RESUMO

Postmenopausal hyperandrogenism constitutes a very rare condition of tumoral or non-tumoral origin primarily residing either in the ovary or in the adrenal glands. We present herein two cases with this condition; one with abnormal postmenopausal genital bleeding and mild increase in facial hair, and the second with slow-developing hirsutism and virilization. Both cases shared a notorious increase in libido. The laboratory tests showed high levels of testosterone (>100 ng/ml). A normal value of dehydroepiandrosterone sulfate and a normal cortisol level at 9 am after 1 mg of dexamethasone administered at midnight (Nugent test) made an adrenal etiology very unlikely. On the other hand, a high level of inhibine B oriented to an ovarian source. Transvaginal sonography failed to demonstrate an ovarian tumor, but an abdominal and pelvic computed tomography scan or magnetic resonance imaging detected an ovarian tumor and normal adrenal glands. A laparoscopic oophorectomy was performed, and the histological study demonstrated a steroidal cell tumor in the first case and a Leydig cell tumor in the second.

Assuntos

Androgênios/metabolismo , Hiperandrogenismo , Tumor de Células de Leydig/diagnóstico , Neoplasias Ovarianas/diagnóstico , Pós-Menopausa , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Tumor de Células de Leydig/diagnóstico por imagem , Tumor de Células de Leydig/metabolismo , Tumor de Células de Leydig/patologia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/metabolismo , Neoplasias Ovarianas/patologia , Ovariectomia , Tomografia Computadorizada por Raios X

RESUMO

Women carriers of mutations in the genes BRCA1 and BRCA2 coding for tumor suppressor proteins are at high risk of developing breast and ovarian cancers. Hereditary breast and ovarian cancers due to BRCA pathogenic mutations occur at earlier ages: mean age 43 years at diagnosis of breast cancer for BRCA1 mutations; onset of ovarian cancer up to 10-21% by age 50 years. Preventive strategies are then defined in the reproductive years. The National Comprehensive Cancer Network (NCCN) guidelines define that BRCA1/2 genetic testing should begin with the affected cancer individual (BRCA1/2 full sequencing); then, family members should be tested for the specific gene mutation found. A woman known to be a carrier needs a strict specific surveillance strategy to achieve early diagnosis. The NCCN proposes breast imageneological surveillance beginning at age 25 years; ovarian surveillance beginning at age 30-35 years. Concomitantly, risk-reducing strategies should be analyzed: surgical or pharmacological. When prophylactic bilateral salpingo-oophorectomy is performed before menopause, estrogen replacement therapy could be required. For BRCA, we review the risks of cancer in mutations carriers, criteria for genetic testing, surveillance and risk-reduction strategies, and the safety of prescribing hormone therapy when needed.

Assuntos

Neoplasias da Mama/prevenção & controle , Genes BRCA1 , Genes BRCA2 , Predisposição Genética para Doença , Neoplasias Ovarianas/prevenção & controle , Neoplasias da Mama/genética , Terapia de Reposição de Estrogênios , Feminino , Triagem de Portadores Genéticos , Aconselhamento Genético , Humanos , Mutação , Neoplasias Ovarianas/genética , Medição de Risco , Fatores de Risco , Salpingo-Ooforectomia

RESUMO

OBJECTIVE: Non-hormonal treatment for menopausal vasomotor symptoms (VMS) is needed in women in whom there are medical or personal concerns on the use of hormone therapy. This paper reviews conventional and phytochemical therapies available for the relief of VMS, on their mechanisms of action, their efficacy and safety concerns. METHODS: Medline was searched through Pubmed on the names of the diverse therapies analyzed, up to June 2011. The Cochrane Controlled Clinical Trials Register Database was searched for relevant trials that provided data on treatment of menopausal hot flushes. RESULTS: All non-estrogen treatments for VMS are less efficacious than estrogen treatment. Randomized trials with neuroendocrine agents show globally modest to moderate reduction of VMS and frequent bothersome adverse events. The variability of effects makes it possible to undergo treatment in search for individual response where estrogen treatment is contraindicated. The antidepressants that interact with cytochrome P450, inhibiting tamoxifen metabolism to endoxifen, interfere with tamoxifen therapy in breast cancer patients. Otherwise, botanical products containing isoflavones from soy bean or red clover have great variability in bioavailability, have a broader spectrum of action than estradiol, and have predominant estrogen receptor-b activity. The efficacy of phytoestrogens on VMS is similar to placebo. They should be avoided in women with breast cancer and, in particular, in women being treated with tamoxifen or aromatase inhibitors due to possible antagonism. Cimicifuga racemosa is not a phytoestrogen, has partial serotonin agonist action and has a modest effect on VMS. CONCLUSIONS: There are safe non-hormonal conventional treatments for menopausal VMS, although they are less efficacious than estrogens. The indication of phytochemicals is for women who make this choice on personal beliefs; long-term studies of larger groups of patients are needed to assess safety.

Assuntos

Fogachos/tratamento farmacológico , Menopausa/efeitos dos fármacos , Sudorese/efeitos dos fármacos , Sistema Vasomotor/efeitos dos fármacos , Agonistas de Receptores Adrenérgicos alfa 2/farmacologia , Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Aminas/farmacologia , Aminas/uso terapêutico , Anticonvulsivantes/farmacologia , Anticonvulsivantes/uso terapêutico , Cimicifuga , Clonidina/farmacologia , Clonidina/uso terapêutico , Ácidos Cicloexanocarboxílicos/farmacologia , Ácidos Cicloexanocarboxílicos/uso terapêutico , Feminino , Gabapentina , Humanos , Fitoestrógenos/farmacologia , Fitoestrógenos/uso terapêutico , Fitoterapia , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Pregabalina , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Sistema Vasomotor/fisiopatologia , Ácido gama-Aminobutírico/análogos & derivados , Ácido gama-Aminobutírico/farmacologia , Ácido gama-Aminobutírico/uso terapêutico

RESUMO

BACKGROUND: Phytoestrogens are a family of plant-derived compounds with weak estrogenic and antiestrogenic properties. The antioxidant capacity of phytoestrogens has been proposed as one of the important mechanisms that explain their health benefits. OBJECTIVE: To determine the in vitro potency of three phytoestrogens, ubiquitous in food, (biochanin A, daidzein and genistein) as antioxidants of low density lipoprotein (LDL) and to compare them with the well-established antioxidant actions of estradiol and quercetin, an ubiquitous flavonoid which is found in high concentration in onions, tea and berries. METHODS: LDL was isolated by ultracentrifugation from the plasma of ten healthy postmenopausal women who were not on hormone therapy. Aliquots containing 0.5 mg of protein were incubated for 4 h with CuSO4 15 micromol/l to induce oxidative stress and with one of the five compounds studied: estradiol, quercetin, biochanin A, daidzein, and genistein, in doses of 0, 5, 15, 50, 500, 1000 and 2000 micromol/l. In addition, we studied the combined effect of estradiol 1 micromol/l plus quercetin 1 micromol/l, comparing their antioxidant action with that of each compound separately. Malonaldehyde (MDE nmol/ mg protein) was measured as a marker of LDL oxidation. RESULTS: Estradiol and quercetin induced a dose-dependent decrease in MDE concentration (p < 0.01). Comparing the areas under the curve, the antioxidant effect of quercetin was 8 times higher than the one observed with estradiol (p < 0.01). A 50% decrease in MDE was reached by quercetin at a concentration of 3.4 micromol/l, estradiol at 29 micromol/l, genistein at 280 micromol/l, biochanin at 1312 mmol/l and daidzein at 8007 mmol/l. Estradiol 1 micromol/l and quercetin 1 micromol/l did not modify MDE generation separately, but, when incubated combined, there was a significant decrease of MDE (p < 0.02). CONCLUSION: The phytoestrogens studied showed a weak antioxidant activity in vitro. The flavonoid quercetin, in contrast, showed the most potent antioxidant activity in vitro, higher than estradiol. Estradiol and quercetin showed additive antioxidant activity. We speculate that different compounds with variable antioxidant effects could amplify their antioxidant capacity when acting combined.

Assuntos

Antioxidantes/farmacologia , LDL-Colesterol/sangue , Malondialdeído/sangue , Fitoestrógenos/farmacologia , Quercetina/farmacologia , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Estradiol/farmacologia , Feminino , Humanos , Técnicas In Vitro , Isoflavonas/farmacologia , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia

RESUMO

OBJECTIVE: Ethinylestradiol (EE) combined with the antiandrogenic progestin cyproterone acetate (CPA) is a possible treatment in polycystic ovary syndrome (PCOS). We investigated the impact of EE/CPA on lipid and carbohydrate metabolism in women with PCOS,who were otherwise healthy. METHOD: The 31 women were separated into two groups paired by body mass index (BMI): Group A (control, n = 15) were cycled with 10 mg medroxyprogesterone acetate (MPA) x 10 days (Provera, Pharmacia & Upjohn) every month for 3 months; Group B (n = 16) were treated with 35 microg EE/2 mg CPA (Diane 35, Schering) for 3 months. Metabolic and hormonal conditions were similar in both groups. RESULTS: Group A showed no change in any hormone or metabolic parameter. Group B showed a significant decrease in free androgen index (-81%) and increase in sex hormone binding globulin (+ 639%), a decrease in low density lipoprotein cholesterol (-14%) and total cholesterol/high density lipoprotein (HDL) cholesterol index (-19%), and increases in HDL cholesterol (+ 23%) and triglycerides (+ 82%) (p < 0.001). Fasting insulin increased in 18%, the glucose/insulin index worsened in 8%, and the plasma glucose disappearance worsened in 12%, with no statistical significance (p= 0.092, p=0.308 and p= 0.237, respectively). CONCLUSION: Treatment of PCOS with EE/CPA induces important favorable changes regarding hormone parameters associated with hyperandrogenism, significant favorable changes in lipid profile except for triglyceride increase, and no significant change in carbohydrate metabolism (measured by fasting insulin, glucose/insulin index and plasma glucose disappearance). MPA cycling does not change any of these parameters.

Assuntos

Acetato de Ciproterona/uso terapêutico , Etinilestradiol/uso terapêutico , Síndrome do Ovário Policístico/tratamento farmacológico , Administração Oral , Adulto , Androgênios/sangue , Glicemia/efeitos dos fármacos , Colesterol/sangue , HDL-Colesterol/sangue , HDL-Colesterol/efeitos dos fármacos , LDL-Colesterol/sangue , LDL-Colesterol/efeitos dos fármacos , Acetato de Ciproterona/administração & dosagem , Esquema de Medicação , Etinilestradiol/administração & dosagem , Feminino , Humanos , Síndrome do Ovário Policístico/sangue , Estudos Prospectivos , Globulina de Ligação a Hormônio Sexual/efeitos dos fármacos , Resultado do Tratamento , Triglicerídeos/sangue

RESUMO

Evidence that domestic dogs may act as reservoir hosts for cutaneous leishmaniasis in the Peruvian Andes is provided by the isolation, for the first time, from naturally infected dogs of parasites identified (by isoenzymes) as Leishmania peruviana. Leishmania parasites were isolated from nasal aspirates or biopsies from 5 (1.8%) of 279 asymptomatic dogs samples in endemic villages of the Peruvian Andes. In addition, Leishmania (Viannia) infections were identified in 15 (5.4%) of 276 nasal samples by the polymerase chain reaction (PCR) using subgenus-specific primers. Further circumstantial evidence for a reservoir role for dogs comes from the finding of a relatively high dog blood index among the sandfly vectors collected inside houses (29% for Lutzomyia peruensis and 17% for Lu. verrucarum). Possible wild mammal reservoir hosts for Andean cutaneous leishmaniasis were also detected in endemic villages. At least 8 species were identified among the 1266 small mammals trapped. Leishmania parasites were isolated from blood or skin biopsies taken from 2 (2.6%) of 78 Didelphis albiventris and 6 (1.2%) of 511 Phyllotis andinum. Three isolates were identified by isoenzymes as L. peruviana, and the other 5 were identified by PCR as Leishmania (Viannia) species. Leishmania (Viannia) infections were also identified by PCR directly on skin biopsies taken from 2 (2.8%) of 72 D. albiventris, 1 (0.2%) of 499 P. andinum, and 4 (2.6%) of 153 Akodon sp.

Assuntos

Vetores de Doenças , Doenças do Cão/parasitologia , Leishmaniose Cutânea/veterinária , Animais , Animais Domésticos/parasitologia , Antígenos/análise , Doenças do Cão/epidemiologia , Cães , Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/parasitologia , Peru/epidemiologia , Psychodidae/imunologia

RESUMO

During May 1998, we conducted a case-control study of 357 participants from 60 households during an outbreak of acute bartonellosis in the Urubamba Valley, Peru, a region not previously considered endemic for this disease. Blood and insect specimens were collected and environmental assessments were done. Case-patients (n = 22) were defined by fever, anemia, and intra-erythrocytic coccobacilli seen in thin smears. Most case-patients were children (median age = 6.5 years). Case-patients more frequently reported sand fly bites than individuals of neighboring households (odds ratio [OR] = 5.8, 95% confidence interval [CI] = 1.2-39.2), or members from randomly selected households > or = 5 km away (OR = 8.5, 95% CI = 1.7-57.9). Bartonella bacilliformis isolated from blood was confirmed by nucleotide sequencing (citrate synthase [g/tA], 338 basepairs). Using bacterial isolation (n = 141) as the standard, sensitivity, specificity, and positive predictive value of thin smears were 36%, 96%, and 44%, respectively. Patients with clinical syndromes compatible with bartonellosis should be treated with appropriate antibiotics regardless of thin-smear results.

Assuntos

Infecções por Bartonella/epidemiologia , Bartonella/isolamento & purificação , Surtos de Doenças , Adolescente , Adulto , Infecções por Bartonella/diagnóstico , Infecções por Bartonella/fisiopatologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Peru/epidemiologia , Fatores de Risco

RESUMO

En el valle Sagrado de los Incas (Valle del Río Urubamba) encontramos una sola de Lutzomyia, nos referimos a la Lutzomyia suele compartir su habitat con el vector de la enfermedad de Carrión, la Lutzomyia verrucarum. Los aspectos entomológicos fueron levados a cabo, en Mayo de 1998. Las colectas entomológicas se realizaron utilizando trampas de luz CDC toda la noche y en capturas diurnas en las viviendas.Se muestra la importancia de Lutzomyia peruensis incriminándola epidemiológicamente y se detectó Bartonella bacilliformis mediante PCR y haciendo secuenciamiento de ADN. Se presenta también la estimación del riesgo entomólogico de transmisión de bartonelosis por Lutzomyia peruensis, mediante el índice de inoculación de Bartonella bacilliformis

Assuntos

Peru , Psychodidae , Infecções por Bartonella

RESUMO

BACKGROUND: Estradiol (E2) has a potent antioxidant effect on low density lipoproteins (LDL) in vitro and in vivo, which could be important in explaining the cardioprotective effect of hormone replacement therapy (HRT) in post menopausal women. Estriol (E3), on the other hand, is a weak estrogen with low metabolic effects on different tissues, and at present no cardioprotective effect has been attributed to this steroid. AIM: To study the antioxidant effect of E3 on LDL and to compare it with the potent antioxidant action exhibited by E2. SUBJECTS AND METHODS: After LDL was isolated by ultra centrifugation from plasma of 12 healthy untreated post menopausal women, it was divided into aliquots containing 0.5 mg of LDL protein. Estriol and E2 in doses of 0, 1, 5, 15 and 50 microM were incubated with different aliquots of LDL. CuSO4 15 microM was added to each aliquot to induce an oxidative stress. The aliquots were then incubated during 4 hours at 37 degrees C. Malonaldehyde (MDA) was measured as a marker of LDL oxidation, and expressed as nM/mg protein. RESULTS: (mean +/- SD): Estriol induced a dose-dependent decrease in MDA concentration (baseline 62.8 +/- 21.7; 1 microM: 61.5 +/- 23.0; 5 microM: 52.9 +/- 20.3; 15 microM 43.5 +/- 20.1 and 50 microM: 31.0 +/- 17.6 nM/mg protein; F = 92.4; p < 0.0001), reaching a mean decrease of 50.7% at the highest dose tested. Estradiol has a similar dose-dependent decrease in MDA concentration (F = 60.2; p < 0.0001), revealing a more potent effect than E3 (p < 0.05), with a mean decrease of 67.4% at the highest dose tested. CONCLUSIONS: Our results demonstrate that estriol shows an important antioxidant action of LDL in vitro, although its effect is less potent than estradiol. These results raise the possibility that estriol could have a cardioprotective effect in post menopausal women, possibility that has not been yet demonstrated.

Assuntos

Antioxidantes/metabolismo , Estradiol/farmacologia , Estriol/farmacologia , Lipoproteínas LDL/sangue , Lipoproteínas LDL/efeitos dos fármacos , Pós-Menopausa/sangue , HDL-Colesterol/metabolismo , LDL-Colesterol/metabolismo , Feminino , Humanos , Peroxidação de Lipídeos , Pessoa de Meia-Idade

RESUMO

OBJECTIVES: To determine the relative bioavailability of the estrogenic components of a generic brand of conjugated estrogens marketed in Chile in comparison to that of Conpremin (Premarin in the United States). METHODS: A randomized cross-over study was conducted on 16 healthy postmenopausal women receiving single oral doses of either two Conpremin 0.625-mg tablets or two 0.625-mg tablets of the generic brand, with a 14-day wash-out interval between doses. A gas chromatography tandem mass spectrometry assay was used to determine estrogen components. RESULTS: The peak plasma concentrations of unconjugated and total estrone and equilin, unconjugated 17 beta-dihydroequilin and 17 beta-estradiol were higher and occurred earlier with the generic conjugated estrogens than with Conpremin. The 90% confidence limits for both variables lay outside the accepted bioequivalence limits of 80-125%. Additionally, no measurable plasma concentration of unconjugated delta 8,9-dehydroestrone or 17 beta-delta 8,9-dehydroestradiol was seen after administration of the generic conjugated estrogens. CONCLUSIONS: These pharmacokinetic results indicate that the generic tablets do not have the modified-release characteristics of Conpremin tablets. In addition, the absence of delta 8,9-dehydroestrone and 17 beta-delta 8,9-dehydroestradiol in the plasma indicates that the generic form is not compositionally equivalent to Conpremin.

Assuntos

Medicamentos Genéricos/farmacocinética , Equilina/análogos & derivados , Estrogênios Conjugados (USP)/farmacocinética , Adulto , Disponibilidade Biológica , Chile , Estudos Cross-Over , Equilina/sangue , Equilina/farmacocinética , Estradiol/sangue , Estradiol/farmacocinética , Estrona/sangue , Estrona/farmacocinética , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Equivalência Terapêutica , Estados Unidos

RESUMO

Risk factors for cutaneous leishmaniasis were identified from a comparative study of transmission rates in 27 villages in the Departments of Lima, Ancash, and Piura in Peru. To evaluate regression analysis as a tool for the incrimination of sand fly vectors in the absence of other biologic evidence, univariate and multivariate logistic regression analyses were used to identify which of 14 variables (the abundance of nine sand fly species, four social factors, and region) predicted transmission rates in villages (incidence, active prevalence, or cumulative prevalence). In general, suspected or proven vectors (e.g., Lutzomyia peruensis) had the strongest associations with transmission rate, indicating that regression is a useful supplementary method of incriminating vectors. Regression was then used to quantify the importance of suspected risk factors. Transmission rate increased with the abundance of Lu. peruensis, Lu. ayacuchensis, Lu. noguchii, and, to a lesser extent, Lu. verrucarum and transmission was higher among villagers who slept more frequently in temporary shelters in crop areas. There were also weak effects of the number of dogs/ person (negative) and the number of persons/household (positive). Linear regressions failed to detect a threshold sand fly density below which transmission ceases. The minimal adequate multiple regression model explained 82% of the variance in village incidence rates. This model was used to predict the effect on incidence of reducing each of the four suspected vectors in northern and southern Peru. The results indicate that vector control programs in the south should aim at Lu. peruensis, Lu. verrucarum, and Lu. noguchii, but focus on Lu. ayacuchensis in the north.

Assuntos

Insetos Vetores/parasitologia , Leishmaniose Cutânea/epidemiologia , Psychodidae/parasitologia , Análise de Variância , Animais , Estudos de Coortes , Estudos Transversais , Cães , Feminino , Humanos , Incidência , Leishmaniose Cutânea/transmissão , Análise Multivariada , Peru/epidemiologia , Prevalência , Estudos Prospectivos , Análise de Regressão , Fatores de Risco , Inquéritos e Questionários , Zoonoses

RESUMO

BACKGROUND: The effects of different therapies on bone loss rate can be measured using biochemical markers of bone resorption such as urinary hydroxyproline. AIM: To study the effects of hormone replacement therapy on urinary hydroxyproline in postmenopausal women. PATIENTS AND METHODS: Eighty three postmenopausal women without hormone replacement therapy, 54 postmenopausal women receiving hormone replacement therapy and 16 premenopausal women (considered as the control group) were studied. Hydroxyproline was measured in an early morning urine sample, after one day of diet without meat or gelatin. RESULTS: Urinary hydroxyproline in premenopausal women was 33.7 +/- 7.9 mg/g creatinine. The figure for postmenopausal women with hormonal replacement therapy was 33.7 +/- 5.9 mg/g creatinine. Postmenopausal women without replacement therapy had an urinary hydroxyproline of 47.4 +/- 8.5 mg/g creatinine, significantly higher than that of premenopausal and supplemented women. In 21 postmenopausal women, hydroxyproline was measured before and after three months of replacement therapy, values decreased 35.5 +/- 11% in this period and there was a direct correlation between initial values and the degree of reduction (r = 0.69, p < 0.001). CONCLUSIONS: Postmenopausal women receiving hormone replacement therapy have a urinary hydroxyproline excretion similar to that of premenopausal women.

Assuntos

Reabsorção Óssea/tratamento farmacológico , Terapia de Reposição de Estrogênios , Hidroxiprolina/urina , Adulto , Idoso , Análise de Variância , Reabsorção Óssea/urina , Feminino , Humanos , Pessoa de Meia-Idade

RESUMO

Warileya lumbrerasi n. sp. is described from the northern Peruvian Andes. This species was collected inside houses, and is the seventh species described within the genus Warileya Hertig, 1948.

Assuntos

Psychodidae/classificação , Animais , Feminino , Masculino , Peru

RESUMO

BACKGROUND: Prescription of calcium supplements is a frequent practice, considering that diet is insufficient to cover daily requirements of this mineral. AIM: To study the dissolution velocity in an acid solution, of different commercial calcium supplements. MATERIAL AND METHODS: Hydrochloric acid was added to distilled water in increasing amounts to obtain a final pH of 6.9, 3.0, 2.5, 2.0 and 1.5. Eighteen commercial calcium preparations were incubated in these solutions for 60 min and dissolution velocity was measured as the percentage of elemental calcium found in solution after this incubation period. RESULTS: Calcium carbonate preparations had a pH dependent dissolution velocity, ranging from 0.67 +/- 0.8% at pH 6.9 to 77.15 +/- 17.5% at pH 1.5. Using the solution with pH 1.5, the dissolution velocity of different preparations varied widely from 56 to 100%. Calcium acetate, followed by calcium citrate and dicalcic phosphate were the salts in tablets with better dissolution velocities. Among powders and effervescent preparations, those containing calcium lactogluconate and citrate had the better dissolution velocities (95 to 115%), that were independent of the solution's pH. A studied preparation with integral bone had a very low dissolution velocity, not surpassing 33 mg of calcium per tablet. CONCLUSIONS: The dissolution velocity of different calcium carbonate preparations varies greatly and, in conditions of achlorhydria, it is negligible. Calcium lactogluconate and citrate dissolution velocities are independent of the solution's pH.

Assuntos

Cálcio/metabolismo , Suplementos Nutricionais , Solubilidade , Cálcio/uso terapêutico , Carbonato de Cálcio/metabolismo , Citrato de Cálcio/metabolismo , Cálcio da Dieta/metabolismo , Fatores de Tempo

RESUMO

A study was carried out in the Peruvian Andes to test the suitability of CDC light traps for monitoring changes in the human-landing rate of endophagic phlebotomine sandflies, following house-spraying with pyrethroid insecticide. On four pairs of consecutive nights, sandflies were caught inside eight sprayed and eight unsprayed houses, either by human bait or by CDC light traps. The sandflies collected were Lutzomyia verrucarum (97%) and Lu.peruensis (3%), both probable vectors of Leishmania peruviana, and the species composition was unaffected by house-spraying. A non-linear relationship was detected between light-trap and human-bait catches, but the relationship did not diverge significantly from linearity within the range of sandfly abundance found in most houses in the endemic area (i.e. between 3 and 200 sandflies/house-night), and did not differ significantly between sprayed and unsprayed houses. However, light trap catches had a significantly lower proportion of blood-fed females in sprayed than in unsprayed houses, probably due to an insecticidal effect on post-blood-feeding behaviour. The proportion of Lu. verrucarum was significantly higher in light trap than in human bait catches, indicating that Lu.peruensis is either more anthropophilic or less phototropic than Lu.verrucarum.

Assuntos

Controle de Insetos/métodos , Psychodidae , Animais , Comportamento Apetitivo , Estudos de Avaliação como Assunto , Feminino , Humanos , Luz , Masculino , Peru , Psychodidae/classificação , Piretrinas , Razão de Masculinidade

RESUMO

A two-year field study of Andean cutaneous leishmaniasis (uta) in the valley of Purisima, Ancash Department, Peru has provided quantitative epidemiologic and entomologic evidence for the predominant role of Lutzomyia peruensis in the transmission of Leishmania peruviana in this endemic area. The monthly incidence in the valley was greatest in the wet season (from December to May), when Lu. peruensis was particularly endophilic. A significant correlation was detected between intradomiciliary (but not extradomiciliary) Lu. peruensis abundance and the monthly incidence of uta in the valley following a one-month time lag. In contrast, no significant correlation was detected between any measure of Lu. verrucarum abundance and the incidence of uta. Lutzomyia peruensis and Lu. verrucarum comprise more than 98% of all the sand fly captures made in this valley. The increase in incidence of uta with altitude, which reached a peak rate between 2,250 and 2,750 meters above sea level, was associated with an increase in the relative abundance of Lu. peruensis as compared with Lu. verrucarum. Seasonal and altitudinal variation was also detected in the peak time of activity for both sand fly species, a phenomenon that could significantly influence the transmission rate: later host-seeking sand flies being more likely to find sleeping, nondefensive, human hosts.

Assuntos

Insetos Vetores/parasitologia , Leishmaniose Cutânea/transmissão , Psychodidae/parasitologia , Altitude , Animais , Ritmo Circadiano , Feminino , Humanos , Umidade , Incidência , Insetos Vetores/classificação , Insetos Vetores/fisiologia , Leishmaniose Cutânea/epidemiologia , Masculino , Peru/epidemiologia , Prevalência , Psychodidae/classificação , Psychodidae/fisiologia , Saúde da População Rural , Estações do Ano

Assuntos

Cricetinae/parasitologia , Leishmania braziliensis/isolamento & purificação , Psychodidae/parasitologia , Animais , Feminino , Masculino , Peru

RESUMO

PIP: 256 pregnant women were studied for the presence of Neisseria gonorrhea in the endocervical canal of the uterus. Those who had positive cultures also had cultures taken from the rectum and the pharynx before administering treatment. 7 days after treatment, control cultures were taken to confirm the effectiveness of the therapy. The cultures were taken at the Diagnostic Center of the Catholic University of Chile. The treatment consisted of two intramuscular doses of a mixture of clemizol penicillin (400,000 IU) and penicillin sodium (3,600,000 IU). The prevalence of endocervical infection for gonorrhea amounted to 4 cases (1.56%). They presented bacteria in the rectum and one of them presented bacteria in the pharynx. All cultures were negative 7 days after treatment. There were significantly fewer first-trimester pregnancy cases (58) compared to second-trimester (90) and third-trimester (108) cases. There were 116 primiparas and 140 multiparas. As to the couples, 65.6% of the female population and 61.3% of the male population was concentrated in the 21-30 age group. 87.9% of the population was married; 11.3% was single; and 0.8% was widowed. 48.9% of the pregnant women were exclusively housewives; 23.9% were employed in technical or university professions; 7.4% were engaged in commerce; 3.9% were employees; 4.7% were students; and 1.9% were laborers. Their average age was 26.4 years, while the average age of the healthy population was 26.7 years.^ieng

Assuntos

Gonorreia/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adolescente , Adulto , Fatores Etários , Chile , Feminino , Humanos , Masculino , Gravidez , Fatores Socioeconômicos

RESUMO

1. La frecuencia de la cervicitis gonococica en una poblacion obstetrica chilena fue de 1,5%. 2. Se destaca la importancia epidemiologica y perinatal de incorporar al control prenatal la pesquisa rutinaria de la infeccion gonococica asintomatica durante el embarazo

Assuntos

Gravidez , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Gonorreia , Complicações Infecciosas na Gravidez