Cultivating PhD Aspirations during College.

Science, technology, engineering, and mathematics (STEM) career barriers persist for individuals from marginalized communities due to financial and educational inequality, unconscious bias, and other disadvantaging factors. To evaluate differences in plans and interests between historically underrepresented (UR) and well-represented (WR) groups, we surveyed more than 3000 undergraduates enrolled in chemistry courses. Survey responses showed all groups arrived on campus with similar interests in learning more about science research. Over the 4 years of college, WR students maintained their interest levels, but UR students did not, creating a widening gap between the groups. Without intervention, UR students participated in lab research at lower rates than their WR peers. A case study pilot program, Biosciences Collaborative for Research Engagement (BioCoRE), encouraged STEM research exploration by undergraduates from marginalized communities. BioCoRE provided mentoring and programming that increased community cohesion and cultivated students' intrinsic scientific mindsets. Our data showed that there was no statistical significant difference between BioCoRE WR and UR students when surveyed about plans for a medical profession, graduate school, and laboratory scientific research. In addition, BioCoRE participants reported higher levels of confidence in conducting research than non-BioCoRE Scholars. We now have the highest annual number of UR students moving into PhD programs in our institution's history.

The GARP Domain of the Rod CNG Channel's ß1-Subunit Contains Distinct Sites for Outer Segment Targeting and Connecting to the Photoreceptor Disk Rim.

Vision begins when light is captured by the outer segment organelle of photoreceptor cells in the retina. Outer segments are modified cilia filled with hundreds of flattened disk-shaped membranes. Disk membranes are separated from the surrounding plasma membrane, and each membrane type has unique protein components. The mechanisms underlying this protein sorting remain entirely unknown. In this study, we investigated the outer segment delivery of the rod cyclic nucleotide-gated (CNG) channel, which is located in the outer segment plasma membrane, where it mediates the electrical response to light. Using Xenopus and mouse models of both sexes, we now show that the targeted delivery of the CNG channel to the outer segment uses the conventional secretory pathway, including protein processing in both ER and Golgi, and requires preassembly of its constituent α1 and ß1 subunits. We further demonstrate that the N-terminal glutamic acid-rich protein (GARP) domain of CNGß1 contains two distinct functional regions. The glutamic acid-rich region encodes specific information targeting the channel to rod outer segments. The adjacent proline-enriched region connects the CNG channel to photoreceptor disk rims, likely through an interaction with peripherin-2. These data reveal fine functional specializations within the structural domains of the CNG channel and suggest that its sequestration to the outer segment plasma membrane requires an interaction with peripherin-2.SIGNIFICANCE STATEMENT Neurons and other differentiated cells have a remarkable ability to deliver and organize signaling proteins at precise subcellular locations. We now report that the CNG channel, mediating the electrical response to light in rod photoreceptors, contains two specialized regions within the N terminus of its ß-subunit: one responsible for delivery of this channel to the ciliary outer segment organelle and another for subsequent channel sequestration into the outer segment plasma membrane. These findings expand our understanding of the molecular specializations used by neurons to populate their critical functional compartments.

Global assessment of organ specific basal gene expression over a diurnal cycle with analyses of gene copies exhibiting cyclic expression patterns.

BACKGROUND: Studying functional divergences between paralogs that originated from genome duplication is a significant topic in investigating molecular evolution. Genes that exhibit basal level cyclic expression patterns including circadian and light responsive genes are important physiological regulators. Temporal shifts in basal gene expression patterns are important factors to be considered when studying genetic functions. However, adequate efforts have not been applied to studying basal gene expression variation on a global scale to establish transcriptional activity baselines for each organ. Furthermore, the investigation of cyclic expression pattern comparisons between genome duplication created paralogs, and potential functional divergence between them has been neglected. To address these questions, we utilized a teleost fish species, Xiphophorus maculatus, and profiled gene expression within 9 organs at 3-h intervals throughout a 24-h diurnal period. RESULTS: Our results showed 1.3-21.9% of genes in different organs exhibited cyclic expression patterns, with eye showing the highest fraction of cycling genes while gonads yielded the lowest. A majority of the duplicated gene pairs exhibited divergences in their basal level expression patterns wherein only one paralog exhibited an oscillating expression pattern, or both paralogs exhibit oscillating expression patterns, but each gene duplicate showed a different peak expression time, and/or in different organs. CONCLUSIONS: These observations suggest cyclic genes experienced significant sub-, neo-, or non-functionalization following the teleost genome duplication event. In addition, we developed a customized, web-accessible, gene expression browser to facilitate data mining and data visualization for the scientific community.

Two decades of little change: An analysis of U.S. medical school basic science faculty by sex, race/ethnicity, and academic rank.

To examine changes in U.S. medical school basic science faculty over the last 20 years (1998-2018), we undertook an observational study utilizing data from the American Association of Medical Colleges Faculty Roster. Rank (Instructor, Assistant Professor, Associate Professor, and Professor), sex (Female), and race/ethnicity (Asian, Black or African American, Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic, and White) were analyzed; this reflected a population of 14,047 (1998) to 18,601 (2018) faculty. Summary percent of faculty in various gender, race/ethnicity origin categories were analyzed across years of the study using regression models. We found that females (24.47% to 35.32%) were underrepresented at all timepoints and a minority of faculty identified as Black or African American (1.57% to 1.99%), Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic (3.03% to 4.44%), or Asian (10.90% to 20.41%). The largest population at all time points was White Male Professors (30.53% to 20.85%), followed by White Male Associate Professors (15.67% to 9.34%), and White Male Assistant Professors (13.22% to 9.75%). Small statistically significant increases were observed among female faculty and faculty at multiple ranks who identified as Black or African American or Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic. We then completed secondary analyses looking at the interaction of race/ethnicity and Gender. We found: (1) a significant increase (p<0.0001) in both genders who identify as Asian although males had a higher rate of increase (6 point difference, p<0.0001); (2) a significant increase for Black or African American females (P<0.01) not found among males; (3) significant increases (p<0.0001) among both genders of faculty who identify as Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic although females had an approximately 1% higher rate of increase; and (4) among faculty who identify as White, males had a significant decrease (p<0.0001) while females demonstrated an increase (p<0.0001).

Fluorescent Light Incites a Conserved Immune and Inflammatory Genetic Response within Vertebrate Organs (Danio Rerio, Oryzias Latipes and Mus Musculus).

Fluorescent light (FL) has been utilized for ≈60 years and has become a common artificial light source under which animals, including humans, spend increasing amounts of time. Although the solar spectrum is quite dissimilar in both wavelengths and intensities, the genetic consequences of FL exposure have not been investigated. Herein, we present comparative RNA-Seq results that establish expression patterns within skin, brain, and liver for Danio rerio, Oryzias latipes, and the hairless mouse (Mus musculus) after exposure to FL. These animals represent diurnal and nocturnal lifestyles, and ≈450 million years of evolutionary divergence. In all three organisms, FL induced transcriptional changes of the acute phase response signaling pathway and modulated inflammation and innate immune responses. Our pathway and gene clustering analyses suggest cellular perception of oxidative stress is promoting induction of primary up-stream regulators IL1B and TNF. The skin and brain of the three animals as well as the liver of both fish models all exhibit increased inflammation and immune responses; however, the mouse liver suppressed the same pathways. Overall, the conserved nature of the genetic responses observed after FL exposure, among fishes and a mammal, suggest the presence of light responsive genetic circuitry deeply embedded in the vertebrate genome.

Gene expression variation and parental allele inheritance in a Xiphophorus interspecies hybridization model.

Understanding the genetic mechanisms underlying segregation of phenotypic variation through successive generations is important for understanding physiological changes and disease risk. Tracing the etiology of variation in gene expression enables identification of genetic interactions, and may uncover molecular mechanisms leading to the phenotypic expression of a trait, especially when utilizing model organisms that have well-defined genetic lineages. There are a plethora of studies that describe relationships between gene expression and genotype, however, the idea that global variations in gene expression are also controlled by genotype remains novel. Despite the identification of loci that control gene expression variation, the global understanding of how genome constitution affects trait variability is unknown. To study this question, we utilized Xiphophorus fish of different, but tractable genetic backgrounds (inbred, F1 interspecies hybrids, and backcross hybrid progeny), and measured each individual's gene expression concurrent with the degrees of inter-individual expression variation. We found, (a) F1 interspecies hybrids exhibited less variability than inbred animals, indicting gene expression variation is not affected by the fraction of heterozygous loci within an individual genome, and (b), that mixing genotypes in backcross populations led to higher levels of gene expression variability, supporting the idea that expression variability is caused by heterogeneity of genotypes of cis or trans loci. In conclusion, heterogeneity of genotype, introduced by inheritance of different alleles, accounts for the largest effects on global phenotypical variability.

Waveband specific transcriptional control of select genetic pathways in vertebrate skin (Xiphophorus maculatus).

BACKGROUND: Evolution occurred exclusively under the full spectrum of sunlight. Conscription of narrow regions of the solar spectrum by specific photoreceptors suggests a common strategy for regulation of genetic pathways. Fluorescent light (FL) does not possess the complexity of the solar spectrum and has only been in service for about 60 years. If vertebrates evolved specific genetic responses regulated by light wavelengths representing the entire solar spectrum, there may be genetic consequences to reducing the spectral complexity of light. RESULTS: We utilized RNA-Seq to assess changes in the transcriptional profiles of Xiphophorus maculatus skin after exposure to FL ("cool white"), or narrow wavelength regions of light between 350 and 600 nm (i.e., 50 nm or 10 nm regions, herein termed "wavebands"). Exposure to each 50 nm waveband identified sets of genes representing discrete pathways that showed waveband specific transcriptional modulation. For example, 350-400 or 450-500 nm waveband exposures resulted in opposite regulation of gene sets marking necrosis and apoptosis (i.e., 350-400 nm; necrosis suppression, apoptosis activation, while 450-500 nm; apoptosis suppression, necrosis activation). Further investigation of specific transcriptional modulation employing successive 10 nm waveband exposures between 500 and 550 nm showed; (a) greater numbers of genes may be transcriptionally modulated after 10 nm exposures, than observed for 50 nm or FL exposures, (b) the 10 nm wavebands induced gene sets showing greater functional specificity than 50 nm or FL exposures, and (c) the genetic effects of FL are primarily due to 30 nm between 500 and 530 nm. Interestingly, many genetic pathways exhibited completely opposite transcriptional effects after different waveband exposures. For example, the epidermal growth factor (EGF) pathway exhibits transcriptional suppression after FL exposure, becomes highly active after 450-500 nm waveband exposure, and again, exhibits strong transcriptional suppression after exposure to the 520-530 nm waveband. CONCLUSIONS: Collectively, these results suggest one may manipulate transcription of specific genetic pathways in skin by exposure of the intact animal to specific wavebands of light. In addition, we identify genes transcriptionally modulated in a predictable manner by specific waveband exposures. Such genes, and their regulatory elements, may represent valuable tools for genetic engineering and gene therapy protocols.

Photoreceptor discs form through peripherin-dependent suppression of ciliary ectosome release.

The primary cilium is a highly conserved organelle housing specialized molecules responsible for receiving and processing extracellular signals. A recently discovered property shared across many cilia is the ability to release small vesicles called ectosomes, which are used for exchanging protein and genetic material among cells. In this study, we report a novel role for ciliary ectosomes in building the elaborate photoreceptor outer segment filled with hundreds of tightly packed "disc" membranes. We demonstrate that the photoreceptor cilium has an innate ability to release massive amounts of ectosomes. However, this process is suppressed by the disc-specific protein peripherin, which enables retained ectosomes to be morphed into discs. This new function of peripherin is performed independently from its well-established role in maintaining the high curvature of disc edges, and each function is fulfilled by a separate part of peripherin's molecule. Our findings explain how the outer segment structure evolved from the primary cilium to provide photoreceptor cells with vast membrane surfaces for efficient light capture.

Progressive Rod-Cone Degeneration (PRCD) Protein Requires N-Terminal S-Acylation and Rhodopsin Binding for Photoreceptor Outer Segment Localization and Maintaining Intracellular Stability.

The light-sensing outer segments of photoreceptor cells harbor hundreds of flattened membranous discs containing the visual pigment, rhodopsin, and all the proteins necessary for visual signal transduction. PRCD (progressive rod-cone degeneration) protein is one of a few proteins residing specifically in photoreceptor discs, and the only one with completely unknown function. The importance of PRCD is highlighted by its mutations that cause photoreceptor degeneration and blindness in canine and human patients. Here we report that PRCD is S-acylated at its N-terminal cysteine and anchored to the cytosolic surface of disc membranes. We also showed that mutating the S-acylated cysteine to tyrosine, a common cause of blindness in dogs and a mutation found in affected human families, causes PRCD to be completely mislocalized from the photoreceptor outer segment. We next undertook a proteomic search for PRCD-interacting partners in disc membranes and found that it binds rhodopsin. This interaction was confirmed by reciprocal precipitation and co-chromatography experiments. We further demonstrated this interaction to be critically important for supporting the intracellular stability of PRCD, as the knockout of rhodopsin caused a drastic reduction in the photoreceptor content of PRCD. These data reveal the cause of photoreceptor disease in PRCD mutant dogs and implicate rhodopsin to be involved in PRCD's unknown yet essential function in photoreceptors.

Discs of mammalian rod photoreceptors form through the membrane evagination mechanism.

Photoreceptor discs are membrane organelles harboring components of the visual signal transduction pathway. The mechanism by which discs form remains enigmatic and is the subject of a major controversy. Classical studies suggest that discs are formed as serial plasma membrane evaginations, whereas a recent alternative postulates that discs, at least in mammalian rods, are formed through intracellular vesicular fusion. We evaluated these models in mouse rods using methods that distinguish between the intracellular vesicular structures and plasma membrane folds independently of their appearance in electron micrographs. The first differentiated membranes exposed to the extracellular space from intracellular membranes; the second interrogated the orientation of protein molecules in new discs. Both approaches revealed that new discs are plasma membrane evaginations. We further demonstrated that vesiculation and plasma membrane enclosure at the site of new disc formation are artifacts of tissue fixation. These data indicate that all vertebrate photoreceptors use the evolutionary conserved membrane evagination mechanism to build their discs.

Proteomic identification of unique photoreceptor disc components reveals the presence of PRCD, a protein linked to retinal degeneration.

Visual signal transduction takes place on the surface of flat membrane vesicles called photoreceptor discs, which reside inside the light-sensitive outer segment organelle of vertebrate photoreceptor cells. Although biochemical studies have indicated that discs are built with a handful of highly specialized proteins, proteomic studies have yielded databases consisting of hundreds of entries. We addressed this controversy by employing protein correlation profiling, which allows identification of unique components of organelles that can be fractionated but not purified to absolute homogeneity. We subjected discs to sequential steps of fractionation and identified the relative amounts of proteins in each fraction by label-free quantitative mass spectrometry. This analysis demonstrated that the photoreceptor disc proteome contains only eleven components, which satisfy the hallmark criterion for being unique disc-resident components: the retention of a constant molar ratio among themselves across fractionation steps. Remarkably, one of them is PRCD, a protein whose mutations have been shown to cause blindness, yet cellular localization remained completely unknown. Identification of PRCD as a novel disc-specific protein facilitates understanding its functional role and the pathobiological significance of its mutations. Our study provides a striking example how protein correlation profiling allows a distinction between constitutive components of cellular organelles and their inevitable contaminants.

Protein sorting, targeting and trafficking in photoreceptor cells.

Vision is the most fundamental of our senses initiated when photons are absorbed by the rod and cone photoreceptor neurons of the retina. At the distal end of each photoreceptor resides a light-sensing organelle, called the outer segment, which is a modified primary cilium highly enriched with proteins involved in visual signal transduction. At the proximal end, each photoreceptor has a synaptic terminal, which connects this cell to the downstream neurons for further processing of the visual information. Understanding the mechanisms involved in creating and maintaining functional compartmentalization of photoreceptor cells remains among the most fascinating topics in ocular cell biology. This review will discuss how photoreceptor compartmentalization is supported by protein sorting, targeting and trafficking, with an emphasis on the best-studied cases of outer segment-resident proteins.

A single valine residue plays an essential role in peripherin/rds targeting to photoreceptor outer segments.

Peripherin/retinal degeneration slow (rds) is an integral membrane protein specifically localized to the light-sensing organelle of the photoreceptor cell, the outer segment. Within the outer segment, peripherin is found at the edges of photoreceptor discs, where it plays a critical role in disc morphogenesis and maintenance. Peripherin loss or mutations are often associated with severe forms of visual impairments. Like all other resident outer segment proteins, peripherin is synthesized in the photoreceptor cell body and subsequently transported to the outer segment. In an effort to further examine peripherin's delivery to outer segments, we undertook a careful examination of its targeting sequence. Using a fluorescently labeled reporter expressed in the rods of transgenic tadpoles, we narrowed peripherin's targeting sequence to ten amino acids within its C-terminal tail. This small stretch of amino acid residues is both necessary and sufficient for outer segment targeting. We also conducted alanine scanning of all residues within this sequence and found that only a single residue, valine at position 332, is essential for outer segment targeting. This valine is conserved in all species and its mutation is sufficient to completely abrogate the targeting of full-length peripherin in mouse rods.

Despistaje de toxoplasmosis y enfermedad de Chagas en la consulta prenatal del Hospital Universitario de Caracas / Sereening of toxoplasmosis and Chagas disease in the prenatal consultation of the Hospital Universitario de Caracas

Determinar seropositividad para Toxoplasma gondii y Trypanosoma cruzi en embarazadas, Estudio analítico transversal realizado en 678 gestantes. Para la detección de anticuerpos anti-Toxoplasma se utilizó ELISA para la captura de IgM, IgG y avidez de IgG. Para T. cruzi se realizó ELISA IgG y hemaglutinación indirecta. Consulta Prenatal del Hospital Universitario de Caracas. El mayor número de pacientes se ubicó en el grupo etario 16 - 20 años, 42 por ciento cursaba su primer embarazo, 25 por ciento el segundo y 33 por ciento tenía 3 o más. El 39 por ciento se encontraba en el primer trimestre del embarazo, 43 por ciento en el segundo y 18 por ciento en el tercero. El despistaje para T. cruzi no mostró ninguna persona reactiva. Se presentó infección toxoplásmica por ELISA IgG en 38 por ciento de las embarazadas de las cuales 10 pudieran corresponder a infecciones recientes por tener IgM positiva o baja avidez de anticuerpos específicos, 8 de ellas se encontraban en el primero o segundo trimestre del embarazo. Una segunda serología en 54 mujeres no reveló seroconversión. La seropositividad para toxoplasmosis fue alta y detectó algunas embarazadas con infección reciente encontrándose la mayoría en los dos primeros trimestres, cuando hay riesgo de malformaciones congénitas. La combinación de estas técnicas en toxoplasmosis permite estimar tiempo de evolución y su aplicación en consultas prenatales permitiría detectar infecciones recientes para tratamiento oportuno. Es igualmente importante insistir en la obligatoriedad del diagnóstico de enfermedad de Chagas por ser transmisible al feto y encontrarse Venezuela entre los países endémicos

To determine seropositivity for Toxoplasma gondii and Trypanosoma cruzi in pregnant women. A cross-sectional analytical study was conducted at 678 pregnant women. ELISA was used for the detection of anti-Toxoplasma antibodies IgM, IgG and IgG avidity. For T. cruzi IgG ELISA was performed and Indirect Hemagglutination Test. Prenatal care at the Hospital Universitario de Caracas. The highest number of patients was located in the age group 16 to 20 years, 42 percent was in her first pregnancy, 25 percent the second and 33 percent had 3 or more. The 39 percent was in the first trimester, 43 percent in the second and 18 percent in the third. The screening for T. cruzi showed no reactive person. Toxoplasmic infection was presented by IgG ELISA in 38 percent of pregnant women of which 10 might be due to recent infections by having a positive IgM or low avidity of specific antibodies, 8 of them were in the first or second trimester of pregnancy. A second serology in 54 women did not show seroconversion. Toxoplasmosis seropositivity was high and detected some pregnant women with recent infection in the first two quarters, when there is risk of congenital malformations. The combination of these techniques in Toxoplasmosis can estimate time of evolution and its application in prenatal consultations would detect recent infections. It is equally important to emphasize the obligation of the diagnosis of Chagas’ disease which can be transmitted to the fetus and also because Venezuela is an endemic country

Prevalencia y factores asociados en el abuso / dependencia del alcohol en el adulto en Lima Metropolitana y Callao / Prevalence and factors associated with the abuse/dependence on alcohol in the adult in Metropolitan Lima and Callao

En nuestro país el consumo de alcohol es un grave problema de salud pública, con impacto en la salud mental, educación e ingreso económico familiar. OBJETIVOS: Estimar la prevalencia de abuso/ dependencia del alcohol y su asociación con características sociodemográficas, familiares, económicas, tendencias violentas y grado de satisfacción personal y laboral en la población adulta de Lima Metropolitana en el año 2002. MÉTODOS: Estudio descriptivo, epidemiológico y de corte transversal, que forma parte del Estudio Epidemiológico Metropolitano en Salud Mental 2002. RESULTADOS: las mayores prevalencias de abuso dependencia a alcohol se encontraron en el grupo etareo de 20 a 29 años (9.2%), varones con 8,4 por ciento y estado civil no unido (soltero, separado o divorciado) con un 7,4 por ciento. Acerca de las características de relaciones familiares, tendencias violentas, satisfacción personal y satisfacción laboral, sobresalen las prevalencias elevadas para los extremos negativos de percepción asignada por la población. CONCLUSIONES: El perfil epidemiológico del abusador/ dependiente del alcohol en Lima Metropolitana en el 2002 presenta altas prevalencias para indicadores de pobres vínculos familiares, tendencias violentas, satisfacción personal y laboral.

In our country the consumption of alcohol is a serious problem of public health, impact on mental health, education and family income.OBJECTIVES: Estimate the prevalence of abuse/ dependence on alcohol and its association with socio-demographic, family, economic characteristics, violent tendencies and degree of labor and personal satisfaction in the adult population in the metropolitan city of Lima in 2002. METHODS: This is a descriptive, epidemiological and cross-section study, which is part of the 2002 Metropolitan Epidemiological mental health Study. RESULTS: It was noticed that the highest prevalence occurrences of abuse/ dependence on alcohol were found in the 20-aged to 29-aged age bracket (9.2%), male with 8.4% and not joined civil status (single, separated or divorced) with 7.4%. As regards features of family relationships, violent tendencies, personal and labor satisfaction, high prevalences for negative ends of perception assigned by the population. CONCLUSIONS: The epidemiological profile of the abuser/ dependent on alcohol in Lima city in 2002 shows high prevalence for indicators on poor family ties, violent tendencies, labor and personal satisfaction.

Ocurrencia de Isospora belli, Cryptosporidium spp y Cyclospora cayetanenesis en pacientes urbanos evaluados por síntomas gastrointestinales con o sin imnunosupresión / Occurrence of Isospora belli, Cryptosporidium and Cyclospora cayetanenesis spp in urban patients evaluated for gastrointestinal symptoms with or without immunosuppresion

Este estudio de corte transversal, estimó la ocurrencia de infecciones por coccidias intestinales (CI) en pacientes urbanos procedentes de Caracas-Venezuela. Se analizaron, 1 831 referencias de pacientes externos de ambos sexos y con edad promedio ± desviación estándar de 28,8 ± 22,93 años. En la Sección de Geohelmintiasis del Instituto de Medicina Tropical (SGH-IMT), se evaluaron 4 650 muestras de heces seriadas, por examen directo, formol tritón éter y Baermann, pertenecientes a 1 550 pacientes. Adicionalmente, la prueba de Ziehl-Neelsen modificada, se aplicó a las muestras fecales de 150 pacientes, por solicitud del médico tratante o sugerencia de SGH-IMT. La eosinofilia (40,54 por ciento; 225/555) constituyó el principal motivo de referencia y consulta. El promedio ± DS de contaje absoluto de eosinófilo (3 151 ± 5 161) demostró eosinofilias leves (63/204) y moderadas (25/204). Otros motivos de consulta fueron: dolor abdominal (27,72 por ciento; 122/440), náuseas/vómitos (19,03 por ciento; 83/436), pujo/tenesmo (16,05 por ciento; 70/436) y por último, la consistencia líquida de las heces (4,87 por ciento; 74/1 477). Los parasitados (43,7 por ciento; 677/1 550) presentaron evacuaciones pastosa (81,25 por ciento; 494/608) y blandas (37 por ciento; 57/608). Sólo, 5,92. por ciento (36/608) presentaron consistencia líquida. La prueba de Ziehl-Neelsen modificada demostró 12 casos positivos (8 por ciento) para CI: Isospora belli (5,33 por ciento; 8/150), Cryptosporidium spp (2 por ciento; 3/150) y Cyclospora cayetanensis (0,66 por ciento; 1/150). El único caso de ciclosporiosis estaba co-infectado con Blastocystis hominis y no presentó cambios en la consistencia de las heces. Estos resultados apoya la idea de que los médicos interconsultantes soliciten la aplicación de exámenes coproparasitológicos adicionales, en forma seriada, de bajo costo, para evaluar pacientes inmunocompetentes urbanos, con síntomas gastrointestinales/ eosinofilia, ...

These two years follow up; cross-sectional study estimates the occurrence of intestinal coccidias in urban patients from the metropolitan area of Caracas-Venezuela. One thousand eight hundred thirty one outpatient case reports were analyzed, both sex and 28.8 ± 22.93 years. Soil-transmitted helminthes laboratory of the Tropical Medicine Institute (SGH-IMT) evaluated 4 650 feces samples from 1 550 outpatients by direct, formol triton ether and Baermann techniques, Additionally, modified Ziehl-Neelsen, were done because of clinicians or SGH-IMT suggestion for 150 outpatients. Eosinophilia (40.54 percent; 225/555) was the major cause of referral and consultation. The mean of the absolute count of eosinophils (3 151+ 5 161) showed low (63/204) and moderate (25/204) eosinophila. Other causes of consultation were: abdominal pain (27.72 percent; 122/440), nausea/ vomiting (19.03 percent; 83/436), tenesmus/constipation (16.05 percent; 70/436) and finally, liquid fecal consistency (4.87 percent; 74/1477). Parasite infected patients (43.7 percent; 677/1550) had normal (81.25 percent; 494/608) and semi liquid feces (37 percent; 57/608). Only, 5.92 percent (36/608) had liquid consistency. Modified Ziehl-Neelsen demonstrates 12 positive IC (8 percent) for: Isospora belli (5.33. percent; 8/150), Cryptosporidium spp (2 percent; 3/150) and Cyclospora cayetanensis (0.66 percent; 1/150). The only case of cyclosporidiosis was co-infected with Blastocystis hominis and had normal feces. These results agrees with the idea for clinicians to ask for additional, low cost, serial parasitological test in feces, to evaluate urban inmunocompetent outpatients, with gastrointestinal symptoms/eosinophilia, even without diarrhea, because the basic feces techniques, used routinely, fails to make the precise parasite diagnostic, underestimating coccidiosis

Importancia de la referencia médica en el diagnóstico de parasitosis intestinales por métodos coproparasitológicos / Medical reference importance in the intestinal parasitic diagnosis for coproparasitologic method

La Sección de Geohelmintiasis del Instituto de Medicina Tropical estudia las muestras de heces por examen seriado que incluyen examen directo, Formol-Tritón-Éter y Baermann. Otras técnicas coproparasitológicas como: Graham, Kinyoun y Kato-Katz, se realizan por solicitud del médico tratante. Los objetivos del presente estudio fueron: valorar la calidad de la referencia médica, el impacto en el diagnóstico al aplicarse las técnicas coproparasitológicas y la ocurrencia de óarasitosis intestinales de los pacientes que asiste a esta Sección. A cada referencia médica se le colocó una puntuación entre 0 y 12 puntos según la presencia o no de determinados parámetros de calidad. Para un total de 392 referencias: 170 procedentes de hospitales públicos, 157 del Instituto de Medicina Tropical, 38 de instituciones privadas y 27 sin información, el promedio de puntuación fue de 4 puntos. La baja calidad de las referencia médica impidió valorar el impacto de las mismas en el diagnóstico parasitario por técnicas coproparasitológicas. Los parásitos de mayor ocurrencia (n = 460) fueron Blastocystis hominis (8,7 por ciento), Entamoeba coli (3,5 por ciento), Ascaris lumbricoides (2,9 por ciento) y Giardia intestinalis (2,3 por ciento). De los pacientes virus de inmunodeficiencia humana +, a 5 se indicó Kinyoun en la referencia médica (10/173), uno fue positivo para Cryptosporidium sp. Dos pacientes referidos por prurito anal e indicación de Graham, ambos negativos para Enterobius vermicularis. Cuatro pacientes fueron referidos por esquistosomosis sin indicación de Kato-Katz. Una referencia médica completa contribuye en la aplicación de las técnicas coproparasitológicas de elección, favoreciendo un diagnóstico certero y oportuno. A partir de estos resultados se estructuró una referencia médica piloto para iniciar una labor educativa al personal de salud sobre las técnicas coproparasitológicas.

Soil transmitted helminthes laboratory of the Tropical Medicine Institute studies feces by simple method, Formol-Triton-Eter and Baermann. Other coproparasitologic techniques like: Graham, Kinyoun and Kato-Katz are process if they are asked by physicians. The objectives of the current study were: evaluate the reference quality of the medical record, the impact in the final diagnosis applying coproparasitologic techniques and the occurrence of parasitic intestinal disease. Each reference was evaluated between 0 and 12 points, depending on the presence of quality parameters. For a total of 392 reference: 170 patients from public hospital, 157 from Tropical Medicine Institute, 38 from private hospital and 27 without information, the mean reference evaluation was 4 points. The poor quality of the reference did not permit to measure the impact in the final parasitologic diagnosis. The most frequent parasites were Blastocystis hominis (8,9 percent), Entamoeba coli (3,5 percent), Ascaris lumbricoides and Giardia intestinalis (both with 2,54 percent). For the total HIV positive (10/173), only for 5, Kinyoun technique was solicited by the reference, Cryptosporidium sp. was positive for one. Two patients were referred because of pruritus ani and indication of Graham, both were negative for Enterobius vermicularis. Four patients referred with suspect of schistosomiasis without a Kato-Katz indication by the doctor. A complete reference of the medical record contributes to the application of the first choice of coproparasitologic techniques, to favor real diagnosis towards the benefit of the patients. We structured a new model of reference of the medical record to initiate an education labor of the health personal about the coproparasitologic techniques.