Microscopic and submicroscopic Plasmodium infections in indigenous and non-indigenous communities in Colombia.

BACKGROUND: The indigenous population is considered a highly susceptible group to malaria because individuals usually live in areas with high exposure to Anopheles and poverty, and have limited access to health services. There is a great diversity of indigenous communities in Colombia living in malaria-endemic areas; however, the burden of infection in these populations has not been studied extensively. This study aimed to determine the prevalence of Plasmodium infections in indigenous and non-indigenous communities in two malaria-endemic areas in Colombia. METHODS: A community-based cross-sectional survey was conducted in seven villages of Turbo and El Bagre municipalities; three of these villages were indigenous communities. Inhabitants of all ages willing to participate were included. Sociodemographic and clinical data were recorded as well as household information. The parasitological diagnosis was performed by microscopy and nested PCR. The prevalence of microscopy and submicroscopic infection was estimated. An adjusted GEE model was used to explore risk factors associated with the infection. RESULTS: Among 713 participants, 60.7% were from indigenous communities. Plasmodium spp. was detected in 30 subjects (4.2%, CI 95% 2.9-5.9); from those, 29 were in the indigenous population, 47% of infections were afebrile, and most of them submicroscopic (10/14). Microscopic and submicroscopic prevalence was 2.5% (CI 95% 1.6-3.9) and 1.7% (CI 95% 0.9-2.9), respectively. In El Bagre, all infections occurred in indigenous participants (3.9%, CI 95% 2.2-7.1), and 81% were submicroscopic. By contrast, in Turbo, the highest prevalence occurred in indigenous people (11.5%; CI 95%: 7.3-17.5), but 88.8% were microscopic. Living in an indigenous population increased the prevalence of infection compared with a non-indigenous population (PR 19.4; CI 95% 2.3-166.7). CONCLUSION: There is a high proportion of Plasmodium infection in indigenous communities. A substantial proportion of asymptomatic and submicroscopic carriers were detected. The identification of these infections, not only in indigenous but also in the non-indigenous population, as well as their associated factors, could help to implement specific malaria strategies for each context.

Identification and Pilot Evaluation of Salivary Peptides from Anopheles albimanus as Biomarkers for Bite Exposure and Malaria Infection in Colombia.

Insect saliva induces significant antibody responses associated with the intensity of exposure to bites and the risk of disease in humans. Several salivary biomarkers have been characterized to determine exposure intensity to Old World Anopheles mosquito species. However, new tools are needed to quantify the intensity of human exposure to Anopheles bites and understand the risk of malaria in low-transmission areas in the Americas. To address this need, we conducted proteomic and bioinformatic analyses of immunogenic candidate proteins present in the saliva of uninfected Anopheles albimanus from two separate colonies-one originating from Central America (STECLA strain) and one originating from South America (Cartagena strain). A ~65 kDa band was identified by IgG antibodies in serum samples from healthy volunteers living in a malaria endemic area in Colombia, and a total of five peptides were designed from the sequences of two immunogenic candidate proteins that were shared by both strains. ELISA-based testing of human IgG antibody levels against the peptides revealed that the transferrin-derived peptides, TRANS-P1, TRANS-P2 and a salivary peroxidase peptide (PEROX-P3) were able to distinguish between malaria-infected and uninfected groups. Interestingly, IgG antibody levels against PEROX-P3 were significantly lower in people that have never experienced malaria, suggesting that it may be a good marker for mosquito bite exposure in naïve populations such as travelers and deployed military personnel. In addition, the strength of the differences in the IgG levels against the peptides varied according to location, suggesting that the peptides may able to detect differences in intensities of bite exposure according to the mosquito population density. Thus, the An. albimanus salivary peptides TRANS-P1, TRANS-P2, and PEROX-P3 are promising biomarkers that could be exploited in a quantitative immunoassay for determination of human-vector contact and calculation of disease risk.

[Genotyping of human papillomavirus in women under 25 years old treated in the screening program for cervical cancer]. / Genotipificación del virus papiloma humano en mujeres bajo 25 años de edad participantes del Programa Nacional del Cáncer Cérvico-uterino en la Región de la Araucanía, Chile.

BACKGROUND: In Chile, cervical cancer (CC) is the second leading cause of death from malignancy in women. The main causal agent of cervical cancer is the human papillomavirus (HPV). This virus is the most common sexually transmitted infection among sexually active youth. An early onset of sexual life increases the chances of HPV infection; this may involve a possible early development of cervical intraepithelial neoplasia and CC, creating a major public health problem. OBJECTIVE: To present HPV frequency in women under the age of 25, treated in the CC screening program and their follow-up after histopathological diagnosis. METHODS: 173 cervical samples were genotyped by polymerase chain reaction and non-radioactive reverse hybridization (line blot). RESULTS: The overall frequency of HPV was 84.8%. HPV16 was the most prevalent. In 12.1% of women the cervical lesion persisted or progressed. 28.9% of women had irregular follow-up; in this group, 88% were HPV(+) and 52% had no record of Pap smear in the past 3 years. DISCUSSION: The results reaffirm the usefulness of complementing the Pap and HPV detection as a primary screening tool in sexually active women. They also suggest the possibility of extending the age coverage of the national screening program.

Uveitic Glaucoma and Hansen's disease, A case report.

BACKGROUND: The number of Hansen's disease cases in Latin America and the Caribbean has decreased in the last decade; nevertheless, the region is still struggling with infections caused by Mycobacterium leprae. This is a case report that portrays the diagnostic and management challenges associated with atypical uveitic glaucoma that is due to Hansen's disease. CASE PRESENTATION: A 62-year-old female was referred with a 2-year history of anterior uveitis of unknown etiology and ocular hypertension. Past medical history and general physical examination were unremarkable. Upon ocular examination, her best-corrected visual acuity (BCVA) was 20/25 in the OD and 20/60 in the OS. Tonometry showed intraocular pressures (IOPs) of 29 mmHg and 22 mmHg in her right and left eyes, respectively. The slit-lamp examination showed clinical signs of bilateral granulomatous anterior uveitis and cataracts; gonioscopy revealed open angles with some peripheral anterior synechiae for both eyes. Fundus examination and glaucoma tests revealed mild glaucomatous damage in the right eye. Given the presentation of uveitis, the respective questionnaire was completed by internal medicine and rheumatology. Four months later, after bilateral cataract surgery, the patient developed skin plaques on the face, neck, upper back, and extremities, which were biopsied and identified as positive for tuberculoid leprosy. CONCLUSION: This is the first case report in Ecuador of atypical glaucoma triggered by infectious uveitis produced by Mycobacterium leprae. We describe a female patient's clinical presentation with several ocular signs of leprosy and other nonspecific and rarely seen symptoms. Uveitis is a condition that often requires a multidisciplinary team of ophthalmologists and clinicians because of the possible manifestation of an underlying systemic disease, creating a challenge for all the medical personnel involved in the management of the case.

Association of variants in IL1B, TLR9, TREM1, IL10RA, and CD3G and Native American ancestry on malaria susceptibility in Colombian populations.

Host genetics is an influencing factor in the manifestation of infectious diseases. In this study, the association of mild malaria with 28 variants in 16 genes previously reported in other populations and/or close to ancestry-informative markers (AIMs) selected was evaluated in an admixed 736 Colombian population sample. Additionally, the effect of genetic ancestry on phenotype expression was explored. For this purpose, the ancestral genetic composition of Turbo and El Bagre was determined. A higher Native American ancestry trend was found in the population with lower malaria susceptibility [odds ratio (OR) = 0.416, 95% confidence interval (95% CI) = 0.234-0.740, P = 0.003]. Three AIMs presented significant associations with the disease phenotype (MID1752, MID921, and MID1586). The first two were associated with greater malaria susceptibility (D/D, OR = 2.23, 95% CI = 1.06-4.69, P = 0.032 and I/D-I/I, OR = 2.14, 95% CI = 1.18-3.87, P = 0.011, respectively), and the latter has a protective effect on the appearance of malaria (I/I, OR = 0.18, 95% CI = 0.08-0.40, P < 0.0001). After adjustment by age, sex, municipality, and genetic ancestry, genotype association analysis showed evidence of association with malaria susceptibility for variants in or near IL1B, TLR9, TREM1, IL10RA, and CD3G genes: rs1143629-IL1B (G/A-A/A, OR = 0.41, 95% CI = 0.21-0.78, P = 0.0051), rs352139-TLR9 (T/T, OR = 0.28, 95% CI = 0.11-0.72, P = 0.0053), rs352140-TLR9 (C/C, OR = 0.41, 95% CI = 0.20-0.87, P = 0.019), rs2234237-TREM1 (T/A-A/A, OR = 0.43, 95% CI = 0.23-0.79, P = 0.0056), rs4252246-IL10RA (C/A-A/A, OR = 2.11, 95% CI = 1.18-3.75, P = 0.01), and rs1561966-CD3G (A/A, OR = 0.20, 95% CI = 0.06-0.69, P = 0.0058). The results showed the participation of genes involved in immunological processes and suggested an effect of ancestral genetic composition over the traits analyzed. Compared to the paisa population (Antioquia), Turbo and El Bagre showed a strong decrease in European ancestry and an increase in African and Native American ancestries. Also, a novel association of two single nucleotide polymorphisms with malaria susceptibility was identified in this study.

Reacciones adversas cutáneas severas a medicamentos: estado del conocimiento / Severe cutaneous adverse drug reactions: state of knowledge

Resumen: las reacciones adversas a medicamentos afectan de manera global entre el 10% y el 20% de los pacientes hospitalizados y el 7% de los pacientes ambulatorios. Aproximadamente, uno de cada mil pacientes hospitalizados sufren reacciones adversas que amenazan la vida. Las reacciones adversas a medicamentos, denominadas como reacciones alérgicas (inmunológicas), se pueden agrupar según la clasificación de Gell y Coombs en: tipo I (mediada por IgE), tipo II (citotóxica), tipo III (por inmunocomplejos) y tipo IV (hipersensibilidad retardada o celular). Actualmente, las reacciones tipo IV se subclasifican según la célula efectora involucrada y sus correspondientes citoquinas. Estos subgrupos se definen como: tipo IVa (con activación del perfil Th1, los macrófagos como células efectoras y liberación de INF-γ y TNF-α), tipo IVb (con activación del perfil Th2, los eosinófilos como células efectoras y liberación de citoquinas como la IL-5, la IL-4 y la IL-13), tipo IVc (con los linfocitos T citotóxicos como células efectoras y liberación de granzimas B y perforinas) y tipo IVd (con los neutrófilos como células efectoras y liberación de CXCL8 y factor estimulante de colonias de granulocitos y macrófagos). La presente revisión se centra en la epidemiología, etiología, fisiopatología y manifestaciones clínicas de las reacciones adversas cutáneas severas a medicamentos como el síndrome de Stevens Johnson, la necrólisis epidérmica tóxica, el síndrome DRESS y la pustulosis exantemática generalizada aguda (AU)

Abstract: Adverse drug reactions affect globally between 10% to 20% of hospitalized patients and 7% of outpatients. Approximately one in 1,000 hospitalized patients suffer life-threatening adverse reactions. Adverse reactions to drugs, called allergic reactions (immunological), can be grouped according to the Gell and Coombs classification: type I (IgE mediated), type II (cytotoxic), type III (by immunocomplexes), and type IV (delayed or cellular hypersensitivity). Currently type IV reactions are subclassified according to the effector cell involved and its corresponding cytokines. These subgroups are defined as: type IVa (activation of Th1 profile, effector cell macrophages, and release of INF-γ and TNF-α); type IVb (Th2 profile activation, effector cell eosinophil, and release of cytokines such as IL-5, IL-4 and IL-13); type IVc (effector cell cytotoxic T lymphocytes and release of granzymes B and perforins); and type IVd (effector cell neutrophil and release of CXCL8 and granulocyte-macrophage colony-stimulating factor). The present review focuses on the epidemiology, etiology, pathophysiology and clinical manifestations of severe cutaneous adverse drug reactions such as Stevens Johnson syndrome, toxic epidermal necrolysis, DRESS syndrome, and acute generalized exanthematous pustulosis, as well as a therapeutic approach in each of these diseases. (AU)

Identification of volatile compounds of Clinopodium odorum (Lamiaceae):A comparison between HS-SPME and classic hydrodistillation / Identificación de compuestos volátiles de Clinopodium odorum (Lamiaceae): Una comparación entre HS-SPME ehidrodestilación clásica

In the present work an analytical methodology to micro scale based on the use of the HS-SPME/GC-MS to determine volatile compounds present in Clinopodium odorum (Griseb.) Harley (Lamiaceae)was optimized and settled differences and similarities with itsessential oil. A systematic description of the volatile components of flowers, stems, leaves and combined aerial parts (whole plant) was constructed via GC-MS analyses of HS-SPME adsorbed compounds and of essential oils obtained through hydrodistillation of the same tissues. Pulegone was the main component of both the HS-SPME analysis and essential oil analysis. In addition, piperitenone oxide andpiperitone oxide were the other main components in the essential oil whereas in the HS-SPME analysis cis-isopulegone and menthone prevailed. The HS-SPME method can achieve comparable results to those obtained by essential oil analysis, by using very fewer samples, ashorter extraction time and a much simpler procedure.

En el presente trabajo se ha optimizado una metodología analítica a micro-escala basada en HS-SPME/GC-MS para determinar los compuestos volátiles presentes en Clinopodium odorum (Griseb.) Harley (Lamiaceae), y se establecieron diferencias y similitudes con su aceite esencial. Se realizó una descripción sistemática de los componentes volátiles de flores, tallos, hojas y partes aéreas combinadas(planta entera) a partir de los análisis por GC-MS a través del sistema HS-SPME y de los aceites esenciales. Pulegona fue el componenteprincipal tanto del análisis por HS-SPME, como del aceite esencial. Además, el óxido de piperitenona y el óxido de piperitona eran los otroscomponentes principales en el aceite esencial mientras que en el análisis por HS-SPME, prevalecieron cis-isopulegona y mentona. El método de HS-SPME puede lograr resultados comparables a los obtenidos por el análisis de aceite esencial, mediante el uso de muestras de menor tamaño, un tiempo de extracción más corto y un procedimiento más simple.

Genotipificación del virus papiloma humano en mujeres bajo 25 años de edad participantes del Programa Nacional del Cáncer Cérvico-uterino en la Región de la Araucanía, Chile / Genotyping of human papillomavirus in women under 25 years old treated in the screening program for cervical cancer

Background: In Chile, cervical cancer (CC) is the second leading cause of death from malignancy in women. The main causal agent of cervical cancer is the human papillomavirus (HPV). This virus is the most common sexually transmitted infection among sexually active youth. An early onset of sexual life increases the chances of HPV infection; this may involve a possible early development of cervical intraepithelial neoplasia and CC, creating a major public health problem. Objective: To present HPV frequency in women under the age of 25, treated in the CC screening program and their follow-up after histopathological diagnosis. Methods: 173 cervical samples were genotyped by polymerase chain reaction and non-radioactive reverse hybridization (line blot). Results: The overall frequency of HPV was 84.8%. HPV16 was the most prevalent. In 12.1% of women the cervical lesion persisted or progressed. 28.9% of women had irregular follow-up; in this group, 88% were HPV(+) and 52% had no record of Pap smear in the past 3 years. Discussion: The results reaffirm the usefulness of complementing the Pap and HPV detection as a primary screening tool in sexually active women. They also suggest the possibility of extending the age coverage of the national screening program.

Introducción: En Chile, el cáncer cérvico-uterino (CCU) es la segunda causa de muerte por neoplasias malignas en la mujer. El principal agente causal es el virus papiloma humano (VPH), descrito como la infección de transmisión sexual más frecuente entre jóvenes sexualmente activas. El comienzo precoz de la vida sexual incrementa las posibilidades de infección con VPH; esto puede implicar un eventual desarrollo prematuro de neoplasia intraepitelial cervical y CCU, creando un importante problema de salud pública. Objetivo: Presentar la frecuencia del VPH en mujeres bajo 25 años de edad, participantes del programa de CCU y su seguimiento post-lesión. Material y Métodos: Se genotipificaron 173 muestras cervicales, mediante reacción de polimerasa en cadena e hibridación no radioactiva (reverse line blot). Resultados: La frecuencia global del VPH fue 84,8%. El genotipo más frecuente fue VPH16. En 12,3% la lesión cervical persistió o evolucionó a una mayor. Se encontró 28,9% de mujeres con seguimiento post-lesión irregular; en este grupo, 88% fue VPH (+) y 52% no tuvo registro de Papanicolaou en los últimos tres años. Discusión: Los resultados obtenidos reafirman la utilidad de complementar el Papanicolaou con detección del VPH como herramienta de tamizaje primario en mujeres sexualmente activas. Además sugieren la posibilidad de ampliar la edad de cobertura del programa de tamizaje.

Determination of volatile organic compounds of Tagetes filifolia Lag. (Asteraceae) from Córdoba (Argentina) using HS-SPME analysis / Determinación de compuestos orgánicos volátiles de Tagetes filifolia Lag. (Asteraceae) proveniente de Córdoba (Argentina) utilizando análisis por HS-SPME

A headspace solid-phase microextraction (HS-SPME) method followed by gas chromatography-mass spectrometry (GC-MS) and gas chromatography-flame ionization detection (GC–FID) are described for the analysis of volatile compounds in Tagetes filifolia Lag. The composition of the total aerial parts of the plant (whole plant) and the inflorescences, leaves and stems were studied separately using HS-SPME. As a result, 54 compounds were determined, of which 47 were identified. The major components observed in this analysis were trans-anethole and estragole. The HS-SPME method used for the analysis of volatile compounds of T. filifolia is simple, fast, effective, free from the use of solvents, and permits by an analysis of small amounts of samples to achieve better results in terms of the determination of the composition than those reported in the literature for the analysis of essential oil.

Se realizó el análisis de los componentes volátiles de Tagetes filifolia Lag. utilizando el método de microextracción en fase sólida del espacio de cabeza con análisis posterior por cromatografía de gases acoplada a espectrometría de masas y por cromatografía de gases con detección por ionización de llama. Se estudio la composición de la planta entera así como también la de las inflorescencias, hojas y tallos por separado empleando el método de HS-SPME. Como resultado, se determinaron 54 compuestos de los cuales 47 fueron identificados. Los componentes mayoritarios observados en este análisis fueron: trans-anetol y estragol. El método de HS-SPME utilizado para el análisis de los compuestos volátiles de T. filifolia es simple, rápido, efectivo, libre de la utilización de solventes, y permitió mediante el análisis de pequeñas cantidades de muestra alcanzar mejores resultados en cuanto a la determinación de la composición, que los reportados en literatura para el análisis del aceite esencial.

Determination of volatile organic compounds of tagetes Argentina Cabrera (Asteraceae) using HS-SPME analysis / Determinación de compuestos orgánicos volátiles de tagetes Argentina Cabrera (Asteraceae) utilizando análisis por HS-SPME

A headspace solid-phase microextraction (HS-SPME) method followed by gas chromatography-mass spectrometry (GC-MS) and gas chromatography-flame ionization detection (GC-FID) is described for the analysis of volatile compounds in Tagetes argentina Cabrera. The composition of the totality of the aerial parts of the plant (whole plant) and the inflorescences, leaves and stems was studied separately using HS-SPME. As a result, 53 compounds were determined, of which 39 were identified. The major components were: cis-tagetenone, trans-tagetenone, trans-tagetone and cis-tagetone.Using a much smaller amount of samples, a shorter extraction time and a very simple procedure, the HS-SPME method can achieve similar or better results than those obtained by EO analysis. In conclusion, the HS-SPME method is simple, rapid, effective and free of solvent, and can be used for the analysis of volatile compounds in samples of different populations of T. Argentina.

Se realizó el análisis de los componentes volátiles de T. argentina Cabrera utilizando el método de micro-extracción en fase sólida del espacio de cabeza con análisis posterior por cromatografía de gases acoplada a espectrometría de masas y por cromatografía de gases con detección por ionización de llama. Se estudio la composición de la totalidad de las partes aéreas de la planta (planta entera) como así también de las inflorescencias, hojas y tallos por separado empleando el método de HS-SPME. Como resultado, se determinaron 53 compuestos de los cuales 39 fueron identificados. Los componentes mayoritarios fueron: cis-tagetenona, trans-tagetenona, trans-tagetona and cis-tagetona. Utilizando una muy pequeña cantidad de muestra, un corto periodo de tiempo y un procedimiento muy simple se lograron similares o mejores resultados a aquellos reportados mediante el análisis del aceite esencial. En conclusión, el método de HS-SPME es simple, rápido, efectivo, libre de la utilización de solventes y puede ser fácilmente implementado para el análisis de componentes volátiles provenientes de muestras de diferentes poblaciones de T. Argentina.

Phytochemistry of Tagetes minuta L. (Asteraceae) from Córdoba, Argentina: comparative study between essential oil and HS-SPME analyses / Fitoquímica de Tagetes minuta L. (Asteraceae) originario de Córdoba, Argentina: estudio comparativo entre análisis del aceite esencial y análisis por HS-SPME

A headspace solid-phase microextraction (HS-SPME) method followed by gas chromatography-mass spectrometry (GC-MS) and gas chromatography-flame ionization detection (GC–FID) is described for the analysis of volatile compounds in Tagetes minuta L. Five types of SPME commercial fibers including PA, PDMS, CAR-PDMS, PDMS–DVB and DVB–CAR–PDMS were investigated and the best extraction was achieved with the mixed fiber DVB–CAR–PDMS. Parameters for HS-SPME in terms of equilibrium time of HS, fiber exposition time and extraction temperature were also investigated. Additionally, the composition of inflorescences, leaves and stems was also studied separately by HS-SPME. As a result, 68 compounds were determined and 53 were identified. A comparison was made between results obtained by HS-SPME–GC–MS and steam distillation of essential oil of the aerial parts of the plant. In both analyses, the major components were: cis-tagetenone and trans-tagetenone. Using much smaller samples, a shorter extraction time and a simpler procedure, the HS-SPME method can achieve similar results to those obtained by EO analysis. In conclusion, the HS-SPME method is simple, rapid, effective and free of solvent, and can be used for the analysis of volatile compounds in samples of different populations of T. minuta.

Se realizó el análisis de los componentes volátiles de T. minuta L. utilizando el método de micro-extracción en fase sólida del espacio de cabeza con análisis posterior por cromatografía de gases acoplada a espectrometría de masas y por cromatografía de gases con detección por ionización de llama. Se estudiaron cinco tipos de fibras comerciales que incluyeron a PA, PDMS, CAR-PDMS, PDMS–DVB y DVB–CAR–PDMS y se estableció que la fibra de DVB–CAR–PDMS es la que posee mejor comportamiento en el proceso de extracción. Se determinó el efecto del tiempo de equilibrio del espacio de cabeza, de la temperatura de extracción y del tiempo de exposición de la fibra sobre el proceso de HS-SPME. Adicionalmente, también se estudio por separado la composición de inflorescencias, hojas y tallos empleando el método de HS-SPME. Como resultado de este estudio se determinaron 68 componentes de los cuales 53 fueron identificados. Por otra parte se realizó una comparación de los resultados HS-SPME con el análisis del aceite esencial obtenido de las partes aéreas de la planta. En ambos casos, los componentes mayoritarios fueron: cis-tagetenona y trans-tagetenona. Utilizando una muy pequeña cantidad de muestra, un corto periodo de tiempo y un procedimiento más simple se lograron similares resultados a los obtenidos mediante el análisis del aceite esencial. En conclusión, el método de HS-SPME desarrollado es simple, rápido, efectivo y libre de la utilización de solventes, puede ser fácilmente implementado para el análisis de componentes volátiles provenientes de muestras de diferentes poblaciones de T. minuta.