Conceptual issues in trichotillomania, a prototypical impulse control disorder.
To evaluate the efficacy of anthelmintic treatment of Enterobius vermicularis in highly endemic population, total 82 children in two orphanage institutes were divided into 4 groups and treated with placebo, 5 mg/kg of pyrvinium pamoate, 100 mg of mebendazole and 10 mg/kg of pyrantel pamoate respectively. Total 4 anal swabs were taken from each child before treatment and the even distributions of positive rate and consecutive results between groups were considered. Follow-up swabs were taken 8 times up to the 40th day after treatment. After remarkable and significant reduction of positive rates up to 19-27th day after treatment in respective groups, the remarkable egg positive conversions were observed 3-4 weeks after treatment. The positive conversion was the earliest and the most remarkable in pyrantel-treated children and the slowest and the least remarkable in mebendazole-treated cases. Also found was that the figures of negative conversion were different with statistical significance between two categories of cases, consecutively positive and alternately positive cases of pre-treatment swabs. This means that the conventional indices of cure rate in E. vermicularis infection may be variable by the selection of subjected cases. Above results mean that the spectrum of susceptible pinworms according to the developmental stages are different between currently available drugs, and the ability to remove pinworms completely in certain developmental stage are also different between chemotherapeutics. These results suggest the need of interval chemotherapy of Enterobius vermicularis infection in heavily infected cases of in highly endemic population to achieve the complete eradication of whole range of pinworms in intestine.
Two human cases of infection with Lagochilascaris are described from Colombia. One patient was a 21 year-old woman who suffered from repeated attacks of tonsillitis and passage of worms from the nose. When a tonsillectomy was performed, numerous worms were found in the tissues. Treatment with thiabendazole and mebendazole was ineffective. She was cured after treatment with levamisole. The second patient was a 7 year-old girl who had a painful abscess on the neck that contained adult worms. She was also cured of this infection after treatment with levamisole. These are the first cases described from Colombia, and bring the total number of human cases recorded to twenty-three.
We report a case of Hymenolepis diminuta infection in a 2-year-old child living in a suburban area of Catania, Italy. This case was initially referred to us as Dipylidium caninum infection, which was not cured after being treated twice with mebendazole. However, by analyzing the clinical presentation and stool samples we arrived to the diagnosis of H. diminuta infection. The case presented with atypical allergic manifestations which had never been reported as clinical features of symptomatic H. diminuta infection; remittent fever with abdominal pain, diffuse cutaneous itching, transient thoracic rash, and arthromyalgias. The patient was treated with a 7-day cycle of oral niclosamide, which proved to be safe and effective. This case report emphasizes that a correct parasitological diagnosis requires adequate district laboratories and trained personnel. In addition, we recommend the importance of reporting all H. diminuta infection cases, in order to improve knowledge on epidemiology, clinical presentation, and treatment protocols.
The time course of the disease and present knowledge concerning the pathogenic mechanisms of HSP suggest that Strongyloides stercoralis infection could have caused HSP in the presented patient, which was complicated by nephritis.
Mebendazole (MBZ) is extensively used in eel culture for treatment of Pseudodactylogyrus spp. infections. This use may lead to residues of MBZ in eel tissues. Consequently, the residue profile of MBZ in eel after treatment with the drug is of special concern. Therefore, a residue study was performed in European eels (Anguilla anguilla), bath-treated with MBZ at a dose of 1 mg/liter for 24 hr and kept at a water temperature of 25 degrees C. Liver, kidney, fat, skin, and muscle tissues samples were collected at intervals during and after treatment and analyzed for MBZ and its metabolites, hydroxy-MBZ (MBZ-OH) and amino-MBZ (MBZ-NH2), by HPLC. Results showed that MBZ is extensively metabolized to MBZ-OH and MBZ-NH2. Liver and kidney were found to contain the highest levels of MBZ metabolites, and fat contained the highest levels of the parent compound. Skin contained higher residue levels for all three compounds, compared with muscle tissue. MBZ and its hydroxy metabolite were eliminated within 5 days from the edible parts (muscle and skin) of the eels, whereas MBZ-NH2 could be detected by the 14th day after the end of the treatment period. Consequently, although MBZ and MBZ-OH constitute the residues of toxicological concern, MBZ-NH2 should be taken as the compound of interest for estimating the withdrawal time for consumption of eel treated with MBZ.