Noonan Syndrome and Different Morphologic Expressions of Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy is the disease with the largest heterogeneity in clinical cardiology. An underrecognized and incompletely described subgroup within this spectrum comprises patients with ventricular diverticulum, coronary myocardial bridging, and left ventricular crypts and crevices. This report presents the case of a Noonan syndrome patient with these four hypertrophic cardiomyopathy characteristics.     

Disease knowledge among type 2 diabetes mellitus patients attending primary care

OBJECTIVE: assess disease knowledge among a patient population. MATERIAL AND METHODS: Cross-sectional study in two health care centers belonging to the National Institute of Social Security (ISSSTE). A general knowledge questionnaire was applied to 141 patients with type 2 diabetes mellitus. Chi-square tests to compare demographic variables with knowledge level were used. Alpha was set at p < 0.05. RESULTS: 29.2% of participants scored correct answers and only 12.3% were fully knowledgeable. The highest percentage (42.4%) of correct knowledge was related to levels of blood glucose. There was no association between appropriate metabolical control among patients and disease knowledge. Being younger, having higher education and less than 10 years with the disease generated higher levels of knowledge. CONCLUSIONS: Knowledge levels among the studied population are low and similar to the results from the literature. Demographic characteristics such as age and education are associated with changes in degree of knowledge. Patient educational programs are a fundamental component of a comprehensive approach to diabetes prevention.     

Therapeutic efficacy of posaconazole against isolates of Candida albicans with different susceptibilities to fluconazole in a vaginal model.

A battery of 34 vaginal isolates of Candida albicans was tested against posaconazole (POS) and fluconazole (FLU) to determine their in vitro susceptibilities and to obtain FLU-susceptible and FLU-resistant strains for the murine in vivo studies. FLU-resistant strains were chosen on the basis of their 48-h MICs. The 48-h geometric mean MICs for all isolates tested were 0.016 and 0.656 microg/ml for POS and FLU, respectively. The treatment regimens for the vaginal murine infection model were POS or FLU at 10 or 20 mg/kg of body weight/day and 20 mg/kg twice a day. All regimens with POS were effective in reducing fungal burden of both the fluconazole-susceptible and resistant isolates of C. albicans. All FLU regimens were effective against infection induced by the fluconazole-susceptible strain. While FLU at 10 mg/kg was ineffective against fungal burden of the resistant strain, treatment with FLU at 20 mg/kg once or twice a day was effective against this strain. Both POS and FLU at 20 mg/kg twice a day were able to clear C. albicans from vaginas of mice infected with the fluconazole-susceptible strain. POS displayed a more effective in vivo activity than FLU in the treatment of murine C. albicans vaginitis produced by isolates with different susceptibilities to FLU.     

Should We Look for Strongyloides Stercoralis in Foreign-Born HIV-Infected Persons?

The objective was to evaluate the implementation of a systematic Strongyloides stercoralis screening programme in HIV infected immigrants attending an HIV Unit in Spain. An enzyme-linked immunosorbent assay (ELISA) was performed to assess the presence of Strongyloides IgG. Patients with a positive serology were treated with ivermectin; serologic follow-up testing was performed. 237 patients were screened (65.4 % men). Origin: 64.1 % came from Latin America, 16.5 % from Sub-Saharan Africa, 9.7 % from the Caribbean, 9.7 % from other areas. Strongyloides stercolaris IgG was positive in 13 cases (5.5 %). In the multivariate analysis, factors associated with a positive Strongyloides serology were illiteracy (OR: 23.31; p = 0.009) and eosinophilia (OR: 15.44; p < 0.0001). Nine of the 13 patients positive for S. stercoralis IgG and treated with ivermectin had a follow up serologic test: 77.8 % achieved a serologic response (55.5 % seroreversion). Screening of HIV-positive immigrants may be desirable, at least in those with higher risk of hyperinfection syndrome. Serologic testing seems a useful tool in both diagnosis and follow-up of these patients.     

Digital imaging information technology for biospeckle activity assessment relative to bacteria and parasites

This paper reports on the biospeckle processing of biological activity using a visualization scheme based upon the digital imaging information technology. Activity relative to bacterial growth in agar plates and to parasites affected by a drug is monitored via the speckle patterns generated by a coherent source incident on the microorganisms. We present experimental results to demonstrate the potential application of this methodology for following the activity in time. The digital imaging information technology is an alternative visualization enabling the study of speckle dynamics, which is correlated to the activity of bacteria and parasites. In this method, the changes in Red-Green-Blue (RGB) color component density are considered as markers of the growth of bacteria and parasites motility in presence of a drug. The RGB data was used to generate a two-dimensional surface plot allowing an analysis of color distribution on the speckle images. The proposed visualization is compared to the outcomes of the generalized differences and the temporal difference. A quantification of the activity is performed using a parameterization of the temporal difference method. The adopted digital image processing technique has been found suitable to monitor motility and morphological changes in the bacterial population over time and to detect and distinguish a short term drug action on parasites.     

Factors associated with untreated hypertension among older adults: results of the Mexican Health and Aging Study, 2001]

OBJECTIVE: To determine factors associated with failure to adhere to treatment for diagnosed hypertension among a representative sample of older Mexican adults living in the community. METHODS: A cross-sectional study of 2,029 individuals 65 years of age or older with diagnosed hypertension who participated in the Mexican Health and Aging Study, carried out during the summer of 2001. The survey collected information on several demographics (age, sex, schooling, whether living alone, and employment status, among others), any chronic illnesses, symptoms of depression, cognitive deterioration, body mass index, smoking, alcohol consumption, and difficulty performing basic and instrumental activities of daily living. Simple and multifactorial logistical regression analyses were used to evaluate the association among the study variables and self-reported untreated high blood pressure. RESULTS: Of the 2,029 participants, 437 (21.5%) reported not following any treatment whatsoever for controlling their hypertension; 1,584 (78.1%) affirmed they were complying with treatment; and 8 (0.4%) did not respond to this question. The multifactorial analysis adjusted for confounding variables (age, sex, symptoms of depression, and cognitive deterioration) showed that only a low number of years of schooling (adjusted odds ratio [OR] = 1.70; 95% confidence interval [95%CI]: 1.10-2.64; P = 0.02 for 1-6 years of schooling and adjusted OR = 3.32; 95%CI: 2.10-5.24; P < 0.01 for no schooling), alcohol consumption (adjusted OR = 1.52; 95%CI: 1.14-2.03; P = 0.01), and urinary incontinence (adjusted OR = 1.61; 95%CI: 1.15-2.26;P < 0.01) were independently associated with hypertension. CONCLUSIONS: Hypertension is a common and important issue among older adults in Mexico. To obtain better medication compliance, doctors prescribing or modifying hypertension treatment should taken into account whether or not the patient suffers from urinary incontinence, consumes alcohol, and/or has a low level of schooling.