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Although Ascaris lumbricoides occasionally enters the biliary tract, it can cause severe complications in this location ranging from biliary colic, acalculous cholecystitis to hepatic abscess. Hence prompt diagnosis and proper treatment is necessary. There are some reports about the endoscopic removal of A. lumbricoides from the biliary tract, which is reportedly prone to severe complications. Here we present a case of biliary ascariasis successfully diagnosed and treated by non-invasive methods.
Subcutaneous injection of Ascaris lumbricoides suis homogenate in guinea pigs causes a significant increase of "neutral" spleen homogenate proteases, as well as of the activity of the splenic and renal post- nuclear fraction in days 2 or 3. Also, in experimental larval ascariasis in guinea pigs, a rise of proteolytic activity in the post-nuclear spleen fraction is observed 7 to 8 days after infection. The activity of "neutral" lung proteases in animals receiving Ascaris homogenate shows only tendency to increase. The proteolytic activity of liver, kidneys and heart preparations did not reveal significant differences in guinea pigs after Ascaris homogenate administration, nor in experimental larval ascariasis.
The study included 260 hospitalised children with suspected infection with human ascaris. In serological diagnostics a protein antigen obtained from Ascaris lumbricoides was used. ELISA method was applied. IgG antibodies were detected. Positive results were found in 15% of the examined children. No relation to the gender or demographic conditions was found. The most frequently observed symptoms in the patients with Ascaris lumbricoides were: abdominal pain - 87%. diarrhoea 15%. In 31% of the cases eosinophilia was found. Scatoscopy was carried out for all the patients, using the PARASEPT system and Kato and Miura methods as well as decantation and tlotation. The examination. which was repeated three times, did not show cysts or eggs. Serological investigation exhibits higher sensitivity than the traditional methods. Their use in recognising ascariasis in humans significantly facilitates diagnostic procedures, especially in the lung phase of the disease, the larval stage or in cases of infection with an individual parasite, when the faeces samples do not contain the eggs. Serological investigation is also useful in all cases of suspected VLM.
It has been found that alpha-chymotrypsin inhibitor isolated from Ascaris lumbricoides suum acts embryotoxically on the Leghorn chicken embryo. An increase in embryo mortality with increasing dose of the inhibitor has been observed after its administration into the yolk sac on day 4, 8 or 13 of incubation. There is a linear interrelationship between the logarithm of the dose of alpha-chymotrypsin inhibitor and the mortality of chickens. The LD50 values for alpha-chymotrypsin inhibitor increased for injections performed at later stages of embryo development. A significant decrease of mean mass of chicks injected with alpha-chymotrypsin inhibitor in comparison with control groups was observed. There was a more frequent occurrence of developmental abnormalities and pathological changes in groups of hatched chicks which received the Ascaris inhibitor.
The efficacy of mebendazole was evaluated as a result of six-year experience in the treatment of patients of Outpatients Clinic and Clinic of Infectious, Parasitic and Tropical Diseases in Łódź. The treatment covered 6132 subjects infected with: Ascaris lumbricoides, Ancylostoma duodenale, Trichiuris trichiura, Enterobius vermicularis and Echinococcus granulosus. Nematode infections were diagnosed by coproscopic methods whereas echinococcosis with serologie tests and ultrasonographic examination of abdominal cavity. Mebendazole was administered in the dose of 200 mg per day: for 3 days in ascariasis, for 5 days in A. duodenale, T. trichiura and mixed infections. In enterobiosis was applied a pulsation therapy: 200 mg a day for 3 days, a week of break (three subsequent cycles). In echinococcosis the drug was administered in the daily dose of 600 mg for 30 days. Follow-up examinations were carried out 30, 60, 120 and 160 days after the treatment. In the case of inetfectiveness of the first course, the treatment was repeated. The efficacy of the therapy was as follows: ascariasis 97.1%, A. duodenale infection 100%, trichuriasis 92.1%, enterobiosis 93.3%, mixed infections 95.3%, echinococcosis 77.2%. No side effects were observed.
The authors used Albendazole in a single dose of 400 mg in 40 students from Africa and Asia, infected with Ascaris lumbricoides, Trichocephalrus trichiurus and Ancylostomatidae. At the third day after the treatment no parasite eggs have been found in 25 of 30 cases of ancylostomatidosis (83.3%), 16 of 23 cases of trichocephalosis (69.6%) and in all treated cases of ascaridosis (100%). It has been also found that the tolerance for the medicine is good in most patients. Only in two patients (2%) there appeared short time and not very strong pains in the upper part of the abdomen and headaches. An important property of Albendazole is its ability to destroy nematode eggs which is essential for the prophylaxis and nature conservation.
It was proved that the soil of recreational areas can be potential source of human geohelminthiosis. The eggs of Ascaris lumbricoides and Trichocephalus trichiurus as well as of Toxocara canis were found on the beaches of Poznań lakes.
Food contamination, especially related to animals, with infectious pathogens and toxins is one of the most serious health problems. This phenomenon is intensified in third world countries, but the constant movement of people from this region to highly industrialized countries shifts the local problem to the global scale. The development of international trade and tourism also contributes to it.
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