Fiebre chikungunya en México: caso confirmado y apuntes para la respuesta epidemiológica / Chikungunya fever in Mexico: confirmed case and notes on the epidemiologic response

La fiebre chikungunya (CHIK) es una enfermedad viral transmitida al ser humano por el mismo vector del dengue, el mosquito Aedes. Además de fiebre y fuertes dolores articulares, produce otros síntomas como mialgias, cefalea, náuseas, cansancio y exantema. No tiene tratamiento específico; el manejo terapéutico de los pacientes se enfoca en el alivio de los síntomas. Históricamente se han reportado brotes de grandes proporciones; incluso desde 2010 se llegó a considerar como una potencial epidemia emergente. En 2013 se introdujo a las islas del Caribe y recientemente se ha reportado en el continente americano. En este trabajo se describe el primer caso confirmado de chikungunya en México, en el municipio de Tlajomulco de Zúñiga, Jalisco, en mayo de 2014, importado de la isla Antigua y Barbuda, en el Caribe, por una mujer de 39 años de edad.

Chikungunya fever (CHIK) is a viral disease transmitted to human beings by the same vector as dengue -the Aedes mosquito. Besides fever and severe pain in the joints, it produces other symptoms such as myalgias, headache, nausea, fatigue and exanthema. There is no specific treatment for it; the therapeutic management of patients focuses on symptom relief. Historically, outbreaks of large proportions have been reported; even since 2010 it was considered to be a potential emerging epidemic. In 2013 it was introduced into the islands of the Caribbean, and it has recently been reported in the American continent. This paper describes the first confirmed case of chikungunya in Mexico -in the municipality of Tlajomulco de Zúñiga, Jalisco, in May, 2014-, which was imported from the Caribbean island of Antigua and Barbuda by a 39 year-old woman.

Folk uses and pharmacological properties of Casearia sylvestris: a medicinal review

Folk uses and scientific investigations have highlighted the importance of Casearia sylvestris extracts and their relevant bioactive potential. The aim of this work was to review the pharmacological properties of C. sylvestris, emphasizing its anti-ulcer, anti-inflammatory, anti-ophidian and antitumor potentialities. Ethanolic extracts and essential oil of their leaves have antiulcerogenic activity and reduce gastric volume without altering the stomach pH, which corroborates their consumption on gastrointestinal disorders. Leaf water extracts show phospholipase A2 inhibitory activity that prevents damage effects on the muscular tissue after toxin inoculation. This antiphospholipasic action is probably related to the use as an anti-inflammatory, proposing a pharmacological blockage similar to that obtained with non-steroidal anti-inflammatory drugs on arachidonic acid and cyclooxygenase pathways. Bioguided-assay fractionations lead to the identification of secondary metabolites, especially the clerodane diterpenes casearins (A-X) and casearvestrins (A-C), compounds with a remarkable cytotoxic and antitumor action. Therefore, the C. sylvestris shrub holds a known worldwide pharmacological arsenal by its extensive folk utilization, exciting searches for new molecules and a better comprehension about biological properties.

Usos populares e pesquisas científicas têm destacado a importância dos extratos da planta Casearia sylvestris e seu grande potencial bioativo. Neste trabalho, objetiva-se revisar as propriedades farmacológicas de C. sylvestris, enfatizando sua potencialidade antiulcerogênica, antiinflamatória, antiofídica e antitumoral. O extrato etanólico e o óleo essencial das folhas possuem atividade antiulcerogênica promissora, diminuindo o volume gástrico sem alterar o pH estomacal, corroborando sua aplicação contra dores gastrointestinais. Já os extratos aquosos das folhas têm atividade inibitória contra fosfolipase A2 presente em venenos de cobras, atenuando os efeitos lesivos sobre a musculatura esquelética resultantes da inoculação das toxinas. Essa ação antifosfolipásica provavelmente está relacionada ao seu uso como antiinflamatório, sugerindo um bloqueio análogo ao dos fármacos antiinflamatórios não-esteroidais na formação de mediadores oriundos do ácido araquidônico e na ativação da ciclooxigenase. Ensaios de fracionamento bioguiado dos extratos culminaram no isolamento e identificação de inúmeros metabólitos secundários, especialmente os diterpenos clerodânicos casearinas (A-X) e casearvestrinas (AC), compostos que têm surpreendido por sua ação citotóxica e antitumoral. Assim, a planta C. sylvestris apresenta um enorme arsenal farmacológico já mundialmente comprovado por seu vasto uso popular, estimulando pesquisas por novas moléculas e a busca pela compreensão de suas propriedades biológicas.

Revisión de la toxicocinética y la toxicodinamia del ácido cianhídrico y los cianuros / Review of toxicokinetics and toxicodynamics of cyanides and hydrogen cyanide

El cianuro es uno de los tóxicos más peligrosos por su rápida y potente acción, muchas veces letal. Los diferentes tratamientos de la intoxicación tienen su base o explicación en el conocimiento de la toxicocinética y la toxicodinamia. La revisión de la toxicocinética del cianuro muestra que, si bien la vía de la tiosulfato-cianuro sulfotransferasa (rodanasa) es la principal vía metabólica, el complejo con albúmina sérica sería el primer proceso de detoxificación del cianuro en el metabolismo normal. El efecto protector de formadores de cianhidrinas en casos de intoxicación sigue siendo evaluado a nivel experimental. Los estudios actuales sobre la toxicodinamia del cianuro se enfocan en la afinidad de la unión del cianuro al centro binuclear hemo a3-CuB de la citocromo oxidasa en sus diferentes estados redox y enel mecanismo de inhibición de enzimas antioxidantes. Un mayor y mejor entendimiento de la detoxificación del cianuro así como de los mecanismos de acción tóxica podrían llevar al desarrollo de potenciales antídotos.

Cyanide is one of the most dangerous poisons because of its rapid and potent toxicity, most times with lethal outcomes. Different poisoning treatments are based on knowledge of cyanide’s toxicokinetic and toxicodynamic. The review of cyanide’s toxicokinetics shows that, although thiosulfate-cyanide sulfotransferase (rhodanese) is the major metabolic pathway, binding serum albumin would be the first process of detoxification of cyanide in normal metabolism. The protective effect of cyanohydrin formers in cases of poisoning remains experimentally evaluated. Cyanide’s binding affinity to the binuclear center heme a3-CuB of cytochrome oxidase within their different redox states and cyanide’s mechanism of inhibition of antioxidant enzymes are currently still being investigated. More and better understanding of cyanide’s detoxification pathways and/or mechanisms of toxic action could lead to the development of new potential antidotes.

Cuadros tóxicos producidos por mordeduras de araña en Chile: latrodectismo y loxoscelismo / Toxic pictures produced by spider bites in Chile: latrodectism and loxoscelism

Latrodectism, produced by the bite of Latrodectus spiders, is worldwide distributed, occurs in hot seasons, and affects mostly men when carrying out agricultural activities. The main symptoms are muscular pain and tremors, profuse perspiration, increased lacrimal, nasal and salival secretions, and hypertension. Symptoms last one week. Neostigmine is a very efficient drug in the treatment of this condition. Loxoscelism, caused by the bite of Loxosceles spiders, is worldwide distributed, affects individuals of all ages. It may present two clinical forms: cutaneous loxoscelism (CL) and viscerocutaneous loxoscelism (VCL). Both forms have been registered in all seasons, with a higher incidence in hot periods, and in bedrooms, when the person is sleeping or dressing. The cutaneous surface of limbs and face are most frequently affected. Local clinical manifestations are pain, edema and livedoid plaque, most of which evolve into a necrotic scar in CL, whereas hematuria, hemoglobinuria, jaundice, fever and sensorial involvement characterize VCL. If visceral involvement does not appear within 24 hours, it is probable that the diagnosis corresponds to CL, with a good prognosis. If a VCL patient survives 48 hours, the possibilities of recovery are high. The patients are successfully treated with parenteral antihistamines or corticosteroids in CL and corticosteroids in VCL

Desenvolvimento de forma farmacêutica contendo gangliosídeo-GM1 e avaliação in vitro de sua atividade como antídoto para lítio e ferro / Development of pharmaceutical preparation containing ganglioside-GM1 and in vitro evaluation of its activaty as antidote for lithium and iron

Intoxicações constituem sério problema na prática médica, sendo que intoxicações por medicamentos, acidentais ou intencionais, são consideradas principal ocorrência em medicina. Nos casos de intoxicações orais, a conduta geral de emergência corresponde a métodos de descontaminação gastrintestinal visando a diminuição da quantidade de substância absorvida. Neste caso, destaca-se a utilização de carvão ativado como agente adsorvente. Embora seja considerado "antidoto universal", sua efetividade é reduzida ou nula em casos de intoxicações por íons, como, por exemplo, lítio e ferro...

Reversal by methylene blue of tetanic fade induced in cats by nitric oxide

Previous data from our laboratory have indicated that nitric oxide (NO) acting at the presynaptic level increases the amplitude of muscular contraction (AMC) of the phrenic-diaphragm preparations isolated from indirectly stimulated rats, but, by acting at the postsynaptic level, it reduces the AMC when the preparations are directly stimulated. In the present study we investigated the effects induced by NO when tetanic frequencies of stimulation were applied to in vivo preparations (sciatic nerve-anterior tibial muscle of the cat). Intra-arterial injection of NO (0.75-1.5 mg/kg) induced a dose-dependent increase in the Wedensky inhibition produced by high frequencies of stimulation applied to the motor nerve. Intra-arterial administration of 7.2 mug/Kg methylene blue did not produce any change in AMC at low frequencies of nerve stimulation (0.22 Hz), but antagonized the NO-induced Wedensky inhibition. The experimental data suggest that NO-induced Wedensky inhibition may be mediated by the guanylate cyclase-cGMP pathway.

Medicinal utilization of naturally occurring rocks and minerals

The importance of pharmaceutical minerals and rocks have been highlighted. The use of rocks and minerals to produce finished pharmaceutical products find their way for curative and promotive health. A detailed listing of the compounds, naturally occurring minerals as well as rocks and their application if delineated herewith

Antidotismo em urgência Toxicológica: a situaçäo do estoque básico de antídotos na cidade de Joäo Pessoa / Storage of antidotes in hospital pharmacies used in urgent cases in Joäo Pessoa city

Neste trabalho foi arrolada a situaçäo dos Hospitais da cidade de Joäo Pessoa que atendem casos de intoxicaçäo aguda, no que diz respeito ao estoque de antídotos na Farmácia Hospitalar para utilizaçäo urgente em caso de emergência Toxicológica. É proposta a manutençäo de um banco de antídotos no Centro de Informaçäo Toxicológica do Hospital Universitário Lauro Wanderlei da UFPB que atuaria como referencial para todo o Estado da Paraíba na distribuiçäo desses medicamentos mantidos pelo Sistema Tnico de Saúde (SUS). Uma abordagem geral sobre a importância do tratamento antidotal na intoxicaçäo aguda é apresentada

Fat and oil inhibit phosphine release from aluminium phosphide--its clinical implication.

Poisoning by suicidal or accidental ingestion of aluminium phosphide (AlP) is a frequent medical emergency seen all over the world. AlP, a grain fumigant and rodenticide, on exposure to moisture, liberates highly toxic gas, phosphine. The rapidly inhibits mitochondrial respiration and has cytotoxic action. No specific antidote is known against it till date and prognosis depends much on dose and time lag between AlP ingestion and the stomach wash in the hospital (critical period). Physicochemical properties of AlP and nonmiscibility of fat and water promoted us to study the effect of different fats and oils as possible antidotes to inhibit phosphine liberation. In vitro experiments revealed that vegetable oils and liquid paraffin were much more effective than butter and ghee in inhibiting release of phosphine from AlP. These findings may have significant clinical implication.

Antídotos de uso reciente

Los antídotos son sustancias cuya función es contrarrestar el efecto farmacológico y tóxico de otras sustancias, teniendo en cuenta la importancia de las medidas generales en el manejo del intoxicado (baño general, emesis, lavado gástrico, carbón activado, catárticos). Cada día aparecen sustancias nuevas con dichas características. En el presente artículo se pretende dar información breve y detallada sobre las propiedades farmacológicas, indicaciones, dosificación, efectos secundarios y contraindicaciones de algunos de uso general (carbón activado, soluciones electrolíticas con polietilenglycol) y principalmente de algunos específicos de uso reciente: flumazenil, fragmentos Fab-antidigoxina, glucagón, naloxona, clonidina, N-acetil-cisteína, azul de metileno, nitrito y tiosulfato de sodio, ácido-2-3-dimercaptosuccínico, penicilina benzatínica, glicopirrolato y S-adenosil-metionina.

Curative effect of methionine on certain enzymes of chick kidney cortex under lanthanum toxicity situation.

Acute single dose administration of lanthanum chloride (250 mg/kg body wt, ip) to chicks have been found to alter the levels of enzymes of the antioxidant defence system of chick renal cortex fractions. Such changes involved significant decrease in activities of glucose-6-phosphate dehydrogenase, glutathione reductase, glutathione peroxidase and catalase of kidney epithelial cells. However glutathione-S-transferase activity was not altered. Glutathione and total thiol contents were decreased while lipoperoxidative reactions in kidney-cortex was significantly enhanced. The data indicate that amelioration of lanthanum toxicity condition by methionine supplementation may be due to the methionine serving as a precursor of glutathione.