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[Pneumatosis cystoides intestinalis, as a rare complications of coeliac disease].

Intestinal pneumatosis cystoides is rarely diagnosed clinical entity characterized by multiple gas containing cysts inside the wall of the gastrointestinal tract. Primary (15%) and secondary (85%) forms are known. In the more frequent secondary forms small intestine and the right side of the colon are mainly affected, and the underlying pathology can be gastrointestinal, pulmonary or immunological. The 64 year old male patient reported by the authors showed clinical signs of severe malabsorption (his body weight: 47,5 kg, height: 178 cm, BMI: 15). The intestinal pneumatosis was diagnosed by exploration performed because of suspected perforation (pneumoperitoneum). Due to severe malabsorption the patient was admitted to Gastroenterological Department. Duodenoscopy and small bowel biopsy was performed. Small intestinal histology and presence of anti-gliadin and anti-endomysium antibody confirmed the suspected diagnosis of coeliakia. Parenteral nutrition, special gliadin free diet, hyperbaric oxygen inhalation, steroid, and metronidazole treatment resulted in a gradual improvement in the nutritional and general condition of the patient. After one year the patient is without complaints, he gained 24,5 kg body weight BMI: 22,5). The author's case points to a rare serious complication of non-treated coeliakia. Recognition of intestinal pneumatosis in time could have prevented surgical intervention in the high risk patient.

Biopsy↗

Prevalence of intestinal parasitic disease agents in stools of people in a rural area of Nigeria.

Little is known of the prevalence of intestinal parasites in rural areas of Nigeria because there are few published data and laboratories in these areas are rarely well equipped for parasitological work. During a survey of a Nigerian village, Ascaris and hookworms were found to be the commonest helminths and Entamoeba coli the commonest protozoan. Differences in parasite prevalences between rural and urban areas of Nigeria are related to occupation, cultural patterns, and physical, social and biological environments.

Adolescent↗

[Dynamics of intestinal parasitic diseases in children admitted to the TB Preventorium in Gorneşti, Mureş county].

This study follows the evolution of the intestinal parasitic infections during a 5 year period between 2000-2004, detected at the inhabitants of the TBC Preventorium Gornesti from Mureş county. The 127 children included in the study are aged between 3 and 16 year, they attend a special kindergarten and a special school. The most important species of parasites found were Giardia lamblia, Ascaris lumbricoides, Hymenolepis nana and Trichuris trichiura. Most of the infected children had mono-parasitosis, only a few showed poly-parasitic infections with 2 parasites. In spite of the adequate treatment, the infections did not disappear, but neither did their number increase.

Adolescent↗

[Secular trends in intestinal parasitic diseases of childhood in the city of São Paulo, Brazil (1984-1996)].

OBJECTIVE: Data from two consecutive household surveys undertaken in mid-80s and mid-90s allow to characterize and analyse secular trends in infant and child intestinal parasitic diseases in the city of S. Paulo, Brazil. METHODS: The two surveys included random population samples aged from zero to 59 months (1,016 in the period of 1984-85 and 1,280 in 1995-96). Stool samples were collected in both surveys and examined by sedimentation techniques using both unstained and Lugol-stained preparations. For each survey, the study of the social distribution of the parasitic diseases took into account tertiles of the per capita family income. For the study of the determinants of secular trends, hierarchical causal models, multivariate regression analyses and calculations analogous to the ones used to assess population attributable risks were applied. RESULTS/CONCLUSIONS: In the time span from the first to the second survey, there was a substantial reduction in the prevalence of all parasites (from 30.9% to 10.7%), helminths in general (from 22.3% to 4.8%), giardiasis (from 14.5% to 5.5%) and two or more species of parasites (from 13.1% to 0.5%). A significant decline in prevalence was observed in all social strata and the inverse association between income and intestinal parasites was kept unchanged in the period. Positive changes in distal (family income and maternal schooling) and intermediate determinants (housing, sanitation, and access to health care) of helminthic disease could substantially explain part of its decline in the period. The decline in giardiasis was attributed to improvement in maternal schooling, housing and sanitation. The duplication in the attendance rate to day care nurseries may have restricted the decline rate in the giardiasis prevalence in the study period.

Brazil↗

[Characteristics and function of enterotoxins of gram negative bacteria (author's transl)].

Several factors are important for the pathogenesis of bacterial intestinal disease: 1. Colonisation of the intestine; 2. exo(= entero)toxin production without penetration into the intestinal wall; 3. invasion of the intestinal wall with or without (?) simultaneous formation of enterotoxin. These factors are of different importance for the various infective agents. Whereas cholera is exclusively caused by an enterotoxin, this is of minor importance for the pathogenesis of Shigella dysentery. The enterotoxins of Vibrio cholerae, Escherichia coli, and Shigella dysenteriae 1 have been intensively studied. Additional enterotoxic substances have been demonstrated in other gramnegative organisms (Salmonella typhimurium, Yersinia enterocolitica, Klebsiella pneumoniae, Vibrio parahaemolyticus, Aeromonas hydrophila), which, however, are not yet characterized sufficiently. Future studies will aim to the elucidation of the structure and function of these toxins on the molecular level, and their importance for the pathogenesis of intestinal disease.

Aeromonas↗

Mucocutaneous presentations of Crohn's disease.

Crohn's disease is an idiopathic inflammatory process that predominantly affects the gastrointestinal tract. Numerous extraintestinal manifestations of Crohn's disease involving the skin and mucous membranes have been reported in patients with documented intestinal disease. We report here on two patients who presented with multiple manifestations of Crohn's disease before intestinal disease was diagnosed. We review the mucocutaneous manifestations of Crohn's disease with an emphasis on presentations that precede gastrointestinal involvement.

Adult↗

[Parasite prevalence in schools with different socioeconomic status and evaluation of methods for diagnosing intestinal parasitic diseases].

In this study; the parasite prevalence of schools with different socio-economical status and three methods for diagnosing intestinal parasitosis were evaluated. Children from two primary schools and one junior high school with different socio-economical status participated in the study. The three method used for diagnosing parasitosis in this study were direct wet mounts, concentrated saline flotation technique, and zinc sulfate centrifugal flotation method. Parasitosis was found in 69 fecal samples (18%). The distribution of the parasites found were Hymenolepis nana (29%), Ascaris lumbricoides (26%), Enterobius vermicularis (23%), Trichirus trichiura (18%), taenia saginata (4%). The parasite prevalence in schools with low and high socioeconomical status differed significantly (27% vs. 5% respectively). Combined methods were superior to single methods. The combined method of direct wet mounts and zinc sulfate centrifugal flotation was the most sensitive method (diagnosis rate 90%). But we think that the combined method of direct wet mounts and concentrated saline flotation technique is a simpler method with almost equal results (86%).

Adolescent↗