Necrosis retinal aguda. Dos casos clínicos / Acute retinal necrosis. A report of two clinical cases

La necrosis retinal aguda es una afección grave que amenaza la visión. Es frecuente en adultos, tanto inmunocompetentes como inmunocomprometidos. Se presentan dos pacientes, uno de 38 años, con antecedentes de salud anterior que acude a consulta con síntomas y signos de necrosis retinal aguda en el ojo izquierdo, la que fue diagnosticada luego; y otro de 48 años de edad con antecedentes de infección por herpes zóster, tres meses antes de los síntomas oculares, que concluyó con igual diagnóstico. No existió evolución satisfactoria, a pesar del tratamiento adecuado, lo que demostró que independientemente de datos estadísticos y estudios realizados que demuestran lo infrecuente de esta enfermedad, se diagnosticaron dos casos en el periodo de un año, dato que nos exhorta al estudio y práctica de alternativas diagnósticas y terapéuticas para minimizar las consecuencias devastadoras de esta afección.

Acute retinal necrosis is a serious vision-threatening condition. It is common in both immunocompetent and immunocompromised adults. We present two male patients; one aged 38 years, with a previous health history who comes to consultation with symptoms and signs of acute retinal necrosis in his left eye, which was later diagnosed; and another one aged 48 years with a history of herpes zoster infection three months before the ocular symptoms, which concluded with the same diagnosis. Regardless of the statistical data and research carried out on this rare disease, there was no satisfactory evolution despite adequate treatment. Two cases were diagnosed in a period of one year, data that urges us to study and practice diagnostic and therapeutic alternatives to minimize the devastating consequences of this condition.

Dementia and cognitive impairment in adults as sequels of HSV-1-related encephalitis: a review / Demência e déficit cognitivo em adultos como sequelas de encefalite relacionada ao HSV-1: uma revisão

ABSTRACT. Considering the variety of mechanisms of Herpes simplex virus (HSV-1) contamination and its broad invasive potential of the nervous system, a life-long latent infection is established. Infected adult individuals may be susceptible to viral reactivation when under the influence of multiple stressors, especially regarding immunocompromised patients. This guides a series of neuroinflammatory events on the cerebral cortex, culminating, rarely, in encephalitis and cytotoxic / vasogenic brain edema. A sum of studies of such processes provides an explanation, even though not yet completely clarified, on how the clinical evolution to cognitive impairment and dementia might be enabled. In addition, it is of extreme importance to recognize the current dementia and cognitive deficit worldwide panorama. The aim of this literature review is to elucidate the available data upon the pathophysiology of HSV-1 infection as well as to describe the clinical panorama of the referred afflictions.

RESUMO. Considerando a variedade de mecanismos de contaminação pelo vírus Herpes simplex (HSV-1) e seu amplo potencial invasivo do sistema nervoso, uma infecção latente por toda a vida é estabelecida. Indivíduos adultos infectados podem ser suscetíveis à reativação viral quando estão sob a influência de múltiplos estressores, principalmente em pacientes imunocomprometidos. Esse fator orienta uma série de eventos neuroinflamatórios no córtex cerebral, culminando, raramente, em encefalite e edema cerebral citotóxico/vasogênico. Um somatório de estudos desses processos fornece uma explanação, embora ainda não totalmente esclarecida, de como a evolução clínica para déficit cognitivo e demência pode ser possibilitada. Além disso, é de extrema importância reconhecer o panorama mundial atual da demência e do déficit cognitivo. O objetivo da presente revisão de literatura é elucidar os dados disponíveis sobre a fisiopatologia da infecção pelo HSV-1, assim como descrever o panorama clínico das referidas afecções.

Seroprevalencia contra agentes ToRCH en mujeres indígenas en edad fértil, estado Zulia, Venezuela / Prevalence of infectious agents in indigenous women of childbearing age in Venezuela

Introducción. El termino ToRCH comprende a los patógenos Toxoplasma gondii, virus de la rubéola, citomegalovirus y virus herpes simple 1 y 2. En mujeres embarazadas expuestas pueden ser causa de abortos y malformaciones congénitas en el neonato. Objetivo. Determinar la seroprevalencia de infección por los agentes causantes del síndrome ToRCH en mujeres en edad fértil de algunas comunidades indígenas yukpa de Venezuela. Materiales y métodos. En el año 2007 fueron seleccionadas 109 muestras de 151 mujeres, en edades comprendidas entre 14 y 40 años. La detección de anticuerpos se hizo por el método de inmunoensayo enzimático indirecto o ELISA de Smartest Diagnostics™. Resultados. El 85,5 % presentó anticuerpos contra T. gondii, el 95,4 % para rubéola, el 75,2 % para citomegalovirus y el 97,2 % para el virus herpes simple 1 y 2. Se observa que el 21,1 % y el 30,2 % presentaron relación entre la variable aborto y las infecciones por citomegalovirus y virus herpes simple 1 y 2, respectivamente. Conclusiones. Existe alta seroprevalencia de infecciones por los agentes causantes del síndrome ToRCH en mujeres en edad fértil de la etnia indígena yukpa. Las condiciones sanitarias precarias y el consumo de agua contaminada con ooquistes, favorecen la adquisición de la infección por T. gondii. El hacinamiento, el inicio a temprana de edad de la actividad sexual y el número de parejas, pueden incidir en la presencia de citomegalovirus y virus herpes simple 1 y 2.

Introduction. The ToRCH syndrome includes the following infectious pathogens: Toxoplasma gondii, rubella, cytomegalovirus and herpes simplex virus 1 and 2. In susceptible pregnant women, these pathogens can cause abortions and congenital malformation in the newborn babies. Objective. The seroprevalence of infection by ToRCH agents was determined in women of childbearing age in several Venezuelan Yukpa indigenous communities. Material and methods. In 2007, 109 samples were selected from 151 women with an age range of 14 to 40 years old. The determination of antibodies against ToRCH agents was carried out through the indirect enzyme immunoassay technique by ELISA´s technique of Smartest Diagnostics. Results. Of the 109 samples, 85.5% presented antibodies against T. gondii, 95.4% for rubella, 75.2% for cytomegalovirus and 97.2% for and herpes simplex virus 1 and 2. A relationship between abortion and infection by cytomegalovirus and herpes simplex virus 1and 2 was noted in 21.1% and 30.2% of women presented, respectively. Conclusions. The findings show a high prevalence of ToRCH agents in women in childbearing age in Yukpa indigenous communities in Venezuela. Poor sanitary conditions and consumption of water contaminated with oocysts may be an important way of transmission of T. gondii. Overcrowding in the communities, sexual activity at an early age and number of partners and may be related to the presence of cytomegalovirus and herpes simplex virus HSV-1 and 2.

Composicion quimica y evaluacion de la actividad antiherpetica in vitro de aceites esenciales de Lippia alba (Mill) N.E. Brown y sus componentes mayoritarios / Chemical Composition and evaluation in vitro of anti-herpetic activity of essential oils from Lippia alba (Mill) NE Brown and the main components

Introduccion: Lippia alba (Mill) N.E. Brown es una planta aromatica perteneciente a la familia Verbenaceae, ampliamente usada en Suramerica y Norteamerica como infusion contra la hipertension, problemas digestivos, nauseas y resfriados. Objetivo: En el presente estudio, se evaluo la actividad antiviral in vitro frente al Herpesvirus Humano Tipo 1 (HSV-1), de veinte aceites esenciales de L. alba y, diez de sus componentes mayoritarios. Metodologia: La actividad antiviral in vitro fue evaluada empleando la t¨¦cnica modificada, de titulacion del punto final (EPTT). Los aceites esenciales, de plantas de L. alba recolectadas de diferentes regiones del pais, fueron obtenidos por hidrodestilacion asistida con radiacion de microondas (MWHD). Se determino por cromatografia de gases¨Cespectrometria de masas (GC-MS), la composicion quimica, de los veinte aceites esenciales de L. alba, identificandose dos quimiotipos: citral y carvona. Resultados y conclusiones: Los aceites quimiotipo carvona, BC1 y CA2, mostraron actividad antiherpetica in vitro, moderada sobre monocapa de celulas HeLa infectadas, con valores de Rf de 1x101,5, en concentraciones, de 250¦Ìg/mL y 125¦Ìg/mL, respectivamente. Los controles positivos, sulfato de heparina y aciclovir, redujeron el titulo viral con valores de Rf, en orden, de 1x102 y 1x104. Ninguno de los monoterpenos evaluados mostro actividad contra el HSV-1.

Introduction: Lippia alba (Mill.) N.E. Brown is an aromatic shrub belonging to the Verbenaceae family, which is widely used all over South and Central America as an infusion against, hypertension, digestive troubles, nausea and cold. The antiviral activity in vitro against Herpesvirus 1, Human (HSV-1) of twenty essential oils of L. alba and ten of its components were evaluated. Methodology: The antiviral activity was determined using a modified end-point titration technique (EPPT). The essential oils from L. alba collected in different regions of Colombia were obtained by microwave-assisted hydrodistillation (MWHD). Their chemical compositions were determined by GC and GC/MS. Two chemotypes were distinguished, characterized by carvone and citral as main constituents. Results and conclusions: Carvone chemotype oils BC1 and CA2 were found to be moderate antiviral activity over infected confluent monolayers of HeLa cells with Rf value of 1x101,5 at a concentration of 250¦Ìg/mL and 125¦Ìg/mL, respectively. Heparin sodium salt and acyclovir were used as positive controls and showed Rf values of 1x102 and 1x104, respectively. None of monoterpenes tested showed antiviral activity against HSV-1.