ABSTRACT
BACKGROUND: Ciprofloxacin is a fluoroquinolone antibiotic widely used in clinical practice with a fluorine atom in its chemical structure. Like other antibiotics, it can induce several adverse effects, such as tendinopathy, musculoskeletal toxicity, peripheral neuropathy, and cardiotoxicity, thereby causing relevant and irreversible health injuries. Ciprofloxacin fluoride's adverse toxicological effect associated with a urinary fluoride concentration above the reference value has not yet been reported. OBJECTIVE: This case report aimed to provide evidence of ciprofloxacin treatment intoxication, an antibiotic containing a fluorine atom in its chemical structure, associated with a fluoride urine concentration above the reference value. CASE PRESENTATION: A 32-year-old man developed tendinopathy and peripheral neuropathy on the third day's night after initiating the ciprofloxacin doses, exhibiting symptoms comparable to a low-power electrical discharge and very intense motor agitation. After following habitual laboratory exams, a urinary fluoride measurement was performed by an ion-selective electrode. The urinary fluoride concentration was above the reference values in mg/g of creatinine. CONCLUSION: This is the first study that has described an association among ciprofloxacinfluoride, tendinopathies, and peripheral neuropathy. The patient's symptomatology has suggested a toxic effect related to fluoride. We consider the documented finding of a fluorine atom at the ciprofloxacin structure and its toxic potential neuropathies and tendinopathies as an issue of alert.
ABSTRACT
Arsenic and its inorganic compounds affect numerous organs and systemic functions, such as the nervous and hematopoietic systems, liver, kidneys, and skin. Despite a large number of studies on arsenic toxicity, rare reports have investigated the leukopenia incidence in workers exposed to arsenic. In workplaces, the main source of workers' exposure is the contaminated air by the inorganic arsenic in mines, arsenic or copper smelter industries, and chemical factories. Erythropoiesis inhibition is one of the arsenic effects and it is related to regulatory factor GATA-1. This factor is necessary for the normal differentiation of early erythroid progenitors. JAK-STAT is an important intracellular signal transduction pathway responsible for the mediating normal functions of several cytokines related to cell proliferation and hematopoietic systems development and regulation. Arsenic inactivates JAK-STAT by inhibiting JAK tyrosine kinase and using the IFNγ pathway. The intravascular hemolysis starts after the absorption phase when arsenic binds to the globin of hemoglobin in erythrocytes and is transported into the body, which increases the oxidation of sulfhydryl groups in hemoglobin. So, this article intends to highlight the potential leukopenia risk via inhalation for workers exposed to arsenic and suggests a possible mechanism for this leukopenia through the JAK-signal transducer and activator of transcription (STAT) pathway inhibition.
Subject(s)
Arsenic , Leukopenia , Occupational Exposure , Humans , Occupational Exposure/adverse effects , Arsenic/toxicity , Leukopenia/chemically induced , Signal Transduction/drug effects , STAT Transcription Factors/metabolism , Janus Kinases/metabolismABSTRACT
Objetivo: este estudo teve como objetivo avaliar o grau de ansiedade dos acadêmicos de uma instituição de ensino superior privada. Métodos: foi realizada uma pesquisa de corte transversal com abordagem descritiva, quantitativa e observacional em 366 alunos aleatoriamente escolhidos que estavam matriculados no primeiro semestre do ano de 2019. A coleta de dados foi realizada por meio de um questionário com questões sociodemográficas-comportamentais e questões do Inventário de Ansiedade Beck. Os graus de ansiedade (mínimo ou ausente, leve, moderado e grave) foram determinados pelo somatório dos escores do inventário de Beck. Resultados: do total da amostra, 62,3% apresentou algum grau de ansiedade, sendo os cursos da área de saúde os que mais apresentaram estudantes com graus de ansiedade. O sexo e a idade foram as variáveis que apresentaram correlação significativa com os graus de ansiedade. Conclusão: este estudo alerta sobre a ocorrência de transtornos de ansiedade em estudantes universitários, o que implica em uma necessidade crescente de estratégias, dentro do ambiente acadêmico, para reverter e evitar o desencadeamento de patologias de saúde mental nos universitários.
Aims: this study aimed to evaluate the degree of anxiety of academics from a private higher education institution. Methods: a cross-sectional, descriptive, quantitative and observational study was conducted in 366 randomly selected students enrolled in the first semester of 2019. Data collection was performed through a questionnaire with sociodemographic-behavioral questions and questions of the Beck Anxiety Inventory. The degrees of anxiety (minimal or absent, mild, moderate, and severe) were determined by the sum of Beck's inventory scores. Results: of the total sample, 62.3% presented some degree of anxiety, and the courses in the health area presented the most students with degrees of anxiety. Sex and age were the variables that showed a significant correlation with the degrees of anxiety. Conclusion: this study warns about the occurrence of anxiety disorders in university students, which implies a growing necessity for strategies within the academic environment to revert or prevent the onset of mental health pathologies in university students.