Prevalencia de anticuerpos anti-citomegalovirus y anti-virus epstein-barr en Valencia, estado Carabobo, Venezuela / Citomegalovirus and epstein-barr virus prevalence in Valencia, Venezuela

Los Virus de Epstein Barr y Citomegalovirus pueden infectar a los humanos precozmente. Alrededor del 90 por ciento de la población mundial es portadores de este hipervirus, estableciéndose una infección latente por largos períodos de tiempo. Característicamente muestran un patrón seroepidemiológico altamente relacionado con el nivel socioeconómico de la comunidad en estudio. Objetivo: determinar la prevalencia del IgG e IgM anti CMV y VEB en una población menor de 25 años, sana del estado Carabobo. Metodología: El estudio se realizó bajo las Normas de Buenas Prácticas Médicas en Investigación, y el consentimiento informado fue obtenido en cada caso. Se incluyeron 210 individuos en aparentes buenas condiciones de salud, de ambos sexos, distribuidos en 7 grupos etarios: I:<28 días. II: 1-11 meses. III: 12-23 meses. IV: 24-48 meses. V:5-10 años . VI: 11-16 años. VII:16-24 años. La determinación del IgG e IgM se realizó por técnicas de Microelisa. Resultados: La IgM anyti CMV y anti VEB mostró dos picos: el primero en niños menores de 1 año (grupoII) con porcentajes máximos de 23,3 y 6,6 por ciento, respectivamente, y el segundo comenzó después de los 11 años para CMV y a los 16 años para VEB.

Safety, immunogenicity and antibody persistence of an inactivated hepatitis A vaccine in 4 to 15 year old children.

Among 277 healthy Venezuelan children, aged between 4 and 15 years, who were screened for hepatitis A virus (HAV) antibodies, 118 seronegative children were enrolled in an open study. Each child received one dose of the Pasteur Mérieux Connaught inactivated hepatitis A vaccine (AVAXIM¿trade mark omitted¿, 160 antigen units), followed by a booster dose 24 weeks later. All seronegative subjects seroconverted 2 weeks after immunisation (antibody titres greater, similar20 mIU/ml), and antibody titres were still over greater, similar20 mIU/ml after 24 weeks, at the moment of the booster dose. The anti-HAV antibody geometric mean titre (GMT), as measured by a modified radio-immunoassay (HAVAB(R), Abbott Laboratories, North Chicago, IL, USA), was 73.7 mIU/ml, 2 weeks after the first dose. Four weeks after the booster, the GMT value reached 6999 mIU/ml, representing a 29.6-fold rise from pre-booster levels. One year after the booster dose, the GMT value was 1673 mIU/ml in the 92 subjects who provided blood samples at this time, all of whom were still seroconverted ( greater, similar20 mIU/ml). No serious adverse event related to the vaccination occurred during the study. No immediate systemic reaction occurred. Local reactions were reported by 9.3% of subjects who received the primary injection and 5.5% of those given the booster dose. The systemic reactions were mainly fever and myalgia reported over the 7 days following the injection by 3.4% of subjects after the first dose and 5.5% of subjects after the booster dose. A clinically significant elevation of serum transaminase from pre-immunisation levels was noted in one subject (AST level 2.2 times the upper normal limit) 2 weeks after the first injection, although this was not associated with any clinical signs of impaired liver function. This trial demonstrated that AVAXIM¿trade mark omitted¿ containing 160 antigen units is safe and highly immunogenic in healthy children aged between 4 and 15 years, and could be included in the childhood vaccination schedule to control infection in areas endemic for hepatitis A.

[Giardia lamblia: comparison of two diagnostic methods and evaluation of response to treatment with metronidazole]. / Giardia lamblia: comparación de dos métodos de diagnóstico y evaluación de la respuesta al tratamiento con metronidazol.

During the period from March through November 1989, 70 children who were attended at the Pediatric Department at Central Hospital in Valencia, were enrolled in the study, it was thought that Giardia lamblia infection might be present. Giardia L. were identified using two different diagnostic procedures: from stool samples and duodenal aspirates for cysts or trophozoites examination. These children were treated with Metronidazole three dosage of 15, 30 and 50 mg/kg per day for a ten day period. Our study showed predominant giardiasis in children with ages ranging from 2 to 6 years old (60%) with a relationship between female and male sex 1.05:1. In this series, 72.8% of patients presented normal nutrition, and 55.7% of them were from the suburban area. The most frequent symptoms were abdominal pain, diarrhea, vomiting, abdominal distention, constipation and flatulence. The infants prevalent symptom was diarrhea (83.3%) and the older children and school children prevalent symptom was abdominal pain with 78.5 and 100% respectively. In this study, stool examination was positive in 97.1% of the children and duodenal aspirate was positive in all 70 children (100%); the first procedure showed predominant Giardia cysts (88.2%) and the second one showed predominant trophozoites (47.1%). All 70 patients (100%) were cured with Metronidazole to different dosage. Side effects were seen with only the maxim dose, such as nausea 40%, headache 10% and appearance of yeast into 50% of duodenal aspirate.

[Hepatic abscess in children: analysis of 20 cases]. / Abscesos hepáticos en niños: análisis de 20 casos.

Between March 1986 and March 1989, 20 children were diagnosed as having liver abscesses at the Pediatric Department of the Central Hospital in Valencia. 10 were amebic and 10 pyogenic abscesses. 85% occurred in children and 15% in infants. 15 of them (75%) were located in the right lobe, 80% of amebic abscesses had positive serological tests. An etiologic agent was found in 50% of the pyogenic abscesses (3: E. coli, 2: S. Aureus). 80 to 90% of patients presented abnormal prothrombin time. Sedimentation rate was very high in both groups, even at the discharge time. Hepatomegaly, fever, anemia and abdominal pain were the main clinical features. The macroscopic aspect of the aspirate was not helpful in the diagnosis. 60% of amebic liver abscesses needed only medical treatment but 80% of pyogenic abscesses deserved medical treatment and needle aspiration.