Resumen ANTECEDENTES: Las duplicaciones del aparato digestivo son una variante poco frecuente de malformación congénita. Si bien la mejora de los equipos de ecografía ha aumentado la tasa diagnóstica, solo el 30% se diagnostican antes del nacimiento. El diagnóstico diferencial de lesiones quísticas intraabdominales es amplio e incluye, por ejemplo, a los quistes de ovario, colédoco, mesenterio o pseudoquistes de meconio. El tratamiento es quirúrgico mediante la resección y restauración de la continuidad intestinal. CASO CLÍNICO: Paciente de 32 años, con un embarazo previo y en el segundo trimestre del actual, con sospecha de un quiste de duplicación intestinal. El estudio genético no evidenció anomalía alguna. La lesión, de morfología quística tubular, fue aumentando progresivamente de tamaño conforme avanzaban las semanas de embarazo. En la semana 39 se indicó, por diabetes gestacional insulinodependiente, la inducción del parto. Nació un varón, asintomático, mediante parto eutócico, sin complicaciones. La ecografía abdominal, resonancia magnética nuclear y estudio del tránsito intestinal del periodo neonatal temprano confirmó el diagnóstico prenatal de sospecha. Mediante una laparoscopia exploradora, a las dos semanas de vida se practicó la resección del defecto que se reportó como: duplicación intestinal ileal, sin comunicación con la luz intestinal. El curso posoperatorio fue favorable. CONCLUSIONES: El diagnóstico prenatal de quistes de duplicación en el aparato digestivo está en aumento debido a la mejoría en las técnicas de diagnóstico prenatal. La valoración multidisciplinaria es decisiva para procurar una adecuada vigilancia médica del embarazo y del recién nacido.

Abstract BACKGROUND: Duplications of the digestive tract are a rare variant of congenital malformation that can occur anywhere in the digestive tract. Although improved ultrasound equipment has increased the diagnostic rate, only 30% are diagnosed before birth. The differential diagnosis of intra-abdominal cystic lesions is broad and includes, for example, cysts of the ovary, common bile duct, mesentery or meconium pseudocysts. Treatment is surgical by resection and restoration of intestinal continuity. CLINICAL CASE: 32-year-old patient, with a previous pregnancy and in the second trimester of the current pregnancy, with suspicion of an intestinal duplication cyst. The genetic study did not reveal any abnormality. The lesion, of tubular cystic morphology, progressively increased in size as the weeks of pregnancy progressed. Induction of labour was indicated in week 39 due to insulin-dependent gestational diabetes. An asymptomatic male was born by euthecological delivery, without complications. Abdominal ultrasound, nuclear magnetic resonance imaging and intestinal transit study of the early neonatal period confirmed the suspected prenatal diagnosis. By means of exploratory laparoscopy, at two weeks of life, resection of the defect was performed, which was reported as: ileal intestinal duplication, without communication with the intestinal lumen. The postoperative course was favourable. CONCLUSIONS: Prenatal diagnosis of duplication cysts in the digestive tract is increasing due to improved prenatal diagnostic techniques. Multidisciplinary assessment is crucial to ensure adequate medical surveillance of the pregnancy and the newborn.

ABSTRACT Objectives: The pandemic caused by the biological agent SARS-CoV-2 had a great impact among the working population in the health field. This study aims to describe the most relevant events experienced by the professionals of the Navarro Health Service-Osasunbidea, related to infections, reinfections, vaccination and professional contingencies, throughout the pandemic waves. Material and Methods: Descriptive cross-sectional study that encompasses the period between March 4, 2020 to September 30, 2022. The data was obtained from the computer application for registration and monitoring of cases RASTREA® and of the Population Vaccine Registry INMUNIS®. The results were grouped and presented according to age range and job position. The vaccination impact and professional contingencies were estimated using statistical models. Results: The total number of infections studied was 9,692: 88.17% professionals suffered a single infection; 11.32% were reinfected for the second time and only 0.49% professionals registered three infections. The impact of the vaccination intervention was significant during the fourth and fifth pandemic waves and decreased after the sixth. 99.5% (0.97-1.01) fourth, 97.3% (0.95-0.99) fifth, dropping to 72.8% (0.71-0.74) during the sixth and 81.6% (0.79-0.83) and 84.7% (0.83-0.86) during the sixth A and B respectively (direct effectiveness with 95%CI). Conclusions: The sixth wave of the pandemic had a great impact on health workers. The professionals with greater proximity in patient care experienced a higher rate of infections and reinfections of doctors and nurses. Age was a variable associated with a higher prevalence of infection in younger age groups. The highest number of infections and reinfections corresponded to hospital setting. Due to the vaccination intervention, almost no fourth wave was observed in the healthcare workplace.

RESUMEN. Objetivos: El SARS-CoV-2 tuvo gran impacto entre los profesionales del ámbito sanitario. El presente estudio pretende describir los acontecimientos más relevantes experimentados por los profesionales del Servicio Navarro de Salud-Osasunbidea, relacionados con infecciones, reinfecciones, vacunación y contingencias profesionales durante la pandémicas. Material y Métodos: Estudio transversal descriptivo que engloba el periodo entre el 04 de marzo de 2020 y el 30 de septiembre del 2022. Los datos se obtuvieron de la aplicación informática Rastrea® y del Registro Poblacional de vacunas INMUNIS®. Los resultados se agruparon según edad y puesto de trabajo. Se estimaron el impacto vacunal y las contingencias profesionales mediante modelos estadísticos. Resultados: El total de infecciones estudiadas fue de 9692: un 88,17% de profesionales padecieron una infección; el 11,32% dos y solo el 0,49% tres infecciones. El impacto de la intervención vacunal fue importante durante la cuarta y quinta onda pandémica y disminuyó a partir de la sexta. Un 99,5% (0,97-1,01) cuarta, un 97,3% (0,95-0,99) quinta, bajando al 72,8% (0,71-0,74) durante la sexta y 81,6% (0,79-0,83) y 84,7% (0,83-0,86) durante la sexta A y B respectivamente (efectividad directa con IC95%). Conclusiones: La sexta onda tuvo gran impacto en los sanitarios. Los profesionales con mayor proximidad en atención al paciente experimentaron mayor tasa de infecciones y reinfecciones (enfermeras y médicos). La edad fue una variable asociada a mayor prevalencia de infección en grupos de edad menores. El mayor número de infecciones y reinfecciones correspondió al ámbito hospitalario. Debido a la intervención vacunal, casi no se observó cuarta onda en el ámbito laboral sanitario.

Resumen Introducción: El eculizumab es un anticuerpo monoclonal de tipo IgG diseñado para el tratamiento de la hemoglobinuria paroxística nocturna (HPN), en el que su diana farmacológica forma parte del sistema del complemento. Su mecanismo de acción ha permitido implementarlo en el tratamiento de enfermedades huérfanas, como el síndrome urémico hemolítico atípico (SUHa), trastorno del espectro de la neuromielitis óptica (TENMO) y miastenia gravis, cuya incidencia, es baja. Asimismo, es viable en el tratamiento de Guillain Barré y el síndrome antifosfolípido catastrófico (CAPS). Objetivo: Evidenciar aplicaciones terapéuticas del eculizumab y beneficios más significativos en algunos padecimientos. Materiales y métodos: Se realizó búsqueda bibliográfica en el periodo 2010-2021, en bases de datos: Google Scholar, Science Direct, PubMed y Scielo, utilizando como palabra clave “eculizumab”. Posteriormente, se afinó la búsqueda utilizando palabras claves asociadas a enfermedades tratadas con este medicamento. Resultados: Se identificó el mecanismo de acción del fármaco y su efecto sobre la patogénesis de hemoglobinuria paroxística nocturna, síndrome urémico atípico, miastenia gravis generalizada refractaria, trastorno del espectro de la neuromielitis óptica, síndromes antifosfolípidos catastrófico y Guillain-Barré. Conclusiones: El eculizumab tiene una alta seguridad y capacidad para tratar y disminuir síntomas de diversas enfermedades que involucran el sistema del complemento.

Abstract Introduction: Eculizumab is an IgG type monoclonal antibody designed to treat paroxysmal nocturnal hemoglobinuria (PNH) and its pharmacological target is a member of the complement system. Its mechanism of action has permitted its use in the treatment of orphan diseases such as atypical hemolytic uremic syndrome (aHUS), neuromyelitis optic spectrum disorder (NMOSD), and myasthenia gravis, all of which have a low incidence. Likewise, eculizumab is a viable treatment for Guillain Barré and catastrophic antiphospholipid syndrome (CAS). Objective: To describe the therapeutic applications of eculizumab and its most significant benefits in some illnesses. Materials and methods: A bibliographic search was carried out during the 2010-2021 period in Google Scholar, Science Direct, PubMed and Scielo databases using the keyword eculizumab. Then, the search was refined by using keywords associated with diseases treated with this medication. Results: The mechanism of action of the antibody and its effect on the pathogenesis of paroxysmal nocturnal hemoglobinuria, atypical hemolytic uremic syndrome, refractory generalized myasthenia gravis, neuromyelitis optic spectrum disorder, catastrophic antiphospholipid syndrome, and Guillain Barré were identified. Conclusions: Eculizumab has high safety and capacity in treating and diminishing symptoms of diverse illnesses, which involve the complement system.

Resumen En este artículo se hace una reflexión desde el Trabajo Social sobre la elaboración de un diagnóstico social asociado a una comunidad transnacional que se ha configurado entre México y Estados Unidos. El diagnóstico se construye a través de la interpretación de información que circula dentro de la comunidad tamazulense (oriunda de Tamazula de Gordiano) residente en Estados Unidos. Para el estudio de caso se utilizó la interacción comunicativa online, que genera vínculos estrechos, constantes y cotidianos entre la población de “aquí y de allá”, manteniendo unida a la población en la distancia. Así mismo, la interacción comunicativa estudiada mediante la etnografía virtual, pretende generar información útil de carácter teórico-metodológico, con el fin de generar un proyecto de intervención binacional como una oportunidad de colaboración entre disciplinas en el tema de políticas migratorias, así como su participación en programas desarrollados en las oficinas consulares para la atención de los connacionales.

Abstract This article undertakes a reflection, from a perspective of social work, about the elaboration of a social diagnosis associated with a transnational community which has formed between México and The United States of America. The diagnosis is constructed through the interpretation of information which circulates within the Tamazulan community (origin in Tamazula de Gordiano) resident in The United States. This case study takes into account online communicative interaction which generates close and constant quotidian bonds between the population that is “here and there”, and thus maintains unity within the population in spite of the distance. Furthermore, the communicative interaction studied by means of virtual ethnography is intended to generate useful information of a theoretical-methodological character which will contribute to the generation of a project of binational intervention. This project will be an opportunity for collaboration among disciplines in the scope of migratory policies, and will participate in programs developed in consulates.

Abstract: Egg is important in the human diet because it has a high protein index and is widely available in the market; it is easy to prepare and has a competitive price against other sources of protein of animal origin. In 2012, México recorded 20.8 kilograms, the highest per capita consumption of egg in the world. The objective of this study was to analyze the table egg market in México and its defining factors. An econometric model of simultaneous equations was used with information for the 1970-2012 period. The offer tuned out to be inelastic at producer prices of egg, chicken and balanced meal; the demand is inelastic at consumer prices of egg, chili, pork meat, bean, and income. The increase of 73 % in nominal consumer price of egg, which was found between July and August 2012, due to the fall in production caused by the avian flu outbreak, should have increased only 45.78 %; the difference was due to speculative issues.

Resumen: El huevo es importante en la alimentación humana por su alto índice proteínico y amplia disponibilidad en el mercado; es de fácil preparación y con precio competitivo contra otras fuentes de proteína de origen animal. En 2012 México registró un consumo de 20.8 kilogramos, el mayor per cápita de huevo en el mundo. El objetivo de este estudio fue analizar el mercado del huevo para plato en México y sus factores determinantes. Se utilizó un modelo econométrico de ecuaciones simultáneas con información del periodo 1970-2012. La oferta resultó inelástica a los precios al productor de huevo, pollo y alimento balanceado; la demanda es inelástica a los precios al consumidor de huevo, chile, carne de porcino, frijol, y al ingreso. El incremento del precio nominal al consumidor de huevo de 73 %, que se registró entre julio y agosto de 2012, por efecto de la caída en la producción originada por el brote de gripe aviar, debió aumentar solo 45.78 %; la diferencia se debió a cuestiones especulativas.

CONTEXTO: El Sentido de Coherencia (SOC) de Antonowsky (1996) que se desprende del modelo salutogénico y el modelo multifactorial de Salud Mental Positiva (SMP) Lluch (1999), definen dos constructos que sirven para comprender, evaluar e intervenir sobre la promoción y el mantenimiento de un buen estado de salud mental. OBJETIVO(S): Fueron evaluados la autopercepción de salud mental de los profesionales de la salud que trabajan en servicios de salud mental y las relaciones entre ambos constructos y variables sociodemográficas, laborales y de salud. METODOLOGÍA: La muestra estuvo configurada por 102 profesionales asistenciales de las unidades de salud mental del Parc Hospitalari Martí i Julià de Salt, Girona. Las variables estudiadas fueron datos socio demográficos, datos laborales, datos relacionados con la salud y autopercepción de salud mental, evaluada mediante el cuestionario Sentido de Coherencia y el cuestionario de Salud Mental Positiva de Lluch, ambos auto administrados. RESULTADOS: Globalmente, la muestra estudiada obtuvo niveles altos de Sentido de Coherencia y Salud Mental Positiva. En cuanto a la relación entre las puntuaciones globales del cuestionario SOC y el cuestionario SMP, el análisis reveló una relación positiva entre ambos cuestionarios. CONCLUSIONES: La relación positiva puede ser especialmente interesante para abrir futuras investigaciones relacionadas con el estudio del modelo multifactorial de Salud Mental Positiva y el modelo salutogénico que sustenta el Sentido de Coherencia, pudiendo generar un marco conceptual global para el estudio de la salud mental desde la perspectiva positiva.

CONTEXTO: O sentido de coerência de Antonowsky (1996) surge a partir do modelo salutogênico e do modelo multifatorial de Saúde Mental Positivo (SMP) Lluch (1999), que define dois constructos que servem para compreender, avaliar e intervir sobre a promoção e a manutenção de um bom estado de saúde mental. OBJETIVO(S): Avaliar a saúde mental em termos de auto-avaliação dos profissionais de saúde que trabalham em serviços de saúde mental e as relações entre ambos os construtos com as variáveis sociodemográficas, de saúde e de trabalho. METODOLOGIA: A amostra foi constituida por 102 profissionais de saúde das unidades de saúde mental do Parc Hospitalari Martí i Julià, Salt, Girona. As variáveis estudadas incluiram: dados sócio-demográficos,dados profissionais, dados relativos à saúde e auto-perceção da saúde mental avaliada através do questionário Sentido de Coerência de Antonowsky e do questionário de Saúde Mental Positiva de Lluch. Os questionários foram auto-administrados. RESULTADOS: Globalmente, a amostra em estudo obteve níveis elevados de sentido de coerência e de saúde mental positiva. Quanto à relação entre as pontuações globais do questionário SOC e as pontuações globais do questionário SMP, a análise revelou uma relação positiva entre ambos os questionários. CONCLUSÕES: A relação positiva entre o SOC e a SMP pode ser especialmente interessante para abrir futuras pesquisas relacionadas com o estudo do modelo multifatorial de Saúde Mental Positiva e o modelo salutogênico que sustenta o sentido de coerência, podendo originar um marco concetual global para o estudo da saúde mental a partir de uma perspectiva positiva.

BACKGROUND: The Sense of Coherence (SOC) of Antonowsky (1996) which is based on salutogenic theory and the multifactor Positive Mental Health (PMH) model of Lluch (1999) provide two constructs for comprehending, evaluating, and intervening in the promotion and maintenance of a good state of mental health. AIM: Were assessed self-rated mental health of health professionals working in mental health services and relations between both constructs and sociodemographic, work, and health variables. METHODS: The sample was made up of n=102 attending professionals at the mental health units of the Parc Hospitalari Martí i Julià, in Salt, Girona. The variables studied were sociodemographic work-related, health-related, and self-perception of mental health, evaluated by means of the Sense of Coherence questionnaire and the Positive Mental Health questionnaire. The questionnaires were self-administered. RESULTS: Overall, the sample studied scored high in the Sense of Coherence and the Positive Mental Health questionnaires. In terms of the relation between the overall scores of the SOC questionnaire and the PMH, analysis revealed a positive relation between the two. CONCLUSIONS: This positive relation between the two questionnaires may be of particular interest in future studies of the multifactor model of Positive Mental Health and the salutogenic model that underlies the Sense of Coherence, by generating a global conceptual framework for the study of mental health from a positive perspective.

Objectives: 1) Develop a database of carotenoids (BD-carotenoids) in foods widely consumed in Spain. 2) To assess the vitamin A nutritional status (expressed as retinol equivalents [RE] and retinol activity equivalents [RAE]) in young adults. Methods: The BD-carotenoids includes data on carotenes (β-carotene, α-carotene and lycopene) and xanthophylls (β-cryptoxanthin, lutein and zeaxanthin) generated by HPLC. Vitamin A intake was assessed by a 3-day food record in 54 adults (20-35 years of age, not obese and with serum retinol > 30 µg/dl), using the BD-carotenoids and a Food Composition Table widely used in Spain. Results: The BD-carotenoids includes data on 89 foods (9 raw or boiled and 14 processed). The intake of provitamin-A carotenoids is 2.5 mg/p/d, that of RE 682 µg/p/d and that of RAE 499 µg/p/d. The vitamin A intake expressed as RAE is 27% lower than that expressed as RE. Seventy-six percent of the intake meets the daily intake recommendations and 63% meets the reference daily intakes of vitamin A. Conclusions: Data on individual carotenoids ensure greater accuracy in studies on diet and health, and provide easier assessment of the vitamin A intake, expressed as RE, RAE, or any other future forms. The vitamin A intake expressed as RAE represents a substantial reduction in the carotenoid contribution to vitamin A intake, which enhances the detection of inadequacies of that intake.

Objetivos: 1) Elaborar una base de datos de carotenoides (BD-carotenoides) de alimentos consumidos en España. 2) Valorar el estado nutricional en vitamina A (expresada en equivalentes de retinol (ER) y en equivalentes de actividad de retinol (EAR)) en adultos jóvenes. Métodos: La BD-carotenoides incluye datos de carotenos (β-caroteno, α-caroteno y licopeno) y xantofilas (β-critpoxantina, luteína y zeaxantina) generados mediante HPLC. La ingesta de vitamina A se valoró a partir de tres recuerdos de 24 horas, en 54 adultos, 20-35 años, no obesos y con retinol sérico (> 30 µg/dl), utilizando la BD-carotenoides y unas Tablas de Composición de Alimentos de amplio uso en España. Resultados: La BD-carotenoides incluye datos para 89 alimentos (9 en crudo y cocido y 14 son alimentos procesados). La ingesta de carotenoides provitamínicos-A es de 2,5 mg/p/d, la de ER 682 µg/p/d y la de EAR 499 µg/p/d. La vitamina A expresada en EAR es un 27% inferior que como ER. El 76% de las ingestas se adecuan a las ingestas recomendadas y el 63% a la ingesta diaria recomendada. Conclusiones: Los datos individualizados de carotenoides permiten mayor precisión en los estudios entre dieta y salud, y facilitan la valoración de la ingesta de vitamina A, expresada en ER, EAR o en otras formas de expresión futuras. La ingesta de vitamina A expresada como EAR implica una reducción importante en la contribución de los carotenoides a la ingesta de vitamina A, lo que conlleva un aumento en la detección de inadecuaciones en la ingesta de esta vitamina.

During the study of the reproductive biology of Anchoa mitchilli in the Pueblo Viejo Lagoon, Veracruz, Mexico, 3,385 individuals were analyzed (1,530 males and 1,855 females). Of these individuals, an organism of 45.0 mm standard length and 0.89 g in weight, showed that the right gonad (weight of 2.6 mg and 7.5 mm in length) corresponds to a normal ovary, while the left gonad (8.4 mg and 8.0 mm), has a section of ovarian tissue (three quarters) and a section of testicular tissue (one quarter). Even though the reproductive biology of A. mitchilli has been extensively studied, this report is the first record of an ovotestis for this inherently gonochoristic species, and in general, for any member of the Engrarulidae family. Although the presence of ovotestis in gonochoristic species has been related to a male feminization process due to exposure to endocrine-disrupting chemicals (EDCs), it is considered that the reported case is due to an anomaly as a result of an isolated endocrine dysfunction.

Durante el estudio de la biología reproductiva de Anchoa mitchilli en la laguna de Pueblo Viejo, Veracruz, se analizaron 3,385 individuos (1,530 machos y 1,855 hembras). Del total de organismos analizados, un individuo de 45 mm de longitud patrón y peso de 0.89 g, mostró que la gónada derecha (peso de 2.6 mg y longitud de 7.5 mm), corresponde a un ovario normal, mientras que la gónada izquierda (8.4 mg y 8.0 mm), en tres cuartas partes presenta tejido ovárico y en una cuarta parte tejido testicular. A pesar que la biología reproductiva de A. mitchilli ha sido extensamente estudiada, el presente reporte representa el primer registro de la presencia de ovotestis para esta especie inherentemente "gonocorística" y, en general, para cualquier miembro de la Familia Engraulidae. Aunque la presencia de ovotestis en especies dioicas se ha relacionado con el proceso de feminización de machos por exposición a contaminantes endocrino-disruptivos, se considera que el presente reporte obedece a una anomalía endógena debida a una disfunción endocrina aislada.

Human toxocarosis is an important parasitic zoonosis caused by larval stages of Toxocara species, the roundworms from dogs and cats. Larval migration through different soft tissues in the human generates several clinical entities in the patient, such as visceral larva migrans, ocular toxocarosis, and neurotoxocarosis. Definitive diagnosis by histopathological methods is very difficult or almost impossible and, nowadays, the diagnosis is usually made by clinical signs/symptoms, epidemiological background of the patient and the use of hematological and immunological tests which finally help to confirm the clinical suspicion of the illness. The purpose of this paper was to update the available knowledge on the use of different tools for both the diagnosis and following up of human toxocarosis.

La toxocarosis humana es una importante zoonosis parasitaria causada por formas larvarias de especies del género Toxocara, un parásito nematodo de los perros y los gatos. La migración de la larva por los diferentes tejidos blandos en el ser humano genera una serie de entidades clínicas en el paciente, tales como el síndrome de larva migrans visceral, la toxocarosis ocular y la neurotoxocarosis. El diagnóstico definitivo es mediante la histopatología en biopsias, pero resulta ser casi imposible de realizar y actualmente su diagnóstico se establece mediante el análisis de la sintomatología clínica, los antecedentes epidemiológicos del paciente y el uso de pruebas hematológicas e inmunológicas de laboratorio que son las que finalmente ayudan a confirmar la sospecha clínica de la enfermedad. El propósito del presente artículo es actualizar los conocimientos que se tienen sobre el uso de las diferentes herramientas para establecer el diagnóstico y el monitoreo de la toxocarosis humana.

Human toxocarosis is an important parasitic zoonosis caused by larval stages of Toxocara species, the roundworms from dogs and cats. Larval migration through different soft tissues in the human generates several clinical entities in the patient, such as visceral larva migrans, ocular toxocarosis, and neurotoxocarosis. Definitive diagnosis by histopathological methods is very difficult or almost impossible and, nowadays, the diagnosis is usually made by clinical signs/symptoms, epidemiological background of the patient and the use of hematological and immunological tests which finally help to confirm the clinical suspicion of the illness. The purpose of this paper was to update the available knowledge on the use of different tools for both the diagnosis and following up of human toxocarosis.

La toxocarosis humana es una importante zoonosis parasitaria causada por formas larvarias de especies del género Toxocara, un parásito nematodo de los perros y los gatos. La migración de la larva por los diferentes tejidos blandos en el ser humano genera una serie de entidades clínicas en el paciente, tales como el síndrome de larva migrans visceral, la toxocarosis ocular y la neurotoxocarosis. El diagnóstico definitivo es mediante la histopatología en biopsias, pero resulta ser casi imposible de realizar y actualmente su diagnóstico se establece mediante el análisis de la sintomatología clínica, los antecedentes epidemiológicos del paciente y el uso de pruebas hematológicas e inmunológicas de laboratorio que son las que finalmente ayudan a confirmar la sospecha clínica de la enfermedad. El propósito del presente artículo es actualizar los conocimientos que se tienen sobre el uso de las diferentes herramientas para establecer el diagnóstico y el monitoreo de la toxocarosis humana.

O propósito do presente trabalho foi estimar a soroprevalência da toxocaríase humana em três comunidades andinas do Nordeste de Lima, Peru. Foi estudado um total de 303 pessoas, entre crianças e adultos. Foram coletadas amostras de sangue para a detecção de anticorpos anti-Toxocara e para a análise hematológica, além de amostras fecais para o exame parasitológico. A soroprevalência geral da população foi de 20,46% com proporção significativamente maior de positividade em crianças de um a 10 anos (p = 0,034). Das pessoas com sorologia positiva, 32,26% apresentavam sintomas respiratórios, 22,58% moléstias hepáticas, 17,74% manifestações oculares, 14,51% dor abdominal, e 4,84% sinais cutâneos. Além disso, 79,03% das pessoas com sorologia positiva tinham pelo menos algum parasito intestinal com associação significativa (p < 0.05). A presença de cachorros dentro das casas, história de pica ou geofagia e o uso dos lugares públicos também estiveram presentes nesta população, mas o ultimo deles só esteve associado com a sorologia positiva (p < 0.05). Conclui-se que existem evidências clínicas, sorológicas e epidemiológicas de infecção por larvas de Toxocara na população estudada.

The aim of this study was to assess the seroprevalence of human toxocariasis in three Andean communities from the Northeast of Lima, Peru. A total of 303 subjects including children and adults were studied and blood samples were collected to detect anti-Toxocara antibodies by ELISA-IgG test and by hematological examination; stool samples were collected also for parasitological examination. The overall seroprevalence of toxocariasis observed in the total population was 20.46%, with a significant high proportion in children from one to 10 years old (p = 0.034). Among the subjects with positive serology, 32.26% of them had respiratory disturbances, 22.58% hepatomegaly, 17.74% ocular signs or symptoms, 14.51% abdominal pain, 9.68% neurological involvement, and 4.84% cutaneous signs, but none of these clinical features were associated to a positive serology by multivariate analysis. Furthermore, 79.03% of seropositive subjects also harbored at least one intestinal parasite, which was associated to a positive serology (p < 0.05). The presence of pets within the houses, a previous history of pica or geophagia and the use of public places were also present in this population, but only the latter was associated to the serology (p < 0.05). In conclusion, clinical, serological, and epidemiological evidences for larval Toxocara infection were found in the studied population.

O objetivo do presente estudo foi estimar a soroprevalência da infecção por Toxocara em população geral da cidade de Yurimaguas, Peru. Entre os meses de Março e Agosto de 2008, foi estudado um total de 300 pessoas por exame imunológico mediante Toxocara ELISA-IgG teste. Uma ficha clínico-epidemiológica foi utilizada para avaliar a sintomatologia e os fatores de risco associados à toxocaríase. A freqüência geral de anticorpos na população foi de 35,66% com proporção significativamente maior de positividade em meninos de um a 10 anos (p < 0.001). A avaliação clínica revelou que 95.33% do grupo de soropositivos apresentava algum tipo de sintomatologia associada à toxocaríase: 66,36% cefaléia, 63,55% sintomas respiratórios, 54,21% dor abdominal, 40,19% sinais cutâneos e 36,45% manifestações oculares e quase todos estes sinais foram estatisticamente associados ao resultado da sorologia (p < 0.001). Além disso, 56,07% das pessoas com sorologia positiva tinham pelo menos algum parasito intestinal patogênico e com predominância de helmintos, mas sem nenhuma associação significativa (p = 0.334). A análise dos fatores de risco mostrou que o uso de lugares públicos e história de geofagia tiveram significativa associação com a sorologia positiva (p < 0,001). Conclui-se que existem evidências clínicas, sorológicas e epidemiológicas de infecção por Toxocara na população estudada e futuros estudos são necessários para avaliar este sério problema de saúde pública.

The aim of this study was to determine the seroprevalence of the infection by Toxocara in the general population of the Amazonian city of Yurimaguas, Peru. From March to August 2008, a total of 300 subjects were sampled and tested by means of a Toxocara ELISA-IgG test. A clinical and epidemiological questionnaire was used to assess the symptomatology and risk factors associated with human toxocariasis. The overall rate of seropositivity was 35.66%, with a significant high proportion in children (p < 0.001). The clinical evaluation revealed that 95.33% of the seropositive group had some type of symptomatology: headache (66.36%), respiratory compromise (63.55%), abdominal pain (54.21%), cutaneous signs (40.19%) and ocular manifestations (36.45%), and almost all of them were statistically significant (p < 0.001). Furthermore, 56.07% of the seropositive subjects presented at least one intestinal pathogen parasite with predominance of helminthes, but without significant association (p = 0.334). The analysis of risk factors showed only that the use of public places and geophagia exhibited a significant association with the seropositivity (p < 0.001). Clinical, serological and epidemiological findings associated to infection with Toxocara were observed in the present study and future studies should be done to assess this serious health problem.

A bibliographic review was done to update and systematize information on Toxocara human infection. Transmission mechanisms, epidemiology, clinical forms, diagnostic methods and treatment are described. Its importance as an infectious cause of blindness in young people that is potentially preventible and curable by early diagnosis is emphasized. Proposal is done to establish epidemiological surveillance, improve current laws to reduce transmission risk to the general population and increase knowledge on this infection in Peru.

Se realizó una revisión bibliográfica para actualizar y sistematizar la información existente sobre la infección humana por el género Toxocara. Se describe los mecanismos de transmisión, epidemiología, formas clínicas, métodos de diagnóstico, esquemas de tratamiento. Además, se resalta su importancia como causa infecciosa de ceguera, en población joven, que resulta potencialmente prevenible y curable mediante el diagnóstico precoz. Por lo cual, se plantea propuestas para implementar la vigilancia epidemiológica. Asimismo, algunas sugerencias para mejorar la legislación existente que permita disminuir el riesgo de la transmisión a la población en general e incrementar el conocimiento que existe sobre esta infección en nuestro país.

O propósito do presente estudo foi estimar a freqüência da toxocaríase no distrito de Cauday, Cajamarca, Peru, usando o dot-ELISA teste. Entre junho e outubro de 2005, um total de 256 pessoas foram avaliadas. Coletaram-se amostras de sangue para o teste de dot-ELISA e para o exame hematológico e amostras de fezes para exame parasitológico. A freqüência geral de anticorpos anti-Toxocara observada foi de 44,92%, com maior proporção significativa de positividade em pessoas do sexo masculino. Das pessoas com sorologia positiva, 45,6% apresentavam sintomas respiratórios, 40,44% dores abdominais, 32,35% moléstias hepáticas, 14,7% sinais cutâneos, 13,23% manifestações oculares, 43,38% eosinofilia e todos estes fatores foram estatisticamente associados à sorologia. Entre as pessoas avaliadas 90,23% estavam parasitadas e 92,17% das pessoas com sorologia positiva tinham algum parasito intestinal, sendo os mais freqüentes: Blastocystis hominis (68,38%), Giardia lamblia (28,68%), Hymenolepis nana (20,0%), Ascaris lumbricoides (15,65%), Entamoeba histolytica/E. dispar (13,24%), Cyclospora cayetanensis (4,41%), Cryptosporidium sp. (1,47%), Enterobius vermicularis (0,87%), Strongyloides stercoralis (0,87%), Taenia sp. (0,87%) e Trichuris trichiura (0,87%). A taxa de falsos positivos no teste dot-ELISA foi melhorada pela absorção dos soros com antígenos de A. suum, com diminuição das reações cruzadas. Em conclusão, a toxocaríase humana é altamente freqüente nesta população e fatores de risco como ter um cão/gato, presença dos animais dentro de casa e estória prévia de geofagia foram observados durante o presente estudo.

The aim of this study was to estimate the frequency of human toxocariasis in Cauday district, Cajamarca, Peru, using a dot-ELISA test. From June to October 2005, a total of 256 adult subjects were studied. Blood samples were collected for serology by a dot-ELISA test and for hematological examination. Parasitological examination was also carried out in stool samples to check cross-reactions in the dot-ELISA. The frequency observed was 44.92%, with a significant higher proportion of positivity in male subjects. From subjects with positive serology, 45.6% had respiratory symptoms, 40.44% abdominal pain, 32.35% hepatic symptoms, 14.7% cutaneous signs, 13.23% ocular manifestations, 43.38% eosinophilia, and all of these were statistically associated to serology. Among the population evaluated, 90.23% (231/256) were parasitized. From subjects with positive serology, 92.17% had at least one intestinal parasite and the most frequent were: Blastocystis hominis (68.38%), Giardia lamblia (28.68%), Hymenolepis nana (20.0%), Ascaris lumbricoides (15.65%), Entamoeba histolytica/E. dispar (13.24%), Cyclospora cayetanensis (4.41%), Cryptosporidium sp. (1.47%), Enterobius vermicularis (0.87%), Strongyloides stercoralis (0.87%), Taenia sp. (0.87%), and Trichuris trichiura (0.87%). The rate of false positives in the dot-ELISA test was improved by serum absorption each with A. suum antigens, with a decrease of cross-reactions. In conclusion, human toxocariasis is highly frequent in this population and some risk factors like dog/cat ownership, presence of pets within house, and previous history of geophagia were observed in the present study.