Trichinella spp. Y EL CICLO SALVAJE EN LA PROVINCIA DE SANTA FE

Trichinellosis in a zoonotic parasitism of worldwide distribution caused by nematodes of the genus Trichinella. Argentina is considered an endemic country for this zoonosis and so far four species have been identified, spiralis, patagoniensis, britovi and pseudospiralis. It can affect both domestic animals such as pigs, dogs, horses, or wild animals such as cougars, armadillos, wild boars, and wild pigs. With the aim of knowing if any species of Trichinella circulates among the wild fauna of the province of Santa Fe, 22 samples of muscle from pigs between wild and wild boars were analyzed by Artificial Digestion, five from aguará guazú (Chrysocyon brachiurus), one of cat wild (Leopardus geoffroyi), one of weasel (Didelphis albiventris) and one of an equine (Equus caballus). All samples were negative.

Spinal pain revealing brucellar spondylodiscitis: a case report

Background Brucellosis is an anthropozoonosis. It is an endemic disease in the Mediterranean basin. The clinical presentation is polymorphic. The osteoarticular form is the most frequent of the focal forms affecting mainly the spine. In our endemic context, the diagnosis can lead to confusion with tuberculosis. Case presentation We report a case of brucellar spondylodiscitis treated initially as tubercular spondylodiscitis with a good initial evolution. Then, the diagnosis was rectified towards a Brucella origin, after a clinical and biological relapse. Diagnostic confirmation was based on the isolation of Brucella spp in the disco-vertebral CT-guided biopsy and the positive Brucella serology. Then, the patient was put on three antibacterial treatments with doxycycline, rifampicin, plus streptomycin over a period of 6 months with a good evolution. Conclusion Brucellar spondylodiscitis is still common in the Maghreb. It is generally insidious and leads to a delay in diagnosis. The clinician must always mention it when faced with spondylodiscitis in an endemic country and ask for brucella serology.

Verrucous mass of the leg in an octogerian woman

Various clinical forms of cutaneous leishmaniasis can be encountered such as: ulcerated, lupoïd, sporotrichoïd and other rare forms (eczematiform, erysipeloid, psoriasiform, verrucous, and pseudotumoral). We report an atypical presentation. Dermatologists should be aware when facing a verrucous mass, especially if the patient comes from an endemic country.

Echocardiography Screening for Diagnosis of Latent RHD Using Nurses: Is the Project Feasible for Nepal?

Rheumatic Heart Disease (RHD) is a preventable disease which occurs years or decades after the onset of Acute Rheumatic Fever (ARF) in childhood. The prevalence of RHD is still high in Nepal, with most cases of latent RHD concentrated in the rural, resource-limited setting. The sequelae of latent RHD cases often manifest decades later, causing a significant burden on the health system. Training of non-experts with simple protocols in such remote setting for screening of latent RHD is showing promising results worldwide. Screening of latent RHD is advocated in RHD endemic areas where early detection by echo screening can alleviate a massive burden on morbidity and mortality in the future. More research is needed to explore this possibility in the context of an endemic country like Nepal to tackle the burden of RHD.

Curative lobectomy without a preoperative tissue diagnosis in a tuberculosis endemic country: A case report and discussion

Curative surgery for a localized tumour at the early and pre-symptomatic stage is the main aim of lung nodule assessment. As part of the process, pre-operative tissue diagnosis is a key step in making appropriate clinical decisions and avoiding unnecessary invasive surgical intervention which is associated with high morbidity. In this case report, we describe a patient who had a curative lobectomy for a growing nodule without a preoperative tissue diagnosis although the initial discussion deemed it mandatory, and we dissected the arguments supporting it in the setting of a tuberculosis endemic country.

Characteristics of new HIV diagnoses over 1995–2019: A clinic-based study in Montréal, Canada

Background Characterization of populations at risk of acquiring HIV is required to inform the public health response to HIV. To identify potential changing needs in HIV prevention and care cascade, we aim to describe how the demographic profiles and exposure categories of newly diagnosed HIV positive individuals attending a large sexual health clinic in Montréal (Canada) evolved since the beginning of the antiretroviral therapy era in the mid-1990s. Methods Using diagnosis data from participants of the Clinique médicale l’Actuel cohort of HIV-positive patients, we examined the distribution of exposure categories (sexual orientation, sexual behaviours, injection drug use, being born in an HIV-endemic country) by gender and year of diagnosis. Time trends in mean age and in the proportion of patients with late (CD4 <350 cells/μL) or advanced stage (CD4 <200 cells/μL) of HIV infection at diagnosis were assessed through meta-regressions. Results A total of 2,612 patients diagnosed with HIV between January 1st, 1995 and December 31st, 2019 were included. Overall, mean age was 35 years (standard deviation: 10 years) and remained stable over time. The proportion of patients with advanced stage of HIV infection decreased from 16% in 1995 to 4% in 2019. Although men who have sex with men (MSM) consistently accounted for the highest proportion of new diagnoses (77%, 2,022/2,612 overall), their proportion decreased since 2013. There was also a concomitant decrease in the proportion of people who inject drugs, with none of the newly diagnosed participants reporting injection drug use since 2017, and an important increase in the proportion of patients born in an HIV-endemic country (24%, 7/29 in 2019), especially among women. Compared to patients from non-endemic countries, those from HIV-endemic countries were characterized by higher proportions of heterosexuals (88% vs 17%) and of women (52% vs 7%), and were twice likely to get diagnosed at an advanced stage of HIV infection (32% vs 15%). Conclusions In absolute numbers, MSM continue to account for the largest exposure category. However, patients from HIV-endemic countries, who tend to be diagnosed at later stages of HIV infection, constitute an increasing proportion of newly diagnosed individuals. These persons could face distinct barriers to rapid diagnosis. Tailoring HIV testing strategies and other prevention interventions to the specific unmet prevention needs of these individuals is warranted.