Retinoic acid increases tissue and plasma contents of nerve growth factor and prevents neuropathy in diabetic mice

BACKGROUND

Decreased production of nerve growth factor (NGF) may contribute to diabetic neuropathy; however, exogenous administration of NGF induces only a modest benefit. Retinoic acid (RA) promotes the endogenous expression of nerve growth factor and its receptor. We studied the effects of RA on diabetic neuropathy in mice with streptozotocin-induced diabetes.

MATERIAL AND METHODS

One hundred and twenty National Institutes of Health (NIH) albino mice randomly separated into three groups (A, n = 30; B, n = 30; C, n = 60). Diabetes mellitus was induced with streptozotocin in groups A and B. Animals from group A received a subcutaneous injection of 25 microl of mineral oil daily for 90 days, while those from group B received a subcutaneous injection of 20 mg kg(-1) of all trans RA. Animals from group C were taken as controls. At the end of the experiment, blood glucose and NGF levels (both in serum and sciatic nerve) were measured. Two behavioural tests were conducted in a blind fashion to detect abnormalities of thermal and nociceptive thresholds.

RESULTS

Contents of NGF in healthy untreated mice were 1490 +/- 190 pg mg(-1) in nerve and 113 +/- 67 pg mg(-1) in serum; in diabetic untreated mice the values were 697 +/- 219 pg mL(-1) in nerve and 55 +/- 41 pg mL(-1) in serum; and in diabetic mice treated with RA the values were 2432 +/- 80 pg mL(-1) in nerve and 235 +/- 133 pg mg(-1) in serum (P < 0.002). Ultrastructural evidence of nerve regeneration and sensitivity tests improved in diabetic mice treated with RA as compared with nontreated diabetic mice.

CONCLUSION

Our findings indicate that administration of RA increases serum and nerve contents of NGF in diabetic mice and suggest a potential therapeutic role for retinoic acid in diabetic patients.

Relationship between maize stem structural characteristics and resistance to pink stem borer (Lepidoptera: Noctuidae) attack

The pink stem borer, Sesamia nonagrioides (Lefebvre), is one of the most important insect pests of maize (Zea mays L.) in northwestern Spain. The objectives of this work were to evaluate, at different times during the growth of maize, structural traits related to the entry point and tissues on which larvae feed and to determine the relationship between these structural traits and the stem borer resistance. Six inbred lines with different levels of stem resistance to S. nonagrioides were evaluated in several trials. Potential structural resistance factors included rind and pith puncture resistance (RPR and PPR), rind thickness, length of the meristematic area (LMA), and pith parenchyma interlumen thickness (PPIT). Surprisingly, the inbred lines that showed the strongest stalks, EP42 and EP47, were not stem resistant to pink stem borer attack, while the stem resistant inbreds A509, CM151, and PB130 were among the least resistant to rind puncture. There were no significant differences among resistant and susceptible inbreds for the rind thickness. However, the susceptible inbred EP42 had the softest internode pith, and the resistant inbred PB130 showed the hardest, as was expected. Susceptible inbred lines in general showed higher values for the LMA, while the PPIT was important for individual inbreds. The results suggest that the usefulness of these characters as estimators of pink stem borer resistance is limited to some genotypes. Besides, even among those genotypes, other mechanisms of resistance that do not involve stalk strength could be present. Among the traits considered, the LMA was the most promising as an indicator of resistance to pink stem borer, although further experimentation is necessary.

Sensitivity and specificity of ELISA and immunoblot for diagnosing neurocysticercosis

In patients with neurocysticercosis (NCC), clinical manifestations and the results of neuroimaging procedures vary widely and often do not facilitate a definite diagnosis. In order to determine the value of immunodiagnosis for NCC, 222 serum and cerebrospinal fluid samples from patients with NCC and healthy subjects were examined. The samples represented patients from various endemic regions, those with other neurological disorders from an endemic area (Mexico), persons with various helminth infections other than NCC, and a group of healthy volunteers. All specimens were tested by enzyme-linked immunosorbent assay and immunoblot for the presence of Taenia solium-specific antibodies. The sensitivities of the enzyme-linked immunosorbent assay and the immunoblot test in NCC patients were almost identical (80% and 81.7%, respectively). For both tests, the sensitivity was higher when cerebrospinal fluid (86%) was tested compared with serum (75%). The overall specificity of enzyme-linked immunosorbent assay was only 75.3% because of frequent false-positive results in patients with other helminth infections, especially in those with echinococcosis. The specificity (99.4%) of the immunoblot test was clearly superior. It is concluded that enzyme-linked immunosorbent assay as a screening method and immunoblot as a confirmatory test contribute considerably to the diagnosis of NCC.

Varicella, ephemeral breastfeeding and eczema as risk factors for multiple sclerosis in Mexicans

OBJECTIVE

It has been suggested that the incidence of multiple sclerosis (MS) in Mexico and other countries of Latin America has increased steadily for the last two decades. We made a thorough search of antecedents on MS patients that could be potential risk factors.

METHODS

A case-control study was conducted using a questionnaire that included demographic, nutritional, infectious and personal antecedents previously identified in other reports as possible risk factors for MS.

RESULTS

The frequency of varicella, ephemeral breastfeeding and eczema in the medical history of MS patients were significant when compared with controls; all appeared to be mutually additive. However, they were unrelated with clinical characteristics or disease severity.

CONCLUSION

During the last decades, breastfeeding has been abandoned in large segments of society and the incidence of varicella and childhood eczema keeps a north-south gradient similar to that described for MS. These factors may participate in the sharp increase of MS in countries like Mexico traditionally considered as an area of very low incidence.

AT1 receptor is present in glioma cells; its blockage reduces the growth of rat glioma

Malignancy of neoplasms is partly dependent on angiogenesis. Angiotensin II mediates angiogenesis and transcription of growth-related factors through stimulation of the AT1 receptor (AT1R). Losartan, a drug used mostly for treatment of hypertension, binds strongly to this receptor. We found the presence of AT1 receptor on C6 glioma cells and studied the effect of Losartan on the growth and angiogenesis of C6 rat glioma; Losartan in dose of 80 mg/kg induced 79% reduction of tumoural volume with a significant decrease of vascular density, mitotic index and cell proliferation. Our results demonstrate the conspicuous presence of AT1R in malignant glial cells and a favourable therapeutic response in experimental glioma by selective blockage of the AT1 receptor.

Clomipramine increases the striatal concentrations of dopamine and homovanillic acid in rats chronically consuming alcohol

OBJECTIVE

There have been many studies on the relationships between the dopaminergic system, alcoholism and antidepressant drugs; the information, however, is controversial. The purpose of this study was to examine the effect of clomipramine (CMI), a tricyclic antidepressant, on the striatal concentration of dopamine (DA) and homovanillic acid (HVA), and their turnover, in a rat model of chronic alcohol ingestion.

METHOD

After 10 months of exposure to either water (expW) or alcohol (expA), female Wistar rats (N = 60) were randomly assigned to one of the following six groups: (1) (expW) control group (C), normal diet; (2) (expA) alcohol administration group (A), drinking water was replaced by commercial brandy that was 38% ethanol; (3) (expW) clomipramine group (CMI), received intraperitoneal injections over 4 months; (4) (expA) alcohol administration + clomipramine group (ACMI); (5) (expA) alcohol abstinence group (AA); and (6) (expA) alcohol abstinence + clomipramine group (AACMI). Each group consisted of 10 animals.

RESULTS

Chronic alcohol intake decreased striatal dopamine concentration (p < .001), whereas clomipramine administration produced a significant increase (p < .001) when administered in both control rats and rats exposed to long-term alcohol administration. The increase in the ACMI group was significantly different (p < .001) when it was compared with the CMI group. In the AA and AACMI groups, a significant decrease of striatal dopamine was observed (p < .001). During long-term alcohol administration, homovanillic acid decreased (p < .005). HVA/DA ratio increased in AA and AACMI groups (p < .001).

CONCLUSIONS

These findings show that clomipramine produces favorable changes in dopaminergic systems altered by chronic alcohol administration. Results also provide evidence to support further prospective studies of potential therapeutic effects of antidepressant drugs in alcoholism.

Paradoxical effect of aspirin on the growth of C6 rat glioma and on time of development of ENU-induced tumors of the nervous system

PURPOSE

Administration of acetylsalicylic acid (ASA), an inhibitor of the synthesis of prostaglandins and thrombzoxanes, decreases the incidence of colorectal cancer and other neoplasms and inhibits in vitro some tumor growth. We studied the effect of various doses of ASA on the growth of C6 glioma implanted in rats as well as the effect of chronic administration of ASA on time of development and incidence of tumors of the central nervous system (CNS) induced by prenatal exposure to ethylnitrosourea (ENU).

METHODS

In a controlled study, various doses of ASA, 12.5, 25, 50, 100, 200, 300, and 400 mg/kg per day, were administered to Wistar rats in whom a subcutaneous C6 glioma had been transplanted. Changes in tumor size, histologic characteristics, mitotic index, cell proliferation, and vascular density were studied. In a parallel experiment, we administered ASA (70 mg/kg per day) to rats who were prenatally exposed to ENU; treatment started on day 50 of age, and continued until the end of the experiment at day 400. The time of tumor development as well as incidence, localization, and histological diagnosis were compared with matched controls.

RESULTS

A paradoxical effect of ASA administration was observed on the dynamics of cell proliferation of C6 glioma. When high ASA doses were administered (200 or 400 mg/kg per day), tumor volume, cell proliferation, vascular density, and mitotic index increased. In contrast, when low doses were administered (12.5 or 25 mg/kg per day) the tumor size diminished. In the second experiment, localization and incidence of CNS tumors induced by ENU were similar in animals treated with ASA and in controls; however, in rats treated with ASA the time of tumor development was shortened.

CONCLUSIONS

The growth-promoting effects of high doses of ASA found in the present study in both transplanted and chemically-induced brain tumors, might be due to the blockage of autocrine inhibitory factors dependent on the cyclooxygenase pathway or by increased vascular permeability and blood supply to the tumor due to inhibition of platelet aggregation. In contrast, the inhibition of tumor growth obtained with low ASA doses in transplanted glioma might be due to different mechanisms such as the induction of apoptosis.

Quinacrine enhances carmustine therapy of experimental rat glioma

OBJECTIVE

The high rate of mutagenesis in malignant cells has been considered to be a primary factor in the appearance of chemotherapy-resistant cell clones in glioblastomas. Quinacrine binds strongly to deoxyribonucleic acid, preventing mutagenesis. We investigated whether quinacrine could improve carmustine therapy in C6 cell cultures and in C6 malignant gliomas implanted subcutaneously into Wistar rats.

METHODS

A potential chemopreventive effect of quinacrine on acquired resistance to carmustine therapy was studied in vitro and in vivo. Deoxyribonucleic acid damage was measured in cultured C6 cells by using the micronucleus test. Wistar rats with subcutaneously implanted C6 gliomas were treated with carmustine, quinacrine, or carmustine plus quinacrine, using pharmacological schemes similar to those used for human patients.

RESULTS

The addition of quinacrine to cultured C6 cells did not modify carmustine-induced cytotoxicity; however, the deoxyribonucleic acid damage in surviving cells was minor, as indicated by the frequency of micronucleated cells. The surviving cells continued to be susceptible to a second exposure to carmustine, in contrast to non-quinacrine-treated control cells, which developed resistance to carmustine in a subsequent exposure (P < 0.05). The rate of tumor remission was higher for glioma-bearing rats treated with quinacrine plus carmustine, compared with rats treated with carmustine alone (P < 0.01).

CONCLUSION

The addition of quinacrine to carmustine therapy increases the antineoplastic effect of the carmustine therapy. Our results suggest that chemical inhibition of mutagenesis in malignant glial cells during chemotherapy prevents the appearance of resistant clones.

Neurocysticercosis: validity of ELISA after storage of whole blood and cerebrospinal fluid on paper

Cysticercosis is an infestation of Cysticercus cellulosae. When it occurs in the brain, chronic neurological complications can ensue, most commonly seizures. Neurocysticercosis is usually diagnosed by neuroimaging, a technique not available in most endemic countries. Hence immunological tests are valuable for diagnosis and epidemiological surveys. We evaluated the suitability of paper for storing blood and cerebrospinal fluid (CSF) until subsequent testing by enzyme-linked immunosorbent assay (ELISA), by testing whole blood samples on filter paper from 305 patients and CSF samples from 117 patients stored on ordinary white typing paper and on filter paper. Optimal preservation of biological samples is achieved when whole blood is stored on filter paper, CSF on white paper, and when samples are frozen within 1 week after collection. Our results could improve diagnostic capabilities and facilitate epidemiological surveys in endemic countries where immunodiagnostic tests cannot be rapidly performed because of inadequate laboratory infrastructure.

Treatment of hydrocephalus in adults by placement of an open ventricular shunt

OBJECT

Ventricular shunt placement is the neurosurgical procedure most frequently associated with complications. Over the years, it has been a growing concern that the performance of most shunting devices does not conform to physiological parameters. An open ventriculoperitoneal (VP) bypass with a peritoneal catheter for which the cross-sectional internal diameter was 0.51 mm as a distinctive element for flow resistance was evaluated for use in the treatment of adult patients with hydrocephalus.

METHODS

During a 2-year period, open shunts were surgically implanted in 54 adults with hydrocephalus; conventional shunts were implanted in 80 matched controls. Periodic evaluations were performed using neuroimaging studies and measures of clinical status. All patients were followed from 12 to 36 months. 18.5 +/- 4 months for patients with the open shunt and 19.1 +/- 8.1 months for controls (mean +/- standard deviation). The device continued to function in 50 patients with the open shunt (93%) and in 49 controls (61%: p < 0.001). The Evans index in patients with the open shunt was 0.33 +/- 0.09 throughout the follow up. No cases of infection, overdrainage, or slit ventricles were observed: the index in controls was 0.28 +/- 0.08; 60% of them developed slit ventricles. During the follow-up period occlusion occurred in four patients with the open shunt (7%) and in 31 controls (39%: p < 0.001).

CONCLUSIONS

The daily cerebrospinal fluid (CSF) drainage through the open VP shunt is close to 500 ml of uninterrupted flow propelled by the hydrokinetic force generated by the combination of ventricular pressure and siphoning effect. It complies with hydrokinetic parameters imposed by a bypass connection between the ventricular and peritoneal cavities as well as with the physiological archetype of continuous flow and drainage according to CSF production. The open shunt is simple, inexpensive, and an effective treatment for hydrocephalus in adults.

Post-Panning Computer-Aided Analysis of Phagotope Collections Selected with Neurocysticercosis Patient Polyclonal Antibodies Separation of Disease-Relevant and Irrelevant Peptide Sequences

The homology of peptide sequences selected from a 7mer phage display library with antibodies elicited by the multicelled parasite Taenia solium in cerebrospinal fluid and serum of neurocysticercosis (NCC) patients and by antibodies of uninfected control patients with similar neurological complications of other ethiology (non-NCC) were analyzed using a PILEUP-Tudos sequence alignments program. The analysis generated dendrograms bearing two types of sequence clusters, those containing (1) only NCC patients-derived peptides and (2) both NCC- and control non-CC -- patient derivatives. By using ELISA, peptides that were selected by the antibodies were identified predominantly in the NCC-derived clusters. In repeated analysis in which sequences were added or removed, the first type of clusters maintained their structure, while the second type of clusters were split into many separate homology units dispersed throughout the guide tree. These results are interpreted as the ability of the analysis to segregate NCC-specific peptide sequences from other sequences. Altogether, this study demonstrates the high potential of the PILEUP-Tudos computer program to analyze phagotope collections recovered through biopanning with polyclonal antibodies elicited in patients by complex and as yet unknown multiple pathogenic antigens and to separate all phagotopes that are disease-relevant on the basis of the sequence homology.

Taenia solium disease in humans and pigs: an ancient parasitosis disease rooted in developing countries and emerging as a major health problem of global dimensions

This article reviews current knowledge on human and porcine cysticercosis caused by Taenia solium. It highlights the conditions favorable for its prevalence and transmission, as well as current trends in research on its natural history, epidemiology, immunopathology, diagnosis, treatment and prevention. Our opinions on the most urgent needs for further research are also presented.

Bioavailability of praziquantel increases with concomitant administration of food

In the present study we found that after a single oral dose of 1,800 mg of praziquantel, following a high-lipid diet and a high-carbohydrate diet, the maximum levels in plasma increased 243 and 515% and the area under the plasma concentration curve from 0 to 8 h increased 180 and 271%, respectively.

Interstitial quinacrine for elimination of abnormal tissue; therapy of experimental glioma

BACKGROUND

When quinacrine is injected interstitially, an intense migration of leukocytes and accumulation of various lymphokines is obtained locally, and the reaction is followed by cicatricial fibrosis. This property has been used in humans to induce tubal fibrosis in women and pleurodesis in patients with pleural effusion.

METHODS

In a controlled study, a single dose of 150 mg of quinacrine was injected interstitially into a C6 glioma implanted in the subcutaneous tissue of Wistar rats. Changes in size, histologic variations, and microscopic characteristics of leukocyte subpopulations infiltrating the tumor were studied by immunohistochemistry. Tumor necrosis factor and interleukin-1 beta were measured at different times in tumor homogenates.

RESULTS

The day after the injection of quinacrine, infiltration of leukocytes and macrophages was observed, accompanied by an accumulation of proinflammatory endogenous cytokines. Tumoral necrosis soon ensued; complete tumor disappearance was obtained in 72% of the animals. Cicatrization proceeded without injury of perilesional structures. In all controls injected with the vehicle, a large tumor developed (P <.0001).

CONCLUSIONS

Quinacrine, when administered interstitially in a single dose, elicits an intense local recruitment and proliferation of activated immune cells that, at the dose used in this study, induces tissue necrosis within a radius of 1 cm around the site of quinacrine injection, leaving the surrounding tissue unharmed.

[Chemotherapy of cysticercosis. Review about its pharmacokinetics and toxicology]

Neurocysticercosis (NCC) is the most common parasitic infection of the central nervous system. Praziquantel and albendazole are the two cestocide drugs currently used for the treatment of NCC. The present article reviews the studies on the pharmacokinetics of these compounds, both in animals and humans, that have led to more accurate, precise and short treatment schedules for NCC. Toxicological data indicate that both praziquantel and albendazole do not have severe secondary effects in the short term, however, there is still not sufficient information about their long term effects on human health, mainly with respect to albendazole, for which few studies on its effects on human cells are available. These two drugs constitute an effective treatment not only for NCC but also for several helminthiosis. To keep this advantageuos situation, health care professionals should be aware of the necessity of a more rational use of both anthelminthics, since the potentially adverse long term effects could be related to time and dose of exposure as well as to individual susceptibility. In addition, there is always the possibility that the misuse of these compounds could give rise to resistant species, that may represent a significant problem for public health in countries where parasitic diseases are endemic.

Brain tumors in Mexico: characteristics and prognosis of glioblastoma

BACKGROUND

Frequency and clinical characteristics of brain tumors have been studied in several populations from different genetic backgrounds; their peculiarities in the Mexican mestizo population shed light on the descriptive and comparative epidemiologic analysis of the genetic participation in brain tumors.

METHODS

To analyze the frequency of intracranial neoplasms at the National Institute of Neurology and Neurosurgery of Mexico between 1987 and 1994, demographic, clinical, surgical, and neuropathological records were reviewed and compared with other reports. Glioblastoma cases were followed to investigate survival and prognostic factors.

RESULTS

In a seven-year period 1,776 patients with brain tumors were treated; 419 (24%) had pituitary adenoma; 586 (33%) had glioma. Of the latter, 165 had glioblastoma multiforme, representing 28% of all gliomas and 9% of all neoplasms. Mean survival for glioblastoma was 16 months and the longest mean survival was obtained in patients with radical neurosurgical resection plus radiotherapy and chemotherapy. Cumulative analysis showed that 41% of patients survived less than one year, 39% from 1 to 2 years, 12% from 2 to 3 years and 8% more than three years. Factors that showed prognostic significance were age, therapeutic approach, tumor size, and pre- and postoperative clinical status (p < 0.05).

CONCLUSIONS

This study comprises the largest series on the frequency of brain tumors in a Latin American population. When compared with other studies, the proportion of glioma and glioblastoma among brain neoplasms was low whereas pituitary adenoma was high. Mean survival for glioblastoma was similar to other reports; in these patients, the overall therapeutic response is still far from satisfactory.

Cysticercosis: towards the design of a diagnostic kit based on synthetic peptides

Cysticercosis caused by Taenia solium is a very common disease in developing countries that seriously affects human health. Diagnosis can only be confirmed with the aid of computerized tomography or nuclear magnetic resonance (NMR) creating obvious difficulties for epidemiological studies. Reliable immunoassays employing cerebrospinal fluid (CSF) have been developed, based on the use of cysticercal antigens. However, the reliance on parasite material is restrictive. Herein, we report the advances in the design of a diagnostic kit based on immunodominant synthetic peptides, targeting four candidate epitopes KETc1, KETc12, 410 and 413 which were identified from three different clones (KETc1, 12 and 4) selected from a cDNA library of Taenia crassiceps. CSF antibodies against T. solium cysticercal antigens (TCA) as well as the four peptides were determined by enzyme-linked immunoabsorbent assays (ELISA) using two panels of CSF from patients with confirmed neurocysticercosis and other neurological diseases. In the first CSF panel which included patients with high level of antibodies against TCA, KETc12 exhibited almost the same sensitivity (87.5%) as TCA (93.7%) and 100% specificity. In the second panel of 110 CSF collected at random, two peptides (KETc1 and KETc12) exhibited sensitivities of 40 and 36% respectively, and were 100% specific.

Possible association between Taenia solium cysticercosis and cancer: increased frequency of DNA damage in peripheral lymphocytes from neurocysticercosis patients

Helminths, particularly some Schistosoma species, have been associated with cancer in humans. Neurocysticercosis, produced by cysticerci of the helminth Taenia solium, has been associated with the emergence of brain tumours and haematological malignancies. Local tumours, such as glioblastoma, could be explained by the induction of DNA damage in cells surrounding the cysticercus and chronically exposed to an inflammatory host response. However, systemic effects such as haematological malignancies are not easy to understand. The present work was conducted in Mexico to find out whether DNA damage arises in peripheral lymphocytes in patients with neurocysticercosis. We utilized a highly sensitive technique to analyse chromosomal aberrations, in-situ hybridization with probes against chromosomes 1, 2 and 4, and in addition the blocked-cytokinesis technique was used to determine the formation of micronuclei, a peculiar form of DNA damage. The study was made in lymphocytes from 8 patients before and after the administration of praziquantel, 1 of the 2 drugs used for neurocysticercosis treatment. The frequencies of chromosome aberrations and micronuclei in peripheral blood lymphocytes were higher in the infected patients as compared to those observed both in healthy donors and in the group of patients after praziquantel therapy. Our results suggest that chromosome aberrations induced in peripheral cells during neurocysticercosis could be associated with the development of haematological neoplasias.

A proposal to declare neurocysticercosis an international reportable disease

Neurocysticercosis is an infection of the nervous system caused by Taenia solium. It is the most important human parasitic neurological disease and a common cause of epilepsy in Africa, Asia, and Latin America, representing enormous costs for anticonvulsants, medical resources and lost production. Neurocysticercosis is a human-to-human infection, acquired by the faecal-enteric route from carriers of intestinal T. solium, most often in areas with deficient sanitation. Intestinal tapeworms cause few symptoms, but adult taeniae carried by humans release large numbers of infective eggs and are extremely contagious. Ingestion of poorly cooked pig meat infested with T. solium larvae results in intestinal taeniosis but not neurocysticercosis. With a view to hastening the control of taeniosis and neurocysticercosis we propose that neurocysticercosis be declared an international reportable disease. New cases of neurocysticercosis should be reported by physicians or hospital administrators to their health ministries. An epidemiological intervention could then be launched to interrupt the chain of transmission by: (1) searching for, treating and reporting the sources of contagion, i.e. human carriers of tapeworms; (2) identifying and treating other exposed contacts; (3) providing health education on parasite transmission and improvement of hygiene and sanitary conditions; and (4) enforcing meat inspection policies and limiting the animal reservoir by treatment of pigs. We believe that the first step required to solve the problem of neurocysticercosis is to implement appropriate surveillance mechanisms under the responsibility of ministries of health. Compulsory notification also has the major advantage of providing accurate quantification of the incidence and prevalence of neurocysticercosis at regional level, thus permitting the rational use of resources in eradication campaigns.

[A short praziquantel regimen for the treatment of parenchymatous neurocysticercosis]

OBJECTIVE

Fifteen-day praziquantel therapy for parenchymal neurocysticercosis has been shown to be effective. Plasma and cerebrospinal fluid concentrations of praziquantel peak two hours after administration. Maintenance of high concentrations of the drug for six hours may be an adequate therapy for the disease.

METHODS

Thirty patients with parenchymal neurocysticercosis were treated with three oral doses of praziquantel(25 mg/kg) at two-hour intervals. Intramuscular dexamethasone (10 mg/day) was administered for three days after the praziquantel treatment.

RESULTS

Cysts disappeared in 21 patients and showed a decrease in number of 30 to 60% in seven patients. Two patients remained without change. Considering the total number of cysts, this therapy showed a 70.7% eradication rate. Two patients had seizures, six reported headache, and nausea was frequently reported. Patients under antiepileptic treatment did not have seizures.

CONCLUSION

The cost and duration of treatment with praziquantel were significantly reduced and the inflammation that follow the destruction of the parasite was treated sequentially.