Eficacia del metronidazol gel 0.75% vs permetrina crema 5% en pacientes con rosácea. Hospital Manuel Fajardo, 2016-2017 / Effectiveness of metronidazole gel 0.75% vs permetrine cream 5% in patients with rosacea. Manuel Fajardo Hospital, 2016-2017

Introducción: la rosácea es una enfermedad inflamatoria crónica de etiología desconocida que se presenta con eritema centro facial permanente, con episodios transitorios de intensificación asociados a factores desencadenantes unido a otros síntomas y signos variados. Tiene diferentes formas clínicas, es de difícil manejo y por ello, aunque existen diferentes tratamientos, aún es válido continuar la búsqueda de otras alternativas terapéuticas. Objetivo: determinar eficacia del metronidazol gel 0.75%, permetrina crema 5%, y la combinación de ambos medicamentos en pacientes con rosácea facial tratados en el Hospital Fajardo en el período 2016 a 2017. Método: se realizó un estudio de intervención cuasi-experimental, abierto, longitudinal, aleatorizado con tres grupos de 30 pacientes, que recibieron tratamiento durante 3 meses, y fueron evaluados un mes después de terminar el tratamiento. Resultados: predominaron las mujeres, el fototipo cutáneo III, con piel grasa. La mejor respuesta terapéutica fue la asociación de ambos medicamentos con un 100% con respuesta satisfactoria, seguida de 92.9% con la permetrina y 79.3% con el metronidazol. Conclusiones: La respuesta terapéutica en la mayoría de los 3 grupos fue satisfactoria, aunque predominó la combinación de ambos medicamentos. Las reacciones adversas fueron leves y escasas.

Escabiosis: lesiones pruriginosas altamente contagiosas / Scabies: highly contagious pruritic lesions

La escabiosis es una infestación producida por Sarcoptes scabiei, caracterizada por lesiones generalizadas pruriginosas. El diagnóstico es eminentemente clínico. Síntomas compatibles en varios miembros de la misma familia se consideran diagnósticos. El tratamiento consiste en la aplicación de Permetrina al 5% en la superficie cutánea.

Scabies is an infestation produced by Sarcoptes scabiei. Itchy generalized lesions characterized this pathology. The diagnosis is clinical. Compatible symptons presented in some members of the same family are considered diagnostic. The treatment is based in the application of Permetrine 5% in all the cutaneous area.

Crusted scabies due to indiscriminate use of glucocorticoid therapy in infant

Abstract Crusted or Norwegian scabies is a parasitic infectious disease caused by Sarcoptes scabiei var. hominis that mainly affects immunocompromised individuals and those with neurological patients. We report a case of crusted scabies in a 4-month-old infant who had been treated erroneously for atopic dermatitis with high doses of corticosteroids. This initial misdiagnosis associated with the abusive use of corticosteroid facilitated the evolution of scabies to crusted scabies and its main complications of secondary infection and sepsis.

Manejo en atención primaria de escabiosis en una familia con ruralidad extrema / Primary care management of scabies in a family with extreme rurality

La dermatoparasitosis producida por el acaro Sarcoptes scabiei variedad hominis, presenta una distribución poblacional relacionada al hacinamiento, condiciones higiénicas deficientes, pobreza y características geoclimáticas. El contagio ocurre de forma directa cutánea o a través de fómites. Liquiñe,poblado fronterizo de la Región de los Ríos, Chile, presenta en gran parte de su población las características mencionadas, con difícil acceso a comunicación digital y derivación médica. La incidencia de sarna se ve modificada al realizar intervenciones educacionales y saneamiento local, tanto como el diagnostico precoz y el tratamiento oportuno logran una modificación sustancial de la prevalencia. Se presenta el reporte de un caso. Paciente sexo femenino, 33 años, que presenta lesiones por grataje, excoriadas, con pápulo-pústulas de dos años de evolución, con manejo inicial sintomático por diagnóstico de dermatitis y psoriasis sin mejora de las lesiones. Conjuntamente se identifica en la hija de 4 años, lesiones primarias de características similares a las iniciales. Las lesiones de la menor se presentan como vesículas en espacio interdigital, muñe-cas, región periumbilical y surco acarino, compatibles con sarna. Se inicia tratamiento tópico permetrina 5 %a toda la familia, basados en las recomendaciones de la guía de manejo MINSAL. Se logra tras 2 años de evolución regresión total de los signos y síntomas a los 2 meses de iniciada la terapia. La presente revisión de caso pretende reforzar las ideas de diagnóstico precoz, tanto de caso índice como de probables contactos,educación continua a la comunidad. Tratamiento efectivo y oportuno, adecuado a la realidad socio cultural década localidad, tomando en cuenta factores de riesgos para la presentación y el abandono de la terapia. Asimismo promover las redes institucionales para la distribución de tratamiento, asesoramiento por especialistas y conocimientos actualizados de la semiología de cada cuadro dermatológico por el médico general.

The dermato parasitosis producedby the Sarcoptes scabiei mite hominis variety, has apopulation distribution related to over crowding, poor sanitation, poverty and geo-climatic characteristics.Transmission occurs directly through skin or fomites.In the border town of Liquiñe in the Region de los Rios,Chile, a substantial amount of the population is subject to the above characteristics, with difficult access to digital communication and medical referrals. The incidence of scabies is modified through educational interventions, and local sanitation, as well as early diag-nosis and timely treatment thus achieving a substantial change in prevalence. A case report is presented. Female patient, 33 years old presents with excoriated crusted lesions, with papules and pustules following two years of development, initial symptomatic management diagnosis of psoriasis and dermatitis,showed no improvement of the lesions. At the same time the 4 year old daughter of the patient presented with primary lesions similar to baseline characteristics.The child ́s lesions presented as vesicles in interdigital space, wrists, periumbilical region and mite grooves compatible with scabies. Permethrin 5% topical treatment was prescribed for the whole family, basedon the recommendations of the MINSAL guide management is initiated. At 2 months of treatment therapy on set, complete recovery was achieved following two years of evolution of signs and symptoms.This case review aims to reinforce the ideas of earlydiagnosis, in both probable index case and contact,and continuing education in the community. Effective and timely treatment, in conjunction with the socio-cultural reality of each community, taking into account risk factors, such as seeking medical treatment and abandoning therapy. Furthermore, it is also intended to promote institutional networks for treatment dissemination, counseling by specialists and updated information for each dermatological presentation for the general medicine physician.

Serie parasitosis en dermatología: pediculosis / Parasitosis in dermatology: pediculosis

La enfermedad producida por Pediculus humanus capitis, conocida como pediculosis, es una parasitosis específica del ser humano de distribución mundial. El contagio puede ser directo por contacto con el cuero cabelludo de una persona afectada, o por fómites contaminados con parásitos, por lo que no distingue raza, sexo, edad ni nivel socioeconómico. Presentamos el caso de una paciente de 80 años con una forma típica de pediculosis. (AU)

The disease caused by Pediculus humanus capitis, known as pediculosis, is a human specific parasitosis. It has a worldwide distribution. Transmission can be by direct contact with the scalp of an affected person or by contaminated fomites with parasites. This infestation makes no distinction of race, sex, age, or socioeconomic status. We present a case of an 80 years old patient with a typical case of pediculosis. (AU)

The behaviour of mosquitoes in relation to humans under holed bednets: the evidence from experimental huts

The physical integrity of bednets is a concern of national malaria control programs, as it is a key factor in determining the rate of replacement of bednets. It is largely assumed that increased numbers of holes will result in a loss of protection of sleepers from potentially infective bites. Experimental hut studies are valuable in understanding mosquito behaviour indoors, particularly as it relates to blood feeding and mortality. This review summarises findings from experimental hut studies, focusing on two issues: (i) the effect of different numbers or sizes of holes in bednets and (ii) feeding behaviour and mortality with holed nets as compared with unholed nets. As might be expected, increasing numbers and area of holes resulted in increased blood feeding by mosquitoes on sleepers. However, the presence of holes did not generally have a large effect on the mortality of mosquitoes. Successfully entering a holed mosquito net does not necessarily mean that mosquitoes spend less time in contact with the net, which could explain the lack in differences in mortality. Further behavioural studies are necessary to understand mosquito behaviour around nets and the importance of holed nets on malaria transmission.

Evaluación de ovitrampas letales como estrategia para el control de Aedes aegypti / Evaluation of lethal ovitraps as a strategy for Aedes aegypti control

Introducción. El dengue es una enfermedad viral de transmisión vectorial de importancia en salud pública. La ausencia de una vacuna ha llevado a que las acciones de control se enfoquen principalmente en la disminución del mosquito vector. Sin embargo, estas estrategias tienen costos elevados. Las ovitrampas letales podrían contribuir de forma práctica en estrategias costo-efectivas para el control vectorial. Objetivo. Determinar el tipo de ovitrampas letales más eficiente para el control vectorial de Aedes aegypti , combinando diferentes tipos de insecticidas, sustrato de ovipostura e infusión atrayente. Materiales y métodos. El estudio se llevó a cabo en dos etapas. En la primera, se evaluaron en el laboratorio 18 ovitrampas diferentes provenientes de la combinación de insecticidas (deltametrina y permetrina), sustratos de ovipostura (toalla, dacrón y franela) e infusiones atrayentes (infusión de heno al 10 y 20 % y agua declorada). Para esta evaluación, las ovitrampas se colocaron en el interior de una jaula de evaluación y se liberaron 100 hembras grávidas de A. aegypti . Se seleccionaron las seis mejores ovitrampas con base en la mayor cantidad de oviposturas y en la menor emergencia larvaria. La segunda etapa consistió en evaluar las seis mejores ovitrampas en condiciones de campo. Resultados. Se observó una diferencia estadística entre las 18 ovitrampas en el laboratorio. Las que tenían deltametrina fueron las que presentaron los mejores resultados. En campo se observó que la ovitrampa más eficiente fue la compuesta por deltametrina, toalla e infusión de heno al 10 %. Conclusiones. La combinación de deltametrina, toalla y solución de heno al 10 % fue la más eficiente para la reducción vectorial de A. aegypti .

Introduction: Dengue fever is a vector-borne viral disease of major public health importance. In the absence of a vaccine, control measures are primarily focused on reducing the mosquito vector. However, these strategies are very expensive, and the use of lethal ovitraps could contribute, in a practical manner, to the design of cost-effective strategies for vector control. Objective: To determine the most efficient type of lethal ovitrap for Ae. aegypti vector control by combining different types of insecticides, oviposition substrates and attractant infusions. Materials and methods: The study was conducted in two stages. In the first, 18 different ovitraps resulting from the combination of insecticides (deltamethrin and permethrin), oviposition substrates (towel, dacron and flannel), and attractant infusion (10 and 20% hay infusion, and dechlorinated water) were evaluated in the laboratory. For this evaluation, ovitraps were placed into a mosquito holding cage, and 100 gravid Ae. aegypti females were released. The top six ovitraps were selected based on the higher number of registered eggs, and the lower hatched eggs percentage. In the second, the top six ovitraps were evaluated in field conditions. Results: In laboratory conditions, statistical differences were observed between the 18 ovitraps. The ovitraps with deltamethrin were the most efficient showing the best results. In field conditions, the ovitraps with the highest vector reduction were those combining deltamethrin/towel/10% hay infusion. Conclusions: The ovitrap combining deltamethrin, towel as oviposition substrate, and 10% hay infusion as attractant was the most efficient Ae. aegypti vector control.

Demodicidosis en niños: serie de 17 casos / Demodicidosis in children: a series of 17 cases

Introducción: Los ácaros Demodex folliculorum y Demodex brevis son ectoparásitos habituales en la unidad folículo-sebácea de los humanos, fundamentalmente en adultos. En niños inmunocompetentes su presencia es rara. El objetivo de nuestro estudio es describir y caracterizar la demodicidosis en niños. Material y métodos: Se seleccionaron pacientes menores de 15 años con manifestaciones clínicas sugerentes de demodicidosis. El diagnóstico se efectuó mediante la cuantificación de Demodex sp con KOH 30% bajo microscopía de luz. Resultados: Se reclutaron 17 casos, 16 pacientes de sexo femenino, todos con lesiones faciales características. Sólo en 3 pacientes hubo inmunosupresión concomitante. Todos los casos respondieron al tratamiento con permetrina 5% tópica. Conclusión: La demodicidosis infantil puede presentarse en pacientes inmunocompetentes, su diagnóstico requiere un alto índice de sospecha. Se observa una excelente respuesta con permetrina 5% tópica.

Introduction: The mites Demodex folliculorum and Demodex brevis are common ectoparasites in the follicle-sebaceous unit of humans, principally in adults. In immunocompetent children their presence is rare. The aim of our study is to describe and characterize the demodicidosis in children. Materials and methods: Patients under 15 years old with clinical manifestations suggestive of demodicidosis were selected. Diagnosis was made by quantification of Demodex sp with KOH 30% under light microscopy. Results: We found 17 cases, 16 females, all with typical facial lesions. Only 3 patients presented concomitant immunosuppression. All cases responded to topical 5% permethrin treatment. Conclusion: Infantile demodicidosis can occur in immunocompetents patients, and it diagnosis requires a high index of suspicion. An excellent response with topical 5% permethrin is observed.

Comparison of the insecticide susceptibilities of laboratory strains of Aedes aegypti and Aedes albopictus

A susceptible strain of Aedes albopictus derived from the Gainesville strain (Florida, USA) was established in our laboratory. The larvicidal efficacies of the neurotoxic insecticides temephos, permethrin and the pure cis and trans-permethrin isomers and the microbial insecticide Bacillus thuringiensis israelensis (Bti) against Ae. albopictus were estimated and compared to a susceptible strain of Aedes aegypti. The larvicidal effect of insect growth regulator pyriproxyfen was also evaluated in both mosquito strains. The median lethal concentration/median emergency inhibition values for Ae. aegypti and Ae. albopictus, respectively, were: temephos, 3.058 and 6.632 ppb, permethrin, 3.143 and 4.933 ppb, cis-permethrin, 4.457 and 10.068 ppb, trans-permethrin, 1.510 and 3.883 ppb, Bti, 0.655 and 0.880 ppb and pyriproxyfen, 0.00774 and 0.01642 ppb. Ae. albopictus was more tolerant than Ae. aegypti to all six larvicides evaluated. The order of susceptibility for Ae. aegypti was pyriproxyfen > Bti > trans-permethrin > temephos > permethrin > cis-permethrin and for Ae. albopictus was pyriproxyfen > Bti > trans-permethrin > permethrin > temephos > cis-permethrin. Because both species can be found together in common urban, suburban and rural breeding sites, the results of this work provide baseline data on the susceptibility of Ae. albopictus to insecticides commonly used for controlling Ae. aegypti in the field.

Aplicación de un método analítico revalidado por cromatografía líquida para la cuantificación de permetrina 1 por ciento / High performance liquid chromatography-validated analytical method for 1 percent permethrin quantification

INTRODUCCIÓN: en Cuba, al igual que en otros países, la infestación por Pediculus capitis se ha incrementado notablemente a partir de la década de los setenta, por lo que se desarrolla un intenso programa dirigido a su control y prevención, en el cual se incluyen estudios sobre la calidad de la permetrina, que es un piretroide sintético, activo frente a una amplia gama de parásitos, con actividad pediculicida a 1 por ciento y escabicida a 5 por ciento. Dada su baja toxicidad y por responder favorablemente a la relación riesgo/beneficio, constituye uno de los pediculicidas de elección para disminuir la infestación por piojos. OBJETIVO: revalidación de una metódica analítica por cromatografía líquida de alta resolución y su aplicación en la cuantificación de 12 muestras de 2 lotes de loción de permetrina 1 por ciento, de producción nacional. MÉTODOS: los parámetros evaluados fueron linealidad, precisión y exactitud. Se prepararon 7 estándares de calibración y soluciones de trabajo con concentraciones que se encontraban entre 100 y 15 000 µg/mL. Estos parámetros de validación fueron verificados a través del coeficiente de correlación, el coeficiente de variación y el error relativo porcentual. RESULTADOS: la especificidad del método fue corroborada a través de los cromatogramas realizados, en los cuales los tiempos de retención fueron entre 8,8 y 9,2 min para el isómero trans y entre 10,7 y 11,2 min para el isómero cis. El coeficiente de correlación determinado para ambos isómeros fue mayor que 0,99; el coeficiente de variación fue menor que 3 por ciento y el error relativo porcentual estuvo entre -3 y 1 por ciento, tanto para los estudios interdía como intradía. Se determinó que la media de la concentración de permetrina en lotes de solución tópica 1 por ciento resultó de 6 780,14 µg/mL. CONCLUSIONES: el método revalidado fue lineal, preciso y exacto dentro del rango de concentraciones estudiadas. La concentración de permetrina calculada estuvo por debajo de lo esperado según la información de la composición de la solución de permetrina 1 por ciento (9 100-10 900 µg/mL). Este método resulta útil para la cuantificación de solución de permetrina 1 por ciento en los estudios de calidad del producto farmacológico que se distribuye a la población.

INTRODUCTION: in Cuba, as well as in other countries, Pediculus capitis infestation has increased since the 70´s; this is the reason why a program aimed at controlling and preventing this infestation was designed. This program includes quality control studies of the active synthetic pyrethroid Permethrin and its activity at 1 percent on lice and 5 percent on scabies. Due to its low toxicity and positive risk/benefit ratio, Permethrin is a pediculicide of choice to decrease Pediculus capitis infestation. OBJECTIVE: to validate an analytical method using high performance liquid chromatography and its application in the quantification of 12 samples from 2 batches of Cuban-made 1 percent permethrin pediculicidal preparation. METHODS: linearity, precision and accuracy parameters were determined. Seven calibration standards and working solutions with concentrations ranging from 100 to 15 000 µg/mL were prepared. These validation parameters were verified through the correlation coefficient, the variation coefficient and the percentage relative error. RESULTS: the specificity of this method was proved in the chromatograms that showed retention times of 8.8 to 9.2 min for the isomer trans and 10.7 to 11.2 min for the isomer cis. The correlation coefficient for both isomers was higher than 0.99; the variation coefficient was under 3 percent and the percentage relative error was -3 and 1 percent for the inter-day and intraday studies, respectively. The mean permethrin concentration in 1 percent solution batches was estimated at 6 780.14 µg/mL. CONCLUSIONS: the validated method was linear, precise and exact within the range of the studied concentrations. The estimated concentration of permethrin was below the expected rate according to the composition of 1 percent permethrin solution (9 100-10 900 µg/mL). This method may be useful for the quantification of 1 percent permethrin solutions in the quality studies of the product sold to the population.

Actualización: repelentes naturales y sintéticos / Update: natural and synthetic repellents

Las picaduras de mosquitos constituyen un riesgo frecuente al que se adiciona la posible transmisión de enfermedades. Para evitarlas contamos con barreras físicas, ropas, mosquiteros y repelentes. La elección del repelente a usar debe desprenderse de una meticulosa evaluación entre los beneficios y los riesgos generados por cada producto. El DEET (n,n-dietil,m,toluamida o su nueva denominación n,n-dietil-3-metilbenzamida) es, hasta el momento, el repelente más usado, mejor estudiado y efectivo, pero existen otros productos más nuevos. En este artículo se describen los repelentes naturales y sintéticos más utilizados que se encuentran disponibles en el mercado y se intenta orientar para una adecuada elección de los mismos en situaciones especiales como el embarazo, la lactancia y la niñez.

Mosquitoe bites are a common risk in which we have to take into account the transmission of many diseases. To prevent both risks we count with physical barriers, clothes, nets and repellents. The election of the repellent should be the result of a very meticulous evaluation of the risks and benefits of each product. The DEET (n,n-dietil,m,toluamida or the new name for the same product: n,n-dietil-3-metilbenzamida) is up to date the most used, best studied and effective repellent, but there are many other new options. In this article we describe the different natural and synthetic repellents on the market and try to help on the adequate election in special situations such as pregnancy, nursing and childhood.

Pediculosis hasta 2008 / Pediculosis until 2008

La pediculosis es una patología cuya prevalencia está en aumento en todo el mundo. En parte, esto se debe a las dificultades que presentan los tratamientos disponibles. Los pediculicidas químicos usados actualmente son piretrinas (permetrina 1% es la más usada), malatión 0,5%, lindano 1% (cuestionado debido a su neurotoxicidad e impacto ambiental) e ivermectina (sin aprobación de la Food and Drug Administration). Si bien existe una creciente evidencia sobre el desarrollo de resistencia a estos pediculicidas, es importante considerar la correcta realización de los tratamientos o la presencia de una reinfección antes que el desarrollo de resistencia propiamente dicho, razón por la cual es recomendable que el problema sea abordado en forma conjunta por el equipo de salud, la escuela y la familia. Actualmente se investigan nuevas opciones terapéuticas más seguras y eficaces como, por ejemplo, métodos físicos, aceites esenciales y derivados vegetales, nuevos insecticidas o la incorporación formal de opciones como la ivermectina, para lo cual aún se requiere más investigación que aporte evidencia de mejor calidad metodológica.

Head lice is a condition whose prevalence is increasing worldwide, probably because of the difficulties that available treatments present. Chemicals pediculicides currently in use are pyrethrins (1% permethrin is the most widely used), 0.5% malathion, 1% lindane (questioned because of its neurotoxic effects and their environmental impact) and ivermectin (not yet approved by the Food and Drug Administration). While there is increasing evidence of growing development of resistance to these pediculicides, it is important to consider the proper conduct of the treatments or the presence of reinfection before considering the real development of resistance, for these reasons a global assessment that includes the health equipe, the school and the family is desirable. New therapeutic options, both safe and effective, are being investigated. They include physical methods, products derived from essential oils and herbal products, new insecticides and ivermectin, which requires further research to provide evidence of better quality.

Forma de aplicación y efectividad de la Permetrina 1 por ciento, utilizada por convivientes con escolares, para el control de la pediculosis capitis en los niños / Ways of application and effectiveness of 1 permethrin used by schoolchildren relatives for the control of pediculosis capitis

Introducción: entre los problemas que inciden en los fallos, de los tratamientos pediculicidas, están la forma de aplicación y la baja efectividad de los productos utilizados. Objetivos: conocer, por medio de encuestas de opiniones, la forma de aplicación y la efectividad de la Permetrina 1 por ciento fabricada en Cuba para el control de los piojos. Métodos: los cuestionarios se distribuyeron entre los convivientes con escolares de primaria, que con anterioridad habían utilizado el producto en los niños. El trabajo se realizó de mayo a julio de 2007 en escuelas urbanas y rural-urbanas de las provincias Ciudad de La Habana, Sancti Spíritus y Las Tunas, en Cuba. Resultados: de 786 convivientes encuestados, 637 (81,17 por ciento) no aplicaron el pediculicida según las indicaciones formuladas en el prospecto, que se adjunta al frasco, 579 (73,66 por ciento) la consideran ineficaz y solo 143 (16,32 por ciento) la han utilizado como único tratamiento. Conclusiones: no existe sincronización en los pasos seguidos durante el tratamiento. Se evidencia una alta heterogeneidad en las respuestas, porque más de 70 por ciento de los encuestados la consideran ineficaz para el tratamiento de la pediculosis capitis.

Background: Among the problems that influence on failure of pediculosis treatment is the way of application and low effectiveness of used products. Objectives: to find out, through surveys, the ways of application and the effectiveness of 1 percent permethrin manufactured in Cuba for the control of pediculosis capitis. Methods: the questionnaires were distributed among people living with elementary schoolchildren, who had previously applied the products to children. The study was performed from May to July 2007 in urban and rural-urban schools located in City of Havana, Sancti Spiritus and Las Tunas provinces in Cuba. Results: Seven hundred and eighty six people were surveyed, 637 of them (81,17 percent) did not follow the instructions given in the flask in applying the anti-pediculosis products, 579 (73,66 percent) considered it as ineffective and only 143 (16,32 percent) had used it as unique treatment. Conclusions: there is not any agreement in steps followed by these people during treatment. Responses were very heterogeneous because over 70 of surveyed persons stated that permethrin was ineffective for treatment of pediculosis capitis.

Cromatografia líquida de alta eficiência aplicada ao controle da qualidade de cis-permetrina em loção capilar / High-performance liquid chromatography applied to the control of the quality of cis-permethrin in capillary lotion

Doenças ectoparasitárias como a escabiose, a pediculose, a tungíase e a larva migrans cutânea são epidêmicas em inúmeras comunidades carentes no Brasil e seu controle efetivo é um desafio para a Saúde Pública. Embora a permetrina seja um dos medicamentos aprovados pelo Food and Drug Administration para o tratamento da pediculose, não há um método oficial disponível para a realização do controle da qualidade deste produto em loção capilar de uso humano. Assim, o objetivo deste trabalho foi desenvolver e validar um método analítico sensível, específico, preciso e exato para esta análise, seguindo os critérios descritos na Resolução no 899/2003 da Agência Nacional de Vigilância Sanitária (ANVISA). A cromatografia líquida de alta eficiência (HPLC) com detector diode array (λ = 235nm) foi empregada na determinação de cis-permetrina em loção capilar, visando implementar um sistema de controle da qualidade em laboratórios analíticos. A cis-permetrina e a substância utilizada como padrão interno (PI), o cloridrato de nafazolina, foram separados em coluna analítica S5W (4,6 x 150mm) Waters Spherisorb® e eluídos isocraticamente (fluxo de 1,2mL/min). A cis-permetrina e o PI foram caracterizados pelos tempos de retenção de 1,52 e 8,66 minutos respectivamente. O método mostrou-se linear na faixa de 1,6 a 127,5µg/mL e, nos estudos de precisão intra e interensaio, foram obtidos coeficientes de variação inferiores a 5%, calculados a partir dos resultados. A exatidão média do método foi de 103%. Os limites de detecção e quantificação foram 1,6µg/mL e 2,4µg/mL respectivamente. A cis-permetrina manteve-se estável por 24 horas à temperatura ambiente; por 15 dias a 4ºC e 30 dias a -20ºC. O método mostrou-se simples e apropriado para a determinação de cis-permetrina em loção capilar.

Parasitic skin diseases such as scabies, pediculosis, tungiasis, and cutaneous larva migrans are epidemic in numerous communities in Brazil and their effective control is a major challenge to public health. Permethrim is one of the medications approved by the Food and Drug Administration to treat pediculosis. However, official methods of quality control for permethrin's use as hair lotion are currently unavailable. Thus, a specific and accurate method was validated using high performance liquid chromatography (HPLC) with a diode array detector (λ = 235 nm) in order to determine cis-permethrin in hair lotion, aiming to establish a systemof quality control in analytical laboratories. Cis-permethrin and naphazolinechloride (internal standard - IS) were separated in an analytical S5W column (4.6 x 150 mm) Waters Spherisorb® and isocratically eluted (flow rate =1.2 mL/min). Cis-permethrin and IS were characterized by their retention times: 1.52 and 8.66 minutes, respectively. The accuracy of this method was 103%. A linear range was detected from 1.6 to 127.5µg/ml and CV < 5% calculated from intra and inter-essay precision results. LOD and LOQ were 1.6µg/mL and 2.4µg/mL, respectively. Cis-permethrin remained stable for 24 hours at room temperature; for 15 days at 4ºC and 30 days at -20ºC. The method was considered simple and suitable for determination of cis-permethrin in hair lotion.

Brote de sarna en un hospital terciario a partir de un caso de sarna costrosa / An outbreak of scabies in a tertiary-care hospital from a crusted scabies case

Realizamos el estudio epidemiológico de un brote de sarna ocurrido en un hospital terciario, a partir de un caso de sarna costrosa, en febrero de 2005. Detectamos diez casos secundarios; ocho en el personal de salud y dos en pacientes hospitalizados, con una tasa de ataque de 4,1 por ciento. A diferencia de otros brotes, el diagnóstico de sarna costrosa se hizo al ingreso del caso primario al hospital. Las causas del brote fueron: adherencia deficiente a las medidas de aislamiento de contacto, permanencia prolongada del caso primario en sala compartida, y retardo en el inicio del tratamiento específico. Las principales medidas de control fueron: alertar a los servicios sobre el brote, realizar vigilancia epidemiológica, coordinación con la Dirección del Hospital y el Departamento de Salud Ocupacional, capacitar al personal de salud en las medidas de control, instaurar medidas de aislamiento y tratar a los casos y sus contactos con permetrina 5 por ciento loción tópica.

In February 2005 we performed an epidemiological study of an outbreak of scabies in a tertiary-care hospital which started from a crusted scabies case. We detected 10 secondary cases, 8 in healthcare workers and 2 in hospitalized patients. The attack rate was 4.1 percent. In contrast to previously described outbreaks, the crusted scabies case was recognized at admission. The outbreak causes were: lacking adherence to contact precautions, long stay of the primary case in the hospital ward and delay of specific treatment. The main control measures were: alerting the hospital services about the outbreak, performing epidemiologic surveillance, coordinating with the Hospital Direction and the Occupational Health Department, education of healthcare workers in control measures, implementation of isolation measures and treatment of cases and contacts with 5 percent permethrin topical lotion.

Evaluación de dos Piretroides en el Control del Vector del Dengue en Putumayo, Colombia / Evaluating two pyrethroids in dengue vector control in Putumayo, Colombia

Objetivo: Evaluar la eficacia de dos insecticidas piretroides sobre Aedes aegypti, información útil en la toma de decisiones para el control de dengue. Métodos: Se evaluaron los piretroides highcis-Permetrina (Depeâ) en aplicación en ultra bajo volumen (ULV) y ß-cipermetrina en un pote fumígeno (Bolateâ) sobre A. aegypti en 16 manzanas de la cabecera municipal de Puerto Leguízamo, Putumayo, entre Julio y Diciembre del 2004. El efecto inmediato se midió en jaulas centinela colocadas en diferentes sitios de las viviendas y se realizó un seguimiento semanal evaluando las densidades de adultos y presencia de larvas. Resultados: La reducción de las densidades de adultos el día posterior a la aplicación de los insecticidas fue superior al 80 por ciento con los dos insecticidas. Se encontró un desplazamiento de los mosquitos del interior al exterior de las viviendas después de la aplicación de los insecticidas. A pesar del impacto inmediato de los insecticidas, no se observó una disminución sostenida de la densidad de adultos a lo largo de las 5 semanas de evaluación post-tratamiento, debido probablemente a la emergencia de adultos de los criaderos, los cuales no fueron tratados. Conclusión: Los insecticidas mostraron una eficacia superior al 80 por ciento en reducción de las densidades de A.aegypti y se constituyen en una alternativa para el control de Dengue.

Objective: Evaluating the efficacy of two pyrethroid insecticides on Aedes aegypti, thereby providing useful information for decision-making in controlling dengue. Methods: The effect on A. aegypti of ultra low volume (ULV) highcis-Permethrin (Depe) and ß-cypermethrin pyrethroids in a smoke-generating formulation (Bolate) was evaluated in 16 blocks in the town of Puerto Leguizamo, Putumayo, between July and December 2004. Their efficacy was measured by the mortality of mosquitoes kept in sentinel cages set in different parts of the households and weekly follow-up of the number of mosquitoes and the presence of larvae. Results: There was an 80 percent reduction in mosquito density on the day after insecticide treatment for both insecticides. Mosquitoes became displaced from inside the houses to outside them after the insecticides had been applied. In spite of the insecticides' immediate impact, a maintained reduction in mosquito density throughout the 5 weeks' evaluation was not observed, probably due to the emergence of adults from deposits which had not been treated. Conclusion These insecticides showed higher than 80 percent efficacy in reducing A. aegypti mosquito density and they constitute an alternative for dengue control.

Aerial and tidal transport of mosquito control pesticides into the Florida Keys National Marine Sanctuary

This project was undertaken as the initial monitoring program to determine if mosquito adulticides applied along the Florida Keys cause adverse ecological effects in the Florida Keys National Marine Sanctuary (FKNMS). The study monitored the distribution and persistence of two mosquito adulticides, permethrin and dibrom (naled), during three separate routine applications by the Florida Keys Mosquito Control District. The approach was to determine if toxic concentrations of the pesticides entered the FKNMS by aerial drift or tidal transport. The amount of pesticide entering the FKNMS by way of aerial drift was monitored by collection on glass fiber filter pads, set on floats in a grid pattern on either side of the FKNMS. Permethrin was recovered from filter pads on the leeward side for each of the three applications, ranging from 0.5 to 50.1 microg/m(2) throughout the study. Tidal current transport was monitored by collection of surface and subsurface water samples at each grid site. Tidal transport of naled and dichlorvos (naled degradation product) was apparent in the adjacent waters of the FKNMS. These compounds were detected in subsurface, offshore water at 0.1 to 0.6 microg/1, 14 hr after application. Permethrin was not detected in offshore water samples; however, concentrations ranging from 5.1 to 9.4 microg/l were found in surface water from the canal system adjacent to the application route. Comparison of the observed environmental concentrations with toxicity data (permethrin LC-50, 96 hr for Mysidopsis bahia = 0.02 microg/l) indicated a potential hazard to marine invertebrates in the canals with possible tidal transport to other areas

Effect of sub-lethal concentrations of permethrin on ovary activation in the predator Supputius cincticeps (Heteroptera: Pentatomidae)

Inseticidas podem causar mortalidade e efeitos deletérios em percevejos predadores. Por isso investigou-se o efeito de cinco concentrações de permetrina aplicadas em ninfas de terceiro estádio de Supputius cincticeps (Stål) (Heteroptera: Pentatomidae) em sua ativação ovariana. Essas ninfas receberam aplicação tópica de permetrina nas seguintes concentrações (mg i.a./ml): 10ù7, 10ù6, 10ù5, 10ù4, 10ù3. O comprimento dos ovários e o número de ovócitos foram quantificados após a primeira postura. O comprimento do ovário variou de 5,7 mm na concentração de 10ù4 mg i.a./ml a 6,4 mm na concentração de 10ù7 mg i.a./ml, com valores semelhantes para as outras concentrações de permetrina e controle. O número de ovócitos por fêmea variou de 13,5 (10ù3 mg i.a./ml) a 29,2 no controle, com diferenças significativas entre concentrações. O número de ovócitos por fêmea, proveniente de ninfas expostas a concentração de 10ù5 mg i.a./ml, foi semelhante àquele do controle. No entanto, o menor número de ovócitos por fêmea, provenientes de ninfas expostas a outras concentrações de permetrina, sugere que esse inseticida pode afetar a capacidade reprodutiva. Esses resultados são discutidos em relação à tolerância de Heteroptera predador aos inseticidas e a possível ocorrência de hormese.

Fertility and life expectancy of the predator Supputius cincticeps (Heteroptera: Pentatomidae) exposed to sublethal doses of permethrin

The stinkbug Supputius cincticeps (Stål) (Heteroptera: Pentatomidae) can be found in agricultural and forest ecosystems feeding primarily on larvae of Coleoptera and Lepidoptera, where it can be exposed to insecticide applications. This study therefore aimed to evaluate the reproductive potential of'S. cincticeps after exposition to sublethal doses of permethrin (5.74 x 10-3, 5.74 x 10-2, 5.74 x 10-1, 5.74 and 57.44 ppb) through the use of a fertility life table. The development cycle of this predator was determined in order to calculate its net reproductive rate (R0), the infinitesimal (rm) and finite (λ) rates of increase in addition to mean generation time (T). The net reproductive (18.31), infinitesimal (rm) (0.050) and finite (λ) (1.051) rates of increase were higher, while generation time (57.93 days) was shorter for S. cincticeps exposed to 5.74x10-1 ppb of permethrin than in the control. This indicates a higher rate of population increase of this predator when exposed to this permethrin dose.