Hemophagocytic syndrome in patients infected with the human immunodeficiency virus: A study of 15 consecutive patients.

OBJECTIVE: Hemophagocytic syndrome (HPS) is characterized by various clinical and biological data derived from cytokine hyperproduction and cell proliferation. The objectives of this study were to evaluate the epidemiological, etiological, clinical and evolutionary characteristics of patients diagnosed with hemophagocytic syndrome and HIV infection, as well as their comparison with data from the literature. METHODS: A retrospective descriptive observational study was performed, including all adult patients with a diagnosis of HPS and HIV infection treated in the Infectious Diseases and Tropical Medicine Unit of the Hospital Universitario Insular, Las Palmas, Gran Canaria from June 1, 1998 to December 31, 2018. RESULTS: An analysis of this series of case reports of 15 patients showed a higher percentage of males than females, with a mean age of 42 years. With respect to the diagnostic criteria for HPS, presence of fever, cytopenias and hyperferritinemia were a constant in all patients. Clinical neurological manifestations were frequent and clinical respiratory signs and symptoms absent. HPS was confirmed in some patients who were not severely immune-depressed and had undetectable viral loads. Furthermore, 40% of cases were not receiving ART. The most frequent triggering causes of HPS were viral, especially HHV-8. In addition, two new HPS triggers were identified: Blastocystis dermatitidis and Mycobacterium chelonae. CONCLUSIONS: Administration of treatment in HPS is arbitrary. This, together with the high mortality rate and the fact that it is underdiagnosed, indicates the importance of conducting future studies.

Biochemical and biological analysis of Philodryas baroni (Baron's green racer; Dipsadidae) venom: relevance to the findings of human risk assessment.

Philodryas baroni--an attractively colored snake--has become readily available through the exotic pet trade. Most people consider this species harmless; however, it has already caused human envenomation. As little is known about the venom from this South American opisthoglyphous "colubrid" snake, herein, we studied its protein composition by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), as well as its effects on the hemostatic system. Both reducing and nonreducing SDS-PAGE analysis demonstrated that the venom exhibits greatest complexity in the range of 50-80 kDa. The venom displayed proteolytic activity toward azocollagen, with a specific activity of 75.5 U mg⁻¹, and rapidly hydrolyzed the Aα-chain of fibrinogen, exhibiting lower activity toward the Bß- and γ-chains. The venom from P. baroni showed no platelet proaggregating activity per se, but it inhibited collagen- and thrombin-induced platelet aggregation. Prominent hemorrhage developed in mouse skin after intradermal injection of the crude venom, and its minimum hemorrhagic dose was 13.9 µg. When injected intramuscularly into the gastrocnemius of mice, the venom induced local effects such as hemorrhage, myonecrosis, edema, and leucocyte infiltration. Due to its venom toxicity shown herein, P. baroni should be considered dangerous to humans and any medically significant bite should be promptly reviewed by a qualified health professional.

First Report of Fragaria chiloensis cryptic virus, Fragaria chiloensis latent virus, Strawberry mild yellow edge virus, Strawberry necrotic shock virus, and Strawberry pallidosis associated virus in Single and Mixed Infections in Strawberry in Central Mexico.

For phytosanitary purposes, the prevalence and incidence of viruses found in strawberry production within a centralized breeding program was investigated in Abasolo and Irapuato Counties, Guanajuato State, Mexico. Single and mixed infections of Strawberry mottle virus (SMoV) and Strawberry crinkle virus (SCV) were originally reported in the area (3), and subsequently, Strawberry latent ringspot virus (SLRSV) was also found (4). Samples of strawberry plants showing viral symptoms: stunting, mild chlorosis and reddening, occasional wrinkled, curled, and deformed leaves that may exhibit mottling, and chlorotic spots, forming a putative virus complex were collected in April and December 2007 and July and December 2008. The detection and identification of viruses reported in the United States, the country of origin of most of the imported plantlets, was carried out with sets of primers for 11 viruses, through reverse transcription (RT)-PCR (developed by Robert Martin and Ioannis Tzanetakis in Corvallis, OR). The endogenous NADH 2 subunit was employed to test the quality of the RNA extracted. Amplification conditions were: 40 cycles of 1 min at each temperature, denaturation at 95°C, annealing at 50°C for Strawberry necrotic shock virus (SNSV); 52°C for Strawberry mild yellow edge virus (SMYEV); 55°C for Fragaria chiloensis latent virus (FClLV), Strawberry pallidosis associated virus (SPaV), Fragaria chiloensis cryptic virus (FClCV), and SMoV; and 58°C for SCV and NADH dehydrogenase, followed by a final extension at 72°C of 5 min after completion of the 40 cycles. The cloning and nucleotide sequencing of amplified fragments revealed the presence of seven viral species in 40 samples collected. These were FClLV, SCV, SMoV, SNSV, SPaV, and SMYEV, which were allocated GenBank accession numbers of JQ629412, JQ629413, JQ629414, JQ629415, JQ629416, and JQ629417, respectively. Strawberry UC-4 and UC-10 (1,2) were planted as indicators of viral infections on an experimental plot. All seven viruses were detected in single or mixed infections. SMoV was the most commonly found in combination with other viruses. Out of 40 samples, 35 were positive for the presence of viruses and six had single infections, of which five had SMoV and one had SPaV. The remaining 29 samples had mixed infections with two or more viruses in a total of 22 combinations. The combination of FCICV + SMoV was present in five samples, whereas the combination of SMoV + SMYEV was in two samples. All other samples had two and up to six different viruses per plant. SMoV was detected in 26 out of the 40 samples tested. SNSV and FClCV were detected in 14 samples. SMYEV was present in 13 samples. SCV was present in nine samples, whereas SPaV and FClLV were found in eight samples each. To the best of our knowledge, this is the first report of FClLV, FClCV, SNSV, SMYEV, and SPaV in Mexico. References: (1) N. W. Frazier. Plant Dis. Rep. 58:28, 1974. (2) N. W. Frazier. Plant Dis. Rep. 58:203, 1974. (3) D. Teliz-Ortiz and A. Trejo-Reyes. Rev. Mex. Fitopatol. 7:38, 1989. (4) L. Pérez-Moreno et al. Rev. Mex. Fitopatol. 22:187, 2004.

Diagnosis and management of hypersensitivity reactions caused by oxaliplatin.

Hypersensitivity reactions to oxaliplatin have been increasing since its introduction at the end of the 1990s, but allergy tests with antineoplastic drugs are rarely used to aid diagnosis. We describe 5 cases in which hypersensitivity reactions to oxaliplatin after several courses of chemotherapy were managed by allergy testing and desensitization. Skin prick tests were negative at 1 mg/mL in all patients, positive at 10 mg/mL in 2 tested patients, and negative in 10 control subjects. Intradermal tests were positive and not irritant at 0.01 to 0.001 mg/mL concentrations. A desensitization protocol with increasing concentrations and flow rates was successfully completed in all patients. We conclude that prick and intradermal skin tests are useful in the diagnosis of hypersensitivity reactions to oxaliplatin and that the desensitization protocol performed avoided discontinuation of chemotherapy in all patients.

Microspheres of chitosan/poly(vinylalcohol) incorporating tetrasulphonated copper (II) phthalocyanine: preparation and characterization.

Tetrasulphonated copper (II) phthalocyanine (TCP), in the salt form, was incorporated into a blend of chitosan (CTS)/poly(vinylalcohol) (PVA) and microspheres were produced using the method of salt coacervation with (approximately 20% w/v) sodium sulphate. Spectroscopic analysis, DSC and TGA were carried out to characterize the form in which the macro-complex was immobilized in the blend. Alkaline treatment of the coagulating medium produces species which are more stable, but with a different morphology observed by scanning electronic microscopy (SEM). Microspheres coagulated in sodium sulphate and also in an alkaline salt medium (0.5 and 2.0 M NaOH) were exposed to a solution of the dye, methylene blue, at an initial concentration of 7 mg/l and maintained in contact for 14 h at 26 +/- 1 degrees C. The kinetic data revealed a decrease in the capacity of sorption of the microspheres that had received the alkaline treatment. It is proposed that the new morphology attributed to these species blocks some sites for complex formation, making them inaccessible to the dye.

[Carotidynia as a form of presentation of paraxysmal hemicrania]. / Carotidinia como forma de presentación de la hemicránea paroxística.

INTRODUCTION: Paroxysmal hemicrania is a well-defined clinical condition about which many articles have been published. Attempts have been made to explain the response of this illness to indomethacin, suggesting its possible cervical origin. In some patients it is set off by stimulation of certain trigger zones situated in this region. The exceptional radiation of the pain seen in our patient clearly supports this theory. CLINICAL CASE: A 34 year old man with a past history of a similar but briefer episode 5 years previously presented to us. He complained of repeated episodes of stabbing pain with no obvious cause. The pain started at the base of the neck and radiated along the right carotid vessels to the cheek, base of the nose and ipsilateral eye. This was accompanied by injection of the conjunctivae, tears, nasal congestion and nasal discharge. Each episode lasted 15 to 30 minutes and was repeated 20 to 25 times a day without any particular relation to the time of day. The neurological examination, MR and angio-MR were normal. Before being seen by us he had been treated with prednisone and verpamil without effect. Indomethacin at a dose of 100 mg/day controlled the problem completely. CONCLUSIONS: We report a case of paroxysmal hemicrania with a spontaneous description of pain starting at the base of the neck and radiating along the carotid vessels. We consider this clinical description to be of interest since it supports the theories of a cervicogenic origin of this type of headache.

Heparin-induced skin necrosis: nurses beware.

As the prophylactic use of heparin continues to increase, nurses must be aware that heparin use may cause heparin-induced skin necrosis--a rare but serious complication. Although even more severe complications may occur from heparin use, this discussion will focus on skin necrosis caused by subcutaneous heparin. Should heparin-induced skin necrosis develop, heparin therapy must be discontinued immediately. This case presentation illustrates one patient's reaction to this complication.

Dopamine enhances somatostatin receptor-mediated inhibition of adenylate cyclase in rat striatum and hippocampus.

Although there is evidence that suggests that dopamine (DA) has stimulatory effects on somatostatinergic transmission, it is unknown to date if DA increases the activity of the somatostatin (SS) receptor-effector system in the rat brain. In this study, we evaluated the effects of the administration of DA and the DA D1-like (D1, D5) receptor antagonist SCH 23390 and the D2-like (D2, D3, D4) receptor antagonist spiperone on the SS receptor-adenylate cyclase (AC) system in the Sprague-Dawley rat striatum and hippocampus. An intracerebroventricular injection of DA (0.5 microgram/rat) increased the number of SS receptors and decreased their apparent affinity in the striatum and hippocampus 15 hr after its administration. The simultaneous administration of the DA receptor antagonists SCH 23390 (0.25 mg/kg, ip) and spiperone (0.1 mg/kg, ip) before DA injection partially prevented the DA-induced increase in SS binding. The administration of SCH 23390 plus spiperone alone produced a significant decrease in the number of SS receptors in both brain areas studied at 15 hr after injection, an effect that disappeared at 24 hr. The increased number of SS receptors in the DA-treated rats was associated with an increased capacity of SS to inhibit basal and forskolin (FK)-stimulated (AC) activity in the striatum and hippocampus at 15 hr after injection. This effect had disappeared at 24 hr. By contrast, basal and FK-stimulated enzyme activities were unaltered after DA injection. No significant changes in the levels of the alpha i (alpha i1 + alpha i2) subunits were found in DA-treated rats as compared with control rats. In addition, the immunodetection of the alpha i1 or alpha i2 subunits showed no significant changes in their levels in DA-treated rats when compared with controls. DA injection also induced an increase in SS-like immunoreactive content in the rat striatum but not hippocampus at 15 hr after administration and returned to control values at 24 hr. These results provide direct evidence of a functional linkage between the dopaminergic and somatostatinergic systems at the molecular level.

Effect of sulpiride on somatostatin receptors, somatostatin-like immunoreactivity and modulation of adenylyl cyclase activity in the rat brain.

The present study investigates the effects of the administration of an intracerebroventricular (i.c.v.) dose of 500 micrograms/rat of the neuroleptic (-) sulpiride on somatostatin-like immunoreactivity (SSLI) levels, 125I-Tyr11-SS binding to its specific receptors, SS-modulated adenylyl cyclase (AC) activity and the pertussis toxin (PTX) substrates measured by toxin-catalysed ADP ribosylation of the alpha-subunits from G-proteins. (-) Sulpiride significantly decreased the SSLI levels in the frontoparietal cortex at 30 min but was without effect on the SSLI concentration in the striatum. This decrease had disappeared within 24 hr. The administration of (-) sulpiride produced a significant increase in the number of 125I-Tyr11-SS receptors and a significant reduction in their affinity at 30 min after injection in the striatum without affecting the frontoparietal cortex. The effects of the (-) sulpiride injection had disappeared after 24 hr. This change in SS binding was not due to a direct effect of (-) sulpiride on these receptors since no effect on binding was produced by high concentrations of (-) sulpiride (10(-5) M) when added in vitro. No significant differences were seen in either brain region for the basal or the forskolin (FK)-stimulated AC enzyme activities in the control and (-) sulpiride groups. In the (-) sulpiride group, the capacity of SS to inhibit FK-stimulated AC in the frontoparietal cortex was significantly higher than in the control group with no significant difference in the striatum.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain somatostatinergic system at late pregnancy, parturition and the early postpartum period in the rat.

During pregnancy and postpartum rats experience a wide variety of behavioural changes. Since the somatostatinergic system has been implicated in the control of some of these changes, the present study examined somatostatin (SS) content and specific binding in the frontoparietal cortex and hippocampus of non-pregnant, pregnant (17 to 18 days), parturition and postpartum (10 and 30 days) rats as well as in ovariectomized rats which were or were not treated with estradiol valerianate. The content of somatostatin-like immunoreactivity (SSLI) was increased at 17 days of pregnancy in frontoparietal cortex and decreased at parturition and 10 days postpartum in that region and the hippocampus under study when compared with SSLI levels in non-pregnant rats. At 30 days postpartum the SSLI content returned to non-pregnant values in both brain regions. Scatchard analysis showed that the decrease in [125I]Tyr11-SS binding observed at 17 days of pregnancy in the frontoparietal cortex was due to the decrease in the number of SS receptors. In contrast, on the day of delivery the number of SS receptors in the same brain region increased. The affinity of the SS receptors was consistently unchanged in pregnant and non-pregnant rats in both regions. At 10 days postpartum the value of specific binding of the tracer to SS receptors in the frontoparietal cortex was not significantly different from that in the non-pregnant rats, although the actual number of receptors was slightly higher. Pregnancy did not change SS binding in the hippocampus.(ABSTRACT TRUNCATED AT 250 WORDS)

Somatostatin receptors increase in the olfactory bulb of developing pups after perinatal exposure to cocaine.

The effects of chronic prenatal and/or postnatal exposure to cocaine on somatostatin concentration and receptors were studied in the olfactory bulbs of rat pups at birth and at 15 days old. Wistar rats were injected subcutaneously with single daily doses of 40 mg cocaine hydrochloride/kg from days 7 to 19 of gestation, from day 7 of gestation to day 15 postpartum or from parturation to day 15 postpartum. Fetal exposure to cocaine decreased SS concentrations in the olfactory bulb of the newborn pups while prenatal-plus-postnatal exposure increased this parameter. Administration of cocaine only during lactation did not induce any change. Exposure during gestation or during nursing induced an increase in the total number of somatostatin receptors and a decrease in the affinity constant in the olfactory bulb of newborn and 15-day-old pups. These results suggest that the development of somatostatin receptors in the olfactory bulb can be altered by prenatal and/or nursing period exposure to cocaine.

Changes in striatal somatostatin receptors in pups after cocaine administration to pregnant and nursing dams.

Primiparous female Wistar rats were injected subcutaneously with single daily doses of 40 mg of cocaine hydrochloride/kg from day 7 to 19 of gestation, from day 7 of gestation to day 15 postpartum or from parturation to day 15 postpartum. At birth, some of the offspring were fostered to control mothers to limit the effect of cocaine to the prenatal period and some were left with their mothers with the aim of studying prenatal plus postnatal exposure to cocaine. Prenatal and/or postnatal cocaine exposure did not affect the content of somatostatin (SS)-like immunoreactivity (SLI) in the striatum of the offspring as compared with the control groups on day 15 in all experimental groups. Prenatal and prenatal-plus-postnatal exposure to cocaine increased the total number of binding sites for 125I-Tyr11-SS in the rat striatum at 15 days of age. Prenatal exposure to cocaine also decreased the apparent affinity of the receptors. Postnatal exposure to cocaine alone had no such post-treatment effect on 125I-Tyr11-SS binding. These results suggest that the development of SS receptors in the rat striatum can be altered by prenatal exposure to cocaine.

Maternal ethanol ingestion and somatostatin level and binding in developing rat brain.

The effect of maternal ethanol ingestion on 125I-labeled [Tyr11]somatostatin (SS) binding and somatostatin-like immunoreactivity (SLI) in the rat frontoparietal cortex and hippocampus of developing offspring was explored. Female Sprague-Dawley rats were given ethanol in the drinking water before pregnancy, during gestation, and while nursing, whereas controls received a standard diet and fresh water ad libitum. In the ethanol group, food intake decreased as ethanol consumption augmented, with the ethanol calories comprising greater than 30% of the total energy intake during pregnancy. Total energy intake was similar for the ethanol group and normal controls. Maternal alcohol ingestion is associated with an enhanced SLI level in the frontoparietal cortex and hippocampus on the day of birth. This study provided evidence of a selective decrease in SS receptor binding in frontoparietal cortex but not in hippocampus in the 0- to 10-day-old offspring of the ethanol-fed rats. The SS receptor number increased from day 0 to 10 in both control and ethanol groups. However, the affinity appeared to decrease significantly in the ethanol group during this period. At day 30, no differences were found between offspring of control and ethanol-treated rats in any of the parameters. These results suggest that the development of SS receptors in the rat frontoparietal cortex can be transitorily delayed by maternal ethanol ingestion.

Effect of prenatal and postnatal cocaine exposure on somatostatin content and binding in frontoparietal cortex and hippocampus of developing rat pups.

The effects of cocaine administration to pregnant and/or nursing rats on somatostatin (SS) concentration and receptors in offspring brains at birth and 15 days of age were studied. SS was measured by radioimmunoassay and SS receptors by radio receptor assay in frontoparietal cortex and hippocampus. In newborn and 15-day-old animals the exposure to cocaine produced an increase in SS concentration in the frontoparietal cortex and a decrease of this parameter in the hippocampus. Administration of cocaine only during lactation did not induce such changes. Exposure during pregnancy or nursing induced in 0- or 15-day-old offspring an increase in the total number of SS receptors and a decrease in the affinity constant only in the cortex.

Effect of maternal exposure to nicotine in the rat on level and binding of somatostatin in brain of developing offspring.

The effect of maternal exposure to nicotine on the level of somatostatin and specific binding in frontoparietal cortex and hippocampus of developing offspring was investigated. Sprague-Dawley rats were injected subcutaneously, throughout the pregnancy and the nursing period, with either: 3 mg/kg nicotine base or saline vehicle. In the offspring of control rats, the level of somatostatin-like immunoreactivity peaked at day 10 in the frontoparietal cortex, whereas the level of immunoreactivity in the hippocampus was the highest on day 30. Maternal exposure to nicotine caused enhanced levels of immunoreactivity in the frontoparietal cortex, on the day of birth and in the hippocampus, up to day 10. The maximum specific binding of somatostatin to the receptors in membranes from the frontoparietal cortex, peaked at 10 days of age in the offspring of control rats. The number of somatostatin receptors in cortical (but not in hippocampal) membranes was significantly decreased in the 0- to 10-day-old offspring of the nicotine-treated rats. Despite transient alterations in the number of somatostatin receptors, the affinity of the sites for somatostatin was consistently unchanged. The levels of somatostatin-like immunoreactivity and the number of somatostatin receptors in the frontoparietal cortex and hippocampus was comparable in the 30-day-old offspring of the control and nicotine-treated rats.

Effects of acute and chronic ethanol administration and its withdrawal on the level and binding of somatostatin in rat brain.

1. Acute ethanol administration resulted in an increase in the total number of specific somatostatin receptors in rat frontoparietal cortex and hippocampus, and a decrease in the level of somatostatin-like immunoreactivity in the hippocampus but not in the frontoparietal cortex. 2. Chronic administration of ethanol caused a decrease in the number of somatostatin receptors in the frontoparietal cortex but not in the hippocampus, although the level of somatostatin-like immunoreactivity was unchanged in both brain areas. 3. A week after suppressing ethanol the value for specific binding of tracer to somatostatin receptors in the frontoparietal cortex was not significantly different from that of the control rats, although the actual number of receptors was slightly lower. 4. These results suggest a possible role for somatostatin in the nervous system during alcoholism and the post-withdrawal reaction.

The effect of chronic administration of nicotine and withdrawal on somatostatin concentration and binding in brain of rat.

The effects of chronic administration of nicotine (20 or 30 days) and its withdrawal on somatostatin-like immunorectivity and the binding of 125I-Tyr11-somatostatin in the frontoparietal cortex and hippocampus of the rat were investigated. Chronic administration of nicotine resulted in a decrease in the total number of specific somatostatin receptors, while the affinity of the receptors was unaltered and somatostatin-like immunoreactivity was unchanged in both areas of the brain. Three weeks after ending chronic exposure to nicotine in the second experimental group, the number of somatostatin receptors had returned to the same values as those of saline-treated rats.

Effects of acute and chronic cocaine administration on somatostatin level and binding in the rat brain.

The effects of acute and chronic cocaine (40 mg/Kg i.p.) in vivo administration, on 125I-Tyr11-somatostatin binding and somatostatin-like immunoreactivity (SLI) in the rat frontoparietal cortex, hippocampus and olfactory bulb were explored. Acute and chronic cocaine administration did not affect the levels of SLI in the three brain areas studied. Acute cocaine administration resulted in an 55% and 32% decrease in the total number of specific somatostatin receptors in the hippocampus and olfactory bulb respectively, but not in the frontoparietal cortex. Somatostatin receptor affinity increased in the hippocampus and was unaltered in frontoparietal cortex and olfactory bulb. After two weeks of daily cocaine injections the somatostatin binding in the hippocampus and olfactory bulb returned to control values. The in vitro addition of cocaine to a brain membrane preparation obtained from untreated rats did not markedly affect somatostatin binding characteristics. These results are suggestive of a possible role for somatostatin in the limbic structures as a response to cocaine administration.

Effects of acute nicotine and mecamylamine administration on somatostatin concentration and binding in the rat brain.

Since nicotine and somatostatin have regulatory effects on locomotor activity it was of interest to determine whether the receptors for somatostatin are modulated by the cholinergic nicotine-like effects. An i.v. dose of 0.3 mg/kg nicotine induced an increase in the concentrations of somatostatin-like immunoreactivity at 4 min in the parietal cortex and at 15 min in the hippocampus. These changes were associated with a significant increase in the total number of specific somatostatin receptors in the parietal cortex at 15 min and in the hippocampus at 30 min following injection. To determine if the above mentioned changes are related to the nicotine activation of central nicotine-like acetylcholine receptors, a cholinergic nicotinic blocking agent, mecamylamine, was administered before the nicotine injection. Pretreatment with mecamylamine (5.0 mg/kg i.v.) prevented the nicotine-induced changes in somatostatin level and binding in both brain areas. Mecamylamine alone had no observable effect on the somatostatinergic system. These results suggest that the somatostatinergic system can be regulated by nicotine-like acetylcholine receptors and may be involved in some of the behavioral central effects of nicotine.

Somatostatin content and binding in small intestinal mucosa from fed, fasted, and refed rabbits.

The present study is an investigation of the effects of 12- to 96-hours' starvation and 96-hours' starvation plus 48-hours' refeeding on both somatostatin-like immunoreactivity (SLI) and cytosolic somatostatin binding sites in rabbit small intestinal mucosa. The SLI concentration increased after 24 h in duodenal and jejunal mucosa, but not in ileal mucosa, and reached its highest value after 96 h of fasting. The number of specific high and low-affinity somatostatin binding sites, but not their affinity, decreased with the duration of fasting in the same gut segments, refeeding of fasted animals resulted in a return to normal control values for small intestine mucosal SLI and somatostatin binding.