Prevalencia del alcoholismo durante tres décadas en Chile (1952-1982)

Mediante el método de Jellinek se estudió la evolución del número de alcohólicos y de la tasa de prevalencia de alcoholismo en Chile y sus variaciones entre los años 1952 y 1982. Se señalan los sesgos y limitaciones de la metodología empleada y se comparan los resultados obtenidos con los de otras investigaciones chilenas. Se concluye que ha habido un incremento del número de alcohólicos y de la tasa de alcoholismo en el periodo analizado que para 1982 es un 70% mayor que para 1952. Este incremento ha sido irregular y fluctuante. Nuestros resultados cuestionan la eficacia de las políticas de prevención del alcoholismo llevadas a cabo en el período

Candidal meningitis in children with cancer

Candidal meningitis is a rare disease that is seen most frequently in neonates, neurosurgical patients, and the immunocompromised host. We describe a series of 12 children with cancer (all of whom had leukemia) who had candidal meningitis develop. Univariate analysis revealed that duration of fever, antibiotic therapy, and profound neutropenia and use of total parenteral nutrition were significantly associated ( ) with candidal meningitis in children with can- P ! .05 cer, compared with matched control subjects. Only duration of profound neutropenia (P p .08) and use of total parenteral nutrition ( ) approached significance in the multivariate P p .06 analysis. One species of Candida, Candida tropicalis, was responsible for 11 of the 12 cases, indicating increased pathogenicity of this organism in CNS disease. The cases were invariably fatal, supporting aggressive treatment of candidal meningitis in immunocompromised patients and further study of the prevention, diagnosis, and management of C. tropicalis meningitis.NCI NIH HHS P30 CA 2176

Pneumocystis colonization in older adults and diagnostic yield of single versus paired noninvasive respiratory sampling

The presence of Pneumocystis was assessed in oropharyngeal wash specimens from 110 adults (median age, 76 years; age range, 69–95 years), 66 of whom had a paired nasal swab specimen. Pneumocystis jirovecii DNA was detected in 12.8% of oropharyngeal wash specimens, and the frequency increased to 21.5% in paired specimens. Pneumocystis colonization is prevalent in older adults. Double noninvasive sampling increases the diagnostic yield.Fondo Nacional de Desarrollo Cientifico y Tecnologico (FONDECYT), Santiago, Chile 106075

Azithromycin for treatment of severe Cryptosporidium diarrhea in two children with cancer

Two children with cancer received azithromycin for Cryptosporidium-associ- ated diarrhea that was unresponsive to supportive care. One child had choler- iform diarrhea requiring daily fluid replacement of up to 65% of his total body weight; the other had protracted diarrhea and wasting, in both cases, adminis- tration of azithromycin was followed by prompt clinical improvement

Early acquisition of pneumocystis jirovecii colonization and potential association with respiratory distress syndrome in preterm newborn infants

Background. Pneumocystis pneumonia is a well-recognized lung disease of premature and malnourished babies. Even though serologic studies have shown that children are exposed to Pneumocystis jirovecii early in life, the epidemiology of human P. jirovecii infection and the host-microorganism relationship in infancy remain poorly understood. The aim of the present study was to investigate the prevalence of P. jirovecii colonization in preterm infants and its possible association with medical complications. Methods. A prospective observational study of preterm infants (birth weight <1500 g and/or gestational age <32 weeks) was carried out. Identification of P. jirovecii colonization was performed by means of molecular techniques in nasal aspirated samples at birth. Results. A total of 128 preterm infants were included during the study period. Pneumocystis DNA was identified in 25.7% (95% confidence interval [CI], 17.8%-33.7%) of newborns studied. A significant increase of respiratory distress syndrome in colonized group, even after adjusting for confounding factors (odds ratio, 2.7 [95% CI, 1.0-7.5]; P=.04), was observed. No differences were observed in other medical conditions between the 2 groups. Conclusions. Pneumocystis jirovecii colonization is frequent in preterm births and could be a risk factor to develop respiratory distress syndrome among preterm infants.European Commission (ERANet-LAC) ELAC2014/HID0254 Institute of Health Carlos III, Spanish Ministry of Economy, Industry and Competitiveness AC15/00042 FIS-PI11/02468 Conicyt ELAC2014/HID0254 Fondo Nacional de Desarrollo Cientifico y Tecnologico (Fondecyt, Chile) 114041

Apnea as an early sign of Pneumocystis carinii pneumonia in an HIV-negative infant

A few reports in the medical literature suggest an association between Pneumocystis caring and apnea in small infants. This patient, a 1 month 20 days old, HIV negative, infant girl weighing 2,000 grams was admitted to hospital after presenting a severe episode of apnea with cyanosis and bradicardia. She progressively developed bronchopneumonia by P. carinii that required prolonged mechanical ventilation with high ventilatory parameters. The clinical course of this patient illustrates that apnea can be an early sign of P. carinii infection in small infants. Early diagnosis and specific therapy might prevent morbidity and mortality and also decrease the length of hospitalization