Archivos Venezolanos de Farmacología y Terapéutica

Malaria due to Plasmodium knowlesi in South-Eastern Asia and America. May imported cases represent a health care alert?: Plasmodium knowlesi as the fifth malaria parasite

Comportamiento de indicadores de calidad del cultivo en los laboratorios de diagnóstico de tuberculosis en la provincia de Las Tunas, Cuba

Antecedentes: El cultivo bacteriológico, es la prueba de oro para el diagnóstico definitivo de la tuberculosis (TB). La finalidad del control de calidad es mejorar continuamente la eficiencia y el uso del cultivo como una alternativa de diagnóstico y monitoreo, asegurando que la información generada por el laboratorio sea confiable y exacta. Método: Se calcularon los indicadores de calidad (IC) a 5799 cultivos de las muestras de esputo de pacientes con TB pulmonar confirmada bacteriológicamente, recibidas en los laboratorios de diagnóstico de TB de la provincia Las Tunas, 4721 del laboratorio del Centro Provincial de Higiene y Epidemiología (CPHE) y 1078 del laboratorio del Centro Municipal de Higiene y Epidemiología (CMHE) de Puerto Padre, en el período de octubre del 2003 a septiembre del 2005. Resultados: En el CPHE la tasa de contaminación (TC), el aporte del cultivo al diagnóstico (ACD) y el % baciloscopía positiva con cultivo negativo fue de 4.3%, 34.8% y 6.3% respectivamente. En el laboratorio del CMHE la TC presentó un valor de 7.6% y el resto de los indicadores fue de 0%. Conclusiones y recomendaciones: Los indicadores de calidad del cultivo en el laboratorio del CPHE de Las Tunas, exceptuando el % BK (+) CU (-), presentaron valores aceptables para un buen desempeño del laboratorio; en el laboratorio del CMHE de Puerto Padre los valores de los IC, a excepción del % BK (+) CU (-), fueron superiores establecidos por las normas internacionales. Recomendamos incorporar el cálculo de los IC a la red nacional de laboratorios que realizan cultivo, para conocer y evaluar los resultados del trabajo e incorporar la evaluación de la sensibilidad del medio de cultivo para mejorar el rendimiento y la calidad del diagnóstico de la TB.

Background: The bacteriological culture, it is the golden test for the definitive diagnosis of the tuberculosis (TB). The purpose of the quality control is improve the efficiency and use of culture like an alternative of diagnosis and monitoring, and assuring that the information generated by the laboratory are reliable and exact. Method: The quality indicators (QI) were calculated in 5799 sputum samples, from patients with pulmonary TB confirmed by bacteriological culture, received in the TB diagnosis laboratories from Las Tunas province, 4721 from TB Laboratory of the Hygiene and Epidemiology Provincial Center (HEPC) and 1078 from TB Laboratory of the Hygiene and Epidemiology Municipal Center (HEMC) of the Puerto Padre municipality, from October 2003 to September 2005. Results: In the HEPC the contamination rate (CR), the culture contribution to the diagnosis (CCD) and the percent of positive baciloscopy with negative culture (% BK+ CU -) was 4.3%, 34.8% and 6.3% respectively. In the laboratory of the HEMC the CR was 7.6% and the rest of the indicators were 0%. Conclusions and recommendations: The QI of culture in the HEPC laboratory from Las Tunas municipality, excepting the % BK (+) CU (-) presented acceptable values for a good performance, in the HEMC laboratory from Puerto Padre municipality, the IC values, to exception of the % BK (+) CU (-), were superiors to the established for the international norms. We recommended incorporate the calculation of QI in the national network of laboratories culture, in order to improve the yield and quality of TB diagnosis.

Tubercular disease caused by bacillus of Calmette-Guerin administered as a local adjuvant treatment of relapsing bladder carcinoma.: Pathogenetic, diagnostic and therapeutic issues, and literature review

Two exemplary case reports of respiratory granulomatous infection caused by bacillus of Calmette-Guérin (BCG) in patients who were repeatedly treated with local, intravesical adjuvant BCG therapy for a relapsing transitional bladder carcinoma, are outlined and discussed, on the ground of the cumbersome diagnostic and differential diagnostic process (especially when a prior tuberculosis and a concurrent chronic obstructive pulmonary disease are of concern), and an updated literature revision. Only four cases of respiratory BCG-itis (pulmonary tuberculosis-like forms), have been reported until now to the best of our knowledge (two of them following bladder instillation of BCG). One episode of ours represents the first described case with a dual, concomitant granulomatous localization of BCG-itis, also involving the genitourinary tract.

Micobacteriosis sistémica por Mycobacterium avium en paciente con SIDA

Se analizaron repetidas muestras procedentes de un paciente cubano con SIDA, para descartar la presencia de bacilos ácido alcohol resistente (BAAR), pasadas 2-3 semana en las muestras de esputo, líquido cefalorraquídeo y de hemocultivo que habían sido procesadas y cultivadas se detecta la presencia de algunas colonias, como resultado se obtuvo el aislamiento de una cepa micobacteriana no pigmentada, de crecimiento lento perteneciente al Grupo III de Runyon, esta cepas fueron clasificadas como Mycobacterium avium por los métodos convencionales establecidos para la identificación de cepas micobacterianas, como técnica confirmativa diagnóstica se utilizó el análisis de las fracciones de ácido micólicos por la técnica de cromatografía en capa delgada bidimensional. El objetivo fundamental de este estudio ha sido reportar el primer caso de micobacteriosis sistémica en un paciente cubano con SIDA.

Several sputum and blood culture simples from a Cuban HIV/AIDS patient were analyzed to discard the presence of alcohol acid resistant bacillus. After 2-3 weeks the culture revealed in both kinds of samples some colonies from non-pigmented mycobacterium strain with slow growth and belonging to III Runyon Group. This strain was classified as Mycobacterium avium by conventional methods established for mycobacterium identification. To diagnostic confirmative method was used the analysis of fraction mycolic acid by bi-dimensional thin layer chromatography. The main objective of this study was to report the first case of systemic mycobacteriosis in a Cuban HIV/AIDS patient.

Calidad de prescripción de antimicrobianos en servicios seleccionados en hospitales clínico quirúrgicos

Objetivo: Evaluar la calidad de prescripción de antimicrobianos en dos hospitales universitarios clínico quirúrgicos de La Habana. Método: Estudio de prevalencia puntual de pacientes ingresados en los servicios de cirugía general, medicina interna, urología, y unidades de cuidados críticos, en junio 2008. Se obtuvo información de aquellos que utilizaban antimicrobianos, la que fue analizada por expertos, que determinaron aquellos con prescripción inadecuada. Se calculó la proporción uso de antimicrobianos y la proporción de prescripción inadecuada. Resultados: El 25,3% y 33,2% de los pacientes utilizaban antimicrobianos en los hospitales. El servicio de medicina interna del hospital B tuvo una proporción de uso (28.7%) superior al hospital A (6.06%). El hospital A tuvo frecuencias de uso inadecuado (77,1%) superiores (p < 0,05), siendo las causas fundamentales el uso sin evidencias de infección, la elección incorrecta del tratamiento y la profilaxis impropia. Conclusión: Se demuestran deficiencias en la calidad de prescripción que requieren fortalecer políticas institucionales, controles de calidad y programas formativos sobre antimicrobianos.

Objective: To assess the quality of antimicrobials prescription in two university hospitals of Havana. Method: Puntual prevalence study were carry out in general surgery, internal medicine, urology, and critical care unit services, in June 2008. Information was obtained of those that used antimicrobials, the one that was analyzed by experts that determined those with inadequate prescription. It was calculated the proportion antimicrobials use and the proportion of inadequate prescription. Results: 25,3% and 33,2% of the patients used antimicrobials in hospitals. Internal medicine of the hospital B had an use proportion (28.7%) superior to the hospital A (6.06%). The hospital A highest frecuencies of inadequate use (77,1%) (p <0,05), being the fundamental causes the use without infection evidences, the incorrect election of the treatment and the inappropriate prophylaxis. Conclusion: Deficiencies are demonstrated in the quality of prescription that require to strengthen of political institutional, controls of quality and formative programs on antimicrobials.

Efectos de la administración crónica de alcohol sobre la conducta motora y su relación con el sistema colinérgico muscarinico en ratas Sprague Dawley bajo estrés discontinuos

El alcohol y el estrés son problemas de salud pública que afectan el Receptor Colinérgico Muscarínico (RCM). En el presente trabajo se estudia el efecto de ambos fenómenos sobre la funcionalidad y densidad del RCM. Métodos: 43 ratas Sprague Dawley se dividieron en 4 grupos: Control (n=12), Estrés (n=11), Alcohol (n=10) y Alcohol-Estrés (n=10). A los grupos alcohol se le administró diariamente etanol al 10 % ad libitum y los grupos Estrés se sometieron a nado forzado a 5°C por 5 min tres veces/semana. Resultados: las ratas tratadas con alcohol presentaron adicción e hipermotilidad, siendo el efecto mayor en el grupo alcohol-estrés. Escopolamina incremento la motilidad en todos los grupos. No hubo diferencias significativas entre los grupos en el desempeño en el Rotarod. La densidad de los RCM estuvo disminuida significativamente en Hipocampo en el grupo alcohol. Conclusión: el alcohol induce trastornos del RCM relacionados a hipermotilidad.

Alcohol consumption and stress are health problems, which affects the Cholinergic Muscarinic Receptor (CMR) system. Here we studied the effect of both phenomena on CMR functionality and densities. Methods: 43 Sprague Dawley rats were divided in 4 groups: Control (n=11), Stress (n=10), Alcohol (n=10) and Alcohol-Stress (n=9). Alcohol groups received 10% ethanol ad libitum in substitution of water every day, stress groups were submitted 3 days at week to 5 min force swimming at 5°C. Results: rats that had alcohol displayed addiction and hypermotility, the effect was higher at alcohol-stress group. Scopolamine significantly increased motility in all groups. No differences were observed at Rotarod performance. CMR density was decreased in hippocampus of rats belonging to alcohol group. Conclusion: alcohol induces motor disturbances related to CMR system.

Posible efecto antioxidante de la atorvastatina en individuos hiperlipidemicos

La Atorvastatina es usada en el tratamiento de hiperlipidemias por su acción de inhibición de la 3-Hidroxi-3-Metilglutaril Coenzima A reductasa. Adicionalmente, se ha demostrado que pueden reducir el estrés oxidativo y la susceptibilidad de la LDL-C a la oxidación. Considerando estos efectos pleiotrópicos de la Atorvastatina, se propuso esta investigación con el Objetivo: Evaluar el posible efecto antioxidante de la Atorvastatina, sobre los niveles séricos de α-Tocoferol y Retinol en individuos hiperlipémicos. Metodología: previo consentimiento informado, a 30 individuos hiperlipidémicos, se les determino el perfil lipídico, (enzimático-colorimétrico) y vitaminas A y E (HPLC) antes y después de tratamiento por un corto período (7 días) con dosis diferentes de Atorvastatina según criterio médico. Resultados: el tratamiento con 10 mg disminuyó significativamente los Triglicéridos, el Colesterol Total y LDL-C, (p=0.0308), (p=0.031) y (p=0.0193), con un incremento del 2,26% en las HDL-C. La dosis de 20 mg intensificó significativamente el efecto mencionado para los triglicéridos, Colesterol total y LDL-C (p=0.0211), (p=0.0001) y (p=0.0001) respectivamente. Los valores de Vitaminas A y E presentaron un incremento significativo con la dosis de 20 mg. Conclusión: el tratamiento con Atorvastatina a las dosis de 10 y 20 mg disminuyó Triglicéridos, el Colesterol Total y LDL-C en una forma dosis-dependiente. Este efecto y el incremento de las vitaminas A y E reflejan no sólo un efecto hipolipidemiante, sino además a un efecto pleiotrópico, en este caso antioxidante.

The Atorvastatin is used in the treatment of hyperlipidaemia owing its action of inhibition 3-hydroxy-3-methylglutaryl coenzyme A reductase. Additionally, they have showed to reduce oxidative stress and the susceptibility of LDL-C to oxidation. Considering these pleiotropic effects of Atorvastatin this research was proposed with the Objective: To evaluate the possible antioxidant effect of the Atorvastatin on the serum levels of α-Tocopherol and Retinol in hyperlipidemia individuals. Methodology: prior informed consent, 30 individuals with hyperlipidemia, was analyzed for lipid profile (enzymatic-colorimetric) and vitamins A and E (HPLC) before and after short-term treatment (7 days) with different doses of Atorvastatin. Results: Treatment with 10 mg significantly decreased triglycerides, total cholesterol and LDL-C, (p = 0.0308), (p = 0.031) and (p = 0.0193), an increase of 2.26% in HDL-C. The dose of 20 mg intensified significantly the mentioned effect, triglycerides, total cholesterol and LDL-C (p = 0.0211), (p = 0.0001) and (p = 0.0001), respectively. The values of Vitamins A and E showed a significantly increase with dose of 20 mg. Conclusion: Treatment with Atorvastatin at doses of either 10 or 20 mg decreased triglycerides, total cholesterol and LDL-C in a dose-dependent manner. The effect and the increase of Vitamin A and E levels could reflect not only a lipid lowering effect, but also a pleiotrópico, in this case antioxidant effect.

Iatrogenic equine metabolic syndrome in thoroughbred horses

Reasons for performing study: Equine metabolic syndrome (EMS) is a cluster of problem that includes obesity, insulin resistance and laminitis. In EMS peripheral adipocytes synthesize adipokines which are analogous to cortisol, resulting in Cushing syndrome like-signs and insulin resistance. The used of dexamethasone and triancinolone is very common and not permitted. Hypothesis or Objectives: The objective of this study was to describe metabolic syndrome iatrogenic in Thoroughbred horses. Methods: Were studied 22 Thoroughbred horses (12 female and 10 male), between 2-5 years old, in the national race Track La Rinconada Caracas-Venezuela. All equine were euthanized and study by necropsy. Samples were collected from the adrenal glands, gastric mucosa, pancreas, kidneys, liver, spleen, lungs, heart and adenohypofisys. Tissue sections were prepared and stained with Hematoxilin & Eosin (H&E) for light microscopy. Results: Clinical signs were polyury, polydipsy and secondary diabetes mellitus, recurrent infection, lethargie, laminitis and weight loss syndrome. Were isolates of recurrent infection: Salmonella sp., E. coli, Streptococcus sp, Staphylococcus, Enterococcus faecalis and Enterobacter cloacae. Necropsy revealed: weight loss, loss fatty subcutaneous, xantomathosis of subcutaneous tissue. Abscess in coxal tuberous, facial and shoulder region. Liver was swollen, friable and icteric. Renal cortical and papillary necrosis. Equine gastric ulcer syndrome severed. Liver with periacinar necrosis with a prominent acinar pattern and fatty degeneration severed. Necrosis and vacuolar (glycogen) degeneration islets of langerhans, fibrosis and chronic. Renal cortical and medullary necrosis, acute tubular necrosis and glycogen nephrosis, glomerulonephritis membranous. Hemorrhages in adrenal cortex and atrophy cortical. Conclusions: These results suggest a iatrogenic EMS in Thoroughbred associated with overdose and chronic dexamethasone and triancinolona. Potential relevance: This article is a clinical study, laboratory, bacterial, macroscopic and histopathological describing the clinical pathologic presentation of metabolic syndrome pathological in Thoroughbreds horses associated with overdose and chronic dexamethasone and triancinolona.