[Nutritional support in laryngectomized patients]. / Soporte nutricional en los pacientes laringectomizados.

Pathologies involving tumours of the neck are an important group of neoplasias. The tumours themselves are often the cause of malnutrition, and this may be aggravated in these patients by other factors such as: excess of alcohol and cigarettes, anatomical location of the tumour next to the digestive tract and the application of cyto-reducing treatment applied previously. The main purpose of the present study is to analyze the possible effect of hospital diets during the postoperative period in laryngectomized patients, on the development of malnutrition. For this purpose 49 patients were studied, all diagnosed consecutively during the last year as suffering from epidermoid carcinoma of the larynx, subjected to 24 total laryngectomies, 4 partial laryngectomies and 21 supraglottic laryngectomies. A conventional diet was administered at random to 21 patients, and a commercial enteral diet to the remaining 28. The most important conclusions were as follows: a) high incidence of harmful habits, b) positive nutritional state of the patients upon admittance, c) high incidence of malnutrition one week after the operation, which was maintained virtually in the same proportion to the time spent in hospital, d) the lack of influence of the nutritional state by type of diet administered, e) the possible influence on malnutrition by type of surgery performed, location of the tumour (pyriform sinus) and high incidence of complications usually developed.

[Study of Trypanosoma cruzi in wild reservoirs in the ecological reserve of El Zapotal, Chiapas, Mexico]. / Estudio de reservorios silvestres del Trypanosoma cruzi en la reserva ecológica de "El Zapotal", Chiapas, México.

Reservoirs of T. cruzi were studied in the ecological reserve "El Zapotal", in the Tuxtla Gutiérrez municipality located in the state of Chiapas. The parasite transmission cycle exists in that area. A total of 73 specimens of 8 different mammal species were trapped alive. Xenodiagnosis tests showed that 11% of them were positive for T. cruzi. Blood concentration exam, blood culture, serology (CIEP) and histological exam were carried out in 65 specimens from the total captured. T. cruzi positive results in these tests were 1.5, 3.6, and 6.2% respectively. None of the 73 specimens were positive in the histological exams. Amastigote nests were found in cardiac tissue of mice, which were inoculated with triatomine bugs dejections collected from those specimens used from xenodiagnosis testing or by the inoculation of parasites grown in axenic blood cultures. These results indicated that there is a sylvan cycle which is maintained by mammal species, which are plundering this geographic area.

[Nutritional status in children under 6 years of age and its relation to malaria and intestinal parasitism]. / Estado nutricional en niños menores de seis años y su asociación con malaria y parasitismo intestinal.

In order to determine the prevalence of the nutritional situation in children under six years of age and to study the relation with malaria and intestinal parasitism an epidemiological study of a cross sectional was carried out in Cordoba locality, Buenaventura Municipality in the Colombian Pacific Coast. One hundred and twenty eight children were studied to whom a questionnaire, a thick smear examination, and a serological test through the indirect immunofluorescence reaction was practiced. Coproparasitoscopic examination were also done in addition to medical and clinical anthropometric examinations, the latter consisting of the measurements of weight and height. The results of this investigation showed a prevalence of the nutritional state, according to Waterlow classification, of 0.81 percent, 17 percent and 2 percent for the first, second and third degree of malnutrition respectively. Instead, according to the Gómez classification it was 49 percent, 14 percent and 2 percent for the slight, moderate and severe degrees of malnutrition. When the geometric mean of the antibody titles for P. falciparum and for P. vivax were compared, using the methodology of the Waterlow classification, statistical associations were discovered and it was found that the geometric mean for P. falciparum were higher in those children that didn't have any malnutrition. Nevertheless, the geometric mean for P. vivax was higher for those children with a certain degree of malnutrition. Nevertheless, when the intensity of infection of the intestinal helminths, the quality of the dwelling and the breast-fed time duration were compared, no significant differences were detected, therefore we believe it convenient to keep on with this type of investigation, specially with those longitudinal-type studies so as to detect causal association in the relation nutrition/malaria.

Comparison of flubendazole and diethylcarbamazine in treatment of onchocerciasis.

Flubendazole, an injectable benzimidazole drug, was compared with diethylcarbamazine (DEC) in a prospective double-blind study of the treatment of onchocerciasis. Nineteen Mexican men were randomly assigned to receive either flubendazole 750 mg intramuscularly once a week for 5 doses, or DEC 100 mg twice daily for 14 days, and they were then followed up for 12 months. Major systemic side-effects during the first 3 weeks were common in the DEC group but not in the flubendazole group in which there was considerable inflammation at the injection site instead. Ocular complications (limbitis, punctate keratitis, and uveitis) were also common in the DEC group, whereas in the flubendazole group they consisted only of one new punctate opacity at day 4 in one subject. One DEC patient also had several new areas of chorioretinal changes on day 2 but these had disappeared by 2 months. Skin microfilaria counts fell rapidly in the DEC group, but returned to the pretreatment levels. In contrast, skin microfilaria counts in the flubendazole group fell slowly, but by 6 and 12 months were lower than in the DEC group (at 12 months 0.2 vs 7.3 mf/mg, p less than 0.001). In addition, by 6 months none of the flubendazole subjects had intracorneal microfilariae, and only one had microfilariae in the anterior chamber, whereas the numbers of intraocular microfilariae in the DEC group had returned to pretreatment levels. The results suggest that flubendazole is safer and more effective than DEC in the treatment of onchocerciasis.