Reversal of high-glucose-induced transcriptional and epigenetic memories through NRF2 pathway activation.

Diabetes complications such as nephropathy, retinopathy, or cardiovascular disease arise from vascular dysfunction. In this context, it has been observed that past hyperglycemic events can induce long-lasting alterations, a phenomenon termed "metabolic memory." In this study, we evaluated the genome-wide gene expression and chromatin accessibility alterations caused by transient high-glucose exposure in human endothelial cells (ECs) in vitro. We found that cells exposed to high glucose exhibited substantial gene expression changes in pathways known to be impaired in diabetes, many of which persist after glucose normalization. Chromatin accessibility analysis also revealed that transient hyperglycemia induces persistent alterations, mainly in non-promoter regions identified as enhancers with neighboring genes showing lasting alterations. Notably, activation of the NRF2 pathway through NRF2 overexpression or supplementation with the plant-derived compound sulforaphane, effectively reverses the glucose-induced transcriptional and chromatin accessibility memories in ECs. These findings underscore the enduring impact of transient hyperglycemia on ECs' transcriptomic and chromatin accessibility profiles, emphasizing the potential utility of pharmacological NRF2 pathway activation in mitigating and reversing the high-glucose-induced transcriptional and epigenetic alterations.

Psychometric Design and Validation of an Adverse Event Vulnerability Scale in Prehospital Emergency Care.

OBJECTIVE: Care in prehospital emergencies presents differences in terms of safety with respect to that provided in the hospital setting, generating situations of high vulnerability in patients. Vulnerability is intimately related to the possibility of experiencing an adverse event. Currently, there is no validated system to evaluate this issue. The aim of this study was to design and validate an instrument to determine the level of vulnerability of patients treated in the emergency prehospital care. METHODS: A clinimetric validation study was conducted in patients who attended prehospital emergency services. RESULTS: An eight-item instrument with adequate content validity (0.93) was designed and empirically tested in a sample of 549 subjects (50.1% men and 49.9% women) with an average age of 61.56 years (standard deviation = 19.76). Cronbach α was 0.81, with a good interitem and item-total correlation and interobserver reliability, with an intraclass correlation coefficient of 0.90 (95% confidence interval = 0.87-0.93). The exploratory factor analysis identified a bifactorial model that explained 61.27% of the total variance, corroborated by confirmatory factor analysis (goodness-of-fit index = 0.97, normed fit index = 0.96, TLI = 0.92, and root mean square error of approximation = 0.093). Instrument scores showed a moderate and significant positive correlation with the age of the subjects (r = 0.31). CONCLUSIONS: The instrument shows a good reliability and validity for its use in the environment of prehospital emergency services, with a structure composed of a group of items related to condition characteristics safety (consciousness, patient communication, risk factors, and patient coping), and mobility, and a second factor including respiratory and medical interventions safety.

[Assessing the implementation of a nutritional screening protocol in patients admitted to the Medicine Department of a local hospital]. / Evaluación de la aplicación de un protocolo de cribado nutricional en pacientes ingresados en el Servicio de Medicina de un hospital comarcal.

INTRODUCTION: Background: the techniques for screening and nutritional intervention in hospitalized patients are a cost-effective measure. In clinical practice the problem lies in their administration. Objective: to evaluate the implementation of a nutritional screening tool in patients admitted to our Medicine Ward (M). Material and methods: a single-center, prospective, observational study in patients admitted to M. Exclusion criteria: end-stage cancer patients, inpatient stay less than 72 h, and hospital readmission of previously included patients. One out of every 2 hospital admissions was selected. We assessed the following: whether nurses performed the screening test, the Short Nutritional Assessment Questionnaire (SNAQ); the score obtained; consultations with dieticians (ICD); prescribed nutritional support; and coding of malnutrition in the discharge report. Dieticians repeated the SNAQ for one in every 3 patients. Results: during the study period 726 patients were admitted, 377 were selected, and 315 were included. The nursing staff administered the SNAQ to 93.6% of patients and malnutrition was present in 19%. Dieticians detected malnutrition in 37.8%. In 41.9% of patients with severe malnutrition an ICD was performed, whereas in 40% of them no nutritional intervention was implemented. The diagnosis of malnutrition was recorded in the discharge report of 42.1% of our cases. Conclusion: Compliance with screening test administration was good, but there is disagreement with the assessment made by dieticians. For most malnourished patients nutritional support fals to be prescribed, no ICDs are performed, and a malnutrition diagnosis is not included in the discharge report.

INTRODUCCIÓN: Antecedentes: las técnicas de cribado e intervención nutricional en pacientes hospitalizados son una medida coste-efectiva. En la práctica clínica, el problema radica en cómo aplicarlas. Objetivo: evaluar la aplicación de un protocolo de cribado nutricional en pacientes hospitalizados en la Planta de Medicina (M). Material y métodos: estudio unicéntrico, prospectivo y observacional realizado a pacientes que ingresan en M. Los criterios de exclusión fueron: pacientes oncológicos en fase terminal, ingresos inferiores a 72 h y reingresos de pacientes previamente incluidos. Se seleccionaron 1 de cada 2 ingresos. Se evaluaron: si Enfermería había realizado el test de cribado, el Short Nutritional Assessment Questionnaire (SNAQ); la puntuación obtenida; las interconsultas a dietistas (ICD); el soporte nutricional prescrito, y el diagnóstico de desnutrición en el informe de alta. Los dietistas volvieron a administrar el SNAQ a 1 de cada 3 pacientes incluidos. Resultados: durante el periodo de estudio ingresaron 726 pacientes, se seleccionaron 377 y se incluyeron 315. Enfermería administró el SNAQ al 93,6% de los pacientes; presentaban desnutrición el 19%. La determinación realizada por los dietistas detectó un 37,8% de desnutrición. En el 41,9% de los que presentaban desnutrición severa se realizaron ICD; al 40% de ellos no se les realizó ninguna intervención nutricional, y el diagnóstico de desnutrición constaba en el informe de alta del 42,1% de los pacientes. Conclusión: existe un buen cumplimiento en la realización del test de cribado, pero existe también discordancia con la valoración de los dietistas. En la mayoría de los pacientes con desnutrición no se realizan ICD, no se prescribe soporte nutricional y no se hace constar el diagnóstico en el informe de alta.

[The immunosuppressant effect of T. lewisi (Kinetoplastidae) infection on the multiplication of Toxoplasma gondii (Sarcocystidae) on alveolar and peritoneal macrophages of the white rat]. / Efecto inmunosupresor de Trypanosoma lewisi (Kinetoplastidae) sobre la multiplicación de Toxoplasma gondii (Sarcocystidae) en macrófagos alveolares y peritoneales de rata blanca.

The immunosuppressant effect of T. lewisi infection on the multiplication of T. gondii was compared in peritoneal (MP) and alveolar macrophages (MA) of white rat. Two animal groups were infected with T. lewisi and sacrificed after four days and seven days post infection. A group without infection was maintained as a control. The number of intracellular parasites (tachyzoites) (IT) was counted by light microscopy, calculating the rate infection rate per 100 total cells (TC) and per infected cells (IC) for each group of phagocyte cells. The relation quotient IT, TC or IC multiplied percent, provided a statistical ratio (RE) of the relative number of parasites in both cellular types for each time interval. MA as well as MP obtained after 4 days showed a significant increase in the multiplication of T. gondii with respect to the control. Unlike the MP (which had an increase in the multiplication of T. gondii the fourth day of infection with T. lewisi diminishing towards the seventh day), the MA had an increase in the multiplication of the parasite from the fourth to the seventh day. This difference can be related to the route of infection used for the experiments, that affect the MP directly with a greater effect in comparison with the MA of the lungs. Lung compartment will be affected later, when the infection becomes systemic between the fourth and sixth day of infection. The immunity against T. gondii is similar between both phagocytes, but the time of infection and the compartment where the cells are located, makes the difference in the response time against T. gondii. Supernatants from macrophage cultures or T. lewisi by rat did not induced any immunosuppression.

[In vitro growth kinetics of two Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) clones in myocardial cells from rodents of different susceptibility]. / Cinética de crecimiento in vitro de dos cepas de Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) en células miocárdicas de roedores con diferente susceptibilidad.

In vitro growth kinetics of two Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) clones in myocardial cells from rodents of different susceptibility. Two Trypanosoma cruzi isolates, TCR-4 from Costa Rica and UES-1 from El Salvador, were studied in vitro to compare their infectivity or resistance and intracellular replication in myocardial cells in three strains of mice and rats: NGP white mice, C3 H mice and Sprague Dowley rats. Myocardial cells were cultured on coverslips at 37 degrees C in a humid 10% CO2 atmosphere and then infected at a ratio of one tripomastigote per cell. Samples were studied after 24, 72, 96 and 120 h of infection to determine parasite infection capacity and intracellular multiplication. Both parasites had the highest infection capacity in C3 H mice, followed by NGP mice cells with a very low infection rate. Lastly, almost no Trypanosoma cruzi multiplication was observed in Sprague Dowley rats, suggesting a strong natural resistance in this animal to both strains of the parasite. The UES-1 isolate presented higher multiplication and greater invasion than the TCR-4 strain, showing greater virulence of UES-1 in heart cells, at least in vitro.

Evaluación de la aplicación de un protocolo de cribado nutricional en pacientes ingresados en el Servicio de Medicina de un hospital comarcal / Assessing the implementation of a nutritional screening protocol in patients admitted to the Medicine Department of a local hospital

Antecedentes: las técnicas de cribado e intervención nutricional en pacientes hospitalizados son una medida coste-efectiva. En la práctica clínica, el problema radica en cómo aplicarlas. Objetivo: evaluar la aplicación de un protocolo de cribado nutricional en pacientes hospitalizados en la Planta de Medicina (M). Material y métodos: estudio unicéntrico, prospectivo y observacional realizado a pacientes que ingresan en M. Los criterios de exclusión fueron: pacientes oncológicos en fase terminal, ingresos inferiores a 72 h y reingresos de pacientes previamente incluidos. Se seleccionaron 1 de cada 2 ingresos. Se evaluaron: si Enfermería había realizado el test de cribado, el Short Nutritional Assessment Questionnaire (SNAQ); la puntuación obtenida; las interconsultas a dietistas (ICD); el soporte nutricional prescrito, y el diagnóstico de desnutrición en el informe de alta. Los dietistas volvieron a administrar el SNAQ a 1 de cada 3 pacientes incluidos. Resultados: durante el periodo de estudio ingresaron 726 pacientes, se seleccionaron 377 y se incluyeron 315. Enfermería administró el SNAQ al 93,6% de los pacientes; presentaban desnutrición el 19%. La determinación realizada por los dietistas detectó un 37,8% de desnutrición. En el 41,9% de los que presentaban desnutrición severa se realizaron ICD; al 40% de ellos no se les realizó ninguna intervención nutricional, y el diagnóstico de desnutrición constaba en el informe de alta del 42,1% de los pacientes. Conclusión: existe un buen cumplimiento en la realización del test de cribado, pero existe también discordancia con la valoración de los dietistas. En la mayoría de los pacientes con desnutrición no se realizan ICD, no se prescribe soporte nutricional y no se hace constar el diagnóstico en el informe de alta

Background: the techniques for screening and nutritional intervention in hospitalized patients are a cost-effective measure. In clinical practice the problem lies in their administration. Objective: to evaluate the implementation of a nutritional screening tool in patients admitted to our Medicine Ward (M). Material and methods: a single-center, prospective, observational study in patients admitted to M. Exclusion criteria: end-stage cancer patients, inpatient stay less than 72 h, and hospital readmission of previously included patients. One out of every 2 hospital admissions was selected. We assessed the following: whether nurses performed the screening test, the Short Nutritional Assessment Questionnaire (SNAQ); the score obtained; consultations with dieticians (ICD); prescribed nutritional support; and coding of malnutrition in the discharge report. Dieticians repeated the SNAQ for one in every 3 patients. Results: during the study period 726 patients were admitted, 377 were selected, and 315 were included. The nursing staff administered the SNAQ to 93.6 % of patients and malnutrition was present in 19 %. Dieticians detected malnutrition in 37.8 %. In 41.9 % of patients with severe malnutrition an ICD was performed, whereas in 40 % of them no nutritional intervention was implemented. The diagnosis of malnutrition was recorded in the discharge report of 42.1 % of our cases. Conclusion: Compliance with screening test administration was good, but there is disagreement with the assessment made by dieticians. For most malnourished patients nutritional support fals to be prescribed, no ICDs are performed, and a malnutrition diagnosis is not included in the discharge report

[Diagnostic agreement between emergency teams and hospital services]. / Acuerdo diagnóstico entre equipos de emergencias y servicios hospitalarios.

OBJECTIVES: Over the last 10 years the Public Health Emergency Service of Andalusia (Spain) has been conducting a study into the diagnostic agreement among its teams (061 teams) and those of primary care and hospitals. Diagnostic agreement between these teams and hospital teams was evaluated. When discrepancies were found, an assessment was made of whether these corresponded to the emergency team, transfer resources or hospital. PATIENTS AND METHOD: A descriptive study was performed. Five hundred ten patients whose particulars were already known were randomly selected. The patients, who required transfer to a public hospital, received assistance from 061 teams in Malaga in 2001. Data were gathered on personal details, the assistance received, transfer, hospital and diagnosis or diagnoses. The maximum number of diagnoses permitted was three, coded in accordance with the CIE-9 CM classification. The Kappa index was used for comparisons. RESULTS: Ten cases were lost due to missing data. The mean number of diagnoses per patient was 1.48 for 061 teams and was 1.50 in hospital reports. The most common of diagnoses related to injuries and cardiovascular diseases (non-specific diagnoses accounted for approximately 20%). Fifty-nine percent of the patients had at least one diagnosis that coincided. We obtained kappa = 0.478 for a confidence level of 95% (the agreement rate was 73.9%). CONCLUSIONS: Overall agreement was moderate, with better results in the Advanced Coordination Team and conventional ambulance transfer due to the simplicity of the diagnoses. Results classified as "good" were achieved only in the Hospital Costa del Sol, which uses working guidelines similar to those of the Public Health Emergency Service. The percentage of inexact diagnoses was high. Proposals for improvement should range from revising the working methods used to applying new technologies.

[Infection of skin fibroblasts in animals with different levels of sensitivity to Leishmania infantum and Leishmania mexicana (Kinetoplastida: Trypanosomatidae)]. / Infección de fibroblastos de piel de animales con distinto grado de susceptibilidad a Leishmania infantum y Leishmania mexicana (Kinetoplastida: Trypanosomatidae).

Infection and multiplication of Leishmania infantum and L. mexicana inside of skin fibroblasts from hamsters, mice and rats was achieved. This process was demonstrated either by counting parasites inside the stained cells or by electronic microscopy studies. In addition multiplication rate differences in the cells from these rodent species were determined, for L. infantum as well as for L. mexicana. Parasite development in hamsters and mice fibroblasts was evident but there was not multiplication in rat cells showing that apparently they are refractory to Leishmania infection. These results suggest that the parasite affinity for each animal, as well as any intracellular environment resistance, could involve genetic factors in the parasite multiplication. On the other hand, presence of amastigote multiplication inside of parasitophorus vacuole, showed by electronic microscopy images, probes a true parasite transformation. Therefore it is suggested that fibroblasts could work as host cells for parasite survival and permanency in the infected animals.

Falso hipertiroidismo franco por interferencia en inmunoanálisis / False overt hyperthyroidism by interference in immunoassay

No disponible

Escleredema diabeticorum: descripción de 11 casos / Scleredema diabeticorum: Description of 11 cases

No disponible

Parálisis hipopotasémica secundaria en adulto con hipertensión / Secondary hypokalemic paralysis in adult with hypertension

No disponible

Trypanosoma lewisi-induced immunosuppression: the effects on alveolar macrophage activities against Cryptococcus neoformans.

The immunosuppressive effect of Trypanosoma lewisi infection on alveolar macrophage (AM) activities against Cryptococcus neoformans was studied in an animal model. Two groups of rats were treated with T. lewisi and killed after 4 (4d-rats) and 7 days (7d-rats), respectively. A third group not given T. lewisi, served as control. AM were challenged in vitro with C. neoformans. Phagocytosis was assessed with a fluorescence method. Superoxide anion production was evaluated with the nitroblue tetrazolium (NBT) test. The survival of cryptococci was estimated by counting colony-forming units. The numbers of detached AM from culture plates were determined using a Bürker chamber. The NBT response, adhesion to plate surface and killing activity, but not the phagocytosis of AM from 4d-rats were significantly impaired compared to control or 7d-rats. Thus, T. lewisi causes transitory immunosuppressive effects on AM activities. This rapid T. lewisi immunosuppression model may be useful to study new approaches to anticryptococcal therapy.

Efecto inmunosupresor de Trypanosoma lewisi (Kinetoplastidae) sobre la multiplicación de Toxoplasma gondii (Sarcocystidae) en macrófagos alveolares y peritoneales de rata blanca

The immunosuppressant effect of T. lewisi (Kinetoplastidae) infection on the multiplication of Toxoplasma gondii (Sarcocystidae) on alveolar and peritoneal macrophages of the white rat. The immunosuppressant effect of T. lewisi infection on the multiplication of T. gondii was compared in peritoneal (MP) and alveolar macrophages (MA) of white rat. Two animal groups were infected with T. lewisi and sacrificed after four days and seven days post infection. A group without infection was maintained as a control. The number of intracellular parasites (tachyzoites) (IT) was counted by light microscopy, calculating the rate infection rate per 100 total cells (TC) and per infected cells (IC) for each group of phagocyte cells. The relation quotient IT, TC or IC multiplied percent, provided a statistical ratio (RE) of the relative number of parasites in both cellular types for each time interval. MA as well as MP obtained after 4 days showed a significant increase in the multiplication of T. gondii with respect to the control. Unlike the MP (which had an increase in the multiplication of T. gondii the fourth day of infection with T. lewisi diminishing towards the seventh day), the MA had an increase in the multiplication of the parasite from the fourth to the seventh day. This difference can be related to the route of infection used for the experiments, that affect the MP directly with a greater effect in comparison with the MA of the lungs. Lung compartment will be affected later, when the infection becomes systemic between the fourth and sixth day of infection. The immunity against T. gondii is similar between both phagocytes, but the time of infection and the compartment where the cells are located, makes the difference in the response time against T. gondii. Supernatants from macrophage cultures or T. lewisi by rat did not induced any immunosuppression. Rev. Biol. Trop. 57 (1-2): 13-22. Epub 2009 June 30.

El efecto inmunosupresor de la infección de T. lewisi sobre la multiplicación de T. gondii fue comparado en macrófagos peritoneales (MP) y alveolares (MA) de rata. El número de parásitos (taquizoitos) intracelulares (TI) fue contado por microscopía de luz. Los macrófagos alveolares y peritoneales (MP) de animales con 4 días de infección con T. lewisi muestran un aumento significativo en la multiplicación de T. gondii. A diferencia de los MP (que muestran un aumento en la multiplicación de T. gondii al cuarto día de infección con T. lewisi disminuyendo hacia el séptimo día), los MA mantienen un aumento en la multiplicación del parásito desde el cuarto, aumentando hacia el séptimo día de infección. Esta diferencia se puede deber a la ruta de infección utilizada para los experimentos que afectan directamente los MP donde se observa un efecto mayor y más temprano en comparación con los MA aislados de los pulmones, compartimiento afectado cuando la infección se vuelve sistémica entre el cuarto y sexto día de infección. La inmunidad contra T. gondii es similar entre ambas células fagocíticas, pero el tiempo de infección y el compartimiento donde se encuentren las células hace la diferencia en el tiempo de respuesta contra un parásito dado, en nuestro caso T. gondii. No hubo evidencia de que los sobrenadantes de cultivos de macrófagos provenientes de ratas infectadas ni el lisado de tripanosomas indujeran el efecto inmunosupresor.

Parásitos en monos carablanca Cebus capucinus (Primates: Cebidae) de Costa Rica / Parasites of white face monkeys (Cebus capucinus) (Primates: Cebidae) of Costa Rica

Fecal samples of 53 white face monkeys (Cebus capucinus) from some sites of Costa Rica were studied for blood and intestinal parasites. Animals were anesthetized with darts containing Telazol, blood and fecal samples were collected and all the material was studied in the laboratory. For blood parasites, Giemsa stain andKnott concentration was performed. Intestinal parasites were studied by direct examination in 0,85 percent saline solution and a Iodine solution. Haematoxylin stain was used for better protozoa identification. Strongyloides sp, hookworms, acanthocephalid eggs and other nematodes, as well as Tritrichomonas sp (more frequent) and other protozoa were found. The presence of at least one parasites was observed in 33.3 percent to 100 percent of the fecal samples with an average of 73.6 percent. There was not any correlation between sex and infection rate, but the presence of parasite was higher in heavier (older) animals. Microfllarias were the only blood organism detected.The reasons for these high infection rates could be explained for feed diversity, contaminated soil and water contact and sociability of these animals, among other factors.

Se capturaron y anestesiaron un total de 53 primates de la especie Cebus capucinus por medio de dardos con tiletamina de diferentes zonas de Costa Rica. Todos los animales fueron estudiados por la presencia de parásitos sanguíneos e intestinales. En la sangre sólo se encontraron microfilarias (24,5 por ciento) las cuales fueron diagnosticadas usando la concentración de Knott y la tinción de Giemsa. Los parásitos intestinales fueron observados en forma directa y algunos de los protozoos también fueron tejidos con hematoxilina de Heidenhain. Los parásitos encontrados fueron Strongyloides sp, uncinarias, acantocéfalos y otros nemátodos no identificados, en porcentajes que variaron según las zonas de captura. Los índices de infección determinados por la presencia de al menos un parásito fluctuaron entre 33,3 por ciento y el 100 por ciento con una media general del 73,6 por ciento, no existiendo diferencias de infección en cuanto al sexo de los animales. En general se notó un mayor grado de infección en los animales de más peso (más edad) tal y como se ha observado en otros países. Se considera que las infecciones parasitarias son más elevadas en esta especie, posiblemente por tener una alimentación más variada, un mayor contacto con el suelo y aguas contaminadas, así como la gran sociabilidad de estos monos. La presencia de estos parásitos podría ser una de las causas, entre otras para acelerar el riesgo de extinción de los primates en Costa Rica y en América.

Presencia de Plasmodium brasilianum (Apicomplexa, Plasmodidae) en el mono congo (Alouatta palliata, Primates: Cebidae) de Costa Rica: importancia epidemiológica en relación con el ser humano / Plasmodium brasilianum (Apicomplexa, Plasmodidae) in the congo monkey Alouatta brasilianum (Primate: Cebidae) of Costa Rica: epidemiological importance related to human

La especie productora de malaria en primates, Plasmodium brasilianum, fue encontrada por primera vez en Costa Rica en 6 de 104 ejemplares de monos congo o aulladores (Alouatta palliata). Los animales fueron capturados y anestesiados por medio de dardos que contenían hidrocloruro de tiletamina y zolazepam (Zoletil®) combinados en partes iguales. Para estudiar estos animales por parásitos sanguíneos, se prepararon frotis sanguíneos que luego se tiñeron y se estudiaron en el laboratorio, encontrándose las formas de trofozoitos jóvenes o avanzados así como gametocitos y esquizontes. La morfología característica de algunos estados evolutivos, como por ejemplo, las formas en banda de trofozoitos avanzados y los esquizontes en forma de margarita o "rosetta" permitieron el diagnóstico de la especie. Puesto que se han encontrado casos humanos infectados con este organismo y éste es casi indiferenciable de Plasmodium malariae, una especie parásita del ser humano, se discute el hallazgo de este parásito desde un punto de vista epidemiológico en el área de la salud.

Enfermedad de Chagas en Costa Rica: estudio comparativo en dos épocas diferentes / Chagas disease in Costa Rica: comparative study in two different stages

Para actualizar la situación de la Enfermedad de Chagas en Costa Rica se realizó un estudio serológico y epidemiológico parcial en 4 zonas de riesgo en el país. Un total de 1.561 estudiantes de 6 a 12 años fueron estudiados por anticuerpos contra T.cruzi usando una prueba de ELISA como tamiz previo a una confirmatoria. En la primera prueba se obtuvo una positividad que osciló entre 0,6 por ciento y 14,9 por ciento mientras que en la prueba confirmatoria esta positividad fue de 0,1 por ciento. El estudio del 10 por ciento de las casas de los estudiantes seleccionados indicó índices de infestación del 2,9 por ciento al 9,3 por ciento y los triatominos, encontrados peridomiciliarmente presentaron un 8,1 por ciento de infección por T. cruzi. Al comparar estos datos con los conocidos antes de 1980 y basados en un análisis socioeconómico de ambas épocas, se concluye que las mejores condiciones de vida actuales han disminuido la incidencia de Enfermedad de Chagas en Costa Rica.

Nosema like organisms found in an immunocompetent human patient: first report in Central América

Stool samples of a immunocompetent hypertense 61 year old woman were stained by the Weber et al. method and studied by electronic microscopy. Mature microsporidia spores were found and according to their diplokaryotic muclei, as well as the typical polar filament with 12 coils, the organisms was classified as Nosema like genus