Monoinvasion with toxocara canis in children

Department of Infectious Diseases, Nicolae Testemitsanu State University of Medicine and Pharmacy, Consultation and Diagnostic Center of Medical Parasitology and Tropical Diseases, Toma Ciorba Republican Hospital of Infectious Diseases, Chisinau, the Republic of MoldovaBackground: Toxocariasis is a clinical notion that reflects human involvement with the Toxocara larvae in the second stage of development. Its typical syndromes are Larvae Migrans Visceralis, ocular toxocarosis , neurological form and occult form. The most common toxocariasis is asymptomatic, only eosinophilia and the positive serological result being the only manifestations of this helminth. The epidemiological examination and a detailed anamnesis of the patient can be helpful in establishing this diagnosis. Children are part of the risk group, especially because of the childhood habits, their undoubted attraction to puppies, and because of their low immune system. Material and methods: The elaborated prospective-descriptive study presents the evolution features in a group of 94 children with T.canis monoinvasion in which were examined the clinical signs, important laboratory indices, the applied treatment and its influence. Results: The study revealed the most common clinical signs and paraclinical changes in a group of 94 children with T.canis monoinvasion. Was examined the specific treatment by highlighting its influence on laboratory indices representative for this parasitosis. Conclusions: The most common clinical signs were headache, dry cough and abdominal pain. The specific therapy for vicerial chronic toxocariasis in children was far superior in clinical outcomes, this being reflected by maintaining ALT levels within the normal values demonstrating the direct involvement of larvae and toxocara toxins in the establishment and maintenance of hepatic cytolytic syndrome in children

Interaction between SARS-CoV-2 and human organism

Department of Infectious Diseases, Department of Infectious Diseases, Tropical and Medical Parasitology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, the Republic of MoldovaBackground: COVID-19 is a part of the betacoronaviridae group, sabercoviridae subgroup. At the moment we are confronting a pandemy, which has a completely new pathologic pattern for the whole world. Considering the highly contagious characteristics of the virus, which is the cause of death for many people, and also the fact that many people continue to be infected with this virus there is a stringing necesity of combating this pandemy. Because of that we need the knowledge that regards the physiopathologic mechanisms, particularities of the host-invader interactions, relevance of asymptomatic forms, explanations of the evolving divergencies, posibility of recurrent infections, clinical signs, comorbidities that harshen this pathology, pharmacologic agents that are effective to fight the infection and immune mechanisms of defense in the organism. A great importance is given for the identification of the intial criteria needed for a prognostic, to prevent the critical forms of pathology and to set the parameters for the severity indicators. Conclusions: The research in the field of SARS-CoV-2 requires the gathering of the databases that are related to the investigated persons, to establish the clinico-evolutive differences for the COVID-19 patients according to many factors that could influence the course of the disease. An important difference is the identification of early signs and prevention of the critical disease forms, by extending the laboratory investigations, establishing the parameters for severity indicators through determining the degree of the immune response

Manifestations of antropo natural aridization in the agrogenic layer of arable cernozems: factors, mechanisms

In the present research, anthropo-natural aridization is examined as a complex process manifested in reducing the available water reserves below the potential level within the respective climatic conditions of the region, reducing the biological productivity of ecological soil-plant systems, quantitative and qualitative changes at all hierarchical levels of structural-functional organization of the soil ecosystem materialized in changing the meaning and intensity of chernoziomic typogenetic processes, the involvement of anthropo-natural processes uncharacteristic of chernozemic pedogenesis and increasing the degree of inhomogeneity of the soil cover. In this context, anthropo-natural aridization is a process inherent in the use of chernozems in agriculture caused by the evolution of the pedogenetic environment under the unidirectional intercalated action of natural soil degradation processes (water and wind erosion, decay) and physical, physico-chemical and chemical degradation (disintegration-destructuring, compaction, degradation of the porous space, salinization, solonetization, etc.) in conditions of reducing the role of the biological factor and the process of humus formation and accumulation within the anthropogenic chernozemic process. The current trend of climatic conditions in the Pridanubian space, especially reducing the amount of atmospheric precipitation and changing their regime, increasing the frequency and intensity of droughts, increasing the average multiannual and warm temperatures are factors that intensify the effects of anthropo-natural aridization of arable chernozems

Cutaneous leishmaniasis

Department of Infectious Diseases, Nicolae Testemitsanu State University of Medicine and Pharmacy, Toma Ciorba Republican Hospital for Infectious Diseases, The National Health Agency, Chisinau, the Republic of MoldovaAbstract Background: Leishmaniasis is a disease caused by parasites of the Leishmania type. Cutaneous leishmaniasis is a neglected worldwide, zoonotic, vectorborne, tropical disease. The clinical spectrum of leishmaniasis ranges from a self-resolving cutaneous ulcer to a mutilating mucocutaneous disease and even to a lethal systemic illness. People who recover from cutaneous leishmaniasis are protected against future infections. The risk of infection is for people of all ages if they live or travel where leishmaniasis is found. Leishmaniasis usually is more common in rural than in urban areas, but it is found in the outskirts of some cities. The transmission risk is highest from dusk to dawn because this is when sand flies generally are the most active. Cutaneous leishmaniasis causes skin lesions, which can persist for months, sometimes years. The skin lesions usually develop within several weeks or months after the exposure but occasionally first appear years later. Presented here is a clinical case of leishmaniasis of the cutaneous form, diagnosed by the microscopic method. The patient was diagnosed, monitored and treated in Clinical Hospital of Infectious Diseases “Toma Ciorbă” from 10.01.2018-09.02.2018. The progression of the disease was favorable following the etiotropic treatment with antimony meglumine (Glucantime), requiring careful monitoring due to adverse reactions. Conclusions: Clinical symptomatology was characteristic for cutaneous leishmaniasis: skin lesions of various pink-cherry sizes, some with ulcers on the body. The first etiotropic treatment with antimony meglumine was effective. Antimonate Meglumine treatment at a dose of 15 ml resulted in adverse reactions: asthenia, fever, myalgia and arthralgia

Clostridium difficile infection in the intensive care unit

Abstract Background: Clostridium difficile (CD) infection is widespread throughout the world, showing an increased incidence over the recent years and may cause severe forms of disease. This infection most commonly affects patients whom were administered antibiotics. An increased resistance to commonly used antibiotics is associated with Clostridium difficile infection (CDI). CD has a generally recognized infectious potential on a clinical ground. CDI is unpleasant and may sometimes cause serious bowel disorders that are usually treated with another course of antibiotics. The evolution of CD infection depends on the individual characteristics of the patient along with risk factors, associated diseases as well as the particularities of the recommended treatment. However, even under the conditions of a correct and complete treatment the risk of the disease relapse is estimated to occur depending on risk factors. Many clinical instruments that are designated for the purposes to treat non-infectious diseases can be useful in estimating the severity of an infection. This review is important for understanding the abusive and irrational prescription of various groups of antibiotics, often unjustified, including the ones used in the treatment of an infection with SARS-CoV-2. Conclusions: These infections mostly occur in people aged 65 and older that receive medical care, including antibiotics administration, people with a long-term hospital stay, people with a weakened immune system or with a previous CD infection. The following measures, in order to reduce the risk of CDI in patients, should be considered: hand hygiene, avoidance of unnecessary administration of antibiotics – the antibiotic treatment is recommended only if it is prescribed by an experienced specialist, avoidance of unnecessary administration of drugs that reduce gastric acidity, because it favors the invasion of the gastrointestinal tract with CD

Evolution of the toxocariasis monoinvasion in comparison with the toxocariasis associated with other parasites in children

<p><strong>Background:</strong> Toxocariasis is a parasitic infection with a major risk to children, especially because of their incompletely developed immune system, high risk of infection or frequent re-infection, all correlated with living standards and personal hygiene. Toxocariasis occurs most frequently occult. However, evident clinical manifestations may be found, due to the migration of larvae in the second stage of development, the degree of toxocara invasion and the immune system of the child.</p> <p><strong>Material and methods:</strong> The study presents the evolution peculiarities in a group of 94 children with toxocara monoinvasion compared to a group of 73 children with the presence of two or more parasitoses. Clinical particularities, representative laboratory indices, treatment and its influence on clinical and paraclinical indices were examined.</p> <p><strong>Results: </strong>The presented article compared the most common clinical signs and paraclinic changes in both studied groups. Was examined the specific treatment for each group of patients and its action on the laboratory indices and especially the influence of treatment on the antibody titer to <em>T. canis</em><strong>.</strong></p> <p><strong>Conclusions: </strong>The most common clinical signs were asthenia, weight loss. An increase in eosinophil level is recorded only in the 13.5% in the cases of Toxocara monoinvasion and in 15.1% of the cases with Toxocariasis associated with other parasites. Anti-toxocara specific therapy proved to be much superior to other medications with a significant reduction in the percentage of eosinophils and total IgE.</p

HBsAg isoform dynamics during NAP‐based therapy of HBeAg‐negative chronic HBV and HBV/HDV infection

Abstract Nucleic acid polymers block the assembly of hepatitis B virus (HBV) subviral particles, effectively preventing hepatitis B surface antigen (HBsAg) replenishment in the circulation. Nucleic acid polymer (NAP)–based combination therapy of HBV infection or HBV/hepatitis D virus (HDV) co‐infection is accompanied by HBsAg clearance and seroconversion, HDV‐RNA clearance in co‐infection, and persistent functional cure of HBV (HBsAg 2 log10 IU/ml from baseline were correlated with selective clearance of S‐HBsAg in 39 of 42 participants. Selective S‐HBsAg decline was absent in 9 of 10 participants with HBsAg decline < 2 log10 IU/ml from baseline. Mild qHBsAg rebound during follow‐up <10 IU/ml consisted mostly of S‐HBsAg and M‐HBsAg and not accompanied by significant covalently closed circular DNA activity. Conclusion: The faster observed declines in S‐HBsAg indicate the selective clearance of subviral particles from the circulation, consistent with previous mechanistic studies on NAPs. Trace HBsAg rebound in the absence of HBV DNA may reflect HBsAg derived from integrated HBV DNA and not rebound of viral infection