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Nasser Alsharif S, Saleh Alshamrani A, Hadi Asiri D, Yahya Al-Mani S. A Rare Abdominal Pain Associated With Chronic Intestinal Schistosomiasis Diagnosed Endoscopically: A Case Study From Saudi Arabia. Cureus 2024; 16:e58614. [PMID: 38770490 PMCID: PMC11103049 DOI: 10.7759/cureus.58614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Chronic intestinal schistosomiasis (CIS) refers to the long-term effects of infection with Schistosoma parasites in the intestines. This condition typically develops after repeated or prolonged exposure to contaminated freshwater containing Schistosoma eggs. The current study reports a case of an adult male, who complained of abnormal abdominal and anal pain for a month and had a medical history of complex perianal fistulae. The endoscopic investigation revealed different degrees of hyperemia, concentrated in the sigmoid colon and rectum. Lesions were localized in the rectum and sigmoid colon. Yellow granular hyperplasia, whether concentrated or dispersed, single or multiple polyps, along with observations of mucosal congestion, edema, faint vascular striations, erosions, superficial ulcers, and scattered petechial hemorrhages were noted. Also, the segmented areas of the colon had different degrees of inflammation. The microscopic histopathological analysis showed a culprit of surgical scar tissue. The granulomas harbored Schistosome parasites at the submucosal depth. Also, an erosion in the colonic mucosal tissues accompanied by lymphoplasmacytic and micro-abscess infiltrates was seen. A Schistosoma bilharzial ova was observed in the granuloma at the submucosal level. Endoscopic and histopathological investigations are useful tools to differentiate between CIS and Crohn's disease. These tools can distinguish CIS from Crohn's disease. Early detection and treatment are essential to prevent the progression of the disease and minimize long-term complications.
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Affiliation(s)
- Saeed Nasser Alsharif
- Gastroenterology, Armed Forces Hospital - Southern Region (AFHSR), Khamis Mushait, SAU
| | - Ali Saleh Alshamrani
- Gastroenterology, Armed Forces Hospital - Southern Region (AFHSR), Khamis Mushait, SAU
| | - Dawlah Hadi Asiri
- Internal Medicine, Armed Forces Hospital - Southern Region (AFHSR), Khamis Mushait, SAU
| | - Salihah Yahya Al-Mani
- Internal Medicine, Armed Forces Hospital - Southern Region (AFHSR), Khamis Mushait, SAU
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Gosadi IM. Epidemiology of communicable diseases in Jazan region: Situational assessment, risk characterization, and evaluation of prevention and control programs outcomes. Saudi Med J 2023; 44:1073-1084. [PMID: 37926461 PMCID: PMC10712780 DOI: 10.15537/smj.2023.44.11.20230269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
The incidence of communicable diseases has witnessed a reduction in Saudi Arabia during the last 4 decades. Nonetheless, the Jazan region has been indicated as one of the main regions affected by various communicable conditions. The geographical, socioeconomic, and climate characteristics of Jazan have made it vulnerable to communicable and vector-borne diseases. This review aims to provide a comprehensive overview of the epidemiology of communicable diseases in Jazan, Saudi Arabia. This review also gives a historical description of infectious diseases in the region and the relevant prevention and control measures. Prevention and control efforts in the Jazan region successfully eliminated Rift Valley fever and reduced the number of locally acquired malaria and chickenpox cases. Hepatitis B, dengue fever, and pulmonary tuberculosis have exhibited an increased incidence in recent years, suggesting a need for further epidemiological investigations and the application of relevant prevention and control measures.
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Affiliation(s)
- Ibrahim M Gosadi
- From the Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
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3
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Bocanegra C, Álvarez-Martínez MJ, Arsuaga Vicente M, Belhassen-García M, Chamorro Tojeiro S, Camprubí-Ferrer D, Fernández Soto P, García Vázquez E, Herrador Ortiz Z, Martín O, Muro A, Pérez Arellano JL, Reguera Gómez M, Salas-Coronas J, Salvador F, Sotillo Gallego J, Sulleiro E, Torrús Tendero D, Velasco Arribas M, Rodríguez Guardado A. Executive summary consensus statement of imported diseases group (GEPI) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Tropical Medicine and International Health (SETMSI), on the diagnostic and treatment of imported schistosomiasis. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:505-512. [PMID: 37230838 DOI: 10.1016/j.eimce.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/08/2023] [Indexed: 05/27/2023]
Abstract
Schistosomiasis is a highly prevalent disease, especially in immigrant populations, and is associated with significant morbidity and diagnostic delays outside endemic areas. For these reasons, the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Tropical Medicine and International Health (SEMTSI) have developed a joint consensus document to serve as a guide for the screening, diagnosis and treatment of this disease outside endemic areas. A panel of experts from both societies identified the main questions to be answered and developed recommendations based on the scientific evidence available at the time. The document was reviewed by the members from both societies for final approval.
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Affiliation(s)
- Cristina Bocanegra
- Unidad de Medicina Tropical y Salud Internacional Vall d'Hebron-Drassanes, PROSICS Barcelona, Servicio de Enfermedades Infecciosas Hospital Universitario Vall d'Hebron, Spain
| | - Miriam J Álvarez-Martínez
- Servicio de Microbiología, Hospital Clínic de Barcelona, Departamento de Fundamentos Clínicos, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, ISGlobal, Spain
| | - Marta Arsuaga Vicente
- Unidad de Patología Importada y Salud Internacional (CSUR), Unidad de Alto Aislamiento, CIBERINFEC, Hospital La Paz-Carlos III, Madrid, Spain
| | - Moncef Belhassen-García
- Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital Universitario de Salamanca, Centro de Investigación en Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Sandra Chamorro Tojeiro
- Unidad de Referencia Nacional para Enfermedades Tropicales, Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, IRYCIS, CIBERINFEC, Spain
| | | | - Pedro Fernández Soto
- Grupo Enfermedades Infecciosas y Tropicales (e-INTRO), Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (IBSAL-CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Elisa García Vázquez
- Unidad de Enfermedades Infecciosas, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB, Facultad de Medicina, Universidad de Murcia, Spain
| | | | - Oihane Martín
- Servicio de Microbiología y Parasitología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Antonio Muro
- Grupo de Investigación Enfermedades Infecciosas y Tropicales (e-INTRO), IBSAL, CIETUS, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - José Luis Pérez Arellano
- Universidad de las Palmas de Gran Canaria, Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Insular de Gran Canaria, Spain
| | - Marta Reguera Gómez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
| | - Joaquín Salas-Coronas
- Unidad de Medicina Tropical, Hospital Universitario Poniente El Ejido, Almería, Spain
| | - Fernando Salvador
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Sotillo Gallego
- Laboratorio de Referencia e Investigación en Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Spain
| | - Elena Sulleiro
- Servicio de Microbiología, Hospital Vall d́Hebron, Barcelona, CIBERINFEC, ISCIII, Universitat Autònoma de Barcelona, Spain
| | - Diego Torrús Tendero
- Unidad de Referencia de Enfermedades Importadas y Salud Internacional, Unidad de Enfermedades Infecciosas, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Área de Parasitología, Universidad Miguel Hernández, Spain
| | - María Velasco Arribas
- Sección Infecciosas y Medicina Tropical, Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain
| | - Azucena Rodríguez Guardado
- Área de Gestión Clínica Medicina Interna, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.
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Abstract
PURPOSE OF REVIEW Pulmonary hypertension is a deadly disease, the causes of which vary between geographical regions. Eighty four percentage of the world's population lives in majority countries (also called low-income and middle-income countries), yet data on pulmonary hypertension in these settings are proportionally scarce. This article provides a review of pulmonary hypertension in majority countries, focusing in detail on the most common causes in these regions, and highlights contextual challenges faced. RECENT FINDINGS Epidemiological data confirms a complex and overlapping array of causes, with pulmonary hypertension because of conditions such as rheumatic heart disease, HIV, schistosomiasis, chronic lung disease and sickle cell disease. Delayed pulmonary hypertension diagnosis remains a concern and is ascribed to a lack of resources and lack of pulmonary hypertension awareness by health professionals. Pulmonary hypertension diagnosis is frequently considered once signs of right heart failure emerge, while echocardiography and right heart catheterization are unavailable in many settings. Accurate data on the prevalence of pulmonary hypertension in many of these regions are needed and could be achieved by establishing and frequent review of national databases where the incident and prevalent pulmonary hypertension cases are captured. SUMMARY There is urgent need for pulmonary hypertension advocacy among clinicians in the primary, secondary and tertiary healthcare sectors of majority countries, and validated noninvasive diagnostic algorithms are needed. Increased awareness and early diagnosis are likely to improve outcomes of pulmonary hypertension patients in these regions, and potentially stimulate locally relevant research.
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Idrees M, Butrous G, Mocumbi A, Sastry B, Ibrahim A, Alobaidallah K, Hassan A, Farghaly AA, Yacoub M. Pulmonary hypertension in the developing world: Local registries, challenges, and ways to move forward. Glob Cardiol Sci Pract 2020; 2020:e202014. [PMID: 33150158 PMCID: PMC7590932 DOI: 10.21542/gcsp.2020.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/30/2020] [Indexed: 12/11/2022] Open
Abstract
Pulmonary hypertension (PH) is a disease that can only be appropriately managed in the ‘rich’ developed countries, as both diagnostic and therapeutic interventions are extremely expensive and expectations for these to be adopted by the developing, economically-challenged countries are neither practical nor realistic. Furthermore, most of the enormous advances in understanding the pathobiology of PH and the subsequent evidence-based diagnostic and complex treatment algorithms came from the developed world.
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Affiliation(s)
- Majdy Idrees
- Division of Pulmonary Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | | | - Ana Mocumbi
- Instituto Nacional de Saúde Vila de Marracuene, Maputo, Mozambique
| | | | - Ahmed Ibrahim
- Division of Pulmonary Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Khalid Alobaidallah
- Division of Pulmonary Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ahmed Hassan
- Aswan Heart Center, Aswan, Egypt
- Cardiology Department, Cairo University, Cairo, Egypt
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Kassa B, Mickael C, Kumar R, Sanders L, Koyanagi D, Hernandez-Saavedra D, Tuder RM, Graham BB. Paclitaxel blocks Th2-mediated TGF-β activation in Schistosoma mansoni-induced pulmonary hypertension. Pulm Circ 2018; 9:2045894018820813. [PMID: 30511588 PMCID: PMC6304706 DOI: 10.1177/2045894018820813] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Schistosomiasis is a leading cause of pulmonary hypertension (PH) worldwide.
Recent studies reveal that the type-2 immune cytokines IL-4 and IL-13, as well
as consequent activation of TGF-β, are key factors in the pathogenesis of
Schistosoma-PH. Paclitaxel has been reported to act as an
adjuvant for Th2 inflammation while downregulating TGF-β activation. Moreover,
paclitaxel blocks PH in monocrotaline and SU5416-hypoxia models. We hypothesized
that paclitaxel would augment Th2 inflammation while blocking TGF-β activation
and PH after schistosomiasis exposure. Wild-type mice (C57BL6/J; 6/group) were
intraperitoneally (IP) sensitized and then intravenously (IV) challenged with
Schistosoma mansoni eggs. One day after IV egg challenge,
the mice were treated with a single IP dose of 25 mg/kg paclitaxel or vehicle.
Right ventricular (RV) catheterization was performed and granuloma volumes and
vascular remodeling were quantified. Lung cytokines were quantified by ELISA and
reverse transcription polymerase chain reaction, and the quantity of active
TGF-β was determined using a cell reporter line. We also investigated
hypoxia-induced PH. Paclitaxel treatment significantly protected mice from
Schistosoma-PH, with decreased RV systolic pressure
(P = 0.005) and pulmonary vascular media thickness.
Inflammation was significantly suppressed, contrary to our hypothesis, with
decreased IL-4 and IL-13 levels, smaller granulomas, and less active TGF-β
following paclitaxel treatment. There was no change in IFN-γ or FoxO1 or FoxO3
expression. Paclitaxel did not suppress chronic hypoxia-induced PH, which is
also TGF-β-driven but independent of type-2 immunity. Paclitaxel protects
against Schistosoma-induced PH in mice, although by blocking
proximate Th2 inflammation rather than suppressing distal TGF-β activation.
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Affiliation(s)
- Biruk Kassa
- Program in Translational Lung Research, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Claudia Mickael
- Program in Translational Lung Research, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Rahul Kumar
- Program in Translational Lung Research, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Linda Sanders
- Program in Translational Lung Research, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dan Koyanagi
- Program in Translational Lung Research, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Daniel Hernandez-Saavedra
- Program in Translational Lung Research, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Rubin M Tuder
- Program in Translational Lung Research, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Brian B Graham
- Program in Translational Lung Research, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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7
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Identification of Biomarkers for Schistosoma-Associated Pulmonary Arterial Hypertension Based on RNA-Seq Data of Mouse Whole Lung Tissues. Lung 2017; 195:377-385. [DOI: 10.1007/s00408-017-9999-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 01/09/2017] [Indexed: 12/25/2022]
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Al-Moamary MS, Alhaider SA, Idrees MM, Al Ghobain MO, Zeitouni MO, Al-Harbi AS, Yousef AA, Al-Matar H, Alorainy HS, Al-Hajjaj MS. The Saudi Initiative for Asthma - 2016 update: Guidelines for the diagnosis and management of asthma in adults and children. Ann Thorac Med 2016; 11:3-42. [PMID: 26933455 PMCID: PMC4748613 DOI: 10.4103/1817-1737.173196] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 12/08/2015] [Indexed: 12/21/2022] Open
Abstract
This is an updated guideline for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of SINA is to have guidelines that are up to date, simple to understand and easy to use by nonasthma specialists, including primary care and general practice physicians. SINA approach is mainly based on symptom control and assessment of risk as it is the ultimate goal of treatment. The new SINA guidelines include updates of acute and chronic asthma management, with more emphasis on the use of asthma control in the management of asthma in adults and children, inclusion of a new medication appendix, and keeping consistency on the management at different age groups. The section on asthma in children is rewritten and expanded where the approach is stratified based on the age. The guidelines are constructed based on the available evidence, local literature, and the current situation in Saudi Arabia. There is also an emphasis on patient-doctor partnership in the management that also includes a self-management plan.
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Affiliation(s)
- Mohamed S. Al-Moamary
- Department of Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sami A. Alhaider
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Majdy M. Idrees
- Department of Medicine, Pulmonary Division, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammed O. Al Ghobain
- Department of Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed O. Zeitouni
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Adel S. Al-Harbi
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdullah A. Yousef
- Department of Pediatrics, College of Medicine, University of Dammam, Dammam, Saudi Arabia
| | - Hussain Al-Matar
- Department of Medicine, Imam Abdulrahman Al Faisal Hospital, Dammam, Saudi Arabia
| | - Hassan S. Alorainy
- Department of Respiratory Care, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohamed S. Al-Hajjaj
- Department of Medicine, Respiratory Division, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Abstract
Proper and early identification of patients who harbor serious occult illness is the first step in developing a disease-management strategy. Identification of illnesses through the use of noninvasive techniques provides assurance of patient safety and is ideal. PA dilation is easily measured noninvasively and is due to a variety of conditions, including pulmonary hypertension (PH). The clinician should be able to thoroughly assess the significance of PA dilation in each individual patient. This involves knowledge of the ability of PA dilation to accurately predict PH, understand the wide differential diagnosis of causes of PA dilation, and reverse its life-threatening complications. We found that although PA dilation is suggestive of PH, data remain inconclusive regarding its ability to accurately predict PH. At this point, data are insufficient to place PA dilation into a PH risk-score equation. Here we review the causes and complications of PA dilation, define normal and abnormal PA measurements, and summarize the data linking its association to PH, while suggesting an algorithm designed to assist clinicians in patient work-up after recognizing PA dilation.
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