Estimating the impact of amebiasis on health.
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Animals↗
Biomedical subjects
R Haque
Publications and source records attributed to R Haque.
Delivery of dermatopathologic health care in the twenty-first century.
Dermatology and dermatopathology has experienced significant growth over the last century and continues to burgeon. Upheavals as a consequence of the advent of managed care have threatened both specialties, especially with regard to direct access and choice of consultant. The demand for dermatology and dermatopathology services continues to increase, and for patients to be served appropriately, these issues must be addressed.
Cost-Benefit Analysis↗
Inflammatory mediators induce sequestration of VE-cadherin in cultured human endothelial cells.
The mechanisms through which inflammatory mediators modify endothelial junctional structure are not well understood. Endothelial cells exposed to 1 mM H2O2, 0.1 mM histamine or 4 mM EDTA displayed decreased amounts of VE-cadherin on the cell surface in a time-dependent manner. H2O2 and EDTA-treated cells showed a sustained reduction in surface VE-cadherin, but histamine (0.1 mM) decreased cell surface VE-cadherin only at 5 and 15 min, not at 30 and 60 min. Sequestering of VE-cadherin could also be visualized as a decrease in immunofluorescent labeling of endothelial junctions in fixed, non-extracted monolayers. However, junctional staining was observed in these cells after membrane extraction. This decreased surface expression of VE-cadherin was actin-filament, but not PKC/MAP kinase dependent. VE-cadherin binding to the cytoskeleton was decreased by EDTA, but was not diminished by histamine or H2O2. Therefore, by promoting sequestration of junctional cadherins, inflammatory mediators may decrease adhesive bonds between apposed endothelial cells and increase solute permeability.
Antigens, CD↗
Arsenic in drinking water and the prevalence of respiratory effects in West Bengal, India.
BACKGROUND: A large population in West Bengal, India has been exposed to naturally occurring inorganic arsenic through their drinking water. A cross-sectional survey involving 7683 participants of all ages was conducted in an arsenic-affected region between April 1995 and March 1996. The main focus of the study was skin keratoses and pigmentation alterations, two characteristic signs of ingested inorganic arsenic. Strong exposure-response gradients were found for these skin lesions. The study also collected limited information concerning respiratory system signs and symptoms, which we report here because increasing evidence suggests that arsenic ingestion also causes pulmonary effects. METHODS: Participants were clinically examined and interviewed, and the arsenic content in their current primary drinking water source was measured. There were few smokers and analyses were confined to non-smokers (N = 6864 participants). RESULTS: Among both males and females, the prevalence of cough, shortness of breath, and chest sounds (crepitations and/or rhonchi) in the lungs rose with increasing arsenic concentrations in drinking water. These respiratory effects were most pronounced in individuals with high arsenic water concentrations who also had skin lesions. Prevalence odds ratio (POR) estimates were markedly increased for participants with arsenic-induced skin lesions who also had high levels of arsenic in their current drinking water source (> or = 500 microg/l) compared with individuals who had normal skin and were exposed to low levels of arsenic (<50 microg/l). In participants with skin lesions, the age-adjusted POR estimates for cough were 7.8 for females (95% CI : 3.1-19.5) and 5.0 for males (95% CI : 2.6-9.9); for chest sounds POR for females was 9.6 (95% CI : 4.0-22.9) and for males 6.9 (95% CI : 3.1-15.0). The POR for shortness of breath in females was 23.2 (95% CI : 5.8-92.8) and in males 3.7 (95% CI : 1.3-10.6). CONCLUSION: These results add to evidence that long-term ingestion of inorganic arsenic can cause respiratory effects.
Adolescent↗
Diagnosis of amebic liver abscess and intestinal infection with the TechLab Entamoeba histolytica II antigen detection and antibody tests.
A noninvasive diagnostic test for amebic liver abscess is needed, because amebic and bacterial abscesses appear identical on ultrasound or computer tomography and because it is rarely possible to identify Entamoeba histolytica in stool specimens from patients with amebic liver abscess. Here we report a method of detection in serum of circulating E. histolytica Gal/GalNAc lectin to diagnose amebic liver abscess, which was used in patients from Dhaka, Bangladesh. The TechLab E. histolytica II test (which differentiates the true pathogen E. histolytica from Entamoeba dispar) detected Gal/GalNAc lectin in the sera of 22 of 23 (96%) amebic liver abscess patients tested prior to treatment with the antiamebic drug metronidazole and 0 of 70 (0%) controls. After 1 week of treatment with metronidazole, 9 of 11 (82%) patients became serum lectin antigen negative. The sensitivity of the E. histolytica II antigen detection test for intestinal infection was also evaluated. Antigen detection identified E. histolytica infection in 50 samples from 1, 164 asymptomatic preschool children aged 2 to 5 years, including 16 of 16 (100%) culture-positive specimens. PCR analysis of stool specimens was used to confirm that most antigen-positive but culture-negative specimens were true-positive: PCR identified parasite DNA in 27 of 34 (79%) of the antigen-positive, culture-negative stool specimens. Antigen detection was a more sensitive test for infection than antilectin antibodies, which were detected in only 76 of 98 (78%) amebic liver abscess patients and in 26 of 50 (52%) patients with intestinal infection. We conclude that the TechLab E. histolytica II kit is a sensitive means to diagnose hepatic and intestinal amebiasis prior to the institution of metronidazole treatment.
Adult↗
Evaluation of indirect fluorescent antibody test and enzyme-linked immunosorbent assay for diagnosis of hepatic amebiasis in Bangladesh.
Serum samples of 31 amebic liver abscess (ALA) patients, 8 amebic hepatitis (AH) patients, and 60 controls were tested for anti-amebic IgG by enzyme-linked immunosorbent assay (ELISA) and indirect fluorescent antibody tests (IFAT). Sera of 29 (93.6%) ALA and 6 (75%) AH patients and 2 (3.3%) control subjects were positive by IFAT. Anti-amebic antibody titer above the cutoff point (= 0.168; x + 2 SD of control sera) was observed in sera of 27 (87%) ALA, 4 (50%) AH, and 1 (1.7%) control by ELISA. All the 8 pus samples were positive for anti-amebic antibodies by IFAT and ELISA. Sensitivity of ELISA was 87% for ALA, with a positive predictive value of 0.96, and 50% for AH cases, with a positive predictive value of 0.80. The sensitivity of IFAT was 93.6% for ALA, with a positive predictive value of 0.94, and 75% for AH, with a positive predictive value of 0.75. When pus samples were tested, the sensitivity was 100% for both tests. The specificity was 98.3% for ELISA and 96.7% for IFAT. Although not significant, IFAT was found more sensitive than ELISA (P>0.05).
Animals↗
Genitourinary tuberculosis: a profile of 55 in-patients.
OBJECTIVE: To outline the pattern and trends in major cases of genito-urinary tuberculosis (GUTB) which require hospital treatment. METHOD: We retrospectively reviewed 55 patients with proven GUTB who were treated as in-patients in a major referral hospital in Pakistan. RESULTS: The male/female ratio was 3:1. Prevailing symptoms were lower urinary tract symptoms, flank pain, gross hematuria and fever. A urine culture was positive for tuberculosis (TB) in 57%, bladder biopsies in 54%. For renal TB, intravenous urogram (IVU) and ultrasound were suggestive in about 50% of cases. Ultrasound was very helpful in the diagnosis of testicular TB. Patients underwent surgery in 36% of cases. In contrast to the general trend reported worldwide, surgery was mainly ablative rather than re-constructive. Patient compliance in clinical follow-up and drug therapy was poor. CONCLUSION: Surgery for GUTB in Pakistan is still mainly ablative, probably due to a high number of complicated and progressed cases. To date, therapy of GUTB is mainly based on anti-tuberculosis chemotherapy (ATT). However, huge efforts will be required to improve patient compliance without which every therapeutic approach will remain futile.
Adolescent↗
Socioeconomic status, clinical features, laboratory and parasitological findings of hepatic amebiasis patients--a hospital based prospective study in Bangladesh.
Socioeconomic status, clinical, laboratory and parasitological features of 31 hospitalized amebic liver abscess (ALA) and 8 amebic hepatitis (AH) patients were studied. Thirty-seven (94.9%) of the total 39 cases were from low socioeconomic class and 2 (5.1%) were from middle class (p<0.001). Sixteen (51.6%) ALA and 5 (62.5%) AH patients were admitted with duration of disease for 3 weeks or more. Twenty-one (67.7%) ALA and 3 (37.5%) AH cases gave no previous history of diarrhea or dysentery. Epigastric pain was the predominant symptoms in 71% patients compared to high fever (19.4%), nausea and vomiting (9.7%). Neutrophilic leukocytosis was found in 9 (29.0%) ALA and 2 (25%) AH cases. Raised alkaline phosphatase was the predominant abnormal liver function test found elevated in 22 (71.0%) ALA and 5 (62.5%) AH cases. Three (7.7%) of the 5 (12.8%) microscopy positive stool samples yielded growth of Entamoeba histolytica in culture. The right lobe was involved in 28 (90.3%) ALA cases; 29 (93.5%) patients had single abscess. Bacterial super infection was observed in 1 (12.5%) abscess, reactive changes in right lung was observed in 6 (19.4%) ALA and 1 (12.5%) AH cases. Ascaris lumbricoides was the predominant associated intestinal parasite.
Adolescent↗
Molecular-based diagnosis of Entamoeba histolytica infection.
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News↗
Prevalence and immune response to Entamoeba histolytica infection in preschool children in Bangladesh.
Entamoeba histolytica infection was present in 5% and E. dispar in 13% of asymptomatic 2-5-year-old children from an urban slum of Dhaka, Bangladesh. Entamoeba dispar-infected children were no more likely than uninfected children to have serum antibodies to lectin. In contrast, all children infected with E. histolytica had serum antibodies to lectin. This anti-lectin response included antibodies against the carbohydrate recognition domain, which have been demonstrated in animal models to confer passive protection from amebiasis. Antibodies to lectin persisted in the sera of 17 children with E. histolytica infection over one year of follow-up, during which time E. histolytica infection cleared without treatment in 15, and with anti-amebic medication in two. We conclude that half of the children in this population have serologic evidence of amebiasis by five years of age, and that an anti-lectin serum antibody response is associated with limitation of E. histolytica infection to the colon.
Animals↗
Serotonin N-acetyltransferase mRNA levels in photoreceptor-enriched chicken retinal cell cultures: elevation by cyclic AMP.
Serotonin N-acetyltransferase (AA-NAT; arylalkylamine N-acetyltransferase; EC 2.3.1.87) is a key regulatory enzyme in the biosynthesis of melatonin. Previous studies have shown that the activity of this enzyme in the chicken retina is regulated by a cyclic AMP-dependent mechanism. In the present report, we investigated whether cyclic AMP can regulate the levels of AA-NAT mRNA in photoreceptor-enriched chick retinal cell cultures. AA-NAT mRNA levels were elevated by acute treatment with cyclic AMP protagonists, including forskolin; this response was blocked by H-89, a selective inhibitor of cyclic AMP-dependent protein kinase. Forskolin did not alter the rate of disappearance of AA-NAT mRNA in actinomycin D-treated cells, suggesting that cyclic AMP enhances transcription of the AA-NAT gene. Forskolin-induced elevation of AA-NAT mRNA levels was enhanced by cycloheximide, which decreased the degradation of the transcript in cells treated with actinomycin D. These studies indicate that the abundance of AA-NAT mRNA is regulated in part through a cyclic AMP-dependent mechanism.
Animals↗
Marked increase in bladder and lung cancer mortality in a region of Northern Chile due to arsenic in drinking water.
Studies in Taiwan and Argentina suggest that ingestion of inorganic arsenic from drinking water results in increased risks of internal cancers, particularly bladder and lung cancer. The authors investigated cancer mortality in a population of around 400,000 people in a region of Northern Chile (Region II) exposed to high arsenic levels in drinking water in past years. Arsenic concentrations from 1950 to the present were obtained. Population-weighted average arsenic levels reached 570 microg/liter between 1955 to 1969, and decreased to less than 100 microg/liter by 1980. Standardized mortality ratios (SMRs) were calculated for the years 1989 to 1993. Increased mortality was found for bladder, lung, kidney, and skin cancer. Bladder cancer mortality was markedly elevated (men, SMR = 6.0 (95% confidence interval (CI) 4.8-7.4); women, SMR = 8.2 (95% CI 6.3-10.5)) as was lung cancer mortality (men, SMR = 3.8 (95% CI 3.5-4.1); women, SMR = 3.1 (95% CI 2.7-3.7)). Smoking survey data and mortality rates from chronic obstructive pulmonary disease provided evidence that smoking did not contribute to the increased mortality from these cancers. The findings provide additional evidence that ingestion of inorganic arsenic in drinking water is indeed a cause of bladder and lung cancer. It was estimated that arsenic might account for 7% of all deaths among those aged 30 years and over. If so, the impact of arsenic on the population mortality in Region II of Chile is greater than that reported anywhere to date from environmental exposure to a carcinogen in a major population.
Adult↗
Applications of thrombolytic therapy.
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Brain Ischemia↗
Effects of cytokines and nitric oxide on myocardial E-C coupling.
Compelling evidence now exists that pro-inflammatory cytokines and nitric oxide (NO) are newly identified endogenous regulators of myocardial contractility. The mechanism(s) responsible for the inotropic and chronotropic effects of these novel mediators can be explained on the basis of recently established principles of myocardial excitation contraction coupling (E-C). A novel hypothesis is proposed that cytokines and NO-mediated alterations in E-C coupling contribute to the reversible myocardial depression and beta-adrenergic desensitization observed in a diverse group of clinical conditions that activate host inflammatory responses, including congestive heart failure. The results of in vitro studies indicate that cytokines and NO have both immediate, short-term, as well as long-term effects on cardiac performance. Basic studies into these cytokine signaling pathways in cardiac myocytes have the potential to provide important new insights relevant to the design of new management strategies for the treatment of congestive heart failure patients.
Animals↗
Arsenic levels in drinking water and the prevalence of skin lesions in West Bengal, India.
BACKGROUND: A cross-sectional survey was conducted between April 1995 and March 1996 to investigate arsenic-associated skin lesions of keratosis and hyperpigmentation in West Bengal, India, and to determine their relationship to arsenic water levels. METHODS: In all, 7683 participants were examined and interviewed, and the arsenic levels in their drinking water measured. RESULTS: Although water concentrations ranged up to 3400 microg/l of arsenic, over 80% of participants were consuming water containing <500 microg/l. The age-adjusted prevalence of keratosis was strongly related to water arsenic levels, rising from zero in the lowest exposure level (<50 microg/l) to 8.3 per 100 for females drinking water containing >800 microg/l, and increasing from 0.2 per 100 in the lowest exposure category to 10.7 per 100 for males in the highest exposure level (> or =800 microg/l). However, 12 cases with keratosis (2 females and 10 males) were drinking water containing <100 microg/l of arsenic. Findings were similar for hyperpigmentation, with strong dose-response relationships. Among those with hyperpigmentation, 29 cases were exposed to drinking water containing <100 microg/l. Calculation by dose per body weight showed that men had roughly two to three times the prevalence of both keratosis and hyperpigmentation compared to women apparently ingesting the same dose of arsenic from drinking water. Subjects who were below 80% of the standard body weight for their age and sex had a 1.6 fold increase in the prevalence of keratoses, suggesting that malnutrition may play a small role in increasing susceptibility. CONCLUSION: The surprising finding of cases who had arsenic-associated skin lesions with apparently low exposure to arsenic in drinking water needs to be confirmed in studies with more detailed exposure assessment. Further research is also needed concerning susceptibility factors which might be present in the exposed population.
Adolescent↗
Comparison of PCR, isoenzyme analysis, and antigen detection for diagnosis of Entamoeba histolytica infection.
The diagnosis of amebiasis by microscopic identification of the parasite in stool is insensitive and unable to distinguish the invasive parasite Entamoeba histolytica from the commensal parasite E. dispar. In this study, we have tested a PCR technique for the detection of E. histolytica and compared it with isoenzyme analysis and the TechLab E. histolytica-specific antigen detection test. The nested-PCR test we used is based on amplification of the small subunit rRNA gene of E. histolytica and E. dispar followed by restriction digest analysis of the PCR product. Single stool samples were obtained from 98 patients from Dhaka, Bangladesh, with diarrhea: 88 patients diagnosed by microscopy and/or culture with E. histolytica and/or E. dispar infection and 10 patients without infection. Isoenzyme analysis identified 53 of the infections as E. histolytica and 28 as E. dispar. PCR and isoenzyme identification of E. histolytica agreed in 96% (51 of 53) of amebic cultures. PCR for E. histolytica was negative in all 10 samples that were negative for E. histolytica by isoenzyme and antigen detection. PCR and antigen detection had comparable sensitivities when performed directly on fresh stool specimens, identifying 87% (46 of 53) and 85% (45 of 53), respectively, of E. histolytica infections identified by isoenzyme analysis. The correlation of results by antigen detection and PCR for identification of E. histolytica in stool was 93% (45 of 48 cases). Mixed infections with E. histolytica and E. dispar were detected by PCR in 14% (12 of 88) of cases. In conclusion, all three techniques for specific identification of E. histolytica in fresh stool showed excellent correlation. Only the TechLab E. histolytica antigen detection test was both rapid and technically simple.
Animals↗
Entamoeba histolytica and Entamoeba dispar infection in children in Bangladesh.
The prevalence of infection by the invasive parasite Entamoeba histolytica and the noninvasive parasite Entamoeba dispar was determined in 2000 children in Bangladesh. Antigen detection identified more cases of E. histolytica-E. dispar infection than did culture or microscopy. Microscopic identification of E. histolytica-E. dispar complex infection in stool did not equate with the diagnosis of amebic dysentery because most amebic infections in this population were due to E. dispar: Urban children with diarrhea had a 4.2% prevalence of E. histolytica infection and a 6.5% prevalence of E. dispar infection; rural asymptomatic children had a 1.0% prevalence of E. histolytica infection and a 7.0% prevalence of E. dispar infection. Shigella dysenteriae and Shigella flexneri infections were more frequent in children who also had Entamoeba infection, a potentially important consideration for the empiric treatment of dysentery in this population.
Adolescent↗