Dos casos de meningitis crónica por Angiostrongylus cantonensis. Réplica / Two cases of chronic meningitis due to Angiostrongylus cantonensis. Reply

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[C3c activation and intrathecal biosynthesis in children suffering from eosinophilic meningoencephalitis due to Angiostrongylus cantonensis]. / Activación y biosíntesis intratecal de C3c en niños con meningoencefalitis eosinofilica por Angiostrongylus cantonensis.

INTRODUCTION: Eosinophilic meningoencephalitis due to Angiostrongylus cantonensis is an emergent infectious disease in our area. The objective of the present paper is to determine if the activation of the complement system was taken placed with the C3c production in cerebrospinal fluid. PATIENTS AND METHODS: 14 patients with an average age 4.5 years were studied. In such patients a lumbar punction was performed. C3c was quantified in serum and cerebrospinal fluid by radial immunodiffusion. RESULTS: Median cell number was 396 x 10(-6)/L with an average of 8.8% of eosinophils. Main symptoms were headache, vomiting and fever. Meningeal signs were present in 50% of the patients. C3c intrathecal synthesis occurred in 13 patients (92.8%). CONCLUSION: It was demonstrated the participation of complement system in third-stage larvae destruction in cerebrospinal fluid.

Activación y biosíntesis intratecal de C3c en niños con meningoencefalitis eosinofílica por Angiostrongylus cantonensis / C3c Activation and intrathecal biosythsis in children suffering form eosinohilic meningoencephalitis due to angiostrongylus cantonensis

Introducción. La meningoencefalitis por Angiostrongylus cantonensis es una enfermedad infecciosa emergente. El objetivo del presente trabajo es determinar si se produce la activación del sistema del complemento con la consiguiente producción de C3c en el líquido cefalorraquídeo. Pacientes y métodos. Se estudiaron 14 pacientes con edad promedio de 4,5 años a los que se les realizó una punción lumbar diagnóstica. La cuantificación de C3c y albúmina en el suero y el líquido cefalorraquídeo se realizó en placas de inmunodifusión radial. Resultados. El número de células promedio en el líquido cefalorraquídeo fue de 396 × 10–6 células/L. En la cuenta diferencial de células se apreció el 8,8% de eosinófilos promedio. Los principales síntomas de los pacientes fueron cefaleas, vómitos y fiebre. El 50% presentó algún signo meníngeo. Se comprobó la existencia de síntesis intratecal de C3c en 13 de los pacientes estudiados (92,8%). Conclusión. Se demuestra la participación del sistema de complemento en la destrucción de la larva del tercer estadio del parásito en el líquido cefalorraquídeo (AU)

Introduction. Eosinophilic meningoencephalitis due to Angiostrongylus cantonensis is an emergent infectious disease in our area. The objective of the present paper is to determine if the activation of the complement system was taken placed with the C3c production in cerebrospinal fluid. Patients and methods. 14 patients with an average age 4.5 years were studied. In such patients a lumbar punction was performed. C3c was quantified in serum and cerebrospinal fluid by radial immunodiffusion. Results. Median cell number was 396 × 10–6/L with an average of 8.8% of eosinophils. Main symptoms were headache, vomiting and fever. Meningeal signs were present in 50% of the patients. C3c intrathecal synthesis occurred in 13 patients (92.8%). Conclusion. It was demonstrated the participation of complement system in third-stage larvae destruction in cerebrospinal fluid (AU)

Seasonal distribution and evolving forms of multiple sclerosis patients diagnosed from April 2004 to November 2007

Multiple sclerosis (MS) was first reported in Cuba in 1965. The most frequent appearance is observed in the first six months of the year. Objetive: To determine the seasonal distribution and evolving forms of MS patients diagnosed with the disease between April 2004 and November 2007. Twenty-one patients with suspected MS and 42 outbreaks were studied. Patients were classified according to Lublin and Revingold's criteria for clinical forms and according to McDonald. Most patients were classified in outbreak and remission and only two patients classified as primary-progressive multiple sclerosis. The higher number of outbreaks occurred in the first two quarters of the year. It is recommended to study further weather variables that may be related to the emergence of these outbreaks in our environment(AU)

La esclerosis múltiple (EM) fue reportada en Cuba por primera vez en 1965. Se ha venido observando la aparición más frecuente en los primeros seis meses del año. Objetivo: Determinar la distribución estacional y formas evolutivas de EM en pacientes con diagnóstico de esta enfermedad entre abril 2004 y noviembre 2007. Se estudiaron 21 pacientes con sospecha de EM y un total de 42 brotes. Los pacientes fueron clasificados según los criterios de Lublin y Revingold para las formas evolutivas y según los criterios de McDonald. Solo dos pacientes clasificaron en la forma evolutiva progresiva primaria; los primeros dos trimestres del año fueron los de mayor número de brotes. Se recomienda profundizar en las variables climatológicas que pudieran tener vínculo con la aparición de estos brotes en nuestro medio(AU)

[Clinical relevance of haptoglobin/IgG index and Boyer's score to the differential diagnosis of bacterial and viral meningitis]. / Relevancia clínica del índice haptoglobina/IgG y la escala de Boyer en el diagnóstico diferencial de las meningoencefalitis bacterianas y víricas.

INTRODUCTION: The meningitis is one of the most severe diseases in children due to its mortality or sequels. However, timely knowledge of whether the infection is bacterial or viral in origin and applied a specific therapeutic would be beneficial for the patients and clinician. The haptoglobin/IgG index and Boyer's score have been use in this purpose. PATIENTS AND METHODS: 39 pediatric patients, 14 suffering from viral meningoencephalitis and 25 from bacterial meningoencephalitis were study. Boyer's score and Hp/IgG index were applied in order to evaluate its diagnostic accuracy. The clinical relevance of haptoglobin/IgG index and Boyer's score were compared by the analysis of the receiver-operating characteristic (ROC) curves. RESULTS: There were no association between Boyer's score and the cause of the meningitis. The sensitivity and specificity of haptoglobin/IgG index were de 71.4 and 64%, respectively. The same parametric to Boyer's score were de 28 and 100%. Increased haptoglobin/IgG index presents bigger precision for the differential diagnostic of the bacterial and viral meningitis than the scale of Boyer according to the curves ROC. CONCLUSION: The index haptoglobin/IgG showed its diagnostic superiority with relationship to the scale of Boyer to establish the origin of the meningoencephalitis.

Relevancia clínica del índice haptoglobina/IgG y la escala de Boyer en el diagnóstico diferencialde las meningoencefalitis bacterianas y víricas / Clinical relevance of haptoglobin/IgG index and Boyer's score to the differential diagnosis of bacterial and viral meningitis

ntroducción. Las meningoencefalitis son una de las enfermedades más temidas en la infancia, tanto por su mortalidadcomo por sus posibles secuelas. Sin embargo, conocer tempranamente si su origen es bacteriano o vírico e instauraruna terapéutica adecuada resulta muy beneficioso para el paciente y el médico de asistencia. El índice haptoglobina/IgG y la escala de Boyer se han utilizado con estos fines. Pacientes y métodos. Se estudiaron 39 pacientes en edad pediátrica con eldiagnóstico de meningoencefalitis: 14 que sufrían meningoencefalitis bacterianas y 25 meningoencefalitis víricas. Se calculó el índice haptoglobina/IgG y se le aplicó la escala de Boyer para conocer su utilidad en el diagnóstico diferencial de las meningoencefalitis. La relevancia clínica del índice haptoglobina/IgG y la escala de Boyer se compararon a través de las curvas ROC. Resultados. La escala de Boyer no presentó asociación estadísticamente significativa con el origen de las meningoencefalitis.La sensibilidad y especificidad del índice haptoglobina/IgG fueron del 71,4 y el 64 por ciento, respectivamente, para iguales parámetros en la escala de Boyer del 28 y el 100 por ciento. El índice haptoglobina/IgG presentó mayor precisión para el diagnósticodiferencial de las meningitis bacterianas y víricas que la escala de Boyer a través del área bajo la curvas ROC. Conclusiones. El índice haptoglobina/IgG mostró su superioridad diagnóstica con relación a la escala de Boyer para establecer el origen de las meningoencefalitis(AU)

INTRODUCTION: The meningitis is one of the most severe diseases in children due to its mortality or sequels. However, timely knowledge of whether the infection is bacterial or viral in origin and applied a specific therapeutic would be beneficial for the patients and clinician. The haptoglobin/IgG index and Boyer's score have been use in this purpose. PATIENTS AND METHODS: 39 pediatric patients, 14 suffering from viral meningoencephalitis and 25 from bacterial meningoencephalitis were study. Boyer's score and Hp/IgG index were applied in order to evaluate its diagnostic accuracy. The clinical relevance of haptoglobin/IgG index and Boyer's score were compared by the analysis of the receiver-operating characteristic (ROC) curves. RESULTS: There were no association between Boyer's score and the cause of the meningitis. The sensitivity and specificity of haptoglobin/IgG index were de 71.4 and 64 percent, respectively. The same parametric to Boyer's score were de 28 and 100 percent. Increased haptoglobin/IgG index presents bigger precision for the differential diagnostic of the bacterial and viral meningitis than the scale of Boyer according to the curves ROC. CONCLUSION: The index haptoglobin/IgG showed its diagnostic superiority with relationship to the scale of Boyer to establish the origin of the meningoencephalitis(AU)

Relevancia clínica del índice haptoglobina/IgG y la escala de Boyer en el diagnóstico diferencial de las meningoencefalitis bacterianas y víricas / Clinical relevance of haptoglobin/IgG Index and boyer's score to the differential diagnosis of baterial and viral meningitis

Introducción. Las meningoencefalitis son una de las enfermedades más temidas en la infancia, tanto por su mortalidad como por sus posibles secuelas. Sin embargo, conocer tempranamente si su origen es bacteriano o vírico e instaurar una terapéutica adecuada resulta muy beneficioso para el paciente y el médico de asistencia. El índice haptoglobina/IgG y la escala de Boyer se han utilizado con estos fines. Pacientes y métodos. Se estudiaron 39 pacientes en edad pediátrica con el diagnóstico de meningoencefalitis: 14 que sufrían meningoencefalitis bacterianas y 25 meningoencefalitis víricas. Se calculó el índice haptoglobina/IgG y se le aplicó la escala de Boyer para conocer su utilidad en el diagnóstico diferencial de las meningoencefalitis. La relevancia clínica del índice haptoglobina/IgG y la escala de Boyer se compararon a través de las curvas ROC. Resultados. La escala de Boyer no presentó asociación estadísticamente significativa con el origen de las meningoencefalitis. La sensibilidad y especificidad del índice haptoglobina/IgG fueron del 71,4 y el 64%, respectivamente, para iguales parámetros en la escala de Boyer del 28 y el 100%. El índice haptoglobina/IgG presentó mayor precisión para el diagnósticodiferencial de las meningitis bacterianas y víricas que la escala de Boyer a través del área bajo la curvas ROC. Conclusiones. El índice haptoglobina/IgG mostró su superioridad diagnóstica con relación a la escala de Boyer para establecer el origen de las meningoencefalitis

Introduction. The meningitis is one of the most severe diseases in children due to its mortality or sequels. However, timely knowledge of whether the infection is bacterial or viral in origin and applied a specific therapeutic would be beneficial for the patients and clinician. The haptoglobin/IgG index and Boyer’s score have been use in this purpose. Patients and methods. 39 pediatric patients, 14 suffering from viral meningoencephalitis and 25 from bacterial meningoencephalitis were study. Boyer’s score and Hp/IgG index were applied in order to evaluate its diagnostic accuracy. The clinical relevance ofhaptoglobin/IgG index and Boyer’s score were compared by the analysis of the receiver-operating characteristic (ROC) curves.Results. There were no association between Boyer’s score and the cause of the meningitis. The sensitivity and specificity of haptoglobin/IgG index were de 71.4 and 64%, respectively. The same parametric to Boyer’s score were de 28 and 100%. Increased haptoglobin/IgG index presents bigger precision for the differential diagnostic of the bacterial and viral meningitisthan the scale of Boyer according to the curves ROC. Conclusion. The index haptoglobin/IgG showed its diagnostic superiority with relationship to the scale of Boyer to establish the origin of the meningoencephalitis

[Peculiarities of meningoencephalitis caused by Angiostrongylus cantonensis in America]. / Peculiaridades de la meningoencefalitis por Angiostrongylus cantonensis en América.

INTRODUCTION: 25 years ago was first reported in Cuba and in the western hemisphere an emergent disease: eosinophilic meningoencephalitis due to Angiostrongylus cantonensis larvae. AIM: To collect in a summary form the accumulated experience and the findings of the study of this parasitosis during the period in the Western hemisphere. DEVELOPMENT AND CONCLUSIONS: There have been collected the first evidences, the parasitological and malacological findings, the experimental and molecular studies on immunology and neuroimmunology, the clinic-pathological findings in children and adults with the particularities of this diseases in our environment with special emphasis in the never-before scientific findings reported. It has been documented the testimony, the main findings among the malacological studies, the role of the immunoglobulin E and the mechanism involved in the central nervous system, the intrathecal synthesis patterns of immunoglobulins and the clinical elements in children and adults.

Peculiaridades de la meningoencefalitis por Angiostrongylus cantonensis en América / Peculiarities of meningoencephalitis caused by Angiostrongylus cantonensis in America

Introducción. Hace 25 años se informó por primera vez en Cuba y en el hemisferio occidental de la aparición deuna enfermedad emergente: la meningoencefalitis eosinofílica producida por larvas del helminto Angiostrongylus cantonensis.Objetivo. Recopilar de forma resumida la experiencia acumulada y los aportes al estudio de esta zoonosis realizados a lo largo de estos años en el hemisferio occidental. Desarrollo y conclusiones. Se recogen las evidencias iniciales, los aportes a la parasitología y la malacología, los estudios experimentales y moleculares en la esfera de la inmunología y la neuroinmunología, los hallazgos clinicopatológicos en niños y adultos enfermos con las particularidades de la enfermedad en nuestro medio, con especial acento en los aportes científicos nunca antes comunicados. Se documentan el testimonio, los principalesaportes y hallazgos, entre los cuales se encuentran los estudios malacológicos, el papel de la inmunoglobulina E y los mecanismos involucrados en el sistema nervioso central, los patrones de síntesis intratecal de inmnoglobulinas y los elementos clínicos que brinda en niños y adultos(AU)

Introduction. 25 years ago was first reported in Cuba and in the western hemisphere an emergent disease: eosinophilic meningoencephalitis due to Angiostrongylus cantonensis larvae. Aim. To collect in a summary form the accumulated experience and the findings of the study of this parasitosis during the period in the Western hemisphere. Development and conclusions. There have been collected the first evidences, the parasitological and malacological findings, the experimental and molecular studies on immunology and neuroimmunology, the clinic pathological findings in children and adults with theparticularities of this diseases in our environment with special emphasis in the never-before scientific findings reported. It has been documented the testimony, the main findings among the malacological studies, the role of the immunoglobulin E and the mechanism involved in the central nervous system, the intrathecal synthesis patterns of immunoglobulins and the clinicalelements in children and adults(AU)

Peculiaridades de la meningoencefalitis por Angiostrongylus cantonensis en América / Peculiarities of meningoencephalitis caused by I Angiostrongylus cantonensis I in America

25 years ago was first reported in Cuba and in the western hemisphere an emergent disease: eosinophilic meningoencephalitis due to Angiostrongylus cantonensis larvae, Aim, To collect in a summary form the accumulated experience and the findings of the study of this parasitosis during the period in the Western hemisphere, Development and conclusions, There have been collected the first evidences, the parasitological and malacological findings, the experimental and molecular studies on immunology and neuroimmunology, the clinic-pathological findings in children and adults with the particularities of this diseases in our environment with special emphasis in the never-before scientific findings reported; It has been documented the testimony, the main findings among the malacological studies, the role of the immunoglobulin E and the mechanism involved in the central nervous system, the intrathecal synthesis patterns of immunoglobulins and the clinical elements in children and adults(AU)

Peculiaridades de la meningoencefalitis por Angiostrongylus cantonensis en América / Peculiarities of meningoencephalitis caused by angiostrongylus cantonensis in America

Hace 25 años se informó por primera vez en Cuba y en el hemisferio occidental de la aparición de una enfermedad emergente: la meningoencefalitis eosinofílica producida por larvas del helminto Angiostrongylus cantonensis.Objetivo. Recopilar de forma resumida la experiencia acumulada y los aportes al estudio de esta zoonosis realizados a lo largo de estos años en el hemisferio occidental. Desarrollo y conclusiones. Se recogen las evidencias iniciales, los aportes a la parasitología y la malacología, los estudios experimentales y moleculares en la esfera de la inmunología y la neuroinmunología, los hallazgos clinicopatológicos en niños y adultos enfermos con las particularidades de la enfermedad en nuestro medio, con especial acento en los aportes científicos nunca antes comunicados. Se documentan el testimonio, los principalesaportes y hallazgos, entre los cuales se encuentran los estudios malacológicos, el papel de la inmunoglobulina E y los mecanismos involucrados en el sistema nervioso central, los patrones de síntesis intratecal de inmnoglobulinas y los elementos clínicosque brinda en niños y adultos

25 years ago was first reported in Cuba and in the western hemisphere an emergent disease: eosinophilicmeningoencephalitis due to Angiostrongylus cantonensis larvae. Aim. To collect in a summary form the accumulatedexperience and the findings of the study of this parasitosis during the period in the Western hemisphere. Development and conclusions. There have been collected the first evidences, the parasitological and malacological findings, the experimentaland molecular studies on immunology and neuroimmunology, the clinic-pathological findings in children and adults with the particularities of this diseases in our environment with special emphasis in the never-before scientific findings reported. It hasbeen documented the testimony, the main findings among the malacological studies, the role of the immunoglobulin E and the mechanism involved in the central nervous system, the intrathecal synthesis patterns of immunoglobulins and the clinicalelements in children and adults

Esclerosis múltiple y neurocisticercosis / Multiple sclerosis and neurocysticercosis

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Neurocriptococosis en Cuba / Neurocryptococcosis in Cuba

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