Sarcocystosis (sarcosporidiosis)

Sarcocystosis is characterized by the invasion of various tissues by protozoa of the genus Sarcocystis. S. hominis (intermediate host domestic cattle) and S. suihominis (domestic pig) are the most significant to humans, to whom they are transmitted by ingestion of uncooked beef or pork. Camel meat can be a significant source of S. cameli in Arabia. Humans and other primates serve as either intermediate or final host: (1) intermediate host—presence of cysts in muscle is usually asymptomatic, but might cause myositis or myopathy; detected on clinical examination or muscle biopsy; (2) final host—can be asymptomatic or cause fever and gastrointestinal upset; oocysts or sporocysts can be detected in faeces. There is no specific treatment. Prevention is by not eating uncooked meat from any animal and by improving food hygiene in poorer countries.

Risk Factors of Gout in MDR-TB Patients in Eritrea: A Case-Control Study

Though the incidence of gout in general population is less than 5% (globally), a study conducted in Eritrea among patients with multidrug resistant tuberculosis (MDR-TB) revealed a higher incidence (25%). Other similar studies conducted elsewhere, however, did not report gout as an adverse effect. It is unknown why a higher incidence of gout is being reported in Eritrea compared to similar studies from other countries. The objective of this study is therefore to explore risk factors for the increased risk of incident gout among MDR-TB patients in Eritrea. A case-control study was conducted in Merhano MDR-TB National Referral Hospital in Eritrea. All MDR-TB patients diagnosed with gout between June 2011 and June 2018 were considered as cases. Controls matched by age, sex, and cumulative drug exposure time were selected from the same study population (1:1 ratio). A total of 84 MDR-TB patients, 42 cases and 42 controls, were included in this study. No patient from the control group has comorbidities, while six patients from the case group have diabetes (χ2 = 6.46, df=1, p=0.026). Patients having tachycardia (OR=3.26, 95% CI=1.28, 8.27), alopecia (OR=3.11, 95% CI=1.00, 9.67), and gastrointestinal upset (OR=3.17, 95% CI=1.26, 7.96) as adverse effects and being on prolonged use of propranolol (OR=3.26, 95% CI=1.28, 8.27) were found to be more likely to develop incident gout compared to their controls. In conclusion, MDR-TB patients with diabetes mellitus, tachycardia, alopecia, and gastrointestinal upset and on prolonged use of propranolol tablet had increased risk of incident gout.

Assessment of the returning traveller

The extent of global travel is ever increasing, and this is reflected in the number of travellers attending GP surgeries on their return to the UK. Presenting issues more commonly dealt with by GPs, particularly among returning travellers who have visited developing countries and tropical regions, include gastrointestinal upset, feverish illnesses, potential exposure to schistosomiasis and the finding of eosinophilia. The full spectrum of travel-related illness is too extensive to be covered in detail, but an overview of the assessment and management of these clinical presentations is given.

Quantifying the “Slosh Stomach”: A Novel Tool for Assessment of Exercise-Associated Gastroparesis Symptoms in Endurance Athletes

Introduction. We describe a novel scale and its field use for evaluation of exercise-associated gastroparesis in the endurance athlete.Methods. A scale was created based on gastroparesis tools previously described in the medical literature. Surveys of the tool were administered to runners participating in a 210 km multiday foot race in Sri Lanka.Results. Use of this novel scale was demonstrated to be useful in assessing gastroparesis severity scores of athletes and how these symptoms affected their race performance. Of the 27 race participants who completed the survey, 27 felt that the tool adequately captured their symptoms.Conclusions. This novel survey tool was able to assess the presence and severity of exercise-associated gastroparesis symptoms in endurance racers in a remote location. This tool may be helpful with further research of the identification and management of gastroparesis and other gastrointestinal upset in the endurance race environment.

Sarcocystosis (sarcosporidiosis)

Sarcocystosis is characterized by the invasion of muscles and sometimes other tissues by protozoa of the genus Sarcocystis, of which S. hominis (intermediate host domestic cattle) and S. suihominis (domestic pig) are the most significant to humans, to whom they are transmitted by ingestion of uncooked beef or pork. Humans serve as either intermediate or final host: (1) intermediate host—presence of cysts in muscle is usually asymptomatic, but may cause myositis or myopathy; detected on clinical examination or muscle biopsy; (2) final host—may be asymptomatic or cause fever and gastrointestinal upset; oocysts or sporocysts can be detected in faeces. There is no specific treatment. Prevention is by not eating uncooked meat from any animal....