Una experiencia ecuatoriana en la determinación del comportamiento clínico del síndrome de fragilidad en el adulto mayor con ancylostomiasis / An Ecuadorian experience in determining the clinical behavior of frailty syndrome in the elderly with ancylostomiasis

En adultos mayores, la ancylostomiasis tiene manifestaciones básicas como pérdida del apetito y masa muscular, evacuación excesiva, debilidad y otras que hacen propenso al adulto mayor a un estado de fragilidad, un tipo de síndrome de fallo multiorgánico crónico, donde interviene la disfunción de diversos sistemas. Este agravante fundamenta el objetivo de la presente investigación, centrado en identificar el comportamiento de los criterios clínicos, funcionales, mentales y sociodemográficos en la evaluación geriátrica del síndrome de fragilidad en adultos mayores parasitados por Ancylostoma spp. en el cantón Santiago de Píllaro. La muestra resultó integrada por un total de 102 adultos mayores a 65 años. Mediante la revisión de las historias clínicas y la aplicación de una encuesta a los participantes, se evaluó el comportamiento de los criterios sociodemográficos, médicos, funcionales, mentales y de comorbilidad asociada. Los datos obtenidos fueron procesados estadísticamente mediante análisis bivariado y regresión logística múltiple. Los factores estadísticamente asociados a la fragilidad fueron el sexo femenino (p= 0,003, IC 95% ,LI= 1,564 y LS= 8,950), los bajos ingresos económicos (p= 0,011, IC 95%: LI= 1,786 y LS= 7,433), la polifarmacia (p= 0,006, IC 95%: LI= 2,452 y LS= 14,415) ), las evacuaciones frecuentes (p=0,009, con IC95%: LI=2,704 y LS=7,536) y las afecciones bucodentales (p= 0,004, IC 95%: LI= 1,895 y LS= 6,572), por lo que se justifica la elaboración de estrategias y acciones de salud que minimicen los efectos del estado de fragilidad en la población estudiada(AU)

In older adults, ancylostomiasis has basic manifestations such as loss of appetite and muscle mass, excessive evacuation, weakness and others that make the older adult prone to a state of fragility, a type of chronic multi-organ failure syndrome, where dysfunction of various systems. This aggravating factor supports the objective of the present investigation, focused on identifying the behavior of the clinical, functional, mental and sociodemographic criteria in the geriatric evaluation of frailty syndrome in elderly adults parasitized by Ancylostoma spp. in the canton Santiago de Pillaro. The sample was made up of a total of 102 adults over 65 years of age. By reviewing the medical records and applying a survey to the participants, the behavior of the sociodemographic, medical, functional, mental and associated comorbidity criteria was evaluated. The data obtained were statistically processed using bivariate analysis and multiple logistic regression. The factors statistically associated with frailty were female sex (p = 0.003, 95% CI, LI = 1.564 and LS = 8.950), low income (p = 0.011, 95% CI: LI = 1.786 and LS = 7.433) , polypharmacy (p = 0.006, 95% CI: IL = 2.452 and LS = 14.415)), frequent bowel movements (p = 0.009, with 95% CI: IL = 2.704 and LS = 7.536) and oral disorders (p = 0.004 , 95% CI: LI = 1.895 and LS = 6.572), which is why the development of health strategies and actions that minimize the effects of the state of frailty in the population studied is justified(AU)

Opilaçäo, hipoemia ou ancilostomíase? A sociologia de uma descoberta científica / Opillation, hypoemia or ancylostomiasis? The sociology of a scientific discovery

Pretende levantar algumas questões sobre as bem conhecidas descobertas das doenças de natureza parasitária pelas instituições médicas brasileiras no século XIX. As controvérsias sobre a etiologia e a patogeniab atribuídas ao tropical hypoemia - que pode ser chamado ancylostomiasis - opuseram dois grupos rivais, agindo no esteio das inovações cinetíficas, como também produzindo regras, controle e validade dos procedimentos médicos. Um grupo de médicos, liderado por Otto Wucherer, percebendo que suas hipóteses científicas estavam sendo questinadas pela Academia Imperial de Medicina, começou uma importante batalha questionando a capacidade e a autoridade da instituiçäo. Desde entäo, foi criada a imagem da Academia Imperial de Medicina que só agora começou a ser revista.(AU)

Medicina tropical en el Brasil del siglo XIX: la "Escuela Tropicalista Bahiana", 1860-1890 / Tropical Medicine in Brazil during the nineteenth century: the "Escola Tropicalista Bahiana", 1860-1890

Investigación que se refiere a un grupo de doctores de Salvador, Bahia, Brasil, que conformaron lo que se conoció como la Escola Tropicalista Bahiana que surgió en la segunda mitad del siglo XIX. Sus trabajos sobre el beriberi y la anquilostomiasis son examinados como un ejemplo de una creciente tendencia, en el Brasil del XIX, a ver las enfermedades de climas tropicales de una manera distinta de aquellas explicaciones surgidas en la templada Europa.(AU)

Seasonal influence on human enteric infection by Ancylostoma caninum.

Ancylostoma caninum, the cosmopolitan canine hookworm prevalent in domestic pets throughout northeastern Australia, has been identified as a cause of obscure abdominal pain. To investigate the influence of climate on putative and confirmed human infections, a retrospective study of patients with eosinophilic enteritis and established infections was undertaken to identify the monthly and seasonal rates. The numbers seen each month were maintained throughout most of the year but decreased in June and remained low during winter. An increased rate of enteritis occurred during spring, which preceded the wet season. It is concluded that climate directly influences the rate of human enteric infection by canine hookworms. The increase in prevalence before the monsoon season was unexpected and suggests other influences, such as extraneous infection promoted by the irrigation of domestic gardens and possibly endogenous reinfection of the gut by hypobiotic larvae.

Metabolic disposition of methyl [5-[[4-(2-pyridinyl)-1-piperazinyl] carbonyl]-1-H-benzimidazol-2-yl] carbamate in hamsters: a study to understand chemoprophylactic action against experimental Ancylostomiasis.

Methyl [5-[[4-(2-pyridinyl-1-piperazinyl] carbonyl]-1H- benzimidazol-2-yl] carbamate (CDRI Compound 81-470) exhibits a long prophylactic action against experimental ancylostomiasis, when given parenterally but not orally. To find out an explanation for such a behaviour, metabolic disposition studies were performed in hamsters using [3H] compound 81-470. Following intramuscular administration, the compound was found to form a depot at the site of injection and to remain there in substantial amount for more than 7 weeks. The compound was fairly distributed in all the organs studied and the presence of radioactivity could be easily detected up to 7 weeks of observation period. The compound was very slowly eliminated from the body and only 38% of the radioactivity could be recovered in the urine and faeces during 14 days. The oral dose, to the contrary, was poorly absorbed and more than 62.8% was excreted in the faeces within 48 hr. Consequently, this dose yielded lesser area under plasma curve. More than 95% of the oral dose was eliminated within a week and hardly and radioactivity could be detected in the tissues after day 14. In accord with this pattern, in blood also the im dose was detected up to 7 weeks while the orally given compound reached undetectable level within 6 days only. The lower clearance and prolonged stay in the body of the im dose compared to quick elimination of the oral dose may be responsible for the long chemoprophylactic action of compound 81-470 when given through im route.

Biochemical analysis of jejunal brush border membrane of golden hamster: pathogenic modulations due to ancylostomiasis.

The common hookworm (Ancylostoma ceylanicum) infection of humans was studied in golden hamsters model system. Significant biochemical modulations were observed in hamster jejunal brush border membrane (BBM), the primary site of infection. Analysis of BBM at the peak of infection (3-weeks) revealed a marked decrease in the activities of sucrase, lactase and maltase, while activities of alkaline phosphatase, (Ca2+ + Mg2+)-ATPase and gamma-glutamyl transpeptidase were increased. Kinetic studies conducted with maltase, a superficially localised enzyme of jejunal BBM, revealed loss of enzyme active site during the infection. Among other constituents, the levels of cholesterol and triglycerides were significantly decreased with slight increase in phospholipid content in the infected animals. The hookworm infection also caused a decline in total hexose content indicating an altered membrane glycocalyx. Conversely, there was significant enhancement of hydroxyproline and sialic acid contents. SDS-PAGE analysis showed an enhancement in both low and high molecular weight proteins in jejunal BBM preparations of the infected group. Gel electrophoresis of glycoproteins further revealed the appearance of two additional peaks in the low molecular weight region and concomitant disappearance of a peak in the high molecular weight region. These results strongly support the view that the hookworm infection causes severe damage not to the site of attachment alone but also to the entire cell lining of the jejunum and therefore could influence overall digestion and absorption.

Necator americanus and Ancylostoma ceylanicum: development of protocols for dual infection in hamsters.

Two-day-old baby hamsters were infected initially with the infective larvae of hamster-adapted human hookworm, Necator americanus (NaL3). After a specified period they were again infected orally with infective larvae of Ancylostoma ceylanicum (AcL3). Three weeks after the second infection they were killed and the establishment of N. americanus and A. ceylanicum was assessed. The effect of different infection levels and exposure period of N. americanus on the concurrent establishment of A. ceylanicum was also examined. An infection with 50 NaL3 percutaneously, and 3 weeks later, a second infection with 50 AcL3 orally has produced reasonably equal number of hookworms (no statistical difference in the burden of N. americanus and A. ceylanicum) in the intestine of hamsters. Thus this protocol of dual infection was found suitable to develop two species of hookworms in hamsters for anthelmintic screening.