Infección letal por adenovirus: presentación de un caso / Lethal infection for adenovirus: case report

Adenovirus (ADV) can cause serious, localized or disseminated, sometimes lethal disease. There is no specific treatment, only support management according to requirements and severity of disease. Extracorporeal membrane oxygenation (ECMO) has been used in severe ADV infection. Cidofovir has been reported as a therapeutic option. This case reports a lethal case of ADV respiratory infection despite the treatment with cidofovir an ECMO.

El adenovirus (ADV) puede causar infección respiratoria grave, localizada o diseminada y letal en pacientes susceptibles. No existe terapia específica, solo de soporte según requerimientos y gravedad. En este sentido el manejo con oxigenación por membrana extracorpórea (ECMO) ha sido utilizado en niños con infección grave por ADV. Si bien no existe terapia específica actual se ha reportado uso de cidofovir que ha ganado espacio como posibilidad terapéutica en caso de enfermedad grave. Se presenta el caso clínico de un paciente que cursó con infección letal por ADV a pesar del tratamiento de soporte con ECMO y el tratamiento con cidofovir.

Ecmo pediátrico: una puesta al día / Pediatric ecmo up to date

Extracorporeal membrane oxygenation (ECMO) is an ever more available technique for reversible catastrophic heart or pulmonary failure that requires permanent training and actualization. This article reviews inclusion criteria, basic concepts, anticoagulation management, use of vasoactive drugs, respiratory support, laboratory tests and weaning. An up to date and easy to use reference material we hope will facilitate the study and implementation of ECMO in centers that are, or look to be, providers. The authors have made an exhaustive review of published literature and have also referenced the Extracorporeal Life Support Organization (ELSO) guidelines.

La oxigenación de membrana extracorpórea (ECMO) es una técnica indicada para falla cardiológica y/o pulmonar catastrófica de etiología recuperable, cada vez más disponible, lo que hace necesario que los prestadores de cuidados intensivos estén actualizados en esta técnica. Este artículo repasa conceptos, criterios de inclusión, manejo de anticoagulación, uso de drogas vasoactivas, apoyo ventilatorio, exámenes paraclínicos y destete de la asistencia. El tener una referencia actualizada, fácil y concreta facilita el estudio e implementación de ECMO en centros que van a disponer del mismo o que ya la están desarrollando. Los autores hicieron una revisión exhaustiva de la literatura publicada y de la normativa internacional disponible de la Organización del soporte de vida extracorpóreo (ELSO por su sigla en inglés Extracorporeal Life Support Organization).

Evaluation of the mutagenicity of antimalarial products isolated from Solanum nudum (Solanaceae).

Diosgenone is a major component of the hexane extract from the plant Solanum nudum (Solanaceae). The products from degraded and acetylated diosgenone that showed in vitro antimalarial activity against the FCB-2 strain of Plasmodium falciparum and methanol, dichloromethane and ethereal extracts of Solanum nudum were tested for their mutagenic activity using the Ames test with the TA-97a, TA-98, TA-100 and TA-102 strains of Salmonella typhimurium. These compounds were not mutagenic at the tested concentrations.

In vitro and in vivo genotoxic activity of miral, an organophosphorus insecticide used in Colombia.

Miral 500 CS (CAS# 42509-80-8), an organophosphorus insecticide, has been widely used in Columbia to fumigate coffee plantations. Therefore, there is extensive human exposure to this pesticide. Miral's mutagenic and genotoxic activities, however, are not known. In this study, such activities of the pesticide were evaluated using the Salmonella TA98/S9 test and the chromosome aberration assay in bone marrow cells of Swiss albino CD1 male mice. All doses tested with Salmonella in the presence of S9 mix (3.2, 16, 80, 400 and 2000 micrograms/plate) induced a mutagenic response that was three times the spontaneous mutation frequency. The mutagenic response without S9 was twice the spontaneous frequency. Based on a 4-day treatment (i.p.) of mice with Miral, the median lethal dose (LD50) and the maximum tolerated dose (MTD) were 912.5 mg/kg and 730 mg/kg, respectively. A significant dose-dependent cell cycle delay (r2 = 0.85, p < 0.01) was observed in bone marrow cells when mice were treated for 24 h with 73, 146, 219, 292, 365, 438, 511, 584, 657 and 730 mg/kg. Significant increase in mitotic indices (p < 0.02) and chromosome aberrations (p < 0.05) were induced in bone marrow cells, when mice were treated for 18 h with the highest dose 511 mg/kg. Our results indicate that Miral is a mutagenic compound in Salmonella and is capable of inducing chromosome aberrations at high doses in mice. Additional genotoxicity studies in farmers exposed to Miral should be conducted to determine the potential human health risk resulting from chronic low-dose exposures to this pesticide.