New anthelmintic drugs Nuevos medicamentos antihelmínticos.

New anti-helminthic drugs have appeared lately: benzimidazoles (mebendazole, flubendazol, and abendazole), praziquantel and ivermectin. Mebendazol and flubendazol are poorly absorbed and are effective for ascaris, oxyuriasis and trycocephalus both in adults and children. Abendazole is well absorbed and may be considered the drug of choice for ascaris and oxyuriasis at a single 400 mg dose. This drug may also be used for hydatid cyst when surgery is not possible and for cysticercosis of the nervous system. Praziquantel is useful for treatment of tenia infections and ivermectin is useful for strongyloides and trichostrongyloides. Detailed dose schedules for different parasitic diseases are given in the text

Current and developing therapeutic agents in the treatment of Chagas disease

Chagas disease must be treated in all its stages: acute, indeterminate, chronic, and initial and middle determinant chronic, due to the fact that DNA of the parasite can be demonstrated by PCR in chronic cases, where optical microscopy does not detect parasites. Nifurtimox (NF) and benznidazole (BNZ) are the drugs accepted to treat humans based upon ethical considerations and efficiency. However, both the drugs produce secondary effects in 30% of the cases, and the treatment must be given for at least 30-60 days. Other useful drugs are itraconazole and posaconazole. The latter may be the drug to treat Chagas disease in the future when all the investigations related to it are finished. At present, there is no criterion of cure for chronic cases since in the majority, the serology remains positive, although it may decrease. In acute cases, 70% cure with NF and 75% with BNZ is achieved. In congenital cases, 100% cure is obtained if the treatment is performed during the first year of life

New antiprotozoal and antiarthropod drugs Nuevos medicamentos antiprotozoarios y antiartropodos

Few developments have taken place in this area, except for the use of trimethoprim and sulfamethoxazole for isosporosis and spiramycin for cryptosporidiosis in immune suppressed patients. For parasitic arthropods, crotamiton and piretoids have been helpful in treating scabies and pediculosis, respectively

Natural history of chagasic cardiopathy in Chile. Follow-up of 71 cases after 4 years

As part of study of Chagasic cardiopathy in Chile we report a follow-up study of 100 cardiopathic patients from two endemic areas who had been diagnosed 4 years earlier during an epidemiological and clinical survey. The follow-up consisted of a clinical, serological and electrocardiographic examination, and a continuous ECG recording for 60 min to detect possible arrhythmias. From the original 100 cases, three had died: One of a gastric cancer and the other two due to probable chagasic cardiopathy. Twenty-six had migrated to other areas and were lost to our study. From the remaining 71 patients, 48 were asymptomatic and 23 had complaints including palpitations, dyspnoea and Stokes-Adams crisis. In most cases, seropositivity by indirect haemagglutination did not change, but in six cases the titres decreased, becoming negative in three of them. Xenodiagnosis was positive in 19.3% of seropositive patients. The ECG had returned to normal in 18 cases (17%) but showed a higher degree of blo

Epidemiology of Chagas' disease in northern Chile: Isozyme profiles of Trypanosoma cruzi from domestic and sylvatic transmission cycles and their association with cardiopathy

Trypanosoma cruzi was isolated from 98 patients, 59 Triatoma infestans, 51 Triatoma spinolai, and 1 Octodon degus from northern Chile. With few exceptions, stocks originating from domestic hosts were classified, based on their isozyme profile, as principal zymodeme (Z)2, while sylvatic stocks from T. spinolai and the rodent O. degus showed Z1 profiles. These results indicate the existence of separate domestic and sylvatic transmission cycles. Clinical data and T. cruzi isozyme profiles from 107 chronic Chagas' disease patients showed no association between infecting T. cruzi zymodeme and the prevalence of chagasic cardiopathy. However,the age distributions of two groups of patients carrying different zymodemes were significantly different

Acute fasciolosis: A clinical case Fasciolosis aguda: Caso clínico

Woman of 39 years of age from Talca province (VII Region) who presented intense abdominal pain which was interpreted as an acute abdomen, and an exploratory laparotomy was performed, wich was not concludent. After different procedures and tests the diagnosis of acute fasciolosis was achieved. She was treated with triclabendazole

Real-time PCR strategy for the identification of Trypanosoma cruzi discrete typing units directly in chronically infected human blood

© 2017 Elsevier B.V. The protozoan Trypanosoma cruzi is the causative agent of Chagas disease, a major public health problem in Latin America. This parasite has a complex population structure comprised by six or seven major evolutionary lineages (discrete typing units or DTUs) TcI-TcVI and TcBat, some of which have apparently resulted from ancient hybridization events. Because of the existence of significant biological differences between these lineages, strain characterization methods have been essential to study T. cruzi in its different vectors and hosts. However, available methods can be laborious and costly, limited in resolution or sensitivity. In this study, a new genotyping strategy by real-time PCR to identify each of the six DTUs in clinical blood samples have been developed and evaluated. Two nuclear (SL-IR and 18S rDNA) and two mitochondrial genes (COII and ND1) were selected to develop original primers. The method was evaluated with eight genomic DNA of T. cruzi populatio