RESUMO
OBJECTIVE: To study the status of infection with Angiostrongylus cantonensis in wild rats and snails in Jamaica following an outbreak of eosinophilic meningitis amongst tourists. METHODS: One hundred and thirty-one Rattus rattus and 94 R norvegicus were collected, mainly from the eastern portion of Jamaica. The animals were dissected and the heart and pulmonary arteries explored to reveal A cantonensis. Similarly, several species of land snails were collected. A portion of the head/foot was excised, fragmented and placed in separate dishes of digestion fluid (0.01 percent pepsin in 0.7 percent v/v aqeous HCI). Dishes were examined for nematode larvae 4-5 hours and 24 hours post-digestion. A microscopical comparison of larvae with museum specimens confirmed identification. RESULTS: Overall, significantly more R rattus (42.7 percent) than R morvegicus (21.3 percent) were infected (x2=11.28;p<0.0001). Considering only those parishes where 15 or more rats were collected (Hanover, Manchester, St.James, St. Elizabeth, Kingston and St.Andrew, and Portland) the prevalence of rodent infections ranged from 6 to 59 percent. Of three snails and one slug species collected, only Thelidomus asper harboured A cantonensis larvae. This snail was collected from Manchester where the highest prevalence of rodent infections also occurred. CONCLUSIONS: The findings indicate that A cantonensis is present in rats and snails in Jamaica. In the context of reports (1996, 2000) of eosinophilic meningitis on the island, we recommend that public health officials, clinical parasitologists and travel medicine practitioners consider A cantonensis as a causative agent of eosinophilic meningitis in residents and travellers to Jamaica. (AU)
Assuntos
21003 , Humanos , Ratos , Angiostrongylus cantonensis/parasitologia , Meningite/epidemiologia , Ratos/parasitologia , JamaicaRESUMO
Formalin and mercuric chloride-based low-viscosity polyvinyl alcohol (LV-PVA) are widely used by most diagnostic parasitology laboratories for preservation of helminth eggs and protozoan cysts and trophozoites in fecal specimens. Concerns about the toxicity of formalin and the difficulty of disposal of LV-PVA are powerful incentives to use alternate preservatives. Such alternatives have been marketed by several companies and are often presented as one-vial, non-mercuric chloride fixatives that aim at performing the same role as formalin and PVA combined. We compared five, one-vial commercial preservatives, two from Meridian Diagnostics, Inc. (Ecofix and sodium acetate-acetic acid-formalin), and one each from Scientific Device Laboratories, Inc. (Parasafe), Alpha Tec Systems, Inc. (Proto-fix), and Streck Laboratories, Inc. (STF), with 10% formalin and LV-PVA. Fecal specimens obtained from patients in a Brazilian hospital were aliquoted within 12 h of collection into the seven preservatives mentioned above and were processed after 1 month at the Centers for Disease Control and Prevention. Direct and concentrated permanent smears as well as concentrates for 20 positive specimens (a total of 259 processed samples) were prepared, stained according to the manufacturers' instructions, examined, and graded. Positive specimens contained one or more parasites with stages consisting of eggs, larvae, cysts, and a few trophozoites of Giardia intestinalis. Criteria for assessment of the preservatives included the quality of the diagnostic characteristics of helminth eggs, protozoan cysts, and trophozoites, ease of use, and cost. Acceptable alternatives to formalin for wet preparations were found. Ecofix was found to be comparable to the traditional "gold standard" LV-PVA for the visualization of protozoa in permanent stained smears. This study suggests that more acceptable alternatives to the traditional formalin and LV-PVA exist.
Assuntos
Eucariotos/isolamento & purificação , Fezes/parasitologia , Helmintos/isolamento & purificação , Animais , Brasil , Eucariotos/citologia , Formaldeído , Helmintos/citologia , Humanos , Cloreto de Mercúrio , Contagem de Ovos de Parasitas , Álcool de Polivinil , Manejo de Espécimes/métodosRESUMO
Major advances have been made against Wilms' tumor as a result of treatment methods developed by single institutions that then have been confirmed and extended by national cooperating groups. Better survival rates have been achieved, and therapy has been refined so that treatment can be reduced in early stage disease without jeopardizing tumor control. This results in fewer short- and long-term complications, an especially important consideration in children. Their organs and tissues are vulnerable to anti-mitotic treatments such as chemo- and radiotherapy, that can produce disabling if not lethal dysfunctions. This progress has been the result of the cooperative efforts by multiple specialists, and provides evidence of the value of such integrated studies. They have changed the outlook from a 90% death rate in the early years of this century to the 90% survival rate now possible with modern management.