Interaction between grapefruit juice and praziquantel in humans.
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After a single oral dose of praziquantel with 250 ml of grapefruit juice, the area under the concentration-time curve and the maximum concentration in plasma of praziquantel (Cmax) were significantly increased (Cmax for water treatment, 637.71 +/- 128.5 ng/ml; and Cmax for grapefruit juice treatment, 1,037.65 +/- 305.7 ng/ml, P < 0.05). No statistically significant differences were found in the time to maximum concentration of drug in plasma or elimination half-life. (+info)
A combined medical and surgical approach to hydatid disease: 12 years' experience at the Hospital for Tropical Diseases, London.
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BACKGROUND: There is no consensus as to the most appropriate treatment for the varied and often complicated presentations of hydatid disease in Britain. We looked at our own results over a 12-year period to see if a consistent and logical plan had emerged. PATIENTS AND METHODS: 70 patients presenting between 1986 and 1998 were analysed retrospectively, with regard to their presentation, diagnosis, treatment and outcome, with particular reference to the use of chemotherapy, and to the difficulties of post-treatment assessment by serology and imaging. RESULTS: 37 patients had been treated previously. 35 had hepatic cysts and 26 multiple cysts. 4 patients were treated by surgery alone, 44 by chemotherapy and surgery, and 14 by chemotherapy alone. The combined use of albendazole and praziquantel pre-operatively reduced significantly the number of cysts that contained viable protoscolices: 1/25 versus 5/8 that received albendazole alone (P = 0.00013). During the 12-year period, it became our policy to aim for 3 months drug treatment (albendazole throughout with praziquantel for 2 weeks), re-assess and proceed either to surgery or to continue with chemotherapy. CONCLUSIONS: It is possible to construct an algorithm for the management of patients with hydatid disease by chemotherapy and surgery, but the assessment of results by indirect techniques remains difficult. (+info)
Affinity purified oval antigen for diagnosis of Opisthorchiasis viverrini.
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Monoclonal antibodies (MAb) were raised against an oval antigen of the liver fluke Opisthorchis viverrini which is the causative agent of a parasitosis, i.e. opisthorchiasis in Thailand. The antibodies were used in an affinity column to purify the O. viverrini oval antigen from a crude extract of adult parasites by chromatography. The oval antigen was then used in a membrane (dot) ELISA for detecting antibodies in serum samples of parasitologically confirmed Opisthorchis viverrini infected individuals (adult parasites were found in stools after praziquantel treatment and salt purgation), as well as of individuals infected with other parasites and parasite-free controls. The MAb-based dot-ELISA using the affinity purified O. viverrini oval antigen revealed 100% sensitivity, specificity and accuracy for detecting O. viverrini infection. The test is simple, rapid and highly reproducible. Several samples can be tested at the same time without the requirement for special equipment or much increase in testing time; thus it is suitable for mass screening for O. viverrini exposure, especially in new endemic areas. Furthermore using serum specimens could increase patient and community compliance compared to the conventional parasitological survey which uses stool samples for the detection of O. viverrini ova, without treatment and subsequent salt purgation, this conventional method shows a low sensitivity and is also unpleasant to both the sample donors and the laboratory technicians which has historically shown a further negative impact on the final outcome. (+info)
Altered response of strain of Schistosoma mansoni to oxamniquine and praziquantel.
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The susceptibility of a fourth generation Ouh strain (Paranapanema Valley, Sao Paulo, Brazil) of Schistosoma mansoni to oxamniquine (OXA) and praziquantel (PZQ) was studied. Ten groups of 13 female albino mice each were infected with 70 cercariae per animal. These mice were medicated orally on the 50th day after infection. Five groups were given OXA doses of 0, 100, 200, 300 and 400 mg/kg (single doses) and the rest were treated with PZQ doses of 0, 100, 200, and 250 mg/kg/5 days. Each group was sub-divided: 8 animals underwent perfusion after 15 days treatment, 5 mice followed up for oviposition and their feces were tested every 15 days for miracidia hatching. The efficacy of the OXA doses of 100 and 200 mg/kg was 66% and 91.4%, respectively and for the 100 mg/kg PZQ dose it was 90.1%. The follow-up groups with 100 and 200 mg/kg of OXA and PZQ, 100 and 150 mg/kg, showed that they re-established the oviposition after a period of 60 to 75 days of treatment. The ED50 was 69.6 mg/kg OXA and 39.4 mg/kg PZQ. The results show the tolerance of the Ouh strain to a dose of 100 mg with both drugs and they appoint the need for a dose review during the follow up of the oviposition and in monitoring phenomena in the field. (+info)
Spinal cord schistosomiasis in children: analysis of seven cases.
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We describe seven cases of children (ages 2 to 14 years) with myeloradiculopathy caused by infection with S. mansoni. None of them presented hepatosplenic involvement and one presented an intestinal picture. The myeloradicular and pseudotumoral forms were observed in four and three patients, respectively. Comparing the reports in the literature, we found that the pseudotumoral form is more similarly frequent among children than in adults, while the myelitic and myeloradicular forms are the most frequent and distributed across all age groups. Diagnosis is based on clinical and epidemiological findings in association with laboratory tests. The diagnosis was confirmed by the presence of S. mansoni eggs in feces (5 cases) and / or the positivity in specific immunological tests (5 cases) associated with a cerebrospinal fluid inflammatory pattern with presence of eosinophils (between 1 and 24%). Magnetic resonance image, although it does not enable an etiological diagnosis, helped to confirm the form and spinal cord level of the lesion. (+info)
Cimetidine enhances the plasma praziquantel concentration and treatment efficacy against Microcotyle sebastis in cultured rockfish Sebastes schlegeli.
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The effect of cimetidine on the praziquantel concentration in the blood of the rockfish Sebastes schlegeli and the consequent effect on the treatment efficacy against Microcotyle sebastis were investigated. Fish were divided into 7 groups and orally administered praziquantel alone (200 and 100 mg kg(-1) body weight [BW]) or in combination with cimetidine (in doses of 200, 100 or 50 mg kg(-1) BW cimetidine with a praziquantel dose of 100 mg kg(-1) BW). The fish in the sixth group were coadministered 50 mg praziquantel and 200 mg cimetidine kg(-1) BW. The fish in the control group were administered only saline. At 24 h post-treatment, the plasma was analyzed for praziquantel by reversed-phase high-performance liquid chromatography (RP-HPLC) using diazepam as the internal standard, and the gills were examined to confirm the effectiveness of each treatment. The praziquantel concentration in plasma of fish administered 100 mg praziquantel + 200 mg cimetidine kg(-1) BW was not significantly different from that of fish treated with 200 mg praziquantel kg(-1) BW and was significantly (p < 0.05) higher (about 2 times) than that of fish administered 100 mg praziquantel kg(-1) BW. The group of fish administered 50 mg praziquantel + 200 mg cimetidine kg(-1) BW showed a similar plasma praziquantel concentration to that in the fish treated with 100 mg praziquantel kg(-1) BW. The treatment efficacies of the groups of fish coadministered 100 mg praziquantel kg(-1) BW and various concentrations of cimetidine (200, 100 and 50 mg kg(-1) BW) were not significantly different from that of the group of fish administered 200 mg praziquantel kg(-1) BW, but were significantly higher than those of the groups of fish fed 100 mg praziquantel kg(-1) BW alone or coadministered 50 mg praziquantel + 200 mg cimetidine kg(-1) BW. (+info)
Down-regulation of specific antigen-driven cytokine production in a population with endemic Schistosoma japonicum infection.
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Schistosome antigen-driven cytokine responses and antischistosome antibody levels of residents of a Schistosoma japonicum endemic island in Poyang Lake, Jiangxi Province were studied before and 45 days after treatment with praziquantel. IL-4, IL-5, IL-10 and INF-gamma were all detected in the supernatants of whole-blood cultures after stimulation with schistosome soluble egg antigen (SEA) and soluble worm antigen preparation (SWAP). The percentages of subjects producing detectable amounts of each cytokine assayed were higher in the group who were negative by stool examination at the start of the study than in those who were initially stool positive. After praziquantel treatment the percentages of subjects producing both type I and type II cytokines increased. This suggests that the production of both types of cytokine was down-regulated in the presence of live, egg-laying S. japonicum adult worms but that this was reversible by treatment. In contrast, the antibody studies showed higher levels of SWAP and SEA-specific antibodies (IgE, total IgG, IgG4, IgM) in subjects who were originally stool-positive than in those who were stool-negative. After treatment specific IgE responses were elevated, but total IgG and IgG4 anti-SEA and IgM anti-SWAP antibody levels all fell significantly. (+info)
Active hepatic capsulitis caused by Paragonimus westermani infection.
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Paragonimiasis is an important re-emerging parasitosis in Japan. Although the lungs and pleural cavity are the principal sites affected with the parasite, ectopic infection can occur in unexpected sites such as skin and brain. This case report describes a patient with active hepatic capsulitis due to Paragonimus westermani infection. The patient was successfully treated with praziquantel at the dose of 75 mg/kg/day for 3 days. (+info)