Infección cutánea por aeromonas / Aeromonas infection of the skin

Aeromonas spp. son bacilos Gram negativos, anaerobios facultativos. Su hábitat habitual es el medio ambiente. El cuadro clínico más frecuente es lagastroenteritis aguda, pero con menor frecuencia pueden causar infecciones extraintestinales, como infecciones de piel y partes blandas.Se comunica un caso de un paciente de 74 años que realiza tareas de jardinería, que consulta por una lesión dolorosa en dorso de mano, de 3 mesesde evolución, sin respuesta a tratamientos antibióticos con cultivo positivo para Aeromonas spp (AU)

Aeromonas spp. are anaerobic Gram negative bacillae. They are widely distributed in the environment. They typically cause gastroenteritis, but canoccasionally produce extraintestinal infections, such as skin and soft tissue infections.A 74 year old male, occasional gardener, complains with a painful lesion of the hand of three months of evolution. He had been treated unsuccessfullywith various antibiotics. Aeromonas spp. were isolated from the skin culture (AU)

Escorbuto: una entidad que aún existe en la medicina moderna / Scurvy still exists in modern medicine

El escorbuto es un trastorno nutricional secundario al déficit corporal de vitamina C. Comunicamos el caso de un paciente de 37 años que consulta por lumbalgia e impotencia funcional de ambos miembros inferiores asociadas ahemorragias mucocutáneas. Destacamos que es su antecedente personal de déficit de vitamina C en la ingesta lo que, sumado a las características lesiones cutáneas, permite diagnosticar la enfermedad (AU)

Scurvy is a nutritional disorder due to vitamin C deficiency.We communicate the case of a 37-year-old patient who came to us with lumbar pain and lower limbs disability, asuell as, mucosa and cutaneous hemorrhages.We remark that dietary history leads to a rapid diagnosis when characteristic cutaneous lesions are present (AU)

Treatment of linear and spider telangiectasia with an intense pulsed light source.

BACKGROUND: The flashlamp-pumped pulsed dye laser (585 and 577 nm) has proved to be an effective and safe treatment option in the therapy of linear and spider facial telangiectasia. Nevertheless, the postoperative purpura, which most patients see as cosmetically disfiguring, has always been a matter of concern. AIMS: To test the effectiveness and safety of an intense pulsed light source (IPLS), which emits non-coherent light adjustable within the 515-1200 nm range, in the treatment of linear and spider facial telangiectasia. PATIENTS & METHODS: One hundred and forty patients with linear and stellate facial telangiectasia were treated with an IPLS. RESULTS: In 94 (67.1%) the results were considered excellent (clearance of 80-100%), 43 (30.7%) showed good results (clearance of 40-80%) and in 3 patients (2.1%) the results were poor (clearance < 40%). Post-treatment side effects were minimal and well tolerated. There were no instances of scarring or other permanent side effects. Owing to the large spot size, a large area could be treated within one session. No anaesthesia was required. CONCLUSION: IPLS is a highly effective and comparably safe therapeutic alternative to the pulsed dye laser in the treatment of facial telangiectasia. The rate of cosmetically relevant side effects is considerably smaller, patient compliance is excellent and the method can easily be applied in an outpatient setting.

Piomiositis no tropical y síndrome de superposición: lupus / Sjõgren / Nontropical pyomyositis and overlap syndrome: systemic lupus erythematosus and Sjõgren syndrome

La Piomiositis (PMS) es una infección primaria del músculo estriado, con progresión insidiosa de una colección purulenta, que se presenta generalmente en áreas tropicales denominándose por esa razón PMS tropical. La incidencia de PMS se ha incrementado últimamente en zonas templadas, denominándose a esta entidad como PMS no tropical, ya que existen algunas características que la diferencian de la PMS clásica. Presentamos el caso de una mujer de 39 años de edad con Síndrome de Superposición, Lupus Erimatoso Sistémico (LES) / Síndrome de Sjõgren (SS), que presentó durante la evolución de su enfermedad una PMS no tropical como ampliación atípica.

Acute and chronic effects of cadmium on blood homeostasis of an estuarine crab, Chasmagnathus granulata, and the modifying effect of salinity.

Whole body oxygen consumption and some hemolymph parameters such as pH, partial pressure of gases, level of ions and lactate were measured in the estuarine crab Chasmagnathus granulata after both acute (96 h) and chronic (2 weeks) exposure to cadmium at concentrations ranging from 0.4 to 6.3 mg/l. In all instances, the crabs developed hemolymph acidosis, but no respiratory (increased PCO2) or lactate increases were evident. Hemolymph levels of sodium and calcium were always increased by cadmium exposure. The chronic toxicity of cadmium was enhanced at 12 per mil salinity, even causing a significantly higher mortality in comparison with the higher salinity (30 per mil ) used. A general metabolic arrest took place at 12 per mil salinity in the crabs chronically exposed to cadmium, as indicated by decreases of oxygen consumption and PCO2, an increase of PO2, along with no changes in lactate levels. These imbalances were associated with severe necrosis and telangiectasia in the respiratory gills, probably leading to respiratory impairment and finally histotoxic hypoxia and death of the animals.

Acute and chronic effects of cadmium on blood homeostasis of an estuarine crab, Chasmagnathus granulata, and the modifying effect of salinity

Whole body oxygen consumption and some hemolymph parameters such as pH, partial pressure of gases, level of ions and lactate were measured in the estuarine crab Chasmagnathus granulata after both acute (96 h) and chronic (2 weeks) exposure to cadmium at concentrations ranging from 0.4 to 6.3 mg/l. In all instances, the crabs developed hemolymph acidosis, but no respiratory (increased PCO2) or lactate increases were evident. Hemolymph levels of sodium and calcium were always increased by cadmium exposure. The chronic toxicity of cadmium was enhanced at 12 0/00 salinity, even causing a significantly higher mortality in comparison with the higher salinity (30 0/00) used. A general metabolic arrest took place at 12 0/00 salinity in the crabs chronically exposed to cadmium, as indicated by decreases of oxygen consumption and PCO2, an increase of PO2, along with no changes in lactate levels. These imbalances were associated with severe necrosis and telangiectasia in the respiratory gills, probably leading to respiratory impairment and finally histotoxic hypoxia and death of the animals

The morphometric changes in the gills of the estuarine crab Chasmagnathus granulatus under hyper- and hyporegulation conditions are not caused by proliferation of specialised cells.

Chasmagnathus granulatus is a hyper-hyporegulating crab that inhabits changing habitats of salinity in Brazil, Uruguay and Argentina. Since the gills are the main sites for active ion transport in crabs, the adaptive changes in the gill epithelium occurring under different conditions of salinity were studied by means of morphological and morphometric analysis, and immunohistochemical identification of cell proliferation (BrdU technique). In anterior (1-3) gills the epithelium thickness from crabs acclimatised to 12, 34 and 44 g/l ranged from 1.27 to 2.46 microm, with no significant change during acclimatisation, thus denoting a respiratory function. Medial (4-5) gill epithelium was slightly thicker in extreme salinities, but these differences were not statistically significant. In contrast, epithelial thickness of the posterior (6-8) gills increased significantly up to 8.10 microm (dorsal zone of gill 8) both in hyper- and hyposaline media compared with seawater. The dark areas measured in gill 8 treated with AgNO3 revealed putative ion transporting tissue, especially at 12 and 44 g/l, corresponding to the zones of higher epithelial thickness. Hence these areas seem to participate both in hyper- and hyporegulation. Proliferating cells labelled with BrdU almost never occurred in the gills/salinity combinations studied during the initial 48 h of transfer from seawater to hyperconcentrated or diluted media, thus suggesting an increase in cell size rather than cell proliferation.

Bimodal breathing in the estuarine crab Chasmagnathus granulatus Dana 1851--physiological and morphological studies.

Chasmagnathus granulatus is an estuarine crab which actively moves from subtidal to supratidal areas. To elucidate the possible existence of extrabranchial sites for aerial gas exchange, we measured respiratory and acid-base variables in animals with and without branchial water (controls and experimental crabs, respectively) during air exposure. An histological study of the branchiostegite was also performed. Throughout 4 h of emergence C. granulatus did not suffer venous hypoxia, even without branchial water. The rate of oxygen uptake (M(O(2))) was similar in both groups. The rate of carbon dioxide excretion (M(CO(2))) and the gas exchange ratio (R) significantly decreased during emergence in both groups, with R significantly lower for experimental crabs. Consequently, CO(2) was accumulated in the hemolymph. This variable stabilized after 90 min in control animals, but experimental crabs continued accumulating CO(2). Histological study of the branchiostegites demonstrated the presence of an attenuated and greatly perfused epithelium facing the branchial chamber lumen, with a shortest diffusion distance of 0.5 microm. Simple folds and lobulated projections increase the respiratory surface area. These results suggest that C. granulatus is a bimodal breathing crab, active both in water and air. When emerged, this species extract oxygen directly from air through branchiostegal lungs, but relies on branchial exchange to eliminate carbon dioxide.

Sunbed use in Buenos Aires, Argentina.

The objectives were to survey tanning salons in a defined geographic area of Buenos Aires city and to assess the information offered to consumers regarding chronic exposure to ultraviolet radiation, types of radiation used, and safety measures employed. A prospective study using a standardized interview with limited multiple choice responses for data collection was conducted. Results of the interview survey were that 35% of the establishments (tanning salons) said they used UVA exclusively, 6% UVB, and 25% both; 35% did not know the type of radiation to which their clients were exposed. Sunbeds were promoted as healthy in 56% of the tanning salons, whereas potential risks were mentioned in only 15%. One to 3 sessions on the same day were allowed by 84%, while 40% allowed customers to choose the number of weekly sessions. The use of goggles was optional in 65% of the establishments and 21% did not even provide goggles. Use of sunscreens was not compulsory, and none of the salons had associated physicians. Previous history of skin cancer, sunburn or potential photosensitive drug intake were never recorded, and the age of access was not restricted in 71% of the establishments. In Argentina there are no guidelines to regulate the operation of tanning salon establishments or the equipment they use, and there are no specific measures taken to prevent skin and ocular pathologies. Ways to reduce the risks of ocular and skin pathologies from artificial tanning in Argentina are urgently needed.

Equivalent therapeutic efficacy and safety of ivermectin and lindane in the treatment of human scabies.

OBJECTIVE: To compare the therapeutic efficacy and safety of ivermectin and lindane for the treatment of human scabies. DESIGN: Randomized, prospective, controlled, double-blind, "double-dummy," and parallel clinical study. SETTING: A single department of dermatology at a hospital in Buenos Aires, Argentina. PATIENTS: Patients were outpatients, hospitalized patients, and those referred to our hospital from nursing homes and asylums. Fifty-three patients had clinical signs and symptoms compatible with scabies. INTERVENTION: Patients received either a single oral dose of ivermectin (150-200 microg/kg of body weight) or a topical application of 1% lindane solution. Treatment was repeated after 15 days if clinical cure had not occurred. MAIN OUTCOME MEASURES: Clinical healing and adverse effects. RESULTS: Of 53 patients, 43 (81%) completed the study, 19 in the group treated with ivermectin and 24 in the group treated with lindane. At day 15, 14 patients (74%; 95% confidence interval, 48.8%-90.8%) in the group receiving ivermectin showed healing of their scabies and 13 patients (54%; 95% confidence interval, 32.8%-74.4%) in the group treated with lindane were healed. At 29 days, both treatments resulted in statistically equivalent therapeutic efficacy: 18 patients (95%; 95% confidence interval, 74.0%-99.9%) were healed with ivermectin and 23 patients (96%; 95% confidence interval, 78.9%, 99.9%) were healed with lindane (P<.02). Adverse effects from the treatments were few, mild, and transient. Results from laboratory tests showed no major abnormalities and no difference between treatments. CONCLUSIONS: Ivermectin is as effective as lindane for the treatment of scabies. Ivermectin is simpler to use and, therefore, is a promising tool to improve compliance and to control infestations.

Salinity-induced changes in the fine structure of the gills of the semiterrestrial estuarian crab, Uca uruguayensis (Nobili, 1901) (Decapoda, Ocypodidae).

The posterior gills of Uca uruguayensis are mostly lined with a thick tissue which presents the characteristics of a typical salt-transporting epithelium. Electron microscope analysis of gill tissue from crabs acclimated to both low (2.5 per thousand) and high (44 per thousand) salinity showed significant development of the basolateral membrane interdigitations with numerous mitochondria and conspicuous apical membrane infoldings. In high-salinity acclimated crabs, the basolateral interdigitations extended to the apical membrane. Under these conditions, apical infoldings were expanded laterally (forming wide subcuticular spaces), while the apical infoldings of low-salinity adapted animals appeared as regular leaflets. Septate desmosomes were also much more developed in low-salinity exposed animals than in those kept under high-salinity conditions. These morphological observations were analyzed for correlation with the currently-accepted ion hyporegulation model for crustaceans, which is mainly based on transcellular sodium flow. In this study, we propose an ion hyporegulation model involving apical paracellular sodium flux.

[Aplasia cutis congenita. Commentary on 5 cases]. / Aplasia cutis congénita. Comentario sobre cinco casos.

Five cases of aplasia cutis congenita are presented, three of them with the classic localization of the scalp. The fourth case involves the lower extremities and the fifth, the trunk. The malformations associated to each case are described. A review of the existing literature and of possible etiologies is done.

Razoxane y teleroentgen radiación en psoriasis resistentes al PUVA y al metotrexato / Razoxane and teleroentgentherapy in psoriasis resistent to PUVA and methotrexate

Se describe la experiencia clínica con el uso de Razoxone ICRF 159, una nueva droga antitumoral, en el tratamiento de 57 pacientes con formas severas de psoriasis. Esta medicación demostró ser efectiva sobre todo en las formas generalizadas eritrodérmicas y con compromisos articulares. Es bien tolerada y parece estar libre de hepatotoxicidad; sin embargo puede producir depresión medular, efecto que está directamente relacionado con la dosis. Se investigó su asociación con teleroentgenterapia por su propiedad radiopotenciadora (AU)

Razoxane y teleroentgen radiación en psoriasis resistentes al PUVA y al metotrexato / Razoxane and teleroentgentherapy in psoriasis resistent to PUVA and methotrexate

Se describe la experiencia clínica con el uso de Razoxone ICRF 159, una nueva droga antitumoral, en el tratamiento de 57 pacientes con formas severas de psoriasis. Esta medicación demostró ser efectiva sobre todo en las formas generalizadas eritrodérmicas y con compromisos articulares. Es bien tolerada y parece estar libre de hepatotoxicidad; sin embargo puede producir depresión medular, efecto que está directamente relacionado con la dosis. Se investigó su asociación con teleroentgenterapia por su propiedad radiopotenciadora

Razoxane in the treatment of psoriatic patients resistant to or intolerant of PUVA, methotrexate and etretinate.

Thirty-six psoriatic patients resistant to or intolerant to PUVA, methotrexate and/or etretinate were treated with razoxane (ICRF 159) and EDTA derivative with antimitotic effects. The drug is highly effective in cutaneous and arthropathic psoriasis. Razoxane is well tolerated and appears to be free of hepatotoxicity. Besides some nausea and lethargy, 60% of the patients showed neutropenia, which can be easily controlled.