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J R Lambertucci

Publications and source records attributed to J R Lambertucci.

At least 55 records · Page 3Linked to original sources
PubMed1986

Immune responses during human schistosomiasis. XII. Differential responsiveness in patients with hepatosplenic disease.

Thirty-four hospitalized patients and 12 ambulatory patients, all with hepatosplenic schistosomiasis mansoni were evaluated in regard to their peripheral blood mononuclear (PBMN) cell responses to schistosomal antigenic preparations and compared with groups of 40 patients with the hepatointestinal form and 39 patients with the more common, chronic intestinal form of schistosomiasis mansoni. PBMN cell blastogenic responses were measured upon exposure to schistosomal egg antigens (SEA), adult worm antigens (SWAP) and a cercarial antigenic preparation (CERC). All groups had some individuals who did not respond to some or all of these preparations. In the hospitalized hepatosplenic group greater than 50% did not respond to SEA. Analysis of the responses in each group revealed that all responders could be subdivided into moderate and high responders. High responders to SEA had experimental minus control values of greater than 8,000 counts per minute (CPM). For SWAP and CERC, this arbitrary cut-off value was greater than 25,000 CPM and greater than 11,000 CPM, respectively. The percent of high SEA responders in the groups differed considerably. This was 23% in the chronic intestinal group, 40% in the chronic hepatointestinal group, 67% for ambulatory hepatosplenic patients and 20% for hospitalized hepatosplenic patients. Previous studies had demonstrated that 94% of patients with early (2-3 month) acute schistosomiasis mansoni were high responders to SEA and none were nonresponders. Furthermore, at the other end of the spectrum, 100% of former schistosomiasis mansoni patients (treated and cured 7-35 years previously) were high responders to SEA. None were nonresponders to any of the antigen preparations. It is proposed that during acute infection all patients express vigorous responses to SEA. Upon continued infection most patients (75%) modulate this florid response. However, continued high responders comprise 40% of the chronic hepatointestinal cases and almost 70% of the ambulatory hepatosplenic patients. These latter 2 groups may likely represent early forms of the severe clinical disease found in the hospitalized hepatosplenic patient population. Fifty percent of the hospitalized group appear anergic and no longer respond to SEA, while only 20% are high responders. Long after chemotherapy it appears that the anti-SEA regulatory mechanisms of former chronic patients have subsided, leaving strong anti-SEA responsiveness.

Acute Disease↗
PubMed1985

Immune responses during human Schistosomiasis mansoni. XI. Immunologic status of patients with acute infections and after treatment.

Sixteen patients, 8 to 30 yr of age, with acute (toxemic) phase schistosomiasis mansoni were studied immunologically within 2 to 3 mo of their exposure to Schistosoma mansoni cercariae, and were monitored after chemotherapy. Total leukocyte levels and peripheral blood eosinophilias were higher in these patients than in similar individuals with chronic schistosomiasis mansoni. In contrast to chronic patients, the eosinophilias of the acute cases were decreased rather than elevated upon treatment. Total lymphocyte population (T and B cell) percentages were not altered during acute infection. Lymphoid subset (T3+, T4+, and T8+) analysis revealed elevated levels of both T4+ and T8+ cells. In vitro blastogenic responses of peripheral blood mononuclear cells (PBMN) to heterogeneous schistosome-derived antigens (eggs, SEA; adult worms, AW; and cercariae, CERC) were evaluated. SEA responsiveness was considerably higher than that of patients with chronic S. mansoni infections. The ratios of SEA to AW responses in acute cases gave a mean of 2.0, as opposed to 0.5 for a comparable group of chronically infected patients. The sera of most acute patients already contained suppressive factors that specifically decreased schistosomal antigen-induced PBMN blastogenesis. Chemotherapy of acute cases lead to a diminution of PBMN responsiveness to SEA and CERC. Treatment of patients with chronic infections lead to the elevation of such responses. PBMN from patients with acute infections produced lymphokine leukocyte inhibition factor upon exposure of the cells to SEA but not AW. A similar pattern was true for production of the lymphokine activity mitogenic factor. Levels of antibody in sera of acutely infected patients against SEA, CERC, and AW were considerably higher than levels in sera of chronically infected patients matched for age and intensity of their infections. These high antibody titers persisted for at least 6 mo after treatment, and were unrelated to the intensity of infection. The immunologic status of these patients with acute schistosomiasis mansoni differed considerably from patients with chronic infections. These findings re-emphasize the immunoregulatory events that apparently develop upon continued exposure to schistosomes and their products during chronic infection.

Acute Disease↗
PubMed1982

A double blind trial with oxamniquine in chronic schistosomiasis mansoni.

Ninety-one children with chronic schistosomiasis mansoni were selected for this double blind trial. 48 (Group 1) were treated with a single oral dose of oxamniquine (20mg/kg body-weight) and 43 (Group 2) received the placebo. Clinical, laboratory and radiological examinations were performed before and after treatment. Dark urine and vomiting were observed only in the oxamniquine group. Pulmonary condensations with or without air bronchogram were observed in the chest X-ray of 15% of Group 1 patients, between days 3 and 5 after treatment. In the urinalysis made on the first day after treatment, a false positive reaction was reported for urobilinogen and bilirubin in up to 50% of the patients treated with oxamniquine. In Group 1, 69.6% of the patients were cured. No patient was cured in Group 2. There was a 4.4% incidence of infection in the control group. There was a 77.9% egg excretion reduction in the 14 Group 1 patients not cured by oxamniquine. The authors conclude that oral oxamniquine in the prescribed dosage, has low toxicity and good therapeutic efficacy in children with chronic schistosomiasis mansoni.

Adolescent↗
PubMed1980

Therapeutic efficacy of oral oxamniquine in the toxemic form of schistosomiasis mansoni: treatment of eleven individuals from two families, and experimental study.

Two families, comprising 11 individuals in the toxemic form of schistosomiasis mansoni, infected in Belo Horizonte, Brazil were treated. Parasitological cure was obtained in 5 (45%) of the patients after a single oral dose of oxamniquine (Mansil), 20 mg/kg body weight. No significant side effects were observed. To evaluate the possibility of resistance to the drug, cercariae collected from Biomphalaria glabrata infected with micracidia from eggs obtained from three of the individuals not cured were studied. Mice infected with these three strains were cured after a single dose of examniquine. It is suggested that research be continued with other therapeutic schedules and perhaps other, more potent, drugs.

Adolescent↗
PubMedDate not supplied

The association of steroids and schistosomicides in the treatment of experimental schistosomiasis.

The best therapeutic approach to acute schistosomiasis (Katayama fever) is still unsettled. In this paper we report a synergistic effect between schistosomicides and steroids in the treatment of the early stages of Schistosoma mansoni infection in the mouse. CBA mice infected with 150 S. mansoni cercariae were treated with oxamniquine or praziquantel and dexamethasone or prednisolone. The rate of parasite egg excretion by treated mice and appropriate controls was monitored, and the mice were perfused 43 d after infection for estimation of worm burdens and tissue egg densities. Mice treated with schistosomicides alone or with schistosomicides plus steroids had worm burdens of similar size. Significant reductions in egg counts were, however, recorded in faeces, and in the intestines and livers (with consequent reduction in liver pathology), of mice treated with schistosomicide and steroid, when compared to mice treated with schistosomicide alone or steroid alone. The apparent inhibition of fecundity of S. mansoni by combining these drugs has clear implications for treatment of the Katayama syndrome.

Animals↗
PubMedDate not supplied

Analysis of anti-keyhole limpet haemocyanin antibody in Brazilians supports its use for the diagnosis of acute schistosomiasis mansoni.

Antibody (immunoglobulin (Ig) G) to the haemocyanin of the keyhole limpet (KLH) (Megathura crenulata), which shares a well defined carbohydrate epitope with the surface of schistosomula of Schistosoma mansoni, was determined by enzyme-linked immunosorbent assay (ELISA) in the sera of Brazilians with acute schistosomiasis. Of 53 such individuals tested, 51 had a level of KLH reactivity in excess of the mean +2 standard deviations of that exhibited by chronically infected individuals. This difference in reactivity allowed the acute cases to be readily identified by visual inspection of ELISA plates. The levels of IgG in patients with hepatointestinal and hepatosplenic schistosomiasis, as well as in non-infected, seropositive residents of endemic areas and infected children from endemic areas, were not statistically different from those of intestinal patients. Significant levels of anti-KLH IgG were not detected in patients with leishmaniasis, Chagas disease, ancylostomiasis or ascariasis. The results support the use of KLH as a means of rapidly and easily identifying individuals with acute schistosomiasis.

Adolescent↗
PubMedDate not supplied

Evaluation of proteinuria in an area of Brazil endemic for schistosomiasis using a single urine sample.

A two-step protocol was designed to evaluate the frequency of proteinuria related to Schistosoma mansoni infection in an endemic area, as measured by the protein/creatinine ratio (P/C R). A pre-test on 32 in-patients with renal disease and 20 healthy individuals showed a high correlation (r = 0.948) between the classical measurement of protein excretion per square metre of body surface during 24 h and the P/C R. The P/C R was then used to evaluate the frequency of proteinuria in 189 individuals in an endemic area in the northeast of Minas Gerais state, Brazil, with a schistosomiasis prevalence of 49.3% and 3.4% with the hepatosplenic form. The low prevalence of proteinuria (1.06%) in the studied population can be attributed to the accuracy of the method used and to the low prevalence of the hepato-splenic form of schistosomiasis. The P/C R is a reliable and appropriate method for the measurement of proteinuria in field studies.

Adolescent↗
PubMedDate not supplied

Pyogenic liver abscesses and acute schistosomiasis mansoni: report on 3 cases and experimental study.

Three children with acute schistosomiasis mansoni developed pyogenic liver abscesses. The abscesses were diagnosed by ultrasonography and confirmed during laparotomy. Staphylococcus aureus were the sole bacteria isolated from the abscesses. An experimental study was carried out in mice to establish whether schistosomiasis is a predisposing cause for pyogenic liver abscesses. Seventeen mice (group 1) were infected with 40 Schistosoma mansoni cercariae (LE strain) and 60 d later inoculated intravenously with a strain of Staph. aureus, isolated from a patient with bacteraemia; 17 mice infected with Sch. mansoni (group 2), 19 infected with bacteria alone (group 3), and 18 uninfected mice (group 4), served as controls. Thirteen group 1 mice (77%) developed multiple liver abscesses while none was observed in the controls. These results indicate that acute schistosomiasis mansoni concurrent with Staph. aureus bacteraemia favours the colonization of the liver by bacteria and the development of pyogenic hepatic abscesses.

Acute Disease↗
PubMedDate not supplied

Pulmonary hypertension in schistosomiasis mansoni.

To evaluate cardiopulmonary involvement in schistosomiasis mansoni, 246 patients from an endemic area of Brazil were examined; 152 had been previously treated for schistosomiasis. Based on stool examination and/or abdominal ultrasonography, the patients were divided into those with schistosomiasis (69%) and those in whom the disease was not present (31%). M mode measurements were similar in the 2 groups. Pulmonary pressure was measured by Doppler echocardiography; 25% of the subjects had pulmonary hypertension. Those with pulmonary hypertension had a higher prevalence of schistosomiasis (80%) than those without (64%; P = 0.03). No case of cor pulmonale was diagnosed by electrocardiography or Doppler echocardiography. The prevalence of pulmonary hypertension correlated neither with periportal fibrosis nor with prior treatment for schistosomiasis.

Adult↗
PubMedDate not supplied

Ultrasonography of periportal fibrosis in schistosomiasis mansoni in Brazil.

In patients with hepatosplenic schistosomiasis, characteristic thickening of the walls of the portal vein in the hilus and its central and peripheral branches is observed. In an area of high prevalence of the disease in Brazil, 424 individuals older than 5 years have been examined by abdominal ultrasonography and 146 presented fibrosis, classified as central in 31 (21%), peripheral in 56 (38%), and both central and peripheral in 59 (40%). The mean ages of the subjects in the 3 groups were 45.7, 24.1 and 31.9 years, respectively (P < 0.05). The presence of central fibrosis was associated with the presence of peripheral fibrosis (odds ratio 10.7, P < 0.000001). Splenomegaly was found in 16% and 15% of individuals with peripheral and both central and peripheral fibrosis, respectively. No subject with central but no peripheral fibrosis and splenomegaly was identified. We conclude that central fibrosis occurs among older subjects but should not be considered a criterion for advanced disease.

Adolescent↗
PubMedDate not supplied

Stool examination and rectal biopsy in the diagnosis and evaluation of therapy of schistosomiasis mansoni.

From each of a group of 217 adult males selected through enzyme-immunoassay or skin-test (Group A), six stool samples were examined by both the Lutz/Hoffman, Pons & Janer (Lutz/HPJ) and Kato/Katz methods. In addition, one oogram of the rectal mucosa was performed. By these methods, schistosomiasis was detected in 44.7%, 47.5% and 40.1% of the individuals respectively. To evaluate the methods in the assessment of cure, the last 40 patients from group A, treated with a single oral dose of oxamniquine at 15 mg/kg were followed up for six months (Group B). The criteria for parasitological cure included three stool examinations by Kato/Katz and Lutz/HPJ methods, one, three and six months post-treatment and a rectal biopsy between the fourth and sixth months post-treatment. The examinations were negative in 87.5%, 90% and 95% of the patients, respectively. The efficacy of oxamniquine was 82.5% when the three methods were considered together and there was no statistically significant difference between the sensitivity of the individual methods.

Adolescent↗
PubMedDate not supplied

Characterization of the non-apparent clinical form in the initial phase of schistosomiasis mansoni.

In this paper the history of 115 recruits that had bathed simultaneously in streams contaminated with Schistosoma mansoni, during military maneuvers, is reported. Thirty four of the infected patients presented the initial phase of the infection diagnosed through epidemiologic, clinical and laboratory parameters. Three out of the 34 patients did not reveal the clinical picture of the infection, thus being considered representatives of the non-apparent form of the disease. Differences between the intensity of blood eosinophilia, the area of immediate cutaneous reaction and the number of Schistosoma eggs eliminated in the stools proved not to be statistically significant (p > 0.05) when the non-apparent and acute cases of schistosomiasis were compared. These cases actually may be considered evidences of the non-apparent form hitherto merely taken for granted in the literature.

Adolescent↗
PubMedDate not supplied

Acute schistosomiasis: clinical, diagnostic and therapeutic features.

Three distinct syndromes caused by schistosomiasis have been described: cercarial dermatitis or swimmer's itch, acute schistosomiasis or Katayama fever, and chronic schistosomiasis. Complications of acute schistosomiasis have also been reported. The absence of a serological marker for the acute stage has hindered early diagnosis and treatment. Recently, an ELISA test using KLH (keyhole limpet haemocyanin) as antigen, has proved useful in differentiating acute from chronic schistosomiasis mansoni. Clinical and experimental evidence indicate that steroids act synergistically with schistosomicides in the treatment of Katayama syndrome. In this paper, clinical, diagnostic and therapeutic features of acute schistosomiasis are updated.

Acute Disease↗
PubMedDate not supplied

Sonographic features of portal hypertension in schistosomiasis mansoni.

The diagnostic value of real-time sonography in the study of portal hypertension was assessed in 66 patients with hepatosplenic schistosomiasis mansoni, all with Symmers's fibrosis and esophageal varices. Seventy-one individuals without schistosomiasis were selected as controls. The inner diameters of the portal vessels were measured by sonography in all patients and controls: splenoportography was also performed in the schistosomal group. Intra-splenic pressure was over 30 cm of water in 44 of 60 patients with schistosomiasis. The upper limit of normality for portal vessel diameters was set through receiver operating characteristic curve at 12 mm for portal vein, 9 mm for splenic vein at splenic hilus, and 9 mm for superior mesenteric vein. The best discriminative vein for the diagnosis of portal hypertension was the splenic vein followed by the portal vein. A direct correlation was observed between the diameter of the splenic vein, measured by sonography, and the intra-splenic pressure. Except for the paraumbilical and mesenteric veins, more frequently identified by sonography, there was no statistical difference in the frequency of visualization of splanchnic vessels by sonography or splenoportography.

Adolescent↗