[Hansen's disease. Case report of tuberculoid leprosy in Chile]. / Enfermedad de Hansen. Comunicación de un caso de lepra tuberculoide en Chile.

Hansen's disease or leprosy is a chronic infectious disease caused by Mycobacterium leprae, mainly affecting the skin and peripheral nerves. In recent years, a better control of the disease has been achieved globally. However, in Chile the incidence of leprosy has continued to increase. We present a case of a 40-year-old patient Haitian nationality with lesions and histopathology compatible with tuberculoid leprosy. We discuss the importance of education on less prevalent diseases in Chile, in conjunction with a review of the pathophysiology, clinic, and classification of Hansen's disease.

Enfermedad de Hansen: comunicación de un caso de lepra tuberculoide en Chile / Hansen's disease: case report of tuberculoid leprosy in Chile

Resumen La enfermedad de Hansen o lepra es una enfermedad infecciosa crónica causada por Mycobacterium leprae, y que afecta principalmente la piel y nervios periféricos. En los últimos años, se ha logrado un mejor control de la enfermedad en forma global. Sin embargo, en Chile la incidencia de la lepra ha ido en aumento. Presentamos el caso clínico de un paciente de 40 años, haitiano, con lesiones e histopatología compatibles con una lepra tuberculoide. Se discute la importancia en la educación sobre enfermedades menos prevalentes en Chile y se hace una revisión sobre la fisiopatología, clínica y clasificación de la enfermedad de Hansen.

Abstract Hansen's disease or leprosy is a chronic infectious disease caused by Mycobacterium leprae, mainly affecting the skin and peripheral nerves. In recent years, a better control of the disease has been achieved globally. However, in Chile the incidence of leprosy has continued to increase. We present a case of a 40-year-old patient Haitian nationality with lesions and histopathology compatible with tuberculoid leprosy. We discuss the importance of education on less prevalent diseases in Chile, in conjunction with a review of the pathophysiology, clinic, and classification of Hansen's disease.

Phenolics from the Bolivian highlands food plant Ombrophytum subterraneum (Aspl.) B. Hansen (Balanophoraceae): Antioxidant and α-glucosidase inhibitory activity.

The Balanophoraceae Ombrophytum subterraneum is an endemic highland food plant occurring in Bolivia, northern Argentina and Chile. The upper part of this parasitic plant is eaten fresh. The aim of this work was to characterize the compounds occurring in the edible part and to assess any differences between the inflorescence and tuber. Ethanol extracts of the different plant parts were analyzed for antioxidant activity by the ORAC, TEAC, FRAP, CUPRAC and DPPH methods as well as for the effect on enzymes related to metabolic syndrome (α-amylase, α-glucosidase and pancreatic lipase). The main constituents were isolated by a combination of gel permeation in Sephadex LH-20 and countercurrent chromatography (CCC). Five compounds were isolated and fully identified by spectroscopic and spectrometric means. The new 3',5,5',7-tetrahydroxyflavanone 7-O-ß-D-1 â†’ 6 diglucoside was isolated for the first time. HPLC-ESI-MS/MS analysis allowed the identification of 19 compounds, including flavanones, flavanols, flavonols, dehydroflavonols and lignans, mainly as glycosides. A strong inhibition towards α-glucosidase was observed for the edible parts (IC50: 1.46 µg/mL) as well as for the tuber and inflorescence (IC50: 1.56 µg/mL and 0.87 µg/mL, respectively). A significant correlation was established between the total phenolic and the antioxidant capacity of the extracts as well as with the content of the new flavanone diglucoside. This is the first comprehensive report on the naturally occurring antioxidants and enzyme inhibitors from this native highland food resource.

[Impact on social networks after announcement of a case of Hansen's disease in an immigrant in Chile]. / Impacto en las redes sociales ante aviso de un caso de enfermedad de Hansen en un inmigrante Chile.

BACKGROUND: Hansen's disease (HD) is a curable disease of low transmissibility which doesn't need social segregation or public notice. The announcement of a HD case in an immigrant by a governmental medical employee allowed to evaluate its impact within social networks (SN) in Chile, a country without endemic cases. AIM: To measure the impact and tone of mentions within SN after the announcement of an imported case. METHODS: Mention analysis from -21 to +21 days of the notice using commercial software. Mentions were assigned to a positive, neutral or negative tone and net feeling calculated according to established formula. RESULTS: The day of the announcement immigrant mentions concentrated on HD (45%) and tone was distributed almost equally between positive and negative mentions but net feeling analysis indicated predominance of negative values the first day and a dynamic oscillation thereafter. A net negative feeling was registered at least during 3 different dates. CONCLUSIONS: Announcement of a HD case hoarded immigrant mentions towards this disease with a significant fraction of negative comments within SN. Because, there is no public health justification to divulgate this disease, this negative impact generated by an official clerk, could has been avoided. Analysis of SN is a useful tool to explore an infectious disease impact on public opinion.

Impacto en las redes sociales ante aviso de un caso de enfermedad de Hansen en un inmigrante Chile / Impact on social networks after announcement of a case of Hansen's disease in an immigrant in Chile

Resumen Introducción: La enfermedad de Hansen (EH) es una enfermedad curable, poco transmisible, sin necesidad de segregación ni aviso público. La divulgación de un caso de EH en un inmigrante por un funcionario público, permitió medir su impacto en redes sociales (RS) en Chile, un país sin casos endémicos. Objetivo: Medir el impacto y tono de las menciones en RS en Chile que tuvo la divulgación de un caso importado. Métodos: Estudio desde −21 a +21 días de la noticia, con análisis de menciones en RS en Chile a través de un programa computacional. Asignación del tono de las menciones en tres categorías: positiva (Pos), neutra (N) o negativa (Neg) y cálculo de sentimiento neto (SN). Resultados: El día de la divulgación, las menciones sobre migrantes se concentraron en la EH (45%) y el tono mostró una distribución casi equitativa entre tonos Pos y Neg. Sin embargo, predominó el SN negativo el primer día y luego osciló dinámicamente mostrando valores negativos en al menos tres fechas diferentes. Conclusiones: La divulgación de un caso de EH en un inmigrante en Chile acaparó los comentarios sobre migrantes hacia esta enfermedad, observándose una fracción relevante de comentarios de tono negativo en las RS. Debido a que no hay una justificación sanitaria para divulgar la EH, el impacto negativo pudo haberse evitado. El análisis de las RS es una herramienta útil para conocer el impacto de las enfermedades infecciosas en la opinión pública.

Background: Hansen's disease (HD) is a curable disease of low transmissibility which doesn't need social segregation or public notice. The announcement of a HD case in an immigrant by a governmental medical employee allowed to evaluate its impact within social networks (SN) in Chile, a country without endemic cases. Aim: To measure the impact and tone of mentions within SN after the announcement of an imported case. Methods: Mention analysis from −21 to +21 days of the notice using commercial software. Mentions were assigned to a positive, neutral or negative tone and net feeling calculated according to established formula. Results: The day of the announcement immigrant mentions concentrated on HD (45%) and tone was distributed almost equally between positive and negative mentions but net feeling analysis indicated predominance of negative values the first day and a dynamic oscillation thereafter. A net negative feeling was registered at least during 3 different dates. Conclusions: Announcement of a HD case hoarded immigrant mentions towards this disease with a significant fraction of negative comments within SN. Because, there is no public health justification to divulgate this disease, this negative impact generated by an official clerk, could has been avoided. Analysis of SN is a useful tool to explore an infectious disease impact on public opinion.

Saccharomyces eubayanus and Saccharomyces uvarum associated with the fermentation of Araucaria araucana seeds in Patagonia.

Mudai is a traditional fermented beverage, made from the seeds of the Araucaria araucana tree by Mapuche communities. The main goal of the present study was to identify and characterize the yeast microbiota responsible of Mudai fermentation as well as from A. araucana seeds and bark from different locations in Northern Patagonia. Only Hanseniaspora uvarum and a commercial bakery strain of Saccharomyces cerevisiae were isolated from Mudai and all Saccharomyces isolates recovered from A. araucana seed and bark samples belonged to the cryotolerant species Saccharomyces eubayanus and Saccharomyces uvarum. These two species were already reported in Nothofagus trees from Patagonia; however, this is the first time that they were isolated from A. araucana, which extends their ecological distribution. The presence of these species in A. araucana seeds and bark samples, led us to postulate a potential role for them as the original yeasts responsible for the elaboration of Mudai before the introduction of commercial S. cerevisiae cultures. The molecular and genetic characterization of the S. uvarum and S. eubayanus isolates and their comparison with European S. uvarum strains and S. eubayanus hybrids (S. bayanus and S. pastorianus), allowed their ecology and evolution us to be examined.

Luis Prunés Risetti: un gran maestro de la dermatología chilena: su biografía y archivo fotográfico / Luis Prunés Risetti: a great master of Chilean dermatology: his biography and photo archive

El doctor Luis Prunés fue uno de los grandes maestros de la dermatología chilena. Se formó como dermatólogo en el hospital Saint-Louis en París. En la década 1920 ingresó al Hospital San Luis de Santiago y en 1938 asumió como profesor titular de la cátedra “Clínica Universitaria de Piel y Sífilis” del Hospital San Vicente de Paul. En 1938 fue el primer presidente de la Sociedad Chilena de Dermato-sifilología. Fue un gran investigador de patologías cutáneas; estudió principalmente la lepra y las lesiones cutáneas asociadas a minerales. Es recordado por preconizar la importancia de la biopsia cutánea. Jubiló en 1954 dejándonos un importante legado dermatológico. El Dr. Prunés recopiló sus mejores casos en más de 20archivos fotográficos, los cuales se encuentran en la biblioteca del Departamento de Dermatología del Hospital Clínico de la Universidad de Chile. El objetivo de este trabajo es presentar parte de su archivo fotográfico, mostrando imágenes impresionantes de tumores cutáneos y lesiones cutáneas inducidas por arsénico.

Dr. Luis Prunés is one of the masters of the Chilean dermatology. He was trained as dermatologist at the Saint-Louis hospital in Paris. Since 1920 he worked as dermatologist at the San Luis Hospital in Santiago and in 1938 he took over as Professor and Chairman of the “University Clinic of Skin and Syphilis” at San Vicente de Paul Hospital. In 1938, he was the first president of the Chilean Society of Dermatology. He studied leprosy and skin lesions associated with minerals. He is also remembered for advocating the importance of skin biopsy. He retired in 1954, leaving an important legacy. Dr. Prunés compiled his best clinical cases in more than 20 photographic archives, which are located at the Library of the Dermatology Department in the University of Chile Clinical Hospital. The purpose of this paper is to present part of his photographic archive, showing stunning images of large cutaneous tumors and arsenic-induced skin lesions.

Historia del Hospital Hanga Roa / History of the Hospital Hanga Roa

En el año 1917, se obtienen los primeros fondos para la construcción de un primer establecimiento destinado a recibir a los enfermos, específicamente a los que han contraído la lepra en el “Lazareto de Leprosos”, que será administrado por el Obispo por encargo del Presidente de la República de la época. Esta administración obedece a que los misioneros católicos llevaban operando en Rapa Nui desde mediados de la década de 1860. La introducción de la Lepra a la Isla, se debió a un nativo que la había contraído en Tahití, como tantos otros que habían sido llevados a trabajar a esa zona.En 1936 la Armada de Chile comienza a asumir un rol más activo con respecto a la “Compañía Exploradora Williamson & Balfour” exigiéndole respetar la mejora del Leprosario, la construcción de la primera posta médica y la inversión de medicamentos para la población de la Isla de Pascua.

The result patterns of ML Flow and ELISA (PGL-I) serologic tests in leprosy-endemic and non-endemic areas.

ML Flow and anti-PGL-I ELISA are serological tests that detect IgM antibodies against the phenolic glycolipid I (PGL-I), specific to Mycobacterium leprae. To evaluate the outcomes of ML Flow and ELISA (PGL-I) serological tests in leprosy-endemic areas in comparison to non-endemic ones, a total of 351 volunteers from Brazil and Chile were examined, including leprosy patients, healthy controls and others affected by other infectious or non-infectious diseases that are common differential diagnoses for leprosy. The ELISA cut-off point was established using the ROC Curve method (>or= 0.157). In endemic areas, 70% of leprosy patients present positive ML Flow results and 53.3% were ELISA-positive. In non-endemic areas, ML Flow was negative in all the subjects tested and ELISA was positive in 4 volunteers. ML Flow is faster and more easily performed and, therefore, a more adequate test for use in basic, primary-level health care centers. ELISA requires trained personnel, in addition to a more complex laboratory infrastructure.

Comportamento dos testes sorológicos ML Flow e ELISA (PGL-I) em áreas endêmica e não endêmica de hanseníase / The result patterns of ML Flow and ELISA (PGL-I) serologic tests in leprosy-endemic and non-endemic areas

O ML Flow e o ELISA PGL-I são testes sorológicos que detectam anticorpos IgM contra o glicolipídio fenólico I específico do Mycobacterium leprae. Para avaliar o comportamento destes testes em áreas endêmica e não endêmica para hanseníase foram estudados 351 voluntários no Brasil e no Chile, incluindo pacientes com hanseníase, controles sadios, portadores de outras doenças infecciosas, não infecciosas e dermatoses que fazem diagnóstico diferencial com hanseníase. O ponto de corte do ELISA foi estabelecido pelo método da Curva ROC (> 0,157). Em área endêmica, o ML Flow apresentou resultados positivos em 70 por cento dos pacientes com hanseníase; o ELISA foi positivo em 53,3%. Em área não endêmica, o ML Flow foi negativo em todos os voluntários testados; o ELISA foi positivo em 4 voluntários. O ML Flow é um ensaio mais rápido, facilmente aplicável e, portanto, mais adequado para ser utilizado na Atenção Básica; o ELISA necessita, alem de uma infra-estrutura de laboratório adequada, pessoal treinado e especializado em sua execução.

ML Flow and anti-PGL-I ELISA are serological tests that detect IgM antibodies against the phenolic glycolipid I (PGL-I), specific to Mycobacterium leprae. To evaluate the outcomes of ML Flow and ELISA (PGL-I) serological tests in leprosy-endemic areas in comparison to non-endemic ones, a total of 351 volunteers from Brazil and Chile were examined, including leprosy patients, healthy controls and others affected by other infectious or non-infectious diseases that are common differential diagnoses for leprosy. The ELISA cut-off point was established using the ROC Curve method (> 0.157). In endemic areas, 70% of leprosy patients present positive ML Flow results and 53.3% were ELISA-positive. In non-endemic areas, ML Flow was negative in all the subjects tested and ELISA was positive in 4 volunteers. ML Flow is faster and more easily performed and, therefore, a more adequate test for use in basic, primary-level health care centers. ELISA requires trained personnel, in addition to a more complex laboratory infrastructure.

Infección por Mycobacterium leprae en un habitante de la Isla de Pascua, Chile 1993 / Mycobacterium leprae infection in one inhabitant of Eastern Island, Chile, 1993

Se describe las principales bases de diagnóstico de laboratorio de la infección por Mycobacterium leprae. En 1993, un paciente hombre, nativo de la Isla de Pascua fue estudiado para detectar una infección por M. Leprae. Se demostró la presencia de numerosos bacilos ácido-resistentes y globias em frotis de lesiones de la piel, de secreciones nasales, de contenido linfático y en biopsias de piel. Se estudió concomitantemente al grupo familiar y no se encontró ningún otro infectado. La presencia de bacilos ácido-resistentes en las muestras estudiadas fue confirmado por los laboratorios de referencia del Instituto de Salud Pública de Chile y por el Instituto Daniel A. Carrión de Lima, Perú. Desde 1993, no se ha presentado ningún nuevo caso de lepra en Isla de Pascua.

Estudios biomédicos chilenos en Isla de Pascua: 1932-1985 / Biomedical research in Eastern Island: 1932-1985

In 1988 we celebrate the first centennial of the incorporation of Eastern Island to Chile. Famous archeological expeditions to this islan are those of Rutledge (1912), Metraux (1934) and Heyerdhal (1954). However, biomedical research concerning its inhabitants took place from 1932 to 1967 in 6 expedition of medical researchers from the University of Chile Medical School. Main findings reported in 26 publications include: 1) the origin of the population comes from Polynesia as shown by the distribution of genetic markers of blood groups, with later inclusion of some European genes; 2) Exogamy is still prevalent in the population; 3) A rapid hibridization process has led to the present situation in which the current young population is genetically quite similar to that living in the continent; 4) Leprosy has been erradicated from the island; 5) Toward 1962 the island was quite isolated as an ecological niche, with low rates of hypertension and tuberculosis and a good general health situation. The first comercial flights to the island began in 1967, and biomedical investigations in 1972 have shown greater hibridization of the population. (AU)

Tests with three antigens in leprosy-endemic and non-endemic areas.

A study comparing the 48-h and 30-day reactions produced by three antigens was made in areas of low and high leprosy endemicity in Venezuela and in areas of Chile, a non-endemic country. The antigens used for the intradermal tests were standard Mitsuda antigen, supernatant from standard Mitsuda antigen, and PPD. The results indicate that there is no difference in the Mitsuda reaction of persons living in areas of high or low endemicity, but they show a statistically significant difference between the reactions in persons who live in endemic areas and those of persons living in a country where the disease has not been described. The difference in the Fernandez reaction obtained with the supernatant was not statistically significant between the two population groups in the endemic country, but was highly significant when comparing the endemic and the non-endemic countries.