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From the start onwards of testing praziquantel (2 - cyclohexyl - carbonyl - 1,2,3,6,7,11 b - hexahydro - 4H - pyrazino[2,1-a]isoquinolin-4-one, EMBAY 8440, Biltricide) proved to be very promising. By testing numerous trematode species in different host animals, high efficacy was established. There were no limitations due to the geographical origin of all those parasite species. Pharmacokinetic studies in animals and man showed similarly favourable results. The compound passes the blood-liquor barrier into the brain. No toxic alterations of vital functions and organs were revealed. After demonstrating satisfactory tolerability in healthy volunteers, therapeutic trials were begun. As to schistosomiasis, studies started double-blind in close cooperation with WHO, Geneva, with emphasis on future large scale treatment campaigns. Up to now safe and successful treatment of over 25,000 patients has been documented in Africa, Asia and South America with single dose or single day dosage schemes against all five schistosome species pathogenic to man. The analysis of allegedly drug-related adverse reactions often revealed their presence before treatment already, particularly in intestinal schistosomiasis. Irrespective of origin all symptoms and reactions were generally mild, transient and did not require additional treatment. No drug-related risks were detectable in patients with hepatosplenic and other complications of advanced stages of infection. High cure rates were also obtained in infections due to C. sinensis, O. viverrini and Paragonimus species. Infections with Metagonimus yokogawai, Fasciolopsis buski and Heterophyes heterophyes responded well to treatment, too.(ABSTRACT TRUNCATED AT 250 WORDS)
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The variety of pathological changes that occur during parasitic infections is diverse. Recently there has been done considerable progress in understanding the physiopathologic aspects of the direct parasitic action of the products that they release, that affect the digestive function. The pathogenetic effects of intestinal parasites are important, not only for the adult forms that occupy the lumen or the intestinal mucosa, but for the migratory forms. The most important clinical manifestations are in direct relation with the host response to the aggression or trauma caused by the migratory larvae and/or adults parasites, the signs and symptoms depends on the infestation phase and on the severity or in the agent "virulence". The objective of this article is to present a brief revision on the physiopathologic effects of infestations by intestinal parasites.
In four sheep flocks of two age categories dynamics of natural infections by pulmonary and gastrointestinal nematodes was studied; sheep were kept on a farm in Western Bohemia. Dehelminthizations were performed in different intervals during the grazing period on the basis of the results of quantitative coprologic examinations. Total effectiveness of 80--100% intenseffectiveness (IE) was obtained as a result of single peroral or intraruminal dehelminthization with the following preparations: pyrantel hydrochloricum (Spofa), helmatac (SKF) and nilverm (ICI); the effectiveness concerned gastrointestinal nematodes of the genus Haemonchus, Cooperia, Ostertagia, Trichostrongylus, Bunostomum, Chabertia, Nematodirus, Strongyloides, Oesophagostomum and Trichocephalus. The effectiveness of nilverm on lungworms of D. filaria and P. kochi reached 100%; the preparation was less effective and ineffective on M. capillaris. Dehelminthization practices during three years were more successful as to lowering of incidence of lungworm infections of D. filaria and P. kochi than in gastrointestinal nematodes. If sping dehelminthizations had been postponed till the second half of May or June, the climax of the elimination of ova from summer re-infection was put off till November, with an initial significant increase in September. The third dehelminthization, applied in August, did not result in the increased elimination of ova in autumn, while there was no usual autumnal climax following September dehelminthization. Effective dehelminthization performed at the end of November in all three years maintained low levels of infections during winter housing and significantly influenced the health conditions of ewes before lambing. Dynamics of the elimination of ova after dehelminthization was affected by nematodes with the migration phase in organs and tissues -- S. papillosus, Oesophagostomum sp. and Ostertagia sp.; the same effect was observed, during pasture, in nematodes with relatively short exogenous development of the genus Haemonchus, Ostertagia, Trichostrongylus and Nematodirus. In spite of these dehelminthization practices, the elimination of ova and larvae corresponded to the course of temperatures and rainfall in spring and autumn climaxes every year.