Abstract Objective: To determine the prevalence of allergic rhinitis and associated factors in adolescents and in their parents/guardians. Methods: A cross-sectional study, applying a standardized and validated written questionnaire. Adolescents (13–14 years old; n=1,058) and their parents/guardians (mean age=42.1 years old; n=896) living in the city of Uruguaiana, southern Brazil, responded to the Global Asthma Network standard questionnaires. Results: The prevalence of allergic rhinitis in adolescents was 28.0%, allergic rhinoconjunctivitis, 21.3%, and severe forms of allergic rhinitis, 7.8%. In the adults, the prevalence of allergic rhinitis was 31.7%. Some associated factors with allergic rhinitis in adolescents include low physical exercise (OR 2.16; 95%CI 1.15–4.05), having only one older sibling (OR 1.94; 95CI 1.01–3.72) and daily meat consumption (OR 7.43; 95% CI 1.53–36.11). In contrast, consuming sugar (OR 0.34; 95%CI 0.12–0.93) or olive oil (OR 0.33; 95%CI 0.13–0 .81) once or twice a week, and eating vegetables daily (OR 0.39; 95%CI 0.15–0.99) were considered factors negatively associated. In adults, exposure to fungi at home (OR 5.25; 95%CI 1.01–27.22) and consumption of meat once or twice a week (OR 46.45; 95CI 2.12–1020.71) were factors associated with the medical diagnosis of allergic rhinitis, while low education (OR 0.25; 95%CI 0.07–0.92) was found to be a factor negatively associated. Conclusions: The prevalence of allergic rhinitis in adolescents is high, as well as its medical diagnosis in adults living in Uruguaiana. Environmental factors, especially food habits, were associated with findings in both groups. Objective parentsguardians parents guardians Methods crosssectional cross sectional study questionnaire 13–14 1314 13 14 (13–1 old n=1,058 n1058 n 1 058 mean age421 age 42 age=42. n=896 n896 896 Uruguaiana Brazil questionnaires Results 280 28 0 28.0% rhinoconjunctivitis 213 21 3 21.3% 78 7 8 7.8% 317 31 31.7% OR 2.16 216 2 16 95 1.15–4.05, 115405 1.15–4.05 , 15 4 05 1.15–4.05) 1.94 194 94 1.01–3.72 101372 01 72 7.43 743 43 1.53–36.11. 1533611 1.53–36.11 . 53 36 11 1.53–36.11) contrast 0.34 034 34 0.12–0.93 012093 12 93 0.33 033 33 0130 0.13– .81 81 0.39 039 39 0.15–0.99 015099 99 5.25 525 5 25 1.01–27.22 1012722 27 22 46.45 4645 46 45 2.12–1020.71 212102071 1020 71 0.25 025 0.07–0.92 007092 07 92 Conclusions high habits groups 13–1 131 (13– n=1,05 n105 age42 age=42 n=89 n89 89 28.0 21.3 7.8 31.7 2.1 9 11540 1.15–4.0 1.9 19 1.01–3.7 10137 7.4 74 153361 1.53–36.1 0.3 03 0.12–0.9 01209 013 0.13 .8 0.15–0.9 01509 5.2 52 1.01–27.2 101272 46.4 464 2.12–1020.7 21210207 102 0.2 02 0.07–0.9 00709 13– (13 n=1,0 n10 age4 age=4 n=8 n8 28. 21. 7. 31. 2. 1154 1.15–4. 1. 1.01–3. 1013 15336 1.53–36. 0. 0.12–0. 0120 0.1 0.15–0. 0150 5. 1.01–27. 10127 46. 2.12–1020. 2121020 10 0.07–0. 0070 (1 n=1, n1 age= n= 115 1.15–4 1.01–3 101 1533 1.53–36 0.12–0 012 0.15–0 015 1.01–27 1012 2.12–1020 212102 0.07–0 007 ( n=1 1.15– 1.01– 153 1.53–3 0.12– 0.15– 1.01–2 2.12–102 21210 0.07– 00 1.15 1.01 1.53– 0.12 0.15 2.12–10 2121 0.07 1.1 1.0 1.53 2.12–1 212 0.0 1.5 2.12– 2.12

Resumo Objetivo: Determinar a prevalência de rinite alérgica e fatores associados em adolescentes e em seus pais/responsáveis. Métodos: Estudo transversal, com aplicação de questionário escrito padronizado e validado. Adolescentes (13–14 anos; n=1.058) e seus pais/responsáveis (média de idade=42,1 anos; n=896) residentes na cidade de Uruguaiana, Sul do Brasil, responderam aos questionários padrão da Global Asthma Network. Resultados: A prevalência de rinite alérgica em adolescentes foi de 28,0%, a de rinoconjuntivite alérgica foi de 21,3% e a de formas graves de rinite alérgica, de 7,8%. Nos adultos, a prevalência de rinite alérgica foi de 31,7%. Alguns fatores associados à rinite alérgica em adolescentes incluem fazer pouco exercício físico (odds ratio — OR 2,16; intervalo de confiança — IC95% 1,15–4,05), ter apenas um irmão mais velho (OR 1,94; IC95% 1,01–3,72) e consumir carne diariamente (OR 7,43; IC95% 1,53–36,11). Por outro lado, consumir açúcar (OR 0,34; IC5% 0,12–0,93) ou azeite de oliva (OR 0,33 IC95% 0,13–0,81) uma ou duas vezes por semana e comer vegetais diariamente (OR 0,39; IC95% 0,15–0,99) foram considerados fatores associados negativamente. Em adultos, a exposição a fungos no domicílio (OR 5,25; IC95% 1,01–27,22) e o consumo de carne uma ou duas vezes por semana (OR 46,45; IC95 2,12–1020,71) foram fatores associados ao diagnóstico médico de rinite alérgica, enquanto a baixa escolaridade (OR 0,25; IC95% 0,07–0,92) se mostrou como fator associado negativamente. Conclusões: A prevalência de rinite alérgica em adolescentes é alta, assim como seu diagnóstico médico em adultos residentes em Uruguaiana. Fatores ambientais, especialmente hábitos alimentares, foram associados aos achados em ambos os grupos. Objetivo paisresponsáveis pais responsáveis Métodos transversal validado 13–14 1314 13 14 (13–1 anos n=1.058 n1058 n 1 058 média idade421 idade 42 idade=42, n=896 n896 896 Uruguaiana Brasil Network Resultados 280 28 0 28,0% 213 21 3 21,3 78 7 8 7,8% 317 31 31,7% odds 2,16 216 2 16 IC 1,15–4,05, 115405 1,15–4,05 , 15 4 05 1,15–4,05) 1,94 194 94 1,01–3,72 101372 01 72 7,43 743 43 1,53–36,11. 1533611 1,53–36,11 . 53 36 11 1,53–36,11) lado 0,34 034 34 IC5 0,12–0,93 012093 12 93 033 33 0,3 0,13–0,81 013081 81 0,39 039 39 0,15–0,99 015099 99 negativamente 5,25 525 5 25 1,01–27,22 1012722 27 22 46,45 4645 46 45 IC9 2,12–1020,71 212102071 1020 71 0,25 025 0,07–0,92 007092 07 92 Conclusões alta ambientais alimentares grupos 13–1 131 (13– n=1.05 n105 idade42 idade=42 n=89 n89 89 28,0 21, 7,8 31,7 2,1 11540 1,15–4,0 1,9 19 9 1,01–3,7 10137 7,4 74 153361 1,53–36,1 03 0,12–0,9 01209 0, 0,13–0,8 01308 0,15–0,9 01509 5,2 52 1,01–27,2 101272 46,4 464 2,12–1020,7 21210207 102 0,2 02 0,07–0,9 00709 13– (13 n=1.0 n10 idade4 idade=4 n=8 n8 28, 7, 31, 2, 1154 1,15–4, 1, 1,01–3, 1013 15336 1,53–36, 0,12–0, 0120 0,13–0, 0130 0,15–0, 0150 5, 1,01–27, 10127 46, 2,12–1020, 2121020 10 0,07–0, 0070 (1 n=1. n1 idade= n= 115 1,15–4 1,01–3 101 1533 1,53–36 0,12–0 012 0,13–0 013 0,15–0 015 1,01–27 1012 2,12–1020 212102 0,07–0 007 ( n=1 1,15– 1,01– 153 1,53–3 0,12– 0,13– 0,15– 1,01–2 2,12–102 21210 0,07– 00 1,15 1,01 1,53– 0,12 0,13 0,15 2,12–10 2121 0,07 1,1 1,0 1,53 0,1 2,12–1 212 0,0 1,5 2,12– 2,12

Resumen Antecedentes: Aunque en el Ecuador se han realizado varios estudios epidemiológicos de asma en las dos últimas décadas, ninguno de estos ha estimado la prevalencia de asma en poblaciones adultas. Objetivo: Estimar la prevalencia de síntomas de asma en adultos en Quito e identificar posibles factores asociados. Métodos: Se realizó un estudio transversal en sujetos mayores a 18 años residentes en la ciudad de Quito-Ecuador. Se aplicó el cuestionario Global Asthma Network para recolectar información sobre síntomas de asma y datos sociodemográficas y de estilo de vida. Para la identificación de factores asociados con asma se utilizó análisis bivariados y multivariados con regresión logística. Resultados: Un total de 2,476 sujetos respondieron el cuestionario (80.9% mujeres, edad media 40 años). La prevalencia de sibilancias en los últimos 12 meses, asma alguna vez y asma diagnosticado por un médico fue de 6.3%; 1.9% y 1.6%, respectivamente. La prevalencia de rinitis y eczema alguna vez fue de 13.7% y 5.5%. La presencia de moho en el hogar (OR: 2.13; 95% IC: 1.48-3.06; p <0.001), gato en casa (OR: 1.06; 95% IC: 1.06-2.13; p <0.022) y rinitis alguna vez (OR: 3.65; 95% IC: 2.53-5.29; p <0.022) estaban asociados con la presencia de sibilancias en los últimos 12 meses. Conclusiones: Nuestro estudio muestra que, en comparación con otras ciudades de América Latina, la prevalencia de asma en adultos en Quito es relativamente baja. Junto con la presencia de rinitis, factores relacionados con la calidad de la vivienda están estrechamente ligados con la ocurrencia de asma en poblaciones adultas.

Abstract Background: Although several epidemiological studies of asthma have been carried out in Ecuador in the last two decades, none of these has estimated the prevalence of asthma in adult populations. Objective: To estimate the prevalence of asthma symptoms in adults in the city of Quito and to identify possible associated factors. Methods: A cross-sectional study was conducted on subjects older than 18 years residing in the Metropolitan District of Quito. The Global Asthma Network (GAN) questionnaire was applied to collect information on asthma symptoms and sociodemographic and lifestyle data. Bivariate and multivariate analyses with logistic regression were used to identify asthma-related factors. Results: 2,476 subjects answered the questionnaire (80.9% women, mean age 40 years). The prevalence of wheezing in the last 12 months, asthma ever, and asthma diagnosed by a doctor were 6.3%, 1.9% and 1.6%, respectively. The prevalence of rhinitis ever and eczema ever was 13.7% and 5.5%. The presence of mould at home (OR: 2.13; 95% CI: 1.48 -3.06; p <0.001), cat at home (OR: 1.06; 95% CI: 1.06 -2.13; p <0.022) and rhinitis at some time (OR: 3.65; 95% CI: 2.53 - 5.29; p <0.022) were associated with the presence of wheezing in the last 12 months. Conclusions: Our study shows that, compared to other cities in Latin America, the prevalence of asthma in adults in Quito is relatively low. Along with the presence of rhinitis, factors related to housing quality are closely linked to the occurrence of asthma in adult populations.

ABSTRACT Objective: The aim of the study was to describe the clinicopathological profile of patients diagnosed with liver, bile ducts or gallbladder cancer. Materials and methods: Between 2006 and 2017, 89 patients (57% female; mean age: 62 years-old) with these cancers were diagnosed at two national hospitals in Lima, Peru. Results: Most patients (64%) had advanced stages of disease. Anemia was more frequent in patients with bile duct and liver cancer and in advanced stages. Hypertension (HTN) was frequent among liver cancer patients (32%). The analysis by age showed that HTN was more frequent in patients over 50 years. Likewise, people under 50 years had more frequent history of previous infections (50%), Hepatitis B (HBV) being the most common. Conclusions: This study describes the baseline clinicopathological characteristics of a malignancy poorly studied in Peru.

RESUMEN Objetivo: El objetivo del estudio fue describir las características clínico-patológicas de individuos diagnosticados de cáncer de hígado, vías biliares o vesícula. Materiales y métodos: Entre el 2006 y 2017, se diagnosticaron 89 pacientes (57% mujeres; media: 62 años) con estos canceres en dos hospitales nacionales de Lima, Perú. Resultados: Los resultados mostraron que, independientemente del tipo de cáncer, 64% de los participantes habían sido diagnosticados en estadios avanzados. La anemia fue más frecuente en los pacientes con cáncer de vías biliares e hígado y en estadios avanzados. Se observó mayor frecuencia (32%) de hipertensión arterial (HTA) en el grupo con cáncer de hígado. El análisis por edad mostró que en los pacientes mayores de 50 años la HTA fue más frecuente. Asimismo, sujetos menores de 50 años reportaron antecedentes de infecciones previas en mayor frecuencia (50%), siendo Hepatitis B (HBV) la más común. Conclusiones: Este estudio describe las características clínico-patológicas de base de una neoplasia poco estudiada en el ámbito nacional.

Abstract Objective: Identify associated factors for recurrent wheezing (RW) in male and female infants. Methods: Cross-sectional multicentric study using the standardized questionnaire from the Estudio Internacional sobre Sibilancias en Lactantes (EISL). The questionnaire was applied to parents of 9345 infants aged 12-15 months at the time of immunization/routine visits. Results: One thousand two hundred and sixty-one (13.5%) males and nine hundred sixty-three (10.3%) females have had RW (≥3 episodes), respectively (p10 colds episodes (OR = 3.46; IC 95% 2.35-5.07), air pollution (OR = 1.33; IC 95% 1.12-1.59), molds at home (OR = 1.23; IC 95% 1.03-1.47), Afro-descendants (OR = 1.42; IC 95% 1.20-1.69), bronchopneumonia (OR = 1.41; IC; 1.11-1.78), severe episodes of wheezing in the first year (OR = 1.56; IC 95% 1.29-1.89), treatment with bronchodilators (OR = 1.60; IC 95% 1.22-2,1) and treatment with oral corticosteroids (OR = 1,23; IC 95% 0.99-1,52). Associated factors for RW for females were passive smoking (OR = 1.24; IC 95% 1.01-1,51), parents diagnosed with asthma (OR = 1.32; IC 95% 1,08-1,62), parents with allergic rhinitis (OR = 1.26; IC 95% 1.04-1.53), daycare attendance (OR = 1.48; IC 95% 1.17-1,88), colds in the first 6 months of life (OR = 2.19; IC 95% 1.69-2.82), personal diagnosis of asthma (OR = 1.84; IC 95% 1.39-2.44), emergency room visits (OR = 1.78; IC 95% 1.44-2.21), nighttime symptoms (OR = 2.89; IC 95% 2.34-3.53) and updated immunization (OR = 0.62; IC 95% 0.41-0.96). Conclusion: There are differences in associated factors for RW between genders. Identification of these differences could be useful to the approach and management of RW between boys and girls.

Abstract Azotobacter is a type of bacterium nonpathogenic, Gram-negative with ability to synthesize simultaneously under aerobic conditions two biodegradable polymers extra and intracellular such as alginate and polyhydroxyalkanoates, respectively, whose physical, mechanical, and biodegradable properties have awoken the interest in the industry. Thus, this review compiles information on synthesis chemistry of these polymers and the genetic modification of this bacterium in order to produce a particular polymer and improve its yields. Additionally, we show that alginates obtained present a higher molecular weight, degree of acetylation and M/G ratio compared with other organic sources like seaweed; while polyhydroxyalkanoate polymers have better physical and mechanical characteristics (melting temperature, Young's modulus, elongation and glass transition temperature) compared with other synthetic polymers. These characteristics present in both polymers have allowed the development of several applications in the food, pharmaceutical, medical and agronomic industries. Finally, it is necessary to study new strategies to control the variability of the degree of acetylation and molecular weight for alginate polymers and improve the production of polyhydroxyalkanoates in order to propose new future applications in the industry.

Resumen Azotobacter es un tipo de bacteria no patógena, Gram negativa con capacidad para sintetizar simultáneamente en condiciones aerobias dos polímeros biodegradables extra e intracelulares tales como alginatos y polihidroxialcanoatos respectivamente, cuyas propiedades físicas, mecánicas y biodegradables han despertado el interés en la industria. Por ello, esta revisión compila información sobre la síntesis química de estos polímeros y la modificación genética de esta bacteria con la finalidad de producir un polímero particular y mejorar sus rendimientos. Adicionalmente, mostramos que los alginatos obtenidos presentan un mayor peso molecular, grado de acetilación y relación M/G comparado con otras fuentes orgánicas como las algas marinas; mientras los polímeros de polihidroxialcanoatos presentan mejores características físicas y mecánicas (temperatura de fusión, módulo de Young, elongación y temperatura de transición vítrea) comparado con otros polímeros sintéticos. Estas características presentes en ambos polímeros han permitido el desarrollo de diversas aplicaciones en la industria alimentaria, farmacéutica, médica y agronómica. Finalmente, es necesario estudiar nuevas estrategias para controlar la variabilidad del grado de acetilación y peso molecular para los polímeros de alginato y mejorar la producción de polihidroxialcanoatos con la finalidad de promover nuevas futuras aplicaciones en la industria.

Abstract The study of the relationship between executive functions, intellectual abilities, and academic achievement plays an important role in the field of cognitive neuroscience, particularly for their implications in the educational field. Intelligence has been linked to executive functions. In fact, core aspects of intelligence, such as reasoning, problem-solving and planning, are often included in the wide range of frontal lobe functions and over laps with the so-called higher-level executive functions. In addition, executive functioning abilities are associated with skills put in play when participating in learning activities at school. In this sense, different studies have demonstrated that a lower performance on executive function measures typically is associated with a lower performance across different academic areas. The aim of this work was focused on the relationship between intelligence and executive functions, and their ability to predict academic achievement. In the present study, a non-experimental, transversal and descriptive-correlational design was implemented to explore the relationship between intellectual abilities, executive functions, and academic performance in a sample of 37 adolescents (17 girls) aged 13-14 years. The information was collected through the school reports of participants, and their performance on tests BANFE-2 (neuropsychological battery of the executive functions and frontal lobes) and WISC-IV (Wechsler intelligence scale for children 4th Ed.). Also, adolescents were classified into two groups (high- and low performers) based on their performance on the general intelligence score. Participants with IQ scores below the median were assigned to the low-performing group, while participants with IQ scores above the median were assigned to the high-performing group. The data obtained were subjected to descriptive, correlation and regression analyses. Results showed a pattern of positive and significant correlations between executive functions variables (BANFE-2) and intelligence scores (WISC-IV). The 69 % of significant correlations indicated a moderate – strong degree of association (i. e., 49

Resumen El ámbito educativo, indudablemente, puede beneficiarse de los aportes de las neurociencias, enfoque desde el cual, en este estudio, se plantearon los objetivos de explorar la relación existente entre la capacidad intelectual (CI), las funciones ejecutivas (FE) y el rendimiento académico (RA) en adolescentes; analizar si la CI y las FE constituyen variables predictoras del RA, e indagar el funcionamiento ejecutivo de la muestra según la CI fuera baja o alta. Para ello, se realizó un estudio no experimental, transversal, descriptivo-correlacional, en el que participaron 36 sujetos de 13-14 años. Los instrumentos de evaluación utilizados fueron WISC-IV, BANFE-2 y el registro de calificaciones provisto por la institución educativa. Los datos obtenidos fueron sometidos a análisis descriptivos, de correlación y de regresión. Los resultados arrojaron correlación positiva significativa entre las variables CI y FE, y entre la prueba WISC-IV y RA, determinándose el CI como variable predictiva del RA, mientras que en relación con las FE evaluadas con BANFE-2 solo se encontró asociación estadísticamente significativa con las subpruebas correspondientes al área prefrontal anterior. Además se observaron diferencias significativas entre los grupos de alta y baja CI en las FE de planificación, memoria de trabajo (MT) y fluidez verbal, en favor del grupo de alto desempeño intelectual. La conclusión se centra en la importancia de involucrar los hallazgos sobre los diferentes procesos cognitivos en el diseño de las estrategias pedagógicas para favorecer al máximo el RA del estudiante. Finalmente, las limitaciones versaron en relación con el tamaño muestral, y se proponen futuras líneas de estudio que posibiliten generalizar los resultados.

ABSTRACT Introduction: diastematomyelia is a rare form of occult spinal dysraphia that falls under complex dysgraphic conditions not associated with the subcutaneous mass. It consists of a sagittal split that divides the spinal cord into two hemimedules, each wrapped by its own pia mater and separated by a bone, cartilage or fibrous spur. It is observed in between five and 10% of the population and in most cases has a lumbar location. Case report: female patient with a diastematomyelia that manifests itself with symptoms of paraparesis and sensory disorder, with increased temperature in the right foot and a band of hypesthesia in D8-D9; she underwent a nuclear magnetic resonance that showed a lesion of dorsal diastematomyelia. Conclusions: clinical assessment and the use of neuro-imaging are important to reach the diagnosis of this disease; nuclear magnetic resonance avoids late diagnosis.

RESUMEN Introducción: la diastematomielia es una forma rara de disrafia espinal oculta que se engloba dentro de los estados disráficos complejos no asociados a la masa subcutánea. Consiste en una hendidura sagital que divide a la médula espinal en dos hemimédulas, cada una envuelta por su propia piamadre y separadas por un espolón óseo, cartilaginoso o fibroso. Se observa entre el cinco y el 10% de la población y en la mayoría de los casos tiene una localización lumbar. Información del paciente: paciente femenina que presenta una diastematomielia que se manifiesta con síntomas de paraparesia y trastorno sensitivo, con aumento de la temperatura en el pie derecho y banda de hipoestesia en D8-D9; se le realizó una resonancia magnética nuclear que mostró una lesión de diastematomielia dorsal. Conclusiones: son importantes la valoración clínica y el uso de la neuro-imagen para llegar al diagnóstico de esta enfermedad; la resonancia magnética nuclear evita el diagnóstico tardío.

Resumo Objetivo Analisar a principal causa do uso irresponsável de antibióticos em nível pediátrico de doenças muito frequentes, normalmente autolimitadas e virais: infecções respiratórias das vias aéreas superiores. Fontes Diferentes bases de dados foram pesquisadas com termos específicos relacionados à resistência a antibióticos, infecções respiratórias das vias aéreas superiores e pacientes de pediatria. Resumo dos achados A eficácia varia, depende do local, da forma e dos recursos usados. As formas de múltiplas intervenções parecem mais eficazes. O treinamento em aspectos técnicos e habilidades de comunicação para médicos e tempo suficiente para cada paciente, além do treinamento por meio da clínica e da mídia para pacientes/pais, são a base da eficácia. Prescrições de uso posterior e testes de diagnóstico rápido no ambiente de cuidado primário mostraram ser eficazes. Uma relação de confiança entre médicos e pais ou responsáveis é uma das pedras angulares. Conclusões Qualquer projeto que busque ser completamente eficaz deve incluir uma autoridade em saúde, que, além de ajudar a implantar as medidas nos pacientes, tem a sólida intenção de reduzir drasticamente o uso de antibióticos em animais e no meio ambiente, além de favorecer a pesquisa sobre novos antimicrobianos.

Abstract Objective To analyze the main cause of the irresponsible use of antibiotics at the pediatric level in a very frequent, usually self-limited, and typically viral condition: upper airway respiratory infections. Sources Different databases were searched using specific terms related to resistance to antibiotics, upper airway respiratory infections, and pediatrics patients. Summary of the findings Effectiveness varies depending on the place, the form of intervention, and the resources used. Multiple interventions appear to be more effective. The foundations of treatment are training in technical aspects and in communication skills for the prescribers, and having enough time for each patient; and training through the health clinic and the media for patients/parents. Deferred prescription and the use of rapid diagnostic tests in the primary care setting have been shown to be effective. A fluid relationship based on trust between clinicians and parents/guardians is one of the keystones. Conclusions Any project that seeks to be totally effective must include a health authority, which in addition to helping implement these measures, has the firm intention of drastically reducing the use of antibiotics in animals and in the environment, as well as favoring research into new antimicrobials.

Abstract INTRODUCTION: The etiology of several hepatocellular carcinoma (HCC) cases remains largely unknown. Although Fasciola hepatica has been associated with liver fibrosis in Latin America, it has not yet been associated with HCC. This study aimed to determine the existence of specific IgG antibodies against F. hepatica in the serum samples of HCC patients. METHODS In total, 13 serum samples from 13 HCC patients were screened using Fas2-ELISA. RESULTS Fas2-ELISA demonstrated negative results in all HCC patients included in this study. CONCLUSIONS The pre-existence of F. hepatica infection in HCC patients needs to be further investigated in epidemiological and experimental studies.

Human fascioliasis is prevalent in cattle raising areas in Peru. The only effective drug against Fasciola hepatica infections in clinical practice is triclabendazole (TCBZ). However, the occurrence of TCBZ-resistant F. hepatica both in humans and animals has recently been reported in Peru. This issue was previously suspected, due to treatment failure (presence of Fasciola eggs after treatment) in some patients receiving a single dose of TCBZ. Here, we report 11 of 12 human cases infected by F. hepatica who did not respond to TCBZ administered in a single 10 mg/Kg oral dose. Given these results observed in clinical practice, we recommend the use of at least two doses of TCBZ for human fascioliasis. Nowadays, the treatment for fascioliasis has become an emergent problem from the pharmacological point of view. New therapies against Fasciola are urgently needed

La fasciolosis humana es prevalente en zonas ganaderas del Perú. La única droga efectiva para tratar a la infección por Fasciola hepatica en la práctica clínica es el triclabendazole (TCBZ). Sin embargo, se ha reportado recientemente resistencia de la F. hepatica al TCBZ en Perú tanto en humanos como en animales. Este problema ya se sospechaba anteriormente en vista que una dosis única de triclabendazole no curaba (eliminación de huevos de Fasciola en heces) en algunos pacientes. Aquí reportamos 11 de 12 casos humanos infectados por F. hepatica que no respondieron a dosis única de TCBZ 10 mg/kg vía oral. En vista de estos resultados observados en la práctica clínica, recomendamos considerar por lo menos dos dosis de TCBZ para los infectados. Creemos que el tratamiento de fasciolosis se ha convertido en un problema emergente desde el punto de vista farmacológico. Se necesitan nuevos regímenes de terapia o drogas contra F. hepática

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder of uncertain etiology. Several studies have proposed the possible role of intestinal parasites in the pathogenesis of IBS. We aimed to summarize the epidemiological studies that describe a possible link between intestinal parasites and IBS, with special interest in endemic areas for intestinal parasitism such as South America. A comprehensive review of the literature was conducted by using the keywords: irritable bowel syndrome, intestinal parasites, protozoan infection, soil-transmitted helminths and South America. Giardia lamblia may cause IBS symptoms that can persist several years after effective treatment. Dientamoeba fragilis can cause IBS-like symptoms, but low sensitive parasitological techniques may fail to detect it. Entamoeba histolytica can cause a chronic non-dysenteric colitis, but several studies have failed to find an association with IBS. The role of Blastocystis hominis in IBS remains controversial. In addition, epidemiological studies evaluating the effect of soil-transmitted helminths in IBS are scant. Symptoms elicited by intestinal parasites may resemble to those in IBS, especially in endemic areas such as South America, where both the prevalence of IBS and intestinal parasitism are high. Whether these organisms are the cause or contributing factors in IBS remains a subject of study. Routine parasitological examination of stools in individuals who full-fit the criteria for IBS should be included upon initial assessment in endemic countries.

El Síndrome de intestino irritable (SII) es un desorden gastrointestinal funcional de etiología incierta. Muchos estudios han propuesto que los parásitos intestinales pueden tener un rol en la patogénesis del SII. Se sintetizó estudios epidemiológicos que describen una relación posible entre el parasitismo intestinal y el SII, con especial interés en aquellos estudios que fueron realizados en zonas endémicas para dichos organismos. Se realizó una revisión extensa de la literatura por medio de las siguientes palabras clave: síndrome de intestino irritable; parásitos intestinales; protozoarios; helmintos y Sud-América. Giardia lamblia puede causar síntomas similares al SII que pueden persistir por muchos años, después de tratamiento efectivo. Dientamoeba fragilis puede causar un cuadro similar al SII, pero al emplearse técnicas de baja sensibilidad, se puede fallar en detectar su presencia. Entamoeba histolytica puede causar un cuadro de colitis no disentérica, pero varios estudios no han podido encontrar una relacion con el SII. El rol del Blastocystis hominis en el SII sigue siendo controversial. Adicionalmente, los estudios epidemiológicos evaluando el efecto de los helmintos en el SII son escazos. Los parásitos intestinales pueden causar síntomas que pueden parecerse a los que se encuentran en pacientes con SII. Ésta observación merece especial atención en regiones como Sud-América, donde las prevalencias del SII y del parasitismo intestinal han sido estimadas como altas. Si es que éstos organismos son la causa o un factor contributor en el SII, aún es materia de estudio. En la evaluación inicial de un probable caso de SII, los estudios parasitológicos pueden ser necesarios, especialmente en áreas endémicas.

Abstract:INTRODUCTION:The therapeutic scheme of triclabendazole (TCBZ), the recommended anthelmintic against Fasciola hepatica , involves 10mg/kg of body weight administered in a single dose; however, clinical trials in children are scarce. We evaluated the efficacy and tolerability of 2 schemes of TCBZ.METHODS: Eighty-four Peruvian children with F. hepatica eggs in their stools were allocated into 2 groups: 44 received 2 dosages of 7.5mg/kg each with a 12-h interval (Group I), and 40 received a single 10-mg/kg dose (Group II). Evaluation of efficacy was based on the presence of eggs in stools, and tolerability was based on the presence of symptoms and signs post-treatment.RESULTS: A parasitological cure was obtained in 100% of individuals from Group I and 95% of individuals from Group II. The most common adverse event was biliary colic.CONCLUSIONS: The tested scheme was efficacious and tolerable, and it might be an optimal scheme in the region. To the best of our knowledge, this represents the largest series of children treated with TCBZ in a non-hospital setting.