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PubMedDate not supplied

Selective primary health care: strategies for control of disease in the developing world. XIX. Giardiasis.

Giardia lamblia infects millions of individuals throughout the world. In developed countries it appears primarily in waterborne epidemics of diarrhea. In developing countries, it is endemic, but only a small proportion of those infected appear ill. This flagellate parasite infects the small intestine of its host and may cause malabsorption and malnutrition, particularly among infants and young children. Little is known about the extent of illness caused by this parasite because few epidemiologic studies have been done; diagnosis is difficult and Giardia carriers frequently are simultaneously infected with other pathogens. Control measures include intermittent treatment of those infected and improved water supply and sanitation. Efforts to control individual infection can only be successful on a temporary basis. The greatest progress in control should derive from efforts to develop an effective vaccine.

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PubMed1985

Experimental models of heart failure.

Experimental models of heart failure can be used to address specific questions not easily answered in patients, but no single model can reproduce exactly any of the clinical syndromes of heart failure since these are dominated by fatigue and breathlessness. Heart failure may be induced experimentally by pressure loading, volume loading, myocardial infarction, or by the creation of other disease states within the myocardium. Pressure loading may be especially useful in the study of ventricular hypertrophy, cellular derangements and vascular changes. Volume loading may be useful when examining the pathogenesis of hormone and electrolyte disturbances. Models of myocardial infarction or destruction are likely to be the most suitable for assessing novel therapy provided that peripheral reflexes are maintained. Experimental cardiomyopathy can provide an important means of identifying pathological subcellular mechanisms. They may be of use in the evaluation of vasodilator drugs but caution should be exercised in the study of inotropic agents. Any one model may be useful if it permits study of a single factor or variable in isolation or at a time when information is not obtainable from patients. For greatest clinical relevance, studies should be made in conscious animals with intact reflexes.

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PubMed2003

Entamoeba histolytica: an update.

PURPOSE OF REVIEW: Over the past decade, since it was formally recognized that Entamoeba histolytica and Entamoeba dispar were two distinct species, studies in this field have made dramatic in-roads into the understanding of E. histolytica and the pathogenesis of invasive amoebiasis. Over the same period it has also become clear that the true incidence of E. histolytica infection, particularly in vulnerable populations such as low socioeconomic children, is exceedingly high. Understanding the epidemiology, pathophysiology, and the molecular and genetic biology of the organism will not only lead to improved diagnostic and treatment options but, ultimately, to the development of a safe and efficacious vaccine. RECENT FINDINGS: The recent advances in the genetic and molecular sciences have increased our understanding of the mechanisms that make E. histolytica unique among enteric protozoa in causing invasive disease. In addition, host factors, which predispose individuals or populations to infection or disease, are beginning to be elucidated. New diagnostic tools specific to E. histolytica are being exploited by clinicians and researchers to identify and treat patients as well as to add to the knowledge of the epidemiology and natural history of this infection. The ultimate goal - eradication of disease - is theoretically feasible since humans and primates are the only reservoirs of E. histolytica. Many talented and dedicated individuals are pursuing the development of an effective and safe amoebiasis vaccine. SUMMARY: E. histolytica remains an important pathogen in many populations of the world and although there has been substantial progress into understanding the disease major challenges still exist.

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