Normal myocardial perfusion despite a very high coronary calcium score.

An exceptionally high coronary calcium score, greater than 10,000 UA, superior to any other found in the literature reviewed, was reported in an asymptomatic, adult man with hypertension, obesity and dyslipidemia, without myocardial ischemia and no significative coronary stenosis, associated to Glagov's phenomenon in the left coronary artery and an abdominal aortic aneurysm.

Geohelmintiasis en comunidades indígenas del estado Zulia, Venezuela / Geohelminthiasis in native communities from Zulia State, Venezuela7766TVVBV```9W<<<

Introducción: Las geohelmintiasis son las parasitosis intestinales causadas por helmintos que hacen su ciclo de vida en la tierra y representan un problema de salud público a nivel mundial, que afecta en especial aquellos estratos socioeconómicos más bajos. Objetivo: Determinar la prevalencia de geohelmintos en comunidades indígenas del estado Zulia, Venezuela. Métodos: Se analizaron 250 muestras fecales, de individuos de ambos sexos con edades entre 1 a 80 años. Las muestras fueron procesadas con examen directo, concentrado (Ritchie) y recuento de huevos (Kato-Katz). Resultados: El 35,20 por ciento de los individuos presentaron huevos de geohelmintos en sus heces (88 casos). El grupo etario más afectado fue el de escolares (7-12 años: 38,64 por ciento ), seguido de adultos (20 o más años: 26,13 por ciento ). Ascaris lumbricoides con 25,20 por ciento se encontró en primer lugar, seguido de Trichuris trichiura con 14,80 por ciento , y los menos frecuentes Ancilostomideos con 4,40 por ciento . La mayoría de los individuos presentaron infecciones de intensidad leve (A. lumbricoides 74,60 por ciento , T. trichiura 81,08 por ciento y Ancilostomideos 90,91 por ciento ). Conclusiones: Se detecta una moderada prevalencia de geohelmintos, con un mayor porcentaje de las infecciones de intensidad leve. La presencia de los geohelmintos se relaciona con el escaso saneamiento ambiental que poseen estas comunidades indígenas(AU)

Introduction: Geohelminthiases are intestinal parasitic diseases caused by helminths which complete their life cycle in the soil. They are a global public health problem mainly affecting the lowest socioeconomic strata. Objective: Determine the prevalence of geohelminths in native communities from Zulia State, Venezuela. Methods: Analysis was performed of 250 stool samples from individuals of both sexes aged between 1 and 80 years. The samples were processed by direct examination, concentration (Ritchie) and egg count (Kato-Katz). Results: Geohelminth eggs were found in 35.20 percent of the stool samples studied (88 cases). The most affected age group was schoolchildren (7-12 years: 38.64 percent), followed by adults (20 years and over: 26.13 percent). The most common helminth was Ascaris lumbricoides with 25.20 percent, followed by Trichuris trichiura with 14.80 percent. The least common genus was Ancylostoma with 4.40 percent. Infection was mild in most subjects (A. lumbricoides 74.60 percent, T. trichiura 81.08 percent and Ancylostoma 90.91 percent). Conclusions: A moderate prevalence of geohelminth infection was observed, most of which was mild. The presence of geohelminths is related to poor environmental sanitation in these native communities(AU)

Molecular identification of Entamoeba histolytica, E. dispar, and E. moshkovskii in children with diarrhea from Maracaibo, Venezuela / [Identificación molecular de Entamoeba histolytica, Entamoeba dispar y Entamoeba moshkovskii en niños con diarrea en Maracaibo, Venezuela].

Introduction: Entamoeba histolytica is an amebiasis-producing parasite. However, Entamoeba dispar, Entamoeba moshkovskii, and Entamoeba bangladeshi are nonpathogenic amoebae morphologically identical to it and, therefore, molecular techniques are required for their differentiation. Objective: To determine the frequency of Entamoeba species by polymerase chain reaction (PCR) in fecal samples from children under five years with diarrhea from Maracaibo (Venezuela). Materials and methods: A fecal sample per individual was collected from 75 children with diarrhea (case group) and 25 children without diarrhea (control group). Stools were evaluated by microscopic examination, formol-ether concentration method, and nested multiplex PCR in a single round for the identification of E. histolytica, E. dispar, and E. moshkovskii. In addition, a survey was conducted in which demographic data, signs, clinical manifestations, and socioeconomic status were registered. Results: In total, 48% of the children (38 from the case group and 10 from the control group) had intestinal parasites. Only four children presented cysts of the Entamoeba complex in their samples (three from the case group and one from the control group). By means of PCR, nine samples (9%) amplified for the studied amoebae. In the case group, three (28.13%) amplified for E. histolytica, four (30.50%) for E. dispar, and one (9.37%) for E. moshkovskii while only one (25%) sample amplified for E. dispar in the control group. Conclusion: In general, E. dispar predominated. Nevertheless, all those infected with E. histolytica were detected within the group of children with diarrhea and we reported the first case of E. moshkovskii in the region.

Introducción. Las amebas no patógenas Entamoeba dispar, Entamoeba moshkovskii y Entamoeba bangladeshi son morfológicamente idénticas a Entamoeba histolytica, parásito responsable de la amebiasis, por lo cual se necesitan técnicas moleculares para diferenciarlas. Objetivo. Determinar la frecuencia de las diferentes especies de Entamoeba mediante reacción en cadena de la polimerasa (Polymerase Chain Reaction, PCR) en muestras fecales de niños menores de cinco años con diarrea, provenientes de Maracaibo (Venezuela). Materiales y métodos. Se recolectó una muestra fecal por individuo en 75 niños con diarrea (grupo de casos) y en 25 niños sin diarrea (grupo control). Las heces se evaluaron mediante examen microscópico, método de concentración de formól-éter y PCR múltiple anidada en una sola ronda para identificar E. histolytica, E. dispar y E. moshkovskii. Además, se hizo una encuesta en la que se recopilaron los datos demográficos, signos, manifestaciones clínicas y estrato socioeconómico de los niños. Resultados. El 48 % de los participantes (38 del grupo de casos y 10 del grupo de control) tenían enteroparásitos. Solo en las muestras de cuatro de los niños, se encontraron quistes del complejo Entamoeba (tres en el grupo de casos y uno en el de control). Mediante PCR se amplificaron nueve muestras (9 %) para la detección de las amebas estudiadas. En el grupo de casos se registraron tres (28,13 %) de E. histolytica, cuatro (30,50 %) de E. dispar y una (9,37 %) de E. moshkovskii, en tanto que solo una (25 %) muestra amplificó para E. dispar en el grupo de control. Conclusión. En general, predominó E. dispar; sin embargo, todos los infectados con E. histolytica se detectaron en el grupo de niños con diarrea y se detectó el primer caso de E. moshkovskii en la región.

Identificación molecular de Entamoeba histolytica, Entamoeba dispar y Entamoeba moshkovskii en niños con diarrea en Maracaibo, Venezuela / Molecular identification of Entamoeba histolytica, E. dispar, and E. moshkovskii in children with diarrhea from Maracaibo, Venezuela

Resumen | Introducción. Las amebas no patógenas Entamoeba dispar, Entamoeba moshkovskii y Entamoeba bangladeshi son morfológicamente idénticas a Entamoeba histolytica, parásito responsable de la amebiasis, por lo cual se necesitan técnicas moleculares para diferenciarlas. Objetivo. Determinar la frecuencia de las diferentes especies de Entamoeba mediante reacción en cadena de la polimerasa (Polymerase Chain Reaction, PCR) en muestras fecales de niños menores de cinco años con diarrea, provenientes de Maracaibo (Venezuela). Materiales y métodos. Se recolectó una muestra fecal por individuo en 75 niños con diarrea (grupo de casos) y en 25 niños sin diarrea (grupo control). Las heces se evaluaron mediante examen microscópico, método de concentración de formól-éter y PCR múltiple anidada en una sola ronda para identificar E. histolytica, E. dispar y E. moshkovskii. Además, se hizo una encuesta en la que se recopilaron los datos demográficos, signos, manifestaciones clínicas y estrato socioeconómico de los niños. Resultados. El 48 % de los participantes (38 del grupo de casos y 10 del grupo de control) tenían enteroparásitos. Solo en las muestras de cuatro de los niños, se encontraron quistes del complejo Entamoeba (tres en el grupo de casos y uno en el de control). Mediante PCR se amplificaron nueve muestras (9 %) para la detección de las amebas estudiadas. En el grupo de casos se registraron tres (28,13 %) de E. histolytica, cuatro (30,50 %) de E. dispar y una (9,37 %) de E. moshkovskii, en tanto que solo una (25 %) muestra amplificó para E. dispar en el grupo de control. Conclusión. En general, predominó E. dispar; sin embargo, todos los infectados con E. histolytica se detectaron en el grupo de niños con diarrea y se detectó el primer caso de E. moshkovskii en la región.

Abstract | Introduction: Entamoeba histolytica is an amebiasis-producing parasite. However, Entamoeba dispar, Entamoeba moshkovskii, and Entamoeba bangladeshi are non-pathogenic amoebae morphologically identical to it and, therefore, molecular techniques are required for their differentiation. Objective: To determine the frequency of Entamoeba species by polymerase chain reaction (PCR) in fecal samples from children under five years with diarrhea from Maracaibo (Venezuela). Materials and methods: A fecal sample per individual was collected from 75 children with diarrhea (case group) and 25 children without diarrhea (control group). Stools were evaluated by microscopic examination, formol-ether concentration method, and nested-multiplex PCR in a single round for the identification of E. histolytica, E. dispar, and E. moshkovskii. In addition, a survey was conducted in which demographic data, signs, clinical manifestations, and socioeconomic status were registered. Results: In total, 48% of the children (38 from the case group and 10 from the control group) had intestinal parasites. Only four children presented cysts of the Entamoeba complex in their samples (three from the case group and one from the control group). By means of PCR, nine samples (9%) amplified for the studied amoebae. In the case group, three (28.13%) amplified for E. histolytica, four (30.50%) for E. dispar, and one (9.37%) for E. moshkovskii while only one (25%) sample amplified for E. dispar in the control group. Conclusion: In general, E. dispar predominated. Nevertheless, all those infected with E. histolytica were detected within the group of children with diarrhea and we reported the first case of E. moshkovskii in the region.

Surgical Dynamometer to Simultaneously Measure the Tension Forces and the Distance between Wound Edges during the Closure of a Laparotomy.

The closure of the abdominal wall after making a laparotomy is a major challenge for surgeons, since a significant percentage of closures fail and incisional hernias rise. The suture has to withstand the forces required to close the incision, while not hindering the adequate wound healing progression. Currently, there is no surgical measuring device that could be used to determine the required closing forces, which can be very different depending on the patient. This paper presents a dynamometer to measure the tension forces to be applied while closing a surgical incision, and it simultaneously measures the distance between wound edges. It is a compass-like instrument. A mechanism between the two legs incorporates a load cell, whose signal is read by an electronic device that computes the values of the tension forces between wound edges. An angular position sensor at the pin joint between legs provides the distance between both sides of the incision. Measuring capabilities of the instrument prototype were verified at the laboratory. Thereafter, its functionality was demonstrated in experimental surgery tests. Therefore, the instrument could be very useful in clinical applications, assisting personalized surgical techniques.

Detección de Betalactamasas de espectro extendido en Enterobacteriaceae en un Centro de Salud de Maracaibo, Venezuela / Detection of Extended-Spectrum ß-lactamase-producing Enterobacteriaceae in a Healthcare Center from Maracaibo city, Venezuela

La alta incidencia de las enfermedades infecciosas y el aumento de la resistencia a los antibióticos se han convertido en la actualidad en un problema de salud pública, siendo las enterobacterias productoras de Betalactamasas de Espectro Extendido (BLEE) un ejemplo de este fenómeno. En el presente estudio se determinó la producción de BLEE en aislados clínicos de la familia Enterobacteriaceae procedentes de una institución de salud de la ciudad de Maracaibo, durante el periodo septiembre de 2014 a febrero de 2015. Para la detección de BLEE se utilizó como método preliminar el de Kirby-Baüer, siguiendo los lineamientos del CLSI; adicionalmente se utilizó como prueba confirmatoria fenotípica el método de sinergia del doble disco y como prueba confirmatoria genotípica la detección de los genes blaCTX-M, blaTEM y blaSHV mediante PCR. Se analizaron 55 enterobacterias productoras de BLEE, distribuidas de la siguiente manera: Escherichia coli 56,36%, Klebsiella pneumoniae 21,82%, Enterobacter cloacae 7,27%, Proteus mirabilis y Serratia marcescens 5,45% para cada especie, por último, Salmonella spp. y Morganella morganii 1,82% respectivamente. En cuanto al tipo de BLEE detectado mediante PCR, se observó que el 83,63% de los aislados presentó el tipo TEM, seguido de CTX-M (23,63%) y SHV (21,81%), mientras que el 27,27% de los aislados produjo dos o tres BLEE de manera simultánea. Los resultados de este estudio confirman la alta diseminación de este mecanismo de resistencia entre las enterobacterias productoras de infecciones en nuestras instituciones públicas de salud, por lo que deben aplicarse medidas de control que permitan controlar y disminuir su incidencia.

The high incidence of the infectious diseases and the antimicrobial resistance arise represent a public health threat today. The extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae are an example of this phenomenon. We determined the ESBL-production in Enterobacteriaceae isolates from a Healthcare Center in Maracaibo, during September 2014 to February 2015. The Kirby-Baüer method was perform to preliminary phenotypic detection of ESBL, according to CLSI guidelines. ESBL-production was confirmed by a double-disk synergy test according to the CLSI standards. To genotypic confirmation, the genes blaCTX-M, blaTEM and blaSHV were amplified by PCR. Fifty-five (n=55) strains were analyzed distributed in Escherichia coli (56.36 %), Klebsiella pneumoniae (21.82 %), Enterobacter cloacae (7.27 %), Proteus mirabilis and Serratia marcescens (5.45 % each one), Salmonella spp. and Morganella morganii (1.82 % each one). The major encoded ESBL was the blaTEM gene (83.63 %); followed by 23.63% of the blaCTX-M gene, and 21.81 % encoded the blaSHV gene. 27.27 % of the isolates produced two or three ESBL simultaneously. These results confirmed the high spread of this resistant mechanism among Enterobacteriaceae-producing infections in our public health institutions, therefore control measures should applied to control and reduce its incidence.

Nanoparticulate strategies for the treatment of polyglutamine diseases by halting the protein aggregation process.

Polyglutamine (polyQ) diseases are a class of neurodegenerative disorders that cause cellular dysfunction and, eventually, neuronal death in specific regions of the brain. Neurodegeneration is linked to the misfolding and aggregation of expanded polyQ-containing proteins, and their inhibition is one of major therapeutic strategies used commonly. However, successful treatment has been limited to date because of the intrinsic properties of therapeutic agents (poor water solubility, low bioavailability, poor pharmacokinetic properties), and difficulty in crossing physiological barriers, including the blood-brain barrier (BBB). In order to solve these problems, nanoparticulate systems with dimensions of 1-1000 nm able to incorporate small and macromolecules with therapeutic value, to protect and deliver them directly to the brain, have recently been developed, but their use for targeting polyQ disease-mediated protein misfolding and aggregation remains scarce. This review provides an update of the polyQ protein aggregation process and the development of therapeutic strategies for halting it. The main features that a nanoparticulate system should possess in order to enhance brain delivery are discussed, as well as the different types of materials utilized to produce them. The final part of this review focuses on the potential application of nanoparticulate system strategies to improve the specific and efficient delivery of therapeutic agents to the brain for the treatment of polyQ diseases.

Drug Release from Inert Spherical Matrix Systems Using Monte Carlo Simulations.

BACKGROUND: Computational approaches for predicting release properties from matrix devices have recently been purposed as an approach to better understand and predict such systems. The objective of this research is to study the behavior of drug delivery from inert spherical matrix systems of different size by means of computer simulation. METHODS: To simulate the matrix medium, a simple cubic lattice was used, which was sectioned to make a spherical macroscopic system. The sites within the system were randomly occupied by drug-particles or excipient-particles in accordance with chosen drug/excipient ratios. Then, the drug was released from the matrix system simulating a diffusion process. RESULTS: When the released fraction was processed until 90% release, the Weibull equation suitably expressed the release profiles. On the basis of the analysis of release equations, it was found that close to the percolation threshold an anomalous released occurs, while in the systems with an initial drug load greater than 0.45, the released was Fickian type. It was also possible to determine the amount of drug trapped in the matrix, which was found to be a function of the initial drug load. The relationship between the two mentioned variables was adequately described by a model that involves the error function. Based on the these results and by means of a non-linear regression to the previous model, it was possible to determine the drug percolation threshold in these matrix devices. CONCLUSION: It was found that the percolation threshold is consistent with the value predicted by the percolation theory.

Tuberculosis por Mycobacterium bovis en trabajadores de fincas en saneamiento para tuberculosis bovina, de Antioquia, Boyacá y Cundinamarca / Tuberculosis caused by Mycobacterium bovis in workers of bovine tuberculosis sanitation farms in Antioquia, Boyacá and Cundinamarca

RESUMEN Objetivo Realizar la vigilancia epidemiológica clásica y molecular de la tuberculosis (TB) humana causada por Mycobacterium bovis en manipuladores de la cadena de producción bovina en fincas con bovinos PPD positivos de los Departamentos de Antioquia, Boyacá y Cundinamarca en un periodo de un año. Métodos Se visitaron las fincas ganaderas, con bovinos o bufalinos PPD positivos de los departamentos de estudio según información del Programa Nacional de Tuberculosis bovina del ICA. Se recolectó la información socio-demográfica y a los factores de riesgo para adquirir TB asociados a la ocupación a través de una encuesta aplicada a todos los trabajadores de las fincas visitadas. Se recolectaron muestras de esputo luego de haber obtenido un consentimiento informado. Los esputos fueron sometidos a pruebas microbiológicas y moleculares para la identificación de los miembros del complejo M. tuberculosis. Resultados Se visitaron 33 fincas ganaderas y se recolectó información para 164 trabajadores de la cadena de producción bovina. Se identificaron como posibles factores de riesgo para el desarrollo de TB la permanencia en la finca PPD positiva por más de un año, desconocimiento de la enfermedad y presencia de posibles reservorios como perros y gatos. No se encontraron casos de TB por M. bovis ni por M. tuberculosis en los trabajadores de las fincas visitadas. Conclusión No se documentaron casos de la enfermedad por este agente zoonótico en los departamentos de Antioquia, Boyacá y Cundinamarca.(AU)

ABSTRACT Objective To perform classic and molecular epidemiological surveillance of human tuberculosis caused by Mycobacterium bovis in bovine supply chains at farms with PPD positive bovines in the departments of Antioquia, Boyacá and Cundinamarca during a one-year period. Methods Livestock farms with PPD positive bovines or buffalos were visited in the study departments according to information obtained in the "Programa Nacional de Tuberculosis bovina" (National program on bovine Tuberculosis) released by ICA (Colombian Agriculture and Livestock Institute). Data on socio-demographic information and tuberculosis risk factors associated to the occupation were collected through a survey applied to all workers at the visited farms. Sputum samples were obtained after informed consent. The sputa underwent microbiological and molecular testing to identify members of the M. tuberculosis complex. Results Thirty-three livestock farms were visited and information of 164 workers from the bovine supply chain was collected. Staying in a PPD positive farm for more than a year, ignorance about the disease and the presence of possible vectors, like dogs and cats, were identified as possible risk factors for developing tuberculosis. No cases of tuberculosis caused by M. bovis or M. tuberculosis in workers of the visited farms were found. Conclusion No cases of the disease caused by this zoonotic agent were documented in the departments of Antioquia, Boyacá and Cundinamarca.(AU)

Prevalencia de enteroparasitos en individuos seropositivos y seronegativos a los virus HTLV-I/II

Para determinar la prevalencia de enteroparásitos en individuos seropositivos a los virus HTLV-I/II, se seleccionaron aleatoriamente 75 donantes que asistieron a los Bancos de Sangre de dos instituciones sanitarias del municipio Maracaibo, Venezuela. Se contactaron personalmente 50 individuos seropositivos a virus HTLV-I/II (grupo muestra) y 25 seronegativos (grupo control), quienes aportaron una muestra fecal para diagnóstico parasitológico. Estas fueron sometidas al examen al fresco con solución salina fisiológica (SSF) al 0,85%, tinción temporal de Lugol y técnica de concentración con formol-éter (Ritchie). Además se realizó cultivo en Agar Nutritivo (método de Arakaki) para investigar la presencia de larvas de Strongyloides stercoralis. Se determinó una prevalencia general de enteroparásitos en el grupo muestra de 54% y 44% en el grupo control. Predominó el monoparasitismo entre todos los individuos estudiados. Las especies identificadas fueron: Blastocystis spp. 47,3% y 15,4%, Entamoeba coli 21% y 15,4%, Endolimax nana 13% y 53,8%, Complejo Entamoeba 10,5% y 15,4%, Giardia intestinalis 5,2% y 0%, y Entamoeba hartmanni 2,6% y 0% en el grupo muestra y grupo control, respectivamente. No se detectó Strongyloides stercoralis ni otros helmintos intestinales, en los individuos estudiados. Blastocystis spp. fue el más frecuente en los pacientes seropositivos (diferencia estadísticamente significativa) que en el grupo control, lo que pudiese relacionarse con una mayor persistencia de este cromista en pacientes coinfectados con HTLV-I/II. Se puede concluir que el estatus serológico del individuo HTLV-I/II positivo parece no influir en la presencia o adquisición de parásitos intestinales.

Prevalence of intestinal parasites in seropositive and seronegative to HTLV I/II viruses

The prevalence of intestinal parasites in individuals seropositive for the HTLV-I/II virus was studied. A total of 75 donors who attended the blood banks of two health institutions in Maracaibo, Venezuela were randomly selected: 50 patients seropositive for HTLV-I/II (study group) and 25 seronegative individuals (control group). The participants in the study were all contacted personally, after which they provided a fecal sample for parasitological diagnosis. The fresh samples were examined using 0.85% physiological saline solution (PSS), Lugol’s solution for temporary staining and the formalin-ether concentration technique (Ritchie). In addition, samples were cultured on nutrient agar (Arakaki method) to determine the presence of Strongyloides stercoralis larvae. Overall prevalences of 54% intestinal parasites in the study group and 44% in the control group were found. Monoparasitism prevailed among all the individuals studied. The species identified in the study and control groups were: Blastocystis spp. 47.3% and 15.4%, Entamoeba coli 21% and 15.4%, Endolimax nana 13.0% and 53.8%, Entamoeba complex 10.5% and 15.4%, Giardia intestinalis 5.2% and 0%, and Entamoeba hartmanni 2.6% and 0 %, respectively. Strongyloides stercoralis and other intestinal helminths were not detected in the individuals studied. Blastocystis spp. was significantly more common in seropositive patients than in the control group, which could be associated with a greater persistence of this chromista in patients co-infected with HTLV-I / II.It can be concluded that the positive serological status of HTLV-I / II infected individuals does not seem to influence either the presence or acquisition of intestinal parasites.

Detección de rotavirus y parásitos intestinales en infantes menores de 5 años de edad de comunidades indígenas del Estado Zulia, Venezuela / Detection of rotavirus and intestinal parasites in children under 5 years old, from indigenous communities in Zulia state, Venezuela

Rotavirus es un agente viral asociado a la gastroenteritis infantil, siendo junto con los parásitos intestinales, los principales causantes de estos cuadros diarreicos. Con el objetivo de detectar rotavirus y parásitos intestinales en infantes de 0 a 5 años de seis comunidades indígenas del estado Zulia, se tomaron 173 muestras de heces en las que se determinó la presencia de rotavirus empleando la técnica de aglutinación en látex. Las muestras fueron caracterizadas macro y microscópicamente a través del examen con SSF, lugol y concentrado con formol-éter, para detectar formas evolutivas parasitarias. Se determinó la prevalencia de parásitos intestinales de un 71%, significativamente más elevada que la de Rotavirus con 16,2%. Se encontró relación estadísticamente significativa entre la presencia de rotavirus y la existencia de diarrea (p=0,0001); más no entre presencia de rotavirus y niños vacunados (p=0,904). Predominaron las protozoosis sobre las helmintiasis; así como el poliparasitismo (52%). Los parásitos más prevalentes fueron Ascaris lumbricoides con 32,4% y Blastocystis spp. con 31,2%. Los principales parásitos asociados a rotavirus fueron Blastocystis spp. y Entamoeba coli, aunque sin significancia estadística. Se concluye que la prevalencia de rotavirus detectada se corresponde a la referida en Venezuela para niños menores de 5 años de áreas urbanas.

Rotavirus is a viral agent associated with childhood gastroenteritis, being with intestinal parasites, the principal cause of diarrhea in children. In order to detect rotavirus, and intestinal parasites in children from 0 to 5 years old of six indigenous communities in Zulia state, 173 stool samples was recolected, where the presence of rotavirus was determinate using agglutination test. The samples were characterized macroscopically and microscopically by examining with SSF, lugol and concentrate formalin-ether to detect parasitic evolutionary forms. It was determined that the presence of intestinal parasites was 71%, significantly higher than the 16,2% of rotavirus. The most prevalent parasites were Ascaris lumbricoides (32,4%) and Blastocystis spp. (31,2%). Statistically significant relationship between the presence of rotavirus and diarrhea existence (p = 0.0001); more no presence of rotavirus among vaccinated children (p = 0.904 ). About they predominated protozoosis over helminths; as well as polyparasitism (52%). Major parasites associated with rotavirus were Blastocystis spp. and Entamoeba coli, although without statistical significance. It is concluded that the prevalence of rotavirus detected corresponds to that reported in Venezuela for children under 5 years of urban areas.

[Tuberculosis caused by Mycobacterium bovis in workers of bovine tuberculosis sanitation farms in Antioquia, Boyacá and Cundinamarca]. / Tuberculosis por Mycobacterium bovis en trabajadores de fincas en saneamiento para tuberculosis bovina, de Antioquia, Boyacá y Cundinamarca.

OBJECTIVE: To perform classic and molecular epidemiological surveillance of human tuberculosis caused by Mycobacterium bovis in bovine supply chains at farms with PPD positive bovines in the departments of Antioquia, Boyacá and Cundinamarca during a one-year period. METHODS: Livestock farms with PPD positive bovines or buffalos were visited in the study departments according to information obtained in the "Programa Nacional de Tuberculosis bovina" (National program on bovine Tuberculosis) released by ICA (Colombian Agriculture and Livestock Institute). Data on socio-demographic information and tuberculosis risk factors associated to the occupation were collected through a survey applied to all workers at the visited farms. Sputum samples were obtained after informed consent. The sputa underwent microbiological and molecular testing to identify members of the M. tuberculosis complex. RESULTS: Thirty-three livestock farms were visited and information of 164 workers from the bovine supply chain was collected. Staying in a PPD positive farm for more than a year, ignorance about the disease and the presence of possible vectors, like dogs and cats, were identified as possible risk factors for developing tuberculosis. No cases of tuberculosis caused by M. bovis or M. tuberculosis in workers of the visited farms were found. CONCLUSION: No cases of the disease caused by this zoonotic agent were documented in the departments of Antioquia, Boyacá and Cundinamarca.

PREBIOUS trial: a multicenter randomized controlled trial of PREventive midline laparotomy closure with a BIOabsorbable mesh for the prevention of incisional hernia: rationale and design.

BACKGROUND: Development of an incisional hernia is one of the most frequent complications of midline laparotomies requiring reoperation. This paper presents the rationale, design, and study protocol for a randomized controlled trial, the aim of which is to evaluate the efficacy and safety of prophylactically placing a bioabsorbable synthetic mesh for reinforcement of a midline fascial closure. METHODS: The PREBIOUS trial (PREventive midline laparotomy closure with a BIOabsorbable mesh) is a multicenter randomized controlled trial in which adult patients undergoing elective or urgent open abdominal operations through a midline laparotomy incision are assigned to one of two groups based on the laparotomy closure procedure: an intervention group in which a continuous polydioxanone (PDS) suture is reinforced with a commercially available GORE® BIO-A® Tissue Reinforcement prosthesis (W.L. Gore & Associates, Flagstaff, AZ, USA), or a control group with continuous PDS suture only. Both groups are followed over 6 months. OUTCOMES: The primary outcome is the appearance of incisional hernias assessed by physical examination at clinical visits and radiologically (CT scan) performed at the end of follow-up. Secondary outcomes are the rate of complications, mainly infection, hematoma, burst abdomen, pain, and reoperation. The PREBIOUS trial has the potential to demonstrate that suture plus prosthetic mesh insertion for routine midline laparotomy closure is effective in preventing incisional hernias after open abdominal surgery, to avoid the effects on those affected, such as poor cosmesis, social embarrassment, or impaired quality of life, and to save costs potentially associated with incisional hernia surgical repair.

Detección de Entamoeba histolytica y Entamoeba dispar mediante PCR, en niños menores de cinco años con diarrea, en Maracaibo, Venezuela: Estudio preliminar / Detection of Entamoeba histolytica and Entamoeba dispar by PCR in children, less than five years of age with diarrhea, in Maracaibo, Venezuela: A preliminary study

Para determinar la prevalencia de Entamoeba histolytica como productora de diarrea, se realizó un estudio en niños menores de cinco años con diarrea que asistieron a diversas consultas del Servicio Autónomo Hospital Universitario de Maracaibo, Venezuela. A las muestras de heces obtenidas, se les realizó examen macroscópico, microscópico con solución salina fisiológica 0,85% y lugol, así como coloración de Kinyoun. El resto de la muestra se congeló hasta la extracción del ADN y luego se amplificaron mediante PCR separadas para E. histolytica y E. dispar. De las 50 muestras analizadas mediante examen microscópico, ninguna presentó trofozoítos y/o quistes de Entamoeba histolytica/dispar/moshkovskii, ni coccidios intestinales. Los parásitos detectados fueron Giardia lamblia (6%), Blastocystis sp. (6%), Pentatrichomonas hominis (2%), Ascaris lumbricoides (2%) y Trichuris trichiura (2%). Mediante PCR, 6 muestras (12%) presentaron ADN de E. dispar y 2 (4%) ADN de E. histolytica. Ningún niño presentó asociación de ambas amibas. Los dos niños que presentaron E. histolytica tenían 1 año de edad. E. dispar si fue detectada en niños de menor edad. Se sugiere que la prevalencia de E. histolytica en niños menores de cinco años con diarrea es realmente baja.

To determine the prevalence of Entamoeba histolytica as a producer of diarrhea, a study was conducted in children, less than five years of age, with diarrhea who attended several out patient clinics of the Servicio Autónomo Hospital Universitario, Maracaibo, Venezuela. A macroscopic and microscopic examination with physiological saline, lugol and Kinyoun staining were performed to the stool samples obtained. The remainder of the sample was frozen until DNA extraction, and PCR amplification was performed separately for E. histolytica and E. dispar. Microscopic examination showed no trophozoites and/or cysts of Entamoeba histolytica/dispar/moshkovskii, or intestinal coccidians in any of the 50 samples analyzed. Parasites detected were Giardia lamblia (6%), Blastocystis sp. (4%), Pentatrichomonas hominis (2%), Ascaris lumbricoides (2%) and Trichuris trichiura (2%). By PCR, six samples (12%) had DNA of E. dispar and two (4%) had DNA from E. histolytica; no child showed association of both amoebae. The two children who had E. histolytica were one-year-old. E. dispar was detected in younger children. We suggest that the prevalence of E. histolytica in children under five years is really low.

Prevalencia de microsporidios intestinales y otros enteroparásitos en pacientes con VIH positivo de Maracaibo, Venezuela / Prevalence of intestinal microsporidia and other intestinal parasites in hiv positive patients from Maracaibo, Venezuela.

Introducción. Desde 1985, los microsporidios se consideran parásitos causantes de infecciones emergentes y oportunistas en individuos inmunocomprometidos en todo el mundo. Objetivo. Detectar la presencia de microsporidios y otros enteroparásitos en pacientes con VIH/sida del Servicio Autónomo Hospital Universitario de Maracaibo (SAHUM), donde no existían estudios previos en este campo. Materiales y métodos. Las muestras fecales se analizaron mediante examen directo, método de concentración con formol-éter, coloración de Kinyoun y coloración Gram-cromotropo rápida. Se realizaron PCR separadas para diferenciar Entamoeba histolytica o Entamoeba dispar , cuando se observó el complejo E. histolytica/dispar al microscopio. Mediante historia clínica se obtuvo información del paciente. Resultados. De los 56 individuos participantes, 38 (67,86 %) presentaron alguna especie parasitaria comensal o patógena en su muestra fecal. Predominaron los individuos portadores de especies parásitas patógenas (26/38). Fueron diagnosticados protozoos como Isospora belli (17,65 %), Blastocystis spp .(17,65 %), Cryptosporidium spp. (7,84 %), complejo Entamoeba histolytica/dispar (5,88 %) , Entamoeba coli (3,92 %) , Giardia lamblia (3,92 %) , Endolimax nana (3,92 %) , Cyclospora cayetanensis (3,92 %) y Chilomastix mesnili (1,96 %). Entre los helmintos, Ascaris lumbricoides, Trichuris trichiura y Strongyloides stercoralis, presentaron un porcentaje de 27,27 % cada uno, e Hymenolepis nana , de 18,18 %. Solo se detectó E. histolytica en uno de los tres casos que presentaron el complejo al examen microscópico. Mediante Gram-cromotropo, 17 muestras evidenciaron esporas del filo Microsporidia, lo que equivale a un 33,33 % de prevalencia. Conclusión. Los microsporidios pueden ocupar el primer lugar de prevalencia en pacientes con VIH positivo, cuando se utilizan técnicas diagnósticas específicas.

Objective: To detect the presence of microsporidia and other enteric parasites in patients with HIVAIDS of the Autonomous Services University Hospital of Maracaibo (SAHUM), where there are no previous studies in this field. Materials and methods: Fecal samples were analyzed by means of direct exam, concetration method with formal-ether, Kinyoun coloration and fast Gram-Chromotrope coloration. Separate PCR were perfomed to differentiate Entamoeba histolytica and Entamoeba dispar , when the E. histolytica/E. dispar complex was observed in the microscope. Information on the patient was obtained trough clinical history. Results: Of 56 individuals that participated, 38 (67.86%) presented some commensal parasite and/ or pathogenic species in their fecal sample. Carriers of pathogenic species were predominat (26/38). Protozoa such as Isospora belli protozoa (17.65%), Blastocystis spp. (17.65%), Cryptosporidium spp. (7.84%), E. histolytica/E. dispar (5.88%), Entamoeba coli (3.92%), Giardia lamblia (3.92%), Endolimax nana (3.92%), Cyclospora cayetanensis (3.92%), and Chilomastix mesnilli (1.96%) were diagnosed. Among the helminths, Ascaris lumbricoides, Trichuris trichiura and Strongyloides stercoralis , had a percentage of 27.27% each, and Hymenolepis nana , 18.18%. Entamoeba histolytica was only detected in one of three cases presenting complex microscopic examination. By Gram-chromotrope, 17 samples showed spores of the Microsporidia phylum, equivalent to 33.33% prevalence. Conclusion: Microsporidia may be first prevalente in HIV positive patients when specific diagnostic techniques are used.

Prevalencia de Blastocystis sp. y otros protozoarios comensales en individuos de Santa Rosa de Agua, Maracaibo, estado Zulia / Prevalence of Blastocystis sp. and other commensal protozoa in individuals from Santa Rosa del Agua, Zulia State

Con la finalidad de determinar la prevalencia de Blastocystis sp. y especies de protozoarios comensales intestinales del hombre según diferentes aspectos como la edad y el sexo, se evaluaron muestras de heces de 111 individuos varones y mujeres de todas las edades, pobladores de Santa Rosa de Agua, Maracaibo, estado Zulia. Cada muestra fecal se analizó a través de un examen al fresco, tinción de lugol y técnica de concentración de Ritchie. Se utilizó la tinción de hematoxilina férrica para identificar trofozoitos de Dientamoeba fragilis. Las especies del complejo Entamoeba histolytica/Entamoeba dispar se diferenciaron mediante técnicas de PCR. Blastocystis sp. fue la especie predominante (45,6%), seguida por Entamoeba coli (17,9%), Endolimax nana (14,8%), Chilomastix mesnili (6,2%), Entamoeba dispar (5,6%), Dientamoeba fragilis, Pentatrichomonas hominis, Iodamoeba butschlii (3,1%) respectivamente y Entamoeba hartmanni (0,6%). Hubo afinidad parasitaria entre las especies Entamoeba coli y Endolimax nana. No se demostró asociación entre presencia de infección y sexo. Los grupos etarios preescolares y escolares demostraron asociación significativa con la infección parasitaria. Se determinó una elevada prevalencia de Blastocystis sp. y especies comensales intestinales, todas indicadoras de contaminación fecal, donde probablemente factores ambientales y socioculturales promovieron su transmisión.

With the purpose of determining Blastocytis sp. and other commensal intestinal protozoa species prevalence according to different aspects such as age and sex, we evaluated 111 feces samples from male and female individuals of all ages, living at Santa Rosa del Agua, Maracaibo, Zulia State, Venezuela. Each fecal sample was analyzed fresh, stained with lugol, and by Ritchie’s concentration test. We used ferric hematoxilin stain to identify Dientamoeba fragilis trophozoites. Species belonging to the Entamoeba histolytica/Entamoeba dispar complex were differentiated through PCR techniques. Blastocytis sp. was the predominant species (45.6%), followed by Entamoeba coli (17.9%), Endolimax nana (14.8%), Chilomastix mesnili (6.2%), Entamoeba dispar (5.6%), Dientamoeba fragilis, Pentatrichomonas hominis, Iodamoeba butschlii (3.1%, respectively), and Entamoeba hartmanni (0.6%). There was parasitic affinity between the Entamoeba coli and Endolimax nana species. There was no association between presence of infection and sex. Pre-school and school age groups showed a significant association with parasite infection. A high prevalence of Blastocystis sp. and intestinal commensal species was determined, all indicative of fecal contamination, where environmental and sociocultural factors probably promote transmission.

[Prevalence of intestinal microsporidia and other intestinal parasites in hiv positive patients from Maracaibo, Venezuela]. / Prevalencia de microsporidios intestinales y otros enteroparásitos en pacientes con VIH positivo de Maracaibo, Venezuela.

OBJECTIVE: To detect the presence of microsporidia and other enteric parasites in patients with HIVAIDS of the Autonomous Services University Hospital of Maracaibo (SAHUM), where there are no previous studies in this field. MATERIALS AND METHODS: Fecal samples were analyzed by means of direct exam, concetration method with formal-ether, Kinyoun coloration and fast Gram-Chromotrope coloration. Separate PCR were perfomed to differentiate Entamoeba histolytica and Entamoeba dispar , when the E. histolytica/E. dispar complex was observed in the microscope. Information on the patient was obtained trough clinical history. RESULTS: Of 56 individuals that participated, 38 (67.86%) presented some commensal parasite and/ or pathogenic species in their fecal sample. Carriers of pathogenic species were predominat (26/38). Protozoa such as Isospora belli protozoa (17.65%), Blastocystis spp. (17.65%), Cryptosporidium spp. (7.84%), E. histolytica/E. dispar (5.88%), Entamoeba coli (3.92%), Giardia lamblia (3.92%), Endolimax nana (3.92%), Cyclospora cayetanensis (3.92%), and Chilomastix mesnilli (1.96%) were diagnosed. Among the helminths, Ascaris lumbricoides, Trichuris trichiura and Strongyloides stercoralis , had a percentage of 27.27% each, and Hymenolepis nana , 18.18%. Entamoeba histolytica was only detected in one of three cases presenting complex microscopic examination. By Gram-chromotrope, 17 samples showed spores of the Microsporidia phylum, equivalent to 33.33% prevalence. CONCLUSION: Microsporidia may be first prevalente in HIV positive patients when specific diagnostic techniques are used.

[Detection of Entamoeba histolytica and Entamoeba dispar by PCR in children, less than five years of age with diarrhea, in Maracaibo, Venezuela. A preliminary study]. / Detección de Entamoeba histolytica y Entamoeba dispar mediante PCR, en niños menores de cinco años con diarrea, en Maracaibo, Venezuela. Estudio preliminar.

To determine the prevalence of Entamoeba histolytica as a producer of diarrhea, a study was conducted in children, less than five years of age, with diarrhea who attended several out patient clinics of the Servicio Aut6nomo Hospital Universitario, Maracaibo, Venezuela. A macroscopic and microscopic examination with physiological saline, lugol and Kinyoun staining were performed to the stool samples obtained. The remainder of the sample was frozen until DNA extraction, and PCR amplification was performed separately for E. histolytica and E. dispar. Microscopic examination showed no trophozoites and/or cysts of Entamoeba histolytica/dispar/moshkovskii, or intestinal coccidians in any of the 50 samples analyzed. Parasites detected were Giardia lamblia (6%), Blastocystis sp. (4%), Pentatrichomonas hominis (2%), Ascaris lumbricoides (2%) and Trichuris trichiura (2%). By PCR, six samples (12%) had DNA of E. dispar and two (4%) had DNA from E. histolytica; no child showed association of both amoebae. The two children who had E. histolytica were one-year-old. E. dispar was detected in younger children. We suggest that the prevalence of E. histolytica in children under five years is really low.

Correlation between compactibility values and excipient cluster size using an in silico approach.

BACKGROUND: In silico simulation and percolation theory are important tools in the study of physical and mechanical behavior of pharmaceutical compacts. The aim was to generate a new in silico simulation program that describes the mechanical structure of binary compacts formed from an excipient with excellent compactibility and a drug with null compactibility. MATERIALS AND METHODS: Paracetamol and microcrystalline cellulose powders were compressed under different pressures. Values for the indentation hardness and tensile strength were measured and fitted to the Leuenberger's model. On the other hand, compacts with different composition were in silico simulated. In each system, the biggest excipient cluster was identified and quantified using the Hoshen-Kopelman algorithm. Then, the size of the biggest in silico cluster was correlated with experimental compactibility values. RESULTS AND DISCUSSION: The Leuenberger's model resulted in good fit to the experimental data for all formulations over 40% of excipient load. Formulations with high drug load (≥0.8) had reduced range for forming compacts and gave low compactibility values. The excipient percolation threshold for the simulated system was 0.3395, indicating that over this excipient fraction, a compact with defined mechanical properties will be formed. The compactibility values presented a change in the range of 0.3-0.4 of excipient fraction load, just where the in silico excipient percolation threshold was found. CONCLUSION: Physical measurements of the binary compacts showed good agreement with computational measurements. Subsequently, this in silico approach may be used for the optimization of pharmaceutical powder formulations used in tablet compression.