. This study introduces an assay system suitable for studying chemokinetic behavior of larvae of Strongyloides ratti.

  16. Expanding molecular diagnostics of helminthiasis: Piloting use of the GPLN platform for surveillance of soil transmitted helminthiasis and schistosomiasis in Ghana.

    PubMed

    Cunningham, Lucas J; Odoom, John; Pratt, Deborah; Boatemaa, Linda; Asante-Ntim, Nana; Attiku, Keren; Banahene, Bismarck; Osei-Atweneboana, Mike; Verweij, Jaco J; Molyneux, David; Stothard, Russell J; Adams, Emily R

    2018-01-01

    The efforts to control and eradicate polio as a global health burden have been successful to the point where currently only three countries now report endemic polio, and the number of cases of polio continues to decrease. The success of the polio programme has been dependant on a well-developed network of laboratories termed the global polio laboratory network (GPLN). Here we explore collaborative opportunities with the GPLN to target two of the 18 diseases listed as a neglected tropical diseases (NTD) namely soil transmitted helminthiasis (STH) and Schistosomiasis (SCH). These were chosen based on prevalence and the use of faecal materials to identify both polio, STH and SCH. Our study screened 448 faecal samples from the Ghana GPLN using three triplex TaqMan assays to identify Ascaris lumbricoides, Necator americanus, Ancylostoma spp, Trichuris trchiura, Strongyloides stercoralis and Schistosoma spp. Our results found a combined helminth prevalence of 22%. The most common helminth infection was A. lumbricoides with a prevalence of 15% followed by N. americanus (5%), Ancylostoma spp. (2.5%), Schistosoma spp. (1.6%) and S. stercoralis (1%). These results show that it is possible to identify alternative pathogens to polio in the samples collected by the GPLN platform and to introduce new diagnostic assays to their laboratories. The diagnostic methods employed were also able to identify S. stercoralis positive samples, which are difficult to identify using parasitological methods such as Kato-Katz. This study raises the possibility of collaboration with the GPLN for the surveillance of a wider range of diseases which would both benefit the efforts to control the NTDs and also increase the scope of the GPLN as a diagnostic platform.

  17. Comparing Diagnostic Accuracy of Kato-Katz, Koga Agar Plate, Ether-Concentration, and FLOTAC for Schistosoma mansoni and Soil-Transmitted Helminths

    PubMed Central

    Glinz, Dominik; Silué, Kigbafori D.; Knopp, Stefanie; Lohourignon, Laurent K.; Yao, Kouassi P.; Steinmann, Peter; Rinaldi, Laura; Cringoli, Giuseppe; N'Goran, Eliézer K.; Utzinger, Jürg

    2010-01-01

    Background Infections with schistosomes and soil-transmitted helminths exert a considerable yet underappreciated economic and public health burden on afflicted populations. Accurate diagnosis is crucial for patient management, drug efficacy evaluations, and monitoring of large-scale community-based control programs. Methods/Principal Findings The diagnostic accuracy of four copromicroscopic techniques (i.e., Kato-Katz, Koga agar plate, ether-concentration, and FLOTAC) for the detection of Schistosoma mansoni and soil-transmitted helminth eggs was compared using stool samples from 112 school children in Côte d'Ivoire. Combined results of all four methods served as a diagnostic ‘gold’ standard and revealed prevalences of S. mansoni, hookworm, Trichuris trichiura, Strongyloides stercoralis and Ascaris lumbricoides of 83.0%, 55.4%, 40.2%, 33.9% and 28.6%, respectively. A single FLOTAC from stool samples preserved in sodium acetate-acetic acid-formalin for 30 or 83 days showed a higher sensitivity for S. mansoni diagnosis (91.4%) than the ether-concentration method on stool samples preserved for 40 days (85.0%) or triplicate Kato-Katz using fresh stool samples (77.4%). Moreover, a single FLOTAC detected hookworm, A. lumbricoides and T. trichiura infections with a higher sensitivity than any of the other methods used, but resulted in lower egg counts. The Koga agar plate method was the most accurate diagnostic assay for S. stercoralis. Conclusion/Significance We have shown that the FLOTAC method holds promise for the diagnosis of S. mansoni. Moreover, our study confirms that FLOTAC is a sensitive technique for detection of common soil-transmitted helminths. For the diagnosis of S. stercoralis, the Koga agar plate method remains the method of choice. PMID:20651931

  18. Development of a Sensitive and Specific Antigen-Detection System for Strongyloides Stercoralis and Hookworm Infections

    DTIC Science & Technology

    1997-06-01

    deficiency. Treatment usually includes blood transfusions and a three day course of mebendazole and iron substitution and/or single dose albendazole ...1983 Treatment of hookworm, ascariasis and trichuriasis with albendazole or mebendazole. Revista do Instituto de Medicina Tropical de Sao Paulo 25:294

  19. Intestinal Parasitic Infections in HIV Infected and Non-Infected Patients in a Low HIV Prevalence Region, West-Cameroon

    PubMed Central

    Nkenfou, Céline Nguefeu; Nana, Christelle Tafou; Payne, Vincent Khan

    2013-01-01

    The magnitude of intestinal parasitic infection in acquired immunodeficiency syndrome patients requires careful consideration in the developing world where poor nutrition is associated with poor hygiene and several tropical diseases. However, there have been very few studies addressing this issue in Cameroon. This study was conducted to determine the prevalence of intestinal parasitosis in HIV/AIDS patients in Dschang -Cameroon. Stool and blood specimens from HIV/AIDS patients and control group were screened respectively for intestinal parasites and for HIV antibodies. Intestinal parasites were identified using direct microscopy, formalin-ether concentration and Ziehl Neelsen methods. Out of 396 participants recruited among patients consulting at hospital, 42 (10.6%) were HIV positive, thirty of them treatment naïve. The overall prevalence of intestinal parasites was 14.64%. Out of 42 HIV/AIDS patients, 59.5% (25/42) were infected with intestinal parasites, while only 9.32% (33/354) of the HIV negative patients were infected with intestinal parasites. The parasites detected in our study population included Crystosporidium parvum (2.53%), Entamoeba histolytica (7.52%), Entamoeba coli (4.04%), Giardia lamblia (0.25%), Trichuris trichura (0.25%), Strongyloides stercoralis (0.25%) and Taenia spp. (0.25%). In the HIV infected group, Crystosporidium parvum (19.04%), Entamoeba histolytica (19.04%), Entamoeba coli (21.42%), Giardia lamblia (2.38%), Strongyloides stercoralis (0.25%) and Taenia spp. (0.25%) were found. Crystosporidium parvum was found to be significantly higher in HIV/AIDS patients than in controls (P<0.05). Multivariate analysis showed that the HIV status and the quality of water were the major risk factors for intestinal parasitosis. Routine examinations of stool samples for parasites would significantly benefit the HIV patients by contributing in reducing morbidity and improving the efficiency of antiretroviral treatment. Even after the introduction of

  20. HTLV-I infection in the South West Indian Ocean islands, particularly in La Réunion and the Seychelles.

    PubMed

    Aubry, P; Bovet, P; Vitrac, D; Schooneman, F; Hollanda, J; Malvy, D; Gaüzère, B-A

    2013-10-01

    Data on HTLV-I are scarce in several Southwest Indian Ocean islands except for La Réunion and The Seychelles. The two cases of HTLV-I have been confirmed by Western-Blot in La Réunion, among blood donors. In Seychelles (87 400 inhabitants in 2012), where blood donors and some other cases are screened, HTLV-I was confirmed with a line immune assay in 43 persons and at least 10-20 patients are known to have tropical spastic paraparesia or adult T-cell lymphoma associated with HTLV-I. In the south-west Indian Ocean, a possibly important other issue may be co-infection of HTLV-1 with the Strongyloides stercoralis roundworm, which is endemic in all countries of the region and which can sometimes lead to severe symptomatic infestation.

  1. Prevalence of chronic infections and susceptibility to measles and varicella-zoster virus in Latin American immigrants.

    PubMed

    Jackson, Yves; Santos, Lilian; Arm-Vernez, Isabelle; Mauris, Anne; Wolff, Hans; Chappuis, François; Getaz, Laurent

    2016-05-11

    Large numbers of Latin American immigrants recently arrived in Western Europe. Curative and preventive programmes need to take account of their risk of suffering and transmitting imported chronic infections and of their susceptibility to cosmopolitan infections. We aimed to assess the prevalence and co-occurrence of imported chronic infections among Latin American immigrants, and their susceptibility to highly prevalent cosmopolitan infections. Adult participants were recruited in the community and in a primary health centre in Geneva in 2008. Serological tests were performed on stored sera for HIV, HBV, syphilis, Strongyloides stercoralis, Trypanosoma cruzi, varicella and measles. We considered only chronic active infections in the analysis. The 1 012 participants, aged 37.2 (SD 11.3) years, were mostly female (82.5 %) and Bolivians (48 %). Overall, 209 (20.7 %) had at least one and 27 (2.7 %) two or more chronic infections. T. cruzi (12.8 %) and S. stercoralis (8.4 %) were the most prevalent chronic active infections compared to syphilis (0.4 %), HBV (0.4 %) and HIV (1.4 %). Concomitant infections affected 28.2 and 18.5 % of T. cruzi and S. stercoralis infected cases. Bolivian origin (aOR: 13.6; 95 % CI: 3.2-57.9) was associated with risk of multiple infections. Susceptibilities for VZV and measles were 0.7 and 1.4 %, respectively. Latin American immigrants are at risk of complications and possible reactivation of chronic parasitic infections but have overall low risks of chronic viral and syphilitic active infections. Systematic screening for chronic active parasitic infections is therefore necessary especially among Bolivians. The high protection rate against measles and VZV doesn't require specific preventive interventions.

  2. The Nuclear Receptor DAF-12 Regulates Nutrient Metabolism and Reproductive Growth in Nematodes

    PubMed Central

    Wang, Zhu; Stoltzfus, Jonathan; You, Young-jai; Ranjit, Najju; Tang, Hao; Xie, Yang; Lok, James B.; Mangelsdorf, David J.; Kliewer, Steven A.

    2015-01-01

    Appropriate nutrient response is essential for growth and reproduction. Under favorable nutrient conditions, the C. elegans nuclear receptor DAF-12 is activated by dafachronic acids, hormones that commit larvae to reproductive growth. Here, we report that in addition to its well-studied role in controlling developmental gene expression, the DAF-12 endocrine system governs expression of a gene network that stimulates the aerobic catabolism of fatty acids. Thus, activation of the DAF-12 transcriptome coordinately mobilizes energy stores to permit reproductive growth. DAF-12 regulation of this metabolic gene network is conserved in the human parasite, Strongyloides stercoralis, and inhibition of specific steps in this network blocks reproductive growth in both of the nematodes. Our study provides a molecular understanding for metabolic adaptation of nematodes to their environment, and suggests a new therapeutic strategy for treating parasitic diseases. PMID:25774872

  3. [Geohelminths].

    PubMed

    Prieto-Pérez, Laura; Pérez-Tanoira, Ramón; Cabello-Úbeda, Alfonso; Petkova-Saiz, Elizabet; Górgolas-Hernández-Mora, Miguel

    2016-01-01

    Millions of people in in rural areas and deprived tropical and subtropical regions are infected by soil-transmitted helminths: Ascaris lumbricoides, Trichuris trichiura, hookworms (Ancylostoma duodenale and Necator americanus), and Strongyloides stercoralis. Large migratory flows have made their worldwide distribution easier. Besides being debilitating and producing a significant mortality, they cause high morbidity, leading to physical and intellectual impairment in millions of children who live in poverty. Along with the use of benzimidazoles (albendazole and mebendazole), large-scale international campaigns for treatment and prevention have decreased the number of affected individuals. However, re-infestations and benzimidazole-resistance are frequent, so there needs to be awareness about the importance and consequences of these neglected parasites. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  4. A British Second World War veteran with disseminated strongyloidiasis.

    PubMed

    Gill, G V; Beeching, N J; Khoo, S; Bailey, J W; Partridge, S; Blundell, J W; Luksza, A R

    2004-06-01

    A case is described of a 78-year-old British veteran of the Second World War (1939-45) who was stationed in Southeast Asia and who developed a recurrent pneumonia with blood eosinophilia. He was treated with steroids, and eventually died with a severe Pseudomonas pneumonia. Just prior to death, larvae of Strongyloides stercoralis were identified in his sputum, and a specific serum ELISA test was later positive. At autopsy no other organs were involved, but bronchoalveolar carcinoma was found. Longstanding (57 years) chronic strongyloidiasis in a veteran who served in Southeast Asia but who was not a prisoner of war is very unusual. The pattern of dissemination was also not that of a true hyperinfection syndrome, and the case demonstrates the continued need for diagnostic vigilance amongst former soldiers who were based in the Far East.

  5. AIDS-associated parasitic diarrhoea.

    PubMed

    Arora, D R; Arora, B

    2009-01-01

    Since the advent of human immunodeficiency virus infection, with its profound and progressive effect on the cellular immune system, a group of human opportunistic pathogens has come into prominence. Opportunistic parasitic infection can cause severe morbidity and mortality. Because many of these infections are treatable, an early and accurate diagnosis is important. This can be accomplished by a variety of methods such as direct demonstration of parasites and by serological tests to detect antigen and/or specific antibodies. However, antibody response may be poor in these patients and therefore immunodiagnostic tests have to be interpreted with caution. Cryptosporidium parvum, Isospora belli, Cyclospora cayetanensis, Microsporidia, Entamoeba histolytica and Strongyloides stercoralis are the commonly detected parasites. Detection of these parasites will help in proper management of these patients because drugs are available for most of these parasitic infections.

  6. Enterobiasis and strongyloidiasis and associated co-infections and morbidity markers in infants, preschool- and school-aged children from rural coastal Tanzania: a cross-sectional study.

    PubMed

    Salim, Nahya; Schindler, Tobias; Abdul, Ummi; Rothen, Julian; Genton, Blaise; Lweno, Omar; Mohammed, Alisa S; Masimba, John; Kwaba, Denis; Abdulla, Salim; Tanner, Marcel; Daubenberger, Claudia; Knopp, Stefanie

    2014-12-09

    There is a paucity of data pertaining to the epidemiology and public health impact of Enterobius vermicularis and Strongyloides stercoralis infections. We aimed to determine the extent of enterobiasis, strongyloidiasis, and other helminth infections and their association with asymptomatic Plasmodium parasitaemia, anaemia, nutritional status, and blood cell counts in infants, preschool-aged (PSAC), and school-aged children (SAC) from rural coastal Tanzania. A total of 1,033 children were included in a cross-sectional study implemented in the Bagamoyo district in 2011/2012. Faecal samples were examined for intestinal helminth infections using a broad set of quality controlled methods. Finger-prick blood samples were subjected to filariasis and Plasmodium parasitaemia testing and full blood cell count examination. Weight, length/height, and/or mid-upper arm circumference were measured and the nutritional status determined in accordance with age. E. vermicularis infections were found in 4.2% of infants, 16.7%, of PSAC, and 26.3% of SAC. S. stercoralis infections were detected in 5.8%, 7.5%, and 7.1% of infants, PSAC, and SAC, respectively. Multivariable regression analyses revealed higher odds of enterobiasis in children of all age-groups with a reported anthelminthic treatment history over the past six months (odds ratio (OR): 2.15; 95% confidence interval (CI): 1.22 - 3.79) and in SAC with a higher temperature (OR: 2.21; CI: 1.13 - 4.33). Strongyloidiasis was associated with eosinophilia (OR: 2.04; CI: 1.20-3.48) and with Trichuris trichiura infections (OR: 4.13; CI: 1.04-16.52) in children of all age-groups, and with asymptomatic Plasmodium parasitaemia (OR: 13.03; CI: 1.34 - 127.23) in infants. None of the investigated helminthiases impacted significantly on the nutritional status and anaemia, but moderate asymptomatic Plasmodium parasitaemia was a strong predictor for anaemia in children aged older than two years (OR: 2.69; 95% CI: 1.23 - 5.86). E. vermicularis

  7. [Soil transmitted helminthiasis in Argentina. A systematic review].

    PubMed

    Socías, M Eugenia; Fernández, Anabel; Gil, José F; Krolewiecki, Alejandro J

    2014-01-01

    A systematic review of surveys performed between 1980 and 2011 (published in MEDLINE/Pubmed and/or LILACS indexed journals, available in the baseline data from a Mass Deworming National Program (MDNP, 2005) was used to identify the prevalence, distribution and detection of risk areas for soil transmitted helminth infections (STH) in Argentina. We found 310 publications in the database using the pre-defined key-words (medical subject headings) for research purposes. Only 24 articles with 26 surveillance sites in 8 provinces and a total of 5495 surveyed individuals fulfilled the inclusion criteria. Frequency rates for STH had a wide range: Ascaris lumbricoides: 0-67%, hookworms: 0-90%, Trichuris trichiura: 0-24.6 and Strongyloides stercoralis: 0-83%. The estimated combined incidence varied from 0.8% to 88.6%. Baseline surveys from the MDNP reporting on 1943 children from 12 provinces confirmed the heterogeneity, with combined STH frequency rates ranging from 0 to 42.7%. Surveys included in this review showed that the distribution of STH in Argentina is not homogeneous, with areas of high incidence (> 20%) in the northeastern and northwestern provinces where mass deworming activities would be highly beneficial. In several surveys, the high overall incidence was mostly due to hookworms and S. stercoralis, a situation to be considered when selecting diagnostic and therapeutic control strategies. The scarcity or absence of data from various provinces and the availability of less than 8000 surveyed individuals should be considered.

  8. Pneumocystis carinii pneumonia, pulmonary tuberculosis and visceral leishmaniasis in an adult HIV negative patient.

    PubMed

    Toledo, A C; de Castro, M R

    2001-06-01

    This is a case report of a 29 year old male with pneumocystis pneumonia and tuberculosis, and who was initially suspected of having HIV infection, based on risk factor analyses, but was subsequently shown to be HIV negative. The patient arrived at the hospital with fever, cough, weight loss, loss of appetite, pallor, and arthralgia. In addition, he was jaundiced and had cervical lymphadenopathy and mild heptosplenomegaly. He had interstitial infiltrates of the lung, sputum smears positive for Mycobacterium tuberculosis and Pneumocystis carinii, and stool tests were positive for Strongyloides stercoralis and Schistosoma mansoni. He was diagnosed as having AIDS, and was treated for tuberculosis, pneumocystosis, and strongyloidiasis with a good response. The patient did not receive anti-retroviral therapy, pending outcome of the HIV tests. A month later, he was re-examined and found to have worsening hepatosplenomegaly, pancytopenia, fever, and continued weight loss. At this time, it was determined that his HIV ELISA antibody tests were negative. A bone marrow aspirate was done and revealed amastigotes of leishmania, and a bone marrow culture was positive for Leishmania species. He was treated with pentavalent antimony, 20 mg daily for 20 days, with complete remission of symptoms and weight gain. This case demonstrates that immunosuppression from leishmaniasis and tuberculosis may lead to pneumocystosis, and be misdiagnosed as HIV infection. The occurrence of opportunistic infections in severely ill patients without HIV must always be considered and alternate causes of immunosuppression sought.

  9. Strongyloidiasis in Allied ex-prisoners of war in south-east Asia.

    PubMed

    Grove, D I

    1980-03-01

    One hundred and sixty ex-servicemen who had been prisoners of war in south-east Asia during 1942-5 were investigated for infection with Strongyloides stercoralis. Larvae were found in 44 (27.5%) of the men, who had therefore been infected for 34-37 years. Direct microscopy of the faeces was the most successful diagnostic method, giving a positive result in 37 cases (84%); multiple examinations were often necessary. Faecal culture was positive in 30 cases (68%), but examination of duodenal fluid obtained with the string test gave a positive result in only 17 (39%). The mean blood eosinophil count and mean serum IgE concentration were higher in the infected men, though normal values were often found in individual cases. Clinical manifestations of isolated strongyloides infection were analysed by comparing the infected men with control groups of ex-prisoners in south-east Asia without proved strongyloidiasis and ex-prisoners in Europe. Twenty-nine infected men (66%) complained of non-specific urticaria, and 13 (30%) had pathognomonic larva currens. Gastrointestinal symptoms significantly more common in the infected group were diarrhoea, indigestion, lower abdominal pain, pruritus ani, and weight loss (p <0.05-p <0.0005).The study group was thought to be reasonably representative of Allied ex-servicemen imprisoned in south-east Asia during the second world war. Probably there are many thousands of infected persons in several countries. The worm has an unusual ability to multiply, and larvae may spread throughout the body in immunosuppressed subjects.

  10. Decreasing Intestinal Parasites in Recent Northern California Refugees

    PubMed Central

    Chang, Alicia H.; Perry, Sharon; Du, Jenny N. T.; Agunbiade, Abdulkareem; Polesky, Andrea; Parsonnet, Julie

    2013-01-01

    Beginning in 2005, the Centers for Disease Control and Prevention (CDC) expanded the overseas presumptive treatment of intestinal parasites with albendazole to include refugees from the Middle East. We surveyed the prevalence of helminths and protozoa in recent Middle Eastern refugees (2008–2010) in comparison with refugees from other geographical regions and from a previous survey (2001–2004) in Santa Clara County, California. Based on stool microscopy, helminth infections decreased, particularly in Middle Eastern refugees (0.1% versus 2.3% 2001–2004, P = 0.01). Among all refugees, Giardia intestinalis was the most common protozoan found. Protozoa infections also decreased somewhat in Middle Eastern refugees (7.2%, 2008–2010 versus 12.9%, 2001–2004, P = 0.08). Serology for Strongyloides stercoralis and Schistosoma spp. identified more infected individuals than stool exams. Helminth infections are increasingly rare in refugees to Northern California. Routine screening stool microscopy may be unnecessary in all refugees. PMID:23149583

  11. Parasite Infection, Carcinogenesis and Human Malignancy.

    PubMed

    van Tong, Hoang; Brindley, Paul J; Meyer, Christian G; Velavan, Thirumalaisamy P

    2017-02-01

    Cancer may be induced by many environmental and physiological conditions. Infections with viruses, bacteria and parasites have been recognized for years to be associated with human carcinogenicity. Here we review current concepts of carcinogenicity and its associations with parasitic infections. The helminth diseases schistosomiasis, opisthorchiasis, and clonorchiasis are highly carcinogenic while the protozoan Trypanosoma cruzi, the causing agent of Chagas disease, has a dual role in the development of cancer, including both carcinogenic and anticancer properties. Although malaria per se does not appear to be causative in carcinogenesis, it is strongly associated with the occurrence of endemic Burkitt lymphoma in areas holoendemic for malaria. The initiation of Plasmodium falciparum related endemic Burkitt lymphoma requires additional transforming events induced by the Epstein-Barr virus. Observations suggest that Strongyloides stercoralis may be a relevant co-factor in HTLV-1-related T cell lymphomas. This review provides an overview of the mechanisms of parasitic infection-induced carcinogenicity. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  12. Three-Dimensional Reconstruction of the Amphid Sensilla in the Microbial Feeding Nematode, Acrobeles complexus (Nematoda: Rhabditida)

    PubMed Central

    Bumbarger, Daniel J.; Wijeratne, Sitara; Carter, Cale; Crum, John; Ellisman, Mark H.; Baldwin, James G.

    2009-01-01

    Amphid sensilla are the primary olfactory, chemoreceptive, and thermoreceptive organs in nematodes. Their function is well described for the model organism Caenorhabditis elegans, but it is not clear to what extent we can generalize these findings to distantly related nematodes of medical, economic, and agricultural importance. Current detailed descriptions of anatomy and sensory function are limited to nematodes that recent molecular phylogenies would place in the same taxonomic family, the Rhabditidae. Using serial thin-section transmission electron microscopy, we reconstructed the anatomy of the amphid sensilla in the more distantly related nematode, Acrobeles complexus (Cephalobidae). Amphid structure is broadly conserved in number and arrangement of cells. Details of cell anatomy differ, particularly for the sensory neurite termini. We identify an additional sensory neuron not found in the amphid of C. elegans and propose homology with the C. elegans interneuron AUA. Hypotheses of homology for the remaining sensory neurons are also proposed based on comparisons between C. elegans, Strongyloides stercoralis, and Haemonchus contortus. PMID:19003904

  13. Gastrointestinal parasites of the colobus monkeys of Uganda.

    PubMed

    Gillespie, Thomas R; Greiner, Ellis C; Chapman, Colin A

    2005-06-01

    From August 1997 to July 2003, we collected 2,103 fecal samples from free-ranging individuals of the 3 colobus monkey species of Uganda-the endangered red colobus (Piliocolobus tephrosceles), the eastern black-and-white colobus (Colobus guereza), and the Angolan black-and-white colobus (C. angolensis)--to identify and determine the prevalence of gastrointestinal parasites. Helminth eggs, larvae, and protozoan cysts were isolated by sodium nitrate flotation and fecal sedimentation. Coprocultures facilitated identification of helminths. Seven nematodes (Strongyloides fulleborni, S. stercoralis, Oesophagostomum sp., an unidentified strongyle, Trichuris sp., Ascaris sp., and Colobenterobius sp.), 1 cestode (Bertiella sp.), 1 trematode (Dicrocoeliidae), and 3 protozoans (Entamoeba coli, E. histolytica, and Giardia lamblia) were detected. Seasonal patterns of infection were not apparent for any parasite species infecting colobus monkeys. Prevalence of S. fulleborni was higher in adult male compared to adult female red colobus, but prevalence did not differ for any other shared parasite species between age and sex classes.

  14. Post-travel screening of asymptomatic long-term travelers to the tropics for intestinal parasites using molecular diagnostics.

    PubMed

    Soonawala, Darius; van Lieshout, Lisette; den Boer, Marion A M; Claas, Eric C J; Verweij, Jaco J; Godkewitsch, André; Ratering, Marchel; Visser, Leo G

    2014-05-01

    The incidence of asymptomatic travel-related parasitic infection is uncertain. Previous studies did not distinguish new incident infections, from past infections. Regardless of symptoms, we performed multiplex real-time polymerase chain reaction on pre- and post-travel stool samples of Dutch long-term travelers to the (sub)tropics. Serological screening for Schistosoma spp. was only performed in travelers to sub-Saharan Africa. In total, 679 travelers were included in the study. The follow-up rate was 82% (556 of 679). Participants' median travel duration was 12 weeks. There was one incident infection with Strongyloides stercoralis; there were none with Entamoeba histolytica, 4 with Cryptosporidium spp. (1%), and 22 with Giardia lamblia (4%). Nine of 146 travelers (6%) seroconverted for Schistosoma spp. Routine screening of stool samples for parasitic infection is not indicated for asymptomatic people, who travel to the (sub)tropics for up to 3 months. Screening for Schistosoma spp. should be offered to travelers with fresh-water contact in endemic regions.

  15. Post-Travel Screening of Asymptomatic Long-Term Travelers to the Tropics for Intestinal Parasites Using Molecular Diagnostics

    PubMed Central

    Soonawala, Darius; van Lieshout, Lisette; den Boer, Marion A. M.; Claas, Eric C. J.; Verweij, Jaco J.; Godkewitsch, André; Ratering, Marchel; Visser, Leo G.

    2014-01-01

    The incidence of asymptomatic travel-related parasitic infection is uncertain. Previous studies did not distinguish new incident infections, from past infections. Regardless of symptoms, we performed multiplex real-time polymerase chain reaction on pre- and post-travel stool samples of Dutch long-term travelers to the (sub)tropics. Serological screening for Schistosoma spp. was only performed in travelers to sub-Saharan Africa. In total, 679 travelers were included in the study. The follow-up rate was 82% (556 of 679). Participants' median travel duration was 12 weeks. There was one incident infection with Strongyloides stercoralis; there were none with Entamoeba histolytica, 4 with Cryptosporidium spp. (1%), and 22 with Giardia lamblia (4%). Nine of 146 travelers (6%) seroconverted for Schistosoma spp. Routine screening of stool samples for parasitic infection is not indicated for asymptomatic people, who travel to the (sub)tropics for up to 3 months. Screening for Schistosoma spp. should be offered to travelers with fresh-water contact in endemic regions. PMID:24615130

  16. Seroepidemiology of helminths and the association with severe malaria among infants and young children in Tanzania.

    PubMed

    Kwan, Jennifer L; Seitz, Amy E; Fried, Michal; Lee, Kun-Lin; Metenou, Simon; Morrison, Robert; Kabyemela, Edward; Nutman, Thomas B; Prevots, D Rebecca; Duffy, Patrick E

    2018-03-01

    The disease burden of Wuchereria bancrofti and Plasmodium falciparum malaria is high, particularly in Africa, and co-infection is common. However, the effects of filarial infection on the risk of severe malaria are unknown. We used the remaining serum samples from a large cohort study in Muheza, Tanzania to describe vector-borne filarial sero-reactivity among young children and to identify associations between exposure to filarial parasites and subsequent severe malaria infections. We identified positive filarial antibody responses (as well as positive antibody responses to Strongyloides stercoralis) among infants as young as six months. In addition, we found a significant association between filarial seropositivity at six months of age and subsequent severe malaria. Specifically, infants who developed severe malaria by one year of age were 3.9 times more likely (OR = 3.9, 95% CI: 1.2, 13.0) to have been seropositive for filarial antigen at six months of age compared with infants who did not develop severe malaria.

  17. Pilot Study to Assess the Efficacy of Ivermectin and Fenbendazole for Treating Captive-Born Olive Baboons (Papio anubis) Coinfected with Strongyloides fülleborni and Trichuris trichiura.

    PubMed

    Reichard, Mason V; Thomas, Jennifer E; Chavez-Suarez, Maria; Cullin, Cassandra O; White, Gary L; Wydysh, Emily C; Wolf, Roman F

    2017-01-01

    In this study, we evaluated the efficacy of combined treatment with ivermectin and fenbendazole (IVM-FBZ) for treating captive olive baboons (Papio anubis) infected with Strongyloides fülleborni and Trichuris trichiura, 2 common nematode parasites of these NHP. Infected baboons were treated for a total of 9 wk with ivermectin (400 μg/kg IM twice weekly) and fenbendazole (50 mg/kg PO once daily for 3 d; 3 rounds of treatment, 21 d apart). Five baboons naturally infected with both S. fülleborni and T. trichiura (n = 4) or S. fülleborni alone (n = 1) received the combination therapy; an additional baboon infected with both parasites served as a nontreated control. The efficacy of IVM-FBZ was measured as the reduction in fecal egg counts of S. fülleborni and T. trichiura as determined by quantitative fecal flotation examination after treatment of baboons with IVM-FBZ. All baboons treated with IVM-FBZ stopped shedding S. fülleborni and T. trichiura eggs by 8 d after treatment and remained negative for at least 161 d. The nontreated control baboon shed S. fülleborni and T. trichiura eggs throughout the study period. Our results indicate that the IVM-FBZ regimen was efficacious for treating olive baboons infected with S. fülleborni and T. trichiura.

  18. Pilot Study to Assess the Efficacy of Ivermectin and Fenbendazole for Treating Captive-Born Olive Baboons (Papio anubis) Coinfected with Strongyloides fülleborni and Trichuris trichiura

    PubMed Central

    Reichard, Mason V; Thomas, Jennifer E; Chavez-Suarez, Maria; Cullin, Cassandra O; White, Gary L; Wydysh, Emily C; Wolf, Roman F

    2017-01-01

    In this study, we evaluated the efficacy of combined treatment with ivermectin and fenbendazole (IVM–FBZ) for treating captive olive baboons (Papio anubis) infected with Strongyloides fülleborni and Trichuris trichiura, 2 common nematode parasites of these NHP. Infected baboons were treated for a total of 9 wk with ivermectin (400 μg/kg IM twice weekly) and fenbendazole (50 mg/kg PO once daily for 3 d; 3 rounds of treatment, 21 d apart). Five baboons naturally infected with both S. fülleborni and T. trichiura (n = 4) or S. fülleborni alone (n = 1) received the combination therapy; an additional baboon infected with both parasites served as a nontreated control. The efficacy of IVM–FBZ was measured as the reduction in fecal egg counts of S. fülleborni and T. trichiura as determined by quantitative fecal flotation examination after treatment of baboons with IVM–FBZ. All baboons treated with IVM–FBZ stopped shedding S. fülleborni and T. trichiura eggs by 8 d after treatment and remained negative for at least 161 d. The nontreated control baboon shed S. fülleborni and T. trichiura eggs throughout the study period. Our results indicate that the IVM–FBZ regimen was efficacious for treating olive baboons infected with S. fülleborni and T. trichiura. PMID:28905715

  19. Economic Analysis of the Impact of Overseas and Domestic Treatment and Screening Options for Intestinal Helminth Infection among US-Bound Refugees from Asia.

    PubMed

    Maskery, Brian; Coleman, Margaret S; Weinberg, Michelle; Zhou, Weigong; Rotz, Lisa; Klosovsky, Alexander; Cantey, Paul T; Fox, LeAnne M; Cetron, Martin S; Stauffer, William M

    2016-08-01

    Many U.S.-bound refugees travel from countries where intestinal parasites (hookworm, Trichuris trichuria, Ascaris lumbricoides, and Strongyloides stercoralis) are endemic. These infections are rare in the United States and may be underdiagnosed or misdiagnosed, leading to potentially serious consequences. This evaluation examined the costs and benefits of combinations of overseas presumptive treatment of parasitic diseases vs. domestic screening/treating vs. no program. An economic decision tree model terminating in Markov processes was developed to estimate the cost and health impacts of four interventions on an annual cohort of 27,700 U.S.-bound Asian refugees: 1) "No Program," 2) U.S. "Domestic Screening and Treatment," 3) "Overseas Albendazole and Ivermectin" presumptive treatment, and 4) "Overseas Albendazole and Domestic Screening for Strongyloides". Markov transition state models were used to estimate long-term effects of parasitic infections. Health outcome measures (four parasites) included outpatient cases, hospitalizations, deaths, life years, and quality-adjusted life years (QALYs). The "No Program" option is the least expensive ($165,923 per cohort) and least effective option (145 outpatient cases, 4.0 hospitalizations, and 0.67 deaths discounted over a 60-year period for a one-year cohort). The "Overseas Albendazole and Ivermectin" option ($418,824) is less expensive than "Domestic Screening and Treatment" ($3,832,572) or "Overseas Albendazole and Domestic Screening for Strongyloides" ($2,182,483). According to the model outcomes, the most effective treatment option is "Overseas Albendazole and Ivermectin," which reduces outpatient cases, deaths and hospitalization by around 80% at an estimated net cost of $458,718 per death averted, or $2,219/$24,036 per QALY/life year gained relative to "No Program". Overseas presumptive treatment for U.S.-bound refugees is a cost-effective intervention that is less expensive and at least as effective as domestic

  20. Previous contact with Strongyloides venezuelensis contributed to prevent insulitis in MLD-STZ diabetes.

    PubMed

    Peres, Raphael Sanches; Chiuso-Minicucci, Fernanda; da Rosa, Larissa Camargo; Domingues, Alexandre; Zorzella-Pezavento, Sofia Fernanda Gonçalves; França, Thais Graziela Donegá; Ishikawa, Larissa Lumi Watanabe; do Amarante, Alessandro Francisco Talamini; Sartori, Alexandrina

    2013-06-01

    Epidemiological and experimental studies support the idea that helminth infections can induce a protective effect against the development of autoimmune and allergic diseases. In this study we characterized the immune response induced by Strongyloides venezuelensis infection in C57BL/6 mice and then evaluated the effect of a previous contact with this helminth in the outcome of type 1 diabetes. Animals were initially infected with 2000 L3 larvae from S. venezuelensis and euthanized 22 days later. An acute phase, identified by a high amount of eggs per gram of feces, was established between days 7 and 9 post-infection. Recovery from infection was associated with a Th2 polarized response characterized by a significant level of serum IgG1 specific antibodies and also a significant production of IL-5 and IL-10 by spleen cells stimulated with S. venezuelensis soluble antigen. Immunization with soluble S. venezuelensis antigen associated with complete Freund's adjuvant followed by infection with S. venezuelensis protected mice from diabetes development induced by streptozotocin. Protection was characterized by a higher body weight gain, lower glycemic levels, much less severe insulitis and preserved insulin production. Together, these results indicate that S. venezuelensis contributed to protect C57BL/6 mice against experimental diabetes induced by streptozotocin. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Multifunctional Thioredoxin-Like Protein from the Gastrointestinal Parasitic Nematodes Strongyloides ratti and Trichuris suis Affects Mucosal Homeostasis

    PubMed Central

    Hansmann, Jan; Winter, Dominic; Schramm, Guido; Erttmann, Klaus D.; Liebau, Eva

    2016-01-01

    The cellular redox state is important for the regulation of multiple functions and is essential for the maintenance of cellular homeostasis and antioxidant defense. In the excretory/secretory (E/S) products of Strongyloides ratti and Trichuris suis sequences for thioredoxin (Trx) and Trx-like protein (Trx-lp) were identified. To characterize the antioxidant Trx-lp and its interaction with the parasite's mucosal habitat, S. ratti and T. suis Trx-lps were cloned and recombinantly expressed. The primary antioxidative activity was assured by reduction of insulin and IgM. Further analysis applying an in vitro mucosal 3D-cell culture model revealed that the secreted Trx-lps were able to bind to monocytic and intestinal epithelial cells and induce the time-dependent release of cytokines such as TNF-α, IL-22, and TSLP. In addition, the redox proteins also possessed chemotactic activity for monocytic THP-1 cells and fostered epithelial wound healing activity. These results confirm that the parasite-secreted Trx-lps are multifunctional proteins that can affect the host intestinal mucosa. PMID:27872753

  2. Opportunistic and other intestinal parasitic infections in AIDS patients, HIV seropositive healthy carriers and HIV seronegative individuals in southwest Ethiopia.

    PubMed

    Mariam, Zelalem T; Abebe, Gemeda; Mulu, Andargachew

    2008-12-01

    Human Immunodeficiency Virus (HIV) infection leads to acquired immunodeficiency syndrome (AIDS) and major causes of morbidity and mortality of such patients are opportunistic infections caused by viral, bacterial, fungal and parasitic pathogens. To determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections among AIDS patients and HIV positive carrier individuals. Cross-sectional study was conducted among AIDS patients, HIV positive healthy carriers and HIV negative individuals in Jimma University Hospital, Mother Theresa Missionary Charity Centre, Medan Acts Projects and Mekdim HIV positive persons and AIDS orphans' national association from January to May, 2004. Convenient sampling technique was employed to identify the study subjects and hence a total of 160 subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of the patients. Stool samples were examined by direct saline, iodine wet mount, formol-ether sedimentation concentration, oocyst concentration and modified Ziehl-Neelsen staining technique. Out of 160 persons enrolled in this study 100 (62.5%) (i.e. 65 male and 35 female) were infected with one or more intestinal parasites. The highest rate 36 (69.2%) of intestinal parasites were observed among HIV/AIDS patients, followed by HIV positive healthy carriers 35 (61.4%) of and HIV negative individuals (29 (56.9%). Isospora belli 2 (3.9%), Cryptosporidum parvum 8 (15.4%), Strongyloides stercoralis 6 (11.5%) and Blastocystis 2 (3.9%) were found only in HIV/AIDS groups I. belli, C. parvum, S. stercoralis and Blastocystis are the major opportunistic intestinal parasites observed in HIV/AIDS patients. Therefore, early detection and treatment of these parasites are important to improve the quality of life of HIV/AIDS patients with diarrhoea.

  3. Intestinal parasites in cancer patients in the South of Brazil.

    PubMed

    Jeske, S; Bianchi, T F; Moura, M Q; Baccega, B; Pinto, N B; Berne, M E A; Villela, M M

    2017-11-27

    Intestinal parasitic infections in immunocompromised patients can lead to serious complications when not diagnosed and treated early. This study aimed to investigate the frequency of intestinal parasites in cancer patients undergoing chemotherapy in the South of Brazil. Three fecal samples collected from each patient (73 individuals) were processed by Ritchie and Faust techniques and submitted to specific staining methods for intestinal protozoa. A 61.6% parasite and/or commensal positivity was found. Helminths identified were Ascaris lumbricoides (33.3%), Taenia spp. (6.6%), Strongyloides stercoralis (4.4%) and Trichuris trichiura (2.2%). Among protozoans, Giardia lamblia (26.6%), Cryptosporidium spp. (13.3%) and Cystoisospora belli (4.4%) were identified. The presence of Entamoeba coli, Endolimax nana and Entamoeba hartmanni was also recorded. The results obtained warn of the importance of fecal parasitological diagnosis and the use of specific staining methods for the detection of intestinal parasites in cancer patients. These exams should be regularly requested at the patient's first clinic visit, given the high prevalence found in this study and the possible severity of such conditions for these individuals.

  4. Tropical Diseases Screening in Immigrant Patients with Human Immunodeficiency Virus Infection in Spain

    PubMed Central

    Salvador, Fernando; Molina, Israel; Sulleiro, Elena; Burgos, Joaquín; Curran, Adrián; den Eynde, Eva Van; Villar del Saz, Sara; Navarro, Jordi; Crespo, Manuel; Ocaña, Inma; Ribera, Esteve; Falcó, Vicenç; Pahissa, Albert

    2013-01-01

    Latent parasitic infections can reactivate because of immunosuppression. We conducted a prospective observational study of all human immunodeficiency virus (HIV)–infected immigrants who visited the Infectious Diseases Department of the Hospital Universitari Vall d'Hebron, Barcelona, Spain, during June 2010–May 2011. Screening of the most prevalent tropical diseases (intestinal parasitosis, Chagas disease, leishmaniasis, malaria, schistosomiasis, and strongyloidiasis) was performed according to geographic origin. A total of 190 patients were included: 141 (74.2%) from Latin America, 41 (21.6%) from sub-Saharan Africa, and 8 (4.2%) from northern Africa. Overall, 36.8% (70 of 190) of the patients had at least one positive result for any parasitic disease: 5 patients with positive Trypanosoma cruzi serology, 11 patients with positive Schistosoma mansoni serology, 35 patients with positive Strongyloides stercoralis serology, 7 patients with positive Leishmania infantum serology, intestinal parasitosis were detected in 37 patients, malaria was diagnosed in one symptomatic patient. We propose a screening and management strategy of latent parasitic infections in immigrant patients infected with HIV. PMID:23509119

  5. [Intestinal helminthiasis diagnosed in Dakar, Senegal].

    PubMed

    Ndiaye, D; Ndiaye, M; Gueye, P A L; Badiane, A; Fall, I D; Ndiaye, Y D; Faye, B; Ndiaye, J L; Tine, R; Ndir, O

    2013-01-01

    The goal of this study was to determine the prevalence of digestive helminthiasis among patients referred to the laboratory of Parasitology and mycology at Le Dantec Hospital in Dakar for examination of stool samples from 2004 to 2009. Of 1 526 direct stool examinations (Ritchie and Baerman techniques) analyzed at the laboratory of Parasitology and Mycology of Le Dantec Hospital from 2004 to 2009, 310 were positive for intestinal helminthiasis, for a prevalence of 20.3%. The main species found were: Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis, Tænia saginata and Tænia solium. Most patients had a single parasite (90.1%, versus 9% with two and 0.9% with three). Men are infected more often than women, accounting respectively for 58% and 42% of the infections, for a sex ratio of 1.38. Children aged 10 to 15 years had the highest prevalence of infection: 34.5%. The results show that digestive helminthiasis is endemic in Dakar, where it is necessary to implement campaigns of deworming, health education and environmental improvement.

  6. Diversity of human intestinal helminthiasis in Lao PDR.

    PubMed

    Sayasone, Somphou; Vonghajack, Youthanavane; Vanmany, Monely; Rasphone, Oroth; Tesana, Smarn; Utzinger, Jürg; Akkhavong, Kongsap; Odermatt, Peter

    2009-03-01

    Food-borne trematodiasis is an emerging public health problem, including in Lao PDR. We investigated the diversity of intestinal helminthes and polyparasitism in patients with hepatobiliary or intestinal symptoms in hospital and community-based surveys. Stool samples from 232 individuals aged >or=15 years were examined by the Kato-Katz method (three samples) and a formalin ethyl-acetate concentration technique (one sample). Opisthorchis viverrini and minute intestinal flukes (MIF) were common, with prevalences of 86.2% and 62.9%, respectively. Hookworm was the predominant soil-transmitted helminth (65.9%). The prevalences of Taenia spp., Strongyloides stercoralis and Trichuris trichiura were 22.8%, 10.3% and 8.6%, respectively. Additionally, 97 individuals were purged; O. viverrini and Haplorchis taichui were found in 95 and 76 participants, respectively. Other trematodes included Phaneropsolus bonnei (22.7%), Prosthodendrium molenkampi (14.4%), Haplorchis pumilio (5.2%), Haplorchis yokogawai (3.1%) and Echinochasmus japonicus (3.1%). Co-infection with O. viverrini and MIFs was rampant (81.4%). Polytrematode infection is highly prevalent in Lao PDR and hence requires urgent attention.

  7. Rapid Re-Infection with Soil-Transmitted Helminths after Triple-Dose Albendazole Treatment of School-Aged Children in Yunnan, People's Republic of China

    PubMed Central

    Yap, Peiling; Du, Zun-Wei; Wu, Fang-Wei; Jiang, Jin-Yong; Chen, Ran; Zhou, Xiao-Nong; Hattendorf, Jan; Utzinger, Jürg; Steinmann, Peter

    2013-01-01

    Post-treatment soil-transmitted helminth re-infection patterns were studied as part of a randomized controlled trial among school-aged children from an ethnic minority group in Yunnan province, People's Republic of China. Children with a soil-transmitted helminth infection (N = 194) were randomly assigned to triple-dose albendazole or placebo and their infection status monitored over a 6-month period using the Kato-Katz and Baermann techniques. Baseline prevalence of Trichuris trichiura, Ascaris lumbricoides, hookworm, and Strongyloides stercoralis were 94.5%, 93.3%, 61.3%, and 3.1%, respectively, with more than half of the participants harboring triple-species infections. For the intervention group (N = 99), the 1-month post-treatment cure rates were 96.7%, 91.5%, and 19.6% for hookworm, A. lumbricoides, and T. trichiura, respectively. Egg reduction rates were above 88% for all three species. Rapid re-infection with A. lumbricoides was observed: the prevalence 4 and 6 months post-treatment was 75.8% and 83.8%, respectively. Re-infection with hookworm and T. trichiura was considerably slower. PMID:23690551

  8. Tropical diseases screening in immigrant patients with human immunodeficiency virus infection in Spain.

    PubMed

    Salvador, Fernando; Molina, Israel; Sulleiro, Elena; Burgos, Joaquín; Curran, Adrián; Van den Eynde, Eva; Villar del Saz, Sara; Navarro, Jordi; Crespo, Manuel; Ocaña, Inma; Ribera, Esteve; Falcó, Vicenç; Pahissa, Albert

    2013-06-01

    Latent parasitic infections can reactivate because of immunosuppression. We conducted a prospective observational study of all human immunodeficiency virus (HIV)-infected immigrants who visited the Infectious Diseases Department of the Hospital Universitari Vall d'Hebron, Barcelona, Spain, during June 2010-May 2011. Screening of the most prevalent tropical diseases (intestinal parasitosis, Chagas disease, leishmaniasis, malaria, schistosomiasis, and strongyloidiasis) was performed according to geographic origin. A total of 190 patients were included: 141 (74.2%) from Latin America, 41 (21.6%) from sub-Saharan Africa, and 8 (4.2%) from northern Africa. Overall, 36.8% (70 of 190) of the patients had at least one positive result for any parasitic disease: 5 patients with positive Trypanosoma cruzi serology, 11 patients with positive Schistosoma mansoni serology, 35 patients with positive Strongyloides stercoralis serology, 7 patients with positive Leishmania infantum serology, intestinal parasitosis were detected in 37 patients, malaria was diagnosed in one symptomatic patient. We propose a screening and management strategy of latent parasitic infections in immigrant patients infected with HIV.

  9. Effects of various treatments on the chemokinetic behavior of third-stage larvae of Strongyloides ratti on a sodium chloride gradient.

    PubMed

    Tobata-Kudo, H; Higo, H; Koga, M; Tada, I

    2000-11-01

    In observations of the movements of the infective third-stage larvae of a rodent parasitic nematode, Strongyloides ratti, on a sodium chloride gradient set up on agarose plates, two types of chemokinetic behavior were seen: a unidirectional avoidance movement on initial placement of the larvae in unfavorable environmental conditions and a random dispersal movement on their placement within an area of favorable conditions. Track patterns were straight in the avoidance movement but included multiple changes of direction and loops in the dispersal movement. In the present study we examined the interventional activity of treatment with various enzymes, lectins, and chemicals by analyzing the unidirectional avoidance movements of the larvae. We observed that beta-glucosidase, hyaluronidase, beta-galactosidase, trypsin, protease, lipase, phospholipase C, soybean agglutinin, wheat germ agglutinin, and spermidine exerted inhibitory actions on those movements, which may be guided by the chemosensory function of this nematode.

  10. Prevalence of intestinal parasitic infections in military personnel and military dogs, Thailand.

    PubMed

    Leelayoova, Saovanee; Siripattanapipong, Suradej; Naaglor, Tawee; Taamasri, Paanjit; Mungthin, Mathirut

    2009-02-01

    To determine the prevalence of intestinal parasitic infections and risk factors among military personnel and military dogs at the Military Dog Center, Veterinary and Remount Department, Royal Thai Army, Thailand. A cross-sectional study was conducted in January 2006 to examine intestinal parasitic infections using wet preparation and, formalin-ethyl acetate concentration. Modified acid fast and gram-chromotrope stains were used to identify Cryptosporidium spp. and microsporidia, respectively. Culture for Blastocystis was performed using Jone's medium. Genotypic characterization of Blastocystis and Giardia duodenalis were also determined using PCR-RFLP. To determine the risk factors and outcomes of intestinal parasitic infections, standardized questionnaires were used in the present study. Of 317 military personnel, the prevalence of intestinal parasitic infections was 22.4%. Blastocystis was the most predominant intestinal protozoa infection of 14.5% while G. duodenalis was only 1.3%. The prevalence of other helminthic infections were 4.8% which were Strongyloides stercoralis (2.5%), Hookworm (1.0%), Opisthorchis viverrini (1.0%), and Taenia spp. (0.3%), respectively. Blastocystis subtype 1 was identified in 25 positive culture specimens while all 4 positive of G. duodenalis were analyzed as Assemblage B, subgenotype IV. The presented data could not indicate that intestinal parasitic infections and blastocystosis in this army population were significantly linked to risk association among groups with regard to rank, age group, working unit, area of residence, animal contact, source and treatment of drinking water. Of 189 military dogs, the prevalence of intestinal parasitic infections was only 3.7% which was Blastocystis sp. (2.6%), S. stercoralis (0.5%), and Entamoeba coli (0.5%), respectively. The predominant intestinal parasites found in this population, such as Blastocystis sp. and G duodenalis transmit to humans via fecal-oral route so that improvement of

  11. Helminth Infections Coincident with Active Pulmonary Tuberculosis Inhibit Mono- and Multifunctional CD4+ and CD8+ T Cell Responses in a Process Dependent on IL-10

    PubMed Central

    George, Parakkal Jovvian; Anuradha, Rajamanickam; Kumar, Nathella Pavan; Sridhar, Rathinam; Banurekha, Vaithilingam V.; Nutman, Thomas B.; Babu, Subash

    2014-01-01

    Tissue invasive helminth infections and tuberculosis (TB) are co-endemic in many parts of the world and can trigger immune responses that might antagonize each other. We have previously shown that helminth infections modulate the Th1 and Th17 responses to mycobacterial-antigens in latent TB. To determine whether helminth infections modulate antigen-specific and non-specific immune responses in active pulmonary TB, we examined CD4+ and CD8+ T cell responses as well as the systemic (plasma) cytokine levels in individuals with pulmonary TB with or without two distinct helminth infections—Wuchereria bancrofti and Strongyloides stercoralis infection. By analyzing the frequencies of Th1 and Th17 CD4+ and CD8+ T cells and their component subsets (including multifunctional cells), we report a significant diminution in the mycobacterial–specific frequencies of mono- and multi–functional CD4+ Th1 and (to a lesser extent) Th17 cells when concomitant filarial or Strongyloides infection occurs. The impairment in CD4+ and CD8+ T cell cytokine responses was antigen-specific as polyclonal activated T cell frequencies were equivalent irrespective of helminth infection status. This diminution in T cell responses was also reflected in diminished circulating levels of Th1 (IFN-γ, TNF-α and IL-2)- and Th17 (IL-17A and IL-17F)-associated cytokines. Finally, we demonstrate that for the filarial co-infections at least, this diminished frequency of multifunctional CD4+ T cell responses was partially dependent on IL-10 as IL-10 blockade significantly increased the frequencies of CD4+ Th1 cells. Thus, co-existent helminth infection is associated with an IL-10 mediated (for filarial infection) profound inhibition of antigen-specific CD4+ T cell responses as well as protective systemic cytokine responses in active pulmonary TB. PMID:25211342

  12. Loss of surface coat by Strongyloides ratti infective larvae during skin penetration: evidence using larvae radiolabelled with /sup 67/gallium

    SciTech Connect

    Grove, D.I.; Northern, C.; Warwick, A.

    1984-10-01

    The optimal conditions for labelling infective larvae of Strongyloides ratti with /sup 67/Ga citrate were determined. Radiolabelled larvae were injected s.c. into normal and previously infected rats. The distribution of radioactivity in these animals was compared with that in rats infected subcutaneously with a similar dose of free /sup 67/Ga by using a gamma camera linked to a computer system. Whereas free /sup 67/Ga was distributed throughout the body and excreted via the hepatobiliary system, the bulk of radioactivity in rats injected with radiolabelled larvae remained at the injection sites. Direct microscopical examination of these sites, however, revealed only minimalmore » numbers of worms. When rats were infected percutaneously with radiolabelled larvae, it was found that most radioactivity remained at the surface, despite penetration of worms. When infective larvae were exposed to CO/sub 2/ in vitro and examined carefully by light microscopy, loss of an outer coat was observed. It was concluded that infective larvae lose an outer coat on skin penetration.« less

  13. Influence of helminth infections on childhood nutritional status in lowland Bolivia.

    PubMed

    Tanner, S; Leonard, W R; McDade, T W; Reyes-Garcia, V; Godoy, R; Huanca, T

    2009-01-01

    Infectious disease, such as diarrheal disease, respiratory infections, and parasitic infections, are an important source of nutritional and energetic stress in many populations. Inspired by the research and methodological innovations of A. Roberto Frisancho, this work considers the impact of childhood environment and local disease ecology on child health and nutritional patterns among an indigenous group in lowland Bolivia. Specifically, we examine the association between soil-transmitted helminth infection, especially hookworm species, and anthropometric markers of short- and long-term nutritional status. Fecal samples, anthropometric dimensions, and health interviews were collected for 92 children ranging in age from 2.0 to 10.9 years. Microscopic examination revealed high levels of parasitic infection, with 76% of children positive for hookworm species infections (77% of girls and 74% of boys). Less common infections included Ascaris lumbricoides, Trichurius trichiura, and Strongyloides stercoralis with only 15% of children positive for multiple-species infections. After adjusting for sex and age, no statistically significant associations were observed between helminth infections and the frequency of reported illness or anthropometric measures of nutritional status. These data demonstrate the difficulty of assessing nutritional impacts of endemic infections.

  14. Dogs, cats, parasites, and humans in Brazil: opening the black box

    PubMed Central

    2014-01-01

    Dogs and cats in Brazil serve as primary hosts for a considerable number of parasites, which may affect their health and wellbeing. These may include endoparasites (e.g., protozoa, cestodes, trematodes, and nematodes) and ectoparasites (i.e., fleas, lice, mites, and ticks). While some dog and cat parasites are highly host-specific (e.g., Aelurostrongylus abstrusus and Felicola subrostratus for cats, and Angiostrongylus vasorum and Trichodectes canis for dogs), others may easily switch to other hosts, including humans. In fact, several dog and cat parasites (e.g., Toxoplasma gondii, Dipylidium caninum, Ancylostoma caninum, Strongyloides stercoralis, and Toxocara canis) are important not only from a veterinary perspective but also from a medical standpoint. In addition, some of them (e.g., Lynxacarus radovskyi on cats and Rangelia vitalii in dogs) are little known to most veterinary practitioners working in Brazil. This article is a compendium on dog and cat parasites in Brazil and a call for a One Health approach towards a better management of some of these parasites, which may potentially affect humans. Practical aspects related to the diagnosis, treatment, and control of parasitic diseases of dogs and cats in Brazil are discussed. PMID:24423244

  15. Intestinal parasitosis: data analysis 2006-2011 in a teaching hospital of Ancona, Italy.

    PubMed

    Silvestri, Carmela; Greganti, Gianfranco; Arzeni, Daniela; Morciano, Angela; Castelli, Pamela; Barchiesi, Francesco; Cirioni, Oscar; Giacometti, Andrea

    2013-03-01

    Intestinal parasites are a serious problem in developing countries, but should not be underestimated in industrialised countries either. Between January 2006 and December 2011, stool specimens and the scotch tests of 5323 Italian and non Italian patients (adults and children) attending the laboratory of our Infectious Diseases Clinic in a teaching Hospital at Ancona were analyzed specifically for intestinal parasites. The present study shows that, over a six-year period, of a total of 5323 patients 305 harboured at least one species of parasite (5.7%). Among the pathogenic protozoa Giardia lamblia was the most common, the overall prevalence of giardiasis being 1.8 % (99/5323). Helminths were found in 0.9% of the patients (48/5323). In particular, Hymenolepis nana, Strongyloides stercoralis and Trichuris trichiura were most commonly recovered in non-Italian children, suggesting that certain intestinal parasites are restricted to endemic areas in the tropics. Eighteen of the 305 infected patients had more than one parasite in their stools. Our study demonstrates that intestinal parasites must be considered even in industrialised areas and stool examination should be supported by epidemiological data and clinical features.

  16. An improved kit for culturing clean nematode, larvae from faeces.

    PubMed

    Ndalahwa, J B; Lwambo, N J

    1989-03-01

    A kit for rapid recovery of clean hookworm and Strongyloides stercoralis larvae from faeces was devised. It consists of a 2.0dl perspex cup shaped container 35 x 30 x 24mm in size. A horse shoe stirrup aluminium sheet 54mm long and 20mm wide is inserted into the container so that the free ends stand at the bottom of the apparatus. The back of the stirrup carries a plastic disc 30mm in diameter through which two adjacent crescent shaped openings are cut. A strip of filter paper 40 x 20mm in size passes through the crescent openings astride the stirrup and its loose ends are bound together by means of a stapler. When the kit is assembled, the disk fits firmly in the middle of the container dividing it into lower and upper chambers. The staples free ends of the filter paper hang immersed into water in the lower chamber of the apparatus. A faecal sample is smeared on the upper part of the filter paper. Nematode larvae, if present, crawl from the faeces down the damp filter paper into the water at the bottom of the container.

  17. Gastrointestinal parasites of cats in Brazil: frequency and zoonotic risk.

    PubMed

    Monteiro, Maria Fernanda Melo; Ramos, Rafael Antonio Nascimento; Calado, Andréa Maria Campos; Lima, Victor Fernando Santana; Ramos, Ingrid Carla do Nascimento; Tenório, Rodrigo Ferreira Lima; Faustino, Maria Aparecida da Glória; Alves, Leucio Câmara

    2016-04-12

    Gastrointestinal helminths are considered to be the most common parasites affecting cats worldwide. Correct diagnosis of these parasites in animals living in urban areas is pivotal, especially considering the zoonotic potential of some species (e.g. Ancylostoma sp. and Toxocara sp.). In this study, a copromicroscopic survey was conducted using fecal samples (n = 173) from domestic cats living in the northeastern region of Brazil. Samples were examined through the FLOTAC technique and the overall results showed positivity of 65.31% (113/173) among the samples analyzed. Coinfections were observed in 46.01% (52/113) of the positive samples. The most common parasites detected were Ancylostoma sp., Toxocara cati, Strongyloides stercoralis, Trichuris sp., Dipylidium caninum and Cystoisospora sp. From an epidemiological point of view, these findings are important, especially considering that zoonotic parasites (e.g. Ancylostoma sp. and Toxocara sp.) were the nematodes most frequently diagnosed in this study. Therefore, the human population living in close contact with cats is at risk of infection caused by the zoonotic helminths of these animals. In addition, for the first time the FLOTAC has been used to diagnosing gastrointestinal parasites of cats in Brazil.

  18. Prevalence and Types of Coinfections in Sleeping Sickness Patients in Kenya (2000/2009)

    PubMed Central

    Kagira, J. M.; Maina, N.; Njenga, J.; Karanja, S. M.; Karori, S. M.; Ngotho, J. M.

    2011-01-01

    The occurrence of coinfections in human African trypanosomiasis (HAT) patients was investigated using a retrospective data of hospital records at the National Sleeping Sickness Referral Hospital in Alupe, Kenya. A total of 31 patients, 19 males and 12 females, were diagnosed with HAT between the years 2000 and 2009. The observed co-infections included malaria (100%), helminthosis (64.5%), typhoid (22.5%), urinary tract infections (16.1%), HIV (12.9%), and tuberculosis (3.2%). The species of helminthes observed included Ancylostoma duodenale (38.7%), Ascaris lumbricoides (45.7%), Strongyloides stercoralis (9.7%), and Taenia spp. (3.2%). The patients were also infected with Entamoeba spp. (32.3%) and Trichomonas hominis (22.6%) protozoan parasites. The main clinical signs observed at the point of admission included headache (74.2%), fever (48.4%), sleep disorders (45.2%), and general body pain (41.9%). The HAT patients were treated with suramin (early stage, 9/31) and melarsoprol (late stage, 22/31). In conclusion, the study has shown that HAT patients have multiple co-infections which may influence the disease pathogenesis and complicate management of HAT. PMID:21915184

  19. In vitro efficacy of latex and purified papain from Carica papaya against Strongyloides venezuelensis eggs and larvae.

    PubMed

    Moraes, Dayane; Levenhagen, Marcelo Arantes; Costa-Cruz, Julia Maria; Costa, Antônio Paulino da; Rodrigues, Rosângela Maria

    2017-04-03

    Latex from Carica papaya is rich in bioactive compounds, especially papain, which may help to control parasitic diseases. This study evaluated the efficacy of latex from C. papaya and purified papain against Strongyloides venezuelensis. The Egg Hatching Test (EHT) and the Larval Motility Test (LMT) using fresh and frozen latex (250mg/mL), lyophilized latex (34mg/mL), and purified papain (2.8 mg/mL) were performed. Albendazole (0.025 mg/mL) and ivermectin (316 ppm) were used as positive controls. EHT and LMT were carried out through the incubation of each solution with S. venezuelensis eggs or larvae (± 100 specimens), and results were analyzed after 48h (EHT) or 24, 48, and 72h (LMT). EHT showed that latex preparations at higher concentrations (1:10 to 1:100) resulted in partial or complete destruction of eggs and larvae inside the eggs. The result from the 1:1,000 dilution was similar to the positive control. LMT showed effectiveness in all the tested dilutions compared to negative controls. Purified papain showed a dose-dependent response in the EHT. Purified papain (2.8 mg/ mL) showed similar results to lyophilized latex at 1:1,000 in the EHT. Latex and purified papain from C. papaya were effective against S. venezuelensis eggs and larvae in vitro, suggesting their potential use as an alternative treatment for strongyloidiasis.

  20. In vitro efficacy of latex and purified papain from Carica papaya against Strongyloides venezuelensis eggs and larvae

    PubMed Central

    Moraes, Dayane; Levenhagen, Marcelo Arantes; Costa-Cruz, Julia Maria; da Costa, Antônio Paulino; Rodrigues, Rosângela Maria

    2017-01-01

    ABSTRACT Latex from Carica papaya is rich in bioactive compounds, especially papain, which may help to control parasitic diseases. This study evaluated the efficacy of latex from C. papaya and purified papain against Strongyloides venezuelensis. The Egg Hatching Test (EHT) and the Larval Motility Test (LMT) using fresh and frozen latex (250mg/mL), lyophilized latex (34mg/mL), and purified papain (2.8 mg/mL) were performed. Albendazole (0.025 mg/mL) and ivermectin (316 ppm) were used as positive controls. EHT and LMT were carried out through the incubation of each solution with S. venezuelensis eggs or larvae (± 100 specimens), and results were analyzed after 48h (EHT) or 24, 48, and 72h (LMT). EHT showed that latex preparations at higher concentrations (1:10 to 1:100) resulted in partial or complete destruction of eggs and larvae inside the eggs. The result from the 1:1,000 dilution was similar to the positive control. LMT showed effectiveness in all the tested dilutions compared to negative controls. Purified papain showed a dose-dependent response in the EHT. Purified papain (2.8 mg/ mL) showed similar results to lyophilized latex at 1:1,000 in the EHT. Latex and purified papain from C. papaya were effective against S. venezuelensis eggs and larvae in vitro, suggesting their potential use as an alternative treatment for strongyloidiasis. PMID:28380118

  1. Diagnosing Polyparasitism in a High-Prevalence Setting in Beira, Mozambique: Detection of Intestinal Parasites in Fecal Samples by Microscopy and Real-Time PCR.

    PubMed

    Meurs, Lynn; Polderman, Anton M; Vinkeles Melchers, Natalie V S; Brienen, Eric A T; Verweij, Jaco J; Groosjohan, Bernhard; Mendes, Felisberto; Mechendura, Manito; Hepp, Dagmar H; Langenberg, Marijke C C; Edelenbosch, Rosanne; Polman, Katja; van Lieshout, Lisette

    2017-01-01

    Many different intestinal parasite species can co-occur in the same population. However, classic diagnostic tools can only frame a particular group of intestinal parasite species. Hence, one or two tests do not suffice to provide a complete picture of infecting parasite species in a given population. The present study investigated intestinal parasitic infections in Beira, Mozambique, i.e. in the informal settlement of Inhamudima. Diagnostic accuracy of five classical microscopy techniques and real-time PCR for the detection of a broad spectrum of parasites was compared. A cross-sectional population-based survey was performed. One stool sample per participant (n = 303) was examined by direct smear, formal-ether concentration (FEC), Kato smear, Baermann method, coproculture and real-time PCR. We found that virtually all people (96%) harbored at least one helminth, and that almost half (49%) harbored three helminths or more. Remarkably, Strongyloides stercoralis infections were widespread with a prevalence of 48%, and Ancylostoma spp. prevalence was higher than that of Necator americanus (25% versus 15%), the hookworm species that is often assumed to prevail in East-Africa. Among the microscopic techniques, FEC was able to detect the broadest spectrum of parasite species. However, FEC also missed a considerable number of infections, notably S. stercoralis, Schistosoma mansoni and G. intestinalis. PCR outperformed microscopy in terms of sensitivity and range of parasite species detected. We showed intestinal parasites-especially helminths-to be omnipresent in Inhamudima, Beira. However, it is a challenge to achieve high diagnostic sensitivity for all species. Classical techniques such as FEC are useful for the detection of some intestinal helminth species, but they lack sensitivity for other parasite species. PCR can detect intestinal parasites more accurately but is generally not feasible in resource-poor settings, at least not in peripheral labs. Hence, there is a

  2. Low incidence of helminth infections (schistosomiasis, strongyloidiasis, filariasis, toxocariasis) among Dutch long-term travelers: A prospective study, 2008-2011.

    PubMed

    Overbosch, Femke W; van Gool, Tom; Matser, Amy; Sonder, Gerard J B

    2018-01-01

    Despite the considerable burden of helminth infections in developing countries and increasing international travel, little is known about the risks of infection for travelers. We studied the attack and incidence rate of serology confirmed strongyloidiasis, filariasis, and toxocariasis among long-term travelers and associated factors. A second objective was to evaluate eosinophilia as a positive/negative predictive value (PPV/NPV) for a recent helminth infection. From 2008 to 2011, clients of the Public Health Service travel clinic planning travel to (sub)tropical countries for 12-52 weeks were invited to participate in a prospective study. Participants kept a weekly diary, recording itinerary, symptoms, and physician visits during travel and completed a post-travel questionnaire. Pre- and post-travel blood samples were serologically tested for the presence of IgG antibodies against Schistosoma species, Strongyloides stercoralis, filarial species, and Toxacara species and were used for a blood cell count. Factors associated with recent infection were analyzed using Poisson regression. Differences among groups of travelers were studied using chi square tests. For the 604 participants, median age was 25 years (interquartile range [IQR]: 23-29), 36% were male, median travel duration was 20 weeks (IQR: 15-25), and travel purpose was predominantly tourism (62%). Destinations were Asia (45%), Africa (18%), and the Americas (37%). Evidence of previous infection was found in 13/604 participants: antibodies against Schistosoma spp. in 5 (0.8%), against S.stercoralis in 3 (0.5%), against filarial species in 4 (0.7%), and against Toxocara spp. in 1 (0.2%). Ten recent infections were found in 9 participants (3, 1, 6, 0 cases, in the above order), making the attack rates 0.61, 0.17, 1.1 and 0, and the incidence rates per 1000 person-months 1.5, 0.34, 2.6 and 0. The overall PPV and NPV of eosinophila for recent infection were 0 and 98%, respectively. The risk of the helminth

  3. Surveillance of strongyloidiasis in Spanish in-patients (1998–2014)

    PubMed Central

    Soler, Cristina; Carranza-Rodriguez, Cristina; Pérez-Arellano, José Luis

    2017-01-01

    Background Strongyloides stercoralis is a parasite that causes strongyloidiasis, a neglected tropical disease. S. stercoralis is a soil-transmitted helminth that is widely distributed in tropical and subtropical regions of the world. Strongyloidiasis can occur without any symptoms or as a chronic infection characterized by mild, unspecific symptoms such as pruritus, abdominal pain or discomfort; respiratory impairment also may manifest as a potentially fatal hyperinfection or disseminated infection. Most studies on strongyloidiasis in Spain have been related to chronic forms in immigrants or travellers from endemic zones and have mainly analysed out-patient populations. Studies of the impact of strongyloidiasis cases admitted to hospitals in Spain are lacking. Therefore, the aim of this study was to analyse the impact of strongyloidiasis in hospital care in Spain. Methodology We designed a retrospective descriptive study using the Minimum Basic Data Set (MBDS, CMBD in Spanish) for inpatients with ICD-9: 127.2 (strongyloidiasis) diagnoses admitted to hospitals in the Spanish National Health System between 1998 and 2014. Principal findings A total of 507 hospitalizations with diagnosis of strongyloidiasis were recorded, 324 cases (63.9%) were males. The mean (±SD) age was 42.1±20.1 years. The impact of strongyloidiasis on the total population of Spain was 0.06 cases per 105 person-years, and the infection burden increased progressively over time (from 0.01 cases per 105 person-years in 1999 to 0.10 cases per 105 person-years in 2014). 40 cases (7.9%) died. The total cost was approximately €8,681,062.3, and the mean cost per patient was €17,122.4±97,968.8. Conclusions Our data suggest that strongyloidiasis is frequent in Spain and is increasing in incidence. Therefore, it would be desirable to improve the oversight and surveillance of this condition. Due to the fact that strongyloidiasis can be fatal, we believe that there is a need to establish risk categories

  4. Diagnosis of intestinal parasites in a rural community of Venezuela: Advantages and disadvantages of using microscopy or RT-PCR.

    PubMed

    Incani, Renzo Nino; Ferrer, Elizabeth; Hoek, Denise; Ramak, Robbert; Roelfsema, Jeroen; Mughini-Gras, Lapo; Kortbeek, Titia; Pinelli, Elena

    2017-03-01

    A cross-sectional study was carried out to determine the prevalence and diagnostic performance of microscopy and real time PCR (RT-PCR) for 14 intestinal parasites in a Venezuelan rural community with a long history of persistent intestinal parasitic infections despite the implementation of regular anthelminthic treatments. A total of 228 participants were included in this study. A multiplex RT-PCR was used for the detection of Dientamoeba fragilis, Giardia intestinalis, Cryptosporidium sp. and a monoplex RT-PCR for Entamoeba histolytica. Furthermore, a multiplex PCR was performed for detection of Ascaris lumbricoides, Strongyloides stercoralis, Necator americanus and Ancylostoma duodenale. Combined microscopy-PCR revealed prevalences of 49.3% for A. lumbricoides, 10.1% for N. americanus (no A. duodenale was detected), 2.0% for S. stercoralis, 40.4% for D. fragilis, 35.1% for G. intestinalis, and 7.9% for E. histolytica/dispar. Significant increases in prevalence at PCR vs. microscopy were found for A. lumbricoides, G. intestinalis and D. fragilis. Other parasites detected by microscopy alone were Trichuris trichiura (25.7%), Enterobius vermicularis (3.4%), Blastocystis sp. (65.8%), and the non-pathogenic Entamoeba coli (28.9%), Entamoeba hartmanni (12.3%), Endolimax nana (19.7%) and Iodamoeba bütschlii (7.5%). Age- but no gender-related differences in prevalences were found for A. lumbricoides, T. trichiura, G. intestinalis, and E. histolytica/dispar. The persistently high prevalences of intestinal helminths are probably related to the high faecal pollution as also evidenced by the high prevalences of non-pathogenic intestinal protozoans. These results highlight the importance of using sensitive diagnostic techniques in combination with microscopy to better estimate the prevalence of intestinal parasites, especially in the case of D. fragilis trophozoites, which deteriorate very rapidly and would be missed by microscopy. In addition, the differentiation between

  5. Diagnosing Polyparasitism in a High-Prevalence Setting in Beira, Mozambique: Detection of Intestinal Parasites in Fecal Samples by Microscopy and Real-Time PCR

    PubMed Central

    Polderman, Anton M.; Vinkeles Melchers, Natalie V. S.; Brienen, Eric A. T.; Verweij, Jaco J.; Groosjohan, Bernhard; Mendes, Felisberto; Mechendura, Manito; Hepp, Dagmar H.; Langenberg, Marijke C. C.; Edelenbosch, Rosanne; Polman, Katja; van Lieshout, Lisette

    2017-01-01

    Background Many different intestinal parasite species can co-occur in the same population. However, classic diagnostic tools can only frame a particular group of intestinal parasite species. Hence, one or two tests do not suffice to provide a complete picture of infecting parasite species in a given population. The present study investigated intestinal parasitic infections in Beira, Mozambique, i.e. in the informal settlement of Inhamudima. Diagnostic accuracy of five classical microscopy techniques and real-time PCR for the detection of a broad spectrum of parasites was compared. Methodology/Principal Findings A cross-sectional population-based survey was performed. One stool sample per participant (n = 303) was examined by direct smear, formal-ether concentration (FEC), Kato smear, Baermann method, coproculture and real-time PCR. We found that virtually all people (96%) harbored at least one helminth, and that almost half (49%) harbored three helminths or more. Remarkably, Strongyloides stercoralis infections were widespread with a prevalence of 48%, and Ancylostoma spp. prevalence was higher than that of Necator americanus (25% versus 15%), the hookworm species that is often assumed to prevail in East-Africa. Among the microscopic techniques, FEC was able to detect the broadest spectrum of parasite species. However, FEC also missed a considerable number of infections, notably S. stercoralis, Schistosoma mansoni and G. intestinalis. PCR outperformed microscopy in terms of sensitivity and range of parasite species detected. Conclusions/Significance We showed intestinal parasites—especially helminths—to be omnipresent in Inhamudima, Beira. However, it is a challenge to achieve high diagnostic sensitivity for all species. Classical techniques such as FEC are useful for the detection of some intestinal helminth species, but they lack sensitivity for other parasite species. PCR can detect intestinal parasites more accurately but is generally not feasible in

  6. Canine fecal contamination in a metropolitan area (Milan, north-western Italy): prevalence of intestinal parasites and evaluation of health risks.

    PubMed

    Zanzani, Sergio Aurelio; Di Cerbo, Anna Rita; Gazzonis, Alessia Libera; Genchi, Marco; Rinaldi, Laura; Musella, Vincenzo; Cringoli, Giuseppe; Manfredi, Maria Teresa

    2014-01-01

    Intestinal parasites of dogs represent a serious threat to human health due to their zoonotic potential. Thus, metropolitan areas presenting high concentrations of pets and urban fecal contamination on public areas are at sanitary risk. Major aim of this survey was to determine prevalence of zoonotic parasites in dog fecal samples collected from public soil of Milan (north-western Italy). Differences in parasites prevalence distribution were explored by a geographical information system- (GIS-) based approach, and risk factors (human density, sizes of green parks, and dog areas) were considered. The metropolitan area was divided into 157 rectangular subareas and sampling was performed following a 1-kilometer straight transect. A total of 463 fecal samples were analyzed using centrifugation-flotation technique and ELISA to detect Giardia and Cryptosporidium coproantigens. A widespread fecal contamination of soil was highlighted, being fecal samples found in 86.8% of the subareas considered. The overall prevalence of intestinal parasites was 16.63%. Zoonotic parasites were found, such as Trichuris vulpis (3.67%), Toxocara canis (1.72%), Strongyloides stercoralis (0.86%), Ancylostomatidae (0.43%), and Dipylidium caninum (0.43%). Giardia duodenalis was the most prevalent zoonotic protozoa (11.06%), followed by Cryptosporidium (1.10%). Faeces from subareas characterized by broad green areas showed to be particularly prone to infection.

  7. Molecular Paleoparasitological Hybridization Approach as Effective Tool for Diagnosing Human Intestinal Parasites from Scarce Archaeological Remains

    PubMed Central

    Jaeger, Lauren Hubert; Iñiguez, Alena Mayo

    2014-01-01

    Paleoparasitology is the science that uses parasitological techniques for diagnosing parasitic diseases in the past. Advances in molecular biology brought new insights into this field allowing the study of archaeological material. However, due to technical limitations a proper diagnosis and confirmation of the presence of parasites is not always possible, especially in scarce and degraded archaeological remains. In this study, we developed a Molecular Paleoparasitological Hybridization (MPH) approach using ancient DNA (aDNA) hybridization to confirm and complement paleoparasitological diagnosis. Eight molecular targets from four helminth parasites were included: Ascaris sp., Trichuris trichiura, Enterobius vermicularis, and Strongyloides stercoralis. The MPH analysis using 18th century human remains from Praça XV cemetery (CPXV), Rio de Janeiro, Brazil, revealed for the first time the presence E. vermicularis aDNA (50%) in archaeological sites of Brazil. Besides, the results confirmed T. trichiura and Ascaris sp. infections. The prevalence of infection by Ascaris sp. and E. vermicularis increased considerably when MPH was applied. However, a lower aDNA detection of T. trichiura (40%) was observed when compared to the diagnosis by paleoparasitological analysis (70%). Therefore, based on these data, we suggest a combination of Paleoparasitological and MPH approaches to verify the real panorama of intestinal parasite infection in human archeological samples. PMID:25162694

  8. Integration of Multiplex Bead Assays for Parasitic Diseases into a National, Population-Based Serosurvey of Women 15-39 Years of Age in Cambodia

    PubMed Central

    Priest, Jeffrey W.; Jenks, M. Harley; Moss, Delynn M.; Mao, Bunsoth; Buth, Sokhal; Wannemuehler, Kathleen; Soeung, Sann Chan; Lucchi, Naomi W.; Udhayakumar, Venkatachalam; Gregory, Christopher J.; Huy, Rekol; Muth, Sinuon; Lammie, Patrick J.

    2016-01-01

    Collection of surveillance data is essential for monitoring and evaluation of public health programs. Integrated collection of household-based health data, now routinely carried out in many countries through demographic health surveys and multiple indicator surveys, provides critical measures of progress in health delivery. In contrast, biomarker surveys typically focus on single or related measures of malaria infection, HIV status, vaccination coverage, or immunity status for vaccine-preventable diseases (VPD). Here we describe an integrated biomarker survey based on use of a multiplex bead assay (MBA) to simultaneously measure antibody responses to multiple parasitic diseases of public health importance as part of a VPD serological survey in Cambodia. A nationally-representative cluster-based survey was used to collect serum samples from women of child-bearing age. Samples were tested by MBA for immunoglobulin G antibodies recognizing recombinant antigens from Plasmodium falciparum and P. vivax, Wuchereria bancrofti, Toxoplasma gondii, Taenia solium, and Strongyloides stercoralis. Serologic IgG antibody results were useful both for generating national prevalence estimates for the parasitic diseases of interest and for confirming the highly focal distributions of some of these infections. Integrated surveys offer an opportunity to systematically assess the status of multiple public health programs and measure progress toward Millennium Development Goals. PMID:27136913

  9. Non-biting cyclorrhaphan flies (Diptera) as carriers of intestinal human parasites in slum areas of Addis Ababa, Ethiopia.

    PubMed

    Getachew, Sisay; Gebre-Michael, Teshome; Erko, Berhanu; Balkew, Meshesha; Medhin, Girmay

    2007-09-01

    A study was conducted to determine the role of non-biting cyclorrhaphan flies as carriers of intestinal parasites in slum areas of Addis Ababa from January 2004 to June 2004. A total of 9550 flies, comprising of at least seven species were collected from four selected sites and examined for human intestinal parasites using the formol-ether concentration method. The dominant fly species was Chrysomya rufifacies (34.9%) followed by Musca domestica (31%), Musca sorbens (20.5.%), Lucina cuprina (6.8%), Sarcophaga sp. (2.8%), Calliphora vicina (2.2%) and Wohlfahrtia sp. (1.8%). Six intestinal helminths (Ascaris lumbricoides, Trichuris trichiura, hookworms, Hymenolepis nana, Taenia spp. and Strongyloides stercoralis) and at least four protozoan parasites (Entamoeba histolytica/dispar, Entamoeba coli, Giardia lamblia and Cryptosporidium sp.) were isolated from both the external and gut contents of the flies. A. lumbricoides and T. trichiura among the helminths and E. histolytica/dispar and E. coli among the protozoans were the dominant parasites detected both on the external and in the gut contents of the flies, but occurring more in the latter. Among the flies, C. rufifacies and M. sorbens were the highest carriers of the helminth and protozoan parasites, respectively. The public health significance of these findings is highlighted.

  10. Prevalence of intestinal parasitic infections and associated risk factors among pregnant women attending antenatal care center at Felege Hiwot Referral Hospital, northwest Ethiopia.

    PubMed

    Derso, Adane; Nibret, Endalkachew; Munshea, Abaineh

    2016-09-30

    Parasitic infections affect tens of millions of pregnant women worldwide, and directly or indirectly lead to a spectrum of adverse maternal and fetal/placental effects. The objective of this study was to assess the prevalence of intestinal parasite infections and associated risk factors among pregnant women attending antenatal care center in Felege Hiwot Referral Hospital, Bahir Dar city, northwest Ethiopia. A cross-sectional hospital based study was conducted from November 2013 to January 2014 among 384 pregnant women. Stool samples were examined for the presence of trophozoites, cysts, oocysts, and ova using direct, formal-ether sedimentation, and modified Ziehl-Neelsen techniques. An overall prevalence of 31.5 % intestinal parasite infections was recorded. Eight different species of intestinal parasites were found: two protozoan and six helminth species. The highest prevalence was due to Giardia lamblia (13.3 %) followed by Entamoeba histolytica/dispar (7.8 %), hookworm (5.5 %), Ascaris lumbricoides (2.9 %), Schistosoma mansoni (2.9 %), Strongyloides stercoralis (1.6 %), Taenia spp. (0.8 %), and Hymenolepis nana (0.3 %). A relatively high prevalence of intestinal parasite infections was observed among pregnant women. Routine stool examination and provision of health education are required for early medical intervention that would affect the pregnant mothers and their foetuses.

  11. Cross-Sectional Study on the Prevalence of Intestinal Parasites and Associated Risk Factors in Teda Health Centre, Northwest Ethiopia.

    PubMed

    Abate, Abraraw; Kibret, Biniam; Bekalu, Eylachew; Abera, Sendeku; Teklu, Takele; Yalew, Aregawi; Endris, Mengistu; Worku, Ligabaw; Tekeste, Zinaye

    2013-01-01

    Objective. To assess the magnitude of intestinal parasitic infection and associated risk factors in Teda Health Centre, Northwest Ethiopia. Method. A cross-sectional study was conducted in Teda Health Centre from February to April, 2011. Stool samples were collected from 410 study participants and analysed by direct wet mount and formal ether concentration techniques. Furthermore, sociodemographic data were collected by using standardized questionnaire. Result. The overall prevalence of intestinal parasitic infection in this study was 62.3%. Ascaris lumbricoides was the most predominant parasite (23.2%) followed by Giardia intestinalis (12.4%), Entamoeba histolytica/dispar (4.6%), Schistosoma mansoni (8.9%), hookworm (6.6%), Hymenolepis nana (1.5%), Enterobius vermicularis (0.4%), and Strongyloides stercoralis (0.2%). Absence of toilet and hand washing after toilet was shown to be associated with intestinal parasitic infection (P < 0.05 for both). Furthermore, swimming and less shoe wearing habits showed a significant prevalence of S. mansoni and hookworm infections, respectively. Conclusion. The present study showed high prevalence of intestinal parasitic infection in the study area. Absence of toilet and hand washing after toilet was found to be associated with intestinal parasitic infection. Therefore, there is a need for integrated control programme to have a lasting impact on transmission of intestinal parasitic infection.

  12. Canine Fecal Contamination in a Metropolitan Area (Milan, North-Western Italy): Prevalence of Intestinal Parasites and Evaluation of Health Risks

    PubMed Central

    Zanzani, Sergio Aurelio; Di Cerbo, Anna Rita; Gazzonis, Alessia Libera; Genchi, Marco; Rinaldi, Laura; Musella, Vincenzo; Cringoli, Giuseppe

    2014-01-01

    Intestinal parasites of dogs represent a serious threat to human health due to their zoonotic potential. Thus, metropolitan areas presenting high concentrations of pets and urban fecal contamination on public areas are at sanitary risk. Major aim of this survey was to determine prevalence of zoonotic parasites in dog fecal samples collected from public soil of Milan (north-western Italy). Differences in parasites prevalence distribution were explored by a geographical information system- (GIS-) based approach, and risk factors (human density, sizes of green parks, and dog areas) were considered. The metropolitan area was divided into 157 rectangular subareas and sampling was performed following a 1-kilometer straight transect. A total of 463 fecal samples were analyzed using centrifugation-flotation technique and ELISA to detect Giardia and Cryptosporidium coproantigens. A widespread fecal contamination of soil was highlighted, being fecal samples found in 86.8% of the subareas considered. The overall prevalence of intestinal parasites was 16.63%. Zoonotic parasites were found, such as Trichuris vulpis (3.67%), Toxocara canis (1.72%), Strongyloides stercoralis (0.86%), Ancylostomatidae (0.43%), and Dipylidium caninum (0.43%). Giardia duodenalis was the most prevalent zoonotic protozoa (11.06%), followed by Cryptosporidium (1.10%). Faeces from subareas characterized by broad green areas showed to be particularly prone to infection. PMID:25478583

  13. [The effect of ivermectin on geohelminth frequency (i.e. as used in the onchocerciasis control program in Colombia)].

    PubMed

    Knudson, Angélica; Ariza, Yoseth; López, Myriam C; Fajardo, Oscar S; Reyes, Patricia; Moncada, Ligia I; Duque, Sofía; Álvarez, Carlos A; Nicholls, Rubén S

    2012-08-01

    Evaluating the effect of ivermectin on soil-transmitted helminthes (STH) infection frequency in a Colombian population included in the Onchocerciasis Elimination Program for the Americas (OEPA). This was an impact evaluation study which adopted a longitudinal approach using the population of Naicioná (1996) as baseline for comparison to people from the same population as controls (2008). The cross-sectional approach involved comparing the reference population of Naicioná (2008) to the population of Dos Quebradas (2008) used as controls. Fecal samples were processed by a modified Ritchie-Frick method. Ascaris lumbricoides was the most frequently found parasite in Naicioná (60/121; 49.6 %: 37.8-63.895%CI) and in Dos Quebradas (36/76; 47.4 %: 33.2-65.6 95 % CI). Ivermectin's main effect on the population aged over 5 years was a decreased risk of Trichiuris trichiura infection in both longitudinal assessment (86 % reduction: 74-93 95 % CI) and cross-sectional assessment (63 %:24-82 95 % CI). A 93 % reduction (45-99 95 % CI) in Strongyloides stercoralis frequency was found in longitudinal assessment, compared to 85 % in cross-sectional assessment (-031-99 95 % CI). Ivermectin use in the OEPA is not sufficient for STH morbidity control. Integrated programs including education and basic sanitation are required.

  14. Prevalence of Toxoplasma gondii and Other Gastrointestinal Parasites in Domestic Cats from Households in Thika Region, Kenya.

    PubMed

    Nyambura Njuguna, Adele; Kagira, John Maina; Muturi Karanja, Simon; Ngotho, Maina; Mutharia, Lucy; Wangari Maina, Naomi

    2017-01-01

    Gastrointestinal (GIT) parasites of domestic cats (Felis catus) not only cause morbidity but are also potential zoonotic agents. The current study aimed at establishing the prevalence of GIT parasites in cats kept by households in Thika region, Kenya. Fecal samples were collected randomly from 103 cats and analyzed for presence of parasites using standard parasitological methods. In descending order, the prevalence of the detected protozoa parasites was Isospora spp. 43.7% (95% CI: 40.4-47%), Cryptosporidium spp. 40.8% (95% CI: 37.5-44.1%), Toxoplasma gondii 7.8% (95% CI: 4.5-11.1%), and Entamoeba spp. 2.9% (95% CI: 1.6-6.2%). The prevalence of the observed helminths was Strongyloides stercoralis 43.7% (95% CI: 40.4-47%), Toxocara cati 23.3% (95% CI: 20-26.6%), Ancylostoma spp. 9.7% (95% CI: 6.4-13%), Dipylidium caninum 8.7% (95% CI: 5.4-12.0%), and Acanthocephala spp. 1.9% (95% CI: 1-4.2%). The percentage of cats excreting at least one species of parasite was 73.2% (95% CI = 69.9-76.5%). The study shows that the cats have high spectrum (9) of parasites which are known to affect the cat's health and some are of zoonotic significance.

  15. The potential role of strongyloides robustus on parasite-mediated competition between two species of flying squirrels (Glaucomys).

    PubMed

    Krichbaum, Kristle; Mahan, Carolyn G; Steele, Michael A; Turner, Gregory; Hudson, Peter J

    2010-01-01

    There is growing evidence that populations of the northern flying squirrel (Glaucomys sabrinus) are declining in the eastern United States, perhaps due to competition with the southern flying squirrel (Glaucomys volans). Potential causes include parasite-mediated or apparent competition from the shared intestinal nematode, Strongyloides robustus, which has been shown to detrimentally affect the northern flying squirrel but not the southern flying squirrel. To investigate this hypothesis, we conducted a preliminary study on the parasite community of both flying squirrel species from sites in Pennsylvania where the two species occur sympatrically and where G. sabrinus is now considered endangered at the state level. We compared these parasite communities with those from northern flying squirrels from northern New York where the southern flying squirrel is absent. We found eight species of gastrointestinal parasites (Pterygodermatites peromysci, Lemuricola sciuri, Syphacia thompsoni, Syphacia spp., Capillaria spp., Citellinema bifurcatum, Strogyloides robustus, and an unidentifiable cestode species) in both species of flying squirrels examined for our study. The parasite-mediated competition hypothesis was partially supported. For example, in Pennsylvania, S. robustus was overdispersed in southern flying squirrels, such that a small proportion of the hosts carried a large proportion of the worm population. In addition, we found S. robustus to be present in northern flying squirrels when the species were sympatric, but not where southern flying squirrels were absent in New York. However, there was no association between S. robustus and the body condition of flying squirrels. We detected a potential parasite community interaction, as S. robustus abundance was positively associated with P. peromysci.

  16. Intent to Quit among Daily and Non-Daily College Student Smokers

    ERIC Educational Resources Information Center

    Pinsker, E. A.; Berg, C. J.; Nehl, E. J.; Prokhorov, A. V.; Buchanan, T. S.; Ahluwalia, J. S.

    2013-01-01

    Given the high prevalence of young adult smoking, we examined (i) psychosocial factors and substance use among college students representing five smoking patterns and histories [non-smokers, quitters, native non-daily smokers (i.e. never daily smokers), converted non-daily smokers (i.e. former daily smokers) and daily smokers] and (ii) smoking…

  17. Chronic and Daily Stressors Along With Negative Affect Interact to Predict Daily Tiredness.

    PubMed

    Hartsell, Elizabeth N; Neupert, Shevaun D

    2017-11-01

    The present study examines the within-person relationship of daily stressors and tiredness and whether this depends on daily negative affect and individual differences in chronic stress. One hundred sixteen older adult participants were recruited via Amazon's Mechanical Turk for a 9-day daily diary study. Daily tiredness, daily stressors, and negative affect were measured each day, and chronic stress was measured at baseline. Daily stressors, daily negative affect, and chronic stress interacted to predict daily tiredness. People with high chronic stress who experienced an increase in daily negative affect were the most reactive to daily stressors in terms of experiencing an increase in daily tiredness. We also found that people with low levels of chronic stress were the most reactive to daily stressors when they experienced low levels of daily negative affect. Our results highlight the need for individualized and contextualized approaches to combating daily tiredness in older adults.

  18. Intent to quit among daily and non-daily college student smokers

    PubMed Central

    Pinsker, E. A.; Berg, C. J.; Nehl, E. J.; Prokhorov, A. V.; Buchanan, T. S.; Ahluwalia, J. S.

    2013-01-01

    Given the high prevalence of young adult smoking, we examined (i) psychosocial factors and substance use among college students representing five smoking patterns and histories [non-smokers, quitters, native non-daily smokers (i.e. never daily smokers), converted non-daily smokers (i.e. former daily smokers) and daily smokers] and (ii) smoking category as it relates to readiness to quit among current smokers. Of the 4438 students at six Southeast colleges who completed an online survey, 69.7% (n = 3094) were non-smokers, 6.6% (n = 293) were quitters, 7.1% (n = 317) were native non-daily smokers, 6.4% (n = 283) were converted non-daily smokers and 10.2% (n = 451) were daily smokers. There were differences in sociodemographics, substance use (alcohol, marijuana, other tobacco products) in the past 30 days and psychosocial factors among these subgroups of students (P < 0.001). Among current smokers, there were differences in cigarettes smoked per day, recent quit attempts, self-identification as a smoker, self-efficacy and motivation to quit (P < 0.001). After controlling for important factors, converted non-daily smokers were more likely to be ready to quit in the next month versus native non-daily smokers (OR = 2.15, CI 1.32–3.49, P = 0.002). Understanding differences among young adults with different smoking patterns and histories is critical in developing interventions targeting psychosocial factors impacting cessation among this population. PMID:23197630

  19. Disaggregating from daily to sub-daily rainfall under a future climate

    NASA Astrophysics Data System (ADS)

    Westra, S.; Evans, J.; Mehrotra, R.; Sharma, A.

    2012-04-01

    We describe an algorithm for disaggregating daily rainfall into sub-daily rainfall 'fragments' (continuous fine-resolution rainfall sequences whose total depth sums to the daily rainfall amount) under a future, warmer climate. The basis of the algorithm is re-sample sub-daily fragments from the historical record conditional on the total daily rainfall amount and a range of atmospheric predictors representative of the future climate. The logic is that as the atmosphere warms, future rainfall patterns will be more reflective of historical rainfall patterns which occurred on warmer days at the same location, or at locations which have an atmospheric profile more reflective of expected future conditions. When looking at the scaling from daily to sub-daily rainfall over the historical record, it was found that the relationship varied significantly by season and by location, with rainfall patterns on warmer seasons or at warmer locations typically showing more intense rain falling over shorter periods compared with cooler seasons and stations. Importantly, by regressing against atmospheric covariates such as temperature this effect was almost entirely eliminated, providing a basis for suggesting the approach may be valid when extrapolating sub-daily sequences to a future climate. The method of fragments algorithm was then applied to nine stations around Australia, and showed that when holding the total daily rainfall constant, the maximum intensity of a short duration (6 minute) rainfall increased by between 4.1% and 13.4% per degree change in temperature for the maximum six minute burst, between 3.1% and 6.8% for the maximum one hour burst, and between 1.5% and 3.5% for the fraction of the day with no rainfall. This highlights that a large proportion of the change to the distribution of precipitation in the future is likely to occur at sub-daily timescales, with significant implications for many hydrological systems.

  20. [Prevalence of intestinal microsporidia and other intestinal parasites in hiv positive patients from Maracaibo, Venezuela].

    PubMed

    Rivero-Rodríguez, Zulbey; Hernández, Amparo; Bracho, Ángela; Salazar, Solneumar; Villalobos, Rafael

    2013-01-01

    To detect the presence of microsporidia and other enteric parasites in patients with HIVAIDS of the Autonomous Services University Hospital of Maracaibo (SAHUM), where there are no previous studies in this field. Fecal samples were analyzed by means of direct exam, concetration method with formal-ether, Kinyoun coloration and fast Gram-Chromotrope coloration. Separate PCR were perfomed to differentiate Entamoeba histolytica and Entamoeba dispar , when the E. histolytica/E. dispar complex was observed in the microscope. Information on the patient was obtained trough clinical history. Of 56 individuals that participated, 38 (67.86%) presented some commensal parasite and/ or pathogenic species in their fecal sample. Carriers of pathogenic species were predominat (26/38). Protozoa such as Isospora belli protozoa (17.65%), Blastocystis spp. (17.65%), Cryptosporidium spp. (7.84%), E. histolytica/E. dispar (5.88%), Entamoeba coli (3.92%), Giardia lamblia (3.92%), Endolimax nana (3.92%), Cyclospora cayetanensis (3.92%), and Chilomastix mesnilli (1.96%) were diagnosed. Among the helminths, Ascaris lumbricoides, Trichuris trichiura and Strongyloides stercoralis , had a percentage of 27.27% each, and Hymenolepis nana , 18.18%. Entamoeba histolytica was only detected in one of three cases presenting complex microscopic examination. By Gram-chromotrope, 17 samples showed spores of the Microsporidia phylum, equivalent to 33.33% prevalence. Microsporidia may be first prevalente in HIV positive patients when specific diagnostic techniques are used.

  1. Specific detection of Neospora caninum oocysts in fecal samples from experimentally-infected dogs using the polymerase chain reaction.

    PubMed

    Hill, D E; Liddell, S; Jenkins, M C; Dubey, J P

    2001-04-01

    Neospora caninum oocysts, passed in the feces of a definitive host (dog), were isolated, and genomic DNA was extracted. A polymerase cahin reaction (PCR) targeting the N. caninum-specific Nc 5 genomic sequence was performed using the isolated DNA. A synthesized competitor molecule containing part of the Nc 5 sequence was included in the assay as a check against false-negative PCR results and to quantify N. caninum oocyst DNA in fecal samples. A standard curve of the ratio of fluorescence intensity of PCR-amplified competitor to that of oocyst DNA was constructed to compare oocyst equivalents from fecal samples containing unknown numbers of N. caninum oocysts and to assess the sensitivity of the assay. The specificity of the assay was determined using the Nc 5-specific primers in PCR assays against other parasites likely to be found in canine feces. Genomic DNA sequences from the canine coccidians Hammondia heydorni, Cryptosporidium parvum, Sarcocystis cruzi, S. tenella, and Isospora ohioensis and the canine helminth parasites Strongyloides stercoralis, Toxocara canis, Dipylidium caninum, and Ancylostoma caninum were not amplified. In addition, genomic DNA sequences from oocysts of coccidian parasites that might contaminate dog feces, such as Hammondia hammondi, Toxoplasma gondii, or Eimeria tenella, were not amplified in the PCR assay. The assay should be useful in epidemiological surveys of both domestic and wild canine hosts and in investigations of oocyst biology in experimental infections.

  2. A Retrospective Analysis of the Results of a Five-Year (2005-2009) Parasitological Examination for Common Intestinal Parasites from Bale-Robe Health Center, Robe Town, Southeastern Ethiopia.

    PubMed

    Chala, Bayissa

    2013-01-01

    A cross-sectional retrospective survey using the past five years clinical records (2005-2009) was conducted. The study was aimed at assessing the status of common intestinal parasites from Bale-Robe Health Center, Southeastern Ethiopia, in 2009/2010. The survey involved collection of data recorded on intestinal parasite from the health center during 2005-2009. Precoded questionnaires and interviews were also supplemented for knowledge attitude practices survey (KAPs survey) to assess awareness level of treatment seekers. Analysis of the various associations and strength of significant variations among qualitative and quantitative variables were assessed. The results revealed that Entamoeba histolytica (36.1%) and Giardia lamblia (11.0%), both being protozoan parasites were found to be the most prevalent intestinal parasites encountered during 2005-2009. The least prevalent intestinal parasite recorded was Strongyloides stercoralis (1.1%). Most intestinal parasites were detected among age group of 15 years and above than 0-4 and 5-14 years as shown in Table 4. There was a significant correlation between intestinal parasites prevalence and the age of treatment seeking individuals (P < 0.05). A sharp increasing trend of E. histolytica and Ascaris lumbricoides infections was observed owing to low personal and environmental sanitation of the majority of the society. Initiation of health education at different levels could be recommended to mitigate infectious parasites in the area.

  3. Prevalence of intestinal helminthic infections and malnutrition among schoolchildren of the Zegie Peninsula, northwestern Ethiopia.

    PubMed

    Abdi, Merem; Nibret, Endalkachew; Munshea, Abaineh

    A cross-sectional study involving 408 schoolchildren was performed from November 2013 to February 2014 to assess the prevalence of intestinal helminthic infections and malnutrition among schoolchildren of the Zegie Peninsula, northwestern Ethiopia. A structured questionnaire was used to gather data on the demographic and risk factors associated with intestinal helminthic infections. Stool samples were collected and examined for helminth eggs using the formalin-ether concentration technique. In addition, anthropometric measurements were performed to assess the nutritional status of the schoolchildren. The overall prevalence of intestinal helminthic infections in the study area was 69.1%. Single, double, triple, and quadruple infections were 42.2%, 18.4%, 5.9%, and 0.7%, respectively. The prevalence of hookworm, Schistosoma mansoni, Ascaris lumbricoides, Trichuris trichiura, Hymenolepis nana, and Strongyloides stercoralis infections were 43.4%, 29.9%, 12.7%, 10%, 4.6%, and 0.7%, respectively. The prevalence of malnutrition in terms of stunting, being underweight, and wasting were 15.3%, 18%, and 27.6%, respectively. However, no significant association was found between intestinal helminthic infections and stunting, being underweight and wasting (p>0.05). It can be concluded that intestinal helminthic infections, specifically infections due to hookworm and S. mansoni, are important health problems among schoolchildren of the Zegie Peninsula. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  4. Helminths as an alternative therapy for intestinal diseases.

    PubMed

    Sipahi, Aytan Miranda; Baptista, Daniel Machado

    2017-09-07

    Animal models and clinical studies have shown that helminth infections exert immunomodulatory activity, altering intestinal permeability and providing a potential beneficial action on autoimmune and inflammatory disorders in human beings, such as inflammatory bowel disease (IBD) and celiac disease. This is consistent with the theory that intestinal microbiota is responsible for shaping human immunological responses. With the arrival of the immunobiologic era and the use of antibodies, we propose a distinctive pathway for treating patients with IBD and celiac disease. We have some evidence about the safety and tolerability of helminth use, but evidence about their impact on disease activity is lacking. Using worms to treat diseases could be a possible way to lower treatment costs, since the era of immunobiologic agents is responsible for a significant rise in expenses. Some questions remain to be investigated regarding the use of helminths in intestinal disease, such as the importance of the specific species of helminths used, appropriate dosing regimens, optimal timing of treatment, the role of host genetics, diet, environment, and the elucidation of the exact mechanisms of action. One promising approach is the use of helminth-derived anti-inflammatory molecules as drugs. Yet there are still many challenges with this method, especially with regard to safety. Studies on intestinal permeability point to Strongyloides stercoralis as a useful nematode for these purposes.

  5. Opening a Can of Worms: Leprosy Reactions and Complicit Soil-Transmitted Helminths.

    PubMed

    Hagge, Deanna A; Parajuli, Pawan; Kunwar, Chhatra B; Rana, Divya R S J B; Thapa, Ruby; Neupane, Kapil D; Nicholls, Peter; Adams, Linda B; Geluk, Annemieke; Shah, Mahesh; Napit, Indra B

    2017-09-01

    >94% of new annual leprosy cases are diagnosed in populations co-endemic for soil-transmitted helminths (STH). STH can profoundly dysregulate host immune responses towards Th2 bias, which can be restored over time after deworming. We hypothesize that STH co-infection is associated with leprosy reaction (denoted as simply "reaction" herein) occurrence within a co-endemic population. A cohort study was performed on a cohort of Nepalese leprosy patients across treatment and diagnostic classifications who were screened by routine fecal smear microscopy and multiplex quantitative PCR (qPCR) for Ascaris lumbricoides (Al), Strongyloides stercoralis (Ss), Ancyclostoma duodenale (Ad) and Necator americanus (Na). Among 145 patients, 55% were positive for ≥1 STH (STH+): 34% Al+, 18% Ss+, 17% Ad+and 5% Na+. Significant inverse STH and reaction relationships were evidenced by the bulk of cases: 63% reaction-negative were STH+ of total cases (p=0.030) while 65% reaction-positive were STH- in new cases (96; p=0.023). Strikingly, the majority of STH+ were reaction-negative, even when considering each species: 59% Al+, 60% Ss+, 62% Ad+and 67% Na+of new leprosy cases. Absence of STH co-infection is associated with leprosy reaction at diagnosis within a co-endemic population. This is likely due to immune reconstitution effects after deworming or interruption of chronic STH-mediated immune dysregulation. Copyright © 2017. Published by Elsevier B.V.

  6. [Concordance between the zinc sulphate flotation and centrifugal sedimentation methods for the diagnosis of intestinal parasites].

    PubMed

    Inês, Elizabete De Jesus; Pacheco, Flavia Thamiris Figueiredo; Pinto, Milena Carneiro; Mendes, Patrícia Silva de Almeida; Da Costa-Ribeiro, Hugo; Soares, Neci Matos; Teixeira, Márcia Cristina Aquino

    2016-12-01

    The diagnosis of intestinal parasitic infections depends on the parasite load, the specific gravity density of the parasite eggs, oocysts or cysts, and the density and viscosity of flotation or sedimentation medium where faeces are processed. To evaluate the concordance between zinc sulphate flotation and centrifugal sedimentation in the recovery of parasites in faecal samples of children. Faecal samples of 330 children from day care centers were evaluated by zinc sulphate flotation and centrifugal sedimentation techniques. The frequencies of detection of parasites by each method were determined and the agreement between the diagnostic techniques was evaluated using the kappa index, with 95% confidence intervals. The faecal flotation in zinc sulphate diagnosed significantly more cases of Trichuris trichiura infection when compared to centrifugal sedimentation (39/330; 11.8% vs. 13/330; 3.9%, p<0.001), with low diagnostic concordance between methods (kappa=0.264; 95% CI: 0.102-0.427). Moreover, all positive samples for Enterobius vermicularis eggs (n=5) and Strongyloides stercoralis larvae (n=3) were diagnosed only by zinc sulphate. No statistical differences were observed between methods for protozoa identification. The results showed that centrifugal flotation in zinc sulphate solution was significantly more likely to detect light helminths eggs such as those of T. trichiura and E. vermicularis in faeces than the centrifugal sedimentation process.

  7. Twice-Daily versus Once-Daily Pramipexole Extended Release Dosage Regimens in Parkinson's Disease.

    PubMed

    Yun, Ji Young; Kim, Young Eun; Yang, Hui-Jun; Kim, Han-Joon; Jeon, Beomseok

    2017-01-01

    This open-label study aimed to compare once-daily and twice-daily pramipexole extended release (PER) treatment in Parkinson's disease (PD). PD patients on dopamine agonist therapy, but with unsatisfactory control, were enrolled. Existing agonist doses were switched into equivalent PER doses. Subjects were consecutively enrolled into either once-daily-first or twice-daily-first groups and received the prescribed amount in one or two, respectively, daily doses for 8 weeks. For the second period, subjects switched regimens in a crossover manner. The forty-four patients completed a questionnaire requesting preference during their last visit. We measured the UPDRS-III, Hoehn and Yahr stages (H&Y) in medication-on state, Parkinson's disease sleep scale (PDSS), and Epworth Sleepiness Scale. Eighteen patients preferred a twice-daily regimen, 12 preferred a once-daily regimen, and 14 had no preference. After the trial, 14 subjects wanted to be on a once-daily regimen, 25 chose a twice-daily regimen, and 5 wanted to maintain the prestudy regimen. Main reasons for choosing the twice-daily regimen were decreased off-duration, more tolerable off-symptoms, and psychological stability. The mean UPDRS-III, H&Y, and PDSS were not different. Daytime sleepiness was significantly high in the once-daily regimen, whereas nocturnal hallucinations were more common in the twice-daily. Multiple dosing should be considered if once-daily dosing is unsatisfactory. This study is registered as NCT01515774 at ClinicalTrials.gov.

  8. Adolescent daily and general maladjustment: is there reactivity to daily repeated measures methodologies?

    PubMed

    Nishina, Adrienne

    2012-01-01

    The present study examined whether repeated exposure to daily surveys about negative social experiences predicts changes in adolescents' daily and general maladjustment, and whether question content moderates these changes. Across a 2-week period, 6th-grade students (N = 215; mode age = 11) completed 5 daily reports tapping experienced or experienced and witnessed negative events, or they completed no daily reports. General maladjustment was measured in 2-week intervals before, at the end of, and 2 weeks after the daily report study. Daily maladjustment either decreased or did not change across the 5 daily report exposures. General maladjustment decreased across the three 2-week intervals. Combined, results indicate that short-term daily report studies do not place youth at risk for increased maladjustment. © 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.

  9. Azelaic acid 15% gel once daily versus twice daily in papulopustular rosacea.

    PubMed

    Thiboutot, Diane M; Fleischer, Alan B; Del Rosso, James Q; Graupe, Klaus

    2008-06-01

    Twice-daily azelaic acid (AzA) is the conventional regimen for papulopustular rosacea, but once-daily AzA may be equally effective, with greater convenience and dosing flexibility. In order to test this hypothesis, an exploratory study was conducted. The evaluable efficacy population of this 12-week double-blind, parallel-group study included 72 patients and the population that was used to report safety results included 92 patients. Baseline characteristics were comparable between the once-daily and twice-daily study groups. Evaluations were performed at baseline and at weeks 4, 8, and 12. No significant difference was found between the once-daily and twice-daily groups at the end of study therapy in mean investigator global assessment (IGA) scores, treatment success, or treatment response. The mean number of inflammatory lesions, the intensity of erythema intensity, and the intensity of telangiectasia at treatment end were likewise not significantly different (P>.205 for all). More than 90% of subjects in each group rated cosmetic acceptability of this AzA gel as satisfactory or better. Based on these findings and those of prior studies, once-daily AzA 15% gel can therefore be utilized as a safe, effective, and economical dosing option for the treatment of mild-to-moderate papulopustular rosacea. Once-daily dosing of AzA 15% gel was well accepted by patients and can offer considerable dosing flexibility and convenience for the patient as well as for the dermatologist.

  10. Relationships Among Nightly Sleep Quality, Daily Stress, and Daily Affect

    PubMed Central

    Bergeman, Cindy S.; Whitehead, Brenda R.; Braun, Marcia E.; Payne, Jessic D.

    2017-01-01

    Abstract Objectives. We explored the prospective, microlevel relationship between nightly sleep quality (SQ) and the subsequent day’s stress on positive (PA) and negative affect (NA) as well as the moderating relationships between nightly SQ, subsequent stress, and subsequent PA on NA. We investigated whether age moderated these relationships. Method. We collected 56 days of sleep, stress, and affect data using daily diary questionnaires (N = 552). We used multilevel modeling to assess relationships at the between- and within-person levels. Results. Daily increases in SQ and decreases in stress interacted to predict higher daily PA and lower daily NA. Better SQ in older adults enhanced the benefits of PA on the stress–NA relationship more during times of low stress, whereas better sleep in younger adults enhanced the benefits of PA more during times of high stress. Between-person effects were stronger predictors of well-being outcomes than within-person variability. Discussion. The combination of good SQ and higher PA buffered the impact of stress on NA. The moderating impact of age suggests that sleep and stress play different roles across adulthood. Targeting intervention and prevention strategies to improve SQ and enhance PA could disrupt the detrimental relationship between daily stress and NA. PMID:26307483

  11. Parasitic contamination of fresh vegetables sold at central markets in Khartoum state, Sudan.

    PubMed

    Mohamed, Mona Ali; Siddig, Emmanuel Edwar; Elaagip, Arwa Hassan; Edris, Ali Mahmoud Mohammed; Nasr, Awad Ahmed

    2016-03-11

    Fresh vegetables are considered as vital nutrients of a healthy diet as they supply the body with essential supplements. The consumption of raw vegetables is the main way for transmission of intestinal parasitic organisms. This study was aimed at detecting the parasitic contamination in fresh vegetables sold in two central open-aired markets in Khartoum state, Sudan. In this prospective cross-sectional study, a total of 260 fresh vegetable samples and 50 water samples used to sprinkle vegetable(s) were collected from two central open-aired markets (namely; Elshaabi and Central markets) during November 2011 to May 2012. The samples were microscopically examined for detection of parasitic life forms using standardized parasitological techniques for protozoans and helminthes worms. Of the 260 fresh vegetable samples, 35 (13.5 %) were microscopically positive for intestinal parasites whereas 7/50 (14 %) of water samples used to sprinkle vegetable(s) were found positives. Remarkably, high level of contamination in fresh vegetable samples was recorded in lettuce (Lactuca sativa) 36.4 % (4/11) while cayenne pepper (Capsicum annuum) and cucumber (Cucumis sativus) were not contaminated. The identified protozoans and helminthes were Entamoeba histolytica/dispar, Entamoeba coli, Giardia lamblia, Ascaris lumbricoides, Strongyloides stercoralis, T. trichiura and hookworms. The most predominant parasite encountered was E. histolytica/dispar (42.9 %) whereas both T. trichiura and A. lumbricoides (2.9 %) were the least detected parasites. None of the fresh vegetables had single parasitic contamination. The highest percentages found in water samples used to sprinkle vegetable(s) was for Strongyloides larvae 60 % (3/5). It is worth-mentioned that the rate of contamination in Elshaabi market was higher compared with Central market. However, there was no significant correlation between the type of vegetables and existence of parasites in both markets and a high significant

  12. Self-critical perfectionism, daily stress, and disclosure of daily emotional events.

    PubMed

    Richardson, Clarissa M E; Rice, Kenneth G

    2015-10-01

    Although disclosure of stressful events can alleviate distress, self-critical perfectionism may pose an especially strong impediment to disclosure during stress, likely contributing to poorer psychological well-being. In the current study, after completing a measure of self-critical perfectionism (the Discrepancy subscale of the Almost Perfect Scale--Revised; Slaney, Rice, Mobley, Trippi, & Ashby, 2001), 396 undergraduates completed measures of stress and disclosure at the end of each day for 1 week. Consistent with hypotheses and previous research, multilevel modeling results indicated significant intraindividual coupling of daily stress and daily disclosure where disclosure was more likely when experiencing high stress than low stress. As hypothesized, Discrepancy moderated the relationship between daily stress and daily disclosure. Individuals higher in self-critical perfectionism (Discrepancy) were less likely to engage in disclosure under high stress, when disclosure is often most beneficial, than those with lower Discrepancy scores. These results have implications for understanding the role of stress and coping in the daily lives of self-critical perfectionists. (c) 2015 APA, all rights reserved).

  13. Relationships Among Nightly Sleep Quality, Daily Stress, and Daily Affect.

    PubMed

    Blaxton, Jessica M; Bergeman, Cindy S; Whitehead, Brenda R; Braun, Marcia E; Payne, Jessic D

    2017-05-01

    We explored the prospective, microlevel relationship between nightly sleep quality (SQ) and the subsequent day's stress on positive (PA) and negative affect (NA) as well as the moderating relationships between nightly SQ, subsequent stress, and subsequent PA on NA. We investigated whether age moderated these relationships. We collected 56 days of sleep, stress, and affect data using daily diary questionnaires (N = 552). We used multilevel modeling to assess relationships at the between- and within-person levels. Daily increases in SQ and decreases in stress interacted to predict higher daily PA and lower daily NA. Better SQ in older adults enhanced the benefits of PA on the stress-NA relationship more during times of low stress, whereas better sleep in younger adults enhanced the benefits of PA more during times of high stress. Between-person effects were stronger predictors of well-being outcomes than within-person variability. The combination of good SQ and higher PA buffered the impact of stress on NA. The moderating impact of age suggests that sleep and stress play different roles across adulthood. Targeting intervention and prevention strategies to improve SQ and enhance PA could disrupt the detrimental relationship between daily stress and NA. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Adolescent Daily and General Maladjustment: Is There Reactivity to Daily Repeated Measures Methodologies?

    ERIC Educational Resources Information Center

    Nishina, Adrienne

    2012-01-01

    The present study examined whether repeated exposure to daily surveys about negative social experiences predicts changes in adolescents' daily and general maladjustment, and whether question content moderates these changes. Across a 2-week period, 6th-grade students (N = 215; mode age = 11) completed 5 daily reports tapping experienced or…

  15. Combining Radar and Daily Precipitation Data to Estimate Meaningful Sub-daily Precipitation Extremes

    NASA Astrophysics Data System (ADS)

    Pegram, G. G. S.; Bardossy, A.

    2016-12-01

    Short duration extreme rainfalls are important for design. The purpose of this presentation is not to improve the day by day estimation of precipitation, but to obtain reasonable statistics for the subdaily extremes at gauge locations. We are interested specifically in daily and sub-daily extreme values of precipitation at gauge locations. We do not employ the common procedure of using time series of control station to determine the missing data values in a target. We are interested in individual rare events, not sequences. The idea is to use radar to disaggregate daily totals to sub-daily amounts. In South Arica, an S-band radar operated relatively continuously at Bethlehem from 1998 to 2003, whose scan at 1.5 km above ground [CAPPI] overlapped a dense (10 km spacing) set of 45 pluviometers recording in the same 6-year period. Using this valuable set of data, we are only interested in rare extremes, therefore small to medium values of rainfall depth were neglected, leaving 12 days of ranked daily maxima in each set per year, whose sum typically comprised about 50% of each annual rainfall total. The method presented here uses radar for disaggregating daily gauge totals in subdaily intervals down to 15 minutes in order to extract the maxima of sub-hourly through to daily rainfall at each of 37 selected radar pixels [1 km square in plan] which contained one of the 45 pluviometers not masked out by the radar foot-print. The pluviometer data were aggregated to daily totals, to act as if they were daily read gauges; their only other task was to help in the cross-validation exercise. The extrema were obtained as quantiles by ordering the 12 daily maxima of each interval per year. The unusual and novel goal was not to obtain the reproduction of the precipitation matching in space and time, but to obtain frequency distributions of the gauge and radar extremes, by matching their ranks, which we found to be stable and meaningful in cross-validation tests. We provide and

  16. Mesalamine once daily is more effective than twice daily in patients with quiescent ulcerative colitis.

    PubMed

    Dignass, Axel U; Bokemeyer, Bernd; Adamek, Henning; Mross, Michael; Vinter-Jensen, Lars; Börner, Norbert; Silvennoinen, Jouni; Tan, Gie; Pool, Marco Oudkerk; Stijnen, Theo; Dietel, Peter; Klugmann, Tobias; Vermeire, Severine; Bhatt, Aomesh; Veerman, Henri

    2009-07-01

    Oral mesalamine (5-aminosalicylate) is the current standard of care for mild-to-moderate ulcerative colitis. We investigated the efficacy and safety of once daily administration of prolonged-release mesalamine granules in maintenance of remission in patients with quiescent ulcerative colitis, compared with the well established twice daily dosing regimen. In this multicenter, randomized, single blind, noninferiority trial, 362 patients with quiescent ulcerative colitis were randomly assigned (1:1) to groups that were given oral mesalamine 2 g, once daily, or 1 g, twice daily, for 12 months. The primary objective was to compare remission rates at 1 year, based on the ulcerative colitis disease activity index score, using Kaplan-Meier methodology. At 1 year, 70.9% of the group given 2 g mesalamine once daily remained in remission vs 58.9% of the group given 1 g mesalamine twice daily; this difference was statistically significant (P = .024), indicating the increased efficacy of once daily, compared with twice daily, dosing. Self-reported adherence to therapy, measured by visual analog scale score after 4, 8, and 12 months, was significantly greater in the group given 2 g mesalamine once daily, compared with twice daily, at all but 1 study visit (P < .05). Compliance measured by medication taken was not significantly different between the groups. The difference between the 2 groups in overall incidence of adverse events was not statistically significant (P = .23). Patients with ulcerative colitis given prolonged-release oral mesalamine 2 g once daily had better remission rates, acceptability, and self-reported adherence to therapy compared with patients given oral mesalamine 1 g twice daily.

  17. Pattern of co-infection by enteric pathogenic parasites among HIV sero-positive individuals in a Tertiary Care Hospital, Mumbai, India.

    PubMed

    Ahmed, Nishat Hussain; Chowdhary, Abhay

    2015-01-01

    One of the major medical concerns in people living with HIV/AIDS (PLHA) is management of diarrhea that can lead to severe morbidity and mortality. Such clinical scenario warrants an analysis of intestinal parasites, which are important opportunistic pathogens in PLHA. Owing to the scarcity of recent pattern of intestinal opportunistic infections from this region, the study was designed to determine the opportunistic parasites causing diarrhea in PLHA; and to find out whether there is any significant difference in the enteric parasitic pathogens in patients with different immunological status and in those on highly active anti retro-viral therapy (HAART). Analysis of the spectrum of intestinal parasites was carried out with 192 subjects in two groups (142 HIV sero-positive patients having diarrhea and 50 HIV sero-negative patients having diarrhea). The routine light microscopic examination was carried out to determine the infection and CD4+ T-Lymphocyte count was estimated using flow cytometry. Enteric parasites were detected in 35.9% of HIV sero-positive patients having diarrhea and 18% of HIV sero-negative patients having diarrhea. Most common opportunistic enteric parasite was Isospora belli (11.5%); others were Entamoeba histolytica (4.7%), Cryptosporidium sp. (3.6%), Strongyloides stercoralis (3.1%), Giardia intestinalis (3.1%) and Cyclospora cayatanenesis (1.6%). Opportunistic enteric parasites were detected in significantly low numbers in patients with CD4+ T-Lymphocyte counts >500 cells/ml; and in those taking HAART.

  18. THE SUGAR GLIDER (PETAURUS BREVICEPS): A LABORATORY HOST FOR THE NEMATODE PARASTRONGYLOIDES TRICHOSURI

    PubMed Central

    Nolan, Thomas J.; Zhu, Xiaodong; Ketschek, Andrea; Cole, Joan; Grant, Warwick; Lok, James B.; Schad, Gerhard A.

    2011-01-01

    Parastrongyloides trichosuri is a nematode parasite of the Australian brush-tailed possums that can be propagated through many generations in vitro. This makes P. trichosuri uniquely suited for genetic investigations, including those involving transgenesis. However, an obstacle to its use as an experimental model has been the fact that its host is limited to Australia and New Zealand and that it cannot be exported because of its status as a protected species or agricultural pest, respectively. In previous studies, conventional laboratory animals such as rats, mice, rabbits, ferrets, and chickens have failed to support infections. In the present study, gerbils and short-tailed opossums proved similarly refractory to infection. In contrast, the sugar glider (Petaurus breviceps, family Petauridae) proved to be a good host for P. trichosuri. Patent infections resulted using as few as 6 infective larvae (L3i) and as many as 2,000 L3i. Large numbers of L3i (1,000–2,000) produced patent infections of much shorter duration than those seen when 100 L3i were initially given to the sugar glider. In one case, an infection initiated with 100 L3i was patent for over 1 yr. Parastrongyloides trichosuri is easily cryopreserved using a method developed for Strongyloides stercoralis. Thus, we have identified an experimental host for P. trichosuri that will make it possible to conduct research on this parasite in laboratories outside the endemic sites. PMID:18163342

  19. The sugar glider (Petaurus breviceps): a laboratory host for the nematode Parastrongyloides trichosuri.

    PubMed

    Nolan, Thomas J; Zhu, Xiaodong; Ketschek, Andrea; Cole, Joan; Grant, Warwick; Lok, James B; Schad, Gerhard A

    2007-10-01

    Parastrongyloides trichosuri is a nematode parasite of the Australian brush-tailed possums that can be propagated through many generations in vitro. This makes P. trichosuri uniquely suited for genetic investigations, including those involving transgenesis. However, an obstacle to its use as an experimental model has been the fact that its host is limited to Australia and New Zealand and that it cannot be exported because of its status as a protected species or agricultural pest, respectively. In previous studies, conventional laboratory animals such as rats, mice, rabbits, ferrets, and chickens have failed to support infections. In the present study, gerbils and short-tailed opossums proved similarly refractory to infection. In contrast, the sugar glider (Petaurus breviceps, family Petauridae) proved to be a good host for P. trichosuri. Patent infections resulted using as few as 6 infective larvae (L3i) and as many as 2,000 L3i. Large numbers of L3i (1,000-2,000) produced patent infections of much shorter duration than those seen when 100 L3i were initially given to the sugar glider. In one case, an infection initiated with 100 L3i was patent for over 1 yr. Parastrongyloides trichosuri is easily cryopreserved using a method developed for Strongyloides stercoralis. Thus, we have identified an experimental host for P. trichosuri that will make it possible to conduct research on this parasite in laboratories outside the endemic sites.

  20. Gastrointestinal parasitic infection in diverse species of domestic ruminants inhabiting tribal rural areas of southern Rajasthan, India.

    PubMed

    Choubisa, S L; Jaroli, V J

    2013-10-01

    A total of 415 adult domesticated ruminants, 130 cattle (Bos taurus), 108 buffaloes (Bubalus bubalis), 94 goats (Capra hircus) and 83 sheep (Ovis aries) inhabiting tribal rural areas of southern Rajasthan, India were investigated for evidence of gastrointestinal protozoan and helminthic infections. In southern Rajasthan humid ecosystem is predominant and has number of perennial freshwater bodies. Fresh faecal samples of these animals were examined microscopically by direct wet smear with saline and 1 % Lugol's iodine and formalin ether concentration. Of these 296 (71.32 %) were found to be infected with different species of gastrointestinal parasites. The highest (93.84 %) prevalence of these parasitic infections was found in cattle followed by goats (82.97 %), sheep (55.42 %) and buffaloes (46.29 %). Except cattle no other ruminants revealed protozoan infection. A total 8 species of gastrointestinal parasites were encountered. Among these parasites Fasciola hepatica was the commonest (15.18 %) followed by Haemonchus contortus (11.32 %), Ancylostoma duodenale (10.36 %), Trichuris trichiura (9.15 %), Amphistome species (7.95 %), Moniezia expansa (6.98 %), Strongyloides stercoralis (4.57 %) and Balantidium coli (3.37 %). The prevalence rate of these parasitic infections also varied seasonally. The highest prevalence rate was found in rainy season (84.21 %) followed by winter (73.9 %) and summer (52.8 %). The possible causes for variation in prevalence of parasitic infections are also discussed.

  1. Assessment of parasitic pollution in the coastal seawater of Gaza city

    PubMed Central

    2014-01-01

    Background The main objective of the study was the assessment of the prevalence and the identification of species of human gastrointestinal parasites as an indicator of the pollution of the seashore of Gaza City. Methods The investigation was conducted by analysis of the parasitic contamination of seawater along the study area. A total of 52 samples of seawater were analyzed during the summer period; from June to October 2011. The study area was divided into six zones (A, B, C, D, E and F) according to specific criteria such as the presence of the wastewater discharge points and other geographical characteristics. Results The results show that about 48% of the seawater samples from the shoreline region of Gaza City were contaminated with parasites. Zones A, B and D (mouth of Wadi Gaza, Al Sheikh Ejleen discharge and Al Shalehat discharge points respectively) have the highest level of parasitic contamination, while, zones C and E (From Al-Baydar restaurant to Khalel Alwazer Mosque and the basin of the Gaza marina respectively) had a lower level of contamination and zone F (From the northern part of the Gaza marina to the Intelligence Building) was uncontaminated. The parasitic species found were: Ascaris lumbricoides, Giardia lamblia, Strongyloides stercoralis, Hymenolepis nana, Entamoeba histolytica/dispar and Cryptosporidium parvum. Conclusions The present study revealed a high level of contamination with parasites at most of the points which were investigated along the Gaza City coast line. PMID:24410999

  2. [Schistosomiasis and soil-transmitted helminthiasis among schoolchildren of Nikki and Pèrèrè, two northeastern towns of Benin].

    PubMed

    Ibikounlé, M; Gbédjissi, L G; Ogouyèmi-Hounto, A; Batcho, W; Kindé-Gazard, D; Massougbodji, A

    2014-08-01

    Infection with schistosomiasis and soil-transmitted helminthiasis are widespread in sub-Saharan Africa and the burden of disease associated with parasites is enormous. A study was performed to determine the transmission and prevalence of human schistosomiasis and soil-transmitted helminthiasis among school children of Nikki and Perere, two north eastern towns of Benin, bordering Republic of Nigeria. Parasitological investigations by urine filtration and Kato-Katz conducted on 1,344 school children indicated a mean prevalence of S. haematobium and S. mansoni 48.44% and 0%, respectively, in the children of Nikki area and 45.24% and 4.11% in Perere area. Only schoolchildren of Sonon locality were infected by S. mansoni with a mean prevalence rate of 36.24%. KatoKatz tests releaved five species of soil-transmitted helminths: Ankylostoma duodenale (8.16% and 6.73%), Ascaris lumbricoides (6.26% and 2.30%), Enterobius vermicularis (1.09% and 1.97%), Trichuris trichiura (1.97% and 1.90%) and Strongyloides stercoralis (2.04% and 0.99%), respectively, in the schoolchildren of Nikki and Perere areas. The malacological investigations carried out in the freshwater points of each visited locality highlighted the presence of four species of freshwater snails known as intermediate host of schistosome: Biomphalaria pfeifferi, Bulinus forskalii, B. globosus and B. truncatus.Two B. globosus and B. pfeifferi collected in Sonon locality were naturally infected by schistosome, indicated the importance of their two species of snail in schistosome transmission cycle.

  3. Current laboratory diagnosis of opportunistic enteric parasites in human immunodeficiency virus-infected patients

    PubMed Central

    De, Anuradha

    2013-01-01

    Diarrhea is a major cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected individuals. Opportunistic enteric parasitic infections are encountered in 30-60% of HIV seropositive patients in developed countries and in 90% of patients in developing countries. Once the CD4+ cell count drops below 200 cells/μl, patients are considered to have developed acquired immunodeficiency syndrome (AIDS), with the risk of an AIDS-defining illness or opportunistic infection significantly increasing. Opportunistic enteric parasites encountered in these patients are Cryptosporidium, Isospora, Cyclospora, and microsporidia; as well as those more commonly associated with gastrointestinal disease, for example, Giardia intestinalis, Entamoeba histolytica, Strongyloides stercoralis, and also rarely Balantidium coli. In view of AIDS explosion in India, opportunistic enteric parasites are becoming increasingly important and it has to be identified properly. Apart from wet mounts, concentration methods for stool samples and special staining techniques for identification of these parasites, commercially available fecal immunoassays are widely available for the majority of enteric protozoa. Molecular methods such as polymerase chain reaction (PCR), PCR-restriction fragment length polymorphism, flow cytometry, and sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), have also come in the pipeline for early diagnosis of these infections. Proper disposal of the feces to prevent contamination of the soil and water, boiling/filtering drinking water along with improved personal hygiene might go a long way in preventing these enteric parasitic infections. PMID:23961436

  4. Intestinal parasitism, potable water availability and methods of sewage disposal in three communities in Benue State, Nigeria: a survey.

    PubMed

    Jombo, G T A; Egah, D Z; Akosu, J T

    2007-03-01

    To assess the level of parasite burden in a village community and the predisposing factors. Two hundred subjects each were recruited from three communities- Tyogbenda, Jato-Aka and Adikpo during an episode of free medical outreach. A simple random sampling method was adopted and a questionnaire was interviewer administered on relevant aspects of basic hygiene such as- sources of water supply, methods of domestic sewage disposal and frequency of hand washing. Stool samples were collected and tested and findings analysed using appropriate statistical methods, p values < 0.05 were considered significant. The prevalence of intestinal parasites in Tyogbenda, Jato-Aka and Adikpo communities was found to be 71.5%, 65.5% and 40.5% respectively. Ascaris lumbricoides was the commonest parasite in the three centres (34.5%, 28.5% and 19.0% respectively for Tyogbenda, Jato-Aka and Adikpo communities). Other parasites identified were- Entamoeba histolytica, Entamoeba coli, Hookworm. Enterobius vermicularis, Strongyloides stercoralis, Schistosoma mansoni and Trichuris trichura. Multiple parasitic infestation was common in the communities where quality of water supply and methods of sewage disposal facilities were below standard. The prevalence of intestinal parasitism is still high in Nigerian rural communities. The present resolve by the federal ministry of water resources to supply potable water to all Nigerian rural communities should be sustained. Furthermore, a health education program should be properly constituted and integrated into the present primary health care policy for the country.

  5. Detection of Dientamoeba fragilis in patients with HIV/AIDS by using a simplified iron hematoxylin technique.

    PubMed

    Garcia, Juliana Alves; Cimerman, Sergio

    2012-01-01

    Studies strongly indicate Dientamoeba fragilis as one of the causes of diarrhea in human immunodeficiency virus (HIV) patients. The objective of the present study was to evaluate the prevalence of D. fragilis associated with the causes of diarrhea in 82 HIV/ AIDS patients hospitalized at the Instituto de Infectologia Emílio Ribas from September 2006 to November 2008. In total, 105 samples were collected from 82 patients. Unprotected sex was the most frequent cause of HIV infection (46.3%), followed by the use of injectable or non-injectable drugs (14.6%). Patients presented with viral loads of 49-750,000 copies/ mL (average: 73,849 ± 124,850 copies/mL) and CD4 counts ranging of 2-1,306 cells/mm³ (average: 159 ± 250 cells/mm³). On an average, the odds of obtaining a positive result by using the other techniques (Hoffman, Pons and Janer or Lutz; Ritchie) were 2.7 times higher than the chance of obtaining a positive result by using the simplified iron hematoxylin method. Significant differences were found between the methods (p = 0.003). The other techniques can detect a significantly greater amount of parasites than the simplified iron hematoxylin method, especially with respect to Isospora belli, Cryptosporidium sp., Schistosoma mansoni, and Strongyloides stercoralis, which were not detected using hematoxylin. Endolimax nana and D. fragilis were detected more frequently on using hematoxylin, and the only parasite not found by the other methods was D. fragilis.

  6. [Children enteroparasitosis in north east Argentine urban area].

    PubMed

    Milano, Alicia M F; Oscherov, Elena B; Palladino, Alberto C; Bar, Anibal R

    2007-01-01

    The aim of the present investigation was to evaluate the importance of enteroparasitosis in a young urban population. The relationship between enteroparasitosis in this population and biological and environmental conditions was established for 113 infants between 0 and 14 years. Serial stool samples were analyzed and Graham tests were performed in each infant. The degree of nutrition of each infant was also assessed. Environmental data were collected via semi-structured surveys. Soil samples were tested to determine the degree of soil contamination. The following species were identified: Blastocystis hominis, Enterobius vermicularis, coccidios, Giardia intestinalis, hookworms, Strongyloides stercoralis, Trichuris trichura, Ascaris lumbricoides, Entamoeba coli, Endolimax nana and Taenia sp. Children infection prevalence was 73.5%. The frequency of enteroparasitosis was largest in the population from 3 to 8 years. The homes of the children analyzed were brick houses with tin roof and access to tap water. A 79.5% of these houses had bathrooms. The remaining used outdoors latrines. In 95.5% of these houses, the residents lived with one or more dogs and cats. The soil collected from nine houses was contaminated with infectious forms of Toxocara canis and ancilostomideos. The relationship between parasitosis and latrines and overcrowding was verified. Five cases of malnutrition were detected (4.4%). The relevance of physical and cultural factors in relation to enteric parasitosis suggests that the pharmacological treatment should be accompanied with preventive measures regarding hygiene and proper elimination of human and pet faeces.

  7. Drawbacks of proactivity: Effects of daily proactivity on daily salivary cortisol and subjective well-being.

    PubMed

    Fay, Doris; Hüttges, Annett

    2017-10-01

    The benefit of proactive work behaviors for performance-related outcomes has been well established. However, this approach to studying proactivity has not yet acknowledged its potential implications for the actor's well-being. Drawing on the fact that resources at work are limited and that the workplace is a social system characterized by interdependencies, we proposed that daily proactivity could have a negative effect on daily well-being. We furthermore proposed that this effect should be mediated by work overload and negative affect. We conducted a daily diary study (N = 72) to test the potential negative effects of proactivity on daily well-being. Data was collected across 3 consecutive work days. During several daily measurement occasions, participants reported proactivity, work overload, negative affect, and fatigue. They also provided 4 saliva samples per day, from which cortisol was assayed. Based on the 4 samples, a measure of daily cortisol output was produced. Multilevel analyses showed that daily proactivity was positively associated with higher daily cortisol output. The positive association of daily proactivity with bedtime fatigue was marginally significant. There was no support for a mediating effect of work overload and negative affect. Implications for theory-building on the proactivity-well-being link are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Associations among daily stressors and salivary cortisol: findings from the National Study of Daily Experiences.

    PubMed

    Stawski, Robert S; Cichy, Kelly E; Piazza, Jennifer R; Almeida, David M

    2013-11-01

    While much research has focused on linking stressful experiences to emotional and biological reactions in laboratory settings, there is an emerging interest in extending these examinations to field studies of daily life. The current study examined day-to-day associations among naturally occurring daily stressors and salivary cortisol in a national sample of adults from the second wave of the National Study of Daily Experiences (NSDE). A sample of 1694 adults (age=57, range=33-84; 44% male) completed telephone interviews detailing their stressors and emotions on eight consecutive evenings. Participants also provided saliva samples upon waking, 30min post-waking, before lunch and before bed, on four consecutive interview days resulting in 5995 days of interview/cortisol data. Analyses revealed three main findings. First, cortisol AUC was significantly higher on stressor days compared to stressor-free days, particularly for arguments and overloads at home, suggesting that daily stressors are associated with increased cortisol output, but that not all daily stressors have such an influence. Second, individuals reporting a greater frequency of stressor days also exhibited a steeper diurnal cortisol slope. Finally, daily stressor-cortisol associations were unaltered after adjustment for daily negative affect and physical symptoms. Our discussion focuses on the influence of naturally occurring daily stressors on daily cortisol and the role of daily diary approaches for studying healthy cortisol responses to psychosocial stressors outside of traditional laboratory settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Associations among Daily Stressors and Salivary Cortisol: Findings from the National Study of Daily Experiences

    PubMed Central

    Stawski, Robert S.; Cichy, Kelly E.; Piazza, Jennifer R.; Almeida, David M.

    2013-01-01

    While much research has focused on linking stressful experiences to emotional and biological reactions in laboratory settings, there is an emerging interest in extending these examinations to field studies of daily life. The current study examined day-to-day associations among naturally-occurring daily stressors and salivary cortisol in a national sample of adults from the second wave of the National Study of Daily Experiences (NSDE). A sample of 1,694 adults (Age=57, Range=33–84; 44% male) completed telephone interviews detailing their stressors and emotions on eight consecutive evenings. Participants also provided saliva samples upon waking, 30 minutes post-waking, before lunch and before bed, on four consecutive interview days resulting in 5,995 days of interview/cortisol data. Analyses revealed three main findings. First, cortisol AUC was significantly higher on stressor days compared to stressor-free days, particularly for arguments and overloads at home, suggesting that daily stressors are associated with increased cortisol output, but that not all daily stressors have such an influence. Second, individuals reporting a greater frequency of stressor days also exhibited a steeper diurnal cortisol slope. Finally, daily stressor-cortisol associations were unaltered after adjustment for daily negative affect and physical symptoms. Our discussion focuses on the influence of naturally-occurring daily stressors on daily cortisol and the role of daily diary approaches for studying healthy cortisol responses to psychosocial stressors outside of traditional laboratory settings. PMID:23856186

  10. Treatment of streptococcal pharyngitis with once-daily compared with twice-daily amoxicillin: a noninferiority trial.

    PubMed

    Clegg, Herbert W; Ryan, Amy G; Dallas, Steven D; Kaplan, Edward L; Johnson, Dwight R; Norton, H James; Roddey, Oliver F; Martin, Edward S; Swetenburg, Raymond L; Koonce, Elizabeth W; Felkner, Mary M; Giftos, P Michael

    2006-09-01

    Two relatively small previous studies comparing once-daily amoxicillin with conventional therapy for group A streptococcal (GAS) pharyngitis reported similar rates of bacteriologic success for each treatment group. The purpose of this study was to further evaluate once-daily amoxicillin for GAS pharyngitis in a larger study. In a single pediatric practice, from October through May for 2 consecutive years (2001-2003), we recruited children 3 to 18 years of age who had symptoms and signs suggestive of GAS pharyngitis. Patients with a positive rapid test for GAS were stratified by weight (<40 kg or >or=40 kg) and then randomly assigned to receive once-daily (750 mg or 1000 mg) or twice-daily (2 doses of 375 mg or 500 mg) amoxicillin for 10 days. We determined bacteriologic failure rates for GAS in the pharynx from subsequent swabs taken at 14 to 21 (visit 2) and 28 to 35 (visit 3) days after treatment initiation. We conducted a randomized, controlled, investigator-blinded, noninferiority trial to evaluate whether amoxicillin given once daily would have a bacteriologic failure rate no worse than that of amoxicillin given twice daily within a prespecified margin of 10%. GAS isolates were characterized to distinguish bacteriologic failures from new acquisitions. Adverse events were described and adherence was evaluated by review of returned daily logs and dosage bottles. Of 2139 potential study patients during the 2-year period, we enrolled 652 patients, 326 into each treatment group. Children in the 2 groups were comparable with respect to all demographic and clinical characteristics except that children <40 kg more often presented with rash in each treatment group. At visit 2, failure rates were 20.1% (59 of 294) for the once-daily group and 15.5% (46 of 296) for the twice-daily group (difference, 4.53%; 90% confidence interval [CI], -0.6 to 9.7). At visit 3, failure rates were 2.8% (6 of 216) for the once-daily group and 7.1% (16 of 225) for the twice-daily group

  11. Comparison of once-daily versus twice-daily combination of ropinirole prolonged release in Parkinson's disease.

    PubMed

    Yun, Ji Young; Kim, Han-Joon; Lee, Jee-Young; Kim, Young Eun; Kim, Ji Seon; Kim, Jong-Min; Jeon, Beom S

    2013-09-02

    Ropinirole prolonged release (RPR) is a once-daily formulation. However, there may be individual pharmacokinetic differences so that multiple dosing may be preferred in some individuals. This study compares once-daily and twice-daily RPR in patients with Parkinson's disease. This study was an open-label crossover study. We enrolled Parkinson's disease patients on dopamine agonist therapy with unsatisfactory control such as motor fluctuation, dyskinesia and sleep-related problems. Agonists were switched into equivalent dose of RPR. Subjects were consecutively enrolled into either once-daily first or twice-daily first groups, and received the same amount of RPR in a single and two divided dosing for 8 weeks respectively in a crossover manner without a washout period.The primary outcome was a questionnaire of the preference completed by patients in the last visit. The secondary outcome measures included the Unified Parkinson's Disease Rating Scale part 3 (mUPDRS), Hoehn and Yahr stage (H&Y); sleep questionnaire including overall quality of sleep, nocturnal off symptoms and early morning symptoms; Epworth Sleep Scale (ESS); compliances and patient global impression (PGI). A total of 82 patients were enrolled and 61 completed the study. 31 patients preferred twice-daily regimen, 17 preferred the once-daily regimen, and 13 had no preference. Their mean mUPDRS, H&Y, ESS, sleep quality, compliance and adverse events were not statistically different in both regimens. PGI-improvement on wearing off defined was better in twice-daily dosing regimen. RPR is a once-daily formulation, but multiple dosing was preferred in many patients. Multiple dosing of RPR might be a therapeutic option if once-daily dosing is unsatisfactory.

  12. Cost analysis of once-daily ISMN versus twice-daily ISMN or transdermal patch for nitrate prophylaxis.

    PubMed

    Brown, R E; Kendall, M J; Halpern, M T

    1997-02-01

    To compare the costs and outcomes of treating exercise-induced angina with once- or twice-daily isosorbide mononitrate (ISMN) or transdermal patch. A decision-analytic model was designed based on published literature showing compliance and increasing symptoms and estimates from physicians on treatment patterns and worsening symptoms. Data show that patients are more compliant with once-daily ISMN (Imdur, Astra Hässle, Mölndal, Sweden) and patch regimens than with twice-daily dose. Based upon the assumption that more compliant patients are better controlled, the model found that fewer medical care resources were consumed by patients treated with the once-daily and the patch regimens. The unit cost of the twice-daily ISMN regimen is 40% of the unit cost of the once-daily. Annual costs of treating an exercise-induced angina patient are 248 pounds for Imdur compared to 250 pounds for the twice-daily ISMN and 299 pounds for the transdermal patch. Unit prices alone are not good indicators for estimating medical management costs.

  13. Combination of radar and daily precipitation data to estimate meaningful sub-daily point precipitation extremes

    NASA Astrophysics Data System (ADS)

    Pegram, Geoff; Bardossy, Andras; Sinclair, Scott

    2017-04-01

    The use of radar measurements for the space time estimation of precipitation has for many decades been a central topic in hydro-meteorology. In this presentation we are interested specifically in daily and sub-daily extreme values of precipitation at gauged or ungauged locations which are important for design. The purpose of the presentation is to develop a methodology to combine daily precipitation observations and radar measurements to estimate sub-daily extremes at point locations. Radar data corrected using precipitation-reflectivity relationships lead to biased estimations of extremes. Different possibilities of correcting systematic errors using the daily observations are investigated. Observed gauged daily amounts are interpolated to un-sampled points and subsequently disaggregated using the sub-daily values obtained by the radar. Different corrections based on the spatial variability and the sub-daily entropy of scaled rainfall distributions are used to provide unbiased corrections of short duration extremes. In addition, a statistical procedure not based on a matching day by day correction is tested. In this last procedure, as we are only interested in rare extremes, low to medium values of rainfall depth were neglected leaving 12 days of ranked daily maxima in each set per year, whose sum typically comprises about 50% of each annual rainfall total. The sum of these 12 day maxima is first interpolated using a Kriging procedure. Subsequently this sum is disaggregated to daily values using a nearest neighbour procedure. The daily sums are then disaggregated by using the relative values of the biggest 12 radar based days in each year. Of course, the timings of radar and gauge maxima can be different, so the new method presented here uses radar for disaggregating daily gauge totals down to 15 min intervals in order to extract the maxima of sub-hourly through to daily rainfall. The methodologies were tested in South Africa, where an S-band radar operated

  14. Combination of radar and daily precipitation data to estimate meaningful sub-daily point precipitation extremes

    NASA Astrophysics Data System (ADS)

    Bárdossy, András; Pegram, Geoffrey

    2017-01-01

    The use of radar measurements for the space time estimation of precipitation has for many decades been a central topic in hydro-meteorology. In this paper we are interested specifically in daily and sub-daily extreme values of precipitation at gauged or ungauged locations which are important for design. The purpose of the paper is to develop a methodology to combine daily precipitation observations and radar measurements to estimate sub-daily extremes at point locations. Radar data corrected using precipitation-reflectivity relationships lead to biased estimations of extremes. Different possibilities of correcting systematic errors using the daily observations are investigated. Observed gauged daily amounts are interpolated to unsampled points and subsequently disaggregated using the sub-daily values obtained by the radar. Different corrections based on the spatial variability and the subdaily entropy of scaled rainfall distributions are used to provide unbiased corrections of short duration extremes. Additionally a statistical procedure not based on a matching day by day correction is tested. In this last procedure as we are only interested in rare extremes, low to medium values of rainfall depth were neglected leaving a small number of L days of ranked daily maxima in each set per year, whose sum typically comprises about 50% of each annual rainfall total. The sum of these L day maxima is first iterpolated using a Kriging procedure. Subsequently this sum is disaggregated to daily values using a nearest neighbour procedure. The daily sums are then disaggregated by using the relative values of the biggest L radar based days. Of course, the timings of radar and gauge maxima can be different, so the method presented here uses radar for disaggregating daily gauge totals down to 15 min intervals in order to extract the maxima of sub-hourly through to daily rainfall. The methodologies were tested in South Africa, where an S-band radar operated relatively continuously at

  15. Quantification of Daily Physical Activity

    NASA Technical Reports Server (NTRS)

    Whalen, Robert; Breit, Greg; Quintana, Jason

    1994-01-01

    The influence of physical activity on the maintenance and adaptation of musculoskeletal tissue is difficult to assess. Cumulative musculoskeletal loading is hard to quantify and the attributes of the daily tissue loading history affecting bone metabolism have not been completely identified. By monitoring the vertical component of the daily ground reaction force (GRFz), we have an indirect measure of cumulative daily lower limb musculoskeletal loading to correlate with bone density and structure. The objective of this research is to develop instrumentation and methods of analysis to quantify activity level in terms of the daily history of ground reaction forces.

  16. On the impacts of computing daily temperatures as the average of the daily minimum and maximum temperatures

    NASA Astrophysics Data System (ADS)

    Villarini, Gabriele; Khouakhi, Abdou; Cunningham, Evan

    2017-12-01

    Daily temperature values are generally computed as the average of the daily minimum and maximum observations, which can lead to biases in the estimation of daily averaged values. This study examines the impacts of these biases on the calculation of climatology and trends in temperature extremes at 409 sites in North America with at least 25 years of complete hourly records. Our results show that the calculation of daily temperature based on the average of minimum and maximum daily readings leads to an overestimation of the daily values of 10+ % when focusing on extremes and values above (below) high (low) thresholds. Moreover, the effects of the data processing method on trend estimation are generally small, even though the use of the daily minimum and maximum readings reduces the power of trend detection ( 5-10% fewer trends detected in comparison with the reference data).

  17. A Daily Diary Approach to the Examination of Chronic Stress, Daily Hassles and Safety Perceptions in Hospital Nursing.

    PubMed

    Louch, Gemma; O'Hara, Jane; Gardner, Peter; O'Connor, Daryl B

    2017-12-01

    Stress is a significant concern for individuals and organisations. Few studies have explored stress, burnout and patient safety in hospital nursing on a daily basis at the individual level. This study aimed to examine the effects of chronic stress and daily hassles on safety perceptions, the effect of chronic stress on daily hassles experienced and chronic stress as a potential moderator. Utilising a daily diary design, 83 UK hospital nurses completed three end-of-shift diaries, yielding 324 person days. Hassles, safety perceptions and workplace cognitive failure were measured daily, and a baseline questionnaire included a measure of chronic stress. Hierarchical multivariate linear modelling was used to analyse the data. Higher chronic stress was associated with more daily hassles, poorer perceptions of safety and being less able to practise safely, but not more workplace cognitive failure. Reporting more daily hassles was associated with poorer perceptions of safety, being less able to practise safely and more workplace cognitive failure. Chronic stress did not moderate daily associations. The hassles reported illustrate the wide-ranging hassles nurses experienced. The findings demonstrate, in addition to chronic stress, the importance of daily hassles for nurses' perceptions of safety and the hassles experienced by hospital nurses on a daily basis. Nurses perceive chronic stress and daily hassles to contribute to their perceptions of safety. Measuring the number of daily hassles experienced could proactively highlight when patient safety threats may arise, and as a result, interventions could usefully focus on the management of daily hassles.

  18. ONCE DAILY RISPERIDONE IN TREATMENT OF SCHIZOPHRENIA

    PubMed Central

    Agarwal, Vivek; Chadda, Rakesh K.

    2001-01-01

    Forty four schizophrenic patients were randomly assigned to receive risperidone in 4-8 mg doses either once daily or twice daily for 8 weeks. An open trial was conducted to determine the efficacy of once daily administration of risperidone as compared to twice daily administration. Assessment were done on Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) scale Eighty two percent of the once daily patients and 79% of the twice daily patients showed a significant treatment response. No significant differences were observed between the two groups in response pattern and adverse effects at the end point. Risperidone given once daily was as effective as twice daily administration. PMID:21407835

  19. Depression Among Non-Daily Smokers Compared to Daily Smokers and Never-Smokers in the United States: An Emerging Problem.

    PubMed

    Weinberger, Andrea H; Gbedemah, Misato; Wall, Melanie M; Hasin, Deborah S; Zvolensky, Michael J; Chaiton, Michael; Goodwin, Renee D

    2017-09-01

    Depression is strongly associated with daily smoking. Yet, little is known about the association between depression and non-daily smoking. The aim of this study was to investigate the prevalence of past-year depression and changes in past-year depression over time among non-daily smokers, compared to daily smokers and never-smokers, overall and stratified by age, gender, income, nicotine dependence, and cigarettes per day. Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons aged 12 and over (total study population N = 496 805). The prevalence of past-year depression was examined annually among non-daily smokers, daily smokers, and never-smokers from 2005 to 2013 using linear trend analyses. Past-year depression was common among 10.10% of non-daily smokers, common among 10.78% of daily smokers, and 5.51% of never-smokers in 2013. The prevalence of depression increased from 2005 to 2013 among non-daily smokers (9.06% vs. 10.10%; p = .034) while there was no significant change in depression over time among daily smokers. Increases in depression among non-daily smokers occurred for both men and women and appear most pronounced youth, those smoking fewer cigarettes, and those without nicotine dependence. The prevalence of depression among non-daily smokers was equivalent to daily smokers and nearly twice that among nonsmokers. Depression appears to be increasing over time in non-daily smokers especially among youth, those who smoke less, and those without nicotine dependence. More work on the mental health of non-daily smokers is needed as this is an increasing and understudied group. This is the first study to investigate changes in the prevalence of depression among non-daily smokers compared to daily smokers and never-smokers over the past decade in a nationally representative sample of the United States. The results suggest an increase in depression among non-daily smokers over time that did not

  20. Modeling Cortisol Daily Rhythms of Family Caregivers of Individuals With Dementia: Daily Stressors and Adult Day Services Use.

    PubMed

    Liu, Yin; Almeida, David M; Rovine, Michael J; Zarit, Steven H

    2018-03-02

    The study examined the typical diurnal cortisol trajectory and its differential associations with an intervention, the adult day services (ADS) use, among a sample of family caregivers who experienced high levels of daily stress. On hundred and sixty-five caregivers of individuals with dementia completed an 8-day diary on daily stressors, positive events, sleep quality, and ADS use. The caregivers also provided five saliva samples on each diary day. Daily cortisol trajectories were modeled as a function of time elapsed since awakening, and three spline growth curve models were fit to the cortisol data. Based on the best-fitting linear spline model, the effect of daily ADS use was examined at both daily and person levels. Covariates included daily experiences and other caregiving characteristics. On ADS days, caregivers had a steeper cortisol awakening response (CAR) slope and a steeper morning decline. ADS use remained significant after controlling for covariates at both daily and person levels. The findings suggested potential biophysiological benefits of daily ADS use for a sample that was under chronic stress and high levels of daily stress.

  1. Hymenolepis nana Impact Among Children in the Highlands of Cusco, Peru: An Emerging Neglected Parasite Infection.

    PubMed

    Cabada, Miguel M; Morales, Maria Luisa; Lopez, Martha; Reynolds, Spencer T; Vilchez, Elizabeth C; Lescano, Andres G; Gotuzzo, Eduardo; Garcia, Hector Hugo; White, Clinton A

    2016-11-02

    Hymenolepis nana is the most common cestode infection in the world. However, limited information is available regarding its impact on affected populations. We studied the epidemiology and symptoms associated with hymenolepiasis among children 3-16 years old in 16 rural communities of the highlands of the Cusco region in Peru. Information on demographics, socioeconomic status, symptoms as reported by parents, and parasitological testing was obtained from the database of an ongoing Fasciola hepatica epidemiologic study. A total of 1,230 children were included in the study. Forty-five percent were infected with at least one pathogenic intestinal parasite. Giardia spp. (22.9%) was the most common, followed by Hymenolepis (17.4%), Fasciola (14.1%), Ascaris lumbricoides (6.1%), and Strongyloides stercoralis (2%). The prevalence of Hymenolepis infection varied by community, by other parasitic infections, and by socioeconomic status. However, only years of education of the mother, use of well water, and age less than 10 years were associated with Hymenolepis infection in the multivariate analysis. Hymenolepis nana infection was associated with diarrhea, jaundice, headaches, fever, and fatigue. Children with > 500 eggs/g of stool were more likely to have symptoms of weight loss, jaundice, diarrhea, and fever. Hymenolepis nana infection and age were the only factors retained in the multivariate analysis modeling diarrhea. Hymenolepiasis is a common gastrointestinal helminth in the Cusco region and is associated with significant morbidity in children in rural communities. The impact caused by the emergence of Hymenolepis as a prevalent intestinal parasite deserves closer scrutiny. © The American Society of Tropical Medicine and Hygiene.

  2. Intestinal Parasitic Infections and Environmental Water Contamination in a Rural Village of Northern Lao PDR.

    PubMed

    Ribas, Alexis; Jollivet, Chloé; Morand, Serge; Thongmalayvong, Boupha; Somphavong, Silaphet; Siew, Chern-Chiang; Ting, Pei-Jun; Suputtamongkol, Saipin; Saensombath, Viengsaene; Sanguankiat, Surapol; Tan, Boon-Huan; Paboriboune, Phimpha; Akkhavong, Kongsap; Chaisiri, Kittipong

    2017-10-01

    A field survey studying intestinal parasites in humans and microbial pathogen contamination at environment was performed in a Laotian rural village to identify potential risks for disease outbreaks. A parasitological investigation was conducted in Ban Lak Sip village, Luang Prabang, Lao PDR involving fecal samples from 305 inhabitants as well as water samples taken from 3 sites of the local stream. Water analysis indicated the presence of several enteric pathogens, i.e., Aeromonas spp., Vibrio spp., E. coli H7, E. coli O157: H7, verocytotoxin-producing E. coli (VTEC), Shigella spp., and enteric adenovirus. The level of microbial pathogens contamination was associated with human activity, with greater levels of contamination found at the downstream site compared to the site at the village and upstream, respectively. Regarding intestinal parasites, the prevalence of helminth and protozoan infections were 68.9% and 27.2%, respectively. Eight helminth taxa were identified in fecal samples, i.e., 2 tapeworm species (Taenia sp. and Hymenolepis diminuta), 1 trematode (Opisthorchis sp.), and 5 nematodes (Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis, trichostrongylids, and hookworms). Six species of intestinal protists were identified, i.e., Blastocystis hominis, Cyclospora spp., Endolimax nana, Entamoeba histolytica/E. dispar, Entamoeba coli, and Giardia lamblia. Questionnaires and interviews were also conducted to determine risk factors of infection. These analyses together with a prevailing infection level suggested that most of villagers were exposed to parasites in a similar degree due to limited socio-economic differences and sharing of similar practices. Limited access to effective public health facilities is also a significant contributing factor.

  3. Prevalence of bacteria and intestinal parasites among food-handlers in Gondar town, northwest Ethiopia.

    PubMed

    Andargie, Gashaw; Kassu, Afework; Moges, Feleke; Tiruneh, Moges; Huruy, Kahsay

    2008-12-01

    Food-handlers with poor personal hygiene working in food-service establishments could be potential sources of infection due to pathogenic organisms. The study was undertaken to determine the prevalence of bacteria and intestinal parasites among 127 food-handlers working in the cafeterias of the University of Gondar and the Gondar Teachers Training College, Gondar, Ethiopia. Fingernail contents of both the hands and stool specimens were collected from all the 127 food-handlers. The samples were examined for bacteria and intestinal parasites following standard procedures. Coagulase-negative staphylococci were the predominant bacteria species (41.7%) isolated from fingernail contents, followed by Staphylococcus aureus (16.5%), Klebsiella species (5.5%), Escherichia coli (3.1%), Serratia species (1.58%), Citrobacter species (0.8%), and Enterobacter species (0.8%). Shigella species were isolated from stool samples of four food-handlers (3.1%). None of the food-handlers was positive for Salmonella species and Shigella species in respect of their fingernail contents. No intestinal parasites were detected from fingernail contents. Intestinal parasites detected in the stools of the food-handlers included Ascaris lumbricoides (18.11%), Strongyloides stercoralis (5.5%), Entamoeba histolytica/dispar (1.6%), Trichuris trichiura (1.6%), hookworm species (0.8%), Gardia lamblia (0.8%), and Schistosoma mansoni (0.8%); 1.6% of the study subjects were positive for each of A. lumbricoides, T. trichiura, hookworm, and G. lamblia. The findings emphasize the importance of food-handlers as potential sources of infections and suggest health institutions for appropriate hygienic and sanitary control measures.

  4. Prevalence of Bacteria and Intestinal Parasites among Food-handlers in Gondar Town, Northwest Ethiopia

    PubMed Central

    Andargie, Gashaw; Kassu, Afework; Moges, Feleke; Tiruneh, Moges; Huruy, Kahsay

    2008-01-01

    Food-handlers with poor personal hygiene working in food-service establishments could be potential sources of infection due to pathogenic organisms. The study was undertaken to determine the prevalence of bacteria and intestinal parasites among 127 food-handlers working in the cafeterias of the University of Gondar and the Gondar Teachers Training College, Gondar, Ethiopia. Fingernail contents of both the hands and stool specimens were collected from all the 127 food-handlers. The samples were examined for bacteria and intestinal parasites following standard procedures. Coagulase-negative staphylococci were the predominant bacteria species (41.7%) isolated from fingernail contents, followed by Staphylococcus aureus (16.5%), Klebsiella species (5.5%), Escherichia coli (3.1%), Serratia species (1.58%), Citrobacter species (0.8%), and Enterobacter species (0.8%). Shigella species were isolated from stool samples of four food-handlers (3.1%). None of the food-handlers was positive for Salmonella species and Shigella species in res-pect of their fingernail contents. No intestinal parasites were detected from fingernail contents. Intestinal parasites detected in the stools of the food-handlers included Ascaris lumbricoides (18.11%), Strongyloides stercoralis (5.5%), Entamoeba histolytica/dispar (1.6%), Trichuris trichiura (1.6%), hookworm species (0.8%), Gardia lamblia (0.8%), and Schistosoma mansoni (0.8%); 1.6% of the study subjects were positive for each of A. lumbricoides, T. trichiura, hookworm, and G. lamblia. The findings emphasize the importance of food-handlers as potential sources of infections and suggest health institutions for appropriate hygienic and sanitary control measures. PMID:19069624

  5. Intestinal Parasitic Infections and Environmental Water Contamination in a Rural Village of Northern Lao PDR

    PubMed Central

    Ribas, Alexis; Jollivet, Chloé; Morand, Serge; Thongmalayvong, Boupha; Somphavong, Silaphet; Siew, Chern-Chiang; Ting, Pei-Jun; Suputtamongkol, Saipin; Saensombath, Viengsaene; Sanguankiat, Surapol; Tan, Boon-Huan; Paboriboune, Phimpha; Akkhavong, Kongsap; Chaisiri, Kittipong

    2017-01-01

    A field survey studying intestinal parasites in humans and microbial pathogen contamination at environment was performed in a Laotian rural village to identify potential risks for disease outbreaks. A parasitological investigation was conducted in Ban Lak Sip village, Luang Prabang, Lao PDR involving fecal samples from 305 inhabitants as well as water samples taken from 3 sites of the local stream. Water analysis indicated the presence of several enteric pathogens, i.e., Aeromonas spp., Vibrio spp., E. coli H7, E. coli O157: H7, verocytotoxin-producing E. coli (VTEC), Shigella spp., and enteric adenovirus. The level of microbial pathogens contamination was associated with human activity, with greater levels of contamination found at the downstream site compared to the site at the village and upstream, respectively. Regarding intestinal parasites, the prevalence of helminth and protozoan infections were 68.9% and 27.2%, respectively. Eight helminth taxa were identified in fecal samples, i.e., 2 tapeworm species (Taenia sp. and Hymenolepis diminuta), 1 trematode (Opisthorchis sp.), and 5 nematodes (Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis, trichostrongylids, and hookworms). Six species of intestinal protists were identified, i.e., Blastocystis hominis, Cyclospora spp., Endolimax nana, Entamoeba histolytica/E. dispar, Entamoeba coli, and Giardia lamblia. Questionnaires and interviews were also conducted to determine risk factors of infection. These analyses together with a prevailing infection level suggested that most of villagers were exposed to parasites in a similar degree due to limited socio-economic differences and sharing of similar practices. Limited access to effective public health facilities is also a significant contributing factor. PMID:29103267

  6. High frequency of parasitic and viral stool pathogens in patients with active ulcerative colitis: report from a tropical country.

    PubMed

    Banerjee, Debabrata; Deb, Rachana; Dar, Lalit; Mirdha, Bijay R; Pati, Sunil K; Thareja, Sandeep; Falodia, Sushil; Ahuja, Vineet

    2009-01-01

    Diarrhoeal relapses in patients with ulcerative colitis (UC) may be associated with enteric infections and its diagnosis may lessen avoidable exposure to corticosteroids and/or immunosuppressants. The purpose of this study was to assess the frequency of stool pathogens (parasitic and viral) in patients with active UC. This prospective cross-sectional study included 49 consecutive patients (32 M, 17 F, mean age 35.8+/-12 years) with active UC. Three stool samples were collected from each patient and examined for parasitic infection. Rectal biopsies were obtained during sigmoidoscopy to demonstrate cytomegalovirus (CMV) inclusion bodies and to conduct qualitative polymerase chain reaction (PCR) for CMV and herpes simplex virus (HSV) DNA detection. Median duration of illness was 3.9+/-3.7 years and 83.7% of the patients had moderate to severe disease. The prevalence of parasitic infections in UC was 12%. The organisms isolated were Strongyloides stercoralis in 4%, Ankylostoma duodenale in 4%, Cryptosporidium in 2% and Entamoeba histolytica in 2% of the patients. The prevalence of CMV and HSV in rectal biopsies using qualitative PCR was 8% and 10%, respectively. No predictive factor was identified with CMV superinfection in patients with active UC. In India there is a high prevalence of parasitic and viral infections in patients with active UC. The results of the study suggest that, in tropical countries with a known high prevalence of parasitic diseases, aggressive evaluation for parasitic and viral infections should be carried out, as early identification and prompt treatment of such infections can improve the clinical course of patients with active UC.

  7. A comparative survey of the prevalence of human parasites found in fresh vegetables sold in supermarkets and open-aired markets in Accra, Ghana.

    PubMed

    Duedu, Kwabena O; Yarnie, Elizabeth A; Tetteh-Quarcoo, Patience B; Attah, Simon K; Donkor, Eric S; Ayeh-Kumi, Patrick F

    2014-11-25

    Consuming raw vegetables offers essential nutrients that one may not get when such vegetables are usually cooked. However, eating them raw may pose a great risk for transmissions of pathogens. Such risks may be influenced by the sources of the vegetables and washing techniques used. The aim of the study was to compare the prevalence and diversity of parasitic pathogens associated with vegetables sold at the two types of markets in Ghana and compare effectiveness of various washing techniques. We purchased two batches of samples of cabbage, sweet bell pepper, carrot, lettuce, tomato and onion within a two week interval. The vegetables were washed by three methods and the wash solution was concentrated and analyzed for parasites. The prevalent parasites detected were Strongyloides stercoralis larvae (43%) and Cryptosporidium parvum oocyst (16%). Others present were Hookworm ova, Entamoeba histolytica cysts, Giardia lamblia cysts, Cyclospora cayetanensis oocysts, Entamoeba coli cysts, Trichuris trichiuria ova, Enterobius vermicularis ova, Isospora belli oocysts and Fasciolopsis buski ova. Contamination was highest in lettuce (61%) and cabbage and the least contaminated was tomato (18%). Contamination of vegetables sold at the open-aired markets was about ten-times that of the supermarkets. In Ghana, the large open-aired markets are the most patronized and serve as a supply point for most corner shops and stalls. The results thus highlight the potential of fresh vegetables serving as a major source of food-borne disease outbreaks and the contribution of open-aired markets to their transmission. Urgent public education on handling of fresh vegetables is recommended.

  8. Intestinal parasite infections in immigrant children in the city of Rome, related risk factors and possible impact on nutritional status

    PubMed Central

    2012-01-01

    Background Parasitic diseases can represent a social and economic problem among disadvantaged people - even in developed countries. Due to the limited data available concerning Europe, the aims of the present study were to evaluate the presence of parasites in immigrant children and the risk factors favouring the spread of parasites. Subsequently, the possible correlation between nutritional status and parasitic infections was also investigated. Findings A convenience sample of two hundred and forty seven immigrant children (aged 0–15) attending the Poliambulatorio della Medicina Solidale in Rome was examined. Data were collected using structured questionnaires, and parasitological and anthropometric tests were applied. Chi-squared test and binary logistic multiple-regression models were used for statistical analysis. Thirty-seven children (15%) tested positive to parasites of the following species: Blastocystis hominis, Entamoeba coli, Giardia duodenalis, Enterobius vermicularis, Ascaris lumbricoides and Strongyloides stercoralis. A monospecific infection was detected in 30 (81%) out of 37 parasitized children, while the others (19%) presented a polyparasitism. The major risk factors were housing, i.e. living in shacks, and cohabitation with other families (p<0.01). Children classified in the lower height Z-scores had a significantly greater prevalence of parasites (30.9%) than the others (p<0.01). Conclusions This study shows that parasite infection in children is still quite common, even in a developed country and that children’s growth and parasitism may be related. Extensive improvements in the living, social and economic conditions of immigrants are urgently needed in order to overcome these problems. PMID:23168023

  9. The Combined Effects of Daily Stressors and Major Life Events on Daily Subjective Ages.

    PubMed

    Bellingtier, Jennifer A; Neupert, Shevaun D; Kotter-Grühn, Dana

    2017-07-01

    Stressors may be a contributing factor in determining how old an individual feels, looks, or would like to be. Currently, little research has been devoted to understanding the relationship between stressors and subjective age in older adults. We focus on the combined impact of major life-event stressors and daily stressors on multiple indicators of subjective age: felt age, ideal age, and look age. Furthermore, we examine the process by which daily stressors relate to subjective ages by testing whether positive affect, control, and negative affect mediate this relationship. Using a daily-diary design, the current study measured older adults' (60-96 years old) stressors, subjective ages, personal control, and affect. Felt, ideal, and look ages each demonstrated a unique pattern of interactions between daily stressors and major life-event stressors. Furthermore, our findings suggest that on the daily level, the relationship between stressors and felt age is mediated by negative affect but not by control and positive affect. Findings indicate the need to consider the broader contextual picture of stressors, as well as their differential impact on multiple indicators of subjective age. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. The Daily Practices of Successful Principals

    ERIC Educational Resources Information Center

    Brock, Barbara L.; Grady, Marilyn L.

    2011-01-01

    While many books outline the attributes of successful school leaders, few describe how those traits manifest in daily practice. "The Daily Practices of Successful Principals" goes beyond the outward picture of excellence and provides a compendium of daily practices used by successful principals in various settings. Written by former administrators…

  11. Comparison of twice-daily vs once-daily deferasirox dosing in a gerbil model of iron cardiomyopathy

    PubMed Central

    Otto-Duessel, Maya; Aguilar, Michelle; Nick, Hanspeter; Moats, Rex; Wood, John C.

    2010-01-01

    Objective Despite the availability of deferoxamine chelation therapy for more than 20 years, iron cardiomyopathy remains the leading cause of death in thalassemia major patients. Effective chelation of cardiac iron is difficult; cardiac iron stores respond more slowly to chelation therapy and require a constant gradient of labile iron species between serum and myocytes. We have previously demonstrated the efficacy of once-daily deferasirox in removing previously stored cardiac iron in the gerbil, but changes in cardiac iron were relatively modest compared with hepatic iron. We postulated that daily divided dosing, by sustaining a longer labile iron gradient from myocytes to serum, would produce better cardiac iron chelation than a comparable daily dose. Methods Twenty-four 8- to 10-week-old female gerbils underwent iron dextran—loading for 10 weeks, followed by a 1-week iron equilibration period. Animals were divided into three treatment groups of eight animals each and were treated with deferasirox 100 mg/kg/day as a single dose, deferasirox 100 mg/kg/day daily divided dose, or sham chelation for a total of 12 weeks. Following euthanasia, organs were harvested for quantitative iron and tissue histology. Results Hepatic and cardiac iron contents were not statistically different between the daily single-dose and daily divided-dose groups. However, the ratio of cardiac to hepatic iron content was lower in the divided-dose group (0.78% vs 1.11%, p = 0.0007). Conclusion Daily divided dosing of deferasirox changes the relative cardiac and liver iron chelation profile compared with daily single dosing, trading improvements in cardiac iron elimination for less-effective hepatic chelation. PMID:17588475

  12. Incidence of deep vein thrombosis is increased with 30 mg twice daily dosing of enoxaparin compared with 40 mg daily.

    PubMed

    Riha, Gordon M; Van, Philbert Y; Differding, Jerome A; Schreiber, Martin A

    2012-05-01

    The purpose of this study was to analyze whether 2 standard dosing regimens of enoxaparin (30 mg twice daily vs 40 mg once daily) would result in different deep vein thrombosis (DVT) rates and anti-factor Xa activity (anti-Xa) in surgical patients. Patients who required enoxaparin for prophylaxis were followed prospectively. Demographics were recorded. Patients underwent standardized duplex screening. Peak anti-Xa levels were drawn on 4 consecutive days. Sixty-three patients were followed up (28 patients on 30 mg twice daily, 35 patients on 40 mg once daily). There was no significant difference in demographics between groups. Twenty-five percent of patients on 30 mg twice daily developed a DVT, whereas 2.9% of patients on 40 mg once daily developed a DVT. Patients on 30 mg twice daily had significantly lower anti-Xa levels. The incidence of DVT is increased in surgical patients who receive 30 mg twice daily dosing of enoxaparin compared with 40 mg daily. Dosing of 40 mg once daily results in significantly higher peak anti-Xa levels compared with 30 mg twice daily. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Modelling of Sub-daily Hydrological Processes Using Daily Time-Step Models: A Distribution Function Approach to Temporal Scaling

    NASA Astrophysics Data System (ADS)

    Kandel, D. D.; Western, A. W.; Grayson, R. B.

    2004-12-01

    Mismatches in scale between the fundamental processes, the model and supporting data are a major limitation in hydrologic modelling. Surface runoff generation via infiltration excess and the process of soil erosion are fundamentally short time-scale phenomena and their average behaviour is mostly determined by the short time-scale peak intensities of rainfall. Ideally, these processes should be simulated using time-steps of the order of minutes to appropriately resolve the effect of rainfall intensity variations. However, sub-daily data support is often inadequate and the processes are usually simulated by calibrating daily (or even coarser) time-step models. Generally process descriptions are not modified but rather effective parameter values are used to account for the effect of temporal lumping, assuming that the effect of the scale mismatch can be counterbalanced by tuning the parameter values at the model time-step of interest. Often this results in parameter values that are difficult to interpret physically. A similar approach is often taken spatially. This is problematic as these processes generally operate or interact non-linearly. This indicates a need for better techniques to simulate sub-daily processes using daily time-step models while still using widely available daily information. A new method applicable to many rainfall-runoff-erosion models is presented. The method is based on temporal scaling using statistical distributions of rainfall intensity to represent sub-daily intensity variations in a daily time-step model. This allows the effect of short time-scale nonlinear processes to be captured while modelling at a daily time-step, which is often attractive due to the wide availability of daily forcing data. The approach relies on characterising the rainfall intensity variation within a day using a cumulative distribution function (cdf). This cdf is then modified by various linear and nonlinear processes typically represented in hydrological and

  14. Determining soil-transmitted helminth infection status and physical fitness of school-aged children.

    PubMed

    Yap, Peiling; Fürst, Thomas; Müller, Ivan; Kriemler, Susi; Utzinger, Jürg; Steinmann, Peter

    2012-08-22

    Soil-transmitted helminth (STH) infections are common. Indeed, more than 1 billion people are affected, mainly in the developing world where poverty prevails and hygiene behavior, water supply, and sanitation are often deficient. Ascaris lumbricoides, Trichuris trichiura, and the two hookworm species, Ancylostoma duodenale and Necator americanus, are the most prevalent STHs. The estimated global burden due to hookworm disease, ascariasis, and trichuriasis is 22.1, 10.5, and 6.4 million disability-adjusted life years (DALYs), respectively. Furthermore, an estimated 30-100 million people are infected with Strongyloides stercoralis, the most neglected STH species of global significance which arguably also causes a considerable public health impact. Multiple-species infections (i.e., different STHs harbored in a single individual) are common, and infections have been linked to lowered productivity and thus economic outlook of developing countries. For the diagnosis of common STHs, the World Health Organization (WHO) recommends the Kato-Katz technique, which is a relatively straightforward method for determining the prevalence and intensity of such infections. It facilitates the detection of parasite eggs that infected subjects pass in their feces. With regard to the diagnosis of S. stercoralis, there is currently no simple and accurate tool available. The Baermann technique is the most widely employed method for its diagnosis. The principle behind the Baermann technique is that active S. stercoralis larvae migrate out of an illuminated fresh fecal sample as the larvae are phototactic. It requires less sophisticated laboratory materials and is less time consuming than culture and immunological methods. Morbidities associated with STH infections range from acute but common symptoms, such as abdominal pain, diarrhea, and pruritus, to chronic symptoms, such as anemia, under- and malnutrition, and cognitive impairment. Since the symptoms are generally unspecific and subtle

  15. Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children

    PubMed Central

    Yap, Peiling; Fürst, Thomas; Müller, Ivan; Kriemler, Susi; Utzinger, Jürg; Steinmann, Peter

    2012-01-01

    Soil-transmitted helminth (STH) infections are common. Indeed, more than 1 billion people are affected, mainly in the developing world where poverty prevails and hygiene behavior, water supply, and sanitation are often deficient1,2. Ascaris lumbricoides, Trichuris trichiura, and the two hookworm species, Ancylostoma duodenale and Necator americanus, are the most prevalent STHs3. The estimated global burden due to hookworm disease, ascariasis, and trichuriasis is 22.1, 10.5, and 6.4 million disability-adjusted life years (DALYs), respectively4. Furthermore, an estimated 30-100 million people are infected with Strongyloides stercoralis, the most neglected STH species of global significance which arguably also causes a considerable public health impact5,6. Multiple-species infections (i.e., different STHs harbored in a single individual) are common, and infections have been linked to lowered productivity and thus economic outlook of developing countries1,3. For the diagnosis of common STHs, the World Health Organization (WHO) recommends the Kato-Katz technique7,8, which is a relatively straightforward method for determining the prevalence and intensity of such infections. It facilitates the detection of parasite eggs that infected subjects pass in their feces. With regard to the diagnosis of S.stercoralis, there is currently no simple and accurate tool available. The Baermann technique is the most widely employed method for its diagnosis. The principle behind the Baermann technique is that active S.stercoralis larvae migrate out of an illuminated fresh fecal sample as the larvae are phototactic9. It requires less sophisticated laboratory materials and is less time consuming than culture and immunological methods5. Morbidities associated with STH infections range from acute but common symptoms, such as abdominal pain, diarrhea, and pruritus, to chronic symptoms, such as anemia, under- and malnutrition, and cognitive impairment10. Since the symptoms are generally

  16. Unravelling daily human mobility motifs

    PubMed Central

    Schneider, Christian M.; Belik, Vitaly; Couronné, Thomas; Smoreda, Zbigniew; González, Marta C.

    2013-01-01

    Human mobility is differentiated by time scales. While the mechanism for long time scales has been studied, the underlying mechanism on the daily scale is still unrevealed. Here, we uncover the mechanism responsible for the daily mobility patterns by analysing the temporal and spatial trajectories of thousands of persons as individual networks. Using the concept of motifs from network theory, we find only 17 unique networks are present in daily mobility and they follow simple rules. These networks, called here motifs, are sufficient to capture up to 90 per cent of the population in surveys and mobile phone datasets for different countries. Each individual exhibits a characteristic motif, which seems to be stable over several months. Consequently, daily human mobility can be reproduced by an analytically tractable framework for Markov chains by modelling periods of high-frequency trips followed by periods of lower activity as the key ingredient. PMID:23658117

  17. Choline magnesium trisalicylate: comparative pharmacokinetic study of once-daily and twice-daily dosages.

    PubMed

    Levitt, M J; Kann, J

    1984-07-01

    This randomized crossover study compared the pharmacokinetics of choline magnesium trisalicylate tablets administered once daily (3000 mg of salicylate) or twice daily (1500 mg of salicylate) for six d. Serum salicylate levels were measured by HPLC. Mean "trough" concentrations fell within the therapeutic range (5-30 mg/dL) with either regimen and were relatively constant, indicating that the steady state had been reached. The 24-h area under the salicylate curve (AUC0-24 h) after the final 3000-mg salicylate dose averaged about twice the mean 12-h AUC after the last 1500-mg dose, indicating that the two dosing regimens were equally bioavailable. Clinical observations and results of laboratory safety studies indicate that both dosage schedules of the drug are well tolerated. The present findings support the once-daily therapeutic use of choline magnesium trisalicylate.

  18. [Chronic daily headache: clinical presentation].

    PubMed

    Krymchantowski, A V; Moreira Filho, P F

    2000-06-01

    Chronic daily headache (CDH) represents a group of any headache disorder that occurs on a daily or near daily basis, for longer than 6 months. Even though it is a common problem, it is not a well defined disorder, resulting in controversies regarding its identification, description and approach. Three hundred patients, 232 women and 68 men, ages 16 to 86 (mean 38 years old for the women and 42 for the men), attending a headache center and fulfilling the proposed criteria for CDH (Silberstein et al.) and presenting headache 28 days per month were retrospectively studied. The clinical features allowed the primary headache diagnosis, before the transformation into daily presentation as: transformed migraine (TM ) in 271 patients (90,3%), chronic tension-type headache (CTTH) in 26 patients (8,7%) and new daily persistent headache (NDPH) in 3 patients (1%). Among the TM patients, the most observed presentation was pressure or tightening, bilateral fronto-temporal, moderate non-continuous headache, with a progressive onset. The association with nausea and phonophobia was demonstrated in 60% and 32% of the patients respectively. The association with photophobia and sleep disturbances, as well as the occurrence of intermittent headache attacks, was different among male and female patients. With regard to the CTTH patients, pressure or tightening, bilateral fronto-temporal, moderate non-continuous headache, with sleep disturbances and no associated symptoms, was the predominant presentation.

  19. The effects of employment status and daily stressors on time spent on daily household chores in middle-aged and older adults.

    PubMed

    Wong, Jen D; Almeida, David M

    2013-02-01

    This study examines how employment status (worker vs. retiree) and life course influences (age, gender, and marital status) are associated with time spent on daily household chores. Second, this study assesses whether the associations between daily stressors and time spent on daily household chores differ as a function of employment status and life course influences. Men and women aged 55-74 from the National Study of Daily Experiences (N = 268; 133 workers and 135 retirees), a part of the National Survey of Midlife in the United States (MIDUS), completed telephone interviews regarding their daily experiences across 8 consecutive evenings. Working women spent more than double the amount of time on daily household chores than working men. Unmarried retirees spent the most time on daily household chores in comparison to their counterparts. There was a trend toward significance for the association between home stressors from the previous day and time spent on daily household chores as a function of employment and marital status. These findings highlight the importance of gender and marital status in the associations between employment status and time spent on daily household chores and the role that daily stressors, in particular home stressful events, have on daily household chore participation.

  20. Randomized controlled trial comparing impact on platelet reactivity of twice-daily with once-daily aspirin in people with Type 2 diabetes.

    PubMed

    Bethel, M A; Harrison, P; Sourij, H; Sun, Y; Tucker, L; Kennedy, I; White, S; Hill, L; Oulhaj, A; Coleman, R L; Holman, R R

    2016-02-01

    Reduced aspirin efficacy has been demonstrated in people with Type 2 diabetes. Because increased platelet reactivity and/or turnover are postulated mechanisms, we examined whether higher and/or more frequent aspirin dosing might reduce platelet reactivity more effectively. Participants with Type 2 diabetes (n = 24) but without known cardiovascular disease were randomized in a three-way crossover design to 2-week treatment periods with aspirin 100 mg once daily, 200 mg once daily or 100 mg twice daily. The primary outcome was platelet reactivity, assessed using the VerifyNow(™) ASA method. Relationships between platelet reactivity and aspirin dosing were examined using generalized linear mixed models with random subject effects. Platelet reactivity decreased from baseline with all doses of aspirin. Modelled platelet reactivity was more effectively reduced with aspirin 100 mg twice daily vs. 100 mg once daily, but not vs. 200 mg once daily. Aspirin 200 mg once daily did not differ from 100 mg once daily. Aspirin 100 mg twice daily was also more effective than once daily as measured by collagen/epinephrine-stimulated platelet aggregation and urinary thromboxane levels, with a similar trend measured by serum thromboxane levels. No episodes of bleeding occurred. In Type 2 diabetes, aspirin 100 mg twice daily reduced platelet reactivity more effectively than 100 mg once daily, and numerically more than 200 mg once daily. Clinical outcome trials evaluating primary cardiovascular disease prevention with aspirin in Type 2 diabetes may need to consider using a more frequent dosing schedule. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

  1. Daily job demands and employee work engagement: The role of daily transformational leadership behavior.

    PubMed

    Breevaart, Kimberley; Bakker, Arnold B

    2018-07-01

    Using job demands-resources (JD-R) theory, the present study integrates the challenge stressor-hindrance stressor framework and leadership theory to investigate the relationship between daily transformational leadership behavior and employee work engagement. We hypothesized that daily transformational leadership behavior (a) sustains employee work engagement on days characterized by high challenge job demands, and (b) protects work engagement on days characterized by high hindrance job demands. Teachers filled out a short online questionnaire at the end of each workday during a 2-week period (N = 271 × 5.68 days = 1539). Results of latent moderated structural equation modeling showed that teachers' daily challenge demands (workload and cognitive demands) had a positive relationship with work engagement on the days transformational leadership was high (vs. low). In addition, teachers' daily hindrance demands (role-conflict, but not family to work conflict) had a negative relationship with work engagement on the days transformational leadership was low (vs. high). These findings show that the function of transformational leadership behavior changes from day to day, and depends on the type of job demand. We discuss the practical and theoretical implications of these findings. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  2. Productive and counterproductive job crafting: A daily diary study.

    PubMed

    Demerouti, Evangelia; Bakker, Arnold B; Halbesleben, Jonathon R B

    2015-10-01

    The present study aims to uncover the way daily job crafting influences daily job performance (i.e., task performance, altruism, and counterproductive work behavior). Job crafting was conceptualized as "seeking resources," "seeking challenges," and "reducing demands" and viewed as strategies individuals use to optimize their job characteristics. We hypothesized that daily job crafting relates to daily job demands and resources (work pressure and autonomy), which consequently relate to daily work engagement and exhaustion and ultimately to job performance. A sample of 95 employees filled in a quantitative diary for 5 consecutive working days (n occasions = 475). We predicted and found that daily seeking resources was positively associated with daily task performance because daily autonomy and work engagement increased. In contrast, daily reducing demands was detrimental for daily task performance and altruism, because employees lower their daily workload and consequently their engagement and exhaustion, respectively. Only daily seeking challenges was positively (rather than negatively) associated with daily counterproductive behavior. We conclude that employee job crafting can have both beneficial and detrimental effects on job performance. (c) 2015 APA, all rights reserved).

  3. Chronic Daily Headaches

    MedlinePlus

    ... headache New daily persistent headache Hemicrania continua Chronic migraine This type typically occurs in people with a history of episodic migraines. Chronic migraines tend to: Affect one side or ...

  4. Measuring Daily Stress in Children.

    ERIC Educational Resources Information Center

    Parfenoff, Sheila H.; Jose, Paul E.

    A study of school-age children was designed to: (1) identify hassles that children experience in their families, among peers, and at school; (2) determine the ability of hassles to predict unhealthy psychological and physical functioning; and (3) explore the effect of daily hassles on school behavior. A measure of children's daily stress that used…

  5. Digital Daily Cycles of Individuals

    NASA Astrophysics Data System (ADS)

    Aledavood, Talayeh; Lehmann, Sune; Saramäki, Jari

    2015-10-01

    Humans, like almost all animals, are phase-locked to the diurnal cycle. Most of us sleep at night and are active through the day. Because we have evolved to function with this cycle, the circadian rhythm is deeply ingrained and even detectable at the biochemical level. However, within the broader day-night pattern, there are individual differences: e.g., some of us are intrinsically morning-active, while others prefer evenings. In this article, we look at digital daily cycles: circadian patterns of activity viewed through the lens of auto-recorded data of communication and online activity. We begin at the aggregate level, discuss earlier results, and illustrate differences between population-level daily rhythms in different media. Then we move on to the individual level, and show that there is a strong individual-level variation beyond averages: individuals typically have their distinctive daily pattern that persists in time. We conclude by discussing the driving forces behind these signature daily patterns, from personal traits (morningness/eveningness) to variation in activity level and external constraints, and outline possibilities for future research.

  6. Comparing daily drivers of problem drinking among older and younger adults: An electronic daily diary study using smartphones.

    PubMed

    Kuerbis, Alexis; Treloar Padovano, Hayley; Shao, Sijing; Houser, Jessica; Muench, Frederick J; Morgenstern, Jon

    2018-02-01

    By 2030, numbers and proportions of older adults with substance-use problems are expected to increase. While risk factors for problem drinking in late life have been identified, it remains unknown whether these factors drive daily drinking among older problem drinkers. This study examined the daily drivers of drinking among problem drinkers, moderated by age, utilizing ecological momentary assessment (EMA). Participants (N = 139), ages 20-73, received daily EMA online surveys completed via a smartphone prior to initiation of treatment. Multilevel modeling tested the moderating impact of age on within- and between-person relationships between drinking and focal predictors (mood, loneliness, boredom, stress, poor sleep, social factors, alcohol salience, commitment and confidence not to drink heavily). Older adults reported greater alcohol consumption when daily boredom levels were higher. Heavier drinking among younger adults was associated with poorer sleep quality. Greater daily confidence, daily commitment and daily alcohol salience did not impact drinking to the same extent for older adults as for younger adults. Greater person-level commitment predicted reduced drinking equivalently across age, but low person-level commitment predicted greater drinking among older adults compared to their younger counterparts. Older adults may have unique daily drivers of drinking that are not fully realized in current research and intervention efforts. Addressing the growing substance-use treatment needs among this population will require identifying the unique drivers of drinking among older adults, such as boredom, when compared to younger adults. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. "Self-critical perfectionism, daily stress, and disclosure of daily emotional events": Correction to Richardson and Rice (2015).

    PubMed

    2016-01-01

    Reports an error in "Self-critical perfectionism, daily stress, and disclosure of daily emotional events" by Clarissa M. E. Richardson and Kenneth G. Rice (Journal of Counseling Psychology, 2015[Oct], Vol 62[4], 694-702). In the article, the labels of the two lines in Figure 1 were inadvertently transposed. The dotted line should be labeled High SCP and the solid line should be labeled Low SCP. The correct version is present in the erratum. (The following abstract of the original article appeared in record 2015-30890-001.) Although disclosure of stressful events can alleviate distress, self-critical perfectionism may pose an especially strong impediment to disclosure during stress, likely contributing to poorer psychological well-being. In the current study, after completing a measure of self-critical perfectionism (the Discrepancy subscale of the Almost Perfect Scale-Revised; Slaney, Rice, Mobley, Trippi, & Ashby, 2001), 396 undergraduates completed measures of stress and disclosure at the end of each day for 1 week. Consistent with hypotheses and previous research, multilevel modeling results indicated significant intraindividual coupling of daily stress and daily disclosure where disclosure was more likely when experiencing high stress than low stress. As hypothesized, Discrepancy moderated the relationship between daily stress and daily disclosure. Individuals higher in self-critical perfectionism (Discrepancy) were less likely to engage in disclosure under high stress, when disclosure is often most beneficial, than those with lower Discrepancy scores. These results have implications for understanding the role of stress and coping in the daily lives of self-critical perfectionists. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Maintenance of heartburn relief after step-down from twice-daily proton pump inhibitor to once-daily dexlansoprazole modified release.

    PubMed

    Fass, Ronnie; Inadomi, John; Han, Cong; Mody, Reema; O'Neil, Janet; Perez, M Claudia

    2012-03-01

    Many patients with gastroesophageal reflux disease (GERD) take a proton pump inhibitor (PPI) twice daily to control symptoms. Once-daily dexlansoprazole modified release (MR) has a dual-delayed release formulation, making it attractive for step-down management of patients whose symptoms are well controlled on twice-daily PPIs. We investigated whether step-down to once-daily dexlansoprazole controls heartburn in patients with GERD who were receiving twice-daily PPI therapy. Patients 18 years and older taking a twice-daily PPI for symptom control were enrolled (n = 178) in a single-blind, multicenter study; 163 patients completed the study and 142 patients met criteria for the efficacy analysis. During the 6-week screening and treatment periods, patients recorded the presence of heartburn symptoms twice daily in electronic diaries. Patients' heartburn was considered well controlled if they had an average of 1 symptom or fewer per week during the last 4 weeks of screening and treatment. After screening, qualified patients were switched to masked dexlansoprazole MR 30 mg and placebo for 6 weeks. The primary efficacy end point was the proportion of patients whose heartburn remained well controlled after step-down. GERD-related symptoms and quality of life (QOL) also were evaluated using the Patient Assessment of Upper Gastrointestinal Disorders Symptom Severity Index (PAGI-SYM) and the PAGI-QOL questionnaires, respectively. After step-down to once-daily dexlansoprazole MR 30 mg, heartburn remained well controlled in 88% of patients (125 of 142). These patients were able to maintain their GERD-related symptom severity and QOL, indicated by marginal changes in the PAGI-SYM and PAGI-QOL total and subscale scores, respectively. Most patients with GERD who take twice-daily PPI to control heartburn are able to successfully step down to once-daily dexlansoprazole 30 mg. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

  9. Conversion from twice-daily tacrolimus to once-daily extended release tacrolimus (LCPT): the phase III randomized MELT trial.

    PubMed

    Bunnapradist, S; Ciechanowski, K; West-Thielke, P; Mulgaonkar, S; Rostaing, L; Vasudev, B; Budde, K

    2013-03-01

    Phase III noninferiority trial examining efficacy and safety of converting stable renal transplant recipients from twice-daily tacrolimus to a novel extended-release once-daily tacrolimus formulation (LCPT) with a controlled agglomeration technology. Controls maintained tacrolimus twice daily. The primary efficacy endpoint was proportion of patients with efficacy failures (death, graft failure, locally read biopsy-proven acute rejection [BPAR], or loss to follow-up) within 12 months. Starting LCPT dose was 30% lower (15% for blacks) than preconversion tacrolimus dose; target trough levels were 4-15 ng/mL. A total of 326 patients were randomized; the mITT population (n = 162 each group) was similar demographically in the two groups. Mean daily dose of LCPT was significantly (p < 0.0001) lower than preconversion tacrolimus dose at each visit; mean trough levels between groups were similar. There were four efficacy failures in each group; safety outcomes were similar between groups. Frequency of premature study drug discontinuation was LCPT: 12% versus tacrolimus twice daily: 5% (p = 0.028). LCPT demonstrated noninferiority to tacrolimus twice daily in efficacy failure rates. LCPT may offer a safe and effective alternative for converting patients to a once-daily formulation. Compared to currently available tacrolimus formulation, LCPT requires lower doses to achieve target trough levels. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

  10. 27 CFR 19.740 - Daily storage records.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Daily storage records. 19..., DEPARTMENT OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Records and Reports Storage Account § 19.740 Daily storage records. (a) General. Proprietors shall maintain daily records in the storage account...

  11. New daily persistent headache.

    PubMed

    Rozen, Todd D

    2010-01-01

    New daily persistent headache (NDPH) is a unique form of chronic daily headache (CDH) which is marked by a daily headache from onset, typically occurring in individuals without a significant prior history of headaches. There are two subforms of NDPH: one which is self-limited and normally goes away without therapy, and a more chronic refractory form which is unresponsive to typical headache treatment strategies. The pathogenesis of NDPH is unknown but recent observations suggest a connection with cervical spine hypermobility and elevation of proinflammatory cytokines in the cerebrospinal fluid (CSF). Recognized triggers for NDPH include infection, stressful life events, and surgical procedures. Clinically, NDPH is characterized by continuous head pain of mild to severe intensity. Migrainous symptoms are common. The syndrome appears to affect women in their teens and 20s, while males develop NDPH later in life in their 50s or 60s. There are no recognized treatments for this condition, although treatment options will be discussed. Secondary mimics of NDPH will also be touched upon in this chapter. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Early Parental Abuse and Daily Assistance to Aging Parents With Disability: Associations With the Middle-Aged Adults' Daily Well-being.

    PubMed

    Liu, Yin; Kong, Jooyoung; Bangerter, Lauren R; Zarit, Steven H; Almeida, David M

    2018-01-09

    The current study examined the within-person association between providing daily assistance to aging parents with disability and adult children's daily mood in the context of early relationship with parents. We used data from 782 participants and 5,758 daily interviews from the Midlife in the United States (MIDUS) Refresher, with 248 people self-reported providing daily assistance ranging from 1 to 8 days out of the entire daily-interview period. Multilevel models were fit to examine the moderating effect of physical and emotional abuse from parents in early life on the associations between daily assistance to parents today and yesterday and daily mood. Additional analyses were conducted to examine whether the moderating effect of parental abuse remained when the assistance was provided for other family members and friends. Providing assistance today and yesterday to parents had immediate and lagged associations with higher negative affect when adult children experienced childhood emotional abuse from parents. No significant findings were found for daily positive affect. The moderating effect of parental abuse became nonsignificant when the assistance was provided to other family members or friends. Daily assistance to parents with disability needs to be examined in the context of the relationship history with parents. The impact of childhood abuse can linger long after the actual incident. Frequent early emotional abuse from parents was associated with greater distress when the middle-aged provided daily assistance to their aging parents. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Daily Living Resources

    MedlinePlus

    ... PPMD. Click here to review PPMD’s policy on corporate support . Daily Living Resources PPMD Resource Fair Participants ... About PPMD ❯ Mission & Impact Staff & Board News History Finance & Operations Partners Media Contact us Get Involved ❯ Donate ...

  14. The impact of irritable bowel syndrome on daily functioning: Characterizing and understanding daily consequences of IBS.

    PubMed

    Ballou, S; Keefer, L

    2017-04-01

    Despite the well-documented economic and psychosocial burden of irritable bowel syndrome (IBS), few studies have focused on the impact of IBS on daily activities. This study aims to quantitate impairment in daily activities among IBS patients and to evaluate the relationship between impairment, IBS, quality of life, and psychiatric symptoms. A total of 179 participants meeting ROME-III criteria for IBS completed an online research survey evaluating the following variables: (i) the impact of IBS on daily activities, (ii) comorbid psychiatric diagnoses, (iii) symptom severity, (iv) quality of life, and (v) symptom-specific cognitive affective factors related to IBS. This sample reported a high degree of impairment due to IBS, with 76% of the sample reporting some degree of IBS-related impairment in at least five different domains of daily life. Rates of impairment were significantly higher for participants who met criteria for anxiety, depression, and/or panic disorder. This study contributes to existing literature by demonstrating a high level of daily impairment among patients with IBS, particularly those who meet criteria for anxiety, depression, and panic disorder. These findings support the importance of integrated psychosocial and medical care for IBS patients, and highlight the utility of evaluation and intervention for behavioral avoidance/impairment especially among those who exhibit signs or symptoms of psychiatric diagnoses. © 2016 John Wiley & Sons Ltd.

  15. Daily physical activity in stable heart failure patients.

    PubMed

    Dontje, Manon L; van der Wal, Martje H L; Stolk, Ronald P; Brügemann, Johan; Jaarsma, Tiny; Wijtvliet, Petra E P J; van der Schans, Cees P; de Greef, Mathieu H G

    2014-01-01

    Physical activity is the only nonpharmacological therapy that is proven to be effective in heart failure (HF) patients in reducing morbidity. To date, little is known about the levels of daily physical activity in HF patients and about related factors. The objectives of this study were to (a) describe performance-based daily physical activity in HF patients, (b) compare it with physical activity guidelines, and (c) identify related factors of daily physical activity. The daily physical activity of 68 HF patients was measured using an accelerometer (SenseWear) for 48 hours. Psychological characteristics (self-efficacy, motivation, and depression) were measured using questionnaires. To have an indication how to interpret daily physical activity levels of the study sample, time spent on moderate- to vigorous-intensity physical activities was compared with the 30-minute activity guideline. Steps per day was compared with the criteria for healthy adults, in the absence of HF-specific criteria. Linear regression analyses were used to identify related factors of daily physical activity. Forty-four percent were active for less than 30 min/d, whereas 56% were active for more than 30 min/d. Fifty percent took fewer than 5000 steps per day, 35% took 5000 to 10 000 steps per day, and 15% took more than 10 000 steps per day. Linear regression models showed that New York Heart Association classification and self-efficacy were the most important factors explaining variance in daily physical activity. The variance in daily physical activity in HF patients is considerable. Approximately half of the patients had a sedentary lifestyle. Higher New York Heart Association classification and lower self-efficacy are associated with less daily physical activity. These findings contribute to the understanding of daily physical activity behavior of HF patients and can help healthcare providers to promote daily physical activity in sedentary HF patients.

  16. Treatment of Hypertension: Favourable Effect of the Twice-Daily Compared to the Once-Daily (Evening) Administration of Perindopril and Losartan.

    PubMed

    Szauder, Ipoly; Csajági, Eszter; Major, Zsuzsanna; Pavlik, Gabor; Ujhelyi, Gabriella

    2015-01-01

    Little is known about the effect of twice daily administration of same dose of ACE inhibitor and ARB on the diurnal/nocturnal blood pressure (BP) ratio. We aimed to assess the effect of two widely used long-acting drugs: perindopril and losartan in the treatment of hypertension comparing the once-daily (evening) vs. twice-daily (morning and evening) administration with the same daily doses. Untreated primary hypertensive patients without complaints (a total of 164: 65 men, 99 women, 55.7 ± 13.7 years of age, 41-41 patients per treated groups) were selected with non-dipper phenomenon, estimated by diurnal index (DI) <10%. The effect of evening (8 mg perindopril or 100 mg losartan) vs morning and evening (4-4 mg perindopril or 50-50 mg losartan) administration was determined on a 14-day treatment by ABPM. The mean BP, the percent time elevation index, and the hyperbaric impact decreased in both drug groups. Significant difference was observed in the DI in the case of twice-daily administration vs once-daily evening dosing. The twice-daily administration with the same daily dose of perindopril or losartan seems to be more effective compared to the once daily evening administration in eliminating the non-dipper phenomenon. According to some authors the non-dipping phenomenon increases cardiovascular risk, while others are of the opinion that the association of non-dipping with cardiovascular events does not necessarily mean that selective treatment of non-dipping improves cardiovascular outcomes. © 2015 S. Karger AG, Basel.

  17. Never, non-daily, and daily smoking status and progression to daily cigarette smoking as correlates of major depressive episode in a national sample of youth: Results from the National Survey of Drug Use and Health 2013 to 2015.

    PubMed

    Cohn, Amy M

    2018-09-01

    Cigarette smoking is associated with depression, and new initiates who progress more quickly to daily smoking may be at enhanced risk. In a nationally representative sample of youth, this study examined the association between daily, non-daily, and never smoking with past-year and lifetime major depressive episode (MDE) and, among daily smokers, whether faster progression to daily smoking was associated with increased MDE risk. Data were from n = 44,921 youth aged 12-17 in the 2013-2015 National Survey on Drug Use and Health. Weighted adjusted multivariable logistic regression models were used to examine the association of smoking status (daily, non-daily, never) with lifetime and past-year MDE, and the association between progression from cigarette trial to daily smoking with MDE outcomes among daily smokers. Daily and non-daily smokers had similar rates of lifetime and past-year MDE; rates of MDE were approximately 50% lower among never smokers. Compared to never smokers, adjusted models showed that non-daily smokers had a higher risk of past-year and lifetime MDE, while daily smokers had a higher risk of past-year but not lifetime MDE. Daily smoking youth who progressed more quickly from cigarette trial to daily use had an increased risk of both lifetime and past-year MDE. Prevention programs should target factors associated with the shift from cigarette experimentation to regular use to curb deleterious consequences of use. Copyright © 2018. Published by Elsevier Ltd.

  18. Intergenerational Support in a Daily Context

    PubMed Central

    Fingerman, Karen L.; Kim, Kyungmin; Tennant, Patrick S.; Birditt, Kira S.; Zarit, Steven H.

    2016-01-01

    Purpose of the Study: Using retrospective global reports, studies have found that middle-aged adults in the United States provide intermittent support to their aging parents and more frequent support to grown children. To date, studies have not examined support middle-aged adults provide to different generations on a daily basis. Daily support may include mundane everyday exchanges that may (or may not) affect well-being. Design and Methods: Middle-aged adults (N = 191, mean age 55.93) completed a general interview regarding family ties, followed by interviews each day for 7 days (N = 1,261 days). Daily interviews assessed support (e.g., advice, emotional, practical help) participants provided each grown child (n = 454) and aging parent (n = 253). Participants also reported daily mood. Results: Most participants provided emotional support (80%), advice (87%), and practical help (69%) to a grown child and also provided emotional support (61%) and advice (61%) or practical help (43%) to a parent that week. Multilevel models confirmed generational differences; grown children were more likely to receive everyday support than parents. Providing support to grown children was associated with positive mood, whereas providing support to parents was associated with more negative mood. Implications: Daily intergenerational support was more common than studies using global reports of support have found. Some daily support may be fleeting and not stand out in memory. The findings were consistent with the intergenerational stake hypothesis, which suggests middle-aged adults are more invested in their grown children than in their parents. Nonetheless, middle-aged adults were highly involved with aging parents. PMID:26035892

  19. Pharmacokinetic study of once–daily versus twice-daily abacavir and lamivudine in HIV type-1-infected children aged 3–<36 months

    PubMed Central

    2013-01-01

    Background Once-daily dosing of abacavir and lamivudine has been approved for adults, but paediatric data are insufficient. We conducted a pharmacokinetic study of once-daily and twice-daily abacavir and lamivudine in children aged 3–<36 months. Methods Children with stable HIV type-1 (HIV-1) RNA levels after 12 weeks treatment with twice-daily abacavir (8 mg/kg) with or without lamivudine (4 mg/kg) underwent plasma pharmacokinetic sampling. Children then switched to once-daily abacavir (16 mg/kg) with or without lamivudine (8 mg/kg), and sampling was repeated 4 weeks later. The area under the plasma concentration–time curve over 24 h (AUC0–24) and the maximum concentration (Cmax) were compared using geometric mean ratios (GMRs); 90% confidence intervals (CIs) within the range of 0.80–1.25 were considered bioequivalent. Results A total of 18 children (4, 6 and 8 in the 3–<12, 12–<24 and 24–<36 month age ranges, respectively) provided pharmacokinetic data for abacavir (17 for lamivudine). The GMR of AUC0–24, once-daily versus twice-daily, was 1.07 (90% CI 0.92–1.23) for abacavir and 0.91 (90% CI 0.79–1.06) for lamivudine. Cmax almost doubled on once-daily versus twice-daily dosing: abacavir and lamivudine GMRs were 2.04 (90% CI 1.73–2.42) and 1.78 (90% CI 1.52–2.09), respectively. At baseline, 12, 24 and 48 weeks, 89%, 94%, 100% and 89% of children had HIV-1 RNA<400 copies/ml, respectively. Conclusions Bioequivalence was demonstrated on AUC0–24 between twice-daily and once-daily abacavir; very similar AUC0–24 values were seen for twice-daily and once-daily lamivudine. Given that viral load suppression rates were maintained, these data suggest that once-daily abacavir and lamivudine might be an option for children aged 3–<36 months. PMID:20516550

  20. Marked seasonality of Cyclospora cayetanensis infections: ten-year observation of hospital cases, Honduras.

    PubMed

    Kaminsky, Rina Girard; Lagos, Javier; Raudales Santos, Gabriela; Urrutia, Samuel

    2016-02-04

    Document seasonality occurrence and epidemiologic characteristics of Cyclospora cayetanensis infections during a 10-year period from patients consulting at the University Hospital, Honduras. Retrospective non interventional hospital-based study analyzed laboratory results from the period 2002 to 2011 of fresh and Ziehl-Nielsen carbolfuchsin stained routine stool samples received for parasitologic examination. Sporadically a sample with numerous oocysts was allowed to sporulate in 2.5 % potassium dichromate confirming the presence of bi-cystic bi-zoic oocysts. A total of 35,157 fecal samples were examined during a ten-year span, of which a third (28.4 %) was stained by the Ziehl-Neelsen carbolfuchsin method diagnosing a total of 125 (1.3 %) C.cayetanensis infections. A statistically significant apparent seasonality was observed most years during May to August (range p < 0.036-0.001), with 83.3 % of 125 cases occurring in those rainy months. All C. cayetanensis cases came from urban poor neighborhoods; male/female relation was 1:1 except in 2006, when all patients were females (p = 0.05; r(2) = 22,448). Forty four point eight percent of the stool samples were diarrheic or liquid and 65.6 % infections were identified in children 10 years old or less. Enteric helminths and protozoa co-infected Cyclospora positive patients in 52 instances.: 8 % Ascaris lumbricoides, 8 % Giardia duodenalis, 23.2 % Blastocystis spp. and less frequently Entamoeba histolytica/E. dispar, Strongyloides stercoralis, and Trichuris trichiura. Results suggest a seasonal pattern for Cyclospora infections diagnosed in a clinical setting during the rainy months in Tegucigalpa and surrounding areas. Community studies should be conducted to support or dispute these observations.

  1. Improved PCR-Based Detection of Soil Transmitted Helminth Infections Using a Next-Generation Sequencing Approach to Assay Design.

    PubMed

    Pilotte, Nils; Papaiakovou, Marina; Grant, Jessica R; Bierwert, Lou Ann; Llewellyn, Stacey; McCarthy, James S; Williams, Steven A

    2016-03-01

    The soil transmitted helminths are a group of parasitic worms responsible for extensive morbidity in many of the world's most economically depressed locations. With growing emphasis on disease mapping and eradication, the availability of accurate and cost-effective diagnostic measures is of paramount importance to global control and elimination efforts. While real-time PCR-based molecular detection assays have shown great promise, to date, these assays have utilized sub-optimal targets. By performing next-generation sequencing-based repeat analyses, we have identified high copy-number, non-coding DNA sequences from a series of soil transmitted pathogens. We have used these repetitive DNA elements as targets in the development of novel, multi-parallel, PCR-based diagnostic assays. Utilizing next-generation sequencing and the Galaxy-based RepeatExplorer web server, we performed repeat DNA analysis on five species of soil transmitted helminths (Necator americanus, Ancylostoma duodenale, Trichuris trichiura, Ascaris lumbricoides, and Strongyloides stercoralis). Employing high copy-number, non-coding repeat DNA sequences as targets, novel real-time PCR assays were designed, and assays were tested against established molecular detection methods. Each assay provided consistent detection of genomic DNA at quantities of 2 fg or less, demonstrated species-specificity, and showed an improved limit of detection over the existing, proven PCR-based assay. The utilization of next-generation sequencing-based repeat DNA analysis methodologies for the identification of molecular diagnostic targets has the ability to improve assay species-specificity and limits of detection. By exploiting such high copy-number repeat sequences, the assays described here will facilitate soil transmitted helminth diagnostic efforts. We recommend similar analyses when designing PCR-based diagnostic tests for the detection of other eukaryotic pathogens.

  2. A comparative study of the TF-Test®, Kato-Katz, Hoffman-Pons-Janer, Willis and Baermann-Moraes coprologic methods for the detection of human parasitosis.

    PubMed

    Carvalho, Gabriela Lanna Xavier de; Moreira, Luciano Evangelista; Pena, João Luiz; Marinho, Carolina Coimbra; Bahia, Maria Terezinha; Machado-Coelho, George Luiz Lins

    2012-02-01

    This study compares the diagnostic accuracy of the TF-Test(®) (TFT) for human parasitosis with results obtained using the traditional Kato-Katz (KK), Hoffman-Pons-Janer (HPJ), Willis and Baermann-Moraes (BM) techniques. Overall, four stool samples were taken from each individual; three alternate-day TFT stool samples and another sample that was collected in a universal container. Stool samples were taken from 331 inhabitants of the community of Quilombola Santa Cruz. The gold standard (GS) for protozoa detection was defined as the combined results for TFT, HPJ and Willis coproscopic techniques; for helminth detection, GS was defined as the combined results for all five coproscopic techniques (TFT, KK, HPJ, Willis and BM). The positivity rate of each method was compared using the McNemar test. While the TFT exhibited similar positivity rates to the GS for Entamoeba histolytica/dispar (82.4%) and Giardia duodenalis (90%), HPJ and Willis techniques exhibited significantly lower positivity rates for these protozoa. All tests exhibited significantly lower positivity rates compared with GS for the diagnosis of helminths. The KK technique had the highest positivity rate for diagnosing Schistosoma mansoni (74.6%), while the TFT had the highest positivity rates for Ascaris lumbricoides (58.1%) and hookworm (75%); HPJ technique had the highest positivity rate for Strongyloides stercoralis (50%). Although a combination of tests is the most accurate method for the diagnosis of enteral parasites, the TFT reliably estimates the prevalence of protozoa and selected helminths, such as A. lumbricoides and hookworm. Further studies are needed to evaluate the detection accuracy of the TFT in samples with varying numbers of parasites.

  3. Parasitic infections in sickle cell crisis: Nigerian experience.

    PubMed Central

    Sodipo, J. O.; Padgett, D.; Warrie, E.; Olopoenia, L.

    1997-01-01

    Data collected on 150 sickle cell patients in Nigeria were analyzed to determine the frequency of parasitic infections in clinical and hematologic crisis. Fifty-three adult and 97 pediatric patients (mean age: 27.6 years and 9.7 years, respectively) were studied. Of these patients, 82 were males and 68 females. One hundred thirty-nine had the SS and 11 the SC genotype. Blood samples collected from patients on admission for sickle cell-related illnesses were examined microscopically for evidence of Plasmodium sp, and stool samples were analyzed for presence of any helminth. A total of 102 parasitic infections associated with clinical cases of sickle cell crisis were recorded (malaria, 36[35.3%]; helminths, 49 ([48%]; and malaria and helminths together, 17 [16.7%]). Of the 49 helminthic infections, 26 (53.1%) were due to Ascaris lumbricoides, 15 (30.6%) were due to hookworms, 7 (14.3%) were due to Trichuris trichiura, and 1 (2%) was due to Strongyloides stercoralis. The mean hemoglobin levels during clinical crisis were 7.1 g/dL for helminths, 6.4 g/dL for malaria, and 6.1 g/dL for malaria and helminths together. Reticulocyte counts were 1.4% for helminths, 1.5% for malaria, and 1.2% for both malaria and helminths together. Severity and duration of the clinical crisis were longer for events associated with a single parasitic organism infection than for those with multiple organisms. Routine blood smear examination for malaria and stool analysis should be included in the laboratory evaluation of individuals with sickle cell anemia in developing countries as these infestations could play an important role in precipitating a crisis. PMID:9145635

  4. Cultivation of parasites.

    PubMed

    Ahmed, Nishat Hussain

    2014-07-01

    Parasite cultivation techniques constitute a substantial segment of present-day study of parasites, especially of protozoa. Success in establishing in vitro and in vivo culture of parasites not only allows their physiology, behavior and metabolism to be studied dynamically, but also allows the nature of the antigenic molecules in the excretory and secretory products to be vigorously pursued and analyzed. The complex life-cycles of various parasites having different stages and host species requirements, particularly in the case of parasitic helminths, often make parasite cultivation an uphill assignment. Culturing of parasites depends on the combined expertise of all types of microbiological cultures. Different parasites require different cultivation conditions such as nutrients, temperature and even incubation conditions. Cultivation is an important method for diagnosis of many clinically important parasites, for example, Entamoeba histolytica, Trichomonas vaginalis, Leishmania spp., Strongyloides stercoralis and free-living amoebae. Many commercial systems like InPouch TV for T. vaginalis, microaerophilous stationary phase culture for Babesia bovis and Harada-Mori culture technique for larval-stage nematodes have been developed for the rapid diagnosis of the parasitic infections. Cultivation also has immense utility in the production of vaccines, testing vaccine efficacy, and antigen - production for obtaining serological reagents, detection of drug-resistance, screening of potential therapeutic agents and conducting epidemiological studies. Though in vitro cultivation techniques are used more often compared with in vivo techniques, the in vivo techniques are sometimes used for diagnosing some parasitic infections such as trypanosomiasis and toxoplasmosis. Parasite cultivation continues to be a challenging diagnostic option. This review provides an overview of intricacies of parasitic culture and update on popular methods used for cultivating parasites.

  5. Cultivation of parasites

    PubMed Central

    Ahmed, Nishat Hussain

    2014-01-01

    Parasite cultivation techniques constitute a substantial segment of present-day study of parasites, especially of protozoa. Success in establishing in vitro and in vivo culture of parasites not only allows their physiology, behavior and metabolism to be studied dynamically, but also allows the nature of the antigenic molecules in the excretory and secretory products to be vigorously pursued and analyzed. The complex life-cycles of various parasites having different stages and host species requirements, particularly in the case of parasitic helminths, often make parasite cultivation an uphill assignment. Culturing of parasites depends on the combined expertise of all types of microbiological cultures. Different parasites require different cultivation conditions such as nutrients, temperature and even incubation conditions. Cultivation is an important method for diagnosis of many clinically important parasites, for example, Entamoeba histolytica, Trichomonas vaginalis, Leishmania spp., Strongyloides stercoralis and free-living amoebae. Many commercial systems like InPouch TV for T. vaginalis, microaerophilous stationary phase culture for Babesia bovis and Harada-Mori culture technique for larval-stage nematodes have been developed for the rapid diagnosis of the parasitic infections. Cultivation also has immense utility in the production of vaccines, testing vaccine efficacy, and antigen - production for obtaining serological reagents, detection of drug-resistance, screening of potential therapeutic agents and conducting epidemiological studies. Though in vitro cultivation techniques are used more often compared with in vivo techniques, the in vivo techniques are sometimes used for diagnosing some parasitic infections such as trypanosomiasis and toxoplasmosis. Parasite cultivation continues to be a challenging diagnostic option. This review provides an overview of intricacies of parasitic culture and update on popular methods used for cultivating parasites. PMID

  6. A Schistosoma haematobium-specific real-time PCR for diagnosis of urogenital schistosomiasis in serum samples of international travelers and migrants.

    PubMed

    Cnops, Lieselotte; Soentjens, Patrick; Clerinx, Jan; Van Esbroeck, Marjan

    2013-01-01

    Diagnosis of urogenital schistosomiasis by microscopy and serological tests may be elusive in travelers due to low egg load and the absence of seroconversion upon arrival. There is need for a more sensitive diagnostic test. Therefore, we developed a real-time PCR targeting the Schistosoma haematobium-specific Dra1 sequence. The PCR was evaluated on urine (n = 111), stool (n = 84) and serum samples (n = 135), and one biopsy from travelers and migrants with confirmed or suspected schistosomiasis. PCR revealed a positive result in 7/7 urine samples, 11/11 stool samples and 1/1 biopsy containing S. haematobium eggs as demonstrated by microscopy and in 22/23 serum samples from patients with a parasitological confirmed S. haematobium infection. S. haematobium DNA was additionally detected by PCR in 7 urine, 3 stool and 5 serum samples of patients suspected of having schistosomiasis without egg excretion in urine and feces. None of these suspected patients demonstrated other parasitic infections except one with Blastocystis hominis and Entamoeba cyst in a fecal sample. The PCR was negative in all stool samples containing S. mansoni eggs (n = 21) and in all serum samples of patients with a microscopically confirmed S. mansoni (n = 22), Ascaris lumbricoides (n = 1), Ancylostomidae (n = 1), Strongyloides stercoralis (n = 1) or Trichuris trichuria infection (n = 1). The PCR demonstrated a high specificity, reproducibility and analytical sensitivity (0.5 eggs per gram of feces). The real-time PCR targeting the Dra1 sequence for S. haematobium-specific detection in urine, feces, and particularly serum, is a promising tool to confirm the diagnosis, also during the acute phase of urogenital schistosomiasis.

  7. Malnutrition and intestinal parasitic infections in school children of Gondar, North West Ethiopia.

    PubMed

    Worku, Netsanet; Erko, Berhanu; Torben, Workineh; Belay, Mulugeta; Kasssu, Afework; Fetene, Teshome; Huruy, Kahsay

    2009-01-01

    In developing countries, malnutrition is a considerable health problem with prevalence ranges of 4-46%, with 1-10% severely malnourished. This study aimed to determine the prevalence of malnutrition and intestinal parasitoses and identify risk factors of malnutrition in schoolchildren. A cross-sectional study was carried out on 322 schoolchildren, of age 6 to 14 years, attending private and government primary schools, in Gonder town, North West Ethiopia. The study was conducted from December 2006 to February 2007. Nutritional status of these children was determined using anthropometric parameters (weight-for-age, height-for-age and weight-for-height). Epi Info 2000 software was used to evaluate anthropometric results of each individual and formol-ether concentration technique was employed to identify parasites. The prevalence of underweight, stunting, wasting and intestinal parasitoses was 34.8%, 27%, 50% and 55.6%, respectively. Parasites encountered during the study were Ascaris lumbricoides (17.8%), Trichuiris trichiura (3.4%), hookworm (4.3%), Giardia lamblia (9%), Entamoeba histolytica (2.1%), Schistosoma mansoni (2.4%), Hymenolepis nana (4.7%) and Enterobius vermicularis (0.31%), respectively, in single infections. Only two cases of Strongyloides stercoralis was found in multiple infections and none in single infections. The prevalence of multiple parasitoses was 10.9%. Maternal literacy status, sex and age of the child were significantly associated with malnutrition (p < 0.05). Even though chronic type of malnutrition (stunting) was decreasing, indicators of acute type of malnutrition were increasing at a higher rate in the area. Implementation of maternal education and school feeding programs, avoidance of students from getting in contact with waste and river water were recommended to avoid malnutrition and intestinal parasitoses in children of the study area.

  8. Enzyme-linked immunosorbent assay for diagnosis of Amphimerus spp. liver fluke infection in Humans

    PubMed Central

    Cevallos, William; Calvopiña, Manuel; Nipáz, Victoria; Vicente-Santiago, Belén; López-Albán, Julio; Fernández-Soto, Pedro; Guevara, Ángel; Muro, Antonio

    2017-01-01

    BACKGROUND Amphimerus spp. is a liver fluke that infects humans and domestic animals. It is highly prevalent in some Ecuadorian communities. Currently, diagnosis is based on the microscopic observation of eggs in faeces, but this has variable sensitivity. More sensitive methods are needed for diagnostic testing. OBJECTIVE The main objective of this work was to develop an enzyme-linked immunosorbent assay (ELISA) using crude antigens from Amphimerus spp. adult worms to detect anti-Amphimerus IgG in human sera. METHODS Crude somatic antigens were obtained from adult Amphimerus spp. worms. Human sera from 119 patients were tested: 48 from individuals with a confirmed Amphimerus spp. infection, 78 from non-infected Ecuadorians living in the endemic region, 60 from persons living in non-endemic areas (20 Ecuadorians, 20 Europeans, and 20 Africans), and 33 who had other parasitic and non-parasitic infections. PRINCIPAL FINDINGS Results were analysed using the receiver-operator characteristic (ROC) curve analysis with an area under curve (AUC) value of 0.967. The accuracy of the ELISA was high. The sensitivity was 85.0% [95% confidence interval (CI): 80.3-89.7%] and the specificity was 71.0% (95% CI: 65.2-76.8%). Some cross reactivity was detected against Paragonimus mexicanus, Fasciola hepatica, Schistosomiasis, Taenia solium, Strongyloides stercoralis, Mansonella spp., and Vampirolepis nana. MAIN CONCLUSIONS We have developed the first ELISA technique that detects anti-Amphimerus IgG in human sera with good sensitivity, repeatability and reproducibility. However, more specific antigens are needed to further enhance performance of this assay. Regardless, this ELISA test could be useful for early diagnosis and prompt treatment of human Amphimerus spp. infections. PMID:28443982

  9. Leishmania infantum, Dirofilaria spp. and other endoparasite infections in kennel dogs in central Italy

    PubMed Central

    Sauda, Federica; Malandrucco, Livia; Macrì, Gladia; Scarpulla, Manuela; De Liberato, Claudio; Terracciano, Giuliana; Fichi, Gianluca; Berrilli, Federica; Perrucci, Stefania

    2018-01-01

    Prevalence and risk factors of Leishmania infantum, Dirofilaria spp. and other potentially zoonotic or canine-specific endoparasite infections were assessed in 639 kennel dogs from central Italy. To this end, individual blood and fecal samples were examined using parasitological, immunological and molecular techniques. The presence of compatible clinical pictures, as well as age and gender were considered as putative risks factors. To evaluate risk factors, multivariable analysis with logistic regression and univariable analysis with a Chi square test and a Fischer’s exact test were performed. Overall, 52.6% of dogs (95% CI 48.6-56.5) were found positive, while 39.6% of dogs (95% CI 35.8-43.5) were infected by potentially zoonotic species. Leishmania infantum and Dirofilaria repens showed prevalences of 2.5% (95% CI 1.5-4.1) and 2.8% (95% CI 1.7-4.5), respectively. The prevalence of cardiorespiratory parasites was 7.8% (95% CI 5.9-10.3) and included the species Angiostrongylus vasorum, Eucoleus aerophilus, Eucoleus boehmi and D. immitis; the latter showed a prevalence of 0.2% (95% CI 0.001-1). Intestinal parasites were significantly prevalent (38.8%, 95% CI 35-42.7) and they consisted mainly of species of major zoonotic concern, including ancylostomatids, Toxocara canis, Giardia duodenalis, Dipylidium caninum, Taeniidae, Strongyloides stercoralis and Cryptosporidium parvum. Endoparasites were significantly prevalent in clinically suspected dogs. Leishmania infantum and cardiorespiratory nematodes were prevalent in older dogs, while intestinal parasites were prevalent in younger dogs. Results show high dog and public health risks in kennels in central Italy, and suggest the need for more effective control measures. PMID:29388550

  10. Patterns and risk factors of helminthiasis and anemia in a rural and a peri-urban community in Zanzibar, in the context of helminth control programs.

    PubMed

    Knopp, Stefanie; Mohammed, Khalfan A; Stothard, J Russell; Khamis, I Simba; Rollinson, David; Marti, Hanspeter; Utzinger, Jürg

    2010-05-11

    The control of helminth infections and prevention of anemia in developing countries are of considerable public health importance. The purpose of this study was to determine patterns and risk factors of helminth infections and anemia in a rural and a peri-urban community of Zanzibar, Tanzania, in the context of national helminth control programs. We carried out a community-based cross-sectional study in 454 individuals by examining at least two stool samples with different methods for soil-transmitted helminths (Ascaris lumbricoides, hookworm, Strongyloides stercoralis, and Trichuris trichiura) and one urine sample for Schistosoma haematobium. Finger-prick blood was taken to estimate anemia levels and to detect antibody reactions against ascariasis, strongyloidiasis and schistosomiasis, using an enzyme-linked immunosorbent assay (ELISA) approach. Parasitological methods determined a helminth prevalence of 73.7% in the rural, and 48.9% in the peri-urban setting. Most helminth infections were of light intensity with school-aged children showing the highest intensities. Multiple helminth species infections were pervasive in rural dwellers regardless of age. More than half of the participants were anemic, with a particularly high prevalence in the peri-urban setting (64.7%). Risk factors for helminth infections were age, sex, consumption of raw vegetables or salad, recent travel history, and socio-economic status. After several years of chemotherapy-based morbidity control efforts in Zanzibar, helminth prevalences are still high and anemia is common, but helminth infection intensities are low. Hence, chemotherapy should be continued, and complemented with improved access to clean water, adequate sanitation, and health education, along with poverty alleviation measures for a more enduring impact.

  11. Intestinal parasitic infections among expatriate workers in various occupations in Sharjah, United Arab Emirates.

    PubMed

    Dafalla, Abdelmunim Izzeldin Abdelrahman; Almuhairi, Shaikha Ali Salem Obaid; AlHosani, Mohamed Hassan Jasim; Mohamed, Mira Yousif; Alkous, Mariam Ibrahim Ahmed; AlAzzawi, Mousa Abdelsattar; Abakar, Adam Dawoud; Nour, Bakri Yousif Mohamed; Hasan, Hayder; AbuOdeh, Ra'ed Omar; ElBakri, Ali

    2017-12-21

    Intestinal parasitic infections are prevalent throughout many countries. This study aimed to determine the prevalence of intestinal parasite carriers among 21,347 expatriate workers, including food handlers and housemaids attending the public health center laboratory in Sharjah, UAE. Stool sample collection was performed throughout the period between January and December 2013. All samples were examined microscopically. Demographic data were also obtained and analyzed. Intestinal parasites were found in 3.3% (708/21,347) of the studied samples (single and multiple infections). Among positive samples, six hundred and eighty-three samples (96.5%) were positive for a single parasite: Giardia lamblia (257; 36.3%) and Entamoeba histolytica/Entamoeba dispar (220; 31.1%), respectively, whereas mono-infections with helminths accounted for 206 (29.1%) of the samples. Infection rates with single worms were: Ascaris lumbricoides (84; 11.9%), Hookworm (34; 4.8%), Trichuris trichiura (33; 4.7%), Taenia spp. (27; 3.81%), Strongyloides stercoralis (13; 1.8%), Hymenolepis nana (13; 1.8%), and Enterobius vermicularis (2; 0.28%), respectively. Infections were significantly associated with gender (x2 = 14.18; p = 0.002) with males as the most commonly infected with both groups of intestinal parasites (protozoa and helminths). A strong statistical association was noted correlating the parasite occurrence with certain nationalities (x2= 49.5, p <0.001). Furthermore, the study has also found a strong statistical correlation between parasite occurrence and occupation (x2= 15.60; p = 0.029). Multiple infections were not common (3.5% of the positive samples), although one individual (0.14%) had four helminth species, concurrently. These findings emphasized that food handlers with different pathogenic parasitic organisms may pose a significant health risk to the public.

  12. Intestinal parasites isolated in a large teaching hospital, Italy, 1 May 2006 to 31 December 2008.

    PubMed

    Masucci, L; Graffeo, R; Bani, S; Bugli, F; Boccia, S; Nicolotti, N; Fiori, B; Fadda, G; Spanu, T

    2011-06-16

    Intestinal parasites account for the majority of parasitic diseases, particularly in endemic areas. Most are transmitted via contaminated food. Because of increased immigration and travel, enteric parasitoses are now distributed worldwide. Between May 2006 and December 2008, we examined stool specimens from 5,351 patients (4,695 Italians, 656 non-Italians) for ova and parasites using microscopy, culture techniques, and molecular methods. Stools from 594 patients (11.1%) were contaminated and for all patients samples combined, a total of 700 intestinal parasites were counted. Ninety of the 594 infected patients had more than one parasite in their stools. Parasites causing intestinal disease occurred in 8.8% of patients. The prevalence was over twice as high among non-Italians (26.8% vs 8.9% in Italians, p<0.001) and higher in males (13.0% vs 9.5% in females, p=0.003). Most isolates were pathogenic protozoa, including in decreasing order of frequency: Blastocystis hominis, Giardia intestinalis, Entamoeba histolytica, and Cyclospora cayetanensis. The latter two species tended to be more common in Italians, although not at significant level (3.6% (15/418) vs 1.7% (3/176) in non-Italians, OR: 2.15; 95%CI: 0.60–11.70, p=0.22). Helminthes were found in 28 patients, mainly non-Italians (5.7% (10/176) vs 4.3% (18/418), OR: 1.34; 95%CI: 0.54–3.13, p=0.47). Ascaris lumbricoides and Hymenolepis nana were the most common. Strongyloides stercoralis, Enterobius vermicularis, Taenia spp. and Trichuris trichiura were also found. Intestinal parasites are a serious problem in developing countries, but should not be underestimated in industrialised countries.

  13. Epidemiology of chronic daily headache.

    PubMed

    Pascual, J; Colás, R; Castillo, J

    2001-12-01

    Daily or near-daily headache is a widespread problem in clinical practice. The general term of chronic daily headache (CDH) encompasses those primary headaches presenting more than 15 days per month and lasting more than 4 hours per day. CDH includes transformed migraine (TM), chronic tension-type headache (CTTH), new daily persistent headache (NDPH), and hemicrania continua (HC). Around 40% of patients attending a specialized headache clinic meet CDH diagnostic criteria, of which 80% are women. In these clinics about 60% of patients suffer from TM, 20% from CTTH, and 20% meet NDPH criteria. Most, some 80%, overuse symptomatic medications. One should be very cautious on extrapolating these numbers to the general population. CDH prevalence in the general population seems to be around 4% to 5% (up to 8% to 9% for women). Regarding the prevalence of CDH subtypes, NDPH is rare (0.1%), whereas the prevalence of TM (1.5% to 2%) and CTTH (2.5% to 3%) is clearly higher. In contrast to data from specialized clinics, only around a quarter of CDH subjects in the general population overuse analgesics; the prevalence of CDH subjects with analgesic overuse being 1.1% to 1.9% of the general population. Most of these patients with analgesic overuse are TM patients.

  14. Daily Interpersonal and Affective Dynamics in Personality Disorder

    PubMed Central

    Wright, Aidan G.C.; Hopwood, Christopher J.; Simms, Leonard J.

    2015-01-01

    In this naturalistic study we adopt the lens of interpersonal theory to examine between-and within-person differences in dynamic processes of daily affect and interpersonal behaviors among individuals (N = 101) previously diagnosed with personality disorders who completed daily diaries over the course of 100 days. Dispositional ratings of interpersonal problems and measures of daily stress were used as predictors of daily shifts in interpersonal behavior and affect in multilevel models. Results indicate that ~40%–50% of the variance in interpersonal behavior and affect is due to daily fluctuations, which are modestly related to dispositional measures of interpersonal problems but strongly related to daily stress. The findings support conceptions of personality disorders as a dynamic form of psychopathology involving the individuals interacting with and regulating in response to the contextual features of their environment. PMID:26200849

  15. Daily Spiritual Experiences and Prosocial Behavior

    ERIC Educational Resources Information Center

    Einolf, Christopher J.

    2013-01-01

    This paper examines how the Daily Spiritual Experiences Scale (DSES) relates to range of prosocial behaviors, using a large, nationally representative U.S. data set. It finds that daily spiritual experiences are a statistically and substantively significant predictor of volunteering, charitable giving, and helping individuals one knows personally.…

  16. Intergenerational Support in a Daily Context.

    PubMed

    Fingerman, Karen L; Kim, Kyungmin; Tennant, Patrick S; Birditt, Kira S; Zarit, Steven H

    2016-10-01

    Using retrospective global reports, studies have found that middle-aged adults in the United States provide intermittent support to their aging parents and more frequent support to grown children. To date, studies have not examined support middle-aged adults provide to different generations on a daily basis. Daily support may include mundane everyday exchanges that may (or may not) affect well-being. Middle-aged adults (N = 191, mean age 55.93) completed a general interview regarding family ties, followed by interviews each day for 7 days (N = 1,261 days). Daily interviews assessed support (e.g., advice, emotional, practical help) participants provided each grown child (n = 454) and aging parent (n = 253). Participants also reported daily mood. Most participants provided emotional support (80%), advice (87%), and practical help (69%) to a grown child and also provided emotional support (61%) and advice (61%) or practical help (43%) to a parent that week. Multilevel models confirmed generational differences; grown children were more likely to receive everyday support than parents. Providing support to grown children was associated with positive mood, whereas providing support to parents was associated with more negative mood. Daily intergenerational support was more common than studies using global reports of support have found. Some daily support may be fleeting and not stand out in memory. The findings were consistent with the intergenerational stake hypothesis, which suggests middle-aged adults are more invested in their grown children than in their parents. Nonetheless, middle-aged adults were highly involved with aging parents. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Daily disposable contact lens prescribing around the world.

    PubMed

    Efron, Nathan; Morgan, Philip B; Helland, Magne; Itoi, Motozumi; Jones, Deborah; Nichols, Jason J; van der Worp, Eef; Woods, Craig A

    2010-10-01

    Daily disposable contact lenses were introduced into the market 16 years ago. Data that we have gathered from annual contact lens fitting surveys conducted in Australia, Canada, Japan, The Netherlands, Norway, the UK and the USA between 2000 and 2008 indicates an overall increase in daily disposable lens fitting during this period. Daily disposable lenses are especially popular in Japan, Norway and the UK. There is a trend for these lenses to be fitted on a part-time basis. Males are over-represented in daily disposable lens fitting-a trend that is especially evident in Canada. Daily disposable lens wearers are about two years younger than wearers of reusable lenses in Japan and The Netherlands. The convenience and health benefits of daily disposable lenses are expected to fuel continued growth in this sector. Copyright (c) 2010 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  18. An alternative method for determining daily bladder perception.

    PubMed

    Erdem, Erim; Karazindiyanoglu, Sinan; Ulger, Suleyman

    2010-01-01

    To avoid the unphysiologic nature of cystometry, we searched a new tool for evaluating bladder perceptions. The study group consisted of 25 (14 girls and 11 boys) primary monosymptomatic enuretic children with a mean age of 11 (range 8-16). Four children were excluded due to neuromuscular dysfunctions of the bladder, which was demonstrated with the help of cystometry. All children filled a voiding chart 3 times daily to record the duration elapsed till normal desire (ND(daily)) and strong desire (SD(daily)). During cystometry, the amounts of infused medium (cystometric ND(ml) and cystometric SD(ml)) and the duration (cystometric ND(sec) and cystometric SD(sec)), till ND and SD were perceived and recorded. Mean cystometric ND(ml) was 209.9 +/- 107.2 and ND(sec), 318.1 +/- 135.5, whereas mean cystometric SD(ml) was 273.0 +/- 103.1 and SD(sec), 415.7 +/- 136.8. To evaluate the reliability of elapsed time instead of milliliters, as a parameter, cystometric ND/SD values were calculated and a strong correlation was found between the 2 (ND/SD(sec) = 0.77 +/- 0.19 and ND/SD(ml) = 0.77 +/- 0.19, r = 0.9795, P = .000). Although there was a strong correlation between 3 ND(daily) (r = 0.9576, P = .000), between 3 SD(daily) (r = 0.9706, P = .000), and 3 ND/SD(daily) (r = 0.8706, P = .000), no significant correlation was determined between mean ND(daily) and cystometric ND(sec) (r = 0.3410, P = .2032), and also between mean SD(daily) and cystometric SD(sec) (r = 0.2740, P = .2402). Daily durations of sensations do not correlate with those perceived during cystometry. However, as the results of 3 consecutive daily recordings have a strong correlation, comparison of the reliability of these methods is still needed. 2010 Elsevier Inc. All rights reserved.

  19. 1 CFR 5.6 - Daily publication.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 1 General Provisions 1 2011-01-01 2011-01-01 false Daily publication. 5.6 Section 5.6 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.6 Daily publication. There shall be an edition of the Federal Register published for each official Federal working day...

  20. 1 CFR 5.6 - Daily publication.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 1 General Provisions 1 2010-01-01 2010-01-01 false Daily publication. 5.6 Section 5.6 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.6 Daily publication. There shall be an edition of the Federal Register published for each official Federal working day...

  1. Children's Daily Routines during Kindergarten Transition

    ERIC Educational Resources Information Center

    Wildenger, Leah K.; McIntyre, Laura Lee; Fiese, Barbara H.; Eckert, Tanya L.

    2008-01-01

    Routines are an important feature of family life and functioning in families with young children. Common daily routines such as dinnertime, bedtime, and waking activities are powerful organizers of family behavior and may be instrumental to children and families during times of transition, such as elementary school entry. Daily routines were…

  2. 1 CFR 5.6 - Daily publication.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 1 General Provisions 1 2013-01-01 2012-01-01 true Daily publication. 5.6 Section 5.6 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.6 Daily publication. There shall be an edition of the Federal Register published for each official Federal working day...

  3. 1 CFR 5.6 - Daily publication.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 1 General Provisions 1 2012-01-01 2012-01-01 false Daily publication. 5.6 Section 5.6 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.6 Daily publication. There shall be an edition of the Federal Register published for each official Federal working day...

  4. 1 CFR 5.6 - Daily publication.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 1 General Provisions 1 2014-01-01 2012-01-01 true Daily publication. 5.6 Section 5.6 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER GENERAL § 5.6 Daily publication. There shall be an edition of the Federal Register published for each official Federal working day...

  5. A statistical analysis of the daily streamflow hydrograph

    NASA Astrophysics Data System (ADS)

    Kavvas, M. L.; Delleur, J. W.

    1984-03-01

    In this study a periodic statistical analysis of daily streamflow data in Indiana, U.S.A., was performed to gain some new insight into the stochastic structure which describes the daily streamflow process. This analysis was performed by the periodic mean and covariance functions of the daily streamflows, by the time and peak discharge -dependent recession limb of the daily streamflow hydrograph, by the time and discharge exceedance level (DEL) -dependent probability distribution of the hydrograph peak interarrival time, and by the time-dependent probability distribution of the time to peak discharge. Some new statistical estimators were developed and used in this study. In general features, this study has shown that: (a) the persistence properties of daily flows depend on the storage state of the basin at the specified time origin of the flow process; (b) the daily streamflow process is time irreversible; (c) the probability distribution of the daily hydrograph peak interarrival time depends both on the occurrence time of the peak from which the inter-arrival time originates and on the discharge exceedance level; and (d) if the daily streamflow process is modeled as the release from a linear watershed storage, this release should depend on the state of the storage and on the time of the release as the persistence properties and the recession limb decay rates were observed to change with the state of the watershed storage and time. Therefore, a time-varying reservoir system needs to be considered if the daily streamflow process is to be modeled as the release from a linear watershed storage.

  6. Daily Self-Disclosure and Sleep in Couples

    PubMed Central

    Kane, Heidi S.; Slatcher, Richard B.; Reynolds, Bridget M.; Repetti, Rena L.; Robles, Theodore F.

    2014-01-01

    Objective An emerging literature provides evidence for the association between romantic relationship quality and sleep, an important factor in health and well-being. However, we still know very little about the specific relationship processes that affect sleep behavior. Therefore, the goal of this study was to examine how self-disclosure, an important relational process linked to intimacy, relationship satisfaction and health, is associated with sleep behavior. Method As part of a larger study of family processes, wives (n=46) and husbands (n=38) from 46 cohabiting families completed 56 days of daily diaries. Spouses completed evening diaries assessing daily self-disclosure, relationship satisfaction, and mood and morning diaries assessing the prior night's sleep. Multilevel modeling was used to explore the effects of both daily variation in and average levels across the 56 days of self-disclosure on sleep. Results Daily variation in self-disclosure predicted sleep outcomes for wives, but not for husbands. On days when wives self-disclosed more to their spouses than their average level, their subjective sleep quality and sleep efficiency that night improved. Furthermore, daily self-disclosure buffered the negative effect of daily negative mood on sleep latency for wives, but not husbands. In contrast, higher average levels of self-disclosure predicted less waking during the night for husbands, but not for wives. Conclusion The association between self-disclosure and sleep is one mechanism by which daily relationship functioning may influence health and well-being. Gender may play a role in how self-disclosure is associated with sleep. PMID:25068453

  7. Estimating missing daily temperature extremes in Jaffna, Sri Lanka

    NASA Astrophysics Data System (ADS)

    Thevakaran, A.; Sonnadara, D. U. J.

    2018-04-01

    The accuracy of reconstructing missing daily temperature extremes in the Jaffna climatological station, situated in the northern part of the dry zone of Sri Lanka, is presented. The adopted method utilizes standard departures of daily maximum and minimum temperature values at four neighbouring stations, Mannar, Anuradhapura, Puttalam and Trincomalee to estimate the standard departures of daily maximum and minimum temperatures at the target station, Jaffna. The daily maximum and minimum temperatures from 1966 to 1980 (15 years) were used to test the validity of the method. The accuracy of the estimation is higher for daily maximum temperature compared to daily minimum temperature. About 95% of the estimated daily maximum temperatures are within ±1.5 °C of the observed values. For daily minimum temperature, the percentage is about 92. By calculating the standard deviation of the difference in estimated and observed values, we have shown that the error in estimating the daily maximum and minimum temperatures is ±0.7 and ±0.9 °C, respectively. To obtain the best accuracy when estimating the missing daily temperature extremes, it is important to include Mannar which is the nearest station to the target station, Jaffna. We conclude from the analysis that the method can be applied successfully to reconstruct the missing daily temperature extremes in Jaffna where no data is available due to frequent disruptions caused by civil unrests and hostilities in the region during the period, 1984 to 2000.

  8. Twice-daily versus once-daily applications of pimecrolimus cream 1% for the prevention of disease relapse in pediatric patients with atopic dermatitis.

    PubMed

    Ruer-Mulard, Mireille; Aberer, Werner; Gunstone, Anthony; Kekki, Outi-Maria; López Estebaranz, Jose Luis; Vertruyen, André; Guettner, Achim; Hultsch, Thomas

    2009-01-01

    The aim of this study is to compare twice-daily and once-daily applications of pimecrolimus cream 1% for prevention of atopic dermatitis relapses in pediatric patients. This multicenter trial enrolled 300 outpatients aged 2 to 17 years, with mild-to-severe atopic dermatitis. The patients were initially treated with twice-daily topical pimecrolimus until complete clearance or for up to 6 weeks (open-label period). Those who achieved a decrease of at least 1 point in the Investigator's Global Assessment score were then randomized to double-blind treatment with pimecrolimus cream 1% either twice daily or once daily for up to 16 weeks. Study medication was discontinued during periods of disease remission (Investigator's Global Assessment = 0). The primary efficacy end point of the double-blind phase was disease relapse (worsening requiring topical corticosteroids or additional/alternative therapy and confirmed by Investigator's Global Assessment score > or = 3 and pruritus score > or = 2). Of the 300 patients enrolled in the study, 268 were randomized to treatment with pimecrolimus cream 1% either twice daily or once daily (n = 134 in each group). The relapse rate was lower in the twice-daily dose group (9.9%) than that in the once-daily dose group (14.7%), but analysis of the time to disease relapse, using a Cox proportional model to adjust for confounding variables, did not show a statistically significant difference between treatment arms (hazard ratio: 0.64; 95% CI: 0.31-1.30). Treatment of active atopic dermatitis lesions with pimecrolimus cream 1% twice daily, followed by the once-daily dosing regimen, was sufficient to prevent subsequent atopic dermatitis relapses over 16 weeks in pediatric patients.

  9. Making Each Other’s Daily Life: Nurse Assistants’ Experiences and Knowledge on Developing a Meaningful Daily Life in Nursing Homes

    PubMed Central

    James, Inger; Fredriksson, Carin; Wahlström, Catrin; Kihlgren, Annica; Blomberg, Karin

    2014-01-01

    Background: In a larger action research project, guidelines were generated for how a meaningful daily life could be developed for older persons. In this study, we focused on the nurse assistants’ (NAs) perspectives, as their knowledge is essential for a well-functioning team and quality of care. The aim was to learn from NAs’ experiences and knowledge about how to develop a meaningful daily life for older persons in nursing homes and the meaning NAs ascribe to their work. Methods: The project is based on Participatory and Appreciative Action and Reflection. Data were generated through interviews, participating observations and informal conversations with 27 NAs working in nursing homes in Sweden, and a thematic analysis was used. Result: NAs developed a meaningful daily life by sensing and finding the “right” way of being (Theme 1). They sense and read the older person in order to judge how the person was feeling (Theme 2). They adapt to the older person (Theme 3) and share their daily life (Theme 4). NAs use emotional involvement to develop a meaningful daily life for the older person and meaning in their own work (Theme 5), ultimately making each other’s daily lives meaningful. Conclusion: It was obvious that NAs based the development of a meaningful daily life on different forms of knowledge: the oreticaland practical knowledge, and practical wisdom, all of which are intertwined. These results could be used within the team to constitute a meaningful daily life for older persons in nursing homes. PMID:25246997

  10. Once vs twice-daily abacavir and lamivudine in African children.

    PubMed

    Musiime, Victor; Kasirye, Philip; Naidoo-James, Bethany; Nahirya-Ntege, Patricia; Mhute, Tawanda; Cook, Adrian; Mugarura, Lincoln; Munjoma, Marshall; Thoofer, Navdeep K; Ndashimye, Emmanuel; Nankya, Immaculate; Spyer, Moira J; Thomason, Margaret J; Snowden, Wendy; Gibb, Diana M; Walker, Ann Sarah

    2016-07-17

    Antiretroviral therapy (ART) adherence is critical for successful HIV treatment outcomes. Once-daily dosing could improve adherence. Plasma concentrations of once-daily vs twice-daily abacavir + lamivudine are bioequivalent in children, but no randomized trial has compared virological outcomes. Children taking abacavir + lamivudine-containing first-line regimens twice daily for more than 36 weeks in the ARROW trial (NCT02028676, ISRCTN24791884) were randomized to continue twice-daily vs move to once-daily abacavir + lamivudine (open-label). Co-primary outcomes were viral load suppression at week 48 (12% noninferiority margin, measured retrospectively) and lamivudine or abacavir-related grade 3/4 adverse events. Six hundred and sixty-nine children (median 5 years, range 1-16) were randomized to twice daily (n = 333) vs once daily (n = 336) after median 1.8 years on twice-daily abacavir + lamivudine-containing first-line ART. Children were followed for median 114 weeks. At week 48, 242/331 (73%) twice daily vs 236/330 (72%) once daily had viral load less than 80 copies/ml [difference -1.6% (95% confidence interval -8.4,+5.2%) P = 0.65]; 79% twice daily vs 78% once daily had viral load less than 400 copies/ml (P = 0.76) (week 96 results similar). One grade 3/4 adverse event was judged uncertainly related to abacavir + lamivudine (hepatitis; once daily). At week 48, 9% twice daily vs 10% once daily reported missing one or more ART pills in the last 4 weeks (P = 0.74) and 8 vs 8% at week 96 (P = 0.90). Carers strongly preferred once-daily dosing. There was no difference between randomized groups in postbaseline drug-resistance mutations or drug-susceptibility; WHO 3/4 events; ART-modifying, grade 3/4 or serious adverse events; CD4% or weight-for-age/height-for-age (all P > 0.15). Once-daily abacavir + lamivudine was noninferior to twice daily in viral load suppression, with similar resistance, adherence, clinical

  11. Techniques for Daily Living: Curriculum Guides.

    ERIC Educational Resources Information Center

    Wooldridge, Lillian; And Others

    Presented are specific guides concerning techniques for daily living which were developed by the child care staff at the Illinois Braille and Sight Saving School. The guides are designed for cottage parents of the children, who may have both visual and other handicaps, and show what daily living skills are necessary and appropriate for the…

  12. Daily Stressors in Primary Education Students

    ERIC Educational Resources Information Center

    Fernández-Baena, F. Javier; Trianes, María V.; Escobar, Milagros; Blanca, María J.; Muñoz, Ángela M.

    2015-01-01

    Daily stress can have a bearing on children's emotional and academic development. This study aimed to assess daily stressors and to determine their prevalence among primary education students, taking into account their gender, academic year, social adaptation, and the school location. A sample of 7,354 Spanish schoolchildren aged between 6 and 13…

  13. Demographic, socioeconomic and nutritional determinants of daily versus non-daily sugar-sweetened and artificially sweetened beverage consumption.

    PubMed

    Mullie, P; Aerenhouts, D; Clarys, P

    2012-02-01

    The aim of this study was to determine the impact of demographic, socioeconomic and nutritional determinants on daily versus non-daily sugar-sweetened and artificially sweetened beverage consumption. Cross-sectional design in 1852 military men. Using mailed questionnaires, sugar-sweetened and artificially sweetened beverage consumption was recorded. Principal component analysis was used for dietary pattern analysis. Sugar-sweetened and artificially sweetened beverages were consumed daily by 36.3% and 33.2% of the participants, respectively. Age, body mass index (BMI), non-smoking and income were negatively related to sugar-sweetened beverage consumption. High BMI and trying to lose weight were related to artificially sweetened beverages consumption. Three major patterns were obtained from principal component analysis: first, the 'meat pattern', was loaded for red meats and processed meats; second, the 'healthy pattern', was loaded for tomatoes, fruit, whole grain, vegetables, fruit, fish, tea and nuts; finally, the 'sweet pattern' was loaded for sweets, desserts, snacks, high-energy drinks, high-fat dairy products and refined grains. The sugar-sweetened beverage consumption was strongly related with both the meat and sweet dietary patterns and inversely related to the healthy dietary pattern. The artificially sweetened beverage consumption was strongly related with the sweet and healthy dietary pattern. Daily consumption of sugar-sweetened beverages was inversely associated with a healthy dietary pattern. Daily consumption of artificially sweetened beverages was clearly associated with weight-loss intention.

  14. Design of landfill daily cells.

    PubMed

    Panagiotakopoulos, D; Dokas, I

    2001-08-01

    The objective of this paper is to study the behaviour of the landfill soil-to-refuse (S/R) ratio when size, geometry and operating parameters of the daily cell vary over realistic ranges. A simple procedure is presented (1) for calculating the cell parameters values which minimise the S/R ratio and (2) for studying the sensitivity of this minimum S/R ratio to variations in cell size, final refuse density, working face length, lift height and cover thickness. In countries where daily soil cover is required, savings in landfill space could be realised following this procedure. The sensitivity of minimum S/R to variations in cell dimensions decreases with cell size. Working face length and lift height affect the S/R ratio significantly. This procedure also offers the engineer an additional tool for comparing one large daily cell with two or more smaller ones, at two different working faces within the same landfill.

  15. Daily computer usage correlated with undergraduate students' musculoskeletal symptoms.

    PubMed

    Chang, Che-Hsu Joe; Amick, Benjamin C; Menendez, Cammie Chaumont; Katz, Jeffrey N; Johnson, Peter W; Robertson, Michelle; Dennerlein, Jack Tigh

    2007-06-01

    A pilot prospective study was performed to examine the relationships between daily computer usage time and musculoskeletal symptoms on undergraduate students. For three separate 1-week study periods distributed over a semester, 27 students reported body part-specific musculoskeletal symptoms three to five times daily. Daily computer usage time for the 24-hr period preceding each symptom report was calculated from computer input device activities measured directly by software loaded on each participant's primary computer. General Estimating Equation models tested the relationships between daily computer usage and symptom reporting. Daily computer usage longer than 3 hr was significantly associated with an odds ratio 1.50 (1.01-2.25) of reporting symptoms. Odds of reporting symptoms also increased with quartiles of daily exposure. These data suggest a potential dose-response relationship between daily computer usage time and musculoskeletal symptoms.

  16. Development and Validation of a Daily Pain Catastrophizing Scale.

    PubMed

    Darnall, Beth D; Sturgeon, John A; Cook, Karon F; Taub, Chloe J; Roy, Anuradha; Burns, John W; Sullivan, Michael; Mackey, Sean C

    2017-09-01

    To date, there is no validated measure for pain catastrophizing at the daily level. The Pain Catastrophizing Scale (PCS) is widely used to measure trait pain catastrophizing. We sought to develop and validate a brief, daily version of the PCS for use in daily diary studies to facilitate research on mechanisms of catastrophizing treatment, individual differences in self-regulation, and to reveal the nuanced relationships between catastrophizing, correlates, and pain outcomes. After adapting the PCS for daily use, we evaluated the resulting 14 items using 3 rounds of cognitive interviews with 30 adults with chronic pain. We refined and tested the final daily PCS in 3 independent, prospective, cross-sectional, observational validation studies conducted in a combined total of 519 adults with chronic pain who completed online measures daily for 14 consecutive days. For study 1 (N = 131), exploratory factor analysis revealed adequate fit and-unexpectedly-unidimensionality for item responses to the daily PCS. Study 2 (N = 177) correlations indicated adequate association with related constructs (anger, anxiety, pain intensity, depression). Similarly, results for study 3 (N = 211) revealed expected correlations for daily PCS and measures of daily constructs including physical activity, sleep, energy level, and positive affect. Results from complex/multilevel confirmatory factor analysis confirmed good fit to a unidimensional model. Scores on the daily PCS were statistically comparable with and more parsimonious than the full 14-item version. Next steps include evaluation of score validity in populations with medical diagnoses, greater demographic diversity, and in patients with acute pain. This article describes the development and validation of a daily PCS. This daily measure may facilitate research that aims to characterize pain mechanisms, individual differences in self-regulation, adaptation, and nuanced relationships between catastrophizing, correlates, and pain

  17. 1 CFR 6.1 - Index to daily issues.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 1 General Provisions 1 2011-01-01 2011-01-01 false Index to daily issues. 6.1 Section 6.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.1 Index to daily issues. Each daily issue of the Federal Register shall be appropriately indexed. ...

  18. 1 CFR 6.1 - Index to daily issues.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 1 General Provisions 1 2010-01-01 2010-01-01 false Index to daily issues. 6.1 Section 6.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.1 Index to daily issues. Each daily issue of the Federal Register shall be appropriately indexed. ...

  19. 1 CFR 6.1 - Index to daily issues.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 1 General Provisions 1 2012-01-01 2012-01-01 false Index to daily issues. 6.1 Section 6.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.1 Index to daily issues. Each daily issue of the Federal Register shall be appropriately indexed. ...

  20. 1 CFR 6.1 - Index to daily issues.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 1 General Provisions 1 2014-01-01 2012-01-01 true Index to daily issues. 6.1 Section 6.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.1 Index to daily issues. Each daily issue of the Federal Register shall be appropriately indexed. ...

  1. 1 CFR 6.1 - Index to daily issues.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 1 General Provisions 1 2013-01-01 2012-01-01 true Index to daily issues. 6.1 Section 6.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.1 Index to daily issues. Each daily issue of the Federal Register shall be appropriately indexed. ...

  2. New daily persistent headache: An evolving entity.

    PubMed

    Uniyal, Ravi; Paliwal, Vimal Kumar; Anand, Sucharita; Ambesh, Paurush

    2018-01-01

    New daily persistent headache (NDPH) is characterized by an abrupt onset of headache that becomes a daily entity, is unremitting and continuous from the onset, and lasts for more than 3 months. Dr Walter Vanast first described NDPH in the year 1986. Originally, it was proposed as a chronic daily headache but it was placed under "other primary headaches" in the International Classification of Headache Disorder Second Edition (ICHD 2nd edition). However, with evolving literature and better understanding of its clinical characteristics, it was classified as a "chronic daily headache" in the ICHD 3 rd edition beta. There are still many knowledge-gaps regarding the underlying cause, pathophysiology, natural history and treatment of NDPH. This review tries to revisit the entity and discusses the current status of understanding regarding NDPH.

  3. Protocol for the CONVERT trial-Concurrent ONce-daily VErsus twice-daily RadioTherapy: an international 2-arm randomised controlled trial of concurrent chemoradiotherapy comparing twice-daily and once-daily radiotherapy schedules in patients with limited stage small cell lung cancer (LS-SCLC) and good performance status.

    PubMed

    Faivre-Finn, Corinne; Falk, Sally; Ashcroft, Linda; Bewley, Michelle; Lorigan, Paul; Wilson, Elena; Groom, Nicki; Snee, Michael; Fournel, Pierre; Cardenal, Felipe; Bezjak, Andrea; Blackhall, Fiona

    2016-01-20

    Concurrent ONce-daily VErsus twice-daily RadioTherapy (CONVERT) is the only multicentre, international, randomised, phase III trial open in Europe and Canada looking at optimisation of chemoradiotherapy (RT) in limited stage small cell lung cancer (LS-SCLC). Following on from the Turrisi trial of once-daily versus twice-daily (BD) concurrent chemoradiotherapy, there is a real need for a new phase III trial using modern conformal RT techniques and investigating higher once-daily radiation dose. This trial has the potential to define a new standard chemo-RT regimen for patients with LS-SCLC and good performance status. 447 patients with histologically or cytologically proven diagnosis of SCLC were recruited from 74 centres in eight countries between 2008 and 2013. Patients were randomised to receive either concurrent twice-daily RT(45 Gy in 30 twice-daily fractions over 3 weeks) or concurrent once-daily RT(66 Gy in 33 once-daily fractions over 6.5 weeks) both starting on day 22 of cycle 1. Patients are followed up until death. The primary end point of the study is overall survival and secondary end points include local progression-free survival, metastasis-free survival, acute and late toxicity based on the Common Terminology Criteria for Adverse Events V.3.0, chemotherapy and RTdose intensity. The trial received ethical approval from NRES Committee North West-Greater Manchester Central (07/H1008/229). There is a trial steering committee, including independent members and an independent data monitoring committee. Results will be published in a peer-reviewed journal and presented at international conferences. ISRCTN91927162; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. The Effects of Employment Status and Daily Stressors on Time Spent on Daily Household Chores in Middle-Aged and Older Adults

    ERIC Educational Resources Information Center

    Wong, Jen D.; Almeida, David M.

    2013-01-01

    Purpose of the study: This study examines how employment status (worker vs. retiree) and life course influences (age, gender, and marital status) are associated with time spent on daily household chores. Second, this study assesses whether the associations between daily stressors and time spent on daily household chores differ as a function of…

  5. Daily stressors, war experiences, and mental health in Afghanistan.

    PubMed

    Miller, Kenneth E; Omidian, Patricia; Rasmussen, Andrew; Yaqubi, Aziz; Daudzai, Haqmal

    2008-12-01

    Working in Afghanistan's capital city of Kabul, the authors assessed the relative contribution of daily stressors and war-related experiences of violence and loss to levels of depression, PTSD, impaired functioning, and a culturally specific measure of general psychological distress. For women, daily stressors were a better predictor than war experiences of all mental health outcomes except for PTSD; for men, daily stressors were a better predictor of depression and functional impairment, while war experiences and daily stressors were similarly predictive of general distress. For men, daily stressors moderated the relationship between war experiences and PTSD, which was significant only under conditions of low daily stress. The study's implications for research and intervention in conflict and post-conflict settings are considered.

  6. Daily self-disclosure and sleep in couples.

    PubMed

    Kane, Heidi S; Slatcher, Richard B; Reynolds, Bridget M; Repetti, Rena L; Robles, Theodore F

    2014-08-01

    An emerging literature provides evidence for the association between romantic relationship quality and sleep, an important factor in health and well-being. However, we still know very little about the specific relationship processes that affect sleep behavior. Therefore, the goal of this study was to examine how self-disclosure, an important relational process linked to intimacy, relationship satisfaction, and health, is associated with sleep behavior. As part of a larger study of family processes, wives (n = 46) and husbands (n = 38) from 46 cohabiting families completed 56 days of daily diaries. Spouses completed evening diaries assessing daily self-disclosure, relationship satisfaction, and mood and morning diaries assessing the prior night's sleep. Multilevel modeling was used to explore the effects of both daily variation in and average levels across the 56 days of self-disclosure on sleep. Daily variation in self-disclosure predicted sleep outcomes for wives, but not for husbands. On days when wives self-disclosed more to their spouses than their average level, their subjective sleep quality and sleep efficiency that night improved. Furthermore, daily self-disclosure buffered the effect of high negative mood on sleep latency for wives, but not husbands. In contrast, higher average levels of self-disclosure predicted less waking during the night for husbands, but not for wives. The association between self-disclosure and sleep is one mechanism by which daily relationship functioning may influence health and well-being. Gender may play a role in how self-disclosure is associated with sleep.

  7. Four-factor justice and daily job satisfaction: a multilevel investigation.

    PubMed

    Loi, Raymond; Yang, Jixia; Diefendorff, James M

    2009-05-01

    This study examined the differential effects of 4 types of organizational justice on daily job satisfaction at between- and within-individual levels. Specifically, the authors predicted that interpersonal justice and informational justice would exhibit meaningful daily variations and would have direct impacts on individuals' job satisfaction on a daily basis. They further theorized that distributive justice and procedural justice at a between-person level would moderate the within-person relationships. The authors used hierarchical linear modeling to test their hypotheses with a sample of 231 full-time employees in Hong Kong over the course of 25 working days. The results showed that both daily interpersonal and informational justice were positively related to daily job satisfaction. As hypothesized, between-individual distributive justice moderated the relationship between daily interpersonal justice and daily job satisfaction, and between-individual procedural justice moderated the relationship between daily informational justice and daily job satisfaction. (c) 2009 APA, all rights reserved.

  8. Daily stress, presleep arousal, and sleep in healthy young women: a daily life computerized sleep diary and actigraphy study.

    PubMed

    Winzeler, Katja; Voellmin, Annette; Schäfer, Valérie; Meyer, Andrea H; Cajochen, Christian; Wilhelm, Frank H; Bader, Klaus

    2014-03-01

    Our study aimed to further elucidate the mediating role of presleep arousal in the relationship between daily stress and sleep by investigating subjective sleep quality and actigraphy-assessed sleep efficiency (SE) on both within- and between-participant levels in a sample of healthy young women. Multilevel modeling was applied on electronically assessed data comprising 14 consecutive nights in 145 healthy young women to assess the relationship between daily stress, presleep (somatic and cognitive) arousal, and sleep on both levels between participants and within participants across days. Higher levels of daily stress were consistently and significantly associated with higher levels of somatic and cognitive arousal. Somatic arousal mediated the relationship between daily stress and worsened subjective sleep quality on the between-participant level, while cognitive arousal mediated the relationship between daily stress and worsened subjective sleep quality on the within-participants level. Unexpectedly, healthy young women showed higher SE following days with above-average stress with somatic arousal mediating this relationship. Our data corroborate the role of presleep arousal mediating the relationship between daily stress and subjective sleep quality. Interestingly this effect was restricted to somatic arousal being relevant on interindividual levels and cognitive arousal on intraindividual levels. For young and healthy individuals who experience high stress and arousal, well-established cognitive-behavioral techniques could be useful to regulate arousal and prevent worse subjective sleep quality. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Models for estimating daily rainfall erosivity in China

    NASA Astrophysics Data System (ADS)

    Xie, Yun; Yin, Shui-qing; Liu, Bao-yuan; Nearing, Mark A.; Zhao, Ying

    2016-04-01

    The rainfall erosivity factor (R) represents the multiplication of rainfall energy and maximum 30 min intensity by event (EI30) and year. This rainfall erosivity index is widely used for empirical soil loss prediction. Its calculation, however, requires high temporal resolution rainfall data that are not readily available in many parts of the world. The purpose of this study was to parameterize models suitable for estimating erosivity from daily rainfall data, which are more widely available. One-minute resolution rainfall data recorded in sixteen stations over the eastern water erosion impacted regions of China were analyzed. The R-factor ranged from 781.9 to 8258.5 MJ mm ha-1 h-1 y-1. A total of 5942 erosive events from one-minute resolution rainfall data of ten stations were used to parameterize three models, and 4949 erosive events from the other six stations were used for validation. A threshold of daily rainfall between days classified as erosive and non-erosive was suggested to be 9.7 mm based on these data. Two of the models (I and II) used power law functions that required only daily rainfall totals. Model I used different model coefficients in the cool season (Oct.-Apr.) and warm season (May-Sept.), and Model II was fitted with a sinusoidal curve of seasonal variation. Both Model I and Model II estimated the erosivity index for average annual, yearly, and half-month temporal scales reasonably well, with the symmetric mean absolute percentage error MAPEsym ranging from 10.8% to 32.1%. Model II predicted slightly better than Model I. However, the prediction efficiency for the daily erosivity index was limited, with the symmetric mean absolute percentage error being 68.0% (Model I) and 65.7% (Model II) and Nash-Sutcliffe model efficiency being 0.55 (Model I) and 0.57 (Model II). Model III, which used the combination of daily rainfall amount and daily maximum 60-min rainfall, improved predictions significantly, and produced a Nash-Sutcliffe model efficiency

  10. Daily torpor and hibernation in birds and mammals

    PubMed Central

    RUF, THOMAS; GEISER, FRITZ

    2014-01-01

    Many birds and mammals drastically reduce their energy expenditure during times of cold exposure, food shortage, or drought, by temporarily abandoning euthermia, i.e., the maintenance of high body temperatures. Traditionally, two different types of heterothermy, i.e., hypometabolic states associated with low body temperatures (torpor), have been distinguished: Daily torpor, which lasts less than 24 h and is accompanied by continued foraging, versus hibernation, with torpor bouts lasting consecutive days to several weeks in animals that usually do not forage but rely on energy stores, either food caches or body energy reserves. This classification of torpor types has been challenged however, suggesting that these phenotypes may merely represent the extremes in a continuum of traits. Here, we investigate whether variables of torpor in 214 species, 43 birds and 171 mammals form a continuum or a bimodal distribution. We use Gaussian-mixture cluster analysis as well as phylogenetically informed regressions to quantitatively assess the distinction between hibernation and daily torpor and to evaluate the impact of body mass and geographical distribution of species on torpor traits. Cluster analysis clearly confirmed the classical distinction between daily torpor and hibernation. Overall, heterothermic endotherms are small on average, but hibernators are significantly heavier than daily heterotherms and also are distributed at higher average latitudes (~35°) than daily heterotherms (~25°). Variables of torpor for an average 30-g heterotherm differed significantly between daily heterotherms and hibernators. Average maximum torpor bout duration was >30-fold longer, and mean torpor bout duration >25-fold longer in hibernators. Mean minimum body temperature differed by ~13°C, and the mean minimum torpor metabolic rate was ~35% of the BMR in daily heterotherms but only 6% of basal metabolic rate in hibernators. Consequently, our analysis strongly supports the view that

  11. Which metric of ambient ozone to predict daily mortality?

    NASA Astrophysics Data System (ADS)

    Moshammer, Hanns; Hutter, Hans-Peter; Kundi, Michael

    2013-02-01

    It is well known that ozone concentration is associated with daily cause specific mortality. But which ozone metric is the best predictor of the daily variability in mortality? We performed a time series analysis on daily deaths (all causes, respiratory and cardiovascular causes as well as death in elderly 65+) in Vienna for the years 1991-2009. We controlled for seasonal and long term trend, day of the week, temperature and humidity using the same basic model for all pollutant metrics. We found model fit was best for same day variability of ozone concentration (calculated as the difference between daily hourly maximum and minimum) and hourly maximum. Of these the variability displayed a more linear dose-response function. Maximum 8 h moving average and daily mean value performed not so well. Nitrogen dioxide (daily mean) in comparison performed better when previous day values were assessed. Same day ozone and previous day nitrogen dioxide effect estimates did not confound each other. Variability in daily ozone levels or peak ozone levels seem to be a better proxy of a complex reactive secondary pollutant mixture than daily average ozone levels in the Middle European setting. If this finding is confirmed this would have implications for the setting of legally binding limit values.

  12. Safety and efficacy of conversion from twice-daily tacrolimus to once-daily tacrolimus one month after transplantation: randomized controlled trial in adult renal transplantation.

    PubMed

    Oh, Chang-Kwon; Huh, Kyu Ha; Lee, Jong Soo; Cho, Hong Rae; Kim, Yu Seun

    2014-09-01

    The purpose of this study was to compare once-daily tacrolimus with twice-daily tacrolimus in terms of safety, efficacy, and patient satisfaction. This prospective, randomized, open-label, multicenter study was conducted at three institutes. Patients in the investigational group were converted from tacrolimus twice daily to the same dose of extended-release tacrolimus once daily at 1 month post-transplantation, while patients in the control group were maintained on tacrolimus twice daily. The efficacies, safeties, and patient satisfaction for the two drugs at 6 months post-transplantation were compared. Sixty patients were enrolled and randomized to the investigational group (28 of 29 patients completed the study) or the control group (26 of 31 patients completed the study). At 6 months post-transplantation, composite efficacy failure rates including the incidences of biopsy-confirmed acute rejection in the investigational and control groups were 0% and 10.7%, respectively; patient survival was 100% in each group. No difference in estimated glomerular filtration rate values were observed at 6 months post-transplantation (p=0.97). The safety and satisfaction profile (immunosuppressant therapy barrier scale) of once-daily tacrolimus was comparable with that of twice-daily tacrolimus (p=0.35). Conversion from twice-daily tacrolimus to once-daily tacrolimus one month after transplantation is safe and effective.

  13. Daily torpor and hibernation in birds and mammals.

    PubMed

    Ruf, Thomas; Geiser, Fritz

    2015-08-01

    Many birds and mammals drastically reduce their energy expenditure during times of cold exposure, food shortage, or drought, by temporarily abandoning euthermia, i.e. the maintenance of high body temperatures. Traditionally, two different types of heterothermy, i.e. hypometabolic states associated with low body temperature (torpor), have been distinguished: daily torpor, which lasts less than 24 h and is accompanied by continued foraging, versus hibernation, with torpor bouts lasting consecutive days to several weeks in animals that usually do not forage but rely on energy stores, either food caches or body energy reserves. This classification of torpor types has been challenged, suggesting that these phenotypes may merely represent extremes in a continuum of traits. Here, we investigate whether variables of torpor in 214 species (43 birds and 171 mammals) form a continuum or a bimodal distribution. We use Gaussian-mixture cluster analysis as well as phylogenetically informed regressions to quantitatively assess the distinction between hibernation and daily torpor and to evaluate the impact of body mass and geographical distribution of species on torpor traits. Cluster analysis clearly confirmed the classical distinction between daily torpor and hibernation. Overall, heterothermic endotherms tend to be small; hibernators are significantly heavier than daily heterotherms and also are distributed at higher average latitudes (∼35°) than daily heterotherms (∼25°). Variables of torpor for an average 30 g heterotherm differed significantly between daily heterotherms and hibernators. Average maximum torpor bout duration was >30-fold longer, and mean torpor bout duration >25-fold longer in hibernators. Mean minimum body temperature differed by ∼13°C, and the mean minimum torpor metabolic rate was ∼35% of the basal metabolic rate (BMR) in daily heterotherms but only 6% of BMR in hibernators. Consequently, our analysis strongly supports the view that hibernators

  14. Enhancement of the MODIS Daily Snow Albedo Product

    NASA Technical Reports Server (NTRS)

    Hall, Dorothy K.; Schaaf, Crystal B.; Wang, Zhuosen; Riggs, George A.

    2009-01-01

    The MODIS daily snow albedo product is a data layer in the MOD10A1 snow-cover product that includes snow-covered area and fractional snow cover as well as quality information and other metadata. It was developed to augment the MODIS BRDF/Albedo algorithm (MCD43) that provides 16-day maps of albedo globally at 500-m resolution. But many modelers require daily snow albedo, especially during the snowmelt season when the snow albedo is changing rapidly. Many models have an unrealistic snow albedo feedback in both estimated albedo and change in albedo over the seasonal cycle context, Rapid changes in snow cover extent or brightness challenge the MCD43 algorithm; over a 16-day period, MCD43 determines whether the majority of clear observations was snow-covered or snow-free then only calculates albedo for the majority condition. Thus changes in snow albedo and snow cover are not portrayed accurately during times of rapid change, therefore the current MCD43 product is not ideal for snow work. The MODIS daily snow albedo from the MOD10 product provides more frequent, though less robust maps for pixels defined as "snow" by the MODIS snow-cover algorithm. Though useful, the daily snow albedo product can be improved using a daily version of the MCD43 product as described in this paper. There are important limitations to the MOD10A1 daily snow albedo product, some of which can be mitigated. Utilizing the appropriate per-pixel Bidirectional Reflectance Distribution Functions (BRDFs) can be problematic, and correction for anisotropic scattering must be included. The BRDF describes how the reflectance varies with view and illumination geometry. Also, narrow-to-broadband conversion specific for snow on different surfaces must be calculated and this can be difficult. In consideration of these limitations of MOD10A1, we are planning to improve the daily snow albedo algorithm by coupling the periodic per-pixel snow albedo from MCD43, with daily surface ref|outanoom, In this paper, we

  15. Daily estimates of soil ingestion in children.

    PubMed Central

    Stanek, E J; Calabrese, E J

    1995-01-01

    Soil ingestion estimates play an important role in risk assessment of contaminated sites, and estimates of soil ingestion in children are of special interest. Current estimates of soil ingestion are trace-element specific and vary widely among elements. Although expressed as daily estimates, the actual estimates have been constructed by averaging soil ingestion over a study period of several days. The wide variability has resulted in uncertainty as to which method of estimation of soil ingestion is best. We developed a methodology for calculating a single estimate of soil ingestion for each subject for each day. Because the daily soil ingestion estimate represents the median estimate of eligible daily trace-element-specific soil ingestion estimates for each child, this median estimate is not trace-element specific. Summary estimates for individuals and weeks are calculated using these daily estimates. Using this methodology, the median daily soil ingestion estimate for 64 children participating in the 1989 Amherst soil ingestion study is 13 mg/day or less for 50% of the children and 138 mg/day or less for 95% of the children. Mean soil ingestion estimates (for up to an 8-day period) were 45 mg/day or less for 50% of the children, whereas 95% of the children reported a mean soil ingestion of 208 mg/day or less. Daily soil ingestion estimates were used subsequently to estimate the mean and variance in soil ingestion for each child and to extrapolate a soil ingestion distribution over a year, assuming that soil ingestion followed a log-normal distribution. Images Figure 1. Figure 2. Figure 3. Figure 4. PMID:7768230

  16. The effect of orally administered ranitidine and once-daily or twice-daily orally administered omeprazole on intragastric pH in cats.

    PubMed

    Šutalo, S; Ruetten, M; Hartnack, S; Reusch, C E; Kook, P H

    2015-01-01

    Gastric acid suppressants frequently are used in cats with acid-related gastric disorders. However, it is not known if these drugs effectively increase intragastric pH in cats. To examine the effects of PO administered ranitidine and omeprazole on intragastric pH in cats and to compare the efficacy of once-daily versus twice-daily dosage regimens for omeprazole. Eight domestic shorthair cats. Using a randomized 4-way cross-over design, cats were given enteric-coated omeprazole granules (1.1-1.3 mg/kg q24h and q12h), ranitidine (1.5-2.3 mg/kg q12h), and placebo. Intragastric pH was monitored continuously for 96 hours using the Bravo(™) system, starting on day 4 of treatment, followed by a median washout period of 12 days. Mean percentage of time pH was ≥3 and ≥4 was compared among groups using repeated measures ANOVA. Mean ± SD percentage of time intragastric pH was ≥3 and ≥4 was 67.0 ± 24.0% and 54.6 ± 26.4% for twice-daily omeprazole, 24.4 ± 22.8% and 16.8 ± 19.3% for once-daily omeprazole, 16.5 ± 9.0% and 9.6 ± 5.9% for ranitidine, and 9.4 ± 8.0% and 7.0 ± 6.6% for placebo administration. Twice-daily omeprazole treatment significantly increased intragastric pH, whereas pH after once-daily omeprazole and ranitidine treatments did not differ from that of placebo-treated cats. Only twice-daily PO administered omeprazole significantly suppressed gastric acidity in healthy cats, whereas once-daily omeprazole and standard dosages of ranitidine were not effective acid suppressants in cats. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Internal Medicine.

  17. College students' daily-level reasons for not drinking.

    PubMed

    O'Hara, Ross E; Armeli, Stephen; Tennen, Howard

    2014-07-01

    Motivational models of alcohol use posit opposing approach and avoidance motives related to drinking, yet no micro-longitudinal study of college students has examined avoidance motives [i.e. reasons for not drinking (RND)]. This exploratory study examined daily- and person-level correlates of students' RNDs to identify factors that may inhibit alcohol use. College students (n = 1631; 54% female) participated in a 30-day daily diary study in which they reported RNDs for non-drinking evenings, as well as daily moods, global drinking motives and alcohol expectancies. Daily sadness was positively associated with not drinking due to having nobody with whom to drink but negatively associated with not drinking due to school work. Daily anxiety was negatively associated with not drinking due to lack of desire and positively associated with not drinking due to habit or having school or job responsibilities. At the person level, multiple RNDs were associated with both coping and conformity motives (but not social or enhancement motives), as well as positive (but not negative) alcohol expectancies. Results demonstrate the complexity of modelling mood-drinking contingencies proposed by motivational theories of alcohol use. Distinct moods may promote or inhibit drinking through various pathways, which could help explain the weak associations between daily mood and drinking level observed in previous studies. Measuring reasons both for and against drinking in micro-longitudinal studies (e.g. daily diaries) is recommended to better understand the processes underlying alcohol use and to inform future prevention efforts. © 2014 Australasian Professional Society on Alcohol and other Drugs.

  18. Acid-suppressive efficacy of a reduced dosage of rabeprazole: comparison of 10 mg twice daily rabeprazole with 20 mg twice daily rabeprazole, 30 mg twice daily lansoprazole, and 20 mg twice daily omeprazole by 24-hr intragastric pH-metry.

    PubMed

    Shimatani, Tomohiko; Inoue, Masaki; Kuroiwa, Tomoko; Xu, Jing; Tazuma, Susumu; Horikawa, Yoko; Nakamura, Masuo

    2005-07-01

    Rabeprazole achieves more potent acid suppression than other proton pump inhibitors. Therefore it is administered at reduced as well as high dosages in eradication therapy for Helicobacter pylori; however, there is incomplete assessment of the efficacy of a reduced dosage of rabeprazole as might be employed in therapy. In this study, we evaluated acid-suppressive efficacy of a reduced dosage of rabeprazole on day 7 by 24-hr pH-metry in 10 healthy male cytochrome P-450 2C19 extensive metabolizers without Helicobacterpylori infection and compared the results with those of high dosages of rabeprazole, lansoprazole, and omeprazole. Median intragastric pH value, pH >3 holding time ratio (pH>3HT), pH>4HT, pH>5HT, pH>6HT, and pH>7HT for 24 hr with rabeprazole, 10 mg twice daily, were not significantly different from those of rabeprazole, 20 mg twice daily, lansoprazole, 30 mg twice daily, and omeprazole, 20 mg twice daily. In conclusion, for acid-suppressive efficacy, a reduced dosage of rabeprazole is comparable to high dosages of rabeprazole, lansoprazole, and omeprazole.

  19. Increased medication compliance of liver transplant patients switched from a twice-daily to a once-daily tacrolimus-based immunosuppressive regimen.

    PubMed

    Eberlin, M; Otto, G; Krämer, I

    2013-01-01

    Compliance with immunosuppressive therapy plays a major role in the long-term success of liver transplantation. Thus, the development of strategies to promote compliance of liver transplant patients and its evaluation over time are of particular interest. The main objective of this study was to compare medication compliance rates among liver transplant patients over time after transplantation where switched from a twice- to once-daily tacrolimus-based regimen. Sixty-five liver transplant patients being administered tacrolimus-based therapy were classified into three subgroups with regard to time posttransplantation. Medication compliance with tacrolimus-based therapy was measured using an electronic medication event monitoring system over a 12-month period: for 6 months tacrolimus was administered twice-daily and for 6 months, once-daily. Dosing, taking, and timing compliance as well as drug holidays were compared intra-individually between twice- and once-daily intake and among the three subgroups. In addition, patient compliance and quality of life were evaluated using questionnaires. A per protocol analysis of electronically obtained data showed 63 patients to be eligible. The resulting dosing, taking, and timing compliance rates of the patients were higher during the once-daily dosing period. No significant differences in compliance rates with tacrolimus therapy were observed among three subgroups independent of the dosing regimen. More patients failed the correct timing of the evening compared to the morning dose. Missing doses occurred particularly during weekends. Compliance variables measured by questionnaires (Morisky score, self-report, Medication Experience Scale for Immunosuppressants (MESI) score) and the Hospital Anxiety and Depression Scale score were similar in the two dosing periods. The short-form health survey (SF-36) score was higher with once-daily intake. The high measured compliance rates did not vary significantly dependent upon the time

  20. Adding value to daily chest X-rays in the ICU through education, restricted daily orders and indication-based prompting.

    PubMed

    Keveson, Benjamin; Clouser, Ryan D; Hamlin, Mark P; Stevens, Pamela; Stinnett-Donnelly, Justin M; Allen, Gilman B

    2017-01-01

    Chest X-rays (CXRs) are traditionally obtained daily in all patients on invasive mechanical ventilation (IMV) in the intensive care unit (ICU). We sought to reduce overutilisation of CXRs obtained in the ICU, using a multifaceted intervention to eliminate automated daily studies. We first educated ICU staff about the low diagnostic yield of automated daily CXRs, then removed the 'daily' option from the electronic health records-based ordering system, and added a query (CXR indicated or not indicated) to the ICU daily rounding checklist to prompt a CXR order when clinically warranted. We built a report from billing codes, focusing on all CXRs obtained on IMV census days in the medical (MICU) and surgical (SICU) ICUs, excluding the day of admission and days that a procedure warranting CXR was performed. This generated the number of CXRs obtained every 1000 'included' ventilator days (IVDs), the latter defined as not having an 'absolute' clinical indication for CXR. The average monthly number of CXRs on an IVD decreased from 919±90 (95% CI 877 to 963) to 330±87 (95% CI 295 to 354) per 1000 IVDs in the MICU, and from 995±69 (95% CI 947 to 1055) to 649±133 (95% CI 593 to 697) in the SICU. This yielded an estimated 1830 to 2066 CXRs avoided over 2 years and an estimated annual savings of $191 600 to $224 200. There was no increase in reported adverse events. ICUs can safely transition to a higher value strategy of indication-based chest imaging by educating staff, eliminating the 'daily' order option and adding a simplified prompt to avoid missing clinically indicated CXRs.

  1. Simulating Daily and Sub-daily Water Flow in Large, Semi-arid Watershed Using SWAT: A Case Study of Nueces River Basin, Texas

    NASA Astrophysics Data System (ADS)

    Bassam, S.; Ren, J.

    2015-12-01

    Runoff generated during heavy rainfall imposes quick, but often intense, changes in the flow of streams, which increase the chance of flash floods in the vicinity of the streams. Understanding the temporal response of streams to heavy rainfall requires a hydrological model that considers meteorological, hydrological, and geological components of the streams and their watersheds. SWAT is a physically-based, semi-distributed model that is capable of simulating water flow within watersheds with both long-term, i.e. annually and monthly, and short-term (daily and sub-daily) time scales. However, the capability of SWAT in sub-daily water flow modeling within large watersheds has not been studied much, compare to long-term and daily time scales. In this study we are investigating the water flow in a large, semi-arid watershed, Nueces River Basin (NRB) with the drainage area of 16950 mi2 located in South Texas, with daily and sub-daily time scales. The objectives of this study are: (1) simulating the response of streams to heavy, and often quick, rainfall, (2) evaluating SWAT performance in sub-daily modeling of water flow within a large watershed, and (3) examining means for model performance improvement during model calibration and verification based on results of sensitivity and uncertainty analysis. The results of this study can provide important information for water resources planning during flood seasons.

  2. Efficacy and safety of empagliflozin twice daily versus once daily in patients with type 2 diabetes inadequately controlled on metformin: a 16-week, randomized, placebo-controlled trial.

    PubMed

    Ross, S; Thamer, C; Cescutti, J; Meinicke, T; Woerle, H J; Broedl, U C

    2015-07-01

    Patients with type 2 diabetes mellitus (T2DM) with a glycated haemoglobin (HbA1c) level ≥7 and ≤10% were randomized to receive empagliflozin 12.5 mg twice daily (n = 219), 25 mg once daily (n = 218), 5 mg twice daily (n = 219) or 10 mg once daily (n = 220), or placebo (n = 107) as add-on to stable-dose metformin immediate release (IR) twice daily for 16 weeks. The primary endpoint was change from baseline in HbA1c at week 16. At week 16, change from baseline in HbA1c with empagliflozin twice daily was non-inferior to empagliflozin once daily and vice versa. The adjusted mean (95% confidence interval) difference in change from baseline in HbA1c with empagliflozin 12.5 mg twice daily versus 25 mg once daily was -0.11% (-0.26, 0.03), and with empagliflozin 5 mg twice daily versus 10 mg once daily it was -0.02% (-0.16, 0.13). All empagliflozin regimens were well tolerated; thus, when used as add-on to metformin IR in patients with T2DM, the therapeutic effect of empagliflozin twice-daily and once-daily regimens can be considered equivalent. © 2015 John Wiley & Sons Ltd.

  3. 19 CFR 159.35 - Certified daily rate.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TREASURY (CONTINUED) LIQUIDATION OF DUTIES Conversion of Foreign Currency § 159.35 Certified daily rate. The daily buying rate of foreign currency which is determined by the Federal Reserve Bank of New York and certified to the Secretary of the Treasury in accordance with 31 U.S.C. 5151(e) shall be used for...

  4. New daily persistent headache.

    PubMed

    Evans, Randolph W

    2003-08-01

    New daily persistent headache (NDPH), which is the acute onset of headache within 3 days and is persistent for 15 days or more each month for at least 3 months, is a predominantly female heterogeneous subtype of chronic daily headache, typically with migraine features of unknown etiology. NDPH may be a presentation of other primary headaches such as new onset migraine, tension, or benign thunderclap headache. The headaches can be difficult to treat. The diagnosis is one of excluding the many secondary types or NDPH mimics, which is especially critical early in the course of the disease when a secondary etiology is more likely. NDPH mimics include postmeningitis headache, NDPH with medication rebound, neoplasms, temporal arteritis, chronic meningitis, chronic subdural hematoma, post-traumatic headaches, sphenoid sinusitis, hypertension, subarachnoid hemorrhage, low cerebrospinal fluid pressure syndrome, cervical artery dissections, pseudotumor cerebri without papilledema, and cerebral venous thrombosis.

  5. Conversion From Twice-Daily Tacrolimus Capsules to Once-Daily Extended-Release Tacrolimus (LCPT): A Phase 2 Trial of Stable Renal Transplant Recipients

    PubMed Central

    Gaber, A. Osama; Alloway, Rita R.; Bodziak, Kenneth; Kaplan, Bruce; Bunnapradist, Suphamai

    2013-01-01

    Background LCP-Tacro is an extended-release formulation of tacrolimus designed for once-daily dosing. Phase 1 studies demonstrated greater bioavailability to twice-daily tacrolimus capsules and no new safety concerns. Methods In this phase 2 study, adult stable kidney transplant patients on tacrolimus capsules (Prograf) twice-daily were converted to tacrolimus tablets (LCP-Tacro) once-daily; patients continued on LCP-Tacro once-daily for days 8 to 21; trough levels were to be maintained between 5 and 15 ng/mL; 24-hr pharmacokinetic assessments were done on days 7 (baseline pre-switch), 14, and 21. Results Forty-seven patients completed LCP-Tacro dosing per protocol. The mean conversion ratio was 0.71. Pharmacokinetic data demonstrated consistent exposure (AUC) at the lower conversion dose. Cmax (P=0.0001), Cmax/Cmin ratio (P<0.001), percent fluctuation (P<0.0001), and swing (P=0.0004) were significantly lower and Tmax significantly (P<0.001) longer for LCP-Tacro versus Prograf. AUC24 and Cmin correlation coefficients after 7 and 14 days of therapy were 0.86 or more, demonstrating a robust correlation between LCP-Tacro tacrolimus exposure and trough levels. There were three serious adverse events; none were related to study drug and all were resolved. Conclusions Stable kidney transplant patients can be safely converted from Prograf twice-daily to LCP-Tacro. The greater bioavailability of LCP-Tacro allows for once-daily dosing and similar (AUC) exposure at a dose approximately 30% less than the total daily dose of Prograf. LCP-Tacro displays flatter kinetics characterized by significantly lower peak-trough fluctuations. PMID:23715050

  6. Association between Daily Hospital Outpatient Visits for Accidents and Daily Ambient Air Temperatures in an Industrial City.

    PubMed

    Chau, Tang-Tat; Wang, Kuo-Ying

    2016-01-01

    An accident is an unwanted hazard to a person. However, accidents occur. In this work, we search for correlations between daily accident rates and environmental factors. To study daily hospital outpatients who were admitted for accidents during a 5-year period, 2007-2011, we analyzed data regarding 168,366 outpatients using univariate regression models; we also used multivariable regression models to account for confounding factors. Our analysis indicates that the number of male outpatients admitted for accidents was approximately 1.31 to 1.47 times the number of female outpatients (P < 0.0001). Of the 12 parameters (regarding air pollution and meteorology) considered, only daily temperature exhibited consistent and significant correlations with the daily number of hospital outpatient visits for accidents throughout the 5-year analysis period. The univariate regression models indicate that older people (greater than 66 years old) had the fewest accidents per 1-degree increase in temperature, followed by young people (0-15 years old). Middle-aged people (16-65 years old) were the group of outpatients that were more prone to accidents, with an increase in accident rates of 0.8-1.2 accidents per degree increase in temperature. The multivariable regression models also reveal that the temperature variation was the dominant factor in determining the daily number of outpatient visits for accidents. Our further multivariable model analysis of temperature with respect to air pollution variables show that, through the increases in emissions and concentrations of CO, photochemical O3 production and NO2 loss in the ambient air, increases in vehicular emissions are associated with increases in temperatures. As such, increases in hospital visits for accidents are related to vehicular emissions and usage. This finding is consistent with clinical experience which shows about 60% to 80% of accidents are related to traffic, followed by accidents occurred in work place.

  7. Association between Daily Hospital Outpatient Visits for Accidents and Daily Ambient Air Temperatures in an Industrial City

    PubMed Central

    Chau, Tang-Tat; Wang, Kuo-Ying

    2016-01-01

    An accident is an unwanted hazard to a person. However, accidents occur. In this work, we search for correlations between daily accident rates and environmental factors. To study daily hospital outpatients who were admitted for accidents during a 5-year period, 2007–2011, we analyzed data regarding 168,366 outpatients using univariate regression models; we also used multivariable regression models to account for confounding factors. Our analysis indicates that the number of male outpatients admitted for accidents was approximately 1.31 to 1.47 times the number of female outpatients (P < 0.0001). Of the 12 parameters (regarding air pollution and meteorology) considered, only daily temperature exhibited consistent and significant correlations with the daily number of hospital outpatient visits for accidents throughout the 5-year analysis period. The univariate regression models indicate that older people (greater than 66 years old) had the fewest accidents per 1-degree increase in temperature, followed by young people (0–15 years old). Middle-aged people (16–65 years old) were the group of outpatients that were more prone to accidents, with an increase in accident rates of 0.8–1.2 accidents per degree increase in temperature. The multivariable regression models also reveal that the temperature variation was the dominant factor in determining the daily number of outpatient visits for accidents. Our further multivariable model analysis of temperature with respect to air pollution variables show that, through the increases in emissions and concentrations of CO, photochemical O3 production and NO2 loss in the ambient air, increases in vehicular emissions are associated with increases in temperatures. As such, increases in hospital visits for accidents are related to vehicular emissions and usage. This finding is consistent with clinical experience which shows about 60% to 80% of accidents are related to traffic, followed by accidents occurred in work place. PMID

  8. Prevalence and epidemiology of intestinal parasitism, as revealed by three distinct techniques in an endemic area in the Brazilian Amazon

    PubMed Central

    Valverde, J G; Gomes-Silva, A; De Carvalho Moreira, C J; Leles De Souza, D; Jaeger, L H; Martins, P P; Meneses, V F; Bóia, M N; Carvalho-Costa, F A

    2011-01-01

    This survey aims to estimate the prevalence of intestinal parasitic infections in Santa Isabel do Rio Negro, Amazonian Brazil, through three distinct techniques, correlating the prevalence rates with family income and age groups as well as assessing the household clustering of infections. Prevalence rates were assessed through Graham (n = 113), Baermann-Moraes (n = 232) and Ritchie (n = 463) methods. The Graham method was adopted only for children under 5 years old, 15% of whom were positive for Enterobius vermicularis. By the Baermann-Moraes technique, 5.6% of the samples were positive for Strongyloides stercoralis larvae. The Ritchie technique disclosed the following results: Ascaris lumbricoides (26%), Trichuris trichiura (22.5%), hookworms (9.5%), Entamoeba histolytica/Entamoeba dispar (25.3%), Giardia lamblia (12.5%) and E. vermicularis (0.6%). Children aged 5–14 years presented the highest prevalence for pathogenic parasites. Giardiasis and hookworm infection rates were inversely related to family income. The presence of positive contacts in the same household substantially increased the risk of infection by enteric parasites: odds ratio (OR) = 2.70, 95% confidence interval (CI) = 1.69–4.29 for ascariasis; OR = 2.17, 95% CI = 1.34–3.51 for trichuriasis; OR = 2.13, 95% CI = 1.08–4.17 for hookworm disease; OR = 3.42, 95% CI = 1.86–6.30 for giardiasis; and OR = 2.16, 95% CI = 1.35–3.47 for amoebiasis, supporting infection clustering in the home. Intestinal parasitoses are extremely frequent in the studied area, and routine methods for diagnosis may underestimate the prevalence of enterobiasis and strongyloidiasis. PMID:22117850

  9. Effect of Poor Access to Water and Sanitation As Risk Factors for Soil-Transmitted Helminth Infection: Selectiveness by the Infective Route.

    PubMed

    Echazú, Adriana; Bonanno, Daniela; Juarez, Marisa; Cajal, Silvana P; Heredia, Viviana; Caropresi, Silvia; Cimino, Ruben O; Caro, Nicolas; Vargas, Paola A; Paredes, Gladys; Krolewiecki, Alejandro J

    2015-09-01

    Soil-transmitted helminth (STH) infections are a public health problem in resource-limited settings worldwide. Chronic STH infection impairs optimum learning and productivity, contributing to the perpetuation of the poverty-disease cycle. Regular massive drug administration (MDA) is the cardinal recommendation for its control; along with water, sanitation and hygiene (WASH) interventions. The impact of joint WASH interventions on STH infections has been reported; studies on the independent effect of WASH components are needed to contribute with the improvement of current recommendations for the control of STH. The aim of this study is to assess the association of lacking access to water and sanitation with STH infections, taking into account the differences in route of infection among species and the availability of adequate water and sanitation at home. Cross-sectional study, conducted in Salta province, Argentina. During a deworming program that enrolled 6957 individuals; 771 were randomly selected for stool/serum sampling for parasitological and serological diagnosis of STH. Bivariate stratified analysis was performed to explore significant correlations between risk factors and STH infections grouped by mechanism of entry as skin-penetrators (hookworms and Strongyloides stercoralis) vs. orally-ingested (Ascaris lumbricoides and Trichuris trichiura). After controlling for potential confounders, unimproved sanitation was significantly associated with increased odds of infection of skin-penetrators (adjusted odds ratio [aOR] = 3.9; 95% CI: 2.6-5.9). Unimproved drinking water was significantly associated with increased odds of infection of orally-ingested (aOR = 2.2; 95% CI: 1.3-3.7). Lack of safe water and proper sanitation pose a risk of STH infections that is distinct according to the route of entry to the human host used by each of the STH species. Interventions aimed to improve water and sanitation access should be highlighted in the recommendations for the

  10. The Caenorhabditis elegans DAF-12 nuclear receptor: structure, dynamics, and interaction with ligands.

    PubMed

    Alvarez, Lautaro D; Mañez, Pau Arroyo; Estrin, Darío A; Burton, Gerardo

    2012-07-01

    A structure for the ligand binding domain (LBD) of the DAF-12 receptor from Caenorhabditis elegans was obtained from the X-ray crystal structure of the receptor LBD from Strongyloides stercoralis bound to (25R)-Δ(7)-dafachronic acid (DA) (pdb:3GYU). The model was constructed in the presence of the ligand using a combination of Modeller, Autodock, and molecular dynamics (MD) programs, and then its dynamical behavior was studied by MD. A strong ligand binding mode (LBM) was found, with the three arginines in the ligand binding pocket (LBP) contacting the C-26 carboxylate group of the DA. The quality of the ceDAF-12 model was then evaluated by constructing several ligand systems for which the experimental activity is known. Thus, the dynamical behavior of the ceDAF-12 complex with the more active (25S)-Δ(7)-DA showed two distinct binding modes, one of them being energetically more favorable compared with the 25R isomer. Then the effect of the Arg564Cys and Arg598Met mutations on the (25R)-Δ(7)-DA binding was analyzed. The MD simulations showed that in the first case the complex was unstable, consistent with the lack of transactivation activity of (25R)-Δ(7)-DA in this mutant. Instead, in the case of the Arg598Met mutant, known to produce a partial loss of activity, our model predicted smaller effects on the LBM with a more stable MD trajectory. The model also showed that removal of the C-25 methyl does not impede the simultaneous strong interaction of the carboxylate with the three arginines, predicting that 27-nor-DAs are putative ceDAF-12 ligands. Copyright © 2012 Wiley Periodicals, Inc.

  11. ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Soluble immune effector molecules [II]: agents targeting interleukins, immunoglobulins and complement factors).

    PubMed

    Winthrop, K L; Mariette, X; Silva, J T; Benamu, E; Calabrese, L H; Dumusc, A; Smolen, J S; Aguado, J M; Fernández-Ruiz, M

    2018-06-01

    The present review is part of the ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies. To review, from an Infectious Diseases perspective, the safety profile of agents targeting interleukins, immunoglobulins and complement factors and to suggest preventive recommendations. Computer-based MEDLINE searches with MeSH terms pertaining to each agent or therapeutic family. Patients receiving interleukin-1 (IL-1) -targeted (anakinra, canakinumab or rilonacept) or IL-5-targeted (mepolizumab) agents have a moderate risk of infection and no specific prevention strategies are recommended. The use of IL-6/IL-6 receptor-targeted agents (tocilizumab and siltuximab) is associated with a risk increase similar to that observed with anti-tumour necrosis factor-α agents. IL-12/23-targeted agents (ustekinumab) do not seem to pose a meaningful risk of infection, although screening for latent tuberculosis infection may be considered and antiviral prophylaxis should be given to hepatitis B surface antigen-positive patients. Therapy with IL-17-targeted agents (secukinumab, brodalumab and ixekizumab) may result in the development of mild-to-moderate mucocutaneous candidiasis. Pre-treatment screening for Strongyloides stercoralis and other geohelminths should be considered in patients who come from areas where these are endemic who are receiving IgE-targeted agents (omalizumab). C5-targeted agents (eculizumab) are associated with a markedly increased risk of infection due to encapsulated bacteria, particularly Neisseria spp. Meningococcal vaccination and chemoprophylaxis must be administered 2-4 weeks before initiating eculizumab. Patients with high-risk behaviours and their partners should also be screened for gonococcal infection. Preventive strategies are particularly encouraged to minimize the occurrence of neisserial infection associated with eculizumab. Copyright © 2018 European Society of Clinical

  12. Baseline health situation of communities affected by the Nam Theun 2 hydroelectric project in central Lao PDR and indicators for monitoring.

    PubMed

    Erlanger, Tobias E; Sayasone, Somphou; Krieger, Gary R; Kaul, Surinder; Sananikhom, Pany; Tanner, Marcel; Odermatt, Peter; Utzinger, Jurg

    2008-06-01

    Hydroelectric projects offer opportunities for infrastructure development and economic growth; yet, if not well designed, implemented and operated, they have the potential to negatively affect the health and well-being of local and distant downstream communities. Remote rural populations are particularly vulnerable to the sudden influx of men, materials and money, and associated population mixing that accompany project construction phases. Two large-scale baseline health surveys, carried out in 2001/2002 in two communities that were affected by the Nam Theun 2 hydroelectric project in central Lao PDR, were analysed. For the population to be resettled on the Nakai plateau it was observed that access to clean water and basic sanitation facilities was lacking. Faecal examinations revealed a high infection prevalence for Ascaris lumbricoides (67.7%), but relatively low prevalences for hookworm (9.7%), Taenia spp. (4.8%), Enterobius vermicularis (4.4%), Trichuris trichiura (3.9%), Strongyloides stercoralis (1.4%) and Opisthorchis viverrini (0.9%). For the population in the Xe Bang Fai downstream area, rapid diagnostic tests for malaria carried out in the rainy season found a prevalence below 1%, which might be explained by the complete coverage of households with insecticide-treated nets (99.8%). Anthropometric measurements in both populations suggest that wasting, stunting and underweight in under 5-year-old children were moderate to high; 15.9-17.5%, 40.4-55.7% and 35.8-55.7%, respectively. One out of six individuals aged above 14 years were malnourished, most likely as a result of early childhood wasting. Moderate anaemia, assessed by age- and sex-specific haemoglobin levels, was present in 43.8% (Nakai) and 54.9% of the individuals examined (Xe Bang Fai). Several indicators were extracted that can be utilised for monitoring changes in health, well-being and equity, as the project is implemented and operated.

  13. Effect of Poor Access to Water and Sanitation As Risk Factors for Soil-Transmitted Helminth Infection: Selectiveness by the Infective Route

    PubMed Central

    Echazú, Adriana; Bonanno, Daniela; Juarez, Marisa; Cajal, Silvana P.; Heredia, Viviana; Caropresi, Silvia; Cimino, Ruben O.; Caro, Nicolas; Vargas, Paola A.; Paredes, Gladys; Krolewiecki, Alejandro J.

    2015-01-01

    Background Soil-transmitted helminth (STH) infections are a public health problem in resource-limited settings worldwide. Chronic STH infection impairs optimum learning and productivity, contributing to the perpetuation of the poverty-disease cycle. Regular massive drug administration (MDA) is the cardinal recommendation for its control; along with water, sanitation and hygiene (WASH) interventions. The impact of joint WASH interventions on STH infections has been reported; studies on the independent effect of WASH components are needed to contribute with the improvement of current recommendations for the control of STH. The aim of this study is to assess the association of lacking access to water and sanitation with STH infections, taking into account the differences in route of infection among species and the availability of adequate water and sanitation at home. Methods and Findings Cross-sectional study, conducted in Salta province, Argentina. During a deworming program that enrolled 6957 individuals; 771 were randomly selected for stool/serum sampling for parasitological and serological diagnosis of STH. Bivariate stratified analysis was performed to explore significant correlations between risk factors and STH infections grouped by mechanism of entry as skin-penetrators (hookworms and Strongyloides stercoralis) vs. orally-ingested (Ascaris lumbricoides and Trichuris trichiura). After controlling for potential confounders, unimproved sanitation was significantly associated with increased odds of infection of skin-penetrators (adjusted odds ratio [aOR] = 3.9; 95% CI: 2.6–5.9). Unimproved drinking water was significantly associated with increased odds of infection of orally-ingested (aOR = 2.2; 95% CI: 1.3–3.7). Conclusions Lack of safe water and proper sanitation pose a risk of STH infections that is distinct according to the route of entry to the human host used by each of the STH species. Interventions aimed to improve water and sanitation access should

  14. Intestinal parasite infections in a rural community of Rio de Janeiro (Brazil): Prevalence and genetic diversity of Blastocystis subtypes.

    PubMed

    Barbosa, Carolina Valença; Barreto, Magali Muniz; Andrade, Rosemary de Jesus; Sodré, Fernando; d'Avila-Levy, Claudia Masini; Peralta, José Mauro; Igreja, Ricardo Pereira; de Macedo, Heloisa Werneck; Santos, Helena Lucia Carneiro

    2018-01-01

    Intestinal parasitic infections are considered a serious public health problem and widely distributed worldwide, mainly in urban and rural environments of tropical and subtropical countries. Globally, soil-transmitted helminths and protozoa are the most common intestinal parasites. Blastocystis sp. is a highly prevalent suspected pathogenic protozoan, and considered an unusual protist due to its significant genetic diversity and host plasticity. A total of 294 stool samples were collected from inhabitants of three rural valleys in Rio de Janeiro, Brazil. The stool samples were evaluated by parasitological methods, fecal culture, nested PCR and PCR/Sequencing. Overall prevalence by parasitological analyses was 64.3% (189 out of 294 cases). Blastocystis sp. (55.8%) was the most prevalent, followed by Endolimax nana (18.7%), Entamoeba histolytica complex (7.1%), hookworm infection (7.1%), Entomoeba coli (5.8%), Giardia intestinalis (4.1%), Iodamoeba butchilii (1.0%), Trichuris trichiura (1.0%), Pentatrichomonas hominis (0.7%), Enterobius vermicularis (0.7%), Ascaris lumbricoides (0.7%) and Strongyloides stercoralis (0.7%). Prevalence of IPIs was significantly different by gender. Phylogenetic analysis of Blastocystis sp. and BLAST search revealed five different subtypes: ST3 (34.0%), ST1 (27.0%), ST2 (27.0%), ST4 (3.5%), ST8 (7.0%) and a non-identified subtype. Our findings demonstrate that intestinal parasite infection rates in rural areas of the Sumidouro municipality of Rio de Janeiro, Brazil are still high and remain a challenge to public health. Moreover, our data reveals significant genetic heterogeneity of Blastocystis sp. subtypes and a possible novel subtype, whose confirmation will require additional data. Our study contributes to the understanding of potential routes of transmission, epidemiology, and genetic diversity of Blastocystis sp. in rural areas both at a regional and global scale.

  15. High Prevalence of Persistent Parasitic Infections in Foreign-Born, HIV-Infected Persons in the United States

    PubMed Central

    Hochberg, Natasha S.; Moro, Ruth N.; Sheth, Anandi N.; Montgomery, Susan P.; Steurer, Frank; McAuliffe, Isabel T.; Wang, Yun F.; Armstrong, Wendy; Rivera, Hilda N.; Lennox, Jeffrey L.; Franco-Paredes, Carlos

    2011-01-01

    Background Foreign-born, HIV-infected persons are at risk for sub-clinical parasitic infections acquired in their countries of origin. The long-term consequences of co-infections can be severe, yet few data exist on parasitic infection prevalence in this population. Methodology/Principal Findings This cross-sectional study evaluated 128 foreign-born persons at one HIV clinic. We performed stool studies and serologic testing for strongyloidiasis, schistosomiasis, filarial infection, and Chagas disease based on the patient's country of birth. Eosinophilia and symptoms were examined as predictors of helminthic infection. Of the 128 participants, 86 (67%) were male, and the median age was 40 years; 70 were Mexican/Latin American, 40 African, and 18 from other countries or regions. Strongyloides stercoralis antibodies were detected in 33/128 (26%) individuals. Of the 52 persons from schistosomiasis-endemic countries, 15 (29%) had antibodies to schistosome antigens; 7 (47%) had antibodies to S. haematobium, 5 (33%) to S. mansoni, and 3 (20%) to both species. Stool ova and parasite studies detected helminths in 5/85 (6%) persons. None of the patients tested had evidence of Chagas disease (n = 77) or filarial infection (n = 52). Eosinophilia >400 cells/mm3 was associated with a positive schistosome antibody test (OR 4.5, 95% CI 1.1–19.0). The only symptom significantly associated with strongyloidiasis was weight loss (OR 3.1, 95% CI 1.4–7.2). Conclusions/Significance Given the high prevalence of certain helminths and the potential lack of suggestive symptoms and signs, selected screening for strongyloidiasis and schistosomiasis or use of empiric antiparasitic therapy may be appropriate among foreign-born, HIV-infected patients. Identifying and treating helminth infections could prevent long-term complications. PMID:21532747

  16. A cross-sectional study on intestinal parasitic infections in rural communities, northeast Thailand.

    PubMed

    Boonjaraspinyo, Sirintip; Boonmars, Thidarut; Kaewsamut, Butsara; Ekobol, Nuttapon; Laummaunwai, Porntip; Aukkanimart, Ratchadawan; Wonkchalee, Nadchanan; Juasook, Amornrat; Sriraj, Pranee

    2013-12-01

    Despite the existence of effective anthelmintics, parasitic infections remain a major public health problem in Southeast Asia, including Thailand. In rural communities, continuing infection is often reinforced by dietary habits that have a strong cultural basis and by poor personal hygiene and sanitation. This study presents a survey of the prevalence of intestinal parasitic infections among the people in rural Thailand. The community-based cross-sectional study was conducted in villages in Khon Kaen Province, northeastern Thailand, from March to August 2013. A total of 253 stool samples from 102 males and 140 females, aged 2-80 years, were prepared using formalin-ethyl acetate concentration methods and examined using light microscopy. Ninety-four individuals (37.2%) were infected with 1 or more parasite species. Presence of parasitic infection was significantly correlated with gender (P=0.001); nearly half of males in this survey (49.0%) were infected. Older people had a higher prevalence than younger members of the population. The most common parasite found was Opisthorchis viverrini (26.9%), followed by Strongyloides stercoralis (9.5%), Taenia spp. (1.6%), echinostomes (0.4%), and hookworms (0.4%). The prevalence of intestinal protozoa was Blastocystis hominis 1.6%, Entamoeba histolytica 0.8%, Entamoeba coli 0.8%, Balantidium coli 0.4%, Iodamoeba bütschlii 0.4%, and Sarcocystis hominis 0.4%. Co-infections of various helminths and protozoa were present in 15.9% of the people. The present results show that the prevalence of parasitic infections in this region is still high. Proactive education about dietary habits, personal hygiene, and sanitation should be provided to the people in this community to reduce the prevalence of intestinal parasite infections. Moreover, development of policies and programs to control parasites is needed.

  17. Geospatial distribution of intestinal parasitic infections in Rio de Janeiro (Brazil) and its association with social determinants

    PubMed Central

    Faria, Clarissa Perez; Zanini, Graziela Maria; Dias, Gisele Silva; da Silva, Sidnei; de Freitas, Marcelo Bessa; Almendra, Ricardo; Santana, Paula; Sousa, Maria do Céu

    2017-01-01

    Background Intestinal parasitic infections remain among the most common infectious diseases worldwide. This study aimed to estimate their prevalence and provide a detailed analysis of geographical distribution of intestinal parasites in the metropolitan region of Rio de Janeiro, considering demographic, socio-economic, and epidemiological contextual factors. Methods/Principal findings The cross-section survey was conducted among individuals attending the Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ, RJ) during the period from April 2012 to February 2015. Stool samples were collected and processed by sedimentation, flotation, Kato-Katz, Baermann-Moraes and Graham methods, iron haematoxylin staining and safranin staining. Of the 3245 individuals analysed, 569 (17.5%) were infected with at least one parasite. The most common protozoa were Endolimax nana (28.8%), Entamoeba coli (14.8%), Complex Entamoeba histolytica/Entamoeba dispar (13.5%), Blastocystis hominis (12.7%), and Giardia lamblia (8.1%). Strongyloides stercoralis (4.3%), Schistosoma mansoni (3.3%), Ascaris lumbricoides (1.6%), and hookworms (1.5%) were the most frequent helminths. There was a high frequency of contamination by protozoa (87%), and multiple infections were observed in 141 participants (24.8%). A positive association between age (young children) and gender (male) with intestinal parasites was observed. Geospatial distribution of the detected intestinal parasitic infections was not random or homogeneous, but was influenced by socioeconomic conditions (through the material deprivation index (MDI)). Participants classified in the highest levels of deprivation had higher risk of having intestinal parasites. Conclusions/Significance This study provides the first epidemiological information on the prevalence and distribution of intestinal parasitic infections in the Rio de Janeiro metropolitan area. Intestinal parasites, especially protozoa, are highly prevalent, indicating that

  18. The Risk of Chronic Gastrointestinal Disorders Following Acute Infection with Intestinal Parasites

    PubMed Central

    Blitz, Jason; Riddle, Mark S.; Porter, Chad K.

    2018-01-01

    Background: Infectious gastroenteritis (IGE) is caused by numerous bacterial, viral, and parasitic pathogens. A history of IGE has been shown in previous studies to increase the risk of developing chronic gastrointestinal disorders and other chronic conditions. As bacteria and viruses represent the majority of pathogen-specific causes of IGE, post-infectious studies have primarily focused on these organisms. The objective of this study was to investigate an association between a history of parasite-associated IGE and the subsequent development of chronic post-infectious gastrointestinal and non-gastrointestinal disorders in a military population. Methods: International Classification of Diseases, 9th Revision Clinical Modification (ICD-9-CM) diagnostic coding data for primary exposures and outcomes were obtained for a retrospective cohort study of active component military personnel from 1998 to 2013. Exposed subjects consisted of individuals with documented infection with one of ten parasitic pathogens. Unexposed subjects were matched to exposed subjects on demographic and operational deployment history parameters. Adjusted odds ratios (aORs) were estimated using logistic regression for several chronic disorders previously shown to be associated with a history of IGE. Results: A total of 896 subjects with a parasitic exposure were matched to 3681 unexposed subjects for multivariate regression analysis. Individuals infected with Balantidium coli, Ascaris lumbricoides, Strongyloides stercoralis, Necator americanus/Ancylostoma duodenale, and Taenia spp. had higher aOR for development of several chronic gastrointestinal disorders when compared with unexposed subjects after controlling for various covariates. Conclusion: We found that parasite-associated enteric infection increases the risk of development of post-infectious chronic gastrointestinal disorders in a military population. These results require confirmation in similar populations and in the developing world

  19. A Cross-Sectional Study on Intestinal Parasitic Infections in Rural Communities, Northeast Thailand

    PubMed Central

    Boonjaraspinyo, Sirintip; Kaewsamut, Butsara; Ekobol, Nuttapon; Laummaunwai, Porntip; Aukkanimart, Ratchadawan; Wonkchalee, Nadchanan; Juasook, Amornrat; Sriraj, Pranee

    2013-01-01

    Despite the existence of effective anthelmintics, parasitic infections remain a major public health problem in Southeast Asia, including Thailand. In rural communities, continuing infection is often reinforced by dietary habits that have a strong cultural basis and by poor personal hygiene and sanitation. This study presents a survey of the prevalence of intestinal parasitic infections among the people in rural Thailand. The community-based cross-sectional study was conducted in villages in Khon Kaen Province, northeastern Thailand, from March to August 2013. A total of 253 stool samples from 102 males and 140 females, aged 2-80 years, were prepared using formalin-ethyl acetate concentration methods and examined using light microscopy. Ninety-four individuals (37.2%) were infected with 1 or more parasite species. Presence of parasitic infection was significantly correlated with gender (P=0.001); nearly half of males in this survey (49.0%) were infected. Older people had a higher prevalence than younger members of the population. The most common parasite found was Opisthorchis viverrini (26.9%), followed by Strongyloides stercoralis (9.5%), Taenia spp. (1.6%), echinostomes (0.4%), and hookworms (0.4%). The prevalence of intestinal protozoa was Blastocystis hominis 1.6%, Entamoeba histolytica 0.8%, Entamoeba coli 0.8%, Balantidium coli 0.4%, Iodamoeba bütschlii 0.4%, and Sarcocystis hominis 0.4%. Co-infections of various helminths and protozoa were present in 15.9% of the people. The present results show that the prevalence of parasitic infections in this region is still high. Proactive education about dietary habits, personal hygiene, and sanitation should be provided to the people in this community to reduce the prevalence of intestinal parasite infections. Moreover, development of policies and programs to control parasites is needed. PMID:24516280

  20. Human intestinal parasites in non-biting synanthropic flies in Ogun State, Nigeria.

    PubMed

    Adenusi, Adedotun Adesegun; Adewoga, Thomas O Sunday

    2013-01-01

    Filth-feeding and breeding, non-biting synanthropic flies have been incriminated in the dissemination of human enteropathogens in the environment. This study determined the species of non-biting synanthropic flies associated with four filthy sites in Ilishan, Ogun State, southwest Nigeria, and assessed their potentials for mechanical transmission of human intestinal parasites. 7190 flies identified as Musca domestica (33.94%), Chrysomya megacephala (26.01%), Musca sorbens (23.23%), Lucilia cuprina (8.76%), Calliphora vicina (4.59%), Sarcophaga sp. (2.78%) and Fannia scalaris (0.70%) were examined for human intestinal parasites by the formol-ether concentration and modified Ziehl-Neelsen techniques. Eggs of the following parasites: Ascaris lumbricoides (34.08%), Trichuris trichiura (25.87%), hookworms (20.45%), Taenia sp. (2.36%), Hymenolepis nana (1.11%), Enterobius vermicularis (0.56%), Strongyloides stercoralis (larvae; 3.89%) and cysts of Entamoeba histolytica/dispar (27.26%), Entamoeba coli (22.67%), Giardia lamblia (3.34%) and Cryptosporidium sp. (1.81%) were isolated from the body surfaces and or gut contents of 75.24% of 719 pooled fly batches. The helminths A. lumbricoides and T. trichiura and the protozoans, E. histolytica/dispar and E. coli were the dominant parasites detected, both on body surfaces and in the gut contents of flies. C. megacephala was the highest carrier of parasites (diversity and number). More parasites were isolated from the gut than from body surfaces (P < 0.05). Flies from soiled ground often carried more parasites than those from abattoir, garbage or open-air market. Synanthropic fly species identified in this study can be of potential epidemiological importance as mechanical transmitters of human intestinal parasites acquired naturally from filth and carried on their body surfaces and or in the gut, because of their vagility and feeding mechanisms. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Geospatial distribution of intestinal parasitic infections in Rio de Janeiro (Brazil) and its association with social determinants.

    PubMed

    Faria, Clarissa Perez; Zanini, Graziela Maria; Dias, Gisele Silva; da Silva, Sidnei; de Freitas, Marcelo Bessa; Almendra, Ricardo; Santana, Paula; Sousa, Maria do Céu

    2017-03-01

    Intestinal parasitic infections remain among the most common infectious diseases worldwide. This study aimed to estimate their prevalence and provide a detailed analysis of geographical distribution of intestinal parasites in the metropolitan region of Rio de Janeiro, considering demographic, socio-economic, and epidemiological contextual factors. The cross-section survey was conducted among individuals attending the Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ, RJ) during the period from April 2012 to February 2015. Stool samples were collected and processed by sedimentation, flotation, Kato-Katz, Baermann-Moraes and Graham methods, iron haematoxylin staining and safranin staining. Of the 3245 individuals analysed, 569 (17.5%) were infected with at least one parasite. The most common protozoa were Endolimax nana (28.8%), Entamoeba coli (14.8%), Complex Entamoeba histolytica/Entamoeba dispar (13.5%), Blastocystis hominis (12.7%), and Giardia lamblia (8.1%). Strongyloides stercoralis (4.3%), Schistosoma mansoni (3.3%), Ascaris lumbricoides (1.6%), and hookworms (1.5%) were the most frequent helminths. There was a high frequency of contamination by protozoa (87%), and multiple infections were observed in 141 participants (24.8%). A positive association between age (young children) and gender (male) with intestinal parasites was observed. Geospatial distribution of the detected intestinal parasitic infections was not random or homogeneous, but was influenced by socioeconomic conditions (through the material deprivation index (MDI)). Participants classified in the highest levels of deprivation had higher risk of having intestinal parasites. This study provides the first epidemiological information on the prevalence and distribution of intestinal parasitic infections in the Rio de Janeiro metropolitan area. Intestinal parasites, especially protozoa, are highly prevalent, indicating that parasitic infections are still a serious public health problem

  2. Intestinal parasitic infections among expatriate workers in various occupations in Sharjah, United Arab Emirates

    PubMed Central

    Dafalla, Abdelmunim Izzeldin Abdelrahman; Almuhairi, Shaikha Ali Salem Obaid; AlHosani, Mohamed Hassan Jasim; Mohamed, Mira Yousif; Alkous, Mariam Ibrahim Ahmed; AlAzzawi, Mousa Abdelsattar; Abakar, Adam Dawoud; Nour, Bakri Yousif Mohamed; Hasan, Hayder; AbuOdeh, Ra'ed Omar; ElBakri, Ali

    2017-01-01

    ABSTRACT Intestinal parasitic infections are prevalent throughout many countries. This study aimed to determine the prevalence of intestinal parasite carriers among 21,347 expatriate workers, including food handlers and housemaids attending the public health center laboratory in Sharjah, UAE. Stool sample collection was performed throughout the period between January and December 2013. All samples were examined microscopically. Demographic data were also obtained and analyzed. Intestinal parasites were found in 3.3% (708/21,347) of the studied samples (single and multiple infections). Among positive samples, six hundred and eighty-three samples (96.5%) were positive for a single parasite: Giardia lamblia (257; 36.3%) and Entamoeba histolytica/Entamoeba dispar (220; 31.1%), respectively, whereas mono-infections with helminths accounted for 206 (29.1%) of the samples. Infection rates with single worms were: Ascaris lumbricoides (84; 11.9%), Hookworm (34; 4.8%), Trichuris trichiura (33; 4.7%), Taenia spp. (27; 3.81%), Strongyloides stercoralis (13; 1.8%), Hymenolepis nana (13; 1.8%), and Enterobius vermicularis (2; 0.28%), respectively. Infections were significantly associated with gender (x 2 = 14.18; p = 0.002) with males as the most commonly infected with both groups of intestinal parasites (protozoa and helminths). A strong statistical association was noted correlating the parasite occurrence with certain nationalities (x 2= 49.5, p <0.001). Furthermore, the study has also found a strong statistical correlation between parasite occurrence and occupation (x 2= 15.60; p = 0.029). Multiple infections were not common (3.5% of the positive samples), although one individual (0.14%) had four helminth species, concurrently. These findings emphasized that food handlers with different pathogenic parasitic organisms may pose a significant health risk to the public. PMID:29267590

  3. The Risk of Chronic Gastrointestinal Disorders Following Acute Infection with Intestinal Parasites.

    PubMed

    Blitz, Jason; Riddle, Mark S; Porter, Chad K

    2018-01-01

    Background: Infectious gastroenteritis (IGE) is caused by numerous bacterial, viral, and parasitic pathogens. A history of IGE has been shown in previous studies to increase the risk of developing chronic gastrointestinal disorders and other chronic conditions. As bacteria and viruses represent the majority of pathogen-specific causes of IGE, post-infectious studies have primarily focused on these organisms. The objective of this study was to investigate an association between a history of parasite-associated IGE and the subsequent development of chronic post-infectious gastrointestinal and non-gastrointestinal disorders in a military population. Methods: International Classification of Diseases, 9th Revision Clinical Modification (ICD-9-CM) diagnostic coding data for primary exposures and outcomes were obtained for a retrospective cohort study of active component military personnel from 1998 to 2013. Exposed subjects consisted of individuals with documented infection with one of ten parasitic pathogens. Unexposed subjects were matched to exposed subjects on demographic and operational deployment history parameters. Adjusted odds ratios (aORs) were estimated using logistic regression for several chronic disorders previously shown to be associated with a history of IGE. Results: A total of 896 subjects with a parasitic exposure were matched to 3681 unexposed subjects for multivariate regression analysis. Individuals infected with Balantidium coli , Ascaris lumbricoides , Strongyloides stercoralis , Necator americanus/Ancylostoma duodenale , and Taenia spp. had higher aOR for development of several chronic gastrointestinal disorders when compared with unexposed subjects after controlling for various covariates. Conclusion: We found that parasite-associated enteric infection increases the risk of development of post-infectious chronic gastrointestinal disorders in a military population. These results require confirmation in similar populations and in the developing

  4. A cross-sectional study of intestinal parasitic infections in a rural district of west China

    PubMed Central

    Tang, Ning; Luo, Nian Ji

    2003-01-01

    BACKGROUND: Parasitic infections are widespread in rural areas of West China. The remote and humid environment, traditional ways of life, contaminated potable water and limited health services all contribute to the transmission and persistence of fecal parasites. OBJECTIVE: To describe the prevalence of intestinal parasitic infections in an area of West China, including its associations with demographic variables. METHODS: Single fecal specimens were collected using a previously validated kit. Parasites were detected microscopically by iodine-stained smear, modified Kato-Katz thick smear, simple saline smear, test tube filter paper culture and adhesive cellophane tape anal swab. RESULTS: The prevalence of enteric parasites in the population was 51.7%. The proportion of individuals infected with one parasite was 36.5%, two parasites 12.7%, three parasites 3.0% and four parasites 0.08%. Parasites identified included Ascaris lumbricoides in 41.4% of all individuals tested, Ancylostoma duodenale in 17.7%, Trichurias trichuria in 8.25%, Enterobius vermicularis in 0.43%, Blastocystis hominis in 1.37%, Entamoeba coli in 0.47%, Entamoeba histolytica in 0.16%, Giardia lamblia in 0.04%, Strongyloides stercoralis in 0.04% and Clonorchis sinensis in 0.04%. The prevalence was significantly increased in women, people aged 15 to 19 years and over 80 years, the rural farm population, farmers, preschool and primary school groups, residents of a hilly rather than mountainous or plains terrain, and in intermediate income groups. The prevalence was significantly negatively associated with educational level, but not with age or income. CONCLUSIONS: This study supports the use of simple fecal examinations to monitor the parasite burden in rural areas of developing countries. Enteric parasites remain common in this population in rural China. PMID:18159450

  5. Intestinal parasite infections in a rural community of Rio de Janeiro (Brazil): Prevalence and genetic diversity of Blastocystis subtypes

    PubMed Central

    Barbosa, Carolina Valença; Barreto, Magali Muniz; Andrade, Rosemary de Jesus; Sodré, Fernando; d’Avila-Levy, Claudia Masini; Peralta, José Mauro; Igreja, Ricardo Pereira; de Macedo, Heloisa Werneck

    2018-01-01

    Background Intestinal parasitic infections are considered a serious public health problem and widely distributed worldwide, mainly in urban and rural environments of tropical and subtropical countries. Globally, soil-transmitted helminths and protozoa are the most common intestinal parasites. Blastocystis sp. is a highly prevalent suspected pathogenic protozoan, and considered an unusual protist due to its significant genetic diversity and host plasticity. Methodology/main findings A total of 294 stool samples were collected from inhabitants of three rural valleys in Rio de Janeiro, Brazil. The stool samples were evaluated by parasitological methods, fecal culture, nested PCR and PCR/Sequencing. Overall prevalence by parasitological analyses was 64.3% (189 out of 294 cases). Blastocystis sp. (55.8%) was the most prevalent, followed by Endolimax nana (18.7%), Entamoeba histolytica complex (7.1%), hookworm infection (7.1%), Entomoeba coli (5.8%), Giardia intestinalis (4.1%), Iodamoeba butchilii (1.0%), Trichuris trichiura (1.0%), Pentatrichomonas hominis (0.7%), Enterobius vermicularis (0.7%), Ascaris lumbricoides (0.7%) and Strongyloides stercoralis (0.7%). Prevalence of IPIs was significantly different by gender. Phylogenetic analysis of Blastocystis sp. and BLAST search revealed five different subtypes: ST3 (34.0%), ST1 (27.0%), ST2 (27.0%), ST4 (3.5%), ST8 (7.0%) and a non-identified subtype. Conclusions/significance Our findings demonstrate that intestinal parasite infection rates in rural areas of the Sumidouro municipality of Rio de Janeiro, Brazil are still high and remain a challenge to public health. Moreover, our data reveals significant genetic heterogeneity of Blastocystis sp. subtypes and a possible novel subtype, whose confirmation will require additional data. Our study contributes to the understanding of potential routes of transmission, epidemiology, and genetic diversity of Blastocystis sp. in rural areas both at a regional and global scale. PMID

  6. Infection with Soil-Transmitted Helminths Is Associated with Increased Insulin Sensitivity.

    PubMed

    Wiria, Aprilianto E; Hamid, Firdaus; Wammes, Linda J; Prasetyani, Margaretta A; Dekkers, Olaf M; May, Linda; Kaisar, Maria M M; Verweij, Jaco J; Guigas, Bruno; Partono, Felix; Sartono, Erliyani; Supali, Taniawati; Yazdanbakhsh, Maria; Smit, Johannes W A

    2015-01-01

    Given that helminth infections have been shown to improve insulin sensitivity in animal studies, which may be explained by beneficial effects on energy balance or by a shift in the immune system to an anti-inflammatory profile, we investigated whether soil-transmitted helminth (STH)-infected subjects are more insulin sensitive than STH-uninfected subjects. We performed a cross-sectional study on Flores island, Indonesia, an area with high prevalence of STH infections. From 646 adults, stool samples were screened for Trichuris trichiura by microscopy and for Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale, and Strongyloides stercoralis by qPCR. No other helminth was found. We collected data on body mass index (BMI, kg/m2), waist-to-hip ratio (WHR), fasting blood glucose (FBG, mmol/L), insulin (pmol/L), high sensitive C-reactive protein (ng/ml) and Immunoglobulin E (IU/ml). The homeostatic model assessment for insulin resistance (HOMAIR) was calculated and regression models were used to assess the association between STH infection status and insulin resistance. 424 (66%) participants had at least one STH infection. STH infected participants had lower BMI (23.2 vs 22.5 kg/m2, p value = 0.03) and lower HOMAIR (0.97 vs 0.81, p value = 0.05). In an age-, sex- and BMI-adjusted model a significant association was seen between the number of infections and HOMAIR: for every additional infection with STH species, the HOMAIR decreased by 0.10 (p for linear trend 0.01). This effect was mainly accounted for by a decrease in insulin of 4.9 pmol/L for every infection (p for trend = 0.07). STH infections are associated with a modest improvement of insulin sensitivity, which is not accounted for by STH effects on BMI alone.

  7. 1 CFR 6.3 - Daily lists of parts affected.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 1 General Provisions 1 2010-01-01 2010-01-01 false Daily lists of parts affected. 6.3 Section 6.3 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.3 Daily lists of parts affected. (a) Each daily issue of the Federal Register shall carry a...

  8. 1 CFR 6.3 - Daily lists of parts affected.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 1 General Provisions 1 2011-01-01 2011-01-01 false Daily lists of parts affected. 6.3 Section 6.3 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.3 Daily lists of parts affected. (a) Each daily issue of the Federal Register shall carry a...

  9. 1 CFR 6.3 - Daily lists of parts affected.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 1 General Provisions 1 2012-01-01 2012-01-01 false Daily lists of parts affected. 6.3 Section 6.3 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.3 Daily lists of parts affected. (a) Each daily issue of the Federal Register shall carry a...

  10. 1 CFR 6.3 - Daily lists of parts affected.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 1 General Provisions 1 2013-01-01 2012-01-01 true Daily lists of parts affected. 6.3 Section 6.3 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.3 Daily lists of parts affected. (a) Each daily issue of the Federal Register shall carry a...

  11. 1 CFR 6.3 - Daily lists of parts affected.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 1 General Provisions 1 2014-01-01 2012-01-01 true Daily lists of parts affected. 6.3 Section 6.3 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.3 Daily lists of parts affected. (a) Each daily issue of the Federal Register shall carry a...

  12. Concurrent once-daily versus twice-daily chemoradiotherapy in patients with limited-stage small-cell lung cancer (CONVERT): an open-label, phase 3, randomised, superiority trial.

    PubMed

    Faivre-Finn, Corinne; Snee, Michael; Ashcroft, Linda; Appel, Wiebke; Barlesi, Fabrice; Bhatnagar, Adityanarayan; Bezjak, Andrea; Cardenal, Felipe; Fournel, Pierre; Harden, Susan; Le Pechoux, Cecile; McMenemin, Rhona; Mohammed, Nazia; O'Brien, Mary; Pantarotto, Jason; Surmont, Veerle; Van Meerbeeck, Jan P; Woll, Penella J; Lorigan, Paul; Blackhall, Fiona

    2017-08-01

    Concurrent chemoradiotherapy is the standard of care in limited-stage small-cell lung cancer, but the optimal radiotherapy schedule and dose remains controversial. The aim of this study was to establish a standard chemoradiotherapy treatment regimen in limited-stage small-cell lung cancer. The CONVERT trial was an open-label, phase 3, randomised superiority trial. We enrolled adult patients (aged ≥18 years) who had cytologically or histologically confirmed limited-stage small-cell lung cancer, Eastern Cooperative Oncology Group performance status of 0-2, and adequate pulmonary function. Patients were recruited from 73 centres in eight countries. Patients were randomly assigned to receive either 45 Gy radiotherapy in 30 twice-daily fractions of 1·5 Gy over 19 days, or 66 Gy in 33 once-daily fractions of 2 Gy over 45 days, starting on day 22 after commencing cisplatin-etoposide chemotherapy (given as four to six cycles every 3 weeks in both groups). The allocation method used was minimisation with a random element, stratified by institution, planned number of chemotherapy cycles, and performance status. Treatment group assignments were not masked. The primary endpoint was overall survival, defined as time from randomisation until death from any cause, analysed by modified intention-to-treat. A 12% higher overall survival at 2 years in the once-daily group versus the twice-daily group was considered to be clinically significant to show superiority of the once-daily regimen. The study is registered with ClinicalTrials.gov (NCT00433563) and is currently in follow-up. Between April 7, 2008, and Nov 29, 2013, 547 patients were enrolled and randomly assigned to receive twice-daily concurrent chemoradiotherapy (274 patients) or once-daily concurrent chemoradiotherapy (273 patients). Four patients (one in the twice-daily group and three in the once-daily group) did not return their case report forms and were lost to follow-up; these patients were not included in our

  13. Once-daily treatment of rheumatoid arthritis with choline magnesium trisalicylate.

    PubMed

    Mann, C C; Boyer, J T

    1984-01-01

    A pilot study evaluated once-daily treatment of rheumatoid arthritis with choline magnesium trisalicylate (CMT) in patients diagnosed as having classical or definite rheumatoid arthritis, with morning stiffness as a major complaint. Twenty patients were selected who, in an earlier phase of the study, had found twice-daily treatment with CMT effective and tolerable. Efficacy was evaluated in 15 of these patients and safety was evaluated in all 20. Comparisons were made with the twice-daily regimen and with previous nonsteroidal anti-inflammatory drug (NSAID) therapy. Changes in clinical indicators (numbers of painful and swollen joints and the duration of morning stiffness) showed that once-daily treatment with CMT was as effective as twice-daily treatment with CMT or as treatment with other prior NSAIDs in controlling signs and symptoms of rheumatoid arthritis. Side effects in both the twice-daily and the once-daily treatment regimens were similar in incidence and nature.

  14. Daily insufficient sleep and active duty status.

    PubMed

    Chapman, Daniel P; Liu, Yong; McKnight-Eily, Lela R; Croft, Janet B; Holt, James B; Balkin, Thomas J; Giles, Wayne H

    2015-01-01

    We assessed the relationship between active duty status and daily insufficient sleep in a telephone survey. U.S. military service status (recent defined as past 12 months and past defined as >12 months ago) and daily insufficient sleep in the past 30 days were assessed among 566,861 adults aged 18 to 64 years and 271,202 adults aged ≥ 65 years in the 2009 to 2010 Behavioral Risk Factor Surveillance System surveys. Among ages 18 to 64 years, 1.1% reported recent active duty and 7.1% had past service; among ages ≥ 65 years, 0.6% reported recent and 24.6% had past service. Among ages 18 to 64 years, prevalence of daily insufficient sleep was 13.7% among those reporting recent duty, 12.6% for those with past service, and 11.2% for those with no service. Insufficient sleep did not vary significantly with active duty status among ages ≥ 65 years. After adjustment for sociodemographic characteristics, health behaviors, and frequent mental distress in multivariate logistic regression models, respondents aged 18 to 64 years with recent active duty were 34% more likely and those with past service were 23% more likely to report daily insufficient sleep than those with no service (p < 0.05, both). Adults with either recent or past active duty have a greater risk for daily insufficient sleep. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  15. Gender, Emotion Work, and Relationship Quality: A Daily Diary Study

    PubMed Central

    Curran, Melissa A.; McDaniel, Brandon T.; Pollitt, Amanda M.; Totenhagen, Casey J.

    2015-01-01

    We use the gender relations perspective from feminist theorizing to investigate how gender and daily emotion work predict daily relationship quality in 74 couples (148 individuals in dating, cohabiting, or married relationships) primarily from the southwest U.S. Emotion work is characterized by activities that enhance others’ emotional well-being. We examined emotion work two ways: trait (individuals’ average levels) and state (individuals’ daily fluctuations). We examined actor and partner effects of emotion work and tested for gender differences. As outcome variables, we included six types of daily relationship quality: love, commitment, satisfaction, closeness, ambivalence, and conflict. This approach allowed us to predict three aspects of relationship quality: average levels, daily fluctuations, and volatility (overall daily variability across a week). Three patterns emerged. First, emotion work predicted relationship quality in this diverse set of couples. Second, gender differences were minimal for fixed effects: Trait and state emotion work predicted higher average scores on, and positive daily increases in, individuals’ own positive relationship quality and lower average ambivalence. Third, gender differences were more robust for volatility: For partner effects, having a partner who reported higher average emotion work predicted lower volatility in love, satisfaction, and closeness for women versus greater volatility in love and commitment for men. Neither gender nor emotion work predicted average levels, daily fluctuations, or volatility in conflict. We discuss implications and future directions pertaining to the unique role of gender in understanding the associations between daily emotion work and volatility in daily relationship quality for relational partners. PMID:26508808

  16. Gender, Emotion Work, and Relationship Quality: A Daily Diary Study.

    PubMed

    Curran, Melissa A; McDaniel, Brandon T; Pollitt, Amanda M; Totenhagen, Casey J

    2015-08-01

    We use the gender relations perspective from feminist theorizing to investigate how gender and daily emotion work predict daily relationship quality in 74 couples (148 individuals in dating, cohabiting, or married relationships) primarily from the southwest U.S. Emotion work is characterized by activities that enhance others' emotional well-being. We examined emotion work two ways: trait (individuals' average levels) and state (individuals' daily fluctuations). We examined actor and partner effects of emotion work and tested for gender differences. As outcome variables, we included six types of daily relationship quality: love, commitment, satisfaction, closeness, ambivalence, and conflict. This approach allowed us to predict three aspects of relationship quality: average levels, daily fluctuations, and volatility (overall daily variability across a week). Three patterns emerged. First, emotion work predicted relationship quality in this diverse set of couples. Second, gender differences were minimal for fixed effects: Trait and state emotion work predicted higher average scores on, and positive daily increases in, individuals' own positive relationship quality and lower average ambivalence. Third, gender differences were more robust for volatility: For partner effects, having a partner who reported higher average emotion work predicted lower volatility in love, satisfaction, and closeness for women versus greater volatility in love and commitment for men. Neither gender nor emotion work predicted average levels, daily fluctuations, or volatility in conflict. We discuss implications and future directions pertaining to the unique role of gender in understanding the associations between daily emotion work and volatility in daily relationship quality for relational partners.

  17. Intensity of Daily Drinking and its Relation to Alcohol Use Disorders.

    PubMed

    Vergés, Alvaro; Ellingson, Jarrod M; Schroder, Stephanie A; Slutske, Wendy S; Sher, Kenneth J

    2018-06-12

    Daily drinking is an important public health concern and informative for evaluating diagnostic classification. In particular, daily binge drinkers might be considered as the prototype of some forms of alcoholism, as this drinking pattern may drive many alcohol use disorder (AUD) symptoms. However, daily drinking potentially captures a wide range of drinkers, including light-moderate daily drinkers who exhibit presumed control over their drinking behavior and might benefit from salutary effects on health. The current study examined the heterogeneity of daily drinkers in detail. Data from the two waves of the National Epidemiological Survey of Alcohol and Related Conditions were used. Participants who reported drinking "every day" during the last 12 months were classified as daily drinkers. A series of regression and logistic regression analyses were conducted to investigate the association between daily drinking and various outcomes. Daily drinkers were found to vary considerably from each other with respect to diagnostic status, level of consumption, demographic composition, and a range of drinking and health correlates. Further, a substantial number of daily binge drinkers were not diagnosed with AUD under the DSM-IV or DSM-5, although in most groups the DSM-5 criteria diagnosed a larger percentage of participants. Daily drinkers represents a highly heterogeneous group, and the correlates of daily drinking depend on the usual quantity of daily drinks and the frequency of alcohol-related problems in a given sample. Moreover, AUD, defined both according to DSM-IV and DSM-5, did not capture more than 68% of daily binge drinkers. Given that daily binge drinking is an extremely high threshold for use, this finding may present a challenge for our current classification system. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  18. Intrinsic Emotional Fluctuation in Daily Negative Affect across Adulthood.

    PubMed

    Liu, Yin; Bangerter, Lauren R; Rovine, Michael J; Zarit, Steven H; Almeida, David M

    2017-12-15

    The study explored daily negative affect (NA) fluctuation, its associations with age, and its developmental characteristics. The sample (n = 790) was drawn from the Midlife Development in the United States; participants completed two 8-day daily diaries 10 years apart. Multilevel models were estimated within each diary component, where two single daily NA (depression and nervousness) and daily NA diversity were predicted separately by daily stressor exposures, physical health symptoms, age, gender, education, and neuroticism. The variances of within-person residual were output for single NA and NA diversity as intrinsic emotion fluctuation (IEF) within each diary component (i.e., controlled for within- and between-person contextual factors). Then multilevel growth models were fit to explore the developmental characteristics of day-to-day IEF across 10 years. At the daily level, older age was associated with less IEF in depression and nervousness. Over time, IEF in depression decreased. Additionally, IEF in NA diversity increased for older participants longitudinally. IEF represents a new conceptualization of midlife individuals' daily emotional ups and downs, specifically, the intrinsic within-person volatility of emotions. The magnitude of IEF and its longitudinal dynamics may have implications for health and well-being of middle-aged adults. © The Author(s) 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Daily rhythmicity of body temperature in the dog.

    PubMed

    Refinetti, R; Piccione, G

    2003-08-01

    Research over the past 50 years has demonstrated the existence of circadian or daily rhythmicity in the body core temperature of a large number of mammalian species. However, previous studies have failed to identify daily rhythmicity of body temperature in dogs. We report here the successful recording of daily rhythms of rectal temperature in female Beagle dogs. The low robustness of the rhythms (41% of maximal robustness) and the small range of excursion (0.5 degrees C) are probably responsible for previous failures in detecting rhythmicity in dogs.

  20. Associations between daily chronic pain intensity, daily anger expression, and trait anger expressiveness: An ecological momentary assessment study

    PubMed Central

    Bruehl, Stephen; Liu, Xiaoxia; Burns, John W.; Chont, Melissa; Jamison, Robert N.

    2013-01-01

    Links between elevated trait anger expressiveness (anger-out) and greater chronic pain intensity are well documented, but pain-related effects of expressive behaviors actually used to regulate anger when it is experienced have been little explored. This study used ecological momentary assessment methods to explore prospective associations between daily behavioral anger expression and daily chronic pain intensity. Forty-eight chronic low back pain (LBP) patients and 36 healthy controls completed electronic diary ratings of momentary pain and behavioral anger expression in response to random prompts 4 times daily for 7 days. Across groups, greater trait anger-out was associated with greater daily behavioral anger expression (P < 0.001). LBP participants showed higher levels of daily anger expression than controls (P < 0.001). Generalized estimating equation analyses in the LBP group revealed a lagged main effect of greater behavioral anger expression on increased chronic pain intensity in the subsequent assessment period (P < 0.05). Examination of a trait × situation model for anger-out revealed prospective associations between elevated chronic pain intensity and later increases in behavioral anger expression that were restricted largely to individuals low in trait anger-out (P < 0.001). Trait × situation interactions for trait anger suppression (anger-in) indicated similar influences of pain intensity on subsequent behavioral anger expression occurring among low anger-in persons (P < 0.001). Overlap with trait and state negative affect did not account for study findings. This study for the first time documents lagged within-day influences of behavioral anger expression on subsequent chronic pain intensity. Trait anger regulation style may moderate associations between behavioral anger expression and chronic pain intensity. PMID:22940462

  1. The Association of Daily Physical Symptoms with Future Health

    PubMed Central

    Leger, Kate A.; Charles, Susan T.; Ayanian, John Z.; Almeida, David M.

    2015-01-01

    Rationale Daily physical symptoms play a critical role in health and illness experiences. Despite their daily prevalence, the ability of these symptoms to predict future health status is debated. Objective The current study examined whether physical symptom reports predict future health outcomes independent of trait measures of emotion. Methods Participants (N = 1189) who completed both Midlife in the United States (MIDUS) Surveys I and II as well as the National Study of Daily Experiences (NSDE) reported their daily physical symptoms at baseline and number of reported chronic conditions and functional disability nearly 10 years later. Results Physical symptoms at baseline significantly predicted the occurrence of chronic conditions and functional impairment at long-term follow-up, even after adjusting for self-reported affect, self-reported health, and previous health status. Conclusion Findings suggest that daily physical symptoms are unique indicators of future health status. PMID:26364011

  2. Adaptation to daily stress among mothers of children with an autism spectrum disorder: the role of daily positive affect.

    PubMed

    Ekas, Naomi V; Whitman, Thomas L

    2011-09-01

    Raising a child with an autism spectrum disorder is a challenging experience that can impact maternal well-being. Using a daily diary methodology, this study investigates (1) the relationship between stress and negative affect, and (2) the role of daily positive affect as a protective factor in the stress and negative affect relationship. Results from hierarchical linear models revealed that higher levels of stress were associated with decreased negative affect, both within and across days. Daily positive affect buffered the immediate and longer-lasting negative impact of stress on days of low to moderate levels of stress. Implications of the present study are discussed with regard to theoretical models of positive affect, the development of intervention programs, and directions for future research.

  3. Neighborhood cohesion and daily well-being: Results from a diary study

    PubMed Central

    Robinette, Jennifer W.; Charles, Susan T.; Mogle, Jacqueline A.; Almeida, David M.

    2013-01-01

    Neighborly cohesiveness has documented benefits for health. Furthermore, high perceived neighborhood cohesion offsets the adverse health effects of neighborhood socioeconomic adversity. One potential way neighborhood cohesion influences health is through daily stress processes. The current study uses participants (n = 2022, age 30–84 years) from The Midlife in the United States II and the National Study of Daily Experiences II, collected between 2004–2006, to examine this hypothesis using a within-person, daily diary design. We predicted that people who perceive high neighborhood cohesion are exposed to fewer daily stressors, such as interpersonal arguments, lower daily physical symptoms and negative affect, and higher daily positive affect. We also hypothesized that perceptions of neighborhood cohesion buffer declines in affective and physical well-being on days when daily stressors do occur. Results indicate that higher perceived neighborhood cohesion predicts fewer self-reported daily stressors, higher positive affect, lower negative affect, and fewer physical health symptoms. High perceived neighborhood cohesion also buffers the effects of daily stressors on negative affect, even after adjusting for other sources of social support. Results from the present study suggest interventions focusing on neighborhood cohesion may result in improved well-being and may minimize the adverse effect of daily stressors. PMID:24034965

  4. Daily antecedents and consequences of nightly sleep.

    PubMed

    Lee, Soomi; Crain, Tori L; McHale, Susan M; Almeida, David M; Buxton, Orfeu M

    2017-08-01

    Sleep can serve as both cause and consequence of individuals' everyday experiences. We built upon prior studies of the correlates of sleep, which have relied primarily on cross-sectional data, to examine the antecedents and consequences of sleep using a daily diary design. Specifically, we assessed the temporal sequence between nightly sleep and daily psychosocial stressors. Parents employed in a US information technology company (n = 102) completed eight consecutive daily diaries at both baseline and 1 year later. In telephone interviews each evening, participants reported on the previous night's sleep hours, sleep quality and sleep latency. They also reported daily work-to-family conflict and time inadequacy (i.e. perceptions of not having enough time) for their child and for themselves to engage in exercise. Multi-level models testing lagged and non-lagged effects simultaneously revealed that sleep hours and sleep quality were associated with next-day consequences of work-to-family conflict and time inadequacy, whereas psychosocial stressors as antecedents did not predict sleep hours or quality that night. For sleep latency, the opposite temporal order emerged: on days with more work-to-family conflict or time inadequacy for child and self than usual, participants reported longer sleep latencies than usual. An exception to this otherwise consistent pattern was that time inadequacy for child also preceded shorter sleep hours and poorer sleep quality that night. The results highlight the utility of a daily diary design for capturing the temporal sequences linking sleep and psychosocial stressors. © 2016 European Sleep Research Society.

  5. Observability of market daily volatility

    NASA Astrophysics Data System (ADS)

    Petroni, Filippo; Serva, Maurizio

    2016-02-01

    We study the price dynamics of 65 stocks from the Dow Jones Composite Average from 1973 to 2014. We show that it is possible to define a Daily Market Volatility σ(t) which is directly observable from data. This quantity is usually indirectly defined by r(t) = σ(t) ω(t) where the r(t) are the daily returns of the market index and the ω(t) are i.i.d. random variables with vanishing average and unitary variance. The relation r(t) = σ(t) ω(t) alone is unable to give an operative definition of the index volatility, which remains unobservable. On the contrary, we show that using the whole information available in the market, the index volatility can be operatively defined and detected.

  6. Daily Fluctuations in Everyday Cognition: Is It Meaningful?

    PubMed

    Gamaldo, Alyssa A; Allaire, Jason C

    2016-08-01

    This study examined whether there are daily fluctuations in everyday cognition that are consistent with daily fluctuations often observed in traditional measures of basic cognitive abilities. Two hundred six independently living older adults (age range = 60-91 years) were asked to complete a computerized cognitive battery over eight occasions within a 2- to 3-week period. Using multilevel model, significant within-person variability was observed across the Daily Everyday Cognition Assessment (DECA; 46%), with 54% between-person variability. At each occasion, better performance on the DECA was significantly associated with better performance on simple reaction time ( p < .01) and memory (Auditory Verbal Learning Task, p < .01) even after accounting for time, age, education, and performance on other cognitive measures. These findings demonstrate that within-person performance fluctuations can be observed for everyday cognition tasks, and these fluctuations are consistent with daily changes in basic cognitive abilities. © The Author(s) 2015.

  7. Extreme daily precipitation: the case of Serbia in 2014

    NASA Astrophysics Data System (ADS)

    Tošić, Ivana; Unkašević, Miroslava; Putniković, Suzana

    2017-05-01

    The extreme daily precipitation in Serbia was examined at 16 stations during the period 1961-2014. Two synoptic situations in May and September of 2014 were analysed, when extreme precipitation was recorded in western and eastern Serbia, respectively. The synoptic situation from 14 to 16 May 2014 remained nearly stationary over the western and central Serbia for the entire period. On 15 May 2014, the daily rainfall broke previous historical records in Belgrade (109.8 mm), Valjevo (108.2 mm) and Loznica (110 mm). Precipitation exceeded 200 mm in 72 h, producing the most catastrophic floods in the recent history of Serbia. In Negotin (eastern Serbia), daily precipitation of 161.3 mm was registered on 16 September 2014, which was the maximum value recorded during the period 1961-2014. The daily maximum in 2014 was registered at 6 out of 16 stations. The total annual precipitation for 2014 was the highest for the period 1961-2014 at almost all stations in Serbia. A non-significant positive trend was found for all precipitation indices: annual daily maximum precipitation, the total precipitation in consecutive 3 and 5 days, the total annual precipitation, and number of days with at least 10 and 20 mm of precipitation. The generalised extreme value distribution was fitted to the annual daily maximum precipitation. The estimated 100-year return levels were 123.4 and 147.4 mm for the annual daily maximum precipitation in Belgrade and Negotin, respectively.

  8. Mobile Phone Ecological Momentary Assessment of Daily Stressors Among People Living With HIV: Elucidating Factors Underlying Health-Related Challenges in Daily Routines.

    PubMed

    Farmer, Shu; Mindry, Deborah; Comulada, W Scott; Swendeman, Dallas

    Stressful life events and daily hassles affect people living with HIV (PLWH). However, capturing stress-related events and cognitive impairment is often plagued with recall biases. Incorporating reliable information technology, such as mobile phones, can be a resourceful method for measuring health behaviors (MHB). We report findings from an MHB pilot study with 32 African American, Latino/Hispanic, and White PLWH from Los Angeles. Participants reported perceived stressors in their daily routines using a smartphone Ecological Momentary Assessment (EMA) application. Participants self-initiated in-the-moment stressful events reports for up to 6 weeks. Stressful event EMAs queried perceived stress levels (1-10 scale) and open-ended text descriptions. Qualitative analysis of participant text responses was completed using grounded thematic coding. Participants reported multiple stressors in their daily routines, impacting activities of daily living or daily functioning. Eliciting input from PLWH via EMA in real time is a novel approach for assessing and identifying sources of stress. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  9. Dissociation between the pharmacokinetics and pharmacodynamics of once-daily rivaroxaban and twice-daily apixaban: a randomized crossover study.

    PubMed

    Kreutz, R; Persson, P B; Kubitza, D; Thelen, K; Heitmeier, S; Schwers, S; Becka, M; Hemmrich, M

    2017-10-01

    Essentials In this crossover study the anticoagulant effects of rivaroxaban and apixaban were compared. Healthy volunteers received rivaroxaban 20 mg once daily or apixaban 5 mg twice daily. Rivaroxaban was associated with more prolonged inhibition of thrombin generation than apixaban. Rivaroxaban induced a clear prolongation of prothrombin time and activated partial thromboplastin time. Background The anticoagulant actions of the oral direct activated factor Xa inhibitors, rivaroxaban and apixaban, have not previously been directly compared. Objectives To compare directly the steady-state pharmacokinetics and anticoagulant effects of rivaroxaban and apixaban at doses approved for stroke prevention in patients with non-valvular atrial fibrillation. Methods Twenty-four healthy Caucasian male volunteers were included in this open-label, two-period crossover, phase 1 study (EudraCT number: 2015-002612-32). Volunteers were randomized to receive rivaroxaban 20 mg once daily or apixaban 5 mg twice daily for 7 days, followed by a washout period of at least 7 days before they received the other treatment. Plasma concentrations and anticoagulant effects were measured at steady state and after drug discontinuation. Results Overall exposure was similar for both drugs: the geometric mean area under the plasma concentration-time curve for the 0-24-h interval was 1830 μg h L -1 for rivaroxaban and 1860 μg h L -1 for apixaban. Rivaroxaban was associated with greater inhibition of endogenous thrombin potential (geometric mean area under the curve relative to baseline during the 0-24-h interval: 15.5 h versus 17.5 h) and a more pronounced maximal prolongation relative to baseline of prothrombin time (PT) (1.66-fold versus 1.14-fold) and activated partial thromboplastin time (APTT) (1.43-fold versus 1.16-fold) at steady state than apixaban. Conclusions Despite similar exposure to both drugs, rivaroxaban 20 mg once daily was associated with greater and more

  10. New daily-persistent headache versus tension-type headache.

    PubMed

    Robbins, Matthew S; Crystal, Sara C

    2010-12-01

    New daily-persistent headache (NDPH) and chronic tension-type headache (CTTH) are two forms of primary chronic daily headache of long duration that often are similar in their headache manifestations. NDPH distinguishes itself from CTTH and the other forms of chronic daily headache by its continuous head pain from onset. However, despite formalized criteria that specify NDPH must resemble the acute onset of a headache identical to that of CTTH, NDPH commonly has migraine features. Here, we review the available literature on NDPH and compare its clinical features, epidemiology, prognosis, inciting factors, and treatment to CTTH.

  11. The changing aetiology of eosinophilia in migrants and returning travellers in the Hospital for Tropical Diseases, London 2002-2015: An observational study.

    PubMed

    Barrett, Jessica; Warrell, Clare E; Macpherson, Liana; Watson, Julie; Lowe, Patricia; Armstrong, Margaret; Whitty, Christopher J M

    2017-10-01

    Determining the cause of eosinophilia in patients returning from the tropics continues to present a diagnostic challenge. The history, symptoms and degree of eosinophilia are often poor predictors of eventual diagnosis, but helminths are an important cause. The current British Infection Association recommendations use travel history to guide investigation of eosinophilia. However the global burden of helminth disease and travel patterns have changed over the last 3 decades and guidelines based on previous epidemiology need to be reviewed in the light of current data. Consecutive patients presenting with, or referred for, investigation of eosinophilia were identified prospectively. Case notes, laboratory results and electronic records were reviewed for demographic and clinical data. Patients with an eosinophil count ≥0.50 × 10 9 /L were included, and grouped based on lifetime history of travel to: West Africa, elsewhere in Africa, and the rest of the world. Results were compared to published data from 1997 to 2002 collected at the same centre. Of 410 patients who met the inclusion criteria, 407 had a documented travel history. Average yearly referrals for eosinophilia fell from 58 per year between 1997 and 2002, to 33 per year (2002-2015). The proportion of eosinophilia cases diagnosed with a parasitic cause fell from 64% to 50%, and yields for all parasitological investigations fell, the largest reduction in stool microscopy (20% yield to 9%) and day bloods for microfilariae (14% yield to 3%). Strongyloides stercoralis was the commonest diagnosis overall in our cohort, accounting for 50% of the total parasites diagnosed, and was present in 38% of patients from West Africa, 19% from rest of Africa, and 34% from rest of world; a relative increase compared to previous data. Schistosomiasis is slightly less common in those who had travelled to West Africa than the rest of Africa, and overall point prevalence has fallen from 33% (1997-2002) to 17% (2002

  12. Efficacy and safety of once-daily insulin degludec/insulin aspart compared with once-daily insulin glargine in participants with Type 2 diabetes: a randomized, treat-to-target study.

    PubMed

    Kumar, S; Jang, H C; Demirağ, N G; Skjøth, T V; Endahl, L; Bode, B

    2017-02-01

    To investigate, in a 26-week, open-label, randomized, treat-to-target trial, the efficacy and safety of insulin degludec/insulin aspart (IDegAsp) once daily vs insulin glargine (IGlar) once daily in adults with Type 2 diabetes, inadequately controlled on basal insulin. Participants were randomized (1:1) to IDegAsp once daily or IGlar once daily in combination with existing oral antidiabetic drugs. IDegAsp once daily was administered with the main evening meal or the largest meal of the day (agreed at baseline); dosing time was maintained throughout the trial. Participants titrated their insulin dose weekly to a mean pre-breakfast self-measured plasma glucose target [3.9-4.9 mmol/l (70-89 mg/dl)]. IDegAsp once daily was non-inferior to IGlar once daily in reducing HbA 1c after 26 weeks [mean estimated treatment difference IDegAsp once daily - IGlar once daily: -0.03% (95% CI -0.20, 0.14)]. The evening meal glucose increment was significantly lower with IDegAsp once daily vs IGlar once daily [estimated treatment difference IDegAsp once daily - IGlar once daily: -1.32 mmol/l (95% CI -1.93, -0.72); P < 0.05]. The overall confirmed hypoglycaemia rate was higher with IDegAsp once daily (estimated rate ratio 1.43; 95% CI 1.07, 1.92; P < 0.05). The rate of nocturnal hypoglycaemia did not significantly differ between the IDegAsp and IGlar groups [estimated rate ratio 0.80 (95% CI 0.49, 1.30); not significant]. In participants with Type 2 diabetes inadequately controlled on basal insulin, IDegAsp once daily improved glycaemic control and was non-inferior to IGlar once daily. IDegAsp led to higher rates of overall hypoglycaemia than IGlar, with no significant difference in rates of nocturnal hypoglycaemia. © 2016 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  13. Breathlessness during daily activity: The psychometric properties of the London Chest Activity of Daily Living Scale in patients with advanced disease and refractory breathlessness.

    PubMed

    Reilly, Charles C; Bausewein, Claudia; Garrod, Rachel; Jolley, Caroline J; Moxham, John; Higginson, Irene J

    2017-10-01

    The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034). All patients completed the following questionnaires: the London Chest Activities of Daily Living Scale, Chronic Respiratory Questionnaire, the Palliative care Outcome Scale, Palliative care Outcome Scale-symptoms, the Hospital Anxiety and Depression Scale and breathlessness measured on a numerical rating scale. Data quality, scaling assumptions, acceptability, internal consistency and construct validity of the London Chest Activities of Daily Living Scale were determined using standard psychometric approaches. Breathless patients with advanced malignant and non-malignant disease. A total of 88 patients were studied, primary diagnosis included; chronic obstructive pulmonary disease = 53, interstitial lung disease = 17, cancer = 18. Median (range) London Chest Activities of Daily Living Scale total score was 46.5 (14-67). No floor or ceiling effect was observed for the London Chest Activities of Daily Living Scale total score. Internal consistency was good, and Cronbach's alpha for the London Chest Activities of Daily Living Scale total score was 0.90. Construct validity was good with 13 out of 15 a priori hypotheses met. Psychometric analyses suggest that the London Chest Activities of Daily Living

  14. Breathlessness during daily activity: The psychometric properties of the London Chest Activity of Daily Living Scale in patients with advanced disease and refractory breathlessness

    PubMed Central

    Reilly, Charles C; Bausewein, Claudia; Garrod, Rachel; Jolley, Caroline J; Moxham, John; Higginson, Irene J

    2016-01-01

    Background: The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. Aim: To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. Design: A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034). All patients completed the following questionnaires: the London Chest Activities of Daily Living Scale, Chronic Respiratory Questionnaire, the Palliative care Outcome Scale, Palliative care Outcome Scale–symptoms, the Hospital Anxiety and Depression Scale and breathlessness measured on a numerical rating scale. Data quality, scaling assumptions, acceptability, internal consistency and construct validity of the London Chest Activities of Daily Living Scale were determined using standard psychometric approaches. Setting/participants: Breathless patients with advanced malignant and non-malignant disease. Results: A total of 88 patients were studied, primary diagnosis included; chronic obstructive pulmonary disease = 53, interstitial lung disease = 17, cancer = 18. Median (range) London Chest Activities of Daily Living Scale total score was 46.5 (14–67). No floor or ceiling effect was observed for the London Chest Activities of Daily Living Scale total score. Internal consistency was good, and Cronbach’s alpha for the London Chest Activities of Daily Living Scale total score was 0.90. Construct validity was good with 13 out of 15 a priori hypotheses met. Conclusion

  15. Chronic daily headache in children and adolescents: science and conjecture.

    PubMed

    Connelly, Mark; Bickel, Jennifer

    2013-01-01

    SUMMARY Chronic daily headache comprises a group of headache disorders in which headaches occur almost daily or continuously over several months. Although chronic daily headache is one of the most common chronic pain disorders in pediatrics, data on pathophysiological mechanisms and relative efficacy of treatments remain sparse. In this review, we aim to provide contemporary information on classification, epidemiology, etiology and treatment of pediatric chronic daily headache based on extant empirical data when available, or general consensus in the field when not.

  16. Toothbrushing: Do It Daily.

    ERIC Educational Resources Information Center

    Texas Child Care, 1993

    1993-01-01

    Offers a practical guide for promoting daily toothbrushing in young children. Discusses the importance of proper dental care, explains the causes of tooth decay, describes proper dental care for infants and young children, recommends materials and teaching methods, and discusses visits to the dentist and the benefits of fluoride for dental health.…

  17. MO-G-BRE-04: Automatic Verification of Daily Treatment Deliveries and Generation of Daily Treatment Reports for a MR Image-Guided Treatment Machine

    SciTech Connect

    Yang, D; Li, X; Li, H

    2014-06-15

    Purpose: Two aims of this work were to develop a method to automatically verify treatment delivery accuracy immediately after patient treatment and to develop a comprehensive daily treatment report to provide all required information for daily MR-IGRT review. Methods: After systematically analyzing the requirements for treatment delivery verification and understanding the available information from a novel MR-IGRT treatment machine, we designed a method to use 1) treatment plan files, 2) delivery log files, and 3) dosimetric calibration information to verify the accuracy and completeness of daily treatment deliveries. The method verifies the correctness of delivered treatment plans and beams, beammore » segments, and for each segment, the beam-on time and MLC leaf positions. Composite primary fluence maps are calculated from the MLC leaf positions and the beam-on time. Error statistics are calculated on the fluence difference maps between the plan and the delivery. We also designed the daily treatment delivery report by including all required information for MR-IGRT and physics weekly review - the plan and treatment fraction information, dose verification information, daily patient setup screen captures, and the treatment delivery verification results. Results: The parameters in the log files (e.g. MLC positions) were independently verified and deemed accurate and trustable. A computer program was developed to implement the automatic delivery verification and daily report generation. The program was tested and clinically commissioned with sufficient IMRT and 3D treatment delivery data. The final version has been integrated into a commercial MR-IGRT treatment delivery system. Conclusion: A method was developed to automatically verify MR-IGRT treatment deliveries and generate daily treatment reports. Already in clinical use since December 2013, the system is able to facilitate delivery error detection, and expedite physician daily IGRT review and physicist weekly

  18. Daily negative affect and smoking after a self-set quit attempt: The role of dyadic invisible social support in a daily diary study.

    PubMed

    Lüscher, Janina; Stadler, Gertraud; Ochsner, Sibylle; Rackow, Pamela; Knoll, Nina; Hornung, Rainer; Scholz, Urte

    2015-11-01

    Social support receipt from one's partner is assumed to be beneficial for successful smoking cessation. However, support receipt can have costs. Recent research suggests that the most effective support is unnoticed by the receiver (i.e., invisible). Therefore, this study examined the association between everyday levels of dyadic invisible emotional and instrumental support, daily negative affect, and daily smoking after a self-set quit attempt in smoker-non-smoker couples. Overall, 100 smokers (72.0% men, mean age M = 40.48, SD = 9.82) and their non-smoking partners completed electronic diaries from a self-set quit date on for 22 consecutive days, reporting daily invisible emotional and instrumental social support, daily negative affect, and daily smoking. Same-day multilevel analyses showed that at the between-person level, higher individual mean levels of invisible emotional and instrumental support were associated with less daily negative affect. In contrast to our assumption, more receipt of invisible emotional and instrumental support was related to more daily cigarettes smoked. The findings are in line with previous results, indicating invisible support to have beneficial relations with affect. However, results emphasize the need for further prospective daily diary approaches for understanding the dynamics of invisible support on smoking cessation. Statement of contribution What is already known on this subject? Social support receipt from a close other has proven to have emotional costs. According to current studies, the most effective social support is unnoticed by the receiver (i.e., invisible). There is empirical evidence for beneficial effects of invisible social support on affective well-being. What does this study add? Confirming benefits of invisible social support for negative affect in a health behaviour change setting Providing first evidence for detrimental effects of invisible social support on smoking. © 2015 The British Psychological Society.

  19. Instantaneous-to-daily GPP upscaling schemes based on a coupled photosynthesis-stomatal conductance model: correcting the overestimation of GPP by directly using daily average meteorological inputs.

    PubMed

    Wang, Fumin; Gonsamo, Alemu; Chen, Jing M; Black, T Andrew; Zhou, Bin

    2014-11-01

    Daily canopy photosynthesis is usually temporally upscaled from instantaneous (i.e., seconds) photosynthesis rate. The nonlinear response of photosynthesis to meteorological variables makes the temporal scaling a significant challenge. In this study, two temporal upscaling schemes of daily photosynthesis, the integrated daily model (IDM) and the segmented daily model (SDM), are presented by considering the diurnal variations of meteorological variables based on a coupled photosynthesis-stomatal conductance model. The two models, as well as a simple average daily model (SADM) with daily average meteorological inputs, were validated using the tower-derived gross primary production (GPP) to assess their abilities in simulating daily photosynthesis. The results showed IDM closely followed the seasonal trend of the tower-derived GPP with an average RMSE of 1.63 g C m(-2) day(-1), and an average Nash-Sutcliffe model efficiency coefficient (E) of 0.87. SDM performed similarly to IDM in GPP simulation but decreased the computation time by >66%. SADM overestimated daily GPP by about 15% during the growing season compared to IDM. Both IDM and SDM greatly decreased the overestimation by SADM, and improved the simulation of daily GPP by reducing the RMSE by 34 and 30%, respectively. The results indicated that IDM and SDM are useful temporal upscaling approaches, and both are superior to SADM in daily GPP simulation because they take into account the diurnally varying responses of photosynthesis to meteorological variables. SDM is computationally more efficient, and therefore more suitable for long-term and large-scale GPP simulations.

  20. 21 CFR 890.5050 - Daily activity assist device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Daily activity assist device. 890.5050 Section 890.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5050 Daily activity...

  1. 21 CFR 890.5050 - Daily activity assist device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Daily activity assist device. 890.5050 Section 890.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5050 Daily activity...

  2. 21 CFR 890.5050 - Daily activity assist device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Daily activity assist device. 890.5050 Section 890.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5050 Daily activity...

  3. 21 CFR 890.5050 - Daily activity assist device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Daily activity assist device. 890.5050 Section 890.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5050 Daily activity...

  4. 21 CFR 890.5050 - Daily activity assist device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Daily activity assist device. 890.5050 Section 890.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5050 Daily activity...

  5. Effects of daily food processing on allergenicity.

    PubMed

    Cabanillas, Beatriz; Novak, Natalija

    2017-08-11

    Daily food processing has the potential to alter the allergenicity of foods due to modification of the physico-chemical properties of proteins. The degree of such modifications depends on factors such as processing conditions, type of food considered, allergenic content, etc. The impact of daily food processing like boiling, roasting, frying or baking on food allergenicity have been extensively studied. The influence of other thermal treatments such as microwave heating or pressure cooking on allergenicity has also been analyzed. Non-thermal treatment such as peeling impacts on the allergenic content of certain foods such as fruits. In this review, we give an updated overview of the effects of daily processing treatments on the allergenicity of a wide variety of foods. The different variables that contribute to the modification of food allergenicity due to processing are also reviewed and discussed.

  6. Solving Tomorrow's Problems Today? Daily Anticipatory Coping and Reactivity to Daily Stressors.

    PubMed

    Neupert, Shevaun D; Ennis, Gilda E; Ramsey, Jennifer L; Gall, Agnes A

    2016-07-01

    The present study examined the day-to-day fluctuation of state-like anticipatory coping (coping employed prior to stressors) and how these coping processes relate to important outcomes for older adults (i.e., physical health, affect, memory failures). Forty-three older adults aged 60-96 (M = 74.65, SD = 8.19) participated in an 8-day daily diary study of anticipatory coping, stressors, health, affect, and memory failures. Participants reported anticipatory coping behaviors on one day with respect to 6 distinct stressor domains that could occur the following day. Multilevel models indicated that anticipatory coping changes from day to day and within stressor domains. Lagged associations suggested that yesterday's anticipatory coping for potential upcoming arguments is related to today's physical health and affect. Increased stagnant deliberation is associated with reduced cognitive reactivity (i.e., fewer memory failures) to arguments the next day. Taken together, these findings suggest that anticipatory coping is dynamic and associated with important daily outcomes. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. 17 CFR 16.02 - Daily trade and supporting data reports.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Daily trade and supporting... COMMISSION REPORTS BY REPORTING MARKETS § 16.02 Daily trade and supporting data reports. Reporting markets shall provide trade and supporting data reports to the Commission on a daily basis. Such reports shall...

  8. Rich News: Metropolitan Dailies and the Urban Poor.

    ERIC Educational Resources Information Center

    Draper, Mary Jo

    The migration of people from cities to suburbs, new patterns of advertising, a less homogeneous and unified readership, and increasing competition from other media have produced tremendous pressures on daily newspapers. In responding to these pressures, metropolitan dailies are turning from "hard" to "soft" news, away from their poorer urban…

  9. Efficacy and safety of amoxycillin/clavulanate (Augmentin) twice daily versus three times daily in the treatment of acute otitis media in children. The Augmentin 454 Study Group.

    PubMed

    Damrikarnlert, L; Jauregui, A C; Kzadri, M

    2000-02-01

    This multicenter, randomized, single-blind study compared the efficacy and safety of a new, twice-daily formulation of amoxycillin/clavulanate (Augmenting) with the standard three-times-daily formulation. Children with a clinical diagnosis of acute otitis media, aged between 2 months and 12 years, received either amoxycillin/clavulanate 45/6.4 mg/kg/day twice-daily (b.d.) (range 38.3/5.5-76.2/10.9 mg/kg/day) or amoxycillin/clavulanate 40/10 mg/kg/day three-times-daily (t.d.s.) (range 25/6.25-56/14 mg/kg/day) for 7 or 10 days. Patients were evaluated during therapy (Days 3-5), at the end of therapy (Days 7-12) and at follow-up (Days 38-42). At the end of therapy, for the intent-to-treat and per-protocol populations, respectively, clinical success (cure) was achieved by approximately 94% of patients in both treatment groups. A successful bacteriological response at the end of therapy (Visit 3) was documented in 7/9 patients (77.8%) in the twice-daily group and in 11/13 patients (84.6%) in the three-times-daily group. At follow-up (Visit 4), 93.3% of patients in the twice-daily group and 87.9% in the three-times-daily group continued to have a clinically successful response. Both treatment regimens were well tolerated, with most adverse events being of a mild-moderate and transient nature. The most common treatment-related adverse event was diarrhea, occurring in 7.2% of patients in the twice-daily group and in 10.7% of the three-times-daily group. In total, 173 patients (82.8%) in the twice-daily group and 151 patients (73.3%) in the three-times-daily group were compliant with medication. In conclusion, this study confirms that b.d. amoxycillin/clavulanate is an effective treatment for pediatric acute otitis media and demonstrates that the b.d. and t.d.s. formulations of amoxycillin/clavulanate produce equivalent efficacy. Furthermore, there was a trend towards a higher level of compliance and a lower incidence of drug-related adverse events in the twice-daily

  10. Racial Differences in Exposure and Reactivity to Daily Family Stressors

    ERIC Educational Resources Information Center

    Cichy, Kelly E.; Stawski, Robert S.; Almeida, David M.

    2012-01-01

    Using data from the National Study of Daily Experiences, the authors examined racial differences in exposure and reactivity to daily stressors involving family members. Respondents included African American and European American adults age 34 to 84 (N = 1,931) who participated in 8 days of daily interviews during which they reported on daily…

  11. Daily Medicine Record for Your Child

    MedlinePlus

    ... Age: ____ 2 years old___ Weight: ___ 30 pounds ___ Daily Medicine Record Child’s name: ___________________ Today’s date: _________________ Age: ____________ Weight: ________________ (pounds) Time Problem ...

  12. Family and School Spillover in Adolescents' Daily Lives

    ERIC Educational Resources Information Center

    Flook, Lisa; Fuligni, Andrew J.

    2008-01-01

    This study examined spillover between daily family stressors and school problems among 589 ninth-grade students (mean age = 14.9 years) from Mexican, Chinese, and European backgrounds. Spillover was examined using a daily diary methodology in which adolescents reported on their school and family experiences each day for 2 weeks. Analyses using…

  13. Changes to Sub-daily Rainfall Patterns in a Future Climate

    NASA Astrophysics Data System (ADS)

    Westra, S.; Evans, J. P.; Mehrotra, R.; Sharma, A.

    2012-12-01

    An algorithm is developed for disaggregating daily rainfall into sub-daily rainfall 'fragments' (continuous high temporal-resolution rainfall sequences whose total depth sums to the daily rainfall amount) under a future, warmer climate. The basis of the algorithm is to re-sample sub-daily fragments from the historical record conditional on the total daily rainfall amount and a range of temperature-based atmospheric predictors. The logic is that as the atmosphere warms, future rainfall patterns will be more reflective of historical rainfall patterns which occurred on warmer days at the same location, or at locations which have an atmospheric temperature profile more representative of expected future atmospheric conditions. It was found that the daily to sub-daily scaling relationship varied significantly by season and by location, with rainfall patterns on warmer seasons or at warmer locations typically exhibiting higher rainfall intensity occurring over shorter periods within a day, compared with cooler seasons and locations. Importantly, by regressing against temperature-based atmospheric covariates, this effect was substantially reduced, suggesting that the approach also may be valid when extrapolating to a future climate. An adjusted method of fragments algorithm was then applied to nine stations around Australia, with the results showing that when holding total daily rainfall constant, the maximum intensity of short duration rainfall increased by a median of about 5% per degree for the maximum 6 minute burst, and 3.5% for the maximum one hour burst, whereas the fraction of the day with no rainfall increased by a median of 1.5%. This highlights that a large proportion of the change to the distribution of rainfall is likely to occur at sub-daily timescales, with significant implications for many hydrological systems.

  14. Comparative long-term trend analysis of daily weather conditions with daily pollen concentrations in Brussels, Belgium

    NASA Astrophysics Data System (ADS)

    Bruffaerts, Nicolas; De Smedt, Tom; Delcloo, Andy; Simons, Koen; Hoebeke, Lucie; Verstraeten, Caroline; Van Nieuwenhuyse, An; Packeu, Ann; Hendrickx, Marijke

    2018-03-01

    A clear rise in seasonal and annual temperatures, a gradual increase of total radiation, and a relative trend of change in seasonal precipitation have been observed for the last four decades in Brussels (Belgium). These local modifications may have a direct and indirect public health impact by altering the timing and intensity of allergenic pollen seasons. In this study, we assessed the statistical correlations (Spearman's test) between pollen concentration and meteorological conditions by using long-term daily datasets of 11 pollen types (8 trees and 3 herbaceous plants) and 10 meteorological parameters observed in Brussels between 1982 and 2015. Furthermore, we analyzed the rate of change in the annual cycle of the same selected pollen types by the Mann-Kendall test. We revealed an overall trend of increase in daily airborne tree pollen (except for the European beech tree) and an overall trend of decrease in daily airborne pollen from herbaceous plants (except for Urticaceae). These results revealed an earlier onset of the flowering period for birch, oak, ash, plane, grasses, and Urticaceae. Finally, the rates of change in pollen annual cycles were shown to be associated with the rates of change in the annual cycles of several meteorological parameters such as temperature, radiation, humidity, and rainfall.

  15. Comparative long-term trend analysis of daily weather conditions with daily pollen concentrations in Brussels, Belgium.

    PubMed

    Bruffaerts, Nicolas; De Smedt, Tom; Delcloo, Andy; Simons, Koen; Hoebeke, Lucie; Verstraeten, Caroline; Van Nieuwenhuyse, An; Packeu, Ann; Hendrickx, Marijke

    2018-03-01

    A clear rise in seasonal and annual temperatures, a gradual increase of total radiation, and a relative trend of change in seasonal precipitation have been observed for the last four decades in Brussels (Belgium). These local modifications may have a direct and indirect public health impact by altering the timing and intensity of allergenic pollen seasons. In this study, we assessed the statistical correlations (Spearman's test) between pollen concentration and meteorological conditions by using long-term daily datasets of 11 pollen types (8 trees and 3 herbaceous plants) and 10 meteorological parameters observed in Brussels between 1982 and 2015. Furthermore, we analyzed the rate of change in the annual cycle of the same selected pollen types by the Mann-Kendall test. We revealed an overall trend of increase in daily airborne tree pollen (except for the European beech tree) and an overall trend of decrease in daily airborne pollen from herbaceous plants (except for Urticaceae). These results revealed an earlier onset of the flowering period for birch, oak, ash, plane, grasses, and Urticaceae. Finally, the rates of change in pollen annual cycles were shown to be associated with the rates of change in the annual cycles of several meteorological parameters such as temperature, radiation, humidity, and rainfall.

  16. Understanding metropolitan patterns of daily encounters.

    PubMed

    Sun, Lijun; Axhausen, Kay W; Lee, Der-Horng; Huang, Xianfeng

    2013-08-20

    Understanding of the mechanisms driving our daily face-to-face encounters is still limited; the field lacks large-scale datasets describing both individual behaviors and their collective interactions. However, here, with the help of travel smart card data, we uncover such encounter mechanisms and structures by constructing a time-resolved in-vehicle social encounter network on public buses in a city (about 5 million residents). Using a population scale dataset, we find physical encounters display reproducible temporal patterns, indicating that repeated encounters are regular and identical. On an individual scale, we find that collective regularities dominate distinct encounters' bounded nature. An individual's encounter capability is rooted in his/her daily behavioral regularity, explaining the emergence of "familiar strangers" in daily life. Strikingly, we find individuals with repeated encounters are not grouped into small communities, but become strongly connected over time, resulting in a large, but imperceptible, small-world contact network or "structure of co-presence" across the whole metropolitan area. Revealing the encounter pattern and identifying this large-scale contact network are crucial to understanding the dynamics in patterns of social acquaintances, collective human behaviors, and--particularly--disclosing the impact of human behavior on various diffusion/spreading processes.

  17. [Social phobia in daily life].

    PubMed

    Morschitzky, Hans

    2009-12-01

    Based on present diagnostic criteria daily routine of patients with social phobia is described in detail with all its social, educational and occupational impacts. Suffering of affected people is classified as a disease and in need of treatment.

  18. 20 CFR 330.3 - Daily rate of compensation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... employee's daily rate of compensation is his or her straight-time rate of pay, including any cost-of-living allowance provided in any applicable working agreement. It does not include any overtime pay, penalty... mileage basis, the employee's daily rate of compensation is his or her rate of pay for the number of miles...

  19. 20 CFR 330.3 - Daily rate of compensation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... employee's daily rate of compensation is his or her straight-time rate of pay, including any cost-of-living allowance provided in any applicable working agreement. It does not include any overtime pay, penalty... mileage basis, the employee's daily rate of compensation is his or her rate of pay for the number of miles...

  20. New daily persistent headache in children and adults.

    PubMed

    Mack, Kenneth J

    2009-02-01

    New daily persistent headache (NDPH) is frequently seen in young patients with chronic daily headache. NDPH begins with a sudden onset, often associated with an infection or other physical stress. This headache syndrome is difficult to treat and may persist for years. This review discusses the epidemiology, comorbid symptoms, evaluation, and treatment of this disorder.

  1. Daily emotional and physical reactivity to stressors among widowed and married older adults.

    PubMed

    Hahn, Elizabeth A; Cichy, Kelly E; Small, Brent J; Almeida, David M

    2014-01-01

    Widowhood may result in declines in health and potentially stressful changes to daily routines. However, little research has examined how daily stressors contribute to physical and emotional well-being in widowhood. The objectives of the current study were to examine daily stressor exposure and reactivity in widowed versus married older adults. Participants included all 100 widowed and 342 married adults aged 65 and older from the National Study of Daily Experiences, a daily diary study from the second wave of the Midlife in the United States. Daily stressors were measured using the Daily Inventory of Stressful Events; multilevel modeling assessed daily reactivity to stressors using daily negative affect (emotional reactivity) and daily physical symptoms (physical reactivity) as outcomes. Married participants reported more stressors in general, and specifically more interpersonal stressors (e.g., arguments). Both married and widowed participants were reactive to daily stressors. Married participants were physically and emotionally reactive to interpersonal stressors. Widowed participants were more physically reactive to home-related stressors. Attention to the types of daily stressors that widowed older adults experience in daily life and the potential physical effects of daily stressors during widowhood may help to alleviate some of the physical distress that widowed older adults may experience.

  2. Daily Emotional and Physical Reactivity to Stressors Among Widowed and Married Older Adults

    PubMed Central

    2014-01-01

    Objectives. Widowhood may result in declines in health and potentially stressful changes to daily routines. However, little research has examined how daily stressors contribute to physical and emotional well-being in widowhood. The objectives of the current study were to examine daily stressor exposure and reactivity in widowed versus married older adults. Method. Participants included all 100 widowed and 342 married adults aged 65 and older from the National Study of Daily Experiences, a daily diary study from the second wave of the Midlife in the United States. Daily stressors were measured using the Daily Inventory of Stressful Events; multilevel modeling assessed daily reactivity to stressors using daily negative affect (emotional reactivity) and daily physical symptoms (physical reactivity) as outcomes. Results. Married participants reported more stressors in general, and specifically more interpersonal stressors (e.g., arguments). Both married and widowed participants were reactive to daily stressors. Married participants were physically and emotionally reactive to interpersonal stressors. Widowed participants were more physically reactive to home-related stressors. Discussion. Attention to the types of daily stressors that widowed older adults experience in daily life and the potential physical effects of daily stressors during widowhood may help to alleviate some of the physical distress that widowed older adults may experience. PMID:23685921

  3. Variations/Changes in Daily Precipitation Extremes Derived from Satellite-Based Products

    NASA Astrophysics Data System (ADS)

    Gu, G.; Adler, R. F.

    2017-12-01

    Interannual/decadal-scale variations/changes in daily precipitation extremes are investigated by means of satellite-based high-spatiotemporal resolution precipitation products, including TRMM-TMPA, PERSIANN-CDR-Daily, GPCP 1DD, etc. Extreme precipitation indices at grids are first defined, including the maximum daily precipitation amount (Rx1day), the simple precipitation intensity index (SDII), the conditional (Rcond) daily precipitation rate (Pr>0 mm day-1), and monthly frequencies of rainy (FOCc) and wet (FOCw) days. Other two precipitation intensity indices, i.e., mean daily precipitation rates for Pr ≥10 mm day-1 (Pr10II) and for Pr ≥ 20 mm day-1 (Pr20II), are also constructed. Consistency analyses of daily extreme indices among these data sets are then performed by comparing corresponding averages over large domains such as tropical (30oN-30oS) land, ocean, land+ocean, for their common period (post-1997). This can provide a preliminary uncertainty analysis of these data sets in describing daily extreme precipitation events. Discrepancies can readily be found among these products regarding the magnitudes of area-averaged extreme indices. However, generally consistent temporal variations can be found among the indices derived from different satellite products. Interannual variability in daily precipitation extremes are then examined and compared at grids by exploring their relations with the El Nino-Southern Oscillation (ENSO). Linear correlation and composite analyses are used to examine the impact of ENSO on these extreme indices at grids and over large domains during the post-1997 period. Decadal-scale variability/change in daily extreme events is further examined by using the PERSIANN-CDR-Daily that can cover the entire post-1983 period, based on its general consistency with other two products during the post-1979 period. We specifically focus on exploring and discriminating the effects of decadal-scale internal variability such as the Pacific Decadal

  4. Daily Concordance between Parent and Adolescent Sleep Habits

    PubMed Central

    Fuligni, Andrew J.; Tsai, Kim M.; Krull, Jennifer L.; Gonzales, Nancy A.

    2014-01-01

    Purpose To assess the daily concordance between parent and adolescent daily sleep habits, how that concordance compares to other predictors of sleep, and whether the degree of concordance varies across families. Methods A total of 421 adolescents (Mage = 15.03 years) and their primary caregivers (Mage = 41.93 years) reported their sleep, bed, and wake times on a daily basis for a two-week period. Approximately 80% of the sample repeated the same protocol one year later. Results Multi-level modeling indicated a significant concordance between parent and adolescent sleep, bed, and wake times on a daily basis. Concordance existed independent of other predictors of sleep such as day of the week and adolescent study time. Larger families and those with higher levels of parent-adolescent support exhibited greater concordance. Conclusions Adolescent sleep is connected to the sleep habits of their parents, above and beyond commonly-known structural and experiential factors that can shape teenage sleep. Efforts to improve teenage sleep should pay greater attention to the sleep patterns of parents and potentially other family members. PMID:25620309

  5. Compliance, clinical outcome, and quality of life of patients with stable angina pectoris receiving once-daily betaxolol versus twice daily metoprolol: a randomized controlled trial

    PubMed Central

    Kardas, Przemyslaw

    2007-01-01

    Background A randomized, controlled trial was conducted in an outpatient setting to examine the effect of beta-blocker dosing frequency on patient compliance, clinical outcome, and health-related quality of life in patients with stable angina pectoris. Methods One hundred and twelve beta-blockers-naive outpatients with stable angina pectoris were randomized to receive betaxolol, 20 mg once daily or metoprolol tartrate, 50 mg twice daily for 8 weeks. The principal outcome measure was overall compliance measured electronically, whereas secondary outcome measures were drug effectiveness and health-related quality of life. Results The overall compliance was 86.5 ± 21.3% in the betaxolol group versus 76.1 ± 26.3% in the metoprolol group (p < 0.01), and the correct number of doses was taken on 84.4 ± 21.6% and 64.0 ± 31.7% of treatment days, respectively (p < 0.0001). The percentage of missed doses was 14.5 ± 21.5% in the once-daily group and 24.8 ± 26.4% in the twice-daily group (p < 0.01). The percentage of doses taken in the correct time window (58.6% vs 42.0%, p = 0.01), correct interdose intervals (77.4% v 53.1%, p < 0.0001), and therapeutic coverage (85.6% vs 73.7%, p < 0.001) were significantly higher in the once-daily group. Both studied drugs had similar antianginal effectiveness. Health-related quality of life improved in both groups, but this increase was more pronounced in the betaxolol arm in some dimensions. Conclusions The study demonstrates that patient compliance with once-daily betaxolol is significantly better than with twice daily metoprolol. Similarly, this treatment provides better quality of life. These results demonstrate possible therapeutic advantages of once-daily over twice-daily beta-blockers in the treatment of stable angina pectoris. PMID:17580734

  6. Daily Autonomy Support and Sexual Identity Disclosure Predicts Daily Mental and Physical Health Outcomes.

    PubMed

    Legate, Nicole; Ryan, Richard M; Rogge, Ronald D

    2017-06-01

    Using a daily diary methodology, we examined how social environments support or fail to support sexual identity disclosure, and associated mental and physical health outcomes. Results showed that variability in disclosure across the diary period related to greater psychological well-being and fewer physical symptoms, suggesting potential adaptive benefits to selectively disclosing. A multilevel path model indicated that perceiving autonomy support in conversations predicted more disclosure, which in turn predicted more need satisfaction, greater well-being, and fewer physical symptoms that day. Finally, mediation analyses revealed that disclosure and need satisfaction explained why perceiving autonomy support in a conversation predicted greater well-being and fewer physical symptoms. That is, perceiving autonomy support in conversations indirectly predicted greater wellness through sexual orientation disclosure, along with feeling authentic and connected in daily interactions with others. Discussion highlights the role of supportive social contexts and everyday opportunities to disclose in affecting sexual minority mental and physical health.

  7. Unsupervised daily routine and activity discovery in smart homes.

    PubMed

    Jie Yin; Qing Zhang; Karunanithi, Mohan

    2015-08-01

    The ability to accurately recognize daily activities of residents is a core premise of smart homes to assist with remote health monitoring. Most of the existing methods rely on a supervised model trained from a preselected and manually labeled set of activities, which are often time-consuming and costly to obtain in practice. In contrast, this paper presents an unsupervised method for discovering daily routines and activities for smart home residents. Our proposed method first uses a Markov chain to model a resident's locomotion patterns at different times of day and discover clusters of daily routines at the macro level. For each routine cluster, it then drills down to further discover room-level activities at the micro level. The automatic identification of daily routines and activities is useful for understanding indicators of functional decline of elderly people and suggesting timely interventions.

  8. Weak associations between the daily number of suicide cases and amount of daily sunlight.

    PubMed

    Seregi, Bernadett; Kapitány, Balázs; Maróti-Agóts, Ákos; Rihmer, Zoltán; Gonda, Xénia; Döme, Péter

    2017-02-06

    Several environmental factors with periodic changes in intensity during the calendar year have been put forward to explain the increase in suicide frequency during spring and summer. In the current study we investigated the effect of averaged daily sunshine duration of periods with different lengths and 'lags' (i.e. the number of days between the last day of the period for which the averaged sunshine duration was calculated and the day of suicide) on suicide risk. We obtained data on daily numbers of suicide cases and daily sunshine duration in Hungary from 1979 to 2013. In order to remove the seasonal components from the two time series (i.e. numbers of suicide and sunshine hours) we used the differencing method. Pearson correlations (n=22,950) were calculated to reveal associations between sunshine duration and suicide risk. The final sample consisted of 122,116 suicide cases. Regarding the entire investigated period, after differencing, sunshine duration and number of suicides on the same days showed a distinctly weak, but highly significant positive correlation in the total sample (r=0.067; p=1.17*10 -13 ). Positive significant correlations (p˂0.0001) between suicide risk on the index day and averaged sunshine duration in the previous days (up to 11days) were also found in the total sample. Our results from a large sample strongly support the hypothesis that sunshine has a prompt, but very weak increasing effect on the risk of suicide (especially violent cases among males). The main limitation is that possible confounding factors were not controlled for. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Sex in Its Daily Relational Context.

    PubMed

    Dewitte, Marieke; Van Lankveld, Jacques; Vandenberghe, Sjouke; Loeys, Tom

    2015-12-01

    The present study measured the daily correlates of sexual behavior in an ecologically valid context by relying on a daily diary approach. Examining the dyadic and multicomponent nature of sexual behavior is essential to create valid models of sexual responding that are better aligned with the day-to-day context of having sex in a relationship. During 3 weeks, heterosexual couples completed, two times a day, an electronic diary to report on mood, own and perceived partner behavior, relational feelings (in the evening), sexual activity, physical intimacy, and masturbation (in the morning). This design allowed testing bidirectional temporal associations between daily context and different types of sexual behavior. Positive mood, displays of positive partner behavior, perceived positive partner behavior, and positive relational feelings predicted more sexual activity and intimacy in men, which then further increased their positive mood, perceived positive partner behavior, and positive feelings about the relationship on the following day. Women showed a similar pattern of predictors regarding sexual activity as men, though the effect of sexual behavior on next-day feelings and behavior was more relationship-oriented rather than affecting personal mood. Intimacy was related to almost all daily variables in women, but related only to own and perceived positive partner behavior and positive relational feelings the next day. Several partner effects also reached significance, and these were more influential in predicting male than female intimacy. Solitary sexual activity showed a different pattern of results than dyadic sexual activity, with men experiencing masturbation as negatively in the context of their relationship. These results confirm the regulatory function of sex and intimacy in maintaining a positive relational climate and indicate that the quality of the everyday relational context is important to get partners in the mood to act in a sexual way. © 2015

  10. Efficacy and Safety of Once-Daily Minoxidil Foam 5% Versus Twice-Daily Minoxidil Solution 2% in Female Pattern Hair Loss: A Phase III, Randomized, Investigator-Blinded Study.

    PubMed

    Blume-Peytavi, Ulrike; Shapiro, Jerry; Messenger, Andrew G; Hordinsky, Maria K; Zhang, Paul; Quiza, Carlos; Doshi, Uday; Olsen, Elise A

    2016-07-01

    A once-daily minoxidil topical foam (MTF) has been developed to treat female pattern hair loss.
    Determine noninferiority of once-daily 5% MTF versus twice-daily 2% minoxidil topical solution (MTS) based on the change from baseline in target area hair count (TAHC) at 24 weeks. In a randomized, phase III trial, women with female pattern hair loss received once-daily 5% MTF (n=161) or twice-daily 2% MTS (n=161) for 52 weeks. Primary endpoint was change from baseline in TAHC at 24 weeks. Secondary endpoint was change from baseline in TAHC at 12 weeks. Exploratory endpoints included change in total unit area density and change in overall scalp coverage.
    Once-daily 5% MTF increased TAHC from baseline (adjusted mean ± standard error) by 23.9 ± 2.1 hairs/cm2 at week 24. Twice-daily 2% MTS increased TAHC 24.2 ± 2.1 hairs/cm2 at week 24. The treatment difference was -0.3 hairs/cm2 (95% CI = -6.0, 5.4). Since the lower bound of the 95% CI was less than -5.0, the prespecified noninferiority goal was not met. Both treatments were well tolerated.
    Once-daily 5% MTF and twice-daily 2% MTS induced hair regrowth in female pattern hair loss, but prespecified noninferiority criteria were not met.
    ClinicalTrials.gov identifier: NCT01145625

    J Drugs Dermatol. 2016;15(7):883-889.

  11. Clinical trial: a novel high-dose 1 g mesalamine suppository (Salofalk) once daily is as efficacious as a 500-mg suppository thrice daily in active ulcerative proctitis.

    PubMed

    Andus, Tilo; Kocjan, Andreas; Müser, Moritz; Baranovsky, Andrey; Mikhailova, Tatyana L; Zvyagintseva, Tatyana D; Dorofeyev, Andrey E; Lozynskyy, Yurii S; Cascorbi, Ingolf; Stolte, Manfred; Vieth, Michael; Dilger, Karin; Mohrbacher, Ralf; Greinwald, Roland

    2010-11-01

    Mesalamine suppositories are first-line therapy in active ulcerative proctitis; the standard regime still recommends multiple doses per day. The primary objective of this study was to show the noninferiority of once-daily administration of a novel 1 g mesalamine suppository versus thrice-daily administration of the 0.5 g mesalamine suppository. This was a single-blind (investigator-blinded), randomized, multicenter, comparative, Phase III clinical trial. Patients with mild to moderately active ulcerative proctitis inserted either one mesalamine 1 g suppository at bedtime or one mesalamine 0.5 g suppository thrice daily over a 6-week period. The primary endpoint was rate of remission (Disease Activity Index below 4). In all, 354 patients were evaluable for safety and per-protocol analysis. The new regimen demonstrated noninferiority: The percentage of patients with remission was 87.9% for the once-daily 1 g mesalamine suppository and 90.7% for the thrice-daily 0.5 g mesalamine suppository. Each regimen resulted in prompt cessation of clinical symptoms (e.g., median time to ≤3 stools per day (all without blood): 5 days in the 1 g mesalamine once-daily and 7 days in the 0.5 g mesalamine thrice-daily group). Patients preferred applying suppositories once a day. In active ulcerative proctitis the once-daily administration of a 1 g mesalamine suppository is as effective and safe, yet considerably more convenient, than the standard thrice-daily administration of a 0.5 g mesalamine suppository.

  12. Family and school spillover in adolescents' daily lives.

    PubMed

    Flook, Lisa; Fuligni, Andrew J

    2008-01-01

    This study examined spillover between daily family stressors and school problems among 589 ninth-grade students (mean age = 14.9 years) from Mexican, Chinese, and European backgrounds. Spillover was examined using a daily diary methodology in which adolescents reported on their school and family experiences each day for 2 weeks. Analyses using hierarchical linear modeling revealed reciprocal spillover effects between adolescents' daily functioning in the family and school domains that spanned several days. Longitudinal analyses indicated that spillover between family stressors and school problems also occurs across the high school years, from 9th to 12th grade, and that both are predictive of poorer academic performance in 12th grade. These findings have practical implications for adolescents' academic achievement trajectories and general well-being.

  13. New daily persistent headache in children and adolescents.

    PubMed

    Baron, Eric P; Rothner, A David

    2010-03-01

    New daily persistent headache (NDPH) is a form of chronic daily headache (CDH) that may have features of both migraine and tension-type headache. In contrast with other types of CDH, NDPH is characterized by patients recalling the specific date their unremitting daily headache began. In comparison, chronic tension-type headache and chronic migraine are preceded by a gradually increasing frequency of headache. After several months, all three of these CDH forms often have a similar phenotype, making early history a key to diagnosing NDPH. Evaluations to exclude secondary causes are necessary but usually negative. NDPH is difficult to treat and requires a multimodal approach. Questions regarding NDPH remain unanswered. Additional prospective studies are necessary to further understand, characterize, diagnose, and treat NDPH.

  14. Characterizing Sub-Daily Flow Regimes: Implications of Hydrologic Resolution on Ecohydrology Studies

    DOE PAGES

    Bevelhimer, Mark S.; McManamay, Ryan A.; O'Connor, B.

    2014-05-26

    Natural variability in flow is a primary factor controlling geomorphic and ecological processes in riverine ecosystems. Within the hydropower industry, there is growing pressure from environmental groups and natural resource managers to change reservoir releases from daily peaking to run-of-river operations on the basis of the assumption that downstream biological communities will improve under a more natural flow regime. In this paper, we discuss the importance of assessing sub-daily flows for understanding the physical and ecological dynamics within river systems. We present a variety of metrics for characterizing sub-daily flow variation and use these metrics to evaluate general trends amongmore » streams affected by peaking hydroelectric projects, run-of-river projects and streams that are largely unaffected by flow altering activities. Univariate and multivariate techniques were used to assess similarity among different stream types on the basis of these sub-daily metrics. For comparison, similar analyses were performed using analogous metrics calculated with mean daily flow values. Our results confirm that sub-daily flow metrics reveal variation among and within streams that are not captured by daily flow statistics. Using sub-daily flow statistics, we were able to quantify the degree of difference between unaltered and peaking streams and the amount of similarity between unaltered and run-of-river streams. The sub-daily statistics were largely uncorrelated with daily statistics of similar scope. Furthermore, on short temporal scales, sub-daily statistics reveal the relatively constant nature of unaltered streamreaches and the highly variable nature of hydropower-affected streams, whereas daily statistics show just the opposite over longer temporal scales.« less

  15. Trends in Daily Cannabis Use Among Cigarette Smokers: United States, 2002-2014.

    PubMed

    Goodwin, Renee D; Pacek, Lauren R; Copeland, Jan; Moeller, Scott J; Dierker, Lisa; Weinberger, Andrea; Gbedemah, Misato; Zvolensky, Michael J; Wall, Melanie M; Hasin, Deborah S

    2018-01-01

    To estimate changes in the prevalence of daily cannabis use among current, former, and never cigarette smokers from 2002 to 2014 in the United States. The National Survey on Drug Use and Health is a nationally representative cross-sectional study conducted annually among persons aged 12 years and older in the United States. Daily cannabis use occurs nearly exclusively among nondaily and daily cigarette smokers compared with former and never smokers (8.03%, 9.01%, 2.79%, 1.05%, respectively). Daily cannabis use increased over the past decade among both nondaily (8.03% [2014] vs 2.85% [2002]; linear trend P < .001) and daily smokers (9.01% [2014]; 4.92% [2002]; linear trend P < .001). Daily cannabis use increased most rapidly among former cigarette smokers (2.79% [2014] vs 0.98% [2002]; linear trend P < .001). Daily cannabis use occurs predominantly among cigarette smokers in the United States. Daily cannabis use increased among current, former, and never smokers over the past decade, with particularly rapid increases among youth and female cigarette smokers. Future research is needed to monitor the observed increase in daily cannabis use, especially among youths and adults who smoke cigarettes.

  16. Fish Consumption, Sleep, Daily Functioning, and Heart Rate Variability

    PubMed Central

    Hansen, Anita L.; Dahl, Lisbeth; Olson, Gina; Thornton, David; Graff, Ingvild E.; Frøyland, Livar; Thayer, Julian F.; Pallesen, Staale

    2014-01-01

    Study Objectives: This study investigated the effects of fatty fish on sleep, daily functioning and biomarkers such as heart rate variability (HRV), vitamin D status (serum 25-hydroxyvitamin D (25OHD), and eicosapentaenoic acid (EPA, 20:5n-3) + docosahexaenoic acid (DHA, 22:6n-3) in red blood cells. Moreover the relationship among sleep, daily functioning, HRV, vitamin D status, and levels of EPA+DHA was investigated. Methods: Ninety-five male forensic patients from a secure forensic inpatient facility in the USA were randomly assigned into a Fish or a Control group. The Fish group received Atlantic salmon three times per week from September to February, and the Control group was provided an alternative meal (e.g., chicken, pork, beef), but with the same nutritional value as their habitual diet, three times per week during the same period. Sleep (sleep latency, sleep efficiency, actual sleep time, and actual wake time), self-perceived sleep quality and daily functioning, as well as vitamin D status, EPA+DHA, and HRV, were assessed pre- and post-intervention period. Results: There was a significant increase in sleep latency from pre- to post-test in the Control group. The Fish group reported better daily functioning than the Control group during post-test. Fish consumption throughout the wintertime had also an effect on resting HRV and EPA+DHA, but not on vitamin D status. However, at post-test, the vitamin D status in the Fish group was still closer to the level regarded as optimal compared to the Control group. Vitamin D status correlated negatively with actual wake time and positively with sleep efficiency during pre-test, as well as positively with daily functioning and sleep quality during post-test. Finally, HRV correlated negatively with sleep latency and positively with daily functioning. Conclusions: Fish consumption seemed to have a positive impact on sleep in general and also on daily functioning, which may be related to vitamin D status and HRV. Citation

  17. Sedentary Behavior as a Daily Process Regulated by Habits and Intentions

    PubMed Central

    Conroy, David E.; Maher, Jaclyn P.; Elavsky, Steriani; Hyde, Amanda L.; Doerksen, Shawna E.

    2014-01-01

    Objective Sedentary behavior is a health risk but little is known about the motivational processes that regulate daily sedentary behavior. This study was designed to test a dual-process model of daily sedentary behavior, with an emphasis on the role of intentions and habits in regulating daily sedentary behavior. Methods College students (N = 128) self-reported on their habit strength for sitting and completed a 14-day ecological momentary assessment study that combined daily diaries for reporting motivation and behavior with ambulatory monitoring of sedentary behavior using accelerometers. Results Less than half of the variance in daily sedentary behavior was attributable to between-person differences. People with stronger sedentary habits reported more sedentary behavior on average. People whose intentions for limiting sedentary behavior were stronger, on average, exhibited less self-reported sedentary behavior (and marginally less monitored sedentary behavior). Daily deviations in those intentions were negatively associated with changes in daily sedentary behavior (i.e., stronger than usual intentions to limit sedentary behavior were associated with reduced sedentary behavior). Sedentary behavior also varied within-people as a function of concurrent physical activity, the day of week, and the day in the sequence of the monitoring period. Conclusions Sedentary behavior was regulated by both automatic and controlled motivational processes. Interventions should target both of these motivational processes to facilitate and maintain behavior change. Links between sedentary behavior and daily deviations in intentions also indicate the need for ongoing efforts to support controlled motivational processes on a daily basis. PMID:23477579

  18. Physiological responses to daily light exposure

    NASA Astrophysics Data System (ADS)

    Yang, Yefeng; Yu, Yonghua; Yang, Bo; Zhou, Hong; Pan, Jinming

    2016-04-01

    Long daylength artificial light exposure associates with disorders, and a potential physiological mechanism has been proposed. However, previous studies have examined no more than three artificial light treatments and limited metabolic parameters, which have been insufficient to demonstrate mechanical responses. Here, comprehensive physiological response curves were established and the physiological mechanism was strengthened. Chicks were illuminated for 12, 14, 16, 18, 20, or 22 h periods each day. A quadratic relationship between abdominal adipose weight (AAW) and light period suggested that long-term or short-term light exposure could decrease the amount of AAW. Quantitative relationships between physiological parameters and daily light period were also established in this study. The relationships between triglycerides (TG), cholesterol (TC), glucose (GLU), phosphorus (P) levels and daily light period could be described by quadratic regression models. TG levels, AAW, and BW positively correlated with each other, suggesting long-term light exposure significantly increased AAW by increasing TG thus resulting in greater BW. A positive correlation between blood triiodothyronine (T3) levels and BW suggested that daily long-term light exposure increased BW by thyroid hormone secretion. Though the molecular pathway remains unknown, these results suggest a comprehensive physiological mechanism through which light exposure affects growth.

  19. Understanding metropolitan patterns of daily encounters

    PubMed Central

    Sun, Lijun; Axhausen, Kay W.; Lee, Der-Horng; Huang, Xianfeng

    2013-01-01

    Understanding of the mechanisms driving our daily face-to-face encounters is still limited; the field lacks large-scale datasets describing both individual behaviors and their collective interactions. However, here, with the help of travel smart card data, we uncover such encounter mechanisms and structures by constructing a time-resolved in-vehicle social encounter network on public buses in a city (about 5 million residents). Using a population scale dataset, we find physical encounters display reproducible temporal patterns, indicating that repeated encounters are regular and identical. On an individual scale, we find that collective regularities dominate distinct encounters’ bounded nature. An individual’s encounter capability is rooted in his/her daily behavioral regularity, explaining the emergence of “familiar strangers” in daily life. Strikingly, we find individuals with repeated encounters are not grouped into small communities, but become strongly connected over time, resulting in a large, but imperceptible, small-world contact network or “structure of co-presence” across the whole metropolitan area. Revealing the encounter pattern and identifying this large-scale contact network are crucial to understanding the dynamics in patterns of social acquaintances, collective human behaviors, and—particularly—disclosing the impact of human behavior on various diffusion/spreading processes. PMID:23918373

  20. SDCLIREF - A sub-daily gridded reference dataset

    NASA Astrophysics Data System (ADS)

    Wood, Raul R.; Willkofer, Florian; Schmid, Franz-Josef; Trentini, Fabian; Komischke, Holger; Ludwig, Ralf

    2017-04-01

    Climate change is expected to impact the intensity and frequency of hydrometeorological extreme events. In order to adequately capture and analyze extreme rainfall events, in particular when assessing flood and flash flood situations, data is required at high spatial and sub-daily resolution which is often not available in sufficient density and over extended time periods. The ClimEx project (Climate Change and Hydrological Extreme Events) addresses the alteration of hydrological extreme events under climate change conditions. In order to differentiate between a clear climate change signal and the limits of natural variability, unique Single-Model Regional Climate Model Ensembles (CRCM5 driven by CanESM2, RCP8.5) were created for a European and North-American domain, each comprising 50 members of 150 years (1951-2100). In combination with the CORDEX-Database, this newly created ClimEx-Ensemble is a one-of-a-kind model dataset to analyze changes of sub-daily extreme events. For the purpose of bias-correcting the regional climate model ensembles as well as for the baseline calibration and validation of hydrological catchment models, a new sub-daily (3h) high-resolution (500m) gridded reference dataset (SDCLIREF) was created for a domain covering the Upper Danube and Main watersheds ( 100.000km2). As the sub-daily observations lack a continuous time series for the reference period 1980-2010, the need for a suitable method to bridge the gap of the discontinuous time series arouse. The Method of Fragments (Sharma and Srikanthan (2006); Westra et al. (2012)) was applied to transform daily observations to sub-daily rainfall events to extend the time series and densify the station network. Prior to applying the Method of Fragments and creating the gridded dataset using rigorous interpolation routines, data collection of observations, operated by several institutions in three countries (Germany, Austria, Switzerland), and the subsequent quality control of the observations

  1. Daily concordance between parent and adolescent sleep habits.

    PubMed

    Fuligni, Andrew J; Tsai, Kim M; Krull, Jennifer L; Gonzales, Nancy A

    2015-02-01

    To assess the daily concordance between parent and adolescent daily sleep habits, how that concordance compares to other predictors of sleep, and whether the degree of concordance varies across families. A total of 421 adolescents (Mage = 15.03 years) and their primary caregivers (Mage = 41.93 years) reported their sleep, bed, and wake times on a daily basis for a 2-week period. Approximately 80% of the sample repeated the same protocol 1 year later. Multilevel modeling indicated a significant concordance between parent and adolescent sleep, bed, and wake times on a daily basis. Concordance existed independent of other predictors of sleep such as day of the week and adolescent study time. Larger families and those with higher levels of parent-adolescent support exhibited greater concordance. Adolescent sleep is connected to the sleep habits of their parents, above and beyond commonly known structural and experiential factors that can shape teenage sleep. Efforts to improve teenage sleep should pay greater attention to the sleep patterns of parents and potentially other family members. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Effects of daily living occupational therapy and resistance exercise on the activities of daily living and muscular fitness in Guillain-Barré syndrome: a case study.

    PubMed

    Ko, Kwang-Jun; Ha, Gi-Chul; Kang, Seol-Jung

    2017-05-01

    [Purpose] The study aimed to investigate the effects of daily living occupational therapy and resistance exercise on the performance of activities of daily living and muscular fitness in a patient with Guillain-Barré syndrome. [Subject and Methods] A 35-year-old man was diagnosed with Guillain-Barré syndrome. He was hospitalized at A Hospital for 3 years, and was discharged from the hospital after he became able to execute daily life activities. After discharge, he performed daily occupational therapy and resistance exercise twice a week for 70 minutes per session for 12 weeks. Performance in the activities of daily living was assessed using the modified Barthel index, and muscular fitness was measured in terms of isokinetic muscular function using the Biodes system. [Results] The subject's Barthel index score improved from 54 points before the intervention to 62 points after 4 weeks, 69 points after 8 weeks, and 79 points after 12 weeks. In addition, his shoulder flexion and extension, knee flexion and extension, and lumbar flexion and extension were improved. [Conclusion] The present study suggests that daily living occupational therapy and resistance exercise are effective in improving the activities of daily living and muscular fitness in a patient recovering from Guillain-Barré syndrome.

  3. Relationships between fire danger and the daily number and daily growth of active incidents burning in the northern Rocky Mountains, USA

    Treesearch

    Patrick H. Freeborn; Mark A. Cochrane; W. Matt Jolly

    2015-01-01

    Daily National Fire Danger Rating System (NFDRS) indices are typically associated with the number and final size of newly discovered fires, or averaged over time and associated with the likelihood and total burned area of large fires. Herein we used a decade (2003-12) of NFDRS indices and US Forest Service (USFS) fire reports to examine daily relationships between fire...

  4. Loneliness, Daily Pain, and Perceptions of Interpersonal Events in Adults with Fibromyalgia

    PubMed Central

    Wolf, Laurie Dempsey; Davis, Mary C.

    2014-01-01

    Objective This study examined whether individual differences in loneliness and/or daily exacerbations in loneliness relate to daily pain and frequency and perception of interpersonal events among individuals with fibromyalgia (FM). Methods 118 participants with FM completed electronic diaries each evening for 21 days to assess the occurrence of positive and negative interpersonal events, event appraisals, and pain. Multilevel modeling was used to examine relations of chronic and transitory loneliness to daily life outcomes, controlling for daily depressive symptoms. Results Chronic and transitory loneliness were associated with more frequent reports of negative and less frequent reports of positive interpersonal daily events, higher daily stress ratings and lower daily enjoyment ratings, and higher daily pain levels. Neither chronic nor transitory loneliness moderated the relations between daily negative events and either stress appraisals or pain. However, both chronic and transitory loneliness moderated the relation between daily positive events and enjoyment appraisals. Specifically, on days of greater numbers of positive events than usual, lonely people had larger boosts in enjoyment than did nonlonely people. Similarly, days with greater than usual numbers of positive events were related to larger boosts in enjoyment if an individual was also experiencing higher than usual loneliness levels. Conclusions Chronic and transient episodes of loneliness are associated with more negative daily social relations and pain. However, boosts in positive events yield greater boosts in day-to-day enjoyment of social relations for lonely versus nonlonely individuals, and during loneliness episodes, a finding that can inform future interventions for individuals with chronic pain. PMID:25180546

  5. Daily affect variability and context-specific alcohol consumption.

    PubMed

    Mohr, Cynthia D; Arpin, Sarah; McCabe, Cameron T

    2015-11-01

    Research explored the effects of variability in negative and positive affect on alcohol consumption, specifying daily fluctuation in affect as a critical form of emotion dysregulation. Using daily process methodology allows for a more objective calculation of affect variability relative to traditional self-reports. The present study models within-person negative and positive affect variabilities as predictors of context-specific consumption (i.e. solitary vs. social drinking), controlling for mean levels of affect. A community sample of moderate-to-heavy drinkers (n = 47; 49% women) from a US metropolitan area reported on affect and alcohol consumption thrice daily for 30 days via a handheld electronic interviewer. Within-person affect variability was calculated using daily standard deviations in positive and negative affect. Within person, greater negative and positive variabilities are related to greater daily solitary and social consumption. Across study days, mean levels of negative and positive affect variabilities related to greater social consumption between persons; yet, aggregated negative affect variability was related to less solitary consumption. Results affirm affect variability as a unique predictor of alcohol consumption, independent of mean affect levels. Yet, it is important to differentiate social context of consumption, as well as type of affect variability, particularly at the between-person level. These distinctions help clarify inconsistencies in the self-medication literature regarding associations between average levels of affect and consumption. Importantly, consistent within-person relationships for both variabilities support arguments that both negative and positive affect variabilities are detrimental and reflect an inability to regulate emotional experience. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  6. Daily participation in sports and students' sexual activity.

    PubMed

    Habel, Melissa A; Dittus, Patricia J; De Rosa, Christine J; Chung, Emily Q; Kerndt, Peter R

    2010-12-01

    Previous studies suggest that student athletes may be less likely than nonathletes to engage in sexual behavior. However, few have explored sexual risk behavior among athletes in early adolescence. In 2005, a sample of 10,487 students in 26 Los Angeles public middle and high schools completed a self-administered survey that asked about their demographic characteristics, sports participation, sexual behaviors and expectations, and parental relationships. Chi-square analyses compared reported levels of daily participation in sports, experience with intercourse, experience with oral sex and condom use at last intercourse by selected characteristics. Predictors of sexual experience and condom use were assessed in multivariate logistic regression analyses. One-third of students reported daily participation in sports. This group had higher odds of ever having had intercourse and ever having had oral sex than their peers who did not play a sport daily (odds ratios, 1.2 and 1.1, respectively). The increases in risk were greater for middle school sports participants than for their high school counterparts (1.5 and 1.6, respectively). Among sexually experienced students, daily sports participants also had elevated odds of reporting condom use at last intercourse (1.4). Students as young as middle school age who participate in sports daily may have an elevated risk for STDs and pregnancy. Health professionals should counsel middle school athletes about sexual risk reduction, given that young students may find it particularly difficult to obtain contraceptives, STD testing and prevention counseling. Copyright © 2010 by the Guttmacher Institute.

  7. Control of hypertension with single daily doses of sotalol hydrochloride.

    PubMed

    Gabriel, R

    A study was carried out in 12 previously untreated hypertensive patients to assess the efficacy of sotalol given in a once-daily dosage regimen. After an initial dosage titration period (mean 3 weeks) during which diastolic pressure was stabilized at less than 100 mmHg, all patients were satisfactorily maintained on a constant once-daily dose of sotalol for 3 months. Eight of the 12 patients required 320 mg or less daily (mean dose 190 mg). Whilst blood pressure remained controlled for at least 26 hours after daily doses the pulse rate, counted at the same time, showed escape from beta-blockade. Side-effects (vivid dreams) were reported in only 1 patient.

  8. Intraindividual Coupling of Daily Stressors and Cognitive Interference in Old Age

    PubMed Central

    Mogle, Jacqueline; Sliwinski, Martin J.

    2011-01-01

    Objectives. The current study examined emotional and cognitive reactions to daily stress. We examined the psychometric properties of a short cognitive interference measure and how cognitive interference was associated with measures of daily stress and negative affect (NA) between persons and within persons over time. Methods. A sample of 87 older adults (Mage = 83, range = 70–97, 28% male) completed measures of daily stress, cognitive interference, and NA on 6 days within a 14-day period. Results. The measure yielded a single-factor solution with good reliability both between and within persons. At the between-person level, NA accounted for the effects of daily stress on individual differences in cognitive interference. At the within-person level, NA and daily stress were unique predictors of cognitive interference. Furthermore, the within-person effect of daily stress on cognitive interference decreased significantly with age. Discussion. These results support theoretical work regarding associations among stress, NA, and cognitive interference, both across persons and within persons over time. PMID:21743045

  9. Efficacy of alternate day versus daily dosing of rosuvastatin

    PubMed Central

    Dulay, Daisy; LaHaye, Stephen A; Lahey, Karen A; Day, Andrew G

    2009-01-01

    BACKGROUND: Compared with other statins, rosuvastatin has a relatively long half-life, which may allow for the administration of this medication on an alternate day basis. OBJECTIVE: To compare the efficacy of administering rosuvastatin on a daily basis versus on an alternate day basis for the treatment of dyslipidemia. METHODS: In the present crossover study, 45 patients with documented hypercholesterolemia requiring pharmacotherapy were administered either 20 mg of rosuvastatin on alternate days or 10 mg of rosuvastatin daily for six weeks. After a four-week washout period, patients were then switched to the other regimen for another six weeks. The primary end point was the percentage reduction of low-density lipoprotein cholesterol (LDL-C). RESULTS: LDL-C decreased by 48.5% versus 40.9% with daily and alternate day dosing, respectively. This represented an additional absolute reduction of LDL-C of 7.6% (95% CI 1.8% to 13.4%, P=0.012) with the daily dosing regimen. Both dosing regimens provided similar improvements in high-density lipoprotein cholesterol and triglycerides. CONCLUSIONS: Compared with alternate day dosing, daily dosing of rosuvastatin provides a statistically significant advantage in LDL-C reduction. However, the alternate day regimen may be a viable option for those patients in whom cost is a limitation to compliance. PMID:19214297

  10. The stress of food allergy issues in daily life.

    PubMed

    Peniamina, Rana L; Mirosa, Miranda; Bremer, Philip; Conner, Tamlin S

    2016-06-01

    Food allergies are a growing health concern, but their implications for daily psychological functioning are unknown. This micro-longitudinal study investigated the daily frequency of food allergy issues and how this related to experiences of stress, mood and physical energy. One hundred and eight adults with physician-diagnosed food allergies completed an initial Internet survey followed by a 2-week Internet daily diary survey. The initial survey collected socio-demographic and food allergy information. The daily survey collected information about the participants' experiences of stress, mood, physical energy and food allergy issues during that day. Commonly experienced allergy issues included negative physical symptoms, higher food prices, anxiety about safety of food, trouble maintaining a healthy diet and anxiety/stress at social occasions. Furthermore, multilevel modelling analyses showed that stress and negative mood were significantly higher on days with more allergy issues. Older adults experienced lower positive mood and physical energy on days with more issues. This is the first study to incorporate near to real-time tracking to examine the frequency of food allergy issues and the implications for daily psychological functioning. Targeting the issues we identified could reduce stress in patients with food allergies and improve their overall quality of life.

  11. Weekly Cycles in Daily Report Data: An Overlooked Issue.

    PubMed

    Liu, Yu; West, Stephen G

    2016-10-01

    Daily diaries and other everyday experience methods are increasingly used to study relationships between two time-varying variables X and Y. Although daily data potentially often have weekly cyclical patterns (e.g., stress may be higher on weekdays and lower on weekends), the majority of daily diary studies have ignored this possibility. In this study, we investigated the effect of ignoring existing weekly cycles. We reanalyzed an empirical dataset (stress and alcohol consumption) and performed Monte Carlo simulations to investigate the impact of omitting weekly cycles. In the empirical dataset, ignoring cycles led to the inference of a significant within-person X-Y relation whereas modeling cycles suggested that this relationship did not exist. Simulation results indicated that ignoring cycles that existed in both X and Y led to bias in the estimated within-person X-Y relationship. The amount and direction of bias depended on the magnitude of the cycles, magnitude of the true within-person X-Y relation, and synchronization of the cycles. We encourage researchers conducting daily diary studies to address potential weekly cycles in their data. We provide guidelines for detecting and modeling cycles to remove their influence and discuss challenges of causal inference in daily experience studies. © 2015 Wiley Periodicals, Inc.

  12. Daily Food and Activity Diary

    MedlinePlus

    ... Department of Health & Human Services Health Topics The Science Grants and Training News and Events About NHLBI Home » Health Information for the Public » Educational Campaigns & Programs » Aim for a Healthy Weight » Eat Right » Daily Food and Activity Diary Home Assessing Your Weight ...

  13. Forecasting daily patient volumes in the emergency department.

    PubMed

    Jones, Spencer S; Thomas, Alun; Evans, R Scott; Welch, Shari J; Haug, Peter J; Snow, Gregory L

    2008-02-01

    Shifts in the supply of and demand for emergency department (ED) resources make the efficient allocation of ED resources increasingly important. Forecasting is a vital activity that guides decision-making in many areas of economic, industrial, and scientific planning, but has gained little traction in the health care industry. There are few studies that explore the use of forecasting methods to predict patient volumes in the ED. The goals of this study are to explore and evaluate the use of several statistical forecasting methods to predict daily ED patient volumes at three diverse hospital EDs and to compare the accuracy of these methods to the accuracy of a previously proposed forecasting method. Daily patient arrivals at three hospital EDs were collected for the period January 1, 2005, through March 31, 2007. The authors evaluated the use of seasonal autoregressive integrated moving average, time series regression, exponential smoothing, and artificial neural network models to forecast daily patient volumes at each facility. Forecasts were made for horizons ranging from 1 to 30 days in advance. The forecast accuracy achieved by the various forecasting methods was compared to the forecast accuracy achieved when using a benchmark forecasting method already available in the emergency medicine literature. All time series methods considered in this analysis provided improved in-sample model goodness of fit. However, post-sample analysis revealed that time series regression models that augment linear regression models by accounting for serial autocorrelation offered only small improvements in terms of post-sample forecast accuracy, relative to multiple linear regression models, while seasonal autoregressive integrated moving average, exponential smoothing, and artificial neural network forecasting models did not provide consistently accurate forecasts of daily ED volumes. This study confirms the widely held belief that daily demand for ED services is characterized by

  14. Dealing with Daily Challenges in Dementia (Deal-id Study): An Experience Sampling Study to Assess Caregivers' Sense of Competence and Experienced Positive Affect in Daily Life.

    PubMed

    van Knippenberg, Rosalia J M; de Vugt, Marjolein E; Ponds, Rudolf W; Myin-Germeys, Inez; Verhey, Frans R J

    2017-08-01

    Positive emotions and feelings of competence seem to play an important role in the well-being of caregivers of people with dementia. Both are likely to fluctuate constantly throughout the caretaking process. Unlike standard retrospective methods, momentary assessments in daily life can provide insight into these moment-to-moment fluctuations. Therefore, in this study both retrospective and momentary assessments were used to examine the relationship between caregivers' sense of competence and their experienced positive affect (PA) in daily life. Thirty Dutch caregivers provided momentary data on PA and daily sense of competence ratings for 6 consecutive days using the experience sampling methodology. Additionally, they reported retrospectively on their sense of competence with a traditional questionnaire. A positive association was found between retrospective and daily measured sense of competence. Caregivers reported corresponding levels of sense of competence on both measures. Both daily and retrospective sense of competence were positively associated with the experienced levels of PA. However, daily sense of competence appeared to be the strongest predictor. Regarding the variability in PA, only daily sense of competence showed a significant association, with a higher daily sense of competence predicting a more stable PA pattern. This study provides support for redirecting caregiver support interventions toward enhancement of positive rather than negative experiences and focusing more on caregivers' momentary emotional experiences. Momentary assessments are a valuable addition to standard retrospective measures and provide a more comprehensive and dynamic view of caregiver functioning. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  15. A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women.

    PubMed

    Blume-Peytavi, Ulrike; Hillmann, Kathrin; Dietz, Ekkehart; Canfield, Douglas; Garcia Bartels, Natalie

    2011-12-01

    Although twice-daily application of propylene glycol-containing 2% minoxidil topical solution (MTS) stimulates new hair growth, higher concentrations of minoxidil in a once-daily, propylene glycol-free formulation may improve efficacy and reduce unpleasant side effects. We sought to compare the efficacy, safety, and acceptability and to show noninferiority of once-daily 5% minoxidil topical foam (MTF) with twice-daily 2% MTS in women with androgenetic alopecia. A total of 113 women with androgenetic alopecia were randomized to 24 weeks of treatment with 5% MTF or 2% MTS. The primary efficacy parameter was change from baseline in nonvellus target area hair count at week 24. Secondary end points included change in nonvellus target area hair width, overall efficacy by global photographic review as assessed by treatment-blinded evaluators and the subject herself, adverse events, and participants' assessment of product aesthetics. After 24 weeks, women randomized to 5% MTF once daily showed noninferior target area hair count and target area hair width and experienced greater, but nonsignificant, improvements in target area hair count, target area hair width, and overall efficacy by global photographic review than those randomized to 2% MTS used twice daily. 5% MTF was significantly superior to 2% MTS in participants' agreement with "the treatment does not interfere with styling my hair" (P = .002). Women randomized to 5% MTF experienced significantly lower rates of local intolerance (P = .046) especially in pruritus and dandruff compared with 2% MTS. Because of differences in the formulations tested, study participants were not blinded to treatment. Once-daily 5% MTF is noninferior and as effective for stimulating hair growth as twice-daily 2% MTS in women with androgenetic alopecia and is associated with several aesthetic and practical advantages. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  16. Daily Fluctuation in Negative Affect for Family Caregivers of Individuals With Dementia

    PubMed Central

    Liu, Yin; Kim, Kyungmin; Almeida, David M.; Zarit, Steven H.

    2017-01-01

    Objective The study examined associations of intrinsic fluctuation in daily negative affect (i.e., depression and anger) with adult day service (ADS) use, daily experiences, and other caregiving characteristics. Methods This was an 8-day diary of 173 family caregivers of individuals with dementia. Multilevel models with common within-person variance were fit first to show average associations between daily stressors and mean level of daily affect. Then multilevel models with heterogeneous within-person variance were fit to test the hypotheses on associations between ADS use, daily experiences, and intrinsic fluctuation in daily affect. Results The study showed that, when the sum of ADS days was greater than average, there was a stabilizing effect of ADS use on caregivers’ within-person fluctuation in negative affect. Moreover, fewer daily stressors and greater-than-average daily care-related stressors, more positive events, not being a spouse, greater-than-average duration of caregiving, and less-than-average dependency of individuals with dementia on activities of daily living were associated with less fluctuation. Better sleep quality was associated with less intrinsic fluctuation in anger; and younger age and more years of education were associated with less intrinsic fluctuation in daily depression. Conclusions Because emotional stability has been argued as an aspect of emotional well-being in the general populations, intrinsic fluctuation of emotional experience was suggested as an outcome of evidence-based interventions for family caregivers. PMID:25365414

  17. The concentration-response relation between air pollution and daily deaths.

    PubMed Central

    Schwartz, J; Ballester, F; Saez, M; Pérez-Hoyos, S; Bellido, J; Cambra, K; Arribas, F; Cañada, A; Pérez-Boillos, M J; Sunyer, J

    2001-01-01

    Studies on three continents have reported associations between various measures of airborne particles and daily deaths. Sulfur dioxide has also been associated with daily deaths, particularly in Europe. Questions remain about the shape of those associations, particularly whether there are thresholds at low levels. We examined the association of daily concentrations of black smoke and SO(2) with daily deaths in eight Spanish cities (Barcelona, Bilbao, Castellón, Gijón, Oviedo, Valencia, Vitoria, and Zaragoza) with different climates and different environmental and social characteristics. We used nonparametric smoothing to estimate the shape of the concentration-response curve in each city and combined those results using a metasmoothing technique developed by Schwartz and Zanobetti. We extended their method to incorporate random variance components. Black smoke had a nearly linear association with daily deaths, with no evidence of a threshold. A 10 microg/m(3) increase in black smoke was associated with a 0.88% increase in daily deaths (95% confidence interval, 0.56%-1.20%). SO(2) had a less plausible association: Daily deaths increased at very low concentrations, but leveled off and then decreased at higher concentrations. These findings held in both one- and two-pollutant models and held whether we optimized our weather and seasonal model in each city or used the same smoothing parameters in each city. We conclude that the association with particle levels is more convincing than for SO(2), and without a threshold. Linear models provide an adequate estimation of the effect of particulate air pollution on mortality at low to moderate concentrations. PMID:11675264

  18. Bioequivalence and Safety of Twice-Daily Sustained-Release Paracetamol (Acetaminophen) Compared With 3- and 4-Times-Daily Paracetamol: A Repeat-Dose, Crossover Pharmacokinetic Study in Healthy Volunteers.

    PubMed

    Liu, Dongzhou J; Collaku, Agron

    2018-01-01

    Twice-daily sustained-release (SR) paracetamol (acetaminophen) offers convenient administration to chronic users. This study investigated at steady state (during the last 24 hours of a 3-day dosing period) the pharmacokinetics, bioequivalence, and safety of twice-daily SR paracetamol compared with extended-release (ER) and immediate-release (IR) paracetamol. In this open-label, randomized, multidose, 3-way crossover study, 28 healthy subjects received paracetamol SR (2 × 1000 mg twice daily), ER (2 × 665 mg 3 times daily), and IR (2 × 500 mg 4 times daily). At steady state, twice-daily SR paracetamol was bioequivalent to ER and IR paracetamol. The 90% confidence intervals for the ratios of geometric means were within the acceptance interval for SR/ER paracetamol (AUC 0-t , 0.973-1.033; AUC 0-24 , 0.974-1.034; AUC 0-∞ , 0.948-1.011; C max , 1.082-1.212; C av , 1.011-1.106) and SR/IR paracetamol (AUC 0-t , 0.969-1.029; AUC 0-24 , 0.968-1.027; AUC 0-∞ , 0.963-1.026; C max , 0.902-1.010; C av , 1.004-1.098). Given twice daily, the SR formulation demonstrated SR properties as expected. Mean time at or above a 4 μg/mL plasma concentration of paracetamol from 2 daily doses of the SR formulation was significantly longer than that from 4 daily doses of IR paracetamol. SR formulation also had a greater T max , a longer half-life, and lower C min compared with ER and IR paracetamol. All formulations were well tolerated. © 2017, The American College of Clinical Pharmacology.

  19. Routine assistance to parents: effects on daily mood and other stressors.

    PubMed

    Savla, Jyoti; Almeida, David M; Davey, Adam; Zarit, Steven H

    2008-05-01

    The present study examined the association of providing assistance to older parents amid everyday circumstances and short-term psychological consequences for adult children providing assistance. We explored this association using 824 daily diary interviews of 119 adult children providing assistance in the National Study of Daily Experiences by using a left-censored random effects tobit regression model that accounted for the clustered data and floor effects in reported psychological distress. Psychological distress was higher on days adult children provided assistance to their parent (b = 0.88, p <.05) even after we controlled for situational variables such as time spent on daily paid work, time spent on leisure activities, and assistance provided to individuals other than parents. Demographic and psychosocial variables such as having resident children (b = 2.14, p <.01), less education (b = -0.54, p <.05), and neuroticism (b = 2.08, p <.05), also predicted daily psychological distress. Even after we controlled for within-person (daily situational variables) and between-person factors (background characteristics), the act of providing assistance itself had immediate associations with daily mood for helpers, particularly for those with fewer resources and greater demands on time. Feasibility and success of programs that provide respite and relief services to older adults and their children should be assessed in light of daily living.

  20. Retrieving atmospheric transmissivity for biologically active daily dose, in various european sites

    NASA Astrophysics Data System (ADS)

    de La Casinière, A.; Touré, M. L.; Lenoble, J.; Cabot, T.

    2003-04-01

    In the frame of the European Project EDUCE, global UV irradiance spectra recorded all along the year in several European sites are stored in a common database located in Finland. From the spectra set of some of these stations, are calculated atmospheric transmissivities for daily doses of four biologically active UV radiation, namely: UV-B, erythema, DNA damage, and plant damage. A transmissivity is defined as the ratio of the ground level value of the daily dose of interest to its corresponding extra-atmospheric value. Multiple linear correlation of the various transmissivities with three predictors (daily sunshine fraction, cosine of the daily minimum SZA, and daily total ozone column) assumed to be independent variables, are done for year 2000. The coefficients obtained from year 2000 correlation in a given site are expected to retrieve, from the local predictors, the daily dose for year 2001 in the same site, the average error being lesser than 10% for monthly mean values, and lesser than 5% for three-monthly mean values, depending on the daily dose type. Comparison of yearly mean daily doses retrieved in a given site from coefficients obtained in other sites is also presented.

  1. Non-daily pre-exposure prophylaxis for HIV prevention

    PubMed Central

    Anderson, Peter L.; García-Lerma, J. Gerardo; Heneine, Walid

    2015-01-01

    Purpose of review To discuss non-daily pre-exposure prophylaxis (PrEP) modalities that may provide advantages compared with daily PrEP in cost and cumulative toxicity, but may have lower adherence forgiveness. Recent Findings Animal models have informed our understanding of early viral transmission events, which help guide event-driven PrEP dosing strategies. These models indicate early establishment of viral replication in rectal or cervicovaginal tissues, so event-driven PrEP should rapidly deliver high mucosal drug concentrations within hours of the potential exposure event. Macaque models have demonstrated the high biological efficacy for event-driven dosing of oral tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) against both vaginal and rectal virus transmission. In humans, the IPERGAY study demonstrated 86% efficacy for event-driven oral TDF/FTC dosing among men who have sex with men (MSM), while no similar efficacy data are available on women or heterosexual men. The HPTN 067 study showed that certain MSM populations adhere well to non-daily PrEP while other populations of women adhere more poorly to non-daily versus daily regimens. Pharmacokinetic studies following oral TDF/FTC dosing in humans, indicate that TFV-diphosphate (the active form of TFV) accumulates to higher concentrations in rectal versus cervicovaginal tissue but non-adherence in trials complicates the interpretation of differential mucosal drug concentrations. Summary Event-driven dosing for TFV-based PrEP has promise for HIV prevention in MSM. Future research of event-driven PrEP in women and heterosexual men should be guided by a better understanding of the importance of mucosal drug concentrations for PrEP efficacy and its sensitivity to adherence. PMID:26633641

  2. Development of daily "swath" mascon solutions from GRACE

    NASA Astrophysics Data System (ADS)

    Save, Himanshu; Bettadpur, Srinivas

    2016-04-01

    The Gravity Recovery and Climate Experiment (GRACE) mission has provided invaluable and the only data of its kind over the past 14 years that measures the total water column in the Earth System. The GRACE project provides monthly average solutions and there are experimental quick-look solutions and regularized sliding window solutions available from Center for Space Research (CSR) that implement a sliding window approach and variable daily weights. The need for special handling of these solutions in data assimilation and the possibility of capturing the total water storage (TWS) signal at sub-monthly time scales motivated this study. This study discusses the progress of the development of true daily high resolution "swath" mascon total water storage estimate from GRACE using Tikhonov regularization. These solutions include the estimates of daily total water storage (TWS) for the mascon elements that were "observed" by the GRACE satellites on a given day. This paper discusses the computation techniques, signal, error and uncertainty characterization of these daily solutions. We discuss the comparisons with the official GRACE RL05 solutions and with CSR mascon solution to characterize the impact on science results especially at the sub-monthly time scales. The evaluation is done with emphasis on the temporal signal characteristics and validated against in-situ data set and multiple models.

  3. Does daily folic acid supplementation reduce methotrexate efficacy?

    PubMed

    Cline, A; Jorizzo, J L

    2017-11-15

    Methotrexate is a mainstay treatment for autoimmune and inflammatory conditions in the field of Dermatology. However, in some patients, its use is associated with significant side effects and toxicity. Folate supplementation with either folic acid or folinic acid often mitigates side effects and reduces the incidence of systemic toxicity related to methotrexate. Although the value of methotrexate is clear, debate remains about folate supplementation. There is little agreement about the proper dosing or frequency of folate supplementation as many believe that daily folate supplementation can reduce methotrexate efficacy. Although daily use of folic acid does not appear to affect methotrexate efficacy, dosing of folinic acid close to methotrexate administration may hinder methotrexate efficacy. Therefore, folic acid should be used daily with methotrexate to ameliorate side effects, whereas folinic acid should only be used for methotrexate toxicity.

  4. Juvenile myoclonic epilepsy presenting as a new daily persistent-like headache.

    PubMed

    Rozen, Todd D

    2011-12-01

    New daily persistent headache (NDPH) is a recognized subtype of chronic daily headache with a unique presentation of a daily headache from onset typically in individuals with minimal or no prior headache history. Various secondary mimics of NDPH have now been documented but at present there has been no association made between primary epilepsy syndromes and new daily persistent-like headaches. A case patient is presented who developed a daily continuous headache from onset who 3 months after headache initiation had her first generalized tonic-clonic seizure. Further investigation into her history and her specific EEG pattern suggested a diagnosis of juvenile myoclonic epilepsy (JME). Her NDPH and seizures ceased with epilepsy treatment. Clinically relevant was that the headache was the primary persistent clinical symptom of her JME before the onset of generalized tonic-clonic seizures. The current case report adds another possible secondary cause of new daily persistent-like headaches to the medical literature and suggests another association between primary epilepsy syndromes and distinct headache syndromes.

  5. Satisfaction with daily occupations amongst asylum seekers in Denmark.

    PubMed

    Morville, Anne-Le; Erlandsson, Lena-Karin; Danneskiold-Samsøe, Bente; Amris, Kirstine; Eklund, Mona

    2015-05-01

    The aim of this study was to describe asylum seekers' satisfaction with daily occupations and activity level while in a Danish asylum centre, and whether this changed over time. Another aim was to describe whether exposure to torture, self-rated health measures, and ADL ability were related to their satisfaction with daily occupations and activity level. A total of 43 asylum seekers at baseline and 17 at follow-up were included. The questionnaires Satisfaction with Daily Occupations, Major Depression Inventory, WHO-5 Wellbeing, Pain Detect, a questionnaire covering torture, and basic social information were used as well as Assessment of Motor and Process Skills. The results showed a low level of satisfaction with daily occupations at both baseline and follow-up. There was no statistically significant change in satisfaction or activity level between baseline and the follow-up. Associations between AMPS process skills--education, worst pain and activity level--were present at baseline, as was a relationship between AMPS process skills and satisfaction. At follow-up, associations between WHO-5 and satisfaction and activity level and between MDI scores and activity level were found. Asylum seekers experience a low level of