Giardiasis in urban and rural Amazonas, Brazil is driven by zoonotic and cosmopolitan A and B assemblages

BACKGROUND Giardia duodenalis is a protozoan parasite that infects humans and other mammals and causes giardiasis worldwide. Giardia is genotyped into eight assemblages (A-H), with assemblages A and B considered zoonotic. OBJECTIVES The aim of this study was to determine the assemblages of G. duodenalis from individuals living in rural and urban areas of the Amazonas State. METHODS 103 human faecal specimens microscopically positive for the presence of Giardia obtained from four municipalities in Amazonas and four animal faecal specimens were genotyped based on the sequences of two genes, triosephosphate isomerase (TPI) and β-giardin (BG). FINDINGS In humans, assemblage A was the most represented with the identification of sub-assemblages AI, AII and AIII based on BG and sub-assemblages AI and AII based on TPI. Similarly, there is a diversity of sub-assemblage B considering BG (B and BIII) and TPI (B, BIII and BIV). In addition, we characterised homogeneous and heterogeneous genotypes comprising assemblages/sub-assemblages A and B in individuals from urban and rural areas. Here, for the first time, it was genotyped Giardia that infects animals from the Brazilian Amazon region. We identified sub-assemblage AI in one Ateles paniscus and two Felis catus and sub-assemblage BIV in one Lagothrix cana. MAIN CONCLUSIONS Therefore, humans and animals from the urban and rural Amazon share Giardia genotypes belonging to assemblages A and B, which are found in cosmopolitan regions around the world.

Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

Intestinal parasites and genotyping of Giardia duodenalis in children: first report of genotype B in isolates from human clinical samples in Mexico

Giardia duodenalis is one of the most prevalent enteroparasites in children. This parasite produces several clinical manifestations. The aim of this study was to determine the prevalence of genotypes of G. duodenalis causing infection in a region of southeastern Mexico. G. duodenalis cysts were isolated (33/429) from stool samples of children and molecular genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis, targeting the triosephosphate isomerase ( tpi ) and glutamate dehydrogenase ( gdh ) genes. The tpi gene was amplified in all of the cyst samples, either for assemblage A (27 samples) or assemblage B (6 samples). RFLP analysis classified the 27 tpi -A amplicons in assemblage A, subgenotype I. Samples classified as assemblage B were further analysed using PCR-RFLP of the gdh gene and identified as assemblage B, subgenotype III. To our knowledge, this is the first report of assemblage B of G. duodenalis in human clinical samples from Mexico.

Tumores quísticos del páncreas: visión quirúrgica y cohorte de pacientes / Cystic tumors of the pancreas: surgical vision and a patient cohort

Se presenta una cohorte retrospectiva de diez pacientes con tumores quísticos del páncreas, intervenidos en su mayoría – algunos por laparoscopia –, haciendo énfasis en su estudio, diagnóstico y tratamiento quirúrgico, mostrando algunas de las variables evaluadas en su manejo y con especial mención de su enfoque quirúrgico con base en una revisión sistemática de la literatura.

We present a retrospective study of a cohort of ten patients with cystic tumors of the pancreas, most of whom underwent surgery. The study emphasizes study, diagnosis, and treatment of the four who underwent laparoscopic surgery. It presents some of the variables analyzed in their management and pays special attention to their surgery treatment. A systematic review of the literature is also included.

Application of Treatment-dependent Prognosis Index (TPI) for determination of the prognosis in the cases of Oral Squamous Cell Carcinoma

Applied TNM-system for determination and prognostic classification of the cancer patients of Oral and Maxillofacial region does, however, only partly justice, if at all, to the nature of the tumor disease. And the TNM-system implies among other defects a crude simplification of the complex pattern of the tumor disease. But in clinical practice, the prognosis must be determined on the bases of a specific combination of clinical factors under consideration of various therapeutical conditions. For more reliable and objective prognosis determination for the cancer patients of Oral and Maxillofacial region, `Retrospective DOSAK(German-Austrian-Swiss Association for Head and Neck Tumors) study' introduced Treatment-dependent Prognosis Index TPI in 1982. Treatment-dependent Prognosis Index TPI gives the clinician an opportunity to determine the prognosis before starting therapy at the time of the first admission of the patient, during the therapy and immediately after complete of the therapy. The fundamental purpose of the TPI can be summarized as follows. 1) In clinical-therapeutical cancer research the TPI provides a sound basis for the planning and verification of therapy studies. 2) In clinical practice the TPI allows a reliable and objective determination of the prognosis for the individual patient and thus provides the clinician valuable assistance in planning the treatment. The authors estimated the survival curves of the 179 cases of squamous cell carcinoma from 1985.1.1 to 1992.8.31 in the Department of Oral and Maxillofacial Surgery, Seoul National University Hospital according to Treatment-dependent Prognosis Index TPI of Retrospective DOSAK study and compared with the survival curves observed in long term study on prognosis of patients.

Modality of malocclusion according to regional difference using HLD(handicapping labiolingual deviation), TPI(treatment priority index) and HMAR(handicapped malocclusion assessing record) / 대한치과교정학회지

We tried to evaluate frequencies and severities of malocclusion of various socioeconomic areas according to growth and development. To obtain objective validity, we used Handicapping Labiolingual Deviation (HLD) suggested by Draker, Treatment Priority Index (TPI) by Grainger, Handicapped Malocclusion Assessing Record (HMAR) by American Dental Association and American Association of Orthodontist. Seoul and Kwangju were selected as an urban group, Ahnyang as an middle socioeconomic group and Hwasun near the Kwangju area as an rural group. 140 (male 63, female 73) of 5th grade in 'E' elementary school students in Seoul, 202 (male 101, female 101) of 'S' elementary school students in Kwangju, 207(male 105, female 102) of 'H' elementary school students in Hwasun, and 100(male 49, female 51) of 'M' elementary school students of in Ahnyang of all the same grade were analyzed and we obtained the results as follows; 1. TPI, HLD, and HMAR showed high coincidence and reproducibility between different observer. (p<0.01) 2. In comparison of TPI, HLD, and HMAR according to clinical decision, there was statistically difference between each other. (p<0.01) 3. As the severity of malocclusion increases there was high correlation between TPI and HLD, and between HLD and HMAR (p<0.05) 4. With respect to differences between areas in TPI and HLD, there was statistically difference between Ahnyang and other areas. 5. In Seoul as an urban group there was a high incidence of periodic checkup and history of orthodontic treatment than other area. 6. Mode of feeding and posture during sleeping did not affect the severity of malocclusion. As a conclusion, TPI, HLD and HMAR are so reproducible and coincident that they can be used as a guide on evaluating the frequency and severity of malocclusion and determining the priority of orthodontic treatment to determine the need and supply of orthodontic treatment. Furthermore these indices can provide objectively valid data for establishing public health problem solution.

Screening the Mimic Antigen Epitopes of Triosephosphate Isomerase of Schistosoma japonicum Chinese Strain (Sjc Tpi) with Random Phage Peptide Library / 中国寄生虫学与寄生虫病杂志

Objective To screen the mimic antigen epitopes of the triose phosphate isomerase of Schistosoma japonicum Chinese strain (SjC TPI) and investigate their immunogenicity. Methods The random phage peptide library (PH^D^ 12) was screened with the purified antibody(IgG) against SjC TPI to get the positive phage which contained the mimic antigen epitopes of SjC TPI, and the immuno characterization of the mimic antigen epitopes were investigated. Results Two mimic antigen epitopes (M1, M2) of SjC TPI were obtained. The immuno sera of mice (Kunming strain) against the positive phages could recognize both the SjC TPI and the protein of the positive phages. The DNA sequencing data showed no homology between the sequences of the deduced amino acid of the two mimic antigen peptides and the amino acid of SjC TPI. Conclusion The two mimic antigen epitopes of SjC TPI obtained are imitative epitopes of the configuration antigen of SjC TPI.