Vermox
[Echinococcosis. Rational diagnosis and therapy]

[Article in German]

Morl M.

The most dangerous of the parasitoses seen in Middle Europeans, are cystic and alveolar echinococcosis which, here in Germany, varies considerably in frequency. Cystic echinococcosis is found throughout the entire world; the disease is seen mostly in "guest workers". Alveolar echinococcosis may be observed sporadically in all the Alpine countries, in Bavaria, and also in Baden-Wurttemberg. As a result of slow growth, the onset of the symptomatology is considerably delayed. Dangerous complications are jaundice, stenosis of the pylorus of the stomach, incidents resulting from portal hypertension, infections of the cysts, and perforation of the lesion into the neighbouring organs or into the free abdominal cavity. The complement-binding reaction, indirect haemagglutination and the indirect enzyme immuno test, together, achieve a sensitivity of up to 97%. Static scintigraphy of liver and spleen, ultrasonography, laparoscopy, X-ray survey, angiography, and, in particular, computerized tomography, are further diagnostic procedures. If at all possible, treatment should be surgical. The only conservative measure worth trying is the administration of mebendazole (Vermox).

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6213540&dopt=Abstract mebendazole Vermox



Vermox
Improvement of metabolic control in diabetic patients during mebendazole administration: preliminary studies.

Caprio S, Ray TK, Boden G, Reichard GA Jr, Shuman CR, Smith RH, Mozzoli MA, Dayal VK, Hoeldtke RD, Owen OE.

After the observation of decreasing insulin resistance in a diabetic patient during treatment with mebendazole for nematosis, we investigated the effect of mebendazole on metabolic control in six Type 1 (insulin-dependent) and six Type 2 (non-insulin-dependent) diabetic patients, eight of whom were chronically resistant to conventional treatment. Before and after mebendazole treatment for 1 month, plasma glucose and serum C-peptide concentrations were determined both fasting and 4 h after a mixed breakfast. Improvements in fasting blood glucose concentrations occurred in Type 1 (12.83 +/- 1.11 versus 6.56 +/- 0.56 mmol/l; p less than 0.05) and Type 2 (10.22 +/- 0.56 versus 7.56 +/- 0.67 mmol/l; p less than 0.05) diabetic patients and were associated with increases in post-cibal C-peptide responses in Type 1 and Type 2 diabetic patients. Following discontinuation of mebendazole, metabolic control deteriorated in five out of the six Type 1 diabetic patients and in all the Type 2 diabetic patients. We conclude that mebendazole increases insulin secretion, and decreases plasma glucose concentration in Type 1 and Type 2 diabetic patients. However, these beneficial effects may be transient.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6381196&dopt=Abstract mebendazole Vermox



Vermox
[Mebendazole therapy in echinococcosis. Long-term study and course parameters in 8 patients]

[Article in German]

Allgayer H, Harlin M, Weinzierl M, Bircher J, Paumgartner G.

Eight patients with inoperable echinococcosis, four each with the cystic or alveolar form, had received mebendazole (Vermox) at a daily dose of 1.5 g for an average of 27 months. In six patients with clinical symptoms the number of fever attacks fell by 60% and of hospital admissions by 54%, cholangitic and/or icteric attacks disappearing completely. Two patients had no recognizable symptoms, either before or after treatment. One woman with multilocular disease died of bleeding from esophageal varices. The immunological and morphological findings did not reveal any relationship to the clinical course. Apart from reversible leukopenia in one patient there were no serious side effects. These observations indicate a satisfactory effect of long-term treatment of inoperable echinococcosis with mebendazole.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6383765&dopt=Abstract mebendazole Vermox



Vermox
Energy metabolism of adult Haemonchus contortus in vitro: a comparison of benzimidazole-susceptible and -resistant strains.

Bennet EM, Bryant C.

In vitro biochemical characteristics of three strains of Haemonchus contortus, benzimidazole-susceptible, mebendazole-resistant and thiabendazole-resistant isolates, were investigated. Steady-state pool sizes of glucose and metabolic intermediates, including adenine nucleotides and end-products revealed no differences between adult worms resistant or susceptible to benzimidazoles in 30-60 min incubations. Possible regulatory steps in the glycolytic pathway are identified as those involving the enzymes hexokinase, phosphofructokinase and pyruvate kinase. The major component of carbohydrate reserves was trehalose, some glycogen was present and the glucose pool was small. On incubation for 18 h in vitro, carbohydrates were metabolised in all three strains. However, in the benzimidazole-susceptible worms there was a preferential use of the glycogen reserves to maintain energy metabolism. All three strains had similar levels of total lipid, total protein and free amino acid and these did not change on incubation. The major products found in the medium on incubation, in vitro, for 18 h were propionate, acetate and propanol, with smaller amounts of ethanol, lactate and malate. All three strains produced a similar sum total of end-products; however, in the mebendazole-resistant strain there appeared to be a diversion of carbon flow to the ethanol-producing pathway. Carbon dioxide production in 60 min incubations was measured using radioactively labelled glucose. A greater output of labelled CO2 was noted under aerobic than anaerobic conditions. This was particularly true of the mebendazole-resistant strain and, in this strain, was sensitive to cyanide. The extent to which metabolic differences noted in the three strains may be related to benzimidazole resistance is not readily apparent.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6427605&dopt=Abstract mebendazole Vermox



Vermox
The effects of diethylcarbamazine, mebendazole and levamisole on Onchocerca volvulus in vivo and in vitro.

Rivas-Alcala R, Mackenzie CD, Gomez-Rojo E, Greene BM, Taylor HR.

The effects of mebendazole, levamisole, diethylcarbamazine citrate (DEC-C), and the combination of mebendazole and levamisole, on adult Onchocerca volvulus and on the in utero development of microfilariae was studied in nodules excised from patients in Southern Mexico. Adult worms isolated from patients treated with mebendazole showed a reduction in mobility and contained 40 times fewer developing microfilarial forms than did worms from untreated patients. Most of the developmental forms found in adult worms from mebendazole-treated patients were either oocytes or early morulae, with more mature forms being scarce or morphologically abnormal. Treatment with levamisole had a similar effect on embryogenesis, however it was much less marked. The number and distribution of developing forms in worms from patients treated with DEC-C was similar to that found in the control groups. The effect of the same three drugs on microfilariae in vitro was also tested. DEC-C at concentrations of 0.5 microgram - 2000 micrograms/ml did not have any obvious effect on motility or morphology of the worms provided the pH was maintained at physiological levels; levamisole also had no effect in vitro. Mebendazole induced the death of microfilariae when used at concentrations greater than 100 micrograms/ml, however these levels are greater than those found in the blood of patients under treatment. The optimal conditions for short-term maintenance of O. volvulus microfilariae in culture, are discussed. It is apparent from these studies that mebendazole has an effect on the maturation of microfilariae in utero and may also, at high concentrations, have a direct effect on mature microfilariae.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6464189&dopt=Abstract mebendazole Vermox



Vermox
Incidence of helminthic infections and comparative study of pyrantel pamoate with levamisole and mebendazole in hospital patients at Barisal, Bangladesh.

Islam AF, Sadeque M, Biswas K, Ahmed N, Mahmood G.

A study was carried out to find out the incidence of helminthic infections in hospitalized patients at Sher-e-Bangla Medical College, Barisal and to determine the comparative efficacy of pyrantel pamoate, levamisole, and mebendazole. It was observed that 76.2 per cent of total hospitalized patients were infected with intestinal helminths. Polyparasitism (52.6 per cent) was more frequent than single infection (21.8 per cent). Amongst these, 47.5 per cent was suffering from Asearis lumbricoides (AL), 42.5 per cent from Hookworm (H.W) and 65.8 per cent from trichuris trichura (TT). Out of 255 cases examined separately, 40 per cent was suffering from Enterobious vermicularis (EV) infection. The comparative study showed that mebendazole produced egg negative stool in 90.9 per cent of AL, 95.6 per cent of HW and 86.8 per cent of TT after eight days of treatment. On the other hand, pyrantel pamoate cured AL in 93.3 per cent, HW in 78.5 per cent and TT in 34.2 per cent eases. Levamisole cured 75 per cent AL, 4.1 per cent H.W. and 22.2 per cent TT within the same period.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6466265&dopt=Abstract mebendazole Vermox