Oscar Alberto Newton-Sánchez

Hemoglobin measured by Hemocue and a reference method in venous and capillary blood: a validation study

OBJECTIVE To assess the comparability of hemoglobin concentration (Hb) in venous and capillary blood measured by Hemocue and an automated spectrophotometer (Celldyn) and to document the influence of type of blood (capillary or venous) and analysis method on anemia prevalence estimates. MATERIAL AND METHODS Between February and May 2000, capillary and venous samples were collected from 72 adults and children at Hospital del Niño Morelense (Morelos State Childrens Hospital) in Cuernavaca, Morelos, Mexico, and assessed for Hb using the Hemocue and Celldyn methods. Estimated Hb levels were compared using the concordance correlation coefficient and Students t test for paired data. The sensitivity and specificity for anemia diagnosis were estimated and compared between type of blood and method of assessment. RESULTS Capillary blood had higher Hb (+0.5 g/dl) than venous blood in adults and children, as did samples assessed by Celldyn compared to Hemocue (+0.3 g/dl). Specificity to detect anemia was adequate (> 0.90) but sensitivity was low for capillary blood assessed by Hemocue (< 0.80). CONCLUSIONS The difference in Hb between venous and capillary blood is likely related to biological variability. Hemoglobin concentration in capillary blood assessed by Hemocue provides an adequate estimation of population anemia prevalence but may result in excess false negative diagnoses among individuals. The results of this study stress the importance of sample collection technique, particularly for children. Method of analysis and sampling site need to be taken into consideration in field studies. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

Violencia doméstica y riesgo de conducta suicida en universitarios adolescentes

OBJECTIVE: To estimate the degree of association between domestic violence -physical, verbal or sexual- with suicidal behavior among university students. MATERIAL AND METHODS: A matched case-control study was done with students attending the University of Colima, Mexico. The cases were 235 teenagers who presented both suicidal ideation and suicide attempt; the controls were 470 individuals of the same age and sex. RESULTS: Sexual abuse showed the highest degree of association with suicidal behavior (OR= 27.4), followed by verbal violence (OR= 9.28), drug use (OR= 8.6), physical violence (OR= 5.5) and smoking (OR= 3.6). Multivariate logistic regression showed that verbal violence was associated with suicidal behavior independently of the other variables, while physical violence, sexual abuse, smoking and drug use seem to depend on verbal violence. CONCLUSIONS: Domestic violence, particularly verbal or sexual, is strongly associated with suicidal behavior in adolescents and should be considered in suicide prevention programs.

Frecuencia y factores de riesgo asociados a sobrepeso y obesidad en universitarios de Colima, México

OBJECTIVE Determining risk factor frequency regarding obesity and being overweight in university students. METHODS A cross-sectional analytic study was carried out on 821 students from the University of Colima. Some variables analysed were age, gender, alcoholism, smoking and weight-control drug use. RESULTS 821 students were included (380 male, 441 female), 20.9±2.5 average age. 27.8 % of males were overweight and 14.7 % suffered from obesity; this was 17 % and 5.2 % in females, respectively. Smoking (2.1 OR; 1.4-3.8 95 % CI; p=0.01) and alcoholism (2.1 OR; 1.2-3.6 95 % CI; p=0.003) were associated with being overweight and being obese. Weight-control drug use was a protective factor in both genders (0.4 OR; 0.2-0.8 95 % CI; p=0.01); diet control was only a protective factor in women (2.2. OR; 1.1-3.4 95 % CI; p=0.01). CONCLUSIONS 31.6 % of university students were overweight and suffered from obesity. Smoking and alcoholism in males were associated with being overweight and suffering from obesity. Weight-control and diet-control drug use were protective factors.

Detection of sequences from a potentially novel strain of cell fusing agent virus in Mexican Stegomyia ( Aedes ) aegypti mosquitoes

Flaviviruses (FVs) are a very heterogeneous group of viruses that includes viruses capable of infecting insects and/or vertebrates. Different human-disease-causing FVs are disseminated by mosquitoes, and therefore, the search for FV in these insects has recently been proposed in order to evaluate their potential transmission in a given community. An entomological survey was carried out in Colima (the hyperendemic dengue fever transmission zone in Mexico) to collect culicidae in urban and wild areas. No human-pathogenic FVs were found, but sequences related to a potentially novel strain of cell fusing agent virus (CFAV) were detected in Stegomyia (Aedes) aegypti mosquitoes.

Association of matrix metalloproteinase-2 gene promoter polymorphism with myocardial infarction susceptibility in a Mexican population

1School of Medicine, Universidad de Colima, Av. Universidad 333, Colonia Las Viboras, CP 28040, Colima, Col., Mexico 2General Hospital N◦ 1, Instituto Mexicano del Seguro Social, Colima, Zaragoza 377, Colonia, CP 28040, Mexico 3Hospital Regional Universitario, Secretaria de Salud del Estado de Colima, Km 2.0 Carretcra Colima-Guadalajara, CP 28019, Colima, Mexico 4School of Medicine, Universidad Autonoma de Nuevo Leon, Av. Madero Y Aguirre Peqeno, Mitras Centro, CP 64460, Monterrey Nuevo Leon, Mexico

Meningitis caused by Alcaligenes xylosoxidans in a patient with HIV/AIDS

The purpose of the present work was to inform about the first case of meningitis associated to the bacteria Alcaligenes xylosoxidans in a patient with HIV/AIDS. The patient was a 46-year-old male, with the antecedent of have been diagnosed for HIV/ AIDS, who attended in the Hospital Universitario de Colima, Mexico, with fever, shock and meningismus. The study of the cerebrospinal fluid showed pleocytosis, elevated protein levels and hypoglycorrhachia. The culture yielded the presence of Alcaligenes xylosoxidans with sensitivity to ciprofloxacin. After 14 days of treatment with this antibiotic, the patient showed neurologic improvement and was able to continue with his outpatient antiretroviral treatment. The present case shows the importance of the inclusion of this bacterium in the differential diagnosis of the neurological infections in HIV/AIDS patients and emphasizes the importance of considering the bacterial meningitis in this population.

Peritonitis bacteriana espontánea por Listeria monocytogenes, en un paciente con cirrosis hepática: Caso clínico

Infections caused by Listeria monocytogenes are usually found incattle and occasionally appear in humans, particularly pregnant women andimmunocompromised individuals. Peritonitis by Listeria monocytogenes is a rare butdangerous condition that must be recognized early, since it requires a specific treatment. Wereport a 31 year-old male with alcoholic cirrhosis that developed ascites with abdominal painand fever. The peritoneal fluid culture yielded Listeria monocytogenes. The patients was initiallytreated with cefotaxim and later with ampicillin and levofloxacin. The patient voluntarilyabandoned treatment and died at home two weeks later (Rev Med Chile 2006; 134: 1171-4).(Infections caused by Listeria monocytogenes are usually found in cattle and occasionally appear in humans, particularly pregnant women and immunocompromised individuals. Peritonitis by Listeria monocytogenes is a rare but dangerous condition that must be recognized early, since it requires a specific treatment. We report a 31 year-old male with alcoholic cirrhosis that developed ascites with abdominal pain and fever. The peritoneal fluid culture yielded Listeria monocytogenes. The patients was initially treated with cefotaxim and later with ampicillin and levofloxacin. The patient voluntarily abandoned treatment and died at home two weeks later.

Trypanosoma cruzi: Correlation of muscle lesions with contractile properties in the acute phase of experimental infection in mice (Mus musculus)

Parasitism in skeletal muscles and myositis are commonly observed during experimental Trypanosoma cruzi infection. The effect of T. cruzi infection on contractile properties of skeletal muscles in consecutive periods of the acute infection in BALB/c mice was studied. Albarrada strain (clone 4) which was isolated in Mexico and has demonstrated a high level of blood parasitemia and parasitism in skeletal muscles was used. Isolated strips of rectus abdominis muscle were subjected to direct electrical field in vitro. Alternatively, plantaris muscles were stimulated in situ through the sciatic nerve. The peak amplitudes of a single twitch and tetanus contractions were considered to estimate the mechanical properties of muscles. Histopathological analysis was performed to correlate functional changes with the evolution of tissue parasitism and tissue injury. Contractile properties of muscles were significantly attenuated during acute T. cruzi infection. The percentage of damaged muscles rather than the character of tissue pathology affected their contractile properties significantly.

Clinical outcomes in Mexican children with febrile acute upper respiratory tract infections: no impact of antibiotic therapy.

OBJECTIVE To compare the clinical outcomes (duration of signs and symptoms) and the microbiology in Mexican children with non-complicated febrile upper respiratory tract infections (URI), with and without the use of antibiotics. METHODS We conducted a prospective cohort study from September 2006 to July 2007. The study population consisted of 880 children aged 6 months to 5 years 11 months, attending four community daycare centers run by the Instituto Mexicano del Seguro Social (IMSS) and three non-IMSS daycare centers. Children with a febrile URI were enrolled before receiving any antimicrobials and were followed up for two weeks. Duration of the fever, cough, runny nose, stuffy nose, irritability, loss of appetite, tiredness, and diarrhea, and isolation of Haemophilus influenzae,Streptococcus pneumoniae, and Streptococcus pyogenes were compared in those children who received antibiotic treatment and those who did not receive antibiotics. RESULTS During the study period, a total of 145 out of 880 children were enrolled, and among those enrolled, 85/145 (59%) children received antibiotics. There was no significant difference in the duration of the signs and symptoms evaluated in the two groups. Although the proportions of S. pneumoniae, H. influenzae, and S. pyogenes isolated in children with and without antibiotics were comparable, those in whom we isolated S. pneumoniae had both a significantly longer episode of URI, as well as longer lasting diarrhea. Similarly, children receiving trimethoprim-sulfamethoxazole treatment experienced significantly longer durations of fever and diarrhea. CONCLUSIONS The mean duration of signs and symptoms and the microbiological isolates of children with febrile URI were comparable among children treated with or without antibiotics, with the exception of a longer duration of URI and diarrhea in those children with an S. pneumoniae isolate. Our findings suggest that in our population, most cases of febrile URI are caused by viral infections, and demonstrate that antibiotics should not be used routinely in children with non-complicated febrile URI.

[Spontaneous bacterial peritonitis caused by Listeria in a patient with cirrhosis: Case report].

Infections caused by Listeria monocytogenes are usually found incattle and occasionally appear in humans, particularly pregnant women andimmunocompromised individuals. Peritonitis by Listeria monocytogenes is a rare butdangerous condition that must be recognized early, since it requires a specific treatment. Wereport a 31 year-old male with alcoholic cirrhosis that developed ascites with abdominal painand fever. The peritoneal fluid culture yielded Listeria monocytogenes. The patients was initiallytreated with cefotaxim and later with ampicillin and levofloxacin. The patient voluntarilyabandoned treatment and died at home two weeks later (Rev Med Chile 2006; 134: 1171-4).(Infections caused by Listeria monocytogenes are usually found in cattle and occasionally appear in humans, particularly pregnant women and immunocompromised individuals. Peritonitis by Listeria monocytogenes is a rare but dangerous condition that must be recognized early, since it requires a specific treatment. We report a 31 year-old male with alcoholic cirrhosis that developed ascites with abdominal pain and fever. The peritoneal fluid culture yielded Listeria monocytogenes. The patients was initially treated with cefotaxim and later with ampicillin and levofloxacin. The patient voluntarily abandoned treatment and died at home two weeks later.