Tratamiento empírico de las eosinofilias.Prevenir las complicaciones de la estrongiloidiasis / Empirical treatment of eosinophilas. Prevent the complications of srongyloidiasis

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[Suicide attempts attended at a health centre]. / Intentos de suicidio atendidos en un centro de salud.

OBJECTIVE: To describe the characteristics of the suicide attempts attended in a health district over 10 years (June 1989 to December 1998). DESIGN: Cross-sectional, descriptive study. SETTING: Primary care, rural health district.Patients. Everyone attended after a suicide attempt (55 cases). MAIN MEASUREMENTS AND RESULTS: Data of the following variables were obtained from the legal reports: sex, age, place of residence, prognosis, means used and year of attempt. 51% were women and 49% men. Average age was 34.07, SD 3.82. 96% occurred in the health district. 38% had light prognosis, 49% serious, 7% very serious and 4% uncertain. The means used was ingestion of drugs in 44% of cases. 72% of the attempts occurred in the last 5 years. CONCLUSIONS: There were no differences between the sexes. Most of the patients were under 35. Drug overdose was the method of choice. Suicide attempts are on the up. Primary care authorities and doctors need to become more conscious of potentially suicidal conduct.

[Agricultural occupation and strongyloidiasis. A case-control study]. / Actividad laboral agrícola y estrongiloidiasis. Estudio caso-control.

BACKGROUND: In the last few years, Strongyloides stercoralis has been repeatedly recovered from indigenous farmers in the Safor area (Valencia Community). The relationship between the different occupational activities, mainly farming, and the presence of strongyloidiasis was investigated. PATIENTS AND METHODS: A paired case-control study was designed. The investigation was conducted at Oliva Centro de Salud, from October 1997 to October 1999. Diagnosis was established when Strongyloides stercoralis was observed in any of the three serial fecal samples requested when eosinophilia was observed in the hemogram. Controls were persons matched by sex and age (+/- 5) years, with no eosinophilia in the hemogram and in whom the presence of the parasite was excluded in fecal samples. RESULTS: Participants in the study were 47 cases and their respective controls. Each group included 39 (83%) men and 8 (17%) women. Forty-five cases (95%) and 42 controls (89%) had been born in Safor. Only two cases had travelled to endemic areas. Farming was the main activity in 32 (68%) cases and 31 (66%) controls. The only occupational activity which showed influence on strongyloidiasis was working in ricefields, with an OR of 2.97 (95% CI: 1.16-7.71). Dermatologic symptoms were significant for pruritus, OR 7.39 (95% CI: 2.29-27.60). One case with hyperinfection and another with larva currens were diagnosed. CONCLUSION: In our area, working in ricefields and chronic pruritus are associated with chronic strongylodiasis.

Actividad laboral agrícola y estrongiloidiasis. Estudio caso-control / Farming occupation and strongyloidiasis. Case control study

Fundamento. En los últimos años Strongyloides stercoralis ha sido aislado repetidamente en agricultores autóctonos de la comarca de la Safor (Comunidad Valenciana). Se estudia la relación entre las distintas actividades laborales, principalmente las agrícolas, y la presencia de estrongiloidiasis.Sujetos y métodos. Se diseñó un estudio casocontrol apareado. El trabajo se ha desarrollado en el Centro de Salud de Oliva desde octubre de 1997 a octubre de 1999. En los casos el diagnóstico se estableció al observar Strongyloides stercoralis en alguna de las tres muestras seriadas de heces solicitadas ante la presencia de eosinofilias en el hemograma. Los controles eran personas de igual sexo y edad ñ 5 años, sin eosinofilia en el hemograma y en los que se excluyó la presencia del parásito en las muestras de heces. Resultados. Participaron 47 casos y sus respectivos controles. En cada grupo había 39 (83 por ciento) varones y 8 (17 por ciento) mujeres. Habían nacido en la Safor 45 (95 por ciento) casos y 42 (89 por ciento) controles. Sólo dos casos habían viajado a países endémicos. La agricultura era la actividad principal en 32 (68 por ciento) de los casos y en 31 (66 por ciento) de los controles. La única actividad en la que mostró influencias sobre la estrongiloidiasis fue el trabajo en arrozales, que obtuvo una odds ratio (OR) de 2,97 [intervalo de confianza (IC) 95 por ciento: 1,16-7,71]. Los síntomas dermatológicos resultaron significativos para el prurito, OR de 7,39 (IC 95 por ciento: 2,29-27,60). Fueron diagnosticados un caso con síndrome de hiperinfección y otro con larva currens. Conclusión. En nuestra zona el trabajo en arrozales y el prurito crónico muestran relación con la estrongiloidiasis crónica (AU)

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[30 cases of strongyloidiasis at a primary care center: characteristics and possible complications]. / Treinta casos de estrongiloidiasis en un centro de atención primaria: características y posibles complicaciones.

OBJECTIVE: To study the characteristics of the Strongyloides stercoralis infestation in our area. DESIGN: A 30-case series. Survey of workplace behaviour and hygienic conditions in the home. Review of clinical histories to check for factors putting subjects at risk of severe self-infection. SETTING: 21,000 inhabitants covered by the Oliva Health Centre. PATIENTS: All the cases diagnosed between January 1994 and June 1997. MEASUREMENTS AND INTERVENTIONS: The diagnosis was carried out by observing under the microscope both fresh Strongyloides stercoralis larvae and cultures of three serial faecal samples. RESULTS: We found 19 men (63.3%) and 11 women (36.7%), with an average age of 65 (SD, 11.5 years). 28 had been born in the area (93.4%). 15 had never travelled abroad (50%). Of the 19 men, 18 (94%) had done agricultural work barefoot, but none of the women. Clinically, 17 (56.6%) had chronic symptoms; cough was the most common, in 12 (40%). CONCLUSION: Incidence in our area of Strongyloidiasis, although diagnosed infrequently, has increased considerably with the systematic discarding of the infection in non-attributable cases of Eosinophilia.