Identification of Cryptosporidium parvum and Blastocystis hominis subtype ST3 in Cholga mussel and treated sewage: Preliminary evidence of fecal contamination in harvesting area.

Cryptosporidium parvum and Blastocystis hominis are foodborne parasites known for causing diarrhea. They accumulate in mussels grown on contaminated water bodies, due to the discharge of treated sewage from sewage treatment plants (STP). Despite this, some countries like Chile do not include these parasites in the control or monitoring of sewage water. The objective of this research was to evaluate the contamination of C. parvum. and B. hominis from treated sewage (disinfected by chlorination) and Cholga mussels in a touristic rural cove from the bay of Concepción. Cholga mussels from commercial stores and a treated sewage sample were analyzed. Cryptosporidium spp. was identified by Ziehl-Neelsen-Staining (ZNS) and C. parvum by direct-immunofluorescence assay (IFA) from ZNS-positive samples. Blastocystis hominis was identified by PCR using locus SSU rDNA. C. parvum and B. hominis subtype ST3 were found in 40% and 45% of Cholga mussel samples, respectively, and both parasites were identified in the treated sewage. Blastocystis hominis SSU rDNA gene alignment from Cholga mussels and treated sewage showed 89% of similarity, indicating that could be the same parasite in both samples. We describe the first evidence of possible contamination with these parasites from treated sewage to Cholga mussel suggesting an environmental contamination with high human risk. Based on these results, further studies will consider all the rural coves and STP from the bay to prevent possible contamination of these parasites.

[Neuropathies of the spinal accessory nerve secondary to cervical surgery: clinical and electrophysiological study of 7 cases]. / Neuropatias do nervo acessório espinhal secundárias a cirurgias cervicais: estudo clínico e eletrofisiológico de sete casos.

After innervating the sternocleidomastoid muscle, the spinal accessory nerve emerges and down crosses the posterior cervical triangle to innervate the trapezius. At the posterior triangle, the nerve is closely related to local lymph nodes and may be injured by their enlargement or surgical removal. Injury to this nerve is uncommom. Most cases are iatrogenically due to surgical procedures in the posterior cervical triangle, often following lymph nodes biopsies or benign turmors approaches. We present seven cases of post-surgical related spinal accessory nerve injury and discuss its clinical and electrophysiologycal profiles. The major motor signs were shoulder drop and paresis to raise arm. Pain and sensory complaints were almost universal and most probably due to concomitant injury of cervical plexus cutaneous branches, which are in direct relation to the spinal accessory nerve in the posterior cervical triangle. Lesion type is usually axonotmesis, but varied degrees of compression by cicatricial spurs are observed in some patients. Surgical approach and nerve repair must be considered for pacients with delayed recovery.

[Electromyographic recording of the Strümpell phenomenon applied to pyramidal syndrome diagnosis]. / Registro eletromiográfico do fenômeno de Strümpell aplicado ao diagnóstico da síndrome piramidal.

After some years of empirical observation which pointed to the possibility of using the Strümpell phenomenon (SPh) electromyographic register (EMG) as a helpful tool in pyramidal syndrome diagnosis, the author began to study the SPh systematically, from March 1987 on, during the EMG examination of the anterior tibial muscles. The EMG was always effected with a needle concentric electrode and a calibration of 0.05 to 0.2mV and 1s per division. The patient, lying on the back, is asked to slowly and completely stretch his thigh, and a positive SPh displays an EMG which shows involuntary tonic contractions of growing amplitude on the anterior tibial muscle during its extension. In order to establish an EMG systematic schedule of this synkinesia and to be able to evaluate its relevance for pyramidal syndrome diagnosis, the author revised all 579 EMG registers he had established from March-1987 on. 26 reports (4.49%) belonged to SPh-positive patients, and it was possible to detect or to confirm that they presented a pyramidal syndrome. 20 patients of similar age who showed no pyramidal sign presented EMG silence (90%) or some clonic contractions (10%) on the tibial muscle during SPh research. The author suggests, therefore, the inclusion of SPh research into the conventional EMG examination of the anterior tibial muscles, specially in cases of amyotrophic lateral sclerosis and in cases presenting myeloradicular or spinal cord syndromes.

Tratamiento de las hemorragias digestivas altas: cimetidina versus somatostatina / Management of upper gastrointestinal bleedings: cimetidine vs somatostation

Se presenta un estudio comparativo de los resultados obtenidos en el tratamiento medicamertoso, mediante la administración de cimetidina o somatostatina en pacientes con hemorragias digestivas altas por ulcus gastroduodenal y L.A.M.G

Tratamiento de las hemorragias digestivas altas: cimetidina versus somatostatina / Management of upper gastrointestinal bleedings: cimetidine vs somatostation

Se presenta un estudio comparativo de los resultados obtenidos en el tratamiento medicamertoso, mediante la administración de cimetidina o somatostatina en pacientes con hemorragias digestivas altas por ulcus gastroduodenal y L.A.M.G (AU)

Coledocolitiasis residual / Residual choledocholithiasis

Se detalla un estudio de pacientes sometidos a cirugía biliar y referente a la litiasis residual, en cuanto a su incidencia, profilaxis y terapéutica compleja que motivó a revisar la experiencia de los autores en esa patología

Coledocolitiasis residual / Residual choledocholithiasis

Se detalla un estudio de pacientes sometidos a cirugía biliar y referente a la litiasis residual, en cuanto a su incidencia, profilaxis y terapéutica compleja que motivó a revisar la experiencia de los autores en esa patología (AU)

[Polyneuropathy caused by parathion: clinical, electrophysiologic and histologic studies of a case]. / Polineuropatia por parathion: estudo clínico, eletrofisiológico e histológico de um caso.

A case of 38 year old man who worked with organochlorinated and Parathion during 5 years is reported. His follow-up was up to 2 years. The onset of the disease was characterized by cholinergic signs, headache, loss of weight, trembling, miokimias, fasciculations, ataxia, myotonic phenomena (in hands only) and motor sensitive peripheral polyneuropathy (affecting the lower limbs symmetrically). Low concentrations of blood cholinesterases confirmed the etiology. Myotonic phenomena disappeared spontaneously 6 months after the initial observation. One year later, the concentration of erythrocyte acetylcholinesterase was found to be low and plasma cholinesterase was normal, suggesting that the patient was carrier of a congenital deficiency of acetylcholinesterase. In literature relationship between myotonia and intoxication due to organophosphorus was not found. The whole clinical picture, cholinergic symptoms, transitory phenomena and spontaneous motor activity could be explained by an excess of acetylcholine. Electromyography (EMG) in the first observation showed neuromuscular transmission blocking characterized by deficiency or absence of voluntary activity, unexcitability of fibular nerves, with fibrillations and positive peaks as described previously with Mipafox (another organophosphorus agent). During 2 years of observation numerous end-plates potentials of muscular fibres persisted in the EMG. A progressive increase in voluntary activity showed by unit motor potential of almost normal amplitude and very increased duration was observed. No potentials of reinnervation were noted. The results of EMG were explained as disturbances of neuromuscular transmission associated with moderate signs of denervation. The Eaton-Lambert's test and the stimulation of a single unit motor potential confirmed disorder of neuromuscular synapses. The histochemistry of brachial biceps showed scattered atrophic and angulated type I and II fibres. Teased-fibres preparations showed nerve fibres with B, C, and G alterations as defined by Dyck et al. indicating axonal degeneration. These results were according to velocity of sensitive conduction. The conduction velocity of fibular nerves was strongly delayed during all the evolution indicating serious disorders of motor nerves myelin.(ABSTRACT TRUNCATED AT 400 WORDS)

Polineuropatia por parathion. Estudo clinico, eletrofisiologico e histologico de um caso. / Polyneuropathy caused by parathion: clinical, electrophysiologic and histologic studies of a case

Estudamos um paciente com quadro clinico rebelde, produzido por intoxicacao pelo parathion. Foi observado um fenomeno miotonico transitorio, nao descrito na literatura revisada. A constatacao de cifras de AchE eritrocitaria baixas e de colinesterase plasmatica normais, indicou que era portador de deficit congenito de AchE, esclarecendo-se a evolucao cronica do seu quadro. O fenomeno miotonico associado ao quadro clinico, eletrofisiologico, histologico e bioquimico fazem deste paciente um modelo clinico, de etiologia conhecida, da discutida sindrome de Isaacs

[Myotubular myopathy: clinical, electrophysiological and histological study of a case]. / Miopatia miotubular: estudo clínico, eletrofisiológico e histológico de um caso.

A cases of myotubular myopathy in a 10 years old girl is reported. Clinically, palpebral ptosis, ocular movements limitation, facial diplegia, positivity of Gower's test, muscular hypotrophy distal, foot drop and deep absent reflexes were found. These signals were described by most of authors, besides symptoms referred, like partial urinary incontinency and frequent vomits. Reflexes H absents and teary in our patient were observed but were not described in the other cases of the literature. Routine laboratory tests were within normal limits; only aldolase was lightly elevated. In all muscles examined it was noted a spontaneous electromyographic activity with +- of 2,64 +/- 1,33 ms, 36,87 +/- 30,87 microV and 88,13 +/- 24,82 /s of frequency without characteristics of desenervation potentials of myoneural plates. The voluntary electromyographic activity was of myopathic pattern. A curve I/D made in the motor point of braquial biceps muscle was normal. The biopsy was made in the motor point of this muscle for histochemical, electron immunofluorescence and vital stain microscopy. The biopsy showed 35% of fibras with central nuclei, predominance and hypotrophy of type I fibres, in some of them there were not myofibrils in the central zone, and poor differentiation between the fibre types in oxidative enzymes reactions. The electron microscopy confirmed the histochemical studies. The direct immunofluorescence was positive in some fibres. The vital stain showed beaded subterminal motor fibres. The clinical, electromyographic and principally histological findings suggest a innervation congenital disorder of muscle fibres.

Miopatia miotubular: estudo clinico, etrophysiological and histological study so. / Myotubular myopathy: clinical,elecof a case

Sao apresentados os resultados dos exames clinicos, eletrofisiologicos e do estudo do ponto motor, da imunofluorescencia, da histoquimica e da ultramicroscopia da biopsia muscular de um caso de miopatia miotubular. Sao discutidos estes resultados em relacao aos achados de 56 casos desta molestia consignados na literatura ate 1978, sendo cada enfase a etiopatogenia

[Mechanism of electric alternance in pericardial effusion. Study with ultrasonics]. / El mecanismo de la alternancia eléctrica en el derrame pericárdico: estudio con ultrasonido

Two cases are presented, one with chronic renal failure and the other with a hepatic cyst perforated in the pericardium, with a tension pericardic leakage accompanied with by electrocardiographic alternance. After correct treatment, pericardiocentesis and surgery, respectively, the electrocardiogram lost its electric alternance. The echocardiogram evaluates the importance of the pericardic liquid volume which causes, because of the particular cardiac anatomy, an alternating movement of the heart within the pericardic sac. This factor would be decisive in the origen of the electric phenomenon, a fact corroborated when the electric alternance disappears after pericardiocentesis or surgery.