Subject(s)
Chagas Disease/history , Brazil , Chagas Disease/epidemiology , Global Health , History, 20th Century , History, 21st Century , HumansSubject(s)
History, 20th Century , History, 21st Century , Humans , Chagas Disease/history , Brazil , Chagas Disease/epidemiology , Global HealthABSTRACT
Background: International studies show a low compliance with norms for the management of cardiovascular risk factors. Aim: To assess the prevalence of risk factors in patients admitted for a coronary or vascular event and to evaluate the proportion of patients that normalize these factors after one year of follow up. Material and Methods: Three hundred and fifty seven patients aged 64±13 years (264 males), admitted to a University Clinical Hospital for a coronary or vascular event were studied. They were educated about cardiovascular risk factors and followed by their treating physicians for a mean of 11.9±2 months. During this period, smoking habits, body mass index. blood pressure, serum lipid levels, blood glucose and the appearance of new cardiovascular events were registered. Results: One year survival was 96% (all 13 deaths were of cardiac origin). Eighty seven percent of patients were free of major cardiovascular events. At discharge from hospital and at the end of follow up 49% and 44% had a total cholesterol over 200 mg/dl respectively, 9,6% and 20,8% had systolic pressure over 140 mmHg. There was no diastolic hypertension in these patients, 27% and 31% had a body mass index over 25 kg/m2 and 2% smoked (versus 32% before the event). Conclusions: After one year of follow up, the prevalence of risk factors in patients that had suffered a cardiovascular event, continues to be high.
Subject(s)
Adolescent , Adult , Animals , Child , Female , Humans , Male , Middle Aged , Antiprotozoal Agents/therapeutic use , Chagas Disease , Electrocardiography , Trypanosoma cruzi/drug effects , Allopurinol/therapeutic use , Chagas Disease/diagnosis , Chagas Disease/drug therapy , Chagas Disease/parasitology , Follow-Up Studies , Itraconazole/therapeutic use , Polymerase Chain Reaction , Retrospective Studies , Treatment Outcome , XenodiagnosisSubject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Placebos/pharmacology , Allopurinol/pharmacology , Chagas Disease/drug therapy , Drug Tolerance/physiology , Imidazoles/analysis , Quality of Life , Serologic Tests , Chagas Cardiomyopathy/chemically induced , Electrocardiography , Double-Blind Method , Prognosis , Immunologic Tests/methodsABSTRACT
705 inhabitants of rural towns in northern Chile were surveyed to study chagasic infection and cardiac involvement. Clinical evaluation, electrocardiogram, indirect hemagglutination test and senodiagnosis for reactores were employed. culture of positive xendoiagnsis was done to identify different zymodemes and schizodemes of T cruzi, T spinolai was not found in this area implying the absence of a wild cycle. Triotomines were not found over 3000 m high. Four cases of Z2b T. cruzi strains were found. Simultaneous infection by Z1 and Z2b strains was found in the same bug obtained from houses. Overall human infection rate was 10%, and 69% of then showed altered electrocardiograms. Therefore, a lower infection rate but greater evidence of cardiac involvement is found in northern Chile compared to other areas in the country
Subject(s)
Humans , Chagas Cardiomyopathy/epidemiology , Trypanosoma cruzi/parasitology , Chagas Cardiomyopathy/diagnosis , Chagas Cardiomyopathy/parasitology , Chile , Chile/epidemiology , Sex Factors , Prevalence , Fluorescent Antibody Technique , Age Factors , Electrocardiography , Hemagglutination , Rural PopulationABSTRACT
Se hicieron cultivos de cepas de Trypanosoma cruzi aisladas en 97 pacientes chilenos, las cuales se centrifugaron para después efectuar la lisis de los parásitos y obtener sus enzimas. Los extractos enzimáticos se sometieron a electroforesis y se utilizaron para identificar tres cepas designadas Z1, Z2a y Z2b. La cepa Z1, que se encontró en dos pacientes, era una cepa silvestre de T. cruzi transmitida por el insecto Triatoma spinolai; la cepa Z2a, que infectó a 16 pacientes era similar a la cepa brasileña (clon 3 Esmeraldo, Z2) y la cepa Z2b encontrada en 79 pacientes era semejante a la cepa Z2 de Bolivia (clon 1 SC43)
No se hallaron diferencias estadísticamente significativas en la incidencia de alteraciones electrocardiográficas entre los pacientes infectados por las diferentes cepas, tal vez debido a que se consideró un número pequeño de enfermos. Sin embargo, la identificación de la cepa Z1 indica que el hombre puede ser infectado por esta cepa silvestre transmitida por T. spinolai y que la infección puede producir cardiopatologías importantes. Por otro lado, la cepa aislada con más frecuencia (Z2b) fue similar a la cepa boliviana Z2 de T. cruzi. Este hallazgo indica que es necesario llevar a cabo otros estudios estructurales del parásito para poder determinar si este u otros tipos de T. cruzi que se encuentran en Chile son cepas migratorias o autóctonas (AU)
Subject(s)
Trypanosoma cruzi , Enzymes/classification , Heart Diseases/etiology , Chagas Disease/transmission , ChileABSTRACT
Se hicieron cultivos de cepas de Trypanosoma cruzi aisladas en 97 pacientes chilenos, las cuales se centrifugaron para despues efectuar la lisis de los parasitos y obtener sus enzimas. Los extractos enzimaticos se sometieron a electroforesis y se utilizaron para identificar tres cepas designadas Z1, Z2a y Z2b. La cepa Z1, que se encontro en dos pacientes, era una cepa silvestre de T. cruzi transmitida por el insecto Triatoma spinolai; la cepa Z2a, que infecto a 16 pacientes era similar a la cepa brasilena (clon 3 Esmeraldo, Z2) y la cepa Z2b encontrada en 79 pacientes era semejante a la cepa Z2 de Bolivia (clon 1 SC43). No se hallaron diferencias estadisticamente significativas en la incidencia de alteraciones electrocardiograficas entre los pacientes infectados por las diferentes cepas, tal vez debido a que se considero un numero pequeno de enfermos. Sin embargo, la identificacion de la cepa Z1 indica que el hombre puede ser infectado por esta cepa silvestre transmitida por T. spinolai y que la infeccion puede producir cardiopatologias importantes. Por otro lado, la cepa aislada con mas frecuencia (Z2b) fue similar a la cepa boliviana Z2 de T. cruzi. Este hallazgo indica que es necesario llevar a cabo otros estudios estructurales del parasito para poder determinar si este u otros tipos de T. cruzi que se encuentran en Chile son cepas migratorias o autoctonas
Subject(s)
Heart Diseases/etiology , Enzymes/classification , Trypanosoma cruzi , Chile , Chagas Disease/transmissionABSTRACT
In 1977 the authors launched a long-term investigation of the epidemiology of Chagas'disease and its cardiac implications in Chile. During this work, clinical examinations were performed, blood samples were drawn for serologic tests, and electrocardiograms were obtained using a study population of 2 938 subjects residing in rural settlements of northern Chile; and this was done again four years later with 481 study subjects remaining in the area. This article reports on the latter four-year followup study. To begin with, the study subjects were divided into three specific groups: those with no evidence of Chagas'disease but with cardiopathy (as indicated by abnormal ECGs) were disignated Group A; those with positive chagasic serology and cardiopathy were designated Group B; and 67 subjects randomly selected from those with positive chagasic serology and normal ECGs were designated Group C. At the time of the followup work, 216 subjects were retained in Group A and 198 in Group B. Comparison of the initial and final Group A and Grup B data yielded a number of results that seem significant. To beigin with, they indicated that mortality was four times higher among the infected subjects and that the disease tended to threaten a much younger population than was threatened by nonchagasic cardiopathy. Also, cardiopathy appeared to develop among the infected Group C subjects at a rate of about 9.7
Subject(s)
Chagas Cardiomyopathy , Bundle-Branch Block , Follow-Up Studies , Electrocardiography , ChileABSTRACT
Se hicieron cultivos de cepas de Trypanosoma cruzi aisladas en 97 pacientes chilenos, las cuales se centrifugaron para después efectuar la lisis de los parásitos y obtener sus enzimas. Los extractos enzimáticos se sometieron a electroforesis y se utilizaron para identificar tres cepas designadas Z1, Z2a y Z2b. La cepa Z1, que se encontró en dos pacientes, era una cepa silvestre de T. cruzi transmitida por el insecto Triatoma spinolai; la cepa Z2a, que infectó a 16 pacientes era similar a la cepa brasileña (clon 3 Esmeraldo, Z2) y la cepa Z2b encontrada en 79 pacientes era semejante a la cepa Z2 de Bolivia (clon 1 SC43)
No se hallaron diferencias estadísticamente significativas en la incidencia de alteraciones electrocardiográficas entre los pacientes infectados por las diferentes cepas, tal vez debido a que se consideró un número pequeño de enfermos. Sin embargo, la identificación de la cepa Z1 indica que el hombre puede ser infectado por esta cepa silvestre transmitida por T. spinolai y que la infección puede producir cardiopatologías importantes. Por otro lado, la cepa aislada con más frecuencia (Z2b) fue similar a la cepa boliviana Z2 de T. cruzi. Este hallazgo indica que es necesario llevar a cabo otros estudios estructurales del parásito para poder determinar si este u otros tipos de T. cruzi que se encuentran en Chile son cepas migratorias o autóctonas (AU)
