During the first trimester of 2020, the Ministry of Health of Costa Rica reported the first three cases of primary amebic meningoencephalitis (PAM). In two cases, laboratory personnel of the hospitals preliminarily identified amoeboid forms in cerebrospinal fluid (CSF) samples. For the molecular confirmation of species, CSF samples were sent to our laboratory. We carried out microscopic analyses and exflagellation assays. Besides, samples were cultured in 2% casein hydrolysate medium and in non-nutrient agar plates supplemented with Escherichia coli. Finally, PCR and sequencing were employed for the molecular diagnosis and species identification. In all cases, the presence of Naegleria fowleri was confirmed. An environmental investigation to identify the possible infection sources was also performed. Water samples from hot springs and groundwater from an artisan well were collected and after filtration and culture in non-nutrient agar plates supplemented with E. coli, thermotolerance and exflagellation assays were carried out. For the positive samples, PCR and sequencing were performed, confirming the presence of N. fowleri in several water samples. The report of these cases and the possible association with hot springs has had a significant impact on the population and health authorities of Costa Rica.

Helicobacter pylori (H. pylori) infection is a well-established risk factor for the development of gastric cancer (GC), one of the most common and deadliest neoplasms worldwide. H. pylori infection induces chronic inflammation in the gastric mucosa that, in the absence of treatment, may progress through a series of steps to GC. GC is only one of several clinical outcomes associated with this bacterial infection, which may be at least partially attributed to the high genetic variability of H. pylori. The biological mechanisms underlying how and under what circumstances H. pylori alters normal physiological processes remain enigmatic. A key aspect of carcinogenesis is the acquisition of traits that equip preneoplastic cells with the ability to invade. Accumulating evidence implicates H. pylori in the manipulation of cellular and molecular programs that are crucial for conferring cells with invasive capabilities. We present here an overview of the main findings about the involvement of H. pylori in the acquisition of cell invasive behavior, specifically focusing on the epithelial-to-mesenchymal transition, changes in cell polarity, and deregulation of molecules that control extracellular matrix remodeling.

Introducción: COVID-19 ha generado una pausa en la endoscopia electiva, retrasando el diagnóstico de múltiples patologías. Existen varias propuestas para reiniciar las actividades que incluyen el tamizaje por COVID-19 y un reinicio escalonado. Objetivo: Conocer la percepción general de los endoscopistas respecto al reinicio de procedimientos electivos, y la influencia que genera la disponibilidad de equipo de protección personal (EPP) y tamizaje. Metodología: Se encuestan endoscopistas expertos con preguntas enfocadas a la endoscopia durante la pandemia, así como de disponibilidad de EPP y del uso de pruebas de tamizaje de SARS-CoV-2. La encuesta fue distribuida vía e-mail, mensajería instantánea y por contacto directo a distintas sociedades de endoscopia, obteniendo respuesta completa de 168 médicos. Resultados: 88% de los encuestados no practican tamizaje por COVID-19 sin embargo un 70% considera apropiada esta práctica. El 80% afirma contar con EPP adecuado. El 94% de los médicos afirma que deben reiniciarse los procedimientos lo antes posible. Conclusiones: Los endoscopistas latinoamericanos con mayor disponibilidad de EPP, así como la implementación de tamizaje de SARS-CoV-2, presentaron mayor disposición a reiniciar las endoscopias electivas.