Neglected zoonotic helminthiases in wild canids: new insights from South America.

The global threat of neglected tropical diseases (NTDs) constitutes a public health issue in underdeveloped countries. Zoonotic helminthiases are the most common human NTD agents in developing countries in sub-Saharan Africa, Asia, and the Americas, causing a global burden of disease that exceeds that of more recognized infectious diseases such as malaria and tuberculosis. Wild canids are well-known mammals that act as natural reservoirs of zoonotic-relevant helminthiasis worldwide, thus playing a pivotal role in their epidemiology and transmission to humans. Here we evaluate the occurrence of zoonotic gastrointestinal helminths in two Neotropical wild canid species from the Amazonian and Andean regions of Colombia, i.e., the bush dog (Speothos venaticus) and the crab-eating fox (Cerdocyon thous). We recovered tapeworm proglottids from bush dog fecal samples and identified them molecularly as the canine-specific lineage of Dipylidium caninum by using cytochrome c oxidase subunit I (cox1) gene sequences. Moreover, examination of a crab-eating fox during necropsy revealed the presence of non-embryonated eggs of the neglected nematode Lagochilascaris cf. minor, in addition to eggs and gravid proglottids of the cestode Spirometra mansoni. These findings represent the first report of zoonotic-relevant cestodes, i.e., D. caninum ("canine genotype"), S. mansoni, and the nematode L. cf. minor, in bush dogs and crab-eating foxes as final hosts. The occurrence of these zoonotic helminthiases in wild canid species calls for regular monitoring programs to better understand the epidemiology and transmission routes of neglected dipylidiasis, lagochilascariosis, and sparganosis in South America.

Presence of Spirometra mansoni, Causative Agent of Sparganosis, in South America.

We report molecular identification of an adult Spirometra mansoni tapeworm retrieved from a crab-eating fox (Cerdocyon thous) in Colombia, confirming presence of this parasite in South America. This tapeworm is the causative agent of human sparganosis, commonly reported from Southeast Asia, and represents the second congeneric species with known zoonotic potential in the Americas.

Nationwide Seroprevalence Survey of Angiostrongylus vasorum-Derived Antigens and Specific Antibodies in Dogs from Colombia.

Angiostrongylus vasorum is a cardiopulmonary nematode, causing several clinical manifestations in dogs, e.g., severe respiratory signs, coagulopathy, and gastrointestinal or neurological signs. In the last decades, this parasite has been described to spread and emerge in Europe and North America. Scant studies on A. vasorum occurrence in South America exist. Recently, A. vasorum was detected in gastropod intermediate hosts in Colombia, where data on definitive host prevalence, e.g., dogs and wild canids, are still limited. Therefore, the sera of 955 dogs, varying in age and breed from seven different departments all over Colombia, were collected and analysed for A. vasorum antigens and parasite-specific antibodies by ELISA. In total, 1.05 % (n = 10; 95 % CI 0.40-1.69) of the samples were antigen-positive and 2.62 % (n = 25; 95 % CI 1.61-3.63) were antibody-positive. These results confirm the presence of A. vasorum in Colombia, although positive results in antigen and antibody reactions in the same dog were not detected. This study is the first large-scale survey on A. vasorum seroprevalences in dogs from Colombia.

Molecular Evidence of Orthomyxovirus Presence in Colombian Neotropical Bats.

The Orthomyxoviridae family includes the genera Influenzavirus, Isavirus, Quaranjavirus, and Thogotovirus. In turn, Influenzavirus can be classified into four types: α, ß, γ, and δ (Formerly A, B, C, and D), from which Alphainfluenzavirus (AIV) has the broadest host range, including birds, mammals, reptiles, and amphibians. Additionally, AIV has shown global epidemiological relevance owing to its pandemic potential. The epidemiological relevance of Chiropteran due to its multiple functional characteristics makes them ideal reservoirs for many viral agents. Recently, new influenza-like subtypes have been reported in Neotropical bats, but little is known about the relevance of bats as natural reservoirs of influenza viruses. Therefore, the current study aimed to determine the presence of AIV and new influenza-like subtypes in South American bats. For a better understanding of the drivers and interactions between AIV and bats, we used molecular assays with different gene targets (i.e., M, NP, and PB1) to identify AIV in New World bats. A housekeeping gene (CytB) PCR was used to check for nucleic acid preservation and to demonstrate the bat-origin of the samples. A total of 87 free-living bats belonging to 25 different species of the families Phyllostomidae and Vespertilionidae were collected in Casanare, Colombia. As a result, this study found seven AIV-positive bat species, three of them reported for the first time as AIV prone hosts. Neither of the AIV-like analyzed samples were positive for H17N10/H18/N11 subtypes. Although additional information is needed, the presence of a completely new or divergent AIV subtype in neotropical bats cannot be discarded. Collectively, the results presented here expand the epidemiological knowledge and distribution of AIV in neotropical free-ranging bats and emphasize the need to continue studying these viruses to establish the role they could play as a threat to animal and public health.

The Neglected Angio-Neurotrophic Parasite Gurltia paralysans (Nematoda: Angiostrongylidae): Northernmost South American Distribution, Current Knowledge, and Future Perspectives.

Gurltia paralysans is a rare metastrongyloid nematode in South America that has begun to gain relevance in feline internal medicine as a differential diagnosis of progressive degenerative myelopathy disorders. The parasite life cycle has not been fully elucidated but probably involves invertebrate gastropod fauna as obligate intermediate hosts; thus, G. paralysans remaining an extremely neglected parasitosis. Feline gurltiosis intra vitam diagnosis is highly challenging due to lack of evidence in the excretion of G. paralysans eggs and larvae, neither in feces nor in other body secretions because environmental stages and the transmission route of the parasite remain unknown. Unfortunately, no experimental trials for the treatment of feline gurltiosis have been conducted to date. However, there are some reports of the successfully antiparasitic drugs used with different effectiveness and clinical improvement results in diagnosed cats. Further studies are needed to evaluate the parasite occurrence among domestic cats and the neotropical wild felid species distributed within Colombia in addition to the gastropod fauna that may harbor the developing larvae (L1-L3) stages of this underestimated parasite.

Parasites Circulating in Wild Synanthropic Capybaras (Hydrochoerus hydrochaeris): A One Health Approach.

Capybaras (Hydrochoerus hydrochaeris) are affected by a wide range of protozoan and metazoan-derived parasitic diseases. Among parasites of free-ranging capybaras are soil-, water-, food- and gastropod-borne parasitosis, today considered as opportunistic infections in semiaquatic ecosystems. The overlapping of the capybara's natural ecological habitats with human and domestic animal activities has unfortunately increased in recent decades, thereby enhancing possible cross- or spillover events of zoonotic parasites. Due to this, three synanthropic wild capybara populations in the Orinoco Basin were studied for the occurrence of gastrointestinal parasite infections. A total of forty-six fecal samples were collected from free-ranging capybaras in close proximity to livestock farms. Macroscopical analyses, standard copromicroscopical techniques, coproELISA, PCR, and phylogenetic analysis revealed thirteen parasite taxa. In detail, the study indicates stages of five protozoans, four nematodes, one cestode, and three trematodes. Two zoonotic parasites were identified (i.e., Plagorchis muris, and Neobalantidium coli). The trematode P. muris represents the first report within South America. In addition, this report expands the geographical distribution range of echinocoelosis (Echinocoleus hydrochoeri). Overall, parasitological findings include two new host records (i.e., P. muris, and Entamoeba). The present findings collectively constitute baseline data for future monitoring of wildlife-derived anthropozoonotic parasites and call for future research on the health and the ecological impact of this largest semiaquatic rodent closely linked to humans, domestic and wild animals.

Intestinal Parasites of Neotropical Wild Jaguars, Pumas, Ocelots, and Jaguarundis in Colombia: Old Friends Brought Back from Oblivion and New Insights.

Neotropical wild felids (NWF) are obligate carnivore species present in Central and South America, and some are considered endangered due to constantly decreasing populations. NWF can become infected by a wide range of protozoan and metazoan parasites, some of them affecting their health conditions and others having anthropozoonotic relevance. Parasitological studies on NWF are still very scarce, and most data originated from dead or captive animals. On this account, the current study aimed to characterize gastrointestinal parasites of free-ranging jaguars (Panthera onca), pumas (Puma concolor), ocelots (Leopardus pardalis), and jaguarundis (Herpailurus yagouaroundi), i.e., four out of six NWF species endemic to Colombia. Fecal samples from jaguars (n = 10) and ocelots (n = 4) were collected between 2012 and 2017 as part of the Jaguar Corridor Initiative from six geographic locations in Colombia. In addition, cestode specimens were obtained during puma and jaguarundi necropsies. Scat samples were processed by standardized sodium acetate-acetic acid-formalin (SAF), sedimentation, and flotation techniques and by carbol fuchsin-stained fecal smears. Morphological evaluation of feces showed the presence of one cestode (Spirometra sp.), a nematode (Toxocara cati), an acanthocephalan (Oncicola sp.), and one cyst-forming coccidian (Cystoisospora-like oocysts). Feces oocysts were submitted to a Toxoplasma gondii-specific PCR for species identification, but no product was amplified. The cestodes isolated from a puma and jaguarundi were molecularly characterized by sequencing cytochrome c oxidase subunit I, identifying them as Taenia omissa and as a T. omissa sister lineage, respectively. These results collectively demonstrate the potential role of NWF as natural reservoir hosts for neglected zoonotic parasites (e.g., Spirometra sp., T. cati) and highlight their possible role in parasite transmission to human communities. Due to public health concerns, the occurrence of these parasites should be monitored in the future for appropriate zoonotic management practices in conservation strategies and wild felid health management programs.

Comparison between amine fluoride and chlorhexidine with institutionalized elders: a pilot study.

OBJECTIVE: Compare the efficacy of amine fluoride toothpaste and gel with chlorhexidine spray in an institutionalised population. BACKGROUND: People who live in nursing homes have poorer oral hygiene because of their dependency for the basic activities of daily living as they rely on caregivers. METHODS: Twenty-six people over 65 years old who had at least four teeth and living in a nursing home. They were assigned to three groups: A: amine fluoride toothpaste and once a week amine fluoride gel (Elmex(®) ), B: 0.12% spray-chlorhexidine once a day (Perio-Aid(®) ) and C: brush teeth without toothpaste. The plaque and gingival index of Silness and Löe, General Oral Health Assessment Index, McLeran and Pfeiffer index were recorded, and the number of colonies of Streptoccocus mutans and Lactobacillus and the remineralisation of caries were evaluated using Diagnodent(®). Measurements were taken at the beginning of the study and after 6 months. RESULTS: Twenty-two people finished the study. No group showed a statistical difference in the plaque or gingival index, but there was a tendency to show improvement in the amine fluoride group. There was also no difference between the number of colonies of either S. mutans or lactobacillus. There was a significant difference between the plaque and gingival index and the cognitive status (p=0.0054), along with their requirement for assistance to perform good oral hygiene (p=0.0001). Both products remineralised the carious lesions in this period compared with the control group (p=0.0151). CONCLUSION: The plaque and gingival indices did not improve during the study, but both products remineralised the previous caries lesions.

Manejo del paciente diabético anciano / No disponible

Objetivos: Dado que tanto la diabetes como la patología periodontal son altamente prevalentes en el anciano y presentan una gran interrelación presentamos unas pautas de actuación del dentista de atención primaria encaminadas a extremar la colaboración entre médico generalista y odontólogo. Material y métodos: Nuestro trabajo consiste en una revisión bibliográfica en base a artículos del Medline publicados en los últimos años. Resultados: La diabetes mellitus es un factor de riesgo para el desarrollo de enfermedad periodontal. Los pacientes diabéticos con mal control metabólico se asocian con una mayor frecuencia de enfermedad periodontal. La diabetes mellitus es un factor de riesgo para el desarrollo de enfermedad periodontal, aumentando la incidencia, prevalencia y severidad de la periodontitis. Conclusiones: Una diabetes descontrolada puede agravar la enfermedad periodontal y a su vez la patología periodontal contribuye a complicar el control de la diabetes. Es por ello que hemos de conocerla conexión existente entre estas dos patologías, así como el protocolo de actuación que deberíamos seguir cuando nos enfrentamos a este tipo de pacientes en nuestras consultas. Los estudios muestran que una terapia periodontal efectiva mejora el control metabólico de la diabetes. Por tanto hemos de promover la salud oral en los pacientes diabéticos. El cuidado dental de nuestros pacientes diabéticos es insuficiente en la actualidad, por ello, el odontólogo y el médico de familia han de estrechar lazos de colaboración para concienciar a los diabéticos de la importancia de la salud oral en el mantenimiento de su salud general (AU)

Objectives: Provided that diabetes and periodontal pathology are highly prevalents in the elder and present a great interrelationship we present a few dentist primary card guidelines directed to carry to extremes the collaboration between medical general practitioner and odontologist. Material and methods: Our work consists of a bibliographical review on the basis of articles of the Medline published in last years. Results: Diabetes mellitus is a factor of risk for the development of periodontal disease increasing the effect, prevalence and severity of the periodontitis. Diabetic patients with badly metabolic control are associated with a high frequency of periodontal disease. Conclusions: An over-excited diabetes can aggravate the periodontal disease and in turn the periodontal pathology helps to complicate the control of the diabetes. For that reason we have to know the existing connection among these two pathologies, as well as the protocol of performance that we should follow when we face this type of patient in our dental clinics. The studies show that an effective periodontal therapy l is improves the metabolic control of diabetes. Therefore, the oral health in the diabetic patients is insufficient at present, for this reason, the dentist and the general doctor have to increase their collaboration convince the diabetics of the importance of the oral health in the maintenance of theirs general health (AU)

Perfil epidemiológico de la intoxicación con burundanga en la clínica Uribe Cualla S.A. de Bogotá, D.C / Epidemic profile of the intoxication with burundanga in the Clínica Uribe Cualla of Bogotá, D. C

Introducción: Las intoxicaciones con intención delictiva constituyen un motivo frecuente de consulta en urgencias. Objetivo: Presentar el perfil epidemiológico de la intoxicación con burundanga y nueva burundanga en un centro de referencia de Bogotá. Material y métodos: Se hizo una revisión de las historias clínicas de los pacientes que consultaron a la clínica Uribe Cualla SA. entre Enero de 1998 y Julio de 2004. Resultados: Se evaluaron las historias de 860 pacientes, se encontró una mayor frecuencia de pacientes en edad reproductiva (20-50 años), del sexo masculino 79,1 por ciento, en quienes el móvil más frecuente fue el robo 67,44 por ciento. Conclusión: Los datos obtenidos en el estudio concuerdan con los de otras instituciones colombianas que reciben esta clase de pacientes. La Clínica Guillermo Uribe Cualla es un centro de referencia para patologías toxicológicas. Conocer las características de los pacientes atendidos en esta Institución permite una buena aproximación al perfil epidemiológico de estas intoxicaciones en nuestro país y con base en estos datos diseñar estudios que permitan estudiar y mejorar los problemas que traen consigo la intoxicación con estas sustancias y sus consecuencias reales sobre la salud de los Colombianos

Meningitis por Listeria monocytogenes: un caso en el servicio de Pediatría deñ Hospital San José, Bogotá, DC / Meningitis for Listeria monocytogenes: a case in the service of Pediatrics of San José's Hospital, Bogotá

L.monocytogenes es un cocobacilo Gram positivo, no esporulado, anaerobio facultativo, que se encuentra ampliamente distribuido en la naturaleza y crece en un amplio rango de temperatura (-0.4 C a 50 C), y constituye una causa importante de infección, en especial en mujeres embarazadas, recién nacidos e inmunosuprimidos, causando bacteriemia y meningitis en estos pacientes. En pediatría la L. monocytogenes está dentro de las tres principales causas de meningitis neonatal y se presenta como una infección temprana, hasta el tercer día de nacido, comportándose como un cuadro clínico de sepsis neonatal temprana. La listeriosis neonatal de presentación tardía es menos común. Se presenta en recién nacidos a término, después de la segunda semana de vida y cursa como una meningitis. Posterior al período neonatal, 30-50 por ciento de los pacientes presenta un cuadro clínico de meningitis, asociada a inmunosupresión

Factores de riesgo para que la población mayor institucionalizada presente caídas / Risk factors for falls in the institutionalized elder population

El objetivo es determinar los factores de riesgo de caídas en las personas de tercera edad institucionalizadas. Metodología: análisis de datos de un estudio de cohorte longitudinal. Sujetos: residentes voluntarios institucionalizados en un hogar geriátrico en Arbeláez, Colombia, con seguimiento a seis meses (N = 116; edad promedio: 78 años). Medida principal de resultado: caídas según informes de enfermería y registros médicos. Variables independientes: las medidas básicas demográficas, historia médica, medicamentos, depresión, estado mental, agudeza visual, hipotensión ortoestática, índice de masa corporal, estado cardiovascular, deformidades de miembro inferior, fuerza de miembro inferior, tono, trofismo, rango de movimiento, Romberg, prueba de equilibrio: unipedestación, prueba de Get up and go y la prueba de Get up and go cronometrada. Evaluación de instalaciones locativas con la escala de TESS-NH y SCUEQS. Resultados: durante los seis meses de seguimiento, el 36 por ciento experimentó caída. Ninguna con consecuencias graves. Los factores de riesgo independientes significativos para todas las caídas, según la regresión logística, fueron el género femenino, la historia de vértigo y una prueba de unipedestación anormal. Los coeficientes B para cada variable fueron de 1,029,2,024 y 1,712, respectivamente. Conclusión: el género femenino, la historia de vértigo y la prueba de equilibrio (prueba de unipedestación) anormal parecen ser los principales factores significativos de caídas en la población geriátrica institucionalizada. Sin embargo, ningún factor aislado parece ser lo bastante exacto como para ser un predictor de riesgo confiable de caídas por la existencia de múltiples factores relacionados con las caídas.

Encefalitis herpética: un caso en la unidad de ciudado intensivo UCI pediátrica del Hospital Occidente de Kennedy, Bogotá / Herpetic encephalitis: a case in the pediatric unit of intensive care of the Hospital of Kennedy, Bogotá

Presentamos el caso de una lactante con diagnóstico confirmado de encefalitis herpética mediante la reacción en cadena de la polimerasa (PCR), hallazgos típicos por imágenes y pronóstico favorable a corto plazo

Uso de amantadina en el síndrome neuroléptico maligno en el Hospital Occidente de Kennedy, Bogotá / Amantadine usefulness in neuroleptic malignant syndrome

El síndrome neuroléptico maligno, es la complicación mas temida con el uso de medicamentos tales como: las butiferofenonas (haloperidol), las fonotiazinas y las sales de litio en especial, aunque se ha descrito con otros fármacos. Su frecuencia es baja, 1/100 aproximadamente. El síndrome es una reacción idiosincrática caracterizada por la triada clínica de fiebre, rigidez y cambios mentales. Su curso puede ser fatal si no se reconoce y maneja prontamente. Se presentan tres casos de sindrome neuroléptico maligno atendidos en el Hospital Occicente de Kennedy (Bogotá), diagnosticados en fase inicial y tratados con infusión de amantadina con respuesta clínica favorable.