Síndrome congénito asociado a virus Zika

La infección por el virus Zika (ZIKV) inicialmente descrita como una enfermedad febril leve, hoy se conoce por estar asociada a malformaciones congénitas, destacando la microcefalia. En Venezuela son poco los datos registrados, por lo que se plantea la realización de un estudio para describir el comportamiento de la enfermedad congénita en la población venezolana. Metodología: Se realizó un estudio prospectivo, observacional, se incluyeron todos los niños que acudieron a la consulta de Infectología Pediátrica del Hospital Universitario de Caracas entre agosto de 2016 y marzo de 2018 con diagnóstico de microcefalia y/o aquellos con exposición sospechada o confirmada al virus Zika durante la gestación, siendo evaluados mediante examen físico y estudios paraclínicos. Todos los pacientes fueron evaluados por equipo multidisciplinario. Resultados: Se incluyeron 28 pacientes, prevaleciendo el sexo femenino con 53,6 %, el 60,7 % de los pacientes presentaron microcefalia. Se observaron malformaciones esqueléticas: artrogriposis, pie equinovaro, pie valgo, afecciones oculares: endotropía, catarata congénita, leucocoria bilateral, microftalmia. En el 28,6 % de pacientes no se evidenciaron malformaciones. Se observaron casos confirmados para Zika, con microcefalia y TAC de cráneo con ventriculomegalia, así como pacientes con circunferencia cefálica (CC) normal y estudios de imagen sin alteraciones. Se reportan 2 casos con CC normal al nacimiento y progresión a microcefalia en consultas sucesivas. Conclusiones: El virus Zika se encuentra asociado con síndrome genético caracterizado por microcefalia, malformaciones musculoesqueléticas y oftalmológicas. La microcefalia en la infección por virus Zika se puede desarrollar en el período postnatal.

The Zika virus infection (ZIKV) initially described as a mild febrile disease, is now known to be associated with congenital malformations, highlighting microcephaly. In Venezuela there is little data recorded, so it is proposed to conduct a study to describe the behavior of congenital disease in the Venezuelan population. Methodology: A prospective, observational study was carried out, including all children who attended the Pediatric Infectious Disease consultation at the University Hospital of Caracas between August 2016 and March 2018 with a diagnosis of microcephaly and / or those with suspected or confirmed exposure to the Zika virus during pregnancy, being evaluated by physical examination and paraclinical studies. All patients were evaluated by a multidisciplinary team. Results: Twenty-eight patients were included, prevailing the female gender with 53.6 %, 60.7 % of the patients presented microcephaly. Skeletal malformations were observed: arthrogryposis, equinovar foot, valgus foot, ocular affections: endotropia, congenital cataract, bilateral leukocoria, microphthalmia. In 28.6 % of patients, malformations were not observed. Confirmed cases were observed for Zika, with microcephaly and TAC of the skull with ventriculomegaly, as well as patients with normal cephalic circumference (cc) and imaging studies without alterations. Two cases are reported with normal CC at birth and progression to microcephaly in successive consultations. Conclusions: The Zika virus is associated with a genetic syndrome characterized by microcephaly, musculoskeletal and ophthalmological malformations. Microcephaly in Zika virus infection can develop in the postnatal period.

Tratamiento anti-infeccioso de diarreas en pediatría: [revisión] / Anti-infective treatment of diarrhea in pediatrics: [review]

La diarrea es una de las causas más comunes de enfermedad en pediatría y la segunda causa de muerte infantil en el mundo. Cobra la vida de cerca de 4.000 niños cada día. La carga es mayor en el mundo en desarrollo donde el acceso al agua potable, saneamiento y atención médica son a menudo limitadas. Las características de las evacuaciones permiten orientar la terapia inicial. Las diarreas de etiología bacteriana se tratan según criterios muy bien especificados, la mayoría se autolimitan en más del 50 por ciento de los casos. Los virus constituyen la etiología más fecuente de las diarreas (más de 40 por ciento de los episodios agudos). Existen múltiples parásitos causales para los cuales existen también alternativas terapéuticas. La terapia anti-infecciosa cuando este indicado se debe iniciar precozmente, de esta manera, se reduce la duración y gravedad de la enfermedad, se previenen complicaciones, se disminuye la excreción del agente infeccioso y se evita la transmisión del patógeno.

Diarrhea disease is ona of the most commun causes of illness and the second leading cause of child dealth in the world. It claims the lives of nearly 4000 children each day. The burden is greatest in the developing world where access to safe water, sanitation, and medical care are often limited. Viruses are the most common cause of diarrhea (more than 40% of acute episodes). Episodes of bacterial diarrhea are self-limited in more than 50% of cases. There are multiple causative parasites for which there are also therapeutic alternatives. Anti-infective therapy should be initiated early, thus reducing the duration and severity of the disease, preventing complications, decreasing the excretion of the infectious agent and preventing the transmission of the pathogen.

Lesions associated with mineral deposition in the lymph nodes and lungs of cattle: a case-control study of environmental health hazard.

This report focuses on the state of health of the cattle raised in the district of Taranto - city of Italy rated as environmentally at risk. Representative samples of lungs, bronchial and mediastinal lymph nodes of cattle from district of Taranto's slaughterhouses were collected. After a macroscopic examination, samples with marked lesions were processed for light microscopy. Samples were also observed with polarized light microscopy, scanning electron microscopy and with microanalysis. The macroscopic examination revealed that 60 out of 183 samples showed marked lesions. Lung alterations were characterized by thickening of the alveolar septa and by the latter's modifying action on the alveolar spaces, foci of fibrosis and bronchopulmonary inflammation. For 51 out of the 60 samples observed, the histological examination confirmed the presence of pneumoconiosis and lymph nodal anthracosis. Energy-dispersive X-ray microanalysis of lung samples identified a wide range of elements including silicon, aluminium, titanium, iron, carbon and small amount of the other metals. In the lymph-nodes the same kind of metals with a different levels of distribution was observed. Our survey on cattle farmed in areas at high risk of pollution may be helpful to the estimation of the exposure risk for man to environmental contaminants and to the evaluation of the occurrence of the pathological manifestations as well.

First observation of an Hashimoto thyroiditis-like disease in horses from Eastern Europe: histopathological and immunological findings.

Among 622 slaughtered horses from eastern Europe, 156 thyroid glands were selected on the basis of macroscopic alterations (e.g., determination of volume and weight). In the 80% of these thyroids, microscopic alterations consistent with a diagnosis of Hashimoto thyroiditis-like disease were found. In particular, a subverted architecture of the thyroid gland with colloid rarefaction, lymphocytic infiltration, and fibrosis was noted. The confirmation of the histopathological diagnosis of an equine Hashimoto thyroiditis-like disease was provided by the increased serum concentration of thyroglobulin, of antithyroglobulin, and of antithyroid peroxidase autoantibodies. Despite evidence consistent with an Hashimoto thyroiditis-like disease in eastern European horses, the etiopathogenesis of this autoimmune disorder deserves further investigation. In this respect, in some horses histopathological alterations in the pituitary gland may suggest an as-yet-unidentified disorder within the hypothalamus-pituitary adrenal axis associated with Hashimoto thyroiditis.

Conjugates of aberrant gangliosides in antiglioma vaccine: toxicological assay.

We studied sterility and toxicity of vaccine LS1 containing aberrant gangliosides isolated from brain bioptates of 48 patients with gliomas of different malignancy and covalently bound to keyhole limpet hemocyanin. The vaccine was safe. This preparation produced no side effects in experimental animals. Our findings substantiated the necessity of father development of this method of vaccination. The vaccine should undergo clinical tests in patients with malignant gliomas.

Free radicals in rabbit spinal cord ischemia: electron spin resonance spectroscopy and correlation with SOD activity.

1. In nonanesthetized rabbits temporal occlusion of the abdominal aorta was used to induce oxidative stress in the lower part of the body including distal segments of the spinal cord. 2. Spinal cord samples were taken from the animals exposed to 25-min aortic occlusion (AO) or to occlusion followed by 1- or 2-hr reperfusion (AO/R1 or AO/R2, respectively) or from sham-operated animals (C). The presence of free radicals (FR) in the spinal cord samples frozen in liquid N2 was assessed by ESR spectroscopy without spin trapping. Moreover, superoxide dismutase (SOD) activity and conjugated diene (CD) levels were measured in the samples. 3. In the AO group FR were detected in the spinal cord regions close to the occlusion (lower thoracic and distal segments) along with a decrease in SOD activity. The calculated g value (g = 2.0291) indicated that the paramagnetic signal recorded might be attributed to superoxide radicals. FR were absent in the AO/R1 group. Concurrently, the SOD activity revealed a significant tendency to return to the control level. FR appeared again in the AO/R2 group, mostly in the upper and middle lumbar regions, along with a decrease in SOD activity. No sample from the C group revealed FR. A significant increase in CD levels was observed in the thoracolumbar region only in the AO/R2 group. The temporary absence of FR in the AO/R1 group suggests activation of defense antioxidant mechanisms (e.g., specific enzymatic systems such as SOD), which might have been exhausted later. 4. Changes in SOD activity similar to those observed in the thoracolumbar region, though less noticeable, occurred in the obviously noncompromised tissue (upper cervical region). This points to a kind of generalized response of the animal to aortic occlusion. 5. Direct ESR spectroscopy revealed the presence of FR as well as their time course in the spinal cord during the early phase of ischemia/reperfusion injury and the inverse relationship between FR and SOD activity.

1H NMR ganglioside ceramide resonance region on the differential diagnosis of low and high malignancy of brain gliomas.

1. The high-resolution 1H NMR (MRS) spectra of human brain tumor homogenates revealed a broad resonance at 5.3-5.4 ppm in glioblastoma multiforme (N = 16) and brain metastases (N = 3). The broad resonance was identified as ceramide, a sphingosine-fatty acid combination portion of ganglioside, indicating an elevated abundance of monounsaturated fatty acids. GLC analysis of gangliosides in the highly malignant glioblastoma multiforme revealed that the elevated monounsaturated fatty acid is oleic acid (C18:1). The resonance at 5.3-5.4 ppm region was not detectable in normal human brain (N = 2), in meningiomas (N = 2), or in low-grade astrocytomas (N = 12). In normal human brain the abundance of monounsaturated fatty acid is minimal. 2. This investigation was made possible because the method of producing homogenate resulted in (i) no loss of lipids during the process and (ii) a well-homogenised sample, with (iii) no loss in chemical integrity. 3. The properties of tumor gangliosides include antigenic specificity and immunosuppressive activity and the ceramide, a sphingosine-fatty acid combination, noticeably influences the ganglioside immunosuppressive activity. 4. The observation of 1H NMR ceramide resonance in high-malignant brain tumors emphasizes the dramatic role of aberant gangliosides and ceramide precursors on the grade of malignancy and invasiveness. 5. Further insight into the specific nature of the ceramide portion of gangliosides in grading the malignancy of brain tumors should be investigated further.

Extrapulmonary silicosis in two water buffaloes.

Two cases of extrathoracic silicosis in buffaloes raised near a quartz quarry and suffering from clinically severe silicosis are described. The extrapulmonary changes were characterized by silicoconiotic nodules in the tonsils, mesenteric lymph nodes and spleen. A combination of energy dispersive X-ray microanalysis and scanning electron microscopy revealed that the mineral component of these lesions consisted mainly of silicon, aluminium, iron, calcium, magnesium, zinc, sulphur and potassium. It is concluded that domestic animals raised in polluted environmental conditions represent an important biological source from which helpful data may be obtained for assessing risks to human health and gaining new insight into pathogenetic mechanisms.

Primary ciliary dyskinesia in pigs.

The first description of a familial immotile cilia syndrome diagnosed through ovario-hysterectomy in six siblings of pigs has been performed. This report may indicate another possible cause of reproductive failure in domestic animals. In fact, the immotile cilia syndrome has not been considered from this point of view in veterinary medicine. This case emphasizes that a study about ciliary motility in the female reproductive tract in domestic animals is absolutely necessary to improve current knowledge about different causes of infertility. Up to date, it remains unknown what degree of ciliary motility is necessary for mammalian fertility in females.