Surveillance of Candida spp bloodstream infections: epidemiological trends and risk factors of death in two Mexican tertiary care hospitals.

Introduction: Larger populations at risk, broader use of antibiotics and longer hospital stays have impacted on the incidence of Candida sp. bloodstream infections (CBSI).

Objective: To determine clinical and epidemiologic characteristics of patients with CBSI in two tertiary care reference medical institutions in Mexico City.

Extended spectrum β-lactamase producers among nosocomial Enterobacteriaceae in Latin America.

To review the epidemiology of nosocomial extended spectrum β-lactamase-producing Enterobacteriaceae in Latin America, a systematic search of the biomedical literature (PubMed) was performed for articles published since 2005. Rates of nosocomial infections caused by extended spectrum β-lactamase-producing Enterobacteriaceae in Latin America have increased since 2005. Up to 32% of Escherichia coli and up to 58% of Klebsiella pneumoniae isolates are extended spectrum β-lactamase-positive, rates that are higher than in other world regions.

Active surveillance of candidemia in children from Latin America: a key requirement for improving disease outcome.

Background: Active surveillance is necessary for improving the management and outcomes of patients with candidemia. The aim of this study was to describe the epidemiologic and clinical features of candidemia in pediatric patients in Latin America.

Method: Prospective, multicenter, surveillance study of candidemia in a pediatric population from 23 hospitals in 8 Latin America countries between November 2008 and October 2010.

[Notes-hybrid: splenectomy (transvaginal/umbilical)].

In the search of less invasive surgery, laparoscopic procedures through natural orifices accesses have begun to be standardized Considering that women have the higher prevalence of idiopathic thrombocytopenic purpura, the purpose of this presentation is to demonstrate our first experience performing a hybrid NOTES (natural orifice transluminal endoscopic surgery) splenectomy, with the transvaginal and umbilical-multi-port access as doors to perform the procedure. We present a 30-year-old woman with body mass index 22 kg/m2 and platelet count 55,000 per microliter-x103/uL. A refractory autoimmune thrombocytopenic purpura was diagnosed.

A case of acute multifocal inner retinitis associated with nonspecific viral illness.

Purpose: To describe a patient with sudden unilateral loss of vision associated with white inner retinal lesions and a history of a nonspecific viral infection.

Methods: Case report. We reviewed the medical record and retinal angiogram of one patient.

Diagnostic accuracy of immunological methods in patients with tuberculous pleural effusion from Venezuela.

In recent years, better diagnostics for tuberculosis (TB) has received increasing attention, especially the diagnosis of tuberculous pleural effusion, which is difficult and at present the main tool in TPE diagnostic is pleural effusion smear and culture, but unfortunately, sensitivities are low, therefore better TPE diagnostic tools are needed. The aim of this study was to find a diagnostic algorithm to assess the progress in TPE diagnostic at the Hospital Vargas de Caracas, that permits identification of the majority of patients, at a satisfactory cost-benefit ratio, evaluating the levels of IFN-gamma and IL-12p40 in pleural effusion and serum, as well as the antibody reactivity in order to compare it with microbiological tests. A total of 60 individuals with pleural effusion were studied; 20 patients with tuberculous pleural effusion (TPE) formed the patient group and 40 patients with non-tuberculous pleural effusion (NTPE) formed the control group.

Evaluation of the Kudoh swab method for the culturing of Mycobacterium tuberculosis in rural areas.

Objective: To compare the simple, swab 'Kudoh method' for culturing Myobacterium tuberculosis from sputum samples, to the standard Petroff digestion-decontamination procedure. The Kudoh method, which requires no centrifugation and takes only 4-5 min per sample, was also evaluated for its performance in a rural setting.

Methods: Two hospital laboratories in Caracas, Venezuela processed 314 sputum samples, in parallel, with both methods.

Effect of folic acid combined with fluoxetine in patients with major depression on plasma homocysteine and vitamin B12, and serotonin levels in lymphocytes.

Objective(s): Folic acid, a micronutrient supporting the natural defense system, may elevate antidepressant responses, although the lymphocyte serotonergic system has not been explored in folate-supplemented depressed patients.

Methods: Twenty-seven patients were randomly assigned to groups receiving fluoxetine (20 mg) and folic acid (10 mg/day) or fluoxetine and placebo for 6 weeks. Clinical outcome was assessed according to the Hamilton Depression Rating Scale (HDRS) at the beginning, during and at the end of treatment.

Lung metastases of low grade phyllodes tumor of the prostate: histopathologic confirmation.

Objective: Phyllodes tumor of the prostate is a rare neoplasm. We report the clinical, histopathological, and immunohistochemical features of a low grade phyllodes tumor of the prostate with lung metastases.

Methods: A 68-year-old man presented acute urinary obstruction.

[Validation of the PRIME-MD for the detection of generalized anxiety disorder].

The objectives of this study were first, to validate the Primary Care Evaluation of Mental Disorders (PRIME-MD) as an instrument that identifies the generalized anxiety disorder (GAD) in psychiatric consultations and second, to determine the frequency of GAD in two types of psychiatric consultation settings. To begin with, 1000 medical records of outpatients from the Psychiatry Department of the Hospital Vargas de Caracas were checked to determine the frequency of GAD diagnosis. Then, the PRIME-MD was validated with 100 outpatients from the Hospital Vargas de Caracas and 200 outpatients from private hospitals.

24-locus MIRU-VNTR genotyping is a useful tool to study the molecular epidemiology of tuberculosis among Warao Amerindians in Venezuela.

While the gold standard for molecular epidemiological studies on tuberculosis is changing towards MIRU-VNTR typing because this technique generates easily analyzed numerical results, it is less labor intensive and has a discriminative power comparable to that of IS6110-based RFLP, especially when 24 loci are analyzed; more extensive and representative validation studies are needed to confirm this. In this study we genotyped 41 Mycobacterium tuberculosis isolates, about 40% of the total case load of the study year, from the Warao people, an indigenous population who live in a geographically isolated area in Venezuela and have a high TB incidence of 450/100,000. IS6110-based RFLP analysis on these isolates indicates that 78% of the strains are in clusters, suggesting a very high transmission rate.

Pneumococcal carriage among indigenous Warao children in Venezuela: serotypes, susceptibility patterns, and molecular epidemiology.

Little attention has been paid to pneumococcal carriage and disease in Amerindians from Latin America. The Warao people, an indigenous population from Venezuela, live in the delta of the Orinoco River in geographically isolated communities with difficult access to medical care. To obtain insight into pneumococcal carriage and the theoretical coverage of pneumococcal vaccines in this population, we investigated pneumococcal colonization, serotype, and genotype distribution among Warao children in 9 distinct, geographically isolated communities in the Delta Amacuro area in the northeast of Venezuela.

The secretory immunoglobulin A response to Mycobacterium tuberculosis in a childhood population.

We report on the measurement of saliva anti-Purified Protein Derivative sIgA and 38kDa antibodies from 127 children, of whom 31 were strong tuberculosis suspects and 96 were healthy contact children. The results concerning the percentage of children with antibody reactivity to PPD and 38kDa antigens showed that, of these 2 antigens, 38kDa induced higher reactivity in patients positive and negative for the Tuberculin Skin Test (28% and 16.6%, respectively) in comparison to controls positive and negative for the TST (11.

Noradrenaline transporter and its turnover rate are decreased in blood lymphocytes of patients with major depression.

Lymphocytes possess transporters of serotonin and dopamine, and also contain monoamines. The objective of this work was to determine the presence of noradrenaline transporters, the turnover rate of noradrenaline and serotonin in lymphocytes of major depression patients, and to correlate the biochemical parameters with the severity of the disorder. Lymphocytes from peripheral blood were isolated by Ficoll/Hypaque, and noradrenaline transporter was studied by binding of [3H]nisoxetine: control group (29, age 31.

Basaloid carcinoma of the prostate gland. An unusual finding.

Objectives: Carcinoma with basaloid features, known as basaloid carcinoma of prostate, is an extremely rare tumor. We report the clinical, histological and immunohistochemical findings in a case of prostatic basaloid carcinoma.

Methods/results: A 68-year old man consulted with a two-year history of increasing urinary outflow obstruction that developed into acute urinary retention.

Transforming growth factor-beta2 and beta3 expression in carcinoma of the prostate.

Objectives: The present study reports the clinical and histological features of 14 cases of prostate adenocarcinoma coupled with their expression of the TGF isoforms beta2 and beta3, as well as their receptor endogline (CD105).

Methods: Fourteen (14) cases of adenocarcinoma (ADC) of the prostate were examined. Relevant clinical data were gathered From the histological point of view, the tumor's grade and the evidence of perineural, vascular and/or lymphatic invasion were the key elements taken into account.

[Primary urothelial carcinoma of the bulbomembranous urethra. Histologic and immunohistochemical study of a case].

Objective: We report a case of a primary urothelial carcinoma of the bulbomembranous urethra, with special emphasis on histopathological and immunohistochemical findings.

Methods/results: A 63-year-old man presented urethral obstruction symptoms. A radical phalectomy was performed and a 4.

Corkscrew retinal vessels in neurofibromatosis type 1: report of 12 cases.

Aim: To describe a distinctive spectrum of retinal microvascular abnormalities in 12 patients with neurofibromatosis type 1 (NF-1).

Methods: This is an observational prospective study of the ocular fundus evaluated by direct ophthalmoscopy with or without fluorescein angiography, to investigate retinal microvascular abnormalities in 32 patients with NF-1 and in 30 control subjects. The evaluation included a complete general and neurological physical examination and in some cases computed tomography, magnetic resonance imaging with gadolinium-DTPA, or both.

[Influence of helminthic infections and nutritional status on immune response in Venezuelan children].

We investigated the influence of nutritional status, as determined from anthropometric measurement, and of helminthic infections on the immune response of children of low socioeconomic status in two rural communities in Venezuela: El Cardón in the state of Nueva Esparta and San Daniel in the state of Miranda. A total of 125 boys and girls between 2 and 15 years old participated in the study. Their socioeconomic stratum was determined by a modified Graffar method.

Kikuchi-Fujimoto necrotizing lymphadenitis associated with cutaneous lupus erythematosus: a case report.

Histiocytic necrotizing lymphadenitis or Kikuchi-Fujimoto disease is a rare entity, and even more rarely, it is associated with other diseases. In a few cases, the condition is associated with cutaneous lupus erythematosus (CLE). Histiocytic necrotizing lymphadenitis predominantly affects young women, who present with solitary or multiple cervical lymphadenopathy accompanied by symptoms such as fever, weight loss, sweating, or, in exceptional cases, hepatosplenomegaly.

Bacterial resistance to antimicrobial agents in Latin America. The giant is awakening.

Resistant bacteria are emerging in Latin America as a real threat to the favorable outcome of infections in community- and hospital-acquired infections. Despite present extensive surveillance, healthcare workers who most need the information may be unaware of this growing problem. Outbreaks of meningococci with diminished susceptibility to penicillin have been reported in the region; a constant increase of resistance to penicillin in pneumococci and poor activity of commonly used oral antibiotics for the treatment of community-acquired urinary tract infections have made the treatment of these infections more difficult.

Cytogenetic studies in patients with hemophilic hemarthrosis treated by 198Au, 186Rh, and 90Y radioactive synoviorthesis.

This study assesses chromosomal structural changes (CSCs) studied by conventional lymphocyte cultures and banding techniques in 79 hemophilic patients with hemarthrosis treated with radioactive synoviorthesis, 31 hemophilic patients with hemarthrosis not treated by this procedure, and 110 nonhemophilic patients matched by age and sex (control group). In 14 patients treated with 198Au (group A), premalignant CSCs and nonspecific CSCs were found, respectively, in 1.69% and 17.

[Isolation, identification and serotyping of yeasts obtained from the vaginal fluid in patients with clinical vaginitis].

A study was carried out to determine the presence of Candida in 105 patients with clinical vaginitis who consulted in the Infectious Disease Unit of the Vargas Hospital after referral from Gynecology Service. Yeasts were detected in 23 cases (24%), and identified as C. albicans (12), C.