ANGEL MEJIA - Profile on Academia.edu (original) (raw)

Papers by ANGEL MEJIA

Pathogens, 2021

The countries of Central America and the island of Hispaniola have set the goal of eliminating ma... more The countries of Central America and the island of Hispaniola have set the goal of eliminating malaria in less than a decade. Although efforts to reduce the malaria burden in the region have been successful, there has been an alarming increase in cases in the Nicaraguan Moskitia since 2014. The continuous decrease in cases between 2000 and 2014, followed by a rapid expansion from 2015 to the present, has generated a potential bottleneck effect in the populations of Plasmodium spp. Consequently, this study aimed to evaluate the genetic diversity of P. falciparum and the decrease in allelic richness in this population. The polymorphic regions of the pfmsp-1 and pfmsp-2 genes of patients with falciparum malaria from Honduras and Nicaragua were analyzed using nested PCR and sequencing. Most of the samples were classified into the K1 allelic subfamily of the pfmsp-1 gene and into the 3D7 subfamily of the pfmsp-2 gene. Despite the low genetic diversity found, more than half of the samples...

Revista Repertorio de Medicina y Cirugía, 2005

Problema: es importante conocer las estadísticas de infección nosocomial en las instituciones hos... more Problema: es importante conocer las estadísticas de infección nosocomial en las instituciones hospitalarias, ya que tasas altas de infección son indicativas de problemas que deben solucionarse para maximizar la seguridad de los pacientes en el hospital. La neumonía asociada a ventilador (NAV) es una de las infecciones nosocomiales con mayor impacto en lo que respecta a morbilidad y mortalidad.Objetivos: establecer la tasa de incidencia de NAV y explorar factores de riesgo para su adquisición en la Unidad de Cuidados Intensivos (UCI) del Hospital de San José.Métodos: se consideraron elegibles para el estudio los pacientes que ingresaron a la UCI en el período de enero a diciembre de 2003 y que tuvieron ventilación mecánica por más de 48 horas. Se excluyeron aquellos con diagnóstico de neumonía aspirativa, neumonía antes de ingreso a UCI y los que se hubieran intubado por fuera de la UCI. Se recolectaron los datos en cada caso de manera prospectiva. Se realizaron análisis bi y multiva...

Revista Colombiana de Cirugía, Jun 1, 2010

Palabras clave: pancreatitis; nutrición enteral; nutrición parenteral total; glutamina; arginina;... more Palabras clave: pancreatitis; nutrición enteral; nutrición parenteral total; glutamina; arginina; probióticos. Resumen Objetivo: proponer una guía de manejo para la nutrición en los pacientes con pancreatitis aguda grave basada en la mejor evidencia disponible. Diseño: revisión sistemática y guía de práctica clínica. Población: pacientes críticos con pancreatitis aguda grave hospitalizados en la unidad de cuidados intensivos. Intervenciones y controles: nutrición entérica Vs. parenteral; dieta hipocalórica Vs. normocalórica; glutamina Vs. sin glutamina; arginina Vs. sin arginina; ácidos grasos omega 3/omega 6 Vs. omega 6 solamente; prebióticos o probióticos Vs. dieta estándar. Desenlaces: mortalidad, estancia hospitalaria y en la unidad de cuidados intensivos y, infecciones y sepsis, disfunción de órganos.

Malaria Journal

The incidence of malaria in the Americas has decreased markedly in recent years. Honduras and the... more The incidence of malaria in the Americas has decreased markedly in recent years. Honduras and the other countries of Mesoamerica and the island of Hispaniola have set the goal of eliminating native malaria by the year 2020. To achieve this goal, Honduras has recently approved national regulations to expand the possibilities of a shortened double dose primaquine (PQ) treatment for vivax malaria. Considering this new shortened anti-malarial treatment, the high frequency of G6PDd genotypes in Honduras, and the lack of routinely assessment of the G6PD deficiency status, this study aimed at investigating the potential association between the intake of PQ and haemolysis in malaria-infected G6PDd subjects. Methods: This was a prospective cohort and open-label study. Participants with malaria were recruited. Plasmodium vivax infection was treated with 0.25 mg/kg of PQ daily for 14 days. Safety and signs of haemolysis were evaluated by clinical criteria and laboratory values before and during the 3rd and 7th day of PQ treatment. G6PD status was assessed by a rapid test (CareStart ™ ) and two molecular approaches. Results: Overall 55 participants were enrolled. The frequency of G6PD deficient genotypes was 7/55 (12.7%), where 5/7 (71.4%) were hemizygous A-males and 2/7 (28.6%) heterozygous A-females. Haemoglobin concentrations were compared between G6PD wild type (B) and G6PDd A-subjects, showing a significant difference between the means of both groups in the 3rd and 7th days. Furthermore, a statistically significant difference was evident in the change in haemoglobin concentration between the 3rd day and the 1st day for both genotypes, but there was no statistical difference for the change in haemoglobin concentration between the 7th day and the 1st day. Besides these changes in the haemoglobin concentrations, none of the patients showed signs or symptoms associated with severe haemolysis, and none needed to be admitted to a hospital for further medical attention. The findings support that the intake of PQ during 14 days of treatment against vivax malaria is safe in patients with a class III variant of G6PDd. In view of the new national regulations in the shortened treatment of vivax malaria for 7 days, it is advisable to be alert of potential cases of severe haemolysis that could occur among G6PD deficient hemizygous males with a class II mutation such as the Santamaria variant, previously reported in the country.

Pathogens, 2021

The countries of Central America and the island of Hispaniola have set the goal of eliminating ma... more The countries of Central America and the island of Hispaniola have set the goal of eliminating malaria in less than a decade. Although efforts to reduce the malaria burden in the region have been successful, there has been an alarming increase in cases in the Nicaraguan Moskitia since 2014. The continuous decrease in cases between 2000 and 2014, followed by a rapid expansion from 2015 to the present, has generated a potential bottleneck effect in the populations of Plasmodium spp. Consequently, this study aimed to evaluate the genetic diversity of P. falciparum and the decrease in allelic richness in this population. The polymorphic regions of the pfmsp-1 and pfmsp-2 genes of patients with falciparum malaria from Honduras and Nicaragua were analyzed using nested PCR and sequencing. Most of the samples were classified into the K1 allelic subfamily of the pfmsp-1 gene and into the 3D7 subfamily of the pfmsp-2 gene. Despite the low genetic diversity found, more than half of the samples...

Revista Repertorio de Medicina y Cirugía, 2005

Problema: es importante conocer las estadísticas de infección nosocomial en las instituciones hos... more Problema: es importante conocer las estadísticas de infección nosocomial en las instituciones hospitalarias, ya que tasas altas de infección son indicativas de problemas que deben solucionarse para maximizar la seguridad de los pacientes en el hospital. La neumonía asociada a ventilador (NAV) es una de las infecciones nosocomiales con mayor impacto en lo que respecta a morbilidad y mortalidad.Objetivos: establecer la tasa de incidencia de NAV y explorar factores de riesgo para su adquisición en la Unidad de Cuidados Intensivos (UCI) del Hospital de San José.Métodos: se consideraron elegibles para el estudio los pacientes que ingresaron a la UCI en el período de enero a diciembre de 2003 y que tuvieron ventilación mecánica por más de 48 horas. Se excluyeron aquellos con diagnóstico de neumonía aspirativa, neumonía antes de ingreso a UCI y los que se hubieran intubado por fuera de la UCI. Se recolectaron los datos en cada caso de manera prospectiva. Se realizaron análisis bi y multiva...

Revista Colombiana de Cirugía, Jun 1, 2010

Palabras clave: pancreatitis; nutrición enteral; nutrición parenteral total; glutamina; arginina;... more Palabras clave: pancreatitis; nutrición enteral; nutrición parenteral total; glutamina; arginina; probióticos. Resumen Objetivo: proponer una guía de manejo para la nutrición en los pacientes con pancreatitis aguda grave basada en la mejor evidencia disponible. Diseño: revisión sistemática y guía de práctica clínica. Población: pacientes críticos con pancreatitis aguda grave hospitalizados en la unidad de cuidados intensivos. Intervenciones y controles: nutrición entérica Vs. parenteral; dieta hipocalórica Vs. normocalórica; glutamina Vs. sin glutamina; arginina Vs. sin arginina; ácidos grasos omega 3/omega 6 Vs. omega 6 solamente; prebióticos o probióticos Vs. dieta estándar. Desenlaces: mortalidad, estancia hospitalaria y en la unidad de cuidados intensivos y, infecciones y sepsis, disfunción de órganos.

Malaria Journal

The incidence of malaria in the Americas has decreased markedly in recent years. Honduras and the... more The incidence of malaria in the Americas has decreased markedly in recent years. Honduras and the other countries of Mesoamerica and the island of Hispaniola have set the goal of eliminating native malaria by the year 2020. To achieve this goal, Honduras has recently approved national regulations to expand the possibilities of a shortened double dose primaquine (PQ) treatment for vivax malaria. Considering this new shortened anti-malarial treatment, the high frequency of G6PDd genotypes in Honduras, and the lack of routinely assessment of the G6PD deficiency status, this study aimed at investigating the potential association between the intake of PQ and haemolysis in malaria-infected G6PDd subjects. Methods: This was a prospective cohort and open-label study. Participants with malaria were recruited. Plasmodium vivax infection was treated with 0.25 mg/kg of PQ daily for 14 days. Safety and signs of haemolysis were evaluated by clinical criteria and laboratory values before and during the 3rd and 7th day of PQ treatment. G6PD status was assessed by a rapid test (CareStart ™ ) and two molecular approaches. Results: Overall 55 participants were enrolled. The frequency of G6PD deficient genotypes was 7/55 (12.7%), where 5/7 (71.4%) were hemizygous A-males and 2/7 (28.6%) heterozygous A-females. Haemoglobin concentrations were compared between G6PD wild type (B) and G6PDd A-subjects, showing a significant difference between the means of both groups in the 3rd and 7th days. Furthermore, a statistically significant difference was evident in the change in haemoglobin concentration between the 3rd day and the 1st day for both genotypes, but there was no statistical difference for the change in haemoglobin concentration between the 7th day and the 1st day. Besides these changes in the haemoglobin concentrations, none of the patients showed signs or symptoms associated with severe haemolysis, and none needed to be admitted to a hospital for further medical attention. The findings support that the intake of PQ during 14 days of treatment against vivax malaria is safe in patients with a class III variant of G6PDd. In view of the new national regulations in the shortened treatment of vivax malaria for 7 days, it is advisable to be alert of potential cases of severe haemolysis that could occur among G6PD deficient hemizygous males with a class II mutation such as the Santamaria variant, previously reported in the country.