Reviews on trichinellosis (III): cardiovascular involvement

Cardiovascular complaints represent the most important complications of trichinellosis and are particularly evident in the moderate and severe courses of the disease. An overview of 17 epidemiological studies on trichinellosis (including 5268 cases) indicated that cardiovascular events occurred in 26% of patients (range: 1.5%-75%). This narrative systematic review focuses exclusively on the cardiovascular involvement of trichinellosis and includes a brief overview and analysis of selected cases reported in the literature. Our primary goal was to increase the awareness of infectious diseases specialists, cardiologists, and general practitioners about these major complications and their possible fatal outcomes. To our knowledge, this is the first international review of this topic. Eighty-nine cases were detailed enough to allow pooled analysis (in terms of sex, age, source of infection, clinical characteristics, outcome, and routine laboratory parameters). The mean age of the analyzed group was 36.8±14.7 years (range: 3-80), with most cases in the age group of 18-29 years (25.8%, n=23). Males slightly predominated (53.9%), and pork was responsible for 91.2% of the infections. Electrocardiographic (ECG) changes represented the most common findings (80.9%). The mean eosinophil count was 25.9%±18.9% (range: 1-76). Heart failure significantly predominated in patients who died (p=0.047), whereas ECG abnormalities were reported more frequently in those who made complete recovery (p<0.0001). Because of their life-threatening character (our systematic analysis detected a case fatality ratio of 22.5%), we believe that cardiovascular complications must be considered in any patient suspected or diagnosed with trichinellosis. At the same time, practitioners should be able to establish the correct diagnosis in a timely manner and to make the best decision toward the management of these cases. Additionally, public health services located in endemic regions must be perpetually aware of this condition and must implement efficient prophylactic measures.     

Reviews on trichinellosis (I): renal involvement

Besides cardiac and neurological complications of trichinellosis, renal involvement is the most important as regards the cases published and discussed in literature and is generally characteristic of the severe forms of the disease. This article focuses exclusively on the renal disturbances that may occur in this parasitic illness and includes a synopsis of published cases. Our primary goal was to increase the awareness of infectious diseases specialists, nephrologists, and general practitioners about these complications with possible fatal outcome. To our knowledge, this is the first international review dedicated to this topic. Cases for which enough details were available have been analyzed, and the results indicated that the mean age of the affected patients was 31.6 years, with a slightly male predominance (56.2%). The fatality rate was 26.1%. Proteinuria was detected in 84.8% of cases, hematuria in 30.4%, and casts were observed in urine specimens from 23.9% of patients. Renal failure was evidenced in 8.7% of patients, whereas renal lesions were found by biopsy or necropsy in 43.5% of cases. Of the routine laboratory parameters that are relevant for trichinellosis, mean eosinophil count was 32.2% and mean leukocyte count was 17,312 cells/μL. Finally, we emphasize on the necessity of establishing an early and correct diagnosis of trichinellosis to avoid later and severe complications. Additionally, implementation of public health and food safety prophylactic measures against the disease must represent an immediate priority for the affected regions.     

Reviews on trichinellosis (IV): hepatic involvement

Trichinella sp. larvae are released from the intestine and usually migrate through the liver into the general circulation. Nevertheless, hepatic involvement does not represent a leading feature of human trichinellosis. This narrative systematic review focuses exclusively on hepatic complications of trichinellosis and includes a brief overview and analysis of selected cases reported in the literature. Our major goals were to gather important data to understand the substrate of trichinous liver injury and to provide helpful clinical hints for practitioners. To our knowledge, this is the first international review dedicated to this topic. Thirty two cases were detailed enough to allow pooled analysis. The mean age of the analyzed group was 30.5±17 years old with most cases aged 19 to 29 years (29%). Hepatomegaly was noticed in 34.4% of cases, hypoalbuminemia in 40.6%, and hypoproteinemia in 34.4%. Our systematic analyses demonstrated that hepatic complications were mainly evidenced in fatal cases of trichinellosis (65.6%). The most frequent necroptic findings were parenchymatous and/or fatty degeneration of the liver (59.4%). Although less discussed in the literature than other complications, hepatic involvement should be considered more carefully because of its significant consequences on protein metabolism and liver function. Difficult to be revealed intra vitam, hepatic involvement may represent an additional concern to the classical clinical picture of trichinellosis and other life-threatening complications, especially in severe cases of infection. Consequently, physicians should be aware of any possible liver involvement to ensure adequate management of their patients.     

Epidemiological research on trichinellosis in Apulia and Basilicata (Southern Italy)

Trichinellosis is a zoonotic infection and has a worldwide distribution. In Italy numerous sporadic cases and outbreaks of human trichinellosis have been reported. The authors report an epidemiological survey of trichinellosis in Apulia and Basilicata, two regions of southern Italy, where two outbreaks of human trichinellosi (about one hundred cases) have recently occurred, due to ingestion of wild boar meat (sausages). Serological and/or parasitological research was carried out in the trichinellosis patients, in uninfected people (control group), and in wild and synantropic animals. The incidence of infection found in various animal species (sylvatic trichinellosis) in these two regions is high and can represent a serious health risk.     

Occupational relevance of alcohol related neurological involvement

BACKGROUND AND OBJECTIVES: Accidents and various degrees of impairment in working performances and abilities are strongly correlated to alcohol consumption, either of moderate or of severe degree. Accidents, in particular, have been investigated in population studies that strongly suggest a direct effect of alcohol on attention and executive functions as well as a relevant interference of drinking with the neurological functioning and with eventual subclinical dysfunction of individuals: epilepsy threshold, cardiovascular risk and previous events, sleep disorders; post-traumatic sequelae. DISCUSSION AND CONCLUSIONS: Impairment of cognitive function (and concomitant functional/structural brain damage) is characterized, in particular, by difficulties in abstract problem solving, visuo-spatial and verbal learning, memory function, perceptual and motor skills, related to disruption of frontal, pontocerebellar and cerebellothalamocortical systems. These abilities should therefore be monitored in at-risk working populations in order to prevent work accidents and to address appropriate therapeutic and rehabilitative interventions.     

Current knowledge on human trichinellosis

Until the beginning of the nineties, the control of trichinellosis was thought to be a solved problem in Europe. However, as a consequence of social, economical and ecological changes in Central Eastern and Eastern Europe in the past decade, trichinellosis became a re-emerging infectious disease in the region. Molecular genetic studies demonstrated that at least two Trichinella species can be responsible for trichinellosis outbreaks in the region, and the epidemiology of trichinellosis is more complex than previously thought. Although Trichinella spiralis has been successfully eradicated in Hungary, it was recently demonstrated that Trichinella britovi persists in the sylvatic cycle. In view of the considerable epidemiological changes in the region, the aim of this review is to summarise the current knowledge on the clinical aspects of human trichinellosis.     

Effect of surgery on neurological involvement caused by a lumbosacral radicular syndrome

Results of neurological assessment one year after surgical treatment of herniated lumbar intervertebral disc and lumbar stenosis are reported in 443 patients. Follow-up was performed during one year after operation. Preoperatively, surgeons found motor loss more frequently than patients, (28 and 12% respectively) and, postoperatively, motor loss was still present in 25% and 24%, respectively, of these cases. The operation had caused motor loss in 5% and aggravated motor loss in 3%. Sensibility was reported as abnormal one year after surgery by both patients and surgeons in one-third of the cases. Sensory loss, considered by the patient to have been caused or aggravated by the operation, occurred in 15% of the cases and in 12% of these the surgeons agreed. Preoperatively, unilaterally diminished knee and Achilles tendon reflexes were found in 9% and 42% respectively; one year after surgery, these had recovered in 65% and 57%, respectively. Surgery caused or aggravated unilaterally diminished knee or ankle jerks in 3% and 10%, respectively.     

Synthesis and characterization of new Pt(II) and Pd(II) complexes with 2-quinolinecarboxaldehyde selenosemicarbazone: cytotoxic activity evaluation of Cd(II), Zn(II), Ni(II), Pt(II) and Pd(II) complexes with heteroaromatic selenosemicarbazones

New complexes of Pt(II) and Pd(II) with 2-quinolinecarboxaldehyde selenosemicarbazone were synthesized and characterized by elemental analysis, NMR and IR spectroscopy and molar conductivity measurements. The assumed geometry of Pt(II) and Pd(II) complexes was square planar where the ligand was tridentately coordinated via the quinoline and imine nitrogen atoms and the selenium atom. The cytotoxic activity of the new Pt(II) and Pd(II) compounds, as well as of some previously synthesized Cd(II), Zn(II) and Ni(II) complexes with the same or analogous ligand, was tested against a panel of three human cancer cell lines: human cervix carcinoma cells (HeLa), human melanoma cells (FemX) and breast cancer cells (MDA-361). All investigated compounds, except Pt(II) complex, possess a strong dose-dependent cytotoxic activity of the same order of magnitude as cisplatin (CDDP). The investigation of potential of these compounds to induce HeLa cell cycle perturbations was also evaluated.     

The neurological assault on the great toe (1893-1911)

The late 19th/early 20th century heralded a period in neurology when there was claim and counter claim about the founders of new reflex movements of the great toe. The cutaneous plantar reflex is undoubtedly one of the most important signs in clinical neurology, and there have been several methods described of eliciting this sign, each with its own eponymous name. This article reviews the background to these claims and the contribution of the various authors, to the discovery, clinical relevance and ease of eliciting reflex movements of the great toe.     

Polychlorinated biphenyls (PCBs) and neurological development in children: a systematic review

BACKGROUND: Polychlorinated biphenyls (PCBs) are complex mixtures of persistent contaminants that are widespread in the environment. Newborns are exposed across the placenta and through breast feeding. Experimental animal studies have indicated that PCBs are neurotoxic. The neurological effects of these compounds on children are not clear. METHODS: A systematic review of literature on the relation between neurological development in children and exposure to polychlorinated biphenyls. RESULTS: Seven follow up studies evaluated the effect of prenatal exposure to PCBs. Two of these studies evaluated highly exposed children. In newborns, an increase of the abnormal reflexes was observed in all four studies evaluating it. During the first months of life, a decrease in motor skills was observed in four of the five studies that investigated psychomotor development; deficits in the acquisition of cognitive skills were observed only in one study assessing non-highly exposed populations. At 4 years of age, an effect on the cognitive areas was observed in four of the five studies that evaluated it. Postnatal exposure to PCBs through breast feeding was not clearly related to any effect on neurological development. CONCLUSIONS: These studies suggest a subtle adverse effect of prenatal PCBs exposure on child neurodevelopment. Differences in study design, inconsistency in some of the results, and the lack of adequate quantitative exposure data, do not allow the derivation of the degree of risk associated with neurodevelopmental effects at current levels of exposure.     

Synthesis and antitumor studies on novel Co(II), Ni(II) and Cu(II) metal complexes of bis(3-acetylcoumarin)thiocarbohydrazone

The synthesis, structure, physico-chemical investigation and biological studies of some metal complexes of thiocarbohydrazone ligands are described. The ligand is obtained by condensation of N,N'-thiocarbohydrazide with 3-acetylcoumarin. The metal complexes of Co(II), Ni(II) and Cu(II) with bis(3-acetylcoumarin)thiocarbohydrazone were synthesized and isolated as solid products and characterized by analytical means as well as by spectral techniques such as FT-IR, (1)H NMR and EPR and UV spectrometry. The ligand acts as bidentate, through NO or NN, neutral in coordinating the M(II) ions. The bonding sites are the azomethine nitrogen, lactone carbonyl oxygen and respective anion counterparts. The metal complexes exhibit either octahedral or distorted octahedral structures. The complexes are found to be soluble in dimethylformamide and dimethylsulphoxide. Molar conductance values in dimethylsulphoxide indicate the non-electrolytic nature of the complexes. The compounds tested in present study have shown promising cytotoxic activity when screened using the in vitro method and at the same time were shown to have good activity when tested using the Ehrlich Ascites Carcinoma model. Preliminary antimicrobial screening shows the promising results against both bacterial and fungal strains.     

A magnetic ion-imprinted polymer for lead(II) determination: A study on the adsorption of lead(II) by beverages

In this work a variety of beverage samples had been kept in a contaminated area to investigate their lead adsorption. To determine the adsorbed Pb(II), a novel magnetic lead ion-imprinted polymer, grafted onto Fe₃O₄ nanoparticles, was synthesized and used as a selective sorbent for the preconcentration of Pb(II) ions. The sorbent was characterized by different techniques. The synthesized sorbent was applied for highly accurate and selective determination of Pb(II) ions absorbed from polluted air in several beverages and results were compared. To validate the method, three certified reference materials were analyzed by the proposed method and the results showed that pre-concentrating by this sorbent and subsequent determination by flame atomic absorption spectroscopy is an accurate method for lead determination in beverage samples (recoveries higher than 95%). The limits of detection and the relative standard deviations were less than 1.7 μg kg⁻¹ and 4.1%, respectively. The sorption capacity of this new sorbent was 51.8 mg g⁻¹. Finally, this method was used for the determination of Pb(II) ions in polluted beverage samples, and the results revealed that under equal conditions, coffee exhibits more tendency to adsorb Pb(II) ions.