Revista Cubana de Medicina Tropical最新文献

Introduction: the oxidative stress (OS) has been recognized as a co-factor of HIV infection evolution to AIDS condition.

Objectives: to evaluate the possible antioxidant effect and the impact on the functioning of several systems in the body, resulting in the toxicological safety of Vimang use.

Methods: sixty eight HIV-seropositive patients were double-blind randomized in two groups; the first was supplied with Vimang during six months and the other with placebo. Redox condition and the biochemical indexes of the hematological, renal and hepatic functions were measured. Also, dietary intake was assessed through surveys administered for 7 days at the beginning and at the end of the study.

Results: there were statistically significant differences between the groups regarding positive change in redox figures in Vimang group compared to those of the placebo group. No significant difference was found either in the evaluated dietary intake indexes or in the biochemical indexes of the renal, hematological and hepatic functions at the end of the study.

Conclusions: Vimang antioxidant effect was shown, without any toxic influence during the six month-study conducted in HIV/AIDS patients.

Introduction: the continuous use of the organophosphate temephos for Aedes (Stegomyia) aegypti (Linnaeus, 1762) has prompted the emergence of resistance to this product in several countries. Pyriproxyfen is an analogue of the juvenile hormone recommended by the World Health Organization as one of the alternative regulators of the dengue vector in drinking waters.

Objectives: to evaluate the efficacy of pyriproxyfen in those strains with various degrees of temephos resistance, in order to be used as a possible regulator of Ae. aegypti.

Methods: for this study, two reference Ae. aegypti strains were used, one susceptible and the other resistant to temephos, and three field strains collected in Boyeros, Cotorro and 10 de Octubre municipalities, all of them from the City of Havana province, Cuba. For the temephos and pyriproxyfen evaluation, the WHO recommended bioassays were used.

Results: at high concentrations, pyriproxyfen showed larvicidal properties. At 0,01 and 1 ppb concentrations, inhibition of emergence due to increase of pupal mortality and to lesser extent in adults in the process of breaking the pupal exubia was demonstrated. This growth regulator was effective at the same doses in all the strains, regardless of the degree of temephos resistance, being IE50 values within the range for Aedes genus.

Conclusions: according to the results, the effectiveness of pyriproxyfen was not affected by the degree of temephos resistance in the studied strains, and this is a useful tool in the Ae. aegypti control.

Introduction: the Rhodococcus equi is one bacterium of the order Actinomycetales. It rarely appears in humans, but the HIV/AIDS epidemic has increased the number of cases and the main affected organ is the lung. It causes pneumonia characterized by a slow clinical and radiological progression.

Objective: to describe the initial radiological alterations from R. equi infection in 8 AIDS patients, the radiological evolution and the clinical and immunological presentation.

Methods: a retrospective descriptive study of radiological pulmonary images from AIDS patients with respiratory infection due to Rhodococcus equi was conducted.

Results: these patients presented with high fever (39 degrees C), cough with expectoration and shortness of breath. Homogeneous opacity was the most frequent radiological presentation (62,5% of cases), located predominantly in the lower lobules. The radiological evolution was characterized by opacity with inner cavitation in 4 cases, fibrosis in 4 cases, and one case showed total recovery of lesions. The CD4+ T-cell count was low in all the patients. The evolution ranged from 2 to 33 months.

Conclusions: the R equi pneumonia diagnosis should be borne in mind when dealing with HIV/AIDS patients with compromised immunological condition and breathing process with radiological manifestation of pulmonary consolidation evolving into cavitation, and torpid and prolonged clinical and radiological evolution.

Unlabelled: IINTRODUCTION: the occurrence of nosocomial infection in an intensive care unit is very high and increases the possibilities of the patient's death and the cost of care.

Objectives: to find out and apply diagnosis algorithms for nosocomial infection surveillance at the critical patient care service.

Methods: in 2005, a three-phase research study was carried out in "Cira Garcia" clinics: management and analysis of international and national information on this topic, the preparation of the algorithm, and the application of such algorithm in nosocomial infections surveillance at the progressive care units.

Results: three algorithms were found for the most frequent infections and they were used for the nosocomial infection diagnosis for 4 years.

Conclusions: the use of these algorithms is a good supporting method to identify nosocomial infection, which leads to a better and prompt diagnosis and facilitates the involvement of infectious control staff in the individual analysis of each patient.

Objectives: to evaluate the feasibility and immediate effect of an enabling intervention to improve the active screening of respiratory symptomatic patients in groups at risk of suffering tuberculosis and the quality of filling in lab records.

Methods: a quasi-experimental-designed intervention study was conducted in two health areas of Boyeros municipality (Salvador Allende polyclinics and Federico Capdevila polyclinics). Two other areas were selected as controls in "10 de Octubre" municipality ("Turcios Lima" polyclinics and "Puente Uceda" polyclinics). Family physicians and nurses were then trained to identify patients with respiratory symptoms in the risk groups during home visits, finally sputum tests were indicated. A new model for lab recording was used. After 2 months, the ratio of detected respiratory symptomatic cases was estimated. The relative risk (95 % CI) was found. The percentage by type of screening, risk group and number of empty, misplaced and wrongly filled in items in the new model was calculated.

Results: after the intervention, the capabilities of physicians and nurses for detecting respiratory symptomatic patients in "Salvador Allende" health area was almost 2.5 times higher than before (RR= 2.4320) and in "Federico Capdevila" health area was almost 2 times higher (RR = 1.8112). Over 80 % of this improvement was due to active screening carried out almost completely (90 %) in risk groups. There were no misplaced or wrongly filled data, just empty items under 0.5%.

Conclusions: the enabling intervention proved to be immediate and effective in order to raise the active screening of respiratory symptomatic patients in risk groups and to improve the quality of filling in lab records.

This paper assessed the impact of the immunoenzymatic assays on the field of the immunochemistry-based analytics for the last 40 years, and on the detection of infectious agents or the products related to their presence and/or pathogenic activity. It also addressed some designs and formats of these immunoassays from electrochemical methods of detection, assays to determine proteolytic microbial activity and their inhibitors as possible therapeutical targets, more sensitive direct triple antibody systems, alternative enzymatic activity detectors, assays for viral serology of minimal determinations to competitive assays for evaluation of vaccinal candidate effectiveness based on selected peptide combinations. Finally, it provided a rapid overview of the near future of this type of immunoassays in the light of the emerging detection analytical technologies.

Introduction: resistance to organophosphorus insecticides was diagnosed in Aedes aegypti (Linnaeus, 1762) from Santiago de Cuba in 1997 and some of them are still used up to date; hence the need of ascertaining how the insecticidal resistance has changed in recent times, particularly in 2009.

Objective: to evaluate the resistance to organophosporus insecticides in larvae from Santiago de Cuba collected in 2009, and its variation in comparison with that observed in 1997; and to determine the frequency of occurrence of resistance mechanisms on the basis of high esterase activity and its classification.

Methods: resistance to organophosphorus insecticides such as malathion, pirimiphos, methyl, phenitrotion, phention, temephos and clorpiriphos in larvae by using the WHO recommended methodology. The esterase mechanism was identified through biochemical assays and polyacrylamide gel electrophoresis.

Results: larvae from the Santiago de Cuba strain were susceptible to malathion, pirimiphos, methyl and phenitrothion; there was no variation with the results achieved in a Santiago de Cuba strain in 1997, moderate resistance to phenthion and high resistance to temephos and chlorpiriphos were observed. When comparing these results with those of 1997, it was noted that resistance to the three insecticides increased in the 1997-2009 period. In the Santiago de Cuba strain 2009, it was shown that esterase activity was very high at a rate of 0.7. The presence of an amplified type B esterase with relative mobility of 0.95 cm was detected, which did not exist in the reference strain.

Conclusions: resistance to insecticides and its mechanisms are highly variable, even in the same species subjected to various intensities in the insecticidal use, therefore, it is necessary to constantly monitor both aspects at local level in the course of time, with a view to an effective vector control program.

Introduction: in the fight for environmental protection, finding out alternative ways to control vectors that are important from the medical viewpoint is a must. Those plants having potent active principles and high chemical stability to act as pesticides can contribute to this end.

Objective: to evaluate the possible inhibitory effect of photochemically-modified turpentine oil on Aedes aegypti larvae growth.

Methods: Aedes aegypti larvae of an insecticide-sensitive strain from the insect breeding site located in the Institute of Tropical Medicine were used. During a week after the exposure to the lethal dose causing 90% mortality, the mortality indexes of larvae and pupas were recorded as well as the number of emerged adults and their sex in addition to adults stuck to the exuvias.

Results: high larval and pupal mortality was observed in the survivors to the lethal dose causing 90% mortality after one week of the exposure; mortality index was 39.46%. Larvae which managed to grow to become adults amounted to 60.54% of the surviving larvae. Female to male ratio was very similar in the control whereas the exposed group showed a higher number of male adults. On estimating the hatching inhibition percentage, it got 36.47%.

Conclusions: the activity of turpentine oil as larvicide and Ae. aegypti growth inhibitor was demonstrated.

Introduction: oropharyngeal candidiasis is an early marker of progression to AIDS in H1V-positive patients and an indicator of non-adherence of treatment or possible failure in patients undergoing anti-retroviral therapy.

Objective: to determine the in vitro susceptibility to nystatin in Candida strains isolated from the oral cavity of HIV-positive patients, and to correlate the results with the response to treatment.

Methods: a study of in vitro susceptibility to nystatin was conducted in 104 oral isolates from 97 HIV/AIDS patients, who participated as volunteers in a clinical trial to evaluate the response to four antifungal drugs. Fifty-eight of the 104 isolates were obtained before starting treatment and the remaining 46 at the end of therapy. Broth microdilution method was performed according to the document M27-A3 of the Clinical and Laboratory Standards Institute.

Results: one hundred percent of the strains were susceptible to nystatin, with minimum inhibitory concentration (MIC) values of <16 microg/mL, regardless of the time of isolation and of the drug administered to patients. In the group of patients treated with nystatin, the MIC80 ranges (1-2 microg/mL), geometric mean and cumulative values of the drug against Candida albicans isolates before starting treatment were similar to those obtained against strains recovered at the end. Among the identified species, C. lusitaniae reached the highest absolute MIC value (4 microg/mL).

Conclusions: the correlation between the clinical evolution and the results of in vitro susceptibility tests was good in patients with a favorable outcome; however, it did not allow predicting possible treatment failure.

Introduction: Cryptoccosis--systemic mycosis caused by Cryptococcus species--has considerably raised its incidence in the last years, mainly associated with the human immunodeficiency virus infection. It has also been described in animals, but rare cases.

Methods: a case of a female cheetah (Acinonyx jubatus) kept in the Nacional Zoo of Havana was presented. The animal came from South Africa. She began losing weight, and suffering asthenia, anorexia and breathing problems with abundant nasal secretion.

Results: mycological testing of these secretions disclosed the presence of serotype B Cryptococcus gattii. Because of the origin and captive condition of the animal, it was believed that the infection had been latent for 16 months at least.

Conclusions: up to the present, in Cuba, all clinical Cryptococcus isolates were C. neoformans var. grubii, so it is considered that the infection was caught in the country of origin of the female cheetah. This is the first C. gattii isolate in Cuba from an animal coming from South Africa where this fungus is endemic.