[Gallstone ileus as a cause of acute abdomen. Importance of early diagnosis for surgical treatment]. / El íleo biliar como causa de abdomen agudo. Importancia del diagnóstico precoz para el tratamiento quirúrgico.

Gallstone ileus is an uncommon type of mechanical intestinal obstruction caused by an intraluminal gallstone, and preoperative diagnosis is difficult in the Emergency department. This study is a retrospective analysis of the clinical presentation of 5 patients with gallstone ileus treated between 2000-2010. Clinical features, diagnostic testing, and surgical treatment were analyzed. Five patients were included: 2 cases showed bowel obstruction; 2 patients presented a recurrent gallstone ileus with prior surgical intervention; and one patient presented acute peritonitis due to perforation of an ileal diverticula. In all cases CT confirmed the preoperative diagnosis. In our experience, gallstone ileus may present with clinical features other than intestinal obstruction. In suspicious cases CT may be useful to decrease diagnostic delay, which is associated with more complications.

Proteomic study of activated Taenia solium oncospheres.

Taenia solium cysticerci are a major cause of human seizures and epilepsy in the world. In the gastrointestinal tract of infected individuals, taeniid eggs release the oncospheres, which are then activated by intestinal stimuli, getting ready to penetrate the gut wall and reach distant locations where they transform in cysticerci. Information about oncospheral molecules is scarce, and elucidation of the oncosphere proteome could help understanding the host-parasite relationship during the first steps of infection. In this study, using liquid chromatography and tandem mass spectrometry (LC-MS/MS) analysis, we could identify a set of oncospheral proteins involved in adhesion, protein folding, detoxification and proteolysis, among others. In addition, we have characterized one of the identified molecules, the parasite 14-3-3, by immunoblot and immunolocalization. The identification of these oncospheral proteins represents the first step to elucidate their specific roles in the biology of the host-parasite relationship.

Sonicated diagnostic immunoblot for bartonellosis.

Two simple Bartonella bacilliformis immunoblot preparation methods were developed. Antigen was prepared by two different methods: sonication of whole organisms or glycine extraction. Both methods were then tested for sensitivity and specificity. Well-defined control sera were utilized in the development of these diagnostic immunoblots, and possible cross-reactions were thoroughly examined. Sera investigated for cross-reaction with these diagnostic antigens were drawn from patients with brucellosis, chlamydiosis, Q fever, and cat scratch disease, all of whom were from regions where bartonellosis is not endemic. While both immunoblots yielded reasonable sensitivity and high specificity, we recommend the use of the sonicated immunoblot, which has a higher sensitivity when used to detect acute disease and produces fewer cross-reactions. The sonicated immunoblot reported here is 94% sensitive to chronic bartonellosis and 70% sensitive to acute bartonellosis. In a healthy group, it is 100% specific. This immunoblot preparation requires a simple sonication protocol for the harvesting of B. bacilliformis antigens and is well suited for use in regions of endemicity.