Evaluacion clinica, electrocardiografica y angiografica de los reservorios naturales de la enfermedad de chagas en la Republica de Panama / Clinical, electrocardiographic and angiographic evaluation of natural reservoirs of Chagas' disease in the Republic of Panama

The authors studied two groups of natural animal reservoirs for Trypanosoma cruzi: a wild one, the common rat Rattus rattus and the house dog, Canis canis. Thirty one naturally infected rats were evaluated with a technique developed by the authors which allows the recording of the ECG and the performance of a ventricular angiogram without altering the functional capacity of the animal. Forty four dogs were followed clinically for a period of twenty years to study the development of the cardiac lesion seen in the chronic phase of the disease. The authors demonstrate the epidemiologic importance of the dog as a reservoir and the ease with which the infection can be acquired from rats, which live in the same habitat with human patients. The most common lesions in both groups were ventricular and atrial arrhythmias and second degree AV block; and, in the dogs, also death due to refractory cardiac failure, such as is seen in the human patient. Right bundle branch block and dilatation of the right cardiac chambers was the rule in both groups. The authors discuss the pathogenesis of the ECG in the rat and its anatomical basis. They propose the possibility of establishing and standardizing this techniques in the laboratories that study rats or other species

Experiencia clínica en Panamá con metronidazole en el tratamiento de la enfermedad de Chagas, en la fase aguda y en la fase crónica / The clinical experience in Panama with metronidazole in treating Chagas' disease in the acute and chronic phases

The authors evaluated the serological response of metronidazole, or 8823 RP-(Hydroxy-2' ethy1)-1-methyl-2 nitro-5 imidazole) in 1307 patients, with Chagas' disease in the acute or chronic stage with age ranging between 6 months to 73 years. 273 patients were in the acute phase: 153 children and 120 adults. Patients in the chronic stage were classified with serological, clinical and cardiological criteria: 1.-POSITIVE SEROLOGY without cardiological signs or symptomatology (EKG, VECTO, ECHO M mode and 2-D, Chest Rx, physiological and pharmacological tests, radiocardiological-HMIBI, MUGA); 2.- POSITIVE SEROLOGY with cardiological signs and symptoms (all cardiological tests were abnormals); 3.- POSITIVE SEROLOGY with cardiomyopathy and cardiac failure. Metronidazole, P.O. or I.V. was utilizing dosages ranging from 15 to 25 mg/Kilo body weight per five days in acute phase and 250 to 500 mg. P.O. in the chronic stage of the disease for 180 days. The drug was well tolerated by all patients in both phases of the disease. Adequate anabolic effect was identified in both stages of the illness. Serological reactions were negative in all patients (100%) without cardiomyopathy. In patients with cardiomyopathy and cardiac failure, the complement fixation test title were similar before and after treatment

Un caso de peritonitis granulomatosa causada por huevos de Ascaris lumbricoides. / A case of granulomatous peritonitis caused by Ascaris lumbricoides eggs

La presencia de huevos de Ascaris lumbricoides en la cavidad peritoneal del hombre produce una inflamacion granulomatosa. Si estas lesiones no fuesen examinadas antes podrian ser confundidas con las lesiones ocasionadas por el bacilo Mycobacterium tuberculosis o por hongos, con las consiguintes implicaciones de pronostico y de terapeutica