Manifestaciones clínicas y factores de riesgo asociados a la infección por Cryptosporidium en pacientes de Barranquilla y tres municipios del Atlántico (Colombia) / Clinical manifestations and risk factors associated with Cryptosporidium spp. infections in patients from Barranquilla and three “municipios” of Atlántico (Colombia)

Objectives: To characterize the clinical manifestations and risk factors associated with cryptosporidiosis.Materials and methods: A descriptive study was performed on 423 patients, with macroscopic and microscopic faecal sample analyses, to identify the clinical manifestations and risk factors associated with cyptosporidiosis in 3 towns and the principal city in Atlantico(Colombia) over a 4-month period. Cryptosporidium spp oocysts were identified after stainingwith modified Ziehl-Neelsen. A saturated NaCl parasite-concentration method was also compared with wet-mount method for the detection of all intestinal parasites in 279/423 (66.0 percent) patients. Statistical analyses were performed using EPI-INFO 6.04.Results: The prevalence of Cryptosporidium spp. was 1.9percent (8/423). Statistical associationswere found between cryptosporidiosis infections and fever (p=0.01), blood in the faecalsamples (p=0.01) and the presence of household animals (p=0.02). Most of the patients(267/423: 63.1percent) were positive for intestinal parasites. The most commonly identifiedparasites were the non-pathogenic protozoa, Entamoeba coli (118/423: 27.9percent) and Endolimaxnana (86/423: 20.3percent), followed by Blastocystis hominis (76/423: 18percent), Entamoebahistolytica/dispar (28/423: 6.6percent) and Giardia lamblia (23/423: 5.4percent). Ascaris lumbricoides(6/423: 1.4percent) was the most common helminth identified. Sensitivities/specificities of99.4percent/95.2percent and 87.5percent/99.6percent were obtained for protozoa and helminths respectivelyusing the saturated NaCl method.Conclusions: Patients with cryptosporidiosis had fever and bloody faecal samples, andwere probably infected by domestic animals. Microscopy, using the modified Ziehl-Neelsenstain, was essential for Cryptosporidium spp. oocyst identification. The saturated NaClmethod efficiently concentrated the parasites.

Síndrome HELLP. A propósito de un caso en el Hospital Universidad del Norte / Hellp Syndrome. About a case at Hospital Universidad del Norte

El Síndrome Hellp es descrito como una enfermedad ocasional en la que ocurre hemólisis, enzimashepáticas elevadas y trombocitopenia en pacientes con preeclampsial severa. Aunque las característicasdel Síndrome Hellp pueden ser similares a las de la preeclampsia severa, muchos estudios han reportadoalgunas diferencias en su presentación clínica.Se hizo una revisión del número de casos de Síndrome Hellp en el servicio de gineco-obstetricia denuestra institución, y encontramos 8 casos de abril a diciembre del 2005, lo que nos estimuló a revisaresta patología debido al incremento de su presentación. El objetivo de este caso clínico fue revisarfactores de riesgo, curso clínico, manejo y hacer énfasis en la importancia del control prenatal en uncaso presentado en el Hospital Universidad del Norte.

The Hellp syndrome is described as an occasional disease where a combination of hemolysis, elevatedliver enzymes, and thrombocytopenia is displayed in patients with severe gestational hypertension.While many features of Hellp syndrome may be similar to severe preeclampsia, several studies havereported some differences in their clinical presentation. A casesreview of Hellp syndrome was performedin gynecology and obstetric service. Eight cases were found from april to december of 2005, whichstimulate to review this pathology. The aim of this clinic case was to review the risk factors, the cliniccourse and the management, with an emphasis on the importance of prenatal care in a case presentedin Universidad del Norte Hospital.