RESUMO
Aedes aegypti is closely related to human behavior that allows its establishment through the accumulation of urban solid waste where it lays resistant eggs. Generally, adulticides and larvicides are applied in excess, without ovicidal alternatives, and some household products can help reduce the abundance of quiescent eggs in breeding sites by affecting the viability of eggs. A community involved in prevention and control is one of the most effective strategies for adequate vector management. In this investigation, new alternative strategies for the control of Ae. aegypti are assessed, valuing in laboratory the eggs' response to diverse household products. Susceptibility to different doses of bleach, oil, salt, sodium bicarbonate, vinegar, coffee, garlic, peroxide, and alcohol was measured, as well as its duration over time. New home products were found as alternative ovicidal method. Bleach and sunflower oil had an ovicidal effect at their maximum doses and at almost all of the evaluation times. In contrast, vinegar and coffee had no ovicidal effect at any time, turning out to be stimulators of hatching in the laboratory. These alternative and complementary applications could optimize the surveillance and control of Ae. aegypti in the area, allowing new approaches to reduce populations by eliminating eggs on human microhabitats.
Assuntos
Aedes , Dengue , Animais , Humanos , Aedes/fisiologia , Argentina , Ácido Acético/farmacologia , Café , Mosquitos Vetores , LarvaRESUMO
Las enfermedades transmitidas por vectores, principalmente las trasmitidas por el Aedes aegypti, suponen una gran amenaza para la salud de las sociedades en todo el mundo. Uno de los pilares para el éxito de los programas de prevención de las Enfermedades Transmitidas por Aedes aegypti es la participación comunitaria o participación social en salud. Sin embargo, la mayoría de los programas deja de lado la revisión sobre las formas de participación desplegada por los actores de la sociedad civil, se centran en la aplicación ideológica/técnica del concepto. El trabajo de investigación tuvo por objetivo indagar sobre el sentido y significado de la participación comunitaria en salud de los diferentes de actores sociales en el Municipio de Tafí Viejo. Se trató de un estudio cualitativo con enfoque etnográfico, cuyos instrumentos de recolección de datos fueron entrevistas de final abierto, observación participante y notas de campo, con los datos obtenidos construyó una matriz de análisis, en la cual se registraron las voces de los actores, donde luego se trabajó en una categorización y subcategorización resumen del estudio. Resultados Con la investigación se pudieron describir aspectos vinculados al control vectorial, el del estado y la participación social en salud. Las nociones de las medidas preventivas para el Aedes aegypti no se encuentran del todo claras. El AA no es un problema, hasta que aparece el Dengue. La comunidad ha transferido la responsabilidad del control del vector al sector salud, mientras que los profesionales identifican la necesidad de movilizar a la comunidad para planear acciones conjuntas. Conclusiones El desafío en el municipio está en el diseño de estrategias para incluir a la comunidad, donde se parta de la exploración previa de sus determinantes, identificando las necesidades que percibe la población y elaborando programas locales, con impronta local.
Assuntos
Política Pública , Aedes , Controle de Vetores de Doenças , Participação SocialRESUMO
TcTASV-C is a protein family of about 15 members that is expressed only in the trypomastigote stage of Trypanosoma cruzi. We have previously shown that TcTASV-C is located at the parasite surface and secreted to the medium. Here we report that the expression of different TcTASV-C genes occurs simultaneously at the trypomastigote stage and while some secreted and parasite-associated products are found in both fractions, others are different. Secreted TcTASV-C are mainly shedded through trypomastigote extracellular vesicles, of which they are an abundant constituent, despite its scarce expression on culture-derived trypomastigotes. In contrast, TcTASV-C is highly expressed in bloodstream trypomastigotes; its upregulation in bloodstream parasites was observed in different T. cruzi strains and was specific for TcTASV-C, suggesting that some host-molecules trigger TcTASV-C expression. TcTASV-C is also strongly secreted by bloodstream parasites. A DNA prime-protein boost immunization scheme with TcTASV-C was only partially effective to control the infection in mice challenged with a highly virulent T. cruzi strain. Vaccination triggered a strong humoral response that delayed the appearance of bloodstream trypomastigotes at the early phase of the infection. Linear epitopes recognized by vaccinated mice were mapped within the TcTASV-C family motif, suggesting that blockade of secreted TcTASV-C impacts on the settlement of infection. Furthermore, although experimental and naturally T. cruzi-infected hosts did not react with antigens from extracellular vesicles, vaccinated and challenged mice recognized not only TcTASV-C but also other vesicle-antigens. We hypothesize that TcTASV-C is involved in the establishment of the initial T. cruzi infection in the mammalian host. Altogether, these results point towards TcTASV-C as a novel secreted virulence factor of T. cruzi trypomastigotes.
Assuntos
Sangue/parasitologia , Doença de Chagas/parasitologia , Vesículas Extracelulares/parasitologia , Proteínas de Protozoários/metabolismo , Trypanosoma cruzi/crescimento & desenvolvimento , Trypanosoma cruzi/metabolismo , Fatores de Virulência/metabolismo , Animais , Doença de Chagas/sangue , Doença de Chagas/metabolismo , Vesículas Extracelulares/metabolismo , Humanos , Camundongos , Camundongos Endogâmicos C3H , Família Multigênica , Transporte Proteico , Proteínas de Protozoários/genética , Trypanosoma cruzi/genética , Fatores de Virulência/genéticaRESUMO
IMPORTANCE: At least 13 medication-associated diethylene glycol (DEG) mass poisonings have occurred since 1937. To our knowledge, this is the first longitudinal study characterizing long-term health outcomes among survivors beyond the acute poisoning period. OBJECTIVE: To characterize renal and neurologic outcomes among survivors of a 2006 DEG mass-poisoning event in Panama for 2 years after exposure. DESIGN, SETTING, AND PARTICIPANTS: This prospective longitudinal study used descriptive statistics and mixed-effects repeated-measures analysis to evaluate DEG-poisoned survivors at 4 consecutive 6-month intervals (0, 6, 12, and 18 months). Case patients included outbreak survivors with a history of (1) ingestion of DEG-contaminated medication, (2) hospitalization for DEG poisoning, and (3) an unexplained serum creatinine level of 1.5 mg/dL or higher (to convert to micromoles per liter, multiply by 88.4) during acute illness or unexplained exacerbation of preexisting end-stage renal disease. MAIN OUTCOMES AND MEASURES: Demographics, mortality, dialysis dependence, renal function, neurologic signs and symptoms, and nerve conduction studies. RESULTS: Of the 32 patients enrolled, 5 (15.6%) died and 1 was lost to follow-up, leaving 26 patients at 18 months. Three (9.4%) missed 1 or more evaluations. The median age was 62 years (range, 15-88 years), and 59.4% were female. Three (9.4%) patients had preexisting renal failure. Enrollment evaluations occurred at a median of 108 days (range, 65-154 days) after acute illness. The median serum creatinine level for the 22 patients who were not dialysis dependent at time 0 was 5.9 mg/dL (range, 1.8-17.1 mg/dL) during acute illness and 1.8 mg/dL (range, 0.9-5.9 mg/dL) at time 0. Among non-dialysis-dependent patients, there were no significant differences in the log of serum creatinine or estimated glomerular filtration rate over time. The number of patients with subjective generalized weakness declined significantly over time (P < .001). A similar finding was observed for any sensory loss (P = .05). The most common deficits at enrollment were bilateral lower extremity numbness in 13 patients (40.6%) and peripheral facial nerve motor deficits in 7 (21.9%). All patients with neurologic deficits at enrollment demonstrated improvement in motor function over time. Among 28 patients (90.3%) with abnormal nerve conduction study findings at enrollment, 10 (35.7%) had motor axonal involvement, the most common primary abnormality. CONCLUSIONS AND RELEVANCE: Neurologic findings of survivors tended to improve over time. Renal function generally improved among non-dialysis-dependent patients between acute illness and the first evaluation with little variability thereafter. No evidence of delayed-onset neurologic or renal disease was observed.
Assuntos
Etilenoglicóis/intoxicação , Falência Renal Crônica/induzido quimicamente , Doenças do Sistema Nervoso/induzido quimicamente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Contaminação de Medicamentos , Feminino , Humanos , Falência Renal Crônica/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/epidemiologia , Panamá/epidemiologia , Estudos Prospectivos , Adulto JovemRESUMO
STUDY OBJECTIVE: Diethylene glycol is a toxic industrial solvent responsible for more than 13 mass poisonings since 1937. Little is known about the clinical spectrum, progression, and neurotoxic potential of diethylene glycol-associated disease because of its high mortality and the absence of detailed information in published mass poisoning reports. This incident includes the largest proportion of cases with neurotoxic signs and symptoms. We characterize the features of a diethylene glycol mass poisoning resulting from a contaminated cough syrup distributed in Panama during 2006. METHODS: This was a retrospective chart review and descriptive analysis in a tertiary level, urban health care facility. A case was a person admitted to the Social Security Metropolitan Hospital in Panama City between June 1 and October 22, 2006, with unexplained acute kidney injury and a serum creatinine level of greater than or equal to 2 mg/dL, or unexplained chronic renal failure exacerbation (>2-fold increase in baseline serum creatinine level) and history of implicated cough syrup exposure. Main outcomes and measures were demographic, clinical, laboratory, diagnostic, histopathologic, and mortality data with descriptive statistics. RESULTS: Forty-six patients met inclusion criteria. Twenty-four (52%) were female patients; median age was 67 years (range 25 to 91 years). Patients were admitted with acute kidney injury or a chronic renal failure exacerbation (median serum creatinine level 10.0 mg/dL) a median of 5 days after symptom onset. Forty patients (87%; 95% confidence interval [CI] 74% to 95%) had neurologic signs, including limb (n=31; 77%; 95% CI 62% to 89%) or facial motor weakness (n=27; 68%; 95% CI 51% to 81%). Electrodiagnostics in 21 patients with objective weakness demonstrated a severe sensorimotor peripheral neuropathy (n=19; 90%; 95% CI 70% to 99%). In 14 patients without initial neurologic findings, elevated cerebrospinal fluid protein concentrations without pleocytosis were observed: almost all developed overt neurologic illness (n=13; 93%; 95% CI 66% to 100%). Despite use of intensive care and hemodialysis therapies, 27 (59%) died a median of 19 days (range 2 to 50 days) after presentation. CONCLUSION: A high proportion of patients with diethylene glycol poisoning developed progressive neurologic signs and symptoms in addition to acute kidney injury. Facial or limb weakness with unexplained acute kidney injury should prompt clinicians to consider diethylene glycol poisoning. Elevated cerebrospinal fluid protein concentrations without pleocytosis among diethylene glycol-exposed persons with acute kidney injury may be a predictor for progressive neurologic illness.
Assuntos
Injúria Renal Aguda/induzido quimicamente , Surtos de Doenças , Etilenoglicóis/intoxicação , Síndromes Neurotóxicas/etiologia , Injúria Renal Aguda/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes Neurotóxicas/epidemiologia , Panamá/epidemiologia , Estudos RetrospectivosRESUMO
Objetivo: determinar las características clínicas y epidemiológicas de la ambliopía en escolares del seminternado Juventud de Acero, del municipio de Caimito, en la provincia de Artemisa, en el período comprendido de enero a junio de 2011. Métodos: se realizó un estudio observacional, descriptivo, transversal, en escolares con edades comprendidos entre 5 a 11 años. El universo de trabajo estuvo constituido por 459 alumnos, matrícula de la institución durante el curso escolar 2011-2012. La muestra fue de 403 niños, a quienes se les determinó la agudeza visual sin corrección. A los que presentaron agudeza visual menor de 1,0 se les realizó examen oftalmológico y refracción. Se estudiaron las variables: edad, sexo, defecto refractivo, etiología y grado de severidad de la ambliopía. Resultados: en el universo estudiado se constató ambliopía en el 4,2 por ciento, del cual el 76,5 por ciento presentó afectación unilateral. El sexo femenino fue afectado en el 70,6 por ciento y los niños con edades entre 7 y 8 años en un 35,4 y 29,4 por ciento. El astigmatismo miópico mixto fue detectado en el 20,8 por ciento y el miópico compuesto en el 16,7 por ciento. La ambliopía anisometrópica se observó en el 47,0 por ciento, seguida de la refractiva 35,3 por ciento. Se encontró la forma leve en el 76,2 por ciento de los ojos y profunda en el 4,8 por ciento. Conclusiones: la frecuencia de presentación de la ambliopía fue baja, y la unilateral fue la más observada por estar asociada principalmente a anisometropía. Los escolares más afectados fueron los del sexo femenino y los de edades entre 7 y 8 años. El defecto refractivo más frecuente fue el astigmatismo mixto. Predominaron la ambliopía ligera y la de etiología anisometrópica
Objective: to determine the clinical and epidemiological characteristics of amblyopia in school children from Juventud de Acero elementary school in Caimito municipality, Artemisa province. Method: an observational, descriptive and cross-sectional study conducted in 5 through 11 years-old children from January to June 2011. The universe of study was 459 students, who attended the school during the 2011-2012 academic year. The final sample comprised 403 children whose visual acuity without correction was estimated; those with visual acuity smaller than 1.0 underwent ophthalmological test and refraction. The studied variables were age, sex, refractive error, etiology and severity of amblyopia.Results: it was confirmed that amblyopia affected 4.2 percent of students, 76.5 percent of whom presented unilateral amblyopia. The females represented 70.6 percent whereas children aged 7 and 8 years accounted for 35.4 percent and 29.4 percent, respectively. Mixed myopic astigmatism was detected in 20.8 percent and the compound myopic in 16.7 percent of studied children. The anisometropic amblyopia was observed in 47.0 percent, followed by the refractive type in 35.3 percent, being the slight form observed in 76.2 percent and the acute form in 4.8 percent of eyes.Conclusions: the frequency of amblyopia occurrence was low, and the unilateral type was the most observed mainly associated to anisometropia. The female students and those school children aged 7 and 8 years were the most affected. The most frequent refractive defect was mixed astigmatism. Slight amblyopia of anisometropic etiology prevailed