Rinosporidiosis Epidemiologia en la Republica del Paraguay

Sumario La incidencia de la Rinosporidiosis en la República del Paraguay, con 1 caso por 1.000.000 de habitantes le asigna la característica de área endémica. Esta cifra, tomando el número de nuevos casos por año y las poblaciones como las de la India, Ceylán y todas las de la América del Sur, hace del Paraguay el área de mayor incidencia de Rinosporidiosis hallada hasta la actualidad.Nuestros hallazgos son coincidentes con los publicados y considerados como específicos para el ciclo del parásito.No se hallan en los antecedentes de nuestros casos datos imputables a las fuentes de infección ni tampoco algún agente intermediario.No ha sido descrita hasta la actualidad en animales dentro del territorio del Paraguay.Deseo expresar mi sincera gratitud a la Licenciada en Estadística y Matemáticas Srta.Juana Palma, Demógrafa, Consultora de la Organización Mundial de la Salud/Oficina Sanitaria Panamericana en la República del Paraguay, por su asistencia técnica en la evaluación estadística de los datos referentes a la información de la frecuencia y la distribución gráfica de los casos.

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The incidence of one case of Rhinosporidiosis per million inhabitants in the Republic of Paraguay (South America) demonstrates this country to be an endemic area. This figure, considering the number of new cases discovered per year and comparing these figures with the incidence recorded for India, Ceylon and all of South America, makes Paraguay the area of highest incidence of Rhinosporidiosis so far.The disease is found in greater proportion in males. The conjunctive localization in our series is higher than that of other publications. The disease is more frequent in the age group of 10–19 years.Our findings coincide with others published and considered specific of the cycle of the parasite.We have found no clues as to the source of the infection nor have we found an intermediate agent. Until the present date, this disease has not been described in animals within the Paraguayan territory.

     

Actividad del sistema neuronal LHRH en un modelo animal de retraso del crecimiento

ObjectiveMild and chronic energy restriction results in growth retardation with puberal delay, a nutritional disease known as nutritional dwarfing (ND). The aim of the present study was to assess the profile of hypothalamic luteinizing hormone-releasing hormone (LHRH) release, at baseline and under glutamate stimulation, in ND rats to elucidate gonadotrophic dysfunction. Reproductive ability during refeeding was also studied.Material and methodsAt weaning, 60 male rats were assigned to two groups of 30 animals each: a control and an experimental group. Control rats were fed ad libitum with a balanced rodent diet. The experimental group received 80% of the diet consumed by the control group for 4 weeks. After 4 weeks of food restriction, the ND group was fed freely for 8 weeks. Ten rats from each group were sacrificed every 4 weeks for assays.ResultsAt week 4, body weight and length were significantly diminished in the experimental group vs. the control group (p<0.001). No changes were observed in LHRH baseline release, pulse frequency or amplitude in the experimental group compared with the control group at any time. However, under glutamate stimulation, LHRH release was significantly higher in ND rats than in control rats at week 4 (p<0.05). Refeeding the ND group allowed the rats to reach overall growth and reproductive ability.ConclusionsThe results of the present study suggest that the response to the facilitatory effect of glutamate on LHRH release in post-restricted ND rats is probably related to a lesser central nervous system maturation in relation to their chronological age. The adequate somatic growth and normal reproductive ability attained with refeeding suggest the reversibility of the two energetically costly processes compromised by global, mild and chronic food restriction.     

Compromiso del sistema nervioso central en Blastomicosis suramericana

Resumen Se presentan tres casos de blastomicosis suramericana diseminada con lesiones granulomatosas en el encéfalo. En dos de ellos se comprobó la presencia deParacoccidioides dentro de los granulomas encefálicos, pero en uno no fue posible demostrar dicho hongo. Invasión del sistema nervioso central ha sido encontrada muy raramente en esta entidad. Sin embargo, es posible que dicho compromiso sea mucho más frecuente de lo que hacen pensar los trabajos hasta ahora publicados.

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Summary Three cases of disseminated South American Blastomycosis with granulomatous lesions in the brain are presented. In two of them, theParacocciodioides was found in the granulomata but in the other one it was not possible to demonstrate the fungus. Invasion of the central nervous system has been very rarely encountered in this condition. It is nevertheless possible that such an involvement is much more frequent than we gather from previous reports.

     

Eficacia del econazol en embarazadas con candidiasis vulvo-vaginal

Among the female patients attending the out patient clinic of the Obstetric Service of the University Hospital of Caracas, Venezuela a hundred were chosen who presented vaginal discharge and itching. The presence of C. albicans and the existence of candidiasis in the vulvo-vagina of the 100 pregnant women was investigated. Those patients where candidiasis was found, were also investigated as to the simultaneous presence of C. albicans in the mouth and the anal skin. Gyno-Pevaryl therapy was performed by administering one 150 mg ovule daily for three consecutive days. At the same time, their partners were treated with Pevaryl 1% cream. The post-therapy control was made 36 hours after conclusion of treatment and further check-up were made one week and two weeks later. Only those patients who attended the post-treatment controls were taken into account for the evaluation of the results. C. albicans was identified in 60 cases by nascent culture of the vulvar secretions, using a bile-agar medium. Of these, 50 had vulvo-vaginal candidiasis (hyphae and blastospores on direct examination). 92% of the women with vulvo-vaginal candidiasis complained about pruritus at the moment of the examination. No significant differences were observed with respect to the age, the period of gestation and parity of the positive and negative patients. Of the 40 patients who attended only the first control, 23 were cured (57.5%), 9 improved (22.5%) and 8 (20%) were not cured. The cure rate increased to 70% and 72.5% taking into account those patients, who also attended the second and the third consecutive treatment sessions, respectively. In those patients suffering from vulvo-vaginal candidiasis, 37.5% were found to be carriers of C. albicans in the mouth and 70% also in the anal region. This seems to indicate that the mouth and the anal region can constitute the source of re-infection in the majority of the cases following topical vaginal treatment.     

Efectos del uso del 17 β-estradiol y la genisteína en la enfermedad de Alzheimer en mujeres con menopausia

The use of 17 β-estradiol and genistein in women with menopause helps in the reduction of vasomotor symptoms and cognitive improvement. There is evidence on the use of certain flavonoids such as genistein, which has a potentially neuroprotective role in neurodegenerative diseases such as Alzheimer's. Scientific evidence on the effects of phytoestrogens and genistein during menopause and their effect on cognition are scarce, however, in the present review it was found that the intervention with 17 β-estradiol has positive effects on cognition in women with Alzheimer's disease. In addition, the use of genistein, daidzein or any supplement based on isoflavones may influence vasomotor symptoms. 17 β-estradiol supplements in women in early menopause and with some degree of cognitive impairment may have beneficial effects.     

Efectos del estado cognitivo sobre las alteraciones del equilibrio y la marcha en ancianos institucionalizados

BackgroundAgeing has been linked to a high prevalence of cognitive impairment, which, in turn, has been related to balance disturbances and gait disorders. The aim of this study was to identify whether there are differences between subjects with and without cognitive impairment regarding the quality of gait and balance.Material and methodsAn observational study was conducted on institutionalised people older than 65 years (n = 82). Gait and balance was evaluated after the assessment of cognitive impairment using the Mini-Mental State Examination (MMSE). Single and dual tests were used including, the 6-minute walking, stride length, and gait speed. Timed Up and Go tests were also used to evaluate balance.ResultsThe participants were divided into three groups: 28 subjects in the group without cognitive impairment (MMSE ≥ 27), 29 subjects with mild (27 < MMSE ≤ 21) and 26 subjects with moderate cognitive impairment (MMSE < 21). Gait assessment showed significant between-groups differences in all the variables (P < .05). The variables assessing balance also showed significantly worse values in those groups with cognitive impairment.ConclusionThe severity of cognitive impairment is related to impaired balance and gait, thus the clinical monitoring of these variables in population at risk is needed.     

Evaluación del sufrimiento en la demencia avanzada

Introduction

At the end stage of life of dementia, medical comorbidities are associated with a high degree of patient suffering. The aim of this study was to assess the relationship between the lack of symptoms of discomfort and the level of patient suffering. The relationship with psychological distress and caregiver burden was also clarified.

Material and methods

This study included patients with advanced dementia according to the criteria of the Hospice Enrolment Criteria for End-stage Dementia patients. Patient suffering was assessed with Mini-Suffering State Examination (MSSE). The caregivers were scored by Zarit caregiver burden scale (ZR), and the General Health Questionnaire of Goldberg (GHQ-28). Central tendency and correlation tests were used in the statistical analysis.

Results

The study recorded data from 71 patients. In the comorbidity of medical symptoms associated with advanced dementia, pneumonia (Spearman's rho: −0.29; P=.01), and malnutrition (Spearman's rho: −0.25; P=.03), showed a significant association with the total scale score of MSSE. There were no significant correlations between patient suffering and caregiver psychological distress (r: 0.11; P=.37), or caregiver burden (r: 0.13; P=.32).

Conclusions

The identification of suffering in patients with advanced dementia is recognised by specific symptoms, such as pneumonia and malnutrition. The caregiver’ psychological distress of the caregiver was shown to be unrelated to patient suffering as measured by MSSE.     

262 Levaduras del Hombre Aisladas en Caracas,Venezuela

Resumen Se estudian 262 muestras provenientes de uña, ingle, pie, vulvo-vagina, mano, boca, prepucio, oído externo y misceláneos. Se aislan 33 especies diferentes de levaduras, siendoCandida albicans la más común entre ellas con un 41.2 %, seguida deCandida tropicalis, con 16 % yTrichosporon cutaneum con 12.5 %. Dentro de las especies aisladas se encuentran 4 cepas de algasPrototheca sp. (1.5 %).

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From mycological examinations of: nails, groins, feet, vulvo-vagina, hands, mouth, prepuce, external ear, miscelaneous, 262 yeasts strains have been studied. 33 different yeasts species are isolated.Candida albicans was the most frequent with 41.2 %, followed byCandida tropicalis with 16 %, andTrichosporon cutaneum with 12.5 %. The author report 4 strains of algaePrototheca sp. (1.5 %).

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Zusammenfassung 262 Hefestämme sind untersucht worden: von Nägeln, Leistenbeugen, Füssen, Vulvo-vagina, Händen, Munden, Prepucium, Ohren, etc. 33 verschiedene Hefearten sind isoliert worden.Candida albicans war die häufigste mit 41.2 %,C. tropicalis mit 16 %, undTrichosporon cutaneum mit 12.5 %. Vier Stämme von AlgenPrototheca sp. (1.5 %) sind auch gefunden worden.