Efficacy and tolerability of two single-day regimens of triclabendazole for fascioliasis in Peruvian children

Abstract:INTRODUCTION:The therapeutic scheme of triclabendazole (TCBZ), the recommended anthelmintic against Fasciola hepatica , involves 10mg/kg of body weight administered in a single dose; however, clinical trials in children are scarce. We evaluated the efficacy and tolerability of 2 schemes of TCBZ.METHODS: Eighty-four Peruvian children with F. hepatica eggs in their stools were allocated into 2 groups: 44 received 2 dosages of 7.5mg/kg each with a 12-h interval (Group I), and 40 received a single 10-mg/kg dose (Group II). Evaluation of efficacy was based on the presence of eggs in stools, and tolerability was based on the presence of symptoms and signs post-treatment.RESULTS: A parasitological cure was obtained in 100% of individuals from Group I and 95% of individuals from Group II. The most common adverse event was biliary colic.CONCLUSIONS: The tested scheme was efficacious and tolerable, and it might be an optimal scheme in the region. To the best of our knowledge, this represents the largest series of children treated with TCBZ in a non-hospital setting.

Can body traits, other than wings, reflect the flight ability of Triatominae bugs?

Abstract: INTRODUCTION : Insects of the subfamily Triatominae are vectors of Trypanosoma cruzi , the Chagas disease parasite, and their flying behavior has epidemiological importance. The flying capacity is strikingly different across and within Triatominae species, as well as between sexes or individuals. Many Triatoma infestans individuals have wings but no flying muscles. In other Triatominae species, no clear relationships were found between wing length and flying behavior. If wing presence or size is not reflective of the flying behavior, which other parts of the body could be considered as reliable markers of this important function? METHODS : The genus Mepraia has exceptional characteristics with invariably wingless females and wingless or winged males. We calculated the porous surface exposed to odorant molecules to estimate the olfactory capacity of Mepraia spinolai . The head shape and thorax size were estimated using the geometric morphometric approach and traditional morphometric techniques, respectively. RESULTS : Alary polymorphism in M. spinolai was significantly associated with consistent modification of the thorax size, head shape, and notable change in the estimated olfactory capacity. The macropterous individuals had a larger olfactory surface and thorax size and significantly different head shape compared to those of the micropterous individuals. CONCLUSIONS: We concluded that these structural changes could be associated with the flying potential of Triatominae. Thus, morphological attributes not found on wings could help determine the likely flying potential of the bugs.

Changes in body fluid and energy compartments during prolonged hunger strike

Prolonged total food deprivation in non-obese adults is rare, and few studies have documented body composition changes in this setting. In a group of eight hunger strikers who refused alimentation for 43 days, water and energy compartments were estimated, aiming to assess the impact of progressive starvation. Measurements included body mass index (BMI), triceps skinfold (TSF), arm muscle circumference (AMC), and bioimpedance (BIA) determinations of water, fat, lean body mass (LBM), and total resistance. Indirect calorimetry was also performed in one occasion. The age of the group was 43.3±6.2 years (seven males, one female). Only water, intermittent vitamins and electrolytes were ingested, and average weight loss reached 17.9%. On the last two days of the fast (43rd-44th day) rapid intravenous fluid, electrolyte, and vitamin replenishment were provided before proceeding with realimentation. Body fat decreased approximately 60% (BIA and TSF), whereas BMI reduced only 18%. Initial fat was estimated by BIA as 52.2±5.4% of body weight, and even on the 43rd day it was still measured as 19.7±3.8% of weight. TSF findings were much lower and commensurate with other anthropometric results. Water was comparatively low with high total resistance, and these findings rapidly reversed upon the intravenous rapid hydration. At the end of the starvation period, BMI (21.5±2.6 kg/m²) and most anthropometric determinations were still acceptable, suggesting efficient energy and muscle conservation. Conclusions: 1) All compartments diminished during fasting, but body fat was by far the most affected; 2) Total water was low and total body resistance comparatively elevated, but these findings rapidly reversed upon rehydration; 3) Exaggerated fat percentage estimates from BIA tests and simultaneous increase in lean body mass estimates suggested that this method was inappropriate for assessing energy compartments in the studied population; 4) Patients were not morphologically malnourished after 43 days of fasting; however, the prognostic impact of other impairments was not considered in this analysis.

Hyperhomocyst(e)inemia in chronic stable renal transplant patients

PURPOSE: Hyperhomocyst(e)inaemia is an important risk factor for atherosclerosis, which is currently a major cause of death in renal transplant patients. The aim of this study was to assess the influence of immunosuppressive therapy on homocyst(e)inemia in renal transplant recipients. METHODS: Total serum homocysteine (by high performance liquid chromatography), creatinine, lipid profile, folic acid (by radioimmunoassay-RIA) and vitamin B12 (by RIA) concentrations were measured in 3 groups. Group I patients (n=20) were under treatment with cyclosporine, azathioprine, and prednisone; group II (n=9) were under treatment with azathioprine and prednisone; and group III (n=7) were composed of renal graft donors for groups I and II. Creatinine, estimated creatinine clearance, cyclosporine trough level, lipid profile, folic acid, and vitamin B12 concentrations and clinical characteristics of patients were assessed with the aim of ascertaining determinants of hyperhomocyst(e)inemia. RESULTS: Patient ages were 48.8 ± 15.1 yr (group I), 43.3 ± 11.3 yr (group II); and 46.5 ± 14.8 yr (group III). Mean serum homocyst(e)ine (tHcy) concentrations were 18.07 ± 8.29 mmol/l in renal transplant recipients; 16.55 ± 5.6 mmol/l and 21.44 ± 12.1 mmol/l respectively for group I (with cyclosporine) and group II (without cyclosporine) (NS). In renal donors, tHcy was significantly lower (9.07 ± 3.06 mmol/l; group I + group II vs. group III, p<0.008). There was an unadjusted correlation (p<0.10) between age (r=0.427; p<0.005) body weight (r=0.412; p<0.05), serum creatinine (r=0.427; p<0.05), estimated creatinine clearance (r=0.316; p<0.10), and tHcy in renal recipients (group I +II). Independent regressors (r²=0.46) identified in the multiple regression model were age (coefficient= 0.253; p=0.009) and serum creatinine (coefficient=8.07; p=0.045). We found no cases of hyperhomocyst(e)inemia in the control group. In contrast, 38% of renal recipients had hyperhomocyst(e)inemia: 7 cases (35%) on cyclosporine and 4 (45%) without cyclosporine, based on serum normal levels. CONCLUSIONS: Renal transplant recipients frequently have hyperhomocyst(e)inemia. Hyperhomocyst(e)inemia in renal transplant patients is independent of the scheme of immunosuppression they are taking. The older the patients are and the higher are their serum creatinine levels, the more susceptible they are to hyperhomocyst(e)inemia following renal transplantation.

Complications of tracheobronchial foreign body aspiration in children: report of 5 cases and review of the literature

Foreign body aspiration (FBA) is one of leading causes of death in children, especially among those younger than 3 years of age. The inhalation of a foreign body may cause a wide variety of symptoms, and early diagnosis is highly associated with the successful removal of the inhaled foreign material. Despite the great advances in endoscopic procedures and anesthesia, a large number of difficulties and complications still result from foreign body aspiration. We describe 5 cases of serious acute complications following aspiration of foreign bodies that became lodged in the tracheobronchial tree, including pneumomediastinum, pneumothorax, total atelectasis, foreign body dislodgment, and need for thoracotomy in children admitted into our intensive care unit in 1999 and 2000; these were all situations that could have been prevented with early recognition and prompt therapeutic intervention.

Systemic hypertension, diabetes mellitus, and dyslipidemia in relation to body mass index: evaluation of a Brazilian population

OBJECTIVE: To determine the prevalence of systemic hypertension, diabetes mellitus, hypercholesterolemia, and hypertriglyceridemia in a Brazilian population in relation to body mass index. METHOD: Retrospective evaluation of 1213 adults (mean age: 45.2 ± 12.8; 80.6% females) divided into groups according to body mass index [normal (18.5 - 24.4 kg/m²); overweight (25 - 29.9 kg/m²); grade 1 obesity (30 - 34.9 kg/m²); grade 2 obesity (35 - 39.9 kg/m²), and grade 3 obesity (> 40 kg/m²)]. The prevalence of hypertension, diabetes mellitus, hypercholesterolemia, and hypertriglyceridemia were analyzed in each group. The severity of cardiovascular risk was determined. High-risk patients were considered those reporting 2 or more of the following factors: systemic hypertension, HDL < 35 mg/dL, total cholesterol > 240 mg/dL, triglycerides > 200 mg/dL when HDL < 35 mg/dL, and glycemia > 126 mg/dL. Moderate-risk patients were those reporting 2 or more of the following factors: systemic hypertension, HDL < 45, triglycerides > 200 mg/dL, and total cholesterol > 200 mg/dL. RESULTS: The prevalence of systemic hypertension, diabetes mellitus, hypertriglyceridemia, and low HDL-cholesterol levels increased along with weight, but the prevalence of hypercholesterolemia did not. The odds ratio adjusted for gender and age, according to grade of obesity compared with patients with normal weight were respectively 5.9, 8.6, and 14.8 for systemic hypertension, 3.8, 5.8, and 9.2 for diabetes mellitus and 1.2, 1.3, and 2.6 for hypertriglyceridemia. We also verified that body mass index was positively related to cardiovascular high risk (P < .001) CONCLUSION: In our population, cardiovascular risk increased along with body mass index.

Occurrence, body mass and biomass of Syntermes spp. (Isoptera: Termitidae) in Reserva Ducke, Central Amazonia

The leaf-feeding species Syntermes molestus and S. spinosus are two dominant termite species in Reserva Ducke in Central Amazonia; two other species (S. aculeosus, S. longiceps) exist in the area. All species except S. aculeosus were also found in urban areas. The workers of S. molestus and S. spinosus have average body dry weights of 4.5±0.2 and 13.1±1.4 mg, and the weight of their soldiers is 8.2±0.2 and 51.0±1.7 mg, respectively. Therefore, S. spinosus is among the largest termites of the world. In both species, fresh weight is about 4.7 higher than dry weight (a wider relation than in other termite species). The biomass of the populations of both species amounted to about 1 g m-2 (dry weight; indirect estimate), which rises previous assessments of the total termite biomass by about 36-45%, to a value of 3.0-3.5 g m-2.

Ichthyometry and electrical bioimpedance analysis to estimate the body composition of tambatinga

Body composition analysis is relevant to characterize the nutritional requirements and finishing phase of fish. The aim of this study was to investigate the relationship between ichthyometric (weight, total and standard length, density and yields), bromatological (fat, protein, ash and water content) and bioelectrical-impedance-analysis (BIA) (resistance, reactance, phase angle and composition indexes) variables in the hybrid tambatinga (Colossoma macropomum × Piaractus brachypomus). In a non-fertilized vivarium, 520 juveniles were housed and fed commercial rations. Then, 136 days after hatching (DAH), 15 fish with an average weight of 37.69 g and average total length of 12.96 cm were randomly chosen, anesthetized (eugenol) and subjected to the first of fourteen fortnightly assessments (BIA and biometry). After euthanasia, the following parts were weighed: whole carcass with the head, fillet, and skin (WC); fillet with skin (FS); and the remainder of the carcass with the head (CH). Together, FS and CH were ground and homogenized for the bromatological analyses. Estimates of the body composition and yields of tambatinga, with models including ichthyometric and BIA variables, showed correlation coefficients ranging from 0.81 (for the FS yield) to 1,00 (for the total ash). Similarly, models that included only BIA variables had correlation coefficients ranging from 0.81 (FS and CH yields) to 0.98 (for the total ash). Therefore, in tambatinga, the BIA technique allows the estimation of the yield of the fillet with skin and the body composition (water content, fat, ash, and protein). The best models combine ichthyometric and BIA variables.

Eating behavior and body image among psychology students

OBJECTIVE: To characterize eating habits and possible risk factors associated with eating disorders among psychology students, a segment at risk for eating disorders. METHOD: This is a cross-sectional study. The questionnaires Bulimic Investigatory Test Edinburgh (BITE), Eating Attitudes Test (EAT-26), Body Shape Questionnaire (BSQ) and a variety that considers related issues were applied. Statistical Package for the Social Sciences (SPSS) 11.0 was utilized in analysis. The study population was composed of 175 female students, with a mean age of 21.2 (DP ± 3.6 years). RESULTS: A positive result was detected on the EAT-26 for 6.9% of the cases (CI95%: 3.6-11.7%). The prevalence of increased symptoms and intense gravity, according to the BITE questionnaire was 5% (CI95%: 2.4-9.5%) and 2.5% (CI95%: 0.7-6.3%), respectively. According to the findings, 26.29% of the students presented abnormal eating behavior. The population with moderate/severe BSQ scores presented dissatisfaction with corporal weight. CONCLUSION: The results indicate that attention must be given to eating behavior risks within this group. A differentiated gaze is justified with respect to these future professionals, whose practice is jeopardized in cases in which they are themselves the bearers of installed symptoms or precursory behavior.

Body image dissatisfaction and its relationship with physical activity and body mass index in Brazilian adolescents

Objective: To evaluate body image dissatisfaction and its relationship with physical activity and body mass index in a Brazilian sample of adolescents. Methods: A total of 275 adolescents (139 boys and 136 girls) between the ages of 14 and 18 years completed measures of body image dissatisfaction through the Contour Drawing Scale and current physical activity by the International Physical Activity Questionnaire. Weight and height were also measured for subsequent calculation of body mass index. Results: Boys and girls differed significantly regarding body image dissatisfaction, with girls reporting higher levels of dissatisfaction. Underweight and eutrophic boys preferred to be heavier, while those overweight preferred be thinner and, in contrast, girls desired to be thinner even when they are of normal weight. Conclusion: Body image dissatisfaction was strictly related to body mass index, but not to physical activity.

Heart Weight and Heart Weight/Body Weight Coefficient in Malnourished Adults

OBJECTIVE: To compare the heart weight and the heart weight/body weight coefficient of adults with and without chronic malnutrition. METHODS: In an initial case series of 210 autopsies performed in adults, we recorded body and heart weights and calculated the heart weight/body weight coefficients (HW/BW x 100). The exclusion criteria were as follows: positive serology for Chagas' disease, edema, obesity, heart diseases, hepatopathies, nephropathies, and systemic arterial hypertension. Malnutrition was characterized as a body mass index <18.5kg/m². Differences with p<0.05 were considered significant. RESULTS: Individuals in the malnourished (n=15) and control (n=21) groups were statistically different, respectively, in regard to body mass index (15.9±1.7 versus 21.3±2.5kg/m²), heart weight (267.3±59.8 versus 329.1±50.4g), and the HW/BW coefficient (0.64±0.12 versus 0.57±0.09%). A positive and significant correlation was observed between heart weight and body mass index (r=0.52), and between heart weight and body weight (r=0.65). CONCLUSION: Malnourished individuals have lighter hearts and a greater HW/BW coefficient than non-malnourished individuals do. These findings indicate a possible preservation of the myocardium in relation to the intensity of weight loss associated with the probable relative increase in cardiac connective tissue and heart blood vessels.

Body Mass Index: A Scientific Evidence-Based Inquiry

OBJECTVE: To objectively and critically assess body mass index and to propose alternatives for relating body weight and height that are evidence-based and that eliminate or reduce the limitations of the body mass index. METHODS: To analyze the relations involving weight and height, we used 2 databases as follows: 1) children and adolescents from Brazil, the United States, and Switzerland; and 2) 538 university students. We performed mathematical simulations with height data ranging from 115 to 190 cm and weight data ranging from 25 to 105 kg. We selected 3 methods to analyze the relation of weight and height as follows: body mass index - weight (kg)/height (m²); reciprocal of the ponderal index - height (cm)/weight1/3 (kg); and ectomorphy. Using the normal range from 20 to 25 kg/m² for the body mass index in the reference height of 170 cm, we identified the corresponding ranges of 41 to 44 cm/kg1/3 for the reciprocal of the ponderal index, and of 1.45 to 3.60 for ectomorphy. RESULTS: The mathematical simulations showed a strong association among the 3 methods with an absolute concordance to a height of 170 cm, but with a tendency towards discrepancy in the normal ranges, which had already been observed for the heights of 165 and 175 cm. This made the direct convertibility between the indices unfeasible. The reciprocal of the ponderal index and ectomorphy with their cut points comprised a larger age range in children and adolescents and a wider and more central range in the university students, both for the reported (current) and desired weights. CONCLUSION: The reciprocal of the ponderal index and ectomorphy are stronger and are more mathematically logical than body mass index; in addition, they may be applied with the same cut points for normal from the age of 5 ½ years on.

Temperature, urbanization and body color polymorphism in South Brazilian populations of Drosophila kikkawai (Diptera, Drosophilidae)

Body color polymorphism of urban populations of cosmopolite fly Drosophila kikkawai Burla, 1954 was investigated in relation to its possible association with environmental temperature. Samples of D. kikkawai were collected in spring, summer, autumn and winter between 1987 to 1988, in zones with different levels of urbanization in the southern Brazilian city of Porto Alegre, Rio Grande do Sul. A clear association was observed between darker flies and both seasons with low temperatures and areas of low urbanization (where temperature is generally lower than in urbanized areas). Results of preliminary laboratory experiments involving six generations of flies grown in chambers at temperatures of 17º and 25ºC confirmed this tendency to a relationship between body color and temperature, with allele frequency of the main gene involved in body pigmentation changing over time.

The fat body in Rhinocricus padbergi (Diplopoda, Spirobolida)

The distribution and morphology of fat body of Brazilian diplopod Rhinocricus padbergi Verhoeff, 1938 are analyzed by scanning electron microscopy and histology. A terminology is proposed for description of the diplopods fat body.

Protein content and electrophoretic profile of fat body and ovary extracts from workers of Melipona quadrifasciata anthidioides (Hymenoptera, Meliponini)

Workers of Melipona quadrifasciata anthidioides (Lepeletier, 1836) develop their ovaries and lay eggs, therefore the production of vitellogenin is expected. In electrophoretic profiles only fat body extracts from nurse workers and ovary extracts from newly-emerged workers show protein with molecular mass similar to vitellogenin. However, an increase in the protein content was detected in forager fat body. This increase was attributed to storage of vitellogenin or other proteins in the previous phase and not discharged into the hemolymph or to an effect of the increased titre of juvenile hormone in this phase of worker life over the fat body functioning.