scholarly journals Dientamoeba fragilis – the most common intestinal protozoan in the Helsinki Metropolitan Area, Finland, 2007 to 2017

2019 ◽  
Vol 24 (29) ◽  
Author(s):  
Jukka-Pekka Pietilä ◽  
Taru Meri ◽  
Heli Siikamäki ◽  
Elisabet Tyyni ◽  
Anne-Marie Kerttula ◽  
...  
Keyword(s):  
Clinical Picture ◽  
Screening Methods ◽  
Intestinal Protozoan ◽  
Dientamoeba Fragilis ◽  
Fixed Sample ◽  
Resource Poor ◽  
Faecal Urgency ◽  
Helsinki Metropolitan Area ◽  
Study Setting ◽  
Formalin Fixed

Background Despite the global distribution of the intestinal protozoan Dientamoeba fragilis, its clinical picture remains unclear. This results from underdiagnosis: microscopic screening methods either lack sensitivity (wet preparation) or fail to reveal Dientamoeba (formalin-fixed sample). Aim In a retrospective study setting, we characterised the clinical picture of dientamoebiasis and compared it with giardiasis. In addition, we evaluated an improved approach to formalin-fixed samples for suitability in Dientamoeba diagnostics. Methods This study comprised four parts: (i) a descriptive part scrutinising rates of Dientamoeba findings; (ii) a methodological part analysing an approach to detect Dientamoeba-like structures in formalin samples; (iii) a clinical part comparing demographics and symptoms between patients with dientamoebiasis (n = 352) and giardiasis (n = 272), and (iv) a therapeutic part (n = 89 patients) investigating correlation between faecal eradication and clinical improvement. Results The rate of Dientamoeba findings increased 20-fold after introducing criteria for Dientamoeba-like structures in formalin-fixed samples (88.9% sensitivity and 83.3% specificity). A further increase was seen after implementing faecal PCR. Compared with patients with giardiasis, the symptoms in the Dientamoeba group lasted longer and more often included abdominal pain, cramping, faecal urgency and loose rather than watery stools. Resolved symptoms correlated with successful faecal eradication (p < 0.001). Conclusions Previously underdiagnosed, Dientamoeba has become the most frequently recorded pathogenic enteroparasite in Finland. This presumably results from improved diagnostics with either PCR or detection of Dientamoeba-like structures in formalin-fixed samples, an approach applicable also in resource-poor settings. Symptoms of dientamoebiasis differ slightly from those of giardiasis; patients with distressing symptoms require treatment.

scholarly journals Frequency of fungal infections in nasal polypi.

2019 ◽  
Vol 26 (12) ◽  
pp. 2231-2234
Author(s):  
Uzma Aslam ◽  
Nausheen Henna ◽  
Aman-ur- Rehman ◽  
Saniyah Ali ◽  
Shireen Hamid ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Fungal Infections ◽  
Inflammatory Cells ◽  
Cross Sectional Study ◽  
Age Group ◽  
Cross Sectional ◽  
Nasal Polypi ◽  
Margin Of Error ◽  
Study Setting ◽  
Formalin Fixed

Objectives: Determine the frequency of fungal infections in nasal polypi. Study Design: Cross sectional study. Setting: Histopathology Department at Shaikh Zayed Hospital Lahore. Period: Six months from 12/2/2015 to 12/8/2015. Material & Methods: Two hundred surgical resections/biopsies using 95% confidence level, with 7% margin of error were collected. Formalin fixed specimens of patients of both genders and 10- 60 years of age with nasal polyps received after surgical procedure in department of ENT. Grossing and processing was done. Hematoxyin & Eosin stained sections were examined by two consultant Histopathologists independently. The presence of fungal hyphae was confirmed by PAS and Silver stains. The study was approved by College of Physicians & Surgeons Pakistan. All the data was entered and analyzed by using SPSS version 20. Results: Out of 200 patients all the patients showed the prescence of inflammatory cells in polyps (100%) with predominantly eosinophils in their submucosa (82%). Fungus was present in 48 cases (24%) most of them were in the age group of 42-57 years (13%) and 31(15.5%) patients having BMI <30 and 17(8.5%) having BMI >30 were positive for fungus.30 cases were of Aspergillus (62.5%) and rest 8 were of Mucor (37.5%). The fungus positive cases were more in males (13.5%). 160 of the cases were of unilateral polyps (80%) and 40 were of bilateral polypi (20%). Only 8% of the patients having diabetes had fungal infection. Conclusion: Hence, the frequency of fungal infection in nasal polypi is low with Aspergillus being the commonest pathogen affecting males predominantly.

scholarly journals INTRAMEDULLARY INTERLOCKING NAILING WITHOUT IMAGE INTENSIFIER AND ORTHO TABLE

2012 ◽  
Vol 19 (03) ◽  
pp. 400-403
Author(s):  
FAYYAZ AHMED ORFI ◽  
SHAHID MAJEED ◽  
MUSHAHID ASLAM ◽  
M Khalid Siddique
Keyword(s):  
Standard Treatment ◽  
Image Intensifier ◽  
Lower Limbs ◽  
Field Hospital ◽  
Poor Countries ◽  
Distal Interlocking ◽  
Resource Poor ◽  
Humerus Fractures ◽  
Study Setting

Interlocking nails are the gold standard treatment of fractures of shaft of long bones of lower limbs. It is also frequently performedfor most of the humerus fractures. The procedure is commonly performed using an image intensifier and orthotable. These are expensive andare not readily available in peripheral/field hospitals especially in resource – poor countries. Design: Retrospective study. Setting: FieldHospital Muzaffarabad and Combined Hospital Kharian. Period: Sep 2007 to July 2011. Patients & Methods: 138 consecutive cases offractures of femur, tibia and humerus shafts fixed with I/M I/L Nails in a field hospital. Reduction was achieved by open method in 87 (96.66%)cases of femur, 24 (60%) case of tibia and 5(62.5%) of humerus. Results: There were 34 females and 100 males’ ratio 1:2.94. All the cases wereadults with mean age 38.2 years and range was 16-78 years. Bones fixed were femur (90) 65.21%, tibia (40) 28.21%, and humerus (8) 5.70%.Fracture line was transverse in 104 (75.3%) and communited 10 (7.2%). Fractures were closed 112 (81.2%) and 26 (18.8%) of case. Recentfractures were 122 (88.4%) and old non united 16 (11.6%). Mean follow up period was 06 months - range 3 months to 1 ½ years. Complicationswere failure to achieve distal interlocking 6 cases, infection 3 cases. Union time averaged 3.5 months. Conclusions: It is therefore concludedthat I/M I/L nailing can be done without image and traction table.

scholarly journals Evaluation of Intestinal Protozoan Morphology in Human Fecal Specimens Preserved in EcoFix: Comparison of Wheatley’s Trichrome Stain and EcoStain

1998 ◽  
Vol 36 (7) ◽  
pp. 1974-1976 ◽  
Author(s):  
Lynne S. Garcia ◽  
Robyn Y. Shimizu
Keyword(s):  
Polyvinyl Alcohol ◽  
Giardia Lamblia ◽  
Blastocystis Hominis ◽  
Intestinal Protozoan ◽  
Entamoeba Dispar ◽  
Intestinal Protozoa ◽  
Mercury Compounds ◽  
Dientamoeba Fragilis ◽  
Color Differences

As a result of disposal problems related to the use of mercury compounds, many laboratories have switched from mercuric chloride-based Schaudinn’s and polyvinyl alcohol (PVA) stool preservatives to other, non-mercury-based preservatives. A comparison of organism recoveries and morphologies of the intestinal protozoa was undertaken with PVA containing the EcoFix zinc-based Schaudinn’s preservative (Meridian Diagnostics, Inc.); both Wheatley’s modification of Gomori’s trichrome stain (WT) and EcoStain (ES) were used to stain 51 human fecal specimens. Morphology, clarity of nuclear and cytoplasmic detail, overall color differences, and the ease or difficulty in detecting intestinal protozoa in fecal debris were assessed for the two permanent stained smears. Overall, organism morphology of the intestinal protozoa stained with WT and that of protozoa stained with ES were not equal in nuclear and cytoplasmic detail or range of color. However, the same organisms were identified in stained fecal smears with either WT or ES, with the exception of situations in which organism numbers were characterized as rare. Included were 67 protozoan challenges (number of organisms): Entamoeba histolytica-Entamoeba dispar (5), Entamoeba coli (9),Entamoeba hartmanni (6), Endolimax nana (12),Iodamoeba bütschlii (8), Blastocystis hominis (19), Giardia lamblia (6), Dientamoeba fragilis (2), yeast (2), and leukocytes (2). Five specimens were negative for parasites but contained fecal debris that was compared for morphologic detail and color range. The ES produces a more gray-green monotone with very little pink or red tone; contrast among the various colors is less than that seen with WT. Stain intensity for all organisms was acceptable, and there were no problems with stain deposition. The quality of the protozoan morphology with ES was often comparable to that with WT (36 of 67 [53.7%]) and, in some cases, better (24 of 67 [35.8%]). Organisms on the WT-stained smear exhibited better morphology in a few instances (4 of 67 [6%]), and in three instances, there were discrepant organism numbers.

scholarly journals Dientamoeba fragilis, a Commensal in Children in Danish Day Care Centers

2017 ◽  
Vol 55 (6) ◽  
pp. 1707-1713 ◽  
Author(s):  
Pikka Jokelainen ◽  
Betina Hebbelstrup Jensen ◽  
Bente Utoft Andreassen ◽  
Andreas Munk Petersen ◽  
Dennis Röser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Day Care ◽  
Care Center ◽  
Gastrointestinal Symptoms ◽  
Recent History ◽  
Intestinal Protozoan ◽  
Content Type ◽  
Dientamoeba Fragilis ◽  
History Of ◽  
Travel Abroad

ABSTRACT Dientamoeba fragilis is an intestinal protozoan of debated clinical significance. Here, we present cross-sectional and longitudinal observations on D. fragilis in children aged 0 to 6 years from a 1-year multi-day-care-center cohort study set in Copenhagen, Denmark. The inclusion period for the cohort was 2009 through 2012. Stool samples collected from the children were accompanied by questionnaires completed by the parents or guardians of the children. Using real-time PCR, D. fragilis was detected in the first stool sample from 97 of 142 (68.3%) children. We evaluated the associations between seven plausible risk factors (age, sex, having siblings, having domestic animals at home, having had infant colic, recent history of intake of antibiotics, and recent history of travel abroad) as well as six reported symptoms (lack of appetite, nausea, vomiting, abdominal pain, weight loss, and diarrhea) and testing positive for D. fragilis . The final multivariable model identified being >3 years old and having a history of recent travel abroad as risk factors for testing positive for D. fragilis . Moreover, univariable analyses indicated that having siblings was a risk factor. There was no statistical association between a recent history of gastrointestinal symptoms and testing positive for D. fragilis . Among the 108 children who were represented by ≥2 samples and thus included in the longitudinal analysis, 32 tested negative on the first sample and positive later, and the last sample from each of the 108 children was positive. The results are in support of D. fragilis being a common enteric commensal in this population.

scholarly journals PROSTATE CANCER

2010 ◽  
Vol 17 (02) ◽  
pp. 235-240
Author(s):  
H A MWAKYOMA ◽  
J L MAGANDI
Keyword(s):  
Prostate Cancer ◽  
Prospective Longitudinal Study ◽  
Asymptomatic Patients ◽  
Biological Potential ◽  
Trucut Biopsy ◽  
The Mean ◽  
Prospective Longitudinal ◽  
Study Setting ◽  
Choice Of Therapy ◽  
Formalin Fixed

Objectives: To correlate histopathological grades of prostate cancer by Gleason’s scoring system and pretreatment PSA levels in patients with prostate cancer. Study Design: A prospective longitudinal study. Setting: Muhimbili National Hospital in the Departments of Histopathology and Morbid anatomy, Surgery and Biochemistry. Study Period: 15 months (from November 2006 to March 2008). Patients and Methods: Tissues were obtained from 131 cases of Transurethral Trucut biopsy and were formalin fixed and paraffin-embedded for diagnosis. The prostatic tumours were diagnosed and assigned Gleason’s histopathological grades and scores using Haematoxylin and Eosin (H&E) stained sections. Blood for PSA assay was analyzed by a method based on the immunoradiometric principle in which two monoclonal antibodies are directed against two different epitopes of PSA molecule. Results: During the period of study, 113 patients were diagnosed to have carcinoma of the prostate. The mean age at diagnosis was 68 years. The predominant histological type was adenocarcinoma (99.1%). The majority (45.1%) had moderately differentiated adenocarcinoma. Sixty one percent (61%) of patients had Gleason’s score of 5-7 and 81.5% of patients had significant elevation of pretreatment PSA of > 20.0 ng/ml. There was a positive correlation between Gleason’s score and pretreatment PSA levels in patients with Prostate cancer (r = +0.6) and was statistically significant (P< 0.05). Conclusions: It is known that the intermediate (5-7) Gleason’s score prostatic cancers are highly unpredictable in their clinical aggressiveness. This limitation is of particular importance as the majority of the tumours (76%) in our study fell into this intermediate category. Thus, predicting the biological potential of the majority of prostatic cancers in asymptomatic patients based upon histology alone is problematic. The combination of pretreatment PSA levels which correlated well with Gleason’s score in our study will be helpful in planning the choice of therapy in most patients with prostatic cancer in order to improve the prognosis.

scholarly journals Comparison of E test GRD and vancomycin screen agar (BHI-V3 and BHI-V4) in detection of heteroresistant vancomycin intermediate staphylococcus aureus (hVISA).

2019 ◽  
Vol 26 (09) ◽  
pp. 1419-1426
Author(s):  
Kanwal Hassan Cheema ◽  
Iffat Javed ◽  
Suhaila Mushtaq ◽  
Muhammad Saeed Anwar
Keyword(s):  
Staphylococcus Aureus ◽  
Diagnostic Accuracy ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Medical Institute ◽  
Screening Methods ◽  
Clinical Use ◽  
Glycopeptide Resistance ◽  
Clinical Specimens ◽  
Study Setting

Objectives: MRSA isolates with vancomycin MIC of 1-2 μg/ml have been linked with treatment failure and heteroresistant VISA phenotype. This study was aimed at comparing two screening methods i.e. GRD Etest and Vancomycin Screen agar in detection of heteroresistance. Material & Methods: The present study was carried out on 41 Methicillin Resistant Staphylococcus aureus strains isolated from different clinical specimens collected from Lahore General Hospital, Lahore. After screening for methicillin resistance, vancomycin MIC was determined by standard E test. Isolates with a vancomycin MIC of 1-2 μg/ml were screened for heteroresistance by Glycopeptide Resistance Detection (GRD) E-test and Vancomycin screen agar. Data was entered and analyzed by using SPSS version 20.0. Study Design: Comparative Study. Setting: Pathology Department of Post Graduate Medical Institute, Lahore. Period: May 2014 to May 2015. Results: When compared with E test GRD, Vancomycin screen agar (V3) showed 100% sensitivity with a 95% CI 39.76% to 100% and the specificity was 65 % with a 95 % CI 47.46% to 79.79%. Its PPV was 23% and NPV was 100% with an overall diagnostic accuracy of 68%. When compared with E test GRD, Vancomycin screen agar (V4) showed a sensitivity of 75% with a 95% CI 19.41% to 99.37% and a specificity of 86.47% with a 95% CI 71.91 to 95.59%. Its PPV was 37.5% and NPV predictive value was 96.96% with an overall diagnostic accuracy of 85.36%. Conclusion: In developing countries like Pakistan, where E tests are costly and difficult to use in routine laboratories, a screening test, which does not miss heteroresistant VISA may be of clinical use.

scholarly journals The importance of considering the neglected intestinal protozoan parasite Dientamoeba fragilis

2019 ◽  
Vol 68 (6) ◽  
pp. 890-892 ◽  
Author(s):  
Jari Intra ◽  
Cecilia Sarto ◽  
Silvia Besana ◽  
Natalia Tiberti ◽  
Paolo Brambilla
Keyword(s):  
Protozoan Parasite ◽  
Intestinal Protozoan ◽  
Dientamoeba Fragilis

Tumor typing by proteomic analysis of formalin fixed sample ECM

2008 ◽  
Vol 27 ◽  
pp. 32
Author(s):  
Timothy M. Ritty ◽  
Elizabeth Frauenhoffer ◽  
Edward J. Fox ◽  
Bruce Stanley
Keyword(s):  
Proteomic Analysis ◽  
Fixed Sample ◽  
Formalin Fixed

scholarly journals Is Dientamoeba fragilis a Friend or a Foe? A Study from Istanbul on Patients and Healthy Individuals from Different Cohorts

2020 ◽  
Author(s):  
Özgür Kurt ◽  
Sinem Öktem Okullu ◽  
Nestere Mansur Özen ◽  
Nihan Ünübol ◽  
Selma Cat ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Study Group ◽  
Healthy Individuals ◽  
Salmonella Spp ◽  
Intestinal Protozoan ◽  
Dientamoeba Fragilis ◽  
Pediatric Age Group ◽  
Health Group ◽  
Colonic Lumen ◽  
Stool Samples

Objective: Dientamoeba fragilis is an intestinal protozoan found in colonic lumen and it has been demonstrated that it can lead to various gastrointestinal and dermatological complaints. It has been discussed lately that D. fragilis can be found also in high prevalence among healthy individuals and could be a member of healthy gut microbiota. The aim of this study was to compare the prevalence of D. fragilis between patient and healthy-control groups from Istanbul, and to study clinical outcomes of the infection it causes on the patient group ,and patient characteristics. Method: Stool samples of 184 patients admitted to Acıbadem Health Group hospitals in Istanbul between 2016-2018, and 156 healthy controls were examined in the study. After microbiological and parasitological assessments of stool samples, DNA isolation was made followed by conventional PCR test using specific primers. Results: D. fragilis was detected in 15 of 184 (8.2%) patients and 42 of 156 (26.9%) controls, and the intergroup difference was significant (p<0.05). In the study group Salmonella spp. was detected in 3, and Rotavirus in 1 of the D. fragilis positive individuals. Six out of 15 D. fragilis positive individuals in the study group were women and their average age (n=24.3) was higher than other groups (p=0.25). Fifty-five of 57 (96.5%) D. fragilis positive individuals were in the pediatric age group. The leading complaints were diarrhea, anorexia and abdominal pain, while 3 of the 15 patients reported itching and urticaria. Conclusion: These preliminary results related to the metropolitan city of Istanbul tend to support the fact that D. fragilis may show pathogenic effects in some cases but it is more common among healthy individuals. Considering the similar results from different regions of the world, further studies are essential to unveil under which conditions D. fragilis is silent (friend) and acts as a pathogen (foe).

Sign in / Sign up

Export Citation Format

Share Document