Julio Enrique Enders

Trypanosoma cruzi in Persons without Serologic Evidence of Disease, Argentina

Current diagnosis of chronic Chagas disease relies on serologic detection of specific immunoglobulin G against Trypanosoma cruzi. However, the presence of parasites detected by polymerase chain reaction (PCR) in patients without positive conventional serologic testing has been observed. We determined the prevalence and clinical characteristics of persons with seronegative results for T. cruzi DNA detected by PCR in a population at high risk for chronic American trypanosomiasis. We studied a total of 194 persons from two different populations: 110 patients were recruited from an urban cardiology clinic, and 84 persons were nonselected citizens from a highly disease-endemic area. Eighty (41%) of persons had negative serologic findings; 12 (15%) had a positive PCR. Three patients with negative serologic findings and positive PCR results had clinical signs and symptoms that suggested Chagas cardiomyopathy. This finding challenges the current recommendations for Chagas disease diagnosis, therapy, and blood transfusion policies.

Análisis de la frecuencia de experimentación y consumo de drogas de alumnos de escuelas de nivel medio

En el presente trabajo se analiza la frecuencia de experimentacion y consumo de drogas, en alumnos de escuelas de nivel medio de Cordoba, Argentina, en relacion a variables sociodemograficas. De caracter analitico, la investigacion se baso en los registros de la Secretaria de Programacion para la Prevencion de la Drogadiccion y la Lucha contra el Narcotrafico. El procesamiento estadistico fue analisis bivariado, razon de riesgo e intervalos de confianza para cada variable. El consumo de alcohol fue mas frecuente en los hombres, el 12,2% de los adolescentes probo algun tipo de droga ilicita, y los tranquilizantes son los psicofarmacos mas utilizados. El valor del consumo de drogas aumenta segun aumenta el rango de edad, ano de estudio y disponibilidad de dinero. Los hallazgos del presente trabajo identificaron una realidad epidemiologica que permitira elaborar estrategias de prevencion de adiccion en los adolescentes.The aim of this study was to survey the frequency of experimentation and consumption of drugs in high-school students in Cordoba, Argentina, relating it to socio-demographic variables. An observational-analytical method was employed, on the basis of the records of the Secretary for the Planning of Drug-Addiction Prevention and Fighting of Drug-Trafficking. Statistical. Bivariate analysis, odds ratio and confidence interval were applied in the processing of each variable. Alcohol consumption was found to be more frequent among males. Of the subjects 12.2% had tried some type of illicit substance. Tranquilizers were the most commonly used psycho-medicine. Drug consumption increased with age, years of schooling and availability of money. Our detection of an epidemiological situation is deemed useful for prevention strategies for drug addiction among teenagers.

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.

Effects of epinephrine on plasma fibrinogen levels in rats submitted to tissue injury

Tissue injury (laparotomy) produces an increase in plasma fibrinogen. This increase is inhibited by the removal of the adrenal medulla, but injection of epinephrine in laparotomized-medullectomized rats returns fibrinogen levels to values similar to those observed in only laparotomized rats. Epinephrine administration to laparotomized rats increases the fibrinogen compared with the group of laparotomized rats without treatment, but epinephrine by itself does not modify plasma fibrinogen levels in uninjured rats. Epinephrine is apparently responsible for the increase of plasma fibrinogen in rats subjected to tissue injury, probably through beta adrenergic stimulation.

Cognition and Vascular Risk Factors: An Epidemiological Study

We conducted an epidemiological approach to identify the negative impact of the vascular risk factors (such as hypertension, diabetes and hypercholesterolemia) over cognition. The interesting aspect of this study was that the survey was conducted in all age groups through a voluntary call (n = 1365; ≥18 years old, both sexes; age 49 ± 15 y, female 75.7%). Thus, we demonstrated that the use of a Minimum Cognitive Examination (MCE), a brief, simple, and easy managed neuropsychological evaluation, detected a greater number of people with cognitive decline surpassing to the Minimal Mental Statement Examination alone (14.5% of the participants showed MMSE ≤24, 34,6% showed dys-executive function, and 45,8% memory impairment. Out of the 4 studied RF, the only one that was not related to cognitive impairment was dyslipemia. Finally, we noted the importance of cognitive state early detection in all age groups, even in the youngest group. Acting in the middle of the life stages, we can prevent or delay the onset of a disease in adults, nowadays incurable: dementia.

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.

Analysis of mortality from suicide in children, adolescents and youth. Argentina, 2005-2007

Objective. To analyze mortality from suicide in children, adolescents and youth aged 5 to 24 years by gender, method used, place where the incident occurred and residence (province) in Argentina over the period 2005-2007. Method. Data of Statistical Death Reports were used. Mortality rates from suicide were estimated per 100 000 inhabitants using ICD-10 (X60- X84). The statistical method included categorical data analysis. Results: Total deaths from suicide in the 5 to 24 year old group were 861 in 2005, 897 in 2006, and 815 in 2007. During the period 2005-2007, 6 deaths occurred in children younger than 10 years old. In the 10 to 24 year old group males had higher rates than females (p Language: es

Estudio de muertes por causas violentas: un análisis de tendencia en jóvenes, Argentina, 2000-2008

INTRODUCTION: Violence is the leading cause of death among young people in Latin America. The objective of this study was to analyze the trends of youth (ages 10 to 24) mortality resulting from violence, over the period 2000-2008, in the context of the socioeconomic crisis that started in Argentina, in 2001. METHODOLOGY: Databases of the Statistical Reports of Death and Vital Statistics Yearbooks were used. Violent deaths were defined by the International Statistical Classification of Diseases and Related Health Problems (ICD-10), and violent mortality rates for every 100,000 inhabitants were calculated. Statistical analysis was performed according to the nature of the variable involved. RESULTS: Violent mortality rates were 42.48o/0000 deaths for 2000, and 43.09o/0000 for 2008, with the incidence being higher for males (p=0.0015). For both sexes, there was an increase of violent deaths due to car accidents. There was also an increase of deaths by aggression in males. The highest suicide rate corresponded to the period 2000-2005. CONCLUSIONS: Since these violent deaths are preventable, reflection on public health policies is urgent.

Effects of insulin on plasma fibrinogen levels in rats submitted to tissue injury or ACTH administration

Insulin is necessary to produce an increase of plasma fibrinogen in rats submitted to tissue injury or ACTH administration. This increase is more significant when endogenous or exogeneous excess of insulin is present, while in uninjured rats the absence or excess of insulin does not modify plasma fibrinogen.

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.