Tratamiento exitoso de lipodermatoesclerosis aguda con doxiciclina: reporte de diez casos / Successful treatment of acute lipodermatosclerosis with doxycycline: report of ten cases

Resumen La doxiciclina, una tetraciclina semisintética de segunda generación, ampliamente usada para el tratamiento de patologías dermatológicas por sus propiedades antimicrobianas, ha demostrado en varios estudios experimentales sus acciones como un potente fármaco antiinflamatorio, aprobado por estas características por la FDA como una terapia complementaria en la periodontitis del adulto, así como en el tratamiento de la forma papulopustulosa de la rosácea. Se describen además en la literatura otras indicaciones para procesos inflamatorios, tales como, calcinosis cutis, vasculitis livedoide, patologías ampollares, entre otras. Se presenta una serie de 10 pacientes con lipodermatoesclerosis que presentaron una respuesta eficaz a su patología al recibir tratamiento con doxiciclina durante 3 meses, destacando de esta forma su eficacia terapéutica, accesibilidad y baja asociación a efectos adversos.

Abstract Doxycycline, a second generation semi-synthetic tetracycline, widely used for the treatment of dermatological diseases for its antimicrobial effects, has shown in many clinical studies its actions as a powerful anti-inflammatory drug. Approved by the FDA as a complementary therapy in adult periodontitis, and of the papulopustular form of rosacea. In addition, other indications for inflammatory processes are described in the literature, such as calcinosis cutis, livedoid vasculitis, blistering pathologies, among others. We present a series of 10 patients with lipodermatosclerosis who presented an effective response to their pathology when receiving treatment with doxycycline for 3 months. Its therapeutic efficacy, accessibility and low association with adverse effects are highlighted.

Structural and ultrastructural changes during the infection of UFL-AG-286 cells with the baculovirus AgMNPV

During infection of the permissive insect cell line UFL-AG-286 by the baculovirus Anticarsia gemmatalis nucleopolyhedrovirus (AgMNPV-2D) several morphological changes occur. By 12 h postinfection (h p.i.), the infected cells became round and exhibited a decrease in the number of cytoplasmic projections. By 24 h p.i., it was possible to detect a virogenic stroma inside the cell nucleus, and after 48 h p.i., polyhedral inclusion bodies were observed. Some of these morphological modifications are probably due to changes in the cytoskeleton of the cell and this possibility was substantiated by the observation that the distribution of actin and microtubules was dramatically modified upon infection. Several viral-induced proteins were also produced during infection and a sharp decrease in overall protein synthesis was observed. These results are very similar to those obtained with other cell lines infected with different baculoviruses, indicating a similar mechanism of infection. Copyright 1998 Academic Press.

Retrospective study on dengue in Fortaleza, state of Ceará, Brazil.

A retrospective serologic study was carried out in Fortaleza, State of Ceará, Brazil, in order to detect the dengue virus activity before recognizing the epidemic of 1994. Mac-Elisa was performed by using a mixture of specific DEN-1 and DEN-2 antigens on serum samples from the Emilio Ribas Laboratory collection. Samples were obtained from 1,224 patients with exanthematic febrile disease and negative serological results for rubella. All specimens were taken during November 1993 to May 1994. The results confirmed dengue infections in Fortaleza by November 1993, approximately six months before the beginning of the epidemic, proving how misleading diagnosis of dengue infection are still troublesome, in spite of the strong dengue activity in Ceará. The authors stress the urgent necessity to implement the active surveillance system in order to prevent another extensive dengue fever epidemics in the state. Epidemiological background of the dengue activity in the State of Ceará is described.

Retrospective study on dengue in Fortaleza, State of Ceará, Brazil

A retrospective serologic study was carried out in Fortaleza, State of Ceará, Brazil, in order to detect the dengue virus activity before recognizing the epidemic of 1994. Mac-Elisa was performed by using a mixture of specific DEN-1 and DEN-2 antigens on serum samples from the Emilio Ribas Laboratory collection. Samples were obtained from 1,224 patients with exanthematic febrile disease and negative serological results for rubella. All specimens were taken during November 1993 to May 1994. The results confirmed dengue infections in Fortaleza by November 1993, approximately six months before the beginning of the epidemic, proving how misleading diagnosis of dengue infection are still troublesome, in spite of the strong dengue activity in Ceará. The authors stress the urgent necessity to implement the active surveillance system in order to prevent another extensive fever epidemics in the state. Epidemiological background of the dengue activity in the State of Ceará is also described.

Traumatic lumbosacral dislocation in a 5-year-old boy with eight years follow-up.

STUDY DESIGN: The authors present an unusual case of pure traumatic bilateral lumbosacral dislocation in a 5-year-old boy, the conservative treatment carried out, and the long-term result. OBJECTIVES: To describe a rare traumatic lesion in children and evaluate the result obtained with conservative treatment. SUMMARY OF BACKGROUND DATA: Watson-Jones was the first to describe this type of lesion. Since then, only a few cases have been added. Most authors suggest that open reduction should be carried out. No cases of this type of injury in children have been reported. METHODS: A 5-year-old boy was hit in the lumbosacral region with a rocking chair. Examination showed neurologic deficit of left L5 and S1 nerve roots. Roentgenographic examination and computed tomography scan confirmed the anterior dislocation of the fifth lumbar vertebra on the sacrum without any fracture. He was treated with traction, followed by hyperextension in a Cotrel traction table and further immobilization with a lumbar plaster jacket. RESULTS: Eight years after the injury, the patient had no neurologic deficit and lumbar radiographs showed a good alignment of the lumbosacral spine. CONCLUSION: In children with traumatic lumbosacral dislocation, closed reduction should be attempted even if neurologic deficit is present.

Comparative study of various biological markers in infection by HIV1.

A study was performed on 51 human immunodeficiency virus (HIV-1)-infected patients with a previous history of drug abuse. By the CDC staging system for HIV infection they were mainly in advanced stages of that infection, 67% were in IV-A and 8% in IV-CI. Patients were divided in two groups, one composed of 33 individuals who needed AZT therapy and the other of those who did not need that medication (18 patients). Between 3 and 18 months several parameters were assessed on 3 different occasions, according to standard techniques: red blood cells and platelet numeration, CD4 and CD8 cell counts, HIV antigen (p24 Ag), beta 2-microglobulin, high-density serum lipoproteins (HDL), and anticardiolipin antibodies (ACA). In the patients treated with AZT the first bioserologic evaluation was performed before starting this therapy. Finally it was observed that p24 AG and ACA were present in 21% of the patients, all of them in advanced stages of HIV infection and under AZT therapy. A significant correlation was only found between CD4 counts and beta 2-microglobulin (R = 0.34; P = 0.0001).

[Comparative study of various biological markers in HIV 1 infection]. / Estudo comparativo de vários marcadores biológicos na infecção HIV1.

A study was performed on 51 human immunodeficiency virus (HIV 1)-infected patients with a previous history of drug abuse. By the CDC staging system for HIV infection they were mainly in advanced stages of that infection, 67% were in IV-A and 8% in IV-C1. Patients were divided in two groups, one composed of 33 individuals who needed AZT therapy and the other of those who did not need that medication (18 patients). Between 3 and 18 months several parameters were assessed on 3 different occasions, according to standard techniques: red blood cells and platelet numeration, CD4 and CD8 cell counts, HIV antigen (p24 Ag), beta 2-microglobulin, high density serum lipoproteins (HDL), and anticardiolipin antibodies (ACA). In the patients treated with AZT the first bioserologic evaluation was performed before starting this therapy. Finally it was observed that p24 AG and ACA were present in 21% of the patients, all of them in advanced stages of HIV infection and under AZT therapy. A significant correlation was only found between CD4 counts and beta 2-microglobulin (R = 0.34; P = 0.0001).

[Spinal brucellosis. 4 years of experience]. / Espondilite brucélica. Quatro anos de experiência.

The Authors retrospectively studied 17 patients who have been admitted to the Infectious Diseases Clinic of Coimbra University Hospital during a four year period and whose final diagnosis was brucellar spondylitis. Clinical, epidemiological, laboratory and imaging features are analyzed, as well as those related to the therapeutic schedules and outcome. Females were more often affected (70.58%) and the mean age was 53.35 +/- 13.82 years. Lumbar spine was most frequently involved and an unusual elevated incidence of paravertebral soft tissue swelling was noticed (23.52%). Two patients were also suffering from neurobrucellosis (11.76%). The preferred therapeutic schedule was rifampin and doxycycline and surgery was performed in one patient. Finally, several comments are made regarding basically the incidence, laboratory and imaging diagnosis, therapeutic aspects and evolution of the disease. The imaging similarities and differences between tuberculous, pyogenic and brucellar spondylitis are briefly approached.