Malabsorption syndromes in the tropics

2020 ◽  
pp. 2916-2924
Author(s):  
Vineet Ahuja ◽  
Govind K. Makharia
Keyword(s):  
Symptomatic Relief ◽  
Epidemiological Data ◽  
Strongyloides Stercoralis ◽  
Tropical Sprue ◽  
Nutritional Deficiencies ◽  
Chronic Diarrhoea ◽  
Industrialized Countries ◽  
Malabsorption Syndromes ◽  
Immunoproliferative Small Intestinal Disease ◽  
The Tropics

Causes of secondary malabsorption that are most common in the tropics include (1) progressive wasting in people infected with HIV, which is known as ‘slim disease’; (2) various infections—protozoal (e.g. Giardia lamblia, Cryptosporidium parvum), helminthic (e.g. Capillaria philippinensis, Strongyloides stercoralis), and bacterial (Mycobacterium tuberculosis); (3) immunoproliferative small intestinal disease; and (4) hypolactasia. Coeliac disease and Crohn’s disease also occur. When patients with conditions that can cause secondary malabsorption are excluded, a group remains who have chronic diarrhoea, malabsorption, and its nutritional sequelae. This primary or idiopathic malabsorption syndrome is called ‘tropical sprue’, which occurs against the background of tropical enteropathy (describing the fact that the morphology of the mucosa of normal gut is different in tropical preindustrialized countries from that in temperate-zone industrialized countries). The aetiology of tropical sprue is not known: epidemiological data suggests an infective cause, but no causal agent has been identified. Presentation is typically with loose or watery stools lasting for several weeks or months, and with symptoms and signs of nutritional deficiency. Management involves symptomatic relief from diarrhoea, and correction of fluid and electrolyte abnormalities and nutritional deficiencies. Attempts at specific curative measures—folic acid and tetracyclines—are usually given for up to 6 months.

scholarly journals Mosquitoes: Important Sources of Allergens in the Tropics

2021 ◽  
Vol 2 ◽  
Author(s):  
Jose Fernando Cantillo ◽  
Leonardo Puerta
Keyword(s):  
Current Knowledge ◽  
Mosquito Species ◽  
Epidemiological Data ◽  
Cross Reactivity ◽  
Cellular Level ◽  
Whole Body ◽  
Allergic Reactions ◽  
Industrialized Countries ◽  
Allergen Sources ◽  
The Tropics

There are more than 3,000 mosquito species. Aedes aegypti, Ae. communis, and C. quinquefasciatus are, among others, three of the most important mosquito allergen sources in the tropics, western, and industrialized countries. Several individuals are sensitized to mosquito allergens, but the epidemiological data indicates that the frequency of sensitization markedly differs depending on the geographical region. Additionally, the geographical localization of mosquito species has been affected by global warming and some mosquito species have invaded areas where they were not previously found, at the same time as other species have been displaced. This phenomenon has repercussions in the pathogenesis and the accuracy of the diagnosis of mosquito allergy. Allergic individuals are sensitized to mosquito allergens from two origins: saliva and body allergens. Exposure to saliva allergens occurs during mosquito bite and induces cutaneous allergic reactions. Experimental and clinical data suggest that body allergens mediate different manifestations of allergic reactions such as asthma and rhinitis. The most studied mosquito species is Ae. aegypti, from which four and five allergens of the saliva and body, respectively, have been reported. Many characterized allergens are homologs to arthropod-derived allergens, which cause strong cross-reactivity at the humoral and cellular level. The generalized use of whole body Ae. communis or C. quinquefasciatus extracts complicates the diagnosis of mosquito allergy because they have low concentration of saliva allergens and may result in poor diagnosis of the affected population when other species are the primary sensitizer. This review article discusses the current knowledge about mosquito allergy, allergens, cross-reactivity, and proposals of component resolved approaches based on mixtures of purified recombinant allergens to replace saliva-based or whole-body extracts, in order to perform an accurate diagnosis of allergy induced by mosquito allergen exposure.

Malabsorption syndromes in the tropics

2010 ◽  
pp. 2357-2360
Author(s):  
V.I. Mathan
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Cryptosporidium Parvum ◽  
Strongyloides Stercoralis ◽  
Malabsorption Syndromes ◽  
The Tropics ◽  
Capillaria Philippinensis

Causes of secondary malabsorption that are mainly prevalent in the tropics include (1) progressive wasting in people infected with HIV, which is known as ‘slim disease’; (2) various infections—protozoal (e.g. Gardia lamblia, Cryptosporidium parvum), helminthic (e.g Capillaria philippinensis, Strongyloides stercoralis), bacterial (Mycobacterium tuberculosis...

Terminal ileum resection as a trigger for Strongyloides stercoralis hyperinfection and ensuing serial sepsis in a 37-year-old patient with complicated Crohnʼs disease: a case report

2018 ◽  
Vol 56 (04) ◽  
pp. 380-383 ◽  
Author(s):  
Mirjana Topić ◽  
Silvija Čuković-Čavka ◽  
Marko Brinar ◽  
Mirjana Kalauz ◽  
Ivica Škrlec ◽  
...  
Keyword(s):  
Terminal Ileum ◽  
Skin Penetration ◽  
Strongyloides Stercoralis ◽  
Developed Countries ◽  
Clinical Settings ◽  
Solid Organ ◽  
Transplant Patients ◽  
Skin Contact ◽  
Life Threatening ◽  
The Tropics

AbstractThe nematode Strongyloides stercoralis, outside the tropics and subtropics present in small endemic foci, can cause an infection after direct skin contact with contaminated soil containing infective filariform larvae and, rarely, after intimate interhuman contact or after transplantation of an infected solid organ. Following skin penetration, migration, and maturation through several stages, a small number of invasive filariform larvae can develop anew in the gut lumen, perpetuating new cycles of penetration, tissue migration, and reproduction, without leaving the host.In a state of immunosuppression, autoinfection can progress to life-threatening hyperinfection and/or infection disseminated through virtually any organ. In developed countries, the most frequently recognized risk for severe hyperinfection is corticosteroid therapy, but this has been also described in malnourished, alcoholic, cancer, and transplant patients. Due to the frequent need for immunosuppressive therapy, patients suffering from inflammatory bowel disease (IBD) are susceptible to develop overwhelming strongyloidiasis. Strongyloidiasis can be easily overlooked in clinical settings, and in many European regions there is poor insight into the epidemiological burden of this disease.We present a case of S. stercoralis hyperinfection that triggered 3 successive episodes of sepsis caused by pathogens of the gut flora in a young patient suffering from stenotic form of Crohn’s disease. S. stercoralis hyperinfection occurred in the corticosteroid-free period, shortly after resection of the terminal ileum, which was probably the trigger for the overwhelming course. The patient was successfully treated with 10-day albendazole therapy.

scholarly journals Role of Dietary Supplements in the Management of Parkinson’s Disease

Biomolecules ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. 271 ◽  
Author(s):  
Michele Ciulla ◽  
Lisa Marinelli ◽  
Ivana Cacciatore ◽  
Antonio Di Stefano
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Functional Food ◽  
Clinical Symptoms ◽  
Gastrointestinal Diseases ◽  
Food Supplements ◽  
Nutritional Deficiencies ◽  
Biogenic Elements ◽  
Industrialized Countries ◽  
Treatment And Prevention

The use of food supplements or functional food has significantly increased in the past decades, especially to compensate both the modern lifestyle and the food shortages of the industrialized countries. Despite food supplements are habitually intended to correct nutritional deficiencies or to support specific physiological functions, they are often combined with common drug therapies to improve the patient’s health and/or mitigate the symptoms of many chronic diseases such as cardiovascular diseases, cystic fibrosis, cancer, liver and gastrointestinal diseases. In recent years, increased attentions are given to the patient’s diet, and the use of food supplements and functional food rich in vitamins and antioxidants plays a very important role in the treatment and prevention of neurodegenerative diseases such as Parkinson’s disease (PD). Natural compounds, phytochemicals, vitamins, and minerals can prevent, delay, or alleviate the clinical symptoms of PD in contrast to some of the main physiopathological mechanisms involved in the development of the disease, like oxidative stress, free radical formation, and neuroinflammation. The purpose of this review is to collect scientific evidences which support the use of specific biomolecules and biogenic elements commonly found in food supplements or functional food to improve the clinical framework of patients with PD.

Chronic Diarrhoea in AIDS Patients in the Tropics: A Review

1992 ◽  
Vol 22 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Gina A Dallabetta ◽  
Paolo G Miotti
Keyword(s):  
Chronic Diarrhoea ◽  
Aids Patients ◽  
The Tropics

scholarly journals A Nutraceutical Formula Is Effective in Raising the Circulating Vitamin and Mineral Levels in Healthy Subjects: A Randomized Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Hatice Zeynep Nenseth ◽  
Aparna Sahu ◽  
Fahri Saatcioglu ◽  
Steven Osguthorpe
Keyword(s):  
Nutritional Deficiencies ◽  
Health Economy ◽  
Controlled Study ◽  
Control Group ◽  
Placebo Control ◽  
Industrialized Countries ◽  
Clinical Trial Registration ◽  
Metabolic Functions ◽  
Mineral Levels

Low levels of nutrient intake are common in industrialized countries. This has negative implications on health and is associated with chronic diseases. Supplementation of vitamins, minerals, and key nutrients to optimal levels may, therefore, be beneficial for individual health and for the health economy. Although the use of supplements has become very common, due to a lack of monitoring, there is very limited data on the efficacy of supplementation with different formulas. In this study, we present the results of a randomized controlled study on the efficacy of a novel formulated nutraceutical, N247, in 250 healthy volunteers aged 26–75 years and a placebo control group (n = 35). The broad-spectrum formulation of N247 includes essential vitamins, minerals, and trace elements that are adequately balanced in regard to synergies and related metabolic functions. Moreover, tolerance, safety, and nutrient availability is an important aspect of daily, long-term use of N247. After 3 months of regular N247 use, levels of vitamins and minerals in serum were significantly increased in the N247 group compared with the control group and a placebo group, with excellent compliance rates. Coupled with additional natural ingredients that aim to increase the potency of the nutrients, N247 may represent a novel and beneficial supplement for individuals with nutritional deficiencies.Clinical Trial Registration:https://clinicaltrials.gov/, identifier: NCT04054505.

scholarly journals Strongyloides stercoralis infection in San Marino Republic: first epidemiological data from an observational study

2019 ◽  
Vol 147 ◽  
Author(s):  
E. D. Cappella ◽  
A. C. Piscaglia ◽  
A. Cadioli ◽  
S. Manoni ◽  
R. Silva ◽  
...  
Keyword(s):  
At Risk ◽  
Epidemiological Data ◽  
Strongyloides Stercoralis ◽  
Northern Italy ◽  
Sub Saharan Africa ◽  
Routine Practice ◽  
Travel History ◽  
Imported Case ◽  
Serology Test ◽  
Sub Saharan

AbstractStrongyloides stercoralis is a neglected parasite that can cause death in immunocompromised individuals. There were no data on the epidemiology of S. stercoralis infection in San Marino Republic until two patients (one of whom died) were diagnosed with severe strongyloidiasis (hyperinfection) between September 2016 and March 2017. A serology test for Strongyloides spp. was introduced in routine practice in the laboratory of the State Hospital to test patients considered to be at risk for strongyloidiasis. Between August 2017 and August 2018, of 42 patients tested with serology, two (4.8%) were positive. An additional case was found by gastric biopsy. Two of the positive cases were presumably autochthonous infections (elderly people with no significant travel history), while the other was a probable imported case (young man born in Nigeria and settled in Europe since 2003). Epidemiology of strongyloidiasis in San Marino might be similar to Northern Italy, where a relevant proportion of cases was diagnosed in immigrants (mainly from sub-Saharan Africa) and in elderly Italians with eosinophilia. Screening for strongyloidiasis might be worthwhile in inhabitants of San Marino in the same categories of individuals, particularly those at risk of immune suppression.

scholarly journals Hemoptysis in the Immunocompromised Patient: Do Not Forget Strongyloidiasis

2019 ◽  
Vol 4 (1) ◽  
pp. 35 ◽  
Author(s):  
Prakash Shrestha ◽  
Sean E. O’Neil ◽  
Barbara S. Taylor ◽  
Olaoluwa Bode-Omoleye ◽  
Gregory M. Anstead
Keyword(s):  
Developing Countries ◽  
Differential Diagnosis ◽  
Immunocompromised Patient ◽  
Strongyloides Stercoralis ◽  
Immunocompromised Patients ◽  
Secondary Infections ◽  
Immunosuppressed Patients ◽  
Disseminated Strongyloidiasis ◽  
The Tropics ◽  
Candida Pneumonia

Strongyloidiasis, due to infection with the nematode Strongyloides stercoralis, affects millions of people in the tropics and subtropics. Strongyloides has a unique auto-infective lifecycle such that it can persist in the human host for decades. In immunosuppressed patients, especially those on corticosteroids, potentially fatal disseminated strongyloidiasis can occur, often with concurrent secondary infections. Herein, we present two immunocompromised patients with severe strongyloidiasis who presented with pneumonia, hemoptysis, and sepsis. Both patients were immigrants from developing countries and had received prolonged courses of corticosteroids prior to admission. Patient 1 also presented with a diffuse abdominal rash; a skin biopsy showed multiple intradermal Strongyloides larvae. Patient 1 had concurrent pneumonic nocardiosis and bacteremia with Klebsiella pneumoniae and Enterococcus faecalis. Patient 2 had concurrent Aspergillus and Candida pneumonia and developed an Aerococcus meningitis. Both patients had negative serologic tests for Strongyloides; patient 2 manifested intermittent eosinophilia. In both patients, the diagnosis was afforded by bronchoscopy with lavage. The patients were successfully treated with broad-spectrum antibiotics and ivermectin. Patient 1 also received albendazole. Strongyloidiasis should be considered in the differential diagnosis of hemoptysis in immunocompromised patients with possible prior exposure to S. stercoralis.

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