Genotipificación y resistencia antibacteriana de cepas de Campylobacter spp aisladas en niños y en aves de corral / Genotyping and antibacterial resistance of Campylobacter spp strains isolated in children and in free range poultry

Poultry is a main reservoir and source of human infection in campylobacteriosis. Three hundred and forty one stool samples (291 human, 50 avian) were analyzed. In the human group, 220 samples were collected from children with acute diarrheal disease (183 inpatients, 37 outpatients) and 71 from healthy children. Erythromycin and ciprofloxacin agar dilution MIC tests, Penner serotyping and RAPD-PCR genotyping were performed on 23 strains isolated. C. jejuni was reported only in patients with acute diarrhea (5.4 percent inpatients, 2.2 percent outpatients). Campylobacter prevalence in poultry was 34 percent. Cross-resistance to nalidixic acid and ciprofloxacin was found in 33.3 percent of human samples and 11.8 percent of animal samples. Human samples could not be typed using the Penner method. F serotype was the most expressed in poultry. We obtained a total of 14 genotypes (4 / 5 human and 10/15 avian). In conclusion, the predominant species in poultry and humans was C. jejuni, a significant amount of quinolone-resistant human and avian samples were obtained, and avian genotypes and serotypes were not found in human samples. The latter would mean that another source of infection could exist; therefore other reservoirs must be studied.

Las aves de consumo constituyen uno de los principales reservorios y fuente de infección humana de la campilo-bacteriosis. Se analizaron 341 muestras de deposiciones, 291 humanas y 50 aviares. De las muestras, 220 de niños con síndrome diarreico agudo-SDA (183 hospitalizados y 37 consultantes ambulatorios) y 71 niños sanos. A las 23 cepas obtenidas se les realizó CIM por dilución en agar a eritromicina y ciprofloxacina, serotipificación de Penner y genotipiicación por RAPD-PCR. Se encontró Campylobacterjejuni sólo en pacientes con SDA, de ellos 5,4 por ciento ambulatorios y 2,2 por ciento hospitalizados. En aves, la prevalencia de Campylobacter spp., fue de 34 por ciento. Hubo resistencia cruzada a ácido nalidixico y ciprofloxacina en 33,3 por ciento cepas de origen humano y 11,8 por ciento animal. Las cepas humanas fueron no tipiicables por el método de Penner. Predominó entre las aves el serotipo F. Se obtuvo un total de 14 genotipos (4/5 humanos y 10/15 aviares). En conclusión, la especie predominante en aves de corral y en humanos fue C. jejuni, existiendo una alta prevalencia de cepas de origen humano y aviar resistentes a quinolonas. Los genotipos y serotipos aviares no fueron encontrados en cepas de origen humano, lo que indica que podría existir otra fuente de infección, por lo que se requiere estudiar otros reservorios.

Epidemiologia y etiología de la dacriocistitis aguda en el servicio de oftalmología del Hospital Guillermo Grant Benavente, Concepción: Chile / Epidemiology and etiology of acute dacryocystitis in the ophthalmology service of the Guillermo Grant Benavente Hospital, Concepcion. Chile

La Dacriocistitis Aguda (DA) consiste en una inflamación del saco lagrimal y conducto nasolagrimal, secundario a un proceso infeccioso mayoritariamente o a estenosis senil del conducto, traumatismos, tumores, sinusitis, conjuntivitis crónica y/o canaliculitis. Los grupos etarios más afectados son los lactantes y personas de edad avanzada, especialmente mujeres. Los agentes infecciosos más frecuentemente involucrados son Staphylococcus aureus y Streptococcus beta-hemolítico. Objetivos: Determinar la frecuencia de la patología, tiempo de hospitalización, la distribución por edad, la prevalencia por sexo de esta patología, tipo de tratamiento recibido por los pacientes. Metodología: los datos requeridos para el estudio se obtuvieron de la revisión de los antecedentes de hospitalización y de las fichas clínicas. Resultados: En un total de 1.870 hospitalizaciones oftalmológicas efectuadas entre Junio y Diciembre de 2007, 102 fueron por DA (5,5 por ciento). El 78 por ciento de estos era de sexo femenino y el mayor número de consultas se dieron en personas con edades entre los 70 y 79 años (33.3 por ciento). El 52.9 por ciento de los casos necesitó solo un día de hospitalización, recibiendo tratamiento sistémico el 15,7 por ciento de los pacientes que presentaba complicaciones o reagudización del cuadro. Conclusiones: El porcentaje de hospitalizaciones por DA constituye el 5,5 por ciento del total de hospitalizaciones por patologías oculares, la cual se manifiesta mayormente en mujeres adultas mayores, con hospitalizaciones de un día y antibióticoterapia sistémica efectuada con cloxacilina.

Acute dacryocystitis is an inflammation of the lacrimal sac and nasolacrimal duct, mostly secondary infection process, or senile duct stenosis, trauma, tumors, sinusitis, or chronic conjunctivitis and canaliculitis. The age groups most affected are infants and elderly, especially women. Infectious agents most commonly involved are Staphylococcus aureus and Streptococcus beta-hemolytic. There are no epidemiological studies or history of national and local causative of this condition. Objectives: To determine the frequency of hospitalization, the age distribution by sex and prevalence of this disease, know the length of hospital employee and the treatment received by patients Methodology: The data required for the study was obtained from a review of clinical records of patients Results. A total of 1870 hospitalizations eye made between June and Oecember 2007, 102 were for dacryocystitis (55 percent). 78 percent of patients were female and the largest number of inquiries occurred in patients aged 70 to 79 years (33.3 percent) The 52.9 percent of cases needed only one day of hospitalization, receiving systemic treatment for 15.7 percent of patients had complications or exacerbation of the clinical, being the drug of choice, cloxacillin. Conclusions: The incidence of hospitalizations for acute dacryocystitis is 5.5 percent of total hospitalizations for ocular pathologies. Oacryocystitis occurs mostly in older adults, whose age ranges are between 60 and 89 years, mostly female. The hospitalization time required is not more than one day to prepare for surgery, for the treatment of infectious event is performed as an outpatient. Systemic antibiotic therapy conducted in patients who show no response to empiric therapy is cloxacillin.

Polimorfismos del gen del receptor de vitamina D y riesgo de fractura de cadera en la mujer adulta mayor de la Región del Bío Bío / Vitamin D receptor gene polymorphisms and risk of hip fracture in Chilean elderly women

Background: Osteoporotic hip fractures are devastating events in older women. There is a genetic modulation of bone phenotypic parameters including bone density (BMD) and bone fragility fractures. Vitamin D receptor (VDR) gene polymorphisms explain a small part of the genetic influence on BMD, whereas their effect on fractures remains uncertain. Aim: To examine the contributions of VDR genotypes to the susceptibility to hip fracture in elderly Chilean women. Patients and methods: We recruited 126 women (67 with fractures and 59 without) from Bio-Bio Region, Chile, aged 65 to 94 years. Genotyping for Bsm-l, Apa-1, Taq-1 and Fok-1 VDR polymorphisms was performed using polymerase chain reaction methods. All hip fractures were confirmed by X-ray. Results: The alíele frequencies were 0.49 for B, 0.57 for A, 0.60 for T and 0.65 for F in the Bsm-l, Apa-1, Taq-1 and Fok-1 polymorphisms respectively. The prevalence of these VDR gene polymorphisms in women with fractures were 16 percent BB, 69 percent Bb, 15 percent bb for Bsm-l; 30 percent AA, 46 percent Aa, 14 percent aa for Apa-1; 17 percent TT, 34 Tt, 8 percent tt for Taq-1 and 43 percentFF, 41 percent Ff, 16 percent ff for Fok-1. All VDR genotype frequencies did not differ from Hardy- Weinberg expectations. Alíele or genotype frequencies did not differ between women with or without fractures. These results did not change when analysis was adjusted by age weight, height or gynecologic history. Conclusions: The genotype frequencies of the VDR polymorphisms are in accordance with the frequencies of other Hispanic and Caucasian populations. Our results suggest that VDR polymorphisms are not associated with the risk of hip fracture in older women of this Region of Southern Chile.

FACO/LUZ: hacia la construcción de un modelo educativo integral en odontología (parte I) / FACO/LUZ: towards the construction of an integred educational model in dentistry (part I)

Construir un modelo educativo integral que de respuesta a los retos de la odontología como ciencia comprometida socialmente, tanto en el contexto nacional como latinoamericano. Parte de algunas consideraciones que develan los principios y las políticas del Estado que rigen la educación superior en el mundo contemporáneo. Para la construcción de la propuesta, la Facultad de Odontología de la Universidad del Zulia, FACO/LUZ, dio apertura a escenarios de discusión con la participación de los actores involucrados en el proceso, con la finalidad de evaluar la experiencia institucional en materia curricular. Igualmente, realizó un análisis crítico de las tendencias mundiales en educación y salud, a objeto de incorporarlas a la propuesta. En sus alcances el modelo posibilita la formación de talento humano cuya praxis apunte a la transformación cuali-cuantitativa, de la situación de salud bucal de la población. En su marco filosófico reafirma el modelo educativo docencia-servicio-investigación e inserta conceptos actuales relacionados con la bioética, transculturalidad, la epidiscipilinariedad y el uso de las lenguas autóctonas de la región y el país. Finalmente, el modelo permite integrar la teoría y la práctica (estudio-trabajo) en el marco de la estratégia de la atención primaria en salud.

Susceptibilidad in vitro de cepas de helicobacter pylori: aislamiento de cepas resistentes a claritromicina / In vitro antimicrobial susceptibility of helicobacter pylori strains isolated in Chile

Background: Our laboratory has carried out an epidemiological surveillance of Helicobacter pylori antimicrobial susceptibility since 1997. Aim: To report the antimicrobial susceptibility of H pylori strains, isolated in Chile from August 1997 to August 2000. Material and methods: Ninety one H pylori strains, obtained from antral gastric biopsies during upper gastrointestinal endoscopies were studied. Susceptibility towards clarithromycin, amoxicillin, bismuth subcitrate and metronidazole was studied by an agar diffusion technique. Results: All strains were susceptible to amoxicillin and two strains were resistant to clarithromycin. Forty two percent of strains were resistant to metronidazole and 13 per cent were resistant to bismuth subcitrate. Conclusions: These results underscore the need to maintain an epidemiological surveillance of H pylori antimicrobial susceptibility, to modify its eradication therapy accordingly

Ciclosporosis: informe de un caso clínico en Concepción, Chile / Cyclosporosis: report of a case in Concepción, Chile

Cyclospora cayetanensis is a newly recognized parasite widely distributed throughout the world, and isolated from children, immunocompetent adults and HIV infected individuals. The clinical manifestations of the infection are watery prolonged diarrhea, anorexia, fatigue, nausea, bloating and weight loss. In immunocompetent individuals, diarrhea is usually self limited but may last several weeks. In immunocompromised hosts it is prolonged, severe and can be associated with biliary tract involvement. We report a 50 years old female that, five days after returning from Cuba, presented with low grade fever, anorexia, fatigue, explosive diarrhea and weight loss. Physical examination was normal. A stool specimen contained many organisms with morphological features of Cyclospora caetanensis. The diagnosis was confirmed at the Centers for Disease Control (Atlanta Ga)