ABSTRACT
Batoids (rays and skates) are cartilaginous fishes whose jaws are not articulated directly to the neurocranium. The only point of contact between them are the hyomandibular cartilages, resulting in a unique mandibular suspension called euhyostyly. Due to this decoupling of the jaws from the skull, muscles play an essential role in modulating mandibular movements during the feeding process, especially during mandibular protrusion. The main objectives of our study were: (1) to examine the mandibular musculature of eight batoid species from different orders in the Batoidea and (2) establish a standardized musclulature terminology for future comparative myological studies in batoids. For each muscle bundle, the general characteristics of each cranial muscle were described and their origin and insertions were identified. The number of muscle bundles differed intraspecifically. On the dorsal surface, we reported the first evidence of the presence of the precranial muscle (PCM) in U. halleri, as well as the ethmoideo-parethmoidalis muscle (ETM) in R. velezi, P. glaugostigma and Z. exasperata; in addition, the insertion of the spiracularis muscle (SP) extended to the ventral surface of the oropharyngeal tract in myliobatiforms. On the ventral surface of the head, both N. entemedor and M. californica exhibited additional muscles in the mandibular area. These muscles were renamed as part of the standardization of mandibular terminology: the depressor mandibularis minor (DMM) in N. entemedor and the adductor mandibulae profundus (AMP) in M. californica. The standardization of terminology is essential for futures studies of the mandibular apparatus in batoids, to facilitate the morphological description of muscles in species without anatomical accounts and for continuity in broader comparative analyses.
ABSTRACT
La neumonía necrotizante se refiere a la necrosis del parénquima pulmonar producto de una infección. Existe escasa literatura nacional sobre esta complicación. OBJETIVO: Caracterizar a los pacientes que cursaron con neumonía necrotizante en el Hospital Roberto del Río entre los años 2014 y 2020. MÉTODO: Revisión retrospectiva y descriptiva. RESULTADOS: 22 pacientes. Promedio de edad 4 años 7 meses, 68% masculino, esta complicación correspondió a 1,3% de todos los casos de neumonía hospitalizados en ese periodo. Un 95,5% presentó fiebre y un 59% dificultad respiratoria y tos. La duración promedio de la hospitalización fue de 31 días y del tratamiento antibiótico de 30,3 días. El 63% de los pacientes requirió cirugía. En el laboratorio destaca la leucocitosis y proteína C reactiva elevados con 71,4% > a 90 mg/L (promedio: 211 mg/L) y 52,3% leucocitosis > 15.000 (promedio: 18.127). La ecografía torácica fue la imagen más frecuentemente utilizada (95,5%). Agentes identificados Streptococcus pneumoniae (40%) y Staphylococcus aureus (40%). Un 63,6% ingresó a UCI, 35,7% requirió ventilación mecánica invasiva, 35,7% recibió drogas vasoactivas, 9% requirió de soporte ECMO (Oxigenación por Membrana Extracorpórea) y 1 paciente falleció (4,5%). DISCUSIÓN: en nuestro estudio encontramos una baja incidencia de esta patología, un alto índice de gravedad y una evolución favorable en la gran mayoría de los casos.
Necrotizing pneumonia refers to necrosis of lung parenchyma resulting from an infection. There is little national literature on this complication. OBJECTIVE: To characterize patients with necrotizing pneumonia at the Roberto del Río Children´s Hospital between 2014 to 2020. METHOD: Retrospective and descriptive review. RESULTS: A total of 22 patients, average age 4 years 7 months, male (68%). Average incidence 1.3% in 7 years; 95.5% had fever 59% had respiratory distress and cough. Average duration of hospitalization was 31 days and antibiotic treatment 30.3 days. A 63% of the patients had surgery. Leukocytosis and C-reactive protein (CRP) were elevated, 71.4% CRP > 90 mg /L (average: 211 mg /L) and 52.3% leukocytosis > 15.000 (average: 18.127). Chest ultrasound was used in 95.5%. Main agents identified were Streptococcus pneumoniae (40%) and Staphylococcus aureus (40%). A 63.6% of patients were admitted to ICU, 35.7% required invasive mechanical ventilation, 35.7% received vasoactive drugs, 9% required ECMO (Extracorporeal Membrane Oxygenation), and one patient died (4,5%). DISCUSSION: In our study we found a low incidence of this pathology, a high severity index an a favorable evolution in most cases.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Pneumonia, Necrotizing/epidemiology , Hospitals, Pediatric/statistics & numerical data , Staphylococcus aureus/isolation & purification , Streptococcus pneumoniae/isolation & purification , C-Reactive Protein/analysis , Radiography, Thoracic , Extracorporeal Membrane Oxygenation , Incidence , Retrospective Studies , Pneumonia, Necrotizing/complications , Pneumonia, Necrotizing/diagnosis , Pneumonia, Necrotizing/microbiology , Pneumonia, Necrotizing/therapy , Length of Stay , Anti-Bacterial Agents/therapeutic useABSTRACT
RESUMEN Introducción: La peritonitis meconial (PM) corresponde a una inflamación del peritoneo por una reacción química estéril producida por la presencia de meconio, secundaria a una perforación intestinal in útero. Se expone un caso real de PM cuya relevancia está dada por la baja incidencia de esta enfermedad, siendo de aproximadamente 1 caso por cada 30.000 nacidos vivos. El presente trabajo tiene como objetivo dar a conocer la presentación clásica de la PM mediante una revisión actualizada de la literatura. Caso clínico: Paciente de 21 años, primigesta, cursando embarazo de 33 + 5 semanas, con antecedentes de hipotiroidismo gestacional, es derivada al servicio de urgencia maternal por hallazgo en ecografía realizada ese mismo día: Ascitis fetal, intestino hiperecogénico, sin alteraciones en eco-Doppler fetal, hospitalizándose a paciente para estudio. Los exámenes de laboratorio, incluidos VIH y VDRL, resultaron negativos y no esclarecían una etiología. Dado hallazgos ecográficos posteriores se logra orientar el diagnóstico hacia una PM, la cual se objetivó una vez interrumpido el embarazo a la semana 38+5. Discusión: La PM representa un desafío para el médico tanto en su diagnóstico como tratamiento, lo cual está dado en parte por su baja incidencia. El caso expone la presentación más clásica de la PM, en la cual se logró establecer la importancia del diagnóstico prenatal y como este influye en el pronóstico y manejo posterior. Existe acuerdo en adoptar una conducta expectante frente a la PM e incluso esperar el inicio del parto espontaneo, si no existen otras contraindicaciones.
ABSTRACT Introduction: Meconial peritonitis (MP) corresponds to an inflammation of the peritoneum due to a sterile chemical reaction produced by the presence of meconium, secondary to a intestinal perforation in utero. We present a real case of MP whose relevance is given by the low incidence of this disease, being approximately 1 case per 30,000 live births. The present work has as objective to present the classic presentation of the MP through an updated literature review. Clinical case: A 21-year-old woman, primigravous, with a pregnancy of 33 + 5 weeks, and a history of gestational hypothyroidism, is referred to the maternal emergency service due to the following finding on ultrasound performed that same day: Fetal ascites, hyperechogenic bowel, without alterations in fetal echo-Doppler. Patient is hospitalized for study. Laboratory tests, including HIV and VDRL, were negative and did not clarify an etiology. Given later sonographic findings, the diagnosis is oriented towards MP, which was observed once the pregnancy was interrupted at week 38 + 5. Discussion: MP represents a challenge for the physician both in diagnosis and treatment, which is partly due to its low incidence. The case presents the most classic presentation of the MP, in which it was possible to establish the importance of prenatal diagnosis and how it influences the prognosis and subsequent management. There is agreement to adopt an expectant behavior towards MP and even wait for the start of spontaneous birth, if there are no other contraindications.
Subject(s)
Humans , Female , Pregnancy , Adult , Peritonitis/complications , Peritonitis/diagnostic imaging , Prenatal Diagnosis , Ascites/etiology , Ultrasonography, Prenatal , Meconium , Echocardiography, Doppler, Color , Abdominal Wall/abnormalitiesABSTRACT
BACKGROUND: Reinvasion by Aedes aegypti of cities in the Americas poses a threat of urbanisation of yellow fever. After detection of yellow-fever infection in a resident of the city of Santa Cruz, Bolivia, in December, 1997, we investigated all subsequent suspected cases. METHODS: We introduced active surveillance of yellow fever in the Santa Cruz area. Hospitals and selected urban and rural health centres reported all suspected cases. Patients were serologically screened for yellow fever, dengue, hepatitis A and B, and leptospirosis. We collected clinical and epidemiological information from patients' records and through interviews. We also carried out a population-based serosurvey in the neighbourhood of one case. FINDINGS: Between December, 1997, and June, 1998, symptomatic yellow-fever infection was confirmed in six residents of Santa Cruz, five of whom died. Five lived in the southern sector of the city. Two had not left the city during the incubation period, and one had visited only an area in which sylvatic transmission was deemed impossible. Of the 281 people covered in the serosurvey 16 (6%) were positive for IgM antibody to yellow fever. Among five people for whom this result could not be explained by recent vaccination, there were two pairs of neighbours. INTERPRETATION: Urban transmission of yellow fever in Santa Cruz was limited in space and time. Low yellow-fever immunisation coverage and high infestation with A. aegypti in the city, and the existence of endemic areas in the region present a risk for future urban outbreaks. We recommend immediate large-scale immunisation of the urban population, as well as tightened surveillance and appropriate vector control.
PIP: Until recently, urban yellow fever had not been reported from the Americas since 1954, but jungle yellow fever increasingly affects forest dwellers in Bolivia, Brazil, Colombia, Ecuador, and Peru. The reinvasion by Aedes aegypti of cities in the Americas now threatens to urbanize yellow fever. After yellow fever infection was identified in a resident of Santa Cruz, Bolivia, in December 1997, all subsequent suspected cases were investigated. Active surveillance of yellow fever was introduced in the Santa Cruz area, with hospitals and selected urban and rural health centers reporting all suspected cases. Patients were serologically screened for yellow fever, dengue, hepatitis A and B, and leptospirosis; clinical and epidemiological data were collected from patients' records and through interviews; and a population-based serosurvey was conducted in the neighborhood of one case. Between December 1997 and June 1998, symptomatic yellow fever infection was confirmed in 6 residents of Santa Cruz, of whom 5 died. 5 lived in the southern sector of the city. 2 cases did not leave the city during their incubation period, and 1 had visited only an area in which sylvatic transmission was deemed impossible. Of the 281 people covered in the serosurvey, 16 (6%) were positive for IgM antibody to yellow fever. Among 5 people for whom that result could not be explained by recent vaccination, there were 2 pairs of neighbors. This instance of urban yellow fever transmission was limited in both time and space.
Subject(s)
Urban Health , Yellow Fever/epidemiology , Adult , Aedes/virology , Animals , Bolivia/epidemiology , Child , Child, Preschool , Communicable Disease Control/methods , Communicable Disease Control/trends , Disease Transmission, Infectious/prevention & control , Humans , Male , Middle Aged , Population Surveillance/methods , Seroepidemiologic Studies , Yellow Fever/diagnosisABSTRACT
Entre más de 100 especies de triatominae (hemiptera: ruduviidae) descritas en el Nuevo Mundo, triatoma sordida es considerada de significancia epidemiológica como vector de trypanosoma cruzi por su amplia área de distribución y su tendencia para invadir ambientes domésticos.
Subject(s)
Humans , Male , Female , Triatoma , Trypanosoma cruzi , BoliviaABSTRACT
BACKGROUND: During the past decade, dengue and dengue haemorrhagic fever (DHF) have become a public health problem in various Latin American countries. Indications of increased dengue cases in the city of Santa Cruz, Bolivia, early in 1997 were promptly investigated. METHODS: We conducted a sample sero-survey in one district of the city. Levels of antidengue IgM were determined and genetic analysis was performed on virus isolates. RESULTS: IgM antibodies were detected in 6.5% (95% CI: 3.4%-9.6%) of adults (over 15 years old) and 5.1% (2.0%-8.2%) of children (5-7 years old). Dengue virus serotype 2 subtype III ('Jamaica') was isolated. CONCLUSIONS: The estimated attack rates are compatible with a dengue epidemic in Santa Cruz. Isolation of dengue-2 'Jamaica' virus documents the further spread of this subtype from the Caribbean via Brazil into South America. Increased DHF preparedness seems mandatory.
Subject(s)
Dengue/epidemiology , Adult , Antibodies, Viral/blood , Bolivia/epidemiology , Child , Child, Preschool , Dengue Virus/classification , Dengue Virus/immunology , Humans , Immunoglobulin M/blood , SerotypingABSTRACT
OBJECTIVE: To confirm an epidemic outbreak of Dengue virus in the city of Santa Cruz, Bolivia, and to determine the serotype of the virus, to estimate the rate of attack and the proportion of symptomatic infections. MATERIAL AND METHODS: In March 1997, a seroepidemiological survey was conducted with random sampling in a central district of the city of Santa Cruz, Bolivia. Information on recent acute illness and febrile episodes was gathered, and venous blood samples were obtained. Levels of antidengue IgM were determined by MAC Elisa and the virus was typified with RT-PCR. RESULTS: IgM antibodies were detected in 6.5% of adults (CI 95% 3.4-9.6) and 5.1% of children (CI 95% 2.0-8.2). Circulating virus was identified as Dengue serotype 2, subgroup Jamaica. Less than half of the infected children experienced a symptomatic infection compared to almost 90% of adults. CONCLUSIONS: The estimated attack rates are compatible with a Dengue epidemic outbreak in Santa Cruz. The introduction of the serotype 2/ subgroup Jamaica virus into the country increases the risk of hemorrhagic Dengue.
Subject(s)
Dengue Virus/classification , Dengue/epidemiology , Disease Outbreaks , Adolescent , Adult , Antibodies, Viral , Bolivia/epidemiology , Child , Child, Preschool , Data Interpretation, Statistical , Dengue Virus/immunology , Enzyme-Linked Immunosorbent Assay , Humans , Immunoglobulin M/analysis , Polymerase Chain Reaction , Serotyping , Severe Dengue/epidemiologyABSTRACT
The role of Triatoma sordida in the domestic transmission of Trypanosoma cruzi was assessed in 7 rural localities in Velasco Province, Department of Santa Cruz, Bolivia. Tri. sordida, the only triatomine species identified in these localities, was found inside 58.0% of houses but not in large numbers (3.1 bugs per infested house on average). A total of 220 faecal samples from domiciliary bugs was examined microscopically and by the polymerase chain reaction for the presence of trypanosomes: 21.4% were infected. Analysis of blood meals of domiciliary Tri. sordida showed that humans were the commonest host (70.4%), followed by chickens and dogs. Four of 418 persons tested were seropositive for Tryp. cruzi. Only 2 of a second group of 62 persons living in dwellings infested by Tri. sordida were seropositive. Tryp. cruzi infection was demonstrated in dogs and domestic rats. Three other species of small mammals were found to be infected with trypanosomes. In our study area, domestic Tri. sordida are mainly incriminated in the transmission of Tryp. cruzi to synanthropic animals, whereas transmission to humans is very rare. The presence in houses of small populations of Tri. sordida infected with Tryp. cruzi is therefore currently insufficient for this insect to constitute a major epidemiological risk factor.
Subject(s)
Chagas Disease/transmission , Triatoma/parasitology , Animals , Bolivia/epidemiology , Cats , Chagas Disease/epidemiology , Chickens , Disease Reservoirs , Dogs , Feeding Behavior , Housing , Humans , Prevalence , Rats , Seroepidemiologic StudiesABSTRACT
Se presentan los resultados del programa de vigilancia epidemiologica de dengue implementado en Santa Cruz, desde enero de 1996 a abril de 1997 se analizaron 522 muestras de sangre de casos con sospechas sospecha clinica de dengue obteniendose un test Mac-Elisa positivo en 233 (44,6 por ciento). Usando el procedemiento de reaccion en cadena de la polimerasa (RCP) se identifico el serotipo DEN-2 y por estudios geneticos realizados en el CDC de Puerto Rico se identifico a la cepa Jamaica como el agente causal del brote. Las manifestaciones clinicas con mejor valor predictivo positivo fueron el rash maculo-papular (VPP 65 por ciento), dolor ocular (VPP 51 por ciento) y mialgias (VPP 46 por ciento). la mayor incidencia de caso se observo los meses de mayor calor y lluvias copiasas. Se registraron casos en diferentes localidades de la region tropical del pais. Dado el antecedente de un brote por DEN-1 en 1987-88 y ante la presencia actual del DEN-2 en el pais, existe riesgo de observar casos de dengue hemorragico
Subject(s)
Humans , Male , Female , Adolescent , Adult , Aedes/classification , Bolivia , Dengue/transmission , Mosquito Control , Enzyme-Linked Immunosorbent Assay , Rural Population/statistics & numerical dataABSTRACT
Por medio de una encuesta epidemiologica realizada a 61 pacientes con diagnostico confirmado de infeccion por P.vivax en el "Plan 3000", una zona peri-urbana de la ciudad de Santa Cruz, se observo que 9 (15 por ciento) de los casos se presentaron en niños menores de 5 años y que 44 (72 por ciento) reportaron no haber tenido antecedente paludico, no haber vivido en los ultimos 5 años en zonas endemicas, ni haber visitado estas hasta 30 dias antes de la aparicion del cuadro febril lo que hace improbable una recaida por hipnozoito o malaria importada. Ademas, el numero de casos de malaria se concentro en los barrios donde las condiciones ecologicas para la reproduccion del vector son mas favorables tal como fue verificado con capturas larvarias del vector anofeles pseudopunctipennis. todas estas observaciones nos permiten indicar que efectivamente existe transmision local de P.vivax en la ciudad de Santa Cruz y que son necesarios estudios posteriores para cuantificar la magnitud del problema y caracterizarlo con vista de tomar eficientes medidas de control
Subject(s)
Humans , Male , Female , Malaria/transmission , Plasmodium vivax , Pest Control, Biological/methods , Larva/anatomy & histology , Plasmodium falciparum , Plasmodium vivax/parasitologyABSTRACT
Este es un reporte parcial de los resultados observados en Santa Cruz-Bolivia del ensayo multicentrico randomizado doble ciego: Eficacia parasiticida del alopurinol en el tratamiento de la enfermedad de Chagas cronica asintomatica, 40 pacientes fueron aleatoriamente asignados al grupos experimental (alopurinol) o al control (placebo); un placebo cada 8 horas durante 60 dias en 22 pacientes y alopurinol 300 mgr. cada 8 horas por 60 dias en 18 pacientes. El seguimiento fue realizado durante 24 meses, el efecto parasiticida fue evuluado por medio del xenodiagnostico cada 2 meses despues del tratamiento, ademas se realizo una evaluacion clinica y serologica. Al final del estudio solo un pacientes (1/17) en el grupo que recibio alopurinol tenia el xenodiagnostico negativo y todo los pacientes del grupo control tenian el xenodiagnostico positivo. No se observan reacciones adversa mayores. Estos resultados indican que el alopurinol tiene una baja accion parasiticida en la fase cronica de la enfermedad de Chagas por lo que se recomienda sus uso clinico
Subject(s)
Humans , Male , Female , Allopurinol , Chagas Disease/parasitology , Chronic Disease/therapy , Placebos , Public Health/statistics & numerical dataABSTRACT
La malaria causada por plasmodium vivax puede representar una amenaza seria para alrededor de 60.000 residentes del Plan 3000, un area en las afueras de Santa Cruz. Ademas de su dificil situacion economica, estos residentes urbanos generalmente demuestran menos inmunidad que los residentes rurales, debido a que lso ultimos estan mas expuesto a la enfermedad. La poblacion indigena que habita el area puede correr aun un mayor riesgo ya que su participacion social y politica es minima. En virtud del aumento de casos reportados en el area, se efectuo un estudio para determinar el grado de conocimiento de la comunidad con los aspectos de la malaria y, a la vez, tratar de comprender el comportamiento que surge como reaccion a la enfermedad. aunque las personas entrevistadas no tuvieron problemas en identificar la fiebre, en muchos casos no estaban seguras de su relacion con otros sintomas y de su origen. Muy poco demostraron un buen entendimiento de la transmision y sintomas de la malaria
Subject(s)
Humans , Male , Female , Culicidae/classification , Malaria/nursing , Malaria, Falciparum/transmission , Plasmodium vivax/parasitologyABSTRACT
Mientras mayor capacidad diagnostica tenga el centro de referencia en un pais (variedad de tecnicas confiables y personal calificado), y cuente con la posibilidad de un sistema de vigilancia epidemiologica acorde a las caracteristicas de circulacion viral que tenga el mismo, mejor sera su capacidad de respuesta rapida ante cualquier emergencia o cambio en los acontecimientos duarnte la vigilancia. Con el empleo de las tecnicas descritas, el CENETROP COMO CENTRO de referencia posee actualmente las herramientas necesarias para monitorear con base de laboratorio, la situacion del dengue en el pais y dar informacion certera y fidedigna de lo que acontece. Esto posibilita tomar las medidas necesarias por los organizmos competentes acorde a la situacion epidemiologica que exista en el pais
Subject(s)
Humans , Male , Female , Cross Reactions/genetics , Dengue Virus , Bolivia , Enzyme-Linked Immunosorbent Assay , Immunoglobulin G , Immunoglobulin MABSTRACT
A series of 22 chimeric envelope (env) genes were generated between the ecotropic Moloney murine leukemia virus and the amphotropic 4070A isolate. The chimeric envelopes were expressed within the complete, replication-competent provirus and tested for virus viability by transient expression assays. Eleven of the 22 viruses were viable. Five of these chimeric viruses showed an ecotropic host range, and six exhibited an amphotropic host range and viral interference. The host range determinants map to the first half of the surface (SU) protein. The N-terminal 72 amino acids of 4070A (42 of processed SU) are not required for amphotropic receptor usage. Ecotropic and amphotropic viruses differ in their ability to form large, multinucleated syncytia when cocultured with the rat XC cell line. Ecotropic murine leukemia virus forms large syncytia with XC cells, whereas no syncytia are reported for amphotropic virus. All chimeras which contained the N-terminal half of the ecotropic SU protein, encoding the receptor binding domain, formed the large multinucleated syncytia with XC cells.
