Vasculitis inducida por cocaína-levamisol con manifestaciones cutáneas, articulares y abdominales: reporte de caso / Cocaine-levamisole induced vasculitis with cutaneous, joint and abdominal manifestations: case report

Resumen El levamisol es un antiparasitario de uso veterinario que actualmente es empleado para aumentar el volumen y la potencia de la cocaína. La mezcla de estas dos sustancias puede causar un cuadro caracterizado por lesiones propias de la cocaína, como la afección del cartílago septal con perforación del tabique nasal, y vasculitis cutánea de pequeños vasos con afectación de los pabellones auriculares y del cartílago nasal, afección conocida como vasculitis inducida por cocaína-levamisol (VICOL) que puede avanzar a necrosis e incluso ulceraciones cutáneas, asociadas a agranulocitosis, artralgias y glomerulonefritis . En el presente artículo se describe el caso de un paciente con historia de consumo de sustancias en quien se encontraron lesiones purpúricas palpables en miembros superiores, tronco, pabellones auriculares y miembros inferiores. Se consideró una clínica sugestiva de VICOL dado el antecedente de consumo de sustancias. En el proceso diagnóstico se descartaron entidades como la vasculitis por anticuerpos contra el citoplasma de los neutrófilos (ANCAs) y crioglobulinemia, entre otras posibles afecciones. Se llevó a cabo un tratamiento con esteroides y con ello presentó una respuesta adecuada, pero luego recurrieron los síntomas, particularmente abdominales, los cuales se consideraron asociados con vasculitis. Se le brindó manejo adicional con ciclofosfamida y nuevos pulsos de esteroides, con que se logró el control total de los síntomas. A través este caso se resaltan entonces los ejercicios diagnósticos y clínicos en la vasculitis cocaína- levamisol, y se sugiere la consideración de los síntomas abdominales como posible componente del cuadro vasculítico.

Abstract Levamisole is an antiparasitic agent for veterinary use. Currently it is used to increase the volume and potency of cocaine. Levamisole and cocaine combined result in the septum nasal perforation and small-vessel vasculitis in the ears and nasal cartilage. These findings are known as cocaine levamisole-induced vasculitis and can progress to necrosis and even skin ulceration, which is associated with agranulocytosis, arthralgia, and glomerulonephritis. This article describes the case of a patient with a history of substance abuse in whom palpable purpuric lesions were found in the upper and lower limbs, trunk, and ears. A clinical condition suggestive of vasculitis induced by cocaine-levamisole was considered, given the history of substance consumption. In the diagnostic process, entities such as Anti-neutrophil Cytoplasmic Antibodiy (ANCA) vasculitis and cryoglobulinemia, among other possible conditions, were ruled out. Steroid treatment was carried out, to which the patient had an adequate response, but then symptoms recurred, particularly abdominal, which were associated with vasculitis. Additional management with cyclophosphamide and new steroid pulses were provided, and with those symptom control was achieved. In this case report highlights the diagnostic and clinical exercises in cocaine levamisole vasculitis and is suggested the consideration of abdominal symptoms as a possible component of the vasculitis flare.

Biochemical characterization and cytotoxic effect of the skin secretion from the red-spotted Argentina frog Argenteohyla siemersi (Anura: Hylidae)

Argenteohyla siemersi (red-spotted Argentina frog) is a casque-headed tree frog species belonging to the Hylidae family. This species has a complex combination of anti-predator defense mechanisms that include a highly lethal skin secretion. However, biochemical composition and biological effects of this secretion have not yet been studied. Methods: The A. siemersi skin secretion samples were analyzed by mass spectrometry and chromatographic analysis (MALDI-TOF/MS, RP-HPLC and GC-MS). Proteins were also studied by SDS-PAGE. Among the biological activities evaluated, several enzymatic activities (hemolytic, phospholipase A2, clotting, proteolytic and amidolytic) were assessed. Furthermore, the cytotoxic activity (cytolysis and fluorescence staining) was evaluated on myoblasts of the C2C12 cell line. Results: The MALDI-TOF/MS analysis identified polypeptides and proteins in the aqueous solution of A. siemersi skin secretion. SDS-PAGE revealed the presence of proteins with molecular masses from 15 to 55 kDa. Steroids, but no alkaloids or peptides (less than 5 KDa), were detected using mass spectrometry. Skin secretion revealed the presence of lipids in methanolic extract, as analyzed by CG-MS. This secretion showed hemolytic and phospholipase A2 activities, but was devoid of amidolytic, proteolytic or clotting activities. Moreover, dose-dependent cytotoxicity in cultured C2C12 myoblasts of the skin secretion was demonstrated. Morphological analysis, quantification of lactate dehydrogenase release and fluorescence staining indicated that the cell death triggered by this secretion involved necrosis. Conclusions: Results presented herein evidence the biochemical composition and biological effects of A. siemersi skin secretion and contribute to the knowledge on the defense mechanisms of casque-headed frogs.(AU)

Sperm morphophysiology in different sections of the rooster reproductive tract / Morfofisiología espermática en diferentes secciones del tracto reproductivo del gallo

It is important to know the morphological changes that occur in the spermatozoa of rooster during their passage through the reproductive tract, which help to understand what they acquire their fertilization capacity. The morphophysiological changes related to the capacitation and acrosomal reaction processes in the different segments of the rooster reproductive system were analyzed. Samples were obtained from various regions of the rooster reproductive tract and dorso-ventral massage to obtain ejaculates, 25 roosters were used Rhode Island Red with proven fertility, assessments were performed with chlortetracycline and Lectin WGA-FITC to determine the morphophysiological parameters. Sperm motility increases (p<0.05) during the passage of spermatozoa from the testis until they are ejaculated. The parameters of viability and morphology also show differences (p<0.05) in the different segments of the tract. Sperm morphometry shows a spermatic contraction (p<0.05) in the cranial and medial segments of the vas deferens. The acrosomal reaction capacity evaluated with chlortetracycline (CTC) or Wheat germ agglutinin (WGA), was evident increasing the parameters (p<0.05) with the use of the perivitelline layer in the spermatozoa of the reproductive tract and of the ejaculate. Spermatozoa of the reproductive tract of the rooster demonstrate acrosomal reaction capacity without requiring a previous sperm capacitation condition. On the other hand, they do not show parameters of incapacity, which implies that they cannot be stored in any segment of the reproductive tract.

Es importante conocer los cambios morfológicos que se producen en los espermatozoides del gallo durante su paso por el tracto reproductivo y que ayudan a comprender como adquieren su capacidad de fertilización. Se analizaron cambios morfofisiológicos relacionados con los procesos de capacitación y reacción acrosomal de los espermatozoides presentes en los diferentes segmentos del tracto reproductor del gallo. Se obtuvieron espermatozoides de diferentes regiones del tracto reproductor del gallo y de espermatozoides de eyaculado. Se usaron 25 gallos Rhode Island Red con fertilidad probada. Se realizaron evaluaciones básicas, con clortetraciclina (CTC) y lectina Wheat germ agglutinin conjugada con isotiosionato de fluoresceína (WGA-FITC) para determinar los parámetros morfofisiológicos. La motilidad del esperma aumenta (P<0,05) durante el paso de los espermatozoides desde el testículo hasta que son eyaculados. Los parámetros de viabilidad y morfología también muestran diferencias (P <0,05) en los diferentes segmentos del tracto. La morfometría mostró una contracción de los espermatozoides (P<0,05) en los segmentos craneal y medial del conducto deferente. La capacidad de reacción acrosomal evaluada con clortetraciclina CTC o WGAFITC, fue evidente al aumentar los parámetros (P<0,05) con el uso de membrana perivitelina en los espermatozoides del tracto reproductivo y del eyaculado. los espermatozoides del tracto reproductivo del gallo demuestran capacidad de reacción acrosomal sin requerir una condición previa de capacitación espermática. Por otro lado, no muestran parámetros de descapacitación espermática lo que implica que no pueden almacenar en ningún segmento del tracto reproductivo.

Validación del uso tradicional de especies de asclepias contra el veneno de bothrops diporus (yarará chica) en el nordeste de Argentina / Validation of the traditional use of asclepias species against bothrops diporus (yarará chica) venom in northeast of Argentina

La familia Asclepiadaceae posee tradición en etnomedicina. En el nordeste argentino, A.mellodora y A. curassavica se utilizan como cataplasmas en accidentes de ofidios. En este trabajo, los extractos acuosos, etanólicos y hexánicos de A. mellodora y A. curassavica se evaluaron por SDS-PAGE para determinar su actividad alexitérica. El estudio in vitro de la capacidad inhibitoria de las actividades proteolítica, hemolítica indirecta y coagulante permitieron determinar que ambas especies manifiestan actividad, siendo A. mellodora más activa. Estadísticamente los extractos de A. mellodora fueron igualmente activos contra el veneno de Bothrops diporus y no mostraron diferencias significativas respecto del órgano utilizado en la inhibición de la actividad coagulante. Este resultado está en consonancia con la forma tradicional de su uso como cataplasma. Sobre el extracto etanólico de las raíces de A. mellodora se realizó un fraccionamiento bioguiado que permitió identificar fracciones de compuestos responsables de la actividad.

The Aclepiadaceae family has been reported by its use in ethnomedicine. In the northeast of Argentina, A. mellodora and A. curassavica are traditionally used in ofidic accidents as poultices. In this work, aqueous, alcoholic and hexanoic extracts were analyzed by SDS-PAGE to determine their anti-snake activity. The in vitro study of the inhibitory ability of the following activities: proteolytic, indirect hemolytic activity and inhibition of the coagulant activity, allowed demonstrating that both species were active against venom, being A. mellodora the most active. Statistically, all extracts of A. mellodora were active against venom in the inhibition of the coagulant activity, without significant differences with respect to the organ used; which is consistent with the traditional use as external poultice. The alcoholic extract of A. mellodora roots was subjected to a bio-guided separation. The fractions obtained were enriched in compounds which could probably be responsible for the activity against venom.