A proteomic overview of the major venom components from Tityus championi from Panama.

In recent years, morbidity caused by scorpion sting of the species Tityus championi has increased in Panama. Therefore, the LD50 was determined by intravenous injection in 2.9 mg/kg and the venom of T. championi was separated using a HPLC system and their fractions were tested for biological activities in mice to identify the most toxic fractions to mammals. In addition, the venom fractions were also tested against invertebrates to look for insect-specific toxin peptides. The most toxic fractions were analyzed by MS/MS spectrometry. The primary structures of T. championi venom peptides with the most relevant activity were obtained, and the primary structure of one of most neurotoxic peptides was found at least in other four species of Tityus from Panama. This neurotoxin is quite important to be used as a protein target to be neutralized if developing antivenoms against the sting of this Panamanian scorpion or other relevant species of genera Tityus in the country.

Venoms of Centruroides and Tityus species from Panama and their main toxic fractions.

The scorpionism in Panama is notorious for the confluence and coexistence of buthid scorpions from the genera Centruroides and Tityus. This communication describes an overview of the larger representative toxic venom fractions from eight dangerous buthid scorpion species of Panama: Centruroides (C. granosus, C. bicolor, C. limbatus and C. panamensis) and Tityus (T. (A.) asthenes, T. (A.) festae, T. (T.) cerroazul and T. (A.) pachyurus). Their venoms were separated by HPLC and the corresponding sub-fractions were tested for lethality effects on mice and insects. Many fractions toxic to either mice or insects, or both, were found and have had their molecular masses determined by mass spectrometry analysis. The great majority of the lethal components had a molecular mass close to 7000 Da, assumed to be peptides that recognize Na+-channels, responsible for the toxicity symptoms observed in other buthids scorpion venoms. A toxic peptide isolated from the venom of T. pachyurus was sequenced by Edman degradation, allowing the synthesis of nucleotide probe for cloning the correspondent gene. The mature toxin based on the cDNA sequencing has the C-terminal residue amidated, contains 62 amino acid packed by 4 disulfide linkages, with molecular mass of 7099.1 Da. This same toxic peptide seems to be present in scorpions of the species T. pachyurus collected in 5 different regions of Panama, although the overall HPLC profile is quite different. The most diverse neurotoxic venom components from the genus Centruroides were found in the species C. panamensis, whereas T. cerroazul was the one from the genus Tityus. The most common neurotoxins were observed in the venoms of T. festae, T. asthenes and T. pachyurus with closely related molecular masses of 7099.1 and 7332 Da. The information reported here is considered very important for future generation of a neutralizing antivenom against scorpions from Panama. Furthermore, it will contribute to the growing interest in using bioactive toxins from scorpions for drug discovery purposes.

Geographical variability of the venoms of four populations of Bothrops asper from Panama: Toxicological analysis and neutralization by a polyvalent antivenom.

Bothrops asper is the medically most important venomous snake in Central America. In Panama, the country having the highest incidence of snakebites in Latin America, B. asper is widely distributed throughout the country and is responsible for the vast majority of snakebites. This study was performed to analyze whether there are variations in the toxicological profile and in some biochemical parameters between the venoms of B. asper from four different regions in Panama. The venoms showed a similar profile of lethal, hemorrhagic, in vitro coagulant, defibrinogenating, edema-forming, myotoxic and indirect hemolytic activities, with subtle quantitative variations between samples of some regions. The venoms also had similar SDS-PAGE patterns and reverse phase HPLC profiles. A polyvalent antivenom manufactured in Costa Rica, and regularly used in Panama, was effective in the neutralization of lethal activity of the venoms of the four populations, with Mean Effective Doses (ED50) ranging from 5.98 to 9.72 mg venom/mL antivenom. In agreement, a widespread pattern of cross-reactivity between this antivenom and the four venoms was observed by immunoblotting. Overall, results highlight the lack of marked differences between the venoms of the various populations of B. asper in Panama, and that the antivenom from Costa Rica is effective in neutralizing lethality.

Origen anómalo de la arteria coronaria izquierda: reporte de un caso / Anomalous origin of left coronary artery: case report

Se presenta el caso de una paciente de 8 años que acude a control médico por soplo cardiaco. El ecocardiogama evidencia valvulopatía mitral; recibe tratamiento con digoxina y enalapril que producen una leve mejoría, pero posteriomlente se manifiesta disnea que conduce a una nueva evaluación. Se realiza nuevo esquema diagnóstico por medio de tomografia helicoidal y cateterismo que permiten diagnosticar anomalía coronaria izquierda que nace en la arteria pulmonar. La paciente ingresó a esta institución de salud para proceder a la cOITección quirúrgica del origen anómalo de la arteria coronaria y plastia valvular. Fue dada de alta sin complicaciones y con tratamiento ambulatorio profiláctico para endocarditis bacteriana por patología valvular.

Asma en la unidad de terapia intensiva desde 1982 hasta 1988 / Asthma in the Intensive Care Unit from 1982 to 1988

Se realizó un estudio retrospectivo de siete años de atención, en la Unidad de Terapia Intensiva (UTI), de los pacientes con status asmiticus. Se encontró que a pesar del aumento general de hospitalizaciones por asma de 16.5 (por ciento) a 22 (por ciento), en UTI este aumento fue mínimo de 0.5 (por ciento) a 0.6 (por ciento). Los menores de 5 años representaron el 87 (por ciento) del grupo estudiado y las 9 defunciones tenían menos de 5 años. Hubo un predominio del sexo femenino, el 55 (por ciento). Los factores de riesgo para el ingreso a UTI fueron : el asma familiar en 75 (por ciento), un promedio de tres hospitalizaciones previas en 66 (por ciento). El inicio del asma antes del año de edad y la demanda tardía de atención en 58 (por ciento). El cuadro clínico del status asmaticus mejoró en las primeras 24 horas y el 50 (por ciento) de los pacientes egresaron de UTI a las 72 horas. Antes de 1985 se informaron 40 (por ciento) de convulsiones, generalmente por hiponatremia. El esquema de tratamiento utilizado desde 1986 comprendió inhalaciones de salbutanol antes de las 12 horas del ingreso a UTI. Se recomienda la educación permanente y participativa del público sobre las causas, la clínica y el tratamiento del asma