An unidentified cluster of infection in the Peruvian Amazon region

Introduction: Bartonella bacilliformis is the etiological agent of Carrion’s disease, which is a neglected disease linked to people in low-socioeconomic populations in Andean valleys. An outbreak of B. bacilliformis was reported in a rural area of the Peruvian Amazon region. The aim of this study was to characterize this outbreak using molecular techniques. Methodology: Fifty-three blood samples from patients diagnosed with Carrion’s disease were analyzed by molecular tools, using both a Bartonella-specific polymerase chain reaction (PCR) and an universal PCR, both based on 16S rRNA gene amplification. Additional water samples from the area were also analyzed. Results: Unexpectedly, the samples were positive only when the universal PCR was used. Although environmental contamination cannot be ruled out, the results showed that Sphingomonas faeni was the possible causative agent of this outbreak, and that water was the most feasible infection source. Conclusions: Diagnosis by clinical criteria or microscopy may lead to misdiagnosis. There is a need to include molecular tools in the routine diagnosis of febrile syndromes, including Carrion’s disease.

Author(s): Cornejo Tapia, Ángela; Gomes, Cláudia; Suárez Ognio, Luis; Martínez Puchol, Sandra; Bustamante, Pershing; Pons, Maria J.; Ruiz, Joaquim; Del Valle Mendoza, Juana
Source:  The Journal of Infection in Developing Countries (J Infect Dev Ctries.)

URL: http://hdl.handle.net/10757/555445

Atypical presentation of Gorham-Stout syndrome. Case report

Gorham-Stout syndrome is an extremely rare pathology, of unknown etiology. It is characterized by proliferation of vascular channels that causes destruction and reabsorption of the bone matrix. We present a nine year-old male patient with an acute episode characterized by fever, chest pain, respiratory distress and dyspnea. The patient was submitted to computed tomography scan and a biopsy. The findings in the biopsy were multiple lytic lesions, osteolysis, and a mediastinal lymphangioma (lymphangiomatosis). The diagnosis was Gorham-Stout syndrome with atypical presentation

Author(s): González Luna, Alejandro; Nuñez Pizarro, Jorge Luis; Rodríguez Echegaray, Clodo Iván
Source:  Archivos argentinos de pediatría (Arch. argent. pediatr.)

URL: http://hdl.handle.net/10757/555429

Characterization of two Achromobacter xylosoxidans isolates from patients with pertussis-like symptoms

Objective: To characterize two Achromobacter xylosoxidans recovered from 2 patients diagnosed with pertussis during a Bordetella pertussis surveillance program. Methods: Nasopharyngeal swabs from 2 children under 1 year of age with clinical suspicion of pertussis were analyzed by culture and PCR. Results: Two Achromobacter xylosoxidans A8, closely related to Bordetella spp. were recovered from 2 patients diagnosed of pertussis, both carrying the ptxA gene and IS418 the pertussis toxin encoding gene. Subsequently, antibiotic susceptibility was evaluated by disk-diffusion method and by PCR. Conclusions: Although more detailed studies are needed, the present data highlight the possibility that Achromobacter xylosoxidans, closely related Bordetella pertussis microorganisms and not covered under the vaccine umbrella, might also result in cases of whooping cough. Thereby further surveillance is necessary to determine the extension and relevance of their pathogenic role in order to discriminate their real public health implication.

Author(s): Pons, Maria J.; Gomes, Cl觃udia; Bada, Carlos; Reyes, Isabel; Del Valle Mendoza, Juana; Ruiz, Joaquim
Source:  Asian Pacific Journal of Tropical Medicine (Asian Pacific Journal of Tropical Medicine)

URL: http://hdl.handle.net/10757/554305

Nephrology: is a medical specialty unattractive to Peruvian doctors?

Although the National Committee of Medical Residency (CONAREME) has increased the number of nephrology residency positions in Peru, the increase has not been proportional to the number of applicants. This is worrisome in an environment lacking of nephrologists, like our country. The Peruvian Society of Nephrology (SPN) should take the measures to make this specialty more attractive to Peruvian physicians.

Author(s): Herrera Añazco, Percy; Mezones Holguin, Edward; Hernandez, Adrian V.
Source:  Jornal Brasileiro de Nefrologia (J. Bras. Nefrol)

URL: http://hdl.handle.net/10757/554221

Factors associated with poor sleep quality among patients with chronic kidney diseases in hemodialysis

Introduction and objectives Sleep disorders are one of the most common comorbidities among patients on hemodialysis. The aims of this study were to determine the prevalence of poor sleep quality as well as to establish potential factors associated with poor sleep quality. Materials and methods A cross-sectional study was performed enrolling patients with chronic kidney disease on hemodialysis. The outcome was sleep quality evaluated using the Pittsburgh Scale, whereas the exposure variables were time on hemodialysis, history of type-2 diabetes and hypertension, depressive symptoms, anemia, and uremia. We used Poisson regression model to determine the association of interest, reporting prevalence ratios (PR) and 95% confidence intervals (95%CI). Results A total of 450 patients were enrolled, 259 (57.5%) were male, aged from 18 to 97 years. The prevalence of poor sleep quality was 79.3% (95%CI: 75.6%–83.1%). Poor sleep quality was associated with depressive symptoms (PR = 1.28; 95%CI: 1.17-1.39), anemia (PR = 1.18; 95%CI: 1.04-1.34) and uremia (PR = 1.26; 95%CI: 1.17-1.36) after controlling for potential confounders. Conclusions The presence of depressive symptoms, anemia and uremia were positively associated with poor sleep quality among patients with chronic kidney disease on hemodialysis. A great proportion of this population had poor sleep quality. Strategies are needed to improve sleep quality in these patients.

Author(s): Peña Martínez, Bruce; Navarro, Veronica; Oshiro, Harumi; Bernabe Ortiz, Antonio
Source:  Elsevier B.V.

URL: Dialisis y Traspante (Dial Traspl)