Environmental effects on phlebotominae sand flies (Diptera:Phychodidae) and implications for sand fly vector disease transmission in Corrientes city, northern Argentina.

We evaluated species richness, abundance, alpha diversity, and true diversity of Phlebotominae sand flies temporal changes in domiciles within the northern Argentina city of Corrientes. A total of 16 sampling nights were conducted seasonally throughout the years 2012-2014 through light traps supplemented with CO2. Meteorological and remote sensing environmental factors were used to assessed for vectors implications in disease transmission through Generalized Mixt Models. Lutzomyia longipalpis was the most abundant and common species, followed by Nyssomyia neivai and Migonemyia migonei. Lutzomyia longipalpis was more abundant in urban areas, Ny. neivai was associated with vegetation in periurban areas, both were found all sampling years with higher abundance during the rainy season. Positive association of Lu. longipalpis with precipitation and relative humidity and negative association with temperature were observed. Models showed humidity and vegetation as making effects on Lu. longipalpis abundance. Precipitation was significant for Mg. migonei models, with higher abundance in periurban and periurban-rural environments. For Ny. neivai models, relative humidity was the most important variable, followed by precipitation frequency. Our findings led to identify high risk areas and develop predictive models. These are useful for public health stakeholders giving tolls to optimized resources aim to prevent leshmaniasis transmission on the area.

Disfunción sexual en mujeres con lupus eritematoso sistémico / Sexual dysfunction in women with systemic lupus erythematosus

Introducción: la disfunción sexual (DS) es la alteración en una o varias de las fases de la actividad sexual. Puede culminar en frustración, dolor y disminución de la frecuencia de las relaciones sexuales. Objetivos: determinar la frecuencia de DS y analizar los factores asociados en pacientes con lupus eritematoso sistémico (LES). Materiales y métodos: se realizó un estudio de corte transversal. Se incluyeron pacientes femeninas con LES, entre 18 y 50 años, se excluyeron aquellas con síndrome de Sjögren, menopausia, depresión severa y analfabetas. Se evaluaron variables demográficas y de la enfermedad. Se aplicó la escala Depression Anxiety Stress Scale (DASS-21) y el Índice de Función Sexual Femenina (Female Sexual Function Index, FSFI). Se comparó con un grupo control sano. Resultados: se evaluaron 60 mujeres con LES y 63 controles. La prevalencia de DS en LES fue de 71,7% y hubo diferencias significativas en todos los dominios de la función sexual. El score total del FSFI en pacientes con LES fue menor al comparar con los controles. Según la escala DASS-21, estrés, ansiedad y depresión se observaron en al menos la mitad de mujeres lúpicas, sin embargo, no se encontró asociación entre estas variables y DS. Conclusiones: la prevalencia de DS en pacientes con LES fue elevada. Depresión, ansiedad y estrés no fueron determinantes en la presencia de DS.

Introduction: sexual dysfunction is the alteration in one or several phases of sexual activity. It can culminate in frustration, pain and a decrease in the frequency of sexual intercourse. Objectives: determine the frequency of sexual dysfunction and analyze associated factors in patients with SLE. Materials and methods: a descriptive cross-sectional study was conducted. We included patients with SLE, between 18 and 50 years of age, Secondary Sjogren's syndrome, menopause, severe depression and illiterate patients were excluded. Demographic and disease-related variables were studied. The Depression Anxiety Stress Scale (DASS-21), and the Female Sexual Function Index (FSFI) were applied. Results: sixty women with SLE and 63 controls were evaluated. The prevalence of SD in SLE was 71.7% and there were significant differences in all domains of sexual function. The total FSFI score in patients with SLE was lower when compared to controls. According to the DASS-21 scale, stress, anxiety and depression were observed in at least half of lupus women, however no association was found between these variables and SD. Conclusions: the prevalence of SD in patients with SLE was high. Depression, Anxiety, and Stress were not determinants in the presence of SD.

Prevalence and incidence of systemic lupus erythematosus in Tucumán, Argentina.

The aim of this study was to determine the prevalence and incidence of Systemic Lupus Erythematosus (SLE) in Tucumán, Argentina. METHODS: The study included inpatient and outpatient charts from four public hospitals and private practice rheumatology clinics, all of them members of the Tucumán Rheumatology Society. Patients older than 16 years with diagnosis of SLE between January 2005 and December 2012 were included. Prevalence and annual incidence were calculated as the number of cases per 100.000 inhabitants during the period 2005 to 2012. RESULTS: Three hundred fifty-three patients were identified. The mean age at diagnosis was 30.5 ± 11.7 years, 93.5% women, 83% mestizos. Prevalence was 24.3 cases/100.000 inhabitants (CI 95% 22.6-28.8) and age-adjusted (≥16 years) of 34.9 cases/100.000 inhabitants (CI 95% 32.8-41.1). The annual incidence in 2005 was 1.8 cases/100.000 inhabitants (95% CI 1-2.9) and 2012 of 4.2 cases/100.000 inhabitants (95% CI 2.9-5.8). Mortality was 9.1%, with infections being the most frequent cause (14/32). CONCLUSION: The prevalence of SLE in the province of Tucumán was 34.9 cases/100.000 inhabitants.

Características clínico - imagenológicas de los tumores de tallo encefálico en la infancia / Clinical - Imaging Description of Brainstem Tumors in the Childhood

Introducción: los tumores del tronco cerebral suponen el 10-25% de los tumores del sistema nervioso en el niño y del 20% al 25% de los tumores infratentoriales. Objetivo: caracterizar los hallazgos clínicos-imagenológicos en pacientes con tumores del tallo encefálico. Método: se realizó un estudio de serie de casos en niños con el diagnóstico de tumor de tallo encefálico en el Hospital Pediátrico Octavio de la Concepción y de la Pedraja de la ciudad de Holguín, en un período de 12 años comprendidos entre enero 2004 a diciembre de 2016. La muestra se conformó por los 12 pacientes diagnosticados con la enfermedad. Resultados: existió un predominio del sexo femenino en el grupo etario de 0 - 5 años para el 58,3%. La cefalea constituyó el síntoma predominante y al examen físico la parálisis de pares craneales fue el hallazgo predominante. Existió un laxo de tiempo de dos meses aproximadamente entre el inicio de la enfermedad y el diagnóstico médico en el 81,2% de los pacientes. La localización difusa del tumor en el tallo encefálico predominó sobre la distribución focal en el 66,6% con epicentro en el puente encefálico. La opción terapéutica de elección estuvo basada en la radioterapia, quimioterapia y terapia monoclonal Hr3 en la totalidad de los tumores difusos de tallo encefálico. Conclusiones: la resonancia magnética constituye la técnica imagenológica de elección para clasificar los pacientes con tumores de tallo en focales o difusos.

Introduction: brainstem tumors represents about 10 to 25% of the tumors of the nervous system in the child and 20% to 25% of infratentorial tumors. Objective: to describe the clinical-imaging findings in patients with brain stem tumors. Method: a retrospective study was done in children with the diagnosis of brainsteam tumor from the Octavio de la Concepción y de la Pedraja Pediatric Teaching Hospital; Cuba from January 2004 to December 2016. Results: there was a predominance of females in the age group between 0 - 5 years forl 58.3%. The commonest symptoms occurring at any time were headache (25%) and the patsy of cranial nervous was the neurological signs present at diagnosis. The median symptom interval was two months between onset of symptoms and diagnosis in 81.2% of patients. The diffuse location of the tumor in the brainstem predominated over the focal distribution in 66.6% with epicenter in the encephalic bridge. The therapeutic option of choice was based on radiotherapy, chemotherapy and monoclonal therapy Hr3 in all diffuse brain stem tumors Conclusion: magnetic resonance examination is the most suitable imaging technique in the brainsteam` tumors study.

Culicidae (Diptera) community structure, spatial and temporal distribution in three environments of the province of Chaco, Argentina.

The aim of this work was to study the composition of the Culicidae community in three environments with different degrees of anthropic disturbance in the province of Chaco. The nonparametric richness estimator ACE was calculated to measure the completeness of the sampling in each environment, and the diversity of each environment (α-diversity) were estimated. The composition, abundance and uniformity of species from the different environments were compared by means of range-species curves. ß-diversity was measured as species complementarity, which allowed us to know the degree of dissimilarity among the environments. The synanthropic index was estimated, identifying urban environment (synanthropic) species, eusynanthropic species, and wild species. The influence of climatic factors (mean temperature, relative humidity and rainfall) on the monthly and annual variations of the identified mosquito species was analysed using multilevel Poisson models with over-dispersion. The wild environment showed higher diversity and the semi-urban environment higher species richness. Despite having lower S and abundance, the urban environment showed greater diversity than semi-urban environment, although it also showed lower completeness, which means S could increase. Anthropogenic disturbance can lead to the elimination and/or modification or substitution of habitats, with the subsequent loss of richness in the more sensitive species of Culicidae fauna, although the conditions are also favourable for the settling of opportunistic and exotic species well-adjusted to disturbed environments. Most of the species abundances were positively influenced by the analysed climatic variables. The study area showed a rich Culicidae fauna of public health significance, with a risk of pathogen transmission, suggesting the need of further studies and the febrile and entomological surveillance.

Satellite-derived NDVI, LST, and climatic factors driving the distribution and abundance of Anopheles mosquitoes in a former malarious area in northwest Argentina.

Distribution and abundance of disease vectors are directly related to climatic conditions and environmental changes. Remote sensing data have been used for monitoring environmental conditions influencing spatial patterns of vector-borne diseases. The aim of this study was to analyze the effect of the Normalized Difference Vegetation Index (NDVI) and Land Surface Temperature (LST) obtained from the Moderate Resolution Imaging Spectroradiometer (MODIS), and climatic factors (temperature, humidity, wind velocity, and accumulated rainfall) on the distribution and abundance of Anopheles species in northwestern Argentina using Poisson regression analyses. Samples were collected from December, 2001 to December, 2005 at three localities, Aguas Blancas, El Oculto and San Ramón de la Nueva Orán. We collected 11,206 adult Anopheles species, with the major abundance observed at El Oculto (59.11%), followed by Aguas Blancas (22.10%) and San Ramón de la Nueva Orán (18.79%). Anopheles pseudopunctipennis was the most abundant species at El Oculto, Anopheles argyritarsis predominated in Aguas Blancas, and Anopheles strodei in San Ramón de la Nueva Orán. Samples were collected throughout the sampling period, with the highest peaks during the spring seasons. LST and mean temperature appear to be the most important variables determining the distribution patterns and major abundance of An. pseudopunctipennis and An. argyritarsis within malarious areas.

The efficacy of a combined larvicide-adulticide in ultralow volume and fumigant canister formulations in controlling the dengue vector Aedes aegypti (Diptera: Culicidae) in Northwest of Argentina.

The efficacy of an ultralow volume formulation (ULV) and fumigant canister, containing both permethrin and pyriproxyfen, was compared with that of standard permethrin applications in a field assay conducted in Banda del Río Salí, Tucumán (north-western Argentina). Five treatment areas were established: first area was sprayed with a ULV formulation of 10 % permethrin, a second area was treated using a fumigant canister containing 10 % permethrin and 3 % pyriproxyfen, the third area was sprayed with a ULV formulation of 10 % permethrin and 3 % pyriproxyfen, the fourth area with ULV formulation of 10 % permethrin using a portable aerosol generator and the fifth area was a left untreated area. Immature and adult Aedes aegypti individuals placed in containers and sentinel cages were positioned within the treated and control areas. The effects of treatment and time on larval, pupal and adult survival were tested. We also investigated the effects of treatment and time on the numbers of larval and pupal deaths, on the proportion of larvae that metamorphosed into pupae and adults, and on the proportion of dead adults. Larval A. aegypti survivorship in 250 mL containers revealed a significant treatment effect and significant treatment × time interaction 2 and 24 h after the application of the ULV treatment with 10 % permethrin using the portable aerosol generator. The number of dead larvae in 20 L containers differed significantly by treatment and by time. ULV treatment with 10 % permethrin and 10 % permethrin plus 3 % pyriproxyfen using the cold fogger truck mount ULV resulted in the greatest numbers of dead larvae; most larvae died 2 weeks after application. Adult A. aegypti mortality in all treatments did not differ significantly 2 and 24 h after application. In addition, we found no significant differences in adult mortality between cages exposed at 3 m and those at 6 m from the ULV application line. However, there was a significant difference in adult mortality between the 10 % permethrin treatment applied with cold fogger truck mount ULV and that applied using the portable aerosol generator (P < 0.001). The larval index known as Breteau index (BI) was higher before treatment than after treatment in different areas. After the treatments, the lowest value of BI was observed in the area treated with the fumigant canister formulation, and a long-lasting effect was observed with the formulation of 10 % permethrin and 3 % pyriproxyfen.

The spatio-temporal distribution patterns of biting midges of the genus Culicoides in Salta province, Argentina.

The goal of this survey was to analyze the spatio-temporal distribution patterns of Culicoides Latreille species (Diptera: Ceratopogonidae) and their relationship with environmental variables in Salta, northwestern Argentina. Culicoides were collected monthly from January 2003 through December 2005. The influence of the climatic variables on population abundance was analyzed with a multilevel Poisson regression. A total of 918 specimens belonging to five species were collected. The most abundant species was Culicoides paraensis Goeldi (65.5%), followed by Culicoides lahillei Iches (14.6%) and Culicoides debilipalpis Lutz (7.6%). The highest seasonal abundance for C. paraensis, C. debilipalpis and C. lahillei occurred during the spring and summer. A Poisson regression analysis showed that the mean maximum and minimum temperature and the mean maximum and minimum humidity were the variables with the greatest influence on the population abundance of Culicoides species.

Abundance patterns of Anopheles pseudopunctipennis and Anopheles argyritarsis in northwestern Argentina.

Anopheles pseudopunctipennis is an important malaria vector in Argentina but the role of Anopheles argyritarsis in the transmission of the parasite is still unknown. Abundance patterns of both species and their relationship to climatic variables were studied in the subtropical mountainous forest in northwestern Argentina. Adults were collected with CDC light traps from September 2002 to November 2005 in Salta (northern area) and Tucumán (southern area) provinces, from 3 localities in each province. The abundance of both species in localities was compared using the Kruskal-Wallis test, and their changes in abundance in relation to climatic variables were analyzed by Multilevel Poisson Regression. Anopheles argyritarsis was more abundant than A. pseudopunctipennis, and both reached a peak during the spring. There were significant differences in abundance in the northern localities for A. pseudopunctipennis, and between northern and southern localities for A. argyritarsis. Temperature, rainfall and relative humidity were significant predictors of the abundance of these two species.

Malaria transmission in two localities in north-western Argentina.

BACKGROUND: Malaria is one of the most important tropical diseases that affects people globally. The influence of environmental conditions in the patterns of temporal distribution of malaria vectors and the disease has been studied in different countries. In the present study, ecological aspects of the malaria vector Anopheles (Anopheles) pseudopunctipennis and their relationship with climatic variables, as well as the seasonality of malaria cases, were studied in two localities, El Oculto and Aguas Blancas, in north-western Argentina. METHODS: The fluctuation of An. pseudopunctipennis and the malaria cases distribution was analysed with Random Effect Poisson Regression. This analysis takes into account the effect of each climatic variable on the abundance of both vector and malaria cases, giving as results predicted values named Incidence Rate Radio. RESULTS: The number of specimens collected in El Oculto and Aguas Blancas was 4224 (88.07%) and 572 (11.93%), respectively. In El Oculto no marked seasonality was found, different from Aguas Blancas, where high abundance was detected at the end of spring and the beginning of summer. The maximum mean temperature affected the An. pseudopunctipennis fluctuation in El Oculto and Aguas Blancas. When considering the relationship between the number of malaria cases and the climatic variables in El Oculto, maximum mean temperature and accumulated rainfall were significant, in contrast with Aguas Blancas, where mean temperature and humidity showed a closer relationship to the fluctuation in the disease. CONCLUSION: The temporal distribution patterns of An. pseudopunctipennis vary in both localities, but spring appears as the season with better conditions for mosquito development. Maximum mean temperature was the most important variable in both localities. Malaria cases were influenced by the maximum mean temperature in El Oculto, while the mean temperature and humidity were significant in Aguas Blancas. In Aguas Blancas peaks of mosquito abundance and three months later, peaks of malaria cases were observed. The study reported here will help to increase knowledge about not only vectors and malaria seasonality but also their relationships with the climatic variables that influence their appearances and abundances.

Validez del examen visual en el diagnóstico de caries oclusales incipientes / Validity of visual examination in incipient occlusal caries diagnosis

El objetivo de este trabajo fue determinar la validez del examen visual (EV) como método de diagnólstico de caries oclusales incipientes en premolares y molares humanos permanentes, utilizando como "gold standard" los cortes histolólgicos de las piezas dentarias examinadas ex situ. Se utilizaron 21 unidades experimentales (UE), ex situ, premolares y molares permanentes, extraídas por razones ortodónticas y quirúrgicas. Fueron lavados con agua y brochita en micromotor, y secadas con chorro de aire para realizar el EV sin magnificación, según dos posibilidades: sano o caries. Se realizaron cortes longitudinales, procesados para M. óptica, para determinar el diagnóstico histopatológico y profundidad de la lesión. Al EV, el 57 por ciento (n=12) estaba sano y el 43 por ciento (n=9) presentaba caries. La comprobación histológica determinó que el 29 por ciento (n=6) estaba sano y el 71 por ciento (n=15) tenía caries. En los 15 cortes con caries, el 80 por ciento alcanzó esmalte, el 13 por ciento llegó hasta la conexión amelodentinaria (CAD) y el 7 por ciento hasta dentina. El test de concordancia de Kappa fue de 0,46 IC 95 por ciento=(0,10-0,82), con una sensibilidad del 60 por ciento y especificidad del 100 por ciento. Existe una concordancia "buena" entre el examen visual y el examen histopatológico. El porcentaje de decisiones correctas, verdaderos positivos y negatrivos, fue elevado

Correlación entre patrón respiratorio y morfología cráneo-facial / Correlation between respiratory pattern and cranio-facial morphology

lntroducción - El crecimiento posnatal de ciertas estructuras cráneo-faciales está asociado aI desarrollo de Ias funciones vitales: respiración y deglución. El objetivo de este estudio fue comparar Ia morfología cráneo-cervical de dos grupos de pacientes, uno con respiración normal y otro formado por respiradores bucales. Además, relacionar el patrón respiratorio con Ias anomalias morfológicas y Ias de maloclusión, encontradas. Método - Un total de 105 ninos de entre 8 y 12 afios, de ambos sexos, fueron incluidos en este estudio. De ellos, cincuenta y dos respiradores bucales y cincuenta y tres sin trastomos en Ia función respiratoria. Se utilizaron teleradiografias de perfil, Ias que fueron analizadas aI azar por dos profesionales calibrados. Las medidas estudiadas fueron: Posición deI hueso Hioides, Profundidad cráneo-vertebral anterior, Profundidad cráneo-maxilar posterior, ángulo 6 de Handelman, Ángulo formado por los planos palatino y mandibular con respecto a Ia apófisis Odontoides, Ángulo base de cráneo y Ángulo Plano Palatino-Plano de Frankfort. Resultados - El análisis de los resultados con el test t revela que existe diferencia significativa entre respiradores bucales y respiradores nasales respecto de: Posición deI Hioides (p=0,016), Profundidad cráneo-cervical anterior (P=0,035), y ángulo PP-B.Cráneo (p=0,0000). Conclusión - No se encontró asociación entre patrón respiratorio y maloclusión (clasificación de Angle) (p=0,98); ni entre patrón respiratorio y sexo (p=0,23). En este estudio se encontró relación entre el patrón respiratorio anormal y algunas alteraciones en Ia morfología cráneo-cervical

Prevalence of rheumatoid arthritis in Tucumán, Argentina.

OBJECTIVE: To ascertain the prevalence of rheumatoid arthritis (RA) in Tucumán, Argentina. METHODS: The study was conducted between January 1, 1998, and December 31, 1999, in Tucumán province in northwest Argentina. Outpatient and hospitalization medical records for all patients with RA aged > or = 16 years were reviewed. Diagnosis was by 1987 American College of Rheumatology (ACR) criteria for RA and the population data were based on the 1991 national census. Prevalence rates, with 95% CI, were calculated using the number of San Miguel de Tucumán residents who fulfilled the 1987 ACR criteria for RA as numerator, and the city population aged > or = 16 as denominator. Crude and age-specific prevalence rates were calculated as number of cases/1,000 inhabitants. RESULTS: We identified 695 cases of RA. Sex-specific and overall prevalence rates (per 1,000) were 1.97 (95% CI 1.8-2) for all, 0.6 (95% CI 0.49-0.73) for men, 3.2 (95% CI 2.9-3.5) for women. CONCLUSION: Prevalence of RA is low in residents of Tucumán, Argentina, and comparable with rates observed in epidemiological surveys from Southern European countries.

Cambios de la colesterolemia a los cinco años en una población adulta: evidencias a favor de una hipercolesterolemia secundaria al climaterio / Cholesterol serum value changes in an adult population at five years: evidence favoring the concept of a climateric secondary hypercholesterolemia

Antecedentes : en estudios epidemiológicos de corte transversal, la colesterolemia después de los 50 aumenta en el sexo femenino pero no en el masculino. Es posible que los hombres sanos de grupos etarios superiores representen a los de un riesgo lipídico bajo y puede ser erróneo concluir en base a esta información acerca de un incremento climatérico del riesgo lipídico. El objetivo de este estudio es demostrar la existencia de una hipercolesterolemia secundaria al período climatérico. Material y método : se analizaron Historias Clínicas de sanos o enfermos por afecciones no vinculadas a la colesterolemia, con dos determinaciones bioquímicas, sin tratamiento con drogas hipolipemiantes en los dos meses previos y mujeres sin hormonoterapia anticonceptiva o de reemplazo. A los fines de establecer la presencia de un cambio significativo (p<.01) en los valores, se aplicó un ANOVA de medidas repititivas. Resultados : de 1903 Historias Clínicas se seleccionaron las de 83 mujeres y 41 hombres. En los hombres se produce una disminución significativa de los valores de la colesterolemia en el período estudiado, similar en todos los grupos de edad. El cambio en el sexo femenino es diferente para cada grupo etario : en el de 40-49 hay un aumento, en el de 60-75 una disminución y en los de 50-59 y 60-69 no varían. Conclusiones : estos resultados avalan el concepto de una hipercolesterolemia secundaria al climaterio.

Estudio de incidencia de infección de herida quirúrgica limpia en el Hospital Centro de Salud "Zenon Santillan" / Study about prevalence of clean surgical wound infection at the \"Zenon Santillan\" health care

Se estudiaron 99 pacientes sometidos a intervenciones quirúrgicas limpias en el período enero-diciembre de 1989 con el fin de determinar el nvel endémico de infecciones en este tipo de cirugía. El seguimiento de los pacientes fue diario en el período pre-quirurgico y en el postquirúrgico, hasta los 21 dias del acto operatorio, registrando edad, días de internación previa, preparación prequirúrgica; lavado de manos, vestimentas, número de personas y circulación dentro de quirófano. Se registró un 4% de incidencia de infección de herida quirúrgica. La evaluación de las medidas de prevención de infecciones quirúrgicas reveló falta de cumplimiento en la mayoria de los casos analizados. Concluímos que el nivel registrado de infección de herida quirúrgica determina la necesidad de instaurar las medidas de control adecuadas para disminuir dicho registro