Validez de herramientas diagnósticas en pacientes pediátricos hospitalizados con diagnóstico presuntivo de dengue en un Hospital de Referencia de Paraguay / Validity of diagnostic tools in pediatric patients hospitalized with a presumptive diagnosis of dengue in a Reference Hospital in Paraguay

Introducción: El dengue es la enfermedad arboviral más común en los seres humanos. Un diagnóstico temprano y preciso del dengue puede respaldar el manejo clínico, la vigilancia y el control de la enfermedad y es fundamental, por ello en el diagnóstico del dengue es importante contar con pautas clínicas y epidemiológicas que permitan la identificación oportuna y una conducta terapéutica adecuada. Objetivos: Evaluar la validez de herramientas diagnósticas en pacientes pediátricos hospitalizados con diagnóstico presuntivo de dengue en un Hospital de Referencia de Paraguay durante los años de 2012 a 2020. Materiales y métodos: Estudio analítico de tipo observacional, retrospectivo correspondientes a pacientes pediátricos (0 a 18 años) internados en el Hospital de Referencia de Paraguay el periodo enero 2012 a julio 2020 con diagnostico presuntivo de dengue al ingreso. Se realizó́ un análisis bivariado relacionando las frecuencias de 20 grupos de criterios diagnósticos combinados y 3 criterios diagnósticos aislados (OMS 2009, nexo epidemiológico y antigenemia NS1 para dengue) con el gold standard de diagnóstico que fue la conversión serológica. Resultados: Participaron del estudio 342 sujetos. EL 44% tenía edad escolar y 70% tenía 5 años o más. El 52,76% (191) fueron masculinos. Se encontraron desnutrición y sobrepeso en el 13% y 2%, respectivamente. La combinación de proteína C reactiva con plaquetopenia se encontró́ en 0.45% de los pacientes sin dengue y en el 6% de los pacientes con diagnóstico final de dengue (p=0.004). Conclusión: Este resultado aporta la alternativa de uso de una combinación sencilla de exámenes de laboratorio que puede replicarse en salas de urgencias como en salas de internación en un primer contacto con pacientes febriles con sospecha de fiebre dengue.

Introduction: Dengue is the most common arboviral disease in humans. An early and accurate diagnosis of dengue can support the clinical management, surveillance and control of the disease and is essential, therefore in the diagnosis of dengue it is important to have clinical and epidemiological guidelines that allow timely identification and appropriate therapeutic conduct. Objectives: To evaluate the validity of diagnostic tools in pediatric patients hospitalized with a presumptive diagnosis of dengue in a Reference Hospital in Paraguay during the years 2012 to 2020. Materials and methods: Analytical study of case and control type, observational, longitudinal, retrospective corresponding to pediatric patients (0 to 18 years) admitted to the Reference Hospital of Paraguay from January 2012 to July 2020 with a presumptive diagnosis of dengue at income. A bivariate analysis was performed relating the frequencies of 20 groups of combined diagnostic criteria and 3 isolated diagnostic criteria (WHO 2009, epidemiological link and NS1 antigenemia for dengue) with the gold standard of diagnosis, which was serological conversion. Results: 342 subjects participated in the study. 44% were school age and 70% were 5 years old or older. 52.76% (191) were male. Malnutrition and overweight were found in 13% and 2%, respectively. The combination of C-reactive protein with thrombocytopenia was found in 0.45% of patients without dengue and in 6% of patients with a final diagnosis of dengue (p=0.004). Conclusion: This result provides the alternative of using a simple combination of laboratory tests that can be replicated in emergency rooms and inpatient wards in a first contact with febrile patients with suspected dengue fever.

Diagnosis of cutaneous tuberculosis (lymph node scrofuloderma) using the Xpert MTB/RIF® method

Abstract Cutaneous tuberculosis is a rare infection that is difficult to diagnose, because it shows less sensitivity and specificity in classic complementary exams when compared with the pulmonary form. The Xpert MTB/RIF® method offers an early diagnosis that identifies the DNA of Mycobacterium tuberculosis and the main mutations that give the bacterium resistance to rifampicin. The authors present a case of scrofuloderma whose diagnosis was quickly obtained through the secretion of a cervical lesion, allowing an early diagnosis and the initiation of appropriate treatment.

Serum repressor element-1 silencing transcription factor levels in alzheimer's patients from a national institute of health in mexico city, elderly and young controls

ABSTRACT Background: Decreased levels of repressor element-1 silencing transcription (REST) factor in the brain, plasma, and neuron-derived exosomes are associated with Alzheimer’s disease (AD). Objective: The objective of the study was to test the viability of serum REST as a possible blood-based biomarker for AD, comparing serum REST levels in AD patients from a National Institute of Health in Mexico City (with different levels of severity and comorbidities), with elderly controls (EC) and young controls (YC). Methods: We used an enzyme-linked immunosorbent assay to determine serum REST levels in AD patients (n = 28), EC (n = 19), and YC (n = 24); the AD patients were classified by dementia severity and comorbidities (depression and microangiopathy) using clinimetric tests and magnetic resonance imaging. Results: Mean serum REST levels did not differ between AD patients, EC, and YC. The severity of AD and the presence of depression or microangiopathy were not associated with serum REST levels. Conclusion: Our results differ from previously published patterns found for plasma and cerebral REST levels. Free serum REST levels may not be a viable AD blood-based biomarker. (REV INVEST CLIN. 2021;73(1):17-22)

An Observational Study To Validate The Symptomatology And To Evolve The Diagnostic Methodology Of Sirakkamba Vatham Through Siddha Diagnostic Tools

Sirakamba vatham is a clinical entity described by Sage Yugi in his treatise Yugi Vaithiya Chinthamani- 800, as one among the 80 types of Vatha diseases described in Siddha system of medicine. The study was aimed at in depth analysis of the clinical features mentioned under Sirakamba vatham of Siddha literature and to evolve standard Siddha diagnostic methods for management for Sirakamba vatham. This study was an observational, single center study with the sample size of 26, divided into Group I (control group) having normal individuals and group II (cases with Sirakkamba vatham). At the end of the study, it was concluded, that the symptoms of Sirakkamba vatham closely resembled the symptoms of Cerebro Vascular Accident especially of posterior circulation stroke.

Epidemiology of Pancreatitis in the State of Odisha

Backgroundand Aims: Background and Aim of the Study: Acute pancreatitis is a surgical condition which may impact other organsresulting in damage to multiple organs or death. Chronic pancreatitis (CP) has deadly long-term consequences such as diabetes mellitusand pancreatic cancer. Although there have been several studies evaluating the epidemiology of pancreatitis in India, due to the diversityof the country, more evidence is required from different regions of the country. Therefore, this study evaluates the epidemiology of acuteand CP in the state of Odisha.Methodology: This study was a prospective study carried out in a single hospital, Institute of Medical Sciences and Sum Hospital,Bhubaneswar, during 2016–2017.Results: Results showed that there were more acute cases of pancreatitis (n=65, 73.9%) and overall pancreatitis was more prevalent inmen (n = 70; 79%). Unfortunately, an overwhelming majority of the patients do not know what aggravates (n = 71; 81.8%) or alleviates(n = 79; 89.8%) their condition. There was no significant difference in the type of pancreatitis (acute, chronic, acute, or chronic) bygender, smoking, educational status, diet, alcohol intake, socioeconomic status, and religion (P > 0.05).Conclusion: Men were more likely to develop acute and CP than women. Future studies should explore the genetic interactionsmodifying disease development, especially in India

A Cross-sectional study to explore Sexual dysfunctions among male Hypertensive Patients attending Medicine OPD of Tertiary care centre, Western India

Background: Sexual dysfunction has been traditionally attributed to psychogenic origins and managed bymental health professionals and urologists. However, advances in pathophysiology research point to avascular origin of the problem in the majority of patients, possibly due to atherosclerotic lesions in the genitalarteries that result in decreased blood flow. During management of Hypertension; even the highly skilledphysicians fail to raise the question of sexual dysfunction as they have never been accustomed to do it intheir routine practice.Aim: The study has two aims- (i) to evaluate sexual dysfunctions in male patients of Hypertension and (ii)comparison of sexual dysfunctions and other variables between case and control group.Methodology: Consecutive 200 Hypertensive patients were included in the study. Individuals withcomparable age served as a control group. Detailed socio-demographic variables, substance history andtreatment history for hypertension obtained using a semi-structured Performa. Subject’s sexual dysfunctionswere assessed by ASEX (Arizona Sexual Experience Scale), IIEF (International Index of ErectileDysfunction), PEDT ( Premature ejaculation diagnostic tools).Result: Of the 200 hypertensive patients, 74(37%) participants reported erectile dysfunction, 16(8%)participants reported premature ejaculation, while among 200 normotensive participants, only 8(4%)reported erectile dysfunction, 15(7.5%) reported premature ejaculation. Of the hypertensive participantsstudied, 23% had severe, 8% had moderate, 6% had mild erectile dysfunction. Frequency of erectiledysfunction increase with advancing age.Conclusion: The present study has revealed that erectile dysfunction was a major problem, with a higherprevalence among hypertensive men than normotensive men. Age was considered statistically significantpredictors of erectile dysfunction.Keywords: Sexual dysfunctions, International Index of Erectile dysfunction, Arizona sexual experiencescale, Premature ejaculation diagnostic tools, hypertension

Studies on coccidian oocysts (Apicomplexa: Eucoccidiorida) / Estudos sobre oocistos de coccídios (Apicomplexa: Eucoccidiorida)

The oocysts of the coccidia are robust structures, frequently isolated from the feces or urine of their hosts, which provide resistance to mechanical damage and allow the parasites to survive and remain infective for prolonged periods. The diagnosis of coccidiosis, species description and systematics, are all dependent upon characterization of the oocyst. Therefore, this review aimed to the provide a critical overview of the methodologies, advantages and limitations of the currently available morphological, morphometrical and molecular biology based approaches that may be utilized for characterization of these important structures. It has become apparent that no single methodology is sufficient to fully characterize these structures and the majority of researchers favor the use of combinational or polyphasic approaches.

Os oocistos de coccídios são estruturas robustas, frequentemente isoladas das fezes ou urina de seus hospedeiros, os quais oferecem resistência a danos mecânicos e permitem que os parasitas sobrevivam e permaneçam infecciosos por períodos prolongados. O diagnóstico da coccidiose, descrição das espécies e sistemática são dependentes da caracterização do oocisto. Portanto, esta revisão teve como objetivo fornecer uma visão crítica das metodologias, vantagens e limitações dos métodos morfológicos, morfométricos e moleculares que podem ser utilizados para a caracterização destas estruturas importantes. Tornou-se evidente que nenhuma metodologia única é suficiente para caracterizar completamente essas estruturas e que a maioria das pesquisas favorecem o uso de metodologias combinadas ou polifásicas.

Lysosomal Storage Diseases

Abstract Lysosomal storage diseases are a group of inherited and acquired disorders. They are characterized by interruption of recycling of cellular and extracellular molecules. Clinically, they are presented as developmental and neurological symptoms similar to other inherited and acquired disorders. This article reviews the function of lysosomes, the current mechanisms that cause the interruption of recycling, the consequences that are manifested clinically, and the methods to diagnose these disorders.

Diagnosis of psychiatric disorders of the eldery

Korea is rapidly aging society and psychiatric disorders of the elderly increasing Korea is rapidly becoming an aging society and psychiatric disorders of the elderly are increasing significantly in importance. Interviewing the elderly requires special skills because of their physical weakness and cognitive impairments such as difficulty concentrating. There are various diagnostic tools for them, for more accurate diagnosis. Representative scales include the Mini-Mental Status Examination for dementia, the Geriatric Depression Scale for depression, and the Confusional Assessment Method for delirium. Differential diagnosis of psychiatric disorders from cerebral and physical disorders is important.

El diagnóstico de la Leishmaniasis visceral canina: dilemas y retos / The diagnosis of canine visceral Leishmaniasis: dilemmas and challenges

La leishmaniasis visceral (LV) es una enfermedad infecciosa de evolución crónica, causada por un protozoario, Leishmania infantum, que afecta al hombre y a los caninos; es transmitida principalmente por la picadura del vector Lutzomyia longipalpis, con incriminación de Lutzomyia evansi en partes de Colombia y Venezuela. El perro actúa como el principal reservorio doméstico del parásito en todo el mundo, haciendo parte del ciclo epidemiológico de transmisión humana. Dada la importancia epidemiológica de los caninos en el control de la LV y la necesidad de determinar el impacto real de la infección en las zonas endémicas, es fundamental el empleo de pruebas diagnósticas eficientes, que no subestimen la incidencia, ni la prevalencia de la enfermedad, y que permitan además obtener resultados confiables, que minimicen las reacciones falsas positivas y la reacción cruzada con otros parásitos relacionados. El presente artículo revisa las técnicas diagnósticas para la leishmaniasis visceral canina (LVC) y establece de forma general algunas prioridades de investigación y desarrollo en esta área.

Visceral leishmaniasis is an infectious disease of chronic evolution caused by the protozoan Leishmania infantum (Leishmania chagasi), which affects humans and canines. It is transmitted mainly by the vector Lutzomyia longipalpis, with incrimination of Lutzomyia evansi in parts of Colombia and Venezuela. Dogs are considered the main domestic reservoir of the parasite, constituting part of the epidemiological cycle of human transmission. Given the epidemiological importance of canines in the control of visceral Leishmaniasis and the need to determine the real impact of the infection in the endemic areas, the employment of diagnostic efficient tests is fundamental. These tests shouldn’t underestimate the incidence, or the prevalence of the disease; they should also allow the obtainment of reliable results that minimize the false-positive reactions and the cross-reactions with other related parasites. The present article revises the diagnostic methods for canine visceral leishmaniasis and establishes some research and development priorities in this topic.

Mycobacteriophages as versatile tools for genetic manipulation of mycobacteria and development of simple methods for diagnosis of mycobacterial diseases / Micobacteriófagos como herramientas versátiles para la manipulación genética y el desarrollo de métodos simples para el diagnóstico de enfermedades micobacterianas

Tuberculosis, caused by Mycobacterium tuberculosis, is responsible for over two million deaths per year worldwide. Due to its long doubling time (18 h), the microbiological detection of M. tuberculosis by conventional methods takes up to one month, unless the number of bacilli in the biological sample is high enough. Thus, drug resistance assessment requires at least one month for obtaining the primary culture and another month to determine its susceptibility to antimycobacterial drugs. Moreover, for a long time, the lack of genetic tools for mycobacteria has been a barrier for undertaking studies aimed at understanding the mechanisms of drug resistance and drug target identification, being all these topics of utmost importance considering the increase in the number of drug-resistant clones and the few therapeutic options available. Mycobacteriophages are promising as a novel source of genetic elements for mycobacteria manipulation, as well as for the development of versatile, simple, fast and cheap methods for drug resistance assessment of M. tuberculosis clinical isolates. We herein describe the background related to the use of mycobacteriophages, with emphasis placed on their utilization for drug resistance analysis in our country.

La tuberculosis, enfermedad causada por el bacilo Mycobacterium tuberculosis, es responsable de más de dos millones de muertes anuales en el mundo. Debido a su largo tiempo de duplicación (18 h), la detección bacteriológica de M. tuberculosis por métodos convencionales necesita de un mes o aun más, a menos que el número de bacilos en la muestra clínica sea suficientemente alto. Por consiguiente, se necesita un mínimo de dos meses para determinar la resistencia de este microorganismo a las drogas antituberculosas: uno para obtener el cultivo primario y otro para ensayar la sensibilidad frente a aquellas. La falta de herramientas para la manipulación genética de micobacterias ha dificultado la identificación de los blancos de acción de las drogas y el estudio de los mecanismos de resistencia a éstas, tópicos de la mayor relevancia dado el aumento mundial del número de aislamientos clínicos multirresistentes y las pocas opciones terapéuticas disponibles. Los micobacteriófagos son considerados nuevas herramientas para la manipulación de las micobacterias, así como para el desarrollo de métodos simples, rápidos y económicos para determinar la sensibilidad a drogas de los aislamientos clínicos de M. tuberculosis. En esta revisión se describen los antecedentes del uso de micobacteriófagos con énfasis en su utilización para el análisis de resistencia a drogas antituberculosas en nuestro país.

Diagnostic Experience in the 3 Human Brucellosis Cases by the Microbiologic, Serologic and Gene Tests / 대한임상미생물학회지

Brucellosis is a zoonosis caused by Brucella species. B. melitensis, B. suis, B. abortus and B. canis can infect humans. Recently, as the cases of bovine brucellosis have increased every year in Korea, the cases of human brucellosis have also increased among livestock workers and veterinarians in rural areas, since the first human case was reported in 2003. Because clinical manifestations of the disease are nonspecific and may be very atypical, clinicians and laboratory persons need to be active in using diagnostic tools including polymerase chain reaction in addition to the ordinary culture and serologic tests, and taking an appropriate measure to prevent intralaboratory infection. We report herein our experience in three human brucellosis cases diagnosed by cultures, serologic tests and gene detection.

Left heart catheterization of cardioangiography

Left heart catheterization (including left ventricular puncture) and cardioangiography are diagnostic tools for arriving at a precise knowledge of what is going on in the left side of the heart, the left ventricular outflow tract, root of the aorta, coronary arteries and thoracic aorta in general. In experienced hands the facts to be gained from such studies far cutweigh the hazards of the procedures. In such a field like cardiovascular surgery and open-heart procedures in particular where mortality is understandably high every effort must be made to arrive at an accurate pre-operative diagnosis to prevent needless thoracotomies and needless operative deaths. A description of the procedures as we practice them together with the results in 34 cases is shown. Representative ventriculograms, thoracic aortograms and pressure tracings are shown to illustrate what can be achieved with such studies. (Summary)