Trastornos motores esofágicos en pacientes pediátricos con estenosis cáustica

Objetivo: evaluar la función motora esofágica en niños con antecedente de dilataciones esofágicas endoscópicas por estenosis cáustica. Método: Estudio transversal prospectivo que incluyó: endoscopia digestiva superior con toma de biopsia en esófago distal, manometría esofágica y pHmetría intraesofágica de 24 horas. Resultados: Seis pacientes presentaron esofagitis cáustica IIB, cuatro esofagitis cáustica IIIA y uno esofagitis cáustica IIIB en el momento del accidente. Seis (54,5%) pacientes mostraron motilidad inefectiva y 4 (36,3%) aperistalsis del cuerpo esofágico. Al correlacionar la lesión esofágica al momento de ingerir el caústico con la alteración en la motilidad del esófago observada en la manometría no se apreció asociación estadística (p=0,2). Tampoco hay asociación entre la alteración de la motilidad esofágica y el tiempo de evolución desde el accidente hasta el momento de este estudio (p=0,9). Se demostró asociación estadística significativa entre la alteración motora esofágica y el número de dilataciones esofágicas endoscópicas, asi como con el tiempo que ameritó el paciente para resolver la estenosis. Conclusiones: Los pacientes que ingieren cáusticos y sufren lesiones esofágicas de moderadas a severas tienen una alta probabilidad de presentar trastornos motores importantes. Se demuestra la asociación entre el número de dilataciones necesarias para resolver la estenosis cáustica y la aperistalsis de todo el esófago.

Objective: to evaluate esophageal motor function in children with a history of endoscopic esophageal dilations due to caustic stenosis. Method: a prospective cross-sectional study that included: upper GI endoscopy with biopsy taken at the distal esophagus, esophageal manometry and 24 hours pH metry. Results: Six patients presented/displayed caustic esophagitis IIB, four caustic esophagitis IIIA and one caustic esophagitis IIIB at the moment of the accident. Six (54.5%) patients showed inefective motility and 4 (36.3%) aperistalsis of the esophageal body. When correlating the esophageal injury at the time of ingesting the caustic with the motility disorder of the esophagus shown during manometry there was no statistical association (p=0, 2). There is also no correlation between the alteration of the esophageal motility and the time of evolution from the accident to the moment of this study (p=0,9). A statistical significant association was demonstrated between the esophageal motor disorder and the number of endoscopic dilations, as well as with the time needed to solve the stenosis. Conclusions: Patients who ingest caustics and suffer moderate to severe esophageal injuries have a high probability of presenting/displaying important motor disorders. We demonstrate the association between the number of dilations necessary to solve the stenosis and the aperistalsis of the esophagus.

Detection of glutamate dehydrogenase enzyme activity in Plasmodium falciparum infection.

We describe the separation of an active glutamate dehydrogenase [GDH (NADP+)] enzyme from the plasma of patients with P. falciparum infection using columns of sepharose anti-GDH (NADP+) of Proteus spp. The activity of this enzyme was also detected in P. falciparum culture supernatant. The parasitic origin of this enzyme was suggested by western blot analysis using anti-P. falciparum culture supernatant and anti-whole parasite antibodies. The differential inhibition of the P. falciparum GDH (NADP+) indicates that some epitopes recognised by the antibodies in both preparations may be different. The determination of P. falciparum GDH (NADP+) activity could be developed into a specific technique for the diagnosis of falciparum malaria.

Characterization of Plasmodium falciparum glutamate dehydrogenase-soluble antigen

The major aim of this study was to characterize a soluble Plasmodium falciparum antigen from the plasma of malaria-infected humans and Plasmodium falciparum culture supernatants, using immunoabsorbent techniques and Western blotting. An Mr 60-kDa protein was isolated from the plasma of patients with Plasmodium falciparum malaria by affinity chromatography using rabbit anti-Proteus spp GDH(NADP+) serum as ligand. This protein, present in plasma of patients with acute Plasmodium falciparum infection, in Plasmodium falciparum culture supernatants, and in immune complexes, was tested with Plasmodium falciparum malaria hyperimmune serum from patients living in hyperendemic areas and rabbit anti-Proteus spp GDH(NADP+) serum prepared in the laboratory. In this report, we describe the results of a study showing that parasite GDH(NADP+) can be used to detect the presence of Plasmodium falciparum. It appears that this technique permits the chromatographic detection of a Plasmodium falciparum excretion antigen that may be used in the production of monoclonal antibodies to improve immunodiagnostic assays for the detection of antigenemia, and opens the possibility of its use as a non-microscopic screening method.

Un caso de envenenamiento ofídico por Cuima (Lachesis muta muta), en Venezuela / A case of poisoning by venous cuaima (Lachesis muta muta), in Venezuela

Los autores exponen un caso por envenenamiento ocasionado por serpiente conocida vulgarmente como Cuaima, cuyo habitat se encuentra en el neotrópico, con referencia especial a Venezuela, donde se han conprobado la existencia de Lachesis muta muta, con limitada distribución geográfica en el país, principalmente en las áreas de selva tropical de los estados Bolivar, Monagas, Amazonas y Delta Amacuro. La serpiente es muy temida por sus grandes dimensiones y la enorme cantidad de veneno que posee, afortunadamente son escasos los accidentes provocados por ella, por ende no constituye un grave problema de salud pública. Su veneno, aunque débil es neurotóxico, proteolitico y hemorrágico; probablemente miotóxico. El caso de envenenamiento accidental de un adulto de 29 años de edad, por la mordedura de una Cuaima, tratado con suero antiofídico polivalente (Facultad de Farmacia de la Universidad Central de Venezuela), hospitalizado e internado en una Unidad de Terapia Intensiva por presentar trastornos de coagulación, de dificil remisión