[Neurocysticercosis in Spain. Apropos 4 cases seen in immigrant patients from endemic countries]. / Neurocisticercosis en España. A propósito de 4 casos observados en pacientes inmigrados de países endémicos.

Neurocysticercosis is a helminthiasis of the central nervous system produced by the encysted larvae of the pork tapeworm Taenia solium. We report 4 cases of neurocysticercosis observed in immigrants from endemic areas (India and Latin America). Three of the patients were diagnosed because of new onset of seizures, all of the no received anthelmintic therapy with favourable outcome. The fourth case was a form known as racemose cysticercosis. She was admitted because of CNS sensorial symptoms with later development of severe intracranial hypertension that required surgical treatment. All the cases had a positive result in the ELISA test for cysticercosis. In only one patient chronic epilepsy persisted thus needing long-term anticonvulsant therapy as a sequelae. Our report helps to familiarize clinicians with the characteristic radiological findings from cysticercosis and em s the fact that epidemiological suspicion and serological data are usually enough to get the diagnosis and avoid unnecessary probes.

[Demographic characterization, consultation reasons and prevalent morbidity in the African immigrating community of the Maresme district]. / Caracterización demográfica, motivos de consulta y morbilidad prevalente en la comunidad de inmigrantes africanos de la comarca del Maresme.

BACKGROUND: To know the demographic condition, main symptoms and diagnosis in adult African immigrants from a reference Hospital. PATIENTS AND METHOD: A prospective protocol between 1984-1994. RESULTS: 1,321 immigrants were considered. Most of them had an unstable job and illegal situation and they did not speak any European language. Abdominal pain was the most common symptom. The most frequent diagnoses were parasitic/infections and digestive and haematological diseases. CONCLUSIONS: Immigration is not a risk for public health. The illegal situation carries poor sanitary conditions. The clinical protocols help to overcome cultural and idiomatic barriers.

Neurocisticercosis en España. A propósito de 4 casos observados en pacientes inmigrados de países endémicos / Neurocystercosis: report of 4 cases observed in inmigrants from endemic areas

La neurocisticercosis es una helmintiasis del sistema nervioso central causada por la larva enquistada de Taenia solium. Presentamos 4 casos de neurocisticercosis observados en inmigrantes procedentes de areas endémicas. Tres de ellos debutaron en forma de epilepsia y presentaron una respuesta favorable al tratamiento antihelmíntico. El cuarto caso fue una forma especial de cisticercosis conocida como racemosa que debutó en forma de focalidad sensitiva con posterior desarrollo de un cuadro de hipertensión endocraneal severa que requirió tratamiento quirúrgico. En todos los casos se obtuvo un test de ELISA positivo para cisticercosis. Solo en un caso persistieron secuelas crónicas en forma de epilepsia. Con la descripción de estos casos pretendemos familiarizar al clínico con las imágenes radiológicas características de esta entidad y recordar que la sospecha epidemiológica y el estudio serológico permiten habitualmente el diagnóstico y evitan exploraciones innecesarias para el paciente (AU)

[Malaria in the 21st century: clinical and therapeutic problems in imported malaria]. / Paludismo del siglo XXI: problemática clínico-terapéutica en el paludismo importado.

Imported malaria is an ever growing disease in our country because of the increase in travels to endemic tropical areas where this disease is endemic. Many patients, when they come to our hospitals infected with P. falciparum have already received drugs for this disease, either as prophylaxis or treatment, as it occurred in the cases reported here in the years 1995 and 1997, all of the spanish individuals who had travelled to or lived in African countries. To remark from our data the relevance of resistance to prophylactic and therapeutical agents in wide geographical areas, the frequent misuse of antimalarial drugs and complications that can emerge with the standard treatment for malaria. It all leads to the development of new therapeutic approaches for this potentially fatal infection. Based on the clinical efficiency in cases of politreated malaria cases, as well as for its safety in patients to whom first choice drugs cannot be administered (such as quinine), we stress the new therapy made up with the association atovaquone-proguanil.

[Traveller counseling by embassies and consulates]. / Consejos al viajero desde las embajadas y consulados.

BACKGROUND: Before travelling to developing countries is necessary to seek accurate health advice. This paper evaluate the quality of travel information given out in Spain by other embassies and consulates of different countries. METHODS: The information was regarded through a telephone survey calling to 32 embassies and consulates of countries in Asia, Africa and South and Central America posing as potential travellers seeking advice. RESULTS: Of the 15 countries where yellow fever is endemic only 53% advised the appropriate immunization. Malaria prophylaxis was recommended in over 41% of the countries in areas of risk for malaria, denning the existence of malaria the 25%. Other immunizations such as hepatitis, tetanus, typhus was recommended by the 12.5% and over 25% mentioned additional precautions (water purification, insect repellents, food ...). 53% referred us to other sources of information in public health departments and travel clinics. CONCLUSIONS: Diplomatic representations are still not an ideal source of pretravel advice. An accurate advice should be sought from health units of international vaccines and Tropical Medicine.