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PubMedDate not supplied

A randomized double-blind clinical trial of two antivenoms in patients bitten by Bothrops atrox in Colombia. The Regional Group on Antivenom Therapy Research (REGATHER).

A randomized double-blind clinical trial in 39 patients envenomed by Bothrops atrox in Antioquia and Chocó, Colombia, was performed to compare the efficacy and safety of 2 equine-derived antivenoms prepared at Instituto Clodomiro Picado, University of Costa Rica. Twenty patients received a monovalent anti-B. atrox antivenom (group A) and 19 patients were treated with a polyvalent (Crotalinae) antivenom (group B). Both antivenoms were equally efficient in the neutralization of the most relevant signs of envenoming (haemorrhage and blood clotting time alteration). Fourteen patients (36%) presented early adverse reactions to antivenoms and no significant difference between the 2 groups was observed. Urticaria (18%) was the most frequent early adverse reaction and there was no life-threatening anaphylactic reaction. Based on clinical criteria and serum venom levels, estimated by an enzyme immunoassay, 15 patients were classified into 2 groups: mild and moderate/severe envenoming. With the antivenom doses used in this study (3, 6 and 9 vials for mild, moderate and severe envenoming, respectively), both antivenoms were equally efficient in clearing serum venom levels within the first hour of treatment, and the levels remained below the lower limit of venom detection for 24 h. Antivenom concentration in serum remained high for up to 24 h after antivenom infusion, suggesting that an excess of antibody in relation to circulating antigen had been administered.

Adolescent↗
PubMedDate not supplied

Dynamics of Leishmania chagasi infection in small mammals of the undisturbed and degraded tropical dry forests of northern Colombia.

The infection rate with Leishmania chagasi and the population dynamics of small mammals were studied in an undisturbed forest reserve (Colosó) and an area of highly degraded forest (San Andrés de Sotavento [SAS]) in northern Colombia, both endemic for visceral leishmaniasis. Live trapping of mammals was done every month, and species, age, sex and reproductive status determined. L. chagasi was detected in samples of skin or spleen by the polymerase chain reaction, after extraction of deoxyribonucleic acid using specific primers (DB8/AJS3), and dot blood hybridization. Didelphis marsupialis was found to be infected in Colosó (3/21, 14.3%) and SAS (13/137, 9.5%); its relative abundance was higher in SAS (93/113, 82% of the captures). Although Proechimys canicollis was also found to be infected in Colosó (3/34, 8.8%) and SAS (2/4), its relative abundance was much lower (4%) in SAS than in Colosó (56% of 77 animals captured). Sciurus granatensis, Marmosa robinsoni, Heteromys anomalus, Zygodontomys brevicauda and Metachirus nudicaudatus were less common, and no L. chagasi infection was detected in them.

Animals↗
PubMed1998

Comparative study of the venoms of three subspecies of Lachesis muta (bushmaster) from Brazil, Colombia and Costa Rica.

A comparative study was performed on the pharmacology and biochemistry of venoms from three subspecies of Lachesis muta (L. m. stenophrys, L. m. muta and L. m. rhombeata) from Brazil, Colombia and Costa Rica. All venoms induced lethal, hemorrhagic, edema-forming, myotoxic, coagulant and defibrinating effects, showing also proteolytic and indirect hemolytic activities. The venoms of L. m. stenophrys from Costa Rica and L. m. muta from Cascalheira, Brazil, had the highest lethal and hemorrhagic activities and the venom of L. m. rhombeata showed the highest coagulant activity, whereas no significant differences were observed in myotoxic and edema-forming activities at most of the time intervals studied. In addition, venoms showed similar electrophoretic patterns on SDS-polyacrylamide gel electrophoresis. In conclusion, despite quantitative differences in toxic and enzymatic activities, together with subtle variations in electrophoretic patterns, our results indicate that experimental envenomation by these venoms induce a qualitatively similar pathophysiological profile.

Animals↗
PubMed1999

A randomized blinded clinical trial of two antivenoms, prepared by caprylic acid or ammonium sulphate fractionation of IgG, in Bothrops and Porthidium snake bites in Colombia: correlation between safety and biochemical characteristics of antivenoms.

A randomized blinded clinical trial was performed in 53 patients bitten by Bothrops sp. and Porthidium sp. in Antioquia and Chocó, Colombia, in order to compare the efficacy and safety of two antivenoms made of whole IgG obtained by either ammonium sulphate (monovalent anti-B. atrox) or caprylic acid (polyvalent) fractionation. Additionally, antivenoms were compared by electrophoretic and chromatographic analyses and anticomplementary activity in vitro. With a protocol of 2, 4 and 6 antivenom vials for the treatment of mild, moderate and severe envenomings, respectively, both antivenoms were equally efficient to neutralize the most relevant signs of envenoming and to clear serum venom levels in patients from the first hour and later on. Three patients with severe envenoming and initially treated with less than six vials on admission had persistent or recurrent venom antigenemia within 12-48 h. Monovalent antivenom fractionated by ammonium sulphate precipitation had higher amounts of protein aggregates and nonimmunoglobulin proteins than polyvalent antivenom fractionated by caprylic acid precipitation. Both antivenoms presented anticomplementary activity in vitro, being higher in the monovalent product. In agreement, monovalent antivenom induced a significantly higher incidence of early antivenom reactions (52%) than polyvalent antivenom (25%).

Adolescent↗
PubMed2002

Human exposure to mercury in San Jorge river basin, Colombia (South America).

During May-September 1999 human hair samples were collected from the village of Caimito, a fishing community of the state of Sucre (Colombia), in the San Jorge River basin area, and analyzed for total mercury (t-Hg) by cold vapor atomic absorption spectroscopy. T-Hg was measured in both male and female people aged 15-65 years, whose diet mainly consists of fish collected in nearby marshes. Average hair t-Hg concentration in people from Caimito was 4.91 +/- 0.55 microg/g (n = 94), similar to the value previously detected in fishermen living in the gold mining area, 50 km east. Males had similar t-Hg concentrations (4.31 +/- 0.42 microg/g; n = 56) to females (5.78 +/- 1.21 microg/g; n = 38) and there was no difference in t-Hg levels between groups of different age. Mercury content in hair was weakly but significantly associated (R = 0.20, P = 0.05) with fish consumption.

Adolescent↗
PubMed1998

Mercury in environmental samples from a waterbody contaminated by gold mining in Colombia, South America.

Environmental samples from a marsh, which receives mercury discharges from a gold mine in Colombia (South America), were evaluated for total mercury content. Mercury concentrations were analyzed in sediments, macrophytes and fish species from different trophic levels. The Mean mercury levels in sediments oscillated between 140 and 355 micrograms/kg whereas in the macrophyte Eichornia crassipes levels were between 219 and 277 microgram/kg with practically no interseasonal variations. The mercury content in the muscle of fish varied depending on the position in the trophic chain and the feeding habits of each species, oscillating between non-detectable (< 7.4 microgram/kg) and 1084 micrograms/kg. Seasonal variations were only observed in fish species whose habitats are mostly the bottom sediment. The presence of mercury in some fish appeared to be the result of bioaccumulation rather than a biomagnification processes. This was clearly evidenced in the detritivorous species Triportheus magdalenae which obtain their food within the sediments and whose mercury concentrations were significantly higher when compared to the other species including carnivorous. The relatively low mercury concentrations found in fish may be due to both the dispersion of the contaminant once it reaches the waterbody and the migrational characteristics of the fish species.

Animals↗
PubMed2000

Risk factors and context of men who physically abuse in Bogotá, Colombia.

OBJECTIVES: The aim of this study was to identify risk factors for physical abuse caused by male perpetrators, as well as to describe the context of abuse and the role of the female partner in these cases in Bogotá, Colombia. METHODS: Information from in-depth interviews of males reported to authorities for physical child abuse and their female partners (n = 45) was quantitatively and qualitatively analyzed and compared to to males and their female partners from the same neighborhood living with a child of the same gender and age (+/-3 years) as the abused child (n = 44). RESULTS: Situations of abuse occurred more often on a weekday, in the afternoon or early evening hours, with the mother present, exceptionally involved substance abuse, and tended to be repetitive. Male subjects' lower level of education, stepfather status, perceived stress, substance abuse and mental illness, lack of social support, history of childhood physical abuse, negative perceptions, attributions and unrealistic expectations of the child's behavior were associated with abuse. Cases' female partners were more likely to have a lower occupational level, a higher frequency of dependent personality, a history of childhood physical and sexual abuse and be herself physically and emotionally abused by her spouse. At least three scenarios for abuse emerged from the analyses: "explosive" men, "abusive disciplinarians," and "children out of parental control." CONCLUSIONS: Most of the findings are consistent with existing research despite the different social and cultural context. The different scenarios suggest the need to tailor preventive and rehabilitative interventions for abusers.

Adolescent↗
PubMed1998

Buerger's disease at the 'San Juan De Dios' Hospital, Santa Fe De Bogota, Colombia.

OBJECTIVES: To know the clinical characteristics in the presentation of Buerger's disease in San Juan de Dios Hospital, Bogota, Colombia, between 1986 and 1996, and compare them with a previous series from the same Hospital and another reported in international literature; To determine the changes in the form of appearance of the disease. METHODS: We reviewed the clinical information of 22 patients with diagnosis of Buerger's disease, observed between 1986 and 1993, and we added the information of the clinical histories of eight other patients with equal diagnosis, observed between 1994 and 1996 in our Unit. RESULTS: We observed 30 patients: 28 men (93%) and two women (7%), with a ratio M:F of 14:1, with an average age of 39+10 years (range from 18 to 52 years). Sixty percent were younger than 40 years and only the 10% were older than 50 years. The most frequent reasons for consultation were: pain in rest in the affected extremity, gangrene and ulceration in more than 50%. Raynaud's phenomenon in 30%, and the related surgical history in 40%. The pedal pulse was the most compromised followed by popliteal, poster or tibial and femoral. We did not observe the presence of thrombophlebitis. Eighty percent showed compromise of more than one extremity. All of them were active smokers. Three patients showed IgG anticardiolipine antibodies at high level. CONCLUSIONS: The clinical characteristics are similar to those reported, we find also a reduction of the disease diagnosis. It calls to our attention that no thrombophlebitis was found in the present series and the less compromise of the upper extremities with a frequent femoral compromise. All this points toward a change in the natural history of the disease.

Adolescent↗
PubMedDate not supplied

[Marital violence in Barranquilla [Colombia]: prevalence and risk factors].

OBJECTIVE: To determine the prevalence of violence against women of fertile age living in a couple and identify the personal, socioeconomic, and family function characteristics associated with this phenomenon. METHODS: We performed a cross-sectional study in a random sample of 275 women of fertile age living in the neighborhood of Carlos Meisel in Barranquilla, Colombia. Information was gathered through a structured questionnaire and face-to-face interviews at the participants' homes. The questionnaire was adapted from the World Health Organization's recommendations on ethics and safety when investigating domestic violence. The questionnaire included items on personal characteristics, habitual alcohol and drug consumption, family function test (Family Apgar), socioeconomic characteristics, and physical abuse in the 12 months prior to the interview. RESULTS: The prevalence of marital violence was 22.9%. Women aged 25-29 years old were the most commonly affected (33.3%). Factors associated with violence were habitual alcohol consumption in women (Odds ratio [OR] = 6.02; 95% confidence interval [95% CI], 1.7-22.2) and in the spouse (OR = 10.11; 95% CI, 5.1-20.1) and drug consumption by the husband (OR = 11.01; 95% CI, 4.2-29.5). A monthly wage of less than 300,000 Colombian pesos (140 euros) was also significantly associated with domestic violence as was moderate or severe family dysfunction (respectively, OR = 16.9; 95% CI, 4.8-59.0; OR = 81.6; 95% CI, 18.8-335). CONCLUSIONS: Because this was a cross-sectional study, the results should be interpreted with caution. Nevertheless, violence against women in the study sample was associated with potentially modifiable factors.

Adolescent↗
PubMed1996

Evaluation of SPf66 malaria vaccine during a 22-month follow-up field trial in the Pacific coast of Colombia.

A double-blind randomized placebo-controlled field trial with the SPf66 malaria vaccine was carried out in an endemic area consisting of 14 small villages with exclusive fluvial access, in a rain forest area along the Rosario River, Colombia. A total of 1257 subjects completed the full three dose vaccination schedule on days 0, 30 and 180 (643 vaccinated group/623 placebo group) and were followed-up by passive and active surveillance over a period of 22 months. One hundred and thirty-four Plasmodium falciparum malaria episodes were detected (53 in vaccinated group/81 in placebo group), yielding an attack rate of 5.47 cases/100 person years of follow-up (pyears) in the vaccine group and 8.44/100 pyears in the placebo group. The estimated vaccine protective efficacy was 35.2% (95% CI 8.4-54.2%, P = 0.01). This result supports earlier findings that the SPf66 malaria vaccine diminishes the risk of infection by P. falciparum in endemic areas of South America.

Adolescent↗
PubMed1998

An epidemic of collective conversion and dissociation disorder in an indigenous group of Colombia: its relation to cultural change.

We describe a collective episode of psychogenic illness in an indigenous group (Embera) of Colombia, geographically isolated from its native homeland and surrounded by non-indigenous settlers. The condition, which affected three young adult men and six adolescent women, was attributed by them to a spell (maleficio). It was designated as ataques de locura (madness attacks) according to their traditional medical system; and as a conversive disorder with dissociative features by psychiatrists. Different therapeutic approaches, including antipsychotic medication, religious healers and traditional herbal remedies were unsuccessful. Contact with shamans of the same ethnic origin, on the other hand, proved to be an effective way of dealing with the symptoms. We interpret the situation as an expression of psychosocial stress secondary to cultural change. This medical problem bears close resemblance to other specific culture-bound syndromes such as ataques de nervios or possession syndromes and gives clues to ways of dealing with psychogenic expressions of cultural stress.

Adolescent↗
PubMed2001

A novel Cys212Tyr founder mutation in parkin and allelic heterogeneity of juvenile Parkinsonism in a population from North West Colombia.

We report the molecular characterization of three multiplex families and a sporadic case of juvenile Parkinsonism identified in the province of Antioquia (Colombia). Linkage and haplotype analysis using markers in 6q25.2-27 indicated that Parkinsonism in the pedigrees is linked to the parkin gene (maximum LOD-score of 3.85) but that they carry two different mutant haplotypes. Sequence analysis revealed a novel G to A transition in exon 6 at position 736 (G736A) of parkin. This change results in a non-conservative cysteine for tyrosine substitution. All affected individuals from two families were homozygous for this mutation, which was not detected in 100 normal controls. Patients from the family carrying the second haplotype and the sporadic case were homozygous for a GT insertion in exon 3. This mutation has been previously identified in French families with juvenile Parkinsonism. The concomitant presence of founder effects and allelic heterogeneity in Antioquia might relate to the founding admixture at the origin of this population.

Adolescent↗
PubMed2000

Snakebites and ethnobotany in the northwest region of Colombia. Part III: neutralization of the haemorrhagic effect of Bothrops atrox venom.

Thirty-one of 75 extracts of plants used by traditional healers for snakebites, had moderate or high neutralizing ability against the haemorrhagic effect of Bothrops atrox venom from Antioquia and Chocó, north-western Colombia. After preincubation of several doses of every extract (7.8-4000 microg/mouse) with six minimum haemorrhagic doses (10 microg) of venom, 12 of them demonstrated 100% neutralizing capacity when the mixture was i.d. injected into mice (18-20 g). These were the stem barks of Brownea rosademonte (Caesalpiniaceae) and Tabebuia rosea (Bignoniaceae); the whole plants of Pleopeltis percussa (Polypodiaceae), Trichomanes elegans (Hymenophyllaceae) and Senna dariensis (Caesalpiniaceae); rhizomes of Heliconia curtispatha (Heliconiaceae); leaves and branches of Bixa orellana (Bixaceae), Philodendron tripartitum (Araceae), Struthanthus orbicularis (Loranthaceae) and Gonzalagunia panamensis (Rubiaceae); the ripe fruits of Citrus limon (Rutaceae); leaves, branches and stem of Ficus nymphaeifolia (Moraceae). Extracts of another 19 species showed moderate neutralization (21-72%) at doses up to 4 mg/mouse, e.g. the whole plants of Aristolochia grandiflora (Aristolochiaceae), Columnea kalbreyeriana (Gesneriaceae), Sida acuta (Malvaceae), Selaginella articulata (Selaginellaceae) and Pseudoelephantopus spicatus (Asteraceae); rhizomes of Renealmia alpinia (Zingiberaceae); the stem of Strychnos xinguensis (Loganiaceae); leaves, branches and stems of Hyptis capitata (Lamiaceae), Ipomoea cairica (Convolvulaceae), Neurolaena lobata (Asteraceae), Ocimum micranthum (Lamiaceae), Piper pulchrum (Piperaceae), Siparuna thecaphora (Monimiaceae), Castilla elastica (Moraceae) and Allamanda cathartica (Apocynaceae); the macerated ripe fruits of Capsicum frutescens (Solanaceae); the unripe fruits of Crescentia cujete (Bignoniaceae); leaves and branches of Piper arboreum (Piperaceae) and Passiflora quadrangularis (Passifloraceae). When the extracts were independently administered by oral, i.p. or i.v. route either before or after an i.d. venom injection (10 microg), neutralization of haemorrhage dropped below 25% for all the extracts. Additionally, B. rosademonte and P. percussa extracts were able to inhibit the proteolytic activity of B. atrox venom on casein.

Analysis of Variance↗
PubMed2001

A preliminary study of forensic entomology in Medellín, Colombia.

This is the first report of an ongoing study of insect succession on carrion carried out in Medellín, Colombia, using pigs (Sus scrofa) as a model to determine the insect sequence over 207 days. During this period, 2314 insects belonging to the following orders and families were collected: Diptera: Calliphoridae, Muscidae, Piophilidae, Sarcophagidae, Syrphidae, Otitidae; Hymenoptera: Apidae, Formicidae, Halictidae, Mutilidae, Vespidae; Coleoptera: Staphylinidae, Histeridae, Carabidae, Scarabaeidae, Silphidae, Dermestidae, Cleridae, Nitidulidae; Dermaptera: Forficulidae; Hemyptera: Gelastocoridae, Coreidae; Lepidoptera: Hesperiidae. Five decomposition stages were observed (fresh, bloated, active decay, advanced decay, and dry remains) and four insect ecological categories (necrophagous, predators, omnivorous, and incidental). During the fresh stage, the first insects that appeared were flies of the families Sarcophagidae and Muscidae and specimens of Formicidae (Hymenoptera). During the bloated period, species of Calliphoridae (Diptera) were predominant and the first to oviposit. During the third and fourth stages (active decay and advanced decay), the most abundant families were Calliphoridae and Muscidae, although Staphilinidae (Coleoptera) also stood out. During the last stage (dry remains), the dominant family was Formicidae (Hymenoptera) followed by Dermestidae (Coleoptera) with a large number of immature insects.

Animals↗
PubMed2003

An interrupted time series analysis of parenteral antibiotic use in Colombia.

A University-based hospital in Bogotá, Colombia, developed and implemented an educational intervention to complement a new structured antibiotic order form. This intervention was performed after assessing the appropriateness of the observed antibiotic prescribing practices using a quasi-experimental study. An application of interrupted time series intervention analysis was conducted in three antibiotic groups (aminoglycosides, cephradine/cephalothin, and ceftazidime/cefotaxime) and their hospital weekly rate of incorrect prescriptions before and after the intervention. A fourth time series was defined on prophylactic antibiotic use in elective surgery. Preintervention models were used in the postintervention series to test for pre-post series level differences. An abrupt constant change was significant in the first, third, and fourth time series indicating a 47, 7.3, and 20% reduction of incorrect prescriptions after the intervention. We conclude that a structured antibiotic order form, coupled with graphic and educational interventions can improve antibiotic use in a university hospital.

Aminoglycosides↗
PubMed2002

Oriéntame: preventing and solving problems related to unwanted pregnancy for 25 years in Colombia.

For over 25 years, the Oriéntame Foundation in Bogotá, Colombia, has been providing reproductive health services to women, regardless of their socio-economic or marital status, race, age or religious affiliation. Oriéntame started by focusing primarily on unwanted pregnancy and treatment for incomplete abortion, which has contributed to the reduction of maternal mortality in Bogotá. Oriéntame now provides comprehensive sexual and reproductive health services, including sexual health education, Pap smears, gynaecological problems, STIs and sexual violence, with a continuing emphasis on unwanted pregnancy, treatment for incomplete abortion and post-abortion care. The women that come to Oriéntame, some 18,000 per year in recent years, are from all socio-economic levels, and are increasingly more informed. The services are regularly re-evaluated so as to accommodate their changing needs. There is a sliding scale of fees, so that the 40% of women patients with higher incomes subsidize the 60% with lower incomes; this also allows the clinics to be self-supporting. Services are offered in an atmosphere of respect for women and their decisions, with professional staff who are trained to take care of both the medical and emotional needs of each woman. Since 1992, Oriéntame has also been doing outreach to the slum areas of Bogotá, providing education and information, to contribute to the empowerment of the poorest inhabitants of the city.

Colombia↗
PubMed2005

[Environmental distribution of Cryptococcus neoformans in the department of Cundinamarca-Colombia].

Cryptococcus neoformans is an opportunistic fungal pathogen that could cause infection in patients with immunodeficiency and healthy patients. The AIDS epidemic has shown the importance of studying the ecology and epidemiology of this fungus. The aim of this investigation was to determine if there was a relationship between the environmental distribution of the different varieties of C. neoformans and the climate zones in two transects located in department of Cundinamarca, in Colombia. For the isolation and identification of the yeast, conventional phenotypic methods were used and it was determined the population density (CFU/g of sample) and which was the variety of greater prevalence in each altitudinal rank. A total of 765 samples, from 26 municipalities were collected; of these 146 corresponded to pigeon droppings (Columba livia), 437 to Eucalyptus detritus (Eucalyptus camaldulensis and related species) and 182 to detritus of almond trees (Terminalia cattapa). C. neoformans was isolated from 46% of the studied municipalities, in both transects and the climate zones: warm, temperate and cold. The results indicated that the greater frequency of positive isolations came from the last climate zone (cold). The population density in pigeon excrements oscillated between 50 and 9.2 x 1,000,000, in eucalyptus between 500 and 10 x 1,000,000 and in almond trees was 50 CFU/g. Of 100,000 positive isolations 31% were serotype A, 59% serotype B and 10% serotype C; 96% of the isolates grew to 37 degrees C and all showed capsule. In conclusion, C. neoformans prevails in the three habitats studied but it showed a predilection for the cold thermal floor; the population densities did not allow defining a standard pattern of occurrence.

Altitude↗
PubMed2005

[Endophytic fungi in rose (Rosa hybrida) in Bogota, Colombia].

We have investigated the presence of endophytic fungi associated with rose plants (Rosa hybrida) in Colombia. Endophytic fungi were isolated from healthy leaves of ten ornamental roses plants from gardens cultured in malt extract, peptone, yeast extract agar plates (MPY). We sampled 560 leaves fragments, 56 per sample. Endophytic fungi comprised 92 isolates (16.4%); of these isolates, 41 were classified as sterile mycelium (without reproductive structures that allowed their identification), 31 isolates were identified to genus or to species, and 20 isolates could not be identified at all. The identified endophytic fungi were as follow: Nigrospora oryzae, Aureobasidium spp, Acremonium spp. The fungi Nodulisporium sp, Gliocladium virens, Cladosporium sp, Alternaria sp, Phoma sp and Chaetomium globosum were represented by one isolate each. Since the endophytic fungi are known for their capacity to produce metabolites with biological activity, it is possible that the microorganisms found in this study have potential as antagonist of rose pathogens.

Colombia↗