Luis Alejandro Orozco

Achalasia is a motility disorder of the esophagus that might be secondary to a chronic Trypanosoma cruzi infection. Several studies have investigated esophageal achalasia in patients with Chagas disease (CD) in Latin America, but no related studies have been performed in Colombia. The goals of the present study were to determine the presence of anti- T. cruzi antibodies in patients with esophageal achalasia who visited a referral hospital in Bogotá, Colombia, and to detect the presence of the parasite and its discrete typing units (DTUs). This cross-sectional study was conducted in adult patients (18–65 years old) who were previously diagnosed with esophageal achalasia and from whom blood was drawn to assess antibodies against T. cruzi using four different serological tests. Trypanosoma cruzi DNA was detected by conventional polymerase chain reaction (cPCR) and quantitative polymerase chain reaction (qPCR). In total, 38 patients, with an average age of 46.6 years (standard deviation of ±16.2) and comprising 16 men and 22 women, were enrolled. Five (13.15%) patients were found to be positive for anti- T. cruzi antibodies by indirect immunofluorescence assay (IFA), and two patients who were negative according to IFA were reactive by both enzyme-linked immunosorbent assay and immunoblot (5.3%). Parasite DNA was detected in two of these seven patients by cPCR and in one of these by qPCR. The parasite DTU obtained was TcI. In summary, this study identified T. cruzi in Colombian patients with esophageal achalasia, indicating that digestive compromise could also be present in patients with chronic CD.

BACKGROUND: Whipple's disease is a rare systemic disease caused by a gram-positive bacillus called Tropheryma whipplei. First described in 1907 as an intestinal lipodystrophy with histological finding of vacuoles in the macrophages of the intestinal mucous. Usually the symptoms are localized according to the compromised organ. The differential diagnosis is wide. It can be fatal without proper treatment. Recurrence can occur in up to 33% of the cases and usually compromises the neurological system. CASE PRESENTATION: This article reports the case of a 46-year-old female patient with a history of a 6-month hypochromic microcytic anemia of unknown cause. She consulted for a 6-months oppressive abdominal pain located in the mesogastrium as well as abdominal distention associated with nausea and liquid stools; in addition, she had an 8-month small and medium joint pain, without edema or erythema. Physical examination without relevant findings. Multiple esophagogastroduodenoscopies with normal gastric and duodenal biopsies findings and a normal colonoscopy were performed. Endoscope capsule showed red spots in the duodenum and ulcerations in the jejunum and proximal ileum covered by fibrin; histological report showed macrophages with positive periodic acid-schiff reaction staining (PAS staining), disgnosing Whipple's disease. Antibiotics were initiated. The patient is currently in the second phase of treatment without gastrointestinal and joint symptoms. CONCLUSION: This is the first case reported in Colombia. It is a rare entity and difficult to diagnose reason why it is important to continue with clinical investigations to give more clarity about the onset and appropriate diagnose to avoid the delay in treatment of this entity.

In partial fulfillment of the requirements for the degree of Master of Music

El presente trabajo tiene como objetivo conocer las narrativas que construyen las personas con orientacion sexual diversa a la luz de las nuevas masculinidades en la ciudad de Villavicencio. Esta investigacion esta planteada desde la metodologia cualitativa y se encuentra orientada en el metodo hermeneutico; utilizando como estrategia los escenarios conversacionales, de esta manera la investigacion convoca a cuatro participantes que se identifican asi mismos como personas con orientacion sexual diversa (en los que se incluyen gays, lesbianas y bisexuales). Las categorias planteadas para esta investigacion fueron genero, masculinidad, relaciones de poder y nuevas masculinidades. Por otra parte, los resultados del estudio concluyeron que los participantes definen el genero conectandolo directamente con su orientacion sexual y corporalidad, en ese sentido, reconocen que aunque tienen presentes discursos hegemonicos instaurados en su manera de comprender el mundo a raiz de la educacion recibida por sus padres, medios de comunicacion y escuela, siempre han buscando desligarse de dichos modelos patriarcales y tener nuevas visiones de su construccion propia del genero y performance que se desliguen de las categorizaciones binarias. En relacion a las nuevas masculinidades, los participantes narran que la masculinidad como se entiende en la actualidad ha tenido un proceso de transformacion y resignificacion pues expresan que la corporalidad tiene limites difusos, por ende, conciben el cuerpo como un mundo de posibilidades para lograr la expresion de su genero acorde a sus ideales educativos, religiosos, culturales y personales. Manifiestan tambien que un hombre puede oscilar entre lo femenino y lo masculino sin la necesidad de quedarse estatico en alguno de ellos.