Estudio Transversal: Prevalencia de Infecciones por Virus Sincitial Respiratorio en Pacientes Ingresados en el Hospital de Especialidades José Carrasco Arteaga, 2017 / Cross- sectional study: Prevalence of Human Respiratory Syncytial Virus Infections in Patients Admitted at the Hospital José Carrasco Arteaga, 2017

INTRODUCCIÓN: El virus sincitial respiratorio es una de las principales causas de infección respiratoria baja en pacientes menores de 5 años; constituye además una de las principales causas de mortalidad pediátrica a nivel mundial. El objetivo del presente estudio fue determinar la prevalencia de infección por virus sincitial respiratorio en pacientes ingresados en el Hospital de Especialidades José Carrasco Arteaga. METODOLOGÍA: Se realizó un estudio transversal, el universo incluyó a pacientes pediátricos con edades comprendidas entre los 0 y 5 años, que hayan sido ingresados en el Hospital de Especialidades José Carrasco Arteaga con diagnóstico de infección respiratoria baja. Se usó la inmunocromatografía como prueba para detección del virus, los datos fueron tabulados mediante el programa estadístico SPSS versión 22.0. RESULTADOS: 186 pacientes fueron incluidos en el estudio; de estos el 76.35% (n=142) fue diag-nosticado de neumonía, 19.35% (n=36) de bronquiolitis y 4.30% (n=8) de bronquitis aguda. La prevalencia de infecciones por virus sincitial respiratorio en pacientes pediátricos fue del 44% (n=82). Los factores analizados en busca de asociación con la infección fueron: edad 24 ­ 60 meses (p= 0.012), sexo masculino (p= 0.236), parto por cesárea (p= 0.853), patología crónica de base (p=0.060), esquema de vacunación incompleto (p= 0.010), lactancia materna no exclusiva (p= 0.176), tabaquismo pasivo (p= 0.609) y nivel socio económico bajo (p= 0.609). CONCLUSIÓN: La prevalencia general de infección por virus sincitial respiratorio en pacientes menores a 5 años es del 43%. De los factores analizados, la edad (24 ­ 60 meses) y el esquema de vacu-nación incompleto presentaron asociación estadísticamente significativa con la presencia de la infección. Esta investigación no reportó asociación con sexo masculino, parto por cesárea, patología crónica de base, lactancia materna incompleta, tabaquismo previo o nivel socio económico bajo.(AU)

BACKGROUND: Human Respiratory Syncytial Virus is one of the main causes of lower respiratory infections in patients under 5 years of age; it is also one of the main causes of pediatric mortality worldwide. The aim of this study was to determine the prevalence of respiratory syncytial virus infection in patients admitted to Hospital José Carrasco Arteaga. METHODS: A cross-sectional study was performed; the universe included pediatric patients between 0 and 5 years old, who had been admitted to Hospital José Carrasco Arteaga with a diagnosis of low respiratory infection. Immunochromatography was used as a test for virus detection; the data was tabulated using the statistical software SPSS version 22.0. RESULTS: 186 patients were included; 76.35% (n=142) were diagnosed with pneumonia, 19.35% (n=36) of bronchiolitis and 4.30% (n=8) of acute bronchitis. The prevalence of human respiratory syncytial virus infections in pediatric patients was 44% (n=82). The factors analyzed in search of association with the infection were: age 24 - 60 months (p= 0.012), male sex (p= 0.236), cesarean delivery (p= 0.853), chronic base pathology (p= 0.060), incomplete vaccination scheme (p= 0.010), non-exclusive breastfeeding (p= 0.176), passive smoking (p= 0.609) and low socio-economic status (p= 0.609). CONCLUSION: The overall prevalence of human respiratory syncytial virus infection in patients younger than 5 years is 43%. Of the analyzed factors, age (24 - 60 months) and incomplete vaccination scheme showed a statistically significant association with the presence of the infection. This investigation did not report association with male sex, cesarean delivery, chronic basic pathology, incomplete breastfeeding, previous smoking or low socio-economic status.

Nanoemulsion containing essential oil from Xylopia ochrantha Mart. produces molluscicidal effects against different species of Biomphalaria (Schistosoma hosts)

BACKGROUND This work describes a chemical study of the essential oil from leaves of Xylopia ochrantha, an endemic Annonaceae species from Brazil, and its activity against Biomphalaria species. Considering its poor solubility in aqueous medium, the essential oil was nanoemulsified to evaluate its action on controlling some mollusc species of genus Biomphalaria, snail hosts of Schistosoma mansoni that causes schistosomiasis, which mainly affects tropical and subtropical countries. OBJECTIVES The main aims of this work were to analyse the chemical composition of essential oil from X. ochrantha, and to evaluate the effect of its nanoemulsion on molluscs of genus Biomphalaria and their oviposition. METHODS Chemical analysis was performed by gas chromatography coupled to mass spectrometry. Nanoemulsions were prepared by a low energy method and characterised by particle size and polydispersity index. Biological assays evaluating the mortality of adult species of B. glabrata, B. straminea and B. tenagophila and their ovipositions upon contact with the most stable nanoemulsion during 24 and 48 h were performed. FINDINGS Chemical analysis by mass spectrometry revealed the majority presence of bicyclogermacrene and germacrene D in the essential oil. The formulation with a hydrophilic-lipophilic balance (HLB) of 9.26 was the most suitable for the oil delivery system. This nanoemulsion caused the mortality in B. tenagophila, B. straminea and B. glabarata of different sizes at levels ranging from 50 to 100% in 48 h. Additionally, the formulation could inhibit the development of deposited eggs. CONCLUSION Thus, these results suggest the use of nanoemulsified essential oil from X. ochrantha as a possible alternative in controlling some Biomphalaria species involved in the schistosomiasis cycle.

Snail transmitters of schistosomiasis and other mollusks of medical and economic importance at the simplício queda única hydroelectric plant, southeast Brazil

Abstract INTRODUCTION This paper presents the results of an extensive survey of freshwater mollusks in the Simplício Queda Única Hydroelectric Development area, Southeast Brazil. METHODS Mollusks were collected between 2008 and 2013. All specimens were examined for the presence of larval trematodes. RESULTS In total, 12,507 specimens classified into 16 genera were obtained. Known snail vectors of schistosomiasis and fascioliasis and exotic species were identified, and new records are reported. CONCLUSIONS No specimens parasitized by larval trematodes of medical interest were detected. However, the results reinforce the importance of surveillance in study areas vulnerable to the occurrence of schistosomiasis transmission.

Distribuição geográfica dos hospedeiros intermediários do Schistosoma mansoni nos estados do Paraná, Minas Gerais, Bahia, Pernambuco e Rio Grande do Norte, 2012-2014 / Distribución geográfica de los huéspedes intermedios de Schistosoma mansoni en los estados de Paraná, Minas Gerais, Bahia, Pernambuco y Rio Grande do Norte, Brasil, 2012-2014 / Geographical distribution of intermediate hosts of Schistosoma mansoni in the states of Paraná, Minas Gerais, Bahia, Pernambuco and Rio Grande do Norte, Brazil, 2012-2014

Objetivo: descrever a distribuição geográfica dos hospedeiros intermediários do Schistosoma mansoni em cinco estados brasileiros. Métodos: estudo transversal; foram selecionados municípios dos estados do Paraná (78), Minas Gerais (120), Bahia (82), Pernambuco (51) e Rio Grande do Norte (98), nos anos de 2012 a 2014; esses municípios foram escolhidos por não possuírem registros atualizados da presença de caramujos hospedeiros intermediários de S. mansoni; moluscos foram capturados, taxonomicamente identificados e examinados para verificação de cercárias de S. mansoni. Resultados: os trabalhos foram realizados em 427 municípios (99,5% dos 429 selecionados); foi registrada presença de moluscos em 300 (70,2%) municípios e a ocorrência de Biomphalaria glabrata em 62 (21%) municípios, B. straminea em 181 (60%), B. tenagophila em três (1%); associação de B. glabrata/B. straminea foi encontrada em 53 (18%), e de B. glabrata/B. tenagophila em um (0,3%). Conclusão: os registros de B. glabrata, B. straminea e B. tenagophila estão de acordo com a distribuição conhecida.

Objetivo: describir la distribución geográfica de los hospedadores intermediarios de Schistosoma mansoni en cinco estados brasileños. Métodos: estudio epidemiológico transversal; el estudio fue realizado en municipios de los estados de Paraná (78), Minas Gerais (120), Bahia (82), Pernambuco (51) y Rio Grande do Norte (98), entre 2012 y 2014; estos municipios fueron elegidos por no poseer registros actualizados de la presencia de caracoles vectores de S. mansoni; los moluscos fueron capturados, taxonómicamente identificados y examinados para la verificación de cercarias de S. mansoni. Resultados: los trabajos fueron realizados en 427 municipios (99,5% de 429 municipios seleccionados); fue registrada presencia de moluscos en 300 (70,2%) municípios; la presencia de Biomphalaria glabrata fue registrada en 62 (21%) municipios, B. straminea en 181 (60%) y B. tenagophila en três (1%); se observó asociación de B. glabrata con B. straminea en 53 (18%) y de B. glabrata con B. tenagophila en uno (0,3%). Conclusión: los registros de Biomphalaria están de acuerdo con la distribución conocida.

Objective: to describe the geographical distribution of intermediate hosts of Schistosoma mansoni in five Brazilian states. Methods: this was a descriptive cross-sectional study; municipalities were selected in the states of Paraná (78), Minas Gerais (120), Bahia (82), Pernambuco (51) , and Rio Grande do Norte (98), for the period 2012 to 2014; these municipalities were chosen because they did not have current records of the presence of snails vectores de S. mansoni. The molluscs were captured and taxonomically identified and examined for S. mansoni cercariae. Results: the work was carried out in 427 municipalities (99.5% of the 429 selected); the presence of mollusks was registered in 300 (70.2%) municipalities; Biomphalaria glabrata were found in 62 (21%) municipalities, B. straminea in 181 (60%), B. tenagophila in three (1%); B. glabrata/B. straminea association was found in 53 municipalities (18%) and B. glabrata/B. tenagophila association in one (0.3%) municipality. Conclusion: B. glabrata, B. straminea and B. tenagophila distribution records obtained in this study are consistent with previously known distribution.

Estudio Descriptivo: Complicaciones Neonatales en Embarazo Gemelar. Hospital Especialidades José Carrasco Arteaga, Servicio de Neonatología. Enero 2010 - Junio 2016 / Descriptive Research: Neonatal Complications in Twin Pregnancy. Neonatology Service. José Carrasco Arteaga Specialties Hospital. January 2010 - June 2016

INTRODUCCIÓN: El embarazo múltiple es de alto riesgo perinatal, constituye el 1 ­ 3 % de todas las gestaciones a nivel mundial, incrementándose en los últimos 30 años su incidencia y complicaciones. El objetivo fue determinar las complicaciones neonatales del embarazo gemelar en el servicio de neonatología del Hospital de Especialidades José Carrasco Arteaga. Enero 2010 a Junio 2016. MÉTODO: Se trata de un estudio descriptivo, retrospectivo de corte transversal, de Enero 2010 a Junio 2016. Se revisaron las historias clínicas de embarazo gemelar y los neonatos de los embarazos a estudio, que ingresaron a Neonatología del Hospital de Especialidades José Carrasco Arteaga, Cuenca - Ecuador. Durante este período, se incluyeron en una base de datos para su tabulación y análisis por SPSS versión 20. RESULTADOS: La prevalencia de embarazo gemelar fue 0.62 %, se estudiaron 50 niños, la edad media de la madre fue de 29 años (DS 7.16), multíparas: 19 pacientes (76 %). La fertilización natural ocurre en 23 pacientes (92 %). La cesárea electiva en 22 pacientes (88 %). La morbilidad materna más frecuente: Preeclampsia en 4 pacientes (16 %). Los gemelos bicoriales fueron 13 (52 %), según edad gestacional por Capurro se identificó prematurez en 46 niños (92 %). Las complicaciones más frecuentes son prematurez 25.56 %, retardo en el crecimiento intrauterino 15 %, alteraciones respiratorias 23.33 %, cardíacas 3.38 %, metabólicas 12.22 % y fallecimiento 1.11 %. CONCLUSIONES: El embarazo gemelar es una condición frecuente de complicaciones perinatales e ingreso en neonatología. Los gemelos bicoriales fueron 52 %, monocoriales biamnióticos 48 %, la edad materna y multiparidad son condicionantes de riesgo, las complicaciones de mayor frecuencia fueron prematurez 92 %, el retardo del crecimiento intrauterino 17.2 %, con mortalidad de 1.11 %.

BACKGROUND: The multiple pregnancies are a high-risk perinatal, constitute 1 ­ 3 % of all pregnancies worldwide, increasing it was incidence and complications in the last 30 years. The aimwas to determine the neonatal complications oftwin pregnancy in the neonatology service ofthe José Carrasco Arteaga SpecialtiesHospital. January 2010 to June 2016. METHODS: This is a retrospective cross-sectional, descriptive study from January 2010 to June 2016. The medical records of twin pregnancy and infant's pregnancies study, which entered Neonatology of the José Carrasco Arteaga Specialties Hospital Cuenca - Ecuador. During this period, they were included in a database for tabulation and analysis by SPSS version 20. RESULTS: Theprevalenceoftwinpregnancywas0.62%,50childrenwerestudied,theaverage age of the mother was 29 years (SD 7.16), multiparous: 19 patients (76 %). Natural fertilization occurs in 23 patients (92%). Elective cesarean in 22 patients (88%). Themostfrequent maternal morbidity: Preeclampsia in 4 patients (16 %). The bicorial twins were 13 (52 %), according to gestational age by Capurro, prematurity was identified in 46 children (92 %). The most frequent complications are prematurity 25.56 %, intrauterine growth retardation 15%,respiratory alterations 23.33%, cardiac 3.38%,metabolic 12.22%and death 1.11%. CONCLUSIONS: The twin pregnancy is a frequent condition of perinatal complications and entry into neonatology. The bicorialtwins were 52%,monocorial biamnioticos 48%,maternal age and multiparity was risk factors, the most frequent complications were prematurez 92%, intrauterine growth retardation 17.2%, withmortality of 1.11%

Estudio Descriptivo: Neumonía y Complicaciones en Niños en el Hospital de Especialidades José Carrasco Arteaga. Enero - Diciembre 2015 / Desciptive Research: Pneumonia and Complications in Children at José Carrasco Arteaga Specialty Hospital. January - December 2015

INTRODUCCIÓN: La neumonía es la primera causa de morbi ­ mortalidad en los países en desarrollo, según la Organización Mundial de la Salud representa aproximadamente el 19 % de todas las muertes en menores de 5 años. El objetivo del presente estudio fue determinar las características clínicas y complicaciones de niños con neumonía en un Hospital de Especialidades en la zona sur de Ecuador. MÉTODOS: El presente estudio es descriptivo retrospectivo de corte trasversal con recolección de información obtenida de historias clínicas de los pacientes hospitalizados por neumonía de Enero a Diciembre de 2015 en el Hospital de Especialidades José Carrasco Arteaga de la ciudad de Cuenca-Ecuador. Se analizaron las variables demográficas de la población estudiada y sus complicaciones. Se presentan datos en frecuencias y porcentajes. RESULTADOS: En los 6 meses de estudio se revisaron 573 historias clínicas de los cuales 142 casos se registraron como neumonía (24.78 %). La edad media fue 4 a 3.57 años, y es el sexo femenino el más afectado (53.53 %). La tos (91.55 %), alza térmica (87.32 %), taquipnea (70.42 %), estertores (47.18 %), fueron las características clínicas más comunes. La neumonía bacteriana típica (62.68 %), es el tipo de neumonía más frecuente y la que mayor complicación presenta como: derrame pleural (7.04 %), sepsis (6.34 %), fallecimiento (6.34 %), empiema (4.23 %), absceso pulmonar (2.11 %), fistula broncopulmonar (2.11 %). CONCLUSIONES: La neumonía es una patología frecuente de hospitalización en pediatría, la edad más afectada fue de 1 a 3 años, las características clínicas como tos, alza térmica, y taquipnea fueron las más comunes. La neumonía bacteriana típica, es el tipo más grave y las complicaciones que presentaron fueron: derrame pleural, empiema, sepsis, con mortalidad de 5.63 %. (AU)

BACKGROUND: Pneumonia is the leading cause of morbidity and mortality in developing countries, according to the World Health Organization, accounting for approximately 19 % of all deaths in children under 5 years of age. The aim of the present study was to determine the clinical characteristics and complications of children with pneumonia at a Specialty Hospital in the southern area of Ecuador. METHODS: The present study is a descriptive retrospective cross-sectional study with data collection from clinical records of patients hospitalized for pneumonia from January to December 2015 at the José Carrasco Arteaga Specialty Hospital in the city of Cuenca, Ecuador. We analyzed the demographic variables of the studied population and their complications. Data are presented in frequencies and percentages. RESULTS: In the 6-month study, 573 medical records were reviewed, of which 142 cases were recorded as pneumonia (24.78 %). The mean age was 4 a 3.57 years, and the female sex was the most affected (53.53 %). Cough (91.55 %), thermal rise (87.32 %), tachypnea (70.42 %), rales (47.18 %) were the most common clinical features. The most common type of pneumonia is pneumonia (62.68 %), which presents as pleural effusion (7.04 %), sepsis (6.34 %), death (6.34 %), empyema (4.23 %), abscess pulmonary (2.11 %), bronchopulmonary fistula (2.11 %) CONCLUSIONS: The Pneumonia is a pathology frequent pediatrics of hospitalization; the most affected age was 1 to 3 years and clinical characteristics most common such as: cough, fever, and tachypnea. Typical bacterial pneumonia is the most severe type for disease children's and the complications frequents presented were pleural effusion, empyema, and sepsis, with mortality of 5.63 %.(AU)

Asociación de nivel bajo de PAPP-A en primer trimestre con resultados obstétricos adversos / Association of low PAPP-A level in the first trimester with adverse obstetric outcomes

ANTECEDENTES: La PAPP-A es una proteína utilizada en obstetricia de forma rutinaria para el cribado de aneuploidías de primer trimestre. En los últimos años se está conociendo más acerca de su papel en la función placentaria. Diversos estudios están mostrando una asociación entre un nivel bajo de PAPP-A y distintos eventos obstétricos. OBJETIVO: Establecer una asociación entre PAPP-A baja y eventos obstétricos adversos. MÉTODO: Estudio retrospectivo de casos y controles anidado en una cohorte. Se han recogido las gestaciones únicas con PAPP-A inferior a percentil 5 en primer trimestre durante 2 años. Se ha recogido de la misma cohorte un grupo control, en proporción 2:1. Se compara mediante análisis estadístico la incidencia de eventos obstétricos adversos de cada grupo. RESULTADOS: Se incluyó un total de 285 pacientes en el grupo de casos y 570 pacientes en el grupo control. Se observó un aumento significativo en el grupo de casos de la incidencia de prematuridad, restricción del crecimiento, hipertensión gestacional y diabetes gestacional. Se ha correlacionado la PAPP-A baja con varios eventos obstétricos adversos, incluyendo prematuridad (OR 4,27), diabetes gestacional (OR 2,40), restricción del crecimiento (OR 2,36) e hipertensión gestacional (OR 2,22). No se observó relación con el resto de eventos obstétricos adversos. CONCLUSIÓN: Un nivel de PAPP-A bajo se asocia con aumentos significativos de prematuridad, diabetes gestacional, restricción del crecimiento e hipertensión gestacional.

BACKGROUND: PAPP-A is a placental protein used in obstetrics as a first trimester marker in aneuploidy screening. In the last few years we are knowing more about its placental function. Some studies are showing a association between low PAPP-A and obstetrical adverse events. AIM: Establish an association between low PAPP-A an obstetrical adverse events. METHOD: This is a retrospective nested case-control study. We identified each singleton pregnancy with a normal phenotype and a low PAPP-A (under percentile 5) in the last 2 years, and match it with a control group of the same population in a 2:1 proportion. It was compared the incidence of each obstetrical adverse outcomes with statistical analysis. RESULTS: We found 285 patients in the case group and match it with 570 patients from control group. It was observed a significative increase in the incidence of prematurity, intrauterine growth restriction, gestational hypertension and gestational diabetes. A low PAPP-A level was correlated with some obstetrical adverse events, like prematurity (OR 4.27), gestational diabetes (OR 2.40), intrauterine growth restriction (OR 2.36) and gestational hypertension (OR 2.22). We observe no correlation with the rest of outcomes. CONCLUSIONS: A low PAPP-A level is related with significative increases of prematurity, gestational diabetes, intrauterine growth restriction and gestational hypertension.

ASSESSMENT OF BODY FAT IN OBESE PATIENTS PREOPERATIVELY FOR BARIATRIC SURGERY / AVALIAÇÃO DA GORDURA CORPORAL EM PACIENTES OBESAS NO PRÉ-OPERATÓRIO DE CIRURGIA BARIÁTRICA

ABSTRACT Background: The study of body composition in patient candidates for bariatric surgery is directly related to the increase and distribution of body fat in the development of cardiovascular disease. Aim: To correlate anthropometric indicators and bioelectrical impedance in the assessment of body fat in female candidates for bariatric surgery. Methods: Cross-sectional, observational study of 88 women. The weight, height, body mass index and waist circumference data were evaluated in the anthropometric analysis. The body fat was determinate by bioelectrical impedance conducted according to the manufacturer´s recommended technique with a specific severe obesity formula. The patients were divided into two subgroups according to the average waist circumference and body mass index for better analysis of the results. Results: The group had a mean age of 39.7 years (±7.2), average weight of 125.6 kg (±16.2), mean body mass index of 48.7 kg/m2 (±6.4) and the mean waist circumference 137.6 cm (±12.4). Negative and significant relationship between BMI values waist circumference and resistance obtained by bioelectrical impedance ​​were found. By analyzing the two groups the mean BMI and waist circumference, a significant relationship was observed, ie, the higher the degree of obesity less resistance was obtained by bioelectrical impedance. The higher is the obesity the lower is value found for resistance. Conclusion: The increase of anthropometric indicators (BMI and waist circumference) determined reduction in resistance and reactance obtained by bioelectrical impedance analysis in obese women candidates to bariatric surgery.

RESUMO Racional: O estudo da composição corporal em pacientes candidatas à cirurgia bariátrica tem relação direta com o aumento e distribuição da gordura corporal e no desenvolvimento de doenças cardiovasculares. Objetivo: Estudar a correlação entre indicadores antropométricos e da bioimpedância elétrica na avaliação da gordura corporal em mulheres candidatas à cirurgia bariátrica. Métodos: Estudo transversal, observacional com 88 pacientes. Na análise antropométrica foram avaliados os dados de peso, altura, IMC e circunferência da cintura. Para bioimpedância elétrica utilizou-se a técnica recomendada pelo fabricante do aparelho e fórmula específica para obeso grave na determinação da gordura corporal. Para melhor análise dos resultados as pacientes foram divididas em dois subgrupos de acordo com a média de circunferência da cintura e IMC. Resultados: O grupo apresentou média de idade 39,7 anos (±7,2), média de peso 125,6 kg (±16,2), média de IMC 48,7 kg/m2 (±6,4) e média de circunferência da cintura 137,6 cm (±12,4). Foram encontradas relações negativas e significativas entre os valores de IMC, circunferência da cintura e a resistência obtida através da bioimpedância elétrica. Ao analisar os dois subgrupos de valores médios de IMC e circunferência da cintura, observou-se relação significativa, ou seja, quanto maior o grau de obesidade menor é a resistência obtida através da bioimpedância elétrica. Conclusão: O aumento dos indicadores antropométricos (IMC e circunferência da cintura) determinaram redução nas variáveis resistência e reatância obtidas pela bioimpedância elétrica em mulheres candidatas à cirurgia bariátrica.

Tumor fibroso solitario pleural como causa de disnea en un paciente de 53 años / Pleural fibrous solitary tumor as cause of dyspnea in a patient 53 years old

El tumor fbroso solitario pleural es una neoplasia infrecuente originada en las células mesoteliales de la superfcie pleural con una incidencia calculada en alrededor de 2.8 casos por 100.000 pacientes al año [1]; además, representa el 8% de las neoplasias benignas del tórax y 10% de los tumores pleurales [2]. El curso clínico de la mayoría de estos tumores es benigno, raramente pueden recurrir localmente o dar metástasis. Las recurrencias pueden ser tardías, con un período de latencia de hasta 30 años [3], la mayoría de los casos se localizan en la pleura visceral o parietal; además, pueden aparecer en otras áreas tales como peritoneo, mediastino, meninges, pulmón, tiroides, parótida, órbita, nariz y fosas nasales. Clínicamente este tumor es asintomático y suele diagnosticarse de manera casual en una radiografía de tórax. Los síntomas ocasionalmente descritos son tos, disnea, dolor torácico y derrame pleural, y entre las manifestaciones sistémicas fguran artralgias, acropaquias e hipoglicemia

The pleural solitary fibrous tumor is an infrequent neoplasm originated in the mesothelial cells of the pleural surface with an incidence calculated at around 2.8 cases per 100,000 patients per year [1]; In addition, it represents 8% of benign neoplasms of the thorax and 10% of pleural tumors [2]. The clinical course of most of these tumors It is benign, rarely they can recur locally or metastasize. The recurrences may be late, with a latency period of up to 30 years [3], most cases are located in the visceral pleura or parietal; In addition, they may appear in other areas such as peritoneum, mediastinum, meninges, lung, thyroid, parotid, orbit, nose and pits Nasal Clinically, this tumor is asymptomatic and is usually diagnosed casual way on a chest x-ray. The symptoms occasionally described are cough, dyspnea, chest pain and pleural effusion, and between Systemic manifestations include arthralgias, acropachias and hypoglycemia

Prevalencia elevada de factores de riesgo cardiovascular en una población pediátrica / High prevalence of cardiovascular disease risk factors in a pediatric population

Introducción. Los factores de riesgo cardiovascular pueden presentarse desde la infancia y predecir la enfermedad cardiovascular del adulto. Objetivo. Determinar la prevalencia de los factores de riesgo cardiovascular de un grupo de niños, hijos de enfermeras de una institución de salud de Bogotá, Colombia. Materiales y métodos. Se hizo un estudio de corte transversal en niños entre 3 y 17 años de edad, evaluados entre junio de 2011 y julio de 2012. Resultados. Participaron 118 niños, con una edad promedio de 7,4 años (desviación estándar=3,86), la mayoría de ellos eutróficos (72,0 %). Los niños presentaban los siguientes factores de riesgo para enfermedad cardiovascular: malos hábitos alimenticios (89,0 %), sedentarismo (78,8 %), exposición al tabaco (19,5 %), historia familiar de riesgo cardiovascular (16,1 %), sobrepeso (15,3 %) y obesidad (12,7 %). No se encontraron diferencias estadísticamente significativas entre los factores de riesgo según sexo. El sedentarismo en niños con sobrepeso u obesidad fue de 90,9 % y en niños eutróficos, de 36,5 %, (p<0,001). En 84,8 % de los niños con sobrepeso u obesidad y en 42,4 % de los eutróficos, se presentaron malos hábitos alimentarios (p<0,001). El 97,5 % de los niños presentó, al menos, un factor de riesgo, y el 42,4 %, tres o más. La presencia de tres o más factores fue más frecuente en los obesos que en aquellos con sobrepeso (p<0,001) y en los eutróficos (p<0,001). Conclusiones. Los resultados indican que los niños de 3 a 17 años incluidos en el estudio, presentaban varios factores de riesgo de enfermedad cardiovascular, en especial, aquellos con sobrepeso y obesidad.

Introduction: Cardiovascular disease risk factors begin in childhood. Their presence may predict cardiovascular disease in adulthood. Objective: To determine the prevalence of cardiovascular disease risk factors in a group of nurses´ children at a health facility in Bogotá, Colombia. Materials and methods: A cross-sectional, population-based observational study among 3-17 year-old individuals evaluated between June, 2011, and July, 2012. Results: A total number of 118 children were included. The mean age was 7.4 years, with a standard deviation of 3.86; 72.0% of the children had a normal weight. Prevalence of cardiovascular risk factors was distributed as follows: inadequate food habits, 89.0%; sedentary lifestyle, 78.8%; family history of cardiovascular disease, 16.1%; overweight, 15.3%, and obesity, 12.7%. There were no significant differences in risk factors between boys and girls. Among overweight and obese children, sedentary lifestyle was present in 90.9%, and among normal-weight children, in 36.5% (p<0.001). Inadequate food habits were present in 84.8% of the overweight and obese children, and in 42.4% of those with normal weight (p<0.001). Among the study population, 97.5% had at least one risk factor and 42.4% presented 3 or more. The presence of 3 or more cardiovascular disease risk factors was higher in obese children, when compared to overweight (p<0.001) and normal-weight children (p<0.001). Conclusions: The results of this study indicate that there was a substantial burden of cardiovascular disease risk factors in the 3-17 year-old children included, particularly in those who were obese or overweight.

Eosinophilic meningitis caused by Angiostrongylus cantonensis: an emergent disease in Brazil

Eosinophilic meningitis (EoM) is an acute disease that affects the central nervous system. It is primarily caused by infection with the nematode Angiostrongylus cantonensis. This infection was previously restricted to certain Asian countries and the Pacific Islands, but it was first reported in Brazil in 2007. Since then, intermediate and definitive hosts infected with A. cantonensis have been identified within the urban areas of many states in Brazil, including those in the northern, northeastern, southeastern and southern regions. The goals of this review are to draw the attention of the medical community and health centres to the emergence of EoM in Brazil, to compile information about several aspects of the human infection and mode of transmission and to provide a short protocol of procedures for the diagnosis of this disease.

A malacological survey in the Manso Power Plant, State of Mato Grosso, Brazil: new records of freshwater snails, including transmitters of schistosomiasis and exotic species

Introduction Schistosomiasis is a parasitic disease of public health concern in Brazil, and the construction of hydroelectric dams, in addition to increasing permanent human settlement and tourism, has created conditions suitable for the establishment of mollusks that can transmit schistosomiasis. Such areas require a number of actions to prevent the establishment of schistosomiasis. This paper reports on a freshwater malacological survey carried out in the geographical area of the Manso Power Plant. Methods Mollusks were collected in 18 municipalities in the State of Mato Grosso between February 2002 and February 2004 (qualitative study) and from April 2009 to February 2011 (quantitative study). Results Thirty-one species of mollusks were collected, including newly recorded species (Antillorbis nordestensis and Burnupia ingae). In addition, the geographic distributions of known species, including Biomphalaria straminea, a snail vector of Schistosoma mansoni, were expanded. A total of 4,507 specimens were collected in the APM Manso reservoir (Usina Hidrelétrica de Aproveitamento Múltiplo de Manso) during the quantitative study, and Biomphalaria amazonica was found in six of the 10 localities analyzed. The Afroasiatic species Melanoides tuberculata, introduced after February 2009, was the dominant species (relative abundance 94.96%). Conclusions The study area is epidemiologically important due to the occurrence of B. straminea and B. amazonica, which are vectors of schistosomiasis, and M. tuberculata, a snail host of Centrocestus formosanus, which is responsible for centrocestiasis transmission. Observations of M. tuberculata and the exotic freshwater clams Corbicula fluminea and Corbicula largillierti raise concerns about biodiversity. .

Conhecer as emoções: a aplicação e avaliação de um programa de intervenção / Emotions: the implementation and evaluation of an intervention program / Conocé las emociones: la implementación y evaluación de un programa de intervención

Procura-se explorar a importância do conhecimento emocional, através da avaliação de um Programa de Desenvolvimento do Conhecimento Emocional, a partir de um design experimental de pré e pós-teste. Participaram 25 crianças de educação pré-escolar entre cinco e seis anos e foi utilizada a Escala de Avaliação do Conhecimento Emocional (EACE), que permite obter uma nota total da Percepção Emocional Correta (PEC) e foi utilizada em pré e pós-teste. Os resultados evidenciam um aumento significativo do conhecimento emocional entre o pré-teste e o pós-teste, ocorrendo os progressos mais significativos nas dimensões comportamentos emocionais e situações emocionais.

The present research highlights the importance of emotional knowledge through the evaluation of the effectiveness of a program, with experimental design of pre and post-test. 25 children-participants attended a pre-school class, aged from five and six years old. It was used the Assessment of Children's Emotion Skills Questionnaire for the Portuguese context, which gives a total score for the Correct Emotional Perception. The results show a significant increase in emotional knowledge between the pre-test and post-test, more significant progress in the dimensions of emotional behaviors and emotional situations.

La presente investigación pone de relieve la importancia del conocimiento emocional a través de la evaluación de la efectividad de un programa, con un diseño experimental de pre y post-test. 25 niños participantes, con edades comprendidas entre cinco y seis años de edad, asistieron a una clase de preescolar. Se utilizó el Cuestionario de Evaluación de Habilidades Emocionales para la Infancia para el contexto portugués, lo que da una puntuación total de percepción emocional correcta. Los resultados muestran un incremento significativo en el conocimiento emocional entre el pre-test y pos-test, siendo el avance más significativo en las dimensiones de los comportamientos y de las situaciones emocionales.

Freshwater gastropods of the Baixada Maranhense Microregion, an endemic area for schistosomiasis in the State of Maranhao, Brazil: I - qualitative study

Introduction: The Baixada Maranhense Microregion currently has the highest prevalence of schistosomiasis in the State of Maranhão, likely because this parasitosis is characterized as an occupational disease, and increased contact with water increases the risk of infection by Schistosoma mansoni. This paper reports the results of the first comprehensive freshwater malacological survey performed in the Baixada Maranhense Microregion. Methods: Freshwater mollusks were collected from the twenty-one municipalities of the Baixada Maranhense Microregion and from Bacurituba and Cajapió and were evaluated for infection by trematodes. Results: A total of 9,129 mollusks were collected (sixteen species), which included the first records of six species in the State of Maranhão: Gundlachia radiata, G. ticaga, Hebetancylus moricandi, Plesiophysa guadeloupensis, Pomacea bridgesii diffusa and Omalonyx sp. Biomphalaria glabrata was found in five municipalities, whereas B. straminea was found in nine. Biomphalaria glabrata and B. straminea were observed in syntopy in Pinheiro and São Bento. Of the 990 specimens of B. glabrata and the 2,109 specimens of B. straminea that were exposed to and/or analyzed for the presence of larval trematodes, only a single specimen of B. glabrata (0.1%) from São Bento shed S. mansoni. Other larval trematodes were first observed in mollusks from the State of Maranhão. Conclusions: These results indicate that the study area is epidemiologically important due to the presence of two natural vectors of schistosomiasis and the active transmission of schistosomiasis, which was confirmed in the infected specimen that was collected in this study. .

Larval trematodes in freshwater gastropods from Mato Grosso, Brazil: diversity and host-parasites relationships

A survey for freshwater gastropods carrying trematodes parasites was conducted in Manso Dam and the surrounding areas frequented by tourist, focusing particularly on the Pantanal region. Infected snails were recovered from twelve of the eighteen investigated municipalities and forty-one cercaria-snail pairings were recorded. Among these pairings were several first records of snails serving as intermediate hosts for trematodes in Brazil including Biomphalaria amazônica Paraense, 1966, Biomphalaria occidentalis Paraense, 1981, Marisa planogyra Pilsbry, 1933, Pomacea maculata Perry, 1830, Pomacea scalaris (d'Orbigny, 1835) and Gundlachia radiata (Guilding, 1828). Echinostomatidae and Strigeidae were the most common trematode families (ca. 47%) and the greatest diversity of larvae were obtained from Drepanotrema lucidum (Pfeiffer, 1839). Paramphistomatidae, Schistosomatidae or Spirorchiidae and Notocotylidae or Pronocephalidae were recovered in D. lucidum for the first time extending the number of families which use this gastropod as intermediate host. Although no specimens were found harboring larval stages of Schistosoma mansoni Sambon, 1907 other trematode larvae were discovered, including the Schistosomatidae Brevifurcate apharingeate cercaria that can cause dermatitis in humans. Continued studies on the taxonomy and biology of trematodes are essential to better understand the biodiversity of these parasites as well as the epidemiological aspects for control of associated zoonosis.

Foi realizado um levantamento de trematódeos em gastrópodes límnicos provenientes da área da Usina Hidrelétrica de Manso e das proximidades com potencial turístico, como a região do Pantanal. Moluscos parasitados foram encontrados em doze dos dezoito municípios investigados e quarenta e uma interações cercária-gastrópode límnico foram observadas, entre elas Biomphalaria amazônica Paraense, 1966, Biomphalaria occidentalis Paraense, 1981, Marisa planogyra Pilsbry, 1933, Pomacea maculata Perry, 1830, Pomacea scalaris (d'Orbigny, 1835) and Gundlachia radiata (Guilding, 1828) atuando pela primeira vez no Brasil como hospedeiros intermediários de trematódeos. Echinostomatidae e Strigeidae foram as famílias de maior ocorrência (ca. 47%) e a maior variedade de tipos cercarianos foi encontrada em Drepanotrema lucidum (Pfeiffer, 1839). Paramphistomatidae, Schistosomatidae or Spirorchiidae and Notocotylidae or Pronocephalidae foram reportadas pela primeira vez em D. lucidum ampliando o número de famílias que utilizam esse gastrópode como hospedeiro intermediário. Embora nenhum espécime tenha sido encontrado com formas larvais de Schistosoma mansoni Sambon, 1907, outros trematódeos foram observados, como Brevifurcate apharingeate cercaria da família Schistosomatidae que pode causar dermatite no homem. Estudos sobre a taxonomia e a biologia de trematódeos são essenciais para melhor compreender a biodiversidade desses parasitos, assim como os aspectos epidemiológicos para o controle de parasitoses associadas.

Variação espaço-temporal da malacofauna límnica em dois reservatórios no rio Tocantins, com ênfase na transmissão da esquistossomose, no período entre junho de 2004 e outubro de 2010 / Time-space variation of freshwater molluscs from two reservoirs in Tocantins river, focusing shistosomiasis transmission, between june 2004 and octuber 2010

A energia gerada por usinas hidrelétricas constitui a matriz energética brasileira. O grande número de usinas hidrelétricas que vem sendo construídas nos principais rios tem causado grandes transformações ambientais, que afetam tanto o homem quanto as comunidades faunísticas locais. O principal objetivo deste projeto foi avaliar a malacofauna límnica do trecho do rio Tocantins entre as Usinas Hidrelétricas de Peixe Angical e de Cana Brava, entre os Estados de Tocantins e Goiás, respectivamente, nos períodos de pré-enchimento e pós-enchimento dos reservatórios. Foram georreferenciadas 94 estações de amostragem, com coletas periódicas entre junho de 2004 e outubro de 2010. Toda a área foi dividida em sete trechos (I, II, III, IV, V, VI e VII, no sentido jusante a montante) e os moluscos foram obtidos por coleta direta, resultando no número de exemplares/minuto/coletor. Todos os moluscos foram examinados quanto à presença de larvas de trematódeos digenéticos e identificados com base na morfologia e conquiliologia. Representantes de cada estação de amostragem estão sendo depositados na Coleção Malacológica do Instituto Oswaldo Cruz. Diante da ocorrência de Biomphalaria straminea, espécie hospedeira intermediária da esquistossomose, populações dessa espécie foram mantidas no Laboratório de Malacologia e os descendentes submetidos à infecção experimental com três cepas de Schistosoma mansoni (CM, CMO e BH). Das 12 famílias encontradas (Ampullariidae, Ancylidae, Corbiculidae, Hydrobiidae, Hyriidae, Mycetopodidae, Pisidiidae, Physidae, Pomatiopsidae, Planorbidae, Lymnaeidae e Thiaridae), oito foram avaliadas quanto aos índices de constância e abundância.A mesma análise foi realizada em relação às espécies de Planorbidae e Thiaridae. Os índices de diversidade de Shannon, Margalef e a Equitabilidade foram calculados com base nas unidades taxonômicas operacionais. . Para as análises estatísticas foram utilizados o teste t e análise de variância. Houve diferença significativa no índice de constância das famílias de gastrópodes em cinco dos seis trechos analisados, em relação aos dois períodos; o mesmo ocorrendo no índice de constância das espécies de Planorbidae e Thiaridae. Após a formação dos reservatórios B. straminea, Lymnaea columella, Melanoides tuberculatus e Pomacea lineata mostraram-se mais constantes; enquanto Potamolithus sp. tornou-se menos ocorrente. Em relação à abundância, a formação dos reservatórios favoreceu o estabelecimento das populações de Ampullariidae, Lymnaeidae, Physidae, Planorbidae e Thiaridae. O índice de diversidade de Shannon mostrou diferença significativa entre os períodos de pré e pós-enchimento, o que não ocorreu com o índice de Margalef e Equitabilidade. A análise da helmintofauna nas amostras coletadas não revelou ocorrência de S. mansoni ou Fasciola hepatica, embora tipos larvais de 21 famílias de digenéticos, alguns com importância médica, tenham sido obtidos na área de estudo. Quando submetida à infecção experimental, B. straminea mostrou-se suscetível à cepa BH (índice de infecção de 0,6%). Diante do exposto, a área de estudo pode ser considerada indene com potencial de transmissão de parasitoses e vulnerável à ocorrência da esquistossomose, sendo indicada a implementação de medidas preventivas contra a instalação de focos desta endemia na região.

First report of Angiostrongylus cantonensis (Nematoda: Metastrongylidae) in Achatina fulica (Mollusca: Gastropoda) from Southeast and South Brazil

The rat lungworm Angiostrongylus cantonensis is a worldwide-distributed zoonotic nematode that can cause human eosinophilic meningoencephalitis. Here, for the first time, we report the isolation of A. cantonensis from Achatina fulica from two Brazilian states: Rio de Janeiro (specifically the municipalities of Barra do Piraí, situated at the Paraiba River Valley region and São Gonçalo, situated at the edge of Guanabara Bay) and Santa Catarina (in municipality of Joinville). The lungworms were identified by comparing morphological and morphometrical data obtained from adult worms to values obtained from experimental infections of A. cantonensis from Pernambuco, Brazil, and Akita, Japan. Only a few minor morphological differences that were determined to represent intra-specific variation were observed. This report of A. cantonensis in South and Southeast Brazil, together with the recent report of the zoonosis and parasite-infected molluscs in Northeast Brazil, provide evidence of the wide distribution of A. cantonensis in the country. The need for efforts to better understand the role of A. fulica in the transmission of meningoencephalitis in Brazil and the surveillance of molluscs and rodents, particularly in ports, is emphasized.

O caramujo exótico invasor Achatina fulica (Stylommatophora, Mollusca) no Estado do Rio de Janeiro (Brasil): situação atual / The exotic invasive snail Achatina fulica (Stylommatophora, Mollusca) in the State of Rio de Janeiro (Brazil): current status

O caramujo africano invasor Achatina fulica foi introduzido no Brasil a partir de Estados do Sul e Sudeste em pelo menos três ocasiões. Atualmente sua distribuição já abrange 24 dos 26 estados e o Distrito Federal. Populações densas dessa espécie vêm causando incômodos à populações humanas, danos à jardins e pequenas plantações, além de atuarem como transmissoras de duas zoonoses (angiostrongilíase abdominal e meningoencefalite eosinofílica) e outras parasitoses de interesse veterinário. No presente estudo, apresentamos novas ocorrências de A. fulica no Estado do Rio de Janeiro (Brasil) assim como dados sobre as larvas de nematódeos de interesse médico e veterinário encontradas em exemplares dessa espécie coletados neste estado. A. fulica está presente em 26 municípios adicionais em relação aos dados obtidos em 2006, ano do último levantamento, representando um aumento de 50 por cento no número de municípios infestados. Apenas nove dos 92 municípios do estado ainda não registram a presença dessa espécie. Larvas dos nematódeos Aelurostrongylus abstrusus, Rhabditis sp. e Strongyluris-like, todas com importância veterinária, foram encontradas em exemplares de A. fulica de onze municípios. A rápida dispersão de A. fulica evidencia a necessidade de planos de manejo contínuos e eficientes em todo o país visando o controle efetivo dessa invasão. A erradicação de A. fulica é pouco provável devido ao nível atual de infestação.

The invasive African snail Achatina fulica was introduced in Brazil through South and Southeast States in at least three separate occasions. A. fulica is currently present in 24 out of 26 Brazilian States and in the Federal District. Dense populations of A. fulica are nuisance to human populations and pest to gardens and small crops. Such populations also act in the transmission of two zoonosis (abdominal angiostrongyliasis and eosinophilic meningitis) as well as other parasitosis of veterinary importance. Here, we report new records of A. fulica and of nematode larvae of medical and veterinary importance found in this snail in the state of Rio de Janeiro (Brazil). A. fulica is present in 26 additional municipalities of the state when compared to the information obtained in 2006, year of the last census. This result represents an increase of 50 percent in the number of municipalities infested. Only nine out of the 92 municipalities of the state have not yet registered the presence of this invasive species. Nematode larvae of Aelurostrongylus abstrusus, Rhabditis sp. e Strongyluris-like, all of veterinary importance, have been registered in A. fulica individuals from eleven municipalities of the state. The rapid range expansion of A. fulica calls attention for the need of a general and continuous management plan throughout the country in order to effectively control the invasion. The current level of infestation makes a full eradication unlikely.