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Parasitic diseases have a significant impact on human and animal health, representing a major hazard to the public and causing economic and health damage worldwide. Extracellular vesicles (EVs) have long been recognized as diagnostic and therapeutic tools but are now also known to be implicated in the natural history of parasitic diseases and host immune response modulation. Studies have shown that EVs play a role in parasitic disease development by interacting with parasites and communicating with other types of cells. This review highlights the most recent research on EVs and their role in several aspects of parasite-host interactions in five key parasitic diseases: Chagas disease, malaria, toxoplasmosis, leishmaniasis and helminthiases. We also discuss the potential use of EVs as diagnostic tools or treatment options for these infectious diseases., (© 2024 The Author(s). Journal of Extracellular Vesicles published by Wiley Periodicals LLC on behalf of International Society for Extracellular Vesicles.)

Parasites are very widely distributed in the environment and form complex relationships with their hosts, forming host-parasite systems [...].

Purpose: Mesenchymal stem cells (MSCs) are mesodermal-origin postnatal stem cells that are able to self-renew and differentiate into several cell lineages. MSCs possess anti-inflammatory and anti-apoptotic activity, immunomodulatory action, as well as regenerative properties. Since MSCs also have antimicrobial properties, it has been suggested that they should be utilized for treating infectious diseases. In this study, the last pre-clinical advances in the efficacy of MSCs' therapy against parasitic diseases were reviewed., Methods: Data about the effects of MSCs' therapy on experimental and pre-clinical parasitic infections were collected by searching relevant articles and reviewing them., Results: In the present study, empirical findings on the impacts of MSCs' therapy against parasitic diseases were recapitulated. Studies have reported that the administration of MSCs reduces the burden of the parasite and modulates the levels of inflammatory and anti-inflammatory cytokines in parasitic diseases, including schistosomiasis, malaria, cystic echinococcosis, toxocariasis, leishmaniasis, and trypanosomiasis. Also, the administration of MSCs combined with anti-parasitic drugs enhanced anti-parasitic effects and immunomodulatory actions., Conclusion: Based on this review, empirical studies have revealed the beneficial effects of MSCs against some parasitic infections. This new therapeutic strategy showed both anti-parasitic and immunomodulatory effects. Also, the combination of anti-parasitic drugs with MSCs' therapy promoted anti-parasitic and immunomodulatory activities against parasitic infections., (© 2022. The Author(s) under exclusive licence to Witold Stefański Institute of Parasitology, Polish Academy of Sciences.)

Human Leukocyte Antigen-G (HLA-G), a polymorphic non-classical HLA (HLA-Ib) with immune-regulatory properties in cancers and infectious diseases, presents both membrane-bound and soluble (sHLA-G) isoforms. Polymorphism has implications in host responses to pathogen infections and in pathogenesis. Differential expression patterns of HLA-G/sHLA-G or its polymorphism seem to be related to different pathological conditions, potentially acting as a disease progression biomarker. Pathogen antigens might be involved in the regulation of both membrane-bound and sHLA-G levels and impact immune responses during co-infections. The upregulation of HLA-G in viral and bacterial infections induce tolerance to infection. Recently, sHLA-G was found useful to identify the prognosis of Coronavirus disease 2019 (COVID-19) among patients and it was observed that the high levels of sHLA-G are associated with worse prognosis. The use of pathogens, such as Plasmodium falciparum , as immune modulators for other infections could be extended for the modulation of membrane-bound HLA-G in COVID-19-infected tissues. Overall, such information might open new avenues concerning the effect of some pathogens such as parasites in decreasing the expression level of HLA-G to restrict pathogenesis in some infections or to influence the immune responses after vaccination among others.

Parasites, bacteria, and viruses pose serious threats to public health. Many parasite infections, including infections of protozoa and helminths, can inhibit inflammatory responses and impact disease outcomes caused by viral, bacterial, or other parasitic infections. Type I interferon (IFN-I) has been recognized as an essential immune effector in the host defense against various pathogens. In addition, IFN-I responses induced by co-infections with different pathogens may vary according to the host genetic background, immune status, and pathogen burden. However, there is only limited information on the roles of IFN-I in co-infections with parasites and viruses, bacteria, or other parasites. This review summarizes some recent findings on the roles of IFN-I in co-infections with parasites, including Leishmania spp., Plasmodium spp., Eimeria maxima, Heligmosomoides polygyrus, Brugia malayi , or Schistosoma mansoni , and viruses or bacteria and co-infections with different parasites (such as co-infection with Neospora caninum and Toxoplasma gondii , and co-infection with Plasmodium spp. and H. polygyrus ). The potential mechanisms of host responses associated with co-infections, which may provide targets for immune intervention and therapies of the co-infections, are also discussed., (Copyright © 2020 Ma, Su and Lu.)

Background: Machine learning (ML) allows the analysis of complex and large data sets and has the potential to improve health care. The clinical microbiology laboratory, at the interface of clinical practice and diagnostics, is of special interest for the development of ML systems., Aims: This narrative review aims to explore the current use of ML In clinical microbiology., Sources: References for this review were identified through searches of MEDLINE/PubMed, EMBASE, Google Scholar, biorXiv, arXiV, ACM Digital Library and IEEE Xplore Digital Library up to November 2019., Content: We found 97 ML systems aiming to assist clinical microbiologists. Overall, 82 ML systems (85%) targeted bacterial infections, 11 (11%) parasitic infections, nine (9%) viral infections and three (3%) fungal infections. Forty ML systems (41%) focused on microorganism detection, identification and quantification, 36 (37%) evaluated antimicrobial susceptibility, and 21 (22%) targeted the diagnosis, disease classification and prediction of clinical outcomes. The ML systems used very diverse data sources: 21 (22%) used genomic data of microorganisms, 19 (20%) microbiota data obtained by metagenomic sequencing, 19 (20%) analysed microscopic images, 17 (18%) spectroscopy data, eight (8%) targeted gene sequencing, six (6%) volatile organic compounds, four (4%) photographs of bacterial colonies, four (4%) transcriptome data, three (3%) protein structure, and three (3%) clinical data. Most systems used data from high-income countries (n = 71, 73%) but a significant number used data from low- and middle-income countries (n = 36, 37%). Performance measures were reported for the 97 ML systems, but no article described their use in clinical practice or reported impact on processes or clinical outcomes., Implications: In clinical microbiology, ML has been used with various data sources and diverse practical applications. The evaluation and implementation processes represent the main gap in existing ML systems, requiring a focus on their interpretability and potential integration into real-world settings., (Copyright © 2020. Published by Elsevier Ltd.)

Infections caused by protozoan parasites burden the world with huge costs in terms of human and animal health. Most parasitic diseases caused by protozoans are neglected, particularly those associated with poverty and tropical countries, but the paucity of drug treatments and vaccines combined with increasing problems of drug resistance are becoming major concerns for their control and eradication. In this climate, the discovery/repurposing of new drugs and increasing effort in vaccine development should be supplemented with an exploration of new alternative/synergic treatment strategies. Viruses, either native or engineered, have been employed successfully as highly effective and selective therapeutic approaches to treat cancer (oncolytic viruses) and antibiotic-resistant bacterial diseases (phage therapy). Increasing evidence is accumulating that many protozoan, but also helminth, parasites harbour a range of different classes of viruses that are mostly absent from humans. Although some of these viruses appear to have no effect on their parasite hosts, others either have a clear direct negative impact on the parasite or may, in fact, contribute to the virulence of parasites for humans. This review will focus mainly on the viruses identified in protozoan parasites that are of medical importance. Inspired and informed by the experience gained from the application of oncolytic virus- and phage-therapy, rationally-driven strategies to employ these viruses successfully against parasitic diseases will be presented and discussed in the light of the current knowledge of the virus biology and the complex interplay between the viruses, the parasite hosts and the human host. We also highlight knowledge gaps that should be addressed to advance the potential of virotherapy against parasitic diseases.

Background: Blastocystis hominis ( B. hominis ) and Dientamoeba fragilis ( D. fragilis ) are two protozoan parasites of human bowel that are found throughout the world. There is still debate about the pathogenicity of these protozoans, despite them being commonly associated with gastrointestinal symptoms and can cause health issue in both children and adults. These parasites are usually transmitted through faecal-oral contact particularly under poor hygiene conditions or food/water contamination. Once a person is infected, the parasites live in the large intestine and are passed in the faeces., Aim: To investigate the effect of triple antibiotic therapy using enema infusion in the treatment of B. hominis and D. fragilis infections., Methods: This retrospective longitudinal study was conducted in a single medical centre, which included fifty-four patients (≥ 18 years) who were positive for D. fragilis , B. hominis or both between 2017 and 2018. The treatment consisted of triple antibiotics that were infused over two consecutive days through rectal enema. Faecal samples were collected from participants pre- and post-treatment and were tested for parasites using microscopy and polymerase chain reaction. Patients' symptoms were recorded prior and after the treatment as well as patient demographic data., Results: Patients ( n = 54), were either positive for B. hominis (37%), D. fragilis (35%) or both (28%). All patients completed the two-day treatment and no serious adverse effect was reported. The most common side effect experienced by the patients during the treatment was urine discolouration which was cleared by six weeks of follow-up. Common symptoms reported prior to treatment were diarrhoea, abdominal pain, constipation and fatigue. Other symptoms included abdominal discomfort, dizziness and blood in the stool. Eighty-nine percent of patients completed a final stool test post-treatment. At six weeks post-treatment, 79% of patients cleared the parasites from their faeces. Symptoms such as abdominal discomfort, dizziness and blood in the stool decreased significantly at both seven days and six weeks post-treatment ( P < 0.040). The enema retention time, bowel preparation, previous antibiotic treatment or previous gastrointestinal problems had no significant effect on parasite eradication., Conclusion: Overall, eradication of parasites and improvement of clinical outcomes were observed in treated patients, showing the efficacy of this combination to eradicate the parasites and provide positive clinical outcome., Competing Interests: Conflict-of-interest statement:: Professor Thomas J Borody has a pecuniary interest in the Centre for Digestive Diseases and has filed patents for antibiotic therapies for parasitic infections. Dr Niloufar Roshan, Dr Annabel Clancy, Dr Anoja Gunaratne, Ms Antoinette LeBusque and Ms Denise Pilarinos have no disclosures., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

MicroRNAs (miRNAs), as epigenetic regulators, are small non-coding RNAs regulating gene expression in eukaryotes at the post-transcriptional level to control biological functions. MicroRNAs play a role in development, physiology, infection, immunity and the complex life cycles of parasites. Also, parasite infection can alter host miRNA expression that might result in either parasite clearance or infection. Over the past 20 years, thousands of miRNAs have been identified in the nematode Caenorhabditis elegans and other parasites. Thus, miRNA pathways are potential targets for the diagnostic and therapeutic control of parasitic diseases. Here, we review the current status and potential functions of miRNAs related to protozoans, helminths, and arthropods.

The CCR5 molecule was reported in 1996 as the main HIV-1 co-receptor. In that same year, the CCR5Δ32 genetic variant was described as a strong protective factor against HIV-1 infection. These findings led to extensive research regarding the CCR5, culminating in critical scientific advances, such as the development of CCR5 inhibitors for the treatment of HIV infection. Recently, the research landscape surrounding CCR5 has begun to change. Different research groups have realized that, since CCR5 has such important effects in the chemokine system, it could also affect other different physiological systems. Therefore, the effect of reduced CCR5 expression due to the presence of the CCR5Δ32 variant began to be further studied. Several studies have investigated the role of CCR5 and the impacts of CCR5Δ32 on autoimmune and inflammatory diseases, various types of cancer, and viral diseases. However, the role of CCR5 in diseases caused by bacteria and parasites is still poorly understood. Therefore, the aim of this article is to review the role of CCR5 and the effects of CCR5Δ32 on bacterial (brucellosis, osteomyelitis, pneumonia, tuberculosis and infection by Chlamydia trachomatis) and parasitic infections (toxoplasmosis, leishmaniasis, Chagas disease and schistosomiasis). Basic information about each of these infections was also addressed. The neglected role of CCR5 in fungal disease and emerging studies regarding the action of CCR5 on regulatory T cells are briefly covered in this review. Considering the "renaissance of CCR5 research," this article is useful for updating researchers who develop studies involving CCR5 and CCR5Δ32 in different infectious diseases., (© 2020 John Wiley & Sons Ltd.)

Aptamers are single-stranded DNA or RNA sequences that adopt unique three-dimensional structures that allow them to recognize a specific target with high affinity. They can potentially be used for the diagnosis of diseases, as new therapeutic agents, for the detection of food risks, as biosensors, for the detection of toxins, and as drug carriers and nanoparticle markers, among other applications. To date, an aptamer called pegaptanib is the only aptamer approved by the Food and Drug Administration (FDA) for commercial use. Other aptamers are in different clinical stages of development for the treatment of different diseases. In parasitology, investigations carried out with parasites such as Leishmania spp. allowed the acquisition of aptamers that recognize the polyA-binding protein LiPABP and may have potential applications in research and diagnosis and even as therapeutic agents. Regarding malaria, aptamers have been obtained that allow the identification of infected erythrocytes or inhibit the formation of rosettes, along with those that provide promising alternatives for diagnosis by specifically detecting the protein lactate dehydrogenase (PfLDH). In Cryptosporidium parvum allow the detection of oocysts in contaminated food or water. In Entamoeba histolytica, two aptamers called C4 and C5, which inhibit the proliferation of trophozoites in vitro and have potential use as therapeutic agents, have been isolated. Aptamers obtained against Trypanosoma cruzi inhibit the invasion of LLC-MK2 (from monkey kidney) cells by 50-70%, and in T. brucei, aptamers with the potential to transport toxic molecules to the parasitic lysosome were identified as a novel therapeutic strategy.

The mammalian immune system has evolved the capacity to detect and destroy tumor cells. Tumors utilize multiple strategies to evade host immune surveillance, including the induction of the checkpoint molecules cytotoxic T lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1) to suppress antitumor immunity. Pharmacologic blockade of these molecules with checkpoint inhibitors (CPIs) restores T cell function and prolongs survival in patients with various malignancies. Emerging evidence suggests that the same checkpoint pathways may play a crucial role during infections. Indeed, CPIs appear promising as immunotherapeutic agents in infectious diseases, although their efficacy varies depending on pathogen-, cell-, and organ-specific factors. More research will be necessary to clarify the effects and safety of CPIs on clinically relevant outcomes of human infection., (Published by Elsevier Ltd.)

Early diagnosis and treatment of parasitic diseases are indispensable to combat parasites mediated morbidity and mortality in humans and animals. Mammalian sourced antibodies are being successfully used in immunotherapy and immunoassays. However, their increased conservation amongst mammals, involves them in unnecessary interaction and immune mediated pathologies, obstructing their applications in certain approaches in immunoassays. Further, the high production cost and difficulty to achieve high and stable antibody titer hampers their utility for therapeutic purposes. In recent years, chicken egg yolk immunoglobulin, termed as immunoglobulin Y (IgY) has attracted noticeable consideration since it poses greater advantages than mammalian IgG including high yield, low cost and convenience. IgY has unique properties which are being exploited in different aspects for its applications in research, diagnosis and therapy. This review gives an overview of the research outcomes pertaining to chicken IgY as diagnostics and therapeutics in parasitology., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Neurocysticercosis is the most common parasitic neurological disease worldwide, yet in Europe, it remains relatively uncommon, with many practitioners rarely seeing a case. However, immigration and international travel mean that it is becoming increasingly recognised and diagnosed in developed countries. Being a treatable condition, it is essential to be familiar with the diagnosis and to appreciate its mimics and breadth of its possible clinical presentations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Extracellular vesicles (EVs) are small membrane-surrounded structures released by different kinds of cells (normal, diseased, and transformed cells) in vivo and in vitro that contain large amounts of important substances (such as lipids, proteins, metabolites, DNA, RNA, and non-coding RNA (ncRNA), including miRNA, lncRNA, tRNA, rRNA, snoRNA, and scaRNA) in an evolutionarily conserved manner. EVs, including exosomes, play a role in the transmission of information, and substances between cells that is increasingly being recognized as important. In some infectious diseases such as parasitic diseases, EVs have emerged as a ubiquitous mechanism for mediating communication during host-parasite interactions. EVs can enable multiple modes to transfer virulence factors and effector molecules from parasites to hosts, thereby regulating host gene expression, and immune responses and, consequently, mediating the pathogenic process, which has made us rethink our understanding of the host-parasite interface. Thus, here, we review the present findings regarding EVs (especially exosomes) and recognize the role of EVs in host-parasite interactions. We hope that a better understanding of the mechanisms of parasite-derived EVs may provide new insights for further diagnostic biomarker, vaccine, and therapeutic development.

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.

Research approaches that cross disciplinary silos, industry sectors, and political borders are now increasingly prioritized for tackling issues of global concern. Nevertheless, team science can be challenging. The goal of this article is to help researchers proactively consider factors influencing conflicts and successes with an emphasis on the health sciences., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Until recently, basophils had often been neglected in immunologic studies because of their minority status among immune cells or confused with tissue-resident mast cells because of some phenotypic similarities between them in spite of different anatomic localization. It is now appreciated that basophils and mast cells are distinct cell lineages and that basophils play important and nonredundant roles distinct from those played by mast cells. On the one hand, basophils contribute beneficially to protective immunity, particularly against parasitic infections. On the other hand, basophils are involved in the development of various disorders, including allergy and autoimmune disease. Basophils interact with other immune cells and nonhematopoietic cells through cell-to-cell contact or basophil-derived factors, such as cytokines and proteases, contributing to the regulation of immune and allergic responses. In this review article we highlight recent advances in our understanding of basophil pathophysiology in human subjects and animal models by consolidating research findings reported during the past 5 years. Further studies on basophils and their products will help identify suitable targets for novel therapeutics in allergy and effective vaccines against parasitic infection., (Copyright © 2017. Published by Elsevier Inc.)

The Ixodes tick is an important arthropod vector in the transmission of human disease. This 3-part review highlights the biology of the Ixodes tick and manifestations of related diseases. Part 1 addresses the Ixodes tick biology and life cycle; local reactions; and Lyme disease, the most prevalent of associated diseases. Part 2 will address human granulocytic anaplasmosis, babesiosis, Powassan virus infection, Borrelia miyamotoi disease, tick-borne encephalitis, and tick paralysis. Part 3 will address coinfection with multiple pathogens as well as methods of tick-bite prevention and tick removal.

Objective: to describe the causes of hospitalization of Brazilian children under five years old., Methods: this is a systematic review of articles published from 2008 to 2015, searched in the databases Medline and LILACS; selected studies were critically analyzed through a validated instrument., Results: eleven articles were included, four of them are ecological and seven are cross-sectional studies; respiratory diseases (n=5), parasitic infections (n=4) and perinatal diseases (n=2) were the main causes for hospitalizations in the reviwed articles; in the studies that analyzed the sensitive conditions, pneumonia (n=6), gastroenteritis (n=5), and asthma (n=5) were the mais causes pointed out., Conclusion: respiratory, parasitic and perinatal diseases revealed to be the main causes for hospitalizations in Brazilian children; pneumonia, gastroenteritis, and asthma constitute the most important of hospitalizations, treatable in the ambulatory health care.

The stem cell is a class of primitive cells with self-renewal, and multiple pluripotent potential capacities, which can differentiate into multiple specialized cells and generate human organs and tissues. Stem cell therapy is an interventional treatment that introduces new stem cells to damaged tissues, which facilitates the regeneration of trauma, disease and ageing-induced damaged human tissues to repair or replace the damaged tissues, thereby achieving the goal of disease treatment. It has been proved that the stem cell therapy is effective in the treatment of multiple human diseases, including cancer, diabetes, neurological disorders, autoimmune diseases, cardiovascular disorders and blood diseases. This review summarizes the advances in the research of stem cell therapy for human parasitic infections.

Aptamers are short single-stranded RNA or DNA oligonucleotides that are capable of binding various biological targets with high affinity and specificity. Their identification initially relies on a molecular process named SELEX (Systematic Evolution of Ligands by EXponential enrichment) that has been later modified in order to improve aptamer sensitivity, minimize duration and cost of the assay, as well as increase target types. Several biochemical modifications can help to enhance aptamer stability without affecting significantly target interaction. As a result, aptamers have generated a large interest as promising tools to compete with monoclonal antibodies for detection and inhibition of specific markers of human diseases. One aptamer-based drug is currently authorized and several others are being clinically evaluated. Despite advances in the knowledge of parasite biology and host-parasite interactions from "omics" data, protozoan parasites still affect millions of people around the world and there is an urgent need for drug target discovery and novel therapeutic concepts. In this context, aptamers represent promising tools for pathogen identification and control. Recent studies have reported the identification of "aptasensors" for parasite diagnosis, and "intramers" targeting intracellular proteins. Here we discuss various strategies that have been employed for intracellular expression of aptamers and expansion of their possible application, and propose that they may be suitable for the clinical use of aptamers in parasitic infections., (Copyright © 2016 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.)

Photodynamic therapy (PDT) uses photosensitizers (non-toxic dyes) that are activated by absorption of visible light to form reactive oxygen species (including singlet oxygen) that can oxidize biomolecules and destroy cells. Antimicrobial photodynamic inactivation (aPDI) can treat localized infections. aPDI neither causes any resistance to develop in microbes, nor is affected by existing drug resistance status. We discuss some recent developments in aPDI. New photosensitizers including polycationic conjugates, stable synthetic bacteriochlorins and functionalized fullerenes are described. The microbial killing by aPDI can be synergistically potentiated (several logs) by harmless inorganic salts via photochemistry. Genetically engineered bioluminescent microbial cells allow PDT to treat infections in animal models. Photoantimicrobials have a promising future in the face of the unrelenting increase in antibiotic resistance., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Antimicrobial resistance increases it health, social and economic impact. in all areas (state, regional and local), initiatives to try to contain the problem of resistance arise. In the update of this year 2016, we study microbiological, epidemiological and clinical aspects of multi-resistant bacteria, as well as resources for therapeutic approach, from ancient to modern drugs from therapeutic combinations to optimization Stewardship programs. In the case of fungal infection, we analyze clinical scenarios with different species in yeast or new clinical settings in filamentous fungi. Taking paediatric population, homologies and differences with adults in invasive fungal infection were compared. Finally in the field of parasitology, treatment of severe malaria imported or that resistant to antimalarial drugs were reviewed.

Pentastomiasis is a rare zoonotic infection but it is frequently observed in Africa and Asia. Most human infections are caused by members of the Armillifer armillatus species. They are responsible for visceral pentastomiasis in Western and Central Africa. Humans may be infected by eating infected undercooked snake meat or by direct contact with an infected reptile. An increasing number of infections are being reported in Congo, Nigeria, and Cameroon. Despite an occasionally high number of nymphs observed in human viscera, most infections are asymptomatic and often diagnosed by accident during surgery or autopsy. The clinical presentation of pentastomiasis is quite varied and depends on infected tissues. The liver, lungs, and pleura are most frequently involved. Abdominal emergencies have been reported. Diagnostic delays always occur and diagnosis focuses on the patient's lifestyle and living environment. It is mainly based on the morphological description of the parasite's calcified cuticle, the site of the lesion, and the parasite's region of origin. Most patients do not require any treatment. Personal measures such as avoidance of contact with snake droppings are recommended to prevent transmission. Imported pentastomiasis has been observed in African migrants., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

An 11-year-old child presented with poor school attendance, and signs and symptoms of severe anaemia. He was heavily covered in lice. He was investigated for other causes of anaemia. Following treatment for head lice and also iron supplementation, he was back in full-time education. This case highlights the link between head lice (pediculosis capitis) infestation and iron-deficiency anaemia., (2014 BMJ Publishing Group Ltd.)

Research and innovation in the diagnosis of infectious and parasitic diseases has led to the development of several promising diagnostic tools, for example in malaria there is extensive literature concerning the use of rapid diagnostic tests. This means policymakers in many low and middle income countries need to make difficult decisions about which of the recommended tools and approaches to implement and scale-up. The test characteristics (e.g. sensitivity and specificity) of the tools alone are not a sufficient basis on which to make these decisions as policymakers need to also consider the best combination of tools, whether the new tools should complement or replace existing diagnostics and who should be tested. Diagnostic strategies need dovetailing to different epidemiology and structural resource constraints (e.g. existing diagnostic pathways, human resources and laboratory capacity). We propose operational modelling to assist with these complex decisions. Projections of patient, health system and cost impacts are essential and operational modelling of the relevant elements of the health system could provide these projections and support rational decisions. We demonstrate how the technique of operational modelling applied in the developing world to support decisions on diagnostics for tuberculosis, could in a parallel way, provide useful insights to support implementation of appropriate diagnostic innovations for parasitic diseases.

Most imported diseases can be well treated-provided the diagnosis is made in due time. For example, only the rapid and correctly performed treatment of falciparum malaria can impede severe complications and save the patient's life. Effective treatments for amebiasis, giardiasis, leishmaniasis and worm diseases are available. However, it has to be mentioned that evidence from clinical trials is often insufficient. Accordingly only few international guidelines for imported diseases exist.

Stem cell therapy is an interventional treatment that introduces new cells into damaged tissues, which help in treating many diseases and injuries. It has been proved that stem cell therapy is effective for the treatment of cancers, diabetes mellitus, Parkinson's disease, Huntington's disease, cardiovascular diseases, neurological disorders, and many other diseases. Recently, stem cell therapy has been introduced to treat parasitic infections. The culture supernatant of mesenchymal stem cells (MSCs) is found to inhibit activation and proliferation of macrophages induced by the soluble egg antigen of Schistosoma japonicum, and MSC treatment relieves S. japonicum-induced liver injury and fibrosis in mouse models. In addition, transplantation of MSCs into naïve mice is able to confer host resistance against malaria, and MSCs are reported to play an important role in host protective immune responses against malaria by modulating regulatory T cells. In mouse models of Chagas disease, bone marrow mononuclear cell has been shown effective in reducing inflammation and fibrosis in mice infected with Trypanosoma cruzi, and transplantation of the bone marrow mononuclear cells prevents and reverses the right ventricular dilatation induced by T. cruzi infection in mice. Preliminary clinical trials demonstrate that transplantation of bone marrow derived-cells may become an important therapeutic modality in the management of end-stage heart diseases associated with Chagas disease. Based on these exciting results, it is considered by stating that it is firmly believed that, within the next few years, we will be able to find the best animal models and the appropriate stem cell type, stem cell number, injection route, and disease state that will result in possible benefits for the patients with parasitic infections, and stem cell therapy, although at an initial stage currently, will become a real therapeutic option for parasitic diseases.

Dogs and cats in Brazil serve as primary hosts for a considerable number of parasites, which may affect their health and wellbeing. These may include endoparasites (e.g., protozoa, cestodes, trematodes, and nematodes) and ectoparasites (i.e., fleas, lice, mites, and ticks). While some dog and cat parasites are highly host-specific (e.g., Aelurostrongylus abstrusus and Felicola subrostratus for cats, and Angiostrongylus vasorum and Trichodectes canis for dogs), others may easily switch to other hosts, including humans. In fact, several dog and cat parasites (e.g., Toxoplasma gondii, Dipylidium caninum, Ancylostoma caninum, Strongyloides stercoralis, and Toxocara canis) are important not only from a veterinary perspective but also from a medical standpoint. In addition, some of them (e.g., Lynxacarus radovskyi on cats and Rangelia vitalii in dogs) are little known to most veterinary practitioners working in Brazil. This article is a compendium on dog and cat parasites in Brazil and a call for a One Health approach towards a better management of some of these parasites, which may potentially affect humans. Practical aspects related to the diagnosis, treatment, and control of parasitic diseases of dogs and cats in Brazil are discussed.

Rhizobiales (formerly named Rickettsiales) cause in rare instances meningitis and meningovasculitis, respectively. In case of history of exposure, infection by Rhizobiales needs to be considered since both diagnosis and therapy may be extremely difficult and pathogen-specific. The same applies to protozoa; in this chapter, Babesia species, free-living amoebae and Entamoeba histolytica infection, including severe meningitis and brain abscess, infection by Trypanosoma species (South American and African trypanosomiasis) are discussed with respect to history, epidemiology, clinical signs, and symptoms as well as differential diagnosis and therapy. Parasitic flatworms and roundworms, potentially able to invade the central nervous system, trematodes (flukes), cestodes (in particular, Cysticercus cellulosae), but also nematodes (in particular, Strongyloides spp. in the immunocompromised) are of worldwide importance. In contrast, filarial worms, Toxocara spp., Trichinella spp., Gnathostoma and Angiostrongylus spp. are seen only in certain geographically confined areas. Even more regionally confined are infestations of the central nervous system by metazoa, in particular, tongue worms (=arthropods) or larvae of flies (=maggots). The aim of this chapter is (1) to alert the neurologist to these infections, and (2) to enable the attending emergency neurologist to take a knowledgeable history, with an emphasis on epidemiology, clinical signs, and symptoms as well as therapeutic management possibilities., (© 2014 Elsevier B.V. All rights reserved.)

Introduction: Spinal infection is a rare pathology although a concerning rising incidence has been observed in recent years. This increase might reflect a progressively more susceptible population but also the availability of increased diagnostic accuracy. Yet, even with improved diagnosis tools and procedures, the delay in diagnosis remains an important issue. This review aims to highlight the importance of a methodological attitude towards accurate and prompt diagnosis using an algorithm to aid on spinal infection management., Methods: Appropriate literature on spinal infection was selected using databases from the US National Library of Medicine and the National Institutes of Health., Results: Literature reveals that histopathological analysis of infected tissues is a paramount for diagnosis and must be performed routinely. Antibiotic therapy is transversal to both conservative and surgical approaches and must be initiated after etiological diagnosis. Indications for surgical treatment include neurological deficits or sepsis, spine instability and/or deformity, presence of epidural abscess and upon failure of conservative treatment., Conclusions: A methodological assessment could lead to diagnosis effectiveness of spinal infection. Towards this, we present a management algorithm based on literature findings.

Parasitic diseases present a considerable socio-economic impact to society. Zoonotic parasites can result in a considerable burden of disease in people and substantive economic losses to livestock populations. Ameliorating the effects of these diseases may consist of attempts at eradicating specific diseases at a global level, eliminating them at a national or local level or controlling them to minimise incidence. Alternatively with some parasitic zoonoses it may only be possible to treat human and animal cases as they arise. The choice of approach will be determined by the potential effectiveness of a disease control programme, its cost and the cost effectiveness or cost benefit of undertaking the intervention. Furthermore human disease burden is being increasingly measured by egalitarian non-financial measures which are difficult to apply to livestock. This adds additional challenges to the assessment of socio-economic burdens of zoonotic diseases. Using examples from the group of neglected zoonotic diseases, information regarding the socio-economic effects is reviewed together with how this information is used in decision making with regard to disease control and treatment., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Parasitic infections are prevalent in certain parts of the world and may cause pleural involvement, which often goes unrecognized. Common parasites involving the pleura include Entamoeba histolytica, Echinococcus granulosus and Paragonimus westermani. Amebiasis can cause empyema with "anchovy sauce" pus, reactive pleural effusions and bronchopleural fistula with hydropneumothorax. Echinococcosis may result in pleural thickening, pneumothorax, secondary pleural hydatidosis and pleural effusions. Paragonimiasis may cause chylous and cholesterol pleural effusions, pleural thickening and pneumothorax. Less commonly, pulmonary eosinophilia, or Loeffler's syndrome, caused by Ascaris lumbricoides, Ancylostoma duodenale and Necator americanus and tropical pulmonary eosinophilia caused by Wuchereria bancrofti and Brugia malayi may involve the pleura. This article provides a comprehensive review of parasitic infections involving the pleura. A high index of suspicion in the appropriate clinical setting is required to facilitate prompt diagnosis and treatment of these diseases.

Bacteriophages are viruses of bacteria that are used for controlling bacterial food-borne pathogens and have been proposed for more extensive usage in infection control. Protists are now recognised to harbour viruses and virus-like particles. We propose that investigation of their prevalence in parasites be intensified. We also propose that such viruses might be considered for virotherapy to control certain parasite infections of man and animals., (Copyright © 2013. Published by Elsevier Ltd.)

Innate immunity is considered to provide the initial defense against infections by viruses, bacteria, fungi, and protozoa. Detection of the signature molecules of invading pathogens by front-line defense cells via various germline-encoded pattern recognition receptors (PRRs) is needed to activate intracellular signaling cascades that lead to transcriptional expression of inflammatory mediators to coordinate the elimination of pathogens and infected cells. To maintain a fine balance between protective immunity and inflammatory pathology upon infection, the innate signaling pathways in the host need to be tightly regulated. MicroRNAs (miRNAs), a new class of small non-coding RNAs, have been recently shown to be potent modulators that function at post-transcriptional levels. Accumulating evidence demonstrates that the involvement of microorganism-encoded and host miRNAs might play instructive roles in the immune response upon infection. Here, we discuss the current knowledge of miRNAs in the regulation of immune response against infections.

Pentastomiasis is a type of parasitic zoonosis. Most patients with pentastomiasis are asymptomatic. We report here two pediatric patients with severe pentastomiasis (porocephaliais taiwan and armilliferiasis), and the results of their 6-year and 3-year follow-ups, respectively. The manifestations and outcomes of the two cases are described. The diagnoses were established by histopathologic and/or parasitologic examinations. After diagnosis, traditional Chinese medicine (TCM), as well as praziquantel and/or albendazole, were used for treatment. This report highlights the seriousness of pentastomiasis in children. We suggest TCM be considered as supplementary or even primary treatment of children with severe pentastomiasis.

MicroRNAs (miRNAs) are a recently discovered class of small non-coding RNAs that can down-regulate protein expression by specific mRNA recognition. Evidence is accumulating that the miRNAs are implicated in the course and outcome of infectious and non-infectious diseases. Both parasites specific miRNA sequences and the phenomenon of the alteration of host miRNA levels after parasite infection are known, although detailed information about the direct intervention of parasites in the alteration of host miRNA levels and how this is regulated by parasites at molecular level is still lacking. Circulating miRNAs can be detected in biological fluids as serum, saliva and others, exhibiting a good potential as non-invasive biomarkers. Their ability to function as master regulators of the gene expression and the possibility for a relative easy manipulation of the miRNA machinery and related events, coupled with their apparent lack of adverse events when administered, place miRNAs as promising targets for the treatment of diseases. Moreover, the dependence of parasites over the host cellular machinery to accomplish infection and complete their biological cycles, together with the potential manipulation of host's responses through parasite miRNAs, point out that the miRNA machinery is particularly interesting to seek for alternative therapeutic approaches against parasites. Additionally, the studies about parasitic manipulation of the host immune responses thought miRNAs could broaden our knowledge about basic aspects of the host-parasite relationships., (Copyright © 2012 Elsevier B.V. All rights reserved.)

We report a rare parasitic nematode infection in a 26-year-old healthy African American man. Gongylonema nematode infections in humans are unique in their ability to localize in the submucosa of the oral cavity and oropharynx. Humans are incidental hosts for the Gongylonema nematode, which is more commonly found in rudimentary animals, birds, and rodents. Approximately 50 cases of human Gongylonema infections have been reported worldwide, including 11 documented cases in the United States.(1) The pathogenesis, characteristic clinic findings, and identification features will be discussed.

Introduction: Bangladesh harbors many leeches in its vast wetlands. Leeches have a tendency to enter through body orifices with potentially life-threatening consequences. Literature search revealed inadequate description of clinical manifestations and treatment of leech infestations in children. We describe our experience with leech infestations in children., Methods: Between January 1, 2004 and December 31, 2010, 17 cases of leech infestation through body orifices in children were managed. This is a retrospective study on age, sex, route of leech entry, investigation and treatment, and outcome., Results: Age ranged from 4.5 to 11 years (mean 6.4 ± 1.8) and females accounted for more than 70 %. The orifices of leech entry include urethra, vagina, and rectum. Leeches could be found in eight cases. Two boys with leeches in the urinary bladder needed suprapubic removal. Leeches were retrieved from the vagina under general anesthesia in three cases, and on three occasions leeches came out from the vagina after normal saline instillation. In nine cases with different routes of entry where leech was not found, instillation of normal saline was sufficient to stop bleeding. Fifteen cases presented with bleeding and transfusion was required in five cases with Hb% <7 gm/dl., Conclusions: Leech infestation through lower body orifices is common in children of rural Bangladesh. Prompt diagnosis is of paramount importance, and application of normal saline is effective in most cases. Sometimes surgical intervention is required.