Revista Cubana de Medicina Tropical最新文献

Introduction: several dengue outbreaks have taken place in Santiago de Cuba province in the last few years, in which pregnant women have been involved.

Objectives: to determine the immunity and to describe the role of dengue infection and its sequence.

Methods: an observational and descriptive study was conducted to characterize dengue immunity in mothers and children after 10 and 12 months of birth and to determine the influence of certain viral infection sequences in pregnant women who suffered this disease during the dengue 3 epidemics in Santiago de Cuba. To this end, serum samples from 25 females tested dengue 3-positive and from children born to them after 10 and 12 months of childbirth were studied. IgG titers and viral infection sequences were determined and analyzed according to the World Health Organization dengue classification criteria.

Results: the children did not present with the antibodies and the viral infection sequences associated to mothers; in order of frequency, the same percentage was observed in DEN2/DEN3, DEN1/DEN2/DEN3 (21,74 %); but lower percentage in DEN1/DEN3 (17,39 %).

Conclusions: the children did not develop humoral immunity (IgG) despite some manifestations inherent to the disease. The secondary infections prompted the most serious forms of the disease.

Introduction: marine mollusks are natural reservoirs of molecules with therapeutic potential for the treatment of infectious diseases, at a time when many antibiotic-resistant strains are being described.

Objective: to compare three solutions: 30 % acetic acid, 50 % methanol and saline-acid (NaCl 0.6 mol/L, 1 % HCl) according to their capacities to extract molecules with antimicrobial activity from the marine mollusk Cenchritis muricawus.

Methods: the three extraction solutions were used to process the biological material, and then, the obtained extracts were analyzed in terms of total protein concentration and the bacterial growth inhibition of Staphylococcus aureus and Escherichia coli strains by means of a turbidimetric bioassay using 96 well microplates in Luria-Bertani (LB) culture medium.

Results: the highest total protein concentration (7.8 microg/mL) was found in the C. muricatus extract from the saline-acid solution. Additionally, 200 microg/mL of total proteins from the extract caused significant growth inhibition (p< 0.001) of S. aureus (12.64 %) and E. coli (12.1 %) compared to the positive control of growth inhibition using chloramphenicol.

Conclusions: according to these results, the saline-acid solution proved to be more efficient in extracting molecules with antibacterial activity that are likely to be antimicrobial peptides from C. muricatus.

Introduction: the members of the Cryptococcus neoformans species complex are responsible for cryptococcosis in animals and humans. Human infection is thought to be acquired by inhalation of airborne propagules from an environmental source; therefore it is greatly important to study their habitat.

Objective: to determine the ecological relationship of Cryptococcus gattii with Terminalia catappa trees present in urban areas of Montería city in Colombia.

Methods: a total of 163 Terminalia catappa trees were selected; some samples were taken from the bark, the leaves, the flowers, the fruits of these trees and from the surrounding soil. The yeast was isolated using the Guizotia abyssinica seed agar medium; it was identified thanks to biochemical and morphologic tests whereas the right variety was determined by L-canavanine-glycine-bromothymol blue (CGB), D-proline and D-tryptophan tests.

Results: there was obtained 9.050 CFU/g isolate of Cryptococcus spp., 5.795 CFU/g of which were presumptively identified as Cryptococcus gattii. The highest percentage of isolates was found in flowers, followed by bark and fruits, presenting small cellular and capsular sizes. These isolates were more frequent in the south of the city, followed by the center zone and the lowest percentage in the northern zone.

Conclusions: these findings confirmed the close relationship of Cryptococcus gattii and Terminalia catappa, being this the first study conducted in Monteria city. These results give us meaningful information for understanding and analyzing the epidemiology of cryptococcosis in Monteria city, Colombia.

Introduction: frequent relapses and high lethality of criptococcosis has encouraged the search for new therapeutic strategies.

Objectives: to evaluate the effect of the monoclonal antibody 4B3 on the cryptococcal infection in Balb/c mice.

Methods: the kinetics in serum concentration of the studied monoclonal antibody was determined for intraperitoneal administration (500 microg) by quantitative sandwich ELISA. In order to assess its protective capability, were administered 500 microg of 4B3 and innoculated 2 x 10(22) cells/mL of Cryptococcus neoformans. The survival of mice was recorded and the yeast dissemination to the main target organs was evaluated. Macrophages P338.D1 cell lines were used to measure the effect of the monoclonal antibody 4B3 on the phagocytosis and lysis of the microorganism.

Results: the used dose helped to keep high values (38 microg/m) of 4B3 in serum for at least 46 days. It was found that the monoclonal antibody does not give protection, which makes the microorganism dissemination possible, along with the reduction in the survival of mice. Finally, the phagocytosis test showed that 4B3 increased the phagocytic activity of macrophages without any fungicidal effect.

Conclusions: the monoclonal antibody 4B3 stimulates C. neoformans phagocytosis by macrophages without fungicidal effect, thus favoring yeast dissemination and decreasing the survival of mice due to cryptococcal infection

Introduction: antigen immobilization in solid supports is used for the development of several immunoassays. One of the first technologies developed was the protein adsorption by direct application to nitrocellulose.

Objective: to standardize the immobilization of a synthetic peptide of the HIV-2 transmembrane protein gp36 to nitrocellulose support for diagnostic purposes and to evaluate the performance parameters in a group of serum samples with recognized interesting reactivity.

Methods: the peptide was freely immobilized, conjugated to bovine serum albumin (BSA) and to keyhole limpet hemocyanin (KLH) as carrier proteins. Immobilization parameters were analyzed and then, the optimal immobilization alternative was determined. Using the chosen variant, the diagnostic sensitivity and specificity against reference panels of the AIDS Research Laboratory were evaluated. Analytical specificity was evaluated with reactive samples to HIV-1 and HTLV-1.

Results: the analysis of the immobilized peptide variants to nitrocellulose membranes showed that the gp36 peptide-BSA was the one that succeeded in setting the greatest differentiation between positive and negative samples. There were observed 100 % sensitivity, 95.2 % diagnostic specificity and 100 % analytical specificity.

Conclusions: the gp36-BSA peptide immobilized on nitrocellulose membranes showed efficacy for the serological diagnosis of HIV-2, which will allow considering this peptide for diagnostic uses in systems with nitrocellulose -based solid phase.

Introduction: the first pandemic virus of the 21st century - the influenza A (H1N1)/2009 virus-appeared in Mexico in April 2009 after triple reassortment of influenza strains of avian, human and pig origin and from there, it was spread worldwide. With the purpose of facing up to this event, Cuba adopted antipandemic measures including the virology surveillance using all necessary actions.

Objectives: the detection and validation of the entry of the causative agent of pandemic into the country in a fast and timely way, in addition to the definition of involvement of other viruses in the etiology of acute respiratory infections.

Methods: as a result of the lab surveillance, from the 38th to the 42nd epidemiological weeks (September and October, 2009), 1 063 respiratory clinical samples were processed (nasopharyngeal exudates, bronchial aspirates and lung necropsy samples). The highest number of confirmed cases caused by the new virus was detected in this period that represented the first pandemic wave in Cuba. Diagnosis was based on molecular diagnosis algorithm.

Results: out of the 1063 samples, 597 (56.0 %) were positive. The pandemic influenza A (H1N1) virus was the most commonly detected etiological agent in 306 suspected cases (51 %) followed by influenza A (H3N2) virus in 228 cases (38 %). Other respiratory viruses were diagnosed in 63 clinical samples (11 %). The pandemic virus was confirmed in 50 pregnant women. Rhinoviruses were identified more frequently in those samples from patients with clinical diagnosis of bronchial pneumonia and broncholitis. Morbidity increased during this period; 225 825 medical consultations were notified due to acute respiratory infections mid-October 2009.

Conclusions: the molecular diagnosis algorithm proved to be sensitive, specific and effective to assure the systematic virological surveillance in our country during the pandemic phase.

Introduction: Pneumocystis jirovecii is one of the most important opportunistic pathogens affecting AIDS individuals and immunodepressive patients. In spite of the fact that it was observed one hundred years ago for the first time, many fundamental aspects of its biology and the morbidity it causes are still unknown.

Objective: this paper was aimed at presenting updating on the main aspects of the history, the epidemiology and the biology of P. jirovecii and the disease it causes.

Conclusions: a number of review articles have been published since the discovery, all of which provide details and novel elements of the microorganism. However, few original papers dealing with this problem have been found in the Spanish literature.

Introduction: the diagnosis of pulmonary tuberculosis in sputum smears-negative patients is a challenge for today's medical practice, mostly supported on clinical and radiographic elements. In Hospital Neumológico Benéfico Jurídico of Havana, there is an expert commission for the sputum smear-negative diagnosis of tuberculosis called CODIBAARNE.

Objective: to identify the radiological patterns and the final diagnosis of patients submitted to this committee from October 2002 to December 2003.

Methods: a descriptive study was conducted in a sample of patients within the above-mentioned period, who had been studied and followed-up in Hospital Neumológico Benéfico Jurídico in order to define their final diagnoses under the CODIBAARNE commission recommendation. Data were gathered from the register of patients and from the individual medical histories.

Results: the average age of these patients was 68.2 years and 57 % were males. The most frequent symptoms were cough (76 %), general syndrome (70 %) and expectoration (61 %). The mostly seen radiographic patterns were infiltrates, with or without cavitation (44 %) and fibrotic lesions (34 %). The most common diagnoses showed bronchiectasia (26 %), followed by sputum smears-negative pulmonary tuberculosis (24 %).

Conclusions: the results of this research work evinced the importance of the work by the group of experts in CODIBAARNE regarding the sputum smears-negative diagnosis of tuberculosis cases.

Introduction: meningococcal disease is an important health problem worldwide. Since 1991 the vaccine VA-MENGOC-BC has been used in Cuban under one-year old infants.

Objective: to evaluate the effectiveness of the vaccine VA-MENGO-BC METHODS: for the evaluation after licensing this vaccine, all the infants affected by meningococcal disease between 1997 and 2008 were studied.

Results: a total number of 114 cases were recorded. The annual average incidence was 7.1 per 100 000 infants. The mean vaccinal effectiveness for the period was 84.0 %, ranging from 68 % to 104 %. The frequency of disease in unvaccinated children was 20.2 % (23/114); 79.8 % (91/114) within the vaccination age, but only 75.8 % (69/91) of them had confirmed the immunization date. Only 26.4 % (24/91) had one single dose applied whereas 73.6 % (67/91) had completed their vaccination schedule (2 doses). The meningococcal disease prevailed in the first six months of life, declined afterwards and then started to rise again at 10 and 11 months of age. The meningeal form of clinical presentation predominated (89.5 %); case-fatality rate was 7.0 % (8/114), being 4.4 % for meningococcemia and 2,6 % for meningitis.

Conclusions: the vaccine VA-MENGOC-BC effectiveness in infants was satisfactory. It is suggested that further analysis be made by a group of experts on the use of a booster dose.

Introduction: malaria is considered to be a serious health problem in Haiti, mainly in the rural zones of the coastal area located at 600 m above the sea level, particularly shallow zones with rice crops.

Objective: to describe the actions taken in four sites of two Haitian departments to face the rise of the number of malarial cases.

Methods: the advisory work was carried out in three communities located in the West department and one in Nippes department in April 2010. Fever screenings along with sample-taking for thick smear test were performed as well as anti-vector activities including search for breeding sites and thermal treatment in the house and out of it.

Results: it was confirmed in this thick smear test that not all the persons presenting with febrile symptoms suffered malaria since low positive values to this disease were obtained. During this study, only Plasmodium falciparum was diagnosed. Out of the 46 breeding sites, 26 were positive to Anopheles albimanus. The impact of insecticidal treatment could not be assessed since the areas did not have preliminary data on this respect.

Conclusions: these results provide the malaria control program with pieces of knowledge about the distribution and control of vectors in addition to emphasizing the need of making an updated stratification of the incidence of the disease that comprises all the aspects of the malaria control program in Haiti.