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Introduction: Hematopoietic stem cell transplantation (HSCT) is a vital treatment for various hematological disorders. However, HSCT recipients face increased risks of infectious complications due to immunosuppression. Parasitic infections are a significant concern in this vulnerable population and can lead to substantial morbidity and mortality. This review examines parasitic infections in HSCT recipients, focusing on major infections affecting different organ systems, including intestinal parasites (Giardia spp., Entamoeba histolytica, and Cryptosporidium spp.), hematologic parasites (Plasmodium spp. and Babesia spp.), and tissue/visceral parasites (Toxoplasma gondii, Leishmania spp., and Trypanosoma cruzi)., Methods: A systematic search of relevant literature was conducted and included studies up to August 2023. Databases included PubMed, Google Scholar, were queried using specific keywords related to parasitic infections in HSCT patients. The epidemiology, risk factors, clinical presentation, diagnostic methods, and treatment approaches for each infection were evaluated., Results and Conclusion: Knowing the epidemiology, risk factors, and clinical presentations are crucial for timely intervention and successful management. By emphasizing early detection, effective therapies, and the unique challenges posed by each of these infections, this review highlights the importance of tailored strategies for HSCT recipients. Future research can further refine management protocols to enhance care and outcomes for these patients., (© 2023 Wiley Periodicals LLC.)

Objective: To report the prevalence of polyparasitism during pregnancy in the Lambaréné region of Gabon and its association with newborn birth weight., Method: Pregnant women in their third trimester were recruited in a prospective study between November 2011 and March 2015. Parasite infection status was assessed microscopically in stool, urine and blood samples. Maternal demographic and obstetrical characteristics and newborns anthropometric data were collected. Multivariable logistic regression was used to assess the association between low birth weight and polyparasitism., Results: 678 of 927 pregnant women were included for analysis with mean age (SD) of 25 (6.8) years. The analysis showed that 69% (468/678) were infected with at least one parasite (Plasmodium spp., Schistosoma spp., soil-transmitted helminths, filarial infections). This comprised of 38% with monoparasitism and 31% polyparasitism. The proportion of newborn babies with a weight below 2500 g (LBW) in our study was 21% (142/678). Compared to pregnant women without infection, women with monoparasitic infection had adjusted Odds Ratio confidence interval 95% CI (aOR [95%CI]) of 1.6 [0.95-2.73], those with two parasites had aOR 95%CI of 2.63 [1.51-4.62], and those with more than two parasites had aOR of 5.08 [2.5-10.38] for delivering a newborn with low birth weight., Conclusion: In Lambaréné, an endemic area for multiple parasite infections, there is a high prevalence of polyparasitism in pregnant women. Polyparasitism is associated with low birth weight. Therefore, there is an urgent need for active screening and treatment of parasite infections in pregnant women to assess the potential public health benefit of such interventions., (© 2021 John Wiley & Sons Ltd.)

Corticosteroid use is increasing worldwide as recent studies confer survival benefit of corticosteroids in the management of patients with severe COVID-19. Strongyloides and amebic infections are neglected diseases that can progress to catastrophic complications in patients exposed to corticosteroids, even with short treatment courses. To prevent lethal outcomes, clinicians should be aware of the threat these two parasitic infections pose to at-risk patients receiving corticosteroids, especially in the era of COVID-19.

Climate change affects ecological processes and interactions, including parasitism. Because parasites are natural components of ecological systems, as well as agents of outbreak and disease-induced mortality, it is important to summarize current knowledge of the sensitivity of parasites to climate and identify how to better predict their responses to it. This need is particularly great in marine systems, where the responses of parasites to climate variables are less well studied than those in other biomes. As examples of climate's influence on parasitism increase, they enable generalizations of expected responses as well as insight into useful study approaches, such as thermal performance curves that compare the vital rates of hosts and parasites when exposed to several temperatures across a gradient. For parasites not killed by rising temperatures, some simple physiological rules, including the tendency of temperature to increase the metabolism of ectotherms and increase oxygen stress on hosts, suggest that parasites' intensity and pathologies might increase. In addition to temperature, climate-induced changes in dissolved oxygen, ocean acidity, salinity, and host and parasite distributions also affect parasitism and disease, but these factors are much less studied. Finally, because parasites are constituents of ecological communities, we must consider indirect and secondary effects stemming from climate-induced changes in host-parasite interactions, which may not be evident if these interactions are studied in isolation.

Climate change is expected to have complex effects on infectious diseases, causing some to increase, others to decrease, and many to shift their distributions. There have been several important advances in understanding the role of climate and climate change on wildlife and human infectious disease dynamics over the past several years. This essay examines 3 major areas of advancement, which include improvements to mechanistic disease models, investigations into the importance of climate variability to disease dynamics, and understanding the consequences of thermal mismatches between host and parasites. Applying the new information derived from these advances to climate-disease models and addressing the pressing knowledge gaps that we identify should improve the capacity to predict how climate change will affect disease risk for both wildlife and humans., Competing Interests: The authors have declared that no competing interests exist.

Objective: Parasitic diseases have created numerous health and economic problems in developing and developed countries. One of the most prevalent ways of transmitting diseases is by consuming raw vegetables that are contaminated with parasites. With respect to the importance of healthy vegetable consumption, an awareness of vegetable status helps prevent infection. Therefore, the present study was conducted to determine the level of parasitic contamination of vegetables consumed in Tehran., Methods: This descriptive and cross-sectional study was conducted on vegetable samples spread in Tehran from October 2017 to September 2018. The samples included 240 vegetables selected from 10 types of vegetable including leek, basil, mint, spring onion, radish, parsley, lettuce, cress, tarragon and coriander. Each sample was examined after passing through washing and centrifuging. Parasitic agents such as unicellular, egg and larva of the worms were studied. The data were analysed using SPSS software., Conclusion: Parasitic infection was observed in 62 samples (25.8%). The highest and lowest rates of contamination were observed in coriander and lettuce, respectively. Rhabditoid larva (12.5%; 15 cases) and Physaloptera egg (1.6%; 2 cases) were the most and least observed parasites, respectively. Other parasites such as Entamoeba, Giardia, Blastocystis, Hymenolepis, Ascaris and the egg and larva of hookworms were also observed. Despite the relative improvement of social, agricultural, economic and health conditions in Tehran, the prevalence of parasitic infections still persists. Factors such as developing modern waste collection methods, improving urban sewage systems, preventing domestic animal traffic on pastures and promoting the knowledge of different classes of people could reduce the prevalence of these types of diseases.

Parasitic diseases cause significant morbidity and mortality in the developing and underdeveloped countries. No efficacious vaccines are available against most parasitic diseases and there is a critical need for developing novel vaccine strategies for care. IL-21 is a pleiotropic cytokine whose functions in protection and immunopathology during parasitic diseases have been explored in limited ways. IL-21 and its cognate receptor, IL-21R, are highly expressed in parasitized organs of infected humans as well in murine models of the human parasitic diseases. Prior studies have indicated the ability of the IL-21/IL-21R signaling axis to regulate the effector functions (e.g., cytokine production) of T cell subsets by enhancing the expression of T-bet and STAT4 in human T cells, resulting in an augmented production of IFN-γ. Mice deficient for either IL-21 ( Il21 -/- ) or IL-21R ( Il21r -/- ) showed significantly reduced inflammatory responses following parasitic infections as compared with their WT counterparts. Targeting the IL-21/IL-21R signaling axis may provide a novel approach for the development of new therapeutic agents for the prevention of parasite-induced immunopathology and tissue destruction., (Copyright © 2019 Solaymani-Mohammadi, Eckmann and Singer.)

From 1 January 2018 came into force Regulation (EU) 2015/2238 of the European Parliament and of the Council of 25 November 2015, introducing the concept of "novel foods", including insects and their parts. One of the most commonly used species of insects are: mealworms (Tenebrio molitor), house crickets (Acheta domesticus), cockroaches (Blattodea) and migratory locusts (Locusta migrans). In this context, the unfathomable issue is the role of edible insects in transmitting parasitic diseases that can cause significant losses in their breeding and may pose a threat to humans and animals. The aim of this study was to identify and evaluate the developmental forms of parasites colonizing edible insects in household farms and pet stores in Central Europe and to determine the potential risk of parasitic infections for humans and animals. The experimental material comprised samples of live insects (imagines) from 300 household farms and pet stores, including 75 mealworm farms, 75 house cricket farms, 75 Madagascar hissing cockroach farms and 75 migrating locust farms. Parasites were detected in 244 (81.33%) out of 300 (100%) examined insect farms. In 206 (68.67%) of the cases, the identified parasites were pathogenic for insects only; in 106 (35.33%) cases, parasites were potentially parasitic for animals; and in 91 (30.33%) cases, parasites were potentially pathogenic for humans. Edible insects are an underestimated reservoir of human and animal parasites. Our research indicates the important role of these insects in the epidemiology of parasites pathogenic to vertebrates. Conducted parasitological examination suggests that edible insects may be the most important parasite vector for domestic insectivorous animals. According to our studies the future research should focus on the need for constant monitoring of studied insect farms for pathogens, thus increasing food and feed safety., Competing Interests: The authors have declared that no competing interests exist.

Hematopoietic stem cell transplantation (HSCT) recipients may infrequently develop parasitic infections at the time of the procedure via contamination from allograft tissue or blood products, and in the post-transplantation period through the traditional route of infection or as a reactivation caused by immunosuppression related to the transplant. To reduce risk, efforts should be directed at performing a comprehensive history, maintaining a high index of suspicion, and adhering to preventive measures. Additional strategies for the prevention, screening and careful follow-up, identification, and pre-emptive treatment of parasitic infections are required to reduce morbidity and mortality in HSCT patients., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Parasite taxonomy continues to change as molecular and morphologic studies enhance our understanding of parasite relatedness. This minireview builds on the information provided in the last taxonomy update in this journal to summarize new and revised clinically relevant human parasite taxonomic changes that have occurred in 2016 and 2017., (Copyright © 2019 American Society for Microbiology.)

OBJECTIVEAlthough parasitic infections are endemic to parts of the developing world and are more common in areas with developing economies and poor sanitary conditions, rare cases may occur in developed regions of the world.METHODSArticles eligible for the authors' literature review were initially searched using PubMed with the phrases "parasitic infections" and "spine." After the authors developed a list of parasites associated with spinal cord infections from the initial search, they expanded it to include individual diagnoses, using search terms including "neurocysticercosis," "schistosomiasis," "echinococcosis," and "toxoplasmosis."RESULTSTwo recent cases of parasitic spinal infections from the authors' institution are included.CONCLUSIONSKey findings on imaging modalities, laboratory studies suggestive of parasitic infection, and most importantly a thorough patient history are required to correctly diagnose parasitic spinal infections.

Uncooked vegetables are an important part of a healthy diet in different parts of the world. The present descriptive cross sectional type of study was carried out to determine the parasitological contamination of vegetables sold at markets of Mymensingh city of Bangladesh. Parasitological examinations were performed in material derived from 200 specimens of 10 different vegetables to detect intestinal parasites in the department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2015 to July 2016. Each sample was washed with 5 liter distilled water, then washing fluid was centrifuged and resulting sediment was collected for iodine and normal saline wet mount slide preparation to detect human pathogenic intestinal parasites by microscopic examination. Out of 200 vegetable samples, 123(61.5%) were contaminated with different species of parasites. The vegetables red amaranth had the highest contamination rate of 18/20 (90%) followed by jute leaf 17/20 (85%), coriander leaf 15/20 (75%), onion 14/20 (70%), lady's finger 14/20 (70%), radish 13/20 (65%), green pepper 12/20 (60%), carrot 12/20 (60%), cucumber 5/20 (25%), tomato 3/20 (15%). Among the contaminating parasites Ascaris lumbricoides (egg) 36.5% was the most prevalent followed by Strongyloides stercoralis (larva) 35.5%, Entamoeba histolytica ( trophozoite and different cystic stages) 8.5%, Hook worm (egg and larva) 6.5% , Balantidium coli (trophozoite) 4.0%, Enterobius vermicularis (egg) 3.5%, Trichuris trichiura (egg) 1.5%, Giardia lamblia (cyst) 1.0%. To our knowledge, it was the first base line study pursued in Bangladesh. Contamination of raw vegetables from markets with pathogenic parasites would increase the risk of disease to the population that consumes or works with these products. So improperly washed raw eaten vegetables should be considered a potential risk for contracting parasites, particularly helminthes in Mymensingh city.

Travel is important in the spread of diseases, and the number of travelers is increasing daily. Therefore, the importance of the diseases that occur during or after travel is increasing. In underdeveloped countries in particular, parasitic diseases are epidemic or endemic, and these diseases lead to high numbers of deaths. People traveling from developed to underdeveloped countries have a higher risk of transmission of parasitic diseases during travel. Fifteen percent of the world's population lives in Africa. In terms of geography, economics, and development, the continent is divided into four regions: East Africa, South Africa, North Africa, and West Africa. In recent years, international travels to Africa have been increasing. During these travels, there is a risk of contracting parasitic diseases, such as malaria, schistosomiasis, trypanosomiasis (African sleeping disease), onchocerciasis, lymphatic filariasis, and leishmaniasis. Before traveling to Africa, it is vital to take measures against diseases in the region.

Australia is a multicultural country surrounded by water where seafood is regularly consumed. Literature suggests that some popular edible fish sold in fish markets may be infected with parasites transmissible to humans (notably, anisakids and other helminths); however the number of reported human cases due to these parasites is low. In this article we critically review topical publications to understand whether the low number of human infection is due to lack of expertise in Australia to identify and diagnose accurately seafood-borne parasitic infections. The risk these parasites pose to humans may be underestimated due to: (i) errors or inability of diagnosing these infections, primarily due to less sensitive and specific serological tests and misidentifying parasites without a taxonomist in the diagnostic team; and (ii) medical practitioners not being aware of these parasites or not considering them in the differential diagnosis even in patients with history of regular raw or undercooked seafood consumption., (© 2018 Royal Australasian College of Physicians.)

We evaluated the relationship between the temperature-humidity index (THI) and health and growth performance in Japanese black calves in Japan. Data were collected from medical records of 19,313 Japanese black calves aged up to 3 months for correlation analysis with THI from July 2008 to June 2011. Data were also collected on the market weights of 57,144 Japanese black calves, and we calculated the body weight gain (BWG) of each calf based on body weight and age in days at the calf market. Analysis for the relationship between disease incidence and THI demonstrated a negative correlation (r = -0.54, p < 0.01). In addition, the mean disease incidence at THI of ≤50 was significantly higher than that at THI of ≥71. Analysis for the relationship between growth performance in calves and THI revealed that a lower THI during the month of birth was associated with a lower BWG at the calf market and that BWG with THI of ≤70 was significantly lower than that with THI of ≥71 (p < 0.05). In contrast, a higher mean THI during the third month after birth was associated with a lower BWG at the calf market, and BWG with THI of >75 was significantly lower than that with THI of ≤50 or THI ranging from 56 to 60 (p < 0.05). These results indicate that Japanese black calves are susceptible to a cold environment immediately after birth, whereas they are susceptible to a heat environment 3 months after birth.

Background: Iatrogenic parasitic myomas (PMs), caused by intra-corporeal power morcellation during laparoscopy is gradually increasing. However, the pathogenesis and medical treatment of PMs remain largely unelucidated., Methods: Laparoscopically-induced PM xenografted mouse model was conducted by xenografting human uterine myoma fragments into the abdominal cavity of SCID mice and hormonal manipulation was performed using this mouse model to demonstrate the role of oestrogen in the development of implanted PMs. Immunohistochemistry of oestrogen receptor α (ERα), progesterone receptor (PR), vimentin, vascular endothelial growth factor (VEGF), microvessel density (MVD) and Ki-67 index was performed and compared., Results: In the patient with PMs, ERα, PR, angiogenesis and proliferative property expression were upregulated in PM lesions compared to uterine myomas. In the laparoscopically-induced PM mouse model, implanted myomas had more steroid receptor expressions, angiogenesis and proliferative property compared with pre-xenografted or non-implanted myoma. Depletion of oestrogen in the ovariectomized (OVX) mice decreased laparoscopically-induced PM implantations. In comparison, the implantations of PMs were increased with additional E2 supplement. Hormonal manipulation in the PM mouse model, including AI, GnRHa and SERM groups, were compared and AI significantly decreased the implantations, steroid receptor, angiogenesis, cell density, and proliferative index of PMs compared with control group. Furthermore, GnRHa significantly decreased VEGF and MVD expressions compared with control group., Conclusions: These data highlight the crucial role of oestrogen in the development of laparoscopically-induced PMs and suggest that hormone manipulation may be a potential therapeutic agent., Trial Registration: This protocol was approved by the Human and Animal Institutional Review Board of Taipei Veterans General Hospital ( VGHIRB No 2014-10-002C on Nov. 17 th , 2014; IACUC 2014-119 on Aug. 22 nd , 2014).

Infectious complications after allogeneic haematopoietic stem cell transplantation (allo-HCT) remain a clinical challenge. This is a guideline provided by the AGIHO (Infectious Diseases Working Group) of the DGHO (German Society for Hematology and Medical Oncology). A core group of experts prepared a preliminary guideline, which was discussed, reviewed, and approved by the entire working group. The guideline provides clinical recommendations for the preventive management including prophylactic treatment of viral, bacterial, parasitic, and fungal diseases. The guideline focuses on antimicrobial agents but includes recommendations on the use of vaccinations. This is the updated version of the AGHIO guideline in the field of allogeneic haematopoietic stem cell transplantation utilizing methods according to evidence-based medicine criteria.

Despite important differences between infectious diseases and cancers, tumour development (neoplasia) can nonetheless be closely compared to infectious disease because of the similarity of their effects on the body. On this basis, we predict that many of the life-history (LH) responses observed in the context of host-parasite interactions should also be relevant in the context of cancer. Parasites are thought to affect LH traits of their hosts because of strong selective pressures like direct and indirect mortality effects favouring, for example, early maturation and reproduction. Cancer can similarly also affect LH traits by imposing direct costs and/or indirectly by triggering plastic adjustments and evolutionary responses. Here, we discuss how and why a LH focus is a potentially productive but under-exploited research direction for cancer research, by focusing our attention on similarities between infectious disease and cancer with respect to their effects on LH traits and their evolution. We raise the possibility that LH adjustments can occur in response to cancer via maternal/paternal effects and that these changes can be heritable to (adaptively) modify the LH traits of their offspring. We conclude that LH adjustments can potentially influence the transgenerational persistence of inherited oncogenic mutations in populations.

Many hosts are infected by several parasite genotypes at a time. In these co-infected hosts, parasites can interact in various ways thus creating diverse within-host dynamics, making it difficult to predict the expression and the evolution of virulence. Moreover, multiple infections generate a combinatorial diversity of cotransmission routes at the host population level, which complicates the epidemiology and may lead to non-trivial outcomes. We introduce a new model for multiple infections, which allows any number of parasite genotypes to infect hosts and potentially coexist in the population. In our model, parasites affect one another's within-host growth through density-dependent interactions and by means of public goods and spite. These within-host interactions determine virulence, recovery and transmission rates, which are then integrated in a transmission network. We use analytical solutions and numerical simulations to investigate epidemiological feedbacks in host populations infected by several parasite genotypes. Finally, we discuss general perspectives on multiple infections., (© 2015 The Author(s) Published by the Royal Society. All rights reserved.)

Disease outbreaks associated with drinking water drawn from untreated groundwater sources represent a substantial proportion (30.3%) of the 818 drinking water outbreaks reported to CDC's Waterborne Disease and Outbreak Surveillance System (WBDOSS) during 1971 to 2008. The objectives of this study were to identify underlying contributing factors, suggest improvements for data collection during outbreaks, and inform outbreak prevention efforts. Two researchers independently reviewed all qualifying outbreak reports (1971 to 2008), assigned contributing factors and abstracted additional information (e.g., cases, etiology, and water system attributes). The 248 outbreaks resulted in at least 23,478 cases of illness, 390 hospitalizations, and 13 deaths. The majority of outbreaks had an unidentified etiology (n = 135, 54.4%). When identified, the primary etiologies were hepatitis A virus (n = 21, 8.5%), Shigella spp. (n = 20, 8.1%), and Giardia intestinalis (n = 14, 5.7%). Among the 172 (69.4%) outbreaks with contributing factor data available, the leading contamination sources included human sewage (n = 57, 33.1%), animal contamination (n = 16, 9.3%), and contamination entering via the distribution system (n = 12, 7.0%). Groundwater contamination was most often facilitated by improper design, maintenance or location of the water source or nearby waste water disposal system (i.e., septic tank; n = 116, 67.4%). Other contributing factors included rapid pathogen transport through hydrogeologic formations (e.g., karst limestone; n = 45, 26.2%) and preceding heavy rainfall or flooding (n = 36, 20.9%). This analysis underscores the importance of identifying untreated groundwater system vulnerabilities through frequent inspection and routine maintenance, as recommended by protective regulations such as Environmental Protection Agency's (EPA's) Groundwater Rule, and the need for special consideration of the local hydrogeology., (Published 2013. This article is a U.S. Government work and is in the public domain in the USA.)

Background: Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC) is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs), defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth)., Methods and Findings: We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May-July 2009), and revisited households 21 months later (February-April 2011) after the program was delivered. The study enrolled a random sample of 5,209 children <5 years old from 3,039 households that had at least one child <24 months at the beginning of the study. A random subsample of 1,150 children <24 months at enrollment were tested for soil transmitted helminth and protozoan infections in stool. The randomization successfully balanced intervention and control groups, and we estimated differences between groups in an intention to treat analysis. The intervention increased percentage of households in a village with improved sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%-26%; group means: 22% control versus 41% intervention), decreased open defecation among adults by an average of 10% (95% CI for difference: 4%-15%; group means: 73% intervention versus 84% control). However, the intervention did not improve child health measured in terms of multiple health outcomes (diarrhea, HCGI, helminth infections, anemia, growth). Limitations of the study included a relatively short follow-up period following implementation, evidence for contamination in ten of the 40 control villages, and bias possible in self-reported outcomes for diarrhea, HCGI, and open defecation behaviors., Conclusions: The intervention led to modest increases in availability of IHLs and even more modest reductions in open defecation. These improvements were insufficient to improve child health outcomes (diarrhea, HCGI, parasite infection, anemia, growth). The results underscore the difficulty of achieving adequately large improvements in sanitation levels to deliver expected health benefits within large-scale rural sanitation programs., Trial Registration: ClinicalTrials.gov NCT01465204. Please see later in the article for the Editors' Summary.

One of the most important problems faced by world at the present time is food deficiency. Today the third world is facing protein deficiency as one of the major global challenges. In Egypt, the continuous population explosion requires more food production to meet the consequent increasing demands. However, there are many zoonotic fish parasites not only in Egypt but worldwide.

Infections account for approximately 75% of all pulmonary complications in immunocompromised patients, and early and accurate diagnosis is essential because of associated high morbidity and mortality. The number of immunocompromised patients continues to increase because of greater use of immunosuppressive agents. Certain organisms are likely to cause infection with certain types of immunosuppression and during specific times during the course of immunosuppression. Knowledge of the acuity of the patient's illness, environmental exposures, nature of the underlying immune defect(s), and duration and severity of immunodeficiency can help the radiologist provide a more accurate differential diagnosis for the cause of pulmonary infection., (Copyright © 2014 Elsevier Inc. All rights reserved.)

This paper develops an optimal control framework for an ordinary differential equation model to investigate the introduction of sterile mosquitoes to reduce the incidence of mosquito-borne diseases. Existence of a solution given an optimal strategy and the optimal control is determined in association with the negative effects of the disease on the population while minimizing the cost due to this control mechanism. Numerical simulations have shown the importance of effects of the bounds on the release of sterile mosquitoes and the bounds on the likelihood of egg maturation. The optimal strategy is to maximize the use of habitat modification or insecticide. A combination of techniques leads to a more rapid elimination of the wild mosquito population., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Parasitic and tropical diseases are relatively rare in Japan. However, physicians have to realize that a patient may visit your hospital today, who is infected with a potentially fatal parasite. This review focuses on the treatment of the domestic and imported parasitic infections in Japan. Many of the drugs against parasitic diseases, especially imported protozoan diseases, have not been approved, nor have been covered by the National Health Insurance Policy. Therefore, patients who need pharmacotherapy with an unapproved drug have to be treated in one of the hospitals of the Research Group on Chemotherapy of Tropical Diseases, which imports effective drugs against major tropical diseases.

Blood transfusion and transplantation may represent efficient mechanisms of spreading infectious agents to naive populations. In the developed countries, as a consequence of globalization, several factors such as international commerce, tourism, and immigration have acted as important features for the emergence or reemergence of infectious diseases previously referred to as tropical. This article reviews the relevant bacterial, protozoan and viral infections that are more frequently associated with blood transfusion and/or solid organ or marrow transplantation and may affect susceptible populations worldwide., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Infections remain a major complication of solid organ transplantation. For this reason, the clinical microbiology laboratory plays a key role in the success of transplant programs, which must have the support of a qualified laboratory, both technically and professionally. Transplant programs strongly condition the structure and functionality of microbiology laboratories, but at the same time, benefit greatly from the knowledge generated from these programs. The laboratory must make a special effort to implement rapid methods that can respond to the broad spectrum of potential pathogens in solid organ transplant patients. The integration of microbiologists in multidisciplinary teams is highly recommended, as only then can they obtain the highest quality and efficiency in the diagnostic process. This article provides an updated review of the techniques to be used once transplantation has occurred. The role of the microbiologist is also crucial in the pretransplant period, as good microbiological candidate evaluation at this time strongly conditions the success of the transplantation program., (Copyright © 2012 Elsevier España S.L. All rights reserved.)

Double unrelated cord blood transplant (dUCBT) has been used to circumvent cell dose limitation of single UCBT; however, few data are available describing outcomes, infectious disease, and immune recovery. We analyzed 35 consecutive dUCBT recipients with high-risk malignant disorders (n=21) and bone marrow failure syndromes (n=14). Median follow-up was 32 months. Conditioning regimen was myeloablative in 14 and reduced intensity in 21 patients. Median infused nucleated cell dose was 4 × 10(7) /kg. Median time to absolute neutrophil count >0.5 × 10(9) /L was 25 days. Cumulative incidence (CI) of acute grade II-IV graft-versus-host disease was 47%. Estimated overall survival at 2 years was 48%. CI of first viral infections at 1 year was 92%. We observed 49 viral infections in 30 patients, 34 bacterial infections in 19 patients, and 16 fungal or parasitic infections in 12 patients. Lymphocyte subset analyses were performed at 3, 6, 9, and >12 months after dUCBT. Decreased T-cell and B-cell counts with expansion of natural killer cells were observed until 9 months post transplantation. Recovery of thymopoiesis measured by T-cell receptor excision circles was impaired until 9 months after dUCBT, when the appearance of new thymic precursors was observed. Delayed immune recovery and high incidence of infectious complications were observed after dUCBT in patients with high-risk hematological diseases., (© 2011 John Wiley & Sons A/S.)

Adaptationist view proposes that emotions were shaped by natural selection and their primary function is to protect humans against predators and/or disease threat. This study examined cross-cultural and inter-personal differences in behavioural immune system measured by disgust, fear and perceived danger in participants from high (Turkey) and low (Slovakia) pathogen prevalence areas. We found that behavioural immune system in Turkish participants was activated more than those of Slovakian participants when exposed to photographs depicting disease-relevant cues, but not when exposed to disease-irrelevant cues. However, participants from Slovakia, where human to human disease transmission is expected to be more prevalent than in Turkey, showed lower aversion in Germ Aversion subscale supporting hypersensitiveness of the behavioural immune system. Having animals at home was less frequent both in Turkey and in participants who perceived higher danger about disease relevant animals. Participants more vulnerable to diseases reported higher incidence of illness last year and considered perceived disease-relevant animals more dangerous than others. Females showed greater fear, disgust and danger about disease-relevant animals than males. Our results further support the finding that cultural and inter-personal differences in human personality are influenced by parasite threat., (Copyright 2010 Elsevier B.V. All rights reserved.)

Tetraspanin proteins on host cells are involved in the pathogenesis of infectious diseases at different stages. In this review, we will focus on tetraspanins expressed in the immune system and the role they play in the defense to viral, bacterial, parasitic and fungal infections., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)

This study assesses water-borne infection risk perception and water boiling habits in a remote Sankhuwasava region of Nepal using a brief interview-style questionnaire. All subjects were aware of the risks associated with drinking unpurified water, but a majority (65%) reported they did not boil water regularly, and almost 60% of villagers interviewed had history of infection despite their boiling practices. In contrast to reports from other communities in Nepal, risk awareness was sufficient in this region. Water boiling alone did not confer protection. Future efforts should target sanitation, screening, and other sources of contamination.

Despite the huge advance that highly active antiretroviral therapy has represented for the prognosis of infection by human immunodeficiency virus (HIV), opportunistic infections continue to be a cause of morbidity and mortality in HIV-infected patients. This is often the case because of severe immunodepression, poor adherence to antiretroviral therapy, failure of therapy, or the fact that patients are unaware of their HIV-positive status and debut with an opportunistic infection. This article updates the guidelines on treatment of acute episodes of various opportunistic infections in HIV-infected patients, including infections due to parasites, fungi, viruses, mycobacteria, and bacteria. This edition has a new chapter on imported parasite infections as well as additional information on endemic mycoses in the chapter on fungal infections, taking into account the growing number of immigrants in our setting. Lastly, the chapter on the immune reconstitution syndrome has also been updated, providing relevant data on a phenomenon that has clinical and diagnostic repercussions in patients who start antiretroviral therapy while they are severely immunodepressed (English version available at http://www.gesida.seimc.org).

Highly-active antiretroviral therapy is effective in reducing opportunistic infections in industrialized countries. However, opportunistic parasitic infections remain the leading cause of HIV-related mortality in developing countries. These infections can also affect HIV-positive immigrants residing in Spain, as well as HIV-infected patients traveling to low-income countries. In addition, immigrants often have viral infections caused by herpesvirus, papillomavirus and polyomavirus, which are closely related to risk behaviors and commercial sex. The present article reviews the characteristics of parasitic and viral infections in patients with HIV infection with the aim of improving understanding of this vulnerable population group.

Infections are a common occupational hazard, especially in health care (and laboratory) workers, but also for the staff of daycare centers, food handlers, forestry and agricultural workers and persons occupied in waste management and sewage work. EC directives and national German regulations have been implemented to facilitate risk assessment, risk management and prevention of infections. In this contribution, the classification of microbiological agents and their seroprevalence (or one of their antibodies) in different areas of the work environment and the different methods of prevention (technical, organisational, personal, immunological) are discussed.

In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

Heart transplantation has emerged as the therapy of choice for selected patients with life-threatening, irremediable heart disease. Infectious complications are frequent, but are no longer the leading cause of death. Late infections (particularly viral infections), however, are still a threat to long-term graft survival in these patients. Bacterial infections are the most common, particularly of the respiratory tract, which usually appear in the first month or after one year following transplantation in patients with previous COPD. Catheter-related infection is also common, whereas postoperative mediastinitis is much less frequent. The overall incidence of fungal infections has decreased considerably in recent years (2%-15%), but associated mortality remains high. Pulmonary aspergillosis is the most common. Cytomegalovirus is the most important pathogen in heart transplantation, currently affecting 7%-35% of patients. Antiviral prophylactics and pre-emptive therapy have reduced the incidence of acute CMV disease, but the potential role of this microorganism as a cofactor in allograft vascular disease, the most common cause of death in these patients, is a cause for concern. Toxoplasmosis, a particularly severe entity in heart transplant recipients, has decreased with the use of routine prophylaxis in seronegative recipients.

Infections constitute the most common and severe complication of immune deficiencies. The pattern of infections is strikingly dependent on the type of immune defect. Antibody deficiencies usually manifest with recurrent capsulated bacteria related-infections of the respiratory tract, due to pneumoccoci and Haemophilus influenza. The same bacteria are implicated in asplenic patients with frequent sepsis of devastating consequences. Complement deficiencies must be looked for in case of meningococcal infections. Neutropenia and defects in phagocytic cell functions favour bacteraemia and invasive fungal infections. Importantly, neutropenia can rapidly lead to septic shock. Cellular immune deficiencies are associated with opportunistic infections including viral infections due to Herpes viridae, fungal and parasitic infections (Pneumocystis jiroveci, Toxoplasma gondii) and mycobacterial infections. Most of the time, immune defects are combined, accounting for the variety and the complexity of clinical presentations and microbial investigations.

Recognizing a foreign element is an inherent characteristic of living beings and guarantees their survival. Evading this defense mechanism is one of the most difficult requirements for transplant success, but it leads to a series of consequences, mainly related to infection. T lymphocytes are the cornerstone of the allogenic response. These cells recognize intracellular and extracellular antigens over HLA molecules in host cells. As a consequence, lymphocytic expansion occurring on several levels is produced, and a humoral or cellular response is the final result. The immunosuppression regimens used in transplantation include induction, maintenance and rescue therapy. Induction therapy serves primarily to decrease the proportion of T-cell precursors and to lower the efficacy of antigen presentation. With respect to maintenance therapy, cyclosporine and tacrolimus inhibit cytokine transcription, azathioprine, and mycophenolate mofetil inhibit nucleotide synthesis, and sirolimus and everolimus inhibit transduction of growth factor signals. As a consequence of immunosuppression, opportunistic microorganisms may appear with endogenic reactivation of latent infection or from an exogenous origin. Prevention of these infections by proper knowledge of the risk factors, rapid diagnosis, and adequate management are fundamental to guarantee the survival of the patient.

The enzyme chitotriosidase (ChT), the human analogue of chitinases from non-vertebrate species, is one of the most abundant and indicative proteins secreted by activated macrophages. Its enzymatic activity is elevated in serum of patients suffering from Gaucher's disease type 1 and in some other inherited lysosomal storage disorders, as well as in diseases in which macrophages are activated. The last decade has witnessed the appearance of a substantial number of studies attempting to unravel its cellular functions, which have yet not been fully defined. A great deal of progress has been made in the study of the physiological roles of ChT. This review is looks at the key areas of investigations addressed to further illuminate whether ChT activation might have different functional meanings in various diseases.

Since the advent of highly active antiretroviral therapy (HAART), the incidence of specific fungal and parasitic opportunistic infections as observed in HIV disease has been in decline. However, in many parts of the world, and in areas where access to HAART is limited, these specific opportunistic infections are still observed in HIV patients. In this manuscript, we review the epidemiology, clinical manifestations, diagnosis, and treatment of common fungal and parasitic opportunistic infections.

Developmental instability is reflected in imprecise development caused by perturbations of the developmental process, while developmental stability reflects the ability to avoid or reduce such perturbations by developmental means. Developmental instability has been hypothesized to reflect overall individual condition, and asymmetric or otherwise aberrant individuals have thus been predicted to be particularly severely affected by disease and parasitism. An extensive review of the literature on animals, including humans, revealed consistent relationships between increased bilateral asymmetry and elevated risk of parasitism. Parasitism, including parasitism of mothers, is a cause of asymmetry as shown by a number of experiments, and asymmetric individuals are differentially susceptible to a range of different parasites. Extensive studies of humans have shown that asymmetric individuals also suffer disproportionately from a range of different diseases including mental diseases. Studies of transgenic organisms have now demonstrated that single genes associated with disease is a sufficient cause of increased asymmetry. A number of studies have also shown that activation of the immune system causes increased asymmetry in developing individuals, and that asymmetry and immunity show negative covariation. These findings may have important implications for the study of susceptibility of hosts to infectious disease.