Helminths, infections

Antimony potassium tartrate (tartar emetic) has the advantage of being low in cost. It has been called the dmg of choice for Schistosoma japonicum infection (204) even though it fails to cure the disease in many patients. However, trivalent antimonials are no longer recommended for the treatment of helminthic infections because these compounds have an unacceptable toxicity and are too difficult to administer (205). 

Over the last several years, substantial progress in the discovery and development of anthelmintic dmgs has been made. Effective agents are available for most human gastrointestinal infections (Table 1) however, dmgs that are effective in treating the extraintestinal complications of many helminthic infections are still needed. 

Discuss the uses, general drug action, adverse effects, contraindications, precautions, and interactions of the drugs used in the treatment of helminth infections, malaria, and amebiasis. 

Pinworm is a helminHi infection that is universally common most oHier helminth infections are predomi-lianHy found in countries or areas of the world that lack proper sanitary facilities. Malaria is rare in the United States, but it is sometimes seen in individuals who have traveled to or lived in areas where this disease is a healtii problem. The first antimalarial drug, quinine, is derived from the bark of the cinchona tree. Amebiasis is seen Hiroughout the world, but it is less common in developed countries where sanitary facilities prevent Hie spread of the causative organism. 

Promoting an Optimal Response to Therapy The diagnosis of a helminth infection is made by examination of the stool for ova and all or part of the helminth. Several stool specimens may be necessary before the helminth is seen and identified. The patient history also may lead to a suspicion of a helminth infection, but some patients have no symptoms. 

Patients with massive helminth infections may or may not be acutely ill. The acutely ill patient requires hospitalization, but many individuals with helminth infections can be treated on an outpatient basis. 

The diagnosis of a helminth infection is often distressing to patients and their family. The nurse should allow time to explain the treatment and future preventive measures, as well as to allow the patient or family members to discuss their concerns or ask questions. 

IgE Mediates immediate hypersensitivity by causing release of mediators from mast cells and basophils upon exposure to antigen (allergen). Defends against worm infections by causing release of enzymes from eosinophils. Does not fix complement. Main host defense against helminthic infections. 

Enterobiasis, or pinworm infection, is caused by Enterobius vermicularis. It is the most widely distributed helminthic infection in the world. There are approximately 42 million cases in the United States, primarily affecting children. The most common manifestation of the infection is cutaneous irritation... 

Morbidity and disease due to helminthic infections is related to the intensity of infection. The major adverse effects of helminthic infections are malnutrition, fatigue, and diminished... 

In some helminth infections, a migration through various body tissues is essential for maturation, as in ascarasis or schistosomiasis, whereas in other infections, the larva leaves the egg and simply matures in the intestinal tract, as in trichuriasis and enterobiasis. Host tissues involved vary depending upon the parasite. In severely immunocompromised patients, sites may be involved that are not involved in normal hosts. 

Graham, M., Smith, T.S., Munn, E.A. and Newton, S.E. (1993) Recombinant DNA molecules encoding aminopeptidase enzymes and their use in the preparation of vaccines against helminth infections. Patent No. WO 93/23542. 

Artis, D., Humphreys, N.H., Bancroft, A.J., Rothwell, N.J., Potten, C.S. and Grencis, R.K. (1999a) TNF-a is a critical component of IL-13-mediated protective T helper cell type 2 responses during helminth infection. Journal of Experimental Medicine 190, 953-962. 

Grencis, R.K. (1997) Enteric helminth infection immunopathology and resistance during intestinal nematode infection. Chemical Immunology 66, 41-61. 

Nokes, C. and Bundy, D.A.P. (1994) Does helminth infection affect mental processing and educational achievement Parasitology Today 10,1-18. 

The morbidity and mortality that are often associated with human GI helminth infections reflect in part the nutritional consequences of diarrhoea and malabsorption, and the resulting malnutrition that can accentuate the effects of infection by suppressing the protective immune response as well as compromising intestinal repair (Ferguson et al., 1980 Keymer and Tarlton, 1991 Cooper et al, 1992). In experimental rodents the pathology associated with infection is characterized by villus atrophy, crypt hyperplasia, goblet cell hyperplasia and infiltration of the mucosa by a variety of... 

Th2 Involvement in Pathological Responses in Other Helminth Infections... 

Fox, J.G., Beck, P., Dangler, C.A., Whary, M.T., Wang, T.C., Shi, H.N. and Nagler-Anderson, C. (2000) Concurrent enteric helminth infection modulates inflammation and gastric immune responses and reduces helicobacter-induced gastric atrophy. Nature Medicine 6, 536-542. 

Important helminth infections of cattle, sheep and goats... 

Carstensen, L., Vaarst, M. and Poepstorff, A. (2002). Helminth infections in Danish organic swine herds . Veterinary Parasitology, 106, 253-264. 

Nejsum, P., Jprgensen, C., Fredholm, M., Roepstorff, A. and Thamsborg, S. M. (2005). Helminth infections in pigs possible effects of host genotype . Proceedings of the 20th International Conference of the WAAVP, 16-20 October 2005. Christchurch, NZ, p 239. 

Roepstorff, A. and Nansen, P. (1994). Epidemiology and control of helminth infections in pigs under intensive and non-intensive production systems . Veterinary Parasitology, 54(1-3), 69-85. 

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