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Eradication of amebiasis in a large institution for adults with mental retardation in Taiwan.
Infect Control Hosp Epidemiol. 2007 Jun; 28(6): 679-83
Su SB, Guo HR, Chuang YC, Chen KT, Lin CY
OBJECTIVE: Investigation of a program to eradicate amebiasis using consecutive intensive mass screenings followed by medication in a large institute for adults with mental retardation in Taiwan. DESIGN: Prospective cohort study, with 3 years of follow-up. SETTING: A large, 450-bed institution for adults with mental retardation located in southern Taiwan. PARTICIPANTS: All 443 adults with mental retardation in the institution, who have various motor and/or mental handicaps, were included in this study. INTERVENTIONS: A total of 7 consecutive intensive mass screenings for amebiasis for all residents (performed in March, August and November 2001, March and August 2002, January 2003, and May 2004). Infected patients were treated using the standard protocol of the Center for Disease Control of Taiwan. RESULTS: Enzyme immunoassay testing was used for the amebiasis screening, with the rapid detection of the specific antigen for Entamoeba histolytica in human fecal specimens confirmed by microscopic examination. The serial prevalence and cumulative incidence were then calculated. The prevalence of amebic infection declined in serial screenings, but new infections and reinfections were detected in 5 of 6 follow-up screenings. The prevalence was 10.8% at the beginning of the program and then gradually reduced, falling to 6.3%, 3.6%, 2.7%, 3.4%, and 2.2%. Finally, no more positive cases were identified in the last screening (May 2004). The cumulative incidence rate stabilized at around 40% by the fifth screening. Of the 179 infected patients, 120 had primary infections, with 59 cases of multiple amebic infections. CONCLUSIONS: Active surveillance with intensive mass screening is an effective method of identifying asymptomatic and latent cases of amebiasis in areas where it is endemic, such as an institution for adults with mental retardation.
J Formos Med Assoc. 2005 Nov; 104(11): 839-42
Tsai HC, Lee SS, Wann SR, Chen YS, Chen ER, Yen CM, Liu YC
Invasive amoebiasis is rarely seen in human immunodeficiency virus (HIV)-infected individuals, even in endemic areas. By contrast, cytomegalovirus (CMV) disease is recognized as a major clinical problem in acquired immunodeficiency syndrome patients. A 34-year-old HIV-infected man with amoeba colitis, disseminated Mycobacterium avian complex and CMV infection with cecum perforation, presented with the initial symptoms of fever, shortness of breath and painful sensation when swallowing. He was treated with fluconazole, trimethoprim-sulfamethoxazole and hydrocortisone under the impression of esophageal candidiasis and Pneumocystis jiroveci pneumonia. However, diarrhea and abdominal pain developed on day 6 of hospitalization. Invasive amoebiasis and CMV colitis was diagnosed after examination of colon pathological specimens. Emergent laparotomy was performed. Right hemicolectomy with double barrel ileostomy and colostomy was done due to perforation of the cecum. Iodoquinol was given, followed by metronidazole 14 days afterwards. He underwent closure of double barrel ileostomy and colostomy 5 months later. This case illustrates the diagnostic challenge of caring for acquired immunodeficiency syndrome persons with multiple illnesses and medication use. CMV infection, amoebic colitis and possibly corticosteroid may have played a role in colon perforation in our patient.
Anal Sci. 2005 Dec; 21(12): 1533-5
Jalali F, Rajabi MJ, Bahrami G, Shamsipur M
An iodide-miconazole ion-paired complex was used as a suitable ion-exchanger for the preparation of a plasticized-PVC membrane electrode. Among different solvent mediators tested, dioctylsebacate exhibited the proper response characteristics, including Nernstian slope of the calibration curve, fast response time and good reproducibility of the emf values. The electrode exhibits a Nernstian slope of -59.8 +/- 0.5 mV decade(-1) for I- ion over a concentration range of 1.0 x 10(-5) - 1.0 x 10(-2) M with a limit of detection of 7.0 x 10(-6) M. The electrode displays a good selectivity for I- with respect to a number of inorganic and organic species. It canbe used over a pH range of 2.5 - 8.5. The membrane sensor was successfully applied to the determination of iodide in water samples and blood serum, as well as in pharmaceutical products such as iodoquinol and thyroxin.
West Indian Med J. 2005 Jun; 54(3): 210-2
Ibrahim TM, Iheonunekwu N, Gill V, Vantapool H
The colon responds monomorphically to a variety of insults thus making it difficult to differentiate invasive amoebic colitis and inflammatory bowel disease (IBD). The authors present a case with chronic dysentery, haematochezia, anaemia and hypoproteinaemia. The endoscopic findings were suggestive of IBD. The stool examination was negative for trophozoites or cysts of parasites. The recto-colonic biopsy specimens showed mucosal inflammation with exudates containing amoebic trophozoites. The patient was successfully treated with metronidazole and iodoquinol. He recovered within two weeks and repeat colonoscopy four weeks after the treatment showed a normal rectum and colon. Clinicians should have a high level of suspicion for amoebic colitis in cases of colitis especially in regions where amoebiasis is still present. Efforts should be made to find the amoebic trophozoites in multiple stool and colonic biopsy specimens.
J Org Chem. 2005 Jan 7; 70(1): 373-6
Blakemore PR, Kilner C, Milicevic SD
7,7'-Bis(((dimethylamino)carbonyl)oxy)-8,8'-biquinolyl (5) was prepared in 71% yield by regioselective directed ortho metalation (DoM) of N,N-dimethyl O-quinol-7-yl carbamate (2) with LDA followed by oxidation with anhydrous ferric chloride. DoM of 5 with excess LDA induced double anionic ortho-Fries rearrangement and gave 6,6'-bis((dimethylamino)carbonyl)-7,7'-dihydroxy-8,8'-biquinolyl (8). Treatment of N,N-diethyl O-(8-iodoquinol-7-yl) carbamate (16) with LDA in THF solvent at -78 degrees C, followed by addition of anhydrous ferric chloride, resulted in an efficient tandem halogen-dance dimerization process which afforded 7,7'-bis(((diethylamino)carbonyl)oxy)-6,6'-diiodo-8,8'-biquinolyl (17) directly in 54% yield.
Current drug therapy of protozoal diarrhoea.
Indian J Pediatr. 2004 Jan; 71(1): 55-8
Gupta YK, Gupta M, Aneja S, Kohli K
Protozoal infections of the gastrointestinal tract occur worldwide and have substantial morbidity and mortality. Prevalence is higher in the economically deprived regions of the world, especially the developing countries. Infections like amoebiasis and giardiasis have a worldwide distribution, being endemic in India. Apart from producing GI symptoms, growth and development of children is also impaired. It is seen that protozoa multiply rapidly in their hosts and as there is a lack of effective vaccines, chemotherapy has been the only practiced way to treat individuals and reduce transmission. The current treatment modalities for protozoal diarrhoea include 5-nitrosoimidazoles, iodoquinol, diloxanide furoate, paromomycin, chloroquine, and trimethoprim-sulphamethoxazole.
Efficacy of saccharomyces boulardii with antibiotics in acute amoebiasis.
World J Gastroenterol. 2003 Aug; 9(8): 1832-3
Mansour-Ghanaei F, Dehbashi N, Yazdanparast K, Shafaghi A
AIM: To compare the efficacy of antibiotics therapy alone with antibiotics and saccharomyces boulardii in treatment of acute amebiasis. METHODS: In a double blind, random clinical trial on patients with acute intestinal amoebiasis, 57 adult patients with acute amoebiasis, diagnosed with clinical manifestations (acute mucous bloody diarrhea) and amebic trophozoites engulfing RBCs found in stool were enrolled in the study. Regimen 1 included metronidazole (750 mg Tid) and iodoquinol (630 mg Tid) for 10 days. Regimen 2 contained capsules of lyophilized saccharomyces boulardii (250 mg Tid) orally in addition to regimen 1. Patients were re-examined at two and four weeks after the treatment, and stool examination was performed at the end of week 4. Student's t-test, chi(2) and McNemar's tests were used for statistical analysis. RESULTS: Three patients refused to participate. The other 54 patients were randomized to receive either regimen 1 or regimen 2 (Groups 1 and 2 respectively, each with 27 patients). The two groups were similar regarding their age, sex and clinical manifestations. In Group 1, diarrhea lasted 48.0+/-18.5 hours and in Group 2, 12.0+/-3.7 hours (P
J Pharm Biomed Anal. 2002 Feb 1; 27(5): 813-20
Rizk M, Belal F, Ibrahim F, Ahmed S, Sheribah ZA
An accurate, sensitive, and selective reversed phase high performance liquid chromatographic (HPLC) method was developed for the analysis of two halogenated 8-hydroxyquinoline derivatives; clioquinol (CQN) and iodoquinol (IQN). The proposed method depends on the complexation ability of the studied compounds with Pd(II) ions. Reversed phase chromatography was conducted using a 300 x 3.9 mm i.d. stainless steel column packed with 10 microm Bondclone phenyl at ambient temperature. A solution containing 0.005% w/v of Pd(II)-chloride in a mixture of acetonitrile-methanol-water (3:3:4 v/v/v) of pH 3.7 as a mobile phase pumped at a flow rate of 0.75 ml min(-1). UV-detection was performed at 282 and 285 nm for CQN and IQN, respectively. The method showed excellent linearity in the range 0.05-1.8 and 0.1-3.0 microg ml(-1) with limit of detection (S/N=2) 4.8 ng ml(-1) (1.57 x 10(-8) M) and 6.4 ng ml(-1) (1.61 x 10(-8) M) for CQN and IQN, respectively. The suggested method was successfully applied for the analysis of the studied drugs in bulk with average% recoveries of 99.68+/-0.44 for CQN and 99.65+/-0.53 for IQN. The proposed method was successfully applied for the analysis of the studied drugs in single or combined dosage forms with average% recoveries of 99.41+/-0.51-100.02+/-0.63. The proposed method could be used successfully for the determination of the studied compounds in the presence of their degradation product as they could be eluted with different retention times. The presence of metronidazole (MNZ) or tolnaftate (TFT) with the studied drugs does not affect their accurate determination. The results obtained were favorably compared with those obtained by the reference method. The results were satisfactorily, accurate, and precise.
Intestinal amebiasis: a diagnosis not to be missed.
Pathol Res Pract. 2001; 197(4): 271-4; discussion 275-8
Marcus VA, Ward BJ, Jutras P
Entamoeba histolytica is a well-recognized cause of infectious colitis and disseminated amebic abscesses. Most prevalent in the tropics and subtropics, E. histolytica infections may also occur in the developed world. We describe a case of a North American traveler with intestinal amebiasis, a diagnosis first made by colonic biopsy. We review the available diagnostic tools and the role of the surgical pathologist in the detection of this infection.
Gastric wall erosion by an amebic liver abscess in a 3-year-old girl.
Pediatr Surg Int. 2000; 16(5-6): 429-30
Angel C, Chand N, Sankar A, Rowen J, Murillo C
The occurrence of an amebic liver abscess (ALA) rupturing into the stomach is reported. ALAs in children can have atypical presentations, resulting in delayed diagnosis and increased morbidity and mortality. Timely treatment is usually followed by complete recovery.