Poliparasitosis asintomática en un inmigrante subsahariano / Asymptomatic polyparasitosis in a sub-Saharan immigrant

Las infecciones parasitarias intestinales constituyen un problema de salud pública en diversas regiones del mundo, especialmente en áreas tropicales y subtropicales. Se calcula que un tercio de la población mundial está infectada por parásitos intestinales, siendo comunes las poliparasitosis, lo cual es causa de trastornos tales como malnutrición, anemia por déficit de hierro, obstrucción intestinal o retraso de crecimiento. Sin embargo, en adultos lo habitual es que esta patología sea asintomática. Algunos parásitos, como Schistosoma o Strongyloides, persisten durante años, siendo necesario su tratamiento para evitar el desarrollo de complicaciones más serias en estadios avanzados. El cribado de parásitos importados en inmigrantes aparentemente sanos es una prioridad en los centros de atención primaria, especialmente en aquellos que provienen de áreas endémicas. La investigación debe ir dirigida hacia aquellos parásitos prevalentes en el área de procedencia de cada paciente. En este artículo presentamos el caso de un paciente subsahariano que es diagnosticado de un cuadro de poliparasitosis en el contexto de una enfermedad aguda que motiva la asistencia sanitaria (AU)

Intestinal parasitic diseases pose a public health problem in many countries of the world, especially in tropical and subtropical areas. It is estimated that one third of the world's population may be infected with intestinal worms, polyparasitosis being common. This is the cause of a variety of conditions including malnutrition, iron-deficiency anemia, intestinal obstruction or physical growth retardation. Nevertheless, this condition is usually asymptomatic in adults. Some parasites such as Schistosoma and Strongyloides persist for many years and must be treated to prevent the development of serious complications at later stages. Screening for imported parasites in apparently healthy immigrants remains a public health priority in health care settings that attend immigrants, most of whom may have emigrated from countries where intestinal parasitic diseases are endemic. Research must focus on parasites prevalent in the area where the person has lived. In this article, we present the case of a sub-Saharan patient who was diagnosed of polyparasitosis in the context of an acute disease that required health care assistance (AU)

Poliparasitosis asintomática en un inmigrante subsahariano / Asymptomatic polyparasitosis in a sub-Saharan immigrant

Las infecciones parasitarias intestinales constituyen un problema de salud pública en diversas regiones del mundo, especialmente en áreas tropicales y subtropicales. Se calcula que un tercio de la población mundial está infectada por parásitos intestinales, siendo comunes las poliparasitosis, lo cual es causa de trastornos tales como malnutrición, anemia por déficit de hierro, obstrucción intestinal o retraso de crecimiento. Sin embargo, en adultos lo habitual es que esta patología sea asintomática. Algunos parásitos, como Schistosoma o Strongyloides, persisten durante años, siendo necesario su tratamiento para evitar el desarrollo de complicaciones más serias en estadios avanzados. El cribado de parásitos importados en inmigrantes aparentemente sanos es una prioridad en los centros de atención primaria, especialmente en aquellos que provienen de áreas endémicas. La investigación debe ir dirigida hacia aquellos parásitos prevalentes en el área de procedencia de cada paciente. En este artículo presentamos el caso de un paciente subsahariano que es diagnosticado de un cuadro de poliparasitosis en el contexto de una enfermedad aguda que motiva la asistencia sanitaria(AU)

Intestinal parasitic diseases pose a public health problem in many countries of the world, especially in tropical and subtropical areas. It is estimated that one third of the world's population may be infected with intestinal worms, polyparasitosis being common. This is the cause of a variety of conditions including malnutrition, iron-deficiency anemia, intestinal obstruction or physical growth retardation. Nevertheless, this condition is usually asymptomatic in adults. Some parasites such as Schistosoma and Strongyloides persist for many years and must be treated to prevent the development of serious complications at later stages. Screening for imported parasites in apparently healthy immigrants remains a public health priority in health care settings that attend immigrants, most of whom may have emigrated from countries where intestinal parasitic diseases are endemic. Research must focus on parasites prevalent in the area where the person has lived. In this article, we present the case of a sub-Saharan patient who was diagnosed of polyparasitosis in the context of an acute disease that required health care assistance(AU)

Tuberculosis intestinal perforada en paciente inmunocompetente / Perforated intestinal tuberculosis in an immunocompetent patient

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Osteomyelitis caused by Staphylococcus schleiferi and evidence of misidentification of this Staphylococcus species by an automated bacterial identification system.

We report a case of sternal osteomyelitis due to Staphylococcus schleiferi in a patient who underwent thoracic surgery. This constitutes the first documented case of osteomyelitis caused by this Staphylococcus species. We also relate our experience in the utilization of commercially available MicroScan panels for the identification of this microorganism.

Slowed reaction time in HIV-1-seropositive intravenous drug users without AIDS.

One hundred and fourteen subjects with a history of intravenous drug abuse (65 subjects infected with the human immunodeficiency virus, HIV, and 49 seronegative controls) were evaluated with a reaction time (RT) test which included one measure of simple RT and three measures of complex RT. All seropositive patients were in HIV stages A or B. The multivariate analysis of covariance controlled for age, educational level and Montgomery-Asberg Depression Rating Scale score, showed differences between seropositive subjects and controls: the seropositive group scored slower than the control group on two RT tasks, simple RT and a more complex RT measure. Our results suggest that computerized RT measures may be more sensitive than conventional neuropsychological tests in detecting subtle cognitive and motor retardation in the early stages of HIV infection, thus extending the findings of other studies to the intravenous drug-user population.

Talc granulomatosis. A differential diagnosis of interstitial lung disease in HIV patients.

Consumers of adulterated drugs may present with talc-induced interstitial lung disease. A transbronchial biopsy specimen showing granulomas with intracellular talc crystals is necessary to confirm this diagnosis. In patients infected with HIV, such a condition can be indistinguishable at first glance from opportunistic infections or other pulmonary diseases. A case is presented of a seropositive patient whose chest radiographs showed a diffuse interstitial pattern.

Factors associated with neuropsychological performance in HIV-seropositive subjects without AIDS.

BACKGROUND: Previous research has suggested that several factors may influence the presence of cognitive impairment in human immunodeficiency virus (HIV) infection. The objective of this study was to assess the impact of cognitive reserve capacity and other variables on neuropsychological performance in early HIV infection. METHODS: The neuropsychological performance of 100 HIV-seropositive subjects without AIDS (71 men and 29 women) was compared with that of 63 seronegative controls (51 men and 12 women). Measures included a neuropsychological battery, a medical examination and a psychiatric assessment. Cognitive reserve scores were based on a combination of years in school, a measure of educational achievement, and an estimate of pre-morbid intelligence. RESULTS: HIV-positive subjects had longer reaction time latencies than HIV-negative subjects. Those in the HIV-positive group with low cerebral reserve scores showed the poorest performance on the neuropsychological tests. The prevalence of cognitive impairment was significantly higher in the HIV-positive group (27%) than in the controls (32%). Multiple regression analysis and logistic regression analysis were used to identify factors associated with global neuropsychological performance and cognitive impairment. Older age, lower cerebral reserve scores and not being on zidovudine treatment were associated with lower global neuropsychological scores and with the presence of cognitive impairment. CONCLUSIONS: Our results suggest that although cognitive impairment is not characteristic of early HIV infection, there is a subgroup of subjects who perform more poorly than expected. A lower reserve capacity, older age and not being on zidovudine treatment are factors that lower the threshold for neuropsychological abnormalities in cases of early HIV infection.

Endocarditis due to Acinetobacter lwoffi on native mitral valve.

Endocarditis due to Acinetobacter is a rare pathology with high mortality, reported mainly in hospitalized patients with predisposing risk factors. This is the second case of endocarditis due to Acinetobacter reported in our country in the last 10 years.

[Normative data for the neuropsychological evaluation of intravenous drug users]. / Datos normativos para la exploración neuropsicológica de usuarios de drogas por vía parenteral.

BACKGROUND: There are many recent epidemiological studies that find that intravenous drug users' (IDU's) performance in several measures of neuropsychological function are not the same than that of the general population, whether they are seropositive to HIV-1 infection or not. Consequently, it has been stated the need to establish appropriate norms for this population. The purpose of this study is to provide normative data on a battery of neuropsychological tests from a IDU group. SUBJECTS AND METHODS: This report provide normative data from a group of 116 IDU, on a battery of neuropsychological tests stratified by age group (mean = 30.9; SD = 4.5), and educational level (mean = 8; SD = 2.4). Comparisons between the means of the different groups according to age and education, and also with respect to sex are made. The analysis includes estimation of partial correlations between neuropsychological test scores and age and education. RESULTS: The analysis demonstrates that education is an important determinant of performance for most of these tests, while there are no differences in performance between the two age-groups. With respect to sex, females out-performed men on a measure of motor speed and coordination. CONCLUSIONS: This report provides norms that may be of use as a reference for clinical evaluation and research in drug user populations. It also emphasizes the need to establish normative data controlling for variables like educational level, from a population with special characteristics such as IDU population.