Immune response to Nocardia brasiliensis antigens in an experimental model of actinomycetoma in BALB/c mice.

Nine- to twelve-week-old BALB/c mice were injected in footpads with 10(7) CFU of a Nocardia brasiliensis cell suspension. Typical actinomycetoma lesions, characterized by severe local inflammation with abscess and fistula formation, were fully established by day 28 after infection. These changes presented for 90 days, and then tissue repair with scar formation slowly appeared, with complete healing after 150 days of infection. Some animals developed bone destruction in the affected area. Histopathology showed an intense inflammatory response, with polymorphonuclear cells and hyaloid material around the colonies of the bacteria, some of which were discharged from draining abscesses. Sera from experimental animals were analyzed by Western blotting, and immunodominant antigens P61 and P24 were found as major targets for antibody response. Anti-P24 immunoglobulin M (IgM) isotype antibodies were present as early as 7 days, IgG peaking 45 days after infection. Lymphocyte proliferation with spleen and popliteal lymph node cells demonstrated thymidine incorporation at 7 days after infection, the stimulation index decreasing by day 60. Levels of interleukin-1 (IL-1), IL-2, IL-4, IL-6, tumor necrosis factor alpha, and gamma interferon (IFN-gamma) were determined by enzyme-linked immunosorbent assay in the sera of infected animals. The circulating levels of IFN-gamma increased more than 10 times the basal levels; levels of IL-4, IL-6 and IL-10 also increased during the first 4 days of infection.

[Usefulness of simple paranasal sinus radiographs and axial computed tomography in the diagnosis of chronic sinusitis]. / Utilidad de la radiografía simple de senos paranasales y la tomografía axial computada en el diagnóstico de sinusitis crónica.

AIMS: A prospective, observational clinical trial is presented with the object of determining the frequency with which CT scans of the paranasal sinuses establish the diagnosis of chronic sinusitis in patients with symptoms of sinusitis but without alterations in the plain films of the paranasal sinuses. MATERIAL AND METHODS: The study included 113 patients, 64 females and 49 males, with the clinical diagnosis of chronic sinusitis. All had plain films of the paranasal sinuses. CT scans of the paranasal sinuses were performed on all patients with negative findings on plane films. RESULTS: Of the 113 patients, 68 (60%) presented positive radiographic findings of chronic sinusitis on plain films. In the 45 remaining patients (39%) in which plain films were negative, CT scans of the paranasal sinuses were performed and demonstrated ethmoid sinusitis in all of them (100%). CONCLUSION: That CT scan is more sensitive in the diagnosis of ethmoid sinusitis as compared to plain films of the paranasal sinuses, due to the fact that ethmoid anatomy is better delineated by this method. Plain films of the paranasal sinuses are of lesser use in determining ethmoid anatomy due to the superposition of images that occurs in this technique.

[Asthma associated with gastroesophageal reflux]. / Asma asociada a reflujo gastroesofágico.

OBJECTIVE: In order to explore the association between poorly controllable asthma and gastroesophageal reflux (GER), a prospective clinical trial is presented. MATERIAL AND METHOD: This trial included 28 patients with negative atopic indicators who presented difficulty in the management of their disease. All patients underwent a complete medical history as well as skin tests for common airborne allergens, total serum IgE, peripheral blood eosinophils, spirometry, chest X-ray and esophageal barium films. Additionally, esophageal endoscopy was performed on 9 patients, and esophageal manometry in 1 patient. All were submitted to antireflux therapy and received omeprazole and cisapride for 8 weeks. RESULTS: Complete improvement was observed in 24 patients (85.7%), moderate improvement in 3 patients (10.7%), and no improvement in 1 patient (3.6%). Three patients required antireflux surgery. CONCLUSIONS: Symptoms reappeared 2-3 weeks after suspending treatment, which led to the recommendation that antireflux measures become a way of life for these patients.

[Anaphylactic reaction caused by the performance of skin tests: report of a case]. / Reacción anafiláctica por aplicación de pruebas cutáneas: comunicación de un caso.

A case of anaphylaxis following skin tests for airborne allergens in a 25-year-old female patient diagnosed with bronchial asthma and allergic rhinitis, is presented. The purpose of this paper is to alert against severe systemic reactions related to skin tests. The reaction occurred 15 minutes after administration of various airborne allergens (pollens, air molds, and house dust), and the symptoms were: hypogastric pain, transvaginal bleeding, generalized urticaria, and bronchospasm. Immediate treatment consisted of antihistamines, bronchodilatators and steroids; the symptoms subsided in 12 hours. We conclude that skin testing can give rise to severe systemic reactions which should be identified and treated immediately by trained physicians and ancillary personnel, and that these tests should be avoided when pregnancy is suspected.

Experimental intoxication with fruit and purified toxins of buckthorn (Karwinskia humboldtiana).

To determine the extent of extraneural lesions in buckthorn poisoning, 180 CD1 mice were administered either green or ripe fruit or toxins T-544 or T-514 obtained from the fruit of the plant and were observed over a period of three weeks. Marked weakness, hyporeflexia, hair bristling, ptosis, spinal deformity, weight loss and dypsnea were prominent signs. Mortality in mice given green fruit was 100% at all doses; with toxin T-514 the mortality was 100% at 45 mg/kg. One hundred and sixty-two necropsies were performed and major lesions were found in liver and lung. The pulmonary lesions consisted of progressive vascular congestion and hemorrhage. Alterations in liver consisted of congestion, hemorrhage, hepatocyte degeneration, central zone necrosis and acute diffuse necrosis. Green fruit was more toxic than ripe fruit and T-514 was more active than T-544.