Insecticidal and Cholinesterase Activity of Dichloromethane Extracts of Tithonia diversifolia on Atta cephalotes Worker Ants (Formicidae: Myrmicinae).

Leaf-cutter ants are agricultural and urban pests that defy chemical control methods. Laboratory and field studies have revealed repellent and insecticidal activity by the extracts of Tithonia diversifolia (Asteraceae), known as Mexican sunflower, as a promising alternative for the control of the leaf-cutter ant Atta cephalotes. This study evaluated the effects of different extracts (non-polar and polar) of T. diversifolia dry leaves on worker ants from laboratory colonies of A. cephalotes through ingestion and contact. In addition, the biological activity of the extracts as inhibitors of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) was evaluated. A dichloromethane extract at 1000 ppm presented the highest insecticidal activity through ingestion, causing 70% and 90% worker ant mortality after five and seven days of treatment, respectively. The acetylcholinesterase inhibition values showed that the dichloromethane presented the best AChE concentration of inhibition (IC50) at 73.9 ± 11.06 µg/mL, compared to its fractions, which demonstrates that its activity is potentiated when the crude extract is used. Our results can be attributed to the existence of terpenes and sesquiterpene lactones, which are likely inhibitors of AChE, in T. diversifolia.

Prevalence of Diabetes Mellitus in Human Immunodeficency Virus positive Patients in Puerto Rico--San Juan City Hospital Experience.

INTRODUCTION: The total number of patients with Human Immunodeficiency Virus (HIV) is 33 million, with 2.7 million new infections in 2007(1). Puerto Rico has an increasing prevalence trend of Diabetes Mellitus of 12.8% in 2010(3). As treatment of HIV continues to develop, and access to therapy improves, the incidence of HIV associated diabetes is bound to grow. We investigate the prevalence of Diabetes Mellitus and its associated risk factors in a determinate HIV positive population. MATERIALS AND METHODS: A retrospective study, reviewing the medical records of 146 HIV positive patients. The prevalence of DM was statistically measured and a Logistic Regression with Pearson Χ2 Square and Fisher's exact test was used to assess the association between DM and its risks factors. RESULTS: The prevalence of DM in the studied population was 13.7% (n=20). There were 59% (n = 86) males, 43% (n = 63) of patients treated with HAART 46% (n = 67) IVDA, the mean age was 47; with 29% older than 50 years old, and 68% of the patients had a BMI of less than 25. Gender, IVDA, HAART, BMI, and age were not associated as risk factors for the prevalence of DM in the studied population. DISCUSSION: Our data revealed a higher prevalence of DM in HIV infected patients. We observed no significant association between DM and its risks factors. This raises concern for yet unrecognized risk factors contributing to a higher prevalence of the disease in this population. Results of our study alert physicians on the importance of DM screening in the HIV positive patient population.

Clinical and thyroid ultrasound evaluation in an asymptomatic adult Puerto Rican population: The San Juan city hospital experience Coromoto A. Pale.

OBJECTIVES: to determine the prevalence of thyroid disease in an asymptomatic Puerto Rican adult population within an iodine sufficient area. Correlate the clinical thyroic features during palpation with thyroid sonographic findings. Relate gender, laboratory data, and family history with the presence or absence of thyroid pathology. METHODS: Cross-sectional, descriptive, comparative study performed during the period of February 2008-January 2009 in an asymptomatic Puerto Rican copulation. The study sample size consisted of 110 adult participants, employees of the San Juan City Hospital in apparent good health. A questionnaire emphasizing relevant personal and family thyroid pathology (benign and malignant) was obtained. A complete physical examination was performed emphasizing thyroid gland palpation, utilizing a posterior approach. for detection of any abnormal thyroid features. All participants underwent thyroid ultrasonographic (US) examination and blood sampling for ultrasensitive TSH and antiperoxidase antibodies. Subjects with thyroid nodules over one centimeter, found on thyroid US, were encouraged to undergo fine-needle aspiration biopsy (FNAB). RESULTS: The prevalence of thyroid pathology detected by palpation was 52.72% and 38.23% by US. The most frequent thyroid pathology found on palpation was goiter (41.37%) and multinodular goiter (64.85%). Twenty-four percent (24%) of the participants with normal findings on palpation had abnormal findings by US and 33.33% of those met criteria for FNAB. In sixteen patients with abnormal US, only six agreed to have FNAB, all were reported negative for malignancy. CONCLUSION: Our results suggest that routine thyroid US should be seriously considered for all patients with suspected thyroid disease. Statistical analysis demonstrated a significant correlation between palpation findings performed by an experience physician and thyroid ultrasonography results. Even in patients with negative family history of thyroid pathology, abnormal thyroid ultrasound abnormalities were detected in 35.73%. To our knowledge this is the first study done in Puerto Rico, comparing thyroid palpation and ultrasonographic findings.

Right lower quadrant abdominal pain in an immunocompromised patient: importance for an urgent diagnosis and treatment.

This is a case of a 34 years old male Hispanic patient with history of AIDS who presented to the ER with severe right lower quadrant abdominal pain of three days of evolution, associated with fever, chills, nausea, vomiting, watery diarrhea, weakness and general malaise. Acute appendicitis, Clostridium Difficile Colitis and Ischemic Colitis were the most important clinical conditions to consider in the differential diagnosis. Abdominal CT with IV contrast demonstrated thickening of the ascending colonic wall a finding highly suggestive of a transmural inflammatory necrotizing colitis of infectious etiology. Broad-spectrum antibiotic therapy, cancidas and ganciclovir were started with mark clinical improvement. IgG antibodies against CMV were elevated. Typhlitis is a serious illness that affects patients with impairment in immunity. It is important to include it in the differential diagnosis of an HIV/AIDS patient that presents with RLQ pain and fever. Contrast enhanced CT-Scan is mandatory to establish the diagnosis and to differentiate typhlitis from other intra-abdominal pathologies. Therapy needs to be individualized.

An unusual cause of muscle weakness: a diagnostic challenge.

We report a case of 24 year-old-female presenting with bilateral leg heaviness sensation and difficult walking of one-day duration. Over the past three months she developed progressive and frequent tingling sensation on her hands accompanied by headache and increased thirst. Hypokalemia was identified and treated with resolution of symptoms. She was later found to have Graves' disease. After propranolol and radioiodine therapy no further episodes were reported. Thyrotoxic hypokalemic periodic paralysis is an alarming, potentially lethal, and rare complication of hyperthyroidism. The pathogenesis is uncertain. Because the condition is rare, it is frequently overlooked and misdiagnosed on presentation. It is important to recognize these clinical settings in hypokalemic patients in order to promptly start adequate medical therapy and avoid the lethal complications caused by prolonged sustained potassium depletion.

Phenotype-genotype analysis of CYP2C19 in Colombian mestizo individuals.

BACKGROUND: Omeprazole is metabolized by the hepatic cytochrome P450 (CYP) 2C19 enzyme to 5-hydroxyomeprazole. CYP2C19 exhibits genetic polymorphisms responsible for the presence of poor metabolizers (PMs), intermediate metabolizers (IMs) and extensive metabolizers (EMs). The defective mutations of the enzyme and their frequencies change between different ethnic groups; however, the polymorphism of the CYP2C19 gene has not been studied in Colombian mestizos. The aim of this study was to evaluate the genotype and phenotype status of CYP2C19 in Colombian mestizos, in order to contribute to the use of appropriate strategies of drug therapy for this population. METHODS: 189 subjects were genotyped using the multiplex SNaPshot technique and a subgroup of 44 individuals received 20 mg of omeprazole followed by blood collection at 3 hours to determine the omeprazole hydroxylation index by HPLC. RESULTS: 83.6%, 15.3% and 1.1% of the subjects were genotyped as EMs, IMs and PMs, respectively. The frequencies of the CYP2C29*1 and CYP2C19*2 alleles were 91.3% and 8.7% respectively whereas the *3, *4, *5, *6 and *8 alleles were not found. No discrepancies were found between the genotype and phenotype of CYP2C19. CONCLUSION: The frequency of poor metabolizers (1.1%) in the Colombian mestizos included in this study is similar to that in Bolivian mestizos (1%) but lower than in Mexican-Americans (3.2%), West Mexicans (6%), Caucasians (5%) and African Americans (5.4%). The results of this study will be useful for drug dosage recommendations in Colombian mestizos.