Comparison of small mammal prevalence of Leishmania (Leishmania) mexicana in five foci of cutaneous leishmaniasis in the State of Campeche, Mexico.

In the Yucatan Peninsula of Mexico, 95% of the human cases of Cutaneous Leishmaniasis are caused by Leishmania (Leishmania) mexicana with an incidence rate of 5.08 per 100,000 inhabitants. Transmission is limited to the winter months (November to March). One study on wild rodents has incriminated Ototylomys phyllotis and Peromyscus yucatanicus as primary reservoirs of L. (L.) mexicana in the focus of La Libertad, Campeche. In the present study, the prevalence of both infection and disease caused by L. (L.) mexicana in small terrestrial mammals were documented during five transmission seasons (1994-2004) in five foci of Leishmaniasis in the state of Campeche. Foci separated by only 100 km, with similar relative abundances of small mammals, were found to differ significantly in their prevalence of both symptoms and infection. Transmission rates and reservoir species seemed to change in space as well as in time which limited the implementation of effective control measures of the disease even in a small endemic area such as the south of the Yucatan Peninsula.

Comparison of small mammal prevalence of Leishmania (Leishmania) mexicana in five foci of cutaneous leishmaniasis in the State of Campeche, Mexico / Comparación de las prevalencias de Leishmania (Leishmania) mexicana en mamíferos pequeños en cinco focos de leishmaniosis cutánea en el estado de Campeche, México

In the Yucatan Peninsula of Mexico, 95% of the human cases of Cutaneous Leishmaniasis are caused by Leishmania (Leishmania) mexicana with an incidence rate of 5.08 per 100,000 inhabitants. Transmission is limited to the winter months (November to March). One study on wild rodents has incriminated Ototylomys phyllotis and Peromyscus yucatanicus as primary reservoirs of L. (L.) mexicana in the focus of La Libertad, Campeche. In the present study, the prevalence of both infection and disease caused by L. (L.) mexicana in small terrestrial mammals were documented during five transmission seasons (1994-2004) in five foci of Leishmaniasis in the state of Campeche. Foci separated by only 100 km, with similar relative abundances of small mammals, were found to differ significantly in their prevalence of both symptoms and infection. Transmission rates and reservoir species seemed to change in space as well as in time which limited the implementation of effective control measures of the disease even in a small endemic area such as the south of the Yucatan Peninsula.

En la Península de Yucatán, México, la Leishmaniosis Cutánea es causada por Leishmania (L.) mexicana en 95% de los casos humanos, con una incidencia de 5.08% por cada 100,000 habitantes. El ciclo de transmisión se limita a la estación de invierno (noviembre- marzo). Un estudio de mamíferos silvestres incrimina a Ototylomys phyllotis y Peromyscus yucatanicus como reservorios primarios de L. (L.) mexicana en el foco de infección de La Libertad, Campeche. En el presente estudio, se documenta la prevalencia de infección/enfermedad causada por L. (L.) mexicana en pequeños mamíferos, durante cinco estaciones de transmisión (1994-2004) en cinco focos de CL del estado de Campeche. Los focos separados por solamente 100 km. de distancia, aún cuando tienen abundancias relativas de pequeños roedores similares, fueron significativamente diferentes en relación a la prevalencia de síntomas así como de infección. Las tasas de transmisión y las especies de reservorios parecen estar cambiando tanto en el tiempo como en el espacio, lo cual impide el establecimiento de adecuadas medidas de control de la enfermedad aún en un área endémica tan pequeña como lo es el sur de la Península de Yucatán.

[A comparison and synergy in the treatment of essential arterial hypertension]. / Comparación y sinergia en el tratamiento de la hipertensión arterial esencial.

Forty patients with mild or moderate essential hypertension were studied. They received daily doses of either 240 mg verapamil or 10 mg enalapril, as well as a placebo. Total duration of trial was 24 weeks: a "washout" period of 2 weeks, a treatment period of 6 weeks with one of the two drugs, another "washout" period of 2 weeks, and another treatment period of 6 weeks with the alternate drug. Those patients with persistence of diastolic blood pressure (DBP) above 90 mmHg received simultaneously both drugs for an additional period of 8 weeks. Patients were assigned alternately to one of the groups. When each drug was given during the first treatment period, DBP was reduced below 90 mmHg in 15 of 19 patients receiving verapamil, and in 12 of 20 that received enalapril. When the drugs were given during the second treatment period, DBP became normal in 16 of 19 patients receiving enalapril, and in all the 18 patients treated with verapamil. Three patients achieved normal DBP when received simultaneously both drugs. Two patients withdrew from the trial for personal reasons and one for experimenting cough as reaction to enalapril. There were no other undesirable side effects. Laboratory tests did not show changes. Both products were similarly effective. Synergy was shown by the improvement of patients unresponsive to either drug when given singly, but responding when both were given simultaneously.

[Cilazapril, a new ACE inhibitor, in severe arterial hypertension]. / Cilazapril, un nuevo inhibidor de ECA, en la hipertensión arterial severa.

We assessed the efficacy and safety of cilazapril, alone or in combination with hydrochlorothiazide. It was an open trial, that included 14 patients with or more 114 mmHg of diastolic arterial tension. On the first stage of 25 days, the arterial tension was normalized in 5 patients with 10 mg of cilazapril and 7 patients when hydrochlorothiazide was added, 2 patients did not respond. On the second stage of 52 weeks, of the 12 patients whose diastolic arterial tension was normalized, 2 patients remained with normal arterial tension with cilazapril, 5 when hydrochlorothiazide was added and the rest 5 patients did not respond. No undesirable side effects were detected, nor abnormalities in the laboratory tests. The long-term benefit obtained on 50% of patients make evident the usefulness of cilazapril in severe arterial hypertension. Its administration once a day and the absence of side effects increase the interest of its use.