Oh my aching gut: irritable bowel syndrome, Blastocystis, and asymptomatic infection

Blastocystis is a prevalent enteric protozoan that infects a variety of vertebrates. Infection with Blastocystis in humans has been associated with abdominal pain, diarrhea, constipation, fatigue, skin rash, and other symptoms. Researchers using different methods and examining different patient groups have reported asymptomatic infection, acute symptomatic infection, and chronic symptomatic infection. The variation in accounts has lead to disagreements concerning the role of Blastocystis in human disease, and the importance of treating it. A better understanding of the number of species of Blastocystis that can infect humans, along with realization of the limitations of the existing clinical laboratory diagnostic techniques may account for much of the disagreement. The possibility that disagreement was caused by the emergence of particular pathogenic variants of Blastocystis is discussed, along with the potential role of Blastocystis infection in irritable bowel syndrome (IBS). Findings are discussed concerning the role of protease-activated receptor-2 in enteric disease which may account for the presence of abdominal pain and diffuse symptoms in Blastocystis infection, even in the absence of fever and endoscopic findings. The availability of better diagnostic techniques and treatments for Blastocystis infection may be of value in understanding chronic gastrointestinal illness of unknown etiology

Health inequities: lower socio-economic conditions and higher incidences of intestinal parasites

<p>Abstract</p> <p>Background</p> <p>Intestinal parasitic infections affect child health and development and slow down growth, while reducing adults' productivity and work capacity. The aim of the present study was to determine and compare the incidences of intestinal parasitic infections and the socio-economic status of two near primary school children in Manisa, a western city of Turkey.</p> <p>Methods</p> <p>A total of 352 children were involved a questionnaire study from a private school (Ülkem Primary School – ÜPS, 116 children) and a community-based school (Şehzadeler Primary School – ŞPS, 236 children). Of these, stool samples could be obtained from a total of 294 students; 97 (83.6%) from ÜPS, and 197 (83.5%) from ŞPS. The wet mount preparations of the stool samples were examined; samples were also fixed in polyvinyl alcohol and examined with modified formalin ethyl acetate sedimentation and trichrome staining techniques. Data were analyzed using SPSS for Windows version 10.0. The chi-squared test was used for the analytic assessment.</p> <p>Results</p> <p>The percentages of the students found to be infected with intestinal parasites, were 78 (39.6%) and 13 (13.4%) in ŞPS and ÜPS, respectively. Totally 91 (31.0%) of the students from both schools were found to be infected with at least one intestinal parasite. <it>Giardia lamblia </it>was found to be the most common pathogenic intestinal parasite and <it>Blastocystis hominis </it>was prevalent independently from the hygienic conditions. The factors which significantly (<it>p </it>< 0.05) increase the incidence of intestinal parasites were uneducated and unemployed mother, lower social status of father, living in crowded houses with insufficient indoor spaces, using the tap water as drinking water, and living at shanty areas.</p> <p>Conclusion</p> <p>Intestinal parasitic infections in school children were found to be a public health problem that increased due to lower socio-economic conditions. We conclude that organization of education seminars including the topics such as prevention of the infectious diseases, improving general hygienic conditions, and application of supportive programs for the parents may be suggested not only to reduce intestinal parasitic infections, but also to elevate the socio-cultural levels.</p

The in vitro Effects of Azithromycin and Clarithromycin on Promastigotes and Amastigotes of Leishmania tropica

Leishmania (L.) tropica is one of the most common species responsible for cutaneous leishmaniasis (CL) in the Old World including Turkey. the pentavalent antimonials are widely used as intralesional and/or intramuscular in the treatment of CL, but increase in resistance to these agents led to investigations on alternative drugs. in vitro antileishmanial activities of two macrolides, azithromycin and clarithromycin were evaluated on promastigotes in RPMI 1640 medium and amastigotes in macrophage series of L. tropica. ED50 values of azithromycin and clarithromycin were found to be 5 µg/ml and ;lt;5 µg/ml on promastigotes, and 50-75 µg/ml and ;lt;3 µg/ml on amastigotes, respectively, while ED90 values of the same drugs were 75 µg/ml and 25 µg/ml on promastigotes and 100 µg/ml and 10 µg/ml on amastigotes, respectively. Our data suggested that clarithromycin and azithromycin were effective on both L. tropica promastigotes and amastigotes in vitro. Clarithromycin was found to be more effective than azithromycin at lower concentrations on promastigotes and amastigotes. in vivo studies should be planned to detect intracellular concentrations of these drugs for the effective route and dosageLeishmania (L.) tropica, Türkiye'de dahil olmak üzere Eski Dünya'da kutanöz leishmaniasisden (KL) sorumlu en önemli türdür. KL tedavisinde intralezyoner ve intramuskuler yoldan beş değerlikli antimon bileşikleri yaygın olarak kullanılmaktadır, fakat bu ajanlara karşı artan direnç alternatif ilaçların geliştirilmesini gerekli kılmaktadır. Bu çalışmada, makrolid grubundan iki antibiyotik olan azitromisin ve klaritromisinin L. topica'nın RPMI 1640 besiyerindeki promastigotlar ve makrofaj serisindeki amastigotlar üzerine olan antileishmanial aktiviteleri değerlendirilmiştir. Azitromisin ve klaritromisinin promastigotlar üzerindeki ED50 değerleri sırasıyla 5 µg/ml ve 5 µg/ml olarak, amastigotlar üzerindeki ED50 değerleri sırasıyla 50-75 µg/ml ve 3 µg/ml olarak bulunurken ED90 değerleri promastigotlar üzerinde 75 µg/ml ve 25 µg/ml olarak, amastigotlar üzerinde ise 100 µg/ml ve 10 µg/ml olarak bulunmuştur. Bu çalışmada, azitromisin ve klaritromisinin in vitro olarak L. tropica promastigot ve amastigotları üzerine etkili olduğu gösterilmiştir. Klaritromisin her iki parazit formunda da daha düşük dozlarda azitromisinden daha etkili olduğu belirlenmiştir. Bu ilaçların kullanım şekli ve dozajlarının belirlenmesi için hücre içi konsantrasyonlarının saptanması amacıyla in vivo çalışmaların planlanması gerektiği kanısına varılmıştı