Hallazgos citológicos y factores de riesgo asociados a lesión cervical en mujeres pertenecientes a tres etnias indígenas del Estado Zulia / Cytological findings and risk factors associated to cervical lesions in indigenous women belonging to three etnias of Zulia State

El cáncer de cuello uterino (CaCu) representa un problema de salud pública y es considerado la segunda causa de muerte por cáncer en mujeres. Se han descrito factores de riesgo, los cuales están relacionados con hábitos, conductas y agentes infecciosos tales como el Virus de Inmunodeficiencia humana, herpes virus, Chlamydia trachomatis y Virus del Papiloma Humano (VPH). Con el fin de establecer los factores de riesgo y detectar lesiones preinvasivas de cérvix, se seleccionaron 101 mujeres de tres etnias indígenas, a las cuales se les realizó una encuesta clínico-epidemiológica, además del estudio citológico. Del total de pacientes estudiadas un 66,34% presentaron algún tipo de alteración, siendo las Yukpa las más afectadas, así mismo 21 (20,79%) presentaron neoplasia intraepitelial cervical y se encontraron agentes infecciosos en un 56,51% de las mujeres. En un 26,21% de las pacientes se encontraron células coilocíticas sugestivas de VPH. Al analizar los factores de riesgo se encontró que el inicio de relaciones sexuales antes de los 15 años, y el consumo de alcohol fueron los más relevantes. Es de importancia el diagnóstico oportuno en estas comunidades que se encuentran desasistidas y sin acceso a centros de salud, ya sea por condiciones de vida o por implicaciones culturales.

The cervical cancer represents a problem of public health and is considered the second reason of death by cancer in women. There have been described factors associated, related to the conduct, habits and infectious agents, such as Human Immunodeficiency Virus, herpes virus, Chlamydia trachomatis and Human Papilloma Virus (HPV). In order to establish risk factors and detect preinvasive cervical lesions, 101 samples of women from three indigenous ethnic groups of Zulia State were selected; to which a clinical-epidemiological survey was carried out to study the predisposing factors, in addition to the cytological study. Of the total of patients studied 33.66% were negative to the cytological study, while 66.34% had some type of alteration, observing that the Yukpa the most affected, 21 (20.79%) presented Cervical intraepithelial neoplasia and related infectious agents were found in 56.51% of the women. Coelocytic cells suggestive of HPV were found in 26.21% of all patients. When we analyzed the risk factors, we found that, the onset of sexual intercourse before age 15 as well as alcohol consumption were the most relevant. According to the findings, it is important the timely diagnosis in these communities, which are disassociated, and without access to health centers, whether due to living conditions or cultural implications.

Síndrome diarreico por rotavirus en niños menores de 5 años inmunizados y no de la ciudad de Maracaibo, estado Zulia, Venezuela / Diarrheic syndrome due to rotavirus in immunized and non-immunized children under 5, in the city of Maracaibo, state of Zulia, Venezuela

La diarrea aguda es la causa más común de morbi-mortalidad infantil, donde el Rotavirus es uno de los principales agentes involucrados en las diarreas severas en niños menores de 5 años. El presente estudio tiene como objetivo determinar la presencia de rotavirus en una población infantil con cuadros diarreicos, vacunados y no vacunados que acuden a observación pediátrica del Hospital de Niños y Hospital Universitario de Maracaibo, estado Zulia en el período de Abril 2011 hasta Abril 2012, para ello se recolectaron 100 muestras de heces y para el diagnóstico se utilizó la técnica de Aglutinación Directa en partículas de Látex. Resultaron positivos un 43,6% (24/55) de niños no vacunados y 33,3% (10/30) de niños vacunados afectando principalmente a los menores de 1 año con predominio del sexo masculino con un 65,9% sobre el sexo femenino con 40%, la diarrea por el agente viral estudiado representó casi la mitad de las hospitalizaciones por gastroenteritis, encontrándose una diferencia estadística significativa de p= 0.027 en el numero de evacuaciones del cuarto día, entre niños no vacunados (5) y vacunados (3). Los resultados de esta investigación muestran la circulación de rotavirus en niños vacunados y no vacunados, es por ello importante considerar que el presente reporte tiene como fin último alertar a la comunidad médica a considerar en todo niño con gastroenteritis la posibilidad de que se trate de un cuadro por RV.

Acute diarrhea is the most common cause of morbidity and mortality in infants, where rotavirus is one of the main agents involved in severe diarrhea for children under five years. The present study aims to determine the presence of rotavirus in a vaccinated and unvaccinated pediatric population with acute diarrhea that came to the Children’s Hospital and the University Hospital of Maracaibo, State of Zulia, for observation from April 2011 to April 2012. One-hundred stool samples were collected and direct agglutination of latex particles was used for diagnosis. 43.6% of the unvaccinated children were positive (24/55) as were 33.3% (10/30) of the vaccinated children. Principally, children under 1 year were affected, predominantly males with 65.9% and females with 40%. Diarrhea due to the viral agent under study accounted for nearly half the hospitalizations for gastroenteritis. A statistically significant difference of p = 0.027 was found between the number of evacuations on the fourth day in unvaccinated (5) and vaccinated (3) children. Results of this research show rotavirus circulating in vaccinated and unvaccinated children. Therefore, the purpose of this report is to alert the medical community to consider that every child with gastroenteritis could possibly have RV.

Studies of molecular structure parameters of 20-piperidin-2-yl-5alpha-pregnan-3beta,20-diol and its N-methyl derivative: two inhibitors of Delta24(25) sterol methyl transferase and Delta24(24') sterol methyl reductase of Trypanosoma cruzi.

Molecular structural parameters of two potential drugs against Trypanosoma cruzi epimastigotes, 20-piperidin-2-yl-5alpha-pregnan-3beta,20-diol (1) and 20-N-methylpiperidin-2-yl-5alpha-pregnan-3beta, 20-diol (2) were studied using a combination of a stereoselective synthetic route, spectroscopic characterization and single-crystal X-ray analysis. Both compounds were synthesized with an R configuration at C20. This chirality is a consequence of the stereoselectivity observed during the formation of the intermediate 20-pyridin-2-yl-5alpha-pregnan-3beta,20R-diol (4). NMR data indicated that the six-membered aza ring of (2) is conformationally more restrained, in CDCl3 solution, than (1). X-ray studies showed that maximum deviations among structural molecular parameters of (1) and (2) correspond to torsion angles along the C20-C22 bonds, leading to a different relative orientation of the N atom; a critical structural parameter for the binding properties of aza-sterols to Delta(24(25)) sterol methyl transferase. Cremer-Pople parameters of the five-membered rings of (1) and (2) lie in the observed range for a family of tetracyclic fused ring systems retrieved from the CSD. The phi2 parameter of (1) lies just on the mean of the family, while phi2 of (2) deviates significantly towards the lower limit.

Toward a novel metal-based chemotherapy against tropical diseases. 6. Synthesis and characterization of new copper(II) and gold(I) clotrimazole and ketoconazole complexes and evaluation of their activity against Trypanosoma cruzi.

The complexes [Cu(CTZ)(4)]Cl(2).2H(2)O (1), [Cu(CTZ)Cl(2)](2) (2), [Cu(KTZ)(3)Cl(2)] (3), and [Cu(KTZ)Cl(2)](2).2H(2)O (4) were prepared by reaction of CuCl(2) with CTZ and KTZ (where CTZ = 1-[[(2-chlorophenyl)diphenyl]methyl]-1H-imidazole and KTZ = cis-1-acetyl-4-[4-[[2-(2,4-dichlorophenyl)-2-(1H-imidazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy]phenyl]piperazine), respectively, in acetonitrile at different ligand to metal molar ratios. Gold complexes [Au(PPh(3))(CTZ)]PF(6) (5) and [Au(PPh(3))(KTZ)]PF(6).H(2)O (6) were synthesized by reaction of AuClPPh(3), with KPF(6) and CTZ or KTZ in acetonitrile. All the new compounds were characterized by NMR spectroscopy and microanalytical methods, and for the paramagnetic species EPR spectroscopy and DC magnetic susceptibility measurements were also employed. The solid-state structure of 1 has been determined by X-ray crystallography. 1 crystallizes in the triclinic space group P(-)1, with a = 12.773(2) A, b = 15.326(4) A, c = 11.641(2) A, V = 1957.4(7) A(3), Z = 1, and D(calcd) = 1.284 g/cm(3). The structure refinement converged at R1 = 0.0731 and wR2 = 0.1962. Complex 1 displayed a square-planar structure typical for tetrakis(imidazole)copper(II) complexes. The new compounds were tested for in vitro activity against cultures of epimastigotes of Trypanosoma cruzi, the causative agent of Chagas disease. At concentrations equivalent to 10(-6) M of total CTZ or KTZ (in DMSO) all the complexes exhibited significantly higher growth inhibitory activity than their respective parental compounds.

[Viral agents in patients with infectious processes of the central nervous system]. / Agentes virales en pacientes con procesos infecciosos del Sistema Nervioso Central.

Local statistics report a great number of cases of neurological diseases of unidentified cause. The purpose of this research was to determine the presence of viral agents in patients with affection of the central nervous system, in Zulia State, Venezuela. In different health centers throughout the state, we collected 129 randomized samples of cerebrospinal fluid (CSF) and serum from patients ranging from 1 day to 41 years of age, showing symptoms of CNS disease and whose bacteriological test resulted negative. The serum/CSF albumin ratio was determined to exclude contaminated CSF samples, thus 54 optimal samples were obtained for the research. We determined serum IgM and CSF IgG specific for Venezuelan equine encephalomyelitis (VEE), Herpes simplex (HSV), Epstein Barr (EBV), Dengue, Rubella and Measles virus, through ELISA and indirect immunofluorescence techniques. Of the 54 samples studied, 33 (61.11%) were positive. %). The etiological agents implicated were VEE 14 cases (42.42%); HSV 11 cases (33.33%); EBV 5 cases (15.15%) and Dengue 3 cases (9.09%). We did not detect Rubella o Measles. Regarding the age distribution, the most affected group was that of children under 12 (83.34%). We analyzed the clinical manifestations and the CSF characteristics and did not find differences suggestive of an specific etiological diagnosis, even though certain signs could be considered early indications of CNS alterations due to viral causes. Our study shows that a large percentage of CNS affections of unknown etiology are produced by viral agents, indicating that in our region, most of this cases are not registered.

[Effect of climatic factors on the epidemiology of rotavirus infection in children under 5 years of age in the city of Maracaibo, Venezuela]. / Influencia de los factores climatológicos en la epidemiología de la infección por rotavirus en los niños menores de 5 años de la ciudad de Maracaibo, Venezuela.

Diarrhea is one of the most common problem of public health worldwide, specially in developing countries. In Venezuela, this affection must be weekly reported when it occurs in children under five years of age. During June 1993 to May 1995, 379 stool specimens were obtained from children under five years of age with diarrhea admitted in Hospital de Niños of Maracaibo, Venezuela. Control group was conformed by 93 asymptomatic children. The rotavirus RNA was extracted with phenol-chloroform and precipitated with ethanol. Finally, polyacrylamide-gel-electrophoresis (PAGE), followed by silver staining was employed for rotavirus detection. Our results showed 62 (16.4%) positive cases for rotavirus in symptomatic children and 9 (9.7%) in control group. The highest incidence was showed in the infants under one year of age (21.5%). The electrophoretic analysis revealed only one long electropherotype pattern in studied samples. It was observed a close relationship between the increase of rotavirus cases and the increase of the pluviometric index and a decrease of mean temperature observed during the period of study. Both variables determine the increase or decrease of viral infection in our region. This result shows the importance of the climatic factors in the rotavirus epidemiology.

Antigenic diversity of hepatitis B virus strains of genotype F in Amerindians and other population groups from Venezuela.

The adw4 subtype of hepatitis B virus (HBV) belongs to a unique genomic group (genotype F) representing the original HBV strains from the New World. Data regarding the prevalence of this subtype among HBV carriers in South America are, however, scarce, and those concerning HBV genotype F are based on only a few samples from Latin America. In this study, serum samples were obtained from 141 hepatitis B surface antigen (HBsAg) carriers from Amerindians and urban populations from Venezuela. The HBsAg subtype was identified with monoclonal antibodies in 105 samples, and the HBV genotype was identified by reverse-phase hybridization with DNA fragments in 58 samples. The adw4 subtype was highly prevalent in the population studied (75%); among the Amerindians, the prevalence was 97%. The adw2 subtype was also present (10%), while other subtypes (ayw3 and ayw4) were only occasionally found. The HBV subtype was associated with the expected genotype in most cases (80%), and thus genotype F was highly prevalent. Sequencing of viral strains that gave genotypes unpredicted by the HBsAg subtyping confirmed seven of them as belonging to not previously described genotype-subtype associations: namely, adw2 and ayw4 within genotype F.

A Novel Mixed Macrocycle Complex of Nickel: Synthesis, Structure, and Redox Chemistry of [Ni(II)([9]aneN(3))([9]aneS(3))](ClO(4))(2).CHCl(3) ([9]aneN(3) = 1,4,7-Triazacyclononane and [9]aneS(3) = 1,4,7-Trithiacyclononane).

The mixed macrocycle cation, [Ni([9]aneN(3))([9]aneS(3))](2+) (where [9]aneN(3) = 1,4,7-triazacyclononane and [9]aneS(3) = 1,4,7-trithiacyclononane), has been prepared by stepwise complexation of [9]aneN(3) and [9]aneS(3), respectively, to Ni(II) cation. The intermediate [Ni([9]aneN(3))(CH(3)NO(2))(3)](2+) has been isolated and characterized by mass spectrometry and UV-visible spectroscopy. Cyclic voltammetry of [Ni([9]aneN(3))(CH(3)NO(2))(3)](2+) shows a quasireversible wave for the Ni(II/III) couple (E(1/2) = 0.73V vs Fc(+/0)), and the Ni(III) species exhibits an axial ESR spectrum (g( perpendicular) = 2.101 and g( parallel) = 1.985). The structure of [Ni([9]aneN(3))([9]aneS(3))](ClO(4))(2).CHCl(3) has been determined. It crystallizes in monoclinic space group P2(1)/c with a = 13.3911(8) Å, b = 14.4430(9) Å, c = 13.6116(8) Å, beta = 107.2090(10) degrees, V = 2514.7(3) Å(3), and Z = 4. Of the 15 047 reflections collected, 5765 reflections (I > 2sigma(I)) were used in the refinement to obtain a final R(w) = 0.0278 and R(F) = 0.0368. In the cation [Ni([9]aneN(3))([9]aneS(3))](2+), the two macrocycles occupy the trigonal faces of the Ni(2+) ion, imposing a distorted octahedral geometry. Cyclic voltammetry of the complex in CH(3)CN (Pt electrodes, 0.1 M n-Bu(4)NClO(4), 500 mV) shows a quasireversible wave for the Ni(II)/Ni(III) couple (E(1/2) = 0.86V vs Fc(+/0)). Chemical oxidation by NOPF(6) of the cation [Ni([9]aneN(3))([9]aneS(3))](2+) generates a Ni(III) species that shows axial ESR spectrum with g( perpendicular) = 2.106 and g( parallel) = 2.063. No characteristic reduction wave was observed in either CH(3)CN or CH(3)NO(2) media.

The pattern of fetal haemoglobin disappearance after birth.

Haemoglobin F (Hb F) levels were determined in 209 full-term newborn babies or infants of different ages ranging from birth to 11 months. A follow-up study of the disappearance of Hb F after birth was carried out on 25 premature babies; they were followed periodically from birth until 8 months. The results obtained in both samples show that Hb F levels remain constant after birth for periods varying from about 15 d in at term babies to about 40 d in premature babies; a linear decrease follows in both cases. The initial plateau is a finding contrary to what has been reported. A possible model for the phenomenon is discussed in terms of haemoglobin genes and ontogenetic differentiation.