Violencia sexual: un nuevo enfoque institucional / Sexual violence: a new institutional approach

Introducción: la violencia por motivos de género es una cuestión social que cobra un enorme precio en materia de salud mental y física. Es posible que la mitad de todas las mujeres estén sujetas en algún momento de su vida actos de violencia por motivos de género. Cada año, dos millones de niñas y mujeres corren riesgo de mutilación genital. La violencia puede ser evidente, como en el caso de los castigos físicos o las agresiones sexuales, o encubierta, como en el abandono o en maltrato emocional. Objetivo: Contribuir a la concientización del cuerpo profesional, a fin de hacerlo perceptivo a las necesidades de las víctimas de violaciones, pudiendo así lograr el desarrollo de un programa asistencial integral de las mismas. Material y método: Se realizó una revisión de los conceptos de definición y diagnósticos diferenciales de violación y abuso sexual. Se realizó el estudio comparativo entre distintos Códigos Penales (Españo, Argentino y su modificatoria del año 1999) de los principales artículos que reglamentan este tema. Se selecionaron las principales normativas vigentes que reglamentan los derechos humanos, la eliminación de las formas de discriminación de la mujer y los principios fundamentales de justicia para las víctimas de delitos. Resultados: Se conceptualizaron premisas profesionales, éticas y humanas que creemos fundamentales en el abordaje de esta problemática. Se plantea como necesidad una definición más abarcativa de violación de nuestro Código Penal, que permita instaurar una forma inequívoca la fellatio in ore como delito de violación. Se reseñan los principales indicadores específicos y de sospecha, así como los estudios infectológicos y la profilaxis a instaurar en caso de violación y abuso sexual. Conclusiones: No actuar para asegurar los derechos de la mujer es ponerse del lado del abuso y la violencia. Al ser indiferentes, resultaremos destructivos

Immunodiagnosis of Trypanosoma cruzi (Chagas' disease) infection in naturally infected dogs

This study reports on the standardization of an enzyme-linked immunosorbent assay (ELISA) for detecting specific antibodies anti-Trypanosoma cruzi in naturally infected dogs. Sera from 182 mongrel dogs of all ages residing in four rural villages in Santiago del Estero, Argentina, were collected in November 1994 and preserved in buffered neutral glycerin. All sera were tested by indirect hemagglutination test (IHAT), indirect immunofluorescence test (IFAT), and ELISA using the flagellar fraction of T. cruzi as antigen. Dog sera from an area without vectorial transmission were used to calculate ELISA specificity and cut-off-value. Eighty-six percent of sera had concordant results for all tests. All sera reactive for IHAT and IFAT were also rective for ELISA, except in one case. Sera tested by ELISA when diluted 1:200 allowed a clearer division between non-reative and reactive sera than when 1:100 with greater agreement among serologic techniques. The specificity of ELISA was 96,2 per cent. Among 34 adult dogs with a positive xenodiagnosis, sensitivity was 94 per cent both for ELISA and IFAT. ELISA is the first choice for screening purposes and one of the pair of techniques recommended for diagnostic studies in dog populations.

Chronic experimental infection by Trypanosoma cruzi in Cebus apella monkeys

Twenty young male Cebus apella monkeys were infected with CAl Trypanosoma cruzi strain and reinfected with CA l or Tulahuen T.cruzi strains, with different doses and parasite source. Subpatent parasitemia was usually demonstrated in acute and chronic phases. Patent parasitemia was evident in one monkey in the acute phase and in four of them in the chronic phase after re-inoculations with high doses of CAl strain. Serological conversion was observed in all monkeys; titers were low, regardless of the methods used to investigate anti-T. cruzi specific antibodies. Higher titers were induced only when re-inoculations were perfomed with the virulent Tulahuén strain or high doses of CAl strain. Clinical electrocardiographic and ajmaline test evaluations did not reveal changes between infected and control monkeys. Histopathologically, cardiac lesions were always characterized by focal or multifocal mononuclear infiltrates and/or isolated fibrosis, as seen during the acute and chronic phases; neither amastigote nests nor active inflammation and fibrogenic processes characteristic of human acute and chronic myocarditis respectively, were observed. These morphological aspects more closely resemble those found in the "indeterminate phase" and contrast with the more diffuse and progressive pattern of the human chagasic myocarditis. All monkeys survived and no mortality was observed.

Standardization of serological tests for detecting anti-Trypanosoma cruzi antibodies in dogs

his paper reports on the standardization of four serological reactions currently used in human serodiagnosis for the detection of anti-Trypanosoma cruzi antibodies in naturally and experimentally infected dogs. Indirect immunofluorescence test (IFAT) and hemagglutination test (IHAT) were standardized, and complement fixation test (CFT) and direct agglutination test (DAT) were used for diagnostic confirmation. Four hundred and eighty one mongrel dogs that were studied by xenodiagnosis were used: (1) parasitemic dogs of two localities of endemic area (EA) of Santiago del Estero province in Argentina (n = 134); (2) non-parasitemic dogs of the same area (n = 285); (3) dogs experimentally infected with T. cruzi in the patent period (n = 6); (4) non-infected dogs (n = 56) which were born in the city of Buenos Aires (BA), one non-EA for Chagas' disease. For IFAT, parasitemic dogs EA showed 95 per cent of reactive sera. Non parasitemic dogs EA showed 77 per cent of non reactive sera. None sera from BA were reactive for dilutions higher than four. For IHAT, 84 per cent of sera of parasitemic dogs EA showed serological reactivity and among non parasitemic dogs BA, 61 per cent were non reactive, while the remainder showed at most titres of 1/16. The cut-off titres for IFAT and IHAT were 1/16 and 1/32 respectively, and for CFT and DAT 1/1 and 1/128 respectively. Sensitivity for IFAT, IHAT, CF and DAT were 95 per cent , 84 per cent , 97 per cent and 95 per cent respectively