ABSTRACT
We report the evaluation of four techniques for Giardia lamblia diagnosis in children's stool. The Iron haematoxilin staining and direct examination with lugol showed lower positivity, while the method of Faust et al. Continues to be a good option for G. lamblia diagnosis and Immunoenzymatic assay increases the detection of this parasite.
Subject(s)
Feces/parasitology , Giardia lamblia/isolation & purification , Giardiasis/diagnosis , Adolescent , Animals , Brazil , Child , Humans , Parasitology/methodsABSTRACT
We report the evaluation of four techniques for Giardia lamblia diagnosis in children's stool. The Iron haematoxilin staining and direct examination with lugol showed lower positivity, while the method of Faust et al. Continues to be a good option for G. lamblia diagnosis and Immunoenzymatic assay increases the detection of this parasite.
Relatamos a comparação de quatro metodologias para o diagnóstico da Giardia lamblia em material fecal de crianças, Belém/PA. A Hematoxilina Férrica e o método direto apresentaram menor positividade, enquanto que o Método de Faust continua uma boa escolha para o diagnóstico e o Ensaio imunoenzimático melhora a qualidade da detecção deste parasito.
Subject(s)
Adolescent , Animals , Child , Humans , Feces/parasitology , Giardia lamblia/isolation & purification , Giardiasis/diagnosis , Brazil , Parasitology/methodsABSTRACT
OBJECTIVE: Evaluation of epidemiological, clinical and laboratory features of Plasmodium vivax malaria in children and adolescents. METHODS: This study was carried out in the Malaria Program of the Evandro Chagas Institute (Belém, Pará), from January 1995 to November 1996. 100 children and adolescents with the diagnosis of P. vivax malaria (thick blood film) were randomly enrolled. A protocol was created to assess epidemiological, clinical and laboratory parameters of this pathology. RESULTS: Malaria occurred in both sexes, and had a prevailing incidence among adolescents (37%). Most of the children and adolescents (92%) had been infected in the State of Pará. Autochthonous cases in the metropolitan area of Belém accounted for 34 % of the sample. Primary infection was seen in 80% of the patients. Fever was the major onset clinical symptom (88%). A history of typical febrile paroxysm was recorded in only 25% of the casuistic. In the first day of treatment (D0) fever (97%), chills (91%), pallor (85%), splenomegaly (46%) and hepatomegaly (29%) were some of the clinical features observed. Pallor (clinical signal) was found to be significantly (p=0.0004) associated with anemia (hemoglobin rate). There was a high significant negative correlation (p=0.0001) between delay of diagnosis (mean 12,5 days) and hemoglobin values. Regarding parasitological examination, just children and adolescents with positive results to hookworms were significantly (p=0.0133, p=0.0075) more anemic than those who had a positive parasitological examination to other helminths and/or protozoa species. CONCLUSIONS: Malaria affected children and adolescents from both sexes. An emphasis on epidemiological and clinical data is an important tool to the precocious diagnosis of the disease. Delay on diagnosis made anemia worse.
ABSTRACT
OBJECTIVES: In the treatment of vivax malaria, an important factor affecting the occurrence of relapse is the duration of treatment. In Belém, a number of patients with vivax malaria were found to be cured despite failure to complete the standard course of treatment. In Belém, a number of patients with vivax malaria were found to be cured despite failure to complete the standard course of treatment. This observation suggested the present study, investigating more practicable courses of treatment for children with vivax malaria.METHODS: A randomized prospective clinical trial was conducted in 200 outpatient children with vivax malaria. Parasite clearance time and response to four therapeutic schedules were investigated: a) chloroquine*, 10 mg/kg in a single dose (chloroquine SD) + primaquine, 0.50 mg/kg/dose for 7 days; b) chloroquine SD + primaquine, 0.25 mg/kg/dose for 7 days; c) chloroquine SD + primaquine, 0.50 mg/kg/dose for 5 days; d) chloroquine SD + primaquine, 0.25 mg/kg/dose for 5 days. Fisherss Exact test was used to compare the responses to the schedules.RESULTS: All 144 children who completed the study had clearance of asexual parasitemia by the fourth day of treatment. Significant differences were observed between schedules A/D (p= 0.022) and C/D (p= 0.005). A doubled dose of primaquine (schedules A and C) proved to be significantly more effective (p=0.0042) than the standard dose (B and D). However, duration of treatment had no significant effect (p = 0.6104).CONCLUSIONS: In this study, complete cure of vivax malaria was better achieved with a doubled dose of primaquine than with standard doses. Effectiveness of the doubled dose was independent of the duration of treatment. Treatment schedule D is not recommended.
ABSTRACT
A proposta deste estudo foi apresentar uma série de pacientes com doença oclusiva da artéria subclávia tratados por procedimento cirúrgico ou angioplastia. Durante um período de cinco anos, nove pacientes com idade média de 54 anos foram submetidos a seis derivaçöes carótidas-subclávias, uma endarterectomia e duas angioplastias. Os resultados clínicos foram inteiramente satisfatórios em quatro pacientes com sintomas cerebrais, em dois com isquemia de membro e em dois dos três com sintomas mistos. Um paciente faleceu e dois foram perdidos para seguimento. As reconstruçöes permaneceram pérvicas em cinco pacientes entre 12 e 28 meses de seguimento de seguimento mas ocluiu em outro. A revascularizaçäo das artérias subclávia é efetiva tanto com procedimentos cirúrgicos como com a angioplastia.
