PubMed Health⌕ Search

Biomedical subjects

S Cimerman

Publications and source records attributed to S Cimerman.

9 recordsLinked to original sources

A randomized trial comparing mebendazole and secnidazole for the treatment of giardiasis.

To compare the efficacy of the two drugs in the treatment of giardiasis, 146 children (aged 5-15 years) with confirmed Giardia lamblia infection were randomly allotted to treatment with mebendazole (200 mg three times daily for 3 days) or secnidazole (30 mg/kg, in a single dose). Parasitological response to treatment was evaluated in each child by the microscopical examination of faecal samples collected 3, 5 and 7 days after he or she had completed treatment. Although the frequency of cure was higher for secnidazole (79.4%) than for mebendazole (78.1%), the difference was not statistically significant (P > 0.05). Both treatment regimens were well tolerated, with only mild, transient and self-limiting side-effects reported. Mebendazole may be preferable to secnidazole in the treatment of giardiasis cases who have an history of intolerance to 5-nitromidazoles, and where infections with Giardia and soil-transmitted helminths frequently co-occur.

Adolescent↗

Enteric parasites and AIDS.

OBJECTIVE: To report on the importance of intestinal parasites in patients with AIDS, showing relevant data in the medical literature, with special emphasis on epidemiology, diagnosis and treatment of enteroparasitosis, especially cryptosporidiosis, isosporiasis, microsporidiasis and strongyloidiasis. DESIGN: Narrative review.

AIDS-Related Opportunistic Infections↗

Prevalence of intestinal parasitic infections in patients with acquired immunodeficiency syndrome in Brazil.

OBJECTIVES: To evaluate the prevalence of intestinal parasitic infections and to investigate the possible associations of clinical status and laboratory findings with the different parasites found in stool samples. METHODS: Each patient was provided with one standard fecal collection vial containing 10% formalin for detecting ova, larvae, and cysts. To detect Cryptosporidium parvum and Isospora belli, the acid-fast Kinyoun stain and fluorescent auramine-rhodamine stain were used. RESULTS: A total of 200 patients with acquired immunodeficiency syndrome participated in this study; 40% were infected with at least one pathogenic species. The total prevalence of parasites was 16% for Giardia lamblia, 13% for Entamoeba coli, 7% for Cryptosporidium parvum, 3.5% for Endolimax nana, 2.5% for Ascaris lumbricoides, 2.5% for Strongyloides stercoralis, 2% for Isospora belli, and 0.5% for Blastocystis hominis. Results showed that diarrhea was significantly associated with cryptosporidiosis, giardiasis, and isosporiasis. However, no association was observed between the CD4+ cell counts and the manifestation of any particular parasite. CONCLUSIONS: The data support the value of standard fecal examinations in human immunodeficiency virus-infected patients, even in the absence of diarrhea, since these examinations easily can be performed, with low costs, and frequently disclose treatable conditions.

AIDS-Related Opportunistic Infections↗

Case report. Histoplasmosis in an AIDS paediatric patient.

Histoplasmosis has been little reported among HIV-infected children. We report a case of a 4-year old boy with AIDS who presented with disseminated histoplasmosis diagnosed by lung biopsy. The patient had a good clinical response to amphotericin B followed by itraconazole oral solution.

Acquired Immunodeficiency Syndrome↗

Paracoccidioidomycosis in a boy infected with HIV.

Paracoccidioidomycosis has been rarely reported among HIV patients, despite being an endemic mycosis in Latin America. The present report illustrates a case of PM in a teenager infected with HIV. Clinicians must be aware that this mycosis may occur in young HIV infected patients who live in endemic areas.

AIDS-Related Opportunistic Infections↗

Malaria Transmission Associated with Airplane Travel.

Plasmodium falciparum malaria was diagnosed in 3 patients in Sã o Paulo during a 5 day period between August 31, and September 4, 1996, at a time and place where malaria transmission does not occur. After investigation of the 3 cases it was determined that the infections were acquired as a result of an international airplane flight from Lebanon to São Paulo on August 16, which included a 30 minute stop-over in Abidjan, Ivory Coast, Africa. During the epidemiological evaluation, it was found that each of the 3 patients had been seated in the first class cabin. Entomological investigation at the airport revealed the presence of 4 specimens of Anopheles gambiae in airplanes (3 in the first class cabin and 1 in the luggage compartment) used on this route. The species of mosquito identified is predominant in Africa. Two of the patients were seriously ill, but all recovered after treatment with either mefloquine (1 patient) or artesunate (2 patients). A survey of other passengers on the same flight or on similar Aights did not reveal any other eases of malaria. Malaria was not considered during initial evaluation by the attending physicians at the three different hospitals where the patients were admitted. These cases reveal the existence of vector borne disease transmission during airplane travel, and emphasize the importance of obtaining a travel history during the evaluation of an ill patient. In addition, the cases reinforce the need for vigilance in the control of vectors of disease around seaports, airports and hospitals.

Journal Article↗

Evaluation of Secnidazole Gel and Tinidazole Suspension in the Treatment of Giardiasis in Children.

Giardiasis is a cosmopolitan parasitosis. Diarrhea, abdominal colic, and flatulence are the main clinical symptoms, however, malabsorption, and impairment of growth of children may occur. The 5-nitroimidazoles are the drugs of choice in the treatment of giardiasis. Methods: The efficacy and tolerability of secnidazole and tinidazole were evaluated in a randomized, open-label, clinical trial performed with 267 Giardia lamblia-positive children. Secnidazole, in a new gel formulation, and tinidazole suspension were prescribed as single oral doses of 30mg/kg and 50mg/kg, respectively. Clinical and parasitological follow-up was carried out before, and at 7, 14, and 21 days after treatment. Results: Clinical cure was observed in 77.3% and 75.7% of the patients in the secnidazole and tinidazole groups, respectively. Parasitological cure was obtained in the 91.3% and 89.6% in the secnidazole and tinidazole groups, respectively. A metallic taste after drug ingestion was more commonly reported in the tinidazole group than in the secnidazole group (p<0.05). Conclusions: The authors conclude that both secnidazole gel and tinidazole administered as a single oral dose are effective treatments for children with giardiasis since both high cure rates and good tolerability were observed.

Journal Article↗

[An evaluation of the relationship between intestinal parasitoses and the risk factors for HIV in AIDS patients].

We conducted a cohort survey on 200 AIDS patients in São Paulo, SP, Brazil, to verify if the presence of enteroparasites is associated with the various risk factors for HIV infection. Diarrhea was significantly more frequent in the group of patients presenting enteroparasitosis (p < 0.00001). Giardia lamblia, found in 32 (16%) cases, was the most prevalent parasite. The presence of parasites in the stool samples was not significantly associated with risk factors for HIV infection, mainly when considering Giardia lamblia and Cryptosporidium parvum (p = 0.99 and 0.69, respectively). The controversy found in the literature indicates that additional studies should be done in the different geographical regions of the country.

AIDS-Related Opportunistic Infections↗

[Concurrent leishmaniasis and human immunodeficiency virus (HIV) infection: a study of four cases].

Few cases of concurrent leishmaniasis and HIV infection have been reported in Brazil, despite both infections being in expansion. Two cases of visceral leishmaniasis and two cases of mucocutaneous leishmaniasis are discussed. Disseminated skin and oral lesions were found in the patients with the cutaneous form of the disease. Prolonged fever, hepatosplenomegaly and pancytopenia were the main manifestations of the visceral form. The CD4 T lymphocyte count was low in all cases. Direct examination of bone marrow aspirate for leishmania and biopsy of cutaneous lesions are the techniques of choice to confirm diagnosis. Pentavalent antimonials and amphotericin B are preferred drugs for the treatment of leishmaniasis, including patients with AIDS. The authors recommend the inclusion of this parasitosis in the differential diagnosis of opportunistic diseases in patients with AIDS.

Adult↗