Alicia Ruth Fernández

Association of clomipramine and allopurinol for the treatment of the experimental infection with Trypanosoma cruzi

We have previously shown that clomipramine and allopurinol used separately are effective in preventing chronic chagasic cardiomyopathy. The aim of the present study was to evaluate the effect of the association of clomipramine (Clo—5 mg/kg/day/90 days) and allopurinol (Allo—5, 10, or 15 mg/kg/day/90 days) for the treatment of experimental Chagas disease in the acute stage. Treatment effectiveness was evaluated through parasitemia, survival, electrocardiography, serology, and cardiac histopathology. Groups treated showed no electrocardiographic abnormalities, in contrast to those untreated which presented 25% of mice with conduction alterations. The myocardium of treated mice (Clo, Allo10+Clo, and Allo15+Clo) presented no structural alterations. Cardiac b-receptor affinity was preserved in mice treated with Clo or Clo+Allo at the different doses; receptor density of the Clo and Allo15+Clo groups did not differ from the non-infected group. Anti-cruzipain antibody levels were similar in treated and untreated groups. Survival was significantly increased in the treated groups (p < 0.05), with Clo and all the Clo+Allo groups presenting the highest rates. These results show that the association of clomipramine + allopurinol is effective for Chagas disease treatment and has the same effect as clomipramine alone.

Involvement of the β-adrenergic system in the cardiac chronic form of experimental Trypanosoma cruzi infection.

Changes in the cardiac beta-adrenergic system in early stages of Trypanosoma cruzi infection have been described. Here, we studied an early (135 days post-infection-p.i.) and a late stage (365 days p.i.) of the cardiac chronic form of the experimental infection (Tulahuen or SGO-Z12 strains), determining plasma epinephrine and norepinephrine levels, beta-receptor density, affinity and function, cardiac cAMP concentration and phosphodiesterase activity, cardiac contractility, and the presence of beta-receptor autoantibodies. Tulahuen-infected mice presented lower epinephrine and norepinephrine levels; lower beta-receptor affinity and density; a diminished norepinephrine response and higher cAMP levels in the early stage, and a basal contractility similar to non-infected controls in the early and augmented in the late stage. The Tulahuen strain induced autoantibodies with weak beta-receptor interaction. SGO-Z12-infected mice presented lower norepinephrine levels and epinephrine levels that diminished with the evolution of the infection; lower beta-receptor affinity and an increased density; unchanged epinephrine and norepinephrine response in the early and a diminished response in the late stage; higher cAMP levels and unchanged basal contractility. The SGO-Z12 isolate induced beta-receptor autoantibodies with strong interaction with the beta-receptors. None of the antibodies, however, acted a as beta-receptor agonist. The present results demonstrate that this system is seriously compromised in the cardiac chronic stage of T. cruzi infection.

Ganglioside treatment of acute Trypanosoma cruzi infection in mice promotes long-term survival and parasitological cure

Ganglioside treatment of mice during their acute infection with Trypanosoma cruzi promoted long-term survival and clearance of parasites from the bloodstream and organs. Additionally, such treatment completely prevented the clinical manifestations of the infection, and progression into the chronic stages of the disease, for at least 18 months post-infection. Trypanosoma cruzi must invade nucleated cells to survive and reproduce within the mammalian host, and it has been suggested that ganglioside treatment inhibits the parasites phospholipase A2 enzymes (PLA2), which are involved in membrane destabilization. However, since total brain gangliosides were not toxic to the parasite, either in xenic or axenic cultures, it seems unlikely that their action in vivo relates to their inhibition of PLA2. Other possible mechanisms of action are discussed.

GM1 ganglioside induced myocardial restoration and survival of mice with experimental Chagas’ disease☆

In a previous work, our group reported that Albino Swiss male mice inoculated with T. cruzi to develop acute lethal infection by day 15 decreased parasitemia and survived when treated with total brain gangliosides (GT; 1 mg, daily). In this paper, GT were replaced by GM1 in 0.1 mg dose that caused diminished parasitemia from day 15 to 30 and survival of 80% by day 120 p.i. Treatment with GT 0.15 mg was ineffective. This indicates that GT effect was due to GM1 and that more sialyl residues on the same lipid moiety produces adverse results. GM1 was compared to other sialylated molecules: fetuine and colominic acid. Both of them increased parasitemias and death by day 16 p.i., suggesting that sialic residues favor parasite replication. Asialo-GM1 (0.1 mg daily) was also adverse. This pointed to GM1 not to other ganglioside or sphingolipid or sialoprotein as the active agent. Gangliosides are [Ca+2]i modulators, so GM1 was compared to nifedipine which blocks calcium channels only in the host. Nifedipine treated mice behaved as controls. It is proposed that if GM1 calcium modulation is involved it must be on the parasite rather than on the host. Electrocardiographic (ECG) records show that while infected mice die with bradycardia, treated mice survive and recover normal frequency. Uninfected treated mice showed no electrocardiographic alterations.

Consumo de sustancias psicoactivas en dos regiones argentinas y su relación con indicadores de pobreza

Data were analyzed from the National Survey on Substance Use (ENPreCoSP-2.008) in 6,122 cases to estimate the prevalence of psychoactive substance use and assess the association between unmet basic needs (UBN) and family income and the consumption of psychoactive substances by individuals 18-34 years of age in 10 provinces in Northern Argentina. The study conducted descriptive statistical analysis and logistic regression. Prevalence of lifetime drug use and use in the previous year and previous month were higher for legal versus illegal substances. Consumption was also higher in males. Poverty indicators were significantly associated with the consumption of legal substances. The findings show differences in consumption of psychoactive substances related to gender and poverty.Data were analyzed from the National Survey on Substance Use (ENPreCoSP-2.008) in 6,122 cases to estimate the prevalence of psychoactive substance use and assess the association between unmet basic needs (UBN) and family income and the consumption of psychoactive substances by individuals 18-34 years of age in 10 provinces in Northern Argentina. The study conducted descriptive statistical analysis and logistic regression. Prevalence of lifetime drug use and use in the previous year and previous month were higher for legal versus illegal substances. Consumption was also higher in males. Poverty indicators were significantly associated with the consumption of legal substances. The findings show differences in consumption of psychoactive substances related to gender and poverty.

Consumo de alcohol segun caracteristicas sociodemograficas en jovenes de 18 a 24 anos

OBJETIVO: identificar o consumo de alcool, de acordo com as caracteristicas sociodemograficas em jovens de 18 a 24 anos, provenientes da provincia de Cordoba, Argentina, e que participaram do Levantamento Nacional de Fatores de Risco. METODO: foi realizado um estudo quantitativo, analitico e transversal com uma amostra de 240 jovens. O consumo de alcool e as caracteristicas sociodemograficas foram analisados mediante a aplicacao da analise bivariada, razao de risco e intervalos de confianca. RESULTADOS: a prevalencia do consumo de alcool na vida foi de 79,17%, a prevalencia-ano 72,91% e a prevalencia-mes 57,08%, o consumo excessivo episodico e o consumo regular de risco correspondem a 25,55 e 24,19%, respectivamente. O consumo no ultimo mes foi maior entre homens (p=0,0028), jovens solteiros (p=0,0001), com educacao secundaria completa (p=0,0306). CONCLUSAO: na provincia de Cordoba, o uso de substâncias psicoativas, entre elas o alcool, nao tem sido foco de interesse nas investigacoes em anos recentes, porem, o abuso do alcool esta associado a outros fatores de risco, tais como acidentes e violencia, e como fator de comorbidade e mortalidade precoce, portanto, o consumo de alcool entre os jovens e um tema preocupante que, quando caracterizado, deve ser tratado com acoes preventivas.OBJECTIVE To identify alcohol consumption in young people between 18 and 24 years of age in the province of Córdoba who participated in the National Survey of Risk Factors, according to sociodemographic characteristics. METHOD A quantitative, analytic and cross-sectional study was undertaken in a sample of 240 young people. The alcohol consumption and sociodemographic characteristics were analyzed using bivariate analysis, risk ratio and confidence intervals. RESULTS The lifetime prevalence of alcohol consumption corresponded to 79.17%, the one-year prevalence to 72.91% and the one-month prevalence to 57.08%, while episodic abuse and regular hazardous consumption corresponded to 25.55% and 24.19%. Consumption levels in the last month were higher among males (p=0.0028), single people (p=0.0001), with a secondary education degree (p=0.0306). CONCLUSION In the province of Córdoba, drugs use, including alcohol, has not been an area of research interest in recent years, although alcohol abuse is associated with other risk factors, like accidents and violence, and is a factor of comorbidity and early mortality. Therefore, alcohol consumption in young people represents an area of concern and, once characterized, preventive actions should be adopted.

Screening for posttraumatic stress disorder in people affected by the 2010 earthquake in Chile

Se analizo un screening de trastornos de estres postraumatico en habitantes chilenos, como consecuencia del terremoto de febrero de 2010; a partir de una Encuesta Post Terremoto con una muestra multietapica de 24.982 personas mayores de 18 anos, a quienes se aplico la Escala de Trauma de Davidson. La prevalencia de screening positivo para los trastornos de estres postraumatico fue del 11% en el pais, pero a menor nivel de desagregacion llegaron a observarse prevalencias del 30%. El modelo de regresion logistica para la estimacion de la variable trastornos de estres postraumatico identifico como factores de riesgo el hecho de pertenecer un hogar pobre, haber sufrido danos en la vivienda, haber tenido algun problema de salud en el ultimo mes y ser mujer (p<0,05). Tambien se encontro que el afrontamiento del sismo en familia resulto como un factor protector, en relacion a afrontarlo con otros colectivos sociales (vecinos), la mayor cantidad de anos de educacion formal tambien fue identificada como un factor de proteccion (p<0,05). Se observaron claras desigualdades sociales en las personas que presentaron un screening positivo.The authors conducted an assessment of post-traumatic stress disorder screening in the Chilean population following the February 2010 earthquake, based on the Post Earthquake Survey with a multistage sample of 24,982 individuals over 18 years of age, applying the Davidson Trauma Scale. Multivariate analysis was performed with significance set at p<0.05. Prevalence of positive screening for post-traumatic stress disorder was 11% for the country as a whole, but reached 30% at lower-level disaggregation. The logistic regression model for post-traumatic stress disorder identified the following risk factors: belonging to a low-income family, having suffered damage to the household, a history of health problems in the previous month, and female gender (p<0.05). Family coping with the earthquake proved to be a protective factor as compared to other social or neighborhood groups, and more years of schooling were also protective (p<0.05). Positive screening for posttraumatic stress disorders revealed clear social inequalities.

Screening de trastornos de estrés postraumático en población afectada por el terremoto chileno de 2010

Se analizo un screening de trastornos de estres postraumatico en habitantes chilenos, como consecuencia del terremoto de febrero de 2010; a partir de una Encuesta Post Terremoto con una muestra multietapica de 24.982 personas mayores de 18 anos, a quienes se aplico la Escala de Trauma de Davidson. La prevalencia de screening positivo para los trastornos de estres postraumatico fue del 11% en el pais, pero a menor nivel de desagregacion llegaron a observarse prevalencias del 30%. El modelo de regresion logistica para la estimacion de la variable trastornos de estres postraumatico identifico como factores de riesgo el hecho de pertenecer un hogar pobre, haber sufrido danos en la vivienda, haber tenido algun problema de salud en el ultimo mes y ser mujer (p<0,05). Tambien se encontro que el afrontamiento del sismo en familia resulto como un factor protector, en relacion a afrontarlo con otros colectivos sociales (vecinos), la mayor cantidad de anos de educacion formal tambien fue identificada como un factor de proteccion (p<0,05). Se observaron claras desigualdades sociales en las personas que presentaron un screening positivo.The authors conducted an assessment of post-traumatic stress disorder screening in the Chilean population following the February 2010 earthquake, based on the Post Earthquake Survey with a multistage sample of 24,982 individuals over 18 years of age, applying the Davidson Trauma Scale. Multivariate analysis was performed with significance set at p<0.05. Prevalence of positive screening for post-traumatic stress disorder was 11% for the country as a whole, but reached 30% at lower-level disaggregation. The logistic regression model for post-traumatic stress disorder identified the following risk factors: belonging to a low-income family, having suffered damage to the household, a history of health problems in the previous month, and female gender (p<0.05). Family coping with the earthquake proved to be a protective factor as compared to other social or neighborhood groups, and more years of schooling were also protective (p<0.05). Positive screening for posttraumatic stress disorders revealed clear social inequalities.

Psychometric properties of the Internalized Stigma of Mental Illness scale adapted for people who use psychoactive substances.

BACKGROUND People who consume psychoactive substances may experience situations of social stigma on the part of the society in general, and also situations of internalized-stigma derived from their own consumption of substances. The Internalized Stigma of Mental Illness (ISMI) scale has been shown to be valid and reliable to evaluate the internalized-stigma in people with severe mental disorders, but in Argentina there is no a Spanish version of this scale for use with people who use psychoactive substances. The objective of this work was to evaluate the psychometric properties of the Spanish version of the Internalized Stigma of Mental Illness instrument adapted for people who use psychoactive substances. METHOD The work was carried out on a sample of 200 patients older than 18 years under treatment of rehabilitation by consumption of psychoactive substances in a public institution of the city of Córdoba (Argentina) between the years 2014 and 2016. The instrument used was the Internalized Stigma of Mental Illness (ISMI) previously adapted for use in these groups of patients. It was determined the reliability of the scale through Cronbachs coefficients α and factorial structure was analyzed through an exploratory factor analysis. RESULTS The obtained coefficients showed a high reliability, while in the factorial structure emerged the 4 theoretical dimensions described by Ritsher, namely: social isolation, perceived discrimination, alienation and stereotyping. CONCLUSION It is concluded that the scale adapted for people who use psychoactive substances is reliable and with an adequate factorial structure.

Triagem para transtorno de estresse pós-traumático em pessoas afetadas pelo terremoto chileno de 2010

Se analizo un screening de trastornos de estres postraumatico en habitantes chilenos, como consecuencia del terremoto de febrero de 2010; a partir de una Encuesta Post Terremoto con una muestra multietapica de 24.982 personas mayores de 18 anos, a quienes se aplico la Escala de Trauma de Davidson. La prevalencia de screening positivo para los trastornos de estres postraumatico fue del 11% en el pais, pero a menor nivel de desagregacion llegaron a observarse prevalencias del 30%. El modelo de regresion logistica para la estimacion de la variable trastornos de estres postraumatico identifico como factores de riesgo el hecho de pertenecer un hogar pobre, haber sufrido danos en la vivienda, haber tenido algun problema de salud en el ultimo mes y ser mujer (p<0,05). Tambien se encontro que el afrontamiento del sismo en familia resulto como un factor protector, en relacion a afrontarlo con otros colectivos sociales (vecinos), la mayor cantidad de anos de educacion formal tambien fue identificada como un factor de proteccion (p<0,05). Se observaron claras desigualdades sociales en las personas que presentaron un screening positivo.The authors conducted an assessment of post-traumatic stress disorder screening in the Chilean population following the February 2010 earthquake, based on the Post Earthquake Survey with a multistage sample of 24,982 individuals over 18 years of age, applying the Davidson Trauma Scale. Multivariate analysis was performed with significance set at p<0.05. Prevalence of positive screening for post-traumatic stress disorder was 11% for the country as a whole, but reached 30% at lower-level disaggregation. The logistic regression model for post-traumatic stress disorder identified the following risk factors: belonging to a low-income family, having suffered damage to the household, a history of health problems in the previous month, and female gender (p<0.05). Family coping with the earthquake proved to be a protective factor as compared to other social or neighborhood groups, and more years of schooling were also protective (p<0.05). Positive screening for posttraumatic stress disorders revealed clear social inequalities.