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The prevalence of scorpion envenomation in El Palmar, State of Bolivar, was determined from January 2005 to January 2007. There were 9 cases of scorpion envenomation (0.75 cases/1000 inhabitants), affecting mainly the superior members of male students less than 30 years old that came from rural regions. Registered cases occurred in the rainy season between April and August. No fatalities were registered. Findings indicate a non-negligible prevalence of trivial scorpion envenomation, suggesting the possible existence of low toxicity scorpions in the locality under study.

Abstract: The prevalence of scorpion envenomation in El Palmar, State of Bolivar, was determined from January 2005 to January 2007. There were 9 cases of scorpion envenomation (0.75 cases/1000 inhabitants), affecting mainly the superior members of male students less than 30 years old that came from rural regions. Registered cases occurred in the rainy season between April and August. No fatalities were registered. Findings indicate a non-negligible prevalence of trivial scorpion envenomation, suggesting the possible existence of low toxicity scorpions in the locality under study. Resumen: Se determinó la prevalencia del envenenamiento escorpiónico en el Palmar-Edo. Bolívar durante el período comprendido entre enero 2005 y enero 2007. Hubo un total de 9 casos de escorpionismo (0,75 casos/1000 habitantes), afectando principalmente los miembros superiores de varones menores de 30 años, estudiantes, procedentes de zonas rurales. Los casos registrados ocurrieron durante el período lluvioso, entre los meses de abril y agosto. No se registraron casos mortales. Los hallazgos indican una casuística no despreciable de envenenamiento escorpiónico leve, sugiriendo la posible existencia de escorpiones poco tóxicos en la localidad estudiada.

The frequency and clinical characteristics of endemic systemic mycosis associated with tuberculosis were determined in Bolívar State. Clinical case records with confirmed diagnoses of systemic mycosis and tuberculosis were reviewed for a 5-year period. Seven cases of systemic mycoses endemic to the region were detected: Paracoccidioidomycosis and Histoplasmosis, associated with tuberculosis. All patients came from Bolivar state; only one was feminine and no one was seropositive for the Human Immunodeficiency Virus. All presented pulmonary compromise, mostly symptomatic, accompanied by weight loss (6 of 7). In all cases, alterations appeared on the radiological study of the thorax, mainly diffuse bilateral alveolar compromise. In 6 of the 7 patients, acid-resistant bacilli were observed in sputum samples. The mycosis most frequently associated with tuberculosis was Paracoccidioidomycosis (6 of 7); the other associated mycosis was Histoplasmosis (1 of 7). All patients received antimycotic and 4-drug anti-tuberculosis treatments and all of them improved. The association of endemic systemic mycosis with tuberculosis is not unusual in Bolivar state and therefore, the association of these infections should be systematically investigated.

Abstract: The frequency and clinical characteristics of endemic systemic mycosis associated with tuberculosis were determined in Bolívar State. Clinical case records with confirmed diagnoses of systemic mycosis and tuberculosis were reviewed for a 5-year period. Seven cases of systemic mycoses endemic to the region were detected: Paracoccidioidomycosis and Histoplasmosis, associated with tuberculosis. All patients came from Bolivar state; only one was feminine and no one was seropositive for the Human Immunodeficiency Virus. All presented pulmonary compromise, mostly symptomatic, accompanied by weight loss (6 of 7). In all cases, alterations appeared on the radiological study of the thorax, mainly diffuse bilateral alveolar compromise. In 6 of the 7 patients, acid-resistant bacilli were observed in sputum samples. The mycosis most frequently associated with tuberculosis was Paracoccidioidomycosis (6 of 7); the other associated mycosis was Histoplasmosis (1 of 7). All patients received antimycotic and 4-drug anti-tuberculosis treatments and all of them improved. The association of endemic systemic mycosis with tuberculosis is not unusual in Bolivar state and therefore, the association of these infections should be systematically investigated. Resumen: Se determinó la frecuencia y características clínicas de las micosis sistémicas endémicas asociadas a tuberculosis en el estado Bolívar. Se revisaron las historias clínicas de los casos con diagnóstico confirmado de micosis sistémicas y tuberculosis en un período de cinco años. Se detectaron 7 casos de las micosis sistémicas endémicas en la región, Paracoccidioidomicosis e Histoplasmosis, asociadas a tuberculosis. Todos los pacientes procedían del estado Bolívar, sólo uno era del sexo femenino y ninguno tenía serología positiva para la infección por el Virus de Inmunodeficiencia Humana. Todos presentaron manifestaciones pulmonares, la mayoría sintomáticos y con pérdida de peso (6 de 7). En todos los casos, se evidenciaron alteraciones en el estudio radiológico del tórax, con diferentes patrones, predominando el compromiso alveolar difuso bilateral. En 6 de los 7 pacientes, se observaron bacilos ácidos resistentes en muestras de esputo. La micosis más frecuentemente asociada a tuberculosis fue Paracoccidioidomicosis (6 de 7). Todos los pacientes recibieron tratamiento antimicótico y tratamiento antituberculoso con cuatro drogas y todos mostraron mejoría. La asociación de micosis sistémicas endémicas con tuberculosis no es rara en el estado Bolívar, por tanto, la asociación de estas infecciones debería investigarse sistemáticamente.

Abstract: Sstingrays are poisonous fish that can produce lesions by means of injecting poison to the victim through a penetrative structure. The aim of this study was to determine the prevalence of stingray poisoning in the □Ruiz y Páez□ Hospital, the principal hospital in Bolívar state. It was a descriptive, retrospective study. We reviewed data as to stingray poisoning cases during the period between January 1996 and July 2003. Twenty-four cases were registered (3.8 cases / year). Mean age of those affected was 26.2±16.1 years, 91.7% were masculine. The most frequent occupations were: fishermen (33.3%), students (25%) and farmers (16.7%), and 70.8% came from Bolivar State. The wounds were located in the lower members in all the cases, with local pain (100%), erythema (91.6%), hemorrhage (41.6%), necrosis and ulceration (29.2%). All patients were treated with asepsis and antisepsis of the wound, only 33.4% required surgical cleaning of the wound. All evolved satisfactorily. Poisoning by stingrays constitute a reality in the Bolívar state, and the physicians that serve this region have to see to this problem and to prepare to adequately manage it. Resumen: Las rayas son peces venenosos que pueden producir lesiones mediante la inyección de veneno a través de una estructura punzante, al ser pisados bajo la arena. El objetivo de este estudio fue determinar la prevalencia del envenenamiento por raya (Rayismo) en el Hospital □Ruiz y Páez□, centro de referencia del estado Bolívar. Se realizó un estudio descriptivo de los casos de envenenamiento por Raya, durante el período comprendido entre Enero de 1996 y Julio de 2003. Un total de 24 casos fueron registrados (3,8 casos /año). La edad media de los afectados fue 26,2+16,1 años. El 91,7% eran de sexo masculino; y las ocupaciones más frecuentes eran: pescadores (33,3%), estudiantes (25%) y agricultores (16,7%). El 70,8 % procedía del Estado Bolívar. La herida se localizó en los miembros inferiores en todos los casos, con dolor (100%), eritema (91,6%), sangramiento (41,6%), necrosis y ulceración (29,2%). A todos los pacientes se le realizó asepsia y antisepsia de la herida, sólo el 33,4% requirió limpieza quirúrgica de la herida. Todos evolucionaron satisfactoriamente. El rayismo constituye un problema de salud en el estado Bolívar, del que tienen que ocuparse los médicos que ejercen en la región.

Sstingrays are poisonous fish that can produce lesions by means of injecting poison to the victim through a penetrative structure. The aim of this study was to determine the prevalence of stingray poisoning in the Ruiz y Páez Hospital, the principal hospital in Bolívar state. It was a descriptive, retrospective study. We reviewed data as to stingray poisoning cases during the period between January 1996 and July 2003. Twenty-four cases were registered (3.8 cases / year). Mean age of those affected was 26.2±16.1 years, 91.7% were masculine. The most frequent occupations were: fishermen (33.3%), students (25%) and farmers (16.7%), and 70.8% came from Bolivar State. The wounds were located in the lower members in all the cases, with local pain (100%), erythema (91.6%), hemorrhage (41.6%), necrosis and ulceration (29.2%). All patients were treated with asepsis and antisepsis of the wound, only 33.4% required surgical cleaning of the wound. All evolved satisfactorily. Poisoning by stingrays constitutes a reality in the Bolívar state, and the physicians that serve this region have to see to this problem and to prepare to adequately manage it.

Abstract: Patients infected with the Human Immunodeficiency Virus (HIV) often are diagnosed with gastrointestinal disease. We have determined the prevalence of intestinal parasites in HIV seropositive patients from the University Hospital Complex Ruiz y Paez in Bolivar, Venezuela. A study was designed to analyze faeces samples from 35 HIV infected individuals in a 12 months period. Three serial samples were analyzed using (i) direct exam, (ii) concentration methods (i.e., Formol-Ether sedimentation and Willis and Harada-Mori flotation), (iii) tricromic Kinyoun staining for Microsporidium and (iv) direct immunofluorescent. The most frequent parasites found in the faeces of HIV infected individuals were: Blastocystis hominis (85.7%), Entamoeba coli (77.1%) and Endolinax nana (37.1%). In addition, Cryptosporidium parvum was found in 7 AIDS patients, Cyclospora cayetanensis in 3 individuals (two of them with AIDS), and Microsporidium spp in 4 patients (11.4%). Interestingly, a statistically significant correlation between diarrhea and the presence of Coccidian and Microsporidium spp, was observed (p < 0.05). Finally, the most frequent helmints found in HIV infected patients were Ascaris lumbricoides (14.3%), hookworms and Trichuris trichiura (5.7%), while the only cestode found was Hymenolepis diminuta (5.7%). Intestinal parasites are frequently detected in HIV- infected patients from Bolivar State in Venezuela. Resumen: Los pacientes infectados con el Virus de Inmunodeficiencia Humana (VIH) padecen trastornos gastrointestinales. El objetivo de este estudio fue determinar la prevalencia de parásitos intestinales en individuos infectados por el VIH en el Complejo Hospitalario Universitario “Ruiz y Páez”, estado Bolívar, Venezuela; donde no existían estudios previos. Se obtuvieron muestras de heces de pacientes con diagnóstico confirmado de infección por el VIH en un período de 12 meses. Se estudiaron tres muestras seriadas realizando examen directo y métodos de concentración: sedimentación por Formol-Éter, flotación de Willis y Harada-Mori. Además, tinción de Kinyoun, Tricrómica para Microsporidium y observación de la muestra mediante fluorescencia directa. Fueron diagnosticados: Blastocystis hominis (85,7%), Entamoeba coli (77,1%) y Endolinax nana (37,1%). Cryptosporidium parvum se demostró en 7 pacientes con SIDA; Cyclospora cayetanensis en 3 pacientes, 2 de los cuales padecían el SIDA y Microsporidium spp en 4 pacientes (11,4%). Hubo asociación estadísticamente significativa entre diarrea y la presencia de Coccidios y Microsporidium spp (p

Los pacientes infectados con el Virus de Inmunodeficiencia Humana (VIH) padecen trastornos gastrointestinales. El objetivo de este estudio fue determinar la prevalencia de parásitos intestinales en individuos infectados por el VIH en el Complejo Hospitalario Universitario “Ruiz y Páez”, estado Bolívar, Venezuela; donde no existían estudios previos. Se obtuvieron muestras de heces de pacientes con diagnóstico confirmado de infección por el VIH en un período de 12 meses. Se estudiaron tres muestras seriadas realizando examen directo ymétodos de concentración: sedimentación por Formol-Éter, flotación de Willis y Harada-Mori. Además, tinción de Kinyoun, Tricrómica para Microsporidium y observación de la muestra mediante fluorescencia directa. Fueron diagnosticados: Blastocystis hominis (85,7%), Entamoeba coli (77,1%) y Endolinax nana (37,1%). Cryptosporidium parvum se demostró en 7 pacientes con SIDA; Cyclospora cayetanensis en 3 pacientes, 2 de los cuales padecían el SIDA y Microsporidium spp en 4 pacientes (11,4%). Hubo asociación estadísticamente significativa entre diarrea y la presencia de Coccidios y Microsporidium spp (p