Aracnoidismo en el Hospital Universitario Ruíz Páez estado Bolívar Venezuela: y revisión de la literatura / Arachnoidism at Hospital Universitario Ruíz Páez

El aracnoidismo constituye el síndrome producido por la mordeura de arañas. En el estado Bolívar, Venezuela, se desconoce la prevalencia de estos accidentes. El objetivo del presente estudio fue determinar la prevalencia y aspectos clínico-epidemiológicos del aracnoidismo en el Complejo Hospitalario "Ruíz Páez", centro de referencia en el Estado Bolívar, Venezuela. Se realizó un estudio descriptivo, retrospectivo. Se revisaron las historias clínicas de los casos de aracnoidismo que fueron evaluados en el Complejo Hospitalario Universitario "Ruíz Páez" de ciudad bolívar durante el período de enero 1996 a julio 2003, registrándose los datos clínicos y epidemiológicos. Además, se realizó revisión de la literatura. En el período de estudio se diagnosticaron 3 casos de aracnoidismo. En Ciudad Bolívar el aracnoidismo es inusual; suele ser leve y no complicado; sin embargo, el personal de salud debe estar atento ante eventuales envenenamientos graves en la región

Distribución de tipo capsular y sensibilidad antimicrobiana de Streptococcusagalactiae productores de infecciones en Argentina / Distribution of capsular types and antimicrobial susceptibility of Streptococcus agalactiae causing infections in Argentina

Streptococcus agalactiae es una bacteria colonizante que ha emergido en los últimos años como causante de infecciones neonatales, perinatales y en pacientes con compromiso inmunológico. La caracterización del polisacárido capsular, de las proteínas de superficie (c, X, R), así como el análisis de marcadores moleculares, permiten su clasificación en serotipos y genotipos. Esto resulta de utilidad para fines epidemiológicos y para estudios de virulencia de la bacteria. El objetivo de este trabajo fue conocer los serotipos prevalentes y la sensibilidad antimicrobiana de aislamientos provenientes de procesos infecciosos en pacientes de distintas zonas de Argentina. En la muestra analizada se obtuvo predominio de los serotipos Ia y III, seguido de II y IV. Todas las cepas resultaron sensibles a penicilina. Se observó 6% de resistencia a eritromicina y 4,5% a clindamicina. En 3 de las cepas se detectó fenotipo MLS (resistencia a macrólidos, lincosaminas y estreptograminas) constitutiva y en una cepa, resistencia MLS inducible. Los resultados logrados en este estudio destacan la importancia de efectuar un relevamiento de los serotipos más frecuentes en nuestro país en vistas a la prevención de esta infección con una vacuna que realmente sea eficaz, como así también el conocimiento de la sensibilidad antimicrobiana para lograr éxito terapéutico en los tratamientos.

Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6% of resistance to erythromycin and a 4.5% to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.

The situation of malaria along the Vietnam-Lao PDR border and some related factors.

This was a descriptive cross sectional study. It was done in 4 communes along the Vietnam-Lao PDR border of two mountainous provinces: Sonla and Nghean. The cluster multistage sampling technique was applied to choose the study sites. The results of the study show: Among the 2,441 persons given blood tests to find malaria parasites, 0.7% of them carry malaria parasite, of whom 0.6% carry P. falciparum and 0.1% carry P. vivax. The malaria morbidity in the year was 6.9%. The mortality due to malaria is 1.59 per 100,000 population per year. Among the 106 hamlet motivators being interviewed, only 75.5% knew that malaria is transmitted by mosquitos, 71.7% knew that malaria patients are a source of transmission, over 50% of the motivators have mistaken understanding about the living environment of malaria mosquitos. Most of them have had mistakes in diagnosis, treatment of malaria, mosquito-killing spraying. Among the 729 adults being interviewed, 59.0% did not know about the causes of malaria, 30.7% did not take part in malaria control activities. Only 69.3% of the adults regularly sleep inside mosquito nets, 68% of adults buy medicine to cure malaria, 39.9% referred patients to health facilities for cure, and 25% use forest herbs to cure malaria. The factors that increased the malaria morbidity in communes along Vietnam-Lao PDR border have been identified.

Malaria in tree crop plantations in south-eastern and western provinces of Thailand.

During the past three decades almost half of the existing natural tropical forests in Thailand were destroyed and replaced by cash crops, rubber, coffee, fruit orchards (durian, rambutan, mangosteen) and other commercial plantations. In order to determine the proportion of malaria cases contracted from such commercial plantations, an epidemiological study was conducted between June 1996 to May 1997 in two districts, one in Pong Nam Ron, located in a south-eastern province near the Cambodian border and another in Sai Yok, in a western province along the Myanmar border. Data were collected by passive case detection from patients attending the existing malaria clinics and active case detection by monthly malariometric survey in selected villages. All malaria cases were thoroughly investigated and classified according to exposure to different ecotypes prior to onset of malaria symptoms in the preceding two weeks. Malaria cases acquired from commercial plantations accounted for 35.2% and 11.2% in Pong Nam Ron and in Sai Yok districts respectively. In such plantations, most of the malaria cases were contracted from fruit orchards and to a lesser extent from rubber and teak plantations. From this study it is evident that commercial plantations provide a significant site of malaria transmission in addition to the forest and foothills areas in Southeast Asia where efficient vectors such as An. dirus and An. minimus are prevalent and have adapted to such changed ecosystems.

Factors influencing malaria endemicity in Yunnan Province, PR China (analysis of spatial pattern by GIS). Geographical Information System.

This study is an initial attempt to apply disease mapping through Geographical Information System (GIS) with multiple regression analysis to determine the nature and extent of factors influencing malaria transmission in Yunnan Province, PR China, particularly in border areas. Secondary county-based data covering the period 1990 to 1996 were collected and analyzed. The malaria situation in Yunnan Province as a whole is influenced mainly by the combined effects of the physical environment, the presence of efficient vector species, and mobile population along international borders with Myanmar, Lao PDR and Vietnam.

Role of the SEAMEO TROPMED Network in health human resources development. Southeast Asian Ministers of Education Organization. Tropical Medicine and Public Health.

The Southeast Asian Ministers of Education Organization (SEAMEO) is a chartered international organization for the promotion of regional cooperation in education, science, technology and culture. The Regional Tropical Medicine and Public Health Network (TROPMED) operates through four specialized Centers in Indonesia, Malaysia, the Philippines and Thailand, with a coordinating unit, the TROPMED Central Office in Bangkok, Thailand. In line with the overall mission of SEAMEO, the role of TROPMED is to promote health and to prevent or control disease, thus improving the quality of life of people in the Asia-Pacific Region. Toward this end, SEAMEO TROPMED serves to facilitate the strengthening of national and institutional capabilities in research and training through postgraduate academic programs; short-term training courses; scientific fora; publications and information dissemination and as such, has been in the mainstream of health human resources development since its inception in 1967. To date, a total of 3,353 TROPMED alumni have benefited from training in 26 regular course offerings; of these, 1,596 were females and 1,757, males. From 1991 to 1995, a total of 434 key health personnel have attended short-term training courses, with increasing attendance from Cambodia, Lao PDR and Vietnam. TROPMED's effectiveness comes from the collective strength of and the spirit of cooperation among its host institutions and partners. Faced with a health scenario of both developing and developed economies, SEAMEO TROPMED aims to further its role as an international forum for health development thus, addressing the need for effective strategies for health sector reform and advocacy of relevant health, environmental and development policies through its various programs and activities.

Magnesio, calcio y fósforo séricos en neonatos de alto riesgo y controles / Serum magnesium, calcium and phosphorus in normal and high risk neonates

Las convulsiones son un problema neonatal frecuente y grave. Las principales determinaciones sugeridas para investigar su origen tiene relaión por ejemplo con la medición de los niveles de glucosa, magnesio, calcio, etc. Se estudiaron a 32 recién nacidos de alto riesgo y en un grupo control, formado por 30 neonatos sanos, los niveles de magnesio, calcio y fósforo por las metódicas de Calmagite-dye y o-Cresolftaleína-Complexona y Molibdato-Vanadato, respectivamente. Los valores en controles fueron 2,55 ñ 0,28 mg/dl para magnesio; 8,21 ñ 1,20 mg/dl para calcio y 5,96 ñ 1,18 mg/dl para fósforo y en el grupo de riesgo fueron: 2,39 ñ 0,41 mg/dl; 8,21 ñ 1,32 mg/dl y 5,87ñ 1,14 mg/dl. El grupo de riesgo evidenció valores más bajos para magnesio con una mayor dispersión, siendo esto significativo para la prueba de F con un p<0,05. También se observaron niveles levemente más altos de calcio en este grupo, con mayor dispersión de valores pero, no siendo significativas estas diferencias. Los valores de fósforo en ambos grupos fueron muy similares. Se concluye que solamente el magnesio podría ser un indicador sensible ante la presencia de convulsiones, aunque deberían estudiarse estos parámetros conjuntamente con los niveles de glicemia

A symposium on containment of mefloquine-resistant falciparum malaria in Southeast Asia with special reference to border malaria.

Important questions related to the factors responsible for and contributing to the origin and spread of multi-drug resistant falciparum malaria at the Thai-Cambodian and Thai-Myanmar border areas are discussed, including the current geographical distribution of multi-drug resistance and the prevention and control of this phenomenon. Specific recommendations are made on epidemiological surveillance, drug deployment, vector control, and the problem of migration which plays a major role in the dissemination of resistant parasite populations. The recent advent of mefloquine resistance of P. falciparum in Thailand may serve as fair warning in the absence of stern measures for preventing the occurrence of resistance to the next and currently last line of antimalaria drugs, especially those with a long half-life, in areas with intensive, uncontrolled malaria transmission, such as tropical Africa.

Halofantrine in the treatment of acute uncomplicated falciparum malaria in the Philippines.

In an open clinical trial, thirty patients 14 to 44 years old and with acute uncomplicated falciparum malaria were given halofantrine hydrochloride 500 mg (2 tablets) 6-hourly for 3 doses, a total dose of 1500 mg. All 30 patients were cured, with a mean asexual parasite clearance time of 47.6 hours and mean fever clearance time of 36.6 hours. Post-dosing side-effects occurred in 6 patients consisting of mild to moderate headache, dizziness and abdominal muscle spasm. Drug-induced hemolysis did not occur in two G6PD deficient patients. Twenty-three out of 28 isolates tested (82%) were resistant to amodiaquine, 3 (11%) were resistant to the sulfadoxine-pyrimethamine combination, and all were sensitive to chloroquine, quinine and mefloquine by in vitro microtests. The study confirms the efficacy of halofantrine hydrochloride as a blood schizonticide in falciparum malaria.

Oral clindamycin in the treatment of acute uncomplicated falciparum malaria.

Clinical trials on oral clindamycin as an antimalarial in hospitalized patients and residents of endemic communities were conducted in the Philippines between May 1984 and December 1985. Seven and 9 qualified subjects in hospital were treated with 300 mg (regimen A) and 600 mg (regimen B) respectively, twice daily for 5 days. Eighteen patients seen at a rural health unit were given the lower dosage. On the basis of the 28-day extended in vivo test of WHO, P. falciparum in all but one patient showed susceptibility to the drug as a blood schizontocide hence, the clinical cure of malaria. Side effects were few and self-limiting. Ten other patients on regimen A were cured within the 7- and/or 28-day extended test period. Clindamycin per se is currently one of the few alternatives in the treatment of clinically moderate drug-resistant malaria.

Brote Intrahospitalario de Salmonelosis por Salmonella Enteritidis Seropo Agona / Nosocomial Salmonellosis Outbreak by Salmonella Enteritidis, Agona Type

Se describe una epidemia de salmonelosis ocurrida en el servicio de Pediatria del Hospital Militar Central, la cual afecto a quince pacientes. Se concluye que fue una infeccion intrahospitalaria. Como agente etiologico fue plenamente identificado Salmonella Enteritidis, serotipo Agona con una gran multirresistencia a los antibioticos. Como origen posible del brote se demostro un portador sano, preparador de teteros en el servicio. Es, posiblemente, la primera vez que se informa Salmonella Agona en nuestro pais

Acidosis tubular distal con perdida de bicarbonato. / Distal tubular acidosis with bicarbonate losing

Se estudiaron dos pacientes con diagnostico de acidosis tubular distal con perdida de bicarbonato. La estimacion de la reabsorcion fraccional de sodio durante la diuresis salina hipotonica mostro un aumento de la carga de sodio ofrecida al nefron distal y una menor capacidad de reabsorcion a nivel de este segmento, cuando se le compara con el valor control. En un paciente con diagnostico de acidosis tubular distal clasica se obtuvieron resultados similares, de lo cual se concluye que dicha prueba no permite localizar el sitio del defecto en la reabsorcion tubular de bicarbonato en la acidosis tubular distal clasica con perdida de bicarbonato

Las pruebas VDRL falsas reactivas en el manejo de la sifilis: 1. reacciones falsas positivas en el embarazo / The false reactive VDRL tests in syphilis management: 1. false positive reactions in pregnancy

Se presenta un estudio sobre reacciones VDRL falsas reactivas en el embarazo. Se analizan los resultados de las pruebas practicadas a los sueros sanguineos obtenidos de 4.344 gestantes tomadas al azar sobre un universo restringido de 13.477; 64 muestras fueron VDRL reactivas y FTA-ABS no reactivas, lo cual da 1.5% de falsas reactivas; 25 reacciones fueron VDRL reactivas y FTA-ABS reactivas, para 0,6% de sifilis. Las reacciones falsas reactivas estan mas asociadas con el primer embarazo. Las reacciones falsas reactivas estan mas asociadas con el primer embarazo. Las reacciones falsas reactivas lo son a titulos muy bajos de 0 a 2 diluciones. Se encontro una marcada relacion entre la ocurrencia de falsas reactivas y el grupo sanguineo A, Rh(-). No existe relacion entre la falsa reactividad y los antecedentes patologicos generales u obstetricos. Igualmente se encontro que no existe una distribucion especifica por grupos de edad. La falsa reactividad no esta asociada con un periodo especial del embarazo y aparece desde los primeros meses. El seguimiento durante el post-parto se demostro que las pruebas falsas reactivas se negativizan hasta seis meses despues

Observation on biting midge infestations on Mamburao Beach, Mimdoro, Philippines.

The occurrence of biting midge infestation involving the species Leptoconops (Styloconops) spinosifrons Carter 1921 (Diptera, Ceratopogonidae) is reported from a beach resort in Mindoro Island, Philippines. The flies are most active between 0700 and 0900 hours, and again, between 1600 and 1800 hours; they are most abundant in the shoreline and sand beach area.