RESUMEN
Pelvic inflammatory disease (PID) is common infection among reproductive-aged women. The presentation ranges from acute severe illness to a more indolent and mild clinical picture. Attention has turned to subclinical PID as an important entity. The majority of the public health impact from PID comes from its attributable long-term sequelae, including tubal-factor infertility, ectopic pregnancy, and chronic pelvic pain. Tubo-ovarian abscess (TOA) represents a severe form of PID. Vigilance is required when caring for women who have PID to detect the presence of a TOA given the serious nature of the infection and the potential need for procedural intervention.
Asunto(s)
Absceso/etiología , Enfermedades de los Anexos/etiología , Enfermedad Inflamatoria Pélvica , Adolescente , Adulto , Antibacterianos/uso terapéutico , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/tratamiento farmacológico , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/microbiología , Chlamydia trachomatis , Femenino , Gonorrea/complicaciones , Gonorrea/tratamiento farmacológico , Gonorrea/epidemiología , Gonorrea/microbiología , Humanos , Neisseria gonorrhoeae , Enfermedad Inflamatoria Pélvica/complicaciones , Enfermedad Inflamatoria Pélvica/tratamiento farmacológico , Enfermedad Inflamatoria Pélvica/epidemiología , Enfermedad Inflamatoria Pélvica/microbiología , Adulto JovenRESUMEN
In 1998, we investigated a suspected outbreak of amebic liver abscesses caused by Entamoeba histolytica in the Republic of Georgia, using a case-control study. A questionnaire was administered and blood samples were obtained from cases and controls for serologic diagnosis. Medical records showed that E. histolytica infections were rarely diagnosed before 1998. However, from July through September 1998, 177 cases of suspected amebiasis were identified. Of 52 persons who had diagnosed liver abscesses, 37 (71%) were confirmed serologically to have antibodies against E. histolytica, compared with 11 of 53 persons (20.8%) diagnosed with intestinal amebiasis. In addition, 9-14% of asymptomatic controls were seropositive. Logistic regression identified the fact that interruptions in the water supply, decreases in water pressure, and increased water consumption were significantly associated with infection. The data support the hypothesis that drinking water was the source of infection, either because of inadequate municipal water treatment or contamination of municipal water in the distribution system.
Asunto(s)
Anticuerpos Antiprotozoarios/sangre , Brotes de Enfermedades , Entamoeba histolytica/inmunología , Entamebiasis/epidemiología , Adolescente , Adulto , Animales , Estudios de Casos y Controles , Niño , Estudios Transversales , Entamebiasis/parasitología , Georgia (República)/epidemiología , Humanos , Absceso Hepático Amebiano/epidemiología , Absceso Hepático Amebiano/parasitología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Encuestas y Cuestionarios , Agua/parasitología , Abastecimiento de AguaRESUMEN
DNA topoisomerase II (topo II), an enzyme essential for cellular replication, is an eminent target for antimicrobial therapy against Leishmania chagasi, the major cause of visceral leishmaniasis in Latin America. The complete L. chagasi (Lch) TOP2 gene, encoding L. chagasi topo II, was isolated from genomic DNA using the polymerase chain reaction. The LchTOP2 gene revealed an open reading frame (ORF) of 3,711 base pairs predicting a protein with 1,236 amino acids and an estimated molecular weight of 140 kDA. The L. chagasi topo II sequence had high identity with the L. donovani topo II (98.8%) and L. infantum topo II (98.7%), followed by Crithidia fasciculata topo II (84.4%), Trypanosoma cruzi topo II (67.6%) and Trypanosoma brucei topo II (66.6%). Lch topo II had low identity with the human homologs htopo II alpha (26.3%) and htopo II beta (26.4%). Differences between L. chagasi TOP2 and human TOP2 genes suggest that leishmanial topo II is a potential target for the development of new antileishmanial agents.