Indeed many patients rank it as their most bothersome symptom, even above abdominal pain. Despite this fewer patients appear to seek medical attention for this problem compared with other gastrointestinal symptoms. This has been attributed to the fact that most sufferers usually have other symptoms, such as abdominal pain, which they may perceive as potentially more serious, and hence seek preferential medical advice and treatment. This review aims to clarify the meaning of the terms bloating and distension, explores their association with constipation, and discusses possible pathophysiologies,
in particular the relevance of intraluminal gas handling. (C) 2011 Elsevier Ltd. All rights reserved.”
“Background: ERK inhibitor The combined effects of multiple density-dependent, regulatory processes may have an important impact on the growth and stability of a population. In a malaria model system, it has been shown that the progression of Plasmodium berghei through Anopheles stephensi and the survival of the mosquito both depend
non-linearly on parasite density. These processes regulating the development of the malaria parasite within the mosquito may influence the success of transmission-blocking interventions (TBIs) currently under development.
Methods: An individual-based stochastic mathematical model is used to investigate the combined impact of these multiple regulatory processes
and examine how TBIs, which target different parasite life-stages LY2157299 within the mosquito, may influence overall parasite transmission.
Results: The best parasite molecular targets will vary between different epidemiological settings. Interventions that reduce ookinete density beneath a threshold level are likely to have auxiliary benefits, as transmission would be further reduced by density-dependent processes that restrict sporogonic development at low parasite densities. TBIs which reduce parasite density LY411575 but fail to clear the parasite could cause a modest increase in transmission by increasing the number of infectious bites made by a mosquito during its lifetime whilst failing to sufficiently reduce its infectivity. Interventions with a higher variance in efficacy will therefore tend to cause a greater reduction in overall transmission than a TBI with a more uniform effectiveness. Care should be taken when interpreting these results as parasite intensity values in natural parasite-vector combinations of human malaria are likely to be significantly lower than those in this model system.
Conclusions: A greater understanding of the development of the malaria parasite within the mosquito is required to fully evaluate the impact of TBIs.