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Tunagur MT, Aksu H, Tileklioğlu E, Ertabaklar H. The impact of Toxocara-seropositivity on attention and motor skills in children with attention-deficit hyperactivity disorder. Early Hum Dev 2024; 193:106017. [PMID: 38663140 DOI: 10.1016/j.earlhumdev.2024.106017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/07/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The study aims to compare neurological soft signs and executive functions between Toxocara-seropositive and seronegative groups in children with attention-deficit/hyperactivity disorder. METHODS The study included 60 boys with ADHD, aged 7-12. After blood samples were taken, the Stroop Color Word Test and Judgment of Line Orientation test (JLOT) were implemented to measure executive functions. Neurological soft signs were evaluated with Physical and Neurological Examination for Subtle Signs (PANESS). RESULTS Serological tests were positive for Toxocara antibodies in 20 cases. There was no significant difference between Toxocara seropositive and seronegative regarding age, socioeconomic status, developmental stages, and ADHD severity. However, Toxocara-seropositive children had higher Stroop time and Stroop interference scores and lower JLOT scores than Toxocara-seronegative children. Furthermore, Toxocara-seropositive children exhibited more neurological soft signs, such as gait and station abnormalities, dysrhythmia, and a longer total time in timed movements compared to Toxocara-seronegative children. CONCLUSION Our study indicates a link between Toxocara-seropositivity and impaired neurological soft signs and executive functions in ADHD. Further research is needed to understand ADHD mechanisms, develop practical treatments considering immunological factors, and thoroughly evaluate how Toxocara seropositivity affects executive functions and motor skills in children with ADHD.
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Affiliation(s)
- Mustafa Tolga Tunagur
- Sakarya University Training and Research Hospital, Child and Adolescent Psychiatry, Sakarya, Turkiye.
| | - Hatice Aksu
- Aydın Adnan Menderes University, Child and Adolescent Psychiatry, Aydın, Turkiye
| | - Evren Tileklioğlu
- Aydın Adnan Menderes University, Department of Parasitology, Aydın, Turkiye
| | - Hatice Ertabaklar
- Aydın Adnan Menderes University, Department of Parasitology, Aydın, Turkiye
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Izquierdo-Condoy JS, Vásconez-Gonzáles J, Morales-Lapo E, Tello-De-la-Torre A, Naranjo-Lara P, Fernández R, Hidalgo MR, Escobar A, Yépez VH, Díaz AM, Oliva C, Ortiz-Prado E. Beyond the acute phase: a comprehensive literature review of long-term sequelae resulting from infectious diseases. Front Cell Infect Microbiol 2024; 14:1293782. [PMID: 38357446 PMCID: PMC10864624 DOI: 10.3389/fcimb.2024.1293782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Infectious diseases have consistently served as pivotal influences on numerous civilizations, inducing morbidity, mortality, and consequently redirecting the course of history. Their impact extends far beyond the acute phase, characterized by the majority of symptom presentations, to a multitude of adverse events and sequelae that follow viral, parasitic, fungal, or bacterial infections. In this context, myriad sequelae related to various infectious diseases have been identified, spanning short to long-term durations. Although these sequelae are known to affect thousands of individuals individually, a comprehensive evaluation of all potential long-term effects of infectious diseases has yet to be undertaken. We present a comprehensive literature review delineating the primary sequelae attributable to major infectious diseases, categorized by systems, symptoms, and duration. This compilation serves as a crucial resource, illuminating the long-term ramifications of infectious diseases for healthcare professionals worldwide. Moreover, this review highlights the substantial burden that these sequelae impose on global health and economies, a facet often overshadowed by the predominant focus on the acute phase. Patients are frequently discharged following the resolution of the acute phase, with minimal long-term follow-up to comprehend and address potential sequelae. This emphasizes the pressing need for sustained vigilance, thorough patient monitoring, strategic health management, and rigorous research to understand and mitigate the lasting economic and health impacts of infectious diseases more fully.
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Tunali V, Korkmaz M. Emerging and Re-Emerging Parasitic Infections of the Central Nervous System (CNS) in Europe. Infect Dis Rep 2023; 15:679-699. [PMID: 37987400 PMCID: PMC10660548 DOI: 10.3390/idr15060062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/12/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023] Open
Abstract
In a rapidly evolving global landscape characterized by increased international travel, migration, and ecological shifts, this study sheds light on the emergence of protozoal and helminthic infections targeting the central nervous system (CNS) within Europe. Despite being traditionally associated with tropical regions, these infections are progressively becoming more prevalent in non-endemic areas. By scrutinizing the inherent risks, potential outcomes, and attendant challenges, this study underscores the intricate interplay between diagnostic limitations, susceptibility of specific population subsets, and the profound influence of climate fluctuations. The contemporary interconnectedness of societies serves as a conduit for introducing and establishing these infections, warranting comprehensive assessment. This study emphasizes the pivotal role of heightened clinician vigilance, judicious public health interventions, and synergistic research collaborations to mitigate the potential consequences of these infections. Though rare, their profound impact on morbidity and mortality underscores the collective urgency required to safeguard the neurological well-being of the European populace. Through this multifaceted approach, Europe can effectively navigate the complex terrain posed with these emergent infections.
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Affiliation(s)
- Varol Tunali
- Department of Parasitology, Faculty of Medicine, Manisa Celal Bayar University, 45030 Manisa, Turkey
- Department of Emergency Medicine, Izmir Metropolitan Municipality Eşrefpaşa Hospital, 35170 Izmir, Turkey
| | - Metin Korkmaz
- Department of Parasitology, Faculty of Medicine, Ege University, 35100 Izmir, Turkey;
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Beltagi AE, Elsotouhy A, Al-warqi A, Aker L, Ahmed M. Imaging features of fulminant cerebral malaria: A case report. Radiol Case Rep 2023; 18:3642-3647. [PMID: 37593329 PMCID: PMC10432143 DOI: 10.1016/j.radcr.2023.06.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 08/19/2023] Open
Abstract
Cerebral malaria is associated with high mortality and morbidity in patients infected with Plasmodium Falciparum. The mechanisms of cerebral malaria include sequestration of parasitized red blood cells in brain capillaries, production of cytokines, immune cell/platelet accumulation, and release of microparticles, resulting in disruption of the blood-brain barrier, which caused brain injuries. The severity of this reflects on neurological findings ranging from simple delirium to profound coma. We herein present unique magnetic resonance imaging findings of a case of fulminant cerebral malaria as computed tomography studies usually underestimate the extent of cerebral involvement in malaria.
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Affiliation(s)
- Ahmed El Beltagi
- Neuroscience Institute, Department of Neuroradiology, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine (WCM), Clinical Imaging, Doha, Qatar
| | - Ahmed Elsotouhy
- Neuroscience Institute, Department of Neuroradiology, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine (WCM), Clinical Imaging, Doha, Qatar
| | - Akram Al-warqi
- Department of Radiology, Hamad General Hospital, Doha, Qatar
| | - Loai Aker
- Department of Radiology, Hamad General Hospital, Doha, Qatar
| | - Mayada Ahmed
- Weill Cornell Medicine (WCM), Clinical Imaging, Doha, Qatar
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Agrawal S, Garg A, Varshney V. Recent updates on applications of Lipid-based nanoparticles for site-specific drug delivery. Pharm Nanotechnol 2022; 10:24-41. [PMID: 35249522 DOI: 10.2174/2211738510666220304111848] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/07/2022] [Accepted: 01/25/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Site-specific drug delivery is a widespread and demanding area nowadays. Lipid-based nanoparticulate drug delivery systems have shown promising effects for targeting drugs among lymphatic systems, brain tissues, lungs, and skin. Recently, lipid nanoparticles are used for targeting the brain via the mucosal route for local therapeutic effects. Lipid nanoparticles (LNPs) can help in enhancing the efficacy and lowering the toxicities of anticancer drugs to treat the tumors, particularly in lymph after metastases of tumors. LNPs contain a non-polar core that can improve the absorption of lipophilic drugs into the lymph node and treat tumors. Cellular uptake of drugs can also be enhanced using LNPs and therefore, LNPs are the ideal carrier for treating intracellular infections such as leishmaniasis, tuberculosis and parasitic infection in the brain, etc. Furthermore, specific surface modifications with molecules like mannose, or PEG could improve the macrophage uptake and hence effectively eradicate parasites hiding in macrophages. METHOD An electronic literature search was conducted to update the advancements in the field of site-specific drug delivery utilizing lipid-based nanoparticles. A search of the Scopus database (https://www.scopus.com/home.uri) was conducted using the following keywords: lipid-based nanoparticles; site specific delivery. CONCLUSION Solid lipid nanoparticles have shown site-specific targeted delivery to various organs including the liver, oral mucosa, brain, epidermis, pulmonary and lymphatic systems. These lipid-based systems showed improved bioavailability as well as reduced side effects. Therefore, the focus of this article is to review the recent research studies on LNPs for site-specific or targeting drug delivery.
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Affiliation(s)
- Shivanshu Agrawal
- Institute of Pharmaceutical Research, GLA University, Mathura-281406, U.P., India
| | - Anuj Garg
- Institute of Pharmaceutical Research, GLA University, Mathura-281406, U.P., India
| | - Vikas Varshney
- Institute of Pharmaceutical Research, GLA University, Mathura-281406, U.P., India
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Nava-Castro KE, Pavón L, Becerril-Villanueva LE, Ponce-Regalado MD, Aguilar-Díaz H, Segovia-Mendoza M, Morales-Montor J. Sexual Dimorphism of the Neuroimmunoendocrine Response in the Spleen during a Helminth Infection: A New Role for an Old Player? Pathogens 2022; 11:pathogens11030308. [PMID: 35335632 PMCID: PMC8955289 DOI: 10.3390/pathogens11030308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 02/05/2023] Open
Abstract
The interaction of the nervous, immune, and endocrine systems is crucial in maintaining homeostasis in vertebrates, and vital in mammals. The spleen is a key organ that regulates the neuroimmunoendocrine system. The Taenia crassiceps mouse system is an excellent experimental model to study the complex host–parasite relationship, particularly sex-associated susceptibility to infection. The present study aimed to determine the changes in neurotransmitters, cytokines, sex steroids, and sex-steroid receptors in the spleen of cysticercus-infected male and female mice and whole parasite counts. We found that parasite load was higher in females in comparison to male mice. The levels of the neurotransmitter epinephrine were significantly decreased in infected male animals. The expression of IL-2 and IL-4 in the spleen was markedly increased in infected mice; however, the expression of Interleukin (IL)-10 and interferon (IFN)-γ decreased. We also observed sex-associated differences between non-infected and infected mice. Interestingly, the data show that estradiol levels increased in infected males but decreased in females. Our studies provide evidence that infection leads to changes in neuroimmunoendocrine molecules in the spleen, and these changes are dimorphic and impact the establishment, growth, and reproduction of T. crassiceps. Our findings support the critical role of the neuroimmunoendocrine network in determining sex-associated susceptibility to the helminth parasite.
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Affiliation(s)
- Karen Elizabeth Nava-Castro
- Laboratorio de Biología y Química Atmosférica, Departamento de Ciencias Ambientales, Instituto de Ciencias de la Atmósfera y Cambio Climático, Universidad Nacional Autónoma de México, Ciudad de Mexico 04510, Mexico;
| | - Lenin Pavón
- Laboratory of Psychoimmunology, National Institute of Psychiatry “Ramón de la Fuente Muñiz”, Mexico City 14370, Mexico; (L.P.); (L.E.B.-V.)
| | - Luis Enrique Becerril-Villanueva
- Laboratory of Psychoimmunology, National Institute of Psychiatry “Ramón de la Fuente Muñiz”, Mexico City 14370, Mexico; (L.P.); (L.E.B.-V.)
| | - María Dolores Ponce-Regalado
- Centro Universitario de los Altos, Departamento de Ciencias de la Salud, Universidad de Guadalajara, Jalisco 47610, Mexico;
| | - Hugo Aguilar-Díaz
- Centro Nacional de Investigaciones Disciplinarias en Salud Animal e Inocuidad, Instituto Nacional de Investigaciones Forestales Agrícolas y Pecuarias (INIFAP), Morelos 50550, Mexico;
| | - Mariana Segovia-Mendoza
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico 00810, Mexico;
| | - Jorge Morales-Montor
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de Mexico 04510, Mexico
- Correspondence: ; Tel.: +52-55-5622-3854 or +52-55-5622-3732; Fax: +52-55-5622-3369
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Dasovic B, Ewa Borys, Schneck MJ. Granulomatous Diseases of the Central Nervous System. Curr Neurol Neurosci Rep 2022; 22:33-45. [PMID: 35138588 DOI: 10.1007/s11910-022-01173-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW To discuss the pathophysiology, key clinical features, necessary diagnostic evaluation, and current treatment regimens for granulomatous diseases of the central nervous system. RECENT FINDINGS The diagnosis and management of granulomatous disease of the central nervous system has been revolutionized by advances in diagnostic imaging. Nevertheless, tissue and/or cerebrospinal fluid (CSF) sampling remains necessary to establish the diagnosis in most cases. Establishing a specific diagnosis is critical because treatment selection needs to focus on the granulomatous process centering on either antibiotic or immunosuppressive agents. Particular for non-infectious granulomatous disease more aggressive immunotherapies may help in clinical outcome. There are multiple non-infectious and infectious etiologies for granulomatous disease of the central nervous system. Clinical manifestations result from local structural invasion of granulomas or granulomatous inflammation of the blood vessels and meninges. Rapid diagnosis and specific treatment is essential.
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Affiliation(s)
- Braden Dasovic
- Department of Neurology, Stritch School of Medicine, Loyola University Chicago, 2160 South First Avenue Maguire Building Suite 2700, Maywood, IL, 60153, USA
| | - Ewa Borys
- Department of Pathology, Stritch School of Medicine, Loyola University Chicago, 2160 South First Avenue Maguire Building Suite 2700, Maywood, IL, 60153, USA
| | - Michael J Schneck
- Department of Neurology, Stritch School of Medicine, Loyola University Chicago, 2160 South First Avenue Maguire Building Suite 2700, Maywood, IL, 60153, USA.
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8
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Greener M. Parasites and mental health. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2022. [DOI: 10.1002/pnp.733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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9
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Macháček T, Leontovyč R, Šmídová B, Majer M, Vondráček O, Vojtěchová I, Petrásek T, Horák P. Mechanisms of the host immune response and helminth-induced pathology during Trichobilharzia regenti (Schistosomatidae) neuroinvasion in mice. PLoS Pathog 2022; 18:e1010302. [PMID: 35120185 PMCID: PMC8849443 DOI: 10.1371/journal.ppat.1010302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/16/2022] [Accepted: 01/24/2022] [Indexed: 12/17/2022] Open
Abstract
Helminth neuroinfections represent serious medical conditions, but the diversity of the host-parasite interplay within the nervous tissue often remains poorly understood, partially due to the lack of laboratory models. Here, we investigated the neuroinvasion of the mouse spinal cord by Trichobilharzia regenti (Schistosomatidae). Active migration of T. regenti schistosomula through the mouse spinal cord induced motor deficits in hindlimbs but did not affect the general locomotion or working memory. Histological examination of the infected spinal cord revealed eosinophilic meningomyelitis with eosinophil-rich infiltrates entrapping the schistosomula. Flow cytometry and transcriptomic analysis of the spinal cord confirmed massive activation of the host immune response. Of note, we recorded striking upregulation of the major histocompatibility complex II pathway and M2-associated markers, such as arginase or chitinase-like 3. Arginase also dominated the proteins found in the microdissected tissue from the close vicinity of the migrating schistosomula, which unselectively fed on the host nervous tissue. Next, we evaluated the pathological sequelae of T. regenti neuroinvasion. While no demyelination or blood-brain barrier alterations were noticed, our transcriptomic data revealed a remarkable disruption of neurophysiological functions not yet recorded in helminth neuroinfections. We also detected DNA fragmentation at the host-schistosomulum interface, but schistosomula antigens did not affect the viability of neurons and glial cells in vitro. Collectively, altered locomotion, significant disruption of neurophysiological functions, and strong M2 polarization were the most prominent features of T. regenti neuroinvasion, making it a promising candidate for further neuroinfection research. Indeed, understanding the diversity of pathogen-related neuroinflammatory processes is a prerequisite for developing better protective measures, treatment strategies, and diagnostic tools.
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Affiliation(s)
- Tomáš Macháček
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
| | - Roman Leontovyč
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
| | - Barbora Šmídová
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
| | - Martin Majer
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
| | - Oldřich Vondráček
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
| | - Iveta Vojtěchová
- National Institute of Mental Health, Klecany, Czechia
- Laboratory of Neurophysiology of Memory, Institute of Physiology of the Czech Academy of Sciences, Prague, Czechia
| | - Tomáš Petrásek
- National Institute of Mental Health, Klecany, Czechia
- Laboratory of Neurophysiology of Memory, Institute of Physiology of the Czech Academy of Sciences, Prague, Czechia
| | - Petr Horák
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
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10
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Pettersson SD, Ali S, Burmaka P, Fercho J, Szmuda T, Abuhaimed A, Alotaibi Y, Słoniewski P, Krakowiak M. Predictors for complete surgical resection of posterior fossa neurenteric cysts: A case report and meta-analysis. Surg Neurol Int 2021; 12:530. [PMID: 34754580 PMCID: PMC8571428 DOI: 10.25259/sni_723_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/16/2021] [Indexed: 11/04/2022] Open
Abstract
Background Incomplete resection of neurenteric cysts (NCs) has been associated with increased recurrence rates in patients compared to complete resection (CR) and information on intracranial NCs appearance on diagnostic imaging is scarce. We sought to identify factors associated with CR and provide the largest up-to-date review of NCs appearances on various diagnostic images. Methods Data from Medline, EMBASE, and Web of Science were extracted. Univariate and multivariate logistic regression models were used to analyze factors associated with CR. Results A total of 120 publications reporting 162 original cases on posterior fossa NCs met the inclusion criteria for analysis. Eighty-nine (55.6%) of the patients were female, the mean (SD) age of the patients' during operation was 34.3 (16.9) years, and CR was achieved in 98 (60%) of patients. Univariate analysis identified male sex as a statistically significant predictor for complete reaction (OR 2.13, 95% Cl 1.10-4.11, P = 0.02). The retrosigmoid approach (OR 1.89, 95% Cl 0.98-3.63, P = 0.06), far lateral approach (OR 0.46, 95% Cl 0.21-1.02, P = 0.06), and pediatric patient (OR 2.45, 95% Cl 0.94-6.56, P = 0.07) may be possible predictors for CR, however, they were not statistically significant. NCs are mainly hypodense on CT (32 [61.5%]), varied greatly in intensity on T1WI, hyperintense on T2WI magnetic resonance imaging (98 [67.1%]), and hyperintense on fluid-attenuated inversion recovery (17 [63.0%]). Conclusion We recommend utilizing various diagnostic imaging tests to help reduce misdiagnoses when identifying intracranial NCs. For patient safety, CR should be achieved when possible, to reduce risk of additional operations due to recurrence.
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Affiliation(s)
- Samuel D Pettersson
- Department of Neurosurgery, Scientific Circle of Neurology and Neurosurgery, Pomeranian Voivodeship, Poland
| | - Shan Ali
- Department of Neurosurgery, Scientific Circle of Neurology and Neurosurgery, Pomeranian Voivodeship, Poland
| | - Pavlo Burmaka
- Department of Neurosurgery, Scientific Circle of Neurology and Neurosurgery, Pomeranian Voivodeship, Poland
| | - Justyna Fercho
- Department of Neurosurgery, Scientific Circle of Neurology and Neurosurgery, Pomeranian Voivodeship, Poland
| | - Tomasz Szmuda
- Department of Neurosurgery, Medical University of Gdansk, Gdansk, Pomeranian Voivodeship, Poland
| | - Ahmed Abuhaimed
- Department of Neurosurgery, Scientific Circle of Neurology and Neurosurgery, Pomeranian Voivodeship, Poland
| | - Yazeed Alotaibi
- Department of Neurosurgery, Scientific Circle of Neurology and Neurosurgery, Pomeranian Voivodeship, Poland
| | - Paweł Słoniewski
- Department of Neurosurgery, Medical University of Gdansk, Gdansk, Pomeranian Voivodeship, Poland
| | - Michał Krakowiak
- Department of Neurosurgery, Medical University of Gdansk, Gdansk, Pomeranian Voivodeship, Poland
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Álvarez-Hernández DA, García-Rodríguez-Arana R, Ortiz-Hernández A, Álvarez-Sánchez M, Wu M, Mejia R, Martínez-Juárez LA, Montoya A, Gallardo-Rincon H, Vázquez-López R, Fernández-Presas AM. A systematic review of historical and current trends in Chagas disease. Ther Adv Infect Dis 2021; 8:20499361211033715. [PMID: 34408874 PMCID: PMC8365018 DOI: 10.1177/20499361211033715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 07/01/2021] [Indexed: 01/15/2023] Open
Abstract
Introduction Chagas disease (CD) is caused by Trypanosoma cruzi. When acquired, the disease develops in stages. For diagnosis, laboratory confirmation is required, and an extensive assessment of the patient's health should be performed. Treatment consists of the administration of trypanocidal drugs, which may cause severe adverse effects. The objective of our systematic review was to analyze data contained in the CD published case reports to understand the challenges that patients and clinicians face worldwide. Materials and methods We performed a systematic review following the PRISMA guidance. PubMed database was explored using the terms 'American trypanosomiasis' or 'Chagas disease'. Results were limited to human case reports written in English or Spanish. A total of 258 reports (322 patients) were included in the analysis. Metadata was obtained from each article. Following this, it was analyzed to obtain descriptive measures. Results From the sample, 56.2% were males and 43.8% were females. Most cases were from endemic countries (85.4%). The most common clinical manifestations were fever during the acute stage (70.0%), dyspnea during the chronic stage in its cardiac form (53.7%), and constipation during the chronic stage in its digestive form (73.7%). Most patients were diagnosed in the chronic stage (72.0%). Treatment was administered in 56.2% of cases. The mortality rate for the acute stage cases was 24.4%, while for the chronic stage this was 28.4%. Discussion CD is a parasitic disease endemic to Latin America, with increasing importance due to human and vector migration. In this review, we report reasons for delays in diagnosis and treatment, and trends in medical practices. Community awareness must be increased to improve CD's diagnoses; health professionals should be appropriately trained to detect and treat infected individuals. Furthermore, public health policies are needed to increase the availability of screening and diagnostic tools, trypanocidal drugs, and, eventually, vaccines.
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Affiliation(s)
| | | | - Alejandro Ortiz-Hernández
- Faculty of Health Sciences, Autonomous University of San Luis Potosi, Centro, San Luis Potosi, Mexico
| | - Mariana Álvarez-Sánchez
- Faculty of Health Sciences, Anahuac University Mexico - North Campus, Huixquilucan, Mexico State, Mexico
| | - Meng Wu
- Department of Infectious Diseases, Rheumatology & Infectious Diseases PLLC, Houston, TX, USA
| | - Rojelio Mejia
- Laboratory of Human Parasitology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Alejandra Montoya
- Department of Digital Health, Carlos Slim Foundation, Miguel Hidalgo, Mexico City, Mexico
| | - Héctor Gallardo-Rincon
- Direction of Operational Solutions, Carlos Slim Foundation, Miguel Hidalgo, Mexico City, Mexico
| | - Rosalino Vázquez-López
- Faculty of Health Sciences, Anahuac University Mexico - North Campus, Huixquilucan, Mexico State, Mexico
| | - Ana-María Fernández-Presas
- Faculty of Health Sciences, Anahuac University Mexico - North Campus, Huixquilucan, Mexico State, Mexico
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Neurologic Manifestations of Systemic Disease: Seizure. Curr Treat Options Neurol 2020. [DOI: 10.1007/s11940-020-00638-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Abstract
Infections of the central nervous system cause significant morbidity and mortality in immunocompetent and immunocompromised individuals. A wide variety of microorganisms can cause infections, including bacteria, mycobacteria, fungi, viruses, and parasites. Although less invasive testing is preferred, surgical biopsy may be necessary to collect diagnostic tissue. Histologic findings, including special stains and immunohistochemistry, can provide a morphologic diagnosis in many cases, which can be further classified by molecular testing. Correlation of molecular, culture, and other laboratory results with histologic findings is essential for an accurate diagnosis, and to minimize false positives from microbial contamination.
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Affiliation(s)
- Isaac H Solomon
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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14
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Kulanthaivelu K, Bhat MD, Prasad C, Srinivas D, Mhatre R, Nandeesh BN. Brain MRI Findings in Coenurosis: A Helminth Infection. J Neuroimaging 2020; 30:359-369. [PMID: 32072723 DOI: 10.1111/jon.12696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Parasitic neuroinfections in humans have etiological agents spanning a broad spectrum from unicellular (protozoan) to multicellular helminthic (metazoan) organisms. Cerebral coenurosis is a rare cestodal helminthic infection caused by Taenia multiceps. The neuroimaging features of this entity were reviewed to discern an imaging phenotype. METHODS Retrospective analysis was performed on 6 cases of cerebral coenurosis, whose diagnoses were confirmed by histopathology. The clinical, imaging, and histopathological features were recorded for analysis. RESULTS Clinical expressions included focal neurological deficit due to mass effect (n = 4), intraventricular obstruction with features of raised intracranial tension (n = 1), headache (n = 3), seizures (n = 3), and incidental lesions (n = 1). One patient presented with recurrence 1 year after surgical excision. Neuroimaging revealed cystic thin-walled lesions with clustered eccentric internal nodules corresponding to the plenitude of protoscolices of the tapeworm. Three of the lesions showed a multilocular cystic morphology. Spectroscopic metabolite signature of alanine and succinate commensurate with the parasitic etiology was remarkable in the lesions. Enhancement and edema inversely correlated with the signal suppression on fluid-attenuated inversion recovery (FLAIR) imaging. The lesions had a predominantly juxtacortical distribution. CONCLUSIONS In an appropriate clinical setting, a cystic lesion with clustered eccentric internal nodular foci ought to raise the suspicion of this rare infection. Magnetic resonance spectroscopic signature of succinate and alanine, if present, further strengthens the likelihood of coenurosis. Signal characteristics, wall enhancement, and perilesional edema may vary, possibly determined by the stage in the evolution of the parasite.
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Affiliation(s)
- Karthik Kulanthaivelu
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India, (KK, MDB, CP)
| | - Maya D Bhat
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India, (KK, MDB, CP)
| | - Chandrajit Prasad
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India, (KK, MDB, CP)
| | - Dwarakanath Srinivas
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India, (DS)
| | - Radhika Mhatre
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India, (RM, BNN)
| | - Bevinhalli N Nandeesh
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India, (RM, BNN)
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15
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Zhou H, Chen Z, Limpanont Y, Hu Y, Ma Y, Huang P, Dekumyoy P, Zhou M, Cheng Y, Lv Z. Necroptosis and Caspase-2-Mediated Apoptosis of Astrocytes and Neurons, but Not Microglia, of Rat Hippocampus and Parenchyma Caused by Angiostrongylus cantonensis Infection. Front Microbiol 2020; 10:3126. [PMID: 32038563 PMCID: PMC6989440 DOI: 10.3389/fmicb.2019.03126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 12/24/2019] [Indexed: 01/18/2023] Open
Abstract
Infection with the roundworm Angiostrongylus cantonensis is the main cause of eosinophilic meningitis worldwide. The underlying molecular basis of the various pathological outcomes in permissive and non-permissive hosts infected with A. cantonensis remains poorly defined. In the present study, the histology of neurological disorders in the central nervous system (CNS) of infected rats was assessed by using hematoxylin and eosin staining. Quantitative reverse transcription polymerase chain reaction (RT-qPCR), western blot and immunofluorescence (IF) were used in evolutions of the transcription and translation levels of the apoptosis-, necroptosis-, autophagy-, and pyroptosis-related genes. The distribution of apoptotic and necroptotic cells in the rat hippocampus and parenchyma was further detected using flow cytometry, and the features of the ultrastructure of the cells were examined by transmission electron microscopy (TEM). The inflammatory response upon CNS infection with A. cantonensis evolved, as characterized by the accumulation of a small number of inflammatory cells under the thickened meninges, which peaked at 21 days post-infection (dpi) and returned to normal by 35 dpi. The transcription levels and translation of caspase-2, caspase-8, RIP1 and RIP3 increased significantly at 21 and 28 dpi but decreased sharply at 35 dpi compared to those in the normal control group. However, the changes in the expression of caspase-1, caspase-3, caspase-11, Beclin-1 and LC3B were not obvious, suggesting that apoptosis and necroptosis but not autophagy or pyroptosis occurred in the brains of infected animals at 21 and 28 dpi. The results of RT-qPCR, western blot analysis, IF, flow cytometry and TEM further illustrated that necroptosis and caspase-2-mediated apoptosis occurred in astrocytes and neurons but not in microglia in the parenchyma and hippocampus of infected animals. This study provides the first evidence that neuronal and astrocytic necroptosis and caspase-2-mediated apoptosis are induced by A. cantonensis infection in the parenchymal and hippocampal regions of rats at 21 and 28 dpi but these processes are negligible at 35 dpi. These findings enhance our understanding of the pathogenesis of A. cantonensis infection and provide new insights into therapeutic approaches targeting the occurrence of cell death in astrocytes and neurons in infected patients.
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Affiliation(s)
- Hongli Zhou
- Joint Program of Pathobiology, The Fifth Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, China
| | - Zhe Chen
- Joint Program of Pathobiology, The Fifth Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, China
| | - Yanin Limpanont
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Yue Hu
- Joint Program of Pathobiology, The Fifth Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, China
| | - Yubin Ma
- Joint Program of Pathobiology, The Fifth Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, China
| | - Ping Huang
- Joint Program of Pathobiology, The Fifth Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, China
| | - Paron Dekumyoy
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Minyu Zhou
- Joint Program of Pathobiology, The Fifth Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, China
| | - Yixin Cheng
- Joint Program of Pathobiology, The Fifth Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, China
| | - Zhiyue Lv
- Joint Program of Pathobiology, The Fifth Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, China
- Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
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16
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Deigendesch N, Schlüter D, Siebert E, Stenzel W. [Infections of the central nervous system by protozoa, helminths and fungi]. DER NERVENARZT 2019; 90:623-641. [PMID: 31073673 DOI: 10.1007/s00115-019-0719-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A plethora of different parasites and fungi can lead to infections of the central nervous system (CNS) and cause different clinical symptoms and outcomes depending on the pathogen and the anatomic location of the infection. The diagnosis and treatment of these eukaryotic infections is challenging. The prevalence of CNS infections depends on many factors, including geographical location, living conditions, genetic background and the immune status of the individual. In Germany, infections of the CNS by fungi and parasites are rare but can lead to considerable morbidity. Some parasitic and fungal CNS infections are becoming increasingly more prevalent and clinically relevant due to the increasing number of immunocompromised people. Case fatality rates of these infections, which are difficult to diagnose and to treat, are high. This article provides an overview of a subjective selection of parasitic and fungal infections of the CNS relevant to clinical practice in Germany and presents the diagnostic and therapeutic options.
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Affiliation(s)
- Nikolaus Deigendesch
- Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Schönbeinstraße 40, 4031, Basel, Schweiz.
| | - Dirk Schlüter
- Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - Eberhard Siebert
- Institut für Neuroradiologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Werner Stenzel
- Institut für Neuropathologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
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17
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Brummaier T, Bertschy S, Arn K, Treumann T, Ruf MT, Nickel B, Paris DH, Neumayr A, Blum J. A blind passenger: a rare case of documented seroconversion in an Angiostrongylus cantonensis induced eosinophilic meningitis in a traveler visiting friends and relatives. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2019; 5:6. [PMID: 31016026 PMCID: PMC6466724 DOI: 10.1186/s40794-019-0084-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/08/2019] [Indexed: 01/11/2023]
Abstract
Background Eosinophilic meningitis (EOM) is a rare condition that is caused by various communicable and non-communicable factors. The rat-lungworm Angiostrongylus cantonensis, which is associated with consumption of raw or undercooked paratenic or intermediate hosts, is the most common cause of parasitic eosinophilic meningitis worldwide. While the majority of A. cantonensis cases are reported from endemic regions, cases in travelers pose a challenge to clinicians in non-endemic countries. Here we report a rare case of eosinophilic meningitis caused by A. cantonensis in a Swiss traveler who was diagnosed after returning from Thailand. Case presentation A 33-year old woman with a travel history to rural north-eastern Thailand presented to an emergency department in Switzerland with severe headache and vomiting. Eosinophilic meningitis was confirmed as the cause of the symptoms; however, serologic investigations failed to confirm an A. cantonensis infection on the first evaluation. Nevertheless, empirical treatment with an anthelminthic and steroid regimen led to a rapid alleviation of symptoms. Repeated serology confirmed seroconversion 2 weeks after treatment initiation. Discussion Parasitic etiology must be considered in returning travelers who present with symptoms compatible with a central nervous system infection. A thorough medical history, including types of food consumed, is paramount and can often suggest differential diagnosis. Neuroangiostrongyliasis is rare and might be missed if serology does not cover possible seroconversion.
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Affiliation(s)
- Tobias Brummaier
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland.,3Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.,4Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, UK
| | - Sonja Bertschy
- 5Department of Infectiology, Luzerner Kantonsspital, Luzern, Switzerland
| | - Kornelius Arn
- 6Division of Hematology and Hematology Laboratory, Luzerner Kantonsspital, Luzern, Switzerland
| | - Thomas Treumann
- 7Division of Nuclear Medicine and Radiology, Luzerner Kantonsspital, Luzern, Switzerland
| | - Marie-Therese Ruf
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Beatrice Nickel
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Daniel H Paris
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Andreas Neumayr
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Johannes Blum
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland
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18
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Fungal and Parasitic Infections. Clin Neuroradiol 2019. [DOI: 10.1007/978-3-319-68536-6_47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Fungal and Parasitic Infections. Clin Neuroradiol 2019. [DOI: 10.1007/978-3-319-61423-6_47-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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20
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Freddi T, de Godoy LL, Goncalves FG, Alves CA, Hanagandi P. Fungal and Parasitic Infections. Clin Neuroradiol 2019. [DOI: 10.1007/978-3-319-61423-6_47-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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21
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Saporta-Keating SR, Simões EAF, Yu G, Federman S, Mirsky D, Dominguez SR, Chiu CY, Messacar K. A Child With Intermittent Headaches and Eosinophilic Meningitis. J Pediatric Infect Dis Soc 2018; 7:355-357. [PMID: 29438532 PMCID: PMC6276032 DOI: 10.1093/jpids/piy005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sara R Saporta-Keating
- Division of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
| | - Eric A F Simões
- Department of Epidemiology, Colorado School of Public Health, Aurora
| | - Guixia Yu
- Department of Laboratory Medicine, University of California San Francisco
- University of California San Francisco–Abbott Viral Diagnostics and Discovery Center
| | - Scot Federman
- Department of Laboratory Medicine, University of California San Francisco
- University of California San Francisco–Abbott Viral Diagnostics and Discovery Center
| | - David Mirsky
- Department of Radiology, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
| | - Samuel R Dominguez
- Division of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
| | - Charles Y Chiu
- Department of Laboratory Medicine, University of California San Francisco
- University of California San Francisco–Abbott Viral Diagnostics and Discovery Center
- Division of Infectious Diseases, Department of Medicine, University of California San Francisco
| | - Kevin Messacar
- Division of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
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22
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Parkhouse RME, Carpio A, Campoverde A, Sastre P, Rojas G, Harrison LJS, Cortez MM. A modified lateral flow assay, using serum, for the rapid identification of human and bovine cysticercosis in the absence of false positives. Trans R Soc Trop Med Hyg 2018; 113:101-104. [DOI: 10.1093/trstmh/try116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/25/2018] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Arturo Carpio
- Escuela de Medicina, Universidad de Cuenca, Av. 12 de Abril y Av. Loja. Cuenca, Ecuador
- GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Alfredo Campoverde
- Escuela de Medicina, Universidad de Cuenca, Av. 12 de Abril y Av. Loja. Cuenca, Ecuador
| | | | - Glenda Rojas
- Escuela de Bioanálisis, Facultad de Ciencias de la Salud, Edo. Aragua. Universidad de Carabobo, Maracay, Venezuela
- Instituto de Investigaciones Biomédicas ‘Dr. Francisco J. Triana-Alonso’ Facultad de Ciencias de la Salud, Edo. Aragua. Universidad de Carabobo, Venezuela
| | - Leslie J S Harrison
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian, Scotland, UK
| | - Maria Milagros Cortez
- Instituto de Investigaciones Biomédicas ‘Dr. Francisco J. Triana-Alonso’ Facultad de Ciencias de la Salud, Edo. Aragua. Universidad de Carabobo, Venezuela
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23
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Stewart A, Hunt R, Mitchell R, Muhawenimana V, Wilson CAME, Jackson JA, Cable J. The cost of infection: Argulus foliaceus and its impact on the swimming performance of the three-spined stickleback ( Gasterosteus aculeatus). J R Soc Interface 2018; 15:rsif.2018.0571. [PMID: 30355808 DOI: 10.1098/rsif.2018.0571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/04/2018] [Indexed: 11/12/2022] Open
Abstract
For fish, there can be multiple consequences of parasitic infections, including the physical impacts on swimming and the pathological costs of infection. This study used the three-spined stickleback (Gasterosteus aculeatus) and the ectoparasitic fish louse, Argulus foliaceus, to assess both physical (including form drag and mass) and pathological effects of infection. Both sustained (prolonged swimming within an open channel flume) and burst (C-start) swimming performance were measured on individual fish before (trials 1-2) and after infection (trials 3-5). Experimental infection occurred shortly before the third trial, when the physical impacts of infection could be separated from any subsequent pathology as transmission of adult parasites causes instantaneous drag effects prior to observable pathology. Despite the relatively large size of the parasite and corresponding increase in hydrodynamic drag for the host, there were no observable physical effects of infection on either sustained or burst host swimming. By contrast, parasite-induced pathology is the most probable explanation for reduced swimming performance across both tests. All sticklebacks displayed a preference for flow refugia, swimming in low-velocity regions of the flume, and this preference increased with both flow rate and infection time. This study suggests that even with large, physically demanding parasites their induced pathology is of greater concern than direct physical impact.
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Affiliation(s)
- A Stewart
- School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK
| | - R Hunt
- School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK
| | - R Mitchell
- School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK
| | - V Muhawenimana
- School of Engineering, Cardiff University, Cardiff CF24 3AA, UK
| | - C A M E Wilson
- School of Engineering, Cardiff University, Cardiff CF24 3AA, UK
| | - J A Jackson
- School of Environment and Life Sciences, University of Salford, Salford M5 4WX, UK
| | - J Cable
- School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK
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24
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Carpio A, Fleury A, Romo ML, Abraham R. Neurocysticercosis: the good, the bad, and the missing. Expert Rev Neurother 2018. [DOI: 10.1080/14737175.2018.1451328] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Arturo Carpio
- Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca, Ecuador
- G.H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Agnès Fleury
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma, Ciudad de México, México
- Secretaría de Salud, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
| | - Matthew L. Romo
- Department of Epidemiology & Biostatistics and Institute for Implementation Science in Population Health, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Ronaldo Abraham
- Departamento de Medicina, Universidade de Taubaté, São Paulo, Brazil
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25
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Parkhouse RME, Carpio A, Campoverde A, Sastre P, Rojas G, Cortez MM. Reciprocal contribution of clinical studies and the HP10 antigen ELISA for the diagnosis of extraparenchymal neurocysticercosis. Acta Trop 2018; 178:119-123. [PMID: 29155204 DOI: 10.1016/j.actatropica.2017.11.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/03/2017] [Accepted: 11/15/2017] [Indexed: 11/19/2022]
Abstract
To evaluate diagnosis of active neurocysticercosis, paired cerebral spinal fluid (CSF) and serum samples from 24 neurocysticercosis (NCC) patients and 17 control neurological patients were assayed in the HP10 Taenia antigen (Ag) ELISA. The CSF samples were also tested with an HP10 Lateral Flow Assay (LFA). The HP10 Ag was detected by ELISA in the CSF of 5/5 patients with Definitive extraparenchymal NCC, and in 4/5 of the corresponding sera. In the Definitive parenchymal group, on the other hand, the HP10 Ag was absent in 2/3 CSF (with a very low value in the one positive sample) and all the corresponding serum samples. Samples of CSF from 4/7 patients in the Probable parenchymal group, were also significantly HP10 Ag positive, suggesting the presence of extraparenchymal cysts not identified by the imaging studies. With the possible exception of one patient, the corresponding serum samples of the Probable parenchymal NCC group, were all HP10 Ag negative. Samples of CSF from 9 NCC patients diagnosed with Mixed parenchymal and extraparenchymal NCC were all significantly HP10 Ag positive, confirming the presence of extraparenchymal cysts, with only 7/9 of the corresponding serum samples being HP10 positive. Thus detection of the HP10 Ag indicates extraparenchymal and not parenchymal cyst localization and is more sensitive with CSF than serum. Three neurological patients clinically diagnosed as subarachnoid cyst, hydrocephalus and tuberculoma, respectively, were clearly positive for HP10 Ag. Of these, two were confirmed as NCC by subsequent imaging; the third died prior to further examination. Thus, a total of 8 patients had their clinical diagnosis questioned. Finally, there was good agreement between the HP10 Ag ELISA and LFA with CSF samples giving an optical density ≥0.4 in the ELISA assay. In conclusion, the HP10 Ag assay should provide a valuable and reciprocal tool in the clinical diagnosis and follow up of extraparenchymal NCC.
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Affiliation(s)
- R Michael E Parkhouse
- Institute Gulbenkian de Ciência, Rua da Quinta Grande, 6, 2780-156 Oeiras, Portugal.
| | - Arturo Carpio
- Escuela de Medicina, Universidad de Cuenca, Cuenca, Av. 12 de Abril y Av. Loja, Ecuador; GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
| | - Alfredo Campoverde
- Escuela de Medicina, Universidad de Cuenca, Cuenca, Av. 12 de Abril y Av. Loja, Ecuador.
| | | | - Glenda Rojas
- Escuela de Bioanálisis, Facultad de Ciencias de la Salud, Edo. Aragua. Universidad de Carabobo, Venezuela; Instituto de investigaciones Biomédicas "Dr. Francisco J. Triana-Alonso" Facultad de Ciencias de la Salud, Edo. Aragua. Universidad de Carabobo, Venezuela.
| | - María Milagros Cortez
- Instituto de investigaciones Biomédicas "Dr. Francisco J. Triana-Alonso" Facultad de Ciencias de la Salud, Edo. Aragua. Universidad de Carabobo, Venezuela.
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26
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Gripper LB, Welburn SC. Neurocysticercosis infection and disease-A review. Acta Trop 2017; 166:218-224. [PMID: 27880878 DOI: 10.1016/j.actatropica.2016.11.015] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/15/2016] [Accepted: 11/15/2016] [Indexed: 10/20/2022]
Abstract
Neurocysticercosis (NCC) is the most common parasitic disease of the human central nervous system (CNS), a pleomorphic disease with a diverse array of clinical manifestations. The infection is pleomorphic and dependent on a complex range of interconnecting factors, including number and size of the cysticerci, their stage of development and localisation within the brain with resulting difficulties in accurate diagnosis and staging of the disease. This review examines the factors that contribute to the accurate assessment of NCC distribution and transmission that are critical to achieving robust disease burden calculations. Control and prevention of T. solium transmission should be a key priority in global health as intervention can reduce the substantial healthcare and economic burdens inflicted by both NCC and taeniasis. Surveillance systems need to be better established, including implementing obligatory notification of cases. In the absence of reliable estimates of its global burden, NCC will remain-along with other endemic zoonoses, of low priority in the eyes of funding agencies-a truly neglected disease.
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27
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Carpio A, Campoverde A, Romo ML, García L, Piedra LM, Pacurucu M, López N, Aguilar J, López S, Vintimilla LC, Toral AM, Peña-Tapia P. Validity of a PCR assay in CSF for the diagnosis of neurocysticercosis. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2017; 4:e324. [PMID: 28105460 PMCID: PMC5241005 DOI: 10.1212/nxi.0000000000000324] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/07/2016] [Indexed: 12/01/2022]
Abstract
Objective: To prospectively evaluate the validity of a PCR assay in CSF for the diagnosis of neurocysticercosis (NC). Methods: We conducted a multicenter, prospective case-control study, recruiting participants from 5 hospitals in Cuenca, Ecuador, from January 2015 to February 2016. Cases fulfilled validated diagnostic criteria for NC. For each case, a neurosurgical patient who did not fulfill the diagnostic criteria for NC was selected as a control. CT and MRI, as well as a CSF sample, were collected from both cases and controls. The diagnostic criteria to identify cases were used as a reference standard. Results: Overall, 36 case and 36 control participants were enrolled. PCR had a sensitivity of 72.2% (95% confidence interval [CI] 54.8%–85.8%) and a specificity of 100.0% (95% CI 90.3%–100.0%). For parenchymal NC, PCR had a sensitivity of 42.9% (95% CI 17.7%–71.1%), and for extraparenchymal NC, PCR had a sensitivity of 90.9% (95% CI 70.8%–98.9%). Conclusions: This study demonstrated the usefulness of this PCR assay in CSF for the diagnosis of NC. PCR may be particularly helpful for diagnosing extraparenchymal NC when neuroimaging techniques have failed. Classification of evidence: This study provides Class III evidence that CSF PCR can accurately identify patients with extraparenchymal NC.
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Affiliation(s)
- Arturo Carpio
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Alfredo Campoverde
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Matthew L Romo
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Lorena García
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Luis M Piedra
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Mónica Pacurucu
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Nelson López
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Jenner Aguilar
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Sebastian López
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Luis C Vintimilla
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Ana M Toral
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
| | - Pablo Peña-Tapia
- Facultad de Ciencias Médicas (A. Carpio, A. Campoverde, L.G., L.M.P.), Universidad de Cuenca, Ecuador; GH Sergievsky Center (A. Carpio), College of Physicians and Surgeons, Columbia University; Department of Epidemiology and Biostatistics (M.L.R.), CUNY Graduate School of Public Health and Health Policy, City University of New York, NY; Hospital del Instituto Ecuatoriano de Seguridad Social (L.M.P., N.L.), José Carrasco Arteaga; Hospital Vicente Corral Moscoso (M.P., J.A.), Ministerio de Salud Pública; Hospital Santa Inés (S.L.); Clínica Santa Ana (L.C.V.); and Hospital Universitario del Río (A.M.T., P.P.-T.), Cuenca, Ecuador
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Fleury A, Sastre P, Sciutto E, Correia S, Monedero A, Toledo A, Hernandez M, Harrison LJS, Parkhouse RME. A lateral flow assay (LFA) for the rapid detection of extraparenchymal neurocysticercosis using cerebrospinal fluid. Exp Parasitol 2016; 171:S0014-4894(16)30277-6. [PMID: 27983954 DOI: 10.1016/j.exppara.2016.10.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 09/13/2016] [Accepted: 10/26/2016] [Indexed: 12/01/2022]
Abstract
A lateral flow assay (LFA) for the diagnosis and monitoring of extraparenchymal neurocysticercosis, has been developed. The assay is based on the use of the monoclonal antibody HP10, and when applied to cerebrospinal fluid, correctly identified 34 cases of active extraparenchymal neurocysticercosis, but was negative with 26 samples from treated and cured neurocysticercosis patients and with 20 samples from unrelated neurological diseases. There was complete agreement between the HP10 Ag-ELISA results and the HP10-LFA. The HP10-LFA thus has utility for diagnosis and treatment of extraparenchymal neurocysticercosis, frequently a more dangerous form of the infection.
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Affiliation(s)
- Agnes Fleury
- Unidad de Neuroinflamación (Instituto de Investigaciones Biomédicas-UNAM, Instituto Nacional de Neurología y Neurocirugia, Facultad de Médicina-UNAM), Insurgentes Sur 3877, Colonia La Fama, delegación Tlalpan, Mexico D.F, Mexico; Neurocysticercosis Clinic, Instituto Nacional de Neurología y Neurocirugia, Mexico D.F, Mexico.
| | - Patricia Sastre
- Inmunología y Genética Aplicada S.A. (INGENASA), C/Hermanos García Noblejas 39, 28037 Madrid, Spain.
| | - Edda Sciutto
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México D.F. 04510, Mexico.
| | - Silvia Correia
- Instituto Gulbenkian de Ciência, 2780-156, Oeiras, Portugal.
| | - Alejandro Monedero
- Inmunología y Genética Aplicada S.A. (INGENASA), C/Hermanos García Noblejas 39, 28037 Madrid, Spain.
| | - Andrea Toledo
- Unidad de Neuroinflamación (Instituto de Investigaciones Biomédicas-UNAM, Instituto Nacional de Neurología y Neurocirugia, Facultad de Médicina-UNAM), Insurgentes Sur 3877, Colonia La Fama, delegación Tlalpan, Mexico D.F, Mexico.
| | - Maricela Hernandez
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México D.F. 04510, Mexico.
| | - Leslie J S Harrison
- University of Edinburgh, Royal (Dick) School of Veterinary Science, Easter Bush Veterinary Centre, Easter Bush, ROSLIN, Midlothian, EH259RG Scotland, UK.
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29
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Affiliation(s)
| | | | - Robert H Gilman
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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