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Biomedical subjects

M Corachan

Publications and source records attributed to M Corachan.

At least 19 recordsLinked to original sources

Histoplasmosis infection in Spanish travelers to Latin America.

The aim of the study presented here was to assess the incidence of histoplasma infection in a cohort of 342 individuals in Spain who had traveled to Latin America for the first time. The histoplasmin skin test was positive in 20% of the travelers, and Central America posed a higher risk for infection than South America (p=0.013). Sleeping outdoors (p=0.031) and the duration of travel (p=0.016) were also identified as significant risk factors. Serological testing demonstrated poor overall sensitivity for detecting infection in the travelers, but for the symptomatic acute cases the results were improved. Histoplasmosis must be considered in patients presenting with fever (odds ratio=3.51 [1.52-8.12]) or cough (odds ratio=4.24 [1.32-13.58]) after visiting Latin America. The results of this study have public health implications and indicate the risks of acquiring histoplasmosis should be included in pre-travel counseling.

Adult↗

Quinolone resistance in enterotoxigenic Escherichia coli causing diarrhea in travelers to India in comparison with other geographical areas.

Enterotoxigenic Escherichia coli isolates were identified as a cause of traveler's diarrhea in 82 of 520 (16%) patients and tested for resistance to seven antimicrobial agents. Thirty patients (36%) needed antimicrobial therapy: 17 (56%) for persistence of symptoms and 13 (44%) for severity of symptoms. Ampicillin, tetracycline, and trimethoprim-sulfamethoxazole resistance was high. Chloramphenicol showed moderate activity, and amoxicillin plus clavulanic acid, nalidixic acid, and ciprofloxacin showed very good activity. Five nalidixic acid-resistant strains were isolated, four from patients visiting India.

Diarrhea↗

Campylobacter jejuni as a cause of traveler's diarrhea: clinical features and antimicrobial susceptibility.

Traveler's diarrhea is the most common health problem of international travelers. Although enterotoxigenic Escherichia coli seems to be the most frequent cause of traveler's diarrhea, many other microorganisms, such as Campylobacter jejuni, may cause this infectious disease. Campylobacter jejuni is recognized as a leading cause of enteritis in humans both in developing and in developed countries. However, a few reports on the incidence and antimicrobial resistance of Campylobacter spp. as a cause of traveler's diarrhea have been published. The limited data on the treatment of C. jejuni infections suggest that ciprofloxacin may shorten the duration of symptoms. However, treatment failure associated with the emergence of quinolone-resistant strains of C. jejuni has been documented. The purpose of this study was to determine the prevalence of C. jejuni associated with traveler's diarrhea and to analyze the geographic distribution as well as the clinical features and susceptibility to antibiotics.

Anti-Bacterial Agents↗

Circulating antigens in schistosomiasis: detection of 31/32-kDa proteins in sera from patients infected with Schistosoma japonicum, S. mansoni, S. haematobium, or S. intercalatum.

A sandwich enzyme-linked immunosorbent assay (ELISA) was developed to detect 31/32-kDa schistosome proteins as circulating antigens in sera from schistosomiasis patients. A monoclonal antibody was used as a capture antibody and rabbit antiserum raised against purified 31/32-kDa proteins was the detecting antibody. Positive results were obtained with patients infected with Schistosoma japonicum (88%; n = 69), S. mansoni (80%; n = 56), S. haematobium (100%; n = 40), or S. intercalatum (94%; n = 65). Sera from uninfected Chinese and African individuals and from Chinese patients with trichinosis, cysticercosis, or paragonimiasis did not react in the assay. This ELISA appears to be valuable in diagnosing infections by all major human schistosome species.

Adolescent↗

Morphometric variability of Schistosoma intercalatum eggs: a diagnostic dilemma.

Variability of Schistosoma intercalatum eggs in shape and size, and their similarity to those of S. haematobium presented a problem of species identification when egg morphology was the diagnostic criterion used in a study of human schistosomiasis conducted on São Tomé and Principe. More than 2500 egg measurements were obtained by light micoscopy to gather data relating to size variability of S. intercalatum eggs, to evaluate whether factors such as age of host, sex of host and intensity of infection are correlated with variability, and the data were compared with previously published measurements on different isolates and strains of S. intercalatum: the range in length (104-203 microns) embraces most of the measurements reported in other studies of S. intercalatum eggs. There was no correlation either between age and sex of the host, or intensity of infection with variability of egg size. Comparison between measurements of the eggs of S. haematobium, S. intercalatum and S. bovis eggs are presented.

Adolescent↗

Cyclospora in patients with traveller's diarrhea.

Following the description in 1986 of a new enteropathogen called Cyanobacteria-like body (CLB), several outbreaks caused by this microorganism have been described. Since then several research teams have agreed to place CLB in the genus Cyclospora and to establish the epidemiological, pathogenical and clinical features of the illness. This paper describes and assesses those features in 20 travellers diagnosed with CLB and reviews the main literature concerning this enteropathogen. CLB was found in 2.8% of all cases of traveller's diarrhea in our series.

Adult↗

Antimicrobial resistance of Shigella isolates causing traveler's diarrhea.

Shigella isolates were identified as a cause of traveler's diarrhea in 67 (10%) of 675 patients and were tested for resistance to seven antimicrobial agents in a comparative study with those causing nontraveler's diarrhea in Spain. Ampicillin and chloramphenicol resistance was more frequent in Shigella flexneri (60 and 46%, respectively) than in Shigella sonnei (32 and 18%, respectively) and in travel-related isolates (P < 0.05 and 0.04, respectively). Of S. sonnei isolates from patients with traveler's diarrhea, 73 and 54% showed tetracycline and trimethoprim-sulfamethoxazole resistance, respectively, compared with only 8% of isolates from patients without a history of travel to developing countries (P < 0.007 and P < 0.0002). Low-level resistance to cephalosporins was found, whereas quinolone-resistant strains were not detected among travel-related Shigella isolates. Thus, quinolones may be an effective alternative therapy for travel-related shigellosis.

Developing Countries↗

Hematospermia: a new etiology of clinical interest.

Ten Spanish male tourists developed hematospermia and ultrasonographic evidence of involvement of the prostate and/or seminal vesicles after recreational exposure in bodies of fresh water in the Dogon country of Mali. Schistosoma eggs were detected in the ejaculate of five men, in the others, eggs were observed in the urine or feces. Three different species were observed: S. intercalatum, S. haematobium, and S. mansoni. Hemospermia and clinical prostatitis may be frequently unrecognized clinical manifestations of the early stages of infection in previously nonexposed persons. Travelers to endemic areas should be advised on the potential dangers of swimming and other exposure in bodies of freshwater.

Adult↗

Cyanobacteria-like body (CLB) in travellers with diarrhea.

The cyanobacteria-like body (CLB) is a recently described agent, causing a travellers' disease (TD) syndrome characterized mainly by diarrhea. It has been described in travellers who have visited Asia and Latin America. We report 6 cases seen over a 16-month period among those attending a travellers' clinic. All patients suffered from fatigue, watery diarrhea and abdominal cramps; some also lost weight. The episodes were recurrent.

Adult↗

Schistosomiasis and the Dogon country (Mali)

A previously unknown area of schistosomiasis transmission is reported based on findings from a travelers' clinic in Barcelona. Three species of Schistosoma (S. haematobium, S. mansoni, and S. intercalatum) were diagnosed in a cluster of 43 patients who had been swimming in the Bandiagara and Bankas districts of Mali, where the Dogon people live. Three villages in the Bankas district appear to harbor these three species. The transmission potential of such a focus in this area is outlined. The travelers involved had little or no information on the risks of contracting schistosomiasis in that area. Obtaining a traveler's history, including accurate geographic data, is shown to be a crucial asset for improving epidemiologic research.

Adult↗

Serological survey of hepatitis B in northern Rwanda.

To assess the importance of perinatal transmission of hepatitis B virus and the risk of infection in different age groups in Northern Rwanda, filter paper dried blood samples from 350 subjects were examined for HBsAg and anti HBs. The study shows that vertical transmission is not very frequent in this area, and that the risk of infection increases with age. These results indicate that vaccination against hepatitis B in children could be delayed and included in the standard immunization programme.

Adult↗