Correlation study and histopathological description of intestinal alterations in dogs infected with Leishmania infantum / Estudo de correlação e descrição histopatológica das lesões intestinais de cães infectados com Leishmania infantum

Abstract The aim of this work was a correlation study and histopathological description of alterations associated with the presence of Leishmania infantumamastigote in the intestinal wall of dogs infected with canine visceral leishmaniasis (CVL). Three groups were used: G1 (n = 8), comprising naturally infected dogs with CVL with amastigotes of L. infantum in the small and large intestines; G2 (n = 9), infected dogs with CVL, without intestinal amastigotes; and G3 (n = 3), uninfected dogs. Histochemistry and immunohistochemistry methods were used for histopathology and amastigotes identification. 47.1% (8/17) of dogs from G1 group had amastigotes in the mucosa, submucosa and muscle layers of the small and large intestines and it was observed a prominent inflammatory reaction characterized by chronic infiltration of mononuclear cells: macrophages, lymphocytes and plasma cells. Comparison between the groups showed only a significant difference in relation to mucosal microscopic structural alterations in dogs from G1 in relation to G2 and G3. Parasite burden showed significant correlations with the microscopic alterations and clinical status of dogs in G1. By the conclusion, the inflammatory reactions caused by the parasites in the intestines might have contributed towards alterations in digestive processes, worsening the dogs’ clinical status of CVL.

Resumo O objetivo foi realizar um estudo de correlação e descrição histopatológica das lesões associadas à presença de amastigotas de Leishmania infantum na parede intestinal de cães infectados com leishmaniose visceral canina (LVC). Os cães foram subdivididos em três grupos: G1 (n = 8) cães naturalmente infectados com LVC e com amastigotas de L. infantum no intestino; G2 (n = 9) com LVC, mas sem o parasitismo intestinal; e G3 (n = 3) cães não infectados. Métodos histoquímicos e imunoistoquímicos foram utilizados para a histopatologia e a identificação das amastigotas, respectivamente. 47,1% (8/17) dos cães infectados (grupo G1) apresentavam formas amastigotas na mucosa, submucosa e camada muscular do intestino delgado e grosso, destacando-se uma reação inflamatória caracterizada por infiltrado crônico de células mononucleares; macrófagos, linfócitos e plasmócitos. Observou-se uma diferença significativa somente com relação às alterações estruturais microscópicas intestinais nos cães do G1 quando comparadas com G2 e G3. A intensidade parasitária intestinal teve correlação significativa com as alterações microscópicas e os sinais clínicos dos cães do G1. Concluiu-se que as amastigotas de L. infantum por causarem reações inflamatórias na parede intestinal dos cães podem ter contribuído para as alterações dos processos digestórios, agravando ainda mais o quadro clínico dos animais.

Pathological and parasitological characterization of infection by trematodes (Paramphistomatidae) in the large intestine of capybaras / Caracterização patológica e parasitológica da infecção por trematódeos (Paramphistomatidae) no intestino grosso de capivaras

Gross and histological lesions caused by an intestinal parasite were described in three capybaras. The parasites presented a mean length of 14 mm and width of 7 mm, were round to oval or piriform, reddish and pedunculated, and adhered strongly to the mucosa of the large intestine. The intestinal mucosa at the parasite attachment site presented loss of surface epithelium and most glands, with replacement by fibrovascular proliferation that protruded from the mucosa and was involuted by the ventral sucker of the parasite. The lamina propria presented cellular debris, eosinophils, macrophages and plasma cells. The morphological characteristics, observed using serial histological sections, made it possible to classify the parasite as a trematode (Paramphistomatidae), compatible with Taxorchis schistocotyle. One capybara also harbored many ciliated protozoa in the large intestine (at the site of attachment of the parasite) and inside the caeca of the trematodes. In conclusion, this study described a multifocal necrotizing colitis associated with T. schistocotyle parasitism in capybaras.

Lesões macroscópicas e histológicas causadas por um parasita intestinal foram descritas em três capivaras. Os parasitas apresentaram média de 14 mm de comprimento e 7 mm de largura, eram de circulares a ovais ou piriformes, avermelhados, pedunculados e estavam fortemente aderidos à mucosa do intestino grosso. A mucosa intestinal, em que os parasitas estavam aderidos, apresentou perda do epitélio e da maioria das glândulas, sendo substituídos por proliferação fibrovascular que se projetava a partir da mucosa e era envolvida pela ventosa ventral do parasita. A lâmina própria apresentou restos celulares, eosinófilos, macrófagos e plasmócitos. As características morfológicas, utilizando cortes histológicos seriados, proporcionaram a classificação do parasita como um trematoda Paramphistomatidae, compatível com Taxorchis schistocotyle. Uma capivara continha também numerosos protozoários ciliados no intestino grosso (no local de fixação do parasita) e no lúmen do ceco desses parasitos. Em síntese, este estudo demonstrou a ocorrência de colite necrótica associada ao parasitismo por T. schistocotyle em capivaras.

Conocimientos sobre parasitismo intestinal en personal médico / Knowledge about intestinal parasites among the medical personnel

OBJETIVO: evaluar los conocimientos básicos sobre parasitismo intestinal de médicos que prestan servicios en la atención primaria de salud. MÉTODOS: se realizó una encuesta que incluyó cuatro preguntas que evaluaban conocimientos generales acerca del parasitismo intestinal y una pregunta sobre Giardia lamblia, protozoo patógeno de elevada incidencia y prevalencia en nuestro medio. Se aplicó entre los meses de enero y marzo de 2011, con carácter anónimo, a un grupo de médicos de la atención primaria de salud. RESULTADOS: todos los médicos que fueron encuestados tuvieron errores al responder el cuestionario. A pesar de que en los temas evaluados las respuestas correctas superaron el 50 %, el promedio de respuestas correctas de los 26 incisos que conformaban las cinco preguntas del cuestionario fue 20,73 %. CONCLUSIONES: los médicos que prestan servicio en diferentes unidades de la atención primaria de salud, mostraron insuficiente conocimiento sobre el parasitismo intestinal, por lo que se impone el desarrollo de un programa educativo en aras de atenuar estas dificultades.

OBJECTIVE: evaluate the level of basic knowledge about intestinal parasites among primary health care doctors. METHODS: an anonymous survey was conducted made up of four questions evaluating general knowledge about intestinal parasites and one question about Giardia lamblia, a pathogenic protozoan of high incidence and prevalence in our country. The survey was applied to a group of primary health care doctors between January and March 2011. RESULTS: all the doctors surveyed had errors in their answers to the questionnaire. Despite the fact that correct answers about the topics evaluated exceeded 50 %, the average of correct answers for the 26 items included in the five questions was 20.73 %. CONCLUSIONS: primary health care doctors showed insufficient knowledge about intestinal parasites. Hence the need to develop an education program to attenuate those difficulties.

Schistosoma mansoni granuloma in late evolutive phase, in a case of tumoral form in man / Granuloma equistossomótico em fase evolutiva tardia, em um caso de forma tumoral no homem

INTRODUCTION: Authors describe human schistosomal granuloma in late chronic phase, from the morphological and evolutionary viewpoints. METHODS: The study was based on a histological analysis of two fragments obtained from a surgical biopsy of peritoneum and large intestine of a 42-year-old patient, with a pseudotumoral form mimicking a peritoneal carcinomatosis associated to the schistosomiasis hepatointestinal form. RESULTS: Two hundred and three granulomas were identified in the pseudotumor and 27 in the intestinal biopsy, with similar morphological features, most in the late chronic phase, in fibrotic healing. A new structural classification was suggested for granulomas: zone 1 (internal), 2 (intermediate) and 3 (external). CONCLUSIONS: Regarding granuloma as a whole, we may conclude that fibrosis is likely to be controlled by different and independent mechanisms in the three zones of the granuloma. Lamellar fibrosis in zone 3 seems to be controlled by matrix mesenchymal cells (fibroblasts and myoepithelial cells) and by inflammatory exudate cells (lymphocytes, plasmocytes, neutrophils, eosinophils). Annular fibrosis in zone 2, comprising a dense fibrous connective tissue, with few cells in the advanced phase, would be controlled by epithelioid cells involving zone 1 in recent granulomas. In zone 1, replacing periovular necrosis, an initialy loose and tracery connective neoformation, housing stellate cells or with fusiform nuclei, a dense paucicellular nodular connctive tissue emerges, probably induced by fibroblasts. In several granulomas, one of the zones is missing and granuloma is represented by two of them: Z3 and Z2, Z3 and Z1 or Z2 and Z1 and, ultimately, by a scar.

INTRODUÇÃO: Os autores descrevem o granuloma esquistossomótico no homem, na fase crônica tardia, do ponto de vista morfológico e evolutivo. MÉTODOS: O estudo baseou-se na análise histológica de dois fragmentos obtidos de biópsia cirúrgica do peritônio e do intestino grosso de um paciente de 42 anos de idade, com a forma pseudotumoral mimetizando carcinomatose peritoneal associada à forma hepatointestinal da esquistossomose. RESULTADOS: Foram identificados 203 granulomas no pseudotumor e 27 na biópsia intestinal, com aspectos morfológicos semelhantes, a maioria na fase crônica tardia, em cura por fibrose. Foi sugerida nova classificação estrutural para os granulomas: zona 1 (interna), zona 2 (intermediária) e zona 3 (externa). CONCLUSÕES: Considerando o granuloma como um todo, concluímos que, provavelmente, a fibrose é comandada por mecanismos diferentes e independentes nas três zonas do granuloma. A fibrose lamelar na zona 3 parece ser comandada pelas células mesenquimais da matriz (fibroblastos e células mioepiteliais) e pelas células do exsudato inflamatório (linfócitos, plasmócitos, neutrófilos, eosinófilos). A fibrose anular na zona 2, composta por conjuntivo fibroso denso, pouco celular na fase avançada, seria comandada pelas células epitelioides que envolvem a zona 1 nos granulomas recentes. Na zona 1, substituindo a necrose periovular, a neoformação conjuntiva inicialmente frouxa, rendilhada, albergando células estreladas ou com núcleos fusiformes, surge um conjuntivo denso, paucicelular, nodular, provavelmente induzido pelos fibroblastos. Em muitos granulomas falta uma das zonas descritas e o granuloma é representado apenas por duas delas: Z3 e Z2, Z3 e Z1 ou Z2 e Z1 e, no final, por uma cicatriz.

Intestinal myiasis.

Purpose: Intestinal myiasis is a condition when the fly larvae inhabit the gastrointestinal tract and are passed out in faeces. This type of infestation results when eggs or larvae of the fly, deposited on food are inadvertently taken by man. They survive the unfavourable conditions within the gastrointestinal tract and produce disturbances, which may vary from mild to severe. The condition is not uncommon and is often misdiagnosed as pinworm infestation. Correct diagnosis by the clinical microbiologist is important to avoid unnecessary treatment. Materials and Methods: We had 7 cases of intestinal myiasis. In 2 cases the larvae were reared to adult fly in modified meat and sand medium (developed by Udgaonkar). This medium is simple and can be easily prepared in the laboratory. Results: Of the 7 larvae, 5 were Sarcophaga haemorrhoidalis, 1 Megaselia species and 1 was identified as Muscina stabulans. Conclusions: S. haemorrhoidalis was the commonest maggot involved. A high index of suspicion is required for clinical diagnosis when the patient complains of passing wriggling worms in faeces for a long period without any response to antihelminthics. The reason for long duration of illness and recurrence of infestation is baffling. The nearest to cure was colonic wash. We feel prevention is of utmost importance, which is to avoid eating food articles with easy access to flies.

Enteroparasitosis en niños desnutridos graves de un hospital de la ciudad de Maracaibo, Venezuela / Intestinal parasitosis in severely malnourished children at a hospital in the city of Maracaibo, Venezuela

Para comparar la prevalencia de enteroparásitos en niños con desnutrición severa de la Unidad de Recuperación Nutricional del Hospital Chiquinquirá de Maracaibo, Estado Zulia, con niños eutróficos que asisten a la consulta de niños sanos del mismo hospital; se realizó un examen coproparasitológico a 50 niños desnutridos graves y 50 niños eutróficos, mediante examen directo; técnica de concentración (Ritchie) y coloración de Ziehl Neelsen. Entre los protozoarios, Cryptosporidium sp. ocupó el primer lugar con un 14% en el grupo de los desnutridos graves y Giardia lamblia en los eutróficos con un 20%. De los helmintos identificados, Trichuruis trichiura prevaleció con 12% en los desnutridos, mientras Ascaris lumbricoides en los eutróficos ocupó el primer lugar con un 8%. No se encontró diferencia estadísticamente significativa entre la prevalencia de parásitos en general con la edad, el sexo o la desnutrición, ni entre poliparasitismo versus monoparasitismo. La medida en que se relacionan la desnutrición y las parasitosis intestinales es difícil de esclarecer, al ser la desnutrición una condición multifactorial ya que depende de la especie parasitaria presente, la intensidad de la parasitosis, las características inmunológicas y genéticas del hospedero, del medio socioeconómico en el que se desenvuelva el individuo, entre otros factores.

To compare the prevalence of intestinal parasites in children with severe malnutrition in the Nutritional Recovery Unit at the Chiquinquirá Hospital of Maracaibo, State of Zulia, with eutrophic children attending consult for healthy children at the same hospital, stool examinations were performed for 50 seriously malnourished children and 50 eutrophic children by direct examination, using the concentration technique (Ritchie) and Ziehl Neelsen. Among the protozoa, Cryptosporidium sp. ranked first, with 14% in the group of severely malnourished and Giardia lamblia in 20% of the eutrophic children. Of the identified helminths, Trichuris trichiura prevailed, with 12% in the malnourished group, while Ascaris lumbricoides took first place with 8% in the eutrophic group. No statistically significant difference was found between the prevalence of parasites in general with age, sex or malnutrition, or between polyparasitism versus monoparasitism. The extent to which malnutrition and intestinal parasites relate is difficult to clarify, since malnutrition is a multifactorial condition that depends on the parasite species present, intensity of the parasitosis, immunologic and genetic characteristics of the host, the socio economic environment in which the individual develops and other factors.

Clinical, endoscopic and histopathological profiles of parasitic duodenitis cases diagnosed by upper digestive endoscopy / Perfil clínico, endoscópico e histopatológico de casos de duodenite parasitária diagnosticados por endoscopia digestiva alta

CONTEXT: Intestinal parasites induce detectable histopathological changes, which have been studied in groups with known diagnosis of parasitic disease. There is no available study with a larger base without previous diagnosis. OBJECTIVE: To describe clinical and histopathological findings of parasitosis diagnosed by endoscopic biopsy in patients submitted to upper digestive endoscopy. METHODS: Recorded biopsies archive at "Complexo Hospitalar Professor Edgar Santos" , a general teaching Hospital in the state of Bahia, Northeast Brazil, from January 1995 to January 2009, were reviewed. One thousand ten duodenal biopsy reports were found. Reports positive for parasites had their specimens reviewed and photographed. All blocks of biopsy selected as case were retrieved and reviewed by an experienced pathologist. Clinical, laboratorial and endoscopic data were collected. RESULTS: Eleven biopsies showed parasites, including cases of Cryptosporidium sp. and Strongyloides stercoralis. Vomiting (91 percent), abdominal pain (78 percent), diarrhea (78 percent) and weight loss (78 percent) were usual symptoms. Seventy-five percent had duodenal mucosa changes on endoscopy, while 25 percent have no changes. Anemia and low serum albumin were important laboratorial data. HIV infection association was observed. Villus atrophy and reactive epithelium were usual in Strongyloides cases. CONCLUSIONS: No endoscopic or histopathologic finding was pathognomonic. One percent of duodenal endoscopic biopsies showed parasites.

CONTEXTO: Parasitas intestinais podem induzir alterações histopatológicas, que têm sido estudadas em subgrupos com diagnóstico firmado de parasitose. Não há estudo disponível com base mais ampla, sem diagnóstico prévio. OBJETIVO: Descrever os achados clínicos e histopatológicos de parasitoses diagnosticadas por biopsia em pacientes submetidos a endoscopia digestiva alta. MÉTODO: Laudos de biopsias realizadas de janeiro de 1995 a janeiro de 2009, no Complexo Hospitalar Professor Edgar Santos, hospital geral universitário localizado no nordeste brasileiro, foram revisados. Mil e dez laudos de biopsia duodenal foram revistos. Biopsias positivas para parasitas tiveram suas lâminas revisadas e fotografadas. Todos os blocos de biopsia selecionados como casos foram recuperados e revisados por experiente patologista. Dados clínicos, laboratoriais e endoscópicos foram coletados. RESULTADOS: Onze biopsias mostraram parasitas, incluindo casos de Cryptosporidium sp. e Strongyloides stercoralis. Vômitos (91 por cento), dor abdominal (78 por cento), diarreia (78 por cento) e perda ponderal (78 por cento) foram sintomas comuns. Setenta e cinco por cento apresentaram alterações na mucosa duodenal à endoscopia, enquanto 25 por cento não apresentaram modificações. Anemia e hipoalbuminemia foram importantes dados laboratoriais. Foi observada associação com infecção pelo HIV. Atrofia de vilosidades e epitélio reativo foram comuns nos casos de S. stercoralis. CONCLUSÕES: Nenhum achado endoscópico ou histopatológico foi patognomônico. Um por cento das biopsias duodenais por via endoscópica mostraram parasitas.

Salmonella spp. en manipuladores de alimentos en los comedores de una universidad venezolana / Salmonella spp. among food handlers in the dining room at a venezuelan university

La relación existente entre una inadecuada manipulación de los alimentos y la producción de infecciones gastrointestinales a través de éstos, ha sido ampliamente demostrada y una gran variedad de microorganismos entre ellos Salmonella spp. está asociada a esta transmisión. El propósito de esta investigación fue detectar la prevalencia de Salmonella a partir de muestras de heces en manipuladores de alimentos que laboran en dos comedores universitarios del estado Zulia. Entre los meses abril y julio del año 2009, se cultivaron 40 muestras de heces de individuos asintomáticos de ambos sexos y diferentes edades. El aislamiento e identificación bioquímica y serológica se realizó siguiendo la metodología convencional. Las pruebas de susceptibilidad a los agentes antimicrobianos se efectuaron según el método de difusión del disco siguiendo los criterios establecidos por el CLSI. Del total de muestras procesadas 4 de ellas (10%) resultaron positivas para el género Salmonella, 3 (75%) correspondientes al serogrupo B y 1 (25%) resultó ser al serogrupo E1. El 50% de las cepas mostró resistencia a ampicilina. La presencia de Salmonella en las heces de los manipuladores constituye un grave problema de salud pública, que no debe pasar desapercibido debido a su elevada infectividad y a su asociación a brotes importantes

The relationship between inadequate food handling and the production of gastrointestinal infections has been amply demonstrated, and a variety of organisms, including Salmonella, are associated with this transmission. The purpose of this research was to detect the prevalence of Salmonella in stool samples from food handlers who work in two dining rooms at the Zulia state university. Between April and July of 2009, 40 samples were cultured from stools of asymptomatic individuals of both sexes and different ages. Isolation, biochemical and serological identification were performed using conventional methodology. Tests for susceptibility to antimicrobial agents were done using the disk diffusion method, following criteria established by the CLSI. Of the total samples processed, four of them (10%) were positive for Salmonella 3, (75%) for serogroup B and 1 (25%) for serogroup E1. 50% of the strains were ampicillin resistant. The presence of Salmonella in the stools of food handlers is a major public health problem that should not go unnoticed due to its high infectivity and association with major outbreaks

Lower production of IL-17A and increased susceptibility to Mycobacterium bovis in mice coinfected with Strongyloides venezuelensis

The presence of intestinal helminths can down-regulate the immune response required to control mycobacterial infection. BALB/c mice infected with Mycobacterium bovis following an infection with the intestinal helminth Strongyloides venezuelensis showed reduced interleukin-17A production by lung cells and increased bacterial burden. Also, small granulomas and a high accumulation of cells expressing the inhibitory molecule CTLA-4 were observed in the lung. These data suggest that intestinal helminth infection could have a detrimental effect on the control of tuberculosis (TB) and render coinfected individuals more susceptible to the development of TB.

Abdominal angiostrongyliasis with involvement of liver histopathologically confirmed: a case report / Angiostrongiliasis abdominal con lesión hepática histopatológicamente confirmada

Human abdominal angiostrongyliasis is a zoonotic disease caused by ingestion of the L3 larvae of Angiostrongylus costaricensis. The human infection gives rise to a pathological condition characterized by acute abdominal pain, secondary to an inflammatory granulomatous reaction, marked eosinophilia and eosinophilic vasculitis. Most commonly this disease is limited to intestinal location, primary ileocecal, affecting the mesenteric arterial branches and intestinal walls. We present one of the few cases reported around the world with simultaneous involvement of the intestines and liver, including proved presence of nematodes inside the hepatic arteriole.

La enfermedad conocida como angiostrongiliasis abdominal humana es una zoonosis causada por la ingestión del estadio larval L3 de Angiostrongylus costaricensis. En el ser humano, esta infección provoca un estado patológico caracterizado por dolor abdominal agudo, secundario a una reacción inflamatoria granulomatosa; eosinofilia marcada y vasculitis eosinofílica. Comúnmente el cuadro se encuentra limitado a una localización intestinal, predominantemente ileocecal, que compromete las ramas de la arteria mesentérica y la pared intestinal. Presentamos uno de los pocos casos reportados alrededor del mundo con hallazgos simultáneos en intestino e hígado; se incluye la demostración histológica del nemátodo dentro de la arteriola hepática.

Evaluación de la posible asociación entre la presencia de parásitos intestinales y Helicobacter pylori en población infantil de la etnia Warao, Venezuela / Evaluation of the possible association between the presence of intestinal parasites and Helicobacter pylori in children of ethnic Warao

Las infecciones por microorganismos gastrointestinales constituyen hoy en día una de las principales causas de morbilidad y mortalidad en países en vías de desarrollo. Nos planteamos como objetivo evaluar la posible asociación entre la presencia de parásitos intestinales y la infección por Helicobacter pylori, y el comportamiento de anticuerpos séricos y secretores en una población infantil de la etnia Warao del Edo. Delta Amacuro, Venezuela. La presencia de parásitos se determinó por examen microscópico directo de las heces. Los niveles séricos de IgE total, IgG anti H. pylori e IgA anti Giardia duodenalis; y los secretores IgA total y específica a G. duodenalis y H. pylori en muestra de saliva, se determinaron utilizando el método de ELISA. El 65% de los niños estaban parasitados por protozoarios, observándose un 47% de poliparasitismo. Encontramos una mayor seroprevalencia de H. pylori en el grupo de niños no parasitados (46%) comparado con los parasitados (25%) (P<0,05). Sin embargo, los niños seropositivos a H. pylori y parasitados con G. duodenalis mostraron niveles séricos de IgE total mayores que los no parasitados (P<0,01); en contraparte, los niveles de IgA secretora total y especifica a H. pylori y G. duodenalis estaban disminuidos (P<0,05). Es posible que la respuesta inflamatoria generada por Giardia pueda aumentar los niveles de IgE total y disminuir la respuesta de IgA secretora favoreciendo la instauración de la infección por H. pylori.

The infections for gastrointestinal microorganisms represent nowadays one of the major reasons of morbidity and mortality in developing countries. We had evaluated both, the possible association between the presence of intestinal parasites and infection by Helicobacter pylori, and the production of serum and salivary antibodies in Amerindian Warao children from the Orinoco Delta, Venezuela. The prevalence of parasites was determined by faecal examination. The levels of serum antibodies (total IgE, specific anti- H. pylori IgG and anti G. duodenalis IgA) and salivary antibodies (total and specific IgA to G. duodenalis and H. pylori), was determined by ELISA. 65% of the child population was parasitized by protozoos, and a 47% of polyparasitism was observed. We found a major seroprevalence of H. pylori in the group of children not parasitized (46 %) compared with the parasitized ones (25 %) (P<0.05). Nevertheless, the seropositive children to H. pylori and parasitized with G. duodenalis showed levels of total IgE higher than the non parasitized ones (P<0.01); in contrast, levels of total and specific secretory IgA to H. pylori and G. duodenalis were decreased (P<0.05). It is possible that the inflammatory response generated by G. duodenalis infection may increase levels of total IgE and diminish secretory IgA response favoring the establishment of infection by H. pylori.

Parasitosis intestinales en preescolares y escolares inmunodeficientes secundarios, con síntomas gastrointestinales Barquisimeto, Venezuela / Intestinal parasitic infection in immunocompromised pre school and school children with gastro intestinal symptoms

En niños inmunodeficientes secundarios con síntomas gastrointestinales, es indispensable estudiar causas parasitarias. Caracterizar las parasitosis intestinales en preescolares y escolares inmunodeficientes secundarios, con síntomas gastrointestinales, que acuden al Hospital Universitario de Pediatría ¨Dr. Agustín Zubillaga¨, Barquisimeto-Lara. Se evaluaron 50 niños, examinando de cada uno, entre una y tres muestras de heces (directo, concentrado, Hematoxilina Férrica, Ziehl-Neelsen modificado, Quenzel, Graham y Baerman). Se calcularon porcentajes y proporciones y se utilizó Chi cuadrado y test de Fisher con intervalo de confianza estadística de 95%. Se encontró parasitada 68,00% de la muestra, predominando en preescolares (64,70%) y en pacientes masculinos (64,70%). Dolor abdominal e hiporexia fueron los síntomas más frecuentes (34,00% cada uno). La especie predominante fue B. hominis (50,00%), seguida de G. Lamblia y Cryptosporidium sp. (41,18% cada uno), E. histolytica (20,59%), A. lumbricoides (5,88%) y Estrongiloideos (2,94%). E. vermicularis se encontró en 6,90% de 29 pruebas de Graham. La frecuencia de parasitados fue proporcional al número de muestras evaluadas. Los más afectados fueron los pacientes oncológicos (88,24%). La tinción de Ziehl-Neelsen modificado fue la única técnica que permitió demostrar Cryptosporidium sp. E. vermicularis se demostró sólo por el método de Graham. La frecuencia de parasitosis intestinales en niños inmunodeficientes secundarios fue mayor a la reportada para la población infantil, con elevada proporción de Cryptosporidium sp

In secondary immunodeficient children suffering gastrointestinal symptoms it is essential to study parasitic causes To characterize the intestinal parasitoids in secondary immunedeficient school children and preschool children with gastrointestinal symptoms attending the Pediatric University Hospital ¨Dr. Agustín Zubillaga¨ Barquisimeto-Lara. 50 children were evaluated. One to three feces samples were obtained from each children (direct, concentrate, ferric hematoxiline, modified Ziehl-Neelsen, Quenzel, Graham and Baerman). Percentage and proportions were calculated and square Chi and Fisher test used, with an interval of statistical confidence of 95%. 68.00% of the samples were parasited, mainly in preschool children (64.70%) and males (64.70%). Abdominal pain and hyporexia were the most frequent symptons (34.00% each). The predominant specie was B. hominis (50.00%), followed by G. Lamblia and Cryptosporidium sp. (41.18% each), E. histolytica (20.59%), A. lumbricoides (5.88%) and strongiloides (2.94%). E. vermicularis was present in 6.90% of 29 tests of Graham. The frequency of parasited children was proportional to the number of samples evaluated. The more affected were oncological patients (88.24%). Modified Ziehl-Neelsen stain was the unique technique that allowed to demonstrate Cryptosporidium sp. E. vermicularis was demonstrated for Graham method only. A higher frequency of intestinal parasitoses was demonstrated in secondary immunodeficient children when compared with the general children population, with a high proportion of Cryptosporidium sp

Primer caso humano parasitado por Paramphistomidae (Trematoda: Digenea) en Venezuela / First human case parasitized by Paramphistomidae (Trematoda: Digenea) in Venezuela

Se presenta el primer caso humano en Venezuela de infección por Paramphistomidae (Fischoeder, 1901) perteneciente a una familia primitiva de trematodos descrita en mamíferos, reptiles y peces; en mamíferos se ha señalado en el rumen y la redecilla de rumiantes, cerdos, equinos, caprinos y bovinos. El caso clínico corresponde a una paciente de diez años procedente del estado Portuguesa. Quien presentó, durante un año de evolución, dolor abdominal difuso, náuseas con vómitos que coinciden con la expulsión con las heces de estructuras parasitarias adultas. Fueron colectados huevos del interior de los parásitos adultos (poro genital), mientras que de las heces de la paciente se evidenciaron iguales estructuras ovígeras. Por medio de análisis morfológicos y morfométricos se definió el parásito como de la familia Paramphistomidae. La niña proviene de un grupo familiar numeroso con deficiente nutrición calórico-proteica que refería alimentarse de productos del río próximo a la vivienda, la cual se encuentra en un área rural dispersa, con malas condiciones socio-sanitarias y está circundada por cultivos de arroz, con amplias zonas que están anegadizas durante todo el año. El presente parásito no está descrito en Venezuela por lo que se realizarán estudios para identificar la especie y señalar los hospedadores que intervienen en su ciclo.

It is reported the first human case of Paramphistomatidae infection (Fischoeder, 1901) in Venezuela, belonging to a primitive family of trematodes which are described in mammals, reptiles and fish, in mammals have been identified in the rumen and reticulum of ruminants, pigs, horses, goats and cattle. The clinical case belongs to a ten-year-old girl from Portuguesa State, who had a year of evolution: Diffuse abdominal pain, nausea with vomiting that match the stool expulsion of adult parasitic structures. Eggs were collected inside the genital pore of adult parasites while the patient’s stool showed the same ovigerous structures. The parasite is defined as Paramphistomatidae family by means of its morphological and morphometric analysis. The girl comes from a large family group with protein-calorie deficient nutrition who eats products coming from the river near her home, which is located in a dispersed rural area with poor socio-sanitary conditions and is surrounded by rice fields, with large areas that are subject to flooding during the year. This parasite is not described in Venezuela so studies will be undertaken to identify it accurately and to identify the hosts involved in the cycle.

Efecto de las parasitosis intestinales sobre los parámetros antropométricos en niños de un área rural de Río Chico Estado Miranda, Venezuela / Effect of intestinal parasites on anthropometric parameters in children from a rural area of Rio Chico Miranda State, Venezuela

Las infecciones parasitarias tienen una alta prevalencia en poblaciones de países en desarrollo y modifican la condición nutricional afectando mayormente los grupos con mayor déficit nutricional. De 166 niños, pertenecientes a familias de la comunidad Madre Nueva de Río Chico, Estado Miranda - Venezuela; 51 escolares (28 niñas, 54,9 por ciento y 23 niños, 45,1. por ciento) siendo el 30,7 por ciento del total de los niños, entregaron muestra de heces para realizar examen al fresco. Las variables peso (kg), talla parada (cm), circunferencia de brazo izquierdo (CBI) (cm), pliegues de tríceps y subescapular (mm), índice de masa corporal (IMC) (kg/m2), área magra (mm) y área grasa (mm) fueron seleccionadas para establecer la relación. El 75 por ciento del grupo total presentó normalidad en crecimiento dimensional. El examen de heces mostró que 74 por ciento estaban parasitados, con similar incidencia en niños y niñas, la carga parasitaria fue leve según criterios de la OMS. Los parásitos mayormente encontrados fueron: Ascaris lumbricoides, Tenia y Giardia intestinalis. La media de las variables resultó ser menor en el grupo de parasitados, sin diferenciarse significativamente, del grupo no parasitado. La diferencia de las variables entre los niños, rango de edad de 10 - 13 años y los niños, rango de edad ≤ 6 años, fue una tendencia a la disminución en la ganancia de todas las variables excepto talla, para el grupo de parasitados. La alta prevalencia y la baja carga parasitaria no afectaron el estado nutricional de los niños; por lo que a los indicadores relacionados al acceso a los alimentos y recursos económicos suficientes a los hogares, se les debería prestar mayor atención

Intestinal parasitic infections have a high prevalence in populations of developing countries and affect mainly those individuals who have greater nutritional deficit. From 166 children, belonging to families of the community of "Nueva Madre de Rio Chico, Edo. Miranda, Venezuela"; 51 (28 girls, 54.9 percent and 23 boys, 45.1 percent) 30, 7 percent from the total children, delivered stool and fresh examination was made. The following variables were selected: weight (kg), tall (cm), left arm circumference (LAC) (cm), triceps folds (mm) and subscapular folds (mm), body mass index (BMI) (kg/m2), lean area (mm) and fat area (mm), to establish a relationship between parasites and anthropometric variables. 75 percent of the total group presented normal dimensional growth. The stool examination showed that 74 percent were infected, with similar incidence between boys and girls; the parasite load was mild according to criteria of WHO. The parasites with bigger frequency were: Ascaris lumbricoides, Taenia and Giardia intestinalis. The media of the anthropometric variables were lower in subjects with parasites and did not differ significantly from the group without parasites. The difference observed between the anthropometric values found for children in the age range: 10 - 13 years, and children in the age range ≤ 6 years was a trend towards a decrease in gain for all variables except tall for the group of parasitized children. The high prevalence and low parasite load did not affect the nutritional status of children, therefore, the indicators related to access to food and adequate financial resources to households, should be paid more attention

Alterations of the myenteric plexus of the ileum and the descending colon caused by Toxoplasma gondii (genotype III) / Alterações do plexo mientérico do íleo e cólon descendente causadas por Toxoplasma gondii (genótipo III)

Alterations caused by a genotype III strain of Toxoplasma gondii were assessed with respect to the number and the morphometry of the myenteric neurons in the terminal ileum and the descending colon. Eighteen rats were divided into four groups: Acute Control Group (ACG, n=4); Acute Experimental Group (AEG, n=4); Chronic Control Group (CCG, n=5) and Chronic Experimental Group (CEG, n=5). NaCl solution was administered through gavage to the animals in the ACG and CCG. Toxoplasma gondii tachyzoites (10(4)) from a genotype III strain were orally administered to the AEG and CEG. Acute Groups were died after 24 hours, and the Chronic Groups after 30 days. Neuronal loss was not observed in both organs. The neurons atrophied in the terminal ileum as the opposite occurred with the neurons at the descending colon during the chronic phase of infection. In the terminal ileum, the neurons atrophied during the chronic phase of the infection as no alteration was found during the acute phase. For the descending colon, the neurons became hypertrophic during the chronic infection in opposition to the atrophy found during the acute phase.

Objetivou-se avaliar as alterações causadas por uma cepa genótipo III de Toxoplasma gondii, sobre o número e a morfometria de neurônios mientéricos, do íleo terminal e do cólon descendente. Dividiu-se dezoitos ratos em quatro grupos: controle agudo (GCA, n=4), experimental agudo (GEA, n=4), controle crônico (GCC, n=5) e experimental crônico (GEC, n=5). Os animais do GCA e GCC receberam solução de NaCl por gavagem, e os animais do GEA e GEC 10(4) taquizoítos de uma cepa genótipo III de T. gondii por via oral. Os grupos agudos após 24 horas foram mortos e os crônicos após 30 dias. Observou-se que não houve perda neuronal em ambos os órgãos. No íleo terminal, os neurônios atrofiaram-se na fase crônica da infecção, enquanto nenhuma alteração ocorreu na fase aguda. Já no cólon descendente, os neurônios tornaram-se hipertróficos na fase crônica da infecção, em oposição à atrofia observada na fase aguda.

Frecuencia de parasitosis intestinal en pacientes con infección por VIH: centro regional de inmunología Barquisimeto julio-noviembre / Frequency of intestinal parasitism in patients with infection by HIV: Barquisimeto Regional Center of Inmunology July-November 2003

Se determinó en el Centro Regional de Inmunología del Estado Lara, la frecuencia de parasitosis intestinal en pacientes con infección por VIH y la distribución según la clasificación CDC Atlanta 1993, durante Julio-Noviembre 2003, con un descriptivo de corte transversal, un error del 10% y 90% de confianza, la muestra estuvo conformada por 50 pacientes, se realizó una encuesta estructurada con preguntas cerradas y examen de heces empleando solución salina fisiológica, Lugol, Quensel, técnica de concentración de Ritche, colocación de Kinyou modificado y técnica de Kato-Miura modificado. 80% pertenecían al sexo masculino, predominaron las edades comprendidas entre 25 y 34 años y 40% presentó parasitosis intestinal. Se catalogó 42% con serología positiva para VIH y 58% con SIDA. La frecuencia de parasitosis intestinal en la población femenina fue 50% y en la masculina 37,5% y predominó en el grupo de edad de 25 a 34 años. Del total de pacientes 72% presentó sintomatología gastrointestinal, de los cuales 44,44% presentó parasitosis intestinal, 75,86% del grupo de SIDA y 66,66% con serología positivo para VIH, encontrándose flatulencia en 61,11%, seguido de diarrea, dolor abdominal y náuseas. Al examen coproparasitológico los protozoarios fueron más frecuente, reportando Blastocystis hominis 55%, seguido de Entamoeba histolytica 30% y Cryptosporidium sp. 20%. Esta investigación constituye una referencia regional para identificar algunas características epidemiológicas de las parasitosis intestinales en pacientes con infección por VIH.

Parasitosis intestinal en niños en edad escolar (6 - 12 años) Escuela Graduada Nº 1994 Dr. Raúl Peña José Augusto Saldivar

Estudio prospectivo, analítico-descriptivo realizado en niños en edad escolar, que presenta las características de los infectados. Clasifica la parasitosis con sus repercusiones inmediatas en los niños

Significance of schistosomal granuloma modulation

Hepatic Schistosoma mansoni periovular granulomas undergo changes in size, cellular composition and appearance with time. This phenomenom, known as "immunological modulation", has been thought to reflect host immunological status. However, as modulation has not been observed outside the liver, participation of local factors, hitherto little considered, seems crucial. Components of the extracellular matrix of periovular granulomas of the mouse were particularly studied in three different organs (liver, lung and intestine) and during three periods of infection time (acute, intermediate and chronic) by means of histological, biochemical and imunofluorescence techniques, while quantitative data were evaluated by computerized morphometry, in order to investigate participation of local factors in granuloma modulation. Results confirmed modulation as a exclusively hepatic phenomenom, since pulmonary and intestinal granulomas, formed around mature eggs, did not change size and appearance with time. The matricial components which were investigated (Type I, III and IV collagens, fibronectin, laminin, proteoglycans and elastin) were found in all granulomas and in all organs examined. However, their presence was much more prominent in the liver. Elastin was only found in hepatic granulomas of chronic infection. The large amount of extracellular matrix components found in hepatic granulomas was the main change responsible for the morphological aspects of modulation. Therefore, the peculiar environment of the liver ultimately determines the changes identified in schistosomal granuloma as "modulation".