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Biomedical subjects

J R Lambertucci

Publications and source records attributed to J R Lambertucci.

At least 37 records · Page 2Linked to original sources
PubMed1999

Abdominal ultrasound in acute schistosomiasis mansoni.

Reports on abdominal ultrasound studies in patients with acute schistosomiasis are still scarce and limited data are available on structural changes of the liver parenchyma in this stage of the disease. 26 patients with acute schistosomiasis mansoni were submitted to clinical and ultrasound examination. For ultrasound comparison, each acute patient was paired by age, gender, weight and height to a non-infected individual. Ultrasound showed a non-specific homogeneous size increase of the liver, and spleen in all acute patients, and easily identified intraabdominal lymph nodes in the periportal region in most cases. Three out of the five patients with periportal thickening underwent percutaneous liver biopsy. Periportal thickening disappeared 6 months after treatment for schistosomiasis. 24 months after successful treatment there was involution of the liver and spleen; lymph nodes, although reduced in size, were still easily recognized. Liver biopsy showed dense inflammatory infiltration of neutrophils, macrophages and eosinophils in the portal tracts associated with discrete fibrous tissue formation.

Abdomen↗
PubMed1998

Schistosomiasis and associated infections.

In hospital-based series viral hepatitis B has been frequently described in association with schistosomiasis whilst in field-based studies the association has not been confirmed. The association between schistosomiasis and Salmonella bacteraemia has been well documented. More recently, acute schistosomiasis has been shown to be a facilitating factor in the genesis of pyogenic liver abscesses caused by Staphylococcus aureus. New evidences indicate an interaction between the acquired immunodeficiency syndrome (AIDS) and schistosomiasis. In this paper, data on the association of schistosomiasis with other infections are updated.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Splenic palpation for the evaluation of morbidity due to schistosomiasis mansoni.

This study was undertaken to determine the accuracy of splenic palpation for the diagnosis of splenomegaly, and to determine whether the frequency of individuals with a palpable spleen in an endemic area can be considered as an index of morbidity of schistosomiasis. For the clinical diagnosis of splenomegaly, two criteria have been tested: (A) presence of a palpable spleen and (B) presence of a palpable spleen whose border could be felt more than 4 cm below the costal margin. In an area of high prevalence of the disease (66.3%) 285 individuals aged 18 years or more have been submitted to abdominal ultrasonography and physical examination. Splenomegaly was defined as a splenic length greater than 120 mm by ultrasound and the sensitivity, specificity, positive and negative predictive values of criterion A were 72.2%, 90.5%, 35.1% and 97.8%. The values for criterion B were 27.8%, 98%, 50% and 95%, respectively. In an non endemic area, 517 individuals were submitted to the same protocol and 22 individuals had a palpable spleen, but no patient fulfilled criterion B for splenomegaly, and only one met the ultrasonographic criterion for splenomegaly. The authors concluded that abdominal palpation is a poor method for the diagnosis of splenomegaly.

Adolescent↗
PubMed1998

Chronic carriers of hepatitis B surface antigen in an endemic area for schistosomiasis mansoni in Brazil.

Data on the association of schistosomiasis and hepatitis B in field-based studies are scarce. Two areas have been selected for this study: i) Queixadinha, endemic for schistosomiasis, with a population of 693 individuals, and ii) Capão, a control non-endemic area, with 515 inhabitants. Sera of all individuals in both areas were tested for hepatitis B infection, yearly, from 1994 to 1997. In the first area hepatitis B was found in 32.1% of children up to one year old and reached a peak of 68.7% in the age range of 15 to 19 years. In the control area the prevalence of hepatitis B was under 5% up to 19 years of age and the highest prevalence was observed in adults over 45. HBsAg was detected in 9.4% of the individuals living in the endemic area for schistosomiasis and in 1.4% of the controls (OR = 4.98; 95% CI = 3.7-6.7). The index of chronicity of HBsAg was not statistically different in the studied areas (8.1% x 7.3%; OR = 1.09; 95% CI = 0.42-3.03), nor was it different for people with and without schistosomiasis in Queixadinha (8.7% x 7.0%). We conclude that the Schistosoma mansoni infection has not altered the course of hepatitis B in the studied area.

Adolescent↗
PubMed1998

Cytokines as determinants of resistance and pathology in human Schistosoma mansoni infection.

The role of different cytokines in the peripheral blood mononuclear cell (PBMC) proliferative response and in in vitro granuloma formation was evaluated in a cross-sectional study with patients with the different clinical forms and phases of Schistosoma mansoni infection, as well as a group of individuals "naturally" resistant to infection named normal endemic (NE). The blockage of IL-4 and IL-5 using anti-IL-4 and anti-IL-5 antibodies significantly reduced the PBMC proliferative response to soluble egg (SEA) and adult worm (SWAP) antigens in acute (ACT), chronic intestinal (INT) and hepatosplenic (HS) patients. Similar results were obtained in the in vitro granuloma formation. Blockage of IL-10 had no significant effect on either assay using PBMC from ACT or HS. In contrast, the addition of anti-IL-10 antibodies to PBMC cultures from INT patients significantly increased the proliferative response to SEA and SWAP as well as the in vitro granuloma formation. Interestingly, association of anti-IL-4 and anti-IL-10 antibodies did not increase the PBMC proliferative response of these patients, suggesting that IL-10 may act by modulating IL-4 and IL-5 secretion. Addition of recombinant IL-10 decreased the proliferative response to undetectable levels when PBMC from patients with the different clinical forms were used. Analysis of IFN-gamma in the supernatants showed that PBMC from INT patients secreted low levels of IFN-gamma upon antigenic stimulation. In contrast, PBMC from NE secreted high levels of IFN-gamma. These data suggest that IL-10 is an important cytokine in regulating the immune response and possibly controlling morbidity in human schistosomiasis mansoni, and that the production of IFN-gamma may be associated with resistance to infection.

Animals↗
PubMed1998

Short report: endomyocardial fibrosis and cardiomyopathy in an area endemic for schistosomiasis.

An association of schistosomiasis and endomyocardial fibrosis or cardiomyopathy has been suggested. Clinical, stool, abdominal ultrasound, electrocardiogram, and Doppler echocardiogram examinations were performed on 226 patients from an area endemic for schistosomiasis. The diagnosis of schistosomiasis was made in 152 patients (69%) but clinical, electrocardiographic, or Doppler echocardiographic evidence of a schistosome cardiomyopathy or endomyocardial fibrosis could not be detected in any patient.

Abdomen↗
PubMed1996

Pathogenetic factors of acute schistosomiasis mansoni: correlation of worm burden, IgE, blood eosinophilia and intensity of clinical manifestations.

A clinical study of 34 previously healthy young patients simultaneously infected in an endemic area of schistosomiasis mansoni is presented, emphasizing the initial phase of the infection. Its intensity was established according to the occurrence, intensity, and duration of the signs and symptoms in order to investigate the possible correlations between the worm burden (estimated by the number of eggs in faeces), the blood eosinophilia and specific levels of IgE (estimated by the area of immediate intradermal reaction), with the clinical manifestations. A significant but low-level association was found between the worm burden and morbidity, suggesting that multiple factors, besides worm burden itself, may contribute to the pathogenesis of the disease.

Acute Disease↗
PubMed1995

Gastro-intestinal manifestations of the initial phase of schistosomiasis mansoni.

Clinical gastro-intestinal manifestations were studied in 34 patients in the initial phase of schistosomiasis mansoni. The patients, all men, were of similar age and in similar nutritional condition and had been infected simultaneously at the same transmission site. Most (85%) showed some gastro-intestinal sign or symptom, generally of light or moderate intensity; 56% had liquid or pasty diarrhoea, 41% abdominal pain, 29% hepatomegaly, 21% dysentery, 15% anorexia, 12% pain on colon palpation and 9% nausea and/or vomiting. High worm burden was associated with blood in faeces but apparently not with any other clinical manifestation. There was no apparent association between any clinical manifestation and peripheral-blood eosinophil counts or titres of IgE specific for Schistosoma mansoni (evaluated by the area of immediate intradermal reaction to injected adult worm antigen). The absence of association between worm burden and nearly all the clinical gastro-intestinal manifestations strengthens the concept that factors other than worm burden, such as host reactivity, constitute important pathogenetic elements in the initial phase of schistosomiasis mansoni.

Adolescent↗
PubMed1995

Secondary cutaneous manifestations of acute schistosomiasis mansoni.

The secondary cutaneous manifestations of the initial phase of schistosomiasis mansoni were studied in 34 patients who had been infected simultaneously in the same location. Sixteen of the patients developed angioedema and/or urticaria, generally of short duration and of mild intensity and usually about 30 days post-infection. There was no apparent association between the occurrence of these skin manifestations and the patients' worm burdens, blood eosinophilias or areas of immediate reaction to an intradermal inoculation with worm antigen. Other factors, particularly host immunological reactivity, are thought to be important elements in the genesis of the manifestations.

Acute Disease↗
PubMed1991

The immune dependence of chemotherapy.

In this review, Mike Doenhoff and colleagues discuss the immune dependency of chemotherapy and the consequences for drug resistance. They also consider the implications for the control of infections that are relatively unresponsive to drugs, such as opportunistic infections in immunosuppressed patients.

Journal Article↗
PubMed1990

Immune dependence of schistosomicidal chemotherapy: an ultrastructural study of Schistosoma mansoni adult worms exposed to praziquantel and immune serum in vivo.

This study examines the immune-dependence of praziquantel (PZQ) for the treatment of Schistosomiasis mansoni in mice. We have shown elsewhere from worm recovery data that the efficacy of PZQ is significantly enhanced when mice are treated concomitantly with antisera raised against antigens released from adult schistosomes, even though such antisera show no intrinsic helminthotoxic activity (Doenhoff et al. 1987, Doenhoff, Modha & Lambertucci 1988). Moreover, indirect immunofluorescence assays have shown that male worms exposed to the dual treatment regime in vivo bind antiserum to their dorsal surfaces in a pattern that seems to follow the outline of the dorsal tubercles. Scanning and transmission electron microscopy have now been used to further define the features of damage inflicted upon worms through exposure to antiserum alone, drug alone, or the two treatments in combination. Such investigations revealed that the antiserum induces a classical membrane repair process in worms of both sexes, but little other damage. PZQ causes the formation of spherical protuberances on the dorsal tubercles of male worms, while the dual treatment regime induces both kinds of damage in male schistosomes, but with much enhanced severity. The protuberances show evidence of explosion and some regions of the tegument become completely destroyed. Regions other than the dorsal surfaces of the male worms do not exhibit comparable trauma, and neither do the females. These data are discussed in relation to the known schistosomicidal activity of PZQ, the notion that male and female worms exhibit regional and sexual differences in susceptibility, documented evasive strategies of the parasite and the interdependence of immuno- and chemotherapy.

Animals↗
PubMed1989

A new approach to the treatment of acute schistosomiasis.

Clinical and experimental evidence indicates that steroids act synergistically with schistosomicides in the treatment of Katayama syndrome. Due to the low efficacy of schistosomicides in the acute toxaemic phase of schistosomiasis, some authors have suggested that specific treatment for schistosomiasis should be delayed, in these patients, until the disease has entered it's chronic stage (Stuiver, 1984; Harries and Cook, 1987). A dramatic improvement (quick amelioration of symptoms and higher cure rates) was observed when patients with acute schistosomiasis were treated with steroids and schistosomicides. We do not know the explanation for the synergistic effect between steroids and schistosomicides but it has been demonstrated that the association of drugs affected, in some way, the fecundity of S. mansoni worms. The data and arguments presented here reinforce the need to use steroids in conjunction with schistosomicides for the treatment of patients with Katayama syndrome. This approach will give better cure rates, speed the recovery time (reducing the demand for hospital treatment) and improve the quality of medical care.

Acute Disease↗
PubMed1988

Glomerulonephritis in Salmonella-Schistosoma mansoni association.

In 3 patients with Salmonella-Schistosoma mansoni association and clinical evidence of renal lesions, a percutaneous renal biopsy was performed. Renal function, assessed by endogenous creatinine clearance, was abnormal in 2 cases and serum levels of complement were decreased in all cases. Immune complex glomerulonephritis, evidenced by the presence of immunoglobulin and complement in the glomeruli was demonstrated in all cases. S. dublin and S. typhimurium antigens were found in the mesangium and in the capillary walls of 2 patients. After treatment with chloramphenicol, the S. mansoni infection persisted, but the clinical, laboratory, and immunopathological alterations were resolved. These findings suggest a direct role for Salmonella in the pathogenesis of glomerulonephritis described in patients with associated Salmonella and S. mansoni infections.

Adolescent↗
PubMed1988

Anti-schistosome chemotherapy enhanced by antibodies specific for a parasite esterase.

The immune-dependent action of praziquantel has been investigated in Schistosoma mansoni-infected mice by passive transfer of rabbit antisera simultaneously with drug treatment. Significant synergistic activity was obtained with polyspecific sera against culture medium extracts of adult worms, but not with sera against detergent extracts or whole worm homogenates. Serum from a rabbit 'infected' with unattenuated S. mansoni cercariae was also synergistically active with praziquantel, and from this serum were derived two further active and monospecific sera which immunoprecipitated a 27,000 MW antigen with non-specific esterolytic enzyme activity. The antigen against which the monospecific sera reacted was detected by indirect immunofluorescence on the tubercles of drug-treated worms, but not on control worms. The immune-dependence of praziquantel thus appears related to drug-induced damage on the surface on the worm, which results in exposure of antigens sensitive to damage by antibody.

Animals↗
PubMed1987

Pulmonary schistosomiasis mansoni: post-treatment pulmonary clinical-radiological alterations in patients in the chronic phase: a double-blind study.

A double blind trial was set up to study the pulmonary effects of specific treatment with oxamniquine of 40 patients with chronic schistosomiasis mansoni. Radiological alterations characterized by bronchopneumonitis were seen in 17.5% of the patients after treatment, but in none of the placebo group; non-migratory condensation occurred between 25 and 72 h after treatment, with a mean duration of 7 d. 86% of the patients showed spontaneous healing with no radiological sequelae after 30 d of follow-up. Slight pulmonary clinical manifestations without any functional repercussions were also seen. The alterations were probably related to the host-parasite interaction, and the lesions may have been caused by deposition of immune complexes in the lungs with local activation of complement.

Adolescent↗
PubMed1987

Pulmonary involvement in schistosomiasis mansoni.

The post-treatment pulmonary alterations were evaluated in patients (Study 1) and in mice (Study 2) infected with Schistosoma mansoni. Study 1: the patients were examined pre and post-treatment (with ora oxamniquine) and the following exams were performed: sputum for eosinophils and chest x-ray. Study 2: four groups of mice (total = 64) were studied; Group I (infected and treated with oxamniquine); II (infected and not treated); III (not infected and treated) and IV (not infected and not treated). All were x-rayed to check for pulmonary abnormalities pre and post-treatment and lung specimens were studied by optical microscopy and immunofluorescence. We have found abnormalities in the parameters checked in both studies and the results suggest an immunological reaction, probably due to deposition of immune complexes in the lungs, with subsequent activation of the complement system. The experimental study showed that the alterations are not dependent of the presence of eggs and/or worms of S. mansoni in the lungs, thus corroborating the hypothesis of deposition of circulating material.

Animals↗