Clinical and laboratory findings of Plasmodium vivax malaria in Colombia, 2001

A descriptive study was carried out in 104 patients with Plasmodium vivax malaria, from the region of Turbo (Antioquia, Colombia). Clinical features and levels of hemoglobin, glycemia, serum bilirubin, alanine-aminotransferase (ALT), aspartate-aminotransferase (AST), creatinine and complete blood cell profile were established. 65% of the studied individuals were men and their mean age was 23. Of all individuals 59% had lived in the region for > 1 year and 91% were resident in the rural area. 42% were farmers and 35% had a history of malaria. The mean parasitaemia was 5865 parasites/mm³. The evolution of the disease was short (average of 4.0 days). Fever, headache and chills were observed simultaneously in 91% of the cases while the most frequent signs were palmar pallor (46%), jaundice (15%), hepatomegaly (17%), and spleen enlargement (12%). Anemia was found in 39% of the women and in 51% of the men, 8% of individuals had thrombocytopaenia and 41% had hypoglycemia.

Fatal septicemia caused by Chromobacterium violaceum in a child from Colombia

A 4-year old child living in Colombia presented with a history of fever and severe abdominal pain for four days. The patient developed pneumonia, septic shock, multiple organ failure and died on the fifth day of hospitalization. Chromobacterium violaceum was isolated from admission blood cultures and was resistant to ampicillin, cephalosporins, carbapenems and aminoglycosides.

Giardia intestinalis and nutritional status in children participating in the complementary nutrition program, Antioquia, Colombia, May to October 2006

Giardia intestinalis infection is prevalent throughout the world and widely distributed in developing countries. In general, children display serious consequences to their state of health, including slow height-weight development; therefore, the main aim of this study was to determine the association between Giardia infection and the nutritional status of children who participate in the program of complementary feeding (Mejoramiento Alimentario y Nutricional de Antioquia (MANA) - Instituto Colombiano de Bienestar Familiar (ICBF)). A cross-sectional study examining the association of giardiasis with nutritional status was conducted. A total of 2035 children aged eight months to six years-old were studied. Data were collected using structured questionnaires, anthropometric measurements and laboratory analysis of blood and stool samples. Analysis of the results showed that 27.6% of children were infected with G. intestinalis, while 8.1% and 1.9% were mildly and significantly underweight, respectively, and 14.1% presented stunting. Giardiasis was statistically identified as a strong predictor of stunting in this study population.

Thermoterapy effective and safer than miltefosine in the treatment of cutaneous leishmaniasis in Colombia

In Colombia, pentavalent antimonials and miltefosine are the drugs of choice for the treatment of cutaneous leishmaniasis; however, their toxicity, treatment duration, (treatment adherence problems), cost, and decreased parasite sensitivity make the search for alternative treatments of American cutaneous leishmaniasis necessary. Based on the results found in a controlled, open, randomized, phase III clinical trial, the efficacy and safety of miltefosine was compared to that of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia. Adult patients from the Colombian army participated in the study; they received either 50 mg of miltefosine three times per day for 28 days by the oral route (n = 145) or a thermotherapy (Thermomed®) application of 50 °C for 30 seconds over the lesion and surrounding area (n = 149). Both groups were comparable with respect to their sociodemographic, clinical, and parasitological characteristics. The efficacy of miltefosine by protocol and by intention to treat was 70% (85/122 patients) and 69% (85/145 patients), respectively. The adverse effects were primarily gastrointestinal for miltefosine and pain at the lesion site after treatment for thermotherapy. No statistically significant difference was found in the efficacy analysis (intention to treat and protocol) between the two treatments. ClinicalTrials.gov: NCT00471705.

CONTRIBUTIONS TO RICKETTSIOSES RESEARCH IN COLOMBIA (1917-1943), LUIS B. PATIÑO CAMARGO

Colombian physician Luis Benigno Patiño Camargo was one of the pioneers in the study of rickettsioses in South America, demonstrating for the first time in Colombia the presence of Rickettsia rickettsii as the etiological agent of a highly deadly exanthematic febrile syndrome in the 1930s. However, Patiño-Camargo performed other investigations from 1917-1943, which represent the first descriptions and scientific evidence of the presence ofR. prowazekii and R. typhi in Colombia. Almost 60 years after the latest research conducted by Dr. Patiño-Camargo, rickettsioses were again a matter of interest and research. In the last decade over 20 research studies have been published, showing new endemic areas forR. rickettsii, as well as the description of new rickettsial species in Colombia.

Serological and parasitological study and report of the first case of human babesiosis in Colombia

A study on the presence of Babesia in humans was performed in Puerto Berrío (Latitude 6.50deg. Longitude: -74.38deg. River: Magdalena. Area: 74.410km², Colombia-South America). Indirect immunofluorescence, thin and thick blood smears were used to study 194 individuals. Patients were grouped according to their risk-factors for Babesia infection: (group 1) individuals with fever, chills, sweating and other malaria-type symptoms; (group 2) symptomatic and asymptomatic individuals from local cattle ranches, which were enrolled in an active form, and (group 3) workers from the local slaughterhouse. Seven individuals were serologically positive for Babesia: Three individuals presented IgM antibodies against B. bovis, while one had IgG against this species; one individual had IgM against B. bigemina, another had IgG and a third both IgM and IgG against this species. Only one individual was parasitologically positive for Babesiaand serologically positive for Babesia bovis (IgM 1:64)

Platelet profile is associated with clinical complications in patients with vivax and falciparum malaria in Colombia

Introduction Thrombocytopenia is a common complication in malaria patients. The relationship between abnormal platelet profile and clinical status in malaria patients is unclear. In low and unstable endemic regions where vivax malaria predominates, the hematologic profiles of malaria patients and their clinical utility are poorly understood. The aim of this study was to characterize the thrombograms of malaria patients from Colombia, where Plasmodium vivax infection is common, and to explore the relationship between thrombograms and clinical status. Methods Eight hundred sixty-two malaria patients were enrolled, including 533 (61.8%) patients infected with Plasmodium falciparum, 311 (36.1%) patients infected with Plasmodium vivax and 18 (2.1%) patients with mixed infections. Results The most frequently observed changes were low platelet count (PC) and high platelet distribution width (PDW), which were observed in 65% of patients; thrombocytopenia with <50,000 platelets/µL was identified in 11% of patients. Patients with complications had lower PC and plateletcrit (PT) and higher PDW values. A higher risk of thrombocytopenia was identified in patients with severe anemia, neurologic complications, pulmonary complications, liver dysfunction, renal impairment and severe hypoglycemia. The presence of thrombocytopenia (<150,000 platelets/µL) was associated with a higher probability of liver dysfunction. Conclusions Young age, longer duration of illness and higher parasitemia are associated with severe thrombocytopenia. Our study showed that thrombocytopenia is related to malaria complications, especially liver dysfunction. High PDW in patients with severe malaria may explain the mechanisms of thrombocytopenia that is common in this group of patients.

Dengue in Brazil and Colombia: a study of knowledge, attitudes, and practices

Introduction This study was conducted in Brazil and Colombia,where dengue is endemic and vector control programs use chemical insecticides. Methods We identified knowledge, attitudes, and practices about dengue and determined the infestation levels of Aedes aegypti in one Brazilian and four Colombian communities. Results The surveys show knowledge of the vector, but little knowledge about diagnosis, prognosis, and treatment. Vector infestation indices show Brazil to have good relative control, while Colombia presents a high transmission risk. Conclusions Given the multidimensionality of dengue control, vertical control strategies are inadequate because they deny contextualized methods, alternative solutions, and local empowerment.

Cryptococcosis in Atlántico, Colombia: an approximation of the prevalence of this mycosis and the distribution of the etiological agent in the environment

ABSTRACTINTRODUCTION:Cryptococcosis is an invasive disease acquired by inhalation of infectious propagules from the environment. Currently, compulsory notification of the spread of this disease is not required in Colombia. However, reporting of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome cases to the National Surveillance System has suggested that there is a growing population at risk of contracting cryptococcosis. Few studies have described the occurrence of cryptococcosis in Colombia. Therefore, in this study, we examined the pathology of this disease in Atlántico, Colombia and determined the distributions of Cryptococcus neoformans and Cryptococcus gattii in the environment.METHODS:Clinical samples/isolates were gathered from cases of cryptococcosis previously diagnosed at health institutions in Atlántico, and surveys were completed by clinicians. The environmental study considered 32 sampling points and three tree species, i.e., Quickstick ( Gliricidia sepium ), Almond ( Terminalia catappa ), and Pink trumpet ( Tabebuia rosea ). Environmental and clinical samples/isolates were analyzed for phenotypic and genotypic confirmation.RESULTS:From 1997-2014, 41 cases of cryptococcosis were reported. The mean patient age was 40.5 years (range: 18-63 years); 76% were men, and 78% were HIV positive. Isolation was possible in 38 cases ( C. neoformans , molecular type VNI in 37 cases and C. gattii , molecular type VGI in one case). In 2012-2014, 2,068 environmental samples were analyzed with a positivity of 0.4% ( C. neoformans , molecular type VNI) in Almond and Pink trumpet trees.CONCLUSIONS:Cryptococcus neoformans , molecular type VNI had a higher prevalence than C. gattii and was associated with human exposure and the pathogenesis of cryptococcosis in this geographical region.

Guantánamo y el Imperio del Derecho en el Contexto Internacional

Desde el año 2001, uno de los casos más controvertidos de suspensión del derecho ha sido seguramente el que se observa en la prisión que los Estados Unidos han establecido en su base militar de Guantánamo. A pesar de las múltiples presiones y promesas de cerrar esta prisión, el gobierno norteamericano mantiene aún en ella a sujetos sospechados de terrorismo internacional. Si bien la Corte Suprema de Justicia de los Estados Unidos se ha pronunciado en diversas ocasiones alrededor de los derechos de los presos de Guantánamo, lamentablemente no se han logrado avances significativos hacia un mayor respeto de los derechos humanos de sus detenidos. Las previsibles violaciones del Derecho Internacional originadas a partir de la existencia de la prisión militar de Guantánamo y del tratamiento dispensado a las personas allí detenidas, especialmente las disposiciones vinculadas a la protección internacional de los Derechos Humanos, a la vigencia del Derecho Internacional Humanitario y del Derecho Penal Internacional, convierten al objeto de la presente investigación en una necesidad requerida a la comunidad universitaria. Pretendiendo dar respuesta a esta demanda, la Universidad Católica de Córdoba (Córdoba, Argentina) y la Pontificia Universidad Javeriana (Bogotá, Colombia), en estrecha colaboración con Europa-Universität Viadrina (Frankfurt/Oder, Alemania), a través de sus respectivas Facultades de Derecho y de Ciencias Jurídicas, han decidido conducir en forma conjunta el presente proyecto académico, fundado en la publicación de artículos científicos escritos por selectos especialistas en las diversas áreas comprendidas en esta problemática. El proyecto tiene por objeto poner al alcance de la comunidad hispano parlante un trabajo de referencia en la materia y contribuir en la toma de conciencia sobre la importancia del respeto de las disposiciones del orden jurídico internacional.

Competencias genéricas en las culturas institucionales de la escuela media: su potencial significación para la educación superior universitaria

El proyecto tematiza la identificación de competencias genéricas (no disciplinarias) originadas en las culturas institucionales de la escuela media con potencial significación para la educación superior universitaria. La necesidad de identificar competencias genéricas en las culturas institucionales de la escuela media encuentra sus antecedentes en algunas investigaciones que, si bien analizan la problemática desde la perspectiva de la articulación Escuela Media – Universidad, focalizan su interés en explorar cuestiones vinculadas al ámbito epistemológico de las disciplinas es decir, al ámbito de las competencias específicas. En este sentido, estos estudios resaltan el déficit en la adquisición por parte de los alumnos de la escuela media de competencias académico-curriculares, particularmente en los conocimientos vinculados con las disciplinas escolares (matemática, lengua, química, física, biología; entre las más atendidas). El estudio posibilitará identificar competencias genéricas construidas en las culturas institucionales de la escuela media con potencial significación para la educación superior universitaria. En otra etapa –no prevista en esta investigación - permitirá el diseño e implementación de un plan de formación para equipos directivos de escuela media y responsables de gestión de educación superior universitaria.

Investigación – acción en el Profesorado Universitario: implementación de experiencias en la docencia universitaria

Este relato de experiencia recoge las actividades planificadas en torno a dos cátedras universitarias que se comprometen en integrar contenidos específicos de Didáctica Especial y de Investigación Educativa bajo la episteme y metodología de la investigación-acción porque se integran ambas asignaturas, bajo la episteme de la inv-acción, esto es denominado en la enseñanza para la integración, la integración desde lo metodológico Ambas asignaturas desarrollan el proceso de enseñanza y aprendizaje en instancias individuales y compartidas, particularmente estas últimas, se orientan a promover la sensibilización, diagnóstico y aplicación de la investigación en problemas didácticos de los alumnos, docentes universitarios y de nivel medio, ya que ambas desarrollan instancias específicas en cuanto al campo de conocimiento y para la comprensión del mismo se elabora el proyecto. Se identifican, durante el proceso, dificultades tales como la imposibilidad de tránsito desde el paradigma original positivista hacia el paradigma crítico, la construcción del objeto de conocimiento, la identificación de la didáctica como teoría y por ende la articulación de categorías del campo de la didáctica como analizadores de las prácticas docentes, la selección de técnicas para la triangulación y la tensión entre la aspiración a integrar espacios curriculares y las condiciones efectivas para concretarlo.El problema de generar conductas autorreflexivas orientadas al diagnóstico de sus propias cátedras opera como consecuencia de una concepción de docencia universitaria autorreferencial que sitúa los problemas de enseñanza y aprendizaje a un problema de técnicas, centrado en carencias de los alumnos o en el contexto ampliado, antes que en la propuesta de cátedra y en el reconocimiento del estatuto de la investigación-acción como ámbito de producción de conocimiento académico útil. Asimismo, transpuesto estos nudos críticos del reconocimiento y problematización, la inmersión en la labor colaborativa grupal posibilitó cuestionamientos y diseño de estrategias de transformación dialéctica. La calidad de la producción satisfizo y superó las expectativas docentes, generándose un espacio de revisión del cotidiano de las prácticas docentes.