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The bacteriological diagnosis of gonorrhea in women has a low efficiency. A dot immunobinding assay, using whole piliated Neisseria gonorrhoeae cells, was used to detect antigonococcal antibodies in 300 prostitutes in whom a parallel Thayer-Martin culture of endocervical secretion was performed. Twenty sera from men with bacteriologically confirmed gonorrhoea were used as positive controls and 20 sera from children without history of gonococcal infections, as negative controls. Antibodies were detected in 49.7% of women and culture was positive in only one. All men with gonorrhea has positive titers and all sera from children were negative, except one that had a cross-reaction. Test sensitivity in the female population was 1 and specificity 0.5. There were no false negative reactions. Although the test detected antibodies in high risk women, there were cross-reactions. Therefore, the technique should be improved, using a more specific antigen.

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The aim of this work was to study the clinical, epidemiological and laboratory features of 90 children, hospitalized between 1988 and 1991 with the diagnosis of acute bacterial meningitis in a region with a high proportion of aboriginal population. Twenty six percent of studied patients were of mapuche origin. The causative organism was identified in 82% of cases (H influenzae in 38% of cases, S pneumoniae in 29% and N meningitidis in 10%). H influenzae was resistant to ampicillin in 16% of cases and resistant to chloramphenicol in 4%. This agent was identified in 52% of patients of mapuche origin compared with 33% of non mapuche patients. Seventy three percent of children were less than 2 years old. Thirty seven percent of children had complications during hospitalization, 12 children died (13.3%) and 38% of children had neurological sequelae at the moment of discharge.

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Fifty samples of cerebrospinal fluid (CSF) from patients with acute bacterial meningitis were studied with direct gram examination, culture and latex agglutination. Twenty one of these samples had previous antimicrobial treatment. In 42 patients, blood cultures were also made. Thirty control CSF samples were also studied. The diagnostic yield of CSF culture was 72%, of direct gram examination 74% and latex agglutination 80%. All the techniques as a whole has a diagnostic yield of 92%. In the 21 CSF samples with previous antimicrobial treatment, culture was positive in 47.6% and latex agglutination in 85.7%. All control CSF samples were negative. It is concluded that the diagnostic yield of latex agglutination test in patients with previous antimicrobial treatment is significantly better than culture.

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Ninety four children with diarrhea and a positive stool culture for Shigella, hospitalized at the Hospital Regional de Temuco, were studied. Forty six percent of patients were less than two years old. Forty two percent of microorganisms were resistant to Ampicillin, 45% to trimethoprim/sulfamethoxazole, 8% to tetracycline and none to chloramphenicol. Isolated species were Shigella flexneri 83% and Shigella sonnei 17%. Seventy nine percent of patients had fever, 60% dysentery and 21.3% seizures. Ninety two percent of symptomatic family contacts had a positive stool culture for Shigella. Due to the high incidence of resistance to ampicillin and trimethoprim/sulfamethoxazole, these antimicrobials are not recommended as the first choice treatment of Shigellosis in the Ninth region of Chile.

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We evaluated immunofluorescence techniques to investigate the presence of S pneumoniae, N meningitidis, H influenzae types a and b and L monocytogenes in 85 samples of CSF fluid: 60 were taken from patients suffering meningitis and 25 from a control group. Results were compared to conventional bacteriologic methods. There were no false positive results in the control group. In patients with meningitis, 28 were positive by both methods. Nine additional patients were positive only to immunofluorescence which allowed identification of S pneumoniae in 6, N meningitidis in 2 and H influenzae in 1. 37 samples were positive by immunofluorescence and 28 of them were positive to conventional bacteriology. There was only 1 case of Group B streptococcus identified by bacteriology which was not diagnosed by immunofluorescence. Thus, immunofluorescence increases the ability to make a bacteriologic diagnosis in patients with meningitis.

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Se estudiaron 46 ninos de bajo peso de nacimiento (peso de nacimiento menor o igual a 2.500 gramos), y 129 ninos de peso de nacimiento normal (peso de nacimiento mayor o igual a 2.501 gramos), controlados en un consultorio periferico de Santiago, con el objetivo de describir la incidencia de desnutricion en ambos grupos y determinar la magnitud de las acciones de salud otorgadas a ambos grupos hasta los seis meses de edad. Se comen tan algunas de las dificultades para catalogar el estado nutricional de los ninos de bajo peso de nacimiento y se destaca la necesidad de elaborar acciones de salud especialmente dirigidas a estos ninos, a nivel de la atencion primaria de salud, como corresponde a su condicion de "alto riesgo"

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