Mejoramiento de la eficiencia productiva de caprinos de leche de la zona norte de la provincia de Córdoba por el control de enfermedades infecciosas y parasitarias (Red Pictor)

En el norte de la Provincia de Córdoba, la progresiva intensificación de la producción láctea caprina, debido al fuerte incentivo desde áreas gubernamentales, ha dado como resultado la aparición de algunos problemas sanitarios que generalmente pasan desapercibidos cuando las condiciones productivas se desarrollan en sistemas extensivos y muy rudimentarios. Se comienzan a visualizar problemas sanitarios-productivos inherentes a sistemas de mayor eficiencia y derivados de una mayor carga animal y productividad individual como son las parasitosis por nematodes gastrointestinales y las mastitis. El control químico de ambas afecciones se está llevando a cabo en forma totalmente empírica y con un uso indiscriminado e irracional de antimicrobianos y antiparasitarios, con fracasos terapéuticos, aparición de residuos y sin control de tiempos de retiro. En este contexto, además de las pérdidas productivas, existe un riesgo real de enviar leche al consumo o a la industrialización con concentraciones importantes de antibióticos y/o antiparasitarios. Por todo ello, con este proyecto nos planteamos como objetivos identificar principales especies bacterianas y parasitarias que infectan a nuestros rodeos caprinos; identificar los antimicrobianos y antiparasitarios que se utilizan; realizar los mismos estudios de eficacia, farmacocinética y de resistencia, siendo los beneficiarios directos de estos resultados los productores, el profesional veterinario, los consumidores y la industria láctea.

Infección por Toxocara Canis: detección en suelo y en niños y adolescentes de comunidades de la provincia de Córdoba

Toxocara canis es un parásito cosmopolita frecuentemente hallado en el intestino delgado de los caninos. El hombre adquiere la infección con Toxocara por la ingestión de huevos embrionados que se encuentran en el suelo contaminado. En Argentina, las cifras reales de prevalencia de esta infección no se conocen por tratarse de una patología que no es de notificación obligatoria y por la existencia de casos asintomáticos. Los objetivos de este proyecto de investigación son: a) determinar el grado de contaminación con huevos de Toxocara canis de suelos en áreas de uso público y privado de las comunas de Villa El Prado y Los Cedros de la Provincia de Córdoba, b) detectar la presencia de anticuerpos anti-Toxocara canis en niños y adolescentes de estas Comunas, c) relacionar la presencia de anticuerpos con factores de riesgo y d) obtener antígenos excresión/secreción de larvas L2 de Toxocara canis. La presencia de huevos de Toxocara se evaluará en suelo (tierra, arena, mixta) del área de recreo de las escuelas y de áreas externas de cada vivienda (patio, jardín). La presencia de anticuerpos específicos será detectada en niños y adolescente entre 1 a 15 años de edad de ambos sexos que asistan a los dispensarios de las comunas. Para elaborar un sistema de detección de anticuerpos específicos se obtendrán antígenos excresión/secreción de larvas L2 de Toxocara canis. Este proyecto permitirá comparar la seroprevalencia de infección por Toxocara en niños y adolescentes, con otras regiones del país y el extranjero y analizar la relación entre títulos y manifestaciones clínicas. Además, posibilitará caracterizar asociaciones entre infección y factores de riesgo. Debido a la carencia de información sobre esta infección parasitaria en nuestro medio, esta investigación aportará datos útiles para las campañas de desparasitación de mascotas, saneamiento ambiental, tratamiento antiparasitario en personas afectadas y caracterización de manifestaciones clínicas asociadas a esta parasitosis.

Efecto de las Fenotiazinas sobre la vitalidad del Trypanosoma cruzi

La Enfermedad de Chagas, causada por el Tripanosoma cruzi es una parasitosis ampliamente difundida en los países latinoamericanos, constituyendo una patología con un intrincado problema bioecológico y político social. Dado que existen sólo dos drogas tripanocidas aprobadas por la Organización Mundial de la Salud (OMS) efectivas durante la fase aguda de la enfermedad (Nifrutimox, Benznidasol) y con un alto nivel de toxicidad, es que resulta de imperiosa necesidad la búsqueda de nuevos agentes terapéuticos que presenten menores riesgos y mayores beneficios para el paciente, así como para la quimioprofilaxis de la sangre a transfundir en zonas alejadas de centros de salud de complejidad. Hemos demostrado que algunas fenotiazinas, derivados tricíclicos y usados en la clínica psiquiátrica resultan letales sobre tripomastigotes y epimastigotes de T. cruzi, cepa Tulahuen, produciendo disrupción de membrana celular con liberación del contenido citoplasmático o disrupción de la mitocondria del parásito con la consiguiente alteración en la producción de ATP y la posterior muerte del mismo. Los ensayos "in vivo" han revelado ausencia o disminución de la parasitemia con importante sobrevida de los ratones infectados. El presente plan de trabajo tiene como objetivos: Continuar con los estudios de los efectos de derivados fenotiazínicos (Tioridazina) e iniciar el de otros compuestos (Propanolol), sobre la vitalidad del T. cruzi en diseños "in vitro" e "in vivo". El conocimiento de los mecanismos de acción de los compuestos señalados sobre la biología y composición química del parásito, así como sobre el huésped facilitará el hallazgo de potenciales agentes terapéuticos para la Enfermedad de Chagas experimental.

Infección por toxocara canis: detección en suelo y en niños y adolescentes de comunidades de la provincia de Córdoba (Programa: enfermedades transmisibles y emergentes).

Toxocara canis es un parásito cosmopolita frecuentemente hallado en el intestino delgado de los caninos. El hombre adquiere la infección con Toxocara por la ingestión de huevos embrionados que se encuentran en el suelo contaminado. En Argentina, las cifras reales de prevalencia de esta infección no se conocen por tratarse de una patología que no es de notificación obligatoria y por la existencia de casos asintomáticos. Los objetivos de este proyecto de investigación son: a) determinar el grado de contaminación con huevos de Toxocara canis de suelos en áreas de uso público y privado de las comunas de Villa El Prado y Los Cedros de la Provincia de Córdoba, b) detectar la presencia de anticuerpos anti-Toxocara canis en niños y adolescentes de estas Comunas, c) relacionar la presencia de anticuerpos con factores de riesgo y d) obtener antígenos excreción/secreción de larvas L2 de Toxocara canis para el desarrollo de un técnica inmunoenzimática "in house". La presencia de huevos de Toxocara se evaluará en suelo (tierra, arena, mixta) del área de recreo de las escuelas y de áreas externas de cada vivienda (patio, jardín). La presencia de anticuerpos específicos será detectada en niños y adolescente entre 1 a 15 años de edad de ambos sexos que asistan a los dispensarios de las comunas. Para elaborar un sistema de detección de anticuerpos específicos se obtendrán antígenos excreción/secreción de larvas L2 de Toxocara canis. Este proyecto permitirá comparar la seroprevalencia de infección por Toxocara en niños y adolescentes, con otras regiones del país y el extranjero y analizar la relación entre títulos y manifestaciones clínicas. Además, posibilitará caracterizar asociaciones entre infección y factores de riesgo. Debido a la carencia de información sobre esta infección parasitaria en nuestro medio, esta investigación aportará datos útiles para las campañas de desparasitación de mascotas, saneamiento ambiental, tratamiento antiparasitario en personas afectadas y caracterización de manifestaciones clínicas asociadas a esta parasitosis.

Esclerose de varizes do esôfago em pacientes esquistossomóticos

To assess the therapeutic possibilities of injection sclerosis in schistosomotic portal hypertension, a 5-year prospective study was conducted in northeast Brazil, where this parasitosis is endemic. Fifty patients undergoing endoscopy for upper gastrointestinal hemorrage from rupture of esophageal varices from July through December 1981 were chosen for the study. The 32 consenting patients were submitted to injection sclerotherapy paravariceally, using ethanolamine oleate; the 18 refusing to participate were assigned to the control group. The incidence of rebleeding was 28.1% in the former and 44.5% in the latter, a difference wich was not statistically significant (Fisher's test, p = 0.017). Since sclerotherapymarkedly improved the long-term survival rate of the patients, this procedure is advocated for the treatment of esophageal varices in cases of portal hypertension due to schistosomiasis.

The Last Fifteen Years of Schistosomiasis in Venezuela: Features and Evolution

Control of schistosomiasis in Venezuela has been a topic of major interest and controversy among the metaxenic parasitosis. A small area of transmission of approximately 15,000 km2 was thought to be eradicated some years ago. However, some epidemiological characteristics of our transmission area have limited the success on the way toward eradication. Since 1945, when the Schistosomiasis Control Program started, the prevalence in the endemic area has decreased from 14% in 1943 to 1.4% in 1996. Until 1982, the surveillance of active cases was based on massive stool examination. Since then, the Schistosomiasis Research Group (SRG) recommended the additional use of serologic tests in the Control Program and the selective or massive chemotherapy depending on serological and parasitological prevalence of each community. At present, the real prevalence is underestimated due to the fact that approximately 80% of the individuals eliminate less than 100 eggs/g of feces. Those persons could be responsible for the maintenance of the foci going on and therefore limiting the impact of the control measures. Efforts of the SRG are being oriented toward improvement of immunodiagnostic tests by using defined antigens (enzymes) and chemically synthesized peptides, derived from relevant molecules of the parasite, either for antibodies or antigens search. On the other hand, introduction of snail competitors has been a biological weapon in the control of the intermediate host in certain areas. However, the recent reinfestation of water courses by Biomphalaria glabrata, the increased prevalence in some areas, together with important administrative changes at the Control Program of the Minister of Health, have arisen new questions and doubts, challenging the eradication strategy proposed during the last decade.

Schizophrenic delusions: a phenomenological approach.

The issue of specificity of delusions in schizophrenia is still a matter of debate. The authors analyze the delusion formation in schizophrenia from a prototypical, phenomenological point of view, focusing on the subject's experience. This perspective links delusion formation to the autistic predisposition, which is considered here as the elementary phenotypic expression of the vulnerability to schizophrenia. Autism is viewed as a defective preconceptual (i.e., before language) attunement to the world. It impedes the individual's sharing of "common sense" with others and impairs the ability to project into the future. The development of delusions is illustrated, in part, by Klaus Conrad's work on the onset of paranoid schizophrenia. Delusions are viewed as transformations of the structure of experiencing. When threatened in future ability to be, the autistic, vulnerable person looks for the clues to becoming by attributing significance to disparate elements of the environment, which become self-referential. The link established between these disparate elements is based on universal characteristics that give the schizophrenic delusion a metaphysical quality. The transitivistic experience in delusions of control and omnipotence points to a specific way of crossing the border between "mine" and "yours" (disturbances of the experiencing "I"). What strikes a clinician in these delusions is that the normally tacit link between the sense of being and the sense of acting becomes quite apparent. The authors also propose a specificity in the themes of schizophrenic delusions. Delusions acquire a schizophrenic quality when ontological (i.e., universal) elements of the discourse between the locutor and the Other dominate at the expense of the worldly elements. It is emphasized that delusional content and form are dialectically related and hardly distinguishable. The authors consider the delusion formation as a phenomenon of emergence, a situation in which a new qualitative order arises from the reorganization of essentially unchanged elements. To consider schizophrenia as an emergent, particular way of experiencing, related to the autistic defect, has important consequences for research and for treatment. A dialectic exchange is needed between prototypical models generated by phenomenological inquiry and empirical, operational validation of testable aspects of such models.

Clinical-epidemiological profile of children with schistosomal myeloradiculopathy attended at the Instituto Materno-Infantil de Pernambuco

The most critical phase of exposure to schistosomal infection is the infancy, because of the more frequent contact with contaminated water and the immaturity of the immune system. One of the most severe presentations of this parasitosis is the involvement of the spinal cord, which prognosis is largely dependent on early diagnosis and treatment. Reports on this clinical form of schistosomiasis in children are rare in the literature. We present here the clinical-epidemiological profile of schistosomal myeloradiculopathy (SMR) from ten children who were admitted at the Instituto Materno-Infantil de Pernambuco over a five-year period. They were evaluated according to an investigation protocol. Most of these patients presented an acute neurological picture which included as the main clinical manifestations: sphincteral disorders, low back and lower limbs pain, paresthesia, lower limbs muscle weakness and absence of deep tendon reflex, and impairment of the gait. The diagnosis was presumptive in the majority of the cases. This study emphasizes the importance of considering the diagnosis of SMR in pediatric patients coming from endemic areas who present a low cord syndrome, in order to start the appropriate therapy and avoid future complications.

Effects of Brazilian propolis on Leishmania amazonensis

Leishmaniasis, an endemic parasitosis that leads to chronic cutaneous, mucocutaneous or visceral lesions, is part of those diseases, which still requires improved control tools. Propolis has shown activities against different bacteria, fungi, and parasites. In this study we investigated the effect of four ethanolic extracts of typified propolis collected in different Brazilian states, on Leishmania amazonensis performing assays with promastigote forms, extracellular amastigotes, and on infected peritoneal macrophages. Ethanolic extracts of all propolis samples (BRG, BRPG, BRP-1, and BRV) were capable to reduce parasite load as monitored by the percentage of infected macrophages and the number of intracellular parasites. BRV sample called red propolis, collected in the state of Alagoas, and containing high concentration of prenylated and benzophenones compounds, was the most active extract against L. amazonensis. The anti-Leishmania effect of BRV sample was increased in a concentration and time dependent manner. BRV treatment proved to be non-toxic to macrophage cultures. Since BRV extract at the concentration of 25 µg/ml reduced the parasite load of macrophages while presented no direct toxic to promastigotes and extracellular amastigotes, it was suggested that constituents of propolis intensify the mechanism of macrophage activation leading to killing of L. amazonensis. Our results demonstrate, for the first time, that ethanolic extracts of Brazilian propolis reduce L. amazonensis infection in macrophages, and encourage further studies of this natural compound in animal models of leishmaniasis.

Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis

BACKGROUND Persons with schizophrenia and related disorders may be particularly sensitive to a number of determinants of service use, including those related with illness, socio-demographic characteristics and organizational factors. The objective of this study is to identify factors associated with outpatient contacts at community mental health services of patients with schizophrenia or related disorders. METHODS This cross-sectional study analyzed 1097 patients. The main outcome measure was the total number of outpatient consultations during one year. Independent variables were related to socio-demographic, clinical and use of service factors. Data were collected from clinical records. RESULTS The multilevel linear regression model explained 46.35% of the variance. Patients with significantly more contacts with ambulatory services were not working and were receiving welfare benefits (p = 0.02), had no formal education (p = 0.02), had a global level of severity of two or three (four being the most severe) (p < 0.001), with one or more inpatient admissions (p < 0.001), and in contact with both types of professional (nurses and psychiatrists) (p < 0.001). The patients with the fewest ambulatory contacts were those with diagnoses of persistent delusional disorders (p = 0.04) and those who were attended by four of the 13 psychiatrists (p < 0.001). CONCLUSIONS As expected, the variables that explained the use of community service could be viewed as proxies for severity of illness. The most surprising finding, however, was that a group of four psychiatrists was also independently associated with use of ambulatory services by patients with schizophrenia or related disorders. More research is needed to carefully examine how professional support networks interact to affect use of mental health.

Tropical diseases screening in immigrant patients with HIV infection in a European country.

Prospective observational study of all HIV infected immigrants visited at the Infectious Diseases Department of the Hospital Universitari Vall d’Hebron from June 2010 to May 2011. Screening of most prevalent tropical diseases was performed according to geographical origin. 190 patients were included. Overall, 36.8% (70/190) patients had at least one positive result for any parasitic disease, including Chagas disease, schistosomiasis, strongyloidiasis, leishmaniasis, intestinal parasitosis and malaria. We propose a screening and management strategy of latent parasitic infections in immigrant HIV infected patients.

Délire temporel systématisé et trouble auditif d'origine corticale [Systematized temporal delusion and hearing disorders of cortical origin].

We report a case of delusion characterized by a time disorientation with a constant three days advance. Five years previously, the patient had suffered a left hemisphere stroke with aphasia. The delusional belief appeared at the same time as a cortical deafness following a second right hemisphere infarction. There was severe behaviour disturbances which lasted seven months, then cleared without any other change in the clinical picture. The lesions involved the left parietal lobe as well as the temporal and insular regions of both hemispheres.

Identifying psychotic defenses in a clinical interview.

The Defense Mechanisms Rating Scales (DMRS), one of the most widely used and validated instruments in the study of defense mechanisms, does not include psychotic defenses. The Psychotic-DMRS (P-DMRS) has been developed to include 6 psychotic defense mechanisms: psychotic denial, autistic withdrawal, distortion, delusional projection, fragmentation, and concretization. We discuss psychotic defenses, including the difference between psychotic defenses and psychotic symptoms. Six clinical illustrations demonstrate how the 6 P-DMRS defenses can be identified in patients' narratives selected from the transcripts of dynamic interviews. Implications with respect to patient evaluation and treatment are discussed.

Toward partial redirection of energy policy for responsible development

This paper addresses the surprising lack of quality control on the analysis and selection on energy policies observable in the last decades. As an example, we discuss the delusional idea that it is possible to replace fossil energy with large scale ethanol production from agricultural crops. But if large scale ethanol production is not practical in energetic terms, why huge amount of money has been invested in it and is it still being invested? In order to answer this question we introduce two concepts useful to frame, in general terms, the predicament of quality control in science: (i) the concept of “granfalloons” proposed by K. Vonnegut (1963) flagging the danger of the formation of “crusades to save the world” void of real meaning. These granfalloons are often used by powerful lobbies to distort policy decisions; and (ii) the concept of Post-Normal science by S. Funtowicz and J. Ravetz (1990) indicating a standard predicament faced by science when producing information for governance. When mixing together uncertainty, multiple-scale and legitimate but contrasting views it becomes impossible to deal with complex issue using the conventional scientific approach based on reductionism. We finally discuss the implications of a different approach to the assessment of alternative energy sources by introducing the concept of Promethean technology.

What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation

The study shows that social anxiety and persecutory ideation share many of the same predictive factors. Non-clinical paranoia may be a type of anxious fear. However, perceptual anomalies are a distinct predictor of paranoia. In the context of an individual feeling anxious, the occurrence of odd internal feelings in social situations may lead to delusional ideas through a sense of" things not seeming right". The study illustrates the approach of focusing on experiences such as paranoid thinking rather than diagnoses such as schizophrenia.