Difteria en Venezuela: análisis de las manifestaciones clínicas y evolución de una serie de casos

Objetivo: Analizar las manifestaciones clínicas y evolución de los casos sospechosos o confirmados de Difteria en Venezuela. Materiales y Métodos: Se realizó un estudio prospectivo, observacional, descriptivo, longitudinal y multicentrico en los estados Anzoátegui, Bolívar, Carabobo, Distrito Capital, Lara, Mérida, Miranda y Zulia, se siguieron 48 pacientes sospechosos o confirmados para difteria y se describieron sus características clínicas. Resultados: 54,2 % fueron de sexo femenino, 2 de ellas embarazadas, 1 de ellas falleció. La localización más frecuente de lesiones fue la faríngea, sin embargo se observaron otras como la tonsilar, laringotraqueal, nasal y cutánea. Todos los pacientes recibieron antibióticos pero solo 32 toxina antidiftérica. Solo 11 pacientes tenían esquema vacunal completo y 18 presentaron complicaciones. El 18,8 % de la muestra falleció y el resto egresó sin secuelas. Conclusiones: El brote de difteria en Venezuela sigue activo, las cifras de pacientes afectados invitan a implementar estrategias de control a través de la inmunización de susceptibles, erradicación de portadores asintomáticos, diagnóstico temprano, reporte obligatorio, atención y manejo adecuado de los infectados.

Objective: To analize the clinical manifestations and evolution of suspected or confirmed cases of Diphtheria in Venezuela. Methods: A prospective, observational, descriptive, longitudinal and multicentric study was conducted in the Venezuelan's states of Anzoategui, Bolivar, Carabobo, Capital District, Lara, Merida, Miranda and Zulia. The time 1 of the investigation was at the hospital admission and the final time was at discharge. During the hospitalization, the follow-up was performed. Results: 48 patients were followed and all of them had suspected or confirmed Diphtheria. 45,5 % were men and 54.2 % were female, 2 of them were pregnant, and 1 of them died. The most frequent location of lesions was the pharyngeal, however other location were observed such as tonsillar, laryngotracheal, nasal and cutaneous. All patients received antibiotics but only 32 diphtheria antitoxin. Only 11 patients had a complete vaccination scheme and 18 (36 %) had complications. 18.8 % of the sample died and the rest withdrew without sequelae. Conclusions: The diphtheria outbreak in Venezuela is still active, the number of affected patients invite to implement strategies of control through the immunization of susceptibles, eradication of asymptomatic carriers, early diagnosis, mandatory reporting, care and adequate management of the infected.

[Assessment of the Mathias criteria for establishing occupational causation of contact dermatitis]. / Evaluación de los criterios de imputabilidad de dermatosis profesional definidos por Mathias.

BACKGROUND: Dermatoses account for up to 30% of occupational diseases. Of these, 90% correspond to contact dermatitis, a disease associated with a marked economic burden and considerably impaired quality of life. In 1989, Toby Mathias proposed 7 criteria to assess the relationship between contact dermatitis and occupation. OBJECTIVE: To assess the Mathias criteria for establishing occupational causation of contact dermatitis in patients with dermatoses. MATERIALS AND METHODS: This was a descriptive study of 103 patients with dermatoses, attended consecutively between January and March of 2009 in the immunology and skin allergy department of the Parc de Salut Mar, Barcelona, Spain. The diagnosis of an occupational cause of the skin complaint by a specialist after interviewing the patient was correlated with diagnosis according to the Mathias criteria, applied by an independent specialist. Descriptive and inferential statistics were calculated. RESULTS: An occupational cause was identified in 13 patients according to the Matthias criteria and in 12 according to the judgment of the dermatologist. The sensitivity for the Mathias criteria was 100% and the specificity was 98.90%, with a positive predictive value of 92.31% and a negative predictive value of 100%. The prevalence of occupational contact dermatitis was 11.65%. CONCLUSIONS: The Mathias criteria show a high validity and diagnostic yield, making them useful for establishing occupational causation of contact dermatitis. We believe that application of these criteria would help improve diagnostic and prognostic accuracy in occupational contact dermatitis.

Histopathological and Histometrical Assessment of Boron Exposure Effects on Mouse Spermatogenesis / Evaluación Histopatológica e Histométrica del Efecto en la Espermatogénesis por Exposición a Boro

Boron is a chemical element widely used in many industrial activities. Exposure to it affects many organs in mammals, mainly reproductive male organs. This work evaluates boron effect in testis. For this purpose, 12mg Boron/L of drinking water, equivalent to Arica tap water, was given for 42 days to 85 days old CFl male mice (experimental group). Another group (control group) drunk tap water of Santiago (0.6mg Boron/L) was used. Testicular histopathology and morphometric analysis was done. These studies showed that Borum induces alterations such as epithelial vacuolization, blockage of the tubular lumen and atrophy. Morphometrical data showed that Borom induces also enlargement of tubular diameter, epithelial height and tubular lumen. Therefore, it is concluded that Boron acts as testicular toxicant and that further studies are needed to establish its mechanism of action upon spermatogenesis.

El Boro es un elemento químico ampliamente usado en variadas actividades industriales. La exposición a éste afecta a varios órganos en mamíferos, principalmente órganos reproductivos. Este trabajo evaluó los efectos del Boro en testículo. Para este propósito, 12mg Boro/Ide agua potable, equivalente al agua bebestible de Arica, se administró por 42 días a ratones machos CF1 de 85 días de edad (grupo experimental). Otro grupo (grupo control) bebió agua de Santiago (0.6mg Boro/L). Se realizaron estudios histopatológicos y morfométricos del testículo. Estos estudios mostraron que el Boro induce alteraciones como vacuolización epitelial, taponamiento y atrofia del lumen testicular. Los estudios morfométricos mostraron que el Boro también induce aumento del diámetro tubular, altura del epitelio y del lumen tubular. En consecuencia, se concluye que el Boro actúa como un tóxico testicular y que futuros estudios son necesarios para establecer su mecanismo de acción sobre la espermatogénesis.

Evaluation of rapid methods for in-situ characterization of organic contaminant load and biodegradation rates in winery wastewater.

Rapid methods for the in-situ evaluation of the organic load have recently been developed and successfully implemented in municipal wastewater treatment systems. Their direct application to winery wastewater treatment is questionable due to substantial differences between municipal and winery wastewater. We critically evaluate the use of UV-VIS spectrometry, buffer capacity testing (BCT), and respirometry as rapid methods to determine organic load and biodegradation rates of winery wastewater. We tested three types of samples: actual and treated winery wastewater, synthetic winery wastewater, and samples from a biological batch reactor. Not surprisingly, respirometry gave a good estimation of biodegradation rates for substrate of different complexities, whereas UV-VIS and BCT did not provide a quantitative measure of the easily degradable sugars and ethanol, typically the main components of the COD in the influent. However, our results strongly suggest that UV-VIS and BCT can be used to identify and estimate the concentration of complex substrates in the influent and soluble microbial products (SMP) in biological reactors and their effluent. Furthermore, the integration of UV-VIS spectrometry, BCT, and mathematical modeling was able to differentiate between the two components of SMPs: substrate utilization associated products (UAP) and biomass associated products (BAP). Since the effluent COD in biologically treated wastewaters is composed primarily by SMPs, the quantitative information given by these techniques may be used for plant control and optimization.

Towards a benchmarking model for winery wastewater treatment and disposal.

We propose a benchmarking model for winery wastewater treatment systems and use it to quantitatively compare the performance of Chilean wine-making operations. The benchmarking model integrates three components: the influent characteristics, the wastewater treatment alternatives, and the location constraints. Four performance levels may be defined when plotting the available data of the wine production versus the ratio of wastewater to wine, for the French, US, and Chilean industries. Knowing where a certain system lies in this diagram helps to quantify the gap between the current and a target performance, and to set performance goals for planned expansions. The analysis of construction and operating costs of treatment systems currently in operation in Chile shows that similar compliance levels can be achieved at remarkably different costs. A steep decrease in the unitary cost is observed as wastewater flow increases; yet, the treatment alternative for achieving that cost may change. Further selection is obtained when location constraints are considered, including stringent discharge standards and proximity to urban settlements. The application of this simple benchmark model to three Chilean winery facilities shows how it produces meaningful quantitative and qualitative results. However, there is still ample room to improve this benchmarking model by considering additional complexity, including technical detail in the treatment options and costs related to technology conversion.

Análise electroforética da farinha de trigo sarraceno em comazaçao com a farinha de trigo suave / Electrophoretic analysis of meal of buckwheat in comparison with common wheat flour

A composiçao das proteínas alcool (prolaminas) obtidas das farinhas de trigo suave por dois procedimentos foram analizadas por el electroforense a pH 3,1 e, após disociaçao, na presença de dodecil sulfato de sódio a pH 8,0. Os perfis obtidos da fracâo prolamina do trigo sarraceno muito diferentes tanto qualitativamente como quantitativamente daqueles da prolamina, do trigo suave. Parece, portanto, provável que ofeitos adversos associados com alimentares contendo gliadina de trigo a pacientes celíacos seriam reduzidos e possivelmente evitados se a farinha de trigo fosse substituida pela farinha de trigo sarraceno