Enzootic Trypanosoma cruzi infection by Rhodnius prolixus shows transmission to humans and dogs in Vichada, Colombia.

Background: Rhodnius prolixus is considered the most relevant Trypanosoma cruzi vector in Colombia and Venezuela due it is responsible for domestic transmission in both countries. However, a wild population of this species is distributed in the eastern plains of the Orinoco region and Amazonia jungle, where its epidemiological importance has not been sufficiently elucidated. This study aimed to assess epidemiological parameters of T. cruzi transmission in the Department of Vichada, Colombia. Methods: We determined the characteristics of T. cruzi transmission using entomological studies in domestic and sylvatic ecotopes. We analyzed the T. cruzi infection in triatomine insects, identified blood meal sources, and conducted a serological determination of T. cruzi infection in scholar-aged children, domestic dogs, and wild hosts. Results: Fifty-four triatomine bugs, 40 T. maculata and 14 R. prolixus were collected in peridomestic and sylvatic ecotopes. Infected R. prolixus was observed in La Primavera, Santa Rosalia, and Cumaribo municipalities. All the T. maculata bugs were not infected. Serological analysis indicated that two of 3,425 children were T. cruzi positive. The seroprevalence in domestic dogs was 10,5% (49/465). Moreover, 22 synanthropic mammals were sampled, being Didelphis marsupialis the most common. TcI genotype was detected in seropositive dogs, R. prolixus, and D. marsupialis. Conclusion: The present work describes extra domestic R. prolixus and D. marsupialis in a sylvatic T. cruzi transmission cycle with transmission to humans and domestic dogs in Colombia's Vichada Department.

Eco-epidemiological study reveals the importance of Triatoma dimidiata in the Trypanosoma cruzi transmission, in a municipality certified without transmission by Rhodnius prolixus in Colombia.

Boyaca department is an endemic area for Chagas disease in Colombia, where 24 of its municipalities have been certified by the PAHO with interruption of Trypanosoma cruzi transmission by R. prolixus. However, the presence of secondary vectors, represent a risk of parasite transmission for citizens and a challenge for the health care institutions. The aim of this work was to investigate eco-epidemiological features of Chagas disease in the municipality of Socota (Boyaca), in order to improve control and surveillance strategies. To understand the transmission dynamics of T. cruzi in this area, we designed a comprehensive, multi-faceted study including: (i) entomological survey in five villages (La Vega, Comaita, Chusvita, Guaquira and Pueblo Nuevo), (ii) blood meal source determination, (iii) T. cruzi infection rate in collected triatomines, (iv) identification of circulating T. cruzi genotypes, (v) serological determination of T. cruzi infection in domestic dogs; and (vi) evaluation of infection in synanthropic mammals. A total of 90 T. dimidiata were collected, of which 73.3% (66/90) and 24.4% (22/90) were collected inside dwellings and peridomestic areas, respectively, while the rest (2/90) in Chusvita Elementary School. T. cruzi infection was evidenced in 40% (36/90) of triatomine bugs using PCR analyses, in which only DTU I was found, and TcI Dom was the most distributed. Blood-meal analysis showed that T. dimidiata only fed of humans. Seroprevalence in domestic dogs was 4.6% (3/66), while that two Didelphis marsupialis captured showed no infection. In conclusion, the high dispersion and colonization of T. dimidiata shown in this municipality, along the high rate of T. cruzi (TcI) infection and its anthropophilic behavior constitute a risk situation for Chagas disease transmission in this municipality certified without R. prolixus. The epidemiological implications of these findings are herein discussed.

Las mordidas abiertas anteriores en pacientes de 9 a 14 años de edad / The anterior open bites in patients from 9-14 years of age

Introducción: la mordida abierta es una de las maloclusiones motivo de preocupación científica y un problema de salud bucal desde hace más de un siglo. Además de las alteraciones estéticas se observa en estos pacientes trastornos de la masticación, la fonación y la respiración. Objetivo: caracterizar las mordidas abiertas anteriores en niños de 9-14 años de edad que recibieron atención en la Clínica Estomatológica Docente Provincial "Antonio Briones Montoto". Material y método: se realizó un estudio observacional, descriptivo y transversal en la Clínica Estomatológica Docente Provincial "Antonio Briones Montoto", Pinar del Río, en el período de mayo de 2011 a abril de 2013. El universo fue de 188 pacientes de 9-14 años de edad que acudieron a consulta de Ortodoncia por presentar maloclusión, en el período del estudio (N=188). La muestra fue seleccionada con niños (as) con mordida abierta anterior (n=60). Los datos se recogieron en bases automatizadas y se utilizó la estadística descriptiva para el análisis de las variables. Resultados: el 65% de las mordidas abiertas se encontraron en el sexo femenino y la raza blanca, disminuyendo la prevalencia a medida que aumenta la edad. Los factores etiológicos más representativos fueron los hábitos bucales deformantes y el patrón morfogenético vertical; predominó la mordida esquelética entre dolicofaciales. Conclusiones: la mordida abierta anterior fue más frecuente en el sexo femenino y el color de piel blanca. Los hábitos bucales y el patrón morfogenético vertical fueron los factores etiológicos asociados. El patrón dolicofacial fue el más afectado por la mordida abierta esquelética.

Introduction: open bite is one of the malocclusions for scientific concerns and has been an oral health problem for more than a century. Besides; mastication, phonological and respiratory disorders are aesthetic alterations observed in these patients. Objective: to characterize the anterior open bites in children from 9-14 years of age who received dentist care at Antonio Briones Montoto Provincial Teaching Dental Clinic in Pinar del Río. Material and methods: an observational and descriptive study was conducted at Antonio Briones Montoto Provincial Teaching Dental Clinic in Pinar del Río during the period of May 2011-April 2013. The target group was comprised of 188 patients from 9- 14 years old who attended to the orthodontic office for presenting malocclusion in the period of the study (N = 188). The sample was chosen children with anterior open bite (n = 60). Data were collected in automated databases. Descriptive statistics for the analysis of the variables was used. Results: 65% of the open bites prevailed in females and Caucasians, prevalence decreased as the age increased. The most representative etiologic factors were deforming oral habits and vertical morphogenetic pattern; skeletal bite predominated among dolichofacial pattern. Conclusions: anterior open bite was more frequent in female and white skin patients. Oral habits and vertical morphogenetic patterns were associated with etiological factors. The dolichofacial pattern was the most affected by skeletal open bite.

Hipoparatiroidismo primario asociado a convulsiones / Primary hypoparathyroidism associated with seizures

Resumen Se presenta el caso de un hombre de 31 años, sano hasta hace cuatro años, cuando inicia episodios de convulsiones tonicoclónicas generalizadas con episodios de tetania, espasmo carpo pedal, mialgias, pérdida progresiva de la agudeza visual bilateral y cambios del comportamiento con mutismo y apatía. Al examen físico con cataratas bilaterales subcapsulares posteriores grado III, hiperplasia gingival, con actitud perpleja, mutista, posturas catatoniformes, signo de Chvostek y espasmo carpo pedal positivos. El calcio inicial fue de 3.9 mg/dL (8.2-10.2), el fósforo de 10.1 mg/dL (2.5-4.5) y los niveles de parathormona de 0.2 pg/mL (15-68.3). La tomografía de cráneo mostró calcificaciones en los ganglios basales. Con estos hallazgos se realiza diagnóstico de hipoparatiroidismo primario idiopático, con marcada mejoría clínica y paraclínica con calcitriol y carbonato de calcio. Este caso invita a tener en mente la hipocalcemia como causa metabólica de convulsiones, las cuales son totalmente reversibles al mejorar la hipocalcemia. (Acta Med Colomb 2013; 38: 186-192).

Abstract We report the case of a 31 years old man healthy until four years ago, when he started to present episodes of generalized tonic-clonic seizures with episodes of tetany, carpal pedal spasm, myalgia, bilateral progressive loss of visual acuity and behavioral changes with mutism and apathy. Physical examination showed bilateral posterior subcapsular cataracts grade III, gingival hyperplasia, with perplexed attitude, mutism, catatonic postures and positive Chvostek sign and carpal pedal spasm. Initial calcium was 3.9 mg/dL (8.2-10.2), Phosphorus 10.1 mg/dL (2.5-4.5) and parathyroid hormone levels 0.2 pg/mL (15-68.3). The brain computed tomography showed basal ganglia calcifications. With these findings we made the diagnosis of primary idiopathic hypoparathyroidism, with marked clinical and paraclinical improvement with calcitriol and calcium carbonate. This case shows the importance of considering hypocalcemia as a metabolic cause of seizures, which are fully reversible by improving hypocalcemia. (Acta Med Colomb 2013; 38: 186-192).