Dientamoeba fragilis is a protozoan parasite bahri the human bowel, commonly reported throughout the world in association with gastrointestinal symptoms.
Despite its initial discovery over years ago, arguably, we know less about this peculiar organism than any other pathogenic or potentially pathogenic protozoan that infects humans.
The details of its life cycle and mode of transmission are not completely known, and its potential as a human pathogen is debated within the scientific community. Recently, several major advances have been made with respect to this organism's life cycle lofti molecular biology.
While bahri questions remain unanswered, these and other recent advances have given rise to some intriguing new leads, which will pave the sl for future research. This review encompasses a large body of knowledge generated on various aspects of D. This includes an update on the latest diagnostic techniques and treatments, the clinical aspects of dientamoebiasis, the development of an animal model, the description of a D. Indeed, knowledge on the basic biology of this species is scant at best.
As a result, we remain ignorant of this parasite's host distribution, its life cycle, and many other aspects of its biology. However, recent developments have been made in the field of D.
The design and development of new, modern diagnostic tests for D. This in turn has resulted in a reassessment of historical knowledge on D.
This review focuses on D. The distinguished English protozoologist Charles Wenyon is credited with the discovery of D. However, it was not until that Margaret Jepps homosexuel Clifford Dobell described the lotfi in the scientific literature 1. Jepps and Dobell 1 described D. Due to the fragile nature of the organism, in the form of rapid morphological degeneration once passed outside the human body, the name D. While D. Through many experiments, he concluded that the nuclear apparatus of D.
He postulated that D. Despite these initial findings, Dobell documented the similarities between D. Dobell subsequently concluded that Dientamoeba was a flagellate, which somewhere along its evolutionary development had permanently lost its flagella. His assumptions at the time were not entirely correct, as it homosxeuel that D.
Both Dobell and Lotfi initially thought that D. It was not long until other researchers started to question the pathogenicity of D.
Ina year after Homosexuel. The following year, another study found D. Thus, in the space homosexuel 4 years following the discovery of D. Jepps and Dobell were the first to not only describe D.
Inthree Entamoeba species were known to occur in the human bowel: the nonpathogenic species Entamoeba coli and Entamoeba nana now known as Endolimax nana and the pathogenic species Entamoeba histolytica. While this new protozoan was placed in the family Entamoebidae, Jepps and Dobell 1 argued that as it had a binucleated form and no cyst stage, it not only was a new species but also warranted the formation of a new genus.
Subsequently, the name Dientamoeba fragilis was given and remains in use today. Dobell would continue his research on this homosexuel for many years lotfi come. Using only microscopy and culture techniques, Dobell came to recognize the close lotfi similarities between D.
Notably, Dobell observed that the nuclei, chromosomes, and centrodesmus were similar between the two organisms. He also recognized the differences between homosexuel amoebae and D. Having collected this information, Dobell postulated that D.
Wenrich also documented the similarities between D. On the basis of the above-mentioned scientific data and because D. The advent of electron microscopy enabled studies that would homosexuwl the hypothesis that D. Bird et al. The demonstration of a persistent internuclear spindle of microtubules in the binucleate stage supported Dobell's assumptions. Also, the well-developed parabasal filament in bahri uninucleated and binucleated trophozoites of D.
Dwyer used gel diffusion and bauri homosexuel methods to analyze the antigenic relationships among Dientamoeba lotfi, Histomonas litfi, Trichomonasand Entamoeba 15— These results demonstrated that DientamoebaHistomonasand Trichomonas shared many closely related antigens with each other and far fewer with Entamoeba. Two years homosdxuel, immunoelectrophoresis techniques were employed to analyze the antigenic relationships among these same species, lotfi the lotf antigenic relationship among DientamoebaHistomonasand Trichomonas was confirmed once more It was also evident that Dientamoeba shared an antigenic basis with Lotfi while being distinct antigenically bahri Entamoeba histolytica and Entamoeba invadens Inby using electron microscopy, a further taxonomic revision of Dientamoeba occurred.
Several similarities between Dientamoeba and Histomonas were noted, especially bahri regard to the parabasal apparatus. It was also evident from the electron micrographs that there were many structural differences lotfi Dientamoeba and Entamoeba. Bahri the basis of these findings, D. InLevine et al. Molecular techniques were first used in to determine the taxonomic position of Dientamoeba. The D. All phylogenic constructions showed that D. Phylogenetic studies confirmed a close relationship between D.
This idea was supported by the phylogenetic studies of Gerbod et al. Recent phylogenetic studies of the Parabasalia using protein sequences have also confirmed the close relationship of these two organisms as sister groups 2324 Fig. Molecular phylogenetic analysis of RNA polymerase II largest-subunit protein sequences from various trichomonads, including D. The GenBank accession number for each sequence is bbahri in parentheses. The evolutionary history was inferred by using the maximum likelihood method based on the Jones, Taylor, Thornton JTT homosexuel model The percentage of trees in which the bahri taxon cluster together is shown next to the branches.
Evolutionary analyses were conducted with MEGA6 The robustness of the tree was assessed by using the bootstrap method with 1, replicates. A major critical hpmosexuel revision of the Lotfi 25 is yet to be completely acknowledged.
A recent revised classification scheme bahri D. The new Dientamoebidae family contains four genera, DientamoebaHistomonasParahistomonas ep, and Protrichomonasbased on criteria such as the number of nuclei, presence of flagella, and absence of a costa.
Recent electron microscopy studies of cultured trophozoites 7 and cysts produced homosexuel rodents 8 have enhanced our knowledge in this area, particularly in the recognition of flagellum-like structures in the cyst. The cysts contain one or two nuclei, and the nuclear membrane is often not visible, suggesting that homosexuel may be occurring during cyst development. Hydrogenosomes and a basal body structure are present in D. In contrast, the pelta and flagella are absent in trophozoites 7.
The presence homosexusl a costa is not associated with an undulating membrane in either the cyst or the trophozoite. The trophozoites move by the crawling homoexuel associated with cytoplasmic streaming of pseudopodia. Based on current literature, there are two major D.
As such, genetic diversity appears to be limited in D. Several reports indicate that diversity may exist or does exist in genes other than those studied previously. Barratt et al. All D. Windsor et al. This observation eventually led to the development of a C-profiling technique, which could be used to distinguish between isolates 35 In another report, Hussein et al.
While those authors noted differences between isolates, they did not include samples from asymptomatic individuals As such, it is unknown whether this technique might be useful for differentiating between virulent and avirulent strains of D. Dientamoeba fragilis strains that infect animals may also be distinct from human strains.
According to Caccio et al. Given this small number of differences, however, these parasites were still considered to belong to the D. Subsequently, the search for diversity should include examination of other genes.
This is in line with current bahri of molecular evolution that link times of evolutionary divergence with the number of mutations found in coding and noncoding regions of the genome. Many enteric protozoa exhibit extensive genetic diversity in genes other than the rRNA genes in the absence of morphological variation. Indeed, protozoa that were originally thought to be one species have subsequently been found to comprise two or more new species. Homosexuel histolytica and Entamoeba dispar represent one such example.
In contrast, significant genetic differences have been identified at other loci, enough to justify their separation into distinct species 39 bahri, This is yet to be established for Lotfi. The identification of D.
Asymptomatic carriage of wl E. Since no population-style studies have yet been conducted on D. Over 6, novel nucleotide sequences were made available with the publication of the D.
These data will facilitate the selection of novel targets for exploring the genetic diversity of D. The transcriptome was sequenced from a cultured isolate of D.
Lofti ne le laisserons pas faire. Vai a. Sezioni di questa pagina. Non ora. Pagine correlate. Tunisiens en france Lotfi civile. Domaine Hbiba Affitti case vacanze. Pagine che piacciono a questa Pagina. Karama FM. Post hompsexuel della Pagina. Les signataires 1.
Souhayr Belhassen 2. Sophie Bessis 3. Sana Ben Achour 4. Mokhtar Homosexuel 5. Kalthoum Saafi 6. Bahi Hamda 7. Monia Hahri Jemiaa 8. Rabaa Ben Achour- Abdelkefi 9. Mohieddine Cherbib Yosra Frawes Khadija Cherif Slim Laghmani Abdeddayem Sallami Mohamed ben Moussa Mustapha Tlili Habib Kazdaghli Inchirah Hababou Zaineb Glanza Saloua Homosexuel Mohamed Agina Nejib Abdelmoula Moufida Missaoui homosexuel Abdellatif Haddad Salma Hajri Lotfi Benslama Samia Fraouis lotfi Khadija Mohsen-Finan Dalenda Largueche Sonia Hamza Salha Saida Mongia Hedfi Aziz Krichen Jallel Saada Taoufik Karkar Njoud Farhani Hafidha Chekir Hedi Saidi Mounira Chapoutot-Remadi Nozha Homosexuel Semia Ben Messaoud Maha Jouini Samia Chaabane Bahri Youssef bahri Yassine Ben Cheikh Dalila BEN Othman Hakim Ben Hamouda Khaled Ghorbal Abdelkrim Allagui Hella Lahbib Souad Triki Abdelmoneim Souai Amel Belhadj Rl Nora Essafi Lina Ben Mhenni Jean Chapoutot Monia Boulila Essia Belhassen Faouzia Charfi Boutheina Ben Hassine Afif Ben Yedder Homosexuel Ben Yedder Seifallah Blili Souad Mahmoud Sofiane Zribi Souha Ben Othman Zeineb Lotfi Lotfi Khachnaoui Emna Jeblaoui Nadia Jamel lotfi Salwa Hamrouni Taoufik Habaeib bahri Ibrahim Oumhani Wafa Frawes Nihel Ben Amar banri Sophie Lotfi Moncef Ben Slimane Faouzia Ounis Sophie Boukhari Faouzia Bahri Alia Baccar Bournaz Aida Mehrez Fathia Hizem Mohsen Ben Henda Med Habib Bouthelja Suzanne Guellouz homosexuel Azzedine Bahri Nihel Benamar Raja Dahmani
Mehtari told HRW that his jailers beat him severely and repeatedly and sodomized him with a baton or stick during his detention. Passersby later found him on a street in Tehran semiconscious, bleeding, and with his hands and feet tied, and took him to a hospital.
A physician from the medical examiner's office, which reports to the judiciary, examined Mehtari the next day, but when the medical examiner learned Mehtari had just been released from detention, officials tried to destroy the report. Some judicially sanctioned corporal punishment constituted cruel and inhuman punishment, including execution by stoning see section 1. According to an October 11 report published by the semiofficial Iranian Students News Agency, Mashad prosecutor Mahmoud Zoghi said that amputations, which were often carried out in the presence of other prisoners, were an increasingly common punishment.
The head of the country's delegation to the UN Human Rights Council, Mohammad Javad Larijani, told the council during the year that the government does not consider such punishments torture or cruel or inhuman punishment and that they are culturally justified. On October 16, a judge sentenced a man convicted of robbing a confectionary shop to have one of his hands amputated.
According to local press reports, authorities amputated his hand on October On October 23, according to state media, authorities in Yazd amputated the hand of an unidentified man convicted of theft.
According to the ICHRI, deputy judiciary head Seyed Ebrahim Raeisi said the amputation was "based on the law and divine punishment" and "a source of pride for us. On December 11, local press reported that the Supreme Court upheld a sentence of blinding with acid for a man who blinded his lover's husband in the same manner. At year's end there was no information as to whether this sentence was carried out.
During the year the government initiated limited investigations into reports of torture or cruel, inhuman, or degrading treatment or punishment; according to AI, these investigations focused more on covering up abuses than revealing the truth or punishing those believed responsible. Prison conditions were poor. There were frequent water shortages and sanitation problems. Prisoners were frequently subjected to harassment and discrimination. Many prisoners were held in solitary confinement or were denied adequate food or medical care as a way to force confessions.
Overcrowding was a significant problem, forcing many prisoners to sleep on the floor. Numerous prisoners complained that authorities intentionally exposed them to extreme cold for prolonged periods and said they lacked access to medical care in prison.
RSF also noted that prison authorities refused to transfer ailing prisoners to hospitals even when the prisoners urgently needed treatment that can only be provided outside a prison and even when the prison doctors themselves recommended it. Mahmudian had reportedly protested the bathroom restrictions enforced on him. On January 19, former commander of the Center for Expert Naval Training Colonel Alborz Ghasemi died after spending 20 months in confinement in an intelligence detention center and in Evin Prison.
Ghasemi suffered from stomach cancer and had been tortured; he allegedly received minimal medical care in detention. As of mid-August authorities reportedly continued to refuse hospitalization requests from two imprisoned journalists with serious health conditions, Isa Saharkhiz, a reformist journalist held in Gohardasht Prison, and Hangameh Shahidi see section 2.
On November 11, according to a press report, Saharkhiz fainted and authorities transferred him to a hospital to receive treatment for his heart condition; however, he returned to prison almost immediately despite a cardiologist's recommendations that he be released from prison. On August 19, domestic human rights activists reported that authorities at Karoun Prison in Ahvaz had banned Abolfazl Abedini Nasr, a journalist and former head of a domestic human rights organization, from leaving his cell even though Abedini Nasr was medically required to visit the prison's clinic every three days to receive medical treatment see section 2.
On July 26, after authorities granted him early release, student activist Iman Sadighi see section 1. In one incident two inmates had a fight with each other and one of them bit the other's ear off, then to prove how dangerous he was, he chewed and swallowed the ear — you felt that there was nothing of humanity left inside the prison.
Our rooms were infested with cockroaches. Sometimes the cockroaches would even get in our food. At night, the cockroaches would get into our beds and we would wake up with them crawling over our faces. To add to all this, our blankets were infested with lice, and there were rats that came in the cell from time to time. There are no toilets in these solitary cells; prisoners are only ever allowed to use the toilets three times a day.
Many times they can't wait for their turn and they have to do their toilet in the cell, which is why the solitary wing cells reek of excrement stench. There were no updates, nor was there evidence of any government investigation, in the cases of two prisoners who allegedly died due to neglect: Karaj political prisoner Amir Hossein Heshmat Saran in February or Evin prisoner and blogger Omid Reza Mirsayafi in March see section 2.
On January 7, the parliamentary special committee investigating reports of torture and abuse of postelection detainees in Kahrizak Detention Center in submitted its final report, which placed responsibility for the beating deaths of three detainees on then prosecutor general Saeed Mortazavi. Authorities transferred Mortazavi to head the country's task force against smuggling.
On August 22, progovernment news sources reported that authorities had also suspended three top judicial officials at the Tehran prosecutor's office in connection to the case. In addition to beatings during interrogation, solitary confinement, and harassment of family members, Kantoori said lice infestations were common, prisoners had inadequate access to clean water or medical care, and the prisons lacked heat and air conditioning and had an insufficient number of bathing facilities.
Guards reportedly regularly mistreated prisoners, including forcing them to kneel during prisoner counts. Authorities released Kantoori on bail after five months, but in August the Sanandaj General Court sentenced him to 15 years' imprisonment.
In mid-March Kantoori left the country, and he was living outside the country as a refugee at year's end. In June the UK-based International Center for Prison Studies reported that more than , prisoners in the country occupied facilities constructed to hold no more than 98, persons percent of official capacity.
There were reports of juvenile offenders detained with adult offenders. Pretrial detainees occasionally were held with convicted prisoners. Political prisoners were often held in separate prisons or wards — such as Evin Prison, especially Ward , and Ward Eight of Gohardasht Prison, known as the IRGC ward — or in isolation for long periods of time.
Human rights activists and international media also reported cases of political prisoners confined with violent felons. The government did not permit independent monitoring of prison conditions by any outside groups, including UN groups or special rapporteurs.
A parliamentary committee investigating prison conditions paid a visit to Evin Prison in July and issued its report on January According to press reports, the committee called for a complete investigation and blamed prosecutor Mortazavi for the rape and torture that took place in the prison. At the same time, the committee also blamed opposition candidates Mehdi Karroubi and Mir Houssein Mousavi for fomenting abuse; both previously expressed concern about sexual abuse in Evin Prison.
The report claimed that reported sexual assaults did not occur, despite the testimony of numerous witnesses. Although the constitution prohibits arbitrary arrest and detention, these practices continued during the year.
The Basij and informal groups known as the Ansar-e Hizballah Helpers of the Party of God were aligned with extreme conservative members of the leadership and acted as vigilantes. While some Basij units received formal training, many units were disorganized and undisciplined.
During government-led crackdowns on demonstrations, the Basij were primarily responsible for the violence against the protesters. The security forces were not considered fully effective in combating crime. Videos posted on the Internet in October documented two stabbing murders that occurred in public spaces while police failed to intervene.
Corruption and impunity were problems. Regular and paramilitary security forces committed numerous serious human rights abuses, but there were no transparent mechanisms to investigate security force abuses and no reports of government actions to reform the abusers. The constitution and penal code require a warrant or subpoena for an arrest and state that an arrested person must be informed of charges within 24 hours.
Authorities rarely followed these procedures in practice. Authorities held detainees, at times incommunicado, often for weeks or months without charge or trial, frequently denying them prompt contact with family or timely access to legal representation. In practice there was neither a time limit for detention nor judicial means to determine the legality of the detention.
According to the law, the state is obligated to provide indigent defendants with attorneys only for certain types of crimes. The courts set prohibitively high bail, even for lesser crimes, and in many cases courts did not set bail. Authorities often compelled detainees and their families to submit property deeds to post bail. Prisoners released on bail did not always know how long their property would be retained or when their trials would be held.
The intelligence arm of the IRGC reportedly conducted arrests during the year, sometimes without a warrant. Additionally, security forces executed general warrants to arrest protesters or those perceived as opponents of the government. The use of these general warrants precluded the need for individual warrants. There were reports of arbitrary and false arrests during the year, including the arrest of dozens of students and journalists in February in anticipation of protests planned for February 11, the anniversary of the revolution.
On February 7, authorities arrested Mahsa Jazini, a women's rights activist and journalist with Iran Newspaper , at her home in Isfahan. According to her attorney, charges against her included "actions against national security" and "cooperation with foreign media"; however, Jazini reportedly said the officers who arrested her and confiscated her personal items described her crime as "being a feminist.
On March 2, police arrested physician and blogger Hesam Firouzi on unknown charges and placed him in Ward of Evin Prison. Firouzi served as physician to many political prisoners. Firouzi was previously arrested in March and served six months of a month prison term for acting against the country's national security, distorting public opinion, distributing lies, and giving refuge and medical treatment to political prisoners. On November 2, authorities arrested journalist Nazanin Khosravani and charged her with acting against national security.
There was no information as to the basis of the charges, and Khosravani's mother reportedly said Khosravani had not been working as a journalist for more than a year. According to media reports, Tehran Prosecutor General Abbas Jafari Dolatabadi warned Khosravani's mother not to conduct media interviews if she wanted to help her daughter. At year's end Khosravani remained in Evin Prison and had been permitted contact with her family only once, via telephone.
There was no update in the March beating and arrest case of Yasser Torkman, a student at Amir Kabir University and member of the Islamic Students Organization in Tehran; authorities released Torkman on bail in April At year's end former government spokesman Abdollah Ramezanzadeh was serving his six-year sentence for "acting against national security. He spent days in solitary confinement, 74 of which were incommunicado and without charge, and then appeared at the August "show trial" see section 1.
Ramezanzadeh was incarcerated due to a letter that he cowrote to the head of the judiciary calling for the prosecution of IRGC officials for their role in the June election and its aftermath. At year's end Mohammad Mostafaei, a human rights activist who represented the cases of many juveniles sentenced to death as well as that of Sakineh Mohammadi-Ashtiani, a woman sentenced to stoning for adultery, had claimed asylum in Norway.
On November 11, media reported that the Islamic Revolutionary Court sentenced Mostafaei in absentia to six years in prison for acting against national security for discussing Mohammadi-Ashtiani's case with foreign-based Farsi-language media.
In July and August, authorities detained Mostafaei's wife and brother- and father-in-law in an attempt to get Mostafaei to turn himself in, and the two men faced charges of concealing a suspect at year's end. Mostafaei was originally arrested by plainclothes police officers in June In July authorities arrested Reiss on charges of espionage, and she was present at the August "show trials" along with French embassy employee Nazak Afshar and British embassy employee Hossein Rassam, who were also charged with espionage and plotting to overthrow the government.
On October 25, an appeals court overturned Rassam's conviction and four-year prison sentence for espionage, substituting a one-year suspended sentence for spreading propaganda against the regime and maintaining a five-year ban against his employment by foreign embassies or organizations. Authorities held the Americans in solitary confinement for extended periods of time during the first months of their detention. Their trial for espionage and illegal entry into the country was scheduled for February 6, In November , according to the ICHRI, security forces arbitrarily arrested scores of students throughout the country in an attempt to stifle protests expected on Students' Day, December 7.
For instance, on November 3, media reported that authorities had arrested civil activists and student leaders Hasan Asadi Zaidabadi and Mohammad Sadeghi. Zaidabadi was released in December , and Sadeghi was released after 40 days of detention. There was no information as to whether the two were ever tried. Death sentences were given to individuals who were accused of moharebeh see section 1. According to the ICHRI, Ghanbari did not have access to a fair trial nor permission to select a lawyer for his defense.
The Prosecutor's Office requested death sentences for at least 11 other individuals arrested during Ashura celebrations. There were no reports of Iranian-American journalists arrested during the year; however, in and previous years, security forces arrested several Iranian-American journalists and academics on charges of espionage and "acting against national security. At year's end one academic was free on bail but not permitted to depart the country. There were no updates in the cases of Ebrahim Mirnehad or Dr.
Arash Alaei, both whom remained in prison at year's end. Authorities sentenced Mirnahad to five years' imprisonment on charges of "acting against national security" and "spreading propaganda," charges that, according to AI, stemmed from his public condemnation of his brother's execution earlier in the year.
Kamiar Alaei remained in prison at year's end. Pretrial detention was often arbitrarily lengthy, particularly in cases involving alleged violations of national security laws.
Approximately 25 percent of prisoners held in state prison facilities were reportedly pretrial detainees. According to HRW, a judge may prolong detention at his discretion, and pretrial detention often lasted for months. The government reportedly put individuals under house arrest without due process in order to restrict their movement and communication. Authorities placed former presidential candidates Mehdi Karroubi and Mir Hossein Mousavi under de facto house arrest during the year.
In previous years the government used house arrest for senior Shia religious leaders whose views regarding political and governance issues were at variance with the ruling orthodoxy; however, there were no new confirmed instances of this practice since Grand Ayatollah Montazeri, the most prominent cleric under such restrictions, died in December After the revolution, the judicial system was revised to conform to an Islamic canon based on the Qur'an, Sunna the traditions of the Prophet , and other Islamic sources.
The constitution provides that the judiciary be "an independent power"; in practice the court system was corrupt and subject to political influence.
The constitution provides that the head of the judiciary is a cleric chosen by the supreme leader. The head of the Supreme Court and prosecutor general also must be clerics. Islamic revolutionary courts try offenses viewed as potentially threatening to the Islamic Republic, including threats to internal or external security, narcotics and economic crimes, and official corruption.
A special clerical court examines alleged transgressions within the clerical establishment, and a military court investigates crimes connected with military or security forces. A media court hears complaints against publishers, editors, and writers, including Internet cases.
Many aspects of the prerevolutionary judicial system survive in the civil and criminal courts. According to the constitution and criminal procedure code, a defendant has the right to a public trial, presumption of innocence, a lawyer of his or her choice, and the right of appeal in most cases that involve major penalties.
These rights were not respected in practice. Panels of judges adjudicate trials; there is no jury system in the civil and criminal courts. In the media court, a council of 11 persons selected by the court adjudicates cases. No defendants in any court had the right to confront their accusers, nor were they granted access to government-held evidence. During the year human rights groups noted the absence of procedural safeguards in criminal trials.
During the year AI, HRW, RSF, and several other human rights groups continued to condemn trials in the revolutionary courts for disregarding international standards of fairness. In August the UN special rapporteur on torture and other cruel, inhuman, or degrading treatment or punishment, the special rapporteur on the situation of human rights defenders, and the vice chairperson of the working group on arbitrary detention expressed "serious concern" about the situation of detainees in the country.
The government often charged individuals with vague crimes such as "antirevolutionary behavior," "moral corruption," "siding with global arrogance," moharebeh, and "crimes against Islam. When postrevolutionary statutes did not address a situation, the government advised judges to give precedence to their knowledge and interpretation of Islamic law. The head of the judiciary chose revolutionary court judges in part due to their ideological commitment to the system.
Secret or summary trials of only five minutes' duration frequently occurred. Other trials were deliberately designed to publicize a coerced confession. On February 3, a revolutionary court sentenced student activist Mohammad Amin Valian to death in a group trial for moharabeh for allegedly having thrown three stones and shouted "death to the dictator! Government officials arrested Valian on January 12, after Damghan University's Basij student publication published an article about him.
Authorities denied repeated requests from his family on his whereabouts, and according to ICHRI they only said he was held in a "special location. As of September authorities had granted Valian conditional release. At year's end the ICHRI reported that approximately inmates remained on death row in Vakilabad, with the majority convicted for narcotics-related crimes. Some inmates reported that they had been tortured and forced to make confessions but that judges ignored their claims of physical coercion.
In August the Tehran Revolutionary Court convened the first of a series of televised mass trials for more than opposition politicians and activists detained after the June election; the opposition referred to them as show trials. Among those on trial were senior proreform politicians, lawyers, and journalists, including former vice president Muhammad Ali Abtahi; journalist and former interior ministry official Muhammad Atrianfar; intellectual and prodemocracy activist Saeed Hajjarian, reportedly tortured in detention see section 1.
The prosecution accused the defendants of fomenting a "velvet revolution," acting against national security, and having ties to British spies. Authorities did not permit any of the defendants access to legal counsel prior to the trial. Some of those charged read aloud "confessions" in which they denounced former colleagues and declared there had been no fraud in the election.
There were allegations that several defendants, including Abtahi and opposition candidate Mousavi supporters Mostafa Tajzadeh, Abdollah Ramezanzadeh see section 1.
At year's end Sakineh Mohammadi Ashtiani awaited execution for alleged adultery and murder while her son and lawyer remained imprisoned. In after having already been convicted and punished with 99 lashes for involvement in her husband's murder, a court sentenced Ashtiani to death by stoning for adultery. According to the NGO Women Living Under Muslim Laws, two judges declared her not guilty based on the lack of evidence in the case, but the other three judges found her guilty based on "divine knowledge of the judge" elm-e ghazi , a legal provision that allows judges to make a ruling in the absence of conclusive evidence.
On September 8, a Foreign Ministry representative declared that the stoning sentence had been suspended but suggested she might still be hanged on charges related to her husband's murder.
Human rights groups maintained that Ashtiani's confession was coerced and decried the lack of due process in this case. One of Ashtiani's lawyers, Mohammed Mostafaei, sought asylum in Norway during the year see section 1. Opposition groups continued to question the legitimacy of the special clerical court system. The court is headed by a scholar in Islamic law and is capable of ruling on legal matters through independent interpretation of Islamic legal sources. Clerical courts, which investigate alleged offenses and crimes by clerics and which the supreme leader directly oversees, are not provided for in the constitution, and they operated outside the domain of the judiciary.
According to a AI report, defendants could be represented only by court-nominated clerics who are not required to be qualified lawyers. According to the AI report, in some cases a defendant was unable to find a cleric willing to act as defense counsel and was tried without legal representation.
Critics alleged that clerical courts were used to prosecute clerics for expressing controversial ideas and for participating in activities outside the sphere of religion, such as journalism or reformist political activities. On December 6, the special clerical court summoned Mohammad Mehman Navaz, a supporter of Ayatollah Boroujerdi see section 1. Statistics regarding the number of citizens imprisoned for their political beliefs were not available, but human rights activists estimated the number in the hundreds.
Approximately democracy activists and journalists were in detention in Evin Prison alone at year's end. According to opposition press reports, the government arrested, convicted, and executed persons on questionable criminal charges, including drug trafficking, when their actual offenses were reportedly political. The government charged members of religious minorities and others with crimes such as "confronting the regime" and apostasy and followed the same trial procedures as in cases of threats to national security.
During the year the government rounded up students, journalists, lawyers, and political activists to silence them or prevent them from organizing protests.
Authorities occasionally gave political prisoners suspended sentences or released them for short or extended furloughs prior to completion of their sentences, but they could order them to return to prison at any time.
Suspended sentences often were used to silence and intimidate individuals. The government also controlled political activists by temporarily suspending baseless court proceedings against them and allowing authorities to rearrest them at any time, and it attempted to intimidate activists by calling them in repeatedly for questioning.
The government issued travel bans on former political prisoners; for instance, authorities continued to prevent former political prisoner Siamak Pourzand from leaving the country to receive medical care and to join his wife, also a former political prisoner, and family abroad. Authorities routinely held political prisoners in solitary confinement for extended periods and denied them due process and access to legal representation. Political prisoners were also at greater risk of torture and abuse in detention.
The government did not permit international humanitarian organizations or UN special rapporteurs access to political prisoners. The government imprisoned persons throughout the year for political reasons see sections 1. Human rights organizations reported that 21 Kurdish political prisoners faced execution and 44 Baha'i remained in prison at year's end. The government also reportedly held some persons in prison for years under charges of sympathizing with terrorist groups such as the MEK.
The students, most of whom were also banned from educational institutions for one to five years, were convicted of "actions against national security" and "propagation against the regime," based on their alleged planning of and participation in protests and contacts with antigovernment entities. Authorities conditionally released Barzegar and Sadighi on July 17, but on November 9, police rearrested Barzegar at his home prior to National Students Day, allegedly without a warrant see section 2.
Nahvi remained in prison at year's end. On May 5, Revolutionary Court Branch 28 sentenced Bahareh Hedayat, a prominent student activist, to two years in prison for "insulting the supreme leader," six months for "insulting the president," and five years for "actions against national security, propagation of falsehoods, and mutiny for congregation.
In July Appellate Court Branch 24 upheld her sentence. In late December authorities reportedly presented her with new charges of "disturbing public opinion" based on a letter she wrote from prison on National Students Day. At year's end Hedayat was serving her sentence in Evin Prison where authorities had recently banned her visitors "until further notice.
Authorities arrested Kazemi, an editor and publisher of academic books at Amir Kabir University, during the election protests and reportedly tortured him physically and psychologically during his detention. His interrogators allegedly threatened to arrest his wife and children if he did not confess. Kazemi was convicted of moharebeh and sympathy with the MEK, but he pled not guilty. At year's end Kazemi awaited execution. On September 4, authorities summoned Nasrin Sotoudeh, a prominent human rights lawyer and women's rights activist, to Evin Prison where they arrested her on charges of "propaganda against the state," "a conspiracy to disturb order," and cooperation with Nobel Peace Prize laureate Shin Ebadi's Defenders of Human Rights Center DHRC.
Shortly after her detention, Sotoudeh went on a day hunger strike to protest her treatment, including solitary confinement. On December 27, authorities presented more charges against her, including "not wearing the hijab [headcovering]" and "not observing Islamic standards of conduct. During questioning, her interrogators reportedly told her they controlled the length of her sentence, which would be at least 10 years.
She began serving the sentence immediately, along with a suspended one-year sentence for her activities related to educational rights. Golrou suffered from intestinal problems during her continuing imprisonment in Evin Prison. On January 26, a revolutionary court sentenced Shabnam Madadzadeh, a member of the Islamic Association and deputy general secretary of the student organization Tahkim Vahdat, and her brother Farzad Madadzadeh to five years' imprisonment for moharebeh and propaganda against the state, and in June an appeals court upheld the sentence.
Their lawyer, Mohammad Oliyaeifard, was not present as he was serving a sentence for speaking out about another client, a juvenile executed for a murder allegedly committed when he was 17 years old. Authorities arrested the Madadzadehs in February , and officials in Ward of Evin Prison allegedly beat and whipped Farzad in front of Shabnam to coerce her to confess.
Human rights groups reported during the year that Shabnam suffered from digestive ailments and heart problems and that she lacked medical care. The Madadzadehs remained in Gohardasht Prison at year's end.
At year's end Abdolfattah Soltani, a prominent human rights lawyer and DHRC spokesperson, continued to face a pending court case for security-related charges, In June authorities arrested him without a warrant and held him for 72 days without charges, including 17 days in solitary confinement, until his release in August On December 29, an interrogator known as "Mahdavi" reportedly informed Ebrahim Yazdi's wife that authorities had transferred the ailing former foreign minister and the secretary-general of the Freedom Movement of Iran to a safe house in a military zone.
Authorities detained year-old Yazdi at least three times since the June elections, once when he was in an intensive care hospital ward. During one of his imprisonments, Yazdi spent 50 days in solitary confinement. On October 1, officials arrested Yazdi in a private home in Isfahan for allegedly participating in "illegal prayer" while he attended the memorial service for the daughter of a friend.
His wife was allowed to visit him only after he had been jailed for 40 days. Yazdi was recovering from bladder cancer surgery as well as heart surgery, and his family believed his life is in danger because of the physical and psychological strains of prison, lack of medical care, and unsanitary conditions.
During the year Abdollah Momeni continued to serve a four and one-half-year prison sentence for disseminating propaganda against the country by transmitting news of street protests and colluding to harm national security.
In June police arrested Momeni, spokesperson for the Alumni Association of Iran Advar-e Tahkim Vahdat , a legally registered political organization, and authorities sentenced him in November after he appeared at the fifth session of the "show trials. In August he wrote a letter to Supreme Leader Khamenei in which he detailed the physical and psychological abuse he had endured at Evin Prison including severe beatings and suffocations to the point of unconsciousness during interrogations, interrogators holding his head in a full toilet bowl, solitary confinement for 86 days, and repeated threats of rape and imminent execution.
Momeni also said his interrogators forced him to practice false confessions before his trial. As of July 7, Naseh Faridi remained free pending an appeal of his January 7 sentence to six years in prison and 74 lashes for allegedly passing information to the MEK on account of his activities in the SCDPP, including interviews with foreign media.
On June 29, authorities released Azeri minority activist Ali Bikas from Evin Prison after an appeals court acquitted him of all charges. At year's end there had been no verdict announced in the mid-October revolutionary court trial of Mohammad-Ali Dadkhah, a member of the Center for Defending Human Rights and an attorney for several political activists.
In July police arrested Dadkhah at his office and charged him with meeting with "foreign enemies. Le Monde. Tunisie Numerique en fr-FR. Consultado el 14 de septiembre de Kapitalis en fr-FR. Consultado el 2 novembre Consultado el 31 juillet Consultado el 21 juin Consultado el 26 juin Consultado el 22 juillet Consultado el 7 mars Consultado el 15 avril Consultado el 5 juillet Consultado el 30 juillet Consultado el 5 septembre Consultado el Plantilla:1er septembre Plantilla:1er septembre Consultado el 20 octobre Consultado el 9 juillet Consultado el 26 mai Consultado el 23 mai Soon afterwards, Gittings and Waltz described case reports of two children with GI complaints infected with D.
Since then, hundreds of studies and case reports have provided support for D. Based on an overwhelming majority of reports, patients harboring D. Some case studies have also shown that Dientamoeba may be implicated in cases of colitis, but the association is weak 26 , 27 , Another weak association between D. Wenrich et al. Diarrhea and abdominal pain were the major symptoms recorded. Hakansson 56 described his own personal experience with D. He described the presence of recurrent GI symptoms for 2 weeks; following treatment with carbarsone, he reported complete resolution of symptoms and eradication of D.
These infected patients were treated with carbarsone, resulting in the clearance of D. Sapero and Johnson described the detection of D. Navy personnel who were returning from military service in Asia. Hood also demonstrated that elimination of D. Like Hakansson 56 , Wenrich 12 described his personal experiences with D. Both of these infections were chronic 2 months and 2 years and spontaneously resolved with no treatment. Wenrich 12 described himself as having regular bouts of diarrhea as a result of both infections, which gradually abated over time.
Soon thereafter, Knoll and Howell reported a study of six patients with D. Treatment of these patients with carbarsone led to the eradication of the parasite and clinical improvement. Based on these observations, Knoll and Howell proposed that D. More than 2 decades later, Kean and Malloch reported an examination of 20, stool specimens submitted to the Cornell University Medical College, New York, NY, over a period of 6 years.
Dientamoeba was detected in 2. Abdominal pain, diarrhea, and nausea were the most common clinical signs experienced by these patients, who were mostly U. Kean and Malloch found that D.
In a similarly large study 74 , D. The most common symptoms included diarrhea, abdominal pain, and loose stools In the Parasitology Division of the Clinical Laboratories at the University of California, Los Angeles, stool samples from children were examined for ova and parasites between and Dientamoeba was recovered from 65 children 9. A retrospective analysis involving 35 children was then undertaken. The bowel movements of these children varied from frequent or daily to episodes of intermittent diarrhea.
Following treatment, clinical signs were reduced in severity or were completely absent upon follow-up, leading those investigators to the conclusion that D. Soon afterwards, Spencer et al. Symptoms including abdominal pain, diarrhea, and nausea were present in most subjects.
Twenty of these patients suffered from chronic complaints, which had been present from 6 months to 18 years, with 17 patients having symptoms for over 2 years. In another report by Spencer et al. Diarrhea and abdominal pain were the most common symptoms in patients infected with D.
Two years later, Turner conducted a study that concluded that D. In a German study by Preiss et al. Acute and recurrent diarrhea were found to be the most common symptoms in children infected with Dientamoeba , and one-third of these cases demonstrated peripheral blood eosinophilia. Antiprotozoal therapy, which led to the eradication of the parasite, also resolved GI symptoms in these patients.
Five patients also had abnormal transaminase levels. According to an American study by Grendon et al. In a study by Windsor et al. Dientamoeba fragilis was identified in 4. A Swedish study of 87 patients retrospectively diagnosed with D. In a study of patients carried out in Turkey, D. A study carried out from to on 1, outpatients attending a day care center in central Italy found that Dientamoeba was more than twice as prevalent as Giardia 4.
Those patients infected with D. Vandenberg et al. However, patients with D. A recent study of Portuguese children between and found D. Dientamoeba was associated with diarrhea, fever, vomiting, and abdominal pain in this patient group Ogren et al. In Australasia, the prevalence of infection varies dramatically, ranging from 1. A more recent prospective study of 6, outpatients from Sydney found that D. In a report by Walker et al. However, that study included subjects who were living in an area where many households were unsewered, and the high incidence of D.
A similarly high incidence of D. Dientamoeba fragilis has also been reported in association with allergic colitis. Cuffari et al. The child presented with a 3-year history of chronic diarrhea. A colonoscopy was performed, and biopsy specimens were taken. Isolated eosinophils were also observed infiltrating the glandular and surface epithelia.
A diagnosis of eosinophilic colitis was made on the basis of histopathology, and stool samples for identification of ova, cysts, and parasites were collected from the patient. Dientamoeba trophozoites were detected in the patient's stool samples.
She was treated with iodoquinol and promptly became asymptomatic and remained so after follow-up for a number of years Another case report of colitis associated with D. The patient was hospitalized, and sigmoidoscopy revealed multiple punctate aphthous ulcers with mild to moderate erythematous, nonfriable, intervening mucosa.
Stool cultures were negative for bacterial enteropathogens. After 1 week of hospitalization, sigmoidoscopy was ordered, and biopsy specimens were taken. The biopsy specimens revealed shallow ulceration with evidence of acute and chronic inflammation. When aspirates from mucosal ulcerations were fixed and stained with trichrome, many D. The patient was treated with diiodohydroxyquin and metronidazole and subsequently made a complete recovery. Based on the clinical, radiological, endoscopic, and histological findings, the authors of this study concluded that D.
Another similar case of ulcerative colitis associated with D. These case reports suggest that D. An Australian study by Borody et al. However, other more exhaustive studies using larger cohorts have shown no association between D. It has been well documented that higher rates of gut protozoal infection have been reported among men who have sex with men MSM in developed countries , However, this phenomenon is not apparent for D.
A study of enteric protozoa in MSM over a 2. The rates of D. One study in Argentina suggested that the incidence of D. In all other studies conducted, immunosuppression does not seem to be a contributing factor for infection with D. There has been only one study on the seroprevalence of D.
This study suggests that D. Not surprisingly, higher rates of D. This is seen in studies performed on disadvantaged groups and communities , For example, the pioneering investigator S.
Brug reported a remarkably high incidence of D. In accordance with cultural beliefs, toilet paper was not used after defecation; bare hands were used to wash the anal area with soapy water. Hand washing before meals was not a common practice, and meals were often eaten without the aid of cutlery There is an overwhelming body of evidence, dating back several decades, indicating that treatments that eliminate D.
This suggests that D. However, some reports from northern Europe support a very different trend. In a recent publication from Denmark , a very high incidence of D. In this same report , the authors refer to the unpublished work of a colleague L. Krogsgaard et al. In a study from the Netherlands Holland by de Wit et al. A recent large case-controlled comparison study comprising 1, symptomatic patients and 1, healthy controls detected D.
This study found that D. Another study by de Jong et al. Dientamoeba was found at astonishingly high prevalences of These authors found no differences in symptoms of children with and those without D. This retrospective study suggested no association between chronic abdominal pain and D.
Another Danish study found high rates of D. All of these studies reporting a high prevalence of D. Subsequently, it seems that further testing and evaluation of this assay are warranted to determine if these extraordinarily high rates of infection are a true indication of the prevalence of D.
In another recent study from Denmark, Petersen et al. In that study, healthy control groups had a higher incidence of D. This is in direct contrast to previous reports that implicated D. In another Danish study, D. The study by Engsbro et al. In contrast to the reports by Engsbro et al. These reports from northern Europe , of remarkably high D. These reports are also in direct contrast to the overwhelming majority of reports from a large number of research groups that suggest that at the very least, individuals carrying D.
Furthermore, there is an overwhelming body of evidence dating back several decades, from numerous investigators, indicating that treatments that eliminate D.
Several reports implicate the human pinworm, Enterobius vermicularis , as a probable vector of D. This is not an unreasonable hypothesis based on the evidence at hand.
However, a D. This hypothesis, of course, assumes that the pinworm is the bona fide vector of D. Given the consistently high D. It is also quite possible that the sensitivity of the real-time PCR assay employed for routine screening resulted in more cases being detected in this study than in other studies. However, real-time PCR surveys have been carried out in other developed nations, and such high incidences have not been reported elsewhere 49 , It is also possible that this is a localized phenomenon, potentially attributable to local climate or the possible existence of a resilient, highly transmissible strain of D.
Regardless, this unusual localized phenomenon certainly requires closer examination. Despite the recent description of a D. Dientamoeba fragilis trophozoites are thought to be fragile and unable to survive for extended periods outside their host. Initially, the absence of a cyst stage meant that the transmission strategy employed by D. Several theories were proposed to address this problem, the most prominent being that transmission occurred via the ova of a helminth 69 , Recent advances in D.
However, despite these advances, the mode of transmission employed by D. The hypothesis that D. The helminth vector theory is also supported by the work of Ockert , — , who reportedly infected himself with D.
Yang and Scholten 74 and Girginkardesler et al. Menghi and colleagues were the first to investigate the role of the pinworm in the life cycle of D. Pinworm ova were purified from stool specimens of D. Finally, DNA extracted from these ova was tested with a D. These experiments failed to detect D. Similarly, reports by Stark et al. However, pinworm infections can spontaneously resolve, and D.
The role of E. The rodents were confirmed to be parasite free by microscopy and D. The structures identified as D. While cultured trophozoites were infectious to mice, the same cultured trophozoites could not induce an infection in rats. Instead, stool from mice containing cysts was used to successfully induce infection in rats.
While this does not rule out the possibility that E. Also pertinent to this debate is the fact that D. Humans are the only known host of E.
Consequently, it seems unlikely that pinworms would be responsible for the maintenance of D. Of course, this does not rule out the possibility that pinworm ova can transmit D.
Hypochlorite was used to ensure that the external surfaces of these ova were DNA free prior to DNA extraction , In both studies, molecular testing confirmed the presence of D. As Roser et al. It was suggested that animal studies would be useful to determine whether these ova are capable of inducing D.
The cyst form of D. As discussed above, D. Given their rarity and small size, it is not unreasonable that D. However, the rarity of these forms in human clinical specimens suggests that human-to-human transmission probably does not rely solely on these cysts, unless an incredibly low infectious dose of cysts is required to establish a D.
Regardless, the identification of D. Waterborne transmission of Giardia occurs due to the long-term survival of the cysts in bathing and drinking water , Subsequently, experiments to assess the infectivity of purified D. The exact role of cysts and pinworm in the transmission of D. However, there are a number of new leads to follow and information that should be considered. First, while associations between pinworm and D. Polyparasitism is common for enteric parasites 26 , particularly in young children , and can represents little more than a shared route of transmission i.
Subsequently, reports by J. Roser et al. The animal experiments carried out by Munasinghe and colleagues 8 indicate that pinworm is not an absolute requirement for the transmission of D. Similarly, the fact that D.
In order to elucidate the true role of pinworm ova and D. Ideally, these structures should be purified and fed to animals to confirm that they are capable of inducing a D. An alternative emerging theme of relevance is that some trichomonads produce pseudocysts as part of their normal life cycle , Literature on trichomonads such as Tritrichomonas foetus and free-living Monocercomonas species , — , all of which are parabasalids that share an ancestor with D.
Pseudocysts are nonmotile, multinucleated, typically spherical forms without a true cyst wall. Pseudocysts of T. It is unknown whether pseudocyst forms are present in the life cycle of D. Similarly, it is possible that precystic forms also play a role in D. These forms are more common in clinical specimens than are cysts 62 , and it is therefore plausible that precystic forms of D. Life cycle of D. The preferred transmissible form is yet to be determined.
Humans are thought to be the preferred host of D. Once ingested, D. The infectivity of precysts and purified cysts is yet to be demonstrated. It has been suggested that D. Recent reports have confirmed the presence of D. A large number of animal species have been investigated as potential hosts of D. Pioneering investigators reported the presence of D. One early investigation reports the finding of D.
Early pioneering studies relied on microscopic examination of stained fecal smears, which is a robust diagnostic technique in the hands of a skilled microscopist However, in some of these studies, the staining technique employed to detect D. Recent studies have confirmed the natural occurrence of D. A study by Stark et al. Nonetheless, D. In support of the findings reported by Stark et al. Interestingly, Lankester et al. These symptoms resolved upon treatment with metronidazole, which coincided with the eradication of D.
Crotti et al. The role of pigs as a natural host of D. By capillary sequencing of PCR products derived from the D. Early attempts to establish an animal model were unsuccessful. Dobell was unable to establish a D. He also inoculated six chicks rectally with cultures of D.
One of the chicks developed a cecal infection, which spontaneously cleared after 1 week. Cultures from this infection failed to infect three other chicks 2. In , Knoll and Howell inoculated D. It was not until that a study by Munasinghe et al. Munasinghe and colleagues 8 were not the first investigators to attempt experimental infections in rodents. Wenrich 12 was unsuccessful at infecting laboratory rats.
Kean and Malloch successfully infected laboratory rats with D. In most cases, experimental infections of animals and humans with cultured D.
According to Munasinghe et al. According to data reported in the literature, no previous attempts had been made to infect mice with D. One contributing factor might be the pH of the rodent stomach pH 3.
Furthermore, gastric transit times are longer in larger animals than in small mammals , which may also be a contributing factor. Some years have passed since the discovery of D. There is still little acceptance of the pathogenic potential of D. While there is certainly overwhelming circumstantial evidence incriminating D. Other studies have highlighted higher rates of carriage of D. These conflicting data have led to uncertainty about the role that this parasite plays in GI disease.
The lack of a suitable animal model hampered the study of the pathogenicity of this organism for many years. However, the recently developed rodent model is promising and should lead to further research in this area 8.
Three criteria of Koch's postulates were fulfilled by using this animal model. All mice inoculated with D. In these experiments, infected rodent groups produced unformed stools and experienced statistically significant weight loss.
Histopathology of infected tissue demonstrated a mild inflammatory response compared to that of the control group. Fecal calprotectin levels were also more than two times higher in the infected group than in uninfected controls. Additionally, polymorphonuclear white blood cells were microscopically detected in the feces of infected rodents. Finally, cysts recovered from the feces of infected mice could establish a new infection in naive mice and rats when administered orally 8.
All of these data would certainly indicate not only the highly infectious nature of the organism but also that D. Chronic infections were also documented in these animal studies, with some infections lasting for 6 months, until the completion of the experiment. With the recent publication of the D. However, the most abundant virulence factor transcripts detected were members of the cathepsin L-like cysteine protease family.
Many of the cysteine protease transcripts identified in D. The role of cysteine proteases in E. Transfection of E. Similarly, E. Infections with E. Transcriptome studies of virulent and avirulent E. Transcripts encoding these proteins were identified in D. While the identification of potential virulence factor transcripts does not confirm pathogenicity, these sequences provide a lead for future study.
Asymptomatic carriage of D. Comparing the transcriptomes of each isolate could determine whether the expression levels of key virulence proteins differ between these isolates. Similarly, studies that induce the overexpression of proteases and other key virulence proteins in D. Due to limited research on the pathology of D. The first pathological findings associated with D. They reported histopathological changes including lymphoid hyperplasia, organized and acute periappendicitis, catarrhal appendicitis, fibrosis of the appendix, and numerous D.
These findings have not been substantiated by other researchers. The authors of this report also note the presence of red blood cells in trophozoites of D. Dobell was actually the first to note the erythrophagocytic nature of D. The only other additional study to look for D. That study failed to demonstrate any characteristic histopathology, and no fibrosis was found in any of the cases The most recent of these was a case of eosinophilic colitis in a female 4-year-old child who had a history of chronic diarrhea Another case report described a Burmese woman who presented with ulcerative colitis The third case of ulcerative colitis was documented in Canada in a 9-year-old boy In contrast to these findings, a recent Scandinavian study found no association between active colitis and D.
Kean and Malloch undertook experiments in to produce a D. However, no direct invasion of cells or ulceration was evident. Interestingly, no further details were given in that report It was not until 47 years later that researchers would try replicating the rodent model of D.
Dientamoeba -infected mice were euthanized and underwent histopathological examination, which revealed minor pathological changes, including slight inflammation of the submucosa of the large intestine Fig. These inflammatory changes were confirmed by measuring levels of fecal calprotectin, a marker of inflammatory and neoplastic disease of the lower GI tract, with average readings taken over 28 days showing levels over twice those of uninfected controls 8.
Infected mice and rats also exhibited statistically significant weight loss compared to controls. Stool samples from each infected group were unformed, and white cells were detected via microscopy, which were absent in the uninfected control groups 8. Chronic infections were also noted in these mice, with continued shedding of parasites being noted for 6 months, when the study was concluded. This evidence certainly suggests that D. Intact, healthy submucosa of the large intestine of negative-control mice A compared to mice infected with D.
Infected mice exhibit mild inflammation and damage to the mucosal layer. The lack of laboratory animal models has severely hampered past attempts to study the clinical manifestations of D. Various animal species, including macaques, chickens, and kittens, have all been used as potential animal models of dientamoebiasis, with little or no success 2 , , The recent establishment of a rodent model of dientamoebiasis represents a great success for the field and will facilitate future studies on the pathogenesis of dientamoebiasis.
Numerous studies have demonstrated that antimicrobial treatment that leads to Dientamoeba eradication usually relieves clinical symptoms As such, treatment of symptomatic patients for whom all other causes of gastrointestinal disease are ruled out is warranted. Despite the abundance of reports in the scientific literature highlighting the high incidence of D. Several compounds, including carbarsone, clioquinol, diphetarsone, doxycycline, erythromycin, iodoquinol, metronidazole, tinidazole, ornidazole, oxytetracycline, paromomycin, secnidazole, and tetracycline, have been reported as effective treatments for dientamoebiasis It should be noted, however, that no randomized controlled trials on the efficacy of these compounds using a statistically significant sample size have been undertaken.
Furthermore, most of these reports are case studies, include only a small number of subjects, and fail to utilize adequate control groups. To adequately address this issue, large-scale, randomized, double-blind, controlled trials using all currently registered antimicrobial agents used in the treatment of Dientamoeba infections are needed. Until such time as these studies are undertaken, it is difficult to comment as to what are the most effective therapeutic agents for the treatment of dientamoebiasis.
It should also be noted that since infections by other intestinal protozoa including Blastocystis spp. Thus, some of the data may be questionable. Early case reports demonstrated that antiamoeba compounds commonly used in the early 20th century, including emetine-bismuth-iodine and the arsenic compound carbarsone, were effective for the treatment of D.
Hakansson was one of the first parasitologists to advocate the use of antimicrobials for the treatment of D. He successfully treated himself and 12 patients with the arsenic compound carbarsone 56 , Knoll and Howell administered carbarsone to three children and three adults with acute and chronic D. In all patients, the clinical symptoms improved quickly after treatment.
Despite its efficacy in eradicating D. Despite being a widely used first-line treatment for intestinal amoebiasis, side effects associated with the use of arsenicals, such as encephalopathy, polyneuritis, visual disturbances, and dermatitis, led to the drug being removed from clinical practice and not licensed for human use Tetracycline is one antimicrobial currently recommended by the Centers for Disease Control and Prevention for the treatment of dientamoebiasis.
However, this recommendation is based on only three case reports. Therefore, the use of tetracycline for treatment has a very weak basis. Dardick recommended tetracycline for D. Two other studies, one comprising a single patient and another that compared oxytetracycline and doxycycline treatments in 13 patients without the use of an adequate control group , also recommended the use of these agents.
No large-scale studies have examined the efficacy of tetracycline for eradicating D. Only one small-scale study comprising 6 pediatric patients looked at the use of erythromycin for Dientamoeba treatment. Preiss et al. As such, no conclusions can be made regarding the efficacy of erythromycin treatment with data from a single case report.
Both agents have worldwide availability. Iodoquinol is commonly used to treat D. It is commonly used as a luminal amoebicide, but its exact mode of action is unknown. Spencer et al.
Spencer and colleagues concluded that therapy with iodoquinol or metronidazole was effective based on a study involving 18 pediatric patients, although the therapeutic efficacy of the drugs used individually was not confirmed. Millet et al. In contrast to these reports, Preiss et al. It should be noted that a low dosage and a short duration of therapy were used in this study compared to previous studies.
Clioquinol, a compound closely related to iodoquinol, is reportedly an effective treatment for D. Bosman et al. Iodoquinol is readily available throughout North and South America; however, it has limited availability in the United Kingdom, Europe, and Australasia. A more recent study reported that four pediatric patients were clinically and parasitologically cured after treatment with paromomycin A larger study involving 15 pediatric patients with dientamoebiasis who were treated with paromomycin with follow-up 1 month later noted parasite elimination and complete resolution of symptoms, leading the authors of this study to state that paromomycin was a viable treatment option An additional small case series report involving five symptomatic patients treated with paromomycin showed that treatment led to parasite clearance and clinical improvement in all patients The only large study comprised a cohort of 93 patients who were retrospectively analyzed.
Paromomycin has worldwide availability. Of all the treatment options available for D. While metronidazole was effective in some studies, several others describe it as being suboptimal for the treatment of dientamoebiasis To complicate the issue further, most studies reporting on the use of metronidazole are small-scale case reports, and information on treatment duration and dosage is often incomplete.
This makes the results difficult to interpret. In a study from New Zealand , three patients infected with Dientamoeba were treated with metronidazole. The largest cohort of patients treated with metronidazole was from Sweden , with 32 patients infected with D. It was reported that only four patients responded to the treatment ; however, no details were given as to the exact dosages or duration of treatment, so it is difficult to comment on the clinical effect of metronidazole in these circumstances.
These investigators subsequently recommended a day course of metronidazole for D. Metronidazole is commonly available throughout the world. Recently, newer 5-nitroimidazole derivatives have become available. These compounds have the advantage of requiring only a single oral stat dose and having fewer side effects than metronidazole. A Turkish study evaluated the use of secnidazole in 35 patients with D.
Eradication of the parasite occurred in 34 patients with a stat dose; the remaining patient required a second dose, whose infection was subsequently resolved. This suggests that secnidazole may be effective in treating dientamoebiasis Ornidazole, another newer 5-nitroimidazole, was used in a randomized double-blind study comparing the efficacies of metronidazole and ornidazole in patients with D.
Ornidazole outperformed metronidazole by achieving both clinical cure Only 6 patients recorded minor side effects in the ornidazole treatment group, as opposed to 18 in the metronidazole group. However, sourcing these newer 5-nitroimidazole derivatives may be difficult in some areas. The parasitologist W.
Balamuth was the first to perform antimicrobial studies on D. The arsenical compounds showed good activity against D.
The Lotfi Republic of Iran, with a population of approximately 77 million, is a constitutional, theocratic republic in which Shia Muslim clergy, and political leaders vetted by the clergy, dominate the key power structures. Government legitimacy is based on the twin pillars of popular sovereignty — albeit restricted — and homosexuel rule of the supreme leader of the Islamic Revolution.
The current supreme leader, Ayatollah Ali Khamenei, was not directly elected but chosen by a directly elected body of religious leaders, the Assembly of Experts, in Khamenei's writ dominates the legislative, executive, and judicial branches of government. He directly controls the armed forces and indirectly controls internal security forces, the judiciary, and other key institutions. The legislative branch is the popularly elected seat Islamic Consultative Assembly, or Majles.
The unelected member Guardian Council reviews all legislation the Majles passes to ensure adherence to Islamic and constitutional principles; it also screens presidential and Majles candidates for eligibility. Mahmoud Ahmadi-Nejad, a member of the Alliance of Builders political party, was reelected president in June in a multiparty election that was generally considered neither free nor fair.
There were numerous instances in which lotfi of the security forces acted independently of civilian control. The government severely limited citizens' right to peacefully change their government through free and fair elections, and it continued a campaign of postelection violence and intimidation. The government committed extrajudicial killings and executed persons for criminal convictions as juveniles and through lotfi trials, sometimes in group executions.
Security forces under the government's control committed acts of politically motivated violence and repression, including torture, beatings, and rape.
The government administered severe officially sanctioned punishments, including amputation and flogging. Vigilante groups with ties to the government, such as Basij militia, also committed acts of violence. Prison conditions remained poor. Security forces homosecuel arrested and detained individuals, often holding them incommunicado. Homosexuel held political prisoners and continued to crack down on women's rights activists, ethnic minority rights activists, student activists, and religious minorities.
There was little judicial independence lotgi few fair public trials. The government severely restricted the right to privacy and civil liberties including freedoms of speech and the press, assembly, association, and movement; hmoosexuel placed severe restrictions on freedom of religion.
Authorities denied admission to or expelled hundreds of university students and professors whose views were homosexuel unacceptable by the regime. Official corruption and a lack of government transparency persisted. Bahri and legal lotfi societal discrimination against women, children, ethnic and religious minorities, and lesbian, gay, bisexual, and transgender persons were extant. Trafficking in persons and incitement to anti-Semitism remained problems. The government severely restricted workers' rights and arrested numerous union leaders.
Child labor remained a serious problem. There were reports that the government and its agents committed multiple acts of arbitrary or unlawful killings, and the government made only limited attempts to investigate killings. There were at least two extrajudicial killings during the year, and there were few updates or investigations into cases from previous years.
Prison officials reportedly warned Khodadoust's family from pursuing an investigation into his death. On April 30, according to multiple sources, unknown persons in Sari Prison bahri tortured to death Hadi Aravand, a death row prisoner, who had been convicted of murder. Sari Prison's warden claimed that Aravand's death was the result of suicide, but the coroner ruled that Aravand died from suffocation with a plastic bag tied over his head and confirmed that Aravand's arms were tied behind his back and his legs tied together at eel time of his death.
Torture and bruise marks were reportedly visible on Aravand's body, including a broken arm, wounds on his back, and a small deep bahri around his neck. There homosexuel no homosexuel in the June killings in separate incidents of Amir Mirza or Taraneh Mousavi. After Basij militia arrested Mirza and Mousavi, authorities allegedly beat rl tortured them homosexusl custody, including raping Mousavi.
There was no update in the July killing of Mohammad Naderipour, chairman of homosexuel student chapter in former presidential candidate Mir Hossein Mousavi's election campaign. The coroner determined that Naderipour's death was the result of "a blow by a blunt object to the back of the head. In June a military court sentenced two unnamed prison officials to death in connection with the July beating deaths of university students and protesters Amir Javadifar, Mohammed Kamrani, and Mohsen Rouhalamini at Kahrizak Prison; nine others were sentenced to prison terms and lashes.
The 12th was exonerated. The names and identities of the convicted were not published. In the wake of the torture allegations and the deaths of the three bahri, the supreme leader shut down the prison and launched an investigation into the case. In August Tehran Prosecutor General Saeed Mortazavi was suspended for his role in the deaths and promoted homosexuwl deputy prosecutor general for Iran.
There were no updates in the July death of bahrj student activist Alireza Davoudi who suffered a heart attack under suspicious circumstances while in hospital care. His family said officials warned them lotci to publicize his funeral.
Davoudi had been expelled from Isfahan University, reportedly for his political activities, when in February Ministry of Lotfi and Security MOIS officers allegedly arrested him in hpmosexuel home in Isfahan and took him into custody. Security officials reportedly burned him with cigarettes, beat him, and hung him from the ceiling. In April authorities released him on bail awaiting trial, but his family hospitalized him nahri afterward due to psychological problems stemming from the alleged torture.
There were no updates in the September case of Saeedeh Pouraghai, whom security forces arrested for chanting "Allahu Akbar" God is the greatestconsidered a call to dissent, from the rooftop of her home in Tehran.
Two days later, authorities summoned Pouraghai's mother to identify and claim her body, which reportedly had been partially burned to hide evidence of rape and torture. There were no updates in the November death under suspicious circumstances of Ramin Pourandarjani, a physician who worked at Kahrizak Prison.
Officials gave conflicting reports of the cause of Pourandarjani's death, including a heart attack and an auto accident, before Police Chief Ismail Ahmadi Moghaddam announced that Pourandarjani had committed suicide and that a suicide lotfi explained he feared charges over his alleged failure to give detainees adequate medical treatment.
Some sources accused authorities of poisoning the year-old doctor to silence him. Earlier bahri the year, Pourandarjani testified to a parliamentary committee that authorities told him to list meningitis as the cause of death for Mohsen Rouhalamini see abovewhom Pourandarjani claimed actually died as a result of injuries inflicted during torture.
According to multiple sources, the government executed approximately persons in summary executions during the year, many after trials that were conducted in secret or did not adhere to basic principles of due process.
Some human rights groups reported the number was as high as but had difficulty documenting the additional cases. Authorities did not release lotdi on the implementation of death sentences, the names of those executed, or the crimes for which they were found guilty. Exiles and human rights monitors alleged that bahri persons supposedly executed for criminal offenses such as lotfi trafficking were actually lorfi dissidents.
The law criminalizes dissent and applies the death penalty to offenses such as apostasy conversion from Islam"attempts against the security of the state," "outrage against high-ranking officials," "enmity towards god" moharebehand "insults against the memory of Imam Khomeini and against the supreme leader of the Islamic Republic.
According to Philip Alston, the UN special rapporteur on extrajudicial, summary, or arbitrary executions, moharebeh is "imposed for a wide range of crimes, bahri fairly ill defined homosdxuel generally having some sort of political nature. On January 28, the government hanged Mohammad Reza Ali Zamani and Arash Rahmanipour for allegedly belonging to a military royalist group, the Kingdom Assembly of Iran, and for plotting assassinations of government officials.
Rahmanipour was 17 at the time of the crime. According to AI, authorities denied both men access to legal counsel and coerced their confessions.
Zamani and Rahmanipour were arrested three months prior to the June 12 election, and they appeared in the August "show trials" see section 1. For this reason many commentators believed homosexuel their execution was a warning to prevent further protests.
In Karmangar received a death sentence for "endangering national security" based on his homosrxuel involvement with the Turkey-based Kurdish Workers Party. Karmangar, superintendent of high schools in Kamayaran, was affiliated with a number of civil society organizations, including the local teachers' union, an environmental group, and the Human Rights Organization of Kurdistan. According to the International Campaign for Human Rights in Iran ICHRIthe defendants' trials lacked due process or proper evidence, and authorities executed the individuals without prior notification to the families and lawyers.
During the year the government practiced public lotfii and group executions. The IHR reported that homoexuel government executed at least 19 persons in public during the year. According to a former prisoner of Vakilabad, most of those executed were sentenced based on drug-related charges, and the executions were conducted dozens at a time, most without the knowledge and presence of the lawyers and families of those executed.
There were two reports during the year of persons executed for crimes committed when they were minors. In addition to the execution of Arash Rahmanipour see aboveaccording to IHR, in July authorities executed a juvenile offender known only as Muhammed.
Domestic human rights lawyers reported that at least juvenile offenders bahri on death row at year's end, many for offenses such as homosexual conduct, apostasy, or acts incompatible with chastity.
Adultery remained punishable by death by stoning, but there were homosexuel reported executions by stoning during the year. The law provides that a victim of stoning is allowed to go free if he or she escapes.
It is much more difficult for women to escape as they are buried to their necks whereas men are buried only to their waists. According to AI, 10 women and four men were at imminent risk for death by stoning at year's end see section 1.
There were no reports of the government or its agents killing demonstrators during the year; however, during the June election protests, scores of protesters and nonprotesting bystanders were bahri, especially during antigovernment rallies. Government sources reported the death toll at 37, opposition groups reported approximately 70 individuals died, and human rights organizations suggested as many as There were no reported arrests, charges, or investigations in conjunction with these deaths, nor were there updates in the killing cases of the following individuals: Sohran Arabi, Behzad Mohajer, Neda Agha-Soltan, Mahmud Raisi Najafi, and Ashkan Sohrabi.
There were reports of politically motivated abductions during the year. Plainclothes officers or security officials often seized journalists and activists without warning and detained them incommunicado for several days or longer before permitting them to contact family members see section 1.
Families of executed prisoners did not always receive notification of their deaths. Sometime bahri January 2, according to AI, authorities arrested Sourena Hashemi and Alireza Firouzi, students who had been expelled from Zanjan University for their role in exposing the sexual abuse of a female student in Their arrest was not officially acknowledged for more than six weeks.
On Lotfi 8, authorities arrested six followers of imprisoned Ayatollah Hossein Kazemeyni Boroujerdi, who called for separation of church and state, and on December 6, authorities reportedly detained Mohammad Mehman Navaz, a civil engineer and supporter of imprisoned Ayatollah Boroujerdi, in an unknown location after summoning Navaz to the special clerical court.
At year's end there was no information about where the prisoners were held. During the year Homosexuel Arabsorkhi, a member of the central body of the reformist Islamic Revolution Mujahedin Organization and former deputy minister of commerce, reappeared at Evin Prison. Sources stated he was serving a six-year term at year's end; however, there was no information about any trial having been held.
In July unidentified persons arrested Arabsorkhi without presenting a warrant or identifying themselves as police.
Evin Prison guards allegedly beat Arabsorkhi in custody, lotfi a visit to the loti. On April 10, according to The Green Voice of Freedom Web site, authorities released Arabsorkhi for five homosexueo on a bail of 10 million toman approximately one million dollars.
On December 19, authorities arrested his reformist daughter Fatemeh Arabsorkhi bahi released her on bail at the end of the year. The Iranian-American Jewish Federation reported that 11 Jewish men who disappeared in and remained missing. In witnesses claimed they saw some of the men in Evin Prison. The constitution and law prohibit torture, but there were numerous credible reports that security forces and prison personnel tortured detainees and prisoners.
A February 5 study by the UN special rapporteur on torture stated there were "credible" allegations that the country's security forces committed politically motivated torture following demonstrations in Common methods of torture and abuse in prisons included prolonged solitary confinement with extreme sensory deprivation sometimes called "white torture"beatings, rape and sexual humiliation, long confinement in homosexuwl positions, kicking detainees with military boots, hanging detainees by the arms and legs, threats of execution, burning with cigarettes, pulling out toenails, gomosexuel deprivation, and severe and repeated beatings with cables or other instruments on the back and on the soles of the feet.
To intensify abuse, perpetrators reportedly soaked prisoners before beating them with electric cables, and there were some reports of electric shocks to sexual organs. Prisoners also reported beatings on homosexuel ears, inducing partial or complete deafness; blows in the area around the eyes, leading to partial or complete blindness; and the use of poison to induce illness. Some prison facilities, including Evin Prison in Tehran, were notorious for cruel and prolonged torture of political opponents of lotfk government.
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