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1.
Exp Parasitol ; 261: 108749, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38593864

RESUMEN

Trypanosoma cruzi (T. cruzi) causes Chagas, which is a neglected tropical disease (NTD). WHO estimates that 6 to 7 million people are infected worldwide. Current treatment is done with benznidazole (BZN), which is very toxic and effective only in the acute phase of the disease. In this work, we designed, synthesized, and characterized thirteen new phenoxyhydrazine-thiazole compounds and applied molecular docking and in vitro methods to investigate cell cytotoxicity, trypanocide activity, nitric oxide (NO) production, cell death, and immunomodulation. We observed a higher predicted affinity of the compounds for the squalene synthase and 14-alpha demethylase enzymes of T. cruzi. Moreover, the compounds displayed a higher predicted affinity for human TLR2 and TLR4, were mildly toxic in vitro for most mammalian cell types tested, and LIZ531 (IC50 2.8 µM) was highly toxic for epimastigotes, LIZ311 (IC50 8.6 µM) for trypomastigotes, and LIZ331 (IC50 1.9 µM) for amastigotes. We observed that LIZ311 (IC50 2.5 µM), LIZ431 (IC50 4.1 µM) and LIZ531 (IC50 5 µM) induced 200 µg/mL of NO and JM14 induced NO production in three different concentrations tested. The compound LIZ331 induced the production of TNF and IL-6. LIZ311 induced the secretion of TNF, IFNγ, IL-2, IL-4, IL-10, and IL-17, cell death by apoptosis, decreased acidic compartment formation, and induced changes in the mitochondrial membrane potential. Taken together, LIZ311 is a promising anti-T. cruzi compound is not toxic to mammalian cells and has increased antiparasitic activity and immunomodulatory properties.


Asunto(s)
Enfermedad de Chagas , Simulación del Acoplamiento Molecular , Óxido Nítrico , Tiazoles , Tripanocidas , Trypanosoma cruzi , Trypanosoma cruzi/efectos de los fármacos , Tiazoles/farmacología , Tiazoles/química , Enfermedad de Chagas/tratamiento farmacológico , Enfermedad de Chagas/inmunología , Humanos , Animales , Ratones , Óxido Nítrico/metabolismo , Óxido Nítrico/biosíntesis , Tripanocidas/farmacología , Tripanocidas/química , Concentración 50 Inhibidora , Potencial de la Membrana Mitocondrial/efectos de los fármacos , Hidrazinas/farmacología , Hidrazinas/química , Citocinas/metabolismo , Ratones Endogámicos BALB C
3.
Trop Med Infect Dis ; 9(4)2024 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-38668552

RESUMEN

The zoonotic visceral leishmaniasis is caused by the protozoan Leishmania infantum and dogs are reservoirs for this parasite. For the diagnosis of Leishmania at the species level in dogs in formalin-fixed, paraffin-embedded skin (FFPES) samples, colorimetric in situ hybridization (CISH) and quantitative real-time polymerase chain reaction (qPCR) are options, but their sensitivities are not well established. Therefore, the aim of this study was to determine the sensitivity of these two techniques in FFPES for the diagnosis of the L. infantum infection in dogs using culture as the reference standard. The FFPES of 48 dogs with cutaneous infection by L. infantum confirmed by culture and by multilocus enzyme electrophoresis were examined by CISH and qPCR using specific probes for L. infantum. The sensitivities of qPCR, CISH and their combination were, respectively, 77.0%, 58.0% and 83.3%. The sensitivities of qPCR in dogs with and without clinical signs were, respectively, 74.2% and 82.4%. The sensitivities of CISH in dogs with and without clinical signs were, respectively, 61.3% and 52.9%. The CISH and qPCR showed satisfactory sensitivities for the diagnosis of L. infantum in the FFPES of dogs, even in dogs without clinical signs, and their combination increases the sensitivity for this diagnosis.

4.
Anim Reprod Sci ; 265: 107475, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38663149

RESUMEN

A greater understanding of factors influencing fertility is essential to improve pregnancy rates and reduce the occurrence of embryonic mortality in beef herds. The objective of the current study was to evaluate retrospective data of pregnancy per artificial insemination (P/AI) and pregnancy loss in Nelore females subjected to timed-AI (TAI) in Brazil. Data from 40,104 TAI collected from six breeding seasons (2016-2022) were analyzed, and the effects of animal category (e.g., classification based on age and parity), farm, month of parturition, sire, sire breed (Nelore vs Angus), estrus expression at TAI, animal temperament, and body condition scores (BCS) were evaluated. P/AI and pregnancy loss were affected (P < 0.001) by animal category. There was also an effect of farm (P = 0.0013) on P/AI and pregnancy loss (P = 0.001), as P/AI ranged from 49.28% and 55.58% and pregnancy loss from 3.37% to 6.89% across the herds evaluated. Month of parturition also affected (P < 0.001) P/AI and was higher for cows that became pregnant at the beginning of the previous breeding season. Calmer animals, presenting lower velocity scores while exiting the chute following TAI, achieved higher P/AI (P < 0.001). Lower BCS at TAI was associated (P < 0.001) with increased pregnancy loss, and BCS gain following AI was associated (P < 0.001) with reduced rates of embryonic mortality. There was a major effect (P < 0.001) of sire on P/AI and pregnancy loss, as P/AI ranged from 11% to 79%, and embryonic mortality from 0% to 40% for the bulls used in the study, highlighting the importance of the sire fertility on overall pregnancy success. Results from the current study reinforce the idea that animal age and parity at the beginning of the breeding season, BCS at the onset of estrous synchronization, BCS gain following AI, estrus expression at TAI, sire, and month of parturition are important factors influencing P/AI and rates of embryonic mortality in beef herds.


Asunto(s)
Inseminación Artificial , Animales , Femenino , Embarazo , Bovinos/fisiología , Inseminación Artificial/veterinaria , Brasil , Estudios Retrospectivos , Índice de Embarazo , Sincronización del Estro , Aborto Veterinario
5.
Pharmaceuticals (Basel) ; 17(4)2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38675445

RESUMEN

Lidocaine is the most commonly used local anesthetic worldwide, known for its rapid onset and moderate duration of anesthesia. However, it is short-lived and does not effectively promote effective topical anesthesia in the oral cavity when used alone. Our aim was to investigate whether an approximate 50% encapsulation of lidocaine in poly(ε-caprolactone) nanocapsules (LDC-Nano) would be able to increase its permeation and analgesic efficacy and reduce cytotoxicity. In this study, we characterized LDC-Nano and conducted MTT tests with HaCaT cells to assess their in vitro cytotoxicity. Additionally, in vitro permeation assays across the pig esophageal epithelium and the anesthetic efficacy of the hind paw incision model in rats were performed. Plain lidocaine (LDC) was compared with LDC-Nano and lidocaine hydrochloride plus epinephrine (LDC-Epi). The physicochemical characteristics of LDC-Nano were satisfactory (pH: 8.1 ± 0.21; polydispersity index: 0.08 ± 0.01; mean diameter (nm): 557.8 ± 22.7; and encapsulation efficiency (%): 51.8 ± 1.87) and remained stable for up to 4 months. LDC-Nano presented similar in vitro cytotoxicity to LDC but was higher than LDC-Epi (LD50: LDC = 0.48%; LDC-Nano = 0.47%; and LDC-Epi = 0.58%; p < 0.0001). Encapsulation increased the permeability coefficient about 6.6 times and about 7.5 the steady-state flux of lidocaine across the mucosal epithelium. Both encapsulation and epinephrine improved anesthesia duration, with epinephrine demonstrating superior efficacy (100% of animals were anesthetized up to 100, 30, and 20 min when LDC-Epi, LDC-nano, and LDC were used, respectively). Although LDC-Epi demonstrated superior in vivo anesthetic efficacy, the in vitro permeation and cytotoxicity of LDC-Nano indicate promising avenues for future research, particularly in exploring its potential application as a topical anesthetic in the oral cavity.

6.
Environ Pollut ; 346: 123688, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38431247

RESUMEN

One challenge of the citrus industry is the treatment and disposal of its effluents due to their high toxicity, substantial organic load, and consequent resistance to conventional biotechnological processes. This study introduces a novel approach, using electrochemical oxidation with a boron-doped diamond anode to efficiently remove organic compounds from biodegraded pulp wash (treated using the fungus Pleurotus sajor-caju.) The findings reveal that employing a current density of 20 mA cm-2 achieves notable results, including a 44.1% reduction in color, a 70.0% decrease in chemical oxygen demand, an 88.0% reduction in turbidity, and an impressive 99.7% removal of total organic carbon (TOC) after 6 h of electrolysis. The energy consumption was estimated at 2.93 kWh g-1 of removed TOC. This sequential biological-electrochemical procedure not only significantly reduced the mortality rate (85%) of Danio rerio embryos but also reduced the incidence of morphologically altered parameters. Regarding acute toxicity (LC50) of the residue, the process demonstrated a mortality reduction of 6.97% for D. rerio and a 40.88% lethality decrease for Lactuca sativa seeds. The substantial reduction in toxicity and organic load observed in this study highlights the potential applicability of combined biological and electrochemical treatments for real agroindustrial residues or their effluents.


Asunto(s)
Diamante , Contaminantes Químicos del Agua , Diamante/química , Contaminantes Químicos del Agua/análisis , Electrólisis/métodos , Compuestos Orgánicos , Electrodos , Oxidación-Reducción
7.
J Vasc Bras ; 23: e20230085, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38433981

RESUMEN

The largest branch of the terminal division of the brachial artery is the ulnar artery, which arises after the cubital fossa. This artery usually has a deep path in the muscles of the anterior forearm and is responsible for vascularization of the superficial and deep musculature on the ulnar side of the forearm and hypothenar area of the hand. We report an anatomical variant diagnosed by Doppler ultrasound in which the ulnar artery had a superficial position in the forearm. Occurrence of a superficial ulnar artery is rare, but it is an important fact for clinicians, surgeons, and nursing professionals.

9.
PLoS One ; 19(2): e0292872, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38330039

RESUMEN

The present Systematic Review with Meta-analysis study aimed to evaluate the validity and reliability of the Portable A-mode Ultrasound (P-US) for measuring body fat percentage (BF%). Only studies with participants of both genders which had assessed BF% using P-US compared to the reference standard were selected. Publications up until May 31, 2022 were searched in the MEDLINE, COCHRANE, Science Direct, Web of Science, LILACS, SciELO, PEDro, SPORT Discus, CINAHL and SCOPUS databases. QUADAS-2 was used to assess the risk of bias in the validity studies and QAREL was used for the methodological quality of reliability studies. The JAMOVI software program synthesized the results, from which the Pearson Correlation Coefficient (r) or the square root of the Multiple Linear Regression Determination Coefficient (R2) were extracted for the validity studies, and the Mean of Errors of the Bland-Altman Test (ME) and the Confidence Interval (95%CI) with Upper and Lower Limits for the reliability studies. A total of 13 studies were included, generating 26 results for the quantitative synthesis, 14 for validity and 12 for reliability. Regarding the validity results, a strong correlation was identified between the equipment (r = 0.870 [0.845-0.895], P<0.001), with moderate and true heterogeneity (I2 = 53.47%, P = 0.003), presenting publication bias. A small effect size was identified regarding the reliability results, overestimating the results due to chance between the devices (ME = 0.207 [-0.798-1.212], P = 0.686), with low heterogeneity also due to chance (I2 = 19.44%, P = 0.253), with no publication bias. All of the evaluated studies showed some violation of the instruments, confirming the high risk of bias and the low methodological quality. There is concern with heterogeneity for the validity results explained by the subgroups' analysis. The P-US associated with anthropometric perimeters satisfactorily measures the BF% with samples greater than 100 participants, and males. The results in the reliability assessment show high agreement and high variability, greatly expanding the confidence interval, which should be viewed with reservations. This review received financial support from the Brazilian Air Force. The study was registered with PROSPERO under the number CRD42020166617.


Asunto(s)
Deportes , Humanos , Masculino , Femenino , Reproducibilidad de los Resultados , Ultrasonografía/métodos , Tejido Adiposo/diagnóstico por imagen , Brasil
10.
J Sci Food Agric ; 104(4): 2110-2119, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-37919871

RESUMEN

BACKGROUND: This study explores the use of liquid-liquid extraction with thermosensitive polymers for producing laccase (Lac) from Pleurotus sajor-caju. This process leverages liquid waste from the citrus industry, specifically pulp wash. The research delves into extractive fermentation and thermoseparation, both processes being facilitated by a polymer exhibiting a lower critical solution temperature transition. RESULTS: Key factors considered include the choice of polymer, its concentration, pH, separation temperature, and the behavior of the polymer-rich phase post-extractive fermentation concerning the lower critical solution temperature. Notably, under conditions of 45% by weight of Pluronic L-61 and pH 5.0 at 25 °C, the Lac resulted in an enhancement in the purification factor of 28.4-fold, compared with the Lac obtained directly from the fermentation process on the eighth day. There was an 83.6% recovery of the Lac enzyme in the bottom phase of the system. Additionally, the unique properties of Pluronic L-61, which can induce phase separation and also allow for thermoseparation, led to a secondary fraction (aqueous solution) of Lac with purification factor of 2.1 ± 0.1-fold (at 32 ± 0.9 °C and 30 ± 0.3 min without stirring) from the polymeric phase (top phase). Fourier-transform infrared analysis validated the separation data, particularly highlighting the α-helix content in the amide I region (1600-1700 cm-1 ). CONCLUSION: In summary, the insights from this study pave the way for broader industrial applications of these techniques, underscoring benefits like streamlined process integration, heightened selectivity, and superior separation efficacy. © 2023 Society of Chemical Industry.


Asunto(s)
Lacasa , Pleurotus , Lacasa/metabolismo , Polímeros/química , Poloxámero , Temperatura , Fermentación , Pleurotus/metabolismo
11.
Chemosphere ; 349: 140742, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38013027

RESUMEN

Currently, scarcity/security of clean water and energy resources are the most serious problems worldwide. Industries use large volume of ground water and a variety of chemicals to manufacture the products and discharge large volume of wastewater into environment, which causes severe impacts on environment and public health. Fossil fuels are considered as major energy resources for electricity and transportation sectors, which release large amount of CO2 and micro/macro pollutants, leading to cause the global warming and public health hazards. Therefore, algae-bacterial consortium (A-BC) may be eco-friendly, cost-effective and sustainable alternative way to treat the industrial wastewaters (IWWs) with Bio-H2 production. A-BC has potential to reduce the global warming and eutrophication. It also protects environment and public health as it converts toxic IWWs into non or less toxic (biomass). It also reduces 94%, 90% and 50% input costs of nutrients, freshwater and energy, respectively during IWWs treatment and Bio-H2 production. Most importantly, it produce sustainable alternative (Bio-H2) to replace use of fossil fuels and fill the world's energy demand in eco-friendly manner. Thus, this review paper provides a detailed knowledge on industrial wastewaters, their pollutants and toxic effects on water/soil/plant/humans and animals. It also provides an overview on A-BC, IWWs treatment, Bio-H2 production, fermentation process and its enhancement methods. Further, various molecular and analytical techniques are also discussed to characterize the A-BC structure, interactions, metabolites and Bio-H2 yield. The significance of A-BC, recent update, challenges and future prospects are also discussed.


Asunto(s)
Contaminantes Ambientales , Aguas Residuales , Humanos , Bacterias , Plantas , Combustibles Fósiles , Biomasa , Agua , Biocombustibles
13.
J. vasc. bras ; 23: e20230085, 2024. graf
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1534796

RESUMEN

Resumo O maior ramo da divisão terminal da artéria braquial é a artéria ulnar, que se origina após a fossa cubital. Essa artéria usualmente tem trajeto profundo aos músculos do antebraço anterior e é responsável pela vascularização da musculatura superficial e profunda da região ulnar do antebraço e hipotênar da mão, sendo a principal responsável pela formação do arco palmar superficial após o retináculo dos flexores. Reportamos uma variação anatômica após diagnóstico com ultrassom vascular na qual a artéria ulnar situava-se em posição superficial no antebraço. A ocorrência da artéria ulnar superficial é rara, porém de grande importância para clínicos, cirurgiões e profissionais de enfermagem.


Abstract The largest branch of the terminal division of the brachial artery is the ulnar artery, which arises after the cubital fossa. This artery usually has a deep path in the muscles of the anterior forearm and is responsible for vascularization of the superficial and deep musculature on the ulnar side of the forearm and hypothenar area of the hand. We report an anatomical variant diagnosed by Doppler ultrasound in which the ulnar artery had a superficial position in the forearm. Occurrence of a superficial ulnar artery is rare, but it is an important fact for clinicians, surgeons, and nursing professionals.

14.
Asclepio ; 75(2): e24, Juli-Dic. 2023.
Artículo en Español | IBECS | ID: ibc-228671

RESUMEN

El artículo se explaya sobre el proceso de reclutamiento de profesoras de enseñanza primaria, popularmente llamadas normalistas, en la evolución de la formación en Brasil de las profesiones de salud (educadoras, visitadoras sanitarias y enfermeras). Las características socioculturales de las normalistas las convirtieron en el tipo ideal de mujeres para servir a las nuevas profesiones de salud. Además de la similitud de género (profesiones femeninas), las profesiones docentes primarias y de la salud compartían saberes y prácticas de matriz biomédica e higienista y un mismo campo profesional (escuelas, centros de salud y hogares), lo que determinó afinidades entre las políticas públicas de educación y de salud.(AU)


The article discusses the mobilization of primary teachers, popularly called normalists in the process of constitution, in Brazil, of the sanitary professions (educators or health visiters and nurses). The sociocultural characteristics of normalists made them the ideal type of women recruited to the new health professions. The sociocultural characteristics of normalists made them the ideal type of women recruited to the new health professions. In addition to the similarity of gender (female professions), the primary teaching and health professions shared knowledge and practices of biomedical and hygienist matrix and the same field of professional activity (schools, health posts and households), which translated the affinities between public policies for education and heal.(AU)


Asunto(s)
Humanos , Femenino , Salud Pública/educación , Personal de Salud/educación , Docentes/educación , Mujeres/educación , Características Culturales , Maestros , Brasil , Facultades de Enfermería , Estudiantes de Enfermería , Educación en Enfermería
16.
Cureus ; 15(10): e47103, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38022194

RESUMEN

Anesthesia for awake neurosurgery requires meticulous planning. We report the case of a 44-year-old female with glioblastoma undergoing an awake craniotomy. Due to her asthma and von Willebrand disease, an opioid-free approach was chosen. Conscious sedation was attained using propofol and dexmedetomidine. The operation was successful after nine hours with patient comfort maintained. The patient was discharged from the intensive care unit in two days without sequelae. However, the use of desmopressin caused hyponatremia and cerebral edema. The scalp block was effective for pain management. This case highlights the importance of individualized anesthetic strategies in awake neurosurgeries.

17.
Malar J ; 22(1): 361, 2023 Nov 27.
Artículo en Inglés | MEDLINE | ID: mdl-38012686

RESUMEN

BACKGROUND: Plasmodium vivax is the main species responsible for human malaria in Brazil, and one of its manifestations is splenic malaria, though there are still challenges in its diagnosis. The present study aimed to standardize Plasmodium sp. DNA extraction from histological slices of spleen and diagnosis using real-time qPCR. METHODS: This study performed a microtomy of a paraffin-embedded spleen as a positive control for P. vivax from a patient who had been previously diagnosed with the parasite. The sample was deparaffinized with xylol and ethanol, then DNA extraction was performed with two commercial kits. qPCR was carried out with the Taqman system for detection of Plasmodium sp. and was made species-specific using PvmtCOX1 gene. From 2015 to 2019, 200 spleen samples were obtained from trauma patients subjected to splenectomy in Manaus, Amazonas. All the samples were tested for cell-free human DNA (cfDNA). RESULTS: The deparaffinization and the Plasmodium vivax DNA extraction method was successfully standardized, and the control sample was positive for P. vivax. Of the 200 samples, all qPCRs were negative, but they were positive for human PCR. CONCLUSION: Paraffinization is practical and efficient for the preservation of samples, but the formation of bonds between proteins and DNA makes extraction difficult. Despite this, in this study, it was possible to standardize a method of DNA extraction for detecting P. vivax.


Asunto(s)
Malaria Vivax , Malaria , Humanos , Bazo , Malaria/diagnóstico , Malaria Vivax/diagnóstico , Malaria Vivax/parasitología , Plasmodium vivax/genética , ADN , Estándares de Referencia , Plasmodium falciparum/genética
18.
Expert Opin Drug Deliv ; 20(9): 1251-1265, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37781735

RESUMEN

INTRODUCTION: Oral cavity drug and vaccine delivery has the potential for local targeting, dose reduction, minimization of systemic side effects, and generation of mucosal immunity. To overcome current limitations of delivery into the oral cavity mucosa, microneedles (MNs) have emerged as a promising technology. AREAS COVERED: We reviewed the literature on MN application in the oral cavity, including in vitro studies, in vivo animal studies, and human clinical trials. EXPERT OPINION: MNs are sufficiently robust to cross the oral cavity epithelium and nearly painless when applied to different parts of the human oral mucosa including the lip, cheek, tongue, and palate. In recent years, MNs have been evaluated for different applications, including vaccination, topical anesthetic delivery, and treatment of local oral pathologies such as oral lesions or carcinomas. MNs are attractive because they have the potential to produce a better treatment outcome with reduced side effects. Over the coming years, we project a significant increase in research related to the development of MNs for use in dentistry and other medical conditions of the mouth.


Asunto(s)
Mucosa Bucal , Boca , Animales , Humanos , Preparaciones Farmacéuticas , Vacunación , Sistemas de Liberación de Medicamentos , Agujas , Administración Cutánea
19.
Chemosphere ; 344: 140407, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37838029

RESUMEN

Ciprofloxacin (CIP) is a commonly prescribed fluoroquinolone antibiotic that, even after uptake, remains unmetabolized to a significant extent-over 70%. Unmetabolized CIP is excreted through both urine and feces. This persistent compound manages to evade removal in municipal wastewater facilities, leading to its substantial accumulation in aquatic environments. This accumulation raises concerns about potential risks to the health of various living organisms. Herein, we present a study on the remediation of CIP in synthetic urine by electrochemical oxidation in an undivided cell with a DSA (Ti/IrO2) anode and a stainless-steel cathode. Physisorbed hydroxyl radical formed at the anode surface from water discharge and free chlorine generated from Cl- oxidation were the main oxidizing agents. The effect of pH and current density (j) on CIP degradation was examined, and its total removal was easily achieved at pH ≥ 7.0 and j ≥ 60 mA cm-2 due to the action of free chlorine. The CIP decay always followed a pseudo-first-order kinetics. The components of the synthetic urine were also oxidized. The main nitrogenated species released was NH3. A very small concentration of free chlorine was quantified at the end of the treatment, thus demonstrating the good performance of electrochemical oxidation and its effectiveness to destroy all the organic pollutants. The present study demonstrates the simultaneous oxidation of the organic components of urine during CIP degradation, thus showing a unique perspective for its electrochemical oxidation that enhances the environmental remediation strategies.


Asunto(s)
Antibacterianos , Contaminantes Químicos del Agua , Antibacterianos/química , Ciprofloxacina/química , Cloro , Oxidación-Reducción , Electrodos , Contaminantes Químicos del Agua/análisis
20.
Toxins (Basel) ; 15(9)2023 08 26.
Artículo en Inglés | MEDLINE | ID: mdl-37755950

RESUMEN

Bothrops snakebite envenomation (SBE) is consider an important health problem in Brazil, where Bothrops atrox is mainly responsible in the Brazilian Amazon. Local effects represent a relevant clinical issue, in which inflammatory signs and symptoms in the bite site represent a potential risk for short and long-term disabilities. Among local complications, secondary infections (SIs) are a common clinical finding during Bothrops atrox SBE and are described by the appearance of signs such as abscess, cellulitis or necrotizing fasciitis in the affected site. However, the influence of SI in the local events is still poorly understood. Therefore, the present study describes for the first time the impact of SBE wound infection on local manifestations and inflammatory response from patients of Bothrops atrox SBE in the Brazilian Amazon. This was an observational study carried out at the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus (Brazil), involving victims of Bothrops SBE. Clinical and laboratorial data were collected along with blood samples for the quantification of circulating cytokines and chemokines before antivenom administrations (T0) and 24 h (T1), 48 h (T2), 72 h (T3) and 7 days after (T4). From the 94 patients included in this study, 42 presented SI (44.7%) and 52 were without SI (NSI, 55.3%). Patients classified as moderate envenoming presented an increased risk of developing SI (OR = 2.69; CI 95% = 1.08-6.66, p = 0.033), while patients with bites in hands showed a lower risk (OR = 0.20; CI 95% = 0.04-0.96, p = 0.045). During follow-up, SI patients presented a worsening of local temperature along with a sustained profile of edema and pain, while NSI patients showed a tendency to restore and were highlighted in patients where SI was diagnosed at T2. As for laboratorial parameters, leukocytes, erythrocyte sedimentation ratio, fibrinogen and C-reactive protein were found increased in patients with SI and more frequently in patients diagnosed with SI at T3. Higher levels of circulating IL-2, IL-10, IL-6, TNF, INF-γ and CXCL-10 were observed in SI patients along with marked correlations between these mediators and IL-4 and IL-17, showing a plurality in the profile with a mix of Th1/Th2/Th17 response. The present study reports for the first time the synergistic effects of local infection and envenoming on the inflammatory response represented by local manifestations, which reflected on laboratorial parameters and inflammatory mediators and thus help improve the clinical management of SI associated to Bothrops SBE.


Asunto(s)
Bothrops , Coinfección , Mordeduras de Serpientes , Humanos , Animales , Mordeduras de Serpientes/complicaciones , Mordeduras de Serpientes/diagnóstico , Brasil/epidemiología , Antivenenos/uso terapéutico
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