Estudio de la sensibilidad especifica en residentes de un area endemica a la Paracoccidioidomicosis en Venezuela

Resumen Se presenta el estudio de la reacción a la Paracoccidioidina de los habitantes de un área de alta incidencia de Micosis de Lutz y Splendore, encontrándose positividad en el 52% de los residentes. Se hizo simultáneamente intradermo-reacciones al P.P.D., Histoplasmina y Esporotriquina, encontrándose cierta correlación de resultados sólo con la Histoplasmina. Con fines de comparación se hizo encuesta en pequeño grupo de habitantes de otra área del pais, encontrándose una diferencia estadisticamente significante con los resultados de la zona en estudio. Se hacen varios comentarios.

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Cutaneous sensitivity to paracoccidiodin was tested in 686 persons of an endemic area of Paracoccidioidomicosis in Venezuela. The antigen was prepared in our laboratory according to the technique used byFava Netto (Brasil). Skin-testing such as histoplasmin, sporotrichin and P.P.D. also were performed. Due to the high percentage obtained in the reading of the paracoccidioidin (52%) an inquiry was made in a not endemic area obtaining a percentage of 6,1%; this difference is statistically significant. Significant results are also obtained for the two remaining antigens of mycotic origin.Emphasis is laid on the importance of working with the same antigen used in Brasil.Commentaries are made on the common reactions that occur between paracoccidioidin and histoplasmin, and on the possibility of interpreting them as crossed reactions or that the same person is sensitive to the two agents which are in the environment of the place where they live.No crossed reactions were found between sporotrichin and paracoccidioidin in a significant number of cases, nor between the latter and the P.P.D. and this is considered very important in connection with the active or residual possible pulmonary lesions that could be seen in the persons with negative P.P.D.The appearance of positive reactions to paracoccidioidin was observed by beginning at the age of 10 and becoming more intense at 20 and it is higher in males than in females.

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Trabajo realizado con la ayuda económica de la FundaciónJose Maria Vargas.     

Psoriasis verrugosa en un hombre con antecedentes de psoriasis en placa,reporte de caso y revisión de la literatura

Verrucous psoriasis is an atypical and rare variant of psoriasis with few cases reported in the literature. It is characterized by the presence of symmetric hypertrophic and verrucous plaques on the limbs and trunk.We present the case of a 63-year-old male patient with a history of vulgar psoriasis for 20 years who was receiving treatment with topical steroids and had developed a verrucous plaque in the distal third of the posterior aspect of the leg 10 years before. We conducted a biopsy of the lesion to confirm or discard the diagnostic impression of squamous cell carcinoma (verrucous). The histopathological study showed changes compatible with verrucous psoriasis ruling out the presence of malignancy.     

Estudio de la patogenicidad de conidiobolus Coronatus en animales de experimentacion

Resumen A partir de una cepa de Conidiobolus coronatus aislada de Aenolamia postica, se inocularon 152 ratones, 42 cobayos y 47 hamsters por vías intraperitoneal (IP), subcutánea (SC), intratraqueal y por escarificación en la mucosa oral; cada animal se inoculó 3 veces a intervalos de una semana. Los animales se sacrificaron a los 1, 8, 15, 45 y 225 días de la primera inoculación, haciéndose estudios de alteraciones macroscópicas (nódulos, abscesos, adherencias), exámenes directos, cultivos e histopatología. Las alteraciones macroscópicas de los tejidos fueron las más frecuentes y todas evolucionaron a la curación espontánea. Los animales presentaron un mayor múmero de estudios positivos cuando se inocularon por vía IP y SC. Los estudios histopatológicos hechos al 1° y 8° día, demostraron un infiltrado inflamatorio agudo y filamentos fúngicos bien conservados; a los 15 días se observaron granulomas con células gigantes y filamentos fragmentados en desintegración; a los 45 y 225 días se observó una reacción de fibrosis sin filamentos fúngicos. Se consideró que en ningún caso se logró reproducir la rinoentomoftoromicosis y de acuerdo a éstos resultados se estima que esta cepa no tiene patogenicidad o bien ésta es muy baja.

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The pathogenicity of a strain of Conidiobolus coronatus isolated from Aenolamia postica was investigated in 152 mice, 42 guinea pigs and 47 hamsters. Four routes of inoculation were used: intraperitoneal, subcutaneous, intratracheal and scarification in the oral mucosa. Each animal was inoculated 3 times at 3 week intervals. Animals were sacrificed at 1, 8, 15, 45 of 225 days after the first inoculation. Observations of macroscopic lesions (nodules, abscesses, adhesions, etc.) direct examinations, cultures and histopathological studies of different tissues were performed. The aforementioned lesions of tissue were the most frequently found and all of them were resolved by spontaneous cure. The animals inoculated intraperitoneally and subcutaneouslly presented the highest number of positive results. The histopathological features at the 1st and 8th days after inoculation showed an acute inflamatory infiltrate with well preserved fungus filaments; at the 15th day granulomas with giant cells were observed containing fragmented and disintegrated fungal hyphae; at the 45th and 225th days a fibrosis reaction was observed and no fungal filaments, could be found. In no animal was rhinoentomophthoromycosis never reproduced, and according to these results it is considered that either this strain is not a pathogen or its pathogenicity is very low.

     

Utilización del servicio de urgencia de un hospital universitario por los adultos mayores en Santiago de Chile

Introduction

An increase in visits to Emergency Departments by older adults has been reported, but there are no data available on this in countries in the early phases of demographic and epidemiological transition. This paper describes the characteristics of people over 60 years-old (AM) who visited the Emergency Department of the Hospital Clínico Universitario de la Pontificia Universidad Católica, Chile (SU-PUC), compared to those less than 60 years-old (AJ).

Material and methods

Demographic data and reasons for admission and re-admission were collected retrospectively from the SU-PUC monthly statistics report. Obstetrics, paediatrics and «scheduled admissions» were excluded. The frequencies were compared using Chi-squared (significance: P < .05).

Results

A total of 37,660 visits to the SU-PUC were recorded (81% AJ; 19% AM; with 8% being older than 75 years). No statistical differences were found in the visit time (70% daytime), or by season between the groups.A total of 7,414 (19.6%) of those who visited were hospitalised, with differences being detected between groups (AM: 48.9% vs 12.9% AJ; P < .001), particularly in those over 75 years (59%). The primary cause of admission was cardiopulmonary in AM (22%) and gastrointestinal in AJ (31%). Re-admissions were 10% in AM and 6% in AJ (P < .001).

Conclusion

The use of SU by AM and some characteristics of their care process (hospitalisation) are similar to those found in countries in more advanced phases of demographic transition.     

Existencia de un foco endemico de rinosporidiosis en la provincia Del Chaco. V. Estudio de nuevas observaciones y consideraciones finales

Summary In the East Center area of the Chaco province (Argentina) 41 cases of rhinosporidiosis have been studied: 6 cases in humans, 33 cases in horses, 1 case in dog and also 1 in cow.The authors assume that there is an endemic focus of rhinosporidiosis in this country whose center may be situated in the Villa Angela region.30 cases of rhinosporidiosis in horses and 1 in humans is the authors' contribution to the study of this disease in the province of Chaco (Argentina).     

Traqueobronquitis obstructiva por Aspergillus fumigatus en un paciente inmunocompetente

Background

Aspergillus tracheobronchitis (ATB) is an uncommon type of invasive pulmonary aspergillosis in which fungal involvement is limited to the tracheobronchial tree. While the more severe forms, such as pseudomembranous and ulcerative ATB, occur almost exclusively in immunocompromised patients, the milder obstructive form may occur in patients without immune deficiency.

Frugivoría por Aves en un Paisaje Fragmentado: Consecuencias en la Dispersión de Semillas1

Few data exist on seed dispersal by frugivorous birds in fragmented landscapes, originating from tropical dry forests, in contrast to more abundant data from tropical rain forests. In this study, we assessed the effect of frugivorous birds in a fragmented landscape of Veracruz, Mexico, now occupied by remnant fragments of tropical semi‐deciduous forest and dry deciduous forest, grassland, and shrubby patches on sand dunes. We determined four characteristics related to seed dispersal by birds: the interacting species of plants and birds, the characteristics of these species, spatio‐temporal variation in the dispersal system, and the outcome of the process. During one year, we recorded 54 frugivorous bird species and 33 ornithochorous plant species, which engaged in 176 different bird‐plant species interactions. Similarity (Sorensen index) of frugivorous bird communities using different vegetation types was high (>70%), suggesting that many bird species used all of the vegetation types. In contrast, the similarity of ornithochorous plant communities among vegetation types commonly was low (<37%), suggesting that most plant species were restricted to particular sites in this landscape. At the landscape level, as well as for tropical deciduous forest, we detected a significant positive relationship (Spearman's correlation of rank coefficient >0.65, P <0.05) among richness per month of frugivorous birds and plant species bearing fleshy fruits. Seeds of many plant species previously detected in studies of seed rain at the site were eaten by birds during this study. Most seeds of zoochorous species, which are deposited in the dry and decidous tropical forests patches, are produced within these vegetation types (i.e., they are autochthonous species), whereas bird‐dispersed seeds arriving in grassland and shrubby patches are produced outside (i.e., allochthonous) and are mostly woody species. Birds are important seed dispersers among vegetation types in this landscape but they have different effects in each one. The four characteristics studied, as well as the landscape approach of this research, allowed us to detect spatial and temporal patterns that otherwise would have remained undetected.     

Linfoma esplénico presentado como pancreatitis aguda en una paciente de 84 años: reporte de un caso

A case is presented of an 84 year-old woman who was admitted to the Emergency Department due to an episode of non-calculous acute pancreatitis. In the aetiological study, the presence of a splenic lymphoma was documented, which had a compressive effect on the pancreas. After resolving the symptoms, she was scheduled for a splenectomy with a good technical result. At six months after admission the patient was in an excellent clinical and functional condition. This case highlights the unusual clinical presentation of this haematological disease, and the need to evaluate all the available therapeutic options in selected elderly patients.     

Colonización por levaduras en recién nacidos y personal de salud en la unidad de cuidados intensivos neonatales de un hospital universitario en Bogotá, Colombia

Candida infections in the neonatal intensive care unit (NICU) are associated with high morbidity and mortality rates. The main objective of this work was to determine the risk factors for colonization by Candida species in the newborns in a hospital NICU in Bogota, Colombia, and to evaluate the colonization of intravascular devices and healthcare personnel. Fifty newborns at high risk (low birth-weight, gestational age under 35 weeks, previous exposure to antibiotics and eight days of stay in the NICU) were followed prospectively. Clinical specimens from conjunctiva, nasal orifices, oral cavity, inguinal skin, rectum, intravascular devices, and the resulting watery solution of the washing of hands of healthcare personnel were cultured. Samples were cultured on Sabouraud agar with chloramphenicol (50 ppm). Identification of yeasts was peformed using phenotypic and biochemical tests. A multivariate analysis of the risk factors for colonization in the newborns was performed. Growth of different Candida spp. was found in samples recovered from 38% of the newborns tested. However, no yeasts were obtained in cultures from intravascular devices. About 32% of the samples from healthcare personnel (paediatricians, undergraduate and postgraduate students, professional nurses and nursé assistants), showed presence of yeasts. In the multivariate regression analysis length of stay in the NICU was the only identified risk factor for colonization.