Modification of the Daily Activity Pattern of the Diurnal Triatomine Mepraia spinolai (Hemiptera: Reduviidae) Induced by Trypanosoma cruzi (Trypanosomatida: Trypanosomatidae) Infection.

Mepraia spinolai, (Porter) 1934, is a diurnal triatomine endemic to Chile and a wild vector of the protozoan Trypanosoma cruzi, (Chagas) 1909, which causes Chagas disease. Behavioral changes in M. spinolai induced by this parasite have been reported previously, which include detection of a potential host, defecation latency, and some life history traits. In this study we assessed changes in locomotor and daily activity due to infection with T. cruzi. No difference was detected in distance traveled between infected and uninfected individuals. However, the groups differed in their daily activity patterns; infected individuals showed significant reduction of movements during the light phase and concentrated their activity in the dark phase. Uninfected individuals showed no differences in locomotor activity between the phases. The results suggest that T. cruzi induces a displacement in the activity of M. spinolai toward the dark phase of the circadian cycle, which may improve its vector competence.

Feeding profile of Mepraia spinolai, a sylvatic vector of Chagas disease in Chile.

American trypanosomiasis is a chronic disease transmitted mainly by vectors. The hematophagous triatomine vectors transmit Trypanosoma cruzi to a wide variety of mammals, which usually are their food source. This study determined the feeding profile of Mepraia spinolai, a sylvatic triatomine vector, present in endemic areas of Chile. Vectors were captured in the north-central area of Chile. Samples of intestinal contents were analyzed by an Enzyme-linked immunosorbent assay (ELISA) that identifies and discriminates the presence of serum antigens from Homo sapiens and nine animal species (Canis familiaris, Felis catus, Capra hircus, Mus musculus, Gallus gallus, Octodon degus, Thylamys elegans, Phyllotis darwini and Oryctolagus cuniculus). Our data indicate the most frequent feeding source in this area was P. darwini, followed by O. degus, O. cuniculus, M. musculus, G. gallus, T. elegans, C. familiaris, F. catus and C. hircus. Mixed food sources were also identified.

Moral Absolutism, Self-Deception, and Moral Self-Concept in Men Who Commit Intimate Partner Violence: A Comparative Study With an Opposite Sample.

The objective of this study is to show compatible data with the idea that men who commit intimate partner violence are uninhibited about the moral consequences of their behaviors, probably because they feel certainty about the rightness of their moral values and they strongly deceive themselves to maintain a good moral self-concept, and thus a good level of well-being. To do that, we compare their scores with those obtained by an opposite sample regarding the use of violence, made up of professional male psychologists who work in the social field trying to teach others alternative strategies to violence.

Blood glucose control and quality of health care in non-insulin-treated patients with Type 2 diabetes in Spain: a retrospective and cross-sectional observational study.

AIMS: To assess blood glucose control and quality of health care provided to non-insulin-treated patients with Type 2 diabetes mellitus in routine clinical practice in Spain. METHODS: In this observational, retrospective, cross-sectional study, patients were grouped as either having good or suboptimal blood glucose control according to International Diabetes Federation or American Diabetes Association HbA(1c) goals. Clinical and socio-demographic data and compliance with the main standard level of care recommendations of the International Diabetes Federation were recorded during a routine visit. Correlates of glucose control were analysed by logistic regression. RESULTS: Many patients were grouped as having suboptimal control under International Diabetes Federation (61.9%) or American Diabetes Association (45.0%) criteria. The mean number of accomplished International Diabetes Federation recommendations (7.3 out of 11) was higher for endocrinologists (than for internists or primary care physicians), and significantly more patients under their care were in the good glucose control group (than with primary care physicians). More recommendations were associated with blood glucose control using International Diabetes Federation than American Diabetes Association criteria, demanding higher quality of health care for achieving stricter goals. Some recommendations were poorly observed, particularly those concerning patients' education on diabetes, the prompt prescription of effective treatments and monitoring of complications. Diabetes complications were associated with being in the suboptimal control group. Patients' education on diabetes and HbA(1c) monitoring were associated with being in the good control group. CONCLUSIONS: These results demonstrate the need for improvement in the management of patients with non-insulin-treated Type 2 diabetes in actual clinical practice in Spain. Such improvement would entail a stricter adherence to International Diabetes Federation recommendations.

Functioning and symptomatic outcomes in patients with bipolar I disorder in syndromal remission: a 1-year, prospective, observational cohort study.

BACKGROUND: Recent studies demonstrate that many Bipolar Disorder (BD) patients experience mild symptoms and/or suffer significant functional impairment during periods of syndromal remission, suggesting greater relapse risk and need for more intensive therapeutic strategies. However, most studies have cross-sectional designs and other methodological limitations. This study aimed to prospectively evaluate whether the presence of subsyndromal symptoms and level of functionality have long-term consequences in BD patients in syndromal remission. METHODS: A 1-year, prospective, observational cohort study of BD patients in syndromal remission assessed participants at study entry and 3, 6 and 12months after baseline on a range of clinical, social and functional outcomes. RESULTS: A total of 473 BD patients were screened at 51 study sites across Spain. Finally, 398 patients with bipolar I disorder in syndromal remission were included. After the 12-month, follow-up period, 87.6% of patients remained in syndromal remission, 79.9% of patients were free of subsyndromal symptoms, but only 53.5% had normal levels of functionality. Patients without subsyndromal symptoms and with normal levels of functionality at baseline had longer time to relapse, lower relapse risk, fewer changes on medication and hospitalizations, better employment, less medical/psychiatric leaves and better functional household membership. LIMITATIONS: Limitations of this study are related with its naturalistic design. CONCLUSIONS: In a prospectively assessed BD cohort with all patients in syndromal remission at baseline, syndromal remission was not always accompanied by normal functioning and/or the presence subsyndromal symptoms. Interventions, including medication and psychosocial approaches, should go beyond syndromal remission and target subsyndromal symptoms and functional recovery.

Condiciones higiénico-sanitarias como factores de riesgo para las parasitosis intestinales en una comunidad rural venezolana / Sanitary conditions as risk factors for intestinal parasites in a rural community in venezuelan

Las parasitosis intestinales, enfermedades tropicales desasistidas, contribuyen con el ciclo de la pobreza en poblaciones rurales, con acceso limitado a la atención médica, malas condiciones higiénicas, con consumo de agua y alimentos contaminados. El propósito de este estudio de prevalencia, muestra no aleatoria de 69 niños, fue evaluar los factores de riesgo higiénico-sanitarios mediante inspección, las normas de disposición de residuos sólidos y manipulación de alimentos en la Unidad Educativa de Panaquire-Miranda, ejecutar encuesta sobre las condiciones de vida, examinar muestras de heces mediante el método Formol-Tritón-Éter y asociar las condiciones higiénico-sanitarias de la vivienda con la presencia de parasitosis. La disposición de residuos y manipulación de alimentos fue insatisfactoria según los parámetros validados por los inspectores de salud a nivel nacional. Diecinueve por ciento de los encuestados sin acceso al agua peridomiciliaria, 17% viven en ranchos y 10% disponen sus excretas a cielo abierto. Casi 60% de las muestras fueron positivas para mono o poliparasitosis. Las infecciones por helmintos con alta prevalencia (73,5%), mmás frecuente la Trichuris trichiura (34,4%). Se encontró una asociación causal entre la defecación a campo abierto y la infección por Áscaris lumbricoides (Odds Ratio OR=8; IC 95%:1,27–50; p=0,03) y Trichuris trichiura (OR=14; IC 95%:1,51–133,4; p=0,01). Los hallazgos refuerzan la necesidad de políticas de salud para mejorar las condiciones higiénico-sanitarias en las comunidades rurales y proteger la salud pública.

Intestinal parasites, neglected tropical diseases, contribute to the cycle of poverty in rural populations with limited access to medical care and unhygienic conditions, coupled with the consumption of contaminated food and water. Prevalence study which involved 69 children, to evaluate through inspection, standards for solid waste disposal and food handling in the Panaquire-Miranda school unit, sanitation and hygiene life conditions obtained by the participant survey, examine fecal samples of participants using the method formaldehyde-Triton-ether and associate sanitary conditions of housing with the presence of parasites. Waste, water and food management handling were unsatisfactory according to official parameters validated by health inspectors. Nineteen percent of participants do not have access to water, 17% live on poor housing and 10% have their excreta in the open field. Nearly 60% of stool samples were positive for mono or poliparasitosis. Helminthes infections were highly prevalent (73.5%) and Trichuris trichiura (34.4%) most frequent. The results showed a positive correlation between open field defecation and infection with Ascaris lumbricoides (Odds Ratio OR=8; 95%CI=1.27-50, p=0.03) and Trichuris trichiura(OR=14 95%CI=1.51-133.4, p=0.01). These findings reinforce the need for political action to improve sanitary conditions in rural communities and protect public health.

Immunohistochemical expression of estrogen receptor beta in normal and tumoral canine mammary glands.

To date, two isoforms of estrogen receptors (ER) have been identified, cloned, and characterized from several species, estrogen receptor-alpha (ERalpha) and estrogen receptor-beta (ERbeta). Although the presence of ERalpha has been demonstrated in normal and tumoral canine mammary tissues, the issue of ERbeta expression has not been addressed in the dog. In this study, we have analyzed the expression of ERbeta in formalin-fixed, paraffin-embedded tissue samples of nonaltered mammary gland, 30 malignant (six complex carcinoma, 12 simple carcinoma, three carcinosarcoma, and nine carcinoma or sarcoma in benign tumor), and five benign (one fibroadenoma, one complex papilloma, one complex adenoma, and two benign mixed tumors) mammary tumors of the dog by using a polyclonal ERbeta antibody and the avidin-biotin-peroxidase complex immunohistochemical technique. Our results show that high numbers of normal ductal and acinar epithelium and approximately one third of canine mammary tumors express ERbeta. This expression was higher in benign than in malignant tumors. Furthermore, expression was higher in complex and mixed histologic subtypes of malignant tumors when compared with simple subtypes.

Differential effects of light/dark recombinant human prolactin administration on the submaxillary lymph nodes and spleen activity of adult male mice.

OBJECTIVES: Day/night variations in cellularity, percentage of CD4+, CD8+ and double-positive (CD4+-CD8+) lymphocytes, lipopolysaccharide (LPS)- and concanavalin A (Con A)-induced lymphocyte proliferation and natural killer (NK) activity, and the effect of timed administration of recombinant human prolactin (h-PRL) on the above-mentioned parameters were investigated in the submaxillary lymph nodes and spleen of adult male mice. RESULTS: In controls, the percentage of CD4+, double-positive lymphocytes, LPS- or Con A-induced blastogenic proliferation and NK activity in the spleen differ during the dark phase as compared to the light phase. When administered during the dark period, h-PRL induced immunosuppresion in the percentage of CD4+, double-positive (CD4+-CD8+) lymphocytes. Con A- and LPS-induced lymphocyte proliferation and NK activity as compared to untreated controls. When h-PRL was administered during the light period, the cellularity increased, and h-PRL was immunosuppressive in Con A- and LPS-induced lymphcoyte proliferation and NK activity as compared to controls. Moreover, in control submaxillary lymph nodes the cellularity, percentage of CD8+, double-positive lymphocytes, blastogenic proliferation in the presence of Con A and LPS and NK activity differ when comparing the dark with the light phase. When administered during the dark period h-PRL induced immunosuppression in the percentage of double-positive (CD4+-CD8+) lymphocytes, Con A- and LPS-induced lymphocyte proliferation as compared to controls. When h-PRL is administered during the light period, no effects were observed. CONCLUSIONS: These results indicate the existence of differential day/night variations in the cellular immune response depending upon the lymphoid organ considered. Because of the administration of h-PRL a differential modulation of this circadian variation was also observed.

Chronobiological features of the immune system. Effect of calorie restriction.

The circadian organization of living organisms is fully established being a key component the activity of the neuro-endocrin-immune system that maintains the homeostasis. Secondary lymph organs, such as submaxillary lymph nodes and spleen, have been shown to exhibit a 24 h variation in blastogenic proliferative capacity and distribution of B and T subsets, with specific achrophases depending on the parameter studied or the lymphoid organ considered. However, less is known about the thymus. The immune system has been shown to change by calorie restriction, although no information is available about possible effects in 24 h variations. Similar questions can be posed for the neuro-endocrine system. As an example, some data are shown in this article about the effects of calorie restriction on the neuro-endocrin-immune system in growing male Wistar rats. Calorie restriction blunted the circadian secretory pattern of TSH observed in the control group that was characterized by the existence of two peaks at 17:00 or 01:00 h and that explained the low basal metabolic rate of these animals under this experimental condition. Concerning the immune system, the thymus gland exhibited 24 h variations in T, B and immature cells in both control and calorie-restricted male rats, thus confirming the circadian organization of the immune system. Moreover this circadian organization was changed by calorie restriction.

Age-dependent changes in 24-hour rhythms of catecholamine content and turnover in hypothalamus, corpus striatum and pituitary gland of rats injected with Freund's adjuvant.

BACKGROUND: Little information is available on the circadian sequela of an immune challenge in the brain of aged rats. To assess them, we studied 24-hour rhythms in hypothalamic and striatal norepinephrine (NE) content, hypothalamic and striatal dopamine (DA) turnover and hypophysial NE and DA content, in young (2 months) and aged (18-20 months) rats killed at 6 different time intervals, on day 18th after Freund's adjuvant or adjuvant's vehicle administration. RESULTS: Aging decreased anterior and medial hypothalamic NE content, medial and posterior hypothalamic DA turnover, and striatal NE concentration and DA turnover. Aging also decreased NE and DA content in pituitary neurointermediate lobe and augmented DA content in the anterior pituitary lobe. Immunization by Freund's adjuvant injection caused: (i) reduction of DA turnover in anterior hypothalamus and corpus striatum; (ii) acrophase delay of medial hypothalamic DA turnover in old rats, and of striatal NE content in young rats; (iii) abolition of 24-h rhythm in NE and DA content of neurointermediate pituitary lobe, and in DA content of anterior lobe, of old rats. CONCLUSIONS: The decline in catecholamine neurotransmission with aging could contribute to the decrease of gonadotropin and increase of prolactin release reported in similar groups of rats. Some circadian responses to immunization, e.g. suppression of 24-h rhythms of neurointermediate lobe NE and DA and of anterior lobe DA were seen only in aged rats.

Manejo de herida operatoria con apósito oclusivo / Management of operatory wounds using occlusive dressing

Con el propósito de evaluar una alternativa eficaz, sencilla y económica en el manejo de las heridas operatorias, se diseñó un estudio prospectivo y randomizado, comparando el sistema tradicional de curación de heridas, con el uso de un apósito oclusivo que se mantuvo hasta la remoción de los puntos. Ciento cinco pacientes consecutivos, con 110 heridas operatorias limpias o limpias-contaminadas, intervenidos en el Hospital de Quilpué entre junio y septiembre de 1999, se separaron en dos grupos al azar de los cuales 52 recibieron apósito oclusivo y 58 apósito tradicional. El grupo que recibió parche oclusivo tuvo un 5,8 por ciento de complicaciones locales de la herida, mientras que el grupo tradicional tuvo un 10,3 por ciento. El costo intrahospitalario fue de $100 y $2.346 respectivamente. Se demuestra la ventaja del método propuesto en relación a efectividad, costo, tiempo y confort de los pacientes

Effect of local sympathectomy on 24-h changes in mitogenic responses and lymphocyte subset populations in rat submaxillary lymph nodes during the preclinical phase of Freund's adjuvant arthritis.

Wistar male rats received a bilateral superior cervical ganglionectomy or sham-operation and 10 days later were injected with Freund's complete adjuvant or its vehicle. Two days later, rats were killed at six different time intervals throughout a 24-h cycle. The mitogenic effect of lipopolysaccharide (LPS) and concanavalin A (Con A) and the relative size of lymphocyte subset populations were measured in submaxillary lymph nodes. Cells from sympathectomized lymph nodes showed a lower response to Con A. Freund's adjuvant injection decreased amplitude of daily rhythm in Con A response, an effect prevented by denervation. Generally, ganglionectomy increased Con A response at the early phase of arthritis. Acrophases for Con A and LPS effect occurred at early afternoon and did not change after ganglionectomy. Administration of Freund's adjuvant caused a 10-h advance in acrophase of LPS mitogenic activity, an effect prevented by ganglionectomy. Significant 24-h rhythms were observed in relative size of lymph node B and T cells. Denervation augmented amplitude of rhythm in B cells in adjuvant's vehicle-injected rats. As far as T lymphocyte subsets, acrophases occurred at the afternoon (CD4(+) and CD4(+)-CD8(+) cell types) or at night (CD8(+) cell types). Immunization augmented amplitude of 24-h rhythms in CD4(+)-CD8(+) cells regardless of innervation whereas denervation counteracted the suppression of daily rhythm in CD8(+) cells seen in arthritis. The results indicate that some of the changes seen in 24-h organization of immune responses in lymph nodes at an early phase of arthritis are modified by severing the local sympathetic nerves.

Filamentous intranuclear inclusion bodies in psittacine birds. A structural and ultrastructural study.

This paper concerns a disease affecting a group of African grey parrots, which involves intranuclear inclusion bodies composed of filamentous material. The disease was characterized by either sudden death or death within 2-3 days from onset of non-specific symptoms. At necropsy, gross lesions included enlarged liver, mild hepatic congestion and focal necrosis. Samples from five birds were fixed in 10% formol and routinely processed for light and electron microscopy. In four birds, numerous hepatocytes displayed an enlarged nucleus, with peripheral margination of chromatin; the nucleus was partially or wholly filled by a basophilic inclusion body. In the remaining bird, inclusion bodies were acidophilic and completely filled the nucleus; nuclear enlargement was less evident than in the other birds. At ultrastructural examination, and in both types of IIB, nuclei contained looped filaments but no evidence of viral structures. However, virion-like structures were observed in the cytoplasm of some hepatocytes.

Comparative immunohistochemical study of stellate cells in normal canine and equine adenohypophyses and in pituitary tumours.

The presence and distribution of S100 protein (alpha and beta subunits), cytokeratin polypeptides, glial fibrillary acidic protein, neurofilaments, vimentin, neuron specific enolase, synaptophysin, HLA class II DR antigen, and pituitary hormones (prolactin, adrenocorticotropic hormone and human chorionic gonadotrophin) in stellate cells were studied immunohistochemically in four normal canine pituitary glands, five canine pituitary adenomas, two canine pituitary carcinomas and two equine pituitary adenomas (with surrounding normal glandular tissue). Stellate cells of the pars distalis and pars intermedia of canine and equine adenohypophyses showed a strong reaction with antibodies against S100 protein subunits alpha and beta. They also reacted with antibody against high and low molecular weight cytokeratins, but not with those against other intermediate filament proteins, neuroendocrine markers, the HLA-class II DR antigen or the pituitary hormones. Other populations of cells expressing both subunits of the S100 protein were polygonal cells of the pars distalis of the adenohypophysis (horse) and marginal epithelial cells of the pars intermedia of the adenohypophysis (dog and horse). Some pituitary tumours had S100-immunoreactive cells with a distribution of alpha and beta subunits that differed between the two species. Some canine tumours (one adenoma and one carcinoma) expressed only the alpha subunit, but both of the equine adenomas expressed alpha and beta protein subunits. Some of the S100-immunoreactive tumour cells reacted with RCK-102 (cytokeratins 5+8) antibody in the dog but not in the horse. The results suggested that canine and equine stellate cells of the adenohypophysis are more closely related to epithelial than to glial cells, as is the case in cattle, sheep and goats but not human beings or mice. No subpopulation of cells of bone marrow origin could be identified among canine stellate cells, as they lack MHC class II antigen. The results also suggested that the presence of S100-immunoreactive cells is more striking in canine and equine tumours than in human tumours.

Consequences of the North American Free Trade Agreement for health services: a perspective from Mexico.

OBJECTIVES: The purposes of the study were to assess the potential impact of the North American Free Trade Agreement (NAFTA) on medical care in Mexico and to identify internal measures Mexico could take to increase the benefits and minimize the risks of free trade. METHODS: The dual nature of the health sector is examined; the Mexican, Canadian, and US health care systems are compared; and modes and consequences of international exchange of health services are analyzed. RESULTS: Four issues require immediate attention: accreditation of health care facilities, licensing and certification of professionals, technology assessment, and financial equity. CONCLUSIONS: NAFTA offers opportunities for positive developments in Mexico, provided risks can be anticipated and preventive measures can be taken to avoid negative impacts on the health system. Medical services, like other elements of the Mexican economy, must be modernized to respond to the demands of global competition. The Mexican National Academy of Medicine has recommended to the Mexican government (1) internal strengthening of the Mexican health care system to improve its ability to respond to the new conditions created by NAFTA and (2) a gradual process to facilitate equitable and mutually beneficial interactions among the three countries.

[Conceptual basis of international health]. / Bases conceptuales de la nueva salud internacional.

International health is becoming an important field of study and practice due mainly to the increasing complexity of international relationships which imply both changes in the epidemiologic profile of the population, and transformations of health care delivery systems. At the same time, the character of health problems does not recognize the geographical boundaries of nations; instead, it may open or reinforce new areas of cooperation or conflict in the international arena. The many interactions between international relations and health impose the need to build and consolidate an academic and intellectual tradition of international health, which supports its efforts to generate knowledge and leads its practical applications. International health is experiencing important conceptual and strategic changes which have to be taken into account if educational programs, research projects, and national, binational and multinational health actions are to be comprehensive in their approach, scope, and focus. This article identifies those conceptual and strategic changes, proposes basic definitions, the universe for action, and the disciplinary base of the new international health. In short, the article proposes the transition towards a new international health concept and practice.

[Education, investigation and action in international health: Unit of International Studies in Public Health, Mexico]. / Educación, investigación y acción en salud internacional: la Unidad de Estudios Internacionales en Salud Pública, México.

The internationalization of health causes, conditions, and responses require the consolidation of a vigorous academic and pragmatic tradition of international health. The Unit for International Studies in Public Health constitutes an interinstitutional effort for the training of human resources, research, consulting and practice in health needs and actions that go beyond national borders and that affect two or more countries. The main objectives of the Unit are, on the one hand, to develop a conceptual framework and consolidate international health as a field of public health and, on the other, to foster international technical cooperation among the national institutions that conform the Unit and foreign universities, governments of developing and developed countries, and international organizations. The strategies of the Unit are: interinstitutional and intrainstitutional collaboration, consolidation of multidisciplinary teams, integration of research-teaching-service, and external resources fund-raising. The functioning of the Unit is based on an academic program and on an international technical cooperation program.

International health in transition.

The need for a transition towards a new concept of international health is emphasized and a paradigm for making the transition is proposed. The challenge of building a vigorous intellectual and academic tradition of international health which supports its efforts to generate knowledge and leads to its practical application is recognized and addressed. It is argued that the development of such an intellectual field is based on four elements: conceptual base, production base, reproduction base, and utilization base. The Unit for International Studies in Public Health (UISPH) of Mexico is presented as one example of efforts to consolidate an academic tradition in this field.

[Leishmaniasis of the genital organs]. / Leishmaniasis en órganos genitales.

Five cases of leishmaniasis in genital organs are exposed. The patients are males, farmers, with less than 30 years old (except one), residents of high leishmaniasis incidence zones. The majority of lesions were in penis, and of scabies ulcer type, destructive, painless and of slow evolution. In this cases generally, the clinic diagnosis was difficult to corroborate by the habitual laboratory methods and we insist that the principal differential diagnosis are the neoplastic process of the zone. The suspicion high index is important even to proceed to the therapeutic test and solve this kind of problems.