Detection by PCR of pathogenic protozoa in raw and drinkable water samples in Colombia.

We evaluated the presence of DNA of Giardia, Toxoplasma, and Cryptosporidium by PCR, and of Giardia and Cryptosporidium genera by immunofluorescence antibody test (IFAT), in water samples, before, during, and after plant treatment for drinkable water. We applied this method in 38 samples of 10 l of water taken from each of the water treatment steps and in 8 samples taken at home (only for Toxoplasma PCR) in Quindio region in Colombia. There were 8 positive samples for Cryptosporidium parvum (21 %), 4 for Cryptosporidium hominis (10.5 %), 27 for Toxoplasma gondii (58.6 %), 2 for Giardia duodenalis assemblage A (5.2 %), and 5 for G. duodenalis assemblage B (13.1 %). By IFAT, 23 % were positive for Giardia and 21 % for Cryptosporidium. An almost perfect agreement was found between IFAT and combined results of PCR, by Kappa composite proportion analysis. PCR positive samples were significantly more frequent in untreated raw water for C. parvum (p = 0.02). High mean of fecal coliforms, high pH values, and low mean of chlorine residuals were strongly correlated with PCR positivity for G. duodenalis assemblage B. High pH value was correlated with PCR positivity for C. parvum. Phylogenetic analysis of DNA sequences was possible, showing water and human clinical sequences for Toxoplasma within the same phylogenetic group for B1 repeated sequence. PCR assay is complementary to IFAT assay for monitoring of protozoa in raw and drinkable water, enabling species identification and to look for phylogenetic analysis in protozoa from human and environmental sources.

Striking Divergence in Toxoplasma ROP16 Nucleotide Sequences From Human and Meat Samples.

BACKGROUND: ROP16 is a protein kinase of Toxoplasma gondii identified in the mouse model as a virulent marker, but it is unknown whether this finding is relevant in human toxoplasmosis. METHODS: We obtained the Toxoplasma ROP16 locus DNA sequence in samples from 12 patients with ocular toxoplasmosis, 1 sample from a patient with congenital toxoplasmosis, 22 samples from soldiers operating in the jungle, 2 samples from urban soldiers, and 10 samples from meat for human consumption. An enzyme-linked immunosorbent assay specific for antibodies against the ROP16 mouse-virulent peptide was performed in 46 serum specimens from patients with ocular toxoplasmosis and in 28 serum specimens from patients with chronic asymptomatic infection, of whom 19 had congenital infection and 11 had toxoplasmic lymphadenitis. RESULTS: We found a striking divergence of the ROP16 nucleotide sequences. Ten of 12 sequences (83.3%) from patients with ocular toxoplasmosis clustered with those of mouse-virulent strains, whereas 7 of 7 ROP16 sequences (100%) from meat were clustered with those of mouse-avirulent strains. Only 11 of 104 serum specimens (10.5%) had specific antibodies against the mouse-virulent peptide, and there was no association between clinical forms and positive results of serological assays. CONCLUSIONS: The majority of ROP16 nucleotide sequences from Colombian patients with ocular toxoplasmosis belonged to the group of mouse-virulent strains.

Evaluation of IgG anti-toxoplasma avidity and polymerase chain reaction in the postnatal diagnosis of congenital toxoplasmosis.

Confirmatory tests for congenital toxoplasmosis were evaluated in 23 infected and 31 uninfected newborns. Conventional polymerase chain reaction was better than real-time polymerase chain reaction, but did not identify additional cases. Avidity tests added 2 new cases that were not identified by other criteria. Overall sensitivity was 82.6%. Avidity assay, but not polymerase chain reaction, increased the sensitivity of confirmatory assays in congenital toxoplasmosis.

Determinación de la actividad antifúngica de extractos de Lantana camara frente a Candida spp / Determination of antifungal activity of extracts of Lantana camara against Candida spp

Objetivo. El objetivo del trabajo fue determinar si los extractos de la planta Lantana camara presentan actividad antifúngica frente a seis especies de Candida spp y un aislamiento humano de origen primario. Materiales. Se obtuvieron los extractos etanólicos totales por el método de percolación y se hizo fraccionamiento cromatográfico con eluyentes de diferente polaridad. Se caracterizaron los grupos funcionales mediante espectroscopía infrarroja. La actividad antifúngica se evaluó frente a seis especies de Cándida spp. (C. albicans, C. dubliniensis, C. krusei, C. guillermondii, C. tropicalis, C. parapsilosis y un aislamiento primario de C. albicans). La prueba de inhibición del crecimiento se hizo con un ensayo en suero humano, observando con absorbancia a 600 nm las curvas de crecimiento relacionadas. Resultados. El análisis por espectroscopía infrarroja demostró la presencia de flavonoides en los tallos y en las hojas de L. camara. Se encontró una fracción de tallo que inhibió el crecimiento de C. dublinensis y C. albicans, tanto para la cepa de referencia como para el aislamiento primario, y otra que inhibió C. guillermondii. Una fracción de hojas inhibió C. krusei. Conclusiones. Se encontraron fracciones con presencia de flavonoides y con efecto antifúngico en el tallo y en las hojas de L. camara.

Introduction: The aim of this study was to determine if Lantana camara extracts show antifungal activity against six Candida spp. species and one human isolate from primary origin. Methods: We extracted the total ethanol extracts by the percolation method and a chromatographic fractionation was carried out using solvents of different polarities. Functional groups were characterized by infrared spectroscopy. The antifungal activity was evaluated against six species of Candida spp. (C. albicans, C. dublinienses, C. krusei, C. guilliermondii, C. tropicalis, C. parapsilosis and a primary isolate of C. albicans). The growth inhibition test was performed in human serum and by observing growth curves at an absorbance of 600 nm. Results: Infrared spectroscopy confirmed the presence of flavonoids in the leaves and the stem of L. camara. A fraction from the stem inhibited C. dublinensis growth and another inhibited C. albicans and C. guillermondii growth. One fraction from the leaf inhibited C. krusei. Conclusions: Chromatographic fractions obtained from the stem and leaves of L. camara contained flavonoids with antifungal effect.

First Colombian multicentric newborn screening for congenital toxoplasmosis.

AIMS: To determine the incidence of congenital toxoplasmosis in Colombian newborns from 19 hospital or maternal child health services from seven different cities of five natural geographic regions (Caribbean, Central, Andean, Amazonia and Eastern). MATERIALS AND METHODS: We collected 15,333 samples from umbilical cord blood between the period of March 2009 to May 2010 in 19 different hospitals and maternal-child health services from seven different cities. We applied an IgM ELISA assay (Vircell, Spain) to determine the frequency of IgM anti Toxoplasma. The results in blood cord samples were confirmed either by western blot and repeated ELISA IgM assay. In a sub-sample of 1,613 children that were negative by the anti-Toxoplasma IgM assay, the frequency of specific anti-Toxoplasma IgA by the ISAGA assay was determined. All children with positive samples by IgM, IgA, clinical diagnosis or treatment during pregnancy were recalled for confirmatory tests after day 10 of life. RESULTS: 61 positive samples for specific IgM (0.39%) and 9 positives for IgA (0.5%) were found. 143 questionnaires were positive for a clinical diagnosis or treatment for toxoplasmosis during pregnancy. 109 out of the 218 children that had some of the criteria for postnatal confirmatory tests were followed. Congenital toxoplasmosis infection was confirmed in 15 children: 7 were symptomatic, and three of them died before the first month of life (20% of lethality). A significant correlation was found between a high incidence of markers for congenital toxoplasmosis and higher mean annual rainfall for the city. CONCLUSIONS: Incidence for congenital toxoplasmosis is significantly different between hospitals or maternal child health services from different cities in Colombia. Mean annual rainfall was correlated with incidence of congenital toxoplasmosis.

[Low levels of 25-hydroxyvitamin D (25OHD) in patients with inflammatory bowel disease and its correlation with bone mineral density]. / Níveis baixos de 25-hidroxivitamina D (25OHD) em pacientes com doença inflamatória intestinal e sua correlação com a densidade mineral óssea.

UNLABELLED: Patients with inflammatory bowel disease (IBD) are at risk of having vitamin D deficiency (25-OHD) and low bone mineral density (BMD). OBJECTIVES: To measure 25OHD in a young group of IBD patients submitted to a clinical evaluation, routine biochemistry and BMD measurement (lumbar spine and proximal femur). RESULTS: 39 Crohn disease (CD) and 37 ulcerative colitis (UC) patients had lower serum levels of 25OHD compared to the control group (CD p = 0.003; UC p < 0.001), and 48.5% of the UC patients were 25OHD deficient. Lumbar spine BMD was lower in patients than controls (CD p = 0.001; UC p = 0.008). In CD patients, serum levels of 25OHD were significantly correlated with total femur (r = 0.391; p = 0.027) and femoral neck (r = 0.384; p = 0.03) BMD. CONCLUSION: It was found lower levels of 25OHD and BMD in young IBD patients compared to normal controls, suggesting an important role of 25OHD deficiency in the pathogenesis of the IBD bone disease.

Níveis baixos de 25-hidroxivitamina D (25OHD) em pacientes com doença inflamatória intestinal e sua correlação com a densidade mineral óssea / Low levels of 25-hydroxyvitamin D (25OHD) in patients with inflammatory bowel disease and its correlation with bone mineral density

INTRODUÇÃO: Pacientes com doenças inflamatórias intestinais (DII) estão propensos a apresentar níveis baixos de vitamina D (25OHD) e densidade mineral óssea (DMO) diminuída. OBJETIVO: Verificar o nível de 25OHD em jovens com DII submetidos à avaliação clínica, dosagens bioquímicas rotineiras e medida da DMO de coluna lombar e fêmur, comparando-os com controles saudáveis. RESULTADOS: 39 pacientes com doença de Crohn (DC) (p = 0, 003) e 37 com retocolite ulcerativa inespecífica (RCUI) (p < 0,001) apresentaram níveis mais baixos de 25OHD comparados aos controles, 48,5 por cento dos pacientes com RCUI tinham deficiência de 25OHD. A DMO em coluna lombar foi mais baixa nos doentes (DC p = 0,001; RCUI p = 0,008). A 25OHD correlacionou-se significativamente com a DMO do fêmur total (r = 0,391; p = 0,027) e colo do fêmur (r = 0,384; p = 0,03) na DC. CONCLUSÃO: Foram encontrados níveis baixos de 25OHD e DMO em jovens com DII, sugerindo papel importante desta deficiência na patogênese da doença óssea desses pacientes.

Patients with inflammatory bowel disease (IBD) are at risk of having vitamin D deficiency (25-OHD) and low bone mineral density (BMD). OBJECTIVES: To measure 25OHD in a young group of IBD patients submitted to a clinical evaluation, routine biochemistry and BMD measurement (lumbar spine and proximal femur). RESULTS: 39 Crohn disease (CD) and 37 ulcerative colitis (UC) patients had lower serum levels of 25OHD compared to the control group (CD p = 0,003; UC p < 0,001), and 48.5 percent of the UC patients were 25OHD deficient. Lumbar spine BMD was lower in patients than controls (CD p = 0,001; UC p = 0,008). In CD patients, serum levels of 25OHD were significantly correlated with total femur (r = 0,391; p = 0,027) and femoral neck (r = 0,384; p = 0,03) BMD. CONCLUSION: It was found lower levels of 25OHD and BMD in young IBD patients compared to normal controls, suggesting an important role of 25OHD deficiency in the pathogenesis of the IBD bone disease.

Detección de Toxoplasma gondii en carnes de consumo humano por la técnica de reacción en cadena de la polimerasa en tres ciudades del eje cafetero / Toxoplasma gondii infection of meat for human consumption detected by PCR assay in three cities from the coffee region of Colombia

Antecedentes. Es necesario conocer el grado de exposición a Toxoplasma gondii en la carne de diferentes especies para consumo humano en Colombia. Objetivo. Detectar material genómico de T. gondii por la técnica de PCR en muestras de carne de res, cerdo y pollo obtenidas en Armenia, Manizales y Pereira, con el fin de establecer el tipo de carne y la ciudad en donde es más frecuente el hallazgo del parásito. Materiales y métodos. En cada ciudad se obtuvieron 20 muestras por tipo de carne de establecimientos comerciales clasificados en estratos. Se extrajeron 180 muestras de ADN, las cuales se utilizaron para realizar una PCR anidada (nested PCR) con el fin de obtener una región de 160 pares de bases específica de T. gondii.

[Correlation of Doppler ultrasound of the portal system with endoscopic changes caused by portal hypertension in cirrhotic patients]. / Correlação das características do ecodoppler do sistema porta com presença de alterações endoscópicas secundárias à hipertensão porta em pacientes com cirrose hepática.

BACKGROUND: The portal hypertension in cirrhotic patients is the main cause of this illness complication, that are clinically translated to visible collateral circulation in the abdominal wall, ascites and esophageal varices. AIM: To evaluate if the portal system echodoppler is able to estimate the presence of esophageal varices, gastric varices and congestive gastropathy in patients with hepatic cirrhosis. PATIENTS AND METHODS: One hundred and eighty six patients of the gastroenterology and hepatology ambulatory of the Clinical Hospital of the Federal University of Paraná, Curitiba, PR, Brazil, had been selected for evaluation. Of those, 145 had completed all the stages of the evaluation and 133 had been enclosed in the final analysis. All had been submitted to high digestive endoscopy for evaluation of esophagogastric varices and congestive gastropathy and then to Doppler ultrasound of the portal system with study of the systolic peak speed of the portal vein, diameter of the portal and splenic vein and spleen size, presence of the umbilical vein recanalization and hepatofugal flow. RESULTS: The patients with esophagogastric varices had significant difference of the spleen size when compared to patients without these change. However, none of the Doppler ultrasound parameters showed good accuracy and specificity in this group of cirrhotic patients. Congestive gastropathy patients had their diagnosis predict with significant manner not only by the portal and splenic vein diameter but also by the spleen size. Similarly to that described above, they do not have a good accuracy and specificity. These evaluations were validated by the construction of ROC (Receiver Operating Characteristic) curves, whose areas below the curves had always been less than 0,8. CONCLUSION: There was not a good correlation of the Doppler ultrasound parameters of the portal system to the presence of the main endoscopic alterations (esophagogastric varices and congestive gastropathy) in patients with hepatic cirrhosis.

Correlação das características do ecodoppler do sistema porta com presença de alterações endoscópicas secundárias à hipertensão porta em pacientes com cirrose hepática / Correlation of Doppler ultrasound of the portal system with endoscopic changes caused by portal hypertension in cirrhotic patients / Correlation of Doppler ultrasound of the portal system with endoscopic changes caused by portal hypertension in cirrhotic patients

RACIONAL: A hipertensão portal é a causa principal das complicações da cirrose hepática, traduzidas clinicamente por circulação colateral visível na parede abdominal, ascite e varizes esofágicas. OBJETIVO: Avaliar a capacidade do ecodoppler do sistema porta no diagnóstico de alterações esôfago-gástricas endoscópicas secundárias à hipertensão porta em pacientes com cirrose hepática. PACIENTES E MÉTODOS: Cento e oitenta e seis pacientes dos ambulatórios de gastroenterologia e hepatologia do Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, PR, foram selecionados para avaliação. Destes, 145 completaram todas as etapas e 133 puderam ser incluídos na análise final dos dados. Todos foram submetidos a endoscopia digestiva alta, visando determinar presença e grau de varizes esofágicas e gástricas e de gastropatia congestiva e ao ecodoppler do sistema porta para medir/aferir pico de velocidade sistólica da veia porta, diâmetro das veias porta e esplênica, tamanho do baço, presença de recanalização da veia umbilical e de fluxo hepatofugal. RESULTADOS: Os pacientes com varizes esofágicas e gástricas tiveram diferença significativa do tamanho do baço quando comparados com os pacientes sem essas alterações. No entanto, a exatidão e a especificidade deste parâmetro não foi adequada. O diagnóstico de gastropatia congestiva pode ser predito de maneira significativa, tanto pelo diâmetro da veia porta, quanto pelo da esplênica e também pelo tamanho do baço. Da mesma forma, todavia, a exatidão e especificidade destes parâmetros foram ruins. As medidas foram validadas pela construção de curvas ROC ("Receiver Operating Characteristic"), cujas áreas sob as curvas foram sempre menores que 0,8. CONCLUSÃO: Nesta série de pacientes não houve boa correlação dos parâmetros do ecodoppler do sistema porta com a presença das principais alterações endoscópicas (varizes esofágicas, varizes gástricas, gastropatia congestiva) em pacientes com cirrose hepática.

BACKGROUND: The portal hypertension in cirrhotic patients is the main cause of this illness complication, that are clinically translated to visible collateral circulation in the abdominal wall, ascites and esophageal varices. AIM: To evaluate if the portal system echodoppler is able to estimate the presence of esophageal varices, gastric varices and congestive gastropathy in patients with hepatic cirrhosis. PATIENTS AND METHODS: One hundred and eighty six patients of the gastroenterology and hepatology ambulatory of the Clinical Hospital of the Federal University of Paraná, Curitiba, PR, Brazil, had been selected for evaluation. Of those, 145 had completed all the stages of the evaluation and 133 had been enclosed in the final analysis. All had been submitted to high digestive endoscopy for evaluation of esophagogastric varices and congestive gastropathy and then to Doppler ultrasound of the portal system with study of the systolic peak speed of the portal vein, diameter of the portal and splenic vein and spleen size, presence of the umbilical vein recanalization and hepatofugal flow. RESULTS: The patients with esophagogastric varices had significant difference of the spleen size when compared to patients without these change. However, none of the Doppler ultrasound parameters showed good accuracy and specificity in this group of cirrhotic patients. Congestive gastropathy patients had their diagnosis predict with significant manner not only by the portal and splenic vein diameter but also by the spleen size. Similarly to that described above, they do not have a good accuracy and specificity. These evaluations were validated by the construction of ROC (Receiver Operating Characteristic) curves, whose areas below the curves had always been less than 0,8. CONCLUSION: There was not a good correlation of the Doppler ultrasound parameters of the portal system to the presence of the main endoscopic alterations (esophagogastric varices and congestive gastropathy) in ...

Avaliação da densidade mineral óssea em pacientes com doença inflamatória intestinal / Bone mineral density evaluation in inflammatory bowel disease patients

RACIONAL: Pacientes com doença inflamatória intestinal têm maior prevalência de redução da densidade mineral óssea em comparação às pessoas saudáveis. OBJETIVO: Avaliar a densidade mineral óssea em uma população de pacientes com doença inflamatória intestinal. MÉTODOS: Noventa pacientes de 20 a 50 anos de idade, do ambulatório de doença inflamatória intestinal do Serviço de Gastroenterologia do Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, PR, foram selecionados para avaliação. Desses, 76 completaram todas as etapas de avaliação. A densitometria foi realizada da coluna lombar e fêmur direito em aparelho Hologyc QDR 1000/W. RESULTADOS: Os pacientes com doença inflamatória intestinal tiveram significativa redução da densidade mineral óssea, avaliada por massa óssea em números absolutos (g/cm²), em todas as regiões avaliadas, colo do fêmur, fêmur total e coluna lombar. As variáveis analisadas como, índice de atividade de doença, uso de corticóide, cirurgias prévias, índice de massa corpórea e falta de atividade física, não demonstraram correlação com a massa óssea, ou seja, não influenciaram os resultados da densidade mineral óssea no grupo estudado de doentes com doença inflamatória intestinal. CONCLUSÃO: Densidade mineral óssea reduzida foi encontrada nos pacientes com doença inflamatória intestinal do Ambulatório de Doença Inflamatória Intestinal do Serviço de Gastroenterologia do Hospital de Clínicas da Universidade Federal do Paraná, mais pronunciadamente nos pacientes com doença de Crohn, semelhante ao descrito na literatura. Nenhuma das variáveis analisadas mostrou correlação com a densidade mineral óssea.

Prevalencia de giardiasis y parásitos intestinales en preescolares de hogares atendidos en un programa estatal en Armenia, Colombia / Prevalence of giardiasis and intestinal parasites in pre-school children from homes being attended as part of a state programme in Armenia, Colombia

OBJETIVO: El propósito de este estudio es el de obtener datos sobre la giardiasis y el parasitismo intestinal en una muestra significativa de los niños en edades pre-escolares de los hogares de madres comunitarias del Instituto Colombiano de Bienestar Familiar (ICBF). MATERIALES Y MÉTODOS: Se recolectó un seriado de tres muestras de heces en 328 niños, con previo consentimiento del tutor legal. Se le realizó el análisis de laboratorio por examen directo microscópico y macroscópico utilizando Lugol al 1 por ciento, solución salina al 0,83 por ciento, solución salina-eosina, Kato Katz y formol-éter o metodo de concentración de Ritchie (prueba comprobatoria). Las muestras positivas se conservaron en formol salino. RESULTADOS: Los parásitos con potencial patógeno tuvieron las siguientes prevalencias: Ascaris lumbricoides 2,4 por ciento, Hymenolepsis nana 0,6 por ciento, Trichuris trichura 2,1 por ciento, Blastocystis hominis 6,1 por ciento y Giardia lamblia 13 por ciento. CONCLUSIONES: Este estudio muestra la baja frecuencia de los helmintos con respecto a los protozoos, por lo tanto estrategias de desparasitación masiva con dosis únicas de Albendazol no tienen utilidad. Se recomienda la vigilancia periódica de parásitos por exámenes en estos niños. Se confirma que el parásito patógeno mas prevalente es Giardia lamblia en los niños de las guarderias infantiles del ICBF. La prevalencia de Giardia no se relacionó de manera estadisticamente significativa con el estado nutricional de los niños de las guarderias del ICBF. La mayoria de niños infectados por Giardia son asintomáticos.

Genetic and biologic characteristics of Toxoplasma gondii isolates in free-range chickens from Colombia, South America.

The prevalence of Toxoplasma gondii in free-ranging chickens is a good indicator of the prevalence of T. gondii oocysts in the soil because chickens feed from the ground. The prevalence of T. gondii in 77 free-range chickens (Gallus domesticus) from Colombia, South America was determined. Antibodies to T. gondii were assayed by the modified agglutination test (MAT), and found in 32 (44.4%) of 72 chickens with titers of 1:5 in 4, 1:10 in 3, 1:20 in 1, 1:40 in 1, 1:80 in 8, 1:160 in 8, 1:320 in 3, and 1:640 or higher in 4. Hearts and brains of 31 seropositive chickens were pooled and bioassayed in mice. Tissues from 32 (16+16) seronegative chickens were pooled and fed to two, T. gondii-free cats, and tissues from nine chickens without matching sera were fed to one T. gondii-free cat. Feces of cats were examined for oocysts. T. gondii oocysts were excreted by a cat that was fed tissues of 16 seronegative chickens. T. gondii was isolated by bioassay in mice from 23 chickens with MAT titers of 1:20 or higher. All infected mice from 16 of the 23 isolates died of toxoplasmosis. Overall, 82 (81.1%) of 101 mice that became infected after inoculation with chicken tissues died of toxoplasmosis. Genotyping of these 24 isolates using polymorphisms at the SAG2 locus indicated that seven T. gondii isolates were Type I, 17 were Type III, and none was Type II. Phenotypically, T. gondii isolates from chickens from Colombia were similar to isolates from Brazil but different from the isolates from North America; most isolates from chickens from Brazil and Colombia were lethal for mice whereas isolates from North America did not kill inoculated mice. Genetically, none of the T. gondii isolates from Colombia and Brazil was SAG2 Type II, whereas most isolates from chickens from North America were Type II. This is the first report of genetic characterization of T. gondii isolates from Colombia, South America.

[Prevalence of giardiasis and intestinal parasites in pre-school children from homes being attended as part of a state programme in Armenia, Colombia]. / Prevalencia de giardiasis y parásitos intestinales en preescolares de hogares atendidos en un programa estatal en Armenia, Colombia.

OBJECTIVE: Determining the prevalence of giardiasis and intestinal parasitism in pre-school children from the Instituto Colombiano de Bienestar Familiar (ICBF). MATERIALS AND METHODS: Three serial faecal samples were collected from 328 children following informed consent from their legal guardians. Microscopic and macroscopic tests were made using 1% Lugol, 0.83% saline solution, saline-eosin solution and Kato Katz and Ritchie's test as a confirming test. Positive samples were preserved in saline formol solution. RESULTS: Pathogen parasites had the following prevalence frequencies: 2.4% for Ascaris lumbricoides, 0.6% for Hymenolepsis nana, 2.1% for Trichuris trichura, 6.1% for Blastocystis hominis and 13% for Giardia lamblia. CONCLUSIONS: The results of this work showed low helminth frequency compared to that for protozoa; control strategies using single doses of Albendazol are therefore not useful. The most prevalent pathogen parasite was Giardia lamblia in children from the ICBF in Armenia. Periodic surveillance of parasites in children is thereby recommended. The prevalence of Giardia lamblia was not statistically related to the children's nutritional state. Most Giardia-infected children were asymptomatic.

[Bone mineral density evaluation in inflammatory bowel disease patients]. / Avaliação da densidade mineral óssea em pacientes com doença inflamatória intestinal.

BACKGROUND: Inflammatory bowel disease patients have shown greater reduction of the bone mineral density compared to healthy people. AIM: To evaluate the bone mineral density in a population of patients with inflammatory bowel disease. METHODS: Ninety patients from 20 to 50 years old, of the Inflammatory Bowel Disease Ambulatory of the Gastroenterology Service of the Clinics Hospital, Curitiba, PR, Brazil, were selected for the evaluation. From those, 76 completed all the stages of the evaluation. The densitometry was made from lumbar column and right femur with a dual-energy x-ray absorptiometry (Hologyc QDR 1000/W) device. RESULTS: The inflammatory bowel disease patients had a significant reduction of the bone mineral density in all the evaluated parts, femur neck, total femur and lumbar column. The analysed variables, disease activity index, usage of corticoids, the lack of physical activities, the index body mass and previous surgeries did not have influence in the results. CONCLUSION: Reduced bone mineral density was founded in inflammatory bowel disease patients of the Clinics Hospital, mainly in the Crohn's disease patients, as described in literature. None analyzed variables had significant correlation to the bone mineral density.

Prevalencia de la Entamoeba histolytica en asentamientos temporales post terremoto de la ciudad de Armenia / Entamoeba histolytica prevalence in temporary housing after the earthquake, Armenia, Colombia

Objetivo: determinar la prevalencia de parásitos intestinales y de Entamoeba histolytica mediante la prueba ELISA de adhesina en heces en asentamientos temporales post-terromoto. Diseño: estudio de prevalencia de punto. Lugar: ocho asentamientos temporales post-terremoto de la ciudad de Armenia. Población: muestra representativa de la población entre 4 y 65 años de edad de asentamientos, en total 169 personas. Mediciones: coproscópico y prueba ELISA para adhesina de Entamoeba histolytica en heces. Resultados: Endolimax nana fue el parásito comensal más prevalente con 66 por ciento, seguido por Entamoeba coli 26 por ciento y Lodamoeba buschtlii 10 por ciento. Giardia lamblia fue la especie patógena más prevalente con 38 por ciento, seguida de Ascaris lumbricoides 10 por ciento, Strongyloides stercoralis 2 por ciento, Trichuris trichura 1.7 por ciento, Hymenolepsis nana 0.6 por ciento (1/169). Los quistes de Entamoeba histolytica/dispar fueron detectados por microscopía en 17.5 por ciento y la prueba de adhesina fue positiva en sólo una de las 169 muestras estudiadas (0.6 por ciento). Conclusiones: este estudio señala que E. histolytica es poco frecuente en asentamientos temporales post-terremoto y la necesidad en Colombia de realizar pruebas específicas, con el fin de determinar la instauración de un tratamiento antiamibiano, el cual no se puede basar en el resultado de la microscopía óptica dada la alta frecuencia de amibas no patógenas