Análida Elizabeth Pinilla

Historia del protozoo Entamoeba histolytica

This article presents a history of Entamoeba histolytica spanning since the remote times when it was not even recognized as a cause of human disease to the recent molecular advances. Feder Losch (1875) in Saint Petersburg, found amoebae in fecal samples but only regarded them as responsible for maintaining the inflammatory process, not as a cause of dysentery. Fritz Schaudinn (1903) established the differentiation between Entamoeba histolytica and Endamoeba coli, Schaudinn decided to call it E. histolytica because of its ability to cause tissue lysis. Emile Brumpt (1925) based on experimental studies, pointed out the existence of E. Histolytica as a species complex, comprising two morphologically indistinguishable species, E. dysenteriae which is the cause of symptomatic infection, and Entamoeba dispar found only in asymptomatic carriers. Louis Diamond et al (1961) during the 1960’s developed an axenic culture medium for E. histolytica which allowed in vivo and in vitro studies. Sargeaunt and Williams (1978) distinguished for the first time E. histolytica strains by isoenzyme electrophoresis, thus confirming that E. hystolytica was indeed a species complex comprising both pathogenic and non-pathogenic species. William Petri et al (1987 demonstrated that the 170 kDa protein with greater antigenicity was the Gal/GalNac-specific lectin. Diamond and Clark (1993) described again Brumpt’s original 1925 hypothesis, concluding that there was enough evidence to support the existence of two morphologically indistinguishable species, a pathogenic and a nonpathogenic one, corresponding to E. histolytica and Entamoeba dispar respectively. The World Health Organization accepted this hypothesis in 1997 (Rev Med Chile 2008; 136: 118-24). (Key words: Dhg12 protein, Entamoeba dispar; Dysentery, amebic; Entamoeba histolytica)

Liver abscess caused by Ascaris lumbricoides: case report

A case is reported of a woman who lived in a rural area with a chronic illness that consisted of weight loss and abdominal pain in the epigastrium and upper right quadrant. The initial diagnosis was a mass in the liver, which was later, demonstrated, both by direct and histological examination, to be an abscess caused by Ascaris lumbricoides. Eggs of Ascaris lumbricoides and abundant Charcot-Leyden Crystals were found.

Actividades de prevención del pie diabético en pacientes de consulta externa de primer nivel

Objetivo Determinar la frecuencia de actividades de prevencion del pie diabetico recomendadas por el medico y efectuadas por pacientes de consulta externa en medicina general, para autocuidado de los pies y describir los habitos alimentarios. Metodologia Estudio descriptivo de corte transversal, realizado en dos instituciones de salud de Bogota, marzo-octubre 2008; muestra ponderada, por conveniencia, 307 pacientes diabeticos mayores de 18 anos. Resultados Antecedente de ulceras en pies 13 %, amputaciones en miembros inferiores 1,6 %. Refirieron: disestesias 65,5 % y claudicacion intermitente 33,6 %; no habian recibido educacion sobre el cuidado del pie por parte del medico 78,2 %. Su medico no le habia examinado los pies en el ultimo ano al 76,2 %; a pesar de presentar disestesias y claudicacion intermitente no se indago sobre estos sintomas al 89 % y 93 % de pacientes respectivamente. Actividades de pacientes: no revisaban diariamente los pies 63,1 %, no realizaban automonitoreo 93,4 %, consumian mas de dos fuentes de carbohidratos en comidas principales 38,1 %; adicionaban a las preparaciones azucar, panela, miel de abejas 38,8 %. Conclusiones La prevalencia de actividades de prevencion del pie diabetico recomendadas por medicos y efectuadas por pacientes fue deficiente. Es necesario crear y fortalecer programas interdisciplinarios para la prevencion de la diabetes mellitus y del pie diabetico a nivel primario de atencion, ademas de formacion del equipo de profesionales en salud.

Inmunología del absceso hepático amebiano

La infeccion por el parasito Entamoeba histolytica es causa de disenteria y absceso hepatico amebianos, enfermedades asociadas con alta morbi-mortalidad. En el caso de la amebiosis hepatica, el papel de la inmunidad humoral en la proteccion no ha sido del todo establecido pero tiene importancia en estudios seroepidemiologicos y metodos diagnosticos. La inmunidad celular es importante para el control de la infeccion y desarrollo de inmunidad protectora luego de amebiosis invasiva. Las tecnicas de genetica molecular y los nuevos modelos de experimentacion han ensenado mucho acerca de la patogenesis de la amebiosis, su entendimiento adecuado junto con el conocimiento de la biologia molecular y genetica del parasito y los mecanismos inmunes del huesped permitira no solo el desarrollo de nuevas opciones diagnosticas y de tratamiento sino tambien de una vacuna efectiva y segura para eliminar la enfermedad.

Diferenciación del complejo Entamoeba histolytica/Entamoeba dispar mediante Gal/GalNAc-lectina y PCR en aislamientos colombianos

Background: Entamoeba histolytica and Entamoeba dispar are morphologically identical. However, the former is highly pathogenic and the latter is not. Aim: To differentiate Entamoeba histolytica from Entamoeba dispar through ELISA and PCR techniques in Colombian isolates from feces. Material and Methods: Descriptive study of Colombian fecal samples from 53 males and 47 women, that were positive for the complex E. histolytica/E. dispar on light microscopy. Positive samples were cultured on Robinson medium to isolate trophozoites. The presence of specific Gal/ GalNAc-lectin was determined by ELISA and polymerase chain reaction in genomic DNA, using the combination of three nucleotides that recognize a variable region of 16S small subunit ribosomal RNA, generating a 166 base pair (bp) product for E. histolytica and 752 pb product for E. dispar. Results: After verification, only eight of the 100 samples were positive for the complex E. histolytica/E. dispar and were cultivated. Isolates were obtained in six cultures, one corresponded to E. histolytica and six to E. dispar. Conclusions: The presence of E. histolytica/E. dispar complex was largely overestimated with light microscopy. In the few samples where isolates were obtained, the technique described differentiated between both strains.

Inequalities in prescription of hydrochlorothiazide for diabetic hypertensive patients in Colombia

OBJECTIVE Evaluating differences in the suitable prescription of thiazides in hypertense patients, according to affiliation regime. MATERIALS AND METHODS This was an analytical cross-sectional study. The database from a previous study was used regarding two groups of hypertense patients (subsidised regime and contributory regime) who had attended out-patient consultation between 01-09-2007 and 29-02-2008. Ideal therapy was evaluated in both groups. Univariate and multivariate analysis was carried out. RESULTS 136 patients (contributory: 41.9 %; subsidised: 58.1 %). Subsidised regime patients were older (mean=68.8±10) than those from the contributory regime (mean=64.1±11.1) (t-test, p=0.0110). Prescribing antihypertensive drugs was ideal in 49/136 of the patients (36.0 %). Ideal prescription accounted for 24/79 (30 %) of the patients in the subsidised regime and 25/57 (43.8 %) in the contributory one (OR=1.79; 95 % CI:0.88-3.64). Older people (aged ≥ 65 yo) were at risk of receiving a non-ideal prescription (OR=2.12; 95 %CI:1.02-4.38) whilst this was not so in the subsidised regime (OR=1.62; 95 % CI:0.78-3.35). CONCLUSIONS Ideal prescription of antihypertensive drugs was low in the population being studied. There were differences regarding age ideal prescription but not concerning affiliation regime. It is suggested that a longitudinal study be carried out in the future.